bluuebunny/crossref_metadata_2025 huggingface dataset:
The Measurement of Performance in Probabilistic Diagnosis
Authors: Hilden J. , Habbema J. D. F. , Bjerregaard B.
Published: March 2018

Attention is focused on one important aspect of good performance in probabilistic diagnosis, the »reliability« (external validity) of probabilistic assertions: a diagnostic alternative claimed to be 90% certain, say, must occur neither more nor less than nine times out of ten on the average. Statistical measures are offered by which departures from such perfect reliability can be estimated, and statistical tests are developed in order to test the hypothesis of perfect reliability. The specific reliability defects looked for include overconfident diagnoses and so-called size bias (common diseases being over diagnosed). Reliability is contrasted with discriminatory power and other performance aspects. The illustrative data derive from a study of computer-aided diagnosis of the acute abdomen.
A Procedure for Comparing Groups of Time-Dependent Measurements
Authors: Prestele H. , Gaus W. , Horbach L.
Published: March 2018

A three step procedure is proposed for the comparison of groups, where for each individual a process is investigated on the basis of repeated measurements (e.g. 3 up to about 15 time points).

1. A natural cubic spline function is fitted to the time-dependent measurements of each individual. A cubic spline is a function which is composed of piecewise polynomials, continuous up to and including second derivatives; it has a minimal »curvature«, so that a »smooth« curve is generated.

2. For each individual the value of a problem-oriented parameter is estimated from the spline function.

3. The values of the problem-oriented parameter are evaluated with standard, not necessarily longitudinal methods for estimating and hypothesis testing.

The proposed procedure requires neither an equal number of measurements for each individual, nor the same time points of measurement for all individuals, nor equal length of the time intervals. Splines can be fitted to very different patterns of curves. They can be used for a more exact calculation of parameters adequate to the problem concerned. The procedure necessitates the use of a computer; programs are available and do not demand excessive arithmetic precision and computing time.
Ein System von Zusatznotationen zur Vereinfachung der histologischen Tumordokumentation mittels ICD-O
Authors: Schüler G. , Kayser K. , Burkhardt H.-U.
Published: March 2018

Es wird eine Zusatznotation zur ICD-0 bei voller Kompatibilität vorgestellt, die eine leichte Auswertung und Codierung patho-histologischer Tumordiagnosen nach Malignität und Ausdehnung sowie nach der geweblichen Herkunft des Tumors zuläßt. Wie am Beispiel der histologischen Diagnosen des Regionalen Krebsregisters Nordbaden für Magen-Darm-Tumoren aufgezeigt wird, ist diese Zusatznotation zur Auswertung übergeordneter Begriffe, z.B. Anzahl der mesenchymalen Tumoren im untersuchten Material, äußerst nützlich.
Evaluation of a Field Test of Computers for the Doctor’s Office*
Authors: Reichertz P. L. , Möhr J. R. , Schwarz B. , Schlatter A. , von Gärtner-Holthoff G. , Filsinger E.
Published: March 2018

Based on extensive analysis of functions and structures in general practices and the resulting definitions of needs and possibilities for a computer support; six installations of dedicated computer systems in offices of private physicians were evaluated. The installations involved practices for gynecology, ENT, ophthalmology, and general medicine.

The study comprised detailed analyses of the functional characteristics of each office before, during and after the computer installation, especially in regard to work load and work distribution, cost, time performance and motivation.

The results of computer support vary in regard to the different types of practices and the pre-test organizational structure of the offices. An increased systematization of recording and claim processing could be achieved. Time gam could only be seen in the registration of new patients or >repeaters< with extensive updates. Retrieval of administrative data was slightly longer in normal >repeaters< than in the manual process. The frequency of diagnoses, recorded procedures and the measurements of various time parameters are reported. The actual set of codes used is manageable in regard to volume and differentiation in the individual office.

Evaluation by the physicians themselves reveals different emphasis on priorities of the administrative area, of medical documentation, tune gain or quality. The results of cost analysis vary depending upon the type of practice. In some offices time gain and shift in work load led to an economic gain. The calculations were based on a monthly rental of DM 2,000. However, system architecture and hardware of the experimental system were not yet optimal.

Cost/effectiveness and motivational satisfaction relate to the classification of the practices under scrutiny by methods developed in earlier studies.

General aspects of the experiment and resulting design criteria for a possible product for the doctor’s office are discussed.
Diabetes des Kindes- und Jugend- alters im Zeitalter von Technik und Telemedizin
Authors: Kapellen T. M. , Kiess W. , Klamt S.
Published: March 2018

