Coding System Research Articles

Integrating 3DVAR and ANN for inversion optimization of physical models of fuel-assembly bowing

This study introduces a novel inversion optimization method for the core physical model of fuel-assembly bowing, integrating measurement data based on three-dimensional variational (3DVAR) data assimilation and artificial neural network (ANN) techniques. Recognizing the deviation between theoretical physical models and actual core conditions due to factors like uneven coolant distribution and fuel-assembly bowing, this work aims to enhance model reliability and simulation accuracy. By generating a dataset through random perturbation and employing ANN for training, the method establishes a relationship between the core physical model and model-simulated values corresponding to measurement data. The construction of the cost function, essential for optimizing the inversion process, is executed using 3DVAR. To verify its validity, the method is implemented, and an inversion optimization process is developed using our self-developed Bamboo-C code system. The optimization process, validated through application in a commercial pressurized water reactor (PWR) in a nuclear power plant (NPP) in China, demonstrates a significant reduction in the relative errors of power distribution, thus affirming the method’s efficacy in achieving a more realistic model of fuel-assembly bowing. The integration of measurement data into the optimization process addresses the critical need for accurate core physical models in nuclear engineering, offering a promising avenue for enhancing the safety and efficiency of nuclear reactor operations.

Quality of parent–child interaction in underserved migrant areas in Kyrgyz Republic: a pilot study

BackgroundAfter societal change in Kyrgyz Republic, the pattern of parent–child interaction in the changing parenting culture is an important factor influencing the positive development of Kyrgyz children. This study is aim to assess the quality of parent–child interactions in Kyrgyzstan by analyzing the interaction patterns and playfulness of children during free play at home.MethodsThis was a descriptive pilot study using video-recorded observations to explore parent–child interactions. The Dyadic Parent–Child Interaction Coding System and a playfulness instrument were used to assess the patterns and quality of the interaction. A total of 20 dyads of children aged 24 to 58 months and their parents, living in migrant communities of Kyrgyzstan, participated in this study.ResultsMajor parent–child interaction patterns included 731 turns of parent–child dyads during 1040 episodes. Verbal as well as nonverbal behaviors of parents were observed while interacting with their children. Parents used direct and indirect commands most frequently, while praise was used the least in interactions. Children frequently used compliance as well as noncompliance when they interacted with their parents. Children had low playfulness scores while interacting with their parents. Cognitive spontaneity was the component with the lowest score among all subdomains of playfulness.ConclusionFuture studies are recommended to develop strategies to facilitate parents’ active interaction with their children, promote children’s playfulness, and improve the quality of their mutual interaction.

Optimizing Integration with the Italian EHR: The Use of LOINC Codes.

According to the regulation "Decreto del Presidente del Consiglio dei Ministri" (DPCM) of September 29, 2015, n.178, the Logical Observation Identifiers Names and Codes (LOINC) system is included among the coding systems adopted in the Italian Electronic Health Record (EHR). As part of the Digital Health Solutions in Community Medicine (DHEAL-COM) project, one key goal is to categorize parameters using international classification systems. This enables the identification of appropriate Information and Communication Technology (ICT) solutions tailored to support people's health needs. Our objective is to incorporate LOINC codes for parameter categorization, thus anticipating the future use of EHR.

Standardizing X-Ray and Angiography Procedure Coding in Estonia: Validating TermX Through the Implementation of SNOMED CT.

The existence of multiple code systems and standards has highlighted the necessity for innovative solutions to bridge these discrepancies. This research investigates the utilisation of TermX to tackle the challenges of interoperability in radiology procedures, with a specific emphasis on angiography and X-ray modalities. The study produced a revised RadLex data model and mapping guide, designed to classify radiology services using TermX. In total, 380 concepts were required to comprehensively describe all 622 procedures examined. Our study demonstrates the effectiveness of TermX in simplifying the process of mapping between code systems, thus enabling more efficient analysis, and reporting of data.

