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Biomedical subjects

F del Pozo

Publications and source records attributed to F del Pozo.

At least 19 recordsLinked to original sources
PubMed2001

Optimisation and evaluation of an asynchronous transfer mode teleradiology co-operative system: the experience of the EMERALD and the BONAPARTE projects.

This paper describes the work carried out to optimise and evaluate in clinical routine a multimedia telemedicine application for co-operative imaging diagnosis. This research has been attained within the framework of two European research projects, namely the EMERALD [1] and the BONAPARTE [2]. A user-centred telemedicine application was developed on an existing advanced broadband multimedia teleradiology platform to exploit the possibilities offered by Asynchronous Transfer Mode (ATM) technology to support real-time teleconsultation services for medical imaging. The evaluation of this telemedicine system in both projects has been performed with the aim of (1) characterising and optimising the ATM teleradiology platform, minimising the bandwidth requirements without degrading the quality of service offered to users and (2) evaluating the telemedicine system usability to improve the fulfillment of user's needs. The assessment outcomes have provided insights into technical limitations of broadband multimedia technologies for an optimum usage of a teleradiology co-operative diagnosis systems and the organisational difficulties and limitations involved in setting-up these new advanced telemedicine services to achieve the expected clinical benefits.

Computer Graphics↗
PubMed2000

Evaluation of DIABNET, a decision support system for therapy planning in gestational diabetes.

DIABNET is a knowledge-based system designed to aid doctors with therapy planning in gestational diabetes. The system core is a qualitative model, implemented by a Causal Probabilistic Network, that is able to detect the insulin effectiveness on a daily basis. DIABNET analyses monitoring data and proposes quantitative changes in insulin therapy and qualitative diet modifications. This paper proposes an evaluation methodology to assess the system performance when working in a real scenario. The methodology manages the absence of a gold standard and includes: a subjective analysis based on questionnaires and an objective analysis based on a quantitative comparison of the system's and experts' proposals. The paper also shows the results of two experiments in which expert diabetologists evaluated the therapeutical advice provided by DIABNET during the follow up of 9 patients with gestational diabetes. DIABNET detected the need of a therapy modification in 92% of the cases showing its appropriateness for automatic alarm generation. Around 80% of the proposals were accepted by experts. The evaluation results are encouraging and allow characterisation of the system's performance when proposing therapy modifications. Evaluation in its turn helps to refine the knowledge managed by DIABNET and enables us to look towards the further clinical use of DIABNET as a decision tool in gestational diabetes integrated in a telemedicine service.

Artificial Intelligence↗
PubMed1998

Automated FISH spot counting in interphase nuclei: statistical validation and data correction.

The evaluation of an automated system for Fluorescence In Situ Hybridization (FISH) spot counting in interphase nuclei is presented in this paper. Different types of experiments have been performed with samples from known populations. In all of them the goal is to detect mosaicism of chromosome X in leukocytes from mixtures in known proportions of healthy male and female blood. First the initial results from the automatic FISH analysis system were obtained and evaluated. Then the analysis was modified to reduce systematic errors, so that the results are closer to what an experienced human operator would have obtained (system calibration step). Finally, an additional control probe of chromosome Y was used to detect and discard cells where incorrect hybridization or other abnormal situations had occurred. In each step the system sensitivity was determined by the use of two statistical validation tests, so that the improvement brought about by the correction methods could be assessed. The results obtained in the study showed that, using both corrections, the system is able to detect 10% monosomies with a significance level alpha = 0.1%.

Algorithms↗
PubMed1998

MRI visualization of small structures using improved surface coils.

In this paper we present the spatial resolution enhancement and noise reduction level achieved with an optimized inductively coupled surface coil specifically designed for our experiments. The technique of designing and implementing customized coils for magnetic resonance imaging of very small structures is described. We have designed a low cost prototype of an inductively coupled circular surface coil, tuned for 1H magnetic resonance imaging at 200 MHz. The coil is mounted on a customized teflon support. The inductive coupling used in this coil improves the signal-to-noise ratio by reducing various loss mechanisms (specially the dielectric losses). Test images have been acquired to determine the evolution of induced articular lesions in a rabbit animal model, as well as brain tumors in rats. The images show high spatial resolution, excellent B1 field homogeneity and no "hot spots". Comparing these images with those acquired with conventional coils, one finds better spatial resolution and signal-to-noise ratio, as well as larger field of view with less intense illumination artifact. The methodology can be used in any application that requires high quality imaging of small structures.

Animals↗
PubMed1998

A broadband multimedia collaborative system for advanced teleradiology and medical imaging diagnosis.