Diabetes mellitus Typ 1 bleibt die häufigste Stoffwechselerkrankung im Kindes- und Jugendalter. Dementsprechend überschlagen sich seit Jahren Meldungen in der Presse bezüglich Neuigkeiten im Diabetes-Management und der Diabetes-Therapie. Hochbrisant ist derzeit vor allem die seit dem GB-A-Beschluss im Juni 2016 nun für nahezu jedermann zugängliche kontinuierliche Glukosemessung, die einen weiteren Meilenstein auf dem Weg zur künstlichen Bauchspeicheldrüse darstellt. Schon jetzt steht fest: Die real-time kontinuierliche Glukosemessung wird für einen bedeutenden Teil unserer kleinen Patienten eine Verbesserung der Stoffwechseleinstellung, Verminderung unbemerkter bzw. schwerer Hypoglykämien und eine Verbesserung der Lebensqualität bedeuten. Dennoch sollte beachtet werden, dass diese Form der Glukosemessung nicht für jedermann geeignet ist und durchaus auch Nachteile haben kann. Indikation und Therapieziele sollten daher individuell mit den Patienten und deren Angehörigen besprochen und festgelegt werden. Des Weiteren sollte der Einsatz einer rt- CGM immer auch vor dem Hintergrund möglicher psychischer Konsequenzen für die Patienten und deren Familien gesehen werden. Ständig wird versucht, Patienten das tägliche Management mit ihrer Diabetes-Erkrankung etwas zu erleichtern, so z. B. mit Apps zur Berechnung von Kohlenhydraten. Es bleibt allerdings abzuwarten, wie hilfreich und vor allem individuell diese Apps wirklich für unsere Patienten sind.

Es gibt Ergebnisse von Studien mehrerer Forschergruppen zu Heilungsansätzen für Patienten mit Typ-1-Diabetes. Die Ergebnisse beruhen bisher jedoch in der Regel auf Tiermodellen mit geringen Fallzahlen und kurzer Beobachtungsdauer, sodass hier weiterer Forschungsbedarf besteht und wir auch im Jahr 2017 bis zur Möglichkeit der Heilung des Typ- 1-Diabetes noch einen weiten Weg vor uns haben.

Auch deshalb wird aktuell der Früherkennung des Typ-1-Diabetes eine entscheidende Bedeutung zugeschrieben. Oberstes Ziel ist neben der Früherkennung vor allem die Reduktion schwerer Stoffwechselentgleisungen bei Manifestation der Erkrankung. In Sachsen gibt es bereits die Möglichkeit, Neugeborene auf Risiko- Gene untersuchen zu lassen. Inwieweit die erhofften Ziele erreicht werden und wir den hohen Anforderungen im Fall positiver Befunde gerecht werden, müssen die nächsten Jahre zeigen.
Evaluation of an Audio Mode of the Automated Medical History
Authors: Stead W. W. , Hammond W. E. , Estes E. H.
Published: March 2018

The Westinghouse Voice Response System is a stand-alone hardware unit designed for automated data collection. Questions are asked in the audio mode. Responses are printed at the time of the interview and stored on magnetic tape for future retrieval. This audio system was evaluated as a method for the collection of the initial medical history. In addition, comparisons were made among three techniques of automated data collection: audio, video and paper and pencil. The audio mode of automated history taking was more effective than comparable paper and pencil and video systems in situations where the patient population was of borderline literacy. The Westinghouse Voice Response System is a viable stand-alone system for those situations in which on-line access to a computer is not available.
Thesaurus der Medizin (TdM) - An Internationally Compatible Diagnostic System of Medicine
Authors: Kayser K. , Ramisch W. , Höpker W.-W.
Published: March 2018

An internationally compatible medical thesaurus in German, the TdM, is presented. The principle of its structure is based on a documentation language including a complete hierarchic classification as well as a very variable faceted one. The structure items of the thesaurus are marked by abbreviations constructed mnemotechnically by letter corresponding to the hierarchic classification, the digits to the facet division. The organisation of the facets is done in such a way that they can be regarded as additional aspects within the arrangement of the hierarchic classification. The aspect of the meaning of a diagnosis is marked by a string, every item consisting of several strings. The number of strings is unlimited in general. The codification structures of the ICD/E, KDS and SNOP are included in every diagnosis. The thesaurus has a total volume of about 22,000 diagnoses.
Patient Scheduling — (Bibliography)
Authors: Köhler C. O. , Wagner G. , Wolber U.
Published: March 2018

The entire field of information processing in medicine is today already spread out and branched to such an extent that it is no longer possible to set up a survey on relevant literature as a whole. But even in narrow parts of medical informatics it is hardly possible for the individual scientist to keep up to date with new literature. Strictly defined special bibliographies on certain topics are most helpful.

In our days, problems of optimal patient scheduling and exploitation of resources are gaining more and more importance. Scientists are working on the solution of these problems in many places.

The bibliography on »Patient Scheduling« presented here contains but a few basic theoretical papers on the problem of waiting queues which are of importance in the area of medical care. Most of the papers cited are concerned with practical approaches to a solution and describe current systems in medicine.

