bluuebunny/crossref_metadata_2025 huggingface dataset:
Biomechanical Simulations for Planning of Scoliosis Surgery
Authors: Stokes Ian A.F.  , Gardner-Morse Mack  , Aubin Carl-Éric  , Poulin François  , Labelle Hubert
Published: February 2025

This paper summarizes a series of investigations to determine whether biomechanical simulations can be used to plan scoliosis surgery by predicting the outcome as a function of choices available to the surgeon. In order to test this idea, simulations have initially been performed with prior knowledge of the real outcome (from postoperative radiographs). In addition, intra-operative measurements of the spine shape and displacement of instrumentation have been used to improve documentation of the influence of different steps in the surgical procedure. Several difficulties have emerged which have given new understanding of both the mode of action of surgical procedures, as well as the biomechanical modeling. 1. Important reduction of the Cobb angle occurs in the anesthetized patient compared to pre-operative (standing) radiographs. 2. For an elastic analysis the stiffness of the spine and rib cage should be known for each anatomical level of each patient. 3. Shape changes in the non-instrumented part of the spine are mainly due to the patient and their muscles, not the instrumentation directly, and are difficult to analyze biomechanically. 4. The large difference in stiffness between the stiffest and the least stiff parts of the model, as well as the large displacements which occur in surgical procedures, create technical difficulties in simulations using finite element modeling. 5. Segmental instrumentation offers surgeons many variables and multistep maneuvers to adapt to individual patients’ needs, but conversely create many unknown inputs for the biomechanical analyses, and difficulties in validation of model predictions.
Short and Long-Term Heart Rate Dynamics in Atrial Fibrillation
Authors: Balocchi Rita  , Carpeggiani Clara  , Fronzoni Leone  , Peng C-K  , Michelassi Claudio  , Mietus Joseph  , Goldberger Ary L.
Published: February 2025

The purpose of this study was to quantify the short and long-term correlation characteristics of heart rate variability with atrial fibrillation (AF). Long term analysis was performed on the entire 24-hour heart rate series by applying two independent methods: a) analysis of correlation dimension, and b) analysis of fractal scaling properties using detrended fluctuation analysis (DFA). Short term analysis was performed on non-overlapping series of 500-beat segments, spanning the entire 24 hours, by applying two complementary techniques: the DFA analysis and the autocorrelation function (ACF). We obtained consistent results among the subjects for both long and short-term analysis. DFA analysis of the 24-hours showed a two-slope “cross-over” behavior with the inflection point occurring at about 100 beats. The average slope was αl = 0.55±0.05 (below 100 beats) and α2 = 1.16±0.06 (above 100 beats). DFA analysis on the short 500-beat segments showed a single slope behavior in all subjects (α = 0.56±0.04), with the exception of a patient who underwent electrical cardioversion. The second point of the ACF follows an almost identical behavior (α = -0.49±0.03). Therefore, for time scales less than 100 beats the local beat-to-beat behavior is reminiscent of a “white noise” (uncorrelated) process. In contrast, for time scales greater than 100 beats, the heart rate scaling properties in AF are surprisingly comparable to those in sinus rhythm (long-range Organization). However, we find no evidence of low-dimensional deterministic chaos in AF.
KNOWLEDGE OPTIMIZATION$^{\®}$ THEORY AND APPLICATION TO POINT-OF-CARE TESTING
Authors: Kost Gerald J.
Published: February 2025

Point-of-care testing is defined as testing at or near the site of patient care wherever that medical care is needed. The number and types of tests available at the point of care are increasing dramatically. Point-of-care testing provides test results to the clinical team immediately, usually within a therapeutic turnaround time of five minutes. Immediacy of data is a primary benefit, but we must evaluate when, why, and where point-of-care testing should be used because in most cases this new modality is more expensive than conventional testing in clinical laboratories. Knowledge optimization integrates key components of testing, patient focusing, performance, and test clusters, in concert with synthesis of temporal and diagnostic-therapeutic process information that the physician can assimilate quickly and act on to improve patient outcomes. We identify through literature searches, meta-analysis, and documented outcomes results, the optimal applications of point-of-care testing in critical care and other medical settings. The basis for optimality is improved medical and/or economic outcomes. Results show that point-of-care testing is strongly justified for emergency resuscitations under any circumstances, in critical care, such as the operating room and intensive care unit, and in disease management. Long-range implications are: (1) the point-of-care testing trend will accelerate; (2) viable optimization tools include integrative strategies, clinical algorithms, care paths, and performance maps; (3) attention should be focused on rapid communication and understanding of critical results; and (4) enhanced human interfaces are crucial for efficient medical decision making and efficacious patient therapy.
BRAVO/TeleTrend: A Comprehensive WWW-based Neuromonitoring System for the Neurosurgery ICU
Authors: Nenov Valeriy I.  , Buxey Farzad  , Yamaguchi Yoshiyuki
Published: February 2025

