bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Electronic Health Records on the Completeness of Clinical Documentation Generated during Diabetic Retinopathy Consultations
Authors: Mitsch Christoph  , Huber Patrick  , Kriechbaum Katharina  , Scholda Christoph  , Duftschmid Georg  , Wrba Thomas  , Schmidt-Erfurth Ursula
Published: February 2025

Background: Two years ago, the Diabetic Retinopathy (DRP) and Traumatology clinic of the Department of Ophthalmology and Optometrics at the Department of Ophthalmology and Optometrics at the Medical University of Vienna, Austria switched from paper-based to electronic health records. A customized electronic health record system (EHR-S) was implemented.
Standardized Data Sharing in a Paediatric Oncology Research Network – A Proof-of-Concept Study
Authors: Hochedlinger Nina  , Nitzlnader Michael  , Falgenhauer Markus  , Welte Stefan  , Hayn Dieter  , Koumakis Lefteris  , Potamias George  , Tsiknakis Manolis  , Saraceno Davide  , Rinaldi Eugenia  , Ladenstein Ruth  , Schreier Günter
Published: February 2025

Data that has been collected in the course of clinical trials are potentially valuable for additional scientific research questions in so called secondary use scenarios. This is of particular importance in rare disease areas like paediatric oncology. If data from several research projects need to be connected, so called Core Datasets can be used to define which information needs to be extracted from every involved source system. In this work, the utility of the Clinical Data Interchange Standards Consortium (CDISC) Operational Data Model (ODM) as a format for Core Datasets was evaluated and a web tool was developed which received Source ODM XML files and – via Extensible Stylesheet Language Transformation (XSLT) – generated standardized Core Dataset ODM XML files. Using this tool, data from different source systems were extracted and pooled for joined analysis in a proof-of-concept study, facilitating both, basic syntactic and semantic interoperability.
Evaluation of a Clinical Decision Support Rule-set for Medication Adjustments in mHealth-based Heart Failure Management
Authors: Kropf Martin  , Modre-Osprian Robert  , Gruber Katharina  , Fruhwald Friedrich  , Schreier Günter
Published: February 2025

Decision-support based medication adjustment in heart failure management. Prospective analysis of clinical decision support in fifteen patients that collected vital parameters and medication intake up to one year within a clinical trial. Correlation of event episodes and medication adjustments with respect to applied rule-sets and medication classes. 713 events were grouped to 195 event episodes. Physicians performed 86 medication adjustments. 30 of them were triggered by event episodes. 35% of all performed medication adjustments occurred between event episodes. 20% of all episodes triggered a medication adjustment. 15% of all episodes triggered the expected medication adjustment. Correlation between episodes and medication adjustment was low. Further analysis needs to be done, to evaluate reasons for low correlation and how the rule-set should be adapted to increase reliability.
Towards Sustainable Data Management in Professional Biobanking
Authors: Leusmann Philipp  , Veeck Jürgen  , Jäkel Jörg  , Dahl Edgar  , Knüchel-Clarke Ruth  , Spreckelsen Cord
Published: February 2025

Background: Professional biobanks become increasingly important for fostering personalized medicine. While setting up and operating a high-quality collection of biomaterial specimens, biobank managers must face several challenges concerning quality management.
Innovative Information Systems in the Intensive Care Unit, King Saud Medical City in Saudi Arabia
Authors: Al Saleem Nouf  , Al Harthy Abdulrahman
Published: February 2025

The purpose of this paper is to discuss the experience of implementing innovative information technology to improve the quality of services in one of the largest Intensive Care Units in Saudi Arabia. The Intensive Care Units in King Saud Medical City (ICU-KSMC) is the main ICU in the kingdom that represents the Ministry of Health. KSMC's ICU is also considered one of the largest ICU in the world as it consists of six units with 129 beds. Leaders in KSMC's ICU have introduced and integrated three information technologies to produce powerful, accurate, and timely information systems to overcome the challenges of the ICU nature and improve the quality of service to ensure patients' safety. By 2015, ICU in KSMC has noticed a remarkable improvement in: beds' occupation and utilization, staff communication, reduced medical errors, and improved departmental work flow, which created a healthy professional work environment. Yet, ICU in KSMC has ongoing improvement projects that include future plans for more innovative information technologies' implementation in the department.
The Empowerment of Patients with Mental Conditions and Addictions through e-Health
Authors: Nakos Giorgos  , Magita Andrianna  , Mechili Aggelos E.  , Diomidous Marianna  , Mantas John
Published: February 2025

The aim of the current paper is the imparting of useful information to both patients and people in general regarding the development of mental conditions based on drug addictions, through e-health. It will provide all related information in order to achieve the empowerment of the selected sample regarding their conditions in terms of conceptualizing their health status. The general part is consisting of an overview on patient empowerment and e-health. The special part refers to the details of developing and presenting the above mentioned website. The information presented in the web site is addressing the general population and not only patients suffering a mental condition or addiction. The website contains the related articles and information obtained from the related bibliographical search. The main goal of the website is to impart concise information on the related issues.
Ontology-based Medical Decision Support System to Enhance Chronic Patients' Lifestyle within E-care Telemonitoring Platform
Authors: Benmimoune Lamine  , Hajjam Amir  , Ghodous Parisa  , Andres Emmanuel  , Talha Samy  , Hajjam Mohamed
Published: February 2025

