bluuebunny/crossref_metadata_2025 huggingface dataset:
The case for smart cards in the U.S. Healthcare industry
Authors: Sharpe B.  , Warthen M.
Published: February 2025

The U.S. healthcare industry is attempting to reinvent itself in response to severe pressures to reduce cost. In an information-intensive environment, it is natural that information systems solutions would be sought to aid in the cost reduction efforts. However, traditional client-server applications and technologies have had little impact on the cost of patient care, and benefits fraud has reached unprecedented levels. And the growing use of electronic medical records has raised great concerns over patient privacy and the confidentiality of those electronic files.
VR Simulation Of Abdominal Trauma Surgery
Authors: Bro-Nielsen Morten  , Helfrick David  , Glass Bill  , Zeng Xiaolan  , Connacher Hugh
Published: February 2025

In this paper we describe a test-bed we have developed for simulation of abdominal trauma surgery.
Comparing Virtual and Real Worlds for Acrophobia Treatment
Authors: Huang Milton P.  , Himle Joseph  , Beier Klaus-Peter  , Alessi Norman E.
Published: February 2025

Traditional treatment of phobias involves a process of gradual exposure to the feared object. Virtual Reality (VR) environments have been used to effectively treat phobias by simulating feared situations, yet these initial studies have been performed by comparing the effect to no-treatment conditions. We are in the process of comparing VR exposure treatment to “gold-standard” in-vivo exposure treatment by replicating an actual in-vivo exposure area in a VR model. The process of controlling for differences between the two environments highlights a general procedure of selecting elements in virtual environment design, targeted towards producing particular emotional effects. It also raises questions about the necessity for highly realistic simulation in VR phobia treatment.
A THEORETICAL COMPARISON OF 2-CAMERA AND 3-CAMERA OPTICAL LOCALIZERS WITH ACTIVE OR PASSIVE INSTRUMENTATION
Authors: Faul Ivan
Published: February 2025

Since the technology was first pioneered in the medical arena in the early 1990s, optical localizers have increasingly been used in computer assisted surgical procedures. This surgical practice is commonly referred to as “Image Guided Surgery (IGS)”. Historically, mechanical stereotactical frames have been used for 3-D position measurement in surgery. Now, new computer input devices can generate high speed numeric position data for direct input into a host computer. This enables application software to acquire the real-time position of surgical instruments and display the positions relative to previously acquired Computer Tomography (CT) or Magnetic Resonance (MR) images on the same computer screen.
VIRTUAL ENVIRONMENTS FOR TRAINING CRITICAL SKILLS IN LAPAROSCOPIC SURGERY
Authors: Downes Michael  , Cavusoglu M. Cenk  , Gantert Walter  , Way Lawrence W.  , Tendick Frank
Published: February 2025

Surgical training simulations must incorporate not only advanced technical features, such as detailed geometric organ models and physically-based modeling techniques, but also a thorough understanding of the major training issues relating to a particular procedure. We have developed a prototype environment for training laparoscopic cholecystectomy, or gallbladder removal surgery, which focuses a student's attention on the critical steps performed during the procedure and provides feedback as to the common errors committed during a session. The current version of our system runs in real-time on a mid-range graphics workstation. The simulation also provides a platform for research into a variety of different areas, including tissue modeling, finite element methods, and generalized simulation authoring.
Knowledgebased Segmentation
Authors: Burghart Catherina R.  , Pernozzoli Arno  , Rembold Ulrich
Published: February 2025

The segmentation of medical images like CT or MRI scans represents a great challenge to researchers in computer vision, due to the variability of the individual anatomy and the different characteristics of the scanning systems. As an anatomical knowledge base improves the recognition of structures in CT or MRI scans, we chose a knowledge based segmentation in our approach, which will be explained in the following.
Generating finite element models from volumetric medical images
Authors: Grabowski H. A.
Published: February 2025

For planning and simulating of surgical interventions geometric models have to be generated from medical images. In this paper, we will present a new method for generating finite element meshes from volumetric images. The method is designed to capture even very small anatomic structures, while the mesh density can be controlled and locally increased.
INFORMATION FRAMES: A NEW MULTIMEDIA APPROACH TO WEB-BASED LEARNING OF BIOLOGY AND MEDICINE
Authors: Heinrichs Wm. LeRoy  , Pichumani Ramani  , Mather Rory  , Dev Parvati
Published: February 2025

Presentation of content in hyperlinked multimedia formats for teaching has failed using the computer's power of navigation through rich visual and auditory information. We have developed “Information Frames”, an authoring tool in hypertext markup language (html) format, that allows easy utilization by technology-challenged teachers and professors, and attracts students because of interactive, design-based learning. An Information Frame contains a definition, explanation and illustration of a single concept. Topics are provided with hyperlinks to other Information Frames having related concepts that may provide prerequisite knowledge, or may raise the concept to a more integrative level. A graphical view of the linked Information Frames presents a Concept Map of the overall topic.
Medical Informatics in the New Millennium
Authors: Ball Marion J.  , Douglas Judith V.
Published: February 2025

