bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of a Prediction Model for Identification of Individuals at Diabetic Risk
Authors: Edington D. W. , Park J. 
Published: March 2018

SummaryAs a follow-up to our preceding paper, we attempted to extract features of health risk progression for diabetes in Sequential Multi Layered Perceptron (SMLP) via inverse processing of the learned structure. The time-varying risk progress was assessed with risk trajectory and conditional mixture model.Overall risk cut along with the prediction was stable over time and high body mass index (BMI) tops the health behavioral risks predicting the onset of diabetes. For the initial prediction, high BMI (obesity), high blood pressure (BP), high cholesterol, and diet in fatty food were significant. Over time, variations in trajectory were due to changes in BMI, stress, BP, cholesterol, and fatty food intake.We tested the effectiveness of identifying prediabetics by the SMLP by applying the implemented SMLP to a test population of employees from a large manufacturing company, where an early worksite health promotion was initiated (1984). This resulted in a potential sensitivity (71.4%) although there were issues like mapping corresponding risks and large time lags.A secondary test on the similar population as in the previous paper showed a promising sensitivity (86.5%) over 3 years.When combining with targeted screening such as impaired glucose tolerance test only for those predicted to be diabetics, the presented prediction model and extracted features can be used in implementing an effective disease prevention and management program.
Statistical Linkage of Treatment to Diagnosis for Research and Monitoring of Practice Patterns
Authors: Falkoe E. , Maclure M. , Schroll H. , Rasmussen K. B. 
Published: March 2018

Summary

Objectives:
At each patient contact general practitioners enter information about the diagnoses and the interventions in the electronic medical record (EMR) system. If there is only one diagnosis during a single patient-physician contact, then a causal connection between the diagnosis and the intervention is established. Otherwise it is uncertain what may have been the cause of the intervention.

Methods:
Ideally the general practitioners would record a match between each intervention and the diagnosis that justifies it. However, most EMR software is not capable of recording explanatory matches. Furthermore, supplying the matches is a resource-demanding task. In this study the general practitioners were supplied with a matching module for the EMR, so data with full matching between intervention and diagnosis was collected (our “gold standard“). The study models how close the full matching can be recreated by model linkage using different kinds of simple assumptions.

Results:
The modeling demonstrates a raise in the measure of prediction (sensitivity) from 41.9 percent for a completely random linkage to 90.9 percent based on simple assumptions in the model. The small substantial potential further gain makes it less attractive to apply more intricate assumptions or use more complex modeling (including neural networks).

Conclusions:
The perspective of the study lies in the support of the general practitioners with software for comparison of their decisions with those of their peers and also with guidelines. Thus a system for simple quality assurance and awareness to untypical decisions could be incorporated into the electronic medical record systems.
Grid Requirements for the Integration of Biomedical Information Resources for Health Applications
Authors: Oliveira J. L. , Sanchez J. P. , López-Alonso V. , Martin-Sanchez F. , Maojo V. , Sousa Pereira A. , Oliveira I. C. 
Published: March 2018

Summary

Objectives:
The goal of this paper is to identify how Grid technology can be applied for the development and deployment of integration systems, bringing together distributed and heterogeneous biomedical information sources for medical applications.

Methods:
The integration of new genetic and medical knowledge in clinical workflows requires the development of new paradigms for information management in which the ability to access and relate disparate data sources is essential. We adopt a requirements perspective based on the user needs we have identified in the development of the INFOGENMED system to assess current Grid technology against those requirements.

Results:
The gap between Grid features and distributed biomedical information integration needs is characterized. Results from prospective studies are also reported.

Conclusions:
Grid infrastructures offer advanced features for the deployment of collaborative computational environments across virtual organizations. New Grid developments are in line with the problem of multiple site information integration. From the INFOGENMED point of view, Grid infrastructures need to evolve to implement structured data access services and semantic content description and discovery.
Interoperability and HealthGRID
Authors: Schmitt D. , Kass J. , García-Barbero M. , Kantchev P. , Bescos C. 
Published: March 2018

Summary

Objectives:
GRID technology, with initiatives like the GGF, will have the potential to allow both competition and interoperability not only among applications and toolkits, but also among implementations of key services.The pyramid of eHealth interoperability should be achieved from standards in communication and data security, storage and processing, to the policy initiatives, including organizational protocols, financing procedures, and legal framework.The open challenges for GRID use in clinical fields illustrate the potential of the combination of grid technologies with medical routine into a wider inter-operable framework.

Methods:
The Telemedicine Alliance is a consortium (ESA, WHO and ITU), initiated in 2002, in building a vision for the provision of eHealth to European citizens by 2010. After a survey with more that 50 interviews of experts, interoperability was identified as the main showstopper to eHealth implementation.

