A feasibility study for the provision of electronic healthcare tools and services in areas of Greece, Cyprus and Italy

Background: Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of thesoutheast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED. Methods: The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i) Telecollaboration and teleconsultation services between remotely located healthcare providers, ii) telemedicine services in emergencies, iii) home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv) eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc) and persons supporting "at risk" citizens. These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G), and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics. Results: The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances, homes of "at-risk" citizens, and a ferry. Conclusions: The results proved the functionality and utilization of the platform in various rural places in Greece, Cyprus and Italy. However, further actions are needed to enable the local healthcare systems and the different population groups to be familiarized with, and use in their everyday lives, mature technological solutions for the provision of healthcare services

Analysis of neuromuscular disorders using statistical and entropy metrics on surface EMG

This paper introduces the surface electromyogram (EMG) classification system based on statistical and entropy metrics. The system is intended for diagnostic use and enables classification of examined subject as normal, myopathic or neuropathic, regarding to the acquired EMG signals. 39 subjects in total participated in the experiment, 19 normal, 11 myopathic and 9 neuropathic. Surface EMG was recorded using 4-channel surface electrodes on the biceps brachii muscle at isometric voluntary contractions. The recording time was only 5 seconds long to avoid muscle fatigue, and contractions at fiveforce levels were performed, i.e. 10, 30, 50, 70 and 100 % of maximal voluntary contraction. The feature extraction routine deployed the wavelet transform and calculation of the Shannon entropy across all the scales in order to obtain a feature set for each subject. Subjects were classified regarding the extracted features using three machine learning techniques, i.e. decision trees, support vector machines and ensembles of support vector machines. Four 2-class classifications and a 3-class classification were performed. The scored classification rates were the following: 64+-11% for normal/abnormal, 74+-7% for normal/myopathic, 79+-8% for normal/neuropathic, 49+-20% for myopathic/neuropathic, and 63+-8% for normal/myopathic/neuropathic

Guest Editorial Cardiovascular Health Informatics: Risk Screening and Intervention

Despite enormous efforts to prevent cardiovascular disease (CVD) in the past, it remains the leading cause of death in most countries worldwide. Around two-thirds of these deaths are due to acute events, which frequently occur suddenly and are often fatal beforemedical care can be given. New strategies for screening and early intervening CVD, in addition to the conventional methods, are therefore needed in order to provide personalized and pervasive healthcare. In this special issue, selected emerging technologies in health informatics for screening and intervening CVDs are reported. These papers include reviews or original contributions on 1) new potential genetic biomarkers for screening CVD outcomes and high-throughput techniques for mining genomic data; 2) new imaging techniques for obtaining faster and higher resolution images of cardiovascular imaging biomarkers such as the cardiac chambers and atherosclerotic plaques in coronary arteries, as well as possible automatic segmentation, identification, or fusion algorithms; 3) new physiological biomarkers and novel wearable and home healthcare technologies for monitoring them in daily lives; 4) new personalized prediction models of plaque formation and progression or CVD outcomes; and 5) quantifiable indices and wearable systems to measure them for early intervention of CVD through lifestyle changes. It is hoped that the proposed technologies and systems covered in this special issue can result in improved CVD management and treatment at the point of need, offering a better quality of life to the patient

Mediterranean Region

This book provides for the first time a Europe-wide overview on the state of the art of management of recreation and nature tourism in forests. It describes the current situation and conflicts in the different regions of Europe and provides solutions illustrated by good practise examples. It addresses traditions, differences and similarities in European forests as well as new tasks, goals and strategies. The final discussion provides a profound insight into future trends regarding forest recreation and nature based tourism. The Mediterranean countries participating in the COST Action E33 are: Cyprus, Greece, Croatia, Portugal, Italy, Serbia and Bosnia-Herzegovina (Fig. 5.1). Geographically, these countries are distributed from the eastern Mediterranean area to the coasts of the Atlantic Ocean. Parts of France, which is treated as one of the central European countries has also parts with Mediterranean character and similar features to the other countries discussed in this chapter. Spain was not part of the Cost Action, so that there is no data available.COST E3

