Woon-Man Kung

Hiding Patients Confidential Datainthe ECG Signal viaa Transform-Domain Quantization Scheme

Watermarking is the most widely used technology in the field of copyright and biological information protection. In this paper, we use quantization based digital watermark encryption technology on the Electrocardiogram (ECG) to protect patient rights and information. Three transform domains, DWT, DCT, and DFT are adopted to implement the quantization based watermarking technique. Although the watermark embedding process is not invertible, the change of the PQRST complexes and amplitude of the ECG signal is very small and so the watermarked data can meet the requirements of physiological diagnostics. In addition, the hidden information can be extracted without knowledge of the original ECG data. In other words, the proposed watermarking scheme is blind. Experimental results verify the efficiency of the proposed scheme.

Wavelet-Based Watermarking and Compression for ECG Signals with Verification Evaluation

In the current open society and with the growth of human rights, people are more and more concerned about the privacy of their information and other important data. This study makes use of electrocardiography (ECG) data in order to protect individual information. An ECG signal can not only be used to analyze disease, but also to provide crucial biometric information for identification and authentication. In this study, we propose a new idea of integrating electrocardiogram watermarking and compression approach, which has never been researched before. ECG watermarking can ensure the confidentiality and reliability of a users data while reducing the amount of data. In the evaluation, we apply the embedding capacity, bit error rate (BER), signal-to-noise ratio (SNR), compression ratio (CR), and compressed-signal to noise ratio (CNR) methods to assess the proposed algorithm. After comprehensive evaluation the final results show that our algorithm is robust and feasible.

Optimization-based image watermarking with integrated quantization embedding in the wavelet-domain

This study presents an optimization-based image watermarking scheme with integrated quantization embedding. First, peak signal to noise ratio (PSNR) is rewritten as a performance index in matrix form. In order to guarantee the robustness, this study embeds a watermark into the low-frequency coefficients of discrete wavelet transform (DWT). Unlike traditional way of single-coefficient quantization, this study applies amplitude quantization to embed the watermark and then rewrite this amplitude quantization as a constraint with embedding state. Then, an optimization-based equation connecting the performance index and amplitude-quantization constraint is obtained. Second, Lagrange Principle is used to solve the equation and then the optimal results are applied to embed the watermark. In detection, the hidden watermark can be extracted without original image. Finally, the performance of the proposed scheme is evaluated by PSNR and BER.

Optimization-Based Embedding for Wavelet-Domain Audio Watermarking

This work proposes a new blind digital audio watermarking system by using optimization-based modification on low-frequency amplitude of discrete wavelet transform (DWT). To modify the low-frequency amplitude under the best signal-to-noise ratio (SNR), the proposed embedding system minimizes the difference between the original and the embedded coefficients. Accordingly, an optimization-based embedding formula connecting the SNR and the embedding system is derived. The formula is then applied to embed the synchronization codes and the watermarks. Based on this formula, the number of DWT coefficients for embedding a binary bit can be increased to enhance the robustness without decreasing the audio quality. Consequently, the embedded audio has good quality and good robustness under high capacity. In addition, the system can extract the hidden data without the knowledge of original audio signal. Finally, the performance of the proposed watermarking method is tested. Experimental results indicate that the performance of proposed system is better than other DWT amplitude modification method.

Deploying Cloud Computing to Implement Electronic Health Record in Indian Healthcare Settings

Background: In April 2013, Ministry of Health and Family Welfare (MoHFA) India released Electronic Health Record (EHR) standard to encourage electronic health information exchange among healthcare stakeholders. In addition, MoHFA expressed a need to find a suitable technology for EHR. Many technology solution providers have advocated cloud computing as a solution for realizing the EHR in India. Therefore, the aim of this study is to obtain insights into the desirability, feasibility, and concern to deploy cloud computing as a technology solution for EHR. Methods: A focus group discussion involving sixteen medical informatics experts was facilitated. The experts exchanged 76 emails using a group email address. The texts generated through emails were analyzed using grounded theory method. NVivo 10 was used for the coding of texts. Results: The textual analysis revealed three broad themes: (1) desirability to have superior attributes in cloud computing technology compared to the existing technologies; (2) concerns towards cloud computing to implement EHR; (3) solutions suggested in the current healthcare and ICT infrastructure of India. Conclusions: The results of this study suggest that the use of cloud computing for the EHR is likely to emerge in the future. However, given the current ICT infrastructure and healthcare system of India, several concerns were raised. Therefore, the superiority of cloud computing over other technologies needs to be assured, and stakeholder’s concerns should be satisfactorily answered.

Cardiac Autonomic Function in Patients With Ankylosing Spondylitis: A Case-Control Study.

