bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design and Analysis of Two-color Microarray Experiments Using Linear Models
Authors: Landgrebe J. , Brunner E. , Bretz F. 
Published: March 2018

Summary

Objectives:
A variety of linear models have recently been proposed for the design and analysis of micro-array experiments. This article gives an introduction to the most common models and describes their respective characteristics.

Methods:
We focus on the application of linear models to logarithmized and normalized microarray data from two-color arrays. Linear models can be applied at different stages of evaluating microarray experiments, such as experimental design, background correction, normalization and hypothesis testing. Both one-stage and two-stage linear models including technical and possibly biological replicates are described. Issues related to selecting robust and efficient microarray designs are also discussed.

Results:
Linear models provide flexible and powerful tools, which are easily implemented and interpreted. The methods are illustrated with an experiment performed in our laboratory, which demonstrates the value of using linear models for the evaluation of current microarray experiments.

Conclusions:
Linear models provide a flexible approach to properly account for variability, both across and within genes. This allows the experimenter to adequately model the sources of variability, which are assumed to be of major influence on the final measurements. In addition, design considerations essential for any well-planned microarray experiments are best incorporated using linear models. Results from such experimental design investigations show that the widely used common reference design is often substantially less efficient than alternative designs and its use is therefore not recommended.
The Use of a Structured Form during Urology Out-patient Consultations
Authors: Emberton M. , Reeves B. , Thomas K. 
Published: March 2018

Summary

Objectives:
To compare the completeness of documentation in the medical record using a structured form (SF) versus a traditional medical record (TMR).

Methods:
Randomised controlled trial comparing the use of SF and TMR in urology out-patient clinics for documentation of 15 items of clinical information, time taken to complete and acceptability to clinicians assessed by a self-completion questionnaire. in a teaching and district general hospitals

Results:
Four hundred new urology patient consultations, 11 clinicians. Completeness of information was compared between groups based on the medical record alone (SF vs. TMR), medical record plus letter to GP and letter alone. SFs were significantly (p<0.0001) more complete than TMRs for the majority of the items in all three groups. There was no significant difference in the time taken to document information using either type of record. The clinicians generally found the SF acceptable for routine use.

Conclusions:
Structured forms significantly improved the completeness of documentation for new out-patient consultations in urology.
Paradigms for Recording Cognitive Brain Electrical Activity
Authors: McAllister H. G. , Howard R. , Hong Neo L. , McCullagh P. J. 
Published: March 2018

Abstract:Human event-related potentials reflect cognitive processing, and are normally elicited by external events, such as acoustic sounds or visual stimuli. As such they provide an opportunity to study normal and abnormal brain function noninvasively, at sub-second resolution. Advances in multimedia technology permit specialists in informatics and neuropsychology to co-operate in the design and implementation of paradigms, which influence ERP components. The paper illustrates the progression from standard paradigms such as the auditory oddball, which can be used to study memory update through to contingent negative variation and three condition, visual paradigms which can be used to study cognitive and emotional responses. Data from a study investigating the comparative processing of target pictures and words illustrate how external stimuli influence the later cognitive potentials.
Partitioning an Object-Oriented Terminology Schema
Authors: Perl Y. , Halper M. , Geller J. , Kuo F. , Cimino J. J. , Gu H. 
Published: March 2018

Abstract:Controlled medical terminologies are increasingly becoming strategic components of various healthcare enterprises. However, the typical medical terminology can be difficult to exploit due to its extensive size and high density. The schema of a medical terminology offered by an object-oriented representation is a valuable tool in providing an abstract view of the terminology, enhancing comprehensibility and making it more usable. However, schemas themselves can be large and unwieldy. We present a methodology for partitioning a medical terminology schema into manageably sized fragments that promote increased comprehension. Our methodology has a refinement process for the subclass hierarchy of the terminology schema. The methodology is carried out by a medical domain expert in conjunction with a computer. The expert is guided by a set of three modeling rules, which guarantee that the resulting partitioned schema consists of a forest of trees. This makes it easier to understand and consequently use the medical terminology. The application of our methodology to the schema of the Medical Entities Dictionary (MED) is presented.
An Object-Oriented Framework for the Development of Computer-Based Guideline Implementations
Authors: Corb G.J , Liaw Y. , Brandt C.A. , Shiffman R.N. 
Published: March 2018