The aim of this paper is to describe an original approach which consists of designing ontology based Medical Decision Support System (MDSS) to enhance the patients' lifestyle. This system is composed of two main parts: data collector which collects relevant lifestyle-related patent data by prompting the only significant questions in connection with the patient's medical background, and advices provider which provides personalized lifestyle advices to the patients regarding their lifestyle changes. The proposed MDSS is integrated within E-care home health monitoring platform in order to: (i) improve the patient's healthy lifestyle; (ii) educate the patients towards their disease; (iii) increase the early detection of risky situation.
StepKinnection: A Fall Prevention Game Mindfully Designed for the Elderly
Authors: Garcia Jaime A.  , Felix Navarro Karla
Published: February 2025

This paper presents the StepKinnection game, a Kinect-driven stepping game for the elderly that delivers stepping exercises to train specific cognitive and physical abilities associated with falls. This system combines a set of suitable age-related features, meaningful exercise routines and an embedded clinical test for fall risk assessment. The combination of these three aspects makes the game potentially useful in practice as the game is appealing to the elderly cohort, trains one of the most important abilities to prevent falls and at the same time allows for a continuous assessment of health outcomes; characteristics not available in the literature nor in current commercial games.
Le Bon Samaritain: A Community-Based Care Model Supported by Technology
Authors: Gay Valerie  , Leijdekkers Peter  , Gill Asif  , Felix Navarro Karla
Published: February 2025

Background: The effective care and well-being of a community is a challenging task especially in an emergency situation. Traditional technology-based silos between health and emergency services are challenged by the changing needs of the community that could benefit from integrated health and safety services. Low-cost smart-home automation solutions, wearable devices and Cloud technology make it feasible for communities to interact with each other, and with health and emergency services in a timely manner.
Informatics Competencies in Nursing Management
Authors: Jensen Rodrigo  , Casteli Christiane Pereira Martins  , Kobayashi Rika Miyahara  , Leite Maria Madalena Januário
Published: February 2025

This study aimed to identify in scientific literature the informatics competencies required from the nurses to make decision in management process. Through a scoping review, literature databases were searched to find articles published in Portuguese, English, or Spanish, until July 2013. 188 articles were found, and seven were included in this study, published between 1994 and 2011. The studies were written in English (5; 71%), in USA (5; 71%), using experience reports or literature review designs (5; 71%). The informatics competences were categorized according the Technology Informatics Guiding Education Reform (TIGER). The findings highlight gaps in informatics competence to make decisions in the management process – essentially in information management competence.
Use of Self-Service Query Tools Varies by Experience and Research Knowledge
Authors: Hruby Gregory W.  , Ancker Jessica  , Weng Chunhua
Published: February 2025

The lack of understanding of user experience with self-service query tools is a barrier to designing effective query tools and is what propelled this study. User actions were documented and transformed into networks of actions for qualitative analysis. Proficient use of self-service query tools requires significant technical experience. To decrease the user learning curve, additional user education is necessary for novice users.
Development and evaluation of task-specific NLP framework in China
Authors: Ge Caixia  , Zhang Yinsheng  , Huang Zhenzhen  , Jia Zheng  , Ju Meizhi  , Duan Huilong  , Li Haomin
Published: February 2025

Natural language processing (NLP) has been designed to convert narrative text into structured data. Although some general NLP architectures have been developed, a task-specific NLP framework to facilitate the effective use of data is still a challenge in lexical resource limited regions, such as China. The purpose of this study is to design and develop a task-specific NLP framework to extract targeted information from particular documents by adopting dedicated algorithms on current limited lexical resources. In this framework, a shared and evolving ontology mechanism was designed. The result has shown that such a free text driven platform will accelerate the NLP technology acceptance in China.
A Comparative Study of Bayes Net, Naive Bayes and Averaged One-Dependence Estimators for Osteoporosis Analysis
Authors: Waleska Simões Priscyla  , Mazzuchello Leandro Luiz  , Toniazzo de Abreu Larissa Letieli  , Garcia Diego  , dos Passos Maitê Gabriel  , Venson Ramon  , Bisognin Ceretta Luciane  , Veiga Silva Ana Carolina  , da Rosa Maria Inês  , Martins Paulo João
Published: February 2025

This paper presents an evaluation of the accuracy of the Bayesian classifiers: Bayes Net, Naive Bayes and Averaged One-Dependence Estimator, to support diagnoses of osteopenia and osteoporosis. All classifiers showed good results, thus, given data, it is possible to produce a reasonably accurate estimate of the diagnosis.
Utilizing Dental Electronic Health Records Data to Predict Risk for Periodontal Disease
Authors: Thyvalikakath Thankam P.  , Padman Rema  , Vyawahare Karnali  , Darade Pratiksha  , Paranjape Rhucha
Published: February 2025

