bluuebunny/crossref_metadata_2025 huggingface dataset:
Virtual Reality Aided Training of Combined Arm and Leg Movements of Children with CP
Authors: Riener Robert  , Dislaki Evangelia  , Keller Urs  , Koenig Alexander  , Van Hedel Hubertus  , Nagle Aniket
Published: February 2025

Cerebral palsy (CP) occurs in over 2 out of 1000 live births and can impair motor control and cognition. Our goal was to create a robotic rehabilitation environment that mimics real-life situations by allowing simultaneous exercise of upper and lower limbs. We chose to use the Lokomat as a gait robot and added a novel removable arm robot, called PASCAL (pediatric arm support robot for combined arm and leg training), that was integrated into the Lokomat environment. We also added a virtual reality (VR) environment that enables the subject to perform motivating game-like scenarios incorporating combined arm and leg movements. In this paper we summarize the design of PASCAL and present the novel virtual environment including first experimental results. The next step will be to test whether a combined application of the virtual environment and the two simultaneously working robots is feasible in healthy participants, and finally to clinically evaluate the entire system on children with CP.
Endotracheal Intubation with a Traditional Videolaryngoscope Blade versus an Integrated Suction Blade in a Hemorrhagic Airway Cadaver Model
Authors: Wadman Michael C.  , Nicholas Thomas A.  , Bernhagen Mary A.  , Kuper Gail M.  , Schmidt Steven  , Massignan Jason  , Boedeker Ben H.
Published: February 2025

Lightly embalmed hemorrhagic cadaver models and the Storz CMAC videolaryngoscope fitted with either an integrated suction blade vs. a traditional blade were used to determine efficacy of the instruments in hemorrhagic airway intubation. Significant differences were found between the devices in intubation success rates of the viscosity saliva and frothy blood models, as well as a significant difference in intubation times in the frothy blood model. Feedback provided by the study participants indicated preference for the integrated video suction blade in hemorrhagic airway intubation.
Co-Located Haptic and 3D Graphic Interface for Medical Simulations
Authors: Berkelman Peter  , Miyasaka Muneaki  , Bozlee Sebastian
Published: February 2025

We describe a system which provides high-fidelity haptic feedback in the same physical location as a 3D graphical display, in order to enable realistic physical interaction with virtual anatomical tissue during modelled procedures such as needle driving, palpation, and other interventions performed using handheld instruments. The haptic feedback is produced by the interaction between an array of coils located behind a thin flat LCD screen, and permanent magnets embedded in the instrument held by the user. The coil and magnet configuration permits arbitrary forces and torques to be generated on the instrument in real time according to the dynamics of the simulated tissue by activating the coils in combination. A rigid-body motion tracker provides position and orientation feedback of the handheld instrument to the computer simulation, and the 3D display is produced using LCD shutter glasses and a head-tracking system for the user.
The Use of Web-Based Learning for Simulation-Based Education and Training of Central Venous Catheterization in Novice Learners
Authors: Cheung Jeffrey J.H.  , Koh Jansen  , MacKinnon Kim  , Brett Clare  , Bägli Darius  , Kapralos Bill  , Dubrowski Adam
Published: February 2025

Both simulation-based education and training (SBET) and Web-based Learning (WBL) are increasingly used in medical education. We developed a Web-based learning course on “Observational Practice and Educational Networking” (OPEN), to augment SBET for central venous catheterization (CVC), a complex clinical skill, for novice learners. This pilot study aimed to firstly, understand the perspectives of novice learners on using WBL in preparation for SBET for a psychomotor skill and secondly, to observe how learners use the OPEN courseware to learn more about how to perform this skill.
Objective Performance Measures Using Motion Sensors on an Endoscopic Tool for Evaluating Skills in Natural Orifice Translumenal Endoscopic Surgery (NOTES)
Authors: Chin Lauren I.  , Sankaranarayanan Ganesh  , Dargar Saurabh  , Matthes Kai  , De Suvranu
Published: February 2025

Natural orifice translumenal endoscopic surgery is an emerging procedure. High fidelity virtual reality-based simulators allow development of new surgical procedures and tools and train medical personnel without risk to human patients. As part of a project funded by the National Institutes of Health, we are developing a Virtual Transluminal Endoscopic Surgery Trainer (VTESTTM) for this purpose. In this work, objective performance measures derived from motion tracking sensors attached to an endoscope was tested for the transgastric NOTES appendectomy procedure performed with ex-vivo pig organs using the EASIE-RTMtrainer box. Results from our study shows that both completion time and economy of motion parameters were able to differentiate between expert and novice NOTES surgeons with p value of 0.039 and 0.02 respectively. Jerk computed on sensor 2 data also showed significant results (p = 0.02). We plan to incorporate these objective performance measures in VTESTTM.
Spectral Imaging in Preclinical Research and Clinical Pathology
Authors: Levenson Richard  , Beechem Joseph  , McNamara George
Published: February 2025

