bluuebunny/crossref_metadata_2025 huggingface dataset:
Telebaby® Videostreaming of Newborns over Internet
Authors: Spanjers Ronald  , Feuth Sander
Published: February 2025

New information technologies are used to fill gaps in our need for communication. Hospitals are now starting to discover the possibilities of multimedia communication for their patients. Telebaby® is a project of the University Medical Centre Utrecht that allows parents to view their newborn on the intensive care, high care or medium care unit at home. Standard Internet technology for distributing multimedia allows parents to virtually “visit” their baby more often and give parents the feeling of control. A non-complex technical system like Telebaby® is easily adopted by the parents, implementing it in a closed environment like a hospital is the real challenge.
Text Retrieval Based on Medical Subwords
Authors: Honeck Martin  , Hahn Udo  , Klar Rüdiger  , Schulz Stefan
Published: February 2025

In biomedical documents, there is ample evidence for complex morphological structures in specialized terms. While inflection is relatively easy to deal with, productive morphological processes such as derivation and single-word composition constitute a major challenge. Considering the problem from an information retrieval perspective, we split morphologically complex words into biomedically significant, morpheme-like subwords and match subwords the query terms and document terms are composed of. This way, morphologically motivated word form alterations can be eliminated from the retrieval procedure. Based on a series of retrieval experiments, we have gathered evidence that subword-based indexing and retrieval – for the German biomedical sublanguage, at least – outperforms conventional string matching approaches.
Consistency and reproducibility of attribute extraction by different machine learning systems
Authors: Lukacic Zoran  , Kern Josipa
Published: February 2025

Machine learning systems as tools for intelligent data analysis are used for extracting attributes relevant for prediction of defined outcomes. The aim of the paper was to compare two machine learning (ML) systems and propose method for intra- and inter-testing of consistency and reproducibility in attributes extracted from real dataset. See5 and FMLS extracted relevant attributes from real medical dataset. Comparison of results of both systems shows that: accuracy and sensitivity are nearly the same for both FMLS and See5 when FMLS was forced by attributes extracted by See5, and little bit lower when FMLS used its own extracted attributes; specificity is nearly the same for both FMLS and See5 when FMLS was forced by attributes extracted by See5, and much more higher when FMLS used its own extracted attributes; both of ML systems show intra-testing consistency and does not show any inter-testing consistency.
Building Strategies for Healthcare Information Systems
Authors: Mihalas George I.  , Bazavan Mariana
Published: February 2025

An overview of the Romanian health information system development at a national scale is presented. A critical analysis of anterior phases tries to explain some of the differences between the expected results and real achievements. A set of principles for the “updated” strategy is proposed and each of them is associate a comment supporting its importance within the frame of present trends.
Effect of different sources of ventricular repolarization heterogeneity on the resultant cardiac vectors. A model study
Authors: Szathmáry Vavrinec  , Ruttkay-Nedecký Ivan
Published: February 2025

The computer model of ventricular activation was used to study the effects of eventual differences in the repolarization pattern between the right and the left ventricle, as well as between the apical and the basal parts of the ventricles. All changes in model action potential durations (APDs) were performed in the range corresponding to the APD variability measured in myocytes. The vectorcar-diographical spatial T loop was very sensitive on the changes in the right to left ventricular gradient of APD, while the similar changes in the apico-basal gradient of APD influenced the T loop minimally.
Effects of the Belgian Health Care Policy on the Conceptual Choice of a Hospital Information System
Authors: Cottem D.
Published: February 2025

Specific aspects of the Belgian health care policy may have a direct or indirect effect on the way hospitals should develop their information system. This article illustrâtes three important aspects of this policy and their effects on the conceptual choices of a Hospital Information System.
Smart multisensor kernel
Authors: Bruno Stéphane  , Scalart Pascal  , Lutzler Pierre
Published: February 2025

We describe in this paper a smart multisensor kernel, given the shape of a wriststrap and able to characterise a current physiological state among a number of ones resulting from a previous analysis, and to transmit those results using a radio link. The main advantage of this product is its adaptability. As examples, we describe two applications which are the remote monitoring of elderly people and the sleep staging.
Image integrity verification in medical information systems
Authors: Lenti Jozsef  , Lovanyi Istvan
Published: February 2025

In nowadays it is a major objective to protect healthcare information against unauthorized access. Comparing conventional and electronic management of medical images the later one demands much more complex security measures. We propose a new scenario for watermark data buildup and embedding which is independent from the applied watermarking technology. In our proposed method the embedded watermark data is dependant on image and patient information too. The proposed watermark buildup method provides watermark information where it is small in size and represents a unique digest of the image and image related data. The embedded data can be considered unique with high probability even if the same algorithm was used in different medical information systems. Described procedures ensure new, more secure links between image and related data, offering further perspectives in smartcard implementations.
Myocardium structure analysis on echocardiographic images
Authors: Puniene Jurate  , Punys Vytenis  , Punys Jonas  , Jurkevicius Renaldas
Published: February 2025

