bluuebunny/crossref_metadata_2025 huggingface dataset:
MEDICA - 9 years of Development and Use of a Clinical Information System in the University Hospital of Endocrinology and Gerontology - Sofia
Authors: Tcharaktchiev Dimitar  , Dimitrov Anton  , Dimov George  , Tzonov Petar  , Bajkushev Bojidar  , Kirov Vladimir  , Georgiev Borislav
Published: February 2025

The project of the Hospital Information System (HIS) in the University Hospital of Endocrinology and Gerontology was designed in 1987. The HIS is organised in modules. The first modules, operational in the end of 1987 represent the core of necessary functions and make possible registration of administrative data, clinical data in the wards, management of the laboratory results ordering and reporting. After that we have designed the modules for radiology, management of the consultations, centre for hemodialyse, pharmacy, dietology, the functions for clinical audit, research and education, management of the hospital. The object oriented method is implemented. There are subsystems for management of the patient’s records and the ressources. The patient is the centre of the integration of all clinical and administrative data. The ICD-9-CM classification is used for the codification of diagnoses and procedures. There are possibilities to extract the medical Minimum Basic Data Set for analyses and comparisons. This approach have a possibility to: validate alternative treatment regimes, based upon common diagnostic and therapeutic criteria (Protocols); construct cost models of alternative service processes; implement new standards of documentation and communication. The new documentation and messages conforming the rules of EDIFACT are created. We have intention to improve the interface and the performence of the system introducing the new multimedia modules.
A Method to Define and Design Tools for Hypermedia Medical Reports Management
Authors: Consorti F.  , di Prospero J.  , Merialdo P.  , Sindoni G.
Published: February 2025

In this paper methods and tools for assisting physicians in creating and organizing large collections of hypermedia reports arc described. A method to automatically create a hypermedia network representing a collection of reports is defined. The design of a hypermedia report management system has been based on these concepts, and the methods, architecture and features of the system are illustrated. The medical report is modeled as a hypermedia structured document. In order to improve report compiling and reading facilities, graphical models libraries of the investigated anatomical structures are integrated in the hypermedia environment. In the system, the report collection is a hypermedia network offering an interesting approach to multimedia documents access.
PROforma: A Method And Language For Specifying Clinical Guidelines And Protocols
Authors: Fox John  , Johns Nicky  , Rahmanzadeh Ali  , Thomson Richard
Published: February 2025

The need for flexible and well understood knowledge representations which are capable of capturing clinical guidelines and protocols for decision support systems is widely recognised. PROforma is a method for specifying clinical guidelines and protocols in a form which can be executed by a computer to support the management of medical procedures and clinical decision making. The PROforma method comprises a graphical notation for designing protocols and a formal knowledge representation language to enable clinical concepts to be interpreted by a computer. This paper provides an overview of the motivation, structure and use of PROforma in developing computerised clinical guidelines.
Using a Diabetes Advisory System to evaluate a patient-led system of semi-quantitative dietary assessment
Authors: Meeking D.R.  , Hejlesen O.K.  , Metcalfe J.  , Andreassen S.  , Hovorka R.  , Cavan D.A.
Published: February 2025

This paper describes how the Diabetes Advisory System (DIAS) was used to assess the reliability of a novel form of individualised dietary carbohydrate assessment. DIAS is based on a mathematical model of the carbohydrate metabolism and can be used to estimate blood glucose profiles and to provide decision support for the adjustment of insulin regimen in patients with insulin-dependent diabetes. In order to generate appropriate insulin dose advice, details on blood sugar values, insulin dosages and dietary carbohydrate intake are collected from the patient for a period of several days. This paper proposes a new system of dietary assessment which is individualised to each patient and to each meal type (breakfast, lunch, evening meal and snack). This is simple for the patient to use and merely involves a decision as to whether a meal is large, small or of a standard size. By inputting this adjusted carbohydrate data into DIAS and comparing the insulin dose advice to that generated using exact carbohydrate data, we were able to show that our simple dietary system is able to provide reliable information on carbohydrate consumption which can be used to generate similar insulin dose advice. This paper also discusses improvements which can be made to increase accuracy in dietary data collection in the future.
AntibiosIS: An Information System Supporting Antibiotic Prescription
Authors: Gogou G.  , Ambrosiadou V.  , Goulis D.  , Maglaveras N.  , Pappas C.
Published: February 2025

AntibiosIS is an information system based on a data management system architecture and implemented on the Windows environment for personal computers and the DELPHI language. The system incorporates two models. These are first, a patient model including clinical information (diagnosis). Second, an antibiotic drug model incorporating features such as indications, contraindications, adverse reactions, interactions, possible combinations with other antibiotics and others. It is shown how the system AntibiosIS facilitates therapy planning by providing support both in empirical and etiologic therapy and whenever necessary, it gives explanations with respect to the suggested antibiotic therapy. AntibiosIS is demonstrated in clinical decision situations of antibiotic prescription.
Synapses -Federated Healthcare Record Server
Authors: Grimson Jane  , Grimson William  , Hurlen Petter  , Ingram David  , Milan Jo  , Osseyran Anwar  , Wilson Michael
Published: February 2025

