bluuebunny/crossref_metadata_2025 huggingface dataset:
Database for gynecological laparoscopy
Authors: Bernad Elena  , Bernad Sandor  , Munteanu loan
Published: February 2025

Laparoscopy is a wonderful tool for performing gynecologic surgery. Whether or not laparoscopic surgery is advisable to diagnose or treat a particular gynecologic problem requires a careful consultation with an experienced gynecologist, who can help the patient weight the pros and cons of laparoscopy versus other options. For the management of this kind of surgical intervention we realise a computer based patient record.
3 Overview on Security Standards for Healthcare Information Systems
Authors: Kokolakis Spyros  , Gritzalis Dimitris  , Katsikas Sokratis  , Ottes Fenno
Published: February 2025

The intense need for Healthcare information exchange has revealed a lack of interoperability of systems and applications. Security controls, usually based on proprietary methods and techniques, aggravate the current situation. However, timely development of HIS security standards may improve the interoperability and enable the integration of systems. This chapter provides an overview of the standardisation work that is being done by official standardisation organisations in Europe and world-wide.
A Virtual Reality System for Hand Acupuncture
Authors: Kim K.H.  , Choi Y.K.  , Lee E.T.  , Ryou W.B.
Published: February 2025

A virtual reality system for the hand acupuncture treatment is proposed. The hand acupuncture, called sujichim, is mostly conducted at home and many people try to learn and apply it to the health care of their family. Using our system, a novice can easily perform the acupuncture by himself to improve his body condition. According to the experiments, our system is proved to be very effective and easy to use.
A More Efficient Method of Texture Use in Surgical Robot Simulation
Authors: Lin Ying-Wei  , Schermeier Olaf  , Lueth Birgit  , Albrecht Jochen
Published: February 2025

Texture mapping is a crucial supplement to modeling in 3D graphic simulation technology. Relatively small objects in a simulation environment can be represented with textures rather than by modeling, which helps economize on precious data storage space. Textures also lend some surfaces a more realistic appearance, both for the user and the viewer. The production of a texture, however, is a very complex process of repeated trial-and-error approximations. This inspired the idea of using mathematical formulas to determine the optimal texture so that the desired simulation environment is achieved with maximum effect and efficiency. In this paper the mathematical formulas for producing optimal texture are described. The results are presented as applied in a surgical robot simulation environment in an operating room.
Intuitive Operation Planning Based on Force Feedback
Authors: Münchenberg J.  , Wörn H.  , Brief J.  , Kübler C.  , Hassfeld S.  , Raczkowsky J.
Published: February 2025

In the craniofacial surgery image-slices obtained from tomographies are used for planning and simulation of surgical interventions. Using these image-slices three-dimensional geometric models can be reconstructed, representing bones and soft tissue. However, for planning complex surgical interventions simulation methods are needed additionally to the pure visualisation. Exemplary, planning a Frontal Orbital Advancement (FOA) operation the cutting trajectories, their depth and orientation in each point, the drill hole, the position, orientation and deformation of bones, etc. are the point of interest. Especially for intraoperative execution supported by navigation systems or robots. In order to be able to plan such complex interventions with the help of computers, geometrical and haptical models must be generated from the image-slices. On the one hand these models represent the anatomical structures exactly, on the other hand they are needed for the simulation of the different activities, which have to be performed during the surgical intervention like drilling, milling, deforming, positioning, etc. Beside the geometrical and haptical models methods for interactions must be supplied to the physician for an accurate and intuitive planning of the surgical intervention. We developed such an operation planning system which is already used in clinical practise in Heidelberg.
Computer Assisted Surgery with 3D Robot Models and Visualisation of the Telesurgical Action
Authors: Rovetta Alberto
Published: February 2025

This paper deals with the support of virtual reality computer action in the procedures of surgical robotics. Computer support gives a direct representation of the surgical theatre. The modelization of the procedure in course and in development gives a psychological reaction towards safety and reliability.
LAHYSTOTRAIN
Authors: Voss Gerrit  , Bockholt Ulrich  , Los Arcos José Luis  , Müller Wolfgang  , Oppelt Peter  , Stähler Jan
Published: February 2025

Rapid developments in the medical field, as an expanding knowledge base and emerging new technologies require continuing medical education to achieve life long learning and to keep the surgeons up to date. Consequently, specific training is necessary to guarantee qualification of the surgeons. The goal of LAHYSTOTRAIN is to overcome the current drawbacks of traditional training methods for laparoscopic/hysteroscopic procedures. A computer-assisted simulator for training and quality control in laparoscopy and hysteroscopy is developed using Virtual Reality (VR), Multimedia (MM) technology, and Intelligent Tutoring Systems (ITS).
Design of a Distributed CORBA Based Image Processing Server
Authors: Giess Christoph  , Evers Harald  , Heid Volker  , Meinzer Hans-Peter
Published: February 2025

