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At least 487 records · Page 27Linked to original sources

Structured data collection and knowledge-based user guidance for abdominal ultrasound reporting.

This paper describes a system for structured data collection and report generation in abdominal ultrasonography. The system is based on a controlled vocabulary and hierarchies of concepts; it uses a graphical user interface. More than 17,000 reports have been generated by 43 physicians using this system, which is integrated into a departmental information system. Evaluations have shown that it is a well accepted tool for the fast generation of reports of comparatively high quality. The functionality is enhanced by two additional components: a hybrid knowledge-based module for "intelligent" user guidance and an interactive tutoring system to illustrate the terminology.

Abdomen↗

Dissociations between implicit and explicit memory in children: the role of strategic processing and the knowledge base.

A review of the literature shows that explicit memory develops substantially from three years of age to adulthood, while implicit memory remains stable across this age range. Previously, this developmental dissociation has been attributed to different memory systems, or to confounds with perceptual vs. conceptual processing. Prompted by an alternative developmental framework, the experiments reported here provide evidence against both interpretations. Instead, it will be argued that (a) the implicit-explicit developmental dissociation reflects differences in strategic processing (strategy use and metamemory) across childhood and (b) that implicit memory can show development if a child's knowledge base in the tested domain is developing with age.

Adolescent↗

Boltzmann's principle, knowledge-based mean fields and protein folding. An approach to the computational determination of protein structures.

The data base of known protein structures contains a tremendous amount of information on protein-solvent systems. Boltzmann's principle enables the extraction of this information in the form of potentials of mean force. The resulting force field constitutes an energetic model for protein-solvent systems. We outline the basic physical principles of this approach to protein folding and summarize several techniques which are useful in the development of knowledge-based force fields. Among the applications presented are the validation of experimentally determined protein structures, data base searches which aim at the identification of native-like sequence structure pairs, sequence structure alignments and the calculation of protein conformations from amino acid sequences.

Amino Acid Sequence↗

Knowledge-based verification of clinical guidelines by detection of anomalies.

As shown in numerous studies, a significant part of published clinical guidelines is tainted with different types of semantical errors that interfere with their practical application. The adaptation of generic guidelines, necessitated by circumstances such as resource limitations within the applying organization or unexpected events arising in the course of patient care, further promotes the introduction of defects. Still, most current approaches for the automation of clinical guidelines are lacking mechanisms, which check the overall correctness of their output. In the domain of software engineering in general and in the domain of knowledge-based systems (KBS) in particular, a common strategy to examine a system for potential defects consists in its verification. The focus of this work is to present an approach, which helps to ensure the semantical correctness of clinical guidelines in a three-step process. We use a particular guideline specification language called Asbru to demonstrate our verification mechanism. A scenario-based evaluation of our method is provided based on a guideline for the artificial ventilation of newborn infants. The described approach is kept sufficiently general in order to allow its application to several other guideline representation formats.

Artificial Intelligence↗

Knowledge-based multi-modality three-dimensional image analysis of the brain.

With the recent advances in medical imaging, three-dimensional anatomical and metabolic images of the brain are now available through MR/CT and PET/SPECT imaging modalities. Computerized multi-modality three-dimensional brain image registration and analysis can provide important correlated information for improving diagnosis and studying the pathology of disease. Such analysis may also provide help in planning brain surgery. Further, an anatomical model based quantification and analysis of internal structure can be used to develop a computerized anatomical atlas. Conventional anatomical atlases provide rigid spatial distribution of internal structures extracted from a single subject. The proposed computerized anatomical atlas provides probabilistic spatial distributions which can be easily updated to incorporate the variability of brain structures of subjects selected from pre-defined groups. This paper first presents a review of the current trends in knowledge-based segmentation, labeling, and analysis of MR brain images and then describes the Principal Axes Transformation based registration of three-dimensional MR brain images to develop composite models of selected internal brain structures. The composite models can be used as a computerized anatomical atlas in model-based segmentation and labeling of MR brain images. Three-dimensional labeled MR images of the brain can also be registered and correlated with PET images for analyzing the metabolic activity in the anatomically selected volume of interest. On the other hand, a volume of interest can be selected using the metabolic information and then analyzed for correlated anatomical information using the registered MR-PET images.

Algorithms↗

Knowledge-based reconstruction of random porous media.