This paper presents an overview of the Synapses Project, funded under the EU Health Telematics Framework IV Programme. Synapses sets out to solve problems of sharing data between autonomous information systems, by providing generic and open means to combine healthcare records or dossiers consistently, simply, comprehensibly and securely, whether the data passes within a single healthcare institution or between institutions. The approach to be taken in Synapses is to build as far as possible on existing results in both technology and standards. The fundamental enabling technologies for Synapses are open distributed computing, object orientation, browsing, information filtering, multimedia, security mediation and telecommunications. The project plans to bring them together, apply them to healthcare, and produce demonstrations validating the approach. The result will be in the public domain in the form of a set of specifications and guidelines.
Health Information Services Using VEMMI Technology
Authors: Alcolea Antonio  , Gómez Enrique J.  , del Pozo Francisco  , Quiles José A.
Published: February 2025

This paper introduces the use of VEMMI technology for developing Health Information Services, which can become a promising telematic environment, when applied to an adequate communication platform,. VEMMI Technology is a multimedia object-oriented client-server syntax that assures a full control of processes and user iteractions at the user terminal. A VEMMI terminal over ISDN videotex has been implemented achieving a low cost, efficient, user friendly and safety window-oriented multimodal interface to browse multimedia information services. To evaluate the performance, a Health Information Service has been developed where high interactivity and multimedia data are supported. ISDN VEMMI technology has been shown a very powerful solution to develop telematic environments for Health Information Services.
An Asynchronous Cooperative Model for Coordinating Medical Unit Activities
Authors: Yousfi F.  , Beuscart R.  , Souf N.
Published: February 2025

CSCW is devoted to the analysis of interactions among humans when performing together their work [2]. The main application fields are work organization, healthcare, education and training. Our main goal is to study the cooperative models allowing task coordination and conflict management between actors within a distributed environment, in particular medical units. We do not aim to produce a practical system suitable for near-term deployment in the Intensive Care Units (ICU), but rather an experimental system that performs and coordinates a range of intelligent planning tasks in ICU activities. The emphasis will be put especially on asynchronous cooperation. We apply the Workflow approach to ICU organization through the analysis and propose of a cooperative model.
Problems with Nursing Information Systems: are there Solutions?
Authors: Goossen William T.F.  , Epping Paul J.M.M.  , Abraham Ivo L.  , Dassen Theo W.N.  , Hasman Arie
Published: February 2025

The use of information systems in health care is widespread in the Netherlands, and nurses are confronted with these systems on many sites and occasions. However, the computerised support of the nursing process - the core of nursing care delivering activities - is limited to a few sites. This situation calls for an analysis of the problems that exist in the development and use of Nursing Information Systems (NISs). Possible solutions are suggested for an adequate use of information systems by Dutch nurses. A reference model for a proper course of action in the development and use of NISs is proposed.
Novel kinetic quantification of HIV-1 p24 antigen with an extended range
Authors: Giacomini Mauro  , Ruggiero Carmelina  , Lillo Flavia  , McDermott Jennifer  , Varnier Oliviero E.
Published: February 2025

Colorimetric methodology using enzyme activity as a quantitative label has been applied to a variety of easy, standardised and highly sensitive tests. In the p24 antigen assay - the only inexpensive quantitative test for monitoring AIDS patients - the p24 antigen levels exceed the upper limit of the assay in more than 30% of the cases. An automatic management software is presented, which allows to extend this range. This software is meant to be used very easily by laboratory technicians and produces output reports to be used directly by physicians treating AIDS patients. The dynamic range achieved is 4 linearity logs, whereas the kits on the market reach only 2 linearity logs.
Nonlinearity and Nonstationarity: The Use of Surrogate Data in Interpreting Fluctuations
Authors: Kaplan Daniel T.
Published: February 2025

“Surrogate data” is the basis for a technique for testing a time series for nonlinear dynamics and process nonstationarities. The theory behind surrogate data is briefly described, along with an algorithm for generating it. Examples are given of its use in detecting nonlinearity in heart rate signals, detecting non-stationarity, and estimating the sampling distribution of complicated statistics of heart rate variability.
Educational Applications
Authors: Pérez Rogelio Segovia  , Hasman Arie
Published: February 2025

Before plunging into the subject of telematics and its possible applications to education in the health sector, it is best to meditate on the use of internet and telematics for education in general, thus applying all the experience already gathered on this subject to the health sector in a more effective manner.
Virtual Reality and Minimally Invasive Techniques
Authors: Satava Richard M.  , Nord Michael E.  , Marescaux Jacques F.  , Christensen Jens P.
Published: February 2025