In a period of social transformation, we must reinvent health care. For guidance, we can look to the evolving discipline of medical informatics and to the patterns of investment in the practice arena. A top ranked application need, the computerized patient record (CPR) offers cost savings and supports clinical quality and ambulatory care. In the new millennium, we need to define our values with precision and use technology to achieve quality health care.
An Examination of the Variables Associated with the Adoption of a Computerized Innovation (An Operating Room Simulation Model)
Authors: Podolak Irene
Published: February 2025

The purpose of this study was to describe the variables that influenced senior staff to decide to adopt (or reject) a computerized innovation (Operating Room Simulation Model) and to describe the decision process at four hospitals. Rogers' Innovation-Decision Process Model (1983) and Model of the Innovation Process in Organizations (1983) formed the conceptual framework for this study. Five specific variables (relevant advantage, compatibility, complexity, trialability, observability), that were shown in the literature to increase the probability of an innovation to be adopted, were investigated. The results of this study indicated that there was a match between relevant advantage and adoption and no match between compatibility and adoption. There were insufficient data to determine if a match existed between complexity, trialability and observability with adoption of the Model. The links between the organizational variables (agenda setting, matching, decision) and adoption of the OR Simulation Model were not conclusive.
Towards an Ethical Protocol in Mental Health Informatics
Authors: Rigby Michael  , Hamilton Ian  , Draper Ronald
Published: February 2025

Application of informatics to mental health has the potential to benefit a disadvantaged yet important patient group. At the same time, difficult issues are raised with regard to data protection and ethics because many patients are not able to express informed and rational views, and this increases their vulnerability.
Detection of Epileptiform Activities in the EEG Using Neural Network and Expert System
Authors: Park Hyun S.  , Lee Yong H.  , Kim Nam G.  , Lee Doo S.  , Kim Sun I.
Published: February 2025

This paper proposes a multichannel spike detection in long term EEG monitoring for epilepsy. It is achieved by wavelet transform(WT), artificial neural network(ANN) and the expert system. First, a small set of wavelet coefficients is used to represent the characteristics ofa single channel epileptic spikes and normal activities.
Can the US Minimum Data Set Be Used for Predicting Admissions to Acute Care Facilities?
Authors: Abbott Patricia A.  , Quirolgico Stephen  , Manchand Roopak  , Canfield Kip  , Adya Monica
Published: February 2025

This paper is intended to give an overview of Knowledge Discovery in Large Datasets (KDD) and data mining applications in healthcare particularly as related to the Minimum Data Set, a resident assessment tool which is used in US long-term care facilities. The US Health Care Finance Administration, which mandates the use of this tool, has accumulated massive warehouses of MDS data. The pressure in healthcare to increase efficiency and effectiveness while improving patient outcomes requires that we find new ways to harness these vast resources. The intent of this preliminary study design paper is to discuss the development of an approach which utilizes the MDS, in conjunction with KDD and classification algorithms, in an attempt to predict admission from a long-term care facility to an acute care facility. The use of acute care services by long term care residents is a negative outcome, potentially avoidable, and expensive. The value of the MDS warehouse can be realized by the use of the stored data in ways that can improve patient outcomes and avoid the use of expensive acute care services. This study, when completed, will test whether the MDS warehouse can be used to describe patient outcomes and possibly be of predictive value.
An Integrated Multimedia Medical Information Network System
Authors: Yamamoto Kazuko  , Makino Jun  , Sasagawa Norio  , Nagira Masami
Published: February 2025

An integrated multimedia medical information network system at Shimane Medical university has been developed to organize medical information generated from each section and provide information services useful for education, research and clinical practice. The report describes the outline of our system. It is designed to serve as a distributed database for electronic medical records and images. We are developing the MML engine that is to be linked to the world wide web (WWW) network system. To the users, this system will present an integrated multimedia representation of the patient records, providing access to both the image and text-based data required for an effective clinical decision making and medical education.
The Effect of a Teledermatology Program on Rural Referral Patterns to Dermatologists and the Management of Skin Disease
Authors: Perednia Douglas A.  , Wallace James  , Morrisey Mary  , Bartlett Marjorie  , Marchionda Larry  , Gibson Andrew  , Campbell Emily
Published: February 2025

Teledermatology can be defined as the use of imaging and telecommunications technologies to provide skin care services at a distance. The potential value of teledermatology is especially great in rural and medically underserved areas that do not have, or cannot support, providers specializing in the diagnosis and management of skin diseases. Rural patients and primary care providers should be able to use teledermatology as a greatly simplified and potentially less expensive means of referral to an urban dermatologist.
Features for a B-ISDN Telemedicine System and its Application
Authors: Choi Jinwook  , Kim Younghan  , Lee Sanggoo  , Lee Jaeok  , Woo Jonginn  , Seo Jungdon  , Yoo Taewoo  , Cho Hanik
Published: February 2025