Evaluation of radiation protection effectivity in a cardiac angiography room using visualized scattered radiation distribution

In this study, we devised a radiation protection tool specifically designed for healthcare professionals and students engaged in cardiac catheterization to easily monitor and evaluate scattered radiation distribution across diverse C-arm angles and arbitrary physician associated staff positions—scrub nurse and technologist positions. In this study, scattered radiation distributions in an angiography room were calculated using the Monte Carlo simulation of particle and heavy ion transport code system (PHITS) code. Four visualizations were performed under different C-arm angles with and without radiation protection: (1) a dose profile, (2) a 2D cross-section, (3) a 3D scattered radiation distribution, and (4) a 4D scattered radiation distribution. The simulation results detailing the scattered radiation distribution in PHITS were exported in Visualization Toolkit format and visualized through the open-source visualization application ParaView for analysis. Visualization of the scattered dose showed that dose distribution depends on the C-arm angle and the x-ray machine output parameters (kV, mAs s−1, beam filtration) which depend upon beam angulation to the patient body. When irradiating in the posterior–anterior direction, the protective curtain decreased the dose by 62% at a point 80 cm from the floor, where the physician’s gonads are positioned. Placing the protection board close to the x-ray tube reduced the dose by 24% at a location 160 cm from the floor, where the lens of the eye is situated. Notably, positioning the protection board adjacent to the physician resulted in a 95.4% reduction in incident air kerma. These visualization displays can be combined to understand the spread and direction of the scattered radiation distribution and to determine where and how to operate and place radiation protection devices, accounting for the different beam angulations encountered in interventional cases. This study showed that scatter visualization could be a radiation protection teaching aid for students and medical staff in angiography rooms.

Challenges of Integrating ICD 11 into Automatic Alerting Systems.

Automatic alerting systems (AASs) can identify adverse health events but emergency communication relies on human operators and natural languages. For complete automation, we need to code the diversity of adverse events in a granularity that supports optimal dispatches. Hence, AAs shall integrate with the International Classification of Diseases (ICD). The ICD-11 coding system includes chapters for external causes of injury. However, ICD-11 supports coding injury incidents in electronic health records (EHRs) after they have occurred, while disregarding integrating real-time injury reporting within its framework. We explore the potential challenges associated with integrating ICD-11 into AAS by analyzing external causes of morbidity or mortality and the dimensions of external causes as potential areas of integration. We recognize the themes: (i) incident of injury, (ii) mode of transport, (iii) indoor location, (iv) outdoor location, and (v) type of building, and identify four challenges: (i) conceptual differences between the two systems, (ii) injury identification, (iii) presence of entities below the shoreline in ICD-11, and (iv) lack of specificity in certain ICD-11 codes related to AASs. For easy integration of ICD-11 into AASs, we recommend an AAS data dictionary and propose ICD-11 updates related to external causes of injury.

Multi-Source Data ETL (Extract, Transform, Load) for a Genetic Epilepsy Diagnosis and Treatment Dashboard.

The growing number of genes identified in relation to epilepsy represents a major breakthrough in diagnosis and treatment, but experts face the challenge of efficiently accessing and consolidating the vast amount of genetic data available. Therefore, we present the process of transforming data from different sources and formats into an Entity-Attribute-Value (EAV) model database. Combined with the use of standard coding systems, this approach will provide a scalable and adaptable database to present the data in a comprehensive way to experts via a dashboard.

Unlocking the Potential of Free Text in Electronic Health Records with Large Language Models (LLM): Enhancing Patient Safety and Consultation Interactions.

Computer-mediated clinical consultation, involving clinicians, electronic health record (EHR) systems, and patients, yield rich narrative data. Despite advancements in Natural Language Processing (NLP), these narratives remain underutilised. Free text recording in EHRs allows expressivity, complements structured data from clinical coding systems, and facilitates collaborative care. Large language models (LLMs) excel in understanding and generating natural language, enabling complex dialogue processing. Integrating LLM tools into consultations could harness the untapped potential of free text to identify patient safety concerns, support diagnosis and provide content to enhance clinical-patient interactions. Tailoring LLMs for specific consultation tasks through pre-training and fine-tuning is viable. This paper outlines approaches for adopting LLMs in primary care and suggests that using fine-tuned LLMs with prompt engineering could enhance computer-mediated clinical consultation cost-effectively.

