bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Temperature on the Interface Shear Resistance Between Precompressed Bentonite Backfill-Blocks of a Nuclear Waste Repository in Finland
Authors: Sinnathamby Gowthaman  , Korkiala-Tanttu Leena  , Gustavsson Henry
Published: February 2025

The effect of temperature on the interface shear resistance between bentonite backfill blocks of a typical deep-rock nuclear waste repository is studied. In Finland, the proposed nuclear waste repository at Olkiluoto incorporates the Swedish KBS-3V multi-barrier concept for the isolation of contained spent nuclear fuel. This multi-barrier comprised of the fuel canister, bentonite buffers around the fuel canisters, backfill materials in deposition tunnels and the host rock. One of the key aspects of the multi-barrier design in the KBS-3V is the buffer-backfill interaction. The saturated density of the buffer should be maintained within a narrow range of 1950 and 2050 kg/m3at all times, so that the integrity of the multi-barrier is not compromised. Interface shear resistance of tunnel backfills is a key parameter that controls the uplift (swelling) of the buffer into the tunnel backfill upon water saturation that causes loss of buffer density. In other words, the tunnel backfill should be able to sustain and provide adequate resistance against the swelling buffer. The present KBS-3V backfilling concept involves the use of pre-compacted bentonite clay blocks to fill the majority of the deposition tunnel volume. These individual clay blocks form interfaces which could act as potential planes of shear failure. Therefore, the shear resistance and behavior of the block interfaces under varying repository conditions such as temperature needs to be studied. In the present study, interface shear behavior between proposed bentonite blocks were tested under a range of temperatures between +20°C and +80°C. A modified temperature controlled simple direct shear box was used in the testing. Test results showed no significant variation in the interface friction with increasing temperature. The interface shear resistance data from this study could be incorporated into the detailed modelling of the buffer-backfill design of the KBS-3V.
Remote Monitoring of Cardiac Implantable Devices: Ontology Driven Classification of the Alerts
Authors: Rosier Arnaud  , Mabo Philippe  , Temal Lynda  , Van Hille Pascal  , Dameron Olivier  , Deleger Louise  , Grouin Cyril  , Zweigenbaum Pierre  , Jacques Julie  , Chazard Emmanuel  , Laporte Laure  , Henry Christine  , Burgun Anita
Published: February 2025

The number of patients that benefit from remote monitoring of cardiac implantable electronic devices, such as pacemakers and defibrillators, is growing rapidly. Consequently, the huge number of alerts that are generated and transmitted to the physicians represents a challenge to handle. We have developed a system based on a formal ontology that integrates the alert information and the patient data extracted from the electronic health record in order to better classify the importance of alerts. A pilot study was conducted on atrial fibrillation alerts. We show some examples of alert processing. The results suggest that this approach has the potential to significantly reduce the alert burden in telecardiology. The methods may be extended to other types of connected devices.
Adapting Guidelines for Google Glass: the Case of Pediatric CPR
Authors: Ehrler Frederic  , Siebert Johan  , Haddad Kevin  , Sahin Ayhan  , Schrurs Philippe  , Diener Raphael  , Gervaix Alain  , Manzano Sergio  , Lovis Christian
Published: February 2025

Early recognition and management of patients at risk and more aggressive implementation of evidence-based resuscitation guidelines play a role to the reduction of patients' mortality. If, in paediatric emergency department, the proper adherence to the paediatric cardiac arrest guidelines is critical to increase the chance of survival, this adherence is unfortunately often suboptimal. Connected glasses, such as the Google Glass, offer an interesting support to provide guidelines at the point of care. However, existing guidelines format is not adapted to be used directly on the small screen of connected glasses. Their transformation to be displayed on the Google Glass is not a simple task. Problems such as the navigation and the formalization of the guidelines must be solved. In this article, we present the transformation process of the paediatric cardiac arrest algorithm from its paper version to its implementation on the Google Glass.
Performances des modèles d'éléments finis 3D en géotechnique
Authors: Mestat P.  , Bourgeois E.  , Humbert P.  , Riou Y.
Published: February 2025

Cette communication présente plusieurs études sur la modélisation numérique 3D. L'objectif est d'analyser l'influence de la finesse de la discrétisation géométrique sur les résultats. L'une des études est fondée sur le premier concours de prévisions exclusivement 3D. Toutes les observations démontrent que les calculs 3D sont aujourd'hui possibles, mais que le raffinement des maillages 3D reste limité. Il n'est pas encore possible d'obtenir les densités de maillage utilisées couramment pour les modèles 2D.
Considerations on the shear strength behavior of weathered rockfill
Authors: Sayão Alberto S.F.J.  , Maia Paulo C.A.  , Nunes Anna Laura L.S.
Published: February 2025

