bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementing OpenMRS for patient monitoring in an HIV/AIDS care and treatment program in rural Mozambique
Authors: Manders Eric-Jan  , José Eurico  , Solis Manuel  , Burlison Janeen  , Nhampossa José Leopoldo  , Moon Troy
Published: February 2025

We have adopted the Open Medical Record System (OpenMRS) framework to implement an electronic patient monitoring system for an HIV care and treatment program in Mozambique. The program provides technical assistance to the Ministry of Health supporting the scale up of integrated HIV care and support services in health facilities in rural resource limited settings. The implementation is in use for adult and pediatric programs, with ongoing roll-out to cover all supported sites. We describe early experiences in adapting the system to the program needs, addressing infrastructure challenges, creating a regional support team, training data entry staff, migrating a legacy database, deployment, and current use. We find that OpenMRS offers excellent prospects for incountry development of health information systems, even in severely resource limited settings. However, it also requires considerable organizational infrastructure investment and technical capacity building to ensure continued local support.
Using ProMED-Mail and MedWorm Blogs for Cross-Domain Pattern Analysis in Epidemic Intelligence
Authors: Stewart Avaré  , Denecke Kerstin
Published: February 2025

In this work we motivate the use of medical blog user generated content for gathering facts about disease reporting events to support biosurveillance investigation. Given the characteristics of blogs, the extraction of such events is made more difficult due to noise and data abundance. We address the problem of automatically inferring disease reporting event extraction patterns in this more noisy setting. The sublanguage used in outbreak reports is exploited to align with the sequences of disease reporting sentences in blogs. Based our Cross Domain Pattern Analysis Framework, experimental results show that Phase-Level sequences tend to produce more overlap across the domains than Word-Level sequences. The cross domain alignment process is effective at filtering noisy sequences from blogs and extracting good candidate sequence patterns from an abundance of text.
A 3-step eHealth approach to transfer knowledge on HIV and sexual violence in developing countries
Authors: van Zyl Hendra  , Dartnall Liz
Published: February 2025

This paper discusses an innovative 3-step eHealth approach to translate research for target audiences' knowledge uptake in developing countries. The first step uses a knowledge transfer model for the identification and packaging of health content as well as the selection of appropriate Information and Communication Technologies (ICT) platforms; followed by consumer health informatics studies to evaluate the efficacy of addressing health consumers' information needs; and the final step recommends forming of strategic partnerships to strengthen and support knowledge transfer and sharing. The 3-step eHealth approach is based on a convergence of ICTs, and application of the practices and principles of informatics and knowledge management. It was refined during the development of AfroAIDSinfo, an AIDS information portal of the SA Medical Research Council (MRC). The approach was evaluated during the forming of a strategic partnership between the AfroAIDSinfo project of the MRC's Web and Media Technologies Platform and the Sexual Violence Research Initiative. The successful outcome of the eHealth approach served to collect evidence for good practice in informatics and knowledge management.
Leapfrogging Paper-Based Records Using Handheld Technology: Experience from Western Kenya
Authors: Were Martin C.  , Kariuki James  , Chepng'eno Viola  , Wandabwa Margaret  , Ndege Samson  , Braitstein Paula  , Wachira Juddy  , Kimaiyo Sylvester  , Mamlin Burke
Published: February 2025

Problem: There is limited experience with broad-based use of handheld technologies for clinical care during home visits in sub-Saharan Africa. Objective: We describe the design, development, implementation, and evaluation of a PDA/GPS-based system currently used during home visits in Western Kenya. Results: The system, built on Pendragon Forms, was used to create electronic health records for over 40,000 individuals over a three-month period. Of these, 1900 represented cases where the individual had never received care for the identified condition in an established care facility. On a five-point scale, and compared to paper-and-pen systems, end-users felt that the handheld system was faster (4.4 ± 0.9), easier to use (4.5 ± 0.8), and produced higher quality data (4.7 ± 0.7). Projected over three years to cover two million people, use of the handheld technologies would cost about $0.15 per person – compared to $0.21 per individual encounter entered manually into a computer from a paper form. Conclusion: A PDA/GPS system has been successfully and broadly implemented to support clinical care during home-based visits in a resource-limited setting.
Theories, Models and Frameworks for Diagnosing Technology-Induced Error
Authors: Borycki Elizabeth  , Kushniruk Andre  , Brender Jytte
Published: February 2025

Information technology has the potential to greatly streamline healthcare and reduce the chance of human error. However, there is a growing literature indicating that if systems are not designed adequately they may actually increase the possibility of error in the complex interaction between clinician and machine in healthcare (i.e. they may lead to technology-induced errors). In other domains the study of error has been guided by a variety of theories, models and frameworks for understanding human error. In this paper we argue for the need to consider and extend this work to the study of technology-induced error in healthcare. Insights from the software engineering, human factors and organizational behaviour literature will be described, including a set of models and frameworks that we have been using to guide our work in detecting and preventing technology-induced error in healthcare.
Extraction of Adverse Drug Effects from Clinical Records
Authors: Aramaki Eiji  , Miura Yasuhide  , Tonoike Masatsugu  , Ohkuma Tomoko  , Masuichi Hiroshi  , Waki Kayo  , Ohe Kazuhiko
Published: February 2025

