bluuebunny/crossref_metadata_2025 huggingface dataset:
The Use of the Optical Memory Card to Facilitate Patient Centred Care during Pregnancy and to Provide a Basis for an Integrated Perinatal Data Collection System
Authors: Brockman A.F.  , Steer P.J.
Published: February 2025

Previous studies have shown that computerisation of antenatal records can improve the quality of data collection, reduce major data errors and increase the accessibility of information. An antenatal computer system has been developed at the Chelsea and Westminster Hospital, London which uses an optical memory card to provide a single electronic patient record. Data is entered on to the computer during the consultation and is then simultaneously written onto the optical memory card. The card is carried by the pregnant woman and presented at all antenatal visits where the record is read and updated. The software has been written to take advantage of the ability of the computer to provide context sensitive help - calculations and comments designed to assist decision making, which appear automatically in appropriate circumstances. We hypothesise this will lead to improved antenatal care and pregnancy outcome. Early results are indicating that there is a greater compliance with established protocols if the appropriate information is displayed on the screen during the consultation. Proposed future developments of this project include using the optical memory card as a means to provide a child health record with the pregnancy and delivery information as the start of the record. This will hopefully provide valuable new information about links between pregnancy and delivery abnormalities and childhood illnesses.
Optical Memory Card - Present and Future State of the Technology and its Applications
Authors: Hirayama K.  , Morishima K.  , Hosoya H.  , Kamijima J.
Published: February 2025

The Optlcal Card is a credit card slzed memory media. It features large memory capacity, high security, portability and is inexpensive. By utilizing these features, many projects have been carried out worldwide ln which the individual carries its own information on an Optical Card. Some applications have been actively underway especially in the medical, health and welfare field. This paper will first focus on the latest technology of OMC and Reader/Writer as of October, 1995 and the future trend of the technologies. And then, this paper will outline the newest information of some applications using an Optical Card in practical use.
Smart Cards and Fraud
Authors: Thomasson J.-P.
Published: February 2025

The general concepts of security are described, covering the protection of assets from threats. The need is stated to develop a TOE which correctly interprets the security requirements into functional specifications and a security target. The evaluation criteria set the basis for the evaluation of the security properties of the product and system, the results of which can be aggregated to acheive system accreditation. For Smart card ICs the main security threats and protection is outlined.
The PANCEA Project
Authors: Hopkins R.  , Griffith N.  , Trivett S.
Published: February 2025

PANACEA is a EUREKA funded project that builds upon the previous Exeter Care Card Trial [1] and incorporates thinking from the ongoing standardisation process within CEN in relation to patient data cards. Its principal product is an open software infrastructure that can integrate into individual health services information system strategies providing a seamless view of the electronic patient record, no matter where the data is held. Project PANACEA consists of two discrete phases. The production of a software interface, incorporating coding system translation, to enable patient data cards of differing technologies to be utilised within one application. The production of a universal software interface incorporating coding system translation, capable of being integrated with any medical application independent of platform or architecture. A ‘universal’ messaging structure defined in ASN.1 [2] is also being developed allowing applications to communicate via a number of methodologies, capable of moving the multimedia media record independent of database architecture, in a fashion transparent to the user. This second software interface will allow system and communications developers to work independently of each other and still provide communication via this “standardised” medical interface. PANACEA is developing this software infrastructure, integrating it with multiple supplier systems with differing architectures and coding systems and then testing its acceptability both from a technical and clinical (user) view initially in two locations: Exeter, UK and Lisbon, Portugal.
The Universal Medical Device Nomenclature System
Authors: Gaev Jonathan A.
Published: February 2025

To facilitate access to medical information, ECRI has developed and promulgated a hierarchical medical device nomenclature system containing over 4,800 valid terms and 3,100 cross-references. The Universal Medical Device Nomenclature System (UMDNS) is appropriate for a wide range of applications. It is used world-wide and is available in 5 languages (7 additional translations are in progress).
Network Security Guidelines for Health Care Management
Authors: Patel A.  , Kantzavelou I.  , Clissman C.  , Maroulis D.
Published: February 2025

This document includes two parts. The scope of Part I is to accomplish the final set of Network Security guidelines that aim at providing a secure environment in European Health Care networking information systems. These guidelines will be used by Reference Centres to implement security mechanisms and protocols for the provision of network security in Health Care Establishments in EC member countries.
High Level Security Policy Guidelines
Authors: Katsikas S.  , Gritzalis D.
Published: February 2025

High Level Security Policies (HLSPs) are management instructions indicating how an organisation is to be run. They are the primary building blocks for any information security effort. In order to successfully install security in Information Systems operating in European Health Care Establishments (HCEs), a set of principles and guidelines must exist, which establishes both direction and management support.
Guidelines on IT Security Risk Analysis for Health Care System Users
Authors: Davey J.  , King S.
Published: February 2025

