bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a Data Fusion System using Color Information for Real-time Intraoperative Liver Surface Measurement
Authors: Uematsu Miyuki  , Suzuki Naoki  , Hattori Aasaki  , Otake Yoshito  , Hayashibe Mitsuhiro  , Suzuki Shigeyuki  , Uchiyama Akihiko
Published: February 2025

The goal of our study is to develop a data fusion system, which enables surgeons to easily visualize the inner structures of elastic organs during open surgery. We chose the liver as the focus of this study due to its easily deformable nature and complex vascular structures. To do so, we propose using preoperative data and supplementary intraoperative data We captured a sequence of liver surface data for the intraoperative data by using trinocular stereo and we applied them to the preoperative 3D model's surface. Then, we modified the model to fit the intraoperative liver condition and portrayed the model's inner structures. With this method, we could establish this system.
Modelling Human Burn Injuries in a Three-Dimensional Virtual Environment
Authors: Dirnberger J.  , Giretzlehner M.  , Ruhmer M.  , Haller H.  , Rodemund C.
Published: February 2025

This paper gives a work-in-progress report on our research project BurnCase, a virtual environment for modelling human burn injuries. The goal of the project is to simplify and improve the diagnosis and medical treatment of burns. Due to the lack of electronic and computational support for current diagnosis methods, enormous variations regarding the approximated size of burned skin regions exist. And although Simplifications like the Rule-Of-Nines-Method ([Weidringer, 2002]), Lund and Browder ([LundBrowder, 1944]) and others try to compensate for these errors, the fact remains that different physicians overestimate the BSA (Body Surface Area) by 20% up to 50%, depending on the different experience and subjectivity of the approximation process. Nevertheless, different supporting mechanisms have been developed to assist the process of burn region transfer so that after transferring all burned regions on the virtual human body, calculations can be applied in order to evaluate standard indices like the ABSI (Abbreviated Burn Severity Index), and Baux ([Baux, 1989]) as well as ICD10 (International Classification of Diseases) diagnosis encoding. The virtual body simulation is based on state-of-the-art 3D computer graphics (OpenGL).
Novel Algorithms for Polarization Imaging Resulting in Improved Quantification of Retinal Blood Vessels
Authors: Elsner Ann E.  , Miura Masahiro  , Stewart Jason B.  , Kairala Mariane B.M.  , Burns Stephen A.
Published: February 2025

Novel algorithms of polarization imaging data produce views not visible in the images resulting from the instrumentations. These computed images are rapidly produced, and reveal clinically relevant features. A virtual reality implementation that allows a selection of such views during diagnostic procedures or treatment might improve patient management.
3D Visualization Methods to Guide Surgery for Parkinson’s Disease
Authors: Gibson Vince  , Peifer John  , Gandy Maribeth  , Robertson Scott  , Mewes Klaus
Published: February 2025

In this paper we present 2D and 3D visualization techniques that are part of our ongoing effort to improve the accuracy of neurosurgical procedures such as ‘Pallidotomy’ and ‘Deep Brain Stimulation’ (DBS), which are performed to alleviate the symptoms of Parkinson's disease. The precise targeting and mapping of structures in the Basal Ganglia particularly the internal Globus Pallidus (GPi) using a combination of stereotactic frame- registered Magnetic Resonance Imaging (MRI) and intraoperative microelectrode recording (IMR) is key to the success of these procedures. We have designed a set of software components, including a knowledge- based system (KBS), a digital signal processing module and a 2D/3D imaging system with automated mapping paradigm, which will work in combination to improve upon the standards currently in use. The imaging system will be the focus of this publication.
Realistic Virtual Endoscopy of the Ventricle System and Haptic-Based Surgical Simulator of Hydrocefalus Treatment
Authors: Goncharenko I.  , Emoto H.  , Matsumoto S.  , Mishima H.  , Tanaka S.  , Kanou Y.  , Fujii T.  , Sugou N.  , Mito T.  , Shibata I.
Published: February 2025

New methods and software tools for automatic extraction of the ventricle system from magnetic resonance imagery (MRI) data, ventricle part classification, and realistic texturing are proposed to support Virtual Endoscopy (VE). Volume- and surface-based medical atlases are intensively used as templates in the methods. The processed ventricle-related surfaces are then utilized in a haptic-based system, which provides a surgeon with several basic functions simulating “virtual treatment” of hydrocephalus.
Communication of Informatiom in the Homecare context
Authors: Bricon-Souf N.  , Dufresne E.  , Beuscart-Zephir M C  , Beuscart R.
Published: February 2025

