bluuebunny/crossref_metadata_2025 huggingface dataset:
An Interactive Visual Man—Patient Interface for Semlmmersive Endoscopic Surgery
Authors: Laurent Christophe R.  , Orstein Markus H.  , Ysebaert Dirk K.  , Veschave Jean  , Van Hee Robrecht
Published: February 2025

Endoscopy, a we know it today, is far from perfect. In an attempt to make the interventions as little invasive as possible, the ergonomics of the procedure, for the surgeon, are often not dealt with at all. In an attempt to improve the surgeon patient interface during endoscopic procedures, a new concept is presented to allow the surgeon a much more natural visual interaction with the inside of the patient. It is made possible for the sugeon to look around into the cavity, with a stereo endoscope, mounted on a robot arm. This robot arm is directed by the motion of the head of the surgeon.
A Desktop Image Processing System for Computer-Assisted Orthopedic Surgery (DISOS)
Authors: Radermacher K.  , Bliem R.  , Hennecke Ch.  , Staudte H.W.  , Rau G.
Published: February 2025

Within the framework of our research activities in orthopedic surgery a PC-based imageprocessing system for the processing of x-ray computertomographic data has been developed. The system is used as a work platform for the investigations concerning interaction modalities, strategies and techniques for an efficient planning and execution of surgical interventions in orthopedic surgery by means of individual templates. The method of individual templates has been presented in /1,2/ and will not be subject of this paper.
Introduction to the SEISMED Guidelines
Authors: Bleumer G.
Published: February 2025

The efficiency of modem health care relies more and more upon a computerised infrastructure. Open distributed information systems have started to bring professionals together from all over the world. On the one hand easy processing and communication of images, sounds and texts will help to represent and treat illnesses and diseases efficiently, on the other hand the very ease of access and use can threaten patient privacy, accountability and health care professional secrecy. The European Union (EU) initiated a multi-disciplinary project to come up with practical guidelines detailing how to achieve a Secure Environment for Information Systems in MEDicine (SEISMED). The project has taken into account the traditional and proven principles of health care data processing, the various legislative environments within the EU, the enormous and subtle risks to the security of health care information systems, and the cost of changing existing technology. The guidelines have been validated by the SEISMED reference centres.
Time Domain Methods for Characterizing Respiratory Fluctuations of the Heart Rate: Linear Stationary, Non-Stationary and Non-Linear Approaches
Authors: Yana K.  , Mizuta H.  , Yoshida H.  , Saul J.P.  , Cohen R.J.
Published: February 2025

This paper introduces time domain methods for relating fluctuations in heart rate (HR) to respiration. Three methods: (1) linear stationary, (2) linear non-stationary and (3) non-linear approaches are described. (1) Experimental and signal processing contrivances called random breathing and noise injection methods enable the stable estimation of the impulse response of the HR to the instantaneous lung volume (ILV) signals. The comparison of the HR power spectra and the inpulse response revealed that the respiratory HR fluctuations are mostly affected by the parasympathetic autononic nervous activity. (2)Adaptive signal processing techniques enable recursive estimation of the impulse response, which allows us to keep track its temporal changes. Computer simulation confirmed the feasibility of the method in a practical situation. (3)An index called the degree of non-linearity (d.n.) has been introduced to evaluate how much non-linear the system is. Computer simulation confirmed the validity of the estimation method. Real data analysis showed that 30-35 % of the HR fluctuations associated with ILV cannot be predicted by the linear combination of ILV signals.
An Analysis of the Effect of Harrington Instrumentation for Adolescent Idiopathic Scoliosis (AIS). A Follow-Up Study Revealing some Skeletal and Soft Tissues Involved in Curve Progression
Authors: Wojcik A.S.  , Webb J.K.  , Burwell R.G.  , Cole A.A.
Published: February 2025

This paper reports a radiological study of Harrington-Luque instrumentation (HLI) with spinal fusion for the treatment of thoracic AIS. The spinal radiographs of 24 patients were studied preoperatively, postoperatively and at follow-up (average 3.2 years). HLI causes an immediate reduction of the thoracic Cobb angle by 56% (lumbar Cobb angle by 48%) but this reduced in follow-up to 30% (lumbar 32%). The apical vertebral rotation showed an immediate reduction by 12% (not significant) but in follow-up it increased by 22% along with progression of vertebral rotation from T7 -12. Vertebral tilt in the frontal plane is corrected in opposite directions in the upper and lower parts of the thoracic scoliosis curve and recurred in follow-up. In connection with RVAs (Mehta and corrected RVAs considered together) the findings are consistent with the view that HLI by straightening and lengthening the spine reveals tethering by soft tissues of (1) ribs on the concavity of the thoracic curve (thoracic concave tether) and (2) lower convex ribs on the concavity of the lumbar compensatory curve (lumbar concave tether). Spinal curve progression in follow-up it is suggested results from spinal growth against these two tethers which together create a force couple acting in the lower thoracic spine; the upper thoracic spine adapts to maintain upright balance. Secondary spinal growth adaptations determine the progression of the scoliosis curve.
Visualization of Compression Neuropathies through Volume Deformation
Authors: Mcdonald John S.  , Yagel Roni  , Schmalbrock Petra  , Stredney Don  , Reed David M.  , Sessanna Dennis
Published: February 2025

