bluuebunny/crossref_metadata_2025 huggingface dataset:
A Signal Analysis Method for Impulse-like Eye Movements
Authors: Juhola Martti  , Aalto Heikki  , Hirvonen Timo
Published: February 2025

Eye movement investigations are performed in several fields of medicine. We have developed signal analysis methods of eye movements studied in otoneurology for several years. Previously, we have designed methods for eye movement types of saccades, nystagmus, smooth pursuit, and vestibulo-ocular reflex. In this paper we extend and develop further our method to concern also impulse-like eye movements, i.e. a new type of eye movement tests for investigations of vertiginous patients. According to our preliminary results the use of our method is efficient to differentiate patients with inner ear diseases from normals.
Monte Carlo Simulation of the Radiographic Imaging Procedure for Electronically Designed Phantoms
Authors: Lazos D.  , Kolitsi Z.  , Pallikarakis N.
Published: February 2025

This paper presents a software simulation package of the entire X-ray projection radiography process including beam generation, absorber structure and composition, irradiation set up, radiation transport through the absorbing medium and image formation. This software tool is an augmented version of a previously presented system with expanded range of application by the implementation of Monte Carlo approach for the simulation of the radiation interaction at the absorber and the detector. Phantoms are created as composite objects from geometrical or voxelized primitives and can be subjected to simulated irradiation process. The acquired projection images represent the two dimensional spatial distribution of the energy absorbed in the detector and are formed at any geometry, taking into account energy spectrum, beam geometry and detector response.
Automated computer-assisted evaluation of diagnosis-and-procedure-reports in Austrian hospitals
Authors: Hagenbichler E.  , Klingler D.  , Neuner L.  , Pfeiffer K.-P.
Published: February 2025

Austria's 320 hospitals with 73.000 beds have to transmit a minimum basic data set for each hospital stay with diagnosis and procedures as well as scores for use in intensive care units (last only in performance-oriented financed hospitals). Based on these data, 160 hospitals or 53.000 beds are financed through performance oriented flat rates per case (LDFs - Leistungsorientierte Diagnosen-Fallpauschalen). Those LDFs are in some principles similar to DRGs (diagnosis related groups), but have been developed by the Federal Ministry of Labor, Health and Social Affairs (BMAGS). 1.94 million data sets of hospital stays, which were reported for financing in the year 1997 had to be analyzed for their correctness and plausibility. For this aim the “Scoringprogramm” of the BMAGS is in use. We describe in detail how many diagnoses and procedures are automatically checked with diagnosis, sex, age, length of stay etc. 1.6% warnings resulted from this checking, and no errors have been reported. The checking routines have to be further developed. At present data seem to be used only with caution for epidemiology or for analyzing medical quality. For financing purposes it might be reliable, especially if data quality commissions are enlarged and if evaluation of data with medical records is improved.
Availability humanization expert model
Authors: Molan Marija  , Molan Gregor
Published: February 2025

AH model as a tool for estimation in the occupational health care is presented. This is an expert model connecting data from the working environment with human availability and health status data. In this paper the idea of model and its components are presented.
TIDE: An Intelligent Home-Based Healthcare Information & Diagnostic Environment
Authors: Abidi Syed Sibte Raza
Published: February 2025

The 21stcentury promises to usher in an era of Internet based healthcare services—Tele-Healthcare. Such services augur well with the on-going paradigm shift in healthcare delivery patterns, i.e. patient centred services as opposed to provider centred services and wellness maintenance as opposed to illness management. This paper presents a Tele-Healthcare info-structure TIDE—an ‘intelligent’ wellness-oriented healthcare delivery environment. TIDE incorporates two WWW-based healthcare systems: (1) AIMS (Automated Health Monitoring System) for wellness maintenance and (2) IDEAS (Illness Diagnostic & Advisory System) for illness management. Our proposal comes from an attempt to rethink the sources of possible leverage in improving healthcare; vis-à-vis the provision of a continuum of personalised home-based healthcare services that emphasise the role of the individual in self health maintenance.
The RITHME Inter-Mediation Platform for data exchanges between Healthcare Professionals
Authors: Beuscart Régis  , Beuscart-Zéphir Marie-Catherine  , Renard Jean-Marie  , Delerue David  , Souf Alexandre
Published: February 2025

Data Exchanges between Healthcare Professionals are always limited to paper. For letters, reports, results, the physicians and hospitals are yet using the classical post-office mailing system. With the growing development of Medical Informatics within the Hospital Information Systems and the GPs offices, the way to exchange medical data will be more and more oriented towards the Telematics procedures. If Tele-consultation, video-conferencing applications appear as routine procedures, a safe, protected, and rapid transmission of medical data and records through electronic mailing systems is not yet really available.The Rithme*Inter- mediation Platform is an experimental product, tested in the town of Armentières (in the City of Lille) in the North of France to allow a better, safer, more rapid electronic communication between all the professionals of a geographical sector. One of the mail component of this platform is the “Events Server” which collects and displays all the available information concerning a dedicated patient to the medical authorised correspondents. To realise this task the Rithme*Platform takes charge of 4 main functions: formatting the messages, assuring the security, managing the directories, notifying emergencies. Currently experimented with success in the City of Lille, this Platform will be soon customised and commercialised.
The “Mediator Service”, a component to ease the integration of medical applications in the SynEx framework
Authors: Xu Yigang  , Sauquet Dominique  , Zapletal Eric  , Lemaitre David  , Degoulet Patrice
Published: February 2025

