bluuebunny/crossref_metadata_2025 huggingface dataset:
Time-variant spectral analysis of laser Doppler flow signals on the basis of multivariate autoregressive modelling
Authors: Arnold M.  , Witte H.  , Leger P.  , Boccalon H.  , Bertuglia S.  , Colantuoni A.  , Bauer R.
Published: February 2025

Clinical and experimental laser Doppler flow (LDF) signals were analysed by means of time-variant multivariate AR spectral analysis. The model fitting was performed using Kalman filters. This methodical strategy was used in patients with Raynaud phenomena and in experimental areas. By means of time-variant coherence analysis it was shown that vasomotion rhythms can be detected in LDF signals. Partial coherence was used for investigations of the cardiorespiratory system.
Arterial Baroreceptors as Determinants of 0.1Hz and Respiration-Related Changes in Blood Pressure and Heart Rate Spectra
Authors: Bernardi Luciano  , Passino Claudio  , Spadacini Giammario  , Valle Felice  , Leuzzi Stefano  , Piepoli Massimo  , Sleight Peter
Published: February 2025

Although the so-called low-frequency (around 0.1Hz) components of heart rate variability are an accepted marker of sympathetic activity to the heart and the circulation, their origin remains elusive. In order to characterise the frequency response of the heart and the vessels to the stimulation of the arterial baroreceptors we applied the neck suction technique with a sinusoidal function at different frequencies, and studied the changes in the cardiovascular system. In all subjects the neck suction induced RR interval oscillations at both low- (0.10Hz) and high (0.20Hz) frequencies, but with greater response at 0.1Hz, while blood pressure and skin blood flow oscillations responded only at low frequency (low-pass behaviour). To assess whether this kind of response could have played a role in the genesis of spontaneous LF fluctuations we studied the changes induced by an impulsive neck suction during post-expiratory apnoea: if the LF were due to a resonance in the baroreceptor loop, a single perturbation of the cardiovascular system would have produced oscillations in the cardiovascular system similar to those observed spontaneously. We found that, after the suction, a damped oscillation (whose period was similar and correlated to that of the spontaneous LF) was generated in the cardiovascular system, suggesting that the LF could be indeed generated by a peripheral mechanisms, primarily involving the baroreceptors. In further support of this hypothesis, we also found that counteracting the respiratory fluctuations in blood pressure by appropriately timing a sinusoidal neck suction, we significantly reduced not only the respiratory fluctuations in RR interval, but also the LF. Nevertheless, during undisturbed apnoeas, we observed spontaneous oscillations in the LF range (though slower than those observed during breathing). This observation contrasts with the hypothesis that a resonance in the cardiovascular system is the only source of the LF fluctuations, (since after removing the effects of respiration the LF should disappear as well) and suggests the contemporary presence of other factors, such as a central oscillator, tuned at a similar frequency. In conclusion, the arterial baroreceptors exert a strong, though probably not exclusive influence on the cardiovascular fluctuations, through both sympathetic and vagal activity; the LF appears to be generated not only by a resonance in the cardiovascular system, but also by other independent factors, such as a central oscillator.
Computer-Assisted Decision Support
Authors: Wyatt Jeremy
Published: February 2025

A clinical decision support system (DSS) is a computer-based tool which aids decisions about a specific patient by selective application or display of medical knowledge, leading to improved clinical practice. Many DSS projects in the past have been technology-led, leading to a profusion of prototypes, relatively few of which had a clear clinical role. However, there are at least 29 rigorous controlled trials showing beneficial effects of DSS on clinical practice. Surprisingly, few DSS have been implemented yet in either hospital or primary care. Identifying reasons for the delayed uptake of DSS, suitable roles for them within health services and how to develop and maintain reliable, evidence-based, decision support systems is a priority for medical informatics.
In Vitro Mechanical Characterization of Costovertebral Junction
Authors: Skalli W.  , Diop A.  , Marec P.  , Zeller R.  , Lemosse D.  , Le Rue O.  , Lavaste F.
Published: February 2025

The aim of the present paper is to study 3D mechanical behavior of costovertebral junction. 9 fresh cadaveric specimens were used, from which T1-T2, T5-T6, and T9-T10 functional units were removed, each including a pair of ribs cut at 10 cm from the costal head. 0.6 Nm Torsion, flexion normal to costo-transverse articular facet and transverse flexion were considered, first intacts then with successive resection of ligaments. Total range of motion was: for T5-6 respectively 22° in torsion, 10° in flexion and 6° in transverse flexion, for T1-2 level respectively 41°, 14° and 9°, and for T9-10 28°, 18°and 16°.This experimental data base should be useful both for a better comprehension of the mechanical behaviour of this junction and for improvement of existing finite element models.
Biomechanical Analysis of the Elastic Behaviour of the Spine with Aging
Authors: Aulisa L.  , Vinciguerra A.  , Tamburrelli F.  , Lupparelli S.  , Di Legge V.
Published: February 2025

