• Title/Summary/Keyword: 원격 의료

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Effect of Digital Health Interventions on Psychotic Symptoms among Persons with Severe Mental Illness in Community: A Systematic Review and Meta-Analysis (디지털 헬스 중재가 지역사회 중증정신질환자의 정신병적 증상에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Oh, Eunjin;Gang, Moonhee
    • Journal of Korean Academy of Nursing
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    • v.53 no.1
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    • pp.69-86
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    • 2023
  • Purpose: This study aimed to evaluate the effects of digital health interventions on the psychotic symptoms among people with severe mental illness in the community. Methods: A systematic review and meta-analysis were conducted in accordance with the Cochrane Intervention Research Systematic Review Manual and PRISMA. A literature search was conducted of published randomized controlled trials (RCTs) for digital health interventions from January 2022 to April 2022. RevMan software 5.3 was used for quality assessment and meta-analysis. Results: A total 14 studies out of 9,864 studies were included in the review, and 13 were included in meta-analysis. The overall effect size of digital health interventions on psychotic symptoms was - 0.21 (95% CI = - 0.32 to - 0.10). Sub-analysis showed that the reduction of the psychotic symptoms was effective in the schizophrenia spectrum group (SMD = - 0.22; 95% CI = - 0.36 to - 0.09), web (SMD = - 0.41; 95% CI = - 0.82 to 0.01), virtual reality (SMD = - 0.33; 95% CI = - 0.56 to - 0.10), mobile (SMD = - 0.15; 95% CI = - 0.28 to - 0.03), intervention period of less than 3 months (SMD = - 0.23; 95% CI = - 0.35 to - 0.11), and non-treatment group (SMD = - 0.23; 95% CI = - 0.36 to - 0.11). Conclusion: These findings suggest that digital health interventions alleviate psychotic symptoms in patients with severe mental illnesses. However, well-designed digital health studies should be conducted in the future.

Hospital Room Environment Monitoring System based on Wireless Communication (무선통신에 기반한 병실 환경 모니터링 시스템)

  • Lee, Seung-Chul;Kim, Nam-Ho
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2022.10a
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    • pp.28-30
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    • 2022
  • Recently, the number of confirmed cases has increased again with the new variant of COVID-19. Quarantine is recommended, especially to prevent the rapidly increasing spread, as environmental controls, such as minimizing contact with others, can increase safety. In addition, there are often cases in which the patient's condition cannot be confirmed from the standpoint of a guardian, such as visitation being prohibited under certain conditions. At this time, the sensor data values of oxygen, carbon dioxide concentrations, temperature and humidity, and alcohol, which are medical gases used in hospitals, are collected remotely using ZigBee wireless communication technology. Design a system that can be stored and monitored in a database. We propose an environmental monitoring system, which is a visualization system designed to allow hospitals to check and feedback data on the managed environment, and to give reliability to parents.

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User Authentication Protocol preserving Enhanced Anonymity and Untraceability for TMIS

  • Mi-Og Park
    • Journal of the Korea Society of Computer and Information
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    • v.28 no.10
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    • pp.93-101
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    • 2023
  • In this paper, as a result of analyzing the TMIS authentication protocol using ECC and biometric information proposed by Chen-Chen in 2023, there were security problems such as user impersonation attack, man-in-the-middle attack, and user anonymity. Therefore, this paper proposes an improved authentication protocol that provides user anonymity to solve these problems. As a result of analyzing the security of the protocol proposed in this paper, it was analyzed to be secure for various attacks such as offline password guessing attack, user impersonation attack, smart-card loss attack, insider attack, perfect forward attack. It has also been shown to provided user privacy by guaranteeing user anonymity and untraceability, which must be guaranteed in TMIS. In addition, there was no significant increase in computational complexity, so the efficiency of execution time was achieved. Therefore, the proposed protocol in this paper is a suitable user authentication protocol for TMIS.

