bluuebunny/crossref_metadata_2025_split huggingface dataset:
Heart Rate Signal Decomposition
Authors: Mizuta H. , Yana K. 
Published: March 2018

Abstract:This paper proposes a method for decomposing heart rate fluctuations into background, respiratory and blood pressure oriented fluctuations. A signal cancellation scheme using the adaptive RLS algorithm has been introduced for canceling respiration and blood pressure oriented changes in the heart rate fluctuations. The computer simulation confirmed the validity of the proposed method. Then, heart rate fluctuations, instantaneous lung volume and blood pressure changes are simultaneously recorded from eight normal subjects aged 20-24 years. It was shown that after signal decomposition, the power spectrum of the heart rate showed a consistent monotonic 1/fa
type pattern. The proposed method enables a clear interpretation of heart rate spectrum removing uncertain large individual variations due to the respiration and blood pressure change.
Simulation Evaluation of Cardiac Assist Devices
Authors: Bing Z. , Bai J. 
Published: March 2018

Abstract:During past decades, various cardiac assist devices were invented. These cardiac assist devices can be classified into two categories: parallel connected or sequentially connected to the natural heart. In the past, more attention was paid to the assistance of the device provided to the failing heart and most research was conducted towards that goal. While less attention was paid to the “dose” of the assistance for rehabilitation of the natural heart. In our study, the hemodynamic effects of parallel as well as sequential cardiac assist devices are investigated in terms of the working load to the natural heart, and the oxygen supply and consumption of the natural heart. Preliminary results show that the sequential assistance could reduce the working load of the natural heart as well as increase the coronary flow. The results also indicate that the control scheme of the cardiac assist device has effect on the oxygen supply and consumption of the natural heart. There is optimal “dose” of assistance for the rehabilitation of the natural heart.
Band-Suppressed Restoration of X-Ray Images Blurred by Body Movement
Authors: Saitoh Y. , Kiryu T. , Okamoto K. , Sakai K. , Hori J. 
Published: March 2018

Abstract:The restoration of X-ray images that have been blurred due to body movement are discussed. The observation system for these images is described using a mathematical model, and several restoration filters composed of a series of such models are proposed. These filters restore band-suppressed approximations of the original images. In addition, redundancy is introduced into these restoration filters in order to suppress additive noise. These filters are expanded to be applicable not only to parallel translations, but also to rotations by coordinate transformation. The proposed methods are applied to blurred X-ray images of a bone model of the elbow joint. The parameters of the restoration filter are estimated using a marker attached to the subject as a reference signal.
Health and Medical Informatics Competencies: Call to Participate in Updating the IMIA Recommendations
Authors: Douglas Judith , Hovenga Evelyn 
Published: March 2018

Summary

Objectives:
On behalf of the International Medical Informatics Association (IMIA), its Working Group 1 (WG1) addresses health and medical informatics education.

Methods:
As part of its mission, WG1 developed recommendations for competencies, describing a three-dimension framework and defining learning outcomes.

Results:
Officially approved by IMIA in 1999, the recommendations have been translated into seven languages. In 2001, WG1 charged a small group with updating the recommendations and consider the work undertaken by others to develop competencies. Additional work underway in support of the recommendations includes a literature review to help extract the fundamental competencies from the recommendations. To ensure the highest quality of input in the updated recommendations, WG1 is issuing a call for participation to the international informatics community.

Conclusions:
Further work with the competencies will result in updated IMIA guidelines. These are expected to support the creation of a virtual university for health and medical informatics.
Comparison of Computer-based Information Support to Clinical Research in Chinese and Japanese Hospitals
Authors: Ogasawara K. , Endoh A. , Sakurai T. , Jiang G. 
Published: March 2018

Summary

Objectives:
The objectives of this research are to examine the current situation of computer-based information support of clinical research in hospitals and to determine the expectations of clinicians toward clinical research support functions of hospital information systems (HISs) in both China and Japan.

Methods:
172 clinicians from 42 major hospitals in China (2 groups), and 568 clinicians from 79 university hospitals in Japan (2 groups), were surveyed by postal questionnaire during July and August, 1999. The Kruskal-Wallis test was performed to analyze the differences among the groups.

Results:
The total response rate was 66.9%. The result shows that 94.8% of the Japanese clinicians, 3.5 times more than those in China, use computers almost every day. High significance was shown for the frequency of non-HIS based information resources used by clinicians between China and Japan (p <0.001), whereas no significance for the frequency of HIS use by clinicians between the China I and Japan I groups (p = 0.725) was found. 33.3% clinicians in China thought they could obtain 30-50% of the necessary patient data for clinical research from the HIS, about 2 times more than in Japan (p = 0.009).

