bluuebunny/crossref_metadata_2025 huggingface dataset:
1-D saturated-unsaturated behaviour of sand-geotextile columns
Authors: Bathurst R.J.  , Siemens G.
Published: February 2025

The paper describes a series of laboratory tests that were carried out to quantify the saturated-unsaturated hydraulic properties of woven and nonwoven geotextiles in virgin condition and contaminated with kaolin fines. The test program included 1-D column tests of a single geotextile layer in sand subjected to surface water infiltration loading. The column tests showed detectable changes in rate of wetting front advancement in the vicinity of the geotextile layer consistent with a capillary break mechanism. Transient ponding of water above the geotextile was observed to vary with the initial unsaturated hydraulic conductivity of the geotextile. A numerical code was developed to simulate the 1-D column tests and numerical results are shown to be in good agreement with physical test results. The work reported here leads to the recommendation that the ratio of geotextile to sand saturated hydraulic conductivity may have to be greater than one to prevent lateral flow of water above a geotextile in sand fills used in wall, embankment and road applications.
Use of vertical reinforcement to reduce ground movement due to tunnelling
Authors: Juneja A.  , Hegde A.  , Lee F.H.
Published: February 2025

This paper examines centrifuge results of tunnel excavation adjacent to vertical reinforcement in small-scale sand beds. The tunnel walls were represented by pressurised rubber liner. Results of 6 tests conducted at 50g using large diameter centrifuge at IITBombay are reported. Depth of the tunnel and spacing between the tunnel axis and reinforcement are the variables investigated. To simulate tunnel excavation, hydraulic pressure on walls of the rubber liner was decreased in steps whilst the centrifuge was in-flight. The magnitude and extent of settlement trough with increase in ground loss was captured using potentiometers and pore pressure transducers placed in vicinity of the tunnel axis. From the limited test observations, vertical rods of not more than 14-times the particle size is shown to affect the width of settlement trough.
Centrifuge model tests on soil desaturation as a liquefaction countermeasure
Authors: Takemura J.  , Igarashi R.  , Izawa J.  , Okamura M.  , Masuda M.
Published: February 2025

In this study a series of centrifuge model test has been conducted to investigate the mechanical behavior of the submerged but partially saturated sand during earthquake. In the centrifuge tests, an attempt was made to prepare partially saturated model sand by lowering and regaining ground water table under 50g centrifugal acceleration. The process of desaturation was monitored by Time Domain Reflectometer (TDR) and pore pressure transducers (PPT). A shaking test of the model was then conducted for the sand with a gravity type structure on the top to study the applicability of soil desaturation as a liquefaction countermeasure.
Wellbore instability mechanisms in very hard clay
Authors: Abdulhadi N.O.  , Akl S.A.  , Germaine J.T.  , Whittle A.J.
Published: February 2025

This paper summarizes the results of an integrated program of laboratory measurements and numerical analyses that have been performed to understand the mechanisms of instability associated with drilling of high angle wells through unlithified mudstones/very hard clays. The laboratory tests use Resedimented Boston Blue Clay (RBBC) consolidated to confining pressures up to 10 MPa as an analog test material. Cavity deformations are measured in a novel Thick-Walled Cylinder (TWC) apparatus with independent control of the vertical stress and radial pressures acting on the inner and outer walls of the specimen. Numerical simulations of these experiments are obtained using finite element analyses incorporating the MIT-E3 effective stress soil model, with parameters directly calibrated from high-pressure element tests. Comparisons with the deformations measured in undrained TWC tests provide an initial validation of predictive capabilities for vertical wellbores.
Neural modelling of CBR values for compacted fly ash
Authors: Zabielska-Adamska K.  , Sulewska M.J.
Published: February 2025

The aim of the paper was to study a prediction model of California Bearing Ratio values on the basis of other geotechnical parameters of fly ash. Reliable statistical correlations were not obtained. Next tests were conducted with the use of the MPL type (Multi-Layer Perception) artificial neural networks. The topology of the best ANNs model is denoted by 8-5-1. It was determined that the most significant variables were dry density and w/wopt, which confirmed that fly ash optimum water content and moisture content at compaction were the dominant parameters in CBR estimation. Dry density was the dominant parameter at comparison of different fly ash shipments, compacted by various methods.
Patient Safety Through Intelligent Procedures in Medication: The PSIP Project
Authors: Beuscart Régis  , McNair Peter  , Brender Jytte
Published: February 2025