This paper describes an interdisciplinary effort to simulate and visualize the mechanisms involved in compression neuropathies, specifically tissue deformation occurring during vaginal delivery. These neuropathies often evolve into chronic pelvic pain. We present our methodologies of using high resolution magnetic resonance acquisitions from submillimeter pulse sequences to develop interactive computer simulations based on physically plausible volume models to drive 3D simulations of childbirth. This effort will elucidate tissue movements and mechanics involved in pain disorders and better explain the etiology of these disorders.
Neural network analysis of biochemical markers for early assessment of acute myocardial infarction
Authors: Ellenius Johan  , Groth Torgny  , Lindahl Bertil
Published: February 2025

Neural network analysis was applied for early diagnosis/exclusion of acute myocardial infarction and prediction of infarct size. Eighty-eight patients admitted with onset of chest pain within 8 hours were included. Frequent blood samples for measurement of myoglobin, CK-MB and troponin-T were obtained and used in the development of a set cf neural network components of a decision support system. The results indicate that this approach could provide useful support for assessment of patients with suspected AMI.
Integration of Digital Angiography and γ-camera Diagnostic Modalities to a Generalized Hospital Information System
Authors: Doukoglou Tilemachos D.  , Bacharakis Eustathios  , Kamilatos Iraklis  , Strintzis Michael G.  , Haloutsos Georgios
Published: February 2025

Within the framework of the NIKA project’ for the development of a “Generalized System for Processing and Management of Medical Images”, we have integrated a Digital Subtraction Angiography (DSA) station and a γ-camera diagnostic modality to the newly developed generalized hospital-wide information system. The integration consists of acquiring, digitizing, converting and filing the information from the above diagnostic modalities to the hospital's Picture Archiving and Communication System (PACS). The PACS, which is installed in the Onasio Cardiosurgery Centre of Athens, Greece, is responsible for archival, cataloging, retrieval and viewing of the large volume of patient examination data accumulated during his/her stay in the Centre. The ultimate goal is for all patient data, from all different examinations, to be viewed on dedicated client workstations. Information from different modalities can then be simultaneously presented to the attending physician, for a complete picture of the patient history and condition.
Medical Informatics Training Programme to Support the Romanian Health Care Management Information System
Authors: Bazavan Mariana  , Dimitriu Rodica
Published: February 2025

The Health Management Information System (HMIS) project initiated by the Ministry of Health as a component of the healthcare reform is aiming to ensure the technical, functional and operative support for: i) a better overview of the population health status, of the medical care needs and of the Health System performances; ii) the improvement of the resource allocation and consumption; iii) reform support. This system is supposed to assure a better information flow from the lower to the upper levels of the healthcare network by help of a modem IT support. In the first development stage the system is planned to link the Ministry of Health with the 41 District Health Authorities (DHAs) and with more than 200 pilot health units. The implementation of such a large system raises serious problems of acceptability and a thorough training programme for both technical staff and end users must be considered in order to face this challenge.
Nursing Process Redesign with the Implementation of a Computer Based Patient Record in the Ambulatory Setting
Authors: Murphy J.A.  , Ahlstrom J.S.
Published: February 2025

Increasingly, health care organizations are considering moving to Computer Based Patient Records (CPR), a trend driven by managed care and capitated payments. Central to the change is recognition of the need for community based and clinically relevant information systems that span the care continuum. Thus, Aurora Health Care chose to start their CPR effort in the ambulatory setting as the focus of health care delivery in the evolving paradigm. This paper describes computerization of the ambulatory record in a 45 physician clinic and associated workflow redesign. Months were spent in the processes of: current state documentation and analysis, future state design, detail system design, and workflow reengineering. There was substantial impact on nursing care delivery with computer system interaction at the point of care in the exam room. Access to clinically relevant longitudinal data was found key to the implementation and evaluation of Care Management strategies.
The Nightingale Tracker™: Information Technology for Community Nursing Education
Authors: Elfrink V.L.  , Martin K.S.  , Davis L.S.
Published: February 2025

The international health care delivery system is evolving to include an increased emphasis on community care and automated clinical information and communication systems. These trends are dramatically affecting nursing education in the U.S. as faculty consider the strategies needed to communicate with their students at multiple clinical sites, and to educate students to fulfill their changing practice roles. In response to these changes, FITNE, Inc. is using triangulated research methods to develop an information technology system for use in community nursing education. Named the Nightingale Tracker, this system will: (1) facilitate real time voice and data distance communication between students at the point of care and their instructors, and (2) electronically process clinical data related to community nursing education visits. The Nightingale Tracker was pilot tested in 1996; findings will be used to plan a national beta test. Project completion is scheduled for late 1997.
The Spanish social security smart card project (TASS Project)
Authors: de la Higuera J.M.
Published: February 2025

