Books in the Synthesis Lectures on Biomedical Engineering series

Recently, immunomodulatory nanomaterials have gained immense attention due to their involvement in the modulation of the body's immune response to cancer therapy. This book highlights various immunomodulatory nanomaterials (including organic, polymer, inorganic, liposomes, viral, and protein nanoparticles) and their role in cancer therapy. Additionally, the mechanism of immunomodulation is reviewed in detail. Finally, the challenges of these therapies and their future outlook are discussed. We believe this book will be helpful to a broad community including students, researchers, educators, and industrialists.

This book has a two-fold purpose:(1) An introduction to the computer-based modeling of influenza, a continuing major worldwide communicable disease.(2) The use of (1) as an illustration of a methodology for the computer-based modeling of communicable diseases.For the purposes of (1) and (2), a basic influenza model is formulated as a system of partial differential equations (PDEs) that define the spatiotemporal evolution of four populations: susceptibles, untreated and treated infecteds, and recovereds. The requirements of a well-posed PDE model are considered, including the initial and boundary conditions. The terms of the PDEs are explained. The computer implementation of the model is illustrated with a detailed line-by-line explanation of a system of routines in R (a quality, open-source scientific computing system that is readily available from the Internet). The R routines demonstrate the straightforward numerical solution of a system of nonlinear PDEs by the method of lines (MOL), an established general algorithm for PDEs.The presentation of the PDE modeling methodology is introductory with a minumum of formal mathematics (no theorems and proofs), and with emphasis on example applications. The intent of the book is to assist in the initial understanding and use of PDE mathematical modeling of communicable diseases, and the explanation and interpretation of the computed model solutions, as illustrated with the influenza model.

The identification and interpretation of the signs of breast cancer in mammographic images from screening programs can be very difficult due to the subtle and diversified appearance of breast disease. This book presents new image processing and pattern recognition techniques for computer-aided detection and diagnosis of breast cancer in its various forms. The main goals are: (1) the identification of bilateral asymmetry as an early sign of breast disease which is not detectable by other existing approaches; and (2) the detection and classification of masses and regions of architectural distortion, as benign lesions or malignant tumors, in a unified framework that does not require accurate extraction of the contours of the lesions. The innovative aspects of the work include the design and validation of landmarking algorithms, automatic Tabar masking procedures, and various feature descriptors for quantification of similarity and for contour independent classification of mammographic lesions. Characterization of breast tissue patterns is achieved by means of multidirectional Gabor filters. For the classification tasks, pattern recognition strategies, including Fisher linear discriminant analysis, Bayesian classifiers, support vector machines, and neural networks are applied using automatic selection of features and cross-validation techniques. Computer-aided detection of bilateral asymmetry resulted in accuracy up to 0.94, with sensitivity and specificity of 1 and 0.88, respectively. Computer-aided diagnosis of automatically detected lesions provided sensitivity of detection of malignant tumors in the range of [0.70, 0.81] at a range of falsely detected tumors of [0.82, 3.47] per image. The techniques presented in this work are effective in detecting and characterizing various mammographic signs of breast disease.

Mechanical testing is a useful tool in the field of biomechanics. Classic biomechanics employs mechanical testing for a variety of purposes. For instance, testing may be used to determine the mechanical properties of bone under a variety of loading modes and various conditions including age and disease state. In addition, testing may be used to assess fracture fixation procedures to justify clinical approaches. Mechanical testing may also be used to test implants and biomaterials to determine mechanical strength and appropriateness for clinical purposes. While the information from a mechanical test will vary, there are basics that need to be understood to properly conduct mechanical testing. This book will attempt to provide the reader not only with the basic theory of conducting mechanical testing, but will also focus on providing practical insights and examples.

Biomedical Signals and Systems is meant to accompany a one-semester undergraduate signals and systems course. It may also serve as a quick-start for graduate students or faculty interested in how signals and systems techniques can be applied to living systems. The biological nature of the examples allows for systems thinking to be applied to electrical, mechanical, fluid, chemical, thermal and even optical systems. Each chapter focuses on a topic from classic signals and systems theory: System block diagrams, mathematical models, transforms, stability, feedback, system response, control, time and frequency analysis and filters. Embedded within each chapter are examples from the biological world, ranging from medical devices to cell and molecular biology. While the focus of the book is on the theory of analog signals and systems, many chapters also introduce the corresponding topics in the digital realm. Although some derivations appear, the focus is on the concepts and how to apply them. Throughout the text, systems vocabulary is introduced which will allow the reader to read more advanced literature and communicate with scientist and engineers. Homework and Matlab simulation exercises are presented at the end of each chapter and challenge readers to not only perform calculations and simulations but also to recognize the real-world signals and systems around them. Table of Contents: Preface / Acknowledgments / Introduction / System Types / System Models / Laplace Transform / Block Diagrams / Stability / Feedback / System Response / Control / Time Domain Analysis / Frequency Domain Analysis / Filters / Author's Biography

Part II of Health Care Engineering begins with statistics on the occurrence of medical errors and adverse events, and includes some technological solutions. A chapter on electronic medical records follows. The knowledge management process divided into four steps is described; this includes a discussion on data acquisition, storage, and retrieval. The next two chapters discuss the other three steps of the knowledge management process (knowledge discovery, knowledge translation, knowledge integration and sharing). The last chapter briefly discusses usability studies and clinical trials. This two-part book consolidates material that supports courses on technology development and management issues in health care institutions. It can be useful for anyone involved in design, development, or research, whether in industry, hospitals, or government.

