bluuebunny/crossref_metadata_2025 huggingface dataset:
2.1 Information Management in Patient Care
Authors: ONLY Martin J.
Published: February 2025

Distribution, information management, and integration are central themes in BERMED. Before describing the realization of an open distributed management system, this chapter provides a clarification of certain terms and an overview of the architectural approach adopted. It clarifies the benefits and problems associated with distribution in computing systems, the prime aims of information management, and the meaning of the term open. The architectural approach follows that described in the draft international standard for open distributed processing [1]. One part of this architecture is the open distributed management system, another is the integrated medical application.
2.2 Realization of an Open Distributed Management System
Authors: OHLY Martin J.
Published: February 2025

The BERMED open distributed management system provides the infrastructure on which to base the integrated medical application. In essence it can be seen to provide the transparency mechanisms that mask from the medical applications programmer the distribution and access methods. The descriptions used here correspond to the computational, and engineering viewpoints. The information and technology viewpoints of BERMED are described later in “Integrated Medical Application”.
Analysis of the Rehabilitation Technology sector in the Netherlands
Authors: Swarte V.P.P.
Published: February 2025

The Dutch RT market show actors that have several strong interrelations, clustered in four mutual networks. Five of the actors influence the RT market by introduction of interventions. These interventions are based on three policies and they attack in three different battlefields. Indicators of the Dutch RT market motivate the introduction of interventions. Changing circumstances adapt the policies. Because of a stronger basis in the RT market, interventions can be more effective than ten years ago.
MODEMA - A Knowledge Based Browsing System to Facilitate the Employment of People with Disabilities
Authors: Hewitt Jill  , Sapsford-Francis John  , Bolstad Greta  , Eftedal Olav  , Halford Philip  , Vervenne Dirk  , Verheyen Michael
Published: February 2025

This paper describes the stages of the MODEMA project which have been carried out to establish the user requirements for a computer system and to implement a prototype version. Sections describe the Market and User Analysis, the Knowledge Extraction methodology, modelling and implementation and the evaluation procedures. Finally, potential exploitation possibilities and future developments are discussed
Tools for Living: Design Principles for Rehabilitation Technology
Authors: Craig Ian  , Nisbet Paul  , Odor Phil  , Watson Marion
Published: February 2025

This paper addresses some issues of design of rehabilitation technology. We argue that the complexity of configuration and use, of emerging R.T. systems must be managed if systems is to be practically useful. We suggest that the nature of the market demands open, modular systems. A modeless, object-oriented design developed for an intelligent powered wheelchair is presented by way of example. The approach provides an open, cost-effective technique for designing and developing complex R.T. systems.
The Information Prosthetic for Severely Physically Handicapped Children
Authors: Hoenkamp E.  , Voort R.
Published: February 2025

Physically handicapped children can derive exceptional benefits from computer applications. A careful evaluation of such applications is called for, however, to thwart unjustified hopes or claims. This paper describes the development and evaluation of a computer based environment, refered to as the ‘information prosthetic’. It consists of pointing devices and a computer program. In a large scale pre-test post-test design, the information prosthetic was evaluated on its effects on attention and cognitive- and emotional development of physically handicapped children aged four to eight. The experimental group worked five months, twice a week, during 20 minutes with the computer. Teacher questionnaires confirmed previous research that immediate effects may be considerable. In contrast however, an analysis of variance (ANOVA) showed long term treatment effects to be negligible.
Open Control Architecture for an Intelligent Omni-Directional Wheelchair
Authors: Hoyer Helmut  , Hoelper Ralf
Published: February 2025

This paper presents an open control architecture for a smart omni-directional wheelchair allowing a flexible configuration of user required functionality, which is essential for an individual adaptation to the special needs of severely physically disabled and mentally handicapped people. The demand for a large functionality with high flexibility, leads to a modular structured control system, composed of different smart units. Each unit is provided with local intelligence to yield a high independence from other modules as well as to get an open control system.
On higher-level operational facets of diagnostic expert systems
Authors: Popper M.
Published: February 2025

Macro-operations, as conveyors of strategy-directed diagnostic reasoning, are considered: they, as identifiable task-specific prescriptions, are to extend the expressiveness of knowledge representation and surpass the limitations of universal inferential operations.
Knowledge-Based Interpretation of Magnetic Resonance Images : Detecting Multiple Sclerosis Lesions
Authors: Kamber M.  , Shinghal R.  , Evans A.C.  , Collins D.L.  , Francis G.S.
Published: February 2025

