bluuebunny/crossref_metadata_2025_split huggingface dataset:
Security Aspects of Grid-based Digital Mammography
Authors: Slaymaker M. A. , Politou E. , Power D. J. , Lloyd S. , Simpson A. C. 
Published: March 2018

Summary

Objectives:
The principal aim of the eDiaMoND project is to develop a prototype Grid infrastructure to support the needs of the breast care community. The prototype system is but one major deliverable of the project; the other is a blueprint document that describes how a system such as eDiaMoND might be deployed throughout the United Kingdom to support the NHS Breast Screening Programme. A key consideration of both the prototype and the blueprint is security. In this paper we address some of the generic security issues faced by projects such as eDiaMoND. We also indicate how these problems are being overcome within our project.

Methods:
In order to fully understand the security issues faced by the project a review of current initiatives within the NHS was performed. The work of the NHS Information Authority was found to be particularly significant. Also reviewed was BS7799, the British Standard for the deployment of security systems and processes. Finally, modelling of the proposed prototype was performed using methods proposed by the e-Science Security Task Force, in particular the method proposed by Flechais and Sasse.

Results and Conclusions:
It is felt that the issues of security surrounding the eDiaMoND project are sufficiently generic that the eHealth community can consider and criticise the work described. It is hoped that this will enable the eHealth community to move forwards with a common agenda.
A Grid Service for the Interactive Use of a Parallel Non-rigid Registration Algorithm of Medical Images
Authors: Pennec X. , Ayache N. , Stefanescu R. 
Published: March 2018

Summary

Objective:
The goal of this work is to improve the usability of a non-rigid registration software for medical images.

Method:
We have built a registration grid service in order to use the interactivity of a visualization workstation and the computing power of a cluster.On the user side, the system is composed of a graphical interface that interacts in a complex and fluid manner with the registration software running on a remote cluster.

Conclusion:
Although the transmission of images back and forth between the computer running the user interface and the cluster running the registration service adds to the total registration time, it provides a user-friendly way of using the registration software without heavy infrastructure investments in hospitals. The system exhibits good performances even if the user is connected to the grid service through a low throughput network such as a wireless network interface or ADSL.
Health Promotion in Occupational Health
Authors: Kaijser C. F. O. 
Published: March 2018

Summary

Objectives:
To describe a Swedish approach to occupational health and its implications for health promotion.

Methods:
We start business with a new customer by creating a health policy for the whole company. Every year a follow-up is presented to top management where decisions are taken on what to do for the coming period.

Results:
The result from a paper mill is presented where cost savings were five times more than expected. We have found that close follow-up and the use of personalized reminders is very useful for individuals. We have also found the importance of working more with “the softer side” i.e. looking into a person’s total life situation. Management training activities are essential. This training includes for instance personality, communication and conflict handling seminars and every manager has to go through those seminars. The focus is moved from sick care to health improvement. The result is measured in long-term health for individuals. To reach that level you have to be healthy and have no absences for at least two years.

Conclusion:
The Swedish occupational health system is a unique system for creating health. With a specially trained staff including MDs, nurses, physiotherapists, psychologists, management consultants and engineers, and working from prevention to treatment, they can create a total view of both individual health and customer company wealth. Working closely together in teams and in close cooperation with customers, they can initiate great changes in both these dimensions.
HIV/AIDS Health Literacy in Zimbabwe
Authors: Masvaure T. B. , Gavin L. , Terry P. E. 
Published: March 2018

Summary

Objective:
This qualitative study was designed to assess program needs and evaluate and improve HIV/AIDS prevention efforts at the University of Zimbabwe.

Methods:
We conducted eight focus group discussions with 70 students and conducted key informant interviews with formal and informal opinion leaders. Four mixed-sex focus group discussions, two all-female, and two all-male sessions were held.

Results:
We found a pervasive sense of despondency and powerlessness among students. Consistent across focus groups, but particularly within the women’s groups, respondents revealed that financial and accommodation needs and peer pressure were causing many male and female students to engage in prostitution. Focus group discussions also revealed condom use with regular partners is low and that students dating partners who are employed find it hard to insist on condom use in the relationship.

Conclusions:
Participants stated programs had positively influenced their reduction in the number of sexual partners and intentions to get tested for HIV.
The SARS Epidemic in Hong Kong – A Human Calamity in the 21st Century
Authors: Lee S. H. 
Published: March 2018

Summary

Purpose:
This paper reviews the epidemiology and control measures of the SARS epidemic in Hong Kong. It sets out proposals for better preparedness to tackle the disease in future.

Background:
Severe Acute Respiratory Syndrome (SARS) started to strike Hong Kong in March 2003. A total of 1,755 SARS cases with 298 deaths were reported. Prior to the occurrence of the disease in Hong Kong, an intense outbreak of atypical pneumonia was reported in the nearby Guangdong Province in Mainland China.