The first chapter describes the health care delivery systems in Canada and in the U.S. This is followed by examples of various approaches used to measure physiological variables in humans, either for the purpose of diagnosis or monitoring potential disease conditions; a brief description of sensor technologies is included. The function and role of the clinical engineer in managing medical technologies in industrialized and in developing countries are presented. This is followed by a chapter on patient safety (mainly electrical safety and electromagnetic interference); it includes a section on how to minimize liability and how to develop a quality assurance program for technology management. The next chapter discusses applications of telemedicine, including technical, social, and ethical issues. The last chapter presents a discussion on the impact of technology on health care and the technology assessment process. This two-part book consolidates material that supports courses on technology development and management issues in health care institutions. It can be useful for anyone involved in design, development, or research, whether in industry, hospitals, or government.

Architectural distortion is an important and early sign of breast cancer, but because of its subtlety, it is a common cause of false-negative findings on screening mammograms. Screening mammograms obtained prior to the detection of cancer could contain subtle signs of early stages of breast cancer, in particular, architectural distortion. This book presents image processing and pattern recognition techniques to detect architectural distortion in prior mammograms of interval-cancer cases. The methods are based upon Gabor filters, phase portrait analysis, procedures for the analysis of the angular spread of power, fractal analysis, Laws' texture energy measures derived from geometrically transformed regions of interest (ROIs), and Haralick's texture features. With Gabor filters and phase-portrait analysis, 4,224 ROIs were automatically obtained from 106 prior mammograms of 56 interval-cancer cases, including 301 true-positive ROIs related to architectural distortion, and from 52 mammograms of 13 normal cases. For each ROI, the fractal dimension, the entropy of the angular spread of power, 10 Laws' texture energy measures, and Haralick's 14 texture features were computed. The areas under the receiver operating characteristic (ROC) curves obtained using the features selected by stepwise logistic regression and the leave-one-image-out method are 0.77 with the Bayesian classifier, 0.76 with Fisher linear discriminant analysis, and 0.79 with a neural network classifier. Free-response ROC analysis indicated sensitivities of 0.80 and 0.90 at 5.7 and 8.8 false positives (FPs) per image, respectively, with the Bayesian classifier and the leave-one-image-out method. The present study has demonstrated the ability to detect early signs of breast cancer 15 months ahead of the time of clinical diagnosis, on the average, for interval-cancer cases, with a sensitivity of 0.8 at 5.7 FP/image. The presented computer-aided detection techniques, dedicated to accurate detection and localization of architectural distortion, could lead to efficient detection of early and subtle signs of breast cancer at pre-mass-formation stages. Table of Contents: Introduction / Detection of Early Signs of Breast Cancer / Detection and Analysis of Oriented Patterns / Detection of Potential Sites of Architectural Distortion / Experimental Set Up and Datasets / Feature Selection and Pattern Classification / Analysis of Oriented Patterns Related to Architectural Distortion / Detection of Architectural Distortion in Prior Mammograms / Concluding Remarks

In addition to being essential for safe and effective patient care, medical equipment also has significant impact on the income and, thus, vitality of healthcare organizations. For this reason, its maintenance and management requires careful supervision by healthcare administrators, many of whom may not have the technical background to understand all of the relevant factors. This book presents the basic elements of medical equipment maintenance and management required of healthcare leaders responsible for managing or overseeing this function. It will enable these individuals to understand their professional responsibilities, as well as what they should expect from their supervised staff and how to measure and benchmark staff performance against equivalent performance levels at similar organizations. The book opens with a foundational summary of the laws, regulations, codes, and standards that are applicable to the maintenance and management of medical equipment in healthcare organizations. Next, the core functions of the team responsible for maintenance and management are described in sufficient detail for managers and overseers. Then the methods and measures for determining the effectiveness and efficiency of equipment maintenance and management are presented to allow performance management and benchmarking comparisons. The challenges and opportunities of managing healthcare organizations of different sizes, acuity levels, and geographical locations are discussed. Extensive bibliographic sources and material for further study are provided to assist students and healthcare leaders interested in acquiring more detailed knowledge. Table of Contents: Introduction / Regulatory Framework / Core Functions of Medical Equipment Maintenance and Management / CE Department Management / Performance Management / Discussion and Conclusions

