bluuebunny/crossref_metadata_2025 huggingface dataset:
3.1 Integrated Medical Application
Authors: KLEINHOLZ Lutz  , OHLY Martin  , KORCH Claudia  , EMMEL Dirk  , MÄRKLE Steffen
Published: February 2025

The Integrated Medical Application (IMA) gives the physician access to medical services and functionality from a single graphical desktop. The desktop offers services for the local and remote access to electronic patient records of hospitals, specialist clinics, and general practitioners. The distributed patient records within a hospital or practice are logically combined by means of a meta-patient record. A meta-patient record provides information about the local multimedia patient documents. In addition to basic data such as document type, location, and creation date, the record provides information concerning the document structure (see chapter “Multimedia Documents”).The information supplied by the meta-record from each practice and hospital can be combined to form the complete, virtual patient record. The management and access to each record and each document is carried out by the Open Distributed Management System (see chapter “Realization of an Open Distributed Management System”). An object-oriented model has been used throughout. Each local implementation of the record may be different, depending on the facilities of the local environment, but each presents the same external interface to the outside. This mechanism enables the scalable integration over a wide area of all patient documents. At present, the two implemented meta-records provide information and access to all the multimedia documents of the German Heart Institute and the University Hospital Rudolf Virchow departments of cardiology and radiology.
An Integrated Research Strategy for Improving Communication Systems for Severely Physically Impaired Non-speaking People
Authors: Alm Norman  , Newell Alan F.  , Arnott John L
Published: February 2025

Efforts to provide technical assistance to enable severely physically impaired non-speaking people to be able to communicate as effectively as unimpaired speakers have thus far been limited in their results. This is because human communication is a complex and rapid process, the physical mechanisms of which are not controlled consciously. Also the rules of human interaction through language are only imperfectly understood. There are a number of implications from this position for research to improve the situation. Such research must be multi-disciplinary, it must involve potential users as consultants and evaluators at all stages of the process, and it must take into account the whole range of social and personal functions which a communication system should assist with. This paper describes a research strategy which takes these points into account.
The Development of a Computer Animation Program for the Teaching of Lipreading
Authors: Bothe Hans-Heinrich  , Lindner Gerhart  , Rieger Frauke
Published: February 2025

In March 1991 a new interdisciplinary research project was launched at the Technical University of Berlin (TUB). The aim is to design a computer animation program showing realistic movements of an abstracted speaker's face. For this purpose, video tapes with prototypic speakers have been recorded and analyzed. The investigations lead to the fundamental correlation between phonetic sequences of given German text and corresponding visual movements of the articulation organs. The animation program is designed to be a training aid for lipreading for hearing-impaired people and is based on an open vocabulary. First performance evaluations at a hard-of-hearing school show that after a short-term crash-course the recognition of long single words increased by approx. 15% for a natural speaker. Involved in this project are the Departments of Electronics and Linguistics of the TUB as well as the Department of Special Education (in the field of Rehabilitation) of the Humboldt-University, Berlin. The project is based on various preliminary studies of the participating departments.
CARE PROTOCOLS AND HEALTHCARE INFORMATICS
Authors: Gordon C  , Herbertb S I  , Jackson-Smale A  , Renaud-Salis J-L
Published: February 2025

The paper describes a trans-national generic clinical protocol model designed using a blend of logic engineering and business modelling techniques as part of the CEC AIM programme's DILEMMA project. It will be used to implement protocol use in acute, primary and home care, including the support of shared care.
Sharing and reusing therapeutic knowledge for managing leukemic children
Authors: Quaglini Silvana  , Bellazzi Riccardo  , Stefanelli Mario  , Locatelli Franco
Published: February 2025

Managing complex medical problems requires the ability to execute different medical tasks: diagnosis, therapy planning and monitoring. Moreover, therapeutic plans have to be modified several times along the patient's progress according to his/her conditions. In this paper we propose a method useful both for representing the management knowledge and for individuating pieces of knowledge that can be shared and reused in a knowledge based system. The methodology is illustrated by using a challenging clinical example: the management of leukemic children.
ITVIC, AN INTELLIGENCE TEST FOR VISUALLY IMPAIRED CHILDREN
Authors: BOTER Roeland D.  , HOEKSTRA-VROLIJK Suzan A.
Published: February 2025

An intelligence test for blind and low vision children -aged 6 to 15 years- had been constructed and published in 1991. Based on a short vision test, two groups of braille educated children were distinguished: children without usable vision and children with usable vision. No blindfold is used in this test. The results of different types of statistical analyses have been published recently. Within this framework, more detailed quantitative research can be interpreted. The subtests appear to be highly reliable, and achievement in school can be predicted with some accuracy. Factor analysis indicates four interpretable factors in both vision groups. The vision groups -for which separate age-norms were establisheddiffered mainly on tests measuring spatial ability. A Manual in English is available.
The Legibility of TV-Subtitles for the Elderly and Visually Impaired
Authors: Neve J.J.  , Jenniskens A.J.W.
Published: February 2025