Conclusions:
Although the degree of computer involvement among clinicians in Japan is much higher than in China, the computer-based hospital information systems have not been developed well for supporting clinical research in both countries. The clinicians expect comprehensive computerized patient records (CPRs) and full use of patient related information in the existing HISs to support their clinical research.
Evaluating the Impact of Primary Care Consultations on Teenage Lifestyle: A Pilot Study
Authors: Oakley L. L. , Townsend J. L. , Walker Z. A. K. 
Published: March 2018

AbstractThis study piloted an evaluation of the effectiveness of inviting teenagers to UK general practice consultations with health behaviour advice and appropriate follow-up care. 132 teenagers aged 14/15 years were randomised: intervention teenagers were invited to attend a health consultation with a practice nurse, the control group received usual care. Teenagers in two practices were consulted by postal survey and in focus groups to ensure the intervention met their needs. 56% of the teenagers invited attended for a consultation. 55% of the intervention group and 45% of the controls reported some positive change in health related behaviour at one month.
Point of Care Technology: A Sociotechnical Approach to Home Health Implementation
Authors: Struk C. M. , Stricklin M. L. V. 
Published: March 2018

Summary
Objectives: This paper describes an ongoing evaluation study of the design and implementation of Point of Care (POC) technology in a home health agency. Methods: During the implementation of POC technology data about user acceptance were collected with the help of surveys and statistically analyzed. The survey also allowed for entering non-structured observations. A time series study was conducted to identify factors associated with technology change and its effect on professional competency.
Results and Conclusions: Healthcare markets and consumers are demanding that providers use sophisticated information technology to document, transmit and access clinical and financial information across all delivery points. Newly adapted Patient Care Information Systems (PCIS) are available for clinical use in home care. The factors associated with home care nurses’ end user acceptance and use of the POC technology in clinical work are described. A sociotechnical approach with selected change management strategies appears to have positively influenced the nurse end users’ POC technology adoption and use in clinical work.
Presenting XML-based Medical Discharge Letters According to CDA
Authors: Wolff A. , Hochlehnert A. J. , Bludau H. B. 
Published: March 2018

SummaryThe HL7 Clinical Document Architecture (CDA) is an important XML-based standard for the representation of clinical documents.

Objectives:
The use of Markup Languages could satisfy the demands of involved healthcare staff as well as the needs of patients, to receive an overview of the patient’s treatment during the hospital stay. The standardization efforts of different groups dealing with this problem have demonstrated progress, but have not, as yet, achieved a routinely usable result. In particular, differentiating information according to a hierarchical order has not been published to date.

Methods:
A retrospective analysis of 60 discharge letters from a cardiology ward (ward A) as well as 60 discharge letters from a gastroenterology ward (ward B) were extracted from the central hospital information system, by taking every fifth discharge letter issued over a one year period.

Results:
An XML-based prototype for medical discharge letters has been put in place representing the required information units and information elements. By means of an XSL-stylesheet, a detailed representation of the conventional discharge letter has been produced that is platform independent and permits the recurrent use of information units.

Conclusions:
Through the introduction of definitions like information elements and information units, progress in the development of CDA level two and three might be realized. We present a method by which discharge letters can be used by an Internal Medicine Department. This concept is implemented in a XML-based prototype allowing a special view on XML data to generate this document type.
Online Medical Records: A Decade of Experience
Authors: Sands D. Z. , Rind D. M. , Safran C. 
Published: March 2018

AbstractThe electronic patient record at the Beth Israel Deaconess Medical Center has fundamentally changed the practice of medicine in ways that its developers never foresaw. This type of highly interactive and work flow enabled program is creating new collaborative roles for computers in complex organizations [4]. With the system able to supervise and monitor care, computers are able to perform many care coordination and documentation functions, freeing people to concentrate more on interpersonal interactions and provision of health care services. One of the challenges in the design of electronic patient records to assist health care providers is how to support collaboration while not requiring that people meet face-to-face. Moreover, a greater challenge for each of us as clinicians is to use this technology as a bridge (rather than a barrier) towards better patient-doctor relationships.
Confidentiality Issues within a Clinical Information System: Moving from Data-driven to Event-driven Design
Authors: Joubert M. , Fieschi D. , Fieschi M. , Staccini P. 
Published: March 2018

AbstractWithin a hospital, the moving of medical information systems from retrospective data-gathering methods to prospective clinical information systems raises the question of the confidentiality of patient data. A method of improving the traditional matrix model usually used to achieve access controls is described. The event-driven model refers to the way a security system ensures that a given user has a valid »need-to« relationship to a given patient. Events are defined as the occurrence of specific data that trigger the creation or the updating of the relationship between the identity of a user and the identity of a patient (e. g., admission, discharge, transfer, prescription, and report). The creation and the deletion of the relationships between users and patients are based on numerous repositories and working lists of patients. This implementation requires an organization of the hospital activities which is able to manage, in a real-time manner, those repositories as closely as possible to the steps occurring during the patient’s care process. Although this approach seems to reasonably fit the dynamic of the care process, it adds significant organizational constraints.
Medical Narratives and Patient Analogs: The Ethical Implications of Electronic Patient Records
Authors: Kluge E.-H. W. 
Published: March 2018

