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Background; Each year, the International Medical Informatics Association Yearbook recognizes significant scientific papers, labelled as "best papers", published the previous year in the subfields of biomedical informatics that correspond to the different section topics of the journal. For each section, about fifteen pre-selected "candidate" best papers are externally peer-reviewed to select the actual best papers. Although based on the available literature, little is known about the pre-selection process. Objective: To move toward an explicit formalization of the candidate best papers selection process to reduce variability in the literature search across sections and over years. Methods: A methodological framework is proposed to build for each section topic specific queries tailored to PubMed and Web of Science citation databases. The two sets of returned papers are merged and reviewed by two independent section editors and citations are tagged as "discarded", "pending", and "kept". A protocolized consolidation step is then jointly conducted to resolve conflicts. A bibliographic software tool, Bib Review, was developed to support the whole process. Results: The proposed search strategy was fully applied to the Decision Support section of the 2013 edition of the Yearbook. For this section, 1124 references were returned (689 PubMed-specific, 254 WoS-specific, 181 common to both databases) among which the 15 candidate best papers were selected. Conclusions: The search strategy for determining candidate best papers for an IMIA Yearbook's section is now explicitly specified and allows for reproducibility. However, some aspects of the whole process remain reviewer-dependent, mostly because there is no characterization of a "best paper". [ABSTRACT FROM AUTHOR]

Objectives: The object of this research is to develop and evaluate the Online Abstract and Paper Entry System (OAPES) that collects and delivers medical academic meeting information online in Japan.Methods: CGI technology and semi-automated program generation method are employed for the OAPES software development to accommodate the various data collected by many meetings in a common data format and to achieve both flexibility and efficiency.Results: Using OAPES, an abstract, or paper, and its related information can be submitted via the Internet. After contributions have been accepted, bibliographic information is automatically added to the bibliographic information database that is retrievable, free of charge, from the Internet. Since 1997, we have provided OAPES for biomedical academic meetings in Japan. In fiscal 2006, 488 biomedical academic meetings, most of those held in Japan, used OAPES; 106,461 abstracts and papers were handled. To the best of our knowledge, there are no other abstract entry systems in any populous country that are almost monopolistic in a particular major academic field in the way OAPES is. The data format of OAPES and its user interface are now the de facto standard for academic information exchange related to academic meetings in Japan.Conclusions: We succeeded in developing an efficient and prompt online collection and delivery system for medical academic meeting information in Japan and demonstrated that it really works. [ABSTRACT FROM AUTHOR]

The article discusses several reports published within the issue, including one by Enrico Coeira on the multilevel approach to informatics and medicine and another by Ali Dhansay on the challenges for biomedical informatics in developing "hybrid" countries.

Background: Manual mapping of laboratory data to Logical Observation Identifiers Names and Codes (LOINC) requires a major effort. Application of the LOINC mapping assistant RELMA V.6.6 can reduce the effort required for mapping. The goal of the paper is to perform a semi-automated mapping of Russian laboratory terms to LOINC.Methods: A semi-automated mapping of the 2563 terms from two clinics in Russia was performed. The first step was automatic mapping using RELMA V.6.6 and LOINC V.2.48 Russian translation by Yaroslavl state medical academy. The second step was a manual expert mapping. To evaluate the correctness of mapping all the mapped terms were reviewed by two experts.Results: The paper presents the results of semi-automatic mapping of Russian laboratory terms to LOINC. Two clinics (A and B) and a laboratory service participated in the project. The following results were achieved: mapping of 86% terms from Clinic A and 87% from Clinic B. It has to be mentioned that 99% of terms used in 2014 were mapped. In total 2398 out of 2563 were mapped.Discussion: The required effort was reasonable and the price of mapping and maintenance was considered as relatively low in comparison to manual methods.Conclusion: RELMA V.6.6 and LOINC V.2.48 offer the opportunity of a low effort LOINC mapping even for non-English languages. The study proved that the mapping effort is acceptable and mapping results are on the same level as the manual mapping. [ABSTRACT FROM AUTHOR]

Speech-language pathologists and board-certified behavior analysts both provide important support services to children who are candidates for augmentative and alternative communication. Current assessment practices neglect critical socioecological factors that are necessary to inform communication-based interventions. By leveraging the unique knowledge, research, and expertise of both disciplines, an interprofessional approach to assessment may help realize individualized or precision interventions and personalized supports that address the unique communication needs of each person. The purpose of this article is to introduce a process-based approach to assessment called the "Applied Model of Interprofessional Collaboration—Assessment (AMIC–A)." The AMIC–A will be defined and detailed including the rationale for development, a description of the approach, and recommendations for implementation. A case study example is provided to illustrate implementation of the AMIC–A. [ABSTRACT FROM AUTHOR]