The Spanish Ministry of Labour and Social Affairs is working jointly with the Healthcare Services in implementing radical changes in administration by introducing a Social Security Card for all individuals in Spain. The card is to be used in all transactions with Social Security and Healthcare and contains personal and biometric information that will be used for secure identification.
Computerized Endoscopic Surgical Grasper
Authors: Hannaford Blake  , Trujillo Jason  , Sinanan Mika  , Moreyra Manuel  , Rosen Jacob  , Brown Jeff  , Leuschke Rainer  , MacFarlane Mark
Published: February 2025

We report a computerized endoscopic surgical grasper with computer control and a force feedback (haptic) user interface. The system uses standard unmodified grasper shafts and tips. The device can control grasping forces either by direct surgeon control, via teleoperation, or under software control. In this paper, we test an automated palpation function in which the grasper measures mechanical properties of the grasped tissue by applying a programmed series of squeezes. Experimental results show the ability to discriminate between the normal tissues of small bowel, lung, spleen, liver, colon, and stomach. We anticipate applications in telesurgery, clinical endoscopic surgery, surgical training, and research.
UltraTrainer-A Training System for Medical Ultrasound Examination
Authors: Stallkamp Jan  , Wapler Matthias
Published: February 2025

This paper introduces the prototype of the computer program UltraTrainer, which could simplify the education and training of physicians working with medical ultrasound systems. The UltraTrainer replaces probe and patient by a magnetical tracking system and 3D-data from a real examination, which are registered with a phantom. In this way the UltraTrainer makes a simulation of the real ultrasound examination possible, which can be useful for students and physicians. This paper describes the system components and gives an overview of potential applications.
Dental Interview System with a Native-language Interpreting Engine
Authors: Ojima Miki  , Tamagawa Hiroo  , Hayashi Naoji  , Shizukuishi Satoshi
Published: February 2025

We developed a Dental Interview System with a Native-language Interpreting Engine (DISNIE) on the Internet. DISNIE uses simple natural sentences without dental terminology and interprets these sentences in five languages such as Japanese, English, Korean, Chinese and French, respectively.DISNIE is a good tool not only for patients who are able to read, write and speak only their mother languages but also for the staff at a dental hospital because of its accessibility via the Internet.
Length of the Multifidus Muscle in Adolescent Idiopathic Scoliosis
Authors: Maruyama Toru
Published: February 2025

The aetiology of adolescent idiopathic scoliosis(AIS) remains unknown. If the muscular tissue is an aetiologic factor of AIS, the multifidus muscle is a key structure, because its action causes vertebral rotation. The multifidus originates from the mammillary process, that is a small tubercle adjacent to the base of the transverse process, and it goes up by three to six vertebral levels and inserts to the small bony tubercle on the posterolateral aspect of the spinous process. 3-D coordinate value of the origin and insertion of the multifidus were determined on the 3-D CT image of 10 AIS patients to calculate the length of the multifidus. Comparison of the length of the multifidus on both sides of the 13 curves demonstrated that the multifidus on the convex side of the curve was significantly longer than that on the concave side. A multiple regression analysis revealed that this asymmetry of the multifidus length was correlated with the scoliotic deformity in the frontal plane, but not with the rotational deformity in the horizontal plane. These results suggest that the multifidus is not an aetiologic factor of AIS.
Surgeon-Tool Force/Torque Signatures - Evaluation of Surgical Skills in Minimally Invasive Surgery
Authors: Rosen Jacob  , Macfarlane Mark  , Richards Christina  , Hannaford Blake  , Sinanan Mika
Published: February 2025

The best method of training for laparoscopic surgical skills is controversial. Some advocate observation in the operating room, while others promote animal and simulated models or a combination of surgical related tasks. The mode of proficiency evaluation common to all of these methods has been subjective evaluation by a skilled surgeon. In order to define an objective means of evaluating performance, an instrumented laparoscopic grasper was developed measuring the force/torque at the surgeon hand/tool interface. The measured database demonstrated substantial differences between experienced and novice surgeon groups. Analyzing forces and torques combined with the state transition during surgical procedures allows an objective measurement of skill in MIS. Teaching the novice surgeon to limit excessive loads and improve movement efficiency during surgical procedures can potentially result in less injury to soft tissues and less wasted time during laparoscopic surgery. Moreover the force/torque database measured in this study may be used for developing realistic virtual reality simulators and optimization of medical robots performance.
Bed Utilization Performances Of Slovenian And Croatian Acute Hospitals Systems
Authors: Premik Marjan  , Mayer Vladimir  , Kuzman Marina  , Mayer Miroslav
Published: February 2025