A comprehensive investigation on the mechanical behavior of rockfill has been carried out in large-size shear devices in the laboratory. Triaxial and direct shear tests were performed on basalt riprap specimens from Marimbondo Dam in Brazil, which was constructed in 1975. The main results and conclusions on the shear strength envelopes are presented in this paper. Weathered riprap particles were collected at the region of water level fluctuation, where natural alteration by disintegration and decomposition of the basalt rockfill was noted to be more intense. An artificially weathered rockfill material was produced in the laboratory by continuous lixiviation in large Soxhlet equipment. Lixiviated basalt rockfill exhibits marked changes of surface chemical concentration, number of joints and deformability of rock particles. Processes of basalt weathering in the field and in the laboratory are compared in the paper. The methodology for accelerated weathering in the laboratory proved to adequately simulate the effects of field weathering, making possible a prediction of the long-term mechanical behavior of basalt rockfill. A significant reduction of the shear strength of weathered rockfill may be noted when compared to the intact material. The upstream rip-rap at Marimbondo Dam is predicted to remain competent as a slope protection material for at least more 50 years.
Optimization concepts for the design of piled raft foundation systems
Authors: Bezerra J.E.  , Cunha R.P.  , Sales M.M.
Published: February 2025

In the past decade several papers have been published with emphasis on what are now called “piled-rafts”, i.e., pile groups in which the raft connecting the pile heads positively contributes to the overall foundation behavior (for example Poulos, 1991; Ta and Small, 1996; Sales et al., 1999; Cunha et al., 2001). Hence, this paper continues on this line of research, exploring the numerical evaluation of piled rafts and its advantages for a real case design. The paper presents the results of a comparative and parametric analysis in which a numerical program developed exclusively for groups of deep foundations under general loading (vertical, horizontal and moment loads) was used. It is concluded that an optimization procedure is suitable to technically and economically enhance the design of piled raft systems.
Hydraulic conductivity of consolidated slimes from sand mining pits
Authors: Bouazza A.  , Wang D.M.
Published: February 2025

The generation of massive volume of slimes from sand mining industry ascertains the need for effective waste treatment. The application of slimes in landfill barrier/liner construction works has been identified as one of the processes that can be used to reduce their volume, enabling in this way the rehabilitation of dangerous sites. This paper presents results on the characterization of slimes from two sites located in South-East Melbourne. The hydraulic conductivity test show that values lower than 10−9m/s can be achieved to meet local guidelines. However, the presence of high level of heavy metals, exceeding the local authority threshold concentrations, needs to be overcome before the slimes can be considered as a potential liner material.
Evaluation of shear strength parameters for rain-induced slope instabilities
Authors: Farooq Khalid  , Orense Rolando P.  , Towhata Ikuo
Published: February 2025

The stress path followed by a soil element along a potential failure plane in a slope subjected to rainfall infiltration is characterized by pore pressure increase at almost constant total stress condition. This stress path can be simulated in the laboratory by conducting constant shear stress drained (CSD) triaxial tests wherein back pressure within a saturated soil specimen is increased while keeping the shear stress constant, i.e. σ1and σ3are kept constant. Such stress path is obviously different from that reproduced in conventional triaxial tests in which σ3remains constant and σ1increases. To investigate the soil response under different stress paths, CSD tests, as well as conventional triaxial drained and undrained tests, were performed on sandy soils obtained at previous landslide sites. The test results confirmed that CSD-derived strength parameters were more appropriate when analyzing rainfall-induced failure initiation. Realizing that CSD tests are not easy to perform, correlations were made to express the strength parameters obtained through conventional triaxial tests with those derived from CSD tests.
Estimation of long-term settlement and determination of additional sampling positions using GIS
Authors: Kim H.-T.  , Lee H.-J.  , Song B.-W.  , Kim Y.-U.  , Choi I.-G.
Published: February 2025

We estimate the ground information for the interesting region by using the results obtained from in-situlaboratory tests with GIS (Geographic Information Systems). Incheon International Airport that was reclaimed is the objective area in this paper. The settlements of the ground surface have been measured at the beginning of the construction. Since the primary consolidation in this site has been completed, the settlement due to the secondary consolidation was expected and predicted by the SSCI (Secant Secondary Compression Index). To estimate the long-term settlement in the future, geostatistics, such as the ‘Kriging interpolation method’ and the ‘IDWI (Inverse Distance Weighted Interpolation) method’ in GIS was used. The results by the IDWI method are compared with those by Kriging interpolation method. Using the concept of ‘thoroughness’, additional sampling positions are proposed. As a result, it is known that 1) the GIS can be useful tool to estimate soil parameters at any point without the measurement in site or test in the lab; 2) the long-term settlement estimated by the Kriging interpolation method show better agreement with the measured ones than IDWI method; and 3) the GIS can be useful to estimate the long-term settlement in the future and additional sampling positions.
Characterization of swelling materials by Huder-Amberg oedometric test
Authors: Romana M.  , Serón J.B.
Published: February 2025

