bluuebunny/crossref_metadata_2025 huggingface dataset:
The development of the virtual reality system for the treatment of the fears of public speaking
Authors: Jo Hang Joon  , Ku J.H.  , Jang D.P.  , Shin M.B.  , Ahn H.B.  , Lee J.M.  , Cho B.H.  , Kim Sun I.
Published: February 2025

The fear of public speaking is a kind of social phobias. The patients having the fear of public speaking show some symptoms like shame and timidity in the daily personal relationship. They are afraid that the other person would be puzzled, feel insulted, and they also fear that they should be underestimated for their mistakes. For the treatment of the fear of public speaking, the cognitive-behavioral therapy has been generally used. The cognitive-behavioral therapy is the method that makes the patients gradually experience some situations inducing the fears and overcome those at last. Recently, the virtual reality technology has been introduced as an alternative method for providing phobic situations. In this study, we developed the public speaking simulator and the virtual environments for the treatment of the fear of public speaking. The head- mounted display, the head-tracker and the 3 dimensional sound system were used for the immersive virtual environment. The imagery of the virtual environment consists of a seminar room and 8 virtual audiences. The patient will speak in front of these virtual audiences and the therapist can control motions, facial expressions, sounds, and voices of each virtual audience.
The Virtual Brain Project - development of a neurosurgical simulator
Authors: Larsen Ole Vilhelm  , Haase Jens  , Hansen Kim Vang  , Nielsen Henning
Published: February 2025

As a joined project between Aalborg University and Aalborg Hospital Denmark, a neuro-surgical simulator is being developed. In this paper the objective of the project is outlined and an overview of the research activities within the project is given. Focus is on 3D modelling of the brain, deformable models and the development of two demonstrators, including one for training of punctuation of ventricle using visual and haptic feedback.
An Open and Flexible Framework for Computer Aided Surgical Training
Authors: Larsson Anders
Published: February 2025

During the past year we have developed a new surgical skills training application called LapSim. We intend to describe the design, architecture and concepts of the software framework we have developed concurrently with the application. The framework is based on the concept of a classroom with students and teachers. Students, courses and results are stored in a centralized database and can be retrieved for review or modification. The students can also monitor their progress relative to other students or experts.
Robotic Stabilization that Assists Cardiac Surgery on Beating Hearts
Authors: Nakamura Yoshihiko  , Kishi Kosuke
Published: February 2025

Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) requires surgeons the precision of hand skill and the mental concentration, since it needs to work on beating hearts. We propose a surgical robot system that compensates motions of organs during operations. The motion canceling robot system consists of three technologies: visual synchronization, motion synchronization and master slave control In this paper, we verify the effectiveness of the prototype system by in-vivo experiment.
Exploring the Visible Human’s Inner Organs with the VOXEL-MAN 3D Navigator
Authors: Pflesser B.  , Petersik A.  , Pommert A.  , Riemer M.  , Schubert R.  , Tiede U.  , Höhne K.H.  , Schumacher U.  , Richter E.
Published: February 2025

Improved rendering and segmentation techniques lead to a new quality of 3D reconstructions of the Visible Human. Using these we have implemented an interactive atlas of anatomy and radiology of the inner organs.
CompAc Information System for Traditional Chinese Medicine
Authors: Radu Alexandra  , Alecu Cristina-Simona  , Raclariu Adina  , Nanu Lavinia  , Loghin Maria  , Stanciu Emilia  , Necula Andrei  , Ionescu-Tirgoviste Constantin  , Patrugan Victor
Published: February 2025

The paper presents a system developed for the assistance of diagnosis and treatment in alternative medicine, based on traditional Chinese methods. The system named CompAc, is a result of an interdisciplinary cooperation and is designed for the physician, specialist in acupuncture. The Compac system allows the determination of the type of energetic imbalance starting from the clinical picture of the patient and establishing whether an organ or any of the viscera are affected. It allows also the indication of different variants of treatment. The diagnosis proposed by the system has to be confirmed by the physician and can be modified by him. The system is also useful for medical training.
Using Virtual Reality to teach special populations how to cope in crisis: The case of a virtual earthquake
Authors: Tarnanas Ioannis  , Manos George C.
Published: February 2025

The unique characteristics of special populations such as pre-school children and Down syndrome kids in crisis and their distorted self-image were never studied before, because of the difficulty of crisis reproduction. This study proposes a VR setting that tries to model some special population’s behaviour in the time of crises and offers them a training scenario. The sample population consisted of 30 pre-school children and 20 children with Down syndrome. The VR setting involved a high-speed PC, a VPL EyePhone 1, a MR toolkit, a vibrations plate, a motion capture system and other sensors. The system measured and modelled the typical behaviour of these special populations in a Virtual Earthquake scenario with sight and sound and calculated a VR anthropomorphic model that reproduced their behaviour and emotional state. Afterwards one group received an emotionally enhanced VR self-image as feedback for their training, one group received a plain VR self- image and another group received verbal instructions. The findings strongly suggest that the training was a lot more biased by the emotionally enhanced VR self-image than the other approaches. These findings could highlight the special role of the self-image to therapy and training and the interesting role of imagination to emotions, motives and learning. Further studies could be done with various scenarios in order to measure the best-biased behaviour and establish the most natural and affective VR model. This presentation is going to highlight the main findings and some theories behind them.
Clinical Validation of Computer Assisted Pelvic Surgery using Ultrasound, A percutaneous safe Technique with low Radiation Exposure
Authors: J Tonetti  , L Carrat  , S Blendea  , J Troccaz  , Ph Merloz  , S Lavallee  , J-P Chirossel
Published: February 2025