Fractal analysis is useful in digital image processing for the characterization of shape roughness and gray-scale texture or complexity. Breast masses present shape and gray-scale characteristics in mammograms that vary between benign masses and malignant tumors. This book demonstrates the use of fractal analysis to classify breast masses as benign masses or malignant tumors based on the irregularity exhibited in their contours and the gray-scale variability exhibited in their mammographic images. A few different approaches are described to estimate the fractal dimension (FD) of the contour of a mass, including the ruler method, box-counting method, and the power spectral analysis (PSA) method. Procedures are also described for the estimation of the FD of the gray-scale image of a mass using the blanket method and the PSA method. To facilitate comparative analysis of FD as a feature for pattern classification of breast masses, several other shape features and texture measures are described in the book. The shape features described include compactness, spiculation index, fractional concavity, and Fourier factor. The texture measures described are statistical measures derived from the gray-level cooccurrence matrix of the given image. Texture measures reveal properties about the spatial distribution of the gray levels in the given image; therefore, the performance of texture measures may be dependent on the resolution of the image. For this reason, an analysis of the effect of spatial resolution or pixel size on texture measures in the classification of breast masses is presented in the book. The results demonstrated in the book indicate that fractal analysis is more suitable for characterization of the shape than the gray-level variations of breast masses, with area under the receiver operating characteristics of up to 0.93 with a dataset of 111 mammographic images of masses. The methods and results presented in the book are useful for computer-aided diagnosis of breast cancer. Table of Contents: Computer-Aided Diagnosis of Breast Cancer / Detection and Analysis of\newline Breast Masses / Datasets of Images of Breast Masses / Methods for Fractal Analysis / Pattern Classification / Results of Classification of Breast Masses / Concluding Remarks

This book represents the first in a two-volume set on biological rhythms. This volume focuses on supporting the claim that biological rhythms are universal and essential characteristics of living organisms, critical for proper functioning of any living system. The author begins by examining the potential reasons for the evolution of biological rhythms: (1) the need for complex, goal-oriented devices to control the timing of their activities; (2) the inherent tendency of feedback control systems to oscillate; and (3) the existence of stable and powerful geophysical cycles to which all organisms must adapt. To investigate the second reason, the author enlists the help of biomedical engineering students to develop mathematical models of various biological systems. One such model involves a typical endocrine feedback system. By adjusting various model parameters, it was found that creating a oscillation in any component of the model generated a rhythmic cascade that made the entire system oscillate. This same approach was used to show how daily light/dark cycles could cascade rhythmic patterns throughout ecosystems and within organisms. Following up on these results, the author discusses how the twin requirements of internal synchronization (precise temporal order necessary for the proper functioning of organisms as complex, goal-oriented devices) and external synchronization (aligning organisms' behavior and physiology with geophysical cycles) supported the evolution of biological clocks. The author then investigates the clock systems that evolved using both conceptual and mathematical models, with the assistance of Dr. Bahrad Sokhansanj, who contributes a chapter on mathematical formulations and models of rhythmic phenomena. With the ubiquity of biological rhythms established, the author suggests a new classification system: the F4LM approach (Function; Frequency; waveForm; Flexibility; Level of biological system expressing rhythms; and Mode of rhythm generation) to investigate biological rhythms. This approach is first used on the more familiar cardiac cycle and then on neural rhythms as exemplified and measured by the electroencephalogram. During the process of investigating neural cycles, the author finds yet another reason for the evolution of biological rhythms: physical constraints, such as those imposed upon long distance neural signaling. In addition, a common theme emerges of a select number of autorhythmic biological oscillators imposing coherent rhythmicity on a larger network or system. During the course of the volume, the author uses a variety of observations, models, experimental results, and arguments to support the original claim of the importance and universality of biological rhythms. In Volume 2, the author will move from the establishment of the critical nature of biological rhythms to how these phenomena may be used to improve human health, well-being, and productivity. In a sense, Volume 1 focuses on the chronobio aspect of chronobioengineering while Volume 2 investigates methods of translating this knowledge into applications, the engineering aspect of chronobioengineering. Table of Contents: Time and Time Again / Walking on Air: An Empirical Proof-of-Concept / Clock Tech, Part 1 / Clock Tech II From External to Internal Timers / Clock Tech III Rise of the CircaRhythms / The Circle Game: Mathematics, Models, and Rhythms / The Power of Circular Reasoning

