bluuebunny/crossref_metadata_2025 huggingface dataset:
Towards Symbiosis in Knowledge Representation and Natural Language Processing for Structuring Clinical Practice Guidelines
Authors: Weng Chunhua  , Payne Philip R. O.  , Velez Mark  , Johnson Stephen B.  , Bakken Suzanne
Published: February 2025

The successful adoption by clinicians of evidence-based clinical practice guidelines (CPGs) contained in clinical information systems requires efficient translation of free-text guidelines into computable formats. Natural language processing (NLP) has the potential to improve the efficiency of such translation. However, it is laborious to develop NLP to structure free-text CPGs using existing formal knowledge representations (KR). In response to this challenge, this vision paper discusses the value and feasibility of supporting symbiosis in text-based knowledge acquisition (KA) and KR. We compare two ontologies: (1) an ontology manually created by domain experts for CPG eligibility criteria and (2) an upper-level ontology derived from a semantic pattern-based approach for automatic KA from CPG eligibility criteria text. Then we discuss the strengths and limitations of interweaving KA and NLP for KR purposes and important considerations for achieving the symbiosis of KR and NLP for structuring CPGs to achieve evidence-based clinical practice.
From Capturing Nursing Knowledge to Retrieval of Data From a Data Warehouse
Authors: Thoroddsen Asta  , Guðjónsdóttir Hanna K.  , Guðjónsdóttir Elisabet
Published: February 2025

The purpose of the project was to capture nursing data and knowledge, represent it for use and re-use by retrieval from a data warehouse, which contains both clinical and financial hospital data. Today nurses at LUH use standardized nursing terminologies to document information related to patients and the nursing care in the EHR at all times. Pre-defined order sets for nursing care have been developed using best practice where available and tacit nursing knowledge has been captured and coded with standardized nursing terminologies and made explicit for dissemination in the EHR. All patient-nursing data is permanently stored in a data repository. Core nursing data elements have been selected for transfer and storage in the data warehouse and patient-nursing data are now captured, stored, can be related to other data elements from the warehouse and be retrieved for use and re-use.
Diagnosis Related Groups Information Quality: User's Acceptance in Greece
Authors: Tsirintani Maria
Published: February 2025

The health care sector today is found in the threshold of important managerial changes and political challenges. Diagnosis Related Groups (DRGs) constitutes the method with which the public sector can classify each clinical incident with a concrete code debit on the base of patient diagnosis and the relative clinical interventions or medical actions. This article aims to investigate user's acceptance of DRG's information quality in Greece in public and private hospitals using electronic patient care records. First results are showing positive reactions and expectations from health care and managerial users of DRGs.
Roadmap for Engaging Consumers in Using Health Information Technology
Authors: Long Sandra  , Khairat Saif
Published: February 2025

As healthcare costs continue to grow, one method proposed to help reduce costs is consumer engagement in prevention, management, and self-care. This results in less costs incurred by providers and the healthcare system overall. Using consumer Health Information Technology (HIT) makes it easier for consumers to be engaged in managing their own health. The purpose of this research is to develop a strategic roadmap for providers to use when engaging consumers in HIT. Interviews and a literature search of journals and other publications were completed to find successful actions related to engagement of consumers. The research used included healthcare entities in addition to strategic planning practices within business administration. The findings were used to create a method for developing a consumer HIT engagement roadmap. A roadmap was also successfully developed, which can be utilized by organizations as a basis for tailoring their own strategic plans.
Patient-Centered e-Health Record over the Cloud
Authors: Koumaditis Konstantinos  , Themistocleous Marinos  , Vassilacopoulos George  , Prentza Andrianna  , Kyriazis Dimosthenis  , Malamateniou Flora  , Maglaveras Nicos  , Chouvarda Ioanna  , Mourouzis Alexandros
Published: February 2025

The purpose of this paper is to introduce the Patient-Centered e-Health (PCEH) conceptual aspects alongside a multidisciplinary project that combines state-of-the-art technologies like cloud computing. The project, by combining several aspects of PCEH, such as: (a) electronic Personal Healthcare Record (e-PHR), (b) homecare telemedicine technologies, (c) e-prescribing, e-referral, e-learning, with advanced technologies like cloud computing and Service Oriented Architecture (SOA), will lead to an innovative integrated e-health platform of many benefits to the society, the economy, the industry, and the research community. To achieve this, a consortium of experts, both from industry (two companies, one hospital and one healthcare organization) and academia (three universities), was set to investigate, analyse, design, build and test the new platform. This paper provides insights to the PCEH concept and to the current stage of the project. In doing so, we aim at increasing the awareness of this important endeavor and sharing the lessons learned so far throughout our work.
‘Schizophrenia’ as a Metaphor in Greek Newspaper Websites
Authors: Athanasopoulou Christina  , Välimäki Maritta
Published: February 2025

