bluuebunny/crossref_metadata_2025 huggingface dataset:
Telemedicine and Medical Informatics in the Multimedia Super Corridor: The Malaysian Vision
Authors: Abidi Syed Sibte Raza  , Goh Alwyn  , Yusoff Zaharin
Published: February 2025

The practice of medicine, with its wide range of environmental conditions and complex dependencies, has long been used as a test bed for various advanced technologies. Telemedicine, as conceptualised within the Multimedia Super Corridor (MSC) context, is seen as the application of several relatively mature technologiesartificial intelligence (AI), multimedia communication and information systems (IS) amongst othersso as to benefit a large cross-section of the Malaysian population. We will discuss in general terms the Malaysian vision on the comprehensive MSC telemedicine solution, its functionality and associated operational conditions. In particular, this paper focuses on the conceptualisation of one key telemedical component i.e. the Lifetime Health Plan (LHP) system, which is eventually intended to be a distributed multi-module application for the periodic monitoring and generation of health-care advisories for upwards of 20 million Malaysians.
Conceptual Integration of Information Databases into an Intranet
Authors: Joubert Michel  , Volot Françoise  , Fieschi Dominique  , Fieschi Marius
Published: February 2025

Large information systems handle massive volume of data stored in heterogeneous sources of information. Each server has its own model of concepts representation with regard to its aims. One of the main problems encountered by end-users when accessing different servers is to match their own viewpoint on biomedical concepts with their various representations that are made in the database servers. The aim of the project ARIANE is to provide end-users with easy-to-use and natural means to access and query heterogeneous information databases. The objectives of this research work consist in building a conceptual interface by means of the Internet technology inside an enterprise Intranet, and to propose a method to realize it. Moreover, this method provides designers of web sites with a powerful tool to manage them on the basis of an ontology of the biomedical domain. This method is based on the knowledge sources provided by the Unified Medical Language System project of the U.S. National Library of Medicine and exploits intensively the conceptual graphs theory.
Middleware for Healthcare Information Systems
Authors: Spahni Stéphane  , Scherrer Jean-Raoul  , Sauquet Dominique  , Sottile Pier-Angelo
Published: February 2025

Middleware is now a commonly used expression and anyone building distributed applications is referring to “middleware services”. Nevertheless this notion lacks of sound theoretical foundation. This paper tries to clarify the relationship between the components of distributed environments, especially in healthcare, and to establish some classification aiming at gaining a common understanding of the functionalities and interdependency of the existing modules of distributed environments.
Decision Support for Medication Use in an Inpatient Physician Order Entry Application and a Pharmacy Application
Authors: Kuperman Gilad J.  , Cooley Tom  , Tremblay Joanne  , Teich Jonathan M.  , Churchill William
Published: February 2025

Studies have shown that adverse drug events are common, expensive, and due to causes that can be remedied by information technologies. At our institution we have developed a physician order entry application and a pharmacy application designed to decrease the risk of such adverse drug events. In this paper, we describe the applications, with attention to the clinical decision support features present in each. We also describe the manner in which the two applications interact.
Implementation of a Fuzzy Prototype-based Machine Learning Method to predict Myocardial Infarction from Coronary Angiography
Authors: Colombet Isabelle  , Jaulent Marie-Christine  , Diebold Benoît  , Degoulet Patrice
Published: February 2025

Formal knowledge on the predictive value of morphological angiographic factors is lacking to estimate the risk of myocardial infarction. This article presents a computer system for predicting the incidence of myocardial infarction from angiographic morphological descriptions of coronary lesions. The system includes two phases. The learning phase consists in extracting from a large database of described stenoses two classes represented by one or several fuzzy prototypes. One class corresponds to stenoses leading to infarction and the other to stenoses not leading to that event. The evaluation phase consists in classifying a stenosis according to its morphological characteristics in one of these two classes. The learning method is based on a fuzzy supervised Machine Learning algorithm that combines some aspects of the K-nearest neighbours clustering approach with a defined measure of similarity, and a prototype induction function from the most similar stenoses, taking into account their degree of typicality. The current results of the evaluation phase to correctly predicted X % stenoses for their risk of myocardial infarction. This article emphasizes the feasibility of the approach, however, the learning phase relies on some heuristics that should be validated to get a formal evaluation of the system.
Relevant Information for Decision Support Systems: Application in Cardiology
Authors: Zvárová Jana  , Tomeèková Marie  , Boudík František
Published: February 2025

