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PubMed2003

A multiagent architecture for developing medical information retrieval agents.

Information that is available on the world wide web (WWW) is already more vast than can be comprehensibly studied by individuals and this quantity is increasing at a staggering pace. The quality of service delivered by physicians is dependent on the availability of current information. The agent paradigm offers a means for enabling physicians to filter information and retrieve only information that is relevant to current patient treatments. As with many specialized domains, agent-based information retrieval in medical domains must satisfy several domain-dependent constraints. A multiple agent architecture is developed and described in detail to efficiently provide agent-based information retrieval from the WWW and other explicit information resources. A simulation of the proposed multiple agent architecture shows a 97% decrease in information overload and an 85% increase in information relevancy over existing meta-search tools (with even larger gains over standard search engines).

Artificial Intelligence↗

PubMed2006

A study of evolutionary multiagent models based on symbiosis.

Multiagent Systems with Symbiotic Learning and Evolution (Masbiole) has been proposed and studied, which is a new methodology of Multiagent Systems (MAS) based on symbiosis in the ecosystem. Masbiole employs a method of symbiotic learning and evolution where agents can learn or evolve according to their symbiotic relations toward others, i.e., considering the benefits/losses of both itself and an opponent. As a result, Masbiole can escape from Nash Equilibria and obtain better performances than conventional MAS where agents consider only their own benefits. This paper focuses on the evolutionary model of Masbiole, and its characteristics are examined especially with an emphasis on the behaviors of agents obtained by symbiotic evolution. In the simulations, two ideas suitable for the effective analysis of such behaviors are introduced; "Match Type Tile-world (MTT)" and "Genetic Network Programming (GNP)". MTT is a virtual model where tile-world is improved so that agents can behave considering their symbiotic relations. GNP is a newly developed evolutionary computation which has the directed graph type gene structure and enables to analyze the decision making mechanism of agents easily. Simulation results show that Masbiole can obtain various kinds of behaviors and better performances than conventional MAS in MTT by evolution.

Algorithms↗

PubMed2000

The importance of considering trial design when interpreting clinical trial results.

BACKGROUND: In recent decades, clinical trials have played an increasingly important role in determining how we practice. Trial results proving that a clinical finding poses risk have led to interventions that try to reduce risk. Clinical trials proving that a particular therapy provides better outcome than another therapy have changed the therapies we now use. Unfortunately, the results of clinical trials are too often affected by biases or design issues that may overtly or covertly alter the results or the way they should really be used. In addition, these biases and design and analysis issues are rarely evident in the abstract sections or key figures and tables in the publications reporting the trials, which may be all the busy physician either reads or remembers. METHODS AND MATERIALS: This manuscript discusses the issues involved in optimally understanding clinical trial design and interpretation so that practitioners can better understand how to intelligently read and apply trial results to clinical practice. CONCLUSIONS: Clinical trial results can not be properly applied without consideration of trial design features and intertrial comparisons.

Anti-Arrhythmia Agents↗

PubMed1982

Care of the patient receiving antineoplastic drugs.

Caring for patients who receive chemotherapeutic agents is among the most challenging and potentially rewarding dimensions of oncologic nursing practice. The nurse must possess sound knowledge of not only the biologic and behavioral sciences, but also of current oncologic nursing practices, pathology, and the pharmaceutics of antineoplastic drugs. However, comprehensive nursing care must counterbalance clinical expertise with sensitivity to the unique problems patients with cancer and their families experience. Because the nurse is often the only health care professional with whom the patient and family have consistent contact, clinical expertise and sensitivity are of critical importance to the well-being of patients and their families during therapy. Through accurate, ongoing assessment and identification of problems, prompt recognition of learning needs, and intelligent, supportive, and creative interventions, nurses can do much to assure that patients and families receive the comprehensive care to which they are entitled. It is the purpose of this paper to discuss essential aspects of antineoplastic drug therapy and the important role of the nurse in caring for patients receiving this type of treatment.

Antineoplastic Agents↗

PubMed2004

A multidisciplinary approach to teach responses to weapons of mass destruction and terrorism using combined simulation modalities.