This paper presents the design and implementation of a distributed image processing server based on CORBA. Existing image processing tools were encapsulated in a common way with this server. Data exchange and conversion is done automatically inside the server, hiding these tasks from the user. The different image processing tools are visible as one large collection of algorithms and due to the use of CORBA are accessible via intra-/ internet.
General Compartmental Models of the Cardiovascular System
Authors: Ottesen Johnny T.
Published: February 2025

A systematic discussion on linear as well as non-linear compartmental models of the cardiovascular system and its various feedback mechanism is given. Most of the results are independent of explicit functional expressions. The topological structure of the model is essential for the response to a local change in peripheral resistance. Inclusion of Parallel paths versus serial paths gives qualitatively different response. Global asymptotic stability follows from the general theory.
A Baroreflex Model of Short Term Blood Pressure and Heart Rate Variability
Authors: Ten Voorde Ben J.  , Kingma René
Published: February 2025

Parameters based on heart rate variability alone or on both heart rate and blood pressure variability (baroreflex sensitivity) are becoming increasingly clinical relevant. Nevertheless a complete insight in physiological mechanisms underlying these parameters is still lacking. A computer model may help to fill up some of the gaps. We present a model which consists of a simple beat-to-beat hemodynamic part (Starling heart and Windkessel) linked to a detailed continuous modelled neural control part. The intermediate between continuous and beat-to-beat part is an integral pulse frequency modulator (IPFM) acting as cardiac pacemaker. Input for the IPFM is a “sympathovagal” balance signal, with different dynamics for sympathetic and vagal branches. Low-frequency variability is supposed to arise from resonance of existing noise, while high-frequency variability (respiration) is assumed to enter the closed loop at the hemodynamic (blood pressure) site. Results of three studies have been used for validation: (1) spontaneous variability in heart rate and blood pressure (baroreflex transfer functions), (2) vagal blockade with atropine, (3) a modified Valsalva manoeuvre performed in normal and quadriplegic man. Steady state as well as dynamic properties of the model reasonably well fitted to these experimental data.
Education and Training in the Medicom System
Authors: Marinos G.  , Palamas S.  , Vlachos I.  , Panou-Diamandi O.  , Kalivas D.  , Koutsouris D.
Published: February 2025

MEDICOM system is a world wide telematics application for electronic commerce of medical devices. It has been designed so as to provide the health care professionals with a central Internet access to up-to-date information about medical equipment from multiple manufacturers, in a particular easy and friendly way. Moreover, the Medicom system will serve the health care professionals’ requirements for high-quality information about specific products in a form of multimedia presentations and that of a secure communication channel with the community of manufacturers, especially for post marketing surveillance. The system will provide the medical staff (physicians and technicians) with demonstrations of the operation procedures and the functioning of high-tech equipment in a form of virtual models. Moreover, through the medicom system the end users of medical devices can have access to on line libraries and participate in special newsgroups. This paper discusses the architectural structure of the MEDICOM system with emphasis to its educational and training functionality.
WISECARE WWW-Server
Authors: Dounavis Petros  , Karistinou Emily  , Mantas John
Published: February 2025

The WISECARE project has collected a variety of clinical data from the Validation Sites. Thus a communication channel between the participants was established not only for the exchange of information but also for the exchange of data. Here we describe the design of the Web server of the WISECARE project as well as the establishment of the BSCW-server (Basic Support for Cooperative Work), which was a file depository for the documents produced for the project.
Incorporating Knowledge into Commercially Available Systems
Authors: Roberts Jean
Published: February 2025

The ways in which a potential commercial ‘user’ treats different knowledge types are explored in this paper. The issues are dealt with by the pragmatism with which a marketing manager might evaluate an opportunity. Academics are typically motivated by drivers that are different from a commercial ‘push’. Thus partnership is needed for a productive compromise; addressing questions such as why should academic institutions let commercial organizations have their intellectual capital. The paper considers issues of hand-over, product maintenance and a continued development partnership, especially in a volatile [Inter] net-based age.
Paperless Hospital: Reality, Dream or a Nightmare?
Authors: Madjaric Miroslav  , Nesek-Madjaric Vesna  , Leitner Hubert  , Köle Wolfgang  , Gell Günther  , Leodolter Werner
Published: February 2025

Public Hospitals of Styria (KAGes) are implementing new hospital information system (MEDOCS - MEdical and nursing Documentation and Communication network of Styria) in its 21 hospitals. One of the outstanding features of this system is the coverage of virtually all communication and documentation functions related to the patient. This should be the way to fulfill the conditions for gradually removing the paper as an information medium from daily hospital practice. This approach will be tested in the MEDOCS project at two evaluation sites. In this paper the authors discuss in form of "pros and contras" the chances and risks of this approach, as well as possible strategies during the steps of implementing the "paperless" hospital. Besides of general technological, medical and cultural considerations the paper discuss also the technical and economical aspects of "paperless" hospital implementation and production.
XML for Immediate Discharge Letters in Scotland
Authors: Woolman P.S.  , Oates J.  , Frame J.  , Hardy J.
Published: February 2025

