bluuebunny/crossref_metadata_2025 huggingface dataset:
Team Work based Care in Speech and Language Therapy through Web-based Tools and Methods
Authors: Glykas Michael  , Chytas Panagiotis
Published: February 2025

Speech and language therapists (SLTs) are faced daily with a diversity of speech and language disabilities, which are associated with a variety of conditions ranging from client groups with overall cognitive deficits to those with more specific difficulties. It is desirable that those working with such a range of problems and with such a demanding workload, plan care efficiently. Therefore, the introduction of methodologies, reference models of work and tools, which significantly improve the effectiveness of therapy, are particularly welcome. This paper describes the first web-based tool for diagnosis, treatment and e-Learning in the field of Language and Speech therapy. The system allows SLTs to find the optimum treatment for each patient, it also allows any non - specialist user - SLT, patient or helper (relative etc.) - to explore their creativity, by designing their own communication aid in an interactive manner, with the use of editors such as: configuration and vocabulary. The system has been tested and piloted by potential users in Greece and the UK.
Putting E-government to Work in Healthcare Environment: a Multiregional Project Funded by the Italian Innovation & Technology Ministry
Authors: Ballardini Luigi  , Germagnoli Fabio  , Pagani Marco  , Picchi Marco  , Stoppini Andrea  , Cristiani Paolo
Published: February 2025

In 2002, the Italian Ministry of Innovation promoted a national bid for e-government projects. Specifically it allocated a budget of 120M$\euro$. One of the four project approved in healthcare sector was the “Information, Care (“Assistenza” in italian) and healthcare Education by the Web” (IAEW), with a global budget of 2580 k$\euro$, partially financed by Ministry with a quota of 830 k$\euro$. The project involves 12 medical structures (both national excellences centers and local regional hospitals) located in two different Region of North Italy, dealing with two different healthcare regional systems (Lombardia and Emilia-Romagna), with potentially 3 millions of users.
Conceptual Framework of Health Indicators: The IDA Model
Authors: Surjän György  , Szilágyi Éva  , Kováts Tamás  , Kincses Gyula
Published: February 2025

This paper presents a flexible conceptualframework for public health indicator databases. The model is a multidimensional-hierarchical representation of statistical data describing health and health influencing factors. The main characteristics of the IDA model are the strong discrimination of concepts (categories of entities enumerated in statistical systems) and dimensions (aspects that divide categories). Top level concepts of known data sources (WHO HFA database, OECD Health Data and ECHI) have been compared and a generalized structure had been created which can represent easily and consistently all the top level concepts of the known data sources. The model has been implemented in a prototype system, which demonstrates the feasibility of the approach.
Potential Impact of Advanced Clinical Information Technology on Healthcare in 2015
Authors: Sittig Dean F.
Published: February 2025

Clinical information technologies now sporadically available will soon be in routine clinical use, bringing many changes to healthcare. For example, 1) The next generation Internet; 2) Real-time clinical decision support systems; 3) Off-line, population-based systems; 4) Large, integrated, individual patient-level phenotypic and genotypic databases with intelligent data mining capabilities; 5) Wireless, invasive and non-invasive physiologic monitoring devices; 6) Natural Language Processing (NLP) systems; and 7) Mathematical models ofcomplex biological systems have the potential to impact significantly the future healthcare delivery system. While new information management and communication techniques and technologies will reduce many of the inefficiencies and inaccuracies of our present systems, there will be an equal, and potentially far more dangerous, set of unintended consequences. Informatics investigators and health system administrators must focus on the study of what is working and what is not, as well as, on development and testing of the new clinical information management and communication technologies, if we are to be ready for the future.
Safe introduction of in-hospital wireless LAN
Authors: Hanada Eisuke  , Hoshino Yasushi  , Kudou Takato
Published: February 2025

Insufficient research on electromagnetic interference (EMI) with medical electronic equipment by the signals of wireless LAN has been done. Therefore, electromagnetic compatibility between medical electronic equipment and wireless LAN data communications was done (IEEE802.11 a, b, and g).
Patterns of Usage for a Web-Based Clinical Information System
Authors: Chen Elizabeth S.  , Cimino James J.
Published: February 2025

Understanding how clinicians are using clinical information systems to assist with their everyday tasks is valuable to the system design and development process. Developers of such systems are interested in monitoring usage in order to make enhancements. System log files are rich resources for gaining knowledge about how the system is being used. We have analyzed the log files of our Web-based clinical information system (WebCIS) to obtain various usage statistics including which WebCIS functions are frequently being used. We have also identified usage patterns, which convey how the user is traversing the system. We present our method and these results as well as describe how the results can be used to customize menus, shortcut lists, and patient reports in WebCIS and similar systems.
Scenario-based Assessment of Physicians’ Information Needs
Authors: Seol Yoon-Ho  , Kaufman David R.  , Mendonça Eneida A.  , Cimino James J.  , Johnson Stephen B.
Published: February 2025