Often, newspapers use the term ‘schizophrenia’ as a metaphor with negative connotations. The use of the term in Greek newspapers, has never been investigated. The aim of this study is to examine how the term ‘schizophrenia’ is used in Greek newspaper websites. For 2014, ‘To Vima’, ‘Kathimerini’, and ‘Eleftherotypia’, were the most popular newspaper websites. By searching the term ‘schizophrenia’ in Greek (‘σχιζoφρϵνϵια’), the first fifty results were collected from the three websites (N=150). Deductive content analysis was applied. Out of the included articles (N=140), the majority were news (n=39, 28%), while more than a third (n=48, 34%) reported schizophrenia as a metaphor. The metaphoric use of ‘schizophrenia’ indicated predominately incoherence/contradiction/split (n=43, 90%). Monitoring how schizophrenia is presented within popular media is crucial, since it could influence public perceptions regarding the disorder. Continual use of schizophrenia as a metaphor could contribute to maintaining the stigma attached to mental illness.
Monitoring and Identifying in Real time Critical Patients Events
Authors: Chavez Mora Emma
Published: February 2025

Nowadays pervasive health care monitoring environments, as well as business activity monitoring environments, gather information from a variety of data sources. However it includes new challenges because of the use of body and wireless sensors, nontraditional operational and transactional sources. This makes the health data more difficult to monitor. Decision making in this environment is typically complex and unstructured as clinical work is essentially interpretative, multitasking, collaborative, distributed and reactive. Thus, the health care arena requires real time data management in areas such as patient monitoring, detection of adverse events and adaptive responses to operational failures. This research presents a new architecture that enables real time patient data management through the use of intelligent data sources.
Automatically Assessing the Expert Degree of Online Health Content using SVMs
Authors: Zowalla Richard  , Wiesner Martin  , Pfeifer Daniel
Published: February 2025

More and more people search for health information regarding diseases, diagnoses and treatments over the Web. However, lay people often have difficulties in assessing the understandability of related articles. Therefore, they could benefit from a system, which computes the medical expert degree of a corresponding piece of text in advance. In this paper we present an approach to automatically compute this expert degree using a machine learning approach. For evaluation purposes we constructed a large text corpus and tested our trained text classifier, which is based on Support Vector Machines.
Active and Healthy Ageing as a Wicked Problem: The Contribution of a Multidisciplinary Research University
Authors: Riva Giuseppe  , Graffigna Guendalina  , Baitieri Maddalena  , Amato Alessandra  , Bonanomi Maria Grazia  , Valentini Paolo  , Castelli Guido
Published: February 2025

The quest for an active and healthy ageing can be considered a “wicked problem.” It is a social and cultural problem, which is difficult to solve because of incomplete, changing, and contradictory requirements. These problems are tough to manage because of their social complexity. They are a group of linked problems embedded in the structure of the communities in which they occur. First, they require the knowledge of the social and cultural context in which they occur. They can be solved only by understanding of what people do and why they do it. Second, they require a multidisciplinary approach. Wicked problems can have different solutions, so it is critical to capture the full range of possibilities and interpretations. Thus, we suggest that Università Cattolica del Sacro Cuore (UCSC) is well suited for accepting and managing this challenge because of its applied research orientation, multidisciplinary approach, and integrated vision. After presenting the research activity of UCSC, we describe a possible “systems thinking” strategy to consider the complexity and interdependence of active ageing and healthy living.
“Stay Tuned”: The Role of ICTs in Elderly Life
Authors: Colombo Fausto  , Aroldi Piermarco  , Carlo Simone
Published: February 2025

Ageing in western society has become a key issue in political and academic debate: politicians, sociologists, doctors, demographers, psychologists, economists are trying to understand how ageing will impact our future society. In this frame, media and communication technologies seem to be more and more relevant for the elderly, thanks to those services and devices helping people to grow old actively. Technologies, the Internet and ICTs could help the elderly to improve their quality of life, to be healthy and independent and to get better assistance. Our ongoing research investigates the relationship between the elderly and use of technologies, and explores the role played by media and ICTs in building a friendly and positive environment for the elderly, and in constructing and maintaining social relations and promoting healthy ageing. Specifically, the research will investigate the use of ICTs by the elderly by taking into account two different perspectives: a) Exchanges between generations: lengthening of life corresponds to a longer period of cohabitation between at least three generations (grandparents, children, grandchildren), and also of co-use of digital media. The research wants to investigate relations between two age groups (grandparents and grandchildren; young people and older people) to understand the dynamics of intergenerational mutuality in the use of technologies and ICTs. b) Media, ICTs, Health: the Western world is increasingly populated by elderly population. Technologies and ICTs can help elderly people to improve their quality of life, to be healthy and independent and to get better assistance. ICTs should encourage active ageing and, in the case of health technologies, new models of care. The project, lasting 1 year, is based on (1) a survey on young elderly (65–74 yrs) population in Italy, and (2) a field-work which consists of family interviews and ethnographical sections in natural contexts.
Demographic Changes and the Challenge for a Healthy Ageing
Authors: Rossini Paolo Maria  , Marra Camillo
Published: February 2025

