Assistant Personal Robot (APR): Conception and Application of a Tele-Operated Assisted Living Robot.

PubMed

Clotet, Eduard; Martínez, Dani; Moreno, Javier; Tresanchez, Marcel; Palacín, Jordi

2016-04-28

This paper presents the technical description, mechanical design, electronic components, software implementation and possible applications of a tele-operated mobile robot designed as an assisted living tool. This robotic concept has been named Assistant Personal Robot (or APR for short) and has been designed as a remotely telecontrolled robotic platform built to provide social and assistive services to elderly people and those with impaired mobility. The APR features a fast high-mobility motion system adapted for tele-operation in plain indoor areas, which incorporates a high-priority collision avoidance procedure. This paper presents the mechanical architecture, electrical fundaments and software implementation required in order to develop the main functionalities of an assistive robot. The APR uses a tablet in order to implement the basic peer-to-peer videoconference and tele-operation control combined with a tactile graphic user interface. The paper also presents the development of some applications proposed in the framework of an assisted living robot.

Virtual collaboration, satisfaction, and trust between nurses in the tele-ICU and ICUs: Results of a multilevel analysis.

PubMed

Hoonakker, Peter L T; Pecanac, Kristen E; Brown, Roger L; Carayon, Pascale

2017-02-01

The purpose of the study was to examine how tele-intensive care unit (tele-ICU) nurse characteristics and organizational characteristics influence tele-ICU nurses' trust and satisfaction of monitored bedside ICU nurses, and whether these influences are mediated by communication. Data of tele-ICU characteristics and characteristics of the ICUs they monitored were collected at 5 tele-ICUs located throughout the country. One hundred ten tele-ICU nurses at those tele-ICUs completed a questionnaire containing items related to their characteristics and their trust, satisfaction, and perceived communication with monitored bedside nurses. We analyzed the data using a hierarchical path model, with communication variables entered as mediators. Many of the tele-ICU nurse characteristics (age, currently or previously worked at the monitored ICU, hours worked per week, and years as a ICU nurse) had statistically significant direct effects on perception of communication timeliness, accuracy, and openness, as well as trust and satisfaction with monitored bedside ICU nurses. Communication openness mediated the relationships of both working at a monitored ICU and being older (≥55) on satisfaction. Communication accuracy mediated the relationships of both a specialized monitored ICU and working at a monitored ICU on trust. Tele-ICUs and monitored ICUs should work to optimize communication so that trust can be established among the nurses. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluation of a tele-education programme in Brazil.

PubMed

Joshi, Ashish; Novaes, Magdala A; Iyengar, Sriram; Machiavelli, Josiane L; Zhang, Jiajie; Vogler, Robert; Hsu, Chiehwen E

2011-01-01

We evaluated a tele-education programme for primary care staff in Pernambuco State, Brazil. During 2008 and 2009, tele-education sessions occurred four times each week for one hour per day. The topics included public health, child and adolescent health, mental health and nursing. After each session, participants completed an evaluation questionnaire. A total of 73 municipalities and 141 health centres participated in the programme. There were 254 tele-education sessions scheduled during the 20-month study period; of these, 224 sessions were successfully performed and 30 were cancelled. We collected 3504 responses from the satisfaction survey. There was high acceptance of the programme: 97% rated it as excellent or good.

Arizona TeleMedicine Network: System Procurement Specifications.

ERIC Educational Resources Information Center

Atlantic Research Corp., Alexandria, VA.

Providing general specifications and system descriptions for segments within the Arizona TeleMedicine Project (a telecommunication system designed to deliver health services to rurally isolated American Indians in Arizona), this document, when used with the appropriate route segment document, will completely describe the project's required…

Cardiac ultrasonography over 4G wireless networks using a tele-operated robot

PubMed Central

Panayides, Andreas S.; Jossif, Antonis P.; Christoforou, Eftychios G.; Vieyres, Pierre; Novales, Cyril; Voskarides, Sotos; Pattichis, Constantinos S.

2016-01-01

This Letter proposes an end-to-end mobile tele-echography platform using a portable robot for remote cardiac ultrasonography. Performance evaluation investigates the capacity of long-term evolution (LTE) wireless networks to facilitate responsive robot tele-manipulation and real-time ultrasound video streaming that qualifies for clinical practice. Within this context, a thorough video coding standards comparison for cardiac ultrasound applications is performed, using a data set of ten ultrasound videos. Both objective and subjective (clinical) video quality assessment demonstrate that H.264/AVC and high efficiency video coding standards can achieve diagnostically-lossless video quality at bitrates well within the LTE supported data rates. Most importantly, reduced latencies experienced throughout the live tele-echography sessions allow the medical expert to remotely operate the robot in a responsive manner, using the wirelessly communicated cardiac ultrasound video to reach a diagnosis. Based on preliminary results documented in this Letter, the proposed robotised tele-echography platform can provide for reliable, remote diagnosis, achieving comparable quality of experience levels with in-hospital ultrasound examinations. PMID:27733929

A Low-Cost Tele-Imaging Platform for Developing Countries

PubMed Central

Adambounou, Kokou; Adjenou, Victor; Salam, Alex P.; Farin, Fabien; N’Dakena, Koffi Gilbert; Gbeassor, Messanvi; Arbeille, Philippe

2014-01-01

Purpose: To design a “low-cost” tele-imaging method allowing real-time tele-ultrasound expertise, delayed tele-ultrasound diagnosis, and tele-radiology between remote peripherals hospitals and clinics (patient centers) and university hospital centers (expert center). Materials and methods: A system of communication via internet (IP camera and remote access software) enabling transfer of ultrasound videos and images between two centers allows a real-time tele-radiology expertise in the presence of a junior sonographer or radiologist at the patient center. In the absence of a sonographer or radiologist at the patient center, a 3D reconstruction program allows a delayed tele-ultrasound diagnosis with images acquired by a lay operator (e.g., midwife, nurse, technician). The system was tested both with high and low bandwidth. The system can further accommodate non-ultrasound tele-radiology (conventional radiography, mammography, and computer tomography for example). The system was tested on 50 patients between CHR Tsevie in Togo (40 km from Lomé-Togo and 4500 km from Tours-France) and CHU Campus at Lomé and CHU Trousseau in Tours. Results: A real-time tele-expertise was successfully performed with a delay of approximately 1.5 s with an internet bandwidth of around 1 Mbps (IP Camera) and 512 kbps (remote access software). A delayed tele-ultrasound diagnosis was also performed with satisfactory results. The transmission of radiological images from the patient center to the expert center was of adequate quality. Delayed tele-ultrasound and tele-radiology was possible even in the presence of a low-bandwidth internet connection. Conclusion: This tele-imaging method, requiring nothing by readily available and inexpensive technology and equipment, offers a major opportunity for telemedicine in developing countries. PMID:25250306

Prototyping a Hybrid Cooperative and Tele-robotic Surgical System for Retinal Microsurgery.

PubMed

Balicki, Marcin; Xia, Tian; Jung, Min Yang; Deguet, Anton; Vagvolgyi, Balazs; Kazanzides, Peter; Taylor, Russell

2011-06-01

This paper presents the design of a tele-robotic microsurgical platform designed for development of cooperative and tele-operative control schemes, sensor based smart instruments, user interfaces and new surgical techniques with eye surgery as the driving application. The system is built using the distributed component-based cisst libraries and the Surgical Assistant Workstation framework. It includes a cooperatively controlled EyeRobot2, a da Vinci Master manipulator, and a remote stereo visualization system. We use constrained optimization based virtual fixture control to provide Virtual Remote-Center-of-Motion (vRCM) and haptic feedback. Such system can be used in a hybrid setup, combining local cooperative control with remote tele-operation, where an experienced surgeon can provide hand-over-hand tutoring to a novice user. In another scheme, the system can provide haptic feedback based on virtual fixtures constructed from real-time force and proximity sensor information.

Prototyping a Hybrid Cooperative and Tele-robotic Surgical System for Retinal Microsurgery

PubMed Central

Balicki, Marcin; Xia, Tian; Jung, Min Yang; Deguet, Anton; Vagvolgyi, Balazs; Kazanzides, Peter; Taylor, Russell

2013-01-01

This paper presents the design of a tele-robotic microsurgical platform designed for development of cooperative and tele-operative control schemes, sensor based smart instruments, user interfaces and new surgical techniques with eye surgery as the driving application. The system is built using the distributed component-based cisst libraries and the Surgical Assistant Workstation framework. It includes a cooperatively controlled EyeRobot2, a da Vinci Master manipulator, and a remote stereo visualization system. We use constrained optimization based virtual fixture control to provide Virtual Remote-Center-of-Motion (vRCM) and haptic feedback. Such system can be used in a hybrid setup, combining local cooperative control with remote tele-operation, where an experienced surgeon can provide hand-over-hand tutoring to a novice user. In another scheme, the system can provide haptic feedback based on virtual fixtures constructed from real-time force and proximity sensor information. PMID:24398557

Membrane-mirror-based autostereoscopic display for tele-operation and teleprescence applications

NASA Astrophysics Data System (ADS)

McKay, Stuart; Mair, Gordon M.; Mason, Steven; Revie, Kenneth

2000-05-01

An autostereoscopic display for telepresence and tele- operation applications has been developed at the University of Strathclyde in Glasgow, Scotland. The research is a collaborative effort between the Imaging Group and the Transparent Telepresence Research Group, both based at Strathclyde. A key component of the display is the directional screen; a 1.2-m diameter Stretchable Membrane Mirror is currently used. This patented technology enables large diameter, small f No., mirrors to be produced at a fraction of the cost of conventional optics. Another key element of the present system is an anthropomorphic and anthropometric stereo camera sensor platform. Thus, in addition to mirror development, research areas include sensor platform design focused on sight, hearing, research areas include sensor platform design focused on sight, hearing, and smell, telecommunications, display systems for all visual, aural and other senses, tele-operation, and augmented reality. The sensor platform is located at the remote site and transmits live video to the home location. Applications for this technology are as diverse as they are numerous, ranging from bomb disposal and other hazardous environment applications to tele-conferencing, sales, education and entertainment.

[Robotics in general surgery: personal experience, critical analysis and prospectives].

PubMed

Fracastoro, Gerolamo; Borzellino, Giuseppe; Castelli, Annalisa; Fiorini, Paolo

2005-01-01

Today mini invasive surgery has the chance to be enhanced with sophisticated informative systems (Computer Assisted Surgery, CAS) like robotics, tele-mentoring and tele-presence. ZEUS and da Vinci, present in more than 120 Centres in the world, have been used in many fields of surgery and have been tested in some general surgical procedures. Since the end of 2003, we have performed 70 experimental procedures and 24 operations of general surgery with ZEUS robotic system, after having properly trained 3 surgeons and the operating room staff. Apart from the robot set-up, the mean operative time of the robotic operations was similar to the laparoscopic ones; no complications due to robotic technique occurred. The Authors report benefits and disadvantages related to robots' utilization, problems still to be solved and the possibility to make use of them with tele-surgery, training and virtual surgery.

Organizational and Teamwork Factors of Tele-Intensive Care Units.

PubMed

Wilkes, Michael S; Marcin, James P; Ritter, Lois A; Pruitt, Sherilyn

2016-09-01

Use of tele-intensive care involves organizational and teamwork factors across geographic locations. This situation adds to the complexity of collaboration in providing quality patient-centered care. To evaluate cross-agency teamwork of health care professionals caring for patients in tele-intensive care units in rural and urban regions. A national qualitative study was conducted in 3 US geographic regions with tele-intensive care programs. Discussions and interviews were held with key participants during site visits at 3 hub sites (specialist services location) and 8 rural spoke sites (patient location). The effects of communication and culture between the hub team and the spoke team on use of the services and effectiveness of care were evaluated. A total of 34 participants were interviewed. Specific organizational and teamwork factors significantly affect the functionality of a tele-intensive care unit. Key operational and cultural barriers that limit the benefits of the units include unrealistic expectations about operational capabilities, lack of trust, poorly defined leadership, and a lack of communication policies. Potential solutions include education on spoke facility resources, clearly defined expectations and role reversal education, team-building activities, and feedback mechanisms to share concerns, successes, and suggestions. Proper administration and attention to important cultural and teamwork factors are essential to making tele-intensive care units effective, practical, and sustainable. ©2016 American Association of Critical-Care Nurses.

Tele-Interpersonal Psychotherapy Acutely Reduces Depressive Symptoms in Depressed HIV-Infected Rural Persons: A Randomized Clinical Trial.

PubMed

Heckman, Timothy G; Heckman, Bernadette D; Anderson, Timothy; Lovejoy, Travis I; Markowitz, John C; Shen, Ye; Sutton, Mark

2017-01-01

Human immunodeficiency virus (HIV)-positive rural individuals carry a 1.3-times greater risk of a depressive diagnosis than their urban counterparts. This randomized clinical trial tested whether telephone-administered interpersonal psychotherapy (tele-IPT) acutely relieved depressive symptoms in 132 HIV-infected rural persons from 28 states diagnosed with Diagnostic and Statistical Manual of Mental Disorders-IV major depressive disorder (MDD), partially remitted MDD, or dysthymic disorder. Patients were randomized to either 9 sessions of one-on-one tele-IPT (n = 70) or standard care (SC; n = 62). A series of intent-to-treat (ITT), therapy completer, and sensitivity analyses assessed changes in depressive symptoms, interpersonal problems, and social support from pre- to postintervention. Across all analyses, tele-IPT patients reported significantly lower depressive symptoms and interpersonal problems than SC controls; 22% of tele-IPT patients were categorized as a priori "responders" who reported 50% or higher reductions in depressive symptoms compared to only 4% of SC controls in ITT analyses. Brief tele-IPT acutely decreased depressive symptoms and interpersonal problems in depressed rural people living with HIV.

Tele-Pediatric Intensive Care for Critically Ill Children in Syria.

PubMed

Ghbeis, Muhammad Bakr; Steffen, Katherine M; Braunlin, Elizabeth A; Beilman, Gregory J; Dahman, Jay; Ostwani, Waseem; Steiner, Marie E

2017-12-12

Armed conflicts can result in humanitarian crises and have major impacts on civilians, of whom children represent a significant proportion. Usual pediatric medical care is often disrupted and trauma resulting from war-related injuries is often devastating. High pediatric mortality rates are thus experienced in these ravaged medical environments. Using simple communication technology to provide real-time management recommendations from highly trained pediatric personnel can provide substantive clinical support and have a significant impact on pediatric morbidity and mortality. We implemented a "Tele-Pediatric Intensive Care" program (Tele-PICU) to provide real-time management consultation for critically ill and injured pediatric patients in Syria with intensive care needs. Over the course of 7 months, 19 cases were evaluated, ranging in age from 1 day to 11 years. Consultation questions addressed a wide range of critical care needs. Five patients are known to have survived, three were transferred, five died, and six outcomes were unknown. Based on this limited undertaking with its positive impact on survival, further development of Tele-PICU-based efforts with attention to implementation and barriers identified through this program is desirable. Even limited Tele-PICU can provide timely and potentially lifesaving assistance to pediatric care providers. Future efforts are encouraged.

Tele-existence and/or cybernetic interface studies in Japan

NASA Technical Reports Server (NTRS)

Tachi, Susumu

1991-01-01

Tele-existence aims at a natural and efficient remote control of robots by providing the operator with a real time sensation of presence. It is an advaced type of teleoperation system which enables a human operator at the controls to perform remote manipulation tasks dexterously with the feeling that he or she exists in one of the remote anthropomorphic robots in the remote environment, e.g., in a hostile environment such as those of nuclear radiation, high temperature, and deep space. In order to study the use of the tele-existence system in the artificially constructed environment, the visual tele-existence simulator has been designed, a pseudo-real-time binocular solid model robot simulator has been made, and its feasibility has been experimentally evaluated. An anthropomorphic robot mechanism with an arm having seven degrees of freedom has been designed and developed as a slave robot for feasibility experiments of teleoperation using the tele-existence method. An impedance controlled active display mechanism and a head mounted display have also been designed and developed as the display subsystem for the master. The robot's structural dimensions are set very close to those of humans.

Comparative cost-benefit analysis of tele-homecare for community-dwelling elderly in Japan: Non-Government versus Government Supported Funding Models.

PubMed

Akiyama, Miki; Abraham, Chon

2017-08-01

Tele-homecare is gaining prominence as a viable care alternative, as evidenced by the increase in financial support from international governments to fund initiatives in their respective countries. The primary reason for the funding is to support efforts to reduce lags and increase capacity in access to care as well as to promote preventive measures that can avert costly emergent issues from arising. These efforts are especially important to super-aged and aging societies such as in Japan, many European countries, and the United States (US). However, to date and to our knowledge, a direct comparison of non-government vs. government-supported funding models for tele-homecare is particularly lacking in Japan. The aim of this study is to compare these operational models (i.e., non-government vs. government-supported funding) from a cost-benefit perspective. This simulation study applies to a Japanese hypothetical cohort with implications for other super-aged and aging societies abroad. We performed a cost-benefit analysis (CBA) on two operational models for enabling tele-homecare for elderly community-dwelling cohorts based on a decision tree model, which we created with parameters from published literature. The two models examined are (a) Model 1-non-government-supported funding that includes monthly fixed charges paid by users for a portion of the operating costs, and (b) Model 2-government-supported funding that includes startup and installation costs only (i.e., no operating costs) and no monthly user charges. We performed base case cost-benefit analysis and probabilistic cost-benefit analysis with a Monte Carlo simulation. We calculated net benefit and benefit-to-cost ratios (BCRs) from the societal perspective with a five-year time horizon applying a 3% discount rate for both cost and benefit values. The cost of tele-homecare included (a) the startup system expense, averaged over a five-year depreciation period, and (b) operation expenses (i.e., labor and non-labor) per user per year. The benefit of tele-homecare was measured by annual willingness to pay (WTP) for tele-homecare by a user and medical expenditures avoided. Both costs and benefits were inflated using the relevant Japanese consumer price index (CPI) and converted into 2015 US dollars with purchasing power parity (PPP) adjusted. Base case net benefits of Model 1 and Model 2 were $417.00 and $97.30, respectively. Base case BCR of Model 1 tele-homecare was 1.63, while Model 2 was 1.03. The probabilistic analysis estimated mean (95%CI) for BCRs of Model 1 and Model 2 was 1.84 (1.89, 1.88) and 1.46 (1.43, 1.49), respectively. Sensitivity analysis showed robustness of Model 1 in 7 parameters but Model 2 was sensitive in all key parameters such as initial system cost, device cost, number of users, and medical expenditure saved. Break-even analysis showed that the system cost of Model 2 had to be under $187,500. Our results for each model collectively showed that tele-homecare in Japan is cost-saving to some extent. However, the government-funded model (i.e., Model 2), which typically requires use of all startup funding to be spent within the first year on system costs, was inferior to the monthly fee model (i.e., Model 1) that did not use the government funding for installation or continued operations, but rather incorporated a monthly fee from users to support the receipt of services via tele-homecare. While the benefits of Model 1 outweighed the benefits of Model 2, the government-subsidized method employed in Model 2 could be more beneficial in general if some explicit prequalifying estimated metrics are instituted prior to funding. Thus, governments need to require applicants requesting funding to note, at a minimum, (a) estimated costs, (b) the expected number of tele-homecare users, and expected benefits such as (c) WTP by the user, or (d) medical expenditure saved by tele-homecare as a means of financing some of the operational costs. Copyright © 2017 Elsevier B.V. All rights reserved.

Robust H∞ cost guaranteed integral sliding mode control for the synchronization problem of nonlinear tele-operation system with variable time-delay.

PubMed

Al-Wais, Saba; Khoo, Suiyang; Lee, Tae Hee; Shanmugam, Lakshmanan; Nahavandi, Saeid

2018-01-01

This paper is devoted to the synchronization problem of tele-operation systems with time-varying delay, disturbances, and uncertainty. Delay-dependent sufficient conditions for the existence of integral sliding surfaces are given in the form of Linear Matrix Inequalities (LMIs). This guarantees the global stability of the tele-operation system with known upper bounds of the time-varying delays. Unlike previous work, in this paper, the controller gains are designed but not chosen, which increases the degree of freedom of the design. Moreover, Wirtinger based integral inequality and reciprocally convex combination techniques used in the constructed Lypunove-Krasoviskii Functional (LKF) are deemed to give less conservative stability condition for the system. Furthermore, to relax the analysis from any assumptions regarding the dynamics of the environment and human operator forces, H ∞ design method is used to involve the dynamics of these forces and ensure the stability of the system against these admissible forces in the H ∞ sense. This design scheme combines the strong robustness of the sliding mode control with the H ∞ design method for tele-operation systems which is coupled using state feedback controllers and inherit variable time-delays in their communication channels. Simulation examples are given to show the effectiveness of the proposed method. Copyright © 2017 ISA. All rights reserved.

Semi-autonomous unmanned ground vehicle control system

NASA Astrophysics Data System (ADS)

Anderson, Jonathan; Lee, Dah-Jye; Schoenberger, Robert; Wei, Zhaoyi; Archibald, James

2006-05-01

Unmanned Ground Vehicles (UGVs) have advantages over people in a number of different applications, ranging from sentry duty, scouting hazardous areas, convoying goods and supplies over long distances, and exploring caves and tunnels. Despite recent advances in electronics, vision, artificial intelligence, and control technologies, fully autonomous UGVs are still far from being a reality. Currently, most UGVs are fielded using tele-operation with a human in the control loop. Using tele-operations, a user controls the UGV from the relative safety and comfort of a control station and sends commands to the UGV remotely. It is difficult for the user to issue higher level commands such as patrol this corridor or move to this position while avoiding obstacles. As computer vision algorithms are implemented in hardware, the UGV can easily become partially autonomous. As Field Programmable Gate Arrays (FPGAs) become larger and more powerful, vision algorithms can run at frame rate. With the rapid development of CMOS imagers for consumer electronics, frame rate can reach as high as 200 frames per second with a small size of the region of interest. This increase in the speed of vision algorithm processing allows the UGVs to become more autonomous, as they are able to recognize and avoid obstacles in their path, track targets, or move to a recognized area. The user is able to focus on giving broad supervisory commands and goals to the UGVs, allowing the user to control multiple UGVs at once while still maintaining the convenience of working from a central base station. In this paper, we will describe a novel control system for the control of semi-autonomous UGVs. This control system combines a user interface similar to a simple tele-operation station along with a control package, including the FPGA and multiple cameras. The control package interfaces with the UGV and provides the necessary control to guide the UGV.

[The virtual university applied to telesurgery: from tele-education to telemanipulation].

PubMed

Marescaux, J; Mutter, D; Soler, L; Vix, M; Leroy, J

1999-06-01

The advent of new computer technologies can appear as a revolution in surgical teaching, as well as in the planing and realization of surgical procedures. The introduction of a camera into the body of a patient, allowing the visual display of the operative procedure through the use of a miniaturized camera, constitutes the greatest change that the surgical world has experienced at the end of this century: mini-invasive surgery is born. This revolution also predicts further changes: the development of telecommunication devices applied to medicine (tele-education, tele-training, tele-mentoring, tele-proctoring and tele-accreditation), constitutes the basis of cybersurgery or virtual reality allowing the merging of the concepts of tele-presence and telemanipulation. These new concepts were developed at the European Institute of TeleSurgery at Strasbourg. The TESUS project developed the use of surgical images and data transmission through the realization of international multi-site video conferences between surgeons. The WEBS project created the first virtual university concept by placing surgical techniques at the surgeon's disposal through the Internet. The HESSOS project uses virtual reality as a surgical simulation system. The MASTER project allows the development of the concept of distant telemanipulation. It is now possible to face surgical teaching outside of the restricted University framework, and to conceive teaching on a world-wide level, offering the practitioner unimaginable possibilities of formation, training and the planning of surgical procedures.

A Systems Approach to Planning a Tele-Education System.

ERIC Educational Resources Information Center

Vazquez-Abad, Jesus; Mitchell, P. David

1983-01-01

Presents a systems analysis for transforming an educational system operating under a conventional scheme into a tele-education system. Particular attention is paid to developing and analyzing a preferred media mix and to the use of models and simulations as part of conducting a systems analysis. (Author)

Development and Implementation of Tele-Savvy for Dementia Caregivers: A Department of Veterans Affairs Clinical Demonstration Project.

PubMed

Griffiths, Patricia C; Whitney, M Kate; Kovaleva, Mariya; Hepburn, Kenneth

2016-02-01

To test fidelity and preliminary efficacy of Tele-Savvy, an internet-based version of the in-person, evidence-based psychoeducation Savvy Caregiver Program (SCP) for dementia caregivers. Tele-Savvy used synchronous (tele-conferences) and asynchronous components (video modules) to provide program access to caregivers in their homes. SCP experts were surveyed to evaluate Tele-Savvy's fidelity to SCP. A convenience sample of 30 dementia caregivers from the Atlanta VA Medical Center enrolled in the Tele-Savvy clinical demonstration program. Twenty-two caregivers completed both pre- and postprogram evaluations, which included measures of caregiver stress and competence and behavioral and psychological symptoms of dementia (BPSD). Expert review confirmed Tele-Savvy's fidelity with and, in certain domains, improvement on the original. Participants demonstrated moderately high initial levels of burden, anxiety, and depressive symptoms all of which decreased significantly postprogram in an intention to treat analysis. Similar reductions were seen in care recipients' BPSD and caregivers' reactions to them. Marginally significant increases in caregiver competence were observed. Caregiver and expert panel evaluations of program quality were enthusiastic. An effective online caregiver psychoeducation program could provide greatly expanded access for caregivers who cannot attend in person for reasons of distance, transportation limitations, and caregiving responsibilities. Further testing in a controlled trial is needed to establish program efficacy. Published by Oxford University Press on behalf of the Gerontological Society of America 2015.

Iconic Gestures for Robot Avatars, Recognition and Integration with Speech.

PubMed

Bremner, Paul; Leonards, Ute

2016-01-01

Co-verbal gestures are an important part of human communication, improving its efficiency and efficacy for information conveyance. One possible means by which such multi-modal communication might be realized remotely is through the use of a tele-operated humanoid robot avatar. Such avatars have been previously shown to enhance social presence and operator salience. We present a motion tracking based tele-operation system for the NAO robot platform that allows direct transmission of speech and gestures produced by the operator. To assess the capabilities of this system for transmitting multi-modal communication, we have conducted a user study that investigated if robot-produced iconic gestures are comprehensible, and are integrated with speech. Robot performed gesture outcomes were compared directly to those for gestures produced by a human actor, using a within participant experimental design. We show that iconic gestures produced by a tele-operated robot are understood by participants when presented alone, almost as well as when produced by a human. More importantly, we show that gestures are integrated with speech when presented as part of a multi-modal communication equally well for human and robot performances.

Integrity mechanism for eHealth tele-monitoring system in smart home environment.

PubMed

Mantas, Georgios; Lymberopoulos, Dimitrios; Komninos, Nikos

2009-01-01

During the past few years, a lot of effort has been invested in research and development of eHealth tele-monitoring systems that will provide many benefits for healthcare delivery from the healthcare provider to the patient's home. However, there is a plethora of security requirements in eHealth tele-monitoring systems. Data integrity of the transferred medical data is one of the most important security requirements that should be satisfied in these systems, since medical information is extremely sensitive information, and even sometimes life threatening information. In this paper, we present a data integrity mechanism for eHealth tele-monitoring system that operates in a smart home environment. Agent technology is applied to achieve data integrity with the use of cryptographic smart cards. Furthermore, the overall security infrastructure and its various components are described.

Iconic Gestures for Robot Avatars, Recognition and Integration with Speech

PubMed Central

Bremner, Paul; Leonards, Ute

2016-01-01

Co-verbal gestures are an important part of human communication, improving its efficiency and efficacy for information conveyance. One possible means by which such multi-modal communication might be realized remotely is through the use of a tele-operated humanoid robot avatar. Such avatars have been previously shown to enhance social presence and operator salience. We present a motion tracking based tele-operation system for the NAO robot platform that allows direct transmission of speech and gestures produced by the operator. To assess the capabilities of this system for transmitting multi-modal communication, we have conducted a user study that investigated if robot-produced iconic gestures are comprehensible, and are integrated with speech. Robot performed gesture outcomes were compared directly to those for gestures produced by a human actor, using a within participant experimental design. We show that iconic gestures produced by a tele-operated robot are understood by participants when presented alone, almost as well as when produced by a human. More importantly, we show that gestures are integrated with speech when presented as part of a multi-modal communication equally well for human and robot performances. PMID:26925010

Telescience testbed experiments for biomedical studies: fertilization potential recording of amphibian eggs using tele-manipulation under stereoscopic vision.

PubMed

Watanabe, S; Tanaka, M; Wada, Y; Suzuki, H; Takagi, S; Mori, S; Fukai, K; Kanazawa, Y; Takagi, M; Hirakawa, K; Ogasawara, K; Tsumura, K; Ogawa, K; Matsumoto, K; Nagaoka, S; Suzuki, T; Shimura, D; Yamashita, M; Nishio, S

1994-07-01

The telescience testbed experiments were carried out to test and investigate the tele-manipulation techniques in the intracellular potential recording of amphibian eggs. Implementation of telescience testbed was set up in the two separated laboratories of the Tsukuba Space center of NASDA, which were connected by tele-communication links. Manipulators respective for a microelectrode and a sample stage of microscope were moved by computers, of which command signals were transmitted from a computer in a remote control room. The computer in the control room was operated by an investigator (PI) who controlled the movement of each manipulator remotely. A stereoscopic vision of the microscope image were prepared by using a head mounted display (HMD) and were indispensable to the intracellular single cell recording. The fertilization potential of amphibian eggs was successfully obtained through the remote operating system.

Assessment of a Tele-education System to Enhance Retinopathy of Prematurity Training by International Ophthalmologists-in-Training in Mexico.

PubMed

Patel, Samir N; Martinez-Castellanos, Maria Ana; Berrones-Medina, David; Swan, Ryan; Ryan, Michael C; Jonas, Karyn E; Ostmo, Susan; Campbell, J Peter; Chiang, Michael F; Chan, R V Paul

2017-07-01

To evaluate a tele-education system developed to improve diagnostic competency in retinopathy of prematurity (ROP) by ophthalmologists-in-training in Mexico. Prospective, randomized cohort study. Fifty-eight ophthalmology residents and fellows from a training program in Mexico consented to participate. Twenty-nine of 58 trainees (50%) were randomized to the educational intervention (pretest, ROP tutorial, ROP educational chapters, and posttest), and 29 of 58 trainees (50%) were randomized to a control group (pretest and posttest only). A secure web-based educational system was created using clinical cases (20 pretest, 20 posttest, and 25 training chapter-based) developed from a repository of over 2500 unique image sets of ROP. For each image set used, a reference standard ROP diagnosis was established by combining the clinical diagnosis by indirect ophthalmoscope examination and image-based diagnosis by multiple experts. Trainees were presented with image-based clinical cases of ROP during a pretest, posttest, and training chapters. The accuracy of ROP diagnosis (e.g., plus disease, zone, stage, category) was determined using sensitivity and specificity calculations from the pretest and posttest results of the educational intervention group versus control group. The unweighted kappa statistic was used to analyze the intragrader agreement for ROP diagnosis by the ophthalmologists-in-training during the pretest and posttest for both groups. Trainees completing the tele-education system had statistically significant improvements (P < 0.01) in the accuracy of ROP diagnosis for plus disease, zone, stage, category, and aggressive posterior ROP (AP-ROP). Compared with the control group, trainees who completed the ROP tele-education system performed better on the posttest for accurately diagnosing plus disease (67% vs. 48%; P = 0.04) and the presence of ROP (96% vs. 91%; P < 0.01). The specificity for diagnosing AP-ROP (94% vs. 78%; P < 0.01), type 2 ROP or worse (92% vs. 84%; P = 0.04), and ROP requiring treatment (89% vs. 79%; P < 0.01) was better for the trainees completing the tele-education system compared with the control group. Intragrader agreement improved for identification of plus disease, zone, stage, and category of ROP after completion of the educational intervention. A tele-education system for ROP education was effective in improving the diagnostic accuracy of ROP by ophthalmologists-in-training in Mexico. This system has the potential to increase competency in ROP diagnosis and management for ophthalmologists-in-training from middle-income nations. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

TELE-X and its role in a future operational Nordic satellite system

NASA Astrophysics Data System (ADS)

Anderson, Lars

In the middle of 1987 it is planned to launch TELE-X, the first Nordic telecommunications satellite. The Swedish-Norwegian company NOTELSAT (Nordic Telecommunications Satellite Corporation) will be responsible for the operation of the TELE-X system. Via the experimental TELE-X satellite the Nordic countries will get access to direct broadcasting of two TV-programs and at least four digital sound programs in stereo by use of two transponders in the 12.2 to 12.5 GHz band. The programs are planned to be composed of nationally produced programs in Norway. Sweden and Finland. By means of distributing these programs via satellite they will reach up to 4 times as many viewers and listernes as presently in the terrestrial national systems. The basic motivations for exchanging programs are to strengthen the cultural ties between the Nordic countries and to give the individuals more freedom in the choice of programs. Another goal is to give the public a better sound and picture quality than can be achieved today. These quality improvements shall be met by using small receiver parabolas of less than 1 m in diameter. Contributing to the improved quality is the choice of the C-MAC (Multiplexed Analoque Components) modulation system. TELE-X is a multipurpose satellite which besides the two TV-transponders will have two transponders for data/video communication in the frequency band 12.5 to 12.75 GHz. The choice of system for data and video is based on the philosophy of thin-route traffic between small and low cost earth stations (1.8 to 2.5 m) placed directly at the subscribers premises. The system includes an advanced Data/Video Control Station which automatically connects the traffic stations with standarized transmission speeds up to 2 Mbps. The system which is based on the SCPC/DAMA method can be expanded up to 5000 traffic stations. Numerous data/video applications will be investigated in the initial experimental phase of the project which also will be used for market development of the services. The following text describes the dimensioning criteria for the TELE-X experimental system and a possible specification for an operational system.

Towards a Location-based Service for Early Mental Health Interventions in Disaster Response Using Minimalistic Tele-operated Android Robots Technology

NASA Astrophysics Data System (ADS)

Vahidi, H.; Mobasheri, A.; Alimardani, M.; Guan, Q.; Bakillah, M.

2014-04-01

Providing early mental health services during disaster is a great challenge in the disaster response phase. Lack of access to adequate mental-health professionals in the early stages of large-scale disasters dramatically influences the trend of a successful mental health aid. In this paper, a conceptual framework has been suggested for adopting cellphone-type tele-operated android robots in the early stages of disasters for providing the early mental health services for disaster survivors by developing a locationbased and participatory approach. The techniques of enabling GI-services in a Peer-to-Peer (P2P) environment were studied to overcome the limitations of current centralized services. Therefore, the aim of this research study is to add more flexibility and autonomy to GI web services (WMS, WFS, WPS, etc.) and alleviate to some degree the inherent limitations of these centralized systems. A P2P system Architecture is presented for the location-based service using minimalistic tele-operated android robots, and some key techniques of implementing this service using BestPeer were studied for developing this framework.

Effect of tele-emergency services on recruitment and retention of US rural physicians.

PubMed

Potter, Andrew J; Mueller, Keith J; Mackinney, A Clinton; Ward, Marcia M

2014-01-01

As competition for physicians intensifies in the USA, rural areas are at a disadvantage due to challenges unique to rural medical practice. Telemedicine improves access to care not otherwise available in rural settings. Previous studies have found that telemedicine also has positive effects on the work environment, suggesting that telemedicine may improve rural physician recruitment and retention, although few have specifically examined this. Using a mixed-method approach, clients of a single telemedicine service in the Upper Midwestern USA were surveyed and interviewed about their views of the impact of tele-emergency on physician recruitment and retention and the work environment. Surveys were completed by 292 clinical and administrative staff at 71 hospitals and semi-structured interviews were conducted with clinicians and administrators at 16 hospitals. Survey respondents agreed that tele-emergency had a positive effect on physician recruitment and retention and related workplace factors. Interviewees elucidated how the presence of tele-emergency played an important role in enhancing physician confidence, providing educational opportunities, easing burden, and supplementing care, workplace factors that interviewees believed would impact recruitment and retention. However, gains were limited by hospitals' interpretation of the Emergency Medical Treatment and Labor Act as requiring on-site physician coverage even if tele-emergency was used. Results indicate that, all other factors being equal, tele-emergency increases the likelihood of physicians entering and remaining in rural practice. New regulatory guidance by the Centers for Medicare and Medicaid Services related to on-site physician coverage will likely accelerate implementation of tele-emergency services in rural hospitals. Telemedicine may prove to be an increasingly valuable recruitment and retention tool for rural hospitals as competition for physicians intensifies.

A tele-operated mobile ultrasound scanner using a light-weight robot.

PubMed

Delgorge, Cécile; Courrèges, Fabien; Al Bassit, Lama; Novales, Cyril; Rosenberger, Christophe; Smith-Guerin, Natalie; Brù, Concepció; Gilabert, Rosa; Vannoni, Maurizio; Poisson, Gérard; Vieyres, Pierre

2005-03-01

This paper presents a new tele-operated robotic chain for real-time ultrasound image acquisition and medical diagnosis. This system has been developed in the frame of the Mobile Tele-Echography Using an Ultralight Robot European Project. A light-weight six degrees-of-freedom serial robot, with a remote center of motion, has been specially designed for this application. It holds and moves a real probe on a distant patient according to the expert gesture and permits an image acquisition using a standard ultrasound device. The combination of mechanical structure choice for the robot and dedicated control law, particularly nearby the singular configuration allows a good path following and a robotized gesture accuracy. The choice of compression techniques for image transmission enables a compromise between flow and quality. These combined approaches, for robotics and image processing, enable the medical specialist to better control the remote ultrasound probe holder system and to receive stable and good quality ultrasound images to make a diagnosis via any type of communication link from terrestrial to satellite. Clinical tests have been performed since April 2003. They used both satellite or Integrated Services Digital Network lines with a theoretical bandwidth of 384 Kb/s. They showed the tele-echography system helped to identify 66% of lesions and 83% of symptomatic pathologies.

TeleMEDiana: telesurgery and telemedicine by satellite and the Internet

NASA Astrophysics Data System (ADS)

Dobrosavljevic, Sneja; Welter, Roger

2002-08-01

The rapid development of technology and its integration into the spectrum of medical care are creating a pressing need for healthcare professionals to continuously update their knowledge and skills. In view of these needs the European Association of Visceral Surgery (AECV) which had been a platform for medical congresses in Luxembourg (1988, 1992, 1995, 1998) has developed TeleMEDiana a new broadband communication service introducing standards of excellence in Continuous Medical Education.TeleMEDiana broadcast a daily program with pedagogically enhanced video content in a number of therapeutic areas to MD's, professors and students in hospitals, universities and research centers. The educational programs are provided by leading European hospitals which have joined the TeleMEDiana Scientific Network TSN. The scientific integrity is certified by an international committee composed of recognized pioneers. Committed to deliver high resolution video streaming, TeleMEDiana has set up and successfully tested a new platform built on secure and cost-efficient satellite operator SES-ASTRA complemented by the Internet and can deliver programs to any workplace equipped with satellite dishes and high-quality set-top boxes. Telemediana offers herewith an optimal collaboration and dissemination platform to decisive players involved in Continuing Medical Education.

The Global Education Network for Retinopathy of Prematurity (Gen-Rop): Development, Implementation, and Evaluation of A Novel Tele-Education System (An American Ophthalmological Society Thesis).

PubMed

Chan, R V Paul; Patel, Samir N; Ryan, Michael C; Jonas, Karyn E; Ostmo, Susan; Port, Alexander D; Sun, Grace I; Lauer, Andreas K; Chiang, Michael F

2015-01-01

To describe the design, implementation, and evaluation of a tele-education system developed to improve diagnostic competency in retinopathy of prematurity (ROP) by ophthalmology residents. A secure Web-based tele-education system was developed utilizing a repository of over 2,500 unique image sets of ROP. For each image set used in the system, a reference standard ROP diagnosis was established. Performance by ophthalmology residents (postgraduate years 2 to 4) from the United States and Canada in taking the ROP tele-education program was prospectively evaluated. Residents were presented with image-based clinical cases of ROP during a pretest, posttest, and training chapters. Accuracy and reliability of ROP diagnosis (eg, plus disease, zone, stage, category) were determined using sensitivity, specificity, and the kappa statistic calculations of the results from the pretest and posttest. Fifty-five ophthalmology residents were provided access to the ROP tele-education program. Thirty-one ophthalmology residents completed the program. When all training levels were analyzed together, a statistically significant increase was observed in sensitivity for the diagnosis of plus disease, zone, stage, category, and aggressive posterior ROP (P<.05). Statistically significant changes in specificity for identification of stage 2 or worse (P=.027) and pre-plus (P=.028) were observed. A tele-education system for ROP education is effective in improving diagnostic accuracy of ROP by ophthalmology residents. This system may have utility in the setting of both healthcare and medical education reform by creating a validated method to certify telemedicine providers and educate the next generation of ophthalmologists.

A Practical Comparison of Motion Planning Techniques for Robotic Legs in Environments with Obstacles

NASA Technical Reports Server (NTRS)

Smith, Tristan B.; Chavez-Clemente, Daniel

2009-01-01

ATHLETE is a large six-legged tele-operated robot. Each foot is a wheel; travel can be achieved by walking, rolling, or some combination of the two. Operators control ATHLETE by selecting parameterized commands from a command dictionary. While rolling can be done efficiently, any motion involving steps is cumbersome - each step can require multiple commands and take many minutes to complete. In this paper, we consider four different algorithms that generate a sequence of commands to take a step. We consider a baseline heuristic, a randomized motion planning algorithm, and two variants of A* search. Results for a variety of terrains are presented, and we discuss the quantitative and qualitative tradeoffs between the approaches.

The TERESA project: from space research to ground tele-echography

NASA Technical Reports Server (NTRS)

Vieyres, Pierre; Poisson, Gerard; Courreges, Fabien; Merigeaux, Olivier; Arbeille, Philippe

2003-01-01

Ultrasound examinations represent one of the major diagnostic modalities of future healthcare. They are currently used to support medical space research but require a high skilled operator for both probe positioning on the patient's skin and image interpretation. TERESA is a tele-echography project that proposes a solution to bring astronauts and remotely located patients on ground quality ultrasound examinations despite the lack of a specialist at the location of the wanted medical act.

EQClinic: a platform for learning communication skills in clinical consultations.

PubMed

Liu, Chunfeng; Scott, Karen M; Lim, Renee L; Taylor, Silas; Calvo, Rafael A

2016-01-01

Doctors' verbal and non-verbal communication skills have an impact on patients' health outcomes, so it is important for medical students to develop these skills. Traditional, non-verbal communication skills training can involve a tutor manually annotating a student's non-verbal behaviour during patient-doctor consultations, but this is very time-consuming. Tele-conference systems have been used in verbal communication skills training. We describe EQClinic, a system that enables verbal and non-verbal communication skills training during tele-consultations with simulated patients (SPs), with evaluation exercises promoting reflection. Students and SPs can have tele-consultations through the tele-consultation component. In this component, SPs can provide feedback to students through a thumbs-up/ thumbs-down tool and a comments box. EQClinic automatically analyses communication features in the recorded consultations, such as facial expressions, and provides graphical representations. Our 2015 pilot study investigated whether EQClinic helped students be aware of their non-verbal behaviour and improve their communication skills, and evaluated the usability of the platform. Students received automated feedback, and SP and tutor evaluations, and then completed self-assessment and reflection questionnaires. Eight medical students and three SPs conducted 13 tele-consultations using EQClinic. More students paid attention to their non-verbal communication and students who were engaged in two consultations felt more confident in their second consultation. Students rated the system positively, felt comfortable using it (5.9/7), and reported that the structure (5.4/7) and information (5.8/7) were clear. This pilot provides evidence that EQClinic helps, and positively influences, medical students practise their communication skills with SPs using a tele-conference platform. It is not easy to improve non-verbal communication skills in a short time period. Further evaluation of EQClinic with larger numbers will ascertain learning gains and application in health professional training. Developing a standard model for the assessment of non-verbal behaviour in tele-consultations and providing students with more valuable evaluation and suggestions are part of our future work.

The Global Education Network for Retinopathy of Prematurity (Gen-Rop): Development, Implementation, and Evaluation of A Novel Tele-Education System (An American Ophthalmological Society Thesis)

PubMed Central

Chan, R.V. Paul; Patel, Samir N.; Ryan, Michael C.; Jonas, Karyn E.; Ostmo, Susan; Port, Alexander D.; Sun, Grace I.; Lauer, Andreas K.; Chiang, Michael F.

2015-01-01

Purpose: To describe the design, implementation, and evaluation of a tele-education system developed to improve diagnostic competency in retinopathy of prematurity (ROP) by ophthalmology residents. Methods: A secure Web-based tele-education system was developed utilizing a repository of over 2,500 unique image sets of ROP. For each image set used in the system, a reference standard ROP diagnosis was established. Performance by ophthalmology residents (postgraduate years 2 to 4) from the United States and Canada in taking the ROP tele-education program was prospectively evaluated. Residents were presented with image-based clinical cases of ROP during a pretest, posttest, and training chapters. Accuracy and reliability of ROP diagnosis (eg, plus disease, zone, stage, category) were determined using sensitivity, specificity, and the kappa statistic calculations of the results from the pretest and posttest. Results: Fifty-five ophthalmology residents were provided access to the ROP tele-education program. Thirty-one ophthalmology residents completed the program. When all training levels were analyzed together, a statistically significant increase was observed in sensitivity for the diagnosis of plus disease, zone, stage, category, and aggressive posterior ROP (P<.05). Statistically significant changes in specificity for identification of stage 2 or worse (P=.027) and pre-plus (P=.028) were observed. Conclusions: A tele-education system for ROP education is effective in improving diagnostic accuracy of ROP by ophthalmology residents. This system may have utility in the setting of both healthcare and medical education reform by creating a validated method to certify telemedicine providers and educate the next generation of ophthalmologists. PMID:26538772

Development and verification of ground-based tele-robotics operations concept for Dextre

NASA Astrophysics Data System (ADS)

Aziz, Sarmad

2013-05-01

The Special Purpose Dextreous Manipulator (Dextre) is the latest addition to the on-orbit segment of the Mobile Servicing System (MSS); Canada's contribution to the International Space Station (ISS). Launched in March 2008, the advanced two-armed robot is designed to perform various ISS maintenance tasks on robotically compatible elements and on-orbit replaceable units using a wide variety of tools and interfaces. The addition of Dextre has increased the capabilities of the MSS, and has introduced significant complexity to ISS robotics operations. While the initial operations concept for Dextre was based on human-in-the-loop control by the on-orbit astronauts, the complexities of robotic maintenance and the associated costs of training and maintaining the operator skills required for Dextre operations demanded a reexamination of the old concepts. A new approach to ISS robotic maintenance was developed in order to utilize the capabilities of Dextre safely and efficiently, while at the same time reducing the costs of on-orbit operations. This paper will describe the development, validation, and on-orbit demonstration of the operations concept for ground-based tele-robotics control of Dextre. It will describe the evolution of the new concepts from the experience gained from the development and implementation of the ground control capability for the Space Station Remote Manipulator System; Canadarm 2. It will discuss the various technical challenges faced during the development effort, such as requirements for high positioning accuracy, force/moment sensing and accommodation, failure tolerance, complex tool operations, and the novel operational tools and techniques developed to overcome them. The paper will also describe the work performed to validate the new concepts on orbit and will discuss the results and lessons learned from the on-orbit checkout and commissioning of Dextre using the newly developed tele-robotics techniques and capabilities.

Application of Robotics in Decommissioning and Decontamination - 12536

DOE Office of Scientific and Technical Information (OSTI.GOV)

Banford, Anthony; Kuo, Jeffrey A.; Bowen, R.A.

Decommissioning and dismantling of nuclear facilities is a significant challenge worldwide and one which is growing in size as more plants reach the end of their operational lives. The strategy chosen for individual projects varies from the hands-on approach with significant manual intervention using traditional demolition equipment at one extreme to bespoke highly engineered robotic solutions at the other. The degree of manual intervention is limited by the hazards and risks involved, and in some plants are unacceptable. Robotic remote engineering is often viewed as more expensive and less reliable than manual approaches, with significant lead times and capital expenditure.more » However, advances in robotics and automation in other industries offer potential benefits for future decommissioning activities, with the high probability of reducing worker exposure and other safety risks as well as reducing the schedule and costs required to complete these activities. Some nuclear decommissioning tasks and facility environments are so hazardous that they can only be accomplished by exclusive use of robotic and remote intervention. Less hazardous tasks can be accomplished by manual intervention and the use of PPE. However, PPE greatly decreases worker productivity and still exposes the worker to both risk and dose making remote operation preferable to achieve ALARP. Before remote operations can be widely accepted and deployed, there are some economic and technological challenges that must be addressed. These challenges will require long term investment commitments in order for technology to be: - Specifically developed for nuclear applications; - At a sufficient TRL for practical deployment; - Readily available as a COTS. Tremendous opportunities exist to reduce cost and schedule and improve safety in D and D activities through the use of robotic and/or tele-operated systems. - Increasing the level of remote intervention reduces the risk and dose to an operator. Better environmental information identifies hazards, which can be assessed, managed and mitigated. - Tele-autonomous control in a congested unstructured environment is more reliable compared to a human operator. Advances in Human Machine Interfaces contribute to reliability and task optimization. Use of standardized dexterous manipulators and COTS, including standardized communication protocols reduces project time scales. - The technologies identified, if developed to a sufficient TRL would all contribute to cost reductions. Additionally, optimizing a project's position on a Remote Intervention Scale, a Bespoke Equipment Scale and a Tele-autonomy Scale would provide cost reductions from the start of a project. Of the technologies identified, tele-autonomy is arguably the most significant, because this would provide a fundamental positive change for robotic control in the nuclear industry. The challenge for technology developers is to develop versatile robotic technology that can be economically deployed to a wide range of future D and D projects and industrial sectors. The challenge for facility owners and project managers is to partner with the developers to provide accurate systems requirements and an open and receptive environment for testing and deployment. To facilitate this development and deployment effort, the NNL and DOE have initiated discussions to explore a collaborative R and D program that would accelerate development and support the optimum utilization of resources. (authors)« less

[The Virtual University applied to telesurgery: from tele-education to tele-manipulation].

PubMed

Marescaux, J; Mutter, D; Soler, L; Vix, M; Leroy, J

1999-01-01

The advent of new computer technologies appears as a revolution of surgical teaching, as well as the planning and realisation of surgical procedures. The introduction of a camera into the body of a patient, allowing the visual display of the operative procedure through the use of miniaturised camera constitutes the greatest alteration that the surgical world has experienced at the end of this century: mini-invasive surgery is born. This revolution was announces further changes: the development of telecommunication devices applied to medicine (tele-education, teletraining, telementoring, teleproctoring and tele-accreditation) constitutes the basis of cybersurgery or virtual reality allowing the merging of the concepts of telepresence and telemanipulation. These new concepts were developed at the European Institute of TeleSurgery of Strasbourg. The TESUS project developed the use of surgical images and data transmission through the realisation of international multi-site video conferences between surgeons. The WEBS project created the first Virtual University concept placing surgical techniques at the surgeon's disposal through Internet. The HESSOS project uses virtual reality as a surgical simulation system. The MASTER project allows to develop the concept of distant telemanipulation. It is now possible to face surgical teaching outside of the restricted University frame and to conceive teaching on a world level, offering to the practitioner unimaginable possibilities of formation, training and planning of surgical procedures.

Design issues for stereo vision systems used on tele-operated robotic platforms

NASA Astrophysics Data System (ADS)

Edmondson, Richard; Vaden, Justin; Hyatt, Brian; Morris, Jim; Pezzaniti, J. Larry; Chenault, David B.; Tchon, Joe; Barnidge, Tracy; Kaufman, Seth; Pettijohn, Brad

2010-02-01

The use of tele-operated Unmanned Ground Vehicles (UGVs) for military uses has grown significantly in recent years with operations in both Iraq and Afghanistan. In both cases the safety of the Soldier or technician performing the mission is improved by the large standoff distances afforded by the use of the UGV, but the full performance capability of the robotic system is not utilized due to insufficient depth perception provided by the standard two dimensional video system, causing the operator to slow the mission to ensure the safety of the UGV given the uncertainty of the perceived scene using 2D. To address this Polaris Sensor Technologies has developed, in a series of developments funded by the Leonard Wood Institute at Ft. Leonard Wood, MO, a prototype Stereo Vision Upgrade (SVU) Kit for the Foster-Miller TALON IV robot which provides the operator with improved depth perception and situational awareness, allowing for shorter mission times and higher success rates. Because there are multiple 2D cameras being replaced by stereo camera systems in the SVU Kit, and because the needs of the camera systems for each phase of a mission vary, there are a number of tradeoffs and design choices that must be made in developing such a system for robotic tele-operation. Additionally, human factors design criteria drive optical parameters of the camera systems which must be matched to the display system being used. The problem space for such an upgrade kit will be defined, and the choices made in the development of this particular SVU Kit will be discussed.

Experiences with the JPL telerobot testbed: Issues and insights

NASA Technical Reports Server (NTRS)

Stone, Henry W.; Balaram, Bob; Beahan, John

1989-01-01

The Jet Propulsion Laboratory's (JPL) Telerobot Testbed is an integrated robotic testbed used to develop, implement, and evaluate the performance of advanced concepts in autonomous, tele-autonomous, and tele-operated control of robotic manipulators. Using the Telerobot Testbed, researchers demonstrated several of the capabilities and technological advances in the control and integration of robotic systems which have been under development at JPL for several years. In particular, the Telerobot Testbed was recently employed to perform a near completely automated, end-to-end, satellite grapple and repair sequence. The task of integrating existing as well as new concepts in robot control into the Telerobot Testbed has been a very difficult and timely one. Now that researchers have completed the first major milestone (i.e., the end-to-end demonstration) it is important to reflect back upon experiences and to collect the knowledge that has been gained so that improvements can be made to the existing system. It is also believed that the experiences are of value to the others in the robotics community. Therefore, the primary objective here will be to use the Telerobot Testbed as a case study to identify real problems and technological gaps which exist in the areas of robotics and in particular systems integration. Such problems have surely hindered the development of what could be reasonably called an intelligent robot. In addition to identifying such problems, researchers briefly discuss what approaches have been taken to resolve them or, in several cases, to circumvent them until better approaches can be developed.

Australian national networked tele-test facility for integrated systems

NASA Astrophysics Data System (ADS)

Eshraghian, Kamran; Lachowicz, Stefan W.; Eshraghian, Sholeh

2001-11-01

The Australian Commonwealth government recently announced a grant of 4.75 million as part of a 13.5 million program to establish a world class networked IC tele-test facility in Australia. The facility will be based on a state-of-the-art semiconductor tester located at Edith Cowan University in Perth that will operate as a virtual centre spanning Australia. Satellite nodes will be located at the University of Western Australia, Griffith University, Macquarie University, Victoria University and the University of Adelaide. The facility will provide vital equipment to take Australia to the frontier of critically important and expanding fields in microelectronics research and development. The tele-test network will provide state of the art environment for the electronics and microelectronics research and the industry community around Australia to test and prototype Very Large Scale Integrated (VLSI) circuits and other System On a Chip (SOC) devices, prior to moving to the manufacturing stage. Such testing is absolutely essential to ensure that the device performs to specification. This paper presents the current context in which the testing facility is being established, the methodologies behind the integration of design and test strategies and the target shape of the tele-testing Facility.

Tele-periodontics - Oral health care at a grass root level.

PubMed

Avula, Haritha

2015-01-01

A new concept of tele-periodontics, which merges the innovative technology of telecommunications and the field of periodontics, is proposed. This new field of tele-periodontics will have an infinite potential where access to a specialist will be provided at a grass root level, enhancing effective delivery of therapy and information to the rural and under privileged areas. It would allow the specialist and the patient to interact either by video conferencing (real time) or through supportive information (store and forward) over geographic distances. Different probabilities of tele-periodontics such as tele consultation, tele training, tele education and tele support are also discussed in this paper.

Tele-periodontics - Oral health care at a grass root level

PubMed Central

Avula, Haritha

2015-01-01

A new concept of tele-periodontics, which merges the innovative technology of telecommunications and the field of periodontics, is proposed. This new field of tele-periodontics will have an infinite potential where access to a specialist will be provided at a grass root level, enhancing effective delivery of therapy and information to the rural and under privileged areas. It would allow the specialist and the patient to interact either by video conferencing (real time) or through supportive information (store and forward) over geographic distances. Different probabilities of tele-periodontics such as tele consultation, tele training, tele education and tele support are also discussed in this paper. PMID:26644730

EQClinic: a platform for learning communication skills in clinical consultations

PubMed Central

Liu, Chunfeng; Scott, Karen M.; Lim, Renee L.; Taylor, Silas; Calvo, Rafael A.

2016-01-01

Background Doctors’ verbal and non-verbal communication skills have an impact on patients’ health outcomes, so it is important for medical students to develop these skills. Traditional, non-verbal communication skills training can involve a tutor manually annotating a student's non-verbal behaviour during patient–doctor consultations, but this is very time-consuming. Tele-conference systems have been used in verbal communication skills training. Methods We describe EQClinic, a system that enables verbal and non-verbal communication skills training during tele-consultations with simulated patients (SPs), with evaluation exercises promoting reflection. Students and SPs can have tele-consultations through the tele-consultation component. In this component, SPs can provide feedback to students through a thumbs-up/ thumbs-down tool and a comments box. EQClinic automatically analyses communication features in the recorded consultations, such as facial expressions, and provides graphical representations. Our 2015 pilot study investigated whether EQClinic helped students be aware of their non-verbal behaviour and improve their communication skills, and evaluated the usability of the platform. Students received automated feedback, and SP and tutor evaluations, and then completed self-assessment and reflection questionnaires. Results Eight medical students and three SPs conducted 13 tele-consultations using EQClinic. More students paid attention to their non-verbal communication and students who were engaged in two consultations felt more confident in their second consultation. Students rated the system positively, felt comfortable using it (5.9/7), and reported that the structure (5.4/7) and information (5.8/7) were clear. This pilot provides evidence that EQClinic helps, and positively influences, medical students practise their communication skills with SPs using a tele-conference platform. Discussion It is not easy to improve non-verbal communication skills in a short time period. Further evaluation of EQClinic with larger numbers will ascertain learning gains and application in health professional training. Developing a standard model for the assessment of non-verbal behaviour in tele-consultations and providing students with more valuable evaluation and suggestions are part of our future work. PMID:27476537

EQClinic: a platform for learning communication skills in clinical consultations.

PubMed

Liu, Chunfeng; Scott, Karen M; Lim, Renee L; Taylor, Silas; Calvo, Rafael A

2016-01-01

Background Doctors' verbal and non-verbal communication skills have an impact on patients' health outcomes, so it is important for medical students to develop these skills. Traditional, non-verbal communication skills training can involve a tutor manually annotating a student's non-verbal behaviour during patient-doctor consultations, but this is very time-consuming. Tele-conference systems have been used in verbal communication skills training. Methods We describe EQClinic, a system that enables verbal and non-verbal communication skills training during tele-consultations with simulated patients (SPs), with evaluation exercises promoting reflection. Students and SPs can have tele-consultations through the tele-consultation component. In this component, SPs can provide feedback to students through a thumbs-up/ thumbs-down tool and a comments box. EQClinic automatically analyses communication features in the recorded consultations, such as facial expressions, and provides graphical representations. Our 2015 pilot study investigated whether EQClinic helped students be aware of their non-verbal behaviour and improve their communication skills, and evaluated the usability of the platform. Students received automated feedback, and SP and tutor evaluations, and then completed self-assessment and reflection questionnaires. Results Eight medical students and three SPs conducted 13 tele-consultations using EQClinic. More students paid attention to their non-verbal communication and students who were engaged in two consultations felt more confident in their second consultation. Students rated the system positively, felt comfortable using it (5.9/7), and reported that the structure (5.4/7) and information (5.8/7) were clear. This pilot provides evidence that EQClinic helps, and positively influences, medical students practise their communication skills with SPs using a tele-conference platform. Discussion It is not easy to improve non-verbal communication skills in a short time period. Further evaluation of EQClinic with larger numbers will ascertain learning gains and application in health professional training. Developing a standard model for the assessment of non-verbal behaviour in tele-consultations and providing students with more valuable evaluation and suggestions are part of our future work.

A virtual reality-based method of decreasing transmission time of visual feedback for a tele-operative robotic catheter operating system.

PubMed

Guo, Jin; Guo, Shuxiang; Tamiya, Takashi; Hirata, Hideyuki; Ishihara, Hidenori

2016-03-01

An Internet-based tele-operative robotic catheter operating system was designed for vascular interventional surgery, to afford unskilled surgeons the opportunity to learn basic catheter/guidewire skills, while allowing experienced physicians to perform surgeries cooperatively. Remote surgical procedures, limited by variable transmission times for visual feedback, have been associated with deterioration in operability and vascular wall damage during surgery. At the patient's location, the catheter shape/position was detected in real time and converted into three-dimensional coordinates in a world coordinate system. At the operation location, the catheter shape was reconstructed in a virtual-reality environment, based on the coordinates received. The data volume reduction significantly reduced visual feedback transmission times. Remote transmission experiments, conducted over inter-country distances, demonstrated the improved performance of the proposed prototype. The maximum error for the catheter shape reconstruction was 0.93 mm and the transmission time was reduced considerably. The results were positive and demonstrate the feasibility of remote surgery using conventional network infrastructures. Copyright © 2015 John Wiley & Sons, Ltd.

How does tele-learning compare with other forms of education delivery? A systematic review of tele-learning educational outcomes for health professionals.

PubMed

Tomlinson, Jo; Shaw, Tim; Munro, Ana; Johnson, Ros; Madden, D Lynne; Phillips, Rosemary; McGregor, Deborah

2013-11-01

Telecommuniciation technologies, including audio and videoconferencing facilities, afford geographically dispersed health professionals the opportunity to connect and collaborate with others. Recognised for enabling tele-consultations and tele-collaborations between teams of health care professionals and their patients, these technologies are also well suited to the delivery of distance learning programs, known as tele-learning. To determine whether tele-learning delivery methods achieve equivalent learning outcomes when compared with traditional face-to-face education delivery methods. A systematic literature review was commissioned by the NSW Ministry of Health to identify results relevant to programs applying tele-learning delivery methods in the provision of education to health professionals. The review found few studies that rigorously compared tele-learning with traditional formats. There was some evidence, however, to support the premise that tele-learning models achieve comparable learning outcomes and that participants are generally satisfied with and accepting of this delivery method. The review illustrated that tele-learning technologies not only enable distance learning opportunities, but achieve comparable learning outcomes to traditional face-to-face models. More rigorous evidence is required to strengthen these findings and should be the focus of future tele-learning research.

Improving fatigue in multiple sclerosis by smartphone-supported energy management: The MS TeleCoach feasibility study.

PubMed

D'hooghe, Marie; Van Gassen, Geert; Kos, Daphne; Bouquiaux, Olivier; Cambron, Melissa; Decoo, Danny; Lysandropoulos, Andreas; Van Wijmeersch, Bart; Willekens, Barbara; Penner, Iris-Katharina; Nagels, Guy

2018-03-27

Fatigue is a frequently occurring, often disabling symptom in MS with no single effective treatment. In current fatigue management interventions, personalized, real-time follow-up is often lacking. The objective of the study is to assess the feasibility of the MS TeleCoach, a novel intervention offering telemonitoring of fatigue and telecoaching of physical activity and energy management in persons with MS (pwMS) over a 12-week period. The goal of the MS TeleCoach, conceived as a combination of monitoring, self-management and motivational messages, is to enhance levels of physical activity thereby improving fatigue in pwMS in an accessible and interactive way, reinforcing self-management of patients. We conducted a prospective, open-label feasibility study of the MS TeleCoach in pwMS with Expanded Disability Status Scale ≤ 4 and moderate to severe fatigue as measured by the Fatigue Scale for Motor and Cognitive Functions (FSMC). Following a 2-week run-in period to assess the baseline activity level per patient, the target number of activity counts was gradually increased over the 12-week period through telecoaching. The primary efficacy outcome was change in FSMC total score from baseline to study end. A subset of patients was asked to fill in D-QUEST 2.0, a usability questionnaire, to evaluate the satisfaction with the MS TeleCoach device and the experienced service. Seventy-five patients were recruited from 16 centres in Belgium, of which 57 patients (76%) completed the study. FSMC total score (p = 0.009) and motor and cognitive subscores (p = 0.007 and p = 0.02 respectively) decreased from baseline to week 12, indicating an improvement in fatigue. One third of participants with severe fatigue changed to a lower FSMC category for both FSMC total score and subscores. The post-study evaluation of patient satisfaction showed that the intervention was well accepted and that patients were very satisfied with the quality of the professional services. Using MS TeleCoach as a self-management tool in pwMS suffering from mild disability and moderate to severe fatigue appeared to be feasible, both technically and from a content perspective. Its use was associated with improved fatigue levels in the participants who completed the study. The MS Telecoach seems to meet the need for a low-cost, accessible and interactive self-management tool in MS. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

National French survey on tele-transmission of EEG recordings: More than a simple technological challenge.

PubMed

Sauleau, Paul; Despatin, Jane; Cheng, Xufei; Lemesle, Martine; Touzery-de Villepin, Anne; N'Guyen The Tich, Sylvie; Kubis, Nathalie

2016-04-01

Assessment of current practice and the need for tele-transmission and remote interpretation of EEG in France. Transmission of EEG to a distant center could be a promising solution to the problem of decreasing availability of neurophysiologists for EEG interpretation, in order to provide equity within health care services in France. This practice should logically follow the legal framework of telemedicine and the recommendations that were recently edited by the Société de neurophysiologie clinique de langue française (SNCLF) and the Ligue française contre l'épilepsie (LCFE). A national survey was designed and performed under the auspices of the SNCLF. This survey reveals that there is an important gap between the official recommendations and the "reality on the ground". These local organizations were mainly established through the impulse of individual initiatives, rarely driven by health regulatory authorities and sometimes far from legal frameworks. For the majority, they result from a need to improve medical care, especially in pediatrics and neonatology, and to ensure continuity of care. When present, tele-transmission of EEG is often only partially satisfactory, since many technical procedures have to be improved. Conversely, the lack of tele-transmission of EEG would penalize medical care for some patients. The survey shows both the wealth of local initiatives and the fragility of most existing networks, emphasizing the need for better cooperation between regulatory authorities and health care professionals to establish or improve the transmission of EEG in France. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Test Waveform Applications for JPL STRS Operating Environment

NASA Technical Reports Server (NTRS)

Lux, James P.; Peters, Kenneth J.; Taylor, Gregory H.; Lang, Minh; Stern, Ryan A.; Duncan, Courtney B.

2013-01-01

This software demonstrates use of the JPL Space Telecommunications Radio System (STRS) Operating Environment (OE), tests APIs (application programming interfaces) presented by JPL STRS OE, and allows for basic testing of the underlying hardware platform. This software uses the JPL STRS Operating Environment ["JPL Space Tele com - munications Rad io System Operating Environment,"(NPO-4776) NASA Tech Briefs, commercial edition, Vol. 37, No. 1 (January 2013), p. 47] to interact with the JPL-SDR Software Defined Radio developed for the CoNNeCT (COmmunications, Navigation, and Networking rEconfigurable Testbed) Project as part of the SCaN Testbed installed on the International Space Station (ISS). These are the first applications that are compliant with the new NASA STRS Architecture Standard. Several example waveform applications are provided to demonstrate use of the JPL STRS OE for the JPL-SDR platform used for the CoNNeCT Project. The waveforms provide a simple digitizer and playback capability for the SBand RF slice, and a simple digitizer for the GPS slice [CoNNeCT Global Positioning System RF Module, (NPO-47764) NASA Tech Briefs, commercial edition, Vol. 36, No. 3 (March 2012), p. 36]. These waveforms may be used for hardware test, as well as for on-orbit or laboratory checkout. Additional example waveforms implement SpaceWire and timer modules, which can be used for time transfer and demonstration of communication between the two Xilinx FPGAs in the JPLSDR. The waveforms are also compatible with ground-based use of the JPL STRS OE on radio breadboards and Linux.

Urban Scaling in Europe

DTIC Science & Technology

2016-03-16

European city has experienced periods of profound crisis alternating with booming development and has seen enormous demographic, economic, political...simplest model of network effects, proposed for a simple all-to-all tele- communications network, a city is characterized by more limited increases in...Urban characteristics attributable to density-driven tie formation. Nat. Commun . 4, 1961. (doi:10.1038/ncomms2961) 29. Sim A, Yaliraki SN, Barahona M

Tele-care robot for assisting independent senior citizens who live at home.

PubMed

Katz, Reuven

2015-01-01

In the last twenty years most developed countries face dramatic demographic changes, and predominantly the rapid aging of their population. As the share of elderly people is climbing while the number of care providers is declining, the aging problem is becoming an increasingly important social and economic challenge. The supply of care at home, utilizing affordable tele-care systems and smart home technologies, is one of the promising strategies to cope with challenges posed by these demographic changes. The goal of this paper is to present a tele-care robot (TCR) aimed to assist Senior citizens who live independently at their home, that need assistance in daily life activities. The idea of the proposed system is that a caregiver, operating from a central location, will be able to service between 10 to 20 patients living at their home, by using the tele-care robot. The robot will possess motion control capabilities to move inside the house of each patient and alert in case that emergency events occur. The robot will allow the care provider to communicate remotely with the patient using audio and video equipment installed on the robot. By using the robot, the caregiver will be able to examine several times during the day the well-being of the patient, his medication consumption, and his overall functionality.

Telemedicine Enables Broader Access to Movement Disorders Curricula for Medical Students.

PubMed

Cubo, Esther; Doumbe, Jacques; López, Emiliano; Lopez, Guadalupe A; Gatto, Emilia; Persi, Gabriel; Guttman, Mark

2017-01-01

The impact of tele-education for movement disorders on medical students is unknown. The present study had three objectives. First, to create a tele-education program for medical students in regions with limited access to movement disorders curricula. Second, to analyze the feasibility, satisfaction, and improvement of medical knowledge. Third, to assess the main reasons of medical students for attending this course. In 2016, a program was piloted in a low-middle income (Cameroon) and a middle-high income (Argentina) country. Medical students were offered a free movement disorder tele-education program (four medical schools in Argentina, and 1 medical school in Cameroon). Six real-time videoconferences covering hyperkinetic and hypokinetic movement disorders were included. Evaluations included attendance, pre- and post-medical knowledge, and satisfaction questionnaires. The study included 151 undergraduate medical students (79.4% from Argentina, 20.6% from Cameroon). Feasibility was acceptable with 100% and 85.7% of the videoconferences completed in Argentina and Cameroon, respectively. Attendance was higher in Argentina compared to Cameroon (75% vs. 33.1%). According to student reports, the topics and innovative educational environment were the main reasons for attendance. Both groups ranked satisfaction as moderate to high, and medical knowledge improved similarly in both countries. Tele-education can improve movement disorders knowledge in medical schools in high-middle and low-middle income countries lacking access to other educational opportunities.