Spectral imaging methods are attracting increased interest from researchers and practitioners in basic science, preclinical and clinical arenas. A combination of better labeling reagents and better optics creates opportunities to detect and measure multiple parameters at the molecular and cellular level. These tools can provide valuable insights into the basic mechanisms of life, and yield diagnostic and prognostic information for clinical applications. There are many multispectral technologies available, each with its own advantages and limitations. This chapter will present an overview of the rationale for spectral imaging, and discuss the hardware, software and sample labeling strategies that can optimize its usefulness in clinical settings.
A Conceptual Framework for Automating the Operational and Strategic Decision-Making Process in the Health Care Delivery System
Authors: Ruohonen Toni  , Ennejmy Mohammed
Published: February 2025

Making reliable and justified operational and strategic decisions is a really challenging task in the health care domain. So far, the decisions have been made based on the experience of managers and staff, or they are evaluated with traditional methods, using inadequate data. As a result of this kind of decision-making process, attempts to improve operations usually have failed or led to only local improvements. Health care organizations have a lot of operational data, in addition to clinical data, which is the key element for making reliable and justified decisions. However, it is progressively problematic to access it and make usage of it. In this paper we discuss about the possibilities how to exploit operational data in the most efficient way in the decision-making process. We'll share our future visions and propose a conceptual framework for automating the decision-making process.
Memetic Multi-Agent Computing in Difficult Continuous Optimisation
Authors: Byrski Aleksander  , Korczyński Wojciech  , Kisiel-Dorohinicki Marek
Published: February 2025

In the paper an application of hybridized Evolutionary Multi-Agent System (EMAS) with local search (in memetic style) to the problem of continuous optimisation is presented. Before, the concept of evolutionary and memetic agent-based computing is given, the former being a computing paradigm researched for over 15 years, the latter being introduced recently. Two ways of memetic hybridization (Lamarckian and Baldwinian) are discussed, and examined in the course of experiments. In the presented experiments, evolutionary and memetic multi-agent systems are compared with classical evolutionary algorithm (Michalewicz model) implemented with allopatric speciation (island-model of evolutionary algorithm), based on a selected popular benchmark continuous optimization functions.
An Ontological Approach for Collaborative Business Processes formulation with Consensus Methodology
Authors: Nguyen Trung Van  , Hoang Minh T.N.  , Hoang Hanh Huu
Published: February 2025

Dynamic cross-enterprise collaboration is one of challenges on the business-to-business integration (B2Bi) research nowadays. Semantic Web-based approaches for BPM have been foreseen as a promising solution with taking advantages of Semantic Web technologies such as ontologies, Semantic Web services. With the support of Semantic Web technologies, the gap between business and information technology (IT) communities has been reduced in order to tackle the challenge. Together with the development of web services and its extension with Semantic Web augmented one—Semantic Web Services (SWS), the recent approaches in B2Bi focus on their business process integration between enterprises using SWS. Taking into account the challenge of dynamically forming collaborative business processes with attached services into the execution, in this paper, we proposed an ontological approach for forming a dynamic collaboration of business processes within our BizKB systems for across-enterprise collaboration using the consensus theory in knowledge processing. We focus on an dynamic service discovery based on the consensus methodology.
Introduction
Authors: Cercone Nick
Published: February 2025

We explain our use of computational approaches to assistive technology for persons with disabilities and introduce the four parts of this manuscript, including sixteen chapters and 2 appendices. The four parts include: Part I – Introduction and Underpinnings; II – Applications; Part III – Theories and Systems; and Part IV – Conclusions and Future.
I-Math: an Intelligent Accessible Mathematics system for People with Visual Impairment
Authors: Wongkia Wararat  , Naruedomkul Kanlaya  , Cercone Nick
Published: February 2025

We propose an intelligent accessible mathematics approach, called i-Math for people with visual impairment on reading math expressions in Thai. Math expressions in various forms were investigated for developing a set of rules to correctly read the math expressions. Our proposed approach has revealed it is possible to construct a practically automatic math expressions reading system by suitable technologies of speech processing. The i-Math system prototype was tested to generate the accurate speech (intelligibility and overall speech quality) for a math problem sample set and its usage (user satisfaction) was determined by voluntary participants, both students and teachers. The intelligibility indicated that i-Math can generate the understandable pronunciations for math text. Overall speech quality showed that the utterances read by i-Math are good quality and understandable with slight effort. The user satisfaction questionnaire can be included that the teachers and students had positive perceptions toward the use of i-Math.
Scientific and technical communication and the Fukushima Daiichi nuclear disaster: The social dimension
Authors: Karasawa Kaori  , Todayama Kazuhisa
Published: February 2025

This paper examined the generic texts in scientific and technical communication since the Fukushima Daiichi nuclear disaster from the perspective of its social implications. The analysis revealed that persuasive rhetoric is one form of paternalism that occurs in communication and suggests the importance to switch from the communication to persuade the citizens to the communication to aids the citizen-based decision-making process.
Improvement of Factor Model with Text Information Based on Factor Model Construction Process
Authors: Saga Ryosuke  , Fujita Tetsuya  , Kitami Kodai  , Matsumoto Kazunori
Published: February 2025

