OBJECTIVE: The progress in computer and communication technologies is making the Internet increasingly heterogeneous in terms of network, hardware and software capacities. Moreover, this has made it possible for emergency telemedicine services to provide high quality medical services. However, resource availability on the Internet varies unexpectedly. Thus, providing an efficient access to emergency telemedicine services requires that medical multimedia streams be adapted according to the environment constraints. One approach to this issue is based on the use of intermediate nodes within the network to perform such adaptations (media transformations and data transcoding). For this purpose, we have designed and implemented a proxy server for Quality of Service adaptations of medical multimedia streams. METHODS: We have organized a new emergency telemedicine system by designing a proxy server to execute transcoding. The proxy server is located between a patient system and a doctor system over heterogeneous networks. Before a patient system can deliver medical video streams to a doctor system, the proxy server measures uplink bandwidth which is one of the Quality of Service factors, from the proxy server to the doctor system. At this moment, frame rates are determined according to the measured bandwidth, and the proxy server transmits medical video streams modified for new frame rates to the doctor system. We describe the implementation of this proxy server on top of the Microsoft DirectShow(R) environment and report on a performance evaluation which demonstrates the effectiveness of the approach. RESULTS: The quality of requested medical video streams can be predicted when they are adapted to the receiver. With this prediction, adapted medical video streams which meet the frame rates constraints of the receiver can be delivered without additional measurements of bandwidth. CONCLUSION: This study represents a proxy server of a hybrid multimedia telemedicine system over heterogeneous networks. We expect that the designed proxy server can provide not only dynamic Quality of Service monitoring functions along bandwidth measurement, but also medical video adaptations to the receiver in heterogeneous network environments.
Emergencies ; Humans ; Internet ; Multimedia ; Proxy* ; Rivers* ; Telemedicine

OBJECTIVES: Deficit schizophrenia (DS) constitutes a disease separate from non-deficit schizophrenia (NDS). The aim of the current study was to compare the quantitative EEG and low resolution electromagnetic tomography (LORETA) imaging between DS and NDS. METHODS: This study was performed by 32 channels EEG for 42 schizophrenia patients who we categorized into DS and NDS using proxy instrument deficit syndrome (PDS). We performed the absolute power spectral analyses for delta, theta, alpha, low beta and high beta activities. We compared power spectrum between two groups using Independent t-test. Partial correlation test was performed with clinical parameters. Standardized LORETA (sLORETA) was used for comparison of cortical activity, and statistical nonparametric mapping (SnPM) was applied for the statistical analysis. RESULTS: DS showed significantly increased delta and theta absolute power in fontal and parietal region compared with NDS (p<0.05). Power spectrum showed significant correlation with 'anergia' and 'hostility/suspiciousness' subscale of brief psychiatric rating scale (BPRS)(p<0.05). sLORETA found out the source region (anterior cingulate cortex/limbic part) that delta activity was significantly increased in DS (p=0.042). CONCLUSIONS: DS showed different cortical activity compared with NDS. Our results may suggest QEEG and LORETA could be the marker in differentiating between DS and NDS.
Brief Psychiatric Rating Scale ; Electroencephalography ; Humans ; Magnets ; Naphthalenesulfonates ; Proxy ; Schizophrenia

PURPOSE: Recent studies suggest that the symptomatic improvement in benign prostatic hyperplasia significantly related with transition zone volume (TZV). The purpose of this study was to determine the clinical significance of TZV and transition zone index (TZI) in changes of prostate volume (PV) and clinical parameters following finasteride therapy. MATERIALS AND METHODS: 140 patients over 50 years of age with symptomatic benign prostatic hyperplasia were treated with finasteride (5mg/d) for 12 months and underwent transrectal ultrasound evaluation of PV and TZV prior to initiating therapy and after 12 months. Patients were grouped according to the results of PV (> OR =40ml or <40ml), TZI (> OR =0.45 or <0.45) and PSA level (> OR =2.5 or <2.5). The responders was determined as improvement in peak flow rate more than 3mL/sec. RESULTS: PV decreased by 14.11% in patients with TZI less than 0.45, while the decrease was 19.25% for men with TZI greater than 0.45 (p<0.01). In addition, PV was significantly decreased by 16.72% in patients with PV less than 40cc and TZI greater than 0.45 (p<0.01). PV decreased by 17.37% in patients with PSA less than 2.5, while the decrease was 18.92% in men with PSA greater than 2.5. In responders, only TZI was significantly different among PSA, PV and TZI (p<0.05). CONCLUSIONS: Treatment effect of finasteride on symptomatic benign prostatic hyperplasia patients was increased in proportion to enlarged PV, increased TZI, increased PSA. TZI was a useful proxy for predicting clinical outcomes in initiating finasteride therapy on benign prostatic hyperplasia.
Finasteride* ; Humans ; Male ; Prostate ; Prostatic Hyperplasia* ; Proxy ; Ultrasonography

