bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Automated Drug Simulant Recognition System for Naturalistic Real-Time Medical Simulation
Authors: Samosky Joseph T.  , Mikulis Brandon  , Bregman Russell  , Nelson Douglas A.
Published: February 2025

The ability for a medical simulator to automatically recognize and respond to a “drug” injected during a training exercise offers powerful capabilities for objective assessment and real-time interaction. To address some of the limitations of available mannequin drug recognition systems, we developed a novel sensing system that recognizes an IV-injected agent based on an inherent property of the fluid. Our system uses varying concentrations of saline to represent different drugs and identification is made via conductivity measurement. The system also determines the volume administered and the time over which the dose is injected. Simulant solutions in IV bags (e.g., simulated Hextend or crystalloids) can be identified even if the bag is placed at a distance from the body. The system may offer advantages for field training exercises, as no external components need to be attached to the syringe or IV bag.
Molecular pathogenesis of endometrial and ovarian cancer
Authors: Merritt Melissa A.  , Cramer Daniel W.
Published: February 2025

Pregnancy, breastfeeding, and oral contraceptive pill use interrupt menstrual cycles and reduce endometrial and ovarian cancer risk. This suggests the importance of turnover within Mullerian tissues, where the accumulation of mutations in p53 and PTEN has been correlated with number of cycles. The most common type of endometrial cancer (Type I) is endometrioid and molecular abnormalities include mutations in PTEN, KRAS and β-catenin. The Type I precursor is Endometrial Intraepithelial Neoplasia which displays PTEN defects. Type II endometrial cancer (whose precursors are less clear) includes serous and clear cell tumors and the most common alteration is p53 mutation. For ovarian cancer, histopathologic types parallel endometrial cancer and include serous, mucinous, endometrioid, and clear cell; some molecular features are also shared. The most frequent type of ovarian cancer is high grade serous that often displays p53 mutation and its precursor lesions may originate from normal-appearing fallopian tube epithelium that contains a p53 “signature”. Mutations in KRAS, BRAF and PTEN are described in mucinous, endometrioid and low grade serous cancers and these may originate from ovarian cortical inclusion cysts. A consideration of molecular and other pathogenetic features, like epidemiology and histopathology, may provide a better understanding of endometrial and ovarian cancer.
Molecular pathology of prostate cancer
Authors: Cazares L.H.  , Drake R.R.  , Esquela-Kirscher A.  , Lance R.S.  , Semmes O.J.  , Troyer D.A.
Published: February 2025

This chapter includes discussion of the molecular pathology of tissue, blood, urine, and expressed prostatic secretions. Because we are unable to reliably image the disease in vivo, a 12 core method that oversamples the peripheral zone is widely used. This generates large numbers of cores that need to be carefully processed and sampled. In spite of the large number of tissue cores, the amount of tumor available for study is often quite limited. This is a particular challenge for research, as new biomarker assays will need to preserve tissue architecture intact for histopathology. Methods of processing and reporting pathology are discussed. With the exception of ductal variants, recognized subtypes of prostate cancer are largely confined to research applications, and most prostate cancers are acinar. Biomarker discovery in urine and expressed prostatic secretions would be useful since these are readily obtained and are proximate fluids. The well-known challenges of biomarker discovery in blood and urine are referenced and discussed. Mediators of carcinogenesis can serve as biomarkers as exemplified by mutations in PTEN and TMPRSS2:ERG fusion. The use of proteomics in biomarker discovery with an emphasis on imaging mass spectroscopy of tissues is discussed. Small RNAs are of great interest, however, their usefulness as biomarkers in clinical decision making remains the subject of ongoing research. The chapter concludes with an overview of blood biomarkers such as circulating nucleic acids and tumor cells and bound/free isoforms of prostate specific antigen (PSA).
Application Repository and Science Gateway for Running Molecular Docking and Dynamics Simulations
Authors: Terstyanszky Gabor  , Kiss Tamas  , Kukla Tamas  , Lichtenberger Zsolt  , Winter Stephen  , Greenwell Pamela  , McEldowney Sharron  , Heindl Hans
Published: February 2025

Molecular docking and dynamics studies are of considerable importance in a range of disciplines including molecular biology, drug design, environmental studies, psychology, etc. Using in silico tools to support or even to substitute wet laboratory work could help better focusing the laboratory experiments resulting not only in considerable saving of resources but also increasing the number of molecules and scenarios investigated. There are several software packages that support in silico modeling. However, these tools require lot of compute resources and special technical knowledge. As a result, many bio-scientists cannot use them. The paper describes a science gateway based solution which provides access to Distributed Computing Infrastructures such as clouds, desktop and service grids. This environment enables bio-scientists to execute simple molecular modeling scenarios or build more complex use-cases from existing building blocks while hiding the technical details of the infrastructure. Four scenarios have been defined and deconstructed in order to identify common building blocks supporting a large number of complex use-cases. A reference implementation for the first scenario regarding the impact on indicator species of pharmaceuticals released into water courses has been implemented on the EDGI infrastructure, demonstrating the feasibility of the approach.
Stability Analysis of Structural Glass Systems
Authors: Lenk Peter  , Lancaster Franklin
Published: February 2025