AbstractAn electronic patient record consists of electronically stored data about a specific patient. It therefore constitutes a data-space. The data may be combined into a patient profile which is relative to a particular speciality as well as phenomenologically unique to the specific professional who constructs the profile. Further, a diagnosis may be interpreted as a path taken by a health care professional with a certain specialty through the data-space relative to the patient profile constructed by that professional. This way of looking at electronic patient records entails certain ethical implications about privacy and accessibility. However, it also permits the construction of artificial intelligence and competence algorithms for health care professionals relative to their specialties.
The Past, Present and Future of International Health Evaluation Association (IHEA)
Authors: Hinohara Shigeaki 
Published: March 2018

SummaryIn this paper I mention the 19-year history of International Health Evaluation Association (IHEA) which was started in Washington D.C. by the great effort of Dr. G. Gilbert in Hawaii. In 1973 three regions were organized in this Association: 1) U.S.A., 2) Europe and 3) Pan-Pacific including Asia.I also mention the history of periodical health checkups in U.K., U.S.A. and Japan. In Japan it started in 1954, however, after adapting the system of Automated Multiphase Health Testing designed by the Kaiser Foundation of Auckland, Calif., in 1973, Japanese people paid much attention to this health screening system and the number of hospitals and clinics for health screening has increased tremendously and the number of examinees amounted to 2,875,449 in 2001.Finally, I conclude that IHEA should create a multi-disciplinary system to sustain a lifestyle with a high level of Quality of Life (QOL) for the people who really want to live fruitful lives by the successive health education.
Medicine in the 21st Century: Global Problems, Global Solutions
Authors: Lindberg D.A.B. 
Published: March 2018

Summary

Objectives:
To discuss application areas of information technology in medicine and health care on the occasion of the opening of the Private Universität für Medizinische Informatik und Technik Tirol/University for Health Informatics and Technology Tyrol (UMIT) at Innsbruck, Tyrol, Austria.

Results and Conclusions:
Important application areas of information technology in medicine and health are appropriate individual access to medical knowledge, new engineering developments such as new radiant imaging methods and the implantable pacemaker/ defibrillator devices, mathematical modeling for understanding the workings of the human body, the computer-based patient record, as well as new knowledge in molecular biology, human genetics, and biotechnology. Challenges and responsibilities for medical informatics research include medical data privacy and intellectual property rights inherent in the content of the information systems.
Analytical and Graphical Methods to Model the Association between Family History and Disease from a Case-control Study
Authors: Severi G. , Robertson C. , Hopper J. L. , Baglietto L. 
Published: March 2018

AbstractSubjects within a family have a high probability of sharing environmental factors as well as genes. Without any previous hypothesis, familial aggregation cannot be attributed to genetic or environmental factors. In epidemiology a common measure of familial aggregation is the odds ratio (OR) evaluated from case-control studies which gives a measure of the increased risk associated with particular aspects of the family’s history of disease. An analytical method is presented to model the OR of case-control studies in the presence of risk factors, genetic or environmental, that are correlated between relatives. A graphical approach that can be used to link the parameters of the model with the values of the OR is also described. The method is illustrated using the example of familial aggregation in colorectal cancer.
Design Issues and Sample Size when Exposure Measurement is Inaccurate
Authors: Rippin G. 
Published: March 2018

AbstractMeasurement error often leads to biased estimates and incorrect tests in epidemiological studies. These problems can be corrected by design modifications which allow for refined statistical models, or in some situations by adjusted sample sizes to compensate a power reduction. The design options are mainly an additional replication or internal validation study. Sample size calculations for these designs are more complex, since usually there is no unique design solution to obtain a prespecified power. Thus, additionally to a power requirement, an optimal design should also fulfill the criteria of minimizing overall costs. In this review corresponding strategies and formulae are described and appraised.
Review of Biomedical Knowledge and Data Representation with Conceptual Graphs
Authors: Joubert M. , Fieschi M. , Volot F. 
Published: March 2018

Abstract:The basis of conceptual graphs theory is an ontology of types of concepts. Concepts issued from the ontology are interlinked by semantic relationships and constitute canonical conceptual graphs. Canonical graphs may be combined to derive new conceptual graphs by means of formation rules. This formalism allows to separate knowledge representation into a conceptual level and a domain-dependent level, and enables to share and reuse a representation. This paper presents conceptual graph applications to biomedical data and concept representation, classification systems, information retrieval, and natural language understanding and processing. A discussion on the unifying role conceptual graphs theory plays in the implementation of knowledge-based systems is also presented.
Generation of Correlated Logistic-Normal Random Variates for Medical Decision Trees
Authors: El-Taha M. , Clark D. E. 
Published: March 2018

