bluuebunny/crossref_metadata_2025 huggingface dataset:
A Clustering Method Based on Rough Sets and Its Application to Knowledge Discovery in the Medical Database
Authors: Hirano Shoji  , Tsumoto Shusaku  , Okuzaki Tomohiro  , Hata Yutaka
Published: February 2025

This paper proposes a clustering method for nominal and numerical data based on Rough Sets and its application to knowledge discovery in the medical database. Classification is performed according to the indiscernibility relations defined on the basis of relative similarity between objects. The similarity is defined as a combination of two types of similarity measures: the Hamming distance for nominal attributes and the Mahalanobis distance for numerical attributes. Excessive generation of small category is suppressed by modifying similar equivalence relations into the same equivalence relation. An analysis of the meningoencephalitis diagnosis database was performed to validate this method. The result showed that this method could deal well with both types of attributes and discover the primary factors for diagnosis.
The Nursing Terminology Summit: Collaboration for Progress
Authors: Ozbolt Judy  , Androwich Ida  , Bakken Suzanne  , Button Patricia  , Hardiker Nicholas  , Mead Charles  , Warren Judith  , Zingo Christine
Published: February 2025

The Nursing Terminology Summit has used collaborative processes to bring about significant changes in the development of terminology standards for nursing. This paper draws on agendas, reports, notes, and other documents from the Summit, in addition to the authors’ own experience as Organizer, Steering Committee, and participants, to provide a brief history of the Summit process. The analysis identifies factors that increased the risk of failure as well as factors that fostered success. The paper concludes with lessons learned that can be applied in other arenas to promote change in medical informatics.
On Conceptualization of a Decision Support System in Health Informatics
Authors: Nykänen Pirkko
Published: February 2025

A decision support system can be approached from two major disciplinary perspectives, those of information systems science (IS) and artificial intelligence (AI). We present in this study an extended ontology for a decision support system in health informatics, which is founded on experience from related research fields as well as being informed by our case studies. The ontology emphasises the need to cover environmental and contextual variables as an integral part of a decision support systems development methodology. With the addition of these variables, the focus in decision support systems development shifts from a task ontology towards a domain ontology. The results of this study help the system developers to take the system’s context into account through the set of defined variables that are linked to the application domain. These variables explicate relevant constructs and present a vocabulary for a decision support system. However, applying the ontology requires a more thorough analysis of the domain and therefore more qualified resources for systems development. This indicates the need to focus more on education and training in health informatics.
A Program Designed to Monitor the Course and Management of Depressive Illness across the Primary/Secondary Interface
Authors: Crowther Ruth  , Gask Linda  , Ives Rob  , Jakenfelds John
Published: February 2025

Information Technology (IT) is an increasingly important area for all aspects of life in the twenty first century. Computers have an impact on both our home life and our work life with information on many aspects of our lives being held on computer systems, some of which we are unaware. Despite this universal progression towards IT, certain areas within the National Health Service are still considered to be somewhat old fashioned in their tendency to resolutely adhere to recording information on paper. One of these areas is that of the mental health services, which perhaps given the nature of having a number of care sites makes it well suited to having the use of a well designed computer system capable of collating and coordinating all aspects of patient's management.
From Legacy and Client/Server Systems to Components in Healthcare Information Systems in Finland
Authors: Mykkänen Juha  , Korpela Mikko  , Eerola Anne  , Porrasmaa Jari  , Ruonamaa Hellevi  , Sormunen Marko
Published: February 2025

A strategy and toolset (FixIT) for migrating a specific type of legacy systems – based on the FileMan DBMS of the U.S. Department of Veterans Affairs – to a two-tier client/server and web browser-based architecture was presented in MEDINFO'98. In the current paper we discuss the further migration to a multi-tier software component architecture. A literature survey and industry contacts were used to speck an open, component-based target architecture for healthcare information systems to be reached by the year 2005, as well as a phased migration strategy from the present FileMan/FixIT-based systems towards the target.
Anamnesis via the Internet - Prospects and Pilot Results
Authors: Emmanouil Athanasios  , O. Klein Gunnar
Published: February 2025

A comprehensive computerized questionnaire was developed to obtain the anamnesis of patients seeking contact with a physician for any type of new problem. The purpose of this pilot study was to investigate if a structured questionnaire filled out by the patient and complementing an interview at the physician’s office would contribute to a better quality of the total anamnesis and/or lead to savings in time at the visit. The results encourage further developments in this direction. The potential uses proposed are, in addition to being used to improve a visit, the correct assessment of the history for prioritization and scheduling of visits and in some situations, the anamnesis obtained over the net may be the basis for medical advice without a visit. This study emphasizes the great improvement of information captured by this type of questionnaire based on medical knowledge about associated symptoms and relevant questions depending on the problem presented compared to the results obtained by a simple open question used in many e-health services today.
Use of an Electronic Medical Record in Disease Management Programs: A Case Study in Hyperlipidemia
Authors: Hunt Jacquelyn  , Siemienczuk Joseph  , Erstgaard Pat  , Slater James  , Middleton Blackford
Published: February 2025