Interoperability is a key issue and a long-term domain of research for distributed healthcare information systems. The European project SynEx provides an open and standard integration platform for both new and legacy medical applications. It allows the collaboration of distributed and heterogeneous healthcare records and services. It aims to provide access to Hospital Information Services, to remote sources of medical data and to medical knowledge, in a seamless way, hiding the distribution aspects and the heterogeneity of systems.
An Approach for Access Differentiation Design in Medical Distributed Applications Built on Databases
Authors: Shoukourian S.K.  , Vasilyan A.M.  , Avagyan A.A.  , Shukurian A.K.
Published: February 2025

A formalized “top to bottom” design approach was described in [1] for distributed applications built on databases, which were considered as a medium between virtual and real user environments for a specific medical application.
Integrated Databases - The Foundation for the Information Linking of the Actors in the National Health Care and Health Insurance Systems
Authors: Marˇun Tomaž  , Košir Franc
Published: February 2025

Among the characteristics of the present time, we meet the ranking of information among the key resources of effective management of business systems. Up to date, integral and accurate information have gained precedence over conventional economic resources. This applies particularly in the case of large and complex business systems, including the national health care and health insurance systems. High quality and unified databases form the foundation for rational and quality procedures ranging from the operative level to the national strategy level.
Establishment Of National Information Infrastructure Program
Authors: Tchaklosh Ihor  , Tchaklosh Yury  , Luchechko Ivan  , Lubinets Jaroslav
Published: February 2025

This article presents main principles and ideology of establishment of national information infrastructure program and describes experience of the implementation of the pilot project in L'viv Region. The project primary goal is to improve the quality management of three major health care segments - financial management, medical personnel performance evaluation and health condition of population monitoring. System provides informational basis for decision-making support systems. The problems of system implementation and ways of their solutions have been presented in the article as well.
Site Specific Outcomes Analysis: Inducing Knowledge from a Limited Set of the Cardiac Assist Support Data
Authors: Babic Ankica
Published: February 2025

Introducing a new mechanical cardiac support into a surgical practice assumes, among other things, the risk stratification. However, the favourable outcome would not relate barely to the performance of device, but would rather concern all other risk factors that could be identified in clinical data sets.
Application of Thanatos in Creating Thyroid Cancer Registry
Authors: Plasaj Tomislav  , Lechpammer Mirna  , Šimunović Dalibor  , Cyjetko Ivan  , Strnad Marija  , Kusić Zvonko  , Belicza Mladen
Published: February 2025

The aim of this paper is to present the practical results of processing data from biopsy findings by Thanatos the Information System developed for Department of Clinical Patology Sisters of Mercy University Hospital, Zagreb, Croatia. After completing the Thyroid Cancer Registry which is a part of the Hospital Cancer Registry we are able to make distribution of histological representation of each type od thyroid cancer. From age distribution at diagnosis advansed informations are gained souch as increasing of average age for patients with follicular cancer. By comparing data from our Thyroid Cancer Registry wiht Croatian Cancer Registry for follow up purposes it is possible to calculate 5-year survival rate. We expected that all these advanced informations will makes possible to better predict behavior of thyroid diseases and to use more efficient prevention or cure.
A New Efficient Method for 3D Registration Using Human Brain Atlases
Authors: Juan M.C.  , Alcañiz M.  , Hernńndez V.  , Montesinos A.  , Barcia J.L.  , Monserrat C.  , Grau V.
Published: February 2025

In this article a new efficient method in deformable brain atlases is proposed. To achieve this goal we use the composition of two applications, an affine transformation and other one. In this second application we have used three different approaches. One approach that has been used and two new approaches. We use a set of points to be identified both in brain atlas and in patient's brain for registration. The three approach present an advantage: the mathematical solution obtained makes it to be very fast, almost immediate. Several results have been obtained and they have been classified as very satisfactory by the neurosurgeons that have tested our system.
3-D Computer Visualization and Interactive Prostate Biopsy Simulation Leads to an Improved Systematic Technique for the Detection of Prostate Cancer: Clinical Correlation
Authors: Bauer John J.  , Zeng Jianchao  , Zhang Wei  , Mcleod David G.  , Sesterhenn Isabell A.  , Connelly Roger R.  , Mun Seong K.  , Moul Judd W.
Published: February 2025