With Barber-Johnson-Yates scattergrams (BJYS), the performances of Slovenian and Croatian acute hospital system were explored by taking turnover interval as a predictor variable, length of stay as a dependent variable, and by looking at the variables of bed throughput and percentage of bed emptiness on installed network.
Power of Heterogeneous Computing as a Vehicle for Implementing E$^{\3}$ Medical Decision Support Systems
Authors: Podgorelec Viii  , Brest Janez  , Kokol Peter
Published: February 2025

A computer system of PCs, workstations, minicomputers etc., connected together via a local area network or wide area network represents a large pool of computational power. Our aim is to use this power for the implementation of E3(efficiency, effectiveness, efficacy) medical decision support system, which can be based on different models; the best of them are providing an explanation together with an accurate and reliable response. One of the most viable among models are decision trees, already used for many medical decision making purposes. In this paper we would like to present a heterogeneous implementation of genetic algorithm for the induction of decision trees with emphasis on solving the mitral valve prolapse syndrome.
Telematics applications to support the role of the community pharmacists as self-medication advisors
Authors: Sanz Ferran  , Sil Veira Claudio  , Alonso Albert  , Diaz Carles  , Loza Maria Isabel  , Cordero Luis  , Fernandez-Llimós Fernando  , Tiddens Lisette  , Giorgio Flora  , Cranz Hubertus  , Mircheva Jasmina
Published: February 2025

One of the applications developed within the EU-funded projects TESEMED and TESEMED-II is a program for the information and continuous training of community pharmacists, with the aim to empower them as advisors of the citizens about self-medication topics. Several programs are being developed on the basis of ad-hoc developed protocols about minor ailments (currently, cold and flu, haemorrhoids, constipation and cough). Each program includes three modules: a hypertextual version of the protocol, an interactive scheme of it, and an educational tool called Encounter Simulator, that trains the pharmacist about the protocol by means of simulated pharmacist-customer interactions. The testing of these applications with 84 community pharmacists offers positive results in terms of expectations, program characteristics and perceived usefulness.
An experimental electronic patient record for stroke patients
Authors: van der Meijden M.J.  , Tange H.J.  , Boiten J.  , Troost J.  , Hasman A.
Published: February 2025

This contribution describes an electronic patient record for stroke patients at the neurology ward of the Maastricht University Hospital. Daily practice at the ward will be supported with the developed electronic patient record that integrates both the medical and the nursing record, that will provide decision support and it will be connected to the hospital information system. In an evaluation project wc will study the effects of the usage of the electronic patient record and additional effects of providing decision support
DIABCARD Core System - A Chip Card Medical Information System For Diabetes Care
Authors: Gogou G.  , Mavromatis A.  , Maglaveras N.  , Pappas C.  , Engelbrecht R.
Published: February 2025

A chip card based medical information system was developed as a good possibility to create a portable electronic patient record. The produced software module provides an on-line, portable diabetes medical record information system. In particular the patient data card makes the up-to-date patient's record available whenever needed. The developed Core System includes a patient record management system that has the ability to handle topics such as medical anamnesis, administrative, medical and physical examination data. Issues tackled were simplicity, data security and reporting. Customization and internationalization were also covered by presenting a novel approach using native initialization files. Proper care has been addressed during the development of the software modules for matters of security, data integrity and confidentiality.
Catheter Insertion Simulation with Co-registered Direct Volume Rendering and Haptic Feedback
Authors: Gobbetti Enrico  , Tuveri Massimiliano  , Zanetti Gianluigi  , Zorcolo Antonio
Published: February 2025

We have developed an experimental catheter insertion simulation system supporting head-tracked stereoscopic viewing of volumetric anatomic reconstructions registered with direct haptic 3D interaction. The system takes as input data acquired with standard medical imaging modalities and regards it as a visual and haptic environment whose parameters are interactively defined using look-up tables. The system's display, positioned like a surgical table, provide a realistic impression of looking down at the patient. Measuring head motion via a six degrees-of-freedom head tracker, good positions to observe the anatomy and identify the catheter insertion point are quickly established with simple head motion. By generating appropriate stereoscopic images and co-registering physical and virtual spaces beforehand, volumes appear at fixed physical positions and it is possible to control catheter insertion via direct interaction with a PHANToM haptic device. During the insertion procedure, the system provides perception of the effort of penetration and deviation inside the traversed tissues. Semi-transparent volumetric rendering augment the sensory feedback with the visual indication of the inserted catheter position inside the body.
A Secure Web-based Medical Digital Library Architecture based on TTPs
Authors: Papadakis Ioannis  , Chrissikopoulos Vassilios  , Polemi Despoina
Published: February 2025