7-Deaza-2'-deoxyisoguanosine, a Noncanonical Nucleoside for Nucleic Acid Code Expansion and New DNA Constructs: Nucleobase Functionalization of Inverse Watson-Crick and Purine-Purine Base Pairs.

7-Deaza-2'-deoxyisoguanosine forms stable inverse Watson-Crick base pairs with 5-methyl-2'-deoxyisocytidine and purine-purine base pairs with 2'-deoxyguanosine or 5-aza-7-deaza-2'-deoxyguanosine. Both base pairs expand the genetic coding system. The manuscript reports on the functionalization of these base pairs with halogen atoms and clickable side chains introduced at 7-position of the 7-deazapurine base. Oligonucleotides containing the functionalized base pairs were prepared by solid-phase synthesis. To this end, a series of phosphoramidites were synthesized and clickable side chains with short and long linkers were incorporated in oligonucleotides. Fluorescent pyrene conjugates were obtained by postmodification. Functionalization of DNA with a single inverse Watson-Crick base pair by halogens or clickable residues has only a minor impact on duplex stability. Pyrene click adducts increase (long linker) or decrease (short linker) the double helix stability. Stable hybrid duplexes were constructed containing three consecutive purine-purine pairs of 7-functionalized 7-deaza-2'-deoxyisoguanine with guanine or 5-aza-7-deazaguanine in the center and Watson-Crick pairs at both ends. The incorporation of a hybrid base pair tract of 7-deaza-2'-deoxyisoguanosine/5-aza-7-deaza-2'-deoxyguanosine pairs stabilizes the double helix strongly. Fluorescence intensity of pyrene short linker adducts increased when the 7-deazapurine base was positioned opposite to 5-methylisocytosine (inverse base pair) compared to purine-purine base pairs with guanine or 5-aza-7-deazaguanine in opposite positions. For long liker adducts, the situation is more complex. Circular dichroism (CD) spectra of purine DNA differ to those of Watson-Crick double helices and are indicative for the new DNA constructs. The impact of 7-deaza-2'-deoxyisoguanine base pair functionalization is studied for the first time and all experimental details are reported to prepare DNA functionalized at the 7-deazaisoguanine site. The influence of single and multiple incorporations on DNA structure and stability is shown. Clickable residues introduced at the 7-position of the 7-deazaisoguanine base provide handles for Huisgen-Sharpless-Meldal click cycloadditions without harming the stability of purine-pyrimidine and purine-purine base pairs. Other chemistries might be used for bioconjugation. Our investigation paves the way for the functionalization of a new DNA related recognition system expanding the common Watson-Crick regime.

Vicarious facilitation of facial responses to pain: Does the others' expression need to be painful?

Prior exposure to others' facial expressions of pain can lead to a facilitation of pain responses, including its corresponding response channel, namely facial responses to pain. It has been questioned, however, whether this vicarious pain facilitation occurs only when observing others' pain or whether the observation of other negative expressions can trigger similar facilitation of facial responses to pain. The study aimed to test this, by comparing the impact of viewing others' facial expressions of pain versus another negative expression (sadness) and two control expressions (neutral, happiness) on facial responses to pain. Participants (N = 56; 31 females), watched short video clips of computer-generated facial expressions (pain, sadness, neutral & happiness) before they received painful and non-painful heat stimuli. Facial responses were analysed using the Facial Action Coding System. In addition, subjective and autonomic responses were assessed. The prior exposure to others' expressions of pain and sadness versus neutral did not lead to significantly increased facial responses to pain. Likewise, subjective and autonomic pain responses were not facilitated. However, viewing others' expressions of happiness, consistently reduced facial as well as subjective and autonomic responses to pain compared to others' negative or neutral expressions. This dampening effect was not observed for non-painful heat. Facial and other pain responses were most strongly affected by prior exposure to others' facial expressions of happiness, which led to a pain-dampening effect. In contrast, the evidence for vicarious facilitation of pain was rather weak in the present study, with no evidence of pain-specificity. Facial responses to pain - along with subjective and autonomic responses - are reduced when observing others' expressions of happiness, demonstrating pain modulation by positive affective social signals, which may also transfer to clinical contexts.