Results:
There were three phases in the epidemic. The first phase in March 2003 involved a teaching hospital. The infection originated from a visiting professor from Guangdong, He developed SARS in Hong Kong and died in a Hong Kong hospital. The second phase in April was the spread of the infection from the hospital to the community. The third phase in May was the declining period which ended in June following the removal of Hong Kong from the list of infected areas by WHO.

Conclusion:
Hong Kong was ill prepared at the early stage of the epidemic. The epidemic produced not only health but also social, economic and humanitarian problems. The epidemic, however, created a strong sense of unity among all sectors of the population in the fight against the disease.
The Future Profile of Health Promotion and Disease Prevention in Japan
Authors: Doba N. , Hinohara S. 
Published: March 2018

Summary

Objectives:
One of the serious challenges for Japanese healthcare is the aging population. Analysis of health evaluation data, especially of the elderly over 75 years, is considered very important. In view of this prolonged life expectancy in Japan, our government started the new campaign of Healthy Japan 21, of which details are described, and also we will demonstrate the general profile of our perspective cohort study program concerning the new elder citizens in Japan.

Methods and Results:
Our group has started a health evaluation program for those apparently healthy new elder citizens over the age of 75. A ten-year cohort study is in progress, which is designed to accumulate health check-up data annually. The study collects information on physical well being, as well as information on the individual’s lifestyle, and social, emotional and spiritual environment. Such health appraisal is of primary importance. Preliminary results will be demonstrated with their special implications in clinical and epidemiological significance. The degree of frailty of the individual was also carefully evaluated, so that we can learn about the QOL of the seniors in Japan.

Conclusions:
At the present stage, we can only report a part of our study including the mental and spiritual environments of the individual. This kind of outcome study will give us some insights concerning the natural progress of frailty in the apparently healthy elderly.
On Genetic Information, Diversity and Distance
Authors: Vajda I. , Zvárová J. 
Published: March 2018

Summary

Objectives:
General information-theoretic concepts such as f-divergence, f-information and f-entropy are applied to the genetic models where genes are characterized by randomly distributed alleles. The paper thus presents an information-theoretic background for measuring genetic distances between populations, genetic information in various observations on individuals about their alleles and, finally, genetic diversities in various populations.

Methods:
Genetic distances were derived as divergences between frequencies of alleles representing a gene in two different populations. Genetic information was derived as a measure of statistical association between the observations taken on individuals and the alleles of these individuals. Genetic diversities were derived from divergences and information.

Results:
The concept of genetic f-information introduced in the paper seems to be new. We show that the measures of genetic distance and diversity used in the previous literature are special cases of the genetic f-divergence and f-diversity introduced in the paper and illustrated by examples. We also display intimate connections between the genetic f-information and the genetic f-divergence on one side and genetic f-diversity on the other side. The examples at the same time also illustrate practical computations and applications of the important concepts of quantitative genetics introduced in the paper.

Conclusions:
We discussed a general class of f-divergence measures that are suitable measures of genetic distance between populations characterized by concrete frequencies of alleles. We have shown that a wide class of genetic information, called f-information, can be obtained from f-divergences and that a wide class of measures of genetic diversity, called f-diversities, can be obtained from the f-divergences and f-information.
Shape and Size of Dental Arch
Authors: Tauferová E. , Teuberová Z. , Seydlová M. , Smutný V. , Racek J. , Bartonova M. , Dostálová T. 
Published: March 2018

Summary

Objectives:
The diagnostic procedure commences with the initial examination, during which a number of individual findings of the occlusion or malocclusion are clarified [1]. The objective is to describe the morphological and functional characteristics on each patient using specific guidelines, and then to provide a prognosis of the therapy. Upper and lower arch compression in first premolars and molars area was visible before treatment.

Methods:
A special device (Czech technical university research prototype) was prepared for this purpose. The optical head contains a digital color camera. The front of the optical head consists of a removable prism which is put into the mouth. The findings can display live images from the camera, which can be archived on a PC. The device captured and geometrically calibrated images permitting comparison of several different dental casts.

Results:
In the first part of this study 792 sets of study plaster casts were screened. Measurements of dental arch width between reference points of canines, first premolars and first molars were made: upper jaw: men: 3-3 – 35.1 mm (SE 0.13); 4-4 – 37.5 mm (SE 0.13); 6-6 – 48.1 mm (SE 0.19); women: 3-3 – 33.4 mm (SE 0.13); 4-4 – 35.6 mm (SE 0.15); 6-6 – 46.7 mm (SE 0.19). The second part concerns the group of 36 patients which is different from the 792 controls. There were studied changes between initial, post-treatment and post-retention alignment of upper and lower dental arch.

