MedLAN: Compact mobile computing system for wireless information access in emergency hospital wards

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.As the need for faster, safer and more efficient healthcare delivery increases, medical consultants seek new ways of implementing a high quality telemedical system, using innovative technology. Until today, teleconsultation (the most common application of Telemedicine) was performed by transferring the patient from the Accidents and Emergency ward, to a specially equipped room, or by moving large and heavy machinery to the place where the patient resided. Both these solutions were unpractical, uneconomical and potentially dangerous. At the same time wireless networks became increasingly useful in point-of-care areas such as hospitals, because of their ease of use, low cost of installation and increased flexibility. This thesis presents an integrated system called MedLAN dedicated for use inside the A&E hospital wards. Its purpose is to wirelessly support high-quality live video, audio, high-resolution still images and networks support from anywhere there is WLAN coverage. It is capable of transmitting all of the above to a consultant residing either inside or outside the hospital, or even to an external place, thorough the use of the Internet. To implement that, it makes use of the existing IEEE 802.11b wireless technology. Initially, this thesis demonstrates that for specific scenarios (such as when using WLANs), DICOM specifications should be adjusted to accommodate for the reduced WLAN bandwidth. Near lossless compression has been used to send still images through the WLANs and the results have been evaluated by a number of consultants to decide whether they retain their diagnostic value. The thesis further suggests improvements on the existing 802.11b protocol. In particular, as the typical hospital environment suffers from heavy RF reflections, it suggests that an alternative method of modulation (OFDM) can be embedded in the 802.11b hardware to reduce the multipath effect, increase the throughput and thus the video quality sent by the MedLAN system. Finally, realising that the trust between a patient and a doctor is fundamental this thesis proposes a series of simple actions aiming at securing the MedLAN system. Additionally, a concrete security system is suggested, that encapsulates the existing WEP security protocol, over IPSec

Intelligent computing applications based on eye gaze : their role in mammographic interpretation training

Early breast cancer in women is best identified through high quality mammographic screening. This is achieved by well trained health professionals and appropriate imaging. Traditionally this has used X-ray film but is rapidly changing to utilise digital imaging with the resultant mammograms visually examined on high resolution clinical workstations. These digital images can also be viewed on a range of display devices, such as standard computer monitors or PDAs. In this thesis the potential of using such non-clinical workstation display devices for training purposes in breast screening has been investigated. The research introduces and reviews breast screening both in the UK and internationally where it concentrates upon China which is beginning screening. Various imaging technologies used to examine the breast are described, concentrating upon the move from using X-ray film to digital mammograms. Training in screening in the UK is detailed and it is argued that there is a need to extend this. Initially, a national survey of all UK mammography screeners within the National Health Breast Screening Programme (NHSBSP) was undertaken. This highlighted the current main difficulties of mammographic (film) interpretation training being tied to the device for inspecting these images. The screeners perceived the need for future digital imaging training that could be outside the breast screening centre; namely 3W training (Whatever training required, Whenever and Wherever). This is largely because the clinical workstations would logistically not be available for training purposes due to the daily screening demand. Whilst these workstations must be used for screening and diagnostic purposes to allow visualisation of very small detail in the images, it is argued here that training to identify such features can be undertaken on other devices where there is not the time constraints that exist during breast screening. A series of small pilot studies were then undertaken, trialling experienced radiologists with potential displays (PDAs and laptops) for mammographic image examination. These studies demonstrated that even on a PDA small mammographic features could be identified, albeit with difficulty, even with a very limited HCI manipulation tool. For training purposes the laptop, studied here with no HCI tool, was supported. Such promising results of display acceptability led to an investigation of mammographic inspection on displays of various sizes and resolutions. This study employed radiography students, potentially eventual screeners, who were eye tracked as they examined images on various sized displays. This showed that it could be possible to use a small PDA to deliver training. A detailed study then investigated whether aspects of an expert radiologist s visual inspection behaviour could be used to develop various training approaches. Four approaches were developed and examined using naïve observers who were eye tracked as they were trained and tested. The approaches were found to be all feasible to implement but of variable usefulness for delivering mammographic interpretation training; this was confirmed by opinions from a focus group of screeners. On the basis of the previous studies, over a period of eight months, a large scale study involving 15 film readers from major breast screening centres was conducted where they examined series of digital mammograms on a clinical workstation, monitor and an iPhone. Overall results on individuals performance, image manipulation behaviour and visual search data indicated that a standard monitor could be employed successfully as an alternative for the digital workstation to deliver on-demand mammographic interpretation training using the full mammographic case images. The small iPhone, elicited poor performance, and was therefore judged not suitable for delivering training with the software employed here. However, future software developments may well overcome its shortcomings. The potential to implement training in China was examined by studying the current skill level of some practicing radiologists and an examination of how they responded to the developed training approaches. Results suggest that such an approach would be also applicable in other countries with different levels of screening skills. On-going further work is also discussed: the improvement of performance evaluation in mammography; new visual research on other breast imaging modalities and using visual search with computer aided detection to assist mammographic interpretation training.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Adaptive intra refresh for robust wireless multi-view video