Content-based image retrieval (CBIR) is the process of retrieval of images from a database that are similar to a query image, using measures derived from the images themselves, rather than relying on accompanying text or annotation. To achieve CBIR, the contents of the images need to be characterized by quantitative features; the features of the query image are compared with the features of each image in the database and images having high similarity with respect to the query image are retrieved and displayed. CBIR of medical images is a useful tool and could provide radiologists with assistance in the form of a display of relevant past cases. One of the challenging aspects of CBIR is to extract features from the images to represent their visual, diagnostic, or application-specific information content. In this book, methods are presented for preprocessing, segmentation, landmarking, feature extraction, and indexing of mammograms for CBIR. The preprocessing steps include anisotropic diffusion and the Wiener filter to remove noise and perform image enhancement. Techniques are described for segmentation of the breast and fibroglandular disk, including maximum entropy, a moment-preserving method, and Otsu's method. Image processing techniques are described for automatic detection of the nipple and the edge of the pectoral muscle via analysis in the Radon domain. By using the nipple and the pectoral muscle as landmarks, mammograms are divided into their internal, external, upper, and lower parts for further analysis. Methods are presented for feature extraction using texture analysis, shape analysis, granulometric analysis, moments, and statistical measures. The CBIR system presented provides options for retrieval using the Kohonen self-organizing map and the k-nearest-neighbor method. Methods are described for inclusion of expert knowledge to reduce the semantic gap in CBIR, including the query point movement method for relevance feedback (RFb). Analysis of performance is described in terms of precision, recall, and relevance-weighted precision of retrieval. Results of application to a clinical database of mammograms are presented, including the input of expert radiologists into the CBIR and RFb processes. Models are presented for integration of CBIR and computer-aided diagnosis (CAD) with a picture archival and communication system (PACS) for efficient workflow in a hospital. Table of Contents: Introduction to Content-based Image Retrieval / Mammography and CAD of Breast Cancer / Segmentation and Landmarking of Mammograms / Feature Extraction and Indexing of Mammograms / Content-based Retrieval of Mammograms / Integration of CBIR and CAD into Radiological Workflow

Recent advances in development of sequencing technology has resulted in a deluge of genomic data. In order to make sense of this data, there is an urgent need for algorithms for data processing and quantitative reasoning. An emerging in silico approach, called computational genomic signatures, addresses this need by representing global species-specific features of genomes using simple mathematical models. This text introduces the general concept of computational genomic signatures, and it reviews some of the DNA sequence models which can be used as computational genomic signatures. The text takes the position that a practical computational genomic signature consists of both a model and a measure for computing the distance or similarity between models. Therefore, a discussion of sequence similarity/distance measurement in the context of computational genomic signatures is presented. The remainder of the text covers various applications of computational genomic signatures in the areas of metagenomics, phylogenetics and the detection of horizontal gene transfer. Table of Contents: Genome Signatures, Definition and Background / Other Computational Characterizations as Genome Signatures / Measuring Distance of Biological Sequences Using Genome Signatures / Applications: Phylogeny Construction / Applications: Metagenomics / Applications: Horizontal DNA Transfer Detection

The presence of oriented features in images often conveys important information about the scene or the objects contained; the analysis of oriented patterns is an important task in the general framework of image understanding. As in many other applications of computer vision, the general framework for the understanding of oriented features in images can be divided into low- and high-level analysis. In the context of the study of oriented features, low-level analysis includes the detection of oriented features in images; a measure of the local magnitude and orientation of oriented features over the entire region of analysis in the image is called the orientation field. High-level analysis relates to the discovery of patterns in the orientation field, usually by associating the structure perceived in the orientation field with a geometrical model. This book presents an analysis of several important methods for the detection of oriented features in images, and a discussion of the phase portrait method for high-level analysis of orientation fields. In order to illustrate the concepts developed throughout the book, an application is presented of the phase portrait method to computer-aided detection of architectural distortion in mammograms. Table of Contents: Detection of Oriented Features in Images / Analysis of Oriented Patterns Using Phase Portraits / Optimization Techniques / Detection of Sites of Architectural Distortion in Mammograms

Increasingly, biomedical scientists and engineers are involved in projects, design, or research and development that involve humans or animals. The book presents general concepts on professionalism and the regulation of the profession of engineering, including a discussion on what is ethics and moral conduct, ethical theories and the codes of ethics that are most relevant for engineers. An ethical decision-making process is suggested. Other issues such as conflicts of interest, plagiarism, intellectual property, confidentiality, privacy, fraud, and corruption are presented. General guidelines, the process for obtaining ethics approval from Ethics Review Boards, and the importance of obtaining informed consent from volunteers recruited for studies are presented. A discussion on research with animals is included. Ethical dilemmas focus on reproductive technologies, stem cells, cloning, genetic testing, and designer babies. The book includes a discussion on ethics and the technologies of body enhancement and of regeneration. The importance of assessing the impact of technology on people, society, and on our planet is stressed. Particular attention is given to nanotechnologies, the environment, and issues that pertain to developing countries. Ideas on gender, culture, and ethics focus on how research and access to medical services have, at times, been discriminatory towards women. The cultural aspects focus on organ transplantation in Japan, and a case study of an Aboriginal child in Canada; both examples show the impact that culture can have on how care is provided or accepted. The final section of the book discusses data collection and analysis and offers a guideline for honest reporting of results, avoiding fraud, or unethical approaches. The appendix presents a few case studies where fraud and/or unethical research have occurred. Table of Contents: Introduction to Ethics / Experiments with Human Subjects or Animals / Examples of Ethical Dilemmas in Biomedical Research / Technology and Society / Gender, Culture, and Ethics / Data Collection and Analysis