Component-Level Electronic-Assembly Repair (CLEAR) System Architecture

NASA Technical Reports Server (NTRS)

Oeftering, Richard C.; Bradish, Martin A.; Juergens, Jeffrey R.; Lewis, Michael J.; Vrnak, Daniel R.

2011-01-01

This document captures the system architecture for a Component-Level Electronic-Assembly Repair (CLEAR) capability needed for electronics maintenance and repair of the Constellation Program (CxP). CLEAR is intended to improve flight system supportability and reduce the mass of spares required to maintain the electronics of human rated spacecraft on long duration missions. By necessity it allows the crew to make repairs that would otherwise be performed by Earth based repair depots. Because of practical knowledge and skill limitations of small spaceflight crews they must be augmented by Earth based support crews and automated repair equipment. This system architecture covers the complete system from ground-user to flight hardware and flight crew and defines an Earth segment and a Space segment. The Earth Segment involves database management, operational planning, and remote equipment programming and validation processes. The Space Segment involves the automated diagnostic, test and repair equipment required for a complete repair process. This document defines three major subsystems including, tele-operations that links the flight hardware to ground support, highly reconfigurable diagnostics and test instruments, and a CLEAR Repair Apparatus that automates the physical repair process.

Miniature Intermittent Contact Switch

NASA Technical Reports Server (NTRS)

Sword, Antony

1972-01-01

This tech brief concerns work to provide a shock-resistant switch capable of being actuated by forces of varying magnitude and direction, primarily for use as a sensor on remote control (tele-operator) and prosthetic devices.

Tele-auscultation support system with mixed reality navigation.

PubMed

Hori, Kenta; Uchida, Yusuke; Kan, Tsukasa; Minami, Maya; Naito, Chisako; Kuroda, Tomohiro; Takahashi, Hideya; Ando, Masahiko; Kawamura, Takashi; Kume, Naoto; Okamoto, Kazuya; Takemura, Tadamasa; Yoshihara, Hiroyuki

2013-01-01

The aim of this research is to develop an information support system for tele-auscultation. In auscultation, a doctor requires to understand condition of applying a stethoscope, in addition to auscultatory sounds. The proposed system includes intuitive navigation system of stethoscope operation, in addition to conventional audio streaming system of auscultatory sounds and conventional video conferencing system for telecommunication. Mixed reality technology is applied for intuitive navigation of the stethoscope. Information, such as position, contact condition and breath, is overlaid on a view of the patient's chest. The contact condition of the stethoscope is measured by e-textile contact sensors. The breath is measured by a band type breath sensor. In a simulated tele-auscultation experiment, the stethoscope with the contact sensors and the breath sensor were evaluated. The results show that the presentation of the contact condition was not understandable enough for navigating the stethoscope handling. The time series of the breath phases was usable for the remote doctor to understand the breath condition of the patient.

Automation of a Versatile Crane (the LSMS) for Lunar Outpost Construction, Maintenance and Inspection

NASA Technical Reports Server (NTRS)

Doggett, William R.; Roithmayr, Carlos M.; Dorsey, John T.; Jones, Thomas C.; Shen, Haijun; Seywald, Hans; King, Bruce D.; Mikulas, Martin M., Jr.

2009-01-01

Devices for lifting, translating and precisely placing payloads are critical for efficient Earth-based construction operations. Both recent and past studies have demonstrated that devices with similar functionality will be needed to support lunar outpost operations. Although several designs have been developed for Earth based applications, these devices lack unique design characteristics necessary for transport to and use on the harsh lunar surface. These design characteristics include: a) lightweight components, b) compact packaging for launch, c) automated deployment, d) simple in-field reconfiguration and repair, and e) support for tele-operated or automated operations. Also, because the cost to transport mass to the lunar surface is very high, the number of devices that can be dedicated to surface operations will be limited. Thus, in contrast to Earth-based construction, where many single-purpose devices dominate a construction site, a lunar outpost will require a limited number of versatile devices that provide operational benefit from initial construction through sustained operations. The first generation test-bed of a new high performance device, the Lunar Surface Manipulation System (LSMS) has been designed, built and field tested. The LSMS has many unique features resulting in a mass efficient solution to payload handling on the lunar surface. Typically, the LSMS device mass is estimated at approximately 3% of the mass of the heaviest payload lifted at the tip, or 1.8 % of the mass of the heaviest mass lifted at the elbow or mid-span of the boom for a high performance variant incorporating advanced structural components. Initial operational capabilities of the LSMS were successfully demonstrated during field tests at Moses Lake, Washington using a tele-operated approach. Joint angle sensors have been developed for the LSMS to improve operator situational awareness. These same sensors provide the necessary information to support fully automated operations, greatly expanding the operational versatility of the LSMS. This paper develops the equations describing the forward and inverse relation between LSMS joint angles and Cartesian coordinates of the LSMS tip. These equations allow a variety of schemes to be used to maneuver the LSMS to optimize the maneuver. One such scheme will be described in detail that eliminates undesirable swinging of the payload at the conclusion of a maneuver, even when the payload is suspended from a passive rigid link. The swinging is undesirable when performing precision maneuvers, such as aligning an object for mating or positioning a camera. Use of the equations described here enables automated control of the LSMS greatly improving its operational versatility.

Tele-Education in South Africa

PubMed Central

Mars, Maurice

2014-01-01

Introduction: Telemedicine includes the use of information and communication technology for education in the health sector, tele-education. Sub-Saharan Africa has an extreme shortage of health professionals and as a result, doctors to teach doctors and students. Tele-education has the potential to provide access to education both formal and continuing medical education. While the uptake of telemedicine in Africa is low, there are a number of successful and sustained tele-education programs. The aims of this study were (i) to review the literature on tele-education in South Africa, (ii) describe tele-education activities at the University of KwaZulu-Natal (UKZ-N) in South Africa, and (iii) review the development of these programs with respect to current thinking on eHealth project implementation. Method: A literature review of tele-education in South Africa was undertaken. The development of the tele-education services at UKZ-N from 2001 to present is described. The approaches taken are compared with current teaching on eHealth implementation and a retrospective design-reality gap analysis is made. Results: Tele-education has been in use in South Africa since the 1970s. Several forms of tele-education are in place at the medical schools and in some Provincial Departments of Health (DOH). Despite initial attempts by the National DOH, there are no national initiatives in tele-education. At UKZ-N, a tele-education service has been running since 2001 and appears to be sustainable and reaching maturity, with over 1,400 h of videoconferenced education offered per year. The service has expanded to offer videoconferenced education into Africa using different ways of delivering tele-education. Conclusion: Tele-education has been used in different forms for many years in the health sector in South Africa. There is little hard evidence of its educational merit or economic worth. What it apparent is that it improves access to education and training in resource constrained settings. The development of local and international tele-education at the UKZ-N has not followed what is currently considered to be best practice but shows how programs can develop if there is a real need and the solution assists in meeting the need. Further work is required to analyze the economics of these tele-education endeavors. PMID:25405146

Parents' perceptions of tele-audiological testing in a rural hearing screening program in South India.

PubMed

Ramkumar, Vidya; Selvakumar, K; Vanaja, C S; Hall, James W; Nagarajan, Roopa; Neethi, J

2016-10-01

Tele-diagnostic audiological testing in a hearing screening program for infants and young children is a novel practice, and this study is the first to explore its application in a rural community. It is important to understand parental perceptions and confidence when introducing a new process such as tele-audiological diagnostic testing in rural areas. A questionnaire with 17 rater-administered items was designed to elicit comments concerning the quality of tele-hearing testing and video-conferencing, access to tele-hearing testing, and parents' attitudes regarding tele-hearing testing in the village. The questionnaire was administered by an audiologist not involved in tele-diagnostic testing to avoid bias. Parents perceived tele-hearing testing as equal in quality to in-person testing. Technical factors such as good video-conferencing quality and logistical factors such as ease of access due to reasonable travel time to testing facility could have influenced these perceptions. While these results show tele-hearing testing is an acceptable alternative, occasional poor signal quality should be addressed prior to large-scale implementation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The robot and the satellite for tele-operating echographic examination in Earth isolated sites, or onboard ISS.

PubMed

Arbeille, Ph; Ruiz, J; Ayoub, J; Vieyres, P; Porcher, M; Boulay, J; Moreau, V; Poisson, G

2004-07-01

The objective was to design and validate a method for tele-operating (from an expert site) an echographic examination in an isolated site. The isolated places, defined as areas with reduced medical facilities, could be secondary hospitals 20 to 50 km from the university hospital, or dispensaries in Africa or Amazonia, or a moving structure like a rescue vehicle or the International Space Station (ISS). At the expert center, the ultrasound medical expert moves a fictive probe, connected to a computer (n degrees 1) which sends, the coordinate changes of this probe via an ISDN or satellite line to a second computer (n degrees 2), located at the isolated site, which applies them to the robotic arm holding the real echographic probe. The system was tested at Tours Hospital on 105 patients. A complete investigation (visualization) of all the organs requested for different clinical cases was obtained in 76% of the cases with the robot, and 87% at the reference echography: In 11% of the cases, at least one of the organ visualized at reference echo could not be investigated by the robot, thus the diagnostic was not done. The number of repositioning was higher for the robot (6.5 +/- 2) than for the reference echo (5.1 +/- 2 = or > 24% more with robot). The duration of the examination was higher with the robot (16 +/- 10 min) than for the reference echography (11 +/- 4 min = or > +43% with the robot compare to reference echography. The system was also tested successfully using satellite links in a limited number of cases (approx 30).

Tele-Manipulation with Two Asymmetric Slaves: Two Operators Perform Better Than One.

PubMed

van Oosterhout, Jeroen; Heemskerk, Cock J M; de Baar, Marco R; van der Helm, Frans C T; Abbink, David A

2018-01-01

Certain tele-manipulation tasks require manipulation by two asymmetric slaves, for example, a crane for hoisting and a dexterous robotic arm for fine manipulation. It is unclear how to best design human-in-the-loop control over two asymmetric slaves. The goal of this paper is to quantitatively compare the standard approach of two co-operating operators that each control a single subtask, to a single operator performing bi-manual control over the two subtasks, and a uni-manual control approach. In a human factors experiment, participants performed a heavy load maneuvering and mounting task using a vertical crane and a robotic arm. We hypothesize that bi-manual control yields worse task performance and control activity compared to co-operation, because of conflicting spatial and temporal constraints. Literature suggests that uni-manual operators should perform better than co-operation, as co-operators critically depend on each other's actions. However, other literature provides evidence that individual operators have limited capabilities in controlling asymmetric axes of two dynamic systems. The results show that the two co-operators perform the maneuvering and mounting task faster than either bi- or uni-manual operators. Compared to co-operators, uni-manual operators required more control activity for the vertical crane and less for the robotic arm. In conclusion, this study suggests that when controlling two asymmetric slaves, a co-operating pair of operators performs better than a single operator.

Step-by-step training in basic laparoscopic skills using two-way web conferencing software for remote coaching: A multicenter randomized controlled study.

PubMed

Mizota, Tomoko; Kurashima, Yo; Poudel, Saseem; Watanabe, Yusuke; Shichinohe, Toshiaki; Hirano, Satoshi

2018-07-01

Despite its advantages, few trainees outside of North America have access to simulation training. We hypothesized that a stepwise training method using tele-mentoring system would be an efficient technique for training in basic laparoscopic skills. Residents were randomized into two groups and trained to proficiency in intracorporeal suturing. The stepwise group (SG) practiced the task step-by-step, while the other group practiced comprehensively (CG). Each participant received weekly coaching via two-way web conferencing software. The duration of the coaching sessions and self-practice time were compared between the two groups. Twenty residents from 15 institutions participated, and all achieved proficiency. Coaching sessions using tele-mentoring system were completed without difficulties. The SG required significantly shorter coaching time per session than the CG (p = .002). There was no significant difference in self-practice time. The stepwise training method with the tele-mentoring system appears to make efficient use of surgical trainees' and trainers' time. Copyright © 2017 Elsevier Inc. All rights reserved.

Multi-arm multilateral haptics-based immersive tele-robotic system (HITS) for improvised explosive device disposal

NASA Astrophysics Data System (ADS)

Erickson, David; Lacheray, Hervé; Lai, Gilbert; Haddadi, Amir

2014-06-01

This paper presents the latest advancements of the Haptics-based Immersive Tele-robotic System (HITS) project, a next generation Improvised Explosive Device (IED) disposal (IEDD) robotic interface containing an immersive telepresence environment for a remotely-controlled three-articulated-robotic-arm system. While the haptic feedback enhances the operator's perception of the remote environment, a third teleoperated dexterous arm, equipped with multiple vision sensors and cameras, provides stereo vision with proper visual cues, and a 3D photo-realistic model of the potential IED. This decentralized system combines various capabilities including stable and scaled motion, singularity avoidance, cross-coupled hybrid control, active collision detection and avoidance, compliance control and constrained motion to provide a safe and intuitive control environment for the operators. Experimental results and validation of the current system are presented through various essential IEDD tasks. This project demonstrates that a two-armed anthropomorphic Explosive Ordnance Disposal (EOD) robot interface can achieve complex neutralization techniques against realistic IEDs without the operator approaching at any time.

Real-time 3D video compression for tele-immersive environments

NASA Astrophysics Data System (ADS)

Yang, Zhenyu; Cui, Yi; Anwar, Zahid; Bocchino, Robert; Kiyanclar, Nadir; Nahrstedt, Klara; Campbell, Roy H.; Yurcik, William

2006-01-01

Tele-immersive systems can improve productivity and aid communication by allowing distributed parties to exchange information via a shared immersive experience. The TEEVE research project at the University of Illinois at Urbana-Champaign and the University of California at Berkeley seeks to foster the development and use of tele-immersive environments by a holistic integration of existing components that capture, transmit, and render three-dimensional (3D) scenes in real time to convey a sense of immersive space. However, the transmission of 3D video poses significant challenges. First, it is bandwidth-intensive, as it requires the transmission of multiple large-volume 3D video streams. Second, existing schemes for 2D color video compression such as MPEG, JPEG, and H.263 cannot be applied directly because the 3D video data contains depth as well as color information. Our goal is to explore from a different angle of the 3D compression space with factors including complexity, compression ratio, quality, and real-time performance. To investigate these trade-offs, we present and evaluate two simple 3D compression schemes. For the first scheme, we use color reduction to compress the color information, which we then compress along with the depth information using zlib. For the second scheme, we use motion JPEG to compress the color information and run-length encoding followed by Huffman coding to compress the depth information. We apply both schemes to 3D videos captured from a real tele-immersive environment. Our experimental results show that: (1) the compressed data preserves enough information to communicate the 3D images effectively (min. PSNR > 40) and (2) even without inter-frame motion estimation, very high compression ratios (avg. > 15) are achievable at speeds sufficient to allow real-time communication (avg. ~ 13 ms per 3D video frame).

Exploring physical activity behaviour - needs for and interest in a technology-delivered, home-based exercise programme among patients with intermittent claudication.

PubMed

Cornelis, Nils; Buys, Roselien; Fourneau, Inge; Dewit, Tijl; Cornelissen, Véronique

2018-02-01

Supervised walking is a first line therapy in peripheral arterial disease (PAD) with complaints of intermittent claudication. However, uptake of supervised programmes is low. Home-based exercise seems an appealing alternative; especially since technological advances, such as tele-coaching and tele-monitoring, may facilitate the process and support patients when adopting a physically active lifestyle. To guide the development of such an intervention, it is important to identify barriers of physical activity and the needs and interests for technology-enabled exercise in this patient group. PAD patients were recruited at the vascular centre of UZ Leuven (Belgium). A questionnaire assessing PA (SF-International Physical Activity Questionnaire), barriers to PA, and interest in technology-supported exercise (Technology Usage Questionnaire) was completed. Descriptive and correlation analyses were performed. Ninety-nine patients (76 men; mean age 69 years) completed the survey. Physical activity levels were low in 48 %, moderate in 29 %, and high in 23 %. Intermittent claudication itself is the most important barrier for enhanced PA, with most patients reporting pain (93 %), need for rest (92 %), and obstacles worsening their pain (74 %) as barriers. A total of 93 % participants owned a mobile phone; 76 % had Internet access. Eighty-seven reported the need for an exercise programme, with 67 % showing interest in tele-coaching to support exercise. If technology was available, three-quarter stated they would be interested in home-based tele-coaching using the Internet (preferably e-mails, 86 %); 50 % via mobile phone, 87 % preferred text messages. Both were inversely related to age (rpb = 0.363 and rpb = 0.255, p < 0.05). Acquaintance with elastic bands or gaming platforms was moderate (55 and 49 %, respectively), but patients were interested in using them as alternatives (84 and 42 %). Interest in platforms was age-dependent (rs = -0.508, p < 0.01). PAD patients show significant interest in technology-delivered exercise, offering opportunities to develop a guided home-based exercise programme.

A Business Case for Tele-Intensive Care Units

PubMed Central

Coustasse, Alberto; Deslich, Stacie; Bailey, Deanna; Hairston, Alesia; Paul, David

2014-01-01

Objectives: A tele-intensive care unit (tele-ICU) uses telemedicine in an intensive care unit (ICU) setting, applying technology to provide care to critically ill patients by off-site clinical resources. The purpose of this review was to examine the implementation, adoption, and utilization of tele-ICU systems by hospitals to determine their efficiency and efficacy as identified by cost savings and patient outcomes. Methods: This literature review examined a large number of studies of implementation of tele-ICU systems in hospitals. Results: The evidence supporting cost savings was mixed. Implementation of a tele-ICU system was associated with cost savings, shorter lengths of stay, and decreased mortality. However, two studies suggested increased hospital cost after implementation of tele-ICUs is initially expensive but eventually results in cost savings and better clinical outcomes. Conclusions: Intensivists working these systems are able to more effectively treat ICU patients, providing better clinical outcomes for patients at lower costs compared with hospitals without a tele-ICU. PMID:25662529

Telemedicine in Gastroenterohepatology

PubMed Central

Zildzic, Muharem; Salihefendic, Nizama; Krupic, Ferid; Beganovic, Emina; Zunic, Lejla; Masic, Izet

2014-01-01

Telemedicine itself is not the medical profession, it is not a medical specialty, but the way in which the medical profession conduct its activity. Therefore we are talking about tele otorhinolaryngology, tele cardiology or tele pathology. In the definition of a multitude of telemedicine that can be found in the literature is the following: Telemedicine is a system that supports the process of health care by providing ways and means for more efficient exchange of information that allows multitude of activities related to health care, including health care and health personnel, including education, administration and treatment. Telemedicine applications include tele diagnosis, tele consultation, tele monitoring, tele-care, tele consultations and remote access to information contained in one or more databases. It turned out that telemedicine is an important factor in technological, professional, financial and organizational uniformity of development of the health system. Telemedicine, although a new area, to a large extent already changed the ways of providing health care, and even more influence on the ways of designing the future of medicine. PMID:25395732

Development, Implementation, and Evaluation of a Telemedicine Service for the Treatment of Acute Stroke Patients: TeleStroke

PubMed Central

2012-01-01

Background Health care service based on telemedicine can reduce both physical and time barriers in stroke treatments. Moreover, this service connects centers specializing in stroke treatment with other centers and practitioners, thereby increasing accessibility to neurological specialist care and fibrinolytic treatment. Objective Development, implementation, and evaluation of a care service for the treatment of acute stroke patients based on telemedicine (TeleStroke) at Virgen del Rocío University Hospital. Methods The evaluation phase, conducted from October 2008 to January 2011, involved patients who presented acute stroke symptoms confirmed by the emergency physician; they were examined using TeleStroke in two hospitals, at a distance of 16 and 110 kilometers from Virgen del Rocío University Hospital. We analyzed the number of interconsultation sheets, the percentage of patients treated with fibrinolysis, and the number of times they were treated. To evaluate medical professionals’ acceptance of the TeleStroke system, we developed a web-based questionnaire using a Technology Acceptance Model. Results A total of 28 patients were evaluated through the interconsultation sheet. Out of 28 patients, 19 (68%) received fibrinolytic treatment. The most common reasons for not treating with fibrinolysis included: clinical criteria in six out of nine patients (66%) and beyond the time window in three out of nine patients (33%). The mean “onset-to-hospital” time was 69 minutes, the mean time from admission to CT image was 33 minutes, the mean “door-to-needle” time was 82 minutes, and the mean “onset-to-needle” time was 150 minutes. Out of 61 medical professionals, 34 (56%) completed a questionnaire to evaluate the acceptability of the TeleStroke system. The mean values for each item were over 6.50, indicating that respondents positively evaluated each item. This survey was assessed using the Cronbach alpha test to determine the reliability of the questionnaire and the results obtained, giving a value of 0.97. Conclusions The implementation of TeleStroke has made it possible for patients in the acute phase of stroke to receive effective treatment, something that was previously impossible because of the time required to transfer them to referral hospitals. PMID:23612154

Measuring tele-ICU impact: does it optimize quality outcomes for the critically ill patient?

PubMed

Goran, Susan F

2012-04-01

To determine the relationship between tele-ICU (intensive care unit) implementations and improvement in quality measures and patient outcomes. Tele-ICUs were designed to leverage scarce critical-care experts and promised to improve patient quality. Abstracts and peer-reviewed articles were reviewed to identify the associations between tele-ICU programmes and clinical outcomes, cost savings, and customer satisfaction. Few peer-reviewed studies are available and many variables in each study limit the ability to associate study conclusions to the overall tele-ICU programme. Further research is required to explore the impact of the tele-ICU on patient/family satisfaction. Research findings are highly dependent upon the level of ICU acceptance. The tele-ICU, in collaboration with the ICU team, can be a valuable tool for the enhancement of quality goals although the ability to demonstrate cost savings is extremely complex. Studies clearly indicate that tele-ICU nursing vigilance can enhance patient safety by preventing potential patient harm. Nursing managers and leaders play a vital part in optimizing the quality role of the tele-ICU through supportive modelling and the maximization of ICU integration. © 2012 Blackwell Publishing Ltd.

Virtual and remote robotic laboratory using EJS, MATLAB and LabVIEW.

PubMed

Chaos, Dictino; Chacón, Jesús; Lopez-Orozco, Jose Antonio; Dormido, Sebastián

2013-02-21

This paper describes the design and implementation of a virtual and remote laboratory based on Easy Java Simulations (EJS) and LabVIEW. The main application of this laboratory is to improve the study of sensors in Mobile Robotics, dealing with the problems that arise on the real world experiments. This laboratory allows the user to work from their homes, tele-operating a real robot that takes measurements from its sensors in order to obtain a map of its environment. In addition, the application allows interacting with a robot simulation (virtual laboratory) or with a real robot (remote laboratory), with the same simple and intuitive graphical user interface in EJS. Thus, students can develop signal processing and control algorithms for the robot in simulation and then deploy them on the real robot for testing purposes. Practical examples of application of the laboratory on the inter-University Master of Systems Engineering and Automatic Control are presented.

Virtual and Remote Robotic Laboratory Using EJS, MATLAB and Lab VIEW

PubMed Central

Chaos, Dictino; Chacón, Jesús; Lopez-Orozco, Jose Antonio; Dormido, Sebastián

2013-01-01

This paper describes the design and implementation of a virtual and remote laboratory based on Easy Java Simulations (EJS) and LabVIEW. The main application of this laboratory is to improve the study of sensors in Mobile Robotics, dealing with the problems that arise on the real world experiments. This laboratory allows the user to work from their homes, tele-operating a real robot that takes measurements from its sensors in order to obtain a map of its environment. In addition, the application allows interacting with a robot simulation (virtual laboratory) or with a real robot (remote laboratory), with the same simple and intuitive graphical user interface in EJS. Thus, students can develop signal processing and control algorithms for the robot in simulation and then deploy them on the real robot for testing purposes. Practical examples of application of the laboratory on the inter-University Master of Systems Engineering and Automatic Control are presented. PMID:23429578

Current Directions in Videoconferencing Tele-Mental Health Research

PubMed Central

Richardson, Lisa K.; Frueh, B. Christopher; Grubaugh, Anouk L.; Egede, Leonard; Elhai, Jon D.

2009-01-01

The provision of mental health services via videoconferencing tele-mental health has become an increasingly routine component of mental health service delivery throughout the world. Emphasizing the research literature since 2003, we examine: 1) the extent to which the field of tele-mental health has advanced the research agenda previously suggested; and 2) implications for tele-mental health care delivery for special clinical populations. Previous findings have demonstrated that tele-mental health services are satisfactory to patients, improve outcomes, and are probably cost effective. In the very small number of randomized controlled studies that have been conducted to date, tele-mental health has demonstrated equivalent efficacy compared to face-to-face care in a variety of clinical settings and with specific patient populations. However, methodologically flawed or limited research studies are the norm, and thus the research agenda for tele-mental health has not been fully maximized. Implications for future research and practice are discussed. PMID:20161010

A software communication tool for the tele-ICU.

PubMed

Pimintel, Denise M; Wei, Shang Heng; Odor, Alberto

2013-01-01

The Tele Intensive Care Unit (tele-ICU) supports a high volume, high acuity population of patients. There is a high-volume of incoming and outgoing calls, especially during the evening and night hours, through the tele-ICU hubs. The tele-ICU clinicians must be able to communicate effectively to team members in order to support the care of complex and critically ill patients while supporting and maintaining a standard to improve time to intervention. This study describes a software communication tool that will improve the time to intervention, over the paper-driven communication format presently used in the tele-ICU. The software provides a multi-relational database of message instances to mine information for evaluation and quality improvement for all entities that touch the tele-ICU. The software design incorporates years of critical care and software design experience combined with new skills acquired in an applied Health Informatics program. This software tool will function in the tele-ICU environment and perform as a front-end application that gathers, routes, and displays internal communication messages for intervention by priority and provider.

Arizona TeleMedicine Network: System Procurement Specifications, Phase 1.

ERIC Educational Resources Information Center

Atlantic Research Corp., Alexandria, VA.

Defining the system procurement specifications for a telecommunications system designed to provide health services to rurally isolated American Indians living on reservations in Arizona, this document presents detailed specifications for: (1) a complete communications facility; (2) a mobile health communications treatment and diagnosis unit; (3)…

Design and experimental validation of a simple controller for a multi-segment magnetic crawler robot

NASA Astrophysics Data System (ADS)

Kelley, Leah; Ostovari, Saam; Burmeister, Aaron B.; Talke, Kurt A.; Pezeshkian, Narek; Rahimi, Amin; Hart, Abraham B.; Nguyen, Hoa G.

2015-05-01

A novel, multi-segmented magnetic crawler robot has been designed for ship hull inspection. In its simplest version, passive linkages that provide two degrees of relative motion connect front and rear driving modules, so the robot can twist and turn. This permits its navigation over surface discontinuities while maintaining its adhesion to the hull. During operation, the magnetic crawler receives forward and turning velocity commands from either a tele-operator or high-level, autonomous control computer. A low-level, embedded microcomputer handles the commands to the driving motors. This paper presents the development of a simple, low-level, leader-follower controller that permits the rear module to follow the front module. The kinematics and dynamics of the two-module magnetic crawler robot are described. The robot's geometry, kinematic constraints and the user-commanded velocities are used to calculate the desired instantaneous center of rotation and the corresponding central-linkage angle necessary for the back module to follow the front module when turning. The commands to the rear driving motors are determined by applying PID control on the error between the desired and measured linkage angle position. The controller is designed and tested using Matlab Simulink. It is then implemented and tested on an early two-module magnetic crawler prototype robot. Results of the simulations and experimental validation of the controller design are presented.

COSTS AND COST-EFFECTIVENESS OF A TELE-ICU PROGRAM IN SIX INTENSIVE CARE UNITS IN A LARGE HEALTHCARE SYSTEM

PubMed Central

Franzini, Luisa; Sail, Kavita R.; Thomas, Eric J; Wueste, Laura

2011-01-01

Purpose To estimate the costs and cost-effectiveness of a tele-ICU program. Materials and methods We used an observational study with ICU patients cared for during the pre-tele-ICU period and ICU patients cared for during the post-tele-ICU period in 6 ICUs at 5 hospitals, part of a large non-profit health care system in the Gulf Coast region. We obtained data on a sample of 4142 ICU patients: 2,034 in the pre-tele-ICU period and 2,108 in the post-tele-ICU period. Economic outcomes were hospital costs, ICU costs and floor costs, measured for average daily costs, costs per case, and costs per patient. Results After the implementation of the tele-ICU, the hospital daily cost increased from $4,302 to $5,340 (24%), the hospital cost per case from $21,967 to $31,318 (43%), and the cost per patient from $20,231 to $25,846 (28%). While the tele-ICU intervention was not cost effective in patients with SAPS II ≤ 50, it was cost effective in the sickest patients with SAPS II > 50 (17% of patients) as it decreased hospital mortality without increasing costs significantly. Conclusions Hospital administrators may conclude that a tele-ICU program aimed at the sickest patients is cost effective. PMID:21376515

75 FR 69470 - Tele Atlas North America, Inc., Currently Doing Business as Tom Tom Including Off-Site Workers...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-12

...,839B; TA-W-70,839C] Tele Atlas North America, Inc., Currently Doing Business as Tom Tom Including Off... Business as Tom Tom, Concord, MA; Tele Atlas North America, Inc. Currently Doing Business as Tom Tom, Detroit, MI; Tele Atlas North America, Inc. Currently Doing Business as Tom Tom, Redwood, CA; Amended...

A novel tele-medical environment appropriate for use in tele-advisory and tele-surgery cases.

PubMed

Chatzipapadopoulos, F; Georgantas, N; Kotaras, A; Mamais, G; Tombros, S; Tselikis, G

1996-08-01

Tele-medical systems have been recently introduced in the field of networking as promising applications that can significantly improve the offering of medical treatment by providing services such as tele-advising, tele-surgery and remote monitoring in places where the presence of doctors or any medical specialists is difficult or time consuming. Some already existent networking models can be used for the establishment of a connection between the communicating sides. The offered network's security is also a significant factor. The present paper describes a software environment implementing a particular aspect of a tele-medical system. The developed system includes features such as direct communication between doctors and medical assistants, medical information acquisition and storing and high band information transfer in real-time. TCP/IP point-to-point protocol has been used for the implementation of the non bandwidth-critical connections. The application introduces novel features with the use of ATM connection for supporting the time-critical service of video transfer to and from the medical database.

Lessons from tele-emergency: improving care quality and health outcomes by expanding support for rural care systems.

PubMed

Mueller, Keith J; Potter, Andrew J; MacKinney, A Clinton; Ward, Marcia M

2014-02-01

Tele-emergency services provide immediate and synchronous audio/video connections, most commonly between rural low-volume hospitals and an urban "hub" emergency department. We performed a systematic literature review to identify tele-emergency models and outcomes. We then studied a large tele-emergency service in the upper Midwest. We sent a user survey to all seventy-one hospitals that used the service and received 292 replies. We also conducted telephone interviews and site visits with ninety clinicians and administrators at twenty-nine of these hospitals. Participants reported that tele-emergency improves clinical quality, expands the care team, increases resources during critical events, shortens time to care, improves care coordination, promotes patient-centered care, improves the recruitment of family physicians, and stabilizes the rural hospital patient base. However, inconsistent reimbursement policy, cross-state licensing barriers, and other regulations hinder tele-emergency implementation. New value-based payment systems have the potential to reduce these barriers and accelerate tele-emergency expansion.

Army Operations in China. January 1944 - August 1945

DTIC Science & Technology

1956-08-31

in early or mid-A- agust . 172 Places to be Occupied: Vital coastal zones near Yungchia and Fuchou. Part of tha force will reinforce Esiamen.2...una.er e coErna.no. O.i. -u .. 1e l\\aVa.i. .Lanct:Lng ·orce comt .’la.noer. - 6. The description of these operations was obtained from tele- grams in the

The AMADEE-15 Mars simulation

NASA Astrophysics Data System (ADS)

Groemer, Gernot; Losiak, Anna; Soucek, Alexander; Plank, Clemens; Zanardini, Laura; Sejkora, Nina; Sams, Sebastian

2016-12-01

We report on the AMADEE-15 mission, a 12-day Mars analog field test at the Kaunertal Glacier in Austria. Eleven experiments were conducted by a field crew at the test site under simulated martian surface exploration conditions and coordinated by a Mission Support Center in Innsbruck, Austria. The experiments' research fields encompassed geology, human factors, astrobiology, robotics, tele-science, exploration, and operations research. A Remote Science Support team analyzed field data in near real time, providing planning input for a flight control team to manage a complex system of field assets in a realistic work flow, including: two advanced space suit simulators; and four robotic and aerial vehicles. Field operations were supported by a dedicated flight planning group, an external control center tele-operating the PULI-rover, and a medical team. A 10-min satellite communication delay and other limitations pertinent to human planetary surface activities were introduced. This paper provides an overview of the geological context and environmental conditions of the test site and the mission architecture, with a focus on the mission's communication infrastructure. We report on the operational workflows and the experiments conducted, as well as a novel approach of measuring mission success through the introduction of general analog mission transferrable performance indicators.

BioDAQ--a simple biosignal acquisition system for didactic use.

PubMed

Csaky, Z; Mihalas, G I; Focsa, M

2002-01-01

A simple non expensive device for biosignal acquisition is presented. It mainly meets the requirements for didactic purposes specific in medical informatics laboratory classes. The system has two main types of devices: 'student unit'--the simplest one, used during lessons on real signals and 'demo unit', which can be also used in medical practice or for collecting biological signals. It is able to record: optical pulse, sphygmogram, ECG (1-4 leads) EEG or EMG (1-4 channels). For didactical purposes it has a large scale of recording options: variable sampling rate, gain and filtering. It can also be used in tele-acquisition via Internet.

Usability of digital media in patients with COPD: a pilot study.

PubMed

Cheung, Amy; Janssen, Anton; Amft, Oliver; Wouters, Emiel F M; Spruit, Martijn A

2013-04-01

Digital media can be integrated in tele-monitoring solutions, serving as the main interface between the patient and the caregiver. Consequently, the selection of the most appropriate digital medium for the specified target group is critical to ensure compliance with the tele-monitoring system. This pilot study aims to gather insights from patients with chronic obstructive pulmonary disease (COPD) on the ease-of-use, efficacy, effectiveness, and satisfaction of different types of digital media. Five off-the-shelf digital media devices were tested on nine patients at CIRO+ in Horn, The Netherlands. Usability was evaluated by asking patients to use each device to answer questions related to their symptoms and health status. Subsequently, patients completed a paper-based device usability questionnaire, which assessed prior experience with digital media, device dimensions, device controllability, response speed, screen readability, ease-of-use, and overall satisfaction. After testing all the devices, patients ranked the devices according to their preference. We identified the netbook as the preferred type of device due to its good controllability, fast response time, and large screen size. The smartphone was the least favorite device as patients found the size of the screen to be too small, which made it difficult to interact with. The pilot study has provided important insights to guide the selection of the most appropriate type of digital medium for implementation in tele-monitoring solutions for patients with COPD. As the digital medium is an important interface to the patient in tele-monitoring solutions, it is essential that patients feel motivated to interact with the digital medium on a regular basis.

Auto TeleCare -- understanding the failures and successes of small business in telehealth.

PubMed

McMahon, David

2005-01-01

Auto TeleCare provided an automatic daily telephone service for people living alone. The business used an interactive voice response (IVR) system to call clients at a set time each day. The clients were required to press a button on their telephone to listen to a message (e.g. joke of the day), thereby indicating that they were alright. If the client did not respond, staff would call the given list of contacts to check on the client's welfare. The service was first offered in December 2003 and there was a lot of interest from clients and health-care groups. Although the technology was sophisticated, it was very simple for the clients to use. However, it was the marketing and advertising costs of the business that in the end proved to be too costly. The number of clients required for commercial viability was calculated to be 3,000, and after nearly 15 months of business it was decided to close the business.

Design and Field Test of a Mass Efficient Crane for Lunar Payload Handling and Inspection: The Lunar Surface Manipulation System

NASA Technical Reports Server (NTRS)

Doggett, William R.; King, Bruce D.; Jones, Thomas Carno; Dorsey, John T.; Mikulas, Martin M.

2008-01-01

Devices for lifting, translating and precisely placing payloads are critical for efficient Earthbased construction operations. Both recent and past studies have demonstrated that devices with similar functionality will be needed to support lunar outpost operations. Lunar payloads include: a) prepackaged hardware and supplies which must be unloaded from landers and then accurately located at their operational site, b) sensor packages used for periodic inspection of landers, habitat surfaces, etc., and c) local materials such as regolith which require grading, excavation and placement. Although several designs have been developed for Earth based applications, these devices lack unique design characteristics necessary for transport to and use on the harsh lunar surface. These design characteristics include: a) composite components, b) compact packaging for launch, c) simple in-field reconfiguration and repair, and d) support for tele-operated or automated operations. Also, in contrast to Earth-based construction, where special purpose devices dominate a construction site, a lunar outpost will require versatile devices which provide operational benefit from initial construction through sustained operations. This paper will detail the design of a unique, high performance, versatile lifting device designed for operations on the lunar surface. The device is called the Lunar Surface Manipulation System to highlight the versatile nature of the device which supports conventional cable suspended crane operations as well as operations usually associated with a manipulator such as precise positioning where the payload is rigidly grappled by a tool attached to the tip of the device. A first generation test-bed to verify design methods and operational procedures is under development at the NASA Langley Research Center and recently completed field tests at Moses Lake Washington. The design relied on non-linear finite element analysis which is shown to correlate favorably with laboratory experiments. A key design objective, reviewed in this paper, is the device s simplicity, resulting from a focus on the minimum set of functions necessary to perform payload offload. Further development of the device has the potential for significant mass savings, with a high performance device incorporating composite elements estimated to have a mass less than 3% of the mass of the maximum lunar payload lifted at the tip. The paper will conclude with future plans for expanding the operational versatility of the device.

Tele-operated search robot for human detection using histogram of oriented objects

NASA Astrophysics Data System (ADS)

Cruz, Febus Reidj G.; Avendaño, Glenn O.; Manlises, Cyrel O.; Avellanosa, James Jason G.; Abina, Jyacinth Camille F.; Masaquel, Albert M.; Siapno, Michael Lance O.; Chung, Wen-Yaw

2017-02-01

Disasters such as typhoons, tornadoes, and earthquakes are inevitable. Aftermaths of these disasters include the missing people. Using robots with human detection capabilities to locate the missing people, can dramatically reduce the harm and risk to those who work in such circumstances. This study aims to: design and build a tele-operated robot; implement in MATLAB an algorithm for the detection of humans; and create a database of human identification based on various positions, angles, light intensity, as well as distances from which humans will be identified. Different light intensities were made by using Photoshop to simulate smoke, dust and water drops conditions. After processing the image, the system can indicate either a human is detected or not detected. Testing with bodies covered was also conducted to test the algorithm's robustness. Based on the results, the algorithm can detect humans with full body shown. For upright and lying positions, detection can happen from 8 feet to 20 feet. For sitting position, detection can happen from 2 feet to 20 feet with slight variances in results because of different lighting conditions. The distances greater than 20 feet, no humans can be processed or false negatives can occur. For bodies covered, the algorithm can detect humans in cases made under given circumstances. On three positions, humans can be detected from 0 degrees to 180 degrees under normal, with smoke, with dust, and with water droplet conditions. This study was able to design and build a tele-operated robot with MATLAB algorithm that can detect humans with an overall precision of 88.30%, from which a database was created for human identification based on various conditions, where humans will be identified.

Improving Recapitalization Planning: Toward a Fleet Management Model for the High-Mobility Multipurpose Wheeled Vehicle

DTIC Science & Technology

2008-01-01

Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding...Planning: Toward a Fleet Management Model for the HMMWV For more information on RAND Arroyo Center, contact the Director of Operations (tele- phone 310-393...may benefit from additional information about the relationships between Army vehicle ages and operating costs and the practical implications of those

Construction of a high-tech operating room for image-guided surgery using VR.

PubMed

Suzuki, Naoki; Hattori, Asaki; Suzuki, Shigeyuki; Otake, Yoshito; Hayashibe, Mitsuhiro; Kobayashi, Susumu; Nezu, Takehiko; Sakai, Haruo; Umezawa, Yuji

2005-01-01

This project aimed to construct an operating room to implement high dimensional (3D, 4D) medical imaging and medical virtual reality techniques that would enable clinical tests for new surgical procedures. We designed and constructed such an operating room at Dai-san Hospital, the Jikei Univ. School of Medicine, Tokyo, Japan. The room was equipped with various facilities for image-guided, robot and tele- surgery. In this report, we describe an outline of our "high-tech operating room" and future plans.

TEJAS - TELEROBOTICS/EVA JOINT ANALYSIS SYSTEM VERSION 1.0

NASA Technical Reports Server (NTRS)

Drews, M. L.

1994-01-01

The primary objective of space telerobotics as a research discipline is the augmentation and/or support of extravehicular activity (EVA) with telerobotic activity; this allows increased emplacement of on-orbit assets while providing for their "in situ" management. Development of the requisite telerobot work system requires a well-understood correspondence between EVA and telerobotics that to date has been only partially established. The Telerobotics/EVA Joint Analysis Systems (TEJAS) hypermedia information system uses object-oriented programming to bridge the gap between crew-EVA and telerobotics activities. TEJAS Version 1.0 contains twenty HyperCard stacks that use a visual, customizable interface of icon buttons, pop-up menus, and relational commands to store, link, and standardize related information about the primitives, technologies, tasks, assumptions, and open issues involved in space telerobot or crew EVA tasks. These stacks are meant to be interactive and can be used with any database system running on a Macintosh, including spreadsheets, relational databases, word-processed documents, and hypermedia utilities. The software provides a means for managing volumes of data and for communicating complex ideas, relationships, and processes inherent to task planning. The stack system contains 3MB of data and utilities to aid referencing, discussion, communication, and analysis within the EVA and telerobotics communities. The six baseline analysis stacks (EVATasks, EVAAssume, EVAIssues, TeleTasks, TeleAssume, and TeleIssues) work interactively to manage and relate basic information which you enter about the crew-EVA and telerobot tasks you wish to analyze in depth. Analysis stacks draw on information in the Reference stacks as part of a rapid point-and-click utility for building scripts of specific task primitives or for any EVA or telerobotics task. Any or all of these stacks can be completely incorporated within other hypermedia applications, or they can be referenced as is, without requiring data to be transferred into any other database. TEJAS is simple to use and requires no formal training. Some knowledge of HyperCard is helpful, but not essential. All Help cards printed in the TEJAS User's Guide are part of the TEJAS Help Stack and are available from a pop-up menu any time you are using TEJAS. Specific stacks created in TEJAS can be exchanged between groups, divisions, companies, or centers for complete communication of fundamental information that forms the basis for further analyses. TEJAS runs on any Apple Macintosh personal computer with at least one megabyte of RAM, a hard disk, and HyperCard 1.21, or later version. TEJAS is a copyrighted work with all copyright vested in NASA. HyperCard and Macintosh are registered trademarks of Apple Computer, Inc.

Validation of DPOAE screening conducted by village health workers in a rural community with real-time click evoked tele-auditory brainstem response.

PubMed

Ramkumar, Vidya; Vanaja, C S; Hall, James W; Selvakumar, K; Nagarajan, Roopa

2018-05-01

This study assessed the validity of DPOAE screening conducted by village health workers (VHWs) in a rural community. Real-time click evoked tele-auditory brainstem response (tele-ABR) was used as the gold standard to establish validity. A cross-sectional design was utilised to compare the results of screening by VHWs to those obtained via tele-ABR. Study samples: One hundred and nineteen subjects (0 to 5 years) were selected randomly from a sample of 2880 infants and young children who received DPOAE screening by VHWs. Real time tele-ABR was conducted by using satellite or broadband internet connectivity at the village. An audiologist located at the tertiary care hospital conducted tele-ABR testing through a remote computing paradigm. Tele-ABR was recorded using standard recording parameters recommended for infants and young children. Wave morphology, repeatability and peak latency data were used for ABR analysis. Tele-ABR and DPOAE findings were compared for 197 ears. The sensitivity of DPOAE screening conducted by the VHW was 75%, and specificity was 91%. The negative and positive predictive values were 98.8% and 27.2%, respectively. The validity of DPOAE screening conducted by trained VHW was acceptable. This study supports the engagement of grass-root workers in community-based hearing health care provision.

Implementation of system intelligence in a 3-tier telemedicine/PACS hierarchical storage management system

NASA Astrophysics Data System (ADS)

Chao, Woodrew; Ho, Bruce K. T.; Chao, John T.; Sadri, Reza M.; Huang, Lu J.; Taira, Ricky K.

1995-05-01

Our tele-medicine/PACS archive system is based on a three-tier distributed hierarchical architecture, including magnetic disk farms, optical jukebox, and tape jukebox sub-systems. The hierarchical storage management (HSM) architecture, built around a low cost high performance platform [personal computers (PC) and Microsoft Windows NT], presents a very scaleable and distributed solution ideal for meeting the needs of client/server environments such as tele-medicine, tele-radiology, and PACS. These image based systems typically require storage capacities mirroring those of film based technology (multi-terabyte with 10+ years storage) and patient data retrieval times at near on-line performance as demanded by radiologists. With the scaleable architecture, storage requirements can be easily configured to meet the needs of the small clinic (multi-gigabyte) to those of a major hospital (multi-terabyte). The patient data retrieval performance requirement was achieved by employing system intelligence to manage migration and caching of archived data. Relevant information from HIS/RIS triggers prefetching of data whenever possible based on simple rules. System intelligence embedded in the migration manger allows the clustering of patient data onto a single tape during data migration from optical to tape medium. Clustering of patient data on the same tape eliminates multiple tape loading and associated seek time during patient data retrieval. Optimal tape performance can then be achieved by utilizing the tape drives high performance data streaming capabilities thereby reducing typical data retrieval delays associated with streaming tape devices.

Medical teleconferencing with high-definition video presentation on the 'usual' Internet.

PubMed

Obuchi, Toshiro; Shima, Hiroji; Iwasaki, Akinori

2013-06-01

Although medical teleconferences on advanced academic networks have been common (Telemed J E Health 15:112-117, 1; Asian J Endosc Surg 3:185-188, 2; Surg Today 41:1579-1581, 3; Telemedicine development center of Asia. http://www.aqua.med.kyushu-u.ac.jp/eg/index.html . Accessed 6 March 2013, 4), reports regarding 'usual' Internet teleconferences or tele-lectures employing a telecommunication system for business use are very rare. Medical teleconferences and tele-lectures on the Internet were held three times between our institutions and other institutions, using the 'HD Com' made by Panasonic (HD Com. http://panasonic.biz/com/visual/ . Accessed 6 March 2013, 5), which is a high-definition telecommunication system for business tele-meeting. All of our medical telecommunications were successfully completed without any troubles. This system allows for all kinds of presentations using personal computers to be made from each station, so that discussions with high-definition surgical video presentation, which has recently been developed, could be effortlessly established despite the distance between institutions. Unlike telecommunication using advanced academic networks, this system can run without any need for specific engineering support, on the usual Internet. Medical telecommunication employing this system is likely to become common among ordinary hospitals in the near future.

Exploring User Experience of a Telehealth System for the Danish TeleCare North Trial.

PubMed

Lilholt, Pernille Heyckendorff; Hæsum, Lisa Korsbakke Emtekær; Hejlesen, Ole Kristian

2015-01-01

The aim was to explore user experiences of using a telehealth system (Telekit) designed for the Danish TeleCare North trial. Telekit is designed for patients diagnosed with chronic obstructive pulmonary disease (COPD) in order to manage the disease and support patient empowerment. This article sums up COPD-participants' user experiences in terms of increased sense of freedom, of security, of control, and greater awareness of COPD symptoms. A consecutive sample of sixty participants (27 women, 33 men) were recruited from the TeleCare North trial. At home the participants completed a non-standardised questionnaire while a researcher was present. The questionnaire identified their health status, their use of specific technologies, and their user experiences with the telehealth system. Results from the questionnaire indicate that the majority of participants (88%) considered the Telekit system as easy to use. 43 (72%) participants felt increased sense of security, and 37 (62%) participants felt increased sense of control by using the system. 30 (50%) participants felt greater awareness of their COPD symptoms, but only 16 (27%) participants felt increased freedom. The study has provided a general picture of COPD participants' user experiences which is important to emphasise as it has a bearing on whether a given implementation will be successful or not.

Telehealth Problem-Solving Therapy for Depressed Low-Income Homebound Older Adults: Acceptance and Preliminary Efficacy

PubMed Central

Choi, Namkee G.; Hegel, Mark T.; Nathan Marti, C.; Mary Lynn Marinucci, M.S.S.W.; Leslie Sirrianni, M.S.S.W.; Bruce, Martha L.

2012-01-01

Objective To evaluate the acceptance and preliminary efficacy of in-home telehealth delivery of problem-solving therapy (tele-PST) among depressed low-income homebound older adults in a pilot randomized control trial (RCT) designed to test its feasibility and preliminary efficacy. Methods 121 homebound individuals who were age 50+ and scored 15+ on the 24-item Hamilton Rating Scale for Depression (HAMD) participated in the 3-arm RCT, comparing tele-PST to in-person PST and telephone support calls. Six sessions of the PST-PC (primary care) were conducted for the PST participants. For tele-PST, second through sixth sessions were conducted via Skype video call. Acceptance of tele-PST or in-person PST was measured with the 11-item, 7-point scale modified Treatment Evaluation Inventory (TEI). Mixed-effect regression analysis was used to examine the effects of treatment group, time, and the interaction term between treatment group and time on the HAMD scores. Results The TEI score was slightly higher among tele-PST participants than among in-person PST participants. The HAMD scores of tele-PST participants and in-person PST participants at 12-week follow-up were significantly lower than the HAMD scores of telephone support call participants, and the treatment effects were maintained at 24-week follow-up. The HAMD scores of tele-PST participants did not differ from those of in-person PST participants. Conclusions Despite their initial skepticism, almost all participants had extremely positive attitudes toward tele-PST at 12-week follow-up. Tele-PST also appears to be an efficacious treatment modality for depressed homebound older adults and to have significant potential to facilitate their access to treatment. PMID:23567376

Adaptive Tele-Therapies Based on Serious Games for Health for People with Time-Management and Organisational Problems: Preliminary Results

PubMed Central

Frutos-Pascual, Maite; García Zapirain, Begoña; Méndez Zorrilla, Amaia

2014-01-01

Attention Deficit with Hyperactivity Disorder (ADHD) is one of the most prevalent disorders within the child population today. Inattention problems can lead to greater difficulties in completing assignments, as well as problems with time management and prioritisation of tasks. This article presents an intelligent tele-therapy tool based on Serious Games for Health, aimed at the improvement of time management skills and the prioritisation of tasks. This tele-system is based on the use of decision trees within Django, a high-level Python Web framework. The technologies and techniques used were selected so as to boost user involvement and to enable the system to be easily customised. This article shows the preliminary results of the pilot-phase in an experiment performed to evaluate the use of adaptive tele-therapies within a group of typically developing children and adolescents aged between 12 and 19 years old without ADHD. To do so, we relied on the collection of parameters and the conduct of surveys for assessing time management skills, as well as measuring system usability and availability. The results of a time management survey highlighted that the users involved in the trial did not use any specific or effective time management techniques, scoring 1.98 and 2.30 out of 5 points in this area for ages under 15 and over 16 years old, respectively. The final calculations based on the usability questionnaire resulted in an average score of 78.75 out of 100. The creation of a customisable tool capable of working with different skills, in conjunction with the replication of the current study, may help to understand these users’ needs, as well as boosting time management skills among teenagers with and without ADHD. PMID:24402063

Adaptive tele-therapies based on serious games for health for people with time-management and organisational problems: preliminary results.

PubMed

Frutos-Pascual, Maite; Zapirain, Begoña García; Zorrilla, Amaia Méndez

2014-01-07

Attention Deficit with Hyperactivity Disorder (ADHD) is one of the most prevalent disorders within the child population today. Inattention problems can lead to greater difficulties in completing assignments, as well as problems with time management and prioritisation of tasks. This article presents an intelligent tele-therapy tool based on Serious Games for Health, aimed at the improvement of time management skills and the prioritisation of tasks. This tele-system is based on the use of decision trees within Django, a high-level Python Web framework. The technologies and techniques used were selected so as to boost user involvement and to enable the system to be easily customised. This article shows the preliminary results of the pilot-phase in an experiment performed to evaluate the use of adaptive tele-therapies within a group of typically developing children and adolescents aged between 12 and 19 years old without ADHD. To do so, we relied on the collection of parameters and the conduct of surveys for assessing time management skills, as well as measuring system usability and availability. The results of a time management survey highlighted that the users involved in the trial did not use any specific or effective time management techniques, scoring 1.98 and 2.30 out of 5 points in this area for ages under 15 and over 16 years old, respectively. The final calculations based on the usability questionnaire resulted in an average score of 78.75 out of 100. The creation of a customisable tool capable of working with different skills, in conjunction with the replication of the current study, may help to understand these users' needs, as well as boosting time management skills among teenagers with and without ADHD.

A pilot study of tele-anaesthesia by virtual private network between an island hospital and a mainland hospital in Japan.

PubMed

Miyashita, Tetsuya; Mizuno, Yusuke; Sugawara, Yo; Nagamine, Yusuka; Koyama, Yukihide; Miyazaki, Tomoyuki; Uchimoto, Kazuhiro; Iketani, Yasuhiro; Tojo, Kentaro; Goto, Takahisa

2015-03-01

We studied the use of tele-anaesthesia between Sado General Hospital (SGH) located on Sado Island and Yokohama City University Hospital (YCUH) located in mainland Japan. The two sites were connected via a virtual private network (VPN). We investigated the relationship between the bandwidth of the VPN and both the frame rate and the delay time of the tele-anaesthesia monitoring system. The tool used for communication between the two hospitals was free videoconferencing software (FaceTime), which can be used over Wi-Fi connections. We also investigated the accuracy of the commands given during teleanaesthesia: any commands from the anaesthetist at the YCUH that were not carried out for any reason, were recorded in the anaesthetic records at the SGH. The original frame rate and data rate at the SGH were 5 fps and approximately 18 Mbit/s, respectively. The frame rate at the transmission speeds of 1, 5 and 20 Mbit/s was 0.6, 1.6 and 5.0 fps, respectively. The corresponding delay time was 12.2, 4.9 and 0.7 s. Twenty-five adult patients were enrolled in the study and tele-anaesthesia was performed. The total duration of anaesthesia was 37 hours. All 888 anaesthetic commands were completed. There were 7 FaceTime disconnections, which lasted for 10 min altogether. Because no commands needed to be given during the FaceTime disconnection, the telephone was not used. The anaesthesia assistance system might form part of the solution to medical resource shortages. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

"Tele"working in Higher Education: What Managers Should Know "before" Developing Teleworking Policies

ERIC Educational Resources Information Center

Waters, Kristin Albright

2015-01-01

Over the last several decades, changes in the workplace within higher education has led to the notion of teleworking: the opportunity for employees to complete work in a remote location. This article will review the various concepts of teleworking, as well as the pros, cons, and implications for the work environment within higher education.

Deep Space Gateway Support of Lunar Surface Ops and Tele-Operational Transfer of Surface Assets to the Next Landing Site

NASA Astrophysics Data System (ADS)

Kring, D. A.

2018-02-01

The Deep Space Gateway can support astronauts on the lunar surface, providing them a departure and returning rendezvous point, a communication relay from the lunar farside to Earth, and a transfer point to Orion for return to Earth.

Tele-Presence: Bringing the Operator Back in the Loop

DTIC Science & Technology

2006-06-01

1998). Improved Camera - Monitor system for driving YPR-765 under armour (Report TM-98-A024). Soesterberg, The Netherlands: TNO Human Factors Research...Institute. [25] Van Erp, J.B.F., Padmos, P. (1997). Improving outside view when driving YPR-765 under armour (TM-97-A026). Soesterberg, The

A Dynamic Non Energy Storing Guidance Constraint with Motion Redirection for Robot Assisted Surgery

DTIC Science & Technology

2016-12-01

Abstract— Haptically enabled hands-on or tele-operated surgical robotic systems provide a unique opportunity to integrate pre- and intra... robot -assisted surgical systems aim at improving and extending human capabilities, by exploiting the advantages of robotic systems while keeping the...move during the operation. Robot -assisted beating heart surgery is an example of procedures that can benefit from dynamic constraints. Their

The MARS2013 Mars analog mission.

PubMed

Groemer, Gernot; Soucek, Alexander; Frischauf, Norbert; Stumptner, Willibald; Ragonig, Christoph; Sams, Sebastian; Bartenstein, Thomas; Häuplik-Meusburger, Sandra; Petrova, Polina; Evetts, Simon; Sivenesan, Chan; Bothe, Claudia; Boyd, Andrea; Dinkelaker, Aline; Dissertori, Markus; Fasching, David; Fischer, Monika; Föger, Daniel; Foresta, Luca; Fritsch, Lukas; Fuchs, Harald; Gautsch, Christoph; Gerard, Stephan; Goetzloff, Linda; Gołebiowska, Izabella; Gorur, Paavan; Groemer, Gerhard; Groll, Petra; Haider, Christian; Haider, Olivia; Hauth, Eva; Hauth, Stefan; Hettrich, Sebastian; Jais, Wolfgang; Jones, Natalie; Taj-Eddine, Kamal; Karl, Alexander; Kauerhoff, Tilo; Khan, Muhammad Shadab; Kjeldsen, Andreas; Klauck, Jan; Losiak, Anna; Luger, Markus; Luger, Thomas; Luger, Ulrich; McArthur, Jane; Moser, Linda; Neuner, Julia; Orgel, Csilla; Ori, Gian Gabriele; Paternesi, Roberta; Peschier, Jarno; Pfeil, Isabella; Prock, Silvia; Radinger, Josef; Ramirez, Barbara; Ramo, Wissam; Rampey, Mike; Sams, Arnold; Sams, Elisabeth; Sandu, Oana; Sans, Alejandra; Sansone, Petra; Scheer, Daniela; Schildhammer, Daniel; Scornet, Quentin; Sejkora, Nina; Stadler, Andrea; Stummer, Florian; Taraba, Michael; Tlustos, Reinhard; Toferer, Ernst; Turetschek, Thomas; Winter, Egon; Zanella-Kux, Katja

2014-05-01

We report on the MARS2013 mission, a 4-week Mars analog field test in the northern Sahara. Nineteen experiments were conducted by a field crew in Morocco under simulated martian surface exploration conditions, supervised by a Mission Support Center in Innsbruck, Austria. A Remote Science Support team analyzed field data in near real time, providing planning input for the management of a complex system of field assets; two advanced space suit simulators, four robotic vehicles, an emergency shelter, and a stationary sensor platform in a realistic work flow were coordinated by a Flight Control Team. A dedicated flight planning group, external control centers for rover tele-operations, and a biomedical monitoring team supported the field operations. A 10 min satellite communication delay and other limitations pertinent to human planetary surface activities were introduced. The fields of research for the experiments were geology, human factors, astrobiology, robotics, tele-science, exploration, and operations research. This paper provides an overview of the geological context and environmental conditions of the test site and the mission architecture, in particular the communication infrastructure emulating the signal travel time between Earth and Mars. We report on the operational work flows and the experiments conducted, including a deployable shelter prototype for multiple-day extravehicular activities and contingency situations.

Multi-unit Operations in Non-Nuclear Systems: Lessons Learned for Small Modular Reactors

DOE Office of Scientific and Technical Information (OSTI.GOV)

OHara J. M.; Higgins, J.; DAgostino, A.

2012-01-17

The nuclear-power community has reached the stage of proposing advanced reactor designs to support power generation for decades to come. Small modular reactors (SMRs) are one approach to meet these energy needs. While the power output of individual reactor modules is relatively small, they can be grouped to produce reactor sites with different outputs. Also, they can be designed to generate hydrogen, or to process heat. Many characteristics of SMRs are quite different from those of current plants and may be operated quite differently. One difference is that multiple units may be operated by a single crew (or a singlemore » operator) from one control room. The U.S. Nuclear Regulatory Commission (NRC) is examining the human factors engineering (HFE) aspects of SMRs to support licensing reviews. While we reviewed information on SMR designs to obtain information, the designs are not completed and all of the design and operational information is not yet available. Nor is there information on multi-unit operations as envisioned for SMRs available in operating experience. Thus, to gain a better understanding of multi-unit operations we sought the lesson learned from non-nuclear systems that have experience in multi-unit operations, specifically refineries, unmanned aerial vehicles and tele-intensive care units. In this paper we report the lessons learned from these systems and the implications for SMRs.« less

Learning in tele-autonomous systems using Soar

NASA Technical Reports Server (NTRS)

Laird, John E.; Yager, Eric S.; Tuck, Christopher M.; Hucka, Michael

1989-01-01

Robo-Soar is a high-level robot arm control system implemented in Soar. Robo-Soar learns to perform simple block manipulation tasks using advice from a human. Following learning, the system is able to perform similar tasks without external guidance. It can also learn to correct its knowledge, using its own problem solving in addition to outside guidance. Robo-Soar corrects its knowledge by accepting advice about relevance of features in its domain, using a unique integration of analytic and empirical learning techniques.

A comparison of foveated acquisition and tracking performance relative to uniform resolution approaches

NASA Astrophysics Data System (ADS)

Dubuque, Shaun; Coffman, Thayne; McCarley, Paul; Bovik, A. C.; Thomas, C. William

2009-05-01

Foveated imaging has been explored for compression and tele-presence, but gaps exist in the study of foveated imaging applied to acquisition and tracking systems. Results are presented from two sets of experiments comparing simple foveated and uniform resolution targeting (acquisition and tracking) algorithms. The first experiments measure acquisition performance when locating Gabor wavelet targets in noise, with fovea placement driven by a mutual information measure. The foveated approach is shown to have lower detection delay than a notional uniform resolution approach when using video that consumes equivalent bandwidth. The second experiments compare the accuracy of target position estimates from foveated and uniform resolution tracking algorithms. A technique is developed to select foveation parameters that minimize error in Kalman filter state estimates. Foveated tracking is shown to consistently outperform uniform resolution tracking on an abstract multiple target task when using video that consumes equivalent bandwidth. Performance is also compared to uniform resolution processing without bandwidth limitations. In both experiments, superior performance is achieved at a given bandwidth by foveated processing because limited resources are allocated intelligently to maximize operational performance. These findings indicate the potential for operational performance improvements over uniform resolution systems in both acquisition and tracking tasks.

How Can Health Information Technologies Contribute to Improve Health Care Services for High-Need Patients?

PubMed

Nøhr, Christian; Botin, Lars; Zhu, Xinxin

2017-01-01

This paper discusses how health information technologies like tele-care, tele-health and tele-medicine can improve the condition for high-need patients, specifically in relation to access. The paper addresses specifically the values of timeliness and equity and how tele technological solutions can support and enhance these values. The paper introduces to the concept of scaffolding, which constitutes the framework for dynamic, appropriate, caring and embracing approaches for engaging and involving high-need patients that are vulnerable and exposed. A number of specific considerations for designing tele-technologies for high-need patients are derived, and the paper concludes that ethical and epistemological criterions for design are needed in order to meet the needs and requirements of the weak and exposed.

Barriers and Facilitators for Sustainability of Tele-Homecare Programs: A Systematic Review.

PubMed

Radhakrishnan, Kavita; Xie, Bo; Berkley, Amy; Kim, Miyong

2016-02-01

To identify the barriers and facilitators for sustainability of tele-homecare programs implemented by home health nursing agencies for chronic disease management. English-language articles on home telehealth in the CINAHL, PubMed/MEDLINE, PsychInfo, Web of Science, and Cochrane Reviews databases published from January 1996 to December 2013. We performed a systematic literature review. Data extraction using PRISMA guidelines and quality appraisal using the Mixed Methods Appraisal Tool (MMAT) were conducted on relevant empirical studies. Thematic analysis across the studies and narrative summaries were used to synthesize the findings from the included studies. Of the initial 3,920 citations, we identified 16 articles of moderate quality meeting our inclusion criteria. Perceptions on effectiveness of tele-homecare programs for achieving intended outcomes; tailoring of tele-homecare programs to patient characteristics and needs; relationship and communication between patient, nurse, and other health care professional users of tele-homecare; home health organizational process and culture; and technology quality, capability, and usability impacted the sustainability of tele-homecare programs. The findings of this systematic review provide implications for sustained usage of tele-homecare programs by home health nursing agencies and can help such programs realize their potential for chronic disease management. © Health Research and Educational Trust.

The development and feasibility of an online aphasia group intervention and networking program - TeleGAIN.

PubMed

Pitt, Rachelle; Theodoros, Deborah; Hill, Anne J; Russell, Trevor

2017-09-04

Aphasia group therapy offers many benefits, however people with aphasia report difficulty accessing groups and speech-language pathologists are faced with many challenges in providing aphasia group therapy. Telerehabilitation may offer an alternative service delivery option. An online aphasia group therapy program - Telerehabilitation Group Aphasia Intervention and Networking (TeleGAIN) - has been developed according to the guidelines of the Medical Research Council (MRC) framework for complex interventions. The purpose of this paper is to describe the development of TeleGAIN and the results of a pilot trial to determine feasibility and acceptability. The development of TeleGAIN was informed through literature reviews in relevant topic areas, consideration of expert opinion and application of the social cognitive theory. TeleGAIN was then modelled through a feasibility pilot trial with four people with aphasia. TeleGAIN appeared to be feasible and acceptable to participants and able to be implemented as planned. Participant satisfaction with treatment was high and results suggested some potential for improvements in language functioning and communication-related quality of life. TeleGAIN appeared to be feasible and acceptable, however the study highlighted issues related to technology, clinical implementation and participant-specific factors that should be addressed prior to a larger trial.

Bauru School of Dentistry Tele-Health League: an educational strategy applied to research, teaching and extension among applications in tele-health

PubMed Central

da SILVA, Andressa Sharllene Carneiro; RIZZANTE, Fabio Antonio Piola; PICOLINI, Mirela Machado; de CAMPOS, Karis; CORRÊA, Camila de Castro; FRANCO, Elen Caroline; PARDO-FANTON, Cássia de Souza; BLASCA, Wanderléia Quinhoneiro; BERRETIN-FELIX, Giédre

2011-01-01

Tele-health is more than an innovative alternative; it is an excellent tool that enables access to health and education in health, making it possible to minimize distances, optimize time and reduce costs. Based on these advantages, some Brazilian Universities have used these actions in strategies of education, research and extension, aiming at the application of Tele-health in Brazil. In that way, the Bauru School of Dentistry - University of São Paulo (FOB-USP) has applied the use of information and communication technologies in health by means of a "Tele-Health League" (TL), in order to diagnose, prevent and treat diseases, in addition to educate the population and health services. Objective The present study aims to introduce the characteristics of the Tele-Health League of FOB-USP, as well as the development of its projects. Material and Methods The Tele-Health League consisted as a Diffusion Course approved by the Provost of Culture and Academic Extension of the University of São Paulo. It is composed as a large group enclosing professoriate coordinator, academician principal, contributing professors and league members, those, diversified between undergraduates students, graduated, health employees, technology and information areas. The participant members are evaluated by the presence frequency (minimum of 85%), and by the performance of tests and paperwork about the theoretical content provided. Results In four years of activities, the TLFOB-USP obtained a high satisfaction index (90%), an increased number of vacancies due to the interest to become a member, more commitment of the professors of the University and the accomplishment of association with other Brazilian leagues. It is emphasized that the approval percentage of the course results in approval from approximately half of its members. Also, it is important to identify and repair the causes related to the quitting of some members. Conclusions The results showed that the TLFOB-USP members, adjoining to the professor's participants, develop projects in Tele-helth, in Tele-aid and Tele-education areas, thus resulting in the involvement of the University and the community. PMID:22230993

Bauru School of Dentistry Tele-Health League: an educational strategy applied to research, teaching and extension among applications in tele-health.

PubMed

Silva, Andressa Sharllene Carneiro da; Rizzante, Fabio Antonio Piola; Picolini, Mirela Machado; Campos, Karis de; Corrêa, Camila de Castro; Franco, Elen Caroline; Pardo-Fanton, Cássia de Souza; Blasca, Wanderléia Quinhoneiro; Berretin-Felix, Giédre

2011-01-01

Tele-health is more than an innovative alternative; it is an excellent tool that enables access to health and education in health, making it possible to minimize distances, optimize time and reduce costs. Based on these advantages, some Brazilian Universities have used these actions in strategies of education, research and extension, aiming at the application of Tele-health in Brazil. In that way, the Bauru School of Dentistry - University of São Paulo (FOB-USP) has applied the use of information and communication technologies in health by means of a "Tele-Health League" (TL), in order to diagnose, prevent and treat diseases, in addition to educate the population and health services. The present study aims to introduce the characteristics of the Tele-Health League of FOB-USP, as well as the development of its projects. The Tele-Health League consisted as a Diffusion Course approved by the Provost of Culture and Academic Extension of the University of São Paulo. It is composed as a large group enclosing professoriate coordinator, academician principal, contributing professors and league members, those, diversified between undergraduates students, graduated, health employees, technology and information areas. The participant members are evaluated by the presence frequency (minimum of 85%), and by the performance of tests and paperwork about the theoretical content provided. In four years of activities, the TLFOB-USP obtained a high satisfaction index (90%), an increased number of vacancies due to the interest to become a member, more commitment of the professors of the University and the accomplishment of association with other Brazilian leagues. It is emphasized that the approval percentage of the course results in approval from approximately half of its members. Also, it is important to identify and repair the causes related to the quitting of some members. The results showed that the TLFOB-USP members, adjoining to the professor's participants, develop projects in Tele-helth, in Tele-aid and Tele-education areas, thus resulting in the involvement of the University and the community.

Supporting telemicroscopy and laboratory medicine activities. The Greek "TELE.INFO.MED.LAB" project.