The European project Patient Safety through Intelligent Procedures in medication (PSIP) aims at preventing medical errors. The objective are: (1) to facilitate the systematic production of epidemiological knowledge on Adverse Drug Events (ADE) and (2) to improve the entire medication cycle in a hospital environment. The first sub-objective is to produce knowledge on ADE: to know, as exactly as possible, per hospital, per medical department, their number, type, consequences and causes, including human factors. Data Mining of structured hospital data bases, and semantic mining of free-texts will provide a list of observed ADE, with frequencies and probabilities, thus giving a better understanding of potential risks. The second sub-objective is to develop innovative knowledge based on the mining results and to deliver professionals and patients contextualized alerts and recommendations fitting the local risk parameters. This knowledge will be implemented in a PSIP-Platform independent of existing ICT applications.
Development of an EHR System for Sharing – A Semantic Perspective
Authors: Liu Haifeng  , Hou Xue Qiao  , Hu Gang  , Li Jing  , Ding Yu Qi
Published: February 2025

Building up Electronic Health Record (EHR) systems is considered a promising approach to improve health care quality in China. In order to meet the challenges of EHR semantic interoperability, we present a HL7 Clinical Document Architecture (CDA) R2 based EHR system prototype developed for Guangdong Hospital of Traditional Chinese Medicine (GDHTCM). In particular, we demonstrate how semantic technologies are leveraged to benefit EHR users from enabling semantic search against an EHR repository. Pilot users of the system deemed it clinically useful, which encourages us to develop more capabilities based on EHR in future, like cross-institution sharing and integration with a clinical decision support system.
Development and Validation of Strategies to Test for Interoperability of Virtual Patients
Authors: Kononowicz Andrzej A.  , Heid Jörn  , Donkers Jeroen  , Hege Inga  , Woodham Luke  , Zary Nabil
Published: February 2025

Interoperability of e-learning resources requires the adherence to specific standards. In the domain of virtual patients (VP) a central role is played by the MedBiquitous' MVP specification and its application profile proposed by the eViP (Electronic Virtual Patients) project. An important factor in promoting a standard is the use of metrics for assessing the conformity of the resources to the constraints imposed by the specifications. The overall aim of this study was to explore strategies to test for conformance and investigate the capabilities and limitations of automated conformance testing. A four-level scale of conformance of virtual patient packages to the eViP profile is presented, as well as two implementations of conformance testing applications. The developed tools have been tested upon level two on a sample of four VP cases acquired from the eViP repository of virtual patients.
An RDF-Based Mediator for Health Data Interoperability
Authors: Kuo Mu-Hsing  , Kushniruk Andre  , Borycki Elizabeth
Published: February 2025

In this paper the authors propose and describe a Resource Description Framework (RDF)-based mediator designed to solve the health data interoperability problem that exists among heterogeneous health information systems (e.g., Electronic Health Records). The RDF-based mediator framework has three main components: (1) the Synonym Dictionary (SD) that can be used to map metadata semantics, (2) the CXTR module that can translate source XML-based health documents into RDF-XML format, and (3) the CRTX module that can translate an RDF-XML document into a target XML-based health document. The proposed mediator is expected to make health information exchange more efficient.
Usability Laboratory as the Last Outpost before Implementation – Lessons Learnt from Testing New Patient Record Functionality
Authors: Seland Gry  , Sørby Inger Dybdahl
Published: February 2025

The implementation of clinical IT systems is resource-demanding and difficult. In this paper we show how laboratory-based usability tests can be used as a last checkpoint before a system is rolled out, and share lessons learnt on how to conduct such tests in order to obtain valid results. The recommendations are based on experiences from two usability tests of a new medication module conducted in the spring 2008, where two nurses and two physicians simulated a pre round meeting, ward round, and administration of medication in a usability lab furnished as a hospital ward. The results show that details around the test situation are important for testing of implementation ready clinical IT systems. Patient cases must be adapted to the clinical specialties of the test participants, the patient data in the system must be complete, and persons holding the roles as patients have to understand the patient histories and the medical problem.
Application of Simple Digital Methods in the Treatment of Hemorrhoid Disease
Authors: Hajdarevic Braco  , Slaku Jasmina  , Pandza Haris  , Salihefendic Nizama  , Hadziahmetovic Zoran
Published: February 2025

The treatment of patient with relapse of bleeding after application of minimally invasive treatment of hemorrhoidal disease such as elastic band ligation, cryosurgical treatment Hemorrhoidal Arterial Ligation (HAL) can be presented as serious clinical problem in patients with concomitant diseases that can be contraindication for radical surgical treatment. We compared the Simple Digital Method and standard above mentioned minimally invasive ambulatory treatment. We used special proctoscope with Doppler Flowmeter in order to identify all branches of hemorrhoidal artery in the anal canal creating graphical presentation using specially adapted software. HAL method is then used to perform ligation of hemorrhoidal artery branches. The elastic ligatures (called gummiligatures) are then applied to the piles in which most prominent flow was registered using Doppler Flowmeter. Antibiotic prophylaxis and sedation was administered preoperatively. Special computer program registered all steps. Hemorrhoidal ointments and paracetamol were used after surgical procedure. Average number of identified hemorrhoid arteries branches was six, and total duration of the procedure was in average 28 min. We compared patient treatment with our method and standard methods. In tested group we noticed significantly fewer complications (after eight days the number of complications 11% vs. 74%, p<0.001, after 15 days 3% vs. 11%: p=0.101). One year after procedure, the treatment was successful in 91.4%, or 32 out of 35 patients according to proctoscopy and Doppler Flowmeter exam. There were three patients with relapse of symptoms. In 77% of patients hat were treated with rubber bands ligation relapse occurred. Our method is significantly more successful in comparison to classical methods of ambulatory treatment and can be alternative to radical surgical treatment.
Data-Mining-Based Detection of Adverse Drug Events
Authors: Chazard Emmanuel  , Preda Cristian  , Merlin Béatrice  , Ficheur Grégoire  , Beuscart Régis
Published: February 2025