Many normally sighted elderly and visually impaired viewers have problems in reading TV-subtitles. We have investigated the influence of character size, contrast, luminance and presentation time on the legibility of subtitles for a group of normally sighted young and elderly subjects and a group of visually impaired subjects. For that purpose pairs of text lines were presented on a TV-monitor. For the partially sighted the text lines were presented against a smooth background and with the normally sighted a comparison was made between the legibility of text lines against a smooth background and text lines presented against a TV-scene background.
How should computers be used in the visual training of young visually impaired children?
Authors: BOZIC Nick
Published: February 2025

This paper outlines a recent study into one of the ways in which visual training software might be used in the classroom environment. The study highlighted the critical nature of the teacher’s role in the phrasing of questions and the grading of visual stimuli into different levels of complexity. The type of interaction described relies heavily on the techniques of task analysis. There is a discussion of the problems involved in this type of interaction.
The Therapeutic Toddler Group for Visually Impaired Pre-schoolers
Authors: VAN DER BURG Jan J.W.
Published: February 2025

Supplying emotional and instrumental support to parents in the education of their visually impaired pre-schooler is the main objective of early intervention. The early intervention program consists of parent counseling at home, parent courses and for some children the therapeutic toddler group. The main purposes of this group are longitudinal assessment and intensive stimulation. Next to its purposes, the entrance requirements, the planning of intervention and the daily routine in the therapeutic toddler group are described
VISUAL IMPAIRMENT AND EATING DISORDERS
Authors: van de Wege Anna J.
Published: February 2025

Visual impairment and eating disorders can be related. This has both theoretical and practical implications. Visually impaired women with an eating disorder suffer from a mild form of a dissociative disorder due to their visual handicap. For proper treatment contact between the “psychiatric” field (for the eating disorder) and the “ophthalmological” field is necessary.
EVALUATION OF THE EFFECTS OF SERVICE ASSISTANCE AT THE VISUAL ADVICE CENTRE EINDHOVEN (VAC)
Authors: Buijk C.A.
Published: February 2025

In September 1990 a Visual Advice Centre (VAC) was opened in Eindhoven in the south of the Netherlands.The first evaluation took place in 1992.
A Survey of the Utilization of Rehabilitation Services by the Visually Impaired Elderly Population
Authors: GRESSET Jacques  , BAUMGARTEN Mona
Published: February 2025

Data on the prevalence of visual impairment, and on the utilization of rehabilitation services were collected on a large sample consisting of 1800 people over age 65 living in the community. As in previous Statistics Canada surveys,- a visual disability was considered present if the answer to one of the following two questions was positive: Do you have trouble reading ordinary newsprint with glasses (if normally worn)? Do you have trouble clearly seeing the face of someone 12 feet away with glasses (if normally worn)? Prevalence of disability at near was 7.6%, prevalence of a distance disability was 4.4%, and prevalence of both types of disability was 3.5%. Among those with both disabilities, 11.4% received services from a rehabilitation center, 23.3% from an eye-care practitioner and 10.0% from a nonprofit agency. The overestimation of the prevalence of visual impairment by survey techniques has already been documented. However, the low utilization of rehabilitation services observed in this study raises questions concerning the respective role of general eye-care practitioners, community-based health centers and rehabilitation centers in the rehabilitative process of the visually impaired elderly.
DOMICILIARY FOLLOW UP IN LOW VISION CARE
Authors: Muirhead Paul
Published: February 2025

Low Vision in Australia is generally practiced in a clinical setting. The patient presents at a Low Vision Clinic and is treated by a multi-disciplinary team consisting of a consulting ophthalmologist, optometrist, social worker and occupational therapist.
Mapping the Topography of Residual Vision after Macular Vision Loss
Authors: Mackeben Manfred  , Colenbrander August
Published: February 2025

A novel approach to the assessment of residual vision in patients with maculopathies is described. It stresses finding intact areas of the retina that might be useful for re-learning to read using eccentric viewing. The test is implemented on an affordable off-the-shelf microcomputer and can yield results within minutes without discomfort to the patient. It uses a set of peripheral landmarks to stabilize gaze without foveation. Local responses of the visual field are tested using brief (234 msec) displays of letters or groups of letters. Preliminary results show that the test can be used with good reliability on a variety of patients with macular vision loss. Individual test data enable the low vision specialist to make clear and goal-directed recommendations to the patient regarding new viewing strategies that can help to make the best of residual vision.
A Perspective on the Use of Knowledge-based Systems, Model-based Diagnosis, and Interactive Multimedia Technology in Health Care
Authors: Horn Werner
Published: February 2025

This paper presents a perspective on the future use of knowledge processing and decision support in the health sector on a number of topics, namely the integration of decision support techniques into clinical information systems, use of model-based reasoning techniques, wide-spread use of information systems, multimedia information systems, and utilization of virtual reality technology.
The Five Commandments of KBS to Be Used in Daily Clinical Practice
Authors: de Zegher Isabelle  , Venot Alain  , de Rosis Fiorella
Published: February 2025