OBJECTIVES: This study presents the indicators and proxy variables for the quantitative assessment of green chemistry technologies and evaluates the relative importance of each assessment element by consulting experts from the fields of ecology, chemistry, safety, and public health. METHODS: The results collected were subjected to an analytic hierarchy process to obtain the weights of the indicators and the proxy variables. RESULTS: These weights may prove useful in avoiding having to resort to qualitative means in absence of weights between indicators when integrating the results of quantitative assessment by indicator. CONCLUSIONS: This study points to the limitations of current quantitative assessment techniques for green chemistry technologies and seeks to present the future direction for quantitative assessment of green chemistry technologies.
Chemistry ; Ecology ; Green Chemistry Technology* ; Health Resorts ; Humans ; Proxy ; Public Health ; Weights and Measures

OBJECTIVES: This study presents the indicators and proxy variables for the quantitative assessment of green chemistry technologies and evaluates the relative importance of each assessment element by consulting experts from the fields of ecology, chemistry, safety, and public health. METHODS: The results collected were subjected to an analytic hierarchy process to obtain the weights of the indicators and the proxy variables. RESULTS: These weights may prove useful in avoiding having to resort to qualitative means in absence of weights between indicators when integrating the results of quantitative assessment by indicator. CONCLUSIONS: This study points to the limitations of current quantitative assessment techniques for green chemistry technologies and seeks to present the future direction for quantitative assessment of green chemistry technologies.
Chemistry ; Ecology ; Green Chemistry Technology* ; Health Resorts ; Humans ; Proxy ; Public Health ; Weights and Measures

BACKGROUND: Inter-observer and intra-observer variation in histologic tumor grading are well documented. To determine whether histologic disorderliness in the arrangement of tumor cells may serve as an objective criterion for grading, we tested the hypothesis the degree of disorderliness is related to the degree of tumor differentiation on which tumor grading is primarily based. METHODS: Borrowing from the statistical thermodynamic definition of entropy, we defined a novel mathematical formula to compute the relative degree of histologic disorderliness of tumor cells. We then analyzed a total of 51 photomicrographs of normal colorectal mucosa and colorectal adenocarcinoma with varying degrees of differentiation using our formula. RESULTS: A one-way analysis of variance followed by post hoc pairwise comparisons using Bonferroni correction indicated that the mean disorderliness score was the lowest for the normal colorectal mucosa and increased with decreasing tumor differentiation. CONCLUSIONS: Disorderliness, a pathologic feature of malignant tumors that originate from highly organized structures is useful as an objective tumor grading proxy in the field of digital pathology.
Adenocarcinoma ; Colonic Neoplasms ; Entropy ; Humans ; Mucous Membrane ; Neoplasm Grading ; Observer Variation ; Pathology ; Proxy ; Thermodynamics

PURPOSE: Recently, detrusor contraction duration (DCD) has been suggested to be a useful urodynamic parameter for differentiating bladder outlet obstruction. Therefore, we studied the relationship between DCD and bladder outlet obstruction to determine whether DCD is a useful parameter for characterizing bladder outlet obstruction with lower urinary tract symptoms in men. MATERIALS AND METHODS: The urodynamic records of 212 consecutive male patients with lower urinary tract symptoms subdivided into 4 groups as bladder outlet obstruction (BOO), detrusor underactivity (DU), detrusor instability (DI), and normal (NL). DCD was defined as the contraction time elapsed between the first rise in detrusor pressure from baseline to the time at which detrusor pressure returned to baseline at the end of voiding. The correlations of DCD with other urodynamic parameters were assessed. RESULTS: DCD was significantly increased in patients with BOO and DU groups compared to other groups (DI, NL) (p<0.05). However, DCD were only weakly correlated with other urodynamic obstructive parameters in the BOO groups. CONCLUSIONS: Since DCD may also depend on detrusor contractility and bladder volume, DCD alone cannot be used as obstructive parameters to diagnose bladder outlet obstruction. However, considering the fact that the bladder outlet obstruction can be easily differentiated from the decreased detrusor contractility with other urodynamic parameters, DCD seems to be useful proxy for evaluating bladder outlet obstruction.
Humans ; Lower Urinary Tract Symptoms ; Male ; Proxy ; Urinary Bladder Neck Obstruction* ; Urinary Bladder* ; Urodynamics