This paper describes the results of the first UK project to send and receive discharge letters using XML as a message format for clinical data. The SIGN guideline for immediate discharge has broad clinical acceptance across Scotland and forms the basis for the discharge message content. NHS net as a secure private network and X400 as a secure email message format is intended for the final production systems. Internet mail was used for validating.
Rollenbasiertes Konzept für den Zugriff auf Patientendaten im Mainzer Uniklinikum
Authors: Sergl Marita
Published: February 2025

Zugriff auf Patientendaten im Krankenhaus und im besonderen automatisierter Zugriff über elektronische Medien kann nur unter strenger Berücksichtigung der geltenden Datenschutzbestimmungen geschehen. Die Datenschutzgesetze zur elektronischen Verarbeitung personenbezogener Daten und das Rheinland- Pfälzische Landeskrankenhausgesetz [8] stellen hohe Anforderungen an Zugriffskontrollkonzepte. Berechtigung zur Datenverarbeitung besteht nur im Zusammenhang mit dem Behandlungsauftrag des Patienten an einen Arzt oder eine klinische Einrichtung. Der Umfang der verarbeiteten Daten richtet sich exakt nach den Erfordernissen der Behandlung und den damit verbundenen Aufgaben wie z. B. Dokumentationspflicht nach §301. Die Funktionen verschiedener Personen bei der Wahrnehmung des Behandlungsauftrages müssen im Zugriffskontrollmodell abgebildet werden. Die Beschreibung der Funktionen erfordert eine standardisierte Sprache. Neben der Personal- und Einrichtungsstruktur des Klinikums spielen zeitliche Aspekte eine wesentliche Rolle. So verändert sich beispielsweise die Zusammensetzung der beteiligten Personengruppe durch die Verlegung des Patienten in eine andere Fachabteilung oder durch Anforderung von Diagnose- oder Therapieleistungen bei anderen Fachkliniken im Behandlungszeitraum. Der Beitrag stellt das Zugriffskontrollkonzept des Mainzer Uniklinikums vor, das auf der Basis rollenbasierter Zugriffsberechtigungen und einer Funktionsbeschreibung unter Zuhilfenahme des HL7-Protokolls umgesetzt wird.
Intranet Health Clinic: Web-based Medical Support Services Employing XML
Authors: Stalidis George  , Prentza Andriana  , Vlachos Ioannis N.  , Anogianakis George  , Maglavera Stavroula  , Koutsouris Dimitris
Published: February 2025

In this paper, the implementation of an Internet-based telematic service for medical support is presented, which operates in pilot form within the INTRANET HEALTH CLINIC project - a two-year project supported by the European Commission under the Health Telematics Programme. The aim of the application is to offer high quality care to users of health services over inexpensive communication pathways, using Internet-based, interactive communication tools, like remote access to medical records and transmission of multimedia information. The XML technology was employed to achieve customised views on patient data, according to the access rights of different users. Strict security and access control policy were implemented to ensure secure transmission of medical data through the Internet. The system is designed to collaborate with existing clinical patient record systems and to be adjustable to different medical applications. Current pilot implementations are under clinical evaluation and include oncological patients (Greece), Lupus Erythrematosis (Canada), Obstetrics (Belgium) and Chronic Obstructive Pulmonary disease (Spain).
The teleconsultation service ENDOTEL Implementation and first experiences
Authors: SußMann Helmut  , Griebel Hermann  , Allescher Hans-Dieter  , Egger Klaus  , Sandschin Werner  , Horsch Alexander
Published: February 2025

The multimedia teleconsultation service ENDOTEL launches in May 2000 with its asynchronous component. In the initial phase, three hospitals and four general practitioners use the service to consult a specialist in the domain of gastroenterology and endoscopy. By validation of the patient information, i. e. videos, voice clips, still images and text, the experts can decide the further proceeding, for example, whether a patient shall be transported to a specialized hospital or not (cost-saving). We report about the expieriences during the initiation and the first months of operation.
TelFam: A Telemedicine System for the Family Doctor Practices
Authors: Kurzynski Marek  , Puchala Edward  , Wozniak Michal
Published: February 2025

The paper presents the TelFam telemedicine service system to support the daily practice of family doctors. The TelFam system covers two basic telemedicine services: telemonitoring of patients, and teleconsulting. The system architecture is comprised by three main components: server in the teleconsulting center, the doctor workstations and patient’s home units. During a consultation a general practitioner and a specialist in the teleconsulting center exchange patient information, opinions, treatment suggestions and perform cooperative work on the same data in the WYSIWIS mode. Telemonitoring covers patient’s vital signs (ECG, respiration, body temperature, SpO2, blood pressure) which next are processed to assess the patient's state.
3-D image analysis of abdominal aortic aneurysm
Authors: Subasic Marko  , Loncaric Sven  , Sorantin Erich
Published: February 2025