Disease management programs seek to improve the health of a population of patients with a disease through a multidisciplinary approach founded in the collection, analysis and feedback of disease-specific outcomes. Currently, the majority of disease management programs have been conducted by insurers or external vendors. Limitations of these programs derive from separation of care from primary care and the inability to rapidly and accurately obtain the necessary clinical data. The utility offered by an electronic medical record allows physician organizations to conduct disease management programs of higher quality at lower cost.
The Role of Wireless Technology in Home Care Delivery
Authors: Maglaveras N.  , Koutkias V.  , Meletiadis S.  , Chouvarda I.  , Balas E.A.
Published: February 2025

Health care delivery is changing drastically. In its current state it tends to use the home care model in order to increase quality of life, to rationalize costs and to achieve wellness. Pivotal to these purposes are contact centers, which act as mediators between the medical staff and the citizens seeking advice and/or therapy. Main platforms used for the development of such applications are the INTERNET and PCs, and the telecommunication networks, including mobile solutions. In this paper, a generic contact center model shall be presented, which is under development in the context of an IST European project in health telematics entitled ‘Distance Information Technologies for Home care. The Citizen Health System (CHS)’. After the description of this generic contact center, an application for health care delivery to diabetic patients shall be described. In this application we shall see the possible use of the Wireless Application Protocol (WAP) scheme. This application proves the usefulness of wireless technology in providing health care services all around the clock and everywhere the citizen is located, it shows the necessity for restructuring the medical knowledge for education delivery to the patient, and it shows the virtue of interactivity by means of using the limited, yet useful browsing capabilities of the WAP technology.
The Evaluation of the Maternity and Infant Clinic on the Net
Authors: Kouri Pirkko  , Saarikoski Seppo  , Wuorisalo Jyri
Published: February 2025

In our project one health care service chain is being used as a model and the pattern is renewed with the help of the most advanced and recent information and communication technologies (ICT). The target of this pilot and patterning project is maternity and infant care. During four years the project has developed a new service, Maternity and Infant Clinic on the Net (Net Clinic), which is available via Internet to users. The project gathers and studies all the participants experiences on this new practice including the pilot families, public health nurses, midwives and doctors. This scientific demo is a presentation of the Net Clinic, how it works, what the benefits or hindrances are and how it influences on one's health.
Mimos: A Description Framework for Exchanging Medical Image Processing Results
Authors: Aubry F.  , Todd-Pokropek A.
Published: February 2025

Image processing plays increasingly important role in using medical images, both for routine as for research purposes, due to the growing interest in functional studies (PET, MR, etc.). Unfortunately, there exist nearly as many formats for data and results coding as image processing procedures. If Dicom presently supports a kind of structured reporting of image studies, it does not take into account the semantics of the image handling domain. This can impede the exchange and the interpretation of processing results.
Harmonization of Patient Data Card Structure with Messaging Standards
Authors: Emelin Ivan  , Galinovskaia Olga
Published: February 2025

Harmonization of patient data card (PDC) structure with messaging standards is discussed on example of pilot project of patient data card system implemented by the Medical Center of the Russian Federation President's Management Department. Such a harmonization may help to improve medical PDC interoperability on the seventh, application level.
Measurement of In-vivo Local Shear Modulus by Combining Multiple Phase Offsets MR Elastography
Authors: Suga Mikio  , Matsuda Tetsuya  , Minato Kotaro  , Oshiro Osamu  , Chihara Kunihiro  , Okamoto Jun  , Takizawa Osamu  , Komori Masaru  , Takahashi Takashi
Published: February 2025

To provide realistic surgical simulation, haptic feedback is important. In the existing surgical simulators, the fidelity of the deformation and haptic feedback is limited because they are based on the subjective evaluation of the expert-user and not on an objective model-based evaluation. To obtain elastic modulus of in-vivo human tissues, magnetic resonance elastography (MRE) was developed. MRE is a phase-contrast-based method that can visualize propagating strain waves in materials. The quantitative values of shear modulus can be calculated by estimating the local wavelength of the wave pattern. Low frequency mechanical motion must be used for soft tissue-like materials, because strain waves rapidly attenuate at higher frequency. Therefore, wavelength in MRE is long. It is difficult to estimate local wavelength with high spatial resolution especially from noisy MRE. In the MRE sequence, motion-sensitizing gradient (MSG) are synchronized with the mechanical cyclic motion. MRE with multiple initial phase offsets can be generated with increasing delays between the MSG and mechanical excitation. In this paper, we describe a method of measuring local wavelength with high spatial resolution by combining multiple phase offsets MRE. To confirm the reliability of this method, a computer simulation and phantom study were performed. The shear modulus measured with various elastic objects was well consistent with the value obtained by MRE and the mechanical method. The shear moduli of excised porcine liver and invivo human calf muscle were also analyzed by this method.
RAMEDIS - Rare Metabolic Diseases Publishing Tool for Genotype-Phenotype Correlation
Authors: Mischke Ulrike  , Scholz Uwe  , Toepel Thoralf  , Scheible Dagmar  , Hofestaedt Ralf  , Trefz Friedrich
Published: February 2025