Magnetic Resonance (MR) imaging is a medical technique which permits the visualization of a variety of tumors, lesions, and abnormalities present within the soft biological tissues of the body. Segmentation of medical image data is the process of assigning anatomically-meaningful labels to each component of the image. This paper presents a method of knowledge-based interpretation of MR images of the head. In particular, the method is designed for the segmentation, or detection, of multiple sclerosis (MS) lesions of the brain. Knowledge of brain anatomy is represented in the form of a tissue probability model which provides a priori probabilities of brain tissue distribution per unit voxel in a standardized 3D ‘brain space’. As 90-95% of 118 lesions occur in white matter tissue [1], the model was used to confine the search for MS lesions to plausible white matter locations. Use of the model to segment multiple sclerosis lesions reduced the number of false positive lesions by 50-80% in comparison to non-model-based (i.e. purely data-driven) segmentation.
A Framework for Modular Knowledge Bases in the Domain of Hypertension Diseases
Authors: Heller Barbara  , Schlegelmilch Sonja
Published: February 2025

To manage medical diagnosis and treatment in extremely involved knowledge domains we consider particular aspects of structuring medical knowledge into knowledge modules. In our approach we arrange these modules in a three-dimensional structure. The three dimensions are defined by the degree of knowledge abstraction, specifity of domain knowledge and system-technical form of knowledge description. Furthermore we propose an idea of how to manage the transfer of knowledge among modules. To achieve an appropriate modular model of our knowledge domain we explain the decomposition of domain knowledge into knowledge modules. Finally, an example illustrates the knowledge transfer among modules.
Clinical decision-support in the field of TETANUS serology using an associative storage model implemented in LISP
Authors: Schröder J.P.  , Henne P.  , Kuhlmann W.D.
Published: February 2025

Vaccination without the knowledge of the immune status run the risk of complications to vaccination to a high degree. Therefore a quantitative serological detection of TETANUS-antitoxin is recommended before booster-vaccination. The diagnostic interpretation of results can be improved by including extensive knowledge using a neural-network-system implemented in LISP. This system constitutes of a general associative storage-model, which can be used for the implementation of a variety of purposes, for instance simple perceptrons, associative sequences or semantic nets. The latter is done using context-sensitive association, where an output is obtained from input together with an additional context-form. The essential characteristics of the structure of that knowledge base as well as examples are presented.
A Neural Network Identifies Faces with Morphological Syndromes
Authors: Herpers R.  , Rodax H.  , Sommer G.
Published: February 2025

The diagnosis of craniofacial dysmorphic signs hasa high medical importance. Physicians specialized on human genetics need to get quick reliable information about dysmorphic syndromes characterized by facial abnormalities to give a prognosis about the risk of incidence for following children. In numerous cases of dysmorphic syndromes no chromosomal aberration can be found. Therefore the dysmorphic diagnosis is based on an extensive phenotyp analysis of craniofacial signs. In this study we investigate an artificial neural network approach to identify face images with morphological abnormalities. Different full-connected multi-layer perceptrons (MLP) are trained only with a small set of observations using back-propagation as learning algorithm. The gray level images are sampled, preprocessed and scaled to a size of 55 x 72 pixel. The best results are achieved with a network architecture of 4 hidden and 2 output units. The individual classification error of each investigated network architecture is calculated by the leaving-one-out method. The average classification error was 5 %, the best percentage of correct identifications of one network architecture reached 100 %. The presented results show that classifications generated by aritificial neural networks based on small sets of training examples are able to support a dysmorphic diagnosis.
Self Organizing Maps for the Evaluation of High Resolution ECG
Authors: Schulz Barbi  , Pelikan Erich  , Silny Jiri  , Sigmund Martin  , Rau Günter
Published: February 2025

An approach for an all-embracing ECG signal analysis is introduced. Self organizing maps are applied to spatial high resolution multilead ECG recorded during the acute phase of myocardial infarction to detect characteristic changes. The algorithm deals with the measurement of similarity between different pathological signal types.
Screening of visual function compared with self-report visual disability
Authors: KOOIJMAN Aart C.  , (Ruud) KEMPEN G.I.J.M.  , CORNELISSEN Frans W.  , van HEUVELEN Marieke J.G.  , van de WEGE Anja  , FRITSCHE Peter  , HOUTMAN Wim A.
Published: February 2025

Determining the incidence of visual impairment in elderly persons (>60 years) is one of the objectives of the NESTOR subprogram GLAS: “Functional Status and Need for Care”. For this purpose we designed a self-report questionnaire with 13 questions concerning day-to-day life such as “Can you see approaching bicycles and cars in the street?”, “Can you read numbers in a phone book?”, etc., and a set of screening techniques to measure visual acuity, edge contrast sensitivity, disability glare, near reading acuity, macular light sensitivity and quadrant visual field defects to test different aspects of visual functioning.
The Intelligence Profile of Children with Unequal Vision
Authors: GROENVELD Maryke  , JAN James E.
Published: February 2025

As part of a study recently completed at BCCH the cognitive profiles of 65 children with partial sight were analyzed with the Wechsler batteries. A consistent profile emerged, related to the degree of residual vision. Subsequently the profiles of children between the ages of 6 and 17 with unequal vision of at least one octave, were analyzed. Contrary to expectations the profile of children with unequal vision did not correspond to the vision in the better eye, but was indicative of a more severe impairment.
Ergonomic workplace design for a visually impaired person
Authors: van Bergem-Jansen P.M.
Published: February 2025

