This welcome addition to the series Update in Intensive Care and Emergency Medicine emerges from the most recent of a series of meetings organized by Alvar Net and Salvador Benito of Barcelona. This gathering provided a forum for European intensive care specialists to exchange ideas, knowledge and experience on, the measurements feasible in mechanically ventilated patients. The scope was ambitious, ranging from basics like the measurement of airway pressure and blood gases to topics such as CT, MRI and the multiple inert gas elimination technique. The success of the meeting made publication a logical consequence. The book is unique in its breadth. The contributors, from numerous centers in Europe and North America, cover all tech niques employed in intensive care units, describing indications, contraindications, procedures, biases and complications. This volume will be an invaluable source for intensive care specialists and other clinicians. Alongside practical descriptions of procedures they employ routinely (spirometry, measurement of sys temic vascular oxygen pressure, Swan-Ganz catheterization, BOPA etc.), they will find accounts of such sophisticated techniques as on line measurement offunctional residual capacity, isotope determina tion of ventilation/perfusion ratios, diaphragmatic metabolism and peripheral oxygen exchange. I am especially happy to see the book published by Springer-Verlag, which has distinguished itself in the field of intensive care medicine.

This book presents a collection of invited contributions, each reflecting an area of biomedicine in which simulation techniques have been successfully applied. Thus, it provides a state-of-the-art survey of simulation techniques in a variety of biomedical applications. Chapter one presents the conceptual framework for advanced simulations such as parallel processing in biological systems. Chapter two focuses on structured biological modeling based on the bond graph method. This is followed by an up-to-date account of advanced simulation of a variety of sophisticated biomedical processes. The authors provide many insights into how computer simulation techniques and tools can be applied to research problems in biomedicine. The idea for this book arose out of the daily work by experts in their field and reflects developing areas. Therefore, I think the material is timely and hope that the work described will be an encouragement for others. It is the objective of this book to present advanced simulation techniques in biomedicine and outline current research, as well as to point out open problems, in this dynamic field. Finally, I wish to express my thanks to those colleagues who have made this book possible with their contributions.

The Second European Conference on Artificial Intelligence in Medicine followed the successful meeting in Marseilles in 1987. As for AIME 87, the goal of AIME 89 was to promote scientific interchange within and between all subfields of AI in medicine, among researchers from all over the world, and especially from Europe. There were sessions on: knowledge elicidation and acquisition, architectures for medical knowledge-based systems, clinical applications, methodology, reasoning based on physiological models, and uncertainty. It is clear form the quality of papers presented, that the rate of development which took place between the Pavia meeting of 1985 and AIME 87 has been well maintained. With the launch of the European Community's exploratory programme in Advanced Informatics in Medicine in Europe, 1989 is clearly a very important year for this discipline. AIME 89 provided an important forum which demonstrated progress in some of the more difficult methodological problems, and advances in the application of these techniques to real-world medicine. This volume should be consulted by anyone who wishes to appreciate the state of the art in Medical AI in Europe.

Der vorliegende Band fasst die Ergebnisse eines zweitagigen Symposions "Multiple Hypothesenprufung" am 6. und 7. November 1987 in Gerolstein/ Eifel zusammen. Das Problem der multiplen Hypothesenprufung stellt sich immer dann, wenn aufgrund eines statistischen Experimentes mehrere Fragestellungen beantwortet werden sollen. Insbesondere innerhalb biologisch-medizi- nischer Studien sind haufig mehrere Behandlungen, mehrere Zielgrossen oder Messungen zu mehreren Zeitpunkten zu beurteilen. In der Vergangenheit wurde dem Problem der Multiplizitat der Fragestel- lungen nicht genugend Beachtung geschenkt. Im deutschsprachigen Raum erschien dieses Thema etwa ab Ende der 70er Jahre vermehrt auf Kongres- sen sowie in Veroffentlichungen, ausgelost durch die Arbeiten von MARCUS, PERITZ und GABRIEL (1976) und HOLM (1979). Besonders durch das Schwerpunkuhema "Simultane Hypothesenprufung" und die gemein- same Publikation der Referate im Rahmen des Biometrischen Seminars im Jahre 1981 in Bad Ischl, Osterreich, wurde die Aufmerksamkeit vieler Biometriker auf neuere Entwicklungen in diesem fur die Anwendung so wichtigen Bereich gelenkt. In der Folge kam es zu einer intensiven For- schungstatigkeit an den verschiedensten Stellen, vorwiegend von Biometr- kern und von Statistikern mit engem Verhaltnis zur Biometrie. Es war daher naheliegend zu versuchen, die in diesem Bereich methodisch tatigen Biometriker und Statistiker zu einem intensiven Meinungsaus- tausch zusammenzubringen. Dabei sollte eine Bestandsaufnahme vorge- nommen und uber die Richtung weiterer Entwicklungen diskutiert werden. Schon wahrend des Symposions wurde von emlgen Teilnehmern der Vor- schlag gemacht, den Tagungsband in englischer Sprache abzufassen, um IV den Ergebnissen international eine grossere Verbreitung zu ermoglichen.