Demographic changes bring about a wide range of new research fields including policy topics, health, social welfare, work & productivity, urban & rural development, communication tools, and mobility. This new situation requires a new multi-disciplinary approach bringing together different research programs in order to provide solutions for the upcoming challenges. National Health services are now facing a huge shift in the population structure with a predominance of older generations in the total number of citizens. Good health is the most important factor to live independently in old age. A better understanding of ageing processes and the related “plasticity” of individual performance for environmental adaptation, the prevention for age-related illnesses and healthcare strategies are the basis for keeping very old people healthy and active throughout the course of their lives. We will face mainly the biological, cognitive and psychological dimensions of ageing. Afterwards, we will focus on the relationships linking various biological and lifestyle factors – such as nutrition – that are crucial to obtain a comprehensive picture of ageing and to promote preventing strategies against degenerative neurological diseases. Finally we will investigate which interventions – nutritional and physical – could help in keeping people healthy, in particular which factors could promote people's physical, social and psychological functional abilities and the systemic multilevel consequences induced by a healthy ageing.
Expert insights on the design and implementation of interactive patient websites for people with chronic pain
Authors: Merolli Mark  , Gray Kathleen  , Martin-Sanchez Fernando  , Schulz Peter
Published: February 2025

Chronic pain is a burden on an individual, social and economic level. Growing published research outlines various innovative online solutions aimed at addressing this issue, including interactive patient websites. This paper presents expert insights regarding an existing interactive chronic pain website, ‘ONESELF’, operating in Switzerland. Based on their experience, members of the research team involved in the ‘ONESELF’ project were asked to reflect about what they understood to be key considerations salient to designing and implementing such interventions. Thematic analysis uncovered five main themes that these experts used to interpret what worked, when and why in ‘ONESELF’ design and implementation: health literacy, Internet literacy, access to healthcare, adherence and attrition, and health outcomes. These findings may serves as a base to assist Australian health researchers and practitioners working toward developing effective interactive patient websites for people with chronic pain.
Towards a Light-Weight Query Engine for Accessing Health Sensor Data in a Fall Prevention System
Authors: Kreiner Karl  , Gossy Christian  , Drobics Mario
Published: February 2025

Connecting various sensors in sensor networks has become popular during the last decade. An important aspect next to storing and creating data is information access by domain experts, such as researchers, caretakers and physicians. In this work we present the design and prototypic implementation of a light-weight query engine using natural language processing for accessing health-related sensor data in a fall prevention system.
Using Geographic Information Systems to Simulate Patient Access Areas
Authors: Doi Shunsuke  , Inoue Takashi  , Ide Hiroo  , Nakamura Toshihito  , Fujita Shinsuke  , Suzuki Takahiro  , Takabayashi Katsuhiko
Published: February 2025

We constructed a simulation model with a geographic information system (GIS) to predict the future shortage of beds in the Tokyo Metropolitan Area. With a grid square method, we calculated patient numbers for every 500 square meters of the Tokyo Metropolitan Area until 2040 and estimated whether those in need could be admitted to hospitals within an hour's drive from their homes. The simulation demonstrates that after 2025 many patients may not be able to find hospitals within this time framework. The situation will be especially serious in the center of Tokyo and along the railway lines, where many senior citizens reside. We can now apply this innovative GIS method in many fields and especially for the precise estimation of future demands for and supply of medical assistance.
Computer Aided Detection and Measurement of Peripheral Artery Disease
Authors: Dehmeshki Jamshid  , Ion Adina  , Ellis Tim  , Doenz Francesco  , Jouannic Anne-Marie  , Qanadli Salah
Published: February 2025

Computer-Aided Tomography Angiography (CTA) images are the standard for assessing Peripheral artery disease (PAD). This paper presents a Computer Aided Detection (CAD) and Computer Aided Measurement (CAM) system for PAD. The CAD stage detects the arterial network using a 3D region growing method and a fast 3D morphology operation. The CAM stage aims to accurately measure the artery diameters from the detected vessel centerline, compensating for the partial volume effect using Expectation Maximization (EM) and a Markov Random field (MRF). The system has been evaluated on phantom data and also applied to fifteen (15) CTA datasets, where the detection accuracy of stenosis was 88% and the measurement accuracy was with an 8% error.
Security challenges in integration of a PHR-S into a standards based national EHR
Authors: Mense Alexander  , Hoheiser Pförtner Franz  , Sauermann Stefan
Published: February 2025

Health related data provided by patients themselves is expected to play a major role in future healthcare. Data from personal health devices, vaccination records, health diaries or observations of daily living, for instance, is stored in personal health records (PHR) which are maintained by personal health record systems (PHR-S). Combining this information with medical records provided by healthcare providers in electronic health records (EHR) is one of the next steps towards “personal care”. Austria currently sets up a nationwide EHR system that incorporates all healthcare providers and is technically based on international standards (IHE, HL7, OASIS,). Looking at the expected potential of merging PHR and EHR data it is worth to analyse integration approaches. Although knowing that an integration requires the coordination of processes, information models and technical architectures, this paper specifically focusses on security issues by evaluating general security requirements for a PHR-S (based on HL7 PHR-S FM), comparing them with the information security specifications for the Austrian's national EHR (based on ISO/IES 27000 series) and identifying the main challenges as well as possible approaches.
Longitudinal Data Driven Study Design
Authors: Hund Hauke  , Gerth Sven  , Lossnitzer Dirk  , Fegeler Christian
Published: February 2025