In the paper we show information theory tools for extracting relevant information for decision support systems from medical databases. Each proposed algorithm for selecting a set of relevant features has a specific score function defined by means of information-theoretical characteristics. Then algorithms are classified according to the primary criterion, that can lead to influence-preferring algorithms or weight-preferring algorithms. Other type of classification can be based on the way of selecting of features as forward, backward or combined algorithms. The software package called CORE (COnstitution and REduction) that supports the process of selection of features relevant for a decision making problem is described. Application on data about 1417 middle age men collected in the twenty years lasting interventional study of cardiovascular risk factors in middle aged men and for decision support in primary care are shown. However, the methodology presented is applicable for any decision making problem where extracting relevant information from data is required.
Microcomputer Decision Support System for Intensive Care
Authors: Cañizares Nelson Juan  , Díaz Raúl  , Gurris Luis Armando  , Sánchez José Antonio  , Pear Israel  , Quintero Rubén  , Soto Emilio  , Hernández Héctor  , Morales Ricardo  , Lannes Rom´n  , Rodriguez Oscar  , Díaz Ileana  , Obrador Lourdes
Published: February 2025

This article describes a computer system to support decisions in Intensive Medicine developed for a multipurpose Intensive Care Unit (13 beds and about 700 yearly patients). The system is used in a microcomputer (486DX4). Works done in this area are mentioned; and the different programs which integrate the system, the advantages of its use and the results accomplished are described. Some of the most important results are the quality increment of the medical care given, physicians' possibilities of dedicating more time to their patients, cost reductions, and improvements in the development of teaching and in the conditions to carry out research work in the Intensive Care Unit (ICU). An analysis is made of the system requirements that guarantee its integration to the Unit work, and the easy and safe use of it by the physicians and nurses.
Diagnosing Breast Cancer from FNAs: Variable Relevance in Neural Network and Logistic Regression Models
Authors: Ohno-Machado Lucila  , Bialek Donald
Published: February 2025

We compared the selection of variables for building a classification model for the diagnosis of breast cancer using neural networks and logistic regression. A set of 460 cases was used to build neural network and logistic regression models that classify cell samples obtained by fine-needle aspiration (FNA) as malignant or benign, depending on nine pathology features. Variables selected by a step down logistic regression model were compared to those selected by a measure of relevance derived from neural network weights. Since both types of models resulted in similar predictive accuracy, we expected approximately the same variables to be selected. The variables with the highest relevance values for the neural network models corresponded to those of high significance in univariate logistic regression models, but were not the ones selected in the step down procedure of multivariate models. Variable relevance based on weights for neural network models does not seem to be a consistent index of the importance of that variable for multivariate models such as logistic regression.
An Evaluation of UMLS as a Controlled Terminology for the Problem List Toolkit
Authors: Goldberg Howard  , Goldsmith Denise  , Law Vincent  , Keck Kevin  , Tuttle Mark  , Safran Charles
Published: February 2025

We are developing a set of software components—the Problem List Toolkit (PL-Tk) – to support operations on clinical problem labels. An adaptation of the National Library of Medicine’s Unified Medical Language System (UMLS) provides general vocabulary services to domain-specific software components. Our initial investigation centers on the inclusion in UMLS of problem labels used in the Beth Israel Deaconess Medical Center's Online Medical Record (OMR). We also explore the semantic typing of problem labels matched in UMLS. We have operationally defined a clinical problem to derive its semantic type from classes of terms representing findings or processes typically requiring diagnostic evaluation or therapeutic management in clinical practice. Of 1262 unique OMR problem labels, 999 terms (79%) have matches in UMLS. 986 of 999 terms (99%) map to the UMLS concept of the corresponding lexical match. 952 of 999 terms (95%) have semantic types that comply with our operational definition of clinical problems. These 952 terms (75%) constitute Version 1.0 of the problem list vocabulary BI96. Matching terms with inappropriate semantic types raise issues regarding requirements for PLTk, typing of existing UMLS terms, and the adequacy of our operational definition for clinical problems. UMLS provides a large repertoire of pre-coordinated terms that are used as problem labels in a heavily used computer-based patient record system. The semantic type hierarchy provides a framework for the consistent use of clinical concepts in problem lists such that clinical problem labels represent “good” clinical problems.
Collaboration over the Internet - the Melbourne-Singapore way
Authors: Goh L.G.  , Liaw S.T.  , Lun K.C.
Published: February 2025

The University of Melbourne and The National University of Singapore have established a joint WWW page under the auspices of the Cyberspace Hospital to facilitate inter-regional collaboration and discussion about best practice in research, teaching and clinical activities in general and family practice. Information about each of the two departments are available as well as an electronic forum over the WWW (URL is http://ch.nus.sg/fammed). Seminal papers on research, teaching and clinical practice are discussed and summarised after critique from GPs from both regions. A paper is discussed every 8 weeks: 1 week to post the paper plus a critique, 6 weeks for discussion, and 1 week to sum up and post the summary. It is planned to progress to audio- and video-conferencing and to widen the participant groups. The process of and difficulties with establishing, maintaining and running the electronic forum is described. Results of the discussions, comments from participants and strategies for the future will be presented as well as a demonstration ofthe electronic forum.
“THE ELECTRONIC WARDENî Management of the Data Security Access in a Heterogeneous University Hospital Environment in Belgium
Authors: Piret C.  , Roger France F.H.  , Clae D.  , Dubr F.
Published: February 2025

