bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modelling and Simulation of Complex Control Structures in Cell Biology
Authors: Sandblad B. , Meinzer H.P. 
Published: March 2018

Abstract:Biological and biomedical tissues and organs represent very complex and highly dynamic systems. The problem to model such complex systems is twofold. First, it is necessary to identify and describe the biological properties and the connecting control mechanisms of the studied system and its subparts. Here, biological knowledge is often missing. Secondly, we are confronted with the problem to formulate the model of the control structure in a form that allows model analysis. Here, a normal mathematical formalism is often inadequate. To solve these modelling problems and to develop methods for building models of complex control structures that will enable the formulation of dynamic systems in biology, a framework for building such models is presented. The model framework is here mainly used for studies of dynamic cell structures, but the possible application areas are more general. An example is given for modelling cell structures of epithelial tissues in the intestine.
MS2/Cardio: Towards a Multi-Service Medical Software for Cardiology
Authors: Combi C. , Pozzi G. , Rossi R. , Pinciroli F. 
Published: March 2018

Abstract:Many clinics are interested to use software packages in daily practice, but lack of integration of such packages seriously limits their scope. In practice this often entails switching between programs and interrupting the run of an individual program. A multi-task approach would not solve this problem as it would not eliminate the need to input the same data many times, as often occurs when using separate packages. The construction of a Multi-Service Medical Software package (MSx2) is described, which was also developed as an example of practical integration of some clinically relevant functions. The package runs on a personal computer in an MS-DOS environment and integrates a time-oriented medical record management unit (TOMRU) for data of ambulatory patients, and a drug information management unit (DIMU) concerning posology, content, effects, and possible interactions. Of the possible database configurations allowed by MSx2, the cardiology patient database (MSx2/C) and hypertensive patient database (MSx2/H) were developed and described here. Clinical information to be included in the configurations was obtained after discussion and consensus of clinical practitioners. MSx2/C was distributed to several hundred clinical centers during computerized courses to train future users. MSx2 can easily transfer patient data to statistical processing packages.
Application of Adjusted Survival Curves to Renal Transplant Data
Authors: Bender R. , Schultz A. , Pichlmayr R. , Grouven U. 
Published: March 2018

Abstract:An important means in the analysis of survival time data is the estimation and graphical representation of survival probabilities. In this paper unifactorial parametric and non-parametric survival curve estimators and two types of adjusted survival curves based on a parametric multifactorial approach are applied to renal transplant data. It is shown that the resulting survival curves can differ substantially. The unifactorial survival curves yield biased results in case of serious disequilibrium in the data. This drawback of the unifactorial methods has been overcome by the use of adjusted survival curves which take possible distortions in the data set into account. The benefits of adjusted survival curves in assessing potentially prognostic factors are elucidated by the application to data from renal transplantation.
Computerized Electrocardiogram Diagnosis: Fuzzy Approach
Authors: Degani Rosanna 
Published: March 2018

Abstract:This paper investigates the computerized analysis of electrocardiographic signals. The biological variability, the laáck of standards in the definition of measurements and of diagnostic criteria make the classification problem a complex task. Two basic methods of the diagnostic process are described: the statistical model and the deterministic approach. In particular, a model for ECG classification will be illustrated where the imprecise knowledge of the state of cardiac system and the vague definition of the pathological classes are taken care of by means of the fuzzy set formalism.
Health Program Effectiveness Measurement: A Case of Degenerative Disease
Authors: Klementiev A. A. 
Published: March 2018

Abstract:An administrator of a Health Program aiming at the control of a specified disease has a need for a quantitative evaluation of the consequences of the Program’s realization. On the population level, Lifetime Lost (LTL) figures calculated for both target and reference populations might be used for this purpose. The LTL methodology provides a user with a new procedure for medical data processing. It allows to estimate the LTL values from mortality data only, without the laborious procedure of registration of the morbidity episodes in target and reference populations. This approach is valid for a special case of degenerative diseases.
Significant Left Ventricular Hypertrophy in Subjects with Normal Resting Pressures but Exaggerated Pressure Response During Light Exertion
Authors: Bowyer A. F. , Thomas R. A. , Cannon C. E. 
Published: March 2018

