Lukman Heryawan, P. Khotimah, Osamu Sugiyama, Goshiro Yamamoto, Luciano H. O. Santos, Angga Eko Pramono, K. Okamoto, T. Kuroda
{"title":"Toward Design of an Agent-based Writing Support System for the SOAP Note: A Content Analysis of the Video-based Survey","authors":"Lukman Heryawan, P. Khotimah, Osamu Sugiyama, Goshiro Yamamoto, Luciano H. O. Santos, Angga Eko Pramono, K. Okamoto, T. Kuroda","doi":"10.14326/abe.9.146","DOIUrl":"https://doi.org/10.14326/abe.9.146","url":null,"abstract":"Subjective, objective, assessment, and plan (SOAP) notes are widely used by physicians to document clinical reasoning in assessing, diagnosing, and treating patients. SOAP notes are also used in medical coding tasks for reimbursement of insurance claims. In Indonesia, medical coders who are independent from physicians assess SOAP notes to assign diagnostic codes and medical procedure codes based on the corresponding International Classification of Diseases standards. Discrepancies between physicians who write the SOAP notes and coders who assign diagnoses and treatments, may occur. These discrepancies were assessed by performing a video-based survey to understand the coder ʼ s perspective, allowing the development of a writing support system to achieve unproblematic SOAP notes. This survey found that problematic SOAP notes were not caused by a single problem but by multiple problems. Abbreviations used by physicians are the major problem in assigning diagnostic codes, whereas incomplete data are the major problem in determining planning. This survey also showed that problematic SOAP notes may contain helpful keywords for coders that can help in determining diagnosis and treatment. The findings show that the system should be able to recognize separate sections of the SOAP note to provide writing support features and identify helpful keywords to encourage physicians to write unproblematic SOAP notes.","PeriodicalId":54017,"journal":{"name":"Advanced Biomedical Engineering","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67007615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dynamics of Stimulus Selectivity in Inferotemporal Neurons","authors":"Lulin Dai, J. Okamura, Gang Wang","doi":"10.14326/abe.9.93","DOIUrl":"https://doi.org/10.14326/abe.9.93","url":null,"abstract":"Neuroscientists usually investigate stimulus selectivity by using a stimulus set and identifying the stimulus that evokes the largest electrophysiological responses averaged over a certain time period. However, the visual environment, and hence the brain activity, changes all the time. A method with sufficiently high temporal resolution for the investigation of dynamic changes in stimulus selectivity is desired. Here, we propose a method by dividing the usual time window for spike rate calculation into multiple smaller time windows. We applied this method to the analysis of temporal change in stimulus selectivity of inferotemporal (IT) cells in macaque monkey recorded previously using microelectrode while they were performing an object discrimination task, in which one object had to be discriminated from others regardless of change in viewing angle. The IT cortex is located at the last stage of the ventral cortical pathway, and is important for object recognition and discrimination. The proposed method theoretically possesses temporal resolution in millisecond order. We demonstrated its ability by following the changes in stimulus selectivity with temporal resolution as high as 20 ms. Furthermore, we divided the response time window into early phase and late phase. In each phase, single cell responses to images (4 objects × 4 views; 16 images in each of the stimulus set) were compared to iden-tify the stimulus evoking the largest response. When comparing the early and late phases, 40% of the cells showed the largest response to the same stimulus (same object and same viewing angle); 13% of the cells showed the largest response to the same object but at different viewing angles; 20% of the cells showed the largest response to different objects at the same viewing angle; and 20% of the cells showed the largest response to different objects at different viewing angles. The dynamic change of stimulus selectivity from early phase to late phase may provide important information about the underlying neuronal mechanism for object recognition. Successful application of the proposed method to the analysis of IT cell activity demonstrates the validity and usefulness of the method.","PeriodicalId":54017,"journal":{"name":"Advanced Biomedical Engineering","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67008456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Introduction of Medical Device Development through Industry–Academia Collaboration by the Hamamatsu Method","authors":"Yuko Amano-Ito","doi":"10.14326/abe.9.112","DOIUrl":"https://doi.org/10.14326/abe.9.112","url":null,"abstract":"To develop medical devices, collaborations are necessary between universities and hospitals that have technological problems and companies with the appropriate technological facilities to solve these problems. Large companies do not generally compete in