Objectives. Urologists routinely use the systematic sextant needle biopsy technique to detect prostate cancer. However, recent evidence suggests that this teclmique has a significant sampling error. Recent data based upon whole-mounted step-sectioned radical prostatectomy specimens using a 3-D computer assisted prostate biopsy simulator suggests that an increased detection rate is possible using laterally placed biopsies. A new 10-core biopsy pattern was shown to be superior to the traditional sextant biopsy. This pattern includes the traditional sextant biopsy cores and four laterally placed biopsies in the right and left apex and mid portion of the prostate gland. The objective of this study is to confirm the higher prostate cancer detection rate obtained using the 10-core biopsy pattern in a small cohort of patients. Methods. We retrospectively reviewed 35 consecutive patients with a pathologic diagnosis of prostate cancer biopsied by a single urologist using the 10-core biopsy pattern. The frequency of positive biopsy was determined for each core. Additionally, the sextant and 10-core prostate biopsy patterns were compared with respect to prostate cancer detection rate. Results. Of the 35 patients diagnosed with prostate cancer, 54.3% (19/35) were diagnosed when reviewing the sextant biopsy data only. Review of the 10-core pattern revealed that an additional 45.7% (16/35) of patients were diagnosed solely with the laterally placed biopsies. The laterally placed biopsies had the highest frequency of positive biopsies when compared to the sextant cores. Conclusions. Our results suggest that biopsy protocols that use laterally placed biopsies based upon a five region anatomical model are superior to the routinely used sextant prostate biopsy pattern. Lateral biopsies in the apex and mid portion of the gland are the most important.
Laparoscopic Surgical Simulator and Port Placement Study
Authors: Oppenheimer Peter  , Weghorst Suzanne  , Williams Lori  , Ali Amjad  , Cain James  , MacFarlane Mark  , Sinanan Mika
Published: February 2025

We have developed a virtual laparoscopic surgical simulator and gathered data during student trial runs. The students performed simulated surgical dissections from 3 pairs of port positions with angles between the cutting and grasping instruments set to 60, 90, and 120 degrees.
Ontology-based, medical domain-specific, use-case driven EMRs for use in clinical quality assurance and passive decision support
Authors: Boye N  , Veirum NE
Published: February 2025

The next evolving stage of the electronic medical records (EMR) - the clinical information system - must be able to support the mental processes involved in clinical reasoning. We have developed a framework for building such systems.
Automated Rejection of Contaminated Surface Measurements for Improved Surface Registration in Image Guided Neurosurgery
Authors: Bucholz Richard  , Macneil William  , Fewings Paul  , Ravindra Arjun  , Mcdurmont Lee  , Baumann Carol  , Bakewell Jean H.
Published: February 2025

Most image guided Neurosurgery employs adhesively mounted external fiducials for registration of medical images to the surgical workspace. Due to high logistical costs associated with these artificial landmarks, we strive to eliminate the need for these markers. At our institution, we developed a handheld laser stripe triangulation device to capture the surface contours of the patient’s head while oriented for surgery. Anatomical surface registration algorithms rely on the assumption that the patient’s anatomy bears the same geometry as the 3D model of the patient constructed from the imaging modality employed. During the time interval from which the patient is imaged and placed in the Mayfield head clamp in the operating room, the skin of the head bulges at the pinsite and the skull fixation equipment itself optically interferes with the image capture laser. We have developed software to reject points belonging to objects of known geometry while calculating the registration. During the course of development of the laser scanning unit, we have acquired surface contours of 13 patients and 2 cadavers. Initial analysis revealed that this automated rejection of points improved the registrations in all cases, but the accuracy of the fiducial method was not surpassed. Only points belonging to the offending instrument are removed. Skin bulges caused by the clamps and instruments remain in the data. We anticipate that careful removal of the points in these skin bulges will yield registrations that at least match the accuracy of the fiducial method.
Models of the Venous System
Authors: Mehlsen Jesper
Published: February 2025

Cardiac output is largely controlled by venous return, the driving force of which is the energy remaining at the postcapillary venous site. This force is influenced by forces acting close to the right atrium, and internally or externally upon the veins along their course. Analogue models of the venous system require at least three elements: a resistor, a capacitor and an inductor, with the latter being of more importance in the venous than in the arterial system. Non-linearities must be considered in pressure/flow relations in the small venules, during venous collapse, or low flow conditions. The venous capacitance is also non-linear, but may be considered linear under certain conditions. The models have to include time varying pressure sources created by respiration and skeletal muscles, and if the description includes the upright position, the partly unidirectional flow through the venous valves has to be considered.
Mathematical Models Behind Advanced Simulators in Medicine
Authors: Larsen Jesper  , Pedersen Stig Andur
Published: February 2025

The paper presents as an example the types of mathematical models that are used in a full scale anesthesia simulator. The models vary from detailed reference models, based on fundamental physiological laws and principles, to simple script based models. A few considerations on the implementation of the models are also given.
Evaluation of knowledge using ExaMe program on the Internet
Authors: Zvárová Jana  , Zvára Jr. Karel
Published: February 2025