This paper describes BRAVO/TeleTrend - a comprehensive client/server-based system for remote access, review and analyses of continuously acquired multiparametric physiological data from Intensive Care unit (ICU) patients. The system is designed as a distributed three tier model and implemented in Java (Sun Microsystems). TeleTrend is a data review package, which interfaces to existing physiological bedside monitors such as the BRAVO suite of products (Nicolet Biomedical, Madison, WI) and the vital signs monitors compatible with the Unity Network (Marquette Electronics, Milwaukee, WI). It does not transfer over the web the entire patient record, which can be hundreds of megabytes. Instead, it provides tools to view a compressed representation of the raw data in a trend display and to zoom into the raw data if needed. Thus, it eliminates the need for a high-bandwidth Internet connection and makes possible the use of a slower modem access to the vast amount of physiological data acquired per patient. In addition, TeleTrend features a rule-based module capable of generating clinical alerts, which is a potentially useful tool for neuro-intensivists and other critical care personnel. Finally, TeleTrend is intended as a multi-user, semi real-time telemedical application, which features built-in white-board and chat components. These components allow several physicians at different locations around the world to simultaneously view and brainstorm over critical chunks of continuously recorded raw and trend data. By allowing the end-user user to switch on-the-fly from monitoring patients in one ICU to those in another, and by integrating an HL7 interface TeleTrend steps over the boundaries of a single ICU. Thus, it can be provide a medical enterprise-wide solution to the remote access of an important component of the electronic patient medical record. Currently in house validation, verification and alpha testing of the system are underway.
DIGITAL IMAGE RECORDING: AN INTEGRAL ASPECT OF VIDEO ENDOSCOPY
Authors: Preminger Glenn M.  , Delvecchio Fernando C.  , Birnbach Jeffrey M.
Published: February 2025

In today's medical environment, efficiency and accuracy are the keys to successful outcomes. This concept is especially applicable during video endoscopic imaging, where image clarity is of utmost importance for medical applications. One of the most exciting advances in video endoscopy is the development of digital image storage devices. We report on a fast and efficient way to grab and store images during endoscopic procedures. Images can be stored on standard 3.5″ floppy disks using an innovative new digital image recorder. The images are stored as high resolution JPEG files (640×480×24) for excellent clarity and detail. Once loaded onto the computer or network, the images can be placed into electronic medical records, imported into internet web pages, incorporated into slide presentations, and most importantly, stored in well organized archives which take up a minimum of space and are easily accessed by multiple users. This digital image recorder provides a complete system for acquiring images on a standard format 3.5″ floppy disk - the world's most ubiquitous storage format.
LIMITATIONS OF DISTRIBUTED SEGMENTATION FOR THREE-DIMENSIONAL RADIOLOGICAL MODELING
Authors: Rubenstein Jason C.  , Silverstein Jonathan C.  , Panko Walter B.
Published: February 2025

While the use of three-dimensional models has been shown to be useful clinically, the specialized computational equipment and expertise necessary for their construction and use keeps these tools out of reach of most physicians. This paper explores the construction of a Web-based Java application that allows medical radiological models to be built on a remote server and navigated locally on the physician's desktop PC. This paper will also address issues that arose from a public, unrestricted testing of usability over the Internet, such as model size management, easy navigation, processor loading and security. Based on observations and data collected, we suggest what steps are necessary to make a telemedicine application useable in a true clinical setting.
EARLY EXPERIENCE AND VALIDATION WORK WITH PROCEDICUS VA - THE PROSOLVIA VIRTUAL REALITY SHOULDER ARTHROSCOPY TRAINER
Authors: Smith Simon  , Wan Andrew  , Taffmder Nick  , Read Sam  , Emery Roger  , Darzi Ara
Published: February 2025

Shoulder arthroscopy is a difficult procedure, commonly used for both diagnostic and therapeutic purposes. Until now, the majority of training has been done in theatre, assisting and practising under supervision. Few good simulations exist.
INTERACTIVE VOLUME VISUALIZATIONS FOR SYNCHRONOUS AND ASYNCHRONOUS REMOTE COLLABORATION
Authors: Stredney Don  , Crawfis Roger  , Wiet Gregory J.  , Sessanna Dennis  , Shareef Naeem  , Bryan Jason
Published: February 2025

The value of information acquisition is not simply to acquire data at increased precision, but to make these data both available and usable to as many specialists as possible. We have developed a working prototype for intuitive realtime interaction over the Internet. Current scenarios include use by expert head and neck surgeons, for use in preoperative assessment of head and neck cancers, and remote synchronous collaboration scenarios such as expert-expert and expert-referring physician. This prototype demonstrates a shared virtual environment that allows multiple users to interactively manipulate large volumetric data sets across long distances. The system is easily extensible to many other applications that utilize discrete data sampling and thus is readily extensible to a wide range of scientific investigations
A VOICE-CONTROLLED ROBOTIC ASSISTANT FOR NEUROENDOSCOPY
Authors: Wapler Matthias  , Bräucker Martin  , Dürr Mark  , Hiller Andrea  , Stallkamp Jan  , Urban Volker
Published: February 2025

