bluuebunny/crossref_metadata_2025 huggingface dataset:
Multidisciplinary Education in Medical Informatics – A course for medical and informatics students
Authors: Breil Bernhard  , Fritz Fleur  , Thiemann Volker  , Dugas Martin
Published: February 2025

Design and implementation of healthcare information systems affect both computer scientists and health care professionals. In this paper we present our approach to integrate the management of information systems in the education of healthcare professionals and computer scientists alike. We designed a multidisciplinary course for medical and informatics students to provide them with practical experience concerning the design and implementation of medical information systems. This course was implemented in the curriculum of the University of Münster in 2009. The key element is a case study that is performed by small teams of medical and informatics students. A practical course on management of information systems can be useful for medical students who want to enhance their knowledge in information systems as well as for informatics students with particular interests in medicine.
Strengthening Health Systems through training of Health Care Providers in the conduct of Routine Waiting Time and System Efficiency Surveys
Authors: Reagon Gavin  , Igumbor Ehimario
Published: February 2025

The effective functioning of Health Systems is reliant on good quality information being available for decision-making. Routine surveys exemplify an under-utilised source of such information that could enable Health Departments to gain insights into the performance of health service provision, from both the stand-point of the providers and users. Amongst these, Waiting Time and System Efficiency Surveys (WTSES) directly responds to the commonest complaint of users of healthcare services. There is, however, little information on approaches to routinely implement robust and sustainable facility-based WTSES especially in resource-constrained settings. This paper describes the conceptual and methodological basis for implementing WTSES in health care facilities, using a method that places the conduct of the survey within the purview of the normal service activities of health care providers, and thus makes the routine assessment of Waiting Times possible at low cost and with high benefit. The authors aver that the universal implementation of the WTSES presents the potential for enriching patient and health facility information systems, particularly in resource-constrained settings, where efficient use of limited resources is critical.
A Configurable Home Care Platform for Monitoring Patients with Reminder Messaging and Compliance Tracking Services
Authors: Capozzi Davide  , Lanzola Giordano
Published: February 2025

This paper illustrates a platform based on a general architecture for implementing home care services for chronic patients composed of a Remote Care Unit located at a patient's home and a Health Care Center Unit located at the treating center. The Remote Care Unit may be deployed on multiple platforms including PCs, mobile phones and even embedded devices not equipped with monitor, and may be configured to support many interoperability issues occurring among the parties involved in a health care delivery process. The platform may be tailored to match the specific issues of any chronic disease supporting either data acquisition as well as customized reminders and notifications from the center. Remote Care Unit platforms are also able to exploit multiple channels for acquiring data, including wireless links with medical devices, speech interaction and graphical user interaction. In this paper a couple of applications addressing the needs of diabetic and nephropatic patients developed on top of that platform are also introduced.
Exploiting UMLS Semantics for Checking Semantic Consistency among UMLS concepts
Authors: Erdogan Halit  , Erdem Esra  , Bodenreider Olivier
Published: February 2025

Objectives: To quantify semantic inconsistency in UMLS concepts from the perspective of their hierarchical relations and to show through examples how semantically-inconsistent concepts can help reveal erroneous synonymy relations. Methods: Inconsistency is defined in reference to concepts from the UMLS Metathesaurus. Consistency is evaluated by comparing the semantic groups of the two concepts in each pair of hierarchically-related concepts. A limited number of inconsistent concepts was inspected manually. Results: 81,512 concepts are inconsistent due to the differences in semantic groups between a concept and its parent. Four examples of wrong synonymy are presented. Conclusions: A vast majority of inconsistent hierarchical relations are not indicative of any errors. We discovered an interesting semantic pattern along hierarchies, which seems associated with wrong synonymy.
Healthcare Chains – Enabling Application and Data Privacy Controls for Healthcare Information Systems
Authors: Omran Esraa  , Grandison Tyrone  , Abu Almaati Shereef
Published: February 2025

Healthcare applications that have access control, disclosure management and or privacy enforcement requirements may implement the respective solutions to these issues at the application level or at the database level or in both. Unfortunately, there are technical and non-technical factors that influence what can be done. In this paper we present a flexible, simple and novel approach to seamlessly imbuing current healthcare applications and their supporting infrastructure with security and privacy functionality, while being cognizant of these factors. This approach is called the Chain method. This paper will highlight the smaller design footprint, the increased ease of implementation and use of the Chain method, while demonstrating that it is as powerful and effective as traditional methods.
An Accelerated Meshfree Analysis of Three Dimensional Soil Slope Failure under Finite Deformation
Authors: Wang Dongding  , Li Zhuoya  , Li Ling  , Wu Youcai
Published: February 2025

