bluuebunny/crossref_metadata_2025_split huggingface dataset:
Privacy Enhancing Techniques
Authors: Claerhout B. , De Meyer F. , De Moor G. J. E. 
Published: March 2018

Summary
Objectives: To introduce some of the privacy protection problems related to genomics based medicine and to highlight the relevance of Trusted Third Parties (TTPs) and of Privacy Enhancing Techniques (PETs) in the restricted context of clinical research and statistics.
Methods: Practical approaches based on two different pseudonymisation models, both for batch and interactive data collection and exchange, are described and analysed.
Results and Conclusions: The growing need of managing both clinical and genetic data raises important legal and ethical challenges. Protecting human rights in the realm of privacy, while optimising research potential and other statistical activities is a challenge that can easily be overcome with the assistance of a trust service provider offering advanced privacy enabling/enhancing solutions. As such, the use of pseudonymisation and other innovative Privacy Enhancing Techniques can unlock valuable data sources.
Integr8: Enhanced Inter-Operability of European Molecular Biology Databases
Authors: Morris L. , Hermjakob H. , Apweiler R. , Kersey P. J. 
Published: March 2018

Summary
Objectives: The increasing production of molecular biology data in the post-genomic era, and the proliferation of databases that store it, require the development of an integrative layer in database services to facilitate the synthesis of related information. The solution of this problem is made more difficult by the absence of universal identifiers for biological entities, and the breadth and variety of available data. Methods: Integr8 was modelled using UML (Universal Modelling Language). Integr8 is being implemented as an n-tier system using a modern object-oriented programming language (Java). An object-relational mapping tool, OJB, is being used to specify the interface between the upper layers and an underlying relational database.
Results: The European Bioinformatics Institute is launching the Integr8 project. Integr8 will be an automatically populated database in which we will maintain stable identifiers for biological entities, describe their relationships with each other (in accordance with the central dogma of biology), and store equivalences between identified entities in the source databases. Only core data will be stored in Integr8, with web links to the source databases providing further information.
Conclusions: Integr8 will provide the integrative layer of the next generation of bioinformatics services from the EBI. Web-based interfaces will be developed to offer gene-centric views of the integrated data, presenting (where known) the links between genome, proteome and phenotype.
Tele-Affiliation in Medical Education: Experience from the International Program at Yale Office of Telemedicine
Authors: Condos S. G. , Selles J. M. , Merrell R. C. , Stamkopoulos T. 
Published: March 2018

Summary
Objectives: Telemedicine is developed in response to the needs of users that results in a more viable model. Yale has developed a process called tele-affiliation to combine services that are customized to the international client’s needs.
Methods: Several defined steps compose the tele-affiliation process. The Yale-Greece telemedicine program is used as an illustration of this process. Some of the programs developed in response to Greek needs include breast cancer clinics, women’s health clinics and tele-homecare monitoring for post-operative and chronically ill patients.
Results: Tele-affiliation creates an infrastructure that has the potential to change the method of health care delivery. By using the infrastructure created by the tele-affiliation process, templates for disease management, as well as health promotion and education can be delivered to a global audience.
Conclusions: A tele-affiliation education environment has been developed and tested between Yale University School of Medicine and Greece resulting in an improved infrastructure for health education and management.
Development of a Regional Health Care Network and the Effect of Knowledge Intensive Work on Personnel and Organisation
Authors: Itkonen P. 
Published: March 2018

Summary
Objectives: a) To present a regional health care communication system developed in the North Karelia Hospital District with the help of two EU funded information technology projects namely the TERVE project (1) which was implemented at the national level financed by the regional subsidy 6 of the ERDF and the CHIN project (2) that was implemented at the European level. b) To present the questions and issues that arose when implementing new technologies in a regional health care environment.
Results: Transformations in information technology are usually parts of other organisational transformations in health care. As a result of these issues, implementation of great information technology transformations has failed because of too strong a technology emphasis, insufficent participative touch and underestimation of social factors. Another result is that there is a cultural shock for physicians working in organisations where there are networks rather than hierarchies and relationships are predominantly contractual rather than professional.
Conclusions: The effectiveness, productivity and profitability of the hospitals will be decisively dependent on information technology as well as its regional applications. Transformations in information technology are parts of other organisational transformations in health care, and can induce cultural shocks for physicians since the networked environment has a different philosophy than the hierarchy-based environment which was the case until recently. Finally, in a taxation based system, one key requirement is to understand that the network contacts and the time spent on networks must bring additional value to health care.
Extensions to the HISA Standard – the SynEx Computing Environment
Authors: Jung B. , van Mulligen E. M. , van Ginneken A. , Pardon S. , Sottile P. A. , Grimson W. 
Published: March 2018