Organizing the Homecare with new information technologies is nowadays an important challenge. Indeed, some medical evolutions as the improvement of the duration of life, the number of chronic diseases and some social evolutions, such as the quality of patient life, or economic evolutions, such as the reduction of hospitalisation costs, could benefit from homecare. In this paper, we present the problem of the communication of information in the homecare context. Some main phases have been described that compose the two homecare processes: a logistic process and a care process. The communication of information during homecare depends on the concerned phases: first, some exchanges of information from existing Information System to the Homecare Information System; then, some exchanges between the homecare system and the mobile health care actors; and then, some mails during the outcome phase. Coordination architecture is briefly described, and two different implementations for the communication of information during homecare are presented: one is using XML messages to exchange information between Information Systems; the other is using mobile tools for communicating with mobile actors.
Pervasive Self-Care Solutions in Telecardiology. Typical use cases from the EPI-MEDICS project
Authors: Gouaux Flore  , Chautemps Lucas Simon  , Fayn Jocelyne  , Adami Stefano  , Arzi Mohammad  , Assanelli Deodato  , Forlini Marie-Claire  , Malossi Cesare  , Martinez Antonio  , Ohlsson Mattias  , Placide Joël  , Ziliani Gian-Luca  , Rubel Paul
Published: February 2025

In western countries, heart disease is the main cause of premature death. Most of cardiac deaths occur out of hospital. Because of a continuously growing elderly population, the number of heart attacks is steadily increasing. Symptoms are often interpreted incorrectly. Victims do not survive long enough to benefit from inhospital treatments. To reduce the time before treatment, the only useful diagnostic tool to assess the presence of a cardiac event is the electrocardiogram (ECG). Event and transtelephonic ECG recorders are used to improve decision-making but require setting up new infrastructures. The pervasive solution proposed by the European EPI-MEDICS project is an intelligent Personal ECG Monitor for the early detection of cardiac events. It includes part of the patient electronic health record (EHR), embeds a web server and decision-making techniques, generates different alarm levels and forwards alarm messages to the relevant care providers by means of new generation wireless communication. It is cost saving, involving care providers only if necessary, without requiring to set-up specific infrastructures. Healthcare becomes personalized, wearable and ubiquitous.
Programming Secure Mobile Agents in Healthcare Environments using Role-based Permissions
Authors: Georgiadis C.K.  , Baltatzis J.  , Pangalos G.I.
Published: February 2025

The healthcare environment consists of vast amounts of dynamic and unstructured information, distributed over a large number of information systems. Mobile agent technology is having an ever-growing impact on the delivery of medical information. It supports acquiring and manipulating information distributed in a large number of information systems. Moreover is suitable for the computer untrained medical stuff. But the introduction of mobile agents generates advanced threads to the sensitive healthcare information, unless the proper countermeasures are taken. By applying the role-based approach to the authorization problem, we ease the sharing of information between hospital information systems and we reduce the administering part. The different initiative of the agent’s migration method, results in different methods of assigning roles to the agent.
Automatic Coregistration, Segmentation and Classification for Multimodal Cytopathology
Authors: Würflinger Thomas  , Stockhausen Jens  , Meyer-Ebrecht Dietrich  , Böcking Alfred
Published: February 2025

The paper describes the key component of the Multimodal Cell Analysis approach, a novel cytologic evaluation method for early cancer detection. The approach is based on a repeated staining of a cell smear. The correlation of features and data extracted from different stainings, and related to relocated individual cells, will yield a dramatic increase of diagnostic reliability.
Interoperability and Medical Communication Using “Patient Envelope”-Based Secure Messaging
Authors: Cordonnier Emmanuel  , Croci Stéphane  , Laurent Jean-Francois  , Gibaud Bernard
Published: February 2025

The process of transmitting patient medical information between djerent healthcare parties involves harmonizing multiple elements: addresses, certificates, patient IDs, communication protocol, message format, and documents/EPR to be exchanged Beyond the work done at the “information structure level” within CEN TC251, ISO TC21S, HL7 and DICOM, it is necessary to focus on the “basic medical communication level.” An original approach, based on the “Patient Envelope”, has been developed and successfully implemented for Oncology. The operator of the National “Réseau Santé Social” is now proposing a new “secure messaging” service supporting the “Envelope”-based communication. The authors are actively involved in standardization organizations' works, including EDI Santé, DICOM, IETF, and ISO TC 215. The current “envelope” format is compatible with all the e-mail clients. It will evolve to be based on the ebXML envelope, extended with a “medical header” containing HL7/EHRCOM Data Types and C-METS/GPICs. This document describes the results from a 3-year experience, as well as the different steps included in the project.
The new Navigation in EHRs: Enabling Teamwork of Professionals and Patients
Authors: Ückert F  , Görz M  , Ataian M  , Teßmann S  , Prokosch Hu
Published: February 2025

After development of a state of the art electronic health record, which is accessible via the internet and belongs to a patient, who can manage access to it, the methods of introducing it into routine use in the environment of children’s oncology is the theme of this paper. The new navigation in an EHR intends a shared use for the patient, relatives, and different HCPs.
The PropeR way to support medical doctors in daily practice. Developing the Protocol Based DSS
Authors: van Oosterhout E.M.W.  , Talmon J.L.  , De Clercq P.A.  , Schouten H.C.  , Jansen M.P.F.  , Hasman A.
Published: February 2025