Glass, as a load bearing material, has been the focus of extensive research and development over the past few decades. Stability of slender glass elements and glass laminates has been studied by many researchers, initially studying behaviour on small scale samples and comparing glass behaviour with the behaviour of other, more established, structural materials. Similarities and comparisons have been made between the behaviour of steel and glass. In this paper the behaviour of structural glass frames will be discussed. A short introduction with case studies showing the use of glass frames in recently completed landmark projects is presented. Both global and local geometric stability is discussed with specific attention given to the boundary conditions imposed by expected initial imperfections and restraints. Practical modelling approaches addressing the complex behaviour of multi-ply glass laminates with viscoelastic interlayer material is also proposed and discussed. This leads into a geometrically non-linear analysis of an example glass frame showing predicted P-Δ-δ behaviour and comparison between effective thickness (2D plate) simplifications and full build-up (3D brick) numerical approximations. Throughout this paper numerical discretisation and analysis is performed using the Strand 7 software package.
Ceramic Digital Printing – Customizing Glass Façade Design
Authors: Hoffmann Bernd
Published: February 2025

Modern digital printing technologies using ceramic inks are providing new interesting opportunities for longlasting decorations and optical effects on glass. This way even multicoloured very large format images and decors can be printed and fired on glass providing reflective high resolution prints, turning the functional glass skin of a building into a more or less translucent artistic screen. After a short introduction into the basic principles of the Ceramic Digital Printing technologie and the world of Glass Façade Design the presentation will give an overview about the advantages and limitations of the Ceramic Digital Printing for architectural applications. Different design intentions, challenges and achievements will be presented and discussed. TOPAZ – a helpful concept of preceding considerations for the design process of glass facades will be introduced.
Building Integrated Photovoltaics
Authors: Siebert Barbara
Published: February 2025

In terms of rising energy costs and limited fossil fuels the solar energy becomes more and more important. In the last years a change of applications was visible: From energy plants on fields and grasslands only for producing energy to the so called BIPV (building integrated Photovoltaic). Here the PV acts not only for producing energy: Other purposes are e.g. acting as building envelope and/or acting as architectural element. In this paper the basics of PV are shortly presented. Other important points are the aspects of safety e.g. for overhead glazing and large façade systems with PV and aspects of static analysis. Finally some examples of BIPV are presented.
Aviation Industry Roadmap to Sustainability
Authors: Rötger Thomas
Published: February 2025

Based on IATA's four-pillar strategy (technology, operations, infrastructure and economic measures) a set of high-level industry goals was submitted to ICAO in 2009: average fuel efficiency improvement of 1.5% p.a. till 2020; carbon-neutral growth from 2020, net CO2 emissions reduction by 50% in 2050 relative to 2005. Aircraft fuel efficiency measures include technologies, mainly for engines, aerodynamics and lightweight materials, which are estimated to save around 25 to 35% between 2005 and 2020. Operational and infrastructural improvements are expected to save around 10%. High potential is seen from aviation biofuels, which have been flight-tested and certified for commercial use. Sustainability standards exist that are applicable to them. However, their production costs are still high and investments into aviation biofuel production need to be encouraged by a suitable political framework.
Structure of the Combustion in a Trapped Vortex Combustor
Authors: Burguburu Joseph  , Cabot Gilles  , Cazalens Michel  , Renou Bruno
Published: February 2025

Due to continuous efforts through past and ongoing European projects, lean combustion by means of internally staged injectors now appears to be the promising technology for obtaining the required emission reductions compatible with a sustainable growth of aviation transport. The European project “TECCAE” – Technologies Enhancement for Clean Combustion in Aero-Engines – addresses a number of fundamental issues. To look even after ahead and to overcome the complexity issues inherent to stages lean combustors, TECC-AE also focuses on the design of an innovative lean combustor concept and on the development of a compact Ultra Low NOX (ULN) injection system.
Small Aircraft Transport as a New Component of the European Air Transport System
Authors: Piwek Krzysztof
Published: February 2025

A visionary European Transport system should be based on an environmentally sustainable, cost efficient, seamless and co-modal passenger friendly system aiming at ensuring mobility and cohesion for the Europeans. The challenge is to create a new component of European transport by wider use of small aircraft using regional airports, to enable access to more communities in less time. The FP6 “EPATS (European Personal Air Transport System) Study” showed that 7% of the future car travel in 2020 could be shifted to Small Aircraft Transport Systems (SATS).The FP7 study called “SAT – Roadmap” will set out a technology roadmap for the research actions necessary to implement such a transport system.
Neurohumoral Regulation in Children with Idiopathic Scoliosis
Authors: Khaymina T.  , Avaliani T.  , Dudin M.  , Pinchuk D.
Published: February 2025