PubMed

Miaoulis, G; Protopapa, E; Skourlas, C; Delides, G

1995-01-01

In this paper the authors present the basic results of the study for the "TELE.INFO.MED.LAB" project. This study is based on the local experience of the Metaxas Cancer Institute case and on international references. The possibilities rendered by current developments in telemedicine and particularly in telepathology accelerate and facilitate the communication of crucial medical data and creation of "second level" medical services overcoming the geographical particularities of the country. The availability of data transmission (signals, images, texts, etc.) enables the creation of a "uniform market" for various services. This system must take into account the financial realities, geographical aspects transportation problems and technological developments. Organization of this system, the choices of technical standards and the realization of a complete pilot project are described. For this system we also describe the functional and technical aspects, as well as software and hardware components for the different types of units.

Developing criterion-based competencies for tele-intensive care unit.

PubMed

Schleifer, Sarah Joy; Carroll, Karen; Moseley, Marthe J

2014-01-01

Over the last 5 years, telemedicine has developed nursing roles that differ from traditional bedside care. In the midst of this transition, current competency development models focused on task completion may not be the most effective form of proficiency validation. The procedure of competency creation for the role of tele-intensive care unit registered nurse requires a thoughtful process using stakeholders from institutional leadership to frontline staff. The process must include stakeholder approval to ensure appropriate buy-in and follow-through on the agreed-upon criteria. This can be achieved using a standardized method of concept stimulation related to the behaviors, not a memorized list of tasks, expected of a telemedicine registered nurse. This process serves as the foundation for the development of criterion-based competency statements that then allows for clearer expectations. Continually reviewing the written competencies, ensuring current applicability, and revising as needed are necessities for maintaining competence and, therefore, patient safety.

Development and human factors analysis of an augmented reality interface for multi-robot tele-operation and control

NASA Astrophysics Data System (ADS)

Lee, Sam; Lucas, Nathan P.; Ellis, R. Darin; Pandya, Abhilash

2012-06-01

This paper presents a seamlessly controlled human multi-robot system comprised of ground and aerial robots of semiautonomous nature for source localization tasks. The system combines augmented reality interfaces capabilities with human supervisor's ability to control multiple robots. The role of this human multi-robot interface is to allow an operator to control groups of heterogeneous robots in real time in a collaborative manner. It used advanced path planning algorithms to ensure obstacles are avoided and that the operators are free for higher-level tasks. Each robot knows the environment and obstacles and can automatically generate a collision-free path to any user-selected target. It displayed sensor information from each individual robot directly on the robot in the video view. In addition, a sensor data fused AR view is displayed which helped the users pin point source information or help the operator with the goals of the mission. The paper studies a preliminary Human Factors evaluation of this system in which several interface conditions are tested for source detection tasks. Results show that the novel Augmented Reality multi-robot control (Point-and-Go and Path Planning) reduced mission completion times compared to the traditional joystick control for target detection missions. Usability tests and operator workload analysis are also investigated.

Immersive Virtual Reality with Applications to Tele-Operation and Training

DTIC Science & Technology

2016-03-07

to design accurate models for the control of a remote agent by retargeting human gestures (or body part movements) on the control structure of the...which is designed to co-operate with human inhabitants will need to posses, on some levels, a theory of mind [20]. This will enable the system to...University of Houston-Victoria, a designated Hispanic Serving Institution of higher education. The requested equipment and instrumentation will be

Ecological Interfaces for Improving Mobile Robot Teleoperation

DTIC Science & Technology

2007-10-01

reviewers’ comments. C. W. Nielsen is with the Idaho National Laboratory, Idaho Falls, ID 83415 USA (e-mail: curtis.nielsen@inl.gov). M . A. Goodrich is with...tele- operation. Section III presents the ecological interface paradigm and describes the 3-D interface. Section IV presents the sum- maries from new...in an empty laboratory environment that was filled with cardboard boxes and was more than 700 m from the operator. The display that the test subjects

Validating the TeleStroke Mimic Score: A Prediction Rule for Identifying Stroke Mimics Evaluated Over Telestroke Networks.

PubMed

Ali, Syed F; Hubert, Gordian J; Switzer, Jeffrey A; Majersik, Jennifer J; Backhaus, Roland; Shepard, L Wylie; Vedala, Kishore; Schwamm, Lee H

2018-03-01

Up to 30% of acute stroke evaluations are deemed stroke mimics, and these are common in telestroke as well. We recently published a risk prediction score for use during telestroke encounters to differentiate stroke mimics from ischemic cerebrovascular disease derived and validated in the Partners TeleStroke Network. Using data from 3 distinct US and European telestroke networks, we sought to externally validate the TeleStroke Mimic (TM) score in a broader population. We evaluated the TM score in 1930 telestroke consults from the University of Utah, Georgia Regents University, and the German TeleMedical Project for Integrative Stroke Care Network. We report the area under the curve in receiver-operating characteristic curve analysis with 95% confidence interval for our previously derived TM score in which lower TM scores correspond with a higher likelihood of being a stroke mimic. Based on final diagnosis at the end of the telestroke consultation, there were 630 of 1930 (32.6%) stroke mimics in the external validation cohort. All 6 variables included in the score were significantly different between patients with ischemic cerebrovascular disease versus stroke mimics. The TM score performed well (area under curve, 0.72; 95% confidence interval, 0.70-0.73; P <0.001), similar to our prior external validation in the Partners National Telestroke Network. The TM score's ability to predict the presence of a stroke mimic during telestroke consultation in these diverse cohorts was similar to its performance in our original cohort. Predictive decision-support tools like the TM score may help highlight key clinical differences between mimics and patients with stroke during complex, time-critical telestroke evaluations. © 2018 American Heart Association, Inc.

Rapid Deployment of International Tele-Intensive Care Unit Services in War-Torn Syria.

PubMed

Moughrabieh, Anas; Weinert, Craig

2016-02-01

The conflict in Syria has created the largest humanitarian emergency of the twenty-first century. The 4-year Syrian conflict has destroyed hospitals and severely reduced the capacity of intensive care units (ICUs) and on-site intensivists. The crisis has triggered attempts from abroad to support the medical care of severely injured and acutely ill civilians inside Syria, including application of telemedicine. Within the United States, tele-ICU programs have been operating for more than a decade, albeit with high start-up costs and generally long development times. With the benefit of lessons drawn from those domestic models, the Syria Tele-ICU program was launched in December 2012 to manage the care of ICU patients in parts of Syria by using inexpensive, off-the-shelf video cameras, free social media applications, and a volunteer network of Arabic-speaking intensivists in North America and Europe. Within 1 year, 90 patients per month in three ICUs were receiving tele-ICU services. At the end of 2015, a network of approximately 20 participating intensivists was providing clinical decision support 24 hours per day to five civilian ICUs in Syria. The volunteer clinicians manage patients at a distance of more than 6,000 miles, separated by seven or eight time zones between North America and Syria. The program is implementing a cloud-based electronic medical record for physician documentation and a medication administration record for nurses. There are virtual chat rooms for patient rounds, radiology review, and trainee teaching. The early success of the program shows how a small number of committed physicians can use inexpensive equipment spawned by the Internet revolution to support from afar civilian health care delivery in a high-conflict country.

TeleFood: a worldwide appeal.

PubMed

1997-12-01

In 1997, the UN Food and Agriculture Organization (FAO) broadcast its first global television program on the theme of "Food for All" to an audience of approximately 450 million viewers. The objective of "TeleFood" was to raise awareness of the scale of the problem and to encourage solidarity in the fight against hunger. TeleFood raised funds to support the FAO's Special Programme for Food Security (SPFS) and similar grassroots projects that target rural people in developing countries. The SPFS project, now operational in 19 countries and being formulated in 32 more, emphasizes national ownership, farmer participation, environmental awareness, and recognition of the role of women in food production and marketing. The 3-year SPFS pilot phase involves 1) small-scale water harvesting, irrigation, and drainage; 2) sustainable intensification of crop production; 3) diversification of production; and 4) removal of policies that impede food security. Results to date include 1) greatly increased maize and potato yields in Bolivia and more modest increases in Nepal; 2) doubled yields of maize and rice in Tanzania; and 3) expansion of the area under low-cost irrigation in Zambia. South-South cooperation is allowing some developing countries to benefit from experience gained in other developing countries. The pilot activities are being funded with an increasing number of "soft" loans from governments and financial institutions.

Tele-Intervention: The Wave of the Future Fits Families' Lives Today

ERIC Educational Resources Information Center

Behl, Diane D.; Houston, K. Todd; Guthrie, W. Spencer; Guthrie, Nancy K.

2010-01-01

This article provides information on providing early intervention services virtually using distance communication technologies. It describes "tele-intervention," a new method of providing services to children and their families, and how it is used in a family with a deaf child. Tele-intervention has proven to be a viable service delivery model for…

Efficacy of a Telehealth Intervention on Colonoscopy Uptake When Cost Is a Barrier: The Family CARE Cluster Randomized Controlled Trial.

PubMed

Steffen, Laurie E; Boucher, Kenneth M; Damron, Barbara H; Pappas, Lisa M; Walters, Scott T; Flores, Kristina G; Boonyasiriwat, Watcharaporn; Vernon, Sally W; Stroup, Antoinette M; Schwartz, Marc D; Edwards, Sandra L; Kohlmann, Wendy K; Lowery, Jan T; Wiggins, Charles L; Hill, Deirdre A; Higginbotham, John C; Burt, Randall; Simmons, Rebecca G; Kinney, Anita Y

2015-09-01

We tested the efficacy of a remote tailored intervention Tele-Cancer Risk Assessment and Evaluation (TeleCARE) compared with a mailed educational brochure for improving colonoscopy uptake among at-risk relatives of colorectal cancer patients and examined subgroup differences based on participant reported cost barriers. Family members of colorectal cancer patients who were not up-to-date with colonoscopy were randomly assigned as family units to TeleCARE (N = 232) or an educational brochure (N = 249). At the 9-month follow-up, a cost resource letter listing resources for free or reduced-cost colonoscopy was mailed to participants who had reported cost barriers and remained nonadherent. Rates of medically verified colonoscopy at the 15-month follow-up were compared on the basis of group assignment and within group stratification by cost barriers. In intent-to-treat analysis, 42.7% of participants in TeleCARE and 24.1% of participants in the educational brochure group had a medically verified colonoscopy [OR, 2.37; 95% confidence interval (CI) 1.59-3.52]. Cost was identified as a barrier in both groups (TeleCARE = 62.5%; educational brochure = 57.0%). When cost was not a barrier, the TeleCARE group was almost four times as likely as the comparison to have a colonoscopy (OR, 3.66; 95% CI, 1.85-7.24). The intervention was efficacious among those who reported cost barriers; the TeleCARE group was nearly twice as likely to have a colonoscopy (OR, 1.99; 95% CI, 1.12-3.52). TeleCARE increased colonoscopy regardless of cost barriers. Remote interventions may bolster screening colonoscopy regardless of cost barriers and be more efficacious when cost barriers are absent. ©2015 American Association for Cancer Research.

Clinical and financial considerations for implementing an ICU telemedicine program.

PubMed

Kruklitis, Robert J; Tracy, Joseph A; McCambridge, Matthew M

2014-06-01

As the population in the United States increases and ages, the need to provide high-quality, safe, and cost-effective care to the most critically ill patients will be of great importance. With the projected shortage of intensivists, innovative changes to improve efficiency and increase productivity will be necessary. Telemedicine programs in the ICUs (tele-ICUs) are a successful strategy to improve intensivist access to critically ill patients. Although significant capital and maintenance costs are associated with tele-ICUs, these costs can be offset by indirect financial benefits, such as decreased length of stay. To achieve the positive clinical outcomes desired, tele-ICUs must be carefully designed and implemented. In this article, we discuss the clinical benefits of tele-ICUs. We review the financial considerations, including direct and indirect reimbursement and development and maintenance costs. Finally, we review design and implementation considerations for tele-ICUs.

Attitudinal Change in Elderly Citizens Toward Social Robots: The Role of Personality Traits and Beliefs About Robot Functionality

PubMed Central

Damholdt, Malene F.; Nørskov, Marco; Yamazaki, Ryuji; Hakli, Raul; Hansen, Catharina Vesterager; Vestergaard, Christina; Seibt, Johanna

2015-01-01

Attitudes toward robots influence the tendency to accept or reject robotic devices. Thus it is important to investigate whether and how attitudes toward robots can change. In this pilot study we investigate attitudinal changes in elderly citizens toward a tele-operated robot in relation to three parameters: (i) the information provided about robot functionality, (ii) the number of encounters, (iii) personality type. Fourteen elderly residents at a rehabilitation center participated. Pre-encounter attitudes toward robots, anthropomorphic thinking, and personality were assessed. Thereafter the participants interacted with a tele-operated robot (Telenoid) during their lunch (c. 30 min.) for up to 3 days. Half of the participants were informed that the robot was tele-operated (IC) whilst the other half were naïve to its functioning (UC). Post-encounter assessments of attitudes toward robots and anthropomorphic thinking were undertaken to assess change. Attitudes toward robots were assessed with a new generic 35-items questionnaire (attitudes toward social robots scale: ASOR-5), offering a differentiated conceptualization of the conditions for social interaction. There was no significant difference between the IC and UC groups in attitude change toward robots though trends were observed. Personality was correlated with some tendencies for attitude changes; Extraversion correlated with positive attitude changes to intimate-personal relatedness with the robot (r = 0.619) and to psychological relatedness (r = 0.581) whilst Neuroticism correlated negatively (r = -0.582) with mental relatedness with the robot. The results tentatively suggest that neither information about functionality nor direct repeated encounters are pivotal in changing attitudes toward robots in elderly citizens. This may reflect a cognitive congruence bias where the robot is experienced in congruence with initial attitudes, or it may support action-based explanations of cognitive dissonance reductions, given that robots, unlike computers, are not yet perceived as action targets. Specific personality traits may be indicators of attitude change relating to specific domains of social interaction. Implications and future directions are discussed. PMID:26635646

Attitudinal Change in Elderly Citizens Toward Social Robots: The Role of Personality Traits and Beliefs About Robot Functionality.

PubMed

Damholdt, Malene F; Nørskov, Marco; Yamazaki, Ryuji; Hakli, Raul; Hansen, Catharina Vesterager; Vestergaard, Christina; Seibt, Johanna

2015-01-01

Attitudes toward robots influence the tendency to accept or reject robotic devices. Thus it is important to investigate whether and how attitudes toward robots can change. In this pilot study we investigate attitudinal changes in elderly citizens toward a tele-operated robot in relation to three parameters: (i) the information provided about robot functionality, (ii) the number of encounters, (iii) personality type. Fourteen elderly residents at a rehabilitation center participated. Pre-encounter attitudes toward robots, anthropomorphic thinking, and personality were assessed. Thereafter the participants interacted with a tele-operated robot (Telenoid) during their lunch (c. 30 min.) for up to 3 days. Half of the participants were informed that the robot was tele-operated (IC) whilst the other half were naïve to its functioning (UC). Post-encounter assessments of attitudes toward robots and anthropomorphic thinking were undertaken to assess change. Attitudes toward robots were assessed with a new generic 35-items questionnaire (attitudes toward social robots scale: ASOR-5), offering a differentiated conceptualization of the conditions for social interaction. There was no significant difference between the IC and UC groups in attitude change toward robots though trends were observed. Personality was correlated with some tendencies for attitude changes; Extraversion correlated with positive attitude changes to intimate-personal relatedness with the robot (r = 0.619) and to psychological relatedness (r = 0.581) whilst Neuroticism correlated negatively (r = -0.582) with mental relatedness with the robot. The results tentatively suggest that neither information about functionality nor direct repeated encounters are pivotal in changing attitudes toward robots in elderly citizens. This may reflect a cognitive congruence bias where the robot is experienced in congruence with initial attitudes, or it may support action-based explanations of cognitive dissonance reductions, given that robots, unlike computers, are not yet perceived as action targets. Specific personality traits may be indicators of attitude change relating to specific domains of social interaction. Implications and future directions are discussed.

Feasibility and acceptance of a pharmacist-run tele-oncology service for chemotherapy-induced nausea and vomiting in ambulatory cancer patients.

PubMed

Yap, Kevin Y-L; Low, Hui X; Koh, Ken S; Un, Matthew; Shih, Vivianne; Chan, Alexandre

2013-05-01

The use of telemedicine for cancer patients is limited, particularly in Asia. These patients need to be monitored because more are being treated as outpatients, so that any treatment-related side effects can be managed. We assessed the feasibility and acceptance of a pharmacist-run tele-oncology service to monitor chemotherapy-induced nausea and vomiting (CINV) in ambulatory cancer patients. A single-center, prospective study was conducted at a local cancer center. Patients' CINV symptoms were monitored through short message service (SMS) for 5 days post-chemotherapy. Feasibility was measured by patients' adherence to the service, patient satisfaction, and number of pharmacist interventions. Acceptance was measured by the accrual rate. The accrual rate was 37.6% (68/181 patients). Sixty patients (median age, 49.5 years) completed the study. Overall adherence was 73.3%. The majority (90.0%) were comfortable with the duration of SMS monitoring, especially adherent patients (95.5% versus 75.0%, p=0.038). Over half (61.7%) found the SMS advice useful. Twenty-two intervention calls were made by pharmacists for uncontrolled CINV. A pharmacist-run tele-oncology service for real-time monitoring of CINV is feasible in ambulatory cancer patients. Incorporating the monitoring of other side effects will enhance its value and acceptance by patients for post-chemotherapy symptom management.

Towards an SEMG-based tele-operated robot for masticatory rehabilitation.

PubMed

Kalani, Hadi; Moghimi, Sahar; Akbarzadeh, Alireza

2016-08-01

This paper proposes a real-time trajectory generation for a masticatory rehabilitation robot based on surface electromyography (SEMG) signals. We used two Gough-Stewart robots. The first robot was used as a rehabilitation robot while the second robot was developed to model the human jaw system. The legs of the rehabilitation robot were controlled by the SEMG signals of a tele-operator to reproduce the masticatory motion in the human jaw, supposedly mounted on the moving platform, through predicting the location of a reference point. Actual jaw motions and the SEMG signals from the masticatory muscles were recorded and used as output and input, respectively. Three different methods, namely time-delayed neural networks, time delayed fast orthogonal search, and time-delayed Laguerre expansion technique, were employed and compared to predict the kinematic parameters. The optimal model structures as well as the input delays were obtained for each model and each subject through a genetic algorithm. Equations of motion were obtained by the virtual work method. Fuzzy method was employed to develop a fuzzy impedance controller. Moreover, a jaw model was developed to demonstrate the time-varying behavior of the muscle lengths during the rehabilitation process. The three modeling methods were capable of providing reasonably accurate estimations of the kinematic parameters, although the accuracy and training/validation speed of time-delayed fast orthogonal search were higher than those of the other two aforementioned methods. Also, during a simulation study, the fuzzy impedance scheme proved successful in controlling the moving platform for the accurate navigation of the reference point in the desired trajectory. SEMG has been widely used as a control command for prostheses and exoskeleton robots. However, in the current study by employing the proposed rehabilitation robot the complete continuous profile of the clenching motion was reproduced in the sagittal plane. Copyright © 2016. Published by Elsevier Ltd.

How to set up a low cost tele-ultrasound capable videoconferencing system with wide applicability

PubMed Central

2012-01-01

Background Worldwide ultrasound equipment accessibility is at an all-time high, as technology improves and costs decrease. Ensuring that patients benefit from more accurate resuscitation and diagnoses from a user-dependent technology, such as ultrasound, requires accurate examination, typically entailing significant training. Remote tele-mentored ultrasound (RTUS) examination is, however, a technique pioneered in space medicine that has increased applicability on earth. We, thus, sought to create and demonstrate a cost-minimal approach and system with potentially global applicability. Methods The cost-minimal RTUS system was constructed by utilizing a standard off-the-shelf laptop computer that connected to the internet through an internal wireless receiver and/or was tethered through a smartphone. A number of portable hand-held ultrasound devices were digitally streamed into the laptop utilizing a video converter. Both the ultrasound video and the output of a head-mounted video camera were transmitted over freely available Voice Over Internet Protocol (VOIP) software to remote experts who could receive and communicate using any mobile device (computer, tablet, or smartphone) that could access secure VOIP transmissions from the internet. Results The RTUS system allowed real-time mentored tele-ultrasound to be conducted from a variety of settings that were inside buildings, outside on mountainsides, and even within aircraft in flight all unified by the simple capability of receiving and transmitting VOIP transmissions. . Numerous types of ultrasound examinations were conducted such as abdominal and thoracic examinations with a variety of users mentored who had previous skills ranging from none to expert. Internet connectivity was rarely a limiting factor, with competing logistical and scheduling demands of the participants predominating. Conclusions RTUS examinations can educate and guide point of care clinical providers to enhance their use of ultrasound. The scope of the examinations conducted is limited only by the time available and the criticality of the subject being examined. As internet connectivity will only improve worldwide, future developments need to focus on the human factors to optimize tele-sonographic interactions. PMID:22871099

Vision systems for manned and robotic ground vehicles

NASA Astrophysics Data System (ADS)

Sanders-Reed, John N.; Koon, Phillip L.

2010-04-01

A Distributed Aperture Vision System for ground vehicles is described. An overview of the hardware including sensor pod, processor, video compression, and displays is provided. This includes a discussion of the choice between an integrated sensor pod and individually mounted sensors, open architecture design, and latency issues as well as flat panel versus head mounted displays. This technology is applied to various ground vehicle scenarios, including closed-hatch operations (operator in the vehicle), remote operator tele-operation, and supervised autonomy for multi-vehicle unmanned convoys. In addition, remote vision for automatic perimeter surveillance using autonomous vehicles and automatic detection algorithms is demonstrated.

Remote Learning for the Manipulation and Control of Robotic Cells

ERIC Educational Resources Information Center

Goldstain, Ofir; Ben-Gal, Irad; Bukchin, Yossi

2007-01-01

This work proposes an approach to remote learning of robotic cells based on internet and simulation tools. The proposed approach, which integrates remote-learning and tele-operation into a generic scheme, is designed to enable students and developers to set-up and manipulate a robotic cell remotely. Its implementation is based on a dedicated…

Tele-counseling and social-skill trainings using JGNII optical network and a mirror-interface system

NASA Astrophysics Data System (ADS)

Hashimoto, Sayuri; Hashimoto, Nobuyuki; Onozawa, Akira; Hosoya, Eiichi; Harada, Ikuo; Okunaka, Junzo

2007-09-01

"Tele-presence" communication using JGNII - an exclusive optical-fiber network system - was applied to social-skills training in the form of child-rearing support. This application focuses on internet counseling and social training skills that require interactive verbal and none-verbal communications. The motivation for this application is supporting local communities by constructing tele-presence education and entertainment systems using recently available, inexpensive IP networks. This latest application of tele-presence communication uses mirror-interface system which provides to users in remote locations a shared quasi-space where they can see themselves as if they were in the same room by overlapping video images from remote locations.

E-Learning as New Method of Medical Education

PubMed Central

Masic, Izet

2008-01-01

CONFLICT OF INTEREST: NONE DECLARED Distance learning refers to use of technologies based on health care delivered on distance and covers areas such as electronic health, tele-health (e-health), telematics, telemedicine, tele-education, etc. For the need of e-health, telemedicine, tele-education and distance learning there are various technologies and communication systems from standard telephone lines to the system of transmission digitalized signals with modem, optical fiber, satellite links, wireless technologies, etc. Tele-education represents health education on distance, using Information Communication Technologies (ICT), as well as continuous education of a health system beneficiaries and use of electronic libraries, data bases or electronic data with data bases of knowledge. Distance learning (E-learning) as a part of tele-education has gained popularity in the past decade; however, its use is highly variable among medical schools and appears to be more common in basic medical science courses than in clinical education. Distance learning does not preclude traditional learning processes; frequently it is used in conjunction with in-person classroom or professional training procedures and practices. Tele-education has mostly been used in biomedical education as a blended learning method, which combines tele-education technology with traditional instructor-led training, where, for example, a lecture or demonstration is supplemented by an online tutorial. Distance learning is used for self-education, tests, services and for examinations in medicine i.e. in terms of self-education and individual examination services. The possibility of working in the exercise mode with image files and questions is an attractive way of self education. Automated tracking and reporting of learners’ activities lessen faculty administrative burden. Moreover, e-learning can be designed to include outcomes assessment to determine whether learning has occurred. This review article evaluates the current status and level of tele-education development in Bosnia and Herzegovina outlining its components, faculty development needs for implementation and the possibility of its integration as official learning standard in biomedical curricula in Bosnia and Herzegovina. Tele-education refers to the use of information and communication technologies (ICT) to enhance knowledge and performance. Tele-education in biomedical education is widely accepted in the medical education community where it is mostly integrated into biomedical curricula forming part of a blended learning strategy. There are many biomedical digital repositories of e-learning materials worldwide, some peer reviewed, where instructors or developers can submit materials for widespread use. First pilot project with the aim to introduce tele-education in biomedical curricula in Bosnia and Herzegovina was initiated by Department for Medical Informatics at Medical Faculty in Sarajevo in 2002 and has been developing since. Faculty member’s skills in creating tele-education differ from those needed for traditional teaching and faculty rewards must recognize this difference and reward the effort. Tele-education and use of computers will have an impact of future medical practice in a life long learning. Bologna process, which started last years in European countries, provide us to promote and introduce modern educational methods of education at biomedical faculties in Bosnia and Herzegovina. Cathedra of Medical informatics and Cathedra of Family medicine at Medical Faculty of University of Sarajevo started to use Web based education as common way of teaching of medical students. Satisfaction with this method of education within the students is good, but not yet suitable for most of medical disciplines at biomedical faculties in Bosnia and Herzegovina. PMID:24109154

E-learning as new method of medical education.

PubMed

Masic, Izet

2008-01-01

NONE DECLARED Distance learning refers to use of technologies based on health care delivered on distance and covers areas such as electronic health, tele-health (e-health), telematics, telemedicine, tele-education, etc. For the need of e-health, telemedicine, tele-education and distance learning there are various technologies and communication systems from standard telephone lines to the system of transmission digitalized signals with modem, optical fiber, satellite links, wireless technologies, etc. Tele-education represents health education on distance, using Information Communication Technologies (ICT), as well as continuous education of a health system beneficiaries and use of electronic libraries, data bases or electronic data with data bases of knowledge. Distance learning (E-learning) as a part of tele-education has gained popularity in the past decade; however, its use is highly variable among medical schools and appears to be more common in basic medical science courses than in clinical education. Distance learning does not preclude traditional learning processes; frequently it is used in conjunction with in-person classroom or professional training procedures and practices. Tele-education has mostly been used in biomedical education as a blended learning method, which combines tele-education technology with traditional instructor-led training, where, for example, a lecture or demonstration is supplemented by an online tutorial. Distance learning is used for self-education, tests, services and for examinations in medicine i.e. in terms of self-education and individual examination services. The possibility of working in the exercise mode with image files and questions is an attractive way of self education. Automated tracking and reporting of learners' activities lessen faculty administrative burden. Moreover, e-learning can be designed to include outcomes assessment to determine whether learning has occurred. This review article evaluates the current status and level of tele-education development in Bosnia and Herzegovina outlining its components, faculty development needs for implementation and the possibility of its integration as official learning standard in biomedical curricula in Bosnia and Herzegovina. Tele-education refers to the use of information and communication technologies (ICT) to enhance knowledge and performance. Tele-education in biomedical education is widely accepted in the medical education community where it is mostly integrated into biomedical curricula forming part of a blended learning strategy. There are many biomedical digital repositories of e-learning materials worldwide, some peer reviewed, where instructors or developers can submit materials for widespread use. First pilot project with the aim to introduce tele-education in biomedical curricula in Bosnia and Herzegovina was initiated by Department for Medical Informatics at Medical Faculty in Sarajevo in 2002 and has been developing since. Faculty member's skills in creating tele-education differ from those needed for traditional teaching and faculty rewards must recognize this difference and reward the effort. Tele-education and use of computers will have an impact of future medical practice in a life long learning. Bologna process, which started last years in European countries, provide us to promote and introduce modern educational methods of education at biomedical faculties in Bosnia and Herzegovina. Cathedra of Medical informatics and Cathedra of Family medicine at Medical Faculty of University of Sarajevo started to use Web based education as common way of teaching of medical students. Satisfaction with this method of education within the students is good, but not yet suitable for most of medical disciplines at biomedical faculties in Bosnia and Herzegovina.

Introduction of Tele-ICU in rural hospitals: Changing organisational culture to harness benefits.

PubMed

Goedken, Cassie Cunningham; Moeckli, Jane; Cram, Peter M; Reisinger, Heather Schacht

2017-06-01

This study evaluates rural hospital staff perceptions of a telemedicine ICU (Tele-ICU) before and after implementation. We conducted a longitudinal qualitative study utilising semistructured group or individual interviews with staff from three rural ICU facilities in the upper Midwest of the United States that received Tele-ICU support. Interviews occurred pre-implementation and at two time points post-implementation. Interviews were conducted with: ICU administrators (n=6), physicians (n=3), nurses (n=9), respiratory therapists (n=5) and other (n=1) from July 2011 to May 2013. Transcripts were analysed for thematic content. Overall, rural ICU staff viewed Tele-ICU as a welcome benefit for their facility. Major themes included: (1) beneficial where recruitment and retention of staff can be challenging; (2) extra support for day shifts and evening, night and weekend shifts; (3) reduction in the number of transfers larger tertiary hospitals in the community; (4) improvement in standardisation of care; and (5) organisational culture of rural ICUs may lead to under-utilisation. ICU staff at rural facilities view Tele-ICU as a positive, useful tool to provide extra support and assistance. However, more research is needed regarding organisational culture to maximise the potential benefits of Tele-ICU in rural hospitals. Published by Elsevier Ltd.

Staff Acceptance of Tele-ICU Coverage

PubMed Central

Chan, Paul S.; Cram, Peter

2011-01-01

Background: Remote coverage of ICUs is increasing, but staff acceptance of this new technology is incompletely characterized. We conducted a systematic review to summarize existing research on acceptance of tele-ICU coverage among ICU staff. Methods: We searched for published articles pertaining to critical care telemedicine systems (aka, tele-ICU) between January 1950 and March 2010 using PubMed, Cumulative Index to Nursing and Allied Health Literature, Global Health, Web of Science, and the Cochrane Library and abstracts and presentations delivered at national conferences. Studies were included if they provided original qualitative or quantitative data on staff perceptions of tele-ICU coverage. Studies were imported into content analysis software and coded by tele-ICU configuration, methodology, participants, and findings (eg, positive and negative staff evaluations). Results: Review of 3,086 citations yielded 23 eligible studies. Findings were grouped into four categories of staff evaluation: overall acceptance level of tele-ICU coverage (measured in 70% of studies), impact on patient care (measured in 96%), impact on staff (measured in 100%), and organizational impact (measured in 48%). Overall acceptance was high, despite initial ambivalence. Favorable impact on patient care was perceived by > 82% of participants. Staff impact referenced enhanced collaboration, autonomy, and training, although scrutiny, malfunctions, and contradictory advice were cited as potential barriers. Staff perceived the organizational impact to vary. An important limitation of available studies was a lack of rigorous methodology and validated survey instruments in many studies. Conclusions: Initial reports suggest high levels of staff acceptance of tele-ICU coverage, but more rigorous methodologic study is required. PMID:21051386

Telerobotic management system: coordinating multiple human operators with multiple robots

NASA Astrophysics Data System (ADS)

King, Jamie W.; Pretty, Raymond; Brothers, Brendan; Gosine, Raymond G.

2003-09-01

This paper describes an application called the Tele-robotic management system (TMS) for coordinating multiple operators with multiple robots for applications such as underground mining. TMS utilizes several graphical interfaces to allow the user to define a partially ordered plan for multiple robots. This plan is then converted to a Petri net for execution and monitoring. TMS uses a distributed framework to allow robots and operators to easily integrate with the applications. This framework allows robots and operators to join the network and advertise their capabilities through services. TMS then decides whether tasks should be dispatched to a robot or a remote operator based on the services offered by the robots and operators.

Effect of Nurse-Led Telephone Follow ups (Tele-Nursing) on Depression, Anxiety and Stress in Hemodialysis Patients.

PubMed

Kargar Jahromi, Marzieh; Javadpour, Shohreh; Taheri, Leila; Poorgholami, Farzad

2015-07-26

Depressive and anxious patients on hemodialysis have a higher risk of death and hospitalizations. The aim of this study was to evaluate the effect of nurse-led telephone follow ups (tele-nursing) on depression, anxiety and stress in hemodialysis patients. The subjects of the study who were selected based on double blind randomized clinical trial consisted of 60 patients with advanced chronic renal disease treated with hemodialysis. The patients were placed in two groups of 30 individuals. Before the intervention, a questionnaire was completed by patients.  There was no telephone follow up in the control group and the patients received only routine care in the hospital. The participants allocated to the intervention group received telephone follow-up 30 days after dialysis shift, in addition to conventional treatment. Every session lasted 30 minutes, as possible. Then the DASS scale was filled out by the patients after completion of study by two groups. Significant differences were observed between the two groups in the posttest regarding the dimensions scores of DASS scale. The result of this trial is expected to provide new knowledge to support the effective follow-up for hemodialysis patient in order to improve their emotional and health status.

A university extension course in leprosy: telemedicine in the Amazon for primary healthcare.

PubMed

Paixão, Maurício Pedreira; Miot, Hélio Amante; de Souza, Pedro Elias; Haddad, Ana Estela; Wen, Chao Lung

2009-01-01

There is a high prevalence of leprosy in the Amazon region of Brazil. We have developed a distance education course in leprosy for training staff of the Family Health Teams (FHTs). The course was made available through a web portal. Tele-educational resources were mediated by professors and coordinators, and included the use of theoretical content available through the web, discussion lists, Internet chat, activity diaries, 3-D video animations (Virtual Human on Leprosy), classes in video streaming and case simulation. Sixty-five FHT staff members were enrolled. All of them completed the course and 47 participants received a certificate at the end of the course. At the end of the course, 48 course-evaluation questionnaires were answered. A total of 47 participants (98%) considered the course as excellent. The results demonstrate the feasibility of an interactive, tele-education model as an educational resource for staff in isolated regions. Improvements in diagnostic skills should increase diagnostic suspicion of leprosy and may contribute to early detection.

TeleMed: Wide-area, secure, collaborative object computing with Java and CORBA for healthcare

DOE Office of Scientific and Technical Information (OSTI.GOV)

Forslund, D.W.; George, J.E.; Gavrilov, E.M.

1998-12-31

Distributed computing is becoming commonplace in a variety of industries with healthcare being a particularly important one for society. The authors describe the development and deployment of TeleMed in a few healthcare domains. TeleMed is a 100% Java distributed application build on CORBA and OMG standards enabling the collaboration on the treatment of chronically ill patients in a secure manner over the Internet. These standards enable other systems to work interoperably with TeleMed and provide transparent access to high performance distributed computing to the healthcare domain. The goal of wide scale integration of electronic medical records is a grand-challenge scalemore » problem of global proportions with far-reaching social benefits.« less

Robotics Strategy White Paper

DTIC Science & Technology

2009-03-19

Cargo packaging and pallet assembly. Use of robotics tools to support palletization falls under the supply functional area which tasks the Army to...system. 17 At first glance, remote tele-operated surgery capability appears to already exist in civilian hospitals (i.e., DaVinci Machine: http... tool free maintenance and anticipatory sustainment and improved distribution. The UJTL tasks suggest nominal improvements in the maintenance area

Anthro-Centric Multisensory Interfaces for Sensory Augmentation of Telesurgery

DTIC Science & Technology

2011-06-01

compares favorably to standing astride an operating table using laparoscopic instruments, the most favorable ergonomics would facilitate free movement...either through direct contact with the tissues or indirect contact via rigid laparoscopic instruments), opportunities now exist to utilize other...tele-surgical methods. Laparoscopic instruments were initially developed as extended versions of their counterparts used in open procedures (e.g

Robonaut testing

NASA Image and Video Library

2013-08-05

ISS036-E-029110 (6 Aug. 2013) --- In the International Space Station’s Destiny laboratory, NASA astronaut Chris Cassidy, Expedition 36 flight engineer, wears tele-operation gear consisting of a vest, gloves and visor to telerobotically test Robonaut 2’s maneuvers. Cassidy was able to manipulate R2’s head, neck, arms and fingers telerobotically through his own movements as well as through verbal commands.

Robonaut testing

NASA Image and Video Library

2013-08-05

ISS036-E-029109 (6 Aug. 2013) --- In the International Space Station’s Destiny laboratory, NASA astronaut Chris Cassidy, Expedition 36 flight engineer, wears tele-operation gear consisting of a vest, gloves and visor to telerobotically test Robonaut 2’s maneuvers. Cassidy was able to manipulate R2’s head, neck, arms and fingers telerobotically through his own movements as well as through verbal commands.

Cassidy with Robonaut 2

NASA Image and Video Library

2013-08-28

ISS036-E-038293 (28 Aug. 2013) --- In the International Space Station's Destiny laboratory, NASA astronaut Chris Cassidy, Expedition 36 flight engineer, wears tele-operation gear consisting of a vest, gloves and visor to telerobotically test Robonaut 2's maneuvers. Cassidy was able to manipulate R2's head, neck, arms and fingers telerobotically through his own movements as well as through verbal commands.

Robonaut 2 Teleops

NASA Image and Video Library

2013-07-22

ISS036-E-029140 (6 Aug. 2013) --- In the International Space Station?s Destiny laboratory, NASA astronaut Chris Cassidy, Expedition 36 flight engineer, wears tele-operation gear consisting of a vest, gloves and visor to telerobotically test Robonaut 2?s maneuvers. Cassidy was able to manipulate R2?s head, neck, arms and fingers telerobotically through his own movements as well as through verbal commands.

Robonaut 2 Teleops

NASA Image and Video Library

2013-07-22

ISS036-E-029144 (6 Aug. 2013) --- In the International Space Station?s Destiny laboratory, NASA astronaut Chris Cassidy, Expedition 36 flight engineer, wears tele-operation gear consisting of a vest, gloves and visor to telerobotically test Robonaut 2?s maneuvers. Cassidy was able to manipulate R2?s head, neck, arms and fingers telerobotically through his own movements as well as through verbal commands.

Training of beauty salon professionals in disease prevention using interactive tele-education.

PubMed

Vieira Júnior, Elso Elias; Wen, Chao Lung

2015-01-01

Infectious diseases can be acquired in places where invasive procedures are often performed without the proper care of hand washing and material sterilization. There are approximately 500,000 beauty and esthetics centers in Brazil, which are visited by thousands of people every day. Many diseases, including sexually transmitted infections, are still highly prevalent in Brazil, such as warts caused by human papillomavirus, hepatitis B and C, and human immunodeficiency virus infection, and can be transmitted in beauty salons. We have developed a tele-education course divided into four main themes: sexually transmitted infections, indoor health in beauty salon workplaces, hand washing, and material sterilization. The course was made available through a Web site, which included a face-to-face meeting, Web synchronous meetings (chats and Web conferences), and asynchronous resources (reading material, discussion lists, situations simulator, educational videos, and three-dimensional virtual human video animation on sexually transmitted infections and hand washing), mediated by professors and coordinators. Fifty-two beauty professionals and 33 other professionals were enrolled from different regions. Of the 61 who completed the course and received a certificate at the course's end, 100% considered good to excellent the course's applicability to everyday life and would recommend it to a fellow professional. The results demonstrate the feasibility of an interactive, tele-education model using low-cost tools as an educational resource to teach beauty professionals. In the future, this may become a branch of nationwide telehealth action.

Subsea approach to work systems development

NASA Technical Reports Server (NTRS)

Gernhardt, M. L.; Frisbie, F. R.; Brown, C. E.

1988-01-01

Self-contained undersea working environments with applications to space station EVA environments are discussed. Physiological limitations include decompression, inert gas narcosis, high-pressure nervous system, gas toxicity, and thermal limitations. Work task requirements include drilling support, construction, inspection, and repair. Work systems include hyperbaric diving, atmospheric work systems, tele-operated work systems, and hybrid systems. Each type of work system is outlined in terms of work capabilities, special interface requirements, and limitations. Various operational philosophies are discussed. The evolution of work systems in the subsea industry has been the result of direct operational experience in a competitive market.

Tele-Ophthalmology for Age-Related Macular Degeneration and Diabetic Retinopathy Screening: A Systematic Review and Meta-Analysis.

PubMed

Kawaguchi, Atsushi; Sharafeldin, Noha; Sundaram, Aishwarya; Campbell, Sandy; Tennant, Matthew; Rudnisky, Christopher; Weis, Ezekiel; Damji, Karim F

2018-04-01

To synthesize high-quality evidence to compare traditional in-person screening and tele-ophthalmology screening. Only randomized controlled trials (RCTs) were included in this systematic review and meta-analysis. The intervention of interest was any type of tele-ophthalmology, including screening of diseases using remote devices. Studies involved patients receiving care from any trained provider via tele-ophthalmology, compared with those receiving equivalent face-to-face care. A search was executed on the following databases: Medline, EMBASE, EBM Reviews, Global Health, EBSCO-CINAHL, SCOPUS, ProQuest Dissertations and Theses Global, OCLC Papers First, and Web of Science Core Collection. Six outcomes of care for age-related macular degeneration (AMD), diabetic retinopathy (DR), or glaucoma were measured and analyzed. Two hundred thirty-seven records were assessed at the full-text level; six RCTs fulfilled inclusion criteria and were included in this review. Four studies involved participants with diabetes mellitus, and two studies examined choroidal neovascularization in AMD. Only data of detection of disease and participation in the screening program were used for the meta-analysis. Tele-ophthalmology had a 14% higher odds to detect disease than traditional examination; however, the result was not statistically significant (n = 2,012, odds ratio: 1.14, 95% confidence interval (CI): 0.52-2.53, p = 0.74). Meta-analysis results show that odds of having DR screening in the tele-ophthalmology group was 13.15 (95% CI: 8.01-21.61; p < 0.001) compared to the traditional screening program. The current evidence suggests that tele-ophthalmology for DR and age-related macular degeneration is as effective as in-person examination and potentially increases patient participation in screening.

Inflammatory Bowel Disease Telemedicine Clinical Trial: Impact of Educational Text Messages on Disease-Specific Knowledge Over 1 Year.

PubMed

Abutaleb, Ameer; Buchwald, Andrea; Chudy-Onwugaje, Kenechukwu; Langenberg, Patricia; Regueiro, Miguel; Schwartz, David A; Tracy, J Kathleen; Ghazi, Leyla; Patil, Seema A; Quezada, Sandra M; Russman, Katharine M; Quinn, Charlene C; Jambaulikar, Guruprasad; Beaulieu, Dawn B; Horst, Sara; Cross, Raymond K

2018-05-18

Effective treatments are available for patients with inflammatory bowel disease (IBD); however, suboptimal outcomes occur and are often linked to patients' limited disease knowledge. The aim of this analysis was to determine if delivery of educational messages through a telemedicine system improves IBD knowledge. TELEmedicine for Patients with IBD (TELE-IBD) was a randomized controlled trial with visits at baseline, 6 months, and 12 months; patient knowledge was a secondary aim of the study. Patients were randomized to receive TELE-IBD every other week (EOW), weekly (TELE-IBD W), or standard of care. Knowledge was assessed at each visit with the Crohn's and Colitis Knowledge (CCKNOW) survey. The primary outcome was change in CCKNOW score over 1 year compared between the TELE-IBD and control groups. This analysis included 219 participants. Participants in the TELE-IBD arms had a greater improvement in CCKNOW score compared with standard care (TELE-IBD EOW +2.4 vs standard care +1.8, P = 0.03; TELE-IBD W +2.0 vs standard care +1.8, P = 0.35). Participants with lower baseline CCKNOW scores had a greater change in their score over time (P < 0.01). However, after adjusting for race, site, and baseline knowledge, there was no difference in CCKNOW score change between the control and telemedicine arms. Telemedicine improves IBD-specific knowledge through text messaging, although the improvement is not additive with greater frequency of text messages. However, after adjustment for confounding variables, telemedicine is not superior to education given through standard visits at referral centers. Further research is needed to determine if revised systems with different modes of delivery and/or frequency of messages improve disease knowledge.

Virtual rapid response: the next evolution of tele-ICU.

PubMed

Hawkins, Carrie L

2012-01-01

The first of its kind in the Veterans Affairs (VA) system, the Denver VA Medical Center's tele-intensive care unit (ICU) program is unique because it is entirely nurse driven. A nontraditional tele-ICU model, the program was tailored to meet the needs of rural veterans by using critical care nursing expertise in Denver, Colorado. An experienced CCRN-certified nurse manages the system 24 hours a day, 7 days a week, from Eastern Colorado Health Care System. The virtual ICU provides rapid response interventions through virtual technology. This tele-ICU technology allows for a "virtual handshake" by nursing staff at the start of the shift and a report on potential patient issues. Clinical relationships have been strengthened between all 5 VA facilities in the Rocky Mountain Region, increasing the likelihood of early consultation at the onset of clinical decline of a patient. In addition, the tele-ICU nurse is available for immediate nursing consultation and support, coordinates point-to-point virtual consultation between physicians at the rural sites and specialists in Denver, and assists in expediting critical care transfers. The primary objectives for the tele-ICU program include improving quality and access of care to critical care services in rural sites, reducing community fee basis costs and frequency of transfers, and increasing collaboration and collegiality among nursing and medical staff in all Region 19's medical centers.

A pilot trial of tele-ophthalmology for diagnosis of chronic blurred vision.

PubMed

Tan, Johnson Choon Hwai; Poh, Eugenie Wei Ting; Srinivasan, Sanjay; Lim, Tock Han

2013-02-01

We evaluated the accuracy of tele-ophthalmology in diagnosing the major causes of chronic blurring of vision. Thirty consecutive patients attending a primary eye-care facility in Singapore (the Ang Mo Kio Polyclinic, AMKP) with the symptom of chronic blurred vision were recruited. An ophthalmic technician was trained to perform Snellen acuity; auto-refraction; intraocular pressure measurement; red-colour perimetry; video recordings of extraocular movement, cover tests and pupillary reactions; and anterior segment and fundus photography. Digital information was transmitted to a tertiary hospital in Singapore (the Tan Tock Seng Hospital) via a tele-ophthalmology system for teleconsultation with an ophthalmologist. The diagnoses were compared with face-to-face consultation by another ophthalmologist at the AMKP. A user experience questionnaire was administered at the end of the consultation. Using face-to-face consultation as the gold standard, tele-ophthalmology achieved 100% sensitivity and specificity in diagnosing media opacity (n = 29), maculopathy (n = 23) and keratopathy (n = 30) of any type; and 100% sensitivity and 92% specificity in diagnosing optic neuropathy of any type (n = 24). The majority of the patients (97%) were satisfied with the tele-ophthalmology workflow and consultation. The tele-ophthalmology system was able to detect causes of chronic blurred vision accurately. It has the potential to deliver high-accuracy diagnostic eye support to remote areas if suitably trained ophthalmic technicians are available.

Natural interaction for unmanned systems

NASA Astrophysics Data System (ADS)

Taylor, Glenn; Purman, Ben; Schermerhorn, Paul; Garcia-Sampedro, Guillermo; Lanting, Matt; Quist, Michael; Kawatsu, Chris

2015-05-01

Military unmanned systems today are typically controlled by two methods: tele-operation or menu-based, search-andclick interfaces. Both approaches require the operator's constant vigilance: tele-operation requires constant input to drive the vehicle inch by inch; a menu-based interface requires eyes on the screen in order to search through alternatives and select the right menu item. In both cases, operators spend most of their time and attention driving and minding the unmanned systems rather than on being a warfighter. With these approaches, the platform and interface become more of a burden than a benefit. The availability of inexpensive sensor systems in products such as Microsoft Kinect™ or Nintendo Wii™ has resulted in new ways of interacting with computing systems, but new sensors alone are not enough. Developing useful and usable human-system interfaces requires understanding users and interaction in context: not just what new sensors afford in terms of interaction, but how users want to interact with these systems, for what purpose, and how sensors might enable those interactions. Additionally, the system needs to reliably make sense of the user's inputs in context, translate that interpretation into commands for the unmanned system, and give feedback to the user. In this paper, we describe an example natural interface for unmanned systems, called the Smart Interaction Device (SID), which enables natural two-way interaction with unmanned systems including the use of speech, sketch, and gestures. We present a few example applications SID to different types of unmanned systems and different kinds of interactions.

Diagnosis of retinal detachments by a tele-ophthalmology screening program.

PubMed

McCord, Sarah A; Lynch, Mary G; Maa, April Y

2018-01-01

In 2015, a tele-ophthalmology program was undertaken at the Atlanta Veterans Affairs Medical Center to provide screening eye care for veterans in their primary care clinics. Though this program was developed as a screening tool, the availability of these services in primary care clinics has enabled triage of certain acute eye complaints. These case reports describe two patients who were diagnosed with retinal detachments through this program, although their primary care providers had triaged them as requiring non-urgent referrals to the eye clinic. Although many patients are seen for acute ocular complaints in primary care clinics and emergency departments, providers in such settings may lack the ability to adequately examine eyes and thus triage ocular complaints. These cases demonstrate the ability of tele-ophthalmology to assist in diagnosing urgent ocular conditions in primary care clinics. Though tele-ophthalmology has been accepted in some parts of the world, in the United States of America it remains widely underutilized. These cases highlight the ability of tele-ophthalmology to close the gap in acute eye care coverage that exists in the USA, most prominently in rural regions.

WTP (willingness to pay) for tele-health consultation service in Hokkaido, Japan.

PubMed

Ogasawara, Katsuhiko; Abe, Tamotsu

2013-01-01

We developed a tele-health consultation system that combines a sphygmomanometer with a tele-conference system. These were placed in pharmacies and the University. We selected five pharmacies to set up a consultation room; one in a local area, two in a suburban area, and the remaining two in an urban area. Nurses with more than 5 years of clinical experience were assigned as consultants. These consultants offer health consultation but do not practice medicine. Some researchers have indicated the economic viability of at-home health management systems, but nothing has been researched on the economic viability of tele-health consultation. The objective of present study was estimated Willingness to Payment (WTP) of Tele-health consultation service. The WTP was estimated by Double-Bounded Dichotomous-Choice model. We performed logistic-regression analysis to confirm factors to affect WTP. The number of the respondent was 480. Mean WTP was calculated 495 yen and the median was 367 yen. There was significant difference for factor of "annual income", "have a willingness to use this system", and "have a child/children".

Home-based tele-assisted robotic rehabilitation of joint impairments in children with cerebral palsy.

PubMed

Chen, Kai; Ren, Yupeng; Gaebler-Spira, Deborah; Zhang, Li-Qun

2014-01-01

A portable rehabilitation robot incorporating intelligent stretching, robot-guided voluntary movement training with motivating games and tele-rehabilitation was developed to provide convenient and cost-effective rehabilitation to children with cerebral palsy (CP) and extend rehabilitation care beyond hospital. Clinicians interact with the patients remotely for periodic evaluations and updated guidance. The tele-assisted stretching and active movement training was done over 6-week 18 sessions on the impaired ankle of 23 children with CP in their home setting. Treatment effectiveness was evaluated using biomechanical measures and clinical outcome measures. After the tele-assisted home robotic rehabilitation intervention, there were significant increases in the ankle passive and active range of motion, muscle strength, a decrease in spasticity, and increases in balance and selective control assessment of lower-extremity.

Shared control of a medical robot with haptic guidance.

PubMed

Xiong, Linfei; Chng, Chin Boon; Chui, Chee Kong; Yu, Peiwu; Li, Yao

2017-01-01

Tele-operation of robotic surgery reduces the radiation exposure during the interventional radiological operations. However, endoscope vision without force feedback on the surgical tool increases the difficulty for precise manipulation and the risk of tissue damage. The shared control of vision and force provides a novel approach of enhanced control with haptic guidance, which could lead to subtle dexterity and better maneuvrability during MIS surgery. The paper provides an innovative shared control method for robotic minimally invasive surgery system, in which vision and haptic feedback are incorporated to provide guidance cues to the clinician during surgery. The incremental potential field (IPF) method is utilized to generate a guidance path based on the anatomy of tissue and surgical tool interaction. Haptic guidance is provided at the master end to assist the clinician during tele-operative surgical robotic task. The approach has been validated with path following and virtual tumor targeting experiments. The experiment results demonstrate that comparing with vision only guidance, the shared control with vision and haptics improved the accuracy and efficiency of surgical robotic manipulation, where the tool-position error distance and execution time are reduced. The validation experiment demonstrates that the shared control approach could help the surgical robot system provide stable assistance and precise performance to execute the designated surgical task. The methodology could also be implemented with other surgical robot with different surgical tools and applications.

An Operationally Simple Sonogashira Reaction for an Undergraduate Organic Chemistry Laboratory Class

ERIC Educational Resources Information Center

Cranwell, Philippa B.; Peterson, Alexander M.; Littlefield, Benjamin T. R.; Russell, Andrew T.

2015-01-01

An operationally simple, reliable, and cheap Sonogashira reaction suitable for an undergraduate laboratory class that can be completed within a day-long (8 h) laboratory session has been developed. Cross-coupling is carried out between 2-methyl-3-butyn-2-ol and various aryl iodides using catalytic amounts of bis(triphenylphosphine)palladium(II)…

Telemedicine Based Ultrasound for Detecting Neonatal Heart Disease in Babies at Remote Military or Native American Health Care Facilities

DTIC Science & Technology

2009-09-01

Telemedicine & Advanced Technology Research Center (TATRC). The additional funds are being used to extend the life of the TeleEcho Project in order to...practitioners for the Tele-ECHO project. This is held at Madigan Army Medical Center in the clinic and the NICU . Learning objectives: 1. Learners will...support and expertise. Funding is provided through AMEDD Advanced Medical Technology Initiative (AAMTI) FY09, APC-T690 Special Fund for TeleEcho. The

About Small Streams and Shiny Rocks: Macromolecular Crystal Growth in Microfluidics

NASA Technical Reports Server (NTRS)

vanderWoerd, Mark; Ferree, Darren; Spearing, Scott; Monaco, Lisa; Molho, Josh; Spaid, Michael; Brasseur, Mike; Curreri, Peter A. (Technical Monitor)

2002-01-01

We are developing a novel technique with which we have grown diffraction quality protein crystals in very small volumes, utilizing chip-based, microfluidic ("LabChip") technology. With this technology volumes smaller than achievable with any laboratory pipette can be dispensed with high accuracy. We have performed a feasibility study in which we crystallized several proteins with the aid of a LabChip device. The protein crystals are of excellent quality as shown by X-ray diffraction. The advantages of this new technology include improved accuracy of dispensing for small volumes, complete mixing of solution constituents without bubble formation, highly repeatable recipe and growth condition replication, and easy automation of the method. We have designed a first LabChip device specifically for protein crystallization in batch mode and can reliably dispense and mix from a range of solution constituents. We are currently testing this design. Upon completion additional crystallization techniques, such as vapor diffusion and liquid-liquid diffusion will be accommodated. Macromolecular crystallization using microfluidic technology is envisioned as a fully automated system, which will use the 'tele-science' concept of remote operation and will be developed into a research facility aboard the International Space Station.

A Randomized Controlled Trial Evaluating a Manualized TeleCoaching Protocol for Improving Adherence to a Web-Based Intervention for the Treatment of Depression

PubMed Central

Mohr, David C.; Duffecy, Jenna; Ho, Joyce; Kwasny, Mary; Cai, Xuan; Burns, Michelle Nicole; Begale, Mark

2013-01-01

Background Web-based interventions for depression that are supported by coaching have generally produced larger effect-sizes, relative to standalone web-based interventions. This is likely due to the effect of coaching on adherence. We evaluated the efficacy of a manualized telephone coaching intervention (TeleCoach) aimed at improving adherence to a web-based intervention (moodManager), as well as the relationship between adherence and depressive symptom outcomes. Methods 101 patients with MDD, recruited from primary care, were randomized to 12 weeks moodManager+TeleCoach, 12 weeks of self-directed moodManager, or 6 weeks of a waitlist control (WLC). Depressive symptom severity was measured using the PHQ-9. Results TeleCoach+moodManager, compared to self-directed moodManager, resulted in significantly greater numbers of login days (p = 0.01), greater time until last use (p = 0.007), greater use of lessons (p = 0.03), greater variety of interactive tools used (p = 0.02), but total instances of tool use did not reach statistical significance. (p = 0.07). TeleCoach+moodManager produced significantly lower PHQ-9 scores relative to WLC at week 6 (p = 0.04), but there were no other significant differences in PHQ-9 scores at weeks 6 or 12 (ps>0.20) across treatment arms. Baseline PHQ-9 scores were no significantly related to adherence to moodManager. Conclusions TeleCoach produced significantly greater adherence to moodManager, relative to self-directed moodManager. TeleCoached moodManager produced greater reductions in depressive symptoms relative to WLC, however, there were no statistically significant differences relative to self-directed moodManager. While greater use was associated with better outcomes, most users in both TeleCoach and self-directed moodManager had dropped out of treatment by week 12. Even with telephone coaching, adherence to web-based interventions for depression remains a challenge. Methods of improving coaching models are discussed. Trial Registration Clinicaltrials.gov NCT00719979 PMID:23990896

Design and implement of mobile equipment management system based on QRcode

NASA Astrophysics Data System (ADS)

Yu, Runze; Duan, Xiaohui; Jiao, Bingli

2017-08-01

A mobile equipment management system based on QRcode is proposed for remote and convenient device management. Unlike conventional systems, the system here makes managers accessible to real-time information with smart phones. Compared with the conventional method, which can only be operated with specific devices, this lightweight and efficient tele management mode is conducive to the asset management in multiple scenarios.

Ubiquitous Wireless Smart Sensing and Control

NASA Technical Reports Server (NTRS)

Wagner, Raymond

2013-01-01

Need new technologies to reliably and safely have humans interact within sensored environments (integrated user interfaces, physical and cognitive augmentation, training, and human-systems integration tools). Areas of focus include: radio frequency identification (RFID), motion tracking, wireless communication, wearable computing, adaptive training and decision support systems, and tele-operations. The challenge is developing effective, low cost/mass/volume/power integrated monitoring systems to assess and control system, environmental, and operator health; and accurately determining and controlling the physical, chemical, and biological environments of the areas and associated environmental control systems.

Ubiquitous Wireless Smart Sensing and Control. Pumps and Pipes JSC: Uniquely Houston

NASA Technical Reports Server (NTRS)

Wagner, Raymond

2013-01-01

Need new technologies to reliably and safely have humans interact within sensored environments (integrated user interfaces, physical and cognitive augmentation, training, and human-systems integration tools).Areas of focus include: radio frequency identification (RFID), motion tracking, wireless communication, wearable computing, adaptive training and decision support systems, and tele-operations. The challenge is developing effective, low cost/mass/volume/power integrated monitoring systems to assess and control system, environmental, and operator health; and accurately determining and controlling the physical, chemical, and biological environments of the areas and associated environmental control systems.

The use of computer graphic simulation in the development of on-orbit tele-robotic systems

NASA Technical Reports Server (NTRS)

Fernandez, Ken; Hinman, Elaine

1987-01-01

This paper describes the use of computer graphic simulation techniques to resolve critical design and operational issues for robotic systems used for on-orbit operations. These issues are robot motion control, robot path-planning/verification, and robot dynamics. The major design issues in developing effective telerobotic systems are discussed, and the use of ROBOSIM, a NASA-developed computer graphic simulation tool, to address these issues is presented. Simulation plans for the Space Station and the Orbital Maneuvering Vehicle are presented and discussed.

Histamine and tele-methylhistamine quantification in cerebrospinal fluid from narcoleptic subjects by liquid chromatography tandem mass spectrometry with precolumn derivatization.

PubMed

Croyal, Mikaël; Dauvilliers, Yves; Labeeuw, Olivier; Capet, Marc; Schwartz, Jean-Charles; Robert, Philippe

2011-02-01

An ultra-performance liquid chromatography tandem mass spectrometry (UPLC™-MS/MS) assay was developed for the simultaneous analysis of histamine, its major metabolite tele-methylhistamine, and an internal standard (N-tele-(R)-α-dimethylhistamine) from human cerebrospinal fluid (CSF) samples. The method involves derivatization of primary amines with 4-bromobenzenesulfonyl chloride and subsequent analysis by reversed phase liquid chromatography with mass spectrometry detection and positive electrospray ionization. The separation of derivatized biogenic amines was achieved within 3.5 min on an Acquity® BEH C(18) column by elution with a linear gradient of acetonitrile/water/formic acid (0.1%). The assay was linear in the concentration range of 50-5000 pM for each amine (5.5-555 pg/ml for histamine and 6.25-625 pg/ml for tele-methylhistamine). For repeatability and precision determination, coefficients of variation (CVs) were less than 11.0% over the tested concentration ranges, within acceptance criteria. Thus, the developed method provides the rapid, easy, highly sensitive, and selective requirement to quantify these amines in human CSF. No significant difference was found in the mean ± standard error levels of these amines between a group of narcoleptic patients (histamine=392 ± 64 pM, tele-methylhistamine=2431 ± 461 pM, n=7) and of neurological control subjects (histamine=402 ± 72 pM, tele-methylhistamine=2209 ± 463 pM, n=32). Copyright © 2010 Elsevier Inc. All rights reserved.

Cost comparison between home telemonitoring and usual care of older adults: a randomized trial (Tele-ERA).

PubMed

Upatising, Benjavan; Wood, Douglas L; Kremers, Walter K; Christ, Sharon L; Yih, Yuehwern; Hanson, Gregory J; Takahashi, Paul Y

2015-01-01

From 1992 to 2008, older adults in the United States incurred more healthcare expense per capita than any other age group. Home telemonitoring has emerged as a potential solution to reduce these costs, but evidence is mixed. The primary aim of the study was to evaluate whether the mean difference in total direct medical cost consequence between older adults receiving additional home telemonitoring care (TELE) (n=102) and those receiving usual medical care (UC) (n=103) were significant. Inpatient, outpatient, emergency department, decedents, survivors, and 30-day readmission costs were evaluated as secondary aim. Multivariate generalized linear models (GLMs) and parametric bootstrapping method were used to model cost and to determine significance of the cost differences. We also compared the differences in arithmetic mean costs. From the conditional GLMs, the estimated mean cost differences (TELE versus UC) for total, inpatient, outpatient, and ED were -$9,537 (p=0.068), -$8,482 (p =0.098), -$1,160 (p=0.177), and $106 (p=0.619), respectively. Mean postenrollment cost was 11% lower than the prior year for TELE versus 22% higher for UC. The ratio of mean cost for decedents to survivors was 2.1:1 (TELE) versus 12.7:1 (UC). There were no significant differences in the mean total cost between the two treatment groups. The TELE group had less variability in cost of care, lower decedents to survivors cost ratio, and lower total 30-day readmission cost than the UC group.

Singapore Tele-technology Aided Rehabilitation in Stroke (STARS) trial: protocol of a randomized clinical trial on tele-rehabilitation for stroke patients.

PubMed

Koh, Gerald Choon-Huat; Yen, Shih Cheng; Tay, Arthur; Cheong, Angela; Ng, Yee Sien; De Silva, Deidre Anne; Png, Carolina; Caves, Kevin; Koh, Karen; Kumar, Yogaprakash; Phan, Shi Wen; Tai, Bee Choo; Chen, Cynthia; Chew, Effie; Chao, Zhaojin; Chua, Chun En; Koh, Yen Sin; Hoenig, Helen

2015-09-05

Most acute stroke patients with disabilities do not receive recommended rehabilitation following discharge to the community. Functional and social barriers are common reasons for non-adherence to post-discharge rehabilitation. Home rehabilitation is an alternative to centre-based rehabilitation but is costlier. Tele-rehabilitation is a possible solution, allowing for remote supervision of rehabilitation and eliminating access barriers. The objective of the Singapore Tele-technology Aided Rehabilitation in Stroke (STARS) trial is to determine if a novel tele-rehabilitation intervention for the first three months after stroke admission improves functional recovery compared to usual care. This is a single blind (evaluator blinded), parallel, two-arm randomised controlled trial study design involving 100 recent stroke patients. The inclusion criteria are age ≥40 years, having caregiver support and recent stroke defined as stroke diagnosis within 4 weeks. Consenting participants will be randomized with varying block size of 4 or 6 assuming a 1:1 treatment allocation with the participating centre as the stratification factor. The baseline assessment will be done within 4 weeks of stroke onset, followed by follow-up assessments at 3 and 6 months. The tele-rehabilitation intervention lasts for 3 months and includes exercise 5-days-a-week using an iPad-based system that allows recording of daily exercise with video and sensor data and weekly video-conferencing with tele-therapists after data review. Those allocated to the control group will receive usual care. The primary outcome measure is improvement in life task's social activity participation at three months as measured by the disability component of the Jette Late Life Functional and Disability Instrument (LLFDI). Secondary outcome variables consist of gait speed (Timed 5-Meter Walk Test) and endurance (Two-Minute Walk test), performance of basic activities of daily living (Shah-modified Barthel Index), balance confidence (Activities-Specific Balance Confidence Scale), patient self-reported health-related quality-of-life [Euro-QOL (EQ-5D)], health service utilization (Singapore Stroke Study Health Service Utilization Form) and caregiver reported stress (Zarit Caregiver Burden Inventory). The goal of this trial is to provide evidence on the potential benefit and cost-effectiveness of this novel tele-rehabilitation programme which will guide health care decision-making and potentially improve performance of post-stroke community-based rehabilitation. This trial protocol was registered under ClinicalTrials.gov on 18 July 2013 as study title "The Singapore Tele-technology Aided Rehabilitation in Stroke (STARS) Study" (ID: The STARS Study, ClinicalTrials.gov Identifier: NCT01905917 ).

Radiological tele-immersion for next generation networks.

PubMed

Ai, Z; Dech, F; Rasmussen, M; Silverstein, J C

2000-01-01

Since the acquisition of high-resolution three-dimensional patient images has become widespread, medical volumetric datasets (CT or MR) larger than 100 MB and encompassing more than 250 slices are common. It is important to make this patient-specific data quickly available and usable to many specialists at different geographical sites. Web-based systems have been developed to provide volume or surface rendering of medical data over networks with low fidelity, but these cannot adequately handle stereoscopic visualization or huge datasets. State-of-the-art virtual reality techniques and high speed networks have made it possible to create an environment for clinicians geographically distributed to immersively share these massive datasets in real-time. An object-oriented method for instantaneously importing medical volumetric data into Tele-Immersive environments has been developed at the Virtual Reality in Medicine Laboratory (VRMedLab) at the University of Illinois at Chicago (UIC). This networked-VR setup is based on LIMBO, an application framework or template that provides the basic capabilities of Tele-Immersion. We have developed a modular general purpose Tele-Immersion program that automatically combines 3D medical data with the methods for handling the data. For this purpose a DICOM loader for IRIS Performer has been developed. The loader was designed for SGI machines as a shared object, which is executed at LIMBO's runtime. The loader loads not only the selected DICOM dataset, but also methods for rendering, handling, and interacting with the data, bringing networked, real-time, stereoscopic interaction with radiological data to reality. Collaborative, interactive methods currently implemented in the loader include cutting planes and windowing. The Tele-Immersive environment has been tested on the UIC campus over an ATM network. We tested the environment with 3 nodes; one ImmersaDesk at the VRMedLab, one CAVE at the Electronic Visualization Laboratory (EVL) on east campus, and a CT scan machine in UIC Hospital. CT data was pulled directly from the scan machine to the Tele-Immersion server in our Laboratory, and then the data was synchronously distributed by our Onyx2 Rack server to all the VR setups. Instead of permitting medical volume visualization at one VR device, by combining teleconferencing, tele-presence, and virtual reality, the Tele-Immersive environment will enable geographically distributed clinicians to intuitively interact with the same medical volumetric models, point, gesture, converse, and see each other. This environment will bring together clinicians at different geographic locations to participate in Tele-Immersive consultation and collaboration.

A Computer-Controlled Classroom Model of an Atomic Force Microscope

NASA Astrophysics Data System (ADS)

Engstrom, Tyler A.; Johnson, Matthew M.; Eklund, Peter C.; Russin, Timothy J.

2015-12-01

The concept of "seeing by feeling" as a way to circumvent limitations on sight is universal on the macroscopic scale—reading Braille, feeling one's way around a dark room, etc. The development of the atomic force microscope (AFM) in 1986 extended this concept to imaging in the nanoscale. While there are classroom demonstrations that use a tactile probe to map the topography or some other property of a sample, the rastering of the probe over the sample is manually controlled, which is both tedious and potentially inaccurate. Other groups have used simulation or tele-operation of an AFM probe. In this paper we describe a teaching AFM with complete computer control to map out topographic and magnetic properties of a "crystal" consisting of two-dimensional arrays of spherical marble "atoms." Our AFM is well suited for lessons on the "Big Ideas of Nanoscale" such as tools and instrumentation, as well as a pre-teaching activity for groups with remote access AFM or mobile AFM. The principle of operation of our classroom AFM is the same as that of a real AFM, excepting the nature of the force between sample and probe.

Tele-monitoring of ventilator-dependent patients: a European Respiratory Society Statement.

PubMed

Ambrosino, Nicolino; Vitacca, Michele; Dreher, Michael; Isetta, Valentina; Montserrat, Josep M; Tonia, Thomy; Turchetti, Giuseppe; Winck, Joao Carlos; Burgos, Felip; Kampelmacher, Michael; Vagheggini, Guido

2016-09-01

The estimated prevalence of ventilator-dependent individuals in Europe is 6.6 per 100 000 people. The increasing number and costs of these complex patients make present health organisations largely insufficient to face their needs. As a consequence, their burden lays mostly over families. The need to reduce healthcare costs and to increase safety has prompted the development of tele-monitoring for home ventilatory assistance.A European Respiratory Society Task Force produced a literature research based statement on commonly accepted clinical criteria for indications, follow-up, equipment, facilities, legal and economic issues of tele-monitoring of these patients.Many remote health monitoring systems are available, ensuring safety, feasibility, effectiveness, sustainability and flexibility to face different patients' needs. The legal problems associated with tele-monitoring are still controversial. National and European Union (EU) governments should develop guidelines and ethical, legal, regulatory, technical, administrative standards for remote medicine. The economic advantages, if any, of this new approach must be compared to a "gold standard" of home care that is very variable among different European countries and within each European country.Much more research is needed before considering tele-monitoring a real improvement in the management of these patients. Copyright ©ERS 2016.

