bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of In Vivo Vertebral Growth Modulation by Shape Memory Alloy Staples on a Porcine Model for the Correction of Scoliosis
Authors: Wakula Yaroslav  , Parent Stefan  , Villemure Isabelle
Published: February 2025

Introduction: Scoliosis progresses within a biomechanical process involving asymmetrical vertebral loading and growth modulation. There is a growing interest in fusionless technique of vertebral stapling for the correction of scoliosis, as it presents less surgical risks and complications than the traditional fusion surgery.
Evaluation of Finger and Hand Dexterity in Idiopathic Scoliosis
Authors: Mihaila Dana  , Calancie Blair
Published: February 2025

Aims: The ethiopathogenesis of idiopathic scoliosis (IS) deformity has not yet been established. There is evidence suggesting that an abnormality in central nervous system (CNS) development may play a role. Our previous work has demonstrated functional anomalies of spinal innervation by axons of the corticospinal tract (CST) in some subjects with IS. This led us to predict that hand/finger dexterity would be lower in subjects with IS, because the monosynaptic projections of CST axons to cervical motoneurons are crucial for the control of dexterous finger and hand movements.
Could Brace Treatment Influence the Flexibility and Curve Correction of Adolescent Idiopathic Scoliosis?
Authors: Liu Wen-Jun  , Qiu Yong  , Sun Xu  , Qian Bang-ping  , Liu Zhen  , Shu Hao  , Wang Xin-hua  , Sun Chao
Published: February 2025

Introduction: Bracing is the most commonly used non-operative treatment for skeletally immature patients with adolescent idiopathic scoliosis (AIS) with a mild or moderate curve. However, the influence of brace treatment on curve flexibility has not been reported in the literature.
Converting the SRS-24, SRS-23 and SRS-22 to the SRS-22r: Establishing Conversion Equations using Regression Modeling
Authors: Riazi Mariam  , Burton Doug C.  , Lai Sue-Min  , Carlston Brandon  , Asher Marc A.
Published: February 2025

Introduction: The SRS-24 outcomes measure was designed to allow monitoring of scoliosis patients health-related quality of life. Introduced in 1999 it fulfilled a need and was widely used. A number of improvements in the questionnaire's psychometric properties produced a sequence of three improved editions. This resulted in the need to establish, if possible, conversion equations to the last edition, SRS-22r. Our purpose is to assess the feasibility of translating similar domain scores from SRS-24, SRS-23 and SRS-22 to SRS-22r.
Normal juvenile girls and boys: evidence suggesting central controls for energy allocation to skeletal development of girls differ from boys which, in dysfunction, may predispose girls to adolescent idiopathic scoliosis (AIS)
Authors: Burwell R. Geoffrey  , Aujla Ranjit K.  , Randell Tabitha L.  , Dangerfield Peter H.  , Moulton Alan
Published: February 2025

Introduction. Trunk asymmetry in normal children becomes evident in juvenility, earlier in girls than boys. It is likely that AIS in girls is also initiated in juvenility.
Design and Measurement of an In Vitro Torque Device in Ox-Tails
Authors: Rizza R.  , Liu Xue C.  , Thometz J.  , Tassone C.  , Lyon R.
Published: February 2025

Introduction: In adolescent idiopathic scoliosis patients, the vicious cycle hypothesis proposed by Dr. Stokes suggests, a lateral spinal curvature produces asymmetrical loading of the skeletally immature spine, which in turn causes asymmetrical growth and therefore progressive wedging deformity. Numerous studies have been done to evaluate the effect of sustained compression-tension loading on spinal growth. However, the previous study did not have independent control of torque and bending moments.
Discriminative Ability of 8 New Surface Features Describing Rib Cage Deformity in Scoliosis
Authors: Emrani Mahdieh  , Hill Doug  , Parent Eric  , Watkins Elise
Published: February 2025

Design: Retrospective study
Nickel Ion Level in Scoliotic Patients Implanted with Nitrogen Plasma Surface Modified Nickel-titanium Superelastic Spinal Implant: Preliminary Clinical Trial Results
Authors: Yeung K.W.K.  , Lam W.N.  , Natarajan D.  , Wu S.L.  , Tu H.  , Chu P.K.  , Chung C.Y.  , Lu W.W.  , Luk K.D.K  , Cheung K.M.C.
Published: February 2025