In order to inquire the biomechanical behaviour of a column undergoing elastic deformation, A mathematical model was first developed. In this paper the reaction of the intervertebral discs to torsion was investigated as a function of two parameters, disc location in the spine and age. The physical quantity describing the disc response to a torque moment Mtis represented by the G module of rigidity to torsion, which qualitatively expresses the resilience of the annulus fibrosus to twist. The values of G referred to a infancy spine model (0-8 yrs) were assessed, It was determined that the G values are roughly 1/3 of those calculated in adult life and that the ratios between the G modules of two consecutive discs, compared with adulthood, are not modified.
Scoliosis Imaging and the Problem of Postural Sway
Authors: Goldberg C.J.  , Fogarty E.E.  , Moore D.P.  , Dowling F.E.
Published: February 2025

To test the reproducibility of the Quantec Imaging Systems under clinical conditions, all patients referred for imaging in the scoliosis unit were scanned twice, having stepped out and in again between scans. Analysis of the first 269 patients showed that while there was good correlation between first and second scans, and paired t-tests gave non-significant results, individual cases showed differences in readings too large to allow meaningful follow-up. In a special study, 106 consecutive patients were scanned eight times, being re-positioned between the fourth and fifth scans. Taking the mean of selected measures from the two sets of scans and comparing them statistically showed a significantly reduced variance. We conclude that multiple imaging is essential to offset the variation introduced by the physiological fact of postural sway and the innate variability of erect posture.
Study of Posterior Trunk Surface Changes by Age and Sex Using Moiré Topography
Authors: Grivas T.B  , Karras G.E.  , Katrabasas J.  , Papavasiliou N.
Published: February 2025

This paper is a cross-sectional study of posterior trunk surface morphology variations in healthy Greek controls, by age and sex, using Moiré Topography (MT), and a database for comparison with the counterpart data of low back pain patients. Moiré images of 131 controls (65 men aged 15-70 and 74 women aged 8-82) were examined and assessed with a modified Moreland classification. No subject was suffering scoliosis clinically or radiographically. Frequencies of the various contour prototypes are presented for the right and left parts of the posterior trunk surface. Statistically significant changes were found by age: In women, results indicate that kyphosis increases by age due to trunkal changes of the upper thoracic and lower cervical region. Lumbar lordosis decreases by age due to changes of the lower lumbar region and inclination of pelvis, in both women and men. In men, unlike women, no change was basically found by age in the upper thoracic region. These findings reflect 3-D change by age in the posterior trunk surface. Our hypothesis is that these changes are related to osteoporosis, especially in women, and probably form part of the aetiological base for low back pain.
A Methodology for the 3D Description of the Deformation Patterns of Scoliotic Vertebrae
Authors: Landry C.  , de Guise J.A.  , Dansereau J.  , Labelle H.  , Zeller R.  , Skalli W.  , Lavaste F.
Published: February 2025

A method for the quantitative description of scoliotic vertebrae is proposed. Morphological analysis is performed on a computer generated surfacic model of the vertebrae, obtained from medical imaging techniques. Preliminary results show that the method allows for true 3D measures while giving access to the whole vertebral geometry. This method offers the possibility of documenting quantitatively vertebral deformations, leading to the definition of vertebral deformation patterns in the expression of scoliosis.
Augmented Reality In Spinal Surgery
Authors: Peuchot B.  , Tanguy A.  , Eude M.
Published: February 2025

Scoliosis is a three-dimensional deforming process which should receive a three-dimensional correction as well. Several limitations with the current techniques do not allow for this goal to be accomplished. Evaluation of vertebral displacements while corrective forces are taking place is the first step to know precisely what the surgery accomplishes We have already reported on a method based on video tracking of vertebral displacements. Such a method allowed the surgeon to watch vertebral displacements occuring through the 3D positioning of vertebral model on a monitor by the side of the surgeon. The main drawback is the need for the surgeon to distract his attention from the operative field to get a plane view of a screen. We propose our method called V.V.V.R. (Vertebral Vision with Virtual Reality) to superpose a 3D “transparent” vision of the vertebra on the surgeon operative view. This method uses virtual reality tools to produce an augmented reality where simulation-images improve reality perception of the operative field.
Accuracy Requirements in Optical Back Shape Analysis. What is Enough for the Clinic?
Authors: Drerup B.
Published: February 2025

Accuracy requirements of optical back shape analysis are discussed from the standpoint of clinical requirements. In practice, the accuracy of surface measurement ranges from 5 mm down to 0.2 mm, depending on the sophistication of the technique and data analysis. Low accuracy suffices for assessment of coarse parameters such as indices. For automatic determination of anatomical landmarks and similar structures, on the other hand, high accuracy combined with high point density is required.
Aging of Human Intervertebral Discs. A Histological and Immunohistochemical Study
Authors: Aulisa L.  , Tamburrelli F.  , Lupparelli S.  , Tartarone M.  , Merolli A.
Published: February 2025

