bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Narrative and Clinical Organisation: Properties of Radiology Reports
Authors: Rooksby John  , Kay Stephen
Published: February 2025

Radiology reports, as a form of clinical narrative, are more than a repository of patient information but are active in patient care. They are not unique and individual to each patient but have structured content suitable for supporting the activities of care. We consider these activities of care and how they manifest in the report. This recognition of the infusion of clinical organisation in clinical narrative leads to the recognition of seven properties of radiology reports: labels, concepts, genre, structure, author, subject, reader. These properties exist across two relationships: the intertextual relationship between radiology reports and the interpersonal relationship between a radiology report and people.
Development of the Set of Data Identifiers for Medical Record Information Exchange
Authors: Hatano Kenji  , Ohe Kazuhiko  , Yamamoto Ryuichi
Published: February 2025

The standard set of data identifiers in exchanging electronic medical record information (J-MIX) was developed. Medical data identifiers were collected and arranged from various forms of medical documents. Although the set does not have fixed structure, each identifier has unique label with semantic structure. This set will facilitate smooth medical data exchange and be easily applied to eXtended Markup Language (XML) based description of medical record information.
Migration of the Japanese Healthcare Enterprise from a Financial to Integrated Management: Strategy and Architecture
Authors: Akiyama Masanori
Published: February 2025

The Hospital Information System (HIS) has been positioned as the hub of the healthcare information management architecture. In Japan, the billing system assigns an “insurance disease names” to performed exams based on the diagnosis type. Departmental systems provide localized, departmental services, such as order receipt and diagnostic reporting, but do not provide patient demographic information. The system above has many problems. The departmental system's terminals and the HIS's terminals are not integrated. Duplicate data entry introduces errors and increases workloads. Order and exam data managed by the HIS can be sent to the billing system, but departmental data cannot usually be entered. Additionally, billing systems usually keep departmental data for only a short time before it is deleted. The billing system provides payment based on what is entered. The billing system is oriented towards diagnoses. Most importantly, the system is geared towards generating billing reports rather than at providing high-quality patient care. The role of the application server is that of a mediator between system components. Data and events generated by system components are sent to the application server that routes them to appropriate destinations. It also records all system events, including state changes to clinical data, access of clinical data and so on. Finally, the Resource Management System identifies all system resources available to the enterprise. The departmental systems are responsible for managing data and clinical processes at a departmental level. The client interacts with the system via the application server, which provides a general set of systemlevel functions. The system is implemented using current technologies CORBA and HTTP. System data is collected by the application server and assembled into XML documents for delivery to clients. Clients can access these URLs using standard HTTP clients, since each department provides an HTTP compliant web-server. We have implemented an integrated system communicating via CORBA middleware, consisting of an application server, endoscopy departmental server, pathology departmental server and wrappered legacy HIS. We have found this new approach solves the problems outlined earlier. It provides the services needed to ensure that data is never lost and is always available, that events that occur in the hospital are always captured, and that resources are managed and tracked effectively. Finally, it reduces costs, raises efficiency, increases the quality of patient care, and ultimately saves lives. Now, we are going to integrate all remaining hospital departments, and ultimately, all hospital functions.
Experience with an XML/HTTP-based Federative Approach to Develop a Hospital-Wide Clinical Information System
Authors: Geissbuhler Antoine  , Lovis Christian  , Lamb Alexander  , Spahni Stéphane
Published: February 2025

The authors present a two-year experience with an approach aimed at federating applications into a component-based hospital-wide clinical information system. Recognizing the need for better integration, clearer separation of knowledge from applications, as well as the necessity to respect and integrate the diversity of roles in a healthcare network, a strategy was implemented that included the development of a shared vision, organizational changes to promote appropriation at all levels, and the elaboration and maintenance of a common architecture and terminology by an instrumental technical group.
XML and the VITAL Standard: The Document-oriented Approach for Open Telemedicine Applications
Authors: Anagnostaki Angie  , Pavlopoulos Sotiris  , Koutsouris Dimitris
Published: February 2025

This paper describes an effort to create a common, document-oriented architecture for the interchange of medical data in healthcare telemedicine applications. Key components are: The VITAL standard specifying a common (medical device independent) representation of Vital Signs Information and the Extensible Markup Language (XML) specking the document specifications form, an architecture that, in aggregate, define the semantics and structural constraints necessary for the exchange of vital signs and related medical data. The modelling and design technique for the described application has been the Unified Modelling Language (UML). The XMI (XML Metadata Interchange Format) of the Object Management Group (OMG) provided the meta-model for this application, for sharing objects using XML, via the transfer of the application’s UML model to XML documents and DTDs.
Improving Dialysis Services through Information Technology: From Telemedicine to Data Mining
Authors: Bellazzia Riccardo  , Magnia Paolo  , Bellazzi Roberto
Published: February 2025

