bluuebunny/crossref_metadata_2025 huggingface dataset:
Using Stereoscopy for Medical Virtual Reality
Authors: John Nigel W.
Published: February 2025

The use of stereoscopy to enhance the immersive experience obtained from a virtual environment is well known, and many medical applications can benefit from this technology. The stereoscopic projection sessions at the last two MMVR conferences contain many excellent examples. Stereoscopy need not be expensive to implement, and can easily be provided on a desktop PC. This paper looks at the different options available today, from active stereo, to passive stereo, to autostereoscopic displays, and their deployment on both high-end and low-end systems. The potential benefits of these different approaches are illustrated with examples from medical visualisation projects currently being carried out at the Manchester Visualization Centre (MVC).
Daily patient set-up control in radiation therapy by coded light projection
Authors: Krempien R.  , Daeuber S.  , Hoppe H.  , Treiber M.  , Harms W.  , Raczkowsky J.  , Brief J.  , Debus J.  , Woern H.  , Wannenmacher M.
Published: February 2025

Advances in conformal radiation therapy to control disease via dose escalation are challenged by set-up uncertainties. Recently, techniques have been developed to use surface features to evaluate the patient’s position and correct it where necessary. The aim of this study was to use the patient’s surface as a tool for daily set-up control and monitoring. We use a surface scanner based on the projection of coded light to receive -in a daily routine- a large amount of surface points which enables us to register the CT-based planning data with the patient’s current position. By superimposing current and planned volumes, a volume of congruency was obtained. An error below 1 mm was considered acceptable. In cases where set-up was not satisfactory a map of the surface comparison was evaluated showing the areas of missing alignment. According to this information a manual repositioning was performed. This procedure was repeated until the error was acceptable. No more then 3 repetitions where necessary to obtain an acceptable result. The whole procedure including registration, calculation and visualization took about 20 sec for one repetition. The use of structured light projection in the daily set-up control and monitoring proved to be a noninvasive, easy, quick, inexpensive and reliable solution.
Virtual Food in Virtual Environments for the Treatment of Eating Disorders
Authors: Lozano José A.  , Alcañiz Mariano  , Gil José A.  , Moserrat Carlos  , Juán Mari C.  , Grau Vicente  , Varvaró Hugo
Published: February 2025

Eating disorders (Eds) are one of the problems with higher social repercussion in the last years. Sometimes, these clinical syndromes, which are characterized by an altered eating behavior, can have dramatic consequences. In eating disorders, one of the more critical situations, in addition to other of equal or more importance, is the patient’s confrontation with food: the visual confrontation, the eating process and the repercussion on his weight. Virtual Reality (VR) technology has been used in psychology, as a therapeutic help tool for the treatment of different psychological problems, for several years now. Their helpfulness is increasingly being recognized. Some developed virtual environments (VE) and their corresponding published studies endorse the efficiency of this tool. Nevertheless, in order to increase the possibilities of success, it is very important to obtain a complete patient immersion in the VE: visual, auditory and interactive. Sometimes there are processes or actions of reality, which are difficult to simulate virtually, and simulating them coarsely would result in the patient lack of immersion in the VE, thus seriously decreasing the possibilities of success. The eating process is an example, since it consists of several steps, some of which (biting, chewing, etc.) don't have an evident virtual solution. This article shows how food and eating process have been simulated virtually in the development of a virtual environment for the treatment of eating disorders.
The VEPSY UPDATED Project: Technical and Clinical Rationale
Authors: Riva G.  , Alcaniz M.  , Anolli L.  , Bacchetta M.  , Baños R.  , Beltrame F.  , Botella C.  , Galimberti C.  , Gamberini L.  , Gaggioli A.  , Molinari E.  , Mantovani G.  , Klinger E.  , Optale G.  , Orsi G.  , Perpiñá C.  , Troiani R.
Published: February 2025

The emergence of new shared media, such as the Internet and virtual reality are changing the ways in which people relate, communicate, and live. Health care, and in particular clinical psychology, is one of the areas that could be most dramatically reshaped by these new technologies. To exploit and understand this potential is the overall goal of the “Telemedicine and Portable Virtual Environment in Clinical Psychology” -VEPSY UPDATED – an European Community funded research project (IST-2000-25323, http://www.vepsy.com ) whose specific goal is the development of different PC based virtual reality modules to be used in clinical assessment and treatment. In particular the developed modules have been using to address the following pathologies: anxiety disorders; male impotence and premature ejaculation; obesity, bulimia and binge-eating disorders. The chapter details the general technical and clinical characteristics of the developed modules.
An Augmented Reality System for Ultrasound Guided Needle Biopsies
Authors: Sauer Frank  , Khamene Ali  , Bascle Benedicte  , Vogt Sebastian
Published: February 2025