This paper attempts to identify the necessary features that make the difference between a KBS which will remain in its authors laboratory and a system that becomes really used, i.e a product. We illustrate these features with a prescribing optimization decision support system, called OPADE; this software is being developed in the setting of the AIM initiative and definitively aims at becoming a product used in daily clinical practice in several European countries. While developing the system, we purposedly take a pragmatical, product oriented approach, which may hurt by its simplicity. But it is our feeling that the only future of KBS is to prove that, even if simplified, it does work now.
Spectral Analysis of Fluctuations in Heart Rate and Blood Pressure
Authors: ROMPELMAN O.  , TENVOORDE B.J.
Published: February 2025

The analysis of very rapid fluctuations in heart rate (heart rate variability, HRV) and (systolic) blood pressure (BPV, Blood Pressure Variability) is hampered by the fact that neither the cardiac events, nor the systolic blood pressure values are regularly spaced in time. It is shown that the beat-to-beat variability in systolic blood pressure values is due to both the timing of these values (closely related to the cardiac event series) and an external influence. The well-known model for the SA-node, viz. the Integral Pulse Frequency Modulator (IPFM) appears to operate as an interface between continuously varying external influences and the irregularly spaced values of blood pressure. Three algorithms for the estimation of the spectrum of this external influence are introduced. On the basis of simulation studies it is discussed which method is to be favoured.
Equity and Improvement in Outcome of Breast Cancer in Denmark
Authors: Andreasen Arne H.  , Mouridsen Henning T.  , Andersen Knud West  , Lynge Elsebeth  , Madsen Mette  , Olesen Knud P.  , Blichert-Toft Mogens
Published: February 2025

The trend in the prognosis for female breast cancer patients was investigated by comparing Kaplan-Meier survival curves of different patient cohorts diagnosed during the period 1948-87. The study is based on 71,448 patients from the Danish Cancer Registry. The cohorts were defined by age at diagnosis, year of diagnosis, and residential area. The survival time from diagnosis nearly doubled from 1948-57 to 1978-87, the most important improvement taking place after 1978. Patients diagnosed in 1948-77 in the Copenhagen area had a far better prognosis than patients diagnosed during this period in other parts of Denmark. For patients diagnosed in 1978-87 the prognosis, however, reached an equal level in all parts of the country. Thus, it is reasonable to assume that the national programme introduced in 1977 by the Danish Breast Cancer Cooperative Group (DBCG) has played an important role and not only brought about therapeutic improvements in breast cancer treatment in Denmark, but also ensured equity in the outcome on a national scale.
BERTE - A Database for Children with Congenital Heart Defects
Authors: Hagemo Petter S.
Published: February 2025

To secure the follow-up of children with congenital heart defects in Norway the Dept. of Pediatric Cardiology has developed a tailor-made database. This also simplifies the regular flow of information about these patients both inside the hospital and between the hospital and the others who are in charge of the patient care on various levels.
Mechanical Characterization and Modelling of Human Costo-Vertebral and Costo-Transverse Articulations
Authors: AUBIN C.E.  , SAINT-CYR E.  , SKALLI W.  , DIOP A.  , KIEFFER G.  , DANSEREAU J.
Published: February 2025

Up to now, only one experimental study reported the mechanical properties of the global costo-vertebral (CV) and costo-transverse (CT) articulations. However, from this study, it was not possible to determine the specific contribution of each component of these articulations. Therefore, to complete the understanding of these articulations, more data were collected. Twelve different functional units (FU) composed of 2 adjacent vertebrae (T1-T2, T5-T6and T9-T10) and one corresponding rib were tested. A steel rod was inserted in the costal neck and used to give the following loads to the FU: normal to CT facet, cranial and caudal, as well as torsional loadings around the rod. Each FU was firstly loaded with most of ligaments intact, then with the CT joint ligaments removed (costal neck and head ligaments intact) and finally with only the costal head ligaments. For normal loads, results showed that CT joint ligaments represent 52% of the rigidity for FU T5-T6. The torsional rigidity was found to be almost the same for FU T9-T10nevertheless of the ligaments tested (4.95 Nm/rad ± 0.71 Nm/rad). Other results showed that the FU T5-T6is the stiffest, followed by FU T9-T10and FU T1-T2, which is in concordance with results published by Schultz et al.. Small dispersion of the results was observed in spite of the small amount of specimen tested. These preliminary results were used to calculate CV and CT mechanical properties needed for finite element modelling of these articulations. Simulations were performed with the model and adequation was found with experimental results.
Considerations on the Clinical Relevance of Photogrammetric Error in 3-D Reconstruction of the Spine Based on Routine X-Ray Films
Authors: MEROLLI Antonio  , TRANQUILLI LEALI Paolo  , AULISA Lorenzo
Published: February 2025

Three dimensional reconstruction methods generally obtain a very low photogrammetric error in the laboratory set-up but a this error may rise very high in the clinical environment where other factors are involved. Authors analyzed errors due to human factors, vertebral deformities or unusual spatial orientation, optical factors. A method is proposed to translate in clinical terms the absolute values of photogrammetric error to evaluate the clinical reliability of a stereophotogrammetric 3-D computer reconstruction.
Functional Evaluation of the Spine through the Analysis of Lateral Bending Test Kinematics by Mean of Non-Ionising Technique
Authors: D’AMICO Moreno  , GRILLET Christine  , MARIOTTI Sergio  , RONCOLETTA Piero
Published: February 2025

