bluuebunny/crossref_metadata_2025 huggingface dataset:
Decision-Support System for Arterial Hypertension: Haemodynamic Monitoring and Treatment
Authors: Adilova Fatima T.  , Tursunbaev Olim  , Paizieva M.
Published: February 2025

In order to study the daily fluctuation of central haemodynamic's parameters a mathematical model was developed, which take into account internal (neurohumoral) and external (metrological) factors. Study results have been used to design a computer-based simulation system for diagnosing the initial stages of arterial hypertension and choosing the optimal ways of treatment. The validity of the model was evaluated by comparing a group of patients treated traditionally, with a group treated using the system.
MULTI-SEARCH - A SEARCH TOOL FOR LITERATURE RETRIEVAL
Authors: Åhlfeldt Hans  , Lanhammar Erik  , Wigertz Ove
Published: February 2025

This paper reports on the design and implementation of a search tool for access to the Elhill family of databases. The architecture is in principle similar to other existing client/server based search applications for literature retrieval, but offers a series of important features in relation to access to Swedish databases as well as to major international databases. The system offers a uniform search form which is initialised with search elements and access methods depending on the chosen database structure. The search form could be adapted according to the users search experience and utilises in its full power all available access elements and search strategies offered in the different databases. The paper also discusses similarities and differences compared to other search tools and indicates possible future directions.
Discovering Knowledge from Visual Field Data: Results in Optic Nerve Diseases
Authors: Cheng Gongxian  , Liu Xiaohui  , Wu John  , Jones Barrie  , Hitchings Roger
Published: February 2025

In this paper we propose a method for knowledge discovery from visual field test data. First, noise in the data is located and filtered out. Second, the self-organising feature maps (SOFM) are used to extract regularities or features in the resultant data. Third, visualisation methods are employed to display the features so that these features can be easily observed by knowledge analysts or domain experts. Finally, these features are analyzed by the knowledge analysts to form useful knowledge. We have experimented with the proposed method using large quantities of clinical data from subjects with different kinds of optic nerve diseases such as glaucoma and onchocerciasis. We report on the kind of knowledge discovered by the proposed method and their clinical implications.
Anticipation by Learning of Image Retrieval
Authors: Bandon David  , Kanz Robert  , Wehenkel Claude
Published: February 2025

The performance of a Picture Archiving and Communication System (PACS) can be substantially improved by anticipating the image retrievals made by physicians. Appropriate radiological exams are transferred to their workstation before the session of consultation occurs. Our contribution is to propose a model able to select relevant historical exams for the future sessions whatever the medical speciality is. The approach is to reproduce the specific medical cognitive processes by handling the relevance of exams and by learning and reusing the medical procedural knowledge. The relevance is judged by physicians and the learning process is provided by storing past sessions. The reasoning is supported by a hybrid model integrating three different techniques: the case-based reasoning, the radiological summary and a default technique based on heuristic rules. These techniques are attempted one after the other until a solution is found.
Preliminary Research using K-Mean Clustering for Auditory Brainstem Response Detection
Authors: Grönfors Tapio  , Tian Jilei  , Juhola Martti
Published: February 2025

The major task in the automatic interpretation of the auditory brainstem response is the detection of the pedestal peak, which is a broad peak filtered out from the auditory brainstem response signal. The preliminary classification of auditory brainstem response is special validation stage of preliminary peak used to determine whether a real response is present. Its results drive the automatic pattern recognition process. Parameters of pedestal peak can be clustered statistically significant.
Interactive Atlas of Congenital Craniofacial Malformations
Authors: Larsen Per  , Kreiborg Sven  , Vinther Flemming  , Darvann Tron  , Schiemann T.  , Tiede U.  , Höhne K.H.
Published: February 2025

A true 3D interactive atlas of the craniofacial region in patients with severe congenitalcraniofacial anomalies, such as Apert and Crouzon syndromes, has been developed using an extended version of the VOXEL-MAN software [1].
The education of an informatics nurse A bachelor program for graduate nurses in the Netherlands
Authors: van Aalst Esther
Published: February 2025

The Holland University has developed a program that educates nurses to be nurse informaticions. The program has been implemented now for 5 years. This paper provides an overview of an education program that the Health Department of the Holland University offers graduate nurses to become nurse informaticions (BSNi) and will give a contribution to the discussion about the competences that a nurse informaticion must have acquired upon completion of the course.
A CAL System for Training and Treatment in an ITU
Authors: Hollingsworth Robert. A.  , Richards Bernard  , Doran Barry
Published: February 2025

An Expert System has been designed for use in an Intensive Care Environment. As a major part of that system, a series of modules for CAL have been incorporated. These cover Cardiac Arrest and the Insertion of a Pulmonary Artery Catheter. As a further part of training, screens are provided to give a full explanation for every course of treatment proposed.
Health Informatics Education - Establishing a Faculty Mindset
Authors: Hovenga Evelyn J.S.
Published: February 2025