On the basis of ergonomic design principles an administrative workplace has been designed for a visually impaired person suffering from albinism. The design is determined by task requirements, anthropometry, the person’s visual capabilities and former experiences.
Print Enhancement for Eccentric Vision
Authors: Engel F.L.  , Jenniskens A.J.W.
Published: February 2025

Image magnification is a well known means for print enhancement. However, a too large magnification hampers reading because of the decreased field of view. For certain patients with maculopathies, it has recently been reported that by using individualized compensation filters, less magnification is needed and higher reading rates are achieved. In this paper the possibilities of print enhancement for eccentric vision are explored further by using subjective estimates of image quality. The obtained results suggest that for two-tone text, image enhancement through spatial filtering, only makes sense in situations where the available contrast range is not entirely used.
An interdisciplinary model for the rehabilitation of visually impaired and blind people
Authors: van Hof Carola
Published: February 2025

The increase of insight in and knowledge of visual impairments, the technical possibilities and the aim to integrate visually impaired and blind people in normal life, have led to a gradual development of social care for visually impaired and blind people into rehabilitation. Many disciplines became involved in the rehabilitation of visually impaired and blind people. Every one with their own professional knowledge, framework and concepts. The need for a common, conceptual framework was felt: an interdisciplinary model, in order to be able to offer the visually impaired or blind person co-ordinated and combined use of all the possible paramedical, social, technical and educational measures.
The Assessment of Contrast Sensitivity and Contrast Reserve for Reading Rehabilitation
Authors: WHITTAKER Stephen G.  , LOVIE-KITCHIN Jan E.
Published: February 2025

Several visual diseases not only reduce visual acuity, they also may impair a client’s ability to detect lower contrast objects that are well above acuity threshold. A letter contrast threshold function describes the lowest contrast letters that a client can recognize, over a range of sizes. Contrast sensitivity is the reciprocal of contrast threshold; higher sensitivity is better. Poor overall contrast sensitivity would increase a client’s problems with glare, and decrease reading performance with low contrast materials like newspapers, or currency. Very poor overall contrast sensitivity would slow reading of even the highest contrast magnified print and indicate the need for a CCTV or non-visual devices.
The Baromodulation Hypothesis, Baroreflex Resetting and One-over-f Blood Pressure Spectra
Authors: WESSELING K.H.  , SETTELS J.J.  , WIELING W.  , Van MONTFRANS G.A.  , KAREMAKER J.M.
Published: February 2025

That blood pressure is highly variable over 24-hour, yet would be tightly controlled by the baroreflex system is a baroreflex paradox. Not only blood pressure varies but baroreflex sensitivity varies with it. Changes in baroreflex sensitivity can cause great changes in blood pressure, as we have shown in model studies. Consequently, the baromodulation hypothesis says that sensitivity modulation is the primary mechanism in the baroreflex that changes arterial pressure. The baroreflex then becomes not just a pressure stabilizer but a pressure controller: in interaction with other inputs such as coming from higher brain centers, it moves the blood pressure from one desired level to another. This system is effective, fast, and safe. We prefer not to use the word resetting for this mechanism but to reserve ‘resetting’ traditionally for changes in the receptor function. For resetting the baroreflex as a functional unit the word ‘baromodulation’ could be used. From recently recorded 24-hour 1/f blood pressure spectra it has again been confirmed that speaking of a baroreflex setpoint, even of a setpoint that is reset occasionally, is less appropriate. Blood pressure changes continuously and intentionally. Baromodulation is capable of doing that.
Computer Modelling the Dynamics of the Circulation under Gravitational Stress
Authors: AKKERMAN E.M.  , KAREMAKER J.M.  , STRACKEE J.
Published: February 2025

A computer model for the circulation was developed that takes gravitational effects into account. Gravity was supposed to act on the filling of the left and right atrium and the hydrostatic distance between heart and baroreceptors. The model is based on difference equations describing essential conditions of the circulation, like heart period, systolic pressure or stroke volume, on a beat-to-beat basis. It was possible in this model to simulate the cardiovascular dynamics after a passive tilt from upright to supine, assuming only baroreflex control. However, the dynamic behaviour after a tilt from supine to upright was only wellsimulated when low-pressure baroreceptors (in the atria) were incorporated in the model as well. Depending on the parameter settings of the model sustained 0.1 Hz oscillations in heart rate and blood pressure showed up in the upright situation, due to non-linearities in the model and sympathetic feedback reaction times.
The Evolution of Case-Mix Measurement Using DRGs: Past, Present and Future
Authors: Averill Richard F.
Published: February 2025

