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At least 145 records · Page 8Linked to original sources

Modeling microbial growth within food safety risk assessments.

Risk estimates for food-borne infection will usually depend heavily on numbers of microorganisms present on the food at the time of consumption. As these data are seldom available directly, attention has turned to predictive microbiology as a means of inferring exposure at consumption. Codex guidelines recommend that microbiological risk assessment should explicitly consider the dynamics of microbiological growth, survival, and death in foods. This article describes predictive models and resources for modeling microbial growth in foods, and their utility and limitations in food safety risk assessment. We also aim to identify tools, data, and knowledge sources, and to provide an understanding of the microbial ecology of foods so that users can recognize model limits, avoid modeling unrealistic scenarios, and thus be able to appreciate the levels of confidence they can have in the outputs of predictive microbiology models. The microbial ecology of foods is complex. Developing reliable risk assessments involving microbial growth in foods will require the skills of both microbial ecologists and mathematical modelers. Simplifying assumptions will need to be made, but because of the potential for apparently small errors in growth rate to translate into very large errors in the estimate of risk, the validity of those assumptions should be carefully assessed. Quantitative estimates of absolute microbial risk within narrow confidence intervals do not yet appear to be possible. Nevertheless, the expression of microbial ecology knowledge in "predictive microbiology" models does allow decision support using the tools of risk assessment.

Bacteria↗

Conceptual integration of information databases into an Intranet.

Large information systems handle massive volume of data stored in heterogeneous sources of information. Each server has its own model of concepts representation with regard to its aims. One of the main problems encountered by end-users when accessing different servers is to match their own viewpoint on biomedical concepts with their various representations that are made in the database servers. The aim of the project ARIANE is to provide end-users with easy-to-use and natural means to access and query heterogeneous information databases. The objectives of this research work consist in building a conceptual interface by means of the Internet technology inside an enterprise Intranet, and to propose a method to realize it. Moreover, this method provides designers of web sites with a powerful tool to manage them on the basis of an ontology of the biomedical domain. This method is based on the knowledge sources provided by the Unified Medical Language System project of the U.S. National Library of Medicine and exploits intensively the conceptual graphs theory.

Computer Communication Networks↗

[Why controlled studies may lead to misleading and unconfirmed therapeutic concepts--a critical view of evidence-based medicine].

The concept of evidence-based medicine has gathered widespread support during recent years. While this concept has clear merits in compiling and qualifying up-to-date information for clinical decisions, it should be viewed with caution as the sole valid knowledge source for clinical decision-making. The limitations of such an approach are particularly striking when reviewing two key developments in modern cardiology, fibrinolysis and acute percutaneous intervention in acute myocardial infarction. In both cases, early studies and meta-analyses showed no benefit for these therapeutic interventions over earlier treatment. Only after further refinement (mainly in dosage, time window, concomitant heparin therapy for fibrinolysis, and the introduction of stents and IIb/IIIa inhibitors for acute intervention) did these therapies become universally acknowledged. It is therefore crucial to understand that especially for physicians actively participating in the development of a clinical field clinical decisions cannot be exclusively based on published evidence. Another important problem to consider is the time gap between the emergence of new therapies and the publication and reception by the medical audience, in particular in rapidly evolving fields as cardiology. While it is clear that clinical decision-making must be backed by solid knowledge of the published evidence, in particular the specialist involved in-depth in the field may use not yet proven therapeutic concepts and measures to the patient's advantage.

Angioplasty, Balloon, Coronary↗

Attitudes to water fluoridation in South Africa 1998. Part I. Analysis by age, sex, population and province.

The successful implementation of water fluoridation (WF) depends upon support from the public. A survey was conducted in 1998 by the Human Sciences Research Council to assess attitudes of the South African population towards WF. A representative sample of 2,220 persons over the age of 18 years was interviewed. Questions relating to current knowledge, sources of information, the purpose of water fluoridation and its desirability as a public health measure were put to respondents. Only 25% of the population had heard or read of WF. The major sources of information were the electronic and printed media (40% and 27% respectively), while 2.5% heard about it from dentists. Just over a third of the sample (35.5%) identified the purpose of WF as protecting teeth from decay; 28% said it was to purify water and 28.5% were uncertain of, or did not know its purpose. Nearly two-thirds (61.9%) indicated that fluoride should be added to drinking water if it can reduce tooth decay, while 9% were not in favour and 29% were uncertain. The results suggest that most people do not know what WF is or does, though most were in agreement that it should be implemented to reduce tooth decay.

