MEDICON 2016
MARCH 31ST - APRIL 2ND 2016 PAPHOS, CYPRUS
Plenary Speakers
Dimitris Koutsouris
National Technical University of Athens, Greece
Prof. Dimitris Koutsouris, Esq was born in Serres, Greece in 1955. He received his Diploma in Electrical Engineering in 1978 (Greece), DEA in Biomechanics in 1979 (France), Doctorate in Genie Biologie Medicale (France), Doctorat d' Etat in Biomedical Engineering 1984 (France). Since 1986 he has been research associate at the USC (Los Angeles), Renè Dèscartes (Paris) and Assoc. Professor at the Dept. of Electrical & Computers Engineering of National Technical University of Athens. He is currently Professor and Head of the Biomedical Engineering Laboratory. He has published over 150 research articles, more than 300 conference communications and 48 chapters. He supervised more than 40 PhD theses and more than 150 undergraduate & post graduate dissertations. In his career, he has already more than 2.500 citations. He has also been a reviewer in 20 international journals. Prof. Koutsouris has been the former President elect of the Hellenic Society of Biomedical Technology, HL7 Hellas and member of the IFMBE (International Federation Medical & Biological Engineering). He was the main Organizer of 4 Global conferences and member of the Organizing Committee in over 20 international Conferences. In addition, he was recently appointed the position of Chairman of the Organizing Committee of the E-Health Forum 2014 which was organized under the auspices of the Greek EU Presidency in cooperation with the European Commission. Within ICCSS he has participated in more than 80 EU projects and coordinated 10 of them.
The Evolution of Medical Care: From The Beginnings to Personalized Medicine
Abstract
The practice of medical care is as old as the first recordings in human history, conceiving the human body and disease in a holistic manner. Early medical traditions include those of ancient Egypt and Babylon. The Greeks went even further, introducing the concepts of medical diagnosis, prognosis, and advanced medical ethics. Around 800 BCE Homer in The Iliad gives descriptions of wound treatment by the two sons of Asklepios, the admirable physicians Podaleirius and Machaon and one acting doctor, Patroclus. The Hippocratic Oath, still taken by doctors up to today, was written in Greece in the 5th century BCE. In the medieval age, surgical practices inherited from the ancient masters were improved and then systematized in Rogerius's The Practice of Surgery. Universities began systematic training of physicians around the years 1220 in Italy. During the Renaissance, understanding of anatomy improved with pioneering works such as those from Andreas Vesalius, and the microscope was invented. The germ theory of disease in the 19th century led to cures for many infectious diseases. Military doctors advanced the methods of trauma treatment and surgery. Public health measures were developed especially in the 19th century as the rapid growth of cities required systematic sanitary measures. Advanced research centers opened in the early 20th century, often connected with major hospitals. The mid-20th century was characterized by new biological treatments, such as antibiotics. These advancements, along with developments in chemistry, genetics, and lab technology (such as the x-ray) led to modern medicine. Medicine was heavily professionalized in the 20th century, and new careers opened to women as nurses (from the 1870s) and as physicians (especially after 1970) and at the same time disease specialization arose in the sense of providing medical care with respect to the specific characteristics of the disease as well as provided from specialized medical professionals. The 21st century is characterized by highly advanced research involving numerous fields of science.
Yet, the advancement of medical care was moving hand in hand with technological advancement. Besides basic knowledge of biomedical processes, technology was the main implementer of that knowledge. The 21st century could be characterized by the phrase “Biology is the new Physics”, stated in an article by Philip Hunter in 2010 . These very technological breakthroughs, which include the innovations in semi-conductors, the increase in computational power along with the lowering of cost of computational power, were the main factors for the onset of personalized medicine. It would unthinkable to speak of such applications such as providing health care based on the patients profile without the use of high throughput screening methods, such as microarrays and next generation sequencing (NGS). Or it would be impossible to interpret genomic data without the analytical and mathematical tools from physics, mathematics and engineering. Hence, it was the “marriage” biology and engineering that brought about such possibilities. Further on, pioneering work in engineering has created new possibilities through the application of biosensors, nanoparticles and nano-bots, advanced imaging methodologies, as well as improved procedures towards the understanding of biological signal transduction and information transmission. This interdisciplinary interaction gave the possibility of predicting the health risks of an individual based on his/hers genomic profile (still considering that this process is in its infancy and there more to be learned about). At the same time, those new analytical tools gave the possibility of treating human disease from a holistic perspective, yet this time considering biological systems as a complete entity and not as isolated molecular events. Hence, there should be an increasing effort towards the intercoupling of the biological sciences with engineering, since this is, a one-way road to the improvement of medical care and consequently to personalized medicine.