Periodontal disease is a major cause for tooth loss and adversely affects individuals' oral health and quality of life. Research shows its potential association with systemic diseases like diabetes and cardiovascular disease, and social habits such as smoking. This study explores mining potential risk factors from dental electronic health records to predict and display patients' contextualized risk for periodontal disease. We retrieved relevant risk factors from structured and unstructured data on 2,370 patients who underwent comprehensive oral examinations at the Indiana University School of Dentistry, Indianapolis, IN, USA. Predicting overall risk and displaying relationships between risk factors and their influence on the patient's oral and general health can be a powerful educational and disease management tool for patients and clinicians at the point of care.
Towards a Clinical Decision Support System for Drug Allergy Management: Are Existing Drug Reference Terminologies Sufficient for Identifying Substitutes and Cross-Reactants?
Authors: Ogallo William  , Kanter Andrew S.
Published: February 2025

Drug allergy cross-reactivity checking is an important component of electronic health record systems. Currently, a single, open-source medication dictionary that can provide this function does not exist. In this study, we assessed the feasibility of using RxNorm and NDF-RT (National Drug File – Reference Terminology) for allergy management decision support. We evaluated the performance of using the Pharmacological Class, Mechanism of Action and Chemical Structure NDF-RT classifications in discriminating between safe and cross-reactive alternatives to a sample of common drug allergens. The positive predictive values for the three approaches were 96.3%, 99.3% and 96.2% respectively. The negative predictive values were 94.7%, 56.8% and 92.6%. Our findings suggest that in the absence of an established medication allergy classification system, using the Pharmacologic Class and Chemical Structure classifications in NDF-RT may still be effective for discriminating between safe and cross-reactive alternatives to potential allergens.
Mobile early detection and connected intervention to coproduce better care in severe mental illness
Authors: Whelan Pauline  , Machin Matthew  , Lewis Shôn  , Buchan Iain  , Sanders Caroline  , Applegate Eve  , Stockton Charlotte  , Preston Sally  , Bowen Robert Andrew  , Ze Zhimin  , Roberts Chris  , Davies Linda  , Wykes Til  , Tarrier Nicholas  , Kapur Shitij  , Ainsworth John
Published: February 2025

Current approaches to the management of severe mental illness have four major limitations: 1) symptom reporting is intermittent and subject to problems with reliability; 2) service users report feelings of disengagement from their care planning; 3) late detection of symptoms delay interventions and increase the risk of relapse; and 4) care systems are held back by the costs of unscheduled hospital admissions that could have been avoided with earlier detection and intervention. The ClinTouch system was developed to close the loop between service users and health professionals. ClinTouch is an end-to-end secure platform, providing a validated mobile assessment technology, a web interface to view symptom data and a clinical algorithm to detect risk of relapse. ClinTouch integrates high-resolution, continuous longitudinal symptom data into mental health care services and presents it in a form that is easy to use for targeting care where it is needed. The architecture and methodology can be easily extended to other clinical domains, where the paradigm of targeted clinical interventions, triggered by the early detection of decline, can improve health outcomes.
Bluetooth Roaming for Sensor Network System in Clinical Environment
Authors: Kuroda Tomohiro  , Noma Haruo  , Takase Kazuhiko  , Sasaki Shigeto  , Takemura Tadamasa
Published: February 2025

A sensor network is key infrastructure for advancing a hospital information system (HIS). The authors proposed a method to provide roaming functionality for Bluetooth to realize a Bluetooth-based sensor network, which is suitable to connect clinical devices. The proposed method makes the average response time of a Bluetooth connection less than one second by making the master device repeat the inquiry process endlessly and modifies parameters of the inquiry process. The authors applied the developed sensor network for daily clinical activities in an university hospital, and confirmed the stabilitya and effectiveness of the sensor network. As Bluetooth becomes a quite common wireless interface for medical devices, the proposed protocol that realizes Bluetooth-based sensor network enables HIS to equip various clinical devices and, consequently, lets information and communication technologies advance clinical services.
Quality indicators from laboratory and radiology information systems
Authors: Schuers Matthieu  , Joulakian Mehr B.  , Griffon Nicolas  , Pachéco Joanne  , Périgard Carine  , Lepage Eric  , Watbled Ludivine  , Massari Philippe  , Darmoni Stéfan J.
Published: February 2025