To gain further knowledge about rare genetic diseases, a world wide method for data collection via the Internet has been established. This new approach will improve collecting valuable data from single case reports. RAMEDIS saves standardised patient data which will be usable for statistics, longitudinal examinations and co-operative studies in future time. Embedded in the scene of the German Human Genome Project, RAMEDIS directly will enable phenotype-genotype correlation's. Technically RAMEDIS is based on the Oracle database management system with some additional tools. Since November 2000 first case reports are committed online. Beside the better characterisation of clinical heterogeneity of rare diseases, there may be a great benefit for the treatment of these patients in whom prospective studies are otherwise expensive and difficult to perform. Quality of clinical diagnostic process and therapy will increase.
Volumetric Virtual Body Structures
Authors: Hatfield Paul  , Temkin Bharti  , Griswold John A.  , Deeb Sammy A.  , Dev Parvati  , Heinrichs W. LeRoy  , Srivastava Sakti  , Waldron Kenneth
Published: February 2025

Understanding the visuospatial aspects of anatomic structures is one of the most important goals of gross anatomy. Creation of realistic three-dimensional structures of human anatomy has thus been a goal of medical doctors and computer scientists. In this paper, we describe a PC/NT based system in which a user can easily select anatomical structures to be created, along with the chosen connected structures. The system then constructs a three-dimensional volumetric model, a virtual body structure, slice-by-slide. Once the virtual structure is assembled it is possible to “walk” through the volume with coronal, sagittal, and transverse views, or at any angle. The dynamic nature of the system is unique in that it allows for real time choice of volumetric body structures to be created, their rapid generation, and the ability to manipulate the resulting visualization.
Development of a Virtual Speaking Simulator Using Image Based Rendering
Authors: Lee J.M.  , Kim H.  , Oh M.J.  , Ku J.H.  , Jang D.P.  , Kim I.Y.  , Kim S.I.
Published: February 2025

The fear of speaking is often cited as the world’s most common social phobia. The rapid growth of computer technology has enabled the use of virtual reality (VR) for the treatment of the fear of public speaking. There are two techniques for building virtual environments for the treatment of this fear: a model-based and a movie-based method. Both methods have the weakness that they are unrealistic and not controllable individually. To understand these disadvantages, this paper presents a virtual environment produced with Image Based Rendering (IBR) and a chromakey simultaneously. IBR enables the creation of realistic virtual environments where the images are stitched panoramically with the photos taken from a digital camera. And the use of chroma-keys puts virtual audience members under individual control in the environment. In addition, real time capture technique is used in constructing the virtual environments enabling spoken interaction between the subject and a therapist or another subject.
Risk Reduction in Craniofacial Surgery using Computer-based Modeling and Intraoperative Immersion
Authors: Salb Tobias  , Burgert Oliver  , Gockel Tilo  , Brief Jakob  , Hassfeld Stefan  , Muehling Joachim  , Dillmann Ruediger
Published: February 2025

We present a two-stage concept for risk reduction in craniofacial surgery, consisting of preoperative risk modeling and intraoperative risk reduction. Preoperatively it is important to find and to visualize risk sources in order to minimize them. Our risk model is composed by superimposition of an isotropic risk potential and an anisotropic tissue field constituent. It is being applied to preoperative planning and simulation of craniofacial surgeries, for example to determine an access path with least overall risk value.
Virtual Endoscopy using Spherical QuickTime-VR Panorama Views
Authors: Tiede Ulf  , Sternberg-Gospos Norman von  , Steiner Paul  , Höhne Karl Heinz
Published: February 2025

Virtual endoscopy needs some precomputation of the data (segmentation, path finding) before the diagnostic process can take place. We propose a method that precomputes multinode spherical panorama movies using Quick-Time VR. This technique allows almost the same navigation and visualization capabilities as a real endoscopic procedure, a significant reduction of interaction input is achieved and the movie represents a document of the procedure.
Virtual Reality Assisted Cognitive Behavioral Therapy for the Treatment of Panic Disorders with Agoraphobia
Authors: Vincelli F.  , Choi H.  , Molinari E.  , Wiederhold B.K.  , Bouchard S.  , Riva G.
Published: February 2025

The chapter describes the characteristics of the Experiential-Cognitive Therapy (ECT) protocol for Panic Disorder and Agoraphobia. The goal of ECT is to decondition fear reactions, to modify misinterpretational cognition related to panic symptoms and to reduce anxiety symptoms. This is possible in an average of eight sessions of treatment plus an assessment phase and booster sessions, through the integration of Virtual Experience and traditional cognitive-behavioral techniques. We decided to employ the techniques included in the cognitive-behavioral approach because they showed high levels of efficacy. Through virtual environments we can gradually expose the patient to feared situation: virtual reality consent to re-create in our clinical office a real experiential world. The patient faces the feared stimuli in a context that is nearer to reality than imagination.
Training and Pretreatment Planning of Interventional Neuroradiology Procedures – Initial Clinical Validation
Authors: Chui Chee-Kong  , Li Zirui  , Anderson James H.  , Murphy Kieran  , Venbrux Anthony  , Ma Xin  , Wang Zhenlan  , Gailloud Philippe  , Cai Yiyu  , Wang Yaoping  , Nowinski Wieslaw L.
Published: February 2025