Biotesting of blood serum in children aged 8-15 with adolescent idiopathic scoliosis (0°-60° by Cobb) showed the change of neurohumoral regulation in comparison with the age norm. The degree and direction of changes in the biotesting give the indication of the progression of spinal deformity. The effectivness of treatment can be judged by control biotesting.
Toward the next generation of simulator for intraoperative navigation of scoliotic spine surgeries
Authors: Cartiaux Olivier  , Aubin Carl-Éric  , Labelle Hubert  , Cheriet Farida
Published: February 2025

Surgical navigation systems are useful for planning pedicle screw positioning and guiding drilling trajectories. However, it is not yet possible to intraoperatively predict the correction of the scoliotic spine resulting from specific screw and rod configuration and instrumentation maneuvers. In this context, the objective of this study is to develop a novel intraoperative simulator for navigated scoliotic spine surgeries. An instrumentation strategy (pedicle screw insertion, rod attachment and rotation, set screw tightening) was computationally simulated on a synthetic model of a scoliotic spine using the preoperative radiographs in the standing position and various parameters recreating the preoperative conditions. The intraoperative decubitus position was then simulated. The resulting geometry was identified using a navigation system and transferred to the simulator, which enabled the updating of the preoperative planning, computing of clinical indices (Cobb angles, etc.) and simulation of instrumentation maneuvers. The Cobb angle decreased from 34° to 24° between the simulated pre- and intraoperative spine (before the instrumentation). Difference in pedicle screw positioning between the preoperative planning and the intraoperative situation was less than 0.5 mm. The intraoperative simulation of the rod attachment and rotation maneuvers resulted in a 12° Cobb angle. In conclusion, this preliminary study is a first step toward developing an integrated simulator for preoperative planning and intraoperative navigation of scoliotic spine surgeries. Once completed, the new intraoperative simulator will enable the surgeon to obtain real-time biomechanical feedback during the navigated surgery of a scoliotic spine, and may contribute to improve the resulting correction and instrumentation parameters (instrumented levels, surgical maneuvers, generated forces, etc.).
Integrated Assessment of Back Muscles Bioelectrical Activity and H-reflex Research in AIS
Authors: Syngayevskaya I.  , Bumakova S.  , Pinchuk D.  , Dudin M.
Published: February 2025

The study of the back muscles bioelectric activity in 216 children in the age between 10-15 years showed that the total paravertebral muscles bioelectrical activity on the convex side of the proximal curve and on the concave side of its distal part is higher compared with that on the opposite side. Analysis of H-reflex and M-responses in 302 patients in the age between 10-15 years created a normative database. This allows, in comparison with the total individual electrophysiological parameters, to determine patient's progression risk.
Peculiarities of Brain Functioning in Children with Adolescence Idiopathic Scoliosis (AIS) According to EEG Studies
Authors: Pinchuk D.  , Dudin M.  , Bekshayev S.  , Pinchuk O.
Published: February 2025

Brain structures with bioelectric activity (BA) different from BA of the same structures in healthy peers were revealed using an original 3DLocEEG analysis of EEGs that solves so-called “reverse EEG task”. These were the following structures: thalamus, pineal gland, hypothalamic area, including suprahiasmatic nuclei, and infratemporal cortex. The shift of BA focus to structures of the left hemisphere including left thalamus was recorded in patients with AIS; the shift increased both with worsening of deformation and increasing progression activity. This was not observed in healthy children (aged 7–14 years), although it is natural for older adolescents (15–17 years) and healthy adults. In other words, the interhemispheric asymmetry of brain BA in children with AIS becomes typical for the definitive brain much earlier. This phenomenon may be used for future development of a method for prediction of deformation progression patterns. A number of differences obtained in comparative analysis of EEGs, processed by 3DLocEEG method, between right-side and left-side AIS allow us to hypothesize about aetiology and pathogenesis differences of these two AIS clinical forms. Data obtained suggest that brain structures play a much more important role in aetiology and pathogenesis of AIS right-side forms compared with left-side ones. Primary subclinical dysfunctions of brain regulatory systems leading to disturbances of spinal cord and brain associated growth and subsequently to scoliosis development are supposed to play the main role in pathogenesis of right-side AIS forms (or their substantial part). Evidently, the major reason for manifesting these latent dysfunctions is an overstrain of central nervous system (CNS) adaptation-compensation mechanisms during the pubertal period.
Multimodal User Interfaces to Improve Social Integration of Elderly and Mobility Impaired
Authors: Dias Miguel Sales  , Pires Carlos Galinho  , Pinto Fernando Miguel  , Teixeira Vítor Duarte  , Freitas João
Published: February 2025