This paper discusses the issues related to use of Information Technology (IT) solutions in dialysis, and describes the implementation of some of them in a medium size dialysis center. First, starting from the analysis of the organization of public-health nephrology services, the potential role of IT is highlighted. Second, the main directions for IT exploitation in dialysis, namely telemedicine and automated monitoring of dialysis sessions are discussed. Third, the on-field implementation of these services is described, together with some preliminary results. The work here presented shows how IT may improve dialysis services by ameliorating quality and reducing costs.
Review of Virtual Reality Treatment for Mental Health
Authors: Gourlay D.  , Lun K.C.  , Liya Guan
Published: February 2025

This paper describes recent research that proposes virtual reality techniques as a therapy for patients with cognitive and psychological problems. Specifically this applies to victims of conditions such as traumatic brain injury, alzheimers and parkinsons. Additionally virtual reality therapy offers an alternative to current desensitization techniques for the treatment of phobias Some important issues are examined including means of user interaction, skills transfer to the real world, and side-effects of virtual reality exposure.
A Survey to Identify the Clinical Coding and Classification Systems Currently in Use Across Europe
Authors: de Lusignan Simon  , Minmagh Christopher  , Kennedy John  , Zeimet Marco  , Bommezijn Hans  , Bryant John
Published: February 2025

Introduction: This is a survey to identify what clinical coding systems are currently in use across the European Union, and the states seeking membership to it. We sought to identify what systems are currently used and to what extent they were subject to local adaptation.
Radiographic Absorptiometry of the Phalanx
Authors: Grashuis Jan L.
Published: February 2025

Radiographic absorptiometry of the phalanx for the assessment of bone mass density has a long history. Since it is a relatively cheap method that is easy to perform it is very suitable for screening purposes.
Bioinformatics in Medical Practice: What is Necessary for a Hospital?
Authors: Bürkle Thomas  , Hain Torsten  , Hossain Hamid  , Dudeck Joachim  , Domann Eugen
Published: February 2025

Building bioinformatic facilities for a university hospital is pretty similar to using standardized building blocks to construct a house. Starting with the intention to built a dwelling house, a factory or just a shelter the architect draws a construction plan and determines the material to be used. In general, the building is then constructed by the workmen following exactly the plan. However, for particular reasons, minor alterations may be needed to improve the construction of the building.
A New Network-based Biologic Database System
Authors: Zhang Yan  , Zhang Zhengguo
Published: February 2025

Bioinformatics is playing an increasingly important role in the processing and analysis of biomedical data. The collection, storage and analysis of biologic information are key components of bioinformatics. In the genome era, with the explosion of sequence and structural information available to researchers, the structure of biologic databases is becoming more complicated, the contents is becoming larger, and the management and development is also becoming more difficult. A network-based biologic database has been developed. This database system integrates administration, development and analysis of bioinformatics with common and friendly interface. For the life scientists without much computer programming expertise, the system is easy to master.
Navigation by Walking Around: Using the Pressure Mat to Move in Virtual Worlds
Authors: Couvillion Warren  , Lopez Roger  , Ling Jian
Published: February 2025

This paper describes a new virtual reality (VR) locomotion input device, the Pressure Mat, which allows a simulator user to navigate/traverse a virtual environment (VE) using similar motions as in the real world; i.e., walk, run, crawl. The device consists of an array of pressure sensitive resistors covered by a thin, flexible mat. The resistor array is connected to a personal computer (PC) that uses a real-time pattern recognition algorithm to determine if the user is standing still, or walking forward, backward, left or right. The information from the Pressure Mat was used to allow users to navigate in a VE. The Pressure Mat may also be useful in the diagnosis of a variety of conditions and/or in rehabilitative therapy.
Heuristic Haptic Texture for Surgical Simulations
Authors: Acosta Eric  , Temkin Bharti  , Griswold John A.  , Deeb Sammy A.  , Krummel Tom  , Haluck Randy S.  , Kavoussi Louis R.
Published: February 2025

Generation of credible force feedback renderings adds the sense of touch crucial for the development of a realistic virtual surgical environment. However, a number of difficulties must be overcome before this can be achieved. One of the problems is the paucity of data on the in-vivo tissue compliance properties needed to generate acceptable output forces. Without this “haptic texture,” the sense of touch component remains relatively primitive and unrealistic. Current research in the quantitative analysis of biomechanics of living tissue, including collection of in-vivo tissue compliance data using specialized sensors, has made tremendous progress. However, integration of all facets of biomechanical data in order to transfer them into haptic texture remains a very difficult problem. For this reason, we are attempting to create a library of heuristic haptic textures of anatomical structures. The library of heuristic haptic textures will capture the expert's sense of feel for selected anatomical structures and will be used to convey the sense of touch for surgical training simulations. Once the techniques for converting biomechanical data into haptic texture become more robust, this library can be used as a benchmark to verify theoretical computational models used for generating output forces in haptic devices.
Using Mixed Reality, Force Feedback and Tactile Augmentation to Improve the Realism of Medical Simulation
Authors: Fisher J. Brian  , Porter Susan M.
Published: February 2025