This paper describes the first phase of the development of a Protocol based Decision Support System (PDSS) that will be linked to an Electronic Patient Record system (EPR system). The protocol system will be pro-active: the physician will be automatically prompted from the EPR of a particular patient if the protocol that applies for that patient defines it necessary. The PropeR project studies the impact of a PDSS that is linked to an EPR on daily care processes. There are two areas of research: hospital and home care. This paper describes the application in the hospital. The protocol that is being computerized is a treatment protocol for Acute Myelogenous Leukaemia (AML) that also studies treatment alternatives (conventional versus experimental treatment). This paper based AML protocol has been translated into a formal representation. The KA-tool Gaston is used to make this representation. Twenty-eight subprotocols have been organized in a hierarchical structure with three levels. One of the aims of the project is to make a representation of the AML protocol that can be used in other organizations as well. The main problem we encountered is that the representation not only contains the content of the protocol, but also aspects of application of that protocol in daily care of the hospital and aspects of support. The solution to this problem is the creation of two layers of representation: the first layer is an exact copy of the protocol and thus sharable and the second layer focuses on the support of the protocol in the daily working processes and is mainly domain specific: for the University Hospital Maastricht. At the moment, this division into two layers is being discussed
Evaluation of WordNet as a source of lay knowledge for molecular biology and genetic diseases: A feasibility study
Authors: Bodenreider Olivier  , Burgun Anita  , Mitchell Joyce A.
Published: February 2025

Objectives: While several sources of biomedical knowledge are available, these resources are often highly specialized and usually not suitable for a lay audience. This paper evaluates whether concepts needed for molecular biology and genetic diseases are present in WordNet, the electronic lexical database. Methods: Terms for four broad categories of concepts (phenotype, molecular function, biological process, and cellular component) were extracted from LocusLink and mapped to WordNet. All terms from the Gene Ontology database (gene products and ontology concepts) were also mapped to WordNet in order to evaluate its global coverage of the domain. Additionally, we tested two methods for improving the mapping of genetic disease names to WordNet. Results: The coverage of concepts ranged from 0% (gene product symbols) to 2.8% (cellular components). Removing specialization markers from the terms and using synonyms significantly increased the rate of mapping of genetic disease names to WordNet. Conclusions: Many of the most common single gene disorders are present in WordNet, as well as many high-level concepts in Gene Ontology. Therefore, WordNet is likely to be a useful source of lay knowledge in the framework of a consumer health information system on genetic diseases.
Matching controlled vocabulary words
Authors: Grabar Natalia  , Zweigenbaum Pierre  , Soualmia Lina  , Darmoni Stéfan
Published: February 2025

This study examines an enabling condition for natural language access to medical knowledge resources (Medline, CISMeF) indexed with controlled vocabularies (e.g., the MeSH): is the vocabulary of user queries comparable with that of the index terms? The two vocabularies were compared in their original form, then under incrementally normalized forms, using character-based normalizations then linguistic normalizations. Only 16.7% of the user vocabulary, in its original form, is in the MeSH. Progressive normalizations increase this proportion to 65.5%. Besides, if the frequencies of occurrence of words are taken into account, 89.3 % of user word occurrences can be matched to MeSH words. This shows the interest of taking into account further matching methods between queries and index terms than those presented here.
Getting Evidence to Prescribers and Patients or How to Make EBM a Reality
Authors: Boissel Jean-Pierre  , Cucherat Michel  , Amsallem Emmanuel  , Nony Patrice  , Fardeheb Malik  , Manzi Wilmondes  , Haugh Margaret C
Published: February 2025

Bringing all available evidence on therapy efficacy to users is a necessary step in the evidence-based medicine paradigm. Today, the needs of physicians in medical information, including therapeutic information, are not met. Further, the information reaching the doctors is rarely consistent with the available evidence. The growth rate of emerging evidence and its increasing complexity make the doctors unable to cope with it within the current medical information system. So, there is a real need to sort out a new way for transferring therapeutic information to doctors and patients. We conceived a new paradigm and designed an Internet process based on it by which unbiased evidence is brought to doctors in such a format that it can be accessed and used during the visit.
Watching symptoms and illnesses through the eyes of Multiple Correspondence Analysis: a case study in Toxicology
Authors: Rialle Vincent  , Danel Vincent
Published: February 2025

The goal of the reported research was the design of a computerized tool aimed at aiding an emergency specialist, in a toxicological emergency unit, to quickly identj, at the admission time, the various poisons ingested by a comatose patient. This medical decision making problem has been proved to be computationally intractable since a lot of patient cases sharing the same clinical table have different diagnoses in terms of psychotropes combinations. The paper explores the idea that the outcome of Multiple Correspondence Analysis (MCA), a mathematical data analysis method, can be thought of as visual and analytical aids for the physician facing this decision problem. We argue that the expert’s clinical reasoning can be enhanced by the factorial maps and some computerized results provided by MCA. Using a learning database of 505 diagnosed cases, we realized a whole decision aiding system called TOXSYMEDIA. A test-base of 97 patients was used to partially assess the system. The method and resulting tool revealed to be appreciable to early inform the physician about the possible combination of ingested psychotropes.
MedCIRCLE: Collaboration for Internet Rating, Certification, Labelling and Evaluation of Health Information on the World-Wide-Web
Authors: Mayer MA.  , Darmoni SJ.  , Fiene M.  , Köhler C.  , Roth-Berghofer Thomas R.  , Eysenbach G.
Published: February 2025

