bluuebunny/crossref_metadata_2025 huggingface dataset:
Probleme der psychiatrischen Wissenschaftssprache
Authors: Möller Hans-Jürgen
Published: March 2018

Die psychiatrische Terminologie erfüllt nicht die an eine Wissenschaftssprache zu stellende Forderung nach semantischer Konsistenz. Dadurch wird die wissenschaftliche Kommunikation und der Forschungsprozeß (Erhebung von Beobachtungsdaten, Hypothesengenerierung, Hypothesenprüfung, Statistik, elektronische Datenverarbeitung usw.) in höchstem Maße gefährdet. Um die für eine Wissenschaftssprache nötige mtersubjektive und intrasubjektive Übereinstimmung der psychiatrischen Termini zu gewährleisten, muß der Gebrauch dieser Termini durch exakte Definitionen geregelt werden. Dabei stehen Nominaldefinitionen oder operationale Definitionen in Form von Reduktionssätzen zur Auswahl. Es werden die Besonderheiten und Probleme dieser Definitionen erörtert.
Der Instituts-Computer
Authors: Koeppe P.
Published: March 2018

Neben Großanlagen für überregionale Rechenzentren und mittelgroßen Anlagen für Universitäten und ähnliche wissenschaftliche Einrichtungen werden in zunehmendem Maße kleinere Computer in einzelnen Instituten installiert. Diese Entwicklung ist unter bestimmten Voraussetzungen sachlich vertretbar. Trotz der erheblichen relativen Verbilligung der Computer darf jedoch ein gewisser Aufwand nicht unterschritten werden.

Voraussetzungen und Schlußfolgerungen werden einschließlich finanzieller Konsequenzen im einzelnen besprochen.

Es ist das Ziel der Arbeit, denjenigen, die die Aufstellung einer Institutionsanlage planen, die Tragweite einer solchen Entscheidung vor Augen zu führen.
Requirements for Configuration and Management of an Integral Medical Computer Center
Authors: Reichertz L. P.
Published: March 2018

The author analyzes the requirements and charges of an integrated medical information processing center and discusses the resulting problems in regard to software, hardware and management. A certain level of these factors is considered as a conditio sine qua non for adequate function. This level is defined by the specific structure of medical information and by the dominating principle of patient care. Suggestions are made to resolve possible conflicts between service and research functions. An appropriate curriculum for medical students is proposed.
Automatization of Radiological Records
Authors: Lacronique M.
Published: March 2018

A methodology is presented for processing medical records in radiology. The system is original in that it uses the methods of automatic documentation, setting up thesauri for symptoms, localizations and diagnoses. Each radiological picture is described by a module of three elements: symptom + describer + locator. The relations between these three elements are regulated by a relatively simple syntax. The system is sufficiently flexible to allow the input of data in semi-natural language. It is assumed that the system is general enough to be applied to a great variety of medical problems. The fact that it can easily be handled by medical personnel should also be emphasized.
Modification of a Management Information System Software Package to Process Drug Reaction Data
Authors: Cuddihy R. V. , Ring W. S. , Augustine N. F.
Published: March 2018

Design and implementation of computer systems to process drag adverse reaction data usually require considerable investment in time, personnel and money. Modification of a commercially available program package offers a potentially economical means to establish an effective system in a relatively short period of time. Adaptation of this program package to our specific task involved only three major steps: (1) definition of the data to be stored; (2) definition of file organization, and (3) modification of the package to provide programming for field definition, an edit routine, and input/output routines. These steps were accomplished within a matter of weeks and at relatively low cost, including the original expenditure for the purchase of the commercial software. Seven subsystems were developed for the formation, maintenance and utilization of the data base. Each : subsystem is described in detail to permit ready application of this approach to any similar data management problem.
Zum Problem der EDV-gerechten Erfassung medizinischer Befunde
Authors: KOEPPE P.
Published: March 2018

Das Problem der on-line-Erfassung »harter« Daten, etwa im Bereich der Nuklearmedizin, kann heute trotz mancher Schwierigkeiten im Detail als technisch gelöst oder wenigstens als lösbar betrachtet werden. Im Gegensatz dazu ist die Erfassung jener Informationen, die das Ergebnis direkter ärztlicher Tätigkeit sind, noch weit von einer befriedigenden Lösung entfernt.

Nach zweijährigen Erfahrungen mit einem System zur Echtzeit-Erfassung röntgenologischer Befunde scheint festzustehen, daß auch bei optimaler Technik eine zeitliche Mehrbelastung gegenüber dem üblichen Diktat vom Arzt in Kauf genommen werden muß.

Als Konsequenz ergibt sich die Notwendigkeit, ein System so großzügig auszulegen, daß dem Arzt Informationen zugänglich werden, die seine unmittelbare Tätigkeit erleichtern und die ihm ohne dieses System nicht zugänglich wären, und weiterhin zu überprüfen, welche der Informationen, die heute eine Krankengeschichte füllen, prognostisch relevant sind.
Automatisch gezeichnete Streuungsellipsen
Authors: HOYER G.
Published: March 2018

Seit Computer in zunehmendem Maße mit Zeichengeräten ausgerüstet werden, verdienen besonders die technisch aufwendigen graphischen Darstellungsmethoden statistischer Auswertungsergebnisse neues Interesse.