In this paper we propose a technique for 3-D segmentation of abdominal aortic aneurysm (AAA) from computed tomography (CT) angiography images. Output data form the proposed method can be used for measurement of aortic shape and dimensions. Knowledge of aortic shape and size is very important for selection of appropriate stent graft device for treatment of AAA. The technique is based on a 3-D deformable model and utilizes the level-set algorithm for implementation of the method. The method performs 3-D segmentation of CT images and extracts a 3-D model of aortic wall. Once the 3-D model of aortic wall is available it is easy to perform all required measurements for appropriate stent graft selection. The method proposed in this paper uses the level-set algorithm instead of the classical active contour algorithm developed by Kass et al. The main advantage of the level set algorithm is that it enables easy segmentation surpassing most of the drawbacks of the classical approach. In the level-set approach for shape modeling, a 3-D surface is represented by a real 3-D function or equivalent 4-D surface. The 4-D surface is then evolved through an iterative process of solving the differential equation of surface motion. Surface motion is defined by velocity at each point. The velocity is a sum of constant velocity and curvature-dependent velocity. The stopping criterion is calculated based on image gradient. The algorithm has been implemented in MATLAB and C languages. Experiments have been performed using real patient CT angiography images and have shown good results
A Windows Based Viewing Application for Image Postprocessing in DICOM Format
Authors: Gillessen C  , Ricke J  , Haderer A  , Zielinski C  , Teichgräber U  , Ehrenstein T  , Felix R
Published: February 2025

Objective: To design, implement and evaluate a PC-based medical viewing application including image postprocessing for DICOM images for use within an existing hospital infrastructure. Material and methods: A user-friendly DICOM compliant viewing application including image postprocessing (spatial frequency and contrast enhancement) and HL7 communication ability was designed and implemented on PC basis to run under Windows OS. To assess its quality compared to high-end workstations, an ROC analysis was performed. Results: The use of image postprocessing on a PC significantly improved the perception of low-contrast details in computed radiographs. Review at a radiological workstation was superior to review at a PC with image postprocessing.
Lossless Compression of Emission Tomography Images
Authors: Mykkänen Jouni  , Tossavainen Timo  , Juhola Martti
Published: February 2025

An adaptive lossless compression method using predictive coding with the Rice codes is proposed for low resolution three-dimensional biomedical images. The method is evaluated with the brain positron emission tomography (PET) images. The results are considerably better than with static arithmetic coding.
Diagnostic, Therapeutic and Economic Value of Intravascular Ultrasound (IVUS) Imaging in Patients with Coronary Artery Disease and in Patients after Heart Transplantation
Authors: Klauss V.  , Siebert U.  , Peeters J.  , Regar E.  , Rieber J.  , Aidelsberger P.  , Corzillius M.  , Mühlberger N.  , Wasem J.
Published: February 2025

1. Background: Cardiovascular diseases present the most frequent causes of morbidity and mortality in Western nations. One of the main reasons is coronary artery disease. For the diagnosis of coronary artery disease coronary angiography is currently the gold standard. Intravascularultrasound imaging is a method which might lead to more precise information and might influence therapeutic decisions.
Clinical Workstations supporting Evidence- Based Medicine
Authors: Graeber Stefan  , Geib Dieter
Published: February 2025

The application of the principles of evidence-based medicine is based on a rigorous analysis of clinical research tailored to the individual characteristics of a specific patient. Thus the physician must have information about the patient and about the latest results of clinical research simultaneously. We present a computer-based clinical workstation offering sources for both kinds of information: the current patient data is delivered by access to the electronic patient record and the results of research may be searched at the Internet, Intranet, or other online databases. Performing an evaluation study we are testing this configuration in the setting of a university hospital. The physicians are interviewed about their use of the single information sources and their consequences for clinical research and evidence-based medicine. We hope to show that in spite of some technical and methodological problems the clinical workstation is a promising tool for decision-making at the clinical workplace.
Cartographic Mapping of Health Data
Authors: Greiner Götz  , Kundt Günther  , Gierl Lothar
Published: February 2025

Health is a primary, individual interest of the population. The observation of health standard and health risks requires the consideration of geographical information. The cartographic visualization of health data is used to show spatial relations and correlations. A presupposition is that health data has local references. There are various local references: the local reference by domicile is most important in investigating the spatio-temporal occurrence, the geographically spread, the intensity and temporal periodicity of diseases. Cartographic visualization allows a quick and intuitive recognition of the situation in a geographical region.
Quality Assurance Issues Concerning Healthcare Information Systems Project Development
Authors: Bazavan Mariana  , Dimitriu Rodica
Published: February 2025

The quality of the Healthcare Information System (HIS) product refers three major aspects: technical, use and organisational quality. The product quality is the result of the development process and from this perspective it must be considered from the early stages including terms of reference definition and procurement of goods and services. The issues investigated in this paper are concerning the possibilities of extending the view upon HIS projects quality by integrating the control instruments in an analytical frame covering both product and process aspects.
Entwicklung eines Lehr- und Lernsystems f¨r Neurochirurgie
Authors: Bastani P.P.  , Osada N.  , Schwering I.  , Meier N.  , Wassmann H.  , Köpcke W.
Published: February 2025

