bluuebunny/crossref_metadata_2025 huggingface dataset:
Compartmentmodelle in der Medizin
Authors: Fuchs G.
Published: March 2018

Die Begriffe Compartment und Compartment-Modell werden definiert, und ein Katalog möglicher Typen wird vorgestellt. Zur mathematischen Bearbeitung von Aufgaben müssen drei Gruppen von Gleichungen formuliert bzw. postuliert werden: Bilanz-Gleichungen, Übergangs-Gleichungen, Modell-Gleichungen. Mit Hilfe dieser mathematischen Ansätze können drei verschiedene Typen von Fragestellungen theoretisch bearbeitet werden.

An fünf Beispielen aus dem Gesamtgebiet der Medizin wird das Verfahren der Modellaufstellung und die Durchführung der Modellrechnungen erläutert. Die Beispiele sind aus sehr verschiedenen Bereichen der Medizin ausgewählt, doch kann gezeigt werden, daß das formale Vorgehen in seinen Grundzügen immer das gleiche ist.
EDV-Vermessung von Ekg-Kurven bei Telemetrieversuchen
Authors: Reinhard H.-J.
Published: March 2018

Die EDV-Vermessung von Ekg-Kurven während Belastung wird bei Telemetrieversuchen erprobt. Es werden Störspannungen analysiert und Rechenverfahren zur Störbefreiung untersucht. Ein Verfahren zur sicheren Erkennung des QRS-Komplexes wird beschxieben. Möglichkeiten zur Bestimmung der Bezugslinie werden erläutert. Ein Vergleich zwischen manuell und automatisch bestimmten Ekg-Strecken wird durchgeführt.
System Design Considerations for Automated Health Screening
Authors: Henderson C.
Published: March 2018

The current trend in health care indicates that future multiphasic screening systems may require automated decision-making techniques in order to accommodate the attendant problems of screening system load, screening test accuracy, and disease prevalence among the population being screened. This paper discusses a methodology for on-line classification of patients by means of the medical history questionnaire. The work presented indicates that the dynamic characteristics of an automated screening system can be enhanced through the use of trainable pattern classifiers and automatically adjusted screening thresholds.
stematic Signalling of Adverse Reactions to Drugs
Authors: Finney D. J.
Published: March 2018

Many national centres now cooperate with the World Health Organization in a system for monitoring information on suspected adverse reactions to therapeutic drugs. Proposals are made here for various methods of systematically producing signals from the computer files, with the object of indicating disproportions in frequencies that may be due to adverse reactions. Signals are intended to arouse suspicions and to stimulate deeper investigation; they are not to be equated with warnings of danger. Emphasis is laid on the dissemination of signals to national centres and on the logic of interpretation. Particularly important is restriction of the number of non-urgent signals, so as to ensure a reasonable chance of thorough investigation nationally for each that is transmitted.
Indexed Text-Analysis
Authors: Kayser K. , Höpker W. W. , Müller U.
Published: March 2018

General conditions for medical text analysis are discussed. By means of formal description the errors which occur during manual codification with the over-cross method are analysed by distribution in different classes of diagnoses. It is pointed out that the largest error arises through incorrect correlation of the diagnoses in the summary of findings with those of the thesaurus and that, furthermore, a thesaurus of 4,500 medical terms is not sufficient for documentation in pathology. The entropy losses were only slightly larger than the losses of diagnoses calculated by percentage. The distribution of the classes of diagnoses follows a general statistical theory. In the over-cross method a loss of information Iμ = 1.532 in a total entropy of HD = 5.789 must be reckoned with as shown in an example.
Diagnostic Rules for Qualitative Variables with Interactions
Authors: Victor N. , Trampisch H. J. , Zentgraf R.
Published: March 2018

An allocation rule for qualitative variables is derived which permits taking into account s-th order interactions (Lancaster’s definition is used). A formula is given using only the relative frequencies of the (s+1)-dimensional marginals for the estimation of the cell probabilities. In contrast to other procedures (e.g. the log-linear-model), the method is practicable for a large number of symptoms, too, and the estimates of the parameters of the allocation rule are stable even if samples of relatively small size are used. For the examination of the practicability of the method, two modular programs were written which permit the estimation of the parameters of the model and the expectations of the error rates. The modules are designed in a way which permits the implementation in a sequential diagnostic process.
Drug Recording and Classification by the WHO Research Centre for International Monitoring of Adverse Reactions to Drugs
Authors: Helling Margaretha , Venulet J.
Published: March 2018

Recording and classifying drugs reported in relation to suspected drug adverse reactions by fifteen countries has required the development of a special system. A comprehensive cross reference system between different types of drug names (INN, other nonproprietary names, trade names, etc.) and their occurrence in single and multiple ingredient products has been developed. Separate pharmacologic and therapeutic classifications designed for the needs of drug monitoring provide for farther special grouping.