Adolescent↗

When is schematic knowledge used in source monitoring?

Source monitoring involves judgments regarding the origin of information (M. K. Johnson, S. Hashtroudi, & D. S. Lindsay, 1993). When participants cannot remember the source in a source-monitoring task, they may guess according to their prior schematic knowledge (U. J. Bayen, G. V. Nakamura, S. E. Dupuis, & C.-L. Yang, 2000). The present study aimed at specifying conditions under which schematic knowledge is used in source monitoring. The authors examined the time course of schema-based guesses with a response-signal technique (A. V. Reed, 1973), and multinomial models that separate memory and guessing bias. Use of schematic knowledge was observed only when asymptotic old-new recognition was low. The time course of schematic-knowledge retrieval followed an exponential growth function. Implications for theories of source monitoring are discussed.

Adolescent↗

Knowledge-based cephalometric analysis: a comparison with clinicians using interactive computer methods.

In modern orthodontic practice great reliance is placed on systematic and objective methods of characterizing craniofacial forms, using measurements based on both hard and soft tissue landmarks. Lateral skull X-ray images are routinely used in cephalometric analysis to provide quantitative measurements useful to clinical orthodontists. It is argued that a model- and knowledge-based methodology provides the best approach in successfully interpreting digitized lateral skull radiographs. A rule-based segmentation system, making use of an image appearance model, is used to extract image features from gray-level images. Complex image features and cephalometric landmarks are constructed from these segmented component features. A predictive model, defining picture structure, allows location hypotheses to be made for image features. The underlaying structure of the location model provides the basis for a geometric constraint model of use in discriminating between image feature candidates. A blackboard system is used to organize these tasks hierarchically, with individual knowledge sources grouped according to function and the individual stages of the adopted image interpretation cycle. Quantitative results demonstrate the superiority of this complex system over its component segmentation system run on its own. Comparisons with clinicians demonstrate both the strengths and the weaknesses of the present system. Comparisons with previous systems are favorable.

Cephalometry↗

[Physicians, internet and new knowledge. Utilization and efficiency of new continuing education media in the hospital].

BACKGROUND AND OBJECTIVES: The application of new information technologies will have a lasting impact on the physicians' working environment. Not only will classic learning methods change, but also ways of communication and strategies to find relevant information. This survey is designed to demonstrate current methods of and demand for continuing medical education and communication. METHODS: 110 participating physicians (26% female, 74% male) in nine different regional hospitals were asked regarding "continuing medical education", "communication" and "use of computerized technology". RESULTS: Most physicians regard their colleagues, scientific journals, textbooks and scientific meetings as most useful. The internet, scientific staff at research institutions and pharmaceutical representatives were valued as less useful. Physicians regarded scientific basis, speed and user-friendliness as the most important features of potential data and knowledge sources. Case specificity, German language and interactivity were viewed as less important. Most physicians expressed a growing need for education regarding use of e-mail as a communication tool and internet research techniques. CONCLUSION: Continuing medical education is in strong demand. The successful introduction of modern information technologies into physicians' daily work may and should be enhanced by specifically tailored training courses.

Adult↗

The completeness of existing lexicons for representing radiology report information.

Although most medical lexicons contain up to 80% of clinical terms used in an ambulatory patient medical records archive, preliminary research suggests that they may be far less complete for radiology terms. We therefore compared the likelihood that several existing medical lexicons would contain terms found in a radiology report to the likelihood they would contain terms found in an ambulatory care medical record. We used three samples of imaging terms to assess the completeness of existing lexicons for medical imaging: (1) a random sample of imaging terms from the Unified Medical Language System Large Scale Vocabulary Test (UMLS-LSVT; n = 218), (2) terms actually used in the first 80 clinical knee magnetic resonance imaging reports generated by the routine clinical use of a structured reporting system (eDictation, Marlton, NJ; n = 76), and (3) terms listed in a glossary of thoracic imaging prepared by the Fleischner Society (n = 173). Using the UMLS Web-based Knowledge Source Server (http://umlsks.nlm.nih. gov/), we measured the rate at which terms in each of the above three sources were found in the UMLS and two of its major constituent terminologies: ICD-9-CM and SNOMED International. ICD-9-CM contained matches for 3%, 8%, and 11% of terms from the Fleischner Society Glossary, eDictation, and NLM-LSVT, respectively. SNOMED International contained matches for 32%, 46%, and 36% of terms from the Fleischner Society Glossary, eDictation, and NLM-LSVT, respectively. The UMLS contained matches for 36%, 50%, and 45% of terms from the Fleischner Society Glossary, eDictation, and NLM-LSVT, respectively. The assessed vocabularies were least likely to contain a term from the Fleischner Society Glossary and most likely to contain a term from the eDictation lexicon. The UMLS was the most complete, and ICD-9 was the least complete of the three systems evaluated. No lexicon achieved greater than 50% completeness for any test set of imaging terms. Our results show that no single lexicon is sufficiently complete to allow comprehensive indexing, search, and retrieval of radiology report information. These results confirm the few results available from the medical literature indicating that existing controlled vocabularies are insufficiently complete to represent the contents of radiology reports. A subjective analysis of these results may identify particular imaging sub-areas for which new terms should be developed.