This paper describes experiments with a voice-controlled robot system to be used in endoscopic neurosurgery. The robot was a modified version of the robot described in previous publications of the group at Fraunhofer IPA and HSK. To control the robot a voice-controlled user interface was developed. The experiments were conducted on cadavers for three standard approaches in neuroendoscopy. The goal was to gain experience with a voice-controlled user interface and also with the set-up and use of the robotic system under clinical conditions.. The results indicate that modifications to the robot and user interface are necessary. However the overall feasibility of the application was demonstrated.
Defining The Role Of Haptic Feedback In Minimally Invasive Surgery
Authors: Bholat Omar S.  , Haluck Randy S.  , Kutz Richard H.  , Gorman Paul J.  , Krummel Thomas M.
Published: February 2025

Introduction: The applications of Minimally Invasive Surgery (MIS) and Laparoscopy are rapidly expanding. Despite this expansion, the technology related to our understanding of the importance of haptic feedback related to laparoscopic surgery remains in its infancy. While many surgeons feel that the use of minimally invasive techniques eliminates force feedback and tactile sensation, the importance of haptics in MIS has not been fully evaluated. Moreover, there is considerable interest in the development of haptic simulators for MIS even though the importance of force feedback remains poorly understood. This study was designed to determine the ability of novice surgeons to interpret haptic feedback with respect to texture, shape and consistency of an object.
A SYSTEM FOR THE SIMULATION AND PLANNING OF ORTHODONTIC TREATMENT USING A LOW COST 3D LASER SCANNER FOR DENTAL ANATOMY CAPTURING
Authors: Alcañiz M.  , Grau V.  , Monserrat C.  , Juan C.  , Albalat S.
Published: February 2025

The detection and correction of malocclusions and other dental abnormalities is a significant area of work in orthodontic diagnosis. To assess the quality of occlusion between the teeth the orthodontist has to estimate distances between specific points located on the teeth of both arches. Distance measuring is based on the observation, by the orthodontist, of a plaster model of the mouth. Gathering of information required to make the diagnosis is a time consuming and costly operation. On the other hand, obtaining and manipulation of plaster casts constitute a huge problem in clinics, due to both the large space needed and high costs associated with plaster casts manufacturing. For this problem we present a new system for three-dimensional orthodontic treatment planning and movement of teeth. We describe a computer vision technique for the acquisition and processing of three-dimensional images of the profile of hydrocolloids dental imprints taken by mean of a own developed 3D laser scanner. Profile measurement is based on the triangulation method which detects deformation of the projection of a laser line on the dental imprints. The system is computer-controlled and designed to achieve depth and lateral resolutions of 0.1 mm and 0.2 mm, respectively, within a depth range of 40 mm. The developed diagnosis software system (named MAGALLANES) and the 3D laser scanner (named 3DENT) are both commercially available and have been designed to replace manual measurement methods, which use costly plaster models, with computer measurements methods and teeth movement simulation using cheap hydrocolloid dental wafers. This procedure will reduce the cost and acquisition time of orthodontic data and facilitate the conduct of epidemiological studies.
3.5 Nursing Information System
Authors: Liaskos Joseph  , Mantas John
Published: February 2025

Nursing Information System (NIS) is a part of a health care information system that deals with nursing aspects, particularly the maintenance of the nursing record. The several objectives that a Nursing Information system should meet in order to succeed its aims, cover the users' needs and operate properly are described. The functions of such systems, which combine with the basic tasks of the nursing care process, are examined. As Nursing Information System is part of the health care and hospital information system, the different strategies and approaches for designing and developing Hospital Information Systems followed from the decade of 1970 until the recent decade of 1990, are presented. The three main approaches followed were the “centralized approach”, the “departmental approach”, and the “distributed approach”. The advantages and drawbacks of each different approach are examined. For the implementation or upgrade of Nursing Information System a NIS committee comprised by different health care professionals, is necessary to be formed. The implementation and upgrade of a Nursing Information System follows some specific phases. These steps, include planning phase, analysis phase, design phase, development phase, implementation phase, and upgrade phase. A paragraph at the end of this chapter summarizes the future trends of Nursing Information Systems.
The Survey of Healthcare Software in Yugoslavia
Authors: Grbic Dragana  , Simic Snezana  , Marinkovic Jelena  , Kocev Nikola  , Matijevic Borislava
Published: February 2025

The aim of this study is to identify vendors of software packages applicable to health care system as well as to evaluate software packages offered to the health sector by a variety of sources, namely state owned software development companies, privately operated software development companies as well as sole traders. The approach undertaken was to preselect the potential suppliers via an initial targeted interview. Subsequently a questionnaire, consisting of 23 questions, was addressed to the selected vendors and suppliers. The response rate to the questionnaire was 58%. Investigation of 113 has revealed the non government software suppliers clearly lead in copyright ownership, I B M compatible personal computers were the platform of choice whereas majority of code was written utilising languages capable of supporting relational data base queries. The final outcome of the above study is a database of software packages and applications available to the health sector offering the health professionals and institutions guide lines and support in developing information systems, relevant subsystems and modules.
Developing a Health Care Information System for Scotland
Authors: Williams M. Howard  , Venters Gavin  , Venters George  , Marwick David
Published: February 2025