Attention-Based Heart Rate Estimation using MobilenetV3

  • Yeo-Chan Yoon
    • Journal of the Korea Society of Computer and Information
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    • v.28 no.12
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    • pp.1-7
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    • 2023
  • The advent of deep learning technologies has led to the development of various medical applications, making healthcare services more convenient and effective. Among these applications, heart rate estimation is considered a vital method for assessing an individual's health. Traditional methods, such as photoplethysmography through smart watches, have been widely used but are invasive and require additional hardware. Recent advancements allow for contactless heart rate estimation through facial image analysis, providing a more hygienic and convenient approach. In this paper, we propose a lightweight methodology capable of accurately estimating heart rate in mobile environments, using a specialized 2-channel network structure based on 2D convolution. Our method considers both subtle facial movements and color changes resulting from blood flow and muscle contractions. The approach comprises two major components: an Encoder for analyzing image features and a regression layer for evaluating Blood Volume Pulse. By incorporating both features simultaneously our methodology delivers more accurate results even in computing environments with limited resources. The proposed approach is expected to offer a more efficient way to monitor heart rate without invasive technology, particularly well-suited for mobile devices.

Current status and needs for special education to support educational gaps for students with disabilities after COVID-19 (코로나19 이후 장애학생 교육 격차 지원을 위한 특수교육 현황과 요구)

  • Janghyun Lim;Haein Jeon
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.6
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    • pp.33-39
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    • 2023
  • Although COVID-19 has transitioned to a level 4 infectious disease in 2023 and has entered a stable trend, in special education settings, the importance of supporting the academic and social development gaps of students with disabilities caused by non-face-to-face learning situations such as remote classes during the COVID-19 period is emerging. there is. Accordingly, in this study, in order to identify and support the educational status and academic deficits of students with disabilities after COVID-19, we conducted a survey targeting 2,214 special education teachers in 17 cities and analyzed the results. As a result of the study, due to COVID-19, the developmental delay and educational gap in students with disabilities in terms of academics, emotions, and behavior deepened, and there was a high demand for manpower support, psychological counseling, and medical support for emotional behavior as a way to support this. Based on the results of this study, follow-up results were proposed.

Clinical Characteristics of Pleomorphic Carcinoma (다형성 암종의 임상적 고찰)

  • Lee, Deok-Heon;Park, Hoon;Park, Chang-Kwon;Kwon, Kun-Young;Park, Nam-Hee;Choi, Sae-Young;Lee, Kwang-Sook;Yoo, Young-Sun
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.397-403
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    • 2003
  • Background: The research sought to identify the clinical features of pleomorphic carcinoma of the lung generally known as a rare subtype in accordance with the lung cancer classification done in 1999 by WHO. Material and Method: 250 cases of surgically resected lung cancers were collected in this hospital from January 1992 to December 2001. This study included 42 cases of pleomorphic carcinoma diagnosed through light microscope and immunohistochemistry. Result: Out of 42 cases, males represented 31, and females 11, the age ranged from 26 to 77. Main clinical symptoms included coughing, hemoptysis, sputum. Diagnoses disclosed the stage as stage la in 3 cases (7%), Ib in 16 (38%), IIa in 1 (2%), IIb in 8 (19%), IIIa in 15 (35%), and IIIb in 1 (2%). Out of these, no lymph node metastasis was represented in 23 cases (54%), while N1 and N2 involving lymph node metastasis was shown 19 cases (46%). A total of 19 patients developed metastasis, comprising the brain in 5 cases (26%), bone in 4 (21%), muscle in 4 (21%), Lymph node in 2 (10%), and 1 liver, ovary, contralateral lung, and adrenal gland, respectively. The size of the tumor ranged from 1 cm to 11 cm, averaging 5.85 cm. Out of the 42 patients, the total two-year and five-year survival rates in accordance with the Kaplan-Meier method represented 26% and 13%, respectively, These figures compared to the corresponding 44% and 34% in cases other than pleomorphic carcinoma from the survey target of 256 cases, proved to be significantly low (p<0.002). No significant difference was found in the survival rates compared between age and tumor size, between stage I and above stage II, and between N0 and above N1. Patients who developed postoperative metastasis all died, and showed significantly low survival rates (p<0.002) compared to those patients without metastasis. Conclusion: With the new diagnosis method of f999 WHO's lung cancer classification applied, pleomorphic carcinoma showed a higher prevalence rate than under previous classifications, their postoperative survival rate was significantly low compared to histologic type of non small cell lung carcinomas.

