bluuebunny/crossref_metadata_2025 huggingface dataset:
The General Practitioner in the Giant's Web
Authors: Heimly Vigdis
Published: February 2025

Most General Practitioners (GPs) in Norway use Electronic Health Record (EHR) systems to support their daily work processes. These systems were developed with basis in local needs. Electronic collaboration between the different actors has developed over time. Larger national projects like the ePrescription and the Core EHR are examples of projects that interact with the GPs EHR systems. The requirements from these projects need to be addressed by the vendors of the EHR systems. At the same time the GPs see a need for further development of their EHR systems to make them more suited as tools to support the daily work processes. This paper addresses the how GPs can influence on the design and development of their EHR systems in a situation with a preexisting installed base of systems and increasing requirements from many actors.
Does PACS facilitate work practice innovation in the intensive care unit?
Authors: Hains Isla M.  , Creswick Nerida  , Westbrook Johanna I.
Published: February 2025

Picture Archiving and Communication Systems (PACS) allow the fast delivery of imaging studies to clinicians at the point-of-care, supporting quicker decision-making. PACS has the potential to have a significant impact in the Intensive Care Unit (ICU) where critical decisions are made on a daily basis, particularly during ward rounds. We aimed to examine how accessing image information is integrated into ward rounds and if the presence of PACS produced innovations in ward round practices. We observed ward rounds and conducted interviews with ICU doctors at three hospitals with differing levels of PACS availability and computerization. Imaging results were infrequently viewed by clinicians during ward rounds in two ICUs: one without PACS and one which had both PACS and bedside computers. In the third ICU, where PACS was only available at a central workstation, images were frequently viewed throughout the daily round and integrated into decisions about patient care. The presence of bedside computers does not automatically result in innovations to work practice. Despite the ability to utilize PACS at the bedside to support decision-making, use was varied. Research to understand how the complexities and context of the ICU contribute to work practice innovation and why practice changes differ is required.
Using Multimodal Mining to Drive Clinical Guidelines Development
Authors: Pasche Emilie  , Gobeill Julien  , Teodoro Douglas  , Vishnyakova Dina  , Gaudinat Arnaud  , Ruch Patrick  , Lovis Christian
Published: February 2025

We present exploratory investigations of multimodal mining to help designing clinical guidelines for antibiotherapy. Our approach is based on the assumption that combining various sources of data, such as the literature, a clinical datawarehouse, as well as information regarding costs will result in better recommendations. Compared to our baseline recommendation system based on a question-answering engine built on top of PubMed, an improvement of +16% is observed when clinical data (i.e. resistance profiles) are injected into the model. In complement to PubMed, an alternative search strategy is reported, which is significantly improved by the use of the combined multimodal approach. These results suggest that combining literature-based discovery with structured data mining can significantly improve effectiveness of decision-support systems for authors of clinical practice guidelines.
Integration of Classifications and Terminologies in Metadata Registries Based on ISO/IEC 11179
Authors: Ngouongo Sylvie Mn  , Stausberg Jürgen
Published: February 2025

Empirical medical research needs services for the maintenance of item collections. We evaluated the appropriateness of ISO/IEC 11179 “Information technology - Metadata Registries (MDR)” part 3 “Registry Metamodel and basic attributes” for a national MDR. In particular, possibilities of including classifications and terminologies (summarized as vocabularies) using the metamodel of this standard were assessed. The hierarchical structure of classifications and terminologies could be mapped easily to ISO's metamodel. The Classification Markup Language (ClaML) is attractive as interface standard for the import of classifications into the MDR. The correct linkage between data elements and vocabularies remained unclear however. An extension of the ISO 11179 metamodel might be necessary to satisfy the predefined needs of a national MDR.
Recording Associated Disorders Using SNOMED CT
Authors: Cornet Ronald  , de Keizer Nicolette F.
Published: February 2025

Multidisciplinary communication about patients with multiple and often interrelated diseases is of utmost importance to guarantee high quality of care. In this paper we focus on storing into the electronic medical record patients' disorders which are associated with each other, taking into account the role of SNOMED CT. The objectives of this paper are to design and discuss possibilities to appropriately record the associations between two disorders as defined in SNOMED CT and to get insight into the use of the relationship “associated with” in SNOMED CT and its consequences for data reuse. Our study showed that textual and concept-based reproducible recording of reusable data is hampered due to incorrect or incomplete modeling of associations between disorders in SNOMED CT. A possible solution for this is to record constituting characteristics of concepts directly into the record, instead of only being represented in the terminology. Further research on binding of information models and terminologies is needed.
Experimental research on shearing resistance property of geogrid-sand interface under normal cyclic load
Authors: Shi Zhi-long  , Xu Chao
Published: February 2025

