End-to-end delay is an important consideration of the design of wireless tele-ultrasonography systems because such systems support delay-sensitive applications and require critical delay constraints. This paper addresses the characterisation and estimation of end-to-end delay distributions by using the Effective Capacity (EC) technique. A cross-layer simulation platform is built to 1) represent a scenario of remote medical ultrasound video streaming over fixed WiMAX networks, 2) transmit a real ultrasound medical video and 3) verify the accuracy of the EC-based delay distribution estimation for video frames. The results show that in most cases, the simulation results and estimation results are in good agreement.

It is well known that the evolution of 4G-based mobile multimedia network systems will contribute significantly to future mobile healthcare (m-health) applications that require high bandwidth and fast data rates. Central to the success of such emerging applications is the compatibility of broadband networks, such as mobile Worldwide Interoperability For Microwave Access (WiMAX) and High-Speed Uplink Packet Access (HSUPA), and especially their rate adaption issues combined with the acceptable real-time medical quality of service requirements. In this paper, we address the relevant challenges of cross-layer design requirements for real-time rate adaptation of ultrasound video streaming in mobile WiMAX and HSUPA networks. A comparative performance analysis of such approach is validated in two experimental m-health test bed systems for both mobile WiMAX and HSUPA networks. The experimental results have shown an improved performance of mobile WiMAX compared to the HSUPA using the same cross-layer optimization approach.

The application of advanced error concealment techniques applied as a post-process to conceal lost video information in error-prone channels, such as the wireless channel, demand additional processing at the receiver. This increases the delivery delay and needs more computational power. However, in general, only a small region within medical video is of interest to the physician and thus if only this area is considered, the number of computations can be curtailed. In this paper we present a technique whereby the Region of Interest (ROI) specified by the physician is used to delimit the area where the more complex concealment techniques are applied. A cross layer design approach in mobile WiMAX wireless communication environment is adopted in this paper to provide an optimized Quality of Experience (QoE) in the region that matters most to the mobile physician while relaxing the requirements in the background, ensuring real-time delivery. Results show that a diagnostically acceptable Peak Signal-to-Noise-Ratio (PSNR) of about 36 dB can still be achieved within reasonable decoding time.

M-health is an emerging area of research and one of the key challenges in future research in this area is medical video streaming over wireless channels. Contrasting requirements of almost lossless compression and low available bandwidth have to be tackled in medical quality video streaming in ultrasound and radiology applications. On one side, compression techniques need to be conservative, in order to avoid removing perceptively important information; on the other side, error resilience and correction should be provided, with the constraint of a limited bandwidth. A quality-driven, network-aware approach for joint source and channel coding based on a controller structure specifically designed for enhanced video streaming in a robotic teleultrasonography system is presented. The designed application based on robotic teleultrasonography is described and the proposed method is simulated in a wireless environment in two different scenarios; the video quality improvement achievable through the proposed scheme in such an application is remarkable, resulting in a peak signal-to-noise ratio (PSNR) improvement of more than 4 dB in both scenarios.

The design of an efficient mobile healthcare system using 3.5G and 4G wireless networks is a challenging problem especially for bandwidth demanding telemedical applications. In this paper, we focus on the concept of medical quality of service (m-QoS) applied to a typical bandwidth demanding m-health application. Based on this concept, we propose a novel multiobjective rate-control mechanism for the optimized delivery of diagnostically acceptable ultrasound video images over 3.5G wireless networks. The performance of the proposed algorithm has been evaluated via both simulations and experimental studies. The proposed optimal rate control algorithm achieved performance improvements that are compatible with the medical QoS requirements.

A new real-time compression method for electrocardiogram (ECG) signals has been developed based on the wavelet transform approach. The method is specifically adaptable for packetized telecardiology applications. The signal is segmented into beats and a beat template is subtracted from them, producing a residual signal. Beat templates and residual signals are coded with a wavelet expansion. Compression is achieved by selecting a subset of wavelet coefficients. The number of selected coefficients depends on a threshold which has different definitions depending on the operational mode of the coder. Compression performance has been tested using a subset of ECG records from MIT-BIH Arrhythmia database. This method has been designed for real-time packetized telecardiology scenarios both in wired and wireless environments.

m-health is a new and evolving research discipline that is defined as emerging merging mobile communications and network technologies for healthcare. This new evolutionary research area will involve the provision of new paradigms in healthcare that will provide both the health care professionals and patients with an efficient, secure, ubiquitous and robust infrastructure coupled with tools for the assessment and management of patient health status and the support of preventive and patient empowerment programmes. However, for such new services to be provided, in which patient confidential data will be routinely transferred between mobile devices having no prior knowledge of each other, robust new security services will be essential. These will have to be based on new security paradigms that, unlike today, cannot assume the presence of common trusted third parties, or require the patients to use cumbersome key or password management techniques. The assessment and the trustworthiness of "stranger" devices such as future wireless wearables and implantable devices will need to replace me former or some of the existing security methodologies. Issues such as context awareness and mobile ubiquitous computing systems will be the driving force for such development in existing security architectures and technologies that will be compatible with the requirement of such systems and services and the whole m-health security infrastructure will need to be autonomic and predictive with self annealing so that it can determine when it is being attacked or not.