Medical information systems such as Radiology Management Information Systems (RIS), Picture Archiving and Communications (PACS) and Hospital Information Systems (HIS) will soon be standard tools to support routine work in hospitals. An interface between PACS/RIS and RIS/HIS is increasingly necessary in order to co-ordinate the flow of information throughout these systems. This book discusses a systematic analysis of interfacing strategies. An introduction is given to the status of present radiology departments and trends for the future. Then, to define a PACS-RIS interface in a multivendor environment, the so-called Marburg Model is described: a comprehensive systems analysis method that includes the requirements of radiologists, software and hardware engineers, and medical informatitians. A detailed PACS-RIS interface for a specific systems implementation is derived using the Marburg Model, which can be used as a standardized approach to designing interfaces.

Big data and the Internet of Things (IoT) play a vital role in prediction systems used in biological and medical applications, particularly for resolving issues related to disease biology at different scales. Modelling and integrating medical big data with the IoT helps in building effective prediction systems for automatic recommendations of diagnosis and treatment. The ability to mine, process, analyse, characterize, classify and cluster a variety and wide volume of medical data is a challenging task. There is a great demand for the design and development of methods dealing with capturing and automatically analysing medical data from imaging systems and IoT sensors. Addressing analytical and legal issues, and research on integration of big data analytics with respect to clinical practice and clinical utility, architectures and clustering techniques for IoT data processing, effective frameworks for removal of misclassified instances, practicality of big data analytics, methodological and technical issues, potential of Hadoop in managing healthcare data is the need of the hour. This book integrates different aspects used in the field of healthcare such as big data, IoT, soft computing, machine learning, augmented reality, organs on chip, personalized drugs, implantable electronics, integration of bio-interfaces, and wearable sensors, devices, practical body area network (BAN) and architectures of web systems. Key Features: Addresses various applications of Medical Big Data and Internet of Medical Things in real time environment Highlights recent innovations, designs, developments and topics of interest in machine learning techniques for classification of medical data Provides background and solutions to existing challenges in Medical Big Data and Internet of Medical Things Provides optimization techniques and programming models to parallelize the computationally intensive tasks in data mining of medical data Discusses interactions, advantages, limitations, challenges and future perspectives of IoT based remote healthcare monitoring systems. Includes data privacy and security analysis of cryptography methods for the Web of Medical Things (WoMT) Presents case studies on the next generation medical chair, electronic nose and pill cam are also presented.

Computer applications in medical care have been greatly increasing during the last ten years. Combined with other electronic devices, computers can produce images which represent human organ sections. Such a way to get informations on patient organs widely improves di agnosis and surgery efficiency. But we can go through a new step by generating three dimensional models of these organs and by displaying them. Most of research in this area focuses on the visualization process. But, in order to efficiently exploit the data collected and processed by the computer, we need to create a high-level three-dimensional model of the organ to be displayed. An interactive approach to get such a model is described in this paper as the way to use it for the study of kidney anatomy. I. 20 and 30 data visualization in medical care Classical X-ray radiographs give us a projection of human body inner parts, with an enhancement of high-density elements. But they cannot give us a complete view of organs, such as in cross-sections. Recent imaging techniques solve this problem, usually by computing those sections from a set of projections along different directions. Physicians can then get a full examination of organs by using such equipments as X-ray scanners or those producing Mag netic Resonance, ultrasonic or radionuclide images. The information collected on the organ (density, acoustic property, etc."

Implementation of Smart Healthcare Systems using AI, IoT, and Blockchain provides imperative research on the development of data fusion and analytics for healthcare and their implementation into current issues in a real-time environment. While highlighting IoT, bio-inspired computing, big data, and evolutionary programming, the book explores various concepts and theories of data fusion, IoT, and Big Data Analytics. It also investigates the challenges and methodologies required to integrate data from multiple heterogeneous sources, analytical platforms in healthcare sectors. This book is unique in the way that it provides useful insights into the implementation of a smart and intelligent healthcare system in a post-Covid-19 world using enabling technologies like Artificial Intelligence, Internet of Things, and blockchain in providing transparent, faster, secure and privacy preserved healthcare ecosystem for the masses.