In listing the literature, we were assisted by Mrs. Wieland, Mr. Dusberger and Mr. Henn, in data acquisition and computer handling by Mrs. Gieß and Mr. Schlaefer. We wish to thank all those mentioned for their assistance.
What is a Valid Scientific Argument? – A Linguistic Approach to an Answer)
Authors: Bross I. D. J.
Published: March 2018

Many of the major disagreements or controversies in the sciences hinge on the question: What is a valid scientific argument ? A linguistic approach to answer this question is proposed. Based on the mathematical structures of language of Dr. Zellig Habbis, a computerized parse of a scientific argument can now be made. This permits an objective, formal reduction of the overall analysis into smaller, more manageable subarguments. It also allows a separation of questions of fact from questions of language. To illustrate the approach, the scientific argument in »Comparison of profadol and morphine« by Beaver et al. has been considered using this linguistic approach. This analysis shows how difficult and complex issues can be reduced to a series of simpler components. The question of validity for a given component is much easier to resolve. It is argued that this linguistic approach to validity should replace the intuitive, subjective evaluations based on »expert opinion« which are currently used in many areas of biomedical research.
Utility Estimation of a Set of States of Health
Authors: Card W. I. , Rusinkiewicz M. , Phillips C. I.
Published: March 2018

A decision maker was presented with three states of health, such that an imaginary patient was in the middle state while the two other states could be described as more preferred and less preferred. The decision maker was then asked to choose the minimal odds at which he would advise an operation which would result in success, the patient moving into the more preferred state, or failure, the patient moving into the less preferred state. Eight decision makers were tested in this way and each made 24 such wagers on a set of three states chosen from a total set of eight; each of these states differed unidimen sionally only in the visual acuity of the remaining eye in the imaginary patient. If the utility of I is arbitrarily assigned to the state of perfect vision, and the utility of 0 to the state of non-perception of light, estimates of the utilities of the intervening states can then be made. The utility function for each decision maker was constructed and was found to be linear against the logarithm of the visual acuity. From this it follows that if all decision makers, e.g. ophthalmic surgeons, show such linearity, they will all choose the same odds before deciding whether to operate and these odds are independent of the utilities which the individual decision maker attaches to the different states of health.
The Value of Subjective Appreciation in the Medical Record – II. The Evalution of the General Condition of the Patient
Authors: Lahaye D. , Roosels D. , Viaene J.
Published: March 2018

Based on the analysis of 13,110 medical examinations performed on a standardized population of pneumoconiosis patients recorded on the F.O.D. computer file, the authors describe the value of the subjective estimations of »obesity«, »thinness« or »normal weight« by their correlation with the observed weight and height. Although there are striking differences in appreciation between the physicians performing the examinations, the qualifications »obese«, »thin« or »normal« correspond with real group differences in weight, between certain limits which can be defined. The ratio between the observed weight and the expected weight (using the Broca formula) shows the same pattern. In tins way it becomes possible to propose upper and lower limits for obesity, thinness and normal weight based on purely empiric data. Feeding back this information to the examining physicians should help reduce the differences between physicians and improve the results. Therefore, the authors find it useful to keep such information in the computer file.
Fundamentals of Controlled Clinical Trials
Authors: Martini P.
Published: March 2018

The result of therapeutic research should, if possible, also benefit the recovery of the patient. The basic rule for every therapeutic-clinical trial must involve a comparison of therapeutic approaches. In acute conditions, such as acute infectious diseases, infarcts, etc., comparisons should be made between two or more groups: the collective therapeutic comparison, i.e. the between-patients trial. The formation of groups to be compared one with the other can be justified only if one is reasonably sure that a pathogenic condition does indeed exist. In chronic diseases, which extend essentially unchanged over a lengthy period but are nevertheless reversible, therapeutic comparisons may be made between two or more time intervals within the course of the disease in the same individual. This type of therapeutic trial rests primarily upon a (refined!) type of specious reasoning and secondarily upon modified statistics: the individual therapeutic comparison, i.e. the within-patient trial. The collective therapeutic comparison on the one hand and the individual therapeutic comparison on the other hand overlap somewhat in scope. The immediate therapeutic effect is not always an indication of its true value which may become evident only upon long-term treatment. The short-term trials of therapeutic regimens in an individual must, therefore, be frequently supplemented by long-term trials which can only be carried out by comparing two groups. For many clinical investigations the joint efforts of numerous hospitals are, therefore, absolutely necessary.

The second basic rule of therapeutic research is the elimination of secondary causes. The difficulties introduced by these secondary considerations are far greater in therapeutic trials carried out on ambulatory patients than has hitherto been realized. In order to remove subjective secondary causes, the author demanded in 1931 the use of hidden or illusory media (placebos, dummies), i.e. unconscious causative agents. The double blind procedure is indispensible in all experiments, especially where psychological processes and problems are of foremost importance. Therefore, it is absolutely necessary that convincing tests be finally carried out with the double blind procedure on the one hand and the simple blind procedure on the other hand in order to determine the range and limitations of both. Therapeutic research of the future is threatened by the hazard of self-satisfaction which produces a sense of accomplishment merely as the result of obeying formal conditions and of following formal standards of accuracy.
Surgical Complications after Right Hepatectomy for Live Liver Donation: Largest Single-Center Western World Experience
Authors: Gorgen Andre , Goldaracena Nicolas , Zhang Wei , Rosales Roizar , Ghanekar Anand , Lilly Les , Cattral Mark , Greig Paul , McCluskey Stuart , McGilvray Ian , Selzner Nazia , Bhat Mamatha , Selzner Markus , Levy Gary , Grant David , Sapisochin Gonzalo
Published: March 2018