Introduction of ICD-11 in Germany: Seizing opportunities together.

With the new ICD-11 developed by the WHO and translated into German for use in Germany by the Federal Institute for Drugs and Medical Devices, the German healthcare system is facing a change that is more than a simple change of a medical coding system. The ICD-11 modernises the coding system, for example, by including new, separate health conditions such as sleep-wake disorders and conditions related to sexual health, thus making the corresponding diseases more visible. The ICD-11 is more precise than the ICD-10: it allows cross-referencing between diagnoses, symptoms, functionality and locations and partially abandons the strict hierarchy of the ICD-10. In addition, a greater number of rare diseases are represented with their own specific code than was previously possible with ICD-10. Finally, the ICD-11 is also significantly more "modern" than the ICD-10 (which dates back to pre-digital times) in that it enables new, digitally-supported processes, such as keywords flexibility and sustainability when updating the system as well as actual coding at the point of care. The switch to ICD-11 can be a great opportunity for the German healthcare system that should not be missed. It will benefit health service research, which at best will be able to work with much more detailed and correct data sets. But medical care will also benefit because the ICD-11 reflects current medical knowledge. In addition, certain illnesses will be removed from the psychiatric category, meaning that those affected will no longer be stigmatised by their classification in the ICD. The improved coding of diagnoses will ultimately also support guideline-based treatments. However, the changeover is only the first step. The challenges - also for health service research - include in particular the latency of introduction and uniform use as well as the necessary change in coding habits. For ICD-11 to be a success in Germany, authorities, the medical profession, payers and patients must work together on strategies to ensure not only a rapid but also a comprehensive implementation that maximises the potential of ICD-11.

Simulation of late phase phenomena with the system code AC2

Simulation codes like the AC2 system code package developed by German Gesellschaft für Anlagen-und Reaktorsicherheit (GRS) gGmbH are used in international reactor safety research to investigate hypothetical severe incidents and accidents in nuclear power plants. Valuable impetuses for the development of prevention and mitigation measures for such events can be derived from the analyses. This article presents selected work by PSS on the development of simulation models for the late phase of nuclear accidents. Topical issues as the formation and thermodynamic interactions of debris beds in the lower plenum of the reactor pressure vessel (RPV), the release of fission products as well as the interaction of the molten core material with concrete in the reactor cavity in case of RPV failure are discussed. The analyses carried out provide important findings regarding the validation of the developed models. In addition, future development needs are derived for the consideration of further relevant phenomena.

Numerical study on benchmark analysis of NACIE-UP facility with uniform and non-uniform power distribution

The NACIE-UP (NAtural Circulation Experiment-Upgrade) facility is located at the ENEA Brasimone Research Centre (Italy) and is designed to investigate the thermal–hydraulic properties of Lead-Bismuth Eutectic (LBE) within a wire-spaced assembly under uniform and non-uniform power distribution conditions. This benchmark exercise proposed by ENEA is based on previous experiment results, intending for development and validation of CFD/TH system code, stand-alone CFD simulation, etc. In this study, the thermal–hydraulic characteristics of Fuel Pin Simulator (FPS) are analyzed, which contains inlet bend and outlet section. ANSYS Fluent solver is applied with the COUPLE algorithm of RANS SSTk-ω model. Cheng&Tak correlation and computational conditions are implanted into Fluent in the form of UDFs. Moreover, calculations were performed for ADP10, ADP06 and ADP07. The results show that the RMSEs of ADP10SS1 and ADP10SS2 are 2.52 K and 3.69 K, 7.05 K and 8.48 K for ADP06SS1 and ADP06SS2, respectively, which indicate that the adopted models have good prediction ability for the temperature of the experimental conditions. Meanwhile, the heat transfer characteristics of different sub-channels and sections are investigated and compared with the correlations of Ushakov, Mikityuk, Kazimi and Carelli. The experimental and simulation values of the uniformly heated ADP10 are in good agreement with the correlations, while there is a large deviation for the non-uniformly heated ADP06. Therefore, it is necessary to develop new correlations for the heat transfer characteristics of LBE in wire-wrapped bundle. Above all, this study provides quantitative and qualitative analysis for verification and validation of CFD/TH system code and stand-alone CFD simulation.