This paper presents a new telemedicine system currently in routine clinical usage, developed within the European Union (EU) ACTS BONAPARTE project (1). The telemedicine system is developed on an asynchronous transfer mode (ATM) multimedia hardware/software platform comprising the following set of telemedicine services: synchronous cooperative work, high-quality video conference, multimedia mail, medical image digitizing, processing, storing and printing, and local and remote transparent database access. The medical information handled by the platform conforms to the Digital Imaging and Communications in Medicine (DICOM) 3.0 medical imaging standard. The telemedicine system has been installed for clinical routines in three Spanish hospitals since November 1997 and has been used in an average of one/two clinical sessions per week. At each clinical session, a usability and clinical evaluation of the system was carried out. Evaluation is carried out through direct observation of interactions and questionnaire-based subjective data. The usability evaluation methodology and the results of the system usability study are also presented in this article. The experience gained from the design, development, and evaluation of the telemedicine system is providing an indepth knowledge of the benefits and difficulties involved in the installation and clinical usage of this type of high-usability and advanced multimedia telemedicine system in the field of teleradiology and collaborative medical imaging diagnosis.

Diagnostic Imaging↗
PubMed1997

Applying watershed algorithms to the segmentation of clustered nuclei.

Cluster division is a critical issue in fluorescence microscopy-based analytical cytology when preparation protocols do not provide appropriate separation of objects. Overlooking clustered nuclei and analyzing only isolated nuclei may dramatically increase analysis time or affect the statistical validation of the results. Automatic segmentation of clustered nuclei requires the implementation of specific image segmentation tools. Most algorithms are inspired by one of the two following strategies: 1) cluster division by the detection of internuclei gradients; or 2) division by definition of domains of influence (geometrical approach). Both strategies lead to completely different implementations, and usually algorithms based on a single view strategy fail to correctly segment most clustered nuclei, or perform well just for a specific type of sample. An algorithm based on morphological watersheds has been implemented and tested on the segmentation of microscopic nuclei clusters. This algorithm provides a tool that can be used for the implementation of both gradient- and domain-based algorithms, and, more importantly, for the implementation of mixed (gradient- and shape-based) algorithms. Using this algorithm, almost 90% of the test clusters were correctly segmented in peripheral blood and bone marrow preparations. The algorithm was valid for both types of samples, using the appropriate markers and transformations.

Algorithms↗
PubMed1997

Simulated surgery on computed tomography and magnetic resonance images: an aid for intraoperative radiotherapy.

Intraoperative radiotherapy (IORT) is a relatively new technique in which irradiation with electrons is performed during an open surgery procedure. This approach poses significant problems in obtaining accurate dosimetry, since neither the pre- nor the postoperative patient images actually matches the irradiation field. Our objective was to implement a software tool able to provide an estimate of the dose distribution, overcoming the problem of the geometrical mismatch between the images and the surgical field during the irradiation. The program was developed in the C programming language, on a noncommercial version of a Philips EasyVision workstation. The application allows to create a new data set by manipulating the preoperative computed tomography and magnetic resonance images in order to simulate the final geometry of the surgical area during the IORT procedure. The exact dose distribution can then be calculated by transferring these new images to a standard radiotherapy planning system. Also an approximate dose distribution can be quickly displayed by superimposing isodose curves obtained from a water phantom. The proposed approach introduces a helpful tool for dosimetry and planning in IORT protocols, improving their accuracy and safety and allowing for more objective quality control and patient follow-up.

Brain Neoplasms↗
PubMed1997

Evaluation of autofocus functions in molecular cytogenetic analysis.

This work describes a systematic evaluation of several autofocus functions used for analytical fluorescent image cytometry studies of counterstained nuclei. Focusing is the first step in the automatic fluorescence in situ hybridization analysis of cells. Thirteen functions have been evaluated using qualitative and quantitative procedures. For the last of these procedures a figure-of-merit (FOM) is defined and proposed. This new FOM takes into account five important features of the focusing function. Our results show that functions based on correlation measures have the best performance for this type of image.

Algorithms↗
PubMed1996

A telemedicine system for remote cooperative medical imaging diagnosis.

Telemedicine is changing the classical form of health care delivery, by providing efficient solutions to an increasing number of new situations: here we consider those which require some type of computer-supported cooperative work (CSCW) between health care professionals located in different clinical sites. This paper presents the design and development of a telemedicine system for remote computer-supported cooperative medical imaging diagnosis. The main and novel component of our system is a new CSCW distributed architecture, comprised by a collaborative toolkit to add audioconferencing, telepointing, window sharing, user's coordination and application synchronization facilities, either to existing or new medical imaging diagnosis applications. In comparison with existing CSCW products, mainly based on centralized architectures, our distributed toolkit is specially designed for telemedicine applications: to allow different levels of sharing between participants, to improve user feedback in highly interactive user interfaces, and to optimize the required communication bandwidth in order to implement a telemedicine CSCW application on almost any telecommunication network. This telemedicine CSCW system has been applied to build a cooperative medical imaging diagnosis application, in which two doctors, located in different hospitals, need to achieve a cooperative diagnosis on haemodynamic studies using cardiac angiography images. The design of the graphical user interface for this kind of telemedicine CSCW systems, a critical component which conforms any telemedicine application, is also addressed with a new methodological approach, to assure the system usability and final user acceptance. The telemedicine cardiac angiography pilot has been implemented, tested and evaluated within the Research Project 'FEST-Framework for European Services in Telemedicine' funded by EU AIM Programme.