Physicians' information needs routinely arise during their practice. Several studies have demonstrated that a useful way to understand the nature of the needs is to examine questions posed by physicians during the course of medical care. This paper presents an analysis of clinical questions collected when physicians were engaged in reviewing clinical cases. The main objective of the study was to investigate characteristics of the physicians' information needs to provide insight into the development of a conceptual guidance approach in information retrieval. The analysis focused on categories, search contexts, and patterns of the questions with respect to the scenarios. The results of the study showed that physicians’ information needs exhibited distinct characteristics according to the scenarios, and that their needs could be expressed with a relatively small number of question patterns. These observations supported our approach of using patterns of information needs in facilitating digital information access.
Really, Is Medical Sublanguage That Different? Experimental Counter-evidence from Tagging Medical and Newspaper Corpora
Authors: Wermter Joachim  , Hahn Udo
Published: February 2025

We compare the performance of two part-of-speech taggers trained on a German newspaper corpus for mixed types of medical documents. TnT, a tagger based on a statistical language model, outperforms Brill’s rule-based tagger, and supplied with additional lexicon resources matches state-of-the-art performance figures (close to 97% accuracy) on the medical corpus. We explain this unexpected result by focusing on the statistically significant part-of-speech type overlap between the newspaper training set and the medical test set. At least at that level, sublanguage differences seem to vanish. Thus, statistical off-theshelf part-of-speech taggers can immediately be reused for medical language processing.
Electronic Medical Records in Solo/Small Groups: A Qualitative Study of Physician User Types
Authors: Miller Robert H.  , Sim Ida  , Newman Jeff
Published: February 2025

Background. There is growing recognition that physician use of electronic medical records (EMRs) is critical for improving quality of care in outpatient settings. Methods: We interviewed EMR physician champions from 20 solo/small group practices to understand different types of EMR users and their EMR-related costs and benefits. Results: Interviewees differed greatly in the EMR-related benefits they generated. These differences were associated with how they used the EMR, and the amount of effort they invested in making changes to complement EMR use. We defined five types of physician EMR users: Viewers, Basic Users, Strivers, Arrivers, and System Changers. The majority of interviewees were Strivers and Arrivers, physicians who have already invested substantial time in numerous process changes that help generate EMR-related benefits. Conclusions: Incentives and comprehensive support services for facilitating complementary process changes could be important for moving physicians from one user group to another. Additional research is needed to verify this user typology and to further define the relationship between user types and EMR-generated financial and quality benefits.
Enhancing Access to the Bibliome: The TREC Genomics Track
Authors: Hersh William  , Bhupatiraju Ravi Teja  , Corley Sarah
Published: February 2025

The growing amount of scientific discovery in genomics and related biomedical disciplines has led to a corresponding increase in the amount of on-line data and information. A new challenge for biomedical researchers has been how to access and manage this ever-increasing quantity of information. The Text Retrieval Conference (TREC) has implemented a Genomics Track to create an experimental environmentfor research in the use of information retrieval systems in the genomics domain. In the first year of the track, an ad hoc document retrieval task and an information extraction task were carried out by 29 research groups. Future work will focus on more complex data sources, searching tasks, and types of experiments.
Assessing Readability of Consumer Health Information: An Exploratory Study
Authors: Gemoets Darren  , Rosemblat Graciela  , Tse Tony  , Logan Robert
Published: February 2025

Researchers and practitioners frequently use readability formulas to predict the suitability of health-related textsfor consumers (e.g., patient instructions, informed consent documents). However, the appropriateness of using readability formulas—originally developed for students and educational texts—for lay audiences and health-related texts remains to be validated. In this exploratory study, we compared two methods of assessing the readability of consumer health materials: the Cloze procedure, using actual readers, and readability formulas, using our Readability Analyzer program. A statistically significant inverse correlation (r = -0.581, p = 0.01) was found, suggesting that the Readability Analyzer may provide a reasonable “first approximation” for predicting readability of consumer health texts. We also identified several linguistic factors associated with increased reading ease as candidates for improving the performance of the Readability Analyzer. Our ultimate objective is to develop tools to support the design and evaluation of health information that is comprehensible and accessible to laypersons.
Helping Healthcare Consumers Understand: An “Interpretive Layer” for Finding and Making Sense of Medical Information
Authors: Soergel Dagobert  , Tse Tony  , Slaughter Laura
Published: February 2025