Mit elementaren mathematischen Mitteln wird gezeigt, daß an der Standard-Streuungsellipse 11 statistische Maßzahlen abgelesen werden können.

An vier Beispielen aus verschiedenen medizinischen Fachgebieten werden einige typische Möglichkeiten der Anwendung und Interpretation automatisch gezeichneter Streuungsellipsen erläutert.
The Diagnostic Process and Multiple Screening Techniques
Authors: MURPHY E. A.
Published: March 2018

Medical examination of the patient may be of two fundamental kinds. It may concern itself with his presenting complaint. It is then a matter of solving a problem by a method which is by nature sequential. It differs logically from classical sequential analysis in that pieces of information to be used as evidence are neither infinite in number nor mutually independent; moreover the process is complicated by considerations of »cost«, by the fact that multiple pieces of information may be solicited simultaneously, and in many cases by the real-time nature of the problem. Alternatively the examination may be directed to the problems of a population as a whole (such as is the case with epidemiological studies, preventive physical examinations and multiphasic screening) where the logical process is more akin to the classical methods for non-sequential analysis. It has not been sufficiently stressed that the clinical introduction of multichannel analysers (which furnish the physician engaged in the first kind of activity with masses of unsolicited information) carries with it the logical attributes of a population study. Two solutions to the consequent logical disruption are suggested: either that the clinician ignore unsolicited information so that the established methods of medicine may be preserved; or that, with respect to unsolicited information the physician assume the responsibilities of preventive medicine with a drastic reorientation of his notions of the normal and the abnormal. The latter course is preferable, but also more complicated. Failure to confront the decision can lead only to chaos.
Handling of Files on Mini-Computers
Authors: Gehin P. , Echallier J. F. , Laviron A. , Peronnet F.
Published: March 2018

This paper describes a programme for bibliographical, medical and other files. It is run on a mrnicomputer with 4 K words of 12 bits each and with external storage on magnetic tape.

After the data has been stored, a series of checks is systematically carried through in order to keep the file reliable.

Logic relations (»and«, »or«, »except«) of characteristics of a record can be combined for searching purposes.

As a rule, computers made for and bought by laboratories are used for processing laboratory data; the programme described here permits an interesting additional application: the handling of files of bibliographical or other textual information.
System Design of a Computer Based Library Circulation System for the Radiology File Room
Authors: Stein M. A. , Winter J.
Published: March 2018

The operation and configuration of a reliable and inexpensive computer based system for locating X-ray film jackets are proposed. Card-dialer Touch-Tone telephones are used to accurately inform the computer of loans, to reserve film jackets, and to inquire about their locations. Computerassisted identification and recall of overdue and reserved film jackets increases their availability and the efficiency of file room personnel.
Computer Application in the Clinical Laboratory
Authors: Höhne K. H. , Dahlmann K. , Dix W.-R. , Harm K.
Published: March 2018

The utilisation of computers in clinical chemistry has decreased administrative overhead and improved the efficiency of the measuring equipment. Supervising physicians can hardly keep up with the increased flow of valuable data. Thus, besides the straightforward data acquisition and reporting of results, the aim of computer application in the clinical laboratory is to make data interpretation more transparent.

LABMAT, in addition to acquiring data, offers the possibility of presenting, checking and analyzing the data according to user-selected criteria at any time. The’ system, which has now been in daily operation for over three years, has a satellite structure. A PDP-8/I computer acquires data from 5 measuring devices and can present the results on five terminals or on a typewriter. It is connected by telephone to a large computing center (2 x IBM/370—168) where data storage and retrieval are performed. The structure of the system, examples of its usage and conclusions based on three years experience with daily operation are described.
Decision Theory and Surgical Risk
Authors: Cattaneo A. D. , Lucchelli P. E. , Rocca E.
Published: March 2018

Reliability on the automatic prediction of the outcome in arterial reconstructive surgery was evaluated with the aid of a computer program based on decision theory. Twenty items of information were collected from 92 patients and used as predictors. Accuracy of the computerized allocation was checked by simple reclassification. Two risk functions, derived from two different loss matrices, were used to minimize the error probabilities.
Statistical Methods as Applied to Dermatology
Authors: Free S. M.
Published: March 2018

This report describes how statistical techniques can be used in the planning of laboratory experiments and clinical trials. Most often research projects are conducted to provide data for decisions. Yet, biological material can be extremely variable and thus at times lead to wrong decisions. Several types of decision errors are outlined. The emphasis on planning suggests ways to avoid such errors. Some examples are given. The paper includes a table and a figure which can be used to help determine the number of observations needed for an experiment with a known objective.
Bedeutung und Probleme der Begriffsbestimmung im Rahmen der Biologie
Authors: Scheele M.
Published: March 2018

Einleitend wird dargelegt, daß die Sprache für Biologie und Medizin eine besondere Bedeutung besitzt und daß daher neben der seit LINNE einheitlichen Nomenklatur auch eine einheitliche Terminologie gefordert werden muß. Auf die Probleme der Terminologie stößt vor allem auch der Literaturforscher und der Dokumentär, wenn es darum geht, die im Schrifttum verstreuten Angaben über bestimmte Themen für eine einheitliche Auswertung zusammenzufassen.