Impact of contrast agents on organ dosimetry in pediatric diagnostic fluoroscopy: the voiding cystourethrogram.

ICRP Task Group 113 is developing reference values of organ and effective dose coefficients for radiography, fluoroscopy, and computed tomography imaging exams. In support of these efforts, our focus is on pediatric diagnostic fluoroscopy. Contrast agents used during clinical examinations are an important consideration of the work undertaken by the Task Group. This work demonstrates the importance of including organ contrast volume concentrations for the calculation of reference organ dose coefficients in the voiding cystourethrogram (VCUG). The ICRP newborn and 15-year female reference phantoms were utilized within the Particle and Heavy Ion Transport code System (PHITS) for the calculation of organ dose coefficients. A pediatric radiologist with over 30 years of clinical experience defined the imaging fields for a VCUG examination consistent with clinical practice. Of these, four imaging fields were selected for investigation. The transport simulations modeled an iodinated contrast solution similar to Bracco Group's 18% weight per volume, cystografin diatrizoate meglumine and typical bladder content was supplemented to make up the remainder volume. Iodinated contrast volumes of 0, 25, 50, 75, and 100 percent concentration by volume were modeled and associated dose coefficients for in-field organs were computed. Organ dose coefficients were calculated for the urinary bladder wall, colon wall, ovaries, and uterus for both female phantoms under irradiation geometries representative of a VCUG examination. Some organ dose coefficients increased with iodine volume in the bladder and other organ dose coefficients decreased as the iodine contrast volume completely filled the bladder (100%). The study results demonstrate for the newborn phantom percent differences in organ dose coefficients varied between 0-10% for the organs of interest, while they varied between 0-22% in the 15-year phantom suggesting the importance of including contrast media in Monte Carlo radiation transport simulations of the VCUG examination.&#xD.

The Interrater Reliability of a Coding System for Measuring Mental Health Professionals’ Decisions and Actions

ABSTRACT Objective The clinical decisions and actions of evidence-based practice in psychology (EBPP) are largely underspecified and poorly understood, in part due to the lack of measurement methods. We tested the reliability of a behavioral coding system that characterizes a flow of interrelated activities that includes problem detection and prioritization, intervention selection and implementation, and review of intervention integrity and impact. Method The context included two publicly funded youth mental health service organizations located in geographically distinct and underresourced communities in the U.S. where service inequities are common. We sampled 84 digitally recorded and transcribed supervision events that included a sample of professionals who were mostly women (93.02%) and BIPOC (86.04%) whose self-reported race/ethnicity matched the youth populations they served. We coded these events for activities (e.g., considering) and their predicate content (i.e., problems or practices) and examined reliability of these codes applied to excerpts (i.e., small contiguous units of dialogue) as well as to complete events. Results Interrater reliability estimates showed that, overall, coders reliably rated the occurrence and extensiveness of activities and content. Excerpt coding was generally more reliable than event coding. However, mathematical aggregation of excerpt coding offered a superior method for estimating event codes reliably, reducing individual subjectivity while providing event level synthesis of activities that are grounded in excerpt level details. Conclusions The assessment of clinical decisions and actions has the potential to unpack the black box of EBPP, with different methods best suited to different research questions and resource considerations.