With the rapidly growing use of electronic health records, the possibility of large-scale clinical information extraction has drawn much attention. We aim to extract adverse drug events and effects from records. As the first step of this challenge, this study assessed (1) how much adverse-effect information is contained in records, and (2) automatic extracting accuracy of the current standard Natural Language Processing (NLP) system. Results revealed that 7.7% of records include adverse event information, and that 59% of them (4.5% in total) can be extracted automatically. This result is particularly encouraging, considering the massive amounts of records, which are increasing daily.
Implementation of a Clinical Decision Support System using a Service Model: Results of a Feasibility Study
Authors: Borbolla Damian  , Otero Carlos  , Lobach David F.  , Kawamoto Kensaku  , Gomez Saldaño Ana M.  , Staccia Gustavo  , Lopez Gastón  , Figar Silvana  , Luna Daniel  , de Quiros Fernan Gonzalez Bernaldo
Published: February 2025

Numerous studies have shown that the quality of health care is inadequate, and healthcare organizations are increasingly turning to clinical decision support systems (CDSS) to address this problem. In implementing CDSS, a highly promising architectural approach is the use of decision support services. However, there are few reported examples of successful implementations of operational CDSS using this approach. Here, we describe how Hospital Italiano de Buenos Aires evaluated the feasibility of using the SEBASTIAN clinical decision support Web service to implement a CDSS integrated with its electronic medical record system. The feasibility study consisted of three stages: first, end-user acceptability testing of the proposed CDSS through focus groups; second, the design and implementation of the system through integration of SEBASTIAN and the authoring of new rules; and finally, validation of system performance and accuracy. Through this study, we found that it is feasible to implement CDSS using a service-based approach. The CDSS is now under evaluation in a randomized controlled trial. The processes and lessons learned from this initiative are discussed.
HIPAA Compliance and Patient Privacy Protection
Authors: Grandison Tyrone  , Bhatti Rafae
Published: February 2025

Recent prosecutions of violations of the Health Insurance Portability and Accountability Act (HIPAA), and the amendments currently in process to strengthen the Act of 1996, has led many companies to take serious notice of the measures they must take to be a compliance. A company's privacy policy states the business' privacy practices and embodies the firm's commitments to its users and is normally mandatory step in reaching legislative compliance. in the face of this, the patient has to decipher if the company's privacy practices are congruent with their thoughts on the level of privacy protection they should be receiving. This is the core of our investigation. In this paper, we explore the question “Is a helthcare entity's compliance with regulation sufficient to provide the patient with adequate privacy protection?” in the context of the United States of America.
A Qualitative Approach to Signal Mining in Pharmacovigilance using Formal Concept Analysis
Authors: Lillo-Le Louët Agnès  , Toussaint Yannick  , Villerd Jean
Published: February 2025

“Pharmacovigilance is the process and science of monitoring the safety of medicines, consisting in (i) collecting and managing data on the safety of medicines (ii) looking at the data to detect ‘signals’ (any new or changing safety issue)” [1]. Pharmacovigilance is mainly based on spontaneous reports: when suspecting an adverse drug reaction, health care practitioners send a report to a spontaneous reporting system (SRS). This produces huge databases containing numerous reports and their manual exploration is both cost and time prohibitive. Existing techniques that automatically extract relevant signals rely on statistics or Bayesian models but do not provide information to the experts about possible biases lying in the data, nor about the specificity of a signal to a particular patient profile. Our extraction method combines numerical methods from the state of the art with a qualitative approach that helps interpretation. We build a synthetic representation of the database that is used to (i) identify unexpected patterns and biases (ii) extract potentially relevant signals w.r.t. patient profiles (iii) provide traceability facilities between extracted signals and raw data.
Addressing SNOMED CT Implementation Challenges Through Multi-disciplinary Collaboration
Authors: Liu Justin  , Lane Kelly  , Lo Elisa  , Lam Mary  , Truong Tran  , Veillette Christian
Published: February 2025

This article describes the challenges of implementing SNOMED CT into electronic clinical documentation systems for discharge summaries, synoptic operative notes and ambulatory documentation. Four significant implementation challenges were identified throughout these projects, which required collaboration between specialists across several disciplines to resolve. The challenges included: designing the graphical user interface for selecting SNOMED CT values, gathering and validating template specifications that use SNOMED CT subsets, handling SNOMED CT subsets and extensions, and, creating algorithms and the technological infrastructure to generate fast, meaningful, non-redundant search results. Our experiences suggest that, while the usage of SNOMED CT in tertiary care settings is promising, collaboration between specialists from multiple disciplines is needed to utilize their unique project management, data modeling, technical, and clinical skills in overcoming implementation challenges.
Landmark Rating and Selection Considering the Observability Regions
Authors: Hochdorfer Siegfried  , Schlegel Christian
Published: February 2025