In einigen allgemeinen Überlegungen zur Begriffsbestimmung wird besonders betont, daß wir zwischen den Bezeichnungen der natürlichen Gegebenheiten und den Bezeichnungen für die Beschäftigung des Menschen mit diesen Gegebenheiten streng unterscheiden müssen. Es kann viel Arbeit gespart werden, wenn man die Definitionen der Beschäftigung des Menschen mit den . Gegebenheiten (also die Definitionen der Wissenschaftsdisziplinen) als sekundäres Problem zunächst beiseite läßt.

Um zu zeigen, wie vielgestaltig und schwierig die Probleme der Terminologie und der einheitlichen Definition in allen ihren Zusammenhängen sind, werden einige spezielle Beispiele abgehandelt. Dazu dienen die Termini ,,Länge”, ,,Symmetrie” und ,,Plankton”.
Automation in der Entwicklung der modernen Medizin
Authors: Proppe Albin
Published: March 2018

Der Wunsch nach einem Diagnostik-Automaten bildet den Ausgangspunkt für die Ausführungen. Die Elemente, die das Prinzip eines solchen Automaten bilden, sind paradigmatisch der geschichtlichen Entwicklung der abendländischen Medizin, dem Problem der Vollständigkeit einer Befunderhebung und der auf die Person bezogenen Optimierung des therapeutischen Index entnommen. Eine mehr als 15 Jahre lange praktische Erfahrung mit der automatischen Befundauswertung in einer Klinik ergibt, daß dabei außerdem eine systematische Fehlerforschung im Bereich der Befunderhebung notwendig ist, weil die naturgegebenen Grenzen menschlicher Zuverlässigkeit unzureichend sind. Aus gleichem Grunde leitet sich die Forderung nach der »elektronischen Schwester« zum Schutz des Kranken ab. Einige Beispiele für die Leistungsfähigkeit einer automatisch auswertbaren Befunddokumentation (Falsifizierung der These von einer Altersdisposition zur lupösen Erkrankung; der Einfluß eines Rechnungshofes auf die Bettenausnutzung; der gelungene Versuch einer automatisierten Klassifizierung) sind angefügt. Endlich wird zum Schutz gegen fatale Überempfindlichkeitsreaktionen auf die Notwendigkeit eines automatisch abzurufenden Katasters hingewiesen, in dem fortlaufend und personaliter alle auftretenden allergischen Reaktionen gesammelt werden.
Aufbau und Auswertungen einer pathologisch-anatomischen Diagnosenkartei durch Computer-Einsatz
Authors: Becker H.
Published: March 2018

Das beschriebene System zur elektronischen Verarbeitung pathologisch-anatomischer Befunddaten ist im Verlaufe mehrerer Jahre aus einer Maschinenlochkartei hervorgegangen; es erfaßt zur Zeit etwa 23 000 Sektionsprotokolle aus 10 Jahren (1954—1963). Von entscheidender Bedeutung für das Auswertungsergebnis ist der Wert der eingegebenen Befunddaten, die mit allen Mitteln »gehärtet« werden müssen (Quantifizierung, pathohistologische, histochemische, bakteriologische und biochemische Zusatzuntersuchungen). Das im Computer zu lösende Problem muß exakt formuliert werden und ein Weg zur” Lösung vorgezeichnet werden. Die dafür notwendigen Routineprogramme und das speziell für Auswertungen von Sektionsprotokollen entworfene flexible Standardprogramm werden ausführlich beschrieben. Von sehr großer Bedeutung ist die Durchführung möglichst vieler automatischer Kontrollen auf formale und sachlogische Fehler. Mehrere große Auswertungen und zahlreiche kleine Untersuchungen, die mit Hilfe vorgedruckter Diagnosenverzeichnisse durchgeführt wurden, haben die Brauchbarkeit dieser pathologisch-anatomischen Diagnosenkartei erwiesen.
An On-line Computer System for a Rehabilitation Hospital
Authors: Baker R. L. , Vallbona C. , Spencer W. A. , Levy A. H. , Liss D. M. , Pope S. B.
Published: March 2018

An on-line computer system has been implemented for processing medical information at the Texas Institute for Rehabilitation and Research. The major objectives of the system are: 1. to improve the process of patient care by expediting the flow of information among, members, of .the rehabilitation team, 2. to facilitate the utilization of medical data for research purposes, 3. to enhance efficient hospital management, and 4. to obtain accurate data for an effective study of. the cost of hospitalization.

The system consists of the following interrelated programs: a) recording- of physiological monitoring, b) on-line processing of data collected at the bedside, c) processing of laboratory data, d) on-line processing of results of physiological studies, e) processing of data pertaining to treatments administered to patients, f) on-line calculation of fluid and electrolyte requirements, and g) statistical analysis of the hospital census.

