bluuebunny/crossref_metadata_2025 huggingface dataset:
Classification of protein patterns using neural networks: pixel based versus feature based approach
Authors: Vargas J.R.  , Bologna G.  , Appel R.D.  , Hochstrasser D.F.  , Pellegrini C.
Published: February 2025

We present a new approach for classifying images produced using two-dimensional polyacrylamide gel electrophoresis (2D-PAGE). In traditional approaches, features representing proteins are first detected in the images and quantified. The corresponding features are then matched across the images. In a final step, classification programs are used on the matched features. Protein detection, quantification, and matching are usually considered to be the problem areas of the classification process because they are subject to many errors and imprecisions. The approach described in this paper is original in that feature extraction and matching are not needed. Classification is carried out using artificial neural networks in a three steps process. First, the 2D-PAGE images are aligned with each other using a polynomial warping method. Second, a multiresolution pyramid is generated for each aligned image. Third, one resolution level is selected and fed into a neural network. Results and performance are discussed and compared with other methods.
Statistical survey of the follow-up study of 200 rehabilitation patients
Authors: Pérez Nicolasa  , Carmen Moreno M$^{\underbar{{\rm a}}}$  , Magdaleno Rocío
Published: February 2025

After several years of experience in the field of visual rehabilitation, we felt it was necessary to assess the patients’ use of optical aids. Do they use the optical aids? Are the optical aids for near vision more successful than the aids for distance? Does the use of the optical aids depend on factors such as age, job activity, etc.?
New Ergonomic Stand Magnifiers
Authors: Spitzberg Larry A.  , Goodrich Gregory L.
Published: February 2025

These new ergonomically designed stand magnifiers offer a more comfortable viewing angle, the capacity for both reading and writing, a wider field of view, more illumination, and also variable power. These four new magnifiers are a spherical mirror magnifier, a cylindrical mirror magnifier, a reflecting prism magnifier, and a variable power zoom magnifier. These units have been developed and clinically tested on low vision patients at five clinical testing sites. Results show that 29 out of 39 patients picked one of the new magnifiers as their device of choice over a comparable commercial stand magnifier.
Video Enhancement of Text and Movies for the Visually Impaired
Authors: Peli Eli  , Fine Elisabeth M.  , Pisano Kathleen
Published: February 2025

Image enhancement has been demonstrated to improve face recognition and increase reading speed in the visually impaired. Previous studies used still, monochrome (black and white) images processed off line. We are now able to apply the adaptive enhancement algorithm in real time to color video movie segments and scrolled text. Low vision patients with central vision loss were evaluated using either moving video segments or scrolled text. Subjects had a subjective appreciation for the enhanced video, as well as measurable improvement in perception of information such as facial expression and fine scene details. However, subjects from this same patient population showed no statistically significant increase in reading speed for similarly enhanced text. The latter result is in contrast to previous studies.
Reading with Hand Magnifiers
Authors: Fotinakis Vassilis P  , Dickinson Chris M
Published: February 2025

Nine normally-sighted subjects read aloud text using two hand magnifiers of different power at two different eye-to-lens distances for each magnifier, in an attempt to assess the limitations that magnifiers impose on the reader. The reading speed of the subjects was measured and their reading eye movements were recorded on paper by means of Infra-Red Oculography. The data showed that reading speed declined significantly with increasing magnification, while the effect of a shorter eye-to-lens distance was not statistically significant. It is argued that increasing magnification reduces the number of letters conceived by the reader in each fixation during reading. In contrast to the “staircase” eye movement pattern observed in normal reading, a “saw-tooth” pattern was observed when the magnifiers were used, featuring smooth leftward eye movements in the place of fixation pauses. The results imply that despite being essential for the visually-impaired, magnification will limit their reading speed, while the adoption of a “saw-tooth” eye movement pattern may not be beneficial for aged low vision patients, as its components (saccades and smooth eye movements) are adversely affected by age.
Developing visual training programs on an IBM PC compatible microcomputer
Authors: Vallender Mike
Published: February 2025

This paper examines the potential of a typical IBM PC compatible microcomputer as a tool for visual training work with young visually impaired children. There is a discussion of how the choice of machine can influence such factors as the image resolution, possible range of displayed colours and speed of animation. Examples of the range of peripherals which can be used to affect a display are given. From the point of view of writing appropriate software several points are made: mention is made of the level of programming skill required to produce a typical program; the desirability of writing framework programs; and the ways in which programs can be designed for ease of control. Programs developed at the Research Centre for the Education of the Visually Handicapped are used to illustrate the points made.
Meet the elderly
Authors: VERSTRATEN Peter
Published: February 2025

There is an increasing number of older blind and visually impaired people. Rehabilitation facilities should be created, adapted or at least be made accessible to the elderly. For those who work with the older visually handicapped some basic gerontological knowledge is essential.
Benefits to Clients arising from the Provision of Audiology Services within the Low Vision Clinic
Authors: OSBORN Richard  , MYERS Carolyn
Published: February 2025