Simultaneous localization and mapping (SLAM) is a fundamental problem in mobile robotics. The ever growing number of landmarks during robot action is still a problem on the way to lifelong operation. The reason is that the continuously growing number of landmarks leads to an unbounded increase of computational complexity in terms of computational power and memory.
Application of Geological Radar in Health Diagnosis of Nanjing Gulou Tunnel
Authors: Wang Yuan  , Liu Songyu  , Tan Yuehu  , Duan Jianli  , Zeng Jing  , Gao Lei
Published: February 2025

Taking health diagnosis of Nanjing Gulou tunnel as background, the principles and methods of making non-destructive testing on the tunnel lining quality by using geological radar were expounded. General rules on the radar images, the thickness of formwork concrete and sprayed concrete, metallic doors and windows, the dense dripping section and the leaking water cranny were interpreted. The detecting results of geological radar show that bugs existing behind the tunnel lining is serious with a consecutive leaking water cranny every 5~7 meters, and the concrete thickness is uneven from 27cm to 37cm. When the tunnel is repaired, it is found that the chiseled structure state and the geological radar detecting results are unanimous.
Study on the Integration of Digitalization and Numerical Analysis Based on the Digital Underground Space and Engineering
Authors: Zhu H.H  , Li X.X
Published: February 2025

With the development of information technology in geotechnical engineering, Underground Space and Engineering System (DUSES), a digital product was introduced. It is a managerial platform, which can provide information sharing and analysis for the construction, the management, the operation and the maintenance of the underground engineering. Its main functions include 3D modeling, visualization, data query, spatial analysis and so on. However, the supreme deficiency of DUSES lies in the fact that it cannot be introduced into numerical analysis to guide engineering practice. So it is necessary for the underground engineering, the resource sharing of the strata information and the numerical analysis to realize the integration of DUSES and numerical analysis. The paper describes an extension for DUSES that enables to perform finite element analysis by integration. Firstly, the integration mode of the system is researched and a combined type (embedded and loose coupling) is presented. That is to say, the numerical modeling is embedded into the function of DUSES and the modeling module is exploited; the calculation and the result feedback are performed with the loose data conversion module. Secondly, the contents of the integration are discussed in detail from the aspects of function, data and technique. The general framework of implementation is established. Finally, to illustrate the applicability of the proposed method, one example is provided. The results show that the integration of digitalization and numerical analysis can extend the professional analysis functions of DUSES. By employing the integration technique, mechanical analysis in partial region can be optionally implemented and the project design can be optimized. For the numerical analysis system, the automatic modeling can be realized by extracting the data from database. The efficiency of preprocessor and the accuracy of the calculation results can also be largely improved. The proposed technique will give some useful references for the continuous research on this subject.
Study on shield tunnel database on construction data
Authors: Sugimoto Mitsutaka  , Arai Yasushi  , Nishida Yoshio  , Kayukawa Koji  , Sato Wataru  , Kuriki Minoru
Published: February 2025

Shield tunnelling method was used from 1920 in Japan. As the innovation of closed type shield technology around 1970's, the number of shield tunnel constructions in urban area increased rapidly. As a result, more than 4000 shield tunnels have been constructed in Japan and maintenance work for aged shield tunnels increases recently. To carry out the maintenance work efficiently, not only the maintenance data after the completion of shield tunnel construction, but also the construction data are necessary. Therefore, JSCE established the technical committee on shield tunnel database in 2007. At first, the TC carried out the questionnaire survey on the database concerned with shield tunnels to the owners and contractors of shield tunnels to grasp present status. From this questionnaire survey, it was found that the maintenance data are well updated by the owners, but the detail construction data become lost according to time passing. Therefore, the TC focused on the detail construction data and discussed the methodology to establish the shield tunnel database on construction data. This paper presents the overview of the shield tunnel database, based on the interim report by the TC.
Analyzing Stationary States of Gene Regulatory Network Using Petri Nets
Authors: Gambin Anna  , Lasota Sławomir  , Rutkowski Michał
Published: February 2025

We introduce and formally define the notion of a stationary state for Petri nets. We also propose a fully automatic method for finding such states. The procedure makes use of the Presburger arithmetic to describe all the stationary states. Finally we apply this novel approach to find stationary states of a gene regulatory network describing the flower morphogenesis of A. thaliana. This shows that the proposed method can be successfully applied in the study of biological systems.
A Framework for Treatment of Autism Using Affective Computing
Authors: Chung Seong Youb  , Yoon Hyun Joong
Published: February 2025

It is known that as many as 1 in 91 children are diagnosed with autistic spectrum disorder. Since the children with autism usually do not express their own emotional status, it is needed to develop a novel technology to sense their emotional status and give proper psychological treatment. This article presents a framework of the treatment system for children with autism using affective computing technologies.
A Serious Game for Off-Pump Coronary Artery Bypass Surgery Procedure Training
Authors: Cowan Brent  , Sabri Hamed  , Kapralos Bill  , Moussa Fuad  , Cristancho Sayra  , Dubrowski Adam
Published: February 2025