M-Health can be defined as “mobile computing, medical sensor, and communications technologies for health-care.” This emerging concept represents the evolution of e-health systems from traditional desktop “telemedicine” platforms to wireless and mobile configurations. Current and emerging developments in wireless communications integrated with developments in pervasive and wearable technologies will have a radical impact on future health-care delivery systems. This editorial paper presents a snapshot of recent developments in these areas and addresses some of the challenges and future implementation issues from the m-Health perspective. The contributions presented in this special section represent some of these recent developments and illustrate the multidisciplinary nature of this important and emerging concept.

This paper evaluates the compression performance and characteristics of two wavelet coding compression schemes of electrocardiogram (ECG) signals suitable for real-time telemedical applications. The two proposed methods, namely the optimal zonal wavelet coding (OZWC) method and the wavelet transform higher order statistics-based coding (WHOSC) method, are used to assess the ECG compression issues. The WHOSC method employs higher order statistics (HOS) and uses multirate processing with the autoregressive HOS model technique to provide increasing robustness to the coding scheme. The OZWC algorithm used is based on the optimal wavelet-based zonal coding method developed for the class of discrete "Lipschitizian" signals. Both methodologies were evaluated using the normalized rms error (NRMSE) and the average compression ratio (CR) and bits per sample criteria, applied on abnormal clinical ECG data samples selected from the MIT-BIH database and the Creighton University Cardiac Center database. Simulation results illustrate that both methods can contribute to and enhance the medical data compression performance suitable for a hybrid mobile telemedical system that integrates these algorithmic approaches for real-time ECG data transmission scenarios with high CRs and low NRMSE ratios, especially in low bandwidth mobile systems.

This paper describes the design of a prototype integrated mobile telemedicine system that is compatible with existing mobile telecommunications networks and upgradable for use with third-generation networks. The system, when fully developed, will enable a doctor to monitor remotely a patient who is free to move around for sports medicine and for emergency situations.

A new integrated design approach for an optimal zonal wavelet-based ECG data compression (OZWC) method for a mobile telecardiology model is presented. The hybrid implementation issues of this wavelet method with a GSM-based mobile telecardiology system are also introduced. The performance of the mobile system with compressed ECG data segments selected from the MIT-BIH arrhythmia data base is evaluated in terms of bit error rate (BER), percent rms difference (PRD), and visual clinical inspection. The compression performance analysis of the OZWC is compared with another wavelet-based (Discrete Symmetric Wavelet Compression) approach. The optimal wavelet algorithm achieved a maximum compression ratio of 18: 1 with low PRD ratios. The mobile telemedical simulation results show the successful compressed ECG transmission at speeds of 100 (km/h) with BER rates of less than 10(-15), providing a 73% reduction in total mobile transmission time with clinically acceptable reconstruction of the received signals. This approach will provide a framework for the design and functionality issues of GSM-based wireless telemedicine systems with wavelet compression techniques and their future integration for the next generation of mobile telecardiology systems.

Many signal processing applications pose optimization problems with multimodal and nonsmooth cost functions. Gradient methods are ineffective in these situations. The adaptive simulated annealing (ASA) offers a viable optimization tool for tackling these difficult nonlinear problems. We demonstrate the effectiveness of the ASA using three applications, infinite-impulse-response (IIR) filter design, maximum likelihood (ML) joint channel and data estimation and evaluation of minimum symbol-error-rate (MSER) decision feedback equalizer (DFE).

Feedback controller implementations with fixed-point arithmetic offer the advantages of speed, memory space, cost and simplicity compared to floating-point arithmetic. Thus, to date, fixed-point processors dedicated for digital controller implementations are still the dominant architecture in many modern digital control engineering applications, particularly for automotive, consumer, military and medical applications. However, most control design methodologies assume that the designed controller will be implemented with infinite precision. Thus, when the controller is implemented on a fixed-point platform, rounding errors can cause a performance degradation and even instability. Hence, there is a trade-off between the cost of the controller in terms of word-length, memory and computation requirements (the controller compactness) and the performance of the system. This paper presents an approach to designing finite word-length feedback controller structures by means of a multi-objective genetic algorithm. The approach provides a set of solutions that are (near) Pareto optimal with respect to minimal word-length and memory requirements and to closed-loop performance. The method is applied to the design of finite word-length controller structures for two examples, a PID controller for a rolling strip mill, and a controller for the IFAC93 benchmark problem.

The objective of this correspondence is to present an overview of some of the current development and some of the ongoing telemedicine programs in the United Kingdom. The issues of the future integration of telemedicine activities within the National Health Service that promises better access to healthcare with higher efficiency, mobility, and lower cost are also discussed.

This paper presents a microcontroller-based underwater acoustic telemetry system for digital transmission of the electrocardiogram (ECG). The system is designed for the real time, through-water transmission of data representing any parameter, and it was used initially for transmitting in multiplexed format the heart rate, breathing rate and depth of a diver using self-contained underwater breathing apparatus (SCUBA). Here, it is used to monitor cardiovascular reflexes during diving and swimming. The programmable capability of the system provides an effective solution to the problem of transmitting data in the presence of multipath interference. An important feature of the paper is a comparative performance analysis of two encoding methods, Pulse Code Modulation (PCM) and Pulse Position Modulation (PPM).