On the basis of accumulated data, some analysis is given of reporting patterns and drug profiles in different countries.
An Adaptable Interactive System for Medical and Research Data Management
Authors: Baker L. R.
Published: March 2018

The design of interactive information systems that ease the implementation of new applications, and facilitate their use by persons (users and programmers) with varied levels of training remains a problem that has not been satisfactorily solved, although some progress is being made by many investigators. TIRRIS, an interactive data base management system in use at the Texas Institute for Rehabilitation and Research, includes features that permit it to adapt to a variety of applications, users, and terminals. Key features of the system, including capabilities, modes of operation, commands, and system tailoring options are described.
Erfahrungen bei der Auswertung des ,,Allgemeinen Krankenblattkopfes”
Authors: Thurmayr R.
Published: March 2018

Für die Auswertung der nach dem Muster des ,,Allgemeinen Krankenblattkopfes” erstellten Lochkarten haben sich deren Sammlung in Form einer Diagnosenkartei und die Listung der Karten am Ende des Jahres bewährt. Die Listung vereinfacht das Heraussuchen von Kombinationen für eine kleine Patientengruppe gegenüber dem Sortieren. Zwei Listen, einmal geordnet nach Diagnosen und einmal geordnet nach Operationen, erscheinen am günstigsten. Der Aufbau der Listen und ihre Handhabung werden geschildert.
Direkte maschinelle Erfassung von Krankenblattdaten
Authors: Ehlers C.
Published: March 2018

In der vorliegenden Arbeit wird ein modernes Verfahren zur Erfassung des klinischen Aufnahmebefundes und der Anamnese dargestellt. Es ermöglicht die direkte maschinelle Verarbeitung klinischer Informationen durch eine elektronische Datenverarbeitungsanlage. Die Befunde sind speicherbar und stehen jederzeit zur weiteren Auswertung zur Verfügung. Im einzelnen wird der Aufbau dieses neuartigen Krankenblattes besprochen und die Prinzipien aufgestellt, denen ein derartiges Verfahren unterworfen ist, wenn es Anspruch auf Flexibilität erheben und in der Praxis anwendbar sein soll.
Morphological Analysis of Cells and Chromosomes by Digital Computer
Authors: Mendelsohn M. L. , Kolman W. A. , Peheyand B. , Peewitt J. M. S.
Published: March 2018

A computer-oriented approach to the analysis of microscopic images has been developed around CYDAC, a data conversion system which scans through the microscope and records the optical information in digital form on magnetic tape. The quality of the optical information thus made available to the computer is surprisingly good, as evidenced by reconstructions of the original image using the high-speed printer. Preparations for the computer- interpretation of scanned images are underway, using blood cells as a model system. Parallel attempts to classify human chromosomes by means of CYDAC scans have given very encouraging preliminary results.
Some Computer Applications to Problems in Human Genetics
Authors: Mckusick V. A.
Published: March 2018

Computer methods have been useful in the following applications in human genetics research (among many): 1) demonstration of what genes are on the same chromosome and the distance separating pairs of loci on the chromosome; 2) demonitration of sex differences in the recombination fraction; 3) assemblage of catalogs of rare recessive phenotypes in man; 4) maintenance of total genealogy of closed populations for such uses as a) determining common ancestor(s) of parents of persons with rare recessive disorders, and b) calculation of coefficients of consanguinity.
Numerical Analysis of Analog Signals for Data Processing in Electrocardiology
Authors: Koechlin R.
Published: March 2018

The principle of a new data acquisition system is given for the numerical analysis of a visualized analogue signal. The operator chooses the sequence of interest. A 1/4 inch magnetic tape loop repeats the sequence on an oscilloscope screen. With numerical knobs he can either obtain automatically the full series of coded samples within the limits of a chosen zone of interest, or pick up the point by point coordinates of the only sample or segment he expects to be pertinent. The selected samples are brightened on the screen. The data are immediately made available in printed numbers to the physician for the patient’s medical file, or on punched tape for further processing and for Telex transmission.
Factor Analysis in the Evaluation of Criteria and Variants of Systemic Lupus Erythematosus
Authors: Mustakallio K. K. , Lassus A. , Putkonen T.
Published: March 2018

The value of factor analysis in defining complex diseases was tested with a series of 135 patients with more or less evidence of systemic lupus erythematosus (SLE).

The factor analytic classification of the patients according to the interdependence of 25 unweighed criteria for’ SLE concurred rather well with a clinical classification into definite, probable, and possible SLE cases obtained by transforming the »diagnostic«, »major«, and »minor« criteria into numerical values. The clinical evaluation of the criteria appeared thus to have a sound statistic basis, even if there was evidence of that too much confidence had been paid to the diagnostic value of certain criteria, especially in oligosymptomatic cases.