An evolutionary optimization technique is used to reconstruct digitized material models of 300(3) nm3 size for mesoporous two-phase systems. The models are adapted to the two-point probability (TPP) and to a volume-based pore-size distribution (PSD) which were derived from SANS and adsorption experiments and which carry statistical information about morphology and topology of the pore system. To avoid extreme update-costs, the bulk of mutations are assessed by means of a suitable approximation of the PSD; it is demonstrated that a sporadic insertion of the PSD suffices to drive the algorithm towards satisfactory models in acceptable time. Our approach is knowledge-based in the sense that (i) the mutations are restricted to expedient exchanges of phase-voxels by a heuristic rule, and (ii) the sporadic calculation of the PSD from the current state of the model, in essence, provides an efficient self-control for the evolutionary process. We applied the method to reconstruct periodic models of the xerogel Gelsil 200. Such reconstructs of real mesoporous solids could be utilized, for instance, to verify theories of adsorption and capillary condensation.

Journal Article↗

Defaults, context, and knowledge: alternatives for OWL-indexed knowledge bases.

The new Web Ontology Language (OWL) and its Description Logic compatible sublanguage (OWL-DL) explicitly exclude defaults and exceptions, as do all logic based formalisms for ontologies. However, many biomedical applications appear to require default reasoning, at least if they are to be engineered in a maintainable way. Default reasoning has always been one of the great strengths of Frame systems such as Protégé. Resolving this conflict requires analysis of the different uses for defaults and exceptions. In some cases, alternatives can be provided within the OWL framework; in others, it appears that hybrid reasoning about a knowledge base of contingent facts built around the core ontology is necessary. Trade-offs include both human factors and the scaling of computational performance. The analysis presented here is based on the OpenGALEN experience with large scale ontologies using a formalism, GRAIL, which explicitly incorporates constructs for hybrid reasoning, numerous experiments with OWL, and initial work on combining OWL and Protégé.

Abstracting and Indexing↗

Neural network pattern recognition of photoacoustic FTIR spectra and knowledge-based techniques for detection of mycotoxigenic fungi in food grains.

Fourier transform infrared photoacoustic spectroscopy (FTIR-PAS), a highly sensitive probe of the surfaces of solid substrates, is used to detect toxigenic fungal contamination in corn. Kernels of corn infected with mycotoxigenic fungi, such as Aspergillus flavus, display FTIR-PAS spectra that differ significantly form spectra of uninfected kernels. Photoacoustic infrared spectral features were identified, and an artificial neural network was trained to distinguish contaminated form uncontaminated corn by pattern recognition. Work is in progress to integrate epidemiological information about cereal crop fungal disease into the pattern recognition program to produce a more knowledge-based, and hence more reliable and specific, technique. A model of a hierarchically organized expert system is proposed, using epidemiological factors such as corn variety, plant stress and susceptibility to infection, geographic location, weather, insect vectors, and handling and storage conditions, in addition to the analytical data, to predict Al. flavus and other kinds of toxigenic fungal contamination that might be present in food grains.

Aflatoxins↗

Pseudodihedrals: simplified protein backbone representation with knowledge-based energy.

Pairwise contact energies do not explicitly take protein secondary structure into account, and so provide an incomplete description of conformational energy. In order to construct a Hamiltonian that specifically relates to protein backbone conformations, a simplified backbone angle is used. The pseudodihedral angle (the torsion angle between planes defined by 4 consecutive alpha-carbon atoms) provides a simplified backbone representation and continues to manifest information about secondary-structure elements: the pseudo-Ramachandran plot contains helical and sheetlike regions. The distribution of pseudodihedral angles is highly sensitive to the identity of the central pair of amino acids. Therefore, a sequence-dependent, knowledge-based potential energy was found according to a quasichemical approximation. These functions form complementary additions to the contact potentials currently in use. This pseudodihedral potential greatly enhances the ability to design sequences that are specific to a given conformation and also improves the ability to discriminate a native conformation from many other conformations.

Amino Acids↗

A knowledge-based scale for amino acid membrane propensity.

In this article, a membrane-propensity scale for amino acids is derived using only two ingredients: (i) a set of transmembrane helices segments from membrane protein crystal structures and (ii) the request that each component of the set has a free energy lower than that of a typical soluble protein sequence of the same length. Although the most widely used hydropathy scales satisfy this request, we use an optimization procedure that allows for extraction of an optimal scale, which correlates equally well with those scales. We show that, if the choice of the sequence database is accurate, significant knowledge-based scales, which are robust with respect to changes in the learning set, can be easily derived. The obtained scales can be used for transmembrane helices prediction. The predictive power of one of these scales is tested on membrane proteins, soluble proteins, and signal peptides databases, finding that its performances is comparable with those of the hydropathy scales.

