bluuebunny/crossref_metadata_2025 huggingface dataset:
A Semantic Approach for the Homogeneous Identification of Events in Eight Patient Databases: A Contribution to the European eu-ADR Project
Authors: Avillach Paul  , Mougin Fleur  , Joubert Michel  , Thiessard Frantz  , Pariente Antoine  , Dufour Jean-Charles  , Trifirò Gianluca  , Polimeni Giovanni  , Catania Maria Antonietta  , Giaquinto Carlo  , Mazzaglia Giampiero  , Baio Gianluca  , Herings Ron  , Gini Rosa  , Hippisley-Cox Julia  , Molokhia Mariam  , Pedersen Lars  , Fourrier-Réglat Annie  , Sturkenboom Miriam  , Fieschi Marius
Published: February 2025

The overall objective of the eu-ADR project is the design, development, and validation of a computerised system that exploits data from electronic health records and biomedical databases for the early detection of adverse drug reactions. Eight different databases, containing health records of more than 30 million European citizens, are involved in the project. Unique queries cannot be performed across different databases because of their heterogeneity: Medical record and Claims databases, four different terminologies for coding diagnoses, and two languages for the information described in free text. The aim of our study was to provide database owners with a common basis for the construction of their queries. Using the UMLS, we provided a list of medical concepts, with their corresponding terms and codes in the four terminologies, which should be considered to retrieve the relevant information for the events of interest from the databases.
Using Knowledge Modelling to Measure How Clinical Practice Could Actually Be Evidence-Based: A Preliminary Analysis with Arterial Hypertension Management
Authors: Séroussi Brigitte  , Bouaud Jacques  , Denké Denké L.  , Falcoff Hector  , Julien Jacques
Published: February 2025

ASTI is a guideline-based decision support system to be used in primary care. We analyzed the knowledge modelling carried out in the development of ASTI knowledge base (KB) from French clinical practice guidelines (CPGs) on arterial hypertension management to evaluate the evidence status of therapeutic propositions issued by the system. We defined three status: “evidence-based” (EB) when propositions are graded A, B, or C, “consensus-based” (CB) when propositions are explicitly mentioned in CPGs but supported by professional agreement (grade D), and “non-supported” (NS) when propositions are expert-based and provided by a domain specialist. We compared the distributions of evidence status on the 44,571 theoretical patient profiles extracted from ASTI KB, and on a data set of 435 actual hypertensive patients. Only 8.3% of actual patients, managed by 0.5% of the KB, have an EB profile and 46.9% of patients, managed by 12.6% of the KB, have a CB profile. Thus, there is no CPG recommendation for nearly half of the patients (44.8% have a NS profile).
Visualizing Patient Trajectories on Wall-Mounted Boards – Information Security Challenges
Authors: Faxvaag Arild  , Rø stad Lillian  , Tøndel Inger A.  , Seim Andreas R.  , Toussaint Pieter J.
Published: February 2025

Since operating room departments are among the costliest resources at a hospital, much attention is devoted to maximize their utilization. Operating room activities are however notoriously hard to plan in advance. This has to do with the unpredictable, problem-solving nature of the work and that the work is carried out by a multidisciplinary team of health personnel, members of which also have commitments outside the operating room department. We assume that operating room teams have the capacity to coordinate themselves and that coordination might be facilitated by visualizing relevant information on wall-mounted boards. To characterize clinical situations that require coordination and re-planning of the teams' work, we have developed a realistic scenario. We analyse and discuss the information security challenges that follow from displaying information on the whereabouts of other teams, actors and patients on wall-mounted boards in the operating rooms. Information security threats could be mitigated by de-identification techniques. Information demands could thereby be met without sacrificing the privacy of those whose information is displayed.
Collection and Sharing of Information on Patient Safety Education and Training in Europe
Authors: Zikos Dimitris  , Liaskos Joseph  , Diomidous Marianna  , Mantas John
Published: February 2025

The European Union Network for Patient Safety (EUNetPaS) is a project funded and supported by the European Commission within the 2007 Public Health Programme and aims to encourage and enhance the collaboration of participating EU countries in the field of Patient Safety. One of its major objectives is to promote Patient Safety (PS) education and training in Member States, through building a platform for mutual exchange of experience and knowledge on methods of planning and implementing sustainable learning activities. Towards this direction, a methodology has been applied, based on a three axes schema, which describes the roles, the awareness level and the competences of the PS Education and Training Activities. Based on this scheme, a questionnaire has been developed and distributed across EU organizations though National Contact Points, as a tool for information collection. Looking to the above structure, a web-based resource has been developed aiming to facilitate the information collection and sharing, in a truly networking environment.
Equity of Accessibility to Dialysis Facilities
Authors: Richard Jean-Baptiste  , Aldigier Jean-Claude  , Le Mignot Loïc  , Glaudet Florence  , Ben Said Mohamed  , Landais Paul
Published: February 2025