We have begun development of an interactive, multi-player serious game for the purpose of training cardiac surgeons, fellows, and residents the series of steps comprising the Off-Pump Coronary Artery Bypass grafting (OPCAB) surgical procedure. It is hypothesized that by learning the OPCAB procedure in a “first-person-shooter gaming environment”, trainees will have a much better understanding of the procedure than by traditional learning modalities. The serious game will allow for simulation parameters related to levels of fidelity to be easily adjusted so that the effect of fidelity on knowledge transfer can be examined.
Technology Transfer at the University of Nebraska Medical Center
Authors: Matsuo Kulia  , Runge Henry J.  , Miller David J.  , Barak-Bernhagen Mary A.  , Boedeker Ben H.
Published: February 2025

The course of developing a new product from an idea is a complicated process. This paper will discuss that process, in detail, from conception to product. We approach this by first discussing what the inventor must do begin the process of developing his or her idea, and then two pathways that occur simultaneously: the Technology Transfer process of patenting, marketing, and licensing the invention; and the engineering process of developing, modifying, and manufacturing the invention. Although the process is lengthy and most ideas never become a marketed product, there are those few ideas that do become realized into marketed products.
Fuzzy Control of a Hand Rehabilitation Robot to Optimize the Exercise Speed in Passive Working Mode
Authors: Baniasad Mina Arab  , Akbar Mohammad  , Alasty Aria  , Farahmand Farzam
Published: February 2025

The robotic rehabilitation devices can undertake the difficult physical therapy tasks and provide improved treatment procedures for post stroke patients. During passive working mode, the speed of the exercise needs to be controlled continuously by the robot to avoid excessive injurious torques. We designed a fuzzy controller for a hand rehabilitation robot to adjust the exercise speed by considering the wrist angle and joint resistive torque, measured continuously, and the patient's general condition, determined by the therapist. With a set of rules based on an expert therapist experience, the fuzzy system could adapt effectively to the neuromuscular conditions of the patient's paretic hand. Preliminary clinical tests revealed that the fuzzy controller produced a smooth motion with no sudden change of the speed that could cause pain and activate the muscle reflexive mechanism. This improves the recovery procedure and promotes the robot's performance for wide clinical usage.
Personal Health Systems for Mental Health: The European Projects
Authors: Riva Giuseppe  , Banos Rosa  , Botella Cristina  , Gaggioli Andrea  , Wiederhold Brenda K.
Published: February 2025

Since the European funded project VREPAR – Virtual Reality in Neuro-Psycho-Physiology (1995) – different European research activities have been using virtual reality and advanced information and communication technologies to improve the quality of care in the treatment of many different mental health disorders including anxiety disorders, eating disorders and obesity. Now the European Commission funding is shifting from the traditional hospital-centred and reactive healthcare delivery model toward a person-centred and preventive one. The main outcome of this shift is the “Personal Health Systems” (PHS) paradigm that aims at offering continuous, quality controlled, and personalized health services to empowered individuals regardless of location. The paper introduces four recently funded projects – Interstress, Monarca, Optimi and Psyche – that aim at using PHS based on virtual reality, biosensors and/or mobile technologies to improve the treatment of bipolar disorders, depression and psychological stress.
Applications of Tactile Feedback in Medicine
Authors: Wottawa Christopher  , Fan Richard  , Bisley James W.  , Dutson Erik P.  , Culjat Martin O.  , Grundfest Warren S.
Published: February 2025

A tactile feedback system has been developed in order to provide augmentative sensory feedback for a number of medical applications. The key component to the system is a pneumatic balloon-based tactile display, which can be scaled and adapted for a variety of configurations. The system also features pneumatic and electronic control system components, a commercial force sensor modified to fit the desired application. To date, this technology has been successfully applied to medical robotics, minimally invasive surgery, and rehabilitation medicine.
Combined Intubation Training (Simulated and Human) for 4
Authors: Boedeker Ben H.  , Bernhagen Mary  , Nicholas IV Thomas A.  , Murray W. Bosseau
Published: February 2025

The video laryngoscope is a useful tool in intubation training as it allows both the trainer and the student to share the same view of the airway during the intubation process. In this study, the Center for Advanced Technology and Telemedicine's airway training program employed videolaryngoscopy (VL) in teaching both simulated (manikin) and human intubation. The videolaryngoscope statistically improved the glottic view in both the standard and difficult manikin airways when compared to that with standard (direct) laryngoscopy. The success rate in simulated difficult airway intubation was significantly improved using VL. With human intubation training, there was statistically significant improvement in airway views using VL and a 97.5% intubation success rate. The enhanced view of the videolaryngoscope in airway intubation facilitates the learning process in performing both simulated and human intubation, making it a powerful tool in intubation training.
An Online Method for Diagnosis of Difficult TB Cases for Developing Countries
Authors: Marcelo Alvin  , Fatmi Zafar  , Firaza Paul Nimrod  , Shaikh Shiraz  , Dandan Alvin Joseph  , Irfan Muhammad  , Bari Vaqar  , Scott Richard E.
Published: February 2025

