bluuebunny/crossref_metadata_2025 huggingface dataset:
Intraoperative Tracking of the Trunk DuringPosterior Instrumentation of the Scoliotic Spine: A Feasibility Study
Authors: Mac-Thiong Jean-Marc  , Labelle Hubert  , Vandal Sylvie  , Aubin Carl-Éric
Published: February 2025

Scoliosis involves spine and trunk deformities. However, during posterior instrumentation of the scoliotic spine, only the exposed spine is currently seen or tracked using navigation systems. A technique for intraoperative tracking of the trunk was developed in order to optimize the surgical correction of the scoliotic trunk deformity. The feasibility of this technique was assessed by comparing the trunk geometry between 19 normal and 21 scoliotic subjects, using an experimental set-up simulating the position adopted during posterior scoliosis surgery. Eleven magnetic sensors placed on anatomical landmarks of the trunk were used to compute nine geometric indices. The geometric indices were closer to zero for normal subjects. Therefore, indices approaching zero during the surgical manoeuvres would indicate a reduction of the trunk asymmetry. Only three of the nine indices were significantly different between normal and scoliotic subjects. This result indicates that the positioning of the subjects on the Relton-Hall frame tends to “normalize” the trunk geometry since the standing position gives more significant differences between normal and scoliotic subjects. The real-time quantification of the trunk geometry during surgical correction of scoliosis may allow the surgeon to improve the correction of both spinal and trunk deformities or to optimize the positioning of the patients on the operating table.
Secure Exchange of Medical Data: Requirements and Solutions
Authors: Spahni Stéphane  , Weber Patrick
Published: February 2025

It is now common to access and to exchange data through computer networks. The major applications used are Web access and e-mail. But while there is no security concern when accessing classical or anonymous data, the exchange of sensitive data (e.g. patient-related information) is subject to legal constraints. This paper summarizes the current legal obligations in Switzerland and presents state of the art techniques for applying the legal rules. A commercial implementation in Switzerland is taken as illustration.
akteonline — an electronic healthcare record as a medium for information and communication
Authors: Ückert Frank  , Görz Michael  , Ataian Maximilian  , Prokosch Hans-Ulrich
Published: February 2025

The functionality of a personal Electronic Healthcare Record (EHR) may vary from a simple web- based interface for interactive data entry and data review up to a much more powerful system additionally supporting electronic data/document communication between clinical information systems of primary care practitioners or hospitals and even reminder based support for the empowered citizen, to actively take care of his health, based on relevant disease management programs. It is one mean to support patient empowerment. Since storage and communication of data in an EHR comprises sensible personal health data, each of those functions need specific security and access management requirements to be considered and implemented.
Analysis of the Time Series for some Causes of Death
Authors: Kis Maria
Published: February 2025

The mortality data may be analysed by time series methods such as autoregressive integrated moving average (ARIMA) modelling. This method is demonstrated by two examples: analysis of the mortality data of cerebrovascular diseases and analysis of the mortality data of cancer of cervix. Mathematical expressions are given for the results of analysis. The relationships between time series of mortality rates were studied with ARIMA models. Calculations of confidence intervals for autoregressive parameters by tree methods: standard normal distribution as estimation and estimation of the White's theory and the continuous time case estimation. Analysing the confidence intervals of the first order autoregressive parameters we may conclude that the confidence intervals were much smaller than other estimations by applying the continuous time estimation model.
Representing Clinical Guidelines in UML: A Comparative Study
Authors: Hederman Lucy  , Smutek Daniel  , Wade Vincent  , Knape Thomas
Published: February 2025

Clinical guidelines can be represented using models, such as GLIF, specifically designed for healthcare guidelines. This paper demonstrates that they can also be modelled using a mainstream business modelling language such as UML. The paper presents a guideline in GLIF and as UML activity diagrams, and then presents a mapping of GLIF primitives to UML. The potential benefits of using a mainstream modelling language are outlined. These include availability of advanced modelling tools, transfer between modelling tools, and automation via business workflow technology.
RESIS3D - Online information about spatial and temporal spreading of resistant pathogens
Authors: Dümcke Knut  , Ihracky Dusan  , Schmidt Rainer  , Gierl Lothar
Published: February 2025

Considering resistances of supposed or identified pathogens is of vital importance in antibiotics therapy. Additionally local details play a very important role. So the resistance situation can be different on two wards of the same facility. Furthermore it is possible that there is spatial extension of resistances across the wards that the physicians suppose a future resistance development in a specific unit. The idea of RESIS3D is to visualize spatial and temporal development of resistant pathogens and to give the attending physician (as well as the laboratory) important information for using antibiotics. RESIS3D is an addition to our computer-based therapy adviser called ICONS for calculated antibiotics therapy in intensive care medicine.
A case study on Constructive Assessment of bids to a Call for Tender
Authors: Brender Jytte  , Schou-Christensen Jens  , McNair Peter
Published: February 2025