The Geotechnical Engineering Department of the Polytechnic University of Valencia is currently doing a research program on swelling materials (soils and soft rocks) and the long time effect of swelling on tunnels. In this program several swelling oedometric tests, by the Huder-Amberg technique, have been carried out. The usual Huder-Amberg test takes a lot of time, so it is frequent that they are finished before the actual end of the swelling of the probes. In this research some of the tests have been maintained during more than a year, with almost continuous expansion of the samples (argillite with some gypsum inclusions) in each one of the deloading steps. This paper describes the testing techniques, and the special testing challenges and problems derived from the extraordinary time length of the tests; discusses some simple numerical models to forecast the end of each swelling step (in order to reduce as much as possible the testing time); and gives some preliminary results of the expansion parameters for clayey materials, (comparing them with other published data) which can be useful in tunnel design.
A Study on the Effectiveness of XMOOC Teaching in Improving Practical Nursing Teaching
Authors: Zhou Hongwei  , Qiu Wan  , Zhu Jiyin  , Feng Jing  , Gong Wenjing  , Le Wenwei
Published: February 2025

This article studies the effectiveness of xMOOC teaching in the area of nursing education, by making a comparison between two study groups. Though observation, academic tests and interview, this study finds out that the application of xMOOC to teaching scheme practice could effectively increase teaching ability of teachers, learning ability of students and their test scores which had positive significance in improving clinical nursing teaching quality.
Gamification of Clinical Routine: The Dr. Fill Approach
Authors: Bukowski Mark  , Kühn Martin  , Zhao Xiaoqing  , Bettermann Ralf  , Jonas Stephan
Published: February 2025

Gamification is used in clinical context in the health care education. Furthermore, it has shown great promises to improve the performance of the health care staff in their daily routine. In this work we focus on the medication sorting task, which is performed manually in hospitals. This task is very error prone and needs to be performed daily. Nevertheless, errors in the medication are crucial and lead to serious complications. In this work we present a real world gamification approach of the medication sorting task in a patient's daily pill organizer. The player of the game needs to sort the correct medication into the correct dispenser slots and is rewarded or punished in real time. At the end of the game, a score is given and the user can register in a leaderboard.
Using Co-Design with Nursing Students to Create Educational Apps for Clinical Training
Authors: O'Connor Siobhan  , Andrews Tom
Published: February 2025

Mobile technology is being trialed in nursing education to support students in clinical practice, as it can provide instant access to high quality educational material at the point of care. However, most educational mobile apps are generic, off-the-shelf applications that do not take into consideration the unique needs of nursing students, who can require personalised software solutions. This study adapted a socio-cognitive engineering approach and through a series of focus groups with final year nursing students explored the co-design process and gained their input on the design and functionality of a clinical skills based educational app. Results showed students required an uncluttered interface that was fast to navigate and easy to use in busy clinical environments. They also requested simple visual descriptions of key clinical skills and equipment to enable them to quickly refresh their memory so they could perform the skill in practice.
Advancing the Digital Health Discourse for Nurse Leaders
Authors: Remus Sally
Published: February 2025

Limited informatics competency uptake is a recognized nursing leadership challenge impacting digital practice settings. The health system's inability to reap the promised benefits of EHRs is a manifestation of inadequate development of informatics competencies by chief nurse executives (CNEs) and other clinicians. Through the application of Transformational Leadership Theory (TL), this discussion paper explains how informatics competencies enable CNEs to become transformational nursing leaders in digital health allowing them to meet their accountabilities to lead integrated, high-quality care delivery through evidence based practices (EBPs). It is proposed that successful CNE eHealth sponsors will be those armed with informatics competencies who can drive health organizations' investment in technology and innovation. Finally, some considerations are suggested in how nurse informaticists globally play a critical role in preparing our existing and future CNEs to fulfill their transformational leader roles in the digital age.
A Quantitative Study Investigating the Effects of Computerised Clinical Decision Support in the Emergency Department
Authors: Bennett Paula  , Hardiker Nicholas
Published: February 2025

This paper describes the evaluation of a computerized clinical decision support system (CCDSS) for Emergency Department (ED) triage. The CCDSS for triage was developed as a means to improve ED quality and safety. Whilst there is significant research on the role of CCDSS in health care, their role in EDs remains under-investigated. In this study, a CCDSS for ED triage was developed and evaluated using a quasi-experimental interrupted time-series design. Data was collected at four time points before and after the introduction of the CCDSS to assess key aspects of quality and safety within the ED. The results demonstrated a statistically significant improvement in triage prioritization (p < 0.001), pain scoring (p < 0.001) and pain management (p < 0.001). This study clearly identifies the positive clinical impact that a CCDSS can have on quality and safety for ED patients and provides a unique contribution to the current knowledge base.
Networking Hospital ePrescribing: A Systemic View of Digitalization of Medicines' Use in England
Authors: Lichtner Valentina  , Hibberd Ralph  , Cornford Tony
Published: February 2025