Healthcare consumers need to find, comprehend, and interpret health information before making informed decisions. Recent work by others and our own work suggest that mismatches in representations of health information used by consumers and professionals occur at different levels of knowledge representation, such as terminology (i.e., form or surface structure and concept or meaning) and semantic relationships. A challenge for consumer health informatics research is to devise a comprehensive strategy to bridge the gap between consumer understanding and biomedical knowledge at all levels. We propose a framework to inform the design of an “interpretive layer” to “mediate” between lay (illness model) and professional (disease model) perspectives, at all levels. In our view, the goal is to assist consumers in identifying terms to describe their needs, finding and understanding relevant information, and applying that knowledge for informed healthcare decision making.
Enhancing Medical Communication Training Using Motion Capture, Perspective Taking and Virtual Reality
Authors: Alexandrova Ivelina V.  , Rall Marcus  , Breidt Martin  , Tullius Gabriela  , Kloos Uwe  , Bülthoff Heinrich H.  , Mohler Betty J.
Published: February 2025

The aim of this work is to increase the effectiveness of real world medical training simulations by helping trainees gain a better understanding of the importance of communication and teamwork. Therefore we develop an online application which can be used together with real world simulations to improve training. To produce the online application we reconstructed two real world scenarios (one with students and one with practitioners) in an immersive virtual environment. Our application enables the trainees to view the scenario from different perspectives or to freely explore the environment. We aim to integrate it into the medical student curriculum at the University of Tübingen.
AMILab Software: Medical Image Analysis, Processing and Visualization
Authors: Krissian Karl  , Santana-Jorge Francisco  , Santana-Cedrés Daniel  , Falcón-Torres Carlos  , Arencibia Sara  , Illera Sara  , Trujillo Agustín  , Chalopin Claire  , Alvarez Luis
Published: February 2025

AMILab is a free software for image analysis, processing and visualization. It provides convenient visualization tools for 2D and 3D images and it is highly extensible through its own scripting language. We describe the main visualization features and the scripting language of AMILab. The software includes an automatic C++ wrapping system which permits fast development of new visualization tools and image processing algorithms.
Moving Past Normal Force: Capturing and Classifying Shear Motion Using 3D Sensors
Authors: Kwan Calvin  , Salud Lawrence  , Ononye Chiagozie  , Zhao Shenshen  , Pugh Carla
Published: February 2025

In our previous research, we used clinical breast examination models instrumented with direct (normal) force sensors for training and assessment. A weakness of the normal force sensors is the ability to delineate, in detail, all of the performance measures we wish to understand. This study incorporated the use of newly developed shear force sensors to extend a framework for quantifying hands-on performance.
STRIVE: Stress Resilience In Virtual Environments: A Pre-Deployment VR System for Training Emotional Coping Skills and Assessing Chronic and Acute Stress Responses
Authors: Rizzo Albert  , Buckwalter J. Galen  , John Bruce  , Newman Brad  , Parsons Thomas  , Kenny Patrick  , Williams Josh
Published: February 2025

The incidence of posttraumatic stress disorder (PTSD) in returning OEF/OIF military personnel is creating a significant healthcare challenge. This has served to motivate research on how to better develop and disseminate evidence-based treatments for PTSD. One emerging form of treatment for combat-related PTSD that has shown promise involves the delivery of exposure therapy using immersive Virtual Reality (VR). Initial outcomes from open clinical trials have been positive and fully randomized controlled trials are currently in progress to further validate this approach. Based on our research group's initial positive outcomes using VR to emotionally engage and successfully treat persons undergoing exposure therapy for PTSD, we have begun development in a similar VR-based approach to deliver stress resilience training with military service members prior to their initial deployment. The Stress Resilience In Virtual Environments (STRIVE) project aims to create a set of combat simulations (derived from our existing Virtual Iraq/Afghanistan exposure therapy system) that are part of a multi-episode narrative experience. Users can be immersed within challenging combat contexts and interact with virtual characters within these episodes as part of an experiential learning approach for training a range of psychoeducational and cognitive-behavioral emotional coping strategies believed to enhance stress resilience. The STRIVE project aims to present this approach to service members prior to deployment as part of a program designed to better prepare military personnel for the types of emotional challenges that are inherent in the combat environment. During these virtual training experiences users are monitored physiologically as part of a larger investigation into the biomarkers of the stress response. One such construct, Allostatic Load, is being directly investigated via physiological and neuro-hormonal analysis from specimen collections taken immediately before and after engagement in the STRIVE virtual experience.
A Simulation Framework for Tool Tissue Interactions in Robotic Surgery
Authors: Sankaranarayanan Ganesh  , Arikatla Venkata Sreekanth  , De Suvranu
Published: February 2025

Robotic surgery is preferred over other traditional methods due to reduced complications and improved ergonomics for the operating surgeon. They are also a perfect platform for telesurgery. Automated surgery in which the robot is allowed to do various surgical tasks with minimal intervention is getting wider attention recently. In this paper, we introduce a simulation framework that can realistically simulate tool tissue interactions in robotic surgery, which can be used to design and test various control methodologies for automated surgical tasks. We present preliminary results from simulating a simple model of a surgical robot interacting with a volumetric model while performing a grasping and hold task.
Assessment of Laparoscopic Surgical Skill Acquisition and Retention
Authors: Skinner Anna  , Lathan Corinna
Published: February 2025