Development of a program for tele-rehabilitation of COPD patients across sectors: co-innovation in a network

PubMed Central

Dinesen, Birthe; Seeman, Janne; Gustafsson, Jeppe

2011-01-01

Introduction The aim of the Telekat project is to prevent re-admissions of patients with chronic obstructive pulmonary disease (COPD) by developing a preventive program of tele-rehabilitation across sectors for COPD patients. The development of the program is based on a co-innovation process between COPD patients, relatives, healthcare professionals and representatives from private firms and universities. This paper discusses the obstacles that arise in the co-innovation process of developing an integrated technique for tele-rehabilitation of COPD patients. Theory Network and innovation theory. Methods The case study was applied. A triangulation of data collection techniques was used: documents, observations (123 hours), qualitative interviews (n=32) and action research. Findings Obstacles were identified in the network context; these obstacles included the mindset of the healthcare professionals, inter-professionals relations, views of technology as a tool and competing visions for the goals of tele-rehabilitation. Conclusion We have identified obstacles that emerge in the co-innovation process when developing a programme for tele-rehabilitation of COPD patients in an inter-organizational context. Action research has been carried out and can have helped to facilitate the co-innovation process. PMID:21637709

What CORBA can do: An example of a new system developed with object technology: TeleMed

DOE Office of Scientific and Technical Information (OSTI.GOV)

Forslund, D.; Phillips, R.; Tomlinson, B.

1996-05-01

The TeleMed application grew out of a relationship with physicians at the National Jewish Center for Immunology and Respiratory Medicine (NJC) in Denver. These physicians are experts in pulmonary diseases and radiology, helping patients combat effects of TB and other lung diseases. To make the knowledge and experience at NJC available to a wider audience, LANL has developed a virtual patient record system called TeleMed which is based on distributed national radiographic and patient record repository located throughout the country. Without leaving their offices, participating doctors can view clinical drug and radiographic data via a sophisticated multimedia interface. TeleMed ismore » also valuable for teaching and presentation as well. Thus a resident can use TeleMed for self-training in diagnostic techniques and a physician can use it to explain to a patient the course of their illness. Data can be viewed simultaneously by users at two or more distant locations for consultation with specialists in different fields. This capability is made possible by integration of multimedia information using commercial CORBA technology linking object-enable databases with client interfaces using a three-tiered architecture.« less

[Tele-medicine system for high-risk asthmatic patients].

PubMed

Kokubu, F; Suzuki, H; Sano, Y; Kihara, N; Adachi, M

1999-07-01

We have developed a tele-medicine system to monitor the airway status at home for patients with poorly controlled asthma, whereby a nurse provides instructions to individuals via the telephone to help them manage exacerbation under the supervision of their physicians. We examined the effectiveness of this system with a randomized control study. Patients with high hospitalization risk were enrolled in the study by screening patients for those with multiple previous emergency room visits and randomly assigned to either the tele-medicine or control group. After six months of participation in the program, the number of emergency room visits decreased significantly and the activities of daily living were improved in the tele-medicine group. Most of the patients in the tele-medicine group were able to continue measuring and transmitting peak expiratory flow (PEF) value successfully, and at six months had noticed an improvement in PEF. We therefore conclude that the system effectively contributes to the management of poorly controlled asthma. In addition, further consideration suggests that the reduction of emergency room visits may lead to reduction in hospitalization since we found a good correlation between number of emergency room visits and hospitalization from the studies published previously.

Assessment of atmospheric models for tele-infrasonic propagation

NASA Astrophysics Data System (ADS)

McKenna, Mihan; Hayek, Sylvia

2005-04-01

Iron mines in Minnesota are ideally located to assess the accuracy of available atmospheric profiles used in infrasound modeling. These mines are located approximately 400 km away to the southeast (142) of the Lac-Du-Bonnet infrasound station, IS-10. Infrasound data from June 1999 to March 2004 was analyzed to assess the effects of explosion size and atmospheric conditions on observations. IS-10 recorded a suite of events from this time period resulting in well constrained ground truth. This ground truth allows for the comparison of ray trace and PE (Parabolic Equation) modeling to the observed arrivals. The tele-infrasonic distance (greater than 250 km) produces ray paths that turn in the upper atmosphere, the thermosphere, at approximately 120 km to 140 km. Modeling based upon MSIS/HWM (Mass Spectrometer Incoherent Scatter/Horizontal Wind Model) and the NOGAPS (Navy Operational Global Atmospheric Prediction System) and NRL-GS2 (Naval Research Laboratory Ground to Space) augmented profiles are used to interpret the observed arrivals.

Tele-surgery simulation with a patient organ model for robotic surgery training.

PubMed

Suzuki, S; Suzuki, N; Hattori, A; Hayashibe, M; Konishi, K; Kakeji, Y; Hashizume, M

2005-12-01

Robotic systems are increasingly being incorporated into general laparoscopic and thoracoscopic surgery to perform procedures such as cholecystectomy and prostatectomy. Robotic assisted surgery allows the surgeon to conduct minimally invasive surgery with increased accuracy and with potential benefits for patients. However, current robotic systems have their limitations. These include the narrow operative field of view, which can make instrument manipulation difficult. Current robotic applications are also tailored to specific surgical procedures. For these reasons, there is an increasing demand on surgeons to master the skills of instrument manipulation and their surgical application within a controlled environment. This study describes the development of a surgical simulator for training and mastering procedures performed with the da Vinci surgical system. The development of a tele-surgery simulator and the construction of a training center are also described, which will enable surgeons to simulate surgery from or in remote places, to collaborate over long distances, and for off-site expert assistance. Copyright 2005 John Wiley & Sons, Ltd.

Field testing of a remote controlled robotic tele-echo system in an ambulance using broadband mobile communication technology.

PubMed

Takeuchi, Ryohei; Harada, Hiroshi; Masuda, Kohji; Ota, Gen-ichiro; Yokoi, Masaki; Teramura, Nobuyasu; Saito, Tomoyuki

2008-06-01

We report the testing of a mobile Robotic Tele-echo system that was placed in an ambulance and successfully transmitted clear real time echo imaging of a patient's abdomen to the destination hospital from where this device was being remotely operated. Two-way communication between the paramedics in this vehicle and a doctor standing by at the hospital was undertaken. The robot was equipped with an ultrasound probe which was remotely controlled by the clinician at the hospital and ultrasound images of the patient were transmitted wirelessly. The quality of the ultrasound images that were transmitted over the public mobile telephone networks and those transmitted over the Multimedia Wireless Access Network (a private networks) were compared. The transmission rate over the public networks and the private networks was approximately 256 Kbps, 3 Mbps respectively. Our results indicate that ultrasound images of far higher definition could be obtained through the private networks.

Outpatient virtual clinical encounters after complex surgery for cancer: a prospective pilot study of "TeleDischarge".

PubMed

Katz, Matthew H G; Slack, Rebecca; Bruno, Morgan; McMillan, Jermaine; Fleming, Jason B; Lee, Jeffrey E; Bednarski, Brian; Papadopoulos, John; Matin, Surena F

2016-05-01

Outpatient clinical encounters are used to promote recovery after complex surgical procedures for cancer. These care episodes are resource intensive. Virtual clinical encounters (VCEs) can now be conducted using widely available videoconferencing technologies. However, whether these technologies may be used to monitor postoperative recovery is unknown. In this pilot study, we provided care using a comprehensive "TeleDischarge" protocol to 15 patients after pancreatectomy. In addition to routine follow-up, all patients participated in two scheduled and an unlimited number of unscheduled VCEs using mobile hardware and secure videoconferencing software. We evaluated feasibility, patient satisfaction, postoperative adverse events, and health care human resource utilization. The median age of enrolled patients was 63 y (range, 52-83 y) and 93% underwent pancreatoduodenectomy. Twenty-eight scheduled VCEs (93%) were completed successfully, and only one unscheduled VCE was requested. Twelve patients (80%) felt their postoperative care was enhanced by VCEs and 14 (93%) felt that VCEs should be a regular part of postoperative care. Minor interventions in four patients (27%) were performed on the basis of clinical data gathered during a VCE. On a per patient basis, the TeleDischarge pathway was estimated to take 36 min longer and to have a direct labor cost $39 greater than the standard pathway. Secure VCEs can be conducted using widely available hardware and software solutions. Although cancer patients support the introduction of mobile technology into postoperative care, further studies are needed to identify ways in which such technology can be used most effectively and efficiently to reduce barriers to recovery. Copyright © 2016 Elsevier Inc. All rights reserved.

Demonstration of improved seismic source inversion method of tele-seismic body wave

NASA Astrophysics Data System (ADS)

Yagi, Y.; Okuwaki, R.

2017-12-01

Seismic rupture inversion of tele-seismic body wave has been widely applied to studies of large earthquakes. In general, tele-seismic body wave contains information of overall rupture process of large earthquake, while the tele-seismic body wave is inappropriate for analyzing a detailed rupture process of M6 7 class earthquake. Recently, the quality and quantity of tele-seismic data and the inversion method has been greatly improved. Improved data and method enable us to study a detailed rupture process of M6 7 class earthquake even if we use only tele-seismic body wave. In this study, we demonstrate the ability of the improved data and method through analyses of the 2016 Rieti, Italy earthquake (Mw 6.2) and the 2016 Kumamoto, Japan earthquake (Mw 7.0) that have been well investigated by using the InSAR data set and the field observations. We assumed the rupture occurring on a single fault plane model inferred from the moment tensor solutions and the aftershock distribution. We constructed spatiotemporal discretized slip-rate functions with patches arranged as closely as possible. We performed inversions using several fault models and found that the spatiotemporal location of large slip-rate area was robust. In the 2016 Kumamoto, Japan earthquake, the slip-rate distribution shows that the rupture propagated to southwest during the first 5 s. At 5 s after the origin time, the main rupture started to propagate toward northeast. First episode and second episode correspond to rupture propagation along the Hinagu fault and the Futagawa fault, respectively. In the 2016 Rieti, Italy earthquake, the slip-rate distribution shows that the rupture propagated to up-dip direction during the first 2 s, and then rupture propagated toward northwest. From both analyses, we propose that the spatiotemporal slip-rate distribution estimated by improved inversion method of tele-seismic body wave has enough information to study a detailed rupture process of M6 7 class earthquake.

A pilot study for the integration of cytometry reports in digital cytology telemedicine applications.

PubMed

Giansanti, Daniele; Cerroni, Fabio; Amodeo, Rachele; Filoni, Marco; Giovagnoli, Maria Rosaria

2010-01-01

Up to date, tele-pathology in the three different forms of application, "dynamic", "static" and "virtual microscopy" has been mainly based on tele-hystology remote consulting. Today the diffusion of specialized WAN connections is guiding the research of new applications of tele-pathology. A specific analysis has been conducted, focused on digital cytology, in the biomedical laboratory of Sant'Andrea Hospital to investigate the technologies potentially useful to integrate in the LAN/WAN for telemedicine applications. Among the possible tools useful to be integrated in the LAN/WAN for telemedicine applications, the cytometry equipment available in the technical unity of cytometry has been considered important. The study finally provides a proposal for a tele-consulting architecture for the integration of cytometry reports both in the hospital LAN and the WAN for possible cooperative diagnosis and second opinion support.

Implementation and evaluation of a tele-education system for the diagnosis of ophthalmic disease by international trainees

PubMed Central

Campbell, J. Peter; Swan, Ryan; Jonas, Karyn; Ostmo, Susan; Ventura, Camila V.; Martinez-Castellanos, Maria A.; Anzures, Rachelle Go Ang Sam; Chiang, Michael F.; Chan, R.V. Paul

2015-01-01

Tele-education systems are increasingly being utilized in medical education worldwide. Due to limited human resources in healthcare in low and middle-income countries, developing online systems that are accessible to medical trainees in underserved areas potentially represents a highly efficient and effective method of improving the quantity and quality of the health care workforce. We developed, implemented, and evaluated an interactive web-based tele-education system (based on internationally accepted, image-based guidelines) for the diagnosis of retinopathy of prematurity among ophthalmologists-in-training in Brazil, Mexico, and the Philippines. We demonstrate that participation in this tele-education program improved diagnostic accuracy and reliability, and was preferred to standard pedagogical methods. This system may be employed not only in training, but also in international certification programs, and the process may be generalizable to other image-based specialties, such as dermatology and radiology. PMID:26958168

Implementation and evaluation of a tele-education system for the diagnosis of ophthalmic disease by international trainees.

PubMed

Campbell, J Peter; Swan, Ryan; Jonas, Karyn; Ostmo, Susan; Ventura, Camila V; Martinez-Castellanos, Maria A; Anzures, Rachelle Go Ang Sam; Chiang, Michael F; Chan, R V Paul

Tele-education systems are increasingly being utilized in medical education worldwide. Due to limited human resources in healthcare in low and middle-income countries, developing online systems that are accessible to medical trainees in underserved areas potentially represents a highly efficient and effective method of improving the quantity and quality of the health care workforce. We developed, implemented, and evaluated an interactive web-based tele-education system (based on internationally accepted, image-based guidelines) for the diagnosis of retinopathy of prematurity among ophthalmologists-in-training in Brazil, Mexico, and the Philippines. We demonstrate that participation in this tele-education program improved diagnostic accuracy and reliability, and was preferred to standard pedagogical methods. This system may be employed not only in training, but also in international certification programs, and the process may be generalizable to other image-based specialties, such as dermatology and radiology.

Impact of new information technologies on training and continuing education for rural health professionals.

PubMed

Crandall, L A; Coggan, J M

1994-01-01

Recently developed and emerging information and communications technologies offer the potential to move the clinical training of physicians and other health professionals away from the resource intensive urban academic health center, with its emphasis on tertiary care, and into rural settings that may be better able to place emphasis on the production of badly needed primary care providers. These same technologies also offer myriad opportunities to enhance the continuing education of health professionals in rural settings. This article explores the effect of new technologies for rural tele-education by briefly reviewing the effect of technology on health professionals' education, describing ongoing applications of tele-education, and discussing the likely effect of new technological developments on the future of tele-education. Tele-education has tremendous potential for improving the health care of rural Americans, and policy-makers must direct resources to its priority development in rural communities.

Multinational Experiment 7. Protecting Access to Space: Presentation to Senior Leaders

DTIC Science & Technology

2013-07-08

Multinational Experiment 7: Outcome 3: Space Access Briefing to SLS 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d...operations Consequence management Ship status during search & rescue Tele-medicine Broadband internet TV signal distribution Satellite radio Rural...military-usage • Significant economic & societal consequences Access to space at risk • Current approach unsustainable • Broad range of threats

Setup and Operation of the TeleEngineering Communications Equipment - Fixed Site (TCE-F), Version II

DTIC Science & Technology

2004-10-01

Overview ......................................................................... 3 A D T R A N IM U X ...the interconnections of the components. ADTRAN The ADTRAN provided with the continental United States systems is typi- cally a 2 x 64 version and...34FDX." After the FDX message appears and the system remains in the FDX mode, the Online button will flash , indicating the system is ready for a

Cost Comparison Between Home Telemonitoring and Usual Care of Older Adults: A Randomized Trial (Tele-ERA)

PubMed Central

Upatising, Benjavan; Wood, Douglas L.; Kremers, Walter K.; Christ, Sharon L.; Yih, Yuehwern; Hanson, Gregory J.

2015-01-01

Abstract Background: From 1992 to 2008, older adults in the United States incurred more healthcare expense per capita than any other age group. Home telemonitoring has emerged as a potential solution to reduce these costs, but evidence is mixed. The primary aim of the study was to evaluate whether the mean difference in total direct medical cost consequence between older adults receiving additional home telemonitoring care (TELE) (n=102) and those receiving usual medical care (UC) (n=103) were significant. Inpatient, outpatient, emergency department, decedents, survivors, and 30-day readmission costs were evaluated as secondary aim. Materials and Methods: Multivariate generalized linear models (GLMs) and parametric bootstrapping method were used to model cost and to determine significance of the cost differences. We also compared the differences in arithmetic mean costs. Results: From the conditional GLMs, the estimated mean cost differences (TELE versus UC) for total, inpatient, outpatient, and ED were −$9,537 (p=0.068), −$8,482 (p =0.098), −$1,160 (p=0.177), and $106 (p=0.619), respectively. Mean postenrollment cost was 11% lower than the prior year for TELE versus 22% higher for UC. The ratio of mean cost for decedents to survivors was 2.1:1 (TELE) versus 12.7:1 (UC). Conclusions: There were no significant differences in the mean total cost between the two treatment groups. The TELE group had less variability in cost of care, lower decedents to survivors cost ratio, and lower total 30-day readmission cost than the UC group. PMID:25453392

Medical reliable network using concatenated channel codes through GSM network.

PubMed

Ahmed, Emtithal; Kohno, Ryuji

2013-01-01

Although the 4(th) generation (4G) of global mobile communication network, i.e. Long Term Evolution (LTE) coexisting with the 3(rd) generation (3G) has successfully started; the 2(nd) generation (2G), i.e. Global System for Mobile communication (GSM) still playing an important role in many developing countries. Without any other reliable network infrastructure, GSM can be applied for tele-monitoring applications, where high mobility and low cost are necessary. A core objective of this paper is to introduce the design of a more reliable and dependable Medical Network Channel Code system (MNCC) through GSM Network. MNCC design based on simple concatenated channel code, which is cascade of an inner code (GSM) and an extra outer code (Convolution Code) in order to protect medical data more robust against channel errors than other data using the existing GSM network. In this paper, the MNCC system will provide Bit Error Rate (BER) equivalent to the BER for medical tele monitoring of physiological signals, which is 10(-5) or less. The performance of the MNCC has been proven and investigated using computer simulations under different channels condition such as, Additive White Gaussian Noise (AWGN), Rayleigh noise and burst noise. Generally the MNCC system has been providing better performance as compared to GSM.

Low Cost Space Demonstration for a Single-Person Spacecraft

NASA Technical Reports Server (NTRS)

Griffin, Brand N.; Dischinger, Charles

2011-01-01

This paper introduces a concept for a single-person spacecraft and presents plans for flying a low-cost, robotic demonstration mission. Called FlexCraft, the vehicle integrates propulsion and robotics into a small spacecraft that enables rapid, shirt-sleeve access to space. It can be flown by astronauts or tele-operated and is equipped with interchangeable manipulators used for maintaining the International Space Station (ISS), exploring asteroids, and servicing telescopes or satellites. Most FlexCraft systems are verified using ground facilities; however, a test in the weightless environment is needed to assess propulsion and manipulator performance. For this, a simplified, unmanned, version of FlexCraft is flown on a low-cost launch vehicle to a 350 km circular orbit. After separation from the upper stage, the vehicle returns to a target box mounted on the stage testing the propulsion and control capability. The box is equipped with manipulator test items that are representative of tasks performed on ISS, asteroid missions, or for satellites servicing. Nominal and off-nominal operations are conducted over 3 days then the vehicle re-enters the atmosphere without becoming a debris hazard. From concept to management to operations, the FlexCraft demonstration is designed to be low cost project that is launched within three years. This is possible using a simplified test configuration that eliminates nine systems unique to the operational version and by designing-to-availability. For example, the propulsion system is the same as the Manned Maneuvering Unit because it capable, simple, human-rated and all components or equivalent parts are available. A description of the launch vehicle options, mission operations, configuration, and demonstrator subsystems is presented.

Six-year prevalence and incidence of diabetic retinopathy and cost-effectiveness of tele-ophthalmology in Manitoba.

PubMed

Kanjee, Raageen; Dookeran, Ravi I; Mathen, Mathen K; Stockl, Frank A; Leicht, Richard

2017-11-01

The purpose of this study was to evaluate the diabetic retinopathy (DR) tele-ophthalmology screening program in Manitoba to determine prevalence and incidence of DR, as well as to estimate the program's cost-effectiveness. Retrospective chart review. A total of 4676 patients with type 2 diabetes examined 9334 times from 2007 to 2013. Focused ophthalmic histories were recorded and examinations were performed by trained nurses, including visual acuities, intraocular pressure, and mydriatic 7 standard field stereoscopic fundus photography. Images were evaluated by retinal specialists according to the Early Treatment of Diabetic Retinopathy Study criteria. DR prevalence and incidence were then calculated during the study period. Cost-effectiveness was estimated by comparing the cost of running the tele-ophthalmology program compared with the cost of screening the same volume of patients in-office. The average prevalence of any DR in each year was 25.1%. The cumulative incidence of DR across 6 years was 17.1% (95% CI, 15.4%-18.7%). The average savings per tele-ophthalmology examination was $1007. DR is highly prevalent among the studied population. Tele-ophthalmology provides a cost-effective means of monitoring patients as well as identifying new or treatable disease. Copyright © 2017. Published by Elsevier Inc.

SatCom Systems for Health and Medical Care

NASA Astrophysics Data System (ADS)

Diez, Hubert

2002-01-01

Convinced since 1997 that the satellite was capable of providing a real added value either autonomously or as a complement to terrestrial infrastructures, CNES (the French Space Agency) began a determined study, validation and demonstration procedure for new satellite services. At a national but also European and worldwide level, several experiments or projects have been set-up. In each of them (tele-consultations, distant education, tele-epidemiology, tele-echography, assistance to people, training and therapeutic assistance, disaster telemedicine, etc...) well suited satcoms are used. (telecommunications for broadcasting, multicasting, downloading,...- localization, positioning, - low medium and high data rate bidirectional systems,). Medical reference people are associated in each pilot projects first to define the needs but also to manage the medical validation aspects. Our aim is always to test, validate and adapt these new services to bring them into line with the users' expectations. The value added of these technologies in sustainable healthcare services are systematically demonstrated in real situations, with real users, both in terms of quality of service and of economic validity. For several projects CNES has developed typical hardware, or technical on as technical platform. The main projects and their relevant satcom systems will be presented and discussed : - Tele-consultation, - Distance learning and training, - Assistance to people, - Tele-epidemiology, - Disaster telemedicine.

Fetal tele-echography using a robotic arm and a satellite link.

PubMed

Arbeille, P; Ruiz, J; Herve, P; Chevillot, M; Poisson, G; Perrotin, F

2005-09-01

To design a method for conducting fetal ultrasound examinations in isolated hospital sites using a dedicated remotely controlled robotic arm (tele-echography). Tele-echography was performed from our hospital (expert center) on 29 pregnant women in an isolated maternity hospital (patient site) 1700 km away, and findings were compared with those of conventional ultrasound examinations. At the patient site, a robotic arm holding the real ultrasound probe was placed on the patient's abdomen by an assistant with no experience of performing ultrasound. The robotic arm, remotely controlled with a fictive (expert) probe, reproduced the exact movements (tilting and rotating) of the expert hand on the real ultrasound probe. In 93.1% of the cases, all biometric parameters, placental location and amniotic fluid volume, were correctly assessed using the teleoperated robotic arm. In two cases, femur length could not be correctly measured. The mean duration of fetal ultrasound examination was 14 min (range, 10-18) and 18 min (range, 13-23) by conventional and tele-echography methods, respectively. The mean number of times the robotic arm was repositioned on the patient's abdomen was seven (range, 5-9). Tele-echography using a robotic arm provides the main information needed to assess fetal growth and the intrauterine environment within a limited period of time.

An Intelligent Catheter System Robotic Controlled Catheter System

PubMed Central

Negoro, M.; Tanimoto, M.; Arai, F.; Fukuda, T.; Fukasaku, K.; Takahashi, I.; Miyachi, S.

2001-01-01

Summary We have developed a novel catheter system, an intelligent catheter system, which is able to control a catheter by an externally-placed controller. This system has made from master-slave mechanism and has following three components; 1) a joy stick as a master (for operators) 2)a catheter controller as a slave (for a patient),3)a micro force sensor as a sensing device. This catheter tele-guiding system has abilities to perform intravascular procedures from the distant places. It may help to reduce the radiation exposures to the operators and also to help train young doctors. PMID:20663387

Evaluating satisfaction of patients with stutter regarding the tele-speech therapy method and infrastructure.

PubMed

Eslami Jahromi, Maryam; Ahmadian, Leila

2018-07-01

Investigating the required infrastructure for the implementation of telemedicine and the satisfaction of target groups improves the acceptance of this technology and facilitates the delivery of healthcare services. The aim of this study was to assess the satisfaction of patients with stutter concerning the therapeutic method and the infrastructure used to receive tele-speech therapy services. This descriptive-analytical study was conducted on all patients with stutter aged between 14 and 39 years at Jahrom Social Welfare Bureau (n = 30). The patients underwent speech therapy sessions through video conferencing with Skype. Data were collected by a researcher-made questionnaire. Its content validity was confirmed by three medical informatics specialists. Data were analyzed using SPSS version 19. The mean and standard deviation of patient satisfaction scores concerning the infrastructure and the tele-speech therapy method were 3.15 ± 0.52 and 3.49 ± 0.52, respectively. No significant relationship was found between the patients satisfaction and their gender, education level and age (p > 0.05). The results of this study showed that the number of speech therapy sessions did not affect the overall satisfaction of the patients (p > 0.05), but the number of therapeutic sessions had a direct relationship with their satisfaction with the infrastructure used for tele-speech therapy (p < 0.05). The present study showed that patients were satisfied with tele-speech therapy. According to most patients the low speed of the Internet connection in the country was a major challenge for receiving tele-speech therapy. The results suggest that healthcare planner and policy makers invest on increasing bandwidth to improve the success rate of telemedicine programs. Copyright © 2018 Elsevier B.V. All rights reserved.

Working Alliance, Interpersonal Problems, and Depressive Symptoms in Tele-Interpersonal Psychotherapy for HIV-infected Rural Persons: Evidence for Indirect Effects.

PubMed

Anderson, Timothy; McClintock, Andrew S; McCarrick, Shannon S; Heckman, Timothy G; Heckman, Bernadette D; Markowitz, John C; Sutton, Mark

2018-03-01

Interpersonal psychotherapy (IPT) has demonstrated efficacy for the treatment of depression, yet little is known about its therapeutic mechanisms. As a specific treatment, IPT has been shown to directly reduce depressive symptoms, although it is unclear whether these reductions occur via interpersonal changes. Within IPT, the potential role of the working alliance, a common factor, as a predictor of depression and interpersonal changes is also unclear. Participants were 147 depressed persons living with HIV in rural communities of 28 U.S. states enrolled in a randomized clinical trial. Seventy-five patients received up to 9 sessions of telephone-administered IPT (tele-IPT) plus standard care and 72 patients received standard care only. Two models were tested; one included treatment condition (tele-IPT vs. control) and another included the working alliance as independent variables. The first model found an indirect effect whereby tele-IPT reduced depression via decreased social avoidance. There was a direct effect between tele-IPT and reduced depression. In the second model, the working alliance influenced depressive symptom relief via reductions in social avoidance. Both goal and task working alliance subscales were indirectly associated with reductions in depressive symptoms, also through reductions in social avoidance. There were no direct effects involving the working alliance. Tele-IPT's influence on depressive symptom reduction was primarily through a direct effect, whereas the influence of working alliance depression was almost entirely via an indirect effect through interpersonal problems. Study findings have implications for IPT when intervening with depressed rural people living with HIV/AIDS over the telephone. © 2017 Wiley Periodicals, Inc.

Virtually There.

ERIC Educational Resources Information Center

Lanier, Jaron

2001-01-01

Describes tele-immersion, a new medium for human interaction enabled by digital technologies. It combines the display and interaction techniques of virtual reality with new vision technologies that transcend the traditional limitations of a camera. Tele-immersion stations observe people as moving sculptures without favoring a single point of view.…

Arizona TeleMedicine Project.

ERIC Educational Resources Information Center

Arizona Univ., Tucson. Coll. of Medicine.

Designed to provide health services for American Indians living on rurally isolated reservations, the Arizona TeleMedicine Project proposes to link Phoenix and Tucson medical centers, via a statewide telecommunications system, with the Hopi, San Carlos Apache, Papago, Navajo, and White Mountain Apache reservations. Advisory boards are being…

Lunar Sample Return Missions Using a Tele-Robotic Lander

NASA Astrophysics Data System (ADS)

Downes, H.; Crawford, I. A.; Alexander, L.

2018-02-01

Deep Space Gateway would allow tele-robotic landers and rovers to access regions of the Moon which have not been previously sampled. Scientific questions, e.g., the nature and duration of volcanic activity and the composition of the mantle/lower crust, could be addressed.

Integrated Internet based tools for learning and evaluating the International Classification of Nursing Practice.

PubMed

Alecu, C S; Jitaru, E; Moisil, I

2000-01-01

This paper presents some tools designed and implemented for learning-related purposes; these tools can be downloaded or run on the TeleNurse web site. Among other facilities, TeleNurse web site is hosting now the version 1.2 of SysTerN (terminology system for nursing) which can be downloaded on request and also the "Evaluation of Translation" form which has been designed in order to improve the Romanian translation of the ICNP (the International Classification of Nursing Practice). SysTerN has been developed using the framework of the TeleNurse ID--ENTITY Telematics for Health EU project. This version is using the beta version of ICNP containing Phenomena and Actions classification. This classification is intended to facilitate documentation of nursing practice, by providing a terminology or vocabulary for use in the description of the nursing process. The TeleNurse site is bilingual, Romanian-English, in order to enlarge the discussion forum with members from other CEE (or Non-CEE) countries.

Smart ophthalmics: the future in tele-ophthalmology has arrived

NASA Astrophysics Data System (ADS)

Fink, Wolfgang; Tarbell, Mark A.; Garcia, Kevin

2016-05-01

Smart Ophthalmics© extends ophthalmic healthcare to people who operate/live in austere environments (e.g., military, third world, natural disaster), or are geographically dispersed (e.g., rural populations), where time, cost, and the possibility of travel/transportation make access to even adequate medical care difficult, if at all possible. Operators attach optical devices that act as ophthalmic examination extensions to smartphones and run custom apps to perform examinations of specific areas of the eye. The smartphone apps submit over wireless networks the collected examination data to a smart remote expert system, which provides in-depth medical analyses that are sent back in near real-time to the operators for subsequent triage.

Effects of home-based tele-exercise on sarcopenia among community-dwelling elderly adults: Body composition and functional fitness.

PubMed

Hong, Jeeyoung; Kim, Jeongeun; Kim, Suk Wha; Kong, Hyoun-Joong

2017-01-01

This study aims to develop a form of tele-exercise that would enable real-time interactions between exercise instructors and community-dwelling elderly people and to investigate its effects on improvement of sarcopenia-related factors of body composition and functional fitness among the elderly. Randomized, controlled trial, with a 12-week intervention period. Community-dwelling senior citizens in Gangseo-gu, Seoul, South Korea. The participants were 23 elderly individuals (tele-exercise group: 11, control group: 12), aged 69 to 93years. The tele-exercise program was developed utilizing a 15-in. all-in-one PC and video conferencing software (Skype™), with broadband Internet connectivity. The tele-exercise group performed supervised resistance exercise at home for 20-40min a day three times per week for 12weeks. The remote instructor provided one-on-one instruction to each participant during the intervention. The control group maintained their lifestyles without any special intervention. The sarcopenia-related factors of body composition and functional fitness were examined prior to, as well as following, a 12-week intervention period. The data were analyzed with a two-way repeated measures ANOVA. There were significant improvements in lower limb muscle mass (p=0.017), appendicular lean soft tissue (p=0.032), total muscle mass (p=0.033), and chair sit-and-reach length (p=0.019) for the tele-exercise group compared to the control group. No group×time interaction effects were detected for the 2-min step, chair stand, and time effects (p<0.05). Video conferencing-based supervised resistance exercise had positive effects on sarcopenia-related factors such as total-body skeletal muscle mass, appendicular lean soft tissue, lower limb muscle mass, and the chair sit-and-reach scores among community-dwelling elderly adults. These results imply that tele-exercise can be a new and effective intervention method for increasing skeletal muscle mass and the physical functioning of the lower limbs from the perspective of sarcopenia improvement among the elderly. Copyright © 2016 Elsevier Inc. All rights reserved.

Training Substance Abuse Clinicians in Motivational Interviewing Using Live Supervision via Tele-conferencing

PubMed Central

Smith, Jennifer L.; Carpenter, Kenneth M.; Amrhein, Paul C.; Brooks, Adam C.; Levin, Deborah; Schreiber, Elizabeth A.; Travaglini, Laura A.; Hu, Mei-Chen; Nunes, Edward V.

2012-01-01

Background Training through traditional workshops is relatively ineffective for changing counseling practices. Tele-conferencing Supervision (TCS) was developed to provide remote, live supervision for training motivational interviewing (MI). Method 97 community drug treatment counselors completed a 2-day MI workshop and were randomized to: live supervision via tele-conferencing (TCS; n=32), standard tape-based supervision (Tape; n=32), or workshop alone (Workshop; n=33). Supervision conditions received 5 weekly supervision sessions at their sites using actors as standard patients. Sessions with clients were rated for MI skill with the Motivational Interviewing Treatment Integrity (MITI) coding system pre-workshop and 1, 8, and 20 weeks post-workshop. Mixed effects linear models were used to test training condition on MI skill at 8 and 20 weeks. Results TCS scored better than Workshop on the MITI for Spirit (mean difference = 0.76; p < .0001; d = 1.01) and Empathy (mean difference = 0.68; p < .001; d = 0.74). Tape supervision fell between TCS and Workshop, with Tape superior to Workshop for Spirit (mean difference = 0.40; p < .05). TCS was superior to Workshop in reducing MI non-adherence and increasing MI adherence, and was superior to Workshp and Tape in increasing the reflection to question ratio. Tape was superior to TCS in increasing complex reflections. Percentage of counselors meeting proficiency differed significantly between training conditions for the most stringent threshold (Spirit and Empathy scores ≥ 6), and were modest, ranging from 13% to 67%, for TCS and Tape. Conclusion TCS shows promise for promoting new counseling behaviors following participation in workshop training. However, further work is needed to improve supervision methods in order to bring more clinicians to high levels of proficiency and facilitate the dissemination of evidence-based practices. PMID:22506795

Tele-EnREDando.com: A Multimedia WEB-CALL Software for Mobile Phones.

ERIC Educational Resources Information Center

Garcia, Jose Carlos

2002-01-01

Presents one of the world's first prototypes of language learning software for smart-phones. Tele-EnREDando.com is an Internet based multimedia application designed for 3G mobile phones with audio, video, and interactive exercises for learning Spanish for business. (Author/VWL)

Arizona TeleMedicine Network: Engineering Master Plan.

ERIC Educational Resources Information Center

Atlantic Research Corp., Alexandria, VA.

As the planning document for establishing a statewide health communications system initially servicing the Papago, San Carlos and White Mountain Apache, Navajo, and Hopi reservations, this document prescribes the communications services to be provided by the Arizona TeleMedicine Network. Specifications include: (1) communications services for each…

Technical Report on Tele-Communications.

ERIC Educational Resources Information Center

San Mateo County PACE Center, Redwood City, CA.

To provide background material for those interested in tele-communication in education and for those planning to implement such programs in their schools, a research study was conducted to gather information from a variety of sources including educational and technical experts, conference participation, visits to schools conducting projects, and…

Implementation of a model of robotic tele-presence (RTP) in the neuro-ICU: effect on critical care nursing team satisfaction.

PubMed

Rincon, Fred; Vibbert, Matthew; Childs, Valerie; Fry, Robin; Caliguri, Dennis; Urtecho, Jacqueline; Rosenwasser, Robert; Jallo, Jack

2012-08-01

Robotic tele-presence (RTP) is a form of mobile telemedicine, which enables a direct face-to-face rapid response by the physician, instead of the traditional telephonic paradigm. We hypothesized that a model of RTP for after-hour ICU rounds and emergencies would be associated with improved ICU nurse satisfaction. We implemented a prospective nighttime multidisciplinary ICU round time, using RTP at our neuro-ICU. To test for critical ICU nurse team satisfaction, a questionnaire was implemented. The primary outcome was nurse satisfaction measured through a questionnaire with answers trichotomized into: agreement, disagreement, and no opinion. The occurrence of outcomes was compared between the groups by χ2 or Fisher exact tests for the difference in proportions (PD) with Bonferroni correction for multiple pairwise comparisons. In total, 34 nurses completed the pre-survey and 40 nurses completed the post-survey. Night nurses were more likely to agree that RTP was associated with: ICU physicians being sufficiently available in the ICU (agreement 6-20%, PD 14%, p = 0.008), present during acute emergencies (agreement 44-65%, PD 21%, p = 0.007), and had enough time to get questions answered from the physician team (agreement 41-53%, PD 11%, p = NS). This data suggest improvement in critical care nursing team satisfaction with a model of RTP in the neuroscience ICU, particularly during nighttime hours. RTP is a tool that may enhance communication among components of the ICU team.

Pan-American Teletandem Language Exchange Project

ERIC Educational Resources Information Center

Castillo-Scott, Aurora

2015-01-01

This paper describes a TeleTandem language exchange project between English speaking Spanish students at Georgia College, USA, and Spanish speaking English students at Universidad de Concepción, Chile. The aim of the project was to promote linguistic skills and intercultural competence through a TeleTandem exchange. Students used Skype and Google…

Using Asynchronous AV Communication Tools to Increase Academic Self-Efficacy

ERIC Educational Resources Information Center

Girasoli, Anthony J.; Hannafin, Robert D.

2008-01-01

Technology-enhanced learning environments (TELEs) deliver instructional content and provide an array of scaffolding features designed to support independent student learning. TELEs also support teacher efforts to guide student inquiry within these sometimes complex environments. Self-efficacy, defined by Bandura [Bandura, A. (1994). Self-efficacy.…

A Randomized Controlled Trial of In-Home Tele-behavioral Health Care Utilizing Behavioral Activation for Depression

DTIC Science & Technology

2015-03-01

health, primary care, and operational medicine service programs at JBLM and PVA (e.g., psychologists, psychiatrists, physicians, social workers, nurse ...practitioners, and nurses ). Military chaplains on JBLM also serve as a recruitment source. These referring professionals are not affiliated with the...session early? YES a. lfyes, explain: 3. Was the session rescheduled ? YES NO (cir a. lf yes, who was it rescheduled by? 4. Did the participant miss

Experimental Evaluation of Computer-Aided Tele-operation (CATO) and Computer-Aided Robotic Manipulation (CARMAN) Technology

DTIC Science & Technology

2010-08-01

Consent Form 29 Appendix B. Demographics Questionnaire 35 Appendix C. NASA TLX Questionnaire 39 Appendix D. Symptom Questionnaire 41 List of Symbols...Index ( NASA - TLX ) Participants were given the NASA - TLX subjective workload rating at the end of each task (appendix C, Hart and Staveland, 1987).1 The... NASA - TLX is a multi-dimensional rating procedure that derives an overall workload score based on a weighted average of ratings on six subscales

Results of a Prospective Echocardiography Trial in International Space Station Crew

NASA Technical Reports Server (NTRS)

Hamilton, Douglas R.; Sargsyan, Ashot E.; Martin, David; Garcia, Kathleen M.; Melton, Shannon; Feiverson, Alan; Dulchavsky, Scott A.

2009-01-01

In the framework of an operationally oriented investigation, we conducted a prospective trial of a standard clinical echocardiography protocol in a cohort of long-duration crewmembers. The resulting primary and processed data appear to have no precedents. Our tele-echocardiography paradigm, including just-in-time e-training methods, was also assessed. A critical review of the imaging technique, equipment and setting limitations, and quality assurance is provided, as well as the analysis of "space normal" data.

Translations on Telecommunications Policy, Research and Development, Number 25

DTIC Science & Technology

1977-12-28

Portuguese Agreement 47 ITALY Digital Image Processing System Described (A. D’Amore, et al .; ALTA FREQUENZA, Jan 77) 48 - d WORLDWIDE AFFAIRS...equipment cost 4 million dinars. The radio station operates on the strength of 1 kilo- watt. [Belgrade BORBA in Serbo-Croatian 14 Nov 77 p 9 AU] CSO...The Communications Ministry First Under Secretary Eng ’Abd al -Mun’im al -Muhandis has said that the tele- communications authority will begin

Does a robotic scrub nurse improve economy of movements?

NASA Astrophysics Data System (ADS)

Wachs, Juan P.; Jacob, Mithun; Li, Yu-Ting; Akingba, George

2012-02-01

Objective: Robotic assistance during surgery has been shown to be a useful resource to both augment the surgical skills of the surgeon through tele-operation, and to assist the surgeon handling the surgical instruments to the surgeon, similar to a surgical tech. We evaluated the performance and effect of a gesture driven surgical robotic nurse in the context of economy of movements, during an abdominal incision and closure exercise with a simulator. Methods: A longitudinal midline incision (100 mm) was performed on the simulated abdominal wall to enter the peritoneal cavity without damaging the internal organs. The wound was then closed using a blunt needle ensuring that no tissue is caught up by the suture material. All the instruments required to complete this task were delivered by a robotic surgical manipulator directly to the surgeon. The instruments were requested through voice and gesture recognition. The robotic system used a low end range sensor camera to extract the hand poses and for recognizing the gestures. The instruments were delivered to the vicinity of the patient, at chest height and at a reachable distance to the surgeon. Task performance measures for each of three abdominal incision and closure exercises were measured and compared to a human scrub nurse instrument delivery action. Picking instrument position variance, completion time and trajectory of the hand were recorded for further analysis. Results: The variance of the position of the robotic tip when delivering the surgical instrument is compared to the same position when a human delivers the instrument. The variance was found to be 88.86% smaller compared to the human delivery group. The mean task completion time to complete the surgical exercise was 162.7+/- 10.1 secs for the human assistant and 191.6+/- 3.3 secs (P<.01) when using the robotic standard display group. Conclusion: Multimodal robotic scrub nurse assistant improves the surgical procedure by reducing the number of movements (lower variance in the picking position). The variance of the picking point is closely related to the concept of economy of movements in the operating room. Improving the effectiveness of the operating room can potentially enhance the safety of surgical interventions without affecting the performance time.

Building an environment model using depth information

NASA Technical Reports Server (NTRS)

Roth-Tabak, Y.; Jain, Ramesh

1989-01-01

Modeling the environment is one of the most crucial issues for the development and research of autonomous robot and tele-perception. Though the physical robot operates (navigates and performs various tasks) in the real world, any type of reasoning, such as situation assessment, planning or reasoning about action, is performed based on information in its internal world. Hence, the robot's intentional actions are inherently constrained by the models it has. These models may serve as interfaces between sensing modules and reasoning modules, or in the case of telerobots serve as interface between the human operator and the distant robot. A robot operating in a known restricted environment may have a priori knowledge of its whole possible work domain, which will be assimilated in its World Model. As the information in the World Model is relatively fixed, an Environment Model must be introduced to cope with the changes in the environment and to allow exploring entirely new domains. Introduced here is an algorithm that uses dense range data collected at various positions in the environment to refine and update or generate a 3-D volumetric model of an environment. The model, which is intended for autonomous robot navigation and tele-perception, consists of cubic voxels with the possible attributes: Void, Full, and Unknown. Experimental results from simulations of range data in synthetic environments are given. The quality of the results show great promise for dealing with noisy input data. The performance measures for the algorithm are defined, and quantitative results for noisy data and positional uncertainty are presented.

Preliminary experience of shared clinical management between Milan and Pointe Noire using the INteractive TeleConsultation Network for Worldwide HealthcAre Services (INCAS): telemedicine between Milan and Africa.

PubMed

Malacarne, Mara; Lesma, Alessandro; Madera, Angelo; Malfatti, Eugenio; Castelli, Alberto; Lucini, Daniela; Pizzinelli, Paolo; Pagani, Massimo

2004-01-01

This paper describes preliminary experience in shared clinical management of patients located in Pointe Noire, Africa, and a referral center, Sacco University Hospital, located in Milan, Italy. The employed infrastructure INteractive TeleConsultation Network for Worldwide HealthcAre Services (INCAS) jointly developed by CEFRIEL (Center of Excellence For Research, Innovation, Education & Industrial Labs partnership) and ENI (Ente Nazionale Idrocarburi) is based on commercial off-the-shelf technology. This minimizes maintenance problems, while permitting a simple and friendly sharing of data using the telephone and e-mail for store-and-forward applications. The critical aspect of the flow of events comprising the exchange of information is discussed. In 60% of cases, only one telemedicine consultation was required. In the remainder 40%, a number of telemedicine consultations were required for appropriate management of clinical cases. The project demonstrated flexibility as documented by the wide range of pathologies that can be dealt with it. Finally the possibility of using shared clinical management as a learning tool is highlighted by the steep and rising learning curve. We conclude, however, that the patient, although handled in a "virtual" manner, should be viewed as very "real," as some of them elected to close the gap physically between Pointe Noire and Milan, and chose to be treated at the referral site.

Quebec's Tele-Universite: A Long Way to Xanadu

ERIC Educational Resources Information Center

Guillemet, Patrick

2005-01-01

This article is a descriptive overview of one aspect of the history of Quebec's Tele-universite (TU). This case is used to unveil the inter-organizational and political tensions which may accompany the somewhat difficult development of a distance education model. Teleuniversite was created in 1972 as an experimental project by the Universite du…

Communications technology satellite

NASA Technical Reports Server (NTRS)

1976-01-01

A description of the Communications Technology Satellite (CTS), its planned orbit, its experiments, and associated ground facilities was given. The communication experiments, to be carried out by a variety of groups in both the United States and Canada, include tele-education, tele-medicine, community interaction, data communications and broadcasting. A historical summary of communications satellite development was also included.

Tele-Learning and Distance Learning Re-Engineering Process.

ERIC Educational Resources Information Center

Cruz, Dulce Marcia; de Moraes, Marialice; Barcia, Ricardo Miranda

The adoption and use of new interactive technologies in Distance Education, especially Tele-learning is a growing tendency in the most advanced countries. Nowadays, this tendency is so strong that being interactive is seen as a necessary pre-condition. Some reasons for this are a the growing perceived value of group-working; the popularization of…

TeleCITE: Telehealth--A Cochlear Implant Therapy Exchange

ERIC Educational Resources Information Center

Stith, Joanna; Stredler-Brown, Arlene; Greenway, Pat; Kahn, Gary

2012-01-01

What might bring the efforts of a physician, a speech-language pathologist, a teacher of the deaf and hard of hearing, and a nurse together? The answer is the innovative use of telepractice to deliver high quality, family-centered early intervention to infants and toddlers with hearing loss. TeleCITE: Telehealth--A Cochlear Implant Therapy…

3D display for enhanced tele-operation and other applications

NASA Astrophysics Data System (ADS)

Edmondson, Richard; Pezzaniti, J. Larry; Vaden, Justin; Hyatt, Brian; Morris, James; Chenault, David; Bodenhamer, Andrew; Pettijohn, Bradley; Tchon, Joe; Barnidge, Tracy; Kaufman, Seth; Kingston, David; Newell, Scott

2010-04-01

In this paper, we report on the use of a 3D vision field upgrade kit for TALON robot consisting of a replacement flat panel stereoscopic display, and multiple stereo camera systems. An assessment of the system's use for robotic driving, manipulation, and surveillance operations was conducted. A replacement display, replacement mast camera with zoom, auto-focus, and variable convergence, and a replacement gripper camera with fixed focus and zoom comprise the upgrade kit. The stereo mast camera allows for improved driving and situational awareness as well as scene survey. The stereo gripper camera allows for improved manipulation in typical TALON missions.

Auto-converging stereo cameras for 3D robotic tele-operation

NASA Astrophysics Data System (ADS)

Edmondson, Richard; Aycock, Todd; Chenault, David

2012-06-01

Polaris Sensor Technologies has developed a Stereovision Upgrade Kit for TALON robot to provide enhanced depth perception to the operator. This kit previously required the TALON Operator Control Unit to be equipped with the optional touchscreen interface to allow for operator control of the camera convergence angle adjustment. This adjustment allowed for optimal camera convergence independent of the distance from the camera to the object being viewed. Polaris has recently improved the performance of the stereo camera by implementing an Automatic Convergence algorithm in a field programmable gate array in the camera assembly. This algorithm uses scene content to automatically adjust the camera convergence angle, freeing the operator to focus on the task rather than adjustment of the vision system. The autoconvergence capability has been demonstrated on both visible zoom cameras and longwave infrared microbolometer stereo pairs.

Scalable Telemonitoring Model in Cloud for Health Care Analysis

NASA Astrophysics Data System (ADS)

Sawant, Yogesh; Jayakumar, Naveenkumar, Dr.; Pawar, Sanket Sunil

2017-08-01

Telemonitoring model is health observations model that going to surveillance patients remotely. Telemonitoring model is suitable for patients to avoid high operating expense to get Emergency treatment. Telemonitoring gives the path for monitoring the medical device that generates a complete profile of patient’s health through assembling essential signs as well as additional health information. Telemonitoring model is relying on four differential modules which is capable to generate realistic synthetic electrocardiogram (ECG) signals. Telemonitoring model shows four categories of chronic disease: pulmonary state, diabetes, hypertension, as well as cardiovascular diseases. On the other hand, the results of this application model recommend facilitating despite of their nationality, socioeconomic grade, or age, patients observe amid tele-monitoring programs as well as the utilization of technologies. Patient’s multiple health status is shown in the result such as beat-to-beat variation in morphology and timing of the human ECG, including QT dispersion and R-peak amplitude modulation. This model will be utilized to evaluate biomedical signal processing methods that are utilized to calculate clinical information from the ECG.

Semi-autonomous exploration of multi-floor buildings with a legged robot

NASA Astrophysics Data System (ADS)

Wenger, Garrett J.; Johnson, Aaron M.; Taylor, Camillo J.; Koditschek, Daniel E.

2015-05-01

This paper presents preliminary results of a semi-autonomous building exploration behavior using the hexapedal robot RHex. Stairwells are used in virtually all multi-floor buildings, and so in order for a mobile robot to effectively explore, map, clear, monitor, or patrol such buildings it must be able to ascend and descend stairwells. However most conventional mobile robots based on a wheeled platform are unable to traverse stairwells, motivating use of the more mobile legged machine. This semi-autonomous behavior uses a human driver to provide steering input to the robot, as would be the case in, e.g., a tele-operated building exploration mission. The gait selection and transitions between the walking and stair climbing gaits are entirely autonomous. This implementation uses an RGBD camera for stair acquisition, which offers several advantages over a previously documented detector based on a laser range finder, including significantly reduced acquisition time. The sensor package used here also allows for considerable expansion of this behavior. For example, complete automation of the building exploration task driven by a mapping algorithm and higher level planner is presently under development.

CAALYX: a new generation of location-based services in healthcare.

PubMed

Boulos, Maged N Kamel; Rocha, Artur; Martins, Angelo; Vicente, Manuel Escriche; Bolz, Armin; Feld, Robert; Tchoudovski, Igor; Braecklein, Martin; Nelson, John; Laighin, Gearóid O; Sdogati, Claudio; Cesaroni, Francesca; Antomarini, Marco; Jobes, Angela; Kinirons, Mark

2007-03-12

Recent advances in mobile positioning systems and telecommunications are providing the technology needed for the development of location-aware tele-care applications. This paper introduces CAALYX--Complete Ambient Assisted Living Experiment, an EU-funded project that aims at increasing older people's autonomy and self-confidence by developing a wearable light device capable of measuring specific vital signs of the elderly, detecting falls and location, and communicating automatically in real-time with his/her care provider in case of an emergency, wherever the older person happens to be, at home or outside.

The effects of TeleWound management on use of service and financial outcomes.

PubMed

Rees, Riley S; Bashshur, Noura

2007-12-01

This study investigated the effects of a TeleWound program on the use of service and financial outcomes among homebound patients with chronic wounds. The TeleWound program consisted of a Web-based transmission of digital photographs together with a clinical protocol. It enabled homebound patients with chronic pressure ulcers to be monitored remotely by a plastic surgeon. Chronic wounds are highly prevalent among chronically ill patients in the United States (U.S.). About 5 million chronically ill patients in the U.S. have chronic wounds, and the aggregate cost of their care exceeds $20 billion annually. Although 25% of home care referrals in the U.S. are for wounds, less than 0.2% of the registered nurses in the U.S. are wound care certified. This implies that the majority of patients with chronic wounds may not be receiving optimal care in their home environments. We hypothesized that TeleWound management would reduce visits to the emergency department (ED), hospitalization, length of stay, and visit acuity. Hence, it would improve financial performance for the hospital. A quasi-experimental design was used. A sample of 19 patients receiving this intervention was observed prospectively for 2 years. This was matched to a historical control group of an additional 19 patients from hospital records. Findings from the study revealed that TeleWound patients had fewer ED visits, fewer hospitalizations, and shorter length of stay, as compared to the control group. Overall, they encumbered lower cost. The results of this clinical study are striking and provide strong encouragement that a single provider can affect positive clinical and financial outcomes using a telemedicine wound care program. TeleWound was found to be a credible modality to manage pressure ulcers at lower cost and possibly better health outcomes. The next step in this process is to integrate the model into daily practice at bellwether medical centers to determine programmatic effectiveness in larger clinical arenas.

Modelling the complete operation of a free-piston shock tunnel for a low enthalpy condition

NASA Astrophysics Data System (ADS)

McGilvray, M.; Dann, A. G.; Jacobs, P. A.

2013-07-01

Only a limited number of free-stream flow properties can be measured in hypersonic impulse facilities at the nozzle exit. This poses challenges for experimenters when subsequently analysing experimental data obtained from these facilities. Typically in a reflected shock tunnel, a simple analysis that requires small amounts of computational resources is used to calculate quasi-steady gas properties. This simple analysis requires initial fill conditions and experimental measurements in analytical calculations of each major flow process, using forward coupling with minor corrections to include processes that are not directly modeled. However, this simplistic approach leads to an unknown level of discrepancy to the true flow properties. To explore the simple modelling techniques accuracy, this paper details the use of transient one and two-dimensional numerical simulations of a complete facility to obtain more refined free-stream flow properties from a free-piston reflected shock tunnel operating at low-enthalpy conditions. These calculations were verified by comparison to experimental data obtained from the facility. For the condition and facility investigated, the test conditions at nozzle exit produced with the simple modelling technique agree with the time and space averaged results from the complete facility calculations to within the accuracy of the experimental measurements.

Transferring brain-computer interfaces beyond the laboratory: successful application control for motor-disabled users.

PubMed

Leeb, Robert; Perdikis, Serafeim; Tonin, Luca; Biasiucci, Andrea; Tavella, Michele; Creatura, Marco; Molina, Alberto; Al-Khodairy, Abdul; Carlson, Tom; Millán, José D R

2013-10-01

Brain-computer interfaces (BCIs) are no longer only used by healthy participants under controlled conditions in laboratory environments, but also by patients and end-users, controlling applications in their homes or clinics, without the BCI experts around. But are the technology and the field mature enough for this? Especially the successful operation of applications - like text entry systems or assistive mobility devices such as tele-presence robots - requires a good level of BCI control. How much training is needed to achieve such a level? Is it possible to train naïve end-users in 10 days to successfully control such applications? In this work, we report our experiences of training 24 motor-disabled participants at rehabilitation clinics or at the end-users' homes, without BCI experts present. We also share the lessons that we have learned through transferring BCI technologies from the lab to the user's home or clinics. The most important outcome is that 50% of the participants achieved good BCI performance and could successfully control the applications (tele-presence robot and text-entry system). In the case of the tele-presence robot the participants achieved an average performance ratio of 0.87 (max. 0.97) and for the text entry application a mean of 0.93 (max. 1.0). The lessons learned and the gathered user feedback range from pure BCI problems (technical and handling), to common communication issues among the different people involved, and issues encountered while controlling the applications. The points raised in this paper are very widely applicable and we anticipate that they might be faced similarly by other groups, if they move on to bringing the BCI technology to the end-user, to home environments and towards application prototype control. Copyright © 2013 Elsevier B.V. All rights reserved.

Rapid Deployment of International Tele–Intensive Care Unit Services in War-Torn Syria

PubMed Central

Moughrabieh, Anas

2016-01-01

The conflict in Syria has created the largest humanitarian emergency of the twenty-first century. The 4-year Syrian conflict has destroyed hospitals and severely reduced the capacity of intensive care units (ICUs) and on-site intensivists. The crisis has triggered attempts from abroad to support the medical care of severely injured and acutely ill civilians inside Syria, including application of telemedicine. Within the United States, tele-ICU programs have been operating for more than a decade, albeit with high start-up costs and generally long development times. With the benefit of lessons drawn from those domestic models, the Syria Tele-ICU program was launched in December 2012 to manage the care of ICU patients in parts of Syria by using inexpensive, off-the-shelf video cameras, free social media applications, and a volunteer network of Arabic-speaking intensivists in North America and Europe. Within 1 year, 90 patients per month in three ICUs were receiving tele-ICU services. At the end of 2015, a network of approximately 20 participating intensivists was providing clinical decision support 24 hours per day to five civilian ICUs in Syria. The volunteer clinicians manage patients at a distance of more than 6,000 miles, separated by seven or eight time zones between North America and Syria. The program is implementing a cloud-based electronic medical record for physician documentation and a medication administration record for nurses. There are virtual chat rooms for patient rounds, radiology review, and trainee teaching. The early success of the program shows how a small number of committed physicians can use inexpensive equipment spawned by the Internet revolution to support from afar civilian health care delivery in a high-conflict country. PMID:26788827

Agile: From Software to Mission System

NASA Technical Reports Server (NTRS)

Trimble, Jay; Shirley, Mark H.; Hobart, Sarah Groves

2016-01-01

The Resource Prospector (RP) is an in-situ resource utilization (ISRU) technology demonstration mission, designed to search for volatiles at the Lunar South Pole. This is NASA's first near real time tele-operated rover on the Moon. The primary objective is to search for volatiles at one of the Lunar Poles. The combination of short mission duration, a solar powered rover, and the requirement to explore shadowed regions makes for an operationally challenging mission. To maximize efficiency and flexibility in Mission System design and thus to improve the performance and reliability of the resulting Mission System, we are tailoring Agile principles that we have used effectively in ground data system software development and applying those principles to the design of elements of the mission operations system.

TRUST-tPA trial: Telemedicine for remote collaboration with urgentists for stroke-tPA treatment.

PubMed

Mazighi, Mikael; Meseguer, Elena; Labreuche, Julien; Miroux, Patrick; Le Gall, Catherine; Roy, Patricia; Tubach, Florence; Amarenco, Pierre

2017-01-01

Background Previous observational studies have shown that telemedicine is feasible and safe to deliver intravenous (IV) recombinant tissue plasminogen activator (rt-PA). However, implementation of telemedicine may be challenging. To illustrate this fact, we report a study showing that telemedicine failed to improve clinical outcome and analyze the reasons for this shortcoming. Methods We established a tele-stroke network of 10 emergency rooms (ERs) of community hospitals connected to a stroke center to perform a randomized, open-label clinical trial with blinded outcome evaluation. Eligible patients were randomly assigned to either a usual care arm (i.e. immediate transfer to the stroke center and administration of IV rt-PA if indication was confirmed upon stroke arrival) or tele-thrombolysis arm (i.e. immediate administration of IV rt-PA in ER and transfer to the stroke center). The primary efficacy outcome was an excellent outcome (modified Rankin scale (mRS) 0-1 at 90 days). Secondary endpoints included favorable outcome (90-day mRS 0-2) and early neurological improvement (NIHSS score 0-1 at 24 hours or a decrease of ≥ 4 points within 24 hours). Safety outcomes included symptomatic intracerebral hemorrhage (ICH) per ECASS II definition, any ICH and all-cause mortality. Results During an accrual time of 48 months, because of a slow enrollment rate, only 49 of 270 patients initially planned for inclusion were randomized into usual care ( n = 23) and tele-thrombolysis ( n = 26). Despite random assignment, patients allocated to tele-thrombolysis were older and had more severe stroke than patients allocated to usual care. The median duration of video-conference was 23 minutes in the usual care arm and 73 minutes in the tele-thrombolysis arm. Eighty-four percent of patients in the tele-thrombolysis arm were treated by IV rt-PA in comparison to 18% in the usual care arm. In univariate analysis but not after adjustment for age and baseline NIHSS, patients allocated in the usual care arm had a higher rate of excellent or favorable outcome. There were no differences in safety outcomes, with only one symptomatic ICH occurring in the tele-thrombolysis arm. Conclusions Stroke patients included in the telemedicine arm of the TRUST-tPA trial increased their rt-PA eligibility five-fold. However, the efficacy and safety remains to be determined (ClinicalTrials.org, NCT00279149).

Assessment of Internet-based tele-medicine in Africa (the RAFT project).

PubMed

Bagayoko, Cheick Oumar; Müller, Henning; Geissbuhler, Antoine

2006-01-01

The objectives of this paper on the Réseau Afrique Francophone de Télémédecine (RAFT) project are the evaluation of feasibility, potential, problems and risks of an Internet-based tele-medicine network in developing countries of Africa. The RAFT project was started in Western African countries 5 years ago and has now extended to other regions of Africa as well (i.e. Madagascar, Rwanda). A project for the development of a national tele-medicine network in Mali was initiated in 2001, extended to Mauritania in 2002 and to Morocco in 2003. By 2006, a total of nine countries are connected. The entire technical infrastructure is based on Internet technologies for medical distance learning and tele-consultations. The results are a tele-medicine network that has been in productive use for over 5 years and has enabled various collaboration channels, including North-to-South (from Europe to Africa), South-to-South (within Africa), and South-to-North (from Africa to Europe) distance learning and tele-consultations, plus many personal exchanges between the participating hospitals and Universities. It has also unveiled a set of potential problems: (a) the limited importance of North-to-South collaborations when there are major differences in the available resources or the socio-cultural contexts between the collaborating parties; (b) the risk of an induced digital divide if the periphery of the health system in developing countries is not involved in the development of the network; and (c) the need for the development of local medical content management skills. Particularly point (c) is improved through the collaboration between the various countries as professionals from the medical and the computer science field are sharing courses and resources. Personal exchanges between partners in the project are frequent, and several persons received an education at one of the partner Universities. As conclusion, we can say that the identified risks have to be taken into account when designing large-scale tele-medicine projects in developing countries. These problems can be mitigated by fostering South-South collaboration channels, by the use of satellite-based Internet connectivity in remote areas, the appreciation of local knowledge and its publication on-line. The availability of such an infrastructure also facilitates the development of other projects, courses, and local content creation.

Pre-hospital electrocardiogram triage with tele-cardiology support is associated with shorter time-to-balloon and higher rates of timely reperfusion even in rural areas: data from the Bari- Barletta/Andria/Trani public emergency medical service 118 registry on primary angioplasty in ST-elevation myocardial infarction.

PubMed

Brunetti, Natale Daniele; Di Pietro, Gaetano; Aquilino, Ambrogio; Bruno, Angela I; Dellegrottaglie, Giulia; Di Giuseppe, Giuseppe; Lopriore, Claudio; De Gennaro, Luisa; Lanzone, Saverio; Caldarola, Pasquale; Antonelli, Gianfranco; Di Biase, Matteo

2014-09-01

We report the preliminary data from a regional registry on ST-elevation myocardial infarction (STEMI) patients treated with primary angioplasty in Apulia, Italy; the region is covered by a single public health-care service, a single public emergency medical service (EMS), and a single tele-medicine service provider. Two hundred and ninety-seven consecutive patients with STEMI transferred by regional free public EMS 1-1-8 for primary-PCI were enrolled in the study; 123 underwent pre-hospital electrocardiograms (ECGs) triage by tele-cardiology support and directly referred for primary-PCI, those remaining were just transferred by 1-1-8 ambulances for primary percutaneous coronary intervention (PCI) (diagnosis not based on tele-medicine ECG; already hospitalised patients, emergency-room without tele-medicine support). Time from first ECG diagnostic for STEMI to balloon was recorded; a time-to-balloon <1 h was considered as optimal and patients as timely treated. Mean time-to-balloon with pre-hospital triage and tele-cardiology ECG was significantly shorter (0:41 ± 0:17 vs 1:34 ± 1:11 h, p<0.001, -0:53 h, -56%) and rates of patients timely treated higher (85% vs 35%, p<0.001, +141%), both in patients from the 'inner' zone closer to PCI catheterisation laboratories (0:34 ± 0:13 vs 0:54 ± 0:30 h, p<0.001; 96% vs 77%, p<0.01, +30%) and in the 'outer' zone (0:52 ± 0:17 vs 1:41 ± 1:14 h, p<0.001; 69% vs 29%, p<0.001, +138%). Results remained significant even after multivariable analysis (odds ratio for time-to-balloon 0.71, 95% confidence interval (CI) 0.63-0.80, p<0.001; 1.39, 95% CI 1.25-1.55, p<0.001, for timely primary-PCI). Pre-hospital triage with tele-cardiology ECG in an EMS registry from an area with more than one and a half million inhabitants was associated with shorter time-to-balloon and higher rates of timely treated patients, even in 'rural' areas. © The European Society of Cardiology 2014.

Soviet Naval Special Purpose Forces: Origins and Operations in World War II

DTIC Science & Technology

1989-12-01

amphibious aircraft onto a lake, from which they walked into the area between Nikel and Luostari and back out again. Their journey lasted ten days and...moved up into the snow-covered hills, and after some hours of movement, followed a tele- phone wire to a German guard post. Without carefully observing...telephone wire in rolls. They moved all the captured materiel to shore, and then to their base. The detachment now had enemy guns and ammunition for use

Pulse laser head with monolithic thermally bonded microchip operating at 1.5 μm wavelength

NASA Astrophysics Data System (ADS)

Młyńczak, Jarosław; Kopczyński, Krzysztof; Belghachem, Nabil; Kisielewski, Jarosław; Stepień, Ryszard; Wychowaniec, Marek; Galas, Jacek; Litwin, Dariusz; CzyŻewski, Adam

2016-12-01

On the basis of thermally bonded Er,Yb:glass/Co:MALO microchip a laser head pumped by fiber coupled laser diode was designed. The performance of the laser head were investigated and the main output parameters were determined. The energy over 40 μJ in 3.8 ns pulse with repetition rate of 0.735 kHz was achieved. The laser head characterized by such parameters can successfully be used in tele-detection applications.

An admissible level \\widehat{osp} ( 1 \\big \\vert 2 ) -model: modular transformations and the Verlinde formula

NASA Astrophysics Data System (ADS)

Snadden, John; Ridout, David; Wood, Simon

2018-05-01

The modular properties of the simple vertex operator superalgebra associated with the affine Kac-Moody superalgebra \\widehat{{osp}} (1|2) at level -5/4 are investigated. After classifying the relaxed highest-weight modules over this vertex operator superalgebra, the characters and supercharacters of the simple weight modules are computed and their modular transforms are determined. This leads to a complete list of the Grothendieck fusion rules by way of a continuous superalgebraic analog of the Verlinde formula. All Grothendieck fusion coefficients are observed to be non-negative integers. These results indicate that the extension to general admissible levels will follow using the same methodology once the classification of relaxed highest-weight modules is completed.

Determining Salinity by Simple Means.

ERIC Educational Resources Information Center

Schlenker, Richard M.

This paper describes the construction and use of a simple salinometer. The salinometer is composed, mainly, of a milliammeter and a battery and uses the measurement of current flow to determine the salinity of water. A complete list of materials is given, as are details of construction and operation of the equipment. The use of the salinometer in…

Score Big! Pinball Project Teaches Simple Machine Basics

ERIC Educational Resources Information Center

Freeman, Matthew K.

2009-01-01

This article presents a design brief for a pinball game. The design brief helps students get a better grasp on the operation and uses of simple machines. It also gives them an opportunity to develop their problem-solving skills and use design skills to complete an interesting, fun product. (Contains 2 tables and 3 photos.)

Understanding the Adoption of TELEs--The Importance of Management

ERIC Educational Resources Information Center

Christiansen, Ellen; Nyvang, Tom

2006-01-01

For a TELE to become adopted by the vast majority of individual learners as a tool for learning, adoption at the institutional level must be considered, because the vast majority of a population of technology users depends on external stimuli to adopt the technology. This article analyses a case where a social simulation game, a prize-winning…

Training Teachers to Assess the Challenging Behaviors of Students with Autism Using Video Tele-Conferencing

ERIC Educational Resources Information Center

Machalicek, Wendy; O'Reilly, Mark F.; Rispoli, Mandy; Davis, Tonya; Lang, Russell; Franco, Jessica Hetlinger; Chan, Jeffrey M.

2010-01-01

We examined the effects of performance feedback provided via video tele-conferencing (VTC) on the acquisition of functional analysis procedures by six teachers. A university supervisor used VTC equipment (i.e., computers equipped with web cameras and Internet) to provide feedback to teachers learning to implement functional analysis conditions…

A broadband multimedia TeleLearning system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Ruiping; Karmouch, A.

1996-12-31

In this paper we discuss a broadband multimedia TeleLearning system under development in the Multimedia Information Research Laboratory at the University of Ottawa. The system aims at providing a seamless environment for TeleLearning using the latest telecommunication and multimedia information processing technology. It basically consists of a media production center, a courseware author site, a courseware database, a courseware user site, and an on-line facilitator site. All these components are distributed over an ATM network and work together to offer a multimedia interactive courseware service. An MHEG-based model is exploited in designing the system architecture to achieve the real-time, interactive,more » and reusable information interchange through heterogeneous platforms. The system architecture, courseware processing strategies, courseware document models are presented.« less

Beware! A simple renal cyst could be a hydatid cyst.

PubMed

Sehgal, Nidhi; Priyadarshi, Vinod

2017-01-01

Kidney is one of the most common sites for the cyst formation in the body, and the management of simple cysts is required entirely for its symptoms and complications. Surgical decortication is an established treatment for a large and symptomatic simple renal cyst. On the other hand, hydatid cysts of the kidney are usually multiloculated complex or calcified cysts and are quite rare. Their surgical treatment also differs and requires complete excision with pericystectomy or partial/complete nephrectomy depending upon residual functional parenchyma, using extreme caution to avoid spillage, recurrence or development of severe anaphylactic shock. A simple cyst harboring a hydatid cyst is highly uncommon and quite dangerous; as if not diagnosed preoperatively, it can create huge trouble for both the patient and the operating surgeon which happened in the present case.

Customer needs, expectations, and satisfaction with clinical neurophysiology services in Ireland: a case for tele-neurophysiology development.

PubMed

Fitzsimons, M; Ronan, L; Murphy, K; Browne, G; Connolly, S; McMenamin, J; Delanty, N

2004-01-01

Although equitable access to services should be based on need, geographical location of patients and their clinicians can give rise to inequalities in healthcare delivery. Development of tele-medicine services can improve equity of access. The specialty of Clinical Neurophysiology (CN), currently under-developed in Ireland provides an example of such potential. This study aimed to determine the needs, expectations, and satisfaction of CN customers, namely patients and referring clinicians. The goal was to examine geographical impediments to access that might be addressed by the introduction of tele-neurophysiology. Two customer surveys were conducted: CN referring clinicians and CN patients. Thirty-one North Western Health Board (NWHB) consultant clinicians responded to a postal survey. Distance and delays caused by long waiting lists were felt to deter or make CN referral irrelevant. Ninety-seven percent believed the lack of a local service negatively impacts on patient management and 93% would welcome the introduction of a tele-neurophysiology service. The geographical location of patient's residence and/or the location of the referring clinician's practice influenced waiting lists for CN. Fifty-eight (105/182) percent of patients living in a region with a CN service compared to 39% (50/128) of those living in a region with no service received an appointment within one month. In addition to the current insufficient CN service capacity in Ireland, these surveys highlighted geographical inequities. Tele-neurophysiology has the potential to speed-up diagnosis, result in more patients being appropriately investigated and be fairer to patients.