Humans↗

Use of condoms as contraceptive and disease preventive measures among residents of Jos, northern Nigeria.

The effectiveness, acceptability and protective aspects of condoms as both contraceptive and disease control measures was evaluated in 168 male residents of Jos in Nigeria. They were aged between 15 and 40 years and were attending the Family Planning Clinic of the Jos University Teaching Hospital. The results showed that the majority (87.5%) of our patients were in the 21 to 30 years age group and most of the clients had used condoms for between 1 to 5 years. A good number of our clients (40.5%) used condom because it protects them against venereal disease while others felt it was safe and effective. The Family Planning Clinic was the main source of knowledge of the condom among our clients (42.9%), and the condom was rated as good or excellent by 137 (81.5%) clients. The only side effect of condom usage which featured prominently among our clients was reduced sexual excitement. The results were compared with studies carried out elsewhere. It was concluded that the condom could be an acceptable and effective form of contraception in this population. The users must, however, be highly motivated so as to use it during every act of coitus for optimal efficacy.

Adolescent↗

Free text analysis.

In the context of hospital information systems (HIS) medical free text analysis is reviewed with respect to current automated approaches to literature retrieval, case retrieval and fact retrieval from textual data in the patient record. The Unified Medical Language System (UMLS) project has enormously stimulated current research. It is expected that UMLS knowledge sources and SNOMED III (which need a translation into other languages as soon as possible) as well as the conceptual graphs formalism, could become standards to utilize free text information contained in HIS databases.

Abstracting and Indexing↗

The role of the UMLS in 'storing' and 'sharing' across systems.

We will argue that 'sharing', 're-use', 're-purposing', and 'addition' of health care information is difficult, intrinsically; that the best way to overcome the difficulty is to start doing it, as soon as possible, and that the UMLS Knowledge Sources provide the best place to start. We recommend that the UMLS be used as a default source of biomedical concept names and relationships, as a comprehensive, data-based, 'reference model', and as an example of a large, ecumenical, evolving, continuously updated source of re-usable health care information.

Computer User Training↗

The cross-reactivity of IgE antibodies with pollen allergens. II. Analyses of various species of ragweed and other fall weed pollens.

Although the antigenic composition of short ragweed pollen has been extensively investigated, very few studies have analyzed the allergenic cross-reactivity among various types of ragweed pollens. Using a serum pool from patients sensitive to short ragweed, we studied the cross-reactivity of IgE antibodies to six ragweeds by the radioallergosorbent test. Extracts were analyzed for their inhibitory activities with solid-phase allergens prepared from all of the ragweed pollens. Also, samples of serum were absorbed with the various solid-phase allergens and the reactivity of the remaining IgE antibodies was determined. Two patterns of reactivity were observed. Short, giant, western, and false ragweeds displayed comparable reactivity in both inhibition and absorption experiments. Slender and southern ragweed were considerably less active, indicating that they lacked allergenic groupings possessed by the other species. These same patterns of cross-reactivity were found using ragweed pollens from four commercial sources. Knowledge of these patterns of cross-allergenicity is of importance for diagnosis and treatment of sensitive patients as well as for in vitro standardization of extracts.

Absorption↗

Overcoming deficiencies of the rule-based medical expert system.

One of the current deficiencies of the rule-based expert system is its static nature. As these systems are applied to medicine, this shortcoming becomes accentuated by: the rapid speed at which new knowledge is generated, the regional differences associated with the expression of many diseases, and the rate at which patient demographics and disease incidence change over time. This research presents a solution to the static nature of the rule-based expert system by proposing a hybrid system. This system consists of an expert system and a statistical analysis system linked to a patient database. The additional feature of a rule base manager which initiates automatic database analysis to refresh the statistical correlation of each rule ensures a dynamic, current, statistically accurate rule base. The philosophical differences between data and knowledge are also addressed as they apply to this type of hybrid system. The system is then used to generate four rule bases from different knowledge sources. These rule bases are then compared.