A PC based system for simulating image-guided interventional neuroradiological procedures for physician training and patient specific pretreatment planning is described. The system allows physicians to manipulate and interface interventional devices such as catheters, guidewires, stents and coils within 2-D and hybrid surface and volume rendered 3-D patient vascular images in real time. A finite element method is employed to model the interaction of the catheters and guidewires with the vascular system. Fluoroscopic, roadmapping and volume rendered 3-D presentations of the vasculature are provided. System software libraries allow for the use of commonly employed catheters, guidewires, stents and occluding coils of various shapes and sizes. The results of an initial clinical validation suggest that the experience gained from our simulator is comparable with that of using a vascular phantom. We are conducting further validation with the aim of providing patient specific pretreatment planning.
Electronic Health Care Records in Europe: confidentiality issues from an American perspective
Authors: Petrisor Alexandru I.  , Close Julia M.
Published: February 2025

The confidentiality and security issues related to the European Electronic Health Care Records have been approached in the United States as well. This paper synthesizes several solutions and comments on these issues from the legal viewpoint in the United States, as well as some preoccupations of the academic world to improve and standardize the quality of the security and confidentiality of data from studies involving human subjects.
Standards Supporting Interoperability and EHCR Communication – A CEN TC251 Perspective
Authors: Marley Tom
Published: February 2025

This paper has been submitted by Tom Marley. Tom was a member of the project team which produced ENV13606 Part 1: and acted as liaison to the Part 4 project team. Tom is currently writing up the document on General Purpose Information Components.
Unified EHR Standards - Is convergence possible?
Authors: Beale Thomas
Published: February 2025

This paper examines the current state of the art in standards for the electronic health record (EHR) and messaging, and proposes a theoretical design basis for the EHR which is formal yet flexible, and which takes into account many of the difficulties experienced in the past. Recommendations are given for how convergence of EHR specifications might occur, in order to achieve a unified standard suitable for all clinical and cultural contexts.
Augmented Reality in Spine Surgery. Critical Appraisal and Status of Development
Authors: Bastien S.  , Peuchot B.  , Tanguy A.
Published: February 2025

In spinal surgery, computer assistance in the operating room is gaining fast- paced acceptance, but it would be simplistic to imagine that added technology is systematically beneficial to the patient. As surgeons are not experts in computer technology, there is a tendency to abandon the evaluation to the market and say the best will emerge. Based on our experience with the development of our own system and confronted with the emergence of new systems adopting solutions we had rejected, we propose a framework to compare various systems between them. Similar evaluation protocols are in use for surgical implants, the same should be done for computer assistance.
Brace Monitoring System for the Treatment of Scoliosis
Authors: Lou E.  , Raso J.  , Hill D.  , Durdle N.  , Mahood J.  , Moreau M.
Published: February 2025

Determining the efficacy of brace treatment for AIS has been hampered by poor data on the wear pattern of those children prescribed this treatment. Although there is some information on brace compliance, there is very little on how well the brace is secured and the resulting loads imposed on the trunk. The purpose of this study was to determine the daily brace wear pattern of adolescents prescribed Boston braces. The brace monitoring system consists of a force transducer and a microcomputer unit. A force transducer was placed in the lining of the Boston brace. The microcomputer unit was carried while the brace was worn. The force imposed by the brace pad during daily activity was recorded at 1 minute intervals over a period of 3 to 14 days. The samples were stored by the microcomputer. Five subjects (3F;2M; age: 14±2 years) who were to wear the brace full time were studied. The subjects adjusted their braces to a prescribed level of tightness as indicated by a light on the microcomputer. Overall compliance, compliance during school days, and forces imposed by the brace were analysed. The force provided by the Boston brace varies considerably during daily activity. Overall brace compliance was lower than expected, with 2 of 5 subjects wearing their brace infrequently. The compliance rate during school time was not different than during the rest of the study period. Peer pressure at school did not appear to affect brace compliance.
Computer Modelling of Hooks for Use as Intra-Operative Force Sensors
Authors: Duke K.K.  , Fyfe K.R.  , Moreau M.J.  , Mahood J.K.  , Raso V.J.  , Hill D.L.
Published: February 2025

There are a number of forces applied during scoliosis surgery, the magnitude and direction of which remains unknown. There is little literature concerning the in vivo distribution of forces along the spine. Computer modelling (ANSYS) was used to investigate the possibility of using an instrumented hook to intra-operatively measure the antero-posterior and distraction/compression forces applied by the surgeon during corrective scoliosis surgery. Three hook designs were evaluated based on specific design criteria. ANSYS provided the preliminary analysis to determine the strain distribution in these hooks. One design, the "membrane" design, was selected and a prototype was manufactured. Preliminary tests demonstrate that this prototype will be able to differentiate between the four major forces applied during the surgical correction.
SYDESCO : a Laser-Video Scanner for 3D Scoliosis Evaluations
Authors: Treuillet S.  , Lucas Y.  , Crepin G.  , Peuchot B.  , Pichaud J.C.
Published: February 2025