Results:
There are already several groups and organizations contributing to standardization. TM-Alliance is supporting the “e-Health Standardization Coordination Group” (eHSCG).

Conclusions:
It is now, in the design and development phase of GRID technology in Health, the right moment to act with the aim of achieving an interoperable and open framework. The Health area should benefit from the initiatives started at the GGF in terms of global architecture and services definitions, as well as from the security and other web services applications developed under the Internet umbrella. There is a risk that existing important results of the standardization efforts in this area are not taken up simply because they are not always known.
Security and Confidentiality Approach for the Clinical E-Science Framework (CLEF)
Authors: Singleton P. , Milan J. , MacKay J. , Detmer D. , Rector A. , Ingram D. , Kalra D. 
Published: March 2018

Summary

Objectives:
CLEF is an MRC sponsored project in the E-Science programme that aims to establish methodologies and a technical infrastructure for the next generation of integrated clinical and bioscience research.

Methods:
The heart of the CLEF approach to this challenge is to design and develop a pseudonymised repository of histories of cancer patients that can be accessed by researchers. Robust mechanisms and policies have been developed to ensure that patient privacy and confidentiality are preserved while delivering a repository of such medically rich information for the purposes of scientific research.

Results:
This paper summarises the overall approach adopted by CLEF to meet data protection requirements, including the data flows, pseudonymisation measures and additional monitoring policies that are currently being developed.

Conclusion:
Once evaluated, it is hoped that the CLEF approach can serve as a model for other distributed electronic health record repositories to be accessed for research.
Interactive Volume Reconstruction and Measurement on the Grid
Authors: Osorio A. , Texier R. , Germain-Renaud C. 
Published: March 2018

Summary

Objectives:
To prove the advantages of integrating grid computing within medical image analysis software, and to discuss the technological, sociological and health care-related issues.

Methods:
Presentation of an instant volume reconstruction and measurement tool (PTM3D) used in clinical practice, including percutaneous nephrolithotomy examples; description of a parallel implementation of volume reconstruction, evaluation of this implementation on lung and body reconstruction, presentation of the technical limitations for clinical use and description and discussion of a prototype grid implementation.

Results:
Volume reconstruction can broaden its medical scope and use by accessing high-performance computing systems; interactive exploration of medical images can co-exist with the usual batch workload of grid systems; the EGEE grid middleware offers some of the required core services; a fully adequate computing environment needs further evolution to integrate real-time constraints.

Conclusions:
Clinical experiments of a grid-enabled PTM3D become possible. Widespread adoption of grid technology in the medical images analysis field will benefit from this “early user” project. Convergences appear between two broadly different fields, high energy physics and medical image, towards the need of a smooth integration of the new resources offered by grid systems into the everyday tools of their respective end-users. It can be expected that the convergence will mature towards truly interactive grids, able to serve the needs of the medical community.
A Procedural Model for Planning and Evaluating Behavioral Interventions
Authors: Hyner G. C. 
Published: March 2018

Summary

Objective:
A model for planning, implementing and evaluating health behavior change strategies is proposed. Variables are presented which can be used in the model or serve as examples for how the model is utilized once a theory of health behavior is adopted.

Results:
Examples of three innovative strategies designed to influence behavior change are presented so that the proposed model can be modified for use following comprehensive screening and baseline measurements. Three measurement priorities: clients, methods and agency are subjected to three phases of assessment: goals, implementation and effects.

Conclusion:
Lifestyles account for the majority of variability in quality-of-life and premature morbidity and mortality. Interventions designed to influence healthy behavior changes must be driven by theory and carefully planned and evaluated. The proposed model is offered as a useful tool for the behavior change strategist.
Cancer Screening Beliefs and Reactions to an Innovative Colorectal Cancer Screening Kit among Chinese Worksite Population
Authors: Chen P. , Hou S. 
Published: March 2018

Summary

Objectives:
This study assessed the relationships between cancer screening beliefs (perceived pros, cons, and susceptibility) and reactions (acceptance, self-efficacy, intention to purchase) to an innovative home-administered kit (HAK) for fecal occult blood test (FOBT) among Chinese worksite population.

Methods:
A total of 450 Chinese people aged 40 and older were recruited from ten worksites in Taiwan (2002), with response rate of 83% (375/450).

Results:
All the belief scales of cancer screening in general showed good internal consistency (Cronbach alphas >0.70). Perceived benefits and barriers to-wards cancer screening were significantly correlated with the acceptance, self-efficacy, and order intention towards the FOBT-HAK (p-values <0.001). Perceived susceptibility of cancer was associated with intention to purchase. After taking gender into consideration, the regression analyses showed similar relationships.