This study presents early results of the clinical experience of computer assisted surgery (CAS) applied to percutaneous iliosacral screwing. The results of these 10 first cases (4 patients) are compared to an historical series of 51 cases (30 patients). The CAS technique shows better screw placement without outside bone screw and a very low radiation exposure.
ICAPS An Integrative Computer-Assisted Planning System for Pedicle Screw Insertion
Authors: Voss Gerrit  , Bisler Alex  , Bockholt Uli  , Müller-Wittig Wolfgang K.  , Schäffer Albert
Published: February 2025

Robot Assisted Surgery (RAS) Systems win more and more recognition in the field of orthopaedics. Especially in Hip Surgery RAS has proved to be suited for application in medical routine. Often Robot Assisted Surgery Systems consist of a planning- and an interoperative component. According to specifications done with the planning software the tools are driven. Benefits of the robot assisted surgery should be higher precision and a better surgical outcome. In the co-operation project of several Fraunhofer Institutes “RoMed” (Robots and Manipulators for Medical Application) an exemplary application of robot aided spine surgery is developed [1]. The planning software used in this context is proposed in this article.
A Prototype Haptic Suturing Simulator
Authors: Webster Roger W.  , Zimmerman Dean I.  , Mohler Betty J.  , Melkonian Michael G.  , Haluck Randy S.
Published: February 2025

A new haptic simulation designed to teach basic suturing for simple wound closure is described. Needle holders are attached to the haptic device as the graphics of the needle holders, needle, sutures and virtual skin are displayed and updated in real time. The simulator incorporates several interesting components such as real-time modeling of deformable skin, tissue and suture material and real-time recording of state of activity during the task using a finite state model.
Developing A Knowledge-based Tool for Authoring Clinical Trial Protocols
Authors: Modgil Sanjay  , Hammond Peter  , Wyatt Jeremy  , Potts Henry
Published: February 2025

Many published clinical trials are poorly designed, suggesting that the protocol was incomplete, disorganised or contained errors. This fact, doctors' limited statistical skills and the shortage of medical statisticians, prompted the development of a knowledge-based aid, Design-a-Trial, for authoring clinical trial protocols. Design-a-Trial interviews a physician, prompts and guides them through suitable design options, comments on the statistical rigour and feasibility of their proposed design, and generates a 6-page draft protocol document. This paper reviews the progress of the Design-a-Trial project by describing a working prototype and its recent and planned development.
Simulated Learning Environments in Anatomy and Surgery Delivered via the Next Generation Internet
Authors: Dev Parvati  , Heinrichs W. LeRoy  , Srivastava Sakti  , Montgomery Kevin N.  , Senger Steven  , Temkin Bharti  , Hasser Chris  , Latombe Jean-Claude  , Heegaard Jean  , Youngblood Patricia  , Friedman Charles P.  , Waldron Kenneth
Published: February 2025

The Next Generation Internet (NGI) will provide high bandwidth, guaranteed Quality of Service, collaboration and security, features that are not available in today's Internet. Applications that take advantage of these features will need to build them into their pedagogic requirements. We present the Anatomy Workbench and the Surgery Workbench, two applications that require most of these features of the NGI.
An Exchange Format for Use-cases of Hospital Information Systems
Authors: Masuda Gou  , Sakamoto Norihiro  , Sakai Rumi  , Yamamoto Ryuichi
Published: February 2025

Object-oriented software development is a powerful methodology for development of large hospital information systems. We think use-case driven approach is particularly useful for the development. In the use-cases driven approach, use-cases are documented at the first stage in the software development process and they are used through the whole steps in a variety of ways. Therefore, it is important to exchange and share the usecases and make effective use of them through the overall lifecycle of a development process. In this paper, we propose a method of sharing and exchanging use-case models between applications, developers, and projects. We design an XML based exchange format for use-cases. We then discuss an application of the exchange format to support several software development activities. We preliminarily implemented a support system for objectoriented analysis based on the exchange format. The result shows that using the structural and semantic information in the exchange format enables the support system to assist the object-oriented analysis successfully.
Electronic Health Summaries – Building on the Foundation of Scottish Record Linkage System
Authors: Walsh David  , Smalls Mary  , Boyd James
Published: February 2025