A case study based on constructive assessment methodology is taking place at the purchase of a Laboratory Information System. The present report describes the strategy and approach for the selection process, together with some results and lessons learned, while a parallel paper presents the tools applied.
Prevention of prescription errors by computerized, on-line, individual patient related surveillance of drug order entry
Authors: Oliven A.  , Zalman D.  , Shilankov Y.  , Yeshurun D.  , Odeh M.
Published: February 2025

Computerized prescription of drugs is expected to reduce the number of many preventable drug ordering errors. In the present study we evaluated the usefullness of a computerized drug order entry (CDOE) system in reducing prescription errors. A department of internal medicine using a comprehensive CDOE, which included also patient-related drug-laboratory, drug-disease and drug-allergy on-line surveillance was compared to a similar department in which drug orders were handwritten. CDOE reduced prescription errors to 25-35%. The causes of errors remained similar, and most errors, on both departments, were associated with abnormal renal function and electrolyte balance. Residual errors remaining on the CDOE-using department were due to handwriting on the typed order, failure to feed patients' diseases, and system failures. The use of CDOE was associated with a significant reduction in mean hospital stay and in the number of changes performed in the prescription. The findings of this study both quantity the impact of comprehensive CDOE on prescription errors and delineate the causes for remaining errors.
Virtual Universities - the reality of e-learning?
Authors: Wright Graham  , Betts Helen J
Published: February 2025

With the growth of the internet and world wide web new ways of exchanging information are emerging, barriers are being overcome, new partnerships and ways of working are emerging. Amongst the hype is the notion a Virtual University; it is hype or reality? What are the issues? A description of a University will not just include the programmes that it delivers but would no doubt include research and the academic environment. This paper raises some of the issues for Health Informatics.
DIACOM: A Collective Learning Forum for Continuing Medical Education
Authors: Joiron Céline  , Leclet Dominique
Published: February 2025

DIACOM forum (Case based Interactive discussions for Medical education) is a computing tool dedicated to physicians in continuing education. Its goal is learning based on a distant clinical case confrontation between peers. Each learner can describe a case from his or her own experience, and the underlying system puts authors in touch whose cases have common points of interest. Research works managed in the SaSo Laboratory aims at developing a DIACOM from prototype for Continuing Medical Education (CME) in pediatric pain management. This paper presents the theoretical and pedagogic context and the functioning of the DIACOM forum.
Development of the neurocentral junction as seen on magnetic resonance images
Authors: Rajwani T.  , Bhargava R.  , Lambert R.  , Moreau M.  , Mahood J.  , Raso V.J.  , Jiang H.  , Huang E.M.  , Wang X.  , Daniel A.  , Bagnall K.M.
Published: February 2025

The neurocentral junction (NCJ) is a cartilaginous growth plate in the vertebra that has been implicated as a potential cause of adolescent idiopathic scoliosis (AIS) since the early 1900s. Studies to date have focused on the age of closure without characterizing normal NCJ development. Using MRI, the normal development of the NCJ image can be determined and the stages preceding the disappearance of the NCJ image can be characterized. 405 NCJs from 11 pediatric patients were examined using MRI and the various images were categorized. NCJ development encompassed five stages, with a specific pattern of absence of the NCJ image noted in each vertebra and in the vertebral column as a whole. The image of the NCJ first became absent in the cervical region (age 6), then in the lumbar region (age 12) and finally in the thoracic region (age 14). These patterns of development serve as a baseline to evaluate NCJ pathology in conditions such as adolescent idiopathic scoliosis (AIS).
Curvature progression in patients treated with scoliosis in-patient rehabilitation – A sex and age matched controlled study
Authors: Weiss Hans-Rudolf  , Weiss Grita
Published: February 2025

The aim of this study is to test the hypothesis that physiotherapy-based intervention can reduce incidence of progression in children with IS because progression of spinal curvature in patients with idiopathic scoliosis (IS) is of paramount concern in treatment strategies.
Is The Boston Brace Mechanically Effective in AIS?
Authors: Raso VJ  , Lou E.  , Hill DL  , Mahood JK  , Moreau MJ
Published: February 2025

The application of three-point loading is thought to be the essential basis for effective bracing of adolescent idiopathic scoliosis. Care is taken to ensure that active pressure pad is located to provide maximum support to the apex of the scoliosis while minimizing its lordosising effect. Paradoxically, while cited as an essential factor in the design of braces, there is no consensus as to the importance of such loading to the clinical effectiveness of braces. It may be that braces are effective but that they are effective for reasons unrelated to mechanics. There are few studies that link brace mechanics and change in spinal alignment. Optimal bracing for AIS requires a much better understanding of the role of the mechanical support of braces used to treat AIS. Sixteen subjects, 3 males and 13 females, were participated to this study to determine the correlation between quantity and quality of brace wear and treatment outcomes in AIS. This study showed that the target force levels set for the active pad in braces prescribed for the treatment of AIS vary considerably and that brace applies the desired load 25% of the prescribed time.
Online Health Networks
Authors: Gilbert M.  , Vael Th.  , Vandenberghe A.  , Gérard P.
Published: February 2025