Five factors corresponded to a clinically meaningful symptom complex or variant of SLE: the classical visceral and erythematous types of SLE, and rheumatoid, discoid and drug associated variants. This suggests that the factorial structure of SLE obtained in this study is rather invariant, i.e., susceptible to profound alterations neither by réévaluation with other series nor by addition of new characteristics to the set of criteria for SLE.
Data Processing in Oncology
Authors: Wolff-Tehhoine Madeleine
Published: March 2018

We endeavoured to describe the organization and functions of a Scientific Documentation Center concerned only with cancer, which after a very modest start is now in a phase of expansion. We would like to avail ourselves of the services of a computer, which would require a reconversion of our system, to modify the operation of the center, thus allowing its users to benefit maximally from the intellectual potential of our team at Institut Gustave Roussy, as well as from the most recent breakthroughs in non-numerical data processing.
Citations and Citation Indexes: A Review
Authors: Tagliacozzo R.
Published: March 2018

Recent studies concerned with the distribution and interconnection of citations in the scientific literature are reviewed. Some of the properties of citations networks are examined and their implications for the methodology of information retrieval, the evaluation of the scientific literature, and the problem of literature obsolescence are outlined. The main features of citation indexes are described and discussed, and the need for further studies to test and evaluate them is emphasized.
Die diagnostische Bedeutung von »Steilen Potentialen« für die Erkennung von epileptischen Anfallsleiden )
Authors: Gutjahr L. , Machleidt W. , Ferber G.
Published: March 2018

Seit Entdeckung der Steilen Potentiale im EEG wird nach ihrer diagnostischen Bedeutung für die Erkennung von epileptischen Anfallsleiden gefragt. Anhand zweier EEG-Dokumentationen aus Berlin (5001 Erst-EEGs) und Hannover (7094 Erst-EEGs) wird die bedingte Wahrscheinlichkeit für ein epüeptisches Anfallsleiden bei Vorliegen von Steilen Potentialen im EEG berechnet. Es zeigt sich, daß nach Plausibilitäts- und Validitätskorrektur der Schätzwert für die bedingte Wahrscheinlichkeit von 45% auf 63% ansteigt. Die mathematisch-statistischen Korrekturmöglichkeiten werden exemplarisch dargestellt. Die subjektiven Schätzungen anhand einer computergestützten Schätzungsprozedur durch 6 EEG-Experten ergaben im Mittel einen Schätzwert von 63% für die bedingte Wahrscheinlichkeit. Es besteht eine gute Übereinstimmung der Expertenschätzung mit dem korrigierten Schätzwert aus der Dokumentation. Das Ergebnis zeigt, daß etwa 1/3 aller Patienten mit Steilen Potentialen im Erst-EEG kein epileptisches Anfallsleiden haben. Bei Männern ist die Sensitivität von Steilen Potentialen (69%) höher als bei Frauen (58%).
A Pathology Data Management System (PADAMS 7810) for the Interactive Storage and Retrieval of Autopsy Records)
Authors: Takahashi M. , Masttda M. , Isiglo K. , Matsttmoto T.
Published: March 2018

An on-line system for the computer-assisted management of pathology data, calledPADAMS (Pathology Data Management System), was developed to construct a data base and to gam direct access to the up-to-date information in daily practice. It utilizes the time-sharing system (TSS) of FACOM M-190 and is operable from a terminal in the pathology department. By prompting data input the system leads the user to register cases and to form interrogations for data retrieval. Pathological and anatomical terms are automatically coded according to SNOP and decoded during output. In the absence of the term in the dictionary, the code is requested and filed so that the vocabulary is increased stepwise during operation of PADAMS. Additional subroutines can be called to read and to correct the dictionary. PADAMS was successfully tested on 100 samples of record. Further data are now being accumulated in the file.
Fixation of Trochanteric Osteotomies in Laboratory Beagles with Absorbable Screws of Polylactic Acid
Authors: Parchman M. , Krook L. , Vainionpää S. , Mero M. , Rokkanen P. , Törmälä P. , Räihä J. E.
Published: March 2018

An absorbable, biocompatible 4.5 mm screw, with a matrix of polyright-left-isomeric lactic acid of equal amounts of isomers and fibres of poly-left-isomeric lactic acid comprising a self-reinforced structure, was tested for fixation of a trochanteric osteotomy on six laboratory Beagles. The proximal femurs were harvested two months later and embedded in methylmethacrylate for histological, microradiographic, and fluorescence evaluation. Five specimens showed bony union and one trochanter was ununited. The coarse thread configuration and poor torque strength of the screw required exaggerated tapping of the screw hole resulting in a loose fit for the implant. An improved screw could be clinically appealing and a secondary removal operation would then be omitted.

To test a totally absorbable polylactic acid screw with good initial in vitro strength values a trochanteric osteotomy was fixed with this implant in six laboratory Beagles. Radiographic, microradiographic, fluorescence and histological evaluations indicated healing in five dogs at two months. Nonunion in one dog was attributed to diastasis between the fragments. The strength and strength retention of the screw were considered adequate, but the poor torsional strength made implantation of the screw tedious.
Computerized Nursery Discharge Summary
Authors: Smith R. , Blackmon L. , Hammond W. , Jelovsek F.
Published: March 2018

Expansion of a computerized obstetric medical record to include newborn nursery information is described. Data sheets are entered for each infant discharged, and a computer-typed discharge summary is generated which abstracts information originally gathered by both obstetric and pediatric medical personnel. The system has improved communication with medical providers who administer follow-up care after discharge and has replaced some physician dictation effort, especially in the Full Term Nursery. In the Intensive Care Nursery the summary has not been successful because data collected is not felt adequate to describe the chronology of a long hospitalization. Comparison of the computer record and manual discharge diagnosis sheet is presented.
One Method for the Systematic Evaluation of Adverse Drug Experience Data within a Pharmaceutical Firm
Authors: Westlin W. F. , Cuddihy R. V. , BursiK R. J. , Seifert Beverley G. , Koelle Joyce G.
Published: March 2018