A three dimensional updated Lagrangian Galerkin meshfree formulation with improved computational efficiency is presented to analyze the failure of soil slopes under finite deformation. This nonlinear meshfree formulation is featured by the Lagrangian stabilized conforming nodal integration method where the low cost nature of nodal integration approach is kept and at the same time the spatial stability is achieved. The initiation and propagation of failure in the soil slope is modeled by the coupled constitutive equations of isotropic damage and pressure dependent plasticity. The effectiveness of the present method is demonstrated by a three dimensional slope failure example.
Petri Nets for Steady State Analysis of Metabolic Systems
Authors: Voss Klaus  , Heiner Monika  , Koch Ina
Published: February 2025

Computer assisted analysis and simulation of biochemical pathways can improve the understanding of the structure and the dynamics of cell processes considerably. The construction and quantitative analysis of kinetic models is often impeded by the lack of reliable data. However, as the topological structure of biochemical systems can be regarded to remain constant in time, a qualitative analysis of a pathway model was shown to be quite promising as it can render a lot of useful knowledge, e. g., about its structural invariants. The topic of this paper are pathways whose substances have reached a dynamic concentration equilibrium (steady state). It is argued that appreciated tools from biochemistry and also low-level Petri nets can yield only part of the desired results, whereas executable high-level net models lead to a number of valuable additional insights by combining symbolic analysis and simulation.
MeRiTS: Simulation-Based Training for Healthcare Professionals
Authors: Chodos David  , Stroulia Eleni  , King Sharla
Published: February 2025

Simulation-based training has been used in numerous settings for procedural training. In this research, we focus on a method of simulation-based procedural skills training that uses virtual worlds. This method, implemented in our MeRiTS software system, models procedures using executable workflows, which are enacted by the trainee in a virtual world. The workflows may be defined by educators, or demonstrated by experts and then extracted from system logs. To demonstrate the utility of the system, we have created a scenario for training EMTs in patient rescue and transition procedures. We have pilot tested this scenario with students at a polytechnical institute, and will be conducting more rigorous testing with a range of students and institutions in the near future.
Design and Implementation of a Visual and Haptic Simulator in a Platform for a TEL System in Percutaneuos Orthopedic Surgery
Authors: Luengo Vanda  , Larcher Aurelie  , Tonetti Jérôme
Published: February 2025

Within a research project whose aim is to promote the learning of percutaneous operation in orthopedic surgery we design a Technological Enhanced Learning (TEL) system. This project belongs to a multidisciplinary field including computer, orthopedic surgery, medical imaging, didactic and cognitive sciences. The article presents the design principles of TEL with a particular interest in the development of a simulator. This simulator allows a virtual exercise interacting with the learner in visual, temporal and haptic dimension.
Computational Modeling of Human Head Electromagnetics for Source Localization of Milliscale Brain Dynamics
Authors: Malony Allen D.  , Salman Adnan  , Turovets Sergei  , Tucker Don  , Volkov Vasily  , Li Kai  , Song Jung Eun  , Biersdorff Scott  , Davey Colin  , Hoge Chris  , Hammond David
Published: February 2025

Understanding the milliscale (temporal and spatial) dynamics of the human brain activity requires high-resolution modeling of head electromagnetics and source localization of EEG data. We have developed an automated environment to construct individualized computational head models from image segmentation and to estimate conductivity parameters using electrical impedance tomography methods. Algorithms incorporating tissue inhomogeneity and impedance anisotropy in electromagnetics forward simulations have been developed and parallelized. The paper reports on the application of the environment in the processing of realistic head models, including conductivity inverse estimation and lead field generation for use in EEG source analysis.
Generation of Connectivity-Preserving Surface Models of Multiple Sclerosis Lesions
Authors: Meruvia-Pastor Oscar  , Xiao Mei  , Soh Jung  , Sensen Christoph W.
Published: February 2025

Progression of multiple sclerosis (MS) results in brain lesions caused by white matter inflammation. MS lesions have various shapes, sizes and locations, affecting cognitive abilities of patients to different extents. To facilitate the visualization of the brain lesion distribution, we have developed a software tool to build 3D surface models of MS lesions. This tool allows users to create 3D models of lesions quickly and to visualize the lesions and brain tissues using various visual attributes and configurations. The software package is based on breadth-first search based 3D connected component analysis and a 3D flood-fill based region growing algorithm to generate 3D models from binary or non-binary segmented medical image stacks.
Development of a Wireless Hybrid Navigation System for Laparoscopic Surgery
Authors: Ren Hongliang  , Rank Denis  , Merdes Martin  , Stallkamp Jan  , Kazanzides Peter
Published: February 2025