Healthcare networks fonction as a structural synergy serving the various healthcare actors, including the patient, who is the beneficiary. Medically speaking, they meet the need of healthcare professionals for targeted information sharing with regard to the medical record. Economically speaking, they may represent an added value and/or a diminution of costs, thus contributing to quality of care. The adoption of the same standards for ail concerned servers is an absolute prerequisite if multidisciplinary applications are to be generated, as well as related services of an informational and educational nature.
Special Visual Effects for Surgical Simulation: Cauterization, Irrigation and Suction
Authors: Agarwal Ritesh  , Bhasin Yogendra  , Raghupathi Laks  , Devarajan Venkat
Published: February 2025

Simulation of cauterization and irrigation forms an important part of a virtual laparoscopic trainer. Typically, they are carried out to stop the intragastric bleeding due to an accidental cut by the surgeon. In this paper, we present a method to simulate these special visual effects in an integrated fashion in real-time. We have simulated cauterization and irrigation using a particle-based system. A physics-based model is used to simulate accumulation and removal of fluids. The integrated special effects were implemented and tested in a prototype environment.
Development of a New Three-dimensional Endoscopic Ultrasound System Through Endoscope Shape Monitoring
Authors: Koizumi Naoshi  , Sumiyama Kazuki  , Suzuki Naoki  , Hattori Asaki  , Tajiri Hisao  , Uchiyama Akihiko
Published: February 2025

We have developed a new three-dimensional (3D) endoscopic ultrasound system (EUS) with convex scanning echoendoscope to diagnose and navigate for endoscopic puncture using the 3D image. To detect the position of the probe and to monitor the shape of the scope inside the body, we use a fiber optic tracking system which is shaped like a ribbon (Shapetape, Measurand Inc.). The fiber optic tracking system could measure bend and twist at each position of the ribbon The position of the tip of the echoendoscope is allotted to a 2D image, and the system can reconstruct and visualize a 3D image in real-time. We have reported results of our experimental studies and animal studies.
The Operating Room of the Future: White Paper Summation
Authors: Moses Gerald R.  , Farr Jr James O.
Published: February 2025

On November 8 and 9, 2001, leading experts in patient safety, medical informatics, advanced surgical devices, telesurgery, and surgical facilities met to formulate strategic directions for the “OR of the Future” in both military and civilian healthcare. The meeting was co-hosted by the Telemedicine and Advanced Technology Research Center (TATRC) part of the U.S. Army Medical Research and Materiel Command at Fort Detrick, and the University of Maryland Medical Center. Researchers, surgeons, and experts in the field of operating room (OR) technology addressed the current state of research and technological developments.
Wireless Virtual Instrument Measurement of Surgeons' Physical and Mental Workloads for Robotic Versus Manual Minimally Invasive Surgery
Authors: Smith Warren D.  , Berguer Ramon  , Rosser Jr. James C.
Published: February 2025

The human-technology interface in traditional minimally invasive surgery (MIS) is difficult for the surgeon. Efforts to improve this interface include the use of robotic surgery systems. Ergonomics studies are required to help understand and improve the MIS user interface.
Deduction of Principles on Long-term Conservation of Electronically Signed Documents by Multi professional Analyses
Authors: Bess Andreas  , Brandner Ralf
Published: February 2025

Due to actual equalization of qualified electronic signatures with handwritten signatures and the legal acknowledgment of the electronic form, the opportunity to use electronic patient records instead of classic paper-based ones is given. The archiving of medical records over a period of 10 to 30 years represents an important factor in medical documentation which has to be assured for electronically signed documents as well. The ArchiSig project deduces principles on long-term conservation of electronically signed documents and corresponding technical components to be realized by the means of multi professional analyses.
Specification Levels and Collaborative Definition for the Integration of Health Information Systems
Authors: Mykkänen Juha  , Tikkanen Tomi  , Rannanheimo Juha  , Eerola Anne  , Korpela Mikko
Published: February 2025

In this paper, we extend our previous work for defining interoperability for health information systems into proposed documentation levels for specking integration, and a model for defining various interoperability aspects in collaboration between integrators, health service providers and system providers. We are using these models in defining solutions for a set of different integration needs in PlugIT project in Finland We propose collaborative definition and clear levels of integration specifications to promote adequacy, consistency and efficiency of integration solutions and software component specifications in health information systems.
Data Representation in Healthcare: A design for a freely-available openly-developed international reference terminology for healthcare
Authors: Elkin Peter L.  , Brown Steven H.  , Lincoln Michael J.  , Pittelkow Mark  , Bauer Brent A.  , Wahner-Roedler Dietlind  , Thomas Rhonda  , Bergstrom Larry
Published: February 2025