The heart disease is caused by the alterations in the biological tissue of its muscles. The myocardium alterations have been analysed and evaluated on echocardiographic images. The statistical parameters of the heart texture on the defined region of interest present information about the state of myocardium. There are hundreds of the texture parameters, which could be used to evaluate the heart tissue structure. The goal was to choose the most informative ones by applying the statistical analysis techniques. The Fisher statistics has been applied for hypothesis testing to define the most informative texture parameters. The data for the certain position of a transducer has been compiled for sound and heart patients. Two kinds of echocardiographic images (native and harmonic ones) have been used for analysis. The most informative texture parameters on evaluating changes in myocardium structure proved to be: local mean intensity, the form of local histogram, local variance and run-length nonuniformity. The statistical analysis was limited to the measurements of the most informative position of the transducer from the compiled database.
Genetic Programming in Medical Diagnosis
Authors: Malolepszy Andrzej  , Kącki Edward
Published: February 2025

The paper describes the results obtained for differential diagnostics of substantially complex disorders in the acid-base status. Since the first attempts of applying the genetic programming to this problem, presented by the authors at MIE 2000, proved promising, the investigation has been continued. The goal of the present study is to create computer genetic programs which, while taking into account a set of laboratory gasometric and electrolyte measurments, would be able to assist the diagnostics of acid-base disorders. Seven (7) single acid-base disorders, eleven (11) double acid-base disorders and six (6) triple complicated disorders with accompanying anion gap alterations are approached in the study. A set of simulated laboratory measurements has been prepared, providing 250 results for the evaluation of the fitness function of the designed genetic computer programs, plus some additional results for testing. The final results are presented in the form of a confusion matrix for the testing data, which shows that the developed system may be helpful in clinical practice.
On the Use of Vignettes for Eliciting Test-Selection Strategies
Authors: Sent Danielle  , van der Gaag Linda C.  , Witteman Cilia L.M.  , Aleman Berthe M.P.  , Taal Babs G.
Published: February 2025

Decision-support systems often include a strategy for selecting tests in their field of application. This strategy in essence captures procedural knowledge and serves to provide support for the reasoning processes involved. Generally, a test-selection strategy is offered in which tests are selected sequentially. For our field of application, we noticed that such a strategy would be an oversimplification, and decided to acquire knowledge about the actual strategy used by the experts. To this end, we composed a method that comprised an unstructured interview to gain general insight in the test-selection strategy used, and a subsequent structured interview, simulating daily practice through vignettes, to acquire full details. We used the method with two experts in our field of application and found that it closely fitted in with their daily practice and resulted in a large amount of detailed knowledge.
Diabetes Websites Accredited by the Health On the Net Foundation Code of Conduct: Readable or Not?
Authors: Kusec Sanja  , Brborovic Ognjen  , Schillinger Dean
Published: February 2025

Health information posted on the Internet has become a popular mode of communication with the population at large because millions of people now use the Internet to gather health information. Many studies on readability have shown that patient education information is frequently written at the reading level too high for the average population to understand, and the same holds true for health information on the Internet. The aim of this study was to determine the readability levels of health information found on diabetesrelated websites displaying HONcode logo, which indicates to high quality of the information provided. The 99 websites tested for readability using the Flesch Reading Ease formula and Flesch-Kincaid level showed FRE score 2.1 to 79.6, with the mean 41.7 (10thgrade, 8thmonth Flesch-Kincaid level), which indicates that 86.9% of these materials would be too difficult to read for the average adult population. It is suggested that the readability level, and the name of the formula used, be used on the websites themselves to help the Internet users decide which sites could be of the greatest benefit to them.
Security and Privacy of EHR Systems – Ethical, Social and Legal Requirements
Authors: Kluge Eike-Henner W.
Published: February 2025

This paper addresses social, ethical and legal concerns about security and privacy that arise in the development of international interoperable health information systems. The paper deals with these concerns under four rubrics: the ethical status of electronic health records, the social and legal embedding of interoperable health information systems, the overall information-requirements healthcare as such, and the role of health information professionals as facilitators. It argues that the concerns that arise can be met if the development of interoperability protocols is guided by the seven basic principles of information ethics that have been enunciated in the IMIA Code of Ethics for Health Information Professionals and that are central to the ethical treatment of electronic health records.
Finnish Health Telematics Approach for Patient Centric Care
Authors: Itkonen Pentti
Published: February 2025