Central Queensland University is located in a Regional Centre on the rural coastal area of Queensland, with five regional campuses up to 350 kms apart. The nearest major cities are around 700 kms to the north and south. Though the University is isolated in a geographical sense it provides access to higher education at both the undergraduate and post graduate levels. The University is committed to open learning, the concept of an Integrated Regional University and is an internationally recognised provider of distance education. A variety of innovative educational approaches are used. The vision is for its staff to manage their own information well by effectively accessing and evaluating a variety of external information. The University has and is developing programs that equip its students with information management skills. It is this environment that has ensured the provision of a suitable information and communications technology infrastructure. This paper aims to describe how the University's vision is operationalised through its IT infrastructure and by Faculty and Division initiatives to create a mindset by staff to embrace the use of technology to enhance teaching and learning.
MIDWIVES AND INFORMATION TECHNOLOGY
Authors: Carroll T  , Philbin M  , Lavin M  , Williams M  , Young H  , Kelly M
Published: February 2025

The benefits of involving end users in the procurement and implementation project cycles are discussed. Re-engineering health care through empowerment and the changes that need to take place if the full potential of IT is to be realised are addressed. The untapped potential of midwives is demonstrated.
The PRESTIGE Project: Implementing Guidelines in Healthcare
Authors: Gordon Colin  , Veloso Mario
Published: February 2025

There is a wide consensus among healthcare professionals that unacceptable delays occur in the implementation of new standards for best clinical practice. This problem is common to the everyday practice of healthcare professionals throughout Europe and results in poor quality of care and wasted resources. PRESTIGE addresses this problem by the use of clinical guidelines and protocols which have been shown to be effective in improving the healthcare process in terms of quality, efficiency and outcome. The project will use healthcare telematics technology to assist in the generation, dissemination and routine application of guidelines, and thus will bridge the gap between medical research and everyday clinical practice. The outcome of PRESTIGE will be an installed and sustainable healthcare telematics infrastructure that supports the dissemination and application of research-based and consensus-based guidelines defining best practice in clinical care.
TELEMATICS SUPPORT FOR THE SHARED CARE MANAGEMENT OF CORONARY ARTERY DISEASE IN THE PRESTIGS PROJECT
Authors: Pitty David  , Reeves Phil  , Gordon Colin  , Ilic Zeljko  , Rickards Tony
Published: February 2025

PRESTIGS is a European Commission funded project looking at the application of clinical guidelines and protocols in routine clinical care with the support of information technology. This paper outlines one part of the PRESTIGS project, namely the management of coronary artery disease between primary, secondary and specialist centres. We identify a number of information technology based components required to support the clinical scenario, such as an electronic patient record, terminology servers, protocol and act management servers, knowledge bases, enterprise managers and protocol authoring tools, and we then show how these components work together to support the guideline based approach to clinical care.
Software: Main Applications
Authors: Devlies José  , Mehuys Alex  , Sosa-Iudicissa Marcelo
Published: February 2025

The objective of Information Systems is to ensure that reliable and accurate information is available when it is needed and that it is presented in a usable form. According to the purpose for data processing, information systems can be classified in different application types. However, these categories are more or less artificial. They are all related to each other and the functionalities are not always strictly different. In each type an example of the application used in health care will be described.
Clinical Landmarks, Horizontal Strains and Prognosis in Thoracic Scoliosis
Authors: Geyer B.  , Le Merrer Y.
Published: February 2025

In Thoracic scoliosis, can the evolution and/or the result of an orthopaedic treatment be in relation with clinical morphology of the scoliotic patient? To answer this question we choose two parameters which could détermine clinical morphology of scoliotic patients : The sagittal trunk balance (STB) and the thoracic factor (TF) (TF = relation between thoracic diameters). These parameters were chosen according to their simplicity, their reliability and also their dynamic significance. It is obvious that other landmarks exist but we limit the study to be clear. With the STB we emphasize the variety of posterior muscular chain activity, with the TF we consider rather the mechanical forces of the thoracic wall and their changes in a horizontal plan. The TF is coming from clinical or radiological datas.
Quantifying Shape Changes Using Surface Curvature
Authors: Durdle N.G.  , Polak M.  , Raso V.J.  , Hill D.L.
Published: February 2025