Currently, a need exists for a more comprehensive understanding of the nature of laparoscopic surgical skill acquisition and decay; novel, objective metrics with which to assess these skills over time; and simulation-based training that supports rapid acquisition, longitudinal retention, and targeted retraining for sustainment of these critical and perishable skills. This pilot study examined traditional metrics of laparoscopic surgical skills training, as well as a novel motion tracking metric using an instrumented glove. Data were compared for PreTest, PostTest following training to specified proficiency levels, and ReTest following an 8-10 week retention period, as well as comparison to expert performance. Despite a small number of complete data sets (n=5 novice, n=1 expert), these preliminary results demonstrate a lack of sensitivity of the current manual skills assessment metrics and demonstrate initial technical feasibility for the development of novel objective metrics based on instrumented glove motion tracking data.
Use of a Malleable Bougie and Curved Forceps with Videolaryngoscopy in Airway Management Training in a Cadaver Model – A Pilot Study
Authors: Wadman Michael  , Nicholas Thomas A.  , Bernhagen Mary A.  , Kuper Gail M.  , Miljkovic Nikola  , Schmidt Steven  , Massignan Jason  , Boedeker Ben H.
Published: February 2025

The wider angle of view of videolaryngoscopy versus standard direct laryngoscopy requires an assessment of the adjunctive devices used to facilitate intubation. In this study, subjects performed malleable bougie-assisted intubation and curved forceps removal of a glottic foreign body using videolaryngoscopy on a lightly embalmed cadaver and completed a post-procedure questionnaire. All subjects valued access to the malleable bougie available at their hospitals and 82% valued access to the curved forceps. Malleable bougie and curved forceps seem well-suited to facilitate videolaryngoscopic airway management.
A Decision Fusion Strategy for Polyp Detection in Capsule Endoscopy
Authors: Zhao Qian  , Dassopoulos Themistocles  , Mullin Gerard E.  , Meng Max Q.-H.  , Kumar Rajesh
Published: February 2025

Wireless capsule endoscopy (CE) is now routinely used for non-invasive diagnosis of small bowel diseases. But, it still requires manual assessment of the approximately 50,000 study images. Literature has recently investigated automated methods to detect and analyze various anomalies in CE images to improve reading efficiency and reduce variability. We propose such a computer aided diagnosis (CAD) approach to detect small bowel polyps. For supervised classification of polyps, we investigated fusing multiple statistical classifiers based on color, texture and edge features. The combined boosted classifier when evaluated using 1200 CE images outperformed all individual classifiers and achieved a ~90% classification accuracy.
Merging Genomic and Phenomic Data for Research and Clinical Impact
Authors: Shublaq Nour W.  , Coveney Peter V.
Published: February 2025

Driven primarily by advances in genomics, pharmacogenomics and systems biology technologies, large amounts of genomic and phenomic data are today being collected on individuals worldwide. Integrative analysis, mining, and computer modeling of these data, facilitated by information technology, have led to the development of predictive, preventive, and personalized medicine. This transformative approach holds the potential inter alia to enable future general practitioners and physicians to prescribe the right drug to the right patient at the right dosage. For such patient-specific medicine to be adopted as standard clinical practice, publicly accumulated knowledge of genes, proteins, molecular functional annotations, and interactions need to be unified and with electronic health records including phenotypic information, most of which still reside as paper-based records in hospitals. We review the state-of-the-art in terms of electronic data capture and medical data standards. Some of these activities are drawn from research projects currently being performed within the European Virtual Physiological Human (VPH) initiative; all are being monitored by the VPH INBIOMEDvision Consortium. Various ethical, legal and societal issues linked with privacy will increasingly arise in the post-genomic era. This will require a closer interaction between the bioinformatics/systems biology and medical informatics/healthcare communities. Planning for how individuals will own their personal health records is urgently needed, as the cost of sequencing a whole human genome will soon be less than U.S. $100. We discuss some of the issues that will need to be addressed by society as a result of this revolution in healthcare.
Lessons from the English National Programme for IT about Structure, Process and Utility
Authors: Swindells Matthew  , de Lusignan Simon
Published: February 2025

Sharing of health data though the effective deployment of information systems should allow safer and more efficient health systems. However, to date many large IT system deployments in health care have had major short comings. This paper critically appraises the UK National Programme for IT and suggests where there are important lessons of for other large scale eHealth projects. Our method combined the classic evaluation methods of Donnabedian with Pawson's realistic review to analyze the impact of the program at health service, locality or major provider, and client-service impact levels. Financial incentives promoted uptake and use of IT systems at all levels. Health service level interventions that were capable of incorporation into clinical workflow were used. These included: a national unique identifier, creation of national registries and electronic transfer of data, records, and results. At the regional and major provider level we identified how vendors offer very different electronic patient record (EPR) systems which influence what is recorded and health care delivery. Using the EPR at the point of care takes longer, but this investment of time creates a more usable record and facilitates quality. National IT systems need to be clinically orientated, patient accessible, and underpinned by a secure, standardized back office system that enables messaging and information sharing between authenticated users. Learning the lessons from the UK and other large system deployments might enable other countries to leap to the forefront of health care computing.
Implementation of the Recommendations in Master's Courses in Health Informatics
Authors: Mantas John
Published: February 2025