STUDY OBJECTIVE: To reinforce concepts presented in the lectures; understand the complexity and speed of casualty and information generation during a Weapons of Mass Destruction and Terrorism (WMD/T) event; experience the novelty of combined weapons' effects; recognize the time course of the various chemical, biological, and radiation agents; and make challenging decisions with incomplete and conflicting information. SETTINGS: Two environments simulated simultaneously: one a major trauma center emergency room (ER) with two patient simulators and several human actors; the other an Emergency Operations Command Center (EOC). TARGET AUDIENCE: Students for this course included: clinicians, scientists, military and intelligence officers, lawyers, administrators, and logistic personnel whose jobs involve planning and executing emergency response plans to WMD/T. SIMULATION SCRIPT: A WMD/T attack in Washington, D.C., has occurred. Clinical students performed in their real life roles in the simulated ER, while nonclinical students did the same in the simulated EOC. Six ER casualties with combined WMD/T injuries were presented and treated over 40 minutes. In the EOC, each person was given his or her role title with identification tag. The EOC scenario took cues from the action in the ER via two television (TV) news feeds and telephone calls from other Emergency Operations Assets. PERFORMANCE EXPECTATIONS: Students were expected to actively engage in their roles. Student performances were self-evaluated during the debriefing. DEBRIEFING: The two groups were reunited and debriefed utilizing disaster crisis resource management tools. ASSESSMENT OF EFFECTIVENESS: Students answered an 18-point questionnaire to help evaluate the usefulness and acceptance of multimodality patient simulation. LESSONS LEARNED: Large-scale multimodality patient simulation can be used to train both clinicians and nonclinicians for future events of WMD/T. Students accepted the simulation experience and thought that scenario was appropriately realistic, complex, and overwhelming. Difficulties include the extensive man-hours involved in designing and presenting the live simulations. EOC-only sessions could be staged with only a few video cassette recorders, TVs, telephones, and callers.

Disasters↗

PubMed1984

Calcium blockers in angina. How they work, when to prescribe.

The calcium channel blocking drugs--nifedipine, verapamil, and diltiazem--are an important adjunct to treatment of typical exertional angina and are the treatment of choice for angina due to coronary artery spasm. These drugs are as effective as nitrates and beta-adrenergic blocking agents in treatment of patients with ischemic heart disease. With certain precautions, they may also be used in combination with nitrates and beta blockers. The three calcium blockers are not completely interchangeable because each has distinctive therapeutic applications and side effects. Detailed knowledge of each drug is important for its intelligent application in treatment of angina pectoris.

Adrenergic beta-Antagonists↗

PubMed1997

Ten criteria for evaluating the management of community disasters.

The discussion herein concerns important factors in the local management of disasters. We contrast this with the related but distinct process of disaster planning. Our assumption is that what is crucial is not management per se, but good management. Thus, to assess intelligently the management of community disasters requires an answer to the question: What is good management? The results of empirical research carried out by social scientists over the past 40 years are drawn upon in considering this question. The criteria identified entail: (1) correctly recognising differences between response and agent-generated demands; (2) adequately carrying out generic functions; (3) effectively mobilising personnel and resources; (4) generating an appropriate delegation of tasks and division of labour; (5) adequately processing information; (6) properly exercising decision-making; (7) developing overall coordination; (8) blending emergent and established organisational behaviours; (9) providing appropriate reports for the news media; and (10) having a well-functioning emergency operations centre. An issue also raised in the paper is how applicable these research findings-derived mostly from developed countries-are to the developing world.

Developing Countries↗

PubMed1995

Risk identification using structural concepts: the potential carcinogenicity of praziquantel.

The potential of praziquantel (PZ) to induce cancers in rodents was evaluated using a structure-activity relational expert system (CASE/MULTICASE). The analyses indicated that based upon structural features PZ had the potential for being a "nongenotoxic" carcinogen. The potential risk to humans of nongenotoxic carcinogens is considered to be much less than that posed by "genotoxic" ones. Moreover, PZ has demonstrated therapeutic effectiveness against parasitic diseases that affect millions of individuals. Additionally, PZ was developed to replace antiparasitic agents which were genotoxic rodent carcinogens. Thus, on balance, the beneficial effects of PZ appear to outweigh its potential for causing harm to humans.

Animals↗

PubMed1991

Relationships between medication treatments and neuropsychological test performance in schizophrenia.

Few investigations have assessed the neuropsychological effects of psychotropic medications on schizophrenic patients. In this study, 44 clinically stable schizophrenic inpatients were administered a battery of neuropsychological tests, and their performance was correlated with dosage of neuroleptic medication and benztropine. Neuroleptic dose was correlated with poorer performance on tests of psychomotor speed and attention, and with the number of perserverative errors on the Wisconsin Card Sort. Anticholinergic dose was associated with poorer verbal learning, verbal fluency, and motor speed. Both medication dosages were associated with poorer verbal recognition memory, but this association was strongly influenced by the performance of individuals on the highest medication doses. The findings, which were independent of clinical state and intelligence, indicate that higher doses of neuroleptic and anticholinergic medications are associated with poorer neuropsychological functioning in schizophrenia.

Adult↗

PubMed2006

Cocaine profiling for strategic intelligence purposes, a cross-border project between France and Switzerland. Part I. Optimisation and harmonisation of the profiling method.