This paper describes an application of a display approach which uses chromakey techniques to composite real and computer-generated images allowing a user to see his hands and medical instruments collocated with the display of virtual objects during a medical training simulation. Haptic feedback is provided through the use of a PHANTOM™force feedback device in addition to tactile augmentation, which allows the user to touch virtual objects by introducing corresponding real objects in the workspace. A simplified catheter introducer insertion simulation was developed to demonstrate the capabilities of this approach.
A New, Accurate and Easy To Implement Camera and Video Projector Model
Authors: Hoppe Harald  , Däuber Sascha  , Kübler Carsten  , Raczkowsky Jörg  , Wörn Heinz
Published: February 2025

In 2000, the Institute for Process Control and Robotics/Universität Karlsruhe (TH) has developed a prototype system for projector based augmented reality consisting of a state-of-the-art PC, two CCD cameras and a video projector which is used for registration and projection of surgical planning data. Tracking, registration as well as projection require an accurate calibration process for cameras and video projectors. We have developed a new, flexible, plain and easy to implement model, which can both be used for calibration of cameras and video projectors.
Objective Surgical Performance Evaluation based on Haptic Feedback
Authors: Moody Louise  , Baber Chris  , Arvanitis Theodoros N.
Published: February 2025

In order to develop effective virtual reality training systems for surgery there is a need to provide appropriate sensory and performance feedback to the user. This paper aims to demonstrate a method by which performance data can be collected. This is used to investigate the effect of haptic feedback on performance.
On Defining Metrics for Assessing Laparoscopic Surgical Skills in a Virtual Training Environment
Authors: Payandeh Shahram  , Lomax Alan J.  , Dill John  , Mackenzie Christine L.  , Cao Caroline G.L.
Published: February 2025

One of the key components of any training environment for surgical education is a method that can be used for assessing surgical skills. Traditionally, defining such a method has been difficult and based mainly on observations. However, through advances in modeling techniques and computer hardware and software, such methods can now be developed using combined visual and haptic rendering of a training scene. This paper presents some ideas on how metrics may be defined and used in the assessment of surgical skills in a virtual laparoscopic training environment
Neuropsychological Performance and Integrated Evaluation for Disabled People using Virtual Reality: Integrated VR Profile
Authors: Piccini PierAntonio
Published: February 2025

This chapter describes a Virtual Reality (VR) based innovative model of evaluation of the performance and potentiality of young mentally/psychically disabled subjects with learning difficulties. Using an immersive PC-based VR system, the study investigated the characteristics of 150 disabled subjects in the EU funded project “Horizon O.D.A. - Catania-1998-2000”. The result is the definition of an individual neuropsychological “Integrated Profile”, based on VR performance, that allows an objective functional benchmark between different subjects. This model can be used to investigate the possibility of job integration for mentally/psychically disabled subjects.
A New Haptic Interface for VR Medical Training
Authors: Riener Robert  , Burgkart Rainer
Published: February 2025

Successful applications of haptic displays are limited to tool-based interfaces that simulate haptic effects on surgical and other medical instruments. However, no satisfactory haptic display exist so far, that enable the simulation of high fidelity palpation of human tissue or body segments. Existing approaches developed for medical training fail due to unrealistic haptic effects, time-consuming donning and doffing, and inconvenient use (e.g., mechatronic tactile and kinesthetic displays) or due to restricted function and adjustability (e.g., passive mannequins). The key idea of the new haptic interface is to attach artificial organs or segments (e.g. a plastic leg) to a force actuating mechatronic unit (e.g. robot). A set of different materials combined in certain layers yield components that look and feel like real objects. When the user touches the artificial object the contact forces and position changes are measured and fed into a model-based controller. Thus, the actuator moves the object so that the user gets the impression that he had induced the movement. The new haptic display has been verified with a setup developed for the training of functional joint evaluation after knee injuries. Compared to classical approaches, this display is convenient to use, provides realistic tactile properties and can be partly adjusted to different system properties (e.g. pathological joint properties). This kind of new interface can be applied to many different medical applications, where the clinician directly touches human limbs or tissue, such as in obstetrics, reanimation, organ palpation, etc.
The Blue DRAGON - A System for Monitoring the Kinematics and the Dynamics of Endoscopic Tools in Minimally Invasive Surgery for Objective Laparoscopic Skill Assessment
Authors: Rosen Jacob  , Brown Jeffrey D.  , Barreca Marco  , Chang Lily  , Hannaford Blake  , Sinanan Mika
Published: February 2025