It was to be expected that questions concerning the implementation of new technology were to arise in many respects. Nowadays hospitals cannot function effectively and profitably without medical technology equipment like magnetic resonance imaging devices, computerised tomography and ultrasound equipment or automatic laboratory analytic.
Approaches in European Health Information Systems Architectures
Authors: Sottile Pier Angelo
Published: February 2025

Information and Communication Technology (ICT) in healthcare represents a fundamental and highly qualifying pre-requisite for enabling the interoperability of information systems, the continuity of the caring process to the patient over the territory, the creation of an integrated electronic healthcare record, as well as the monitoring and optimisation of the organisational and economical aspects of healthcare enterprises. This paper presents a European architectural strategy for healthcare information systems, capable of facilitating the evolution of the existing procedures and their smooth integration into a homogeneous information and functional infrastructure, without requiring major modifications in already existing modules and protecting, therefore, previous investments.
A Study of Overlapping Virtual Objects on Real Objects in 3D Space
Authors: Kondo Takamitsu  , Matsunaga Katsuya  , Shidoji Kazunori  , Matsuki Yuji
Published: February 2025

Augmented reality (AR) is anticipated for use in medical practice. However, virtual objects cannot be overlaid exactly on real objects using theoretical data. Therefore, this study is intended to determine the correction method to overlay a virtual object with real object accurately. Experimental results confirmed that differences of perceived depth position between real and virtual objects can be made negligible (within 1 mm on average) by correcting sizes of virtual objects such that they can be seen identically to the real object.
Training and Assessment of Psychomotor Skills for Performing Laparoscopic Surgery Using BEST-IRIS Virtual Reality Training Simulator
Authors: Makam Ramesh  , Rajan CS  , Brendon Tulip  , Shreedhar V  , Saleem K  , Shrivastava Sangeeta  , Sudarshan R  , Naidu CRJ Prakash
Published: February 2025

In this article, we present the results of a pilot study that examined the performance of people training on a Virtual Reality based BEST-IRIS Laparoscopic Surgery Training Simulator. The performance of experienced surgeons was examined and compared to the performance of residents. The purpose of this study is to validate the BEST-IRIS training simulator. It appeared to be a useful training and assessment tool.
Virtual Reality Combats Test Anxiety: A Case Study Report
Authors: North Max M.  , North Sarah M.  , Crunk John
Published: February 2025

This pilot study is the first known in-depth case study of the effectiveness of virtual reality therapy (VRT) as a treatment for Test Anxiety (TA). The subject of the study was a 28-year-old male, whose anxiety and avoidance behavior was interfering with his normal academic activities. For treatment, he was placed in a virtual classroom and later in a virtual auditorium. The subject was exposed to six moderately increasing in difficulty level virtual situations. The subject rated each situation for discomfort. As a simple measure of anxiety, a modified version of the Subjective Units of Disturbance (SUD) scale was used every five minutes during exposure. This case study showed VRT to be an effective treatment method for reducing self-reported TA. Symptoms experienced by the subject during VRT sessions were just as real to the subject as actual test taking and general TA situations. They included increased heart rate, mild dizziness, and headaches. This case study of TA indicates that VRT may be used as an effective treatment method for reducing self-reported anxiety and improving the performance of subject(s) who suffer from TA.
Virtual interaction in cognitive neuropsychology
Authors: Morganti Francesca
Published: February 2025

Several recent studies have investigated whether knowledge representation turns possible within virtual reality simulated environments. According to these affirmative results different clinical applications were developed in psychology. Among these applications virtual reality seems to have a specific role in assessment and treatment of neuropsychological diseases. This chapter will firstly investigate possibilities and challenges carried from virtual-reality-based neuropsychological application focusing both on patient's and therapist's point of view. Afterward it will provide a survey of research and intervention application examples. More in detail a clear explanation of contribution goals will be discussed, in order to place research and applied works within a cognitive neuroscience frame of reference, according with their usefulness and effectiveness in clinical treatment. Fulfilling these objectives neuropsychological virtual reality approaches in memory, motor abilities, executive functions and spatial representation will be shown.
Translating Arden MLMs into GLIF Guidelines – A Case Study of Hyperkalemia Patient Screening
Authors: Wang Dongwen
Published: February 2025

To re-examine the validity of the medical knowledge that are embedded in the legacy system, we translated a Medical Logic Module (MLM) for hyperkalemia patient screening into the GuideLine Interchange Format (GLIF). We used a set of guiding principles to direct the translation. In addition, we used the GLIF3 Guideline Execution Engine (GLEE) as a testing tool to validate the encoded GLIF guideline by applying it to 5 simulated patient cases. The result has shown that it is possible to translate Arden MLMs into GLIF guidelines. However, significant efforts are necessary to handle the problems arose during the translation process. Automatic translation could be a more generalizable approach for future work.
Policy Management and Access Control in Practice
Authors: Nordberg Ragnar
Published: February 2025