SYDESCO is a new 3D vision system developed for trunk surface topography. This structured light surface scanner uses the principle of triangulation-based range sensing to infer 3D shape. The complete trunk acquisition is fast (2 seconds). The accuracy of the metric data is ensured by a subpixel image detection and a calibration process, which rectifies image deformations. A preliminary study presents results on 50 children in a gymnastics school. These children, aged between eight to sixteen years, are particularly exposed to spinal deformities. An asymmetry index is calculated from the 3D data to detect the pathologic cases. These results have been compared to an independent medical diagnosis. The system results have been confirmed for 72,1% of the patients.
The Early Detection of Adolescent Idiopathic Scoliosis in Three Positions Using the Scoliometer and Real-time Ultrasound: Should the Prone Position also be Used?
Authors: Burwell R.G.  , Aujla R.K.  , Kirby A.S.  , Moulton A.  , Webb J.K.
Published: February 2025

The standing forward bending position is in general use for the early detection of adolescent idiopathic scoliosis. It also reveals humps caused by leg-length inequality and for this reason some workers have advocated using the sitting forward bending position [5]. Most recently the prone position has been evaluated and even recommended [10]. The introduction of B-mode and subsequently real-time ultrasound to measure rib rotation and spinal rotation has involved using the prone position [7,9]. The numerical description of back humps in scientific studies requires measurements at several levels on the back from Tl-Sl [1]. This paper utilizes 30 subjects referred by school screening for scoliosis from whom 10-level Scoliometer Angle of Trunk Inclinations (ATIs) were obtained twice in each of three positions - standing forward bending, sitting forward bending and prone. The ATIs were converted to 18 levels and (1) analysed for reproducibility, (2) compared in the three positions, and (3) compared with real-time ultrasound data of rib rotation obtained in the prone position. Several statistical methods are used. The reproducibility is best in the sitting and prone positions. While the prone position produces lower ATI readings, R squared values are significantly higher and Residual Mean Square (RMS) values significantly lower than those for each of the standing and sitting forward bending positions. Though the prone position has clear advantages, it is not advocated in clinical practice for various reasons. More research is needed. The evidence supports the view [5] that the sitting forward bending position has advantages for the early detection of adolescent idiopathic scoliosis.
Cognitive Engineering in Interface Design
Authors: Jaspers M. W. M.  , Steen T.
Published: February 2025

Today, many medical information systems are not satisfactory to their users. To ensure ultimate acceptance of health care information systems asks for systems that map on health care workers’ tasks and on their cognitive processes in performing these tasks. The development of human-oriented computer interfaces requires insight in users' information needs and information processing in view of the tasks that will be computer-supported. Cognitive engineering aims at understanding the fundamental principles behind human activities that are relevant in designing a system that supports these activities. The application of cognitive engineering methods may therefore contribute to computer systems that fit better in health care working practices. We used cognitive engineering methods in designing a user interface for a physicians’ workstation to support them in preparing their patient screening. The information needs and information search strategies of 4 physicians were revealed by systematic analyses of verbal protocols and video's while they successively worked through 10 paper-based patient records in preparing their patient visits. The results of these analyses were used as input for the design of a conceptual higher-order model that represents both the information needs and information search strategy of these physicians. Based on this higher-order conceptual model, we developed paper-mock ups and a first prototype of the user interface. The physicians will evaluate this prototype in the next phase of the project.
Electronic Patient Records: Dutch Domain Information Model Perinatology
Authors: Goossen William TF  , Jonker Marcel  , Kabbes Bert L.
Published: February 2025

Currently a national domain information model is developed to support information exchange via electronic patient records (EPR), and to support the adoption of the EPR in Dutch healthcare practice. This article describes a pilot for the domain information model for mother- and childcare (perinatology) that serves as a first ‘use case’. The ‘use case’ is modeled using the Health Level 7 version 3 Reference Information Model (HL7 RIM) as the methodology and modeling tool.
Step-By-Step Mark-Up of Medical Guideline Documents
Authors: Svátek Vojtěch  , Růžička Marek
Published: February 2025

The quality of document-centric formalisation of medical guidelines can be improved using a decomposition of the whole process into several explicit steps. We present a methodology and a software tool supporting the step-by-step formalisation process. The knowledge elements can be marked up in the text with increasing level of detail, rearranged into an XML knowledge base and exported into the operational representation. Semi-automated transitions can be specified by means of rules. The approach has been tested in a hypertension application.
Medical Information Systems for Cardiac Risk Assessment and Remote Monitoring
Authors: Balázs Gabor  , Drozdik Béla  , Vassányi István  , Mógor Emil
Published: February 2025

