Algorithm developed to improve remote electrocardiography

ScienceDaily (Aug. 23, 2011) — Today someone in a remote village in India is able to run an electrocardiogram (ECG) via their smart phone on a loved one having a potential heart attack and send to a doctor in New Delhi for analysis.

Mobile technology is already bringing health care to places it has never been able to reach. However, there is still room for error that can lead to misdiagnosis.

Xiaopeng Zhao, assistant professor in the Department of Mechanical, Aerospace and Biomedical Engineering at the University of Tennessee, Knoxville, is working to eliminate these errors. Zhao and his team of graduate and undergraduate students and physicians have developed an award-winning algorithm that improves the effectiveness of ECGs.

The ECG is the most commonly performed screening tool for a variety of cardiac abnormalities. However, it is estimated that about 4 percent of all ECGs are taken with misplaced electrodes, leading to faulty diagnoses and mistreatments.

Zhao's algorithm examines interferences that result from electrode misplacement and disturbances, including patient motion and electromagnetic noise. Unlike conventional algorithms used to evaluate ECGs, Zhao's algorithm is more reliable because it is based on a matrix which simultaneously tests for irregular patterns caused by such interferences. Therefore, instead of a typical "yes-no" type of classification result, Zhao's produces a more accurate A-F letter grade of the ECG -- indicating specific weaknesses in the test. The algorithm also makes recommendations as to where to accurately place the electrodes.

Zhao's team has implemented the algorithm in a java program, which can be installed and operated on a smart phone. The program takes only a split second to execute on a smart phone and assess a 10-second ECG. The speed is key in situations where a second can mean the difference between life and death.

The goal is for users in remote areas to be able to know which ECGs are accurate to decrease misdiagnoses and ultimately save lives. The algorithm is also helpful in intensive care units where medical staff may be overworked, as well as for novice health professionals.

"There is a large population that does not receive good health care because they live in rural communities," said Zhao. "This algorithm helps to bring the doctor to their home through the help of mobile phone technology. We hope our invention brings their health care quality more in line with that of the developed world by reducing errors and improving the quality of ECGs."

The algorithm recently won the top spots in Physionet Challenge 2011 -- first, first and third places. Sponsored by the National Institutes for Health, Physionet and the annual Computing in Cardiology conference jointly host a series of challenge problems that are either unsolved or not well-solved. Starting in 2000, a new challenge topic is announced each year, aiming to stimulate work on important clinical problems and to foster rapid progress towards their solution.

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Tennessee at Knoxville, via EurekAlert!, a service of AAAS.

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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Remote Access

Mobile professionals must have the means to remotely access their work (in office) computer with minimal fuss and which can be installed and set up by themselves. Frequent long distance travelers don’t need the expense or hassle of relying on their tech people to talk them through remote access installations.

Before considering and deciding upon a method of remote access, there are some important considerations to keep in mind which can determine the remote access solution which will be best for your needs.

The Type of Work You Will Do:
Examine the type of work that you do and plan to do when working remotely. Will you need to be sending and receiving emails, creating documents and/or require files and data on your work computer? Remote access is a great alternative to carrying external drives and prevents you from losing or unwittingly destroying or corrupting data.

Will the remote access solution you are considering enable you to check email using your own email client? Will you have full access to all data or read-only access? What programs are compatible with the remote access solution and will you have all functions available?