Minimally invasive surgery (MIS) involves a multi-dimensional series of tasks requiring a synthesis between visual information and the kinematics and dynamics of the surgical tools. Analysis of these sources of information is a key step in mastering MIS surgery but may also be used to define objective criteria for characterizing surgical performance. The BIueDRAGON is a new system for acquiring the kinematics and the dynamics of two endoscopic tools along with the visual view of the surgical scene. It includes two four-bar mechanisms equipped with position and force torque sensors for measuring the positions and the orientations (P/O) of two endoscopic tools along with the forces and torques applied by the surgeon’s hands. The methodology of decomposing the surgical task is based on a fully connected, finite-states (28 states) Markov model where each states corresponded to a fundamental tool/tissue interaction based on the tool kinematics and associated with unique FIT signatures. The experimental protocol included seven MIS tasks performed on an animal model (pig) by 30 surgeons at different levels of their residency training. Preliminary analysis of these data showed that major differences between residents at different skill levels were: (i) the types of tool/tissue interactions being used, (ii) the transitions between tool/tissue interactions being applied by each hand, (iii) time spent while performing each tool/tissue interaction, (iv) the overall completion time, and (v) the variable F/T magnitudes being applied by the subjects through the endoscopic tools. Systems like surgical robots or virtual reality simulators that inherently measure the kinematics and the dynamics of the surgical tool may benefit from inclusion of the proposed methodology for analysis of efficacy and objective evaluation of surgical skills during training
Engineering and Algorithm Design for an Image Processing API: A Technical Report on ITK - the Insight Toolkit
Authors: Yoo Terry S.  , Ackerman Michael J.  , Lorensen William E.  , Schroeder Will  , Chalana Vikram  , Aylward Stephen  , Metaxas Dimitris  , Whitaker Ross
Published: February 2025

We present the detailed planning and execution of the Insight Toolkit (ITK), an application programmers interface (API) for the segmentation and registration of medical image data. This public resource has been developed through the NLM Visible Human Project, and is in beta test as an open-source software offering under cost-free licensing. The toolkit concentrates on 3D medical data -segmentation and registration algorithms, multimodal and multiresolution capabilities, and portable platform independent support for Windows, Linux/Unix systems. This toolkit was built using current practices in software engineering. Specifically, we embraced the concept of generic programming during the development of these tools, working extensively with C++ templates and the freedom and flexibility they allow. Software development tools for distributed consortium-based code development have been created and are also publicly available. We discuss our assumptions, design decisions, and some lessons learned.
Computer-Controlled Motorized Endoscopic Grasper for In Vivo Measurement of Soft Tissue Biomechanical Characteristics
Authors: Brown Jeffrey D.  , Rosen Jacob  , Moreyra Manuel  , Sinanan Mika  , Hannaford Blake
Published: February 2025

Accurate biomechanical characteristics of tissues are essential for developing realistic virtual reality surgical simulators utilizing haptic devices. Surgical simulation technology has progressed rapidly but without a large database of soft tissue mechanical properties with which to incorporate. The device described here is a computer-controlled, motorized endoscopic grasper capable of applying surgically relevant levels of force to tissue in vivo and measuring the tissue's force-deformation properties.
Scoliosis and Cavus Foot. Is There a Relationship? Study in Referrals, with and without Scoliosis, from School Screening
Authors: Grivas Theodoros B.  , Stavlas Panagiotis  , Koukos Kostas  , Samelis Panagiotis  , Polyzois Basil
Published: February 2025

Background. The correlation of idiopathic scoliosis and cavus foot has been previously reported, [1], This has been ascribed to possible lesions related to muscular imbalance influenced by the central nervous system. The aim of this study is the assessment of this correlation.
CTM Brace Effect on Scoliotic Intervertebral Discs Using MRI Method
Authors: Perie D.  , Sales De Gauzy J.  , Sevely A.  , Hobatho M.C.
Published: February 2025

MRI has been clinically only used for investigation of intervertebral disc disorders. In this study, MR images were used and a new 3D modelling of the intervertebral discs was proposed.
A 3-D Parametric Biomechanical Skeleton Model for Posture and Spine Shape Analysis
Authors: D'Amico Moreno  , D'Amico Gabriele  , Roncoletta Piero
Published: February 2025

A project has been undertaken by our group to merge different segmental biomechanical models presented in literature into a full 3D parametric human skeleton representation, based on opto-electronic measurements. The obtained 3D skeleton model can then be fitted to each subject’s anthropometrical characteristics. The accuracy and precision of this model relies both on anatomical findings (cadaver dissections, in vivo measurements, and parametric regression equations) reported in literature and on the approach and signal processing procedures we largely described and discussed in previous papers. The aim of this work is to present and describe the above mentioned 3D parametric biomechanical skeleton model. This model and the related graphical software package have been developed as a clinical tool for diagnostic and therapeutic purposes, and they are currently used in different clinical centres.
In Vivo Quantitative Analysis of Scoliotic Vertebrae
Authors: Perie D.  , Sales De Gauzy J.  , Baunin C.  , Hobatho M.C.
Published: February 2025