Post-marketing surveillance of drug adverse experience incidents constitutes a major interest for physicians, pharmaceutical firms and federal regulatory bodies alike. The development and operation of a total information system for the management of adverse experience data related to a single pharmaceutical firm’s commercial products is described. Data is carefully collected from clinical investigations, visits and correspondence with practicing physicians and from the published medical literature. Each such alleged incident is carefully medically reviewed. Thereafter, the data is reported to the United States Food and Drug Administration (FDA) and entered into an internal data bank. Computer management of the data for information retrieval and trend analysis was accomplished in a rapid and economical fashion by the use of commercially available computer programming packages. This approach, combining meticulous data collection, computer management of files and links to the firm’s FDA reporting system offers a flexible, thorough approach operative within the economic constraints naturally inherent within a single corporation.
Problems of Medical Diagnosis
Authors: Wagner G. , Tautu P. , Wolber U.
Published: March 2018

The present bibliography aims at informing and stimulating researchers when studying the multiple facets of medical diagnosis. The complexity of investigation in this domain can be judged by the fact that papers dealing with medical diagnosis do not appear in medical journals only. Clearly, medical diagnosis is no longer a strictly medical problem. Mathematical and statistical models and analyses must be created and improved before computer programs for diagnostics can be elaborated.
The Process of Medical Diagnosis: Routes of Mathematical Investigations
Authors: Tautu P. , Wagner G.
Published: March 2018

This paper is an analysis of the most important mathematical aspects of medical diagnosis: logical probability, rationality and decision theory, gambling models, pattern analysis, hazy and fuzzy subsets theory and, finally, the stochastic inquiry process.
The Physician’s Task and the Problem of Documentation
Authors: Proppe A.
Published: March 2018

Case histories suitable for statistical evaluation can be found even as far back as in the Corpus Hippocraticum. Such simple data as the patient’s age, body weight, size, the date of menarche, etc. are practically always included in the case records, and it is demonstrated that, when such data are recorded in a system of documentation suitable for mechanical sorting, it may enable us to draw conclusions of very great importance. Mechanical registration methods have revealed that, in the determination and recording of data as hitherto carried out. there has been a surprisingly large number of errors and a high degree of unreliability. This view has a considerable influence on modern clinical methods; it renders a more democratic relation between physician and patient necessary and makes clear the need for measures to enhance the reliability of diagnosis and treatment of pathological conditions. The author illustrates this view with reference to the mechanical falsification of the thesis of the proneness of early age groups to lupus vulgaris, furthermore with reference to the mechanical rationalization of modern routine diagnostic methods, to the constant surveillance of adverse effects on public health and to the protection against allergic reactions with the aid of recording systems of personal allergy and intolerance data with mechanical sorting and computer techniques.
Interactive Computer-Video Modules for Health Sciences Education
Authors: McArthur J. , Bolles J. , Fine J. , Kidd P. , Bessis M.
Published: March 2018

Advances in electronic image recording and computer technologyhave resulted in a remarkable increase in the power and flexibility of interactive computer-video teaching systems. The University of Washington Health Science Videodisc Development Group first demonstrated a laser videodisc controlled by a remote central computer in 1980. Even this rudimentary unit highlighted basic medical informatics principles including: rapid accessibility; a “generic” or multi-purposed format; ease of computer control; and large collections of valid, rigorously reviewed images. Advances in medical informatics have led to the development of the following previously undescribed series of teaching units:

1. The hypertext programs Hypercard, Linkway, and Guide have been used with videodiscs to develop easy-to-use instructional and reference materials. These materials demonstrate the ease with which a computer-naive instructor may develop new programs and the advantage that the intuitive nature of these programs brings to student users.

2. Patient simulations using single and double screens plus pre-defined knowledge structures;

3. Interactive single topic tutorials using preset knowledge structures;

4. A key-word-based disc searching system;

5. Electronic video microscopy;

6. A series of programs developed independently by health science faculty who have purchased multi-purpose videodiscs that demonstrate the flexibility of the multi-purpose or “generic”: collection concept.
New Media in Medical Education
Authors: Ackerman M.
Published: March 2018

ln 1984 the American Association of Medical Colleges´ Panel on the General Professional Education of the Physician challenged the medical community to take a leadership position in the effective application of information science and computer technology to medical education. The medical education community has risen to that challenge through the use of microcomputer technology and optical disc media including the recently developed fully integrated Hypermedia environment to enhance the learning environment.
Logic and Diagnosis
Authors: Kayser K.
Published: March 2018

Among the diagnostic algorithms, the statistic syllogism, the Westmeyer model and the confirmative model are discussed. Three methods to eliminate the logical inconsistencies of the statistical syllogism are shown: 1) Substitution of the inductive probability for the objective probability; 2) Replacement of the unconditional probability by the probability limited to the specific antecedents; 3) Proposing a certain distribution of diagnostic rules.