We have developed an augmented reality visualization system that helps the physician perform ultrasound guided needle biopsies. For a needle biopsy, the needle has to be inserted into an anatomical target to remove a tissue sample. Ultrasound guidance is routinely used e.g. for breast needle biopsies. The real-time ultrasound images allow the physician to locate the target and to monitor the needle position. Our system uses a combination of an optical laser guide and a virtual guide in the augmented image to provide intuitive guidance for the needle placement. There is no need to track the needle, i.e. there is no need to instrument the needle for tracking. In phantom tests, users have performed well with the system without prior training. This paper describes special features of our system and the workflow for the needle placement procedure.
Exploratory Design and Evaluation of a User Interface for Virtual Reality Exposure Therapy
Authors: Schuemie Martijn J.  , van der Mast Charles A.P.G.  , Krijn Merel  , Emmelkamp Paul M.G.
Published: February 2025

Virtual reality exposure therapy is slowly becoming a viable option for therapists. For virtual reality systems to be used in the daily practice of therapists, their usability needs to be taken into consideration. This paper describes the current state-of-the-art in interfaces for these systems, and describes several proposals for improving the design of these systems. An exploratory evaluation is performed to assess the merits of aspects of the proposed user interface.
Nomenclatures, Classifications and Case-Mix: From Patient Description to Abstraction
Authors: Chute Christopher G.
Published: February 2025

Detailed nomenclatures, clinical classifications, and diagnostic related groups lay along a common continuum of patient description, albeit at different levels of abstractions. The intellectual origins of classification, and present challenges of practical terminologies, and a unified potential future are outlined. Today’s classifications should be created and published as rule-driven databases, defined from well-formed patient descriptions at a detailed, nomenclature level. Then, analogous to the DRG grouper process, we can realize administrative and resource efficiencies from the detailed encoding of patients, which will enable an era of evidence-based medicine and best-practice as the norm.
3-D Measurement of Posture and Back Shape Using a Low Cost, Portable System -a Reliability Study
Authors: Warren J.G.  , Bettany-Saltikov J.  , Van Schaik P.  , Papastefanou S.L.
Published: February 2025

The reliability and accuracy in the measurement of landmark points using a 3-D digitizer on a static back phantom are reported. The results show the systems clinical reliability as a low cost, portable and flexible method for recording back posture. Consistent results are demonstrated for a single measurer and good agreement was found between two measurers. Few intrinsic errors were found in the devices performance.
Validation of the NSCP Technique on Scoliotic Vertebrae
Authors: Mitulescu A.  , De Guise J.A.  , Dubousset J.  , Labelle H  , Adamsbaum C.  , Skalli W.
Published: February 2025

The purpose of the present study is to validate a quite recent stereoradiographic 3D reconstruction technique, called Non Stereo Corresponding Points (NSCP), on scoliotic patients. The validation of the NSCP technique on scoliotic patients was performed on 59 scoliotic vertebrae from 14 patients, by comparison to the CT scan. The results of this study show mean errors of 1.5 mm. These results should still be optimized for the geometrical modelling. Nevertheless, this technique may already be used as a diagnosis tool in clinics.
Readability of Patient Information on Diabetes on the Croatian Web Sites
Authors: Kusec Sanja  , Mastilica Miroslav  , Pavlekovic Gordana  , Kovacic Luka
Published: February 2025

Many studies on readability have shown that patient information is frequently written at the reading level too high for the average population to understand. The aim of this study was to determine the reading level of patient information on diabetes found on the Croatian Web sites and written in Croatian language. Patient information on diabetes from 10 Croatian Web sites was tested for readability using the SMOG formula. The reading levels of the tested materials ranged from 11 to 15, which showed that these materials would not be understood by at least 80% of the Croatian adult population.
A comparative study of EPR projects in Denmark
Authors: Andersen Stig Kjær  , Vingtoft Søren  , Bernstein Knut  , Rasmussen Morten Bruun
Published: February 2025

The EPR-Observatory – a public funded project organization - has monitored Danish EPR-projects with respect to various parameters such as diffusion and diffusion rate, barriers and limitations, experience gained. Furthermore, the Observatory has aggregated and disseminated the results and has established a constructive dialogue between the Danish EPR projects. The Observatory has also focused in the later years on analysis of common frames of reference for EPR systems. The National Board of Health and some of the larger counties have developed such frames. First generation systems have been implemented in a few counties with moderate coverage, but a number of projects developing second generation systems are making progress, and the market situation is quickly maturing. There are still, however, major problems in the practical implementation of the systems.
Patient's permanent identification and PMSI chaining system. Complementary or competing methods?
Authors: Herengt G.  , Toussaint E.  , Musse JP.  , Kohler F.
Published: February 2025

In order to “chain” all the information concerning their patients' files, hospitals have set up their own identification system. This system is not easy to manage and can encounter several difficulties.
Data Mining Server- On-line Knowledge Induction Tool
Authors: Sonicki Zdenko  , Gamberger Dragan  , Šmuc Tomislav  , Sonicki Darija  , Kern Josipa
Published: February 2025

The aim of this paper is to present an on-line data mining tool and illustrate its use on example of real medical data. Data from the Laboratory for in-vitro Thyroid diagnostics at the Sisters of Charity University Hospital in Zagreb were used. Preparation of the data set and one session of knowledge induction is described.
The ‘cube’ meta-model for the information system of large health sector organizations
Authors: Balkányi László
Published: February 2025