In this study twelve L5-S1 disc necropsy samples aging from 28 weeks (stillborn foetus) to 84 years were examined by histological and immunohistochemical methods. The histological investigation was performed by light microscope (magnification *100, *250 and *400) and hematoxylin-eosin. The immunohistochemical examination inquired type III and VI collagen arrangement in lumbar disc. Notably, type III and type VI collagen organization in seven specimens aging from 28 weeks to 1 month , previously described by no Author, differed from that observed in adulthood and elderly life.
Analysis of Symmetry of Vertebral Body Loading Consequent to Lateral Spinal Curvature
Authors: Stokes I.A.F.
Published: February 2025

Lateral curvature is thought to cause asymmetrical loading of vertebral physes, resulting in asymmetrical vertebral growth according to the Hueter-Volkmann principle. A biomechanical model was used to calculate trunk muscle forces and intervertebral forces in a lumbar scoliosis and in a symmetrical spine, in order to quantify the degree of asymmetrical loading. The analysis included five lumbar vertebrae, the thorax and the sacrum/pelvis and 90 pairs of muscles. Five spinal geometries were analyzed: the mean spinal shape of 15 patients with left lumbar scoliosis having a Cobb angle of 38° and apex at L1-2 (reference or ‘100%’ geometry), and this geometry scaled such that it had 0%, 33%, 67%, and 132% of the lateral and axial asymmetry of the reference shape. The muscle and intervertebral forces for maximum efforts opposing moments applied to the T12 vertebra in each of the three principal directions were calculated. The loading state of each interspace was expressed as the resultant force, the lateral offset of the resultant force from the disc center, and the angle of the resultant force from the axial direction. These analyses indicate that lumbar scoliosis produces asymmetrical spinal loading characterized by shear forces tending to increase the scoliosis, but with little increase in the lateral offset of the resultant forces transmitted through motion segments. If scoliosis progression results from asymmetrical loading, it appears that it is the shear force component more than the lateral bending moment which is responsible for this.
ICNP in a Danish Version of NUREC
Authors: Nielsen Tommy M.
Published: February 2025

The objective of TELENURSE is to implement ICNP (“The $\underbar{I}$nternational $\underbar{C}$lassification for $\underbar{N}$ursing $\underbar{P}$ractice”) electronically in nursing modules of electronic patient records. In Denmark, we will implement a prototype of an electronic nursing care record which will focus on the application of ICNP for documentation of nursing activities. This prototype will be verified in three different hospital wards in Denmark. The ideas and concepts behind the design of the prototype are the subject of this article.
An Augmented Reality System for Health Care Provision via Telematics Support
Authors: Pavlopoulos S.  , Dembeyiotis S.  , Koutsouris D.
Published: February 2025

We are developing a prototype portable health care support device for Emergency Telemedicine. This device can telematically “bring” a specialist doctor at the site of a medical emergency, allow him to evaluate patient data and issue directions to the emergency personnel on treatment procedures until the patient is brought to hospital. The portable device is carried by a paramedic technician in “wearable” form, allowing the technician to perform his normal duties while communicating with the specialist at the hospital site. This augmented reality system allows for maximum utilisation of available resources and offers a complete, practical solution for increasing survival rates before and during the transportation of accident victims to hospital.
Transeuropean Network for the Provision of Added-$\underline{VA}$lue $\underbar{S}$ervices in $\underbar{T}$elemedicine - (VAST-Net)
Authors: Anogianakis George  , Maglavera Stavroula
Published: February 2025

Populations most likely to use telemedicine are usually located far away from ISDN networks in contrast to providers of telemedical services who normally dwell in urban centers. VAST-Net is a consortium that aspires to reach such populations by introducing added-value ISDN-based telemedical services across Europe, through networking a small number of selected, strategically distributed, points-of-care and by focusing on a series of well defined health care provision scenaria. This will be achieved by relying on: (1) the Euro-ISDN infrastructure, (2) satellite based ISDN medical networks (e.g. the INMARSAT / VSAT based MERMAID network), (3) private ISDN networks. The VAST-Net telemedical network will be initially operated on a small but transnational scale in order to assess: (1) the acceptance of telemedical services by end users, (2) the economic viability of the telemedical sector, especially in an international context (3) the legal implications of telemedical practice (4) the regulatory framework within which telemedicine will be developed in the E.U.
Surgical Navigation Using Audio Feedback
Authors: Wegner Christian M.  , Karron D.B.
Published: February 2025

Current medical visualization technology intended for positional guidance in surgical applications may only ever have limited utility in the operating room due to the preexisting visual requirements of surgical practice. Additionally, visual systems impose limits as a result of their high latency, poor image resolution, problems with stereopsis and physical strain upon the user.
Virtual Reality for Autism Communication and Education, with Lessons for Medical Training Simulators
Authors: Max Mayer L.  , Burke John C.
Published: February 2025