Consequences of the computerization of laboratory and radiology information system (LIS and RIS) are not well documented. The aim of this study was to evaluate the impact of computerization of LIS and RIS of four hospitals on performance and quality of care. The study was divided into three phases. First, the subprocesses and information flows of LIS and RIS were described. Then, a literature review was performed in order to identify the indicators used to assess the impact of computerization. Finally, comparisons were made between 2 hospitals. Using the initial framework, each partner described its process mapping concerning LIS and RIS. The review identified a wide panel of indicators. Only 41 were useful to assess the impact of information systems. For each two by two comparison, lists of relevant indicators have been selected from the identified indicators and according to the process mapping comparison. Two by two comparisons have to be completed. Eventually, these indicators may be integrated in the quality process of hospital information systems.
Patient Safety at Transitions of Care: Use of a Compulsory Electronic Reconciliation Tool in an Academic Hospital
Authors: Rizzato Lede Daniel A.  , Benítez Sonia E.  , Mayan III John C.  , Smith María I.  , Baum Analía J.  , Luna Daniel R.  , González Bernaldo de Quirós Fernán
Published: February 2025

Medication errors are responsible for most inpatient adverse events. Medication reconciliation emerged as an effective strategy to decrease these problems, enhancing patient safety. Electronic health records with reconciliation tools could improve the process, but many aspects should be considered in order to reach expected outcomes. In this paper we analyzed how a compulsory, electronic reconciliation application was used at Hospital Italiano in Buenos Aires, through admission and discharge processes. We evaluated all medications that were reconciled during patient admission and discharge since its implementation, from February to November 2014. During that period, there were 78,714 reconciled medications regarding 37,741 admissions (2.08 reconciled medications per hospitalization), of 27,375 patients (2.88 medications per patient). At admission, 63% of medications were confirmed and the remaining were paused or deleted. At discharge, 41% of all medications were reconfirmed. In the creation of the best possible medication history, the use of an electronic reconciliation tool would clean overloaded lists, but at the same time medications could be erroneously deleted.
Pre-Implementation Study of a Nursing e-Chart: How Nurses Use Their Time
Authors: Schachner Maria B.  , Recondo Francisco J.  , Sommer Janine A.  , González Zulma A.  , García Gabriela M.  , Luna Daniel R.  , Benítez Sonia E.
Published: February 2025

In clinical practice, nurses perform different activities that exceed direct care of patients, and influence workload and time administration among different tasks. When implementing changes in an electronic nursing record, it is important to measure how it affects the time committed to documentation. The objective of this study was to determine the time dedicated to different activities, including those related to electronic documentation prior to implementing a redesigned nurse chart in an Electronic Health Record at the Hospital Italiano de Buenos Aires. An observational work sampling study was performed. Nursing activities observed were categorized as direct care, indirect care, support, non-patient related, and personal activities. During the study, 74 nurses were observed and 2,418 observations were made in the Intensive Care Unit (32.22%), the Intermediate Care Unit (29.57%), and the General Care Unit (38.21%). Nurses' activities included 37.40% of direct care, 41.18% of indirect care, 0.43% support tasks, 11.14% non-related to patient tasks, and 9.77% personal activities. The results allow for the estimation of the impact of a nursing e-chart on nurses' activities, workflow and patient care.
Living with Lung Cancer – Patients' Experiences as Input to eHealth Service Design
Authors: Hägglund Maria  , Bolin Peter  , Koch Sabine
Published: February 2025

The objective of the study is to describe the lung cancer care process as experienced by patients, as well as to perform a qualitative analysis of problems they encounter throughout the patient journey. A user-centered design approach was used and data collected through two focus group meetings with patients. We present the results in the form of a patient journey model, descriptions of problems related to the journey as expressed by patients and proposed eHealth services discussed by patients in the focus groups. The results indicate that not only is the patient journey fragmented and different for each patient going through it depending upon their specific type of lung cancer and treatment options, but their experiences are also highly individual and dependent on their personal needs and interpretations of the process. Designing eHealth to improve the patient journey will therefore require flexibility and adaptability to the individual's needs.
Applying a Geospatial Visualization Based on USSD Messages to Real Time Identification of Epidemiological Risk Areas in Developing Countries: A Case of Study of Paraguay
Authors: Ochoa Silvia  , Talavera Julia  , Paciello Julio
Published: February 2025

The identification of epidemiological risk areas is one of the major problems in public health. Information management strategies are needed to facilitate prevention and control of disease in the affected areas. This paper presents a model to optimize geographical data collection of suspected or confirmed disease occurrences using the Unstructured Supplementary Service Data (USSD) mobile technology, considering its wide adoption even in developing countries such as Paraguay. A Geographic Information System (GIS) is proposed for visualizing potential epidemiological risk areas in real time, that aims to support decision making and to implement prevention or contingency programs for public health.
Validation of Minimum Data of Archetyped Telehealth Clinical Report for Monitoring Prenatal Care
Authors: Santos Alves Danielle  , Cesário Times Valéria  , de Araújo Novaes Magdala
Published: February 2025