Leonidas Phylactou
Cyprus Institute of Neurology and Genetics, Cyprus
Leonidas Phylactou studied Medical Biochemistry at the University of Birmingham in UK and then did a PhD in Molecular Genetics and Gene Therapy in the same University, although most of the time was spent at the University of Connecticut Health Centre in USA. He then moved back to UK at the University of Oxford for as a post-doctoral scientist, where he set up a team working on gene therapy for Myotonic Dystrophy. In 1998 he established a research group at the Cyprus Institute of Neurology and Genetics working on the gene function and gene therapy. In 2005 he was appointed Head of the Department of Molecular Function and Therapy in which apart from the research activities he is responsible for diagnostic services in Medical Genetics. Since last November he is the Chief Executive and Medical Director of the Cyprus Institute of Neurology and Genetics. Leonidas Phylactou sits on the Editorial Boards of the journals Molecules and Pharmaceuticals and has secured international funding from several organisations such as the Association Francaise contres Les Myopathies, the Human Frontiers Sciences Program and the Muscular Dystrophy Campaign of UK. He participates in several European Networks and published extensively in the areas of expertise.
Systems Medicine: the example of genetics – making progress in the right direction
Abstract
The recent explosion of information in human biology and medicine has created a huge demand and need for advanced computing analysis. Currently, there is tremendous amount of information which is waiting to be analysed and interpreted. What is even more important is the translation of this information into the language of biology and medicine, having as ultimate aim the improvement of human health. During the presentation, I will use as an example the field of genetics and will describe how advanced computing is making real progress in this discipline.
IFMBE Perspective
James Goh
IFMBE President, Professor and Head, Department of Biomedical Engineering, National University of Singapore, Singapore
James GOH obtained his BSc (1st Class Honors) in Mechanical Engineering (1978) as well as PhD in Bioengineering (1982) from the University of Strathclyde, Glasgow, UK. He is currently Professor and Head, Department of Biomedical Engineering, Faculty of Engineering, National University of Singapore (NUS) and holds a joint appointment as Research Professor in the Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, NUS. Prof Goh is on a number of national as well as international committees. He is the President of the International Federation of Medical and Biological Engineering (IFMBE) and the President of the Biomedical Engineering Society (Singapore). He is also a Fellow of the Institute of Engineers, Singapore (IES) and chairs IES’ Technical Committee on Biomedical Engineering. He also chairs the Science and Technology Advisory Board of the Singapore Sports Institute. He is a member of the Biomedical Standards Committee. Dr Goh has been actively involved in organizing international conferences and had served on numerous International Advisory Boards and Scientific Committees. He chaired the 6th World Congress of Biomechanics, (2010), TERMIS-AP (2011) and 15th ICBME (2013). Dr Goh has a strong research interest in musculoskeletal research and actively promotes the field of biomedical engineering. He has given numerous invited talks at international and regional conferences. He has published well over 130 international peer review journal papers, more than 500 conference papers and 12 book chapters.
Systems Medicine for the Delivery of Better Healthcare Services - IOMP Perspective
Abstract
The International Federation on Medical and Biological Engineering was established in 1952, it currently has 60 national and transnational societies. It is the largest federation of its kind in representing and unifying the world-wide Medical and Biological Engineering community. Its mission is to encourage, support the promotion of health and quality of life through advancement of research, development, application and management of technology. True to its goals, it has a global network of professionals at the international level to advance collaboration between national and transnational societies, industry, government and non-governmental organizations engaged in health care and in biomedical research and its applications. IFMBE is a Non-Governmental Organization in official relations with the World Health Organization. In IFMBE, we recognized that the healthcare services landscape is changing rapidly due to multiple factors, ie healthcare economics leading to reformation in the healthcare system, major trends in public health, continuing advances in our understanding of human biology that has the potential impact on medical practice and the development of new innovative technologies for effective and precise diagnosis, treatment and monitoring. As such the field of medical and biological engineering has an important role to constantly attain scientific innovation and translate invention to practice, so as to enhance the healthcare interventions. Even so, there are four key challenges which must be overcome to achieve better healthcare services. The first challenge is comparative effectiveness. Comparative data is necessary and must be available to demonstrate that a new healthcare intervention is an improvement over existing treatment methods. The second challenge is cost containment and reduction. Cost control measures are required to ensure that the public has greater affordable accessibility to high-quality healthcare. The third challenge is global inequities. There is a strong need to bridge the divide between wealthy and poor nations by implementing procedures to support fair healthcare provision. The fourth challenge is accessibility to medicine. It is important to provide adequate access to advanced medical technologies for patients from around the world. In view of these challenges, a systems and multidisciplinary approach would be required to address such complex interactions to achieve better healthcare services.