Telemedicine technology is emerging as a new way of medical practice. It will provide more cooperative activity between departments and more comfortable access for disabled patients home. We developed two types of telemedicine system: a telediagnosis system and a home care system. Our telemedicine application is aimed to be run on the broadband-integrated services digital network (B-ISDN). The legacy network is also considered. The user interface is designed to help doctors to communicate easily. The key elements of telemedicine systems are user friendly interface, medical multimedia database design highly refined display technique.
Smartcard - a Vehicle of Access to the Health Care Services
Authors: Sušelj Marjan  , Cuber Stanislav
Published: February 2025

This paper presents an outline of the Slovenian national project of introduction of the health insurance card system: the background, the grounds for its launching and benefits anticipated, system design, project phases, and interoperability with international healthcard systems.
Standardization of the Nationwide Health Examination in Korea
Authors: Huh Bong Yul  , Yoo Taiwoo  , Cho Sungja  , Suh Sang-yeon  , Sang Woo O.  , Park Min-sun
Published: February 2025

The Korea Medical Insurance Corporation has held the periodic Health Examination for the public servants and teachers from 1977 as a nationwide health preventive task. But the Health Examination result is not computerized rather than paperwork, so the use of the Health Examination is limited and the results of Health Examination can not be stored or interchangeable between hospitals or health examination centers in this system. So we planed the Standardization of the Nationwide Health Examination project and developed the Health Examination computer program in 1996. The object of standardized program is to contribute to cost-effective analysis of each item or other studies about the factors influences development of diseases. And now, an Exhibition work for the standardization is being held with the Health Examination computer program. At the ending of the Exhibition work, we will evaluation and revision the computerized program for standardization process.
Hospital Management Decision Support: A Balanced Scorecard Approach
Authors: Gordon Daniel  , Chapman Rick  , Kunov Hans  , Dolan Alf  , Carter Michael
Published: February 2025

Hospital management teams receive voluminous data from a wide variety of sources, but are unable to distill the essential data they require to make good decisions. We have used a methodology, which helps teams define and use important management data coupled with an information system that makes this data accessible. Results of our evaluation indicate that the process of developing a Balanced Scorecard indicator system helps management teams to define meaningful strategic objectives and measurable performance indicators. The framework combined with the information acts as an integrating force, providing a shared understanding of the unit's goals. We conclude that a customized decision support system, which integrates multiple measures in a balanced Scorecard framework, is a powerful tool for enabling complex decision making by a management team.
Architecture of a Neural Network Client / Server System for Decision Support in Clinical Information Systems
Authors: Leon Mauricio  , Keller James
Published: February 2025

Neural networks have demonstrated their research potential in bio-medical sciences. The literature is filled with experiments that evidence the value of neural networks for the solution of diagnostic and predictive problems. The next step is to direct research efforts toward implementation of these neural networks into the clinical information environments where their diagnostic and predictive capabilities can be truly utilized. To accomplish this goal, it is necessary to create a new generation of neural network tools that ease the transition of experimental results to a production state. This paper describes the architecture of such a system.
The Nurse Scheduling Problem: a Combinatorial Problem, Solved by the Combination of Constraint Programming and Real Users Heuristics
Authors: Weil Georges  , Heus Kamel  , Chan Peter  , François Patrice
Published: February 2025

Nurse scheduling consists of assigning shifts and rest to nurses for each day, on a time schedule, taking in account legal and collective constraints, and individual wishes. The Nurse Scheduling Problem (NSP) is a highly difficult and complicated problem that has already be explored using several operational research methods. Nevertheless, those methods are not flexible enough to match the individual requests from nursing staff and they don't allow for effective management of unforeseen absences. This paper explores the use of a Constraint Programming (CP) to build Gymnaste, which is since June 1997 a available package, after five years of a slow research and development process. We describe the way the problem is modeled, the constraints typology, and the interface. In fact, the NSP is also an ill defined problem, making the man computer interface critical to let the user chose the best heuristics. Gymnaste is currently beta-tested on several pilot sites. Schedules have been generated very quickly, typically in less than a minute for 20-30 persons over 4 weeks. An evaluation process is running, which preliminary results also show some interesting sociological and organizational aspects.
Prognoses of Multiparametric Medical Time Courses Applied to Kidney Function Assessments
Authors: Schmidt Rainer  , Pollwein Bernhard  , Gierl Lothar
Published: February 2025