Algorithms↗

A problem-oriented, knowledge-based patient record system.

The concept of a problem-oriented patient record was presented in the late 1960s but has yet to gain wide acceptance. In this paper we suggest a distinction between the idea of problem orientation and the implementation of the idea. We argue that the problem-oriented patient record offers an intuitive and useful way to work with patient information. We show that the concept of problem-oriented patient records facilitates better care of patients by supporting continuity of care, removing redundant and confusing information, and enabling easy overview of and access to its content. We further propose a two-layer framework that has knowledge of its content and use and is able to better utilize information in the record by presenting relevant information to the user at a time when needed. Conceptually, this is done by adding a layer of knowledge to the patient record system: 1) Knowledge about physicians' way of thinking and working, 2) Their corresponding information use and need during patient care, and 3) Tools to determine information relevance in a given situation; such a knowledge-based system is able to reason with its content and use.

Artificial Intelligence↗

The sensitivity of medical diagnostic decision-support knowledge bases in delineating appropriate terms to document in the medical record.

A pertinent, legible and complete medical record facilitates good patient care. The recording of the symptoms, signs and lab findings which are relevant to a patient's condition contributes importantly to the medical record. The consideration and documentation of other disease states known to be related to the patient's primary illness provide further enhancement. We propose that developing sets of disease-specific core elements which a physician may want to document in the medical record can have many benefits. We hypothesize that for a given disease, terms with high importance (TI) and frequency (TF) in the DX-plain, QMR and Iliad knowledge bases (KBs) are terms which are used commonly in the medical record, and may be, in fact, terms which physicians would find useful to document. A study was undertaken to validate ten such sets of disease-specific core elements. For each of ten prevalent diseases, high TI and TF terms from the three KBs mentioned were pooled to derive the set of core elements. For each disease, all patient records (range 385 to 16,972) from a computerized ambulatory medical record database were searched to document the actual use by physicians of each of these core elements. A significant percentage (range 50 to 86%) of each set of core elements was confirmed as being used by the physicians. In addition, all medical concepts from a selection of full text records were identified, and an average of 65% of the concepts were found to be core elements.(ABSTRACT TRUNCATED AT 250 WORDS)

Artificial Intelligence↗

Knowledge-based automation.

Future technologic advances in microcomputer hardware will allow us to build complex interactive information systems that go far beyond conventional laboratory management functions to address the needs of laboratorians as well as physicians in patient care activities. These systems will use a "local-area network to transmit not only text but also images to workstations throughout a hospital. Unlike current systems driven from a central computer, future systems will decentralize much of the memory and processing to individual workstations." The expansion of software tools for modeling the decision-making process coupled with the development and testing of useful systems in relatively narrow problem domains will help the laboratory construct the necessary knowledge bases for future applications. Such systems will present complex medical data in a useful, informative manner, leading to a more rapid, consistent, and, it is hoped, cost effective decision making process. Utilizing these techniques, laboratory medicine can play a crucial role in fostering the appropriate and logical use of the laboratory.

Artificial Intelligence↗

Tools for acquisition, processing and knowledge-based diagnostic of the electroencephalogram and visual evoked potentials.

The objective of our research is to develop computer-based tools to automate the clinical evaluation of the electroencephalogram (EEG) and visual evoked potentials (VEP). This paper describes a set of solutions to support all the aspects regarding the standard procedures of the diagnosis in neurophysiology, including: (1) acquisition and real-time processing and compression of EEG and VEP signals, (2) real-time brain mapping of spectral powers, (3) classifier design, (4) automatic detection of morphologies through supervised neural networks. (5) signal analysis through fuzzy modelling, and (6) a knowledge based approach to classifier design.

Adolescent↗

Are knowledge-based potentials derived from protein structure sets discriminative with respect to amino acid types?

