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PubMed1988

Helping patients decide: from Hippocrates to videodiscs--an application for patients with low back pain.

This paper outlines a modular, microcomputer and videodisc expert system, for patients with mechanical low back pain. The system incorporate facts, rules, and methods to extract data, opinions, information, and user preferences. It supports individual patient needs with a broad knowledge base, and analytical modelling techniques that connect flexible inference structures and user choices. Videodisc based expert systems help break the bottleneck in relevant medical knowledge representation. The expert system program serves the user in the capacity of teacher, confidant, interpreter, diagnostician, and adviser.

Adult↗

PubMed1989

Expert system reasoning about dynamic systems by semi-quantitative simulation.

Current symbolic knowledge representation techniques are inadequate for describing complex dynamic systems, which are time-varying and contain feedback loops. These systems are particularly difficult to represent when quantitative knowledge about the relationships within the system is incomplete. This paper describes a symbolic extension of the system dynamics method which can answer 'what if' questions about system dynamics models semi-quantitatively. The method consists of (1) definition of generic model 'building blocks' which map directly onto difference equations; (2) development of a symbolic causal model of a system in terms of the generic functional 'building blocks', any available quantitative or semi-quantitative parameters, and a set of generic default values; (3) automatic translation of the model into a system of first-order difference equations; and (4) numerical integration of the equations by standard methods. A complex model with semi-quantitative parameters, representing the human cardiovascular system, is used to illustrate the method. This method couples the descriptive abilities of mathematics with the symbolic power of causal inference methods by providing the same knowledge base for both computational levels. It also eases truth maintenance, knowledge acquisition, and explanation. It may prove useful for expert system development in a variety of application domains whose processes are time-varying and homeostatic.

Computer Simulation↗

PubMed1993

Structure design: an artificial intelligence-based method for the design of molecules under geometrical constraints.

This study presents an algorithm that implements artificial-intelligence techniques for automated, and site-directed drug design. The aim of the method is to link two or more predetermined functional groups into a sensible molecular structure. The proposed designing process mimics the classical manual design method, in which the drug designer sits in front of the computer screen and with the aid of computer graphics attempts to design the new drug. Therefore, the key principle of the algorithm is the parameterization of some criteria that affect the decision-making process carried out by the drug designer. This parameterization is based on the generation of weighting factors that reflect the knowledge and knowledge-based intuition of the drug designer, and thus add further rationalization to the drug design process. The proposed algorithm has been shown to yield a large variety of different structures, of which the drug designer may choose the most sensible. Performance tests indicate that with the proper set of parameters, the method generates a new structure within a short time.

Algorithms↗

PubMed2004

Definition and system implementation of strategies for method development of chiral separations in normal- or reversed-phase liquid chromatography using polysaccharide-based stationary phases.

This paper proposes strategies in normal- and reversed-phase liquid chromatography (NP-HPLC or NPLC and RP-HPLC or RPLC), which were developed using three polysaccharide-based stationary phases. Those strategies are implemented in a knowledge-based system for the chiral separation of drug enantiomers. Each strategy includes a screening and an optimisation stage. The screening stage allows a fast evaluation of separation possibilities and enantioselectivity for many drugs in a short period of time, while the optimisation stage gives the opportunity to enhance, if needed, the initially obtained separation. Different examples demonstrate the effectiveness of the strategies for fast method development.

Chromatography, High Pressure Liquid↗

PubMed2005

Folkbiology of freshwater fish.

Cross-cultural comparisons of categorization often confound cultural factors with expertise. This paper reports four experiments on the conceptual behavior of Native American and majority-culture fish experts. The two groups live in the same general area and engage in essentially the same set of fishing-related behaviors. Nonetheless, cultural differences were consistently observed. Majority-culture fish experts tended to sort fish into taxonomic and goal-related categories. They also showed an influence of goals on probes of ecological relations, tending to answer in terms of relations involving adult fish. Native American fish experts, in contrast, were more likely to sort ecologically. They were also more likely to see positive and reciprocal ecological relations, tending to answer in terms of relations involving the full life cycle of fish. Further experiments support the view that the cultural differences do not reflect different knowledge bases but rather differences in the organization and accessibility of knowledge. At a minimum the results suggest that similar activities within a well-structured domain do not necessarily lead to common conceptualizations.