A very flexible software system called «Electronic Warden» has been developed. It is based on a «client/server» architecture. It controls and manages the access right of the complex and heterogeneous data computer system at St Luc Hospital in Brussels. The electronic warden is independent of the other software applications of the hospital and is connected to them through API'S. The physical access is managed with the use of smart card and allows the electronic signature. The management of the users and their accesses to the data is run in a centralised or a decentralised way which allows a lot of flexibility.
A Hospital Information System based on Common Object Request Broker Architecture(CORBA) for Exchanging Distributed Medical Objects - an approach to future environment of sharing healthcare information-
Authors: Ohe Kazuhiko
Published: February 2025

Tightly related subsystems in a HIS have to exchange medical data flexibly by the data object rather than by the battery of the data. We developed a CPR subsystem based on Common Object Request Broker Architecture (CORBA) that retrieves and stores clinical information in the object-oriented database via Internet Intra-ORB Protocol (IIOP). The system is hybridized with the legacy HIS applications on the client terminals. We believe that our solution and the experiences will contribute to the future CORBA-based environment in which computerized patient information is shared among hospitals, clinics, and tightly related systems.
Annex VIII: Electronic Transactions. Levels of Protection
Authors: Ferrer-Roca O.
Published: February 2025

This annex introduces some aspects related with present electronic money and electronic transactions, particularly on the solutions existing at present, especially those that have been standardised. A summary of the levels of protection is also included at the end of this annex.
Information dissemination and training: two key issues for consolidating and strengthening the results of health telematic projects
Authors: Arcarese Tiziana  , Boi Silvia  , Gagliardi Roberto
Published: February 2025

The concepts expressed in this paper concerns the activities to be developed within HEALTHLINE, a European project under the Telematics Application programme. HEALTHLINE is an umbrella project which takes initiatives and provides links to other international projects on health telematics. The projects involved are NIVEMES and RISE; they represent the starting point from which a common approach will be developed.
PERSONAL STORIES WITHIN VIRTUAL ENVIRONMENTS: CREATING THREE EXPERIENCES IN CANCER INFORMATION SOFTWARE
Authors: Drew Greene Darcy
Published: February 2025

Virtual environments can create a relaxed mood, increasing a patient's receptivity to leaming. Personal stories and an individual approach to the content, rather than abstract facts, make the CD-generated experience vivid and informative. With the user in control, selecting content and interacting constantly with the program, the virtual experience is more meaningful than the one created by simply retrieving information. This chapter explains how three CD-ROMs containing cancer information - Breast Cancer Lighthouse, Easing Cancer Pain and Cancer Prevention Park - embody personal stories and medical information in virtual environments.
CURRENT USES OF VIRTUAL REALITY FOR CHILDREN WITH DISABILITIES
Authors: McComas Joan  , Pivik Jayne  , Laflamme Marc
Published: February 2025

Technological advances, including the use of virtual reality, have contributed enormously to improving the treatment, training, and quality of life of children with disabilities. This paper describes the advantages of VR for children with disabilities, how VR can minimize the effects of a disability, the role of VR in training and skills enhancement, and how social participation and the child's quality of life may be improved through the use of VR.
GAIT AND PARKINSON'S DISEASE: A CONCEPTUAL MODEL FOR AN AUGMENTED-REALITY BASED THERAPEUTIC DEVICE
Authors: Riess THOMAS J.
Published: February 2025

This chapter presents an augmented-reality based therapeutic device designed to overcome gait problems associated with Parkinson’s Disease (PD). A normal model of gait is proposed followed by a model of Parkinsonian gait with the goal of construction of a gait enabling therapeutic device. The fondamental underlying tenet of the model is that vision pathology is responsible for the majority of Parkinsonian gait pathology. The basis for such a claim is the well documented phenomenon known as Kinesia Paradoxa, whereby in the presence of certain so-called visual cues a PD subject can be transformed from a totally immobile, helpless victim of this disease into a near normal walking individual. Several gait-enabling devices are also described.
VIRTUAL REALITY IN PARAPLEGIA: A VR-ENHANCED ORTHOPAEDIC APPLIANCE FOR WALKING AND REHABILITATION
Authors: Riva Giuseppe
Published: February 2025

Spinal cord injuries (SCIs) have a profound physical, social and emotional cost to patients and their families. Obviously SCIs severely disrupt normal patterns of interaction with the environment. Firstly, the opportunities for active interaction are inevitably diminished due to motor or sensory impairment. Moreover, such problems may increase as the time since injury lengthens and the patient becomes more withdrawn and isolated in all spheres of activity. However, advances in Information Technology are providing new opportunities for rehabilitation technology. These advances are helping people to overcome the physical limitations affecting their mobility or their ability to hear, see or speak.
VR EXPERIENCE WITH NEUROLOGICAL PATIENTS: BASIC COST/BENEFIT ISSUES
Authors: Pugnetti Luigi  , Mendozzi Laura  , Barbieri Elena  , Motta Achille
Published: February 2025

