bluuebunny/crossref_metadata_2025 huggingface dataset:
Adaptive Intelligent Systems for pHealth - An Architectural Approach
Authors: González Carolina  , Blobel Bernd  , López Diego M.
Published: February 2025

Health systems around the globe, especially in developing countries, are facing the challenge of delivering effective, safe, and high quality public health and individualized health services independent of time and location, and with minimum of allocated resources (pHealth). In this context, health promotion and health education services are very important, especially in primary care settings. The objective of this paper is to describe the architecture of an adaptive intelligent system mainly developed to support education and training of citizens, but also of health professionals. The proposed architecture describes a system consisting of several agents that cooperatively interact to find and process tutoring materials to disseminate them to users (multi-agent system). A prototype is being implemented which includes medical students from the Medical Faculty at University of Cauca (Colombia). In the experimental process, the student´s learning style - detected with the Bayesian Model - is compared against the learning style obtained from a questioner (manual approach).
Wearable Monitoring Systems in Pre-term Newborns Care
Authors: Perego Paolo  , Moltani Alessia  , Fusca Marcello  , Zanini Rinaldo  , Bellù Roberto  , Andreoni Giuseppe
Published: February 2025

In the last decade, the trends in the development and management of healthcare services are focused on the personalization of prevention, diagnosis and treatment. This paper presents an example of the development of wearable technology for biosignal monitoring in the field of pre-term newborns care. The system was validated by an in-hospital pre-clinical test demonstrating efficiency, reliability and quality.
R&D in Micro-Nano-Bio Systems and Contribution to pHealth
Authors: Lymberis Andreas
Published: February 2025

The capacity to research, develop and manufacture systems that employ components based on nano- and microstructures with biological functionality, and are capable to share, ubiquitously, information is at the forefront of worldwide competition. A new generation of advanced materials, processes and emerging technologies is building up enabling highly integrated, miniaturized and smart micro-nano-bio-systems to be engineered. These fast technology developments are also stimulating the explosive growth in life sciences, which is leading to an ever increasing understanding of life at the sub-cellular and molecular level. By bringing these parallel developments to biomedicine and health, ultrafast and sensitive systems can be developed to prevent illness, to support lifestyle, to make early diagnosis or treat diseases with high accuracy and less invasiveness, and to support body functions or to replace lost functionality. Such systems will enable the delivery of individualized health services with better access and outcomes at lower costs than previously deemed possible, making a substantial contribution to bringing healthcare expenditures under control and increase its productivity. The MNBS (Micro-Nano-Bio Systems) group of EU funded projects aims at speeding up the convergence of micro- and nanotechnology with the life sciences and accelerating the development of highly integrated diagnostic, monitoring and therapeutics devices. This paper presents R&D activities supported through the MNBS group that are relevant to pHealth and discusses directions to be taken in order to overcome the current problems. Finally, it addresses future challenges to build highly integrated and reliable systems including innovation and usability issues.
Classification of pathology reports for cancer registry notifications
Authors: Nguyen Anthony  , Moore Julie  , Zuccon Guido  , Lawley Michael  , Colquist Shoni
Published: February 2025

Objective: To develop a system for the automatic classification of pathology reports for Cancer Registry notifications.
Computational recognition of SNOMED CT codes from ED case notes
Authors: Patrick Jon  , Nguyen Dung  , Wang Tingxin  , Paoloni Richard
Published: February 2025

This paper is a study of patient notes from an emergency department and a determination of their consistency for correct SNOMED CT encoding of the diagnosis, and comparison with a clinical language processing (CLP) system that determined the SCT diagnoses. Three set of notes were reviewed by a clinician with 500 records in each where: the clinician and CLP codes where the same (Matched Set); where they were different (Unmatched Set); and, where the clinicians had failed to enter a code (Unassigned Set) giving accuracies of 75%, 33.4% and 44.9% respectively.
State of the Art and Trends for Digital Pathology
Authors: García Rojo Marcial
Published: February 2025

Anatomic pathology is a medical specialty where both information management systems and digital images systems paly a most important role. Digital pathology is a new concept that considers all uses of this information, including diagnosis, biomedical research and education. Virtual microscopy or whole slide imaging, resulting in digital slides, is an outreaching technology in anatomic pathology. Limiting factors in the expansion of virtual microscopy are formidable storage dimension, scanning speed, quality of image and cultural change. Anatomic pathology data and images should be an important part of the patient electronic health records as well as of clinical data warehouse, epidemiological or biomedical research databases, and platforms dedicated to translational medicine. Integrating anatomic pathology to the “healthcare enterprise” can only be achieved using existing and emerging medical informatics standards like Digital Imaging and Communications in Medicine (DICOM®1), Health Level Seven (HL7®), and Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT®), following the recommendations of Integrating the Healthcare Enterprise (IHE®). The consequences of the full digitalization of pathology departments are hard to foresee, but short term issues have arisen that imply interesting challenges for health care standards bodies
State of the Art in Pathology Business Process Analysis, Modeling, Design and Optimization
Authors: Schrader Thomas  , Blobel Bernd  , García-Rojo Marcial  , Daniel Christel  , SŁodkowska Janina
Published: February 2025