In this paper, we describe an approach to utilize Case-Based Reasoning methods for trend prognoses for the monitoring of the kidney function in an Intensive Care Unit (ICU) setting. Since using conventional methods for reasoning over time does not fit for course predictions with poor medical knowledge of typical course patterns, we have developed abstraction methods suitable for integration into our Case-Based Reasoning system ICONS. These methods combine medical experience with prognoses of multiparametric courses. On the ICU, the monitoring system NIMON provides a daily report based on current measured and calculated kidney function parameters. We subsequently generate course-characteristic trend descriptions of the renal function over the course of time. Using Case-Based Reasoning retrieval methods, we search in the case base for courses similar to the current trend descriptions. Finally, we present the current course together with similar courses as comparisons and as possible prognoses to the user. We applied Case-Based Reasoning methods in a domain which seemed reserved for statistical methods and conventional temporal reasoning.
Automatic Extraction of Linguistic Knowledge from an International Classification
Authors: Baud Robert  , Lovis Christian  , Rassinoux Anne-Marie  , Michel Pierre-André  , Scherrer Jean-Raoul
Published: February 2025

Automatic extraction of knowledge from large corpus of texts is an essential step toward linguistic knowledge acquisition in the medical domain. The current situation shows a lack of computer-readable large medical lexicons, with a partial exception for the English language. Moreover, multilingual lexicons with versatility for multiple languages applications are far from reach as long as only manual extraction is considered. Computer-assisted linguistic knowledge acquisition is a must.
A Multimedia Database for Dermatology
Authors: Kindler Hauke  , Densow Dirk  , Baranov Alexander E.  , Fliedner Theodor M.  , Peter Ralf U.
Published: February 2025

The World Health Organisation (WHO) Radiation Emergency Medical Preparedness (REMPAN) centres have built up the International Computer Database for Radiation Accident Case Histories (ICDREC) to document the treatment of acute radiation syndrome (ARS) patients.
Methodology for Developing Educational Hypermedia Systems
Authors: Bearman Margaret  , Kidd Michael  , Cesnik Branko
Published: February 2025

Hypermedia has the potential to greatly enhance teaching. It can, however, be difficult to develop hyperdocuments which provide medical students with the full benefit of the technology. We wish to resolve this problem by providing a methodology for creating educational hypermedia systems with specific emphasis on the medical domain, but applicable across disciplines. This paper examines some of the specific issues involved in educational hypermedia, and outlines a series of practical guidelines, drawing together the disparate disciplines necessary to the development process. We illustrate the methodology with our own experience in creating and updating the HIV Hypermedia Medical Education Software over a period of two years.
The Development of Digital Library System for Drug Research Information
Authors: Kim H.J.  , Kim S.R.  , Yoo D.S.  , Lee S.H.  , Suh O.K.  , Cho J.H.  , Shin H.T.  , Yoon J.P.
Published: February 2025

The sophistication of computer technology and information transmission on internet has made various cyber information repository available to information consumers. In the era of information super-highway, the digital library which can be accessed from remote sites at any time is considered the prototype. of information repository. Using object-oriented DBMS, the very first model of digital library for pharmaceutical researchers and related professionals in Korea has been developed. The published research papers and researchers' personal information was included in the database. For database with research papers, 13 domestic journals were abstracted and scanned for full-text image files which can be viewed by Internet web browsers. The database with researchers' personal information was also developed and interlinked to the database with research papers. These database will be continuously updated and will be combined with world-wide information as the unique digital library in the field of pharmacy.
Data Collection in Multi-center Clinical Trials via Internet. A Generic System in Java
Authors: Sippel Heiko  , Eich Hans-Peter  , Ohmann Christian
Published: February 2025

Data collection via Internet is usually performed with an HTML/CGI combination, which has a lot of disadvantages, most important the lack of security features. We therefore have developed a system written entirely in Java, which implements a true client/server application based on TCP/IP. The documents are created using a multi-lingual data dictionary, and the used GUI components are able to perform plausibility checks, which improves quality of the data. The system is designed to be easily extensible so that it can be used in almost any kind of clinical trials. It is based on a three-tier model where client requests are handled and monitored by an application server. We will describe this system and it's implementation and compare it to the HTML/CGI approach. Of special interest are security features, which are possible through the use of Java.
Telematics in the Northern United Kingdom
Authors: Skouras Costas A  , Divanis George
Published: February 2025

The application, integration and development of methods and technology facilitating the seamless interchange of clinical, demographic and administrative information presented the medical and clinical community with unforeseen problems. Surprisingly, the wealth of existing solutions did not find the expected application and acceptance in hospital/General Practice environments. Even more surprising was the fact of the failure of many computer-based solutions to deliver the expected benefits. This paper outlines the Telematics project established in the Northern United Kingdom and its success in maintaining a working balance between technological needs and the clinical requirements. The result is a robust service linking five major Trusts and 12 General Practices in terms of clinical and administrative data, e-mail and other facilities.
The strategic plans of OTE concerning the development of telemedicine applications based on the Euro-ISDN technology
Authors: Danelli Vassiliki
Published: February 2025