The future of VR applications for mental health is currently regarded as depending on the rational development of ideas and Systems. Criteria to guide this development have been suggested that are both clear and agreeable. Their application, however, may not be easy at this stage. While we may already be able to predict costs of specific VR applications, a period of more extensive clinical research is needed in order to assess adequately any benefit. In our still hmited experience, the development of VR applications to increase the diagnostic sensitivity of traditional tests to strategy apphcation disorders is worthwhile, but the uniqueness of VR assets may make the adherence to some of the proposed criteria somewhat problematic.
Biomechanical Modeling of the Control of Trunk Muscles
Authors: Beauséjour M.  , Aubin C.-É.  , Mitnitski A.B.  , Feldman A.G.
Published: February 2025

This paper presents 2 models postulating specific control mechanisms for trunk movement production. The first model represents the trunk as an inverted pendulum with two degrees of freedom (trunk inclination and flexion/extension in sagittal plane) controlled by 6 mono- and bi-articular muscles. Dynamic equations for trunk extension included gravitational, passive elastic and muscle forces. The equilibrium point hypothesis (λ model) was used to simulate the control processes underlying the movement based on 3 control parameters (reciprocal and co-activation commands, and a damping factor). This model was able to simulate the empirical relationship between trunk inclination and flexion/extension as well as EMG patterns during load lifting. The second model is characterized by a more geometrically elaborated representation of the spine, rib cage and pelvis and uses a finite elements approach. It includes 160 muscle fascicles represented by non-linear springs with threshold lengths modified according to the λ model to produce the muscle recruitment patterns for specific motor tasks. This model, personalized to the shape of two subjects (one scoliotic and one healthy), was used to simulate a lateral bending test. Preliminary results showed the coherent behavior of the multiple muscle structure.
The Range of Motion of the Scapula and its Functional Implications
Authors: Lawrence-Tayler Terri M.  , Gunther Michael M.  , Dangerfield Peter H.
Published: February 2025

The scapula is often overlooked or ignored in shoulder complex studies as its motions occur under skin and muscles which, in vivo, makes measurements difficult to obtain. In fact, the scapula is often considered as a separate entity to the shoulder mechanism, as it has no fixed relationship to other features on the thorax, as found with, for example, the arm. The aim of this study is the description of complete 3D-scapular motion in its functional context. Distances were measured from three bony landmarks on the scapula to a fixed point on a vertebra. It is clear from data analysis of a ‘normal’ (i.e. without scoliosis) population that males were generally more flexible and achieved greater scapular range of motion than females. Differences also exist between arm (i.e. left/right, one-arm/two-arm) movements and between passive and active movements. This study has produced new data regarding motion of the scapula in various planes of movement, which has direct relevance to the study of shoulder asymmetry and resulting arm length differences found in scoliotic patients.
Interobserver Reliability of Scoliometer Measurements of Rotational Deformity in Adolescent Idiopathic Scoliosis
Authors: Galatz Leesa M.  , Sturm Peter F.  , Bomze Shira  , Simmens Sam
Published: February 2025

Assessment of rotational deformity of spinal curvature is an important method of evaluating curves and in following the progression of adolescent idiopathic scoliosis. An evaluation of the interobserver reliability of scoliometer measurements was performed. We also iinvestigated whether interobserver reliability varied with the magnitude of the Cobb angle. Three clinicians, measured the axial rotation of thoracic and lumbar curves in degrees on fifty patients with adolescent idiopathic scoliosis during the same office visit. The Cobb angles were measured on the same day. Correlations were made by determining a Pearson correlation coefficient. Agreement between the raters was good with coefficients ranging from .83 to .89 (average= .86). The interobserver variability was 1.3 degrees and was not dependent on the magnitude of the Cobb angle. Correlation between degrees of rotation and Cobb angle was poor for each of the raters with average coefficient .55. These results demonstrate that interobserver reliability in use of the Scoliometer is good, not excellent. They also confirm that rotational deformity has no relation to the sagittal curve. The Scoliometer is a useful augmentation device in evaluating and planning treatment in scoliosis, but is not reliable in long term tracking of progression when used by multiple observers.
Relationship of Thoracic Kyphosis to Lumbar Bone Density
Authors: Goh S.  , Price R.I.  , Leedman P.  , Singer K.P.
Published: February 2025

This study examined the association between thoracic kyphosis derived from rasterstereographic measurement of back shape and lumbar bone mineral density (BMD) in 31 female subjects. Back shape imaging was performed following routine lumbar densitometry utilising dual energy X-ray absorptiometry. Thoracic kyphosis parameters were moderately correlated with mean BMD when second order polynomial regression models were fitted to the dataset. The association between accentuation of kyphosis and reductions in BMD was further confirmed following conversion of mean BMD values to age-matched Z-scores. These data conform to previous studies investigating radiographic indices of thoracic curvature and clinical lumbar BMD. Non-invasive examination of thoracic kyphosis may hence complement other existing methods for detecting early indicators of spinal osteoporosis.
A Correlation Study of Global and Local Descriptors of the Scoliotic Spine Deformity
Authors: Villemure I.  , Aubin C.-É.  , Dansereau J.  , Petit Y.  , Labelle H.
Published: February 2025