Connected Audiological Rehabilitation: 21st Century Innovations

PubMed Central

Saunders, Gabrielle H.; Chisolm, Theresa H.

2016-01-01

Background Tele-audiology provides a means to offer audiologic rehabilitation (AR) in a cost-, resource-, and time-effective manner. If designed appropriately, it also has the capability of personalizing rehabilitation to the user in terms of content, depth of detail, etc., thus permitting selection of the best content for a particular individual. Synchronous/real-time data collection, store and forward telehealth, remote monitoring and mobile health using smartphone applications have each been applied to components of audiologic rehabilitation intervention (sensory management, instruction in the use of technology and control of the listening environment, perceptual and communication strategies training, and counseling). In this article, the current state of tele-audiological rehabilitation interventions are described and discussed. Results The provision of AR via tele-audiology potentially provides a cost-effective mechanism for addressing barriers to the routine provision of AR beyond provisions of hearing technology. Furthermore, if designed appropriately, it has the capability of personalizing rehabilitation to the user in terms of content, depth of detail, etc., thus permitting selection of the best content for a particular individual. However, effective widespread implementation of tele-audiology will be dependent on good education of patients and clinician alike, and researchers must continue to examine the effectiveness of these new approaches to AR in order to ensure clinicians provide effective evidence-based rehabilitation to their patients. Conclusions While several barriers to the widespread use of tele-audiology for audiologic rehabilitation currently exist, it is concluded that through education of patients and clinicians alike, it will gain greater support from practitioners and patients over time and will become successfully and widely implemented. PMID:26415970

Leveraging Scarce Resources With Bone Health TeleECHO to Improve the Care of Osteoporosis.

PubMed

Lewiecki, E Michael; Rochelle, Rachelle; Bouchonville, Matthew F; Chafey, David H; Olenginski, Thomas P; Arora, Sanjeev

2017-12-01

Osteoporosis is a common condition with serious consequences because of fractures. Despite availability of treatments to reduce fracture risk, there is a large osteoporosis treatment gap that has reached crisis proportions. There are too few specialists to provide services for patients who need them. Bone Health Extension for Community Health Care Outcomes (TeleECHO) is a strategy using real-time ongoing videoconferencing technology to mentor health care professionals in rural and underserved communities to achieve an advanced level of knowledge for the care of patients with skeletal diseases. Over the first 21 months of weekly Bone Health TeleECHO programs, there were 263 registered health care professionals in the United States and several other countries, with 221 attending at least 1 online clinic and typically 35 to 40 attendees at each session at the end of the reported period. Assessment of self-confidence in 20 domains of osteoporosis care showed substantial improvement with the ECHO intervention ( P = 0.005). Bone Health TeleECHO can contribute to mitigating the crisis in osteoporosis care by leveraging scarce resources, providing motivated practitioners with skills to provide better skeletal health care, closer to home, with greater convenience, and lower cost than referral to a specialty center. Bone Health TeleECHO can be replicated in any location worldwide to reach anyone with Internet access, allowing access in local time zones and languages. The ECHO model of learning can be applied to other aspects of bone care, including the education of fracture liaison service coordinators, residents and fellows, and physicians with an interest in rare bone diseases.

Assessing the Impact of Telemedicine on Nursing Care in Intensive Care Units.

PubMed

Kleinpell, Ruth; Barden, Connie; Rincon, Teresa; McCarthy, Mary; Zapatochny Rufo, Rebecca J

2016-01-01

Information on the impact of tele-intensive care on nursing and priority areas of nursing care is limited. To conduct a national benchmarking survey of nurses working in intensive care telemedicine facilities in the United States. In a 2-phased study, an online survey was used to assess nurses' perceptions of intensive care telemedicine, and a modified 2-round Delphi study was used to identify priority areas of nursing. In phase 1, most of the 1213 respondents agreed to strongly agreed that using tele-intensive care enables them to accomplish tasks more quickly (63%), improves collaboration (65.9%), improves job performance (63.6%) and communication (60.4%), is useful in nursing assessments (60%), and improves care by providing more time for patient care (45.6%). Benefits of tele-intensive care included ability to detect trends in vital signs, detect unstable physiological status, provide medical management, and enhance patient safety. Barriers included technical problems (audio and video), interruptions in care, perceptions of telemedicine as an interference, and attitudes of staff. In phase 2, 60 nurses ranked 15 priority areas of care, including critical thinking skills, intensive care experience, skillful communication, mutual respect, and management of emergency patient care. The findings can be used to further inform the development of competencies for tele-intensive care nursing, match the tele-intensive care nursing practice guidelines of the American Association of Critical-Care Nurses, and highlight concepts related to the association's standards for establishing and sustaining healthy work environments. ©2016 American Association of Critical-Care Nurses.

Self-Regulated Learning in a TELE at the Universite de Technologie de Compiegne: An Analysis from Multiple Perspectives

ERIC Educational Resources Information Center

Trigano, Philippe

2006-01-01

Self-regulation has become a very important topic in the field of learning and instruction. At the same time, the introduction of new technologies in the field of Information and Communication Technologies (ICT) has made it possible to create rich Technology-Enhanced Learning Environments (TELEs) with multiple affordances for supporting…

Tele-Proximity: Tele-Community of Inquiry Model. Facial Cues for Social, Cognitive, and Teacher Presence in Distance Education

ERIC Educational Resources Information Center

Themeli, Chryssa; Bougia, Anna

2016-01-01

Distance education is expanding in all continents, and the use of video has dominated internet. Synchronous Video Communication (SVC) has not been an option thoroughly investigated and practitioners, who use and design synchronous learning scenarios, are in urgent need of guidance. Distant learners face many barriers, and as a result, they drop…

Tele-ICU and Patient Safety Considerations.

PubMed

Hassan, Erkan

The tele-ICU is designed to leverage, not replace, the need for bedside clinical expertise in the diagnosis, treatment, and assessment of various critical illnesses. Tele-ICUs are primarily decentralized or centralized models with differing advantages and disadvantages. The centralized model has sufficiently powered published data to be associated with improved mortality and ICU length of stay in a cost-effective manner. Factors associated with improved clinical outcomes include improved compliance with best practices; providing off-hours implementation of the bedside physician's care plan; and identification of and rapid response to physiological instability (initial clinical review within 1 hour) and rapid response to alerts, alarms, or direct notification by bedside clinicians. With improved communication and frequent review of patients between the tele-ICU and the bedside clinicians, the bedside clinician can provide the care that only they can provide. Although technology continues to evolve at a rapid pace, technology alone will most likely not improve clinical outcomes. Technology will enable us to process real or near real-time data into complex and powerful predictive algorithms. However, the remote and bedside teams must work collaboratively to develop care processes to better monitor, prioritize, standardize, and expedite care to drive greater efficiencies and improve patient safety.

Remote clinical assessment of gastrointestinal endoscopy (tele-endoscopy): an initial experience.

PubMed Central

Kim, C. Y.; Etemad, B.; Glenn, T. F.; Mackey, H. A.; Viator, G. E.; Wallace, M. B.; Mokhashi, M. S.; Cotton, P. B.; Hawes, R. H.

2000-01-01

BACKGROUND: Gastrointestinal (GI) endoscopy is an effective tool to screen for cancers of the digestive tract. However, access to endoscopy is limited in many parts of South Carolina. This trial is a part of a prospective multi-part study for remote cancer screening in coastal South Carolina. This pilot study was to evaluate the quality of tele-endoscopy for cancer screening. METHODS: 10 patients scheduled for endoscopic procedures were observed simultaneously by the endoscopist and a remote observer connected over a 512 kbps ISDN line. Findings by both were compared for concordance on malignant or premalignant lesions. RESULTS: The image quality was adequate to support remote diagnosis of GI cancer and abnormal lesions by an experienced observer. However, assessment of the esophagogastric junction for Barrett's esophagus was equivocal. CONCLUSIONS: Overall, our tele-endoscopy setup shows great promise for remote supervision or observation of endoscopic procedures done by nurse endoscopists. Tele-endoscopy is both adequate and feasible for diagnosis of most gastrointestinal lesions. Subtle lesions still may be missed in our current setup. However, improvements are being made in our setup to address the problem with resolution prior to further evaluation. PMID:11079918

TeleMed: An example of a new system developed with object technology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Forslund, D.; Phillips, R.; Tomlinson, B.

1996-12-01

Los Alamos National Laboratory has developed a virtual patient record system called TeleMed which is based on a distributed national radiographic and patient record repository located throughout the country. Without leaving their offices, participating doctors can view clinical drug and radiographic data via a sophisticated multimedia interface. For example, a doctor can match a patient`s radiographic information with the data in the repository, review treatment history and success, and then determine the best treatment. Furthermore, the features of TeleMed that make it attractive to clinicians and diagnosticians make it valuable for teaching and presentation as well. Thus, a resident canmore » use TeleMed for self-training in diagnostic techniques and a physician can use it to explain to a patient the course of their illness. In fact, the data can be viewed simultaneously by users at two or more distant locations for consultation with specialists in different fields. This capability is of enormous value to a wide spectrum of healthcare providers. It is made possible by the integration of multimedia information using commercial CORBA technology linking object-enabled databases with client interfaces using a three-tiered architecture.« less

Robotic vehicle uses acoustic sensors for voice detection and diagnostics

NASA Astrophysics Data System (ADS)

Young, Stuart H.; Scanlon, Michael V.

2000-07-01

An acoustic sensor array that cues an imaging system on a small tele- operated robotic vehicle was used to detect human voice and activity inside a building. The advantage of acoustic sensors is that it is a non-line of sight (NLOS) sensing technology that can augment traditional LOS sensors such as visible and IR cameras. Acoustic energy emitted from a target, such as from a person, weapon, or radio, will travel through walls and smoke, around corners, and down corridors, whereas these obstructions would cripple an imaging detection system. The hardware developed and tested used an array of eight microphones to detect the loudest direction and automatically setter a camera's pan/tilt toward the noise centroid. This type of system has applicability for counter sniper applications, building clearing, and search/rescue. Data presented will be time-frequency representations showing voice detected within rooms and down hallways at various ranges. Another benefit of acoustics is that it provides the tele-operator some situational awareness clues via low-bandwidth transmission of raw audio data for the operator to interpret with either headphones or through time-frequency analysis. This data can be useful to recognize familiar sounds that might indicate the presence of personnel, such as talking, equipment, movement noise, etc. The same array also detects the sounds of the robot it is mounted on, and can be useful for engine diagnostics and trouble shooting, or for self-noise emanations for stealthy travel. Data presented will characterize vehicle self noise over various surfaces such as tiles, carpets, pavement, sidewalk, and grass. Vehicle diagnostic sounds will indicate a slipping clutch and repeated unexpected application of emergency braking mechanism.

Macromolecular Crystal Growth by Means of Microfluidics

NASA Technical Reports Server (NTRS)

vanderWoerd, Mark; Ferree, Darren; Spearing, Scott; Monaco, Lisa; Molho, Josh; Spaid, Michael; Brasseur, Mike; Curreri, Peter A. (Technical Monitor)

2002-01-01

We have performed a feasibility study in which we show that chip-based, microfluidic (LabChip(TM)) technology is suitable for protein crystal growth. This technology allows for accurate and reliable dispensing and mixing of very small volumes while minimizing bubble formation in the crystallization mixture. The amount of (protein) solution remaining after completion of an experiment is minimal, which makes this technique efficient and attractive for use with proteins, which are difficult or expensive to obtain. The nature of LabChip(TM) technology renders it highly amenable to automation. Protein crystals obtained in our initial feasibility studies were of excellent quality as determined by X-ray diffraction. Subsequent to the feasibility study, we designed and produced the first LabChip(TM) device specifically for protein crystallization in batch mode. It can reliably dispense and mix from a range of solution constituents into two independent growth wells. We are currently testing this design to prove its efficacy for protein crystallization optimization experiments. In the near future we will expand our design to incorporate up to 10 growth wells per LabChip(TM) device. Upon completion, additional crystallization techniques such as vapor diffusion and liquid-liquid diffusion will be accommodated. Macromolecular crystallization using microfluidic technology is envisioned as a fully automated system, which will use the 'tele-science' concept of remote operation and will be developed into a research facility for the International Space Station as well as on the ground.

EMR-based TeleGeriatric system.

PubMed

Pallawala, P M; Lun, K C

2001-01-01

As medical services improve due to new technologies and breakthroughs, it has lead to an increasingly aging population. There has been much discussion and debate on how to solve various aspects such as psychological, socio-economic and medical problems related to aging. Our effort is to implement a feasible telegeriatric medical service with the use of the state of the art technology to deliver medical services efficiently to remote sites where elderly homes are based. The TeleGeriatric system will lead to rapid decision-making in the presence of acute or subacute emergencies. This triage will also lead to a reduction of unnecessary admission. It will enable the doctors who visit these elderly homes once a week basis to improve their geriatric management skills by communication with geriatric specialist. Nursing skills in the geriatric care will also benefit from this system. Integrated electronic medical record (EMR) system will be indispensable in the face of emergency admissions to hospitals. Evolution of EMR database would lead to future research in telegeriatrics and will help to identify the areas where telegeriatrics can be optimally used. This system is based on current web browsing technology and broadband communication. The TeleGeriatric web based server is developed using Java Technology. The TeleGeriatric database server was developed using Microsoft SQL server. Both are based at the Medical Informatics Programme, National University of Singapore. Two elderly homes situated in the periphery of Singapore and a leading government hospital in geriatric care have been chosen for the project. These 3 institutions and National University of Singapore are connected via ADSL protocol. ADSL connection supports high bandwidth, which is necessary for high quality videoconferencing. Each time a patient needs a teleconsultation a nurse or a doctor in the remote site sends the patient's record to the TeleGeriatric server. The TeleGeriatric server forwards the request to the Alexandra Hospital for consultation. Geriatrics specialists at the Alexandra Hospital carry out teleward rounds twice weekly and on demand basis. Following the implementation of the system, a trial run has been done. Total results have demonstrated a high degree of coordination and cooperation between remote site and the Alexandra Hospital. Also the patient compliance is very high and they prefer teleconsultation. Initial results show that the TeleGeriatric system has definite advantages in managing geriatric patients at a remote site. As the system evolves, further research will show the areas where telegeriatrics can be used optimally.

Tele-education as method of medical education.

PubMed

Masic, Izet; Pandza, Haris; Kulasin, Igor; Masic, Zlatan; Valjevac, Salih

2009-01-01

Development of computer networks and introduction and application of new technologies in all aspects of human activity needs to be followed by universities in their transformation on how to approach scientific, research, and education teaching curricula. Development and increased use of distance learning (DL) over the past decade have clearly shown the potential and efficiency of information technology applied in education. Use of information technology in medical education is where medical informatics takes its place as important scientific discipline which ensures benefit from IT in teaching and learning process involved. Definition of telemedicine as "use of technologies based on health care delivered on distance" covers areas such as electronic health, tele-health (eHealth), telematics, but also tele-education. Web based medical education today is offered in different forms--from online lectures, online exams, web based continuous education programs, use of electronic libraries, online medical and scientific databases etc. Department of Medical Informatics of Medical Faculty of University of Sarajevo has taken many steps to introduce distance learning in medical curricula--from organising professional--scientific events (congresses, workshop etc), organizing first tele-exam at the faculty and among first at the university, to offering online lectures and online education material at the Department's website (www.unsa-medinfo.org). Distance learning in medical education, as well as telemedicine, significantly influence health care in general and are shaping the future model of medical practice. Basic computer and networks skills must be a part of all future medical curricula. The impact of technical equipment on patient-doctor relationship must be taken into account, and doctors have to be trained and prepared for diagnosing or consulting patients by use of IT. Telemedicine requires special approach in certain medical fields--tele-consultation, tele-surgery, tele-radiology and other specific telemedicine applications should be introduced to the curricula. Telemedicine and distance learning are best suited for medical education and doctor-to-doctor consultation--first contact between doctor and a patient should stay face-to-face when possible. In this paper, we present the results of the project Introduction and Implementation of Distance Learning at the Medical Faculty of University of Sarajevo and compare it with the following expected outcomes: development and integration of information technology in medical education; creation of flexible infrastructure which will enable access to e-learning to all students and teaching staff; improvement of digital literacy of academic population; ensuring high educational standards to students and teaching staff; helping medical staffto develop "life-long learning" approach in work and education.

Absolute colorimetric characterization of a DSLR camera

NASA Astrophysics Data System (ADS)

Guarnera, Giuseppe Claudio; Bianco, Simone; Schettini, Raimondo

2014-03-01

A simple but effective technique for absolute colorimetric camera characterization is proposed. It offers a large dynamic range requiring just a single, off-the-shelf target and a commonly available controllable light source for the characterization. The characterization task is broken down in two modules, respectively devoted to absolute luminance estimation and to colorimetric characterization matrix estimation. The characterized camera can be effectively used as a tele-colorimeter, giving an absolute estimation of the XYZ data in cd=m2. The user is only required to vary the f - number of the camera lens or the exposure time t, to better exploit the sensor dynamic range. The estimated absolute tristimulus values closely match the values measured by a professional spectro-radiometer.

"Tele Pour Tous" in Rural Ivory Coast: Audience, Impact, Perceptions: Report of Two Surveys Conducted in January and April, 1977.

ERIC Educational Resources Information Center

Etaix, Mireille; Lenglet, Frans

This report presents the results of two surveys conducted in January and April 1977 in the Ivory Coast to assess the impact of the "Tele Pour Tous" programs on rural audiences in terms of awareness, learning, and action. Descriptions of the socio-economic characteristics of the audience and their viewing patterns were sought, and…

Clinical Examination Component of Telemedicine, Telehealth, mHealth, and Connected Health Medical Practices.

PubMed

Weinstein, Ronald S; Krupinski, Elizabeth A; Doarn, Charles R

2018-05-01

Telemedicine and telehealth are the practices of medicine at a distance. Performing the equivalent of a complete clinical examination by telemedicine would be unusual. However, components of a more traditional clinical examination are part of the telemedicine workup for specific conditions. Telemedicine clinical examinations are facilitated, and enhanced, through the integration of a class of medical devices referred to as telemedicine peripherals (eg, electronic stethoscopes, tele-ophthalmoscopes, video-otoscopes, and so forth). Direct-to-consumer telehealth is a rapidly expanding segment of the health care service industry. Copyright © 2018 Elsevier Inc. All rights reserved.

CAALYX: a new generation of location-based services in healthcare

PubMed Central

Boulos, Maged N Kamel; Rocha, Artur; Martins, Angelo; Vicente, Manuel Escriche; Bolz, Armin; Feld, Robert; Tchoudovski, Igor; Braecklein, Martin; Nelson, John; Ó Laighin, Gearóid; Sdogati, Claudio; Cesaroni, Francesca; Antomarini, Marco; Jobes, Angela; Kinirons, Mark

2007-01-01

Recent advances in mobile positioning systems and telecommunications are providing the technology needed for the development of location-aware tele-care applications. This paper introduces CAALYX – Complete Ambient Assisted Living Experiment, an EU-funded project that aims at increasing older people's autonomy and self-confidence by developing a wearable light device capable of measuring specific vital signs of the elderly, detecting falls and location, and communicating automatically in real-time with his/her care provider in case of an emergency, wherever the older person happens to be, at home or outside. PMID:17352802

Providing Telehealth Services to a Public Primary Care Network: The Experience of RedeNUTES in Pernambuco, Brazil.

PubMed

Diniz, Paula Rejane Beserra; Ribeiro Sales, Fernando José; de Araújo Novaes, Magdala

2016-08-01

Information technologies have been applied in primary care domains to improve the delivery of health services. This article reports the telehealth network experience in Pernambuco, Brazil. Five different data sets were used, one by each service and the structural aspects of the network, collected from 2008 until August 2015. The data include solicited themes for educational activities, users' evaluation of services, numbers of sites, municipalities participating, participants in tele-education activities, teleconsultations, telediagnosis, and remote screenings. The analysis was done in absolute and percentage values using Microsoft Excel (version 2007). The indicators show high utilization of tele-education resources, followed by the teleconsultation service. The synchronous modality was the most used and the general clinical question was the most frequent type of question. Nurses are the professional category that most used the teleconsultation services (36%). Telediagnosis of electrocardiography has growth utilization, overcoming teleconsulting more recently. The satisfaction rate was 89%, and 68.5% of professionals changed their planning to patients' referrals to specialists. Telehealth has been considered effective since it avoids inappropriate referrals of the patient and provides continuous actualization to health professionals. Our results provide evidence of the feasibility and importance of using telehealth as a tool to ensure the universality, equality, and completeness in the health system.

Experiences with online consultation systems in primary care: case study of one early adopter site

PubMed Central

Casey, Michael; Shaw, Sara; Swinglehurst, Deborah

2017-01-01

Background There is a strong policy drive towards implementing alternatives to face-to-face consultations in general practice to improve access, efficiency, and cost-effectiveness. These alternatives embrace novel technologies that are assumed to offer potential to improve care. Aim To explore the introduction of one online consultation system (Tele-Doc) and how it shapes working practices. Design and setting Mixed methods case study in an inner-city general practice. Method The study was conducted through interviews with IT developers, clinicians, and administrative staff, and scrutiny of documents, websites, and demonstrator versions of Tele-Doc, followed by thematic analysis and discourse analysis. Results Three interrelated themes were identified: online consultation systems as innovation, managing the ‘messiness’ of general practice consultations, and redistribution of the work of general practice. These themes raise timely questions about what it means to consult in contemporary general practice. Uptake of Tele-Doc by patients was low. Much of the work of the consultation was redistributed to patients and administrators, sometimes causing misunderstandings. The ‘messiness’ of consultations was hard to eliminate. In-house training focused on the technical application rather than associated transformations to practice work that were not anticipated. GPs welcomed varied modes of consulting, but the aspiration of improved efficiency was not realised in practice. Conclusion Tele-Doc offers a new kind of consultation that is still being worked out in practice. It may offer convenience for patients with discrete, single problems, and a welcome variation to GPs’ workload. Tele-Doc’s potential for addressing more complex problems and achieving efficiency is less clear, and its adoption may involve unforeseeable consequences. PMID:28993306

Tele-evidence: A videoconferencing tool as a viable alternative to physical appearance of doctors for the judicial summons.

PubMed

Bari, S; Arora, P; Gupta, A K; Singh, M; Aggarwal, A K

2018-06-26

The role of physicians often extends beyond provision of direct patient care and includes appearance in courts as professional or expert witnesses to give their testimony in various legal cases. This often consumes precious time and resources of the doctors and the hospitals. This study was taken up to evaluate the present system of the physical appearance of the doctors to various courts and compare it with the videoconferencing mode of giving testimony (tele-evidence). Available records of summons and vehicles used were analyzed to calculate the cost involved and man-hours consumed in honoring the court summons. Telemedicine facility, available in our institute, was used for conducting tele-evidence with selected courts of the two states as a pilot, which was later expanded. A survey was also done to assess the experience of the physicians with physical appearance and videoconferencing using structured questionnaire after approval from the Institute's Ethics Committee. Likert scale of 0-10 points was used to measure satisfaction. There was 43% drop in the monthly mileage of vehicles, 49% reduction in the fuel cost per month, and 28% savings in terms of time consumed for court duties. Satisfaction score for parameters of time consumed, physical strain, mental strain, communication with Honorable Judges, and overall experience was 87% through tele-evidence as compared to 31% with physical appearance. Tele-evidence is an acceptable and implementable mode of testifying and has led to tremendous resource savings in our tertiary care setting. The model needs to be replicated for deliverance of justice and is in consonance with Government's push toward Digital India.

Development of a prototype of the tele-localisation system in radiotherapy using personal digital assistant via wireless communication.

PubMed

Wu, Vincent Wing-Cheung; Tang, Fuk-hay; Cheung, Wai-kwan; Chan, Kit-chi

2013-02-01

In localisation of radiotherapy treatment field, the oncologist is present at the simulator to approve treatment details produced by the therapist. Problems may arise if the oncologist is not available and the patient requires urgent treatment. The development of a tele-localisation system is a potential solution, where the oncologist uses a personal digital assistant (PDA) to localise the treatment field on the image sent from the simulator through wireless communication and returns the information to the therapist after his or her approval. Our team developed the first tele-localisation prototype, which consisted of a server workstation (simulator) for the administration of digital imaging and communication in medicine localisation images including viewing and communication with the PDA via a Wi-Fi network; a PDA (oncologist's site) installed with the custom-built programme that synchronises with the server workstation and performs treatment field editing. Trial tests on accuracy and speed of the prototype system were conducted on 30 subjects with the treatment regions covering the neck, skull, chest and pelvis. The average time required in performing the localisation using the PDA was less than 1.5 min, with the blocked field longer than the open field. The transmission speed of the four treatment regions was similar. The average physical distortion of the images was within 4.4% and the accuracy of field size indication was within 5.3%. Compared with the manual method, the tele-localisation system presented with an average deviation of 5.5%. The prototype system fulfilled the planned objectives of tele-localisation procedure with reasonable speed and accuracy. © 2012 The Authors. Journal of Medical Imaging and Radiation Oncology © 2012 The Royal Australian and New Zealand College of Radiologists.

Secure environment for real-time tele-collaboration on virtual simulation of radiation treatment planning.

PubMed

Ntasis, Efthymios; Maniatis, Theofanis A; Nikita, Konstantina S

2003-01-01

A secure framework is described for real-time tele-collaboration on Virtual Simulation procedure of Radiation Treatment Planning. An integrated approach is followed clustering the security issues faced by the system into organizational issues, security issues over the LAN and security issues over the LAN-to-LAN connection. The design and the implementation of the security services are performed according to the identified security requirements, along with the need for real time communication between the collaborating health care professionals. A detailed description of the implementation is given, presenting a solution, which can directly be tailored to other tele-collaboration services in the field of health care. The pilot study of the proposed security components proves the feasibility of the secure environment, and the consistency with the high performance demands of the application.

How to develop a tele-ICU model?

PubMed

Rogove, Herb

2012-01-01

The concept of the tele-ICU (intensive care unit) is about 30 years old and more hospitals are utilizing it to cover multiple hospitals in their system or for hospitals that lack on-site critical care coverage such as in the rural setting. Doing a needs analysis, picking the appropriate committee to oversee development of the correct model, choosing quality metrics to measure, and designing an implementation plan that has a timeline is how the process should begin. Research including visitation to established programs and connecting with professional societies are helpful. Developing both a business and financial plan will optimize the value of a tele-ICU program. The innovative ICU nursing director will help to integrate a telemedicine program seamlessly with the on-site program to insure a successful program that benefits patients, their families, the ICU staff, and the hospital.

Computer Reader for the Blind

NASA Technical Reports Server (NTRS)

1990-01-01

Optacon II uses the same basic technique of converting printed information into a tactile image as did Optacon. Optacon II can also be connected directly to a personal computer, which opens up a new range of job opportunities for the blind. Optacon II is not limited to reading printed words, it can convert any graphic image viewed by the camera. Optacon II demands extensive training for blind operators. TSI provides 60-hour training courses at its Mountain View headquarters and at training centers around the world. TeleSensory discontinued production of the Optacon as of December 1996.

Silicon nitride photonics: from visible to mid-infrared wavelengths

NASA Astrophysics Data System (ADS)

Micó, Gloria; Bru, Luis A.; Pastor, Daniel; Doménech, David; Fernández, Juan; Sánchez, Ana; Cirera, Josep M.; Domínguez, Carlos; Muñoz, Pascual

2018-02-01

Silicon nitride has received a lot of attention during the last ten years, for applications such as bio-photonics, tele/datacom, optical signal processing and sensing. In this paper, firstly an updated review of the state of the art of silicon nitride photonics integration platforms will be provided. Secondly, our developments on a moderate confinement Si3N4 platform in the near-infrared will be presented. Finally, our steps towards establishing a Si3N4 based platform for broadband operation spanning from visible to mid-infrared wavelengths will be introduced.

NASA's Space Launch System: Positioning Assets for Tele-Robotic Operations

NASA Technical Reports Server (NTRS)

May, Todd A.; Creech, Stephen D.; Robinson, Kimberly F.

2013-01-01

The National Aeronautics and Space Administration (NASA) is designing and developing America's most capable launch vehicle to support high-priority human and scientific exploration beyond Earth's orbit. The Space Launch System (SLS) will initially lift 70 metric tons (t) on its first flights, slated to begin in 2017, and will be evolved after 2021 to a full 130-t capability-larger than the Saturn V Moon rocket. This superior lift and associated volume capacity will support game-changing exploration in regions that were previously unattainable, being too costly and risky to reach. On the International Space Station, astronauts are training for long-duration missions to asteroids and cis-martian regions, but have not had transportation out of Earth's orbit - until now. Simultaneously, productive rovers are sending scientists - and space fans - unprecedented information about the composition and history of Mars, the planet thought to be most like Earth. This combination of experience and information is laying the foundation for future missions, such as those outlined in NASA's "Mars Next Decade" report, that will rely on te1e-robotic operations to take exploration to the next level. Within this paradigm, NASA's Space Launch System stands ready to manifest the unique payloads that will be required for mission success. Ultimately, the ability to position assets - ranging from orbiters, to landers, to communication satellites and surface systems - is a critical step in broadening the reach of technological innovation that will benefit all Earth's people as the Space Age unfolds. This briefing will provide an overview of how the Space Launch System will support delivery of elements for tele-robotic operations at destinations such as the Moon and Mars, which will synchronize the human-machine interface to deliver hybrid on-orbit capabilities. Ultimately, telerobotic operations will open entirely new vistas and the doors of discovery. NASA's Space Launch System will be a safe, affordable, and sustainable platform for these purposes and more.

Research and Development for Advanced Tele-maintenance Capability with Remote Serial Console Access and Proactive Monitoring of Medical Devices

DTIC Science & Technology

2009-09-01

Tele-maintenance Capability with Remote Serial Console Access and Proactive Monitoring of Medical Devices PRINCIPAL INVESTIGATOR...Remote Serial Console Access and Proactive Monitoring of Medical Devices 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d...ORGANIZATION REPORT NUMBER Concepteers LLC 880 Bergen Avenue, Suite 403 Jersey City, NJ 07306 9. SPONSORING / MONITORING

Rapid Prototyping as a Faculty-Wide Activity: An Innovative Approach to the Redesign of Courses and Instructional Methods at the University of Twente.

ERIC Educational Resources Information Center

Collis, B. A.; de Boer, W. F.

1998-01-01

In the Science and Technology department of the University of Twente (Toegepaste Onderwijskunde, T.O., Netherlands), a revolutionary process of institutional change is occurring under the banner of C@MPUS+ initiative. The TeleTOP (Tele-Learning at T.O.) team is committed to blending the best of traditional education with new didactics and advanced…

A Browser-Server-Based Tele-audiology System That Supports Multiple Hearing Test Modalities

PubMed Central

Yao, Daoyuan; Givens, Gregg

2015-01-01

Abstract Introduction: Millions of global citizens suffering from hearing disorders have limited or no access to much needed hearing healthcare. Although tele-audiology presents a solution to alleviate this problem, existing remote hearing diagnosis systems support only pure-tone tests, leaving speech and other test procedures unsolved, due to the lack of software and hardware to enable communication required between audiologists and their remote patients. This article presents a comprehensive remote hearing test system that integrates the two most needed hearing test procedures: a pure-tone audiogram and a speech test. Materials and Methods: This enhanced system is composed of a Web application server, an embedded smart Internet-Bluetooth® (Bluetooth SIG, Kirkland, WA) gateway (or console device), and a Bluetooth-enabled audiometer. Several graphical user interfaces and a relational database are hosted on the application server. The console device has been designed to support the tests and auxiliary communication between the local site and the remote site. Results: The study was conducted at an audiology laboratory. Pure-tone audiogram and speech test results from volunteers tested with this tele-audiology system are comparable with results from the traditional face-to-face approach. Conclusions: This browser-server–based comprehensive tele-audiology offers a flexible platform to expand hearing services to traditionally underserved groups. PMID:25919376

A Browser-Server-Based Tele-audiology System That Supports Multiple Hearing Test Modalities.

PubMed

Yao, Jianchu Jason; Yao, Daoyuan; Givens, Gregg

2015-09-01

Millions of global citizens suffering from hearing disorders have limited or no access to much needed hearing healthcare. Although tele-audiology presents a solution to alleviate this problem, existing remote hearing diagnosis systems support only pure-tone tests, leaving speech and other test procedures unsolved, due to the lack of software and hardware to enable communication required between audiologists and their remote patients. This article presents a comprehensive remote hearing test system that integrates the two most needed hearing test procedures: a pure-tone audiogram and a speech test. This enhanced system is composed of a Web application server, an embedded smart Internet-Bluetooth(®) (Bluetooth SIG, Kirkland, WA) gateway (or console device), and a Bluetooth-enabled audiometer. Several graphical user interfaces and a relational database are hosted on the application server. The console device has been designed to support the tests and auxiliary communication between the local site and the remote site. The study was conducted at an audiology laboratory. Pure-tone audiogram and speech test results from volunteers tested with this tele-audiology system are comparable with results from the traditional face-to-face approach. This browser-server-based comprehensive tele-audiology offers a flexible platform to expand hearing services to traditionally underserved groups.

Control and Guidance of Low-Cost Robots via Gesture Perception for Monitoring Activities in the Home

PubMed Central

Sempere, Angel D.; Serna-Leon, Arturo; Gil, Pablo; Puente, Santiago; Torres, Fernando

2015-01-01

This paper describes the development of a low-cost mini-robot that is controlled by visual gestures. The prototype allows a person with disabilities to perform visual inspections indoors and in domestic spaces. Such a device could be used as the operator's eyes obviating the need for him to move about. The robot is equipped with a motorised webcam that is also controlled by visual gestures. This camera is used to monitor tasks in the home using the mini-robot while the operator remains quiet and motionless. The prototype was evaluated through several experiments testing the ability to use the mini-robot’s kinematics and communication systems to make it follow certain paths. The mini-robot can be programmed with specific orders and can be tele-operated by means of 3D hand gestures to enable the operator to perform movements and monitor tasks from a distance. PMID:26690448

Cost analysis of in-home telerehabilitation for post-knee arthroplasty.

PubMed

Tousignant, Michel; Moffet, Hélène; Nadeau, Sylvie; Mérette, Chantal; Boissy, Patrick; Corriveau, Hélène; Marquis, François; Cabana, François; Ranger, Pierre; Belzile, Étienne L; Dimentberg, Ronald

2015-03-31

Rehabilitation provided through home visits is part of the continuum of care after discharge from hospital following total knee arthroplasty (TKA). As demands for rehabilitation at home are growing and becoming more difficult to meet, in-home telerehabilitation has been proposed as an alternate service delivery method. However, there is a need for robust data concerning both the effectiveness and the cost of dispensing in-home telerehabilitation. The objective of this study was to document, analyze, and compare real costs of two service delivery methods: in-home telerehabilitation and conventional home visits. The economic analysis was conducted as part of a multicenter randomized controlled trial (RCT) on telerehabilitation for TKA, and involved data from 197 patients, post-TKA. Twice a week for 8 weeks, participants received supervised physiotherapy via two delivery methods, depending on their study group allocation: in-home telerehabilitation (TELE) and home-visit rehabilitation (VISIT). Patients were recruited from eight hospitals in the province of Quebec, Canada. The TELE group intervention was delivered by videoconferencing over high-speed Internet. The VISIT group received the same intervention at home. Costs related to the delivery of the two services (TELE and VISIT) were calculated. Student's t tests were used to compare costs per treatment between the two groups. To take distance into account, the two treatment groups were compared within distance strata using two-way analyses of variance (ANOVAs). The mean cost of a single session was Can $93.08 for the VISIT group (SD $35.70) and $80.99 for the TELE group (SD $26.60). When comparing both groups, real total cost analysis showed a cost differential in favor of the TELE group (TELE minus VISIT: -$263, 95% CI -$382 to -$143). However, when the patient's home was located less than 30 km round-trip from the health care center, the difference in costs between TELE and VISIT treatments was not significant (P=.25, .26, and .11 for the <10, 10-19, and 20-29 km strata, respectively). The cost of TELE treatments was lower than VISIT treatments when the distance was 30 km or more (30-49 km: $81<$103, P=.002; ≥50 km: $90<$152, P<.001). To our knowledge, this is the first study of the actual costs of in-home telerehabilitation covering all subcosts of telerehabilitation and distance between the health care center and the patient's home. The cost for a single session of in-home telerehabilitation compared to conventional home-visit rehabilitation was lower or about the same, depending on the distance between the patient's home and health care center. Under the controlled conditions of an RCT, a favorable cost differential was observed when the patient was more than 30 km from the provider. Stakeholders and program planners can use these data to guide decisions regarding introducing telerehabilitation as a new service in their clinic. International Standard Registered Clinical Study Number (ISRCTN): 66285945; http://www.isrctn.com/ISRCTN66285945 (Archived by WebCite at http://www.webcitation.org/6WlT2nuX4).

Virtual TeleRehab: a case study.

PubMed

Pareto, Lena; Johansson, Britt; Zeller, Sally; Sunnerhagen, Katharina S; Rydmark, Martin; Broeren, Jurgen

2011-01-01

We examined the efficacy of a remotely based occupational therapy intervention. A 40-year-old woman who suffered a stroke participated in a telerehabilitation program. The intervention method is based on virtual reality gaming to enhance the training experience and to facilitate the relearning processes. The results indicate that Virtual TeleRehab is an effective method for motivational, economical, and practical reasons by combining game-based rehabilitation in the home with weekly distance meetings.

Distance Learning in North Dakota: A Cross-Technology Study of the Schools, Administrators, Coordinators, Instructors, and Students. Two-Way Interactive Television, AudioGraphic Tele-Learning, [and] Instruction by Satellite.

ERIC Educational Resources Information Center

Hobbs, Vicki M.

In 1990 a comparative analysis was conducted of North Dakota student achievement across three forms of distance education: instruction by satellite, audiographic tele-learning, and two way interactive educational television. Based in part on the 1988 study of a German by Satellite program in Missouri and North Dakota, this study mailed…

Effect of Problem-Solving Therapy on Depressed Low-Income Homebound Older Adults’ Death/Suicidal Ideation and Hopelessness

PubMed Central

Choi, Namkee G.; Marti, C. Nathan; Conwell, Yeates

2015-01-01

Previous study findings of psychotherapy’s effect on suicide prevention have been inconsistent. The present study reports the results of secondary analyses of outcome data from a short-term depression treatment on reducing death/suicidal ideation among 158 low-income homebound adults aged 50+. The treatment, in-person or telehealth problem-solving therapy (PST), compared to telephone support call, has been found effective in reducing depressive symptoms and disability among participants. Compared to support call participants, tele-PST participants, but not in-person PST participants, exhibited lower ideation ratings across the follow-up period. Effect sizes at 36 weeks were 0.31 for tele-PST and 0.17 for in-person PST. Hopelessness mediated the effect of tele-PST but not in-person PST; however, in-person PST also alleviated hopelessness, which led to lower ideation. Clinical implications of the findings are discussed. PMID:26456016

Effect of Problem-Solving Therapy on Depressed Low-Income Homebound Older Adults' Death/Suicidal Ideation and Hopelessness.

PubMed

Choi, Namkee G; Marti, C Nathan; Conwell, Yeates

2016-06-01

Previous study findings of psychotherapy's effect on suicide prevention have been inconsistent. This study reports the results of secondary analyses of outcome data from a short-term depression treatment on reducing death/suicidal ideation among 158 low-income homebound adults aged 50+. The treatment, in-person or telehealth problem-solving therapy (PST), compared with telephone support call, has been found effective in reducing depressive symptoms and disability among participants. Compared with support call participants, tele-PST participants, but not in-person PST participants, exhibited lower ideation ratings across the follow-up period. Effect sizes at 36 weeks were 0.31 for tele-PST and 0.17 for in-person PST. Hopelessness mediated the effect of tele-PST but not in-person PST; however, in-person PST also alleviated hopelessness, which led to lower ideation. Clinical implications of the findings are discussed. © 2015 The American Association of Suicidology.

Telemedicine in South Africa: success or failure?

PubMed

Gulube, S M; Wynchank, S

2001-01-01

A national telemedicine system for South Africa was planned in 1998. In the first phase, starting in 1999, 28 pilot sites were established in six provinces. The initial applications were teleradiology, tele-ultrasound for antenatal services, telepathology and tele-ophthalmology. Telemedicine equipment was connected by ISDN at 256 kbit/s. From January to September 2000, 2663 radiographic studies were performed at the three Northwest Province teleradiology transmission sites, of which 264 studies (10%) were selected for specialist radiologist reporting by teleradiology. From June to August 2000, nine antenatal care tele-ultrasound consultations were performed in the Northern Cape Province and four transfers were avoided through the use of telemedicine. One area of concern is the relatively low usage of the telemedicine system, which raises questions about its cost-effectiveness. The experience of telemedicine in South Africa confirmed, as others have found, that common problems relate to the technical and organizational challenges of introducing telemedicine.

An intelligent tele-healthcare environment offering person-centric and wellness-maintenance services.

PubMed

Abidi, S S

2001-06-01

Worldwide healthcare delivery trends are undergoing a subtle paradigm shift--patient centered services as opposed to provider centered services and wellness maintenance as opposed to illness management. In this paper we present a Tele-Healthcare project TIDE--Tele-Healthcare Information and Diagnostic Environment. TIDE manifests an 'intelligent' healthcare environment that aims to ensure lifelong coverage of person-specific health maintenance decision-support services--i.e., both wellness maintenance and illness management services--ubiquitously available via the Internet/WWW. Taking on an all-encompassing health maintenance role--spanning from wellness to illness issues--the functionality of TIDE involves the generation and delivery of (a) Personalized, Pro-active, Persistent, Perpetual, and Present wellness maintenance services, and (b) remote diagnostic services for managing noncritical illnesses. Technically, TIDE is an amalgamation of diverse computer technologies--Artificial Intelligence, Internet, Multimedia, Databases, and Medical Informatics--to implement a sophisticated healthcare delivery infostructure.

Telemedicine and advances in urban and rural healthcare delivery in Africa.

PubMed

Mars, Maurice

2013-01-01

Telecardiology holds great promise for Africa, from tele-echocardiography and tele-ECG s, to home monitoring and text messaging for medication adherence monitoring. The burden of disease is great and there is an extreme shortage of health professionals. Telemedicine can provide access to scarce specialist care, improve the quality of care in rural areas and reduce the need for rural patients to travel to seek medical attention. International cross border service can alleviate the shortage of doctors. But telecardiology, and telemedicine uptake in general, has been poor in Africa. Legal and ethical issues around local and cross border telemedicine have not been resolved. The literature was reviewed and obstacles to telemedicine in Africa and current telemedicine activities in Africa, are described. There are few sustained telemedicine services in Africa with the exception of tele-education. There is an expectation that mobile phones will facilitate a range of telemedicine activities in Africa. Africa needs telemedicine. © 2013.

Emotional attachment and emotional availability tele-intervention for adoptive families.

PubMed

Baker, Megan; Biringen, Zeynep; Meyer-Parsons, Beatrice; Schneider, Abby

2015-01-01

This study evaluated the new online Emotional Attachment and Emotional Availability (EA2) Intervention for use with adoptive families in enhancing parent-child EA, parental perceptions of EA, child attachment behaviors, parent-child emotional attachment, and reducing parent-reported child behavioral problems and parenting-related stress. Participants in this study were adoptive parents and their adopted children ages 1.5 to 5 years old (N = 15 dyads). Participants were placed in an immediate intervention group (IG) or a delayed intervention group (DG) that would receive the 6-week EA2 Tele-Intervention after the IG. Results revealed significant differences in the IG in child behavioral problems, parent-child EA, parental perceptions of EA, and parent-child emotional attachment, improvements not seen in the DG. Analysis of effects of the DG after receiving the EA2 Tele-Intervention revealed significant differences over time also in most of these qualities. © 2015 Michigan Association for Infant Mental Health.

Hand-held medical robots.

PubMed

Payne, Christopher J; Yang, Guang-Zhong

2014-08-01

Medical robots have evolved from autonomous systems to tele-operated platforms and mechanically-grounded, cooperatively-controlled robots. Whilst these approaches have seen both commercial and clinical success, uptake of these robots remains moderate because of their high cost, large physical footprint and long setup times. More recently, researchers have moved toward developing hand-held robots that are completely ungrounded and manipulated by surgeons in free space, in a similar manner to how conventional instruments are handled. These devices provide specific functions that assist the surgeon in accomplishing tasks that are otherwise challenging with manual manipulation. Hand-held robots have the advantages of being compact and easily integrated into the normal surgical workflow since there is typically little or no setup time. Hand-held devices can also have a significantly reduced cost to healthcare providers as they do not necessitate the complex, multi degree-of-freedom linkages that grounded robots require. However, the development of such devices is faced with many technical challenges, including miniaturization, cost and sterility, control stability, inertial and gravity compensation and robust instrument tracking. This review presents the emerging technical trends in hand-held medical robots and future development opportunities for promoting their wider clinical uptake.

Enabling the mission through trans-atlantic remote mentored musculoskeletal ultrasound: case report of a portable hand-carried tele-ultrasound system for medical relief missions.

PubMed

Kirkpatrick, Andrew W; Blaivas, Michael; Sargsyan, Ashot E; McBeth, Paul B; Patel, Chirag; Xiao, Zhengwen; Pian, Linping; Panebianco, Nova; Hamilton, Douglas R; Ball, Chad G; Dulchavsky, Scott A

2013-07-01

Modern medical practice has become extremely dependent upon diagnostic imaging technologies to confirm the results of clinical examination and to guide the response to therapies. Of the various diagnostic imaging techniques, ultrasound is the most portable modality and one that is repeatable, dynamic, relatively cheap, and safe as long as the imaging provided is accurately interpreted. It is, however, the most user-dependent, a characteristic that has prompted the development of remote guidance techniques, wherein remote experts guide distant users through the use of information technologies. Medical mission work often brings specialist physicians to less developed locations, where they wish to provide the highest levels of care but are often bereft of diagnostic imaging resources on which they depend. Furthermore, if these personnel become ill or injured, their own care received may not be to the standard they have left at home. We herein report the utilization of a compact hand-carried remote tele-ultrasound system that allowed real-time diagnosis and follow-up of an acutely torn adductor muscle by a team of ultrasonographers, surgeons, and physicians. The patient was one of the mission surgeons who was guided to self-image. The virtual network of supporting experts was located across North America, whereas the patient was in Lome, Togo, West Africa. The system consisted of a hand-carried ultrasound, the output of which was digitized and streamed to the experts within standard voice-over-Internet-protocol software with an embedded simultaneous videocamera image of the ultrasonographer's hands using a customized graphical user interface. The practical concept of a virtual tele-ultrasound support network was illustrated through the clinical guidance of multiple physicians, including National Aeronautics and Space Administration Medical Operations remote guiders, Olympic team-associated surgeons, and ultrasound-focused emergentologists.

Telemedicine deployments within NATO military forces: a data analysis of current and projected capabilities.

PubMed

Lam, David M; Poropatich, Ronald K

2008-11-01

Since the creation of the NATO Telemedicine Expert Panel (now renamed the TMED Expert Team) in 2000, when few nations had deployed telemedicine systems to support military field operations, this group has been encouraging the nations to deploy telemedicine (TMED) in support of their forces, and to write the use of TMED into NATO doctrine. This has been a relatively successful effort, and TMED is increasingly being used within the military medical structures of some NATO and Partnership for Peace nations to provide medical care to deployed military personnel. We report the results of a multinational survey of current and projected availability of various telemedicine modalities within the NATO medical services that are participating in the work of the TMED expert team (ET). Though only a "snapshot in time," and not representing all NATO nations, this is the first attempt to identify both current and planned TMED utilization within the multinational military medical community. Participating nations report that communication systems now in place at the lowest levels of medical support increasingly enable the routine use of Web-based teleconsultation modalities. Teleradiology is now being seen as the de facto standard for imaging support. While a number of nations report they have deployed capabilities for obtaining clinical consultations at a distance, most responding nations do not have a formal organizational structure to control and manage remote consultation and rely on informal clinical relationships (e.g., requesting consults from the deployed clinician's home hospital or from friends). Military electronic health records are in use by only a minority of nations and fewer still are capable of civilian interface. Less common TMED capabilities (e.g., tele-microbiology, tele-pathology, tele-medical maintenance) are being increasingly used, but are still rarely deployed. As a result of the findings of this survey, specific recommendations for expanding the use of TMED in the NATO multinational medical setting have been made to appropriate NATO bodies.

Appropriateness and acceptability of a Tele-Yoga intervention for people with heart failure and chronic obstructive pulmonary disease: qualitative findings from a controlled pilot study.

PubMed

Selman, Lucy; McDermott, Kelly; Donesky, DorAnne; Citron, Tracie; Howie-Esquivel, Jill

2015-02-07

Heart failure (HF) and chronic obstructive pulmonary disease (COPD) are highly prevalent and associated with a large symptom burden, that is compounded in a dual HF-COPD diagnosis. Yoga has potential benefit for symptom relief; however functional impairment hinders access to usual yoga classes. We developed a Tele-Yoga intervention and evaluated it in a controlled pilot trial. This paper reports on the appropriateness and acceptability of the intervention and the evaluation design. A controlled, non-randomised trial was conducted of an 8-week Tele-Yoga intervention versus an educational control (information leaflets mailed to participants with one phone call a week). Biweekly one-hour Tele-Yoga classes were implemented via multipoint videoconferencing that connected participants to live classes via an Internet connection to their televisions. Semi-structured qualitative interviews were conducted with participants post study exit to explore reasons for and experiences of participating, including views of study outcome measures and physiological tests. Transcribed interviews were analysed using thematic content analysis. Fifteen people participated in the pilot study (7 in the intervention group, 8 in the control). Of these, 12 participants were interviewed, 6 in each group, mean age 71.2 years (SD 10.09); 3 were male. Themes are reported in the following categories: acceptability and appropriateness of the intervention, potential active ingredients of the intervention, acceptability and appropriateness of the control, participation in the research, and acceptability of the testing procedures. The intervention was acceptable and appropriate: the intervention group reported enjoying yoga and valuing the home-based aspect and participants described a high symptom burden and social isolation. However, technological problems resulted in poor video-streaming quality for some participants. Potential active ingredients included physical postures, breathing exercises and guidance in relaxation and meditation. The educational control intervention was acceptable and appropriate, with participants reporting little effect on their well-being and no impact on mechanisms hypothesised to explain yoga's effectiveness. The questionnaires and home physiological testing were acceptable to participants. Tele-Yoga is an acceptable and appropriate intervention in people with HF and COPD and further research is warranted to refine the technology used in its delivery. Findings provide guidance for researchers working in tele-interventions, yoga, and similar populations. ClinicalTrials.gov Identifier: NCT02078739 (4 March 2014).

A simple dynamic engine model for use in a real-time aircraft simulation with thrust vectoring

NASA Technical Reports Server (NTRS)

Johnson, Steven A.

1990-01-01

A simple dynamic engine model was developed at the NASA Ames Research Center, Dryden Flight Research Facility, for use in thrust vectoring control law development and real-time aircraft simulation. The simple dynamic engine model of the F404-GE-400 engine (General Electric, Lynn, Massachusetts) operates within the aircraft simulator. It was developed using tabular data generated from a complete nonlinear dynamic engine model supplied by the manufacturer. Engine dynamics were simulated using a throttle rate limiter and low-pass filter. Included is a description of a method to account for axial thrust loss resulting from thrust vectoring. In addition, the development of the simple dynamic engine model and its incorporation into the F-18 high alpha research vehicle (HARV) thrust vectoring simulation. The simple dynamic engine model was evaluated at Mach 0.2, 35,000 ft altitude and at Mach 0.7, 35,000 ft altitude. The simple dynamic engine model is within 3 percent of the steady state response, and within 25 percent of the transient response of the complete nonlinear dynamic engine model.

Effect of a real-time tele-transmission system of 12-lead electrocardiogram on the first-aid for athletes with ST-elevation myocardial infarction.

PubMed

Zhang, Huan; Song, Donghan; An, Lina

2016-05-01

To study the effect of a real-time tele-transmission system of 12-lead electrocardiogram on door-to-balloon time in athletes with ST-elevation myocardial infarction. A total of 60 athletes with chest pain diagnosed as ST-elevation myocardial infarction (STEMI) from our hospital were randomly divided into group A (n=35) and group B (n=25), the patients in group A transmitted the real-time tele-transmission system of 12-lead electrocardiogram to the chest pain center before arriving in hospital, however, the patients in group B not. The median door-to-balloon time was significant shorter in-group A than group B (38min vs 94 min, p<0.01) and the ratio of door-to-balloon time below 90 min was remarkable higher in-group A (94.2% vs 60%, p<0.01). The rate of catheter laboratory occupied was 5.7% in-group A and 40% in group B respectively (p=0.001). There was no statistically difference in mortality between the two groups (5.7% vs 4%, p>0.05). The median length of stay was significant reduced in-group A (5 days vs 7 days, p<0.01). Real-time tele-transmission system of 12 lead electrocardiogram is beneficial to the pre-hospital diagnosis of STEMI.

Remote tele-mentored ultrasound for non-physician learners using FaceTime: A feasibility study in a low-income country.

PubMed

Robertson, Thomas E; Levine, Andrea R; Verceles, Avelino C; Buchner, Jessica A; Lantry, James H; Papali, Alfred; Zubrow, Marc T; Colas, L Nathalie; Augustin, Marc E; McCurdy, Michael T

2017-08-01

Ultrasound (US) is a burgeoning diagnostic tool and is often the only available imaging modality in low- and middle-income countries (LMICs). However, bedside providers often lack training to acquire or interpret US images. We conducted a study to determine if a remote tele-intensivist could mentor geographically removed LMIC providers to obtain quality and clinically useful US images. Nine Haitian non-physician health care workers received a 20-minute training on basic US techniques. A volunteer was connected to an intensivist located in the USA via FaceTime. The intensivist remotely instructed the non-physicians to ultrasound five anatomic sites. The tele-intensivist evaluated the image quality and clinical utility of performing tele-ultrasound in a LMIC. The intensivist agreed (defined as "agree" or "strongly agree" on a five-point Likert scale) that 90% (57/63) of the FaceTime images were high quality. The intensivist felt comfortable making clinical decisions using FaceTime images 89% (56/63) of the time. Non-physicians can feasibly obtain high-quality and clinically relevant US images using video chat software in LMICs. Commercially available software can connect providers in institutions in LMICs to geographically removed intensivists at a relatively low cost and without the need for extensive training of local providers. Copyright © 2017 Elsevier Inc. All rights reserved.

A Bio-Inspired Model-Based Approach for Context-Aware Post-WIMP Tele-Rehabilitation.

PubMed

López-Jaquero, Víctor; Rodríguez, Arturo C; Teruel, Miguel A; Montero, Francisco; Navarro, Elena; Gonzalez, Pascual

2016-10-13

Tele-rehabilitation is one of the main domains where Information and Communication Technologies (ICT) have been proven useful to move healthcare from care centers to patients' home. Moreover, patients, especially those carrying out a physical therapy, cannot use a traditional Window, Icon, Menu, Pointer (WIMP) system, but they need to interact in a natural way, that is, there is a need to move from WIMP systems to Post-WIMP ones. Moreover, tele-rehabilitation systems should be developed following the context-aware approach, so that they are able to adapt to the patients' context to provide them with usable and effective therapies. In this work a model-based approach is presented to assist stakeholders in the development of context-aware Post-WIMP tele-rehabilitation systems. It entails three different models: (i) a task model for designing the rehabilitation tasks; (ii) a context model to facilitate the adaptation of these tasks to the context; and (iii) a bio-inspired presentation model to specify thoroughly how such tasks should be performed by the patients. Our proposal overcomes one of the limitations of the model-based approach for the development of context-aware systems supporting the specification of non-functional requirements. Finally, a case study is used to illustrate how this proposal can be put into practice to design a real world rehabilitation task.

Tele-surgery: a new virtual tool for medical education.

PubMed

Russomano, Thais; Cardoso, Ricardo B; Fernandes, Jefferson; Cardoso, Paulizan G; Alves, Jarcedy M; Pianta, Christina D; Souza, Hamilton P; Lopes, Maria Helena I

2009-01-01

The rapid evolution of telecommunication technology has enabled advances to be made in low cost video-conferencing through the improvement of high speed computer communication networks and the enhancement of Internet security protocols. As a result of this progress, eHealth education programs are becoming a reality in universities, providing the opportunity for students to have greater interaction at live surgery classes by means of virtual participation. Undergraduate students can be introduced to new concepts of medical care, remote second opinion and to telecommunication systems, whilst virtually experiencing surgical procedures and lectures. The better access this provides to the operating theater environment, the patient and the surgeon can improve the learning process for students. An analogical system was used for this experimental pilot project due to the benefits of it being low cost with a comparatively easy setup. The tele-surgery lectures were also transmitted to other universities by means of a Pentium 4 computer using open source software and connected to a portable image acquisition device located in the São Lucas University Hospital. Telemedicine technology has proven to be an important instrument for the improvement of medical education and health care. This study allowed health professionals, professors and students to have greater interaction during surgical procedures, thus enabling a greater opportunity for knowledge exchange.

Developing a telepresence robot for interpersonal communication with the elderly in a home environment.

PubMed

Tsai, Tzung-Cheng; Hsu, Yeh-Liang; Ma, An-I; King, Trevor; Wu, Chang-Huei

2007-08-01

"Telepresence" is an interesting field that includes virtual reality implementations with human-system interfaces, communication technologies, and robotics. This paper describes the development of a telepresence robot called Telepresence Robot for Interpersonal Communication (TRIC) for the purpose of interpersonal communication with the elderly in a home environment. The main aim behind TRIC's development is to allow elderly populations to remain in their home environments, while loved ones and caregivers are able to maintain a higher level of communication and monitoring than via traditional methods. TRIC aims to be a low-cost, lightweight robot, which can be easily implemented in the home environment. Under this goal, decisions on the design elements included are discussed. In particular, the implementation of key autonomous behaviors in TRIC to increase the user's capability of projection of self and operation of the telepresence robot, in addition to increasing the interactive capability of the participant as a dialogist are emphasized. The technical development and integration of the modules in TRIC, as well as human factors considerations are then described. Preliminary functional tests show that new users were able to effectively navigate TRIC and easily locate visual targets. Finally the future developments of TRIC, especially the possibility of using TRIC for home tele-health monitoring and tele-homecare visits are discussed.

Humanlike robot hands controlled by brain activity arouse illusion of ownership in operators

PubMed Central

Alimardani, Maryam; Nishio, Shuichi; Ishiguro, Hiroshi

2013-01-01

Operators of a pair of robotic hands report ownership for those hands when they hold image of a grasp motion and watch the robot perform it. We present a novel body ownership illusion that is induced by merely watching and controlling robot's motions through a brain machine interface. In past studies, body ownership illusions were induced by correlation of such sensory inputs as vision, touch and proprioception. However, in the presented illusion none of the mentioned sensations are integrated except vision. Our results show that during BMI-operation of robotic hands, the interaction between motor commands and visual feedback of the intended motions is adequate to incorporate the non-body limbs into one's own body. Our discussion focuses on the role of proprioceptive information in the mechanism of agency-driven illusions. We believe that our findings will contribute to improvement of tele-presence systems in which operators incorporate BMI-operated robots into their body representations. PMID:23928891

Monte-Carlo based assessment of MAGIC, MAGICAUG, PAGATUG and PAGATAUG polymer gel dosimeters for ovaries and uterus organ dosimetry in brachytherapy, nuclear medicine and Tele-therapy.

PubMed

Adinehvand, Karim; Rahatabad, Fereidoun Nowshiravan

2018-06-01

Calculation of 3D dose distribution during radiotherapy and nuclear medicine helps us for better treatment of sensitive organs such as ovaries and uterus. In this research, we investigate two groups of normoxic dosimeters based on meta-acrylic acid (MAGIC and MAGICAUG) and polyacrylamide (PAGATUG and PAGATAUG) for brachytherapy, nuclear medicine and Tele-therapy in their sensitive and critical role as organ dosimeters. These polymer gel dosimeters are compared with soft tissue while irradiated by different energy photons in therapeutic applications. This comparison has been simulated by Monte-Carlo based MCNPX code. ORNL phantom-Female has been used to model the critical organs of kidneys, ovaries and uterus. Right kidney is proposed to be the source of irradiation and another two organs are exposed to this irradiation. Effective atomic numbers of soft tissue, MAGIC, MAGICAUG, PAGATUG and PAGATAUG are 6.86, 7.07, 6.95, 7.28, and 7.07 respectively. Results show the polymer gel dosimeters are comparable to soft tissue for using in nuclear medicine and Tele-therapy. Differences between gel dosimeters and soft tissue are defined as the dose responses. This difference is less than 4.1%, 22.6% and 71.9% for Tele-therapy, nuclear medicine and brachytherapy respectively. The results approved that gel dosimeters are the best choice for ovaries and uterus in nuclear medicine and Tele-therapy respectively. Due to the slight difference between the effective atomic numbers of these polymer gel dosimeters and soft tissue, these polymer gels are not suitable for brachytherapy since the dependence of photon interaction to atomic number, for low energy brachytherapy, had been so effective. Also this dependence to atomic number, decrease for photoelectric and increase for Compton. Therefore polymer gel dosimeters are not a good alternative to soft tissue replacement in brachytherapy. Copyright © 2018 Elsevier B.V. All rights reserved.

Telegenetics: application of a tele-education program in genetic syndromes for Brazilian students

PubMed Central

MAXIMINO, Luciana Paula; PICOLINI-PEREIRA, Mirela Machado; CARVALHO, José Luiz Brito

2014-01-01

With the high occurrence of genetic anomalies in Brazil and the manifestations of communication disorders associated with these conditions, the development of educative actions that comprise these illnesses can bring unique benefits in the identification and appropriate treatment of these clinical pictures. Objective The aim of this study was to develop and analyze an educational program in genetic syndromes for elementary students applied in two Brazilian states, using an Interactive Tele-education model. Material and Methods The study was carried out in 4 schools: two in the state of São Paulo, Southeast Region, Brazil, and two in the state of Amazonas, North Region, Brazil. Forty-five students, both genders, aged between 13 and 14 years, of the 9th grade of the basic education of both public and private system, were divided into two groups: 21 of São Paulo Group (SPG) and 24 of Amazonas Group (AMG). The educational program lasted about 3 months and was divided into two stages including both classroom and distance activities on genetic syndromes. The classroom activity was carried out separately in each school, with expository lessons, graphs and audiovisual contents. In the activity at a distance the educational content was presented to students by means of the Interactive Tele-education model. In this stage, the students had access a Cybertutor, using the Young Doctor Project methodology. In order to measure the effectiveness of the educational program, the Problem Situation Questionnaire (PSQ) and the Web Site Motivational Analysis Checklist adapted (FPM) were used. Results The program developed was effective for knowledge acquisition in 80% of the groups. FPM showed a high satisfaction index from the participants in relation to the Interactive Tele-education, evaluating the program as "awesome course". No statistically significant differences between the groups regarding type of school or state were observed. Conclusion Thus, the Tele-Education Program can be used as a tool for educational purposes in genetic syndromes of other populations, in several regions of Brazil. PMID:25591016

The Fountain of Health: Bringing Seniors’ Mental Health Promotion into Clinical Practice

PubMed Central

Thoo, Vanessa; Freer, Janya; Cassidy, Keri-Leigh

2015-01-01

Background The Fountain of Health (FoH) initiative offers valuable evidence-based mental health knowledge and provides clinicians with evaluated tools for translating knowledge into practice, in order to reduce seniors’ risks of mental disorders, including dementia. Methods A presentation on mental health promotion and educational materials were disseminated to mental health clinicians including physicians and other allied health professionals either in-person or via tele-education through a provincial seniors’ mental health network. Measures included: 1) a tele-education quality evaluation form, 2) a knowledge transfer questionnaire, 3) a knowledge translation-to-practice evaluation tool, and 4) a quality assurance questionnaire. Results A total of 74 mental health clinicians received the FoH education session. There was a highly significant (p < .0001) difference in clinicians’ knowledge transfer questionnaire scores pre- and post-educational session. At a two-month follow-up, 19 (25.7%) participants completed a quality assurance questionnaire, with all 19 (100%) of respondents stating they would positively recommend the FoH information to colleagues and patients. Eleven (20.4%) translation-to-practice forms were also collected at this interval, tracking clinician use of the educational materials. Conclusions The use of a formalized network for knowledge transfer allows for education and evaluation of health-care practitioners in both acquisition of practical knowledge and subsequent clinical behavior change. PMID:26740830

A smart phone/tablet based mobile health care system for developing countries.

PubMed

Vaidya, Avinash S; Srinivas, M B; Himabindu, P; Jumaxanova, Daria

2013-01-01

Increasing cost of health care in developing countries is placing heavy financial burden on its populations. With the advent of mobile and tablet technologies however, it is possible to reduce this burden to some extent through tele-healthcare. In this paper, authors describe their effort to design portable diagnostic devices that can communicate to smart phones and tablets there by making tele-healthcare possible. A possible architecture of their model is presented and components thereof discussed.

Distributed telemedicine for the National Information Infrastructure

DOE Office of Scientific and Technical Information (OSTI.GOV)

Forslund, D.W.; Lee, Seong H.; Reverbel, F.C.

1997-08-01

TeleMed is an advanced system that provides a distributed multimedia electronic medical record available over a wide area network. It uses object-based computing, distributed data repositories, advanced graphical user interfaces, and visualization tools along with innovative concept extraction of image information for storing and accessing medical records developed in a separate project from 1994-5. In 1996, we began the transition to Java, extended the infrastructure, and worked to begin deploying TeleMed-like technologies throughout the nation. Other applications are mentioned.

A remote operating slit lamp microscope system. Development and its utility in ophthalmologic examinations.

PubMed

Tanabe, N; Go, K; Sakurada, Y; Imasawa, M; Mabuchi, F; Chiba, T; Abe, K; Kashiwagi, K

2011-01-01

To develop a remote-operating slit lamp microscope system (the remote slit lamp) as the core for highly specialized ophthalmology diagnoses, and to compare the utility of this system with the conventional slit lamp microscope system (the conventional slit lamp) in making a diagnosis. The remote slit lamp system was developed. Three factors were evaluated in comparison to the conventional slit lamp. The ability to acquire skills was investigated using a task loading system among specialists and residents in ophthalmology. Participants repeated a task up to ten times and the time required for each task was analyzed. The consistency of the two systems in making a diagnosis was investigated using eyes of patients with ocular diseases as well as healthy volunteers. The remote slit lamp is composed of a patient's unit and ophthalmologist's unit connected by high-speed internet. The two units share images acquired by the slit lamp in addition to the images and voices of patients and ophthalmologists. Both ophthalmology specialists and residents could minimize the completion times after several trials. The remote slit lamp took more time than the conventional slit lamp. Both systems showed a high consistency in evaluations among eyes with healthy eyes or those with ocular diseases. The remote slit lamp has a similar diagnostic ability, but required more examination time in comparison to the conventional slit lamp. The currently developed remote slit lamp has the potential to be employed for tele-medicine purposes in the field of ophthalmology.

Remote control of an MR imaging study via tele-collaboration tools

NASA Astrophysics Data System (ADS)

Sullivan, John M., Jr.; Mullen, Julia S.; Benz, Udo A.; Schmidt, Karl F.; Murugavel, Murali; Chen, Wei; Ghadyani, Hamid

2005-04-01

In contrast to traditional 'video conferencing' the Access Grid (AG), developed by Argonne National Laboratory, is a collaboration of audio, video and shared application tools which provide the 'persistent presence' of each participant. Among the shared application tools are the ability to share viewing and control of presentations, browsers, images and movies. When used in conjunction with Virtual Network Computing (VNC) software, an investigator can interact with colleagues at a remote site, and control remote systems via local keyboard and mouse commands. This combination allows for effective viewing and discussion of information, i.e. data, images, and results. It is clear that such an approach when applied to the medical sciences will provide a means by which a team of experts can not only access, but interact and control medical devices for the purpose of experimentation, diagnosis, surgery and therapy. We present the development of an application node at our 4.7 Tesla MR magnet facility, and a demonstration of remote investigator control of the magnet. A local magnet operator performs manual tasks such as loading the test subject into the magnet and administering the stimulus associated with the functional MRI study. The remote investigator has complete control of the magnet console. S/he can adjust the gradient coil settings, the pulse sequence, image capture frequency, etc. A geographically distributed audience views and interacts with the remote investigator and local MR operator. This AG demonstration of MR magnet control illuminates the potential of untethered medical experiments, procedures and training.

Concurrent multiscale imaging with magnetic resonance imaging and optical coherence tomography

NASA Astrophysics Data System (ADS)

Liang, Chia-Pin; Yang, Bo; Kim, Il Kyoon; Makris, George; Desai, Jaydev P.; Gullapalli, Rao P.; Chen, Yu

2013-04-01

We develop a novel platform based on a tele-operated robot to perform high-resolution optical coherence tomography (OCT) imaging under continuous large field-of-view magnetic resonance imaging (MRI) guidance. Intra-operative MRI (iMRI) is a promising guidance tool for high-precision surgery, but it may not have sufficient resolution or contrast to visualize certain small targets. To address these limitations, we develop an MRI-compatible OCT needle probe, which is capable of providing microscale tissue architecture in conjunction with macroscale MRI tissue morphology in real time. Coregistered MRI/OCT images on ex vivo chicken breast and human brain tissues demonstrate that the complementary imaging scales and contrast mechanisms have great potential to improve the efficiency and the accuracy of iMRI procedure.

3D laptop for defense applications

NASA Astrophysics Data System (ADS)

Edmondson, Richard; Chenault, David

2012-06-01

Polaris Sensor Technologies has developed numerous 3D display systems using a US Army patented approach. These displays have been developed as prototypes for handheld controllers for robotic systems and closed hatch driving, and as part of a TALON robot upgrade for 3D vision, providing depth perception for the operator for improved manipulation and hazard avoidance. In this paper we discuss the prototype rugged 3D laptop computer and its applications to defense missions. The prototype 3D laptop combines full temporal and spatial resolution display with the rugged Amrel laptop computer. The display is viewed through protective passive polarized eyewear, and allows combined 2D and 3D content. Uses include robot tele-operation with live 3D video or synthetically rendered scenery, mission planning and rehearsal, enhanced 3D data interpretation, and simulation.