The importance of data representation in healthcare has been of concern for centuries. In the last fifty years there has been an increasing awareness of the need for formal representations of terminological systems. We propose that terminological system development should be consensus driven and the product of iterative open refinement in order to practically serve the needs of the healthcare community. The system of development and maintenance of such a system must involve recruitment of the best and the brightest in the medical community to take responsibility for insuring the accuracy and completeness of such an effort. We suggest a method for algorithmically building a starting point for such a reference terminology. Further we suggest a distributed authoring environment that would allow domain experts to contribute regardless of their location or language. Open intellectual contribution is the necessary ingredient for a consensus based international health reference terminology.
A Frame-based Representation of ICD-10
Authors: Fabry Paul  , Baud Robert  , Ruch Patrick  , Beux Pierre Le  , Lovis Christian
Published: February 2025

Physicians are required to code information concerning a patient's stay in order to measure the medical activity in hospitals. They use the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10). Coding is usually performed manually and computerized tools may be useful in speeding up and facilitating the tedious task of coding patient information. The aim of this work is to build a surface semantic model of ICD-10 in order to ameliorate a coding help system.
SIGAPS a prototype of bibliographic tool for medical research evaluation
Authors: Devos P  , Dufresne E  , Renard JM  , Beuscart R
Published: February 2025

Evaluation of research activity is extremely important but remains a complex domain. There's no standardized methods and evaluation is often based on the scientific publications. It is easy to identify, for a researcher, all the publications realized over a given period of time. At the level of an important establishment like an University Hospital, with about 500 researchers, this sort of inventory is very difficult to realize : we have to list the researchers, to list their publications, to determine the quality of articles produced, to store retrieved data and to calculate summary statistics. We have developed a full-Web prototype, using free software which, for a given researchers' list, interrogates the Pubmed server, downloads the found references and stores them in a local database. They are then enriched with local data which allow the realization of more or less complex analyses, the automatic production of reports, or keyword search. This tool is very easy to use, allowing for immediate analysis of publications of a researcher or a research team. This tool will allow to identy those active teams to be maintained or emergent teams to be supported It will also allow to compare candidate profiles for appointments to research posts.
An Approach to Enrich Online Medical Problem-Based Learning with Tacit Healthcare Knowledge
Authors: Cheah Yu-N  , Rashid Faridah Abdul  , Abidi Syed Sibte Raza
Published: February 2025

Existing Problem-Based Learning (PBL) problems, though suitable in their own right for teaching purposes, are limited in their potential to evolve by themselves and to create new knowledge. Presently, they are based on textbook examples of past cases and/or cases that have been transcribed by a clinician. In this paper, we present (a) a tacit healthcare knowledge representation formalism called Healthcare Scenarios, (b) the relevance of healthcare scenarios in PBL in healthcare and medicine, (c) a novel PBL-Scenario-based tacit knowledge explication strategy and (d) an online PBL Problem Composer and Presenter (PBL-Online) to facilitate the acquisition and utilisation of expert-quality tacit healthcare knowledge to enrich online PBL. We employ a confluence of healthcare knowledge management tools and Internet technologies to bring tacit healthcare knowledge-enriched PBL to a global and yet more accessible level.
Health Telematics: Towards Harmonisation of the Legal Framework?
Authors: Skouma Georgia  , Vaneecke Patrick
Published: February 2025

The use of telematics in medicine inaugurates a new era in the provision of healthcare services at a global level. The potential of improved quality of care, easy accessibility to innovative treatment and more efficient utilisation of resources are some of the challenges of health telematics applications. A sound legal basis is needed to boost the expansion of ICT systems in healthcare, which is also expected to enhance the confidence of patients and healthcare professionals in the use thereof. Because of the global nature of the Internet, the legal solutions that will be adopted cannot be fragmented on a per country basis. Solid legislation at the EU level that will frame the provision of Information Society services in general is now under construction. Some core EU directives have already been transposed into the national legal systems, while some others are under the way of implementation. It is highly likely that even after their implementation these acts will not secure an ideal harmonisation in the provision of services as far as healthcare is concerned. A flexible regulatory approach is therefore needed to complete the regulatory gaps that the everyday practice has been ascertaining. A remedy to this direction can be the preparation and adoption on an EU scale of self-regulatory instruments, insofar as they can be broadly recognised and enforced by the judge.
Medical Research Networks – An International Comparison
Authors: Rienhoff Otto
Published: February 2025