Particularly 2) and 3) are of significance in the construction of a medical thesaurus and point to the separation of identification numbers and search structures. The Westmeyer model can be used to calculate the maximum possible number of diagnoses. The ›static‹ confirmative model can be modified into a dynamic one. This dynamic model allows conclusions regarding. the time-dependence of diagnoses and examination methods.
Reliability of Diagnosis of Partial Union of Scaphoid Waist Fractures on Computed Tomography
Authors: Drijkoningen Tessa , ten Berg Paul , Guitton Thierry , Ring David , Mudgal Chaitanya
Published: March 2018

Computed tomography (CT) is increasingly used not just to diagnose union but also to estimate the percentage of the fracture gap that is bridged by healing bone. This study tested the primary null hypothesis that there is no agreement between observers on the extent of union of a scaphoid waist fracture on CT. CT scans of 13 nondisplaced scaphoid waist fractures treated nonoperatively were rated by 145 observers. CT scans were done 10 to 12 weeks after injury. Observers were asked to “eyeball” measure percentage of union. We found that there was a moderate agreement on the categorical degree of partial union of a scaphoid waist fracture on CT (k = 0.34). Agreement on the location of bony bridging was slight (k = 0.31). We concluded that there is limited reliability of diagnosis of partial union of a scaphoid waist fracture on CT and that this should be taken into account in both patient care and research. This is a Level III, diagnostic study.
Extended Hueston Flap: New Solution for Primary Closure
Authors: Brambullo Tito , Dalla Venezia Erica , Vindigni Vincenzo , Bassetto Franco
Published: March 2018

Thumb tip injuries are very common in hand trauma, and several flaps are available to restore the defect. One of them is the Hueston flap. It is very simple and quick to harvest, but it could lead to donor site problems. The variant “radial extended” of this flap, proposed in this article, allows a primary closure of donor site avoiding making scar on contact areas subject to frequent use. We performed this technique in a clinical case that presented a distal thumb amputation with good aesthetic result and satisfactory function.
Spatial Fluctuation of Regional Myocardial Blood Flows
Authors: Matsumoto T. , Ebata J. , Tsujioka K. , Ogasawara Y. , Kajiya F.
Published: March 2018

Digital radiography (100 pixels/mm2) combined with the technique of 3H-labeled desmethylimipramine deposition was employed to visualize regional blood flow distributions in rabbit left ventricular myocardium. A fluctuated pattern of myocardial flow and its dependence on arterial oxygen tension (PaO2) was evaluated with the coefficient of variation (CV) computed at each step of coarse-graining; flow images were revisualized by increasing pixel area (PA) step by step from 0.01 to 1 mm2. The CV values decreased with hypoxia at all resolution levels, suggesting that there is a vascular regulatory mechanism for making myocardial perfusion uniform in response to decreased PaO2. In both perfusion states, Cl/decreased with increasing PA. The relationship between CV and PA fitted the noninteger power law function, implying an apparent fractality of CV.
Temporal and Spatial Heterogeneity of Blood Supply to the Heart: Visualization and Interpretation
Authors: Kajiya F.
Published: March 2018

Blood flow of the heart muscle (the coronary circulation) exhibits both temporal and spatial heterogeneity. In this paper, the unique blood velocity waveform during a cardiac cycle, the flow fluctuation of a longer period and the within-layer spatial flow heterogeneity of the coronary circulation are described with a reference to the pathogenesis of angina pectoris and myocardial infarction.
Stabilization of traumatic coxofemoral luxation with an extra-capsular suture from the greater trochanter to the origin of the rectus femoris
Authors: Shani J. , Johnston D. E. , Shahar R.
Published: March 2018

A wide variety of surgical techniques to stabilize the coxo-femoral joint have been described in the veterinary literature. In this paper twenty small animals (19 dogs and 1 cat) were treated successfully with open reduction and an extra-capsular suture taken between the greater trochanter of the femur and the origin of the rectus femoris muscle. The technique is simple, quick and safe, and avoids many of the potential complications associated with other methods.
Diagnosis and Treatment of Tuberous Sclerosis Manifestations in Children: A Multicenter Study
Authors: Ebrahimi-Fakhari Daniel , Gortner Ludwig , Poryo Martin , Zemlin Michael , Macaya-Ruiz Alfons , Meyer Sascha , Flotats-Bastardas Marina
Published: March 2018