Virtual Reality (VR) Techniques and Multimedia Telematics are rapidly changing health care and medicine by their ability to represent the real world in bits and bytes, and present this “reality” without geographical barriers in an adequate way to the health professional. There are infinite possibilities and uses of thse techniques in medicine and one of the prime areas is minimally invasive techniques including surgery. To master the techniques education and training are needed. The new information technology is in itself a strong tool for this purpose.
Health Information Systems in an Environment of Change
Authors: Rodrigues Roberto J.
Published: February 2025

The social areas, and especially the health sector, have suffered a major impact as result of the profound social and political changes of the last decades, the ongoing process of economic globalization and interdependence, and the harsh realities of structural readjustment taking place practically in all societies.
The Rib Vertebral Angle Asymmetry in Idiopathic, Neuromuscular and Experimentally Induced Scoliosis
Authors: Sevastik B.  , Xiong B.  , Sevastik J.  , Lindgren U.  , Willers U.
Published: February 2025

The concave and convex rib-vertebral angles (RVA) at levels T2 to T12 were measured on AP radiographs of 19 patients with right convex idiopathic thoracic scoliosis, and of ten patients with major thoracic right convex neuromuscular scoliosis. The difference between the angles of the concave and the convex sides, the RVAD, was calculated. The RVA:s were also measured on radiographs from three animal groups where spinal curves had been induced experimentally: in group I, by selective electrostimulation of a) the latissimus dorsi, b) the erector spinae and c) the intercostal muscles, in 16 rabbits; in group II, by manual bending of the spine of four dead rabbits; and in group III by mechanical elongation of one rib in eight rabbits. In both the idiopathic and the neuromuscular groups, the convex RVA was smaller than the concave RVA between levels T2 and T8, with a maximal difference between T4 to T5. From T9 to T12 the concave RVA was smaller than the convex. With increasing Cobb angle the RVAD:s increased linearly with the greatest difference at the second vertebra above the apex. In the experimental groups the pattern of the RVAD:s between T6 to T12 was similar to the findings of the clinical study. The typical pattern of the RVA:s of the concave and convex side seems to be independent of the underlying cause of the spinal curvature.
3-D Study of Scoliotic Compensation by Comparison of Spinal Deformities to Rib Cage Deformities
Authors: Dansereau J.  , Labelle H.  , de Guise J.A.  , Bellefleur C.
Published: February 2025

Based on the 3-D stereoradiographic reconstruction of the spine and rib cage, a new method was developed to obtain the centroid curve of the rib cage to compare its shape to the curvilinear representation of the spinal deformity and evaluate the “compensation-decompensation” phenomenon associated to scoliosis deformity. Evaluation on a cohort of 108 idiopathic scoliotic adolescents shows that the rib cage offset is similar or greater than the spinal offset in 63% of cases even if Cobb angle measurements are significantly smaller and in the same direction for the rib cage centroid curves than for the spinal curves. These results indicate that the rib cage is not a stabiliser of the scoliotic curve and may in fact tend to aggravate decompensation of the spine.
Mechanical Properties and Predictive Relationships of the Lumbar Spine
Authors: Hobatho M.C.  , Young Rho J.  , Ashman R.B.
Published: February 2025

The objectives of the study were to investigate mechanical properties function of its anatomical location, its degree of inhomogeneity and anisotropy. An atlas was obtained presenting range of values and predictive relationships between mechanical properties. A total of 120 cubic specimens were obtained from eight cadaveric specimens of human lumbar spine. Transmission ultrasonic technique was used to assess elastic modulus of spongious bone in the three directions [1]. Apparent densities, CT number were also measured. Multi analysis of variance showed significant variation of the mechanical properties within subjects and its anatomical position (p<0.05). Mechanical properties were found to be lower at the anterior side for L1 to L4 (p<0.05). They were found to be the lowest and the highest for L1 and L5 respectively (p<0.05). The degree of anisotropy showed that the spongious bone of the lumbar spine should be described as an orthotropic material. General linear model analysis showed that linear predictive relationships were found to be sufficient to describe the mechanical behavior. These results demonstrated the inhomogeneity and anisotropy of the lumbar spine. Consequently, these informations should be considered in the comprehension of spinal deformities and finite element modelization by using adequate predictors.
Biomechanical Study of the Lumbar Spondylolysis Using a Three-Dimensional Finite Element Model and 3D-CT Images
Authors: Tajima N.  , Totoribe K.  , Chosa E.
Published: February 2025

Biomechanical characteristics of the interarticular portion of the lumbar vertebra were investigated using a three-dimensional finite element method. Stress distribution results indicate that there were high stresses in the pars interarticularis, especially the ventral cortical bone of it, and the anterior shear force had an increasing effect on the magnitude of the stress in the pars interarticularis. 3D-CT is helpful in understanding the complex anatomy such as the spine. The results of finite-element studies and 3D-CT were in good agreement with each other. It is suggested that the stress on the interarticular portion of lumbar vertebra is an important factor in the etiology of spondylolysis.
Volumetric Evaluation of Normal and Scoliotic Vertebral Bodies. A Methodological Study
Authors: Diabi K.  , Ollmar S.  , Sevastik J.  , Svensson A.
Published: February 2025