As research on expert systems has moved well into its second decade, it has become popular to cite the limitations of the phenomenologic or associational approach to knowledge representation that was typical of first generation systems. For example, the Internist-1 knowledge base represents explicitly over 600 diseases, encoding associated disease manifestations (signs, symptoms, physical findings, and lab abnormalities) but failing to deal with the reasons that those findings may be present in the disease [Miller, R. A. 82]. In recent years Pople has sought to add detailed causal models to the knowledge base in a revised version of the program known as CADUCEUS [Pople 82]. Similarly, a typical production rule in the MYCIN system states inferences that may be drawn when specific conditions are found to be true [Buchanan 84], but the underlying explanations for such relationships are not encoded. Clancey has argued that MYCIN needs such "supporting knowledge" represented, especially if its knowledge base is to be used for teaching purposes [Clancey 83]. By the late 1970s, artificial intelligence researchers were beginning to experiment with reasoning systems that used detailed mechanistic or causal niodels of the object being analyzed. Among the best early examples were a program to teach students how to analyze electronic circuits [Brown 82] and a system for diagnosing problems with mechanical devices [Rieger 76].

The Working Group 5 of the International Medical Informatics Associ ation (IMIA) dedicates its work to information systems in primary and ambulatory care. The first conference of this Working Group in Hanno ver in 1980 produced a review of the state of the art of that time and gave perspectives for future development (Rienhoff, O. and Abrams, M.E. (eds.): The Computer in the Doctor's Office, Horth Holland, Amsterdam: 1980). In the meantime, a rapid development has taken place. Therefore it seemed appropriate to hold another working conference which was con ducted in Munich, December 2-6, 1985. The goal of this working conference was to review the developments in this field and to critically evaluate the progress achieved so far. The conference addressed general principles in system development and prerequisists for their successful introduction into routine use. Furthermore, the topics of expert systems and new technologies were discussed in the context of their usefulness and usability in ambula tory care systems. As before, it became very clear that actual computer systems to sup port ambulatory and/or primary care have to meet the conditions of the health care delivery systems, into which they are to be placed."

Operations research aims to assist managers faced with problems of coordinating activities; improving the quality of care of services delivered; making optimal resource allocation decisions and generally, managing services and institutions. Operations research (or O.R.) was originally developed in response to the problems of the second World War. It was characterised then by a unifying and clear objective; clear problems that had to be solved and the use of inter-disciplinary teams to analyse and solve identified problems. This analysis often drew on mathematical techniques. After the war, operations research moved in two separate but related directions. In England, the emphasis on inter-disciplinary approaches and problem solving teams remained. The operations researcher still used mathematical techniques but these were not systematised into a volume of standard formulae. The emphasis of operations research was on the approach not the tools used (see, for example, Luckman & Stringer, 1974; also Luck, Luckman, Smith & Stringer 1971; and McLachlan, 1975). In the United States, the emphasis was placed on the use of mathematical techniques. Operations research became a mathematically based science relying on standardised models (e. g. queuing, allocation) and formulae. This approach was facilitated by the availability of computers.

The Working Group 5 of the International Medical Informatics Associa tion (IMIA) is dedicated to information systems in primary care with special emphasis on computer systems in the doctor's office. Accord ingly, a conference was held in Hannover in 1980 where the first ap proaches were described and experiences in system analysis, system construction and evaluation were discussed (Rienhoff, O. and Abrams, M.E. (eds.): The Computer in the Doctor's Office, North-Holland, Amsterdam: 1980). Computer hardware and software development has been rapid over the last years. Thus the prerequisites for a successful support of the work of the physician in his office have improved. But system con struction still lags behind and the actual penetration of systems is lower than 2 % of the doctors' offices in most countries. This applies to industrialized countries. However, attempts are made everywhere to improve primary care by means of modern information technology. Information systems depend upon the real environment into which they are placed: administrative procedures govern priorities and procedures in doctor's office computers, possibilities to defray cost upon the various carriers or the patients have a great influence on the propagation of systems. Furthermore, various procedures of accounting or re-imbursement may lead to a facilitation or to a delay of the in troduction of systems. The 'art of medical practice' has reached a comparable standard within at least the industrialized countries."