A novel remote center of motion mechanism for the force-reflective master robot of haptic tele-surgery systems.

PubMed

Hadavand, Mostafa; Mirbagheri, Alireza; Behzadipour, Saeed; Farahmand, Farzam

2014-06-01

An effective master robot for haptic tele-surgery applications needs to provide a solution for the inversed movements of the surgical tool, in addition to sufficient workspace and manipulability, with minimal moving inertia. A novel 4 + 1-DOF mechanism was proposed, based on a triple parallelogram linkage, which provided a Remote Center of Motion (RCM) at the back of the user's hand. The kinematics of the robot was analyzed and a prototype was fabricated and evaluated by experimental tests. With a RCM at the back of the user's hand the actuators far from the end effector, the robot could produce the sensation of hand-inside surgery with minimal moving inertia. The target workspace was achieved with an acceptable manipulability. The trajectory tracking experiments revealed small errors, due to backlash at the joints. The proposed mechanism meets the basic requirements of an effective master robot for haptic tele-surgery applications. Copyright © 2013 John Wiley & Sons, Ltd.

A cloud computing based 12-lead ECG telemedicine service

PubMed Central

2012-01-01

Background Due to the great variability of 12-lead ECG instruments and medical specialists’ interpretation skills, it remains a challenge to deliver rapid and accurate 12-lead ECG reports with senior cardiologists’ decision making support in emergency telecardiology. Methods We create a new cloud and pervasive computing based 12-lead Electrocardiography (ECG) service to realize ubiquitous 12-lead ECG tele-diagnosis. Results This developed service enables ECG to be transmitted and interpreted via mobile phones. That is, tele-consultation can take place while the patient is on the ambulance, between the onsite clinicians and the off-site senior cardiologists, or among hospitals. Most importantly, this developed service is convenient, efficient, and inexpensive. Conclusions This cloud computing based ECG tele-consultation service expands the traditional 12-lead ECG applications onto the collaboration of clinicians at different locations or among hospitals. In short, this service can greatly improve medical service quality and efficiency, especially for patients in rural areas. This service has been evaluated and proved to be useful by cardiologists in Taiwan. PMID:22838382

A cloud computing based 12-lead ECG telemedicine service.

PubMed

Hsieh, Jui-Chien; Hsu, Meng-Wei

2012-07-28

Due to the great variability of 12-lead ECG instruments and medical specialists' interpretation skills, it remains a challenge to deliver rapid and accurate 12-lead ECG reports with senior cardiologists' decision making support in emergency telecardiology. We create a new cloud and pervasive computing based 12-lead Electrocardiography (ECG) service to realize ubiquitous 12-lead ECG tele-diagnosis. This developed service enables ECG to be transmitted and interpreted via mobile phones. That is, tele-consultation can take place while the patient is on the ambulance, between the onsite clinicians and the off-site senior cardiologists, or among hospitals. Most importantly, this developed service is convenient, efficient, and inexpensive. This cloud computing based ECG tele-consultation service expands the traditional 12-lead ECG applications onto the collaboration of clinicians at different locations or among hospitals. In short, this service can greatly improve medical service quality and efficiency, especially for patients in rural areas. This service has been evaluated and proved to be useful by cardiologists in Taiwan.

Utilisation of Wearable Computing for Space Programmes Test Activities Optimasation

NASA Astrophysics Data System (ADS)

Basso, V.; Lazzari, D.; Alemanni, M.

2004-08-01

New technologies are assuming a relevant importance in the Space business domain also in the Assembly Integration and Test (AIT) activities allowing process optimization and capability that were unthinkable only few years ago. This paper has the aim to describe Alenia Spazio (ALS) gained experience on the remote interaction techniques as a results of collaborations established both on European Communities (EC) initiatives, with Alenia Aeronautica (ALA) and Politecnico of Torino (POLITO). The H/W and S/W components performances increase and costs reduction due to the home computing massive utilization (especially demanded by the games business) together with the network technology possibility (offered by the web as well as the hi-speed links and the wireless communications) allow today to re-think the traditional AIT process activities in the light of the multimedia data exchange: graphical, voice video and by sure more in the future. Aerospace business confirm its innovation vocation which in the year '80 represents the cradle of the CAD systems and today is oriented to the 3D data visualization/ interaction technologies and remote visualisation/ interaction in collaborative way on a much more user friendly bases (i.e. not for specialists). Fig. 1 collects AIT extended scenario studied and adopted by ALS in these years. ALS experimented two possibilities of remote visualization/interaction: Portable [e.g. Fig.2 Personal Digital Assistant (PDA), Wearable] and walls (e.g.VR-Lab) screens as both 2D/3D visualisation and interaction devices which could support many types of traditional (mainly based on EGSE and PDM/CAD utilisation/reports) company internal AIT applications: 1. design review support 2. facility management 3. storage management 4. personnel training 5. integration sequences definition 6. assembly and test operations follow up 7. documentation review and external access to AIT activities for remote operations (e.g. tele-testing) EGSE Portable Clean room Walls PDM/CAD Tele-operations Product Control room External World

Evaluation of Oral and Maxillofacial Surgery Residents' Operative Skills: Feasibility and Engagement Study Using SIMPL Software for a Mobile Phone.

PubMed

Kaban, Leonard B; Cappetta, Alyssa; George, Brian C; Lahey, Edward T; Bohnen, Jordan D; Troulis, Maria J

2017-10-01

There are no universally accepted tools to evaluate operative skills of surgical residents in a timely fashion. The purpose of this study was to determine the feasibility of using a smartphone application, SIMPL (System for Improving and Measuring Procedural Learning), developed by a multi-institutional research collaborative, to achieve a high rate of timely operative evaluations and resident communication and to collect performance data. The authors hypothesized that these goals would be achieved because the process is convenient and efficient. This was a prospective feasibility and engagement study using SIMPL to evaluate residents' operative skills. SIMPL requires the attending surgeon to answer 3 multiple-choice questions: 1) What level of help (Zwisch Scale) was required by the trainee? 2) What was the level of performance? 3) How complex was the case? The evaluator also can dictate a narrative. The sample was composed of 3 faculty members and 3 volunteer senior residents. Predictor variables were the surgeons, trainees, and procedures performed. Outcome variables included number and percentage of procedures performed by faculty-and-resident pairs assessed, time required to complete assessments, time lapsed to submission, percentage of assessments with narratives, and residents' response rates. From March through June 2016, 151 procedures were performed in the operating room by the faculty-and-resident teams. There were 107 assessments submitted (71%). Resident response (self-assessment) to faculty evaluations was 81%. Recorded time to complete assessments (n = 75 of 107) was shorter than 2 minutes. The time lapsed to submission was shorter than 72 hours (100%). Dictations were submitted for 35 evaluations (33%). Data for the type of help, performance, and complexity of cases were collected for each resident. SIMPL facilitates timely intraoperative evaluations of surgical skills, engagement by faculty and residents, and collection of detailed procedural data. Additional prospective trials to assess this tool further are planned. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Five-year experience of tele-ophthalmology for diabetic retinopathy screening in a rural population.

PubMed

Rodríguez Villa, S; Alonso Álvarez, C; de Dios Del Valle, R; Salazar Méndez, R; Cuesta García, M; Ruiz García, M J; Cubillas Martín, M; Rodríguez Vazquez, M

2016-09-01

To identify the prevalence and risk factors of diabetic retinopathy (DR) among rural inhabitants included in a tele-ophthalmology program. To analyse diagnostic accuracy among primary care physicians, concordance with ophthalmologists, and financial savings. An observational randomised study was conducted on 394 patients included in a tele-ophthalmology program (from January 2010 to January 2015). An analysis was performed on the clinical characteristics, DR findings in retinography images, and correspondence between the request for a second interpretation by an ophthalmologist, and previously established criteria for it: presence of moderate to severe DR, vision loss, poor image quality and/or intraocular pressure >22mmHg. Statistical analysis was performed using the SPSS program (Student t and χ(2) tests). DR prevalence was 12.1%. Patients with glycosylated haemoglobin values >7.68% or those treated with a combination of insulin and oral antidiabetic drugs showed a higher risk of DR (P<.05). 43.3% of patients correctly referred to ophthalmologists showed moderate to severe DR. Unnecessary referrals to specialists were improved from 91.7% in 2010 to 98.6% in 2014. It is estimated that the program has made a total saving of €152,550.45. Tele-ophthalmology programs are a useful tool in DR screening. Primary care physicians are able to distinguish patients who need specialist care, avoiding unnecessary referrals to ophthalmologists, and saving costs. Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

Use of video-based education and tele-health home monitoring after liver transplantation: Results of a novel pilot study.

PubMed

Ertel, Audrey E; Kaiser, Tiffany E; Abbott, Daniel E; Shah, Shimul A

2016-10-01

In this observational study, we analyzed the feasibility and early results of a perioperative, video-based educational program and tele-health home monitoring model on postoperative care management and readmissions for patients undergoing liver transplantation. Twenty consecutive liver transplantation recipients were provided with tele-health home monitoring and an educational video program during the perioperative period. Vital statistics were tracked and monitored daily with emphasis placed on readings outside of the normal range (threshold violations). Additionally, responses to effectiveness questionnaires were collected retrospectively for analysis. In the study, 19 of the 20 patients responded to the effectiveness questionnaire, with 95% reporting having watched all 10 videos, 68% watching some more than once, and 100% finding them effective in improving their preparedness for understanding their postoperative care. Among these 20 patients, there was an observed 19% threshold violation rate for systolic blood pressure, 6% threshold violation rate for mean blood glucose concentrations, and 8% threshold violation rate for mean weights. This subset of patients had a 90-day readmission rate of 30%. This observational study demonstrates that tele-health home monitoring and video-based educational programs are feasible in liver transplantation recipients and seem to be effective in enhancing the monitoring of vital statistics postoperatively. These data suggest that smart technology is effective in creating a greater awareness and understanding of how to manage postoperative care after liver transplantation. Copyright © 2016 Elsevier Inc. All rights reserved.

Reach the Unreached -IIRS Outreach program for enhanced learning to all

NASA Astrophysics Data System (ADS)

Krishna Murthy, Y. V. N.; Raju, P. L. N.; Srivastav, S. K.; Karnatak, H.; Gupta, P. Kumar; Mahadevaswamy, M.; Viswakarma, J.

2014-11-01

With the advent of Information and Communication Technology and improved broadband internet connectivity has enhanced the scope of learning any time anywhere, going beyond the traditional classroom approach. To support distance learning, Indian Space Research Organisation, Government of India has launched dedicated communication satellite called EDUSAT in 2004. The satellite is widely used for variety of applications like Tele-education, Tele-medicine, Village Resource Centres, mobile satellite services, disaster management support and television broadcasting educating farmers for agriculture and other purposes. One of the prime applications of EDUSAT satellite is tele-education at various levels (i.e. school level/UG /PG level) by different ministries / autonomous organizations / departments/institutions/universities in India effectively utilized the EDUSAT for Tele-education. The initial focus of IIRS was to use EDUSAT/INSAT 4CR satellite for distance learning but extended the scope to use broadband internet so that access to large number of institutions/universities /individuals with little cost the User. IIRS distance learning program initiated in 2007 and successfully conducted 12 programs in the last eight years. The first course was attended from twelve universities and the number of institutions /universities increased manifold. The thirteenth course is progress with more than 210 institutions /universities /departments /individuals with more than 3200 number of participants attending the program live and interactive. IIRS program is unique and interactive and demand is increasing not only universities but among research institutions, user departments and individuals.

Ethical considerations for the utilization of tele-health technologies in home and hospice care by the nursing profession.

PubMed

Demiris, George; Oliver, Debra Parker; Courtney, Karen L

2006-01-01

Home care, including hospice care, is a growing component of the current healthcare system and pertains to care services that are provided to individuals, their family members, and caregivers in their own residence. Both domains face funding limitations as life expectancy and the segment of the population older than 65 years increase. Tele-health, defined as the use of advanced telecommunication technologies to enable communication between patients and healthcare providers separated by geographic distance, is perceived as a concept that can enhance both home and hospice care and address some of the current challenges. This article discusses ethical challenges associated with the utilization of tele-health technologies by the nursing profession in the home setting. These factors form a framework for the ethical considerations that result from the introduction of these technologies in nursing practice. Specifically, the article discusses the issue of privacy and confidentiality of patient data, informed consent, equity of access, promoting dependency versus independence, the lack of human touch and the impact of technology on the nurse-patient relationship, and the medicalization of the home environment. These issues constitute a road map both for nursing practitioners who are aiming to provide an efficient delivery of services in the home and for nursing administrators who are asked to make judgments about the use of tele-health technology as a supplement to traditional care and as a cost-saving tool.

A cost minimisation analysis of a telepaediatric otolaryngology service.

PubMed

Xu, Cathy Q; Smith, Anthony C; Scuffham, Paul A; Wootton, Richard

2008-02-04

Paediatric ENT services in regional areas can be provided through telemedicine (tele-ENT) using videoconferencing or with a conventional outpatient department ENT service (OPD-ENT) in which patients travel to see the specialist. The objective of this study was to identify the least-cost approach to providing ENT services for paediatric outpatients. A cost-minimisation analysis was conducted comparing the annual costs of the two modes of service provided by the Royal Children's Hospital (RCH) in Brisbane. Activity records were reviewed to analyse volume of activity during a 12 month period in 2005, i.e. number of clinics, duration of clinics, number of consultations via telemedicine and in outpatient clinics, diagnoses, and travel related information. A sensitivity analysis was conducted using factors where there was some uncertainty or potential future variation. During the study period, 88 ENT consultations were conducted via videoconference for 70 patients at Bundaberg Base Hospital. 177 ENT consultations were conducted at the RCH for 117 patients who had travelled from the Bundaberg region to Brisbane. The variable cost of providing the tele-ENT service was A$108 per consultation, compared with A$155 per consultation for the conventional outpatient service. Telemedicine was cheaper when the workload exceeded 100 consultations per year. If all 265 consultations were conducted as tele-ENT consultations, the cost-savings would be $7,621. The cost-minimisation analysis demonstrated that under the circumstances described in this paper, the tele-ENT service was a more economical method for the health department of providing specialist ENT services.

Specific technological communication skills and functional health literacy have no influence on self-reported benefits from enrollment in the TeleCare North trial.

PubMed

Lilholt, Pernille Heyckendorff; Hæsum, Lisa Korsbakke Emtekær; Ehlers, Lars Holger; Hejlesen, Ole K

2016-07-01

The Danish TeleCare North trial has developed a telehealth system, Telekit, which is used for self-management by patients diagnosed with chronic obstructive pulmonary disease (COPD). Self-management is the engagement in one's own illness and health by monitoring and managing one's symptoms and signs of illness. The study examines the association between COPD patients' use of Telekit and their functional health literacy and the association between their use of Telekit and their specific technological communication skills. A consecutive sample of participants (n=60) from the TeleCare North trial were recruited. Face-to-face interviews were conducted with each participant to collect demographic data. Functional health literacy was measured with the Danish TOFHLA test. Participants completed a non-standardised questionnaire about their health status, their use of the Telekit system, and their specific technological communication skills. Binary logistic regressions were performed to examine how functional health literacy and specific technological communication skills influenced the use of Telekit by giving users an enhanced sense of freedom, security, control, and a greater awareness of COPD symptoms. Participants (27 women, 33 men) had a mean age of 70 (SD: 8.37) years. Functional health literacy levels were classified as inadequate in 14 (23%) participants, as marginal in 12 (20%), and as adequate in 34 (57%). Participants self-reported a feeling of increased security (72%), greater freedom (27%), more control (62%), and greater awareness of symptoms (50%) when using Telekit. The use of Telekit was not significantly associated with levels of functional health literacy or with the number of specific technological communication skills (p>0.05) based on the binary logistic regressions. The enhanced sense of security, freedom, control, and the greater awareness of COPD symptoms achieved by using Telekit were unassociated both with the patients' score of functional health literacy and with their specific technological communication skills. On the basis of our results it seems that the specific technological communication skills and functional health literacy are not a prerequisite for the use of the Telekit system. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Tele-Autonomous control involving contact. Final Report Thesis; [object localization

NASA Technical Reports Server (NTRS)

Shao, Lejun; Volz, Richard A.; Conway, Lynn; Walker, Michael W.

1990-01-01

Object localization and its application in tele-autonomous systems are studied. Two object localization algorithms are presented together with the methods of extracting several important types of object features. The first algorithm is based on line-segment to line-segment matching. Line range sensors are used to extract line-segment features from an object. The extracted features are matched to corresponding model features to compute the location of the object. The inputs of the second algorithm are not limited only to the line features. Featured points (point to point matching) and featured unit direction vectors (vector to vector matching) can also be used as the inputs of the algorithm, and there is no upper limit on the number of the features inputed. The algorithm will allow the use of redundant features to find a better solution. The algorithm uses dual number quaternions to represent the position and orientation of an object and uses the least squares optimization method to find an optimal solution for the object's location. The advantage of using this representation is that the method solves for the location estimation by minimizing a single cost function associated with the sum of the orientation and position errors and thus has a better performance on the estimation, both in accuracy and speed, than that of other similar algorithms. The difficulties when the operator is controlling a remote robot to perform manipulation tasks are also discussed. The main problems facing the operator are time delays on the signal transmission and the uncertainties of the remote environment. How object localization techniques can be used together with other techniques such as predictor display and time desynchronization to help to overcome these difficulties are then discussed.

NASA Virtual Glovebox (VBX): Emerging Simulation Technology for Space Station Experiment Design, Development, Training and Troubleshooting

NASA Technical Reports Server (NTRS)

Smith, Jeffrey D.; Twombly, I. Alexander; Maese, A. Christopher; Cagle, Yvonne; Boyle, Richard

2003-01-01

The International Space Station demonstrates the greatest capabilities of human ingenuity, international cooperation and technology development. The complexity of this space structure is unprecedented; and training astronaut crews to maintain all its systems, as well as perform a multitude of research experiments, requires the most advanced training tools and techniques. Computer simulation and virtual environments are currently used by astronauts to train for robotic arm manipulations and extravehicular activities; but now, with the latest computer technologies and recent successes in areas of medical simulation, the capability exists to train astronauts for more hands-on research tasks using immersive virtual environments. We have developed a new technology, the Virtual Glovebox (VGX), for simulation of experimental tasks that astronauts will perform aboard the Space Station. The VGX may also be used by crew support teams for design of experiments, testing equipment integration capability and optimizing the procedures astronauts will use. This is done through the 3D, desk-top sized, reach-in virtual environment that can simulate the microgravity environment in space. Additional features of the VGX allow for networking multiple users over the internet and operation of tele-robotic devices through an intuitive user interface. Although the system was developed for astronaut training and assisting support crews, Earth-bound applications, many emphasizing homeland security, have also been identified. Examples include training experts to handle hazardous biological and/or chemical agents in a safe simulation, operation of tele-robotic systems for assessing and diffusing threats such as bombs, and providing remote medical assistance to field personnel through a collaborative virtual environment. Thus, the emerging VGX simulation technology, while developed for space- based applications, can serve a dual use facilitating homeland security here on Earth.

[Toxicological consultation data management system based on experience of Pomeranian Center of Toxicology].

PubMed

Kabata, Piotr Maciej; Waldman, Wojciech; Sein Anand, Jacek

2015-01-01

In this paper the structure of poisonings is described, based on the material collected from tele-toxicology consults by the Pomeranian Center of Toxicology in Gdańsk and harvested from its Electronic Poison Information Management System. In addition, we analyzed conclusions drawn from a 27-month operation of the system. Data were harvested from the Electronic Poison Information Management System developed in 2012 and used by the Pomeranian Center of Toxicology since then. The research was based on 2550 tele-toxicology consults between January 1 and December 31, 2014. Subsequently the data were electronically cleaned and presented using R programming language. The Pomeranian voivodeship was the prevalent localisation of calls (N = 1879; 73.7%). Most of the calls came from emergency rooms (N = 1495; 58.63%). In the case of 1396 (54.7%) patients the time-lag between intoxication and the consult was less than 6 h. There were no differences in the age distribution between genders. Mean age was 26.3 years. Young people predominated among intoxicated individuals. The majority of intoxications were incidental (N = 888; 34.8%) or suicidal (N = 814; 31.9%) and the most of them took place in the patient's home. Information about Poison Control Center consultations access should be better spread among medical service providers. The extent of poison information collected by Polish Poison Control Centers should be limited and unified. This should contribute to the increased percentage of properly documented consultations. Additional duties stemming from the need of digital archiving of consults provided, require the involvement of additional staff, leading to the increased operation costs incurred by Poison Control Centers. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Telescience Operations on International Space Station

NASA Technical Reports Server (NTRS)

Schubert, Kathleen E.

1999-01-01

This paper describes the concept of telescience operations for the International Space Station (ISS). The extended duration microgravity environment of the ISS will enable microgravity science research to enter into a new era of increased scientific and technological data return. The National Aeronautics and Space Administration (NASA) has a vision of distributed ground operations which enables the Principal Investigator direct interaction with his/her on-board experiment from his/her home location. This is the concept of telescience and is essential for maximizing the use of the long duration science environment that ISS provides. The goal of telescience is to provide the capability to fully tele-operate an experiment from any ground location in such a way as to increase the amount and quality of scientific and technological data return and decrease the operations cost of an individual experiment relative to the era of Space Shuttle experiments. This paper also describes the NASA Lewis Research Center (LeRC) implementation approach for the LeRC Telescience Support Center (TSC) and Principal Investigator Science Operations Sites (SOS) which will fully meet the concept of telescience as prescribed by the Agency.

Rural telemedicine project in northern New Mexico

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zink, S.; Hahn, H.; Rudnick, J.

A virtual electronic medical record system is being deployed over the Internet with security in northern New Mexico using TeleMed, a multimedia medical records management system that uses CORBA-based client-server technology and distributed database architecture. The goal of the NNM Rural Telemedicine Project is to implement TeleMed into fifteen rural clinics and two hospitals within a 25,000 square mile area of northern New Mexico. Evaluation of the project consists of three components: job task analysis, audit of immunized children, and time motion studies. Preliminary results of the evaluation components are presented.

[Communication subsystem design of tele-screening system for diabetic retinopathy].

PubMed

Chen, Jian; Pan, Lin; Zheng, Shaohua; Yu, Lun

2013-12-01

A design scheme of a tele-screening system for diabetic retinopathy (DR) has been proposed, especially the communication subsystem. The scheme uses serial communication module consisting of ARM 7 microcontroller and relays to connect remote computer and fundus camera, and also uses C++ programming language based on MFC to design the communication software consisting of therapy and diagnostic information module, video/audio surveillance module and fundus camera control module. The scheme possesses universal property in some remote medical treatment systems which are similar to the system.

Tele-manufactured affordable smartphone anterior segment microscope.

PubMed

Chiong, Hong Sheng; Fang, Joyce Lim Luann; Wilson, Graham

2016-11-01

The recent advances in mobile technology have made the smartphone a powerful and accessible tool. This article describe the development of a novel smartphone-based anterior segment microscope that is compatible with tele-manufacturing. The anterior segment microscope is equipped with both cobalt-blue and red-free filters that can be used for clinical photo-documentation. The digital files of the microscope are transferrable and compatible with additive-manufacturing. Therefore, the entire device can be locally manufactured with rapid prototyping techniques such as 3D printing. © 2016 Optometry Australia.

An Automated Web Diary System for TeleHomeCare Patient Monitoring

PubMed Central

Ganzinger, Matthias; Demiris, George; Finkelstein, Stanley M.; Speedie, Stuart; Lundgren, Jan Marie

2001-01-01

The TeleHomeCare project monitors home care patients via the Internet. Each patient has a personalized homepage with an electronic diary for collecting the monitoring data with HTML forms. The web pages are generated dynamically using PHP. All data are stored in a MySQL database. Data are checked immediately by the system; if a value exceeds a predefined limit an alarm message is generated and sent automatically to the patient's case manager. Weekly graphical reports (PDF format) are also generated and sent by email to the same destination.

Arizona TeleMedicine Network: Segment Specifications--Tuba City via Mt. Elden, Phoenix; Keams Canyon, Second Mesa, Low Mountain; Phoenix, San Carlos, Bylas; Keams Canyon via Ganado Mesa, Ft. Defiance; Tuba City via Black Mesa, Ft. Defiance; and Budgetary Cost Information--Pinal Peak via San Xavier, Tucson.

ERIC Educational Resources Information Center

Atlantic Research Corp., Alexandria, VA.

The communication links of five different segments of the Arizona TeleMedicine Network (a telecommunication system designed to provide health services for American Indians in rurally isolated areas) and budgetary cost information for Pinal Peak via San Xavier and Tucson are described in this document. The five communication links are identified…

UGV technology for urban environments

NASA Astrophysics Data System (ADS)

Christensen, Henrik I.; Folkeson, John; Hedstrom, Andreas; Lundberg, Carl

2004-09-01

Deployment of humans in an urban setting for search and rescue type missions poses a major risk to the personnel. In rescue missions the risk can stem from debris, gas, etc. and in a strategic setting the risk can stem from snipers, mines, gas, etc. There is consequently a natural interest in studies of how UGV technology can be deployed for tasks such as reconnaissance, retrieval of objects (bombs, injured people, etc.). Today most vehicles used by the military and bomb squads are tele-operated and without any autonomony. This implies that operation of the vehicles is a stressful and demanding task. Part of this stress can be removed through introduction of autonomous functionality. Autonomy implicitly requires use of map information to allow the system to localize and traverse a particular area in addition autonomous mapping of an area is a valuable functionality as part of reconnaissance missions to provide an initial inventory of a new area. A host of different sensory modalities can be used for mapping. In general no single modality is, however, sufficient for robust and efficient mapping. In the present study GPS, Inertial Cues, Laser ranging and Odometry is used for simultaneous mapping and localization in urban environments. The mapping is carried out autonomously using a coverage strategy to ensure full mapping of a particular area. In relation to mapping another important issue is the design of an efficient user interface that allows a regular rescue worker, or a soldier, to operate the vehicle without detailed knowledge about robotics. A number of different designs for user interfaces will be presented and results from studies with a range of end-users (soldiers) will also be reported. The complete system has been tested in an urban warfare facility outside of Stockholm. Detailed results will be reposted from two different test facilities.

Virtual university applied to telesurgery: from teleeducation to telemanipulation.

PubMed

Marescaux, J; Soler, L; Mutter, D; Leroy, J; Vix, M; Koehl, C; Clément, J M

2000-01-01

PROBLEM/BACKGROUND: In order to improve patient care by minimal invasive surgery (MIS), we perfected a Virtual TeleSurgical University that allows for teleeducation, teleconcertation, surgical planning and telemanipulation, through new Virtual Reality and multimedia systems. The organization of this innovative school was federated around three major research programs. First, the TESUS program focused on the teletransmission of medical information, allowing for videoconferencing around the world and telementoring. Next, the WeBS-Surg program is a multimedia continuous surgical education system on internet, that allows for teleeducation and teleconcertation between world experts in MIS. Then, the MASTER program (Minimal Access Surgery by Telecommunications and Robotics) allowed the development of the third millenium Operating room. It included Virtual Reality systems that delineate automatically anatomical and pathological structures of a patients from him CT-scan, and that allow for an interactive surgical planning and force-feed-back simulation. It also included a telesurgical robot named Zeus controlled by surgeons through telemanipulation system. Tests and validation shows that all these systems improved all steps of the surgical procedure: preoperatively due to a better continuous education and a computer assisted surgical planning, and peroperatively due to teleconcertation, telementoring and telemanipulation systems. Revolutionary tools for minimal invasive surgery learning, planning and performing are all ready available. These tools represents the first prototype of the computer assisted tele-robotical surgery that will be the future of surgery.

Robot-based tele-echography: clinical evaluation of the TER system in abdominal aortic exploration.

PubMed

Martinelli, Thomas; Bosson, Jean-Luc; Bressollette, Luc; Pelissier, Franck; Boidard, Eric; Troccaz, Jocelyne; Cinquin, Philippe

2007-11-01

The TER system is a robot-based tele-echography system allowing remote ultrasound examination. The specialist moves a mock-up of the ultrasound probe at the master site, and the robot reproduces the movements of the real probe, which sends back ultrasound images and force feedback. This tool could be used to perform ultrasound examinations in small health care centers or from isolated sites. The objective of this study was to prove, under real conditions, the feasibility and reliability of the TER system in detecting abdominal aortic and iliac aneurysms. Fifty-eight patients were included in 2 centers in Brest and Grenoble, France. The remote examination was compared with the reference standard, the bedside examination, for aorta and iliac artery diameter measurement, detection and description of aneurysms, detection of atheromatosis, the duration of the examination, and acceptability. All aneurysms (8) were detected by both techniques as intramural thrombosis and extension to the iliac arteries. The interobserver correlation coefficient was 0.982 (P < .0001) for aortic diameters. The rate of concordance between 2 operators in evaluating atheromatosis was 84% +/- 11% (95% confidence interval). Our study on 58 patients suggests that the TER system could be a reliable, acceptable, and effective robot-based system for performing remote abdominal aortic ultrasound examinations. Research is continuing to improve the equipment for general abdominal use.

The linear -- non-linear frontier for the Goldstone Higgs

DOE PAGES

Gavela, M. B.; Kanshin, K.; Machado, P. A. N.; ...

2016-12-01

The minimalmore » $SO(5)/SO(4)$ sigma model is used as a template for the ultraviolet completion of scenarios in which the Higgs particle is a low-energy remnant of some high-energy dynamics, enjoying a (pseudo) Nambu-Goldstone boson ancestry. Varying the $$\\sigma$$ mass allows to sweep from the perturbative regime to the customary non-linear implementations. The low-energy benchmark effective non-linear Lagrangian for bosons and fermions is obtained, determining as well the operator coefficients including linear corrections. At first order in the latter, three effective bosonic operators emerge which are independent of the explicit soft breaking assumed. The Higgs couplings to vector bosons and fermions turn out to be quite universal: the linear corrections are proportional to the explicit symmetry breaking parameters. Furthermore, we define an effective Yukawa operator which allows a simple parametrization and comparison of different heavy fermion ultraviolet completions. In addition, one particular fermionic completion is explored in detail, obtaining the corresponding leading low-energy fermionic operators.« less

Robotics and tele-manipulation: update and perspectives in urology.

PubMed

Frede, T; Jaspers, J; Hammady, A; Lesch, J; Teber, D; Rassweiler, J

2007-06-01

Robotic surgery in urology has become a reality in the year 2007 with several thousand robotic prostatectomies having been performed already worldwide. Compared to conventional laparoscopy, the process of learning the robotic technique is short and the operative results are comparable to those of conventional laparoscopy or even open surgery. However, there are still some disadvantages with the robotic systems, mainly technical (tactile feedback) and financial (investment and running costs). Alternative and more inexpensive technologies must be considered in order to overcome the difficulties of conventional laparoscopy (instrument handling, degrees of freedom, 3-D vision), while also integrating advantages of the robotic systems.

Utilization of the NASA Robonaut as a Surgical Avatar in Telemedicine

NASA Technical Reports Server (NTRS)

Dean, Marc; Diftler, Myron

2015-01-01

The concept of teleoperated robotic surgery is not new; however, most of the work to date has utilized specialized robots designed for specific set of surgeries. This activity explores the use of a humanoid robot to perform surgical procedures using the same hand held instruments that a human surgeon employs. For this effort, the tele-operated Robonaut (R2) was selected due to its dexterity, its ability to perform a wide range of tasks, and its adaptability to changing environments. To evaluate this concept, a series of challenges was designed with the goal of assessing the feasibility of utilizing Robonaut as a telemedicine based surgical avatar.

An open real-time tele-stethoscopy system.

PubMed

Foche-Perez, Ignacio; Ramirez-Payba, Rodolfo; Hirigoyen-Emparanza, German; Balducci-Gonzalez, Fernando; Simo-Reigadas, Francisco-Javier; Seoane-Pascual, Joaquin; Corral-Peñafiel, Jaime; Martinez-Fernandez, Andres

2012-08-23

Acute respiratory infections are the leading cause of childhood mortality. The lack of physicians in rural areas of developing countries makes difficult their correct diagnosis and treatment. The staff of rural health facilities (health-care technicians) may not be qualified to distinguish respiratory diseases by auscultation. For this reason, the goal of this project is the development of a tele-stethoscopy system that allows a physician to receive real-time cardio-respiratory sounds from a remote auscultation, as well as video images showing where the technician is placing the stethoscope on the patient's body. A real-time wireless stethoscopy system was designed. The initial requirements were: 1) The system must send audio and video synchronously over IP networks, not requiring an Internet connection; 2) It must preserve the quality of cardiorespiratory sounds, allowing to adapt the binaural pieces and the chestpiece of standard stethoscopes, and; 3) Cardiorespiratory sounds should be recordable at both sides of the communication. In order to verify the diagnostic capacity of the system, a clinical validation with eight specialists has been designed. In a preliminary test, twelve patients have been auscultated by all the physicians using the tele-stethoscopy system, versus a local auscultation using traditional stethoscope. The system must allow listen the cardiac (systolic and diastolic murmurs, gallop sound, arrhythmias) and respiratory (rhonchi, rales and crepitations, wheeze, diminished and bronchial breath sounds, pleural friction rub) sounds. The design, development and initial validation of the real-time wireless tele-stethoscopy system are described in detail. The system was conceived from scratch as open-source, low-cost and designed in such a way that many universities and small local companies in developing countries may manufacture it. Only free open-source software has been used in order to minimize manufacturing costs and look for alliances to support its improvement and adaptation. The microcontroller firmware code, the computer software code and the PCB schematics are available for free download in a subversion repository hosted in SourceForge. It has been shown that real-time tele-stethoscopy, together with a videoconference system that allows a remote specialist to oversee the auscultation, may be a very helpful tool in rural areas of developing countries.

Potential role of tele-rehabilitation to address barriers to implementation of physical therapy among West African stroke survivors: A cross-sectional survey.

PubMed

Sarfo, Fred S; Adamu, Sheila; Awuah, Dominic; Sarfo-Kantanka, Osei; Ovbiagele, Bruce

2017-10-15

The greatest burden from stroke-related disability is borne by Low-and-Middle Income countries (LMICs) where access to rehabilitation after stroke is severely challenged. Tele-rehabilitation could be a viable avenue to address unmet rehabilitation needs in LMICs. To assess the burden of post-stroke physical deficits, rates of utilization of physiotherapy services, and perceptions of tele-rehabilitation among recent Ghanaian stroke survivors. Using a consecutive sampling strategy, 100 stroke survivors attending an outpatient Neurology clinic in a Ghanaian tertiary medical center were enrolled into this cross-sectional study. After collecting basic demographic data, clinical history on stroke type, severity and level of disability, we administered the validated 20-item Functional Independence Measure questionnaire to evaluate functional status of study participants and an 8-item questionnaire to assess participants' attitudes towards telemedicine administered rehabilitation intervention. Mean±SD age of study participants was 57.2±13.3years of which 51.0% were males with a mean duration of stroke of 1.3±2.2years. 53% had Modified Rankin scores of ≥3, 57% were fully independent and only 27% reported utilizing any physiotherapy services. Barriers to access to physiotherapy included financial constraints due to cost of physiotherapy services and transportation as well as premature discharge from physiotherapy to avoid overburdening of available physiotherapy services. These factors led to the limited provision of rehabilitative therapy. Participants held positive views of the potential for tele-rehabilitation interventions (80-93%). However, while 85% owned mobile phones, only 35% had smart phones. Despite, a high burden of residual disability, only about 1 out of 4 stroke patients in this Ghanaian cohort was exposed to post-stroke physiotherapy services, largely due to relatively high costs and limited health system resources. These Ghanaian stroke patients viewed the potential role of Tele-rehabilitation as positive, but this promising intervention needs to be formally tested for feasibility, efficacy and cost-effectiveness. Copyright © 2017 Elsevier B.V. All rights reserved.

Global Systems Science and Hands-On Universe Course Materials for High School

NASA Astrophysics Data System (ADS)

Gould, A.

2011-09-01

The University of California Berkeley's Lawrence Hall of Science has a project called Global Systems Science (GSS). GSS produced a set of course materials for high school science education that includes reading materials, investigations, and software for analyzing satellite images of Earth focusing on Earth systems as well as societal issues that require interdisciplinary science for full understanding. The software has general application in analysis of any digital images for a variety of purposes. NSF and NASA funding have contributed to the development of GSS. The current NASA-funded project of GSS is Lifelines for High School Climate Change Education (LHSCCE), which aims to establish professional learning communities (PLCs) to share curriculum resources and best practices for teaching about climate change in grades 9-12. The project explores ideal ways for teachers to meet either in-person or using simple yet effective distance-communication techniques (tele-meetings), depending on local preferences. Skills promoted include: how to set up a website to share resources; initiating tele-meetings with any available mechanism (webinars, Skype, telecons, moodles, social network tools, etc.); and easy ways of documenting and archiving presentations made at meetings. Twenty teacher leaders are forming the PLCs in their regions or districts. This is a national effort in which teachers share ideas, strategies, and resources aimed at making science education relevant to societal issues, improve students' understanding of climate change issues, and contribute to possible solutions. Although the binding theme is climate change, the application is to a wide variety of courses: Earth science, environmental science, biology, physics, and chemistry. Moreover, the PLCs formed can last as long as the members find it useful and can deal with any topics of interest, even if they are only distantly related to climate change.

Improving patient access to specialized health care: the Telehealth Network of Minas Gerais, Brazil

PubMed Central

Alkmim, Maria Beatriz; Figueira, Renato Minelli; Marcolino, Milena Soriano; Cardoso, Clareci Silva; Pena de Abreu, Monica; Cunha, Lemuel Rodrigues; da Cunha, Daniel Ferreira; Antunes, Andre Pires; de A Resende, Adélson Geraldo; Resende, Elmiro Santos

2012-01-01

Abstract Problem The Brazilian population lacks equitable access to specialized health care and diagnostic tests, especially in remote municipalities, where health professionals often feel isolated and staff turnover is high. Telehealth has the potential to improve patients’ access to specialized health care, but little is known about it in terms of cost-effectiveness, access to services or user satisfaction. Approach In 2005, the State Government of Minas Gerais, Brazil, funded the establishment of the Telehealth Network, intended to connect university hospitals with the state’s remote municipal health departments; support professionals in providing tele-assistance; and perform tele-electrocardiography and teleconsultations. The network uses low-cost equipment and has employed various strategies to overcome the barriers to telehealth use. Local setting The Telehealth Network connects specialists in state university hospitals with primary health-care professionals in 608 municipalities of the large state of Minas Gerais, many of them in remote areas. Relevant changes From June 2006 to October 2011, 782 773 electrocardiograms and 30 883 teleconsultations were performed through the network, and 6000 health professionals were trained in its use. Most of these professionals (97%) were satisfied with the system, which was cost-effective, economically viable and averted 81% of potential case referrals to distant centres. Lessons learnt To succeed, a telehealth service must be part of a collaborative network, meet the real needs of local health professionals, use simple technology and have at least some face-to-face components. If applied to health problems for which care is in high demand, this type of service can be economically viable and can help to improve patient access to specialized health care. PMID:22589571

Bidirectional and Multi-User Telerehabilitation System: Clinical Effect on Balance, Functional Activity, and Satisfaction in Patients with Chronic Stroke Living in Long-Term Care Facilities

PubMed Central

Lin, Kwan-Hwa; Chen, Chin-Hsing; Chen, You-Yin; Huang, Wen-Tzeng; Lai, Jin-Shin; Yu, Shang-Ming; Chang, Yuan-Jen

2014-01-01

Background The application of internet technology for telerehabilitation in patients with stroke has developed rapidly. Objective The current study aimed to evaluate the effect of a bidirectional and multi-user telerehabilitation system on balance and satisfaction in patients with chronic stroke living in long-term care facilities (LTCFs). Method This pilot study used a multi-site, blocked randomization design. Twenty-four participants from three LTCFs were recruited, and the participants were randomly assigned into the telerehabilitation (Tele) and conventional therapy (Conv) groups within each LTCF. Tele group received telerehabilitation but the Conv group received conventional therapy with two persons in each group for three sessions per week and for four weeks. The outcome measures included Berg Balance Scale (BBS), Barthel Index (BI), and the telerehabilitation satisfaction of the participants. Setting A telerehabilitation system included “therapist end” in a laboratory, and the “client end” in LTCFs. The conventional therapy was conducted in LTCFs. Results Training programs conducted for both the Tele and Conv groups showed significant effects within groups on the participant BBS as well as the total and self-care scores of BI. No significant difference between groups could be demonstrated. The satisfaction of participants between the Tele and the Conv groups also did not show significant difference. Conclusions This pilot study indicated that the multi-user telerehabilitation program is feasible for improving the balance and functional activity similar to conventional therapy in patients with chronic stroke living in LTCFs. PMID:25019632

Expanding technology in the ICU: the case for the utilization of telemedicine.

PubMed

Deslich, Stacie; Coustasse, Alberto

2014-05-01

Telemedicine has been utilized in various healthcare areas to achieve better patient outcomes, lower costs of providing services, and increase patient access to care. Tele-intensive care unit (ICU) technology has been introduced as a way to provide effective ICU services to patients with reduced access, as well as to decrease costs and improve patient care. The methodology for this qualitative study was a literature search and review of case studies. The search was limited to sources published in the last 10 years (2003-2013) in the English language. In total, 55 references were used for this research exploration inquiry. Tele-ICU was found to be an effective way to use technology to decrease costs of providing intensive care, while improving patient outcomes such as mortality and length of stay. Several case studies supported the use of telemedicine in ICUs to provide intensive care to patients who lived in rural areas and lacked access to traditional ICUs. Furthermore, it was noted that, although the initial costs for tele-ICU startup were significant, as much as $100,000 per bed, the benefits of the utilization of this technology can offset those costs by reducing costs by 24% via decreased length of stay for patients. The findings of this study have suggested that the implementation of tele-ICU may have been more beneficial than costly, and it may have provided healthcare organizations the opportunity to increase quality of care and decrease mortality, while it might have decreased costs of delivering ICU services in both rural and urban areas.

[The operating room of the future].

PubMed

Broeders, I A; Niessen, W; van der Werken, C; van Vroonhoven, T J

2000-01-29

Advances in computer technology will revolutionize surgical techniques in the next decade. The operating room (OR) of the future will be connected with a laboratory where clinical specialists and researchers prepare image-guided interventions and explore the possibilities of these techniques. The virtual reality is linked to the actual situation in the OR with the aid of navigation instruments. During complicated operations the images prepared preoperatively will be corrected during the operation on the basis of the information obtained peroperatively. MRI currently offers maximal possibilities for image-guided surgery of soft tissues. Simpler techniques such as fluoroscopy and echography will become increasingly integrated in computer-assisted peroperative navigation. The development of medical robot systems will make possible microsurgical procedures by the endoscopic route. Tele-manipulation systems will also play a part in the training of surgeons. Design and construction of the OR will be adapted to the surgical technology, and include an information and control unit where preoperative and peroperative data come together and from where the surgeon operates the instruments. Concepts for the future OR should be regularly adjusted to allow for new surgical technology.

Hardware platform for multiple mobile robots

NASA Astrophysics Data System (ADS)

Parzhuber, Otto; Dolinsky, D.

2004-12-01

This work is concerned with software and communications architectures that might facilitate the operation of several mobile robots. The vehicles should be remotely piloted or tele-operated via a wireless link between the operator and the vehicles. The wireless link will carry control commands from the operator to the vehicle, telemetry data from the vehicle back to the operator and frequently also a real-time video stream from an on board camera. For autonomous driving the link will carry commands and data between the vehicles. For this purpose we have developed a hardware platform which consists of a powerful microprocessor, different sensors, stereo- camera and Wireless Local Area Network (WLAN) for communication. The adoption of IEEE802.11 standard for the physical and access layer protocols allow a straightforward integration with the internet protocols TCP/IP. For the inspection of the environment the robots are equipped with a wide variety of sensors like ultrasonic, infrared proximity sensors and a small inertial measurement unit. Stereo cameras give the feasibility of the detection of obstacles, measurement of distance and creation of a map of the room.

Long distance cell communication using spherical tether balloons

NASA Astrophysics Data System (ADS)

Manchanda, R. K.; Rajagopalan, Vasudevan; Vasudevan, Rajagopalan; Mehrotra, R. K.; Sreenivasan, S.; Pawaskar, M.; Subba Rao Jonnalagadda, Venkata; Buduru, Suneelkumar; Kulkarni, P. M.

A proof-of-concept experiment was conducted for long-range cell communication for rural tele-phony and internet. We designed and fabricated a spherical tether balloon to carry the con-ventional micro base transceiver station (BTS) along with three slotted antenna to cover 2-pi radius. AC power and optical fiber were anchored along with the tether line. A special fre-quency license was obtained from Wireless Planning Commission (WPC) wing of Department of Telecommunication (DoT), India for the period of experiment so as not to affect the opera-tional networks. The experiments were carried out for different BTS heights up to 500 meter. Signal measurement both in data mode and voice quality were done in different quadrant using mobile vans. This paper describes the methodology (under patenting) and utility of technique for operational application.

Closure of colostomy.

PubMed Central

Beck, P H; Conklin, H B

1975-01-01

We analyzed the records of 77 cases of loop colostomy closure in Vietnam War Casualties. All records were complete from the date of injury to discharge following colostomy closure. Simple of the loop colostomy was performed in 44 patients and resection of the stoma and reanastomosis of bowel segments was performed in 33 patients. Average operating time for simple closure of the loop was 70 minutes compared to 115 minutes for resection and anastomosis. Nasogastric suction was used less frequently and for a shorter time with simple loop closure. The total postoperative complication rate was 9% with simple loop closure as compared to 24% for resection and anastomosis. Simple closure of the loop described in this report is technically easier and as safe as resection of the stoma and reanastomosis. Images Fig. 1. PMID:1094967

Teledermatology: quality assessment by user satisfaction and clinical efficiency.

PubMed

Klaz, Itay; Wohl, Yonit; Nathansohn, Nir; Yerushalmi, Nir; Sharvit, Sharon; Kochba, Ilan; Brenner, Sarah

2005-08-01

The Israel Defense Forces implemented a pilot teledermatology service in primary clinics. To assess user satisfaction and clinical short-term effectiveness of a computerized store and forward teledermatology service in urban and rural units. A multi-center prospective uncontrolled cohort pilot trial was conducted for a period of 6 months. Primary care physicians referred patients to a board-certified dermatologist using text email accompanied by digital photographs. Diagnosis, therapy and management were sent back to the referring PCP. Patients were asked to evaluate the level of the CSAFTD service, effect of the service on accessibility to dermatologists, respect for privacy, availability of drugs, health improvement and overall satisfaction. PCPs assessed the quality of the teledermatology consultations they received, the contribution to their knowledge, and their overall satisfaction. Tele-diagnosis alone was possible for 95% (n=413) of 435 CSAFTD referrals; 22% (n=95) of referrals also required face-to-face consultation, Satisfaction with CSAFTD was high among patients in both rural and urban clinics, with significantly higher scores in rural units. Rural patients rated the level of service, accessibility and overall satisfaction higher than did urban patients. PCPs were satisfied with the quality of the service and its contribution to their knowledge. Rural physicians rated level of service and overall satisfaction higher than did urban physicians. Tele-referrals were completed more efficiently than referral for face-to-face appointments. CSAFTD provided efficient, high quality medical service to rural and urban military clinics in the IDF.

Unique identification code for medical fundus images using blood vessel pattern for tele-ophthalmology applications.

PubMed

Singh, Anushikha; Dutta, Malay Kishore; Sharma, Dilip Kumar

2016-10-01

Identification of fundus images during transmission and storage in database for tele-ophthalmology applications is an important issue in modern era. The proposed work presents a novel accurate method for generation of unique identification code for identification of fundus images for tele-ophthalmology applications and storage in databases. Unlike existing methods of steganography and watermarking, this method does not tamper the medical image as nothing is embedded in this approach and there is no loss of medical information. Strategic combination of unique blood vessel pattern and patient ID is considered for generation of unique identification code for the digital fundus images. Segmented blood vessel pattern near the optic disc is strategically combined with patient ID for generation of a unique identification code for the image. The proposed method of medical image identification is tested on the publically available DRIVE and MESSIDOR database of fundus image and results are encouraging. Experimental results indicate the uniqueness of identification code and lossless recovery of patient identity from unique identification code for integrity verification of fundus images. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Role of Retinal Imaging and Portable Screening Devices in Tele-ophthalmology Applications for Diabetic Retinopathy Management.

PubMed

DeBuc, Delia Cabrera

2016-12-01

In the years since its introduction, retinal imaging has transformed our capability to visualize the posterior pole of the eye. Increasing practical advances in mobile technology, regular monitoring, and population screening for diabetic retinopathy management offer the opportunity for further development of cost-effective applications through remote assessment of the diabetic eye using portable retinal cameras, smart-phone-based devices and telemedicine networks. Numerous retinal imaging methods and mobile technologies in tele-ophthalmology applications have been reported for diabetic retinopathy screening and management. They provide several advantages of automation, sensitivity, specificity, portability, and miniaturization for the development of point-of-care diagnostics for eye complications in diabetes. The aim of this paper is to review the role of retinal imaging and mobile technologies in tele-ophthalmology applications for diabetic retinopathy screening and management. At large, although improvements in current technology and telemedicine services are still needed, telemedicine has demonstrated to be a worthy tool to support health caregivers in the effective management and prevention of diabetes and its complications.

Mobile tele-echography: user interface design.

PubMed

Cañero, Cristina; Thomos, Nikolaos; Triantafyllidis, George A; Litos, George C; Strintzis, Michael Gerassimos

2005-03-01

Ultrasound imaging allows the evaluation of the degree of emergency of a patient. However, in some instances, a well-trained sonographer is unavailable to perform such echography. To cope with this issue, the Mobile Tele-Echography Using an Ultralight Robot (OTELO) project aims to develop a fully integrated end-to-end mobile tele-echography system using an ultralight remote-controlled robot for population groups that are not served locally by medical experts. This paper focuses on the user interface of the OTELO system, consisting of the following parts: an ultrasound video transmission system providing real-time images of the scanned area, an audio/video conference to communicate with the paramedical assistant and with the patient, and a virtual-reality environment, providing visual and haptic feedback to the expert, while capturing the expert's hand movements. These movements are reproduced by the robot at the patient site while holding the ultrasound probe against the patient skin. In addition, the user interface includes an image processing facility for enhancing the received images and the possibility to include them into a database.

COTS technologies for telemedicine applications.

PubMed

Triunfo, Riccardo; Tumbarello, Roberto; Sulis, Alessandro; Zanetti, Gianluigi; Lianas, Luca; Meloni, Vittorio; Frexia, Francesca

2010-01-01

To demonstrate a simple low-cost system for tele-echocardiology, focused on paediatric cardiology applications. The system was realized using open-source software and COTS technologies. It is based on the transmission of two simultaneous video streams, obtained by direct digitization of the output of an ultrasound machine and by a netcam showing the examination that is taking place. These streams are then embedded into a web page so they are accessible, together with basic video controls, via a standard web browser. The system can also record video streams on a server for further use. The system was tested on a small group of neonatal cases with suspected cardiopathies for a preliminary assessment of its features and diagnostic capabilities. Both the clinical and technological results were encouraging and are leading the way for further experimentation. The presented system can transfer clinical images and videos in an efficient way and in real time. It can be used in the same hospital to support internal consultancy requests, in remote areas using Internet connections and for didactic purposes using low cost COTS appliances and simple interfaces for end users. The solution proposed can be extended to control different medical appliances in those remote hospitals.

Robots to assist daily activities: views of older adults with Alzheimer's disease and their caregivers.

PubMed

Wang, Rosalie H; Sudhama, Aishwarya; Begum, Momotaz; Huq, Rajibul; Mihailidis, Alex

2017-01-01

Robots have the potential to both enable older adults with dementia to perform daily activities with greater independence, and provide support to caregivers. This study explored perspectives of older adults with Alzheimer's disease (AD) and their caregivers on robots that provide stepwise prompting to complete activities in the home. Ten dyads participated: Older adults with mild-to-moderate AD and difficulty completing activity steps, and their family caregivers. Older adults were prompted by a tele-operated robot to wash their hands in the bathroom and make a cup of tea in the kitchen. Caregivers observed interactions. Semi-structured interviews were conducted individually. Transcribed interviews were thematically analyzed. Three themes summarized responses to robot interactions: contemplating a future with assistive robots, considering opportunities with assistive robots, and reflecting on implications for social relationships. Older adults expressed opportunities for robots to help in daily activities, were open to the idea of robotic assistance, but did not want a robot. Caregivers identified numerous opportunities and were more open to robots. Several wanted a robot, if available. Positive consequences of robots in caregiving scenarios could include decreased frustration, stress, and relationship strain, and increased social interaction via the robot. A negative consequence could be decreased interaction with caregivers. Few studies have investigated in-depth perspectives of older adults with dementia and their caregivers following direct interaction with an assistive prompting robot. To fulfill the potential of robots, continued dialogue between users and developers, and consideration of robot design and caregiving relationship factors are necessary.

Phase-locked tracking loops for LORAN-C

NASA Technical Reports Server (NTRS)

Burhans, R. W.

1978-01-01

Portable battery operated LORAN-C receivers were fabricated to evaluate simple envelope detector methods with hybrid analog to digital phase locked loop sensor processors. The receivers are used to evaluate LORAN-C in general aviation applications. Complete circuit details are given for the experimental sensor and readout system.

Design of automatic startup and shutdown logic for a Brayton-cycle 2- to 15-kilowatt engine

NASA Technical Reports Server (NTRS)

Vrancik, J. E.; Bainbridge, R. C.

1975-01-01

The NASA Lewis Research Center is conducting a closed-Brayton-cycle power conversion system technology program in which a complete power system (engine) has been designed and demonstrated. This report discusses the design of automatic startup and shutdown logic circuits as a modification to the control system presently used in this demonstration engine. This modification was primarily intended to make starting the engine as simple and safe as possible and to allow the engine to be run unattended. In the modified configuration the engine is started by turning the control console power on and pushing the start button after preheating the gas loop. No other operator action is required to effect a complete startup. Shutdown, if one is required, is also effected by a simple stop button. The automatic startup and shutdown of the engine have been successfully and purposefully demonstrated more than 50 times at the Lewis Research Center during 10,000 hours of unattended operation. The net effect of this modification is an engine that can be safely started and stopped by relatively untrained personnel. The approach lends itself directly to remote unattended operation.

Medical color displays and their calibration

NASA Astrophysics Data System (ADS)

Fan, Jiahua; Roehrig, Hans; Dallas, W.; Krupinski, Elizabeth

2009-08-01

Color displays are increasingly used for medical imaging, replacing the traditional monochrome displays in radiology for multi-modality applications, 3D representation applications, etc. Color displays are also used increasingly because of wide spread application of Tele-Medicine, Tele-Dermatology and Digital Pathology. At this time, there is no concerted effort for calibration procedures for this diverse range of color displays in Telemedicine and in other areas of the medical field. Using a colorimeter to measure the display luminance and chrominance properties as well as some processing software we developed a first attempt to a color calibration protocol for the medical imaging field.

Ada Compiler Validation Summary Report: Certificate Number: 900131I1. 10269,Telesoft and MODCOMP, MODCOMP TeleGen2 Ada System, MODCOMP 9730 Host and Target

DTIC Science & Technology

1990-01-31

STrh FILE COPy 0 REPORT DOCUMENTATION PAGE O OW .- Sba,-, S Vm, _.b~ ,, S a. 1__ __ ,,.In ,,IWu O Sim w q viwim. _S . W .-.- smi Won m m,,~Ov -f ym...nd MODCOMP, MODCOMP TeleGen2 Ada System, MODUOMP 9730 (Hostt to arget), 90013111. 10269 CJ S AUHOR( S ) IABG-AVF 101tobrunn, FEDERAL REPUBLIC OF GERMANY...1. ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ a AGENCYG US NY(M W)LAP~rDT ~ ~ TTp N AE ORDIATO . PFIUNDI OGGNITION NAE( S ) ADO OOESS(ES) NUBER S IABG-AVF, Industr

Reconnaissance and Autonomy for Small Robots (RASR) team: MAGIC 2010 challenge

NASA Astrophysics Data System (ADS)

Lacaze, Alberto; Murphy, Karl; Del Giorno, Mark; Corley, Katrina

2012-06-01

The Reconnaissance and Autonomy for Small Robots (RASR) team developed a system for the coordination of groups of unmanned ground vehicles (UGVs) that can execute a variety of military relevant missions in dynamic urban environments. Historically, UGV operations have been primarily performed via tele-operation, requiring at least one dedicated operator per robot, and requiring substantial real-time bandwidth to accomplish those missions. Our team goal was to develop a system that can provide long-term value to the war-fighter, utilizing MAGIC-2010 as a stepping stone. To that end, we self-imposed a set of constraints that would force us to develop technology that could readily be used by the military in the near term: • Use a relevant (deployed) platform • Use low-cost, reliable sensors • Develop an expandable and modular control system with innovative software algorithms to minimize the computing footprint required • Minimize required communications bandwidth and handle communication losses • Minimize additional power requirements to maximize battery life and mission duration

Telemedicine for patients with rheumatic diseases: Systematic review and proposal for research agenda.

PubMed

Piga, Matteo; Cangemi, Ignazio; Mathieu, Alessandro; Cauli, Alberto

2017-08-01

To systematically review the scientific literature regarding tele-rheumatology and draw conclusions about feasibility, effectiveness, and patient satisfaction. PubMed, Scopus, and Cochrane database searches were performed (April 2016) using relevant MeSH and keyword terms for telemedicine and rheumatic diseases. Articles were selected if reporting outcomes for feasibility, effectiveness, and patient satisfaction and methodologically appraised using the Cochrane Collaboration's tool for assessing risk of bias and a modified version of CONSORT 2010 Statement. A total of 177 articles were screened, 23 were selected for the present review but only 9 were RCTs. Five studies reported on feasibility, 14 effectiveness, and 9 satisfaction rates for different tele-rheumatology interventions grouped in synchronous (remotely delivered consultation) and asynchronous (remote disease activity assessment; tele-monitoring of treatment strategies or rehabilitation; and remotely delivered self-management programs). Seven studies (30.4%) were on rheumatoid arthritis, 2 (8.7%) were on systemic sclerosis (1 including also rheumatoid arthritis patients), 5 (21.7%) on fibromyalgia, 2 (8.7%) on osteoarthritis, 3 (13.0%) on juvenile idiopathic arthritis and 4 (17.4%) on mixed disease cohorts. Interventions and outcomes heterogeneity prevented meta-analysis of results. Overall, feasibility and patient satisfaction rates were high or very high across intervention types. Effectiveness was equal or higher than standard face-to-face approach in controlled trials which, however, were affected by small sample size and lack of blinding participants according to appraisal tools. Telemedicine may provide a well-accepted way to remotely deliver consultation, treatment and monitoring disease activity in rheumatology. Higher quality RCTs demonstrating effectiveness of different tele-rheumatology interventions are needed. Copyright © 2017 Elsevier Inc. All rights reserved.

[Telemedicine in Bolivia: RAFT-Altiplano project, experiences, future prospects, and recommendations].

PubMed

Vargas, Alejandro; Ugalde, Miguel; Vargas, Reynaldo; Narvaez, Ramiro; Geissbuhler, Antoine

2014-01-01

The objective of the RAFT-Altiplano project (RAFT: Réseau en Afrique Francophone pour la Télémédecine, or African Francophone Telemedicine Network) is to evaluate the viability, potential, and risks of implementing and developing a telemedicine network in the context of a developing country-specifically, the Altiplano region of Bolivia-to improve access to medical care and continuing education in a rural area. The activities described in this report took place between 2011 and 2013. Digital telemedicine equipment was donated to the health centers and a Microsoft®-based platform capable of integration with other technologies (using standardized formats) was developed to manage documents and clinical content electronically. Health professionals were trained in teleconsultation and the teleconsultation workflow was designed. The tele-education system used is Dudal, which requires only a small bandwidth. After three years of implementation, an organized working structure of teleconsultation and tele-education tools, adapted to the Latin American context, is now in place and connections have been established with hospitals, institutions, and health centers. The project has improved access to specialized medical care in remote health centers and third-level hospitals in urban areas, and it has become the foundation for development of the national project "TeleSalud for Bolivia" promoted by the Ministry of Health, which involves use of the new Bolivian satellite, Túpac Katari. It is viable to develop and set up telemedicine tools to serve the population in remote regions of Bolivia when they are made available to government and municipal health institutions and communication between them and the health centers takes place in a coordinated manner. The sharing of experiences, challenges, and risks encountered is very useful in designing and implementing the telemedicine project "TeleSalud for Bolivia" on a national scale.

The mechanics of landing when stepping down in unilateral lower-limb amputees.

PubMed

Jones, S F; Twigg, P C; Scally, A J; Buckley, J G

2006-02-01

The ability to successfully negotiate stairs and steps is an important factor for functional independence. While work has been undertaken to understand the biomechanics of gait in lower-limb amputees, little is known about how amputees negotiate stairs and steps. This study aimed to determine the mechanics of landing in unilateral lower-limb amputees when stepping down to a new level. A secondary aim was to assess the effects of using a shank-mounted shock-absorbing device (Tele-Torsion Pylon) on the mechanics of landing. Ten unilateral amputees (five transfemoral and five transtibial) and eight able-bodied controls performed single steps down to a new level (73 and 219 mm). Trials were repeated in amputees with the Tele-Torsion Pylon active and inactive. The mechanics of landing were evaluated by analysing peak limb longitudinal force, maximal limb shortening, lower extremity stiffness, and knee joint angular displacement during the initial contact period, and limb and ankle angle at the instant of ground-contact. Data were collected using a Vicon 3D motion analysis system and two force platforms. Amputees landed on a straightened and near vertical limb. This limb position was maintained in transfemoral amputees, whereas in transtibial amputees knee flexion occurred. As a result lower extremity stiffness was significantly greater in transfemoral amputees compared to transtibial amputees and able-bodied controls (P<0.001). The Tele-Torsion Pylon had little effect on the mechanics of landing in transtibial amputees, but brought about a reduction in lower extremity stiffness in transfemoral amputees (P<0.05). Amputees used a stepping strategy that ensured the direction of the ground reaction force vector was kept anterior of the knee joint centre. Using a Tele-Torsion Pylon may improve the mechanics of landing during downward stepping in transfemoral amputees.

The KIDROP model of combining strategies for providing retinopathy of prematurity screening in underserved areas in India using wide-field imaging, tele-medicine, non-physician graders and smart phone reporting

PubMed Central

Vinekar, Anand; Gilbert, Clare; Dogra, Mangat; Kurian, Mathew; Shainesh, Gangadharan; Shetty, Bhujang; Bauer, Noel

2014-01-01

Aim: To report the Karnataka Internet Assisted Diagnosis of Retinopathy of Prematurity (KIDROP) program for retinopathy of prematurity (ROP) screening in underserved rural areas using an indigenously developed tele-ROP model. Materials and Methods: KIDROP currently provides ROP screening and treatment services in three zones and 81 neonatal units in Karnataka, India. Technicians were trained to use a portable Retcam Shuttle (Clarity, USA) and validated against ROP experts performing indirect ophthalmoscopy. An indigenously developed 20-point score (STAT score) graded their ability (Level I to III) to image and decide follow-up based on a three-way algorithm. Images were also uploaded on a secure tele-ROP platform and accessed and reported by remote experts on their smart phones (iPhone, Apple). Results: 6339 imaging sessions of 1601 infants were analyzed. A level III technician agreed with 94.3% of all expert decisions. The sensitivity, specificity, positive predictive value and negative predictive value for treatment grade disease were 95.7, 93.2, 81.5 and 98.6 respectively. The kappa for technicians to decide discharge of babies was 0.94 (P < 0.001). Only 0.4% of infants needing treatment were missed. The kappa agreement of experts reporting on the iPhone vs Retcam for treatment requiring and mild ROP were 0.96 and 0.94 (P < 0.001) respectively. Conclusions: This is the first and largest real-world program to employ accredited non-physicians to grade and report ROP. The KIDROP tele-ROP model demonstrates that ROP services can be delivered to the outreach despite lack of specialists and may be useful in other middle-income countries with similar demographics. PMID:24492500

Infrasound wave propagation over near-regional and tele-infrasonic distances

NASA Astrophysics Data System (ADS)

McKenna, Sara Mihan House

2005-11-01

Infrasound research is experiencing a renaissance due to advances in acoustic propagation calculations and a deeper understanding of the atmosphere. Uniquely combining observed data and propagation modeling, the three papers presented here quantify the effects of the atmosphere on propagation from a variety of sources at distances from less than 100 km (near-regional distances) to nearly 600 km (tele-infrasonic distances) for sources on the surface and at altitude (63 km). Paper one analyzes infrasound signals recorded at the CHNAR seismo-acoustic array. These sources are predominantly on the surface, result from human activity and occur closer than 250 km away. Propagation for these near-regional distances depends on tropospheric weather patterns and temporally varying, low-altitude ducts. To predict the observed arrivals local meteorological data is necessary; MSIS/HWM (Mass Spectrometer Incoherent Scatter/Horizontal Wind Model) and NRL-G2S (Naval Research Laboratory Ground To Space) did not predict the observed arrivals. Paper two is the first time a waveform from an explosion at height has ever been reproduced; the recorded waveform was from the break-up of the space shuttle Columbia. For the tele-infrasonic normal mode modeling, MSIS/HWM and NRL-G2S yielded identical waveform results. Paper three looks at the tele-infrasonic path between an iron mine in Minnesota and an infrasound array in Manitoba, Canada. Over a four month period, the IS-10 infrasound array provided infrasound data to compare to archived blast statistics. NRL-G2S better reproduced the observed arrival travel times than MSIS/HWM; whether or not arrivals were observed depended on the noise field at the infrasound array. For any distance range or source height, accurate atmospheric parameters from the corresponding propagation paths are necessary to predict observed infrasound.

Value of interactive scanning for improving the outcome of new-learners in transcontinental tele-echocardiography (VISION-in-Tele-Echo) study.

PubMed

Bansal, Manish; Singh, Shaanemeet; Maheshwari, Puneet; Adams, David; McCulloch, Marti L; Dada, Tanuj; Sengupta, Shantanu P; Kasliwal, Ravi R; Pellikka, Patricia A; Sengupta, Partho P

2015-01-01

Point-of-care (POC) echocardiography may be helpful for mass triage, but such a strategy requires adequately trained sonographers at the remote site. The aim of this study was to test the feasibility of using a novel POC echocardiography training program for improving physicians' imaging skills during preanesthetic cardiac evaluations performed in a community camp organized for treating cataract blindness. Seventeen physicians were provided 6 hours of training in the use of POC echocardiography; nine were taught on site and eight were taught online through a transcontinental tele-echocardiography system. The trained physicians subsequently scanned elderly patients undergoing cataract surgery. The quality of images was graded, and agreement between local physicians' interpretations and Web-based interpretations by worldwide experts was compared. A total of 968 studies were performed, with 660 used for validating physicians' competence. Major cardiac abnormalities were seen in 136 patients (14.2%), with 32 (3.3%) deemed prohibitive to surgery in unmonitored settings. Although good-quality images were obtained more frequently by physicians trained on site rather than online (P = .03), there were no differences between the two groups in agreement with expert interpretations. The majority of physicians (70.6%) expressed satisfaction with the training (average Likert-type scale score, 4.24 of 5), with no difference seen between the two groups. The training resulted in significant improvements in self-perceived competence in all components of POC echocardiography (P < .001 for all). This study establishes the feasibility of using short-duration, one-on-one, personalized transcontinental tele-echocardiography education for wider dissemination of echocardiographic skills to local physicians in remote communities, essential for optimizing global cardiovascular health. Copyright © 2015 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

iPhone otoscopes: Currently available, but reliable for tele-otoscopy in the hands of parents?

PubMed

Shah, Manan Udayan; Sohal, Maheep; Valdez, Tulio A; Grindle, Christopher R

2018-03-01

Tele-otoscopy has been validated for tympanostomy surveillance and remote diagnosis when images are recorded by trained professionals. The CellScope iPhone Otoscope is a device that may be used for tele-otoscopy and it enables parents to record their children's ear examinations and send the films for remote physician diagnosis. This study aims to determine the ability to diagnose, and the reliability of the diagnosis when utilizing video exams obtained by a parent versus video exams obtained by an otolaryngologist. Parents of children ages 17 years or younger attempted recordings of the tympanic membrane of their children with the CellScope after a video tutorial; a physician subsequently used the device to record the same ear. Recordings occurred prior to standard pediatric otolaryngology office evaluation. Later, a remote pediatric otolaryngologist attempted diagnosis solely based on the videos, blinded to whether the examination was filmed by a parent or physician. Interrater reliability between video diagnosis and original diagnosis on pneumatic otoscopy was measured, and objective tympanic membrane landmarks visualized on the films were recorded. Eighty ears were enrolled and recorded. There was low interrater agreement (k = 0.42) between diagnosis based on parent videos as compared with pneumatic otoscopy. There was high agreement (k = 0.71) between diagnosis based on physician videos and pneumatic otoscopy. Physician videos and parent videos had only slight agreement on objective landmarks identified (k = 0.087). iPhone otoscopy provides reliable tele-otoscopy images in when used by trained professionals but, currently, images obtained by parents are not suitable for use in diagnosis. Copyright © 2018 Elsevier B.V. All rights reserved.

ATHLETE's Feet: Mu1ti-Resolution Planning for a Hexapod Robot

NASA Technical Reports Server (NTRS)

Smith, Tristan B.; Barreiro, Javier; Smith, David E.; SunSpiral, Vytas; Chavez-Clemente, Daniel

2008-01-01

ATHLETE is a large six-legged tele-operated robot. Each foot is a wheel; travel can be achieved by walking, rolling, or some combination of the two. Operators control ATHLETE by selecting parameterized commands from a command dictionary. While rolling can be done efficiently with a single command, any motion involving steps is cumbersome - walking a few meters through difficult terrain can take hours. Our goal is to improve operator efficiency by automatically generating sequences of motion commands. There is increasing uncertainty regarding ATHLETE s actual configuration over time and decreasing quality of terrain data farther away from the current position. This, combined with the complexity that results from 36 degrees of kinematic freedom, led to an architecture that interleaves planning and execution at multiple levels, ranging from traditional configuration space motion planning algorithms for immediate moves to higher level task and path planning algorithms for overall travel. The modularity of the architecture also simplifies the development process and allows the operator to interact with and control the system at varying levels of autonomy depending on terrain and need.