The complex and interrelated trunk asymmetries due to scoliosis are difficult to quantify succinctly. Changes in topography can be quantified independent of both orientation and growth by using the curvatures inherent in the trunk surface. Digital representations of the trunk surface were produced by projecting a pattern on the otherwise featureless trunk. This paper reviews approaches to representing surface shape. An approximation technique was used to quantify the curvature from the discretely sampled surface. Curvature is a combination of both the first and second order partial derivatives. These derivatives were determined through convolution with a Gaussian kernel. Tradeoffs were necessary between kernel size and width of the Gaussian. The goal was to have the Gaussian large enough so a sufficient local area could be used to compute the partial derivatives while ensuring that the majority of the volume of the Gaussian was within the kernel. The surface was segmented into local regions of similar characteristics. A shape index was used to distinguish nine regions - spherical cup, trough, rut, saddle rut, saddle, saddle ridge, ridge, dome and spherical cap. We concluded that this shape index provides the most discriminating representation of trunk shape.
A Posture Control System for the Treatment of Scoliosis
Authors: Lou E.  , Durdle N.G.  , Raso V.J.  , Hill D.L.
Published: February 2025

A posture control system has been developed to help scoliotic children improve the cosmetic appearance of their trunk. The system consists of an electromagnetic transmitter and receivers and a microcontroller. The electromagnetic system measures topographical features of the trunk; the microcontroller analyses the acquired data and provides immediate feedback to the subject about body position. The device is battery powered so that subjects can be monitored during their daily activities and capable of detecting changes with a resolution of 0.5 cm and 1.5° in the range of 30 to 45 cm.
Surface Topography and Spinal Imaging: The Advantages and Disadvantages
Authors: Dangerfield P.H.
Published: February 2025

There are a range of different methods available to image the spine and to measure and study the surface topography of the trunk deformity. These include use of Surface contact instruments, such as the scoliometer and formulator contour tracer, Moire topography, light-projection techniques including raster-sterography, traditional radiography, CT scanning, Magnetic Resonance Imaging and ultrasound. All are relatively easy to use, range in cost per image and have different potential applications in the management of scoliosis. Although patient attitude is important in considering the merits of any one technique, surface topography as a technique will only demonstrate is value if it can be applied to developing understanding of the aetiology, natural history and pathomechanisms of spinal deformity. Its clinical recognition with widespread use in spinal units for patient management is also important. Thus it is essential to spell out exact benefits from any one imaging method and to be fully aware of the strengths and weaknesses of the overall approach of employing them and surface topography methodology to scoliosis and spinal deformity.
The Relationship Between Stature and the Volume of the Lumbar Disc Investigated Using MRI
Authors: Dangerfield P.H.  , Roberts N.  , Hogg D.C.  , Whitehouse G.H.  , Edwards R.H.T.
Published: February 2025

Magnetic Resonance Imaging (MRI) has been applied to the examination of changes in the length of the spine which occurs between the recumbent and upright positions. Disc volume changes and their correlation with the variation in standing height were examined in seven normal female volunteers with the results indicating that dynamic time-dependent deformations are present within the intervertebral disks. These are attributed to fluid flowing to and from the disk and by visco-elastic deformation of the anulus fibres under the influence of osmotic and mechanical pressures. A significant difference between the sexes in the maximum volume of the disks was present, attributed to the increased lumbar lordosis in the female. Spinal length changes between recumbent and upright postures and the associated sexual dimorphism are biomechanical and physical effects which may have major clinical significance in the context of scoliosis aetiology.
Architecture of Nursing Modules for Electronic Healthcare Records
Authors: Assimacopoulos André  , Kruezsely Attila  , Borgazzi André
Published: February 2025

Patient record is the repository of data describing the patient care process. It is the center of many diverging aims such as monitoring the care delivery process for a given patient to the recycling of care data for health statistics, accounting and billing. The nursing care process, as an example of the problem solving paradigm applied to health care plays a key role in the nursing activity. Its architecture is apparently quite compatible with emerging European standards for Electronic Healthcare Records (EHCR). A detailed study of nursing modules implemented in various existing or recently developed patient information systems will give critical indications for the integration of nursing data in a standardized architecture of electronic healthcare records.
Computerized Hand Diagnostic/Rehabilitation System Using a Force Feedback Glove
Authors: Burdea Grigore  , Deshpande Sonal  , Popescu Viorel  , Langrana Noshir  , Gomez Daniel  , DiPaolo Daneca  , Kanter Melissa
Published: February 2025

This paper describes recent results of a unified computerized system for hand diagnosis and rehabilitation. Automatic diagnosis data collection and Virtual Reality rehabilitation exercises are the main characteristics of the system. The diagnosis subsystem includes a tactile sensing glove in addition to standard devices such as electronic dynamometer, pinchmeter and goniometer. Three standard rehabilitation exercises were simulated in a Virtual Reality environment, using the WorldToolKit graphics library. The first two exercises (ball squeezing and DigiKey) allow measurement of finger forces exerted during the rehabilitation routine. The third exercise (Peg board) involves the patient's visual-motor coordination. The rehabilitation subsystem uses a VPL DataGlove retrofitted with Rutgers Master (RM-I) and its interface. The exercises involve manipulation of objects with different stiffnesses and geometry. Grasping forces were modeled and fed back using the Rutgers Master worn on patient's hand. Data is gathered in real time from both diagnosis and rehabilitation subsystems. Finger specific forces recorded during rehabilitation exercises allow better diagnosis of the patient impairment. An ORACLE database is used to store and manipulate patients' records. Proof of concept trials were performed in a clinical environment. Some results of patient records analysis are presented in this paper. A new version of the system using an RM II haptic interface is presently under consideration.
Use of the virtual Instrumentation Laboratory for the Assessment of Human Factors in Surgery and Anesthesia
Authors: Berguer Ramon  , Loeb Robert G.  , Smith Warren D.
Published: February 2025