We describe MedCIRCLE, an EU-funded semantic web project to implement the first steps towards a global, collaborative rating and guidance system for health information proposed in the MedCERTAIN project. In MedCIRCLE, three European gateway sites for consumer health information will implement the metadata vocabulary HIDDEL (Health Information Disclosure, Description and Evaluation Language). HIDDEL allows portals and gateways to make the results of their evaluations accessible as XML/RDF. The three participating national portals are: AQUMED (Agency for Quality in Medicine) patienteninformation. de, COMB (Official Medical College of Barcelona) and CISMeF, a qualitycontrolled health gateway developed at Rouen University Hospital. Other health subject gateways, accreditation, or rating services are invited to join the collaboration simply by implementing HIDDEL on their gateways. Widespread implementation HIDDEL will allow intelligent agents or client-side software to harvest statements and opinions about the trustworthiness of other websites, assisting users in selecting trustworthy websites. The MedCIRCLE project builds on, expands and continues work on rating health information on the Internet piloted within the MedCERTAIN project. While MedCERTAIN provided the core technologies and software for rating and "trustmarking" health information, MedCIRCLE is built around these technologies and involves a wider medical community to assess health information, demonstrating the power of collaborative and interoperable evaluations in a semantic web environment. MedCIRCLE is a project with the overall objective to develop and promote technologies able to guide consumers to trustworthy health information on the Internet, to establish a global web of trust for networked health information, and to empower consumers to positively select high quality health information on the web. Other aims include refinement and expansion of HIDDEL, to become a standard vocabulary and interchange format for self- and third-party ratings of health information.
Web Versus Press With a High Circulation: An Italian Case Study
Authors: Mazzoleni M. Cristina  , Marello Annalisa  , Giorgi Ines  , Marchi Antonietta
Published: February 2025

The problem: the quality of health-related information available for general public on the web has been widely debated, often expressing concern, in the last few years, but also other mass media supply medical contents for health consumer. The objective: To evaluate the quality of information available by the Italian people through Internet in comparison with the one published on the press with a high circulation. A general interest topic such as over-weight and obesity has been identified as a convenient field for the comparison. Methods: A sample of web sites and articles have been collected — excluding the promotional ones- in order to compare their completeness and correctness. National guidelines were the golden standard For the web sites, the availability of indications to let the user know the reliability of the site – we will refer to these as “transparency” - has been evaluated through 9 parameters. Results: 45 informative sites and 35 articles have been found: the Italian population has a good chance of getting information. Web sites are much more complete than articles. Correctness of both is quite good Transparency of web sites leaves much to desire, independently from the quality of the content. Lesson learnt: There is probably an excessive confidence about the transparency and caution of articles in dealing with health-related topics. Conclusion: The web publishers must necessarily be educated to apply the existing good practice rules, but in the meantime also the press with a high circulation, that is read by a high percentage of people, has to improve its quality in order to co-operate in supplying adequate information. In general, from the traditional exceptionalist approach for medical information on the internet, a definition of media quality standard could be derived.
Modelisation of Consumer Health Information in a Quality-Controlled Gateway
Authors: Soualmia Lina F.  , Darmoni Stéfan J.  , Douyère Magaly  , Thirion Benoît
Published: February 2025

The amount of health data accessible on the Web is increasing and Internet has become a major source of health information. Many tools and search engines are available but medical information retrieval remains difficult for both the health professional and the patients. In this paper we describe CISMeF-patients. It is a sub part of CISMeF, a structured quality-controlled subject gateway. CISMeF-patients has been designed for the patients, their families and the general public who are often unfamiliar with the medical domain and the medical vocabulary. The resources included in CISMeF patients are described using the Dublin Core metadata format. To index them, CISMeF-patients and CISMeF share the same terminology, which ‘encapsulates’ the MeSH thesaurus with a layer of synonyms. Unlike Medline-plus and Medline, sharing the same terminology allows to a CISMeF patients end-user the possibility to extend his query to the CISMeF catalogue (e.g. for searching teaching resources or clinical guidelines).
A Dynamic Web Application within an n-tier Architecture: a Multi-Source Information System for End-Stage Renal Disease
Authors: Saäd Mohamed Ben  , Simonet Ana  , Guillon Didier  , Jacquelinet Christian  , Gaspoz Franck  , Dufour Eric  , Jais Jean Philippe  , Simonet Michel  , Landais Paul
Published: February 2025