A series of direct shear tests were performed by using self-developed large-scale interface shear apparatus to investigate the shearing resistance properties of sand-geogrid interface and compare the experimental results under normal cyclic load with those under static load. The test results demonstrate that the development trend of shear stress-displacement curves under cyclic load are similar to those under static load, but the shear curves under cyclic load show cyclic development characteristics; the relationships between the maximal shear stress of peak value and normal stress, and the maximal shear stress of trough value and normal stress both conform basically to Mohr-Coulomb rule; the maximal shear strength under cyclic load decreases with the increasing of frequency, but increases with amplitude increasing; the shear strength under cyclic load fluctuates with shear displacement, but is always in between the upper and lower boundaries defined by the shear stress under corresponding static normal stresses, the specific quantitative relationship among these related physical variables needs further researches.
AIM: Advanced Informatics in Medicine the AIM Exploratory Action, 1988-1990
Authors: Rossing Niels
Published: February 2025

A brief survey is given of the development of the AIM Programme and the AIM Exploratory Action. The action included 42 projects and accompagnying activities, which are described in the contributions to this volume, and which are introduced here.
Standards in Health Care Informatics
Authors: De Moor Georges J.E.
Published: February 2025

In order to respond to the challenge of integration and communications in the world of Medical Informatics, the Technical Board (BT) of the European Standardisation Committee (CEN), approved the constitution of a Technical Committee for Medical Informatics, in 1990. This paper aims to review the current situation in the area of European standardization applied to the vast domain of informatics for the Health Care Sector, as well as the roles played by the various organizations, involving a rich network of technical and medical knowledge and skills.
ADAM: ADvanced Architecture in Medicine
Authors: Frassine Rosangela  , Innocenti Emilio Bugli  , Fisher Phil J.
Published: February 2025

During the AIM Exploratory Action the ADAM -ADvanced Architecture in Medicine- project, undertook to design a workstation architecture for General Practitioners, which would be integrated with the services supplied by the National Health Care Systems. This architecture is presented globally. Other results, as contributions to standardisation, conditions for a functional reference model for the information processing environment in general practice, and grants for security are discussed. Validation of the model was achieved by the design and implementation of basic modules, namely the Medical Data Base and the Integration Tools. Account is taken of the exploitation of the results, and further plans are outlined.
TECHNIQUES FOR STUDYING SHORT-TERM CHANGES IN CARDIO-RESPIRATORY DATA
Authors: Kitney R.I.  , Bignall S.
Published: February 2025

Within the broad range of physiological oscillations is a sub-group which occurs in physiological systems involved in homeostasis. Such systems have the potential for oscillatory behaviour because their distributed nature allows the existence of significant time delays in reflex arcs. Physiological systems of this type can be considered as a number of different elements linked together, typically by neural pathways, to give the negative feedback necessary for homeostasis. Often such systems behave as spontaneous oscillators (Hyndman, Kitney and Sayers, 1971), the frequency of oscillation being determined by the characteristics of the system. A change in these characteristics can be considered to be equivalent to changing the setting of an oscillator so that it takes up a new and normally stable oscillatory mode. It is possible to envisage the human body as containing a number of systems which frequently oscillate. There is also evidence that biological systems which oscillate at frequencies higher than that consistent with the 24-hour day interact with each other, e.g. the interaction between heart rate control and respiration.
NEURAL AND HUMORAL FACTORS IN REGULATION OF BLOOD PRESSURE IN THE INVESTIGATION OF ESSENTIAL HYPERTENSION
Authors: Akselrod Solange  , Oz Orna  , Eliash Sara
Published: February 2025

Fluctuations in arterial blood pressure (ABP), the pattern of their power spectrum and the frequency specificity of the various pressor mechanisms, may provide important information regarding the maintenance of normal ABP levels. The study of these parameters may contribute to the characterization of a cardiovascular system prone to hypertension, and to the understanding of its pathogenesis.
SEQUENTIAL SPECTRAL ANALYSIS OF BLOOD PRESSURE AND HEART RATE IN HUMANS AND ANIMALS
Authors: Ramirez A.J.  , Mancia G.  , Pedotti A.
Published: February 2025

The analysis of Blood Pressure (BP) and Heart Rate (HR) variability in the frequency domain is currently used to investigate the mechanisms responsible for cardiovascular control. The potentialities of this methodology are greatly enhanced by techniques able to track the changes of BP and HR spectral characteristics for prolonged time periods. Up to now, specific techniques for dynamic spectral analysis are complex and provide results not always easy to interpret by visual inspection. Simplified tracking procedures may be obtained by the application of standard spectral estimators in a sequential fashion. Aim of this paper is to address the methodological and practical aspects of sequential spectral analysis in the study of long term BP and HR recordings. A short review of the results we obtained by this technique in the analysis of data from humans and animals is provided as well.
FOURIER AND RELATED ANALYSES: AN APPROACH TO STUDY BLOOD PRESSURE NYCTOHEMERAL CYCLE
Authors: Germanò G.  , Damiani S.  , Germanò U.  , Milito U.  , Caparra A.  , Santucci A.  , Balsano F.
Published: February 2025