A new method for evaluation of the volume of the vertebral body in vivo is presented. The height of the vertebral body is measured at three standardised points on one AP radiograph and at another two points on one lateral radiograph. Moreover, the area of the body is measured using a special grid superimposed on one CT-scan from the middle of the vertebra. The volume of the vertebra is calculated using Cavalieri's formula for irregular objects : V = Δa × H, where V is the volume of the vertebral body, Δa is the mean surface area on the CT-scan and H is the mean of the heights at the five points on the radiographs. Using this formula the volume of one normal and one scoliotic vertebra was evaluated and the obtained values were compared with the values derived from serial CT-scans of the vertebrae. The results showed that the volume of the normal vertebra estimated with this method was 15.9 cm3and with serial CT-scans using the same grid was 15.07 cm3. For the scoliotic vertebra the values were 17.6 and 17.3 cm3respectively. The degree of accuracy of the measurements with the presented method as compared with the serial CT-method was 95% for the normal and 98.5% for the scoliotic vertebra. It is concluded that the proposed method can easily be applied with satisfactory accuracy for in vivo longitudinal studies of the volume of the vertebral body on available radiographs and CT-scans.
3-D Personalized Geometrical Reconstruction and Modelling of the Pelvis for Scoliotic Deformity Studies
Authors: Gauvin C.  , Dansereau J.  , de Guise J.A  , Aubin C.-É.  , Labelle H.
Published: February 2025

In order to study biomechanical aspects of scoliotic deformities, modelling of the pelvis is essential since it is the base of the spine. Personalized and simplified 3-D geometry of the pelvis is obtained by digitizing 16 anatomical landmarks on PA and lateral X-rays of scoliotic patients and by reconstructing them in 3-D using the DLT method. The geometrical modelling consists in the kriging deformation of a referential pelvis obtained by serial CT-scan in order to fit it adequately on the 16 reconstructed pelvic landmarks. The first validation method of the model was performed on 11 patients. It consists in the retroprojection of the modelled landmarks on X-ray planes by applying the DLT algorithm in an inverse way and by comparing them with the digitized landmarks. The second validation method consists in measuring a dry pelvis specimen with a computer measuring machine and in comparing the measured and the modelled landmarks. The retroprojection errors of modelled anatomical landmarks for the patients and the differences between the measured and the modelled landmarks for the dry pelvis were approximately 3 mm for the best anatomical landmarks and 10 mm at worst. This adequate geometrical model of the pelvis will be useful to make clinical measurements of its orientation in space and can now be integrated in a biomechanical model of the spine and rib cage to simulate more realistically the biomechanical behaviour of the whole scoliotic trunk.
Clinical Analysis of Coupling Mechanisms Between the Scoliotic Spine and Rib Cage Involved in Orthotic Treatments
Authors: Aubin C.-É.  , Dansereau J.  , de Guise J.A.  , Labelle H.
Published: February 2025

The aim of this study was to investigate the coupled movements between the scoliotic spine and rib cage initiated by wearing the Boston brace. The 3 D reconstructions of the spine and rib cage were obtained using a stereo-radiographic technique in a cohort of 36 idiopathic scoliotic adolescents presenting a right thoracic curve (34°±9°), with and without their Boston brace. Several clinical and geometrical indices were evaluated on the trunk, and the differences resulting from brace application were compared. It was found that rib cage translations imposed by the brace are linearly transmitted to the spine (r=0.88 in frontal plane & r=0.65 in sagittal plane). However, coupled movements between the spine and rib cage were found to produce a significant effect on the correction of the trunk. In particular, substantial anterior displacements of the thorax were observed and were associated with lateral shifts of the thoracic spine toward its convexity (r=0.41) and also with an aggravation of spinal curvatures in the frontal and sagittal planes (−10°±13°). There was no significant correlation between the correction of the rib hump rotation and axial derotation of the apical vertebra. It appears that brace loads are not applied in an optimal way to correct the 3-D deformities associated with thoracic scoliosis. It is supposed that brace loads on the rib hump produce too much anterior forces. Thus, it is recommanded to re-equilibrate loads applied on the posterior rib hump in order to reduce trunk anterior shift and its associated coupled displacements in the frontal plane.
Modified PLL Method for Fringe Pattern Demodulation
Authors: Kozlowski J.  , Serra G.
Published: February 2025

The modified phase locked loop (PLL) technique was applied to human body shape determination. The analysis of two-dimensional carrier-frequency fringe pattern was based on two images with projected grating shifted in phase by half of the period. The obtained standard deviation of results was smaller than 1%, with only two iterations. Due to the properties of PLL technique there was no problem with phase unwrapping and a very short time of calculation was needed. The technique was applied with dedicated medical software for spinal deformities analysis.
A Preliminary Study of a New Real-Time Ultrasound Method for Measuring Rib Rotation and Spinal Rotation in Scoliosis
Authors: Kirby A.S.  , Aujla R.K.  , Burwell R.G.  , Cole A.A.  , Moulton A.  , Polak F.J.  , Webb J.K.
Published: February 2025