IOMP Position
Slavik Tabakov
President IOMP, Dept. Medical Engineering and Physics, King’s College London, UK
Prof. SLAVIK TABAKOV, PhD, Dr. h.c., CSci, FIPEM, FHEA, FIOMP. Prof Tabakov is President of the International Organization for Medical Physics (IOMP). He was born in Plovdiv, Bulgaria and graduated at Technical University Sofia. He started his career at Plovdiv Medical University, where he received his Doctorate (PhD, 1988) and habilitated in 1990. During this period he underwent training and worked for the companies Technicare, CGR and GE. Since 1991 he works at King’s College Hospital and King’s College London, UK and his current academic positions include: Director of three MSc Programmes in King’s College London: MSc Clinical Sciences (Medical Physics), MSc Clinical Sciences (Clinical Engineering), and MSc Medical Engineering and Physics. He is also Co-Director of the International College on Medical Physics, ICTP, Trieste, Italy; Visiting Professor at Medical University Plovdiv, Bulgaria and Consultant at King’s College Hospital, Dept. Medical Engineering and Physics, London, UK. He is a world renowned educationalist and pioneer of e-learning in medical physics, developing and coordinating seven pilot international projects and advising on the development of over 10 others. These include the projects EMERALD and EMIT, currently used in c. 70 countries, and the project EMITEL, which included 300 specialists from 36 countries. EMERALD and EMIT were awarded the inaugural EU Award for Education – The Leonardo da Vinci Award, while EMITEL developed the first e-Encyclopaedia of Medical Physics with Multilingual Dictionary of Terms (translated in 29 Languages). These e-learning materials have c. 8,000 users per month. He is Co-author and Co-Editor of 7 textbooks, 5 e-books and Image databases, 3 Educational web sites, one Encyclopaedia and over 100 papers. He is an active contributor to the international development of medical physics for over 30 years. Among his activities in this field are: member of the IOMP Executive Committee since 2000; active member of the IFMBE and IUPESM; Founding Co-Editor (together with Perry Sprawls) of the IOMP e-Journal “Medical Physics International”; Chair of the Education and Training Committees of IOMP, IFMBE and IUPESM and advisor for the development of 15 MSc courses. Among his awards is the IOMP Harold Johns Medal for Excellence in Teaching and International Education Leadership.
Systems Medicine for the Delivery of Better Healthcare Services - IOMP Perspective
Abstract
The International Organisation for Medical Physics (IOMP) is the world's premier professional organization for medical physics with about 22,000 members in 84 countries. The main activities of medical physicists in the field of Medical Imaging, Radiotherapy, Radiation Safety, Physiological measurements and others, already include a number of elements associated with Systems Medicine. This includes various types of Physiological modeling and work in e-Healthcare delivery, while in the Imaging-related research medical physicists are in the forefront of Personalised medicine.
Systems Medicine is a large interdisciplinary field, where the collaboration of medical physicists and biomedical engineers with specialists in biology and medicine is vital. While so far the collaboration was mainly in the field of focused research projects, we need to think of further expanding the scope of the profession in order to prepare better for the challenges of the future, and to further apply the potential of our professionals for the benefit of the patient and the overall healthcare provision.
Such a large task could start with emphasis on elements of Systems Medicine, which are already applied by medical physicists – e.g. modelling. An action plan on the subject will include various activities, including:
- Run Webinars and Overview papers on the subject
- Increase the emphasis on modelling in future Conferences
- Develop joint sessions with IFMBE and other parties on the subject
- Include topics on personalised medicine at various fora
- Include e-Health systems in the training tasks
- Encourage inclusion of specific mathematical tools in the education
- Encourage inclusion of modelling in educational and training systems
In fact some developed countries already include in their educational systems tools and elements which will be applied in future Systems medicine research. Usually this is achieved through delivery of specific inter-linked BSc and MSc medical physics courses. Most current tasks of IOMP are related to expanding the main medical physics activities in low-and-middle-income countries, however the coming “Way Forward” IOMP document will address the above discussed professional expansion and inter-professional collaboration.