In Zusammenarbeit mit der Klinik und Poliklinik für Neurochirurgie ist ein Lehr- und Lernsystem zur Unterstützung der studentischen Ausbildung im Fach Neurochirurgie konzipiert worden. Die vorliegende Arbeit befasst sich mit der Beschreibung der standardisierten Struktur der verwendeten Lehrdokumente und erlautert die Vorteile, die der Einsatz von rechnergestiitzten Lehrsystemen im Fach Neurochirurgie gegeniiber konventionellen Lehrmethoden bietet.
Integrated Internet based tools for learning and evaluating the International Classification of Nursing Practice
Authors: Alecu Cristina-Simona  , Jitaru Elena  , Moisil Ioana
Published: February 2025

This paper presents some tools designed and implemented for learning- related purposes; these tools can be downloaded or run on the TeleNurse web site. Among other facilities, TeleNurse web site is hosting now the version 1.2 of SysTerN (terminology system for nursing) which can be downloaded on request and also the “Evaluation of Translation” form which has been designed in order to improve the Romanian translation of the ICNP (the International Classification of Nursing Practice).
WWW-based Continuing Medical Education: How Do General Practitioners Use it ?
Authors: Dickmann C.  , Habermeyer E.  , Spitzer K.
Published: February 2025

WWW-based Continuing Medical Education (CME) is assumed to have the potential to make up for shortcomings in traditional lifelong learning of General Practitioners (GPs). This is obvious for CME systems with accreditation and control of the individual GP’s CME activities but seems less clear for non-controlled CME systems like in several European countries, e.g. Germany. This paper reports results from the evaluation of a German CME website by 59 GPs (internet experience of 20 months on average) during a 4-months period. GPs mainly learned at home after work, with 46% of the GPs visiting the website at least once per month. Self-study and information seeking accounted for 58% of the activities, while communication and interaction were used infrequently. 77% of the GPs judged less but detailed information on selected topics more important than being able to access many but broad contents. GPs mostly prefer established means of learning and communication.
Building a Web-based Drug Ordering System for Hospitals: from Requirements Engineering to Prototyping
Authors: Hübner Ursula  , Klein Frank  , Hofstetter Jürgen  , Kammeyer Gerold  , Seete Helmut
Published: February 2025

Web-based drug ordering allows a growing number of hospitals without pharmacy to communicate seamlessly with their external pharmacy. Business process analysis and object oriented modelling performed together with the users at a pilot hospital resulted in a comprehensive picture of the user and business requirements for electronic drug ordering. The user requirements were further validated with the help of a software prototype. In order to capture the needs of a large number of users CAP10, a new method making use of pre-built models, is proposed. Solutions for coping with the technical requirements (interfacing the business software at the pharmacy) and with the legal requirements (signing the orders) are presented.
Evaluation of a Probabilistic Model for Staging of Oesophageal Carcinoma
Authors: van der Gaag Linda C.  , Renooij Silja  , Aleman Berthe M.P.  , Taal Babs G.
Published: February 2025

With the help of two experts in gastrointestinal oncology from the Netherlands Cancer Institute, Antoni van Leeuwenhoekhuis, a decision-support system is being developed for patient-specific therapy selection for oesophageal carcinoma. The kernel of the system is a probabilistic model describing the characteristics of oesophageal carcinoma and the pathophysiological processes of invasion and metastasis. Using data from 185 patients, an evaluation study of the model was conducted. We found that for 86% of the patients, the model established the stage of the patient’s carcinoma correctly.
Health Expert’s Tacit Knowledge Acquisition and Representation Using Specialised Healthcare Scenarios
Authors: Yu-N Cheah  , Abidi Syed Sibte Raza
Published: February 2025

The abundance and transient nature to healthcare knowledge has rendered it difficult to acquire with traditional knowledge acquisition methods. In this paper, we propose a Knowledge Management approach, through the use of scenarios, as a mean to acquire and represent tacit healthcare knowledge. This proposition is based on the premise that tacit knowledge is best manifested in atypical situations. We also provide an overview of the representational scheme and novel acquisition mechanism of scenarios.
Calming admins and managers - Experiences from four years using thin client technology in a hospital environment
Authors: Heitmann Kai U.  , Koop A.  , Morzinck T.  , Schneichel W.
Published: February 2025

End user desktop computers in a hospital are often full-blown and rich featured PCs. But the distribution of this kind of “computing power” causes big efforts in administration and maintenance and - considering the total cost of owning a PC - is associated with high expenditures of financial and human resources. At the university hospital of Cologne thin client technology is used as an end user desktop device wherever possible. Experiences from four years using this technology are described in this paper.
Chapter 3.3 - PSG-EXPERT An Expert System for the Diagnosis of Sleep Disorders
Authors: Fred Ana  , Filipe Joaquim  , Partinen Markku  , Paiva Teresa
Published: February 2025

This paper describes PSG-EXPERT, an expert system in the domain of sleep disorders exploring polysomnographic data. The developed software tool is addressed from two points of view: (1)- as an integrated environment for the development of diagnosis-oriented expert systems; (2)- as an auxiliary diagnosis tool in the particular domain of sleep disorders. Developed over a Windows platform, this software tool extends one of the most popular shells — CLIPS (C Language Integrated Production System) with the following features: backward chaining engine; graph-based explanation facilities; knowledge editor including a fuzzy fact editor and a rules editor, with facts-rules integrity checking; belief revision mechanism; built-in case generator and validation module. It therefore provides graphical support for knowledge acquisition, edition, explanation and validation.
Chapter 3.8 - The Epilepsy Tutorial
Authors: Binnie Colin  , Spreng Manfred
Published: February 2025