Tier-scalable reconnaissance: the future in autonomous C4ISR systems has arrived: progress towards an outdoor testbed

NASA Astrophysics Data System (ADS)

Fink, Wolfgang; Brooks, Alexander J.-W.; Tarbell, Mark A.; Dohm, James M.

2017-05-01

Autonomous reconnaissance missions are called for in extreme environments, as well as in potentially hazardous (e.g., the theatre, disaster-stricken areas, etc.) or inaccessible operational areas (e.g., planetary surfaces, space). Such future missions will require increasing degrees of operational autonomy, especially when following up on transient events. Operational autonomy encompasses: (1) Automatic characterization of operational areas from different vantages (i.e., spaceborne, airborne, surface, subsurface); (2) automatic sensor deployment and data gathering; (3) automatic feature extraction including anomaly detection and region-of-interest identification; (4) automatic target prediction and prioritization; (5) and subsequent automatic (re-)deployment and navigation of robotic agents. This paper reports on progress towards several aspects of autonomous C4ISR systems, including: Caltech-patented and NASA award-winning multi-tiered mission paradigm, robotic platform development (air, ground, water-based), robotic behavior motifs as the building blocks for autonomous tele-commanding, and autonomous decision making based on a Caltech-patented framework comprising sensor-data-fusion (feature-vectors), anomaly detection (clustering and principal component analysis), and target prioritization (hypothetical probing).

User interface for a tele-operated robotic hand system

DOEpatents

Crawford, Anthony L

2015-03-24

Disclosed here is a user interface for a robotic hand. The user interface anchors a user's palm in a relatively stationary position and determines various angles of interest necessary for a user's finger to achieve a specific fingertip location. The user interface additionally conducts a calibration procedure to determine the user's applicable physiological dimensions. The user interface uses the applicable physiological dimensions and the specific fingertip location, and treats the user's finger as a two link three degree-of-freedom serial linkage in order to determine the angles of interest. The user interface communicates the angles of interest to a gripping-type end effector which closely mimics the range of motion and proportions of a human hand. The user interface requires minimal contact with the operator and provides distinct advantages in terms of available dexterity, work space flexibility, and adaptability to different users.

The development of a tele-monitoring system for physiological parameters based on the B/S model.

PubMed

Shuicai, Wu; Peijie, Jiang; Chunlan, Yang; Haomin, Li; Yanping, Bai

2010-01-01

The development of a new physiological multi-parameter remote monitoring system is based on the B/S model. The system consists of a server monitoring center, Internet network and PC-based multi-parameter monitors. Using the B/S model, the clients can browse web pages via the server monitoring center and download and install ActiveX controls. The physiological multi-parameters are collected, displayed and remotely transmitted. The experimental results show that the system is stable, reliable and operates in real time. The system is suitable for use in physiological multi-parameter remote monitoring for family and community healthcare. Copyright © 2010 Elsevier Ltd. All rights reserved.

Operational Resource Theory of Coherence.

PubMed

Winter, Andreas; Yang, Dong

2016-03-25

We establish an operational theory of coherence (or of superposition) in quantum systems, by focusing on the optimal rate of performance of certain tasks. Namely, we introduce the two basic concepts-"coherence distillation" and "coherence cost"-in the processing quantum states under so-called incoherent operations [Baumgratz, Cramer, and Plenio, Phys. Rev. Lett. 113, 140401 (2014)]. We, then, show that, in the asymptotic limit of many copies of a state, both are given by simple single-letter formulas: the distillable coherence is given by the relative entropy of coherence (in other words, we give the relative entropy of coherence its operational interpretation), and the coherence cost by the coherence of formation, which is an optimization over convex decompositions of the state. An immediate corollary is that there exists no bound coherent state in the sense that one would need to consume coherence to create the state, but no coherence could be distilled from it. Further, we demonstrate that the coherence theory is generically an irreversible theory by a simple criterion that completely characterizes all reversible states.

From Tele-ed to Telehealth: the need for IT ubiquity in nursing.

PubMed

Simpson, Roy L

2005-01-01

Although numerous studies have shown that information technology (IT) improves care, makes the workplace better for clinicians, and reduces costs, healthcare-especially nursing-has been slow to adopt it for a variety of reasons. However, because of a worsening nursing shortage, couples with increasing healthcare costs and administrative overhead, nursing demands that IT become not only common, but pervasive, playing a role in every aspect of nursing, from recruitment and education, to patient care. This article will examine the several potential applications of IT to nursing and their benefits, challenges to widespread IT adoption, and the importance of IT ubiquity to the very viability of the profession.

Thayeria tapajonica (Characiformes: Characidae), a new species from rio Tapajós basin, Brazil.

PubMed

Moreira, Cristiano R; Lima, Flávio C T

2017-11-06

A new species of penguin tetra, Thayeria tapajonica, is described from the rio Tapajós basin. It is most similar to T. boehlkei by presenting a straight midlateral stripe running anteriorly to immediately posterior to the head, while in T. ifati and T. obliqua the midlateral stripe is restricted to the caudal peduncle, merging with an anterodorsal oblique stripe. The new species is restricted to the rio Tapajós basin downriver of the confluence of the rio Juruena and rio Teles Pires, and lower rio Teles Pires, where its distribution overlaps with T. boehlkei.

Achieving consistent color and grayscale presentation on medial color displays

NASA Astrophysics Data System (ADS)

Fan, Jiahua; Roehrig, Hans; Dallas, William; Krupinski, Elizabeth A.

2008-03-01

Color displays are increasingly used for medical imaging, replacing the traditional monochrome displays in radiology for multi-modality applications, 3D representation applications, etc. Color displays are also used increasingly because of wide spread application of Tele-Medicine, Tele-Dermatology and Digital Pathology. At this time, there is no concerted effort for calibration procedures for this diverse range of color displays in Telemedicine and in other areas of the medical field. Using a colorimeter to measure the display luminance and chrominance properties as well as some processing software we developed a first attempt to a color calibration protocol for the medical imaging field.

ETS-5, ETS-6, and COMETS projects in Japan

NASA Technical Reports Server (NTRS)

Iida, Takashi; Wakana, Hiromitsu; Obara, Noriaki

1992-01-01

Three satellite communication projects now in progress in Japan are described. The first is a project to establish a telecommunication network for tele-education, TV conference, and tele-medicine in the Asia-Pacific region by using the Japan's Engineering Test Satellite-5 (ETS-5). The second is a project of the ETS-6 satellite, to be launched in 1993, for inter-satellite communication, mobile and fixed communication, and millimeter wave personal communication experiments. The third is a project of the Communications and Broadcasting Engineering Test Satellite (COMETS), to be launched in 1997, for advanced mobile satellite communication, inter-satellite link, and advanced broadcasting experiments at higher frequencies.

A tele-obstetric broadband service including ultrasound, videoconferencing and cardiotocogram. A high cost and a low volume of patients.

PubMed

Norum, Jan; Bergmo, Trine S; Holdø, Bjørn; Johansen, May V; Vold, Ingar N; Sjaaeng, Elisabeth E; Jacobsen, Heidi

2007-01-01

We established a tele-obstetric service connecting the Department of Obstetrics and Gynaecology at the Nordland Hospital in Bodø to the delivery unit at the Nordland Hospital in Lofoten. The telemedicine service included a videoconferencing link (3 Mbit/s) for transmission of ultrasound scans and a low-speed data link (telephone modem) for transmission of cardiotocograms (CTGs). One hundred and thirty pregnant women entered the antenatal clinic in Lofoten during the eight-month study period. A total of 140 CTGs were recorded. The tele-ultrasound service was used in five cases (4%). The cases were serious malformation, Down's syndrome, breech presentation, vaginal bleeding during pregnancy and triplets. Analysis showed that the cost of patient travel was NOK 2460 per transfer. The variable cost of videoconferencing was NOK 250 per consultation. However, the total investment costs for the telemedicine service, including the broadband infrastructure, was NOK 1.7 million (Euro 212,000). The telemedicine service was not cost saving at annual workloads below 208. We conclude that the installation has to be used by other medical specialities to make it cost-effective.

Allergy and Asthma Care in the Mobile Phone Era.

PubMed

Huang, Xinyuan; Matricardi, Paolo Maria

2016-05-21

Strategies to improve patients' adherence to treatment are essential to reduce the great health and economic burden of allergic rhinitis and asthma. Mobile phone applications (apps) for a better management of allergic diseases are growing in number, but their usefulness for doctors and patients is still debated. Controlled trials have investigated the feasibility, cost-effectiveness, security, and perspectives of the use of tele-medicine in the self-management of asthma. These studies focused on different tools or devices, such as SMS, telephone calls, automatic voice response system, mobile applications, speech recognition system, or cloud-computing systems. While some trials concluded that m-Health can improve asthma control and the patient's quality of life, others did not show any advantage in relation to usual care. The only controlled study on allergic rhinitis showed an improvement of adherence to treatment among tele-monitored patients compared to those managed with usual care. Most studies have also highlighted a few shortcomings and limitations of tele-medicine, mainly concerning security and cost-efficiency. The use of smartphones and apps for a personalized asthma and allergy care needs to be further evaluated and optimized before conclusions on its usefulness can be drawn.

Collaborative volume visualization with applications to underwater acoustic signal processing

NASA Astrophysics Data System (ADS)

Jarvis, Susan; Shane, Richard T.

2000-08-01

Distributed collaborative visualization systems represent a technology whose time has come. Researchers at the Fraunhofer Center for Research in Computer Graphics have been working in the areas of collaborative environments and high-end visualization systems for several years. The medical application. TeleInVivo, is an example of a system which marries visualization and collaboration. With TeleInvivo, users can exchange and collaboratively interact with volumetric data sets in geographically distributed locations. Since examination of many physical phenomena produce data that are naturally volumetric, the visualization frameworks used by TeleInVivo have been extended for non-medical applications. The system can now be made compatible with almost any dataset that can be expressed in terms of magnitudes within a 3D grid. Coupled with advances in telecommunications, telecollaborative visualization is now possible virtually anywhere. Expert data quality assurance and analysis can occur remotely and interactively without having to send all the experts into the field. Building upon this point-to-point concept of collaborative visualization, one can envision a larger pooling of resources to form a large overview of a region of interest from contributions of numerous distributed members.

Trans-Pacific tele-ultrasound image transmission of fetal central nervous system structures.

PubMed

Ferreira, Adilson Cunha; Araujo Júnior, Edward; Martins, Wellington P; Jordão, João Francisco; Oliani, Antônio Hélio; Meagher, Simon E; Da Silva Costa, Fabricio

2015-01-01

To assess the quality of images and video clips of fetal central nervous (CNS) structures obtained by ultrasound and transmitted via tele-ultrasound from Brazil to Australia. In this cross-sectional study, 15 normal singleton pregnant women between 20 and 26 weeks were selected. Fetal CNS structures were obtained by images and video clips. The exams were transmitted in real-time using a broadband internet and an inexpensive video streaming device. Four blinded examiners evaluated the quality of the exams using the Likert scale. We calculated the mean, standard deviation, mean difference, and p values were obtained from paired t tests. The quality of the original video clips was slightly better than that observed by the transmitted video clips; mean difference considering all observers = 0.23 points. In 47/60 comparisons (78.3%; 95% CI = 66.4-86.9%) the quality of the video clips were judged to be the same. In 182/240 still images (75.8%; 95% CI = 70.0-80.8%) the scores of transmitted image were considered the same as the original. We demonstrated that long distance tele-ultrasound transmission of fetal CNS structures using an inexpensive video streaming device provided images of subjective good quality.

Privacy enhanced group communication in clinical environment

NASA Astrophysics Data System (ADS)

Li, Mingyan; Narayanan, Sreeram; Poovendran, Radha

2005-04-01

Privacy protection of medical records has always been an important issue and is mandated by the recent Health Insurance Portability and Accountability Act (HIPAA) standards. In this paper, we propose security architectures for a tele-referring system that allows electronic group communication among professionals for better quality treatments, while protecting patient privacy against unauthorized access. Although DICOM defines the much-needed guidelines for confidentiality of medical data during transmission, there is no provision in the existing medical security systems to guarantee patient privacy once the data has been received. In our design, we address this issue by enabling tracing back to the recipient whose received data is disclosed to outsiders, using watermarking technique. We present security architecture design of a tele-referring system using a distributed approach and a centralized web-based approach. The resulting tele-referring system (i) provides confidentiality during the transmission and ensures integrity and authenticity of the received data, (ii) allows tracing of the recipient who has either distributed the data to outsiders or whose system has been compromised, (iii) provides proof of receipt or origin, and (iv) can be easy to use and low-cost to employ in clinical environment.

An open real-time tele-stethoscopy system

PubMed Central

2012-01-01

Background Acute respiratory infections are the leading cause of childhood mortality. The lack of physicians in rural areas of developing countries makes difficult their correct diagnosis and treatment. The staff of rural health facilities (health-care technicians) may not be qualified to distinguish respiratory diseases by auscultation. For this reason, the goal of this project is the development of a tele-stethoscopy system that allows a physician to receive real-time cardio-respiratory sounds from a remote auscultation, as well as video images showing where the technician is placing the stethoscope on the patient’s body. Methods A real-time wireless stethoscopy system was designed. The initial requirements were: 1) The system must send audio and video synchronously over IP networks, not requiring an Internet connection; 2) It must preserve the quality of cardiorespiratory sounds, allowing to adapt the binaural pieces and the chestpiece of standard stethoscopes, and; 3) Cardiorespiratory sounds should be recordable at both sides of the communication. In order to verify the diagnostic capacity of the system, a clinical validation with eight specialists has been designed. In a preliminary test, twelve patients have been auscultated by all the physicians using the tele-stethoscopy system, versus a local auscultation using traditional stethoscope. The system must allow listen the cardiac (systolic and diastolic murmurs, gallop sound, arrhythmias) and respiratory (rhonchi, rales and crepitations, wheeze, diminished and bronchial breath sounds, pleural friction rub) sounds. Results The design, development and initial validation of the real-time wireless tele-stethoscopy system are described in detail. The system was conceived from scratch as open-source, low-cost and designed in such a way that many universities and small local companies in developing countries may manufacture it. Only free open-source software has been used in order to minimize manufacturing costs and look for alliances to support its improvement and adaptation. The microcontroller firmware code, the computer software code and the PCB schematics are available for free download in a subversion repository hosted in SourceForge. Conclusions It has been shown that real-time tele-stethoscopy, together with a videoconference system that allows a remote specialist to oversee the auscultation, may be a very helpful tool in rural areas of developing countries. PMID:22917062

Performance study of the application of Artificial Neural Networks to the completion and prediction of data retrieved by underwater sensors.

PubMed

Baladrón, Carlos; Aguiar, Javier M; Calavia, Lorena; Carro, Belén; Sánchez-Esguevillas, Antonio; Hernández, Luis

2012-01-01

This paper presents a proposal for an Artificial Neural Network (ANN)-based architecture for completion and prediction of data retrieved by underwater sensors. Due to the specific conditions under which these sensors operate, it is not uncommon for them to fail, and maintenance operations are difficult and costly. Therefore, completion and prediction of the missing data can greatly improve the quality of the underwater datasets. A performance study using real data is presented to validate the approach, concluding that the proposed architecture is able to provide very low errors. The numbers show as well that the solution is especially suitable for cases where large portions of data are missing, while in situations where the missing values are isolated the improvement over other simple interpolation methods is limited.

Progress in video immersion using Panospheric imaging

NASA Astrophysics Data System (ADS)

Bogner, Stephen L.; Southwell, David T.; Penzes, Steven G.; Brosinsky, Chris A.; Anderson, Ron; Hanna, Doug M.

1998-09-01

Having demonstrated significant technical and marketplace advantages over other modalities for video immersion, PanosphericTM Imaging (PI) continues to evolve rapidly. This paper reports on progress achieved since AeroSense 97. The first practical field deployment of the technology occurred in June-August 1997 during the NASA-CMU 'Atacama Desert Trek' activity, where the Nomad mobile robot was teleoperated via immersive PanosphericTM imagery from a distance of several thousand kilometers. Research using teleoperated vehicles at DRES has also verified the exceptional utility of the PI technology for achieving high levels of situational awareness, operator confidence, and mission effectiveness. Important performance enhancements have been achieved with the completion of the 4th Generation PI DSP-based array processor system. The system is now able to provide dynamic full video-rate generation of spatial and computational transformations, resulting in a programmable and fully interactive immersive video telepresence. A new multi- CCD camera architecture has been created to exploit the bandwidth of this processor, yielding a well-matched PI system with greatly improved resolution. While the initial commercial application for this technology is expected to be video tele- conferencing, it also appears to have excellent potential for application in the 'Immersive Cockpit' concept. Additional progress is reported in the areas of Long Wave Infrared PI Imaging, Stereo PI concepts, PI based Video-Servoing concepts, PI based Video Navigation concepts, and Foveation concepts (to merge localized high-resolution views with immersive views).

Web-based asthma collaboration management and public awareness.

PubMed

Glykas, Michael; Chytas, Panagiotis

2004-01-01

Recent studies have shown that long-term monitoring of asthma severity can reduce asthma exacerbations, optimise drug therapy and decrease the cost of asthma management. The management of a chronic patient is a collective and cooperative enterprise that may exploit Information Technologies (IT) to improve the overall quality of care. The aim of this paper is to present a web based asthma tool that significantly enhances public information and awareness to support illness prevention, patients independent living through user profiling and personalisation and collaborative work between health professionals, therapists, caregivers and patients through Tele-Care and Tele-Consultation. The system has been tested through a preliminary survey that took place in UK and Greece.

The Feasibility of Real-Time Intraoperative Performance Assessment With SIMPL (System for Improving and Measuring Procedural Learning): Early Experience From a Multi-institutional Trial.

PubMed

Bohnen, Jordan D; George, Brian C; Williams, Reed G; Schuller, Mary C; DaRosa, Debra A; Torbeck, Laura; Mullen, John T; Meyerson, Shari L; Auyang, Edward D; Chipman, Jeffrey G; Choi, Jennifer N; Choti, Michael A; Endean, Eric D; Foley, Eugene F; Mandell, Samuel P; Meier, Andreas H; Smink, Douglas S; Terhune, Kyla P; Wise, Paul E; Soper, Nathaniel J; Zwischenberger, Joseph B; Lillemoe, Keith D; Dunnington, Gary L; Fryer, Jonathan P

Intraoperative performance assessment of residents is of growing interest to trainees, faculty, and accreditors. Current approaches to collect such assessments are limited by low participation rates and long delays between procedure and evaluation. We deployed an innovative, smartphone-based tool, SIMPL (System for Improving and Measuring Procedural Learning), to make real-time intraoperative performance assessment feasible for every case in which surgical trainees participate, and hypothesized that SIMPL could be feasibly integrated into surgical training programs. Between September 1, 2015 and February 29, 2016, 15 U.S. general surgery residency programs were enrolled in an institutional review board-approved trial. SIMPL was made available after 70% of faculty and residents completed a 1-hour training session. Descriptive and univariate statistics analyzed multiple dimensions of feasibility, including training rates, volume of assessments, response rates/times, and dictation rates. The 20 most active residents and attendings were evaluated in greater detail. A total of 90% of eligible users (1267/1412) completed training. Further, 13/15 programs began using SIMPL. Totally, 6024 assessments were completed by 254 categorical general surgery residents (n = 3555 assessments) and 259 attendings (n = 2469 assessments), and 3762 unique operations were assessed. There was significant heterogeneity in participation within and between programs. Mean percentage (range) of users who completed ≥1, 5, and 20 assessments were 62% (21%-96%), 34% (5%-75%), and 10% (0%-32%) across all programs, and 96%, 75%, and 32% in the most active program. Overall, response rate was 70%, dictation rate was 24%, and mean response time was 12 hours. Assessments increased from 357 (September 2015) to 1146 (February 2016). The 20 most active residents each received mean 46 assessments by 10 attendings for 20 different procedures. SIMPL can be feasibly integrated into surgical training programs to enhance the frequency and timeliness of intraoperative performance assessment. We believe SIMPL could help facilitate a national competency-based surgical training system, although local and systemic challenges still need to be addressed. Copyright © 2016. Published by Elsevier Inc.

Researching the acceptability of using Skype to provide Speech and Language Therapy

PubMed Central

Matthews, Rebecca Alison; Woll, Bencie; Clarke, Mike

2012-01-01

In the current economic climate, whilst the demand for health services, including Speech and Language Therapy (SLT) continues to rise, there is pressure to reduce health service budgets, Tele-technology—the use of tele-communication technology to link patient and clinician remotely—could potentially provide a solution to meeting the demand for SLT with reduced resources. However, only a few SLT services in the United Kingdom (UK) have reported on using tele-technology to provide their service (Howell, Tripoliti and Pring, 2009; Styles, 2008; McCullough, 2001; Katsavarus, 2001). In 2002 the American Speech and Hearing Association (ASHA) surveyed its members on their experience and views of using tele-technology and specifically video-conferencing to provide an SLT service. The analysis of the responses identified five areas of concern—lack of professional guidelines, limited evidence of clinical efficacy, disruption and problems managing the technology, change in the interaction and loss of rapport as well as anticipated, additional costs to provide the service. The study reported here set up an SLT service using the desktop videoconferencing system, Skype, in an independent SLT practice based in the UK. Data were collected to evaluate the acceptability of the clinical sessions, the technology, the quality of interaction and costs of an SLT service using Skype. Eleven participants aged between 7 and 14 years with varying therapy needs took part. Each received a mix of face-to-face (F2F) and Skype SLT over the ten session trial period. Data were collected for every session using a report card; adults supporting the children were asked for their views using a questionnaire at the beginning and end of the trial; the child participants were interviewed after the trial period was over; one F2F and one Skype session was video recorded for each participant; work activity was recorded along with identifiable costs of F2F and Skype SLT sessions. A total of 110 session report cards, 24 questionnaires, 10 interviews and 16 hours of video recording were analysed. The responses from interviews and questionnaires were compared with the discourse analysis of the session video recordings and session report cards. A greater percentage of goals were completed in the Skype sessions. Whilst there were breaks in internet connection, this did not reduce the number of goals achieved. The ratio of turn moves and utterance functions were the same for therapist and child in both session formats; the only difference identified was the increased use of requests for objects/action in the F2F session. The discourse analysis supported the participant observations that the children worked harder and focused better in the Skype sessions. The presence of clarifications and the reduced numbers of interruptions were in line with other research observations that the speakers were able to judge the mood of the conversation partner in remote interaction. Costs of Skype SLT were lower than equivalent F2F sessions. The combination of positive findings suggests that Skype SLT sessions are potentially acceptable and are likely to have a useful role to play in service provision.

Mobile, Cloud, and Big Data Computing: Contributions, Challenges, and New Directions in Telecardiology

PubMed Central

Hsieh, Jui-Chien; Li, Ai-Hsien; Yang, Chung-Chi

2013-01-01

Many studies have indicated that computing technology can enable off-site cardiologists to read patients’ electrocardiograph (ECG), echocardiography (ECHO), and relevant images via smart phones during pre-hospital, in-hospital, and post-hospital teleconsultation, which not only identifies emergency cases in need of immediate treatment, but also prevents the unnecessary re-hospitalizations. Meanwhile, several studies have combined cloud computing and mobile computing to facilitate better storage, delivery, retrieval, and management of medical files for telecardiology. In the future, the aggregated ECG and images from hospitals worldwide will become big data, which should be used to develop an e-consultation program helping on-site practitioners deliver appropriate treatment. With information technology, real-time tele-consultation and tele-diagnosis of ECG and images can be practiced via an e-platform for clinical, research, and educational purposes. While being devoted to promote the application of information technology onto telecardiology, we need to resolve several issues: (1) data confidentiality in the cloud, (2) data interoperability among hospitals, and (3) network latency and accessibility. If these challenges are overcome, tele-consultation will be ubiquitous, easy to perform, inexpensive, and beneficial. Most importantly, these services will increase global collaboration and advance clinical practice, education, and scientific research in cardiology. PMID:24232290

Traditional Nurse Triage vs. Physician Tele-Presence in a Pediatric Emergency Department

PubMed Central

Marconi, Greg P.; Chang, Todd; Pham, Phung K.; Grajower, Daniel N.; Nager, Alan L.

2014-01-01

Objectives To compare traditional nurse triage (TNT) in a Pediatric Emergency Department (PED) to physician tele-presence (PTP). Methods Prospective, 2×2 crossover study with random assignment using a sample of walk-in patients seeking care in a PED at a large, tertiary care children’s hospital, from May 2012 to January 2013. Outcomes of triage times, documentation errors, triage scores, and survey responses were compared between TNT and PTP. Comparison between PTP to actual treating PED physicians regarding the accuracy of ordering blood and urine tests, throat cultures, and radiologic imaging was also studied. Results Paired samples t-tests showed a statistically significant difference in triage time between TNT and PTP (p=0.03), but no significant difference in documentation errors (p=0.10). Triage scores of TNT were 71% accurate, compared to PTP, which were 95% accurate. Both parents and children had favorable scores regarding PTP and the majority indicated they would prefer PTP again at their next PED visit. PTP diagnostic ordering was comparable to the actual PED physician ordering, showing no statistical differences. Conclusions Utilizing physician tele-presence technology to remotely perform triage is a feasible alternative to traditional nurse triage, with no clinically significant differences in time, triage scores, errors and patient and parent satisfaction. PMID:24445223

Cranial implant design using augmented reality immersive system.

PubMed

Ai, Zhuming; Evenhouse, Ray; Leigh, Jason; Charbel, Fady; Rasmussen, Mary

2007-01-01

Software tools that utilize haptics for sculpting precise fitting cranial implants are utilized in an augmented reality immersive system to create a virtual working environment for the modelers. The virtual environment is designed to mimic the traditional working environment as closely as possible, providing more functionality for the users. The implant design process uses patient CT data of a defective area. This volumetric data is displayed in an implant modeling tele-immersive augmented reality system where the modeler can build a patient specific implant that precisely fits the defect. To mimic the traditional sculpting workspace, the implant modeling augmented reality system includes stereo vision, viewer centered perspective, sense of touch, and collaboration. To achieve optimized performance, this system includes a dual-processor PC, fast volume rendering with three-dimensional texture mapping, the fast haptic rendering algorithm, and a multi-threading architecture. The system replaces the expensive and time consuming traditional sculpting steps such as physical sculpting, mold making, and defect stereolithography. This augmented reality system is part of a comprehensive tele-immersive system that includes a conference-room-sized system for tele-immersive small group consultation and an inexpensive, easily deployable networked desktop virtual reality system for surgical consultation, evaluation and collaboration. This system has been used to design patient-specific cranial implants with precise fit.

Mobile, cloud, and big data computing: contributions, challenges, and new directions in telecardiology.

PubMed

Hsieh, Jui-Chien; Li, Ai-Hsien; Yang, Chung-Chi

2013-11-13

Many studies have indicated that computing technology can enable off-site cardiologists to read patients' electrocardiograph (ECG), echocardiography (ECHO), and relevant images via smart phones during pre-hospital, in-hospital, and post-hospital teleconsultation, which not only identifies emergency cases in need of immediate treatment, but also prevents the unnecessary re-hospitalizations. Meanwhile, several studies have combined cloud computing and mobile computing to facilitate better storage, delivery, retrieval, and management of medical files for telecardiology. In the future, the aggregated ECG and images from hospitals worldwide will become big data, which should be used to develop an e-consultation program helping on-site practitioners deliver appropriate treatment. With information technology, real-time tele-consultation and tele-diagnosis of ECG and images can be practiced via an e-platform for clinical, research, and educational purposes. While being devoted to promote the application of information technology onto telecardiology, we need to resolve several issues: (1) data confidentiality in the cloud, (2) data interoperability among hospitals, and (3) network latency and accessibility. If these challenges are overcome, tele-consultation will be ubiquitous, easy to perform, inexpensive, and beneficial. Most importantly, these services will increase global collaboration and advance clinical practice, education, and scientific research in cardiology.

Pressure Mapping Mat for Tele-Home Care Applications

PubMed Central

Saenz-Cogollo, Jose Francisco; Pau, Massimiliano; Fraboni, Beatrice; Bonfiglio, Annalisa

2016-01-01

In this paper we present the development of a mat-like pressure mapping system based on a single layer textile sensor and intended to be used in home environments for monitoring the physical condition of persons with limited mobility. The sensor is fabricated by embroidering silver-coated yarns on a light cotton fabric and creating pressure-sensitive resistive elements by stamping the conductive polymer poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS) at the crossing points of conductive stitches. A battery-operated mat prototype was developed and includes the scanning circuitry and a wireless communication module. A functional description of the system is presented together with a preliminary experimental evaluation of the mat prototype in the extraction of plantar pressure parameters. PMID:26978369

New technology applied to well logging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stremel, K.

1984-11-01

Remote locations and increasingly complex geology require a higher level of sophistication in well-logging equipment and services. Applying technological advancements, well-logging contractors have developed a variety of new products and services designed to provide better quality data at reasonable prices. One of the most significant technological breakthroughs has been in satellite communications. Denver-based Western Tele-Communications Inc. is one of the few companies offering voice and data transmission services via satellite. Up to 9600 bits per second of realtime data is transmitted from terminals at remote wellsites through a main station in Denver to locations throughout the world. Because management inmore » separate offices can review well data simultaneously, critical operations decisions can be made more quickly.« less

Internet application to tele-audiology--"nothin' but net".

PubMed

Givens, Gregg D; Elangovan, Saravanan

2003-12-01

The Telehealth program at East Carolina University has developed a system for real-time assessment of auditory thresholds using computer driven control of a remote audiometer via the Internet. The present study used 45 adult participants in a double-blind study of 2 different systems: a conventional audiometer and an audiometer operated remotely via the Internet. The audiometric thresholds assessed by these 2 systems varied by no more than 1.3 dB for air conduction and 1.2 dB for bone conduction. The results demonstrated the feasibility of this new "telehearing" audiometric system. With the rapid development of Internet-based applications, telehealth has the potential to provide important healthcare coverage for rural areas where specialized audiological services are lacking.

Synergy-Based Bilateral Port: A Universal Control Module for Tele-Manipulation Frameworks Using Asymmetric Master–Slave Systems

PubMed Central

Brygo, Anais; Sarakoglou, Ioannis; Grioli, Giorgio; Tsagarakis, Nikos

2017-01-01

Endowing tele-manipulation frameworks with the capability to accommodate a variety of robotic hands is key to achieving high performances through permitting to flexibly interchange the end-effector according to the task considered. This requires the development of control policies that not only cope with asymmetric master–slave systems but also whose high-level components are designed in a unified space in abstraction from the devices specifics. To address this dual challenge, a novel synergy port is developed that resolves the kinematic, sensing, and actuation asymmetries of the considered system through generating motion and force feedback references in the hardware-independent hand postural synergy space. It builds upon the concept of the Cartesian-based synergy matrix, which is introduced as a tool mapping the fingertips Cartesian space to the directions oriented along the grasp principal components. To assess the effectiveness of the proposed approach, the synergy port has been integrated into the control system of a highly asymmetric tele-manipulation framework, in which the 3-finger hand exoskeleton HEXOTRAC is used as a master device to control the SoftHand, a robotic hand whose transmission system relies on a single motor to drive all joints along a soft synergistic path. The platform is further enriched with the vision-based motion capture system Optitrack to monitor the 6D trajectory of the user’s wrist, which is used to control the robotic arm on which the SoftHand is mounted. Experiments have been conducted with the humanoid robot COMAN and the KUKA LWR robotic manipulator. Results indicate that this bilateral interface is highly intuitive and allows users with no prior experience to reach, grasp, and transport a variety of objects exhibiting very different shapes and impedances. In addition, the hardware and control solutions proved capable of accommodating users with different hand kinematics. Finally, the proposed control framework offers a universal, flexible, and intuitive interface allowing for the performance of effective tele-manipulations. PMID:28421179

A cross-platform solution for light field based 3D telemedicine.

PubMed

Wang, Gengkun; Xiang, Wei; Pickering, Mark

2016-03-01

Current telehealth services are dominated by conventional 2D video conferencing systems, which are limited in their capabilities in providing a satisfactory communication experience due to the lack of realism. The "immersiveness" provided by 3D technologies has the potential to promote telehealth services to a wider range of applications. However, conventional stereoscopic 3D technologies are deficient in many aspects, including low resolution and the requirement for complicated multi-camera setup and calibration, and special glasses. The advent of light field (LF) photography enables us to record light rays in a single shot and provide glasses-free 3D display with continuous motion parallax in a wide viewing zone, which is ideally suited for 3D telehealth applications. As far as our literature review suggests, there have been no reports of 3D telemedicine systems using LF technology. In this paper, we propose a cross-platform solution for a LF-based 3D telemedicine system. Firstly, a novel system architecture based on LF technology is established, which is able to capture the LF of a patient, and provide an immersive 3D display at the doctor site. For 3D modeling, we further propose an algorithm which is able to convert the captured LF to a 3D model with a high level of detail. For the software implementation on different platforms (i.e., desktop, web-based and mobile phone platforms), a cross-platform solution is proposed. Demo applications have been developed for 2D/3D video conferencing, 3D model display and edit, blood pressure and heart rate monitoring, and patient data viewing functions. The demo software can be extended to multi-discipline telehealth applications, such as tele-dentistry, tele-wound and tele-psychiatry. The proposed 3D telemedicine solution has the potential to revolutionize next-generation telemedicine technologies by providing a high quality immersive tele-consultation experience. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Synergy-Based Bilateral Port: A Universal Control Module for Tele-Manipulation Frameworks Using Asymmetric Master-Slave Systems.

PubMed

Brygo, Anais; Sarakoglou, Ioannis; Grioli, Giorgio; Tsagarakis, Nikos

2017-01-01

Endowing tele-manipulation frameworks with the capability to accommodate a variety of robotic hands is key to achieving high performances through permitting to flexibly interchange the end-effector according to the task considered. This requires the development of control policies that not only cope with asymmetric master-slave systems but also whose high-level components are designed in a unified space in abstraction from the devices specifics. To address this dual challenge, a novel synergy port is developed that resolves the kinematic, sensing, and actuation asymmetries of the considered system through generating motion and force feedback references in the hardware-independent hand postural synergy space. It builds upon the concept of the Cartesian-based synergy matrix, which is introduced as a tool mapping the fingertips Cartesian space to the directions oriented along the grasp principal components. To assess the effectiveness of the proposed approach, the synergy port has been integrated into the control system of a highly asymmetric tele-manipulation framework, in which the 3-finger hand exoskeleton HEXOTRAC is used as a master device to control the SoftHand, a robotic hand whose transmission system relies on a single motor to drive all joints along a soft synergistic path. The platform is further enriched with the vision-based motion capture system Optitrack to monitor the 6D trajectory of the user's wrist, which is used to control the robotic arm on which the SoftHand is mounted. Experiments have been conducted with the humanoid robot COMAN and the KUKA LWR robotic manipulator. Results indicate that this bilateral interface is highly intuitive and allows users with no prior experience to reach, grasp, and transport a variety of objects exhibiting very different shapes and impedances. In addition, the hardware and control solutions proved capable of accommodating users with different hand kinematics. Finally, the proposed control framework offers a universal, flexible, and intuitive interface allowing for the performance of effective tele-manipulations.

Impact of a chronic disease self-management program on health care utilization in rural communities: a retrospective cohort study using linked administrative data.

PubMed

Jaglal, Susan B; Guilcher, Sara J T; Hawker, Gillian; Lou, Wendy; Salbach, Nancy M; Manno, Michael; Zwarenstein, Merrick

2014-05-01

Internationally, chronic disease self-management programs (CDSMPs) have been widely promoted with the assumption that confident, knowledgeable patients practicing self-management behavior will experience improved health and utilize fewer healthcare resources. However, there is a paucity of published data supporting this claim and the majority of the evidence is based on self-report. We used a retrospective cohort study using linked administrative health data. Data from 104 tele-CDSMP participants from 13 rural and remote communities in the province of Ontario, Canada were linked to administrative databases containing emergency department (ED) and physician visits and hospitalizations. Patterns of health care utilization prior to and after participation in the tele-CDSMP were compared. Poisson Generalized Estimating Equations regression was used to examine the impact of the tele-CDSMP on health care utilization after adjusting for covariates. There were no differences in patterns of health care utilization before and after participating in the tele-CDSMP. Among participants ≤ 66 years, however, there was a 34% increase in physician visits in the 12 months following the program (OR = 1.34, 95% CI 1.11-1.61) and a trend for decreased ED visits in those >66 years (OR = 0.59, 95% CI 0.33-1.06). This is the first study to examine health care use following participation in the CDSMP in a Canadian population and to use administrative data to measure health care utilization. Similar to other studies that used self-report measures to evaluate health care use we found no differences in health care utilization before and after participation in the CDSMP. Future research needs to confirm our findings and examine the impact of the CDSMP on health care utilization in different age groups to help to determine whether these interventions are more effective with select population groups.

Flexible kinematic earthquake rupture inversion of tele-seismic waveforms: Application to the 2013 Balochistan, Pakistan earthquake

NASA Astrophysics Data System (ADS)

Shimizu, K.; Yagi, Y.; Okuwaki, R.; Kasahara, A.

2017-12-01

The kinematic earthquake rupture models are useful to derive statistics and scaling properties of the large and great earthquakes. However, the kinematic rupture models for the same earthquake are often different from one another. Such sensitivity of the modeling prevents us to understand the statistics and scaling properties of the earthquakes. Yagi and Fukahata (2011) introduces the uncertainty of Green's function into the tele-seismic waveform inversion, and shows that the stable spatiotemporal distribution of slip-rate can be obtained by using an empirical Bayesian scheme. One of the unsolved problems in the inversion rises from the modeling error originated from an uncertainty of a fault-model setting. Green's function near the nodal plane of focal mechanism is known to be sensitive to the slight change of the assumed fault geometry, and thus the spatiotemporal distribution of slip-rate should be distorted by the modeling error originated from the uncertainty of the fault model. We propose a new method accounting for the complexity in the fault geometry by additionally solving the focal mechanism on each space knot. Since a solution of finite source inversion gets unstable with an increasing of flexibility of the model, we try to estimate a stable spatiotemporal distribution of focal mechanism in the framework of Yagi and Fukahata (2011). We applied the proposed method to the 52 tele-seismic P-waveforms of the 2013 Balochistan, Pakistan earthquake. The inverted-potency distribution shows unilateral rupture propagation toward southwest of the epicenter, and the spatial variation of the focal mechanisms shares the same pattern as the fault-curvature along the tectonic fabric. On the other hand, the broad pattern of rupture process, including the direction of rupture propagation, cannot be reproduced by an inversion analysis under the assumption that the faulting occurred on a single flat plane. These results show that the modeling error caused by simplifying the fault model is non-negligible in the tele-seismic waveform inversion of the 2013 Balochistan, Pakistan earthquake.

UAV-guided navigation for ground robot tele-operation in a military reconnaissance environment.

PubMed

Chen, Jessie Y C

2010-08-01

A military reconnaissance environment was simulated to examine the performance of ground robotics operators who were instructed to utilise streaming video from an unmanned aerial vehicle (UAV) to navigate his/her ground robot to the locations of the targets. The effects of participants' spatial ability on their performance and workload were also investigated. Results showed that participants' overall performance (speed and accuracy) was better when she/he had access to images from larger UAVs with fixed orientations, compared with other UAV conditions (baseline- no UAV, micro air vehicle and UAV with orbiting views). Participants experienced the highest workload when the UAV was orbiting. Those individuals with higher spatial ability performed significantly better and reported less workload than those with lower spatial ability. The results of the current study will further understanding of ground robot operators' target search performance based on streaming video from UAVs. The results will also facilitate the implementation of ground/air robots in military environments and will be useful to the future military system design and training community.

Automatic spacecraft detumbling by internal mass motion

NASA Technical Reports Server (NTRS)

Edwards, T. L.; Kaplan, M. H.

1974-01-01

In the operation of future manned space vehicles, there will always be a finite probability that an accident will occur which results in uncontrolled tumbling of a craft. Hard docking by a manned rescue vehicle is not acceptable because of the hazardous environment to which rescue crewmen would be exposed and excessive maneuvering accelerations during docking operations. A movable-mass control concept, which is activated upon initiation of tumbling and is autonomous, can convert tumbling motion into simple spin. The complete equations of motion for an asymmetric rigid spacecraft containing a movable mass are presented, and appropriate control law and system parameters are selected to minimize kinetic energy, resulting in simple spin about the major principal axis. Simulations indicate that for a large space station experiencing a collision, which results in tumbling, a 1% movable mass is capable of stabilizing motion in 2 hr.

Analysis of the correlative factors for velopharyngeal closure of patients with cleft palate after primary repair.

PubMed

Chen, Qi; Li, Yang; Shi, Bing; Yin, Heng; Zheng, Guang-Ning; Zheng, Qian

2013-12-01

The objective of this study was to analyze the correlative factors for velopharyngeal closure of patients with cleft palate after primary repair. Ninety-five nonsyndromic patients with cleft palate were enrolled. Two surgical techniques were applied in the patients: simple palatoplasty and combined palatoplasty with pharyngoplasty. All patients were assessed 6 months after the operation. The postoperative velopharyngeal closure (VPC) rate was compared by χ(2) test and the correlative factors were analyzed with logistic regression model. The postoperative VPC rate of young patients was higher than that of old patients, the group with incomplete cleft palate was higher than the group with complete cleft palate, and combined palatoplasty with pharyngoplasty was higher than simple palatoplasty. Operative age, cleft type, and surgical technique were the contributing factors for postoperative VPC rate. Operative age, cleft type, and surgical technique were significant factors influencing postoperative VPC rate of patients with cleft palate. Copyright © 2013 Elsevier Inc. All rights reserved.

Starbase Data Tables: An ASCII Relational Database for Unix

NASA Astrophysics Data System (ADS)

Roll, John

2011-11-01

Database management is an increasingly important part of astronomical data analysis. Astronomers need easy and convenient ways of storing, editing, filtering, and retrieving data about data. Commercial databases do not provide good solutions for many of the everyday and informal types of database access astronomers need. The Starbase database system with simple data file formatting rules and command line data operators has been created to answer this need. The system includes a complete set of relational and set operators, fast search/index and sorting operators, and many formatting and I/O operators. Special features are included to enhance the usefulness of the database when manipulating astronomical data. The software runs under UNIX, MSDOS and IRAF.

Intramedullary reduction and stabilisation of adult radial neck fractures.

PubMed

Keller, H W; Rehm, K E; Helling, J

1994-05-01

We report the treatment of six adult patients with displaced fractures of the radial neck by intramedullary reduction and stabilisation. Nine months after operation all the patients had good joint function, little or no pain, complete healing and no significant periarticular calcification. This simple semi-closed procedure may help to avoid resection of the radial head in some cases.

Ada Compiler Validation Summary Report: Certificate Number: 911028I1. 11229 Telesoft, Telegen2, Ada Development System, for VAX to 1750, Version 3.25, MicroVAX 3800 under VAX/VMS Version V5.4 (Host) to MIL-STD-1750A ECSPO ITS RAID Simulator, Version 6.0 (Target)

DTIC Science & Technology

1991-10-28

included as appropriate. 2-1 IMPLEMENTATION DEPENDENCIES The following 185 tests have floating-point type declarations requiring more digits than...SYSTEM.MAX DIGITS : C24113F..Y (20 tests) C? 705F..Y (20 tests) C35706F..Y (20 tests) C35707F..Y (20 tests) C35708F..Y (20 tests) C35802F..Z (21 tests...trademark of Teleoft. TeleGen2m is a trademark of TeleSofL VAX and VMS! are registered trademarks of Digital Equipment Corp. RESTRICTED RIGHTS LEGEND Use

The role of health information technology on critical care services in Thailand.

PubMed

Wacharasint, Petch

2014-01-01

Health information technology (IT) has become an important part of current medical practice, especially in critical care services. One significant advance is the use of telemedicine which was initiated in Thailand nearly two decades ago. Telemedicine is also used in the intensive care unit or what has been termed the "Tele-ICU". It has evolved as an alternate paradigm linking the intensivist and critical care specialists to critically ill patients in remote areas. In this article, the author has reviewed the evidence of health IT on critical care services in Thailand, focusing on telemedicine, as well as the concept of the 'Tele-ICU' and its challenges. These factors may assist intensivists to reach more critically ill patients in remote areas.

Incorporating teledermatology into emergency medicine.

PubMed

Muir, Jim; Xu, Cathy; Paul, Sanjoy; Staib, Andrew; McNeill, Iain; Singh, Philip; Davidson, Samantha; Soyer, H Peter; Sinnott, Michael

2011-10-01

The aim of the present study was to investigate the feasibility of using a store-and-forward Skin Emergency Telemedicine Service (SETS) to provide rapid specialist diagnostic and management advice for dermatological cases in an ED. This pilot study was conducted at the Princess Alexandra Hospital between August 2008 and August 2009. Study subjects were consenting patients over 18 years of age who presented with a dermatological condition to the ED. The ED doctor sent the patient's history, examination findings and the digital images of the skin conditions to a secure email address, which automatically forwarded this to the teledermatologist. The teledermatologist reviewed the cases and sent advice on diagnosis and management to the referring ED doctor via email and/or telephone. Face-to-face follow-up consultations with the patients were conducted within 2 weeks. The diagnostic and management concordance between ED doctors, teledermatologists and reviewing dermatologists were analysed. A total of 60 patients participated in the present study. SETS provided a rapid response with 56 (93%) of ED consultations receiving a dermatology opinion within 2 h. Face-to-face follow up occurred in 50 patients (83%). Statistical analysis showed significant levels of agreement between tele-diagnosis and ED diagnosis of 71.2% (Kappa 0.42) and tele-diagnosis and final clinical diagnosis of 98% (Kappa: 0.93). The clinical management concordance was 96% in complete agreement and 4% in relative agreement between the teledermatologists and reviewing dermatologists, based on chart review. The present study has shown that SETS can provide rapid and accurate diagnostic and treatment advice from a specialist for dermatological presentations to the ED. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

An overview and process evaluation of TeleWalk: a telephone-based counseling intervention to encourage walking in older adults.

PubMed

Kolt, Gregory S; Oliver, Melody; Schofield, Grant M; Kerse, Ngaire; Garrett, Nick; Latham, Nancy K

2006-09-01

Despite the benefits associated with a physically active lifestyle, many older adults are insufficiently active to achieve health gain, and also exhibit decreased activity levels with age. Insufficient physical activity in this population is associated with increased morbidity, mortality and demand on health care services and expenditure. There is a clear need for effective intervention to encourage physical activity in older adults. The aim of this paper is to describe the development and participant evaluation of a randomized controlled trial of TeleWalk, a telephone-based motivational counseling intervention to encourage physical activity in adults aged 65 years and older. Participants (N = 186, mean age 74 +/- 6 years) were recruited through their General Practitioner (primary care physician) and randomized to either receive eight telephone counseling sessions and related printed materials over 3 months (intervention group) or participate in outcome assessments only (control group). Intervention group participants were mailed an anonymous evaluation questionnaire on intervention completion. A high response rate was achieved (70%). All respondents (100%) agreed or strongly agreed that a good overall level of service and support was provided, and that the counselor was understanding and supportive. Nearly all respondents agreed or strongly agreed that the service was professional, the counselor advice was helpful and motivating and the information provided was relevant (97, 95 and 89%, respectively). Most (87%) agreed or strongly agreed that the telephone calls encouraged them to be physically active. Among the participants who received printed material, most agreed or strongly agreed that these encouraged them to become or remain active. Findings from this evaluation can be used to inform such interventions and ensure their relevance to community-dwelling older adults.

DreamTel; Diabetes risk evaluation and management tele-monitoring study protocol

PubMed Central

Tobe, Sheldon W; Wentworth, Joan; Ironstand, Laurie; Hartman, Susan; Hoppe, Jackie; Whiting, Judi; Kennedy, Janice; McAllister, Colin; Kiss, Alex; Perkins, Nancy; Vincent, Lloyd; Pylypchuk, George; Lewanczuk, Richard Z

2009-01-01

Background The rising prevalence of type 2 diabetes underlines the importance of secondary strategies for the prevention of target organ damage. While access to diabetes education centers and diabetes intensification management has been shown to improve blood glucose control, these services are not available to all that require them, particularly in rural and northern areas. The provision of these services through the Home Care team is an advance that can overcome these barriers. Transfer of blood glucose data electronically from the home to the health care provider may improve diabetes management. Methods and design The study population will consist of patients with type 2 diabetes with uncontrolled A1c levels living on reserve in the Battlefords region of Saskatchewan, Canada. This pilot study will take place over three phases. In the first phase over three months the impact of the introduction of the Bluetooth enabled glucose monitor will be assessed. In the second phase over three months, the development of guidelines based treatment algorithms for diabetes intensification will be completed. In the third phase lasting 18 months, study subjects will have diabetes intensification according to the algorithms developed. Discussion The first phase will determine if the use of the Bluetooth enabled blood glucose devices which can transmit results electronically will lead to changes in A1c levels. It will also determine the feasibility of recruiting subjects to use this technology. The rest of the Diabetes Risk Evaluation and Management Tele-monitoring (DreamTel) study will determine if the delivery of a diabetes intensification management program by the Home Care team supported by the Bluetooth enabled glucose meters leads to improvements in diabetes management. Trial Registration Protocol NCT00325624 PMID:19426530

DreamTel; Diabetes risk evaluation and management tele-monitoring study protocol.

PubMed

Tobe, Sheldon W; Wentworth, Joan; Ironstand, Laurie; Hartman, Susan; Hoppe, Jackie; Whiting, Judi; Kennedy, Janice; McAllister, Colin; Kiss, Alex; Perkins, Nancy; Vincent, Lloyd; Pylypchuk, George; Lewanczuk, Richard Z

2009-05-09

The rising prevalence of type 2 diabetes underlines the importance of secondary strategies for the prevention of target organ damage. While access to diabetes education centers and diabetes intensification management has been shown to improve blood glucose control, these services are not available to all that require them, particularly in rural and northern areas. The provision of these services through the Home Care team is an advance that can overcome these barriers. Transfer of blood glucose data electronically from the home to the health care provider may improve diabetes management. The study population will consist of patients with type 2 diabetes with uncontrolled A1c levels living on reserve in the Battlefords region of Saskatchewan, Canada. This pilot study will take place over three phases. In the first phase over three months the impact of the introduction of the Bluetooth enabled glucose monitor will be assessed. In the second phase over three months, the development of guidelines based treatment algorithms for diabetes intensification will be completed. In the third phase lasting 18 months, study subjects will have diabetes intensification according to the algorithms developed. The first phase will determine if the use of the Bluetooth enabled blood glucose devices which can transmit results electronically will lead to changes in A1c levels. It will also determine the feasibility of recruiting subjects to use this technology. The rest of the Diabetes Risk Evaluation and Management Tele-monitoring (DreamTel) study will determine if the delivery of a diabetes intensification management program by the Home Care team supported by the Bluetooth enabled glucose meters leads to improvements in diabetes management. Protocol NCT00325624.

Invariant measure of the one-loop quantum gravitational backreaction on inflation

NASA Astrophysics Data System (ADS)

Miao, S. P.; Tsamis, N. C.; Woodard, R. P.

2017-06-01

We use dimensional regularization in pure quantum gravity on a de Sitter background to evaluate the one-loop expectation value of an invariant operator which gives the local expansion rate. We show that the renormalization of this nonlocal composite operator can be accomplished using the counterterms of a simple local theory of gravity plus matter, at least at one-loop order. This renormalization completely absorbs the one-loop correction, which accords with the prediction that the lowest secular backreaction should be a two-loop effect.

The Neutralization of Ion-Rocket Beams

NASA Technical Reports Server (NTRS)

Kaufman, Harold R.

1961-01-01

The experimental ion-beam behavior obtained without neutralizers is compared with both simple collision theory and plasma-wave theory. This comparison indicates that plasma waves play an important part in beam behavior, although the present state of plasma-wave theory does not permit more than a qualitative comparison. The theories of immersed-emitter and electron-trap neutralizer operation are discussed; and, to the extent permitted by experimental data, the theory is compared with experimental results. Experimental data are lacking completely at the present time for operation in space. The results that might be expected in space and the means of simulating such operation in Earth-bound facilities, however, are discussed.

Towards Autonomous Inspection of Space Systems Using Mobile Robotic Sensor Platforms

NASA Technical Reports Server (NTRS)

Wong, Edmond; Saad, Ashraf; Litt, Jonathan S.

2007-01-01

The space transportation systems required to support NASA's Exploration Initiative will demand a high degree of reliability to ensure mission success. This reliability can be realized through autonomous fault/damage detection and repair capabilities. It is crucial that such capabilities are incorporated into these systems since it will be impractical to rely upon Extra-Vehicular Activity (EVA), visual inspection or tele-operation due to the costly, labor-intensive and time-consuming nature of these methods. One approach to achieving this capability is through the use of an autonomous inspection system comprised of miniature mobile sensor platforms that will cooperatively perform high confidence inspection of space vehicles and habitats. This paper will discuss the efforts to develop a small scale demonstration test-bed to investigate the feasibility of using autonomous mobile sensor platforms to perform inspection operations. Progress will be discussed in technology areas including: the hardware implementation and demonstration of robotic sensor platforms, the implementation of a hardware test-bed facility, and the investigation of collaborative control algorithms.

Robotics in cardiac surgery: the Istanbul experience.

PubMed

Sagbas, Ertan; Akpinar, Belhhan; Sanisoglu, Ilhan; Caynak, Baris; Guden, Mustafa; Ozbek, Ugur; Bayramoglu, Zehra; Bayindir, Osman

2006-06-01

Robots are sensor-based tools capable of performing precise, accurate and versatile actions. Initially designed to spare humans from risky tasks, robots have progressed into revolutionary tools for surgeons. Tele-operated robots, such as the da Vinci (Intuitive Surgical, Mountain View, CA), have allowed cardiac procedures to start benefiting from robotics as an enhancement to traditional minimally invasive surgery. The aim of this text was to discuss our experience with the da Vinci system during a 12 month period in which 61 cardiac patients were operated on. There were 59 coronary bypass patients (CABG) and two atrial septal defect (ASD) closures. Two patients (3.3%) had to be converted to median sternotomy because of pleural adhesions. There were no procedure- or device-related complications. Our experience suggests that robotics can be integrated into routine cardiac surgical practice. Systematic training, team dedication and proper patient selection are important factors that determine the success of a robotic surgery programme. Copyright 2006 John Wiley & Sons, Ltd.

Design and Calibration of a New 6 DOF Haptic Device

PubMed Central

Qin, Huanhuan; Song, Aiguo; Liu, Yuqing; Jiang, Guohua; Zhou, Bohe

2015-01-01

For many applications such as tele-operational robots and interactions with virtual environments, it is better to have performance with force feedback than without. Haptic devices are force reflecting interfaces. They can also track human hand positions simultaneously. A new 6 DOF (degree-of-freedom) haptic device was designed and calibrated in this study. It mainly contains a double parallel linkage, a rhombus linkage, a rotating mechanical structure and a grasping interface. Benefited from the unique design, it is a hybrid structure device with a large workspace and high output capability. Therefore, it is capable of multi-finger interactions. Moreover, with an adjustable base, operators can change different postures without interrupting haptic tasks. To investigate the performance regarding position tracking accuracy and static output forces, we conducted experiments on a three-dimensional electric sliding platform and a digital force gauge, respectively. Displacement errors and force errors are calculated and analyzed. To identify the capability and potential of the device, four application examples were programmed. PMID:26690449

TelePain: Primary Care Chronic Pain Management through Weekly Didactic and Case-based Telementoring.

PubMed

Flynn, Diane M; Eaton, Linda H; McQuinn, Honor; Alden, Ashley; Meins, Alexa R; Rue, Tessa; Tauben, David J; Doorenbos, Ardith Z

2017-12-01

Chronic pain is a significant problem among military personnel and a priority of the military health system. The U.S. Army Surgeon General's Pain Management Task Force recommends using telehealth capabilities to enhance pain management. This article describes the development and evaluation of a telehealth intervention (TelePain) designed to improve access to pain specialist consultation in the military health system. The study uses a wait-list controlled clinical trial to test: 1) effectiveness of the intervention, and 2) interviews to assess barriers and facilitators of the intervention implementation. The intervention involves a didactic presentation based on the Joint Pain Education Curriculum followed by patient case presentations and multi-disciplinary discussion via videoconference by clinicians working in the military health system. A panel of pain specialists representing pain medicine, internal medicine, anesthesiology, rehabilitation medicine, psychiatry, addiction medicine, health psychology, pharmacology, nursing, and complementary and integrative pain management provide pain management recommendations for each patient case. We use the Pain Assessment Screening Tool and Outcomes Registry (PASTOR) to measure patient outcomes, including pain, sleep, fatigue, anxiety, and depression. This article reports some of the challenges and lessons learned during early implementation of the TelePain intervention. Weekly telephone meetings among the multisite research team were instrumental in problem solving, identifying problem areas, and developing solutions. Solutions for recruitment challenges included additional outreach and networking to military health providers, both building on.

[Implementation of a community tele-epidemiological surveillance system using information and communication technologies in Paraguay].

PubMed

Galván, Pedro; Cane, Virgilio; Samudio, Margarita; Cabello, Agueda; Cabral, Margarita; Basogain, Xavier; Rivas, Ronald; Hilario, Enrique

2014-01-01

Report preliminary results of the application of the BONIS system in community tele-epidemiological surveillance in Paraguay. A study of viability and implementation carried out in the Family Health Unit located in Bañado Sur in the city of Asunción by the Paraguay River. The system automatically records personal data and symptoms of individuals who make telephone reports, and suspected cases of dengue are classified and prioritized. This information goes to community agents for follow-up and to specialists in charge of epidemiological surveillance. From April 2010 to August 2011, 1 028 calls to the system were logged. Of 157 reported cases of fever, home visits were made to 140 (89.2%); of these, fever and headache or body ache were confirmed in 52 (37.1%) cases, and headache or body ache without fever in 58 (41.4%) cases. Community agents referred 49 (35.0%) of them for medical consultation and blood tests, and they took blood samples in the homes of 19; of these, 56 (82.3%) were positive for dengue and 12 (17.4%) for influenza. Paraguay has a low-cost community tele-epidemiological surveillance system based on information and communication technologies and open-source software, which is scalable to other health symptoms and disorders of interest. To enable its acceptance and application, education programs should be developed to strengthen the management and promotion of community health.

Globalization and pollution: tele-connecting local primary PM2.5 emissions to global consumption.

PubMed

Meng, Jing; Liu, Junfeng; Xu, Yuan; Guan, Dabo; Liu, Zhu; Huang, Ye; Tao, Shu

2016-11-01

Globalization pushes production and consumption to geographically diverse locations and generates a variety of sizeable opportunities and challenges. The distribution and associated effects of short-lived primary fine particulate matter (PM 2.5 ), a representative of local pollution, are significantly affected by the consumption through global supply chain. Tele-connection is used here to represent the link between production and consumption activity at large distances. In this study, we develop a global consumption-based primary PM 2.5 emission inventory to track primary PM 2.5 emissions embodied in the supply chain and evaluate the extent to which local PM 2.5 emissions are triggered by international trade. We further adopt consumption-based accounting and identify the global original source that produced the emissions. We find that anthropogenic PM 2.5 emissions from industrial sectors accounted for 24 Tg globally in 2007; approximately 30% (7.2 Tg) of these emissions were embodied in export of products principally from Brazil, South Africa, India and China (3.8 Tg) to developed countries. Large differences (up to 10 times) in the embodied emissions intensity between net importers and exporters greatly increased total global PM 2.5 emissions. Tele-connecting production and consumption activity provides valuable insights with respect to mitigating long-range transboundary air pollution and prompts concerted efforts aiming at more environmentally conscious globalization.

Globalization and pollution: tele-connecting local primary PM2.5 emissions to global consumption

NASA Astrophysics Data System (ADS)

Meng, Jing; Liu, Junfeng; Xu, Yuan; Guan, Dabo; Liu, Zhu; Huang, Ye; Tao, Shu

2016-11-01

Globalization pushes production and consumption to geographically diverse locations and generates a variety of sizeable opportunities and challenges. The distribution and associated effects of short-lived primary fine particulate matter (PM2.5), a representative of local pollution, are significantly affected by the consumption through global supply chain. Tele-connection is used here to represent the link between production and consumption activity at large distances. In this study, we develop a global consumption-based primary PM2.5 emission inventory to track primary PM2.5 emissions embodied in the supply chain and evaluate the extent to which local PM2.5 emissions are triggered by international trade. We further adopt consumption-based accounting and identify the global original source that produced the emissions. We find that anthropogenic PM2.5 emissions from industrial sectors accounted for 24 Tg globally in 2007; approximately 30% (7.2 Tg) of these emissions were embodied in export of products principally from Brazil, South Africa, India and China (3.8 Tg) to developed countries. Large differences (up to 10 times) in the embodied emissions intensity between net importers and exporters greatly increased total global PM2.5 emissions. Tele-connecting production and consumption activity provides valuable insights with respect to mitigating long-range transboundary air pollution and prompts concerted efforts aiming at more environmentally conscious globalization.

Imperceptible watermarking for security of fundus images in tele-ophthalmology applications and computer-aided diagnosis of retina diseases.

PubMed

Singh, Anushikha; Dutta, Malay Kishore

2017-12-01

The authentication and integrity verification of medical images is a critical and growing issue for patients in e-health services. Accurate identification of medical images and patient verification is an essential requirement to prevent error in medical diagnosis. The proposed work presents an imperceptible watermarking system to address the security issue of medical fundus images for tele-ophthalmology applications and computer aided automated diagnosis of retinal diseases. In the proposed work, patient identity is embedded in fundus image in singular value decomposition domain with adaptive quantization parameter to maintain perceptual transparency for variety of fundus images like healthy fundus or disease affected image. In the proposed method insertion of watermark in fundus image does not affect the automatic image processing diagnosis of retinal objects & pathologies which ensure uncompromised computer-based diagnosis associated with fundus image. Patient ID is correctly recovered from watermarked fundus image for integrity verification of fundus image at the diagnosis centre. The proposed watermarking system is tested in a comprehensive database of fundus images and results are convincing. results indicate that proposed watermarking method is imperceptible and it does not affect computer vision based automated diagnosis of retinal diseases. Correct recovery of patient ID from watermarked fundus image makes the proposed watermarking system applicable for authentication of fundus images for computer aided diagnosis and Tele-ophthalmology applications. Copyright © 2017 Elsevier B.V. All rights reserved.

Globalization and pollution: tele-connecting local primary PM2.5 emissions to global consumption

PubMed Central

Meng, Jing; Xu, Yuan; Guan, Dabo; Liu, Zhu; Huang, Ye; Tao, Shu

2016-01-01

Globalization pushes production and consumption to geographically diverse locations and generates a variety of sizeable opportunities and challenges. The distribution and associated effects of short-lived primary fine particulate matter (PM2.5), a representative of local pollution, are significantly affected by the consumption through global supply chain. Tele-connection is used here to represent the link between production and consumption activity at large distances. In this study, we develop a global consumption-based primary PM2.5 emission inventory to track primary PM2.5 emissions embodied in the supply chain and evaluate the extent to which local PM2.5 emissions are triggered by international trade. We further adopt consumption-based accounting and identify the global original source that produced the emissions. We find that anthropogenic PM2.5 emissions from industrial sectors accounted for 24 Tg globally in 2007; approximately 30% (7.2 Tg) of these emissions were embodied in export of products principally from Brazil, South Africa, India and China (3.8 Tg) to developed countries. Large differences (up to 10 times) in the embodied emissions intensity between net importers and exporters greatly increased total global PM2.5 emissions. Tele-connecting production and consumption activity provides valuable insights with respect to mitigating long-range transboundary air pollution and prompts concerted efforts aiming at more environmentally conscious globalization. PMID:27956874

The Future Training Room.

ERIC Educational Resources Information Center

Barbian, Jeff

2001-01-01

Looks at some of the electronic learning technology that has already been developed and will become common for training, including robots, lucid dreaming, tele-immersion, human interface technology, among others. (JOW)

Project Air Force, Annual Report 2003

DTIC Science & Technology

2003-01-01

to Simulate Personnel Retention The CAPM system is based on a simple assumption about employee retention: A rational individual faced with the...analysis to certain parts of the force. CAPM keeps a complete record of the assumptions , policies, and data used for each scenario. Thus decisionmakers...premises and assumptions . Instead, the Commission concluded that space is a separate oper- ating arena equivalent to the air, land, and maritime

NASA's Robotics Mining Competition Provides Undergraduates Full Life Cycle Systems Engineering Experience

NASA Technical Reports Server (NTRS)

Stecklein, Jonette

2017-01-01

NASA has held an annual robotic mining competition for teams of university/college students since 2010. This competition is yearlong, suitable for a senior university engineering capstone project. It encompasses the full project life cycle from ideation of a robot design to actual tele-operation of the robot in simulated Mars conditions mining and collecting simulated regolith. A major required element for this competition is a Systems Engineering Paper in which each team describes the systems engineering approaches used on their project. The score for the Systems Engineering Paper contributes 25% towards the team's score for the competition's grand prize. The required use of systems engineering on the project by this competition introduces the students to an intense practical application of systems engineering throughout a full project life cycle.

Optimisation Issues of High Throughput Medical Data and Video Streaming Traffic in 3G Wireless Environments.

PubMed

Istepanian, R S H; Philip, N

2005-01-01

In this paper we describe some of the optimisation issues relevant to the requirements of high throughput of medical data and video streaming traffic in 3G wireless environments. In particular we present a challenging 3G mobile health care application that requires a demanding 3G medical data throughput. We also describe the 3G QoS requirement of mObile Tele-Echography ultra-Light rObot system (OTELO that is designed to provide seamless 3G connectivity for real-time ultrasound medical video streams and diagnosis from a remote site (robotic and patient station) manipulated by an expert side (specialists) that is controlling the robotic scanning operation and presenting a real-time feedback diagnosis using 3G wireless communication links.

TIDE: an intelligent home-based healthcare information & diagnostic environment.

PubMed

Abidi, S S

1999-01-01

The 21st century promises to usher in an era of Internet based healthcare services--Tele-Healthcare. Such services augur well with the on-going paradigm shift in healthcare delivery patterns, i.e. patient centred services as opposed to provider centred services and wellness maintenance as opposed to illness management. This paper presents a Tele-Healthcare info-structure TIDE--an 'intelligent' wellness-oriented healthcare delivery environment. TIDE incorporates two WWW-based healthcare systems: (1) AIMS (Automated Health Monitoring System) for wellness maintenance and (2) IDEAS (Illness Diagnostic & Advisory System) for illness management. Our proposal comes from an attempt to rethink the sources of possible leverage in improving healthcare; vis-à-vis the provision of a continuum of personalised home-based healthcare services that emphasise the role of the individual in self health maintenance.

E-learning for laurea in biomedical laboratory technicians: presentation of a pilote study.

PubMed

Giansanti, D; Castrichella, L; Giovagnoli, M R

2007-01-01

The aim of the paper is to afford the design and construction of an e-learning model answering to these requirements for the LHCP in Technician of Biomedical Laboratory. The SCENARIO of work for the technician in biomedical laboratory (TBL) is radically changed and e-learning should answer to these new challenges. In particular today He or She should be able to mange in tele-pathology applications the tissue on the so called virtual glass. An architecture for the e-learning based on Web-Dav and a Light software for the virtual glass tele-pathology consultation has been designed with also a special care for the teachers' and students' platforms. At the moment we are investigating Telepathology platforms for the extranet consulting of virtual glasses.

Hydralazine is involved in tele-methylhistamine metabolism by inhibiting monoamine oxidase B in pregnancy-associated hypertensive mice.

PubMed

Kawasaki, Shohei; Kako, Koichiro; Nagashima, Yusuke; Kanou, Akihiko; Ishida, Junji; Fukamizu, Akiyoshi

2017-02-01

Hypertensive disorders of pregnancy globally affect 6-8% of gestation and remain a major cause of both foetal and maternal morbidity and mortality. However, the antihypertensive medications for the patients of this disease are strictly limited due to the teratogenic potentials. Here, we found that tele-methylhistamine (tMH) increased in response to the administration of hydralazine (Hdz), a vasodilative agent, in the pregnancy-associated hypertensive (PAH) mice. Hdz abrogated the degradation of tMH catalyzed by monoamine oxidase B (MAO-B) in vitro. These results suggested that Hdz inhibited the MAO-B activity and consequently tMH increased in the maternal circulation of PAH mice. © The Authors 2016. Published by Oxford University Press on behalf of the Japanese Biochemical Society. All rights reserved.

Finite Time Control Design for Bilateral Teleoperation System With Position Synchronization Error Constrained.

PubMed

Yang, Yana; Hua, Changchun; Guan, Xinping

2016-03-01

Due to the cognitive limitations of the human operator and lack of complete information about the remote environment, the work performance of such teleoperation systems cannot be guaranteed in most cases. However, some practical tasks conducted by the teleoperation system require high performances, such as tele-surgery needs satisfactory high speed and more precision control results to guarantee patient' health status. To obtain some satisfactory performances, the error constrained control is employed by applying the barrier Lyapunov function (BLF). With the constrained synchronization errors, some high performances, such as, high convergence speed, small overshoot, and an arbitrarily predefined small residual constrained synchronization error can be achieved simultaneously. Nevertheless, like many classical control schemes only the asymptotic/exponential convergence, i.e., the synchronization errors converge to zero as time goes infinity can be achieved with the error constrained control. It is clear that finite time convergence is more desirable. To obtain a finite-time synchronization performance, the terminal sliding mode (TSM)-based finite time control method is developed for teleoperation system with position error constrained in this paper. First, a new nonsingular fast terminal sliding mode (NFTSM) surface with new transformed synchronization errors is proposed. Second, adaptive neural network system is applied for dealing with the system uncertainties and the external disturbances. Third, the BLF is applied to prove the stability and the nonviolation of the synchronization errors constraints. Finally, some comparisons are conducted in simulation and experiment results are also presented to show the effectiveness of the proposed method.