The rapid development and uptake of Internet technology has created opportunities for large-scale information networks to replace paper-based information sources. In order to obtain the maximum benefits for patients and medical practitioners it is important that health care providers work together to produce an integrated information service. However, the task of bringing together a large number of different information providers to create a huge structured pool of information covering a wide range of topics with appropriate quality assurance is non-trivial. This paper describes an approach being used to create healthcare information systems in a set of co-operative healthcare information networks in Europe, and specifically in Scotland.
Introduction of a new Hospital Information System at the Innsbruck University Hospital
Authors: Callegari Verena  , Pfeiffer Karl Peter  , Lechleitner Georg
Published: February 2025

The aim of the introduction of an advanced hospital information system at the Innsbruck University Hospital is mainly to support the care process and to improve quality and efficiency of care. These requirements entail changes in the clinical processes and many obstacles with respect to the organization have to be considered. The article gives an overview of the goals, organization and problems of the introduction which is still in the planning phase.
An IT awareness programme for the health sector in Ireland
Authors: Grimson Jane  , Flahive Michael  , Grimson William  , O'Moore Rory  , Nolan John  , Chadwick Geoff
Published: February 2025

This paper describes an Awareness Programme delivered throughout Ireland which aims to increase the level of understanding of healthcare professionals as to the benefits of Information and Communications Technology (ICT) and of emerging trends in Health Informatics in Europe. The programme examines the use of ICT across the whole health sector - primary, secondary and tertiary. It has been delivered at over 30 centres to more than 1500 health professionals.
Computerised System for the Networking of Health Services
Authors: Teseleanu M.  , Afteni V.  , Sucholotiuc M.  , Stefan L.  , Dobre I.
Published: February 2025

The integration of health services in the health insurance system can only be performed by using an advanced informational system, due to the large volume of documents needed for the payment of medical services by the health insurance firms. To better facilitate the access to the medical databases throughout the country is it necessary that the different application and their respective supports are able to communicate with each other.
Experiences with a new Security Standard for Healthcare Information Systems
Authors: Louwerse Kees  , van Ditmarsch Margot  , Flikkenschild Erik
Published: February 2025

This article describes the results of the implementation and demonstration of the Standard CEN ENV 12924 (Security Categorisation and Protection of Health Care Information Systems), that was performed as part of the ISIS/MEDSEC project of the EU. The categorisation scheme given in the standard was followed through for almost all information systems or sub-systems in the Leiden University Medical Centre. The status of the security measures was evaluated for ten systems; further implementation plans were then drawn up for these systems, and partly effectuated. Findings are reported, both on the present security level, and on the applicability of the standard (which in general was found to be very positive). In the course of this work, use was made of a database support tool, developed in an earlier EU project (SEISMED).
An efficient algorithm for automatic decoding of ECG signals
Authors: Palamarchouk Evgen A.
Published: February 2025

Creating of computer ECG-conclusion, based on decodings of ECG- signals, as a rule includes three main stages - morphological analysis, comparison of obtained parameters and synthesis the conclusion. In a considered circuit the most critical point is the first stage. Here even the minor errors of automated, i.e. computer determination of elements, can provoke synthesis incorrect conclusions, in particular automated measurement of heart rate variability [1]. From this point of view it is extremely important to creat algorithms of decoding which are stable against parasites of electrical and biological origin, and also which are capable adequately to react to signal polymorphism [2]. Research in this direction have revealed the following.
GIN AUSTRIA Assuring quality and relevance on Internet-Health-Informations for patients
Authors: Göbel Georg  , Pfeiffer Karl Peter
Published: February 2025

GIN AUSTRIA (Gesundheitsinformationsnetz AUSTRIA) offers patients and consumers reliable medical knowledge about diseases, wellness and disease management in an understandable way and enables them to quick and incessant access to informations about the Austrian health system and Austrian health organizations. To improve the quality of the database and to achieve full customer (patients, citizens) satisfaction a systematic approach for implementing total quality management is also applied. Focusing the attention on understanding and responding to customer needs, systematic and continous improving of the IS and total involvement of all participants are the three core TQM principles at this project. The second focus of the project is the development and the implementation (prototype) of a medical dictionary or rather medical thesaurus as interface for patients, who are not used to scientific terms and expressions. This interface is based on the controlled vocabulary of the MeSH-Thesaurus (german version).
Expanding DIOGENE with a Clinical Information System Based on a New Hospital-Wide Clinical Finding Dictionary
Authors: Bréant Claudine  , Borst François  , Campi Daniel  , Griesser Vincent  , Le Huy Son
Published: February 2025