Patients' end-stage renal disease (ESRD) characteristics are changing. Improving the quality of care requires a steady adaptation of treatment modalities together with equity of access to dialysis facilities. We explored the ability of the health system to cope with the demand of ESRD care. An analysis of a 5-year follow-up cohort of ESRD patients in the Limousin region, France, was performed. Data were entered in the Multi-Source Information System of the Renal Epidemiology and Information Network (REIN). The participation rate of centres was complete. We analysed patient characteristics, therapeutic options and driving time to reach dialysis facilities. We investigated geographic accessibility by defining areas within 45 minutes from dialysis units. We constructed scenarios to assess the impact of health care reorganization. In-centre haemodialysis units represented 73% of treatment modalities. One quarter of patients lived at more than 45 minutes of their dialysis unit. Based on a scenario of creating an additional In-centre unit, the number of patients living far from their centre would decrease by 31%. This study emphasizes important issues related to ESRD epidemiology, comorbidity and health care planning. It stimulates the development of new scenarios allowing the assessment of equity in accessing health care facilities.
An Investigation of Factors Influencing Healthcare Workers' Use and Acceptance of E-Learning in Post-School Healthcare Education
Authors: Mikalsen Marius  , Walderhaug Ståle
Published: February 2025

The objective of the study presented here was to perform an empirical investigation on factors affecting healthcare workers acceptance and utilisation of e-learning in post-school healthcare education. E-learning benefits are realised when key features of e-learning are not only applied, but deemed useful, compatible with the learning process and supportive in order to reach the overall goals of the learning process. We conducted a survey of 14 state-enrolled nurses and skilled-workers within the field of healthcare in Norway. The results show that perceived compatibility and subjective norm explain system usage of the e-learning tool amongst the students. We found that the fact that the students considered the e-learning to be compatible with the course in question had a positive effect on e-learning tool usage. We also found support for factors such as facilitating conditions and ease of use leads to the e-learning tool being considered useful.
Usage and Effectiveness of E-Learning Courses for Continuous Medical Education
Authors: Mazzoleni M. Cristina  , Rognoni Carla  , Finozzi Enrico  , Giorgi Ines  , Pugliese Franco  , Landro Mauro  , Imbriani Marcello
Published: February 2025

The paper describes the results of an e-learning experimental project for Continuous Medical Education (CME) in Occupational Medicine in terms of: extent of the e-learning courses usage by the healthcare personnel, knowledge acquisition and satisfaction. 11 courses have been available for 11 months during which 2,034users all over Italy enrolled in5,183 courses with a success percentage of 72% and a significant difference between test scores performed before and after attending the e-learning courses. Also user's satisfaction, inspected through a questionnaire, has provided good results. Starting from the experience reported, the authors are confident that e-learning will gain ground and evolve as an effective and appreciated educational mean for CME.
HL7's Comprehensive Standards Set and Its International Collaboration for Enabling Semantically Interoperable eHealth and pHealth Solutions
Authors: Blobel Bernd  , Chronaki Catherine  , Stegwee Robert  , Grain Heather  , Hammond William E.  , Jaffe Charles  , Kalra Dipak  , Koehn Marc  , Macary Francois  , Sabutsch Stefan  , Sheetham Edward  , Schulz Stefan  , Tan Michael
Published: February 2025

The workshop is organized by HL7 and its affiliates to present and to discuss HL7's activities for providing international standards and specifications to enable advanced semantically interoperable eHealth and pHealth solutions, adaptable to national health systems through localization. The workshop especially focuses on the multi-disciplinary structure of HL7 and its liaisons with international and national standards developing organizations as well as important health informatics initiatives. Demonstrating existing and emerging solutions and strategies within HL7's broad scope and spectrum, the international scope of HL7 standards is highlighted.
Requirements Engineering of an Access Protection
Authors: Friedrich Sharon  , Paech Barbara
Published: February 2025

Access protection is an important requirement for systems, which handle confidential data. This paper describes an approach for the requirements engineering of an access protection using the example of an open system. A major problem of open systems is that many users with different roles access it. Moreover, the open system is connected to the Internet and has ports for connecting hardware like an external storage medium. Therefore, it is easy to steal or misuse confidential data from open systems if access protection is not existent. First, we used Task and Object-Oriented Requirements Engineering (TORE) in order to specify functional requirements on the access protection. For the elicitation of non-functional requirements, we applied Misuse-Oriented Quality Requirements Engineering (MOQARE), on which this paper is focused. Furthermore, we used the German IT-Safety and Security Standard Handbook in order to ensure the completeness of the solution requirements. For consideration of architectural requirements, we used Integrated Conflict Resolution and Architectural Design (ICRAD). It allows to analyze which design can realize which requirements and therefore to identify the most suitable one. Combining these three requirements engineering methods ensured a complete and appropriate solution.
Method Engineering: State-of-the-Art Survey and Research Proposal
Authors: Rolland Colette
Published: February 2025