The authors assessed the incidence, management, and risk factors for postoperative complications after right lobe (RL) live donor hepatectomy in a high-volume center in North America. All donors undergoing an RL live donor hepatectomy between 2000 and 2017 at our institution were included. The primary outcome was the development of complications (both medical and surgical). Predictors of postoperative complications were determined by logistic regression. A total of 587 patients underwent RL live donor hepatectomy. Among those, 187 postoperative complications were diagnosed in 141 (24%) patients. One patient had >90-day morbidity, and there were no donor deaths. Overall complications were significantly higher in the first era, 2000 to 2008 (81 [57.4%]) versus the second era, 2009 to 2017 (60 [42.6%]) (p = 0.01). On multivariate analysis, the only predictor of postoperative complications was the center volume of RL live donor hepatectomy in the previous 12 months with an odds ratio of 0.97 (95% confidence interval: 0.95–0.99). In conclusion, increasing center volume is associated with lower rates of postoperative complications after RL living liver donation.
Berliner Gesellschaft für Psychiatrie und Neurologie
Authors: Holdorff B.
Published: March 2018

Nach der Gründung der “Berliner medicinisch- psychologischen Gesellschaft”, der späteren Berliner Gesellschaft für Psychiatrie und Nervenkrankheiten (Neurologie) 1867 durch Wilhelm Griesinger (1817–1868) und andere Gründungsmitglieder war die BGPN ein Forum der sich rasch entwickelnden Neuropsychiatrie, das auch von außeruniversitären Polikliniken und Instituten genutzt wurde für die Berichte aus der Hirnlokalisationsforschung, Semiologie und Nosologie peripherer Nerven- und Rückenmarkerkrankungen einschließlich der Elektrodiagnostik, später der morphologischen Identifizierung degenerativer Hirnkrankheiten. Psychiatrische Themen waren über Jahrzehnte unterrepräsentiert. Jüdische Kollegen nahmen zunächst als Polikliniker, nach dem ersten Weltkrieg als Chefärzte neugegründeter Neurologieabteilungen die Rolle einer einzigartigen Avantgarde ein. Die Verbrechen unter der NS-Herrschaft, die Wiedergründung der BGPN nach dem zweiten Weltkrieg, die Teilung in Ost- und West-Sektionen bis zu ihrer Wiedervereinigung 1991 und die in ihr fortbestehende Einheit von Psychiatrie und Neurologie bestimmten die weitere Geschichte der BGPN.
Health Informatics Training at the University of Missouri
Authors: Reid J.C. , Mitchell J.A. , Balas E.A.
Published: March 2018

Health informatics training has a long tradition at the University of Missouri. The current program prepares future researchers for the rapidly changing field of health informatics. This paper describes the training program, the fellowships, the interdisciplinary strengths of the program, and representative projects. Research opportunities range from information analyses of basic medical sciences through development of clinical information systems to the evaluation of information systems. The informatics training program at the University of Missouri promotes evidence-based medical informatics and has a strong emphasis on the organizational aspects of successful information system implementation.
Health Informatics and Health Management Education at Central Queensland University
Authors: Hovenga E.J.S. , Whymark G.K
Published: March 2018

Health informatics education is relatively new in Australia. It began at Central Queensland University in the early 1990s with the development of postgraduate programs in health administration and information systems. The University has a long tradition of distance education. The adoption of this approach for our combined health informatics and management courses enabled program delivery to students located anywhere in Australia and beyond. This paper describes course development and planned future developments
Health Informatics Education and Research at the University of Athens
Authors: Mantas J.
Published: March 2018

In Europe, coordinated activities in healthcare informatics education started in the late 1980s with the establishment of European courses in health telematics. At the same time the European Commission foresaw the need for spreading the knowledge of Information Technology (IT) in the healthcare sector. Therefore the EC, since then, has supported the initiatives that aim to create awareness, stimulate diffusion, and educate and train the users (healthcare professionals) in the application of IT in health care [I] Initiatives, such as the NIGHTINGALE project, are essential for the planning and implementation of strategies for training the nursing profession in using and applying healthcare information systems. Other projects are the IT EDUCTRA project, which is a practical project in the field of education and training of healthcare professionals in information technologies, and the ERASMUS Master’s Course, which aims at giving those working (or intending to work) in the health service and related activities, a broad advanced postgraduate education in health informatics.
Electronic Healthcare Records: an essential part of Health Telematics Applications
Authors: Engelbrecht R. , Hildebrand C. , Moser W.
Published: March 2018

A healthcare record should ideally be a repository of data, describing a person’s health and how it is being supported; and not, as it is now, describing a person’s diseases and treatment only. The healthcare record is the basis for monitoring and decisions. Therefore it should be open and available to all authorized health professionals and to the patient. To make this easier is one of the major advantages of electronic healthcare records (EHCR). The computer-based patient record could make major contributions to improving the healthcare system. This is the motivation to initiatives, projects and routine implementations of electronic patient records. The European Union and national initiatives have put major efforts into the support of this main field of medical information processing.
Twenty Five Years of Medical Informatics Education at Heidelberg/Heilbronn: Discussion of a Specialized Curriculum for Medical Informatics
Authors: Leven F.J. , Haux R.
Published: March 2018