In this paper, a secure medical digital library architecture is presented, that is based on the CORBA specifications for distributed systems. Special attention is given to the distinguished nature of medical data, whose integrity and confidentiality should be preserved at all costs. This is achieved through the employment of Trusted Third Parties (TTP) technology for the support of the required security services.
A Personalised Healthcare Information Delivery System: Pushing Customised Healthcare Information Over the WWW
Authors: Abidi Syed Sibte Raza  , Goh Alwyn
Published: February 2025

Easier and focused access to healthcare information can empower individuals to make ‘informed’ choices and judgements about personal health maintenance. To achieve ‘optimum’ patient empowerment, we need to re-evaluate and potentially re-design the processes of healthcare information delivery. Our suggestion is that healthcare information should be personalised according to each individual’s healthcare needs and it should be pro-actively delivered, i.e. pushed towards the individual. We present an intelligent Personalised Healthcare Information Delivery Systems that aims to enhance patient empowerment by pro-actively pushing customised, based on one's Electronic Medical Record, health maintenance information via the WWW.
Design, Implementation and Evaluation of a Clinical Decision Support System to Prevent Adverse Drug Events
Authors: Fiol Guilherme Del  , Rocha Beatriz H.S.C.  , Nohama Percy
Published: February 2025

Adverse drug events are known to be a major health problem worldwide. It is estimated that the annual costs related to these events in the United States are greater than the total costs with cardiovascular disease care. Decision support systems that assist drug ordering have demonstrated to be a powerful tool to prevent prescription errors and adverse drug events. On the other hand, some issues related to the development, implementation, configuration, and evaluation of these decision support systems still need further research. This paper presents the development and evaluation of a decision support system prototype that helps with the prevention of adverse drug events by detecting drug-drug interactions in drug orders. The structure of the system tries to solve some of the problems described by the literature, such as integration with hospital information systems, adaptability to local needs, and knowledge base maintenance. The proposed model has shown to be an effective method for representing drug-drug interactions. The prototype was evaluated by a retrospective study using a dataset with 37.237 prescriptions. The system was able to detect 10.044 (27,0%) orders containing one or more drug-drug interactions. Among these interactions, 6,4% had high severity. In a future study, it is intended to apply the developed system in a real-time on-line environment, evaluating the benefits achieved in terms of improvement in medical practice and patient outcomes.
The Future of Information Technology for Health in Developing Countries
Authors: Ratzan Scott C.  , Busquets Maria I.
Published: February 2025

What is the future of communication technology for health in developing countries? This chapter sets out to answer this question by first considering the background and potential of information technology, identifying some of the issues and trends in communication, and finally following with some challenges and opportunities of how communication technologies can make a difference in health in developing countries. Past research has shown that communication can contribute to all aspects of population, health, and nutrition programs and is relevant in a number of contexts. Some of the trends in using information technology can be classified in the following categories: competition, cognitive-based presentations, comprehensive translation, convergence, and culture. Challenges include finding a way to include the South in the exchange of ideas and information. In addition, reaching a consensus on worldwide quality standards will not be easy. Yet, beyond these challenges, there are many opportunities being created for international development agencies to increase their capacity for impact.
Telemedicine Used in a Simulated Disaster Response
Authors: Balch David C.  , West Vivian L.
Published: February 2025

In June 2000, the Telemedicine Center at the Brody School of Medicine, East Carolina University in Greenville, NC participated in a simulated disaster response in Pu'u Paa, Hawaii, a lava plain without running water, electricity, or human habitation. During the five-day exercise we evaluated the ability to establish telecommunications and the effectiveness of the infrastructure, services, and applications implemented for an operational global emergency response. Scaleable technologies were configured and systematically tested to determine the ability to provide medical and health care in an austere environment. A medical communications matrix was constructed and used throughout the evaluation. Results show that telemedicine can be an important contribution to humanitarian relief efforts and medical support following disasters. Additional research is needed to build upon the lessons learned from participation in this exercise.
An Experiment in Sharing and Reusing OncoDoc's Breast Cancer Guideline Knowledge
Authors: Séroussi Brigitte  , Bouaud Jacques  , Antoine Éric-Charles  , Zelek Laurent  , Spielmann Marc
Published: February 2025

Developed and experimented at the Service d'Oncologie Médicale Pitié-Salpêtrière (Paris, France) as a computer-based breast cancer guideline system, OncoDoc has already proven to improve physicians' compliance. The underlying methodology relies on a decision-tree knowledge base that the clinician interprets in the context of an actual patient. In order to test whether the implemented strategy and the encoded knowledge base could be reused and shared in another institution, we have experimented the system at the Institut Gustave Roussy with only minor but legitimate customizations. For each patient, clinicians had to record their a priori therapeutic attitude, to use the system, to evaluate the system, and to record their final decision. Adherence (79%) and compliance (88%) rates were even higher than those previously observed. In addition, the approach appeared to influence clinicians' behavior—16% of initial decisions were changed to comply with recommendations—and to increase clinical trial accrual (+50%).
Assessment of the GALEN Methodology on Holistic Classifications for Professions Allied to Medicine
Authors: Nape Huib Ten  , Rogers Jeremy
Published: February 2025