End-users have a very real contribution to make towards the evaluation of risks to the automated information systems which they use. Their knowledge and understanding of what might happen and how people may respond in reaction to a security breach is vital to the proper understanding of risk.
The Diabetes Advisory System - an IT approach to the management of insulin dependent diabetes
Authors: Andreassen Steen  , Hejlesen Ole K.  , Hovorka Roman  , Cavan David A.
Published: February 2025

The Diabetes Advisory System (DIAS) is a decision support system for the management of insulin dependent diabetes. It incorporates a model of the human carbohydrate metabolism implemented in a causal probabilistic network (CPN), which gives it the ability to handle the uncertainty, for example, in blood glucose measurements or physiological variations in glucose metabolism. The present paper gives a description of the system, and the evaluation results obtained so far. The results suggest that, at least in our hands, DIAS can generate advice that is safe and of a quality that is at least comparable to what is available from experienced clinicians.
INTERNED: A Telemedical Council on Rheumatic Diseases for Primary Health Care
Authors: Swoboda W.  , Adelhard K.  , Schewe S.
Published: February 2025

This paper describes a medical advisory board on the Internet. The service focuses on the needs of primary care physicians in upper Bavaria for diagnosis and therapy. This pilot study deals with rheumatic diseases. Highly qualified doctors of the University hospitals with specialized knowledge in this field give support to their colleagues in deciding whether a patient should be treated by the general practitioner, should be send to an expert or should be transferred to a hospital. Patients may participate in a Internet-based self-help group. Data security is guaranteed by password access. Frequently asked questions (FAQ's) are stored in a data base. These are sent regularly to the physicians as a training package for frequent problems of rheumatic diseases.
A conceptual model for a terminological system for healthcare in Sweden
Authors: Junfors Allan  , Wallin Sven-Bertil  , Thurin Anders  , Carlsson Mats
Published: February 2025

This report describes goals, requirements and information structure of a planned terminological system for the healthcare sector of Sweden. A conceptual model developed in the Spriterm-project in Sweden is presented and its properties is discussed in relation to published criteria for a good terminology and also in comparison with other similar models.
HERMES - Telematic $\underline(He)$althcare - $\underbar(R)$emoteness and $\underbar(M)$obility Factors in Common $\underbar(M)$uropean $\underbar(S)$cenarios - CEC Project HC 1021
Authors: Dripps Jimmy  , Lamb Andrew  , Boddy Ken
Published: February 2025

This project will develop a horizontal, open platform, on which Telemedicine Client and Provider Services and Technologies can inter-operate as Vertical Applications, leading potentially to a Client and Service Telemedicine Market Place. The aim of the project is to demonstrate Quality Assured Telemedicine Services which are interoperable throughout Europe. This will lead to improved team-care and acceptability of care and improved access to care and to expert advice. Scaleable services will be provided over a network and single number access for urgent responses using automatic routing and security/access control.
Electronic Medical Record in GastroBase-II. Clinical and Educational Aspects
Authors: Kocna Petr
Published: February 2025

GastroBase - as a clinical information system - incorporates patient identification, medical records, images, laboratory data, patient history, physical examination and other patient related information. Program modules are written in C-language, all data are processed by using Novell-Btrieve data manager. Patient-identification database represents the main core of this information systems. Graphic library developed in the past year and graphic modules with a special video-card enables to store, archive and link different images to the electronic patient-medical-record. GastroBase is routinely used now more than five years and the database contains > 60.000 medical records and 2000 images. The educational aspects of clinical data are discussed and a CD-ROM electronical textbook is prepared.
A Computer-based patient record system to promote quality care in surgical practices
Authors: Forssell Henrik  , Chowdhury Shamsul
Published: February 2025

Computer-based patient records (CPR) not only support patient care but also could improve its quality. With this aim in mind a CPR was introduced at the Department of Surgery, Blekinge County Hospital, by employing the Relational Data Base Management System - DataEase. The results so far are encouraging and the systems are in constant use and modification with new functionalities.
The Electronic Diabetes Medical Record. Purpose design of a human-computer interface
Authors: Nielsen L.H.  , Wagner I-V.  , Schneider W.  , Binder C.
Published: February 2025

Innovation, design and development leading to proof of concept for a purpose designed diabetes electronic medical record is described. A matrix presenting data in a relevant context is described along with graphic representations. The possible impacts on clinical practice are discussed, with special reference to integration with the Danish national health care system. Details of utilities allow for comparison with other designs. A hands-on, electronic demonstrator will be available for testing.
Current Research on Medical Knowledge-Based systems in Germany
Authors: Kraut U.  , Mann G.
Published: February 2025