Nickel-titanium (NiTi) shape memory alloys have been used as surgical implants in orthopaedic procedures. However, nickel ion release remains a concern. Therefore, an advanced surface technology using plasma immersion ion implantation (PIII) has been developed to address this issue. This paper describes serum nickel ion level monitoring of patients with scoliosis operated upon using nitrogen plasma implanted NiTi spinal rods compared with standard titanium alloy rods in a randomized human clinical trial. NiTi spinal rods with 50.8% Ni were treated by nitrogen PIII at 40kV with 100Hz. Seventeen patients with spinal scoliosis were surgically treated by either Ti alloy rods or nitrogen plasma implanted NiTi rods. The mean age at operation was 16.6 years. The mean number of treated spinal segments was 9. Blood samples were collected as baseline before surgery and up to 1 year post-surgery. Nickel levels were assayed by inductively coupled plasma mass spectrometry. Twelve patients (7M and 5F, 6=NiTi and 6=Ti) were followed up for 6 months, and five of them (2M and 3F, 2=NiTi and 3=Ti) had completed 1-year follow-up. In all cases, at Day 1 after surgery, patients who had NiTi rods implanted had a 2.5 times increase in the Ni level, compared with before surgery. However, all were within recommended safe limits. The Ni levels returned to baseline in all subjects between 7 days to 1 month postsurgery. No clinical signs and symptoms of Ni allergy or toxicity was observed.
Developing the Maastricht Brace with Pressure Measurements
Authors: Hermus J.  , Hulsbosch M.  , Arts C.  , Rhijn L.V.
Published: February 2025

Introduction: Pressure measurements are being used to understand the brace working mechanism, because the forces exerted by a brace cause correction of the scoliotic curve. Wiley et al reported that a group of patients who were not compliant to wearing their brace had significantly less correction of the curve at brace delivery than patients who wear their brace permanent or temporarily.
Finite Element Comparison of Different Growth Sparring Instrumentation Systems for the Early Treatment of Idiopathic Scoliosis
Authors: Driscoll Mark  , Aubin Carl-Éric  , Moreau Alain  , Parent Stefan
Published: February 2025

Fusionless growth sparring implants seek to restore spinal alignment through the early intervention of pediatric scoliosis. Amongst a growing number of concepts, the stainless steel (SS) staple, flexible tether and shape memory alloy (SMA) staple have demonstrated their validity by retarding convex vertebral growth while modifying spinal alignment. The purpose of this study was to explore the biomechanics of these devices in a human scoliotic finite element model (FEM) constructed from patient data. A FEM of a scoliotic anterior spine (28° thoracic curve) was developed to include growth dynamics and shown to represent typical scoliotic progression. The explored implant concepts were alternatively introduced around the apical vertebra of the FEM (T5–T9). Immediate impact (asymmetrical loading of the vertebral growth plates and correction of scoliotic curve) and long term impact (correction of scoliotic curve after 2 years of growth) were simulated and compared to the behavior of the non-instrumented model and patient data. Results of the difference in asymmetrical growth plate stress between instrumented and non-instrumented models reveal: insignificant initial impact by the SS staple, a 52% reduction with the flexible tether, and a 31% reduction with the SMA staple. Initial and long term modifications of coronal spinal alignment following simulated growth was respectfully 28° to 62°in non-instrumented model and patient data, 28° to 31° with SS staple, 23° to 31° with flexible tether, and 27° to 34° with SMA staple. The interpretation of such methods suggests that the long term correction, achieved via growth modulation, would benefit from improved control of asymmetrical stresses within the growth plates. From a biomechanical perspective, fusionless growth sparring techniques for the early treatment of idiopathic scoliosis show promising preliminary results.
Using Multi-Agent Based Simulation in an IDSS for Evaluating Performance in Flow-shop Manufacturing System
Authors: Taghezout Noria  , Zarate Pascale
Published: February 2025

This paper presents an approach which takes into account robustness and flexibility of a real time scheduling, by integrating agents into an IDSS. The proposed system mainly includes six components: Resource Agent (RA), Planning Agent (PA), Performance Evaluation Agent (PEA), Database Management Agent (DMA), Rules and Criteria Selection Agent (RCSA) and User interface Agent (UIA). The multi-agent simulation is used to allow agents to cooperate with an intelligent behaviour, and to coordinate their goals and action plans to solve a problem. We use UVA methodology to calculate the production costs. This method provides the enterprise with new information on its performances, the profitability of its customers, markets, product, which will generate decisions in all business functions for a permanent progress. One objective of this work is to demonstrate that the UVA method is not an accounting method of repartition and that it is built on the choice of one measuring unit and one specific analysis approach. Experimental results demonstrate that the proposed IDSS could implement effective production control decision-making for solving the flow-shop manufacturing system. The study reports the basic design principles of the system as well as details of the application.
Uses of Ontologies in Open Source Blog Mining
Authors: Ulicny Brian  , Kokar Mieczyslaw M.  , Matheus Christopher J.
Published: February 2025

The blogosphere provides a novel window into an important segment of public opinion, but its dynamic nature makes it an elusive medium to analyze and interpret in the aggregate, where it is most informative. We are developing a new open-source blog mining technology that employs ontologies to solve this problem by fusing the signals of the blogosphere and zeroing in on issues that are most likely to migrate offline. This technology is designed to enable analysts to anticipate the threats or opportunities these issues represent in a timely and efficient fashion.
Grid based Evaluation of a Liver Segmentation Method for Contrast Enhanced Abdominal MRI
Authors: Specovius Svenja  , Siewert René  , Doege Juliane  , Schnapauff Dirk  , Denecke Timm  , Krefting Dagmar
Published: February 2025