In the paper we describe the function of the ExaMe program that serves for evaluation of students’ knowledge using Internet. Evaluation is based on the knowledge base of a given course. Two types of evaluation tests are described. The fixed test is appropriate for examination of students by the teacher in computer classroom connected to Internet. By this test the evaluation is done in the limited time period and all students are tested with the same evaluation test. The automatic test is appropriate for self-evaluation and self-study by students on remote places. The student can ask the ExaMe program for the test of different difficulty levels and state the number of questions required. Finally thee first experience with the ExaMe program in practice is given
Thoughts about Curricula in Health Informatics
Authors: Hasman Arie  , Haux Reinhold
Published: February 2025

In this contribution it is argued that it is difficult to talk of medical informatics education since the groups that need education in this field are not very homogeneous. Also these groups overlap. WG 1 of IMIA is in the process of producing recommendations for curricula in medical informatics. The target groups are defined by their career type, which is categorised using three axes: discipline, stage of career and level of expertise. An example is given of the knowledge requirements for medical students.
User acceptance by individuals of health telematics from distributed EPRs associated with knowledge couplers
Authors: Scherrer Jean-Raoul  , Spahni Stephane  , Boyer Celia
Published: February 2025

The patient in a hospital bed is also a private individual that might access his or her own Electronic Patient Record (EPR) in association with additional tools that are able to show critical up-to-date knowledge about diagnoses, clinical investigations or treatments. The distributed EPRs are shown here in full production with the DOMED application of DIOGENE 2. Besides, in order to facilitate an easier understanding of the EPRs by the patient, the HON Web Site services are at his or her disposal in this respect at the same terminal.
Knowledge and Change in Health Care Organizations
Authors: Lorenzi Nancy M.  , Riley Robert T.
Published: February 2025

All of us realize that these are times of high change in virtually every health care system, regardless of size or location. As part of this change process, many health care systems are taking a serious look at the area that has evolved as knowledge management. While change may be mandatory, progress is definitely optional.
Web-based virtual endoscopy
Authors: Loncaric Sven  , Markovinovic Tomislav
Published: February 2025

A web-based application for computed tomography (CT) image analysis and visualization of the bronchial airways is presented in the paper. The technique used in this application provides a non-invasive way to examine the interior of the bronchial tubes. Many different properties of the tubes such as presence of the foreign objects or structure abnormalities of the tubes can be detected this way. This method can also be used for other similar structures, such as blood vessels. The application uses the CT images obtained by spiral computed tomography as input. Amplitude thresholding is used for segmentation of the airways. The medial axis of the airways has been used as the path for animation. The procedure produces a fly-through animation in the MPEG format, which is obtained by volume rendering of the original CT images along the extracted path. The user can choose the appropriate path using the Virtual Reality Modeling Language (VRML) model, which is sufficient for visualization of basic structures. The algorithms and the software have been developed on the SUN Ultra 1 workstation.
ICD-10-SGBV and ICD-l0-Diagnosenthesaurus
Authors: Graubner Bernd
Published: February 2025

In the year 2000 ICD-10-coding of diagnoses in ambulatory and hospital health care was legally introduced in Germany. Whereas the complete ICD-10 is used for coding of mortality, physicians got the special version “ICD-10-SGBV” for coding of diagnoses of treated patients. First experience with this version shows the necessity for its further improvement. In addition, the so-called ICD-10-Diagnosen-thesaurus was developed and proved to be a very useful aid for easier and better encoding of diagnoses. It is not only widely used in Germany but also in Austria and Switzerland. National and international efforts are necessary to improve ICD-10 and its utilisation.
Do Children with Hodgkin's Disease have a Better Prognosis than Adults? Application of a Generalised Linear Model to a Systematic Review of Published Results
Authors: Franklin Jeremy
Published: February 2025

This investigation aimed to compare survival rates in paediatric and adult Hodgkin's disease using published results. When comparing results obtained in different studies and institutions it is important to explain, estimate and allow for heterogeneity between studies. This was attempted though systematic inclusion of a large number of published results, through modelling the influence of covariates on survival using a generalised linear model, and by estimation of both the sampling errors in the extracted survival rates and the heterogeneity between studies. A significant superiority of treatment results in paediatric institutions compared with adult institutions was demonstrated, allowing for differences in patient and treatment characteristics.
Application of Kohonen neural network for the elaboration of electrogastrograms
Authors: Giacomini Mauro  , Ruggiero Carmelina  , Mansi Carlo
Published: February 2025

A method is presented for processing and analysis of electrograstrography (EGG) a noninvasive technique by which gastric myolectrical activity is recorded using abdominal surface electrodes. The analysis is based on FFT and on unsupervised artificial neural networks. Three kinds of patterns can be identified on the neurons of a Kohonen output map with 32×16 neurons: one relating to noisy spectral profiles, one relating to pre-prandial profiles, one relating post-prandial profiles. It is concluded that the described method is reliable and can be used for objective automated analysis of EGG and for investigation of possible relations of the EGG with gastric pathologies.
Integrating Users’ Activity Analysis in the Design and Assessment of Medical Software Applications: the example of Anesthesia
Authors: Beuscart-Zéphir M.C.  , Anceaux F.  , Renard J.M.
Published: February 2025

