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Journal ArticleDOI

3G wireless communications for mobile robotic tele-ultrasonography systems

01 Sep 2006-IEEE Communications Magazine (IEEE)-Vol. 44, Iss: 4, pp 91-96
TL;DR: The real-time 3G performance results show the successful operation of this bandwidth demanding robotic m-health system over the 3G mobile communications network.
Abstract: Mobile healthcare (m-health) is a new paradigm that brings together the evolution of emerging wireless communications and network technologies with the concept of 'connected healthcare' anytime and anywhere. In this article, we present the performance analysis of an end-to-end mobile tele-echography using an ultra-light robot (OTELO), over the third-generation (3G) mobile communications network. The experimental setup of the OTELO system over a 3G connectivity link used to measure the system performance is described. The performance of the relevant medical data and the relevant quality of service (QoS) issues defined in terms of the average throughput, delta-time packet delay, and jitter delay are investigated. The real-time 3G performance results show the successful operation of this bandwidth demanding robotic m-health system.

Summary (3 min read)

INTRODUCTION

  • M-Health has been defined as “mobile computing, medical sensor, and communications technologies for healthcare” [1].
  • One of the first ultrasound telemedicine studies on remote examinations was reported in the mid-1990s, where the ultrasound video images acquired by the technician at the patient’s side were transmitted to a medical expert [2].
  • These robotic devices have different degrees of freedom (DoFs) dedicated to special applications.
  • The following section presents an overview of the OTELO system.
  • Next, the authors outline the 3G wireless connectivity of the system and the medical data-rate requirements.

3G MOBILE ROBOTIC TELE-ECHOGRAPHY SYSTEM

  • The advanced medical robotic system, mObile Tele-Echography using an ultra-Light rObot , was a European Information Society Technologies (IST) funded project that developed a fully integrated end-to-end mobile teleechography system for population groups that are not served locally, either temporarily or permanently, by medical ultrasound experts.
  • The system comprises three main parts: The expert station: where the medical expert interacts with a dedicated patented pseudohaptic fictive probe instrumented to control the positioning of the remote robot and emulates an ultrasound probe that medical experts are used to handle, thus providing better ergonomy.
  • OTELO is adaptable to operate on different types of communication (satellite, 3G wireless and terrestrial) links, also known as The communication links.
  • Hence, the authors consider that both the ambient video plus the voice can be transmitted when such a data type is required following the reception of ultrasound data by the expert station.
  • These data rates enables 3G connectivity to reach anyone, anywhere and transmit any kind of information in real time.

EXPERIMENTAL SETUP ENVIRONMENT

  • The experimental setup is designed to measure the end-to-end system performance over the 3G network, as shown in Fig.
  • The following performance metrics are measured: Average throughput (ultrasound stream and robot control data) End-to-end packet delay and delay jitter.
  • The ultrasound scanner data is acquired at the rate of 13 frames/s, each frame with the resolution of (320 × 240) pixels for the videoconferencing format, and (176 × 144) pixels for the Quarter Common Intermediate Format (QCIF).
  • OTELO mobile robotic system connectivity over a 3G network.

IMPLEMENTATION OF THE STREAMING PROTOCOL

  • It is well known that protocols for streaming media are commonly designed and standardized for communications between clients and streaming servers.
  • They are concerned with issues such as network addressing, transport, and session control [10].
  • Since TCP retransmission introduces delays that are not acceptable for real-time streaming applications with stringent delay requirements, especially for transmission over fading wireless links, UDP is typically employed as the transport protocol for video streams over such fading channels.
  • RTP is an Internet standard protocol designed to provide end-to-end transport functions for supporting real-time applications.
  • The UDP/IP protocol is used for the robot data that is transmitted in both directions.

ULTRASOUND STREAM CODEC

  • The video compression standard used in this application is H263 codec, which has a wide range of applications, including medical consultation and diagnosis at a distance.
  • Further details on this codec design and the imaging functionality of this codec for OTELO can be found in [11].

PERFORMANCE RESULTS AND DISCUSSION

  • The OTELO system was tested on a live 3G network (Vodafone, U.K.).
  • The experimental tests for the system were carried within the greater London area between Kingston University, London (patient side) and St. George’s Medical School, London (expert side).
  • The following results summarize some of the performance tests carried out.