In the field of health care terminology it has proven to be difficult, but not impossible, to build a formal Reference Model (knowledge-model) for medical terminology. The intuition is that it is even more difficult to build such a reference model for the so called ‘holistic’ classification schemes as used by Nursing and Allied Health Care Professionals. There is a growing perceived need for formal reference models for specific professional groups. These reference models are used in many different ways, such as for building, maintaining and manipulating classification schemes. This paper focuses on the usability of the GALEN methodology for the formalisation of the Dutch Classification of Pain (NCP) as an example of such a ‘holistic classification’. The first results of this exploration show that the GALEN methodology is very useful for analysing and understanding a' holistic classification'. A high number of necessary concepts from the NCP already exist within the OpenGalen Common Reference Model-2 (OCRM2). A substantial number of concepts from the NCP do not yet exist in the OCRM2 or are underspecified. Additional modelling of the OCRM2 has to be performed, to enrich the expressivity of the model.
Methods for Exploring the Semantics of the Relationships between Co-occurring UMLS Concepts
Authors: Burgun Anita  , Bodenreider Olivier
Published: February 2025

Objective: To characterize the relationships among UMLS concepts that co-occur as MeSH descriptors in MEDLINE citations (1990-1999). Design: 18,485 UMLS concepts involved in 7,928,608 directed pairs of co-occurring concepts were studied. For each directed pair of concepts Cl-C2: (i) the “family” of Cl was built, using the UMLS Metathesaurus, and we tested whether or not C2 belonged to Cl's family; (ii) we used the semantic categorization of Metathesaurus concepts through the UMLS Semantic Network and Semantic Groups to represent the semantics of the relationships between Cl and C2. Results: In 6.5% of the directed pairs, the co-occurring concept C2 was found within the “family” of Cl. Detailed results are given. The most frequent co-occurrences involved “Chemicals & Drugs” and “Chemicals & Drugs”, as well as “Disorders” and “Chemicals & Drugs”. Discussion: This work takes advantage of both symbolic and statistical information represented in the UMLS, and analyzes their overlap. Further research is suggested.
Algorithm-based Decision Rules to Safely Reduce Laboratory Test Ordering
Authors: Schubart Jane R.  , Fowler Chad E.  , Donowitz Gerald R.  , Connors Jr. Alfred F.
Published: February 2025

PURPOSE: Our study develops decision rules to define appropriate intervals at which repeat tests might be indicated for commonly ordered laboratory tests for hospitalized patients.
Use of HL7 to Integrate a HIS-subsystem: Limits and Possibilities
Authors: Flaiga Monika  , Graeber Stefan  , Sybrechta Gerhardt W.
Published: February 2025

Modern computer-based hospital information systems are mostly distributed with several heterogeneous subsystems connected together by specialized communication services. The common standard to integrate subsystems is HL7. By the example of subsystem integration for a pulmonary function test lab, we discuss the possibilities of HL7, the limits we encountered and how we overcame these.
e-Health in Eating Disorders: Virtual Reality and Telemedicine in Assessment and Treatment
Authors: Riva Giuseppe  , Bacchetta Monica  , Cesa Gianluca  , Conti Sara  , Molinari Enrico
Published: February 2025

e-health, the integration of telehealth technologies with the Internet and shared virtual reality could become a significant enabler of consumer health initiatives. In fact, they provide an increasingly accessible communication channel for a growing part of the population. In the past decade medical applications of virtual reality (VR) and telemedicine have been rapidly developing, and the technology has changed from a research curiosity to a commercially and clinically important area of medical informatics technology.
A Generic Arthroscopy Simulator Architecture
Authors: Wills D P M  , Abblard E  , Sherman K P
Published: February 2025

Virtual Environments offer considerable potential to improve training for arthroscopic surgery. However, current systems are developed for individual joints, which requires healthcare providers to purchase and maintain multiple environments with differing interfaces and capabilities. This paper describes a generic arthroscopy system architecture that allows the fast development of training environments for any joint, each sharing a common user-interface. The use of the architecture in developing a simple ankle simulator is also described.
Tools for Constructive Assessment of bids to a Call for Tender - some experiences
Authors: Brender Jytte  , McNair Peter
Published: February 2025

The paper describes the experiences from a full-scale case study applying a number of novel assessment techniques for selecting among income bids at a call for tender, based on a User Requirements Document that comprises non-prescriptive, goal-oriented requirements.
Impact of Site-Specific Customizations on Physician Compliance with Guidelines
Authors: Bouaud Jacques  , Seroussi Brigitte
Published: February 2025