The on-line computer facility is based on a time-shared teleprocessing system located at Baylor University College of Medicine and time-shared with various departments of the College. Remote terminal units installed at the Texas Institute for Rehabilitation and Research are connected by cable with the computer at the College of Medicine.
Probleme und Prinzipien der Diagnosen-Klassifikation
Authors: Immich Herbert
Published: March 2018

Es wird die Aufgabe besprochen, einen fünfstelligen systematischen Klassifikationsschlüssel für klinische Diagnosen zu entwerfen. Der Schlüssel dient dem Zweck, Einzeldiagnosen zu finden und Diagnosengruppen zusammen zu erfassen. Grundlage eines solchen Schlüssels ist ein Thesaurus. Um den Thesaurus aufzustellen, muß man die formal-logischen Definitionen der Begriffe und Urteile kennen. Der vorliegende Thesaurus enthält rund 750 topographische und rund 8000 nosologische Begriffe. Man muß Topographie und Nosologie parallel verschlüsseln.
Symptomenstatistik
Authors: Griesseh G.
Published: March 2018

Für die Stellung der Diagnose ist eine genauere Kenntnis der subjektiven und objektiven Krankheitsmerkmale (Symptome und Krankheitszeichen) und der (relativen) Häufigkeit ihres Vorkommens notwendig. Die Kenntnis dieser Größen, die nicht nur als Mittel für eine „elektronische Diagnostik”, sondern als ein wesentlicher Bestandteil der modernen klinischen Medizin anzusehen ist, wird im Sinne einer klinischen Grundlagenforschung durch Präzisierung, Einordnung und Gewichtung eine schärfere Abgrenzung der Krankheitsbilder als bisher ermöglichen. Dazu sind aber eine weitgehende Übereinstimmung in Gehalt und Terminologie der diagnostischen Begriffe und einwandfreie, nicht mit systematischen Fehlern behaftete Erhebungsmethoden die Voraussetzungen für derartige, nur überörtlich durchführbare Forschungsvorhaben.
The Medical Event Vector*)
Authors: Gleseb M.
Published: March 2018

The Medical Event Vector (MEV) is a vector of nineteen dimensions which serves as the basic storage unit for all medical observations in an automated medical information system. Each MEV dimension stores an attribute of the observation; e.g., date recorded, patient and provider identification, the subject of the observation, the data type, etc. Symptoms, signs, diagnoses, laboratory results, procedures ancl treatments all can be stored as MEVs in identical format. Data can be stored in sufficient detail for clinical applications, ancl can be summarized easily for administrative and research purposes. The use of a single consistent, multidimensional data item for all medical information greatly simplifies database design and facilitates data manipulation, organization, selective retrieval and software development.
Management of Anxiety and Depressive Disorders in Patients ≥ 65 Years of Age by Homeopath General Practitioners versus Conventional General Practitioners, with Overview of the EPI3-LASER Study Results
Authors: Duru Gérard , Vetel Jean , Danno Karine
Published: March 2018

Background The increasing use of psychotropic drugs to treat anxiety and depressive disorders (ADDs) is concerning. According to the study, ‘Etude Pharmacoépidémiologique de l'Impact de Santé Publique des modes de prise en charge pour 3 groupes de pathologies’ (EPI3)-LASER, adult ADD patients who consult a general practitioner prescribing homeopathic medicines (GP-Ho) report less psychotropic drug use and are marginally more likely to experience clinical improvement than those receiving conventional care. We determined whether these observations also apply to patients ≥ 65 years old in the EPI3 cohort.

Methods The EPI3-LASER study, conducted in France between March 2007 and July 2008, was a nationwide, observational survey of the three most common reasons for primary care consultation, including ADD, and the impact of the GPs' prescribing preferences: homeopathy (GP-Ho), conventional medicines (GP-CM) or mixed prescriptions (GP-Mx). This sub-analysis included 110 patients ≥ 65 years old with ADD from the EPI3 cohort who consulted either a GP-CM or GP-Ho. Socio-demographic and medical data and details of any medications prescribed were collected at inclusion. Information regarding the patients' functional status (Hospital Anxiety and Depression Scale [HADS)]) was obtained via a telephone interview 72 hours after inclusion, and at 1, 3 and 12 months post-inclusion. Medication use and outcome were determined over the 12-month period. Differences between the GP-CM and GP-Ho groups were assessed by multivariate logistic regression analysis.

Results One hundred and ten patients were recruited and 87 (79.1%) with ADD (HADS ≥ 9) at the 72-hour interview were evaluated (age range: 65–93 years, 82.8% female). Patients who consulted a GP-Ho were more likely (odds ratio [OR] = 10.38, 95% confidence interval [CI]: 1.33–81.07) to have clinical improvement (HADS < 9) after 12 months than those in the GP-CM group. Patients who consulted a GP-Ho reported less psychotropic drug use (OR = 22.31 [95% CI: 2.20–226.31]) and benzodiazepine use (OR = 60.63 [95% CI: 5.75–639.5]) than GP-CM patients.