Conclusions:
Geometrically calibrated images help compare several different steps of the treatment and show a significant difference between patients before and after treatment.
Characterizing Decision Support Telemedicine Systems
Authors: Abu-Hanna A. , Nannings B. 
Published: March 2018

Summary

Objectives:
Decision Support Telemedicine Systems (DSTS) are at the intersection of two disciplines: telemedicine and clinical decision support systems (CDSS). The objective of this paper is to provide a set of characterizing properties for DSTSs. This characterizing property set (CPS) can be used for typing, classifying and clustering DSTSs.

Methods:
We performed a systematic keyword-based literature search to identify candidate-characterizing properties. We selected a subset of candidates and refined them by assessing their potential in order to obtain the CPS.

Results:
The CPS consists of 14 properties, which can be used for the uniform description and typing of applications of DSTSs. The properties are grouped in three categories that we refer to as the problem dimension, process dimension, and system dimension. We provide CPS instantiations for three prototypical applications.

Conclusions:
The CPS includes important properties for typing DSTSs, focusing on aspects of communication for the telemedicine part and on aspects of decisionmaking for the CDSS part. The CPS provides users with tools for uniformly describing DSTSs.
Association between Split Selection Instability and Predictive Error in Survival Trees
Authors: Gefeller O. , Rabenstein T. , Hothorn T. , Radespiel-Tröger M. 
Published: March 2018

Summary

Objectives:
To evaluate split selection instability in six survival tree algorithms and its relationship with predictive error by means of a bootstrap study.

Methods:
We study the following algorithms: logrank statistic with multivariate p-value adjustment without pruning (LR), Kaplan-Meier distance of survival curves (KM), martingale residuals (MR), Poisson regression for censored data (PR), within-node impurity (WI), and exponential log-likelihood loss (XL). With the exception of LR, initial trees are pruned by using split-complexity, and final trees are selected by means of cross-validation. We employ a real dataset from a clinical study of patients with gallbladder stones. The predictive error is evaluated using the integrated Brier score for censored data. The relationship between split selection instability and predictive error is evaluated by means of box-percentile plots, covariate and cutpoint selection entropy, and cutpoint selection coefficients of variation, respectively, in the root node.

Results:
We found a positive association between covariate selection instability and predictive error in the root node. LR yields the lowest predictive error, while KM and MR yield the highest predictive error.

Conclusions:
The predictive error of survival trees is related to split selection instability. Based on the low predictive error of LR, we recommend the use of this algorithm for the construction of survival trees. Unpruned survival trees with multivariate p-value adjustment can perform equally well compared to pruned trees. The analysis of split selection instability can be used to communicate the results of tree-based analyses to clinicians and to support the application of survival trees.
Deconfounding Microarray Analysis
Authors: Jacobsen M. , Repsilber D. , Gutschmidt A. , Neher A. , Feldmann K. , Mollenkopf H. J. , Kaufmann S. H. E. , Ziegler A. 
Published: March 2018

Summary

Objectives:
Microarray analysis requires standardized specimens and evaluation procedures to achieve acceptable results. A major limitation of this method is caused by heterogeneity in the cellular composition of tissue specimens, which frequently confounds data analysis. We introduce a linear model to deconfound gene expression data from tissue heterogeneity for genes exclusively expressed by a single cell type.

Methods:
Gene expression data are deconfounded from tissue heterogeneity effects by analyzing them using an appropriate linear regression model. In our illustrating data set tissue heterogeneity is being measured using flow cytometry. Gene expression data are determined in parallel by real time quantitative polymerase chain reaction (qPCR) and microarray analyses. Verification of deconfounding is enabled using protein quantification for the respective marker genes.

Results:
For our illustrating dataset, quantification of cell type proportions for peripheral blood mononuclear cells (PBMC) from tuberculosis patients and controls revealed differences in B cell and monocyte proportions between both study groups, and thus heterogeneity for the tissue under investigation. Gene expression analyses reflected these differences in celltype distribution. Fitting an appropriate linear model allowed us to deconfound measured transcriptome levels from tissue heterogeneity effects. In the case of monocytes, additional differential expression on the single cell level could be proposed. Protein quantification verified these deconfounded results.

Conclusions:
Deconfounding of transcriptome analyses for cellular heterogeneity greatly improves interpretability, and hence the validity of transcriptome profiling results.
Impact of CPOE on Mortality Rates – Contradictory Findings, Important Messages
Authors: Talmon J. , Ash J. S. , Bates D. W. , Beuscart-Zéphir M.-C. , Duhamel A. , Elkin P. L. , Gardner R. M. , Geissbuhler A. , Ammenwerth E. 
Published: March 2018

Summary

Objective:
To analyze the seemingly contradictory results of the Han study (Pediatrics 2005) and the Del Beccaro study (Pediatrics 2006), both analyzing the effect of CPOE systems on mortality rates in pediatric intensive care settings.