OTE SA, the Hellenic Telecommunications Organization, is the major public network operator of Greece and aims to actually promote all services made available through this technology and more peculiarly that of telemedicine. Through its modernization plan in progress, OTE aims at providing wide/range, high/quality competitive services on the basis of customer oriented policies. Its activities cover, besides basic telephony (5,9 million lines), data communications, leased lines, maritime communications and value-added services. The public health service has a lot to profit from efficient use of telecommunications. The greatest challenge the health service is faced with, is the growing gap between the expectations of the population, and the resources that society can set-aside for health purposes. Increasing the level of efficiency and co-operation is therefore the best probable response to the challenge. Telecommunications may contribute to a more effective utilization of resources, tying together those that could be in benefit of the health sectors in the process of implementing a large number of telemedical services.
Electronic Health Care Record Systems - New possibilities of processing health care activities and medical information
Authors: Hjertkvist Mats
Published: February 2025

The simultaneous events of Health Care reorganisation, Information Technology progress and increased demands on Health Care outcome evaluation have created a new concept of a more sophisticated way how to use an electronic health care patient record. The importance of health care process analysis and case processing is illustrated and an operating patient record system in Umeå, Sweden, is demonstrated.
Computerised Coordinated Care System in the RISE Project
Authors: Charalambakis Dimitrios  , Samiotakis Yiannis  , Sasson Laura
Published: February 2025

It is a fact that elderly peoples’ life is characterised by problems such as deteriorating health and physical condition, feelings of loneliness, isolation, and of being dependent on others, in many aspects of their everyday lives. The objective of the RISE project is to provide an efficient vehicle for Heath Care Professionals for improving Health Care, quality of life and integration of the elderly and disabled people with society by implementing Information technology applications. In particular, RISE project aims in developing a distributed network of service providers across the European Union, which will provide integrated types of sennces to the elderly and disabled population. The purpose of this paper is to present the impact of this project concerning the Health Informatics sector. It will describe the issues regarding, the needs for education and training of the professionals that arise by the introduction of this concept, and, the possible ways that such a concept forms an efficient vehicle for Health Professionals in assisting these particular groups of users. The longer perspective seeks to redefine and reshape the Health Care services’ larger purpose, ie to make those comport with elementary individual needs of the elderly and disabled by introducing new methods of efficient health service provision. To achieve this there is an increased need for the training of the professionals. The outcome of RISE will be a set of specialised software components, tools and training methodologies designed to assist the Health Professionals achieving the aforementioned tasks.
Data Protection - an Eternal Question
Authors: Tallberg Marianne
Published: February 2025

The always pertinent question of data protection in healthcare was studied through comparison of three surveys. The results from the surveys made 1993, 1995, and in spring 1998 shows that a deeper understanding of data protection is slowly penetrating the nursing profession. When the new national data law, in accordance with EC-directives, will be applied from the autumn 1998, the question of data protection will be brought up again
Critical Social Theory as a Model for the Informatics Curriculum for Nursing
Authors: Wainwright Paul  , Jones Peter G
Published: February 2025

It is widely acknowledged that the education and training of nurses in information management and technology is problematic. Drawing from recent research this paper presents a theoretical framework within which the nature of the problems faced by nurses in the use of information may be analysed. This framework, based on the critical social theory of Habermas, also provides a model for the informatics curriculum. The advantages of problem based learning and multi-media web-based technologies for the delivery of learning materials within this area are also discussed.
VIRTUAL REALITY THERAPY: AN EFFECTIVE TREATMENT FOR PHOBIAS
Authors: North Max M.  , North Sarah M.  , Coble Joseph K
Published: February 2025

Behavioral therapy techniques for treating phobias often includes graded exposure of the patient to anxiety-producing stimuli (Systematic Desensitization). However, in utilizing systematic desensitization, research reviews demonstrate that many patients appear to have difficulty in applying imaginative techniques.
THE EFFECTS OF IMMERSIVENESS ON PHYSIOLOGY
Authors: Wiederhold Brenda K  , Davis Renee  , Wiederhold Mark D.
Published: February 2025

The effects of varying levels of immersion in virtual reality environments on participant's heart rate, respiration rate, peripheral skin temperature, and skin resistance levels were examined. Subjective reports of presence were also noted. Participants were presented with a virtual environment of an airplane flight both as seen from a two-dimensional computer screen and as seen from within a head-mounted display. Subjects were randomly assigned to different order of conditions presented, but all subjects received both conditions. Differences between the non-phobics' physiological responses and the phobic's response when placed in a virtual environment related to the phobia were noted. Also noted were changes in physiology based on degree of immersion.
Technical Improvement of CPT (Complex Phase Tracing) Profilometry in Scoliosis
Authors: Kozlowski Janusz  , Serra Giovanni  , Merolli Antonio  , Guidi Pier Luigi
Published: February 2025