Navigation devices have been essential components for Image-Guided Surgeries (IGS) including laparoscopic surgery. We propose a wireless hybrid navigation device that integrates miniature inertial sensors and electromagnetic sensing units, for tracking instruments both inside and outside the human-body. The proposed system is free of the constraints of line-of-sight or entangling sensor wires. The main functional (sensor) part of the hybrid tracker is only about 15 mm by 15 mm. We identify the sensor models and develop sensor fusion algorithms for the proposed system to get optimal estimation of position and orientation (pose). The proof-of-concept experimental results show that the proposed hardware and software system can meet the defined tracking requirements, in terms of tracking accuracy, latency and robustness to environmental interferences.
A Fixed Point Proximity Method for Extended Contact Manipulation of Deformable Bodies with Pivoted Tools in Multimodal Virtual Environments
Authors: Sankaranarayanan Ganesh  , Lu Zhonghua  , De Suvranu
Published: February 2025

In the real world, tools used for manipulation are pivoted with specialized tips for specific functions including grasping and cutting. Manipulating deformable virtual objects with them involves maintaining extended contact, which is difficult due to the variations in applied force. Our method consists in selecting a fixed set of points on the jaws of a pivoted tool, and placing them either equidistant or according to the geometry of the tool. Vertex and triangle proximities are calculated for each of the interacting deformable objects for collision detection. This method was successfully tested in a surgical simulation scenario where a deformable omental fat model was grasped and retracted while maintaining full contact with the pivoted tool tip at all times.
Using A Virtual Integration Environment in Treating Phantom Limb Pain
Authors: Zeher Michael J.  , Armiger Robert S.  , Burck James M.  , Moran Courtney  , Kiely Janid Blanco  , Weeks Sharon R.  , Tsao Jack W.  , Pasquina Paul F.  , Davoodi R  , Loeb G.
Published: February 2025

The Revolutionizing Prosthetics 2009 program conducted by the Defense Advanced Research Projects Agency (DARPA) has resulted in a Virtual Integration Environment (VIE) that provides a common development platform for researchers and clinicians that design, model and build prosthetic limbs and then integrate and test them with patients. One clinical need that arose during the VIE development was a feature to easily create and model animations that represent patient activities of daily living (ADLs) and simultaneously capture real-time surface EMG activity from the residual limb corresponding to the ADLs. An application of this feature is being made by the Walter Reed Military Amputee Research Program (MARP) where they are utilizing the VIE to investigate methods of reducing upper extremity amputee phantom limb pain (PLP).
Intubation Success Rates and Perceived User Satisfaction Using the Video Laryngoscope to Train Deploying Far Forward Combat Medical Personnel
Authors: Boedeker Ben H.  , Barak-Bernhagen Mary A.  , Boedeker Kirsten A.  , Murray W. Bosseau
Published: February 2025

Studies show the video laryngoscope enhances intubation training by facilitating visualization of airway anatomy. We examined the performance and training of military healthcare providers in a brief intubation training course which included both direct and indirect (video) laryngoscopy. This training format with the video laryngoscope improved airway visualization and intubation performance, promoting increased trainee confidence levels for successful intubation. Web-based training paired with hands-on instruction with the video laryngoscope should be considered as a model for military basic airway management training.
A Requirements Engineering Approach for Improving the Quality of Diabetes Education Websites
Authors: Shabestari Omid  , Roudsari Abdul
Published: February 2025

Diabetes Mellitus is a major chronic disease with multi-organ involvement and high-cost complications. Although it has been proved that structured education can control the risk of developing these complications, there is big room for improvement in the educational services for these patients. e-learning can be a good solution to fill this gap. Most of the current e-learning solutions for diabetes were designed by computer experts and healthcare professionals but the patients, as end-users of these systems, haven't been deeply involved in the design process. Considering the expectations of the patients, this article investigates a requirement engineering process comparing the level of importance given to different attributes of the e-learning by patients and healthcare professionals. The results of this comparison can be used for improving the currently developed online diabetes education systems.
Economic Analysis of Centralized vs. Decentralized Electronic Data Capture in Multi-Center Clinical Studies
Authors: Walden Anita  , Nahm Meredith  , Barnett M. Edwina  , Conde Jose G.  , Dent Andrew  , Fadiel Ahmed  , Perry Theresa  , Tolk Chris  , Tcheng James E.  , Eisenstein Eric L.
Published: February 2025

Background: New data management models are emerging in multi-center clinical studies. We evaluated the incremental costs associated with decentralized vs. centralized models. Methods: We developed clinical research network economic models to evaluate three data management models: centralized, decentralized with local software, and decentralized with shared database. Descriptive information from three clinical research studies served as inputs for these models. Main Outcome Measures: The primary outcome was total data management costs. Secondary outcomes included: data management costs for sites, local data centers, and central coordinating centers. Results: Both decentralized models were more costly than the centralized model for each clinical research study: the decentralized with local software model was the most expensive. Decreasing the number of local data centers and case book pages reduced cost differentials between models. Conclusion: Decentralized vs. centralized data management in multi-center clinical research studies is associated with increases in data management costs.
Defining a Framework for Health Information Technology Evaluation
Authors: Eisenstein Eric L.  , Juzwishin Don  , Kushniruk Andre W.  , Nahm Meredith
Published: February 2025