Transport processes represent important life-sustaining elements in all humans. These include mass transfer processes, including gas exchange in the lungs, transport across capillaries and alveoli, transport across the kidneys, and transport across cell membranes. These mass transfer processes affect how oxygen and carbon dioxide are exchanged in your bloodstream, how metabolic waste products are removed from your blood, how nutrients are transported to tissues, and how all cells function throughout the body. A discussion of kidney dialysis and gas exchange mechanisms is included. Another element in biomedical transport processes is that of momentum transport and fluid flow. This describes how blood is propelled from the heart and throughout the cardiovascular system, how blood elements affect the body, including gas exchange, infection control, clotting of blood, and blood flow resistance, which affects cardiac work. A discussion of the measurement of the blood resistance to flow (viscosity), blood flow, and pressure is also included. A third element in transport processes in the human body is that of heat transfer, including heat transfer inside the body towards the periphery as well as heat transfer from the body to the environment. A discussion of temperature measurements and body protection in extreme heat conditions is also included. Table of Contents: Biomedical Mass Transport / Biofluid Mechanics and Momentum Transport / Biomedical Heat Transport

There are five different types of eye movements: saccades, smooth pursuit, vestibular ocular eye movements, optokinetic eye movements, and vergence eye movements. The purpose of this book is focused primarily on mathematical models of the horizontal saccadic eye movement system and the smooth pursuit system, rather than on how visual information is processed. A saccade is a fast eye movement used to acquire a target by placing the image of the target on the fovea. Smooth pursuit is a slow eye movement used to track a target as it moves by keeping the target on the fovea. The vestibular ocular movement is used to keep the eyes on a target during brief head movements. The optokinetic eye movement is a combination of saccadic and slow eye movements that keeps a full-field image stable on the retina during sustained head rotation. Each of these movements is a conjugate eye movement, that is, movements of both eyes together driven by a common neural source. A vergence movement is a non-conjugate eye movement allowing the eyes to track targets as they come closer or farther away. In this book, a 2009 version of a state-of-the-art model is presented for horizontal saccades that is 3rd-order and linear, and controlled by a physiologically based time-optimal neural network. The oculomotor plant and saccade generator are the basic elements of the saccadic system. The control of saccades is initiated by the superior colliculus and terminated by the cerebellar fastigial nucleus, and involves a complex neural circuit in the mid brain. This book is the second part of a book series on models of horizontal eye movements. Table of Contents: 2009 Linear Homeomorphic Saccadic Eye Movement Model and Post-Saccade Behavior: Dynamic and Glissadic Overshoot / Neural Network for the Saccade Controller

There are five different types of eye movements: saccades, smooth pursuit, vestibular ocular eye movements, optokinetic eye movements, and vergence eye movements. The purpose of this book is focused primarily on mathematical models of the horizontal saccadic eye movement system and the smooth pursuit system, rather than on how visual information is processed. A saccade is a fast eye movement used to acquire a target by placing the image of the target on the fovea. Smooth pursuit is a slow eye movement used to track a target as it moves by keeping the target on the fovea. The vestibular ocular movement is used to keep the eyes on a target during brief head movements. The optokinetic eye movement is a combination of saccadic and slow eye movements that keeps a full-field image stable on the retina during sustained head rotation. Each of these movements is a conjugate eye movement, that is, movements of both eyes together driven by a common neural source. A vergence movement is a non-conjugate eye movement allowing the eyes to track targets as they come closer or farther away. In this book, early models of saccades and smooth pursuit are presented. The smooth pursuit system allows tracking of a slow moving target to maintain its position on the fovea. Models of the smooth pursuit have been developed using systems control theory, all involving a negative feedback control system that includes a time delay, controller and plant in the forward loop, with unity feedback. The oculomotor plant and saccade generator are the basic elements of the saccadic system. The oculomotor plant consists of three muscle pairs and the eyeball. A number of oculomotor plant models are described here beginning with the Westheimer model published in 1954, and up through our 1995 model involving a 4$^{th}$ order oculomotor plant model. The work presented here is not an exhaustive coverage of the field, but focused on the interests of the author. In Part II, a state-of-art model of the saccade system is presented, including a neural network that controls the system. Table of Contents: Introduction / Smooth Pursuit Models / Early Models of the Horizontal Saccadic Eye Movement System / Velocity and Acceleration Estimation / 1995 Linear Homeomorphic Saccadic Eye Movement Model

Evaluating biomedical technology poses a significant challenge in light of the complexity and rate of introduction in today's healthcare delivery system. Successful evaluation requires an integration of clinical medicine, science, finance, and market analysis. Little guidance, however, exists for those who must conduct comprehensive technology evaluations. The 3Q Method meets these present day needs. The 3Q Method is organized around 3 key questions dealing with 1) clinical and scientific basis, 2) financial fit and 3) strategic and expertise fit. Both healthcare providers (e.g., hospitals) and medical industry providers can use the Method to evaluate medical devices, information systems and work processes from their own perspectives. The book describes the 3Q Method in detail and provides additional suggestions for optimal presentation and report preparation. Table of Contents: Introduction / Question #1: Is It Real? / Question #2: Can We Win? / Question #3: Is It Worth It? / 3Q Case Study Example -- Pershing Medical Company / Appendix A: Health Care Technology Assessment Sample Class Syllabus / Appendix B: How do Hospitals and Clinicians Get Paid? / Appendix C: Technology Assessment PowerPoint Report Guidelines / Appendix D: Class Report Scenario Example / Appendix E: Four-Blocker Slide Templates for 3Q Reports

