bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Network Inversion Technique for Estimating Equivalent Dipole Description of Visual Evoked Potential
Authors: Kosugi Y. , He B. , Hayashi Y. 
Published: March 2018

Abstract:For the activation study of the brain, dipole localization from the scalp potential is one of the most promising techniques to realize a reasonable temporal resolution which cannot be realized in functional MR and PET. The goal of our study is to estimate inversely the electrical brain activity in the form of several dipoles from the scalp potential, using a network inversion technique. As a basic approach, we have inversely estimated several dipoles from the potential distribution on a spherical surface, in the homogeneous sphere model.In the training phase, by expanding the neural network input dimensions being redundant, the network can easily learn the forward mapping. In the inversion phase, the space of the expanded-network-input-vector can be narrowed by introducing a penalty term. Additionally, a consensus term was used to force several dipoles to have a similar orientation. We estimate that this is applicable to the localization of several dipoles that reflect the actual brain activity, especially in the visual evoked potentials.
Systems Analysis in Health Care: Framework and Example
Authors: Ehlers F. , Eichstädter R. , Haux R. , Pohl U. , Resch F. , Ammenwerth E. 
Published: March 2018

Summary

Objectives:
Due to the high complexity of structures and processes in health care, thorough systems analyses in health care run the risk of becoming very complex and difficult to handle. Therefore, we aimed to support systematic systems analysis in health care by developing a comprehensive framework that presents and describes potential areas of analysis.

Methods:
A framework for systems analysis in health care was developed and applied in a health care setting. To provide a clear structure, the framework describes the potential views and levels of systems analyses in a health care environment.

Results:
The framework comprises five views (roles and responsibilities, information processing and tools, communication, business processes, teams structure and cooperation) and five levels of analysis (overall organization, organizational unit, staff member, role, task). The framework was successfully applied in an analysis of the structures and processes of the Department of Child and Adolescent Psychiatry of the University Medical Center Heidelberg.

Conclusions:
The proposed comprehensive framework aims to structure the views and levels of systems analysis in the complex health care environment. Our first experiences support the usefulness of such a framework.
Lifestyle Change Improves Individual Health and Lowers Healthcare Costs
Authors: Koyama W. 
Published: March 2018

AbstractIn 1996 the Japanese Ministry of Health and Welfare discontinued the use of the term “Adult onset diseases” used for almost 40 years, and replaced it by “Lifestyle-related diseases”; a meaningful change.Lifestyle is one of the greatest problems facing Japan today. Considering the rapid aging of Japanese society and the continuing increase in medical costs, it is important for all citizens to be concerned not only about their own health but also about the impact on the financial health of the nation as a whole.Our data indicate that the greatest determining factor for increased health-care costs is the percentage of patients hospitalized, and the variable with the greatest influence on this is the relative number of hospital beds available. On the other hand, the variable with the greatest inhibitory effect on the growth of healthcare costs is the availability of guidance to improve lifestyle factors.
Primary Care-based Evaluation of Patient Education for Osteoarthritis of the Knee
Authors: Triggs E. , Ross F. , Axford J. , Victor C. 
Published: March 2018

AbstractPrimary healthcare research in the UK has expanded in conjunction with the wider agenda of a primary care led National Health Service (NHS). This reflects international reconsideration of the place of primary healthcare within national healthcare systems. However the role and standing of research in primary care tends to be marginal and less influential than that originating in research establishments or medical schools pursuing biomedical investigations. There are many reasons for this, some of which this paper attempts to elucidate. We address the perspectives and relationships between ‘stakeholder’ groups in the field of primary care and highlight the ways in which such relationships affect research in this area. The development of a primary care research project concerned with osteo-arthritis of the knee (the OAK project) is used as an exemplar of these stresses and we suggest ways in which the difficulties encountered may be overcome.
Significance of Brain Natriuretic Peptide Measurement as a Diagnostic Indicator of Cardiac Function
Authors: Iida N. , Ishihara T. , Waku S. 
Published: March 2018