Method Engineering has emerged in response to the need to adapt methods to better fit the needs of the development task at hand. It aims at providing techniques for retrieving reusable method components, adapting and assembling these together to form the new method. The paper provides a survey of the main results obtained for the two issues of defining and assembling components. Given the amplitude of the results obtained, the paper concludes that the research community has reached considerable maturity. It argues thereafter that the full power of method components can be widely exploited by moving to the notion of method services and briefly outlines a possible approach towards MaaS, Method as a Service.
The Technical Foundation of the GeneSEZ MDSD Approach
Authors: Haubold Tobias  , Beier Georg  , Golubski Wolfgang  , Herbig Nico  , Beine Gerrit  , Arnold Oliver
Published: February 2025

Model-Driven Software Development (MDSD) is highly regarded and already used in industry. Several approaches exist which use UML (Unified Modeling Language), DSLs (Domain Specific Languages) or other meta models. One weakness of these approaches is the use or complexity of the meta model used to model the application within the whole MDSD process. This restricts the reusability of model transformations in case of another meta model. The GeneSEZ approach targets this problem by introducing a separate meta model for the MDSD process. Decoupling the meta models used during modeling and within model transformations leads to a fixed back-end of the MDSD process consisting of reusable model transformations for code generation resulting in a higher benefit of model driven approaches. Models created by different modeling tools with different meta models can reuse the same model transformations increasing the return of invest of these model transformations. The GeneSEZ approach is a pragmatic model driven approach and evolved through the experience gained by applying it to several industry projects.
A New Windows Desktop Icon for Single Point-of-Control of the Application Window
Authors: Sugawara Kohei  , Maruta Rikio
Published: February 2025

A new concept of the computer icon is presented, whose roles are expanded to have all control functions for the object window from the very limited original roles to show merely the existence and the kind of the object. The “control” icon uses the push-pin icon that consists of a push-pin image and its shadow as proposed by the authors' previously [6,7]. The main subject of this paper is how to apply the new “control” icon concept to the MS Windows environment. The paper describes that the control icon realized as an add-on software program on the MS Windows can control any existing application programs without requiring modifications. Also, a new intuitive method for resizing the displayed object window with a free aspect ratio is presented.
Virtual Medical Doctor Interaction Based on Transactional Analysis
Authors: Fujita Hamido  , Hakura Jun  , Kurematsu Masaki
Published: February 2025

Human computer Interaction based on emotional modeling has been investigated and reported in this paper. Human personality has been analyzed based on ego-gram analysis and accordingly human “SELF” emotional model has been created. We have created as one part a computerized model which reflects a human user (in this paper Medical Doctor model) impeded as a computer model and through it, an emotional interaction between that model and the real human user is established. The interaction scenarios and reasoning are based on transactional analysis. We have implemented the system and empirically, examined it, as experiment in public space for revision and evaluation.
Innovations in Connected Health
Authors: Singh Kanwaljit  , Kvedar Joseph C.
Published: February 2025

Technological advancements in recent decades have made the concept of Connected Health feasible. These innovations include hardware innovations (such as wearable medical technology), and software (such as electronic personal health record systems e.g., Google Health and Microsoft HealthVault). Technology innovations must be accompanied by process innovations to truly add value. In health care that includes clinical process innovations and business process innovations. This chapter outlines how the healthcare system is being affected by innovations in connected health. It provides examples that illustrate the various categories of innovation and their impact. Now more than ever, health care reform is required in the U.S. The systems outlined in this chapter will allow care that is of high quality, while extending providers across more patients (i.e. increasing access) at a lower overall cost (improved efficiency).
Talking About Painful Subjects: Flexibility and Constraints in Patient Interviews
Authors: Moore John  , Lieberman Henry
Published: February 2025

Increasing understanding of how to categorize patient symptoms for efficient diagnosis has led to structured patient interviews and diagnostic flowcharts that can provide diagnostic accuracy and save valuable physician time. But the rigidity of predefined questions and controlled vocabulary for answers can leave patients feeling over-constrained, like the doctor (or computer system) is not really listening to them. In addition, not hearing the patient's own words can lead to the physician overlooking subtle details that are diagnostically relevant. How can we reconcile the need for patients to express themselves with the doctor's need to understand the patient's experience in medically appropriate terms?
Adaptive Information Networks in Healthcare: Spontaneous Interoperability
Authors: DelloStritto James J.
Published: February 2025