A Multi-Source Information System (MSIS) has been designed for the Renal Epidemiology and Information Network (REIN) dedicated to End-Stage Renal Disease. Interoperability has been considered at 4 levels: semantics, network, formats and contents. An n-tier architecture has been chosen at the network level. It is made out ofa universal client, a dynamic Web server connected to a production database and to a data warehouse. The MSIS is patient-oriented, based on a regional organization. Its implementation in the context of a regional experimentation is presented with insights on the design and underlying technologies. The n-tier architecture is a robust model and flexible enough to aggregate multiple information sources and integrate modular developments. The data warehouse is dedicated to support health care decision-making.
Legal and Social Implications of Health Telematics in the EU
Authors: Dierks Christian
Published: February 2025

Health telematics involve the processing of data concerning health. The European Directive 95/46/EC constitutes a general prohibition of processing this special category of data. Exemptions to that principle are found in the data subject's consent, vital interests and professional obligation to secrecy. These exemptions, however, do not sufficiently secure legal grounds for health data protection in practice. It is for that reason, that the member states must establish a harmonised legal basis for telematics services. Multinational working groups, such as EHTEL, need respective support.
Swedish Experience in Secure Health Telematics Applications
Authors: Ribbegård Göran
Published: February 2025

In the paper, some common questions and parallel development of ICT for eGovernment and eHealth in Sweden are discussed. In that context, front office and back office are two areas of information security development. Furthermore, information will be provided on “Catch 22” getting means for eldentification and eSignature out to a large part of the population. Thereby, the catch of how to use a Government procurement of eldentification and eSignature must be solved. The paper evaluates the lessons learned and current situation in Sweden for eServices, certificates and smart cards.
Concepts and Solutions for Future-Proof Health Information Systems and Health Networks
Authors: Blobel Bernd
Published: February 2025

Based on shared care information systems' requirements for high level interoperability, a generic component architecture has been derived. For implementing, running and maintaining acceptable and useable health information systems components, all views of the ISO Reference Model - Open Distributed Processing have to be considered. Following the Model Driven Architecture (MDA) paradigm, a reference model as well as concept-representing domain models both independent of platforms must be specified, which are combined and harmonised as well as automatically transferred into the platform-specific models using appropriate tools.
HL7 – More than a Communications Standard
Authors: Hammond W. Ed
Published: February 2025

Health Level Seven (HL7) has evolved from a small, ad-hoc standards developer organisation focused on creating a standard for the interchange of data primarily in the hospital setting to an accredited American National Standard Organisation with wide-spread international participation. The scope of HL7 has expanded to include standards for the interchange of clinical data in all settings, a reference information model, data types, decision support and clinical guidelines, clinical documents and clinical templates, clinical context objects, terminology, security, XML, and the electronic health record. HL7 has become a gathering place for a number of application-oriented groups making use of the organisational freedom of HL7, the gathering of domain experts, and the use of common and sharable solutions to provide health data standards for a variety of purposes. This paper discusses the factors that lead to these diverse activities.
Cyber care NDMS: An Improved Strategy for Biodefense Using Information Technologies
Authors: Rosen Joseph M.  , Grigg Eliot  , Mc Grath Susan  , Lillibridge Scott  , Koop C. Everett
Published: February 2025

The National Disaster Medical System (NDMS) was created in the early 1980's, and it was designed to meet the threats of the time. Today the threats are much less discreet and predictable. They are distributed; they move and spread quickly; and they walk silently among us. Specifically, biological agents are an enemy unlike any we have had to deal with before. They offer unique challenges that fly in the face of current doctrine. We must redesign the NDMS in order to contain and eliminate this new threat. Tools exist today capable of effectively coordinating distributed resources - even through containment borders. We need to strengthen our public health system, create a net-centric disaster management system, and blur the boundaries between local and federal resources. Ultimately we must move from an incremental, echelon-based response to an immediate, continuons response. This can be accomplished by adding inexpensive, well-estabhshed information technologies to the existing response system.
Augmented Reality Laser Projection Device for Surgery
Authors: Glossop Neil  , Wang Zhanhe  , Wedlake Chris  , Moore John  , Peters Terry
Published: February 2025

We have developed an augmented reality system capable of projecting preoperative plans directly onto a patient using rapidly scanned laser beams. Projected contours can typically represent cut paths, tumors or delineate boundaries of interest. The system can be used as part of, or a replacement for, conventional robotic Telesurgery systems. Because the graphics are projected, there is no degradation in surgeon's view due to optical components interposed between the surgeon's eye and the patient. This system has been designed to work with a common infrared 3D camera system used in image-guided surgery, and projects both visible and infrared beams. The IR beam enables surface digitization functions to be carried out using the camera. The clinical accuracy is in the range required by CAS procedures, around 1-2mm. The device will be particularly useful for executing precise preoperative plans and for teleconsultation applications, where planned or live consultations can be efficiently communicated to a less skilled local caregiver.
Parameter Optimisation for the Behaviour of Elastic Models over Time
Authors: Mosegaard Jesper
Published: February 2025