It is common knowledge that the blood pressure data detected in the same patient at constant intervals, after the artefacts rejection, are dependent and strictly correlated. Such a dependence is as much stronger as closer BP values are. For this reason we used the Fourier analysis, curtailed to the third term, based on time series. We obtained, in previous studies, a good fit between experimental data and the statistical model. We analysed a large normal population as control selected from a multicenter Italian epidemiologic study. In addition we take into account a wide group of hypertensives subdivided in accordance with the target organ damage. The Fourier model evidenced that it is likely to have a connection between the different factors involved in the regulatory mechanisms of blood pressure control and the first term syncronized on a 24 hour basis, i.e. able to fluctuate once a day, the second one twice, the last one three times, every eight hours, daily. The analysis allows a detailed evaluation of the blood pressure nocturnal fall and the incidental presence of a relative minimum in the early afternoon. We can also have the opportunity to evaluate the blood pressure peaks during late morning and late afternoon. The further step was to determine for each model, the tangents to the inflection points.
OCULAR FLUOROMETRY: STANDARDIZATION AND INSTRUMENTATION DEVELOPMENT
Authors: Cunha-Vaz José-G.
Published: February 2025

1. Agreement on common protocols for patient examination and data gathering.
PROGNOSTIC VALUE OF AMBULATORY BLOOD PRESSURE
Authors: Clement D.L.
Published: February 2025

The first major achievement of the present project is having finalised a most difficult multi-centre study protocol. The project has first been running as a pilot study; this has shown clearly that the question posed was scientifically relevant and approachable from the practical point of view. Experience learned from this pilot phase, has permitted to adapt practical aspects that were considered too difficult by a number of centres. The final protocol that emerged out of this learning period has proven to be rather good as judged from comments at international meetings and symposia devoted to the topic. That the project is feasible was shown by inclusion of almost 1600 patients in an 18 month period. A second achievement is the new format to bring in the data. Although sheet forms are available, data can be entirely brought in by computer and the information can be sent to the coordination centre either by post, electronic mail or by EARN. A third achievement is that the techniques to record blood pressure have largely been standardised and that the reading of the data can be transferred either to a MS-DOS or a MacIntosh computer.
1.2 Principles of Open Distributed Processing in Medicine The Berlin Approach
Authors: MAHR Bernd
Published: February 2025

The principles discussed below give guidance for broader development and exploitation of information and communication technology support in medicine. They are based on intensive work since 1988 in the Berlin project initiative in medicine informatics1. and in European consortia in Telemedicine and Health Care Telematics2. They summarize observations that have since been made and proven in practice.
Speech Processing for the Profoundly Hearing Impaired
Authors: Bosman Arjan J.  , Smoorenburg Guido F.
Published: February 2025

Many profoundly hearing impaired listeners experience not only an increase in auditory threshold but also a severe loss in hearing differences among sounds at any level above their threshold. We studied audio-visual perception of natural speech versus synthesized speech based on voice fundamental frequency and on one or two vowel formants. Intelligibility scores of four profoundly hearing impaired subjects showed an interdependency between the type of speech processing scheme and the type of residual hearing. This project was performed within the project ‘STRIDE’ of the TIDE program.
Evaluation Methodologies for Rehabilitation Technology
Authors: Craig Ian  , Nisbet Paul  , Odor Phil  , Watson Marion
Published: February 2025

We consider what sorts of evaluation are appropriate when the rehabilitative technology under development interacts in complex ways with the society it serves. Issues are related to an outline of a project on the design and use of Smart Wheelchairs. The case is made for a multiple measures, systems approach to evaluation, based on formative techniques. Those employed in this particular case include both subjective and objective measures of process and product. The paper describes how such data-gathering is integrated into the development cycle itself.
Comspec - Towards a Modular Software Architecture and Protocol for AAC Devices
Authors: Lundälv Mats  , Svanæs Dag
Published: February 2025

This paper presents research on the development of a software architecture for users with special needs. One of the aims is to gain experience with modular and versatile communication aids and access systems. A software architecture has been specified that incorporates some of the requirements of technical aids for disabled users. To be able to evaluate its feasibility empirically, an interactive design tool based on this architecture has been developed. It includes an Interface Builder, a Configuration Editor and a Vocabulary Editor. Existing software is integrated by way of a communication protocol that implements an abstract application. Trained therapists have already used the tool successfully to construct new applications from existing software components.
Digital lung mechanics simulator as a validation tool
Authors: Groß H.  , Föhring U.
Published: February 2025