Optimal use of limited human, technical and financial resources is a major concern for tuberculosis (TB) control in developing nations. Further impediments include a lack of trained physicians, and logistical difficulties in arranging face-to-face (f-2-f) TB Diagnostic Committee (TBDC) consultations. Use of e-Health for virtual TBDCs (Internet and “iPath”), to address such issues is being studied in the Philippines and Pakistan. In Pakistan, radiological diagnosis of 88 sputum smear negative but suspected TB patients has been compared with the ‘gold standards’ (TB culture, and 2-month clinical follow up). Of 88 diagnostic decisions made by primary physicians at the spoke site and electronic TBDC (e-TBDC) at hub site, there was agreement in 71 cases and disagreement on 17 cases. The turn-around time (TAT; patient registration at spoke site for f-2-f diagnosis to receiving the electronic diagnosis), averaged 34.6 hours; ranging 9 minutes to 289.2 hours. Average TAT at the rural site (59.15 hours) was more than the urban site (15.9 hours). Comparison of e-TBDC and f-2-f diagnosis with the gold standards showed only slight differences. Using culture as the gold standard, e-TBDC decisions showed greater accuracy (sensitivity - 32.4%) as compared to f-2-f (27.6%); using 2-month clinical follow-up as the gold standard, f-2-f diagnosis showed slightly better improvement in patient symptoms and weight as compared to e-TBDC. In Philippines “iPath” was trialed and demonstrated that e-TBDCs have potential. Such groups could review cases, diagnose, and write comments remotely, reducing the diagnosis and treatment delay compared to usual care.
Clinical and Economic Results from a Randomized Trial of Clinical Decision Support in a Rural Health Network
Authors: Eisenstein Eric L.  , Kawamoto Kensaku  , Anstrom Kevin J.  , Willis Janese M.  , Silvey Garry M.  , Johnson Fred S.  , Edwards Rex  , Mise Jean  , Yaggy Susan D.  , Lobach David F.
Published: February 2025

Background: Replication studies evaluate technologies in usual use settings. Methods: We conducted a clinical trial to determine whether reductions in clinical and economic results observed in a previous study could be replicated in a larger setting. Subjects were randomized to receive intervention (email notifications for sentinel health events sent to their care managers) or control. Main Outcome Measures: The primary outcome was the rate of emergency department visits for low severity conditions. Secondary outcomes included: medical costs and other clinical event rates. Results: We randomized 13,454 individuals (intervention, 6740; control, 6714). Subjects in both groups had similar rates of clinical events and medical costs. Conclusion: The use of email notifications to care managers was associated with no reductions in clinical events or medical costs.
Automated Recognition and Post-Coordination of Complex Clinical Terms
Authors: Gooch Philip  , Roudsari Abdul
Published: February 2025

One of the key tasks in integrating guideline-based decision support systems with the electronic patient record is the mapping of clinical terms contained in both guidelines and patient notes to a common, controlled terminology. However, a vocabulary of pre-coordinated terms cannot cover every possible variation – clinical terms are often highly compositional and complex. We present a rule-based approach for automated recognition and post-coordination of clinical terms using minimal, morpheme-based thesauri, neoclassical combining forms and part-of-speech analysis. The process integrates MetaMap with the open-source GATE framework.
Mapping the Finnish National EHR to the LOINC
Authors: Häyrinen Kristiina  , Mykkänen Juha
Published: February 2025

The unified content of EHRs promote shared understanding of patient data, information exchange between information systems and health care organizations, data retrieval from EHR and reuse of data for administrative purposes, statistical analysis or clinical research. The purpose of this study was to analyze to what extent Finnish national headings can be coded with the current version LOINC. Ten (37%) of national headings can be mapped to LOINC terms in clinical class. There were LOINC terms in other classes which correspond to headings. Furthermore, inconsistency exists in the names of headings. The need for mapping national headings to all terms in LOINC is needed.
XML as a Cross-Platform Representation for Medical Imaging with Fuzzy Algorithms
Authors: Gal Norbert  , Stoicu-Tivadar Vasile
Published: February 2025

Machines that perform linguistic medical image interpretation are based on fuzzy algorithms. There are several frameworks that can edit and simulate fuzzy algorithms, but they are not compatible with most of the implemented applications. This paper suggests a representation for fuzzy algorithms in XML files, and using this XML as a cross-platform between the simulation framework and the software applications. The paper presents a parsing algorithm that can convert files created by simulation framework, and converts them dynamically into an XML file keeping the original logical structure of the files.
Towards a Standardised Representation of a Knowledge Base for Adverse Drug Event Prevention
Authors: Koutkias Vassilis  , Lazou Katerina  , de Clercq Paul  , Maglaveras Nicos
Published: February 2025