An in vivo study investigated 2D and 3D relationships between global and local vertebral and discal descriptors of the scoliotic spine deformity. It was performed on a cohort of 40 patients representing a wide range of thoracic curve progression. Global descriptors referred to Cobb angle in PA view as well as corresponding Cobb angle in the plane of maximum deformity and its angular orientation. Local descriptors included vertebral axial rotation, wedging angles in the global and local vertebral frontal planes as well as a 3D maximum wedging angle and its angular orientation. Statistical analyses indicated that, at the thoracic level, vertebral wedging and axial rotation increase with curve severity. The 3D maximum wedging tends to shift towards the left posterolateral vertebral region with curve severity, with simultaneous displacement of the plane of maximum deformity toawrds the coronal plane. These results confirm the importance of 3D measurements in the understanding of biomechanics of idiopathic scoliosis.
Workshop 2 Usefulness of Computer Assisted Measurements During Surgery: Should we Continue?
Authors: Labelle Hubert
Published: February 2025

This report is a summary of the discussion held during the workshop on computer assisted measurement during surgery. The purpose of this workshop was to discuss the value of intra-operative measurements during scoliosis surgery in order to determine if the information gained from these measurements was sufficient to outweigh the costs and other disadvantages involved in collecting the data.
Nonlinear Properties of Cardiovascular Time Series
Authors: Signorini Maria G.  , Cerutti Sergio
Published: February 2025

Nonlinear dynamics are certainly involved in tlie generation and control of cardiovascular signais. The paper presents a methodological and clinical review of nonlinear dynainic analysis in heart rate variability signals (HRV) obtained from normal subjects and pathological cases. The employed methods starts both from state space reconstruction procedures (Correlation Dimension, Lyapunov Exponents, False Nearest Neighborhood, Nonlinear Noise Filtering in the space-state) and by direct estimation of time series characteristics (Self-Similarity Hurst Exponent, Approximate Entropy). Analysis parameters confirm their usefulness in ihe classification of different patient groups. Examples reported for normal subjects, patients after orthotopic heart transplant, patients who recently had an anterior myocardial infarction episode, confirm the ability of these indexes in the HRV patterns classification both in short and long temporal Windows. Moreover, preliminary results in ICU patients indicate that long period indexes seem to be strongly related to the prediction of both positive and negative patient outcome. Computation of parameters from the nonlinear dynamic approach to the cardiovascular system can be a valid help for diagnosis of pathological heart States.
Visual Clues In Minimally Invasive Surgery: Use Of 2-D Versus 6-D Enhanced Performance of Complex Minimally Invasive Complex Skills
Authors: Geis W. Peter  , Gillian G. Kevin  , Berry Marcos
Published: February 2025

In the recent past, we used two 2-D videoscopes to obtain both a close detailed view and simultaneously a panoramic view to improve the efficient and safe access for instruments into the microscopic working field by way of the benefits of the panoramic view. This bi-modal visual set of clues allows for (1) insertion of suture, (2) cutting of suture with scissors (3) retraction of tissue, and (4) removal of suture and needle. During these experiences, we observed the benefits accrued to the surgeon by allowing the focusing of his/her attention on the work (technical skills) without diffusing energy to other activities. Similarly, when training surgeons to perform micro-anastomoses, and while working to improve performance in micro-anastomoses, we hypothesize that two or more videoscopic views of the 3-dimensional working space would provided added visual information to the surgeon during the microscopic work. To exarnine this hypothesis, we have used a non-animate model, in the performance of complex skills in videoscopic surgery.
Virtual Hand Laboratory Meets Endoscopic Surgery
Authors: MacKenzie C.L.  , Graham E.D.  , Cao C.G.L.  , Lomax A.J.
Published: February 2025

We describe two recent research projects: the Virtual Hand Laboratory, and Remote Manipulation in Endoscopic Surgery. The Virtual Hand Laboratory (VHL) is a prototype experimental tool for investigating human visuomotor coordination for object manipulation in augmented and virtual environments. The Remote Manipulation in Endoscopic Surgery (RMES) project examined surgeon's use of viewing and manipulating technologies in laparoscopic surgery, both in clinical and experimental settings. Current research brings together these two parallel research projects (VHL and RMES), for applications in planning and real-time execution of surgical procedures as well as for surgical training. We outline our research directions and detail current activities on superposition of display space on the workspace for the surgeon’s hands.
NEW APPROACHES TO VIRTUAL ENVIRONMENT SURGERY
Authors: Ross Muriel D.  , Twombly Alexander  , Lee Aaron W.F.  , Cheng Rei  , Senger Steven
Published: February 2025