To develop information systems (IS) in the changing environment of the health sector, a simple but throughout model, avoiding the techno-j argon of informatics, might be useful for the top management. A platform neutral, extensible, transparent conceptual model should be established. Limitations of current methods lead to a simple, but comprehensive mapping, in the form of a three-dimensional cube. The three ‘orthogonal’ views are (a) organization functionality, (b) organizational structures and (c) information technology. Each of the cube-sides is described according to its nature. This approach enables to define any kind of an IS component as a certain point/ layer/domain of the cube and enables also the management to label all IS components independently form any supplier(s) and/or any specific platform. The model handles changes in organization structure, business functionality and the serving info-system independently form each other. Practical application extends to (a) planning complex, new ISs, (b) guiding development of multi-vendor, multi-site ISs, (c) supporting large-scale public procurement procedures and the contracting, implementation phase by establishing a platform neutral reference, (d) keeping an exhaustive inventory of an existing large-scale system, that handles non-tangible aspects of the IS.
Performance Evaluation of Artificial Intelligence Classifiers for the Medical Domain
Authors: Smith A.E.  , Nugent C.D.  , McClean S.I.
Published: February 2025

The application of artificial intelligence systems is still not widespread in the medical field, however there is an increasing necessity for these to handle the surfeit of information available. One drawback to their implementation is the lack of criteria or guidelines for the evaluation of these systems. This is the primary issue in their acceptability to clinicians, who require them for decision support and therefore need evidence that these systems meet the special safety-critical requirements of the domain. This paper shows evidence that the most prevalent form of intelligent system, neural networks, is generally not being evaluated rigorously regarding classification precision. A taxonomy of the types of evaluation tests that can be carried out, to gauge inherent performance of the outputs of intelligent systems has been assembled, and the results of this presented in a clear and concise form, which should be applicable to all intelligent classifiers for medicine.
Multidimensional approach for evaluation of system activity of the brain by EEG
Authors: Mayorov Oleg Yu.
Published: February 2025

The way of investigation some fundamental properties of integrative brain activity was worked out. Within the framework of the qEEG system for computer diagnostics of EEG NeuroResearcher™'2001 (Version 7.5) is created modules for investigation of multivariate neurodynamic systems of the brain on the base of multidimensional spectral EEG and ESCoG analysis. It is intended for doctors and neuroscientists who use mathematical methods (classical correlation and spectral analysis and newest methods of multidimensional analysis of neurodynamic systems of the brain) for quantitative EEG (qEEG) successfully.
Development of a computer controlled cognitive diagnostics and rehabilitation method
Authors: Szabó Julianna  , Páll Attila  , Sík-Lányi Cecilia  , Pataky Ilona
Published: February 2025

In this paper we introduce a computer controlled method (HELp Neuropsychology = HELEN) which enables - as a difference to methods used internationally - not only the establishment of the diagnosis, but permits measurement of the effectiveness of the therapy. It allows
Modelling the Effect of Alcohol in Type 1 Diabetes
Authors: Plougmann Søren  , Hejlesen Ole  , Turner Benjamin  , Kerr David  , Cavan David
Published: February 2025

We have recently shown, in studies with patients with Type 1 (insulin dependent) diabetes, that alcohol intake at 2100 hrs significantly reduced blood glucose values after 10-12 hours, compared with control studies with no alcohol. We hypothesised that this was due to the following effects of alcohol: 1. Alcohol metabolism increases NADH, leading to a reduction in hepatic gluconeogenesis; and 2. increased glycogen phosphorylase activity depletes hepatic glycogen stores; 3. After the alcohol is metabolised, hepatic insulin sensitivity is increased, leading to the restoration of glycogen stores and reduction in blood glucose levels, and 4. consequently, after several hours, glycogen stores and insulin sensitivity return to normal. A model describing these changes (DiasNet-Alcohol) was implemented into the DiasNet model of human glucose metabolism. Our study suggests that the DiasNet-Alcohol model gives a reasonable approximation of the effect of alcohol on blood glucose concentration observed in our study and supports our hypothesis for the mechanism behind these effects in Type 1 diabetes.
XML as Standard for Communicating in a Document-based Electronic Patient Record: a Three Years Experiment
Authors: Rassinoux Anne-Marie  , Lovis Christian  , Baud Robert  , Geissbuhler Antoine
Published: February 2025

During the past few years, the extensible Markup Language (XML) has experienced a growing use for accessing, representing and exchanging information, especially in the health care environment. This paper discusses the potentials of the use of XML for the electronic patient record (EPR) in two ways: first, as a format for the exchange of structured messages, and second, as a comprehensible way of representing patient documents. These statements rely on a three years experiment conducted at the Geneva University Hospital as part of its document-centred EPR.
ICT penetration in public Greek hospitals
Authors: Vagelatos Aristides  , Sofotassios Dimitrios  , Papanikolaou Christos  , Manolopoulos Christos
Published: February 2025