Abstract:Concentric left ventricular hypertrophy (LVH) frequently occurs in subjects with normal resting systolic and diastolic pressures (SP and DP, respectively). LVH in this normotensive-hypertrophic group (NH) may be due to an abnormally exaggerated pressure response to exercise. The SP and DP responses to exercise were studied in 130 subjects free from coronary artery disease or cardiomyopathy. The NH subjects (n = 35) had normal resting pressure (SP ≤140 and DP ≤85 mmHg) and increased LV wall thickness (T) by echocardiography (T >1.1 cm). A normal control group (NN) (n = 57) and a hypertensive control group (HH) (n = 23) were simultaneously evaluated. The original groups, subgroups censored for age and weight, and matched-pair subgroups demonstrated greater exercise SP for NH than for NN (p <0.005). Moreover, the rate of SP increase with exercise was greater for NH than for NN or HH (p <0.05). Hence, an exaggerated exercise SP response may have been the stimulus for LVH in these NH subjects.
A Methodology for Determining Patients’ Eligibility for Clinical Trials
Authors: Kemper C. A. , Lane N. M. , Carlson R. W. , Musen M. A. , Tu S. W. 
Published: March 2018

AbstractThe task of determining patients’ eligibility for clinical trials is knowledge and data intensive. In this paper, we present a model for the task of eligibility determination, and describe how a computer system can assist clinical researchers in performing that task. Qualitative and probabilistic approaches to computing and summarizing the eligibility status of potentially eligible patients are described. The two approaches are compared, and a synthesis that draws on the strengths of each approach is proposed. The result of applying these techniques to a database of HIV-positive patient cases suggests that computer programs such as the one described can increase the accrual rate of eligible patients into clinical trials. These methods may also be applied to the task of determining from electronic patient records whether practice guidelines apply in particular clinical situations.
The Explanatory Role of Events in Causal and Temporal Reasoning in Medicine
Authors: Buekens F. , Ceusters W. , De Moor G. 
Published: March 2018

AbstractThe logic of time and the way we reason about time is intrinsically connected with the way we reason about causality. In this paper, we focus our attention on some of the less obvious ways in which reasoning about time and causality interact. It is explained why in temporal reasoning a firm distinction has to be made between the ontology, i. e., what happens, and the way we describe the ontology. Temporal events need to be redescribed in such a way that they causally explain why some of the events are followed by the others. While building a temporal/causal theory, certain events may be omitted, not because they do not play a causal role, but because they do not play an explanatory role. In doing so, it is possible to eliminate the distinction between theories representing time as dense, and theories that represent time as discrete.
On-Line Beat-to-Beat Monitoring of Spectral Parameters of Heart Rate Variability Signal Using a Pole-Tracking Algorithm
Authors: Bianchi A. M. , Cerutti S. , Mainardi L. T. 
Published: March 2018

Abstract:Spectral parameters extracted from the heart rate variability (HRV) signal are obtained on a beat-to-beat basis, following a procedure which uses two recursive algorithms. In the first step of the procedure the set of the AR model coefficients is updated each time a new RR value is available. Then from the estimated AR model parameters, the new position of the poles of the model transfer function in the complex z-plane is evaluated and, finally, through a residual calculation, it is possible to calculate the spectral parameters which quantify the control of the autonomic nervous system in assessing the cardiac frequency (i.e., power and frequency of LF and HF components). The whole procedure has first been tested on a simulated time series, in order to evaluate its performance in tracking the dynamic changes during different conditions; next the algorithms were employed in the study of the HRV signal for continuous monitoring of non-stationary conditions.
A Noxious Agents Information System with State-wide Participation of the Public Health Service
Authors: Kobusch A.-B. , Kohn-Schulze E. , Fehr R. 
Published: March 2018

Abstract:With environmental health receiving increased attention by Public Health Services, there is a need to access as efficiently as possible detailed, current, and reliable information of physico-chemical, epidemiological, and toxicological as well as regulatory and legal aspects on this subject. Correspondingly, targets 19 and 35 of WHO’s “Health for all 2000” strategy all for information systems to meet these demands. On this basis, a Noxious Agents Information System (NIS) was designed with three components: PC-based information workstations allowing access to portable and online databases; a dedicated modular database system providing “immediate answers” as well as support for more comprehensive information retrieval; and a cooperative network for training, information exchange, and consultation. During 1992-93, the system was introduced in Germany in the State of North Rhine-Westphalia, and 54 of 59 eligible institutions (92%) of the Public Health Service decided to participate, proving a virtually state-wide introduction to be feasible. Details are presented of the NIS concept and its realization, and limitations and future perspectives are discussed.
Applying the Jackknife Method to Significance Tests of Diagnostic Diversity
Authors: Izsák J. 
Published: March 2018

Abstract:The sample theory of normal diversity indices is complex. Distributionfree methods, such as the jackknife method, can easily be used to determine confidence intervals and testing diversity. Jackknife estimates and their variances for a number of different diversity indices are described in this paper. A simple numerical example is given for demonstrating this method. Discrimination based on confidence intervals is also discussed. It is assumed that there is a special correlation between the sensitivity parameter m and the relative width of confidence intervals in the Hurlbert index family. It is shown that the usual estimation of the Hurlbert index coincides with the relating jackknife estimate. For demonstration, diagnoses registered in a set of death certificates are used. There is a considerable diversity in diagnoses among different diagnostic groups: the diversity is largest in autopsy reports, whereas it is non-significant in GP’s reports and in reports of physicians authorized to issue death certificates. Knowing that autopsy reports tend to be fairly accurate, our research findings seem to confirm the hypothesis that there is a correlation between reliability and diversity of diagnoses.
Computer-Assisted Quality Assurance in an HIV Serology Laboratory
Authors: Biryahwaho B. , Downing R. G. , Ojwiya A. , Mulder D. W. , Nunn A. J. 
Published: March 2018