There is a growing consensus that human factors issues for anesthesiologists, surgeons, and other operating room personnel require serious attention. We have established a program of collaboration between the University of California Davis Medical Center Departments of Anesthesiology and Surgery and the California State University Sacramento Biomedical Engineering Program to address ergonomic problems in anesthesiology and surgery using a Virtual Instrumentation Laboratory. A 17-workstation Virtual Instrument Laboratory using LabVIEW software on Power Macintosh platforms permits rapid prototyping of medical monitor displays as well as rapid development of data acquisition and processing circuits for physiologic data collection. The Virtual Instrument Lab has been used for three Master's thesis projects and a BME course titled Human Factors in the Design of Medical and Assistive Technology. Course projects have included: 1) The design of novel physiologic data displays for potential use in anesthesia workstations, and 2) The measurement of surface electromyographic signals and heart rate variability to investigate the physical and mental workload of performing laparoscopic surgery. The Virtual Instrument Lab allows BME students to investigate relatively complex human factors issues in anesthesiology and surgery in a short time span.
Virtual Reality in Endonasal Surgery
Authors: Hilbert Margot  , Müller Wolfgang
Published: February 2025

Virtual environments provide a new dimension of graphic simulation. The interaction between the human and the computer is now intuitive for the user. The use of virtual reality (VR) gives the user the feeling of participating in a (computer generated) scenario very much like reality. This feeling is an essential requirement for simulation of surgical interventions using digital data. Especially in the fields of sinus and skull-base surgery, computer assisted simulation could present a valuable and effective alternative method for honing endoscopic skills.
Display of Coregistered Cross-Modality Images Using Time-Weighted Alternation Method
Authors: Sung Lee Jae  , Chee Youngjoon  , Kim Boyeon  , Lee Jong Min  , Park Kwang Suk  , Kwark Cheoleun  , Lee Myung Chul
Published: February 2025

Cross-modality coregistration of functional and anatomical images has rapidly grown as the aid for the interpretation of functional images. Various methods have been previously investigated so that the coregistered images can be easily interpreted and realistically visualized. We used the time/intensityweighted alternation method to display the coregistered images simultaneously. Stereotactic registration was done with two methods. We realized the automated method of alignment using the boundary of head scalp extracted from the sinogram of a PET emission scan and surface-matching algorithm in brain, and the semi-automated method using a paired point-matching algorithm in the chest and abdomen. For the simultaneous display of the stereotactically registered images, rapid switching of the screens were applied on which both images were written with independent color scales. Rapid alternate display of two images, that is synchronized using the monitor scanning process, could induce the fusion of images in the human visual perception system. Also, intensification of an interesting image is possible by weighting the displaying time or global intensities of images with the degree of interest. These techniques could be useful for the interpretation and visualization of the coregistered images.
Force Sensor for Laparoscopic Babcock
Authors: Morimoto Alan K.  , Foral R.D.  , Kuhlman J.L.  , Zucker Karl A.  , Curet Myriam J.  , Bocklage T.  , MacFarlane T.I.  , Kory L
Published: February 2025

General: A force sensor has been designed and fabricated that will fit to existing laparoscopic grasping forceps (Babcocks) from Ethicon Endosurgery Inc. The goal of the sensor development is to provide tool-tissue force information to the surgeons so that surgeons can regain the sense of touch that has been lost through laparoscopy. Eventually, force sensing will provide feedback for robotic laparoscopic surgical platforms.
Telepresence in Neurosurgery: The Integrated Remote Neurosurgical System
Authors: Kassell Neal. F.  , Hunter Downs III J.  , Graves B. Sean
Published: February 2025