Last year a survey was carried out with the main purpose to measure how ICT has been adopted in the public Greek hospitals. The survey was made possible in a rather short period of time through the utilisation of a questionnaire. H/W existence, application S/W installations, WWW sites and E-mail use as well as IT personnel employed, were among the factors that were studied. The outcomes of this survey present a rather high penetration in the administrative sector of the hospitals, whereas the medical sector faces a low level of computerisation. The absence in most of the hospitals, of a well-organised and appropriately staffed IT department, seems be one of the reasons for the low overall penetration of ICT in the average public Greek hospital.
Electronic Health Center (eHC): Integration of Continuing Medical Education, Information and Communication for General Practitioners
Authors: Ivekovic Hrvoje  , Bozikov Jadranka  , Mladinic-Vulic Denis  , Ebling Zdravko  , Kern Josipa  , Kovacic Luka
Published: February 2025

The Electronic Health Center (eHC) is aimed as an Internet service for continuing medical education of general practitioners (GPs) at the national level. It integrates education, access to relevant and trusted information sources and group communication in order to meet the needs of both daily work and continuing education at home.
A Laboratory Test Request Protocol System
Authors: Berry D.  , Grimson W.  , Pardon S.  , Gaffney P.  , Boran G.
Published: February 2025

This paper describes the design, implementation and assessment of a computer-based protocol application to support requests by clinicians for laboratory investigations. As part of the motivation for the work a rigorous engineering software approach was adopted not just for purely technical reasons but also as a means of maximising the role of the user.
The effect of posture on Quantec measurements
Authors: Macdonald A.M.  , Griffiths C.J.  , MacArdle F.J.  , Gibson M.J.
Published: February 2025

The effect of moving the patient's centre of gravity from one extreme to the other, where the weight is entirely supported on the left or right foot at either extreme, was investigated in 33 patients attending for surface topography measurements with the Quantec Spinal Measurement System. Average changes of about 20 were seen in the measured curvature of the lower spine line and pelvic tilt, but there was considerable variation between individual patients. When such extremes of stance were included, the reproducibility of measurements of the curvature of the lower spine, pelvic tilt and vertical alignment was poorer, but not to the extent that a significant improvement in reproducibility would be expected if the patient’s centre of gravity was closely controlled with, for example, a force platform.
Geometric and postural analysis of mild idiopathic scoliotic patients
Authors: Champain N.  , Dupuis R.  , Pomero V.  , Mouilleseaux B.  , Dubousset J.  , Skalli W.
Published: February 2025

Understanding the aggravation process of mild idiopathic scoliosis is still a challenge. The aim of this study is to investigate the spine and pelvis configuration with regard to gravity line using 3D reconstruction coupled with foot pressure measurements. The distance between each vertebral center and the gravity line is calculated in order to observe the global equilibrium of spine. A protocol has been set and used for 10 mild idiopathic scoliotic patients. 34 asymptomatic volunteers who were previously observed with the same protocol were used as reference for biomechanical comparisons. The first results showed differences between scoliotic and asymptomatic subjects and also among scoliotic patients. The proposed protocol should allow clinicians to follow up scoliotic patients with an innovative and efficient tool.
The Significance of Correlation of Radiographic Variables and MOS Short-form Health Survey for Clinical Decision in Symptomatic Low Back Pain Patients
Authors: Korovessis Panagiotis  , Dimas Anastassios  , Lambiris Elias
Published: February 2025

Objectives. To assess any correlation between SF-36 scores and several lateral roentgenographic variables of the lumbar spine, both in low back pain patients and asymptomatic volunteers. The clinical relevance of the method proposed in this study to make a surgical strategy on the basis of distinct lateral roentgenographic parameters and conversely was assessed by independent radiologists and physicians.
Pathomechanic basics of conservative treatment of progressive idiopathic scoliosis according to Dobosiewicz method based upon radiologic evaluation
Authors: Dobosiewicz Krystyna  , Durmala Jacek  , Czernicki Krzysztof  , Jendrzejek Hanna
Published: February 2025

Conservative treatment of idiopathic scoliosis, especially kinesitherapy, is not widely appreciated due to its suspected low effectiveness in relation to a surgical treatment. After long-year assessment of patomechanics of scoliosis in Department of Rehabilitation of Medical University of Silesia a conservative method of treatment, asymmetric trunk mobilization in strictly symmetric positions, was developed. This method enables to detain progression of scoliosis, or even decrease lateral curvature of a spine and angle of rotation assuming adequate cooperation of patient and its family.
Reversal of the Signs and Symptoms of Moderately Severe Idiopathic Scoliosis in Response to Physical Methods
Authors: Hawes Martha C.  , Brooks William J.
Published: February 2025

This report describes improved signs and symptoms of previously untreated symptomatic spinal deformity in an adult female diagnosed with moderately severe thoracic scoliosis at the age of.7 years. Current treatment initiated at the age of forty included massage therapy, manual traction, ischemic pressure, and comprehensive manipulative medicine (CMM). A left-right chest circumference inequity was reduced by >10 cm, in correlation with improved appearance of the ribcage deformity and a 40% reduction in magnitude of Cobb angle, which had been stable for 30 years. The changes occurred gradually over an eight-year period, with the most rapid improvement occurring during two periods when CMM was employed.
Quantitative Measurement of Spinal Brace Use and Compliance in the Treatment of Adolescent Idiopathic Scoliosis
Authors: Nicholson G.P.  , Ferguson-Pell M.W.  , Smith K.  , Edgar M.  , Morley T.
Published: February 2025