An in vivo method based on CT images and finite element meshing had been developed to quantify and visualize the bone density distribution of scoliotic vertebrae. CT examination (axial acquisition of the apical, superior and inferior adjacent vertebral bodies) had been performed on seven girls presenting an idiopathic scoliosis. Using an in-house image processing software and the pre-post processor Patran, a surfacic finite element mesh of each body slice was proposed allowing an automatic mapping of the cancellous bone slices and a volumic mesh for the bone density distribution visualization. In the coronal plane, compared to the body geometrical centre, the body mechanical centre was shifted forward in the concavity of the curvature for six patients and in the convexity for one patient. For each patient, this shift forward was made in a same way for the three vertebrae. In the sagittal plane, the body mechanical inertia centre was shifted forward in the posterior side for 12 vertebrae, in the anterior side for 3 vertebrae and was not shifted forward for 6 vertebrae. This shift forward was made in the anterior side for the inferior adjacent vertebra. The shift forward by slice was made in a same way for each slice, excepted at the end plates. Besides, one can observe that the scoliotic deformation evolution seemed to modify the mechanical property distribution. The results may also suggest predictive criteria of evolution of the scoliotic deformities.
Generic Data Modelling and Use of XML Standard for Home Telemonitoring of Chronically I11 Patients
Authors: Di Giacomo Paola  , Ricci Fabrizio L.
Published: February 2025

In recent years, internet-based home telemonitoring systems that allow transmission of patient data to a central database and offer immediate access to the data by the care providers have become available. The adoption of Extensible Mark-up Language (XML) as a W3C standard has generated a lot of interest in the potential value of this language in health informatics. However the telemonitoring systems often work with only one or a few types of medical devices and thus are limited in the types of diseases they can monitor. This is because different medical devices produce different types of data and the existing telemonitoring systems are generally built around a proprietary data schema specific for the device used. In this paper, we describe a generic data schema for a telemonitoring system that is applicable to different types of medical devices and different diseases, and then we present an architecture for the exchange of clinical information as data, signals of telemonitoring and clinical reports in the XML standard, up-to-date information in each electronic patient record and integration in real time with the information collected during the telemonitoring activities in the XML schema, between all the structures involved in the health care process of the patient.
Using a model of the colour content in retinal fundus images to screen for sight threatening diabetic retinopathy
Authors: Ege Bernhard M.  , Bek Toke  , Larsen Ole V.  , Hejlesen Ole K.
Published: February 2025

The aim of the study was to assess the potential use of a model of the colour content in retinal fundus images to screen for sight threatening retinopathy in diabetes. Diabetic retinopathy is the most frequent cause of blindness in the population of working age in industrialised countries, but efficient therapies do exist, and accurate and early diagnosis, and correct treatment can prevent blindness in more than 50% of all cases. However, up to 50% of cases of type 2 diabetes, which comprises 85-90% of all patients, are undiagnosed, with an average delay of 10 years between the onset of the condition and diagnosis. In an other study we have described how there is a linear relation between age and the colour composition of retinal images from non-diabetic subjects. In the present study this relation was compared to the colour composition of retinal images from diabetes patients. We found that for the patients in the present study there is a significant difference in the colour composition between normal subjects and diabetic subjects with retinopathy. Although the number of patients in our study is too small to allow any conclusion, we suggest that this difference potentially may be used as the basis for a simple screening method for sight threatening retinopathy in unrecognised diabetes, or potentially may help estimating the risk of developing diabetic late complications in newly diagnosed type 2 diabetes.
Optimizing Coding Quality: The Role of the Electronic Medical Record in the Context of Diagnosis Related Groups
Authors: Müller M.L.  , Bürkle T.  , Irps S.  , Roeder N.  , Prokosch H.U.
Published: February 2025

In 2003, a new prospective payment system will be introduced in Germany, which is based on the Australian Refined Diagnosis related Groups (AR-DRGs). Physicians must code diagnoses and procedures themselves. Inaccurately or incompletely coded patient records can result in considerable underpayment, so enhancing physicians' coding compliance and competence seems crucial. Coding shall be well integrated in the electronic patient record, providing a simple interface with background information, which is invoked out of the clinical documentation. This paper describes an existing implementation and possible further development.
Automatic detection of clustered microcalcifications in digital mammograms
Authors: Halkiotis Stelios  , Mantas John
Published: February 2025