Summary
Objectives: This paper reports on the integration work required to support the delivery of healthcare. Specifically, four elements are included being: the DHE (a standards based distributed healthcare environment), Synapses which is a patient record server, XML as a technology to deliver records, and finally two client applications that facilitate structured data entry (SDE) and the remote booking of specialist services. Methods: A general motivation for the work is presented and augmented on hand of a clinical scenario. Additionally, the adoption of a middleware approach is reviewed. The role of computerised patient records is described followed by an account of a federated record server. The approach favoured by standards bodies in utilising XML is covered and the tailoring to suit the needs of the integration is explained. The main practical challenges in achieving integration are presented, one of these being the mapping between the DHE data model and the Synapses server record architecture.
Results: The described environment has been demonstrated to provide the functionality that is required and in addition it has been shown that the engineering challenges can be met in a controlled and orderly manner.
Conclusions: The role of the DHE middleware component acting as an ‘anchor’ has been shown to be a valid one onto which other specialised components can be added to provide a richer service environment. Additionally, it has been demonstrated that XML is a good candidate technology that facilitates connectivity to client applications over an extranet. The demands inherent in both the clinical scenario and the computerised patient record can be met by the computing environment described in the paper.
Automated Nasopharyngeal Carcinoma Detection with Dynamic Gadolinium-Enhanced MR Imaging
Authors: Hsu C.-C. , Lai P.-H. , Huang W.-C. , Lee C. 
Published: March 2018

Summary

Objectives:
The purpose of this research is to develop an automatic medical diagnosis for segmenting nasopharyngeal carcinoma (NPC) with dynamic gadolinium-enhanced MR imaging.

Methods:
This system is a multistage process, involving motion correction, head mask generation, dynamic MR data quantitative evaluation, rough segmentation, and rough segmentation refinement. Two approaches, a relative signal increase method and a slope method, are proposed for the quantitative evaluation of dynamic MR data.

Results:
The NPC detection results obtained using the proposed methods had a rating of 85% in match percent compared with these lesions identified by an experienced radiologist. The match percent for the two proposed methods did not have significant differences. However, the computation cost for the slope method was about twelve times faster than the relative signal increase method.

Conclusions:
The proposed methods can identify the NPC regions quickly and effectively. This system can enhance the performance of clinical diagnosis.
Towards Cooperative Patient Management Through Organizational and Medical Ontologies
Authors: Dazzi L. , Lanzola G. , Quaglini S. , Saracco R. , Stefanelli M. , Falasconi S. 
Published: March 2018

AbstractWithin knowledge and data engineering a new research paradigm is emerging based on the Multi-Agent System (MAS) architectural framework, allowing human and software agents to interoperate and thus cooperate within common application areas. In such a framework, knowledgeable agents of heterogeneous nature, that possess diverse but at least partially compatible or inter-translatable conceptual views, or ontologies, modeling both their own expertise and the external environment, make somehow available their information resources or problem-solving abilities for cooperative processes addressing the construction of a new agent or the achievement of some common goal through a correlated execution of tasks.In this paper, we restrict our analysis to the case of an organization of cognitive agents, illustrated with examples from a prototypical healthcare MAS, that is, a so-called Distributed Healthcare Information System (D-HIS). The prototype makes use of an ontological library written in the standard language Ontolingua. An ongoing application of the methodology to the main problem of Clinical Practice Guidelines (GLs) computer-based dissemination and enforcement is described.
Formal Classification of Medical Concept Descriptions: Graph-Oriented Operators
Authors: Schoop D. , Bernauer J. 
Published: March 2018

AbstractA crucial component of a medical concept representation system is the classifier. It requires features that are not sufficiently supported by current logic based formalisms like description logics and conceptual graphs. Those features are, for instance, the representation of partitive and spatial relations and their impact on sUbsumption. This paper introduces graph oriented classification operators for a concept representation language with normal forms. Emphasis is on the separation of generic and partitive relations and on the mutual interdependence of sUbsumption and part-whole. For that purpose operators are given for formal subsumption, formal part-whole, subsumptive part-whole and part-sensitive subsumption. These operators are based on the formal structure of concept descriptions and on explicitly introduced generic and partitive relationships between their constituents.
How Groups Co-ordinate their Concepts and Terminology: Implications for Medical Informatics
Authors: Garrod S. 
Published: March 2018