Adult↗

PubMedDate not supplied

Genetic discoveries and nursing implications for complex disease prevention and management.

The purpose of this article is to examine the management of patients with complex diseases, in light of recent genetic discoveries, and to explore how these genetic discoveries will impact nursing practice and nursing research. The nursing science processes discussed are not comprehensive of all nursing practice but, instead, are concentrated in areas where genetics will have the greatest influence. Advances in genetic science will revolutionize our approach to patients and to health care in the prevention, diagnosis, and treatment of disease, raising many issues for nursing research and practice. As the scope of genetics expands to encompass multifactorial disease processes, a continuing reexamination of the knowledge base is required for nursing practice, with incorporation of genetic knowledge into the repertoire of every nurse, and with advanced knowledge for nurses who select specialty roles in the genetics area. This article explores the impact of this revolution on nursing science and practice as well as the opportunities for nursing science and practice to participate fully in this revolution. Because of the high proportion of the population at risk for complex diseases and because nurses are occupied every day in the prevention, assessment, treatment, and therapeutic intervention of patients with such diseases in practice and research, there is great opportunity for nurses to improve health care through the application (nursing practice) and discovery (nursing research) of genetic knowledge.

Ecology↗

PubMed1999

Human longevity: an evolutionary approach.

Humans are unique in having a considerably longer life span post female reproductive age as compared to other primates. It is proposed that transmission of knowledge from grandparents to progeny served as a driving force for extending human longevity. It is suggested that grandparents and grandchildren have evolved adaptive complementary behaviors that fit the educator/pupil roles. Older individuals specifically retain the ability to preserve their knowledge base that allows them to focus on transmitting to children knowledge accumulated over generations. A repair management model of aging is proposed, according to which inhibition of repair in older individuals at times of stress allows to focus resources on the task at hand. Such an adaptation will inevitably accelerate the rate of aging in animals and in humans and will appear as 'programmed aging'. It is further suggested that in humans, older individuals in early societies who are no longer useful could increase their reproductive success by activating this programmed aging mechanism, which would result in channeling resources to progeny. Decreased emotional support and mastery are mortality risk factors in the elderly, supporting this hypothesis of programmed death in humans, and providing a rationale for increasing longevity.

Aged↗

PubMed2000

Modeling DNA deformations.

Recent developments have been made in modeling double-helical DNA at four levels of three-dimensional structure: the all-atom level, whereby an oligonucleotide duplex is surrounded by a shroud of solvent molecules; the base-pair level, with explicit backbone atoms; the mesoscopic level, that is, a few hundred base pairs, with the local duplex conformation described by knowledge-based harmonic energy functions; and the scale of several thousand nucleotides, with the duplex described as an ideal elastic rod. Predictions of the sequence-dependent bending and twisting of the double helix, as well as solvent- and force-induced B-->A and over-stretching conformational transitions, are compared with experimental data. These subtle conformational changes are critical to the functioning of the double helix, including its packaging in the close confines of the cell, the mutual fit of DNA and protein in nucleoprotein complexes, and the effective recognition of base pairs in recombination and transcription.

Animals↗

PubMed2002

Coping styles as correlates of health in high school students.

PURPOSE: To study a large, population-based sample of adolescents with the goal of expanding our knowledge base about the relationship of coping and health outcomes. METHOD: We examined 1769 nonclinical, high school students (48% girls, mean age 16 years, predominantly white) using one class period to establish a link between coping styles, health problems, and health risk behaviors. Instruments employed included the Coping Response Inventory - Youth form (abbreviated version) and the Juvenile Wellness and Health Survey. ANCOVAs were used to test the main effects of coping typology, gender, and their interaction on the five health domains. RESULTS: Findings were consistent with previous research and showed that approach coping correlated negatively with indicators of health problems and health risk behaviors, while avoidance coping correlated positively with these domains. The presence of both forms of coping mitigated the negative effects of avoidance coping. CONCLUSION: As early as mid-adolescence, habitual coping styles appear to be associated with significant health outcomes. In screening nonclinical samples the clinician can rely on habitual coping styles as indicators of potential health problems.