Static B-mode ultrasound measurement of rib rotation has been shown to be a better predictor of vertebral rotation than any of our current surface methods for estimating the size of back humps in patients with scoliosis [3]. The temporary availability of an Aloka SSD 500 portable ultrasound machine with a 3.5 MHz wide field of view (172mm) linear array transducer provided the opportunity for a feasibility study of a real-time technique. With the child in a prone position and the head supported, readings of rib rotation and vertebral rotation were made directly on the back at five sites. The 95% confidence limits for one observer (ASK) examining eight subjects with mild scoliosis are best for vertebral rotation at L3 (± 1.8°) and rib rotation at T4 (± 1.9°), and worst at T12 for both rib and vertebral rotation (± 3.6°). The prediction of vertebral rotation by this real-time ultrasound method for rib rotation is better than using the Scoliometer to record back shape at the same levels in the prone position (R2values of 0.8-0.9 for ultrasound compared with 0.6 for Scoliometer at T8 and T12). The method deserves further study in attempts to reduce the number of false positive referrals to hospital in school screening for scoliosis. It also has potential in the pre- and post-operative appraisal of back shape.
Back Pain in Patients with Adolescent Idiopathic Scoliosis(AIS)
Authors: Joncas J.  , Labelle H.  , Poitras B.  , Duhaime M.  , Rivard C.-H.  , Grimard G.  , LeBlanc R.
Published: February 2025

Current knowledge on the association between back pain and idiopathic scoliosis is often contracdictory. The presence, localisation and importance of back pain was evaluated for a cohort of 426 adolescentss with A.I.S. Patients were recuited from a scoliosis clinic in a pediatric hospital. A questionnaire and an analogue scale graduated from 0 (no pain) to 100 (maximium pain) were used in order to verify more precisely, the importance of association between A.I.S. and back pain. Chi-square, linear regression and Student T-test were used for statistical analysis. 239 patients with right thoracic and left lumbar curves (RTLL) had a prevalence of pain of 54%. The mean of maximum pain intensity was 49 mm± 20. No relation was found between the severity of the scoliosis and back pain. The two groups (with and without pain) were comparable. Cobb angles were about the same for the thoracic and the lumbar regions, as well as kyphosis and lordosis. Weight, height and age were also the same. Risser sign, sex, brace and pelvic tilt were the only variables associated with pain (p < 0.0001). Association between A.I.S and pain is more frequent than generally reported. Pain appears to be more related with pelvic tilt than severity of the scoliosis.
Perception of Body Image in Children with Scoliosis
Authors: Raso V.J.  , Hill D.L.  , Mahood M.K.  , Moreau M.J.  , Bering M.  , Magill-Evans J.
Published: February 2025

We developed a questionnaire to quantify the significance of trunk deformity to children with adolescent idiopathic scoliosis. The physical appearance and opposite-sex peer relations scales were taken from a scale developed by Marsh to measure specific areas of self-concept in adolescents. Several questions were added to gauge the impression that the child had concerning her back and the amount of pain she was experiencing. Simple descriptive statistics were compiled to give a score for each subscale. To date we have surveyed 37 subjects: 23 who have not had treatment or who were on an exercise regime only, 8 who have been braced and 6 who have had surgery. This study suggests that the self image of children who have had surgical correction of their scoliosis is not significantly different than other children with scoliosis. The data are preliminary and a longitudinal follow up study is being completed.
Adolescent Idiopathic Scoliosis and Developmental Stability
Authors: Goldberg C.J.  , Fogarty E.E.  , Moore D.  , Dowling F.E.
Published: February 2025

The close association of spinal deformity with growth suggests that scoliosis may be a developmental response to perturbation of growth processes. Developmental criteria in 327 girls with late-onset idiopathic scoliosis were examined. Age at diagnosis correlated with apex (P=.002), Cobb angle (P=.006) and with age at menarche (P=.008). For left-right asymmetry, comparison of dermatoglyphics in 114 normal girls and 164 with AIS showed that in AIS there was increased directional asymmetry. When those with AIS were divided into school screening referrals (N=86) and others (N=78), the latter showed a significantly greater variance about the mean (P=0.0) suggesting that they form different subgroups of the population, with decreased developmental stability. These findings may be interpreted to indicate cephalo-caudal and left-right gradients and significant differences in the control of development in AIS.
Torsion in Lower Limb Bones of Healthy Subjects
Authors: Kirby A.S.  , Aujla R.K.  , Burwell R.G.  , Cole A.A.  , Moulton A.
Published: February 2025