Recent developments in MRI contrast agents give new perspectives in radiological diagnosis and therapy planning, but require specific image analysis methods. By employment of an academic research grid, we are currently validating and optimizing a recently developed fully automatic method for liver segmentation in Gd-EOB enhanced MRI. The grid enables extensive parameter scans and evaluation against expert's reference segmentation. The implementation layout and so far reached results are presented. Furthermore, experiences made in the production phase and consequences resulting for the exploitation of publicly funded research grids for Healthgrid applications are given.
HIV-K: an Integrative Knowledge Base for Semantic Integration of AIDS-related Malignancy Data and Treatment Outcomes
Authors: Tirado-Ramos A.  , Saltz Joel  , Lechowicz Mary Jo
Published: February 2025

Technological innovations such as web services and collaborative Grid platforms like caGrid can create opportunities to converge the worlds of health care and clinical research, by facilitating access and integration of HIV-related malignancy clinical and outcomes data at more sophisticated, semantic levels. At the same time, large numbers of randomized clinical trial and outcomes data on AIDS-defining malignancies (ADM) and non-AIDS-defining malignancies (nADM) have been produced during the last few years. There is still much work to do, though, on obtaining clear conclusions from the integration of such information. This is a white paper on work in progress from Emory University's HIV/AIDS related malignancy data integrative knowledge base project (HIV-K). We are working to increase the understanding of available clinical trial data and outcomes of ADM such as lymphoma, as well as nADM such as anal cancer, Hodgkin lymphoma, or liver cancer. Our hypothesis is that, by creating prototypes of tools for semantics-enabled integrative knowledge bases for HIV/AIDS-related malignancy data, we will facilitate the identification of patterns and potential new overall evidence, as well as the linking of integrated data and results to registries of interest.
Cell Nucleus Architecture in Health and Medicine: Geometrical Descriptors and Their Use in Grid Based Case Studies
Authors: Schmitt Eberhard  , Müller Patrick  , Stein Stefan  , Schwarz-Finsterle Jutta  , Hausmann Michael
Published: February 2025

Adopting the world wide accessible Grid computing power and data management structures enables usage of large image data bases for individual diagnosis and therapy decisions. Here, we define several descriptors of the genome architecture of cell nuclei which are the basis of a detailed analysis for conclusions on the health state of an individual patient. All these descriptors can be accessed by automatic inspection of microscopic images of fluorescently labelled nuclei, obtained from cells from tissue sections or blood and subjected to standard biochemical protocols. We demonstrate how the combinatorial, geometrical and statistical parameters may be used in diagnosis and therapy monitoring.
A Survey of Grid Knowledge and Grid Perception in the Public Sector
Authors: Zhou Xin  , Appleton Owen  , Müller Henning
Published: February 2025

Grids have been developed to enable computational or data intensive scientific applications and to share resources. Existing infrastructures can benefit other possible user groups. This qualitative survey focuses on the public sector with universities, governments and hospitals. Interviews were performed to collect information on the perception of Grids by decision makers, system administrators and high level users in the sector. Application scenarios and main barriers for Grid adoption are discussed based on the users' and institutional interests.
Phylogenetic Code in the Cloud – Can it Meet the Expectations?
Authors: Kraut Adam  , Moretti Sébastien  , Robinson-Rechavi Marc  , Stockinger Heinz  , Flanders Dean
Published: February 2025

Cloud computing has recently become very popular, and several bioinformatics applications exist already in that domain. The aim of this article is to analyse a current cloud system with respect to usability, benchmark its performance and compare its user friendliness with a conventional cluster job submission system. Given the current hype on the theme, user expectations are rather high, but current results show that neither the price/performance ratio nor the usage model is very satisfactory for large-scale embarrassingly parallel applications. However, for small to medium scale applications that require CPU time at certain peak times the cloud is a suitable alternative.
Magnesium Forging Technology: State-of-the-Art and Development Perspectives
Authors: Sillekens W.H.  , Kurz G.  , Werkhoven R.J.
Published: February 2025

This paper summarises the current situation and knowledge on magnesium forging as well as its prospects for further development. It is structured according to the sequential areas of the processing chain: feedstock, forging process, finishing, and components. Attention is given to some specific metallurgical aspects of magnesium forging and the resulting mechanical properties. Further, the weight-saving potential of magnesium forgings over conventional solutions (notably in aluminium), prospective application areas (especially for transport means), demonstrator components and costs are addressed.
Touchscreen Task Efficiency and Learnability in an Electronic Medical Record at the Point-of-Care
Authors: Landis Lewis Zach  , Douglas Gerald P.  , Monaco Valerie  , Crowley Rebecca S.
Published: February 2025