For analyzing current workflows and processes, for improving them, for quality management and quality assurance, for integrating hardware and software components, but also for education, training and communication between different domains' experts, modeling business process in a pathology department is inevitable. The authors highlight three main processes in pathology: general diagnostic, cytology diagnostic, and autopsy. In this chapter, those processes are formally modeled and described in detail. Finally, specialized processes such as immunohistochemistry and frozen section have been considered.
Characteristics of Health Interventions: A Systematic Analysis of the Austrian Procedure Catalogue
Authors: Neururer Sabrina B.  , Pfeiffer Karl-Peter
Published: February 2025

The Austrian Procedure Catalogue contains 1,500 codes for health interventions used for performance-oriented hospital financing in Austria. It offers a multiaxial taxonomy. The aim of this study is to identify characteristics of medical procedures. Therefore a definition analysis followed by a typological analysis was conducted. Search strings were generated out of code descriptions regarding the heart, large vessels and cardiovascular system. Their definitions were looked up in the Pschyrembel Clinical Dictionary and documented. Out of these definitions, types which represent characteristics of health interventions were abstracted. The three axes of the Austrian Procedure Catalogue were approved as well as new, relevant information identified. The results are the foundation of a further enhancement of the Austrian Procedure Catalogue.
A Clinical Research Analytics Toolkit for Cohort Study
Authors: Yu Yiqin  , Zhu Yu  , Sun Xingzhi  , Tao Ying  , Zhang Shuo  , Xu Linhao  , Pan Yue
Published: February 2025

This paper presents a clinical informatics toolkit that can assist physicians to conduct cohort studies effectively and efficiently. The toolkit has three key features: 1) support of procedures defined in epidemiology, 2) recommendation of statistical methods in data analysis, and 3) automatic generation of research reports. On one hand, our system can help physicians control research quality by leveraging the integrated knowledge of epidemiology and medical statistics; on the other hand, it can improve productivity by reducing the complexities for physicians during their cohort studies.
First Experiences in Implementing a Software-Based Support for Patient Recruitment at Heidelberg University Hospital
Authors: Schreiweis Björn  , Grüber Günter  , Bergh Björn
Published: February 2025

Clinical trials have often got problems in achieving their recruitment target. Making the recruitment process more efficient and timely is tried to achieve in Heidelberg by implementing a software-based system to support patient recruitment. The architecture implemented in Heidelberg was developed in a multi-center research project named ‘EHR-based support for patient recruitment’. The architecture is generic as five distinct university hospitals developed it and found it implementable. The same architecture is also implemented at four other university hospitals in Germany. The system was implemented into the existing system architecture and can thus be implemented by the vendor of the system. This makes the system available to all customers of named systems.
Translational Meta-Analysis Tool for Temporal Gene Expression Profiles
Authors: Tusch Guenter  , Tole Olvi
Published: February 2025

Widespread use of microarray technology that led to highly complex datasets often is addressing similar or related biological questions. In translational medicine research is often based on measurements that have been obtained at different points in time. However, the researcher looks at them as a progression over time. If a biological stimulus shows an effect on a particular gene that is reversed over time, this would show, for instance, as a peak in the gene's temporal expression profile. Our program SPOT helps researchers find these patterns in large sets of microarray data. We created the software tool using open-source platforms and the Semantic Web tool Protégé-OWL.
Pluripotent Stem Cells in Mice
Authors: Schmidt Rainer  , Scheubert Lena  , Lustrek Mitja  , Repsilber Dirk  , Fuellen Georg
Published: February 2025

Pluripotent stem cells are able to self-renew and to differentiate into all adult cell types. Many studies report data describing these cells and characterize them in molecular terms. Gene expression data of pluripotent and non-pluripotent cells from mouse were assembled. Machine learning was applied to classify samples into pluripotent and non-pluripotent cells. To identify minimal sets of best biomarkers, three methods were used: information gain, random forests, and genetic algorithm.
Development and Evaluation of an Expert System for the Diagnosis of Child Autism
Authors: Lialiou Pashalina  , Zikos Dimitrios  , Mantas John
Published: February 2025

This paper presents the development of an expert system for the diagnosis of child autism and discusses potential benefits of its implementation in a clinical environment. The development of the expert system was based on a diagnostic algorithm supported by a developmental scale (PEDS) and a diagnostic tool of autism (CARS). Twelve nurses who work in pediatric hospital were asked to use the expert system for a session of 30 minutes and were asked to assess its usefulness, usability and diagnostic value. The majority of nurses agree that it is a useful and promising diagnostic tool for the clinical practice and for the identification of potential child autism cases.
Study of Iranian Breast Cancer Registration Via Established Online System During 2011
Authors: Zare Mohammad  , Rezaee Abolfazl  , Zakiani Sholeh  , Zare Amir
Published: February 2025