The publication of the International Medical Informatics Association revised version of the existing international recommendations in health informatics / medical informatics education was welcome positively by the educational community. The recommendations help to establish courses and complete programs in the field of Biomedical and Health Informatics (BMHI), to further develop existing educational activities in the various nations and to support international initiatives. The paper focuses on the Master's courses, which are the most widely established programs following the recommendations. The number of citations of the recommendations shows the worldwide acceptance. However, an in-depth review is recommended.
Future Application of Structural Use of Glass
Authors: Henriksen Thomas
Published: February 2025

The structural use of glass has been explored extensively over the last decade, especially with Apple stores where the boundaries for their application have been advanced significantly. This paper reviews the history and also the state of the art in the structural use of glass. The aim of this paper is to discuss a way forward in relation to glass as a structural material, so that future innovations are not driven solely by the ability to produce and laminate large pieces of glass. Future challenges lie in having a unified understanding of glass as a structural material, high-lighting current limitations when designing with structural glass in relation to current codes in different parts of the world. A continued dialogue on the wider applications of structural glass will advance the state-of the art beyond its current range of use.
MAAXIMUS – Delivering Innovation
Authors: Gaudin Jocelyn  , Herrmann Ralf
Published: February 2025

Even though composite materials are more and more used in modern airframes, many significant improvements are still achievable. The substitution of the assembly of many small composite parts by one-shot larger part may provide additional weight and recurring cost reduction by removing rivets and holes. Secondly, the final assembly line process must be adapted to composite properties (lack of ductility, stiffness) in order to secure a high assembly rate of composite sections and ensure a high production rate. At last, if the appropriate level of confidence and cycle time was available, Simulation-based design would provide a faster and less expensive path to find the optimal structures than the current development process, which relies on intensive physical test campaigns. MAAXIMUS was set up to explore composite solutions that go beyond traditional black metal approach.
Typical and Atypical AIS. Pathogenesis
Authors: Dudin M.  , Pinchuk D.
Published: February 2025

AIS hypothesis has the right to recognition, if it explains the transition of “healthy” vertebra column into status of “scoliotic” one. AIS is the most investigated disease in the history of orthopedics, but up the present time there is no clear explanation of some its phenomena: vertebra column mono-form deformation along with its poly etiology character, interrelation of its origin and development and child's growth process etc. The key for authors' view at AIS was scoliosis with non-standard (concave side) rotation. On the bases of its' multifunctional instrumental investigation results (Rtg, EMG, EEG, optical topography, hormonal and neuropeptides trials, thermo-vision methods and other) in comparison with typical AIS was worked out the new hypothesis, part of it is suggested for discussion. In the work under observation is the sequence of appearance of typical and atypical scoliosis symptomatology beginning from the preclinical stage.
Analysis of body growth parameters in girls with adolescent idiopathic scoliosis: single thoracic idiopathic scoliosis versus single lumbar idiopathic scoliosis
Authors: Liu Zhen  , Zhu Zezhang  , Guo Jing  , Mao Saihu  , Wang Weijun  , Qian Bangping  , Zhu Feng  , Chu Winnie  , Cheng Jack C.Y.  , Qiu Yong
Published: February 2025

Abnormal pattern of growth has been reported in adolescent idiopathic scoliosis (AIS) patients. However, the sequential changes of growth in different curve types of AIS have not been properly studied. The present study aimed to investigate the body growth characteristics of girls with single thoracic idiopathic scoliosis and lumbar idiopathic scoliosis in China. 339 AIS girls and 3914 healthy girls, aged 10~17yr, were included. All AIS girls had a mean Cobb angle of 32±10° (range 15~63°). According to the locations of curves end vertebrae, AIS girls were divided into 2 subgroups: a single thoracic curve and a single lumbar curve. Body weight and standing height was measured, and body mass index (BMI) and leg length was calculated of each subject in three groups, and corrected height was computed in AIS group according to Bjure's formula. One-way ANOVA was used to determine the differences in weight, height, corrected height and BMI between AIS and healthy girls. Standing height and sitting height showed no significant difference between thoracic scoliosis and lumbar scoliosis girls. Compared to healthy girls at the same age, thoracic and lumbar AIS girls had a significantly higher corrected standing and sitting height, arm span and leg length. Thoracic AIS girls had a significantly lower body weight than healthy girls at the age of 15yr. Yet, body weight showed no significant difference between lumbar AIS and healthy girls. The standing and sitting height between thoracic and lumbar AIS girls were similar during the pubertal period. Compared to healthy girls at the same age, thoracic and lumbar AIS girls had a significantly higher corrected standing, sitting height and leg length. In addition, thoracic AIS girls are leaner than healthy girls.
Ever-present Factors in Healthy Children that can Deform their Spines. Opposition to Dickson's Paradigm on Lordosis
Authors: Van Loon P.J.M.
Published: February 2025