The aim of this project is to expand DIOGENE with a centralized and integrated patient clinical database system providing a standardized framework for the building of future clinical databases and for the integration of existing heterogeneous ones. The combined ‘across time view’ and ‘across departments view’ generated from the integrated clinical data will enable an evolutionary view of the patient state both across time and across medical specialties. For this purpose and to permit the communication and exchange of data, a new controlled vocabulary for representing clinical data has been created. The construction of this vocabulary is based on the international ICD classification, already being used in DIOGENE for encoding patient diagnosis and procedures. A new extension of the ICD is proposed for medical information that goes beyond diagnosis and procedures encoding. The building of a common clinical finding dictionary recording the definition of findings is based on this newly developed clinical vocabulary. This process is incremental, manual, and significant.
Quantitative Collagen as a Golden Standard in Differential Diagnosing of Fibrotic Changes in Liver Tissue
Authors: Jonsson Jens  , Babic Ankica
Published: February 2025

Determining a presence and degree of liver fibrosis provides means for diagnosing disease related processes. We have used two data mining methods, discriminant and regression analyses, to acquire knowledge from the data of 211 patients. We have shown and discussed that quantitative collagen has a distinguished discriminating power and can serve as a golden standard. We have additionally succeeded to obtain a formula consisting of standardised blood tests that can replace quantitative collagen. Practical implications of this is a non-invasive and cost efficient patient examination. All the results are now left for clinical evaluation and so is the current way of histopathological classifications.
C3: Java-based Medical Record System for Cardiology
Authors: Taddei Alessandro  , Cecchetti Gabriele  , Macerata Alberto  , Carpeggiani Clara  , Chelozzi Lia  , Marchessi Carlo
Published: February 2025

This paper describes a system for electronic medical record (EMR) we have developed for use in our health care institution, mainly dealing with diagnosis and treatment of cardiovascular pathologies. This activity is part of the project SPERIGEST, supported by Health Ministry of Italy, for the management of health care delivery, as concerns both clinical and administrative aspects. A networked computer-based information system was realized to integrate the different heterogeneous sources of patient information. Both clinical and administrative patient relevant data are provided from the various systems and stored into a central database. The EMR system was designed using World Wide Web (WWW) technology (Java, HTML). The system is currently under clinical evaluation.
Clinicians must invest resources when implementing Electronic Patient Records
Authors: Nikula Rolf E.  , Elberg Pia B.  , Svedberg Helena B.
Published: February 2025

Most often the investment in Electronic Patient Records (EPR) is decided upon on the basis of descriptions of all the advantages this new technology will bring. However, most of these advantages from EPR’s are only obtainable if the clinicians are motivated to invest their knowledge and resources in this implementation process. This paper proposes a simple method to qualify the decision making process by introducing the “price to pay” concept.
A Prototype Haptic Lumbar Puncture Simulator
Authors: Gorman Paul  , Krummel Thomas  , Webster Roger  , Smith Monica  , Hutchens David
Published: February 2025

Lumbar punctures (LP) are complex, precise procedures done to obtain cerebro-spinal fluid from a patient for diagnostic purposes. Incorrect techniques resulting from inadequate training or supervision can result in sub-optimal outcomes. As tactile feedback is crucial for a successful lumbar puncture, this procedure serves as an ideal candidate for the development of a haptic training simulator. The intent of this project is to engineer a force feedback LP simulator that provides a safe method of training students (medical students, residents, or trained physicians) for an actual LP procedure on a patient.
Planning System for Computer Assisted Total Knee Replacement
Authors: Müller Wolfgang  , Bockholt Ulrich  , Voss Gerrit  , Lahmer Armin  , Börner Martin
Published: February 2025

Total knee replacement (TKR) is a common orthopaedic surgical intervention and includes the removal of bone sections from the end of the femur and the top of the tibia for replacement by prosthetic components. Pain relief and functional improvement are predictable clinical results. But the accuracy of the alignment affects the surgical outcome and the longevity of the prosthesis. Hence, current total knee implantation systems attempt to align the knee joint in the mechanical axis for placement of the total knee components. These approaches use templates and plain radiographs for preoperative planning and alignment devices for bone cuts. To overcome the inherent inaccuracy of the presently used systems a computer-assisted planning system has been developed delivering the necessary control data for the intraoperative surgical robot system.
A Virtual Instrument Ergonomics Workstation for Measuring the Mental Workload of Performing Video-Endoscopic Surgery
Authors: Smith Warren D.  , Chung Yi-Hung  , Berguer Ramon
Published: February 2025