In this paper we consider self organizing frameworks for healthcare in a model mimicking biologic frameworks. We support self organization via attribute based memory mapped information in original random form. ‘Spontaneous interoperability’ and subsequent adaptability is facilitated by the memory map which describes the serialized electronic ordering of transferred information, its evolutionary history, and meta-data associated with the information. Memory maps are transferred in a discovery process facilitating interoperability by means of application adaptation. We demonstrate the potential for network entities utilizing the framework to work together even though they were initially unaware of the potential. We recognize the challenges faced, define initial targeted infrastructure to aid in the advancement of adaptive networks, and suggest future work. The goals of adaptability in healthcare require timely access to information relevant to the decision process and the elimination of slow and costly integrations. It will allow for accurate representation, diversity, longevity/viability, and increased depth/ range of computable information for computational intelligence enhancement. Increased availability of information provided by an adaptive network may help to improved patient outcomes and provide earlier detection, prevention of disease, and a reduction in medical errors.
Indistinguishable From Magic: Health and Wellness in a Future of Sufficiently Advanced Technology
Authors: Feied Craig F.  , Handler Jonathan A.  , Gillam Michael  , Smith Mark S.
Published: February 2025

We describe a future in which health and wellness are transformed by (1) the availability of definitive and unambiguous tests to prove or disprove each diagnosis, (2) new methods based in systems biology to help unravel the web of messages transmitted across cellular and subcellular networks, and (3) universal access to data that has been freed from data silos to produce true data liquidity for a constellation of purposes ranging from personal health management to population health research. We believe the resulting “connected health” environment will have a profound impact on every aspect of modern life.
Wireless City Initiatives in Europe – Towards a Service-Oriented Approach
Authors: Winkler Till J.  , Koroleva Ksenia  , Tamm Gerrit
Published: February 2025

The application of wireless technologies in urban areas is at the beginning of a transformation. While municipalities worldwide have invested in deploying wireless access infrastructures, the services which build up on these and add value for individuals and organizations are still at their early stage. Especially for European municipalities there is still a looming potential. This paper explores the current status of municipal wireless adoption in Europe based on the analysis of 25 initiatives in European metropolitan areas and derives a setup approach for wireless city initiatives which focuses on the definition and evaluation of innovative services. The approach includes overall design requirements, a generic stakeholder analysis as well as clusters for innovative wireless services and is illustrated by a case example of an ongoing wireless city project in Germany.
A Similarity Calculus for Comparing Qualitative Shape Descriptions
Authors: Falomir Zoe  , Almazán Jon  , Grande Jorge  , Museros Lledó  , Escrig M. Teresa
Published: February 2025

An approach for comparing qualitative descriptions of shape of objects is presented in this paper. A similarity factor between shapes is determined as the number of operations required for transforming one shape into another. The possible transformational operations are defined by conceptual neighbourhood diagrams (CND). Our approach has been tested using images from the MPEG-7 CE-Shape-1 library and results show that our similarity calculus is invariant to translations, rotations and dilations and that the values obtained are coherent from the point of view of human perception.
Human-like Heuristics in Scrabble
Authors: Gonzalez Romero Alejandro  , Alquezar René  , Ramirez Arturo  , Gonzalez Acuña Francisco  , Garcia Olmedo Ian
Published: February 2025

The game of Scrabble has been tackled by computers mainly using simulation [1–4]. This technique has already given very positive results. Nevertheless it fails to resemble human approach of thinking when playing Scrabble. A more human-like approach would be desirable both to test human strategies vs. simulation-based computer strategies and to improve and check the soundness of human strategies. This type of approach is being developed with good results [5], yet there is still much room for improvements in this direction. The current approach uses only one heuristic function for the whole game. Playing several games using this heuristic has suggested that other heuristics for the late phases of the game would be convenient. In this paper we recall a second heuristic from [6] and propose a third heuristic for the late phases of the game (Pre-endgame and endgame). We show examples of positions in which these heuristics apply and finally we test their performances using a pool of 1000 random games.
Toward a space-time mobility model for social communities
Authors: Apolloni Bruno  , Bassis Simone  , Valerio Lorenzo
Published: February 2025

We present a sensitivity study of a wait and chase scheme introduced in a previous work to model the contact times between people belonging to a social community. The membership presupposes that, besides purely occasional encounters, people are motivated to meet other members of the community, while the social character of the latter makes each person met an equivalent target. This calls for a mobility in the family of Lévy jumps alternating a wandering period within a limited environment – waiting phase – with jumping to a new site constituting the target of a chase phase. In this paper we aim to connect specific features of single individual dynamics to the overall evolution of the social community in the true thread of the Palm calculus philosophy. We base this study on a large mobility track dataset expressly collected with this objective.
An experimental comparison of Random Projection ensembles with linear kernel SVMs and Bagging and BagBoosting methods for the classification of gene expression data
Authors: Folgieri Raffaella
Published: February 2025