Governments and providers are investing in health information technologies with little evidence as to their ultimate value. We present a conceptual framework that can be used by hospitals, clinics, and health care systems to evaluate their health information technologies. The framework contains three dimensions that collectively define generic evaluation types. When these types are combined with contextual considerations, they define specific evaluation problems. The first dimension, domain, determines whether the evaluation will address the information intervention or its outcomes. The second dimension, mechanism, identifies the specific components of the new information technology and/or its health care system that will be the subject of the evaluation study. And, the third dimension, timing, determines whether the evaluation occurs before or after the health information technology is implemented. Answers to these questions define a set of evaluation types each with generic sets of evaluation questions, study designs, data collection requirements, and analytic methods. When these types are combined with details of the evaluation context, they define specific evaluation problems.
E-Learning for Occupational Physicians' CME: a Study Case
Authors: Mazzoleni M. Cristina  , Rognoni Carla  , Finozzi Enrico  , Gri Tommaso  , Pagani Marco  , Imbriani Marcello
Published: February 2025

The present study reports the results of the evaluation of an e-learning CME course in the field of Occupational Medicine. In particular the following aspects have been investigated: If and how the course contents have met the educational users' needs; The effectiveness of the course in terms of knowledge improvement; Users' behaviour. Attendance data and results of a sample of 1128 attendees have been analyzed via ad hoc developed tools for direct inspection of Moodle CMS database. The results document the effectiveness of the e-learning course, as regards meeting the educational needs of physicians and also the improvement in terms of knowledge and problem solving skill acquisition. Users' behaviour has revealed a certain tendency for passing the tests, more than for pursuing the best possible result. Interaction with the tutor is low.
“Initiate-Build-Operate-Transfer” – A Strategy for Establishing Sustainable Telemedicine Programs Not Only in the Developing Countries
Authors: Latifi Rifat
Published: February 2025

Establishing sustainable telemedicine has become a goal of many developing countries around the world. Yet, despite initiatives from a select few individuals and on occasion from various governments, often these initiatives never mature to become sustainable programs. The introduction of telemedicine and e-learning in the Balkans has been a pivotal step in advancing the quality and availability of medical services in a region whose infrastructure and resources have been decimated by wars, neglect, lack of funding, and poor management. The concept and establishment of the International Virtual e-Hospital (IVeH) has significantly impacted telemedicine and e-health services in Kosova. The success of the IVeH in Kosova has led to the development of similar programs in other Balkan countries and other developing countries in the hope of modernizing and improving their healthcare infrastructure. A comprehensive, four-pronged strategy developed by IVeH “Initiate-Build-Operate-Transfer” (IBOT), may be a useful approach in establishing telemedicine and e-health educational services not only in developing countries, but in developed countries. The development strategy, IBOT, used by the IVeH to establish and develop telemedicine programs is described. IBOT includes assessment of healthcare needs of each country, the development of a curriculum and education program, the establishment of a nationwide telemedicine network, and the integration of the telemedicine program into the very core of healthcare infrastructure. The end point is the transfer of a sustainable telehealth program to the nation involved. By applying IBOT, a sustainable telemedicine program of Kosova and Albania has been established as an effective prototype for telemedicine in the Balkans. Once fully matured, the program is transitioned to the Ministry of Health, which ensures the sustainability and ownership of the program. Similar programs are being established in Macedonia, Montenegro and other countries around the world. The IBOT model has been effective in creating sustainable telemedicine and e-health integrated programs in the Balkans and may be a good model for establishing such programs in developing countries.
Control Over the Virtual Environment Influences the Presence and Efficacy of a Virtual Reality Intervention on Pain
Authors: Gutiérrez-Martínez Olga  , Gutiérrez-Maldonado José  , Loreto-Quijada Desirée
Published: February 2025

The main aim of this study is to investigate whether the control the user has over a virtual environment (VE) influences the sense of presence. A secondary purpose is to explore the relationship between Virtual Reality (VR) presence and pain tolerance during a cold-pressor experience. Ninety-four participants underwent two consecutive cold-pressor trials, one without VR exposure and the other providing a VR stereoscopic figure used as a symbolic representation of the sensation of pain. Participants were randomly assigned to an interactive condition in which they could actively manipulate the VR figure to achieve a pleasant, tranquil environment (analogous to no-pain situation) or to a passive intervention, in which they observed the changes in the VR figure. Results showed that the amount of VR presence reported was significantly higher in the interactive condition. Participants had a higher pain tolerance during both VR conditions than in the no-VR trial, with a greater increase in pain tolerance from the non-VR trial in the interactive condition. Presence scores correlated significantly and positively with pain tolerance scores. We discuss the importance of VR interaction and control over the VR environments used in VR pain interventions designed to increase cognitive control over pain.
A Comparison of Client Characteristics in Cyber and In-Person Counseling
Authors: Murphy Lawrence  , Mitchell Dan  , Hallett Rebecca
Published: February 2025