Studies on the validation of minimum data sets from international information standards have drawn the attention of the academic community to the identification of necessary requirements for the development of Electronic Health Records (EHRs). The primary motivation of such studies is the development of systems using archetypes. The aim of this study was to validate the minimum data set that should be used when constructing an archetyped EHR for prenatal care applications in telehealth. In order to achieve this, a data validation tool was built and used by nine expert obstetricians. The statistical analysis employed was the percentage of agreement and the content validity index. The study was conducted in three steps: 1) Literature review, 2)Instrument development, and 3) Validation of the minimum data set. Of the 179 evaluated pieces of data, 157 of them were validated to be included in the archetyped record of the first prenatal consultation, while 56 of them were allocated for the subsequent consultation record. The benefit of this research is the standardization (data validation for an archetyped system) of prenatal care, with the perspective of employing, both nationally and internationally, an archtyped telehealth system.
One Million Electrocardiograms of Primary Care Patients: A Descriptive Analysis
Authors: Chazard Emmanuel  , Marcolino Milena Soriano  , Dumesnil Chloé  , Caron Alexandre  , Palhares Daniel Moore F.  , Ficheur Grégoire  , Marino Barbara C. A.  , Alkmim Maria Beatriz M.  , Beuscart Régis  , Ribeiro Antonio Luiz
Published: February 2025

In 722 cities of Minas Gerais (Brazil), primary care patients can have their ECGs remotely interpreted by cardiologists of the Telehealth Network of Minas Gerais (TNMG), a public telehealth service. As of December 2014, more than 1.9 million ECGs were interpreted. This study analyzed the database of all ECGs performed by the TNMG on primary care patients from 2009 to 2013 (n=1,101,993). Structured patient data and the results of automated ECG interpretation by the Glasgow Program are described. Mean patient age is 51 years old, 59% of them are women. The average body mass index is 25.9 kg/m2, with an average increase of 0.15 kg/m2per civil year. Those patients notably have hypertension (33.2%), family history of coronary artery disease (14.5%), smoking (6.9%), diabetes (5.8%), obesity (5.8%) or Chagas Disease (3.0%). Seventy percent of ECGs are normal. This percentage is higher in women (72.3%) and decreases in average by 7.4 every 10 years of life. There are notably 12% of possible myocardial infarction, 10% of possible left ventricular hypertrophy and 8% of possible supraventricular extra systole.
A Multi-Relational Model for Depression Relapse in Patients with Bipolar Disorder
Authors: Salvini Rogerio  , da Silva Dias Rodrigo  , Lafer Beny  , Dutra Inês
Published: February 2025

Bipolar Disorder (BD) is a chronic and disabling disease that usually appears around 20 to 30 years old. Patients who suffer with BD may struggle for years to achieve a correct diagnosis, and only 50% of them generally receive adequate treatment. In this work we apply a machine learning technique called Inductive Logic Programming (ILP) in order to model relapse and no-relapse patients in a first attempt in this area to improve diagnosis and optimize psychiatrists' time spent with patients. We use ILP because it is well suited for our multi-relational dataset and because a human can easily interpret the logical rules produced. Our classifiers can predict relapse cases with 92% Recall and no-relapse cases with 73% Recall. The rules and variable theories generated by ILP reproduce some findings from the scientific literature. The generated multi-relational models can be directly interpreted by clinicians and researchers, and also open space to research biological mechanisms and interventions.
Developing an Electronic Medical Record for Interlinked Care Services in Haiti
Authors: Marcelin A.  , Perodin C.  , Baja C.  , Bright A.  , Duperval J.  , Duplan M.  , Dérilus F.  , Duda S.  , Pape J.
Published: February 2025

A large clinical care and research organization in Haiti required an electronic medical record system (EMR) to serve the needs of its 30 interlinked clinical programs. After assessing available open source software, the local team designed and implemented a modular proprietary EMR that is improving data quality and patient care. Despite the many benefits of existing open source medical record systems, clinical centers with complex workflow patterns – even those in resource-limited settings – should consider developing sustainable, local systems that fit their care model.
Computer-Interpretable Clinical Guidelines: A Review and Analysis of Evaluation Criteria for Authoring Methods
Authors: Khodambashi Soudabeh  , Slaughter Laura  , Nytrø Øystein
Published: February 2025

There are a variety of authoring tools and methods for producing computer-interpretable clinical guideline (CIG). This work is a review of the evaluation of tools and methods currently in use to author CIGs. The aim of this paper is to present the results of a literature review on the evaluation criteria. Both controlled database search and a subsequent snowballing were used to identify relevant literature. The evaluation criteria and evaluation methods of CIG-related themes were manually identified in the found literature. Based on the 32 relevant papers found, 68 evaluation criteria were identified which were then classified into ten themes. We identified the most and least frequently mentioned areas of concern in evaluation which indicate areas that have been neglected in system evaluation.
Lessons Learnt from Evaluation of Computer Interpretable Clinical Guidelines Tools and Methods: Literature Review
Authors: Khodambashi Soudabeh  , Nytrø Øystein
Published: February 2025