Objectives: To demonstrate a technology-based approach to continuously improving the safety of medical processes.Methods: The paper describes the Little-JIL process definition language, originally developed to support software engineering, and shows how it can be used to model medical processes. The paper describes a Little-JIL model of a chemotherapy process and demonstrates how this model, and some process analysis technologies that are also briefly described, can be used to identify process defects that pose safety risks.Results: Rigorously modeling medical processes with Little-JIL and applying automated analysis techniques to those models helped identify process defects and vulnerabilities and led to improved processes that were reanalyzed to show that the original defects were no longer present.Conclusions: Creating detailed and precisely defined models of medical processes that are then used as the basis for rigorous analyses can lead to improvements in the safety of these processes. [ABSTRACT FROM AUTHOR]

INTRODUCTION: It is important to understand factors contributing to a neuroleptic-related increased mortality risk. The objective of this study was to test whether the occurrence of neuroleptic-induced extrapyramidal syndromes (EPS) including tardive dyskinesia (TD) is associated with an increased patients' all-cause mortality. METHODS: In 1995, a sample of 200 patients on neuroleptics was assessed with regard to the presence of Parkinson syndrome, akathisia, and TD. By 2003-2004, i.e., during the following 8-9 year period, 63 patients had died. Patients who had died were compared with 120 patients known to be still alive with regard to several socio-demographic variables and the presence of EPS at the first examination. RESULTS: At the basic assessment, there were no significant differences between patients later still alive and deceased patients with regard to TD. The deceased patients were more frequently women, older, suffered more frequently from an organic disorder, had higher average scores for Parkinson syndrome and less frequently akathisia. Multivariate analysis confirmed age as the only factor contributing to the group difference. Repeating the meta-analysis by Ballesteros et?al. (2000) after inclusion of our data, TD remains a weak but a significant predictor of death (OR=1.4). DISCUSSION: Neuroleptic-induced EPS of parkinsonism, akathisia, and TD did not contribute to the patients' all-cause mortality in this study. The association between TD and mortality merits further attention. [ABSTRACT FROM AUTHOR]

Objectives: This paper proposes an efficient method for the discrimination and classification of mammograms with benign, malignant and normal tissues.Methods: The proposed method consists of selection of tissues, feature extraction using independent component analysis, feature selection by the forward-selection technique and classification of the tissue by the multilayer perceptron.Results: The method is tested for a mammogram set of the MIAS database, resulting in a 97.83% success rate, with 98.0% specificity and 97.5% sensitivity.Conclusion: The proposed method showed a good classification rate. The method will be useful for early cancer diagnosis. [ABSTRACT FROM AUTHOR]

Objectives: This paper aims to propose an estimation procedure for the parameters of a generalized fractional process, a fairly general model of long-memory applicable in modeling biomedical signals whose autocorrelations exhibit hyperbolic decay.Methods: We derive a wavelet-based weighted least squares estimator of the long-memory parameter based on the maximal-overlap estimator of the wavelet variance. Short-memory parameters can then be estimated using standard methods. We illustrate our approach by an example applying ECG heart rate data.Results and Conclusion: The proposed method is relatively computationally and statistically efficient. It allows for estimation of the long-memory parameter without knowledge of the short-memory parameters. Moreover it provides a more general model of biomedical signals that exhibit periodic long-range dependence, such as ECG data, whose relatively unobtrusive recording may be advantageous in assessing or predicting some physiological or pathological conditions from the estimated values of the parameters. [ABSTRACT FROM AUTHOR]