Within the European Neurological Network (ENN) project an interactive multimedia tutorial covering the medical field of epilepsy has been created. The first priorities of that project to educate health care professionals, e.g. General Practitioners (GP), throughout the European community as how to best diagnose and treat patients (e.g. reduction of frequent consultations, avoiding of excessive and unnecessary medication and useless laboratory tests) and to inform patients and carers are reached by producing a distributable CD-ROM. Later frequent updates of the content of the installed tutorial will take place by a telematic network contacting the multimedia database of the ENN-project.
Chapter 3.10 - The Sleep Data transfer between remote and central sites
Authors: Escourrou Pierre  , Reddy Kumar  , Courtois Joel  , Morvan Catherine
Published: February 2025

Sleep laboratory have long waiting lists due to the high prevalence of sleep disorders and the low availability of centers. One possibility for improving patient care is an ambulatory recording at home or in a distributed center. Then the data recorded must be transferred for analysis in the specialized center. Similarly, an application is needed for the transfer of raw data when the recordings are made by á health care provider sending sleep technologists to set-up the equipment in the patient’s home. It is ethically preferable that the analysis be made by a physician from an independent organization from the provider to avoid any conflict of commercial interest with the provider whose main purpose is delivering therapeutic equipment (CPAP, oxygen...)
Advanced Technology Program: Information Infrastructure for Healthcare Focused Program
Authors: Spivack Richard N.
Published: February 2025

This paper describes an initiative begun by the Advanced Technology Program in 1994 referred to as the Information Infrastructure for Healthcare (IIH) focused program. The IIH focus program began with an initial exchange of ideas among members of the private and public sectors (industry's submission of “white papers”; workshops conducted by the ATP; meetings held between individuals from both groups) to identify those technologies necessary for the development of a national information infrastructure in healthcare. A discussion of the development of the focus program through a “white paper” process notes differences that existed between what the ATP had hoped to gain through this method and how the private sector responded. A statistical description of the participants as well as a brief discussion of the ATP review and selection process is included.
Future of Medical Knowledge Management and Decision Support
Authors: Greenes Robert A.
Published: February 2025

Attempts to predict the future are typically off the mark. Beyond the challenges of forecasting the stock market or the weather, dramatic instances of notoriously inaccurate prognostications have been those by the US patent office in the late 1800s about the future of inventions, by Thomas Watson in the 1930s about the market for large computers, and by Bill Gates in the early 1990s about the significance of the Internet. When one seeks to make predictions about health care, one finds that, beyond the usual uncertainties regarding the future, additional impediments to forecasting are the discontinuities introduced by advances in biomedical science and technology, the impact of information technology, and the reorganizations and realignments attending various approaches to health care delivery and finance. Changes in all three contributing areas themselves can be measured in “PSPYs”, or paradigm shifts per year.
A methodological tool for computer-assisted surgery interface design: its application to computer-assisted pericardial puncture
Authors: Dubois Emmanuel  , Nigay Laurence  , Troccaz Jocelyne  , Carrat Lionel  , Chavanon Olivier
Published: February 2025

Computer Assisted Surgery systems are becoming more and more prevalent. Design processes currently used, pay only a small attention to the surgeon's interaction. To address this lack in design, we propose the OP-a-S notation: OP-a-S modeling of a system adopts an interaction-centered point of view and highlights the links between the real world and the virtual world. Based on an OP-a-S modeling, predictive usability analysis can be performed by considering the ergonomic property. We illustrate our method on the retro-design of a computer assisted surgical application, CASPER.
An Integrated Environment for Stereoscopic Acquisition, Off-line 3D Elaboration, and Visual Presentation of Biological Actions
Authors: Agus Marco  , Bettio Fabio  , Gobbetti Enrico  , Fadiga Luciano
Published: February 2025

We present an integrated environment for stereoscopic acquisition, off-line 3D elaboration, and visual presentation of biological hand actions. The system is used in neurophysiological experiments aimed at the investigation of the parameters of the external stimuli that mirror neurons visually extract and match on their movement related activity.
Trauma Training: Virtual Reality Applications
Authors: Kaufmann Christoph  , Liu Alan
Published: February 2025