This study is adapting Virtual Reality (VR) technologies to teach children with autism new coping skills that may then be generalized in their everyday lives. It helps to understand that children with autism are challenged by a sensory overload and by aversions to a variety of aditory, visual, and tactile stimuli. In addition, their ability to attenuate and/or ignore these stimuli differs from that of the “typical” child. Therefore, our goals were to: 1. assess the potential of each of the children (both with and without verbal skills) for sustained interaction with task environments, 2. to identify which visual, auditory, and kinetic VR components would be attractive to our test group, 3. to identify each child's ability to attenuate and/or ignore a variety of distractors, and 4. to build new “pivotal behaviors' [2] for learning. These pivotal behaviors include: improvement of time-on-task, meaningful and consistent interaction with the real world, and screening out extraneous environmental stimuli. Our findings to date have been very encouraging, and we will continue to investigate the role of VR as a tool for generalized learning and the modification of pivotal behaviors. This ongoing study also provides technology transfer of communications applications from government, universities and businesses out into telemedicine and elementary schools.
ENT Endoscopic Surgical Training Simulator
Authors: Edmond Jr Charles V.  , Heskamp David  , Sluis Douglas  , Stredney Donald  , Sessanna Dennis  , Wiet Gregory  , Yagel Roni  , Weghorst Suzanne  , Oppenheimer Peter  , Miller Jeff  , Levin Michael  , Rosenberg Louis
Published: February 2025

This paper describes work in progress on the design and development of a prototype simulator for minimally invasive otolaryngology surgical training. The anatomy of the paranasal sinuses is geometrically complex and dangerously close to the brain and orbits, making this procedure challenging to practice and difficult to learn. We discuss the potential role of computer simulation to enhance and accelerate acquisition of surgical skills. The design goals of the prototype include high-fidelity simulation of the endoscopic imagery and haptic cues of surgical palpation. The prototype enables endoscopic navigation and limited interactive tissue manipulation and dissection tasks on a virtual patient using realistic replicas of surgical tools. We present an overview of the system architecture with a discussion of the technological challenges, design issues and current status of the effort.
Finite Element Analyses to Study Periprosthetic Bone Adaptation
Authors: Weinans Harrie  , Sumner Dale R.
Published: February 2025

Periprosthetic bone adaptation around orthopaedic implants can be studied with Finite Element models. It requires a comparison between the mechanical status of the bone in the operated (unnatural) situation and the natural situation. The difference between these two situations is the alteration in mechanical condition of the bone, which is assumed to be the driving force of the adaptation process. The time dependent bone adaptation process can be simulated with a computer algorithm by an iterative (time stepping) procedure. This study reviews some clinical and experimental issues, it addresses the value of computer models of periprosthetic bone adaptation and discusses a new development of voxel based models directly converted from CT scans.
Migration towards a component based HIS architecture
Authors: Toussaint P.J.  , Lodder H.
Published: February 2025

Changing requirements for health care information systems force the development of an open, modular architecture in which components can be integrated. This offers a flexible means for integrating different (heterogeneous) systems used by different users. Migration towards such an open, modular architecture is a difficult task. It consists of breaking down existing systems in components and integrating these components. Many authors on migration strategies focus attention on the ordering of the steps to be taken without detailing how these steps were arrived at. This paper presents a more rigorous approach for deriving a migration strategy.
Cardiomedia: A Multimedia Portable Medical Record on Optical Memory Card
Authors: Delamarre D.  , Croci S.  , Baskurt A  , Bedossa M.  , Le Bretone H.  , Decaix M.  , Pony JC  , Le Beux P.
Published: February 2025

The main objective of the CARDIOMEDIA project is to produce and evaluate a coronarian multimedia data record stored on an optical card. The experimentation concerns patients treated by angioplasty at university hospital of Rennes. Often patients treated in the Regional University Hospital are followed up by another Health structure closer to their home. The patient leaves hospital with his card, which is directly available elsewhere for emergency or for consultation. This will optimize the number of examinations and offer a better patient follow-up. The CARDIOMEDIA card is a specialized record which includes various data type : text, image, image sequence of coronarography and ECG signal. For this purpose optical card with its large memory size is very convenient. For medical imaging, we use in this project the DICOM format for image exchange and management, it is combined with a CARDIOMEDIA specific compressing software. For multimedia record, the HTML format and web intranet method are chosen, this allows intuitive interface which can combine various data type and helpers like DICOM image viewer.
Computer-aided prescription - A prototype system
Authors: Anogianakis G  , Goulis D.  , Vakalis D.
Published: February 2025

This study intends to satisfy two purposes : To prove the necessity of an electronical prescription aid and to propose a structure that can be interpreted into software which will be able to cover that need. The complicated market reality and the disadvantages of the written pharmaceutical directories make the existence of an electronical aid absolutely necessary. The structure of a prescription system should be based upon the drastic substance with its consequences (adverse effects, relative and absolute contraindications. pharmakokinetics and interactions). Every drastic substance will lead to the connection of pharmacology with the market reality and its own consequences (product identification through text and image, trade name, pharmaceutical company, strength, package information). The whole structure constitutes a completed relation - database system that is capable of answering any simple question or query that concerns the field of prescribing. The final production of such an aid is believed to help in a very high degree prescribing in a more precise and correct way, saving financial means for the patient and the health insurance as well as saving the doctor's time.
XBONE: A Hybrid Expert System for Supporting Diagnosis of Bone Diseases
Authors: Hatzilygeroudis I.  , Vassilakos P.J.  , Tsakalidis A.
Published: February 2025

