The Emergency Medical Team Operating System: design, implementation, and evaluation of a field hospital information management system.

In case of sudden-onset disasters (SODs), the World Health Organization deploys specialized emergency medical teams (EMTs); yet, the coordination and operation of such teams pose significant challenges. One issue is the lack of digital information systems and standards. We developed a highly customizable and scalable electronic medical record (EMR) system, tailored to EMT requirements, called the "Emergency Medical Team Operating System" (EOS). EOS was successfully tested through 9 realistic clinical tasks during a full-scale EU Module Exercise. During the initial evaluation, 21 team members from 9 countries evaluated the system positively, stressing the urgent need for an EMR for EMTs. EMTs face unique challenges during disaster relief missions. To provide an effective and coordinated delivery of care, there is a great need for an EMR tailored to the specific needs of EMTs. EOS may serve as an effective EMR during SOD missions.

GATOR: connecting integrated operating room solutions based on the IEEE 11073 SDC and ORiN standards.

PURPOSE: Medical device interoperability in operating rooms (OR) provides advantages for both, patients and physicians. Several approaches were made to provide standards for successful device integration. However, with high heterogeneity of standards in the market, device vendors may reject these approaches. The aim of this work is therefore to provide a proof of concept for the connection of two promising integration solutions OR.NET and SCOT to increase vendor interest. METHODS: The connection of devices between both domains is targeted by implementing an application to map device capabilities between the IEEE 11073 SDC and ORiN standards. Potential properties of the respective architectures are defined. The connection was evaluated by latency measurements in a demonstrator setup utilizing an OR light as an exemplary device. RESULTS: The latency measurements resulted in a similar transmission speed of the GATOR (53.0 ms) and direct SDC-to-SDC (38.0 ms) communication. Direct proprietary ORiN-to-ORiN communication was faster in any case (8.0 ms). CONCLUSION: A connection between both standards was successfully achieved via the GATOR application. The results show comparable magnitudes of the communication between the standards compared to the direct standard-internal communication.

Modular Architecture for Integrated Model-Based Decision Support.

Model-based decision support systems promise to be a valuable addition to oncological treatments and the implementation of personalized therapies. For the integration and sharing of decision models, the involved systems must be able to communicate with each other. In this paper, we propose a modularized architecture of dedicated systems for the integration of probabilistic decision models into existing hospital environments. These systems interconnect via web services and provide model sharing and processing capabilities for clinical information systems. Along the lines of IHE integration profiles from other disciplines and the meaningful reuse of routinely recorded patient data, our approach aims for the seamless integration of decision models into hospital infrastructure and the physicians' daily work.

Measurement of electrical activity of long-term mammalian neuronal networks on semiconductor neurosensor chips and comparison with conventional microelectrode arrays.

Based on complementary metal-oxide semiconductor (CMOS) technology a neurosensor chip with passive palladium electrodes was developed. The CMOS technology allows a high reproducibility of the sensors as well as miniaturization and the on-chip integration of electronics. Networks of primary neurones were taken from murine foetal spinal cord (day 14) and frontal cortex (day 15) tissues and cultured on the silicon surface in a chamber volume of 200 microl with 7 mm diameter. Measurements were performed between days 15 and 59 in vitro. Signals were recorded from both types of cultures. To test the capability of the system to detect pharmacologically induced activity changes two established neuromodulators were applied. The GABA(A)-receptor blocker bicuculline was applied to both tissue cultures, the glycine-receptor blocker strychnine to spinal cord cultures. Four network frequency parameters were analysed: spike rate (SR), burst rate (BR), frequency in bursts (FiB) and peak frequency in bursts (PFiB). Significant changes of spike rate and burst rate were measured with spinal cord cultures after bicuculline application. Significant changes of frequency in bursts and peak frequency in bursts were observed with frontal cortex cultures after bicuculline application. Significant changes of spike rate and frequency in bursts were recorded with spinal cord cultures after strychnine application. These results were compared with results achieved in the same laboratory by using glass-microelectrode arrays (MEAs). This comparison showed for spinal cord similar native spike and burst rate, but higher mean frequency and peak frequency in bursts, whereas frontal cortex activity had higher spike and burst rate and peak frequency in bursts. Application of bicuculline or strychnine to spinal cord networks showed stronger effects on MEAs, whereas with frontal cortex networks the modulation of activity was similar after application of bicuculline.