Conclusions:
Screening beliefs were significantly associated with reactions toward the innovative FOBT-HAK. Intervention programs addressing these beliefs could potentially promote positive reactions to innovative CRC screening strategies.
Effective Prevention of Carotid Artery Atherosclerosis by Following this Motto for Healthy Habits: “Give Up One, Reduce Two, and Increase Three”
Authors: Fujishiro K. , Fukumoto T. , Joki M. , Wada T. 
Published: March 2018

Summary

Objectives:
Lifestyle has a major influence on the development and progression of atherosclerosis. Our motto for healthy habits is “give up one, reduce two, and increase three”. The one thing that is to be given up is smoking. The two things that are to be reduced are intake of food and alcohol. The three things that are to be increased are exercise, rest and enjoyable activities. We assessed correlation between these six-health habits and plaque score indicating degree of atherosclerosis in the carotid artery.

Methods:
Subjects were divided into unfavorable (practicing zero to three habits) and optimal (practicing four to six habits) healthy habits groups.

Results:
Plaque score was significantly higher in the unfavorable group (7.6 ± 5.8) than in the optimal group (4.9 ± 4.2) (P<0.001).

Conclusions:
The healthy habits that significantly contributed to prevention of atherosclerosis were quitting smoking and increasing rest and enjoyable activities.
Induction of Similarity Measures and Medical Diagnosis Support Rules through Separable, Linear Data Transformations
Authors: Bobrowski L. 
Published: March 2018

Summary

Objectives:
To improve the medical diagnosis support rules based on comparisons of diagnosed patients with similar cases (precedents) archived in a clinical database. The case-based reasoning (CBR) or the nearest neighbors (K-NN) classifications, which operate on referencing (learning) data sets, belong to this scheme.

Methods:
Inducing similarity measure through special linear transformations of the referencing sets aimed at the best separation of these sets. Designing separable transformations can be based on dipolar models and minimization of the convex and piecewise linear (CPL) criterion functions in accordance with the basis exchange algorithm.

Results:
Separable linear transformations allow for some data sets to decrease the error rate of the K-NNclassification rule based on the Euclidean distance. Such results can be seen on the example of data sets taken from the Heparsystem of diagnosis support.

Conclusions:
Medical diagnosis support based on the CBRor the K-NNrules can be improved through separable transformations of the referencing sets.
Using Computer and Internet-based Resources to Teach Health Care Planning and Administration in an Undergraduate Medical Program
Authors: Bordin R. , Fisher P. D. , Klück M. M. , Rosa R. S. 
Published: March 2018

Summary

Objective:
We describe the teaching methods, involving computer and Internet-based resources, used in the “Administration and Planning in Health Care” course of the undergraduate medical program at the Federal University of Rio Grande do Sul.

Method:
Description on how the curriculum guidelines for the undergraduate medical education in Brazil have been implemented at this university. The guidelines specify that graduates should be skilled and knowledgeable in health care administration and management, understand the market dynamics of health care services, and be prepared to contribute to the development of health policy.

Results:
A required 60-hour course provides students with an opportunity to learn about the structure, planning and administration of the Brazilian and of other health care systems, and their roles, as health care professionals, within those systems. The course is also intended to allow students to develop the minimal skill set required for manipulation of health care data available from national and international databases, and to use the Internet as a source of information in health care. The curriculum includes: Module 1 – basic computer skills, an introduction to networks as an infrastructure for management, the use of spreadsheets and databases for data processing and system modelling, retrieval of Internet-based health data and on-line bibliographic searches; Module 2 – health system financing and service quality management, using a university hospital as a case study; and Module 3 – a comparison of the Brazilian public health care system (SUS) with other national health systems resulting in a term paper formatted for journal submission and presented at a simulated conference at the end of the course.

Conclusion:
Progressive shift in emphasis from theory to practice in this course has resulted in better development of the skill set required for the students.
Medical Informatics Education Needs Information System Practicums in Health Care Settings
Authors: Ammenwerth E. , Häber A. , Hübner-Bloder G. , Knaup-Gregori P. , Lechleitner G. , Leiner F. , Weber R. , Winter A. , Wolff A. C. , Haux R. 
Published: March 2018

Summary

Objectives:
To report about the themes and about experiences with practicums in the management of information systems in health care settings (health information management) for medical informatics students.

Methods:
We first summarize the topics of the health information management practicums/projects that the authors organized between 1990 and 2003 for the medical informatics programs at Heidelberg/ Heilbronn, Germany, UMIT, Austria, as well as for the informatics program at the University of Leipzig, Germany. Experiences and lessons learned, obtained from the faculty that organized the practicums in the past 14 years, are reported.