Developing electronic patient records is currently a priority for Health Services, so that the clinician treating the patient has all the relevant information available on the desktop. However, as with paper records, there is the danger of information overload, with key information being missed. It is now recognized that electronic health summaries of patient events will be needed.
Info-Vigilance or Safety in Health Information Systems
Authors: Barber Barry  , Allaert François-André  , Kluge Eike-Henner
Published: February 2025

The paper examines the issues of security and safety in Health Information Systems and focuses the need for the development of appropriate Guidelines for the effective use of IEC 61508 standard.
Using Cognitive Work Analysis to Design Clinical Displays
Authors: Effken Judith  , Loeb Robert  , Johnson Karen  , Johnson Steven  , Reyna Valerie
Published: February 2025

In today's ICUs clinicians routinely integrate huge numbers of discrete data points to arrive at a coherent picture of their patients' status. Often the clinician must obtain those data elements from many devices, which makes the problem more difficult. Because presenting data visually amplifies cognition by capitalizing on well-known human perceptual capabilities, it is not surprising that a growing body of research is directed at the effective presentation of visual information in clinical displays. However, developing clinical displays that effectively support clinicians' integration and understanding of many discrete data elements in complex, high technology work domains such as ICUs remains elusive. It may be that traditional analysis and design methods simply are inadequate for this kind of complex environment. Vicente has described a new methodology, called “cognitive work analysis” (CWA), which is targeted at the analysis of complex work domains. The analysis differs from traditional analytic methods in significant ways, particularly in its primary focus on analysis of the work domain, but also in its prescription for explicitly collecting information at five levels (the work domain, diagnostic and treatment tasks, diagnostic strategies, socio-organizational, and clinician skills) that place constraints on the ultimate display design. In this model, the order of data collection is also crucial. Because the work domain constraints tend to be the most permanent, they are likely to have the most impact on design, and so analysis starts there. As the analysis proceeds through the subsequent levels, additional design constraints are identified. We recently used CWA to analyze the information needs for interactive graphical displays that will integrate and represent data in structures that help clinicians visualize a patient's physiological status. We found that the analysis was an effective way to identify information needs at multiple levels. Based on our experience, CWA is a generic methodology that is highly applicable to medical informatics.
Barriers and Resistance to Informatics in Behavioral Health
Authors: Lorenzi Nancy M.  , Riley Robert T.  , Dewan Naakesh A.
Published: February 2025

The levels of resistance to a new informatics system can vary widely both between and among specific groups. The relevance to today's behavioral medicine area is obvious. The aim of effective change management techniques is not to eliminate all resistance. This is typically impossible when a group of any size is involved. The aims are (1) to keep initial general resistance at reasonable levels, (2) to prevent that initial resistance from growing to serious levels, and (3) to identify and deal with any pockets of serious resistance that do occur despite the previous efforts. His article outlines areas of resistance to behavioral informatics and offers suggestions for overcoming the resistance.
A Demographic Database for Monitoring Community Life Support Skills
Authors: Downie Ronnie  , Ferguson Sandra  , Gomez John  , Bryden John  , Wilkie Lesley
Published: February 2025

Training in community life support has been shown to lessen the mortality from sudden myocardial events. Such community training is badly quantified and its efficacy difficult to prove. In a diversity of communities in the West of Scotland emergency life support (ELS) training schemes have been set up in localities ranging from isolated islands tourban centres with considerable social disadvantage. An Access database was created that has captured demographic data about those trained. This simple technique, with data-capture from a wide range of lay trainers, is demonstrating at its crudest exactly how many have been trained. It can show population rates of training and compare these with the international target of 20% of the population. It highlights the age bands of those trained and whether the socially disadvantaged are having equitable training. UK Post-code (Zip-code) has in parallel with other Scottish work been used as a proxy for social circumstances. The greatest value of the database is that it is ready to be married up with national data from the Scottish Ambulance Service and allied studies to show over time how effective the training is in altering mortality. The effort in creating and maintaining such an epidemiological database requires faith. It is the “posterity planting” of modern public health medicine.
Exploiting the Nursing Minimum Data Set for the Netherlands
Authors: Goossen William T.F.
Published: February 2025

The purpose of this overview is to examine and illustrate the feasible options for the statistical analysis of the Nursing Minimum Data Set for the Netherlands.
Supporting Discovery in Medicine by Association Rule Mining in Medline and UMLS
Authors: Hristovski Dimitar  , Stare Janez  , Peterlin Borut  , Dzeroski Saso
Published: February 2025