A study of the GSF Research Center performed in 1995, surveys the current state of research concerning the development of knowledge based systems in medicine in Germany on the example of projects promoted by MEDWIS. Furthermore, recent problems in research were found in the development of systems and their successful application in clinical routine. Important future research topics were identified. The focus of research on knowledge based systems has changed from basic methodical research to application-oriented research lately. The study shows, that especially introducing systems into medical environment still provides considerable problems and affords immense further effort.
Rule-Based Medical Decision Making via Unification Procedure of Information
Authors: Kurzynski Marek W.  , Sas Jerzy  , Blinowska Aleksandra
Published: February 2025

This paper presents the original concept of computer-aided medical decisions, which simultaneously uses the information contained in the case records and expert rules. Adopting the probabilistic model of diagnostic problem the rule-based decision algorithm with learning is presented. Proposed algorithm was applied practically to the diagnosis of acute renal failure in children. Obtained results have proved its effectiveness in the computer medical decision-making.
A heuristic method for diagnosing multiple diseases in complex medical domains modelled by causal probabilistic networks
Authors: Olesen Kristian G.  , Andreassen Steen
Published: February 2025

We propose a method to manage the complexity of large expert systems based on causal probabilistic networks. The method operates by partitioning large domains into smaller subdomains. An iterative procedure operates through increasingly complex subdomains, where inference is limited to consider only plausible diagnoses. The method is introduced by a simple example and we report a case from MUNIN, where a patient with three diseases is diagnosed.
Computer curricula at Albert Szent-Györgyi Medical University: programmes, developments and infrastructure
Authors: Karsai János  , Hantos Zoltán
Published: February 2025

Computers and computer applications are highly involved in medicine and pharmacy, and in the education of these subjects. This paper presents an overview of the teaching programmes involving computer applications. and the role of computers in theoretical and practical courses at Albert Szcnt-Györgyi Medical University. The educational programmes are outlined. and some aspects of the Informatics, Mathematics and Mathematical Modelling courses are considered.
Nursing Informatics: A Delphi Study
Authors: Strachan Heather
Published: February 2025

A two round Delphi study was undertaken to answer the questions, “What information systems (IS) should nurses be using in the next 5-10 years to support their work?” and “What issues need to be addressed to ensure their successful usage?” The study identified that the advantages of existing hospital nursing information systems (NIS) were consistent with those generally associated with computerisation and that few benefits from information usage were realised. A computerised multidisciplinary, multiagency patient record was identified as the top priority system to support hospital nurses in the future. Sixty eight issues were identified for successful usage of existing and future NIS. They covered a wide range of topics including: management of change; procurement issues; hardware and software issues; training and support; information issues; and evaluation. Sixty two of these issues received a consensus of 80% or more.
Framework for the Co-ordination of Processes, Models and Technology Solutions
Authors: Bullas S.  , Lloyd-Williams D.
Published: February 2025

This paper suggests that the information systems cycles are too slow to keep pace with the changing requirements brought about through changing processes. It describes how requirements can be met through building on existing information models and utilising generic, non-health specific, information technology frameworks. The information model must take account of commonality of operational hospital processes, independent of culture and culturally specific management processes, reflecting the political and social priorities of specific countries and regions. This business oriented approach will make the application of technology affordable by utilising the experience form other industrial sectors.
Extracting Fractal Components from Heart Rate Variability Signals
Authors: Yamamoto Yoshiharu  , Hughson Richard L.
Published: February 2025

Beat-by-beat variations of human heartbeat intervals (heart rate variability; HRV) contain fractal components with broad band, 1/fßspectra. In this review, we first revisited the topics “what is the fractal component?” and “why should it be extracted?” A new method called coarse graining spectral analysis (CGSA) was then introduced to extract the fractal components from HRV signal. This was followed by the discussion on the accuracy aspects of CGSA and the application to the actual HRV data.
A New Method for Clinical Measurement of Vertebral Rotation
Authors: Merolli A.  , Tranquilli Leali P.  , Aulisa L.  , Guidi P.L.  , Impagnatello M.
Published: February 2025

In a previous experimentation authors tested a computerized method to measure vertebral rotations from T1 to L5 and then generate vertebral rotation plots (VRP) which proved to be very useful in monitoring the progression of pathology and the efficacy of treatment A manual application of the VRP was performed by the rule of Perdriolle but in this case the step of 5 degree chosen for the range of accuracy limited its application in milder curves With a new transparent rule to overlap on the X-ray film and an easy formula derived from previous experience, it was possible to improve the accuracy of the plots in milder curves and, then, their efficacy in monitoring the progression of the pathology.
Quantitative Analysis of Movement Patterns and Ground Reaction Forces During Voluntary Trunk Movements in Standing Girls with Idiopathic Scoliosis
Authors: Diab K.  , Hirschfeld H.  , Sevastik J.  , Willers U.  , Hedlund R.
Published: February 2025