Knowledge representation is an important part of knowledge engineering activities that is crucial for enabling knowledge sharing and reuse. In this regard, standardised formalisms and technologies play a significant role. Especially for the medical domain, where knowledge may be tacit, not articulated and highly diverse, the development and adoption of standardised knowledge representations is highly challenging and of outmost importance to achieve knowledge interoperability. To this end, this paper presents a research effort towards the standardised representation of a Knowledge Base (KB) encapsulating rule-based signals and procedures for Adverse Drug Event (ADE) prevention. The KB constitutes an integral part of Clinical Decision Support Systems (CDSSs) to be used at the point of care. The paper highlights the requirements at the domain of discourse with respect to knowledge representation, according to which GELLO (an HL7 and ANSI standard) has been adopted. Results of our prototype implementation are presented along with the advantages and the limitations introduced by the employed approach.
Mapping the ATC Classification to the UMLS Metathesaurus: Some Pragmatic Applications
Authors: Merabti Tayeb  , Abdoune Hocine  , Letord Catherine  , Sakji Saoussen  , Joubert Michel  , Darmoni Stefan J.
Published: February 2025

ATC classification is a WHO international classification used to classify drugs. The aim of this paper is to evaluate two lexical methods in English and in French to map ATC to UMLS. Several applications have been impemented to illustrate the use of the ATC mapping in English and French: (a) MeSH translation in Norwegian, (b) Drug Information Portal, and (c) ATC to PubMed tool. Two lexical methods were used to map ATC to UMLS. The first approach used a French natural language processing tool to map French terms of ATC to the French terminologies of UMLS. The second approach used the MetaMap tool to map English terms of ATC to UMLS. The English MetaMap provides slightly more mappings than the French NLP tool (3,170 vs. 2,992). On the other hand, the French NLP tool provides a slightly better precision than MetaMap (88% vs. 86%). Using a manual mapping between ATC and MeSH, the union of the validated mappings between ATC and MeSH provides 2,824 mappings (68.7% of ATC codes of the fifth level). Lexical methods are powerful methods to map health terminologies to the UMLS Metathesaurus. Manual mapping is still necessary to complete the mapping.
Lessons Learnt from Conducting a High Fidelity Simulation Test in Health IT
Authors: Lawton Kitta  , Binzer Kristine  , Skjoet Peter  , Jensen Sanne
Published: February 2025

Testing IT-systems by use of simulation requires a thorough planning and preparation in order to create a realistic clinical environment. For a successful test through simulation a dedicated test team to control the environment is needed, as well as people to play the role of patients and staff. Relevant artifacts and elaborate scenarios ensure the narrative. This paper explores the preliminary work and execution of an extensive test of a Computerized Order Entry System prototype. Central to the setup of the test is a script which outlines the method by guiding the preparation and execution.
Affective Reactions to Visually Masked Stimuli within a Virtual Environment
Authors: Drummond Jason  , Berthouze Nadia  , Steed Anthony
Published: February 2025

Within perceptual psychology, visual masking describes a process whereby the presentation of one image, the mask, affects the conscious perception of another, the target. Given the right conditions the target can effectively be rendered invisible. There is a dearth of research into the effects of visually masked stimuli within virtual environments, particularly with regard to affect psychology. Of the two studies presented here, the first study was used to establish the efficacy of visual masking using three dimensional, masked objects. Usually, mask and target stimuli are co-planar, with no internal depth disparity. This study found that visual masking is possible within a virtual space using target objects with internal depth disparity. The second study investigated affect driven, choice reactions to three dimensional, masked facial expressions. This study also found an effect, specifically an unconscious bias to navigate away from angry, masked faces and towards smiling, masked expressions. These two studies form a foundation for a wider project: using visual masking within a virtual environment for mood induction, primarily as a cybertherapeutic aid.
People Like Virtual Counselors That Highly-Disclose About Themselves
Authors: Kang Sin-Hwa  , Gratch Jonathan
Published: February 2025

In this paper, we describe our findings from research designed to explore the effect of self-disclosure between virtual human counselors (interviewers) and human users (interviewees) on users' social responses in counseling sessions. To investigate this subject, we designed an experiment involving three conditions of self-disclosure: high-disclosure, low-disclosure, and non-disclosure. We measured users' sense of co-presence and social attraction to virtual counselors. The results demonstrated that users reported more co-presence and social attraction to virtual humans who disclosed highly intimate information about themselves than when compared to other virtual humans who disclosed less intimate or no information about themselves. In addition, a further analysis of users' verbal self-disclosure showed that users revealed a medium level of personal information more often when interacting with virtual humans that highly-disclosed about themselves, than when interacting with virtual humans disclosing less intimate or no information about themselves.
Immersive Virtual Environments for Emotional Engineering: Description and Preliminary Results
Authors: Rodríguez Alejandro  , Rey Beatriz  , Alcañiz Mariano
Published: February 2025