The paper presents an interactive discovery support system for the field of medicine. The intended users of the system are medical researchers. The goal of the system is: for a given starting concept of interest, discover new, potentially meaningful relations with other concepts that have not been published in the medical literature before. The known relations between the medical concepts come from the Medline bibliographic database and the UMLS. We use association rules for discovering the relationship between medical concepts. We evaluated the system by testing how successfully it predicted future discoveries (new relations between concepts). We first divided the Medline database into two segments (older and newer) using the publication date. Then we calculated how many of the new relations found by the system in the older segment become known relations in the newer segment. We found out with statistical significance that the system predicts new relations better then someone predicting randomly. The evaluation showed that our approach for supporting discovery in medicine is successful, but also that some improvements are needed, especially on limiting the number of potential discoveries the system generates.
Economical and Technical/Medicojuristical Aspects of Different Remote-Data-Entry Scenarios: A Project Study
Authors: Elsner Christian  , Kottkamp Hans  , Went Tobias  , Hindricks Gerhard
Published: February 2025

For the conduction of clinical trials vast amounts of clinical data needs to be organized. Clear evidence on how effective an electronically organized workflow will prove in reality, is still missing. In our approach three different scenarios were evaluated in a small Pilot-Trial with 103 Patients and analyzed in aspects of economics, user-friendliness and Technical/Medicojuristical performance. The three scenarios consisted of a normal paper-based approach, a Browser/Internet-based approach and an approach with Handheld-Devices being synchronized over the Internet. Overall, electronic data-management proved to be more efficient than the paper-based approach. Calculation of Economics showed, that Investments are very high with Handheld-Devices and economic benefits are hard to calculate. Using only Browser-based technics reduces Implementation Costs, but shows less workflow performance and enables the user not to generate “source data” in sense of FDA 21 CFR Part 11.
Special Challenges in Developing a Data Model for a Multi-Institution Immunization Registry
Authors: Jenders Robert A.  , Fries Frank  , Irigoyen Matilde
Published: February 2025

Immunization registries have been touted as a means to create and sustain high rates of pediatric immunizations. We describe here specific challenges that a registry data model must address related to satisfy documentary and legal standards.
Indexing Medical WWW Documents by Morphemes
Authors: Schulz Stefan  , Honeck Martin  , Hahn Udo
Published: February 2025

Assisting users to search medical information on the WWW is here considered from two perspectives – the linguistic complexity of medical terms, nominal compounds in particular, and cross-lingual relationships between monolingual medical terminologies. In order to solve the first problem, we present an approach to automatic indexing in which medically plausible morphological units are used. Semantic value is added to these index terms by a compact domain-specific thesaurus. We further discuss tools for morphological segmentation and morphosemantic normalization of HTML documents, as well as an adaptation of a standard WWW search engine for morpheme-based retrieval. The second problem, cross-lingual medical document retrieval, is dealt with by defining cross-lingual equivalence relations on the emerging morpheme sets.
Representation of Clinical Practice Guidelines for Computer-Based Implementations
Authors: Wang Dongwen  , Peleg Mor  , Tu Samson W.  , Shortliffe Edward H.  , Greenes Robert A.
Published: February 2025

Representation of clinical practice guidelines is a critical issue for computer-based guideline development, implementation and evaluation. We studied eight types of computer-based guideline representation models. Typical primitives for these models include decisions, actions, patient states and execution states. Temporal constraints and nesting are important aspects of guideline structure representation. Integration of guidelines with electronic medical records can be facilitated by the introduction of formal models of patient data. Patient states and execution states are closely related to one another. Data collection, decision, patient state and intervention are four basic steps in a guideline's logic flow.
Analysis and Modelling of the Multi-Professional Treatment Process: Preliminary Results
Authors: Ehlers Frauke  , Ammenwerth Elske  , Haux Reinhold  , Pohl Ulrike  , Resch Franz
Published: February 2025

This paper presents first results of a research project aimed at improving co-operative work initiatives in hospitals. A holistic analysis of the treatment process is presented as a precondition for process reengineering, quality measurements and improvement of multi professional cooperation. Treatment process modelling attempts within the last years have concentrated on specialised points of views, such as business process modelling or communication modelling. In contrast, we have developed a framework consisting of several views of the treatment process. We tested our framework in a broad system analysis within the Department of Child and Adolescent Psychiatry of the Heidelberg University Hospitals. Our preliminary results support the framework. Weaknesses were described precisely in both the field of organisational procedures and information management.
Linking Personal & Public Health Information: A Vision for Community-Centered Health Information Systems
Authors: Kwiatkowski Kelly  , Brennan Patricia Flatley
Published: February 2025

As health care in the U.S. and worldwide has shifted from a centralized, institution-based model to a distributed process occurring largely in the communities, Integrated Advanced Information Management Systems (IAIMS) initiatives must also move toward addressing the challenges of integrating health information at the community level. The Wisconsin IAIMS initiative strives to create such a solution, anchoring its efforts in a regional health information technology architecture by partnering with Wisconsin-area communities as the foundation that will ensure the establishment of the appropriate collaborations to gain adequate investment and generate sustainable solutions for health information integration.
Information System for the Support of Research, Diagnosis and Therapy of Inborn Metabolic Diseases
Authors: Kauert Ralf  , Töpel Thoralf  , Scholz Uwe  , Hofestädt Ralf
Published: February 2025