The Diagnosis Related Groups patient classification scheme has been evolving for over twenty years. The wide variety of DRG applications in the U.S. has resulted in the development of three major versions of DRGs. The alternative DRG systems are described and compared. Comparative statistical data for each DRG system are presented.
A FEM Analysis of the Effect of Braces on the Rib Cage
Authors: RASO VJ  , SHUTE RD  , THOMPSON JM  , BUDNEY D  , HRUDEY T
Published: February 2025

Braces used to treat children with scoliosis must transmit forces through the ribcage to realign and derotate the scoliotic spine. This involves complex reactions between the brace, the sternum, the ribs, and the vertebrae, as well as the costo-sternal and costo-vertebral junctions. A simple finite element model of the brace-body system is being constructed to analyze the effect of braces used for treatment. The loads used in the model were taken from pressure measurements of a child using a Charleston brace.
Postural Variations vs. Muscular Contractions
Authors: ROTELLI Fabio  , SANTAMBROGIO Giorgio C.
Published: February 2025

The aim of this work is the analysis, in normal subjects and scoliotic patients, of posture modifications associated to suitable muscular contraction induced by means of transcutaneous sinusoidal electrical stimulation. In this preliminary study, only three muscular groups were considered: the rectus abdominis, the external obliquus abdominis and the gluteus maximum. The effects of such muscular action on the postural state have been monitored in real-time by the AUSCAN System, an opto-electronic system for three-dimensional analysis of posture and spinal deformities. The obtained relations between stimulation level and variations of the spinal parameters show, independently on the stimulated muscle group, three different strategies of posture adaptations. Even if general physiologic indications about the macroscopic action of the stimulated muscle groups have been always respected, such strategies point out a meaningful dependence on the posture control system (involving peripheral receptors and sensory afferences) that, in some cases, altered significantly the expected outcomes of the considered muscular contraction. The discrepancy between the produced muscular action and the desired effect seems to be strictly related with the nonlinearity of the posture control system and with the global tonicity of the muscular system. These elements make evident the need of a more specific personalization of the stimulation parameters and confirm the general usefulness of physiokinetic therapies before the electrical stimulation treatment of spinal deformities.
Clinical Experience of Employing Computerised Back Shape Analysis to Measure the 3D Deformity of Scoliosis
Authors: DANGERFIELD P H  , PEARSON J D  , DORGAN J C  , HOBSON C A  , SCUTT D  , GIAKAS G
Published: February 2025

The Spinal Image Processing System (SIPS), developed in Liverpool, is an inexpensive, automated, non-contact, non-invasive computer imaging system which allows direct measurement of parameters of 3D surface deformity in scoliosis. Accurate patient positioning has been found to be important as it can seriously affect the recorded parameters. Use of a standardised foot-plate reduces positional error by offering consistent, reproducible and standard patient positioning. Surface measurements recorded using SIPS are of a different magnitude to those obtained using a scoliometer, attributed to recording the image in the standing position. The representation of surface deformity has also identified pelvic and trunk rotation in scoliosis, raising aetiological questions relating to the factors which may determine progression of the condition. Other findings have included visible effects of respiration on the images as the hump magnitude varied with the degree of inspiration and expiration of the patient. SIPS is used routinely during patient follow-up and post-operatively, often within a week of surgery, and is now employed as part of a prospective study of scoliosis natural history.
Improvement of Rib Cage 3-D Reconstruction by Taking into Account Patient Displacement during Stereoradiography
Authors: MARCIL E.  , DANSEREAU J.  , LABELLE H.  , DE GUISE J.
Published: February 2025

Three-dimensional stereoradiographic reconstruction of scoliotic spines and rib cages is routinely done at Ste-Justine Hospital. For each patient, two postero-anterior X-ray views (PA-0° and PA-20°) are taken at approximately 25 seconds interval to obtain 3-D reconstruction of rib midlines. One major source of error in this reconstruction technique is related to the possible displacement of the patient between the two X-ray exposures even if positioning devices are used. Results of a new rib cage reconstruction method which evaluates and takes into account the patient displacement are presented. Graphical 3-D representation of the rib cage reconstruction showed an evident improvement compared to the previous reconstruction method. This new reconstruction technique has important clinical significance because it allows to measure patient displacement during stereoradiography and to improve the quality of the 3-D rib cage representation given to the clinician for evaluation of scoliotic deformities.
Gait Analysis of Patients with Adolescent Idiopathic Scoliosis
Authors: DANGERFIELD P H  , GIAKAS G  , DALMIRA S.  , BALTZOPOULOS V.  , DORGAN J C  , BRODIE D.
Published: February 2025