Optimisation of parameters for elastic models is essential for comparison or finding equivalent behaviour of elastic models when parameters cannot simply be transferred or converted. This is the case with a large range of commonly used elastic models. In this paper we present a general method that will optimise parameters based on the behaviour of the elastic models over time.
Development and Human Factors Analysis of Neuronavigation vs. Augmented reality
Authors: Pandya Abhilash  , Siadat Mohammad-Reza  , Auner Greg  , Kalash Mohammad  , Ellis R. Darin
Published: February 2025

This paper is focused on the human factors analysis comparing a standard neuronavigation system with an augmented reality system. We use a passive articulated arm (Microscribe, Immersion technology) to track a calibrated end-effector mounted video camera. In real time, we superimpose the live video view with the synchronized graphical view of CT-derived segmented object(s) of interest within a phantom skull. Using the same robotic arm, we have developed a neuronavigation system able to show the end-effector of the arm on orthogonal CT scans. Both the AR and the neuronavigation systems have been shown to be within 3mm of accuracy. A human factors study was conducted in which subjects were asked to draw craniotomies and answer questions to gage their understanding of the phantom objects. The human factors study included 21 subjects and indicated that the subjects performed faster, with more accuracy and less errors using the Augmented Reality interface.
A Comparison of the CathSim$^{\trade}$ System and Simulated Limbs for Teaching Intravenous Cannulation
Authors: Scerbo Mark W.  , Bliss James P.  , Schmidt Elizabeth A.  , Thompson Sommer N.  , Cox Theresa D.  , Poland Harry J.
Published: February 2025

The present study describes a comparison between the CathSim™VR simulator and simulated limbs for training IV cannulation. Two groups of physician assistant students underwent 2 hours of training on either method. Performance was assessed before and after training with a standardized assessment form. The results showed that all students improved after training, but the degree of improvement was greater for those trained with the simulated limbs. These findings may be due to differences between the two training methods as well as the methodology adopted in the present study.
Patient Specific Dynamic Geometric Models From Sequential Volumetric Time Series Image Data
Authors: Cameron B.M.  , Robb R.A.
Published: February 2025

Generating patient specific dynamic models is complicated by the complexity of the motion intrinsic and extrinsic to the anatomic structures being modeled. Using a physics-based sequentially deforming algorithm, an anatomically accurate dynamic four-dimensional model can be created from a sequence of 3-D volumetric time series data sets [1]. While such algorithms may accurately track the cyclic non-linear motion of the heart, they generally fail to accurately track extrinsic structural and non-cyclic motion. To accurately model these motions, we have modified a physics-based deformation algorithm to use a meta-surface defining the temporal and spatial maxima of the anatomic structure as the base reference surface. A mass-spring physics-based deformable model, which can expand or shrink with the local intrinsic motion, is applied to the metasurface, deforming this base reference surface to the volumetric data at each time point. As the meta-surface encompasses the temporal maxima of the structure, any extrinsic motion is inherently encoded into the base reference surface and allows the computation of the time point surfaces to be performed in parallel. The resultant 4-D model can be interactively transformed and viewed from different angles, showing the spatial and temporal motion of the anatomic structure. Using texture maps and per-vertex coloring, additional data such as physiological and/or biomechanical variables (e.g., mapping electrical activation sequences onto contracting myocardial surfaces) can be associated with the dynamic model, producing a 5-D model. For acquisition systems that may capture only limited time series data (e.g., only images at end-diastole/end-systole or inhalation/exhalation), this algorithm can provide useful interpolated surfaces between the time points. Such models help minimize the number of time points required to usefully depict the motion of anatomic structures for quantitative assessment of regional dynamics.
Interactive Cutting Simulation with Adaptive Refinements using Digital Logic Design Analogy
Authors: Choi Kup-Sze  , Sun Hanqiu  , Heng Pheng-Ann
Published: February 2025

A major requirement for surgical simulation is to allow virtual tissue cutting. This paper presents a scalable and adaptive cutting technique based on a mass-spring mesh. By the analogy of digital logic design, an arbitrary incision is modeled systematically by translating the cutting process into a state diagram. Subdivision of mesh elements is driven by the state transitions. Node redistribution, local re-meshing and deformation are applied to refine the subdivided mesh
Towards a Flexible Integration of Clinical Guideline Systems with Medical Ontologies and Medical Information Systems
Authors: Correndo Gianluca  , Terenziani Paolo
Published: February 2025

The integration of a computer-based system dealing with clinical guidelines with a medical ontology can provide several advantages, including standardization and knowledge sharing. Furthermore, in order to operate in the clinical practice, guideline systems must also interact with the hospital databases to retrieve patients’ data. Unfortunately, currently there seems not to be any “standard” consensus model either for the medical ontology or for (the conceptual structure of) patient databases (even if several interesting proposals have been carried out). In this paper we show how we are extending the GLARE guideline manager in order to strictly interact with both a medical ontology and a patient Database, in such a way that GLARE is not committed to any specific ontology and database (i.e., different ontologies and/or databases can be used).
The SAGE Guideline Modeling: Motivation and Methodology
Authors: Tu Samson W.  , Campbell James  , Musen Mark A.
Published: February 2025