Tuberous sclerosis complex (TSC) is a genetic disease with a significant morbidity and mortality. We conducted a retrospective analysis of two cohorts (Vall d'Hebron University Hospital [HVH], Barcelona, Spain, 1982–2015, and at Saarland University Medical Center [UKS], Homburg, Germany, 1998–2015) to assess prevalence and treatment of TSC associated manifestations and to evaluate if the follow-up was in line with published recommendations. This was considered if more than 15% of patients did not receive adequate examination with regard to potential organ involvement. A definite diagnosis was made in 52 patients (96%), and a possible diagnosis was made in 2 patients (4%). Thirty-four (63%) patients were from HVH and 20 (37%) from UKS. Median age at first presentation was 6 months (interquartile range: 0–38 months), and median time of follow-up was 6 years (interquartile range: 2–13 years). Clinical symptoms that led to a diagnosis of TSC were cardiac rhabdomyoma (22/54), epilepsy (20/54), and cutaneous manifestations (4/54). Assessment of neuropsychiatric, renal, and ocular manifestations was inadequate in both hospitals, whereas cutaneous manifestation was inadequate at UKS only. Our data demonstrate insufficient examinations in a substantial number of TSC patients with regard to neuropsychiatric, renal, ocular, and cutaneous manifestations. The recently published guidelines may prove valuable in establishing a more comprehensive approach.
The Agenda of Wearable Healthcare
Authors: Tröster G.
Published: March 2018

Driven by cost and quality issues, the health system in the developed countries will undergo a fundamental change in this decade, from a physician-operated and hospital centred health system to consumer operated personal prevention, early risk detection and wellness system. This paper sketches the vision of a ‘Personal Health Assistant’ PHA, opening up new vistas in patient centred healthcare. The PHA comprises a wearable sensing and communicating system, seamlessly embedded in our daily outfit. Several onbody sensors identify the biometric and contextual status of the wearer continuously. The embedded computer generates the ‘Life Balance Factor’ LBF as an individual feedback to the user and to the surroundings affording an effective prevention, disease management and rehabilitation also in telemedicine. The state-of-the-art enabling technologies – mainly miniaturization of electronics and sensors combined with wireless communication and recent developments in wearable and pervasive computing are presented and assessed concerning multiparameter health monitoring.
The Practical Impact of Ontologies on Biomedical Informatics
Authors: Zhu X. , Cimino J. J.
Published: March 2018

To examine recent research work in the development and evaluation of controlled biomedical terminologies – especially, the representation of structured, controlled definitional knowledge about the terms themselves; such terminologies are often referred to as “ontologies”.

A review of the published literature using PubMed, as well as full-text searches of recent Medinfo and American Medical Informatics Association (AMIA) Symposia proceedings, searching for the terms “ontology” and “ontologies” and for articles discussing specific, prominent ontological work.

We summaries the ontologic aspects of twelve current terminology projects: Galen, the Unified Medical Language System (UMLS), the Medical Entities Dictionary (MED), SNOMED-CT, LOINC, the Foundational Model of Anatomy (FMA), the Gene Ontology (GO), ISO Reference Terminology Model for Nursing Diagnosis, NDF-RT, RxNorm, the NCI Thesaurus, and DOLCE+. We discuss the origins, domain, and ontologic representation of each of these and attempt to summarize the impact that each has had on terminologic work and biomedical applications. We also note the contributions of the Protégé tool to many of these efforts.

Terminologic research and development have advanced significantly in the past 20 years, especially since the recent orientation toward controlled biomedical ontologies. This work has had significant impact on the development of terminologies themselves, their acceptance and dissemination as standards, and their use in supporting biomedical information systems.
Section 7: Bioinformatics: Bioinformatics and its Impact on Clinical Research Methods
Authors: Lang E. ,   Managing Editor for the IMIA-Yearbook Section on Bioinformatics
Published: March 2018

To summarize current excellent research in the field of bioinformatics.

Synopsis of the articles selected for the IMIA Yearbook 2006. Results: Current research in the field of bioinformatics clearly shows ongoing unification of experimental findings and clinical outcomes. Microarray data, gene sequences and clinical data are more and more perceived as different but related facets of one entity. Significant work is done in the area of text and data mining in order to bring together patient data and biochemical phenomena by means of ontologies. A strong trend in the clinical field is performance of exhaustive studies on DNA material derived from patients that suffer from diseases that are already known to be inherited. Examination of appropriate methods covers data and text mining, ontologies as well as machine learning and classification.

The best paper selection of articles on bioinformatics shows examples of excellent research on methods used for studying inherited diseases and their underlying genetic dispositions. Clinical studies, inclusion of experimental findings like microarray data, and of knowledge representation formats all lead to a better understanding the linkage between gene sequences, biological functions and clinical findings in the form of healthy state or physiological disorders.
Sensor, Signal and Image Informatics
Authors: Aach T. , Witte H. , Lehmann T.M.
Published: March 2018

The number of articles published annually in the fields of biomedical signal and image acquisition and processing is increasing. Based on selected examples, this survey aims at comprehensively demonstrating the recent trends and developments.

Four articles are selected for biomedical data acquisition covering topics such as dose saving in CT, C-arm X-ray imaging systems for volume imaging, and the replacement of dose-intensive CTbased diagnostic with harmonic ultrasound imaging. Regarding biomedical signal analysis (BSA), the four selected articles discuss the equivalence of different time-frequency approaches for signal analysis, an application to Cochlea implants, where time-frequency analysis is applied for controlling the replacement system, recent trends for fusion of different modalities, and the role of BSA as part of a brain machine interfaces. To cover the broad spectrum of publications in the field of biomedical image processing, six papers are focused. Important topics are content-based image retrieval in medical applications, automatic classification of tongue photographs from traditional Chinese medicine, brain perfusion analysis in single photon emission computed tomography (SPECT), model-based visualization of vascular trees, and virtual surgery, where enhanced visualization and haptic feedback techniques are combined with a sphere-filled model of the organ.