Proposal of Real-Time Echocardiogram Transmission Based on Visualization Modes with WiMAX Access

This study presents a new approach to improve the echocardiogram transmissions over WiMAX networks. Using a compression method based on visualization modes and a reliable method that adapts to the channel conditions, overall performance results are improved compared to classical approaches. The echocardiogram transmission using a compression method based on visualization modes requires lower bandwidth than without considering visualization modes. Furthermore, if the proposed reliability method is also used, the echocardiogram is more often visualized with adequate clinical quality than compressing the echocardiogram without distinguishing the visualization modes and without using a reliability method for the available dataset. The reduction in the bandwidth ranges from 29 kbps to 166 kbps for the simulated scenarios. 1

Quantitative MRI Brain Studies in Mild Cognitive Impairment and Alzheimer's disease: A Methodological Review

Classifying and predicting Alzheimer's disease (AD) in individuals with memory disorders through clinical and psychometric assessment is challenging especially in Mild Cognitive Impairment (MCI) subjects. Quantitative structural Magnetic Resonance Imaging (MRI) acquisition methods in combination with Computer-Aided Diagnosis (CAD) are currently being used for the assessment AD. These acquisitions methods include: i) Voxel-based Morphometry (VBM), ii) volumetric measurements in specific Regions of Interest (ROIs), iii) cortical thickness measurements, iv) shape analysis and v) texture analysis. This review evaluates the aforementioned methods in the classification of cases into one of the following 3 groups: Normal Controls (NC), MCI and AD subjects. Furthermore, the performance of the methods is assessed on the prediction of conversion from MCI to AD. In parallel, it is also assessed which ROIs are preferred in both classification and prognosis through the different states of the disease. Structural changes in the early stages of the disease are more pronounced in the Medial Temporal Lobe (MTL) especially in the entorhinal cortex, whereas with disease progression both entorhinal cortex and hippocampus offer similar discriminative power. However, for the conversion from MCI subjects to AD, entorhinal cortex provides better predictive accuracies rather than other structures, such as the hippocampus

Government balance-consistent economic growth rates and their implications: A study of the euro area countries

Using the model derived by Bajo-Rubio (2014), this paper estimates government budget balance-consistent growth rates for the euro area countries. A comparison of these estimates to their actual growth rates indicates that most of these countries are growing at rates that are very similar to their government balance-consistent growth rates. This finding implies that many euro area countries would not be experiencing excessive imbalances in their government budget over the long-run that could harm future economic growth. The analysis has also shown that for many euro area countries, the predictions of the model seem to be broadly consistent with their actual fiscal experience

Long-term Human Participation Assessment In Collaborative Learning Environments Using Dynamic Scene Analysis

The paper develops datasets and methods to assess student participation in real-life collaborative learning environments. In collaborative learning environments, students are organized into small groups where they are free to interact within their group. Thus, students can move around freely causing issues with strong pose variation, move out and re-enter the camera scene, or face away from the camera. We formulate the problem of assessing student participation into two subproblems: (i) student group detection against strong background interference from other groups, and (ii) dynamic participant tracking within the group. A massive independent testing dataset of 12,518,250 student label instances, of total duration of 21 hours and 22 minutes of real-life videos, is used for evaluating the performance of our proposed method for student group detection. The proposed method of using multiple image representations is shown to perform equally or better than YOLO on all video instances. Over the entire dataset, the proposed method achieved an F1 score of 0.85 compared to 0.80 for YOLO. Following student group detection, the paper presents the development of a dynamic participant tracking system for assessing student group participation through long video sessions. The proposed dynamic participant tracking system is shown to perform exceptionally well, missing a student in just one out of 35 testing videos. In comparison, a state of the art method fails to track students in 14 out of the 35 testing videos. The proposed method achieves 82.3% accuracy on an independent set of long, real-life collaborative videos