Psychoanalysis and information science are two disciplines that twenty years ago hardly anyone would have considered closely related with re gard either to persons or subject matter. The cooperation between the two fields was made possible, on the one hand, by the development of information science from a technological discipline to a theoretically founded scientific discipline, and on the other, by the development of psychoanalysis from a hermetically closed special discipline to an open and empirical science. This study reports the successful inclusion of information science as an instrument of research on the psychoanalytic process. This direction of work was initiated by Donald Spence and Hartvig Dahl from the Re search Institute of Mental Health, New York, at the end of the 1960s. H. Thom, H. K che1e, and their research group in Ulm must be credited with having adopted Spence's programs as early as 1974; at that time the programs even had to be implemented far away on the IBM computer at the University of Heidelberg. The efforts to expand computer-aided con tent analysis to a method for process research led in 1975 to the ac quisition of the Hamburg program for Electronic Verbal Analysis (EVA). In the following years the author of this study revised, extended, and supplemented the EVA to create the U1m version. This book now describes another step in the integration of information technology in fundamen tal research in psychoanalysis."

The European Federation for Medical Informatics (EFMI) is a regional coordinating body for the National Informatics Societies of Europe. EFMI has organized a number of congresses. The Congresses in Cambridge 1978, Berlin 1979, Toulouse 1981, Dublin 1982 and Brussels 1984 were all successful in providing the wide variety of people in the caring and specialists in the computing profession with up-to-date inform ation from the expanding multidisciplinary field of medical inform atics. We hope that the sixth European Congress on Medical Informatics, MIE-85 in Helsinki will be equally successful. You have in your hand the pre-publication of papers to be presented at MIE-85 as well as the short abstracts of the posters. The proceed ings enable the participants to follow work presented at sessions that they are unable to attend. It also provides a permanent record with relevant bibliography for workers in the field of medical com puting. All the papers have been refereed and the referees' suggest ions incorporated in the final text. Rapid publication, using camera ready paper, reduces the time required for editing and indexing. The editorial board has worked hard to improve the standard of the communications and to reduce the number of errors. Very few papers did not arrive in time to be included in the proceedings: these are marked with * in the table of contents."

The symposium held at Freiburg on September 10th, 1983 had been con- cerned with methodical problems in early detection. chiefly of can- cer. The first lectures dealt with mathematical models. They were followed by contributions to the possibilities of obtaining the pa- rameters required by the models and for the assessment of the me- thods. The two final lectures outlined a monitoring system for rare diseases and some problems in early detecting heart and circulation diseases. The meeting had been organized by the Deutsche Gesellschaft fUr Me- dizinische Dokumentation. Informatik und Statistik (GMDS). Thus the programme committee was set up by the heads of the GMDS Arbeitsgrup- pen affected by the respective topics. namely Dr. Keil (epidemiology}. Prof *. Dr. NeiS (statistical methods). PD Dr. Schwartz (systematic preventive checkup and early detection). PD Dr. Trampisch (methods of prognosis and decision making) and the signer. This is a welcome opportunity to put on record my thanks to various people and organizations. The lecturers had elaborated their manus- cripts and some have revised them. The individual discussions had been conducted by Prof. Dr. Dietz. Prof. Dr. Michaelis. Prof. Dr.

Rick lelovsek is one of the "old timers" in computer medicine, developing and using computer systems for over 15 years. At Duke University, he developed one of the first computerized medical records for obstetrics and gynecology and collaborated with Drs. Stead and Hammond in the development of billing and accounting systems. A founding member and current officer of the American Association for Medical Systems and Informatics (AAMSI), he heads up and writes a quarterly newsletter for a special interest group in computers for the American College of Obstetricians and Gynecologists. He is a genuine (medical) "computernik." . I was asked as a favor to review his manuscript and suggest any needed changes before it was sent to a publisher. (He was not at that time planning to send it to Springer-Verlag.) Reading it was one of those pleasures I usually associate with a review article that finally explains those things about a subject that I was aware of but never really understood. I was familiar with practice billing, for example, but didn't really know the whys and hows of it all. Doctor's Office Com puter Prep Kit has filled the gaps in my knowledge with superb detail."

Mit diesem Vortrag mochte ich das Thema "MENSCH UND INFORMATION" aus einiger Distanz diskutieren. Es gibt ja kaum einen anderen wissenschaftlichen Bereich, in dem die notwendige kulturelle Verarbeitung so weit hinter der praktischen An- wendung zuruckgeblieben ist: Die Informationstechnik macht riesige Sprunge - aber ihre geistige Verarbeitung ruhrt sich nicht vom Fleck und bleibt immer weiter hinter den Notwendigkeiten der Praxis zuruck. So stolpert man blindlings in einen kulturellen Raum hinein, dem die philosophische Erleuchtung ganzlich fehlt. Dies wird besonders deutlich bei den allerorten horbaren Diskussionen uber Orwell und seine War- nungen. Diese wurden kaum dazu genutzt, drohende Gefahren abzuwenden - mehr dazu, eine unverstandene Technik zu blockieren und politisches Ubel zu konservieren. Unser wichtigstes aktuelles Problem - das Leben mit der Luge - kommt kaum zur Srrache. Doch lassen Sie mich das Thema "MENSCH UND INFORMATION" zunachst aus historischer Sicht angehen' 1. ZUR GESCHICHTE DER INFORMATION Als vor Milliarden von Jahren aus kosmischer Materie unsere Erde ent- standen war und sich auf ihr die "Ursuppe" gebildet hatte, jenes Gemisch der Grundstoffe organischen Lebens, da hatte in den Dampfen und Sumpfen auch ein intelligenter Beobachter kaum etwas entdeckt, das Information uberhaupt rechtfertigte: Da war ja alles in standiger Veranderung, Aussagen uber Zustande in einem Moment waren nutzlos fur den nachsten Moment. Es gab da wohl keine bleibenden Strukturen, die Information sinnvoll machten.