As the computers become more and more and aid for the management of medical information, some specialists like anesthetists demand specialized applications to support their own activity. Usually, these applications are developed following a Users' Requirements analysis and functional specifications. We demonstrate here that when the management of medical information is closely intertwined with the physician's activity, it is also necessary to perform a precise ergonomics analysis of this activity in order to identify the cognitive and organizational constraints that affect the usability and acceptance of the tool.
Evaluation of the Computer-Based Dispatching System for Emergency Medical Dispatch
Authors: Rîpanu Aneta  , Oprisan Mircea
Published: February 2025

The work makes an evaluation of the benefits brought by the system to the Ambulance Service of the City of Bucharest (ASCB) as well as to those who are using it, and of the conditions that permitted the bringing into operation of the system and made possible work with this system 7 days per week, 24 hours out of 24 for over 4 years. Also, the problems are presented that appeared with this system during exploitation - hardware, software, in the work with people.
MedView-Design and Adoption of an Interactive System for Oral Medicine
Authors: Ali Y.  , Falkman G.  , Hallnäs L.  , Jontell M.  , Nazari N.  , Torgersson O.
Published: February 2025

MedView is a joint project with participants from oral medicine and computer science. The aim of the project is to build a large database from patient examinations and produce computerised tools to extend, view, and analyse the contents of the database. The contents of the data base is based on a formalisation of health-care processes and clinical knowledge in oral medicine harmonised within the network SOMNET. We give an overview of the current status of the MedView project and discuss background and future directions.
Multivariate Frailty Model with a Major Gene: Application to Genealogical Data
Authors: Begun Alexander  , Desjardins Bertran  , Iachine Ivan  , Yashin Anatoli
Published: February 2025

Multivariate survival models are shown to be appropriate for the analysis of the genetic and the environmental nature of a human life-span. Models which involve continuously distributed individual frailty, play an important role in the genetic analysis of an individual's susceptibility to disease and death. These models, however, are not appropriate for the detection of the effects of separate genes on survival. For this purpose we developed a ‘major gene’ frailty model of multivariate survival and applied it to simulated and real pedigree data. The analysis shows that this model can be used for the detection of the presence of major genes in the population and for the evaluation of the effects of such genes on survival.
Practical aspects to realize data transfer between a patient administration mastersystem and clinical subsystems using ProtoGen/HL7
Authors: Jung Bettina  , Goldschmidt Andreas  , Langenberg Stefan
Published: February 2025

At the Medizinische Einrichtungen Bonn the module IS-H of SAP R/3 is used for patient administration. All clinical subsystems will be provided with patient data using HL7 2.3 messages. These messages are generated from HCM messages a proprietary format of IS-H by means of a communication server.
HL7-Parsing mit Endlichen Automaten
Authors: Ziegert C.  , Weiß R.  , Porth A.J.
Published: February 2025

Häufig stellt sich das Problem, zu einem vorhandenen Informationssystem eine HL7-Schnittstelle implementieren zu mussen. Die formale Definition einer HL7-Message ist im wesentlichen ein regulärer Ausdruck. HL7-Messages können also mit Hilfe von Endlichen Automaten geparst werden. Die Entwicklung von Parsern für verschiedene Message-Typen lässt sich mittels eines Parser-Generators automatisieren, dessen Input die formale Beschreibung einer HL7-Message ist und der als Output den Programmcode für den entsprechenden Parser liefert. Ein maschinell generierter Parser kann dann relativ leicht derart erweitert werden, dass er HL7-Messages in ein anderes Format (z.B. BDT oder LDT) transformiert.
The Danish EPR Observatory. Assessing Organisational Impact from EPR Implementation
Authors: Kristensen Margit  , Nøhr Christian  , Andersen Stig Kjaer
Published: February 2025

The EPR Observatory has studied 13 local Danish electronic patient record (EPR) projects through 2 years. The focus has been on expectations and experiences in relation to organisational changes. The main conclusions are that the healthcare professionals, working with the development, implementation and/or use of EPR, are in a very important and difficult process settling up with old traditions and cultures tied to the healthcare professions. Especially the healthcare professionals, working with EPR, shows interest and readiness to participate in new ways of collaboration and to work with highly structured data in structured frameworks.
Issues in Designing a Controlled Vocabulary and a Patient Data Representation Model for a Hospital-Wide EPR System
Authors: Breant Claudine  , Borst François
Published: February 2025

Careful attention must be paid when designing the following components of a hospital-wide electronic patient record (EPR) system: the common medical controlled terminology, the semantic data model for a standardized representation of patient data and the normalized database. Requirements are detailed. Problems encountered when coordinating the development of a medical terminology with the modeling of patient medical data are analyzed. Solutions implemented in the hospital- wide DOCLIN EPR system at the University Hospital of Geneva (HUG) are presented.
A MeSH based intelligent search intermediary for Consumer Health Information Systems
Authors: Göbel Georg  , Masser Joachim  , Pfeiffer Karl Peter
Published: February 2025