Developed and implemented in the Service d'Oncologie Médicale Pitié- Salpêtrière (Paris, France) as a computer-based guideline system on breast cancer, OncoDoc has already demonstrated high physician compliance rates. To assess how the system could be reused in another institution which was not involved in the development process, we have conducted a new experimentation at the Institut Gustave Roussy. Minor site-specific customizations of the knowledge base have been performed. After four months, 127 cases were recorded. Results showed that there was no significant difference of physician compliance with OncoDoc (85%) when site-specific recommendations were, or not, available, although local recommendations were chosen preferably (55%), thus legitimating the adaptation.
Which clinical decisions benefit from automation? A task complexity approach
Authors: Sintchenko Vitali  , Coiera Enrico
Published: February 2025

This paper describes a model for analysing medical decision making tasks and evaluation of their suitability for automation. The overall approach focuses on the assessment of decision complexity and possible reduction of human effort by automated decision support. The approach consists of five subsequent steps: (1) selection of the domain and relevant tasks; (2) evaluation of the knowledge complexity for tasks selected; (3) selection of potentially most cognitively demanding task; (4) assessment of unaided and aided effort requirements for this task accomplishment; and (5) selection of computational tools to achieve this complexity reduction. The model described allows for task automation without lowering of decision quality.
Surgical Management of a Congenital Kyphotic Deformity in an Adolescent
Authors: Christodoulou A.  , Ploumis A.  , Terzidis J.  , Tapsis K.  , Hantzidis P.
Published: February 2025

This is a case of an adolescent with kyphoscoliosis due to congenital partially segmented vertebrae T12, L1, L2 who was treated operatively by a back-front-back, one stage operation.
The Use of Cognitive Methods in Analyzing Clinicians’ Task Behavior
Authors: Jaspers M. W. M.  , Steen T.  , Van Den Bos C.  , Geenen M.
Published: February 2025

To ensure the acceptance and routine use of information Systems in heathcare tight coupling is required between the work practices of potential end- users and the Systems functionalities and presentation of these functionalities via the user interface. The application of methods from cognitive engineering during requirement analysis may contribute to the support of healthcare work practice by computer Systems. We applied the think aloud method in combination with video analysis during the requirement analysis phase in designing a user interface for a patient information retrieval system. These methods provided a detailed insight in the infomiation needs of physicians and the way in which they search through this information in preparing a patient visit. Using these insights in end- users work practices in the early phase of user interface development may lead to a better fit between physicians’ work practices and the supporting computer System.
Real-time 3D Deformation Imaging of Abdominal Organs in Laparoscopy
Authors: Hayashibe Mitsuhiro  , Suzuki Naoki  , Nakamura Yoshihiko  , Hattori Asaki
Published: February 2025

In laparoscopic surgery, surgeons encounter particular difficulties during the course of the operation. Due to the restricted view from the endoscope and the limited degree of freedom using forceps, surgeons find their movements impeded. It would be necessary to develop a support system to provide surgeons with improved laparoscopic vision. If real-time visualization of the abdominal anatomy is possible, it will be useful for accurate procedure and quantitative evaluation. In this paper, The laser-scan endoscope system acquires and visualizes the shape and texture of the area of interest in a flash of time. Results of in-vivo experiments on the liver of a pig verify the effectiveness of the proposed system.
Knowledge Representation in Digital Medical Documents for Efficient Information Access and Retrieval
Authors: Hoelzer Simon  , Schweiger Ralf Kurt  , Dudeck Joachim
Published: February 2025

Information access and retrieval are essential to serve the delivery and application of evidence-based medicine. The literature provides evidence for the effectiveness of computerization of medical knowledge for increasing compliance with current standards and improving patient outcomes. But all efforts in implementing knowledge-based functions remain limited in respect of either the prolonged exposure to live clinical use, the complexity of knowledge content supported, the dependencies on a technology platform and host system, or the proof of use and content sharing across multiple and varying environments. We have to face currently an information overload, especially in medicine. As a result, efficient ways of implementation of evidence-based care become more and more important. Most of the medical knowledge contained in textbooks, guidelines, journals as well as online resources is text-based. In order to present problem-specific information at the point of care the outlined concept relies on a document-based solution with the eXtensible Markup Language (XML). The adoption of XML as a standard for the publication and interchange of documents creates a great opportunity for better information retrieval. On the basis of structured data we are able to improve the search quality for clinical information which forms a crucial pre-requisite for the implementation of evidence-based care.
Teaching Arden Syntax using a simulated environment
Authors: Karadimas Harry  , Hemery Francois  , Chailloleau Christophe  , Lepage Eric
Published: February 2025

The Arden Syntax is a simple syntax that allows physicians to encode medical knowledge in small modules, called medical logic modules (MLM). These MLM are well suited to data-driven alerts and reminders. While the Arden syntax is simple to teach, the students are most of the time limited to the writing of modules and the verification of the module’s syntax. Our work proposes an environment that simulates various elements required by MLMs, allowing the students to execute the MLMs they have written immediately. This provides the necessary feedback to understand in depth the inner workings of MLMs.
Patient Relation Management: a relevant solution to connect the links of a healthcare chain
Authors: Michel-Verkerke Margreet B.  , Spil Ton A.M.  , Schuring Roel W.
Published: February 2025