Conclusions Management of ADD patients aged ≥ 65 years by GP-Ho appears to have a real public health interest in terms of effectiveness and lower psychotropic drug use.
Computer Applications for Staff Development and Patient Education
Authors: Hannah Kathryn , Conley-Price Paula , Fenty Daryl , McKiel Elaine , Soltes Dana , Hogan Terri , Wiens Donna
Published: March 2018

The changing and evolving profession of nursing necessitates extensive staff development activities on the part of nursing management. This ongoing responsibility is essential to maintaining the currency and competence of practicing nurses and facilitating their professional growth. Simultaneously there are economic constraints coinciding with increased consumer demands for patient education. The purpose of this paper is to explore an innovative teaching method, the use of instructional computing for staff development and patient education programs. The theoretical frameworks for this instructional modality are identified and general advantages and disadvantages of instructional computing applications are described. Specific examples of programs from the literature are briefly discussed.
Informatics in Professional Education
Authors: Ball Marion , Douglas Judith
Published: March 2018

The University of Maryland at Baltimore (UMAB) is a professional school campus, including schools of Dentistry, Law, Medicine, Nursing, Pharmacy, Graduate Studies, and Social Work and Community Planning. In late 1987, UMAB convened a Task Force on Informatics, intended to support the campus as it worked to become a Centre of Excellence for Informatics. The Task Force reviewed the current computing environment at UMAB and the individual schools. In assessing the state ofthe art in informatics, its work was supplemented by the formation of external advisory committees of national and international informaticians. Deliberations proceeded according to a methodology designed to develop factual databases and to generate consensus. The Task Force report, which is excerpted in the following paper, established a tiered taxonomy of competencies; defined the three levels; and set forth program models for the two higher levels. Special note was made of the programs in ´nursing and dental informatics newly established at UMAB. The report concluded with three recommendations, each with detailed action points identified.
Nursing Informatics Competencies
Authors: Grobe Susan
Published: March 2018

The purpose of the paper is to present both the processes and the results of a task force organized to recommend nursing informatics competencies for practicing nurses, nurse administrators, nurse teachers and. nurse researchers. The competencies are designed to be useful in preparing nurses for their specific roles. The criterion for inclusion of a specific informatics competency statement was task force consensus.
Use of the Quick Medical Reference (QMR) Program as a Tool for Medical Education
Authors: Miller R. , Masarie F.
Published: March 2018

The original goal of the INTERNIST-1 project, as formulated in the early 1970s, was to develop an expert consultant program for diagnosis in general internal medicine. By the early 1980s, it was recognized that the most valuable product of the project was its medical knowledge base (KB). The INTERNIST-1/QMR KB comprehensively summarizes information contained in the medical literature regarding diagnosis of disorders seen in internal medicine. The QMR program was developed to enable its users to exploit the contents ofthe INTERNIST-1/ QMR KB in educationally, clinically, and computationally useful ways. Utilizing commonly available microcomputers, the program operates at three levels - as an electronic textbook, as an intermediate level spreadsheet for the combination and exploration of simple diagnostic concepts, and as an expert consultant program. The electronic textbook contains an average of 85 findings and 8 associated disorders relevant to the diagnosis of approximately 600 disorders in internal medicine. Inverting the disease profiles creates extensive differential diagnosis lists for the over 4250 patient findings known to the system. Unlike a standard printed medical textbook, the QMR knowledge base can be manipulated “on the fly” to format displays that match the information needs of users. Preliminary use of the program for education of medical students and medical house officers at several sites has met with an enthusiastic response.
A Generalized Language for Platform-Independent Structured Reporting
Authors: Kahn C. E.
Published: March 2018

Structured reporting systems allow health-care workers to record observations using predetermined data elements and formats. The author developed the Data-entry and Reporting Markup Language (DRML) to provide a generalized representational language for describing concepts to be included in structured reporting applications. DRML is based on the Standard Generalized Markup Language (SGML), an internationally accepted standard for document interchange. The use of DRML is demonstrated with the SPIDER system, which uses public-domain Internet technology for structured data entry and reporting. SPIDER uses DRML documents to create structured data-entry forms, outline-format textual reports, and datasets for analysis of aggregate results. Applications of DRML include its use in radiology results reporting and a health status questionnaire. DRML allows system designers to create a wide variety of clinical reporting applications and survey instruments, and helps overcome some of the limitations seen in earlier structured reporting systems.
Methodological Considerations in the Design of an Obstetric Database Abstracted from Medical Records
Authors: Ellison G. T. H. , Holliday M. , Lucassen E. , Harris H. E.
Published: March 2018

The quality of maternal information contained within contemporary obstetric notes was investigated by abstracting data from the medical records of multiparous women who were admitted to a major city hospital in the South Thames Region. Potential sources of error were identified by comparing information recorded in different sections of each obstetric notes and within the obstetric notes of consecutive pregnancies. The format of the obstetric notes largely determined which variables were recorded and, to some extent, the accuracy of information collected. However, the quality of the data ultimately depended upon whether each variable was self-reported or directly measured. Self-reported variables were subject to selective omission and subjective bias, while measured variables were susceptible to inaccurate equipment and poor measurement practice. By interviewing a sample of midwives currently involved in antenatal care at the Trust it was possible to confirm that extensive variation in measurement and recording procedures routinely occurred.
Cardiovascular and Metabolic Responses to Electrical Stimulation-Induced Leg Exercise in Spinal Cord Injury
Authors: Sutton J. R. , Thomas A. J. , Davis G. M.
Published: March 2018