AbstractA Logistic-Normal random variable (Y) is obtained from a Normal random variable (X) by the relation Y = (ex)/(1 + ex). In Monte-Carlo analysis of decision trees, Logistic-Normal random variates may be used to model the branching probabilities. In some cases, the probabilities to be modeled may not be independent, and a method for generating correlated Logistic-Normal random variates would be useful. A technique for generating correlated Normal random variates has been previously described. Using Taylor Series approximations and the algebraic definitions of variance and covariance, we describe methods for estimating the means, variances, and covariances of Normal random variates which, after translation using the above formula, will result in Logistic-Normal random variates having approximately the desired means, variances, and covariances. Multiple simulations of the method using the Mathematica computer algebra system show satisfactory agreement with the theoretical results.
Toward a General Model for the Description of Multimedia Clinical Data
Authors: Pisanelli D. M. , Ricci F. L. , Consorti F. , Piermattei A. , Ferri F. 
Published: March 2018

AbstractThe patient folder integrates information originating from heterogeneous sources. For this reason computerized tools for patient data management should exploit the advantages of multimediality and offer an integrated environment for data presentation, and image and biosignal visualization. Object-oriented modeling is the best approach for designing systems for multimedia patient folder management.We propose an object-oriented model, able to define the entities constituting the patient folder and their logical organization. This model has sufficient flexibility to adapt to the most varied clinical environments. It allows the physician to structure the information needed for his/her patient folder without employing a programming language.
Decision Support Systems from the Standpoint of Knowledge Representation
Authors: Fieschi M. , Chatellier G. , Degoulet P. 
Published: March 2018

Abstract:Relationships between decision-support systems and knowledge representation are examined from three different points of view: the characteristics of medical decisions that might influence the selection of appropriate knowledge representations, – the extent to which different knowledge representations can support efficient medical decisions and, – the validation of knowledge hypotheses through the practice of decision support systems. A three-level model of knowledge representation is proposed that includes a contextual, a conceptual and a computational level. Taking into consideration the context that leads to the selection of a given representation raises the issue of multiexpertise and multirepresentation modeling. Implementation of decision support systems as sets of cooperative agents and integration in the health information systems are considered.
Medical Language Processing: Applications to Patient Data Representation and Automatic Encoding
Authors: Sager N. , Lyman M. , Nhàn N. T. , Tick L. J. 
Published: March 2018

Abstract:A linguistic approach is presented to develop a representation of patient data. Semantic categories developed for computer processing of narrative clinical reports are shown to be similar to the Medical Concepts used manually to extract data from narrative in Exercises of the Computer-based Patient Record Institute. Clinical statement types composed of these categories are used in the Linguistic String Project (LSP) medical language processing (MLP) system to convert narrative information into relational database tables of patient information. A procedure for mapping the output of the LSP MLP system into SNOMED International codes was developed. Preliminary results and further requirements are discussed.
Naming Notes: Transitions from Free Text to Structured Entry
Authors: Gregory J. , Mattison J. E. , Linde C. 
Published: March 2018

Abstract:To practice medicine in the near future, health care providers in the USA need an information infrastructure they do not yet have. We offer a contribution from social science research to discussions of current medical records practices and how health care activity systems may be transformed by the advent of electronic health records. The goal of the paper is to set forth a framework that connects over-arching questions concerning medical informatics systems development with the practical, cultural and conceptual issues involved in transitions from handwritten and other free text documentation to structured entry of medical records to build patient profiles. The research is broadly framed by an interest in how reciprocal modifications of the design and use of an electronic health record are negotiated in an iterative prototyping project. It is conducted as part of a complex multi-disciplinary research and development effort to create an electronic health record prototype for use in the integrated health care delivery environment of the Southern California Kaiser Permanente Medical Care Program.
SNOMED-Based Knowledge Representation
Authors: Rothwell D. J. 
Published: March 2018

Abstract:A standardized vocabulary and a standardized representation for this vocabulary are necessary prerequisites for the development of a computer-based patient record. A standard conceptual scheme or data structure for this vocabulary must be in place to define clinical events and to share data. SNOMED International is a detailed, fine grained, semantically typed and comprehensive computer processable vocabulary encompassing both human and veterinary medicine. Each term is placed in a standardized data structure that shows the term relationship within its own and other related taxonomic hierarchies. SNOMED International is a standardized vocabulary and data structure suitable for use in the computer-based patient record.