The present paper reports the results of a project aimed at providing Iran with a an online registry for breast cancer patients. A new ad hoc system/software has been developed in order to collect patients' data from the first visit to follow-up visits, including tests and Herceptin based therapy. The system has been designed to address both healthcare personnel needs, but also decision makers' information needs. After having identified in the country the laboratories performing the specific tests and the pharmacies that distribute Hercepting, the developed software have been installed in order to build the operational network representing the input points for the register. In 8 months of usage the results are:
Clinical Decision Support for Monitoring Drug-Drug-Interactions and Potassium-Increasing Drug Combinations: Need for Specific Alerts
Authors: Eschmann Emmanuel  , Beeler Patrick E.  , Kaplan Vladimir  , Schneemann Markus  , Zünd Gregor  , Blaser Jürg
Published: February 2025

Computer-triggered reminders alerting physicians on every potentially harmful drug-drug-interaction (DDI) induce alert fatigue due to frequent messages of limited clinical relevance. On demand DDI-checks, however, are not commonly used by physicians. Optimal strategies for sustained quality assurance have to consider patients' risk factors and focus on the most significant DDIs only. An approach is proposed based on the analysis of concurrent prescription of potassium-sparing diuretics and potassium supplements (CPPP), which are the most frequent DDIs classified as contraindicated. Although the frequency of monitoring potassium serum levels declined during prolonged periods of CPPP, the likelihood of observing a hyperkalaemia increased. The median treatment period of CPPP was 3.3 days, whereas hyperkalaemia occurred after a median observation time of 4.5 days of CPPP. Thus, computer-triggered reminders for ordering potassium serum levels may be indicated if monitoring has been discontinued after 48h of CPPP.
Development of an Electronic Nursing Records System Based on Information Models and Clinical Practice Guidelines
Authors: Park Hyeoun-Ae  , Min Yul Ha  , Jeon Eunjoo  , Kim Younglan  , Km Hyun-Young
Published: February 2025

The purpose of this study was to test the feasibility of an electronic nursing records system for perinatal care that is based on information models and clinical practice guidelines in perinatal care. We first generated 799 nursing statements describing nursing assessment, diagnoses, interventions, and outcomes using the entities, attributes, and value sets of detailed clinical models for perinatal care that we developed in a previous study. We then extracted 506 detailed recommendations from clinical practice guidelines. Finally, we created sets of nursing statements to be used for nursing documentation by grouping nursing statements based on these detailed recommendations. A prototype electronic nursing records system providing nurses with detailed recommendations for nursing practice and sets of nursing statements based on the detailed recommendations to guide nursing documentation was developed and evaluated.
Customization of biomedical terminologies
Authors: Homo Julien  , Dupuch Laëtitia  , Benbrahim Allel  , Grabar Natalia  , Dupuch Marie
Published: February 2025

Within the biomedical area over one hundred terminologies exist and are merged in the Unified Medical Language System Metathesaurus, which gives over 1 million concepts. When such huge terminological resources are available, the users must deal with them and specifically they must deal with irrelevant parts of these terminologies. We propose to exploit seed terms and semantic distance algorithms in order to customize the terminologies and to limit within them a semantically homogeneous space. An evaluation performed by a medical expert indicates that the proposed approach is relevant for the customization of terminologies and that the extracted terms are mostly relevant to the seeds. It also indicates that different algorithms provide with similar or identical results within a given terminology. The difference is due to the terminologies exploited. A special attention must be paid to the definition of optimal association between the semantic similarity algorithms and the thresholds specific to a given terminology.
Patient Support ICT Tool for Hypertension Monitoring Morten
Authors: Bonderup Algy  , Hangaard Stine Veje  , Lilholt Pernille Heyckendorff  , Johansen Mette Dencker  , Hejlesen Ole K.
Published: February 2025

Detection of hypertension is traditionally a matter for the general practitioner, but an alternative detection scheme is home blood pressure measurement by patients, on patients' or doctors' decision. We designed and implemented a prototype software tool to provide information about hypertension, video instructions on correct home blood pressure measurement technique and a measurements diary. The system was developed using standard, software development methods and techniques. The program was developed for Danish-speaking patients. Usability (navigability, level and outcome of instructions, logical arrangement, level and focus of information, and program accessibility) was evaluated in a think-aloud test with test users performing specific, realistic tasks. The prototype provides written information about hypertension, written and video instructions on correct blood pressure measurement technique, and measurements diary functionality. All test users performed all tasks and rated navigability, level and outcome of instructions, logical arrangement, level and focus of information, and program accessibility high, and had positive attitudes towards the system. The components in the patient support tool can be used separately or in combination. The effects of video for home blood pressure measurement technique instruction remain unexplored.
Conceptual Modeling for Prospective Health Technology Assessment
Authors: Gantner-Bär Marion  , Djanatliev Anatoli  , Prokosch Hans-Ulrich  , Sedlmayr Martin
Published: February 2025