Kin Yin Cheung
President, IUPESM Medical Physics & Research Dept., Hong Kong Sanatorium & Hospital, Hong Kong
Professor Kin Yin Cheung is an Adjunct Professor at School of Medical and Health Sciences, Tung Wah College, Hong Kong. He is also Adjunct Associate Professor at the Department of Clinical Oncology, Faculty of Medicine in both University of Hong Kong and Chinese University of Hong Kong. He is a Senior Medical Physicist at the Medical Physics & Research Department, Hong Kong Sanatorium & Hospital. He was Founding President of AFOMP in 2000, President of IOMP 2012-15, and now President of IUPESM 2015-18. He is Chairman of Hong Kong Institution of Physicists in Medicine (HKIPM) since 2011. He has served in the International Atomic Energy Agency (IAEA) as a consultant on a number of their projects on improving medical physics in radiation medicine. He is a Certified Medical Physicist, Chartered Radiation Protection Professional, Chartered Engineer, Fellow of IOMP, Fellow of Hong Kong Institution of Engineers, and an Honorary Member of Hong Kong College of Radiologists. He has published/presented more than 140 peer reviewed papers, book chapters, and abstracts.
Systems Medicine for the Delivery of Better Healthcare Services- IUPESM Perspective
Abstract
Current biological models are considered inadequate in fully explaining the multi-factorial nature and complex behavior of many human diseases and in predicting their response to medical intervention from different modalities. There is a need to develop a more systematic biological approach to address this problem. Systems medicine is one of the biological approaches or concepts under exploration with the aim to investigate and analysis cellular and pathogenetic mechanisms and pattern of disease progression and remission, treatment responses and adverse events as well as disease prevention at the individual patient level. The approach involves the use of appropriate mathematical, computational, bio-informatics and statistical tools that are necessary to address properly the biological mechanism and dynamics of the disease processes. The research and development in this area involves the collaboration and concerted efforts of multi-disciplinary professionals from the medical, scientific, engineering and technological sectors. It also involves the development of new tools and technologies necessary for the R&D work. Biomedical engineers and medical physicists play an increasing and important role in patient management in modern medicine. They contribute to the scientific and technology aspects of our medical system, which include research and development of appropriate medical technologies for analysis, diagnosis and treatment of diseases. They should be prepared to collaborate with other healthcare professionals and to participate in and contribute to the development of the new approach in medicine, particularly in development of the necessary research tools and methodologies. As an umbrella organization for biomedical engineers and medical physicists, the International Union for Physical and Engineering Sciences in Medicine (IUPESM) brings together the two streams of professionals and provides the scientific platforms (such as the World Congress on Medical Physics and Biomedical Engineering and the IUPESM official journal) to facilitate the interaction and networking between these professionals for exchange of ideas, scientific and technological information and research findings. This in turn can foster multidisciplinary collaboration and stimulate the development of new concept and innovation in clinical research and development.
Christos N. Schizas
University of Cyprus, Cyprus
Christos N. Schizas is a Professor of Computational Intelligence at the University of Cyprus. He was born in Cyprus and studied at Queen Mary-University of London, UK, B.Sc. (Eng). Graduate studies at the University of Indianapolis, USA, MBA, and at Queen Mary-University of London, UK, PhD in 1981. He received the William Lincoln Shelley award from the University of London for excellence in research, and a Fulbright fellowship for collaborative research in the USA. He served as Postdoctoral Fellow at the University of London, and Professor of Computer Information Systems at the University of Indianapolis. Among the founders of the Cyprus Institute of Neurology and Genetics. Since 1991 he has been with the Department of Computer Science-University of Cyprus, served as Vice Rector of the University during 2002-2006. His research interests include eHealth, computational intelligence, medical informatics, diagnostic and prognostic systems, and system modeling & identification of brain activity. He is the section editor (eHealth) of the journal Technology and Health Care, served as area editor of the journal IEEE Transactions on Information Technology in Biomedicine, and member of the editorial board of the journal of Intelligent Systems. He is the founder of the Computational Intelligence lab and co-director of the eHealth lab of the University of Cyprus. He teaches eHealth at the Medical School and at the Department of Computer Science of the University of Cyprus. He has taken part in European Commission initiatives for promoting the Information Society, especially the Euro-Mediterranean partnership and the eHealth initiatives. He attends regularly as invited speaker the annual EU Ministerial Forum week meeting on eHealth. Since August 2015 he serves as personal advisor to the Cyprus Minister of Health on eHealth, especially in proposing the road map for implementing the National Health System and monitoring its steps.