The SAGE (Standards-Based Sharable Active Guideline Environment) project is a collaboration among research groups at six institutions in the US. The ultimate goal of the project is to create an infrastructure that will allow execution of standards-based clinical practice guidelines across heterogeneous clinical information systems. This paper describes the design goals of the SAGE guideline model in the context of the technological infrastructure and guideline modeling methodology that the project is developing.
The Challenges of Imaging Based Computational Fluid Dynamics
Authors: Anayiotos Andreas  , Cheng Gary  , Ito Yasushi  , Gray Jeff  , Agarwal Ramesh
Published: February 2025

Image based Computational Fluid Dynamics (CFD) simulation of the cardiovascular system is increasingly becoming important and its application in everyday medical practice can already be envisaged. The goal of this workshop is to address all the factors involved in the development of a computational framework/software for modelling and analyses of the cardiovascular system and provide examples. The development of such framework, requires integration, management and interpretation of data from several technology areas such as a) feature detection and extraction of arterial geometry from imaging data, b) adaptive grid generation techniques for 3-D asymmetric geometries c) hemodynamic modelling, disparate length-scale model, and fluid-tissue interaction with high-performance computing, d) CFD data validation, e) feature extraction/detection and visualisation algorithms, t) graphical user interface to allow remote visualisation of post processed data. These computational tools are employed to study flow in specific problem sites in the vascular tree such as the carotid, femoral, coronary and abdominal arteries. Such studies provide understanding of the factors involved in the initialisation and evolution of arterial disease due to altered flow conditions (as a result of plaque formation) such as flow separation and reversal, and low and oscillatory wall shear stress. It is also used to study the effect of various clinical procedures such as the implantation of stents, vascular grafts, vascular prostheses and artificial valve implants on local and global hemodynamics. This workshop will address a new emerging paradigm in clinical practice known as predictive medicine for effective surgical planning and post surgical rehabilitation. The workshop will also address the difficulties in the implementation of some of the technology areas in this application with examples of carotid, femoral, and abdominal artery simulations.
Flow Patterns and Wall Shear Stresses in Patient-Specific Models of the Abdominal Aortic Aneurysm
Authors: Leung J.  , Wright A.  , Cheshire N.  , Thom S.A  , Hughes A.D  , Xu X.Y.
Published: February 2025

Abdominal Aortic Aneurysms (AAAs) are a major cause of death in Western societies. However, the factors responsible for the growth and ultimate rupture of AAA are not fully understood. Using computation fluid dynamics combined with CT images, the flow patterns and wall shear stress (WSS) in the AAA of a patient were studied. AAA geometry was obtained from images acquired during a routine CT scan, and a realistic abdominal aortic flow waveform was used as an upstream boundary condition. The computational results showed the presence of multiple flow recirculation zones and overall low WSS in the bulge of the aneurysm. This may provide some insight into the growth of thrombus in AAA.
The EAG tool: a decision support system for selection of abdominal aorta aneurysm endografts
Authors: Kunst E.E.  , Geelkerken R.H.  , Rödel S.G.J.
Published: February 2025

This article describes a decision support system (the EAG tool = Effective AAA Graftmanship) that assists the vascular surgeon in deciding whether a patient is fit for an endograft procedure and that assists the vascular surgeon in selecting the proper graft and in planning the endograft procedure. The EAG tool is the first step in the development of a learning environment for AAA procedures. As such the EAG tool is part of the VREST development project aiming to create a complete set of Virtual Reality Educational Surgical Tools [1,2,3,4]. The EAG tool has been validated by using the expert knowledge of five experienced AAA physicians: three vascular surgeons and two interventional radiologists. In over 3,000 assessments, the EAG tool showed a false-positive rate of 0,2%, or in other words: in only 1 out of 500 cases the EAG tool indicated the possible use of an endograft, whereas the combined group of experts believed that it was not possibe. The EAG tool proved to be more prudent than the group of experts in having a false-negative rate of 3,7%. The EAG tool thus proved to be useful in daily clinical practice. Further developments are ongoing to use the EAG tool in a learning environment, specifically for unexperienced physicians.
GOOD HEALTHCARE INNOVATION PRACTICE (GHIP)
Authors: Kalter Eric S.J.  , Naber Lars  , Iske Paul
Published: February 2025

In this article we describe why and how a new approach has been developed for innovation projects in the Dutch healthcare sector. There are three key aspects in the approach: Innovation should be seen as a (fair) process, the process is owned by all stakeholders (which calls for a Network approach) and, finally, the process should be knowledge-enabled, i.e. in each process step it should be clear what knowledge is needed, what knowledge becomes available and how the flow of knowledge should be managed.
MDA-based EHR Application Security Services
Authors: Blobel Bernd  , Pharow Peter
Published: February 2025