GIN AUSTRIA (Gesundheitsinformationsnetz AUSTRIA) offers patients and consumers reliable medical knowledge about diseases, wellness and disease management in an easy understandable way and enables them to quick and incessant access to informations about the Austrian health system and Austrian health organizations. To achieve full customer (patients, citizens) satisfaction to find relevant information we propose a concept of a vector-model oriented IR-Tool based on the controlled vocabulary of the MeSH Thesaurus (german version). By this approach users who are often not used to scientific terms and expressions are supported to build up their own query with MeSH Main Headings. In a second step broader and narrower Main Headings are added to the query-vector by the system. The tool is part of the GIN Search Modul, which will ease gathering health information from different heterogenous internet datasources.
Requirements and Design Aspects of a Data Model for a Data Dictionary in Paediatric Oncology
Authors: Merzweiler Angela  , Knaup Petra  , Creutzig Ursula  , Ehlerding Hartmut  , Haux Reinhold  , Mludek Volker  , Schilling Freimut H.  , Weber Ralf  , Wiedemann Timm
Published: February 2025

German children suffering from cancer are mostly treated within the framework of multicentre clinical trials. An important task of conducting these trials is an extensive information and knowledge exchange, which has to be based on a standardised documentation. To support this effort, it is the aim of a nation- wide project to define a standardised terminology that should be used by clinical trials for therapy documentation. In order to support terminology maintenance we are currently developing a data dictionary. In this paper we describe requirements and design aspects of the data model used for the data dictionary as first results of our research. We compare it with other terminology systems.
Diskussion einer aktuellen Publikation zur Wirkung von Knoblauch auf Atherosklerose
Authors: Tim Friede  , Gerhard Nehmiz
Published: February 2025

In welchem Umfang Knoblauch arterielle Fettablagerungen reduziert, haben Koscielny et al. (1999) in einer randomisierten, placebo-kontrollierten, doppelblinden Prüning untersucht. Das Plaque-Volumen wurde bei Einschluß in die Studie und nach 18,36 und 48 Monaten in beiden Femoral- und Carotis-Arterien mit Hilfe eines Ultraschallverfahrens gemessen und summiert. Je 140 Patienten mit Risikofaktoren für Atherosklerose und nachgewiesenen Ablagerungen wurden einem der beiden Behandlungsarme randomisiert zugewiesen. Die von den Autoren durchgeführte Auswertung ist problematisch. Sie weist im wesentlichen zwei schwerwiegende Mängel auf. Zum einen werden wiederholte Beobachtungen an einem Patienten als unabhängig angesehern, was zu einer Überbewertung der tatsächlich vorhandenen Information führt und damit zu antikonservativen Tests (außerdem wurden einige p-Werte falsch berechnet). Zum anderen werden Patienten, die die Studie vorzeitig beendet haben (128 von 280), nicht in die Auswertung einbezogen. Die Auswertung wird im Lichte internationaler Richtlinien diskutiert und Alternativen werden aufgezeigt.
Conceptual Integration of Guidelines and Workflow into the Electronic Health Record
Authors: Schadow Gunther  , Russler Daniel C.  , McDonald Clement J.
Published: February 2025

Even though computerized practice guidelines and workflow management (WfM) are proven effective techniques to improving quality of care and reducing costs, they are not widely deployed today. One reason for this is the impedance mismatch between guideline systems and electronic heath record (EHR) systems. This paper presents the Unified Service Action Model (USAM) that has been developed for the HL7 Reference Information Model and that conceptually integrates guidelines and workflow management into the EHR. We argue that the information items recorded in the EHR are logically similar to guideline and WfM definition. Therefore, guidelines and EHR reuse the same information structure in the USAM. This reuse is possible through a technique borrowed from natural language grammar and modal logic. The conceptual alignment of guidelines, WfM and the EHR could facilitate the sharing and deployment of guidelines in routine health care.
Applying Bayesian Analysis and Gibbs Sampling to General Linear Mixed Models in the Analysis of a Randomized Study on the Longterm Effect of Garlic on Atherosclerosis
Authors: König Jochem
Published: February 2025

Essential for a valid analysis of treatment efficacy is a prospectively specified analysis, that is robust against violation of those assumptions, which cannot be ascertained a priori. Additional modelling for inference of the treatment effect makes sense, if it is intended to check validity and efficiency of the preplanned analysis and the influence of missing data and protocoll violations on the results. Secondly, the temporal course of therapeutic effect can be investigated and thirtly, a subgroup analysis may be done in order to search for variables that modify the therapeutic effect.
Eignen sich Daten über Arzneimittelverordnungen für das Erkennen arbeitsbedingter Gesundheitsgefahren?
Authors: Bödeker W.  , Ochsmann A.  , Bieniek S.  , Friedrichs M.  , Hanßen R.
Published: February 2025