Optimisation and harmonisation of analytical and statistical methodology have been carried out between two forensic laboratories (Lausanne, CH and Lyon, F) in order to provide drug intelligence for cross-border cocaine seizures. The aim was to improve the gas chromatographic analysis of cocaine samples for profiling. Some important validation parameters were tested to verify the developed method and demonstrate its profiling capacity: the selectivity of the method with retention time reproducibility, the choice of a derivatisation agent improving the chromatography (MSTFA, BSA, TMSI and BSTFA+TMCS 1%), the cutting agents influence (matrix effect), the influence of the sample storage conditions and the sample quantity to weigh for analyses. Eight main alkaloids, which represent the sample signature, have been selected: ecgonine methyl ester, ecgonine, tropacocaine, benzoylecgonine, norcocaine, cis- and trans-cinnamoylcocaine and 3,4,5-trimethoxycocaine. Their stability in the solvent used (CHCl(3)/pyridine) was demonstrated. In order to reach the final objective, which is the comparison of samples seized and analyzed in two different laboratories, the harmonisation of the profiling method between the two laboratories had to be ensured and is the subject of ongoing research.

Journal Article↗

PubMed2001

Consistent integration of non-reliable heterogeneous information resources applied to the annotation of transmembrane proteins.

Information agents integrate multiple distributed heterogeneous information sources. The challenging yet unsolved problem that remains, is to ensure the semantic consistency of the integrated data. In this paper we set out to develop a general approach to inconsistency management for information agents. It is implemented as part of the EDITtoTrEMBL system and applied on a large real-world problem in the domain of bioinformatics.

Amino Acid Sequence↗

PubMed2001

Artificial life simulation of living alga cells and its sorption mechanisms.

Resistance mechanisms of organisms against toxic metals are based on a few different mechanisms provided by algae cells. These mechanisms can be localized on the cell wall, on the cell wall and cytoplasm membrane, and intracellular localized mechanisms. Due to these mechanisms, algae populations could be used for sorption of arsenic from contaminated waters. This process takes a long time and it's not very variable. With artificial life simulation based on multi-agent simulation system we are preparing a simulation that could at least partially substitute the real experiments with real cells. Artificial life simulation of alga Chlorella kessleri is based on real biological parameters and together with partial implementation of other mathematical models of algae population growth it will be used for simulating the process of absorbing heavy metals from contaminated water. Model implementation is done is Swarm--multi agent object based simulation system and it's libraries. Simulation is still in testing and debugging phase and it is not yet available for public.

Adsorption↗

PubMed1993

Treatment of obsessive-compulsive disorder by psychosurgery.

We report a longitudinal study of 26 patients with medically intractable obsessive-compulsive disorder (OCD) who were treated with psychosurgery and had a comprehensive follow-up for a mean 10 years. Seventeen patients had combined orbitomedial and cingulate lesions, 6 cingulate lesions only and 3 orbitomedial lesions only. Eighteen patients were interviewed personally and lesions verified on magnetic resonance imaging scans in fourteen. On a 6-point global rating scale, 10 (38%) patients had obvious improvement, another 6 (23%) showed mild improvement of doubtful clinical value, and the remaining 10 showed either no change (n = 6; 23%) or were judged to be worse (n = 4; 15%). Both obsessive and compulsive symptoms improved, and this change was independent of the changes in anxiety and depression scores. No significant predictors of improvement were identified. Patients with cingulate lesions only fared worse. Eight patients who had a second operation did not show much improvement. A comparison of a subgroup of patients with 10 matched nonsurgical OCD controls supported the contention that the improvement in OCD was attributable to the psychosurgery. Important adverse effects in the stereotactic surgery group (n = 20) were epilepsy (1 patient) and personality change (2 patients). The psychosurgery group performed relatively poorly on the Wisconsin Card Sort Test but did not show any deterioration in Wechsler Intelligence and Memory scores.

Adult↗

PubMed2006

Neural processing of counting in evolved spiking and McCulloch-Pitts agents.

This article investigates the evolution of autonomous agents that perform a memory-dependent counting task. Two types of neurocontrollers are evolved: networks of McCulloch-Pitts neurons, and spiking integrate-and-fire networks. The results demonstrate the superiority of the spiky model in evolutionary success and network simplicity. The combination of spiking dynamics with incremental evolution leads to the successful evolution of agents counting over very long periods. Analysis of the evolved networks unravels the counting mechanism and demonstrates how the spiking dynamics are utilized. Using new measures of spikiness we find that even in agents with spiking dynamics, these are usually truly utilized only when they are really needed, that is, in the evolved subnetwork responsible for counting.

Animals↗

PubMed2005

A criticality-based framework for task composition in multi-agent bioinformatics integration systems.