Prospective Health Technology Assessment (ProHTA) is a new and innovative approach to analyze and assess new technologies, methods and procedures in health care. Simulation processes are used to model innovations before the cost-intensive design and development phase. Thus effects on patient care, the health care system as well as health economics aspects can be estimated. To generate simulation models a valid information base is necessary and therefore conceptual modeling is most suitable. Project-specifically improved methods and characteristics of simulation modeling are combined in the ProHTA Conceptual Modeling Process and initially implemented for acute ischemic stroke treatment in Germany. Additionally the project aims at simulation of other diseases and health care systems as well. ProHTA is an interdisciplinary research project within the Cluster of Excellence for Medical Technology - Medical Valley European Metropolitan Region Nuremberg (EMN), which is funded by the German Federal Ministry of Education and Research (BMBF), project grant No. 01EX1013B.
A Framework for User Involvement and Context in the Design and Development of Safe e-Health Systems
Authors: Kushniruk Andre  , Turner Paul
Published: February 2025

Current approaches to health IT research and development emphasize the valuable role of users. However, differences amongst users, in how they are defined, involved and interact with health IT under conditions of varying complexity has received limited attention. Failure to acknowledge these differences makes assessments of the quality, reliability and transferability of results problematic. More importantly, as e-health systems are increasingly opened up to use by health consumers the implications of differences in the context of system use for patient safety require closer investigation. To support the safety of e-Health systems, it is essential that where users are involved we can more accurately differentiate between types of users and their contexts of use and how these factors interact with usability and the risk of unintended consequences from such systems. This paper presents an extended three dimensional user-task-context matrix for considering who users of healthcare applications are, their needs and their requirements under differing contexts of use.
Clinical Guideline Representation in a CDS: a Human Information Processing Method
Authors: Kilsdonk Ellen  , Riezebos Rinke  , Kremer Leontien  , Peute Linda  , Jaspers Monique
Published: February 2025

The Dutch Childhood Oncology Group (DCOG) has developed evidence-based guidelines for screening childhood cancer survivors for possible late complications of treatment. These paper-based guidelines appeared to not suit clinicians' information retrieval strategies; it was thus decided to communicate the guidelines through a Computerized Decision Support (CDS) tool. To ensure high usability of this tool, an analysis of clinicians' cognitive strategies in retrieving information from the paper-based guidelines was used as requirements elicitation method. An information processing model was developed through an analysis of think aloud protocols and used as input for the design of the CDS user interface. Usability analysis of the user interface showed that the navigational structure of the CDS tool fitted well with the clinicians' mental strategies employed in deciding on survivors screening protocols. Clinicians were more efficient and more complete in deciding on patient-tailored screening procedures when supported by the CDS tool than by the paper-based guideline booklet. The think-aloud method provided detailed insight into users' clinical work patterns that supported the design of a highly usable CDS system.
Migration Path for Structured Documentation Systems including Standardized Medical Device Data
Authors: Kock Ann-Kristin  , Ingenerf Josef  , Halkaliev Stoyan  , Handels Heinz
Published: February 2025

A standardized end-to-end solution has been implemented with the aim of supporting the semantic integration of clinical content in institution spanning applications. The approach outlined is a proof-of-concept design. It has shown that the standards chosen are suitable to integrate device data into forms, to document the results consistently and finally enable semantic interoperability. In detail the implementation includes a standardized device interface, a standardized representation of data entry forms and enables the communication of structured data via HL7 CDA. Because the proposed method applies a combination of standards semantic interoperability and the possibility of a contextual interpretation at each stage can be ensured.
Towards Collaborative Chronic Care Using a Clinical Guideline-Based Decision Support System
Authors: Liu Haifeng  , Mei Jing  , Xie Guotong
Published: February 2025

Few clinical guideline-based decision support systems (DSS) have been successfully applied in chronic disease management. This paper investigates how clinical guideline-based DSS can help to put innovative chronic care models into practice and improve the quality of chronic care. A prototype of a guideline-based collaborative chronic care system called GC3 was developed based on a framework integrating guidelines into care workflow where a business process engine and a GELLO-based decision engine are integrated together to execute guidelines. We deployed the system in one of the largest hospitals in China and its affiliated community centers in order to manage type 2 diabetic patients. Pilot use of GC3 demonstrates its benefits to regional chronic care including evidence-based decision support, shared care content, improved clinician adherence to guidelines and enhanced patient self-management. This study verifies the feasibility and effectiveness in implementing collaborative chronic care across health providers using clinical guideline-based DSS.
A DICOM Architecture for Clinicians and Researchers
Authors: Onken Michael
Published: February 2025

