bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimation of Scale Factors in Presence of Multiple Signals: Application to sEMG Analysis
Authors: Rix H. , Meste O. , Muhammad W. 
Published: March 2018

Abstract:When several realizations of an unknown recurrent signal are observed apart from a time expansion or compression, the classical way of estimating these time scaling factors is to take one signal as reference for the estimation. This approach does not take into account the common information between all possible couples of realizations. To achieve this task we use a Maximum-Likelihood based method, in a sub-optimal manner. Using some realistic assumptions and simplifications, we propose a tractable solution. The improvement of classical results is shown through a simulation whose conclusion is that the larger the number of realizations, the more correct the estimation. Finally, we apply the method to electrically evoked sEMG.
Theoretical Analysis of a Rectifying Gap Junction Model
Authors: Zhang Y. T. , Bao J. L. , Hu X. L. 
Published: March 2018

Abstract:Based on the experimental observations, an electrical circuitry model for a rectifying gap junction was developed in previous work. In order to show the physiological function for each element in the model, a theoretical analysis is carried out in this report. The results indicate that the gap junctional capacitance Cj newly introduced into the model plays a major role in determining the duration increase, the peak attenuation, and the peak delay on the postmembrane action potential. Also, a comparison between the newly proposed model and the widely accepted kinetic model by Giaume is made. The results show that the electrical circuitry model can not only describe the characteristics of Giaume’s model but also allow the interpretation of some experimental phenomena that were not reflected in other gap junctional models.
Time Series and the Dynamics of Demand Pacing
Authors: Kaplan D. T. 
Published: March 2018

Abstract:Motivated by a common practice in cardiology, we analyze the dynamics of a demand paced system where one seeks to create a stable periodic response. By using techniques originally developed for controlling chaotic systems, one can enhance the information contained in time series regarding hidden, unstable periodic orbits. This makes it possible, for example, to track drifts in a system‘s dynamics.
Trend Recognition in Clinical Signals using Template-Based Methods
Authors: Lowe A. , Harrison M. J. , Jones R. W. 
Published: March 2018

Abstract:The recognition of clinically significant trends in monitored signals plays an important role in many medical diagnostic applications. A template-based system technique to identify characteristic patterns in time-series data is described, based on fuzzy logic. Fuzzy set theory allows the creation of fuzzy templates from linguistic rules. The resulting fuzzy template system can accommodate multiple time signals, relative or absolute trends, and automatically generates a normalised “goodness of fit” score. The template approach was originally developed for monitoring during anaesthesia but has the potential to be useful in other domains that require temporal pattern recognition.
The Use of Information Graphs to Evaluate and Compare Diagnostic Tests
Authors: Benish W. A. 
Published: March 2018

Summary

Objectives:
The purpose of this communication is to demonstrate the use of “information graphs” as a means of characterizing diagnostic test performance.

Methods:
Basic concepts in information theory allow us to quantify diagnostic uncertainty and diagnostic information. Given the probabilities of the diagnoses that can explain a patient’s condition, the entropy of that distribution is a measure of our uncertainty about the diagnosis. The relative entropy of the posttest probabilities with respect to the pretest probabilities quantifies the amount of information gained by diagnostic testing. Mutual information is the expected value of relative entropy and, hence, provides a measure of expected diagnostic information. These concepts are used to derive formulas for calculating diagnostic information as a function of pretest probability for a given pair of test operating characteristics.

Results:
Plots of diagnostic information as a function of pretest probability are constructed to evaluate and compare the performance of three tests commonly used in the diagnosis of coronary artery disease. The graphs illustrate the critical role that the pretest probability plays in determining diagnostic test information.

Conclusions:
Information graphs summarize diagnostic test performance and offer a way to evaluate and compare diagnostic tests.
Biomechanical Diagnosis of Atherosclerosis by Ultrasound
Authors: Fukumoto T. , Wada T. 
Published: March 2018

AbstractSetting: Atherosclerosis causes structural changes in artery walls that alter their physical properties. The stiffness parameteris one quantitative index of the elastic properties of large arteries.can be calculated from the measurements of blood pressure and arterial diameter. We examined whether quantitatively evaluates common carotid atherosclerosis. Methods: We measured the common carotid artery inner diameter and its pulsatile change with an ultrasonic instrument. The subjects were healthy persons, patients with atherosclesrosis risk factors, patients with myocardial infarctions, and patients with cerebral infarction. Results: Thein healthy persons aged 40-59 years was 11.2. β was 13.2 in patients with atherosclerosis risk factors, 13.4 in patients with myocardial infarction, and 13.5 in patients with cerebral infarctions. These data in each patient group were significantly higher than those in healthy subjects. Conclusions: This diagnostic method is inexpensive, noninvasive and easily performed.shows promise as a useful diagnostic indicator of atherosclerosis.
Resistance to Computerized Care Planning Systems by Qualified Nurses Working in the UK NHS
Authors: Timmons S. 
Published: March 2018