This paper describes the Integrated Remote Neurosurgical System (IRNS), a remotely-operated neurosurgical microscope with high-speed communications and a surgeon-accessible user interface. The IRNS will allow high quality bidirectional mentoring in the neurosurgical suite. The research goals of this effort are twofold: to develop a clinical system allowing a remote neurosurgeon to lend expertise to the ORbased neurosurgical team and to provide an integrated training environment. The IRNS incorporates a generic microscope/transport model, Called SuMIT (Surgical Manipulator Interface Translator). Our system is currently under test using the Zeiss MKM surgical transport. A SuMIT interface is also being constructed for the Robotics Research 1607. The IRNS Remote Planning and Navigation Workstation incorporates surgical planning capabilities, real-time, 30 fps video from the microscope and overhead video camera. The remote workstation includes a force reflecting handcontroller which gives the remote surgeon an intuitive way to position the microscope head. Bidirectional audio, video whiteboarding, and image archiving are also supported by the remote workstation. A simulation mode permits pre-surgical simulation, post-surgical critique, and training for surgeons without access to an actual microscope transport system. The components of the IRNS are integrated using ATM switching to provide low latency data transfer. The research, along with the more sophisticated systems that will follow, will serve as a foundation and test-bed for extending the surgeon’s skills without regard to time zone or geographic boundaries.
The Brain Project: An Interactive Learning Tool Using Desktop Virtual Reality on Personal Computers
Authors: Kling-Petersen Torben  , Rydmark Martin
Published: February 2025

The BRAIN-project is an endeavor in using computer aided learning to improve the understanding of the human brain anatomy. The project consists of four parts, each based on modular packages:
Preparing our Future Physicians: Integrating Medical Informatics into the Undergraduate Medical Education Curriculum
Authors: Kaufman David M.  , Jennett Penny A.
Published: February 2025

This paper describes how two medical schools have integrated “medical informatics” into their undergraduate medical education programs with the aim of preparing their students for future practice. It describes the components or elements of the informatics programs, how learning opportunities have been integrated into the curricula, how the informatics programs have evolved, and future directions.
Assessment of Trabecular Structure Using High Resolution Magnetic Resonance Imaging
Authors: Majumdar Sharmila  , Genant Harry K.
Published: February 2025

Although bone mineral density is one of the most important contributing factors to bone strength and risk of fracture, studies have shown that changes in bone quality and structure independent of bone mineral density, influence both bone strength and individual risk of fracture. The influence of these other factors is thought to explain at least partially the observed overlap in bone mineral measurements between patients with and without osteoporotic fractures, irrespective of measurement site or technique. Thus, several new emerging techniques have been aimed at quantifying trabecular bone structure in addition to bone density. With recent hardware and software advances magnetic resonance (MR) images with spatial resolutions of 80 - 150 μm and slice thickness of 300 - 700 μm which resolve the trabecular structure have been obtained both in vitro and in vivo. Both modified spin-echo and gradient echo based imaging sequences have been used to obtain these images, and although the technical parameters and the sequence specific mechanisms affect the depiction of trabecular bone. In conjunction with three dimensional image processing and an understanding of the mechanisms of image formation, these high resolution images may be used to quantify trabecular bone architecture. In addition to obtaining standard stereological measures such as trabecular bone volume, mean trabecular width, mean trabecular spacing, mean intercept length as a function of angle, parameters such as three dimensional connectivity as measured by the Euler number, fabric tensor in three dimensions and texture related parameters such as fractal dimension may be derived from such images. Quantitative measures of trabecular architecture derived from such images have been compared with those obtained from higher resolution 18 μm images, and with biomechanical properties. In vivo studies in the radius and calcaneus have been performed and differences between osteoporotic and normal subjects are distinguishable. Thus, MR imaging techniques coupled with computerized image analysis may potentially be very useful for studying osteoporosis and quantifying trabecular bone architecture and may provide information in addition to bone density.
Health Care Reforms in Europe from the Perspective of a Government Chief Nursing Officer
Authors: Zandbergen Willem
Published: February 2025

As a chief nursing officer I am directly involved in healthcare issues on a national level.
User-Centered Design of Experiential Learning Courseware
Authors: Donkers Bram  , Buller Vincent  , Schulz Carl  , Osseyran Anwar
Published: February 2025

To create educational software (courseware) that really meets the needs of the end-user two separate sets of principles should be incorporated in the development process: first a learning model to support the course structure and secondly a product design method to create the final courseware product.
Functional and Control Integration of an ICU, LIS and PACS Information System
Authors: Katehakis D.  , Tsiknakis M.  , Armaganidis A.  , Orphanoudakis S.
Published: February 2025

The need for collaboration and data sharing among systems dedicated to individual functional areas and user groups has initiated major efforts towards the development of an integrated hospital information system. Major issues in the development of any integrated architecture that incorporates autonomous departmental systems include the development of commonly accepted interaction mechanisms, standardisation, the structure of the computerised patient record, its extensibility, as well as limitations multimedia data impose. This paper presents work done within project IHIS, a nationally funded project for the development of an integrated hospital information system that provides ICU staff with access to both the ICU assisting laboratory information system's data as well as radiological multimedia data.
Implementing Security On a Prototype Hospital Database
Authors: Khair Marie  , Pangalos George  , Andria Foteini  , Bozios Lefteris
Published: February 2025