The visual and physical interface imposed on the surgeon by video-endoscopic surgery (VES) increases the surgeon's mental workload. Ergonomic studies are needed to develop ways to reduce this workload. We used virtual instrumentation to devise a portable ergonomic workstation to compare the surgeon's mental workloads during simulated open surgery and VES. The system measures palmar tonic skin conductance level (SCL) and electrooculogram (EOG) and frontalis electrical activity to monitor mental stress and concentration levels. We used the system at a national surgery conference on volunteer subjects during a rest period and as they performed simulated surgery, consisting of tying knots using open and VES techniques. The subjects were asked to self-rate their levels of mental concentration and stress during these activities and reported that both progressively increased from rest to the open surgery task to the VES task. The subjects tied fewer knots during the VES than the open task, consistent with the increased demands of the VES task. The SCL progressively increased from rest to the open task to the VES task, correlating with the subjects' reported increase in mental stress level. Eye blinks and low frequency EOG activity decreased from rest to the open task, consistent with the subjects' reported increase in mental concentration level. From the open to the VES task, eye blinks and EOG activity increased, as expected given the greater demands of the VES task. High frequency frontalis activity merits further study as another indicator of the subjects' levels of mental concentration and stress.
The Use of Virtual Reality in the Assessment of Driving Performance in Persons with Brain Injury
Authors: Wald Jaye  , Liu Lili  , Hirsekorn Linda  , Taylar Sue
Published: February 2025

In this article, we present the results of a pilot study that examined the driving performance of persons with brain injury using a virtual reality environment, known as the DriVR. Virtual driving performance was examined and compared to on-road, cognitive, visual-perceptual, and driving video test results. The DriVR appeared to be a useful adjunctive screening tool for assessing driving performance. However as with any new assessment tool, will need to undergo further empirical validation.
Design and Use of Clinical Ontologies: Curricular Goals for the Education of Health-Telematics Professionals
Authors: Musen Mark A.
Published: February 2025

In computer science, the notion of a domain ontology - a formal specification of the concepts and of the relationships among concepts that characterize an application are a - has received considerable attention. In human-computer interaction, ontologies play a key role in defining the terms with which users and computer systems communicate. Such ontologies either implicitly or explicitly drive all dialogs between the computer and the user. In the construction of health-telematics applications, professionals need to understand how to design and apply domain ontologies to ensure effective communication with end-users. We currently are revising our training program in Medical Information Sciences at Stanford University to teach professional students in health telematics how to develop effective domain ontologies. Instruction concerning the construction and application of clinical domain ontologies should become an integral component of all health telematics curricula.
An Open Standard platform for interoperability of Medical Devices
Authors: Ruiz R.  , Woolman P.  , Rubio J.M.  , Perez J.  , Bernal A.  , Angel M.
Published: February 2025

Patient care in Intensive Care Units and Operating Rooms requires sophisticated instrumentation for monitoring, treatment and control. A major technical problem is the communication between devices, since the connection of medical devices from different manufacturers has similar problems to the communication between people from different countries who do not share a common language.
Application of artificial neural network for the identification of fresh water bacteria
Authors: Giacomini Mauro  , Ruggiero Carmelina  , Caneva Federico  , Bertone Stefania
Published: February 2025

A method based on artificial neural network (ANN) for monitoring aquatic bacteria which would be useful for health care is presented. Environmental micro-organisms include a large number of taxa. Some species that normally are not pathogenic can represent a risk in certain conditions, such as old people and immuno-compromised individuals. A system based on unsupervised ANN has been set up using the fatty acid profiles of standard strains, obtained by gas-chromatography, as learning data. The Kohonen output map resulted in a powerful tool for identification of fresh isolates coming from a line of the major civil water system of Genova (Italy).
Lossy Compression of Auditory Brainstem Response Signals
Authors: Tossavainen Timo  , Juhola Martti  , Grönfors Tapio
Published: February 2025

Compression of digital signals is frequently utilised in numerous applications like music and speech signals. So far compression of biomedical signals has concentrated almost purely on electrocardiography. We recently opened compression studies on biomedical signals concerning otological measurements performed in accord with hearing and balance problems of humans. In this paper we shall present results for auditory brainstem response signals gained with traditional and modern compression methods as well as one of ours.
Intellectual Systems for Differential Diagnostics within Groups of hardly distinguished Diseases
Authors: Mayorov Oleg Yu.
Published: February 2025

A new method of mathematical modeling based on ideas of the artificial intelligence has been developed called as a method of a «mosaic portrait». A description of a universal computer system «Differentiated diagnostics» is given into which it is possible to introduce the «mosaic model» for any group of diseases which are difficult to distinguish. On its base a number of diagnostic medical intellectual systems have been developed.
Evaluation of DICE, a terminological system for intensive care
Authors: de Keizer N.F.  , Abu-Hanna A.  , Cornet R.
Published: February 2025

Evaluative research and the introduction of the Patient Data Management System to support care have increased the need for structured and standardized registration of diagnostic information in Dutch intensive cares (IC). To this end a terminological system to describe diagnoses is needed. A terminological system is a system that denotes terms to concepts in a domain based on specifications of these concepts. During the last two years we have developed DICE (Diagnoses for Intensive Care Evaluation), a terminological system application which includes knowledge about the IC diagnoses domain, such as the anatomical localization, the pathophysiology and the etiology. This paper briefly describes the design of DICE and focus on the preliminary evaluation of DICE. DICE was evaluated on the basis of 126 diagnoses collected. The knowledge modeller as well as the intensivists judged DICE positively. However, there were some points for improvement. The knowledge modeller observed a problem in modelling dependencies between qualifiers of a concept and the intensivists observed some gaps in the knowledge base and were critical about the current interface to compose plural operative procedures.
Simulation to Estimate the Capacity of a Stroke Unit
Authors: Heinrichs Marit  , Beekman Reno  , Limburg Martien
Published: February 2025