Medicine management is at the core of hospital care and digitalization of prescribing and administration of medicines is often the focus of attention of health IT programs. This may be conveyed to the public in terms of the elimination of paper-based drug charts and increased readability of doctors' prescriptions. Based on analysis of documents about hospital medicines supply and use (including systems' implementation) in the UK, in this conceptual paper electronic prescribing and administration are repositioned as only one aspect of an important wider transformation in medicine management in hospital settings, involving, for example, procurement, dispensing, auditing, waste management, research and safety vigilance. Approaching digitalization from a systemic perspective has the potential to uncover the wider implications of this transformation for patients, the organization and the wider health care system.
Integrating a Proposed Population Health Model with Nursing Informatics Research
Authors: Dowding Dawn  , Arcia Adriana  , Bjarnadottir Ragnhildur Ingibjargardottir  , Iribarren Sarah  , Yoon Sunmoo
Published: February 2025

In this panel we discuss how nursing informatics can provide a framework for carrying out population health nursing research, using a conceptual model for nursing and population health; the Conceptual Model of Nursing and Population Health (CMNPH). The panel will provide an overview of the CMNPH and then each presenter will present findings from ongoing informatics research that provides insights to different levels of the CNMPH model. The panel is targeted towards informatics researchers who wish to use novel informatics approaches to carry out population health research.
An Empirical Study on the Successful Implementation of Nursing Information System
Authors: Tsai Hui-Hua  , Chiou Shwu-Fen  , Wang Tsi-Chi  , Wu Meng-Ping  , Feng Rung-Chuang
Published: February 2025

This study investigated the major NIS implementation factors and their capability of predicting the effectiveness of NIS implementation by using the clinical information systems success model. The triangulation method was employed in this study. A total of 348 nurses were recruited from regional hospitals in two districts of Taipei through purposive sampling. Research data were collected through questionnaires and focus group interviews 3 and 6 months after an NIS was implemented at their hospital. The result show the explanatory power of use dependence, use satisfaction, and net benefits in predicting NIS effectiveness was approximately 64.5%–89.4%. The explanatory power of net benefits in predicting NIS effectiveness after 3 and 6 months exceeded 80%. The nurses reported that NIS implementation changed their workflow and positively influenced medication administration safety. This study empirically identified the critical factors that affect the successful implementation of NISs and reported the nurses' experience of NIS use.
A Model for Risk Assessment in Health Care
Authors: Prijatelj Vesna  , Rajkovič Vladislav  , Šušteršič Olga
Published: February 2025

The purpose of our research is to reduce risks and hence prevent errors in the health care process. The aim is to design an organizational information model using error prevention methods for risk assessment in a clinical setting. The model is based on selected indicators of quality nursing care, resulting from the world-known theoretical and practical models combined with experience in the Slovenian health care. The proposed organizational information model and software solution has a significant impact on the professional attention, communication and information, critical thinking, experience and knowledge.
Nursing Informatics Pioneers Continue to Influence the Profession: A Sustainable Impact
Authors: Newbold Susan K.  , Brixey Juliana J.
Published: February 2025

The American Medical Informatics Association (AMIA) established the Nursing Informatics History Project to recognize the pioneers of nursing informatics. Fundamental to the pioneers was dissemination of knowledge. The purpose of this review was to identify contributions to the field of nursing informatics as peer-reviewed manuscripts for the years 2010–2015 and indexed in PubMed. Results indicate that many of the pioneers continue to have manuscripts indexed in PubMed. It is anticipated this project will be extended to identify other types of contributions made by the pioneers in the advancement of nursing informatics.
The Effect of Tele-Consultation Between a Hospital-Based Nurse and a COPD Patient
Authors: Dichmann Sorknaes Anne
Published: February 2025

Patients admitted with exacerbation COPD (AECOPD) were at hospital discharge randomly assigned (1:1) to either daily teleconsultation for one week between hospital-based telenurses and patients with severe COPD or conventional treatment. Addition of one week of teleconsultations was as safe and effective as conventional treatment, but it did not significantly reduce readmissions or affect mortality
Concepts for Quality Assurance of Health Related Apps
Authors: Hillebrand Uta  , von Jan Ute  , Albrecht Urs-Vito
Published: February 2025

The growing number and variety of available mobile health apps makes it increasingly difficult for users to identify apps that match their needs and are safe and trustworthy. Based on the results of a non-systematic search process (internet, PubMed) using terms related to quality and health apps, the presented work aims at giving a short overview over and categorizing existing approaches for assessing and rating the quality of apps to be used in health related contexts.
Evaluation of mHealth Applications Security Based on Application Permissions
Authors: Pustozerov Evgenii  , von Jan Ute  , Albrecht Urs-Vito
Published: February 2025

The presented study covers the evaluation of ratings of a set of 1080 applications classified as “top apps” for the two categories “Medicine” and “Health & Fitness” as they are available on Google's Play Store. Within the evaluation, the manifest files and source code of the applications were analyzed in order to reveal whether the requested set of permissions correspond to the ones really utilized by the apps and whether they surpass what is necessary. For many apps, the declarations in the manifest file do not match what is specified in the source code, raising the question of whether this may be an indication of questionable app quality with a potentially negative impact on the safety and reliability of mHealth related apps.
Apps for Research and Research with Apps – Taking Inventory
Authors: von Jan Ute  , Albrecht Urs-Vito
Published: February 2025