Remote monitoring and interactive remote counselling provide a cost-effective and comfortable means of medical care. The paper presents the first experiences of two such systems, both in the field of cardiovascular diseases. The prototype medical instruments, the database design and the user interfaces are elaborated. The project mns until mid-2004.
Webmastering in Academic Institutions: a New Job Opportunity
Authors: Thirion Benoit  , Darmoni Stéfan Jacques  , Douyere Magaly  , Leroy Jean-Philippe
Published: February 2025

In cyberspace, the health webmaster could be regarded as a virtual editor-in-chief, in charge of content and design. In this circumstance, he/she must follow quality criteria when building any resource. At the Rouen University Hospital (RUH), we have chosen “Net Scoring” as an effective tool to aid the design of a quality Web site. “Net Scoring” contains a list of 49 criteria which fall into eight categories: credibility, content, links, design, interactivity, quantitative aspects, ethics, and accessibility. The webmaster is the key element of the editorial board process. He/she must regularly monitor the Web site in order to retrieve information about whether the site is used and by whom: the method most commonly used is log analysis. At the RUH, an average of 9,000 unique machines visit our Web site each working day. Conclusion: webmaster is a new job opportunity in academic institutions, in particular for medical informaticians and medical librarians both whom are information science professionals.
Three Dimensional Analysis of Chest Wall Motion during Breathing in Healthy Individuals and Patients with Seoliosis using an Ultrasonography-based System
Authors: Kotani Toshiaki  , Minami Shohei  , Takahashi Kazuhisa  , Isobe Keijiro  , Nakata Yoshinori  , Takaso Masashi  , Inoue Masatoshi  , Nishikawa Shinsuke  , Maruta Tetsuro  , Tamaki Tamotsu  , Moriya Hideshige
Published: February 2025

The mechanical inefficiency during respiration in scoliosis remains unclear. Aim: To study the three-dimensional motion of the chest wall during deep breathing in healthy and scoliotic individuals. Materials & Methods: Three-dimensional chest wall motion during breathing was studied in 17 scoliotic patients (right thoracic curvature) and 9 healthy individuals. Measurements were performed using a Zebris CMS 70P system (Zebris Medizintechnik GmbH, Isny, Germany) which analyzes the time delay of ultrasound pulses emitted from markers placed on the chest wall. Nine markers were attached on the upper, the middle and the lower chest wall. Subjects were seated on a chair and asked to breathe deeply and slowly with no elevation of the shoulders for one minute. Results: The amplitudes were symmetric between the two sides in healthy individuals while scoliotic patients exhibited asymmetric chest wall motion. The amplitudes of the right convex side of the chest wall exhibited less motion than those of the left concave side, especially on the lower chest wall. Conclusion: Chest wall motion was asymmetric in the scoliotic patients with diminished motion of the right lower chest wall. This locally diminished ventilation may cause ventilation-perfusion inequality and result in hypoxemia.
Etiologic Theories of Idiopathic Scoliosis: Neurodevelopmental Concepts to be Evaluated
Authors: Burwell R G  , Dangerfield P H
Published: February 2025

There is increasing interest in the concept that neuromuscular mechanisms and the central nervous system (CNS) are somehow involved in the etiology and pathogenesis of idiopathic scoliosis (IS). Yet in the extensive neuroscience research of idiopathic scoliosis certain neurodevelopmental concepts have been neglected. These include: (1) a CNS body schema for posture and movement control generated during development and growth by establishing a long-lasting memory; (2) pruning of cortical synapses at puberty; and (3) neuromorphic engineering. Memory of developing posture and movement might be established in neurons of the CNS body schema in the form of novel proteins; these could be coded by modified genes obtained by the recombination (crossing over) of DNA in a similar way to that in the production of immunological antibodies and during meiosis [11,27]. These concepts need evaluation in relation to (1) the etiopathogenesis of IS and (2) a possible new treatment approach to idiopathic scoliosis involving a neuromorphic device to control the output for muscle stimulators that are inserted and driven with telemetry.
Monitoring the thoracic sagittal curvature in kyphoseoliosis with surface topography: a trend analysis of 57 patients
Authors: McArdle F.J.  , Griffiths C. J.  , Macdonald A. M.  , Gibson M. J.
Published: February 2025

Records of Quantec measurements of tlie kypliotic curvature of the back were reviewed for all patients attending the children’s orthopaedic clinic who were referred for back shape measurements. Of these, 57 children had five or more preoperative visits allowing trends to be calculated. Linear trends were found in 30 of the patients, with gradients ranging from 1.1°/yr to 7.20l/yr. On average, the scatter of measurements about the trend line, or about the mean value in the other 27 cases, compared well with that expected from repeatability studies but the amount of scatter varied from one patient to another. This may well be due to sampling. Where such measurements are monitored for evidence of change in an individual patient, the possibility of larger than average scatter about any emerging trend should be considered.
Cotrel-Dubousset instrumentation (CDI) in the treatment of congenital spinal deformities. Computer topography evalution
Authors: Mikhailovsky M.V.  , Sarnadsky V.N.  , Khanaev A.L.
Published: February 2025