The recent development of non-ionising advanced real-time measurement systems which are able to provide a full 3-D reconstruction of the rachis both in static and in dynamic condition, has largely increased the number of biomechanical variables available for a more complete analysis of spinal function. A significant example of such an improvement concerns the possibility of quantifying the stiffness of the various spinal segments through the investigation of the whole set of kinematic variables defining the movement of the spine during a lateral bending test. The aim of this paper is to present and discuss the results of dynamic analysis obtained in our centre. After having performed a signal processing on the acquired raw data, the study of both linear and angular lateral bending trajectories has been performed on several subjects. This analysis by exploring both global and intersegmental motor behaviour has demonstrated to provide an easy but powerful and detailed description about the contribution to movement supported by each segment of the radius thus pointing out the spinal plasticity. Correlations between spinal deformities such as in the case of scoliosis located at various level of the vertebral column and related differences in various biomechanical variables have been shown. These information coupled to those obtained with the analysis of the standings has been very useful in order to proceed to clinical treatment.
Perceptions of Cosmetic Deformity in Scoliosis
Authors: MAHOOD JK  , MOREAU MJ  , HILL DL  , RASO VJ
Published: February 2025

Scoliosis causes complex deformities of the vertebra and rib cage that cascade into deformities of the trunk. The most important feature of scoliosis to those affected is this visible deformity. Instrumentation systems now attempt to improve both internal spinal alignment and external deformity. The deformity includes asymmetrical elevations of the shoulders and hips, prominence of a shoulder blade, a skin fold on the side of the concavity and a subtle twisting of the trunk. The aim of this study was to determine those features that reliably describe cosmetic appearance. Twenty subjects with spinal deformity ranging from none to severe were photographed in a relaxed standing position. Seven blinded evaluators, ranging from a lay person to an orthopaedic spine surgeon, subjectively scored their impression of the trunk appearance, shoulder height difference, shoulder angle asymmetry, decompensation, scapula asymmetry, waist crease, waist asymmetry and pelvic asymmetry. For each criterion, the evaluators placed a mark on a 50 mm line spanning worst to best. The distance to the mark was measured to the nearest millimeter to give a score from 0 to 50. Regression analysis was used with the latter seven features to predict the overall impression. Regression was also used to determine the relative weightings of the features. Although the evaluators gave a subject different scores, there was general agreement in ranking of the subjects (average Spearman’s rho = 0.61). To predict cosmetic impression, five of the seven evaluators chose scapula asymmetry as the best indicator (average r2= 0.58). The next best predictors were shoulder angle asymmetry (r2= 0.43) and waist asymmetry (r2= 0.41). All seven measures of the deformity predicted 85% of the overall impression. Scapula asymmetry, shoulder angle asymmetry and waist asymmetry contribute to 75% of the cosmetic deformity. Objective measures of deformity can be used to evaluate claims that spinal instrumentation improves trunk deformity.
Technical Error of Vertebral Rotation Measurements
Authors: WEISS HR
Published: February 2025

The measurement of vertebral rotation according to Perdriolle is widely used in the French-speaking and Anglo-American countries. Even in this measurement technique there may be a relatively high estimation error because of the not very accurate grading in steps of five degrees. The measurement according to Raimondi seems to be easier to use and shows a better accuracy with two-degree steps. The purpose of our study was to determine the effectivity of both common measuring methods. The apex vertebra of 40 curves on 20 ap-radiographs were measured by using the Perdriolle torsionmeter and the Regolo Raimondi. Interrater and intrarater reliability were computed. The thoracic Cobb angle was 43 degrees , the lumbar Cobb angle 36 degrees. The average rotation according to Perdriolle was 19.1 degrees thoracic (SD=11.14), lumbar 12.7 degrees (SD=11.21). Measurement of vertebral rotation according to Raimondi showed an average rotation of 20.25 degrees in the thoracic region (SD=11.40) and lumbar of 13.4 degrees (SD=10.92). The intrarater reliability was r=.991 (Perdriolle) and r=.997 (Raimondi). The average intrarater error was 1.025 degrees in the Perdriolle measurement and 0.4 degrees in the Raimondi measurement. Interrater error was at average 3.112 degrees for the Perdriolle measurement and 3.630 degrees for the Raimondi measurement. This shows, that both methods are useful tools for the measurement of vertebral rotation for the experienced clinician. The Raimondi ruler is easier to use and shows a slightly better reliability.
An Example of 3D Imaging for Clinical Support “ Bouclier Program ”
Authors: MOUILLESEAUX B.  , HECQUET J.  , EBERMEYER E.  , DAUNY G.  , GRAF H.
Published: February 2025