AbstractClinical practice guidelines provide a means of directing medical care towards clinically appropriate and cost-effective interventions. A direct relationship exists between the integration of a guideline into clinical workflow and the effectiveness of the guideline in influencing clinicians’ behavior. Computer-based guideline implementations, used at the point-of-care, accomplish this integration. Employing object-oriented technologies, we propose a framework of reusable components for the development of guideline implementation systems. We have identified eight information management services that are common to such systems. Our framework integrates these services and their respective reusable components into clinical workflow to promote the development of comprehensive guideline implementation systems, which should ultimately enhance guideline compliance and the overall quality of care.
Trusting the Record
Authors: Clarke K. , Hartswood M. , Procter R. , Rouncefield M. , Slack R. 
Published: March 2018

Summary
Objectives: This paper aims to contribute to a longstanding interest in documents and paperwork in healthcare work through an examination of everyday work with patient records in a clinic.
Methods: An ethnographic study of record keeping practices in a deliberate self harm clinic was conducted to consider the role that document work plays in the development of trust in the routine social interactions of a working division of labor.
Results and conclusions: Issues of trust are seen to play central roles within the complexities of organizational working and some consequent implications for the deployment and use of electronic medical record systems are considered.
Big is Beautiful: Electronic Patient Records in Large Norwegian Hospitals 1980s – 2001
Authors: Ellingsen G. , Monteiro E. 
Published: March 2018

Summary
Objectives: This paper aims to describe and analyze the prolonged efforts – spanning close to two decades – of developing and using electronic patient records in the large, university-based hospitals in Norway.
Methods: This study belongs to an interpretative approach to the development and use of information systems.
Results: The increase in organizational, institutional, political and technological complexity has been seriously underestimated. This paper describes and analyses the prolonged efforts – spanning close to two decades – of developing and using EPRs in the large, university-based hospitals in Norway. The investments involved were considerable, implying that a crucial aspect of these efforts has been the way alliances have been forged with public institutions and agendas.
Conclusions: The conditions for small-scale, bottom-up and evolutionary approaches never succeeded in constructing themselves as a viable alternative to the larger, more sweeping electronic patient record initiative, reiterating a more general tendency to privilege the more comprehensive and daring projects.
“Computers can land people on Mars, why can’t they get them to work in a hospital?”
Authors: Jones M. R. 
Published: March 2018

Summary
Objectives: This paper aims to describe and interpret the implementation of a hospital information system in a large UK hospital.
Methods: The paper is based on a longitudinal case study over a three-year period in which a cross section of hospital staff involved with the information system were interviewed.
Results and Conclusions: Ambitious government targets for the use of Information Technology in the UK National Health Service sit alongside a history of notable project failures. The decision by a UK hospital to install an advanced, integrated electronic patient record system therefore faced conflicting demands and expectations. This paper suggests that its simple categorisation as either a success or failure is problematic. Rather, the differing viewpoints that lead some clinicians to express “disappointment” with its performance, while others described its features as “tremendous” and managers suggested that the system had become “taken for granted” are explored. A number of broader phenomena relating to the organisational processes surrounding information systems implementation are also identified.
Measuring the Completeness and Currency of Codified Clinical Information
Authors: Williams J. G. 
Published: March 2018

Summary
Objectives: The paper describes how an objective score (CCscore) of the ‘completeness’ and ‘currency’ of codified clinical information relevant to the management of diabetes mellitus may be derived for individual practices.
Methods: A questionnaire was developed and administered to 35 practices and statistical methods were used to test for correlation between the prevalence for diabetes mellitus and the relevant CCscores
Results: No significant correlation could be found. Conclusions: The ‘quality’ of computer-stored information varies widely across English General practices for reasons that are incompletely understood. We demonstrated how CCscores may be calibrated for different ‘views’ of ‘relevance’, ‘completeness’, and ‘currency’ and yet be consistent across practices for a given ‘view’. The potential value of this score and how it may contribute to our understanding of variation in ‘information quality’ are discussed.
A Telemedicine Management Model Based on Message-Trigger Service
Authors: Hu B. , Ye D. , Bai J. 
Published: March 2018

Abstract:A telemedicine system model, based on a message-trigger service, is described. This model distributes system applications on multiple computers and establishes a communication platform to exchange messages among all applications. By broadcasting event messages, an application is able to trigger a set of local and remote services. At the same time, a protocol for message exchange is proposed to fulfill cooperation of applications. To validate the model, a teleconsultation system is designed. The results indicate that the model has good compatibility and that the characteristics are easy to implement.
Modeling the Recovery from Depressive Illness by an Exponential Model with Mixed Effects
Authors: Friede T. , Miller F. , Kieser M. 
Published: March 2018