Eine Zielsetzung des Integrationsprogramms Arbeit und Gesundheit von Unfallversicherung und Krankenkassen (IPAG) besteht in der Prüfung, ob durch Einbeziehung von Sekundärdaten der Sozialversicherungsträger - über die Arbeitsunfähigkeitsdaten hinaus - die Grundlage fur das Erkennen arbeitsbedingter Gesundheitsgefahren verbessert werden kann. Es wurden daher die Daten über Arzneimittelverordnungen für ein Beschäftigtenkollektiv selektiert und mit Informationen über die Arbeitsbedingungen verknüpft. Erste Auswertungen lassen erkennen, daß die Häufigkeit der Arzneimittelverordnungen sowie die jeweiligen Anteile ausgewählter Indikationsgruppen am Verordnungsgeschehen im Vergleich der Arbeitsplatztypen unterschiedlich sind und somit möglicherweise die Einflüsse unterschiedlicher Belastungsfaktoren abbilden. Darüber hinaus enthalten die Verordnungsdaten offenbar Morbiditätsinformationen, die aus den Arbeitsunfühigkeitsdaten nicht gewonnen werden können.
A core middleware service in H.I.S.: the experience of IC_PIDRM
Authors: Verderio Valerio  , Cooper Paul
Published: February 2025

The exploding usage of telematics and internet techniques also in the Health Care environment imposes a re-thinking of the basic services that an Information System should provide. The standard CEN TC251 HISA ENV 12967, “Health Information System Architecture” while addressing specifications for patient coherent identification between departmental and global hospital information systems, leaves a cloud of uncertainty about inter hospital information system collaboration, delegating a pure technological layer (the so called “bitway” layer) to solve communication and interactions. The faced reality of heterogeneous systems in a regional healthcare environment drives the design of an architecture that includes functional middleware services implemented to create co-operation among several local identification systems and laying on a technical platform able to deal with distribution. This article explains how the InterCare HC4011 project designed and tested such services, and the conclusions reached.
Professional Communication for Co-ordination of care : Inter-mediation for a better management of patients
Authors: Renard J.M.  , Souf N.  , Kulik J.F.  , Beuscart R.
Published: February 2025

The communication of data through telecommunication networks between Healthcare professionals and particularly Hospitals and family doctors is a fundamental challenge for the next decade. Some experiences are demonstrating the feasibility of this approach and give clear insight of the potentials, difficulties and constraints of the problem. Different technical solutions are proposed following a centralised or a distributed architecture, security and confidentiality obligations, and the users requirements. We propose an original solutions based on the principle of inter-mediation to provide intelligent treatments and services on the messages that are exchanged between the network participants. This approach proved to be successful in the experimental field of Armentières (France) where more than 30 000 messages were exchanged between the hospital and the General Practitioners during 1999. Following this experimental phase, the prototype is currently customised and industrialised to fulfil the requirements and needs of an healthcare sector.
Chapter 4.2 - ENN Exploitation Plan
Authors: Dekena Robert  , Rehm-Berbenni Caterina  , Seyfried Klaus
Published: February 2025

The objective of the ENN-European Neurologic Network project is to improve knowledge and treatment of sleep disorders, headache and epilepsy.
Developing E-commerce and Improving Resource Management
Authors: Friedman Barbara B.  , Sunseri Albert
Published: February 2025

The pressure on Materials Managers, Information Technology Managers and Chief Executive Officer's has never been greater to re-imagine, re-invent, and re-architect their operations. The need for speed and for emerging Internet skills and sensibilities has led many operations to look to E-business service providers for assistance. The United States market for E-business services, including consulting, IT outsourcing, software development, and system integration has grown from $7.01 billion in 1998 to approximately $10.3 million in 2000 according to Dataquest [1]. With the growth in E-business accelerating, the market is expected to mushroom to $59 billion by 2003. Material Managers know they must introduce E-commerce to their business strategy, but many are not sure how, which is driving them to consulting and services companies. There is confusion in the ranks on whether they need to change their business model and systems structure in order to do this, and the organization is reevaluating how to move forward in the dot.com world.
The Future of Nanofabrication and Molecular Scale Devices in Nanomedicine
Authors: Freitas Jr. Robert A.
Published: February 2025

Nanotechnology is engineering and manufacturing at the molecular scale, and the application of nanotechnology to medicine is called nanomedicine. Nanomedicine subsumes three mutually overlapping and progressively more powerful molecular technologies. First, nanoscale-structured materials and devices that can be fabricated today hold great promise for advanced diagnostics and biosensors, targeted drug delivery and smart drugs, and immunoisolation therapies. Second, biotechnology offers the benefits of molecular medicine via genomics, proteomics, and artificial engineered microbes. Third, in the longer term, molecular machine systems and medical nanorobots will allow instant pathogen diagnosis and extermination, chromosome replacement and individual cell surgery in vivo, and the efficient augmentation and improvement of natural physiological function. Current research is exploring the fabrication of designed nanostructures, nanoactuators and nanomotors, microscopic energy sources, and nanocomputers at the molecular scale, along with the means to assemble them into larger systems, economically and in great numbers.
Affective Medicine: Technology with Emotional Intelligence
Authors: Picard Rosalind W.
Published: February 2025