The objective measurement of compliance with spinal bracing in adolescents with idiopathic scoliosis (AIS) is fundamental in the validation of clinical trials of bracing effectiveness, and in helping clinicians better understand reasons behind poor compliance. Current technology has been developed and tested for discrete, reliable and objective measurement of the times of day a brace is worn and consistency in its use. TLSOs were instrumented with data loggers measuring temperature at the skin/brace interface at 16 minutes intervals over a period of 88 days; between routine follow up and without patient interference. 10 female patients (age 14 years, sd 1.1) with AIS using spinal bracing as part of their treatment regime took part in the study over 15 months. Skin/brace interface temperature during periods of wear in the U K was >30°C, ambient 23°C, sd 4. Compliance ranged from 8-90%, average 65%. Patients tended to over estimate their compliance by 150 % (sd 50%). There was no significant difference between weekday and weekend compliance but wear . patterns differed. Nightwear was significantly greater than daywear. Patients with very good compliance only removed their brace for washing or exercise periods but where poor compliance was evident, the brace was only worn sporadically during the day. Temperature provides a clear signal of brace use and can be used for long-term data logging using discrete instrumentation, providing a tool to help identify and understand the reasons behind poor compliance.
Finite element simulation of various strategies for CD correction
Authors: Lafage V.  , Dubousset J.  , Lavaste F.  , Skalli W.
Published: February 2025

The scoliosis surgery using the Cotrel-Dubousset instrumentation[1,2]is a complex three dimensional correction. This surgery was first simulated for a given patient using a personalized finite element mode[3]: the geometry was extracted from a 3D stereoradiographic reconstruction[4]and mechanical properties were personalized using lateral bending tests[5]. Finally, three alternative surgical strategies were simulated in order to analyze their effects on spine postoperative configuration. First results are promising and should allow surgeons to objectively analyze various strategies or techniques.
The Role of Rigid vs. Dynamic Instrumentation for Stabilization of the Degenerative Lumbosacral Spine
Authors: Korovessis Panagiotis  , Papazisis Zisis  , Lambiris Elias
Published: February 2025

Purpose of the study. This is a prospective comparative randomised study to compare the immediately postoperative effects of a rigid versus dynamic instrumentation for degenerative spine disease and stenosis on the standing sagittal lumbar spine alignment and to investigate if a dynamic spine system can replace the commonly used rigid systems in order to avoid the above mentioned disadvantages of rigid fixation.
Trunk Deformity Correction Stability Following Posterior Instrumentation and Arthrodesis for Idiopathic Scoliosis
Authors: Asher Marc  , Lai Sue Min  , Burton Doug  , Manna Barbara
Published: February 2025

Aim: To determine whether trunk deformity correction is stable over time.
Assessment of the Possibility to Classify Patients According to Cholesterol Guideline Screening Criteria Using Routinely Recorded Electronic Patient Record Data
Authors: Van Wyk J.T.  , Van Wijk M.A.M.
Published: February 2025

Background: Computerised decision support Systems (CDSS) can be categorised as either being inquisitive or non-inquisitive. The non-inquisitive System uses routinely entered electronic patient data, to generate patient specific feedback based on guidelines. The Dutch College of General Practitioners’ (DCGP) cholesterol guideline classifies patients into risk groups, eligible for screening. The availability of sufficient routinely recorded electronic patient data to classify patients according to the DCGP cholesterol guidehne is unknown.
Eye Trackers in a Virtual Laparoscopic Training Environment
Authors: Law Benjamin  , Atkins M. Stella  , Lomax Alan J.  , Wilson John G.
Published: February 2025

Virtual laparoscopic training systems have been shown to differentiate between the skills of experienced and novice laparoscopic surgeons. Measures such as total number of errors and completion time are used to assess skill, but these metrics do not give much insight into the processes behind skilled behavior in simulated laparoscopic tasks. The eye gaze of 2 groups of subjects, one experienced with laparoscopic surgery, and the other with no experience, was recorded while they performed an aiming task in a virtual laparoscopic trainer. The experienced subject committed much lower number of errors than the novices. Initial analysis of the eye data showed that the novice group tended to gaze on the tool they are controlling more often than the experienced subject.
Development and Evaluation of a Simulator of Invasive Procedures in Pediatric Bone Marrow Transplant
Authors: Machado Liliane dos Santos  , Zuffo Marcelo Knõrich
Published: February 2025

In the past we proposed the development of a bone marrow harvest simulator to support the learning of this procedure. This work presents some aspects of this development and shows the results and analysis of the simulator after its first evaluation.
DEVELOPMENT OF A TRAINING TOOL FOR ENDOTRACHEAL INTUBATION: DISTRIBUTED AUGMENTED REALITY
Authors: Rolland Jannick  , Davis Larry  , Hamza-Lup Felix  , Daly Jason  , Ha Yonggang  , Martin Glenn  , Norfleet Jack  , Thumann Richard  , Imielinska Celina
Published: February 2025