Preceding the implementation of a Stroke Unit (SU), data have been collected and used for building a simulation model of patient flow. This model was subsequently used to estimate the optimal capacity of the SU to be implemented. Because stroke patients require acute hospital care, this implies a highly variable number of immediate admissions. This variability complicates optimizing the capacity. In order to support decisions with regard to staffing (i.e. capacity) of the SU, different scenarios are simulated and compared to provide insight in the trade-off between regular understaffmg and a low bed occupancy rate. In 1996 the Department of Neurology of the Academic Medical Center in the Netherlands implemented its SU to improve the quality of care for stroke patients. Data collected in the years 1997 and 1998 that the SU has been operational were evaluated and confirm the predictions made from simulating different scenarios. We conclude that simulation models provide a powerful tool for supporting decision making with regard to resource planning at the departmental level in our hospital.
Medical informatics education for “allied” profiles
Authors: Mihalas G.L  , Lungeanu Diana  , Vernic Corina  , Kigyosi Anca  , Petrescu M.
Published: February 2025

Medical informatics education should be adapted for each speciality of “allied professions”. In this paper we try to share from our experience with students of several profiles: medicine, dentistry, pharmacy, physio-kineto-therapy, clinical laboratory, dentistry techniques and stomatological prophylaxis.
Tacit knowledge - an epistemological framework and implications for research in doctors information needs
Authors: Thirup Poul  , Mikkelsen Peter
Published: February 2025

We propose an epistemological framework of medical knowledge which might guide research and attempts in fulfilling doctors information needs. Tacit knowledge is influencing information needs and medical work but it is epistemological unresolved whether it is possible to articulate all this tacit knowledge and thus making it accessible to decision support system programming. Tacit knowledge might explain the difficulties in building successful decision support systems and should be taken into account in research.
A Model for Optimal Sequential Decisions Applied to Liver Transplantation
Authors: Tusch Guenter
Published: February 2025

The present investigation aims at the construction of a sequential decision rule derived from a decision-theoretic model. An optimal clinical management strategy based on patient risk assessment is to be found. A novel decision theoretic cost model has been selected for this clinical classification task: costs were determined by specifying a minimum acceptable sensitivity and specificity of the overall procedure. Non-linear optimisation combined with a robust partial classification method is used to find the earliest possible decision step where a final decision can be made subject to these quality restrictions. The probabilities needed in the model are estimated from data provided by a clinical study on liver transplantation patients. Decision steps for the decision-theoretic model were chosen before and after donor organ assessment, and postoperatively in the intensive care unit. Clinical parameters acquired in between decision steps were combined to scores obtained from artificial neural networks (ANNs). The encouraging results show the applicability of the model in the clinical setting.
Modellwahl bei longitudinalen Daten – am Beispiel einer Studie zur Langzeitwirkung von Knoblauch auf Fettablagerungen in Arterien
Authors: Schuster Ernst
Published: February 2025

Die Modellauswahl durch absteigendes Vorgehen bei longitudinalen Daten wird an einem Beispiel illustriert. Dabei wird auf die Wahl der festen Effekte und der Kovarianzstruktur eingegangen. Mit WinBUGS werden solche und robustere Modelle geschätzt.
Chapter 3.9 - A Computer-assisted visual sleep scoring program
Authors: Värri Alpo  , Koivuluoma Mikko  , Morvan Catherine
Published: February 2025

The sleep analysis and scoring program WSCORE was developed under the European Neurological Network (ENN) project. The purpose was to implement an analysis and scoring system for ambulatory and standard polysomnography. In addition to visual Rechtschaffen & Kales scoring the program offers a possibility of free form visual scoring. It contains also analysis modules for Periodic Leg Movement Disorder, Hjort parameters, heart rate and EMG amplitude. A FTP client module was built into the program so that it can be used as a telemedicine application.
Effects of Geared Motor Characteristics on Tactile Perception of Tissue Stiffness
Authors: Longnion Jeff  , Rosen Jacob  , Sinanan Mika  , Hannaford Blake
Published: February 2025