AbstractBrain natriuretic peptide (BNP) is increased in patients with heart failure due to myocardial infarction and cardiac hypertrophy, in proportion to the severity of left ventricular dysfunction. The aims of this study were to clarify the clinical features of BNP and to determine the diagnostic value of BNP for mass screening.The subjects were 818 office workers (565 males and 253 females; mean age 47 ± 12 years) who participated in a 1996 routine health check at Kansai University All individuals were examined for blood pressure, serological findings, ECG and plasma BNP level. Thirty-three males underwent 2-D echocardiography. Plasma BNP levels were measured using IRMA (immunoradiometric assay).The results were as follows: (1) BNP levels in females were higher than those in males for healthy subjects (N = 551), in each age group from 20 to 60 years. (2) BNP levels increased with age. (3) There were significant correlations between BNP level and systolic blood pressure and creatinine level. (4) There were significant differences in BNP level between the hypertensive groups with and without hypertensive ECG changes and the age-matched healthy control group. (5) Marked correlations were observed between BNP level and left ventricular wall thickness, fractional shortening, deceleration time and peak early filling velocity. (6) A BNP cut-off-point of 25 pg/ml was best for detecting LV diastolic dysfunction and LV hypertrophy. Measurement of BNP is useful for detecting asymptomatic heart failure in the general population, and is a clinical marker useful in preventing symptomatic heart failure.
Risk Factors for Ischemic Heart Disease in an Urban Area of Japan: A Case-Control Study in AMHTS
Authors: Ohno H. , Tamura M. , Kawakubo K. , Gunji A. , Kashihara H. 
Published: March 2018

AbstractObjectives: In Japan controversy exists as to whether or not the risk factors for ischemic heart disease (IHD) are the same as in western countries. We conducted a case-control study on IHD to clarify the risk factors in males in an urban area of Japan using our automated multiphasic health testing and services (AMHTS) system. Method: Cases were the clients who took the health check-up between January 1987 and July 1994 and had onset of IHD after the check-up. For each case five clients were selected as controls by conditional matching. The check-up data were compared between cases and controls 11 years, 6 years and just before the onset of the heart diseases. Results: The statistically significant items were as follows: (1) Eleven years before the onset: Total cholesterol (T-Chol) for myocardial infarction (MI), and fasting blood sugar (FBS) for angina pectoris (AP). (2) Six years before the onset: T-Chol, electrocardiographic (ECG) findings and the complaint of palpitation or breathlessness for MI, and FBS and palpitation or breathlessness for AP. (3) Just before the onset: T-Chol, the complaint of chest pain, FBS, smoking index and hypertensive status for MI and palpitation or breathlessness, ECG findings, chest pain, systolic blood pressure and erythrocyte sedimentation rate at 60 minutes for AP. In conclusion, the risk factors for MI in males in an urban area of Japan are the same as in western countries. The most significant risk factor for AP in males in an urban area of Japan is fasting blood sugar.
Applications of Virtual Environments in Medicine
Authors: Riva G. 
Published: March 2018

Summary

Objectives:
This paper intends to investigate the role of virtual reality (VR) in medicine. In particular it outlines the current state of research and technology that is relevant to the development of effective virtual environments in medicine.

Methods:
After describing the two different visions of VR we can find in medicine – the presentation of virtual objects to all of the human senses in a way identical to their natural counterpart, and a new human-computer interaction paradigm in which users are active participants within a computer-generated three-dimensional virtual world – the paper presents some of the most interesting applications actually developed in the area. Finally, it discusses the clinical principles, technological devices and safety issues associated with the use of VR in medicine.

Results:
With more than 1,000 VR papers already indexed in Medline, VR is a reality health care. Even if the number of controlled studies is still limited, its merging with emerging technologies like Ambient Intelligence and wireless communication will further improve its diffusion.