Approaches for medical research involving apps are manifold. On the one hand, apps for various health related purposes, e.g. interventions for specific conditions as prevention are themselves being evaluated using different methods. On the other hand, apps are also increasingly becoming popular as tools aiding researchers in (clinical) studies. The presented paper aims at providing a short overview of the current situation in both areas, highlighting potential benefits, but also potentially problematic aspects.
Patient Portal Integration – A Native IHE Connector Implementation for PEHR
Authors: Yüksekogul Nilay  , Schreiweis Björn  , Weiss Nicolas  , Aguduri Lakshmi S.  , Brandner Antje  , Bronsch Tobias  , Pensold Peter  , Stein Katharina E.  , Helmer Axel  , Bergh Björn  , Heinze Oliver
Published: February 2025

Providing patients with access to their medical data has recently evolved as a topic in several countries. Different approaches are possible. For example patient portals are used for patient access towards medical data. The University Hospital Heidelberg is engaged in a research project to develop a personal cross-enterprise electronic health record (PEHR). The objective of this work is to describe the architecture and implementation of a component called IHE Connector which represents the native IHE-based integration between the patient portal and the PEHR core components. The architecture of the PEHR is accepted based on international standards. The core components consist out of ready to use software products like a master patient index. The patient portal has been developed using Liferay framework. The IHE Connector is mainly based on the Open eHealth Integration Platform (IPF) Framework, which has been deeply integrated into the patient portal to support the needed IHE transactions. Several IHE profiles for sharing documents and patient information are supported by the IHE Connector. As IPF already provides interfaces for some IHE profiles others had to be developed from scratch. The IHE Connector can not only be used for connectivity between patient portal and PEHR core, but also provide connectivity for third party apps and healthcare providers' information systems.
Medical Classification and Terminology Systems in a Secondary Use Context: Challenges and Perils
Authors: Hund Hauke  , Gerth Sven  , Katus Hugo A.  , Fegeler Christian
Published: February 2025

Since the introduction of diagnosis-related groups in the German healthcare system, classifying patient diagnosis and procedures with controlled vocabularies have become mandatory and thus creating a large dataset for secondary use in biomedical research. In this paper we present the analysis of an ICD dataset with regards to potentially reimbursement motivated classification and the effects on precision and recall when considering the change history of ICD codes.
Representing ICD-11 JLMMS Using IHTSDO Representation Formalisms
Authors: Mamou Marzouk  , Rector Alan  , Schulz Stefan  , Campbell James  , Solbrig Harold  , Rodrigues Jean-Marie
Published: February 2025

It is investigated whether the content of the Joint Linearization for Mortality and Morbidity Statistics of the 11th ICD revision can be semantically represented by formalisms acting on the clinical terminology SNOMED CT, viz. the IHTSDO Compositional Grammar (CG) and the Expression Constraint Language (ECL). Whereas CG provides a composition syntax for building coordinated SNOMED CT expressions, ECL provides a powerful query mechanism. Both formalisms can be leveraged to guarantee inter-operation between an ontology-based terminology like SNOMED CT and a statistical classification like ICD, characterized by single hierarchies and exhaustive, mutually exclusive classes. We test the feasibility of the method on the circulatory chapter of ICD-11 JLMMS.
Electronic Medical Record-Based Predictive Model for Acute Kidney Injury in an Acute Care Hospital
Authors: Laszczyńska Olga  , Severo Milton  , Azevedo Ana
Published: February 2025

Patients with acute kidney injury (AKI) are at risk for increased morbidity and mortality. Lack of specific treatment has meant that efforts have focused on early diagnosis and timely treatment. Advanced algorithms for clinical assistance including AKI prediction models have potential to provide accurate risk estimates. In this project, we aim to provide a clinical decision supporting system (CDSS) based on a self-learning predictive model for AKI in patients of an acute care hospital. Data of all in-patient episodes in adults admitted will be analysed using “data mining” techniques to build a prediction model. The subsequent machine-learning process including two algorithms for data stream and concept drift will refine the predictive ability of the model. Simulation studies on the model will be used to quantify the expected impact of several scenarios of change in factors that influence AKI incidence. The proposed dynamic CDSS will apply to future in-hospital AKI surveillance in clinical practice.
On the Relationship Between ‘Universal’ and ‘Particular’ in Architecture
Authors: Arenghi Alberto  , Garofolo Ilaria  , Laurìa Antonio
Published: February 2025