In this work we experimentally analyze ensemble algorithms based on Random Subspace and Random Plus-Minus-One Projection, comparing them to the results obtained in literature by the application of Bagging and BagBoosting on the same data sets used in our experiments: Colon and Leukemia. In this work we concentrate on the application of random projection (Badoiu et al., 2006) ensemble of SVMs, with the aim to improve the accuracy of classification, both through SVMs that represent the state-of-the-art in gene expression data analysis (Vapnik, 1998) (Pomeroy et al., 2002), and through the ensemble methods, used in our work to enhance the classification accuracy and capability. Ensemble methods, in fact, train multiple classifiers and combine them to reduce the generalization error of the multi-classifiers system. To make possible the comparison of our results with those obtained in literature by the application of Bagging and BagBoosting, in this works we concentrate on SVMs with linear kernel.
Model Suites For Multi-Layered Database Modelling
Authors: Thalheim Bernhard
Published: February 2025

Database modelling is classically defining the database dictionary, database structuring and functionality within one singleton paradigm. This approach has led to sophisticated financial services, to enterprise information systems and other database-backed practical solution which are easy to handle, relatively simple to change and to implement and which satisfied the needs of business in the 90ies. At the same time a number of applications have been developed that used the potential within the data for analysis, for exchange and collaboration of systems, e.g. OLTP-OLAP systems, decision support systems, scientific information systems, collaborative information systems and web information systems. These applications do not use a singleton language for data storage, data computation and data delivery. Their languages use different paradigms. We therefore need a way for specification of database applications that provide facilities for appropriate modelling depending on the needs.
Analysis and Description System for Children's Inquiry in a Multimedia Science Learning Environment
Authors: Kangassalo Marjatta  , Tuominen Eva
Published: February 2025

This article depicts a system of analysis and description which focuses on children's conceptual thinking and learning in regard to certain selected natural phenomena during spontaneous exploration in a learning environment where the children used the PICCO pictorial multimedia simulation program. The objective of the analysis and description system is to examine and depict the processes of conceptual thinking and learning multi-dimensionally in such a way that social and cognitive factors, as well as their interdependencies and interrelations, are taken into account. In connection with the construction and introduction of the analysis and description system, the system is also illustrated on the basis of research material compiled on three children.
Knowledge management in service-oriented systems
Authors: Šaša Ana  , Krisper Marjan
Published: February 2025

This paper presents an architectural framework for incorporating knowledge management into service-oriented systems. One of the most important characteristics of service-oriented systems is automated orchestration of services into business processes, which we believe can be improved by knowledge management. The approach we discuss is an important step from isolated knowledge management systems to knowledge management integrated into daily work and is based on the observation that business process execution can be seen as an opportunity to capture the knowledge and merge it with the existing knowledge in the organizational memory. The proposed framework not only enables efficient and effective management of knowledge but also enables automation of certain knowledge-based human performed tasks, which is an important achievement in the area of business process management.
A Comparison of a Neuro-Fuzzy Method with a Maximum Likelihood Classification for Land Cover Classes
Authors: Perakis Konstantinos  , Lalou A.  , Stathakis Dimitris
Published: February 2025

Both neural networks and fuzzy systems are attempts to bring “human intelligence” into traditional data processing tasks, although the implementation is approached from different perspectives. The synopsis of the aforementioned methods along with their application as classification tools in remote sensing, are presented in this paper. The two above techniques are applied to the satellite image IKONOS taken at the year 2007, and more specifically to the area of Skiathos. The imagery is used for creating the spectrum signatures of the different land coverage categories. Furthermore, both the neural networks and fuzzy systems were applied to those images. The relevant accuracy between the resultant image classifications and by applying the maximum likelihood (ML) method, was also tested. The resultant data was compared and some important conclusions were drawn. The need of a system that will combine the advantages of the two above technologies was the most important one. Such a paradigm already exists in the literature and is known as a neuro – fuzzy system.
Elementary Electrodynamics
Authors: Jossinet Jacques
Published: February 2025

The paper describes the physical phenomena involved in the conduction of electricity, with particular reference to living tissue. The conduction of electricity depends on the flow of charge carriers in the material, while the dielectric properties are due to the rotation of dipoles that can align along an applied electric field. The relation between the electric variables in a conducting medium and their physical meanings are explained. The phenomena responsible for the electric and dielectric properties of living tissues are described. The presence of cells limits the flow of charge carriers, in particular at low frequency, and the membranes are responsible for dielectric relaxation. The passive response of cell membranes to weak applied signals enables bioelectrical tissue characterisation. Practical tools for electrical impedance spectroscopy are given with an overview of the most recent applications.
Engineering information technology for actionable information and better health
Authors: Detmer Don E.
Published: February 2025