Radiation Results and Survival Rate of Small Cell Lung Cancer (소세포폐암의 방사선치료 성적 및 생존율)

  • Oh, Won-Yong;Song, Mi-Hee;Whang, In-Soon
    • Radiation Oncology Journal
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    • v.14 no.2
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    • pp.105-113
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    • 1996
  • Purpose : To improve treatment modality and results by analysis of clinical characteristics, local control, survival and recurrence rate in limited stage small cell lung cancer. Materials and Methods : patients with limited stage small cell lung cancer were treated with combined radiation and chemotherapy from Feb. 1986 to Dec. 1992 at the National Medical Center We followed up on 21 patients ($81\%$), who were mostly irradiated with 4,000-5.000cGy ($75\%$ of all Patients) in the results by the analysis retrospectively. Survival rate was evaluated by the Kaplan-Meier method Results : Mean survival of irradiated patients with limited small cell lung cancer was 12 months. 1-rear and 2-rear survival rate were $65.3\%$ and $15.4\%$ Tumor response rate and median survival after combined chemotherapy and irradiation were the following: $50\%$ and 15 months of complete response, and $23\%$ and 11 months of partial response respectively. Response rates by radiation dose were $66\%$ for below 4,000cGy $69\%$ for between 4,000-5,000cGy and $86\%$ for above 5,000cGy. 21 of all patients showed treatment failure($81\%$) which as appeared 9 of local failure.9 of distant failure and 3 of local and distant failure. Conclusion : Local response rate after induction chemotherapy alone in limited stage of small cell lung cancer was $54\%$. Furthermore it was increased to $73\%$ after adding of radiation. We have to increase radiation dose above 5,000cGy and need to try new effective chemotherapy agents for the improvement of local control and survival rate and also will try concurrent chemoradiotherapy in near time.

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Cancinoma of Uterine Cervix Treated wvith High Dose Rate Intracavitary Irradiation : 1 Patterns of Failure (자궁경부암의 고선량율 강내치료후 실패양상에 대한 고찰)

  • Kim Ok Bae;Choi Tee Jin;Kim Jin Hee;Lee Ho Jun;Kim Yung Ae;Suh Young Wook;Lee Tae Sung;Cha Soon Do
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.369-376
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    • 1993
  • 226 patients with carcinoma of the uterine cervix treated with curative radiation therapy at the Department of Therapeutic Radiology, Dongsan hospital, Keimyung university, School of medicine, from July,1988 to May,1991 were evaluated. The patients with all stages of the disease were included in this study. The maximum and mean follow up durations were 60 and 43 months. The radiation therapy consisted of external irradiation to the whole pelvis (2700~4500 cGy) and boost parametrial doses (for a total of 4500~6300 cGy)with midline shild $(4{\times}10\;cm),$ and combined with intracavitary irradiation (5700~7500 cGy to point A). The distribution of patients according to the stage was as follows: stage IB 37 $(16.4\%),$ stage IIA 91 $(40.3\%),$ stage IIB 58 $(25.7\%),$ stage III 32 $(13.8\%),$ stage IV 8 $(3.5\%).$ The overall failure rate was $23.9\%$ (54 patients). The failure rate increased as a function of stage from $13.5\%$ in stage IB to $15.4\%$ in stage IIA, $25.9\%$ in stage IIB, $46.9\%$ in stage III, and $62.5\%$ in stage UV. The pelvic failure alone were 32 patients and 11 patients were as a components of other failure, and remaining 11 patients had distant metastasis only. Among the 43 patients of locoregional failure,28 patients were not controlled initially and in other words nearly half of total failures were due to residual tumor. The mean medial paracervical (point A) doses were 6700 cGy in stage IIB,7200 cGy in stage IIA,7450 cGy in stage IIB,7600 cGy in stage III and 8100 cGy in stage IV. The medial paracervical doses showed some correlation with tumor control rate in early stage of disease (stage Ib, IIA), but there were higher central failure rate in advanced stage in spite of higher paracervical doses. In advanced stage, failure were not reduced by simple increment of paracervical doses. To improve a locoregional control rate in advanced stages, it is necessary to give additional treatment such as concomitant chemoradiation.

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Shielding for Critical Organs and Radiation Exposure Dose Distribution in Patients with High Energy Radiotherapy (고 에너지 방사선치료에서 환자의 피폭선량 분포와 생식선의 차폐)