Medical research networks (MRN) are described as a new approach in fostering science for health. It is described that this approach can be found in several countries and global business companies. MRNs try to maximise use of information technology (IT) for speeding up the long research and transfer process from basic science to patient care. Despite the fact that several countries have funding schemes for this approach, nomenclatures and frameworks vary due to different national conditions. Nevertheless there is a general expectation that MRNs are necessary. However, there long-term impact and efficiency has still to be evaluated. The results of this report are based on a benchmarking study currently underway in Germany.
ISO and CEN Standards for Health Informatics – Synergy or Competition
Authors: Klein Gunnar O.
Published: February 2025

The European standardisation of health informatics in CEN/TC 251 started in 1990 with the now twenty national standards bodies as members and a political mandate from the European Union and EFTA. The start of the international work in ISO/TC 215 has been welcomed by Europe and there is a lot of co-operation where European pre-standards have often been the basis for the start of international standards work, particularly in the area of medical device communication and for health cards. CEN and ISO also collaborate with other bodies in the field such as DICOM for imaging, IEEE for devices and the US based HL7 organisation for message development. It is important to find the right level of standards work for different aspects. The European CEN work will be maintained for issues like the electronic health record, some security aspects and medication related communication where there are common views and legislation makes European consensus necessary and achievable. The device market on the other hand requires global standards. In addition to multinational co-operation, it is important with a national strategy for the use of standards and adaptation and promotion of specific profiles to achieve interoperability in the still mainly national health systems.
Software Agents in Surgery: An Update
Authors: Mohr Markus T.J.
Published: February 2025

Intelligent and, thus, autonomously reacting software programs are capable of handling a lot of different tasks as has been realized in economics and network administration. The same so-called software agents can be used for a variety of organizational tasks in medicine. Some software agents already manage an individual patient's health care record from documentation to ambulant or stationary admission, surgical planning, and many other tasks which currently consume more than half of a physician's daily working time. Hence, not only a large potential of time, but also of economical savings result to the physicians' new disposition.
Ergonomic Interface Concepts for Minimally Invasive, Remote, and Virtual Surgical Systems
Authors: Noakes Mark W.  , Dixon Warren E.
Published: February 2025

Traditional open surgical techniques require a surgeon to assume a posture of leaning over the patient with a direct eye-to-hand perspective. As new minimally invasive and remote surgical procedures evolve, the surgeon is not required to maintain the same posture as in open techniques. While more ergonomic postures may be facilitated, some current remote systems have maintained surgeon configurations that are small variants of legacy postures (e.g., maintaining the eye to hand perspective). While the legacy configuration may be more familiar with some surgeons, studies have indicated that it can result in excessive fatigue. Robotics and human factors researchers have determined that fatigue due to inefficiencies in operator interfaces lead to longer completion times and increased task execution errors. This paper discusses operator interface design issues and guidelines that are relevant to remote and minimally invasive surgery, and presents one possible operator interface solution based on the compact remote console deployed for environmental restoration and remote handling of hazardous nuclear waste.
A 3D Interactive Multimodal Viewer as Data Mining Tool for the Visible Human Dataset Color Image Histograms
Authors: Bonacina Stefano  , Menegoni Francesco  , Pinciroli Francesco  , Masseroli Marco
Published: February 2025

An on-line virtual three-dimensional immersive environment to navigate through colorimetric characterization of the Visible Human Dataset (VHD) cryosectional cross-section color images is introduced. Real-time analysis of color component characteristics of a user defined set of VHD images is now possible. This is a potentially useful resource to many developers working on the VHD raw data, however it could be used in medical education.
Comparison of CAVE and HM for Visual Stimulation in Postural Control Research
Authors: Tossavainen Timo
Published: February 2025

The control of balance of 20 healthy subjects under visual stimulation was quantitavely evaluated using a force platform. Three different visual stimuli were administered using a head-mounted display and CAVE. CAVE was significantly more effective in perturbing balance in one stimulus and HMD was significantly more effective in another.
Virtual Reality Exposure in the Treatment of Social Phobia
Authors: Klinger Evelyne  , Légeron Patrick  , Roy Stéphane  , Chemin Isabelle  , Lauer Françoise  , Nugues Pierre
Published: February 2025

Social phobia is one of the most frequent psychiatric disorders and is accessible to two forms of scientifically validated treatments: anti-depressant drugs and cognitive-behavioral therapies. Graded exposure to feared social situations (either in vivo or by imagining the situations) is fundamental to obtain an improvement of the anxious symptoms. Virtual reality (VR) may be an alternative to these standard exposure techniques and seems to bring significant advantages by allowing exposures to numerous and varied situations. Moreover studies have shown that human subjects are appropriately sensitive to virtual environments.
Standardized Terminology for Clinical Trial Protocols Based on Top-Level Ontological Categories
Authors: Heller B.  , Herre H.  , Lippoldt K.  , Loeffler M.
Published: February 2025