For a long time people have kept emotions out of the deliberate tools of medicine and science; scientists, physicians, and patients have often felt and sometimes expressed emotion, but no tools could sense, measure, and respond to their affective information. A series of recent studies indicates that emotions, particularly stress, anger, and depression, are important factors with serious and significant implications for health. This paper highlights research at the MIT Media Lab aimed at giving computers the ability to comfortably sense, recognize, and respond to certain aspects of human emotion, especially affective states such as frustration, confusion, interest, stress, anger, and joy. Examples of recently developed systems are shown, including computer systems that are wearable and computers that respond to people with a kind of active listening, empathy, and sympathy. Results are reported for computer recognition of emotion, for teaching affective skills to autistics, and for having computers help users manage emotions such as frustration.
Intelligent Agent Software for Medicine
Authors: Lieberman Henry  , Mason Cindy
Published: February 2025

An important trend for the future of health technology will be the increasing use of intelligent agent software for medical applications. As the complexity of situations faced by both patients and health care providers grows, conventional interfaces that rely on users to manually transfer data and manually perform each problem-solving step, won't be able to keep up. This article describes how software agents that incorporate learning, personalization, proactivity, context-sensitivity and collaboration will lead to a new generation of medical applications that will streamline user interfaces and enable more sophisticated communication and problemsolving.
Bimanual Haptic Workstation for Laparoscopic Surgery Simulation
Authors: Devarajan Venkat  , Scott Daniel  , Jones Daniel  , Rege Robert  , Eberhart Robert  , Lindahl Charlie  , Tanguy Peter  , Fernandez Raul
Published: February 2025

Realistic laparoscopic surgical simulators will require real-time graphic imaging and tactile feedback. Our research objective is to develop a cost-effective haptic workstation for the simulation of laparoscopic procedures for training and treatment planning. The physical station consists of a custom-built frame into which laparoscopic trocars and surgical tools may be attached/inserted and which are continuously adjustable to various positions and orientations to simulate multiple laparoscopic surgical approaches. Instruments inserted through the trocars are attached to end effectors of two haptic devices and interfaced to a high speed PC with fast graphics capability. The haptic device transduces 3D motion of the two manually operated surgical instruments into slave maneuvers in virtual space. The slave instrument tips probe the simulated organ. Simulations currently in progress include: 1) Surface-only renderings, deformation, and haptic interactions with elements in the gall gladder surgical field; 2) Voxel- based simulations of the bulk manipulation of tissue; 3) laparoscopic herniorrhaphy. This system provides force feed-forward from the grasped tools to the contact tissue in virtual space, with deformation of the tissue by the virtual probe, and force feedback from the deformed tissue to the operator's hands.
Interactive Stereoscopic Full-Color Direct Volume Visualization for Virtual Reality Applications in Medicine
Authors: dos Santos Machado Liliane  , Calixto Cabral M´rcio  , Bittencourt Vidigal Leitao Ricardo  , de Deus Lopes Roseli  , Knörich Zuffo Marcelo
Published: February 2025

Only recently, advanced direct volume visualization techniques have been widely used due to the availability of low cost hardware accelerators; such techniques have a great potential of use for many applications of the virtual reality in medicine. We proposed and implemented a low cost system for interactive and stereoscopic 3D visualization of the full color visible human dataset. Potential use of the proposed system includes anatomical atlases and surgical simulators. A prototype of the proposed system is rendering full color volumes with 256×152×470 in real time (15-20Hz) with stereoscopy.
Development of an Experimental Paradigm In Which to Examine Human Learning Using Two Computer-Based Formats
Authors: Hoffman Helene M.  , Colt Henri G.  , Haas Ariel
Published: February 2025

Computer-based self-instructional programs are frequently promoted as means to augment or replace the traditional anatomy curricula taught in medical schools. These programs may range from static slide shows to fully immersive virtual environments. However, the impact of these learning technologies on knowledge acquisition, and their comparative cost/benefit to education remain unclear. As a consequence, we are embarking on a series of experiments to compare knowledge acquisition and the meaningful use of information among students who are learning anatomy using one of two different computer-based self-instructional formats. These studies will be based on a specially developed learning module on basic lung anatomy; they will utilize a variety of assessment tools to measure factual knowledge, conceptual understanding of spatial-anatomic relationships, and the ability to apply newly acquired knowledge of anatomy to clinical problem-solving scenarios. The primary object of this paper is to describe the design and development of the underlying test module and to outline the two computer-based formats that will be evaluated. The virtual reality (VR) environment, UCSD's Anatomic VisualizeR, provides dynamic access to 3-dimensional polygonal models of the lesson content and supports student-centered exploration and learning. The multimedia environment, Microsoft PowerPoint, provides a structured presentation of the lesson content and illustrates important anatomic structures through the use of 2-dimensional images derived by screen captures of models available in the VR learning module. This paper also provides an overview of the first experiment in the series, a pilot study using first-year medical students without previous participation in a medical school anatomy curriculum. For this study, students will be prospectively randomized into two groups, each group learning the lung anatomy lesson using one of the computer-based formats described. Immediate knowledge retention will be measured by asking students to complete the assessment instrument immediately after completing their learning module. The results of the pilot study will be used to refine and improve the design of the remainder of studies planned in this experimental series.