Electrical stimulation-induced leg muscle contractions provide a useful model for examining the role of leg muscle neural afferents during low-intensity exercise in persons with spinal cord-injury and their able-bodied cohorts. Eight persons with paraplegia (SCI) and 8 non-disabled subjects (CONTROL) performed passive knee flexion/extension (PAS), electrical stimulation-induced knee flexion/extension (ES) and voluntary knee flexion/extension (VOL) on an isokinetic dynamometer. In CONTROLS, exercise heart rate was significantly increased during ES (94 ± 6 bpm) and VOL (85 ± 4 bpm) over PAS (69 ± 4 bpm), but no changes were observed in SCI individuals. Stroke volume was significantly augmented in SCI during ES (59 ± 5 ml) compared to PAS (46 ± 4 ml). The results of this study suggest that, in able-bodied humans, Group III and IV leg muscle afferents contribute to increased cardiac output during exercise primarily via augmented heart rate. In contrast, SCI achieve raised cardiac output during ES leg exercise via increased venous return in the absence of any change in heart rate.
Circadian Rhythm Estimation by Core Body Temperature Filtered with Simultaneously Recorded Physiological Data
Authors: Nakano T. , Koyama E. , Imai T. , Hagiwara H.
Published: March 2018

In field measurements, monitoring of core body temperature is influenced by physical activities; therefore, the estimation of circadian rhythm from the data may not be exact. The purpose of this study is to design a core body temperature filter in order to reduce artifacts induced by physical activities using simultaneously recorded physiological data such as heart rate data.

The effects of physical activities on core body temperature and heart rate are assessed through three experiments. Based on the above knowledge, a core body temperature filter was designed. The filter removes part of rectal temperature data as artifact when heart rate rises above a predetermined threshold. As a result, most of the spike-like noise was removed and the filtered temperature data showed sinusoidal variation more than the unfiltered data. The mesor of the estimated rhythm significantly decreased. This filtering method can provide more precise information about circadian rhythm, especially in field measurements.
Estimation of Arterial Mechanical Properties from Aortic and Tonometric Arterial Pressure Waveforms
Authors: Sugimachi M. , Kawada T. , Shishido T. , Matsumoto N. , Alexander J. , Sunagawa K.
Published: March 2018

Although arterial mechanical properties have been evaluated using arterial input impedance, the relative difficulty in accurate flow measurement made the value of impedance somewhat limited. To develop an alternative method to evaluate arterial mechanical properties, we analyzed the aortic pressure (AoP)-radial arterial pressure (RAP) relationship because of relative ease in obtaining peripheral pressure waveform by tonometry. In 8 patients we simultaneously recorded aortic root and radial arterial pressure waveforms. We calculated the transfer function from AoP to RAP. We then fitted the transfer function to a model of a lossless uniform elastic tube terminated with a modified Windkessel model. The fact that the model transfer function predicted AoP from RAP waveform with considerable accuracy indicated that the model represented the arterial mechanical properties well. We conclude that we can estimate the arterial mechanical properties by the pressure-pressure transfer function analysis.
Extraction of Implicit Information in Biosignals
Authors: Xia Ling , Lu Weixue
Published: March 2018

The first part of this paper explains the meaning of implicit information in biosignals. Image reconstruction from projections and ECG inverse problem are two typical examples. In the second part the limitation of conventional ECG inverse problem study is discussed, that is, the excitation propagation process that was not included in inverse study. In the third part a new approach to ECG inverse problem studies is introduced. To verify the new method, we used this method to localize the ventricular preexcitation site with simulated body surface potentials of WPW syndrome. The experimental results show that the inversely recovered preexcitation sites are in close agreement with the true preexcitation site.
Research and education directions in Medical Informatics at the Aristotle University of Thessaloniki
Authors: Pappas C. , Maglaveras Nicos
Published: March 2018

The field of Medical Informatics is one of the most active fields both in research and education at the Aristotle University of Thessaloniki. The nucleus of this scientific field at the Aristotle University resides in the Medical School and in particular in the Laboratory of Medical Informatics. Education programs exist in undergraduate, graduate and post-graduate levels, and are targeted towards medical students and doctors and information technology related students and professionals. Research projects cover a wide area of medical informatics including medical information processing and management, electronic health records design and implementation, medical decision support, biological systems simulation, telemedicine applications, integration and communication issues related to regional health information systems, and quality assessment of health services and systems. The description and brief presentation of the output of these educational and research directions shall be presented in this paper.
Medical Applications of Virtual Environments
Authors: Riva G.
Published: March 2018

Technologies that were hardly used ten years ago, such as the Internet, e-mail, and video teleconferencing are becoming familiar methods for diagnosis, therapy, education and training. However, the possible impact of virtual reality (VR) on health care is even higher than the one offered by the new communication technologies. In fact, VR is a technology, a communication interface and an experience: a communication interface based on interactive 3D visualization, able to collect and integrate in single real-like experience different inputs and data sets.

The first health care applications of VR started in the early ‘90s with the need for medical staff to visualize complex medical data, particularly during surgery and for surgery planning. A couple of years later, the scope of VR applications in medicine has broadened to include neuropsychological assessment and rehabilitation.