The specialized university curriculum for medical informatics (MI) at the University of Heidelberg/School of Technology Heilbronn is one of the oldest educational approaches in the field of medical informatics, and has been successful for 25 years with about 1,000 graduates (Diplom-Informatikerin der Medizin or Diplom-Informatiker der Medizin). It belongs to the category of dedicated master’s programs for medical informatics and is based on the concept of medical informatics as a medical discipline in its own right. The curriculum is oriented towards the total spectrum of medical informatics ranging from health care economics, biosignal and medical image processing, medical documentation, to information and knowledge processing in medicine. It is a 4.5-year program with strong emphasis on the methodological foundations of medical informatics and on practical education in a number of specific laboratories. Thirty-five students are admitted each semester, and in total about 440 students are enrolled. The faculty consists of 17 full-time members and about 25 part-time lecturers. We report on characteristics, structure and contents of the new 5th version of the curriculum and discuss the features of a specialized curriculum for medical informatics with respect to the challenges for medical informatics in the 21st century.
Countdown to 2001: The Computer-based Patient Record After the Institute of Medicine Report
Authors: Steen E. B. , Detmer D. E.
Published: March 2018

A 1991 Institute of Medicine report called computer-based patient records (CPRs) an essential technology for health care and recommended widespread implementation of CPRs within a decade. Although a broader understanding of CPRs has been achieved and more leadership for CPR development exists today, substantial work remains to be accomplished. Critical tasks include developing a detailed specification of the CPR concept, strengthening standards development efforts through greater federal funding and involvement, developing national policy on key issues, and identifying funding sources for CPR system implementation. This article reviews the major views and issues of the 1991 IOM report and relates them to subsequent developments.
Medical Informatics, Statistics and Epidemiology Education: In the Framework of the Tempus-Phare Joint European Project
Authors: Zvárová Jana
Published: March 2018

Medicine and health care should react to the changing composition of the population, to diseases and new treatments, to the needs of medical ethics and law, and to changing economic conditions and to social needs. The main goal of health care is to improve the health status of the population. To reach this goal the appropriate use of available information, including for example biomedical knowledge, epidemiological data or patient data, is necessary. The need for education in this field of medical informatics, statistics, and epidemiology is a requirement to solve health-care problems, to develop a long-term perspective and successful functioning of health-care systems. The information sciences can play an important role in promoting the construction of basic data, vocabularies and decision procedures, as well as developing formal methods for problem solving.
Trends in Integrated Clinical Workstations
Authors: Timmers T. , van Mulligen E. M.
Published: March 2018

During the last decade, several projects aiming at integrated clinical workstations have been described and several prototypes have been demonstrated. In most of these projects, the clinical workstation accesses information and functionality provided by the present proprietary legacy systems of health-care institutions. We discuss trends in integrated clinical workstations from the viewpoints of software engineering and integration, considering that the clinical workstation itself basically consists of three layers: a presentation layer, a data integration layer, and a communication layer. The software engineering view on clinical workstations focuses on the development of basic building blocks from which clinical workstations, specific to a particular medical domain, can be composed. The integration view on clinical workstations addresses methods and techniques to deal with the, in general, intrinsically closed information systems in health-care institutions.
Health and Clinical Management – Maximising Health Care Efficiency for Better Outcomes
Authors: Kubias D. ,   Section Editor for the IMIA Yearbook Section on Health and Clinical Management
Published: March 2018

Objectives:
To present some of last year’s best papers in the field of health and clinical management.

Method:
Synopsis of the best articles selected for the IMIA Yearbook 2010.

Results:
All five selected articles present promising results, each in a different subtopic of health care management. From automated clinical syndrome detection to global population surveillance, through improving alerting systems’ impact, the selected articles should give an idea of how IT, not only can, but how it does help in health care management.

Conclusions:
While some people fear that computers might, one day, replace humans in health care, this is very far from being the case. What literature shows is that IT merely provides health care professionals with valuable tools that let them spend more time with their patients, prevent them from missing critical information, support them in their decision making and thus help improve their efficiency.
In Cereo and in Silico: Tissue Microarray (TMA) Techniques and Bioinformatics Are Thriving Forces in Medical Science and Personalized Medicine
Authors: Lang E.
Published: March 2018

Objectives:
Tissue microarray (TMA) techniques are among the most promising developments in biomedicine during the last decade. Bioinformatics techniques are indispensable for storing and processing the masses of data related with tissue archive administration and investigation of raw data. Interrelationship between experimental and computational work will be shown.

Methods:
Tissue specimen arrays allow parallel analysis of huge amounts of samples. TMA techniques thus produce enormous masses of raw data, and optimal use of data can only be made using modern bioinformatics techniques based on huge storage systems, scalable multilayer software architecture and high-throughput algorithms for retrieval and statistical processing. Further crucial issues addressed by informatics techniques are specimen identification during the whole processing chain, and anonymization whenever scientific work is performed without regard to a certain patient.

Results:
TMA supported by bioinformatics methods has helped in identification of biomarkers, mainly in cancer diagnosis. Moreover, it provides powerful means of quality assurance and training in histopathology.

Conclusions:
Further statistical analyses seem to be necessary to detect if certain biomarkers are present in nearly all kinds of specimen of the concerned patient, which would allow effective mass screening based on easily accessible specimen. Some investigations showed low dependence on the specimen localization, whereas others suggest to be extremely careful in material selection for the recipient block.
eHealth in North America
Authors: Newsham D. , Bates D. W. , Borycki E. M.
Published: March 2018

Objective: The overall objective of this paper is to provide an overview of the current status of electronic health record (EHR) adoption and implementation in Canada and the United States.