The objective of this study was to determine the relative efficiency of novices compared to a prediction of skilled use when performing tasks using the touchscreen interface of an EMR developed in Malawi. We observed novice users performing touchscreen tasks and recorded timestamp data from their performances. Using a predictive human performance modeling tool, the authors predicted the skilled task performance time for each task. Efficiency and rates of error were evaluated with respect to user interface design. Nineteen participants performed 31 EMR tasks seven times for a total of 4,123 observed performances. We analyzed twelve representative tasks leaving 1,596 performances featuring six user interface designs. Mean novice performance time was significantly slower than mean predicted skilled performance time (p < 0.001). However, novices performed faster than the predicted skilled level in 208 (13%) of successful task performances. These findings suggest the user interface design supports a primary design goal of the EMR – to allow novice users to perform tasks efficiently and effectively.
Can F-MTI semantic-mined drug codes be used for Adverse Drug Events detection when no CPOE is available?
Authors: Merlin Béatrice  , Chazard Emmanuel  , Pereira Suzanne  , Serrot Elisabeth  , Sakji Saoussen  , Beuscart Régis  , Darmoni Stefan
Published: February 2025

Background: Adverse Drug Events (ADEs) endanger the patients. Their detection and prevention is essential to improve the patients' safety. In the absence of computerized physician order entry (CPOE), discharge summaries are the only source of information about the drugs prescribed during a hospitalization. The French Multierminology Indexer (F-MTI) can help to extract drug-related information from those records. Methods: In first and second validation steps, the performance of the F-MTI tool is evaluated to extract ICD10 and ATC codes from free-text documents. In third step, potential ADE detection rules are used and the confidences of those rules are compared in several hospitals: using a CPOE vs. using semantic mining of free-text documents, diagnoses and lab results being available in both cases. Results: The F-MTI tool is able to extract ATC codes from documents. Moreover, the evaluation shows coherent and comparable results between the hospitals with CPOEs and the hospital with drugs information extracted from the reports for potential ADE detection. Conclusion: semantic mining using F-MTI can help to identify previous cases of potential ADEs in absence of CPOE.
Querying the National Drug File Reference Terminology (NDFRT) to Assign Drugs to Decision Support Categories
Authors: Simonaitis Linas  , Schadow Gunther
Published: February 2025

Introduction: The accurate categorization of drugs is a prerequisite for decision support rules. The manual process of creating drug classes can be laborious and error-prone. Methods: All 142 drug classes currently used at Regenstrief Institute for drug interaction alerts were extracted. These drug classes were replicated as fully-defined concepts in our local instance of the NDFRT knowledge base. The performance of these two strategies (manual classification vs. NDFRT-based queries) was compared, and the sensitivity and specificity of each was calculated. Results: Compared to existing manual classifications, NDFRT-based queries made a greater number of correct class-drug assignments: 1528 vs. 1266. NDFRT queries have greater sensitivity (74.9% vs. 62.1%) to classify drugs. However, they have less specificity (85.6% vs. 99.8%). Conclusion: The NDFRT knowledge base shows promise for use in an automated strategy to improve the creation and update of drug classes. The chief disadvantage of our NDFRT-based approach was a greater number of false positive assignments due to the inclusion of non-systemic doseforms.
Ontology Based Modeling and Execution of Nursing Care Plans and Practice Guidelines
Authors: Din Muzammil Abdulrehman  , Abidi Syed Sibte Raza  , Jafarpour Borna
Published: February 2025

Nursing Care Plans (NCP) and Nursing Clinical Practice Guidelines (NCPG) promote evidence-based patient care, but in their paper form they are difficult to be applied at the point-of-care. We present our approach to generate patient-specific nursing care plans by modeling and computerizing these nursing knowledge resources. We present a Nursing CarePlan Ontology (NCO) that models the NCP and NCPG to realize an integrated knowledge base for designing and executing patient-specific nursing CarePlans. We adapted METHONTOLOGY methodology for ontology engineering to develop our OWL-based NCO, and instantiated a set of NCP and NCPG. We have developed an execution engine that provides recommendations to nurses based on the patient's data. NCO was successfully evaluated for representational accuracy and completeness using a set of test NCP and NCPG.
Why GPs do not follow computerized guidelines: an attempt of explanation involving usability with ASTI guiding mode
Authors: Séroussi B.  , Bouaud J.  , Sauquet D.  , Giral P.  , Cornet P.  , Falcoff H.  , Julien J.
Published: February 2025

Clinical decision support systems (CDSSs) have the potential to increase guideline adherence, but factors of success are not well understood. ASTI-GM is an on demand guideline-based CDSS where the user interactively characterizes her patient by browsing the system knowledge base to obtain the recommended treatment. We conducted a web-based evaluation of ASTI-GM as a before-after study to assess whether the system improves general practitioners' (GPs) performance and how they would use it. Five clinical cases had to be solved, as usual in the before phase, and using ASTI-GM in the after phase. On a 2-month period, 266 GPs participated and 1,981 prescription orders were collected. The overall guideline adherence rate increased from 27.2% to 64.3%. Only 56.4% of ASTI-GM uses corresponded to a “good use” of the system. Adherence increased from 28.5% to 86.1% in the sub-group of “good uses”, whereas it only increased from 28.1% to 36.6% in the complementary sub-group. Reasons for non “good uses” of CDSSs should be investigated since they impede their potential impact.
Evaluation of Methods for Bolus Arrival Time Determination using a Four-dimensional MRA Flow Phantom
Authors: Säring Dennis  , Forkert Nils Daniel  , Illies Till  , Fiehler Jens  , Handels Heinz
Published: February 2025