Attitude to Computers↗
PubMed1995

A home telecare management system.

The increasing tendency to discharge chronic patients from hospital, as well as the growing expectation of improved quality of life for elderly and disabled people at home, was the original motivation for the development of a home telecare management system. The system allows a service centre to perform remote monitoring of biological signals and other data via the public telephone network, as well as to manage different emergency situations arising at home. The system is part of the FU-funded EPIC project (European Prototype for Integrated Care). It was tested in Belfast (Northern Ireland) and is currently being installed in Torre del Mar (Spain). This paper describes the system design and preliminary evaluation. The results indicate that the system operators find it highly acceptable in terms of efficiency, effectiveness, helpfulness, control and learnability. Integration of home telecare data with community-care information systems is essential if data captured at home are to be incorporated into the care process effectively.

Aged↗
PubMed1994

Telehygiene system for preventive chronopharmacology in space.

A remote computerized health care (telehygiene) system for space travel includes monitoring devices and pharmaceuticals aimed at the optimization of health and the environment. Early risk indicators are provided by dynamic characteristics of rhythms of several frequencies describing variation inside the physiologic range. These rhythm characteristics, assessed as one goes, can be updated and compacted as data accumulate by the use of chronobiologic software that resolves anticipated components of lower and lower frequency, thus providing summaries of data at intervals of differing length. At any time, harbingers of risk, including characteristics of circannual rhythms, can be retrieved in an instant. On their basis, early preventive action can be instituted for risk lowering and for delivery of timed treatment when needed. Preventive or curative health care in space and terrestrial spin-offs are the more effective the more of the chronome (time-structure) is resolved.

Aerospace Medicine↗
PubMed1994

A telemedicine distributed system for cooperative medical diagnosis.

Telemedicine is changing the classical form of health care delivery, dramatically increasing the number of new applications in which some type of distributed synchronous cooperation between health care professionals is required. This paper presents the design and development of a telemedicine distributed system for cooperative medical diagnosis based on two new approaches: 1) a distributed layered architecture specially designed to add synchronous computer supported cooperative work features either to new or existing medical applications; 2) the definition of a methodological procedure to design graphical user interfaces for telemedicine cooperative working scenarios. The cooperative work is supported by a collaborative toolkit that provides telepointing, window sharing, coordination and synchronization. Finally, we have implemented and installed the telemedicine system in clinical practice between two hospitals, providing teleconferencing facilities for cooperative decision support in haemodynamics studies. This specific implementation and a preliminary evaluation were accomplished under the Research Project FEST "Framework for European Services in Telemedicine" funded by the EU AIM Programme.

Computer Communication Networks↗
PubMed1994

A hybrid knowledge based system for therapy adjustment in gestational diabetes.

This poster describes a system to analyze self-monitoring data of gestational diabetic patients, for obtaining an assessment of their metabolic control with the final goal of supporting decision-making in therapy adjustment. The system is able to manage incomplete data and to make temporal reasoning under uncertainty, the two most important constraints when analyzing ambulatory monitoring data. Two different formalism have been used to represent and manage the knowledge: a dynamic Bayesian network and a production system based on rules. The outcomes provided by the whole system are: information on possible patient transgressions of the prescribed treatment and recommendations of treatment adjustments.

Artificial Intelligence↗
PubMed1993

A pen-based system to support pre-operative data collection within an anaesthesia department.

This paper describes the design and implementation of a pen-based computer system for remote preoperative data collection. The system is envisaged to be used by anaesthesia staff at different hospital scenarios where pre-operative data are generated. Pen-based technology offers important advantages in terms of portability and human-computer interaction, as direct manipulation interfaces by direct pointing, and "notebook user interfaces metaphors". Being the human factors analysis and user interface design a vital stage to achieve the appropriate user acceptability, a methodology that integrates the "usability" evaluation from the earlier development stages was used. Additionally, the selection of a pen-based computer system as a portable device to be used by health care personnel allows to evaluate the appropriateness of this new technology for remote data collection within the hospital environment. The work presented is currently being realised under the Research Project "TANIT: Telematics in Anaesthesia and Intensive Care", within the "A.I.M.--Telematics in Health CARE" European Research Program.

Anesthesia Department, Hospital↗
PubMed1986

Behavior of neurons in the abducens nucleus of the alert cat--I. Motoneurons.