This paper reflects how the combined CEN and ISO standard Privilege Management and Access Control (PMAC) Part 1 to 3 is intended to work. It also gives experiences from a test implementation.
An implementation of the Trigram Phrase Matching method for text similarity problems
Authors: Tardelli Adalberto O.  , Anção Meide S.  , Packer Abel L.  , Sigulem Daniel
Published: February 2025

The representation of texts by term vectors with element values calculated by a TFIDF method yields to significant results in text similarity problems, such as finding related documents in bibliographic or full-text databases and identifying MeSH concepts from medical texts by lexical approach and also harmonizing journal citation in ISI/SciELO references and normalizing author's affiliation in MEDLINE. Our work considered “trigrams” as the terms (elements) of a term vector representing a text, according to the Trigram Phrase Matching published by the NLM's Indexing Initiative and its logarithmic Term Frequency – Inverse Document Frequency method for term weighting. Trigrams are overlapping 3-char strings from a text, extracted by a couple of rules, and a trigram matching method may improve the probability of identifying synonym phrases or similar texts. The matching process was implemented as a simple algorithm, and requires a certain amount of computer resources. An efficiency-focused C-programming was adopted. In addition, some heuristic rules improved the efficiency of the method and made it feasible a regular “find your scientific production in SciELO collection” information service. We describe an implementation of the Trigram Matching method, the software tool we developed and a set of experimental parameters for the above results.
A Comprehensive Model for Evaluating Telemedicine
Authors: Hicks Lanis L.  , Boles Keith E.
Published: February 2025

Increasingly, telecommunications and advanced information technologies are being used for a variety of activities: clinical, administrative, and education/research. These activities are undertaken with the expectation that health care delivery will be improved. To validate this expectation, a number of investigations have been undertaken to assess the effectiveness and efficiency of the activities. Unfortunately, many of these investigations have either been incomplete or have applied inappropriate techniques in the evaluation process. This is especially true in the attempts to evaluate the cost effectiveness of various telecommunication technologies and service delivery. The model presented here provides a systematic framework that can be used in evaluating the effectiveness, efficiency, and feasibility of telemedicine. The model delineates the different aspects and characteristics of an evaluation across three dimensions—focus (cost, quality, access), level (individual, community, society), and activities (clinical, administration, education/research). These dimensions are interrelated, making comprehensive evaluation difficult.
The Impact of Genomics on E-Health
Authors: Mitchell Joyce A.
Published: February 2025

The Human Genome Project (HGP) and e-Health are two fundamental changes that will alter the way we approach human health and life. These two scientific and societal forces will inevitably impact each other. This paper not only explores the ways that the HGP will change health care but also investigates the ways that e-Health systems will be influenced by the genomic data. The Electronic Medical Record (EMR) is discussed at length, including the probable impact on the laboratory, pharmacy, computerized provider order entry (CPOE), and other components. Thirteen points of a possible genomic future involving the EMR are presented. The genomic impact on other e-Health systems includes those at all levels of data: population, disease, patient, tissue and organ banks, cellular and for specific genes. The genomic impact on consumer health systems is explored, including Internet consumer information resources and the movement for direct-to-consumer genetic testing. The paper concludes that technology and trends of e-Health will enable the upcoming revolution caused by the health implications of the research emanating from the Human Genome Project.
An Intelligent Case-Adjustment Algorithm for the Automated Design of Population-based Quality Auditing Protocols
Authors: Advani Aneel  , Jones Neil  , Shahar Yuval  , Goldstein Mary  , Musen Mark A.
Published: February 2025

We develop a method and algorithm for deciding the optimal approach to creating quality-auditing protocols for guidelinebased clinical performance measures. An important element of the audit protocol design problem is deciding which guideline elements to audit. Specifically, the problem is how and when to aggregate individual patient case-specific guideline elements into population-based quality measures. The key statistical issue involved is the trade-off between increased reliability with more general population-based quality measures versus increased validity from individually case-adjusted but more restricted measures done at a greater audit cost. Our intelligent algorithm for auditing protocol design is based on hierarchically modeling incrementally case-adjusted quality constraints. We select quality constraints to measure using an optimization criterion based on statistical generalizability coefficients. We present results of the approach from a deployed decision support system for a hypertension guideline.
A Management Information System Model for Process-Oriented Health Care
Authors: Andersson Anna  , Hallberg Niklas  , Eriksson Henrik  , Timpka Toomas
Published: February 2025