Every year adverse drug events (ADEs) are known to be responsible for 98,000 deaths in the USA. Classical methods rely on report statements, expert knowledge, and staff operated record review. One of our objectives, in the PSIP project framework, is to use data mining (e.g., decision trees) to electronically identify situations leading to risk of ADEs. 10,500 hospitalization records from Denmark and France were used. 500 rules were automatically obtained, which are currently being validated by experts. A decision support system to prevent ADEs is then to be developed. The article examines a decision tree and the rules in the field of vitamin K antagonists.
Developing a Theoretical Model of Clinician Information Usage Propensity
Authors: Scott Philip J.  , Briggs James S.
Published: February 2025

Based on qualitative research, we developed the theoretical construct “clinician information usage propensity” as a hypothetical indicator of attitudes and behaviour towards clinical information and systems. We devised a survey to validate the construct and had 146 responses. Principal components analysis extracted four factors accounting for 47.2% of the variance: beliefs about clinical judgement, beliefs about information quality, cultural resistance and cognitive approach. The components were reasonably consistent with the model but two factors (beliefs about information quality, cognitive approach) had low reliability (α<0.6). Cultural resistance was the main factor and correlated with gender, grade and age group. Female clinicians showed significantly higher cultural resistance and preference for narrative; hospital doctors generally had higher cultural resistance than general practitioners. As only 47.2% of the variance was explained, further work is needed to refine the instrument to remove redundancy, improve sensitivity on the identified components and allow the construct to be explored as a form of technology adoption model. We posit that beliefs about clinical judgement merit further attention in medical informatics research.
A Formal Logical Framework for Cadiag-2
Authors: Ciabattoni Agata  , Vetterlein Thomas  , Adlassnig Klaus-Peter
Published: February 2025

Cadiag-2—where “Cadiag” stands for “computer-assisted diagnosis”— is an expert system based on fuzzy logic assisting in the differential diagnosis in internal medicine. With its aid, it is possible to derive from possibly vague information about a patient's symptoms, signs, laboratory test results, and clinical findings conjectures about present diseases. In this paper, we provide a mathematical formalization of the inferential mechanism of Cadiag-2. The aim is to have a formal logical calculus at hand which corresponds to the mode of operation of Cadiag-2 and which is among others needed to perform consistency checking of Cadiag-2's medical knowledge base.
Assessing Importance of Dietary Data in Anticoagulation Treatment
Authors: Nielsen Peter Brønnum  , Eriksen Esben Haldrup  , Thoft Milthers Rasmus  , Hejlesen Ole K.
Published: February 2025

This paper describes the outcome of including information on dietary intake in the attempt to predict International Normalized Ratio (INR) values. An already published model has been extended and is now tested with the additional dietary data and without it. When predicting INR values seven days into the future, the new proposed model outperforms the existing one. It is concluded that adding information on dietary intake improves the accuracy of INR predictions.
Tissue Engineering in Fractured Mandible Reconstruction
Authors: Robu Andreea  , Stoicu-Tivadar Lacramioara
Published: February 2025

The paper presents an overview of human tissue engineering and modelling-simulating methods currently in use. Tissue engineering is a promising alternative for the reconstruction of altered or totally damaged biological tissue, applied to eliminate the complications associated to traditional transplants.
Fuzzy-Based Extraction of Vascular Structures from Time-of-Flight MR Images
Authors: Forkert Nils Daniel  , Säring Dennis  , Wenzel Karolin  , Illies Till  , Fiehler Jens  , Handels Heinz
Published: February 2025

In this paper an automatic fuzzy based method for the extraction of the cerebrovascular system from 3D Time-of-Flight (TOF) MRA image sequences is presented. In order to exclude non-brain tissue an automatic skull stripping method is applied in a preprocessing step. Based on the TOF images vesselness and maximum parameter images are computed first. These parameter images are then combined with the TOF sequence using a fuzzy inference. The resulting fuzzy image offers an improved enhancement of small as well as malformed vessels against the remaining brain. Finally, the fuzzy-connectedness approach is used to extract the vascular system. A first evaluation showed that the fuzzy-based method proposed performs better than a state of the art method and yields results in the range of the inter-observer variation.
E-Learning for Nurse Continuous Education
Authors: Franchi Maria  , Giorgi Ines  , Rognoni Carla  , Capodaglio Edda  , Bazzini Giacomo  , Broughton Christine  , Mazzoleni M. Cristina
Published: February 2025