The Association for the Blind’s Low vision Clinic provides services to a largely aged population. It has been well documented that the prevalence of hearing loss in this population is high. The incorporation of audiology and aural rehabilitation services into the Low Vision Clinic’s program has delivered a number of benefits to its clients. These benefits will be described in terms of, i) immediate assistance provided and ii) longer term advantages. The former includes the provision of an appropriate acoustic environment in the clinical rooms, and ensuring that clients have suitable amplification available during their interviews and assessments. The longer-term advantages include improved communication following provision of hearing aids, supplementary listening devices and appropriate training. Clients access to available information and participation in the Association’s rehabilitation programs is considerably enhanced by this improved communication.
Evaluation of Low Vision Rehabilitation Using Individual Program Plans
Authors: MYERS Carolyn
Published: February 2025

Successful rehabilitation hinges on the person with vision impairment establishing and achieving positive goals. At the Association for the Blind Low vision clinics, all clients discuss the reasons why they have accessed the services and their expectations of the outcomes. The Individual Program Plans are the directions for intervention for all the rehabilitation services provided by the multi-disciplinary team. The evaluation, a review of the service is client focussed.
Rehabilitation of Visually Impaired Children in China
Authors: Bao-Chen SUN  , Shi-Yuan ZHANG
Published: February 2025

Based on the results of the 1987 National Sample Survey, the prevalences of blindness and low vision in children were 0.42% and 0.43% respectively, or around 250,000 visually impaired children in this country. The chief causes of blindness and low vision, according to analysis of 390 cases, were hereditary/congenital eye diseases in 189 cases (48.46%), ametropia/amblyopia in 70 cases (17,95%), corneal diseases in 40 cases (10.26%), and optic nerve lesions in 27 cases (6.29%). 173 (44.36%) cases needed rehabilitation services. Among the visually impaired children 6 to 14 years of age, 57.14% were not attending schools in 1987. Since 1988, integrated education for visually impaired children has been advocated and promoted in China.
Comparison of Heart Rate Spectral Analysis with Cardiac Noradrenaline Spillover and Muscle Sympathetic Nerve Activity in Human Subjects
Authors: KINGWELL B.A.  , THOMPSON J.M.  , McPHERSON G.A.  , KAYE D.M.  , JENNINGS G.L.  , ESLER M.D.
Published: February 2025

Heart rate variability in the 0.1 Hz frequency range has been reported to provide a non-invasive measure of sympathetic activity, however the technique has not been validated for the quantification of differences in sympathetic activity between individuals. We compared 0.1 Hz power with cardiac noradrenaline spillover and muscle sympathetic nerve activity in conditions of sympathetic denervation, including pure autonomic failure and after cardiac transplantation, and in the context of sympathetic nervous activation, in cardiac failure and in relation to ageing and during application of mental stress and isometric exercise. While there was agreement between techniques in pure autonomic failure and early after transplantation, disparity between spectral analysis and the more direct indices of sympathetic function were obtained for cardiac failure and ageing. Among healthy subjects, in whom measurements were made simultaneously, there was no significant correlation between 0.1 Hz power in either absolute units or normalised for total power and the rate of noradrenaline spillover from the heart to plasma. Heart rate variability clearly provides a functional measure of cardiac sympathetic mechanisms which is dependent on post-synaptic aspects of neural function, in addition to rates of sympathetic nerve firing. One particular application of heart rate spectral analysis in neurophysiological research might be in combination with the cardiac noradrenaline spillover technique, allowing more comprehensive assessment of both neuronal and post-synaptic aspects of the cardiac neuroeffector response.
Spectral Analysis of Blood Pressure and Heart Rate in Patients with Myocardial Infarction
Authors: LOMBARDI F.  , SANDRONE G.  , TORZILLO D.  , MALLIANI A.
Published: February 2025

In 16 patients two weeks after the first uncomplicated myocardial infarction and in 10 control subjects we analyzed heart rate and systolic arterial pressure variabilities. During resting controlled conditions, patients presented an increased LF component of RR and systolic arterial pressure variabilities and a diminished HF component of RR variability. These changes were consistent with a sympathetic excitation and with a reduced vagal tone. The gain of baroreceptive mechanisms was assessed by analyzing the relationship between the spontaneous oscillations present in RR and systolic arterial pressure variabilities in the LF and HF frequency range and was found to be smaller in post-myocardial infarction patients than in control subjects. This non-invasive approach seems therefore capable of providing important information on the alteration on neural mechanisms controlling heart period and vasomotion after myocardial infarction.
Evaluation of a 3D Geometrical Spinal Model
Authors: GODILLON A.P.  , LEPOUTRE F.X.  , CHOPIN D.
Published: February 2025