In this paper we present a method for processing EHR data into a longitudinal data model and examples for using this model to identify patients cross-sectionally and longitudinally as well as testing study designs retrospectively. Our data model describes measurements on four dimensions: the associated patient, observed feature, data source and time of survey. The transformation of structured source data into our model is defined by rules written in XML. To showcase the flexibility of the proposed longitudinal data model, we present an evolution of a retrospective study design as well as an example for interpreting biomarkers in emergency situations. With the proposed longitudinal data model complex queries can be performed, study designs tested and optimized.
Personalized Fall Risk Assessment Tool by using the Data Treasure contained in Mobile Electronic Patient Records
Authors: Eryilmaz Elif  , Ahrndt Sebastian  , Fähndrich Johannes  , Albayrak Sahin
Published: February 2025

This work presents a novel approach for combining multiple Electronic Patient Records (EPRs) to a self-learning fall risk assessment tool. This tool is used by a new type of home-visiting nurses to track the fall risk of their patients. In order to provide personalized healthcare for elderly people, we combine multiple EPRs using an agent-based architecture, where each patient is represented by an associated agent. The patient agents are enabled to negotiate about possible fallrisk indicators recognized in the specific patient population under care. We use distributed information fusion and opinion aggregation techniques to elaborate new fall-risk indicators and in consequence to adapt the fall risk assessment tool.
Developing an mHealth Framework to Improve Diabetes Self-Management
Authors: Khairat Saif  , Garcia Carolyn
Published: February 2025

The need for improved diabetes care outcomes is paramount. Each year, 1.6 million cases are diagnosed with type 2 diabetes and as of 2006; diabetes was the seventh leading cause of death in the United States. Moreover, the financial burden associated with diabetes was estimated to be $174 billion in 2007. Studies show that effective patient-provider communication (PPC) improves diabetes self-care, diabetes outcomes, or both. There has been significant number of studies aimed at improving diabetes care through different telehealth technologies such as patient web portals. However, to the best of our knowledge, there has been limited amount of research done exploring the use of mobile technologies to improve diabetes care.
User Needs and Requirements Analysis for Big Data Healthcare Applications
Authors: Zillner Sonja  , Lasierra Nelia  , Faix Werner  , Neururer Sabrina
Published: February 2025

The realization of big data applications that allow improving the quality and efficiency of healthcare care delivery is challenging. In order to take advantage of the promising opportunities of big data technologies, a clear understanding of user needs and requirements of the various stakeholders of healthcare, such as patients, clinicians and physicians, healthcare provider, payors, pharmaceutical industry, medical product suppliers and government, is needed. Our study is based on internet, literature and market study research as well as on semi-structured interviews with major stakeholder groups of healthcare delivery settings. The analysis shows that big data technologies could be used to align the opposing user needs of improved quality with improved efficiency of care. However, this requires the integrated view of various heterogeneous data sources, legal frameworks for data sharing and incentives that foster collaboration.
Patient Information, Consentsand Privacy Protection Scheme for an Information System Dedicated to Pervasive Developmental Disorders
Authors: Ben Said Mohamed  , Robel Laurence  , Messiaen Claude  , Craus Yann  , Jais Jean Philippe  , Golse Bernard  , Landais Paul
Published: February 2025

Patients explicit and unambiguous information, patients consents and privacy protection are reviewed in this article, in the frame of the deployment of the information system TEDIS dedicated to autism spectrum disorders. The role of the Delegate to the Protection of Data is essential at this stage. We developed a privacy protection scheme based on storing encrypted patients personal data on the server database and decrypting it on the Web browser. It tries to respond to the end-users request to manage nominative data in a human readable form and to meet with privacy protection framework.
Do Electronic Health Records Help Undergraduate Students Develop Health Informatics Competencies?
Authors: Borycki Elizabeth M.  , Griffith Janessa  , Reid Paulette  , Kuo Mu-Hsing  , Kushniruk Andre W.
Published: February 2025

In this paper we describe the effects of hands-on exposure to an educational electronic health record (EHR) system upon undergraduate health informatics (HI) student competency development. We undertook a quasi-experimental study (i.e. pre-test, post-test design), where students were given the opportunity to do hands-on work with an educational EHR over a 10 week period. HI student competencies were measured pre and post educational EHR exposure. Several HI student competencies improved significantly following hands-on work with the EHR. As well, students provided more in-depth and higher quality case study answers after working with the educational EHR.
A new Multiple ANFIS model for classification of hemiplegic gait
Authors: Yardimci A.  , Asilkan O.
Published: February 2025