This paper proposes a method to improve factor models with text information based on the factor model construction process. We analyze the model using the KJ method. However, because this model often has many unidentifiable latent variables due to the lack of observed variables, we need to filter and change the model. To decrease the number of unidentifiable latent variables, we use principal components analysis for keywords in text data and the principal component scores are allocated to the unidentifiable latent variables. Further, we could confirm that GFI (goodness-of-fit index) and AGFI (adjusted goodness-of-fit index) are improved by using the factor model for an online-game analysis.
A System for Visualization of the Polish Sign Language Gestures
Authors: Koziol Wojciech  , Wojtowicz Hubert  , Sikora Kazimierz  , Wajs Wieslaw
Published: February 2025

The paper describes a method for acquiring and visualizing the Polish Sign Language gestures along with mimic sub code. The software allowing visualization of sign language gestures is one of the modules of the system for the translation of texts written in the Polish language into appropriate messages of the sign language. Proper understanding of the information communicated in the sign language requires the information to be presented in the multipath manner. In addition to the ideographic communication, i.e. gestures of the sign language alone, also lip movement (many deaf people are able to read the movement of the lips) and elements of the mimic sub code expressing emotions and intentions of the sign language users should be taken into account. Additional paths improving quality of the communication are: the text displayed during the gestures visualization and the audio channel through which the speech synthesis is realized (most deaf people are not completely deaf and the sounds they hear support the communication process). In order to obtain the most accurate and the fullest understanding of the content in the sign language all these channels are transmitted simultaneously. The paper describes process of the acquisition of sign language gestures, modeling of face mimicry, representation and storing of the animation data in the database and visualization of this data using 3D avatar.
Monitoring the impact of the electronic medical record on the quality of laboratory test ordering practices
Authors: Georgiou Andrew  , Vecellio Elia  , Toouli George  , Eigenstetter Alex  , Li Ling  , Wilson Roger  , Westbrook Johanna I.
Published: February 2025

The aim of this study was to examine the impact of the Electronic Medical Record (EMR) on the quality of laboratory test orders made by clinicians. The study assessed the type and frequency of pre-analytical laboratory test order errors that were associated with the EMR across three hospitals and one pathology service. This involved a retrospective audit of the laboratory error logs for the period 1 March 2010 to 9 October 2011. Test order problems associated with the EMR occurred at a total rate of 1.34 per 1000 test order episodes across the three hospitals. In the majority of cases these errors were caused by the inappropriate use of the EMR system by clinicians. The errors resulted in increased data entry time for laboratory staff in the Central Specimen Reception area and led to a median increase of 181 minutes in test turnaround times for those test orders. The study highlights the importance of monitoring and comparing the impact of EMR systems in different locations over time in order to identify (and act upon) factors that can adversely impact on the effectiveness of pathology laboratory processes.
Recommendations for Implementing Telemedicine in the Developing World
Authors: Alajmi Dana  , Almansour Shaima  , Househ Mowafa S.
Published: February 2025

Telemedicine is a tool used to deliver health care from a distance. Developing countries can benefit from telemedicine because these countries face such issues as a lack of specialists and medical infrastructure. Telemedicine in the developing world can offer solutions to healthcare access for people in rural areas, reduce healthcare costs, and possibly improve healthcare quality. A major benefit for patients is that they will be more involved in maintaining their health without the constant need to visit healthcare centers. The purpose of this paper is to provide solutions and recommendations for the implementation of telemedicine in the developing world. A comprehensive search of both academic and gray literature was conducted in September 2012. The results show that there are potential benefits of and challenges in the implementation of telemedicine in developing countries. How to overcome the key challenges related to financial issues, acceptance, health infrastructure, and legal and privacy issues is discussed.
MRI Texture Analysis in Paediatric Oncology: A Preliminary Study
Authors: Fetit Ahmed E.  , Novak Jan  , Rodriguez Daniel  , Auer Dorothee P.  , Clark Chris A.  , Grundy Richard G.  , Jaspan Tim  , Peet Andrew C.  , Arvanitis Theodoros N.
Published: February 2025

Despite current advances in neuro-imaging, the characterisation of paediatric brain tumours and neurological disorders is very challenging. Whilst Magnetic Resonance Imaging (MRI) provides images of superb clarity, it gives little information on how aggressive a tumour is. It is also very difficult to visually inspect any underlying textural patterns between tumours on MR images. This gives rise to the need for a quantitative means of analysing MR images for characterising tumours. In this work, we present a preliminary investigation into the effectiveness of texture analysis as a quantitative approach for classifying paediatric brain tumours.
Analysis and classification of ultrasound medical images using the Local Binary Pattern operator
Authors: Vătămanu Oana Astrid  , Ionescu Mihaela  , Mihalaş Gheorghe-Ioan
Published: February 2025