Representation of clinical guidelines in a computer interpretable format is an active area of research. Various methods and tools have been proposed which have been evaluated based on different evaluation criteria. The evaluation results in the literature and their lessons learnt can be a valuable learning resource in order to redesign and improve the tools. Therefore, this research investigates the lessons learnt from the evaluation studies. Broad search in literature together with a purposeful snowball method were performed to identify the related papers that report any type of evaluation or comparison. We reviewed and analysed the lessons learnt from the evaluation results and classified them into 17 themes which reflect the suggestion concerns. The results indicate that the lessons learnt are more focused on tool functionalities, integration, sharing and maintenance domain. We provide suggestions for the area which had less attention.
Checking dwelling performance for Aging-in-Place
Authors: van der Vlies Remy D.  , Nauta Joram  , Smit-Rietveld Charlotte
Published: February 2025

About 90% of persons aged 55 and older would prefer to stay in their current residences as long as possible because older adults value their independence. However, aging-in-place is not always a choice. Recently, the Dutch government tightened the criteria for older adults to be admitted in a nursing home. Throughout the past 5 years TNO was requested by the trade association for building service contractors in the Netherlands to develop a number of tools for building service professionals. The ‘dwelling check’ was developed as a ‘basic’ check on the possibility for aging-in-place. A pilot study was conducted to assess the added value of the dwelling check for older adults. During this pilot study the occupants of over 200 dwellings were interviewed by 11 building services contractors using the dwelling check. Based on these interviews a personal advice was written. After which the interviewees were asked to evaluate this service, comprising the interview and written advice. The dwelling check contributed most to the awareness of and interest in possible alterations for aging-in-place. In a few cases the decision (17%) or even action (5%) was taken to make alterations. Overall the dwelling check was rated 8 out of 10 by the interviewees and may therefore be considered of added value.
Supporting Blind Students in STEM Education in Austria
Authors: Petz Andrea  , Miesenberger Klaus
Published: February 2025

Equal access to education will foster a knowledge society for all. In particular for the ICT based information society a benchmark has been set to raise the numbers of graduates in science, technology, engineering and mathematics (STEM) study courses by 15% (748.000) per year, asking for increased efforts in Europe (http://ec.europa.eu/education/policy/strategic-framework/index_en.htm). This holds even more true for people with disabilities who a) participate in and graduate from STEM at a much lower number and b) face a much higher unemployment rate, in particular in STEM related fields. This asks for sound and well-founded education – first and foremost in math – for people with disability and here especially for blind people.
ODINS: On-Demand Indoor Navigation System RFID Based
Authors: Bianchi Federico  , Masciadri Andrea  , Salice Fabio
Published: February 2025

This paper presents an On-Demand Indoor Navigation System (ODINS) based on RFID technology. ODINS is a distributed infrastructure where a set of information points (Fixed Stations – FS) provides the direction to a user who has to reach the destination point he/she has previously selected. ODINS system is proposed for residencies hosting people with mild cognitive disabilities and elderly but it can be also applied to structures where people could be disoriented. The destination is configured at some reception points or it is a predefined (e.g. the bed room or a selected “safe” point). The destination is associated with a RFID disposable bracelet assigned to her/him. The path is algorithmically computed and spread to all FSs. Every time the user is disoriented, she/he can search for the closest FS that displays the right directition. FSs should be located in strategic positions and provide a user-friendly interface such as bright arrows. The complexity is “system-side” making ODINS usable for everyone.
Embedded systems for supporting computer accessibility
Authors: Mulfari Davide  , Celesti Antonio  , Fazio Maria  , Villari Massimo  , Puliafito Antonio
Published: February 2025

Nowadays, customized AT software solutions allow their users to interact with various kinds of computer systems. Such tools are generally available on personal devices (e.g., smartphones, laptops and so on) commonly used by a person with a disability. In this paper, we investigate a way of using the aforementioned AT equipments in order to access many different devices without assistive preferences. The solution takes advantage of open source hardware and its core component consists of an affordable Linux embedded system: it grabs data coming from the assistive software, which runs on the user's personal device, then, after processing, it generates native keyboard and mouse HID commands for the target computing device controlled by the end user. This process supports any operating system available on the target machine and it requires no specialized software installation; therefore the user with a disability can rely on a single assistive tool to control a wide range of computing platforms, including conventional computers and many kinds of mobile devices, which receive input commands through the USB HID protocol.
Biomechanics and Physiology for Propelling Wheelchair Uphill Slope
Authors: Hashizume Tsutomu  , Kitagawa Hiroshi  , Lee Hokyoo  , Ueda Hisatoshi  , Yoneda Ikuo  , Booka Masayuki
Published: February 2025