Technologies for Human-Computer Interaction (HCI) and Communication have evolved tremendously over the past decades. However, citizens such as mobility impaired or elderly or others, still face many difficulties interacting with communication services, either due to HCI issues or intrinsic design problems with the services. In this paper we start by presenting the results of two user studies, the first one conducted with a group of mobility impaired users, comprising paraplegic and quadriplegic individuals; and the second one with elderly. The study participants carried out a set of tasks with a multimodal (speech, touch, gesture, keyboard and mouse) and multi-platform (mobile, desktop) system, offering an integrated access to communication and entertainment services, such as email, agenda, conferencing, instant messaging and social media, referred to as LHC - Living Home Center. The system was designed to take into account the requirements captured from these users, with the objective of evaluating if the adoption of multimodal interfaces for audio-visual communication and social media services, could improve the interaction with such services. Our study revealed that a multimodal prototype system, offering natural interaction modalities, especially supporting speech and touch, can in fact improve access to the presented services, contributing to the reduction of social isolation of mobility impaired, as well as elderly, and improving their digital inclusion.
Dance! Don't Fall – Preventing Falls and Promoting Exercise at Home
Authors: Kerwin Maureen  , Nunes Francisco  , Silva Paula Alexandra
Published: February 2025

Falling is a serious danger to older adults that is usually only addressed after a person has fallen, when doctors administer clinical tests to determine the patient´s risk of falling again. Having the technological capability of performing fall risk assessment tests with a smartphone, the authors set out to design a mobile application that would enable users to monitor their risk themselves and consequently prevent falls from occurring. The authors conducted a literature review and two observation sessions before beginning the iterative design process that resulted in the Dance! Don't Fall (DDF) game, a mobile application that enables users to both monitor their fall risk and actively reduce it through fun and easy exercise.
Modeling Activity Management Instead of Task Realization
Authors: Brézillon Patrick
Published: February 2025

Context modeling and management are intrinsic parts of the decision-making process, especially in domains dealing with knowledge and reasoning. Actors make a decision jointly with the modeling of the context at hand. However, such a co-building of the decision-making and of the specific model of context is generally left implicit, and one generally retains {decision-making, solution} instead of {decision-making, context, solution}. Then, any reuse of a successful decision-making requires a complex phase of contextualization, decontextualization and recontextualization. This problem is well known in the scientific-workflow community—a scientific workflow being a kind of decision-mak implementation—for which we propose a solution. In this paper, we present a solution for decision-making, pointing out similarities of the approach with scientific workflows, their consideration related to task realization, and their integration in the notion of activity management. The key point is to consider decision-making through its entire processing and not its solution only. This shift of paradigm is possible, thanks to the Contextual-Graphs formalism and its uniform representation of knowledge, reasoning and context. A running example illustrates the contribution of this context-oriented approach for representing the contextualization process of decision-making.
An ICU clinical information system – clinicians' expectations and perceptions of its impact
Authors: Hains Isla M.  , Creswick Nerida  , Milliss David  , Parr Michael  , Westbrook Johanna I.
Published: February 2025

The Intensive Care Unit (ICU) is an information intense environment where Clinical Information Systems (CISs) can greatly impact patient care and the workload of clinicians. With the introduction of an ICU CIS imminent across New South Wales hospitals, we aimed to understand how ICU clinicians perceived a new system would impact on work practices in Australian ICUs, as much of the current evidence is generated from overseas. We conducted interviews with 66 doctors and nurses in 3 ICUs without a CIS. Many had positive perceptions regarding the impact of its introduction, though others were more guarded and unsure. Clinicians believed information access to patient would improve, communication processes could potentially change and there was potential for work processes to be more efficient. It was expected that ward rounds and handover would be less disrupted with all information available at the bedside or at the handover setting. There were mixed responses about whether a CIS would save time and how it would influence patient care, though the majority believed a CIS would improve safety by providing a means for increasing accountability and reducing medication errors. Concerns were raised about the transition from paper to a CIS and the training required. This information provides valuable evidence in the Australian setting regarding clinicians' expectations of a new ICU CIS to assist with future implementations. It also provides baseline data as a foundation for future research once the CIS is implemented. It is clear that robust quantitative studies are required to gain a detailed understanding of how a new CIS will impact clinicians' work processes and that appropriate training is crucial for full benefits to be achieved.
Privacy with emergency medical information used in first response
Authors: Croll Peter R.  , Ambrosoli Kimberly M.
Published: February 2025