Aim of the study. CDI and other types of segmental instrumentation are wide used in surgical treatment of congenital spinal deformities. At the same time we didn’t find in orthopaedic literature any data concerning 3-D evaluation of the results of such procedures. The aim of this study is the assessment of 3-D effect of CDI using of computer optical topography.
Pre and Post 3D Modeling of Scoliotic Patients Operated with In Situ Contouring Technique
Authors: Dumas R.  , Mitton D.  , Steib J. P.  , de Guise J. A.  , Skalli W.
Published: February 2025

A three-dimensional segmental analysis was performed on the stereoradiographic reconstructions of ten right thoracic scoliotic patients. From the quantitative model of the spine and pelvis, the vertebral and intervertebral orientations were computed pre and post operatively. These orientations allow to determine the apical and junctional zones of the high thoracic, thoracic and lumbar curves. The apical zone corresponds to the maximum of vertebral axial rotation. Pre operatively, the tendency was T7 for the thoracic transverse apex with 20 Æof axial rotation. The junctional zone corresponds to the maximum of vertebral lateral rotation and the maximum of intervertebral axial rotation. The tendency was T5 and T12 for the junctional vertebrae of the thoracic curve with, at both levels, 30Æ of vertebral lateral rotation and 10Æ of intervertebral axial rotation.
3D Reconstruction and Analysis of the Whole Trunk Surface for Non-Invasive Follow-Up of Scoliotic Deformities
Authors: Pazos Valérie  , Cheriet Farida  , Labelle Hubert  , Dansereau Jean
Published: February 2025

The purpose of this study was to evaluate the 3D reconstruction accuracy of a new technology that allows the acquisition of the whole trunk and to develop a software to analyse the trunk surface asymmetry. A non-invasive active vision system provides a 3D textured reconstruction of the whole trunk. The analysis system provides the clinician with quantitative indices that characterize the whole external trunk asymmetry.
Physician Practice Management Solutions
Authors: Hearn Charles W.
Published: February 2025

Medicine today has changed in many aspects. Physician practices face enormous challenges in the form of higher costs, lower reimbursement, and managed care. Barriers in the form of physician discomfort with information technology and the costs associated with employing this technology make physicians reluctant to adopt information technology systems in their practices. Thus the problem is how to get doctors to adopt technology that can actually help them combat these challenges and problems and provide quality care to patients. This chapter discusses an appropriate and practical orientation from which to approach design and implementation of information technology for the office practice.
Health Care Information Technology: Better Care, Better Business
Authors: Tobin Glenn
Published: February 2025

The health care industry is in crisis. From patient safety concerns to wasteful operations to overburdened workforces, health care is ripe for reinvention. In “Health Care Information Technology: Better Care, Better Business,” Glenn Tobin discusses the aspects of health care in need of transformation; the reasons why health care information technology is the right solution; and the benefits to be realized from implementing IT.
Mixed Messages: Legal Incentives and Disincentives Confronting Technologically Mediated Care
Authors: Terry Nicolas P.
Published: February 2025

The “systems” approach to reducing medical errors is increasingly viewed as dependent upon technology. Issues with the legal system, however, may impede needed reforms. Historically there has been a pervasive disconnect between the legal system and changes in healthcare business models and structures. Further, difficult legal issues will accompany care that is increasingly technologically-mediated. This chapter identifies some of the most serious disconnects and makes suggestions for needed reform.
A Systems Approach to Preventing Adverse Drug Events
Authors: Anderson James G.
Published: February 2025

It is estimated that over three-quarters of a million people are injured or die in hospitals each year from adverse drug events. The majority of medical errors result from poorly designed health care systems rather than from negligence on the part of health care providers. While there is considerable evidence that information technology can be used to significantly reduce medication errors and adverse events, information technology, to be effective, must be implemented using a systems approach. This paper reviews three studies that have used a systems approach to investigate the causes of medication errors and the effectiveness of information technology in preventing adverse drug events. Significant reduction of medication errors and adverse drug events requires systemic implementation of information technology, improvements in the reporting of errors, and integration with other systems designed to detect and prevent errors.
Metrics and Motion Analysis for Assessment of Surgical Skills
Authors: Holbrey Richard P.  , Bulpitt Andrew J.
Published: February 2025

Pressure has grown over the past decade to provide more rigorous and standardized testing of surgical trainees at both higher and lower levels [1]. VR technologies appear to offer a solution but the cost of equipment and realism of the interface present major research challenges. The central requirement of simulation remains assessment, however, and the present study examines this issue within the context of surgical suturing skills. By tracking users during suturing tasks, we argue that errors in technique can be analysed by the examination of standard pattern spaces.
Physically Based Hybrid Approach in Real Time Surgical Simulation With Force Feedback
Authors: Kim J.  , De S.  , Srinivasan M.A.
Published: February 2025