Objectives: Activation time (AT) imaging from electrocardiographic (ECG) mapping data has been developing for several years. By coupling 4-dimensional volume data (3D + time) the electrical sequence can be computed non-invasively. In this paper an approach for extracting the ventricular and atrial blood masses for structurally normal hearts by using cine-gated short-axis data obtained via magnetic resonance imaging (MRI) is introduced.Methods: The blood masses are extracted by employing Active Appearance Models (AAMs). The ventricular blood masses are segmented, applying the AAMs after providing apex cordis and base of the heart in the volume data, whereas the more complex geometry of the atria requires a more specific attempt. On account of this the atrium was divided into three divisions of appearance, where the images of the volume data in the related divisions have a maximum affinity. The first division reaches from the base of the heart to initial visibility of the upper and left lower pulmonary vein. The second division up from there to the last occurrence and the third division from there to the end of the visibility of the right upper and lower pulmonary vein. After extracting the cardiac blood masses the result gets triangulated and remeshed for activation time imaging.Results: With this method the cardiac models of eight patients were extracted and the AT imaging approach was applied to single-beat ECG data of atrial and ventricular depolarization.Conclusion: The advantage of the proposed AAM approach is that only a few initial parameters have to be set. Therefore, the approach can be integrated into a processing pipeline that works semi-automatically. The extracted models can be used for further investigations. [ABSTRACT FROM AUTHOR]

Disseminated intravascular coagulation (DIC) is an intermediary mechanism of disease known to develop as a complication in other conditions like sepsis, trauma, cancer, or obstetrical disorders. Patients with DIC may present to different specialists depending on symptomology and as such a good understanding of the pathophysiological process is necessary to ensure best management. However, more recently, controversy has risen where experts doubt whether DIC really exists in many of the historically well-established diagnoses. This has led to confusion among both basic science researchers and clinical practitioners about when to consider DIC diagnosis. In this review, the various issues which have led to this uncertainty are addressed, including the problem with different terminologies, simpler explanation of current DIC diagnostic criteria, and reasons behind why the diagnosis may be overlooked or not considered at all, along with their possible solutions. It is hoped that the diagnostic aspects of DIC will come full circle, wherein the recent research can build up on what history had taught us and not refute its existence. [ABSTRACT FROM AUTHOR]

The rich feature set and flexibility of mobile technology offers a host of novel opportunities to provide specific and timely supports to individuals with communication and memory disorders. These "just-in-time" (JIT) supports can be used as prompts, reminders, rewards, strategies to increase independence, and expressive language supports for children and adults with communication and memory disorders. The purpose of this article is to examine current research on, and propose future directions for, repurposing consumer products to enhance JIT communication within the field of augmentative and alternative communication. Initially, a brief history of JIT supports will be reviewed, including a timeline and history of JIT-enabling technology. Next, the taxonomy of JIT supports will be applied to current research in both individuals with autism spectrum disorder and individuals with acquired communication disorders (e.g., acquired brain injury, amyotrophic lateral sclerosis) to illustrate current clinical implications and evaluate current limitations of JIT supports. Finally, future directions for research and expanded use of consumer products to provide JIT supports will be discussed. [ABSTRACT FROM AUTHOR]

The author reflects on impact factors and the quality of publications in the journal's previous issues. Explored is the impact of the science journal on the quality of health and patient care. Issues on data analysis, information and database management and medical reporting in biomedicine and health care are also discussed.

The author reflects on how physicians encounter classic language such as Greek and Latin in the medical culture. He mentions that a common language had to be found which would be understandable to the educated scholar around the world when medicine slowly developed into a scientific specialty. An overview on the native French language and its contribution to scientific publication in medicine is also offered.

This article evaluates the methodology used to develop the updated American College of Critical Care Medicine/Society of Critical Care Medicine Pain Agitation and Delirium (PAD) Guidelines in terms of (1) evaluating the role of a medical librarian in the guidelines development process; (2) summarizing the impressions of the guideline task force members on the use of Grades of Recommendation, Assessment, Development, and Evaluation and anonymous voting to develop guideline questions, statements, and recommendations; and (3) analyzing the impact of this approach to developing clinical practice guidelines on interrater reliability in evaluating evidence, statements, and recommendations. [ABSTRACT FROM AUTHOR]

This article offers information regarding the "International Journal of Sports Medicine." It provides an overview of the scope of the journal which provides a forum for the publication of papers dealing with basic or applied information that will enhance the field of exercise science and sports medicine. The various important sections of the journal includes immunology, behavioral science, nutrition, physiology and biochemistry, orthopedics and biomechanics, clinical sciences, and training and testing.