A vertical slope of sidewalks significantly inhibits to the mobility of manual wheelchair users in their daily life. International guidelines of the vertical slope are specified approximately 4% or 5% (1:20) gradient or less as preferred, and allow 8.3% (1:12) as its maximum when it is impossible. Relevant research of the physical strain for wheelchair users with pushing on slopes, and the validity assessment of slope guidelines have been investigated. However, the analysis for the effect of a slope distance and their transient performance are still remained. The purpose of this study is to clarify the physiological and biomechanical characteristics of manual wheelchair users that propelling a wheelchair on an uphill slope. We measured these data by a metabolic analysis system, a heart rate monitor system and an instrumented wheelchair wheel. Sixteen unimpaired subjects (non-wheelchair users) were examined to investigate the effect of a long slope with 120m distance and 8% gradient. And five wheelchair users with cervical cord injury were examined to evaluate the influence of different gradients (5%, 6.7%, 8.3%, 10% and 12.5%) with 3m length in laboratory. Our experimental results of the long slope showed that wheelchair propulsion velocity and power increased considerably at the beginning of the slope where the peak mean value of them were 0.96 m/s and 70.8W and they decreased linearly to 0.55m/s and 33.6W at final interval. A mean oxygen uptake and heart rate were increased as the distance increased and their results indicated the extremely high exercise intensity at a final interval that were 1.2liter /min and 152bpm. While wheelchair pushing cadence reduced after an initial interval, mean of strokes per10m increased to compensate the decrease of upper limb's power. The results of different gradients indicated that the normalized power of subjects with cervical cord injury was significant difference between each subject in the ability to climb a slope. Mean normalized power were 0.23W/kg on a 5% slope, 0.24W/kg on 6.7%, and 0.26W/kg on 8.3% respectively. Based on these findings, we examined the relationship between the theoretical normalized power and the lowest velocity to climb a slope, and we might indicate the ability to push on an uphill slope for the persons with manual wheelchair user.
Building an effective ontology for assistive technology
Authors: Danial-Saad Alexandra  , Kuflik Tsvi  , Weiss Patrice L. (Tamar)  , Schreuer Naomi
Published: February 2025

The aim of this paper was to develop and validate an ontology for one class of assistive technology (AT), namely physically controllable pointing devices, using the Delphi method. Six occupational therapists with AT expertise identified important items and categories to the pointing device prescription through a three-round, structured process consisting of responses to a series of questionnaires. The intraclass correlation coefficient (ICC) was used to assess the interrater reliability of items included in categories related to the pointing devices and to the user profile. During the first round, the ICC ranged from 0.19 to 0.97; this improved to ICCs ranging from 0.72 to 1.0 during the second round. A full consensus was reached by the experts during the final round which included 218 items, divided into five categories, for the pointing device list, and 168 items, divided into six categories, for the user profile list. This ontology is expected to help achieve a more systematic regulation of the AT field, leading to greater standardization and increased knowledge sharing.
Users' Perception and Readiness of the eChez-Soi In-Home Telerehabilitation Platform
Authors: Moffet Hélène  , Vincent Claude  , Saey Didier  , Coats Valérie  , Routhier François  , Choinière Fanny  , Comeau François
Published: February 2025

This longitudinal preliminary study aims to describe the components and features of the eChez-Soi home-based telerehabilitation platform, and present preliminary results on practitioners' readiness for and perception of its usability. Four patients receiving chemotherapy treatments for lung cancer followed an 8-week home-based telerehabilitation program with the new eChez-Soi platform and four healthy adults used it for 2 weeks. The users' perception was very good, with an overall satisfaction rate of 4.6±0.4 (max. score=5) for the patients, 4.8±0.2 for the healthy adults and 4.4±0.3 for the practitioners. Total practitioner telehealth readiness was 73.5±9.1 (max score=85), suggesting that certain items, for at least one practitioner, may adversely impact the use of telehealth. These preliminary results support the usability of this new platform and suggest that practitioner telehealth readiness is reinforced with experience.
A User and Their Family's Perspective of The Use of a Low-Tech Vs A High-Tech AAC System
Authors: Borg S.  , Agius M.  , Agius L.
Published: February 2025

This qualitative case study describes a 9-year-old child, diagnosed with homonymous hemianopia, left side weakness and seizures that has been followed by Access to Communication and Technology Unit in Malta for 5 years. The child previously used a communication book and now uses an iPad as a speech generating device. A semi-structured interview was utilised with the parent to explore preference for each AAC system and the reasons for it. The impact of each AAC system on the family and on the child's communication skills, and perceived barriers in the implementation of the AACs were also explored. The child's own experience using the AAC systems was also investigated using a structured interview format. Talking Mats was used to support the child's understanding of the questions and to explore her perspectives on the two AAC systems using Yes-No responses. The parent interview was analysed thematically and represented visually using a thematic network. This was compared with child responses. Four organising themes emerged including barriers, benefits, facilitators, and expectations. Specific barriers included self-funding in order to provide the child with the best fit high-tech AAC. Perceived benefits for both AAC systems were that it increased her communicative intent. The child's mother perceived access to increased vocabulary and capacity for sentence building, operational autonomy as well as voice output as a benefit of the SGD. The child's results indicated a preference for the high-tech AAC because she found it easier to navigate than the low-tech AAC.
Goal setting for cerebral palsy children in context therapy: improve reliability when linking to ICF
Authors: Alvarelhão Joaquim  , Queirós Alexandra  , Sa-Couto Pedro  , Rocha Nelson Pacheco
Published: February 2025