Enhancing the Horse Grimace Scale (HGS): Proposed updates and anatomical descriptors for pain assessment

The use of grimace scales enables the clinical identification of changes in the facial expressions of animals caused by pain. The Horse Grimace Scale (HGS) is one such tool, comprising a pain coding system based on facial expressions and assessing six Facial Action Units (FAUs). Each FAU is accompanied by descriptions and anatomical details to assist the evaluator. However, the morphological descriptions for certain FAUs in the HGS are not sufficiently detailed, potentially hindering accurate interpretation. This study is an analytical investigation aimed at enhancing the morphoanatomical details in the HGS and providing raters with more comprehensive materials for pain evaluation in horses using this scale.To achieve this, detailed anatomical analyses were conducted using established references in veterinary anatomy. Initially, we propose substituting the term 'ear' with 'auricle' or 'pinna' and replacing 'area above the eye' with 'supraorbital region' for anatomical accuracy. Additionally, we introduce detailed morphoanatomical descriptions that identify specific landmarks, with the goal of ensuring more consistent application of the HGS and reducing interpretation variability. Furthermore, this study provides an explanation of the muscles involved in the investigated FAUs. These adjustments on the descriptions and evaluations remain unverified, however it is anticipated that the descriptive enhancements lead us to understand that higher interobserver reliability can be achieved for each of the FAUs.

Uncertainty Quantification of 237Np, 241Am, and 243Am Reaction Rates in Highly Enriched Uranium Fuel Cores at Kyoto University Critical Assembly

Experimental analyses of 237Np, 241Am, and 243Am fission, as well as 237Np capture reaction rates, are conducted with the Serpent 2 code together with ENDF/B-VIII.0 and JENDL-5 using experimental data for the neutron spectra of thermal and intermediate regions obtained in the solid-moderated and solid-reflected cores with highly enriched uranium fuel at the Kyoto University Critical Assembly. Also, uncertainty quantification of the fission and capture reaction rate ratios of the test samples of 237Np, 241Am, and 243Am with reference samples of 235U and 197Au are evaluated by the MARBLE code system. In terms of the fission reaction rate ratios of 237Np/235U, 241Am/235U, and 243Am/235U, a comparison between experiments and Serpent 2 calculations shows an accuracy of about 5%, 15%, and 10%, respectively, together with ENDF/B-VIII.0 and JENDL-5. For the capture reaction rate ratios of 237Np/197Au, Serpent 2 calculations reveal a fairly good accuracy at the thermal neutron spectrum. The total uncertainties of the 237Np/235U, 241Am/235U, and 243Am/235U fission reaction rate ratios by MARBLE with the covariance data of ENDF/B-VIII.0 and JENDL-5 are found to be about 4% at most in all cores, except for about 8% for 243Am/235U with ENDF/B-VIII.0 at the intermediate neutron spectrum.

Cracking the Code: Reprogramming the Genetic Script in Prokaryotes and Eukaryotes to Harness the Power of Noncanonical Amino Acids.

Over 500 natural and synthetic amino acids have been genetically encoded in the last two decades. Incorporating these noncanonical amino acids into proteins enables many powerful applications, ranging from basic research to biotechnology, materials science, and medicine. However, major challenges remain to unleash the full potential of genetic code expansion across disciplines. Here, we provide an overview of diverse genetic code expansion methodologies and systems and their final applications in prokaryotes and eukaryotes, represented by Escherichia coli and mammalian cells as the main workhorse model systems. We highlight the power of how new technologies can be first established in simple and then transferred to more complex systems. For example, whole-genome engineering provides an excellent platform in bacteria for enabling transcript-specific genetic code expansion without off-targets in the transcriptome. In contrast, the complexity of a eukaryotic cell poses challenges that require entirely new approaches, such as striving toward establishing novel base pairs or generating orthogonally translating organelles within living cells. We connect the milestones in expanding the genetic code of living cells for encoding novel chemical functionalities to the most recent scientific discoveries, from optimizing the physicochemical properties of noncanonical amino acids to the technological advancements for their in vivo incorporation. This journey offers a glimpse into the promising developments in the years to come.

Hierarchical Clustering Analysis to Inform Classification of Congenital Malformations for Surveillance of Medication Safety in Pregnancy.