This paper reports the use of real-time ultrasound methods to measure femoral anteversion (FAV), tibial torsion (TT), femoro-tibial rotation (FTR) at the knee and the summated rotational alignment (ΣRA = FAV+TT+FTR) in 537 healthy subjects age 5-18 years. The findings confirm knowledge that FAV decreases and lateral TT increases significantly with age in each of boys and girls. New findings relate to each of FTR (medial rotation of femur on tibia) and ΣRA. FTR, like TT, increases significantly with age in each of boys and girls. ERA changes significantly from being medially rotated in younger children to laterally rotated in older children with the cross-over from medial to lateral rotation occurring at 8-11 years of age; this explains the clinical observation that young children tend to in-toe as they walk and which resolves spontaneously with growth in most children. Overall, the data collected as means and standard deviations for each age and sex provide controls for comparison with data from subjects referred after school screening for scoliosis, having surgery for AIS and patients with patellofemoral pain syndrome which are considered elsewhere in this volume.
Virtual Reality (VR) Techniques in Orthopaedic Research and Practice
Authors: Chao E.Y.  , Barrance P.  , Genda E.  , Iwasaki N.  , Kato S.  , Faust A.
Published: February 2025

Modeling the musculoskeletal joint system using biomechanical analysis and computer graphics techniques allows us to visualize normal, diseased and reconstructed joint function. This model can be used to study the loading of bones and joints under theoretical and simulated activities. In this study, intact cadavers were imaged using MRI, CT scanning and cryo-sectioning techniques. Using sequential pixel information of bone and soft tissue boundaries collected from digital camera images, MRI and CT scans, the volumetric models of the musculoskeletal joint system are reconstructed. “Descriptive geometry” techniques which treat bones as rigid bodies and cartilage, ligament and muscles as deformable bodies were used to construct the model. Joint resultant forces and moments were determined using an inverse dynamics formulation, while ligament tension, joint contact pressure, and bone stresses are solved through a simplified Rigid Body Spring Modeling technique and the Finite Element Method. The results under static and dynamic loading activities can be visualized using interactive computer graphics. The advantages of such a model are the elimination of the need for large numbers of intact cadaveric specimens, and the unprecedented capability to study joint loading responses under normal, abnormal and surgically reconstructed states. Such a model and its analytical capability are ideal for pre-operative planning and computer-assisted orthopaedic surgery. This Visual, Interactive, Computational, and Anatomic Model(VICAM) and its associated analysis capability represent the next generation of technology which will have an enormous impact in orthopaedic research, education and patient care.
TeleInViVo: A Collaborative Volume Visualization Application
Authors: Coleman John  , Savchenko Andrei  , Goettsch Ammo  , Wang Kui  , Bono Peter  , Littlefield Richard  , Macedonia Maj Christian
Published: February 2025

Converging technologies in the areas of networks, volume visualization algorithms, and computer performance have made possible the development of a new tool for collaboration, which extends the reach of health professionals, and other consumers of volumetric data around the world. TeleInViVo(tm) is a threedimensional (3D) collaborative volume visualization tool for medical applications. It extends the capabilities of InViVo(tm), a fast volume visualization tool developed at the Fraunhofer IGD, Darmstadt, Germany [1-3], with efficient and intuitive network collaboration features for remote consultation and new modes of interaction. The software runs on both UNIX and Windows NT platforms. TeleInViVo provides a high degree of interactivity for the medical professional when interacting with the patient data, facilitates explanation and communication between field personnel and medical experts located far from the field, and permits viewing of the data in a multitude of ways designed to support rapid and accurate diagnosis. Current efforts involve architectural enhancements to support multiuser, distributed telemedical scenarios. The application includes the following features:
Virtual Cutting in Medical Data
Authors: Mazura A.  , Seifert S.
Published: February 2025

In this paper we present a method for virtual 3D cutting operations in 3D tomographic data. When cutting interactively the user specifies a serie of 3D cutting points and correponding cut depths on the surface of the object. Each pair of succeeding cutting points then defines a freeform shape of the incision. A 3D meshing algorithm constructs a Finite Element mesh formed by tetrahedrons, representing the surgical intervention.
Telerobotic Surgery: Applications on Human Patients and Training with Virtual Reality
Authors: Rovetta Alberto  , Bejczy Antal K.  , Sala Remo
Published: February 2025

This paper deals with the developed researches and appiications on telerobotic surgery, devoted to human patients and with training by virtual reality. The researches have been developed in cooperation between Telerobotics Laboratory, Department of Mechanics, Politecnico di Milano, Italy, and Automation and Control Section, Jet Propulsion Laboratory, Pasadena, USA.
In Vivo and In Vitro Measurement of Ultrasound Velocity in Cortical Bone
Authors: Lowet Geert  , Van Der Perre Georges
Published: February 2025

The measurement of ultrasound velocity is gaining increasing interest in clinical and biomedical research. Its applications are mostly in the quantitative assessment of fracture healing, and in the study of the effect of osteoporosis on the bone mechanical properties. We will give an overview of the studies that have been made in the past, aiming at the development of a reliable measurement technique. Further the concept and importance of the wavepath analysis will be discussed and finally we will report on the results obtained so far in clinical trials.
Prospects of computer models for the prediction of osteoporotic bone fracture risk
Authors: van Rietbergen B.  , Weinans H.  , Huiskes R.
Published: February 2025