The authors introduce a tool referred to as the Ultimate Intubation Head (UIH) to train medical practitioners’ hand-eye coordination in performing endotracheal intubation with the help of augmented reality methods. In this paper we describe the integration of a deployable UIH and present methods for augmented reality registration of real and virtual anatomical models. The assessment of the 52 degrees field of view optics of the custom-designed and built head-mounted display is less than 1.5 arc minutes in the amount of blur and astigmatism, the two limiting optical aberrations. Distortion is less than 2.5%. Preliminary results of the registration of a physical phantom mandible on its virtual counterpart yields less than 3mm rms. in registration. Finally we describe an approach to distributed visualization where a given training procedure may be visualized and shared at various remote locations. Basic assessments of delays within two scenarios of data distribution were conducted and reported.
Stereo Imagery from the UNC Augmented Reality System for Breast Biopsy Guidance
Authors: State Andrei  , Keller Kurtis  , Rosenthal Michael  , Yang Hua  , Ackerman Jeremy  , Fuchs Henry
Published: February 2025

This paper shows a number of stereoscopic images depicting the UNC augmented reality guidance system for medical visualization in operation.
Facilitating Real-time Volume Interaction
Authors: Stredney D  , Bryan J  , Sessanna D  , Kerwin T
Published: February 2025

We report on efforts to provide high-level intuitive tools that exploit commodity-based computing to facilitate real-time and distributed interactions with volumetric data. These efforts include an open source volume-rendering library, a portable volume visualization application framework, and parallel volume-rendering exploiting commodity-based hardware. We present our design and implementations, as well as examples of some of the various groups currently utilizing these tools, and discuss the tradeoffs of our developments versus existing techniques.
A VR- System Supporting Symmetry Related Cranio-Maxillofacial Surgery
Authors: Burgert Oliver  , Seifert Sascha  , Salb Tobias  , Gockel Tilo  , Dillmann Rüdiger  , Hassfeld Stefan  , Mühling Joachim
Published: February 2025

The reconstruction of patients with large deformations in the facial area should consider functional aspects as well as aesthetical ones. In this paper, an integrated virtual reality system which allows bone manipulation, osteotomy planning, calculation of implants for soft tissue and bones combined with the calculation of the post-operative appearance is presented. It is a valuable tool for a wide range of cranio-maxillofacial surgeries. Due to the generalized approach of the underlying algorithms, it is a basis for further clinical applications in other surgical fields.
Real-Time Volumetric Deformation for Surgical Simulation using Force Feedback Device
Authors: Wakai Satoshi  , Suzuki Naoki  , Hattori Asaki  , Suzuki Shigeyuki  , Uchiyama Akihiko
Published: February 2025

We have aimed to develop a virtual surgery system that realizes the performance of surgical maneuvers on elastic organs and to construct an elastic organ model known as sphere-filled model. In this paper we describe a new method of deforming volumetric data in real time by using sphere-filled model. As well we modified this model to take the interference between soft tissue and rigid tissue to consideration. Furthermore basic surgical maneuvers (pushing, pinching and incision) and connection with force feedback device are realized on this model similarly to our surface model.
A haptic model of a bone-cutting burr
Authors: Agus Marco  , Giachetti Andrea  , Gobbetti Enrico  , Zanetti Gianluigi  , Zorcolo Antonio  , Picasso Bruno  , Franceschini Stefano Sellari
Published: February 2025

We describe a strategy for collecting experimental data and validating a bone-burr haptic contact model developed in a virtual surgical training system for middle ear surgery. The validation strategy is based on the analysis of data acquired during virtual and real burring sessions. Our approach involves intensive testing of the surgical simulator by expert surgeons and trainees as well as experimental data acquisition in a controlled environment.
A Hybrid Condensed Finite Element Model for Interactive 3D Soft Tissue Cutting
Authors: Wu Wen  , Sun Jian  , Heng Pheng Ann
Published: February 2025

As requested from practical operations, it is necessary in the design to provide the ability to real-time cut and suture the tissue in a surgery simulation apart from the deformation simulation. In this paper, we present a deformation model, referred as the hybrid condensed FE model, based on the volumetric finite element method. The most important advantage of this model is its ability to handle the topology change freely with interactive rate in the surgical simulation on current PC platform.
MammoGrid: Large-Scale Distributed Mammogram Analysis
Authors: Amendolia S. Roberto  , Brady Michael  , McClatchey Richard  , Mulet-Parada Miguel  , Odeh Mohammed  , Solomonides Tony
Published: February 2025

Breast cancer as a medical condition and mammograms as images exhibit many dimensions of variability across the population. Similarly, the way diagnostic systems are used and maintained by clinicians varies between imaging centres and breast screening programmes, and so does the appearance of the mammograms generated. A distributed database that reflects the spread of pathologies across the population is an invaluable tool for the epidemiologist and the understanding of the variation in image acquisition protocols is essential to a radiologist in a screening programme. Exploiting emerging grid technology, the aim of the MammoGrid [1] project is to develop a Europe-wide database of mammograms that will be used to investigate a set of important healthcare applications and to explore the potential of the grid to support effective co-working between healthcare professionals.
Matched time-frequency filter for ECG signal enhancement
Authors: Georgakis Apostolos  , Stergioulas Lampros K
Published: February 2025