Conclusions:
The possible impact of VR on health care could be even higher than the one offered by the new communication technologies like Internet. In fact, VR is at the same tima technology, a communication interface and an experience: a communication interface based on interactive 3D visualization, able to collect and integrate in single real-like experience different inputs and data sets. However, significant efforts are still required to move VR into commercial success and therefore routine clinical use.
Comparison of Fuzzy Inference, Logistic Regression, and Classification Trees (CART)
Authors: Nagata T. , Mattern D. , Schmelzeisen R. , Schumacher M. , Schwarzer G. 
Published: March 2018

Summary

Objectives:
In this paper three statistical methods [logistic regression, classification and regression tree (CART), and fuzzy inference] for the prediction of lymph node metastasis in carcinoma of the tongue are compared.
Methods:
A retrospective collection of data in 75 patients treated for tongue cancer was carried out at the Clinic and Policlinic for Oral and Maxillo-facial Surgery at the University Hospital of Freiburg in Germany between January 1990 and December 1999; biopsy material was used for laboratory evaluations. Statistical methods for the prediction of lymph node metastasis were compared using ROC curves and accuracy rates.
Results:
All three methods show similar results for the prediction of lymph node metastasis with slightly superior results for fuzzy inference and CART. A great overlap is apparent in the ROC curves. The best result observed for fuzzy inference and CART was a sensitivity of 79.2% [95% confidence interval: (57.8%; 92.9%)] and a specificity of 86.3% (73.7%; 94.3%); the best result for predictions based on the logistic regression was a sensitivity of 66.7% (44.7%; 84.4%) and a specificity of 80.4% (66.9%; 90.2%). Accuracy rates of fuzzy method and CART were higher [accuracy rate for fuzzy method and CART: 84% (73.7%; 91.4%), for logistic regression method: 73.3%, 95%-CI: (61.9%; 82.9%)].
Conclusions:
From a clinical point of view, the predictive ability of the three methods is not sufficiently large to justify use of these methods in daily practice. Other factors probably on the molecular level are needed for the prediction of lymph node metastasis.
An Inventory of Publications on Electronic Patient Records
Authors: van der Lei J. , Moorman P. W. 
Published: March 2018

AbstractThis study describes an analysis of 1832 papers dealing with electronic patient records, and indexed in NLM’s MEDLINE. Of each retrieved publication the country of origin and the journal in which it was published was determined. Furthermore, insight into the subjects of the publication was obtained by analysing the MeSH terms by which it was indexed. Since 1990 the number of publications on electronic patient records has increased. Publications originated from 43 different countries representing all continents. However, 75% stemmed from only 4 countries. The publications appeared in 379 different journals, of which 26 journals had 10 or more publications. Of all publications, 5.3% had appeared in journals with an impact factor of at least 4.5. The topics most often dealt with were: Hospital Information Systems, Computer Communication Networks, User-Computer Interface, Confidentiality and Computer Security. No obvious trends, other than an increased interest in confidentiality and computer security, were observed.
Health Informatics and Community Health: Support for Patients as Collaborators in Care
Authors: Brennan P. F. 
Published: March 2018

AbstractHealth informatics has much to offer community health care. Computer networks and telecommunications provide particular support that can enhance the collaboration among clinicians, care providers and patients. Special-purpose computer tools referred to as Consumer Health Informatics (CHI) represent the application of computer and information technologies specifically to support the health information and communication needs of patients and lay persons. Research projects like ComputerLink and CHESS demonstrate that CHI is acceptable to patients and promotes self-care and disease management. Three grand challenges must be faced to insure realization of the promise of health informatics to community health care: development of knowledge management and information discovery tools for patients, insurance of health information literacy for all persons, and re-engineering clinical practice to capitalize on patients as full partners in health care.
Clinical Judgment Revisited
Authors: Weed L. L. 
Published: March 2018