The complex situation of artificial ventilation, especially the consequences of different ventilator settings for the pressure, flow and volume changes of the patients lung with changing mechanical properties, is modeled by a digital lung mechanics simulator. Different lung mechanics properties, designed as RLC circuits, and different ventilator settings can be interactively chosen. Their influences are continuously computed by a transient analysis and then shown as the dynamically updated courses for the pressure, flow and volume parameters. As these calculated curves agree with measured data from patients the system can be used as a component appropriate for the validation of advising systems which give recommendations about better ventilator settings on the basis of measured data from ventilators. The system is a realistic phantom which covers a wide range for the possible different lung mechanics properties in connection with different settings at the ventilator.
Medical system design and knowledge acquisition using cooperating intelligent agents
Authors: Ovalle Arturo  , Hugonnard Emmanuelle  , Garbay Catherine
Published: February 2025

Over the past ten years, a significant amount of research has been devoted to the use of Distributed Artificial Intelligence Techniques for Expert Systems Design and Development. The use of Multi-Agent architectures provides several benefits such as modularizing problem-solving knowledge, alleviating the complexity of developing knowledge-based systems by distributing knowledge amongst a group of cooperating agents, or facilitating the integration of heterogeneous knowledge schemes and reasoning mechanisms. However, significant problems yet remain such as how to model the expertise of the medical application domain and incorporate such models within the multi-agent system architecture.
A Picture without Meaning Isn’t Worth a Thousand Words:Visual Information in Vision Rehabilitation
Authors: GOODRICH Gregory L.
Published: February 2025

Human vision evolved as a means of gathering information from the environment. Efficient use of this sense requires not only a clear image of an object on the retina, but also suitable transmission of the neural representation of the object to the visual cortex and the addition of memory associations to attach meaning to the image. Conditions that cause visual impairments degrade the optical image. They also alter the transmission of the neural representation and decrease the ability to attach meaning to the image, thus affecting the perception of the object. The assessment of visual impairment should include an assessment of the perceptual capacity of the individual, as well as assessments of visual acuity, visual field, and contrast sensitivity. This paper explores how a better understanding of human visual perception can improve the assessment of visual impairment and provide greater specificity in the provision of rehabilitation services. The possble application of one visual perceptual test, the Frostig Figure- Ground, is described.
Designing the occupational environment for visually impaired persons
Authors: KOOIJMAN Aart C.  , CORNELISSEN Frans W.  , van SCHOOT Edith A.J.  , van der WILDT Ger-Jan  , SCHIPPER Jannie  , MEESTER Henk  , DIJKSTRA Marijke
Published: February 2025

We describe the procedures we used for designing an optimal visual environment for partially sighted persons. Two case reports include descriptions of: the visual assessment, the occupational needs, the realised alterations at work and an evaluation after some months of working under these new conditions. Special attention is given to the lighting conditions at work. We base these on the luminance needs of the partially sighted person, and on his susceptibility to disability glare and high luminance differences.
Rehabilitation of Visual impairments in Patients With Brain Damage
Authors: ZIHL Josef
Published: February 2025

Brain damage can impair elementary visual functions as well as higher (cognitive) visual abilities. The majority of brain-damaged patients suffer from homonymous field disorders which impair reading and visual exploration of the hemifield corresponding to the field defect. Other visual functions which can be impaired after brain damage are spatial contrast sensitivity, light and dark adaptation, color vision, and visual space perception including visual spatial orientation. Finally visual-agnosic disorders may impair patient’s ability to correctly identify and recognize objects, faces, and places.
Computer programs for visually impaired pre-school children
Authors: Hammarlund Jenny
Published: February 2025

Can computer play be used for low vision training of pre-school children? If so, how should the software be designed to promote this? Four specially designed softwares for Apple Macintosh with touch-screen have been tested on 34 partially sighted children between 3 and 7 years of age. All children have been tested in connection with an ordinary assessment visit to TRC. We have found that all children enjoy playing with the computer as the software gives both movement and sound which on its part stimulates looking, tracking and fixation. For children who are rather difficult to assess with traditional methods the computer has been a very useful complementary assessment tool.
Effects of training assertive behaviour in groups of visually handicapped adults
Authors: HAKKENS Rick
Published: February 2025

Group counselling for newly visually handicapped adults is offered as part of the rehabilitation program, one of the aims being to (re-)learn social skills or assertiveness. First preliminary screening was done with 22 clients. 6 social skills were found to be difficult. Later a pilot study was done with 7 clients using a pre- and post-test design. On the Scale of Interpersonal Behaviour (SIB), a multi-dimensional measure of both performance and distress, no difference was found in performance. Distress decreased significantly after group attendance. Suggestions for further research are made.
Finding employment for visually impaired people in the Netherlands
Authors: DIJKSTRA Marijke  , SCHOTEL Peter
Published: February 2025