In this paper, XBONE, a hybrid medical expert system that supports diagnosis of bone diseases is presented. Diagnosis is based on various patient data and is performed in two stages. In the early stage, diagnosis is based on demographic and clinical data of the patient, whereas in the late stage it is mainly based on nuclear medicine image data. Knowledge is represented via an integrated formalism that combines production rules and the Adaline artificial neural unit. Each condition of a rule is assigned a number, called its significance factor, representing its significance in drawing the conclusion of the rule. This results in better representation, reduction of the knowledge base size and gives the system learning capabilities.
Design and functional specification of the Synapses Federated Healthcare Record Server
Authors: Skifjeld Knut
Published: February 2025

Synapses is a project funded under the EU Health Telematics Framework Iv Programme. Synapses sets out to solve problems of sharing data between autonomous information systems, by providing generic and open means to combine healthcare records or dossiers consistently, simply, comprehensibly and securely, whether the data passes within a single healthcare institution or between institutions. This paper presents the specification of the Synapses server, the kernel concept of Synapses. It describes the basis in the European prestandard for Electronic Healthcare Record Architecture, the interfaces to the Synapses server and different integration mechanisms for systems providing information to the server. The specification will be verified at a number of validation sites, and the final result will be in the public domain.
Numerical Proposal for a Semiological Classification of Clinical Findings
Authors: Boom-Anglada Ramón  , Colina Cesar  , Cerritos Antonio  , Monteverde Cesar  , Toledano Guzman
Published: February 2025

The principal goal of this paper is to present a numerical classification of the characteristics of symptoms and signs. This classification begins with the ICD9 code and takes into account the semiological aspects of the already mentioned symptoms an signs, in such a way, that a digit represents, in cases of abdominal pain, site, another: radiating to, and the followings: aggravating, relieving factors, progresss, duration and type.
Deformation analysis of brain regions
Authors: Cecchi A.  , Di Sacco C.  , Lutzemberger L.  , Salvetti O.
Published: February 2025

The analysis of 2D and 3D deformations applied to structures having non regular geometry is presented. Deformations are studied in order to understand complex dynamic problems coded into image sequences. In particular, methods have been developed suitable to control the reconstruction and the spatial deformation of cerebral structures, in their different aspects of morphometry, isometry and densitometry. Finally, a simulation process of brain deformation caused by a neoplasia in a real relevant clinical case has been performed.
EP parametrization and classification using wavelet networks - theoretical concept and medical application
Authors: Dickhaus Hartmut  , Heinrich Hartmut
Published: February 2025

The purpose of this paper is to outline the fundamental concept of wavelet networks (WNs) and to demonstrate its specific advantages in a clinical discrimination task. A group of 25 boys with attention deficit hyperactivity disorder (ADHD) should be separated from a control group of 25 healthy boys by auditory evoked potentials. Because of the high variability of the recorded EP signals quantification of the averaged sweeps by peak latencies and amplitudes failed. However, with wavelet networks a maximum classification rate of 80% was achieved by crossvalidation. A WN is basically described as a multilayer perceptron which consists of two parts for feature extraction/parametrization and classification. These essential steps of a pattern recognition task are not separated in different tasks but linked together by the clamp of the learning algorithm. Because no user interaction is necessary we call this procedure a self-learning method.
An Open Distributed Medical Image and Signal Data Server Network with World Wide Web Front-End
Authors: Findling A.  , Horsch A.  , Zink A.
Published: February 2025

In modern patient care and medical research diagnostic imaging from multiple modalities plays an essential role. In general these digital image data are acquired at different locations. An efficient access to the data via network is often not provided due to technical, organisational and political reasons. This article presents an approach to solve the problem by means of an open distributed data server network with Web-based front-ends and describes the prototype DACHS that has been developed at the University Hospital of the Technical University of Munich.
Knowledge generating in expert systems as support of immunological investigations
Authors: Biljana Milicic  , Jelena Marinkovic  , Milorad Radotic  , Branislav Jeremic  , Nebojsa Arsenijevic
Published: February 2025