Information technology in health care (HIT) is getting a major boost in the United States through the passage of the American Recovery and Reinvestment Act (ARRA) of 2009. The portion of the Act that relates to health information technology (HITECH) seeks to achieve widespread implementation of electronic health records (EHRs) across the land and assure that these EHRs achieve sufficient levels of ‘meaningful use’ to improve care, reduce costs, and result in better outcomes. This chapter sets the stage for the other chapters that follow in this section. The chapter will review current thinking about how HIT will facilitate collection, dissemination, and evaluation of information throughout the system. Further, it will discuss the role and potential for HIT to support a learning organization [7,8]. Finally, it will outline the current widely identified barriers to progress, e.g., standards development, lack of interoperability and connectivity, and limited decision support that uses evidence-based guidelines created and maintained explicitly to be actionable through computer-based records and systems. Further, with the passage of HITECH, there is a continued attention given to privacy policy at the expense of access to person-specific health information for legitimate social purposes including research and community health. More will be said about this near the end of the chapter. Finally, the chapter will end with a discussion of the difference between information and communication and it will advocate for greater attention to the use of technology as a tool for improve communications and not simply storage and transmission of information.
Operations research
Authors: Pierskalla William P.
Published: February 2025

In Evita, Andrew Lloyd Webber and Tim Rice wrote: Politics, the Art of the Possible. To those of us in the operations research community, we postulate: Operations Research, the Science of Better – (i.e. better processes, better systems and better decisions). Using our own and other scientific, engineering, mathematical, and social sciences methodologies, operations researchers help decision makers make better decisions; decisions leading to improvements: greater quality, lower costs, greater revenues, better access, better scheduling, lower risks, more satisfaction – with the goal of always striving for the best or optimal decisions.
Engineering healthcare as a service system
Authors: Tien James M.  , Goldschmidt-Clermont Pascal J.
Published: February 2025

Engineering has and will continue to have a critical impact on healthcare; the application of technology-based techniques to biological problems can be defined to be technobiology applications. This paper is primarily focused on applying the technobiology approach of systems engineering to the development of a healthcare service system that is both integrated and adaptive. In general, healthcare services are carried out with knowledge-intensive agents or components which work together as providers and consumers to create or co-produce value. Indeed, the engineering design of a healthcare system must recognize the fact that it is actually a complex integration of human-centered activities that is increasingly dependent on information technology and knowledge. Like any service system, healthcare can be considered to be a combination or recombination of three essential components – people (characterized by behaviors, values, knowledge, etc.), processes (characterized by collaboration, customization, etc.) and products (characterized by software, hardware, infrastructures, etc.). Thus, a healthcare system is an integrated and adaptive set of people, processes and products. It is, in essence, a system of systems which objectives are to enhance its efficiency (leading to greater interdependency) and effectiveness (leading to improved health). Integration occurs over the physical, temporal, organizational and functional dimensions, while adaptation occurs over the monitoring, feedback, cybernetic and learning dimensions. In sum, such service systems as healthcare are indeed complex, especially due to the uncertainties associated with the human-centered aspects of these systems. Moreover, the system complexities can only be dealt with methods that enhance system integration and adaptation.
Academic health centers
Authors: Sanfilippo Fred
Published: February 2025

Academic Health Centers (AHCs) are comprised of academic, hospital, and clinical practice components that play a key role in healthcare delivery by their special ability to identify and implement improvements in outcomes, safety, cost-benefit, and satisfaction. They do this by utilizing a wide range of academic and clinical health professionals and disciplines to provide cutting-edge, highly specialized patient care as well as disproportionate uncompensated care in communities nationwide; to identify the effectiveness of different diagnostic and therapeutic approaches through clinical research; to foster new discoveries in biomedical science and technology and their clinical application; and to educate future generations of health professionals who apply these improvements.
Using the cDnS ontology as upper-level for a Scholarly Debate Ontology
Authors: Benn Neil
Published: February 2025

There is an active area of research concerned with designing tools that support quantitative and qualitative analysis of academic knowledge domains. Knowledge Domain Analysis (KDA) research investigates computational support for users who desire to understand and/or participate in the scholarly inquiry of a given academic knowledge domain. KDA technology supports this task by allowing users to identify important features of the knowledge domain such as the predominant research topics, the experts in the domain, and the most influential researchers. However, a key limitation of work to date is its inability to provide machine-readable models of the debate in academic knowledge domains. This paper argues that KDA technology should support users in understanding the features of scholarly debate as a prerequisite for engaging with their chosen domain. To this end, the paper proposes a Scholarly Debate Ontology which specifies the formal vocabulary for representing debate in academic knowledge domains. The ontology is designed with reference to an upper-level ontology that specifies the generic elements of any domain, such as academic domains, where knowledge is collectively constructed and modified by social agents.
Introducing ontology best practices and design patterns into robotics: USAREnv
Authors: Randelli Gabriele  , Nardi Daniele
Published: February 2025