ULTRASOUND THROUGHPUT ANALYSIS

  • A sample of the instantaneous throughput of the ultrasound stream captured by the expert is shown in Fig. 3, where the average throughput obtained was 23 kb/s and the standard deviation (std) value of 22 kb/s represented the patient station uplink average throughput value.
  • The number of stream packets taken for the analysis was 350.
  • Sample peak throughput of the received ultrasound stream by the expert station.
  • These tests also indicated that approximately 82 percent of the packets received at the expert station were at rate of 18.5 kb/s, whilst the reminder of the packets were received at data rates of up to 60 kb/s.

DELAY DISTRIBUTION

  • The delta-time distribution of the stream packets is shown in Fig. 4, where the performance analysis of the stream packet delay at the expert station gives an average packet delta time (time difference between two consecutive packets) of 0.148 sec.
  • The delay distribution shows a maximum delay of around 0.3 sec for just about 7 percent of the received packets, while 50 percent and about 30 percent of the packets show delays of around 0.12 and 0.22 sec, respectively.
  • The connection between both system ends is always ON during the entire clinical session [9].
  • It should also be noted that any video packet that arrives beyond its delay bound (e.g., its play-out time) is useless and can be regarded as lost [10].
  • The delay variation across this system’s link is considered a key factor for a reliable real-time medical ultrasound stream reception at the expert station.

ROUND-TRIP TIME DELAY

  • Generally, the network RTT can be defined as the time it takes to transmit one packet from, say, a server to a terminal plus the time it takes for the corresponding packet to be sent back from the terminal to the server [12].
  • These packet sizes are chosen to cover the possible size range of the packets generated by the H263 codec used by the system.
  • Internet Control Message Protocol (ICMP) is used for pinging the expert station from the patient station at 500 to 1000 ms time intervals.
  • The RTT delay test is performed with patient-station data rates of 256 kb/s for downlink and up to 64 kb/s for the uplink channel.
  • The end-to-end delay of the system is based on the average packet delta time results, as illustrated in Table 2, which is closely correlated (RTT/2) to pinging 300 bytes (boldface results in.

CONCLUSIONS

  • The experimental test results for transmitting ultrasound streams encoded in the (QCIF) format using the H.263 codec have demonstrated successful transmission in 3G real-time environments.
  • These results are achieved using 64 kb/s at the patient station uplink.
  • Enhanced performance can be achieved using higher rates and depending on the 3G network operators channel assignments.
  • The authors have also found that network delay jitter variations were still within the acceptable boundaries of maintaining high-quality realtime interaction for the system; 297 ms compared to a maximum delay of 325 ms.
  • In general, the authors can conclude that such advanced mobile robotic telemedicine systems can successfully provide clinically acceptable quality ultrasound data using commercial 3G networks.