Summary
Objective: This study investigated whether computerized systems, designed to produce detailed plans for the nursing care of inpatients, were resisted by the nurses who were expected to use them.
Methods: Qualitative study, using semi-structured interviews with nurses working in the UK National Health Service.
Results and Conclusions: Resistance took the form of ‘resistive compliance,’ and this resistance is analyzed and explained. Resistance can best be understood in terms of the culture of nursing. This implies that the design and implementation of computerized systems in health care should take these factors into account.
From Passive to Active Electronic Healthcare Records
Authors: Bisbal J. , Grimson W. , Berry D. , Hederman L. , Grimson J. 
Published: March 2018

Summary

Objectives:
The provision of patient data to clinicians as and when it becomes available is a general objective of information systems in healthcare. It is known that the timely receipt of patient data can have a significant bearing on healthcare outcomes. One of the on-going tasks is to provide this data in the form of an Electronic Healthcare Record according to some agreed standard. The aim in this paper is to provide patient data in electronic form by pushing the information to the end users as soon it becomes available, in advance of any explicit request from the users.

Methods:
This paper describes how an existing record system, the Synapses Federated Healthcare Records Server, has been extended to incorporate active functionality to facilitate pushing the information to end-user applications. The user must specify the information of interest to him, so that the system pushes only information useful to the final user. The approach proposed here relies solely on the use of callbacks through the middleware layer being used, a mechanism available in all existing middleware implementations.

Results:
The Synapses Federated Healthcare Records Server which has resulted from this research is a more flexible and scaleable system, capable of fulfilling the needs of a wider range of healthcare organisation than when a strictly passive approach is used.

Conclusions:
It is shown that healthcare organisation can incorporate a healthcare record system with active functionality without any large investment or significant risk to their existing information systems.
Consultation of Medical Narratives in the Electronic Medical Record
Authors: Tange H. J. 
Published: March 2018

AbstractThis article presents an overview of a research project concerning the consultation of medical narratives in the electronic medical record (EMR). It describes an analysis of user needs, the design and implementation of a prototype EMR system, and the evaluation of the ease of consultation of medical narratives when using this system. In a questionnaire survey, 85 hospital physicians judged the quality of their paper-based medical record with respect to data entry, information retrieval and some other aspects. Participants were more positive about the paper medical record than the literature suggests. They wished to maintain the flexibility of data entry but indicated the need to improve the retrieval of information. A prototype EMR system was developed to facilitate the consultation of medical narratives. These parts were divided into labeled segments that could be arranged source-oriented and problem-oriented. This system was used to evaluate the ease of information retrieval of 24 internists and 12 residents at a teaching hospital when using free-text medical narratives divided at different levels of detail. They solved, without time pressure, some predefined problems concerning three voluminous, inpatient case records. The participants were randomly allocated to a sequence that was balanced by patient case and learning effect. The division of medical narratives affected speed, but not completeness of information retrieval. Progress notes divided into problem-related segments could be consulted 22% faster than when undivided. Medical history and physical examination divided into segments at organ-system level could be consulted 13% faster than when divided into separate questions and observations. These differences were statistically significant. The fastest divisions were also appreciated as the best combination of easy searching and best insight in the patient case. The results of our evaluation study suggest a trade-off between searching and reading: too much detailed segments will delay the consultation of medical narratives. Validation of the results in daily practice is recommended.
An Approach to Policy Analysis and Development of Medical Informatics
Authors: Power M. 
Published: March 2018

AbstractThere are three grand challenges for medical informatics policy: (1) What is it? (2) What should it be? (3) How can we influence its development? To address these challenges requires: (1) an historical analysis of medical informatics policies in a representative sample of countries. This should include an account of major events, the roles of technology, individuals, culture and social settings. Pioneers have been led by visions of what medical informatics should achieve. The role of these visions and the reactions to unmet expectations thus also need to be analysed; (2) a generally applicable medical informatics policy that places the needs of its stake-holders and clients first. Top priorities are to support quality health care delivery and quality management of health care facilities; (3) an explanation of how policies in medical informatics are created and implemented together with a strategy to guide medical informatics professionals in their lobbying efforts.
Preliminary Findings of Adult Health Screening under National Health Insurance in Taiwan
Authors: Huang L. , Tseng H. M. 
Published: March 2018

Summary

Objectives:
To provide baseline values of health elated parameters for the Taiwanese population.