Abstract:A computer-based quality assurance programme for an HIV-1 serology laboratory is described. The programme was designed to minimise transcription errors and to provide rapid feedback on laboratory performance. Similar systems could readily be introduced to any laboratory with access to simple computing facilities.
Management-Focused Health Informatics Research and Education at the University of Manchester
Authors: Peel V. J. 
Published: March 2018

Abstract:The Health Services Management Unit was established in 1956 and the Centre for Health Informatics in 1988 as one of eight new centres of research and professional practice. New programmes of informatics education have been created to integrate many of the areas of social and management sciences with clinical work. The model, of a multi-disciplinary higher education department based at a University with very substantial departments of Bio-Medicine and Computation, enables the Centre to reflect an alternative paradigm of health informatics. Informatics practitioners from many disciplines are taught a combination of knowledge and skills through a range of educational methods. A classification scheme for educational work is offered.
Application of Indicators, Predictors and Diagnostic Indices in Coagulation Disorders
Authors: Wahlberg Th. , Blombäck Margareta , Hall P. , Axelsson G. 
Published: March 2018

A theoretical model for the evaluation of binary and continuous diagnostic variables by indicators and predictors was recently described by Sebag and Hall [5]. The application of the new method for the evaluation of a self-administered questionnaire was described by Wahlberg et al. [6, 7]. In the present study the model is applied to material from two clinical tests :1. Three blood coagulation laboratory tests for the diagnosis of von Willebrand’s disease (continuous variables) ;2. Six blood coagulation laboratory tests performed in healthy males, aged 40, from Edinburgh and Stockholm, for the evaluation of risk factors in ischemic heart disease (continuous variables).The diagnostic power of the laboratory variables is calculated by indicators and predictors. The total diagnostic capacity of all variables is expressed by a laboratory or summation index.The material from the coagulation tests shows that it was possible to separate healthy individuals from diseased ones. By laboratory indices calculated for six coagulation variables, the Stockholm and Edinburgh populations were found to have different blood coagulation patterns.
Feedback of Therapeutic Skills for Quality Assessment within Ward Sessions in Psychiatry
Authors: Rienhoff O. , Machleidt W. 
Published: March 2018

Within the framework of a brief review the state of the art of quality control for therapeutic work with special emphasis on interpersonal skills is summarized.The results of a documentation developed at the Medical School Hannover for ward sessions in psychiatry are presented. They are based on the evaluation of 190 ward sessions. For six months the behaviour of the patients as well as that of the therapists was measured by using a controlled rating scale. The results describe the characteristic differences between the therapists leading a ward-group with respect to the satisfaction with the session in relation to different kinds of quality models. The individual style of the therapists corresponding with the number of ward sessions performed proves to be an important factor for the quality of the therapy. The results are used for the design of a feedback system for the training of therapists.
The Value of Temporary Electrical Pacing for Patients with Acute Myocardial Infarction
Authors: Northover B. J. 
Published: March 2018

SummaryFacilities for temporary electrical pacing were created in a district general hospital. In consequence, a more than twofold increased proportion of patients with acute myocardial infarction who developed electrical conduction defects were treated with temporary electrical pacing. Despite the increased use of pacing, however, the mortality among patients with conduction defects did not decline at all. It is concluded that the widespread reluctance to undertake a formal clinical trial of temporary electrical pacing among patients with acute myocardial infarction is no longer warranted.
Analysis of Maximum Expiratory Flow Volume Curves Using Canonical Correlation Analysis
Authors: van Pelt W. , Quanjer Ph. H. , Wise M. E. , van der Burg E. , van der Lende R. 
Published: March 2018

SummaryAs part of a population study on chronic lung disease in the Netherlands, an investigation is made of the relationship of both age and sex with indices describing the maximum expiratory flow-volume (MEFV) curve. To determine the relationship, non-linear canonical correlation was used as realized in the computer program CANALS, a combination of ordinary canonical correlation analysis (CCA) and non-linear transformations of the variables. This method enhances the generality of the relationship to be found and has the advantage of showing the relative importance of categories or ranges within a variable with respect to that relationship. The above is exemplified by describing the relationship of age and sex with variables concerning respiratory symptoms and smoking habits. The analysis of age and sex with MEFV curve indices shows that non-linear canonical correlation analysis is an efficient tool in analysing size and shape of the MEFV curve and can be used to derive parameters concerning the whole curve.
A Computerized Information System for a Pain Clinic
Authors: Hildebrandt J. , Klar R. , Weyland A. , Wieding J. U. 
Published: March 2018