As cybertherapy diversifies into a wide variety of modalities, it is incumbent upon researchers and clinicians to determine the most suitable cybertherapy approach for clients. Suitability encompasses ethical considerations, client satisfaction, and treatment outcomes. The authors, working with an Employee and Family Assistance Program provider based in Canada, provided text-based e-mail counseling (cybercounseling) to clients across the country. Cybercounseling was accessible to clients through the same avenues as in-person counseling. Clients self-selected either cybercounseling or in-person counseling at intake. For the purposes of this study, data from 211 clients have been collected, including 105 online and 106 in-person clients. Client demographic data including age, gender, presenting problem, referral source and marital status were collected for each client. Comparing the cyber and in-person client data provides insights into the similarities and differences between cyber and in-person client groups.
Design of Hazardous Waste Landfill Liners: Current Practice in South Africa
Authors: Nortjé Riva  , Brink Danie  , Shamrock Jonathan  , Johns David  , Msiza Jabulile
Published: February 2025

A hazardous waste landfill can be regarded a complex system, with many components that contribute to the overall environmental performance of the facility. These include access control, waste containment, drainage systems, operations, gas management systems, and so forth. Of these components, the landfill liner is the first line of defense against long-term environmental contamination. While the requirements for and behavior of compacted clay liners (CCLs) are generally known, the geosynthetic components of hazardous landfill liners also require understanding and informed design. This paper considers issues currently considered in hazardous waste landfill liner design in South Africa, including sub-soil drainage requirements, desiccation, chemical compatibility issues, slope stability issues, and leachate collection requirements. It is noted that this paper cannot be considered to be exhaustive, given its brevity.
Synchronised Integrated Online E-Health Profiles
Authors: Liang Jian  , Iannella Renato  , Sahama Tony
Published: February 2025

Web-based social networking applications have become increasingly important in recent years. The current applications in the healthcare sphere can support the health management, but to date there is no patient-controlled integrator. This paper proposes a platform called Multiple Profile Manager (MPM) that enables a user to create and manage an integrated profile that can be shared across numerous social network sites. Moreover, it is able to facilitate the collection of personal healthcare data, which makes a contribution to the development of public health informatics. Here we want to illustrate how patients and physicians can be benefited from enabling the platform for online social network sites. The MPM simplifies the management of patients' profiles and allows health professionals to obtain a more complete picture of the patients' background so that they can provide better health care. To do so, we demonstrate a prototype of the platform and describe its protocol specification, which is an XMPP (Extensible Messaging and Presence Protocol) [1] extension, for sharing and synchronising profile data (vCard2) between different social networks.
Full scale failure test on a railway embankment; extensive instrumentation and real time monitoring
Authors: Mansikkamäki J.  , Lehtonen V.  , Länsivaara T.  , Luomala H.
Published: February 2025

Tampere University of Technology and the Finnish Transport Agency conducted a full scale stability test on an old railway embankment in October 2009. Though the subsoil consisted of very soft and sensitive clay, the diverse instrumentation gave a lot of valuable information about the capacity and performance of different instrumentation equipments in general. Measurements included pore water and earth pressure gauges, automatic inclinometers, different displacement measurements and laser scanners. The measurement frequency varied from 1 s to 2 min depending on needs and the equipment. A selection of measured data was also plotted to visual curves in real-time. The instrumentation was extensive, containing about 300 separate points with various instruments. Loading was increased in less than 36 hours from 0 kPa to 87 kPa (218 kN/m), with failure occurring two hours after the loading ended. Deformations and pore pressures began to increase exponentially after the loading had ended due to time dependent behavior and strain-softening of the clay. In hard soils the development of displacements can be even more fragile and unexpected. Even though all the monitoring instruments responded accurately, some differences between instruments were recognized. Therefore the test gave valuable information considering the importance of measuring intervals, correct assumptions of limiting values of measuring variables and information regarding the effective placement of the instruments. These issues are in key position when monitoring is used to reduce geotechnical safety risks.
Adhesion measurements on conditioned clays
Authors: Zumsteg R.  , Plötze M.  , Puzrin A.M.  , Egli H.  , Walliser A.
Published: February 2025