This paper presents the different factors which introduce errors during the construction of a 3D spinal model from radiographic data. The influence of the orientation of the radiographic plate is shown as well as the significance between the vertical and horizontal orientations. The digitization procedure introduces errors and the imprecision of the data points is evaluated. The final source of error which is analysed is in model building. A comparison is made between a reference spine and its model.
The Prognostic Significance of Changes in Deformities Following Brace in Patients with Ais: Analysis According to Curve Pattern
Authors: UPADHYAY S.S.  , NELSON I.W.  , LUK K.D.K.  , HO E.K.W.  , HSU L.C.S.  , LEONG J.C.Y.
Published: February 2025

Eighty-five patients with adolescent idiopathic scoliosis treated with Milwaukee or Thoracolumbo-sacral Orthosis (TLSO) were studied longitudinally at 4-6 months interval till maturity or up to the termination of brace treatment in whom brace failed and they went on to have surgery. Changes in post-brace Cobb angle and vertebral rotation were considered as an increase or reduction only when there was an increase or reduction of minimum 5° or more from their pre-brace measurements. These changes were analyzed with respect to the final outcome of brace treatment. Those patients who showed an increase in vertebral rotation and/or in Cobb angle by 5° or more following brace application were shown to have progression of curves leading to brace failure (13 out of 14 patients, 93% failure) and 11 of these (79%) required surgery. The patients with no change in both vertebral rotation and Cobb angle following brace were also largely resulted into brace failure (9 out of 13 patients, 69%). Two patients (15%) required surgery. Therefore, no change in these two measurements or increase in one/both led to brace failure in 81% of patients with a high incidence of surgery. These patterns of changes are mainly confined to thoracic and double major scoliosis. Reduction in one (Cobb angle/vertebral rotation) and no change in the other, following an application of brace was present in 28 patients and 64% of these had good outcome. Two patients (7%) with these changes required surgery. Our results show that reduction of both Cobb angle and vertebral rotation after application of a brace is a prognostic indicator for a good outcome (29 out of 30 patients showed good results or 97%), and none of them required surgery. Most of the patients with lumbar scoliosis (91%) showed such reductions. We found that reduction in both vertebral rotation and Cobb angle following a brace application is an accurate predictor of good outcome, when increase in one or both indicates a failed outcome. This gives a prediction accuracy of 95%.
Survey on Three Years of Practical Work Using Moiré-Topography for the Early Diagnosis of Scoliosis, Hump Back, Flat Back and Funnel Chest
Authors: NEUGEBAUER Hermann  , WINDISCHBAUER Gerhard
Published: February 2025

Moiré-techniques have been developed further for measuring the three dimensional shape of men. Optical methods making use of moiré-figures are well suited for the early detection of scoliosis. The poster will give a survey on some hundred patients examined in the Wirbelsäulenzentrum Wien during the last three years. The experience coming out of this practical work in scoliosis diagnosis may be of interest to all working in this field.
A New Concept for a 3-D Bracing System in the Treatment of Idiopathic Scoliosis
Authors: LABELLE Hubert  , Le BLANC Martin  , DANSEREAU Jean  , RIVARD Charles-Hilaire  , GIRARDIN Guy  , DE GUISE Jacques
Published: February 2025

The concept of a flexible orthotic system made of soft tissue material for the treatment of idiopathic scoliosis is presented. The aims of this device are to provide active “derotational” correction forces on the trunk while preserving normal sagittal curves and allowing near normal mobility of the spine. Preliminary evaluation with 3-D reconstructions of the spine and rib cage deformity in one patient indicate that this concept may be helpful to provide correction of small or moderate and supple curves.
Force Feedback and Medical Simulation
Authors: Jackson Bernie G.  , Rosenberg Louis B.
Published: February 2025

This paper discusses the technical design considerations of high-fidelity haptic interface hardware for medical virtual reality. Though few such systems are commercially available, this type of hardware is critical for the medical VR industry, because many medical procedures rely heavily on haptic cues. A brief listing of new off-the-shelf solutions from Immersion Corp. is included.
Virtual Reality Assisted Surgery Program
Authors: Robb Richard A.  , Cameron Bruce
Published: February 2025

We are developing a system called Virtual Reality Assisted Surgery Program (VRASP) for implementation into the hospital operating room (OR). VRASP will give the surgeon flexible computational support intraoperatively. It will permit modification and control of very large scan datasets in real time. It will render and transmit virtual imagery in response to the surgeon's commands without interfering with normal surgical activities. And it will register the displayed imagery simultaneously with respect to the surgeon and the patient, without computing or display lag. The project is designed in three phases: 1) surgery planning, 2) surgery rehearsal and 3) surgery delivery. The first phase has been implemented, and significant experience has been gained to facilitate effective design and implementation of the second and third phases.
Multinational Studies with the World Organisation of Gastroenterology and Telegastro
Authors: de Dombal Francis T.
Published: February 2025