This paper describes a novel hybrid-modeling paradigm for the simulation of surgical tool-soft tissue interactions in real time medical simulations using force feedback. A local point collocation-based method of finite spheres is coupled with a global boundary element technique to capture local features of the interaction (e.g., nonlinearities of the soft tissue) without sacrificing global accuracy. The technique is demonstrated using realistic examples.
The Joy$^{(\rm nt)}$stick$^{\reg}$: A New Force-Input-Device for a Multi-Modal Desktop Simulator
Authors: Riener Robert  , Frey Martin  , Bernhardt Michael
Published: February 2025

This paper presents a new force-torque input device that can be used to navigate within any kind of anatomical atlas. As an example, we demonstrate how it can be used to drive a virtual knee joint. The device is comprised by a realistic phantom shank that is attached to a self-made high-sensitive force-torque sensor. It records forces and moments in six degrees-of-freedom and feeds them into a biomechanical model of the knee. Resulting joint movements and sounds are displayed by a visual and acoustic display, respectively. The entire multi-modal simulation environment can provide a better understanding of joint anatomy, e.g. for the education of medical students. Furthermore, it can be a practical tool for resident orthopaedic physicians in order to enhance the consultation, clarification, and treatment planning together with the patient.
The Virtual Craniofacial Patient: 3D Jaw Modeling and Animation
Authors: Enciso Reyes  , Memon Ahmed  , Fidaleo Douglas A.  , Neumann Ulrich  , Mah James
Published: February 2025

In this paper, we present new developments in the area of 3D human jaw modeling and animation. CT (Computed Tomography) scans have traditionally been used to evaluate patients with dental implants, assess tumors, cysts, fractures and surgical procedures [1]. More recently this data has been utilized to generate models.
A Study Design to Measure the Outcomes of Education in Data Security Issues among Health Care Professionals
Authors: Immonen Aapo  , Saranto Kaija  , Mauranen Kari
Published: February 2025

The purpose of this paper is to describe a study design compiled to measure the outcomes of education in health care data security issues. Based on previous studies the knowledge in data security is not very comprehensive and health care professionals feel that they need more education and training in information technology, specially in the filed of data security issues.
A Methodology for Multi-source Record Linkage
Authors: Kerkri E.M.  , Quantin C.  , Grison T.  , Yétongnon K.
Published: February 2025

As patient’s medical data is disseminated in different health structures, building a data-warehousing system at a regional level, for healthcare co-operation, has some specific requirements compared to intra healthcare structure datawarehousing projects. In particular, there is no common patient electronic record’s identifier among all the sources. Hence, data integration and Record Linkage is the most important issue in such projects.
Relating UMLS semantic types and task-based ontology to computer-interpretable clinical practice guidelines
Authors: Kumar Anand  , Ciccarese Paolo  , Quaglini Silvana  , Stefanelli Mario  , Caffi Ezio  , Boiocchi Lorenzo
Published: February 2025

Medical knowledge in clinical practice guideline (GL) texts is the source of task-based computer-interpretable clinical guideline models (CIGMs). We have used Unified Medical Language System (UMLS) semantic types (STs) to understand the percentage of GL text which belongs to a particular ST. We also use UMLS semantic network together with the CIGM-specific ontology to derive a semantic meaning behind the GL text.In order to achieve this objective, we took nine GL texts from the National Guideline Clearinghouse (NGC) and marked up the text dealing with a particular ST. The STs we took into consideration were restricted taking into account the requirements of a task-based CIGM. We used DARPA Agent Markup Language and Ontology Inference Layer (DAML+OIL) to create the UMLS and CIGM specific semantic network. For the latter, as a bench test, we used the 1999 WHO-International Society of Hypertension Guidelines for the Management of Hypertension. We took into consideration the UMLS STs closest to the clinical tasks. The percentage of the GL text dealing with the ST “Health Care Activity” and subtypes “Laboratory Procedure”, “Diagnostic Procedure” and “Therapeutic or Preventive Procedure” were measured. The parts of text belonging to other STs or comments were separated. A mapping of terms belonging to other STs was done to the STs under “HCA” for representation in DAML+OIL. As a result, we found that the three STs under “HCA” were the predominant STs present in the GL text. In cases where the terms of related STs existed, they were mapped into one of the three STs. The DAML+OIL representation was able to describe the hierarchy in task-based CIGMs. To conclude, we understood that the three STs could be used to represent the semantic network of the task-bases CIGMs. We identified some mapping operators which could be used for the mapping of other STs into these.
Clinical Guidelines: study of staff awareness of Internet resources
Authors: Anthony Denis  , Brooks Nicky
Published: February 2025

Clinical guidelines (CGs) are widely used in community hospitals. The advantages and limitations of CGs are well understood by nurses and therapists. There are effective human dissemination routes using local training of link nurses and cascade learning. Practice development nurses are a useful resource for locating CGs. However there is a universal lack of awareness of Internet based national CGs in this sample of ward nurses and therapists. Access to these national CGs via the Internet would make local adaptation of CGs more effective and efficient. Access to Internet PCs on the wards backed up with staff training was recommended, and is ongoing.