This paper aims to present a classification and retrieval technique applied to ultrasound medical images, based on different variations of Local Binary Pattern (LBP) algorithm. Using this technique, a dedicated application builds an ultrasound image database, determining the optimum variation of LBP algorithm. These techniques can be applied to an image or to a group of images. Characterization is done through an array of values extracted by the algorithm. The application allows the characterization of an image, a set of images, determining the similarity between different images and the degree of belonging to a particular group. There are also presented several comparisons between existent variations of this algorithm, applied on the same set of ultrasound images.
SOA Governance in Healthcare Organisations
Authors: Koumaditis Konstantinos  , Themistocleous Marinos  , Vassilakopoulos Georgios
Published: February 2025

Service Oriented Architecture (SOA) is increasingly adopted by many sectors, including healthcare. Due to the nature of healthcare systems there is a need to increase SOA adoption success rates as the non integrated nature of healthcare systems is responsible for medical errors that cause the loss of tens of thousands patients per year. Following our previous research [1] we propose that SOA governance is a critical success factor for SOA success in healthcare. Literature reports multiple SOA governance models that have limitations and they are confusing. In addition to this, there is a lack of healthcare specific SOA governance models. This highlights a literature void and thus the purpose of this paper is to proposed a healthcare specific SOA governance framework.
Satisfaction Degree Evaluation of the Users of “Attikon” University General Hospital's Library
Authors: Stamouli Maria-Aggeliki  , Balis Charalampos  , Georgakopoulou Konstantina-Maria
Published: February 2025

The ability of hospital medical libraries to meet users' needs is a complicated issue and has been examined by many surveys. The aim of this study is to evaluate the satisfaction degree of the users of “Attikon” University General Hospital's medical library. A questionnaire was used to collect the necessary information Although, in general, the users seems to be satisfied, some adjustments, such as up-to-date books, journals and computers, have to be made.
Minimally Invasive Surgical Video Analysis: a powerful tool for Surgical Training and Navigation
Authors: Sánchez-González P.  , Oropesa I.  , Gómez E.J.
Published: February 2025

Analysis of minimally invasive surgical videos is a powerful tool to drive new solutions for achieving reproducible training programs, objective and transparent assessment systems and navigation tools to assist surgeons and improve patient safety. This paper presents how video analysis contributes to the development of new cognitive and motor training and assessment programs as well as new paradigms for image-guided surgery.
Development of an Educational Program for the Training of Health Care Professionals Concerning Low Back Pain
Authors: Diomidous Marianna  , Gougoumati Konstantina  , Kolokathi Aikaterini  , Vogdopoulou Diamanto
Published: February 2025

Common low back pain represents a major public health problem due to its direct cost to health care and to various socio economic consequences. Although low back pain may be caused by medical conditions, such as any kind of infections or cancer, the vast majority of the cases are attributed to mechanical or muscle skeletal conditions. Nurses and other health care professionals are on the top of the list for experiencing low back pain based on the duties performed in their working environment. The objective of this study involves the development of an educational program for the nursing stuff focused on the prevention of low back pain.
Contactless Bio-behavioral Technologies for Virtual Reality
Authors: Cipresso Pietro  , Serino Silvia  , Gaggioli Andrea  , Albani Giovanni  , Riva Giuseppe
Published: February 2025

The use of biosensors in human experimental research has become one of the most reliable methods to objectively quantify participants' behavioral, psychological and physiological measures. Modern bio-behavioral technologies can be integrated in Virtual Reality platforms, for a contactless assessment of affective states. This manuscript proposes a paradigm to deeper reach accuracy in assessment and diagnostics of rehabilitation processes.
Designing a Serious Game For In-Field Interventions To Promote Nightlife Well-Being
Authors: Gamberini Luciano  , Zamboni Luca  , Privitera Alessandro  , De Giuli Gianni  , Villa Chiara  , Spagnolli Anna
Published: February 2025

Nightlife well-being interventions, although much needed, face several challenges related to the specificity of the context addressed. We argue that a game-facilitated intervention helps with facing these challenges. The characteristics of a game developed to this goal and the results of user tests conducted in situ are presented.
Classification of Gastric Cancer Subtypes using ICA, MLR and Bayesian Network
Authors: Ishii Hiroyuki  , Sasaki Hiroki  , Aoyagi Kazuhiko  , Yamazaki Toshimasa
Published: February 2025

The purpose of this study is to extract genes that could distinguish between two subtypes (diffuse and intestinal) of gastric cancer (GC) from their gene expression profile, to build a classifier based on the genes and to investigate the relationships among the selected genes, because there are big differences in the survival curve and the medical treatment between the subtypes. First, we applied Wilcoxon test, independent component analysis (ICA) and multiple logistic regression (MLR) to the profile, and conducted a classifier consisting of only three genes. We validated the classifier using test data with new 9 samples (blind test). The classifier yielded the accuracy of 100%. Finally, using the 18 genes selected by MLR and specific to each subtype, Bayesian Network was constructed, and compared with the network from GeneMANIA. Consequently, these networks were very similar each other.
Development of Medical Communication Support System “Health Life Passport”
Authors: Takizawa Kiyomi  , Takesako Kazumi  , Kawamura Masayuki  , Sakamaki Tetsuo
Published: February 2025