The Journal Impact Factor (JIF) is a single citation metric, which is widely employed for ranking journals and choosing target journals, but is also misused as the proxy of the quality of individual articles and academic achievements of authors. This article analyzes Scopus-based publication activity on the JIF and overviews some of the numerous misuses of the JIF, global initiatives to overcome the ‘obsession’ with impact factors, and emerging strategies to revise the concept of the scholarly impact. The growing number of articles on the JIF, most of which are in English, reflects interest of experts in journal editing and scientometrics toward its uses, misuses, and options to overcome related problems. Solely displaying values of the JIFs on the journal websites is criticized by experts as these average metrics do not reflect skewness of citation distribution of individual articles. Emerging strategies suggest to complement the JIFs with citation plots and alternative metrics, reflecting uses of individual articles in terms of downloads and distribution of related information through social media and networking platforms. It is also proposed to revise the original formula of the JIF calculation and embrace the concept of the impact and importance of individual articles. The latter is largely dependent on ethical soundness of the journal instructions, proper editing and structuring of articles, efforts to promote related information through social media, and endorsements of professional societies.
Complement System Proteins ; Editorial Policies ; Humans ; Journal Impact Factor* ; Periodicals as Topic ; Proxy ; Publications ; Social Media

PURPOSE: Prostate volume has been known to be poorly correlated with various parameters used to assess the severity of benign prostatic hyperplasia (BPH). However, recently there were reports that the ratio between transition zone(TZ) volume and prostate volume, which termed the TZ index might served as a useful proxy for evaluating worsening obstruction. The purpose of this study was to determine if transrectal ultrasound(TRUS) measurement of RI(resistive index), PCAR (presumed circle area ratio) correlate with the parameters of prostate volume(total prostate volume, TZ volume, TZ index), Qmax, international prostate symptom score(IPSS) or age. This study was conducted to reveal the relative effects of ultrasonic appearance of BPH on urinary symptoms. MATERIALS AND METHODS: A total of 81 men aged 50 to 89 years with moderate symptom of BPH(IPSS> or =8) underwent measurement of RI, PCAR, total prostate and TZ volume at transrectal ultrasonography. All men were requested to undergo uroflowmetry and complete the IPSS. The IPSS was compared to age, Qmax, prostatic volume, RI and PCAR using simple and multiple regression analysis. RESULTS: Simple regression analysis demonstrated that IPSS correlated with age(r=0.050, p<0.05), Qmax(r=0.253, p<0.05), TV(r=0.096, p<0.05) and PCAR(r=0.266, p<0.05). However, multiple regression analysis showed that age, Qmax and PCAR were significant independent determinants of the IPSS. CONCLUSIONS: As a parameter representing the degree of BPH in terms of the severity of lower urinary symptoms, simple and multiple regression analysis confirmed that the IPSS was influenced considerably by age, peak flow rate and PCAR.
Humans ; Lower Urinary Tract Symptoms* ; Male ; Prostate* ; Prostatic Hyperplasia* ; Proxy ; Ultrasonics ; Ultrasonography

All along the medical procedures, the patient's right of self determination may conflict with the medical doctor's professional decisions. The discharge against medical advice (DAMA) is a kind of conflict which becomes a hot issue recently. We tried to summarize various epidemiologic studies to know how many DAMAs have been. And we consider the limits on DAMA. Patient's right to self-DAMA is to be esteemed within a limit of other interests, especially a life self-DAMA is to be esteemed within a limit of other interests, especially a life of fetus in pregnancy woman as the proxy-DAMA is to a life of patient. Through the balance of these interests, the legitimation of DAMA can be established. When patient or proxy violates the principles in DAMA, the method of punishment on doctor in question. Lastly, we inquire into the types of punishment on doctor, intentional type of crime, negligence type of crime, or not guilty. We concludes with the preference on the negligence type of crime.
Crime ; Epidemiologic Studies ; Female ; Fetus ; Humans ; Korea* ; Malpractice ; Patient Rights ; Personal Autonomy ; Pregnancy ; Proxy ; Punishment