niche markets, where large sales and profits are not expect-ed, which then become the target for small and medium enterprises (SMEs). In this study, the “ Mono-Dzukuri region ” was considered because of its dense concentration of universities or hospitals and SMEs. However, interventions by industry–academia collaboration coordinators (CDs) are required to ensure smooth collaborations between academia and SMEs that are unfamiliar with medical device development as well as companies that lack market presence in the medical device field. In this study, the Hamamatsu area, a locality that is actively engaged in medical device development through collaborations, was evaluated for different hypotheses. The CDs are integral to forming an appropriate ecosystem for the development team to educate doctors, medical workers, SMEs, and venture companies. Specifically, seminars on medical and clinical research methods are used to educate stakeholders on the importance of collaboration. These seminars provide collaborative op-portunities, R&D expenses, and technology transfer and sales promotion support from commercialization to sales. Local governments and banks also support these efforts. CDs from different institutions also actively col-laborate with each other; they use co-working spaces and the Coordinator Support System to share information and consult on problems. Through these efforts, CDs have successfully assisted the continuous development of medical devices. Both successful and failed commercialization cases are reported herein. After examining the causes of failure, it was found that collaborations often failed when the needs of the marketing authorization holders could not be met and when the medical and technical needs were not fully understood. To gradually increase the number of successful cases of medical devices developed in Japan, it is necessary to build a development model, expand it to other geographical areas, such as Shinshu, Oita, and Tottori, and support the development of CDs. Additionally, it is important to develop a knowledge base while utilizing the advantages of the local characteristics of these areas.","PeriodicalId":54017,"journal":{"name":"Advanced Biomedical Engineering","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67006796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Novel Hill-type Two-mode Model of Skeletal Muscle to Simulate Mechanisms Underlying Position Control on the Descending Limb of the Force–Length Relation","authors":"K. Akazawa","doi":"10.14326/abe.9.209","DOIUrl":"https://doi.org/10.14326/abe.9.209","url":null,"abstract":"In a new Hill-type two-mode model of skeletal muscle, a stretch-evoked force enhancement mode is introduced in addition to a sliding filament mode on the descending limb of the isometric force–length relationship. Dynamic behaviors of muscle on the descending limb are examined in computer simulation using the model. First, force responses of the model to ramp-stretch of muscle are similar to those of frog semitendinosus muscle at different levels of muscle activation. Second, length–velocity phase trajectories of the model in isotonic tetanus contraction are similar to those of rabbit skeletal muscle. Third, firing rates of some motor units of human finger extensor muscle are slightly lower in static position control than in isometric contraction. Computer simulation is performed to reveal mechanisms underlying these behaviors. A hypothesis of static position control on the descending limb based on the simulation results is proposed; i.e., some active motor units of the finger extensor muscle operate in a stretch-evoked force enhancement mode, such that the stable finger position can be maintained owing to the spring-like property of these motor units.","PeriodicalId":54017,"journal":{"name":"Advanced Biomedical Engineering","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67007638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Ishii, I. Saito, Junya Fujii, Yusuke Oga, Shizuki Nakai, Sota Iima, Hiraoka Nobuaki
{"title":"Measurement of Micro-Strain in Nail Caused by Pulse Wave","authors":"K. Ishii, I. Saito, Junya Fujii, Yusuke Oga, Shizuki Nakai, Sota Iima, Hiraoka Nobuaki","doi":"10.14326/abe.9.31","DOIUrl":"https://doi.org/10.14326/abe.9.31","url":null,"abstract":"The micro-strains of a ngernail and toenail caused by pulse wave were measured by a conventional strain measuring method using a biaxial strain gauge. The strain uctuations of nails were larger in the lateral direction than in the longitudinal direction. In a previous study, pulse wave measurement by a polyvinylidene di uoride (PVDF) lm, which is a piezo lm, attached to the nail surface was proposed as a new pulse wave measuring method with lower electrical power consumption. The piezo lm can transform a nail surface micro-strain caused by pulse wave into an electrical signal. However, the optimal orientation of the piezo lm on nails remains unclear. The experimental results of the present study showed that a larger displacement was generated from the nails to the piezo lms by aligning the longitudinal direction of the piezo lm with the lateral