Today, the number of foreign residents in Japan is increasingdue to globalization. However, Japan is behind other advanced countries in accepting oversea patients. Japan has to improve medical institutions' readiness to accept foreign patients, and nurture medical interpreters. To address these issues, we developed a language support application for smart phones. Anyone can download it freely.
Display Methods of Electronic Patient Record Screens: Patient Privacy Concerns
Authors: Niimi Yukari  , Ota Katsumasa
Published: February 2025

To provide adequate care, medical professionals have to collect not only medical information but also information that may be related to private aspects of the patient's life. With patients' increasing awareness of information privacy, healthcare providers have to pay attention to the patients' right of privacy. This study aimed to clarify the requirements of the display method of electronic patient record (EPR) screens in consideration of both patients' information privacy concerns and health professionals' information needs. For this purpose, semi-structured group interviews were conducted of 78 medical professionals. They pointed out that partial concealment of information to meet patients' requests for privacy could result in challenges in (1) safety in healthcare, (2) information sharing, (3) collaboration, (4) hospital management, and (5) communication. They believed that EPRs should (1) meet the requirements of the therapeutic process, (2) have restricted access, (3) provide convenient access to necessary information, and (4) facilitate interprofessional collaboration. This study provides direction for the development of display methods that balance the sharing of vital information and protection of patient privacy.
Efficiency and Safety of New Radiofrequency Identification System in a Hospital
Authors: Saito Yuichiro  , Suzuki Ryoji  , Torikai Kota  , Hasegawa Takashi  , Sakamaki Tetsuo
Published: February 2025

Radiofrequency identification (RFID) applications have the capability to obtain real-time information on the location and properties of tagged people or objects. The efficiency and safety of the new RFID system (UHF band, 953 MHz) were tested in our hospital. We examined whether 1 to 4 persons and medical equipment with IC tags were captured by RFID readers in a laboratory. We next tested whether electric signals produced by RFID could affect medical devices. New radio frequency tags provided extensive patient identification and helped track capital equipment within a laboratory. Electric fields produced by the new RFID did not significantly affect medical devices in our hospital. New RFID system was safe and useful for tracking people and medical equipments in a hospital. As healthcare systems today involve increasingly complex and interrelated processes, the new RFID technologies may enhance patient safety, and wellness, and reduce staff workloads in a hospital.
Evaluating the Impact of a Mobile Oral Telemedicine System on Medical Management and Clinical Outcomes of Patients with Complicated Oral Lesions in Botswana
Authors: Tesfalul Martha  , Littman-Quinn Ryan  , Antwi Cynthia  , Ndlovu Siphiwo  , Motsepe Didintle  , Phuthego Motsholathebe  , Tau Boitumelo  , Mohutsiwa-Dibe Neo  , Kovarik Carrie
Published: February 2025

Mobile telemedicine, which involves the use of cellular phone telecommunications to facilitate exchange of information between parties in different locations to assist in the management of patients, has become increasingly popular, particularly in resource-limited settings. In Botswana, small studies of mobile telemedicine programs suggest access to these services positively affect patients, but these programs' impact is difficult to capture given limitations of baseline and comparative data. Our observational study uses each patient receiving mobile oral telemedicine services in Botswana as his/her own control to assess the impact of these services on his/her diagnosis and management plan. At month 5 of 12 total, preliminary analysis of eligible cases (n = 27) reveals management plan discordance between clinicians submitting cases and the specialist was 68.0% (17/25), suggesting that telemedicine can result in significant changes in management of patients.
Exploring Barriers for Health Visitors' Adaption of the Danish Children's Database
Authors: Pape-Haugaard Louise  , Haugaard Karin  , Carøe Per  , Marie Høstgaard Anna
Published: February 2025

Denmark has unique health informatics databases such as “The Children's Database” (CDB), which since 2009 has held data on all Danish children from birth until 17 years of age. In the current set-up a number of potential sources of error exist – both technical and human – which means that the data is flawed. The objective of this paper is both to clarify errors in the database and to enlighten the underlying mechanisms causing these errors. This is done through an ethnographic study using participant observations, interviews and workshops. Errors are documented through statistical analysis. The data show redundant records. This redundancy can be explained by multiple transmissions conducted by end users or systems, or a lack of validation methods in the National CDB. In our results three types of cases are presented: from health visitors at school, from health visitors visiting families and from health visitors at central health offices.
Information Architecture Considerations in Designing a Comprehensive Tuberculosis Enterprise System in Western Kenya
Authors: Gichoya Judy  , Pearce Chris  , Wickramasinghe Nilmini
Published: February 2025