Neuro-fuzzy system is a combination of neural network and fuzzy system in such a way that neural network learning algorithms, is used to determine parameters of the fuzzy system. This paper describes the application of multiple adaptive neuro-fuzzy inference system (MANFIS) model which has hybrid learning algorithm for classification of hemiplegic gait acceleration (HGA) signals. Decision making was performed in two stages: feature extraction using the wavelet transforms (WT) and the ANFIS trained with the backpropagation gradient descent method in combination with the least squares method. The performance of the ANFIS model was evaluated in terms of training performance and classification accuracies and the results confirmed that the proposed ANFIS model has potential in classifying the HGA signals.
Protocol Feasibility Workflow Using an Automated Multi-country Patient Cohort System
Authors: Soto-Rey Iñaki  , Trinczek Benjamin  , Karakoyun Töresin  , Dugas Martin  , Fritz Fleur
Published: February 2025

The Electronic Health Record for Clinical Research (EHR4CR) project aims to improve the current process of clinical trials, providing a technological platform that supports the design and execution of trials. For the protocol feasibility scenario, the system currently allows the user to create a set of in-/exclusion criteria to find patients matching these criteria across sites located in several countries. The automated multi-country patient cohort system developed in EHR4CR implies substantial changes on the current protocol feasibility process, which will be reflected in this study.
The Internet of Things: Building Trust and Maximizing Benefits Through Consumer Control
Authors: Brill Julie
Published: February 2025

This chapter addresses the privacy and security challenges presented by the rapid evolution of the Internet of Things. The exponential growth of potentially sensitive consumer data flowing from a wide range of newly connected devices has the potential to help solve societal challenges and improve consumers' lives, but such vast quantities of data also present privacy and security risks. The chapter describes some of the potential insights that can be gained through connected devices, and then lays out two risks posed by the Internet of Things: the potential for the use of sensitive personal data to make decisions about consumers without safeguards to protect them, and the possibility that privacy concerns will prevent consumers from embracing and benefitting from the Internet of Things. The chapter also discusses behind-the-scenes data collectors, known as data brokers, who play a key role in how information from connected devices can be collected and used in surprising and potentially disconcerting ways. The chapter proposes improved practices for device and service providers, including privacy by design; robust deidentification of consumer data; and transparency measures, such as clear and concise notices. The chapter also calls for improved practices—and ultimately legislation—to provide greater transparency and accountability within the data broker industry.
Use of ground waste glass in concrete production
Authors: Barbhuiya Salim  , Laskar Aminul  , Das Arnesh
Published: February 2025

Use of recycled waste glass in Portland cement and concrete has attracted a lot of interest worldwide due to the increased disposal cost and environmental concern. Being amorphous and containing relatively large quantities of reactive silica, glass is pozzolanic in nature when it is finely ground. Thus, it can be used as cement replacement as well as aggregate in cement and concrete. Attempt has therefore been made in the present work to investigate experimentally the effects of white ground glass on hardened properties of concrete. Experiments were conducted to study the feasibility of using glass sand and glass powder to substitute natural sand. It was observed that the mechanical properties such as compressive strength, splitting tensile strength decrease as the replacement level increases. However, the long-term trend is that the values of these properties tend to increase. Thus, it may be concluded that ground glass can be used in concrete to replace some part of and fine aggregate.
Lowering the embodied CO
Authors: Meddah Mohammed S.  , Nukushina T.  , Seiki S.  , Sato R.
Published: February 2025

Large quantities of recycled materials, including waste aggregates and supplementary cementing materials (SCMs), such as fly ash (FA) are used in concrete mixtures to reduce environmental impact. Recent studies have proven that Recycled Porous Ceramic (RPC) coarse aggregates could successfully be used as an internal curing agent to enhance mechanical properties and mitigate autogenous shrinkage in silica fume high-performance concrete (HPC). This paper discuss the effectiveness of internal curing provided by the RPC in concrete made with 20% of FA as a partial replacement of Portland cement and cured under three different curing systems, namely: sealed, dry and underwater. A single water-to-binder ratios (w/b) of 0.30 was selected; and a single partial replacement level of 40% of natural coarse aggregate (NCA) by the RPC was adopted. Concrete performance was investigated in terms of compressive and splitting tensile strengths, and modulus of elasticity up to 91 days, and autogenous and drying shrinkage. The results showed a significant improvement in the compressive and splitting tensile strengths, and a slight decrease in the modulus of elasticity of RPC concrete compared to the control mixture. It has been found that FA-concrete needs extended wet curing (internal or external) to achieve its potential. Additionally, the use of RPC in FA-concrete seems to be very effective in shrinkage reduction.
Development of geopolymer mortar using palm oil fuel ash-blast furnace slag-fly ash-as binders
Authors: Islam Azizul  , Alengaram U. Johnson  , Jumaat Mohd Zamin  , Bashar Iftekhair Ibnul
Published: February 2025