The paper compares the effectiveness of a traditional residential and an e-learning course for nurses, and suggests ways to identify the psychological characteristics which might lead people to prefer e-learning education.
Health Care Process and Workflow in Continuity of Care
Authors: Mennerat François  , Lundell Karl-Henrik  , Fogelberg Magnus  , Hofdijk Jacob  , Braga Silviu
Published: February 2025

Basically, the workshop aims to raise and collect input to Part 2 (“Health care process and workflow”), currently under development, of the European standard EN 13940 “Health informatics – System of concepts to support continuity of care”, the general objective of which is to enable communication at the semantic level between information systems in health care in the perspective of continuity of care. Its scope encompasses identifying the various processes and process objects involved, taking into consideration resource management aspects, responsibilities of health care providers, and means for patients' participation. While the process description and concept system model is meant as a tool for the development of information systems, it may also be used for enterprise analysis and form the basis for organizational decisions and more widely organizational developments that are not inherently tied to the use of ICT.
The Singularity and the Methuselarity: Similarities and Differences
Authors: Grey Aubrey D.N.J. de
Published: February 2025

Aging, being a composite of innumerable types of molecular and cellular decay, will be defeated incrementally. I have for some time predicted that this succession of advances will feature a threshold, which I here christen the “Methuselarity,” following which there will actually be a progressive decline in the rate of improvement in our anti-aging technology that is required to prevent a rise in our risk of death from age-related causes as we become chronologically older. Various commentators have observed the similarity of this prediction to that made by Good, Vinge, Kurzweil and others concerning technology in general (and, in particular, computer technology), which they have termed the “singularity.” In this essay I compare and contrast these two concepts.
RAGE Control: Regulate And Gain Emotional Control
Authors: Kahn Jason  , Ducharme Peter  , Travers Brian  , Gonzalez-Heydrich Joseph
Published: February 2025

Advances in neurobiology and computer science make possible interventions designed to strengthen basic processes behind emotional control. We present one such computer-based intervention, RAGE Control (Regulate And Gain Emotional Control). This extends the usual paradigm of biofeedback by requiring relaxation in the midst of engaging executive processes in a quick reaction task. RAGE Control teaches children to simultaneously focus, react, inhibit impulses, and keep their heart rate down in the context of a traditional space battle game. The program is grounded in the theory of Cognitive Behavioral Therapy and is currently in clinical use by psychotherapists at Children's Hospital in Boston. It aims to reduce the need for psychotropic medication to help children gain emotional control. Clinical trials to test the promise of this technology are warranted.
Changes in quadratic phase coupling of EEG signals during wake and sleep in two chronic insomnia patients, before and after cognitive behavioral therapy
Authors: Perrig Stephen  , Dutoit Pierre  , Espa-Cervena Katerina  , Shaposhnyk Vladislav  , Pelletier Laurent  , Berger François  , Villa Alessandro E.P.
Published: February 2025

Quantitative EEG studies of primary insomnia (PI) suggest that increased high frequency and reduction in slow frequency EEG activity could be associated with cortical “hyperarousal” and sleep homeostasis dysregulation. This preliminary study is the first to apply higher order EEG analysis in chronic PI patients. We analyzed phase coupling in two patients against two control subjects. We defined an index of resonant frequency (IRF) and show that both patients were characterized by high IRF values that suggest an increase in local cortical information processing before treatment. We show that cognitive behavioral therapy for insomnia (CBT-T) is able to reverse EEG phase coupling towards control values in as little as eight sessions. After treatment the patients were characterized by lower index values, thus suggesting recovery of information processing over wide-spread cortical areas.
Link Analysis of Fuel Laundering Scams and Implications of Results for Scheme Understanding and Prosecutor Strategy
Authors: Jedrzejek Czeslaw  , Falkowski Maciej  , Smolenski Maciej
Published: February 2025

Fuel laundering scam is prevalent in many countries. Typically, a case may concern 100 companies, several hundred people, and up to 100 thousand money transfers/invoices. Analysis of this amount of data is difficult even if it is stored in a database. To gain insight on the mechanism of the case we use in this work the extension of previously proposed ontology model, called the minimal model. The conceptual minimal model consists of eight layers of concepts, that are structured in order to use available data on facts to uncover relations. FuelFlowVis is an intelligent tool that supports continuous visual analytic process by exploiting the following features: navigation between global and local views, filters allowing displaying transactions by value, time, and type of goods. A user can inspect selected flows which give insight into crime patterns. We used the tool for 3 large Polish fuel laundering cases form the 2001–2003 period. For none of the cases we have complete data. We find that the methods to hide the proceeds of crime are very similar between the cases. The evidence as presented by prosecutors is of varied quality, and depends on the size of the crime group. In all the cases prosecutor's had an enormous problem to uncover money flows from the source of money (profit centre) to sinks (where the money leaves companies and goes as cash to organizers of the scheme). This occurs because the use of traditional analytic tools (spreadsheets or non-semantic visualization tools) cannot provide information about chains of transactions – a separate binary relations view does not provide complete insight to the case. Prospects on future reasoning capabilities of the tool will be presented.
Analysis of Urban Areas Combining High-Resolution Optical and SAR Imagery
Authors: Wegner Jan Dirk  , Auer Stefan  , Thiele Antje  , Soergel Uwe
Published: February 2025