MOTIVATION: During task composition, such as can be found in distributed query processing, workflow systems and AI planning, decisions have to be made by the system and possibly by users with respect to how a given problem should be solved. Although there is often more than one correct way of solving a given problem, these multiple solutions do not necessarily lead to the same result. Some researchers are addressing this problem by providing data provenance information. Others use expert advice encoded in a supporting knowledge-base. In this paper, we propose an approach that assesses the importance of such decisions with respect to the overall result. We present a way of measuring decision criticality and describe its potential use. RESULTS: A multi-agent bioinformatics integration system is used as the basis of a framework that facilitates such functionality. We propose an agent architecture, and a concrete bioinformatics example (prototype) is used to show how certain decisions may not be critical in the context of more complex tasks.

Algorithms↗

PubMedDate not supplied

Evaluation of erectile dysfunction therapy in patients previously nonadherent to long-term medications: a retrospective analysis of prescription claims.

Erectile dysfunction (ED) can lead to treatment noncompliance in patients taking medications for chronic health conditions. Using the Intelligent Health Repository, NDCHealth's longitudinal, United States health care claims database, we examined the impact of treating ED on adherence to long-term therapies in previously nonadherent patients. Male patients >or=18 years of age were identified who received antidepressant (AD), antihypertensive (AH), oral hypoglycemic (OHG), or lipid-lowering (LL) agents and initiated therapy with sildenafil citrate (Viagra) between January and June 2003. Treatment adherence was determined using medication possession ratios (MPRs) for the 12 months before and after the first prescription of sildenafil. Prior to initiation of therapy for ED with sildenafil, 64% of patients with comorbid medications were not adherent (MPR <0.8). Among these patients, 728 (27%) received AD, 2112 (78%) received AH, 984 (18%) received OHG, and 1078 (40%) received LL agents, with 66% of patients receiving multiple therapeutic classes. During the 12-month period after the first sildenafil prescription, patients had a significant increase in medication adherence compared with the 12 months before the first prescription of sildenafil (P < 0.0001). The percentage of patients who became adherent (MPR >or=0.8) with medications after sildenafil treatment was from 22% to 36%. With the exception of the LL group, there was a significant relationship between >or=3 sildenafil prescriptions and change in MPR (P < 0.05). Patients aged >or=65 years had similar improvement in MPR as patients <or=65 years. Treatment of ED with sildenafil improved adherence in patients taking common long-term medications who were previously nonadherent.

Adult↗

PubMed2000

Symptom control in the pregnant cancer patient.

While much attention has been devoted to cytotoxic drugs and radiation therapy in the pregnant cancer patient, the drugs used for management of symptoms and complications related to cancer during pregnancy have been overlooked. There is substantial overlap between the symptoms of cancer and cancer management and the symptoms related to pregnancy. The mainstay of symptom management is drug therapy and the potential for a drug to be embryotoxic or teratogenic depends on when it is given. In general, drugs not proven safe in pregnancy should be withheld, especially during the first trimester. The few drugs that have been proven to be teratogenic are alcohol, thalidomide, the folic acid antagonists (which includes methotrexate), diethylstilbestrol, and the vitamin A isomers, but there is a good deal of uncertainty about many other therapeutic agents. Placental transport of drugs from mother to fetus must be taken into consideration from the fifth week of gestation to parturition. Although the first trimester is the time of most organ development in the fetus, the brain continues to develop throughout pregnancy and may be damaged later in pregnancy, resulting in diminished intelligence or behavioral problems. This review will focus on the treatment of the most common symptoms of cancer in a pregnant patient and the potential for fetal damage.

Drug-Related Side Effects and Adverse Reactions↗

PubMedDate not supplied

Relevance of animal carcinogenesis findings to human cancer predictions and prevention.

Use of laboratory animals to identify carcinogenic potential of chemicals, mixtures, and other agents has a modern history of greater than 40 years from which much useful scientific and public health information can be derived. While laboratory animals differ from humans in some respects that may affect responses to hazardous exposures, use of such models is based on experimental evidence indicating that there are more genetic, genomic, physiological, biochemical, and metabolic similarities than differences among mammalian species. Issues of concordance of responses between rodent species and between rodents and humans as well as repeatability and site-specificity are important considerations in evaluating laboratory animal carcinogenicity results. Variables in experimental design such as animal strain, diet, route of exposure, and study, duration as well as single-site versus multisite carcinogenic responses all influence interpretation and intelligent use of study data. Similarities and differences in site-specific laboratory animal and corresponding human cancers should also be considered in study evaluation. Recent attempts to explore genetically engineered mice and to humanize the mouse for more relevant identification of carcinogen hazard identification have yielded mixed results. In the end we are confronted by the realization that virtually all animal cancer models are useful but imperfect surrogates for humans. Assuming the percentage of chemicals currently in commerce that are estimated to be potent animal or human carcinogens is quite low, the task of identifying agents with significant carcinogenic potential is daunting and important. The biological conundrum of scientific debate regarding the relevance of carcinogenicity studies in laboratory animals is likely to continue. Nonetheless public health considerations must take precedence when deciding human safety issues.

Animals↗