Technology is essential to the delivery of health care but it is still only a tool that needs to be deployed wisely to ensure beneficial outcomes at reasonable costs. Among various categories of health technology, medical equipment has the unique distinction of requiring both high initial investments and costly maintenance during its entire useful life. This characteristic does not, however, imply that medical equipment is more costly than other categories, provided that it is managed properly. The foundation of a sound technology management process is the planning and acquisition of equipment, collectively called technology incorporation. This lecture presents a rational, strategic process for technology incorporation based on experience, some successful and many unsuccessful, accumulated in industrialized and developing countries over the last three decades. The planning step is focused on establishing a Technology Incorporation Plan (TIP) using data collected from an audit of existing technology, evaluating needs, impacts, costs, and benefits, and consolidating the information collected for decision making. The acquisition step implements TIP by selecting equipment based on technical, regulatory, financial, and supplier considerations, and procuring it using one of the multiple forms of purchasing or agreements with suppliers. This incorporation process is generic enough to be used, with suitable adaptations, for a wide variety of health organizations with different sizes and acuity levels, ranging from health clinics to community hospitals to major teaching hospitals and even to entire health systems. Such a broadly applicable process is possible because it is based on a conceptual framework composed of in-depth analysis of the basic principles that govern each stage of technology lifecycle. Using this incorporation process, successful TIPs have been created and implemented, thereby contributing to the improvement of healthcare services and limiting the associated expenses. Table of Contents: Introduction / Conceptual Framework / The Incorporation Process / Discussion / Conclusions

The auscultation method is an important diagnostic indicator for hemodynamic anomalies. Heart sound classification and analysis play an important role in the auscultative diagnosis. The term phonocardiography refers to the tracing technique of heart sounds and the recording of cardiac acoustics vibration by means of a microphone-transducer. Therefore, understanding the nature and source of this signal is important to give us a tendency for developing a competent tool for further analysis and processing, in order to enhance and optimize cardiac clinical diagnostic approach. This book gives the reader an inclusive view of the main aspects in phonocardiography signal processing. Table of Contents: Introduction to Phonocardiography Signal Processing / Phonocardiography Acoustics Measurement / PCG Signal Processing Framework / Phonocardiography Wavelets Analysis / Phonocardiography Spectral Analysis / PCG Pattern Classification / Special Application of Phonocardiography / Phonocardiography Acoustic Imaging and Mapping

Segmentation and landmarking of computed tomographic (CT) images of pediatric patients are important and useful in computer-aided diagnosis (CAD), treatment planning, and objective analysis of normal as well as pathological regions. Identification and segmentation of organs and tissues in the presence of tumors are difficult. Automatic segmentation of the primary tumor mass in neuroblastoma could facilitate reproducible and objective analysis of the tumor's tissue composition, shape, and size. However, due to the heterogeneous tissue composition of the neuroblastic tumor, ranging from low-attenuation necrosis to high-attenuation calcification, segmentation of the tumor mass is a challenging problem. In this context, methods are described in this book for identification and segmentation of several abdominal and thoracic landmarks to assist in the segmentation of neuroblastic tumors in pediatric CT images. Methods to identify and segment automatically the peripheral artifacts and tissues, the rib structure, the vertebral column, the spinal canal, the diaphragm, and the pelvic surface are described. Techniques are also presented to evaluate quantitatively the results of segmentation of the vertebral column, the spinal canal, the diaphragm, and the pelvic girdle by comparing with the results of independent manual segmentation performed by a radiologist. The use of the landmarks and removal of several tissues and organs are shown to assist in limiting the scope of the tumor segmentation process to the abdomen, to lead to the reduction of the false-positive error, and to improve the result of segmentation of neuroblastic tumors. Table of Contents: Introduction to Medical Image Analysis / Image Segmentation / Experimental Design and Database / Ribs, Vertebral Column, and Spinal Canal / Delineation of the Diaphragm / Delineation of the Pelvic Girdle / Application of Landmarking / Concluding Remarks

