bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Separation of Reviewing Knowledge from Medical Knowledge
Authors: Musen M. A. , van der Lei J. 
Published: March 2018

Abstract:The developers of reviewing systems that rely on computer-based patient-record systems as a source of data need to model reviewing knowledge and medical knowledge. We simulate how the same medical knowledge could be entered in four different systems: CARE, the Arden syntax, Essential-attending and HyperCritic. We subsequently analyze how the original knowledge is represented in the symbols or syntax used by these systems. We conclude that these systems provide different alternatives in dealing with the vocabulary provided by the computer-based patient records. In addition, the use of computer-based patient records for review poses new challenges for the content of that record: to facilitate review, the reasoning of the physician needs to be captured in addition to the actions of the physician.
Medical Informatics: A Key to the Future of Medicine and Health Care?
Authors: Haux R. 
Published: March 2018

Abstract:Commenting on the paper of Heathfield and Wyatt (The Road to Professionalism in Medical Informatics: A Proposal for Debate. Methods of Information in Medicine 1995) argued that Medical Informatics as a scientific discipline has reached a professional status. However, depending on the geographic location and the field of research, education or applications, requirements for further “professionalization” differ. It is proposed that Medical Informatics and Health Informatics should be regarded as one discipline and that Medical Informatics has to contribute to research, education and to the practice of health care in order to improve diagnostics, therapy and health care organization. The future of Medical Informatics is strongly dependent on health care professionals, who must be well-educated in medical informatics; these may be physicians, nurses, health care administrators, specialists in medical informatics, or others. There is still a continuing need for the systematic processing of data, information and knowledge in medicine and in health care. Also, due to its essentially cross-sectional nature encompassing most other disciplines in medicine and health sciences, Medical Informatics must be regarded as a key to the future of medicine and health care.
Potholes in the Road to Professionalism in Medical Informatics
Authors: Miller R. A. , Giuse D. A. 
Published: March 2018

Abstract:Heathfield and Wyatt’s article in the current issue of Methods opens a debate about the status of Medical Informatics as a discipline and as a profession. While the desire for more professionalism of Medical Informatics is laudable, certain points in the article are debatable. Based on widely circulated definitions of profession and science, on the thousands of people who make medical informatics their main occupation, and on at least 10,000 peer-reviewed publications, the authors argue that the discipline is already a profession, albeit a fledgling one. Contrary to the positions of Heathfield and Wyatt, exemplary, long-lasting medical informatics applications demonstrate that the best artifacts of medical informatics already meet the most important requirement for professionalism, i. e., the commitment to clients and the public to perform a socially useful function.
Graphical Non-Linear Representation of Multi-Dimensional Laboratory Measurements in their Clinical Context
Authors: Hoeke J. O. O. , Gelsema E. S. , WuIkan R. W. , Leijnse B. 
Published: March 2018

AbstractA polygon-based graphical representation of laboratory test results using non-linear scaling is described. It is argued that the non-linearity of the scale and the use of colors in the representation facilitates interpretation of the test result in its relationship to the standard reference range and critical clinical decision levels. Preliminary results suggest that this representation may be fruitfully used to enhance the efficiency of the information transfer from the clinical chemistry laboratory to clinicians. Other applications, inside as well as outside the medical field, may easily be imagined.
Combining Physiologic Models and Symbolic Methods to Interpret Time-Varying Patient Data*
Authors: Kahn M. G. , Fagan L. M. , Sheiner L. B. 
Published: March 2018

AbstractThis paper describes a methodology for representing and using medical knowledge about temporal relationships to infer the presence of clinical events that evolve over time. The methodology consists of three steps: (1) the incorporation of patient observations into a generic physiologic model, (2) the conversion of model states and predictions into domain-specific temporal abstractions, and (3) the transformation of temporal abstractions into clinically meaningful descriptive text. The first step converts raw observations to underlying model concepts, the second step identifies temporal features of the fitted model that have clinical interest, and the third step replaces features represented by model parameters and predictions into concepts expressed in clinical language. We describe a program, called TOPAZ, that uses this three-step methodology. TOPAZ generates a narrative summary of the temporal events found in the electronic medical record of patients receiving cancer chemotherapy. A unique feature of TOPAZ is its use of numeric and symbolic techniques to perform different temporal reasoning tasks. Time is represented both as a continuous process and as a set of temporal intervals. These two temporal models differ in the temporal ontology they assume and in the temporal concepts they encode. Without multiple temporal models, this diversity of temporal knowledge could not be represented.
Correspondence Analysis for Quantification in Electron Energy Loss Spectroscopy and Imaging
Authors: Beckers A. L. D. , Sorber C. W. J. , de Bruijn W. C. , Gelsema E. S. 
Published: March 2018