Bone fractures are major problems for osteoporosis patients. To avoid such fractures, more information is needed about the factors that determine the bone fracture risk. In this chapter, it is discussed how recently developed finite element computer models that can represent the trabecular architecture in full detail can provide such information. It is concluded that a computer modeling approach to this problem is feasible, required and promising. It is expected that, eventually, such models can be used as a basis for an accurate diagnosis of the bone fracture risk.
Contribution of Nursing Informatics in the Health Care Sector
Authors: Gerdin Ulla
Published: February 2025

The health care sector is no easy organisation to understand, its rather very complex as everyone who have had the opportunity to analyse the operations, information needs and procedures knows. Nursing Informatics (NI) is knowledge and competence, tools necessary in the work with development and implementation of computerised nursing information systems (NIS). NI contributes also in many ways to the development of the health care sector. This paper brings forward the expectations, the pre-requisites and a number of unanswered questions.
European Citizens Advisory Systems Based on Telematics for Communication and Health
Authors: Maas Jörg F.
Published: February 2025

The objective of Citizens Advisory Systems for Health in Europe is to provide background information in preventive health care, to offer data-based and knowledge-based facilities and to reduce costs within the national and European wide health systems. In order to do so, easily accessible human-computer-dialogues and systems have to or have been already developed, allowing every citizen to obtain the right information at the right place at any time with any intensity which is wished. The paper will describe the already existing standards, will explain the ideal type and the technical and social implications which have to be taken into consideration for these systems.
Design and Development of On-line Training Services for Professionals based on the Telematics Education and Training Project PRONET
Authors: Samara Veronica
Published: February 2025

This paper describes the work done and the experience gained up to now in the European-funded project PRONET [11 “Multimedia Computer Based On-line Training and Support Service Network for Professionals” (ET-1017). The project aims at the development and demonstration of an integrated training and support service network for professionals. The service offers high-quality tele-training facilities to support the needs of professionals in seeking out and following advances in their field, in order to remain competitive and capitalise on specific achievements in their area. The main objectives of PRONET include the support of on-line multimedia computer based training services with tutoring support system, information database services, and inter-communication services facilitating information exchange between professionals over the World Wide Web [2, 3]. The PRONET current users concentrate on three highly-competitive professional groups: Telecommunications Engineers and Professionals, Environmental Scientists and Remote Sensing Specialists, and Biomedical Engineers and Medical Physicists. It is a two-years project, having started on January 1, 1996.
Intranet and HTML at a major university hospital - experiences from Munich
Authors: Dugas M.
Published: February 2025

Intranet-technology is the application of Internet-Tools in local networks. With this technique electronic information systems for large hospitals can be realized very easily. This technology has been in routine use in ‘Klinikum Großhadern’ for more than one year on over 50 wards and more than 200 computers.
A database on pesticides in Italy: a progress report
Authors: Petrelli G  , Mariotti S  , Siepi G  , Carrani E  , Roazzi P  , Tropeano R  , Mucci N
Published: February 2025

An existing database on pesticides, running in the DOS/Windows environment, is operative at the National Institute of Health and has yielded useful informations for several published researches. The database is currently being restructured for the purpose of making it available on the Web. An HTML interface, allowing to formulate queries on the database from the Web is presently under development, and it will be made available, once the problems related to confidentiality of certain parts of the database are solved. The database in its present form is presented and necessary changes foreseen in the Web edition are discussed.
Clinical Protocol Development using Inter/IntraNet Technology: the FENARETE System
Authors: Errera A.  , Merialdo P.  , Orsano A.  , Sindoni G.  , Rumolo G.
Published: February 2025

In this work we present FENARETE, a software tool to design and distribute clinical protocols in an Inter/IntraNet framework. We consider a medical protocol as a clinical behaviour scheme, formally and clearly defined with sufficient details. Our work allows the knowledge content of any clinical protocol to be fully represented in a symbolic style. A computer based support tool that works as an interface between clinicians and the protocol knowledge base is regarded by the authors as a basic building block developing an integrated environment for medical protocols design and management. The FENARETE application has been developed in Java and it is available for any Internet-linked machine with a Java-compatible browser.
Telematics for Clinical Guidelines: A Conceptual Modelling Approach
Authors: Gordon Colin  , Herbert Ian  , Johnson Peter  , Nicklin Peter  , Pitty David  , Reeves Philip
Published: February 2025

PRESTIGE is a project for applying telematics to assist the dissemination and application of clinical practice guidelines and protocols. Previous publications have described PRESTIGE's technical approach, including the use of a generic model for representing the knowledge content of clinical guidelines. This approach offers the possibility of ‘plug-and-play’ electronic distribution of clinical guidelines produced by multiple authoring bodies for use on multiple healthcare clinical management software platforms. A recent joint workshop held with the Section on Medical Informatics, Stanford University School of Medicine compared the European consensus approach developed in PRESTIGE with a parallel series of projects for computer-assisted protocol-based healthcare undertaken at Stanford and other American centres over the past, which confirmed the convergence and complementarity of our approaches, and holds out prospects of world-wide standardization in healthcare protocol knowledge representation. This paper summarises PRESTIGE conceptual model set which is the design of the project's approach.
Case mix of elderly in-patients in the 29 hospitals in Lorraine in 1994 and 1995
Authors: Gillois Pierre  , Garin Hervé  , Bodenreider Olivier  , Kohler François
Published: February 2025