The parametric description of residue environments through solvent accessibility, backbone conformation, or pairwise residue-residue distances is the key to the comparison between amino acid types at protein sequence positions and residue locations in structural templates (condition of protein sequence-structure match). For the first time, the research results presented in this study clarify and allow to quantify, on a rigorous statistical basis, to what extent the amino acid type-specific distributions of commonly used environment parameters are discriminative with respect to the 20 amino acid types. Relying on the Bahadur theory, we estimate the probability of error in a single-sequence-structure alignment based on weak or absent discriminative power in a learning database of protein structure. We present the results for many residue environment variables and demonstrate that each fold description parameter is sensitive with respect to only a few amino acid types while indifferent to most of the other amino acid types. Even complex structural characteristics combining solvent-accessible surface area, backbone conformation, and pairwise distances distinguish only some amino acid types, whereas the others remain nondiscriminated. We find that the knowledge-based potentials currently in use treat especially Ala, Asp, Gln, His, Ser, Thr, and Tyr as essentially "average" amino acids. Thus, highly discriminative amino acid types define the alignment register in gapless sequence-structure alignments. The introduction of gaps leads to alignment ambiguities at sequence positions occupied by nondiscriminated amino acid types. Therefore, local sequence-structure alignments produced by techniques with gaps cannot be reliable. Conceptionally new and more sensitive environment parameters must be invented.

Amino Acids↗

[A knowledge-based system for the interpretation of pelvimetric findings].

Digital Image Intensifier Radiography (DIR) as well as Nuclear Magnetic Resonance Tomography (NMR) using an especially developed imaging routine for pelvimetry are suitable tools for the assessment of the anatomical conditions when mechanical problems are supposed to occur during birth (cephalopelvic disproportion, breech presentation). A concept for an optimised evaluation procedure of these imaging techniques has been developed, including: a more elaborate measuring protocol, easily and precisely executable due to appropriate software packages being implemented in the diagnostic units, calculation of obstetrically relevant parameters not deriving immediately from the imaging procedures. This is possible by means of multiple regression analysis of a data base from 467 evaluated female pelvis computed tomograms, calculation of intrapelvic soft tissue place requirements by means of correlative analysis of female computed tomograms and weight-/height-index, empirical determination of cut off values in borderline pelvi-fetometric constellations evaluating 190 births by means of logistic regression of the according pelvic-fetometric data. The calculations necessary to obtain all these parameters are implemented in a software package which also contains an algorithm for the general characterisation of an individual pelvis. Thus, a rather sophisticated knowledge base for pelvic assessment becomes easily accessible.

Adult↗

Bedside, classroom and bench: collaborative strategies to generate evidence-based knowledge for nursing practice.

The rise of evidence-base practice (EBP) as a standard for care delivery is rapidly emerging as a global phenomenon that is transcending political, economic and geographic boundaries. Evidence-based nursing (EBN) addresses the growing body of nursing knowledge supported by different levels of evidence for best practices in nursing care. Across all health care, including nursing, we face the challenge of how to most effectively close the gap between what is known and what is practiced. There is extensive literature on the barriers and difficulties of translating research findings into practical application. While the literature refers to this challenge as the "Bench to Bedside" lag, this paper presents three collaborative strategies that aim to minimize this gap. The Bedside strategy proposes to use the data generated from care delivery and captured in the massive data repositories of electronic health record (EHR) systems as empirical evidence that can be analysed to discover and then inform best practice. In the Classroom strategy, we present a description for how evidence-based nursing knowledge is taught in a baccalaureate nursing program. And finally, the Bench strategy describes applied informatics in converting paper-based EBN protocols into the workflow of clinical information systems. Protocols are translated into reference and executable knowledge with the goal of placing the latest scientific knowledge at the fingertips of front line clinicians. In all three strategies, information technology (IT) is presented as the underlying tool that makes this rapid translation of nursing knowledge into practice and education feasible.

Cooperative Behavior↗

Knowledge-based decision support for diagnosis and therapy: on the multiple usability of patient data.

Expert systems in medicine are frequently restricted to assisting the physician to derive a patient-specific diagnosis and therapy proposal. In many cases, however, there is a clinical need to use these patient data for other purposes as well. The intention of this paper is to show how and to what extent patient data in expert systems can additionally be used to create clinical registries and for statistical data analysis. At first, the pitfalls of goal-oriented mechanisms for the multiple usability of data are shown by means of an example. Then a data acquisition and inference mechanism is proposed, which includes a procedure for controlling selection bias, the so-called knowledge-based attribute selection. The functional view and the architectural view of expert systems suitable for the multiple usability of patient data is outlined in general and then by means of an application example. Finally, the ideas presented are discussed and compared with related approaches.

Decision Support Techniques↗