This paper describes the methodology used and the experience gained from the application of a new secure database design approach and database security policy in a real life hospital environment. The applicability of the proposed database security policy in a major Greek general hospital is demonstrated. Moreover, the security and quality assurance of the developed prototype secure database is examined, taking into consideration the results from the study of the user acceptance.
Telematics and Smart Cards in Integrated Health Information System
Authors: Sicurello F.  , Nicolosi A.
Published: February 2025

Telematics and information technology are the base on which it will be possible to build an integrated health information system to support population and improve their quality of life. This system should be based on record linkage of all data based on the interactions of the patients with the health structures, such as general practitioners, specialists, health institutes and hospitals , pharmacies, etc.
Post-integration of a tumor documentation system into a HIS via middleware
Authors: Schweiger R  , Bürkle T  , Dudeck J
Published: February 2025

Integrating autonomous applications is a difficult task since they usually represent similar informations in different data schemes. Any communication requires an agreement of sender and receiver on a common data representation. The number of interfaces to convert one data representation into another is minimized if all participants of an information system agree on one data representation such as Health Level Seven (HL7) or Edifact. Even more convenient is the use of a middleware solution like the Distributed Healthcare Environment (DHE) that keeps message transfer completely transparent to the integration process. This paper discusses a project that aims at the integration of a cancer registry system into a DHE based Hospital Information System (HIS).The project is a cooperation between the universities of Gießen and Magdeburg within the framework of the European Communities Telematics Research Project HC 1019 HANSA (Healthcare Advanced Networked System Architecture).The concept of a so called ‘DHE-Adapter’ to integrate existing legacy systems is explained. This adapter converts a data or message format of a legacy system into calls of the DHE programming interface. To develop a DHE-Adapter for our cancer registry system we intend to design a DHEA-dapter- Generator which would be able to produce DHE-Adapters for different systems and export formats, e.g. HL7 or Edifact. That would allow a variety of software vendors to integrate their products into the DHE without entering deeply into the DHE’s programming interface.
ARMEDA : Accessing Remote Medical Databases over the World Wide Web
Authors: Fernandez Isabel  , Maojo Victor  , Alamo Sebastian  , Crespo Jose  , Sanandres Jose  , Martin Fernando
Published: February 2025

We have created a computer system to access medical information located at remote databases over the World Wide Web, for epidemiological ad health services research. We made a preliminary prototype where a specific database model could be searched and information be retrieved. We are currently working on a new componentbased architecture, where different databases scheme from various sites can be used to create a unified model, giving users a “virtual” vision of a single, local database. Different software engineering and artificial intelligence methods are used to access, integrate, filter and deliver information to users.
A Clinical Quality Management Support System
Authors: Andersen Henrik  , Haustermans Karin  , Glindtvad Karin
Published: February 2025

In the CONQUEST Quality Management System, assessment and improvement of the quality of treatment process and outcome is done by introducing a Clinical Quality Management Support System. Initially the treatment of breast cancer was chosen to illustrate the potential benefits of introducing quality management in the treatment process. The main objective of the CONQUEST Quality Management System is to provide a flexible framework for supplying quality management of the treatment process and enable comparison of clinical results, despite differences in the local best clinical practice guidelines used in the participating treatment centres.
The Role of Communication Servers in the Architecture of Healthcare Information Systems
Authors: Heitmann Kai U.
Published: February 2025

Communication between departmental subsystems within a hospital information system (HIS) is more and more supported by dedicated communication servers (CS). One of the main advantages is a centralized and standardized flow of information. Beside this “classic” approach a communication server may be embedded on at least two other hierarchical levels in the architecture of healthcare information systems: in an organizational unit within a hospital (subsystem) but also in large scale healthcare information systems covering aspects of communication between the involved external healthcare providers.
The Erlangen Hospital Communication Hub: Migration from Proprietary to Standardised Communication
Authors: Wentz Bernhard  , Seggewies Christof  , Bell Robert  , Knispel Sabine  , Kraska Detlef
Published: February 2025

The Erlangen communication hub allows medical subsystems to exchange data by two completely different methods. Since 1995 a communication data base, which is implemented using the relational data base system ADABAS D, contains data from the most important hospital systems. This data can be accessed by other medical systems.
Using a Revised Model to Identify Information Requirements for Cardiac Surgery Patients Operating Mobile Computing Technology
Authors: Gassert C.A.
Published: February 2025

Information system selection and implementation continues to occupy the majority of informatics nurses' time in clinical settings. Despite the availability of more sophisticated guidance for system selection and implementation, some agencies continue to fail when attempting to automate their information processing. Such failures cost the agencies time and resources, two valuable commodities. In some cases information systems were selected and specifications developed without first identifying information needs within the agencies. The Model for Identifying Information System Requirements (MDISR) could be used to help agencies to identify information needing to be considered during the selection and implementation processes.
Nursing Informatics in Nursing Education
Authors: Saba V.K.  , Riley J.B.
Published: February 2025