In the last twenty years, the World Organisation of Gastroenterology has developed considerable experience in multinational studies involving epidemiology of various gastrointestinal complaints. In the last three years, this experience has been supplemented by the development of a telematics product via the Telegastro Project of the European Union Commission. This presentation discusses briefly the experience gained, considers the benefits of such studies, and considers finally what both the OMGE and the Telegastro Project can contribute to studies such as EpiAim.
TELENURSING
Authors: Mortensen Randi Annikki  , Nielsen Gunnar Haase
Published: February 2025

TELENURSING is an EU concerted action within the TELEMATICS Programme area 3: Health Care. The purpose of TELENURSING is to promote standardized and formalized clinical nursing care data based upon uniformed definitions of data items with the purpose of developing countable and comparable nursing minimum data sets as a means of communicating nursing care information electronically between clinical settings, health care sectors nationally and European-wide and as a means of producing Euro-Nursing Health statistics on people's need for nursing care.
IMPACT: Integrating Microscopy for Pathology Activities and Computer Technology
Authors: Brugal Gérard
Published: February 2025

Integrating microscopy for pathology activities and computer technology was achieved through the development of a new hardware interface between microscope and computer taking advantage of recent video - optics technologies and man - machine communication strategies. The computer monitor is built in the microscope and its image projected onto the optical conventional image. The user-friendly computer “mouse” and iconic interface thus become accessible in the microscope observation field. Owing to this opto-electronic hardware the microscope is turned into microscope workstations that can be networked and thus become usable as dedicated computer terminals without looking up from the microscope. In addition, detectors on the stage and the objectives permanently inform the computer about stage moves and magnification in use. Working at the microscope in the framework of the pathology laboratory daily routine was thus improved for quality of decision making, management of medical information, and communication within the laboratory on a local area network (LAN) as well as communication with outside through wide area network (WAN) for remote consultation.
The ‘ELITE’ Program Education and Learning about (Healthcare) Information Technology in Europe
Authors: GLOVER T. M.  , RICHARDSON M. H.  , de DOMBAL F. T.
Published: February 2025

The design of the ‘ELITE’ program is discussed. This PC based program was designed to provide an easy-to-use introduction to Information Science and Technology for professionals working in healthcare.
Hybrid Opto-Smart-Cards: Application to Health Care
Authors: Lender F.  , Horster P.
Published: February 2025

Safety in connection with large storage capacity - these are requirements which at present cannot yet be satisfied by smart cards. Optical cards usually have a high storage capacity but practically they cannot be regarded as safe. Hybrid opto-smart-cards offer an alternative. They make it possible to combine the advantages of an optical storage of data and the safety of smart or crypto-cards. The ongoing standardization efforts in the field of optical memory cards are of outstanding importance in this connection. By specially combining optical memories and processor and crypto-ICs, it is possible to achieve the required safety in particular in application in public health system. Opto-smart-cards will be able to win a greater share in the market only, however, if low priced hybrid write/read devices become available and the algorithm needed for the applications can be developed by means of a suitable tool box.
Legal Aspects of Introducing the Health Insurance Card and Effects on Medical Confidentiality
Authors: Hahne-Reulecke K.
Published: February 2025

This report explains first the difference between medical confidentiality and data protection. It comments the legal aspects of introducing the Health Insurance Card, specially on medical confidentiality. It shows last the requirements a patient card with medical data has to comply to realise that the patient is master of his data.
The SEISMED High Level Security Policy for Health Care
Authors: Katsikas Sokratis K.
Published: February 2025

The proliferation of the use of automated Health Information Systems in the everyday practice of health professionals has brought a number of issues related to the security of health information to a critical point. The preservation of security of health-related information can only be achieved through a concerted approach, comprising legal, organisational, technical and educational actions. These classes of actions constitute a complete “security framework”, a key aspect of which is the set of rules, laws and regulations that govern the usage of information within a Health Care Establishment. This set is commonly referred to as “Security Policy”. In this paper, the SEISMED High Level Security Policy for Health Care Establishments is presented.
Security Aspects for Medical Device Vigilance Information Exchange
Authors: Pangalos George
Published: February 2025

The implementation of appropriate security mechanisms for an effective and efficient medical device vigilance information exchange is very important, as the system handles sensitive information. These mechanisms have to be designed in such a way that they maintain confidentiality, integrity and availability of the data of medical devices. In this paper the security aspects of the information exchange on medical device vigilance is examined in detail.
Virtual Endoscopy of the Head and Neck
Authors: Jones Shaun B.  , Satava Richard M.
Published: February 2025

BACKGROUND: Although flexible endoscopy is only 25 years old, a new technology may soon be used to provide the same view of internal organs without inserting an instrument. This is virtual endoscopy.
The Role of Computer-Based Simulation for Training Surgeons
Authors: McGovern Kevin  , Johnston Rob
Published: February 2025