AbstractConceptual and terminological systems are established and maintained by the communities who use them. This paper reports experiments which investigate the role of communication and interaction in the process. The experiments show that isolated pairs of communicators and virtual communities of interacting pairs naturally converge on their own conceptual and terminological systems when confronted with a common task. The results also indicate that the system converged on is optimal for that particular group engaged in that particular task. These findings are discussed in relation to the increasing use of tightly coordinated medical teams and its implications for getting them to adopt standardized medical terminologies.
Linking a Medical Vocabulary to a Clinical Data Model using Abstract Syntax Notation 1
Authors: Rocha R. A. , Solbrig H. R. , Barnes M. W. , Schrank S. P. , Smith M. , Huff S. M. 
Published: March 2018

AbstractWe have created a clinical data model using Abstract Syntax Notation 1 (ASN.l). The clinical model is constructed from a small number of simple data types that are built into data structures of progressively greater complexity. Important intermediate types include Attributes, Observations, and Events. The highest level elements in the model are messages that are used for inter-process communication within a clinical information system. Vocabulary is incorporated into the model using BaseCoded, a primitive data type that allows vocabulary concepts and semantic relationships to be referenced using standard ASN.l notation. ASN.l subtyping language was useful in preventing unbounded proliferation of object classes in the model, and in general, ASN.l was found to be a flexible and robust notation for representing a model of clinical information.
Desiderata for Controlled Medical Vocabularies in the Twenty-First Century
Authors: Cimino J. J. 
Published: March 2018

AbstractBuilders of medical informatics applications need controlled medical vocabularies to support their applications and it is to their advantage to use available standards. In order to do so, however, these standards need to address the requirements of their intended users. Overthe past decade, medical informatics researchers have begun to articulate some of these requirements. This paper brings together some of the common themes which have been described, including: vocabulary content, concept orientation, concept permanence, nonsemantic concept identifiers, polyhierarchy, formal definitions, rejection of “not elsewhere classified” terms, multiple granularities, mUltiple consistent views, context representation, graceful evolution, and recognized redundancy. Standards developers are beginning to recognize and address these desiderata and adapt their offerings to meet them.
A Model for Medical Knowledge Representation Application to the Analysis of Descriptive Pathology Reports
Authors: Smart J. F. , Roux M. 
Published: March 2018

Abstract:A new knowledge-representation system is presented, designed for medical knowledge-based applications and in particular for the analysis of descriptive medical reports. Knowledge is represented at two levels. A definitional level uses a concept-type hierarchy, a relation-type hierarchy, and a set of schematic graphs to define the concepts used and the relations between them, as well as different types of cardinality restrictions on these relations. A set of compositional hierarchies using the classic “has-part” relation as well as a new set-inclusion relation allows concept composition to be precisely defined. An assertional level allows the creation and manipulation of empirical data, in the form of graphs using the concepts, relations, and constraints defined at the definition level. The use of cardinality constraints in graph unification is considered in the context of descriptive medical discourse analysis.
Evaluating Four Diagnostic Methods with Acute Abdominal Pain Cases
Authors: Ohmann C. , Goos K. , Puppe F. , Mootz O. , Puppe B. 
Published: March 2018

Abstract:Contemporary work in medical decision support is characterized by a multitude of methods. To investigate their relative strengths and weaknesses, we built four diagnostic expert systems based on different methods (Bayes, case-based classification, heuristic classification) for analysis of the same set of 1254 cases of acute abdominal pain previously documented in a prospective multicenter study. The results of the comparative evaluation indicate that differences in overall performance are relatively small (statistically not significant). The performance depends more on the quality of the knowledge base and the case data than on the inference methods of the expert systems. Methods relying exclusively on empirical knowledge (Bayes, case-based classification) tend to have slightly higher overall performance scores due to a diagnostic bias toward ordinary and common diseases. By contrast, methods operating with expert knowledge (e. g., heuristic classification) perform slightly worse overall, but are more sensitive toward uncommon (serious) diseases.
Assigning Value to Clinical Information – A Major Limiting Factor in the Implementation of Decision-Support Systems
Authors: de Dombal F. T. 
Published: March 2018

AbstractThis paper deals with a major difficulty and potential limiting factor in present-day decision support - that of assigning precise value to an item (or group of items) of clinical information. Historical determinist descriptive thinking has been challenged by current concepts of uncertainty and probability, but neither view is adequate. Four equations are proposed outlining factors which affect the value of clinical information, which explain some previously puzzling observations concerning decision support. It is suggested that without accommodation of these concepts, computer-aided decision support cannot progress further, but if they can be accommodated in future programs, the implications may be profound.
Structured Data Entry for Reliable Acquisition of Pharmacokinetic Data
Authors: Schromm T. , Frankewitsch T. , Giehl M. , Keller F. , Zellner D. 
Published: March 2018