Geopolymer mortar can be produced from industrial by products rich in alumina-silicate. This paper presents the development of novel geopolymer mortar developed using palm oil fuel ash (POFA) (waste from palm oil industry), blast furnace slag (BFS) and fly ash (FA) as binders and manufactured sand as conventional sand replacement. A combination of sodium silicate and sodium hydroxide solution was used as alkaline activator of 12 molar. The compressive strength of the geopolymer mortar with POFA:BFS:FA ratios of 100:0:0, 0:100:0, 0:0:100, 50:50:0, 0:50:50, 50:0:50 and sodium silicate to sodium hydroxide solution by mass of 2.5 and 1.0 was investigated on 50 mm cube specimens. Specimens were cured at room temperature and heat curing at 65°C for 24 hours. The compressive strength test result shows that using POFA and BFS as binder maximum cube compressive strength of 56 MPa could be produced.
The application of polymer coated aggregates in flexible pavement
Authors: Rughooputh Reshma  , Fokeerbux Najeeb Ahmad
Published: February 2025

The road construction industry in Mauritius has experienced a boom continuously for the past five to eight years to date. Moreover, since existing roads need maintenance and rehabilitation; these indeed result in costly investment. From literature, it has been found that for bituminous pavements, polymer can be added in the bituminous mix of the wearing and base courses either as Polymer Modified Bitumen Binder (PMBB) or as Polymer Coated Aggregates (PCA) in order to improve performance of the road and achieve longer life-span. Since only around 4% of plastic wastes in Mauritius are being recycled annually, an investigation on the use of recycled Low Density Poly-Ethylene (LDPE) to pre-treat aggregates for use in flexible pavement construction in the form of PCA was carried out. Different percentages of the polymer by weight of the same aggregates were tested for their strength properties using the i) Aggregate Crushing Value (ACV), ii) Aggregate Impact Value (AIV); and the iii) Los Angeles Abrasion (LAA) Test. It was found that the use of recycled LDPE as PCA improved the strength properties of the aggregates, giving higher resistance to loads, impact, and abrasion. As a solid waste management strategy, it was found that by using 2% polymer by weight of aggregates, approximately 7.8 tonnes of LDPE could be used in a road 1km long × 3.75 m × 55 mm thick wearing/base course(s). There would be an insignificant increase in the price of the pavement cost as a proportion of the project cost, due to the aggregate-polymer processing.
Analysis of Medical Care Expenditure by Japanese Prefecture using Fuzzy Robust Regression Model
Authors: Yabuuchi Yoshiyuki  , Kawaura Takayuki  , Watada Junzo
Published: February 2025

In 2012, 15.13% of the total fiscal medical care expenditure was for lifestyle-related health care costs, which was approximately 179 billion yen. Lifestyle-related diseases are not only the biggest factor in reducing healthy life expectancy but also have the most significant impact on the national medical care expenditure. In addition, lifestyle-related diseases can be prevented by moderate daily exercise, a well-balanced diet, and not smoking.
Automatic Vessel Shade-Robust Segmentation of Retinal Layers in OCT Images
Authors: González-López Ana  , Ortega Marcos  , Penedo Manuel G.  , Charlón Pablo
Published: February 2025

Optical Coherence Tomography (OCT) is a promising imaging technique used by ophthalmologists to diagnose diseases. Since retinal morphology can be identified on these images, several image processing-based methods are emerging with the purpose of extracting their information. The first step to tackle any automatic method to extract pathological features from these images is delimiting retinal layers automatically. This is the aim of this paper, which presents an active contour-based method to segment layer boundaries in the retina. Results obtained by this method present high accuracy and robustness, even when some of these layers are low defined or vessel shades are present.
Virtualizing Healthcare: Competing Visions
Authors: Keshavjee Karim  , Lajoie Don  , Murphy Jim
Published: February 2025

Telehealth technologies show tremendous promise in helping reduce health care costs by bridging distance and time. However, neither of the two competing visions for how telehealth should be used is scalable. On the one hand, remote telehealth care providers who triage or monitor patients, are not integrated into the health care system. They are outsiders, lacking access to the records of patients. On the other hand, face-to-face providers who provide the bulk of care in the health care system, are increasingly being asked to keep track of remote monitoring data and to manage patients remotely. They are insiders, but lack the time or training to manage patients remotely. In this paper, we propose a third way: integrate telehealth care providers into the primary care team as a virtual team. Being virtual, they can provide complementary services that patients need, but are not getting, such as peak and off hours care, off hours disease management advice, between-visit support and follow-up and remote device monitoring. We also describe the design requirements, issues and solutions for integrating telehealth technology into electronic medical record systems.
Perspectives of Champlain BASE Specialist Physicians: Their Motivation, Experiences and Recommendations for Providing eConsultations to Primary Care Providers
Authors: Keely Erin  , Drosinis Paul  , Afkham Amir  , Liddy Clare
Published: February 2025