The effectiveness of computer based simulation (CBS) technology for training surgeons has yet to be determined. However, there is a body of research that demonstrates the effectiveness of this technology for other training applications. This research also indicates the substantial savings in cost, time, and effectiveness of simulation.
Using Human Factor Analysis and VR Simulation Techniques for the Optimization of the Surgical Worksystem
Authors: Radermacher K.  , von Pichler K.C.  , Erbse St.  , Boeckmann W.  , Rau G.  , Jakse G.  , Staudte H.-W.
Published: February 2025

The introduction of minimal invasive operating techniques into the conventional surgical worksystem, requires a fundamental analysis of the resulting problems. Based on ergonomic investigations, concerning working postures, static holding work and task sequence analysis, bottlenecks of workplace design can be demonstrated. As a contribution to the optimization of workplace design, the development of a CAD-based VR simulation environment with an integrated anthropometric man-model as a very useful tool for anthropometric system design is presented.
An Intelligent System with EMG-Based Joint Angle Estimation for Telemanipulation
Authors: Suryanarayanan Srikanth  , Reddy Narender P.  , Gupta Vineet
Published: February 2025

Bio-control of telemanipulators is being researched as an alternate control strategy. This study investigates the use of surface EMG from the biceps to predict joint angle during flexion of the arm that can be used to control an anthropomorphic telemanipulator. An intelligent system based on neural networks and fuzzy logic has been developed to use the processed surface EMG signal and predict the joint angle. The system has been tested on various angles of flexion-extension of the arm and at several speeds of flexion-extension. Preliminary results show the RMS error between the predicted angle and the actual angle to be less than 3% during training and less than 15% during testing. The technique of direct biocontrol using EMG has the potential as an interface for telemanipulation applications.
THE ACTIVE ROLE OF 2-D AND 3-D IMAGES: SEMI-AUTOMATIC SEGMENTATION
Authors: Dellepiane Silvana
Published: February 2025

This chapter deals with a semi-automatic approach to the processing of images and to the extraction of regions and volumes of interest. Moreover, it describes the two methods of isovolume segmentation and pseudo-3-D segmentation, which have been installed in different European hospitals for evaluation purposes. Emphasis is placed on segmentation of spatial sequences, and on medical user's requirements: processing speed, ease of use, robustness, transparency, etc.
Introduction to the SEISMED Guidelines
Authors: Bleumer G.
Published: February 2025

The efficiency of modern health care relies more and more upon a computerised infrastructure. Open distributed information systems have started to bring professionals together from all over the world. On the one hand easy processing and communication of images, sounds and texts will help to represent and treat illnesses and diseases efficiently, on the other hand the very ease of access and use can threaten patient privacy, accountability and health care professional secrecy. The European Union (EU) initiated a multi-disciplinary project to come up with practical guidelines detailing how to achieve a Secure Environment for Information Systems in MEDicine (SEISMED). The project has taken into account the traditional and proven principles of health care data processing, the various legislative environments within the EU, the enormous and subtle risks to the security of health care information systems, and the cost of changing existing technology. The guidelines have been validated by the SEISMED reference centres.
Guidelines for Secure System Implementation for Health Care IT and Security Personnel
Authors: van Veenen G.
Published: February 2025

During the process of bringing developed software into operational use, the implementation process, many activities have to be performed, which can have influence on the security of the information system of a health care environment.
Building a Terminology Server with a RDBMS
Authors: Stausberg J.  , Laghmouch M.  , Moraga C.
Published: February 2025

We implemented a Data Dictionary with the relational database management system ORACLE7 as a part of a Terminology Server. The data modeling was carried out using the extended ER-Model of R. Barker. Our data model includes the core entities term and link. Term comprises terminological constructs like concept, relationship, attribute, etc. Connections between terms are realized by the entity link. A link consists of a start_term a link_type and a target_term. In addition a link could be used in the same way as a term. especially for the construction of compositional structures. The main advantages of our implementation are the high flexibility of the data model and the standardized access with the Structured Query Language. We will extend the database step by step to a Terminology Server.
Supporting Health Care Telematics Through Clinical Applications
Authors: Alpay Laurence  , Heathfield Heather
Published: February 2025

This paper examines the way in which work on terminology servers and clinical applications can help solve some of the fundamental problems currently facing telemedicine. We report on the development of two clinical applications (Pen&Pad and GALEN/SCUI) which support and facilitate information exchange within the health care environment.
A Rigorous Approach To Assessing Medical Device Communication Standards
Authors: Curran Phil  , Norrie Kate  , Spicer Mike
Published: February 2025

In this paper we report on our experience of using formal methods to analyse aspects of a national standard for open systems medical device communications. Mathematical techniques are used to specify aspects of the standard and modal logic is used to validate certain safety-related properties. We discuss how these techniques can increase the confidence of developers and users in specific safety related aspects of a standard prior to testing prototypes. This work has informed comments to the balloting process of the standards committee.
Evaluation of Technology in Health Care: The case of Integrated Medical Imaging
Authors: Erimakis George-Marios  , Papadourakis George M.  , Koukoumas Nikos  , Erimaki Sophia
Published: February 2025