This paper intends to investigate the role of VR in medicine, presenting some of the most interesting applications actually developed in the area. Moreover, it discusses the clinical principles, technological devices and safety issues associated with the use of virtual reality in medicine.
The Quest for Identity of Health Informatics and for Guidance to Education in it – The German Reisensburg Conference of 1973 Revisited
Authors: Moehr J.R.
Published: March 2018

Purpose: To review the minutes of the invitational workshop for defining the contents and approaches to education in and the professionalization of health informatics, which took place in Germany thirty years ago; To provide context for the meeting and assess its impact.

Approach: The minutes resulting from the meeting were translated into English, and the literature attesting to the effects of the meeting was compiled in a literature review and commented on.

Results: The meeting had profound effect in Germany, providing a model for several tiers of educational initiatives, and for professional recognition of the field of medical informatics. These were refined over the last thirty years and persist to this day. At the international level, the impact can be traced to the IMIA recommendations for education in health/medical informatics. More recent initiatives at defining the content of health informatics education did not result in fundamentally different models.

Conclusion: One may assume then that the contents of education in medical/health informatics are well defined. The methods of education deserve greater attention.
Knowledge Management In Health Care Organizations
Authors: Stefanelli M.
Published: March 2018

This review article analyzes theories, methods, and technologies that can be effective in building a socio-technical environment within a health care organization that is able to facilitate the collaboration between individuals in the management of patient care and in expanding scientific and professional knowledge. The article is organized as follows. In section 2, I discuss the nature of knowledge in general and with a particular attention to medical knowledge. The future of health information systems (HIS) is discussed in section 3, which provides also an overview of theories for designing and developing such systems. Section 4 describes different types of collaboration, and reviews the methods and information and communication technologies (ICT), which can be exploited for knowledge creation and interaction management. The potential of workflow management technology for building innovative components within HIS is analyzed in section 5. Finally, section 6 presents the conclusions.
Assessing Information Technologies for Health. Editorial
Authors: Kulikowski C. , Haux R.
Published: March 2018

To provide an editorial introduction to the 2006 IMIA Yearbook of Medical Informatics with an overview of its contents and contributors.

A brief overview of the main theme of “Assessing Information Technology for Health Care”, and an outline of the purposes, readership, contents, new format, and acknowledgment of contributions for the 2006 IMIA Yearbook.

Assessing information technology (IT) in biomedicine and health care is emphasized in a number of survey and review articles. Synopses of a selection of best papers for the past 12 months are included, as are original papers on the history of medical informatics by pioneers in the field, and selected research and education programs. Information about IMIA and its constituent societies is given, as well as the authors, reviewers, and advisors to the Yearbook.

The 2006 IMIA Yearbook of Medical Informatics highlights as its theme one of the most significant yet difficult aspects of information technology in health: the assessment of IT as part of the complex enterprise of biomedical research and practice. It is being published in a new format with a wide range of original survey and review articles.
Traceability in Healthcare: Crossing Boundaries
Authors: Lovis C.
Published: March 2018

Objectives This paper is a survey on the problem of traceability in healthcare. Traceability covers many different aspects and its understanding varies among different players. In supply chains and retails, traceability usually covers aspects pertaining to logistics. The challenge is to keep trace of objects manufactured, to track their locations in a production and distribution processes. In food industry, traceability has received a lot of attention because of public health problems related to infectious diseases. For instance, in Europe, the challenge of traceability has been to build the tracking of meat, from the living animal to the shell. In the health sector, traceability has mostly been involved in patient safety around human products such as blood derivates contaminants or implanted devices and prosthesis such as mammary implants. There are growing interests involving traceability in health related to drug safety, including the problem of counterfeited drugs, and to privacy. Traceability is also increasingly seen as a mean to improve efficiency of the logistics of care and a way to better understand costs and usage of resources.

Methods This survey is reviewing the literature and proposes a discussion based on the real use and needs of traceability in a large teaching hospital.

Results and Conclusion Traceability in healthcare is at the crossroads of numerous needs. It is therefore of particular complexity and raises many new challenges. Identification management and entity tracking, from serialization of consumers’ good production in the supply chains, to the identification of actors, patients, care providers, locations and processes is a huge effort, tackling economical, political, ethical and technical challenges. New requirements are needed, not usually met in the supply chain, such as serialization and persistence in time. New problems arise, such as privacy and legal frameworks. There are growing needs to increase traceability for drug products, related to drug safety, counterfeited drugs, and to privacy. Technical problems around reliability, robustness and efficiency of carriers are still to be resolved. There is a lot at stakes. Traceability is a major aspect of the future in healthcare and requires the attention of the community of medical informatics.
Closing the Loops in Biomedical Informatics. Editorial
Authors: Geissbuhler Antoine , Kulikowski C. A.
Published: March 2018

Objectives To provide an editorial introduction to the 2009 IMIA Yearbook of Medical Informatics with an overview of its contents and contributors.

Methods A brief overview of the main theme, and an outline of the purposes, contents, format, and acknowledgment of contributions for the 2009 IMIA Yearbook.

Results This 2009 issue of the IMIA Yearbook highlights important, beneficial loops which, if closed, could lead to considerable advances in the field of biomedical informatics and, indirectly, in healthcare and biomedical research. Progress towards closing the loops and remaining gaps are identified from the recent literature, illustrated by selected papers published during the past 12 months.