Results:
Thirty (of 32) health information management practicums focused on the analysis of health information systems. These took place inside university medical centers. Although the practicums were time-intensive and required intensively tutoring students with regard to health information management and project management, feedback from the students and graduates was mainly positive.

Discussion:
It is clearly recommended that students specializing in medical informatics need to be confronted with real-world problems of health information systems during their studies.
Medical Informatics and Bioinformatics: Integration or Evolution through Scientific Crises?
Authors: Kulikowski C. , Maojo V. 
Published: March 2018

Summary

Objectives:
To contribute a new perspective on recent investigations into the scientific foundations of medical informatics (MI) and bioinformatics (BI). To support efforts that could generate synergies and new research directions.

Methods:
MI and BI are compared and contrasted from a philosophy of science perspective. Historical examples from MI and BI are analyzed based on contrasting viewpoints about the evolution of scientific disciplines.

Results:
Our analysis suggests that the scientific approaches of MI and BI involve different assumptions and foundations, which, together with largely non-overlapping communities of researchers for the two disciplines, have led to different courses of development. We indicate how their respective application domains, medicine, and biology may have contributed to these differences in development.

Conclusions:
An analysis from the point of view of the philosophy of science is characteristic of established scientific disciplines. From a Kuhnian perspective, both disciplines may be entering a period of scientific crisis, where their foundations are questioned and where new ideas (or paradigm shifts) and a progressive research programme are needed to advance them scientifically. We discuss research directions and trends both supporting and challenging integration of the subdisciplines of MI and BI into a unified field of biomedical informatics (BMI), centered around the evolution of information cybernetics.
Modeling End-users’ Acceptance of a Knowledge Authoring Tool
Authors: Del Fiol G. , Rocha R. A. , Hulse N. C. 
Published: March 2018

Summary

Objectives:
Knowledge bases comprise a vital component in the classic medical expert system model, yet the knowledge acquisition process by which they are created has been characterized as highly iterative and labor-intensive. The difficulty of this process underscores the importance of knowledge authoring tools that satisfy the demands of end-users. The authors hypothesize that the acceptability of a knowledge authoring tool for the creation of medical knowledge base content can be predicted by an accepted model in the information technology (IT) field, specifically the Technology Acceptance Model (TAM).

Methods:
An online survey was conducted amongst knowledge base authors who had previously established experience with the authoring tool software. The Likert-based questions in the survey were patterned directly after accepted TAM constructs with minor modifications to particularize them to the software being used. The results were analyzed using structural equation modeling.

Results:
The TAM performed well in predicting end-users’ behavioral intentions to use the knowledge authoring tool. Five out of seven goodness-of-fit statistics indicate that the model represents the behavioral intentions of the authors well. All but one of the hypothesized relationships specified by the TAM were significant with p values less than 0.05.

Conclusions:
The TAM provides an adequate means by which development teams can anticipate and better understand what aspects of a knowledge authoring tool are most important to their target audience. Further research involving other behavioral models and an expanded user base will be necessary to better understand the scope of issues that factor into acceptability.
Time-variant Analysis of Fast-fMRI and Dynamic Contrast Agent MRI Sequences as Examples of 4-dimensional Image Analysis
Authors: Leistritz L. , Hesse W. , Wüstenberg T. , Fitzek C. , Reichenbach J. R. , Witte H. 
Published: March 2018

Summary

Objectives:
Image sequences with time-varying information content need appropriate analysis strategies. The exploration of directed information transfer (interactions) between neuronal assemblies is one of the most important aims of current functional MRI (fMRI) analysis. Additionally, we examined perfusion maps in dynamic contrast agent MRI sequences of stroke patients. In this investigation, the focus centers on distinguishing between brain areas with normal and reduced perfusion on the basis of the dynamics of contrast agent inflow and washout.

Methods:
Fast fMRI sequences were analyzed with time-variant Granger causality (tvGC). The tvGC is based on a time-variant autoregressive model and is used for the quantification of the directed information transfer between activated brain areas. Generalized Dynamic Neural Networks (GDNN) with time-variant weights were applied on dynamic contrast agent MRI sequences as a nonlinear operator in order to enhance differences in the signal courses of pixels of normal and injured tissues.

Results:
A simple motor task (self-paced finger tapping) is used in an fMRI design to investigate directed interactions between defined brain areas. A significant information transfer can be determined for the direction primary motor cortex to supplementary motor area during a short time period of about five seconds after stimulus. The analysis of dynamic contrast agent MRI sequences demonstrates that the trained GDNN enables a reliable tissue classification. Three classes are of interest: normal tissue, tissue at risk for death, and dead tissue.

Conclusions:
The time-variant multivariate analysis of directed information transfer derived from fMRI sequences and the computation of perfusion maps by GDNN demonstrate that dynamic analysis methods are essential tools for 4D image analysis.