Kenya ranks among the twenty-two countries that collectively contribute about 80% of the world's Tuberculosis cases; with a 50–200 fold increased risk of tuberculosis in HIV infected persons versus non-HIV hosts. Contemporaneously, there is an increase in mobile penetration and its use to support healthcare throughout Africa. Many are skeptical that such m-health solutions are unsustainable and not scalable. We seek to design a scalable, pervasive m-health solution for Tuberculosis care to become a use case for sustainable and scalable health IT in limited resource settings. We combine agile design principles and user-centered design to develop the architecture needed for this initiative. Furthermore, the architecture runs on multiple devices integrated to deliver functionality critical for successful Health IT implementation in limited resource settings. It is anticipated that once fully implemented, the proposed m-health solution will facilitate superior monitoring and management of Tuberculosis and thereby reduce the alarming statistic regarding this disease in this region.
Developing on-Demand Secure High-Performance Computing Services for Biomedical Data Analytics
Authors: Robison Nicholas  , Anderson Nick
Published: February 2025

We propose a technical and process model to support biomedical researchers requiring on-demand high performance computing on potentially sensitive medical datasets. Our approach describes the use of cost-effective, secure and scalable techniques for processing medical information via protected and encrypted computing clusters within a model High Performance Computing (HPC) environment. The process model supports an investigator defined data analytics platform capable of accepting secure data migration from local clinical research data silos into a dedicated analytic environment, and secure environment cleanup upon completion. We define metrics to support the evaluation of this pilot model through performance and stability tests, and describe evaluation of its suitability towards enabling rapid deployment by individual investigators.
Developing and Implementing an Interoperable Document-based Electronic Health Record
Authors: Campos Fernando  , Plazzotta Fernando  , Luna Daniel  , Baum Analia  , de Quirós Fernán González Bernaldo
Published: February 2025

Health information exchange ensuring its authenticity and integrity is not a simple task. Many institutions have implemented different solutions to perform this exchange using partial or summary information, and rarely include metadata that establish the context in which they performed the primary data capture.
Investigating the Impact of an Emergency Information System on Patient's Length of Stay in the Emergency Department of a Tertiary Hospital in Saudi Arabia
Authors: Bawazir Warda  , Saddik Basema  , El-Masri Samir
Published: February 2025

The emergency department has a crucial role in saving patient's lives. Efficient and reliable information through reliable information systems contribute to effective communication in these situations and ultimately shorter lengths of stay (LOS). This exploratory, cross-sectional study evaluates a current legacy emergency system in a tertiary hospital and investigates its impact on patient's length of stay (LOS) in the emergency department. A significantly shorter LOS was found between patients whose information was available and was communicated effectively in comparison to patients whose data were not available. Furthermore, longer LOS was associated with patients who required clinical services (pathology, radiology) due to the manual retrieval of results. This study has found that future implementation of a comprehensive electronic information system will facilitate effective communication workflow and timely access to patient data in the emergency department.
Detecting Periodic Limb Movements with Off-the-Shelf Accelerometers: A Feasibility Study
Authors: Dias André  , Gorzelniak Lukas  , Rudnik Juliane  , Stojanovic Dragan  , Horsch Alexander
Published: February 2025

Periodic limb movements are short movements of the legs that can lead to low sleep quality in the general population. Currently, the gold standard to measure periodic limb movements for diagnostic purposes is polysomnography. This is an expensive technique that requires specially fitted laboratories and specialized personnel. In this paper we explore the use of commercial, off-the-shelf accelerometers to detect periodic limb movements during sleep and compare the results to the gold standard. We recruited two subjects for one night and measured limb movements with polysomnography and Actigraph GT3X accelerometers. We developed an open source Java application for processing the data. A total of 846 events were recorded. We found a very low similarity between polysomnography and GT3X data, indicating that our accelerometer-based method is not yet feasible for medical diagnosis. Several options for further development are: the exploration of different sensor locations, sensors with higher sampling rates, as well as enhancement of data analysis methods.
Feasibility Analysis of the Privacy Attributes of the Personal Wellness Information Model
Authors: Nykänen Pirkko  , Seppälä Antto  , Ruotsalainen Pekka  , Blobel Bernd
Published: February 2025

A feasibility analysis has been performed to study the applicability of privacy attributes with a developed wellness information model. Information privacy concerns specifically access to individually identifiable personal information and one's ability to control information about oneself. We carried out a user scenario walk-through of the privacy attributes related to the wellness components. The walk-through showed a need to relate self-regulating privacy policies to the pervasive context so that during various trust-building processes, a person is aware and can control the use, disclosure and even secondary use of his personal, private wellness information.
Genetic Testing Information Standardization in HL7 CDA and ISO13606
Authors: Bosca Diego  , Marco Luis  , Burriel Veronica  , Jaijo Teresa  , Millán Jose M.  , Levin Ana  , Pastor Oscar  , Robles Montserrat  , Maldonado Jose Alberto
Published: February 2025