Methods:
A systematic sample of 9016 out of 692,311 persons undergoing health check-ups is analyzed and described, and compared to a similar survey undertaken ten years ago. Some physical indices and lab tests exhibited significant age and sex related differences.

Results:
The prevalence of groups of diseases, and the distribution of test results by age and sex are reported and compared to other studies.

Conclusions:
Compared to the survey conducted ten years ago, Taiwanese adults are taller and heavier, but not necessarily healthier.
Survival Analysis with Time-varying Relative Risks: A Tree-Based Approach
Authors: Adak S. , Xu R. 
Published: March 2018

AbstractA tree-based method for estimating time-varying effects of baseline patient characteristics on survival is introduced. A Cox-type model for censored survival data is used in which the time-varying relative risks are modelled as piecewise constants.The tree method consists of three steps: 1. Growing the tree, in which a fast algorithm using maximized score statistics is utilized to determine the optimal change points; 2. A pruning algorithm is applied to obtain more parsimonious models; 3. Selection of a final tree, which may be either via bootstrap resampling or based on a measure of explained variation.The piecewise constant model is more suitable for clinical interpretation of the regression parameters than the more continuously time-varying models (spline, loess, etc.) that have been proposed previously.
Digital Libraries and Recent Medical Informatics Research
Authors: Knaup P. , Maier C. , Mludek V. , Singer R. , Skonetzki S. , Wolff A. C. , Haux R. , Kulikowski C. , Ammenwerth E. 
Published: March 2018

AbstractThe Yearbook of Medical Informatics is published annually by the International Medical Informatics Association (IMIA) and contains a selection of recent excellent papers on medical informatics research (http://www.med.uni-heidelberg.de/mi/yearbook/index.htm). The special topic of the just published Yearbook 2001 is “Digital Libraries and Medicine”. Digital libraries have changed dramatically and will continue to change the way we work with medical knowledge. The selected papers present recent research and new results on digital libraries. As usual, the Yearbook 2001 also contains a variety of papers on other subjects relevant to medical informatics, such as Electronic Patient Records, Health Information Systems, Health and Clinical Management, Decision Support Systems, Education, as well as Image and Signal Processing. This paper will briefly introduce the contributions covering digital libraries and will show how medical informatics research contributes to this important topic.
Object-Oriented Modeling and Terminologies for Drug Contraindications
Authors: Liu J. H. , Milstein C. , Séné B. , Venot A. 
Published: March 2018

Abstract:There is no available standardized representation of contraindications that can be used in drug knowledge bases. In this paper, an objectoriented representation of contraindications is proposed that would allow computerized checking of drug prescription safety. It distinguishes four types of contraindications: pathological state, physiological state, findings of investigation procedures, and diagnostic or therapeutic procedures. The vocabulary usable for expressing the contraindications appropriate for automated prescription checking was also investigated. ICDlO (International Classification of Diseases, tenth revision), SNOMED III (Systematized Nomenclature of Medicine), ICPC (International Classification of Primary Care), and ATC (Anatomic Therapeutic and Chemical Classification) were studied as potential sources of standardized vocabulary. A system to support entering data on contraindications into a drug knowledge base, compatible with the proposed structure and using the identified vocabulary sources, is also presented.
Cognitive Models of Clinical Reasoning and Conceptual Representation
Authors: Patel V. L. , Arocha J. F. 
Published: March 2018

Abstract:This paper presents an approach to conceptual representation, informed by theories and methods from cognitive psychology. Our investigation of clinical case comprehension and reasoning from textual information has shifted from instantiation models in which text processing is carried out through schema fitting to more dynamic models that account for how schemata are constructed by a process of construction and integration of meaning, which depends on specific situations. We give an example involving doctor-patient dialogue to illustrate this point. Nonetheless, our main approach has been propositionally-based. As we conduct research into more specific aspects of medical understanding, such as understanding of physiological systems, we have included alternative approaches, such as qualitative functional graphs. We present examples of their use in our research. These representational formalisms allow us better to capture reasoning and understanding in dynamic systems.
Knowledge-Based Medical Image Analysis and Representation for Integrating Content Definition with the Radiological Report
Authors: Mezrich R. S. , Kulikowski C. A. , Gong L. 
Published: March 2018