Full integration of nursing informatics education at all levels at academic institutions and in practice is critical to nursing as the profession faces the 21st century. Nursing informatics, which encompasses computer hardware, software, and network systems, supports the profession's goals of achieving computer literacy by the year 2000. Strategies for successful integration of nursing informatics into curricula are identified, and specific tactics that promote desired outcomes suggested. The benefits that nursing informatics brings to education, administration, research, and practice are stated and the role of professional nursing organizations in promoting nursing informatics' status as a recognized nursing specialty is noted, and the specialty's role in promoting the profession's future development described.
Attention for Security now more Needed than Ever
Authors: Pluyter-Wenting E.S.P.
Published: February 2025

Security is a major consideration for any computer system. Today the topic security is defined and divided in three different domains: confidentiality, integrity and availability. This paper deals with the topic availability and the fact that hospitals are getting more and more dependent of their computer systems In this contribution the different aspects of availability and non-availability are described and measures are mentioned to lower the risk of dysfunction in the hospital in case the system completely has collapsed for a longer period.
Strategies and Tools for Creating a Common Nursing Terminology within a Large Health Maintenance Organization
Authors: Zingo C.A.
Published: February 2025

A common nursing terminology is essential for outcomes research, data comparability and clinical documentation in an electronic health record. Kaiser Permanente has recognized the need to develop a common nursing and medical terminology across the program. The Interregional Nursing Nomenclature Committee has developed a model for developing a common nursing terminology integrated with other healthcare terminologies.
A Conception of a Support System for Optimising the Organisation of Nursing Staff from the Viewpoint of the Nursing Care Needs Structure
Authors: Tsuru S.  , Shindob S.  , Takatanic Y.  , Seod A.
Published: February 2025

Methods of allocating nursing staff in hospitals should be established that improve the “sufficiency rate” of existing care needs for nursing in patients. The conception of a support system for the optimisation of organising nursing staff was proposed so that the degree of meeting care needs could be maximised. In this study, the structure of care needs was defined by sampling information related to eight factors. A basic framework was developed for a support system for the optimisation of organising nursing staff by using data based on (1) rate of satisfying eight selected criteria, (2) condition factors that can affect this rate, and (3) organising nursing. The possible usage of this support system is also discussed in this paper.
Education and Training in Health Informatics. The IT EDUCTRA Project
Authors: Hasman A.
Published: February 2025

In this contribution the AIM project EDUCTRA and the Telematics Applications Programme IT-EDUCTRA will be described. EDUCTRA had as its aim to investigate what gaps in knowledge health professionals have about health informatics and to provide educational material to fill these gaps. It was believed that a basic understanding of health informatics was present and that educational material should only cover the knowledge necessary for appreciating the products of the AIM programme. It appeared that the knowledge with respect to health informatics was deplorable. Guidelines for curricula were developed to change the situation. In IT-EDUCTRA the necessary course material will be developed.
Advances in Digital Video for Electronic Media
Authors: McAfooes J.A.
Published: February 2025

From media's early days of film strips and records, to today's multimedia CD-ROMs, nurses have embraced educational tools. Today, the capabilities of these tools have placed a tremendous demand for providing information any time, any where. This has led to increasing digitization of sights and sounds. Once digitized, this information can travel over information highways made up of telephone lines, fiberoptic cables, microwaves and satellites, or it can be stored on magnetic and optical media. Technological advances have made it possible for computer users to create, store and retrieve high quality digital still and moving video and audio for inclusion in electronic media. Methods for digitizing include capturing and converting the information with cameras, scanners and capture boards. Digital video compression/decompression (codec) standards vary in quality. Potential uses of digital video abound including video on demand, videoconferencing, distance learning, telemedicine, on-line education and computer-based training. Examples illustrating the differences in digital video formats will be shown during the presentation.
A Common Concept Model for the Swedish Health Care System
Authors: Jernberg L.  , Hedin A.  , Lundmark T.  , Lennér H.C.  , Svedberg H.  , Wallin S.B.  , Sandström S.Å.
Published: February 2025

Supporting and making the clinical activities of the health care system more efficient, co-ordinating patient work and enhancing the exchange of information/communication require that standards, a common term system and a common language are in place. A prerequisite for this is the integration of the medical record and the term systems for all categories of care professionals as well as a common definition of basic care concepts to be used by all professional groups.
Classification and Structure of Certificates
Authors: Meister G.
Published: February 2025

Since smart cards with coprocessors handling long number arithmetic are available it is possible to perform the calculation of digital signatures and its verification inside the card in a reasonable time frame.
CARDLINK II - The implementation in GREECE
Authors: Karounou V.  , Troulos C.  , Karounos Th.  , Maglaris B.  , Zorzos G.
Published: February 2025