Ground reaction force parameters have been investigated in children with adolescent idiopathic scoliosis with the objective of examining the dynamic 3D aspects of the untreated condition. An AMTI force plate and gait walkway, installed in the Gait Laboratory, were employed to measure the ground reaction forces for both feet during the walking cycle. 3D Gait parameters examined included the amplitude and temporal characteristics of anteroposterior, mediolateral and vertical ground reaction forces. The results demonstrated differences between the lateral and non-lateral displacement side for these parameters with asymmetry of the right minimum vertical force and peak propulsive force. Normal controls lacked these features of their cycle. Individual scoliosis cases also exhibited a wide range of asymmetry in parameters describing pronation and supination. The difference in propulsive force and in maximum braking time suggests the presence of 3D asymmetry during the push-off phase of gait and time of footstrike while the difference in vertical torque indicates the presence of rotation of the foot. Vertical torque acts asymmetrically through the limbs and pelvis to affect the spine, further supporting the concept that pelvic and spinal movement are important in the causation of scoliosis. The new findings add the dimension of the lower limb and foot to the aetiology of scoliosis. Further investigations are now being undertaken to examine these findings on a larger sample.
Telematics and Protocols of Care in Critical Care Environments
Authors: Wilson A J  , Bowes C L  , Holland J
Published: February 2025

The paper discusses the potential roles for protocols of care within critical care environments from the perspective of providing real-time support for their application. The discussion is based around a conceptual model of care in critical care environments. This model has been developed in the wider context of developing information technology systems to support clinical care in critical care environments. The conceptual model of care is a three layer model which demonstrates both the hierarchical and temporal aspects of the care delivered to patients. It is proposed that if the value of protocols of care is to be realised in critical care environments then they must be seamlessly integrated into the routine data management associated with the care of patients. In order to demonstrate this and to evaluate the utility of this concept in the clinical environment, the systems from the AIM TANIT (Telematics in Anaesthesia and Intensive Therapy) project have been used as prototype platforms. The application of the concepts developed are described in two critical care environments: the anaesthesia department and the intensive care unit. Problems in using protocols of care in intensive care units suggest that integrating these with a problem solving methodology to create an integrated care plan may be a more appropriate approach to patient management.
Framework for quality assessment of knowledge
Authors: Brender J.  , Talmon J.  , McNair P.
Published: February 2025

One of the key issues in the development (and subsequent application) of medical knowledge - be it in terms of a KBS or otherwise - is the assessment of its quality. We present a framework for how to manage and make measurable the quality of the semantic as well as pragmatic aspects of the knowledge embedded in classification models during the development of such models.
Methods for Data Acquisition
Authors: Jørgensen Torben
Published: February 2025

Acquiring data on the variety of effects of information technology, the different domains and from a multiplicity of sources, necessitates the application of a number of methods. This contribution gives but a brief introduction to some common methods for acquiring and judging the validity of data, evolved within various sciences.
The Exploration of Cross-Sectional Data with a Virtual Endoscope
Authors: Lorensen William E.  , Jolesz Ferenc A.  , Kikinis Ron
Published: February 2025

Endoscopes provide real-time, high resolution video views of the interior of hollow organs and cavities that exist within the human body. Although endoscopic examinations are mostly non-invasive, the procedures still require some sedation or anesthesia to reduce patient discomfort. X-Ray Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are non-invasive diagnostic imaging techniques that display internal anatomy in cross sections called slices. For the most part, radiologists view the 2D cross sections and create mental images of the 3D structures present in the study. However, many of the tubular structuresthat exist in the body have complex morphology, passing back and forth through the cross sections. This paper illustrates techniques for the internal exploration of CT / MRI data that have been reconstructed into 3D surfaces. The views produced by the new methods simulate the types of views that can be obtained with endoscopes. Examples from the brain, cranium, chest, and abdomen illustrate the techniques.
Blood Vessel and Feature Extraction Based on Direction Fields
Authors: Kutka Robert  , Stier Sebastian
Published: February 2025

The described work is part of the COVIRA project whose goal is to provide prototypes of clinical workstations for neuroradiological diagnostics and therapy, neurosurgery and 3D radiation therapy for evaluation in several hospitals. An important aspect is the 3D reconstruction and visualisation of the cerebral vessel tree based on several DSA projections combined with an MRA volume data set. This combination promises a higher resolution than that yielded by MRA data alone. This paper presents tools for supporting the 3D reconstruction: the segmentation of blood vessels, the extraction of vessel intensities, diameters and centre lines. During the 3D reconstruction these features reduce the ambiguity that is present when only segmented binary image are used. A further application of these tools is the enhanced representation of blood vessels in 2D images. Blood vessels down to a diameter of 2 pixels can be intensified and visualised even if they are poorly filled with contrast agent. In a first evaluation radiologists confirmed the improved quality and the detailed resolution.
Structural description and combined 3-D display for superior analysis of cerebral vascularity from MRA
Authors: Székely Gábor  , Koller Thomas  , Kikinis Ron  , Gerig Guido
Published: February 2025