We have used for several years “RACHIS 91” software, yet presented in Montreal last meeting, in 1993. This program is able to achieve a 3D reconstruction of the scoliotic deformity from lateral and frontal x-rays of the full spine. The sight from above (axial view) is often difficult to understand for the physician. A new program has been performed as a clinical support : each torsional segment of the scoliotic spine can be placed in a part of the surface of a cylinder, built either since the lateral or the frontal plan : in this case, it looks like a shield. The torsional segment walks along the concave side of the shield, the length,the surface,the radius and arch of which materialise the spacial displacement of the scoliotic spine from the initial sagittal and medial plan ; the shield’s shape varies as the scoliosis, and the relation between the frontal and the sagittal size of its different parameters is an approach of a 3d measurement.
Technics and Preliminary Results Colorado
Authors: ROUSSOULY P.  , CHOPIN D.  , ROY C.  , DIMNET J
Published: February 2025

This article presents different concepts for the reduction of scoliosis. Biomechanical principles are applied to build a new tri-dimensional reduction material. This technic and the material are detailed. Results present an analyse on seventy patient with a stand back of at least 6 month.
Quality Assurance in Clinical Neurophysiology: the ESTEEM project example
Authors: Veloso M.  , Vingtoft S.  , Carvalho M.  , Fawcett P.  , Fuglsang-Frederiksen A.  , Johnsen B.  , Liguori R.  , Nix W.  , Otte G.  , Schofield I.  , Sales-Luís M.  , Sieben G.  , Vila A.
Published: February 2025

This paper describes the current status of the utilisation of clinical practice guidelines (protocols) in the ESTEEM project as one form of the clinical quality assurance procedures considered in the project. The performance of electrodiagnostic studies, in terms of which types of conclusions need to be inferred during the examination plan, is briefly described. The main focus of the paper is a description of an European multicentre clinical audit in the field of Clinical Neurophysiology, using a common data-entry protocol for prospective EMG case collection and assessment with the ultimate objective of building up a multicentre reference database of EMG cases.
Clinical practice should reflect clinical science
Authors: Gøtzsche Peter C.
Published: February 2025

The Cochrane Collaboration was set up in 1992 as a world-wide network for creating and disseminating systematic reviews of randomised controlled trials (RCTs) in healthcare. Systematic reviewing of RCTs is an essential stage, prior to the creation and dissemination of clinical guidelines, in the practice of evidence-based medicine. This paper is intended to provide the health telematics community with an introduction to the motives, aims and activities of the Cochrane Collaboration.
The Responsive Workbench
Authors: Fröhlich Bernd  , Krüger Wolfgang  , Grunst Gernoth  , Wesche Gerold
Published: February 2025

The paper describes the concept of the Responsive Workbench (RW). This virtual environment was designed to support end users working on desks, workbenches, and tables as physicians, architects and scientists with an adequate human-machine interface. We attempt to construct a task-driven interface for this class of users by working in an interdisciplinary team from the beginning.
Clinical Application of Pavlov Conditioning Reflexes in Treatment of Urinary Incontinence
Authors: Godec C.J.
Published: February 2025

A new method of treatment of urinary incontinence is described. A tape recorder with two outlets generates musical stimuli. One outlet brings direct unconverted musical stimuli to the patient's ear, the other outlet conveys the musical stimuli to a converter where the musical pulses are converted into electrical stimuli which are then applied to the patient's anus. At first simultaneous application of stimuli into the ear and anus is performed and anal pressure response recorded. After conditioning takes place, music is applied to the patient's ear, stimulation to the anus is disconnected, and only anal pressure response is recorded. The patients are conditioned enough to generate good anal response to aural stimulation only.
CAD Modeling of the Birth Process
Authors: Liu Y.  , Scudder M.  , Gimovsky M.L.
Published: February 2025

A rational and comprehensive approach for indicating when cesarean delivery (C/S) is necessary would result in a limitation in the overall maternal risks of childbirth as well as in the cost of health care. For this purpose, we are in the process of developing a set of computer aided design (CAD) models and a systematic and flexible simulation of the birth process. Different from the volume-based approach, our system provides three dimensional surface models of 1) the maternal bony pelvis obtained from digital radiographic images of computed tomographic (CT) pelvimetry and 2) fetal anatomy obtained from ultrasound images. Our modelling system and initial simulations bear many similarities to the results of assembly/disassembly planning research in robotics. Our initial result on generating the detailed CAD surface models is reported in this paper.
Contribution of Myocardial Collagen to the Left Ventricular Diastolic Pressure—Volume Relationship
Authors: Janicki Joseph S.
Published: February 2025

Collagen is a stiff structural material with a high tensile strength. While present in the myocardium in relatively small amounts, collagen is the most abundant structural protein of the heart’s connective tissue network. Removal of less than half of the normal amount of collagen results in a dilated ventricle with increased compliance. The hypertrophic response of the myocardium to an abnormal stress includes an increase in collagen concentration, a thickening of existing fibrillar collagen, and the addition of new collagen at all levels of the matrix. The consequence of this remodeling of the collagen matrix is a stiffer left ventricle with diastolic dysfunction. Thus, myocardial collagen is a major factor in determining the left ventricular diastolic pressure-volume relation.
Mechanisms of Large Ventricular Wall Shortening and Thickening
Authors: Waldman Lewis K.  , Costa Kevin D.
Published: February 2025