In an emergency there are many stages of Medical response. This paper focuses on the first response stage of an emergency medical incident, for example, a sporting accident. Today's Information Technology together with mobile devices now permits vital medical information regarding an individual to be available at the scene. Those first in attendance are often not medically trained. The literature shows the importance of appropriate first response in minimising harm and the significant investments being made to educate the public in this regard. It also highlights the privacy concerns that arise from the provision of sensitive health information in electronic form. The method utilised is a Privacy Impact Assessment to ascertain the suitability and compliance of the proposed technology. This approach follows the privacy guidelines specified by the Australian government to include information flow mapping, evaluation, compliance analysis, risk analysis and recommendations to management. The resultant output is a list of specific questions and a set of commendations and recommendations that are matched against the National Privacy Principles. The paper concludes that: the approach is both technical and pragmatically viable; it can meet all the reasonableness tests for privacy concerns; it can adopt standard security measures, and; it discusses its potential to be integrated into Personally Controlled Electronic Health Records.
A-B-C-1-2-3 Healthy Kids in Tennessee - Let's Eat Well, Play, and Be Aware Every Day: A Preliminary Report
Authors: Chafin Cynthia  , Edwards M. Jo  , Morgan Debbie  , Isom Pam  , Morgan Don
Published: February 2025

The “A-B-C-1-2-3 Healthy Kids in Tennessee – Let's Eat Well, Play, and Be Aware Every Day” project is a hands-on educational program emphasizing healthy living that targets childcare providers, the children they care for, and their families. The program was initially implemented as a pilot project in 6 middle Tennessee childcare centers. Materials were organized and developed by the Middle Tennessee Cancer Coalition's childhood action team in conjunction with staff from Middle Tennessee State University (MTSU) Center for Health and Human Services and the MTSU Center for Physical Activity and Health in Youth. The A-B-C-1-2-3 initiative served as a feasibility project to inform the conduct of field operations. Through the MTSU Center for Physical Activity and Health in Youth, an expanded 12-week pilot program took place during 2010 in 2 childcare centers. The purpose of the program is to educate childcare providers who, in turn, educate children and their parents and promote healthy lifestyles and decrease the risk of developing cancer, obesity, and other lifestyle-associated diseases and health conditions. The overall goal of the project is to decrease lifestyle and environmental cancer risk factors among Tennesseans by 2012 as detailed in the 2009-2012 Tennessee Comprehensive Cancer Control Plan and to provide educational opportunities in healthy eating and healthy weight to childcare providers detailed in the 2010-2015 Tennessee Statewide Nutrition and Physical Activity Plan using a “train the trainer approach” along with classroom and family education. In 2012, the project will partner with a statewide Tennessee Department of Health initiative, Gold Sneakers, which provides a policy piece to the A-B-C-1-2-3 Healthy Kids in Tennessee's approach to disseminate nutritional and physical activity education to childcare providers, children, and their families, offering a full-circle approach to health promotion in a childcare setting.
Effective Strategies for Implementation and Evaluation of Public e-Health Innovations
Authors: Lorenzi Nancy M.  , Unertl Kim M.
Published: February 2025

The creation of a new public e-health product is no guarantee that it will be used. Developing an implementation strategy is crucial for success. This paper presents a model for both an implementation and an evaluation process. It offers strategies for the multiple phases of an implementation process (foundational concepts, actual implementation, and the on-going use process). It also offers evaluation considerations that parallel each of the implementation phases.
Advances in Health Informatics Education: Educating Students at the Intersection of Health Care and Information Technology
Authors: Kushniruk Andre  , Borycki Elizabeth  , Armstrong Brian  , Kuo Mu-Hsing
Published: February 2025

The paper describes the authors' work in the area of health informatics (HI) education involving emerging health information technologies. A range of information technologies promise to modernize health care. Foremost among these are electronic health records (EHRs), which are expected to significantly improve and streamline health care practice. Major national and international efforts are currently underway to increase EHR adoption. However, there have been numerous issues affecting the widespread use of such information technology, ranging from a complex array of technical problems to social issues. This paper describes work in the integration of information technologies directly into the education and training of HI students at both the undergraduate and graduate level. This has included work in (a) the development of Web-based computer tools and platforms to allow students to have hands-on access to the latest technologies and (b) development of interdisciplinary educational models that can be used to guide integrating information technologies into HI education. The paper describes approaches that allow for remote hands-on access by HI students to a range of EHRs and related technology. To date, this work has been applied in HI education in a variety of ways. Several approaches for integration of this essential technology into HI education and training are discussed, along with future directions for the integration of EHR technology into improving and informing the education of future health and HI professionals.
Autonomous construction with a mobile robot in a resource-limited environment: a demonstration of the integration of perception, planning and action
Authors: Magnenat Stéphane  , Gribovskiy Alexey  , Mondada Francesco
Published: February 2025

This demo presents a miniature mobile robot performing autonomous construction in an environment where resources are limited. After an exploration phase, the robot builds a structure at a designated location according to an order from a human. Since local resources are scarce, the robot must change its environment to get access to enough resources to complete the construction. This process involves perceiving the environment, reasoning on possible courses of action using a task planner, and implementing these actions to successfully build the requested structure.
An Efficient and Adaptive Approach to Negotiation in Complex Environments
Authors: Chen Siqi  , Weiss Gerhard
Published: February 2025