Tunneling in soft soils with EPB-TBM method is often being extended to clayey soils with medium to high plasticity and susceptible to clogging or sticking. Safe and economic tunneling in these soils is not possible without addition of chemicals, e.g. foams and polymers. Their use can lead to reduction of clogging potential and torque moment of the machine. The quantitative and qualitative effects of the chemicals on the mechanical parameters of the soils are not, however, understood in detail at this stage. In this paper a new measurement device is introduced, which allows the sliding resistance between clay pastes with soft consistency and a metal plate to be measured at different pressure states occuring in the pressure chamber of an EPBM. Initial test results show that the used polymer and foam are acting as lubricants, decreasing shear strength and sliding resistance of the mixtures at soft consistencies. Additionally the type of clay mineral is shown to be an important parameter influencing the efficiency of the used chemicals.
A Comparison of Internal Versus External Risk-Adjustment for Monitoring Clinical Outcomes
Authors: Koetsier Antonie  , De Keizer Nicolette  , Peek Niels
Published: February 2025

Internal and external prognostic models can be used to calculate severity of illness adjusted mortality risks. However, it is unclear what the consequences are of using an external model instead of an internal model when monitoring an institution's clinical performance. Theoretically, using an internal prognostic model is preferred while external models are often more widely available. In this simulation study we explored the difference between the use of internal and external models on the degree and types of warning signals given by RA-EWMA control charts in the detection of increasing mortality in the ICU. Increases in mortality were correctly detected in 60% of cases (after 24 months) with the internal model, regardless of prior ICU performance. When using the external risk adjustment model, such increases were only detected for the average and poor performing ICUs. When the mortality rate was held constant, using the external model resulted in many incorrect warning signals. We conclude that the use of internal risk-adjustment models is preferable for monitoring clinical performance.
Next Steps in Evaluation and Evidence – from Generic to Context-Related
Authors: Rigby Michael  , Brender Jytte  , Beuscart-Zephir Marie-Catherine  , Hyppönen Hannele  , Nykänen Pirkko  , Talmon Jan  , de Keizer Nicolette  , Ammenwerth Elske
Published: February 2025

Introduction: E-health systems are increasingly important and widespread, but their selection and implementation are still frequently based on belief, rather than scientific evidence, and adverse effects are not systematically addressed. Progress is being made in promoting generic evaluation methodologies as a source of scientific evidence, but effort is now needed to consider methods for special situations. Method: Review of five evaluation contexts - national e-health plans, telemedicine, Health Informatics 3.0, usability and economics. Conclusion: Identification of requirements for approaches to be developed in these five settings.
Safe Storage and Multi-Modal Search for Medical Images
Authors: Kommeri Jukka  , Niinimäki Marko  , Müller Henning
Published: February 2025

Modern hospitals produce enormous amounts of data in all departments, from images, to lab results, medication use, and release letters. Since several years these data are most often produced in digital form, making them accessible for researchers to optimize the outcome of care process and analyze all available data across patients. The Geneva University Hospitals (HUG) are no exception with its daily radiology department's output of over 140'000 images in 2010, with a majority of them being tomographic slices. In this paper we introduce tools for uploading and accessing DICOM images and associated metadata in a secure Grid storage. These data are made available for authorized persons using a Grid security framework, as security is a main problem in secondary use of image data, where images are to be stored outside of the clinical image archive. Our tool combines the security and metadata access of a Grid middleware with the visual search that uses GIFT.
A Novel Way of Standardized and Automized Retrieval of Timing Information along Clinical Pathways
Authors: Gattnar Eva  , Ekinci Okan  , Detschew Vesselin
Published: February 2025

Improving the effectiveness and efficiency of acute healthcare is very important nowadays. Optimization of clinical pathways regarding quality, time and costs is one of the key management strategies of critical diseases such as heart attack and stroke. To identify workflow bottlenecks requires a thorough understanding about both the hospital environment (e.g. IT-systems) and processes (e.g. clinical pathways). Having in mind the interoperability issues in hospitals, the standardized division- and system-crossing time measurement is still a challenge. Therefore this paper presents a novel way of structured and standardized retrieval of timing information along the clinical pathway of time-critical diseases in the context of hospital IT-systems, which represents a promising opportunity to identify workflow bottlenecks over several departmental and system borders.
A KPI Framework for Process-based Benchmarking of Hospital Information Systems
Authors: Jahn Franziska  , Winter Alfred
Published: February 2025

Benchmarking is a major topic for monitoring, directing and elucidating the performance of hospital information systems (HIS). Current approaches neglect the outcome of the processes that are supported by the HIS and their contribution to the hospital's strategic goals. We suggest to benchmark HIS based on clinical documentation processes and their outcome. A framework consisting of a general process model and outcome criteria for clinical documentation processes is introduced.
Personal Health Data: Patient Consent in Information Age
Authors: Martinovic Dragana  , Ralevich Victor  , Petkovic Milan
Published: February 2025