Although myofibers can shorten only about 10% during systole, shortening as great as 20% or more has been observed in the inner half of the heart wall. Concomitantly, subendocardial wall thickening may be 30% or more. Here, a finite element analysis is used to demonstrate that transmurally uniform fiber shortening is accompanied by a substantial transmural gradient in circumferential shortening that is essentially an inherent feature of a thick-walled, nearly incompressible continuum with relatively large circumferential curvature. The contributions of myofibers lying at various depths in the ventricular wall are examined by selectively deactivating them. Despite close to normal wall thickening when circumferential fibers are deactivated, ejection fraction is only about half of normal because the wall thickens the “wrong” way.
CAMI: Computer Assisted Medical Interventions
Authors: Cinquin P.  , Gerritsen F.  , Graf von Keyserlinck D.
Published: February 2025

CAMI is the only AIM project devoted to intra-operative image acquisition and processing, and its objective is intra-operative assistance to a surgeon. This clinical objective sets scientific and industrial challenges that were dealt with. Clinically tested solutions have been proposed; they integrate in classical Operating Theatres computer vision tools, such as 3D-localizers. The genericity of this approach has been proven, and is a key point in the future success of the clinical products that will come out of this project.
ISAR: Integration System Architecture
Authors: Beuscart Regis  , Modjeddi Bijan  , DeMeester Michel
Published: February 2025

The task of ISAR is to integrate in to the Hospital Information System (HIS) of the Lille University Hospital (Lille CHRU), several prototypes from the third framework programme. The objectives of ISAR are: (1) to demonstrate the technical and functional integration of these platforms in medical units, (2) to evaluate the technical quality of this integration, its usability and acceptance.
TANIT: Telematics for Anaesthesia and Intensive Therapy
Authors: Bowes Claire L.  , Holland Jos
Published: February 2025

On-going work relating to the development of advanced telematics systems for Critical Care environments is described. This work is in part sponsored by the Commission of European Communities under the AIM TANIT project (A2036). Two example departments have been selected for piloting in the project: Intensive Care and Anaesthesia. The objective of this paper is to outline the complex issues that need to be addressed when developing such systems.
MARGOT: Medical Archive Generation with Object-Oriented Techniques
Authors: Prigione F.
Published: February 2025

MARGOT aimed at the definition of an Object-Oriented model for Computerized Medical Records, and at the creation of a set of tools to support the model for editing and managing Patient Records, and for exchanging and integrating information between systems. Object-oriented technologies allows MARGOT to provide an immediate and flexible method of implementing Patient Records, building and inheriting attributes and functionality so as to provide services for specific purposes. The tools allow to build efficient interactive applications, with the following advantages: cost reduction, flexibility, better exchange and integration of medical records, encouragement to standardization.
Medical Informatics Education at Charles University under the Tempus-Phare Joint European Project
Authors: ZVÁROVÁ J.
Published: February 2025

The paper describes the EuroMISE Joint European Projects developed at Charles University in Prague. It is intended to create a teaching network of higher education in the fields of medical informatics, statistics and epidemiology.
Health Care Data Self-Determination: Fantasy or Real Possibility
Authors: Chaum D.
Published: February 2025

Various trends seem to be making protection of health care data, at the same time, both more difficult and more important. People are becoming more mobile and more concerned about computerization’s effect on privacy, while their expectations of positive uses of technology including quality of care are increasing. And concern over the escalating cost of health care has risen to be a major public issue. However the basis of a solution, it might be said, is in the cards!
Personal Health Card System in Japan
Authors: Ueda H.  , Kiyotani T.
Published: February 2025

Since 1987, personal health card system using IC card with 8KB memory has been developed in Japan by the Ministry of Health and Welfare (MHW). More than 20 projects have been tried by cities or hospitals in Japan. Most of them are relatively small in scale compared with the projects sponsored by MHW. Some of them do not use IC card but optical (laser) card. The outline of the personal card system in Himeji are described.
The Experience of the Introduction of Medical Cards in Italy
Authors: Cortellessa G.
Published: February 2025

Two points should be raised concerning the activity for the introduction of medical cards in Italy. The first one is related to standardisation of the information to be stored on medical cards. The Italian body in charge of the standardisation in all the fields, has a Commission on Medical Informatics that has created a working group, parallel to the corresponding CEN European group. The working group is coordinated by the author of the present abstract. The group has reached a first conclusion that the medical card should be composed of three parts: personal identification parameters, emergency-urgency personal data, oriented clinical data. These three parts will be discussed in some detail. The second part will be the illustration of field activity in Italy, essentially centred around the use of optical cards. It will be shown that this activity goes far beyond the experimental phase, being already an operative tool that includes the building of specialistic medical data bases and the use of telecommunications.
Developing The Security Culture At The SEISMED Reference Centres
Authors: Fowler John
Published: February 2025