Thanks to improved training possibilities and availability of advanced optical and technical aids, the opportunities for a succesful rehabilitation of visually impaired people are nowadays far greater than in the past. The challenge is to make the most of today’s great possibilities. Our paper aims to exemplify the complex role a rehabilitation centre has to play: in addition to a correct diagnosis and the providing for the necessary aids, a careful coordination of the contacts between all regular social security institutions concerned, training centres and employer and employee is of the utmost importance.
Suggestions for the classification of impairments and disabilities of low vision
Authors: LOOIJESTIJN Paul L.
Published: February 2025

For vision rehabilitation and research is a detailed enumeration and classification of concepts of visual perception desirable. An enumeration of visual functions, visual basic skills and aspects of the attitude towards visual impairments and disabilities is made. This enumeration is ordered in accordance with the proposals for amending the International Classification of Impairments, Disabilities and Handicaps (ICIDH), originated with the Dutch Foundation for Research and Postgraduate Education in Physical Therapy (SWSF). Amendments from colleagues of different professions in rehabilitations are made. Through application on a small scale in visual profiles of clients this classification is verified on usefulness in rehabilitation. This way a classification of visual impairments, disabilities and handicaps has been developed, which can be applied in the rehabilitation process. This article gives a briefly sketch of the main categories in a visual profile and an illustration by means of a case. It also refers to possibilities of application in investigation, rehabilitation diagnosis and a rehabilitation programme.
The Importance of Social Work with the Multidisciplinary Assistance of the VAC-E
Authors: van Rooy M.A.L.P.
Published: February 2025

The Visual Advice Centre Eindhoven (VAC-E) is specialised in the rehabilitation of visually impaired persons with visual aids and illumination. The attention of the VAC-E, however, goes further than only trying to find the right aid. When people become visually handicapped they are vulnerable and meet various kinds of ergonomical, physical, psychological and social problems. For a number of patients problems of acceptance, financial, relational or neuropsychological problems or difficulties at work form an obstacle for successful rehabilitation with visual aids. By including the function of social worker in the multidisciplinary team of the centre the VAC-E is able to provide better guidance to these patients. In this paper the role of the social work in the assistance of the VAC-E is discussed and illustrated with examples.
Why and How Will Knowledge Based Systems Become an Established Technology within Health Care?
Authors: Vingtoft Søren  , Fuglsang-Frederiksen Anders
Published: February 2025

There is a widespread expectation regarding future increased productivity within Health Care, with more and better services to be provided with better resource management. In some distinct clinical areas, knowledge based systems have proven the ability to improve the quality of health care services. Based on our experience, this paper proposes the collaboration between groups with clinical and technical expertise that will lead to the development of viable medical KBSs, whose main features are discussed and that will be integrated in the medical telematic infrastructure as integral parts of an electronic patient record.
1/f Fluctuations of the Biological Rhythm
Authors: MUSHA T.
Published: February 2025

The biological rhythm is basically subject to 1/f fluctuations. The typical examples are heart rate and blood pressure. The present author has found that, in addition to the heart rate, spontaneous discharge interval of a giant neuron of African snail has 1/f fluctuations and hand clapping intervals also have 1/f fluctuations. Furthermore, the axon as a transmission line of biological signal has a strong nonlinearity, which modulates the time relation of launched action potential impulses; the time relation of randomly launched impulses is modulated by this nonlinearity and eventually it reached 1/f fluctuations. The biological body has a special affinity to 1/f fluctuations. Computer simulation shows that 1/f interval fluctuations are deeply related to 1/f fluctuations of membrane admittance to ion currents. The physical origin will be the same as conductance fluctuations of electric conductors which have been widely observed in any type of electric conductor. Finally, a possibility is discussed that 1/f fluctuations in biological rhythm and signal transmission have special meaning as regards stable parallel control.
Integrated Specialty and Operational System for Diabetes Management in South West England
Authors: Mason A  , Burrows C
Published: February 2025

The management and control of diabetes throughout South West England has been assisted by the use of a networked computerised information system which is totally integrated with hospital and community information systems. The objectives of the diabetes system are to produce an aid to diabetes management, which includes the creation of a district diabetes register accessed and maintained by clinicians based in both the hospital and in the community, whilst at the same time providing auditable information.
Lessons from a Child Health System on Opportunities and Threats to Quality from Networked Record Systems
Authors: Rigby Michael J.  , Nolder Diane
Published: February 2025

The British Child Health System has been designed and widely implemented to support equity of access to preventive child health services, using case-based integrated records. Lately, telematics has been increasingly applied to improve the timeliness of data entry. A special project has been established to moniter overall quality of the system's use and of the resultant preventive services. The telematics application has been found to be a potential threat to quality in a way which would apply to all remote networked patient-based systems. The demonstration will show the methodology and interim results.
Three-Dimensional Dynamic Characteristics of The Scoliotic Spine Before and After a Four Months Immobilisation Period through the Risser Plaster Brace
Authors: ROTELLI Fabio  , SIBILLA Paolo  , NEGRINI Alberto  , PALMIERO Lucio G.E.  , SANTAMBROGIO Giorgio C.
Published: February 2025