The prototype of a portable instrument for shape measurement and analysis of the human back has been developed. The new principle applied for fringe pattern analysis is based on the registration of two mutually out-of-phase patterns, use of die Fourier transform with corrected intrinsic border-errors and on fringe pattern demodulation based on Complex Phase Tracing method. The software includes correction of distortion of the observation lens, data calibration, three-dimensional Z-axis rotation of the patient normalizing his position, calculus of the curvature map (second derivative) enabling precise indication of the PSIS points, color-map and contour representation of die calculated 3D form as well as calculus and presentation of the natural image of die patient.
Study of the Natural History of the Back Trunk Shape by the use of Scoliometer in Children Aged 5-12 Years
Authors: Grivas TB  , Nakos B  , Kouvaras J  , Kalamakis N  , Polyzois D
Published: February 2025

The amount of asymmetry of the back trunk shape, that is the existence of a hump, in the general adolescent population during School-screening for scoliosis constitutes one of the strongest indicators for further referral. The aim of this study is to map the trunk asymmetry in normal Mediterranean children 5-12 years of age and to determine its natural history. Material and Mediod: The readings of scoliometer in 900 children aged 5-12 years (512 boys and 388 girls) were studied. The children were examined at school, during our School-screening program. The bending test was performed bodi in standing and sitting forward bending positions using die Pruijs scoliometer, in order to quantify, die existing asymmetry, at three areas of interest: in thoracic, thoracolumbar and lumbar area. The severity of asymmetry was defined in two groups: in the 1stgroup the scoliometer reading was 1°- 6°, right or left, and in the 2nd7° respectively. Seven age groups of children were defined: years <7; 7≤years<8; 8≤years<9; 9≤years<10; 10≤years<11, 11≤years<12, years≥12.
A New Approach in the Surgical Treatment of Early Scoliosis
Authors: Xiong B.  , Sevastik J.A.
Published: February 2025

The interrelated results of earlier experimental and clinical studies have provided adequate evidence to support the thoracispinal theory of the pathogenesis of IS. According to this new theory stimulation of longitudinal growth of the left ribs is the origin of right convex thoracic IS in adolescent girls. Subsequently successful attempts also have been made to correct scoliosis in growing rabbits by interventions on the ribs. Case report: Right convex thoracolumbar IS of 26 degrees was diagnosed in a 6-year-old girl. One year later the curve had increased to 46 degrees. The patient was then operated upon by 2 cm shortening of three ribs on the side of the concavity. Fifteen months after the operation the Cobb angle was successively reduced to 30 degrees and after another 12 months to 21 degrees, or by 54 per cent. The results of the earlier studies and of the reported case provide evidence that operations on the ribs if used at proper age under well-defined indications may consistute a new approach in the treatment of early thoracic curves. The vast implications of new, easy-to-perform and harmless operations based on physiological concepts on the overall treatment of early progressing curves need not to be underlined.
Determination of Fixation Level of Osteosynthesis System with Knowledge Base
Authors: Chusseau S.  , Chopin D.  , Godillon Maquinghen A.P.
Published: February 2025

Scoliosis is a three-dimensional deformity of the spine. Surgery is an important means to correct scoliotic deformities. It aims to straighten the spine and maintain it with metallic rods fixed by screws and hooks. The problem consists in determining the fixation levels of the instrumentation and the types of instrumentation, which can be anterior or posterior. The project is an attempt in using knowledge engineering for modelling surgeon problem solving strategies. This project consists in developing an assistance system for surgeons and residents in decision making before surgery. It determines the vertebral levels for instrumentation fixation and the type of instrumentation. This article presents the preliminary results of the application of this assistance system using Case-based Reasoning.
Analysis of HRV and BPV by a Nonlinear Closed Loop Model
Authors: Seydnejad S R  , Kitney R I
Published: February 2025

To obtain a more comprehensive explanation for the generation and interaction of the variabil-ity signais, namely heart rate variability (HRV), blood pressure variation (BPV) and instantaneous lung volume (ILV), a nonlinear closed loop model of the neuro-cardiovascular system is presented. The new model which is based on the Volterra series reprsentation is able to appropriately describe several features observed experimentally in the variability signals in the HF, LF and VLF bands. The model aggregates a set of linear and nonlinear transfer functions representing the physiology involved in producing the rhythmical fluctuations in heart rate and blood pressure normally observed in intact human. It will be shown that the combination of these transfer functions in the order dictated by the underlying physiological system enables us to investigate the HRV and BPV in a systematic manner. Before detailing the structure of the new model a conceptual discussion about the small signal and large signal cardiovascular modelling will help to gain a deeper understanding of the modelling of the variability signals and its relation with the cardiovascular system analysis.
Primary Health Care and ICNP: Data from Clinical Nursing Practice through SAGA
Authors: Thoroddsen Asta
Published: February 2025

Structured and standardized clinical nursing data used by clinical nurses, nurse managers, health care administrators, policy makers and clinical researchers is important for nursing. Information from clinical nursing has been very limited and not comparable primarily due to lack of nomenclatures and classifications in nursing. For success clinical nursing record systems have to be clinically appropriate and extraction of data from databases made possible. This paper shows examples of data from nurses and information on different activities of nurses in three different primary health care centers in Iceland. This paper could therefore be renamed and called ICNP from a clinical point of view like the one presented in Athens two years ago[l].
An Evaluation of Community Nursing Process in the Frame of the International Classification for Nursing Practice
Authors: Sustersic Olga  , Rajkovic Vladislav  , Kljajic Miroljub
Published: February 2025