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IEEE

IEEE Communications Magazine • April 2006
91
INTRODUCTION
M-Health has been defined as “mobile comput
-
ing, medical sensor, and communications tech-
nologies for healthcare” [1]. This emerging
concept represents the evolution of e-health sys
-
tems 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 healthcare delivery sys
-
tems. One of the new areas of advanced mobile
healthcare applications that has not been
explored and investigated in detail is the wireless
robotic tele-ultrasonography (U.S.) system.
It is well known clinically that ultrasound
scanning is a well-established noninvasive
method that is easy to use and very well adapted
for routine clinical examinations in specialist
medical centres and hospitals. However, most of
the available portable ultrasonography and exist-
ing ultrasonography systems require the expert
to carry out the examination on site. Although
these systems offer quick and reliable noninva
-
sive diagnosis in many clinical scenarios, the
major drawback of these portable ultrasound
systems is that they are not available in small
medical centres, isolated sites, and rescue vehi-
cles in emergency cases. Their usefulness is
dependent on the operator’s (expert) skills. In
such circumstances, robotic tele-ultrasonography
could be useful. In addition, such robotic
telemedicine systems could be very valuable for
training in nonspecialist sonograph remote medi-
cal centres, and can also be valuable for expert
opinion in combat and military scenarios as well.
The wider availability of 3G systems in most
of the European and developing countries will
inevitably allow the wider use of such wireless
robotic m-health systems, especially in remote
and isolated areas, which will certainly reflect on
better healthcare efficiency and improved medi-
cal care in these countries.
One of the first ultrasound telemedicine stud-
ies on remote examinations was reported in the
mid-1990s, where the ultrasound video images
acquired by the technician at the patient’s side
were transmitted to a medical expert [2]. Howev-
er, these systems were not efficient enough for
proper medical validation because of their
‘expert dependency’ on the relevant ultrasound
examination.
In 1998, videoconferencing was used between
two experts, with one of them was performing
the echography examination [3]. Both experts
could simultaneously discuss the obtained ultra-
sound image, and the expert who was distant
from the patient could suggest a different probe
orientation to his peer for better observation
and analysis of the area of interest. In 2000, the
European project TeleInVivo was developed [4],
in which the echography was performed by a
clinical expert standing next to the patient, then
ultrasound data were sent via satellite to a data
base station and processed to reconstruct a 3D
representation of anatomical regions of interest
[5].
In Japan, tele-operated robots have been set
up to perform a remote ultrasound examination
between two nearby sites with terrestrial commu-
nications [6, 7].
All these studies have shown the necessity of
a skilled ultrasound expert to drive the robotic
structure holding the probe. We have developed
a new generation of specific lightweight,
0163-6804/06/$20.00 © 2006 IEEE
QUALITY ASSURANCE AND
DEVICES IN TELEMEDICINE
Saleem Garawi, Robert S. H. Istepanian, and Mosa Ali Abu-Rgheff
ABSTRACT
Mobile healthcare (m-health) is a new
paradigm that brings together the evolution of
emerging wireless communications and network
technologies with the concept of ‘connected
healthcare’ anytime and anywhere. In this arti-
cle, we present the performance analysis of an
end-to-end mObile Tele-Echography using an
ultra-Light rObot (OTELO), over the third-gen-
eration (3G) mobile communications network.
The experimental setup of the OTELO system
over a 3G connectivity link used to measure the
system performance is described. The perfor-
mance of the relevant medical data and the rele-
vant quality of service (QoS) issues defined in
terms of the average throughput, delta-time
packet delay, and jitter delay are investigated.
The real-time 3G performance results show the
successful operation of this bandwidth demand-
ing robotic m-health system.
3G Wireless Communications for Mobile
Robotic Tele-Ultrasonography Systems
GARAWI LAYOUT 3/23/06 10:06 AM Page 91