Medical image analysis has to support the clinicians ability to identify, manipulate and quantify anatomical structures. On scalar 2-D image data, a human observer is often superior to computer assisted analysis, but the interpretation of vector-valued data or data combined from different modalities, especially in 3-D, can benefit from computer assistance. The problem of how to convey the complex information to the clinician is often tackled by providing colored multimodality renderings. We propose to go a step beyond by supplying a suitable modelling of anatomical and functional structures encoding important shape features and physical properties. The multiple attributes regarding geometry, topology and function are carried by the symbolic description and can be interactively queried and edited. Integrated 3-D rendering of object surfaces and symbolic representation acts as a visual interface to allow interactive communication between the observer and the complex data, providing new possiblities for quantification and therapy planning.
How We View Systolic Function of the Heart: Emax and PVA
Authors: Suga Hiroyuki
Published: February 2025

This summarizes my 25 year long research carried out for a better understanding of the systolic function of the heart. My research began with the discovery of Emax (end-systolic maximum elastance or pressure volume ratio) as an index of ventricular contractility on the basis of the time-varying elastance model of the left ventricle. The same time-varying elastance model evolved PVA (systolic pressure-volume area) as a measure of the total mechanical energy generated by ventricular contraction. We have found experimentally that both Emax and PVA closely correlate with myocardial oxygen consumption and proposed that the oxygen costs of Emax and PVA characterize the abnormality of cardiac mechanoenergetics under various pathophysiological conditions.
Differences in Systolic and Diastolic Torsional Deformation of the Left Ventricle
Authors: Arts Theo  , Hunter William C.  , Douglas A.S.  , Prinzen Frits W.  , Reneman Robert S.
Published: February 2025

During normal cardiac ejection mechanical load appears to be uniformly distributed over all myocardial fibers. Given the fiber structure of the left ventricle, a specific mathematically determined pattern of deformation of the left ventricle is expected during the ejection phase, irrespective of the actual hemodynamic load.
CAMIREMA: Case Mix and Resource Management
Authors: Hofdijk Jacob
Published: February 2025

This contribution describes the main activities of the Concerted Action on Case Mix and Resource Management, which was organised as part of the AIM program. The concertation process supported the discussion between European researchers in the field of health care management to use Case Mix as a tool to manage the resources available for care and cure in the different areas of health care provision. The Concerted Action has stimulated a joint European approach to the further development of Case Mix tools, and a better use of Information Technology in Health Care.
The OpenLabs Project
Authors: O'Moore R.  , Boran G.
Published: February 2025

The major achievements of the OpenLabs project has been the specification of an Open Architecture for clinical laboratory information systems, and the development of a range of OpenLabs modules which enhance the efficiency and effectiveness of clinical laboratory services. This report provides an account of the motivation for OpenLabs in the user community and the potential benefits to industry, together with outline descriptions of the OpenLabs architecture and advanced add-on modules and perspectives for future work.
LIFECARD - Smart Card Assisted Medical Record Support System
Authors: Drescher S.  , Haase H.-J.
Published: February 2025

The aim of the LIFECARD project is to initiate an infrastructure of an information system in health care based on a processor card, esp. for risc patients. Our motivation is based on the imaginable numerous advantages of such a system to patients, physicians and other health professionals. This presentation will deal mainly with:
Experiences with the X-Ray Card
Authors: Kossmann M.
Published: February 2025

Radiological diagnostics in recent years has been characterized by digital examination techniques. Despite these developments, however, the majority of radiological examinations are still carried out using established film systems. Archive storage has become an increasingly topical and burning issue. Developments in the hospital sector have led to the installation and testing of various PACS in recent years. Conventional X-rays had to be digitized before they could be integrated into these PACS systems. But the projects disregarded radiological and non-radiological specialists in private practise and patients who are interested in their own X-rays. A primarily patient-oriented means of archiving relevant X-rays has now been jointly developed. This digitization system can record and digitize conventional X-rays via a CCD camera and then transfer the data to an optical card. The aim was to define a single unit for simultaneous archiving of both the photographs and the radiological findings, to avoid duplicate examinations and to improve the communication between family doctors and radiologists. A pilot project with 10 radiologists and 50 family doctors has launched already.
The State of Wyoming Smart card Application for Supplemental Food for Pregnant Women, Infants and Children, Food Stamps and Tracking of Immunization
Authors: Williams J.T.
Published: February 2025

Wyoming has successfully implemented PayWest, a smart card based demonstration of Electronic Benefit Transfer (EBT) for the Weman, Infants and Children (WIC) and Food Stamp Programs. The plastic smart card has an imbedded integrated chip that stores data and supports computer-based processing of programs when inserted into a compatible card reading device. The smart card performs transactions in authorized food retailer locations using the card, card reader, and where appropriate, the retailers electronic cash register system without directly exchanging information via telephone with a central host computer. The IC chip in the card stores detailed information about the available benefit and transaction history of the card holder and is not dependent upon telecommunications or a central host computer for authorizing and recording the use of benefits. Data files are transferred between the central host computer, the State’s computers, and computers located in each of the authorized retailers which are connected to the card reader(s) located in check-out lanes. These file transfers allow the system to update benefit authorizations, replenish benefits, manage card issuance and inventory, and support the transfer of payments to retailers and debits against State and Federal program fund accounts using normal commercial ACH processes.
Social Security Card in Spain
Authors: Perez-Garcia J.
Published: February 2025