Idiopathic scoliosis is characterised by lateral and rotatory curvature of the spine associated with asymmetry of spinal muscle activity and pelvic obliquity. To examine if the relation between trunk and pelvis movements on the one hand and ground reaction forces (GRF) on the other hand may contribute to the understanding of the motor patterns of patients with idiopathic scoliosis, we investigated 3D-movement parameters of the interaction between trunk, pelvis and GRF patterns. Preliminary results from one AIS and one control subject indicate similarities in the movement of the thoracic segments in space, but not of the pelvis and the lumbar spine segments, with respect to the axes in space. For example, for lateral bending the segment angles for the upper, the lower thorax and the lumbar spines were computed with respect to the vertical axes and anterior/posterior axes and for the shoulder and the pelvis axes with respect to the horisontal axes, while for the trunk rotation other axes were important. During the performance of the motor task the loading and unloading patterns of applied vertical, anterior/posterior and lateral/medial forces differed in all conditions between the control and AIS subject. The pattern of the Center of Mass displacement (COM) was similar between the AIS and control during trunk rotation but not during side bending. In conclusion, the obtained results imply that the quantitative analysis of spine movements and GRF patterns together seem to be a reliable method for illuminating differences in performance of simple trunk movements between the AIS subject and control.
Morphometric Study of the Intercostal Muscles by High Resolution Ultrasound. Standardisation of a Method
Authors: Diab K.  , Shalabi A.  , Sevastik J.  , Güntner P.
Published: February 2025

There is much experimental and clinical evidence that the intercostal muscles (IM) have an important role in the development of scoliosis and that movements of the arm cause powerful contraction of these muscles. However, there is no method for evaluation of the cross-sectional muscle area to provide an indirect reflection of the force of the IM. The areas of the left and right IM over the 5th to 12th intercostal spaces were determined on sonograms at different points equidistantly from the midline of the back of a fresh specimen of a lamb. The surface area of the IM at the region of the interest (ROI) was determined by tracing or derived from the perpendiculars. The measurements on the sonograms were compared with corresponding measurements on CT-scans or directly on the specimen. The results showed a) that there were no significant differences in the area of the IM at the ROI between left and right sides 12 cm lateral to the midline, corresponding to the dorsal axillary line; b) that evaluation of the area of the IM from the perpendiculars is more accurate than when done by tracing; and c) that there was no significant difference between the measurements on the sonograms and the CT-scans or directly on the specimen. The clinical applicability of the method was further tested on sonograms of one normal adult person during maximal inspiration and expiration. With the exception of the intercostal levels 7 to 8, there was no significant difference between the left and right areas of the IMs at the intercostal levels 5 to 12, either in inspiration or expiration. It is concluded that high resolution sonography is an easy and safe method for comparative evaluation of the surface area between the left and right IM, and can be used as a variable of the outcome of conservative treatment of scoliosis in longitudinal studies.
The Use of the Quantec Scanner in Longitudinal Follow Up of Patients with Spinal Deformities
Authors: Sakka S.A.  , Mehta M.H.
Published: February 2025

A retrospective study of nineteen patients (11 females and 8 males) who had been followed up between 1992 and 1996 by X-ray radiographs and Quantect Scans were studied. Each patients had at least 3 X-rays radiographs and 3 Q scans over 3 years minimum. They included patients with IIS, JIS, AIS, and congenital scoliosis. Non of the patients had surgical correction. They aged between 7.5 and 19.5 yrs with a mean of 13.7 yrs at the last follow up. 195 curved measured on X-ray radiographs with a mean Cobb angle of 21° (range 1-100) with SE of 1.2°, SD of 15.6° and 95 % CI of 2.4°. 139 curves measured on the Quantec scan with a mean Qangle of 23° (range 1-71° ) with a SE 1.2° SD 13.6° and 95% CI of 2.3°. The overall pearson Correlation coefficient is 0.9, but the Regression Coefficient correcting for the inta object analysis using multiple regression is 0.61 (p < 0.05 ). We conclude that the Quantec scanner can be usefull in longitudinal follow up of patients with scoliosis.
A 3-D Analysis of Bone Remodelling in the Area of Vertebral Fusion in Scoliosis Surgery
Authors: Aulisa L.  , Valassina A.  , Tamburrelli F.  , Merolli A.  , Serra F.
Published: February 2025

Bone graft remodelling in any district of the skeletal system is a process by which the graft is converted in a new structure responding to mechanical requests of that district. Spinal instrumentation used to make an easier fusion is, at the same time, a major hindrance to physiologic remodelling of the fusion area after the early stabilization period has passed, Authors think that it is mandatory to remove early the instrumentation and that this will facilitate optimal turn-over and remodelling of the fusion area in a growing spine.
Vertebral Body and Disc Wedging in Scoliosis
Authors: Ronchetti P.J.  , Stokes I.A.F.  , Aronsson D.D.
Published: February 2025