This paper studies automated bilateral negotiation among self-interested agents in complex application domains which consist of multiple issues and real-time constraints and where the agents have no prior knowledge about their opponents' preferences and strategies. We describe a novel negotiation approach called OMAC (standing for “Opponent Modeling and Adaptive Concession”) which combines efficient opponent modeling and adaptive concession making. Opponent modeling is achieved through standard wavelet decomposition and cubic smoothing spline, and concession adaptivity is achieved through dynamically setting the concession rate on the basis of the expected utilities of forthcoming counter-offers. Experimental results are presented which demonstrate the effectiveness of our approach in both discounting and non-discounting domains. Specifically, the results show that our approach performs better than the five top agents from the 2011 Automated Negotiation Agents Competition (ANAC).
On Exploiting Structures of Classical Planning Problems: Generalizing Entanglements
Authors: Chrpa Lukáš  , McCluskey Thomas Leo
Published: February 2025

Much progress has been made in the research and development of automated planning algorithms in recent years. Though incremental improvements in algorithm design are still desirable, complementary approaches such as problem reformulation are important in tackling the high computational complexity of planning. While machine learning and adaptive techniques have been usefully applied to automated planning, these advances are often tied to a particular planner or class of planners that are coded to exploit that learned knowledge. A promising research direction is in exploiting knowledge engineering techniques such as reformulating the planning domain and/or the planning problem to make the problem easier to solve for general, state-of-the-art planners. Learning (outer) entanglements is one such technique, where relations between planning operators and initial or goal atoms are learned, and used to reformulate a domain by removing unneeded operator instances. Here we generalize this approach significantly to cover relations between atoms and pairs of operators themselves, and develop a technique for producing inner entanglements. We present methods for detecting inner entanglements and for using them to do problem reformulation. We provide a theoretical treatment of the area, and an empirical evaluation of the methods using standard planning benchmarks and state-of-the-art planners.
Reasoning with Fuzzy-EL
Authors: Zhou Zhangquan  , Qi Guilin  , Liu Chang  , Hitzler Pascal  , Mutharaju Raghava
Published: February 2025

Fuzzy extension of Description Logics (DLs) allows the formal representation and handling of fuzzy knowledge. In this paper, we consider fuzzy-EL+, which is a fuzzy extension of EL+. We first present revised completion rules for fuzzy-EL+that can be handled by MapReduce programs. We then propose an algorithm for scale reasoning with fuzzy-EL+ontologies based on MapReduce.
Do Worklists Work? A Quantitative Approach to the Assessment of an Electronic Patient Record Function
Authors: Hurlen Petter
Published: February 2025

In this study, a quantitative approach was used to assess an Electronic Patient Record worklist function introduced to prevent radiology reports from being overlooked by the responsible clinicians. The function reduced the rate of overlooked reports, but was not able to eliminate it. Not all reports were identified by the automatic worklist function. Clinicians did not use the worklists to detect new reports. Our results suggest that this was not the result of insufficient user training or user errors, but rather that the worklists function did not comply with the way clinical work was organised and performed. Quantitative methods as used in this study are suggested as supplementary to the traditional qualitative methods.
Collaborative Development of Knowledge-Based Support Systems: A Case Study
Authors: Lindgren Helena  , Winnberg Patrik J.  , Yan Chunli
Published: February 2025

We investigate a user-driven collaborative knowledge engineering and interaction design process. The outcome is a knowledge-based support application tailored to physicians in the local dementia care community. The activity is organized as a part of a collaborative effort between different organizations to develop their local clinical practice. Six local practitioners used the generic decision-support prototype system DMSS-R developed for the dementia domain during a period and participated in evaluations and re-design. Additional two local domain experts and a domain expert external to the local community modeled the content and design of DMSS-R by using the modeling system ACKTUS. Obstacles and success factors occurring when enabling the end-users to design their own tools are detected and interpreted using a proposed framework for improving care through the use of clinical guidelines. The results are discussed.
Concise Healthcare-Associated Infection Reporting and Benchmarking with Minimal Staff Resources
Authors: Koller Walter  , De Bruin Jeroen  , Blacky Alexander  , Mandl Harald  , Adlassnig Klaus-Peter
Published: February 2025

We report on intelligent information technology tools that produce fully-automated surveillance reports of high precision for 12 intensive care units (ICUs) without relevant time expenditure of infection control or ICU staff. This is accomplished by MONI-ICU, a computerized system for automated identification and continuous monitoring of ICU-associated infections, which makes surveillance data readily accessible and presents them in easily perceptible reporting format.
Patient Empowerment in the Process of Sickness Certificates
Authors: Klein Gunnar O  , Andersson Kjell
Published: February 2025