Artificial Intelligence↗

Facial cutaneous reconstructive surgery: facial flaps.

Basic principles of aesthetics and function important for successful facial cutaneous reconstructive surgery with local flaps include the use of appropriate tissue donor sources, knowledge of the mechanisms, dynamics, and effects of tissue movement, and techniques for scar camouflage. Useful flaps for defects in each of the facial cosmetic units are reviewed with these principles used as guidelines.

Cheek↗

Evaluation of two different models of semi-automatic knowledge acquisition for the medical consultant system CADIAG-II/RHEUMA.

As part of a plan to promote semi-automatic knowledge acquisition for the medical consultant system CADIAG-II/RHEUMA, this study sought to explore and cope with the variability of results that may be anticipated when performing knowledge acquisition with patient data from different patient settings. Patient data were drawn both from a published study for the classification of rheumatoid arthritis (RA) and from a large database of rheumatological patient charts developed for the CADIAG-II/RHEUMA system. An analysis of the relationships between RA and selected CADIAG-II/RHEUMA symptoms was done using two models. In one of them, we controlled for the differences in baseline frequencies of symptoms and diseases in the two study populations as an important factor influencing the results of the calculations. Other factors that were identified included inconsistent definitions of symptoms and diseases, and the different composition of study groups in the two study populations. By eliminating differences in baseline frequencies as the most important bias, the results obtained from the two different knowledge sources became more consistent. All remaining inconsistencies and uncertainties about the contribution and relative importance of the factors were formalized using fuzzy intervals.

Arthritis, Rheumatoid↗

Case-based reasoning in IVF: prediction and knowledge mining.

In vitro fertilization (IVF) is a medically-assisted reproduction technique, enabling infertile couples to achieve successful pregnancy. Given the unpredictability of the task, we propose to use a case-based reasoning system that exploits past experiences to suggest possible modifications to an IVF treatment plan in order to improve overall success rates. Once the system's knowledge base is populated with a sufficient number of past cases, it can be used to explore and discover interesting relationships among data, thereby achieving a form of knowledge mining. The article describes the TA3IVF system--a case-based reasoning system which relies on context-based relevance assessment to assist in knowledge visualization, interactive data exploration and discovery in this domain. The system can be used as an advisor to the physician during clinical work and during research to help determine what knowledge sources are relevant for a treatment plan.

Artificial Intelligence↗

Medical knowledge reengineering--converting major portions of the UMLS into a terminological knowledge base.

We describe a semi-automatic knowledge engineering approach for converting the human anatomy and pathology portion of the UMLS metathesaurus into a terminological knowledge base. Particular attention is paid to the proper representation of part-whole hierarchies, which complement taxonomic ones as a major hierarchy-forming principle for anatomical knowledge. Our approach consists of four steps. First, concept definitions are automatically generated from the metathesaurus, with LOOM as the target language. Second, integrity checking of the emerging taxonomic and partonomic hierarchies is automatically carried out by the terminological classifier. Third, terminological cycles and inconsistencies are manually eliminated and, in the last step, the knowledge base built this way is incrementally refined by a medical expert. Our experiments were run on a terminological knowledge base which is composed of 164,000 concepts and 76,000 relations. Empirical evidence for the lack of logical consistency, adequacy and improper granularity of the UMLS knowledge source is given, and finally, assessments of what kind of efforts are needed to render the formal target representation structures complete and empirically adequate.

Anatomy↗

Development of a cross-thesaurus with Internet-based refinement supported by UMLS.

Combinatorial terminological systems are appearing, to solve the issues related to flexibility and precision of representation requested by modern healthcare information systems and in particular by messaging standards. The development of a robust system of descriptors ('cross-thesaurus') is a crucial activity in the production of combinatorial terminological systems. We developed a tool (I-BROWSE) to produce a cross-thesaurus by analysing existing terminological corpora. To facilitate the work of experts and to produce re-usable results, our application interacts via the Internet with the UMLS Knowledge Sources Server. We applied our tool on 6372 dissections on surgical procedures produced in the project GALEN-IN-USE, as a part of the internal Quality Assurance Program. Support from UMLS seems mostly promising about descriptors on , , and . Additional assistance can be given to domain experts on less frequent descriptors on pervasive modifiers. We plan to apply our tool also to production of terminological standards in CEN, as a part of a world-wide process of gradual convergence and transformation of coding systems into second-generation systems and terminological services.

Databases as Topic↗