Global tests of platelet function are often used as screening tests during the laboratory investigation of individuals with suspected hemostatic defects. Because global tests of platelet function do not enable specific diagnosis of platelet disorders, they are normally performed as the first part of a two-step strategy that requires further testing with more specialized assays of platelet function to confirm or refute the diagnosis. The most commonly proposed rationale for testing global platelet function as a first-line investigation is that normal test results may exclude a diagnosis of platelet function disorder so that further specialized testing can be avoided. For this reason, global platelet function tests are usually initially performed at the same time as global assays of coagulation pathway function (prothrombin time and activated partial thromboplastin time, von Willebrand factor screening tests [VWF:Ag, VWF:RCo, and FVIII:C]) and measurement of platelet number. The most widely performed tests for screening platelet function disorders are currently the template bleeding time and the closure time within the Platelet Function Analyzer. These tests will therefore be considered in detail in this review, and we will discuss the limitations of these methods in screening individuals for platelet disorders. [ABSTRACT FROM AUTHOR]

The optimum provision of pharmacological sedation of the critically ill neurological patient requires defining the underlying etiology of agitation or need for sedation to determine the optimal agent: pain management, anxiolysis, or treatment of delirium. An appropriate regimen can then be decided upon based on the profiles of action of the several common classes of sedative agents. Methods to both evaluate the efficacy of sedation as well as titration to a predefined clinical goal are important tools toward safe administration of drugs that often have serious adverse effects. Recognition of an individualized approach is also necessary as patients will vary considerably with respect to the kinetics and pharmacodynamics of sedative therapy. The drug classes often selected for sedation in an intensive care unit will be reviewed as well as the metrics by which physicians can achieve their objectives in a safe manner. [ABSTRACT FROM AUTHOR]

In recent years, there has been increasing concern regarding the safety of in vitro fertilization (IVF) because of the potential health impact on these infants. Multiple pregnancy contributes the vast majority of morbidity associated with IVF and, initially, many thought that adverse outcomes after IVF were solely attributable to the high incidence of twin pregnancies. More recently, multiple studies have suggested that IVF singleton pregnancies may be at increased risk for preterm birth, low birth weight, congenital anomalies, perinatal mortality, and several other pregnancy-related complications compared with unassisted singleton pregnancies. We have focused this review on the increased risk of adverse outcomes in IVF singleton conceptions compared with that of unassisted conceptions. The available evidence evaluating the association between IVF and low birth weight, preterm delivery, placental abruption, preeclampsia, congenital anomalies, and perinatal mortality in singleton pregnancies is summarized. In addition, data reporting an increased risk of congenital and chromosomal anomalies after IVF are presented. [ABSTRACT FROM AUTHOR]

Point of care assays for various analytes have been established in critical care, including blood gas analysis, glucose, electrolytes, and markers for cardiac ischemia. Coagulation assays can also be adapted to the critical care environment by using whole blood as sample material and instruments optimized for point of care analysis. Available assays include the conventional coagulation assays, such as prothrombin time and activated partial thromboplastin time, fibrinogen, assays for monitoring of anticoagulant drugs, global coagulation assays based on thrombelastography and viscosimetry, platelet function assays, and D-dimer assays. The main problem in point of care coagulation diagnostics is quality control. Point of care coagulation assays help in rapidly establishing a diagnosis, clarifying causes of bleeding, and monitoring therapy. Thrombelastography and similar assays extend the scope of coagulation diagnostics by visualizing the process of clot formation and extending the observation period to provide an estimate of clot stability versus mechanical and proteolytic attack. [ABSTRACT FROM AUTHOR]

Joseph Asherman first described intrauterine adhesions in 1948. It is commonly referred to as Asherman''s syndrome and intrauterine synechiae. It is characterized by a spectrum ranging from amenorrhea to menstrual disturbance to normal menses. It is frequently associated with infertility. The true incidence is unknown. Most cases occur within close temporal proximity to a pregnancy, usually within 4 months and usually while the woman is in a hypoestrogenized state. Most cases are associated with trauma to the endometrium from surgical procedures, primarily curettage. Increasingly, cases are associated with myomectomy both abdominal and hysteroscopic, removal of septae, and any other intrauterine surgery. Pathology shows fibrous connective tissue bands with or without glandular tissue, although this may range from filmy to dense. The diagnosis is primarily by history and a high index of suspicion. Confirmatory tests are increasingly saline infusion hysterography (SIS) or hysterosalpingogram (HSG), although magnetic resonance imaging has also been used. Ultimately, hysteroscopy is employed for the final diagnosis and treatment. Hysteroscopic lysis of adhesions is the main method of treatment. Dense scar tissue and difficult entry into the cervix may require laparoscopic or ultrasound guidance. Most authors use an intrauterine stent and follow treatment with sequential estrogen and progesterone therapy. Increasingly early intervention either with repeat SIS or HSG or most recently with flexible hysteroscopy has been advocated. Treatments outcomes are difficult to assess as there are no universally agreed upon classification system. However, intrauterine pregnancies rates range from 22 to 45% and live births range from 28 to 32%. The risk of complications for those that achieve pregnancy is significant with a significant risk for placenta accreta and subsequent blood loss, transfusion, and hysterectomy. Prospective controlled studies are needed to determine the best diagnostic and treatments for intrauterine adhesions. [ABSTRACT FROM AUTHOR]