Forty one patients, featured by a right-thoracic, left-lumbar idiopathic scoliosis, were analysed by the AUSCAN System, an opto-electronic 3D posture analyser, while performing some simple motor tasks (orthostasis and lateral singleside bending of the trunk), before and after a four-months period of immobilisation through a Risser plaster brace. The 3D co-ordinates of 27 anatomical landmarks (11 of them placed on the spinous processes from C7 to S3), acquired at a sampling rate of 100 Hz and featured by a final accuracy better than 1 mm, were collected for each of the trials taken into account.
3-D Correction Obtained with the C-D Procedure During Surgery
Authors: LABELLE H.  , DANSEREAU J.  , BELLEFLEUR C.  , DE GUISE J.  , RIVARD C.  , STOKES I.A.F.
Published: February 2025

A per-operative digitising system using magnetic fields was used to document the 3-D changes in the position of the spine induced by the derotation manoeuver with the C-D instrumentation in 23 subjects with adolescent idiopathic scoliosis. Variability of this system was found to be on average at 0.9 mm for 3-D coordinates and at 2.5° for orientation measures. A significant 3-D change in orientation averaging 11 degrees at each vertebral level after the derotation manoeuver indicates that the procedure truly accomplished 3-D correction of the spinal deformity.
Scoliosis Follow-Up by Back Shape Analysis; Evaluation of Its Reliability
Authors: SUZUKI Nobumasa  , TEZUKA Masaki  , ONO Toshiaki
Published: February 2025

Back-shape analysis of scoliosis by moire topography was used for the observation of mild scoliosis to detect progression since 1987. Sixty-six cases with minimum 2 years’ observation period were reviewed. Patients were divided into two groups ; Group 1, standard rotation group and Group 2, non-standard rotation group. In group 1, the sensitivity rate was 50 % and the specificity rate was 91.6 % . In group 2, 42.9 % and 92.3 % respectively. We conclude that X-ray measurement is more reliable to detect scoliosis progression than surface measurement.
Signal Processing Aspects of 3-Dimensional Shape Measurement
Authors: HOBSON C.Allan  , PEARSON Jeremy D.  , DANGERFIELD Peter H.
Published: February 2025

An image is a two dimensional signal, from which information about the third dimension, height, must be extracted when measuring surface shape. This paper reviews ways in which this may be done, starting with binocular vision systems and then moving on to ways in which additional information may be added to a single image so that height may be extracted. For each system some brief comments are included regarding problems of application and limitations on accuracy.
Digital Radiography Segmentation of Scoliotic Vertebral Pedicles Using Morphological Segmentation
Authors: ROSS Y.  , DE GUISE J. A.  , POTVIN J.  , BLEAU A.  , SABOURIN R.  , DANSEREAU J.  , LABELLE H.
Published: February 2025

A computer segmentation method is developed to detect automatically the contour lines of the vertebral pedicles in digital radiographs of the scoliotic spine. These contour lines are used to identify stereocorrespondent anatomical landmarks for the 3D reconstruction of the scoliotic spine using a stereoradiographic technique. Automation of the digitization of the landmarks should reduce the variability of the actual manual digitization method and improve the 3D reconstruction precision. First, a knowledge based model is used to generate anatomical markers near the pedicle centers. These markers are then used to control a morphological segmentation method allowing the automatic detection of the pedicle contour lines. Next, an ellipsis is fitted to the pedicle contour lines and stereocorrespondent landmarks are estimated in the stereoradiograhs to finally obtain their 3D location. The preliminary results demonstrated a reduction of the 2D standard deviation for the digitization of the pedicles from 2.3±1.6 mm (manual) to 0.39±0.37 mm (automatic) and an improvement in the 3D reconstruction precision by an amelioration of the stereocorrespondence estimation (reduction of the DLT error from 42.3±3.4 mm (manual) to 1.9±2.3 mm (automatic)). The automation of the stereocorrespondent landmarks digitization using computer vision methods seem to effectively reduce the variability of the method and improve the landmark correspondence identification.
Measurement of Intervertebral Displacements During Surgical Correction of Scoliosis
Authors: GODILLON A.P.  , CHOPIN D.  , DUFOUR F.
Published: February 2025

Correction of scoliosis imposes a displacement of the vertebrae in 3D. Until now, the movement of the vertebrae is not known. This paper proposes a protocol to measure the displacement of the vertebrae during a surgical correction procedure. The protocol permits the determination of the movement of several vertebrae in 3D using three diodes. The displacements are recorded by a videosystem and they are included by fixing a hook attached to a screw to the vertebra.
Prescription Guidelines in OPADE: what are they, how are they used ?
Authors: de Zegher Isabelle  , Milstein Claudine  , Séné Bertrand  , Venot Alain
Published: February 2025