In this paper we propose a new algorithm for the detection of clustered microcalcifications using mathematical morphology and artificial neural networks. Considering each mammogram as a topographic representation, each microcalcification appears as elevation constituting a regional maxima. Morphological filters are applied, in order to remove noise and regional maxima that doesn't correspond to calcifications. Each suspicious object is marked using a binary image and finally a feed forward neural network classifies every object achieving a rate of 90% true positive detections with 0.11 false positives per image.
Interoperable Computerized Smart Card Based System for Health Insurance and Health Services Applied in Cardiology
Authors: Cocei Horia-Delatebea  , Stefan Livia  , Dobre loana  , Croitoriu Mihai  , Sinescu Crina  , Ovricenco Eduard
Published: February 2025

In 1999 Romania started its health care reform by promulgating the Health Insurance Law. A functional and efficient health care system needs procedures for monitoring and evaluation of the medical services, communication between different service providers and entities involved in the system, integration and availability of the information. The final goal is a good response to the needs and demands of the patients and of the real life.
A New Kernel Method for Microcalcification Detection: Spin Glass-Markov Random Fields
Authors: Caputo B.  , La Torre E.  , Bouattour S.  , Gigante G.E.
Published: February 2025

Mammography associated with clinical breast examination is the only effective method for mass breast screening. Microcalcifications are one of the primary signs for early detection of breast cancer. In this paper 1 we propose a new kernel method for classification of difficult-to-diagnose regions in mammographic images. It consists of a novel class of Markov Random Fields, using techniques developed within the context of statistical mechanics. This method is used for the classification of positive Region of Interest (ROI's) containing clustered microcalcifications and negative ROI's containing normal tissue. The obtained results show that the proposed approach can be successfully employed for detection of microcalcifications.
Nearest Neighbour Classification of Otoneurological Data
Authors: Viikki Kati  , Tapani Matti  , Juhola Martti  , Pyykkö Ilmari
Published: February 2025

We studied the nearest neighbour classification of patient cases with benign positional vertigo, Meniere's disease, sudden deafness, traumatic vertigo, vestibular neuritis, and vestibular schwannoma. The classification results were compared to the inference results obtained by an otoneurological expert system ONE whose inference mechanism somewhat resembles the classical nearest neighbour method. With respect to the predictive accuracy, the classification results of these two systems agreed. The best predictive accuracy for the expert system ONE was 79.7% and for the nearest neighbour method 80.5%. However, differences in the true positive rates for sudden deafness, traumatic vertigo, vestibular neuritis, and vestibular schwannoma were found. The nearest neighbour classification results will be used in the refinement of ONE's knowledge base.
Remodeling of Legacy Systems in Health Care using UML
Authors: Garde Sebastian  , Knaup Petra  , Herold Ralf
Published: February 2025

Research projects in the field of Medical Informatics often involve the development of application systems. Usually they are developed over a longer period of time, so that at a certain point of time a systematically planned reimplementation is necessary. The first step of reimplementation should be a systematic and comprehensive remodeling. When using UML for this task a systematic approach for remodeling activities is missing. Therefore, we developed a method for remodeling of legacy systems (Qumquad) and applied it to DOSPO, a documentation and therapy planning system for pediatric oncology. Qumquad helps to systematically carry out three steps: the modeling of the current actual state of the application system, the systematic identification of weak points and the development of a target concept for reimplementation considering the identified weak points. Results show that this approach is valuable and feasible and could be applied to various application systems in health care.
Design considerations for an Ontology in the domain of Organ Failure and Transplantation
Authors: Jacquelinet Christian  , Burgun Anita  , Delamarre Denis  , Strang Nigel  , Boutin Bernard  , Le Beux Pierre
Published: February 2025

The Etablissement francais des Greffes (EfG) is a national agency dealing with Public Health issues related to organ, tissue and cell transplantation in France. The evaluation of organ retrieval and transplantation activities, one of its missions, is supported by a national information system (IS). In order to facilitate data recording, to improve the quality of information and to prepare semantic interoperability with other information systems, the existing thesaurus of the EfG was audited, leading to the design a new terminological module devoted to the support of the domain ontology.
The integration environment of the hospitals of H:S in Copenhagen
Authors: Ferrara Fabrizio Massimo  , Endsleff Frederick  , Olsen Asger Søndergård  , Sottile Pier Angelo  , Thomsen Johannes
Published: February 2025

This paper highlights the scenario implemented by the hospitals of the Copenhagen Hospital Corporation (H:S), for allowing the integration and interoperability of legacy and new systems, based on the establishing of a common and open information asset according to the CEN HISA standard and on top of the DHE middleware.
Enhancing a medical e-learning environment: The adaptive DI$^{\2}@$DEM approach
Authors: Pagesy Rolly  , Soula Gérard  , Fieschi Marius
Published: February 2025