This paper describes a new method for the ontologically based standardization of concepts with regard to the quality assurance of clinical trial protocols. We developed a data dictionary for medical and trial-specific terms in which concepts and relations are defined context-dependently. The data dictionary is provided to different medical research networks by means of the software tool Onto-Builder via the internet. The data dictionary is based on domain-specific ontologies and the top-level ontology of GOL. The concepts and relations described in the data dictionary are represented in natural language, semi-formally or formally according to their use.
Gene Ontology application to genomic functional annotation, statistical analysis and knowledge mining
Authors: Martucci Dario  , Masseroli Marco  , Pinciroli Francesco
Published: February 2025

While a massive amount of biomolecular information is increasingly accumulating in different databanks, on the other hand high-throughput technologies are generating a great quantity of data that need to be annotated with the genomic information available, and interpreted. To this aim, the use of specific ontologies can greatly help either in integrating different information stored within heterogeneous databanks, or in identifying and clustering sequence data sharing common characteristics. In the molecular biology domain, the Gene Ontology (GO) is the most developed and widely used ontology. To demonstrate its great utility in the annotation and biological interpretation of gene sets obtained by means of high-throughput experiments, we implemented the web application here described. It enables functional annotations of a given gene set on a genomic scale and across different species. Within our application the annotations provided by the GO vocabulary allow either to easily bind several information from different resources, or to cluster annotated genes according to their biological characteristics. Through the GO structure it is also possible to represent biological concepts with different specificity levels, from very general to very precise concepts. Furthermore, the statistical evaluation of the categorizations provided by the GO annotations enables to highlight the most significant biological characteristics of a gene set, and therefore to mine knowledge from data. Our created tool meets the need to manage a vast quantity of biological data with a simple user interface adapt also for users with limited informatics knowledge, leading them to evaluate the functional significance of experiment's results with graphical views and statistical indexes in a well-known web browser user interface.
Use of the ISO/IEC 17799 Framework in Healthcare Information Security Management
Authors: Posthumus Luuc
Published: February 2025

Shared care implies sharing information. This requires a common concept of information security among healthcare providers and a system to maintain compliance to the security requirements within the healthcare community.
An electronic patient record implementation using clinical document architecture
Authors: Poulymenopoulou M.  , Vassilacopoulos G.
Published: February 2025

Electronic patient records (EPRs) provide the means for integrated access to patient information that may be scattered across dispersed healthcare organizations that, in general, use heterogeneous systems in order to support their internal functions. XML language and Clinical Document Architecture (CDA) provides a mechanism for defining, structuring, manipulating and visualizing patient medical data using the same semantics through web. In this paper, a prototype implementation of a web-based electronic patient record (EPR) system using XML for data format and CDA for defining and structuring patient clinical documents is presented.
Virtual Reality in Laparoscopic Surgery
Authors: Uranüs Selman  , Yanik Mustafa  , Bretthauer Georg
Published: February 2025

Although the many advantages of laparoscopic surgery have made it an established technique, training in laparoscopic surgery posed problems not encountered in conventional surgical training. Virtual reality simulators open up new perspectives for training in laparoscopic surgery. Under realistic conditions in real time, trainees can tailor their sessions with the VR simulator to suit their needs and goals, and can repeat exercises as often as they wish. VR simulators reduce the number of experimental animals needed for training purposes and are suited to the pursuit of research in laparoscopic surgery.
Changing the Medical World Order With Technological Advances: The Future Has Only Begun
Authors: Merrell Ronald C.
Published: February 2025

It is a great honor to contribute in a small way to this book which in a way celebrates the continued evolution of telemedicine in Kosova. I was privileged to visit this brave land on several occasions in the last years. Severe circumstances were repeatedly resolved through great personal and professional sacrifice. Revolutionary solutions have been applied where evolutionary development was simply too slow in the realization of a new land in a complex world. In some ways telemedicine is emblematic of such struggle and success. We aspire to world health when world peace is elusive and hunger haunts us in the midst of plenty. Telecommunications have made it easy to report the failings of medicine, the injustice of health care and the unmet promise of political endeavor. It is the promise of telemedicine to use those same channels of information to empower, unify and advance the cause of health rather than only report the failings. Telemedicine entails the use of telecommunications and information technology to support the delivery of health care at a distance.(1,2). There are critics who believe telemedicine is a waste of precious resources, which are needed urgently for higher health priorities. Telemedicine is dismissed as an expensive irrelevance, another distraction from the real needs of medicine in a chaotic world. That is patently ridiculous. Telemedicine is a part of the wider phenomenon of information and information is arguably the strongest change agent in play for medicine and other societal elements as well. A well-informed public armed with the tools for self-determination and the evidence for efficient action cannot be corrupted. Telemedicine is a part of the great change information brings to the world order, a drastic change toward a better world of health and justice.
Home Based E-Health Applications
Authors: Demiris George
Published: February 2025