Many computerised drug prescription systems have been developed, but they are rarely used in clinical practice; among the reasons are their lack of integration with the functioning of medical institutions and the lack of consideration of general and local clinical practice rules. We present in this paper how OPADE, a computerised drug prescription system does answer this shortcoming by introducing prescription guidelines called Prescribing Principles. We argue that introduction of these Prescribing Principles will not only allow for integration of the computer in medical practice but will also introduce a positive feed back loop in the prescribing process.
Technology Assessment for Decision-Making in the Field of Informatics in Medicine and Health Care
Authors: Berleur Jacques  , Nguyen Nam Tien  , Delhaye Renaud
Published: February 2025

The methodological grid we are developing here has to be considered as a proposal enlightened by some applied research in the field on information TA and, especially in the field of medical informatics. We propose here a general TA approach which borrows many features from more known TA methods. The core of our methodological proposal - which, as explained in chapter 2, cannot be dissociated from the CTA movement - is the controversies analysis. By developing this method, we are searching a better understanding of the real risks and advantages linked to a technology, but also the settlement of solid foundations in order to work out a future consensus around a new technology. This means that the paper will focus on the social construct of technologies. We have to see the problems not in terms of social adjustment, but rather in terms of taking into account the other dimensions of the innovation processes. Following the theoretical presentation of the controversies analysis method, we present a concrete case study concerning the development of Computerised Health Cards in Europe during the late eighties.
Surgical Simulation Support System
Authors: Oyama Hiroshi  , Nomura Kazuhiro  , Miyazawa Tatsuo  , Aono Masaki  , Ohbuchi Ryutarou  , Suda Susumu
Published: February 2025

We describe a Surgical Simulation Support System (SSSS) of cancer treatment. The software we used in this study is the Virtual Reality Distributed Environment and Constructive Kit (VR-DECK)(IBM) and is operated on two ONYX computers with Rearity Engine (RE) and an Indigo II computer. The surgical procedure simulated is a neurosurgical operation in which a neoplasm of the brain was resected without photomicroscopy. The simulated image was composed of approximately 15,000 polygons and the flame rate was about 15-20 /sec. We used 3D texture mapping method for a better presentation of the procedure. Intracranial vessels were not presented in the virtual surgical fields for a technical reason. We recognized that composition and presentation of VR simulated surgical technique using the SSSS seemed to be of help for image training of the surgical procedure for those neurosurgeon who have limited opportunity to get involved in the actual surgery. We will discuss the limitation of the VR technique in view of the reality and utility of the SSSS within the context of present technology and will discuss the future directions.
The CyberMensch Simulation Server for the Planning of Clinical Trials
Authors: Sieburg Hans B.  , Müller-Sieburg Christa
Published: February 2025

The paper outlines a secure computer-network based standard for clinical trials. The development of the software from a simulator package for the support of pre-clinical trials in AIDS towards the CyberMensch is sketched. CyberMensch combines the ability to perform testing of therapies in selected tissues (individual CyberMensch), with the capacity to plan clinical trials (groups of CyberMenschen).
Probabilistic hyperstack segmentation of MR brain data
Authors: Vincken Koen L.  , Koster André S. E.  , Viergever Max A.
Published: February 2025

A multiscale method (the hyperstack) is proposed to segment multi-dimensional MR brain data. In particular, attention will be paid to the detection and classification of partial volume voxels. The result—a list of probabilities for each partial volume voxel—makes measurements of image geometry more reliable and improves volumetric visualization of image objects.
Left Atrial and Pulmonary Venous Flow Visualization by Phase Encoding Magnetic Resonance Imaging
Authors: Milet Sylvain F.  , Walker Peter G.  , Kim Yong  , Houlind Kim  , Pedersen Erik M.  , Yoganathan Ajit P.
Published: February 2025

In order to study the blood flow patterns in the left atrium, as well as the pulmonary venous inflow, Magnetic Resonance Imaging (MRI) was used to visualize the three-dimensional velocity fields in the transversal plane Left Ventricular Outflow Tract (LVOT) view and sagittal plane LVOT view in humans. A dedicated visualization and analysis software named ‘cardiac MARIAN’™ was developed on a Silicon Graphics Onyx computer. Temporal velocity profiles were measured and vector animations of the flow fields produced throughout the cardiac cycle. This provided a dynamic visualization of the complex flow fields in the left atrium.
DILEMMA: Decision Support in Primary Care, Oncology and Shared Care
Authors: Thomson Richard
Published: February 2025