In 1998 Molly Follette Story, James Mueller and Roland Mace published the book The Universal Design File; that can be considered the result of a long way, started by Mace in 1985, towards a design approach based on the principles of Universal Design. In 2010 the Centre for Active Design publishes the Active Design Guidelines: Promoting Physical Activity and Health in Design.
Framing the Universal Design of Information and Communication Technology: An Interdisciplinary Model for Research and Practice
Authors: Giannoumis G. Anthony
Published: February 2025

Research has yet to provide an interdisciplinary framework for examining ICT accessibility as it relates to Universal Design. This article assesses the conceptualizations and interdisciplinarity of ICT accessibility and Universal Design research. This article uses a grounded theory approach to pose a multilevel framework for Universal Design. The macro level, consists of scholarship that examines the context of Universal Design, and is typified by legal and sociological studies that investigate social norms and environments. The meso level, which consists of scholarship that examines activity in Universal Design as an approach to removing barriers for use and participation. The meso level is typified by studies of computer science and engineering that investigate the use of technology as a mechanism of participation. The micro level consists of scholarship that examines individuals and groups in Universal Design as an approach to understanding human characteristics. The micro level is typified by studies of human factors and psychology. This article argues that the multilevel framework for Universal Design may help remove the artificial separation between disciplines concerned with ICT accessibility and promote more fruitful research and development.
Experimental Studies of Wheelchair and Walker Users Passing Through Doors with Different Opening Force
Authors: Nersveen Jonny
Published: February 2025

Users of walkers and users of different categories of wheelchairs tested doors with different opening force, aiming to reveal the limit that these groups of people could manage on an everyday basis. 94.7% of the wheelchair users reported that a door opening force of 30 N was acceptable, while as 92.1% of this group described 40 N as acceptable. Similarly, 100% of the walker users reported that a door opening force of 30 N was acceptable, while as 87,5% of this group described 40 N as acceptable.
On Assessing the Costs and Benefits of Universal Design of ICT
Authors: Halbach Till  , Fuglerud Kristin Skeide
Published: February 2025

In the ICT and IT domains, Universal Design is typically viewed as a burden and an expense, and its application is often justified only by ethics and/or legislation. Advocates for Universal Design (UD) are arguing that it is cost-effective, but so far there are few studies that document this in a detailed way. In this work, we discuss related research and studies dealing with the costs and benefits of accessible and usable ICT solutions. In particular, we discuss the findings regarding what is a universally designed solution, what is needed to make such a solution, how much does it cost, what impact can be anticipated by the extra effort, and how it can be measured. Finally, we suggest an approach for carrying out cost-benefit analyses of developing universally designed solutions. There is a weak indication that the economical benefits of UD solutions are much higher than the initial and running costs.
Steps Toward Technology Design to Beat Health Inequality – Participatory Design Walks in a Neighbourhood with High Health Risks
Authors: Bertelsen Pernille  , Kanstrup Anne Marie  , Madsen Jacob
Published: February 2025

This paper explores participatory design walks (PD walks) as a first step toward a participatory design of health information technology (HIT) aimed at tackling health inequality in a neighbourhood identified as a high-risk health area. Existing research shows that traditional methods for health promotion, such as campaigns and teaching, have little to no effect in high-risk health areas. Rather, initiatives must be locally anchored – integrated into the local culture, and based on social relationships and group activities. This paper explains how we conducted PD walks with residents and community workers in the neighbourhood and how this participatory approach supported a first step toward HIT design that tackles health inequality. This is important, as people in neighbourhoods with high health risks are not the target audience for the health technology innovation currently taking place despite the fact that this group suffers the most from health inequality and weigh most on the public healthcare services and costs. The study identifies social and cultural aspects that influence everyday health management and presents how a citizen-driven approach like PD walks, can contribute valuable insights for design of HIT. The paper provides concrete methodological recommendations on how to conduct PD walks that are valuable to HIT designers and developers who aim to do PD with neighbourhoods.
Prehospital Patient Records: Facilitating Constructive Dialogue and Co-Construction Through PD
Authors: Mogensen Preben Holst  , Wollsen Susanne
Published: February 2025

The paper presents the case of developing, adapting, and implementing an electronic prehospital patient records system in Scandinavia. The system is now fully implemented and it is used by all stakeholders within the prehospital domain. The paper focuses on the participatory design process of adapting the technical solution specified in the call for tender with the complex organizational context of actors with very diverse tasks and objectives and situated in five different regions each with their special geographical and demographical challenges. The paper concludes by discussing a range of lessons learned when using PD within a commercial project (where the starting point is a fixed contract and requirements specification), with a very diverse set of stakeholders (users, customers, and indirect users), and in a very complex domain encompassing a range of highly specialized competencies.
Usability Validation of Medical Devices: Issues in Identifying Potential Use Errors
Authors: Schiro Jessica  , Pelayo Sylvia  , Weinhold Thomas  , Del Zotto Marzia  , Marcilly Romaric
Published: February 2025