Modern space borne SAR sensors provide geometric resolution of one meter. Airborne systems acquire imagery with even higher resolution. In data of this kind many features of urban objects become visible, which were beyond the scope of radar remote sensing only a few years ago. However, layover and occlusion issues inevitably arise in undulated terrain and urban areas because of the side-looking SAR sensor principle. In order to support interpretation, SAR data can be analyzed using additional complementary information provided by optical data. The focus of this paper is on building extraction in urban scenes by means of combined SAR data and optical aerial imagery.
A Comparative Study of Satellite and Ground-Based Vineyard Phenology
Authors: Cunha Mário  , Marçal André R.S.  , Rodrigues Arlete
Published: February 2025

Grapevine phenology observations are essential for ecological adaptability of grape varieties, crop management and crop modelling. Phenological events have traditionally been ground based, with observations mainly providing information concerning grape varieties over a limited spatial area and few inseason observations. Time-series of satellite imagery can rapidly provide a synoptic and objective view of grape vegetation dynamics that may be used for vineyard management. Ten-day VEGETATION image composites from 1999 to 2007 were used to examine temporal profile in the Normalized Difference Vegetation Index (NDVI) and their relationship with ground based observation of grapevine phenology. In Portugal is Douro wine region, 2 suitable tests sites with over 70% or more of their area occupied by grapevines were selected. A number of NDVI metrics were obtained for each year through logistic model adjusted to NDVI time series after noise reduction using a Savitzky-Golay filter. The comparison of ground-based vineyard phenology and satellite-derived flowering, show an average spread deviation of 3 days. The satellite derived full canopy date was significantly correlated to the veraison date (r=0.87; n=7; p<0.02). The data set provided by the VEGETATION sensor proved to be a valuable tool for vineyard monitoring, mainly for inter-annual comparisons on regional scale.
The lessons of New Orleans
Authors: Vrijling J.K.
Published: February 2025

End of August 2005 the flood defences of New Orleans were hit by hurricane Katrina. It quickly became apparent that they could not withstand this force of nature. The three bowls of the city were flooded. Over a thousand people lost their lives and the total damage exceeded $20 billion US. What can we learn from this disaster? Can the process of understanding be supported by mathematics? Is it possible to draw conclusions with the help of mathematics that can help to avoid a repeat of this tragedy?
Electronic health records
Authors: Stead William W.
Published: February 2025

A radical change in technical approach is needed to achieve electronic health records suitable to support an engineered system of healthcare. This chapter suggests a redefinition of interoperable health information. It provides examples of how to break the electronic health record challenge into component parts to match computational technique to the scale of the problem handled by a component.
Transforming healthcare through patient empowerment
Authors: Lenert Leslie
Published: February 2025

The United States faces tremendous challenges with its healthcare system. By any standard, it is expensive and performs poorly in most measures of health and thus, is in great need of reform. But how do we reform things without making the situation worse? Some of the more fundamental problems arise from the combination of a fee-for-service payment system for physicians with insurance-based financing care. This combination results in conflicts among the interests of patients, physicians and payers. This paper examines this issue from a decision analytic perspective, starting with a definition of the patient-centered view, and an assessment of the practicality of controlling costs by making healthcare more patient-centric. It then illustrates how fee-for-service models corrupt decision-making and other solutions designed to reign in the abuses of the fee-for-service model and also negatively impacts the quality of decision making for individual patients. Whatever the strategies for health reform, the degree of patient-centeredness of care is a benchmark that allows policy makers to understand how far they have had to deviate from optimal to achieve the desired ends of cost control.
Aging: Adding complexity, requiring skills
Authors: Cassel Christine K.  , Johnston-Fleece Michelle  , Reddy Siddharta
Published: February 2025