The creation of regional standardized medical information databases in relation with the French anonymous discharge dataset allows the study of the geriatric case mix processed in the Lorraine region for patients over 69. The age histogram (69 to 107 years) presents a two mode distribution with an important dip centered on 79 years probably in connection with the demography of Lorraine and the consequences of the First World War. These geriatric patients represent 17% of hospitalisations in public and private hospitals participating in the public sector. The case mix is related to the size of the hospital and to its juridical status. The bigger the size of an hospital, the less its activity is concentrated on a small number of disorders. Lung and heart diseases represent the first cause of hospitalisation in all hospitals. It is necessary to underline the limitation of an approach which uses the patients’ individual hospitalisations, and which does not allow different stays of a given patient in the same hospital or between different hospitals to be linked. This approach prevents from appreciating the care network for this elderly population suffering from chronic diseases.
POLYAN: a package for a polyparametric approach to cardio-respiratory variability signals analysis
Authors: Maestri Roberto  , Pinna Gian Domenico
Published: February 2025

POLYAN, a computer program based on a point-and-click graphical user interface for easy and efficient polyparametric analysis of cardio-respiratory variability signals is described. The main tasks performed by the package are: univariate and bivariate spectral analysis on selected portions of the signals with the computation of some clinically relevant indices and baroreflex sensitivity assessment by the analysis of the relationship between systolic pressure and heart period signals. Some tools which help the analyst in the solution of common practical problems have been implemented to make analysis easier and more rigorous. Using Matlab language, POLYAN has the flexibility and expandability necessary for a research tool, which often requires implementation of new algorithms and computation of new parameters.
Using World Wide Web technology for educating students in the Health Care Sector
Authors: Dounavis Peter  , Karistinou Emily  , Diomidus Marianna  , Mantas John
Published: February 2025

The Internet was born in December of 1969 and has grown phenomenally since. Its graphically interactive, user-friendly modality, the World Wide Web (WWW), is younger and growing even more explosively. By its nature, the WWW is a tool ideally and uniquely suited for the advancement education. This paper describes the design, development and the implementation of a Web Site for supporting the education of the students in the Faculty of Nursing at the University of Athens.
Medical Emergency Aid through Telematics: design, implementation guidelines and analysis of user requirements for the MERMAID project
Authors: Anogianakis G.  , Maglavera S.  , Pomportsis A.  , Bountzioukas S.  , Beltrame F.  , Orsi G.
Published: February 2025

MERMAID is an EU financed telemedicine project with global reach and 24-hour, multilingual capability. It aspires to provide a model for the provision of health care services based on the electronic transmission of medical information, via ISDN based videoconferencing. This model will not be limited to medical diagnostics but it will encompass all cases where the actual delivery of health care services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an expensive telecommunications infrastructure and the exploration of a number of solutions. In fact, all categories of telemedical applications (audio and video conferencing, multimedia communications, flat file and image transfer with low, medium and high bandwidth data requirements) will be considered while the full range of network choices (Digital land lines, Cellular/Wireless, Satellite and Broadband) will be tested in terms of cost/performance tradeoffs that are inherent to them and the developmental stage each of these options occupies in their in its life cycle. Finally, out that MERMAID utilises advanced land based line transmission technologies to aid the remote patient by making available the specialist care that is best suited in the particular case.
Clinical-HINTS: Integrated Intelligent ICU Patient Monitoring and Information Management System
Authors: Kalogeropoulos D.  , Carson E.R.  , Collinson P.O.
Published: February 2025

Clinical-HINTS (Health Intelligence System) is a horizontally integrated decision support system (DSS) designed to meet the requirements for intelligent real-time clinical information management in critical care medical environments and to lay the foundation for the development of the next generation of intelligent medical instrumentation. The system presented was developed to refine and complement the information yielded by clinical laboratory investigations, thereby benefiting the management of the intensive care unit (ICU) patient. More specifically, Clinical- HINTS was developed to provide computer-based assistance with the acquisition, organisation and display, storage and retrieval, communication and generation of real-time patient-specific clinical information in an ICU. Clinical-HINTS is an object-oriented system developed in C++ to run under Microsoft Windows as an embryo intelligent agent. Current generic reasoning skills include perception and reactive cognition of patient status but exclude therapeutic action. The system monitors the patient by communicating with the available sources of data and uses generic reasoning skills to generate intelligent alarms, or HINTS, on various levels of interpretation of an observed dysfunction, even in the presence of complex disorders. The system's communication and information management capabilities are used to acquire physiological data, and to store them along with their interpretations and any interventions for the dynamic recognition of interrelated pathophysiological states or clinical events.