The impacts of technological innovations to a health care system, will be presented. The diffusion of information technology is examined in medical imaging considering the current status and the potentials in this interaction. Our study shows the dramatic changes in the health services structure induced by the technological evolution. Needs, problems, current trends and future challenges will be reported for every case of study. Acceptance by physicians, changes in the clinical environment and patient benefits will be also considered.
Providing Decision Support for General Practitioners Using the Path.Finder System
Authors: Buchan Iain  , Heathfield Heather  , Kennedy Tom  , Bundred Peter
Published: February 2025

This paper describes the development and initial evaluation of a passive decision support system for general practitioners. Book centric organisation of hypertext and the development of software for this purpose are presented and justified. We demonstrate a highly efficient use of wide area networks for clinical decision support. A district level clinical hypertext library provides the information management structure. Nine months of pilot testing have show that this system is used and is valued highly in clinical practice.
Development of a Model for Knowledge-Based Monitoring of Patients with Systemic Lupus Erythematosus
Authors: Mann G.  , Takabayashi K.
Published: February 2025

Using systemic lupus erythematosus as an example an approach for the monitoring of patients with chronic disease and its underlying design principles are presented. To reveal the structure of the domain knowledge a conceptual knowledge model was built, representing terminology. domain knowledge, and task knowledge. The model is based on an object oriented methodology. By means of examples the transformation of the conceptual representation into a formal knowledge representation formalism is demonstrated. Finally. properties of the approach and further developments are discussed.
EXTENDING AN INTEGRATED HOSPITAL INFORMATION SYSTEM BEYOND THE HOSPITAL
Authors: Chen T S  , Chao C M  , Gough T G
Published: February 2025

In planning for the development of National Cheng Kung University hospital it was felt to be essential to provide as part of the development and installation a fully integrated computer-based hospital information system to service all the hospital’s information needs. Such an information system was developed and installed as an integral component of the building of the hospital. Improvements in technology and ever increasing demands for better, easily accessible information, lead to pressure for additional facilities. However, to ensure that the information provision continues to be comprehensive and accessible it is necessary to integrate any new facilities into the operational system. This paper provides an outline of the computer-based information system as installed in the new hospital and then, explores, briefly, one major additional facility, the health IC card subsystem and its integration into the existing operational system, generating additional benefits in the provision of high quality patient care
Evolution of an Integrated Hospital Information System
Authors: Terazzi Adriana  , Giordano Andrea  , Minuco Giuseppe
Published: February 2025

In 1991, when the planning phase of the SIR (Rehabilitation Information System) project started, the management and IT professionals of the “Salvatore Maugeri” Foundation were convinced that the development of their Hospital Information System should be an evolutionary process based primarily on integration. This turned out to be the case and a vital requisite in order to make the complex effort worthwhile in terms of investment protection, cost/effectiveness and user-needs satisfaction.
Nursing Informatics Educational Issues : The NIGHTINGALE Project
Authors: Mantas John
Published: February 2025

NIGHTINGALE is an essential project in the planning and implementation of strategy in Training the Nursing Profession in using and applying healthcare information systems. NIGHTINGALE will contribute towards the appropriate use of the developed Telematics infrastructure across Europe by educating and training nurses in a harmonising way across Europe in the upcoming field of Nursing Informatics.
The future is no longer what it used to be - Managing cultural diversity & Health telematics
Authors: Demeester Michel  , Beuscart Régis
Published: February 2025

Future used to mean global progress and convergence of science & technology and society. Today, we observe the de-coupling of the two poles of knowledge formation & application (i.e. respectively science & technology, and culture & society) and also fierce confrontation between them. The key issue to reconcile the two poles is to re-invent the link between them. Such an attempt is presented through the analysis of a successful integration & change management project, namely ISA. But the collision of the cultural differences that are embedded in telematics products & services with the cultural diversity that rules over European health care providers hampers the development of a large scale market for European industry. Culture manifests itself in the social behaviour of people, in their approach to solving problems, and also in the products resulting from their activities. In other words, in order to generalise the approach to telematic integration, it is necessary to incorporate cultural diversity. It is proposed (in two projects of the fourth framework programme, VICO & Babe to combine a sevendimension model of cultural behaviour that has been developed and used in the management of multi-national companies with the model of the management of health care telematics integration projects developed in ISAR. The new (future) future may lie in the development of mental & technical capacities for changes : acceptance of and capacity for enterprise-wide solutions, hospitality and capacity to acquire outside knowledge, self-managed, multi-functional team work spirit, reengineering mentality to achieve pertinent technico-cultural solutions.
Fractal Mechanisms and Heart Rate Control: Long-Range Correlations and Their Breakdown with Disease
Authors: Peng C.K.  , Havlin S.  , Hausdorff J.M.  , Mietus J.E.  , Stanley H.E.  , Goldberger A.L.
Published: February 2025