Cognitive Computing for supporting eHealth
Abstract
Various terms have been used in the past for describing the adoption of sophisticated tools that make the life of a medical professional better that subsequently leads to a better life for the citizen. Terms such as Medical Informatics, Computer Aided Diagnosis, Artificial Intelligence in Medicine, Computational Intelligent Medical System, and Machine Learning in Medicine, have been used and are being used in effort to facilitate the main players with better tools and methods. Cognitive computing is the simulation of human thought processes in a computerized model. Cognitive computing involves self-learning systems that use data mining, pattern recognition and natural language processing to mimic the way the human brain works. Different types of cognitive computing solutions offer various capabilities, such as, Learning and building knowledge from various structured and unstructured sources of information, Understanding natural language and interact with humans, Capturing the expertise of top experts, Improving the cognitive processes for better decision making, and making it more uniform across different professionals. Imagine putting all the above in the medical environment and call it Cognitive Computing for supporting eHealth. Today’s consumers want more control over their health, as well as more personalized and convenient care. In spite of the fact that healthcare executives understand such demands, the majority are unable to deliver. Also, they all agree that effective decision making is important in any industry, but in healthcare it can make the difference between life and death.
The question is how specifically healthcare organizations, professional and citizens can utilize cognitive computing to address issues currently troubling the industry, simply because the user becomes more aware of technology and its potential in all disciplines. This new computing paradigm if adopted goes in line with the long standing EU directive, and main theme of the eHealth 2016 Week meeting. Facilitating active participation and empowering people brought in by the three capability areas that align with the three industry focus areas, Engage, Discover and Decide. The healthcare academia and industry can bridge the gap between opportunities and current capabilities in the health sector. Hidden knowledge and insights that reside in data (structured and unstructured), EHR, can be fully exploited for discovery, insight, decision support and dialogue. Cognitive computing systems build knowledge and learn, understand natural language, and reason and interact more naturally with people than traditional programmable systems. It is a common believe that cognitive computing has the potential to radically change healthcare. Our 30 years of experience in the eHealth lab of the University of Cyprus, dealing with various applications in medicine mainly handled with the ancestors of cognitive computing has shown that both the medical professionals and the citizens can be benefited tremendously, not only for curing and monitoring but also for preventing medical incidences. Our theme is “Focus on Health rather that the Illness”. Areas to be demonstrated include, Chromosomal Abnormalities of the Fetus, Preeclampsia, Carotid Stenosis Risk Assessment, Prognostic Factors for Cancer, Neuromuscular Disorder Assessment, mHealth, Telemedicine, etc.
Nitish Thakor
SINAPSE, National University of Singapore, Singapore
Nitish V. Thakor is a Professor of Biomedical Engineering at Johns Hopkins University in the USA as well as the Director the Singapore Institute for Neurotechnology (SINAPSE) at the National University of Singapore. Dr. Thakor’s technical expertise is in the field of Neuroengineering, where he has pioneered many technologies for brain monitoring to prosthetic arms and neuroprosthesis. He is an author of more than 280 refereed journal papers, more than a dozen patents, and co-founder of 3 companies. He is currently the Editor in Chief of Medical and Biological Engineering and Computing, and was the Editor in Chief of IEEE TNSRE from 2005-2011. Dr. Thakor is a recipient of a Research Career Development Award from the National Institutes of Health and a Presidential Young Investigator Award from the National Science Foundation, and is a Fellow of the American Institute of Medical and Biological Engineering, IEEE, Founding Fellow of the Biomedical Engineering Society, and Fellow of International Federation of Medical and Biological Engineering. He is a recipient of the award of Technical Excellence in Neuroengineering from IEEE Engineering in Medicine and Biology Society, Distinguished Alumnus Award from Indian Institute of Technology, Bombay, India, and a Centennial Medal from the University of Wisconsin School of Engineering.
Mind and Machines
Abstract
There is an exciting convergence occurring between the very duality of Mind and Brain. Mind implies, in part, the cognitive functions and reflects matters such as cognition, while Brain implies, in part, the structural and physiological matter of the brain. Thus, the synthesis of the two occurs in the field of brain-machine interface where mental activity and functions are utilized to interface, or control, machines such as prosthesis, orthotics, computers, and robots. While understanding Mind may be daunting, initiating and engaging mental function and capability to interface to the machine, from assisting, augmenting and enhancing may offer realistic challenges. Correspondingly, studying or interfacing to entire brain is equally daunting, but technology to interface or image the brain is growing very strongly. This talk will review the topic of brain machine interface, with greater focus on topics of assessing cognitive function, developments in neural interfacing, building brain-machine interface, and taking inspiration from brain to construct better neuromorphic machines.