In this paper an evaluation of methods determining the bolus arrival time (BAT) using a four-dimensional flow phantom to simulate 4D MR angiography is presented. Spatiotemporal 4D MRA images were acquired for analyzing the hemodynamic characteristics of cerebral vessel anomalies. Model-independent and model-dependent methods for BAT extraction are published. Generally, for the evaluation no gold standard exists and datasets with known BAT values are required. Here, a 4D flow phantom is generated based on a synthetic 3D MRA dataset with BAT values defining the time point of blood inflow for each voxel. Then, voxel-by-voxel concentration-time curves based on the gamma-variate function were computed leading to a simulated 4D MRA dataset. Additionally, partial volume effects and Gaussian noise were integrated. The simulated 4D MRA was visually inspected and regarded as similar to clinical data. Finally, phantom datasets with different vessel diameter and signal-to-noise ratio are computed. Three state-of-the-art methods were used to extract BAT values. Computed and known values were compared. The results suggest that model-dependent approaches perform better than the model-independent method.
Designing a Concept for an IT-Infrastructure for an Integrated Research and Treatment Center
Authors: Stäubert Sebastian  , Winter Alfred  , Speer Ronald  , Löffler Markus
Published: February 2025

Healthcare and medical research in Germany are heading to more interconnected systems. New initiatives are funded by the German government to encourage the development of Integrated Research and Treatment Centers (IFB). Within an IFB new organizational structures and infrastructures for interdisciplinary, translational and trans-sectoral working relationship between existing rigid separated sectors are intended and needed. This paper describes how an IT-infrastructure of an IFB could look like, what major challenges have to be solved and what methods can be used to plan such a complex IT-infrastructure in the field of healthcare. By means of project management, system analyses, process models, 3LGM2-models and resource plans an appropriate concept with different views is created. This concept supports the information management in its enterprise architecture planning activities and implies a first step of implementing a connected healthcare and medical research platform.
A Usability Study of Patient-friendly Terminology in an EMR System
Authors: Hong Yi  , Ehlers Kevin  , Gillis Rick  , Patrick Timothy  , Zhang Jin
Published: February 2025

Misunderstandings due to terminology differences between health care providers and consumers may cause communication problems and adversely affect consumer access to health information, resulting in poor satisfaction for patients and providers. To investigate the usage patterns of consumer health vocabulary and evaluate controlled terminologies used in electronic medical records, we conducted a usability study of patient-friendly terms used in an ambulatory electronic medical record (EMR) and associated patient web portal. After identifying 340 unique diagnosis term / patient-friendly term pairs, we mapped the term pairs determined by UMLS to be pairs of synonyms, near-synonyms, or closely-related terms to the keywords of search queries extracted from a consumer health information web portal to learn the comparative frequency of use of members of each pair by consumers. We found out that use of patient-friendly terms could help to bridge the language gap between providers and consumers but not always. In some cases the professional diagnosis terms were used more frequently than their patient-friendly counterparts, typically in cases where the professional terms were more simple or common than the patient-friendly terms.
Method for testing a CPOE system in the medication process in a cardiology ward
Authors: Nøhr Christian  , Sørensen Marianne  , Kushniruk Andre
Published: February 2025

Medication errors are of major concern in most countries. The European PSIP project aims to identify and prevent medication errors by enabling data mining and designing contextualized decision support functionalities using a human factors engineering approach. To create a basi understanding of the work practice in the medication process members of the staff in a cardiology department in a Danish hospital were asked to take pictures of their workplace. The pictures were used as a memory trigger in a subsequent interview. Furthermore a video based observation of a full day of work was carried out. In this paper the methodological considerations and experiences are presented and discussed.
Developing a User-centered Voluntary Medical Incident Reporting System
Authors: Hua Lei  , Gong Yang
Published: February 2025

Medical errors are one of leading causes of death among adults in the United States [1]. According to the Institute of Medicine, reporting of medical incidents could be a cornerstone to learn from errors and to improve patient safety, if incident data are collected in a properly structured format which is useful for the detection of patterns, discovery of underlying factors, and generation of solutions. Globally, a number of medical incident reporting systems were deployed for collecting observable incident data in care delivery organizations (CDO) over the past several years. However, few researches delved into design of user-centered reporting system for improving completeness and accuracy of medical incident collection, let alone design models created for other institutes to follow. In this paper, we introduce the problems identified in a current using voluntary reporting system and our effort is being made towards complete, accurate and useful user-centered new reporting system through a usability engineering process
CEDRIC: A Computerized Chronic Disease Management System for Urban, Safety Net Clinics
Authors: Ogunyemi Omolola  , Mukherjee Sukrit  , Ani Chizobam  , Hindman David  , George Sheba  , Ilapakurthi Ramarao  , Verma Mary  , Dayrit Melvin
Published: February 2025