This work aims to identify the arousal and presence level during an emotional engineering study. During the experimental sessions, a high-immersion Virtual Reality (VR) system, a CAVE-like configuration, will be used. Thirty-six volunteers will navigate through virtual houses that can be customized and that have been designed for emotional induction. Emotional induction will be obtained by stimulating the senses of sight, hearing and smell. For this purpose, the ambient lighting, music and smell will be controlled by the researcher, who will create a comfortable environment for the subject. Several physiological variables – Electrocardiogram (ECG), Respiratory signal and Galvanic Skin Response (GSR) – will be recorded during the sessions. The obtained results will help furniture companies identify the senses that have more influence on emotions and will be the basis for new studies about user needs in the sector of furniture and interior decoration.
Lateral Response of Suction Caissons in Deep Water Floating Structures off Niger Delta Coast
Authors: Ejezie Samuel U.  , Kabari Baribeop
Published: February 2025

The lateral response of suction caissons used as anchors for floating structures in the offshore Niger Delta has been investigated using the “Lumped Parameter Systems” model. In this process, the dynamic stability (horizontal vibration) of suction caissons used to anchor floating production facilities located deep offshore of the Niger Delta has been examined. Geotechnical conditions prevalent at Niger Delta Deep offshore have been used to determine dynamic soil parameters needed for analyses. Also, dynamic wave properties of the offshore environment which correspond to 100 years return period have served as inputs into the analyses. Results of analyses show that for a given wave condition, an increase in the mass of caisson whose height to diameter ratio is 2:1 causes a decrease in the horizontal amplitudes of vibration of the caissons. Results also reveal that continuous increase in the mass of caisson beyond certain limits does not significantly reduce vibrating amplitude. This is important because it provides information on the limiting mass and hence the size of caisson required in any particular situation. A most striking observation made is the fact that for a given wave steepness, several smaller units of suction caissons can be used rather than a single massive unit. Cases considered show reduction in amplitude by 67%, 41%, 32% and 23% respectively for increase in the number of caissons to 2, 4, 6, and 10.
Utilisation des Bétons Compactés au Rouleau (BCR)
Authors: Cisse I.K.  , Sall A.
Published: February 2025

The construction of flexible pavements is very expensive for countries like Senegal. Moreover these counries aren't producing petroleum which is a raw material for asphalt used in coating. So, it is necessary to find a method of construction that combine fiability, durability and economy. One of these methods is Roller Compacted Concrete or RCC. The modeling of the RCC structure was done with Ecoroute program that allows for a check of allowable stress and strain on all pavement layers. The application of RCC in the stretch Diamniadio-Mbour has shown interesting results. The crushing test made in laboratory yield on the average, 33 MPa as compressive strength and 4 MPa as tensile strength, at 28 days. On the other hand, for a pavement with a thickness of 30 cm, using RCC, 47 percent of economy was achieved relatively to flexible pavement.
Experimental evaluation of free swell method to measure swelling pressure of expansive soil
Authors: Attom M.F.  , El-Emam M.M.
Published: February 2025

Free swell method is a common method used to determine the swelling pressure of expansive soil. In this method the swelling pressure is defined as the pressure that brings the soil sample to its initial void ratio. The main objectives of the this investigation were to study the effect of sample size, stress history and load increment on the soil swelling pressure measured in free swell method. To achieve these objects, three types of expansive clayey soils were selected based on different clay content and consistency limits. Large numbers of identical remolded specimens from each soil were prepared at different initial conditions and tested using the free swell method. For the same identical specimens, the swelling pressure was evaluated at different load increment, different sample size and different stress history. It was found that the final value of the swelling pressure is highly dependent on stress history and sample size as well as on the load increment. The final swelling pressure value decreased with increasing the load increment and the rate of loading and increased as the sample size increased.
Design of deep excavation and retaining structures for the garage house and sewage farm under the road from Portorož to the old part of the city of Piran – Slovenia
Authors: Ocepek D.  , Likar J.
Published: February 2025

The ground conditions are typical for this part of the Slovenian coast and consist of Eocene flysch – a mixed soft rock mass consisting of siltstone, sandstone, intermediate layers of calcarenite and an overlying highly-weathered soft rock zone covered by clayey gravel. In order to determine the rock mass properties, the Rock mass classification, determined by the geological strength index (GSI ),was used, pressuremeter measurements (“in situ” measurements) were conducted and intact samples taken. During laboratory examinations, we conducted triaxial shear tests by way of cyclic loading and reloading and uniaxial compression and point load tests. The road embankment and the highly-weathered soft rock zone was investigated by dynamic penetration tests (DPSH). The construction of a seven storey high rise garage house required excavation under the hill below the Portorož-Piran main road. The road was under a traffic load for the whole duration of construction. In order to fully understand the behaviour of the excavation and retaining measures in the design phase, a 3D stage construction finite element model was required. A geotechnical model was created for the retaining wall and slope protection with self-boring micro piles and anchors from behind the garage house and sewage farm.
Accurate monitoring of displacements by liquid level instrumentation
Authors: van Rietschoten-Rietveld A.J.  , Schellingerhout A.J.G.
Published: February 2025