Using a remote access solution should enable you to work with data and files on your work computer just as though you were sitting there in front of it. Remote Access Security:
What type of security protocols does the remote access method use and how well will these security measures protect you and the data you are remotely accessing? Cost:
Compare the cost of purchasing a remote access solution outright to the cost of a subscription based service. In some cases this can be a deal breaker or deal maker. Ease of Use:
How easy is it to set up the remote access solution? Do you have the right authorization to implement a remote access solution or does it require set up by your IT Dept.? Are the instructions and help files truly useful and enable you to work smoothly? Will you need a particular browser in order to use the remote access solution? Connection Requirements:
Some remote access solutions will require a Broadband Internet connection in order to work to their full capabilities. Remote access solutions should be capable of working over a variety of Internet connections – wireless, Dial-Up, Broadband and Satellite. Will a remote access solution work even you are using your cell phone as an external modem? Minimum Hardware Requirements:
Check to see what the minimum hardware requirements are for remote access solutions. You want a remote access solution that will support a variety of remote devices – laptops, desktops, PDAs and even cell phones.
Now that you have determined your needs and the most ideal operating environment to remotely access your work computer, you have to evaluate the available methods to find a remote access solution which will work the best for you and enable you to work remotely with as much ease as possible. Remote Access Software:
Remote access software involves installing a program on the host (work) computer and the client (remote) computer. Software installations aren’t always easy and the supporting documentation can be somewhat lacking, especially if you run into problems.

Like all other software programs, you will have to pay for any upgrades to remote access software programs. There are some free programs which operate just as well and sometimes better than paid remote access software programs. Web-based/Web Interface Remote Access:
Web-based remote access involves installing an agent program on the host computer which will enable a remote computer or other mobile device to access the host computer through a web browser from any location.

Monthly or annual subscriptions are available for this method of remote access. The majority of web-based remote access methods have free trials available and enables you to try a variety of programs to find the one that provides you with the best remote access.

Make sure that you try a variety of methods, both software programs and web-based. You may find out that what works great for one mobile professional is not going to work the best for you.

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Definition of Remote Access

Definition:

In broad terms, remote access refers to workers being able to access data or resources from a remote location. Traditional remote access solutions used dial-up technologies to allow employees to connect to an office network via telephone networks connecting to remote access servers.

Virtual Private Networking (VPN) has replaced this traditional physical connection between the remote client and the server by creating a secure tunnel over a public network (e.g., the Internet).

The term "remote access," however, still refers to remote users being able to access internal company resources. So, while VPN is the technology for securely connecting two private networks (and can also mean secure connections between two large private networks), remote access VPNs generally refer to individual employees or "clients" connecting to the "host" corporate network.

Beyond just connecting to remote resources, however, remote access solutions may also enable users to control the host computer over the Internet from any location. With "remote desktop" software, you can operate a remote computer as if you were seated in front of it.

Often used interchangeably with: VPN

Examples

Popular remote access software solutions that let you remotely access and control your computer include GoToMyPC, RealVNC, and LogMeIn.

Microsoft's Remote Desktop Connection client, which allows you to remotely control another computer, is built into Windows XP and later versions of Windows and also available for Mac users. Apple also offers Apple Remote Desktop software for network administrators to manage Mac computers on a network.

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Remote Work Policy

Include the responsibilities of the company, employee, employer and HR dept. Each person or group involved with a remote work arrangement should know exactly what is expected of them and how they will be held accountable.