We developed an information system for inborn metabolic diseases. The system consists of three parts. The first part is the MD-Cave for information on laboratory findings, genes, enzymes and metabolic pathways. The second part (ASDB) concerns with active agents and their different mechanisms of action inside the metabolic pathway and possible therapeutic treatment of these illnesses. The third part deals with the integration of these and other data bases for easy access to different information. This information system can be helpful for scientists and physicians working in the field of inborn metabolic diseases.
Intelligent Knowledge Retrieval for Decision Support in Medical Applications
Authors: Montani Stefania  , Bellazzi Riccardo
Published: February 2025

Knowledge management and retrieval are key issues to be addressed in the medical domain, where a large amount of information is generally available, and where the expert’s skills need to be properly shared across the organisation, with the aim of improving the quality of care. Case Based Reasoning (CBR) is a very well suited methodology for the Knowledge Management task, when knowledge is in the operative form. Nevertheless, also well-assessed, formalised medical knowledge, such as clinical guidelines, should be made available to physicians in order to optimise their reasoning process. To take advantage of both knowledge types, we have defined a Multi Modal Reasoning methodology, that integrates CBR and Rule Based Reasoning, for supporting context detection, information retrieval and therapy revision in diabetes care.
Dynamic Viewer of Medical Events in Electronic Medical Record
Authors: Matsumura Yasushi  , Kuwata Shigeki  , Kusuoka Hideo  , Takahashi Yasushi  , Onishi Hisashi  , Kawamoto Toshio  , Takeda Hiroshi
Published: February 2025

Medical record should enable doctors to comprehend the patient’s history and select suitable medical treatment. In paper based medical records, medical events (examination, treatment etc.) are recorded successively, and problem oriented recording is difficult to be applied to patients with much information and a long history. Consequently it is not easy to understand the patient’s history from paper based medical records. In order to solve this problem, we developed the flow sheet system in our electronic medical record (EMR). To make a flow sheet, we analyzed the structure of the medical event data. In this paper we introduced the medical event information model for our EMR. Furthermore, we clarified the specification of the data presentation on the flow sheet. We developed the flow sheet on the basis of these analyses. Because there are 3 layers in the vertical axis of the flow sheet, many items of the medical event can be displayed on the screen. When user clicks the cell, the corresponding detail data including images are shown. This system functions to link medical event items with a problem, and shows the bundled items on the flow sheet when the user selects the problem. We implemented this system in Osaka University Hospital. The number of the types of medical events and those of detail events in inpatients are 5.0±1.7 (mean±SD) and 60±47, respectively. The medical doctors in Osaka University Hospital evaluated this system, and concludes that the flow sheet data presentation makes comprehension of the patient’s history easier than paper based records. As to the function of bundling the items relevant to the problem, they feel it is especially useful for patients with chronic disease. Thus the flow sheet data presentation in EMR is useful for medical practice.
Using the eXtensible Markup Language (XML) in a Regional Electronic Patient Record for Patients with Malignant Diseases
Authors: Wolff Astrid Corinna  , Mludek Volker  , van der Haak Minne  , Bork Wiebke  , Bülzebruck Heinrich  , Drings Peter  , Schmücker Paul  , Wannenmacher Michael  , Haux Reinhold
Published: February 2025

Communication between different institutions which are responsible for the treatment of the same patient is of outstanding significance, especially in the field of tumor diseases. Regional electronic patient records could support the co-operation of different institutions by providing access to all necessary information whether it belongs to the own institution or to a partner.
Human Resource Assignment and Role Representation Mechanism with the “Cascading Staff-Group Authoring” and “Relation/Situation” Model
Authors: Hirosea Yasuyuki  , Sasaki Yoshiyuki  , Kinoshita Atsuhiro
Published: February 2025

We have previously reported the access control mechanism and audit strategy of the “patient-doctor relation and clinical situation at the point-of-care” model with multiaxial access control matrix (ACM). This mechanism overcomes the deficit of ACM in the aspect of data accessibility but does not resolve the representation of the staff's affiliate and/or plural membership in the complex real world.
A UML-based Ontology for Describing Hospital Information System Architectures
Authors: Winter Alfred  , Brigl Birgit  , Wendt Thomas
Published: February 2025

To control the heterogeneity inherent to hospital information systems the information management needs appropriate hospital information systems modeling methods or techniques. This paper shows that, for several reasons, available modeling approaches are not able to answer relevant questions of information management. To overcome this major deficiency we offer an UML-based ontology for describing hospital information systems architectures. This ontology views at three layers: the domain layer, the logical tool layer, and the physical tool layer, and defines the relevant components. The relations between these components, especially between components of different layers make the answering of our information management questions possible.
Individual Authentication of Users for Secure HIS
Authors: Honda Masayuki  , Satomura Yoichi  , Suzuki Takahiro  , Yokoi Hideto
Published: February 2025