Abstract:In clinical trials of antidepressant treatments, a depression rating score is usually measured at several points of time for each patient. We propose an approach to fit data from this type of clinical trial using an exponential mixed-effects model. Compared to previous proposals, this approach has the advantage that individual recovery curves are fitted rather than curves of means. Furthermore, no artificial fixing of model parameters is needed as in other approaches. The flexibility of the proposed model is shown for various situations. The approach is illustrated by an example from a placebo-controlled study for the treatment of depression with St. John’s Wort (Hypericum perforatum).
Simulation of Body Surface Laplacian Maps during Ventricular Pacing in a 3D Inhomogeneous Heart-Torso Model
Authors: Ono K. , Hosaka H. , He B. , Wu D. 
Published: March 2018

Abstract:A computer simulation study has been conducted to investigate the performance of body surface Laplacian maps (BSLMs) in localizing and imaging spatially separated myocardial electrical events. A cellular automaton model of ventricles simulates cardiac electrical activity using a two-site pacing protocol to induce dual simultaneously active myocardial electrical events. The heart model is embedded in a realistically shaped inhomogeneous volume conductor. The BSLMs are numerically computed from the induced electrical activity in the heart model. The present computer simulation results show that the BSLM can provide better separation and localization of two regional myocardial electrical events as compared with the body surface potential map (BSPM).
Bifurcation in a Simple Model of the Cardiovascular System
Authors: Akselrod S. , Eyal S. 
Published: March 2018

Abstract:A simple nonlinear beat-to-beat model of the human cardiovascular system has been studied. The model, introduced by DeBoer et al. was a simplified linearized version. We present a modified model which allows to investigate the nonlinear dynamics of the cardiovascular system. We found that an increase in the -sympathetic gain, via a Hopf bifurcation, leads to sustained oscillations both in heart rate and blood pressure variables at about 0.1 Hz (Mayer waves). Similar oscillations were observed when increasing the -sympathetic gain or decreasing the vagal gain. Further changes of the gains, even beyond reasonable physiological values, did not reveal another bifurcation. The dynamics observed were thus either fixed point or limit cycle. Introducing respiration into the model showed entrainment between the respiration frequency and the Mayer waves.
The Care Information System PIK – the Fit between User and System
Authors: Herbig B. , Büssing A. 
Published: March 2018

Summary

Objectives:
The presented laboratory study explores the relationship between the care information system PIK and its users, focusing on intuitive program usage, occurring errors, the usefulness of the evaluation method, and the role of person related variables.

Methods:
Three studies were conducted. While thinking aloud, a sample of 26 participants performed certain tasks, which were recorded in protocols. In addition, the occurring errors were rated in an error taxonomy.

Results:
While the actual use of the program proved quite easy, conceptual structuring caused the participants difficulties. These difficulties stemmed mainly from problems encountered in generating a clear mental picture of the system, and the consequences of the actions. Over time, the program showed a positive development.

Conclusions:
Discussion of the results focuses on implementation processes in the context of usability research. The need to train users in the conceptual structure of the program and to build realistic expectations are the focus of our outline.
Assessing the Implementation of Workplace Health Programs Outside of Controlled Environments
Authors: Walker E. 
Published: March 2018

AbstractThe study explored the implementation of workplace health programmes in 14 NHS Trusts (hospitals). It sought to identify different approaches to implementation and measures that could be used to guide future development. The study comprised inter-related elements examining the process of implementing workplace health and the impact on staff. An innovative action research approach was applied to the evaluation. The aims of the evaluation were to generate activity and learning within the organisations which was sustainable (long term) and transferable outside the study organisations. The study is described in terms of the multiple methods and the ways in which these have been brought together in the analysis. The approach has been informed by a shift from an individualistic perspective towards one which sees the health of workers within the broader context of organisational development and management. The research identified a number of dilemmas for workplace health with its focus on the health of the individual. A typology was developed which describes different approaches to workplace health and their impact on sustaining such initiatives. It suggests that for workplace health to be successful it must address the organisational context as well as individual staff needs. Results from a survey of staff in the 14 trusts seems to demonstrate an association between the approaches, described in the typology, and an impact on staff. Workplace health programmes need to shift towards approaches where the individual’s health is seen within the wider context of the organisation.
Standard Protocol for Exchange of Health-checkup Data Based on SGML: The Health-checkup Data Markup Language (HDML)
Authors: Yoshida K. , Hara S. , Furumi K. , Tofukuji I. , Kubodera T. , Yoda T. , Kawai M. , Sugimori H. 
Published: March 2018

Summary

Objectives:
To develop a health/medical data interchange model for efficient electronic exchange of data among health-checkup facilities.

Results:
A Health-checkup Data Markup Language (HDML) was developed on the basis of the Standard Generalized Markup Language (SGML), and a feasibility study carried out, involving data exchange between two health checkup facilities. The structure of HDML is described.

Results:
The transfer of numerical lab data, summary findings and health status assessment was successful.