This study was undertaken to evaluate the amount of disc and vertebral body wedging in scoliosis, as well as how the wedging changed over the progression of the scoliosis curve. The degree of vertebra and disc wedging was evaluated in fourteen patients with scoliosis by means of PA radiographs which were obtained early in the course of their scoliosis and late in the progression, prior to surgery. Each vertebral body endplate on the PA film was marked with a horizontal line corresponding to the inclination of the vertebra. Each of the lines was then digitized and the wedge angle of the vertebra and of the disc was calculated. Comparisons were made between the earlier and later curves for the apical five vertebra (Apex ± 2). Among the 70 vertebrae examined, later curves showed a statistically greater wedge angle of the vertebra than the disc. The findings of this study show that early in the scoliotic deformity, the wedging of the vertebra and the disc occur in equal proportions. However, as the curve progresses, the vertebra becomes more wedged with respect to the disc.
Anthropometry and Allometry in Pre-Operative Adolescent Idiopathic Scoliosis (AIS)
Authors: Cole A.A.  , Burwell R.G.  , Kirby A.S.  , Polak F.J.  , Webb J.K.
Published: February 2025

This study evaluates anthropometric data from 110 pre-operative patients with AIS (90 girls, 20 boys). These patients are compared with data from 1362 healthy school children (693 girls, 669 boys). Holtain anthropometric equipment and standard techniques were used to make the anthropometric measurements. In pre-operative AIS, the standing height (corrected for the lateral curve), subischial height, leg lengths and upper limb lengths are increased with no significant increase in sitting height (corrected for the lateral curve) or weight. However, by evaluating ratios of one body segment length to another, there is length disproportion in AIS. The lower limbs are longer compared with the upper limbs which in turn are longer compared with the sitting height. In the upper limbs, all three length components are more asymmetrical in AIS than in healthy children. In right sided AIS curves, the upper arm is longer on the right by 7.7mm, whereas in left sided AIS curves, the upper arm is longer on the left by 2.1 mm. In the trunk, the biacromial and bi-iliac widths are both significantly increased in the AIS patients. The lateral chest diameter is not significantly different from that in healthy children and the AP chest diameter is significantly smaller in the AIS patients. The large extrathoracic skeleton (limbs) relative to the normal/decreased thoracic size and the upper limb asymmetry may all be risk factors in the development of AIS by altering spinal mechanics during movement. Other ligamentous or neuromuscular risk factors would also be required.
ICNP as a Unifying Framework - a Challenge for Nursing
Authors: Lang Norma M.  , Simon Margaret Bond
Published: February 2025

The International Council of Nursing (ICN) has developed an alpha version of an International Classification for Nursing Practice (ICNP). Two questions are discussed: the ICNP as a unifyingframework? and the ICNP as a challenge to nursing? Several other challenges regarding the continuous development and use of the ICNP are discussed with the conclusion that the ICNP indeed provides a unifying framework and a challenge and responsibility to all who are concerned about nursing care received around the world.
Micro-Telerobotic Surgical System for Microsurgery
Authors: Kozlowski David M.  , Morimoto Alan K.  , Charles Steven T.
Published: February 2025

Modern surgical methods which utilize microscopes have allowed medical professionals to visualize the surgical field on the order of microns. This new found visual capacity has created a performance gap between a surgeon’s visual skills and manipulative skills that surgical robotics have the capability to remedy. Robotics can be used as an aid to the surgeon to help correct natural human dexterity problems such as tremor and resolution of motion. Devices that would benefit surgical dexterity at the micron scale are in development at Sandia National Laboratories. A six degree-of-freedom (DOF) force reflecting telerobotic manipulator has been designed and developed for use in microsurgical applications. The system utilizes a unique mechanical platform, actuation schemes, and controller that provides high positional precision while maintaining high frequency response for implementation of force feedback. Thus, the same device is used to form a master-slave telerobotic arrangement to assist the surgeon. This makes the system very intuitive to the surgeon and easier to implement for the engineer. The system utilizes high performance Digital Signal Processors (DSP) for control of both the master and slave platforms. Six dimensional force information is obtained from transducers located at the end effectors of both the master and slave. Two distinctly different types of motors are currently being evaluated, as well as several types of control algorithms. Position scaling, force scaling, and tremor filtering are being implemented in the DSP control software. Control parameters are based upon system frequency response testing. Results from our system identification and performance testing will be discussed.
Telehealth in Africa
Authors: Rovetta Alberto  , Falcone Fulvio  , Sala Remo  , Garavaldi Maria Elena
Published: February 2025

This paper deals with the developments of the project “Telehealth in Africa”, to establish a link between more European reference Hospital Centers and some African Hospital Centers, connected with Peripheral Units of Assistance, to transmit and receive health diagnostic images, etc. The project has been developed by the European Collaboration Group for Telemedicine in developing countries which was created in collaboration with ITU (International Telecommunication Union). A demonstration of telehealth from Milan (Italy), Toulouse (France), to Abidjan (Ivory Coast, Africa) and Midrand (South Africa) proves that it is possible for a diverse group of intergovernmental organizations, non-governmental organizations and the private sector to work together for the benefit of all participants and, most of all, for developing countries.
Assisting Maxillofacial Surgery by Using Multimedia VR Techniques
Authors: Faulkner Gabriele
Published: February 2025