The paper gives a brief summary of the SEISMED project and the particular role played by the Reference Centres. Details are given of the hardware and application systems in use in the Royal Hospitals (NHS) Trust (RHT), one of the SEISMED Reference Centres. It proposes, without verification, a definition of a “Security Culture based on three criteria. These are suggested to be the “Awareness” the “Acceptance” and the “Actions” of the management and staff to improve Information Systems Security throughout the RHT. The way that “Awareness” was increased is shown by the specific initiatives commenced as a result of a CRAMM Risk Analysis and the management and staff training programmes. The specific initiatives mentioned include, an Information Systems Security Policy, a contingency and disaster recovery plan, improvements in the physical protection of equipment and changes to the method of access control. The “Acceptance” by the staff of theses measures is considered and the success or failure of “Developing A Security Culture” examined. The role of SEISMED in this process is assessed.
The EUROMEDIES EDI Prototype System
Authors: Pramataris K.  , Doukidis G.  , Giaglis G.  , Raptakis J.
Published: February 2025

EDI is expected to be the dominant form of business communication between organisations moving to the Electronic Commerce era of 2000. The healthcare sector is already using EDI in the hospital supply function as well as in the clinical area and the reimbursement process. In this paper, we examine the use of EDI in the healthcare administration sector and move specifically its application to the Medical Devices Vigilance System. At a first place, the potential of this approach is examined, after an initial brief presentation of the EDI concept and its application in healthcare. This presentation is followed by an overall description of the EDI prototype system, which was developed in the context of the EUROMEDIES Concerted Action, in order to facilitate the requirements definition phase.
Virtual Reality Enhanced Surgical Conference System
Authors: Oyama Hiroshi  , Wakao Fumihiko  , Sekiguchi Ryuzo  , Ohmatsu Hironobu
Published: February 2025

We present our ongoing work on an enhanced surgical conference system with a technology of virtual reality (VR). We reported on a surgical simulation support system by using a technology of virtual reality last year. In the present time, while using our VR simulation system, we realized that many surgeons and nurses needed to see both a solid real image and a virtual image of the surgical operation at the same time. According to this reason we added a solid video system to our previous VR simulation system. The new system can display both real and virtual images on 100 inch wide screen and a console monitor of Onyx computer. The doctors can see both images with shutter glasses on the screen or console. We can now simulate various cancer surgery while watching the real solid surgical picture.
Real-Time Visually and Haptically Accurate Surgical Simulation
Authors: Reinig Karl D.  , Rush Charles G.  , Pelster Helen L.  , Spitzer Victor M.  , Heath James A.
Published: February 2025

The Visible Human Database provides a complete submillimeter photographic and radiological description of both a male and a female cadaver. The Center for Human Simulation has developed real-time algorithms that allow a user to wield a virtual scalpel and produce arbitrary cuts into the reconstructed body. Real-time interaction is achieved by producing the appropriate texture mapped surfaces directly from the Visible Human Database. We are currently combining a 3 degree of freedom PHANToM haptic device (SensAble Devices) with our surgical cutting algorithms to produce a system with the look and feel of surgical cutting.
Virtual Environments Technology To Aid Needle Biopsies of the Breast
Authors: Fuchs Henry  , State Andrei  , Livingston Mark  , Garrett William  , Hirota Gentaro  , Whitton Mary  , Pisano Etta
Published: February 2025

The ease of use and effectiveness of ultrasound image-guided surgical procedures might be improved by observing single or multiple echographic views properly positioned “within” the patient. Several computer hardware and visualization technologies have to be extended and combined in order to build a system in which such visualizations are available in real time, e.g., during the ultrasound imaging of the patient.
VOLUMETRIC ANALYSIS AND SURFACE RECONSTRUCTION FOR ANATOMICAL STRUCTURE MODELLING
Authors: Malkani Karan  , Chédot Claire  , Sequeira Jean
Published: February 2025

This paper presents a new approach for providing consistent anatomical structure models based on a geometrical description and on topological features. Volumetric and surfacic techniques are combined to make the best use of the knowledge we have about the object.
INDIRECT CONE-BEAM THREE-DIMENSIONAL IMAGE RECONSTRUCTION
Authors: Grangeat Pierre  , Sire Pascal  , Guillemaud Régis  , La Valérie
Published: February 2025

Fully three-dimensional image reconstuction is a major challenge for new tomographic devices in radiology and nuclear medicine. The use of a 2-D detector such as a radiographic image intensifier or an Anger camera provides series of 2-D projections which are processed by the reconstruction software to compute the unknown 3-D image. In cone-beam geometry, all the projection lines converge to a same focal point. This geometry provides a zoom effect. But dedicated reconstruction algorithms are needed since a given line crosses several volume slices. In this chapter, we give an overview of cone-beam reconstruction algorithms, with a special emphasis on transform methods and in particular on indirect algorithms via the Radon domain. We summarize the mathematical framework, and we provide some experimental results using the RADON software. Next, we consider two specific research topics in cone-beam reconstruction which are the processing of the shadow zone in the Radon domain associated with a circular acquisition trajectory and the reconstruction of a region of interest within the object using either a dual magnification acquisition or a multifocal geometry.
ELECTRON TOMOGRAPHY OF BIOLOGICAL SPECIMENS
Authors: Marabini Roberto  , San Martin M. Carmen  , Carazo Jose M.
Published: February 2025