Revision of older knowledge on spinal deformities shows causing factors in all day life and the source of rotational forces in men in respiration. The role of lordosis as a causative factor can change towards a correcting force, supported by different studies. The thoracolumbar spine is the originating area of many deforming processes.
pHealth and Wearable Technologies: a Permanent Challenge
Authors: Cunha João Paulo Silva
Published: February 2025

Wearable technologies have been evolving towards daily usage and are a major player in the personalized health challenge. In this paper we present a personal view of their evolution, how one of them developed within our lab went to the international market and how this type of technology is being used in pHealth projects for first responder professionals and public transportation drivers.
An Ecosystem of Products and Systems for Ambient Intelligence – the AAL4ALL Users Perspective
Authors: Sousa Filipe  , Viola Lara  , Ferreira Liliana  , Trevisan Gabriela  , Cunha David  , Alves José  , Simões Ricardo
Published: February 2025

Developed societies are currently facing severe demographic changes: the world is getting older at an unprecedented rate. In 2000, about 420 million people, or approximately 7 percent of the world population, were aged 65 or older. By 2050, that number will be nearly 1.5 billion people, about 16 percent of the world population. This demographic trend will be also followed by an increase of people with physical limitations. The traditional health care systems, not only in Portugal, but also in all other European states, will be faced with new challenges. There is an urgent need to find solutions that allow extending the time people can live in their preferred environment by increasing their autonomy, self-confidence and mobility. AAL4ALL presents an idea for an answer through the development of an ecosystem of products and services for Ambient Assisted Living (AAL) associated to a business model and validated through large scale trial. This paper presents the results of the first survey developed within the AAL4ALL project: the users' survey targeted at the Portuguese seniors and pre-seniors. In this way, this paper addresses the lives of the Portuguese population aged 50 and over.
The development of online learning designs for patients with type 2 diabetes
Authors: Mason Glenn
Published: February 2025

A case study in the development of online educational material for a patient with type 2 diabetes (T2DM) is presented in this paper. Analysis of an interview of a patient with T2DM was conducted and analysed using Interpretive Phenomenological Analysis. Emerging themes were identified and used as the basis for the development of online educational material and the online platform for hosting this material is discussed. The method presented in this paper for the development of online learning environments for one patient with T2DM is considered to be one way of developing authentic and patient-centred educational resources.
Using utilisation data to estimate future demand for medical internists: The impact of demographic demand driver in Thailand
Authors: Pannarunothai Supasit  , Phanthunane Pudtan
Published: February 2025

The demand for medical doctors can be estimated in many ways. The most challenging approach is the model based on population demand and anticipated contextual factors. The eighth national medical education meeting of Thailand in 2009 called for the need to estimate future demand for medical specialists in Thailand to proper plan for postgraduate trainings of royal colleges of medical specialists. This research was to estimate future demand for medical internists in 2021 in Thailand using utilisation data as the proxy of population demand for medical care. Inpatient data of 2009 from the universal coverage and the civil servant medical benefit schemes were grouped into the Thai diagnosis related group version 5. Age-sex specific utilisation rates by DRG or Major Diagnostic Category (the first two digits of DRG) were matched to the workloads of the specialists in internal medicine. Assumptions were made for comprehensively predicting the demand. Different proportions of time were allocated to fulfill inpatient care, outpatient consultations, academic meetings and administrative function for doctors at community hospitals, general hospitals and regional hospitals including teaching activities for doctors at teaching hospitals. The population pyramid of 2021 was used to forecast future demand taking account of casemix utilisation by each age-sex stratum in 2009. The results show the effects of demographic changes on the number of internists needed. Female reproductive age adults in 2021 need fewer internists than female reproductive age adults in 2009. The elderly in 2021 need an additional of 60 to 70 percent more internists than the elderly of 2009. Overall demands for the internists increase 34 percent over 12 years, while the growths of the population over 14 years and of the elderly populations are 11 and 64 percent respectively. Further fine-tuning of the model for forecasting demand for subspecialty especially the gerontologist is warranted to check for consistency of distribution of subspecialties within the internal medicine. Future policy research is needed for managing production and distribution of the required medical specialists according to needs in different geographical areas.
State of the Art in Telemedicine – Concepts, Management, Monitoring and Evaluation of the Telemedicine Programme in Alentejo (Portugal)
Authors: Oliveira Tiago Cravo  , Branquinho Maria José  , Gonçalves Luís
Published: February 2025