IEEE Communications Magazine • April 2006
92
portable, and fully integrated robotic devices for
tele-ultrasound. These robotic devices have dif-
ferent degrees of freedom (DoFs) dedicated to
special applications. The number of degrees in
the robotic head or arm represents the number
of movements, and a flexibility that translates as
close as possible to human hand movement, for
example, 6 DoF represents movements in total
X, Y, Z and diagonal directions that the human
hand can do.
The article is structured as follows. The fol-
lowing section presents an overview of the
OTELO system. Next, we outline the 3G wire-
less connectivity of the system and the medical
data-rate requirements. The article then presents
the experimental setup, and goes on to present
the performance analysis and discuss the results.
The final section presents the conclusions of the
article.
3G MOBILE ROBOTIC
TELE-ECHOGRAPHY SYSTEM
The advanced medical robotic system, mObile
Tele-Echography using an ultra-Light rObot
(OTELO), was a European Information Society
Technologies (IST) funded project that devel
-
oped a fully integrated end-to-end mobile tele-
echography system for population groups that
are not served locally, either temporarily or per-
manently, by medical ultrasound experts. It com-
prises a fully portable tele-operated robot
allowing a specialist sonographer to perform a
real-time robotised tele-echography (ultrasonog-
raphy) to remote patients [7]. The system com-
prises three main parts:
•The expert station: where the medical expert
interacts with a dedicated patented pseudo-
haptic fictive probe instrumented to control
the positioning of the remote robot and
emulates an ultrasound probe that medical
experts are used to handle, thus providing
better ergonomy.
•The communication links: OTELO is adapt-
able to operate on different types of com
-
munication (satellite, 3G wireless and
terrestrial) links. In this article, we address
the performance of the system under 3G
mobile connectivity. (The other links have
been addressed elsewhere [5, 7, 8]; these
different communication links will allow the
universal usage of the system based on the
availability of these technologies in differ-
ent geographical locations.)
•The patient station: composed of a 6 DoF
lightweight robotic system and its corre-
sponding control unit. This robot manipu-
lates an ultrasound probe according to
orders sent by the medical expert. The
probe also allows the grabbing of the ultra-
sound images that are sent back to the
expert. Figure 1 shows the general end-to-
end functionality of the OTELO system.
Three types of critical data are to be trans-
mitted over the OTELO system: robotic control
data, ultrasound still images, and medical ultra-
sound streaming data. In this article, we only
address the performance issues regarding the
controlled ultrasound medical streams, since this
type of medical data represents the most
“demanding data-rate” requirements of such
robotic telemedicine systems.
The robotic system has also a force feedback
mechanism in order to allow the expert to move
the fictive probe and control the distant probe-
holder for the remote robotic system.
We observed that the voice packet data takes
priority and could cause some degradation (in
terms of the packet delays and jitter) on the
ultrasound reception. In addition, during the
“ultrasound scan” voice is rarely needed by
either the patient or the expert. Hence, we con
-
sider that both the ambient video plus the voice
(videoconference) can be transmitted when such
a data type is required following the reception of
ultrasound data by the expert station. However,
if sufficient 3G bandwidth is available, simulta
-
neous ultrasound stream and videoconferencing
data transmission can be accommodated. It is
reported that at least 80 percent of these in-vivo
tests have led to comparable results with a con-
ventional ultrasound examination for the organs
examined and detected [7, 8].
It is well known that 3G wireless technologies
present an enhanced mobile platform for many
wireless telemedicine applications [8, 9]; in gen-
eral, for:
nn
nn
Figure 1. The OTELO mobile robotic system, general block diagram, and different communication links.
Robotic system
Video-
conference
Image processing
Robot controls
Ultrasound
device
Satellite
or
Communication
links
or
Standard terrestrial links
2.5G/3G mobile
Ultra-
sound
images
Robot controls
Force feedback
Video-
conference
Medical expert
Expert station
located at a hospital center
Patient station
located at an isolated area
GARAWI LAYOUT 3/23/06 10:06 AM Page 92

IEEE Communications Magazine • April 2006
93
High mobility: 3G offers a data rate of 144
kb/s for rural outdoor mobile use for a user
traveling at a speed of more than 120 km
per hour.
Low mobility: 3G offers a data rate of 384
kb/s downlink for pedestrian users traveling
at a speed of less than 5 km per hour ( and
up to 2 Mb/s indoors).
These data rates enables 3G connectivity to
reach anyone, anywhere and transmit any kind
of information in real time. 3G may provide the
following services:
Videoconferencing: to permit videophone-
type communication between mobile termi-
nals.
Video streaming: video recording and
images of various kinds can be sent and
transmitted with this service. Customers
will thus be able to receive real-time televi-
sion programs on their 3G terminals for
entertainment, cultural, or educational pur-
poses.
Internet browsing: the user can browse on
the Web directly with the mobile terminals.
Application sharing: applications running on
the customer terminal can use processing
resources resident on a remote server (e.g.,
one managed by the service provider).
The selected U.S. streams will be transmitted
over different available 3G network data rates.
These range from 56 to 384 kb/s (uplink). These
rates are specifically related to the patient-sta-
tion uplink that represents the specific commu-
nication bottleneck of this telemedicine 3G
connectivity channel. The patient station sends
ultrasound images, ultrasound streams, ambient
video, sound, and robot control data, while it
receives only robot control, ambient video, and
sound from the expert station (i.e., expert-sta
-
tion uploading).
The classification of the OTELO traffic is
mapped to the three major traffic classes defined
by the Third Generation Partnership Project
(3GPP) for Universal Mobile Telecommunica-
tion System (UMTS) quality of service (QoS)
classes. The best-suited QoS class for video
streaming is service class “Streaming” which pre
-
serves the time relation (variation) between
information entities of the stream. However, for
medical image sequences with real-time (RT)
requirements, the “Conversational” class would
be necessary.
The general functional modalities of the sys-
tem are given in Table 1, with those addressed in
this article shown in boldface letters.
EXPERIMENTAL
SETUP ENVIRONMENT
The experimental setup is designed to measure
the end-to-end system performance over the 3G
network, as shown in Fig. 2.
The following performance metrics are mea
-
sured:
Average throughput (ultrasound stream and
robot control data)
End-to-end packet delay and delay jitter.
The ultrasound scanner data is acquired at
the rate of 13 frames/s, each frame with the res-
olution of (320
× 240) pixels for the videoconfer-
encing format, and (176
× 144) pixels for the
Quarter Common Intermediate Format (QCIF).
The robotic data flow bursts from the expert sta-
tion at 16 bytes payload on 70 ms time interval,
nn
nn
Figure 2. OTELO mobile robotic system connectivity over a 3G network.
Gateway
ADSL
modem
Robotic
arm
controller
3G network
1ub
Node
B
SGSN GGSNRNC
Patient station
Expert station
Us
3G phone
or
PCMCIA
card
Ultrasound
probe holder
Gn
1uPS
CNUTRAN
Gi
Internet
nn
nn
Table 1. OTELO medical data rate requirements.
Medical data Data description
Data rates (kb/s)
and resolution (dB)
Data flow direction, patient-to-expert
(P-to-E), expert-to-patient (E-to-P)
Still US images
Grayscale, 512 × 512 pixels
14–97 kbytes Uplink, P-to-E
Stream US images
Grayscale, CIF (R.O.I.), 200 × 200 pixels
10 frames/s, > 35 dB Uplink, P-to-E
Stream US images
Grayscale, CIF, 352 × 288 pixels
7 frames/s, > 35 dB Uplink, P-to-E
Robot control frequency 100–200 Hz 5–6 kb/s Up- or downlink, E-to-P and P-to-E
Stream US images
QCIF, 176 × 144
5 frames/s, > 36 dB Up and down, P-to-E and E-to-P
Videoconf. option 1
QCIF, 176 × 144
7.5 frames/s Up and down, P-to-E and E-to-P
Videoconf. option 2
CIF, 352 × 288
5 frames/s Up and down, P-to-E and E-to-P
GARAWI LAYOUT 3/23/06 10:06 AM Page 93

