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At least 649 records · Page 36Linked to original sources

Improving knowledge navigation with adaptive hypermedia.

Web applications provide access to a tremendous amount of information: hypertext, hypermedia and on-line databases. However, since users' knowledge, motivation and goals are different, they cannot find the relevant information in the data being diffused. Giving the users applications or environments that will take their differences into account is one way of improving their access to knowledge. The authors' objective is to improve knowledge navigation by adapting users' navigation. Adaptive hypermedia is one way of returning information adapted to the user. This paper presents an adaptive hypermedia system based on user representation with the stereotype model. Both adaptive presentation and navigation techniques are also implemented. This paper focuses on the architecture of the general adaptive hypermedia system as well as adaptivity management. A-TOP, a medical adaptive hypermedia prototype implemented in a hospital intranet system, is described. Adaptive hypermedia is a preliminary approach to the vast problem of user access to knowledge. In conclusion, we hope to extend our reflections to the problems involved in access to knowledge on the World Wide Web (Web).

Computer Graphics↗

AIDA for the automation of the patient history.

This article describes the application of a fourth-generation programming package (AIDA) for the construction of an interactive system for history-taking. It is shown that this system has been made very flexible and user-friendly, and that patients can easily answer all questions themselves. Parts of the system, that are supported by AIDA, are an interactive terminal with special, illuminated function keys, a screen driver for the generation and maintenance of 28 different screens, extensive help texts (with 260 help messages), and a report generator. The screens contain altogether 402 questions, through which 434 different answers can be given on 179 different items. The system has been evaluated extensively.

Computer Systems↗

Integrating medical applications in an open architecture through generic and reusable components.

Allowing exchange of information and cooperation among network-wide distributed and heterogeneous applications is a major need of current health care information systems. It forces the development of open and modular integration architectures. Major issues in the development include defining a flexible and robust federation model, developing interaction and communication facilities as well as the mechanism insuring semantic interoperability. We developed generic and reusable software components to ease the construction of any integration platform. The Pilot and the Mediator Service components facilitate the execution of services and the meaningful transformation of information. They have been tested in the context of the SynEx European project to construct a multi-agents based integration architecture. The possibility of such architectures to take into account the issue of semantic interoperability is further discussed.

Computer Communication Networks↗

Engineering and algorithm design for an image processing Api: a technical report on ITK--the Insight Toolkit.

We present the detailed planning and execution of the Insight Toolkit (ITK), an application programmers interface (API) for the segmentation and registration of medical image data. This public resource has been developed through the NLM Visible Human Project, and is in beta test as an open-source software offering under cost-free licensing. The toolkit concentrates on 3D medical data segmentation and registration algorithms, multimodal and multiresolution capabilities, and portable platform independent support for Windows, Linux/Unix systems. This toolkit was built using current practices in software engineering. Specifically, we embraced the concept of generic programming during the development of these tools, working extensively with C++ templates and the freedom and flexibility they allow. Software development tools for distributed consortium-based code development have been created and are also publicly available. We discuss our assumptions, design decisions, and some lessons learned.

Algorithms↗

Introducing information technology into the home: conducting a home assessment.

Abstract As the home becomes an increasingly important site for health care, an increasing number of technology applications or devices are being introduced to support health at home. However, introducing new technology into a household raises a number of issues that must be considered prior to, during, and after the technology is implemented. This paper reviews the experiences of the UW-Madison Advanced Technologies for Health@Home Project, summarizing our assessment of household requirements that should be analyzed prior to introducing new technology. The overall goal of the Health@Home project is to improve the functionality and content of information technology innovations for the home. Using Venkatesh and Mazumdar's framework this article will summarize the relevant social, behavioral, technological, and physical dimensions of households that must be carefully assessed and understood to help ensure that the technology fits the needs of home residents.

Data Collection↗

[Lymphocyte surface antigens in the peripheral blood. Detection by flow cytometry. Applications to the immune system in clinical practice].