Current medical e-learning tools suffer from a variability of student user. Students are different in terms of motivations, training backgrounds, technical skills and learning objectives. It is obvious that these students do not accede relevant information if their educational resources access is misadapted. Adaptive environments propose to take the user into account in order to provide him or her with the most relevant educational resources. We present the adaptive DP2ADEM approach, which enhances the MEDIDACTE e-leaming environment of the Faculty of Medicine in Marseille. DI2ADEM objective is to select the most relevant information and offer it to the user in an adaptive manner. Adaptability is based on management of knowledge regarding both the user and resources distributed. A match is made between student's profile and knowledge of resources organization and semantics.
Using ICNP for Nurse Electronic Charts and Protocols in Rehabilitation Divisions
Authors: Rognoni Carla  , Mazzoleni M. Cristina  , Quaglini Silvana  , Kumar Anand  , Nicola Laura  , Santoro Carmen
Published: February 2025

The aim of this work is to promote the use of standard terminology for nursing documentation and for nurse protocols’ description. We implemented an ICNP browser and we integrated it into two different systems: the nursing electronic patient record and the nursing protocols editor. The former allows nurses to choose ICNP terms for filling the clinical chart, while the latter allows computerising protocols using ICNP terms for the actions specification. Since, in a nursing information system, it should be worth to integrate protocols with the electronic patient record, sharing the same terminology is a crucial issue. We also show how we tailored the information system to the different wards. For each ward, we devised the most frequent patient needs and nursing actions. These lists are used to customise the different interfaces. Finally, by testing the prototype using real-world documents (clinical charts and protocols), we carried out an evaluation of the terminology itself, about its completeness and usability.
A Framework for a Diabetes Mellitus Disease Management System in Southern Israel
Authors: Fox Matthew A.  , Harman-Boehm Ilana  , Weitzman Shimon  , Zelingher Julian
Published: February 2025

Chronic diseases are a significant burden on western healthcare systems and national economies. It has been suggested that automated disease management for chronic disease, like diabetes mellitus (DM), improves the quality of care and reduces inappropriate utilization of diagnostic and therapeutic measures. We have designed a comprehensive DM Disease Management system for the Negev region in southern Israel. This system takes advantage of currently used clinical and administrative information systems. Algorithms for DM disease management have been created based on existing and accepted Israeli guidelines. All data fields and tables in the source information systems have been analyzed, and interfaces for periodic data loads from these systems have been specified. Based on this data, four subsets of decision support algorithms have been developed. The system generates alerts in these domains to multiple end users. We plan to use the products of this information system analysis and disease management specification in the actual development process of such a system shortly.
The effects of exposure to intense, 24 h light on the development of scoliosis in young chickens
Authors: Nette Farrell  , Dolynchuk Kim  , Wang Xiaoping  , Daniel Ariadne  , Demianczuk Christina  , Moreau Marc  , Raso James  , Mahood James  , Bagnall Keith
Published: February 2025

The aetiology of adolescent 5coliosis remains unknown and hindering research is the absence of an appropriate animal model. It is now well-established that pinealectomy in young chickens results in the development of scoliosis that has many of the characteristics seen in patients with adolescent idiopathic scoliosis but the mechanism underlying this phenomenon remains elusive. The principle product of the pineal gland is melatonin and so many studies have focused on studying the effects of reduced levels of this hormone. The results have been mixed and the role of melatonin remains un~ear. As melatonin production is inhibited by light, it was hypothesised that providing the chickens with an environment consisting of intense, continuous light would reduce serum melatonin levels and avoid any of the potential artifacts involved with the pinealectomy surgery. Consequently, pinealectomised and normal chickens were exposed to very intense light for complete 24 h in each day. At the end of 22 days in this environment serum melatonin levels had been reduced to very low levels in all chickens. Most importantly, 15% of the normal chickens had developed scoliosis and the number of pinealectomised chickens that developed scoliosis increased from 50% to 80%. The results showed that a method for reducing serum melatonin without pinealectomy has been established and which can be used in further experiments. Furthermore, the results also showed that reduced levels of serum melatonin has significant effects on the development of scoliosis. The indication is that there is a threshold level of serum melatonin below which scoliosis may develop probably in conjunction with some other factor which has yet to be identified.
The NOTOM Hypothesis for Idiopathic Scoliosis: Is it Nullified by the Delayed Puberty of Female Rhythmic Gymnasts and Ballet Dancers with Scoliosis?
Authors: Burwell R G  , Dangerfield P H
Published: February 2025

Nachemson [3] suggested that there are more girls than boys with progressive adolescent idiopathic because of a different timing between skeletal maturation and postural maturation in the sexes during adolescence. We termed Nachemson’s concept the neuro-osseous timing of maturation (NOTOM) hypothesis and used it to propose a possible medical treatment for idiopathic scoliosis by delaying puberty through the pituitary using gonadorelin analogues as in idiopathic precocious puberty [1,2].
Scoliosis Study Using Finite Element models
Authors: Aubin Carl-Éric
Published: February 2025