Quality of healthcare depends to a large extend on the availability of patient’s heath record at the time it is needed. The importance of this parameter increases in the cases of emergency care. The CARDLINK II project in Greece aims to create a flexible and efficient network among community and state healthcare services at the Municipality of Amaroussion, which supports access to municipal services and information sharing between healthcare professionals. This is expected to improve the quality of community care provision, the effectiveness of emergency case treatment and the design of preventive care programs. The pilot population is the public school students. CARDLINK II creates a technical infrastructure that supports the above mentioned functions and gradually will support access to other services in the community, such as access to swimming pool, gymnastics center, library, INTERNET, etc.
Data under a fingertip: benefits of a smart card in health care
Authors: Vreeken L.B.
Published: February 2025

One of the participants in the “ZorgPas Initiatief”, ANOVA/ZAO is the leading health insurance company in the central region of The Netherlands. Customer needs are supported by the use of smart cards in IJsselstein, a city where 15,000 smart cards are used in a pilot project that started in 1995. The knowledge of the organizational, financial and technical implications come to the disposal of the “ZorgPas Initiatief”. The derived data from the pilot project have been used to figure the benefits on a national scale. It seems that the use of the ZorgPas will benefit all parties involved: the patient, the health professional and the insurance company.
VIRGY: A VIRTUAL REALITY AND FORCE FEEDBACK BASED ENDOSCOPIC SURGERY SIMULATOR
Authors: Baur Charles  , Guzzoni Didier  , Georg Olivier
Published: February 2025

This paper describes the VIRGY project at the VRAI Group (Virtual Reality and Active Interface), Swiss Federal Institute of Technology (Lausanne, Switzerland). Since 1994, we have been investigating a variety of virtual-reality based methods for simulating laparoscopic surgery procedures. Our goal is to develop an endoscopic surgical training tool which realistically simulates the interactions between one or more surgical instruments and gastrointestinal organs. To support real-time interaction and manipulation between instruments and organs, we have developed several novel graphic simulation techniques. In particular, we are using live video texturing to achieve dynamic effects such as bleeding or vaporization of fatty tissues. Special texture manipulations allows us to generate pulsing objects while minimizing processor load. Additionally, we have created a new surface deformation algorithm which enables real-time deformations under external constraints. Lastly, we have developed a new 3D object definition which allows us to perform operations such as total or partial object cuttings, as well as to selectively render objects with different levels of detail. To provide realistic physical simulation of the forces and torques on surgical instruments encountered during an operation, we have also designed a new haptic device dedicated to endososcopic surgery constraints. We are using special interpolation and extrapolation techniques to integrate our 25 Hz visual simulation with the 300 Hz feedback required for realistic tactile interaction.
Experience with MR-Guided Therapy
Authors: Vosburgh Kirby G.  , Schenck John F.
Published: February 2025

The use of magnetic resonance imaging (MRI) for the real time guidance of surgical procedures is now undergoing clinical trials. Among the many procedures explored, open craniotomy neurosurgery appears to be among the most promising. Over 50 such cases have been done at the Brigham and Women's Hospital (BWH) in Boston. We review the technical approach used in these and related procedures. We consider the way in which imaging is used to augment and improve the procedures. As well, the implications of these protocols for remote diagnosis and telesurgery are explored. Finally, the implications of this experience for the insertion of new technology into medicine are discussed.
A System for Robot Assisted Maxillofacial Surgery
Authors: Burghart Catherina R.  , Muenchenberg Jan E.  , Rembold Ulrich
Published: February 2025

In maxillofacial surgery the quality of the surgical outcome mainly depends on the experience of the operating surgeon. Thus we intend to support the surgeon before and during surgery in order to enhance the surgical results. On the one hand this implies the use of image processing, three dimensional modelling techniques and visualization techniques of medical image data, on the other hand planning systems, intraoperative navigation devices and surgical robots are needed. In this paper a complex expert system is presented, which uses a planner for generating treatment plans, an infrared navigation for monitoring both patient, robot, and surgical tool, and a surgical robotic system in order to work on bone. Special stress is laid on the architecture of the planning system, the structure of the treatment plans, and the intraopertative communication protocols.
Quality Criteria for Electronic Publications in Medicine
Authors: Schulz S.  , Auhuber T.  , Schrader U.  , Klar R.
Published: February 2025

This paper defines “electronic publications in medicine (EPM)” as computer based training programs, databases, knowledge-based systems, multimedia applications and electronic books running on standard platforms and available by usual distribution channels. A detailed catalogue of quality criteria as a basis for development and evaluation of EPMs is presented. The necessity to raise the quality level of electronic publications is stressed considering aspects of domain knowledge, software engineering, media development, interface design and didactics.