Adaptation, Psychological↗

PubMed2007

The PharmGKB: integration, aggregation, and annotation of pharmacogenomic data and knowledge.

The Pharmacogenetics and Pharmacogenomics Knowledge Base, PharmGKB (http://www.pharmgkb.org), curates pharmacogenetic and pharmacogenomic information to generate knowledge concerning the relationships among genes, drugs, and diseases, and the effects of gene variation on these relationships. PharmGKB curators collect information on genotype-phenotype relationships both from the literature and from the deposition of primary research data into our database. Their goal is to catalyze pharmacogenetic and pharmacogenomic research.

Biomedical Research↗

PubMed2001

Electronic documentation in endoscopy: present status and future perspectives from a company standpoint.

At the beginning of the development of endoscopic information systems all companies were technology-oriented. Today, we see a change from technology to content orientation, the same development which is seen in internet technology. In future systems, it will not be the software that makes a difference but the contents. Contents means not only patient data but also algorithms for feature extraction within large databases with reference images, for example [20]. The automatic recognition of features, such as a complication rate that is too high or a correlation of a certain disease with an endoscopic finding, will be part of a content-based approach. It means that content will also be the knowledge base which has to be developed for future systems. The system of the future will be much more intelligent and less software technology-oriented.

Computer Communication Networks↗

PubMedDate not supplied

Knowledge discovery in biology and biotechnology texts: a review of techniques, evaluation strategies, and applications.

Arguably, the richest source of knowledge (as opposed to fact and data collections) about biology and biotechnology is captured in natural-language documents such as technical reports, conference proceedings and research articles. The automatic exploitation of this rich knowledge base for decision making, hypothesis management (generation and testing) and knowledge discovery constitutes a formidable challenge. Recently, a set of technologies collectively referred to as knowledge discovery in text (KDT) has been advocated as a promising approach to tackle this challenge. KDT comprises three main tasks: information retrieval, information extraction and text mining. These tasks are the focus of much recent scientific research and many algorithms have been developed and applied to documents and text in biology and biotechnology. This article introduces the basic concepts of KDT, provides an overview of some of these efforts in the field of bioscience and biotechnology, and presents a framework of commonly used techniques for evaluating KDT methods, tools and systems.

Algorithms↗

PubMed2002

The SBASE protein domain library, release 9.0: an online resource for protein domain identification.

SBASE (http://www.icgeb.trieste.it/sbase) is an online resource of protein domain sequences designed to facilitate detection of domain homologies based on a simple database search. The ninth release of the SBASE library of protein domain sequences contains 320 000 annotated structural, functional, ligand-binding and topogenic segments of proteins clustered into over 3481 domain groups and 483 protein families. Domain identification and functional prediction are based on a comparison of BLAST search outputs with a knowledge base of within-group ('self') and out-of-group ('non-self') similarities of the known domain groups. This is a memory-based approach wherein class-specific similarity functions are automatically learned from the database [Stanfill,C. and Waltz,D. (1986) COMMUN: ACM, 29, 1213-1228].

Animals↗

PubMed1996

User involvement in the nursing curriculum: seeking users' views.