One of the most important parameters in immunologic investigations linked with the analysis of TIL phenotypic characteristics is the ratio between particular populations and subpopulations of TIL. Values of exact parameter are not obtained with its direct measurement but with indirect measurement of values in its numerator and its denominator that represent mean values of absolute TIL figures. Exactness of estimate of specific parameter is obtained by determining the intervals of values where this parameter should lie. Determination of confidence intervals for relationship between particular populations and subpopulations of TIL was performed using Fieller's theorem which full filled requests from the nature and process of obtaining exact parameter. By analyzing the obtained confidence intervals informations can be obtained regarding TIL phenotypic characteristics of various histologic types of tumors and various types of intervals within, as well as changes in TIL content that are occurring in malignant tumors.
Parameter Evaluation of the Differential Diagnosis of Female Urinary Incontinence for the Construction of an Expert System
Authors: Laurikkala Jorma  , Juhola Martti  , Penttinen Jorma  , Aukee Pauliina
Published: February 2025

Female urinary incontinence is a difficult problem for a patient but also for a physician. In the differential diagnosis of female urinary incontinence the physician has to determine a diagnostic class for the patient. This task is complex because of the unreliable patient history and the overlapping class boundaries. In order to develop an expert system to help the physician, a retrospective investigation on the incontinent women was performed to detect the potential expert system parameters. Also a diagnosis table was constructed from the expected values of parameters and the diagnostic classes. The results from K-means cluster analysis indicate that it is possible to develop the expert system on basis of the defined parameters and classes.
DIABETOR Computer Aided Tutoring in Diabetes Management
Authors: Ambrosiadou B.V.  , Ketikidis P.H.
Published: February 2025

Computer Aided Instruction (CAI) and Computer Aided Learning (CAL) Systems, are software systems that can tutor people in a given domain. Medicine is a field that is particularly amenable to computer aided instruction because one is allowed to experiment with a large number of hypothetical simulated patient / disease cases, without the ill consequences of the wrong decision in real life. This paper presents an Intelligent Tutoring system for the Management of the diabetes disease, and specifically for instruction in insulin administration. The system will be used for the education of medical personnel (general practitioners, nurses), as well as students of medicine in diabetes management. It is based on an existing expert system for diabetes management called DIABETES as well as on the knowledge of expert diabetologists.
Addressing information security training and awareness within the European healthcare community
Authors: Furnell Steven  , Sanders Peter  , Warren Matthew
Published: February 2025

This paper discusses the need to promote information security issues within modern healthcare establishments and the consequent need for appropriate training and awareness initiatives. Security is an area of extreme significance in healthcare information systems but, whilst the need is generally recognised, many personnel are not familiar with even basic concepts and procedures. As such, adequate promotion of security through training and awareness initiatives is viewed as a vital first step.
Getting IT into Shape -External Factors Effecting the Potential Benefits from Health Informatics
Authors: Roberts Jean  , Peel Vic
Published: February 2025

The introduction of a computer system will not always result in the expected outcomes. Extensive planning must be carried out for a new technological environment, changes in organisational practices and human reorientation. In addition to the specific requirements for the implementation of a particular application system there are more general issues to be considered. There are a number of organisational, technical and human factors which are thought to have affected demands for informatics support to healthcare and to have affected the level of benefits that can accrue from its operation in the healthcare sector of today. Some of the catalysts and inhibitors (positive and negative factors) can be recognised in advance of any specific implementation and the potential risk from their effects can be minimised. This paper considers some of the identified factors and how they are being addressed across Europe.
Some Systems Implications of EU Data Protection Directive
Authors: Barber Barry  , Allaert Francois-Andre
Published: February 2025

The EU Directive “on the protection of individuals with regard to the processing of Personal data and on the free movement of such data” is examined from the point of view of the requirements imposed on the automatic systems processing Personal Health Data and on the relevant implementation timescales.
Color Perimetry with Personal Computer
Authors: Accornero N.  , Capozza M.  , Rinalduzzi S.  , De Feo A.  , Filligoi G.C.  , Capitano L.
Published: February 2025

Color visual field analysis has proven highly sensitive for early visual impairments diagnosis in M. S., yet it has never attained widespread popularity usually because the procedure is difficult to standardize, the devices are costly, and the test is fatiguing. We propose a computerized procedure running on standard PC, cost effective, clonable, and easy handled.
Urgent Response Telecardiology Services and Training —Collaboration between Onassis Cardiac Surgery Hospital and Aegian Islands' Health Care Centers
Authors: Mavrogeni S.  , Tsirintani M.  , Kokkinos D.
Published: February 2025

Since 1995, Onassis Cardiac Surgery Center participates in the development of Telecardiology Services in Greece. Existing connections include the islands Skiathos, Naxos, Santorini, Mykonos, Milos, Plomari and Amorgos. First hundred fifty three (153) cases have been already analysed. Eleven of them were acute myocardial infarctions and have been treated by thrombolytic medication (anistreplase). The participation of physicians and nurses was valuable for the success of the program and their further involvement in the new area of Telemedicine. The purpose of the project was to offer high quality cardiac services in remote area patients and to provide specific training in telemedicine issues to health care professionals.
The current status of Nursing Informatics in undergraduate nursing programs: comparative case studies between Sweden and Australia
Authors: Hardy J.L.  , Lindqvist R.  , Kristofferzon M.-L.  , Dahlberg O.
Published: February 2025