Component-oriented, distributed, virtual EHR systems have to meet enhanced security and privacy requirements. In the context of advanced architectural paradigms such as component-orientation, model-driven, and knowledge-based, standardised security services needed have to be specified and implemented in an integrated way following the same paradigm. This concerns the deployment of formal models, meta-languages, reference models such as the ISO RM-ODP, and development as well as implementation tools. International projects' results presented proceed on that streamline.
A Peculiar Aspect of Patients' Safety: The Discriminating Power of Identifiers for Record Linkage
Authors: Catherine Quantin  , Christine Binquet  , Karima Bourquard  , Ronny Pattisina  , Béatrice Gouyon-Cornet  , Cyril Ferdynus  , Jean-Bernard Gouyon  , François-André Allaert
Published: February 2025

Today, one of the main stake of the interfaced health information systems or networks is to be able to gather the different parts of the medical record of a patient without any risk to mix them with those of one other patient. This objective could appear easy to reach but only in theory because in practice many name are misspelled or erroneous and a great attention has to be paid to define what is the best identifier to link medical record. As a linkage using less informative identifiers could lead to linkage errors, it is essential to quantify the information associated to each identifier. The aim of this study was to estimate the discriminating power of different identifiers susceptible to be used in a record linkage process. This work showed the interest of three identifiers when linking data concerning a same patient using an automatic procedure based on the method proposed by Jaro; the date of birth, the first and the last names seemed to be the more appropriate identifiers. Including a poorly discriminating identifier like gender did not improve the results. Moreover, adding a second christian name, often missing, increased linkage errors. On the contrary, it seemed that using a phonetic treatment adapted to the French language could improve the results of linkage in comparison to the Soundex. However, whatever, the method used it seems necessary to improve the quality of identifier collection as it could greatly influence linkage results.
Access Control Management in Practical Settings
Authors: Louwerse Kees
Published: February 2025

Looking at the subject of access control from a practical side, focussing on the electronic health record, we discuss two special cases: the need of providing emergency access, and the possibilities of having a completely automated access control facility. We conclude that the first is essential, and suggest that the latter might not even be desirable.
Development of a Clinical Pathways Analysis System with Adaptive Bayesian Nets and Data Mining Techniques
Authors: Kopec D.  , Shagas G.  , Reinharth D.  , Tamang S.
Published: February 2025

The use and development of software in the medical field offers tremendous opportunities for making health care delivery more efficient, more effective, and less error-prone. We discuss and explore the use of clinical pathways analysis with Adaptive Bayesian Networks and Data Mining Techniques to perform such analyses. The computation of “lift” (a measure of completed pathways improvement potential) leads us to optimism regarding the potential for this approach.
Telemedicine in Trauma and Disasters – From War to Earthquake: Are we ready?
Authors: Benner T.  , Schachinger U.  , Nerlich M.
Published: February 2025

Every year many disasters cause thousands of injuries, deaths, refugees. Earthquakes and war often cause severe injuries (burns; amputations; Crush-Syndrome; gunshots; landmines; nuclear, biological or chemical warfare / hazardous material; infectious diseases; pediatric specialties). Referring to big earthquakes in the last few years up to 20.000 thousand people were killed (India 2001). 310.000 deaths were caused by war in 2001.
Home Health and Telemedicine: Where Are We Today?
Authors: Krupinski Elizabeth A.
Published: February 2025

This chapter will review the current state-of-the-art of home health services in the telemedicine environment. Special attention will be paid to some of the studies that our telemedicine program has conducted in the past few years. The chapter will conclude with some recommendations and a look to the future.
E-Leadership in the Digital Age: The Equilibrium, the Codes and the Digital Gap
Authors: Harum Hishamuddin
Published: February 2025

Malaysia's experience in implementing the Integrated Telehealth Project has placed her way ahead in the arena of world Telehealth. Thus, she has become the focus point, reference point and benchmark for similar endeavors around the world. In fact, it would not be presumptuous to state that the Integrated Telehealth project is a trail-blazing pioneer with e-leadership experience and skills developed over the last few years. It is hoped that the Integrated Telehealth concept will find acceptance and credence globally.
Integration of Electronic Patient Record Context with Message Context
Authors: Clereq Etienne De  , Bangels Marc  , France Francis Roger
Published: February 2025

A methodology to construct specific messages with clear objectives inside clinical processes, while simultaneously including contextual information, remains a problem today. This paper addresses the issue of combining specific message context (process driven) with the context of a patient record (patient centered).
Is it possible to collect medicalized data in Africa? An experience in the paediatrics service in the University Hospital in Yopougon, Abidjan, Ivory Coast
Authors: Digbeu Hippolyte  , Herengt Gilles  , Aké-Assi Marie Hélène  , Timité-Konan Marguerite  , Mallol Nathalie  , Kohler François
Published: February 2025

The aim of this study is to demonstrate that it can be relevant to implement medicalized data in the African hospitals in order to establish morbidity statistics and economical evaluation.