To meet the challenge of improving health care quality in urban, medically underserved areas of the US that have a predominance of chronic diseases such as diabetes, we have developed a new information system called CEDRIC for managing chronic diseases. CEDRIC was developed in collaboration with clinicians at an urban safety net clinic, using a community-participatory partnered research approach, with a view to addressing the particular needs of urban clinics with a high physician turnover and large uninsured/underinsured patient population. The pilot implementation focuses on diabetes management. In this paper, we describe the system's architecture and features.
Interoperability prototype between hospitals and general practitioners in Switzerland
Authors: Alves Bruno  , Müller Henning  , Schumacher Michael  , Godel David  , Abu Khaled Omar
Published: February 2025

Interoperability in data exchange has the potential to improve the care processes and decrease costs of the health care system. Many countries have related eHealth initiatives in preparation or already implemented. In this area, Switzerland has yet to catch up. Its health system is fragmented, because of the federated nature of cantons. It is thus more difficult to coordinate efforts between the existing healthcare actors. In the Medicoordination project a pragmatic approach was selected: integrating several partners in healthcare on a regional scale in French speaking Switzerland. In parallel with the Swiss eHealth strategy, currently being elaborated by the Swiss confederation, particularly medium-sized hospitals and general practitioners were targeted in Medicoordination to implement concrete scenarios of information exchange between hospitals and general practitioners with a high added value. In this paper we focus our attention on a prototype implementation of one chosen scenario: the discharge summary. Although simple in concept, exchanging release letters shows small, hidden difficulties due to the multi-partner nature of the project. The added value of such a prototype is potentially high and it is now important to show that interoperability can work in practice.
eHealth in Thailand: The current status
Authors: Kijsanayotin Boonchai  , Kasitipradith Narong  , Pannarunothai Supasit
Published: February 2025

The World Health Organization (WHO) defines eHealth as the use of information and communication technologies (ICT) for health. Thailand is one of the leading countries in emerging and developing economy that the use of ICT applications is pervasive including eHealth. However, the status of eHealth in Thailand hasn't been assessed. Employing the WHO global Observatory for eHealth development model and its instrument, this study describes the uptake of eHealth foundations and the extent of eHealth applications and services implemented in the country. A group of the nation 18 eHealth experts met and evaluated country eHealth status and provided recommendations. The results show that the development of the country's eHealth foundations is inadequate and need to be the priority for national eHealth development.
Symptoms from Patients as the Primary Information Source for Real-time Surveillance
Authors: Johansen Monika Alise  , Johnsen Jan-Are Kolset  , Shrestha Neema  , Bellika Johan Gustav
Published: February 2025

The aim of this study was to identify whether patients could become the primary data source for symptom based real-time surveillance. The study investigated people's attitude towards providing symptom information electronically before a consultation, and how they preferred to carry out the reporting. Data was collected by distributing questionnaires to 83 respondents. The results show that 96 percent of the respondents had a positive attitude towards providing information about their symptoms to the GP's office as soon as possible after falling ill. Over half of the respondents preferred to use e-mail or a web-interface to perform this task. Eighty four percent were willing to have their symptom data stored in their EPR and 76 percent agreed that the GP might access and present the symptoms together with the prevalence of matching diseases in order to assist the diagnostic process during the next consultation. This study indicates that patients could become the primary data source for symptom based surveillance in countries with high e-readiness.
Improving general practice based epidemiologic surveillance using desktop clients: the French Sentinel Network experience
Authors: Turbelin Clément  , Boëlle Pierre-Yves
Published: February 2025

Introduction: Web-based applications are a choice tool for general practice based epidemiological surveillance; however their use may disrupt the general practitioners (GPs) work process. In this article, we propose an alternative approach based on a desktop client application. This was developed for use in the French General Practitioners Sentinel Network. Methods: We developed a java application running as a client on the local GP computer. It allows reporting cases to a central server and provides feedback to the participating GPs. XML was used to describe surveillance protocols and questionnaires as well as instances of case descriptions. An evaluation of the users' feelings was carried out and the impact on the timeliness and completeness of surveillance data was measured. Results: Better integration in the work process was reported, especially when the software was used at the time of consultation. Reports were received more frequently with less missing data. This study highlights the potential of allowing multiple ways of interaction with the surveillance system to increase participation of GPs and the quality of surveillance.
IMPACT: A generalisable system for simulating public health interventions
Authors: Buchan Iain  , Ainsworth John  , Carruthers Emma  , Couch Philip  , O'Flaherty Martin  , Smith Duncan  , Williams Richard  , Capewell Simon
Published: February 2025

Populations are under-served by local health policies and management of resources, partly because of a lack of realistically complex models to enable a wide range of potential options to be appraised. Rising computing power coupled with advances in machine learning and healthcare information now enables such models to be constructed and executed. However, such models are not generally accessible to public health practitioners because they do not have the requisite technical knowledge or skills. This paper presents a system for creating, executing and analyzing the results of simulated public health and healthcare policy interventions, which is more accessible and usable by modellers and policy-makers alike.
Trust – Can it be controlled?
Authors: Box Debra  , Pottas Dalenca
Published: February 2025