The Spanish social Security Card Project consists of issuing a smart card for the entire Spanish population (approx. 37,000,000 inhabitants) along a five year period. The objectives of the card are:
Safety and Security of Information Systems
Authors: Shaw Roger
Published: February 2025

This paper discusses some of the similarities and differences between the attributes of safety and security. It places these attributes within the broader topic of dependability and tries to identify what aspects of safety and security are unique and which aspects maybe viewed within the attributes of reliability and availability. The paper then suggests that, rather than analyse systems from the single perspective of safety or security, they should be analysed from the broader perspective of dependability.
Ireland's Competent Authority Initiatives
Authors: Scully Cora
Published: February 2025

Ireland is one of the countries in the European Union, that have transposed both directives on medical devices into national legislation. A detailed discussion on issues regarding the transposition of the directives, the implementation of the vigilance system, the registration requirements in Ireland as well as the Department's view in current developments, particularly the potential use of EDI for the information exchange between all Competent Authorities, is presented in this paper.
National Handling of Medical Devices Vigilance Reports and the Use of Registers
Authors: Nordan Jacob
Published: February 2025

A compalsory incident reporting is operating in Norway, as part of the implementation of the medical devices directives (MDD). Iincidents are being handled locally by the quality councils and only if they prove of importance they are entered into the central database. As for the MDD Vigilance, exchange of information concerning investigation and follow up of incidents is forming a different part of the reporting system. The different possibilities of use of registers, in Norway and accordingly in the European Union, is analysed further in this paper.
Remote Access to Neurosurgical ICU Physiological Data Using the World Wide Web
Authors: Nenov Valeriy  , Klopp John
Published: February 2025

There is a significant demand by physicians and clinical researchers for remote access to continuously acquired physiological patient data. Until recently such access was technically unfeasible. However, with the recent development of Internet-based World Wide Web (WWW) client/server applications and underlying communication protocols, there is now a real possibility for the development of costeffective, platform independent solutions to this problem. We have devised a way using existing WWW tools and minimal startup costs to provide access to current as well as previously acquired physiological patient data. Physicians and clinical researchers can obtain access to these data through personal computers located in the office, at home or even through portable computers while traveling to conferences or while on vacation.
The Expert Surgical Assistant
Authors: Billinghurst M.  , Savage J.  , Oppenheimer P.  , Edmond C.
Published: February 2025

Virtual Reality has made computer interfaces more intuitive but not more intelligent. This paper shows how an expert system can be coupled with multimodal input in a virtual environment to provide an intelligent simulation tool or surgical assistant. This is accomplished in three steps. First, voice and gestural input is interpreted and represented in a common semantic form. Second, a rule-based expert system is used to infer context and user actions from this semantic representation. Finally, the inferred user actions are matched against steps in a surgical procedure to monitor the user’s progress and provide automatic feedback. In addition, the system can respond immediately to multimodal commands for navigational assistance and/or identification of critical anatomical structures. To show how these methods are used we present a prototype sinus surgery interface. The approach described here may easily be extended to a wide variety of medical and non-medical training applications by making simple changes to the expert system database and virtual environment models. Successful implementation of an expert system in both simulated and real surgery has enormous potential for the surgeon both in training and clinical practice
Two- and Three-Dimensional Imaging for Interventional MRI and CT Guidance
Authors: Grönemeyer Dietrich H.W.  , Seibel Rainer M.M.  , Schmidt Armin  , Melzer Andreas  , Deli Martin
Published: February 2025

Minimally invasive techniques using endoscopes for image guided therapy are common in the surgical field and in internal medicine. Interventional procedures in the past were performed with either fluoroscopic, sonographic or CT-guidance, but now MRI-guided interventional procedures are being developed. Combining these technologies will improve surgical access and reduce complications. Today, tomographic 2 D and 3 D imaging (CT , EBT, MRI) can be used for precise and transparent guidance of endoscopes and surgical instruments inside the body for the field of minimally invasive therapy. 3 D imaging is helpful for anatomical , but not for morphological understanding. It has to be used interactivly with actual cross sectional imaging for instrument guidance. This will offer a safe and effective access into the body, especially in high risk areas and lead to the new field of “ Surgical Tomography”.
3-D VISUALIZATION IN MEDICINE: AN OVERVIEW
Authors: Demiris Athanasios  , Mayer Achim  , Meinzer Hans Peter
Published: February 2025