In order to prevent use errors with their medical devices, manufacturers have to integrate a safety-oriented usability engineering process in their product development lifecycle. A critical step of this process is the identification of potential use-errors. Standards and guidelines recommend to triangulate several sources of information e.g. scientific literature, incident reports, manufacturer's files and user's feedbacks. This paper presents lessons learned from applying these recommendations during an international project. We identify issues with (i) searching literature and databases, and (ii) interpreting collected data. Nevertheless triangulation of information sources allows to identify different types of use errors therefore providing valuable lists of potential use errors. Issuing recommendations aim at making easier this critical task.
Adoption of Electronic Health Record System in Community-Based Physiotherapy Clinics: A Pilot Case Study
Authors: Yung Alan
Published: February 2025

Question: Can community-based physiotherapists adopt and use a nationally integrated electronic health record (NEHR) system?
Development and Evaluation of a Case-Based Retrieval Service
Authors: Pasche Emilie  , Chinali Marcello  , Gobeill Julien  , Ruch Patrick
Published: February 2025

Identifying similar patients might greatly facilitate the treatment of a given patient, enabling to observe the response and outcome to a particular treatment. Case-based retrieval services dealing with natural language processing are of major importance to deal with the significant amount of unstructured clinical data. In this paper, we present the development and evaluation of a case-based retrieval (CBR) service tested on a collection of Italian pediatric cardiology cases. Cases are indexed and a search engine is proposed. Search functionalities, such as interactive MeSH normalization and relevance feedback, are proposed. While the qualitative evaluation aims to provide feedback and recommendations, the quantitative evaluation enables to estimate the precision of the system. In more than half of the cases and for up to two thirds of them, the system is able to suggest a similar episode of care at first rank. With an improvement of the feedback relevance strategy, we can expect an improvement of the precision. The CBR can be expanded to multilingual EHR and other fields.
Medical Text Classification Using Convolutional Neural Networks
Authors: Hughes Mark  , Li Irene  , Kotoulas Spyros  , Suzumura Toyotaro
Published: February 2025

We present an approach to automatically classify clinical text at a sentence level. We are using deep convolutional neural networks to represent complex features. We train the network on a dataset providing a broad categorization of health information. Through a detailed evaluation, we demonstrate that our method outperforms several approaches widely used in natural language processing tasks by about 15%.
Clinical Data Warehouse Watermarking: Impact on Syndromic Measure
Authors: Bouzille Guillaume  , Pan Wei  , Franco-Contreras Javier  , Cuggia Marc  , Coatrieux Gouenou
Published: February 2025

Watermarking appears as a promising tool for the traceability of shared medical databases as it allows hiding the traceability information into the database itself. However, it is necessary to ensure that the distortion resulting from this process does not hinder subsequent data analysis. In this paper, we present the preliminary results of a study on the impact of watermarking in the estimation of flu activities. These results show that flu epidemics periods can be estimated without significant perturbation even when considering a moderate watermark distortion.
EHR Improvement Using Incident Reports
Authors: Teame Tesfay  , Stålhane Tor  , Nytrø Øystein
Published: February 2025

This paper discusses reactive improvement of clinical software using methods for incident analysis. We used the “Five Whys” method because we had only descriptive data and depended on a domain expert for the analysis. The analysis showed that there are two major root causes for EHR software failure, and that they are related to human and organizational errors. A main identified improvement is allocating more resources to system maintenance and user training.
Temporal Trends of Psychosociobehavioral Factors Underlying Tobacco Use: A Semi-Automated Exploratory Analysis of Peer-to-Peer Communication in a Health-Related Online Community
Authors: Sridharan Vishnupriya  , Cohen Trevor  , Cobb Nathan  , Myneni Sahiti
Published: February 2025

Online communities have been an integral part of tobacco cessation programs. They are rich in content, and offer insights into factors affecting an individual's behavior change efforts. We used word representation techniques to infer implicit meaning embedded in messages exchanged in a health-related online community. Our analysis of peer interactions revealed that individuals factor in safety, glamour, expense, and media projection when choosing a form of nicotine intake. When choosing pharmacotherapy techniques, individuals focus on brands, dosage, and side effects associated with each form (e.g. gums, patches). Our analysis sheds light on factors embedded in peer interactions, which might lead to opinion formation based on peer influence and knowledge dissemination in these social platforms. Such understanding enables design of high-engagement behavior change technologies, through personalization of content delivery by factoring in individual-level beliefs, behavioral state, and community-level influences.
Perspectives About Personalization for mHealth Solutions Against Noise Pollution
Authors: Kepplinger Sara  , Liebetrau Judith  , Clauss Tobias  , Pharow Peter
Published: February 2025