AbstractIt is widely recognised that accessing and processing medical information in libraries and patient records is a burden beyond the capacities of the physician’s unaided mind in the conditions of medical practice. Physicians are quite capable of tremendous intellectual feats but cannot possibly do it all. The way ahead requires the development of a framework in which the brilliant pieces of understanding are routinely assembled into a working unit of social machinery that is coherent and as error free as possible – a challenge in which we ourselves are among the working parts to be organized and brought under control.Such a framework of intellectual rigor and discipline in the practice of medicine can only be achieved if knowledge is embedded in tools; the system requiring the routine use of those tools in all decision making by both providers and patients.
Effective Multidisciplinary Communication in Healthcare: Cooperative Documentation Systems
Authors: Wastell D. G. , Schoop M. 
Published: March 2018

AbstractTo support multidisciplinary communication and cooperation in healthcare, cooperative documentation systems (CDSs) have been developed. However, in the current generation of systems, communication problems that can pose a serious threat to smooth and effective cooperation have occurred and remain to be addressed. This paper presents a set of features that need to be considered in the design of a new generation of CDSs to avoid breakdowns in communication and cooperation. Our approach is solidly grounded in linguistic and social theories and based on empirical investigations of communication patterns in multidisciplinary healthcare. It is argued that this work provides a theoretically rigorous approach to the design of CDSs that will enable effective multidisciplinary communication and cooperation in healthcare.
Theoretical Considerations on the Health Checkup Accuracy of Combination Testing
Authors: Shibata S. 
Published: March 2018

Summary

Objectives:
To find basic theoretical evidence for an optimum combination of multi-phasic health checkup testing obtained by considering how the health checkup accuracy changes with the number of tests (n) and kinds of combination methods (A, B, C, D and E).

Methods:
To find how the health checkup accuracy changes with the number of tests and type of combination method, generalized formulas as functions of the number of tests, are obtained to calculate the over-all health checkup accuracy which is defined by sensitivity ( ), specificity ( ) and odds-ratio ( ), based on the two-by-two table. Five kinds of combination methods were considered: A) Sequential tests. B) Sequential tests after changing the order in A. C) Simultaneous tests using the Believe-the-Negative Rule. D) Simultaneous tests using the Believe-the-Positive Rule. E) Simultaneous tests using the Believe-all-Positive-all-Negative Rule.

Results:
It was provend that combination methods A, B and C are “equivalent” for health checkup accuracy. Therefore, the five methods could be summarized into three patterns. For A, B and C:andincreased but a decreased with increasing n. For D:increased butanddecreased with n. For E:,andincreased with n.

Conclusion:
Health checkup accuracy of combination testing is the best in case of E, although problems exist concerning how to judge the borderline subjects.
Guidelines, the Internet, and Personal Health
Authors: Moehr J. R. 
Published: March 2018

Summary

Objectives:
To summarize the insights gained in collaborative research in a Canadian Network of Centres of Excellence, devoted to the promotion of evidence-based practice, and to relate this experience to Internet support of health promotion and consumer health informatics.

Methods:
A subjective review of insights is undertaken.

Results:
Work directed the development of systems incorporating guidelines, care maps, etc., for use by professionals met with limited acceptance. Evidence-based tools for health care consumers are a desirable complement but require radically different content and delivery modes. In addition to evidence-based material offered by professionals, a wide array of Internet-based products and services provided by consumers for consumers emerged and proved a beneficial complement.