Technical mechanisms such as authentication and access controls and so on, are important subjects on protecting the security of hospital information system. The function of individual user authentication is essential and important requirement of secure system. Our discussion is focused on techniques of individual authentication using finger print system or IC card system based on the questionnaires answered by several vendors, from the point of effective daily clinical works.
Design and Implementation of an Urban/Rural Telehealth Network for the Evaluation of Abused Children: Implications for Global Primary Care Applications Submitted by IMIA WG V (Primary Care)
Authors: Whitworth J.M.  , Mullins H.C.  , Morse Karen
Published: February 2025

To meet the increasing need for rapid medical evaluation of allegations of child abuse in rural areas and the paucity of trained professionals to provide these evaluations, a model telemedicine network was designed and implemented initially in the State of Florida, USA. The utilization of various types of equipment, transmission modes, and electronic peripherals, will be discussed, as well as utilization of physician extenders for assessment. The expansion of this system for other medical uses will be summarized. Experiences in replication of the model in a southern Alabama rural county will be detailed.
Evaluation of a Telemedicine System for Supporting Thyroid Disease Diagnosis
Authors: Yokota Ken-ichi  , Takamura Noboru  , Shibata Yoshisada  , Yamashita Shunichi  , Mine Mariko  , Tomonaga Masao
Published: February 2025

A telemedicine system connecting Japan and Belarus via a communication satellite and the international ISDN has been in use since February, 1999. Two relational databases, which are essentially the same, are set respectively at Nagasaki University School of Medicine and Gomel Regional Specialized Dispensary in Belarus for management of patients’ data and for research including epidemiologic studies. The thyroid ultrasonographic images, microscopic images of cytological findings and other information on patients are sent from Gomel to Nagasaki once a week with diagnoses and comments by physicians at Gomel Regional Specialized Dispensary for cases whom they found difficult to diagnose. Thyroid specialists at Nagasaki University School of Medicine correct the diagnoses, if necessary, on the basis of information from Gomel and send their comments and instuctions to Gomel for improving diagnosis skills of physicians at Gomel. The findings of 330 cases have been sent from Gomel to Nagasaki by September, 2000 since the commencement of the system in February, 1999. Of the 329 cases, thyroid diagnosis was made at Gomel for 261 cases in whom two or more diagnoses were made for 35 cases. As of the end of October, 2000, the Gomel diagnoses have been reviewed for 217 cases and the remaining 112 cases are under review at Gomel. The diagnoses made at Gomel and Nagasaki were in agreement for 110 (50.7%) of 217 cases. Thyroid cancer was diagnosed in 8 cases in whom 6 had been diagnosed at Gomel while the other 2 were diagnosed anew at Nagasaki. The usefulness of the system for improving thyroid diagnosis in Belarus was indicated.
Exploratory Data Analysis of Irregular Patterns of Longitudinal Laboratory Data from Clinical Trials — A Case Study of Liver Function Test
Authors: Lee Kwan R.  , Lydick Eva  , Park Daniel C.
Published: February 2025

Historical clinical trials data comprises a source of rich data to answer a number of ad hoc questions about disease natural history, drug safety, new markers of clinical outcomes and clinical trial design. In particular, longitudinally measured laboratory data provides information on many possible epidemiological research questions. However irregular patterns of the longitudinal data is an analytical challenge for statisticians. It is common in clinical trials to have laboratory measurements of each patient with a different start date, on unequal intervals, with different number of recordings. Also missing value patterns are neither random nor systematic. In this paper we showed an exploratory data analysis of irregular patterns of a liver function test using modern graphics and advanced statistical analysis. The analysis successfully revealed underlying patterns of the data.
‘Putting It on the Table’
Authors: Encarnação L. Miguel  , Bimber Oliver
Published: February 2025

Collaborative virtual environments for diagnosis and treatment planning are increasingly gaining importance in our global society. Virtual and Augmented Reality approaches promised to provide valuable means for the involved interactive data analysis, but the underlying technologies still create a cumbersome work environment that is inadequate for clinical employment. This paper addresses two of the shortcomings of such technology: Intuitive interaction with multi-dimensional data in immersive and semi-immersive environments as well as stereoscopic multiuser displays combining the advantages of Virtual and Augmented Reality technology.
Wireless Live Streaming Video of Laparoscopic Surgery: A Bandwidth Analysis for Handheld Computers
Authors: Gandsas Alex  , McIntire Katherine  , George Ivan M.  , Witzke Wayne  , Hoskins James D.  , Park Adrian
Published: February 2025

Over the last six years, streaming media has emerged as a powerful tool for delivering multimedia content over networks. Concurrently, wireless technology has evolved, freeing users from desktop boundaries and wired infrastructures. At the University of Kentucky Medical Center, we have integrated these technologies to develop a system that can wirelessly transmit live surgery from the operating room to a handheld computer. This study establishes the feasibility of using our system to view surgeries and describes the effect of bandwidth on image quality.
Cryotherapy Simulator for Localized Prostate Cancer
Authors: Hahn James K.  , Manyak Michael J.  , Jin Ge  , Kim Dongho  , Rewcastle John  , Kim Sunil  , Walsh Raymond J.
Published: February 2025