This qualitative study considers the views of users of mental health services on a pre-registration nursing curriculum. Semistructured group interviews were used to gain the (illustrative) views of twenty members of two user groups on nursing knowledge, skills and qualities. Interest in users' views has generally been belated or reluctant. In more recent literature, statements emerge about the need to develop a climate of respect, acceptance and sensitivity. While nurses have a central role in mental health care, a detailed examination from the user's perspective has been lacking. Despite the rhetoric of involvement, commentaries on nursing practice suggest little has changed. Findings suggest an eclectic knowledge base that respects individual differences and the user's experience, knowledge of local communities, and better recognition of physical illness is required. 'Knowledge of life' is seen as important. An emphasis on interpersonal skills is suggested, including flexible responses, information-giving, and sensitive handling of tense situations. This should be balanced against 'practical' nursing. Traditional teaching in relation to 'psychotic' experiences is challenged. It is suggested that caring should be emphasized as much as 'rational knowledge'. Developing responsive qualities that minimize 'distancing' may demand a reevaluation of boundaries between user and professional.

Attitude to Health↗

PubMedDate not supplied

How nurses make decisions regarding patient medication.

This study seeks to identify the cues used by nurses which enable them to make decisions regarding the administration of medication. The knowledge base which underpins practice is explored and the relationship between knowledge and practice is considered. The rationale for this study was provoked by the possibility that nurses may be given limited prescribing powers. If this becomes a reality, the nurse's role will involve high level decision making (Morris, 1994). It could be that, in the future, changes in the law on drug administration will affect all nurses on the professional register.

Adult↗

PubMed2006

Dissociative symptomatology in posttraumatic stress disorder and disorders of extreme stress.

The present study was designed to assess differences in dissociative symptoms in adults with Posttraumatic Stress Disorder (PTSD) vs. PTSD plus Disorders of Extreme Stress Not Otherwise Specified (DESNOS). This study was done for two reasons: (1) to better understand the clinical profile of DESNOS clients in order to inform more effective treatment, and (2) to further empirical research on the validity of the DESNOS construct. To assess severity of dissociative symptoms, the authors administered the Dissociative Experiences Scale (DES) to 155 participants with PTSD. Using the Structured Interview for Disorders of Extreme Stress (SIDES), participants were divided into two groups: those who also met criteria for DESNOS and those who did not. DES means are provided for the two groups. Participants with PTSD plus DESNOS scored higher than participants with only PTSD on the measure of dissociative symptomatology, particularly on the DES scales that tap absorption/fantasy and depersonalization/derealization. The two groups did not differ on the amnesia subscale of the DES. Findings support the construct validity of the DESNOS concept and further delineate the clinical profiles of community-based PTSD with and without DESNOS, thus contributing to the knowledge base on the assessment of complex adaptations to trauma.

Adolescent↗

PubMed1997

The WISECARE Project and the impact of information technology on nursing knowledge.

The European Union retained the WISECARE project "Work flow Information Systems for European nursing CARE" for funding. The project focuses on the use of telematics technology for clinical and resource management in oncology care in hospitals. This paper outlines the impact of introducing this kind of advanced nursing informatics application on the management of nursing knowledge. Three shift in knowledge management that will get high attention in WISECARE, are identified. The first is the shift from knowledge dissemination to knowledge sharing. The second is the shift from individual knowledge to organisational knowledge. The third is the shift from deductive, prescriptive knowledge as seen in guidelines, protocols to more inductive, experience based knowledge. The paper emphasizes that the real impact of information technology is not in the automation of existing processes but on the discovery of new ways of organisation and living.

Diffusion of Innovation↗

PubMed2001

Patient safety in guideline-based decision support for hypertension management: ATHENA DSS.

The Institute of Medicine recently issued a landmark report on medical error.1 In the penumbra of this report, every aspect of health care is subject to new scrutiny regarding patient safety. Informatics technology can support patient safety by correcting problems inherent in older technology; however, new information technology can also contribute to new sources of error. We report here a categorization of possible errors that may arise in deploying a system designed to give guideline-based advice on prescribing drugs, an approach to anticipating these errors in an automated guideline system, and design features to minimize errors and thereby maximize patient safety. Our guideline implementation system, based on the EON architecture, provides a framework for a knowledge base that is sufficiently comprehensive to incorporate safety information, and that is easily reviewed and updated by clinician-experts.

Artificial Intelligence↗