Conclusion:
The consumer-driven products and services provided via the Internet are a potentially important and beneficial complement of traditional health services. They affect the health consumer-provider roles and require changes in healthcare practices.
Simulation of Hip Operations and Design of Custom-made Endoprostheses using Virtual Reality Techniques
Authors: Ehrhardt J. , Plötz W. , Pöppl S. J. , Handels H. 
Published: March 2018

AbstractIn this paper a system for the virtual planning of hip operations with endoprosthetic reconstruction and its application in bone tumor surgery is described. The system enables the simulation of the operation and the construction of a custom-made implant depending on the chosen resection planes and the patient’s anatomy. During the planning process integrated virtual reality techniques facilitate the interaction with the three-dimensional (3D) medical objects. Stereo viewing improves the perception of the 3D nature of bone structures and tumors. In comparison to conventional planning procedures, different operation strategies and their influence on the geometry of the custom-made endoprosthesis can be easily compared. Furthermore, the combination of multi-modal image information (CT and MR) enables an accurate 3D visualization of the bone tumor within the bone.
Information Processing in Healthcare at the Start of the third Millennium: Potential and Limitations
Authors: Haux R. , Knaup P. , Bauer A. W. , Herzog W. , Reinhardt E. , Überla K. , van Eimeren W. , Wahlster W. 
Published: March 2018

AbstractThe 21st century is said to be a century of the information society. We should be aware that continuing progress in information processing methodology (IPM) and information and communication technology (ICT) is changing our societies, including medicine and health care. At the start of the third Millennium we should ask ourselves, what progress can we expect from modern IPM/ICT for healthcare in the coming decade, what concerns does the information society have to face, and what steps have to be taken. These questions were addressed by clinicians, researchers and industrial representatives in a panel discussion at the joint conference ISCB-GMDS-99 of the International Society of Clinical Biostatistics and the German Society for Medical Informatics, Biometry and Epidemiology. Important aspects raised by the panelists and in the subsequent discussion were: (1) the main goal of expanding IPM/ICT should be to further improve quality of care, while maintaining reasonable costs; (2) with the support of modern IPM and ICT the boundaries between inpatient and outpatient care will fade away enabling a more efficient, patient-centered health care; (3) cooperation between health-care professionals will increase; there will be different ways of communication between them and with the patient, including modern ICT and the Internet; (4) society must be concerned with achieving equal opportunities in being informed about and in using new ICT; (5) misuse of data will remain a serious problem and can become an obstacle to progress.
On the Necessity of Systematically Planning Clinical Tumor Documentation
Authors: Harkener S. , Ellsässer K.-H. , Haux R. , Wiedemann T. , Knaup P. 
Published: March 2018

AbstractTumor documentation is an important task for both clinical research and patient care. Documentation systems for these purposes have to be planned systematically and should be goal oriented. We applied the method of a so-called ‘standardized documentation protocol’ for systematically planning two documentation systems in oncology: one for the tumor center Heidelberg/Mannheim and the other for a nationwide project in the field of documentation and therapy planning in pediatric oncology. The method proved to be helpful in both cases even though the resulting documentation protocols are completely different and although they served different objectives. Therefore, the aim of the paper is to motivate and help medical informatics professionals to systematically plan other documentation systems using this method.
An Integrated Approach for a Knowledge-based Clinical Workstation: Architecture and Experience
Authors: Ringleb P. , Steiner T. , Knaup P. , Hacke W. , Haux R. , Brigl B. 
Published: March 2018

Abstract:Today, the demand for medical decision support to improve the quality of patient care and to reduce costs in health services is generally recognized. Nevertheless, decision support is not yet established in daily routine within hospital information systems which often show a heterogeneous architecture but offer possibilities of interoperability. Currently, the integration of decision support functions into clinical workstations is the most promising way. Therefore, we first discuss aspects of integrating decision support into clinical workstations including clinical needs, integration of database and knowledge base, knowledge sharing and reuse and the role of standardized terminology. In addition, we draw up functional requirements to support the physician dealing with patient care, medical research and administrative tasks. As a consequence, we propose a general architecture of an integrated knowledge-based clinical workstation. Based on an example application we discuss our experiences concerning clinical applicability and relevance. We show that, although our approach promotes the integration of decision support into hospital information systems, the success of decision support depends above all on an adequate transformation of clinical needs.