A national patient portal for secure communication between the patients/citizens and primary care (Mina vårdkontakter) is available in Sweden. This system was used in a pilot project in the Stockholm County where patients were invited to prepare the visit to their physician for the discussion on the need for prolonged sickness leave by filling out a web based questionnaire on their current health status and working conditions. The opinions of the patients and their primary care physicians about the system were analyzed with positive feedback.
A Special Query Tool in the Hospital Information System to Recognize Patients and to Increase Patient Numbers for Clinical Trials
Authors: Koca Mithat  , Husmann Gabriele  , Jesgarz Jürgen  , Overath Martin  , Brandts Christian  , Serve Hubert
Published: February 2025

A powerful hospital information system (HIS) contains information about diagnostic and disease data of all patients in a hospital. In the university hospital in Frankfurt / Main Germany more than 80% of all wards are completely “paperless”. But the identification of patients for clinical trials is very difficult. We developed a special query and reporting tool in the HIS to recognize patients with a specific disease and with basic inclusion and exclusion criteria for a specific clinical trial. With the help of this query tool it is possible to increase significantly the patient numbers for clinical trials in a short period.
An Example of a Multi-Professional Process-Oriented Structured Documentation Bound to SNOMED CT
Authors: Zetterberg Carina  , Ahlzén Karin  , Ericsson Erika  , Kron Bengt
Published: February 2025

Structured code-based documentation, i.e. templates which restrain the user with predetermined terms/phrases bound to terminologies, offers opportunities for advanced types of retrieval and guides the user in multiple ways; to act in accordance with evidence, for decision support and to achieve adequate documentation for the condition in question. This type of documentation is especially appropriate in health care processes which are nearly the same every time. A template for documentation of the family planning process (abortion) was elaborated at a Swedish hospital. It uses both structured elements and free-text and covers all information needed in the process. The predetermined terms and phrases were bound to SNOMED CT concepts. After the template has been completed, it forms the basis for a customary free-text note in the record. The structured information is also stored in its original form and can be used for different kinds of advanced data retrieval. The documentation is completed during the visit and there is no need for additional secretarial work. The implementation has reduced the total time used for documentation, reporting and follow up and shows that process-oriented structured documentation bound to SNOMED CT improves the documentation, supports advanced retrieval of data and reduces resource utilization.
Method for mapping the French CCAM terminology to the UMLS metathesaurus
Authors: Bousquet Cédric  , Souvignet Julien  , Merabti Tayeb  , Sadou Eric  , Trombert Béatrice  , Rodrigues Jean-Marie
Published: February 2025

The French coding system of surgical procedures, the Classification Commune des Actes Médicaux (CCAM), is used in France for DRG databases and fee for services payment. Mapping between CCAM and other clinical procedures terminologies by the means of UMLS metathesaurus is essential in order to increase semantic interoperability between different healthcare terminologies and between different case mix systems. In a previous work the CISMeF team used an automatic approach to map CCAM descriptors to the French part of the UMLS metathesaurus. In another way for the French funded research project InterSTIS, we performed a mapping using MetaMap based on the top level semantic structure descriptors of anatomy and action of CCAM translated from French to English. This paper aims to present this new approach and to compare the results with the previous one. The combination of both approaches significantly improved the coverage of the mapping to 68 % for both descriptors and 95 % for at least one descriptor.
Low-Cost Rapid Usability Testing for Health Information Systems: Is it Worth the Effort?
Authors: Baylis Tristin B.  , Kushniruk Andre W.  , Borycki Elizabeth M.
Published: February 2025

Usability testing is a step of the usability engineering process that focuses on analyzing and improving user interactions with computer systems. This study was designed to determine if an approach known as Low-Cost Rapid Usability Testing can be introduced as a standard part of the system development lifecycle (SDLC) for health information syste ms in a cost effective manner by completing a full cost-benefit analysis of this testing technique. It was found that by introducing this technique into the system development lifecycle to allow for earlier detection of errors in a health information syste m it is possible for a health organization to achieve an estimated 36.5% to 78.5% cost savings compared to the impact of errors going undetected and potentially causing a technology-induced error. Overall it was found that Low-Cost Rapid Usability Testing can be implemented in a cost effective manner to develop health information systems, and computer systems in general, which will have a lower incidence of technology-induced errors
The Role of Simulation in Clinical Information Systems Development
Authors: Jensen Sanne  , Lyng Karen Marie  , Pnøhr Christian
Published: February 2025

This paper describes the role of simulation involving end-users in Health Informatics. Simulation has long been established as a widely accepted method in clinical skills training. During the last decade simulation has also gained a place in the development and evaluation of clinical information systems. Simulation is especially well suited for the evaluation of human factors and organizational aspects in relation to application of information systems. In full-scale simulation tests it is possible to evaluate socio-technical interaction. A near to real life experience can be achieved by creating high fidelity environments. The paper discusses how simulation may be used during the lifecycle of clinical information systems, and the requirements on simulation fidelity in various situations. We recommend that simulation should get a more prominent role in the design and evaluation of clinical information systems.
The Use and Usability of EPR systems in Oncology
Authors: Poulter Thomas  , Bath Peter A.
Published: February 2025