IEEE Communications Magazine • April 2006
94
and the received robot data stream from the
patient station is updating the robotic head posi-
tion continuously.
The patient station is connected to a 3G ter-
minal via a wireless card connected to a laptop
PC. The tests were carried out at different net-
work loading conditions (especially at peak
working hours) and the presented results reflect
these network conditions.
IMPLEMENTATION OF THE
STREAMING PROTOCOL
It is well known that protocols for streaming
media are commonly designed and standardized
for communications between clients and stream-
ing servers. They are concerned with issues such
as network addressing, transport, and session
control [10]. The transport protocol family for
media streaming includes User Datagram Proto-
col (UDP), Transmission Control Protocol
(TCP), Real-Time Protocol (RTP), and Real-
Time Transport Control Protocol (RTCP).
Since TCP retransmission introduces delays
that are not acceptable for real-time streaming
applications with stringent delay requirements,
especially for transmission over fading wireless
links, UDP is typically employed as the transport
protocol for video streams over such fading
channels.
RTP is an Internet standard protocol
designed to provide end-to-end transport func
-
tions for supporting real-time applications.
RTCP is a companion control protocol with
RTP and is designed to provide QoS feedback to
the participants of an RTP session; therefore,
the RTP/UDP/IP protocol is applied in our
work. The UDP/IP protocol is used for the robot
data that is transmitted in both directions.
Although the effect of packet loss on the robotic
control could affect the mechanical functionality
of the robotic control system, the tests carried
out on the OTELO system with an uplink of (64
kb/s) have shown the reliable functioning of the
robotic system in the patient station with the
minimal packet loss of (< 0.5 percent).
ULTRASOUND STREAM CODEC
The video compression standard used in this
application is H263 codec, which has a wide
range of applications, including medical consul-
tation and diagnosis at a distance. The H.263 is
aimed particularly at video coding for low bit
rates (typically, 20 to 30 kb/s and above). Fur-
ther details on this codec design and the imaging
functionality of this codec for OTELO can be
found in [11].
PERFORMANCE RESULTS AND
DISCUSSION
The OTELO system was tested on a live 3G net-
work (Vodafone, U.K.). The experimental tests
for the system were carried within the greater
London area between Kingston University, Lon-
don (patient side) and St. George’s Medical
School, London (expert side). The following
results summarize some of the performance tests
carried out.
ULTRASOUND THROUGHPUT ANALYSIS
A sample of the instantaneous throughput of the
ultrasound stream captured by the expert is
shown in Fig. 3, where the average throughput
obtained was 23 kb/s and the standard deviation
(std) value of 22 kb/s represented the patient
station uplink average throughput value.
The variation in the throughput shown in the
figure can be attributed to the movement of the
robotic probe holder in addition to the varia-
tions in the network conditions.
The number of stream packets taken for the
analysis was 350. This stream length was selected
based on the experimental 3G test results on
nn
nn
Figure 3. Sample peak throughput of the received ultrasound stream by the
expert station.
Time (s)
Peak throughput vs. time
450
0
2
Peak throughput (b/s)
4
6
8
10
12
14
16
18
20
x10
4
50403530252015105
Received ultrasound
Mean throughput = 23 kb/s
Std = 22 kb/s
nn
nn
Figure 4. Distribution of the delta time packet delay at the expert station.
Delta time (s)
Packet delta time distribution
0.9 10
0
20
Number of packets
40
60
80
100
120
140
160
180
0.80.70.60.50.40.30.20.1
GARAWI LAYOUT 3/23/06 10:06 AM Page 94