$\underline{Objective:}$ To develop a conceptual model of a management information system for process-oriented health care organizations.
Integration Challenges of Clinical Information Systems Developed Without a Shared Data Dictionary
Authors: Hicken Val N.  , Thornton Sidney N.  , Rocha Roberto A.
Published: February 2025

Legacy systems have proven to be long-term integration challenges for Intermountain Health Care (IHC) despite commitment and attention to share clinical information across settings and among clinicians. This study measures the extent of the disparity of data elements across three independent data systems in current use. A sample of relevant data elements was selected across systems covering prenatal, labor and delivery, and newborn intensive care units (NICU). The findings revealed only 17% of these sample data elements had compatible structure across all three systems. The implications from differences in granularity, missing data, and duplicate data entry, include diminished data quality, greater risk for medical error, increased costs of integration and inefficient use of clinician time. Retrospective guidelinesfor managing conceptual context and granularity are given to assist in designing an integrated longitudinal patient electronic medical record.
Seamless Information Systems for Critical Care - Myth or Magic?
Authors: Munir Samina K  , Kay Stephen
Published: February 2025

A multi-site study is described that evaluates the scope for seamless Clinical Information Systems (CIS) in critical care. Observations, shadowing of clinical staff, questionnaires and interviews show a triangulation in data collection methods as well as location triangulation as the study is conducted across four sites, two each in UK andDenmark. Role Activity Diagrams (RAD) are used to capture critical care work processes. The RADs are-analysed to show the ‘simplified complexity’ of the workprocesses, which are changed by the introduction of information systems for the management of all clinical information. Further, CIS that reconcile expectations of both hospital management and clinical staffand that have the potential to adapt to their organisational environment have a greater chance of surviving in autopoietic organisations such as critical care. Despite decades of Informatics, no such system exists in its entirety; this study shows that ‘ancient problems’ of clinical information systems development, implementation and integration are still heavily prevalent. However, the potentialfor CIS that consider integrating all clinical information requirements is immense.
Computerization of guidelines: a knowledge specification method to convert text to detailed decision tree for electronic implementation.
Authors: Aguirre-Junco Angel-Ricardo  , Colombet Isabelle  , Zunino Sylvain  , Jaulent Marie-Christine  , Leneveut Laurence  , Chatellier Gilles
Published: February 2025

The initial step for the computerization of guidelines is the knowledge specification from the prose text of guidelines. We describe a method of knowledge specification based on a structured and systematic analysis of text allowing detailed specification of a decision tree. We use decision tables to validate the decision algorithm and decision trees to speck and represent this algorithm, along with elementary messages of recommendation. Edition tools are also necessary to facilitate the process of validation and workflow between expert physicians who will validate the specified knowledge and computer scientist who will encode the specified knowledge in a guideline model. Applied to eleven different guidelines issued by an official agency, the method allows a quick and valid computerization and integration in a larger decision support system called EsPeR (Personalized Estimate of Risks). The quality of the text guidelines is however still to be developed further. The method used for computerization could help to define a framework usable at the initial step of guideline development in order to produce guidelines ready for electronic implementation.
The Clinical Document Architecture (CDA) Enables Electronic Medical Records to Wireless Mobile Computing
Authors: Müller Marcel  , Frankewitsch Thomas  , Ganslandt Thomas  , Bürkle Thomas  , Prokosch Hans-Ulrich
Published: February 2025

The Clinical Document Architecture (CDA) has proved to be a valuable and powerful standard for a structured exchange of clinical documents between heterogeneous software systems like a Hospital Information System and a Physician Office System. In this paper we want to show how the CDA can additionally be used in order to enhance the Hospital Information System's functionality: each patient related document contained in or generatedfrom the HIS can be converted to a CDA/XML document. With the XML/XSLT-based transformation methods, those documents can be device-specifically transformed. We use this method to display HIS-content on mobile devices like Personal Digital Assistants (PDAs) by extracting the respective data fields from the HIS database, converting them to a CDA/XML document, which is transformed and sent to the mobile devices using a wireless intranet connection. Preliminary results and users' comments are promising, but further evaluation will be necessary. Our approach shows a generic model how clinical data can be displayed on different devices independently from the underlying HIS using CDA.
Executing Clinical Practice Guidelines using the SAGE Execution Engine
Authors: Ram Prabhu  , Berg David  , Tu Samson  , Mansfield Guy  , Ye Qin  , Abarbanel Robert  , Beard Nick
Published: February 2025