A flow cytometer enables observation of single cells providing morphological characterization of the cell and identification of cell markers. The cells pass a detection point where they are striked by a sharply focused beam. Light scattering by the cells gives informations about size and granularity. Detection of fluorescence emission permits identification of fluorescent tag such as antibodies. Flow cytometric analysis of immunologic phenotyping allows interpretation of weak fluorescence intensity and detection of two antigens on a single cell with dual fluorescence analysis. Evaluation of B and T cells and their subclasses from whole blood preparations, provides informations of immunological status. Immunophenotyping at the clinical level has been used in a variety of human diseases; immunophenotypic changes have been observed in congenital and acquired immunodeficiency syndromes and auto-immune disorders.

Antigens, Surface↗

A model and application for estimating completeness of registration.

Completeness of population-based registration systems is recognized to be an important aspect of the quality of information in registries which has to be examined. In this paper a model is presented which was used to estimate completeness of reporting of Down syndrome data notified to the Styrian Malformation registry between 1985-92. The model introduced is based on the two-source capture-recapture method allowing for time-varying parameters. For estimation of the parameters a discrete-time filtering algorithm was developed. For the used data set, an estimate of completeness derived from this model was in good agreement with an independent estimator based on demographic data and maternal age-specific Down syndrome risks whereas the usual two-source capture-recapture method gave a higher estimate.

Algorithms↗

The future is no longer what it used to be. Managing health telematics projects.

Future used to mean global progress and convergence of science and technology and society. Today, we observe the decoupling of the two poles of knowledge formation and application (i.e. science and technology, and culture and society, respectively) and also fierce confrontation between them. The key issue to reconcile the two poles is to re-invent the link between them. The new future lies in the development of mental and technical capacities for change and the creation of new forms of solidarity. We propose, as a general attitude, to reactivate and develop the four principles of efficacy-effectiveness-efficiency, hospitality, responsibility and pertinence. Translated into driving forces for the development of health care telematic projects, they amount to the acceptance of and capacity for enterprise-wide solutions, hospitality and capacity to acquire outside knowledge, self-managed, multi-functional team work spirit, reengineering mentality to achieve pertinent technico-cultural solutions.

Attitude↗

Grid requirements for the integration of biomedical information resources for health applications.

OBJECTIVES: The goal of this paper is to identify how Grid technology can be applied for the development and deployment of integration systems, bringing together distributed and heterogeneous biomedical information sources for medical applications. METHODS: The integration of new genetic and medical knowledge in clinical workflows requires the development of new paradigms for information management in which the ability to access and relate disparate data sources is essential. We adopt a requirements perspective based on the user needs we have identified in the development of the INFOGENMED system to assess current Grid technology against those requirements. RESULTS: The gap between Grid features and distributed biomedical information integration needs is characterized. Results from prospective studies are also reported. CONCLUSIONS: Grid infrastructures offer advanced features for the deployment of collaborative computational environments across virtual organizations. New Grid developments are in line with the problem of multiple site information integration. From the INFOGENMED point of view, Grid infrastructures need to evolve to implement structured data access services and semantic content description and discovery.

Computational Biology↗

Artificial intelligence applications in the intensive care unit.

OBJECTIVE: To review the history and current applications of artificial intelligence in the intensive care unit. DATA SOURCES: The MEDLINE database, bibliographies of selected articles, and current texts on the subject. STUDY SELECTION: The studies that were selected for review used artificial intelligence tools for a variety of intensive care applications, including direct patient care and retrospective database analysis. DATA EXTRACTION: All literature relevant to the topic was reviewed. DATA SYNTHESIS: Although some of the earliest artificial intelligence (AI) applications were medically oriented, AI has not been widely accepted in medicine. Despite this, patient demographic, clinical, and billing data are increasingly available in an electronic format and therefore susceptible to analysis by intelligent software. Individual AI tools are specifically suited to different tasks, such as waveform analysis or device control. CONCLUSIONS: The intensive care environment is particularly suited to the implementation of AI tools because of the wealth of available data and the inherent opportunities for increased efficiency in inpatient care. A variety of new AI tools have become available in recent years that can function as intelligent assistants to clinicians, constantly monitoring electronic data streams for important trends, or adjusting the settings of bedside devices. The integration of these tools into the intensive care unit can be expected to reduce costs and improve patient outcomes.