Conclusion Reviews and Surveys of the main research sub-fields in biomedical informatics in the Yearbook provide an overview of progress and current challenges across the spectrum of the discipline.
Next Generation Telehealth
Authors: Gogia S.B. , Hartvigsen G. , Maeder A.J.
Published: March 2018

Telehealth has long been seen as a means of increasing access and quality of care while decreasing costs and logistical burden for remote health care delivery. Underlying technology to support Telehealth has been developed commercially. However, its widespread adoption has been hindered by numerous clinical, social, political, economic and management factors. This paper examines trends which may help to address this situation.

First we consider the current status of Telehealth based on some state-of-the-art reviews. Then we present some new future modes of Telehealth services, as described by various prominent authors. From these we identify some common directional themes and fundamental issues affecting the success of future Telehealth innovations.

This position paper advances a view that Telehealth in the future will be much more driven by widespread pressure from two different drivers: more ubiquitous connectivity and related technological capabilities due to greater diversity in human communication practices, and new models of care emerging from diverse widespread movements towards health services reform.

The IMIA Working Group on Telehealth work agenda will address some specific items within the areas described above.
Health Informatics 3.0 and other Increasingly Dispersed Technologies Require Even Greater Trust: Promoting Safe Evidence-based Health Informatics
Authors: Ammenwerth E. , Talmon J. , Nykänen P. , Brender J. , de Keizer N. , Rigby M.
Published: March 2018

Healthinformaticsisgenerallylesscommittedtoascientific evidence-basedapproach than any other area of health science, which is an unsound position. Introducing the new Web 3.0 paradigms into health IT applications can unleash a further great potential, able to integrate and distribute data from multiple sources. The counter sideisthatitmakestheuserandthepatientevermoredependentonthe

‘blackbox’ of the system, and the re-use of the data remote from the author and initial context. Thus anticipatory consideration of uses, and proactive analysis of evidenceof effects,are imperative,as only when a clinical technology can be proven to be trustworthy and safe should it be implementedwidely as is the case with other health technologies.

Toargueforpromotingevidence-basedhealthinformatics assystemsbecomemorepowerfulandpro-activeyetmoredispersed andremote;andevaluationasthemeansofgeneratingthenecessaryscientific evidencebase.TopresentongoingIMIAandEFMIinitiativesinthisfield.

Critical overview of recent developments in health informatics evaluation, alongside the precedents of other health technologies, summarising current initiatives and the new challenges presented by Health Informatics 3.0.

Web3.0should betaken asanopportunitytomovehealth informatics from being largely unaccountable to one of being an ethical andresponsiblescience-baseddomain.Recentandplannedactivities ofthe EFMIandIMIAworkinggroupshavesignificantlyprogressedkeyinitiatives.

Concurrent with the emergence of Web 3.0 as a means of new-generation diffuse health information systems comes an increasing need for an evidence-based culture in health informatics.
Patienten weiterhin stark infektionsgefährdet
Authors: Arnheim Katharina
Published: March 2018

Bei Patienten mit multiplem Myelom (MM) sind Infektionen eine häufige Komplikation, die Morbidität und Mortalität erhöhen. Auch die Entwicklung neuer Substanzen für die MM-Therapie hat daran nichts geändert.
Patientin mit ZNS-Befall profitiert von CAR-T-Zell-Therapie
Authors: Krome Susanne
Published: March 2018

Im August 2017 ließ die amerikanische Arzneimittelbehörde die hoch personalisierte adoptive Immuntherapie mit CAR-T-Zellen zu. Patienten unter 25 Jahre mit einer Standardtherapie-refraktären akuten lymphatischen Leukämie dürfen behandelt werden. Laut einem Fallbericht von Abramson et al. waren die CAR-T-Zellen bei einem bisher therapierefraktären diffusen großzelligen B-Zell-Lymphom (DLBCL) langfristig wirksam.
Biosimilars: Neue Chancen für die Onkologie!?
Authors: Ludwig Wolf-Dieter
Published: March 2018

Mit wachsender wissenschaftlicher Expertise zu Biosimilars in der Onkologie und zunehmender klinischer Erfahrung sprechen sich führende Onkologie-Fachgesellschaften – nach anfänglich kritischer Distanz – eindeutig für die Anwendung von biopharmazeutischen Nachahmer-Produkten in der Krebsmedizin aus, wie bei einem Fachsymposium „Biosimilare Antikörper in der Onkologie” in Berlin deutlich wurde. Drei relevante Institutionen – neben der Arzneimittelkommission der deutschen Ärzteschaft (AkdÄ) die Deutsche Gesellschaft für Hämatologie und Onkologie (DGHO) und die European Society for Medical Oncology (ESMO) – haben dies in Leitfäden und Positionspapieren deutlich gemacht. Die Onkologische Welt fragte den Internisten und Onkologen Prof. Wolf-Dieter Ludwig, Vorsitzender der AkdÄ und bis August 2017 Chefarzt der Klinik für Hämatologie, Onkologie, Tumorimmunologie und Palliativmedizin im Helios Klinikum Berlin-Buch, nach seiner Einschätzung der therapeutischen Bedeutung von Biosimilars in der Krebsmedizin.