We report the first successful test of an interoperable guideline execution engine that interprets encoded clinical guideline content and executes that content via functions of a target clinical information system (CIS). For this test, an exemplar immunization guideline was encoded in the SAGE guideline model using standards-based information models and terminologies. This guideline content was subsequently executed using the prototype SAGE guideline execution engine, which interacts through standards- based VMR/Action services to instantiate real-time guideline recommendations via existing functions of the target CIS. In this paper, we describe our test implementation and highlight the significance and implications of each component of our deployment architecture.
The Specification of a Frame-based Medical Terminological System in Protégé
Authors: Abu-Hanna Ameen  , Cornet Ronald  , de Keizer Nicolette
Published: February 2025

A medical terminological system (TS) is essentially a representation of concepts, attributes and relationships pertaining to medical terms. Although the requirements and structures of TSs have enjoyed some attention in the literature, the actual implementation of TSs consisted so far of ad-hoc approaches starting from scratch. Recently, Protégé has been suggested as a software environment for the development of knowledge-based systems. In Protégé various component types interact, and knowledge can be represented at various levels. This paper investigates how to specify a frame-based TS in Protégé and demonstrates this in a specific application in the intensive care. Our approach is characterized by the utilization of a conceptual framework for understanding TSs and mapping its components onto Protégé constructs. This results in specifications of knowledge components for the implementation of terminological systems. The significance of the work stems from the generality of the specifications, thus facilitating the principled design and development of terminological systems in various medical domains.
Coping with Medical Polysemy in the Semantic Web: the Role of Ontologies
Authors: Pisanelli Domenico M.  , Gangemi Aldo  , Battaglia Massimo  , Catenacci Carola
Published: February 2025

Polysemy is the linguistic phenomenon by which a term has more than one meaning. It is not a negligible issue in information management, since an effective and unambiguous sharing of the semantic content of data among different databases or knowledge repositories is needed. The paper illustrates a case of polysemy (concerning inflammation), and puts it within the framework provided by the DOLCE+ foundational ontology. This solution enables us to formally represent several senses of inflammation, and their interrelationships. This we take as a demonstration of how ontologies play an essential role in providing precisely the conceptual foundations that are needed in order to make the intended meaning of natural language expressions available to all the (artificial or human) agents that could be involved in the semantic web
CliniViewer: A Tool for Viewing Electronic Medical Records Based on Natural Language Processing and XML
Authors: Liu Hongfang  , Friedman Carol
Published: February 2025

With the evolving use of computers in healthcare, the electronic medical record (EMR) is becoming more and more popular. A tool is needed that would enable physicians to accurately and efficiently access clinical information in multiple medical records associated with a particular patient. Both natural language processing (NLP) and the eXtensible Markup Language (XML) have been used in the clinical domain for capturing, representing, and utilizing clinical information and both have shown great potential. In this paper, we demonstrate another use of XML and NLP through CliniViewer, a tool that organizes and presents the clinical information in multiple records. We also describe the flexibility and capability provided when combining XML and NLP to summarize, navigate, and conceptualize structured information. The tool has been fully implemented and tested using patients with multiple discharge summaries.
Modeling and Analyzing Biomedical Processes using Workflow/Petri Net Models and Tools
Authors: Peleg Mor  , Tu Samson  , Manindroo Abhijit  , Altman Russ B.
Published: February 2025

Computer simulation enables system developers to execute a model of an actual or theoretical system on a computer and analyze the execution output. We have been exploring the use of Petri Net (PN) tools to study the behavior of systems that are represented using three kinds of biomedical models: a biological workflow model used to represent biological processes, and two different computer-interpretable models of health care processes that are derived from clinical guidelines. We developed and implemented software that maps the three models into a single underlying process model (workflow), which is then converted into PNs in formats that are readable by several PN simulation and analysis tools. We show how these analysis tools enabled us to simulate and study the behavior of two biomedical systems: a Malaria parasite invading a host cell, and patients undergoing management of chronic cough.
A Resource to Acquire and Summarize Pharmacogenetics Knowledge in the Literature
Authors: Rubin Daniel L.  , Carrillo Michelle  , Woon Mark  , Conroy John  , Klein Teri E.  , Altman Russ B.
Published: February 2025

To determine how genetic variations contribute the variations in drug response, we need to know the genes that are related to drugs of interest. But there are no publicly available databases of known gene-drug relationships, and it is time-consuming to search the literature for this information. We have developed a resource to support the storage, summarization, and dissemination of key gene-drug interactions of relevance to pharmacogenetics. Extracting all gene-drug relationships from the literature is a daunting task, so we distributed a tool to acquire this knowledge from the scientific community. We also developed a categorization scheme to classify gene-drug relationships according to the type of pharmacogenetic evidence that supports them. Our resource (http://www.pharmgkb.org/home/project-community.jsp) can be queried by gene or drug, and it summarizes gene-drug relationships, categories of evidence, and supporting literature. This resource is growing, containing entriesfor 138 genes and 215 drugs of pharmacogenetics significance, and is a core component of PharmGKB, a pharmacogenetics knowledge base (http://www.pharmgkb.org).
One-hour Lecture/Demo Produces Mastery Level Back Safety Transfer Skills Self-Efficacy in Randomized Comparisons among Hospital Nurses
Authors: Johnson Craig W.  , Vinh David T.  , Phelps Cynthia L.
Published: February 2025