Systems with knowledge representation and reasoning functionality are quite common within the robotics community. Nevertheless, most of the proposed architectures are ad-hoc implementations, which lack of modularity, standardization, and that cannot be reused or shared among different users. We fill that the Semantic Web effort over the past years in promoting standard representations and ontology best practices should be adopted by the robotic community, to foster the design of more effective and reusable systems, adapt for non expert users in everyday activities. In this paper, we investigate how to integrate ontology best practices and standard representations into the robotic system design, modelling an ontology for a real application field: urban search and rescue robotics. We also discuss the benefits of this methodology for robotic systems, as well as presenting some effective design guidelines.
Virtual Reality Interoceptive Exposure for the Treatment of Panic Disorder and Agoraphobia
Authors: Pérez-Ara M.A.  , Quero S.  , Botella C.  , Baños R.  , Andreu-Mateu S.  , García-Palacios A.  , Bretón-López J.
Published: February 2025

The efficacy of cognitive-behavioral therapy for panic disorder and agoraphobia (PDA) has been widely demonstrated. The exposure technique is the main component of these programs; interoceptive exposure also plays an important role. The virtual reality (VR) program for treating PDA developed by Botella's group can simulate physical sensations in a controlled manner while the user is immersed in the VR environments in the consultation room. These include audible effects, such as rapid heartbeat and panting, as well as visual effects, such as blurry vision, double vision and tunnel vision. This work examines the efficacy of the interoceptive exposure (IE) component in two treatment conditions: 1) VR Interoceptive Exposure Simultaneous Condition (VRIE-sim; N=14), and 2) Interoceptive Exposure Traditional Condition (IET; N=15). Results obtained showed that both treatment conditions significantly reduced the main clinical variables at post-treatment; these results were maintained or even improved at three month follow-up. Simultaneous VR interoceptive and VR external stimuli exposure is a new and effective way to apply PDA treatment.
Challenges of Interoperability Using HL7 v3 in Czech Healthcare
Authors: Nagy Miroslav  , Preckova Petra  , Seidl Libor  , Zvarova Jana
Published: February 2025

The paper describes several classification systems that could improve patient safety through semantic interoperability among contemporary electronic health record systems (EHR-Ss) with support of the HL7 v3 standard. We describe a proposal and a pilot implementation of a semantic interoperability platform (SIP) interconnecting current EHR-Ss by using HL7 v3 messages and concepts mappings on most widely used classification systems. The increasing number of classification systems and nomenclatures requires designing of various conversion tools for transfer between main classification systems. We present the so-called LIM filler module and the HL7 broker, which are parts of the SIP, playing the role of such conversion tools. The analysis of suitability and usability of individual terminological thesauri has been started by mapping of clinical contents of the Minimal Data Model for Cardiology (MDMC) to various terminological classification systems. A national-wide implementation of the SIP would include adopting and translating international coding systems and nomenclatures, and developing implementation guidelines facilitating the migration from national standards to international ones. Our research showed that creation of such a platform is feasible; however, it will require a huge effort to adapt fully the Czech healthcare system to the European environment.
Patient Empowerment by the Means of Citizen-managed Electronic Health Records: Web 2.0 Health Digital Identity scenarios
Authors: Falcão-Reis Filipa  , Correia Manuel E.
Published: February 2025

With the advent of more sophisticated and comprehensive healthcare information systems, system builders are becoming more interested in patient interaction and what he can do to help to improve his own health care. Information systems play nowadays a crucial and fundamental role in hospital work-flows, thus providing great opportunities to introduce and improve upon “patient empowerment” processes for the personalization and management of Electronic Health Records (EHRs). In this paper, we present a patient's privacy generic control mechanisms scenarios based on the Extended OpenID (eOID), a user centric digital identity provider previously developed by our group, which leverages a secured OpenID 2.0 infrastructure with the recently released Portuguese Citizen Card (CC) for secure authentication in a distributed health information environment. eOID also takes advantage of Oauth assertion based mechanisms to implement patient controlled secure qualified role based access to his EHR, by third parties.
Patient Safety and Sociotechnical Considerations for Electronic Handover Tools in an Australian ehealth Landscape
Authors: Showell Chris  , Thomas Matthew  , Wong Ming Chao  , Yee Kwang Chien  , Miller Steve  , Pirone Christy  , Turner Paul
Published: February 2025

The Australian Commission for Safety and Quality in Health Care (ACSQHC) coordinates national improvements in a range of complex health system problems including clinical handover, and has funded a range of handover improvement projects in Australia. One of these, the SafeTECH project in South Australia has developed guidelines for safe use of electronic handover tools. These guidelines were developed using evidence from three hospital case studies into the use of an electronic tool to support different types of shift-to-shift handover. This paper provides an overview of the project, and highlights challenges for patient safety in the design and use of electronic tools to support clinical handover in a busy clinical environment. The paper then considers these challenges within the broader context of the Australian ehealth landscape. Australia's National eHealth Transition Authority (NEHTA) is actively developing ehealth standards and infrastructure requirements for the electronic collection and secure exchange of health information. The paper argues for flexible standardisation in the design and implementation of electronic handover tools to ensure that all key dimensions of the challenges faced in ensuring patient safety are addressed.
The sociotechnical configuration of the problem of Patient Safety
Authors: Danholt Peter
Published: February 2025