direction of the nails.","PeriodicalId":54017,"journal":{"name":"Advanced Biomedical Engineering","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67007699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Development of Capacitive Sensor for Diaper Absorption Volume","authors":"S. Konno, Juhyon Kim, K. Nakajima","doi":"10.14326/abe.9.106","DOIUrl":"https://doi.org/10.14326/abe.9.106","url":null,"abstract":"The number of people requiring care in Japan has increased with the increase in number of people aged 65 or more. Thus, the production of disposable diapers for the elderly is also increasing. Two types of diapers; pad-type and tape-type, are generally used in combination in nursing homes. Diaper change is a burden for both the caregiver and the care receiver. To reduce the number of diaper changes, this study aimed to develops electrodes as a capacitive sensor attached to the outer surface of the tape-type diaper. The capacitive sensor evaluates the absorption volume of the pad-type diaper, and consists of electrodes and a converter circuit that converts the capacitance of electrodes into an output voltage. The study used a waist-type torso mannequin wearing a pad-type diaper on the inside and a tape-type diaper on the outside. The inside of the torso was filled with saline, and the weight of the torso including the saline was 8.9 kg in total. The electrodes were made of copper tape fixed to an insulating film, and the copper tape was 500-mm long and 25-mm wide with a 20-mm interelectrode gap. The electrodes were attached to the outside of the tape-type diaper and connected to the circuit. Experiment was conducted with the torso placed in supine and 30º lateral positions. Tap water (100 mL) was introduced via a silicone tube between the pad-type diaper and the torso hip surface at a flow rate of 7.8 mL / s, which is the average urinary flow rate for the elderly. This procedure was repeated six times. The ex periment was repeated three times. The output voltage increased linearly with increasing volume of water absorbed by the pad-type diaper, in both torso positions. Therefore, the absorption volume was quantitatively evaluated, and the results suggested that the resolution was at least 100 mL when using this sensor.","PeriodicalId":54017,"journal":{"name":"Advanced Biomedical Engineering","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67006735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Monte Carlo Modeling of Near-infrared Fluorescence Photon Migration in Breast Tissue for Tumor Prediction","authors":"T. Iida, T. Jin, Y. Nomura","doi":"10.14326/abe.9.100","DOIUrl":"https://doi.org/10.14326/abe.9.100","url":null,"abstract":"Breast cancer is one of the most common types of cancer in Japanese women. To address the low spatial resolution challenges associated with mammography and ultrasonography, we focused on the potential of using fluorescence to observe cellular and subcellular structures. Light scattering in living tissue causes a de-crease in resolution in in vivo imaging. However, scattering in near-infrared region is weaker than that in the visible region. Therefore, it is essential to investigate the behavior of excitation and emission photons in near-in-frared fluorescence within tissues, which could be applied in the detection of breast cancer. We modified our previous multi-layered fluorescence Monte Carlo model of in vivo neuroimaging using quantum dots as the first step for the detection of early-stage breast tumor using both visible and near-infrared light, and developed a model containing skin, breast tissue, and tumor. In the present study, fluorophore concentration and quantum yield parameters were set appropriately based on the mechanism of fluorescence onset. When the depths and sizes of a fluorescent tumor embedded in the breast tissue model were varied, excitation and emission fluence, in addition to intensity were examined from the breast surface. In contrast to visible fluorescence (Ex 488 / Em 520), Monte Carlo simulation for breast cancer using near-infrared fluorescence (Ex 780 / Em 820) could be used to detect a tumor 1.0 cm in diameter at a depth of 1.0 cm.","PeriodicalId":54017,"journal":{"name":"Advanced Biomedical Engineering","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14326/abe.9.100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67007152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sha Wu, E. Furutani, Tomonori Sugawara, Takehiko Asaga, G. Shirakami