Under healthy conditions, the normal cardiac (sinus) interbeat interval fluctuates in a complex manner. Quantitative analysis using techniques adapted from statistical physics reveals the presence of long-range power-law correlations extending over thousands of heartbeats. This scale-invariant (fractal) behavior suggests that the regulatory system generating these fluctuations is operating far from equilibrium. In contrast, we find that for subjects at high risk of sudden death (e.g. congestive heart failure patients) these long-range correlations break down. Application of fractal scaling analysis and related techniques provides new approaches to assessing cardiac risk and forecasting sudden cardiac death, as well as motivating development of novel physiological models of systems that appear to be “hetero-dynamic” rather than “homeo-static.”
Other Applications: FTP, Telnet, Gopher and WAIS
Authors: Urra Pedro
Published: February 2025

Internet developed so rapidly that today it offers numerous services. The generalization of the World Wide Web (WWW) [1] as a point of access to this net has resulted in the confusion of this term. Many new users enter the world of Internet directly by WWW also known simply as the Web.
Eulogy and Introduction to the “de Dombal” Paradigm
Authors: Sosa-Iudicissa Marcelo
Published: February 2025

A eulogy is defined by the dictionary as a laudatory speech or written tribute, and also as a great praise or commendation, or in its strict Greek origin (eulogia) “well discourse” [1]. However, our intention is not to make an apology for a personality, but rather pay due homage to a man and his ideas, and if possible add a touch of gratitude for the personal gain that most people felt after being acquainted with him. This may help to understand why we have decided to dedicate this book to the memory of Professor Tim de Dombal.
Telemedicine: Rural Networking
Authors: Parsons Donald F.
Published: February 2025

In the United States there is a decline of rural hospitals, family practitioners,and specialist services. The main reasons are [1] the rapidly rising costs of health-care services, and [2], the inability of medical practitioners to earn sufficient funds in rural areas to pay for practice costs, liability insurance, and large loans accumulated from their medical education. Rural hospitals frequently cannot afford to run specialty departments and to retain specialist physicians (even in obstetrics, mammography, and emergency-room care in some cases). This situation will be all too familiar to physicians in other rural parts of the world.
Scoliotic Spine. Is it always a 3D Deformity?
Authors: Godillon A.P.  , Dansereau J.  , Labelle H.  , De Guise J.
Published: February 2025

Since Perdriolle [1], it is usually recognised that the scoliotic spine can not be precisely represented by a 2D curve. For this reason, Chèze [2] cuts the spine in different parts, chosen by the expert and studies the best fit plane of each part. In our study, we search to characterise the scoliotic spine by a simple shape. To this end, we have also studied the deviation between 17 vertebral body centroïds and the best fit plane. Our study shows that 31 of 45 cases can be fitted with the best fit plane, if we consider the squared mean distance inferior to 1.5 mm and small angulation between two local planes. The best fit plane of the vertebral centroïds is calculated with the orthogonal distance and least square method. In another part of our study, we examine the orientation of the plane. It appears that the direction of the best fit plane is variable, and its orientation is 1° in the frontal plane and 5° in the sagittal plane. The angle with the vertical axis is less than 7°. No correlation exists between director cosines, the angle with vertical best fit plane, King's classification and distances. However, it is interesting to show that centroïds are near the best fit plane for 69% of scoliotic cases.
Is Spinal Deformity Proprioceptively Perceived? Analysis of Self-Correction Manoeuvre. A Pilot Study
Authors: D'Amico M.  , Vallasciani M.
Published: February 2025

The recent development of advanced non-ionising 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. Given the innocuousness of such an examination a significant improvement concerns the possibility to perform several measurements of the subject during different postural tests so quantifying the stiffness of the various spinal curves. Very recently we included in our standard evaluation protocol, in addition to the indifferent orthostatic postural attitude and the dynamic bending tests, the acquisition of orthostatic posture during the performance of a self-correction manoeuvre asking to the subject to assume the best correct self-perceived standing posture. Results statistically describing a different capability of the sample population between frontal and sagittal planes in the achievement of spinal shape improvement during the execution of the postural self-correction manoeuvre will be presented and discussed.
Non-Ionising Opto-Electronic Measurement and X-Ray Imaging. Two Complementary Techniques for Spinal Deformities Evaluation and Monitoring: Results of One Year Clinical Activity
Authors: D'Amico M.  , Vallasciani M.
Published: February 2025