Anastasios Bezerianos
Singapore Institute for Neurotechnology (SINAPSE), National University of Singapore, Singapore
Department of Medical Physics, School of Medicine, University of Patras, Patras, Greece
Anastasios (Tassos) Bezerianos, BS, MS, Ph.D.. Anastasios Bezerianos is a Research Professor in the ECE, National University of Singapore, Senior Principal Research Fellow of Singapore Institute for Neurotechnology (SINAPSE) and Professor at the Medical School of Patras University, Greece. He studied Physics at Patras University and Telecommunications at Athens University, and he received his Ph.D. from the University of Patras. His research interests at large are in Neuroengineering and Systems Medicine and Bioinformatics, and his work is summarized in 110 journal and 175 conference proceedings publications. He has research collaborations with research institutes and universities in Japan, the USA, and Europe, and he is Associate Editor of IEEE TNSRE and the Annals of Biomedical Engineering journals and a reviewer for several international scientific journals. He is a registered expert of the Horizon 2020 program of the European Union and a reviewer of research grant proposals in Greece, Italy, Cyprus and Canada. He is a Senior Member of IEEE and the Founder and Chairman of the biannual International Summer School on Emerging Technologies in Biomedicine.
Real-time Workload Assessment using EEG Signals in Virtual Reality Environment
Shen Ren, Fabio Babiloni, Nitish V. Thakor and Anastasios BezerianosAbstract
The next generation human-computer interaction requires, a close-to-real, virtual reality environment and a more sensitive real-time brain states monitoring to account for instantaneous human thoughts and feelings. Within this goal area, workload evaluation of human subject is extraordinary critical to both safety and security of risk-sensitive domains, including flight operations and mission success. In this paper, we present a non-intrusive workload assessment framework by real-time processing of continuous EEG signals measured from “pilots” during flight operations. Our framework has been experimented on a 2D computer screen based flight simulation platform (MATB-II, Revised Multi-Attribute Task Battery) and a virtual reality-based realistic flight simulator. This novel framework has the potential of reducing task overloads and improving performance in risk-sensitive domains.
Andreas A. Ioannides
Lab. For Human Brain Dynamics, AAI Scientific Cultural Services Ltd, Cyprus
Prof. Andreas A. Ioannides was born in Morphou, Cyprus. He studied Physics (1970-73) and completed his PhD at Surrey University UK (1973-76), continuing with research in nuclear Physics until 1988. Since 1986 he started research in biology that by 1989 narrowed to magnetoencephalography. The initial emphasis on basic theory and mathematical analysis techniques lead also to development of experimental protocols and dedicated hardware (freely donated to the community with some nowadays installed in MEG systems world-wide). Prof. Ioannides established theoretical teams and set up functional neuroimaging laboratories in international centers of excellence in the UK (1989 -98), Germany (1994-8) and Japan (1998 – 2009) leading to over 130 scientific papers. Over ten of his PhD students are now leading scientist, some heading international centres of excellence in Europe, North America and Asia. Prof. Ioannides returned to Cyprus in 2009 as the director of AAI Scientific Cultural Services Ltd (AAISCS) a private company that continues the basic neuroscience research of previous years with the additional goal of using the resulting knowledge to develop new services and products with cheaper and widely accessible technology. The company also provides support for experiments and data analysis in Electroencephalography and Magnetoencephalography.
Effective use of multimodal imaging for affordable personalized medicine
A.A. Ioannides and L.C. LiuAbstract
The tendency today is to utilize as many neuroimaging techniques as possible to cover the distinct spatiotemporal windows the each technique can access. However, this approach obviously incurs higher cost and in some cases might even limit the utility of the final result to the capabilities of the weaker technique. The case for pushing individual techniques to its limit before bringing the results together will be made first on theoretical grounds. The practical consequences will then be illustrated with real examples using EEG, MEG and fMRI data. The examples will include cases where techniques have been perfected to address specific questions producing results that overturned previously accepted views that implicitly or explicitly relied on deficient integration of techniques. Finally ongoing projects will be described that promote smart use of distinct neuroimaging techniques in an effort to deliver affordable personalized medicine.