Home based e-health applications use telecommunication and video-conferencing technologies to enable a healthcare provider at the clinical site to communicate with patients at their home. Such an interaction is called a ‘virtual visit’. Numerous applications are utilizing commercially available monitoring devices and the Internet to enable home based disease management and monitoring. The aim to meet older adults' desire to remain independent at home while controlling home health care costs has also led to the development of “smart home” technologies. A smart home is a residence equipped with technology that enhances safety of patients at home and monitors their health conditions. Therefore, the devices and sensors chosen to be installed and maintained in the older adults' residences need to address functional limitations and social and health care needs. This paper provides an overview of home based e-health applications and discusses the challenges of implementing and evaluating e-health applications.
Experiences with the Development, Implementation and Evaluation of Automated Decision Support Systems
Authors: Clercq Paul de  , Hasman Arie
Published: February 2025

A framework for the implementation of guidelines -GASTON-was developed. Its functions range from the definition of guidelines (using a GLIF like approach) to the implementation of a DSS that can be coupled to existing information systems. This paper discusses experiences with the development of three systems in different domains. It is concluded that the toolbox corresponding to theframework could be successfully used to develop these systems.
A Submission Model for Use in the Indexing, Searching, and Retrieval of Distributed Pathology Case and Tissue Specimens
Authors: Namini Ahmad H.  , Berkowicz David A.  , Kohane Isaac S.  , Chueh Henry
Published: February 2025

This paper describes the Shared Pathology Informatics Network (SPIN) submission model for uploading de-identified XML annotations ofpathology case and specimen information to a distributed peer-to-peer network architecture. SPIN use cases, architecture, and technologies, as well as pathology information design is described. With the architecture currently in use by six member institutions, SPIN appears to be a viable, secure methodology to submit pathology information for query and specimen retrieval by investigators.
Healthcare Public Key Infrastructure (HPKI) and Non-profit Organization (NPO): Essentials for Healthcare Data Exchange
Authors: Takeda Hiroshi  , Matsumura Yasushi  , Nakagawa Katsuhiko  , Teratani Tadamasa  , Qiyan Zhang  , Kusuoka Hideo  , Matsuoka Masami
Published: February 2025

To share healthcare information and to promote cooperation among healthcare providers and customers (patients) under computerized network environment, a non-profit organization (NPO), named as OCHIS, was established at Osaka, Japan in 2003. Since security and confidentiality issues on the Internet have been major concerns in the OCHIS, the system has been based on healthcare public key infrastructure (HPKI), and found that there remained problems to be solved technically and operationally. An experimental study was conducted to elucidate the central and the local function in terms of a registration authority and a time stamp authority by contracting with the Ministry of Economics and Trading Industries in 2003. This paper describes the experimental design with NPO and the results of the study concerning message security and HPKI. The developed system has been operated practically in Osaka urban area.
Using a Bayesian Network to Predict the Probability and Type of Breast Cancer Represented by Microcalcifications on Mammography
Authors: Burnside Elizabeth S.  , Rubin Daniel L.  , Shachter Ross D.
Published: February 2025

Since the widespread adoption of mammographic screening in the 1980's there has been a significant increase in the detection and biopsy of both benign and malignant microcalcifications. Though current practice standards recommend that the positive predictive value (PPV) of breast biopsy should be in the range of 25-40%, there exists significant variability in practice. Microcalcifications, if malignant, can represent either a non-invasive or an invasive form of breast cancer. The distinction is critical because distinct surgical therapies are indicated. Unfortunately, this information is not always available at the time of surgery due to limited sampling at image-guided biopsy. For these reasons we conducted an experiment to determine whether a previously created Bayesian network for mammography could predict the significance of microcalcifications. In this experiment we aim to test whether the system is able to perform two related tasks in this domain: 1) to predict the likelihood that microcalcifications are malignant and 2) to predict the likelihood that a malignancy is invasive to help guide the choice of appropriate surgical therapy.
Differing Faculty and Housestaff Acceptance of an Electronic Health Record One-Year After Implementation
Authors: Bier Daniel B.  , Rothschild Adam  , LeMaistre Anne  , Keeler Joy
Published: February 2025

In order to determine whether differences exist between housestaff and faculty physician acceptance of an electronic health record system, we conducted a written survey of attitudes towards new electronic medical record at the University of Illinois at Chicago. We surveyed 330 faculty and housestaff physicians. User acceptance of the EHR was high for both faculty physicians and housestaff. 88.0% of the housestaff and 64.7% of the faculty preferred the EHR over a paper record. Although both housestaff and faculty acceptance of an EHR was high, housestaff showed greater approval ratings than faculty. Central to acceptance of an EHR is conservation of physician time including improving system speed, reducing time spent waiting for a computer to become available, and minimizing time spent documenting care.
Inter-Observer Agreement for Quality Measures Applied to Online Health Information
Authors: Sagaram Smitha  , Walji Muhammad  , Meric-Bernstam Funda  , Johnson Craig  , Bernstam Elmer
Published: February 2025