Finite element models have been used for many years to study scoliosis biomechanics. This paper presents some of the work done in our institution over the last decade in this area. It covers the simulations of scoliosis treatment (orthotics, surgical instrumentation), muscle and control, as well as the growth process. The models presented in this paper are of clinical interest because they have the capacity to simulate an unlimited number of variables to investigate scoliosis biomechanics. Current developments are directed toward the integration and validation of specific models (muscle, control, and growth modeling) into a unified refined model of the trunk, thus allowing a more complete understanding of scoliotic spine pathomechanicsms, as well as to predict in advance what would be the resulting shape of the spine in response to the application of a treatment.
The Role of Muscles and Effects of Load on Growth
Authors: Stokes Ian  , Gardner-Morse Mack
Published: February 2025

If mechanical modulation of growth explains progression of scoliosis during adolescent growth, two elements of the ‘vicious cycle’ must be quantified. Firstly we must identify the magnitude of the asymmetrical loading imposed on the spine as a function of the scoliosis curve magnitude. Secondly, we must characterize the growth response of vertebrae and remodeling response of discs to this asymmetrical loading. Animal models are helpful to quantify the former, and extrapolation to the human spine should be possible once the parameters that influence the growth modulation response have been identified. Direct measurement of spinal loading is not currently feasible, so analytical modeling to estimate plausible loading states is required. Our simulations using a model that represents the lumbar spinal musculature and a spine with increasing degrees of spinal curvature suggests that there is a range of muscle activation strategies that may predispose to progression by the ‘vicious cycle’ mechanism, but other strategies can load the spine uniformly, or even reverse the asymmetrical loading that would lead to progressive deformity. However, the latter strategies have a physiological ‘cost’ associated with increased muscle stress and increased spinal loading.
Spinal Surgery Procedure Discretization
Authors: Verniest F.  , Chopin D.  , Godillon-Maquinghen A-P.  , Drazetic P.  , Aubin C-É  , Lepoutre F-X.
Published: February 2025

In the last decades, scientists developed analytic models of spinal surgery to assess surgical choices and instrumentation parameters. They noted the difficulty to represent the boundary conditions on their deterministic models and recognize the lack of knowledge in surgical procedures. This paper presents a formalization technique applied to spinal surgery to improve the formulation of biomechanical models. This technique consisted into two steps: knowledge extraction and knowledge representation. The protocol was established with an expert surgeon using Colorado2 instrumentation. Surgeon's knowledge acquisition has permitted to define eleven detailed independent data cards for the different steps of surgery like hook or screw insertion, rod installation, etc... The behaviour of the concerned elements on its neighbouring entity were specified using three matrices. The link between surgery and modelling becomes easier and permits to better define the boundary conditions on each entity during the simulation.
School Screening in the heavily industrialized area
Authors: Grivas TB  , Samelis P  , Polyzois BD  , Giourelis B  , Polyzois D
Published: February 2025

Introduction: School-screening programs contributed greatly to the study of idiopathic scoliosis (IS) prevalence. A similar program confined to a highly industrialized area is being performed in our Department. Thus the comparison of the findings of IS prevalence of this program with those of programs performed in non-industrialized areas of the same country could imply the significance of special industrial environmental factors on IS aetiology.
Biomechanical factors affecting progression of structural scoliotic curves of the spine
Authors: Lupparelli S.  , Pola E.  , Pitta L.  , Mazza O.  , Aulisa L.
Published: February 2025

The development of the spine is affected by both biological and mechanical factors. As the geometry of the motion segment changes throughout growth, so does the mechanical behaviour of the spine owing to changing vectors acting on a variable geometry system.
Telecommunications Model for Continuing Education of Health Professionals: The Royal Brompton Case
Authors: Kotis Takis
Published: February 2025

Telemedicine is said to be helpful to both patients and providers, but we need real-world examples to demonstrate its effectiveness. This paper presents such an example. Royal Brompton, under the Tele-remedy Program of EC Telecom, conducted a project with the Children’s Hospital of Athens, Greece, to provide remote diagnosis management and continuing education for heart disease, using European ISDN technology. Preliminary results showed that, when carried out in a large scale multi-site environment, Teleremedy program significantly reduced geographic and socio-economic isolation for the patient and the professional isolation for the physician. Comparison of original vs. transmitted data revealed no significant differences, with diagnosis accuracy of 100%.
Business Models for Health Care Decision Support
Authors: Gaughan Phil
Published: February 2025

CareScience™, Inc. is a public company (NASDAQ: CARE) that originated ten years ago to commercialize risk adjustment and complication predictions developed by the Wharton School of Business and the University of Pennsylvania School of Medicine. Over the past decade, the company has grown to approximately 200 clients and 150 employees. Among the “firsts” recorded by the company, CareScience was the first to offer a clinical decision support system as an Application Service Provider (ASP), the first to offer peer-to-peer clinical data sharing among health care provider organizations and practitioners (Santa Barbara Care Data Exchange), and the first to provide a care management outsourcing arrangement.