Methods: A review and synthesis of the empirical and grey literature about adoption of electronic health records in Canada and the United States was undertaken.

Results: Both Canada and the United States have experienced increases in their adoption rates. More specifically, 2012 adoption statistics reveal that the electronic medical record adoption rate in the United States is 69% and in Canada it is 57%. Significant investment by both governments has increased adoption of electronic records across North America.

Conclusions: In the United States and Canada there has been a significant rise in the adoption of electronic records by health professionals with the aid of national government incentive programs.
Evidence-based Practice
Authors: Douali N. , Staccini P.
Published: March 2018

Objectives: To provide an overview of outstanding current research conducted in Education and Consumer Informatics.

Method: Synopsis of the articles on education and consumer health informatics published in 2012 and selected for the IMIA Yearbook of Medical Informatics 2013.

Results: Architecture of monitoring or telehealth information systems for patients with chronic disease must include wireless devices to aid in the collection of personal data. Data acquisition technologies have an impact on patients' willingness to participate in telehealth programmes. Patients are more likely to prefer mobile applications over web-based applications. Social media is widely used by clinicians. Especially younger clinicians use it for personal purposes and for reference materials retrieval. Questions remain on optimal training requirements and on the effects on clinician behavior and on patient outcomes. A high level of e-Health literacy by patients will promote increased adoption and utilization of personal health records.

Conclusion: The selected articles highlight the need for training of clinicians to become aware of existing telehealth systems, in order to correctly inform and guide patients to take part in telehealth systems and adopt personal healthcare records (PHR).
Cervical Stenosis in Adult Arthrogryposis: A Case Report and Review of the Literature
Authors: Ho Allen , Mohole Jyodi , Sussman Eric , Pendharkar Arjun , Singh Harminder
Published: March 2018

Arthrogryposis multiplex congenita is a rare, nonprogressive congenital disorder that describes a constellation of conditions characterized by multiple joint contractures. Spinal pathology and deformity are common; however, the majority of the literature on arthrogryposis is focused on pediatric management. There exist very few reports on long-term outcomes and management of adults with arthrogryposis. We present a case of cervical spinal stenosis in an adult female with arthrogryposis that underwent posterior cervical decompression and fusion. A review of spine-related sequelae seen in adults with arthrogryposis and considerations for spinal surgery for these patients is discussed.
Health and Clinical Management:
Authors: Kubias D. ,   Section Editor for the IMIA Yearbook Section on Health and Clinical Management
Published: March 2018

Summarize some of last year’s best research in the field of Health and Clinical Management.

Synopsis of articles selected for the IMIA Yearbook 2012.

Five articles, from international peer-reviewed journals, have been selected in this section.

The selected articles illustrate some of the topics of health and clinical management: from patient safety issues over the possibilities offered by technological devices to building knowledge from data present in electronic patient records.
Knowledge Representation and Management: Towards Patient Health Self-management
Authors: Rassinoux A.-M. ,   Section Editor for the IMIA Yearbook Section on Knowledge Representation and Management
Published: March 2018

To summarize excellent current research in the field of knowledge representation and management (KRM).

A synopsis of the articles selected for the IMIA Yearbook 2012 is provided and an attempt to highlight the current trends in the field of health management is sketched.

Among the five selected papers, two confirm the benefit of exploiting open-source language toolkits for the automatic extraction of medical concepts, assertions and/or relationships from clinical texts. One paper aims at exploiting domain-specific terminologies to improve the parsing of biomedical noun phrases, and another one aims at discovering rare diseases associations embedded into disparate textual sources. Finally, the last paper describes a collaborative search approach integrated into a homegrown EHR search engine.

This selected set of papers confirms that natural language processing, as well as knowledge extraction, discovering and retrieval, are still active and fruitful research fields. Although these papers are not directly focusing on personal health informatics applications„ important features are highlighted and tailored to fit the requirements of patient health self-management. Delivering timely, friendly and secure access to functional, accurate, up-to-date and sustainable personal health records is a significant challenging task for supporting self-managed healthcare.
Der diagnostische Nutzen einer zusätzlichen 68Ga-PSMA-PET vor der 223Ra-Dichlorid-Therapie bei Patienten mit metastasiertem Prostatakarzinom
Authors: Rahbar Kambiz , Konnert Julia , Bögemann Martin , Stegger Lars , Bräuer Axel
Published: March 2018

Die Bildgebung spielt eine wichtige Rolle bei der Auswahl derjenigen Patienten mit metastasiertem, kastrastionsrefraktärem Prostatakarzinom, die für eine 223Ra-Dichlorid-Therapie von Knochenmetastasen geeignet sind. Das Ziel dieser Studie war zu untersuchen, ob eine zusätzliche 68Ga-PSMA-PET einen inkrementellen Nutzen gegenüber der konventionellen Bildgebung bei der Auswahl geeigneter Patienten für diese Therapie aufweist.