This research focused on two main problems: 1) low cost, high fidelity stereoscopic imaging of complex tissues and organs; and 2) virtual cutting of tissue. A further objective was to develop these images and virtual tissue cutting methods for use in a telemedicine project that would connect remote sites using the Next Generation Internet. For goal one we used a CT scan of a human heart, a desktop PC with an OpenGL graphics accelerator card, and LCD stereoscopic glasses. Use of multiresolution meshes ranging from ∼1,000,000 to 20,000 polygons speeded interactive rendering rates enormously while retaining general topography of the dataset. For goal two, we used a CT scan of an infant skull with premature closure of the right coronal suture, a Silicon Graphics Onyx workstation, a Fakespace Immersive WorkBench and CrystalEyes LCD glasses. The high fidelity mesh of the skull was reduced from one million to 50,000 polygons. The cut path was automatically calculated as the shortest distance along the mesh between a small number of hand selected vertices. The region outlined by the cut path was then separated from the skull and translated/rotated to assume a new position. The results indicate that widespread high fidelity imaging in virtual environment is possible using ordinary PC capabilities if appropriate mesh reduction methods are employed. The software cutting tool is applicable to heart and other organs for surgery planning, for training surgeons in a virtual environment, and for telemedicine purposes.
A technique for very high accuracy image intensifier calibration
Authors: Viant Warren J  , Phillips Roger  , Bielby Michael S  , Zhu Yonggen  , Griffiths John G  , Mohsen Amr MMA  , Sherman Kevin P
Published: February 2025

Accurate characterisation of the image distortion within a fluoroscopic image intensifier is critical if it forms the vision component of an image guided surgical system. By considering non-linear dynamic distortion it is possible to greatly increase the accuracy of the image intensifier, although at the cost of some image quality.
Simulation of Tissue Cutting and Bleeding for Laparoscopic Surgery Using Auxiliary Surfaces
Authors: Basdogan Cagatay  , Ho Chih-Hao  , Srinivasan Mandayam A.
Published: February 2025

Realistic simulation of tissue cutting and bleeding is important components of a surgical simulator that are addressed in this study. Surgeons use a number of instruments to perform incision and dissection of tissues during minimally invasive surgery. For example, a coagulating hook is used to tear and spread the tissue that surrounds organs and scissors are used to dissect the cystic duct during laparoscopic cholecystectomy. During the execution of these procedures, bleeding may occur and blood flows over the tissue surfaces. We have developed computationally fast algorithms to display (1) tissue cutting and (2) bleeding in virtual environments with applications to laparoscopic surgery. Cutting through soft tissue generates an infinitesimally thin slit until the sides of the surface are separated from each other. Simulation of an incision through tissue surface is modeled in three steps: first, the collisions between the instrument and the tissue surface are detected as the simulated cutting tool passes through. Then, the vertices along the cutting path are duplicated. Finally, a simple elastic tissue model is used to separate the vertices from each other to reveal the cut. Accurate simulation of bleeding is a challenging problem because of the complexities of the circulatory system and the physics of viscous fluid flow. There are several fluid flow models described in the literature, but most of them are computationally slow and do not specifically address the problem of blood flowing over soft tissues. We have reviewed the existing models, and have adapted them to our specific task. The key characteristics of our blood flow model are a visually realistic display and real-time computational performance. To display bleeding in virtual environments, we developed a surface flow algorithm. This method is based on a simplified form of the Navier-Stokes equations governing viscous fluid flow. The simplification of these partial differential equations results in a wave equation that can be solved efficiently, in real-time, with finite difference techniques. The solution describes the flow of blood over the polyhedral surfaces representing the anatomical structures and is displayed as a continuous polyhedral surface drawn over the anatomy.
Economic Analysis of Teleradiology Applications with KAMEDIN
Authors: Walz M.  , Bolte R.  , Lehmann KJ.  , Lütgemeier J.  , Georgi M.
Published: February 2025

The teleradiology system KAMEDIN (German Telekom), installed on HP- Unix- and NT-Workstations, was evaluated in different scenarios and a cost-benefit- analysis was performed. CT examinations were transfered from a PACS workstation (GE) to KAMEDIN using DICOM-3 protocol. Teleconferences were realized with an intensive care unit by LAN, with a radiology department at 5 km. distance by ISDN, and with an on- duty radiologist 22 km. away by ISDN. On average, 36 CT slices per patient were transfered. Overall costs (costs for hardware, software, support, ISDN-fees, and staff) were compared to possible cost reduction, mainly concerning transportation and films.
MediLink: A Wearable Telemedicine System for Emergency and Mobile Applications
Authors: Koval Tamara  , Dudziak Martin
Published: February 2025