  • Chu, Sung-Sil;Suh, Chang-Ok;Kim, Gwi-Eon
    • Journal of Radiation Protection and Research
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    • v.27 no.1
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    • pp.1-10
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    • 2002
  • High energy photon beams from medical linear accelerators produce large scattered radiation by various components of the treatment head, collimator and walls or objects in the treatment room including the patient. These scattered radiation do not provide therapeutic dose and are considered a hazard from the radiation safety perspective. Scattered dose of therapeutic high energy radiation beams are contributed significant unwanted dose to the patient. ICRP take the position that a dose of 500mGy may cause abortion at any stage of pregnancy and that radiation detriment to the fetus includes risk of mental retardation with a possible threshold in the dose response relationship around 100 mGy for the gestational period. The ICRP principle of as low as reasonably achievable (ALARA) was recommended for protection of occupation upon the linear no-threshold dose response hypothesis for cancer induction. We suggest this ALARA principle be applied to the fetus and testicle in therapeutic treatment. Radiation dose outside a photon treatment filed is mostly due to scattered photons. This scattered dose is a function of the distance from the beam edge, treatment geometry, primary photon energy, and depth in the patient. The need for effective shielding of the fetus and testicle is reinforced when young patients ate treated with external beam radiation therapy and then shielding designed to reduce the scattered photon dose to normal organs have to considered. Irradiation was performed in phantom using high energy photon beams produced by a Varian 2100C/D medical linear accelerator (Varian Oncology Systems, Palo Alto, CA) located at the Yonsei Cancer Center. The composite phantom used was comprised of a commercially available anthropomorphic Rando phantom (Phantom Laboratory Inc., Salem, YN) and a rectangular solid polystyrene phantom of dimensions $30cm{\times}30cm{\times}20cm$. the anthropomorphic Rando phantom represents an average man made from tissue equivalent materials that is transected into transverse 36 slices of 2.5cm thickness. Photon dose was measured using a Capintec PR-06C ionization chamber with Capintec 192 electrometer (Capintec Inc., Ramsey, NJ), TLD( VICTOREEN 5000. LiF) and film dosimetry V-Omat, Kodak). In case of fetus, the dosimeter was placed at a depth of loom in this phantom at 100cm source to axis distance and located centrally 15cm from the inferior edge of the $30cm{\times}30cm^2$ x-ray beam irradiating the Rando phantom chest wall. A acryl bridge of size $40cm{\times}40cm^2$ and a clear space of about 20 cm was fabricated and placed on top of the rectangular polystyrene phantom representing the abdomen of the patient. The leaf pot for testicle shielding was made as various shape, sizes, thickness and supporting stand. The scattered photon with and without shielding were measured at the representative position of the fetus and testicle. Measurement of radiation scattered dose outside fields and critical organs, like fetus position and testicle region, from chest or pelvic irradiation by large fie]d of high energy radiation beam was performed using an ionization chamber and film dosimetry. The scattered doses outside field were measured 5 - 10% of maximum doses in fields and exponentially decrease from field margins. The scattered photon dose received the fetus and testicle from thorax field irradiation was measured about 1 mGy/Gy of photon treatment dose. Shielding construction to reduce this scattered dose was investigated using lead sheet and blocks. Lead pot shield for testicle reduced the scatter dose under 10 mGy when photon beam of 60 Gy was irradiated in abdomen region. The scattered photon dose is reduced when the lead shield was used while the no significant reduction of scattered photon dose was observed and 2-3 mm lead sheets refuted the skin dose under 80% and almost electron contamination. The results indicate that it was possible to improve shielding to reduce scattered photon for fetus and testicle when a young patients were treated with a high energy photon beam.

Robust Image Fusion Using Stationary Wavelet Transform (정상 웨이블렛 변환을 이용한 로버스트 영상 융합)

  • Kim, Hee-Hoon;Kang, Seung-Hyo;Park, Jea-Hyun;Ha, Hyun-Ho;Lim, Jin-Soo;Lim, Dong-Hoon
    • The Korean Journal of Applied Statistics
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    • v.24 no.6
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    • pp.1181-1196
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    • 2011
  • Image fusion is the process of combining information from two or more source images of a scene into a single composite image with application to many fields, such as remote sensing, computer vision, robotics, medical imaging and defense. The most common wavelet-based fusion is discrete wavelet transform fusion in which the high frequency sub-bands and low frequency sub-bands are combined on activity measures of local windows such standard deviation and mean, respectively. However, discrete wavelet transform is not translation-invariant and it often yields block artifacts in a fused image. In this paper, we propose a robust image fusion based on the stationary wavelet transform to overcome the drawback of discrete wavelet transform. We use the activity measure of interquartile range as the robust estimator of variance in high frequency sub-bands and combine the low frequency sub-band based on the interquartile range information present in the high frequency sub-bands. We evaluate our proposed method quantitatively and qualitatively for image fusion, and compare it to some existing fusion methods. Experimental results indicate that the proposed method is more effective and can provide satisfactory fusion results.