Methods:
Seven CPOE system experts from the United States and Europe comment on these papers.

Results:
The two studies are not contradictory, but almost non-comparable due to differences in design and implementation. They demonstrate the range of outcomes that can be obtained from introducing informatics applications in complex health care settings. Implementing informatics applications is a socio-technical activity, which often depends more on the organizational context than on a specific technology. As health informaticians, we must not only learn from failures, but also avoid both uncritical scepticism that may arise from drawing overly general conclusions from one negative trial, as much as uncritical optimism from limited successful ones.

Conclusion:
The commentaries emphasize the need to promote systematic studies for assessing the socio-technical factors that influence the introduction of increasingly sophisticated informatics applications within complex organizations. The emergence of evidence-based health informatics will be based both on evaluation guidelines and implementation guidelines, both of which increase the chances of successful implementation. In addition, well-educated health informaticians are needed to manage and guide the implementation processes.
Romanian Medical Informatics and Professor Jan H. van Bemmel’s Support
Authors: Mihalas G. I. 
Published: March 2018

Summary

Objective:
The development of medical informatics education in Romania, starting from Timisoara, was strongly influenced by the support offered generously by Professor Jan H. van Bemmel, in a period when the imposed political conditions limited contacts between Western and Eastern countries. We tried to present here some of the most significant actions and events related to this long lasting collaboration.

Methods:
The evolution of the relations between the Departments of Medical Informatics from Medical University in Timisoara and Erasmus University in Rotterdam is described in chronological order.

Results:
Professor van Bemmel found appropriate ways to offer his support, adapted to each historical period. He started by sending books, journals and software, continued with support for attending conferences and then extended to more active collaborations.

Conclusion:
In 2006 professor van Bemmel was the keynote speaker of the EFMI Special Topic Conference held in Timisoara and was awarded the title of “Doctor Honoris Causa” of the Victor Babes University of Medicine and Pharmacy.
The Young Person’s Guide to Biomedical Informatics
Authors: van Bemmel J. H. 
Published: March 2018

Summary

Objective:
To draw a parallel between the challenges by which a research department in biomedical informatics is confronted and those of a symphony orchestra; in both areas different disciplines and various groups of instruments can be discerned.

Method:
Retrospective, personal review of how to conduct biomedical research.

Results:
The importance of mastering one’s instrument and the harmony between the team members is stressed. The conductor has to motivate all players so that they can have a successful career. Competition between orchestras and performance assessments determine survival and success. A record of refereed publications is crucial for continued existence.

Conclusions:
Biomedical informatics is typically multidisciplinary. Hypotheses underlying research should be carefully formulated. The time from research to application may easily take 20 years or more. Mutual trust and knowing each other’s competences is essential for success. A good leader gives enough room to all team members to develop their careers. The outcomes of assessment studies are directly related to the quality of publications.
From Hospital Information Systems to Health Information Systems
Authors: Giuse D. A. , Kuhn K. A. 
Published: March 2018

Summary

Objectives:
Hospital information systems are evolving towards health information systems. This article aims at identifying both proven benefits and critical issues, and at discussing problems and possible solutions.

Methods:
Reports on HIS successes and failures were analyzed, and core challenges were identified. These challenges are discussed against state of the art solutions.

Results:
In spite of demonstrated benefits, there are more severe problems than reports on successes suggest. Among today’s core problems are integration, human-computer interaction, socio-technical issues, and support of processes.

Conclusions:
Significant efforts of all parties involved in the health care process are needed to improve, implement, and evaluate the concepts described.
Determining the Effects of Patient Casemix on Length of Hospital Stay: A Proportional Hazards Frailty Model Approach
Authors: Yau K. K. W. , Lee A. H. 
Published: March 2018

Summary

Objectives:
To identify factors associated with hospital length of stay (LOS) and to model variations in LOS within Diagnosis Related Groups (DRGs).

Methods:
A proportional hazards frailty modelling approach is proposed that accounts for patient transfers and the inherent correlation of patients clustered within hospitals. The investigation is based on patient discharge data extracted for a group of obstetrical DRGs.

Results:
Application of the frailty approach has highlighted several significant factors after adjustment for patient casemix and random hospital effects. In particular, patients admitted for childbirth with private medical insurance coverage have higher risk of prolonged hospitalization compared to public patients.

Conclusions:
The determination of pertinent factors provides important information to hospital management and clinicians in assessing the risk of prolonged hospitalization. The analysis also enables the comparison of inter-hospital variations across adjacent DRGs.