There is growing interest in the secondary use of healthcare data to evaluate medication safety in pregnancy. Tree-based scan statistics (TBSS) offer an innovative approach to help identify potential safety signals. TBSS utilize hierarchically organized outcomes, generally based on existing clinical coding systems that group outcomes by organ system. When assessing teratogenicity, such groupings often lack a sound embryologic basis given the etiologic heterogeneity of congenital malformations. The study objective was to enhance the grouping of congenital malformations to be used in scanning approaches through implementation of hierarchical clustering analysis (HCA) and to pilot test an HCA-enhanced TBSS approach for medication safety surveillance in pregnancy in two test cases using >4.2 million mother-child dyads from two US-nationwide databases. HCA identified (1) malformation combinations belonging to the same organ system already grouped in existing classifications, (2) known combinations across different organ systems not previously grouped, (3) unknown combinations not previously grouped, and (4) malformations seemingly standing on their own. Testing the approach with valproate and topiramate identified expected signals, and a signal for an HCA-cluster missed by traditional classification. Augmenting existing classifications with clusters identified through large data exploration may be promising when defining phenotypes for surveillance and causal inference studies.

Pengembangan Aplikasi Mobile untuk Peningkatan Layanan Kesehatan di Klinik Menggunakan Metode Waterfall: Studi Kasus Klinik XYZ

In this digital era, patients expect ease of access and transparency in healthcare services. Klinik XYZ, currently using conventional methods, faces challenges in meeting these expectations, such as long queues, incomplete information, and difficulties in scheduling appointments with doctors. This study aims to develop a mobile application to enhance service quality at Klinik XYZ. The method used is Waterfall, involving the stages of needs analysis through observation and interviews, system design, coding, and testing. The findings show that the developed application can provide essential features such as doctor profiles, doctor schedules, appointment scheduling, service selection, ratings, news, and health tips. This application successfully improves the efficiency and quality of services at Klinik XYZ by reducing waiting times and providing a better user experience. The implications of this study indicate that integrating mobile technology into healthcare services can significantly enhance patient satisfaction and the operational effectiveness of the clinic. Arifin, M. N., & Siahaan, D. (2020). Structural and Semantic Similarity Measurement of UML Use Case Diagram. Lontar Komputer : Jurnal Ilmiah Teknologi Informasi, 11(2), 88. https://doi.org/10.24843/lkjiti.2020.v11.i02.p03 Febriyanti, N. M. D., Sudana, A., & ... (2021). Implementasi Black Box Testing pada Sistem Informasi Manajemen Dosen. Jurnal Ilmiah …, 2(3). http://download.garuda.kemdikbud.go.id/article.php?article=3457876&val=30165&title=Implementasi Black Box Testing pada Sistem Informasi Manajemen Dosen Haerani, R., Hendriyati, P., Nugroho, P. A., & Lukman, M. (2023). Waterfall Model Implementation in Information Systems Web Based Goods Delivery Service. JURTEKSI (Jurnal Teknologi Dan Sistem Informasi), 9(3), 501–508. https://doi.org/10.33330/jurteksi.v9i3.2267 Lee Ventola, C. (2014). Mobile devices and apps for health care professionals: Uses and benefits. P and T, 39(5), 356–364. Luxton, D. D., Kayl, R. A., & Mishkind, M. C. (2012). MHealth data security: The need for HIPAA-compliant standardization. Telemedicine and E-Health, 18(4), 284–288. https://doi.org/10.1089/tmj.2011.0180 Martínez-Pérez, B., De La Torre-Díez, I., & López-Coronado, M. (2013). Mobile health applications for the most prevalent conditions by the world health organization: Review and analysis. Journal of Medical Internet Research, 15(6). https://doi.org/10.2196/jmir.2600 Nurbaiti Oktaviani, S., Fikri Aziz, C., & Maula Sulthon, B. (2022). Analisa UI/UX Sistem Informasi Penjualan Berbasis Mobile Menggunakan Metode Prototype. KLIK: Kajian Ilmiah Informatika Dan Komputer, 2(6), 225–233. https://doi.org/10.30865/klik.v2i6.401 Rambe, B. H., Pane, R., Irmayani, D., Nasution, M., Munthe, I. R., Ekonomi, F., & Bisnis, D. (2020). UML Modeling and Black Box Testing Methods in the School Payment Information System. Jurnal Mantik, 4(3), 1634–1640. https://iocscience.org/ejournal/index.php/mantik