The selected papers emphasize the five fields forming the chain of biomedical data processing: (1) data acquisition, (2) data reconstruction and pre-processing, (3) data handling, (4) data analysis, and (5) data visualization. Fields 1 and 2 form the sensor informatics, while fields 2 to 5 form signal or image informatics with respect to the nature of the data considered.

Biomedical data acquisition and pre-processing, as well as data handling, analysis and visualization aims at providing reliable tools for decision support that improve the quality of health care. Comprehensive evaluation of the processing methods and their reliable integration in routine applications are future challenges in the field of sensor, signal and image informatics.
Access to Health Information: a Key for Better Health in the Knowledge Society
Authors: Geissbuhler A.
Published: March 2018

Objectives To illustrate how access to health information is a key determinant to the strengthening of health and healthcare systems, and highlight related current challenges of the evolving knowledge society.

MethodsReflections on some of the dimensions of access to health information, with a focus on current evolutions of the World-Wide-Web, unresolved issues and research perspectives.

Conclusion Our knowledge society is growing, maturing, and bringing powerful tools that can improve the quality, safety, and efficiency of healthcare processes and help citizens manage their health. However, many obstacles and challenges are still facing us. These include our ability to manage information and knowledge rather than data, produce decision-support tools with contents and ergonomics that effectively change behaviors, orient information users in the ever-growing jungle of the social World-Wide-Web, learn how to make sense and enable knowledge discovery in the huge and increasingly connected biomedical data repositories, and bridge the digital divides that exist within communities and across the world.
A Bio-Medical Informatics Perspective on Human Factors
Authors: Ruch P. ,   Managing Editor for the IMIA Yearbook Section on Human Factors
Published: March 2018

Objectives To summarize current excellent research in the field of human factors.

MethodsWe provide a synopsis of the articles selected for the IMIA Yearbook 2008, from which we attempt to derive a synthetic overview of the activity and new trends in the field.

Results while the state of the research in the field of human factors is illustrated by a set of fairly heterogeneous studies, it is possible to identify trends. Thus, clearly, the importance of issues related to medical order entry, which also founded human factors studies in medical informatics, still occupies a central role in the field. In parallel, we observe an emerging interest for human factors from the field of bioinformatics, where the mass of data generated by high/ throughput experiments and large-scale genome analysis projects, raises specific processing challenges. Such challenges will have to be addressed to achieve post-genomics era medicine.

Conclusions The best paper selection of articles on human factors shows examples of excellent research on methods concerning original development as well as quality assurance of previously reported studies. The crucial role of preserving interpersonal communication among healthcare staff in computerized working environments is complemented by more original scientific investigations, which demonstrate the needs for computerized applications to transform the biomedical data overflow into more operational clinical knowledge. Altogether these papers support the idea that more elaborated computer tools, likely to combine contextual contents, are needed.
Electronic Health Record Goes Personal World-wide
Authors: Lee PS , Jian WS , Kuo CH , Li YC
Published: March 2018

Objective Increasing patient demand for convenient access to their own healthcare data has led to more personal use of the Electronic Health Record (EHR). With “consumer empowerment” being an important issue of EHR, we are seeing a more “patient-centric” approach of EHR from countries around the world. Researchers have reported on issues in EHR sharing including concerns on privacy and security, consumer empowerment, competition among providers, and content standards. This study attempts to analyze prior research and to synthesize comprehensive, empirically-based conceptual models of EHR for personal use.

Methods We use “B2C(2B)” to represent this new behavior of EHR sharing and exchange, with “consumer” in the center stage.

ResultsBased on different information sharing mechanisms, we summarized the “B2C(2B)” behavior into three models, namely, the Inexpensive data media model, the Internet patient portal model and the Personal portable device model. Models each have their own strengths and weaknesses in their ways to share patient data and to address privacy and security concerns.

Conclusion Personal use of EHR under the B2C(2B) model does look promising based on our study. We started to observe a trend that governments around the world are embarking on related projects. With multiple stake-holders involved, we are only beginning to understand the complexity of such undertakings.
Information Systems in Healthcare – State and Steps towards Sustainability
Authors: Lenz R.
Published: March 2018

Objectives To identify core challenges and first steps on the way to sustainable information systems in healthcare.

Methods Recent articles on healthcare information technology and related articles from Medical Informatics and Computer Science were reviewed and analyzed. Core challenges that couldn’t be solved over the years are identified.

Results The two core problem areas are process integration, meaning to effectively embed IT-systems into routine workflows, and systems integration, meaning to reduce the effort for interconnecting independently developed IT-components. Standards for systems integration have improved a lot, but their usefulness is limited where system evolution is needed.