Cryotherapy is a treatment modality that uses a technique to selectively freeze tissue and thereby cause controlled tissue destruction. The procedure involves placement of multiple small diameter probes through the perineum into the prostate tissue at selected spatial intervals. Transrectal ultrasound is used to properly position the cylindrical probes before activation of the liquid Argon cooling element, which lowers the tissue temperature below -40 degrees Centigrade. Tissue effect is monitored by transrectal ultrasound changes as well as thermocouples placed in the tissue. The computer-based cryotherapy simulation system mimics the major surgical steps involved in the procedure. The simulated real-time ultrasound display is generated from 3-D ultrasound datasets where the interaction of the ultrasound with the instruments as well as the frozen tissue is simulated by image processing. The thermal and mechanical simulations of the tissue are done using a modified finite-difference/finite-element method optimized for real-time performance. The simulator developed is a part of a comprehensive training program, including a computer-based learning system and hands-on training program with a proctor, designed to familiarize the physician with the technique and equipment involved
High Performance Bilateral Telerobot Control
Authors: Kline-Schoder Robert  , Finger William  , Hogan Neville
Published: February 2025

Telerobotic systems are used when the environment that requires manipulation is not easily accessible to humans, as in space, remote, hazardous, or microscopic applications or to extend the capabilities of an operator by scaling motions and forces. The Creare control algorithm and software is an enabling technology that makes possible guaranteed stability and high performance for force-feedback telerobots. We have developed the necessary theory, structure, and software design required to implement high performance telerobot systems with time delay. This includes controllers for the master and slave manipulators, the manipulator servo levels, the communication link, and impedance shaping modules. We verified the performance using both bench top hardware as well as a commercial microsurgery system.
Realtime Textured 3D-Models for Medical Applications
Authors: K¨bler Carsten  , Bauer Lars  , Heinze Peter  , Raczkowsky Jörg  , Wörn Heinz
Published: February 2025

Realistic visualisation becomes more and more important in medicine. Whenever a patient individual 3D-model was generated the aim is to visualise the model as realistic as possible. We use 3D-models in our diagnostic and therapeutic tools for intraoperative visualisation of e.g. CT-scans. Most medical tools uses surface-rendering or volume-rendering for virtual visualisation. The coloration of a visualised model is normally done by using a convenient colour for each surface resp. volume. Our approach for 3D-models generated from motion in image series (e.g. videoendoscopes) is to add textures to the 3D-model. The main problem is, to handle the huge amount of videoimage-data (20Mb/sec.) and render the model in realtime.
CT, MRI and Video Based Analysis of Knee Kinematics - A Basis for CT based Simulation
Authors: Meister Dietmar  , Heinze Peter  , Gonser Martin  , Kober Rudolf  , Worn Heinz
Published: February 2025

With the new computer aided surgery techniques a surgery can be split in two phases, which are pre-operative planning and intervention. The planning is frequently based on three dimensional image data and takes place in the office of the surgeon. Using this approach the surgical feeling, the physical feedback of the patient, is not available during the planning phase. However, this feedback yields information, which is helpful or necessary for the planning. This lack of information can be compensated by a simulation module, which simulates kinematic data from image volume data. To develop such a module first both image volume data and kinematic data have to be captured from a wide range of patients. In this work a new approach for kinematic analysis of the knee is ,presented which yields an accuracy which is necessary for such simulation. Because the analysis has to be done for many patients the degree of invasiveness is emphasized. This contactless and non invasive approach is based on external fixations, anatomical skin markers, video sequences and computer tomograms. Position tracking of femur and tibia for any motion pattern is possible. Because the individual anatomic structures extracted from the tomogram are tracked, an analysis of any point or coordinate system can be done later using the originally captured data. This gives a new degree of freedom for analysis.
Simulation of bleeding during laparoscopic herniorrhaphy
Authors: Raghupathi Lakshminarasimhan  , Devarajan Venkat  , Eberhart Robert  , Jones Daniel B.
Published: February 2025

Simulation of intragastric bleeding due to an accidental cut by the surgeon is an important component of a virtual laparoscopie herniorrhaphy trainer. We present a method for simulating bleeding during laparoscopic herniorrhaphy here. The various approaches used in previous research work are reviewed and our present approach is justified. Physically based fluid models used in computer graphics are used to simulate bleeding.
Integration of intraoperative radiotherapy (IORT) dose distribution into the postoperative CT-based external beam radiotherapy (EBRT) treatment planing
Authors: Treiber Martina  , Daeuber S.  , Krempien R.  , Hoppe H.  , Hensley FW.  , Brief J.  , Woern H.  , Lehnert T.  , Buechler M.  , Wannenmacher M.
Published: February 2025