Over the last years there has been a strong trend of publishing health data in anonymized format in order to make it available for research. This is also true for medical imaging where the DICOM standard is the predominant data format and network protocol. This paper proposes an extension to any DICOM networking infrastructure that permits sharing of medical images in an anonymized way. Standard DICOM software is utilized on client and server side. While offering researchers access to all images in anonymous format, the architecture enables authorized clinicians to access the same images including their original patient information (name, institution, etc.). Identifying parts and anonymous parts of the image data are stored to geologically different databases. Together with sophisticated network protocols, patient privacy is fully preserved.
Automatic Extracting of Patient-related Attributes: Disease, Age, Gender and Race
Authors: Zhu Huijia  , Ni Yuan  , Cai Peng  , Qiu Zhaoming  , Cao Feng
Published: February 2025

In the Evidence-based Medicine (EBM), PICO format is designed to easily and correctly search for the best available evidence. As the main element of PICO, the Patient/Problem (P) represents the attributes of patient in the clinical question and studies. In order to better understand the clinical problems, patient attribute identification is crucial and indispensable. Due to the richness of the human nature language, many issues like various term representations, grammar structures and abbreviations present challenges for automatically extracting the patient-related attributes from the unstructured data. In this paper, we employed the nature language processing (NLP) technologies to deeply analyze the linguistic characteristics of the attributes. Based on the NLP analysis results, we built the rule sets for different attributes and applied the rule-based approach to extract the patient-related attributes.
The FBE development project: toward flexible electronic standards-based bio-psycho-social individual records
Authors: Frattura Lucilla  , Simoncello Andrea  , Bassi Giovanni  , Soranzio Andrea  , Terreni Stefano  , Sbroiavacca Fulvio
Published: February 2025

Under the ARCHITRAVE programme aimed at redesigning the regional health and social information system, the alpha version of a new web application was developed using the International Classification of Functioning, Disability and Health (ICF) and other medical terminology systems as a basis for a flexible electronic standards-based bio-psycho-social record. The web application was developed in order to collect information according to a multiaxial assessment framework consistent with the model of functioning adopted by the ICF. The web application translates information collected in natural language into ICF and releases outputs at different stages of the assessment process useful in evaluating clinical and social outcomes, distinguishing between functioning and disability in the same functioning profile and planning reasonable adaptations to overcome disability. The alpha version works in Italian and was adapted to the Italian welfare system/services/policies, but an international version working in other languages/welfare systems can be designed. The first field trial is ongoing in the Friuli Venezia Giulia Region, implementing the regional Health and Social Action Plan 2010-2012.
Organizing Data Quality Assessment of Shifting Biomedical Data
Authors: Sáez Carlos  , Martínez-Miranda Juan  , Robles Montserrat  , García-Gómez Juan Miguel
Published: February 2025

Low biomedical Data Quality (DQ) leads into poor decisions which may affect the care process or the result of evidence-based studies. Most of the current approaches for DQ leave unattended the shifting behaviour of data underlying concepts and its relation to DQ. There is also no agreement on a common set of DQ dimensions and how they interact and relate to these shifts. In this paper we propose an organization of biomedical DQ assessment based on these concepts, identifying characteristics and requirements which will facilitate future research. As a result, we define the Data Quality Vector compiling a unified set of DQ dimensions (completeness, consistency, duplicity, correctness, timeliness, spatial stability, contextualization, predictive value and reliability), as the foundations to the further development of DQ assessment algorithms and platforms.
Uniforming Information Management in Finnish Social Welfare
Authors: Laaksonen Maarit  , Kärki Jarmo  , Ailio Erja
Published: February 2025

This paper describes the phases and methods used in the National project for IT in Social Services in Finland (Tikesos). The main goals of Tikesos were to unify the client information systems in social services, to develop electronic documentation and to produce specifications for nationally organized electronic archive. The method of Enterprise Architecture was largely used in the project.
COCPIT: A Tool for Integrated Care Pathway Variance Analysis
Authors: Ainsworth John  , Buchan Iain
Published: February 2025

Electronic Health Record (EHR) data has the potential to track patients' journeys through healthcare systems. Many of those journeys are supposed to follow Integrated Care Pathways (ICPs) built on evidence based guidelines. An ICP for a particular condition sets out “what should happen”, whereas the EHR records “what did happen”. Variance analysis is the process by which the difference between expected and actual care is identified. By performing variance analysis over multiple patients, patterns of deviation from idealised care are revealed. The use of ICP variance analysis, however, is not as widespread as it could be in healthcare quality improvement processes – we argue that this is due to the difficulty of combining the required specialist knowledge and skills from different disciplines. COCPIT (Collaborative Online Care Pathway Investigation Tool) was developed to overcome this difficulty and provides clinicians and health service managers with a web-based tool for Care Pathway Variance Analysis.
Noise-minimal landing and take-off trajectories under procedural and safety regulations
Authors: Richter Maximilian  , Fisch Florian  , Holzapfel Florian
Published: February 2025