Since the mid seventies many researchers are dealing with the problem of non invasive diagnosis. One way of doing this are the imaging techniques used in almost every clinical environment, e.g. classic X-rays, ultrasound, Computed Tomography (CT), Magnetic Resonance Imaging (MR), or more experimental techniques like PET or SPECT. The large amount of information contained in such images produced with imaging devices of the above categories is not easy to analyse. Hence, the images obtained have to be processed in a way that will yield 3-D-looking images similar to those in anatomical atlases. This chapter aims at the presentation of the most important methods in medical 3-D-visualization and some representative work for each method discussed.
Guidelines for Secure Systems Procurement, Development and Design for Health Care IT and Security Personnel
Authors: van Dorp H.  , Dubbeldam J.
Published: February 2025

The use of information systems in Health Care Establishments is essential in providing proper treatment and care for patients, and in managing the people and the organisation. However, as improper functioning of those systems can influence the well being of the patient, people and the organisation, it is important to have the best systems one can acquire. The decision what system to acquire is taken, given the budget and the required level of quality and security to be built into the system.
MO-ON: a neuro-ophtalmology computer aided learning application
Authors: Bernad Elena Silvia
Published: February 2025

We realized a neuro-ophtalmology computer based learning application for medical students. using a combination of Windows Help Compiler, Visual Basic and 3D-Studio techniques. The main concern in MO-ON is for the disorders of the eyes movements and the paralysis of the associate movements.
Automated extraction of neurosurgical procedure expressions from full text reports: the Multi-TALE experience
Authors: Ceusters W.  , Deville G  , De Moor G
Published: February 2025

The purpose of the Multi-TALE syntactic-semantic tagger is to identify surgical procedure expressions in full text reports, and to assign semantic tags to its composing elements according to the CEN/TC251/PT002S prestandard. Ten English reports - 5 from the original training sample and 5 from a testing sample - have been used for validation. In total 2139 syntactic units (to be mapped into 6 categories) and 857 semantic-contextual entities (to be mapped into 8 categories) were to be retrieved. Information recall (I-R) and information precision (I-P) were measured for both samples. I-R and I-P for the syntactic units were respectively 93.3% and 94.4% for the training sample, and 95.7% versus 95.7% for the testing sample. I-R and I-P for the semantic tags were respectively 91.3% and 92.0% versus 89.3% and 94.8%.
The GALEN High Level Ontology
Authors: Rector AL  , Rogers JE  , Pole P
Published: February 2025

This papa summarises the top level schema of the GALEN Common Reference model. The top levels of a structure tested in a range of uses is described. This includes a taxonomy and an associated set of semantic link types. The current status of the project and its goals is discussed.
Focussing on the Medical Department: SAMMIE
Authors: Hübner U  , Staemmler M  , Schuier FJ  , Newell J
Published: February 2025

The focus of health care computing has been shifted recently from the hospital as a whole to networking and the individual departments, including medical departments which still suffer from a lack of telematics infrastructure. The objective of SAMMIE project is to provide CLINWORKS, a multifunctional departmental system consisting of the three main modules (i) Infoworks, the electronic multimedia patient folder, (ii) Teleworks, a platform for teleconsultation and cooperative work and (iii) Brainworks, a diagnostic tool for the neurologist, neuroradiologist and neurosurgeon. Infoworks and Teleworks are general applications for hospital departments,whereas Brainworks - as the name implies - is specific to the neurospecialties.
Considering the Human Facets in Innovation and Evaluation of a Primary Health Care System
Authors: Jørgensen Trine  , Christensen Claus
Published: February 2025

The primary health care are in desperate need for information systems, but it is a very complex field to make systems for. In the municipality of Aarhus we have had, with very good results, users participating in the evaluation and development of such a system. We have applied methods like future workshops, interviews and “search and learn” processes organised in a project including different kinds of users, from nurses to executives.
Can concepts and terms in existing classifications satisfy the clinical demands on electronic health care records?
Authors: Olhede Torleif
Published: February 2025

The work concerning electronic health care record (EHCR) systems has brought forward different questions in the EU 3rd framework, in the 4th framework, in CEN TC-251 and at national levels. In some countries EHCRs are only generated by physicians. In some countries it is regarded relevant that the EHCR also contains electronic records generated by nurses and other medical and paramedical groups.
Participative Design, Decision Trees, Automatic Learning and Medical Decision Making
Authors: Kokol P.  , Završnik J.  , Zorman M.  , Malcic I.  , Kancler K.
Published: February 2025

Decision support systems (DSS) have become increasingly important in medical applications, particularly when important decision must be made effectively and reliably. The best way to design a successful DSS is through the participative design, thereafter conceptual simple decision making models with the possibility of automating learning should be considered in the design phase and then implemented by conceptual simple paradigms. In this paper we present a cardiological decision support system, called RO2SE (computeRised prOlaps Syndrome dEtermination, O2stands for Object Oriented implementation), based on decision tree approach and automatic learning, supporting the process of mitral valve prolapse determination. RO2SE is implemented using Object Oriented visual programming language.