Trust is an important component in the security of an information system. The advent of the electronic health record (EHR) and the health information system (HIS) have raised it to greater prominence. These systems and their intended benefits are rendered less effective through a low level of trust between the stakeholders. The potential reciprocal relationship between accountability and trust is investigated. A literature study examines both concepts and their interrelationship. The accountability and audit controls provided by the NIST SP 800-53 security guide and the ISO 27799 security standard are extracted, collated and expanded to strengthen the accountability mechanisms within an HIS security program. A dedicated set of accountability controls (NIM) which is specific to the healthcare environment is produced. It is proposed that through the strengthening of the accountability function of the HIS, its level of trustworthiness may be improved
Why don't innovation models help with informatics implementations?
Authors: Ward Rod
Published: February 2025

This paper describes various models that have been postulated to understand and explain the acceptance and diffusion of technological innovation. The wide range of factors relating to the innovation itself, and, most importantly, the human and organisational factors which will impinge on these processes, is detailed. Attempts to apply the model to healthcare settings are explored. In particular a systematic review in 2005 which attempted to integrate the models and apply them in the UK's National Health Service will be critiqued. The strengths and weaknesses of the models are explored, particularly in relation to the minimal testing they have been subjected to. It is argued that the complexity of the theoretical models makes them difficult to apply and questions their efficacy in supporting informatics implementations. The need for a clearer understanding of the factors which make staff positively disposed towards informatics innovation, and those which are likely to make them resist them is made apparent.
Analyzing effects of providing performance feedback at ward rounds on guideline adherence – The importance of feedback usage analysis and statistical control charts
Authors: Abu-Hanna Ameen  , Eslami Saeid  , Schultz Marcus J.  , de Jonge Evert  , de Keizer Nicolette F.
Published: February 2025

Objective: Feedback to clinicians on their past performance is often aimed at increasing adherence to guidelines. We investigate how various analytical approaches influence the interpretation of adherence data. The analytical approaches vary in considering the actual or the intended use of the feedback, and whether outcomes are inspected over time. Material and Methods: At base line, a computerized decision support system was employed at the ICU bedside to increase adherence to a mechanical ventilation strategy. We intervened by providing feedback about adherence to the guideline at the daily ward rounds. The outcome measure was the percentage of ventilation time (VT) in excess of the guideline's recommendation. Actual usage of the feedback was logged and data analysis was carried out using two approaches: classical statistics, and statistical process control (SPC) that inspect progress of an outcome over time. Design: Prospective, before/after study.
AALIM: A Cardiac Clinical Decision Support System Powered By Advanced Multi-modal Analytics
Authors: Amir Arnon  , Beymer David  , Grace Julia  , Greenspan Hayit  , Gruhl Daniel  , Hobbs Allen  , Pohl Kilian  , Syeda-Mahmood Tanveer  , Terdiman Joseph  , Wang Fei
Published: February 2025

Modern Electronic Medical Record (EMR) systems often integrate large amounts of data from multiple disparate sources. To do so, EMR systems must align the data to create consistency between these sources. The data should also be presented in a manner that allows a clinician to quickly understand the complete condition and history of a patient's health. We develop the AALIM system to address these issues using advanced multimodal analytics. First, it extracts and computes multiple features and cues from the patient records and medical tests. This additional metadata facilitates more accurate alignment of the various modalities, enables consistency check and empowers a clear, concise presentation of the patient's complete health information. The system further provides a multimodal search for similar cases within the EMR system, and derives related conditions and drugs information from them. We applied our approach to cardiac data from a major medical care organization and found that it produced results with sufficient quality to assist the clinician making appropriate clinical decisions.
Bridging the HL7 Template – 13606 Archetype gap with Detailed Clinical Models
Authors: Goossen William T.F.  , Goossen-Baremans Anneke
Published: February 2025

The idea of two level modeling has been taken up in healthcare information systems development. There is ongoing debate which approach should be taken. From the premise that there is a lack of clinician's time available, and the need for semantic interoperability, harmonization efforts are important. The question this paper addresses is whether Detailed Clinical Models (DCM) can bridge the gap between existing approaches. As methodology, a bottom up approach in multilevel comparison of existing content and modeling is used. Results indicate that it is feasible to compare and reuse DCM with clinical content from one approach to the other, when specific limitations are taken into account and precise analysis of each data-item is carried out. In particular the HL7 templates, the ISO/CEN 13606 and OpenEHR archetypes reveal more commonalties than differences. The linkage of DCM to terminologies suggests that data-items can be linked to concepts present in multiple terminologies. This work concludes that it is feasible to model a multitude of precise items of clinical information in the format of DCM and that transformations between different approaches are possible without loss of meaning. However, a set of single or combined clinical items and assessment scales have been tested. Larger groupings of clinical information might bring up more challenges.
Automatically Detecting Medications and the Reason for their Prescription in Clinical Narrative Text Documents
Authors: Meystre Stéphane M.  , Thibault Julien  , Shen Shuying  , Hurdle John F.  , South Brett R.
Published: February 2025