This paper reports preliminary findings of a study relating to the development and use of electronic patient record (EPR) systems in cancer services. The research literature demonstrates an increasing emphasis on reporting clinical outcomes and the need for effective EPR systems and high quality information, which should ultimately influence the quality of life of patients. The study is interpretative and forms part a wider research programme to define and validate CICERO, a reference model for ‘Onco-EPR’ systems. Preliminary conclusions from the primary study site, a leading UK cancer treatment centre, confirm the requirement for more effective Onco-EPR system design and implementation planning with emphasis on the socio-technical aspects of health informatics.
Using a Patient-Centered Approach for Health and Social Care Integration
Authors: Poulymenopoulou Mikaela  , Papakonstantinou Despoina  , Malamateniou Flora  , Vassilacopoulos George
Published: February 2025

The drive in using health and social care resources more effectively has resulted in undertaking various efforts towards better coordination in order to improve patient-centered and personalized care for the individuals. This requires horizontal integration in terms of processes among health and social care organizations existing information systems (ISs) and personal health records (PHRs) in order to enable integrated patient information sharing among all the health and social care staff and individuals involved. Service-oriented and business process management (BPM) technologies are considered most appropriate for achieving such integration especially when is required to change existing processes and to integrate diverse information systems. On these grounds, a patient-centered approach is proposed for redesigning health and social care processes and for integrating diverse ISs and PHRs with the objective to meet holistic care goals.
Evidence based electronic system to ensure quality of care in trauma patients
Authors: Mpletsa Vasiliki  , Kaklamanos Ioannis  , Birbas Konstantinos  , Mantas John
Published: February 2025

Electronic patient records are important for quality health services. Aim of this study is to support the trauma patient care with the development of an electronic system. A survey was conducted in the Emergency Department (ED) of a University hospital to study the effectiveness of an electronic monitoring system in a group of trauma patients, as well as the acceptance of this electronic system by the health professionals of the ED. A questionnaire collected information about the perceptions of 50 health professionals working in the ED on various aspects of patient care. The 86% (Nu=43) replied that there is lack of staff working in their department, 44% (N=22) is satisfied with the co-operation with other departments and 48% (N=24) believe that they spend precious time in administrative work during the care. For the purpose of a more efficient patient monitoring there was developed an electronic trauma patient monitoring system which was evaluated by the above mentioned professionals. The severity, length of care and the health outcomes of 200 trauma patients, were investigated. Half of the patients (N=100) have been monitored by the electronic system and the other 100 were monitored without the use of the system. The time between the admission and completion of the planned care was significantly lower in the electronic monitoring patient group (100±92 minutes) compared to the control group (149±29 minutes).
Using Archetypes for Defining CDA Templates
Authors: Moner David  , Moreno Alberto  , Maldonado José A.  , Robles Montserrat  , Parra Carlos
Published: February 2025

While HL7 CDA is a widely adopted standard for the documentation of clinical information, the archetype approach proposed by CEN/ISO 13606 and openEHR is gaining recognition as a means of describing domain models and medical knowledge. This paper describes our efforts in combining both standards. Using archetypes as an alternative for defining CDA templates permit new possibilities all based on the formal nature of archetypes and their ability to merge into the same artifact medical knowledge and technical requirements for semantic interoperability of electronic health records. We describe the process followed for the normalization of existing legacy data in a hospital environment, from the importation of the HL7 CDA model into an archetype editor, the definition of CDA archetypes and the application of those archetypes to obtain normalized CDA data instances.
The Electronic Healthcare Record for Clinical Research (EHR4CR) information model and terminology
Authors: Ouagne David  , Hussain Sajjad  , Sadou Eric  , Jaulent Marie-Christine  , Daniel Christel
Published: February 2025

A major barrier to repurposing routinely collected data for clinical research is the heterogeneity of healthcare information systems. Electronic Healthcare Record for Clinical Research (EHR4CR) is a European platform designed to improve the efficiency of conducting clinical trials. In this paper, we propose an initial architecture of the EHR4CR Semantic Interoperability Framework. We used a model-driven engineering approach to build a reference HL7-based multidimensional model bound to a set of reference clinical terminologies acting as a global as view model. We then conducted an evaluation of its expressiveness for patient eligibility. The EHR4CR information model consists in one fact table dedicated to clinical statement and 4 dimensions. The EHR4CR terminology integrates reference terminologies used in patient care (e.g LOINC, ICD-10, SNOMED CT, etc). We used the Object Constraint Language (OCL) to represent patterns of eligibility criteria as constraints on the EHR4CR model to be further transformed in SQL statements executed on different clinical data warehouses.