Bei 27 konsekutiv für eine 223Ra- Dichlorid-Therapie vorgestellten Patienten wurde eine zusätzliche 68Ga-PSMA-PET/CT durchgeführt. Die Tracerverteilung wurde systematisch ausgewertet in Hinblick auf die Detektion von viszeralen Metastasen und von ossären Metastasen ohne adäquate Speicherung in der Skelettszintigraphie.

Zusätzliche viszerale Metastasen wurden mittels 68Ga-PSMA-PET bei 4 Patienten (15 %) detektiert (3 Leber, 1 Nebenniere), wobei in der Folge das therapeutische Vorgehen bei 2 der 4 Patienten geändert wurde. Mit der PET wurde eine ausgedehntere Knochenmetastasierung im Vergleich zur Skelettszintigraphie bei 9 Patienten (33 %) nachgewiesen. Bei dreien dieser Patienten war der “Mismatch” ausgedehnt genug, um die Durchführung der 223Ra-Dichlorid-Therapie in Frage zu stellen.

Die zusätzliche Durchführung einer 68Ga-PSMA-PET als Torwächter zwischen konventioneller Bildgebung und der 223Ra-Dichlorid-Therapie kann wichtige zusätzliche Informationen liefern über das Vorliegen von viszeralen Metastasen und von ossären Tumormanifestationen ohne adäquaten Knochenstoffwechsel. Dieses kann bei einer signifikanten Zahl von Patienten zu einer Änderung des therapeutischen Managements führen und sollte in zukünftigen klinischen Studien berücksichtigt werden.
Verbesserung der Überlebensqualität durch SIRT
Authors: Kretzschmar Alexander
Published: March 2018

Patienten mit fortgeschrittenem, inoperablem hepatozellulärem Karzinom (HCC), die in der SARAH Studie (n = 459) in der Regel 1 oder 2 Behandlungen mit zielgerichtet auf die Leber wirkenden SIR-Spheres® Y-90 Harz-Mikrosphären erhielten, zeigten ähnliche Überlebensraten wie Patienten mit einer systemischen Standardtherapie mit Sorafenib. Die mit der Behandlung verbundenen unerwünschten Nebenwirkungen wurden jedoch um mehr als die Hälfte reduziert und waren signifikant weniger schwerwiegend. Die auf dem Internationalen Leber-Kongress (ILC) 2017 vorgestellten Daten zeigten zudem eine signifikante Verbesserung der Lebensqualität.
Herdenimmunität schützt nur heterosexuelle Männer
Authors: Schmale Ine
Published: March 2018

Es gibt mehr als 100 verschiedene Typen des Humanen Papillomavirus (HPV). Die genitale HPV-Infektion ist eine häufige sexuell übertragene Erkrankung, die weltweit für etwa 500 000 Krebsfälle und 250 000 Krebstodesfälle verantwortlich ist. Auf der EAUJahrestagung 2017 wurde über den aktuellen HPV-Impfstatus diskutiert.
EFSUMB Recommendations and Clinical Guidelines for Intestinal Ultrasound (GIUS) in Inflammatory Bowel Diseases
Authors: Maconi Giovanni , Nylund Kim , Ripolles Tomas , Calabrese Emma , Dirks Klaus , Dietrich Christoph , Hollerweger Alois , Sporea Ioan , Saftoiu Adrian , Maaser Christian , Hausken Trygve , Higginson Antony , Nürnberg Dieter , Pallotta Nadia , Romanini Laura , Serra Carla , Gilja Odd
Published: March 2018

The accuracy and usefulness of gastrointestinal ultrasound (GIUS) for detecting activity and complications of inflammatory bowel diseases (IBD), has been reported in studies, promoting this technique as an important tool for the management of IBD patients. Whilst well recognised by international guidelines, standardization and general agreement in the definition of the luminal and extra-intestinal features, still need to be well defined.

A task force group of 17 experts in GIUS faced this issue, by developing recommendations and clinical guidelines for the use of GIUS in IBD, under the auspices of EFSUMB. This article presents the consensus on the current data on sonographic features of IBD and summarises the accuracy of different sonographic modalities for the management of IBD patients.
Maternal Thrombophilia and Recurrent Miscarriage – Is There Evidence That Heparin is Indicated as Prophylaxis against Recurrence?
Authors: Stefanski Ana-Luisa , Specker Christoph , Fischer-Betz Rebecca , Henrich Wolfgang , Schleussner Ekkehard , Dörner Thomas
Published: March 2018

Background Recurrent miscarriage, also referred to as recurrent spontaneous abortion (RSA), affects 1 – 5% of couples and has a multifactorial genesis. Acquired and congenital thrombophilia have been discussed as hemostatic risk factors in the pathogenesis of RSA.

Method This review article was based on a selective search of the literature in PubMed. There was a special focus on the current body of evidence studying the association between RSA and antiphospholipid syndrome and hereditary thrombophilia disorders.

Results Antiphospholipid syndrome (APS) is an acquired autoimmune thrombophilia and recurrent miscarriage is one of its clinical classification criteria. The presence of lupus anticoagulant has been shown to be the most important serologic risk factor for developing complications of pregnancy. A combination of low-dose acetylsalicylic acid and heparin has shown significant benefits with regard to pregnancy outcomes and APS-related miscarriage. Some congenital thrombophilic disorders also have an increased associated risk of developing RSA, although the risk is lower than for APS. The current analysis does not sufficiently support the analogous administration of heparin as prophylaxis against miscarriage in women with congenital thrombophilia in the same way as it is used in antiphospholipid syndrome. The data on rare, combined or homozygous thrombophilias and their impact on RSA are still insufficient.