The anesthetist-computer interface tends to be a problem for the utilization of computer systems for anesthesia. Ergonomic interface design with an emphasis on the coherency of the interface's static and dynamic structure may improve this situation. To investigate this proposition we developed an Anesthesia Information System (AIS) with a touch-sensitive monitor as the hardware-user interface. Basic data input and system control techniques were defined and implemented. Record keeping is integrated into the user interface. Ventilator control from the same interface is an additional feature for laboratory simulations. The system is being evaluated using a technique that simulates live operations. References Anthony J (1982) BAS - A major change coming in delivery. IEEE EMB 1 (1): 36-42 Apple HP, Schneider AJL, Fadel J (1982) Design and evaluation of a semiautomatic anesthesia record system. Med lnstrum 16 (1): 69-71 Arnell WJ, Schultz DG (1983) Computers in anesthesiology - a look ahead. Med Instrum 17 (6): 393-395 Bender HJ, Osswald PM, Hartung HJ, Lutz H (1983) On line - Erfassung haemodynamischer und respiratorischer GraBen in der Anaesthesie. Anaesth Intensivther Notfallmed 18: 37-40 Cooper JB et al. (1982) A graphics-tablet for data entry in computer assisted recordkeeping Proc.

The aims of the Sub-Committee on Computerised Braille Production are to seek international co-operation for the development of computerised braille production facilities and to encourage the cost-effective use of technology for braille production. To fulfil these aims the Sub-Committee is endeavouring to: maintain an international directory of people and organisations involved or interested in computerised braille production; collect and disseminate information about current and future computerised braille production systems; hold international meetings. The Sub Committee comprises: 1) Mr. D. W. Croisdale (Chairman) c/o Royal National Institute for the Blind, 224-228 Great Portland Street, London, W1N 6AA, Uni ted Kingdom. 2) Dr. H. Werner, Rheinische Friedrich-Wilhelms-Universitat Institut fur Angewandte Mathematik Wegeierstrasse 6 0-5300 Bonn German Federal Republic. J) Mr. R.A.J. Gildea, Mitre Corporation, Bedford, Massachusetts 017JO, U.S.A. The international directory is maintained by Mr. Gildea and the collection and dissemination of operational information is being planned by Dr. Werner. Previous workshops have been held at Munster (197J) and Kopenhagen (1974) on private initiative, whereas this conference held in London JO May - 1 June 1979 was the first VI of its kind held under the auspices of the Sub-committee. It is hoped to mount other conferences as circumstances demand."

SALUTIS UNITAS, Unity for Health, an organization 'Uniting physicians of the world to foster better health for all people through international exchange of technological information', was officially founded in 1972 after preceding years of preparation. One of its main objectives is the scientific communication, be it by meeting or by publications. So several scientific meetings could be held, mostly together with other scientific organizations, and resulted in the publication of the respective proceedinqs 1. Studies were commissioned 2 to investigate trends in health care delivery and their socio-economic consequences, which also provided the basis for further investigations 3. So also in 1978 an international congress was organized by SALUTIS UNITAS and sponsored by the international Menarini Foundation under its directorship of Dr. Gorini. This volume is based on the contributions of SALUTIS UNITAS mewbers of this meeting 'Man and his World, Technology and Health', supplemented by further studies and materials. The main objective was to look at various recipients of health care delivery: the individual, the community, the region and the nation. Emphasis was placed on systems analysis, simulation techniques and evaluation. According to the composition of the SALUTIS UNITAS membership, conceptual and interdisciplinary aspects prevail over descriptions of in-depth methodology,thus providing a broad access to the problems investigated. For the Editors Amonqst others see: Mas~, E., Collen, ~.F., Gorini, S. (Eds): The Computer in Health Care Systems in Some European Countries and in the United States (Piccin, Padua 1976).