A framework is presented for the noise minimization of approach and take-off trajectories. Within this framework, population and terrain models are coupled with a dynamic trajectory optimization algorithm. By using a pseudospectral method to discretize the optimal control problem integrals can be handled very efficiently using matrix multiplication. Thus, a large number of noise stations can be included allowing an accurate calculation of the perceived noise on ground. The dynamic aircraft model included in the optimization framework is based on the BADA and ANP database of EUROCONTROL. Specific path constraints have been introduced to model regulations arising from various ICAO and FAA documents. Optimized trajectories for runway 08L of Munich airport are presented and compared.
Psychophysiologic Identification of Subthreshold PTSD in Combat Veterans
Authors: Roy Michael J.  , Costanzo Michelle  , Leaman Suzanne
Published: February 2025

Posttraumatic stress disorder (PTSD) is linked with adverse health outcomes, and many military service members (SMs) are afflicted with it after they return from combat. Since many SMs have an initial honeymoon period characterized by limited symptoms before the onset of full-blown PTSD, the identification of independent predictors of PTSD upon return from deployment could facilitate early intervention. We measured psychophysiologic responses to stimuli including explosions in a Virtual Iraq/Afghanistan environment, as well as a fear potentiated startle paradigm, in a prospective cohort of SMs who did not meet criteria for PTSD and were within 2 months after return from deployment. We report marked psychophysiologic differences between those with (n = 29) and without (n = 30) subthreshold PTSD symptoms (PTSD Checklist score ≥ 28 vs. < 28). We believe this is evidence that psychophysiologic measures can help to identify individuals at high risk for PTSD.
The Use of Virtual Reality in the Treatment of Eating Disorders
Authors: Ferrer-García Marta  , Gutiérrez-Maldonado José
Published: February 2025

A high percentage of patients with eating disorders (ED) respond to treatments such as cognitive-behavioural therapy. However, some patients do not progress significantly with these treatments, or suffer relapses. The incorporation of new technologies may help to increase the efficacy of standard treatments. Virtual reality has been successfully used to treat body image disturbances in ED patients and seems a suitable technology for cue exposure therapy in this setting. We review the published literature and discuss the results.
Quality of Experience in Real and Virtual Environments: Some Suggestions for the Development of Positive Technologies
Authors: Gaggioli Andrea
Published: February 2025

What does one feel when one uses virtual reality? How does this experience differ from the experience associated with “real life” activities and situations? To answer these questions, we used the Experience Sampling Method (ESM), a procedure that allows researchers to investigate the daily fluctuations in the quality of experience through on-line self reports that participants fill out during daily life. The investigation consisted in one-week ESM observation (N = 42). During this week, participants underwent two virtual reality sessions: Immediately after the exposure to virtual environments, they were asked to complete a ESM report. For data analysis, experiential variables were aggregated into four dimensions: Mood, Engagement, Confidence, and Intrinsic Motivation Intrinsic Motivation. Findings showed that virtual experience is characterized by a specific configuration, which comprises significantly positive values for affective and cognitive components. In particular, positive scores of Mood suggest that participants perceived VR as an intrinsically pleasurable activity, while positive values of Engagement indicate that the use of VR and the experimental task provided valid opportunities for action and high skill investment. Furthermore, results showed that virtual experience is associated with Flow, a state of consciousness characterized by narrowed focus of attention, deep concentration, positive affect and intrinsic reward. Implications for VR research and practice are discussed.
FRIEND: A Brain-Monitoring Agent for Adaptive and Assistive Systems
Authors: Morris Alexis  , Ulieru Mihaela
Published: February 2025

This paper presents an architectural design for adaptive-systems agents (FRIEND) that use brain state information to make more effective decisions on behalf of a user; measuring brain context versus situational demands. These systems could be useful for alerting users to cognitive workload levels or fatigue, and could attempt to compensate for higher cognitive activity by filtering noise information. In some cases such systems could also share control of devices, such as pulling over in an automated vehicle. These aim to assist people in everyday systems to perform tasks better and be more aware of internal states. Achieving a functioning system of this sort is a challenge, involving a unification of brain- computer-interfaces, human-computer-interaction, soft-computin deliberative multi-agent systems disciplines. Until recently, these were not able to be combined into a usable platform due largely to technological limitations (e.g., size, cost, and processing speed), insufficient research on extracting behavioral states from EEG signals, and lack of low-cost wireless sensing headsets. We aim to surpass these limitations and develop control architectures for making sense of brain state in applications by realizing an agent architecture for adaptive (human-aware) technology. In this paper we present an early, high-level design towards implementing a multi-purpose brain-monitoring agent system to improve user quality of life through the assistive applications of psycho-physiological monitoring, noise-filtering, and shared system control.
Human Computer Confluence Applied in Healthcare and Rehabilitation
Authors: Viaud-Delmon Isabelle  , Gaggioli Andrea  , Ferscha Alois  , Dunne Stephen
Published: February 2025