Panagiotis Bamidis
Aristotle University of Thessaloniki, Greece
Panagiotis Bamidis is currently Assoc. Prof. in the Lab of Medical Physics, Medical School of the Aristotle University of Thessaloniki, Greece. He has founded and has been leading four research groups, namely, in Medical Education Informatics, in Assistive Technologies and Silver Science, in Applied and Affective Neuroscience, and in Health Services Research. In the last 6 years, he has been the co-ordinator of five large European projects (SmokeFreeBrain.org; www.meducator.net; www.longlastingmemories.eu, www.epblnet.eu, www.childrenhealth.eu) as well as the principal investigator for a number of national and international funded projects. His publication record consist of more than 85 international refereed journal papers, and over 300 international peer reviewed conference papers, as well as several book chapters / edited conference proceedings volumes and over some 700 citations (h-index>17). In addition, he has been acting as a referee in more than 30 journals, and as Guest Editor in more than 17 journal special issues. Finally, he is the President of the Hellenic Biomedical Technology Society (ELEBIT), a member of the Administration Boards of the Greek Federation of Alzheimer’s Associations and Related Disorders, the Greek AeroSpace & Space Medicine Research Association, a member of the Life Sciences Division of the International Academy of Astronautics and past member of the Innovation Zone of Thessaloniki, Greece. He has been the Chairman/Organiser of seven international conferences (iSHIMR2001, iSHIMR2005, MEDICON2010, GASMA2010, SAN2011, MEI2012, ΜΕΙ2015) and several national Biomedical Technology conferences and he is the Conference Producer of the Medical Education Informatics Conference and associated Spring/Summer School Series. He is a visiting scientist at Karolinska Institute, Sweden. He is a member of the Advisory Board of the Open Knowledge Foundation and a founding member of Chapter Greece. In 2009, he was awarded the Prize of the AUTH Research Committee for the Best Track Record in funded research projects among AUTH young academic staff. In 2015, he was awarded the title of the Honorary Professor of Karaganda State Medical University, Kazakhstan, as well as the Pospelov Medal for his contributions to Medical Education development by the same University.
His research interests are within technology enhanced learning in Medical Education (web2.0, semantic web and open linked data, serious games, virtual patients, PBL and scenario based learning, learning analytics), Affective and Applied Neuroscience, Affective and Physiological Computing, multimodal interaction and HCI, Health Information Management, Bio-medical Informatics with emphasis on neurophysiological sensing, signal analysis, and imaging of human emotions. He is also actively researching Assistive Technologies for Active and Healthy Ageing, as well as, special education/developmental disorders, and silvergaming/exergaming/silver-science and the associated use of semantic technologies and IoT.
Neuroscience, brain training, precision medicine: quo vadis?
Abstract
Back in 2008 we had introduced the notion of studying aspects of technological interventions as applied to elderly healthcare with the application of neuroscience methodologies. At that time point the whole plan of claiming any evidence of health impact of any technological artifact on the cognition and general well being of elderly might have sounded like a long-term vision. In the meantime our research was geared towards measuring the effectiveness of exergame-blended cognitive and physical training in multiple ways, one of them being the analysis of resting state EEG recordings. The latter were analysed by means of neuroimaging (LORETTA based) methodologies, synchronisation and de-synchronisation (entropy based) methodologies, as well as, functional connectivity networks. On top of these, emphasis was thrown on studying the in-game metrics of the training session in an attempt to realise new cognitive assessment tools which will have the power of being ecologically valid. The combination of all the above has shaped a powerful set of data and tools which not only align with issues of personalised medicine, but combined with the ecologically valid settings of recordings and the other associated "wild" attributes touch upon what has recently been coined in as precision medicine. In this presentation, the above are illustrated with examples of a 7 year track research record from multiple funding sources in effort to draw the threads together from different domains for the sake of improving elderly health care with technology.
Andrew Nicolaides
Emeritus Professor of Vascular Surgery, Imperial College, London, UK
Honorary Professor of Surgery, University of Nicosia Medical School, Cyprus
Andrew Nicolaides is now Honorary Professor of Surgery at St George’s University of London / University of Nicosia Medical School, Nicosia, Cyprus and Emeritus Professor of Vascular Surgery at Imperial College, London, UK.
He is a graduate of Guy’s Hospital Medical School, London. He was the Professor of Vascular Surgery at Imperial College School of Medicine (1983–2000) and Medical Director of the Cyprus Institute of Neurology and Genetics (2001-2004).