Alentejo – one of five Portuguese continental regions – faces major problems impacting the health and social system of the region. Here, the low population density, the low educational and income level as well as an aging population have to be mentioned. Faced with the task of ensuring equal access to healthcare for all its inhabitants, the regional health authorities created the telemedicine program.
Log Analysis to Understand Medical Professionals' Image Searching Behaviour
Authors: Tsikrika Theodora  , Müller Henning  , Kahn Jr Charles E.
Published: February 2025

This paper reports on the analysis of the query logs of a visual medical information retrieval system that provides access to radiology resources. Our analysis shows that, despite sharing similarities with general Web search and also with biomedical text search, query formulation and query modification when searching for visual biomedical information have unique characteristics that need to be taken into account in order to enhance the effectiveness of the search support offered by such systems. Typical information needs of medical professionals searching radiology resources are also identified with the goal to create realistic search tasks for a medical image retrieval evaluation benchmark.
Personalized Adherence Activity Recognition via Model-driven Sensor Data Assessment
Authors: Hsiao Mark  , Hsueh Pei-yun  , Ramakrishnan Sreeram
Published: February 2025

Creation of a personalized adherence feedback loop is crucial for initiating and sustaining health behavior change. However, self reports are not sufficient to measure actual adherence. Recording and recognizing personal activities in a ubiquitous environment has thus emerged as a promising solution. In this work, we present a model-driven sensor data assessment mechanism capable of identifying high level adherence-related activity patterns from low level signals. The proposed intelligent sensing algorithm can learn from a population-based training data set and adapt quickly to an individual's exercise patterns using the acquired personal data. Upon the recognition of each activity, the system can further provide personalized feedback such as exercise coaching, fitness planning, and abnormal event detection. The resulted system demonstrates the feasibility of a portable real-time personalized adherence feedback system that could be used for advanced healthcare services.
Describing the Sublanguage of Wound Care in an Adult ICU
Authors: Danielsson-Ojala Riitta  , Lundgren-Laine Heljä  , Salanterä Sanna
Published: February 2025

Comprehensive wound documentation is an important tool in evaluating and planning patient care. The sublanguage used in ICUs may affect negatively to the wound care and thus to the healing process. We made a quantitative content analysis of nursing documentation of cardiac surgery adult patients (n=60) who had stayed over four days in the ICU. The sublanguage used in nursing documentation of wounds and ulcers in the ICU was unstructured with many words of colloquial language, misspellings and abbreviations. The documentation did not cover all aspects of proper wound care. The information technology could be helpful for nurses to document right things with plain language.
Representing Clinical Communication Knowledge Through Database Management System Integration
Authors: Khairat Saif  , Craven Catherine  , Gong Yang
Published: February 2025

Clinical communication failures are considered the leading cause of medical errors [1]. The complexity of the clinical culture and the significant variance in training and education levels form a challenge to enhancing communication within the clinical team. In order to improve communication, a comprehensive understanding of the overall communication process in health care is required. In an attempt to further understand clinical communication, we conducted a thorough methodology literature review to identify strengths and limitations of previous approaches [2]. Our research proposes a new data collection method to study the clinical communication activities among Intensive Care Unit (ICU) clinical teams with a primary focus on the attending physician. In this paper, we present the first ICU communication instrument, and, we introduce the use of database management system to aid in discovering patterns and associations within our ICU communications data repository.
CARDIO-i2b2: integrating arrhythmogenic disease data in i2b2
Authors: Segagni Daniele  , Tibollo Valentina  , Dagliati Arianna  , Napolitano Carlo  , G. Priori Silvia  , Bellazzi Riccardo
Published: February 2025

The CARDIO-i2b2 project is an initiative to customize the i2b2 bioinformatics tool with the aim to integrate clinical and research data in order to support translational research in cardiology. In this work we describe the implementation and the customization of i2b2 to manage the data of arrhytmogenic disease patients collected at the Fondazione Salvatore Maugeri of Pavia in a joint project with the NYU Langone Medical Center (New York, USA). The i2b2 clinical research chart data warehouse is populated with the data obtained by the research database called TRIAD. The research infrastructure is extended by the development of new plug-ins for the i2b2 web client application able to properly select and export phenotypic data and to perform data analysis.
Impact of Computerized Order Sets on Practitioner Performance
Authors: Ahmadian Leila  , Khajouei Reza
Published: February 2025

Order sets have the potential to provide evidence at the point of care and improve healthcare practice. In this study we reviewed the literature to assess the effect of computerized order sets on practitioner performance. Our search in PubMed and Science direct identified 442 studies of which 16 met our inclusion criteria. In 15 studies order sets contributed to the improvement of at least one performance outcome. The effect of order sets was evaluated on 34 performance outcomes, of which 19 were improved and the rest remained unchanged. The results provide evidence that the use of order sets can improve health care practice.
Patient Satisfaction in a Context-Aware Hospital Guidance System
Authors: Kim Eunhye  , Yoo Sooyoung  , Hee Hwang  , Park Hyunchul  , Kim Gunhee  , Ha Sungdo
Published: February 2025