Conclusions:
HDML is an improvement to laboratory data exchange. Further work has to address the exchange of qualitative and textual data.
Conversion Problems concerning Automated Mapping from lCD-10 to lCD-9
Authors: Zaiss A. , Brunner R. , Spinner D. , Klar R. , Schulz S. 
Published: March 2018

AbstractThe increasing parallel use of ICD-9 and ICD-10 complicates the comparability of coded diagnoses. This is the reason why we developed a symmetric table for interactive conversion between ICD-9 and ICD-10, based on a vector space text-retrieval method that resulted in unambiguous mapping from ICD-9 to ICD-10 in 64%, from ICD-10 to ICD-9 in 87% of all three- and four-character classes of the tabular list. Out of the remaining 13% of multi-valued relations, a table for automated mapping from ICD-10 to ICD-9 was created. In 9% of cases, the selection offered no problems. A compromise between preserving information content and maintaining the logical integrity had to be found in 2.4%; in 1.6% automated mapping was impossible because of newly defined concepts and structural differences between ICD-9 and ICD-10 that are not counterbalanced by a consistent system of residual categories. We recommend that in a future revision of the ICD, compatibility with the then existing classification system should be considered.
Using a WWW-based Mail User Agent for Secure Electronic Mail Service for Health Care Users
Authors: Ohe K. , Kaihara S. , Kiuchi T. 
Published: March 2018

AbstractWWW-based user interface is presented for secure electronic mail service for healthcare users. Using this method, communications between an electronic mail (WWW) server and users (WWW browsers) can be performed securely using Secure Socket Layer protocol-based Hypertext Transfer Protocol (SSL-HTIP). The mail can be encrypted, signed, and sent to the recipients and vice versa on the remote WWW server. The merit of this method is that many healthcare users can use a secure electronic mail system easily and immediately, because SSL-compatible WWW browsers are widely used and this system can be made available simply by installing a WWW-based mail user agent on a mail server. We implemented a WWWbased mail user agent which is compatible with PEM-based secure mail and made it available to about 16,000 healthcare users. We believe this approach is effective in facilitating secure network-based information exchange among medical professionals.
Issues in the Structuring and Acquisition of an Ontology for Medical Language Understanding
Authors: Bachimont B. , Bouaud J. , Charlet J. , Boisvieux J.-F. , Zweigenbaum P. 
Published: March 2018

Abstract:Medical natural language understanding basically aims at representing the contents of medical texts in a formal, conceptual representation. The understanding process itself increasingly relies on a body of domain knowledge, generally expressed in the same conceptual formalism. The design of such a conceptual representation is a key knowledge-acquisition issue. When representing knowledge, the most important point is to ensure that the formal exploitation of the knowledge representation conforms to its meaning in the domain. We examined some methodological and theoretical principles to enforce this conformity. These principles result from our experience in MENELAS, a medical language understanding project.
Natural Language Processing, Lexicon and Semantics
Authors: Wehrli E. , Clark R. 
Published: March 2018

Abstract:While the design of a fully general procedure for semantico-pragmatic interpretation of natural language texts does not seem to be feasible with current scientific knowledge and technology, the more practical micro-world based approaches lack generality and portability. A compromise between generality and practicality might lie in the use of an intermediate level of representation (“pseudo-semantics”), which can be derived from syntactic representations and lexical information by means of a general procedure. Domain-dependent rules for semantico-pragmatic interpretation can then be applied to these representations, insulating syntactic processing, from details of the application domain.
Objects and Domains for Managing Medical Data and Knowledge
Authors: Wiederhold G. 
Published: March 2018

Abstract:This paper assesses the object-oriented data paradigm, and describes an algebraic approach which permits the generation of data objects from relational data, based on the knowledge captured in a formal Entity-Relationship model, the Structural Model. The advantage is that now objects can be created that satisfy a variety of particular views, as long as the hierarchies represented by the views are subsumed in the network represented by the overall structural model.The disadvantage of creating view-objects dynamically is that the additional layering has performance implications, so that the speedup expected from object-oriented databases versus relational databases, due to their hierarchical object storage, cannot be realized. However, scalability of systems is increased since large systems tend to have multiple objectives, and hence often multiple valid hierarchical views over the data. This approach has been implemented in the Penguin project, and recently some commercial successors are emerging.In truly large systems new problems arise, namely that now not only multiple views will exist, but also that the domains to be covered by the data will be autonomous and hence heterogeneous. One result is that ontologies associated with the multiple domains will differ as well. This paper proposes a knowledge-based algebra over the ontologies, so that the domain knowledge can be partitioned for maintenance. Only the articulation points, where the domains intersect, have to be agreed upon as defined by matching rules which define the shared ontologies.