AbstractAnkylosing spondylitis (AS) is a chronic inflammatory disease involing spine and enthesis. The primary aim of this study is to investigate the autonomic nervous system (ANS) function and the association between ANS and the functional status or disease activity in AS.The study included 42 AS patients, all fulfilling the modified New York criteria. All the patients are totally symptom free for ANS involvement and had normal neurological findings. These AS patients and 230 healthy volunteers receive analysis of 5 minutes heart rate variability (HRV) in lying posture. In addition, disease activity and functional status of these AS patients are assessed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Global Score (BAS-G).Both groups were age and sex-matched. Although the HRV analysis indicates that the peaks of total power (TP, 0–0.5 Hz) and high-frequency power (HF, 0.15–0.40 Hz) are similar in both groups, the activities of low-frequency power (LF, 0.04–0.15 Hz), LF in normalized units (LF%), and the ratio of LF to HF (LF/HF) in AS patients are obviously lower than healthy controls. The erythrocyte sedimentation rate and C-reactive protein revealed negative relationship with HF. The AS patients without peripheral joint disease have higher LF, TP, variance, LF%, and HF than the patients with peripheral joint disease. The AS patients without uvetis have higher HF than the patients with uvetis. The total scores of BASDI, BASFI, and BAS-G do not show any association to HRV parameters.AS patients have significantly abnormal cardiac autonomic regulation. This is closely related with some inflammatory activities. Reduced autonomic function may be one of the factors of high cardiovascular risk in AS patients.

Identification of Suspected Ruptured Atherosclerotic Plaque in Acute Ischemic Stroke on 18 F-Sodium Fluoride Positron Emission Tomography-Computed Tomography

of intracranial hemorrhage, while laboratory data were unremarkable. Magnetic resonance imaging showed acute ischemic stroke in the left middle cerebral artery territory (Figure 1A). Carotid sonography showed non-obstructive atherosclerotic plaque in the bilateral internal carotid arteries near the bifurcation, with only 36% luminal stenosis for the left side (Figure 1B) n 81-year-old woman, with a past history of type 2 diabetes and hypertension, was brought to the emergency room with acute-onset decreased responsiveness accompanying right-sided weakness. Neurological examination indicated motor aphasia, right central facial palsy, and right hemiparesis. Computed tomography (CT) showed no evidence A

Effect of Tai Chi Synergy T1 Exercise on Autonomic Function, Metabolism, and Physical Fitness of Healthy Individuals

Objectives Tai Chi synergy T1 exercise is an aerobic exercise derived mainly from Tai Chi exercise. It is also derived from the Eight Trigrams Palms, form and will boxing, mantis boxing, Qigong, and Yoga, with a total of 16 sessions in 63 minutes. In this study, we investigated its effects on autonomic modulation, metabolism, immunity, and physical function in healthy practitioners. Method We recruited a total of 26 volunteers and 23 control participants. Heart rate variability (HRV), blood pressure, and body mass index (BMI) were recorded before and after practicing Tai Chi synergy T1 exercise and regular walking for 10 weeks, respectively. Serum glucose, cholesterol, and peripheral blood including B and T cell counts were also measured. They underwent one-minute bent-knee sit-ups, sit and reach test, and three-minute gradual step test. Results Tai Chi synergy T1 exercise enhanced parasympathetic modulation and attenuated sympathetic nerve control with increased very low frequency (VLF) and high frequency (HF) but decreased low frequency (LF) compared to the control group. Metabolic profiles including serum glucose, cholesterol, and BMI significantly improved after exercise. The exercise enhanced innate and adaptive immunity by increasing the counts of CD3+ T cells, CD19+ B cells, and CD16+CD56+ NK cells but decreasing the CD3+ cytotoxic T cell count. All monitored parameters including physical fitness and physical strength improved after the exercise. Conclusion Tai Chi synergy T1 exercise improves autonomic modulation, body metabolism, physical fitness, and physical strength after 10 weeks of practice.

Metabolic Risk Factors of Alzheimer’s Disease, Dementia with Lewy Bodies, and Normal Elderly: A Population-Based Study

Background Alzheimers disease (AD) and dementia with Lewy bodies (DLB) share many risk factors. Evidence suggests that metabolic risk factors are important to AD; however, their association with DLB is unclear. The risk of cardiovascular diseases (CVD) associated with AD and DLB is also uncertain. Thus, this nationwide, population-based study was designed to evaluate the metabolic and CVD risks in AD and DLB. Materials and Methods Data were obtained from the Taiwan National Health Insurance Research Database. AD patients, DLB patients, and normal control (NC) individuals from 1996 to 2013 were enrolled for risk assessment. Results In total, 7544 NC individuals, 1324 AD patients, and 562 DLB patients were enrolled. Participants with one or more metabolic risk factors had significantly higher odds of AD or DLB. No significant differences in metabolic risk factors were observed between DLB and AD patients. AD patients had a lower risk of CVD (aHR = 0.67, 95% CI = 0.59–0.76, p value < 0.001) and coronary artery disease (CAD) (aHR = 0.59, 95% CI = 0.51–0.69, p value < 0.001) than NC. DLB patients had a higher risk of ischemic stroke (aHR = 2.27, 95% CI = 1.68–3.06, p value < 0.001) than NC. Conclusion Metabolic risk factors are important in AD and DLB. Patients with AD might have a lower risk of CAD and ischemic strokes. Patients with DLB might have a higher risk of ischemic stroke.