Modern measurement systems for non-ionising 3D evaluation of spinal deformities are progressively moving from the research environment to enter as a complementary investigation tool in clinical activity. In fact their routinely use demonstrates the high level of reliability and accuracy reached by this approach, as well as an high flexibility in designing new tests in order to investigate the 3D nature of spinal deformities and its functional evaluation in an ever increasing deepness. During one year of clinical activity at the “Centro Valutazione Patologie Vertebrali”, more than 150 scoliotic subjects ranging from 6 to 20 years old have been analysed by means of the non-ionising optoelectronic device named AUSCAN. The obtained information, both for static and dynamic tests, constituted a very useful support for the clinicians in order to evaluate the degree of pathology and to design a therapy plan. The comparison with X-ray images, when present, confirmed the appropriateness of the static non-ionising examination.
Biomechanical Analysis of the Spine During Walking. A Pilot Study
Authors: D' Amico M.  , Roncoletta P.
Published: February 2025

Walking is one of the most natural activity in man and thousands of papers describing the biomechanics of normal and pathological gait can be found in literature. In fact multifactorial movement analysis has been largely developed for evaluation of locomotor performance in various disorders and clinical fields. However very few studies outline, except for gross trunk movement description, the behaviour of spine during walking. The aim of this study is to present a new specially developed signal processing procedure to analyse the spine kinematic with respect the pelvis as well as legs movements during walking. This procedure is a very general one and even if it has been tested by using the non-ionising optoelectronic device named AUSCAN system, it can be applied to every motion analyser that allows the simultaneous measurements of the 3D spatial positions of at least 13 body landmarks, 11 on the spine and two on the PSIS.
Clinical and Instrumental Evaluation of Temporomandibular Joint Diseases and Scoliosis Following Treatment
Authors: Leonardi W.  , Varsalona R.  , Onesta M.P.  , Tripi T.
Published: February 2025

All the patients, that we have examined, are subjected to clinical-instrumental valuation of the oral stomatognatic apparatus. This valuation consisted of examination of a somatic postural outline, examination of the occlusion, examination of the widness of the closed and opening moviments of the mouth on the frontal plane and examination of excentric moviments on the orizontal plane, feeling of masticatory and head muscless , feeling and auscultate of the T.M.J. By the clinical-instrumental examinations of the spine, the authors have always distinguished between the nonstructural and the structural Scoliosis. Thus, in the study of the correlation of these two pathologies, the authors have considered T.M.J. disfunction associated with nonstructural Scoliosis and structural Scoliosis.
Influence of Surgical Treatment of Scoliosis in Children with Myelomeningocele on Ambulation and Motoric Skills
Authors: Berned Müller E.  , Nordwall A.  , von Wendt L.
Published: February 2025

The influence on motoric skills of surgical treatment of scoliosis in 14 children with myelomeningocele was studied. Fifty percent of the children had increased flexion contractures of the hips at follow-up and all but one patient had impaired motor ability. There was no influence on ADL, but 57% of the children had lost some of their ambulation capacity. Postoperative physiotherapy is highly advisable. Intensive attempts to treat these children conservatively to prevent scoliosis progression is suggested.
Medical Imaging: Fulfilling the Promises
Authors: Mitchell H.L.
Published: February 2025

Between 1980 and the present, a period which corresponds to the life of the international meetings on spinal deformity, magnetic resonance imaging, computed tomography and ultra-sonic imaging have emerged as new and powerful imaging techniques. Photographic and radiographic imaging have remained as effective imaging techniques over the same period, here too developments in digital imaging hardware and in digital image processing software have allowed the photograph and radiograph to play a role in spinal studies which was previously impossible. To allow MRI, CT and ultra-sonic techniques as well as radiography to be developed effectively for spinal studies, through greater use of digital image processing and with greater user control, some concerted input by interested parties may be beneficial. Specifically, improvements in imaging for spinal study purposes may occur most efficiently and effectively if the International Research Society for Spinal Deformities plays a part in setting goals for useful imaging and user specifications.
Lateral Flexion Induced Axial Rotation in Adolescent Idiopathic Scoliosis (AIS)
Authors: Cole A.A.  , Burwell R.G.  , Webb J.K.
Published: February 2025

The aim of this study is to examine the coupling of lateral flexion and axial rotation in adolescent idiopathic scoliosis (AIS). Seventy six patients with AIS each had left and right supine lateral bending films before surgery. The vertebral rotation (Perdriolle) was measured from T5 to L4 on each radiograph. The change in rotation was calculated for each vertebra from left to right lateral bending = ‘lateral flexion induced rotational change (LFIRC)’
Nursing Minimum Data Sets National and European Perspectives
Authors: Weber Patrick
Published: February 2025

Nursing Minimum Data Set's implementation is now starting in Switzerland. Swiss nurses had at the beginning of this year the opportunity to introduce the concept of nursing data collection into the national medical statistics which are changing in January 1997. First step will be a set up of Minimum Basic Data Set which could be collected at a national level. Our working group is in connection with international groups like ICNP, Telelnurse, Belgium’s NMDS group from Leuven.