Conclusion In contrast to antiphospholipid syndrome, the current data from studies on recurrent spontaneous abortion do not support the prophylactic administration of heparin to treat women with maternal hereditary thrombophilia in subsequent pregnancies. Nevertheless, the maternal risk of thromboembolic events must determine the indication for thrombosis prophylaxis in pregnancy.
Enhanced light trapping by focused ion beam (FIB) induced self-organized nanoripples on germanium (100) surface
Authors: Kamaliya Bhaveshkumar , Mote Rakesh G. , Aslam Mohammed , Fu Jing
Published: March 2018

In this paper, we demonstrate enhanced light trapping by self-organized nanoripples on the germanium surface. The enhanced light trapping leading to high absorption of light is confirmed by the experimental studies as well as the numerical simulations using the finite-difference time-domain method. We used gallium ion (Ga+) focused ion beam to enable the formation of the self-organized nanoripples on the germanium (100) surface. During the fabrication, the overlap of the scanning beam is varied from zero to negative value and found to influence the orientation of the nanoripples. Evolution of nanostructures with the variation of beam overlap is investigated. Parallel, perpendicular, and randomly aligned nanoripples with respect to the scanning direction are obtained via manipulation of the scanning beam overlap. 95% broadband absorptance is measured in the visible electromagnetic region for the nanorippled germanium surface. The reported light absorption enhancement can significantly improve the efficiency of germanium-silicon based photovoltaic systems.
A 1· 6 MHz Survey of the Galactic Background Radio Emission
Authors: Ellis GRA , Mendillo M
Published: March 2018

Observations of the galactic radio emission at 1 �6 MHz have been made during the current solar activity minimum using a radio telescope with a beam width of 25�. The radiation intensity was mapped for six declinations between _12� and _72� and from 1000 to 0500 hours R.A.
Evaluation of the Substance abuse Research and Education Training (SARET) Program: Stimulating Health Professional Students to Pursue Careers in Substance use Research
Authors: Hanley Kathleen , Bereket Sewit , Tuchman Ellen , More Frederick G. , Naegle Madeline A. , Kalet Adina , Goldfeld Keith , Gourevitch Marc N.
Published: March 2018

Background: We developed and implemented the Substance Abuse Research Education and Training (SARET) program for medical, dental, nursing, and social work students to address the dearth of health professionals pursuing research and careers in substance use disorders (SUD). SARET has 2 main components: (1) a novel online curriculum addressing core SUD research topics, to reach a large number of students; (2) a mentored summer research experience for in-depth exposure. Methods: Modules were integrated into the curricula of the lead institution, and of 5 external schools. We assessed the number of Web modules completed and their effect on students’ interest in SUD research. We also assessed the impact of the mentorship experience on participants’ attitudes and early career trajectories, including current involvement in SUD research. Results: Since 2008, over 24,000 modules have been completed by approximately 9700 individuals. In addition to integration of the modules into curricula at the lead institution, all 5 health-professional partner schools integrated at least 1 module and approximately 5500 modules were completed by individuals outside the lead institution. We found an increase in interest in SUD research after completion of the modules for students in all 4 disciplines. From 2008 to 2015, 76 students completed summer mentorships; 8 students completed year-long mentorships; 13 published in SUD-related journals, 18 presented at national conferences, and 3 are actively engaged in SUD-related research. Mentorship participants reported a positive influence on their attitudes towards SUD-related clinical care, research, and interprofessional collaboration, leading in some cases to changes in career plans. Conclusions: A modular curriculum that stimulates clinical and research interest in SUD can be successfully integrated into medical, dental, nursing, and social work curricula. The SARET program of mentored research participation fostered early research successes and influenced career choice of some participants. Longer-term follow-up will enable us to assess more distal careers of the program.
Balancing prescription with teacher and pupil agency: spaces for manoeuvre within a pedagogical model for working with adolescent girls
Authors: Kirk D. , Lamb C. A. , Oliver K. L. , Ewing-Day R. , Fleming C. , Loch A. , Smedley V.
Published: March 2018

This paper explores the possibilities of using a pedagogical model for working with adolescent girls in physical education as a means of balancing the challenge of external prescription from outside the school with teacher and pupil agency. We report data from a study involving four schools in Glasgow. We note that the national curriculum for Scotland, Curriculum for Excellence, is a broad and bold type that provides teachers with ‘spaces for manoeuvre’ in order to shape local curricula that best meet the needs and interests of girls. This is particularly the case in physical education, which in the Basic General Education phase for 12–15 years olds there is no well‐established assessment regime. We identify four spaces for manoeuvre for teachers and pupils within an activist model: new forms of communication based on authorising pupil voice; offering choices and opening up learning possibilities; the co‐construction of a safe class environment; opportunities to rethink traditional structures based on the multi‐activity curriculum form. We conclude that an activist pedagogical model provided teachers and pupils with spaces to explore alternative practices to traditional forms of physical education.