The aim was to examine the influence of high and low volume whole-body circuit weight training on forearm reactive hyperemic blood flow, venous capacitance and outflow in young individuals. Thirty-five individuals (age: 22 ± 1.89 years) participated in an 8 station circuit performed 3 days/week for 5 weeks. The high volume group (n = 15) was encouraged to complete 3 sets/station, whereas the low volume group (n = 20) performed 1 set/station. Before and after training, muscle strength (hand grip, knee extension and bench press) and vascular function (reactive hyperemia, venous capacitance and outflow) were measured. Before training, there were no significant group differences. Training resulted in significant but similar strength gains in both groups (hand grip: 3.89±4.57 kg (+15.59%), knee extension: 30.62 ± 12.52 kg (+35.31%), bench press: 12.4 ± 8.81 kg (+21.03%); p<0.05). Group averages for vascular function did not change following the circuit training. However, individuals with the lowest pretraining vascular measures did have significant increases in reactive hyperemic blood flow (17%, p = 0.006) and venous outflow (18%, p = 0.013), independent of group assignment. In conclusion, high and low volume circuit weight training results in significant and similar strength gains. Individuals with evidence of lower pretraining vascular function appear to respond favorably to short-term circuit weight training. [ABSTRACT FROM AUTHOR]

We examined arterial stiffness, baroreflex sensitivity (BRS), and systolic arterial pressure (SAP) variability after an acute bout of aerobic exercise compared to resistance exercise. We hypothesized that arterial stiffness would be reduced after aerobic exercise, while it would be increased after resistance exercise, and these alterations would be associated with differential changes in BRS and SAP variability. Arterial stiffness, BRS, and SAP variability were assessed before and 20 min after a bout of aerobic exercise and resistance exercise in 13 male participants. Pulse wave velocity (PWV) was used to measure central (carotid-femoral) and peripheral (femoral-dorsalis pedis) arterial stiffness. BRS was derived via the sequence technique. Spectral decomposition of beat-to-beat SAP variability was used as an estimate of sympathetic vasomotor tone. A mode-by-time interaction (p < 0.001) was detected for central PWV, due to an increase in PWV (p<0.05) following resistance exercise and a decrease in PWV following aerobic exercise (p <0.05). A mode-by-time interaction was also detected for peripheral PWV (p < 0.05), due to a decrease in peripheral PWV following aerobic exercise (p < 0.05) with no change following resistance exercise. BRS was significantly lower following resistance compared with aerobic exercise (p < 0.004). SAP variability increased following resistance exercise (p < 0.05) but there was no interaction. In conclusion, aerobic exercise decreased both central and peripheral arterial stiffness, while resistance exercise significantly increased central arterial stiffness only. BRS was reduced after both bouts of exercise, but significantly greater reductions were seen following resistance exercise. [ABSTRACT FROM AUTHOR]

It is known that coagulation and fibrinolysis are activated after exercise, and that the response is related to exercise intensity. The contribution, however, of eccentric exercise has not yet been investigated. Twenty boys (age 13 years) were randomly as- signed to two experimental groups, which had to perform a monopedal stepping exercise until exhaustion. One group had to step up and down (U/D) in the same rhythm of one second each, while the other group (U/DD) had to step up during one second and to step down during two seconds, thereby experiencing a higher eccentric load. Blood samples were collected before and at 0, 1, and 24 hrs after exercise, and F VIII, t-PA, PAI-1, and D-dimer were determined as markers for coagulation or fibrinolysis, respectively. While the tendency for hypercoagulability was counterbalanced by fibrinolysis in the U/D group, the U/DD group showed a prothrombotic and hypotibrinolytic hemostatic response. It is assumed that eccentric exercise, beyond the well-known muscle fiber damage, also leads to some damage of the endothelial cells, affecting their capacity to liberate sufficient amounts of fibrinolytic agents. [ABSTRACT FROM AUTHOR]