The role of systems in addressing the needs of elderly and chronically ill populations remains a far from universal way of thinking, much less practice, in health care. Re-engineering the current fragmented system to align providers, patients and payment models to facilitate proactive management of conditions associated with advanced age and/or one or more chronic diseases – rather than responding to costly consequences of a health care system optimized for acute care conditions – will be a major challenge for all stakeholders. There are, however, promising success stories that are taking place in the United States today that may provide a model for improvement. The authors define the issues faced by the health care providers and payers that arise when providing care for the elderly and those with chronic conditions – issues that threaten to overwhelm the financial and human health care resources that exist to serve these populations. They define innovative ways of thinking about systems of care, and provide examples of unique systems that have applied theory into practice. These successful leaders may offer lessons in proactively managing complex health conditions, overcoming communication barriers and using technology to complement the necessary human touch that is essential to health care delivery.
SOA4All: Towards a Global Service Delivery Platform
Authors: Krummenacher Reto  , Domingue John  , Pedrinaci Carlos  , Simperl Elena
Published: February 2025

Establishing Web services as resources on the Web opens up productive, but challenging new possibilities for open, highly dynamic and loosely-coupled service economies. In addition, lifting services to the semantic level provides a sophisticated means for automating the main service-related management processes and the composition of arbitrary functionalities into new services and businesses. In this article we present the SOA4All approach to a global service delivery platform. By means of semantic technologies, SOA4All facilitates the creation of service infrastructures and increases the interoperability between large numbers of distributed and heterogeneous functionalities on the Web.
Scalable Video Coding: Source for Future Media Internet
Authors: Ramzan Naeem  , Zgaljic Toni  , Izquierdo Ebroul
Published: February 2025

A flexible wavelet-based scalable video coding framework (W-SVC) is proposed to support future media internet, specifically content delivery to different display terminals through heterogeneous networks as the Future Internet. Scalable video bit-stream can easily be adapted to required spatio-temporal resolution and quality, according to the transmission and user context requirements. This enables content adaptation and interoperability in Internet networking environment. Adaptation of the bit-stream is performed in the compressed domain, by discarding the bit-stream portions that represent higher spatio-temporal resolution and/or quality than the desired. Thus, the adaptation is of very low complexity. Furthermore, the embedded structure of a scalable bit-stream provides a natural solution for protection of the video against transmission errors inherent to content transmission over Internet. The practical capabilities of the W-SVC are demonstrated by using the error resilient transmission and surveillance applications. The experimental result shows that the W-SVC framework provides effusive flexible architecture with respect to different application in future media internet.
Towards Security Climate Forecasts
Authors: Neuhaus Stephan  , Massacci Fabio
Published: February 2025

The complexity and interdependencies of deployed software systems has grown to the point where we can no longer make confident predictions about the security properties of those systems from first principles alone. Also, it is very complex to state correctly all relevant assumptions that underlie proofs of security, so that attackers constantly seek to undermine these assumptions. Complexity metrics generally do not correlate with vulnerabilities and security best practices are usually founded on anecdotes rather than empirical data. In this paper, we argue that we will therefore need to embrace empirical methods from other sciences that also face this problem, such as physics, meteorology, or medicine. Building on previous promising work, we suggest a system that can deliver security forecasts just like climate forecasts.
Increasing Airline Operational Robustness: Development of a Monitoring and Forecast Tool to Reduce Network Disruption
Authors: Wesseling Han  , van Blokland Wouter Beelaerts
Published: February 2025

This paper presents the result of a 6 month research project conducted at the Maintenance Control Center of KLM (Royal Dutch Airlines) Engineering & Maintenance (E&M). The research focuses on the development of a monitoring/forecast tool to anticipate days with a high risk of network disruption. A theoretical framework is formulated based on the combination of Lean and the effectiveness-efficiency trade-off. A model is developed to evaluate operational robustness: the ability of the airline operation to absorb disruptive events and ensure a punctual operation. For each of the parameters of the model an analysis is performed to determine its relation with operational robustness. Flexibility is shown to be a key determinant. The parameters are integrated into a monitoring/forecast tool with a 2 week time horizon. Through a monitoring phase the tool is shown to successfully forecast days with high and low risk. The monitoring phase points out that further calibration of the critical values of the tool is required. Based on the output of the tool and the findings of the analyses, ways to increase operational robustness are suggested.
Virtual Reality in the Treatment of Generalized Anxiety Disorders
Authors: Gorini Alessandra  , Pallavicini Federica  , Algeri Davide  , Repetto Claudia  , Gaggioli Andrea  , Riva Giuseppe
Published: February 2025

Generalized anxiety disorder (GAD) is a common anxiety disorder characterized by 6 months of “excessive anxiety and worry” about a variety of events and situations. Anxiety and worry are often accompanied by additional symptoms like restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension and disturbed sleep. GAD is usually treated with medications and/or psychotherapy. In particular, the two most promising treatments seem to be cognitive therapy and applied relaxation. In this study we integrated these approaches through the use of a biofeedback enhanced virtual reality (VR) system used both for relaxation and controlled exposure. Moreover, this experience is strengthened by the use of a mobile phone that allows patients to perform the virtual experience even in an outpatient setting. This paper describe the results of a controlled trial (NCT00602212) involving 20 GAD patients randomly assigned to the following groups: (1) the VR and Mobile group (VRMB) including biofeedback; (2) the VR and Mobile group (VRM) without biofeedback; (3) the waiting list (WL) group. The clinical data underlined that (a) VR can be used also in the treatment of GAD; (b) in a VR treatment, patients take advantage of a mobile device that delivers in an outpatient setting guided experiences, similar to the one experienced in VR.
Secondary Use of Clinical Data
Authors: Elkin Peter L.  , Trusko Brett E.  , Koppel Ross  , Speroff Ted  , Mohrer Daniel  , Sakji Saoussen  , Gurewitz Inna  , Tuttle Mark  , Brown Steven H.
Published: February 2025