Human computer confluence (HCC) is an ambitious research program studying how the emerging symbiotic relation between humans and computing devices can enable radically new forms of sensing, perception, interaction, and understanding. It is an interdisciplinary field, bringing together researches from horizons as various as pervasive computing, bio-signals processing, neuroscience, electronics, robotics, virtual & augmented reality, and provides an amazing potential for applications in medicine and rehabilitation.
A Brief Review of Positive Technology in Europe and the USA
Authors: Wiederhold Brenda
Published: February 2025

The aim of this paper is to demonstrate the potential of positive technology to productively and positively transform the mental health of European and American citizens in the modern era. This work will describe three aspects – hedonic, eudaimonic, and social/interpersonal – of these technologies. We approach them with guarded optimism, as all of them seek to improve our lives through various techniques. After exploring the relevant technologies, this piece will then examine the future for research within this domain.
Virtual Simulation Training Using the Storz C-HUB to Support Distance Airway Training for the Spanish Medical Corps and NATO Partners
Authors: Abadia de Barbara Alberto H.  , Nicholas IV Thomas A.  , Del Real Colomo Antonio  , Boedeker David  , Bernhagen Mary A.  , Hillan Garcia Laura  , Setién Fernando  , Boedeker Ben H.
Published: February 2025

In medicine, the advancement of new technologies creates challenges to providers both in learning and in maintaining competency in required skills. For those medical providers located in remote environments, access to learning can be even more formidable. This work describes a collaboration created to facilitate the use of new communication technologies in providing distance training and support to health care personnel deployed in remote areas.
High Definition 3D Telemedicine: The Next Frontier?
Authors: Stranieri Andrew  , Collmann Richard  , Borda Ann
Published: February 2025

Evidence from the literature indicates that the degree of immersion often referred to as the “sense of being there” experienced by clinicians and patients is a factor in the success of tele-health installations. High definition and 3D telemedicine offers a compelling mechanism to achieve a sense of immersion and contribute to an enhanced quality of use. This article surveys HD3D trials in tele-health and concludes that the way HD3D is integrated into telemedicine depends on the clinical, organisational and technological context. In some settings real time HD3D is not so desirable whereas asynchronous transmission of HD3D images and videos is highly desirable.
A Videoconferencing Tool Acting as a Home-Based Healthcare Monitoring Robot for Elderly Patients
Authors: Mapundu Zamikhaya  , Simonnet Thierry  , van der Walt J.S.
Published: February 2025

Currently, healthcare costs associated with aging at home can be prohibitive if individuals require continual/periodical supervision and assistance because of Alzheimer's disease. Open-source tools and videoconferencing tools are attracting more significant organizations; it has been observed that another way to reduce medical care costs is to reduce the length of the patient's hospitalization and reinforce home sanitary support by medical professionals with family care givers. Videoconferencing has been around for a while and presently this technology is the leading way in reducing healthcare costs, thus making medical care more available and convenient for both doctors and patients. This article portrays how the videoconferencing tool can be utilized to improve communication practices for patient monitoring using a Robot Companion. SWOT analysis method is also presented in a form of a summary and was utilized to evaluate the user's point of view.
Use of Knowledge Discovery Techniques to Understand Nurse Practitioner Practice Patterns and Their Integration into a Healthcare System
Authors: Sangster-Gormley Esther  , Kuo Mu-Hsing  , Borycki Elizabeth M.  , Schreiber Rita
Published: February 2025

The objective of this study is to assess the feasibility of applying knowledge discovery techniques to identifying nurse practitioner practice patterns and enacted scope of practice. For the research, we plan to use data extracted from a Ministry of Health database. The data items are focused around: nurse practitioner demographics, health authorities, and encounter types. This analysis produces patterns that indicate relationships between the demographics, scope of practice and practice settings of nurse practitioners working in British Columbia.
Supporting Cystic Fibrosis With ICT
Authors: Roehrer Erin  , Cummings Elizabeth  , Turner Paul  , Hauser Jenny  , Cameron-Tucker Helen  , Beggs Sean A.  , Micallef Nicole A.  , Wainwright Claire  , Cheney Joyce  , Jessup Mel  , Saddington Heather  , Ellis Leonie  , Walters Haydn  , Reid David W.
Published: February 2025

ICT use in cystic fibrosis management provides an alternative means of information supply to individuals, families, health care professionals and other stakeholders. The purpose of this paper is to present the evolution of a series of projects culminating in a project that translates the previous research into practice. In this paper the sequential nature of the projects will be detailed. The three projects explored are the Pathways Home for Respiratory Illness Project (Pathways Home), Enhancing Self-Efficacy for Self-Management in People with Cystic Fibrosis and the Tasmanian Community Fund Project (myCF pilot).
Applying Usability Methods to Identify Health Literacy Issues: An Example Using a Personal Health Record
Authors: Monkman Helen  , Kushniruk Andre
Published: February 2025