This chapter addresses the issue of three-dimensional reconstruction of biological macromolecules from electron microscopy images. First, the electron microscope device, the micrographs as specimen projections and the projection collection geometry are discussed. After that, a brief introduction to the problems involved in sample preparation and observation is made. In a third section the different three-dimensional reconstruction methods are presented, and finally, the chapter finishes with an example in which a protein is reconstructed starting from micrographs and ending with a nice and very informative volume.
A System for the Management of Epidemiologic Data
Authors: Pourabbas Elaheh  , Rafanelli Maurizio
Published: February 2025

This paper describes a system for the management of epidemiologic data. By this system it is possibile to simulate the dynamic of the disease in order to define the epidemic or endemic natural trend of a disease by the computation of some epidemiological parameters. The schema of the designed system is proposed. The conditions for the elimination of an infection are given, as well as the identification process of the parameters. Finally, the computation of a coefficient which gives the effectiveness of the intervention proposed by the health manager is described.
A Regional, Secure Cancer Documentation System for an Optimal “Shared Care” in Oncology
Authors: Blobel Bernd
Published: February 2025

By example of the highly labour-shared care of cancer patients, the “Shared Care” concept and its support by a regional distributed tumor documentation system will be described. The necessary security measures will be dealt with. Network-based as well as chipcard-based systems will be considered. The principal statements concerning open healthcare information systems will be illustrated by actual and by future realizations in the Magdeburg/Saxony-Anhalt Cancer Register. The activities are part of research projects, funded by the European Commission and the German federal country of Saxony-Anhalt. Finally some remarks will be made on the Saxony-Anhalt Telematics Initiative.
A Commercial Workstation for Laboratory Hematology
Authors: Diamond LW  , Nguyen DT  , Lima M  , Simón R  , Aoutka SB
Published: February 2025

A commercial hematology workstation with a laboratory information system, instrument interfaces, and knowledge-based systems for peripheral blood and flow cytometry, is in use in three hospitals in Spain and Portugal. The workstation, valuable in laboratory management, teaching, and research, features an electronic textbook and a video camera for capturing microscopic images.
Conversion Table between ICD-9 and ICD-10
Authors: Zaiss A.  , Schulz S.  , Graubner B.  , Klar R.
Published: February 2025

In January 1998 encoding of the diagnoses of all inpatient will change from ICD-9 to ICD-10. This necessitates the conversion of ICD-9 codes to ICD-10 codes and vice versa for different purposes. We present a first version of conversion tables between ICD-9 and ICD-10 for interactive use by physicians. The basic method to construct these tables was a modified vector space text retrieval method using word stems. Stemming was done by a lexicon based method on all available textes for ICD-9 and ICD-10. The first output was an automatic generated list of weighted mappings which was filled up by published mappings. Finally the list was revised manually. Doing this took us three months to generate the presented tables. The main results are: direct mapping from ICD-9 to ICD-10 can be done in 65%, from ICD-10 to ICD-9 in 85%. The next version of the tables will have an improved quality, a higher rate of direct mappings from ICD-10 to ICD-9 and more marked automatic mappings and will be released at the end of 1996. Then it should be possible to convert ICD-10 codes automatically into ICD-9 codes. It seems impossible to map from ICD-9 to ICD-10 automatically. The presented vector space text retrieval method is also very helpful to encode complete diagnosis or treatment phrases e.g. direct out of the discharge summary into a corresponding classification.
Evaluation of Clinical Workstations
Authors: Hofmann Karin  , Gräber Stefan  , Flaig Monika
Published: February 2025

The University Hospital of Saarland plans to equip all wards with clinical workstations. Therefore we started tests with two different commercial systems to evaluate their advantages and disadvantages in our environment. We compiled a list of required functions and developed a grading system for the assessment of the functionality. In this paper we present the grading scheme and discuss the results of the evaluation.
Evaluation of the Scottish Clinical Audit Project Register, A Computerised Database System
Authors: Audish Karima  , KINN Sue  , Gregson Karen
Published: February 2025

For the past six years clinical audit in Scotland has been administered and promoted by the Clinical Resource and Audit Group (CRAG) at the Scottish Office in Edinburgh. Traditionally, information about local audit projects was submitted to CRAG as typed reports, which were not widely available to audit staff. We have worked with CRAG to develop the Register, a computerised database system to collect and disseminate audit-related information at a national level. The system was piloted in March 1994 and distributed to all Health Boards and Trusts in Scotland to allow users to enter and then later update details of their audit projects. The Scottish Clinical Audit Resource Centre receives data from each Health Board and Trust and then produces and distributes an up to date version of the Register. The system was evaluated in June 1995 using a postal questionnaire sent to all users in Scotland.