This textbook is intended for undergraduate students (juniors or seniors) in Biomedical Engineering, with the main goal of helping these students learn about classical control theory and its application in physiological systems. In addition, students should be able to apply the Laboratory Virtual Instrumentation Engineering Workbench (LabVIEW) Controls and Simulation Modules to mammalian physiology. The first four chapters review previous work on differential equations for electrical and mechanical systems. Chapters 5 through 8 present the general types and characteristics of feedback control systems and foot locus, frequency response, and analysis of stability and margins. Chapters 9 through 12 cover basic LabVIEW programming, the control module with its pallets, and the simulation module with its pallets. Chapters 13 through 17 present various physiological models with several LabVIEW control analyses. These chapters cover control of the heart (heart rate, stroke volume, and cardiac output), the vestibular system and its role in governing equilibrium and perceived orientation, vestibulo-ocular reflex in stabilizing an image on the surface of the retina during head movement, mechanical control models of human gait (walking movement), and the respiratory control model. The latter chapters (Chapters 13-17) combine details from my class lecture notes in regard to the application of LabVIEW control programming by the class to produce the control virtual instruments and graphical displays (root locus, Bode plots, and Nyquist plot). This textbook was developed in cooperation with National Instruments personnel. Table of Contents: Electrical System Equations / Mechanical Translation Systems / Mechanical Rotational Systems / Thermal Systems and Systems Representation / Characteristics and Types of Feedback Control Systems / Root Locus / Frequency Response Analysis / Stability and Margins / Introduction to LabVIEW / Control Design in LabVIEW / Simulation in LabVIEW / LabVIEW Control Design and Simulation Exercise / Cardiac Control / Vestibular Control System / Vestibulo-Ocular Control System / Gait and Stance Control System / Respiratory Control System

Lung sounds auscultation is often the first noninvasive resource for detection and discrimination of respiratory pathologies available to the physician through the use of the stethoscope. Hearing interpretation, though, was the only means of appreciation of the lung sounds diagnostic information for many decades. Nevertheless, in recent years, computerized auscultation combined with signal processing techniques has boosted the diagnostic capabilities of lung sounds. The latter were traditionally analyzed and characterized by morphological changes in the time domain using statistical measures, by spectral properties in the frequency domain using simple spectral analysis, or by nonstationary properties in a joint time-frequency domain using short-time Fourier transform. Advanced signal processing techniques, however, have emerged in the last decade, broadening the perspective in lung sounds analysis. The scope of this book is to present up-to-date signal processing techniques that have been applied to the area of lung sound analysis. It starts with a description of the nature of lung sounds and continues with the introduction of new domains in their representation, new denoising techniques, and concludes with some reflective implications, both from engineers' and physicians' perspective. Issues of nonstationarity, nonlinearity, non-Gaussianity, modeling, and classification of lung sounds are addressed with new methodologies, revealing a more realistic approach to their pragmatic nature. Advanced denoising techniques that effectively circumvent the noise presence (e.g., heart sound interference, background noise) in lung sound recordings are described, providing the physician with high-quality auscultative data. The book offers useful information both to engineers and physicians interested in bioacoustics, clearly demonstrating the current trends in lung sound analysis. Table of Contents: The Nature of Lung Sound Signals / New Domains in LS Representation / Denoising Techniques / Reflective Implications

Quantitative Neurophysiology is supplementary text for a junior or senior level course in neuroengineering. It may also serve as an quick-start for graduate students in engineering, physics or neuroscience as well as for faculty interested in becoming familiar with the basics of quantitative neuroscience. The first chapter is a review of the structure of the neuron and anatomy of the brain. Chapters 2-6 derive the theory of active and passive membranes, electrical propagation in axons and dendrites and the dynamics of the synapse. Chapter 7 is an introduction to modeling networks of neurons and artificial neural networks. Chapter 8 and 9 address the recording and decoding of extracellular potentials. The final chapter has descriptions of a number of more advanced or new topics in neuroengineering. Throughout the text, vocabulary is introduced which will enable students to read more advanced literature and communicate with other scientists and engineers working in the neurosciences. Numerical methods are outlined so students with programming knowledge can implement the models presented in the text. Analogies are used to clarify topics and reinforce key concepts. Finally, homework and simulation problems are available at the end of each chapter. Table of Contents: Preface / Neural Anatomy / Passive Membranes / Active Membranes / Propagation / Neural Branches / Synapses / Networks of Neurons / Extracellular Recording and Stimulation / The Neural Code / Applications / Biography / Index

Tremor represents one of the most common movement disorders worldwide. It affects both sexes and may occur at any age. In most cases, tremor is disabling and causes social difficulties, resulting in poorer quality of life. Tremor is now recognized as a public health issue given the aging of the population. Tremor is a complex phenomenon that has attracted the attention of scientists from various disciplines. Tremor results from dynamic interactions between multiple synaptically coupled neuronal systems and the biomechanical, physical, and electrical properties of the external effectors. There have been major advances in our understanding of tremor pathogenesis these last three decades, thanks to new imaging techniques and genetic discoveries. Moreover, significant progress in computer technologies, developments of reliable and unobtrusive wearable sensors, improvements in miniaturization, and advances in signal processing have opened new perspectives for the accurate characterization and daily monitoring of tremor. New therapies are emerging. In this book, we provide an overview of tremor from pathogenesis to therapeutic aspects. We review the definitions, the classification of the varieties of tremor, and the contribution of central versus peripheral mechanisms. Neuroanatomical, neurophysiological, neurochemical, and pharmacological topics related to tremor are pointed out. Our goals are to explain the fundamental basis of tremor generation, to show the recent technological developments, especially in instrumentation, which are reshaping research and clinical practice, and to provide up-to-date information related to emerging therapies. The integrative transdisciplinary approach has been used, combining engineering and physiological principles to diagnose, monitor, and treat tremor. Guidelines for evaluation of tremor are explained. This book has been written for biomedical engineering students, engineers, researchers, medical students, biologists, neurologists, and biomedical professionals of any discipline looking for an updated and multidisciplinary overview of tremor. It can be used for biomedical courses. Table of Contents: Introduction / Anatomical Overview of the Central and Peripheral Nervous System / Physiology of the Nervous System / Characterization of Tremor / Prinipal Disorders Associated with Tremor / Quantification of Tremor / Mechanisms of Tremor / Treatments