During the last ten years, the inclusion of education in health information systems has assumed an important role in graduate programs for health professionals. More recently, attention has focused on undergraduate programs. Throughout the world schools of nursing , organisations and associations are addressing the issue of educational offerings in nursing informatics. This paper reports on the status of nursing informatics at undergraduate level. Nurse academics from Gävle and Lund in Sweden, and from Melbourne and Sydney in Australia, took part in a survey of the respective nursing courses. The purpose of the study was to identify and describe examples of types of nursing informatics courses in Australia and Sweden. A convenient sample of academics were approached and interviewed. The results of the survey illustrate, in the schools surveyed, the slow emergence of nursing informatics into nursing curricula.
The Wisecare Project and the Impact of Information Technology on Nursing Knowledge
Authors: Sermeus W.  , Hoy D.  , Jodrell N.  , Hyslop A.  , Gypen T.  , Kinnunen J.  , Mantas J.  , Delesie L.  , Tansley J.  , Hofdijk J.
Published: February 2025

The European Union retained the WISECARE project “\underbar{W}ork flow Information \underbar{S}ystems for \underbar{E}uropean nursing \underline{CARE}” for funding. The project focuses on the use of telematics technololgy for clinical and resource management in oncology care in hospitals. This paper outlines the impact of introducing this kind of advanced nursing informatics application on the management of nursing knowledge. Three shift in knowledge management that will get high attention in WISECARE, are identified. The first is the shift from knowledge dissemination to knowledge sharing. The second is the shift from individual knowledge to organisational knowledge. The third is the shift from deductive, prescriptive knowledge as seen in guidelines, protocols to more inductive, experience based knowledge. The paper emphasizes that the real impact of information technology is not in the automation of existing processes but on the discovery of new ways of organisation and living.
Nursing Informatics in a Registered Nurse Graduate Program
Authors: Aroian J.  , Breton O.
Published: February 2025

For many Registered Nurses the question is not whether to advance their education, but how to attain the requisite formal learning experiences given their professional and personal responsibilities. One innovative approach to facilitating the pathway to graduate education for a group of very experienced nurses lacking the BSN is the RN-MS Program at Northeastern University. This graduate-level curriculum provides an opportunity for selected Associate Degree and Diploma prepared nurses to integrate their basic nursing education, extensive clinical practice, professional leadership experience, and practical knowledge base within an extended (85 quarter hours) formal graduate program of study in a nursing specialization. The learning paradigm includes Nursing Informatics and computer competency. The intent of this work was to analyze the experience of RN applicants - students who participated in the faculty designed seminar and developed a typed portfolio using word processing software as part of the admission process in the RN to MS Program. The Nursing Informatics (computer competency component) and its integration throughout the curriculum will be evaluated.
Determining an Appropriate Clinical Problem for Expert System Development in the Neonatal Intensive Care Unit
Authors: Panniers T.L.
Published: February 2025

The purpose of this pilot study was to demonstrate the use of the Nominal Group Technique (NGT) to identify a clinical problem for expert system (ES) development. NGT is a research method that allows individual judgments about a problem to be combined effectively. Problem identification is the necessary first step for the development of an expert system for use by neonatal nurse practitioners (NNPs) caring for neonates in the neonatal intensive care unit (NICU). Five NNPs identified 21 clinical problems encountered when caring for infants in the NICU and reduced these to the 5 most amenable to ES development. Of these 5 problems, fluid management in the very low birthweight (VLBW) infant was chosen for projected ES development.
Thinking in Nursing Practice
Authors: Fonteyn M.E.
Published: February 2025

Despite the fairly extensive body of research describing nurses' thinking in practice, our understanding of this phenomenon remains incomplete. Until we have a full description of nurses' thinking, the component of our practice that is an exercise in clinical judgment will be less precise and scientific. This descriptive study utilized think aloud method to identify and describe the thinking strategies that nurses use in practice. Findings from this study improve our understanding of nurses' thinking in practice and provide information that can facilitate the development of decision support systems to assist nurses in their practice.
Information Technology in Nursing: A Project Examining Educational Applications of the Internet and World Wide Web
Authors: McKenna L.G.  , Ribbons R.M.
Published: February 2025

Developments in Information Technology are requiring nurses to not only access complex information but also manipulate it within an information rich environment to benefit patient care. Within such an environment, the role played by the Internet and more specifically, the World Wide Web (WWW or web), will become increasingly important to health care providers.
Nurses' MEDLINE Usage and Research Utilization
Authors: Prin P.L.  , Mills M.E.
Published: February 2025

This eploratory study in the field of nursing informatics examined the usage of information technology, namely on-line access to MEDLINE in clinical setting, by a convenience sample of 121 nurses from a large university hospital. A descriptive correlational design was used. Guided by the conceptual frameword of Nurse-Computer Interaction and based on variables set forth in the Theroy of Reasoned Action, the study tested hypotheses regarding attitudinal and normative influences on reported use of on-line bibliographic retrieval systems. It was also hypothesized that using MEDLINE coild increase and improve nurses' adoption of nursing research findings.
A Simulation Program that Teaches Clinical Decision Making in Nursing
Authors: Hjelm-Karlsson K.  , Stenbeck H.
Published: February 2025