Abstract:Electron energy loss spectroscopy (EELS) is a technique to investigate the physical properties of material. Using this technique it is possible to detect the presence of a specific element in a specimen. When used in combination with an electron microscope, energy filtered images may be obtained, which in principle may be used to quantify the local element concentration. This involves a process of background correction, conventionally performed assuming a specific parametric behavior of the spectral intensity as a function of electron energy loss. In this article a parameter-free method is described for background correction based on the formalism of correspondence analysis. Such a method may be used in parts of the spectrum where the functional dependence of the spectral intensity is unknown. Use of this method for element detection has been suggested before. This article reports simulation experiments suggesting its suitability for quantitative determination of element distributions and element concentrations.
Test Selection in Jaundice: A Comparison between Physician Behavior and a Diagnostic Model
Authors: Wilson J. H. P. , Habbema J. D. F. , Segaar R. W. 
Published: March 2018

Abstract:The results of an observational study aimed at a formal assessment of clinicians’ test-selection behavior are presented. We first make a proposal for diagnostic test usage in the latter phases of jaundice diagnosis. Next we compute a probabilistic estimate of the patient diagnosis, based on the COMIK algorithm. From the proposal and the probabilistic estimate we can predict the “test-selection behavior” of clinicians. The assessment follows from a tabulation of the predicted behavior against the tests selected by clinicians. It is shown that for most tests, the predictions are consistent with the observed test-selection behavior at a statistically significant level. Discussions of discrepancies between prediction and observation, and reasons for deviations from general guidelines, provide new dimensions for medical education. The methodology applied is a useful tool to improve medical care for the jaundiced patient.
Graphic Summaries of Expert Knowledge for the Medical Curriculum: An Experiment in Second-Year Nephrology
Authors: Preiss B. , Black R. , Caron C. , Shapcott D. 
Published: March 2018

Abstract:This study was conducted to test the effects of Concept Graphics on learning in clinical nephrology. Second-year medical students were exposed to summaries of the major renal pathologies presented as text with, or without Concept Graphics for 30 minutes, followed by a quiz. Concept Graphics summarize diagnoses using icons that are metaphors of objects or processes. Of nine quiz questions, five were classified as correlation questions and four as memorization questions. The experimental group (n = 39) performed better than the controls (n = 33) in answering the correlation questions (p = 0.018). The experimental group mentioned more frequently than the controls two pathognomonic criteria of the nephritic syndrome (p = 0.02). Results of an opinion poll of the students, comparing sources used in their studies of nephrology were treated by correspondence analysis; the Concept Graphics ranked closest to the classification “very useful”.
Study and Applications of an Informational Measure of Dependence in Survival Models
Authors: EI Hasnaoui A. , Jais J. P. 
Published: March 2018

Abstract:In survival models, when the factor of interest is a continuous variable or is expressed through a group of several variables, the classical measures of risk, i. e. relative risk and odds ratio, are not appropriate and there is no standard measure of dependence between survival and the considered factor. The Information Gain has been proposed by Linfoot (1957) and Kent (1983), giving any parametric model as a generalization of the squared product-moment correlation coefficient of the linear regression model with normal errors. By using simulation methods, we studied the statistical properties of the information gain as a measure of dependence, in the particular case of survival regression models. We suggest several efficient applications of this informational concept to some classical problems of regression analysis and prognostic analysis. Our ideas are illustrated through an example on the prognosis of idiopathic dilated cardiomyopathy.
Athletes as Health Testing Examinees
Authors: Miura K. , Miyakawa S. , Narayama S. , Hirano H. , Kanai K. , Miwa T. 
Published: March 2018

Abstract:Health-testing examination data of 91 male and 54 female athletes were studied, together with age-matched controls, on serum biochemistry, ECG findings, hematology, and some data on gynecological physiology. Analysis of serum biochemical values revealed statistically significant differences in 14 of 18 routine test items as compared with the age-matched controls. In ECG findings, the combination of bradycardia and left ventricular hypertrophy was most frequently found in male athletes, whereas that of bradycardia and sinus arrythmia was observed predominantly in female athletes. The incidence of anemia and menstrual dysfunction was higher in female athletes than in controls, especially in the basketball team. In the same team, a high rate of deviant ECG records and a different distribution of the age at menarche were also observed.
Defining Normality – Art or Science?
Authors: Robinson D. , Bevan E. A. 
Published: March 2018

Abstract:The problem of defining normality, and in particular the establishment of reference ranges, is discussed. A so-called “objective” method of determining such ranges is described. It is suggested, however, that all currently used methods for defining “normal” ranges rely ultimately on a subjective choice. We propose the use of “How Often That Happens” (HOTH) graphs as an alternative to the conventional reference range. Such graphs show the frequency of results at least as extreme as any observed value. We have used such graphs, along with computer simulation models, in an attempt to describe how the frequency distribution of a given parameter changes as a population ages. Finally, an analogy is drawn between the states of “health”, “illness” and “death”, and the attractors which arise in non-linear dynamic systems. We conclude that the definition of normality is in fact more of an art than a science.
HEALTH WATCH: Health Promotion and Disease Prevention in Primary Care
Authors: Schmidt R. M. 
Published: March 2018