The linking process of information to ICF is a common task in different strategies used in rehabilitation practise but is a time consuming process mainly due to reliability issues. This work aims to developed additional rules to those already published in order to improve reliability of the linking process to ICF. The results are encouraging and this work could help to develop information technologies tools for facilitate this process.
Development of Communication Assistive Technology for Persons with Deaf-Blindness and Physical Limitation
Authors: Hatakeyama Takuro  , Watanabe Takashi  , Takahashi Kiriko  , Doi Kouki  , Fukuda Akiko
Published: February 2025

The purpose of this study was to develop a system that will provide communication assistance to persons with deaf-blindness and physical limitation, so that they will be able to communicate with others without the help of an interpreter.
Unveiling the Mobile Learning Paradox
Authors: Mather Carey  , Cummings Elizabeth
Published: February 2025

A mobile learning paradox exists in Australian healthcare settings. Although it is increasingly acknowledged that timely, easy, and convenient access to health information using mobile learning technologies can enhance care and improve patient outcomes, currently there is an inability for nurses to access information at the point of care. Rapid growth in the use of mobile technology has created challenges for learning and teaching in the workplace. Easy access to educational resources via mobile devices challenges traditional strategies of knowledge and skill acquisition. Redesign of learning and teaching in the undergraduate curriculum and the development of policies to support the use of mobile learning at point of care is overdue. This study explored mobile learning opportunities used by clinical supervisors in tertiary and community-based facilities in two Australian States. Individual, organisation and systems level governance were sub-themes of professionalism that emerged as the main theme and impacts on learning and teaching in situ in healthcare environments. It is imperative healthcare work redesign includes learning and teaching that supports professional identity formation of students during work integrated learning.
Monitoring the Amount of Practical Use of eHealth on National Level by Use of Log Data: Lessons Learned
Authors: Villumsen Sidsel  , Harðardóttir Guðrún Auður  , Kangas Maarit  , Gilstad Heidi  , Brattheim Berit Johanne  , Reponen Jarmo  , Hypponen Hannele  , Nøhr Christian
Published: February 2025

This paper set out to define the lessons learned from the process of characterizing the amount of practical use of eHealth on national level by collecting and comparing log data harvested from national logs in the Nordic countries. The health systems of the Nordic countries are quite similar in structure and their eHealth strategies include similar elements, however when confronted with the specific context in the different systems it proved challenging to define a common set of indicators for monitoring the practical use of eHealth. A thorough analysis of context leading to the definitions of the indicators is the basis needed due to the complexity of the data in the national logs. A comprehensive knowledge of the structure that underlines these logs is of utmost importance when striving for collecting comparable data. Although challenging, the process of defining indicators for practical use of eHealth by data harvested trough national logs is not an impossible task, but a task that requires in depth discussions of definitions of indicators as well as a substantial insight into the architecture and content of the national databases. There is need for continuous work on these indicators to ensure their quality and thus make sure that the defined indicators can meaningfully inform eHealth policies.
User Preferences for Improving the Estonian National e-Prescription Service
Authors: Parv Liisa  , Monkman Helen  , Laus Raimo
Published: February 2025

National e-Prescription services are becoming more common in Europe. While enhancing communication between levels of health care, few solutions have demonstrated enhanced quality of care and patient safety benefits. The article presents the results of a project to map the user needs the Estonian national e-prescription service. A survey was conducted among primary care physicians (PCPs) to inquire about their needs in the medication management process. The results showed that PCPs lacked a medication management tool to support patient care across different care settings. A mockup for the national service was developed based on the survey results. The medication management tool features a visual presentation of a patient's medication list and includes decision support functions for allergies and potential interactions. This mockup will be used to further investigate the needs of PCPs as well as other care providers in the medication management process.
Bearing Capacity of Working Platforms using Distinct Layout Optimization Method
Authors: Bałachowski Lech  , Białek Katarzyna
Published: February 2025

Bearing capacity of the working platforms from sandy soil resting on NC and OC clays was analyzed using LimitState GEO program. Different failure modes are considered using distinct layout optimization (DLO) method, which forms the upper bound solution of limit state analysis. Different mechanisms of failure were observed as a function of the platform thickness, angle of internal friction of the platform material and undrained shear strength of the subgrade. The distribution of undrained shear strength with depth was also taken into consideration. The typical failure modes were presented. The calculated bearing capacity was compared to analytical solutions and recommendations of BRE. Special attention was paid to the platform resting on soft clay with undrained shear strength lower than 20 kPa, as this case is not covered by these recommendations. The solution obtained with DLO method was compared to bearing capacity calculation using Plaxis and φ, c reduction method. Additionally some analysis were performed for a real platform of sandy soil on the soft organic clay. Here, the strength and deformation parameters of the platform material and the subgrade were determined with dilatometer test (DMT). This kind of approach permits to determine both strength and deformation parameters of the platform material and soft subgrade in one test.