Endoscopic haptic surgical devices have shown promise in addressing the loss of tactile sensation associated with minimally invasive surgery. However, these devices must be capable of generating forces and torques similar to those applied on the tissue with a standard endoscopic tool. Geared motors are a possible solution for actuation; however; they possess mechanical characteristics that could potentially interfere with tactile perception of tissue qualities. The aim of the current research was to determine how the characteristics of a geared motor suitable for a haptic surgical device affect a user's perception of stiffness. The experiment involved six blindfolded subjects who were asked to discriminate the stiffness of six distinct silicone rubber samples whose mechanical properties are similar to those of soft tissue. Using a novel testing device whose dimensions approximated those of an endoscopic grasper, each subject palpated 30 permutations of sample pairs for each of three types of mechanical loads; the motor (friction and inertia), a flywheel (with the same inertia as motor), and a control (no significant mechanical interference). One factor ANOVA of the error scores and palpation time showed that no significant difference existed among error scores, but mean palpation time for the control was significantly less than for the other two methods. These results indicated that the mechanical characteristics of a geared motor chosen for application in a haptic surgical device did not interfere with the subjects’ perception of the silicone samples’ stiffness, but these characteristics may significantly affect the energy expenditure and time required for tissue palpation. Therefore, before geared motors can be considered for use in haptic surgical devices, consideration should be given to factors such as palpation speed and fatigue.
A Virtual Reality Simulator for Bone Marrow Harvest for Pediatric Transplant
Authors: dos Santos Machado Liliane  , Nebel de Mello Andre  , de Deus Lopes Roseli  , Odone Filho Vicente  , Knorich Zuffo Marcelo
Published: February 2025

Bone marrow transplant is a relatively new procedure to treat recently considered incurable diseases. One important part of the procedure is the process of harvesting the donor bone marrow. We are developing a virtual reality simulator for bone marrow harvest that integrates interactive stereo visualization and force feedback techniques. The main objective is to offer a low cost virtual reality system to boost current adopted training methodologies for bone marrow harvesting.
LAHYSTOTRAIN Development and Evaluation of a complex Training System for Hysteroscopy
Authors: Müller-Wittig Wolfgang K.  , Bisler Alex  , Bockholt Uli  , Los Arcos Jose Luis  , Oppelt Peter  , Stähler Jan  , Voss Gerrit
Published: February 2025

Hysteroscopy has already become an irreplaceable method in gynaecoloic diagnosis and therapy. In the diagnostic case the hysteroscope with a 30� optic is insert transvaginal, in the therapeutic case the resctoscope with a 12° optic is used. The endoscoppic intervention requires special surgical skills for endoscope handling and remote instrument control. To acquire these skills currently hands-on training in clinical praxis has become standard, which is linked with higher danger for the women. To overcome current drawbacks of traditional training methods the European project LAHYSTOTRAIN was set up, that tries to combine Virtual Reality (VR), Multimedia (MM) technology, and Intelligent Tutoring Systems (ITS) to develop an alternative training system for hysteroscopic interventions.
Surgical Trainee Assessment using a VE Knee Arthroscopy Training System (VE-KATS): Experimental Results
Authors: Shenrian K.P.  , Ward J.W.  , Wills D.P.M.  , Sherman V.J.  , Mohsen A.M.M.A.
Published: February 2025

Previous work has described the development of a Virtual Environment Knee Arthroscopy Training System (VE-KATS): a collaborative project between the Orthopaedic Department, Hull and East Yorkshire Hospitals NHS Trust, Hull, U.K., and the Department of Computer Science, University of Hull, U.K. This work describes the initial results obtained by Orthopaedic Surgical Trainees using VE-KATS. The results showed that differences between individual trainees could be measured using the scoring system incorporated within VE-KATS. There was a weak correlation with the seniority of the surgical trainees.
Psychometric Properties of the driVR™: A Virtual Reality Driving Assessment
Authors: Wald Jaye  , Liu Lili
Published: February 2025

This study provides data on the psychometric properties of the driVR™, a virtual reality assessment used to assess driving in persons with brain injury. Several driVR™ measures were compared to other established indicators of driving performance. Many concurrent validity coefficients over r = 0.3 were identified between driVR™ measures of lane tracking with on-road, Trail Making Test, and the Driver Performance Test II scores. The results provide further evidence to support the concurrent validity of the driVR™. Continued research addressing other aspects of validity and reliability is recommended.
Anatomical Accuracy in Medical 3D Modeling
Authors: Wulf J.  , Vitt K.D.  , Gehl H.-B.  , Busch L.C.
Published: February 2025

In complex surgery, medical modeling has become an accepted tool for diagnosis, simulation and the planning of surgical interventions [1]. However, the question concerning the accuracy of the model, i.e. the equivalence between the model itself on the one hand and the original anatomical situation on the other hand, remains unanswererd in the current literature.
Evaluation of the Outcomes of a Multi-Professional Education Programme in Health Informatics
Authors: Saranto Kaija  , Korpela Mikko  , Kivinen Tuula
Published: February 2025

A multi professional continuing education programme on healthcare information systems was designed on the basis of the IMIA WG 1 recommendations for teaching health informatics. This paper presents the outcomes of the education programme on the basis of the participants' (n=19) narrative assessments and a questionnaire. According to the results, the participants were very satisfied with their personal learning outcomes and they felt that the programme content was useful for their duties at work. They regarded that particularly the multi-professional group had given them many ideas and rewarding discussions. The learning arrangements were assessed very successful and the learning methods rewarding. In conclusion we suggest that it is important to include different professions – healthcare and technical – into the same continuing education programmes in health informatics, and to include real life-like team projects. The validity of the results to undergraduate education programmes should be studied.