A new method for ECG signal enhancement is presented, based on “matched” timefrequency filtering in the Wigner representation. Performance analysis shows that the method is particularly useful for noise removal in clinical ECG.
Privilege Management and Access Control in Shared Care IS and EHR
Authors: Blobel Bernd  , Nordberg Ragnar
Published: February 2025

Realising the shared care concept based on distributed health information systems, we have to meet the challenge for advanced security and privacy based on a Public Key Infrastructure (PKI) Beside strong authentication, authorisation of principals and access control using role concepts and security object classification schemes are essential application security services. The paper presents the actual drafts of ISO and CEN standards dealing with privilege management and access control.
The impact of EHR and digital electrocardiograms
Authors: Bruun-Rasmussen Morten  , Kaae Tove  , Tynan Lone  , Chronaki Catherine E.
Published: February 2025

The diffusion of the Electronic Health Record demands seamless integration and interoperability of medical devices with 3-party information systems. Nowadays cardiovascular diseases are the largest cause of mortality in western countries so, especially in the domain of Cardiology, medical devices are an essential part in the process of acquiring, storing and communicating accurately the current health status of a citizen. The Danish Centre for Health Telematics is participating in the European Funded project OpenECG that will assist and support manufacturers and integrators in creating interoperable equipment and software for seamless exchange of electrocardiograms. A pilot project will be established in the Funen Health Care Network to asses the benefits of the electronic communication of electrocardiograms.
Electronic Signatures for Long-lasting Storage Purposes in Electronic Archives
Authors: Pharow Peter  , Blöbel Bernd
Published: February 2025

Communication and co-operation in healthcare and welfare requires certain Trusted Third Party (TTP) services describing both status and relation of communicating principals as well as their corresponding keys and attributes. Additional 77P services are needed to provide trustworthy information about dynamic issues of communication and co-operation such as time and location of processes, workflow relations, and system behaviour. Electronic signatures based on asymmetric cryptography are important means for securing the integrity of a message or file as well as for accountability purposes including non-repudiation of both origin and receipt. These electronic signatures along with certified time stamps are especially important for electronic health records (EHR), electronic archives in general, and other typical purposes of a long-lasting storage. Apart from technical storage problems (e.g. lifetime of the storage devices), this paper needs to look for mechanisms of e.g. re-signing of messages, archive details, or whole archives.
Towards a Unified Medical Lexicon for French
Authors: Zweigenbaum Pierre  , Baud Robert  , Burgun Anita  , Namer Fiammetta  , Jarrousse Éric  , Grabar Natalia  , Ruch Patrick  , Duff Franck Le  , Thirion Benoôt  , Darmoni Stéfan
Published: February 2025

Medical Informatics has a constant need for basic Medical Language Processing tasks, e.g., for coding into controlled vocabularies, free text indexing and information retrieval. Most of these tasks involve term matching and rely on lexical resources: lists of words with attached information, including inflected forms and derived words, etc. Such resources are publicly available for the English language with the UMLS Specialist Lexicon, but not in other languages. For the French language, several teams have worked on the subject and built local lexical resources. The goal of the present work is to pool and unify these resources and to add extensively to them by exploiting medical terminologies and corpora, resulting in a unified medical lexicon for French (UMLF). This paper exposes the issues raised by such an objective, describes the methods on which the project relies and illustrates them with experimental results.
A Probabilistic Information Retrieval Approach to Medical Annotation in SWISS-PROT
Authors: Dobrokhotov Pavel B.  , Goutte Cyril  , Veuthey Anne-Lise  , Gaussier Eric
Published: February 2025

The goal of medical annotation of human proteins in Swiss-Prot is to add features specifically intended for researchers working on genetic diseases and polymorphisms. For this purpose, it is necessary to search through a vast number of publications containing relevant information. Promising results have been obtained by applying natural language processing and machine learning techniques to solve this problem. By using the Probabilistic Latent Categoriser on representative query sets, 69% recall and 59% precision was achieved for relevant documents. This classifier also rejected irrelevant abstracts with more than 96 % precision. Better linguistic pre-processing of source documents can further improve such computer approach.
Towards a Medical Question-Answering System: a Feasibility Study
Authors: Jacquemart Pierre  , Zweigenbaum Pierre
Published: February 2025