An important proportion of the information about the medica tions a patient is taking is mentioned only in narrative text in the electronic health record. Automated information extraction can make this information accessible for decision support, research, or any other automated processing. In the context of the “i2b2 medication extraction challenge,” we have developed a new NLP application called Textractor to automatically extract medications and details about them (e.g., dosage, frequency, reason for their prescription). This application and its evaluation with part of the reference standard for this “challenge” are presented here, along with an analysis of the development of this reference standard. During this evaluation, Textractor reached a system-level overall F1-measure, the reference metric for this challenge, of about 77% for exact matches. The best performance was measured with medication routes (F1-measure 86.4%), and the worst with prescription reasons (F1-measure 29%). These results are consistent with the agreement observed between human annotators when developing the reference standard, and with other published research.
Characterizing Consumer Health Terminology in the Breast Cancer Field
Authors: Messai Radja  , Simonet Michel  , Bricon-Souf Nathalie  , Mousseau Mireille
Published: February 2025

Despite the large availability of medical information on the Internet, health consumers still encounter problems to find, interpret and understand this information. These problems are mainly due to their lack in medical knowledge and the difference between their language and the language of health professionals. In order to propose information retrieval services more adapted to health consumers language and knowledge, we have developed techniques to collect, identify and analyze the terms and the expressions used by lay persons to talk about breast cancer. The study of health consumers' language is a relatively recent research field. Many studies have been conducted to analyze and characterize the vocabulary used by health consumers to talk about medical subjects in English. We have conducted the same study for the French language in the breast cancer field. We have gathered a corpus of texts to identify terms and expressions used by health consumers who talk about breast cancer in French. The terms have been organized in a concept-based terminology. This terminology has been analyzed on several levels: concept level, term level, term-concept level and finally relation level.
Efficient Explanations for Inconsistent Constraint Sets
Authors: Felfernig Alexander  , Schubert Monika  , Mandl Monika  , Friedrich Gerhard  , Teppan Erich
Published: February 2025

Constraint sets can become inconsistent in different contexts. We are interested in identifying minimal sets of constraints that have to be adapted or deleted in order to restore consistency. In this paper we sketch a highly efficient divide-and-conquer based diagnosis approach which identifies minimal sets of faulty constraints in a given over-constrained problem. This approach is specifically applicable in scenarios where the efficient identification of leading (preferred) diagnoses is crucial.
Nested Monte-Carlo Expression Discovery
Authors: Cazenave Tristan
Published: February 2025

Nested Monte-Carlo search is a general algorithm that gives good results in single player games. Genetic Programming evaluates and combines trees to discover expressions that maximize a given evaluation function. In this paper Nested Monte-Carlo Search is used to generate expressions that are evaluated in the same way as in Genetic Programming. Single player Nested Monte-Carlo Search is transformed in order to search expression trees rather than lists of moves. The resulting program achieves state of the art results on multiple benchmark problems. The proposed approach is simple to program, does not suffer from expression growth, has a natural restart strategy to avoid local optima and is extremely easy to parallelize.
Discovering an Event Taxonomy from Video using Qualitative Spatio-temporal Graphs
Authors: Sridhar Muralikrishna  , Cohn Anthony G.  , Hogg David C.
Published: February 2025

This work proposes a graph mining based approach to mine a taxonomy of events from activities for complex videos which are represented in terms of qualitative spatio-temporal relationships. A Hidden Markov Model to obtain stable qualitative spatial relations from noisy measurements is introduced. The effectiveness of the approach is demonstrated through experimental results for a complex aircraft turnaround apron scenario.
Dynamic Matching with a Fall-back Option
Authors: Gujar Sujit  , Parkes David C.
Published: February 2025

We study dynamic matching without money when one side of the market is dynamic with arrivals and departures and the other is static and agents have strict preferences over agents on the other side of the market. In enabling stability properties, so that no pair of agents can usefully deviate from the match, we consider the use of a fall-back option where the dynamic agents can be matched, if needed, with a limited number of agents from a separate “reserve” pool. We introduce the GSODAS mechanism, which is truthful for agents on the static side of the market and stable. In simulations, we establish that GSODAS dominates in rank-efficiency a pair of randomized mechanisms that operate without the use of a fall-back option. In addition, we demonstrate good rank-efficiency in comparison to a non-truthful mechanism that employs online stochastic optimization.
Constraint Based Planning with Composable Substate Graphs
Authors: Gregory Peter  , Long Derek  , Fox Maria
Published: February 2025

Constraint satisfaction techniques provide powerful inference algorithms that can prune choices during search. Constraint-based approaches provide a useful complement to heuristic search optimal planners. We develop a constraint-based model for cost-optimal planning that uses global constraints to improve the inference in planning.