The prevalence of consumer health information systems is increasing. However, usability and health literacy impact both the value and adoption of these systems. Health literacy and usability are closely related in that systems may not be used accurately if users cannot understand the information therein. Thus, it is imperative to focus on mitigating the demands on health literacy in consumer health information systems. This study modified two usability evaluation methods (heuristic evaluation and usability testing) to incorporate the identification of potential health literacy issues in a Personal Health Record (PHR). Heuristic evaluation is an analysis of a system performed by a usability specialist who evaluates how well the system abides by usability principles. In contrast, a usability test involves a post hoc analysis of a representative user interacting with the system. These two methods revealed several health literacy issues and suggestions to ameliorate them were made. Thus, it was demonstrated that usability methods could be successfully augmented for the purpose of investigating health literacy issues. To improve users' health knowledge, the adoption of consumer health information systems, and the accuracy of the information contained therein, it is encouraged that usability methods be applied with an added focus on health literacy.
Role of Healthcare Information Technology in Handoffs
Authors: Koppel Ross  , Telles Joel Leon
Published: February 2025

Handoffs—transfer of patient care from one clinician or service to another—are well known patient safety dangers. Healthcare Information Technology (HIT) as an intervening and powerful force in handoffs has received comparatively little attention. The role of HIT in concert with paper documentation has received even less attention. We analyze handoffs in relation to electronic records and hybrid systems (both paper and HIT) to identify sources of error and miscommunication. We propose a typology of handoffs and illustrate several of them.
Knowledge Translation in eHealth: Building a Virtual Community
Authors: Bassi Jesdeep  , Lau Francis  , Hagens Simon  , Leaver Chad  , Price Morgan
Published: February 2025

Knowledge can be powerful in eliciting positive change when it is put into action. This is the belief that drives knowledge translation. The University of Victoria (UVic) eHealth Observatory is focused on deriving knowledge from health information system (HIS) evaluation, which needs to be shared with HIS practitioners. Through an application of the Knowledge-to-Action Framework and the concept of a virtual community, we have established the virtual eHealth Benefits Evaluation Knowledge Translation (KT) Community. This paper describes the foundational elements of the KT Community and our overall KT strategy.
Complex Interventions in Healthcare and Health Informatics: A Scoping Review
Authors: Kim Julie
Published: February 2025

Complex interventions are pervasive in healthcare. There is a need to make sense of complex interventions to support their better development, implementation and evaluation. This paper summarizes the results of a scoping review undertaken to identify attributes of, and logistical considerations for complex interventions in healthcare. Results suggest five distinct attributes that can assist researchers to identify, conduct, and appraise complex interventions studies. Considerations for applying results to evaluate complex health informatics interventions are discussed.
The Use of Discrete-Event Simulation Modeling to Compare Handwritten and Electronic Prescribing Systems
Authors: Ghany Ahmad  , Vassanji Karim  , Kuziemsky Craig  , Keshavjee Karim
Published: February 2025

Electronic prescribing (e-prescribing) is expected to bring many benefits to Canadian healthcare, such as a reduction in errors and adverse drug reactions. As there currently is no functioning e-prescribing system in Canada that is completely electronic, we are unable to evaluate the performance of a live system. An alternative approach is to use simulation modeling for evaluation. We developed two discrete-event simulation models, one of the current handwritten prescribing system and one of a proposed e-prescribing system, to compare the performance of these two systems. We were able to compare the number of processes in each model, workflow efficiency, and the distribution of patients or prescriptions. Although we were able to compare these models to each other, using discrete-event simulation software was challenging. We were limited in the number of variables we could measure. We discovered non-linear processes and feedback loops in both models that could not be adequately represented using discrete-event simulation software. Finally, interactions between entities in both models could not be modeled using this type of software. We have come to the conclusion that a more appropriate approach to modeling both the handwritten and electronic prescribing systems would be to use a complex adaptive systems approach using agent-based modeling or systems-based modeling.
Design and Development of a Novel Thoracoscopic Tracheoesophageal Fistula Repair Simulator
Authors: Davis Lauren M.  , Barsness Katherine A.  , Rooney Deborah M.
Published: February 2025

Thoracoscopic repair of esophageal atresia with tracheoesophageal fistula (EA/TEF) is a technically challenging surgical procedure. This congenital anomaly is rare; therefore, training opportunities for surgical trainees are limited. There are currently no validated simulation tools available to help train pediatric surgery trainees. The simulator that was developed is a low-cost, reusable model. It simulates the right side of a term neonate chest and contains a tissue block that has been surgically modified to replicate the anatomy of EA/TEF.