More than 1/3 of back injuries among nurses result from patient transfers. So, a rigorous between-subjects quasi-experimental methodology having broad clinical applicability was developed to evaluate the effects of a one-hour didactic back safety and patient transfer training lecture/demonstration upon 42 recently hired hospital nurses. The design implemented independent random samples including independent control groups, though practical constraints required all 42 to participate in the training. Training effects were assessed for each of three back safety transfer skill self-efficacy measures and their composite total self-efficacy score. Four monthly training sessions, each serving different nurses, achieved significant and substantial impacts on both composite total back safetyprocedure self-efficacy (where effect sizes ranged from approximately 0.8 to 1.8 standard deviations) and on each individual backsafety transfer skill self-efficacy measure. After training, 85% to 100% of the nurses rated their back safety procedure self-efficacy within three points of the maximum composite total of 30 on the self-efficacy scale. Results may help improve nursing services and identify training strategies to reduce healthcare worker back injuries.
Medical Expert Systems Developed in j.MD, a Java Based Expert System Shell Application in Clinical Laboratories.
Authors: Van Hoof Viviane  , Wormek Arno  , Schleutermann Sylvia  , Schumacher Theo  , Lothaire Olivier  , Trendelenburg Christian
Published: February 2025

Growing complexity of diagnostic tests, combined with increased workload, stringent laboratory accreditation demands, continuous shortening of turn-around-time and budget restrictions have forced laboratories to automate most of their iterative tasks. Introduction of artificial intelligence by means of expert systems has gained an important place in this automation process. Different parts of clinical laboratory activity can benefit from their implementation and the present project deals with one aspect, namely the clinical interpretation of diagnostic tests. This paper describes how j.MD, a new Java based expert system shell, was used to reprogram the expert system for interpretation of amylase isoenzyme patterns that has been in use for many years in our laboratory, and that was originally programmed in Pro.MD, a Prolog based expert system shell. One of the most important advantages of the j.MD system is its bidirectional link with the laboratory information system. This project shows how expert systems for the interpretation of complex diagnostic tests that demand specific expertise can become an integrated part of the automated clinical chemistry lab.
Telementoring for Airway Management between a Far Forward Special Operations Location to a Major Medical Center Using Inexpensive Telemedicine Solutions
Authors: Irizarry Daniel  , Boedeker Ben H.  , Bernhagen Mary  , Miljkovic Nikola  , Nicholas IV Thomas
Published: February 2025

Critically ill patients in remote settings have limited access to specialized care. Telemedicine/telementoring can improve access to quality care, although VTC equipment is costly. This study showed that an inexpensive internet telecom software program can be effectively employed in the intubation training of a remote trainee.
Real-Time Simulation of Interaction between Colon and Endoscope for the Colonoscopy Simulation
Authors: Jung Hoeryong  , Lee Doo Yong
Published: February 2025

This paper proposes a novel simulation framework for the real-time deformation of the colon and endoscope using a skeleton-driven deformation method. Cylindrical lattices and a centerline are employed as the skeletons, and a mass-spring model is applied to the skeletons for the mechanics-based simulation. The centerline-based collision detection and resolution algorithm is applied to simulate the interaction between the colon and endoscope. The proposed simulation framework is integrated with a colonoscopy simulation. Simulation results show that the proposed method allows real-time simulation (28Hz) using the colon model composed of up to 241,440 meshes.
Validation of Three Virtual Reality Fundamentals of Laparoscopic Surgery (FLS) Modules
Authors: Pitzul Kristen B.  , Grantcharov Teodor P.  , Okrainec Allan
Published: February 2025

The Fundamentals of Laparoscopic Surgery (FLS) box trainer is the gold standard for development of laparoscopic technical skills however the scoring metrics require a trained proctor and do not allow for immediate feedback. The Lap Mentor™ virtual-reality (LMVR) FLS tasks, with automated scoring metrics and haptic feedback, may be a suitable alternative. We determined the construct and concurrent validity of LMVR-FLS. Participants with a range of laparoscopic experience performed 3 FLS tasks on both simulators. The LMVR-FLS demonstrated moderate concurrent validity and evidence for construct validity. Further research is required to determine if skill acquisition on these modules is transferable to the operating room.
Development of Medical Engagement Training Toolkits to Support Special Operations Military Assistance Programs in Austere Environments
Authors: Boedeker Ben H.  , Boedeker David  , Tate Charmaine
Published: February 2025