The practical needs of the medical professional faced with critical care or emergency situations differ from those working in many environments where telemedicine and mobile computing have been introduced and tested. One constructive criticism of the telemedicine initiative has been to question what positive benefits are gained from videoconferencing, paperless transactions, and online access to patient record. With a goal of producing a positive answer to such questions an architecture for multipurpose mobile telemedicine applications has been developed. The core technology is based upon a wearable personal computer with a smart-card interface coupled with speech, pen, video input and wireless intranet connectivity. The TransPAC system with the MediLink software system is designed to provide an integrated solution for a broad range of health care functions where mobile and hands-free or limited-access systems are preferred or necessary and where the capabilities of other mobile devices are insufficient or inappropriate. Structured and noise- resistant speech-to-text interfacing plus the use of a web browser-like display, accessible through either a flatpanel, standard, or headset monitor, gives the beltpack TransPAC computer the functions of a complete desktop including PCMCIA card interfaces for internet connectivity and a secure smartcard with 16-bit microprocessor and upwards of 64K memory. The card acts to provide user access control for security, user custom configuration of applications and display and vocabulary, and memory to diminish the need for PC-server communications while in an active session. TransPAC is being implemented for EMT and ER staff usage.
Communication Security in Open Health Care Networks
Authors: Blobel Bernd  , Pharow Peter  , Engel Kjeld  , Spiegel Volker  , Krohn Rolf
Published: February 2025

Fulfilling the shared care paradigm, health care networks providing open systems' interoperability in health care are needed. Such communicating and co-operating health information systems, dealing with sensitive personal medical information across organisational, regional, national or even international boundaries, require appropriate security solutions. Based on the generic security model, within the European MEDSEC project an open approach for secure EDI like HL7, EDIFACT, XDT or XML has been developed. The consideration includes both securing the message in an unsecure network and the transport of the unprotected information via secure channels (SSL, TLS etc.). Regarding EDI, an open and widely usable security solution has been specified and practically implemented for the examples of secure mailing and secure file transfer (FTP) via wrapping the sensitive information expressed by the corresponding protocols. The results are currently prepared for standardisation.
Lossless Compression of Eye Movement Signals
Authors: Tossavainen Timo  , Juhola Martti  , Koski Antti
Published: February 2025

Compression of digital signals is widely employed in several areas such as speech signals. Concerning biomedical signals almost merely E C G signals have so far been compressed, in fact, in very many applications. To our knowledge, this compression study is the first one presented in the case of eye movement signal which are investigated in several medical specialties. In this study eye movements are electro-oculographically recorded. Tests performed to signals of patients of an equilibrium laboratory gave compression ratios generated with essential lossless compression methods.
The interactive use of networking multimedia - innovative education resource for professionals and patients
Authors: Matthies H.K.  , Walter G.F.  , Brandis A.  , Stan A.C.  , Ammann A.  , von Jan U.  , Porth A.J.
Published: February 2025

The combination of new and rapidly developing interactive multimedia computers and applications with electronic networks will require a restructuring of our traditional approach to strategic planning and organizational structure. World-wide telecommunication networks (using satellites, cable) are now facilitating the global pooling of healthcare information and medical knowledge independent of location. The development of multimedia information and communication systems demands cooperative working teams of authors, who are able to master several areas of medical knowledge as well as the presentation of these in different multimedia forms. The assemblage of telematics and services offers a base for multimedia applications, for example teleteaching, telelearning, telepublishing, teleconsulting, teleconferencing, telemedicine etc. The expansion of the internet will also lead to the formation of interdisciplinary “Global Education Networks”. The theory and practice of education are undergoing dramatic changes. Lifelong learning and adaptation of medical practice to new knowledge and new techniques will be even more important in the future.
Outpatient Health Care Statistics Data Warehouse - Implementation
Authors: Zilli Dejan
Published: February 2025

Data warehouse implementation is assumed to be a very knowledge- demanding, expensive and long-lasting process. As such it requires senior management sponsorship, involvement of experts, a big budget and probably years of development time. Presented Outpatient Health Care Statistics Data Warehouse implementation research provides ample evidence against the infallibility of the above statements. New, inexpensive, but powerful technology, which provides outstanding platform for On-Line Analytical Processing (OLAP), has emerged recently. Presumably, it will be the basis for the estimated future growth of data warehouse market, both in the medical and in other business fields. Methods and tools for building, maintaining and exploiting data warehouses are also briefly discussed in the paper.
Accessing a WWW Reference Library of 3D Models of Pathological Organs to Support Medical Education
Authors: Crudele Michele  , Clapworthy Gordon J.  , Dong Feng  , Krokos Meleagros A.  , Vasilonikolidakis Nikos  , Salcito Giuliano
Published: February 2025