Clinicians involved in clinical care generate daily volumes of important data. This data is important for continuity of care, referrals to specialists and back to the patient's medical home. The same data can be used to generate alerts to improve the practice and to generate care activities to ensure that all appropriate care services are provided for the patient given their known medical histories using electronic quality (eQuality) monitoring. For many years we have used patient records as a data source for human abstraction of clinical research data. With the advent of electronic health record (EHR) data we can now make use of computable EHR data that can perform retrospective research studies more rapidly and lower the activation energy necessary to ask the next important question using electronic studies (eStudies). Barriers to these eStudies include: the lack of interoperable data between and among practices, the lack of computable definitions of measures, the lack of training of health professionals to use Ontology based Informatics tools that allow the execution of this type of logic, common methods need to be developed to distribute computable best practice rules to ensure rapid dissemination of evidence, better translating research into practice.
Analysis Model for Personal eHealth Solutions and Services
Authors: Mykkänen Juha  , Tuomainen Mika  , Luukkonen Irmeli  , Itälä Timo
Published: February 2025

In this paper, we present a framework for analysing and assessing various features of personal wellbeing information management services and solutions such as personal health records and citizen-oriented eHealth services. The model is based on general functional and interoperability standards for personal health management applications and generic frameworks for different aspects of analysis. It has been developed and used in the MyWellbeing project in Finland to provide baseline for the research, development and comparison of many different personal wellbeing and health management solutions and to support the development of unified “Coper” concept for citizen empowerment.
Risk Assessment of Integrated Electronic Health Records
Authors: Bjornsson Bjarni Thor  , Sigurdardottir Gudlaug  , Stefansson Stefan Orri
Published: February 2025

The paper describes the security concerns related to Electronic Health Records (EHR) both in registration of data and integration of systems. A description of the current state of EHR systems in Iceland is provided, along with the Ministry of Health's future vision and plans. New legislation provides the opportunity for increased integration of EHRs and further collaboration between institutions. Integration of systems, along with greater availability and access to EHR data, requires increased security awareness since additional risks are introduced. The paper describes the core principles of information security as it applies to EHR systems and data. The concepts of confidentiality, integrity, availability, accountability and traceability are introduced and described. The paper discusses the legal requirements and importance of performing risk assessment for EHR data. Risk assessment methodology according to the ISO/IEC 27001 information security standard is described with examples on how it is applied to EHR systems.
Meeting EHR Security Requirements: SeAAS Approach
Authors: Katt Basel  , Trojer Thomas  , Breu Ruth  , Schabetsberger Thomas  , Wozak Florian
Published: February 2025

In the last few years, Electronic Health Record (EHR) systems have received a great attention in the literature, as well as in the industry. They are expected to lead to health care savings, increase health care quality and reduce medical errors. This interest has been accompanied by the development of different standards and frameworks to meet EHR challenges. One of the most important initiatives that was developed to solve problems of EHR is IHE (Integrating the Healthcare Enterprise), which adapts the distributed approach to store and manage healthcare data. IHE aims at standardizing the way healthcare systems exchange information in distributed environments. For this purpose it defines several so called Integration Profiles that specify the interactions and the interfaces (Transactions) between various healthcare systems (Actors) or entities. Security was considered also in few profiles that tackled the main security requirements, mainly authentication and audit trails. The security profiles of IHE currently suffer two drawbacks. First, they apply end point security methodology, which has been proven recently to be insufficient and cumbersome in distributed and heterogeneous environment. Second, the current security profiles for more complex security requirements are oversimplified, vague and do not consider architectural design. This recently changed to some extend e.g., with the introduction of newly published white papers regarding privacy [5] and access control [9]. In order to solve the first problem we utilize results of previous studies conducted in the area of security-aware IHE-based systems and the state-of-the-art Security-as-a-Service approach as a convenient methodology to group domain-wide security needs and overcome the end point security shortcomings.
Improvement of Cross-Sector Communication in the Integrated Health Environment
Authors: Demski Hans  , Hildebrand Claudia  , Brass Anton  , Jedamzik Siegfried  , Engelbrecht Rolf
Published: February 2025