In the treatment of malignant disease external beam radiation therapy (EBRT) is often combined with surgery. Intraoperative radiotherapy (IORT) improves the local control by dose escalation. For reasons of recording, improvement and security of the intervention, it would be necessary to merge the IORT-dose distribution with the postoperative CT-based EBRT-planing. The aim of this work was to develop a method to reconstruct the IORT field and register it with the postoperative planing CT. This enables the reconstruction of the IORT dose distribution and merge it with the CT-based EBRT planing data. We use a surface scanner to receive a large amount of surface points which enables us reconstruct the IORT-field and to register it with the CT-based EBRT planning data. Scanning and calculation time is not over 2 seconds, depending mainly on the CPU power. The error of a single point is below 1 mm. The density of the point cloud is approx. 4 per mm2. In this paper we give an overview of our experimental setup and the accuracy of the method.
Case Mix in the USA: Fifteen Years of DRG-Based Hospital Financing in the United States*
Authors: Coffey Rosanna M.  , Louis Daniel Z.
Published: February 2025

Uncontrolled increases in Medicare expenditures spurred U.S. policymakers to turn from a cost-reimbursement system to episode-based hospital financing in the 1980’s. The Diagnosis Related Groups (DRGs ) were used to define patient types, and fixed national prices for patients covered by Medicare were defined to create economic incentives for hospitals to become more efficient. Today, U.S. hospitals are treating only the most seriously ill patients. Simpler procedures are being performed outside the hospital. Nursing care is increasingly moved to intermediate-care facilities or is given during home visits and recuperation is occurring outside the hospital, where patients and families have more responsibility in the recovery process. This paper describes the DR G experience, how hospitals and physicians changed the use o f hospitals, the successes and failures of that experience, and lessons that may be learned as other countries adopt similar hospital financing schemes.
The Protection of Individuals by Protecting Medical Data in EHRs
Authors: Barber Barry
Published: February 2025

The paper discusses the changes in the delivery of Healthcare and the ways in which individuals need to be protected by protecting their Electronic Health Records. A Code of Ethics is needed for health Information Professionals, Data Protection and Security issues need to be taken more seriously. Health Informatics needs to address the issues of safety in the delivery of Healthcare so that it provides solutions to healthcare safety problems rather than increasing the problems to be addressed.
Study of Marker Placements in the Back for Opto-electronic Motion Analysis
Authors: Chockalingam Nachiappan  , Dangerfield Peter H.  , Giakas Giannis  , Cochrane Tom
Published: February 2025

Various investigations into anatomical landmarks that could be employed in spine and back surface measurement have highlighted the usefulness of the spinous processes of the vertebra and the posterior superior iliac spines of the pelvis. Earlier studies used an opto-electronic gait analysis system to examine the motion of skin markers and compared results with similar inter-vertebral movement recorded through radiographs. Consistent patterns of movement suggested a relationship between spinal and back surface motion. Further investigations into the use of opto-electronic gait analysis systems to measure dynamic back movements showed the capability of producing repeatable patterns of back movements. However, these studies, mainly measuring the range of movement (ROM) of spine, have not examined the effects of marker placements. While most ROM studies concentrate on stationary repetitive flexion/extension and bending movements, spinal ROM during walking and in scoliosis has not been widely reported. Spinal range of motion is an important indicator of spinal function and is used in the determination of disability and compensation.
The Relationship Between Minor Asymmetry and Early Idiopathic Scoliosis
Authors: Goldberg C.J.  , Moore D.P.  , Fogarty E.E.  , Dowling F.E.
Published: February 2025

School scoliosis screening programmes have consistently produced large numbers of referrals with minimal trunk asymmetry which then must be assessed, evaluated and perhaps investigated and monitored over a period of time before it is felt safe to discharge them as ‘non-progressive.’ Beyond measures to reduce their number, they have received less attention than the more interesting cases requiring treatment or surgery, which they outnumber to a significant extent. Examination of the figures from a historical database shows that the patients have no greater probability of developing significant scoliosis than their ‘normal’ peers . So they should not be classed as scoliosis but they are still relevant to the broader picture of aetiology.
Dysfunction of the Autonomic Nerve System (ANS) in the Aetiopathogenesis of Adolescent Idiopathic Scoliosis
Authors: Sevastik John A.
Published: February 2025

Despite much evidence of its existence, the relation between impaired ANS function and the aetiopathogenesis of AIS has attracted surprisingly little attention. Studies have shown that the left breast of girls with right convex thoracic AIS is significantly more vascular than the right one and that the mean concave minu s convex rib length in women with thoracic IS is significantly greater than the left minu s right rib length in normal women. Moreover in growing rabbits unilateral regional sympathectomy by resection of intercostal nerves carrying sympathetic fibers results in hypervascularity of the soft tissues, increased rib growth on the side of the operation and thoracic scoliosis convex to the opposite side. The results of these and of other reports provide sufficient indication of a relation between ANS dysfunction and IS, and open new views for research on the connection between the aetiology and pathogenesis of the thoracospinal deformity.