The aim of this project is to produce a multimedia computer simulation program, to be used in the training of clinical decision making with nursing students in Swedish schools of nursing. The program is based on a number of clinical scenes filmed in a ward and dealing with the postoperative care of a patient who has undergone reconstruction of the crucial ligament. The student's task is to assess the need for care for a newly postoperative patient and to plan the care for the first 24 hours. Special emphasis is given to pain assessment, pain relief and drug administration.
The ComputerLink Projects: a Decade of Experience
Authors: Brennan P.F.
Published: February 2025

Telecommunications technology provides a pathway for nurses to reach patients and their family caregivers. The ComputerLink, an experimental computer network, enabled home-bound persons to access information, communications, and decision support services from their homes. Persons naive to computers can and will use telecommunications to maintain contact with peers and professionals. While participants in experimental networks used communication services most often, the access to relevant health information in a timely and convenient fashion may contribute more to the positive health benefits. Nursing interventions need to be tailored to capitalize on the unique features of computer network. The timing, cadence and content of interpersonal interactions must be modified to account for lags in the transmission of messages. Strategies for interpreting written text, which lacks the aural cues found in spoken speech, must be developed.
Reducing Nurses' Workload Using a Computerized Nursing Support System Linked to the Hospital Information System
Authors: Ito C.  , Satoh I.  , Michiya H.  , Kitayama Y.  , Miyazaki K.  , Ota S.  , Satoh H.  , Sakurai T.  , Shirato H.  , Miyasaka K.
Published: February 2025

A computerised nursing support system (CNSS) linked to the hospital information system (HIS) was developed and has been in use for one year, in order to reduce the workload of nurses. CNSS consists of (1) a hand held computer for each nurse (2) desk-top computers in the nurses' station and doctors' rooms (3) a data server (4) an interface with the main hospital information system. Nurses enter vital signs, food intake and other information about the patients into the hand held computer at the bed-side. The information is then sent automatically to the CNSS data server, which also receives patients' details (prescribed medicines etc.) from the HIS. Nurses and doctors can see all the information on the desk-top and hand held computers. This system was introduced in May 1995 into a university hospital ward with 40 beds. A questionnaire was completed by 23 nurses before and after the introduction of CNSS. The mean time required to post vital data was significantly reduced from 121 seconds to 54 seconds (p<0.01). After three months 30% of nurses felt CNSS had reduced their workload, while 30% felt it had complicated their work; after five months 70% noted a reduction and 0% reported that CNSS had made their work more complex. The study therefore concludes that the interface between a computerised nursing support system and the hospital information system reduced the workload of nurses.
The DIABCARD Server Architecture
Authors: Böhm V.  , Engelbrecht R.  , Sulzmann R.  , Moser W.  , Sembritzki J.
Published: February 2025

The DIABCARD project is now, after successful pilot specifications, implementations and field tests, in the stage of application development for large scale European installation leading to marketable products. In order to reach these goals, emerging international standards, promoted by major industry (PC/SC specification, OpenCard framework) are incorporated into the DIABCARD architecture. The article gives a short overview on these specifications and describes DIABCARD-specific functionality and how it is added onto a general architecture for chip card based applications.
The new ISO 7816-7 chapter, a great Opportunity for Standardization in Healthcare
Authors: Parent H.
Published: February 2025

Smart card in Healthcare has already been adopted in many countries. National Health Insurance Institutions have largely expressed their interest in such a technology. However, from a chip technology point of view, no consensus has been reached and no standard has emerged. Many different operating systems are in use, non of them fully meets Healthcare needs. In this respect, the new 7th chapter of the ISO 7816 is a real opportunity both for standardization and improvement of card management systems in Healthcare. New operating systems, based on SQL language, better address Healthcare specific needs for multi-user × multi-data management with high level of security and flexibility. This new ISO 7816-7 chapter should pushed as the ultimate standard in Healthcare, in order to guarantee our customers open, interoperable and evolving solutions.
CARDLINK - A European Project for the Implementation of an Interoperable Emergency Dataset on a Smart Card. The Rome pilot site experience
Authors: Ruscitti G.  , Fabrizi E.  , Aleggiani F.  , Nasi M.  , Ricciardi Tenore G.  , Rosato N.
Published: February 2025

CARDLINK is a user driven project, supported by the European Commission, involving major commercial suppliers, which aims to provide a practical test bed for the EUROCARDS Concerted Action by implementing an emergency portable record stored in a chip card. The emergency data set has been interoperable between the Rome pilot site and the others four pilots’ sites involved in the first phase of CARDLINK and has been enlarged to others countries with the second phase approved in the 4th European Framework Program. For more details about the CARDLINK see the abstract dedicated to the general project described in the Congress Proceedings.