Multimedia and VR technologies are examined as regards their potentiality for medicine, specifically for maxillofacial surgery. The goal is to achieve a surgical procedure of better quality as well as a more interesting way of imparting medical knowledge. Close cooperation with the Maxillofacial and Plastic Surgery Department of the University Hospital Benjamin Franklin (UKBF) ensures the suitability of the material for the user. Doctors give regular feedback on the 3D human-computer interface, graphics and interaction devices because they are crucial for the implementation of multimedia and VR systems in medicine.
Searching and Accessing Medical Literature
Authors: Wiesman F.  , Hasman A.
Published: February 2025

This paper addresses the problem of searching and accessing electronically stored documents, especially medical literature. Our approach combines meta-information about the documents with domain knowledge about the topics of the documents. A graphical browser is used to uniformly present the relations between the domain and the documents. In addition to browsing-oriented search also query-oriented search is supported. An application to the medical domain is discussed, as well as how the approach relates to the World Wide Web.
Educational Software Types - How and Who?
Authors: Højsholt-Poulsen Leo
Published: February 2025

This presentation describes the various types of educational software which are on the market now or which will be published in the near future. First the producer must focus on issues like: Who is going to use it? What do they learn from using the software, and how do they do it? Secondly the producer must develop the product, and deal with all the practical problems from design to marketing. As very few producers reach the stage of financial profit, the presentation offers no advice on how to invest your fortune.
The Chernobyl Accident: predicting cardio-vascular disease in the ex-workers
Authors: Richards B  , Lugovkina T.
Published: February 2025

This paper describes a computer package that has been used to predict the likelihood of the onset of cardiovascular diseases in these patients who were former workers (liquidators) on the Chernobyl site in the Ukraine, Chernobyl being the place where the Nuclear Power Station was destroyed when the atomic reactor got out of control and spread radiation over a very wide area both on the ground and into the atmosphere. The programme predicts the future morbidity in those patients with an accuracy of 90%.
Introducing cards into Slovenian health insurance and health care
Authors: Sušelj Marjan  , Čuber Stanislav  , Zevnik Marija
Published: February 2025

This paper presents an outline of the Slovenian project of introducing card systems into health insurance and health care: bases for its launching, scope, system design, development phases, benefits, and issues of interoperability with the other card systems.
Management of Hospital Discharge Data in Belgrade
Authors: Saulic A.  , Jelaca P.  , Simic S.
Published: February 2025

The paper presents a database on clinically treated patients in Belgrade, a computerized health-statistics information sub-system. It also analyses the organisation of report processing related to hospitalisation, types of indicators on hospital treatment (wich are the result of such a processing) as well as their further utilisation on different levels of management within the system of health care in Belgrade.
Security of Medical Image Databases
Authors: Tzelepi S.  , Pangalos G.  , Khair M.
Published: February 2025

Medical images are an integral and indispensable part of health care information systems. Because of the critical nature of image information and stringent privacy requirements in medical environments, the medical images database systems must provide reasonable safeguards to assure confidentiality, integrity and availability of images to be deployable. In this paper we address mainly the confidentiality issues. Only authorised users should have for example access to medical images. Access to images is usually based on certain security constraints. Security constraints processing is a widely used mechanism for obtaining the appropriate level of the security required in traditional (nonmultimedia) database systems. However, the security constraints processing in multimedia environments posses a number of interesting problems. In this paper we address the advantages and problems of using content-based security constraints on medical image databases. We also propose a methodology for the integration of security constraints into medical image databases, taking into account the true multimedia nature of the medical images (e.g. the content of the medical images).
A Model for Image Formation and Image Quality Prediction in Diagnostic Radiology
Authors: Kandarakis I.  , Cavouras D.  , Koutsourakis C.  , Triantis D.  , Bakas A.  , Panayiotakis G.  , Nomicos C.
Published: February 2025

A computer program modelling the formation of radiological images and predicting values of physical quantities that determine diagnostic image quality has been developed. The quantities are the modulation transfer function (MTF), the noise power spectrum (NPS), and the detective quantum efficiency (DQE) associated with signal to noise ratio (SNR). The program is based on mathematical models that describe the effects of x-ray interactions with the imaged object and the image detector as well as phenomena concerning the optical signal propagation within the detector. All data on x-ray effects necessary for computer calculations were derived from published work whereas optical data were determined in our laboratory using experimental techniques. Model predictions were compared with direct quality measurements performed after image formation, on the image itself.
A Study of Pharmacological vs. Pathological Autonomic Nervous System Blockade in Humans, using Heart Rate Chaotic Dynamics
Authors: Polydoropoulos P.  , Bountis T.  , Christodoulou J.  , Alexopoulos D.  , Bezerianos A.
Published: February 2025