Training medics, medical students, nurses, and residents to perform trauma care skills presents many obstacles. These include: emergent nature of the procedures, instructor time, availability of clinical material, and anatomic knowledge. Virtual Reality simulators address each of these obstacles. The National Capital Area Medical Simulation Center is a unique national asset that not only uses state-of-the-art simulators to teach trauma care skills to medical students and others, but adapts existing technology and develops new simulations to teach these skills. Most standard trauma training is performed on either mannequins or anesthetized animals and requires the constant presence of an instructor. VR applications can be stand-alone devices that have built-in scenarios and multiple patients to increase variation and/or level of technical expertise required to successfully complete the required steps of the trauma procedure. Commercial VR simulators to teach trauma skills include: CathSim Intravenous Simulator (HT Medical), UltraSim Ultrasound Simulator (MedSim), Limb Trauma Simulator (Musculographics/BDI), and the Human Patient Simulator (MedSim). Additionally, we have developed two additional simulators based on the HT CathSim; these are the pericardiocentesis simulator and the diagnostic peritoneal lavage simulator. Future applications include virtual environment triage simulation and surgical airway simulators.
A computer-based simulator for diagnostic peritoneal lavage
Authors: Liu Alan  , Kaufmann Christoph  , Ritchie Thomas
Published: February 2025

Diagnostic peritoneal lavage (DPL) is an emergency diagnostic procedure performed when intra-abdominal bleeding secondary to trauma is suspected. This procedure is part of the surgical skills section of the Advanced Trauma Life Support course. DPL is traditionally taught using anesthetized animals or cadavers. For reasons described below, these alternatives are not ideal. We have developed a computer-based diagnostic peritoneal lavage simulator. Our system addresses the shortcomings of the traditional method. We have used our system to teach ATLS®. Preliminary results suggests that our system is effective.
Laser-Pointing Endoscope System for Natural 3D Interface between Robotic Equipments and Surgeons
Authors: Nakamura Yoshihiko  , Hayashibe Mitsuhiro
Published: February 2025

Precise measurements of reference points would be mandatory if robotic equipments would be introduced in operation rooms. We develop a real-time laser-pointing endoscope using an optical galvano scanner and a 955fps high-speed camera. This system provides the scanned 3D image of the liver under the endoscopic surgery and a touch screen interface so that surgeons can intuitively indicate points of interest with precise 3D position. Some results of in-vivo experiments on a liver of pig are shown to verify the effectiveness of the proposed.
Internet as an “Honest” Management Tool First Experience in a National Institute of Health and Social Services in Argentina
Authors: Altrudi Rodolfo  , Herrero Ricardo  , Melamud Ariel  , Rodas Eduardo
Published: February 2025

The PAMI's website creation (www.pami.org.ar) has had the purpose of spreading its activities, the standards of medical care and administrative management, offering - at the same time - a honest channel of interaction with the community.
REAL-TIME SIMULATION OF DYNAMICALLY DEFORMABLE FINITE ELEMENT MODELS USING MODAL ANALYSIS and SPECTRAL LANCZOS DECOMPOSITION METHODS
Authors: Basdogan Cagatay
Published: February 2025

Real-time simulation of deformable objects using finite element models is a challenge in medical simulation. We present two efficient methods for simulating real-time behavior of a dynamically deformable 3D object modeled by finite element equations. The first method is based on modal analysis, which utilizes the most significant vibration modes of the object to compute the deformation field in real-time for applied forces. The second method uses the spectral Lanczos decomposition to obtain the explicit solutions of the finite element equations that govern the dynamics of deformations. Both methods rely on modeling approximations, but generate solutions that are computationally faster than the ones obtained through direct numerical integration techniques. In both methods, the errors introduced through approximations were insignificant compare to the computational advantage gained for achieving real-time update rates.
An efficient method for modelling soft tissue in Virtual Environment training systems
Authors: Wills Derek P M  , Chapman Peter M
Published: February 2025

Modelling soft tissues in virtual environment training systems is frequently required. The provision of both visually compelling and physically accurate models presents a number of problems for the developer. The Finite element technique presented in this paper, modal analysis, can be programmed to allow the user to easily trade-off accuracy of simulation for execution speed. It has been successfully used to produce simulations of the lateral meniscus on low powered portable computer systems.
Safety in Computer Assisted Surgery
Authors: Burghart Catherina R.  , Hassfeld Stefan  , Soler Luc  , Woern Heinz
Published: February 2025

Today, surgeons accept computer assisted technologies as important tools to enhance the treatment of a patient. The positive impact and acceptance of computer assisted technologies could be increased to a great extent, if all methods and devices used for diagnosis and treatment of a patient are better co-ordinated and more finely tuned. Often computer assisted treatments cannot be performed due to a lack of communication between hospital departments, useless patient data, deficient interfaces, etc. Risks for the patient and potential errors within the treatment are often unrecognised, as up to now the safety of computer integrated surgery is only product-, device and security oriented. We have developed a new approach for a safety architecture, which includes safety aspects considering patients, users, interdependencies and interactions of computer assisted methods and apparatuses.
GOLEM - Multimedia Simulator for Medical Education
Authors: Kofránek Jiří  , Vu Luu Danh Anh  , Snášelová Hana  , Kerekeš Roman  , Velan Tomáš
Published: February 2025