This book is concerned with the study of continuum mechanics applied to biological systems, i.e., continuum biomechanics. This vast and exciting subject allows description of when a bone may fracture due to excessive loading, how blood behaves as both a solid and fluid, down to how cells respond to mechanical forces that lead to changes in their behavior, a process known as mechanotransduction. We have written for senior undergraduate students and first year graduate students in mechanical or biomedical engineering, but individuals working at biotechnology companies that deal in biomaterials or biomechanics should also find the information presented relevant and easily accessible. Table of Contents: Tensor Calculus / Kinematics of a Continuum / Stress / Elasticity / Fluids / Blood and Circulation / Viscoelasticity / Poroelasticity and Thermoelasticity / Biphasic Theory

A medical device is an apparatus that uses engineering and scientific principles to interface to physiology and diagnose or treat a disease. In this Lecture, we specifically consider thosemedical devices that are computer based, and are therefore referred to as medical instruments. Further, the medical instruments we discuss are those that incorporate system theory into their designs. We divide these types of instruments into those that provide continuous observation and those that provide a single snapshot of health information. These instruments are termed patient monitoring devices and diagnostic devices, respectively.Within this Lecture, we highlight some of the common system theory techniques that are part of the toolkit of medical device engineers in industry. These techniques include the pseudorandom binary sequence, adaptive filtering, wavelet transforms, the autoregressive moving average model with exogenous input, artificial neural networks, fuzzy models, and fuzzy control. Because the clinical usage requirements for patient monitoring and diagnostic devices are so high, system theory is the preferred substitute for heuristic, empirical processing during noise artifact minimization and classification. Table of Contents: Preface / Medical Devices / System Theory / Patient Monitoring Devices / Diagnostic Devices / Conclusion / Author Biography

Take one elephant and one man to the top of a tower and simultaneously drop. Which will hit the ground first?You are a pilot of a jet fighter performing a high-speed loop. Will you pass out during the maneuver?How can you simulate being an astronaut with your feet still firmly placed on planet Earth?In the aerospace environment, human, animal, and plant physiology differs significantly from that on Earth, and this book provides reasons for some of these changes. The challenges encountered by pilots in their missions can have implications on the health and safety of not only themselves but others. Knowing the effects of hypergravity on the human body during high-speed flight led to the development of human centrifuges. We also need to better understand the physiological responses of living organisms in space. It is therefore necessary to simulate weightlessness through the use of specially adapted equipment, such as clinostats, tilt tables, and body suspension devices. Each of these ideas, and more, is addressed in this review of the physical concepts related to space flights, microgravity, and hypergravity simulations. Basic theories, such as Newton's law and Einstein's principle are explained, followed by a look at the biomedical effects of experiments performed in space life sciences institutes, universities, and space agencies. Table of Contents: General Concepts in Physics - Definition of Physical Terms / The Effects of Hypergravity on Biomedical Experiments / The Effects of Microgravity on Biomedical Experiments / References

The field of brain imaging is developing at a rapid pace and has greatly advanced the areas of cognitive and clinical neuroscience. The availability of neuroimaging techniques, especially magnetic resonance imaging (MRI), functional MRI (fMRI), diffusion tensor imaging (DTI) and magnetoencephalography (MEG) and magnetic source imaging (MSI) has brought about breakthroughs in neuroscience. To obtain comprehensive information about the activity of the human brain, different analytical approaches should be complemented. Thus, in "e;intermodal multimodality"e; imaging, great efforts have been made to combine the highest spatial resolution (MRI, fMRI) with the best temporal resolution (MEG or EEG). "e;Intramodal multimodality"e; imaging combines various functional MRI techniques (e.g., fMRI, DTI, and/or morphometric/volumetric analysis). The multimodal approach is conceptually based on the combination of different noninvasive functional neuroimaging tools, their registration and cointegration. In particular, the combination of imaging applications that map different functional systems is useful, such as fMRI as a technique for the localization of cortical function and DTI as a technique for mapping of white matter fiber bundles or tracts. This booklet gives an insight into the wide field of multimodal imaging with respect to concepts, data acquisition, and postprocessing. Examples for intermodal and intramodal multimodality imaging are also demonstrated. Table of Contents: Introduction / Neurological Measurement Techniques and First Steps of Postprocessing / Coordinate Transformation / Examples for Multimodal Imaging / Clinical Aspects of Multimodal Imaging / References / Biography