In this paper we report on findings related to treatment of patient consent in various circumstances and geographic domains; explore transfer of health data between custodians and geo-political entities; and emphasize importance of educating general public about issues related to handling health data. A specific set of questions about consent/legislation and related issues in the Canada, the USA and the EU are addressed in an attempt to answer them systematically. This comparison identifies similarities and differences along a set of dimensions.
Precision tunneling in the vicinity of World Heritage Properties in Barcelona
Authors: Kurze S.
Published: February 2025

As a part of the new Spanish high speed railway line (AVE) connecting Madrid, Barcelona and the French border, currently a tunnel with a length of 5.6 km is built under the city centre of Barcelona. The tunnel line passes directly next to the famous church of Sagrada Familia and a building called “Casa Milà”. Both buildings belong to the World Heritage Properties of the UNESCO. To ensure the highest possible safety for these extraordinary historical buildings special requirements in control and construction had to be fulfilled during the tunnelling process. The tunnel is built with a tunnel-boring machine using an earth pressure balanced shield. The church of Sagrada Familia and Casa Milà have already been passed. The maximum measured settlements of Sagrada Familia and Casa Milà induced by the tunnel construction were in the range of the measurement accuracy. Some of the extensive data of the geotechnical and geodetic monitoring is presented focusing on possible influencing factors for the evolution respectively the prevention of surface settlements.
Heat transfer experiments in porous media under induced viscosity and density variations
Authors: Saeid S.
Published: February 2025

The present work analyses the effects of temperature-induced density and viscosity changes on convective flow and heat transfer in saturated porous media. Attention is given to forced convection in sand in the vicinity of hydraulic-impermeable but heat conducting boundaries. A test setup with three saturated layers of clay-sand-clay was made in order to measure and understand the temperature-induced density and viscosity effects together with forced convection on the heat transfer phenomenon. Tests results show preferential flow paths in the sand layer depending on the situation. Under constant pressure gradient significant discharge variations are noticed, mainly due to viscosity effects and to a lesser part due to density changes.
Optimization of the numerical modeling utilization for the design of underground structures
Authors: Vydrová L.  , Veselý J.
Published: February 2025

There is a very significant boom of the tunneling industry in the Czech Republic and generally worldwide in recent years. The main reason is the lack of space on surface in major cities together with requirements for faster traffic connections. Therefore a very significant number of tunnels are either under construction or in the design stage. The recent rapid increase in the capability of computers and user-friendly software has led to a proliferation in the use of numerical analyses in design of underground structures. One important fact is often overlooked. No matter how sophisticated a numerical model is, it is only an approximation of the real situation. The presented paper deals with the optimization of numerical modeling for underground structures. The results of research, which we are working on, should be recommendations for designers of underground constructions using numerical modeling with regard to the application of software and input data. Due to the scope the paper is divided into several parts. The first part is devoted to introduction into current problems. The second part discusses influence of non-linear material model on precision of analyses of tunnels in clays. The last part is devoted to the experience with numerical modeling of underground structures in Prague.
Valuing Capacity In Air Transportation
Authors: Collopy Paul D.
Published: February 2025

The most significant benefits to the European and North American air traffic management modernization programs will be an increase in system capacity for scheduled passenger air transportation. Understanding the value of capacity increases is essential in order to make the right choices investing in and designing these systems. This paper provides a simple, transparent, rigorous model of the value of air transportation capacity with example applications.
Can we still dream?
Authors: de Graaff Ad
Published: February 2025

Air transport operations and aircraft design development is currently governed by incremental improvements. Only once in 16 years there is a step change in civil aviation, often as a result of external factors like military developments. Seldom are step changes due to business or technological developments within the system itself. The introduction of low cost carriers is one of the few examples of novel thinking within the sector. However the concept of airports has not changed since the 1930s, air traffic management is still based on concepts out of the same year, new aircraft look like the first generation of civil jets etc. Is the sector mature and do we still need technological research that is governed by the law of diminishing returns? Can the sector find answers to new challenges that lay ahead? Just to mention a few: environmental pressures often leading to curtailing of air transport; the availability, accessibility and pricing of oil; scarce materials; focus on customer orientation and multi modal solutions; competition from new countries like China and India that experience high growth rates and can spend far more money to become leading aviation countries. Are we looking for creative solutions for long term problems and are we stimulating the younger generation to think out of the box to enable a totally different air transport system in 2050? Initial analysis shows that the education systems do not sufficiently stimulate creative thinking of the new generation. During the EU sponsored Out of the Box and CREATE projects the author together with Trevor Truman experimented with mechanisms to stimulate creative thinking through dedicated workshops. The results were encouraging although perhaps 1% of all ideas generated seem to be promising in the end. These ideas relate to both the overall air transport system, the different elements of that system and breakthrough technologies. The CREATE project recommended to the European Commission to continue the initiatives to generate novel ideas and to enable funding of the most promising ones. And the Commission is willing to follow up this suggestion by funding research. New ideas need to be formulated. These do not always need to be fundamentally new, but can be based on ideas from the past that were not followed up for example due to the limited technological knowledge at the time of invention. Humans resist and are afraid of change. An example is the idea of air taxi operations in Europe developed together with the TU Delft. Instead of emphasizing the possible benefits, people will stress the possible negative elements and hope that nothing will change. Whilst using the argument of safety, many novel ideas are killed at an early stage. In that sense, regulation is a barrier for innovation. There is a need to intensify the search for novel ideas. Universities will have a major task in this process as the industry and research establishments are more and more short term oriented. Creative thinking processes will therefore need to be a permanent element of the university curricula.
Benchmarking the Efficiency of Terminal Processes at Regional Airports
Authors: Martens Roel
Published: February 2025