Algorithms↗

GEMSS: grid-infrastructure for medical service provision.

OBJECTIVES: The European GEMSS Project is concerned with the creation of medical Grid service prototypes and their evaluation in a secure service-oriented infrastructure for distributed on demand/supercomputing. Key aspects of the GEMSS Grid middleware include negotiable QoS support for time-critical service provision, flexible support for business models, and security at all levels in order to ensure privacy of patient data as well as compliance to EU law. METHODS: The GEMSS Grid infrastructure is based on a service-oriented architecture and is being built on top of existing standard Grid and Web technologies. The GEMSS infrastructure offers a generic Grid service provision framework that hides the complexity of transforming existing applications into Grid services. For the development of client-side applications or portals, a pluggable component framework has been developed, providing developers with full control over business processes, service discovery, QoS negotiation, and workflow, while keeping their underlying implementation hidden from view. RESULTS: A first version of the GEMSS Grid infrastructure is operational and has been used for the set-up of a Grid test-bed deploying six medical Grid service prototypes including maxillo-facial surgery simulation, neuro-surgery support, radio-surgery planning, inhaled drug-delivery simulation, cardiovascular simulation and advanced image reconstruction. CONCLUSIONS: The GEMSS Grid infrastructure is based on standard Web Services technology with an anticipated future transition path towards the OGSA standard proposed by the Global Grid Forum. GEMSS demonstrates that the Grid can be used to provide medical practitioners and researchers with access to advanced simulation and image processing services for improved preoperative planning and near real-time surgical support.

Access to Information↗

Extracting data recorded with OpenSDE: possibilities and limitations.

PURPOSE: OpenSDE is an application intended to support structured data entry in a variety of settings, such as routine care and clinical research. The past years development has focused on data entry to support expressiveness and flexibility. The focus is now shifting to data extraction: what are the possibilities for extracting the data and does the adopted strategy pose limitations? METHODS: Data extraction is supported by presenting the concepts for extraction in the same tree structure as for data entry. Users can select all or a sub selection of these concepts for extraction. Selected concepts are extracted and converted to a table format that can be queried using conventional tools. RESULTS: The extraction tool (entity export) provides a successful technical solution for data extraction. Using the extracted data, however, leads to obstacles that are a result of a fundamental design principle of OpenSDE.

Computer Simulation↗

Development of a deterministic XML schema by resolving structure ambiguity of HL7 messages.

Health level 7 (HL7) is a standard for medical information exchange. It defines data transfers for the application systems in the healthcare environment. Alternatively, the extensible markup language (XML) is a standard for data exchange using the Internet. If exchange messages follow the content and the sequence defined by HL7 and are expressed in the XML format, the system may benefit from the advantages of both standards. In creating the XML schema, we found ambiguities in HL7 message structures that cause the XML schema to be non-deterministic. These ambiguous expressions are summarized within 12 structures and can be replaced with equivalent or similar unambiguous structures. The finite state automata are used to verify expression equivalence. Applying this schema, an XML document may eliminate redundant segment group definitions and make the structure simple and easy to reproduce. In this paper, we discuss the methods and our experience in resolving ambiguous problems in HL7 messages to generate a deterministic XML schema.

Health Status↗

The multimod application framework: a rapid application development tool for computer aided medicine.

This paper describes a new application framework (OpenMAF) for rapid development of multimodal applications in computer-aided medicine. MAF applications are multimodal in data, in representation, and in interaction. The framework supports almost any type of biomedical data, including DICOM datasets, motion-capture recordings, or data from computer simulations (e.g. finite element modeling). The interactive visualization approach (multimodal display) helps the user interpret complex datasets, providing multiple representations of the same data. In addition, the framework allows multimodal interaction by supporting the simultaneous use of different input-output devices like 3D trackers, stereoscopic displays, haptics hardware and speech recognition/synthesis systems. The Framework has been designed to run smoothly even on limited power computers, but it can take advantage of all hardware capabilities. The Framework is based on a collection of portable libraries and it can be compiled on any platform that supports OpenGL, including Windows, MacOS X and any flavor of Unix/linux.