Question-answering (QA) systems, as have been presented and evaluated in several TREC conferences, are the next generation of search engines. They combine ‘traditional’ Information Retrieval (IR) with Natural Language Processing (NLP) and Knowledge Engineering techniques to provide shorter, more precise answers to natural language questions. We study here the feasibility of such a system for French in the health care domain. In this purpose, we collected a corpus of student questions in oral surgery. We examined two enabling conditions: on the IR side, how to select the right keywords in a question to identify relevant material on the Web for answering this question, a prerequisite for success; and on the NLP side, whether the contents of the questions fit the conceptual model of an existing QA prototype, a favorable condition for rapid implementation. A manual Web search enabled us to devise automatable principles for building IR queries for these questions. Besides, we could design a semantic model, using UMLS Semantic Network relations, which is consistent with our prototype and covers 90% of the questions. However, the high specialization of the domain and the clinical orientation of the questions, joined with the more limited resources online in the French language, may restrain the quantity of Web material available for answering these questions.
Combining risks estimations and clinical practice guidelines in a computer decision aid: a pilot study of the EsPeR system
Authors: Colombet Isabelle  , Dart Thierry  , Leneveut Laurence  , Zunino Sylvain  , Ménard Joël  , Chatellier Gilles
Published: February 2025

Many preventable diseases such as ischemic heart diseases or breast cancer are still not adequately managed in the population. Computerized decision support systems are one of the solutions for improving the quality of prevention strategies. We designed a system called EsPeR (Personalised Estimate of Risks) combining calculation of several risks and computerisation of guidelines (cardio-vascular prevention, screening for breast cancer, colorectal cancer, uterine cervix cancer, and prostate cancer, diagnosis of depression and suicide risk). We present a qualitative evaluation of its ergonomics, its understanding and acceptance by a group of general practitioners. We organised 4 focus groups comprising 6-11 general practitioners. Physicians worked on several structured clinical scenario with help of EsPeR, and 3 senior investigators leaded structured discussion sessions. Initial sessions identified several ergonomics flaws that were easily corrected. Both clinical scenari and discussion sessions identified several problems of insufficient comprehension (expression of risks, definition of familial history of disease), lack of knowledge, and acceptance of recommandation by both the physician. Educational and organisational components (Le. time constraints) as well as acceptance of evidence-based decision-making should be taken into account before launching computerised decision support system, or testing them in randomised trials.
Interpretative framework of chronic disease management to guide textual guideline GEM-encoding
Authors: Georg Gersende  , Séroussi Brigitte  , Bouaud Jacques
Published: February 2025

The aim of this work is to develop an XML-based application for the automated generation of decision rules from a textual guideline encoded using the Guideline Elements Model (GEM). A formalization of guideline-based chronological steps of treatment has been proposed to resolve the semantic ambiguities of the original document. The GEM DTD has been extended in order to standardize both decision variable and action representations in recommendations. Under these assumptions, the 1999 Canadian Recommendations for the management of hypertension have been marked-up as a GEM-encoded instance of the extended DTD. An XML parser has been used to extract the relevant elements as IF and THEN clauses of decision rules. This GEM application generated 104 rules to be compared to the 98 rules manually developed from the same guideline during the ASTI project.
How many neurologists/epileptologists are needed to provide reliable descriptions of seizure types?
Authors: van Ast J.F.  , Talmon J.L.  , Renier W.O.  , Hasman A.
Published: February 2025

We are developing seizure descriptions as a basis for decision support. Based on an existing dataset we used the Spearman-Brown prophecy formula to estimate how many neurologist/epileptologists are needed to obtain reliable seizure descriptions (rho=0.9). By extending the number of participants to the required level we found that the number of participants needed to obtain a reliability coefficient of 0.9 were in accordance with the number of participants determined from the Spearman- Brown prophecy formula. Systematic differences between the participants were minor and not statistically significant.
Using Mobile Information Technology to Build a Database For Anesthesia Quality Control and to Provide Clinical Guidelines
Authors: Fu Qiang  , Xue Zhanggang  , Klein Gunnar
Published: February 2025

The paper describes a mobile information system to collect patient information for anaesthesia quality control. In this system we use handheld computers, to collect patient data at the bedside with a daily synchronization of the data of the anaesthesiologist’s handheld with the anaesthesia database center, later used for quality control analysis. Further, we design mobile clinical guidelines to be used on the same handhelds.
Societal Dimensions of third-party Evaluation of Internet Health Content
Authors: Lampe Kristian  , Cross Phil  , Brickley Dan  , Kohler Christian  , Roine Risto  , Eysenbach Gunther
Published: February 2025

Rating and certification of Internet health content have been suggested as strategies to guide citizens to high quality information. Attempts to rate Internet content, however, have been criticised for being unfeasible or undesirable. We created and tested a novel concept and technology to evaluate online health resources. In this paper, we view various societal issues and suggest solutions whenever possible. Rating and certification of Internet content should be preceded by a consideration and discussion that has many societal dimensions.
The Danish National Health Informatics Strategy
Authors: Lippert Søren  , Kverneland Arne
Published: February 2025

The central vision for the future information systems in the Danish health care sector is one of a generally accepted, common information model enabling comprehensive digital reuse of shared clinical data. A generic ‘Basic-EHR-structure’ has been developed for this purpose by the National Board of Health from a thorough analysis of the production of clinical information. The strategy contributes to the achievement of the national political goals for the health care sector and describes four important steps to be made by the health care IT systems in order to reach full interoperability and digital reusability of clinical information. Some important initiatives of the strategy are a national terminology server, coordinated implementation of EHRs, and the Public Health Information Portal.