Conclusions Sustainable Healthcare Information Systems should be based on system architectures that support system evolution and avoid costly system replacements every five to ten years. Some basic principles for the design of such systems are separation of concerns, loose coupling, deferred systems design, and service oriented architectures.
Health Information Systems New Shifts and Emerging Trends in Health IT Infrastructures
Authors: Bréant C. ,   Section Editor for the IMIA Yearbook Section on Health Information Systems
Published: March 2018

Objectives Summarize excellent current research in the field of Health Information Systems.

Method Synopsis of the articles selected for the IMIA Yearbook 2009.

ResultsFive papers from international peer reviewed journals have been selected for the section on health information systems. They concentrate on topics such as personal health records, the comparison of IT infrastructures in hospitals from different countries, hospital to hospital IT outsourcing partnership, and the wireless monitoring of patients.

Conclusions The elected articles highlight the new shifts in health information management and challenges faced by hospitals regarding IT infrastructures.
Towards Clinically Available Closed-loop Systems for Mechanical Ventilation in the Intensive Care Unit
Authors: Tschopp M. , Lovis C.
Published: March 2018

Objective To provide an overview of the state-of-the-art of closedloop systems in the field of mechanical ventilation.

Methods This survey is reviewing the literature and proposes an overview of existing closed-loop systems, in different areas of mechanical ventilation. It discusses the key points that guided their development and addresses specific issues such as their performance and penetration at the bedside.

Results Much research has been undertaken in the hope of improving patient-ventilator interaction and shortening the weaning process. This led to the development of new modes of ventilation and expert weaning systems that are starting to achieve a wider clinical audience.

Conclusion Intensive care unit personnel are facing increasing work load during care for patients with severe, multi-system illness, using sophisticated equipments that generate high information flows requiring quick processing. Mechanical ventilation is a good example of a process that requires skilful and timely management of multiple parameters that could be delegated to closed-loop systems. Availability of commercial offerings, validated by randomized controlled trials in a well-defined set of clinical situations, is starting to fulfill the promise of intelligent systems skillfully assisting caregivers at the bedside.
Sensors, Medical Images and Signal Processing:
Authors: Depeursinge A. , Müller H. ,   Section Editors for the IMIA Yearbook Section on Sensor, Signal, and Imaging Informatics
Published: March 2018

Objectives To summarize current excellent research in the field of medical sensor, signal and imaging informatics.

Method Synopsis of the articles selected for the IMIA (International Medical Informatics Association) Yearbook 2009.

Results Current research in the field of sensors, signal, and imaging informatics is characterized by theoretically sound techniques and evaluations with focus in imaging informatics.

Conclusions The best paper selection of articles on sensors, signal, and imaging informatics shows examples of excellent research on methods concerning theoretically sound original development in this field. Imaging and particularly multi-dimensional imaging has had in 2008 by far the largest number of publications compared to signals and sensors.
Towards Health Informatics 3.0. Editorial
Authors: Kulikowski Casimir , Geissbuhler Antoine
Published: March 2018

To provide an editorial introduction to the 2011 IMIA Yearbook of Medical Informatics with an overview of its contents and contributors.

A brief overview of the main theme, and an outline of the purposes, contents, format, and acknowledgment of contributions for the 2011 IMIA Yearbook.

This 2011 issue of the IMIA Yearbook highlights important developments in the development of Web 3.0 capabilities that are increasing in Health Informatics, impacting the activities in research, education and practice in this interdisciplinary field. There has been steady progress towards introducing semantics into informatics systems through more sophisticated representations of knowledge in their underlying information. Health Informatics 3.0 capabilities are identified from the recent literature, illustrated by selected papers published during the past 12 months, and articles reported by IMIA Working Groups.

Surveys of the main research sub-fields in biomedical informatics in the Yearbook provide an overview of progress and current challenges across the spectrum of the discipline, focusing on Web 3.0 challenges and opportunities.
Experience in the Use of Social Media in Medical and Health Education
Authors: Bamidis P. D. , Eysenbach G. , Hansen M. , Cabrer M. , Paton C.
Published: March 2018

Social media are online tools that allow collaboration and community building. Succinctly, they can be described as applications where “users add value”. This paper aims to show how five educators have used social media tools in medical and health education to attempt to add value to the education they provide.

We conducted a review of the literature about the use of social media tools in medical and health education. Each of the authors reported on their use of social media in their educational projects and collaborated on a discussion of the advantages and disadvantages of this approach to delivering educational projects.

We found little empirical evidence to support the use of social media tools in medical and health education. Social media are, however, a rapidly evolving range of tools, websites and online experiences and it is likely that the topic is too broad to draw definitive conclusions from any particular study. As practitioners in the use of social media, we have recognised how difficult it is to create evidence of effectiveness and have therefore presented only our anecdotal opinions based on our personal experiences of using social media in our educational projects.

The authors feel confident in recommending that other educators use social media in their educational projects. Social media appear to have unique advantages over non-social educational tools. The learning experience appears to be enhanced by the ability of students to virtually build connections, make friends and find mentors. Creating a scientific analysis of why these connections enhance learning is difficult, but anecdotal and preliminary survey evidence appears to be positive and our experience reflects the hypothesis that learning is, at heart, a social activity.