The evaluation of client's/patient's health condition is the basis for determination of nursing problems/diagnosis and the nursing planing. Changed health condition to better is also the indication of successful performance of nurse's work. The evaluation of the appropriateness of nursing interventions is based on positive alternations of individual daily activities. That is why a constant, in-fixed- intervals monitoring of client's changed health condition on the basis of attributes or indicators, determined within the individual daily activities, is suggested. At that stage a problem, how to aggregate the individual estimates of indicators into an overall health condition evaluation, emerges. A multicriteria decision-making theory is used for that purpose. Practically that means the introduction of the measuring scale of 3 or 5 descriptive values and the aggregate function into the hierarchically structured indicators, which are in accordance with the International Classification for Nursing Practice (ICNP). In the following article the evaluation case using the shell of expert system DEX (Decision Expert) will be presented. The logical operations and the transparent interpretation of the evaluation within the expert system DEX enables a full presentation of the aggregated knowledge.
Planning of Skull Base Surgery in the Virtual Workbench: Clinical Experiences
Authors: Kockro Ralf A  , Serra Luis  , Yeo Tseng Tsai  , Chan Chumpon  , Yih-Yian Sitoh  , Gim-Guan Chua  , Hern Ng  , Lee Eugene  , Lee Yen Hoe  , Nowinski Wieslaw
Published: February 2025

Based on the KRDL Virtual Workbench, we present a neurosurgical planning system called VIVIAN (Virtual Intracranial Visualization And Navigation). This VR environment allows for fast and intuitive interaction with three-dimensional multimodal (MRI, MRA, MRV, CT) patient specific data-sets. The user reaches behind a mirror into a 3D workspace where the 3D data is surrounded by interactive virtual tools-racks. Tumors, blood vessels, cranial nerves and surgically relevant parts of the brain are segmented by interactive control of density transfer-functions or by manual outlining and tracing tools. A neurosurgical procedure is planned by using various visualization and measurement tools and the system allows for the simulation of bone drilling and tissue removal. We have planned 16 cases which required tumor surgery at the cranial base. VIVIAN provided an efficient and comprehensive way to understand pre-operatively the complexity of anatomical and pathological relationships. The ideal craniotomy and the extent of the required skull base exposure could be specified accurately.
A Portable Virtual Environment Knee Arthroscopy Training System with Objective Scoring
Authors: Sherman K.P.  , Ward J.W.  , Wills D.P.M.  , Mohsen A.M.M.A.
Published: February 2025

We have developed a Virtual Environment Knee Arthroscopy Training System (VE-KATS). Formative analysis indicated several features which surgical trainees indicated were necessary for a system to be useful. We have addressed this need by incorporating both rigid and deformable objects, simultaneous use of camera and surgical instrument, improved optical modeling, portability and low cost. A major advance has been the incorporation of automated objective scoring of performance. VE-KATS has now progressed to a viable training system which will be of practical benefit to trainee orthopaedic surgeons.
Virtual Reality Based Surgery Simulation for Endoscopic Gynaecology
Authors: Székely G.  , Bajka M.  , Brechbühler Ch.  , Dual J.  , Enzler R.  , Haller U.  , Hug J.  , Hutter R.  , Ironmonger N.  , Kauer M.  , Meier V.  , Niederer P.  , Rhomberg A.  , Schmid P.  , Schweitzer G.  , Thaler M.  , Vuskovic V.  , Tröster G.
Published: February 2025

Virtual reality (VR) based surgical simulator systems offer very elegant possibilities to both enrich and enhance traditional education in endoscopic surgery. However, while a wide range of VR simulator systems have been proposed and realized in the past few years, most of these systems are far from able to provide a reasonably realistic surgical environment. We explore the basic approaches to the current limits of realism and ultimately seek to extend these based on our description and analysis of the most important components of a VR-based endoscopic simulator. The feasibility of the proposed techniques is demonstrated on a first modular prototype system implementing the basic algorithms for VR-training in gynaecologic laparoscopy.
Virtual Reality: A Wholistic Approach to Rehabilitation
Authors: Cunningham Donna  , Krishack Marian
Published: February 2025

Virtual Reality (VR) is proving to be an effective treatment tool in rehabilitation. Currently we are providing VR therapy to patients in an out-patient clinic and an adult day center. The main focus to this paper is to show how VR is used in occupational therapy to improve balance and dynamic standing tolerance with geriatric patients. We will discuss our research findings of specific treatment approaches that we are using in therapy. The benefits of VR in rehab, as well as other rehab applications for this modality will also be discussed. We will illustrate the importance of addressing the visual and motor systems simultaneously for maximum efficiency in achieving our rehabilitation goals. The ultimate goal in occupational therapy is to increase a patient's level of independence in activities of daily living and therefore improving their quality of life.
European Field Tests with HISTKOM Telepathology Equipment
Authors: Schwarzmann Peter  , Binder Bernd  , Käser Michael  , Klose Rüdiger
Published: February 2025