The activity of 53 antidromically identified abducens motoneurons was analyzed in alert cats during spontaneous and vestibular induced eye movements. Conduction velocities ranged from 13 to 70 m/s and all motoneurons increased their discharge rates with successive eye positions in the abducting direction. Motoneurons were recruited from -19 degrees to +7 degrees. Within the oculomotor range frequency saturation was never observed for any cell. The slope of rate-position (k) relationships ranged from 2 to 17.7 spikes/s/deg (n = 40, mean 8.7 +/- 2.5). Regression analysis showed that the rate-position plots could be fit by straight lines but in most cases exponential curves produced slightly better statistical fits. Steeper slopes suggest that successively larger increases in k are required for the lateral rectus muscle to maintain more eccentric fixations in the on direction. Interspike intervals for a constant eye position exhibited low variability (less than 3.5%) for fixations shorter than 1 s. Over longer periods, variability increased in proportion to the duration of the fixation in exponential-like fashion up to 14%. Abducens motoneurons showed considerable variability in frequency during repeated fixations of the same eye position. Discharge rates were found to depend upon both the direction of the previous eye movement and, more importantly, the animal's level of alertness. The rate-position regression lines for fixation periods after saccades in the on direction significantly differed in slopes (100%) and thresholds (20%) from those in the off direction. The observed static hysteresis in abducens motoneuron behavior was in opposite direction to that previously described for the mechanical properties of the lateral rectus. This suggests both neural and mechanical factors are significantly involved in determining final eye position. The animal's level of alertness was evaluated in this study by counting the number of saccadic movements/s occurring in "alert" (1 +/- 0.2 saccades/s), and "drowsy" (0.5 +/- 0.2 saccades/s) circumstances. Comparison of the rate-position regression lines between the two conditions showed a significant decrease in slopes (100%) and elevation of thresholds (70%). Discharge rate of abducens motoneurons increased abruptly 8.9 +/- 2.8 ms prior to saccades in the horizontal on direction, and decreased 14.8 +/- 4.05 m before saccades in the off direction. During purely vertical saccades the firing frequency of abducens motoneurons did not change. Burst frequency did not saturate during saccades, but increased with saccadic velocity in a linear fashion.(ABSTRACT TRUNCATED AT 400 WORDS)

Abducens Nerve↗
PubMed1986

Behavior of neurons in the abducens nucleus of the alert cat--II. Internuclear neurons.

The activity of 43 antidromically identified abducens internuclear neurons with conduction velocities ranging from 14 to 54 m/s was analyzed in alert cats during spontaneous and vestibular induced eye movements. The discharge rate of internuclear neurons significantly increased with successive adducting positions of the contralateral eye. Slopes of rate-position (k) relationships ranged from 3.1 to 17.9 spikes/deg (mean 12.01 +/- 3.1). Threshold ranged from -19 degrees to +3 degrees. Frequency saturation was never observed for any internuclear neuron within the oculomotor range. Although straight lines were selected to illustrate the rate-position relationships, exponential curves always provided the best statistical fit demonstrating that an enhancement in frequency potentiation (k) must accompany more eccentric fixations in the on direction. Internuclear neurons showed a low variability in firing rate (less than 3.0%) for fixations less than 1 s. Variability increased with both longer and repeated fixations of the same eye position. Discharge rates were found to depend upon both the direction of the preceding eye movement and the animal's level of alertness. Separate regression lines of rate-position relations following saccades in the on and off directions differed significantly in slope (100%), but not threshold. The observed static hysteresis in an identified non-motoneuron shows this property to be in a central neural circuit prior to the extraocular motoneuron. The slopes (k) of rate-position plots for all internuclear neurons decreased significantly (100%) when level of alertness changed from "alert" (1 +/- 0.2 saccades/s) to "drowsy" (0.5 +/- 0.2 saccades/s). Thresholds, however, were not significantly altered. Discharge rate of abducens internuclear neurons increased abruptly 10.4 +/- 2.5 ms preceding saccades in the on direction, and decreased 20.5 +/- 7.8 ms before saccades in the off direction. Internuclear neuronal activity was not affected by pure vertical saccades. During on direction saccades, firing frequency did not saturate, but increased with velocity in a linear fashion. Exponential functions often fit the data better due to the difference in slopes of rate-velocity plots for on vs off direction saccades. Slopes (rs) of rate-velocity regression lines during spontaneous saccades ranged from 0.99 to 4.10 spikes/s/deg/s (mean 2.16 +/- 0.93). During saccades in the off direction activity always decreased, but it seldom ceased. Rate-velocity regression lines measured during the fast phase of vestibular nystagmus (rsv = 2.09 +/- 0.88) showed no significant differences from rs slopes in 82% of the cases.(ABSTRACT TRUNCATED AT 400 WORDS)

Abducens Nerve↗