Humans↗

The strategic plans of OTE concerning the development of telemedicine applications based on the Euro-ISDN technology.

OTE SA, the Hellenic Telecommunications Organization, is the major public network operator of Greece and aims to actually promote all services made available through this technology and more peculiarly that of telemedicine. Through its modernization plan in progress, OTE aims at providing wide/range, high/quality competitive services on the basis of customer oriented policies. Its activities cover, besides basic telephony (5.9 million lines), data communications, leased lines, maritime communications and value-added services. The public health service has a lot to profit from efficient use of telecommunications. The greatest challenge the health service is faced with, is the growing gap between the expectations of the population, and the resources that society can set-aside for health purposes. Increasing the level of efficiency and co-operation is therefore the best probable response to the challenge. Telecommunications may contribute to a more effective utilization of resources, typing together those that could be in benefit of the health sectors in the process of implementing a large number of telemedical services.

Greece↗

Why did that happen? Exploring the proliferation of barely usable software in healthcare systems.

Clinicians and support staff are faced with increasingly complex computer applications. This complexity stems partly from the integration of heterogeneous systems ranging from computerized patient records to theatre management and dosage planning applications, and also from the increased functionality offered by the new generation of IT systems. Many members of clinical staff are bewildered by the vast array of configuration options and operating modes supported by computer based systems, while manufacturers often feel compelled to offer more and more software features to retain market position. These factors combine to create "usability" problems that have had a direct impact on patient outcomes as well as a number of indirect effects-for example, the costs of replacing and upgrading inadequate computer systems carry significant opportunity costs in terms of services that might otherwise have been funded. In the future we need to educate staff to reject substandard computer interfaces early in the acquisition process; encourage the use of human computer interaction techniques in health care; and train staff to recognize the dangers of "working around" poor interface design.

Attitude to Computers↗

A dynamic Web application within an n-tier architecture: a Multi-Source Information System for end-stage renal disease.

A Multi-Source Information System (MSIS) has been designed for the Renal Epidemiology and Information Network (REIN) dedicated to End-Stage Renal Disease. Interoperability has been considered at 4 levels: semantics, network, formats and contents. An n-tier architecture has been chosen at the network level. It is made out of a universal client, a dynamic Web server connected to a production database and to a data warehouse. The MSIS is patient-oriented, based on a regional organization. Its implementation in the context of a regional experimentation is presented with insights on the design and underlying technologies. The n-tier architecture is a robust model and flexible enough to aggregate multiple information sources and integrate modular developments. The data warehouse is dedicated to support health care decision-making.

Data Display↗

Health-e-child: an integrated biomedical platform for grid-based paediatric applications.

There is a compelling demand for the integration and exploitation of heterogeneous biomedical information for improved clinical practice, medical research, and personalised healthcare across the EU. The Health-e-Child project aims at developing an integrated healthcare platform for European Paediatrics, providing seamless integration of traditional and emerging sources of biomedical information. The long-term goal of the project is to provide uninhibited access to universal biomedical knowledge repositories for personalised and preventive healthcare, large-scale information-based biomedical research and training, and informed policy making. The project focus will be on individualized disease prevention, screening, early diagnosis, therapy and follow-up of paediatric heart diseases, inflammatory diseases, and brain tumours. The project will build a Grid-enabled European network of leading clinical centres that will share and annotate biomedical data, validate systems clinically, and diffuse clinical excellence across Europe by setting up new technologies, clinical workflows, and standards. This paper outlines the design approach being adopted in Health-e-Child to enable the delivery of an integrated biomedical information platform.

Databases as Topic↗