Abstract:Technology breakthroughs in high-speed, high-capacity, and high performance desk-top computers and workstations make the possibility of integrating multimedia medical data to better support clinical decision making, computer-aided education, and research not only attractive, but feasible. To systematically evaluate results from increasingly automated image segmentation it is necessary to correlate them with the expert judgments of radiologists and other clinical specialists interpreting the images. These are contained in increasingly computerized radiological reports and other related clinical records. But to make automated comparison feasible it is necessary to first ensure compatibility of the knowledge content of images with the descriptions contained in these records. Enough common vocabulary, language, and knowledge representation components must be represented on the computer, followed by automated extraction of image-content descriptions from the text, which can then be matched to the results of automated image segmentation. A knowledge-based approach to image segmentation is essential to obtain the structured image descriptions needed for matching against the expert’s descriptions. We have developed a new approach to medical image analysis which helps generate such descriptions: a knowledge-based object-centered hierarchical planning method for automatically composing the image analysis processes. The problem-solving steps of specialists are represented at the knowledge level in terms of goals, tasks, and domain objects and concepts separately from the implementation level for specific representations of different image types, and generic analysis methods. This system can serve as a major functional component in incrementally building and updating a structured and integrated hybrid information system of patient data. This approach has been tested for magnetic resonance image interpretation, and has achieved promising results.
Searching for Answers on a Clinical Information System
Authors: Safran C. 
Published: March 2018

Abstract:We examined observational data on the use of a clinical computing system in an effort to develop an empirical model of clinicians’ information needs. Clinicians turn to information systems most often to review the results of diagnostic studies. After that clinicians turn to information systems most often for communication. Bibliographic retrieval is the third most frequent reason for use, but is an order of magnitude less frequent than either results inquiry or electronic mail. Secondary retrieval of aggregate data from a clinical database is two orders of magnitude less common than primary retrieval. In a study at our hospital, clinicians gained access to an information resource during 16% of all general medical visits of patients with human immunodeficiency virus (HIV) infection while the patient was present. Insofar as our narrow focus on the primary care of HIV infection models the larger context of clinical medicine, clinicians are most often looking at information relating to therapeutics. Whatever knowledge structures are adopted, they must accommodate this observed need for therapeutic information.
The CARE Telematics Network for the Surveillance of Influenza in Europe
Authors: Bensadon M. , Strauss A. , Snacken R. 
Published: March 2018

Abstract:Since the 1950s, national networks for the surveillance of influenza have been progressively implemented in several countries. New epidemiological arguments have triggered changes in order to increase the sensitivity of existent early warning systems and to strengthen the communications between European networks. The WHO project CARE Telematics, which collects clinical and virological data of nine national networks and sends useful information to public health administrations, is presented. From the results of the 1993-94 season, the benefits of the system are discussed. Though other telematics networks in this field already exist, it is the first time that virological data, absolutely essential for characterizing the type of an outbreak, are timely available by other countries. This argument will be decisive in case of occurrence of a new strain of virus (shift), such as the Spanish flu in 1918. Priorities are now to include other existing European surveillance networks.
Correction of Risk Estimates for Measurement Error in Epidemiology
Authors: Bashir S. A. , Duffy S. W. 
Published: March 2018

Abstract:Epidemiologists are under considerable pressure to acknowledge the presence of measurement error in the determination of risk factors. Repeatability and validation studies are often prescribed in conjunction with epidemiological studies. We describe some practical uses for repeatability and validation study data, in terms of correcting risk estimates for measurement error. Commonly available methods are described, with their advantages and shortcomings. A user-friendly computer program to carry out the analyses described accompanies the paper.
Managing Different Time Granularities of Clinical Information by an Interval-based Temporal Data Model
Authors: Pinciroli F. , Pozzi G. , Combi C. 
Published: March 2018

Abstract:In the field of databases, time management at different levels of granularity has been an issue for several years, for instance when dealing with clinical information from different databases using different time units, dealing with natural language expressions, or when dealing with temporal uncertainty. A temporal data model is proposed to manage the temporal aspect of data, presented at various and mixed levels of granularity. The concept of temporal assertions shapes the entire temporal information. The model provides a temporal dimension to the data by using intervals that can be specified at different granularities. The model supports a three-valued logic, where True, False and Undefined are the truth values. The temporal data model allows to manage some degrees of uncertainty when establishing temporal relationships between intervals or between temporal assertions, expressed at different granularities. The logical connectives and quantifiers can manage each of the three truth-values.We applied the temporal data model by implementing an object-oriented database system for managing follow-up clinical data from patients who underwent percutaneous transluminal coronary angioplasty.