Patient care is a complex process with different providers located in various institutions co-operating within an integrated health environment. In spite of technical improvements in medical care, patient information is usually exchanged by paper. Digital and timely communication between regional care providers can improve the exchange of information. Different systems and missing data standards are challenges that have to be met. ByMedConnect, a project sponsored by the Bavarian State Ministry of the Environment and Public Health, develops and demonstrates a communication solution based on the EN 13606 standard. In a first step the dataset, which will be exchanged by the care providers, is defined. ByMedConnect develops the dataset in cooperation with practicing clinicians and converts it via modeling tools into archetypes that provide the base for reliable cross-sector communication. Existing heterogeneous systems are integrated via a dedicated module that transforms legacy data into a normalized representation. Information provided in a standardized form thereby enables semantic interoperability between different systems and allows medical add-on applications to connect. A secure digital communication network guarantees easy and direct data sharing. ByMedConnect aims to evaluate the achieved theoretical preliminary work in practice and to draft approaches, which can be applied beyond the pilot application.
An Improved Method of Measurement of ECG Parameters for Online Medical Diagnosis
Authors: Singh H.R  , Sharma Rahul  , Sahgal Nitin  , Sethi Poonam  , Kushwah Rahul  , Kachhawa Pranav
Published: February 2025

The accuracy in the online measurement of ECG parameters has a decisive role in the better diagnosis and effective treatment of the diseases. The present paper describes a Lab-VIEW based programming using Pan Tompkins method to extract out QRS complex whereas QT interval measurements were carried out using Mat-lab based math-script module. Hilbert transform has been applied on the ECG signal to convert it into an analytical signal for better peak detection. Peak detection and other parameters like RR interval, HR and several time domain measures of heart rate variability such as RR mean and standard deviations, HR mean and standard deviations, RMSSSD, NN50 count, pNN50 etc were calculated for several other clinical applications apart from online disease diagnosis.
Evaluation of Response Time Delay of a Pen-Tablet System in Thin-Client Computing Environments: Implications for Usability
Authors: Teramoto Kei  , Kuwata Shigeki  , Kushniruk Andre W.  , Borycki Elizabeth M.  , Nomura Maki  , Kondoh Hiroshi
Published: February 2025

Changeover from the traditional paper-based patient records to the computerized patient records has been spreading rapidly in medical facilities. Since ordinary input devices such as a keyboard and mouse are often thought insufficient for the needs of medical workers using electronic patient records (EPR) compared with traditional pens and paper-based patient records, a pen-tablet system (PTS) as a digital pen interface tends to be used instead. On the other hand, with the growing adoption of thin-client computing (TCC) in medical facilities, the usability of PTS with TCC has come to be a concern because of possible reduction of the usability due to delays of response time occurring in TCC environments. To analyze the factors that influence the usability of PTS with TCC, the authors focused on the relationship between length and its scattering of the response time delay. The results indicated that the delay scattering could be a more influencing factor than the delay length itself and that values of the scattering should be within approximately 35 milliseconds for the best usability. This study would provide useful indicators for evaluating the usability of PTS in incorporating it into the EPR system with TCC environments.
From Clinical Practice Guidelines, to Clinical Guidance in Practice – Implications for Design of Computerized Guidance
Authors: Lyng Karen Marie
Published: February 2025

This paper presents a case study of clinical guidance within oncology clinics. Close to all patients treated within the observed clinics were treated according to a research or standard treatment protocol. The protocol artifacts were however rarely applied in clinical practice instead we found an extensive application of what we have named second order guiding artifacts. The deployed protocols underwent a local adaptation and transformation process when initiated. The protocols were adapted to match the local resources and transformed into several activity specific second order guiding artifacts. The transformation from protocols was executed according to a standard operating procedure. Each activity type had a standardized template ensuring uniformity across second order guiding artifacts within a clinic. The guiding artifacts were multi-functional and a wide variety of standardized graphical attributes were applied to support effortless appliance. The implications for computerization of clinical practice guidelines are discussed.
Designing Shared Electronic Records for Chronic Care
Authors: Bansler Jørgen P.  , Havn Erling C.  , Mønsted Troels
Published: February 2025

This paper reports preliminary findings from an ongoing research project on the development of IT support for communication and information sharing across institutional and professional boundaries within the Danish healthcare system. The project focuses on the treatment of patients with implanted ICDs (implantable cardioverter-defibrillator). These are chronic patients who usually see several different healthcare providers on a regular basis. The main findings so far are: (1) Most of the data produced and recorded as part of the care process are context-specific and often difficult to interpret unless you are an expert on the subject. Sharing these types of data across institutional and professional boundaries is not feasible. (2) Yet, it appears that a small subset of data can make sense across the different contexts and be of use to others. These data are good candidates for sharing. (3) In addition, there appears to be a need for creating new types of data specifically designed to meet the coordination needs across different contexts and expert domains. (4) The dilemma is, however, that the production of these new types of data must not require too much extra work.