The USIT-tool is used to investigate the health care chain of Multiple Sclerosis (MS) in a Dutch region. The advantage of the USIT-tool is that is results in insight in the relevant problems, solutions and constraints of the caregivers both in the organisational and the information technological area. The main problem in the MS-health care chain proved to be the lack of co-ordination and the inefficient communication between caregivers. Although most caregivers were convinced of the need to improve delivered care for MS-patient, most of them also expressed that they would spend little time and energy on improving MS-care, because of the low relevance of MS-care compared to other kinds of care. To improve care, taking in account this constraint we propose to build a Patient Relation Management (PRM) System. A PRM is a simple web-based application that is based on agreement by the caregivers about the route an MS-patient should follow through health care. PRM supports routing, tracking and tracing of a patient and supplies the caregivers with professional guidelines. The PRM-concept can easily be expanded, to other patient groups or diseases and can serve as a first step to a regional Electronic Patient Record. It is likely that we would have suggested a far more complicated ICT solution if we had only analysed the MS-care process as such, without specific consideration of the USIT dimensions. The USIT analysis helped us to balance the breadth of the proposed solution with the nature of the situation the future users of the system are in.
Introducing a Novel Haptic Interface for the Planning and Simulation of Open Surgery
Authors: Lapeer Rudy J.  , Gasson Paul  , Florens Jean-Loup  , Laycock Stephen  , Karri Vasu
Published: February 2025

Existing simulation software, originally developed for the simulation and planning of inguinal hernia repair, was fused with two haptic feedback devices: the SensAble Technologies Phantom Desktop®, and the ACROE/ICA Telluris system. The former allows easy integration on a PC-based platform, though in the long run, the Telluris system is preferred because of its robustness and its ability to design custombuilt solutions.
Quantifying Surgeon Grasping Mechanics in Laparoscopy Using the Blue DRAGON System
Authors: Brown Jeffrey D.  , Rosen Jacob  , Chang Lily  , Sinanan Mika N.  , Hannaford Blake
Published: February 2025

Mechanical testing of abdominal organs has a profound impact on surgical simulation and surgical robotics development. Due to the nonlinear and viscoelastic nature of soft tissue it is crucial to test them in surgically relevant ranges of applied force, deformation, and duration for incorporating haptic realism into surgical simulators and for safe operation of surgical robots. In order to determine these ranges, a system known as the Blue DRAGON was used to track the motions and the forces applied to surgical tools during live procedures for quantifying how surgeons typically perform a minimally invasive surgical procedure. Thirty-one surgeons of varying skill were recorded performing three different surgical tasks. Grasping force (as applied to the tool handles) and handle angle for each tool were the signals of interest among 26 channels total acquired by the system in real time. These data were analyzed for their magnitudes and frequency content. Using the tool contact state, an algorithm selected tissue grasps to analyze measures during grasps only, as well as obtain grasp durations. The mean force applied to the tool handles during tissue grasps was 8.52 N ± 2.77 N; maximum force was 68.17 N. Ninety-five percent of the handle angle frequency content was below 1.98 Hz d 0.98 Hz. Average grasp time was 2.29 s ± 1.65 s, and 95% of all grasps were held for 8.86 s ± 7.06 s or less. The average maximum grasp time during these tasks was 13.37 s ± 11.42 s. These results form the basis for determining how abdominal tissues are to be mechanically tested in ranges and durations of force and deformation that are surgically realistic. Additionally, this information may serve as design specifications for new surgical robots or haptic simulators.
Cost-Effective Health Services for Interactive Continuous Monitoring of Vital Signs Parameters – the e-Vital Concept
Authors: Prentza Andriana  , Angelidis Pantelis  , Leondaridis Lefteris  , Koutsouris Dimitris
Published: February 2025

The objective of the e-Vital project is the validation of the market concerning the provision of a novel remote telemedicine service aimed at large sensitive parts of the European population, the “at-risk” citizens, who are usually patients with a stable medical condition that allow a near normal life but may suddenly deteriorate and put life at risk. This service will increase their quality of life and their feeling of safety concerning their health. The e-Vital project focuses on the implementation and exploitation of a modular and ambulatory secure telemedicine platform, which is using easily wearable vital signs monitoring devices, causing minimal discomfort to patients, and which transfer in real time and on-line critical vital parameters to doctors and/or medical experts/consultants, regardless of their location, while getting feedback to increase their feeling of comfort or in case of alarm. The interactive continuous monitoring promises cost effective health services, more active involvement of patients in their own care, and a new sense of realism in making a diagnosis.