This paper discusses two approaches to “the sociotechnical”, one coming from the Tavistock tradition and the other from actor network theory. These two differ in important ways and from the latter it follows that what patient safety means must be scrutinized and unpacked. The paper thus rudimentarily discusses central contributions to the problematization of patient safety. Last, it is argued that patient safety does not exist apart from the sociotechnical practices that seek to accomplish it, but is constructed in and through them, which is why it is pertinent to reflect on how those practices constructs what comes to qualify as patient safety.
The Role of Remodeling and Asymmetric Growth in Vertebral Wedging
Authors: Aronsson David D.  , Stokes Ian A.  , McBride Carole
Published: February 2025

Background: Scoliosis with vertebral wedging is thought to be caused by asymmetric growth (Hueter-Volkmann law), but vertebral diaphyseal remodeling (Wolff's law) may also contribute to the deformity. We investigated whether vertebral wedging in scoliosis might involve both mechanisms. Methods: An external fixator was used to impose a 30° scoliosis and compression of 0.1 or 0.2 MPa to the tails of 10 5-week-old and 20 14-week-old Sprague-Dawley rats for 6 weeks. The rats were divided into three groups of 10 animals each: Group 1: 5-week-old animals with 0.1 MPa compression; Group 2: 14-week-old animals with 0.1 MPa compression; Group 3: 14-week-old animals with 0.2 MPa compression. Vertebral wedging and diaphyseal curvature were measured from micro CT scans performed at weeks 1, 3, and 6. Wedging due to asymmetrical growth and remodeling was calculated from a Calcein label administered at week 3 and a Xylenol label at week 6. Results: The growth rate of the loaded vertebrae as a per cent of control vertebrae was 60% in Group 1, 40% in Group 2, and 30% in Group 3. The growth rate of control vertebrae in 14-week-old animals was 16% that of 5-week-old animals. The animals in all 3 groups developed a scoliosis with vertebral wedging that averaged 18.7° in Group 1, 8.2° in Group 2, and 10.1° in Group 3. Asymmetric growth was much greater in Group 1 (5-week-old) animals. The ossified epiphyses became wedged and diaphyseal remodeling occurred in all groups. Conclusions: The major contribution to the vertebral wedging was asymmetric growth in the 5-week-old animals and diaphyseal remodeling in the 14-week-old animals. The results support the concept that if appropriate loads can be applied to human vertebrae through minimally invasive techniques, scoliosis and vertebral wedging can be corrected without a spinal fusion in both adolescents and adults.
Biomechanical analysis of pedicle screw placement: a feasibility study
Authors: Wagnac Éric  , Michardière Denis  , Garo Anaïs  , Arnoux Pierre-Jean  , Mac-Thiong Jean-Marc  , Aubin Carl-Éric
Published: February 2025

In spinal instrumentation surgery, the optimal placement of pedicle screws that takes into account the cortical/cancellous bone quality, geometry and property distribution, and screw design is still undetermined despite several in vitro experiments. The objective of this study was to evaluate the feasibility of using a detailed finite element model (FEM) of an instrumented vertebra to simulate screw axial pull-out and to analyze the bone-screw mechanical interaction. The FEM was built using CT-scan images of the L3 vertebra (0.6mm thick contiguous slices) of a 50th percentile human male volunteer, in order to virtually implant a fully customizable pedicle screw in a straight-forward position. The 753,000 elements model takes into account local cortical bone thickness and integrates advanced material behavior (elasto-plastic) laws that simulate bone failure. Screw axial pull-out was simulated and compared to in vitro experimental data, and the stress distribution at the screw thread-bone interface was analyzed. The simulated screw pull-out force (non-linear response with a failure at 640N) was within the range of experimental data (500-660N). Von Mises stresses in the bony structures were concentrated around the root of each internal thread, with the maximum stress located near the first proximal thread, in the cortical bone of the posterior wall of the pars. This study shows the feasibility and relevance of using a detailed FEM to simulate screw pull-out and to analyze the bone-screw mechanical interaction.
Expression and Significance of BMP-2 in Osteoblasts from Scoliosis Patients with Neurofibromatosis Type1
Authors: Shu Hao  , Qiu Yong  , Sun Chao  , Liu Zhen  , Wang Xin-hua  , Liu Wen-jun  , Yu Yang
Published: February 2025

Introduction: Decreased bone mineral density (BMD) among scoliosis patients with neurofibromatosis type1 (NF1) has been reported. Our previous study showed high proliferation rate but lower differentiation activity of the osteoblasts from scoliosis with NF1. Bone morphogenetic protein-2 (BMP-2) is one of the central regulators of osteoblast differentiation. Whether BMP-2 was involved in the pathogenesis of low BMD and low differentiation activity of osteoblasts in scoliosis with NF1 has not been reported.