Communicating genetic testing reports of a patient in a semantically interoperable way remains difficult. Most of the information is stored as non-communicable documents which cannot automatically be processed. The objective of the project was to obtain semantically interoperable genetic testing reports which could be used not only for communication purposes but also for secondary uses, for example clinical trials or clinical decision support. This work describes the first part of the project, the modeling of genetic information reports using EHR standards. We used the Implementation Guide for CDA R2 Genetic Testing Report (GTR) as a basis for modeling the archetypes for both HL7 CDA and CEN/ISO 13606. This approach was validated with the information included in Usher Syndrome reports available at ISS-La Fe. The result of this work were three archetypes following ISO13606 and three archetypes following HL7 CDA model which contained all the information available in both Usher syndrome genetic testing reports and the implementation guide significant parts.
Explore and Experience: Mobile Augmented Reality for Medical Training
Authors: Albrecht Urs-Vito  , Noll Christoph  , von Jan Ute
Published: February 2025

In medicine, especially in basic education, it may sometimes be inappropriate to integrate real patients into classes due to ethical issues that must be avoided. Nevertheless, the quality of medical education may suffer without the use of real cases. This is especially true of medical specialties such as legal medicine: survivors of a crime are already subjected to procedures that constitute a severe emotional burden and may cause additional distress even without the added presence of students. Using augmented reality based applications may alleviate this ethical dilemma by giving students the possibility to practice the necessary skills based on virtual but nevertheless almost realistic cases. The app “mARble®” that is presented in this paper follows this approach. The currently available learning module for legal medicine gives users an opportunity to learn about various wound patterns by virtually overlaying them on their own skin and is applicable in different learning settings. Preliminary evaluation results covering learning efficiency and emotional components of the learning process are promising. Content modules for other medical specialtiesare currently under construction.
Routinely-collected General Practice Data from the Electronic Patient Record and General Practitioner Active Electronic Questioning Method: A Comparative Study
Authors: De Clercq Etienne  , Moreels Sarah  , Bossuyt Nathalie  , Vanthomme Katrien  , Goderis Geert  , Van Casteren Viviane
Published: February 2025

The numerous existing primary care-based research networks currently use various data collection methods. In this paper, we compared routine data extracted from general practitioners' (GPs') electronic patient records (EPRs) and GPs' answers to an electronic questionnaire.
Large Scale Health Information Exchange: Implementation Experiences from Five States
Authors: Dullabh Prashila  , Hovey Lauren
Published: February 2025

There is widespread consensus that Health Information Exchange, the electronic sharing of patients' health information between delivery settings, is critical to improving the quality and efficiency of patient care. The United States has had limited success in establishing broad-based HIE. To address these issues, the federal government funded the State Health Information Exchange Cooperative Agreement Program. An in-depth qualitative study was conducted, consisting of site visits and semi-structured discussions with 105 respondents in 5 states to understand early HIE implementation experiences. Results show the last two years have seen unprecedented growth in HIE infrastructure. Key factors such as maturity of HIE at baseline and healthcare market characteristics have shaped governance models and technical infrastructures. Early focus on stakeholder value proposition and sustainability planning is critical for long-term success. States continue to face numerous challenges in converting stakeholder support into financial commitment and real-time exchange of health information. We discuss the key issues states faced in attempting to realize broad-based HIE and offer insights that may assist other states.
E-Health Systems for Management of MDR-TB in Resource-Poor Environments: A Decade of Experience and Recommendations for Future Work
Authors: Fraser Hamish S.F.  , Habib Ali  , Goodrich Mark  , Thomas David  , Blaya Joaquin A.  , Fils-Aime Joseph Reginald  , Jazayeri Darius  , Seaton Michael  , Khan Aamir J.  , Choi Sharon S.  , Kerrison Foster  , Falzon Dennis  , Becerra Mercedes C.
Published: February 2025

Introduction: Multi-drug resistant TB (MDR-TB) is a complex infectious disease that is a growing threat to global health. It requires lengthy treatment with multiple drugs and specialized laboratory testing. To effectively scale up treatment to thousands of patients requires good information systems to support clinical care, reporting, drug forecasting, supply chain management and monitoring.
Analyzing Differences between Chinese and English Clinical Text: A Cross-Institution Comparison of Discharge Summaries in Two Languages
Authors: Wu Yonghui  , Lei Jianbo  , Wei Wei-Qi  , Tang Buzhou  , Denny Joshua C.  , Rosenbloom S. Trent  , Miller Randolph A.  , Giuse Dario A.  , Zheng Kai  , Xu Hua
Published: February 2025