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Journal ArticleDOI
TL;DR: This paper proposes a mapping to existing 3GPP QoS Class Identifiers (QCIs) that serve as a basis for the class-based QoS concept of the EPS, and aims to provide network operators with guidelines for meeting heterogeneous e-Health service requirements.
Abstract: E-Health services comprise a broad range of healthcare services delivered by using information and communication technology. In order to support existing as well as emerging e-Health services over converged next generation network (NGN) architectures, there is a need for network QoS control mechanisms that meet the often stringent requirements of such services. In this paper, we evaluate the QoS support for e-Health services in the context of the Evolved Packet System (EPS), specified by the Third Generation Partnership Project (3GPP) as amulti-access all-IP NGN. We classify heterogeneous e-Health services based on context and network QoS requirements and propose a mapping to existing 3GPP QoS Class Identifiers (QCIs) that serve as a basis for the class-based QoS concept of the EPS. The proposed mapping aims to provide network operators with guidelines for meeting heterogeneous e-Health service requirements. As an example, we present the QoS requirements for a prototype e-Health service supporting tele-consultation between a patient and a doctor and illustrate the use of the proposed mapping to QCIs in standardized QoS control procedures.

94 citations


Cites background or methods from "3G wireless communications for mobi..."

  • ...As an example, we present the QoS requirements for a prototype e-Health service supporting tele-consultation between a patient and a doctor and illustrate the use of the proposed mapping to QCIs in standardized QoS control procedures....

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  • ...We note, however, that in certain cases the instances of the same generic type of service (e.g., tele-diagnosis) may have very different QoS requirements depending on actual context in which the service is invoked....

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References
More filters
Journal ArticleDOI
TL;DR: This article provides an overview of H.263, the new ITU-T Recommendation for low-bit-rate video communication, which specifies a coded representation for compressing the moving picture component of audio-visual signals at low bit rates.
Abstract: This article provides an overview of H.263, the new ITU-T Recommendation for low-bit-rate video communication. H.263 specifies a coded representation for compressing the moving picture component of audio-visual signals at low bit rates. The basic structure of the video source coding algorithm is taken from ITU-T Recommendation H.261 and is a hybrid of interpicture prediction to reduce temporal redundancy and transform coding of the prediction residual to reduce spatial redundancy. The source coder can operate on five standardized picture formats: sub-QCIF, QCIF, CIF, 4CIF, and 16CIF. The decoder has motion compensation capability with half-pixel precision, in contrast to H.261 which uses full-pixel precision and employs a loop filter. H.263 includes four negotiable coding options which provide improved coding efficiency: unrestricted motion vectors, syntax-based arithmetic coding, advanced prediction, and PB-frames.