This paper presents the design of a system for a context-aware guidance service for hospital outpatients. Many patients have difficulties in knowing what to do and where to go due to the complexity of hospital-related processes and building structures. The intelligent hospital of the future will evolve in a smart way to automatically provide patients' smart mobile devices with relevant guidance information regarding their tasks, location, and process. In this study, we developed a context-aware-based hospital digital guidance system and evaluated ser satisfaction with respect to outpatient visits. From our pilot experiments with 15 outpatients, they were satisfied with the service. We believe that such a smart system would be a promising model for developing the intelligent hospitals of the future.
Application of the Logical Elements Rule Method for Formalization of Clinical Rules: Case Study of ACOVE-NLI
Authors: Medlock Stephanie  , Eslami Saeid  , Opondo Dedan  , Askari Marjan  , De Rooij Sophia  , Abu-Hanna Ameen
Published: February 2025

The Logical Elements Rule Method (LERM) is a step-wise method for formalizing if-then clinical rules. We applied LERM to a set of 40 clinical rules used in pharmacological quality assessment initiatives to assess (1) the amenability of the rules to formalization for decision support application (2) comparing adherence to rules that can and cannot be formalized, and (3) the usefulness of LERM as a tool for this task. Five rules could not be formalized, all due to unclear decision criteria. The adherence to ambiguous, non-formalizable rules was significantly lower than for formalizable ones (<0.001). We modified LERM with three additions for this task: (a) adding the sub-step of restating the rules in a consistent natural-language grammar before decomposing them into normal form, (b) creating rules to use in lieu of a controlled vocabulary, and (c) adding the requirement that a time frame must be defined for all medications (before hospitalization, current medication, new medication, or discharge medication). Although the clinical rules in this sample are all stated as semi-structured if-then recommendations and are used in quality assessment initiatives, many ambiguities and inconsistencies in the clinical rules were identified by using LERM.
Accuracy of Clinical Data Entry when Using a Computerized Decision Support System: a Case Study with OncoDoc2
Authors: Séroussi Brigitte  , Blaszka-Jaulerry Brigitte  , Zelek Laurent  , Lefranc Jean-Pierre  , Conforti Rosa  , Spano Jean-Philippe  , Rousseau Alexandra  , Bouaud Jacques
Published: February 2025

Some studies suggest that the implementation of health information technology (HIT) introduces unpredicted and unintended consequences including e-iatrogenesis. OncoDoc2 is a guideline-based clinical decision support system (CDSS) applied to the management of breast cancer. The system is used by answering closed-ended questions in order to document patient data while navigating through the knowledge base until the best patient-specific recommended treatments are obtained. OncoDoc2 has been used by three hospitals in real clinical settings and for genuine patients. We analysed 394 navigations, recorded on a 10-month period, which correspond to 6,025 data entries. The data entry error rate is 4.2%, spread over 52% of incorrect navigations (N-). However, the overall compliance rate of clinical decisions with guidelines significantly increased from 72.8% (without CDSS) to 87.3% (with CDSS). Although this increase is lowered because of N- navigations (compliance rates are respectively 95% and 80% for N+ and N- navigations), the benefits of HIT outweighted its disadvantages in our study.
Requirements for Semantic Biobanks
Authors: Andrade André Q.  , Kreuzthaler Markus  , Hastings Janna  , Krestyaninova Maria  , Schulz Stefan
Published: February 2025

World-wide availability of biobank samples is a great desideratum for biomedical researchers. We describe the use case of biobank information retrieval that requires the semantic descriptions of biobank samples and of clinical information. In addition we sketch the foundations of an ontology for biobanks, as a basis on which distributed biobank indexing and retrieval systems can be built. We advocate that a detailed and robust representation of this kind of information improves and allows complex queries that will certainly arise to explore the full potential of biobanks.
Assessing the Clinical Uses of Fuzzy Detection Results in the Automated Detection of CVC-related Infections: A Preliminary Report
Authors: De Bruin Jeroen S.  , Blacky Alexander  , Adlassnig Klaus-Peter
Published: February 2025

Central venous catheters (CVCs) play an essential role in the care of the critically ill, but their use comes at the risk of infection. By using fuzzy set theory and logic to model clinical linguistic CVC-related infection criteria, clinical detection systems can detect borderline infections where not all infection parameters have been (fully) met, also called fuzzy results. In this paper we analyzed the clinical use of these results. We used a fuzzy-logic-based computerized infection control system for the monitoring of healthcare-associated infections to uncover fuzzy results and periods, after which we classified them, and used these classifications together with knowledge of prior CVC-related infection episodes in temporal association rule mining. As a result, we uncovered several rules which can help with the early detection of re-occurring CVC-related infections.