Worldwide adoption of Electronic Medical Records (EMRs) databases in health care have generated an unprecedented amount of clinical data available electronically. There has been an increasing trend in US and western institutions towards collaborating with China on medical research using EMR data. However, few studies have investigated characteristics of EMR data in China and their differences with the data in US hospitals. As an initial step towards differentiating EMR data in Chinese and US systems, this study attempts to understand system and cultural differences that may exist between Chinese and English clinical documents. We collected inpatient discharge summaries from one Chinese and from three US institutions and manually analyzed three major clinical components in text: medical problems, tests, and treatments. We reported comparison results at the document level and section level and discussed potential reasons for observed differences. Documenting and understanding differences in clinical reports from the US and China EMRs are important for cross-country collaborations. Our study also provided valuable insights for developing natural language processing tools for Chinese clinical text.
Reducing Provider Cognitive Workload in CPOE Use: Optimizing Order Sets
Authors: Zhang Yiye  , Padman Rema  , Levin James E.
Published: February 2025

Higher cognitive workload due to poor usability is a significant, unanticipated consequence of healthcare information technology (IT), resulting in new types of medical errors. An important example of this can be observed in the use of order sets, which allow safe and efficient provider order entry guided by known best practices. This paper aims to improve IT-enabled order entry by re-designing order sets using data-driven approaches to develop new order sets that match current usage and workflow, while incurring minimum cognitive workload. Applying optimization models embedded with clustering techniques, our methods identify items for constituting order sets that are relevant based on historical ordering data wherein items for a single patient are often placed together or in close temporal proximity during hospital stay. Results indicate that the new approaches dominate current solutions, significantly reducing cognitive workload, and improving order set content. Data driven methods thus offer a promising approach for designing order sets that are generalizable, evidence-based and up-to-date with current best practices.
Electrophysiological Signal Analysis and Visualization using Cloudwave for Epilepsy Clinical Research
Authors: Jayapandian Catherine P.  , Chen Chien-Hung  , Bozorgi Alireza  , Lhatoo Samden D.  , Zhang Guo-Qiang  , Sahoo Satya S.
Published: February 2025

Epilepsy is the most common serious neurological disorder affecting 50–60 million persons worldwide. Electrophysiological data recordings, such as electroencephalogram (EEG), are the gold standard for diagnosis and pre-surgical evaluation in epilepsy patients. The increasing trend towards multi-center clinical studies require signal visualization and analysis tools to support real time interaction with signal data in a collaborative environment, which cannot be supported by traditional desktop-based standalone applications. As part of the Prevention and Risk Identification of SUDEP Mortality (PRISM) project, we have developed a Web-based electrophysiology data visualization and analysis platform called Cloudwave using highly scalable open source cloud computing infrastructure. Cloudwave is integrated with the PRISM patient cohort identification tool called MEDCIS (Multi-modality Epilepsy Data Capture and Integration System). The Epilepsy and Seizure Ontology (EpSO) underpins both Cloudwave and MEDCIS to support query composition and result retrieval. Cloudwave is being used by clinicians and research staff at the University Hospital – Case Medical Center (UH-CMC) Epilepsy Monitoring Unit (EMU) and will be progressively deployed at four EMUs in the United States and the United Kingdomas part of the PRISM project.
Automatic Identification of Comparative Effectiveness Research from Medline Citations to Support Clinicians' Treatment Information Needs
Authors: Zhang Mingyuan  , Del Fiol Guilherme  , Grout Randall W.  , Jonnalagadda Siddhartha  , Medlin Jr Richard  , Mishra Rashmi  , Weir Charlene  , Liu Hongfang  , Mostafa Javed  , Fiszman Marcelo
Published: February 2025

Online knowledge resources such as Medline can address most clinicians' patient care information needs. Yet, significant barriers, notably lack of time, limit the use of these sources at the point of care. The most common information needs raised by clinicians are treatment-related. Comparative effectiveness studies allow clinicians to consider multiple treatment alternatives for a particular problem. Still, solutions are needed to enable efficient and effective consumption of comparative effectiveness research at the point of care. Objective: Design and assess an algorithm for automatically identifying comparative effectiveness studies and extracting the interventions investigated in these studies. Methods: The algorithm combines semantic natural language processing, Medline citation metadata, and machine learning techniques. We assessed the algorithm in a case study of treatment alternatives for depression. Results: Both precision and recall for identifying comparative studies was 0.83. A total of 86% of the interventions extracted perfectly or partially matched the gold standard. Conclusion: Overall, the algorithm achieved reasonable performance. The method provides building blocks for the automatic summarization of comparative effectiveness research to inform point of care decision-making.
A Universal Exchange Language for Healthcare
Authors: Robson Barry  , Caruso Thomas P.
Published: February 2025

We have defined a Universal Exchange Language (UEL) for healthcare that takes a green field approach to the development of a novel “XML-like” language. We consider here what given a free hand might mean: a UEL that incorporates an advanced mathematical foundation that uses Dirac's notation and algebra. For consented and public information, it allows probabilistic inference from UEL semantic web triplet tags. But also it is possible to use similar thinking to maximize the security and analytic characteristics of private health data by disaggregating or “shredding” it. Both are scalable to millions of records that could be spread across the Internet.