1,294 citations

Journal ArticleDOI
TL;DR: Six key areas of streaming video are covered, including video compression, application-layer QoS control, continuous media distribution services, streaming servers, media synchronization mechanisms, and protocols for streaming media.
Abstract: Due to the explosive growth of the Internet and increasing demand for multimedia information on the Web, streaming video over the Internet has received tremendous attention from academia and industry. Transmission of real-time video typically has bandwidth, delay, and loss requirements. However, the current best-effort Internet does not offer any quality of service (QoS) guarantees to streaming video. Furthermore, for video multicast, it is difficult to achieve both efficiency and flexibility. Thus, Internet streaming video poses many challenges. In this article we cover six key areas of streaming video. Specifically, we cover video compression, application-layer QoS control, continuous media distribution services, streaming servers, media synchronization mechanisms, and protocols for streaming media. For each area, we address the particular issues and review major approaches and mechanisms. We also discuss the tradeoffs of the approaches and point out future research directions.

780 citations


"3G wireless communications for mobi..." refers background in this paper

  • ...It should also be noted that any video packet that arrives beyond its delay bound (e.g., its play-out time) is useless and can be regarded as lost [ 10 ]....

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  • ...They are concerned with issues such as network addressing, transport, and session control [ 10 ]....

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Journal ArticleDOI
01 Dec 2004
TL;DR: This editorial paper presents a snapshot of recent developments in wireless communications integrated with developments in pervasive and wearable technologies and addresses some of the challenges and future implementation issues from the m-Health perspective.
Abstract: 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.

748 citations

Proceedings ArticleDOI
09 Jun 1995
TL;DR: The design and implementation of a digital image capture and distribution system that supports remote ultrasound examinations and, in particular, real-time diagnosis for these examinations is presented.
Abstract: Presents the design and implementation of a digital image capture and distribution system that supports remote ultrasound examinations and, in particular, real-time diagnosis for these examinations. The system was designed in conjunction with radiologists and staff in the Department of Radiology at the University of Virginia Hospital. Based on readily available microcomputer components, our teleultrasound system handles the acquisition, digitizing, and reliable transmission of still and moving images generated by an ultrasound machine. The digital images have a resolution of 640/spl times/480 with an 8-bit color plane, con be captured at rates up to 30 frames/sec, and are compressed and decompressed in real-time using specialized hardware. While scalable to communications networks of any transmission speed, initial deployment is envisioned for 1.5 Mbit/s T-1 leased lines. To achieve real-time still image distribution and to reduce the bandwidth necessary for motion video, the teleultrasound design employs lossy image compression based on the JPEG standard. The effects of JPEG compression on diagnostic quality are being studied in a separate signal detection study with the Department of Radiology at the University of Virginia. >

90 citations

Proceedings ArticleDOI
01 Jan 2000
TL;DR: A transportable telemedicine workstation has been designed, developed and evaluated for use in isolated areas such as islands, rural areas and crisis situation areas and adjusted accordingly to meet needs of developing countries and countries in transition.
Abstract: A transportable telemedicine workstation has been designed, developed and evaluated for use in isolated areas such as islands, rural areas and crisis situation areas. The EU-TeleInViVo is a custom-made device integrating in one solid case: a portable PC with telecommunication capabilities and a light, portable 3D ultrasound station. The system developed has low price, low weight, is transportable and non-radiating. The integrated workstation uses advanced software techniques to acquire 3-dimensional ultrasound data of a patient. The device is now being tested in different socioeconomic conditions and adjusted accordingly to meet needs of developing countries and countries in transition. It currently comes in two versions, one fully portable, self-contained device, and a workstation version (PC attached to an ultrasound scanner for internal hospital use). A dedicated software package has been developed for the needs of this project, based on the InVivoScanNT software package developed at Fraunhofer IGD. During a teleconsultation, both partners, connected over a telecommunications network, are able to share the same interface and perform tasks visible in real time, even on low bandwidth channels, to both ends on the same data set. The system supports various ways of communication, such as Internet, ISDN, common phone lines, GSM, etc.

50 citations


"3G wireless communications for mobi..." refers methods in this paper

  • ...In 2000, the European project TeleInVivo was developed [ 4 ], in which the echography was performed by a clinical expert standing next to the patient, then ultrasound data were sent via satellite to a data base station and processed to reconstruct a 3D representation of anatomical regions of interest [5]....

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Frequently Asked Questions (1)
Q1. What are the contributions in this paper?

In this article, the authors present the performance analysis of an end-to-end mObile Tele-Echography using an ultra-Light rObot ( OTELO ), over the third-generation ( 3G ) mobile communications network.