A major aspiration of the medical community is to use multimedia databases to disseminate important research or clinical information and for education. We describe a WWW reference library of 3D models of human organs containing pathological and normal organs organised in cases, together with a variety of educational and supporting tools. Although the emphasis is chiefly on the teaching of medical students and the continuing education of physicians, the library is also a potentially-valuable resource for diagnostic investigation. This paper describes the environment, methodologies and tools for supporting 3D models in medical education. The prototype of the system is currently being completed; the full system is scheduled for public access in the year 2000 through multimedia publishers.
European and Latin-American Countries Associated in a Networked Database of Outstanding Guidelines in Unusual Clinical Cases (ELCANO)
Authors: Ohmann C.  , Eich H.P.  , Sancho J.J.  , Diaz C.  , Faba G.  , Oliveri N.  , Clamp S.  , Cavanillas J.M.  , Coello E.
Published: February 2025

The aim of ELCANO, an EU - funded project, is to build a virtual multilingual multimedia library of unusual clinical cases related to gastroenterology. Based on a standardisation of the format to report and the representation of clinical information on WWW, the multilingual multimedia case has been developed and till now 350 cases have been included. User satisfaction and user acceptance of ELCANO are under evaluation.
Healthcare Knowledge Management Through Building and Operationalising Healthcare Enterprise Memory
Authors: Yu-N Cheah  , Abidi Syed Sibte Raza
Published: February 2025

In this paper we suggest that the healthcare enterprise needs to be more conscious of its vast knowledge resources vis-à-vis the exploitation of knowledge management techniques to efficiently manage its knowledge. The development of healthcare enterprise memory is suggested as a solution, together with a novel approach advocating the operationalisation of healthcare enterprise memories leading to the modelling of healthcare processes for strategic planning. As an example, we present a simulation of Service Delivery Time in a hospital’s OPD.
A protocol building software tool for medical device Quality Control tests
Authors: Theodorakos Y.  , Gueorguieva K.  , Bliznakov J.  , Kolitsi Z.  , Pallikarakis N.
Published: February 2025

Q-Pro is an application for Quality Control and Inspection of Medical Devices. General system requirements include friendly and comprehensive graphical environment and proper, quick, easy and intuitive user interface. Functions such as, a tool library for protocol design widely used multimedia, as well as, a support of a local database for protocol and inventory data archiving are provided by the system. In order to serve the different categories of users, involved in Quality Control procedures, the system has been split into three modules of different functionality and complexity, each of which can work as a stand-alone application. The implementation of protocols and use of the software functions, as well as, the user interface itself have been proved by the evaluators to be clear and intuitive. The software seems to adapt easily to different kinds of Quality Control procedures and objectives. Q-Pro effectively supports and enhances the processes to attain a highly tuned, professional, responsive and effective quality control and preventive maintenance procedures for biomedical equipment management.
SysTerN A Nursing Terminology System based on ICNP
Authors: Alecu Simona  , Moisil Ioana  , Jitaru Elena
Published: February 2025

This paper is presenting a terminology system for nursing - SysTerN - that is based on the ICNP classification. SysTerN has been developed using the framework of the TeleNurse ID - ENTITY Telematics for Health E U project as a support for the dissemination actions carried on by CCSSDM (Center for Health Computing Statistics and Medical Documentation of the Romanian Ministry of Health) for Romania and other Central Eastern European countries.
A National Society for the Medical Informatics Community: BMiS
Authors: McCart Tita  , Gordon Colin
Published: February 2025

The poster describes the aims and activities of a national society for the medical informatics community in the UK.
Can humoral factors help to predict hypertension?
Authors: Peleška J.  , Reissigová J.  , Janeba D.  , Zvárová J.  , Horký K.  , Jachymová M.  , Jindra A.  , Heller S.  , Marećková Z.  , Umnerová V.
Published: February 2025

The aim of the study was to compare a set of plasma humoral factors, age and body mass index between normotensive sons from hypertensive (SH, n=101) and normotensive (SN, n=100) families. The sons were at the age of 18-40 years. Comparing individual variables, the significant differences were found in basal adrenalin load, noradrenalin before (basal) and after glucose load, basal dopamine, basal endothelin and fibrinogen between SH and SN. Moreover, SH was significantly older by two years than SN. The linear discriminant analysis and neutral network were applied to find the best classifying variables between SH and SN. Basal noradrenalin, fibrinogen, basal glycemia and age were the best discriminating variables between SH and SN using the discriminant analysis. The neural network used, in addition, basal aldosterone, relative plasma viscosity, glycated hemoglobin to estimate family status (SH or SN). There were no essential differences between those methods in predicting family status in the test set (66% of correct classification), even if the results in the training set were far better for the neural network (83% of correct classification) than for the discriminant analysis (69% of correct classification). Simultaneous using of several humoral factors can serve as intermediate phenotype that could improve identification of hypertension.
Registration of real and virtual endoscopy - a model and image based approach
Authors: Kukuk Markus  , Geiger Bernhard
Published: February 2025

This paper describes work in progress to integrate real and virtual endoscopy and to apply virtual endoscopy to the intra-operative guidance of endoscopic procedures. We propose a method for real-time tracking of the endoscope's shape and position. Our approach makes use of a simple and small external device, a computer model of a flexible endoscope and an image-based registration technique.