Abstract:Health Watch, a longitudinal prospective study of healthy aging, was designed to characterize a healthy population of 2,200 men and women, ages 20-80 years in 1970. Biochemical, hematological, and physiological tests are performed annually over three weekly visits, combined with a self-administered Health Watch questtionnaire to measure health status and behaviors in seven areas (with over 1,330 variables). In 1988, the Health Watch study was modified to assess characteristics of an oldest old “productive aging” cohort in Kauai, Hawaii. Nutrition, physical activity, extended family, and spirituality were found to be major health determinants. During 1989 to 1991 a controlled intervention study (ten local primary care physicians and their patients, aged 65-89 years) was completed in the Sun Cities, Arizona. These studies provide evidence that primary care physicians can promote positive health outcomes in patients of any chronological age and baseline health status through active healthy aging interventions.
Heart Rate Response to Exercise in Normal Women
Authors: Bowyer A. F. , Thomas R. A. , Bowyer S. R. 
Published: March 2018

Abstract:Heart rate is known to increase under the influence of increased sympathetic stimulation rates during exertion or stress. Few data are available regarding the rate response to exercise near the fatigue limit, for normal women. The effects on heart rate were studied of fatigue limiting exercise in 87 asymptomatic, normal female subjects employing a bicycle ergometer exercise protocol. The heart rate response to imposed exercise power closely followed a monotonic increasing, negative exponential function. Different age groups followed the same form of function but differed in parameter values. Group fitting was useful to develop parameters with which one group may be compared to another, establish referent ranges, and gain insight into cardiovascular models of exercise physiology.
Probability Graphics Support for Medical Reasoning
Authors: Yoder J. W. , Littell E. , Williams B. T. 
Published: March 2018

Abstract:Graphic displays of data from clinical observations and laboratory testing provide important support to the health practitioner in managing an increasing amount of complex information. A graphic display program is described that preserves much of the context of data that is important to their evaluation, and that maintains a sense of the strength of the signal when aberrant data are encountered.
Computer-Assisted Instruction in Probabilistic Reasoning During the Inpatient Medicine Clerkship
Authors: Lancaster D. J. , McClish D. K. , Smith W. R. 
Published: March 2018

AbstractThe acceptability and utility of computer-assisted instruction in probabilistic reasoning was assessed for medicine clerkship students. After a pretest, the experimental (n = 40), but not the control students (n = 39), completed a program that we designed. The program contained the test and its answers. After program exposure, experimental students rated their knowledge of the program’s content significantly higher (p = 10−4) than control students. On the identical posttest, experimental students also scored significantly higher than control students (p = 10−4) and improved their scores significantly more (p = 10−3). They rated ease-of-use items significantly higher than content-relevance items (p = 1CT−4). We conclude that computer-assisted instruction in probabilistic reasoning is acceptable to clerkship students, and that it may improve their knowledge and skills in this area. However, students may rate the vehicle of this instruction more highly than its content.
Reconstructing Medical Problem Solving Competence: MACCORD
Authors: Petkoff B. , Mannebach H. , Kirkby S. , Kraus D. 
Published: March 2018

AbstractThe building of medical knowledge-based systems involves the reconstruction of methodological principles and structures within the various subdomains of medicine. ACCORD is a general methodology of knowledge-based systems, and MACCORD its application to medicine. MACCORD represents the problem solving behavior of the medical expert in terms of various types of medical reasoning and at various levels of abstraction. With MACCORD the epistemic and cognitive processes in clinical medicine can be described in formal terminology, covering the entire diversity of medical reasoning. MACCORD is close enough to formalization to make a significant contribution to the fields of medical knowledge acquisition, medical didactics and the analysis and application of medical problem solving methods.
Ambulatory Recording and Power Spectral Analysis by Autoregressive Modelling of Polygraphic Sleep Signals in Patients Suffering from Chronic Pain
Authors: Drewes A.M. , Svendsen L. , Bjerregård K. , Taagholt S. , Nielsen K.D. 
Published: March 2018

Abstract:A portable digital recording system and the Nightingale sleep analyser have been applied to record polygraphical sleep signals in patients suffering from chronic pain. Using ambulatory recording the patient can sleep at home making the sleep more natural and reducing the costs. The recording system gives digital recordings of very good quality. It is shown that the Nightingale sleep analyser performs automatic sleep analysis with a quality comparable to visual interrater performance on disordered sleep. It furthermore provides means for extraction of spectral information useful for the description of the sleep-wakefulness processes and for diagnosing the sleep disorders. Using AR-model-based power spectral analysis, it is also shown that the power content in the alpha band relative to the delta power is significantly higher in patients suffering from non-specific chronic pain as compared to normal persons.
ARX Filtering of Single-Sweep Movement-Related Brain Macropotentials in Mono- and Multi-Channel Recordings
Authors: Liberati D. , Cerutti S. , Babiloni F. , Fattorini L. , Urbano A. , Capitanio L. , Filligoi G. C. 
Published: March 2018