He is Editor of International Angiology and chairman of the Board of the European Venous Forum. He is Past-President of the International Union of Angiology and Past-President of the Section of Measurement in Medicine of the Royal Society of Medicine, UK.
His research group is known internationally in several areas which include noninvasive vascular screening and diagnostic investigation, early detection and prevention of cardiovascular and venous disease. He is co-author of over 700 original papers and editor of 14 books.
Image Analysis of Carotid Bifurcation Atherosclerotic Plaques and Stroke Risk Stratification using Ultrasound
Abstract
Until recently our practice has been based on the results of the ACAS and ACST randomized controlled trials (RCT), which provided the first scientific evidence that in patients with asymptomatic carotid stenosis (ACS) > 60-70% carotid endarterectomy can reduce the annual risk of stroke from 2% to 1%. In these trials the perioperative stroke was 2.3% and the number needed to treat (NNT) to prevent one stroke per year was 83.
Recent evidence indicates that the annual risk of ipsilateral cerebral stroke in patients with moderate-severe asymptomatic internal carotid artery stenosis (ACS) receiving optimal medical intervention alone has fallen to approximately 1% making routine carotid endarterectomy unjustified. However, if patient subgroups with sufficiently higher than average risk, despite current optimal medical intervention, could be reliably identified, then carotid surgery may still be justified.
The ACSRS performed under the auspices of the IUA was a prospective, multicentre, cohort study of patients undergoing medical intervention for vascular disease that has answered this question. Hazard ratios for stenosis, clinical features and plaque texture features after image normalization associated with ipsilateral cerebrovascular or retinal ischemic (CORI) events were calculated using proportional hazards models.
1121 patients with 50-99% asymptomatic ICA stenosis in relation to the bulb (ECST method) were followed-up for 6-96 (mean 48) months. A total of 130 ipsilateral CORI events including 59 strokes occurred. Severity of stenosis, age, systolic blood pressure, increased serum creatinine, smoking history of more than 10 pack-years, history of contralateral TIAs or stroke, low gray scale median (GSM), increased plaque area, plaque types 1, 2 and 3 and presence of discrete white areas without acoustic shadowing (DWA) were associated with increased risk.
ROC curves were constructed for predicted risk versus observed CORI events as a measure of model validity. The areas under the ROC curves for a model of stenosis alone, a model of stenosis combined with clinical features and a model of stenosis combined with clinical and plaque texture features were 0.59 (95% CI 0.54 to 0.64), 0.66 (0.62 to 0.72) and 0.82 (0.78 to 0.86) respectively.
In the last model, stenosis, history of contralateral TIAs or stroke, GSM, plaque area and DWA were independent predictors of ipsilateral CORI events. Combinations of these could stratify patients into different levels of risk for ipsilateral CORI and stroke, with predicted risk close to observed risk. Of the 923 patients with ≥70% stenosis, the predicted cumulative five year stroke rate was <5% in 495, 5-9.9% in 202, 10-19.9% in 142 and ≥20% in 84 patients.
Thus, cerebrovascular risk stratification is possible using a combination of clinical and ultrasonic plaque texture features.
Nicolai Petkov
University of Groningen, Netherlands
Nicolai Petkov is a professor of computer science with a chair in intelligent systems at the University of Groningen since 1991. In the period 1998-2009 he was scientific director of the Institute for Mathematics and Computer Science. He applies machine learning and pattern recognition to various problems in dermatology and ophthalmology.
Trainable COSFIRE filters for pattern recognition in medical imaging
Abstract
A trainable filter is a filter that is configured by the automatic analysis of a pattern specified by a user. Subsequently, such a filter can detect similar patterns. This approach is illustrated by the design of filters that can detect bifurcations in retinal fundus images. The user presents a vascular bifurcation as a local pattern of interest. The automatic analysis system applies a bank of Gabor filters to this pattern and identifies which of them respond most strongly and in which positions. The response of the composite trainable filter is then computed as a combination (e.g. a geometric mean) of the responses of the selected Gabor filters, shifted by certain off-set vectors determined in the analysis phase. We call this method Combination of Shifted Filter Responses (COSFIRE). An advantage of this approach is its ease of use, as it requires no programming effort – the parameters of a filter are derived automatically from a single training pattern. This approach is further illustrated by the segmentation of blood vessels and the localization and segmentation of the optic nerve head in retinal fundus images.
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