An effective policy should clearly state the following: Worker's Compensation
Worker's Compensation does apply provided the employee is doing their job and not doing home repairs during the time they should be working. Worker's compensation also is only applicable in the designated workspace. It does not cover the remote worker's entire home. All Standard Work Rules Apply
Overtime, time off etc., Following the rules makes it easier for onsite staff and supervisors to know when the remote worker is available. There is no sense working overtime that is not pre-approved. You wouldn't do it onsite, so why do it when working remotely? Who Provides Equipment & Insurance Coverage
The remote work policy should clearly state who is providing the equipment. The company may provide specific equipment which is required for mobile employees to complete their job functions. The company is responsible for making sure there is insurance in place on these items. Items that remote workers purchase on their own should be covered by their own home insurance. Reimbursable Work Expenses.
Define which expenses are being reimbursed such as second telephone line or monthly ISP charges. Specific forms should be required in order to receive reimbursement and will be completed on a weekly or monthly basis. Non-reimbursable Expenses
This includes costs to changes made to the home to provide a designated workspace. A company should not pay for this type of expense. Remote Work Program is Strictly Voluntary.
An employee can not be forced into a remote work arrangement. This is important for employees to be clear on; they should never feel pressured to work remotely unless a job description clearly states that the position involves remote work – such as Outside Sales. Hours of Work
You should not work more or fewer hours than if you were onsite. As a remote worker slacking off, and not working the same hours you would onsite will only defeat the purpose of the remote work arrangement and cause you to lose the privilege of working remotely. You could even lose your job for failure to do your job in an acceptable manner. Termination of the Remote Work Agreement.
Explain how the agreement can be terminated, what must be done - written or verbal notice and reasons why an agreement may be terminated. State/Provincial Tax Implications
If working in another state/province from employer what are the implications? - Always consult a tax professional for more clarification If you have taxes withheld from your pay for state/province specific reasons, you need to learn the implications of working in a different state/province from where your employer is located. A tax professional can help. Home Office Tax Issues
The remote worker is responsible for any home office tax issues and for paying their appropriate taxes. Consult with a tax professional for more information. Remote Work Determination
Stating who is eligible for remote work can eliminate a lot of frustration for people who may wish to telecommute but due to the nature of their position or duties can not. Creating a list of job functions suited to remote work and characteristics that make successful remote workers eliminate any question of "picking favourites". Benefits & Compensation
All other benefits and compensation remain the same. Remote work can not be used as a reason for changing these. You can not pay someone less for doing their job because they are no longer working onsite. Information Security
Define how remote workers will be responsible for keeping documents and other work-related materials secure in the home office location. Specify that a file cabinet with lock is required is one method.

Smart companies will have their Remote Work Policy reviewed by their legal counsel before making it available to all employees. Companies that uses an ad hoc remote work program and does not create a Policy can leave themselves open to disputes regarding any of the above issues. It is worth the time and expense to create a Policy with involvement from legal personnel to ensure that there are no question marks or grey areas within the Policy.

Remote work Policies should be posted where all employees can have access to it, on a Company Intranet and on physical bulletin boards. There should be no restrictions to who can have access to the information.

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Smartphone Remote Wipe

Smartphones -- and the personal and business information you store on them -- are easily lost or stolen. Thankfully, remote wipe enables you to remotely erase all of the data stored on your phone. It's an important security feature widely available on smartphones, either by default or as an app you can (and should) install.

Here’s some background on using remote wipe by device/platform:

iPhone: As of the iPhone 3.0 software update, it's a fairly simple process for users with a MobileMe account (requiring a yearly paid subscription) to locate their iPhone (or iPod touch) and securely wipe the phone's data if they need to.

BlackBerry: BlackBerry smartphones, being very enterprise-friendly devices, have a specific policy that IT administrators can turn on to enable remotely wiping a BlackBerry to factory defaults. For individual users, third-party apps would be needed to enable remote wipe. You can, however, right now take steps to secure your BlackBerry via password protection and content protection.

Palm: Like the BlackBerry, the Palm Pre allows IT administrators to initiate a remote wipe. Individual users can also perform a "remote erase" on their Palm Pre from their Palm Profile page on Palm.com.

Windows Mobile: Microsoft's My Phone service provides users with devices running Windows Mobile 6.0 or higher to locate lost phones and/or remotely erase their data.

Android: The Android platform does not come with remote wipe capabilities as a default feature, but there are 3rd party apps, like the highly regarded--and free--Mobile Defense app, that enable remote wipe. The Motorola Cliq, which runs a customized version of Android, also has a built-in ability to be remotely wiped by users, and other non-stock Android devices may have this feature built-in.

Google Apps-managed devices (iPhone, Nokia E-series, and Windows Mobile): Google Apps Premier Edition (a paid yearly subscription), for enterprise and schools, enables IT administrators to remotely wipe data from mobile devices.

As you can see, smartphones platforms have remote wipe capabilities, but many are not free or require the smartphone to be managed by an IT department. If you don't have remote wipe built into your device already, however, take a look at free security/remote wipe apps (like Mobile Defense) that are available for your specific device.