Noise harms the environmental quality and can have negative effect on health and wellbeing. Providing silent areas and periods of rest is one way to improve the perceived environmental quality. However, realization is not easy in the day to day life. The usage of mHealth solutions which can provide information about the sound of a certain area and the respective effect on humans could be supportive. As the perception of sound is highly subjective, the prediction of the perceived acoustic environments is very difficult. This paper describes a course of action to develop an automatic estimation of an acoustic environment, based on the measurement of sound properties solely. The challenges of this endeavor are explained in detail. Possible application areas in mHealth are identified and presented. This future vision paper wants to draw the attention to different possibilities to cope with noise pollution either by personal behavior change or by using personalized data to reach out for a more general applicability for example through soundscape.
Implications and Modelling of Data Quality on Confidence of Clinical Decision Support: A Conceptual Framework
Authors: Despotou George  , Jones Richard W.  , Katzis Konstantinos  , Bilici Eda  , Lei Zhao  , Lim Choi Keung Sarah  , Arvanitis Theodoros N.
Published: February 2025

Integrated care paradigms depend on multiple sources of data. The quality of data used in decision-making will ultimately affect the delivered care to the patient. Quality includes several dimensions, which may affect the result. This paper presents how data quality dimensions may affect the delivered service, and propose a conceptual framework for the classification of confidence in data used in clinical decision-making for integrated care.
Exploring Oral Cancer Patients' Preference in Medical Decision Making and Quality of Life
Authors: Cheng Sun-Long  , Liao Hsien-Hua  , Shueng Pei-Wei  , Lee Hsi-Chieh  , Cheewakriangkrai Chalong  , Chang Chi-Chang
Published: February 2025

Little is known about the clinical effects of shared medical decision making (SMDM) associated with quality of life about oral cancer? To understand patients who occurred potential cause of SMDM and extended to explore the interrelated components of quality of life for providing patients with potential adaptation of early assessment. All consenting patients completed the SMDM questionnaire and 36-Item Short Form (SF-36). Regression analyses were conducted to find predictors of quality of life among oral cancer patients. The proposed model predicted 57.4% of the variance in patients' SF-36 Mental Component scores. Patient mental component summary scores were associated with smoking habit (β=−0.3449, p=0.022), autonomy (β=−0.226, p=0.018) and Control preference (β=−0.388, p=0.007). The proposed model predicted 42.6% of the variance in patients' SF-36 Physical component scores. Patient physical component summary scores were associated with higher education (β=0.288, p=0.007), employment status (β=−0.225, p=0.033), involvement perceived (β=−0.606, p=0.011) and Risk communication (β=−0.558, p=0.019). Future research is necessary to determine whether oral cancer patients would benefit from early screening and intervention to address shared medical decision making.
The EVOTION Decision Support System: Utilizing It for Public Health Policy-Making in Hearing Loss
Authors: Katrakazas Panagiotis  , Trenkova Lyubov  , Milas Josip  , Brdaric Dario  , Koutsouris Dimitris
Published: February 2025

As Decision Support Systems start to play a significant role in decision making, especially in the field of public-health policy making, we present an initial attempt to formulate such a system in the concept of public health policy making for hearing loss related problems. Justification for the system's conceptual architecture and its key functionalities are presented. The introduction of the EVOTION DSS sets a key innovation and a basis for paradigm shift in policymaking, by incorporating relevant models, big data analytics and generic demographic data. Expected outcomes for this joint effort are discussed from a public-health point of view.
Understanding Health Professionals' Informal Learning in Online Social Networks: A Cross-Sectional Survey
Authors: Li Xin  , Verspoor Karin  , Gray Kathleen  , Barnett Stephen
Published: February 2025

Online social networks (OSNs) enable health professionals to learn informally, for example by sharing medical knowledge, or discussing practice management challenges and clinical issues. Understanding how learning occurs in OSNs is necessary to better support this type of learning. Through a cross-sectional survey, this study found that learning interaction in OSNs is low in general, with a small number of active users. Some health professionals actively used OSNs to support their practice, including sharing practical and experiential knowledge, benchmarking themselves, and to keep up-to-date on policy, advanced information and news in the field. These health professionals had an overall positive learning experience in OSNs.
The Development of a National Census of the Health Information Workforce: Expert Panel Recommendations
Authors: Butler-Henderson Kerryn  , Gray Kathleen  , Greenfield David  , Low Sarah  , Gilbert Cecily  , Ritchie Ann  , Trujillo Monica  , Bennett Vicki  , Brophy Julie  , Schaper Louise K.
Published: February 2025

Background. There is a need to develop a national census of the health information workforce to inform the planning and forecasting of the workforce and inform education and training needs. Yet, this raises a number of issues that need to be incorporated into the planning stage. This paper discusses the issues and recommendations for the development of a national health information workforce census and an Expert Panel's recommendations for how we should proceed.
Measuring Health Literacy in General Populations: Primary Findings from the HLS-EU Consortium's Health Literacy Assessment Effort
Authors: Pelikan Juergen M.  , Ganahl Kristin
Published: February 2025

This chapter is concerned with the difference of measuring health literacy of general population for purposes of public health as differentiated from measuring personal health literacy of individuals within health care services. The evolution of concept, measurement and empirical research of health literacy in the last decades is discussed, and the position of measuring comprehensive health literacy in general populations, especially by the European Health Literacy Survey (HLS-EU) study, is defined.