SummaryThe concept of the pain clinic constitutes a recent medical development requiring a thorough documentation of patient-related data in order to achieve reasonable standards in diagnosis and treatment, to ensure that the follow-up maintains these standards and to supply necessary data for research on the epidemiology, etiology, and therapy of chronic pain. We, therefore, developed a set of medical questionnaires for pain patients together with a microcomputer system for the storage and analysis of the data obtained. The main features of our approach are the problem-oriented medical records, the multi-user system and the immediate availability of the supplied data to every therapist using the system.
A Scheme for Usage Integrity
Authors: Fenna D. 
Published: March 2018

SummaryThe need for assured integrity and confidentiality in medical information systems has long been recognized and has been the subject of major international working conferences [4, 5]. Beyond the purely physical, the field of data protection is commonly recognized as being divided into data/program integrity and usage integrity. This paper addresses the latter, describing a sophisticated scheme developed at the University of Alberta and progressively implemented at several associated hospitals. The IFIP-IMIA WG4 conference of 1982 reported in its conclusions “a need for well defined and accurately described cases that can be used as a reference”; this paper offers one such case.
Nonparametric Analysis of Treatment-Response Tables by Bipredictive Configurai Frequency Analysis
Authors: Lienert G. A. , Netter Petra 
Published: March 2018

SummaryBipredictive configurai frequency analysis (CFA) is introduced as a complement to predictive CFA as a method for analyzing r X c contingency tables with r treatment modalities and c response patterns. It is illustrated by an example from dose effect regression evaluation in a randomized block design.
On-line Tropical Epidemiology -A Case-Study from The Gambia
Authors: Rowan Kathryn , Byass P. , Snow R. W. 
Published: March 2018

SummaryThis paper reports on a computerised approach to the management of an epidemiological field trial, which aimed at determining the effects of insecticide-impregnated bed nets on the incidence of malaria in children. The development of a data system satisfying the requirements of the project and its implementation using a database management system are discussed. The advantages of this method of management in terms of rapid processing of and access to data from the study are described, together with the completion rates and error rates observed in data collection.
On Clinically Relevant Differences and Shifted Nullhypotheses
Authors: Victor N. 
Published: March 2018

SummaryThe currently usual one value for the judgement of the clinical relevance of therapeutic effects frequently does not suffice to adequately formulate the problems of clinical studies, and the statistical standard procedure (the testing of the classical nullhypothesis) fails to take this value duly into account.Therefore, it is proposed to judge the clinical relevance and importance by means of four values, fixed in discussions with the clinician before commencement of the study, and to proceed by testing non-zero nullhypotheses (shifted nullhypotheses) where the “clinically relevant difference” is the shift parameter.Methodical problems resulting from the shifting of the nullhypothesis are discussed, and other possibilities to take into account the clinically relevant difference (introduction of criteria of success) are considered.
Persons and Computers in Medicine and Health
Authors: Grémy F. 
Published: March 2018

SummaryThe author gives a series of reflections about some claims of Artificial Intelligence supporters on the possibilities for a machine to duplicate human intelligence. He points out:a) the structural peculiarities of the brain,b) the road taken by humans to progress from the beginner’s up to the expert’s level,c) the counter-offensive of phenomenological philosophy against the rationalistic tradition,d) the backward movement of some prominent Artificial Intelligence researchers who renounce some of their previous pretentions.Finally, he tries to specify the respective place of “know how” and “know that” in medicine and to delimit the place of expert systems.In conclusion, the author claims that every information system should be man-oriented and man-centered.
Knowledge Engineering for Clinical Consultation Programs: Modeling the Application Area
Authors: Musen Mark A. , van der Lei Johan 
Published: March 2018

Abstract:Developers of computer-based decision-support tools frequently adopt either pattern recognition or artificial intelligence techniques as the basis for their programs. Because these developers often choose to accentuate the differences between these alternative approaches, the more fundamental similarities are frequently overlooked. The principal challenge in the creation of any clinical consultation program - regardless of the methodology that is used - lies in creating a computational model of the application domain. The difficulty in generating such a model manifests itself in symptoms that workers in the expert systems community have labeled “the knowledge-acquisition bottleneck” and “the problem of brittleness”. This paper explores these two symptoms and shows how the development of consultation programs based on pattern-recognition techniques is subject to analogous difficulties. The expert systems and pattern recognition communities must recognize that they face similar challenges, and must unite to develop methods that assist with the process of building of models of complex application tasks.