Pathological blocking of the Autonomous Nervous System (ANS) is diagnosed for patients having Autonomic Neuropathy passing a well - defined set of criteria. In this work, It is shown that standard analysis can be complemented by a study of the chaotic dynamics of the Heart Rate (HR), over a period of 12min in the resting position. It was found that patients who suffering from ANS blockade, typically exhibit a smaller degree of fractality and complexity of the chaotic attractor reconstructed from the time series of the HR signal. These dynamical measures are more evident in normal human subjects that have been subjected to pharmacological ANS blockade.
Medical image databases for CAD applications in digital mammography: Design issues
Authors: Kallergi Maria  , Clark Robert A.  , Clarke Laurence P.
Published: February 2025

The evaluation of algorithms developed for computer assisted diagnosis in digital mammography requires image databases that allow relative comparisons and assessment of algorithms' clinical value. A review of the literature indicates that there is no consensus on the guidelines of how databases should be established. Image selection is usually done based on subjective criteria or availability. The generation of common database(s) available to the research community makes relative evaluations of algorithms with similar properties easier. However, questions regarding the “right database size,” the “right image resolution,” and the “right contents” remain. In this paper, database issues are reviewed and discussed and possible remedies to the various problems are proposed.
Quality Monitoring, Standardized Documentation and Management with a Computerized System in Oncology
Authors: Beinert Th.  , Dubiel M.  , Mergenthaler H.-G.  , Fleischhacker M.  , Bruhn N.  , Dingeldein G.  , Helle A.  , Lüftner D.  , Wernicke K.D.  , Flath B.  , Akrivakis C.  , Sezer O.  , Novopashenny I.  , Wischnewsky M.B.  , Possinger K.
Published: February 2025

Within the last years the prerequisite was prepared to develop a computerized tumor - patient documentation system including quality monitoring and oncological therapy recommendations for every day use. In medicine today, there is an increasing need for quality oriented low cost and transparent management - what is especially true in the field of oncology. The German Federal Authority of Health demands the documentation of all tumor disorders for the establishment of an cancer registry. For these reasons our study group established the program “OncoDoc” in cooperation with the laboratory for Artificial Intelligence of the University Bremen.
Multimedia Simulator of Patient
Authors: Stempczyńska Joanna  , Kącki Edward
Published: February 2025

The paper presents a concept of an educational system for medical students designed to help them learn taking case history and diagnosing oncological patients. The system is a modification of the SYMULPA system worked out by the authors and implemented and tested at the Chemotherapy Clinic of the Medical Academy of Łódź. The main changes lie in the introduction of multimedia to the system, which improves communication capabilities of the system and enables a wider range of results to be considered and examined during case history taking.
Evaluation Plan for a Cardiological Multi-Media Workstation (I4C Project)
Authors: van der Hofstede J.W.  , Quak A.B.W.M.  , van Ginneken A.M.  , Macfarlane P.W.  , Watson J.  , Hendriks P.R.H.  , Zeelenberg C.
Published: February 2025

The goal of the I4C project (Integration and Communication for the Continuity of Cardiac Care) is to build a multi-media workstation for cardiac care and to assess its impact in the clinical setting. This paper describes the technical evaluation plan for the prototype.
An Approach to Establishing a Health Information Market
Authors: Filip Floriana  , Mihalas George  , Dimitriu Rodica  , Jipescu Irina  , Lungeanu Diana  , Popescu Adrian  , Bazavan Mariana
Published: February 2025

The Tempus CME project “Regional Network for Healthcare Management” was aiming to perform a feasibility study for a communication network dedicated to the healthcare field. The needs assessment survey as well as the debates during the working sessions and during the conference on how communication can support a better healthcare delivery, substantiated the approach for achieving the Romanian health information market. The proposed communication network can be considered as a national information infrastructure offering good links between health, education, research and industry and a unique frame for information providers and users, for the estate and private companies. The network should also provide support and guidance for the development of new educational fields as applied informatics in healthcare.
Virtual Environments in Neuropsychological Assessment and Rehabilitation
Authors: Rose F.D.  , Attree E.A.  , Brooks B.M.
Published: February 2025

Brain damage constitutes a major problem for those affected, for their families and friends and for society as a whole. The need for effective rehabilitation strategies is clear. Yet, until the early 1960s, the brain was generally considered to be a somewhat fixed and inflexible organ. In consequence the impairments associated with brain damage were generally regarded as “incurable”. Since that time neuroscientists have had reason to change their views dramatically. However, much remains to be done. Progress depends upon a co-ordinated multidisciplinary approach within which assistive technology will be a key player. Within the area of assistive technology, one of the developments which holds particular promise for the field of neurological rehabilitation is the computer technology underlying virtual environments (commonly known as virtual reality). In this chapter we describe the new opportunities offered by virtual reality to pursue several aspects of the rehabilitation process.
Healthcare Information System Approaches Based on Middleware Concepts
Authors: Holena Martin  , Blobel Bernd
Published: February 2025