HISTKOM telemicroscopy equipment for telepathology is designed for the most challenging application in telepathology: intraoperational frozen section diagnosis. Adapted to this application, it is also excellently suited for all other telepathology modes requesting less sophisticated equipment. The technical concept and user interface are oriented to routine daily pathology. HISTKOM underwent heavy field-tests at several locations. The field-tests designs and the results of five of these are reported in this paper.
WWW-Based Access to Radiological Patient Data: Two Years of Experience
Authors: Bergh Björn  , Felix Roland
Published: February 2025

This paper describes the theoretical concept behind, the technical implementation of, and the experiences created with a self-developed system to access radiological patient data by WWW-technology. Materials and Methods: The WWW- system interfaces the RIS via HL7 and the PACS via DICOM. Core components are a secure Web-Server and an underlying database system (DB). The DB contains all relevant information from the RIS and thumbnails of corresponding images archived in the PACS. After authorisation, the user receives this information in the form of dynamically generated Web pages. By mouse-clicking a thumbnail, the original DICOM-image is sent. It is displayed with a helper application (DICOM-Viewer), allowing all kinds of image manipulation and post-processing. Results: Determined advantages of the system were: platform independence, security features, a fixed link of image and report, universal availability, and simple usage. The only critical issue was performance. Cost savings could be seen in: a reduction of DICOM workstations, employment of all available hardware, and reduced training and teaching efforts. Conclusions: The author believes that a WWW- based concept is the only feasible approach which is in the same way technically possible, clinically acceptable, and financially affordable in order to grant a variety of users access to radiological data– although improvements in performance have to made by, e.g., closer implementation of those systems to the RIS and PACS architecture, and by employing high-grade image compression.
The Value of an Evaluation Framework for Telehealth Initiatives
Authors: Scott Richard E.  , Coates Ken
Published: February 2025

Healthcare managers and policy makers will, in the immediate and near future, make major decisions about the allocation of scarce healthcare resources for telehealth ‘solutions’. In our haste to capitalize on what technology can do we may be obscuring discussion and research about what technology should do. For example, currently much attention is being paid to standardization for technological aspects of telehealth. In contrast few efforts have been made to seek standardization in regards to a broad evaluation framework for telehealth. A body of opinion believes that missing in our rush into the on-line world is a systematic approach to research into the human, social, cultural, economic, and political factors associated with healthcare. As a result we lack the tools and experience necessary to assess the true value and implications of telehealth ‘solutions’. Developing general guidelines for an evaluation framework, from needs assessment through integrated research to post-study assessment, would greatly enhance the quality of decision making by healthcare managers and policy makers. We propose a model - the Telehealth Integrated Research Model (TIRM) - as the first step in encouraging discussion and development of an internationally accepted standardized telehealth evaluation framework.
Selection of Hospital Information Systems: User Participation
Authors: Stausberg Jürgen
Published: February 2025

Motivated by economic and quality management issues, many hospitals strive for the introduction of information systems into the clinical environment. To introduce the most suitable software product, a systematic selection procedure is required involving all affected staff. The paper describes a methodology that guides the clinical users to an objective motivated decision. This semi-formal methodology is necessary in view of missing standard models for the description of hospital in- formation systems and leads to high acceptance in practical use. The methodology consists of structured product demonstrations with a quantitative assessment, benefit-value-analyses based on step weights for the functions needed, and test installations. Prerequisite of this procedure was the definition of objectives and priorities in a standard catalog that was used as reference in the whole project. Selecting a software product following this systematic procedure establishes a sound basis for a successful application in the clinical environment.
Barriers for dissemination of a National Health Care Data Network A list of recommendations for better dissemination
Authors: Johansen Ib  , Thiel Lone Kaalund
Published: February 2025

Establishment of a Danish Nation-wide Health Care Data Network for exchange of health care related information using standardised EDIF ACT messages is agreed between the Danish Government, the Hospital Owners and the GPs organisations.
Authorisation & Security aspects in the Middleware-based healthcare information system
Authors: Andany Jose  , Bjorkendal Christer  , Ferrara Fabrizio Massimo  , Scherrer Jean-Raoul  , Spahni Stéphane
Published: February 2025

The integration and evolution of existing systems represents one of the most urgent priorities of health care information systems in order to allow the whole organisation to meet the increasing clinical organisational and managerial needs. The CEN ENV 12967-1 ‘Healthcare Information Systems Architecture’(HISA) standard defines an architectural approach based on a middleware of business-specific com- mon services, enabling all parts of the local and geographical system to operate on the common information heritage of the organisation and on exploiting a set of common business-oriented functionality.