The goal of the research on which this paper reports, is to develop a benchmarking tool to provide the regional airport management with a means to quantify the efficiency of their terminal processes against other similar airports and that identifies processes or components of processes that are in need of improvement. This way the airport management is provided with an external optimization path in their aim to optimize the efficiency of their processes. Literature and industry expert opinions are used to define the set of input and output efficiency drivers for each process, from which the Key Efficiency Indicators (KEI) are derived. The KEI is introduced to emphasize the efficiency and daily operations driven approach of the tool, excluding strategic management decisions on cost or quality of the processes that may influence the efficiency of the processes. The benchmarking tool is constructed using partial fraction analysis on KEI level and surface measure of overall performance (SMOP) is used on a process level to benchmark the total efficiency per process. The tool is used to evaluate the efficiency of the terminal processes at three regional airports during peak time and at an annual level. The first results from the tool indicate that benchmarking operational efficiency across airports is indeed valuable in identifying strategic improvement areas.
The influence of cementation in the critical state behaviour of artificial bonded soils
Authors: Cruz Nuno  , Rodrigues Carlos  , Viana da Fonseca António
Published: February 2025

Cemented soils are often seen as problematic materials, since they don't fit into the usual behaviour of transported soils. The accumulated experience in saprolitic residual soils of Portuguese granitic formations (Viana da Fonseca, 1988, 1996, in silty sands, and Rodrigues, 2003, in coarser granular soils) have pointed out to the possibility of working a critical state framework, aiming to define adequate models to characterize these naturally cemented soils. More recently, integrated in a PhD program (Cruz, 2010), a specific study on the applicability of critical state approach to artificially cemented soils, remoulded from the same coarse granitic soils studied by Rodrigues, was pursued. This involved an extensive laboratorial testing program performed over these mixtures with distinct cement contents. Overall, 40 unconfined, diametral and triaxial (CID) compressive tests were executed in samples mixed with different types of cement and percentages. The obtained results revealed the presence of different critical state lines (CSL) varying with cement content, suggesting a significant complexity to predict the ultimate state, as well as distinct behaviours for uncemented and cemented materials.
Mechanical behavior of blended geo-materials for impermeable core zone of small earth-fill dams using recycled materials
Authors: Toshinori Kawabata  , Mariko Suzuki  , Kazunori Uchida  , Takeshi Suzuki
Published: February 2025

Japan has 210,000 earth-fill dams and many of them are located in the Hyogo prefecture. They have distinct zones of dissimilar material, a watertight clay core. The suitable soil materials of impermeable core zone are very important; nevertheless it is difficult for us to secure them near the dam site. It becomes expensive to reconstruct an old earth-fill dam, because the suitable soil materials have to be borrowed in from some distance. In addition, these earth-fill dams have large deposit of muddy soil in the reservoir. Such muddy soil reduced the volume of water kept in the reservoir and declined the quality of water. Though the muddy soil have to be removed, it is not easy to dispose it because of the high moisture content. In this paper, we proposed the using of the soil for impermeable core zone, using materials that should be recycled. It is necessary to be said that the material is not only low cost but also mechanically stable and environmentally friendly. Therefore, we made decision regarding the best mixture proportion based on the results of unconfined compression, and permeability tests.
NEW TECHNOLOGIES FOR FUNCTIONAL NEUROMUSCULAR STIMULATION
Authors: Loeb Gerald E.  , Hood Kevin
Published: February 2025

It is rapidly becoming possible to reanimate a paralyzed limb by applying wellcontrolled electrical stimulation to multiple nerves and muscles. However, fitting the technology to a particular patient with a particular disability now requires a large number of measurements, observations and decisions that are beyond the capabilities of most clinical rehabilitation environments. Fortunately, there are parallel technological advances in four key supporting areas - noninvasive morphometry, motion analysis, graphical user interfaces, and automated kinetic analysis - that may make this problem tractable, but only if they can be harnessed into complete, user-friendly clinical systems.