The Dilemma project has addressed clinical, technical and methodological questions in the design and implementation of aids for medical decision making and patient management. Technically, the project has focused on the use of logic programming and knowledge-based methods for constructing a generic technology to support clinical decision making, and for assisting in the scheduling and execution of clinical tasks in protocol-based care. Dilemma has succeeded in integrating its generic decision support technology and electronic health care record with existing clinical information systems in a number of clinical domains, thereby adding value in such areas as patient data entry and retrieval and knowledge based and hypermedia access to clinical knowledge and data. Applications of the technology have been developed in oncology, cardiology and primary care, and in telematic communication and coordination for multi-site shared care. Project activities have been underpinned by a methodology for establishing clinical and functional requirements for decision support systems, and a generic business model which formalises protocol-based care.
OPADE: Optimization of Drug Prescription Using Advanced Informatics
Authors: de Zegher I.  , Venot A.  , Milstein C.  , Séné B.  , de Rosis F.  , De Carolis B.  , Pietri P.  , Dahlberg B.
Published: February 2025

Computerized drug prescription systems (CDPS) have been developed for many years but the software's currently used in clinical practice are most often limited to simple order entry systems. The OPADE project, presented in this paper, aimed at developing a full fledged CDPS allowing for optimisation of drug prescription from a medical, patient compliance and economical point of view. During the project we identified the key problems that need to be solved before such systems can be usefully installed in clinical settings. Related solutions were integrated in the OPADE prototype evaluated in several European clinical sites; they are at the source of commercial developments by industrial partners and are also being integrated in forthcoming standards of the CEN TC251.
ISAAC: Integrated System Architecture for Advanced primary Care
Authors: Bertelli Stefano
Published: February 2025

The aim of the ISAAC (Integrated System Architecture for Advanced Primary Care) project is to develop information technology and telematic support in the Primary Health Care field. The project aims at describing the tasks and activities performed by General Practitioners throughout Europe and at improving their work through the development of a useful and usable medical workstation for day-to-day patient care. Moreover ISAAC has designed and implemented an Integration System for the improvement of the communications between General Practitioners and heterogeneous pre-existing application environments, namely other components of the health care system.
AFASIA: A standard Framework for AIM Selected Interconnected Applications
Authors: Demeester Michel  , Perez de Talens Antonio Fernandez  , de la Riva Grandal Jose M.  , Ferrara Fabrizio M.  , Salvans Pau Ferrer  , Saranummi Niilo
Published: February 2025

This paper does not represent a final report. It is a summary of the results of the first year on building the principles of an integration methodology . As main sources to analyze the integration needs several AIM projects, currently in the execution phase, and CEN-TC251 standardization initiatives have been used. The present paper introduces the reasons for developing an integration methodology. It defines the concept of integration and centres on Healthcare Enterprises (HE). Following the definition of Healthcare Enterprise different types of integration are described. The tools to achieve it, are mentioned and the background of a Healthcare Information Framework as support for the Healthcare architectural concepts. The bridging between Enterprise and Information System, and the integration procedures and methods are the last steps summarized. The original 165 pages document offers at its end a review of the most accreditated Information Systems methodologies. The further development of an AFASIA extended methodology, and the analysis of the common components to the different projects will complete the key issues to state the final set of Healthcare Information Systems Integration Procedures.
GALEN: Terminology Services for Clinical Information Systems
Authors: Rector A.L.  , Zanstra P.  , Solomon D.
Published: February 2025

GALEN is developing the tools for the next generation of clinical information and medical records systems based on two fundamental ideas — the use of compositional models of medical terminology and the delivery of those models as services encapsulated in software servers. GALEN supports high quality clinical user interfaces and bridges the gap between traditional terminologies and the needs of direct patient care. This paper describes the techniques and the validation of those techniques in practical clinical applications.
The Evaluation of the Rimouski Project: A Strategy for Development
Authors: Bérubé J.  , Fortin J.-P.  , Papillon M-J.  , Lavoie G.  , Kirouac S.
Published: February 2025

The Quebec Provincial Government in Canada has decided to experiment a pilot project in the health care field using a Patient Smart Card (PSC). The experimental project was launched in May 1993. Close to 7.300 patient cards have been issued and a total of more than 300 health care workers have joined the project. The pilot project has now come to an end and we are currently in the process of analyzing the data gathered over the last two years. The assessment constitutes one of the fundamental parts of the pilot project where we analyse the development strategies, the project implementation, the impact of the smart card and how the card may be generalized. Some preliminary findings are presented during the Symposium.
The Present Conditions of the New Health-Medical IC-Card System ‘IKI-IKI’ Card in Himeji
Authors: Fujimori H.
Published: February 2025

7200 ‘IKI-IKI’ cards have been issued to people of the age of sixty and over who wish to carry one. Information related to health, medical care and welfare is included in this card. The information cannot be extracted without an ‘access card’, in order that people’s privacy should be guarded. The basic information about an individual, the name of the disease, and the information about medicine and examinations can be inputted automatically. Most of the card holders think that this system helps them improve their health, in addition to the secure feeling they have by possessing such a card. Most of the doctors think that it gives them no managerial advantage, but hope that this system will be spread to all the medical institutions. There is a plan to improve this system so that this card can be used all over Japan.