This thesis was submitted for the award of PhD and was awarded by Brunel University LondonMobile wireless communication technology is a fast developing field and every day new mobile communication techniques and means are becoming available. In this thesis multi-view video (MVV) is also refers to as 3D video. Thus, the 3D video signals through wireless communication are shaping telecommunication industry and academia. However, wireless channels are prone to high level of bit and burst errors that largely deteriorate the quality of service (QoS). Noise along the wireless transmission path can introduce distortion or make a compressed bitstream lose vital information. The error caused by noise progressively spread to subsequent frames and among multiple views due to prediction. This error may compel the receiver to pause momentarily and wait for the subsequent INTRA picture to continue decoding. The pausing of video stream affects the user's Quality of Experience (QoE). Thus, an error resilience strategy is needed to protect the compressed bitstream against transmission errors. This thesis focuses on error resilience Adaptive Intra Refresh (AIR) technique. The AIR method is developed to make the compressed 3D video more robust to channel errors. The process involves periodic injection of Intra-coded macroblocks in a cyclic pattern using H.264/AVC standard. The algorithm takes into account individual features in each macroblock and the feedback information sent by the decoder about the channel condition in order to generate an MVV-AIR map. MVV-AIR map generation regulates the order of packets arrival and identifies the motion activities in each macroblock. Based on the level of motion activity contained in each macroblock, the MVV-AIR map classifies frames as high or low motion macroblocks. A proxy MVV-AIR transcoder is used to validate the efficiency of the generated MVV-AIR map. The MVV-AIR transcoding algorithm uses spatial and views downscaling scheme to convert from MVV to single view. Various experimental results indicate that the proposed error resilient MVV-AIR transcoder technique effectively improves the quality of reconstructed 3D video in wireless networks. A comparison of MVV-AIR transcoder algorithm with some traditional error resilience techniques demonstrates that MVV-AIR algorithm performs better in an error prone channel. Results of simulation revealed significant improvements in both objective and subjective qualities. No additional computational complexity emanates from the scheme while the QoS and QoE requirements are still fully met.Tertiary Institution Trust Fund (TETFund) of Nigeri

A Hybrid client-server based technique for navigation in large terrains using mobile devices

We describe a hybrid client-server technique for remote adaptive streaming and rendering of large terrains in resource-limited mobile devices. The technique has been designed to achieve an interactive rendering performance on a mobile device connected to a low-bandwidth wireless network. The rendering workload is split between the client and the server. The terrain area close to the viewer is rendered in real-time by the client using a hierarchical multiresolution scheme. The terrain located far from the viewer is portrayed as view-dependent impostors, rendered by the server on demand and, then sent to the client. The hybrid technique provides tools to dynamically balance the rendering workload according to the resources available at the client side and to the saturation of the network and server. A prototype has been built and an exhaustive set of experiments covering several platforms, wireless networks and a wide range of viewer velocities has been conducted. Results show that the approach is feasible, effective and robust.Postprint (published version

MedLAN : compact mobile computing system for wireless information access in emergency hospital wards

As the need for faster, safer and more efficient healthcare delivery increases, medical consultants seek new ways of implementing a high quality telemedical system, using innovative technology. Until today, teleconsultation (the most common application of Telemedicine) was performed by transferring the patient from the Accidents and Emergency ward, to a specially equipped room, or by moving large and heavy machinery to the place where the patient resided. Both these solutions were unpractical, uneconomical and potentially dangerous. At the same time wireless networks became increasingly useful in point-of-care areas such as hospitals, because of their ease of use, low cost of installation and increased flexibility. This thesis presents an integrated system called MedLAN dedicated for use inside the A;E hospital wards. Its purpose is to wirelessly support high-quality live video, audio, high-resolution still images and networks support from anywhere there is WLAN coverage. It is capable of transmitting all of the above to a consultant residing either inside or outside the hospital, or even to an external place, thorough the use of the Internet. To implement that, it makes use of the existing IEEE 802.11b wireless technology. Initially, this thesis demonstrates that for specific scenarios (such as when using WLANs), DICOM specifications should be adjusted to accommodate for the reduced WLAN bandwidth. Near lossless compression has been used to send still images through the WLANs and the results have been evaluated by a number of consultants to decide whether they retain their diagnostic value. The thesis further suggests improvements on the existing 802.11b protocol. In particular, as the typical hospital environment suffers from heavy RF reflections, it suggests that an alternative method of modulation (OFDM) can be embedded in the 802.11b hardware to reduce the multipath effect, increase the throughput and thus the video quality sent by the MedLAN system. Finally, realising that the trust between a patient and a doctor is fundamental this thesis proposes a series of simple actions aiming at securing the MedLAN system. Additionally, a concrete security system is suggested, that encapsulates the existing WEP security protocol, over IPSec.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Wavelet-based image compression for mobile applications.