We created multimedia medical training simulator “GOLEM” for learning diagnostics and therapy of the critical clinical disorders. The theoretical basis of the simulator is the mathematical formulation of the relationship of homeostasis of the internal environment (acid/base and electrolyte equilibrium, of transport of blood gases, of osmotic and volume homeostasis), respiration, circulation and kidneys including regulatory influence of relevant hormones and the influence of some therapeutic procedures. Mathematical description consists of 39 non-linear differential equations and containing 89 input and 179 output variables. For the development of the simulation models developer's tools from Math Works (Matlab and Simulink) has been used. The integration of the multimedia components, hypertext and simulation models interface was achieved by using Control Web, developed by Moravian Instruments, originally designed for long distance controls using PC and Internet. We have used our simulator as an efficient educational tool to help medical students learn circulatory, respiratory, acid-base, electrolyte, osmotic and volume disorders and train the diagnostic and therapeutic decisions by executing simulated interventions on virtual “patients”.
An Innovative Approach to Research and Development: The CEFRIEL Experience
Authors: Castelli Alberto  , Colombo Cesare  , Decina Maurizio  , Frumento Enrico
Published: February 2025

CEFRIEL (Centre for Research and Training in Information Technology) is a non-profit organization that represents a point of contact among University, Technological Companies and Public Government. Since its foundation in 1988 its goal has been related to the education and the research in Information and Communication Technology (ICT). CEFRIEL constitutes itself in seven areas embracing all the aspects of ICT, from hardware design to software engineering. The enormous number of trained specialized technicians represents the most important result of the Centre: more than 500 specialists and about 100 researchers for the ICT sector. In 1998 CEFRIEL created a new area, the Information and communication TEchnology for Medicine area (ITEM), as the result of the previous positive experiences in the healthcare field. In the last two years the results obtained by the ITEM area show that CEFRIEL’s approach could be profitable also in the healthcare sector.
Telehealth Success: Evaluation Framework Development
Authors: Hebert Marilynne
Published: February 2025

Implementing telehealth applications represents a substantial investment of resources, which is one reason why success is of great interest. Many research and evaluation studies have investigated measures of successful telehealth systems. However, the term “telehealth” represents a wide range of variables including clinical application, characteristics of the information being transmitted, temporal relationships of data transfer and the organizational context. These sources of variability pose many challenges for evaluation as well as for building a cumulative history of research.
Comparison of Time Spent Writing Orders on Paper with Computerized Physician Order Entry
Authors: Shu Kirstin  , Boyle Deborah  , Spurr Cynthia  , Horsky Jan  , Heiman Heather  , O'Connor Paula  , Lepore John  , Bates David W.
Published: February 2025

Computerized physician order entry (CPOE) has been shown to improve quality, and to reduce resource utilization, but most available data suggest that it takes longer to enter orders using CPOE. We had previously implemented a CPOE system, and elected to evaluate its impact on physician time in the new setting. To do this, we performed a prospective study using random reminder methodology. Key findings were that interns spent 9.0% of their time ordering with CPOE, compared to 2.1% before, although CPOE saved them an additional 2% of time, so that the net difference was 5% of their total time. However, this is counterbalanced by decreased time for other personnel such as nursing and pharmacy, and by the quality and efficiency changes. We conclude that while CPOE has many benefits, it represents a major process change, and organizations must factor this in when they implement it.
Proactive Assessment of Medical Services
Authors: Vlug A.E.
Published: February 2025

Proactive assessment will collect evaluation data, like factors and effects, already during design stage, establish factor-effect relations to enable predictions and recognize different assessment. In the European project Picnic we developed a plan to reach a coherent model.
An Overview in Healthcare Information Systems Security
Authors: Bourka Athena  , Polemi Nineta  , Koutsouris Dimitris
Published: February 2025

The scope of this paper is to present the current needs and trends in the field of healthcare systems security. The approach applied within the described review was based on three major steps. The first step was to define the point and ways of penetration and integration of security services in current healthcare related applications addressing technical, organisational and legal/regulatory issues. The second step was to specify and evaluate common security technologies applied in healthcare information systems pointing out gaps and efficient solutions, whereas the third was to draw conclusions for the present conditions and identify the future trends of healthcare information security. A number of EU RTD Projects were selected, categorised, analysed and comparatively evaluated in terms of security. The technical focus was on key security technologies, like Public Key Infrastructures (PKIs) based on Trusted Third Parties (TTPs) in conjunction with other state-of-the-art security components (programming tools, data representation formats, security standards & protocols, security policies and risk assessment techniques). The experience gained within this review will provide valuable input for future security applications in the healthcare sector, solving existing problems and addressing real user needs.
Establishing a National Patient Information System on the Internet in Denmark
Authors: Pedersen Claus Duedal  , Fog Lars Hulbæk
Published: February 2025

During 2000 – 2001 a pilot project is being carried out in Denmark with the aim of establishing the opportunity to look up patient information via the Internet. While this presents great opportunities, it also involves major organisational and technical challenges.
International Applications in the Context of the EU Data Protection Directive
Authors: Rogers Ray
Published: February 2025

The EU Data Protection Directive prohibits transfer of personal health data from an EU Member State to a third country that has inadequate data protection provisions. Most non-EU countries are regarded as such. If international applications are to proceed, either adequacy of protection must be assured or the Directive’s derogations invoked.