{"title":"Glycemic Control for Critically Ill Patients with Online Identification of Insulin Sensitivity","authors":"Sha Wu, E. Furutani, Tomonori Sugawara, Takehiko Asaga, G. Shirakami","doi":"10.14326/abe.9.43","DOIUrl":"https://doi.org/10.14326/abe.9.43","url":null,"abstract":"Hyperglycemia is common in critically ill patients and leads to various severe complications and even death. Keeping blood glucose within the range of 80–110 mg / dL (4.4–6.1 mmol / L) has been shown to re-duce mortality and morbidity in intensive care units (ICU). Many studies on BG control systems for ICU patients have been reported. However, it is not easy to maintain blood glucose within the desired range because of the time variability of insulin sensitivity in critically ill patients. In this study, to improve the prediction accuracy of blood glucose level in patients, we modified a glycometabolism model developed in our previous study, by identifying parameter values from clinical ICU data. Then, we modified insulin sensitivity online identification algorithm to avoid a sudden change in insulin sensitivity during online identification that updates insulin sensitivity value at intervals of 30 min. Finally, since hypoglycemia prevention as important, we de-signed a glycemic control system using nonlinear model predictive control based on the modified model and the online identification algorithm of insulin sensitivity. The new glycemic control system achieved 71% of blood glucose measurements within the range of 80–110 mg / dL and 1.5% of measurements below 80 mg / dL, which indicated effectiveness and safety.","PeriodicalId":54017,"journal":{"name":"Advanced Biomedical Engineering","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67007934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ryo Otsuki, Osamu Sugiyama, Yuki Mori, M. Miyake, S. Hiragi, Goshiro Yamamoto, L. Santos, Yuta Nakanishi, Yoshikatsu Hosoda, H. Tamura, S. Matsumoto, A. Tsujikawa, T. Kuroda
{"title":"Deep Learning Model to Predict Postoperative Visual Acuity from Preoperative Multimedia Ophthalmic Data","authors":"Ryo Otsuki, Osamu Sugiyama, Yuki Mori, M. Miyake, S. Hiragi, Goshiro Yamamoto, L. Santos, Yuta Nakanishi, Yoshikatsu Hosoda, H. Tamura, S. Matsumoto, A. Tsujikawa, T. Kuroda","doi":"10.14326/abe.9.241","DOIUrl":"https://doi.org/10.14326/abe.9.241","url":null,"abstract":"Age-related macular degeneration (AMD) causes visual acuity (VA) loss in people aged ≥ 50 years. Common treatments include intravitreal injection of anti-vascular endothelial growth factor agents such as aflibercept. However, lack of response in some patients makes prediction of posttreatment VA difficult. In this paper, we propose a deep neural network model to predict posttreatment VA using pretreatment medical imaging and patient profile data. The proposed model works with image data (optical coherence tomography and color fundus photograph) and patient profile data including gender, age, affected side and pretreatment decimal visual acuity. The model was tested by comparing mean square errors (MSE) between actual and predicted visual acuity obtained from input of image data alone, input of patient profile data alone, and input of both types of data. When examining the concatenation effectiveness of input of both types of data, the outcomes of concatenation conditions 100:100 and 500:500 were compared. For concatenation condition 100:100, MSE was 0.081 for input of image data alone, 0.052 for input of patient profile data alone, and 0.058 for input of both types of data. For concatenation condition 500:500, the MSE values were 0.081, 0.052, and 0.047, respective-ly. The model proposed provides highly accurate prediction of posttreatment VA and indication of recovery to physicians and patients. The method can handle incomplete images and patient profile data usually collected from patients before treatment.","PeriodicalId":54017,"journal":{"name":"Advanced Biomedical Engineering","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67008141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diabetic Retinopathy Lesion Discriminative Diagnostic System for Retinal Fundus Images","authors":"C. Bhardwaj, Shruti Jain, M. Sood","doi":"10.14326/abe.9.71","DOIUrl":"https://doi.org/10.14326/abe.9.71","url":null,"abstract":"Diabetic retinopathy (DR) is the main cause of retinal damage due to fluid leakage from blood vessels. Automated diagnostic systems assist the ophthalmologists practice manual lesion detection techniques which are tedious and time-consuming. A Diabetic Retinopathy Lesion Discrimination (DRLD) model is proposed for abnormality identification followed by DR lesion detection based on identification of DR pathological symptoms. Shape, intensity and gray-level co-occurrence matrix (GLCM) features are extracted from the identified lesions, and exhaustive statistical analysis is performed for optimal feature selection. Overall accura-cies of 97.9% and 91.5% are obtained using multi-layer perceptron neural network (MLPNN) and support vector machine (SVM) classifiers, respectively, for non-diseased versus diseased fundus image discrimination. MLPNN provides better performance for the fundus image discrimination approach, and further accuracy of 98.9% is obtained for DR lesion detection. When compared with other state-of-the-art techniques, the proposed approach provides better performance with significantly less computational complexity. A maximum accuracy improvement of 20.13% in fundus image discrimination and 5.90% in lesion categorization is achieved.","PeriodicalId":54017,"journal":{"name":"Advanced Biomedical Engineering","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14326/abe.9.71","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67008233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}