One caveat to note is that remote wipe requires your phone to have a charge and be on for you to be able to remotely erase the data. There are other possible issues as well, such as if the phone gets rebooted during the remote wipe process (which could be lengthy). Although the security may not be foolproof, however, enabling remote wipe remains an important first step in securing your smartphone … one that needs to be set up before it is lost or stolen.

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Long Distance Tele-Operation system for remote control of unmanned ground vehicles

 Long Distance Tele-Operation technology will allow UGVs such as the TALON robot to be controlled from great distances (Image: Sgt. Giancarlo Casem)

The U.S. military is currently able to operate unmanned aircraft systems (UAS) in far away countries from the U.S., while ground robotic systems such as the TALON can be remotely operated at distances of up to 1,000 m (3,280 ft). Now U.S. Army engineers have provided unmanned ground vehicles (UGVs) with the long distance tele-operation capabilities of a UAS to allow them to be controlled from anywhere in the world and keep soldiers even further out of harm's way.

The technology developed by the U.S. Army Tank Research, Development and Engineering Command's, (TARDEC), Tank and Automotive Research Center currently allows UGVs to be operated via the Internet using a cellular data signal. Operators are able to log into the Long Distance Tele-Operation, (LDTO), system via a secure Web portal. Once connected, the operator selects a platform from a drop-down menu and is directed to a user interface screen that includes a variety of commands and a video link with the platform.

"While UAS are flying in theater, they're being controlled from here," said Ground Vehicle Robotics (GVR) System Integration Laboratory Electrical Engineer Ty Valascho. "Our task within GVR was to see if we could get that capability working and be able to drive it using all in-house assets."

By working with the original equipment manufacturers to get interface information about the various fielded robotic platforms the team was able to integrate the LDTO capability onto a number of UGVs. So far they have demonstrated the system with the TALON, PackBot and Omni-Directional Inspection System platforms.

"One of the constraints we put on ourselves was that we wanted to use whatever systems they were using in theater because it would make the transition to the field easier," Valascho stated. "Because these were largely commercial-off-the-shelf robots that had been rapidly fielded, the government had no technical data packages on the platforms. So that was a big challenge. We had to work with that supplier to get some information. They were very helpful, but it took a few months to get that information."

While LDTO has been successfully used to control UAS's in theater, adapting the system to ground vehicles posed problems that aerial vehicles operating in tightly controlled airspace don't face.

"UGVs have mobility challenges going down slopes, moving up slopes and watching out for obstacles on the ground that they can't overcome or that could overturn them. Those are all things that a UGV operator has to be aware of that someone driving an air asset doesn't," said Valascho.

And while video cameras allow operators to see oncoming hazards, the use of unpredictable Internet connections and data feeds poses significant challenges.

"If the robot's moving at full speed and you're trying to negotiate around something, even a half-second delay can make a huge difference," Valascho noted. "Latency is a problem, and the fact that we're going over the Internet adds another challenge, because it's not constant latency. This is a variable latency, so sometimes the delays are very great and sometimes there's very little delay. We're trying different techniques to minimize the effect on the user."

Currently, a common basic interface is used to control all platforms but the team is developing a user interface that is easy to use, yet still allows for the full range of platform capabilities. The engineers have got the system working and believe they have got the latency down as far as they can by slightly redesigning the system. Valascho believes the system could serve as a foundation for future fielded operations.

"If this were to be a fielded solution, there would have to be a lot of redesign because we would use military satellites and would be doing things a lot differently. Right now, we're just showing what's possible, but there are big parts of the system that could be reused if this were fielded," says Valascho. "Driving a robot professionally is a specialized skill; it isn't something that just anybody can do. Our warfighters are very valuable people, so we try to reduce the amount that they're put into harm's way. I think this would be a very big benefit for the Army in terms of reducing risks to these valuable assets."

Source: U.S. Army

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