Many criteria have been developed to rate the quality of online health information. However, few instruments have been validated for inter-observer reliability. Therefore, we assessed the degree to which two raters agree upon the presence or absence of information based on 22 popularly cited quality criteria on a sample of 21 complementary and alternative medicine websites. Our preliminary analysis showed a poor inter-rater agreement on 10 out of the 22 quality criteria. Therefore, we created operational definitions for each of the criteria, decreased the allowed choices and defined a location to look for the information. As a result 15 out ofthe 22 quality criteria had a kappa >0.6. We conclude that even with precise definitions some commonly used quality criteria to assess the quality of health information online cannot be reliably assessed. However, inter-rater agreement can be improved by providing precise operational definitions.
A Knowledge Management System for New Drug Submission by Pharma-Industries
Authors: Pinciroli Francesco  , Mottadelli Sara  , Vinci Maurizio  , Fabbro Luigi  , Gothager Klas
Published: February 2025

The pharma-industries are facing a number of crucial business issues to improve operational excellence in product time-tomarket and wide regulatory compliance. These organizations own, produce and manipulate a lot of knowledge. The new regulations by Health Authorities (HA) to pharma-industries should make the content and format of new drug application uniform worldwide. In this paper we suggest a novel approach of a pharma- industry to capture, process and transmit clinical data electronically. The approach begins with an analysis of the knowledge generation points, some of them being outside the company. Implementations are grounded on the use of a de facto standard platform being Microsoft, having acceptable cost levels. The proposed infrastructure is integrated into existing company environment and technological platform, minimizing cost and risks, but improving efficiency and efficacy of new drug dossier compilation.
Aligning Knowledge Sources in the UMLS: Methods, Quantitative Results, and Applications
Authors: Bodenreider Olivier  , Burgun Anita
Published: February 2025

The UMLS Semantic Network and Metathesaurus are two complementary knowledge sources. While many studies compare relationships across the two structures, their alignment has never been attempted. We applied two methods based on lexical and conceptual similarity to aligning the Semantic Network with the UMLS Metathesaurus. Approximately two thirds of the semantic types could be aligned by lexical similarity. Conceptual similarity suggested mappings in all but ten cases. Potential applications enabled by the alignment are discussed, namely auditing the consistency between the Semantic Network and the Metathesaurus and extending the Semantic Network downwards. The relative contribution and limitations of the two methods used for the alignment are also discussed.
Improving Information Prescription to Parents of Premature Infants Through An OWLBased Knowledge Mediator
Authors: Goldberg Howard S.  , Morales Alfredo
Published: February 2025

In the Baby CareLink system, information prescription plays an important role in preparing parents of premature infants for the eventual discharge to home of their children. However, the prescription process requires scarce clinician time in order to dispense information, and can become cumbersome as content bases grow in size. We describe the development of an OWLbased knowledge mediator to facilitate information prescription. We describe 1) the initial development of a clinical vocabulary for neonatology using OWL-DL; 2) the reuse of the vocabulary to represent prototypical premature infants and their typical clinical problems and treatments; 3) the software components used to integrate terminology and inferencing services with Baby CareLink. We demonstrate multifaceted uses for description logics in a clinical application, reuse of a base vocabulary for domain knowledge representation, and use of the OWL language in representing clinical vocabularies. We believe that semi -automated knowledge mediation will enhance the process of electronic information prescription using large clinical content collections.
Problems and Solutions with Integrating Terminologies into Evolving Knowledge Bases
Authors: Rickard Kurt L.  , Mejino Jr. José L. V.  , Martin Richard F.  , Agoncillo Augusto V.  , Rosse Cornelius
Published: February 2025

We have merged two established anatomical terminologies with an evolving ontology of biological structure: the Foundational Model of Anatomy. We describe the problems we have encountered and the solutions we have developed. We believe that both the problems and solutions generalize to the integration of any legacy terminology with a disciplined ontology within the same domain.
VA National Drug File Reference Terminology: A Cross-Institutional Content Coverage Study
Authors: Brown Steven H.  , Elkin Peter L.  , Husser Casey  , Bauer Brent A.  , Lincoln Michael J.  , Carter John  , Erlbaum Mark  , Tuttle Mark S.
Published: February 2025

Background: Content coverage studies provide valuable information to potential users of terminologies. We detail the VA National Drug File Reference Terminology’s (NDF-RT) ability to represent dictated medication list phrases from the Mayo Clinic. NDF-RT is a description logic-based resource created to support clinical operations at one of the largest healthcare providers in the US.