Normal Cerebrospinal Fluid Histamine and tele-Methylhistamine Levels in Hypersomnia Conditions

PubMed Central

Dauvilliers, Yves; Delallée, Nathalie; Jaussent, Isabelle; Scholz, Sabine; Bayard, Sophie; Croyal, Mickael; Schwartz, Jean-Charles; Robert, Philippe

2012-01-01

Study Objectives: To determine the activity of cerebral histaminergic system evaluated by CSF levels of histamine (HA) and tele-methylhistamine (t-MHA), its major metabolite, and their relationships with hypocretin-1 levels in a large population of patients with hypersomnia and neurological conditions. Design: sensitive liquid chromatographic-electrospray/tandem mass spectrometric assay was developed for the simultaneous quantification of CSF HA and t-MHA. Setting: ata were collected and CSF hypocretin-1 levels were measured using radioimmunoassay at the Sleep Disorders Center, Montpellier, France. CSF HA and t-MHA were measured in Bioprojet-Biotech, France Participants: One hundred fourteen unrelated patients with a suspicion of central hypersomnia underwent one night of polysomnography followed by the multiple sleep latency test. Sleep disorders were diagnosed clinically and using sleep studies: narcolepsy-cataplexy NC (n = 56), narcolepsy without cataplexy NwC (n = 27), idiopathic hypersomnia IH (n = 11), secondary narcolepsy (n = 3), and unspecified hypersomnia Uns EDS (n = 17). Fifty neurological patients without daytime sleepiness were included as controls. Measurements and Results: No between-hypersomnia group differences were found for CSF HA levels (median 708.62 pM extreme range [55.92-3335.50] in NC; 781.34 [174.08-4391.50] in NwC; 489.42 [177.45-906.70] in IH, and 1155.40 [134.80-2736.59] in Uns EDS) or for t-MHA levels. No association was found between CSF HA, t-MHA, or HA + t-MHA, sleepiness, treatment intake, and frequency of cataplexy. A slight negative correlation was found between age and HA levels. Further adjustment for the age revealed no significant HA levels difference between hypersomnia patients and controls. Conclusion: CSF histamine and tele-methylhistamine did not significantly differ between patients with narcolepsy-cataplexy and other etiologies of non-hypocretin-1 deficient central hypersomnias; these measurements, therefore, are not useful in assessing the etiology or severity of centrally mediated hypersomnia. Citation: Dauvilliers Y; Delalléee N; Jaussent I; Scholz S; Bayard S; Croyal M; Schwartz JC; Robert P. Normal cerebrospinal fluid histamine and tele-methylhistamine levels in hypersomnia conditions. SLEEP 2012;35(10):1359-1366. PMID:23024434

Classification of three-particle states according to an orthonormal SU(3) ⊃ SO(3) basis

NASA Astrophysics Data System (ADS)

del Aguila, F.

1980-09-01

In this paper we generalize Dragt's approach to classifying three-particle states. Using his formalism of creation and annihilation operators, we obtain explicitly a complete set of orthonormal functions YλμRLM on S5. This set of functions carries all the irreducible representations of the group SU(3) reduced according to SO(3). The YλμRLM, which are eigenvectors of the togetherness and angular momentum operators, have very simple properties under three-particle permutations. We obtain also explicitly the coefficients ''3ν'' which reduce the products of these functions.

Lessons Learned from Pit Viper System Deployment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Catalan, Michael A.; Alzheimer, James M.; Valdez, Patrick LJ

2002-04-11

Tele-operated and robotic systems operated in unstructured field environments pose unique challenges for tool design. Since field tasks are not always well defined and the robot work area usually cannot be designed for ease of operation, the tools must be versatile. It's important to carefully consider the orientation of the grip the robot takes on the tool, as it's not easily changed in the field. The stiffness of the robot and the possibility of robot positioning errors encourages the use of non-contact or minimal-contact tooling. While normal hand tools can usually be modified for use by the robot, this ismore » not always the most effective approach. It's desirable to have tooling that is relatively independent of the robot; in this case, the robot places the tool near the desired work location and the tool performs its task relatively independently. Here we consider the adaptation of a number of tools for cleanup of a radioactively contaminated piping junction and valve pit. The tasks to be considered are debris removal (small nuts and bolts and pipe up to 100 mm in diameter), size reduction, surface cleaning, and support of past practice crane-based methods for working in the pits.« less

Photovoltaic Power System and Power Distribution Demonstration for the Desert RATS Program

NASA Technical Reports Server (NTRS)

Colozza, Anthony; Jakupca, Ian; Mintz, Toby; Herlacher, Mike; Hussey, Sam

2012-01-01

A stand alone, mobile photovoltaic power system along with a cable deployment system was designed and constructed to take part in the Desert Research And Technology Studies (RATS) lunar surface human interaction evaluation program at Cinder Lake, Arizona. The power system consisted of a photovoltaic array/battery system. It is capable of providing 1 kW of electrical power. The system outputs were 48 V DC, 110 V AC, and 220 V AC. A cable reel with 200 m of power cable was used to provide power from the trailer to a remote location. The cable reel was installed on a small trailer. The reel was powered to provide low to no tension deployment of the cable. The cable was connected to the 220 V AC output of the power system trailer. The power was then converted back to 110 V AC on the cable deployment trailer for use at the remote site. The Scout lunar rover demonstration vehicle was used to tow the cable trailer and deploy the power cable. This deployment was performed under a number of operational scenarios, manned operation, remote operation and tele-robotically. Once deployed, the cable was used to provide power, from the power system trailer, to run various operational tasks at the remote location.

ERC TeleSeminars

Science.gov Websites

guests. These e-Workshops will be presented by ERC PIs, graduate students, post doctoral candidates, and during Summer 2017. We will post a new schedule once determined. Thank you all for your continued

Ada Compiler Validation Summary Report: Certificate Number: 890409W1. 10063, TeleSoft, TeleGen2 Ada Development System for VAX to E68K, Version 3.23, VAXserver 3602 Host and Motorola MVME117 (MC68010) Target

DTIC Science & Technology

1989-04-09

01hc ’i.’ f’Pf a- ebc 2i1o.-fer-er~hfom Repo.) tUEFCTE $UP1 * ta ~ (Con’rj 01’?Cre V Pot s’o fneccksa’) ortoiorM’f, by blDc n fumYber) Ada Prcr-7n...CLA53SIF1CA1,O0s or IMIS PA ,j (AhnDetsinfree1 AVF Control Number: AVF-VSP-267.0539 69-01-25-TEL Ada COMPILER VALIDATION SUMMARY REPORT: Certificate Number...pragma images controls the creation and allocation of the image table for a specified enumeration type. The default is Deferred, which saves space in the

Tele-yoga for Chronic Pain: Current Status and Future Directions.

PubMed

Mathersul, Danielle C; Mahoney, Louise A; Bayley, Peter J

2018-01-01

Pain is a pervasive, debilitating disorder that is resistant to long-term pharmacological interventions. Although psychological therapies such as cognitive behavior therapy demonstrate moderate efficacy, many individuals continue to have ongoing difficulties following treatment. There is a current trend to establish complementary and integrative health interventions for chronic pain, for which yoga has been found to have exciting potential. Nevertheless, an important consideration within the field is accessibility to adequate care. Telehealth can be used to provide real-time interactive video conferencing leading to increased access to health care for individuals located remotely or who otherwise have difficulty accessing services, perhaps through issues of mobility or proximity of adequate services. This article assesses the current status and feasibility of implementing tele-yoga for chronic pain. Methodological limitations and recommendations for future research are discussed.

Tele-yoga for Chronic Pain: Current Status and Future Directions

PubMed Central

Mahoney, Louise A; Bayley, Peter J

2018-01-01

Pain is a pervasive, debilitating disorder that is resistant to long-term pharmacological interventions. Although psychological therapies such as cognitive behavior therapy demonstrate moderate efficacy, many individuals continue to have ongoing difficulties following treatment. There is a current trend to establish complementary and integrative health interventions for chronic pain, for which yoga has been found to have exciting potential. Nevertheless, an important consideration within the field is accessibility to adequate care. Telehealth can be used to provide real-time interactive video conferencing leading to increased access to health care for individuals located remotely or who otherwise have difficulty accessing services, perhaps through issues of mobility or proximity of adequate services. This article assesses the current status and feasibility of implementing tele-yoga for chronic pain. Methodological limitations and recommendations for future research are discussed. PMID:29637012

Online resources in pediatric surgery: the new era of medical information.

PubMed

Raigani, Siavash; Numanoglu, Alp; Schwachter, Marc; Ponsky, Todd A

2014-08-01

Tele-education has the potential to facilitate rapid sharing and dissemination of current research and knowledge among pediatric surgeons around the world. Classically, the exchange of surgical research occurred via national surgical conferences, articles published in peer-reviewed journals, and textbooks. The advent of Web 2.0 and the rapid pace of technologic advancement have allowed knowledge, education, and research to be exchanged online. Virtual symposiums act as online conferences where participants present and debate new research and surgical techniques in real-time web meetings. Resource libraries allow up-to-date information to be archived and viewed at the user's convenience, bypassing the need to wait long periods for paper publications. Tele-education allows pediatric surgeons to connect and share ideas around the world, while saving time and money. Georg Thieme Verlag KG Stuttgart · New York.

Assessment of Haptic Interaction for Home-Based Physical Tele-Therapy using Wearable Devices and Depth Sensors.

PubMed

Barmpoutis, Angelos; Alzate, Jose; Beekhuizen, Samantha; Delgado, Horacio; Donaldson, Preston; Hall, Andrew; Lago, Charlie; Vidal, Kevin; Fox, Emily J

2016-01-01

In this paper a prototype system is presented for home-based physical tele-therapy using a wearable device for haptic feedback. The haptic feedback is generated as a sequence of vibratory cues from 8 vibrator motors equally spaced along an elastic wearable band. The motors guide the patients' movement as they perform a prescribed exercise routine in a way that replaces the physical therapists' haptic guidance in an unsupervised or remotely supervised home-based therapy session. A pilot study of 25 human subjects was performed that focused on: a) testing the capability of the system to guide the users in arbitrary motion paths in the space and b) comparing the motion of the users during typical physical therapy exercises with and without haptic-based guidance. The results demonstrate the efficacy of the proposed system.

A tele-home care system exploiting the DVB-T technology and MHP.

PubMed

Angius, G; Pani, D; Raffo, L; Randaccio, P; Seruis, S

2008-01-01

The aim of this research work is the development of a low-cost system for telemedicine based on the DVB-T technology. The diffusion of DVB-T standard and the low cost of DVB-T set-top boxes bring the vision of a capillary distribution of tele-home care monitoring systems with easy-to-use patient's interface. Exploiting the potentiality of the DVB-T set-top box, we transformed it into an "on-demand tele-home care interface". The Xlet we developed is able to govern the functionality of an external microcontroller-based unit for the acquisition of the bio-signals of interest. The uplink connection is used to send the exam results to a remote care center. The Xlet providing the patient interface on the set-top box is uploaded by a DVB-T broadcaster without any intervention in the patient's home. A prototypal low-cost base station for the acquisition of the patient's signals (1-lead ECG) has been developed. It is able to be connected to the set-top box via an infrared link. A smart-card-based system is in charge for the customization of the Xlet for every patient. The proposed system, based on a currently widespread infrastructure, is able to allow the patients monitoring from home without any installation procedure. Even untrained (or elderly) people can easily use such system due to their practice with the basic DVB-T home-entertainment equipments.

A mathematical framework for combining decisions of multiple experts toward accurate and remote diagnosis of malaria using tele-microscopy.

PubMed

Mavandadi, Sam; Feng, Steve; Yu, Frank; Dimitrov, Stoyan; Nielsen-Saines, Karin; Prescott, William R; Ozcan, Aydogan

2012-01-01

We propose a methodology for digitally fusing diagnostic decisions made by multiple medical experts in order to improve accuracy of diagnosis. Toward this goal, we report an experimental study involving nine experts, where each one was given more than 8,000 digital microscopic images of individual human red blood cells and asked to identify malaria infected cells. The results of this experiment reveal that even highly trained medical experts are not always self-consistent in their diagnostic decisions and that there exists a fair level of disagreement among experts, even for binary decisions (i.e., infected vs. uninfected). To tackle this general medical diagnosis problem, we propose a probabilistic algorithm to fuse the decisions made by trained medical experts to robustly achieve higher levels of accuracy when compared to individual experts making such decisions. By modelling the decisions of experts as a three component mixture model and solving for the underlying parameters using the Expectation Maximisation algorithm, we demonstrate the efficacy of our approach which significantly improves the overall diagnostic accuracy of malaria infected cells. Additionally, we present a mathematical framework for performing 'slide-level' diagnosis by using individual 'cell-level' diagnosis data, shedding more light on the statistical rules that should govern the routine practice in examination of e.g., thin blood smear samples. This framework could be generalized for various other tele-pathology needs, and can be used by trained experts within an efficient tele-medicine platform.

Mentoring models in neurosurgical training: Review of literature.

PubMed

Akhigbe, Taiwo; Zolnourian, Ardalan; Bulters, Diederik

2017-11-01

Effective mentoring is an invaluable element in the development of next generation of neurosurgeons. A mentor helps to develop professional core values, technical and non-technical skills, attitudes and disposition required to be qualified and competent neurosurgeon. Giving the invaluable significance of mentoring in neurosurgery, we undertook this literature review to identify mentoring models evaluating its success and relative benefit. Literature search identified using MeSH word 'mentor', mentoring, mentorship, mentoring model, neurosurgery' in MEDLINE, EMBASE and Scopus databases from 1990 to 2016. Literature reviewed to identify status of mentoring in neurosurgery, potential barriers, pitfalls and future framework for mentoring in neurosurgery. Additional articles identified through manual search of reference lists. A total of 247 studies were obtained from electronic databases, after removing duplicates, abstracts, letters to the editor and non-neurosurgery papers. Sixteen full text articles retrieved out of which five met the inclusion criteria. Generally, there is paucity of articles regarding mentoring in neurosurgery, all included papers were written in English Language, all of them described mentoring model used including simulation, distance, collaborative, facilitative tele-mentoring and peer mentoring. Mentoring in Neurosurgery is an important aspect of personal and professional development of neurosurgical trainees, currently there is decline in traditional apprenticeship due to increase demand for modern use of specialised technology, simulation and tele-medicine in neurosurgery practice. Effective and efficient mentoring will be an interplay of six mentoring models (collaborative, facilitative, distance, simulation, tele mentoring and peer mentoring) identified. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Quantum dot-based local field imaging reveals plasmon-based interferometric logic in silver nanowire networks.

PubMed

Wei, Hong; Li, Zhipeng; Tian, Xiaorui; Wang, Zhuoxian; Cong, Fengzi; Liu, Ning; Zhang, Shunping; Nordlander, Peter; Halas, Naomi J; Xu, Hongxing

2011-02-09

We show that the local electric field distribution of propagating plasmons along silver nanowires can be imaged by coating the nanowires with a layer of quantum dots, held off the surface of the nanowire by a nanoscale dielectric spacer layer. In simple networks of silver nanowires with two optical inputs, control of the optical polarization and phase of the input fields directs the guided waves to a specific nanowire output. The QD-luminescent images of these structures reveal that a complete family of phase-dependent, interferometric logic functions can be performed on these simple networks. These results show the potential for plasmonic waveguides to support compact interferometric logic operations.

A simple web-based risk calculator (www.anastomoticleak.com) is superior to the surgeon's estimate of anastomotic leak after colon cancer resection.

PubMed

Sammour, T; Lewis, M; Thomas, M L; Lawrence, M J; Hunter, A; Moore, J W

2017-01-01

Anastomotic leak can be a devastating complication, and early prediction is difficult. The aim of this study is to prospectively validate a simple anastomotic leak risk calculator and compare its predictive value with the estimate of the primary operating surgeon. Consecutive patients undergoing elective or emergency colon cancer surgery with a primary anastomosis over a 1-year period were prospectively included. A recently published anastomotic leak risk nomogram was converted to an online calculator ( www.anastomoticleak.com ). The calculator-derived risk of anastomotic leak and the risk estimated by the primary operating surgeon were recorded at the completion of surgery. The primary outcome was anastomotic leak within 90 days as defined by previously published criteria. Area under receiver operating characteristic curve analysis (AUROC) was performed for both risk estimates. A total of 105 patients were screened for inclusion during the study period, of whom 83 met the inclusion criteria. The overall anastomotic leak rate was 9.6%. The anastomotic leak calculator was highly predictive of anastomotic leak (AUROC 0.84, P = 0.002), whereas the surgeon estimate was not predictive (AUROC 0.40, P = 0.243). A simple anastomotic leak risk calculator is significantly better at predicting anastomotic leak than the estimate of the primary surgeon. Further external validation on a larger data set is required.

A simple technique of laparoscopic port closure.

PubMed

Aziz, Homayara Haque

2013-01-01

Laparoscopic and robotic surgery is widely practiced in modern medicine. The operative procedure is not complete until the port sites are closed with a fascial suture. We report a simple new technique that is easy, cost-effective, and quick to apply using 2 S-retractors for suture placement under direct visualization to secure the abdominal wall fascia and peritoneum. As a prospective consecutive case series, this technique was used for fascial closure after laparoscopy ports > 8 mm using 2 S-retractors. One S-retractor is used as a barrier protecting the contents of the abdominal cavity, reducing the risk of visceral injuries. The second S-retractor allows us to directly visualize the different layers, exposing the needle tip during its course through the fascia. This method was used in 100 patients with no intraoperative incidents, additional operative time, or need to access costly instruments. Currently, this technique is also used by many surgeons in our institution without any difficulty. No bowel injuries or port-site hernias were reported during a mean follow-up of 6 wk postoperation and 12-mo annual follow-up. The procedure is simple, easy, cost-effective, and quick to apply.

[MRI of the rotator cuff: evaluation of a new symptomatologic classification].

PubMed

Tavernier, T; Walch, G; Noël, E; Lapra, C; Bochu, M

1995-05-01

The different classifications use for the rotator cuff pathology seem to be incomplete. We propose a new classification with many advantages: 1) Differentiate the tendinopathy between less serious (grade 2A) and serious (grade 2B). 2) Recognize the intra-tendinous cleavage of the infra-spinatus associated with complete tear of the supra-spinatus. 3) Differentiate partial and complete tears of the supra-spinatus. We established this classification after a retrospective study of 42 patients operated on for a rotator cuff pathology. Every case had had a preoperative MRI. This classification is simple, reliable, especially for the associated intra tendinous cleavage.

NASA's Robotic Mining Competition Provides Undergraduates Full Life Cycle Systems Engineering Experience

NASA Technical Reports Server (NTRS)

Stecklein, Jonette

2017-01-01

NASA has held an annual robotic mining competition for teams of university/college students since 2010. This competition is yearlong, suitable for a senior university engineering capstone project. It encompasses the full project life cycle from ideation of a robot design, through tele-operation of the robot collecting regolith in simulated Mars conditions, to disposal of the robot systems after the competition. A major required element for this competition is a Systems Engineering Paper in which each team describes the systems engineering approaches used on their project. The score for the Systems Engineering Paper contributes 25% towards the team’s score for the competition’s grand prize. The required use of systems engineering on the project by this competition introduces the students to an intense practical application of systems engineering throughout a full project life cycle.

Development of a Standardized Cranial Phantom for Training and Optimization of Functional Stereotactic Operations.

PubMed

Krüger, Marie T; Coenen, Volker A; Egger, Karl; Shah, Mukesch; Reinacher, Peter C

2018-06-13

In recent years, simulations based on phantom models have become increasingly popular in the medical field. In the field of functional and stereotactic neurosurgery, a cranial phantom would be useful to train operative techniques, such as stereo-electroencephalography (SEEG), to establish new methods as well as to develop and modify radiological techniques. In this study, we describe the construction of a cranial phantom and show examples for it in stereotactic and functional neurosurgery and its applicability with different radiological modalities. We prepared a plaster skull filled with agar. A complete operation for deep brain stimulation (DBS) was simulated using directional leads. Moreover, a complete SEEG operation including planning, implantation of the electrodes, and intraoperative and postoperative imaging was simulated. An optimally customized cranial phantom is filled with 10% agar. At 7°C, it can be stored for approximately 4 months. A DBS and an SEEG procedure could be realistically simulated. Lead artifacts can be studied in CT, X-ray, rotational fluoroscopy, and MRI. This cranial phantom is a simple and effective model to simulate functional and stereotactic neurosurgical operations. This might be useful for teaching and training of neurosurgeons, establishing operations in a new center and for optimization of radiological examinations. © 2018 S. Karger AG, Basel.

Development of a Telehealth Intervention for Head and Neck Cancer Patients

PubMed Central

Studts, Jamie L.; Bumpous, Jeffrey M.; Gregg, Jennifer L.; Wilson, Liz; Keeney, Cynthia; Scharfenberger, Jennifer A.; Pfeifer, Mark P.

2009-01-01

Abstract Treatment for head and neck cancer precipitates a myriad of distressing symptoms. Patients may be isolated both physically and socially and may lack the self-efficacy to report problems and participate as partners in their care. The goal of this project was to design a telehealth intervention to address such isolation, develop patient self-efficacy, and improve symptom management during the treatment experience. Participatory action research and a review of the literature were used to develop electronically administered symptom management algorithms addressing all major symptoms experienced by patients undergoing treatment for head and neck cancers. Daily questions and related messages were then programmed into an easy-to-use telehealth messaging device, the Health Buddy®. Clinician and patient acceptance, feasibility, and technology issues were measured. Using participatory action research is an effective means for developing electronic algorithms acceptable to both clinicians and patients. The use of a simple tele-messaging device as an adjunct to symptom management is feasible, affordable, and acceptable to patients. This telehealth intervention provides support and education to patients undergoing treatment for head and neck cancers. PMID:19199847

Tele-autonomous control involving contacts: The applications of a high precision laser line range sensor

NASA Technical Reports Server (NTRS)

Volz, R. A.; Shao, L.; Walker, M. W.; Conway, L. A.

1989-01-01

The object localization algorithm based on line-segment matching is presented. The method is very simple and computationally fast. In most cases, closed-form formulas are used to derive the solution. The method is also quite flexible, because only few surfaces (one or two) need to be accessed (sensed) to gather necessary range data. For example, if the line-segments are extracted from boundaries of a planar surface, only parameters of one surface and two of its boundaries need to be extracted, as compared with traditional point-surface matching or line-surface matching algorithms which need to access at least three surfaces in order to locate a planar object. Therefore, this method is especially suitable for applications when an object is surrounded by many other work pieces and most of the object is very difficult, is not impossible, to be measured; or when not all parts of the object can be reached. The theoretical ground on how to use line range sensor to located an object was laid. Much work has to be done in order to be really useful.

Development of a telehealth intervention for head and neck cancer patients.

PubMed

Head, Barbara A; Studts, Jamie L; Bumpous, Jeffrey M; Gregg, Jennifer L; Wilson, Liz; Keeney, Cynthia; Scharfenberger, Jennifer A; Pfeifer, Mark P

2009-01-01

Treatment for head and neck cancer precipitates a myriad of distressing symptoms. Patients may be isolated both physically and socially and may lack the self-efficacy to report problems and participate as partners in their care. The goal of this project was to design a telehealth intervention to address such isolation, develop patient self-efficacy, and improve symptom management during the treatment experience. Participatory action research and a review of the literature were used to develop electronically administered symptom management algorithms addressing all major symptoms experienced by patients undergoing treatment for head and neck cancers. Daily questions and related messages were then programmed into an easy-to-use telehealth messaging device, the Health Buddy(R). Clinician and patient acceptance, feasibility, and technology issues were measured. Using participatory action research is an effective means for developing electronic algorithms acceptable to both clinicians and patients. The use of a simple tele-messaging device as an adjunct to symptom management is feasible, affordable, and acceptable to patients. This telehealth intervention provides support and education to patients undergoing treatment for head and neck cancers.

Critical Design Parameters for Pylon-Aided Gaseous Fuel Injection Upstream of a Flameholding Cavity

DTIC Science & Technology

2009-03-01

Spencer Bowen and Neil Rogers was critical to not only the successful completion of this research but my sanity as well. The care, support, and motivation...missile presents a relatively inexpensive alternative that while complex is much more feasible to achieve in the near term. The hypersonic bomber and...scramjet engine operates supersonically throughout. Though aerodynamically complex the scramjet engine is relatively simple, consisting of an inlet

High Dielectric Low Loss Transparent Glass Material Based Dielectric Resonator Antenna with Wide Bandwidth Operation

NASA Astrophysics Data System (ADS)

Mehmood, Arshad; Zheng, Yuliang; Braun, Hubertus; Hovhannisyan, Martun; Letz, Martin; Jakoby, Rolf

2015-01-01

This paper presents the application of new high permittivity and low loss glass material for antennas. This glass material is transparent. A very simple rectangular dielectric resonator antenna is designed first with a simple microstrip feeding line. In order to widen the bandwidth, the feed of the design is modified by forming a T-shaped feeding. This new design enhanced the bandwidth range to cover the WLAN 5 GHz band completely. The dielectric resonator antenna cut into precise dimensions is placed on the modified microstrip feed line. The design is simple and easy to manufacture and also very compact in size of only 36 × 28 mm. A -10 dB impedance bandwidth of 18% has been achieved, which covers the frequency range from 5.15 GHz to 5.95 GHz. Simulations of the measured return loss and radiation patterns are presented and discussed.

RealityFlythrough: Enhancing Situational Awareness for Medical Response to Disasters Using Ubiquitous Video

PubMed Central

McCurdy, Neil J.; Griswold, William G; Lenert, Leslie A.

2005-01-01

The first moments at a disater scene are chaotic. The command center initially operates with little knowledge of hazards, geography and casualties, building up knowledge of the event slowly as information trickles in by voice radio channels. RealityFlythrough is a tele-presence system that stitches together live video feeds in real-time, using the principle of visual closure, to give command center personnel the illusion of being able to explore the scene interactively by moving smoothly between the video feeds. Using RealityFlythrough, medical, fire, law enforcement, hazardous materials, and engineering experts may be able to achieve situational awareness earlier, and better manage scarce resources. The RealityFlythrough system is composed of camera units with off-the-shelf GPS and orientation systems and a server/viewing station that offers access to images collected by the camera units in real time by position/orientation. In initial field testing using an experimental mesh 802.11 wireless network, two camera unit operators were able to create an interactive image of a simulated disaster scene in about five minutes. PMID:16779092

ODIS the under-vehicle inspection robot: development status update

NASA Astrophysics Data System (ADS)

Freiburger, Lonnie A.; Smuda, William; Karlsen, Robert E.; Lakshmanan, Sridhar; Ma, Bing

2003-09-01

Unmanned ground vehicle (UGV) technology can be used in a number of ways to assist in counter-terrorism activities. Robots can be employed for a host of terrorism deterrence and detection applications. As reported in last year's Aerosense conference, the U.S. Army Tank Automotive Research, Development and Engineering Center (TARDEC) and Utah State University (USU) have developed a tele-operated robot called ODIS (Omnidirectional Inspection System) that is particularly effective in performing under-vehicle inspections at security checkpoints. ODIS' continuing development for this task is heavily influenced by feedback received from soldiers and civilian law enforcement personnel using ODIS-prototypes in an operational environment. Our goal is to convince civilian law enforcement and military police to replace the traditional "mirror on a stick" system of looking under cars for bombs and contraband with ODIS. This paper reports our efforts in the past one year in terms of optimizing ODIS for the visual inspection task. Of particular concern is the design of the vision system. This paper documents details on the various issues relating to ODIS' vision system - sensor, lighting, image processing, and display.

Genetics Home Reference: mucopolysaccharidosis type VI

MedlinePlus

... Citation on PubMed Garrido E, Cormand B, Hopwood JJ, Chabás A, Grinberg D, Vilageliu L. Maroteaux-Lamy ... N, Leão Teles E, Sá Miranda MC, Hopwood JJ. Mutational analysis of 105 mucopolysaccharidosis type VI patients. ...

New tools for sculpting cranial implants in a shared haptic augmented reality environment.

PubMed

Ai, Zhuming; Evenhouse, Ray; Leigh, Jason; Charbel, Fady; Rasmussen, Mary

2006-01-01

New volumetric tools were developed for the design and fabrication of high quality cranial implants from patient CT data. These virtual tools replace time consuming physical sculpting, mold making and casting steps. The implant is designed by medical professionals in tele-immersive collaboration. Virtual clay is added in the virtual defect area on the CT data using the adding tool. With force feedback the modeler can feel the edge of the defect and fill only the space where no bone is present. A carving tool and a smoothing tool are then used to sculpt and refine the implant. To make a physical evaluation, the skull with simulated defect and the implant are fabricated via stereolithography to allow neurosurgeons to evaluate the quality of the implant. Initial tests demonstrate a very high quality fit. These new haptic volumetric sculpting tools are a critical component of a comprehensive tele-immersive system.

Implementing Telerehabilitation Research for Stroke Rehabilitation with Community Dwelling Veterans: Lessons Learned

PubMed Central

Chumbler, Neale R.; Quigley, Patricia; Sanford, Jon; Griffiths, Patricia; Rose, Dorian; Morey, Miriam; Ely, E. Wesley; Hoenig, Helen

2010-01-01

Telerehabilitation (TR) is the use of telehealth technologies to provide distant support, rehabilitation services, and information exchange between people with disabilities and their clinical providers. This article discusses the barriers experienced when implementing a TR multi-site randomized controlled trial for stroke patients in their homes, and the lessons learned. The barriers are divided into two sections: those specific to TR and those pertinent to the conduct of tele-research. The TR specific barriers included the rapidly changing telecommunications and health care environment and inconsistent equipment functionality. The barriers applicable to tele-research included the need to meet regulations in diverse departments and rapidly changing research regulations. Lessons learned included the need for: telehealth equipment options to allow for functionality within a diverse telecommunications infrastructure; rigorous pilot testing of all equipment in authentic situations; and on-call and on-site biomedical engineering and/or IT staff. PMID:25945169

[Hospital and organizational dynamics of the National Institutes of Health. Relationship with high-specialty hospitals].

PubMed

Gabilondo Navarro, Fernando

2011-01-01

In order to primarily encourage medical care, teaching and research activities in high specialty regional hospitals (HSRH), a number of strategies are explored to increase the number of patients cared for, improve the quality and timeliness of care and successfully integrate the function of these hospitals within the care and patient flow model expected by the Federal Government. These strategies include the use of information technology systems as platforms for telemedicine, including tele-imaging, tele-education and telepathology, thus fostering the quality and timeliness of medical care and narrow the relationship between these HSRH with the National Health Institutes. Other strategies such as extra-mural surgery, specific theme workshops, resident rotations, the use of simulators and "Science Weeks" are also explored so as to promote teaching and research. Finally, the reference and counter-reference system and the introduction of pension programs are evaluated as possible strategies supporting resource management.

Forward and store telemedicine using Motion Pictures Expert Group: a novel approach to pediatric tele-echocardiography.

PubMed

Woodson, Kristina E; Sable, Craig A; Cross, Russell R; Pearson, Gail D; Martin, Gerard R

2004-11-01

Live transmission of echocardiograms over integrated services digital network lines is accurate and has led to improvements in the delivery of pediatric cardiology care. Permanent archiving of the live studies has not previously been reported. Specific obstacles to permanent storage of telemedicine files have included the ability to produce accurate images without a significant increase in storage requirements. We evaluated the accuracy of Motion Pictures Expert Group (MPEG) digitization of incoming video streams and assessed the storage requirements of these files for infants in a real-time pediatric tele-echocardiography program. All major cardiac diagnoses were correctly diagnosed by review of MPEG images. MPEG file size ranged from 11.1 to 182 MB (56.5 +/- 29.9 MB). MPEG digitization during live neonatal telemedicine is accurate and provides an efficient method for storage. This modality has acceptable storage requirements; file sizes are comparable to other digital modalities.

A mobile phone based remote patient monitoring system for chronic disease management.

PubMed

Trudel, Mathieu; Cafazzo, Joseph A; Hamill, Melinda; Igharas, Walter; Tallevi, Kevin; Picton, Peter; Lam, Jack; Rossos, Peter G; Easty, Anthony C; Logan, Alexander

2007-01-01

Rising concern over the poor state of chronic disease management led to the user-informed design and development of a home tele-monitoring system. Focus groups with patients and primary care providers guided the research team towards a design that would accommodate the workflow and concerns of the healthcare providers and the low use and comfort with technology found among the patient population. The system was trialed in a before-and-after pilot study of 34 patients with diabetes and hypertension. Findings demonstrate a significant improvement in systolic and diastolic blood pressure. An RCT beginning in 2007 is being conducted to confirm these findings. It is hypothesized that this user-centred approach, utilizing focus groups, iterative design and human factors methods of evaluation, will lead to the next-generation of home tele-monitoring applications that are more intuitive, less cumbersome, and ultimately bring about greater patient compliance and better physician management.

The coalescent process in models with selection and recombination.

PubMed

Hudson, R R; Kaplan, N L

1988-11-01

The statistical properties of the process describing the genealogical history of a random sample of genes at a selectively neutral locus which is linked to a locus at which natural selection operates are investigated. It is found that the equations describing this process are simple modifications of the equations describing the process assuming that the two loci are completely linked. Thus, the statistical properties of the genealogical process for a random sample at a neutral locus linked to a locus with selection follow from the results obtained for the selected locus. Sequence data from the alcohol dehydrogenase (Adh) region of Drosophila melanogaster are examined and compared to predictions based on the theory. It is found that the spatial distribution of nucleotide differences between Fast and Slow alleles of Adh is very similar to the spatial distribution predicted if balancing selection operates to maintain the allozyme variation at the Adh locus. The spatial distribution of nucleotide differences between different Slow alleles of Adh do not match the predictions of this simple model very well.

Normalization of cell responses in cat striate cortex

NASA Technical Reports Server (NTRS)

Heeger, D. J.

1992-01-01

Simple cells in the striate cortex have been depicted as half-wave-rectified linear operators. Complex cells have been depicted as energy mechanisms, constructed from the squared sum of the outputs of quadrature pairs of linear operators. However, the linear/energy model falls short of a complete explanation of striate cell responses. In this paper, a modified version of the linear/energy model is presented in which striate cells mutually inhibit one another, effectively normalizing their responses with respect to stimulus contrast. This paper reviews experimental measurements of striate cell responses, and shows that the new model explains a significantly larger body of physiological data.

Patients Without Borders: Using Telehealth to Provide an International Experience in Veterinary Global Health for Veterinary Students.

PubMed

Mazan, Melissa R; Kay, Gigi; Souhail, Mohammed Larbi; Bubeck, Kirstin; Jenei, Thomas; Merriam, Jay

There is an increasing need to produce veterinarians with knowledge and critical thinking skills that will allow them to participate in veterinary global health equity delivery, particularly in the developing world, where many people remain dependent on animal-based agriculture for a living. This need for veterinarians trained in global health is reflected by the demand among students for greater exposure and education. At the same time, many students are held back from on-site training in global health due to constraints of cost, time, or family obligations. The purpose of this article is to describe the use of a telemedicine approach to educating veterinary students at Tufts Cummings School of Veterinary Medicine. This approach simultaneously provides expert consultation and support for a pro bono hospital in the developing world. The development of a telemedicine teaching service is discussed, from initial ad hoc email consultation among friends and associates to a more formal use of store-and-forward delivery of data along with real-time videoconferencing on a regular basis, termed tele-rounds. The practicalities of data delivery and exchange and best use of available bandwidth are also discussed, as this very mundane information is critical to efficient and useful tele-rounds. Students are able to participate in discussion of cases that they would never see in their usual clinical sphere and to become familiar with diagnostic and treatment approaches to these cases. By having the patient "virtually" brought to us, tele-rounds also decrease the usual carbon footprint of global health delivery.

[Assessment of tele-expertise among elderly subjects in retirement homes].

PubMed

Sparsa, A; Doffoel-Hantz, V; Bonnetblanc, J-M

2013-03-01

Chronic wounds (leg ulcers, pressure ulcers, diabetic foot ulcers, etc.) constitute a real public health problem and engender high economic and human costs. Due to the declining physical and mental conditions of our elderly subjects and their rural environment, we created a computer program to assist with chronic wound management in elderly subjects living in retirement homes and to reduce the amount of ambulance transportation. Each participating establishment was provided with a digital camera and its own secure e-mail address in order to allow photographs to be sent anonymously. Patients with chronic wounds entailing treatment difficulties were included. Details were recorded of the number of tele-expertise consultations given, the chronic wound type, the number of hospitalizations or medical consultations, and the number of ambulance trips avoided. The project was evaluated at 1 year. Of the 40 establishments invited to take part, 22 agreed to do so but only the first 10 respondents were accepted for participation in the pilot feasibility study. Funding ("Health and social prize" provided by the Haute-Vienne region Social Security Office - CPAM) was used to purchase the cameras. Beginning on 15 April 2010, 10 establishments for the elderly sent photographs of 34 patients presenting 26 chronic wounds and tele-expertise was provided for 10 pressure ulcers, two diabetic feet and 14 leg ulcers. Over a two-year period, this program helped avoid 20 trips for patients and enabled rapid hospitalization of nine patients by the university hospital by optimizing chronic wound management for patients residing in establishments for the elderly. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Numerical simulation and experimental investigation of GaN-based flip-chip LEDs and top-emitting LEDs.

PubMed

Liu, Xingtong; Zhou, Shengjun; Gao, Yilin; Hu, Hongpo; Liu, Yingce; Gui, Chengqun; Liu, Sheng

2017-12-01

We demonstrate a GaN-based flip-chip LED (FC-LED) with a highly reflective indium-tin oxide (ITO)/distributed Bragg reflector (DBR) ohmic contact. A transparent ITO current spreading layer combined with Ta 2 O 5 /SiO 2 double DBR stacks is used as a reflective p-type ohmic contact in the FC-LED. We develop a strip-shaped SiO 2 current blocking layer, which is well aligned with a p-electrode, to prevent the current from crowding around the p-electrode. Our combined numerical simulation and experimental results revealed that the FC-LED with ITO/DBR has advantages of better current spreading and superior heat dissipation performance compared to top-emitting LEDs (TE-LEDs). As a result, the light output power (LOP) of the FC-LED with ITO/DBR was 7.6% higher than that of the TE-LED at 150 mA, and the light output saturation current was shifted from 130.9  A/cm 2 for the TE-LED to 273.8  A/cm 2 for the FC-LED with ITO/DBR. Owing to the high reflectance of the ITO/DBR ohmic contact, the LOP of the FC-LED with ITO/DBR was 13.0% higher than that of a conventional FC-LED with Ni/Ag at 150 mA. However, because of the better heat dissipation of the Ni/Ag ohmic contact, the conventional FC-LED with Ni/Ag exhibited higher light output saturation current compared to the FC-LED with ITO/DBR.

Tele-Epidemiology and Public Health in the Canadian Context

NASA Astrophysics Data System (ADS)

Brazeau, Stephanie; Kotchi, Serge Olivier; Ludwig, Antoinette; Turgeon, Patricia; Pelcat, Yann; Aube, Guy; Ogden, Nicholas H.

2016-08-01

The management of key public health issues requires solid evidence-based knowledge for the prevention and control of various emerging or re-emerging vector borne diseases (e.g. Lyme disease, West Nile virus, etc.) and environmentally-linked diseases (e.g. enteric infections from recreational water contamination). Earth observation (EO) images enhance knowledge and capacity to characterize risk of illness across the vast Canadian territory by deriving new and up-to-date data from population, climatic and environmental determinants of health relevant to public health actions such as risk mapping, risk communication and identification of vulnerable populations.Modeling of infectious disease transmission has made possible the identification of risk areas and the underlying factors (human activities, ecology, environment and climate) that may explain this emergence. New data products derived from Earth observation satellites pertaining to climate, land cover and land use, and distribution and density of animal and human populations have greatly improved the resolution and the specificity of explanatory and predictive models.This article focuses on the scope of tele-epidemiology activities of the Canadian public health community as well as current and potential future fields of application for Earth observation data. It will demonstrate the strength, sustainability and innovative character of these approaches to improve scale-dependent decision- making at different levels of government in Canada (federal, provincial/territorial and regional) and increase the efficiency of many preventive, preparedness and response actions.Examples of tele-epidemiology applications will be presented such as the risk assessment of microbial contamination of recreational waters and modelling the risk of vector borne diseases in the Canadian context.

Precipitation extremes and their relation to climatic indices in the Pacific Northwest USA

NASA Astrophysics Data System (ADS)

Zarekarizi, Mahkameh; Rana, Arun; Moradkhani, Hamid

2018-06-01

There has been focus on the influence of climate indices on precipitation extremes in the literature. Current study presents the evaluation of the precipitation-based extremes in Columbia River Basin (CRB) in the Pacific Northwest USA. We first analyzed the precipitation-based extremes using statistically (ten GCMs) and dynamically downscaled (three GCMs) past and future climate projections. Seven precipitation-based indices that help inform about the flood duration/intensity are used. These indices help in attaining first-hand information on spatial and temporal scales for different service sectors including energy, agriculture, forestry etc. Evaluation of these indices is first performed in historical period (1971-2000) followed by analysis of their relation to large scale tele-connections. Further we mapped these indices over the area to evaluate the spatial variation of past and future extremes in downscaled and observational data. The analysis shows that high values of extreme indices are clustered in either western or northern parts of the basin for historical period whereas the northern part is experiencing higher degree of change in the indices for future scenario. The focus is also on evaluating the relation of these extreme indices to climate tele-connections in historical period to understand their relationship with extremes over CRB. Various climate indices are evaluated for their relationship using Principal Component Analysis (PCA) and Singular Value Decomposition (SVD). Results indicated that, out of 13 climate tele-connections used in the study, CRB is being most affected inversely by East Pacific (EP), Western Pacific (WP), East Atlantic (EA) and North Atlaentic Oscillation (NAO).

Tele-ultrasound and paramedics: real-time remote physician guidance of the Focused Assessment With Sonography for Trauma examination.

PubMed

Boniface, Keith S; Shokoohi, Hamid; Smith, E Reed; Scantlebury, Kari

2011-06-01

The aim of this study was to examine the capability of ultrasound-naïve paramedics to obtain interpretable Focused Assessment With Sonography for Trauma (FAST) images under the remote direction of emergency physicians (EPs). Paramedics without experience using ultrasound participated in a 20-minute lecture covering orientation to the ultrasound machine and the FAST examination. The paramedics subsequently performed FAST examinations on a model patient, whereas the EP remained in another room, out of visual contact. The EP communicated with the paramedic via radio, viewing video from the ultrasound machine on a monitor and directing the probe movements to obtain the views of the FAST examination. We examined the success rate, time to complete the examinations, and adequacy of images from the paramedics' first FAST examination. Fifty-one paramedics performed their first FAST examinations and were able to successfully complete 100% of the views of the FAST. The median time from probe placement to examination completion was 262 seconds (interquartile range, 206-343 seconds). The median time to complete right upper quadrant (RUQ) versus left upper quadrant (LUQ) views was 39 and 50 seconds, respectively. The time to complete the LUQ scan took significantly longer than the RUQ (P < .01). Paramedics completed cardiac and pelvic view in a median time of 42 and 25 seconds, respectively. The study demonstrated that paramedics with no prior ultrasound experience could obtain FAST images under remote guidance from experienced EPs in less than 5 minutes. Given rapidly evolving data transmission technology, this has applicability in battlefield, remote, and rural prehospital settings. Copyright © 2011 Elsevier Inc. All rights reserved.

75 FR 40833 - Sunshine Act Meeting; Open Commission Meeting; Thursday, July 15, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-14

... OFFICE OF TITLE: Fixed and ENGINEERING AND Mobile services TECHNOLOGY, in the Mobile WIRELESS TELE... investment in the 2 GHz, Big LEO, and L-bands of the Mobile Satellite Service. 3 WIRELINE TITLE: Electronic...

Research Notes. OERI's Regional Laboratory Technology Efforts.

ERIC Educational Resources Information Center

Garnette, Cheryl P., Ed.; Withrow, Frank B., Ed.

1989-01-01

Examines various educational technology projects that regional laboratories supported by the Office of Educational Research and Improvement (OERI) are undertaking. Highlights include innovative uses of instructional technology; tele-teaching using interactive audio conferencing; making informed decisions about technology; national teleconferences…

Developing a Tele-Robotic Platform for Bridge Inspection

DOT National Transportation Integrated Search

2011-05-01

There are many bridges in Virginia with high traffic volumes or difficult access conditions which make these bridges difficult and expensive to inspect. In addition, the inspection of many bridges exposes the inspectors to hazardous conditions such a...

Crash in Australian outback ends NASA ballooning season

NASA Astrophysics Data System (ADS)

Harris, Margaret

2010-06-01

NASA has temporarily suspended all its scientific balloon launches after the balloon-borne Nuclear Compton Tele scope (NCT) crashed during take-off, scattering a trail of debris across the remote launch site and overturning a nearby parked car.

Automatic centring and bonding of lenses

NASA Astrophysics Data System (ADS)

Krey, Stefan; Heinisch, J.; Dumitrescu, E.

2007-05-01

We present an automatic bonding station which is able to center and bond individual lenses or doublets to a barrel with sub micron centring accuracy. The complete manufacturing cycle includes the glue dispensing and UV curing. During the process the state of centring is continuously controlled by the vision software, and the final result is recorded to a file for process statistics. Simple pass or fail results are displayed to the operator at the end of the process.

Large liquid rocket engine transient performance simulation system

NASA Technical Reports Server (NTRS)

Mason, J. R.; Southwick, R. D.

1989-01-01

Phase 1 of the Rocket Engine Transient Simulation (ROCETS) program consists of seven technical tasks: architecture; system requirements; component and submodel requirements; submodel implementation; component implementation; submodel testing and verification; and subsystem testing and verification. These tasks were completed. Phase 2 of ROCETS consists of two technical tasks: Technology Test Bed Engine (TTBE) model data generation; and system testing verification. During this period specific coding of the system processors was begun and the engineering representations of Phase 1 were expanded to produce a simple model of the TTBE. As the code was completed, some minor modifications to the system architecture centering on the global variable common, GLOBVAR, were necessary to increase processor efficiency. The engineering modules completed during Phase 2 are listed: INJTOO - main injector; MCHBOO - main chamber; NOZLOO - nozzle thrust calculations; PBRNOO - preburner; PIPE02 - compressible flow without inertia; PUMPOO - polytropic pump; ROTROO - rotor torque balance/speed derivative; and TURBOO - turbine. Detailed documentation of these modules is in the Appendix. In addition to the engineering modules, several submodules were also completed. These submodules include combustion properties, component performance characteristics (maps), and specific utilities. Specific coding was begun on the system configuration processor. All functions necessary for multiple module operation were completed but the SOLVER implementation is still under development. This system, the Verification Checkout Facility (VCF) allows interactive comparison of module results to store data as well as provides an intermediate checkout of the processor code. After validation using the VCF, the engineering modules and submodules were used to build a simple TTBE.

Games and Telerehabilitation for Balance Impairments and Gaze Dysfunction: Protocol of a Randomized Controlled Trial.

PubMed

Szturm, Tony; Hochman, Jordan; Wu, Christine; Lisa, Lix; Reimer, Karen; Wonneck, Beth; Giacobbo, Andrea

2015-10-21

Digital media and gaming have received considerable interest from researchers and clinicians as a model for learning a broad range of complex tasks and facilitating the transfer of skills to daily life. These emerging rehabilitation technologies have the potential to improve clinical outcomes and patient participation because they are engaging, motivating, and accessible. Our research goal is to develop preventative and therapeutic point-of-care eHealth applications that will lead to equivalent or better long-term health outcomes and health care costs than existing programs. We have produced a novel computer-aided tele-rehabilitation platform that combines computer game-based exercises with tele-monitoring. Compare the therapeutic effectiveness of an in-home, game-based rehabilitation program (GRP) to standard care delivered in an outpatient physical therapy clinic on measures of balance, gaze control, dizziness, and health-related quality of life. A randomized, controlled, single-blind pilot trial will be conducted. Fifty-six participants with a diagnosis of peripheral vestibular disorder will be randomly assigned to either usual physical therapy (comparator group) or to a game-based intervention (experimental group). Measures to be assessed will include gaze control, dynamic balance, and self-reported measures of dizziness. The project was funded and enrollment was started in August 2014. To date, 36 participants have been enrolled. There have been 6 drop-outs. It is expected that the study will be completed January 2016 and the first results are expected to be submitted for publication in Spring of 2016. A successful application of this rehabilitation program would help streamline rehabilitation services, leverage therapist time spent with clients, and permit regular practice times at the client's convenience. Clinicaltrials.gov: NCT02134444; https://clinicaltrials.gov/ct2/show/NCT02134444 (Archived by WebCite at http://www.webcitation.org/6cE18bqqY).

What impact do anxiety, depression, perceived control and technology capability have on whether patients with chronic heart failure take-up or continue to use home tele-monitoring services? Study design of ADaPT-HF.

PubMed

Crundall-Goode, Amanda; Goode, Kevin M; Clark, Andrew L

2017-04-01

Home tele-monitoring (HTM) is used to monitor the clinical signs and symptoms of patients with chronic heart failure (CHF) in order to reduce unplanned hospital admissions. However, not all patients who are referred will agree to use HTM, and some patients choose to withdraw early from its use. ADaPT-HF will investigate whether depression, anxiety, low perceived control, reduced technology capability, level of education, age or the severity or complexity of a patient's illness can predict refusal of, or early withdrawal from, HTM in patients with CHF. The study will recruit 288 patients who have been recently admitted to hospital with heart failure who have been referred for HTM. At the time of referral, patients will complete depression (nine-item Patient Health Questionnaire), anxiety (seven-item Generalised Anxiety Disorder questionnaire), perceived control (eight-item revised Controlled Attitudes Scale) and technology capability (ten-item Technology Readiness Index 2.0) screening questionnaires. In addition, data on demographics, diagnosis, clinical examination, socio-economic status, history of comorbidities, medication, biochemistry and haematology will be recorded. The primary outcome will be a composite of refusal of or early withdrawal from HTM. The principle analysis will be made using logistic regression. By establishing which factors influence a patient's decision to refuse or withdraw early from HTM, it may be possible to redesign HTM referral processes. It may be that patients with CHF who also have depression, anxiety, low control and poor technology skills should not be referred until they receive appropriate support or that they should be managed differently when they do receive HTM. The results of ADAPT-HF may provide a way of making more efficient and cost-effective use of HTM services.

Interview with David Tauben: University of Washington, Chief of the Division of Pain Medicine.

PubMed

Tauben, David

2017-07-01

Dr Tauben is Clinical Professor jointly appointed in the Departments of Medicine and Anesthesia & Pain Medicine, and is the Hughes M & Katherine G Blake Endowed Professor, board certified in both Internal Medicine and Pain Medicine. He is also University of Washington (UW) Director of Medical Student and Resident Education in Pain Medicine, and Medical Director of UW TelePain, a tele-video-conferencing program intended to provide innovative pain education and consultative support to a five-state northwest regional primary care providers. He served as a member of the NIH National Pain Strategy task force on pain education and is principal investigator for the UW's prestigious NIH Pain Consortium Center of Excellence for Pain Education, leading curriculum development to extend the pain proficiency qualifications of interprofessional primary care providers. Dr Tauben is a member of the American Pain Society and the International Association for the Study of Pain special interest study groups on Pain Education. He is a founding member of the State of Washington Agency Medical Directors panel of medical experts developing opioid prescription guidelines for the state, and a regular clinical and content expert for regulatory and legislative bodies involved in public policy regarding pain medicine practice and standards. He speaks as a clinical expert in medical management of chronic pain, especially as it applies to primary care practices. Dr Tauben served as an expert for several US Centers for Disease Control clinical outreach programs and policy reviews advising primary care providers on how to prescribe opioids for chronic noncancer pain. He is annually recognized by his peers as recipient of regional awards in care of pain patients, and brings decades of clinical experience of best practice medication management of acute and chronic pain. Dr Tauben received his bachelors degree in philosophy from Yale University, medical degree from Tufts University School of Medicine and completed his residency training at the UW, in Seattle. He is a fellow of the American College of Physicians.

A Tele-Behavioral Health Intervention to Reduce Depression, Anxiety, and Stress and Improve Diabetes Self-Management.

PubMed

Mochari-Greenberger, Heidi; Vue, Lee; Luka, Andi; Peters, Aimee; Pande, Reena L

2016-08-01

Depression is prevalent among individuals with diabetes and associated with suboptimal self-management. Little is known about the feasibility and potential impact of tele-behavioral therapy to improve depressive symptoms and self-management among diabetes patients. This was a retrospective observational study of consecutive graduates enrolled in a national 8-week diabetes behavioral telehealth program between August 1, 2014, and January 31, 2015 (N = 466; mean age 56.8 ± 5.0 years; 56% female). Participant characteristics (demographics, comorbidities) were obtained by standardized questionnaire. Depression, anxiety, and stress symptoms (DASS; validated Depression Anxiety and Stress Scale 21 survey), and glucose self-testing frequency and values (point-of-care monitor) were measured at program start and completion. Changes in DASS severity and glucose self-testing frequency were assessed by chi-square tests. Changes in DASS and blood glucose levels were evaluated by paired t-tests. At baseline, approximately one in three participants had elevated depression (32%), anxiety (33%), or stress (31%) scores. Significant reductions in average DASS, depression (-8.8), anxiety (-6.9), and stress (-9.9), scores were observed at graduation among those with elevated baseline scores (p < 0.0001); most (≥80%) improved to less severe depression, anxiety, or stress categories. Improved glucose self-testing frequency (69% vs. 60% tested ≥once per week; p = 0.0005) and significant reductions in mean morning glucose levels (-12.3 mg/dL; p = 0.0002) were observed from baseline to graduation. Participants with normal versus non-normal depression scores were more likely to have lower (

Architecture for autonomy

NASA Astrophysics Data System (ADS)

Broten, Gregory S.; Monckton, Simon P.; Collier, Jack; Giesbrecht, Jared

2006-05-01

In 2002 Defence R&D Canada changed research direction from pure tele-operated land vehicles to general autonomy for land, air, and sea craft. The unique constraints of the military environment coupled with the complexity of autonomous systems drove DRDC to carefully plan a research and development infrastructure that would provide state of the art tools without restricting research scope. DRDC's long term objectives for its autonomy program address disparate unmanned ground vehicle (UGV), unattended ground sensor (UGS), air (UAV), and subsea and surface (UUV and USV) vehicles operating together with minimal human oversight. Individually, these systems will range in complexity from simple reconnaissance mini-UAVs streaming video to sophisticated autonomous combat UGVs exploiting embedded and remote sensing. Together, these systems can provide low risk, long endurance, battlefield services assuming they can communicate and cooperate with manned and unmanned systems. A key enabling technology for this new research is a software architecture capable of meeting both DRDC's current and future requirements. DRDC built upon recent advances in the computing science field while developing its software architecture know as the Architecture for Autonomy (AFA). Although a well established practice in computing science, frameworks have only recently entered common use by unmanned vehicles. For industry and government, the complexity, cost, and time to re-implement stable systems often exceeds the perceived benefits of adopting a modern software infrastructure. Thus, most persevere with legacy software, adapting and modifying software when and wherever possible or necessary -- adopting strategic software frameworks only when no justifiable legacy exists. Conversely, academic programs with short one or two year projects frequently exploit strategic software frameworks but with little enduring impact. The open-source movement radically changes this picture. Academic frameworks, open to public scrutiny and modification, now rival commercial frameworks in both quality and economic impact. Further, industry now realizes that open source frameworks can reduce cost and risk of systems engineering. This paper describes the Architecture for Autonomy implemented by DRDC and how this architecture meets DRDC's current needs. It also presents an argument for why this architecture should also satisfy DRDC's future requirements as well.

Swamp Works: A New Approach to Develop Space Mining and Resource Extraction Technologies at the National Aeronautics Space Administration (NASA) Kennedy Space Center (KSC)

NASA Technical Reports Server (NTRS)

Mueller, R. P.; Sibille, L.; Leucht, K.; Smith, J. D.; Townsend, I. I.; Nick, A. J.; Schuler, J. M.

2015-01-01

The first steps for In Situ Resource Utilization (ISRU) on target bodies such as the Moon, Mars and Near Earth Asteroids (NEA), and even comets, involve the same sequence of steps as in the terrestrial mining of resources. First exploration including prospecting must occur, and then the resource must be acquired through excavation methods if it is of value. Subsequently a load, haul and dump sequence of events occurs, followed by processing of the resource in an ISRU plant, to produce useful commodities. While these technologies and related supporting operations are mature in terrestrial applications, they will be different in space since the environment and indigenous materials are different than on Earth. In addition, the equipment must be highly automated, since for the majority of the production cycle time, there will be no humans present to assist or intervene. This space mining equipment must withstand a harsh environment which includes vacuum, radical temperature swing cycles, highly abrasive lofted dust, electrostatic effects, van der Waals forces effects, galactic cosmic radiation, solar particle events, high thermal gradients when spanning sunlight terminators, steep slopes into craters / lava tubes and cryogenic temperatures as low as 40 K in permanently shadowed regions. In addition the equipment must be tele-operated from Earth or a local base where the crew is sheltered. If the tele-operation occurs from Earth then significant communications latency effects mandate the use of autonomous control systems in the mining equipment. While this is an extremely challenging engineering design scenario, it is also an opportunity, since the technologies developed in this endeavor could be used in the next generations of terrestrial mining equipment, in order to mine deeper, safer, more economical and with a higher degree of flexibility. New space technologies could precipitate new mining solutions here on Earth. The NASA KSC Swamp Works is an innovation environment and methodology, with associated laboratories that uses lean development methods and creativity-enhancing processes to invent and develop new solutions for space exploration. This paper will discuss the Swamp Works approach to developing space mining and resource extraction systems and the vision of space development it serves. The ultimate goal of the Swamp Works is to expand human civilization into the solar system via the use of local resources utilization. By mining and using the local resources in situ, it is conceivable that one day the logistics supply train from Earth can be eliminated and Earth independence of a space-based community will be enabled.

Automatic Locker Key With Barcode Based Microcontroller Atmega 8535

NASA Astrophysics Data System (ADS)

Fahmi, M. Irfan; Efendi Hutagalung, Jhonson

2017-12-01

MCB (miniature circuit breaker) is an electromagnetic device that embodies complete enclosure in a molded insulating material. The main function of an MCB is to switch the circuit, i.e., to open the circuit (which has been connected to it) automatically when the current passing through it (MCB) exceeds the value for which it is set. Unlike fuse, an MCB can be easily reset and thus offers improved operational safety and greater convenience without incurring large operating cost.The principal of operation is simple. In simple terms MCB is a switch which automatically turns off when the current flowing through it passes the maximum allowable limit. Generally MCB are designed to protect against over current and over temperature faults (over heating). Sometimes the overload the current through the bimetal causes to raise the temperature of it. The heat generated within the bimetal itself enough to cause deflection due to thermal expansion of metals. This solution is used by LDR, and LM 35 as the sencor to control center. Therefore it is very important because it is related about local control switches, isolating switches against faults and overload protection devices for installations or specific equipments or appliances

A Motionless Camera

NASA Technical Reports Server (NTRS)

1994-01-01

Omniview, a motionless, noiseless, exceptionally versatile camera was developed for NASA as a receiving device for guiding space robots. The system can see in one direction and provide as many as four views simultaneously. Developed by Omniview, Inc. (formerly TRI) under a NASA Small Business Innovation Research (SBIR) grant, the system's image transformation electronics produce a real-time image from anywhere within a hemispherical field. Lens distortion is removed, and a corrected "flat" view appears on a monitor. Key elements are a high resolution charge coupled device (CCD), image correction circuitry and a microcomputer for image processing. The system can be adapted to existing installations. Applications include security and surveillance, teleconferencing, imaging, virtual reality, broadcast video and military operations. Omniview technology is now called IPIX. The company was founded in 1986 as TeleRobotics International, became Omniview in 1995, and changed its name to Interactive Pictures Corporation in 1997.

Research in mobile robotics at ORNL/CESAR (Oak Ridge National Laboratory/Center for Engineering Systems Advanced Research)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mann, R.C.; Weisbin, C.R.; Pin, F.G.

1989-01-01

This paper reviews ongoing and planned research with mobile autonomous robots at the Oak Ridge National Laboratory (ORNL), Center for Engineering Systems Advanced Research (CESAR). Specifically we report on results obtained with the robot HERMIES-IIB in navigation, intelligent sensing, learning, and on-board parallel computing in support of these functions. We briefly summarize an experiment with HERMIES-IIB that demonstrates the capability of smooth transitions between robot autonomy and tele-operation. This experiment results from collaboration among teams at the Universities of Florida, Michigan, Tennessee, and Texas; and ORNL in a program targeted at robotics for advanced nuclear power stations. We conclude bymore » summarizing ongoing R D with our new mobile robot HERMIES-III which is equipped with a seven degree-of-freedom research manipulator arm. 12 refs., 4 figs.« less

MoonMars Base in Poland: a Simulation Habitat and Laboratory for Research

NASA Astrophysics Data System (ADS)

Kolodziejczyk, Agata; Gocyla, Michal; Harasymczuk, Matt; Krainski, Mateusz; Nawrot, Adam; Orzechowski, Leszek; Wszolek, Bogdan; Vos, Heleen; Foing, Bernard

2017-04-01

Analog simulation missions are notable steps of real space exploration missions, where the hardware, along with the psychological behavior, the scientific and geological experiments, and operations, are scrutinized and conducted in a simulated environment to prepare astronauts and space agencies for actual missions. Here we present the newly built MoonMars base in Poland to investigate human-robotic relations during long-term planetary missions. We apply novel tele-medicine solutions, novel architecture design, life-sustaining systems and novel methods of planning and working to simulate not only "the beginning of life" in the habitat but also "a need to transform". The aim of the project is to facilitate and to speed up development of space education in Europe. Particularly, we are interested to enroll students, engineers and PhD students for realization of their individual projects in the frame of their master and doctoral programmes.

Kalman filtering applied to real-time monitoring of apogee maneuvers

NASA Technical Reports Server (NTRS)

Deboer, Frederic; Barbier, Christian

1993-01-01

Part of the Space Mathematics Division in CNES, the Flight Dynamics Center provides attitude and orbit determinations and maneuvers during the Launch and Early Operation Phase (LEOP) of geostationary satellites. Orbit determination is based on a Kalman filter method; when the 2 GHz CNES/NASA network is used, Doppler measurements are available and allow orbit determination during the apogee maneuvers. This method was used for TELE-X and TDF 2 LEOP (3-axis controlled satellites) and also for TELECOM 2 and HISPASAT (spun satellites): it enables us to follow the evolution of the maneuver and gives out a quite accurate estimation of the reached orbit. In this paper, we briefly describe the dynamic models of the orbit evolution in both cases, '3-axis' and 'inertial' thrust. Then, we present the results obtained for each case. Afterwards, we present some cases to show the robustness of the filter.

[Haptic tracking control for minimally invasive robotic surgery].

PubMed

Xu, Zhaohong; Song, Chengli; Wu, Wenwu

2012-06-01

Haptic feedback plays a significant role in minimally invasive robotic surgery (MIRS). A major deficiency of the current MIRS is the lack of haptic perception for the surgeon, including the commercially available robot da Vinci surgical system. In this paper, a dynamics model of a haptic robot is established based on Newton-Euler method. Because it took some period of time in exact dynamics solution, we used a digital PID arithmetic dependent on robot dynamics to ensure real-time bilateral control, and it could improve tracking precision and real-time control efficiency. To prove the proposed method, an experimental system in which two Novint Falcon haptic devices acting as master-slave system has been developed. Simulations and experiments showed proposed methods could give instrument force feedbacks to operator, and bilateral control strategy is an effective method to master-slave MIRS. The proposed methods could be used to tele-robotic system.

78 FR 38975 - Sunshine Act Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-28

... FEDERAL COMMUNICATIONS COMMISSION Sunshine Act Meetings Open Commission Meeting Thursday, June 27, 2013 The Federal Communications Commission will hold an Open Meeting on the subjects listed below on... data. 2 WIRELESS TELE- TITLE: Service Rules for COMMUNICATIONS. Advanced Wireless Services H Block...

Enabling Arctic Research Through Science and Engineering Partnerships

NASA Astrophysics Data System (ADS)

Kendall, E. A.; Valentic, T. A.; Stehle, R. H.

2014-12-01

Under an Arctic Research Support and Logistics contract from NSF (GEO/PLR), SRI International, as part of the CH2M HILL Polar Services (CPS) program, forms partnerships with Arctic research teams to provide data transfer, remote operations, and safety/operations communications. This teamwork is integral to the success of real-time science results and often allows for unmanned operations which are both cost-effective and safer. The CPS program utilizes a variety of communications networks, services and technologies to support researchers and instruments throughout the Arctic, including Iridium, VSAT, Inmarsat BGAN, HughesNet, TeleGreenland, radios, and personal locator beacons. Program-wide IT and communications limitations are due to the broad categories of bandwidth, availability, and power. At these sites it is essential to conserve bandwidth and power through using efficient software, coding and scheduling techniques. There are interesting new products and services on the horizon that the program may be able to take advantage of in the future such as Iridium NEXT, Inmarsat Xpress, and Omnispace mobile satellite services. Additionally, there are engineering and computer software opportunities to develop more efficient products. We will present an overview of science/engineering partnerships formed by the CPS program, discuss current limitations and identify future technological possibilities that could further advance Arctic science goals.

Communication network for decentralized remote tele-science during the Spacelab mission IML-2

NASA Technical Reports Server (NTRS)

Christ, Uwe; Schulz, Klaus-Juergen; Incollingo, Marco

1994-01-01

The ESA communication network for decentralized remote telescience during the Spacelab mission IML-2, called Interconnection Ground Subnetwork (IGS), provided data, voice conferencing, video distribution/conferencing and high rate data services to 5 remote user centers in Europe. The combination of services allowed the experimenters to interact with their experiments as they would normally do from the Payload Operations Control Center (POCC) at MSFC. In addition, to enhance their science results, they were able to make use of reference facilities and computing resources in their home laboratory, which typically are not available in the POCC. Characteristics of the IML-2 communications implementation were the adaptation to the different user needs based on modular service capabilities of IGS and the cost optimization for the connectivity. This was achieved by using a combination of traditional leased lines, satellite based VSAT connectivity and N-ISDN according to the simulation and mission schedule for each remote site. The central management system of IGS allows minimization of staffing and the involvement of communications personnel at the remote sites. The successful operation of IGS for IML-2 as a precursor network for the Columbus Orbital Facility (COF) has proven the concept for communications to support the operation of the COF decentralized scenario.

Integrating critical interface elements for intuitive single-display aviation control of UAVs

NASA Astrophysics Data System (ADS)

Cooper, Joseph L.; Goodrich, Michael A.

2006-05-01

Although advancing levels of technology allow UAV operators to give increasingly complex commands with expanding temporal scope, it is unlikely that the need for immediate situation awareness and local, short-term flight adjustment will ever be completely superseded. Local awareness and control are particularly important when the operator uses the UAV to perform a search or inspection task. There are many different tasks which would be facilitated by search and inspection capabilities of a camera-equipped UAV. These tasks range from bridge inspection and news reporting to wilderness search and rescue. The system should be simple, inexpensive, and intuitive for non-pilots. An appropriately designed interface should (a) provide a context for interpreting video and (b) support UAV tasking and control, all within a single display screen. In this paper, we present and analyze an interface that attempts to accomplish this goal. The interface utilizes a georeferenced terrain map rendered from publicly available altitude data and terrain imagery to create a context in which the location of the UAV and the source of the video are communicated to the operator. Rotated and transformed imagery from the UAV provides a stable frame of reference for the operator and integrates cleanly into the terrain model. Simple icons overlaid onto the main display provide intuitive control and feedback when necessary but fade to a semi-transparent state when not in use to avoid distracting the operator's attention from the video signal. With various interface elements integrated into a single display, the interface runs nicely on a small, portable, inexpensive system with a single display screen and simple input device, but is powerful enough to allow a single operator to deploy, control, and recover a small UAV when coupled with appropriate autonomy. As we present elements of the interface design, we will identify concepts that can be leveraged into a large class of UAV applications.

Prospective Randomized Study of the Effect of Music on the Efficiency of Surgical Closures.

PubMed

Lies, Shelby R; Zhang, Andrew Y

2015-09-01

Music is commonly played in operating theaters. Some surgeons believe music reduces stress and operative time, while others think music is a distraction and should be avoided. There is limited published evidence evaluating the effects of music on surgical performance. The goal of this study is to evaluate the effect of music on simple wound closure. Plastic surgery residents were asked to perform layered closures on pigs' feet with and without their preferred music playing. Simple randomization was used to assign residents to the music playing first or music playing second group. The time to complete the repair was measured and repairs were graded by blinded faculty. Results were analyzed to determine significant differences in time to complete the task and quality of repair. Participants were retested in a second session with music played in the opposite order to evaluate consistency. Listening to preferred music decreased repair time by 8% for all plastic surgery residents (p = 0.009). Subgroup analysis demonstrated even more significant improvement in speed for senior residents (PGY 4-6), resulting in a 10% decrease in repair time (p = 0.006). The quality of repair was also better in the music group, at 3.3 versus 3.1 (p = 0.047). Retesting revealed results remained significant whether music was played first or second. Playing preferred music made plastic surgery residents faster in completing wound closure with a 10% improvement in senior residents. Music also improved quality of repair as judged by blinded faculty. Our study showed that music improves efficiency of wound closure, which may translate to healthcare cost savings. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

Spectral fluctuations of quantum graphs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pluhař, Z.; Weidenmüller, H. A.

We prove the Bohigas-Giannoni-Schmit conjecture in its most general form for completely connected simple graphs with incommensurate bond lengths. We show that for graphs that are classically mixing (i.e., graphs for which the spectrum of the classical Perron-Frobenius operator possesses a finite gap), the generating functions for all (P,Q) correlation functions for both closed and open graphs coincide (in the limit of infinite graph size) with the corresponding expressions of random-matrix theory, both for orthogonal and for unitary symmetry.

Deriving Sea Surface Salinity and Density Variations from Satellite and Aircraft Microwave Radiometer Measurements: Application to Coastal Plumes Using STARRS

DTIC Science & Technology

2007-11-01

again, with of the prevailing T, S, and, hence, D gradients through the the advent of high-performance spaceborne altimeters (e.g., high- aspect - ratio ... rectangular domains with linear dimensions largely , if not completely, eliminated by the differencing oper- of about 60 km in a 4-h flight. (See...strongest A simple four- quadrant arctangent of the terms in the density in the 00 and 1800 directions, whereas compensation is most ratio would serve our

Tele-Immersion: Preferred Infrastructure for Anatomy Instruction

ERIC Educational Resources Information Center

Silverstein, Jonathan C.; Ehrenfeld, Jesse M.; Croft, Darin A.; Dech, Fred W.; Small, Stephen; Cook, Sandy

2006-01-01

Understanding spatial relationships among anatomic structures is an essential skill for physicians. Traditional medical education--using books, lectures, physical models, and cadavers--may be insufficient for teaching complex anatomical relationships. This study was designed to measure whether teaching complex anatomy to medical students using…