Abstract:A pharmacokinetic database was constructed that is as free of errors as possible. Pharmacokinetic parameters were derived from the literature using a text-processing system and a database system. A random data sample from each system was compared with the original literature. The estimated error frequencies using statistical methods differed significantly between the two systems. The estimated error frequency in the text-processing system was 7.2%, that in the database system 2.7%. Compared with the original values in the literature, the estimated probability of error for identical pharmacokinetic parameters recorded in both systems is 2.4% and is not significantly different from the error frequency in the database. Parallel data entry with a text-processing system and a database system is, therefore, not significantly better than structured data entry for reducing the error frequency.
A Philosophy for Health Informatics Education in Developing Countries: Nigeria as a Case Study
Authors: Soriyan H. A. , Adagunodo E. R. , Akinde A. D. 
Published: March 2018

Abstract:The use of computers in the health sector has increased significantly during the last few years in Nigeria. This paper addresses the integration of health and informatics education, or health education and informatics education, or informatics education in health care delivery. It gives an introduction to the status of a health informatics programme in the daily practice of computer use. The essence of a health informatics curriculum, the planning and administration of the programme in medical schools, and what informatics education offers the health sector, even in a developing country, are presented. The problems of administering an informatics programme in a conventional medical training curriculum are highlighted. The article describes the philosophy which should underline the framework for the formulation of appropriate national policies and curricula for health informatics education in developing countries, using Nigeria as a case study.
Fundamentals of Modern Telemedicine in Africa
Authors: Adeyinka M. B. 
Published: March 2018

Abstract:The FOMTA (Fundamentals of Modern Telemedicine in Africa) project aims to promote the development of indigenous regional networks between R&D centres and universities of the Developing Countries (DCs) and their European counterparts. While FOMTA prepares the way for the use of broadband technology in Africa, it will also associate the DCs with the generation of knowledge, innovative and appropriate technologies needed to solve some of the specific problems, in order to achieve a sustainable economic development. Designed to eliminate the time-delaying lack of infrastructure, FOMTA will embark on the simulation of the Integrated Service Digital Network infrastructure. FOMTA will adopt measures to increase the awareness and stimulate the participation of the DCs in the telemedicine and health care telematics projects through demonstrations, pilot projects, Workshops, training and exchange activities. This will demonstrate the feasibility of telemedicine services in the DCs, including trial of services in real-life circumstances, and will provide training possibilities for researchers in the use of methods and tools for advanced communication technologies and telematics. Undoubtedly, telediagnosis, teleconsultation and other areas of telemedicine would thrive in Africa both as remote testing grounds and fields of practical applications.
Health-Care Technology Transfer: Expert and Information Systems for Developing Countries
Authors: Kahen G. , Sayers B. McA. 
Published: March 2018

Abstract:Computer-based technologies such as information systems and expert systems have an undoubted contribution to health-care development in developing countries. This paper addresses the appropriateness of these technologies for developing countries, the criteria to be used in selection of the technology to be transferred, and the need for a systematic approach to evaluation. A conceptual model for assessing transferability so as to achieve an effective transfer, has been introduced. This requires not only an attempt to amplify the role of information and expert systems in health-care improvement and for socio-economic development, but the analysis of prior experience in transferring these technologies to developing countries. Following this approach, and using operational research techniques such as the Analytic Hierarchy Process, a subjective assessment model has been described that can systematically guide decision-making about computer-based health-care technology to be transferred to developing countries.
Role of an Effective Hospital Information System in a Depressed Economy
Authors: Olabode J. A. , Osunlaja A. A. 
Published: March 2018

Abstract:This work is based on practical experience acquired in the development of a hospital information system in a university hospital in Nigeria. The paper discusses how accurate, adequate and timely medical data can promote economy in health-care delivery in a depressed economy. Existing constraints are identified and solutions offered for an effective hospital information system. An effort has been made to illustrate how the application of informatics technology can be cost effective in the long-term, by ensuring effective and economic use of facilities and resources. Once an effective hospital information is operative, provision of affordable health care in a depressed economy would be feasible. To this end, the need for cooperation between countries to support technology and manpower is emphasized.
Cluster Analysis of Antigenic Profiles of Tumors: Selection of Number of Clusters Using Akaike’s Information Criterion
Authors: Koziol J. A. 
Published: March 2018

AbstractA basic problem of cluster analysis is the determination or selection of the number of clusters evinced in any set of data. We address this issue with multinomial data using Akaike’s information criterion and demonstrate its utility in identifying an appropriate number of clusters of tumor types with similar profiles of cell surface antigens.