To meet the challenges for efficient and high-level quality, health care systems must implement the “Shared Care” paradigm of distributed co-operating systems. To this end, both the newly developed and legacy applications must be fully integrated into the care process. These requirements can be fulfilled by information systems based on middleware concepts. In the paper, the middleware approaches HL7, DHE, and CORBA are described. The relevance of those approaches to the healthcare domain is documented. The description presented here is complemented through two other papers in this volume, concentrating on the evaluation of the approaches, and on their security threats and solutions.
System Design Challenges: The Integration of Controlled Vocabulary Use into Daily Practice
Authors: Douglas K.  , Nubie M.
Published: February 2025

System developers face the challenge of providing tools to improve health care productivity and quality. While progress is being made, clearly defined requirements, standards and development guidelines are not yet complete enough to provide the details needed to build such software. We have moved forward and created a clinical documentation system using a controlled vocabulary. Doctors and nurses use data entry tools such as browsers and templates to access the vocabulary for creating clinical notes. Our library of terms is mapped to SNOMED which is not complete enough to support clinical documentation. Therefore our libraries have been expanded beyond SNOMED. Overall we have found that clinicians will use a controlled vocabulary when it is intuitive, predictable, flexible, complete and fast to use. Other benefits have surfaced such as more complete and consistent documentation. Our experiences to date confirm that there is still much to explore, discover, invent and create.
Using Reengineering to Improve “Customer Visit Processes”
Authors: Salois-Swallow D.
Published: February 2025

Much of informatics has been concerned with computer systems. Informatics took a broader view during the Fifth International Nursing Informatics Symposium Post Conference in Austin (1994) as Henry et al, captured the essence of informatics as being “imperative for assessing the quality of care provided and analyzing effectiveness of nursing interventions across settings and population”. At York Central Hospital (YCH), Ontario, we realized the need to work differently, to keep what's good about what we do and still meet the changed needs of health care. We also realized it's about getting everyone close to the patient. We used a reengineering process to help us achieve that goal.
Description of a Comprehensive Research Project to Develop a Reference Model for Nursing Information Systems
Authors: Epping P.J.M.M.  , Goossen W.T.F.
Published: February 2025

This paper describes a comprehensive research project in progress that aims to develop a Nursing Information Reference Model. The study consists of several components. Together these components should lead to the production of the reference model. At the time of submission of this paper several components of the study are finished. After describing the scope of the study as a whole, individual components will be presented. An overview will also be offered of those parts that are still under development.
European Standardization in Healthcare Informatics and the Need for Increased Involvement of Healthcare Professionals
Authors: Kajbjer K.
Published: February 2025

This paper gives the background and an introduction to the results and present activities of CEN/TC 251 (European Standardization Committee, Technical Committee on Health Care Informatics). The importance of the involvement of healthcare professionals, e.g. nurses, in the standardization development process is stressed. The paper emphasises the need for increased awareness of the standardization efforts in order to accomplish a higher degree of commitment in healthcare professionals.
A Comparison of Network Use by Academic and Clinical Sites
Authors: Anthony D.
Published: February 2025

This survey explores UK nurses' experiences, views, policies on computer networks, ability to access such networks, and to what uses nurses can put the NHSNet (for a description see 1,2,3,4) Internet (for a description see 5) and other networks in the NHS and academic sites.
Teaching Method and Evaluation of Information Education in Shimane Nursing College
Authors: Ezumi H.  , Sota Y.  , Ochiai N.
Published: February 2025

Environment of Information Education using campus LAN was established at Shimane Nursing College in 1995. The campus LAN system was connected to Internet. With this system, the students and the staff of the college are able to access Internet. In this environment, we have been teaching information science/information processing as a required subject to first year students. The teaching method includes “Learning by doing” and allows the student to have “many success experiences”. As a result, most students expressed a positive attitude toward the use of a network system. We utilize this system not only for information education, but also in the field of professional nursing education.
Data Extraction and Archiving for Nursing Research Using a Bedside Clinical Information System
Authors: Saville J.  , Goodwin L.  , Bryars D.
Published: February 2025

Institution wide use of an intensive care bedside information system creates the opportunity to make available vast amounts of clinical data to support research and quality improvement activities. Acting on this opportunity has required the development of several innovative approaches to transform this raw data into usable information. The process described herein uses commercially available software and hardware tools to extract on a daily basis, process and archive data for 7 intensive care units. Once this procedure is complete, attention is turned to using individual and combinations of data elements to build a higher level of information that more directly relates to the kinds of inquiries that help to address questions of outcome, and care quality.