Electronic consultation can improve access to specialist care. However, specialists have been identified as less likely to adopt electronic solutions in clinical settings. We conducted an online survey to explore the perspectives of specialists who use the Champlain BASE eConsult service in Eastern Ontario, Canada. Specialists were asked their opinions on experience with the service, their current consult/referral practices, recommendations for change and expansion of the service, and compensation models. We tabulated descriptive statistics from the multiple choice and Likert scale responses and performed a content analysis with an emergent code strategy for open-text responses. Specialists (n=34, 77% response rate) agreed that the Champlain BASE eConsult service is a feasible way to improve access to specialist care (94%), improves communication between specialists and primary care providers (PCPs) (94%), has educational value for PCPs (91%), and is user friendly (82%). A majority of specialists (88%) felt the service should be expanded provincially and 67% felt it should allow specialist-to-specialist consultation. 88% of specialists agreed that the current compensation process is best. This study provides an in-depth look at the perspective of the specialist physicians who use the Champlain BASE eConsult service. Specialists stated specific recommendations for change that will allow us to ensure the service remains sustainable.
Improving Mental Health Care for Young Adults in Badakshan Province of Afghanistan Using eHealth
Authors: Khoja Shariq  , Khan Maria Arif  , Husyin Nida  , Scott Richard  , Yousafzai Abdul Wahab  , Durrani Hammad  , Mohbatali Fatima  , Khan Dodo
Published: February 2025

Decades of war, social problems and poverty, have led large number of Afghan youth aged between 18-25 years suffering from mental health problems. Other important contributing factors include extreme poverty, insecurity, and violence and gender disparities, contributing to worsening mental and emotional health conditions in the country. The reported project is designed to strengthen the health system for improving mental health services in the province of Badakshan by improving awareness in the community and empowering frontline health workers. The project uses technological innovations, in combination with traditional approaches, to reduce stigma, enhance capacity of health providers and improve access to the specialist. The project also focuses on skills development of health providers, and empowering them to provide quality mental health services through access to interactive protocols, Management Information system and telemedicine.
Governance and Management of National Telehealth Programs in Asia
Authors: Marcelo Alvin  , Ganesh Jai  , Mohan Jai  , Kadam D.B.  , Ratta B.S.  , Kulatunga Gumindu  , John Sheila  , Chandra Andry  , Primadi Oscar  , Mohamed Athika Abdul Sattar  , Khan Muhammad Abdul Hannan  , Azad Abul Alam  , Marcelo Portia
Published: February 2025

Telehealth and telemedicine are increasingly becoming accepted practices in Asia, but challenges remain in deploying these services to the farthest areas of many developing countries. With the increasing popularity of universal health coverage, there is a resurgence in promoting telehealth services. But while telehealth that reaches the remotest part of a nation is the ideal endpoint, such goals are burdened by various constraints ranging from governance to funding to infrastructure and operational efficiency.
NATHCARE – Networking Alpine Health for Continuity of Care. The pilot case in the Province of Trento
Authors: Eccher Caludio  , Dalmartello Michela  , Morganti Elisa  , Torri Emanuele  , Nollo Giandomenico  , Zuffada Roberto  , Allegretti Natalia
Published: February 2025

Mountain areas in the Alps present specific logistic problems, but the vitality and the resources of the local communities offer also many opportunities for development and requalification. In the context of the Alpine Space Programme 2007–2013, the EU transnational co-operation programme for the Alps, the NATHCARE project aims to develop an organizational model of shared and integrated care and an IT platform able to support it. In this paper, we present both the project and the NATHCARE platform, an IT tool to support and improve the care process model, and their application in a pilot case in Province of Trento.
Insights and limits of usability evaluation methods along the health information technology lifecycle
Authors: Marcilly Romaric  , Kushniruk Andre W.  , Beuscart-Zephir Marie-Catherine  , Borycki Elizabeth M.
Published: February 2025

A great variety of usability evaluation methods exist but they do not provide the same kind of results and do not address the same stage of the Health Information Technology (HIT) lifecycle. This paper takes stock of the application of expert evaluation, usability testing, clinical simulation, clinical trials and post-implementation surveillance to provide an overview of their main similarities and differences. Results from this comparison will help in choosing methods that are best able to evaluate a HIT and improve its usability and ultimately its safety of use.
A Framework for Contexual Design and Evaluation of Health Information Technology
Authors: Kuziemsky Craig  , Kushniruk Andre
Published: February 2025

Poor contextual fit is a significant cause of health information technology (HIT) implementation issues. While the need for better fit of HIT and context has been well described there is a shortcoming of approaches for how to do it. While the diversity of the contexts where HIT is used prevents us from designing HIT to fit all contexts, if we had better ways of understanding and modelling contexts we could design and evaluate HIT to better fit contexts of use. This paper addresses the above need by developing a framework consisting of a set of terminology and concepts for modelling contextual structures and behaviours to support HIT design. The framework provides a way of binding contextual considerations to allow us to better model contexts as part of HIT design and evaluation.
Enrich classifications in psychiatry with textual data: an ontology for psychiatry including social concepts
Authors: Richard Marion  , Aimé Xavier  , Krebs Marie-Odile  , Charlet Jean
Published: February 2025