The transmission of digital colour images is rapidly becoming popular on mobile telephones, Personal Digital Assistant (PDA) technology and other wireless based image services. However, transmitting digital colour images via mobile devices is badly affected by low air bandwidth. Advances in communications Channels (example 3G communication network) go some way to addressing this problem but the rapid increase in traffic and demand for ever better quality images, means that effective data compression techniques are essential for transmitting and storing digital images. The main objective of this thesis is to offer a novel image compression technique that can help to overcome the bandwidth problem. This thesis has investigated and implemented three different wavelet-based compression schemes with a focus on a suitable compression method for mobile applications. The first described algorithm is a dual wavelet compression algorithm, which is a modified conventional wavelet compression method. The algorithm uses different wavelet filters to decompose the luminance and chrominance components separately. In addition, different levels of decomposition can also be applied to each component separately. The second algorithm is segmented wavelet-based, which segments an image into its smooth and nonsmooth parts. Different wavelet filters are then applied to the segmented parts of the image. Finally, the third algorithm is the hybrid wavelet-based compression System (HWCS), where the subject of interest is cropped and is then compressed using a wavelet-based method. The details of the background are reduced by averaging it and sending the background separately from the compressed subject of interest. The final image is reconstructed by replacing the averaged background image pixels with the compressed cropped image. For each algorithm the experimental results presented in this thesis clearly demonstrated that encoder output can be effectively reduced while maintaining an acceptable image visual quality particularly when compared to a conventional wavelet-based compression scheme

Web-based Stereoscopic Collaboration for Medical Visualization

Medizinische Volumenvisualisierung ist ein wertvolles Werkzeug zur Betrachtung von Volumen- daten in der medizinischen Praxis und Lehre. Eine interaktive, stereoskopische und kollaborative Darstellung in Echtzeit ist notwendig, um die Daten vollständig und im Detail verstehen zu können. Solche Visualisierung von hochauflösenden Daten ist jedoch wegen hoher Hardware- Anforderungen fast nur an speziellen Visualisierungssystemen möglich. Remote-Visualisierung wird verwendet, um solche Visualisierung peripher nutzen zu können. Dies benötigt jedoch fast immer komplexe Software-Deployments, wodurch eine universelle ad-hoc Nutzbarkeit erschwert wird. Aus diesem Sachverhalt ergibt sich folgende Hypothese: Ein hoch performantes Remote- Visualisierungssystem, welches für Stereoskopie und einfache Benutzbarkeit spezialisiert ist, kann für interaktive, stereoskopische und kollaborative medizinische Volumenvisualisierung genutzt werden. Die neueste Literatur über Remote-Visualisierung beschreibt Anwendungen, welche nur reine Webbrowser benötigen. Allerdings wird bei diesen kein besonderer Schwerpunkt auf die perfor- mante Nutzbarkeit von jedem Teilnehmer gesetzt, noch die notwendige Funktion bereitgestellt, um mehrere stereoskopische Präsentationssysteme zu bedienen. Durch die Bekanntheit von Web- browsern, deren einfach Nutzbarkeit und weite Verbreitung hat sich folgende spezifische Frage ergeben: Können wir ein System entwickeln, welches alle Aspekte unterstützt, aber nur einen reinen Webbrowser ohne zusätzliche Software als Client benötigt? Ein Proof of Concept wurde durchgeführt um die Hypothese zu verifizieren. Dazu gehörte eine Prototyp-Entwicklung, deren praktische Anwendung, deren Performanzmessung und -vergleich. Der resultierende Prototyp (CoWebViz) ist eines der ersten Webbrowser basierten Systeme, welches flüssige und interaktive Remote-Visualisierung in Realzeit und ohne zusätzliche Soft- ware ermöglicht. Tests und Vergleiche zeigen, dass der Ansatz eine bessere Performanz hat als andere ähnliche getestete Systeme. Die simultane Nutzung verschiedener stereoskopischer Präsen- tationssysteme mit so einem einfachen Remote-Visualisierungssystem ist zur Zeit einzigartig. Die Nutzung für die normalerweise sehr ressourcen-intensive stereoskopische und kollaborative Anatomieausbildung, gemeinsam mit interkontinentalen Teilnehmern, zeigt die Machbarkeit und den vereinfachenden Charakter des Ansatzes. Die Machbarkeit des Ansatzes wurde auch durch die erfolgreiche Nutzung für andere Anwendungsfälle gezeigt, wie z.B. im Grid-computing und in der Chirurgie