The Medical Seminar (MEDSEM) is a medical operation that shares culturally appropriate medical information with a defined indigenous population based upon a “train the trainer” concept. This work describes the development of a hand washing training toolkit designed to support a MEDSEM action in Afghanistan.
Workflow-enhanced conformational analysis of guanidine zinc complexes via a science gateway
Authors: Herres-Pawlis Sonja  , Birkenheuer Georg  , Brinkmann André  , Gesing Sandra  , Grunzke Richard  , Jäkel René  , Kohlbacher Oliver  , Krüger Jens  , dos Santos Vieira Ines
Published: February 2025

The new science gateway MoSGrid (Molecular Simulation Grid) enables users to submit and process molecular simulation studies on a large scale. A conformational analysis of guanidine zinc complexes, which are active catalysts in the ring-opening polymerization of lactide, is presented as an example. Such a large-scale quantum chemical study is enabled by workflow technologies. Two times 40 conformers have been generated, for two guanidine zinc complexes. Their structures were optimized using Gaussian03 and the energies processed within the quantum chemistry portlet of the MoSGrid portal. All meta- and post-processing steps have been performed in this portlet. All workflow features are implemented via WS-PGRADE and submitted to UNICORE.
The Einstein Genome Gateway using WASP – A High Throughput Multi-Layered Life Sciences Portal for XSEDE
Authors: Golden Aaron  , McLellan Andrew S.  , Dubin Robert A.  , Jing Qiang  , Ó Broin Pilib  , Moskowitz David  , Zhang Zhengdong  , Suzuki Masako  , Hargitai Joseph  , Calder R. Brent  , Greally John M.
Published: February 2025

Massively-parallel sequencing (MPS) technologies and their diverse applications in genomics and epigenomics research have yielded enormous new insights into the physiology and pathophysiology of the human genome. The biggest hurdle remains the magnitude and diversity of the datasets generated, compromising our ability to manage, organize, process and ultimately analyse data. The Wiki-based Automated Sequence Processor (WASP), developed at the Albert Einstein College of Medicine (hereafter Einstein), uniquely manages to tightly couple the sequencing platform, the sequencing assay, sample metadata and the automated workflows deployed on a heterogeneous high performance computing cluster infrastructure that yield sequenced, quality-controlled and ‘mapped’ sequence data, all within the one operating environment accessible by a web-based GUI interface. WASP at Einstein processes 4–6 TB of data per week and since its production cycle commenced it has processed ~ 1 PB of data overall and has revolutionized user interactivity with these new genomic technologies, who remain blissfully unaware of the data storage, management and most importantly processing services they request. The abstraction of such computational complexity for the user in effect makes WASP an ideal middleware solution, and an appropriate basis for the development of a grid-enabled resource – the Einstein Genome Gateway – as part of the Extreme Science and Engineering Discovery Environment (XSEDE) program. In this paper we discuss the existing WASP system, its proposed middleware role, and its planned interaction with XSEDE to form the Einstein Genome Gateway.
Analytical Approaches for Buckling Verification of In-Plane Loaded Laminated Glass Columns and Panels
Authors: Amadio Claudio  , Bedon Chiara
Published: February 2025

Modern and innovative architectural applications are frequently associated to the structural use of glass beams and panels. Such brittle elements are in fact largely adopted to sustain in-plane or out-of-plane loads (e.g. columns, stiffeners, stairs, etc.). However, due to their typical slenderness, they could be affected by stability problems. Because of these reasons, accurate investigations should be dedicated to the analysis of their buckling response. In the paper, simple analytical formulations are proposed to study the load bearing capacity of in-plane loaded 2-layer laminated glass columns and panels. Comparisons with numerical simulations are proposed to validate the analytical models. At last, useful formulations are suggested also for the buckling verification of in-plane compressed 3-layer laminated glass elements.
The European Project “Aircraft Integrated Structural Health Assessment II”
Authors: Pfeiffer Helge  , Wevers Martine
Published: February 2025

Nowadays aircraft inspection procedures are well-elaborated, but also expensive in many cases. The reason is that scheduled inspections are time-consuming and they seldom provide information on actual structural damage. “Structural Health Monitoring (SHM)” would be an interesting option to tailor inspection to the real needs of aircraft operations. Within the so-called “AISHA II” project, advanced solutions are being developed and a special focus is on development of solutions with a relatively high technology readiness level. The permanent sensor networks proposed are based upon ultrasonic and upon electrical and electromechanical impedance measurements. They are described in this paper, as well as a new sensor developed at the Department of Metallurgy and Materials Engineering, Leuven, Belgium, which uses the loss of percolation conductivity in a composite.