We propose a modular approach to develop an ontology of psychiatry, ONTOPSYCHIA, based on Patient Discharges Summaries (PDS) and divided into three modules (i.e. social, mental disorders and treatments). We decided to take into account the social aspects of the patient life described in PDS to consider information such as family history, social environment or education.
Prediabetes and cardiovascular risk alert programs - useful tools for preventing diabetes mellitus and cardiovascular events in primary medicine
Authors: Virgolici Horia  , Virgolici Bogdana  , Purcarea Victor
Published: February 2025

We propose alert programs, made in Excel using VBA, for general practitioners, in order not to miss the diagnosis of prediabetes and cardiovascular risk factors for their patients and to improve their management.
Discovering the role of morphology on the understanding of biomedical terminology by paramedical students
Authors: Rais Meriem  , Grabar Natalia
Published: February 2025

The ability to learn specialized languages, such as biomedical language, requires not only specialized knowledge specific to this area, but also linguistic skills. We propose to study this hypothesis on the example of biomedical language as it is learned by advanced paramedical students in Algeria. Two particularities are to be addressed: linguistic specificities of biomedical terms and the fact that learning process is done in French while the native language of students is Arabic. We perform a questionnaire-based study through which students have to work on recognition and production of biomedical terms and of their components. Several difficulties are observed. We propose that terminology learning programs should strongly develop and rely on linguistic skills of students and on their morphological conscience.
Competence assessment of centres participating in clinical trials
Authors: Bouzillé Guillaume  , Asfar Pierre  , Cuggia Marc  , Hamel Jean-François
Published: February 2025

Procedures tested in clinical trials require adequate competence of one or more health professionals and an adequate environment of care. In the context of clinical trials, it is usually not possible to separate the effect of treatments studied from the effect of the proficiency levels. This work proposes a method to assess not individual proficiency but practice performance of centres participating in clinical trials. We used the LC-CUSUM test to retrospectively assess centres' proficiency. We were finally able to ascertain one date for each centres from which they were considered as proficient. In conclusion, LC-CUSUM test seems suitable for centre's performance assessment to avoid potential bias in analyses due to suboptimal achievements of studied procedures. Prospective proficiency analyses could also be considered in a preliminary stage to standard clinical trials.
Citizen Personas: Exploring Challenges of Citizen-Centric eHealth
Authors: Petersen Lone Stub  , Bertelsen Pernille
Published: February 2025

Within the field of eHealth, there is a shift towards a patient perspective. However, the focus on the patient often fails to acknowledge and achieve a citizen-centric perspective because there is a lack of understanding of the context and complexities of the person and her relations, interests and activities. In this paper we use the persona of ‘Citizen Hanne’ for two purposes. Firstly, to highlight and provide detail in the understanding of the citizen perspective and thereby facilitate a shift towards a citizen-centric perspective, which is advanced by many in the field of eHealth. Secondly, we want to further nourish a critical goal of highlighting the challenges in doing citizen-centric eHealth and pointing out the barriers for reaching this goal.
Physical activity event regularity and health outcome – ‘Undiscovered country’ in cohort accelerometer data
Authors: Marschollek Michael
Published: February 2025

The increasing use of wearable devices for measuring long-term activity data allows for detailed analyses of real-life behavioral patterns and for the identification of new parameters such as activity event regularity. Thus far, the medical relevance of this new regularity parameter is unknown. The objective of the research work for this paper is to investigate associations between activity regularity and resting systolic blood pressure, as an exemplary well-established cardiovascular risk factor. Using accelerometer and blood pressure data of N=5695 subjects from the NHANES 2005-6 cohort study, three characteristic physical activity parameters (regularity, duration and intensity) were computed and compared for the upper and lower quartiles of subjects with regard to their blood pressure values. Results show statistically significant differences in the parameters regularity (p<0.001) and duration (p=0.008) of physical activity events, but not in intensity (p=0.889). Results confirm that subjects with low resting systolic blood pressure not only are active for longer periods of time, but also are more regularly active. It also shows that low-intensity, short-lived physical activity (< 10 min.) is associated with health-related outcome parameters. More research is necessary to make full use of detailed activity behavior data, and in particular to uncover relations between physical activity patterns and health outcome.
A high-availability architecture for continuous monitoring of sleep disorders
Authors: Iovanovici Alexandru  , Topirceanu Alexandru  , Udrescu Mihai  , Prodan Lucian  , Mihaicuta Stefan
Published: February 2025

We present a complete technical solution for continuously monitoring vital signs required for observing sleep apnoea events, one of the major sleep respiratory disorders. Based on industry accepted medical devices, we developed a GSM-based remote data acquisition and transfer module that is integrated via a set of web services into the server side of the application. The back-end is responsible with aggregating all the data, and, based on machine learning techniques, it provides a first level of filtering in order to warn about possible abnormalities. The proposed solution is currently under the test phase at the “Victor Babes” Hospital in Timisoara, Romania.