Liquid level instrumentation is a commonly accepted and effective method to perform precision monitoring of vertical displacements during building and tunnelling activities. The liquid level sensors mounted to the structure detect the change of the hydrostatic pressure relative to a reference cell outside the zone of influence. The progress in sensor technology by using advanced digital correction technology has minimized the errors in the pressure measurement. Nowadays most errors are caused by the properties of the liquid and routing of the liquid-filled tubes.
Triaxial test simulation on Erksak sand using hardening soil model
Authors: Sokolić I.  , Skazlić Ž.
Published: February 2025

Hardening Soil model (HS) available in numerical computer program Plaxis is widely used in geotechnical practice for modeling both cohesive and non cohesive soils. The basic characteristics of the model are stress dependent stiffness according to a power law, plastic straining due to primary deviatoric loading, plastic straining due to primary compression, elastic unloading/reloading and failure according to the Mohr-Coulomb model. In this paper parameters of HS model are evaluated for Erksak sand. The triaxial tests database used consists of 15 drained and 31 undrained tests and it covers wide range of sand density and isotropic consolidation pressure. Results of simulations show that relative density has to be accounted for to be able to simulate the sand behavior for different states. Some relationships to relative density are proposed for reference secant stiffness, effective angle of internal friction and angle of dilatancy. Great advantages of HS model, but also some limitations are presented in this paper, both for drained and undrained conditions.
Development of a Web-Based Decision Support System for Insulin Self-Titration
Authors: Simon A.C.R.  , Holleman F.  , Hoekstra J.B.  , De Clercq P.A.  , Lemkes B.A.  , Hermanides J.  , Peek N.
Published: February 2025

Insulin is the most potent agent for the treatment of diabetes mellitus. However insulin treatment requires frequent evaluation of blood glucose levels and adjustment of the insulin dose. This process is called titration. To guide patients with type 2 diabetes using once-daily long-acting insulin, we have developed a web-based decision support system for insulin self-titration. The purpose of this paper is to provide an overview of the phases of development and the final design of the system. We reviewed the literature, consulted an expert panel, and conducted interviews with patients to elicit system requirements. This revealed four important aspects: the insulin titration algorithm, the handling of hypoglycemic events, telemedicine functionalities, and visiting frequency monitoring. We used these requirements to develop a fully functional system.
Prognostic Data-Driven Clinical Decision Support - Formulation and Implications
Authors: Rinott Ruty  , Carmeli Boaz  , Kent Carmel  , Landau Daphna  , Maman Yonatan  , Rubin Yoav  , Slonim Noam
Published: February 2025

Existing Clinical Decision Support Systems (CDSSs) typically rely on rule-based algorithms and focus on tasks like guidelines adherence and drug prescribing and monitoring. However, the increasing dominance of Electronic Health Record technologies and personalized medicine suggest great potential for prognostic data-driven CDSS. A major goal for such systems would be to accurately predict the outcome of patients' candidate treatments by statistical analysis of the clinical data stored at a Health Care Organization. We formally define the concepts involved in the development of such a system, highlight an inherent difficulty arising from bias in treatment allocation, and propose a general strategy to address this difficulty. Experiments over hypertension clinical data demonstrate the validity of our approach.
Traceability of Patient Records Usage: Barriers and Opportunities for Improving User Interface Design and Data Management
Authors: Cruz-Correia Ricardo  , Lapão Luís  , Rodrigues Pedro Pereira
Published: February 2025

Although IT governance practices (like ITIL, which recommends on the use of audit logs for proper service level management) are being introduced in many Hospitals to cope with increasing levels of information quality and safety requirements, the standard maturity levels of hospital IT departments is still not enough to reach the level of frequent use of audit logs. This paper aims to address the issues related to the existence of AT in patient records, describe the Hospitals scenario and to produce recommendations. Representatives from four hospitals were interviewed regarding the use of AT in their Hospital IS. Very few AT are known to exist in these hospitals (average of 1 per hospital in an estimate of 21 existing IS). CIOs should to be much more concerned with the existence and maintenance of AT. Recommendations include server clock synchronization and using advanced log visualization tools.
Integration Services to Enable Regional Shared Electronic Health Records
Authors: Oliveira Ilídio C.  , Cunha João P.S.
Published: February 2025

eHealth is expected to integrate a comprehensive set of patient data sources into a coherent continuum, but implementations vary and Portugal is still lacking on electronic patient data sharing. In this work, we present a clinical information hub to aggregate multi-institution patient data and bridge the information silos. This integration platform enables a coherent object model, services-oriented applications development and a trust framework. It has been instantiated in the Rede Telemática de Saúde (www.RTSaude.org) to support a regional Electronic Health Record approach, fed dynamically from production systems at eight partner institutions, providing access to more than 11,000,000 care episodes, relating to over 350,000 citizens. The network has obtained the necessary clearance from the Portuguese data protection agency.