Abstract:A technique of stochastic parametric identification and filtering is applied to the analysis of single-sweep event-related potentials. This procedure, called AutoRegressive with n exogenous inputs (ARXn), models the recorded signal as the sum of n+1 signals: the background EEG activity, modeled as an autoregressive process driven by white noise, and n signals, one of which represents a filtered version of a reference signal carrying the average information contained in each sweep. The other (n-1) signals could represent various sources of noise (i.e., artifacts, EOG, etc.). An evaluation of the effects of both artifact suppression and accurate selection of the average signal on mono- or multi-channel scalp recordings is presented.
Change in Impulse Response of Heart Rate to Instantaneous Lung Volume
Authors: Mizuta H. , Iida Y. , Saul J. P. , Cohen R. J. , Yana K. 
Published: March 2018

Abstract:A method is presented that relates the heart rate variability (HRV) to the change in instantaneous lung volume (ILV) under non-stationary conditions. Methods utilizing a recursive least squares (RLS) algorithm and a modified Widrow LMS algorithm are proposed to keep track of changes in impulse response of HRV to ILV. Results are presented of real data analysis and a dedicated system is proposed utilizing DSP chips for the real time data processing.
Interference Removal with an Improved Incremental Estimation Filter
Authors: Kors J. A. 
Published: March 2018

Abstract:Mains interference in digitized electrocardiographic signals is often removed with a nonlinear filter, the so-called incremental estimaton filter. A prerequisite for proper functioning of the filter is that the variation of the signal is considerably slower than that of the disturbing interference. This condition will often not be true, especially during wave deflections. As a result, the filter will not fully remove the interference when present, or, alternatively, it may generate a sine wave in the absence of interference. These effects are analyzed and different solutions proposed, one of which is the use of new, very simple filters based on the incremental estimation technique.
Microprocessor-Based Memory Device for Ambulatory Heart Rate and Physical Activity Recording
Authors: Makikawa M. , Imai K. , Shindoi T. , Tanooka K. , Iizumi H. , Mitani H. 
Published: March 2018

Abstract:Using microprocessor techniques, a portable digital memory device has been designed for the ambulatory monitoring of heart rate and physical activity. The device consists of a microprocessor, an ECG amplifier to record the heart rate and an accelerometerto detect the physical activity. This accelerometer is piezoresistive and is suitable for ambulatory physical activity recording, because this sensor requires low electrical power, has high durability and wide frequency response (DC~1.2 kHz). Changes in hearti rates and physical activity in daily life have been successfully recorded.
Non-invasive Ultrasonic Urination Sensor for Ambulatory Patient Support
Authors: Kodama H. , Hieda I. , Kuchinomachi Y. , Takeichi H. , Matsumoto H. 
Published: March 2018

Abstract:It is estimated that, in Japan, several million people suffer from urinary incontinence caused by, e.g., cerebrovascular disease, abdominal operations, spinal-cord damage, etc. Urinary incontinence is said to be a ‘hidden’ disease. When no adequate treatment is given, a serious situation may arise for both patients and their family. A non-invasive and unconstrained ultrasonic sensor has been designed enabling patients to discretely manage urination. The major problem of the sensor is how to maintain a proper irradiation angle to obtain an anteroposterior bladder diameter which corresponds to the actual bladder volume. Many types of ultrasonic probe holders have been tested and promising results have been obtained. The most practical, but as yet experimental, method is a four-element ultrasonic sensor, embedded in a flat probe.
Source Estimation in the Human Brain from EEG Based on the SSB Head Model
Authors: Ivanov V. , Konyshev V. , Musha T. 
Published: March 2018

Abstract:Neuronal activity in the brain cortex is replaced by a small current dipole, and hence the localized electric activities of the cortex are well approximated by equivalent current dipoles. Position and moments of these equivalent dipoles are estimated from the scalp potentials. In this analysis, the head as a conductor is divided into three volumes with uniform electric conductivity: Scalp, Skull and Brain tissue; we call this head model the SSB Head Model. The boundary element method is used in solving this problem and reliability of the final result mainly depends on the arrangement of nodal points on the surfaces of these three regions for numerical calculation, the electric conductivity ratios of the three regions in the model, and the number of electrodes. By means of computer simulation we investigated dependence of errors in the estimated dipole position on these factors. It is found that arrangement of nodal points must be decided adaptively depending on the source position.