Development and implementation of clinical guidelines: An artificial intelligence perspective

Clinical practice guidelines in paper format are still the preferred form of delivery of medical knowledge and recommendations to healthcare professionals. Their current support and development process have well identified limitations to which the healthcare community has been continuously searching solutions. Artificial intelligence may create the conditions and provide the tools to address many, if not all, of these limitations.. This paper presents a comprehensive and up to date review of computer-interpretable guideline approaches, namely Arden Syntax, GLIF, PROforma, Asbru, GLARE and SAGE. It also provides an assessment of how well these approaches respond to the challenges posed by paper-based guidelines and addresses topics of Artificial intelligence that could provide a solution to the shortcomings of clinical guidelines. Among the topics addressed by this paper are expert systems, case-based reasoning, medical ontologies and reasoning under uncertainty, with a special focus on methodologies for assessing quality of information when managing incomplete information. Finally, an analysis is made of the fundamental requirements of a guideline model and the importance that standard terminologies and models for clinical data have in the semantic and syntactic interoperability between a guideline execution engine and the software tools used in clinical settings. It is also proposed a line of research that includes the development of an ontology for clinical practice guidelines and a decision model for a guideline-based expert system that manages non-compliance with clinical guidelines and uncertainty.     

A web-based platform for biosignal visualization and annotation

With the advent of wearable sensing and mobile technologies, biosignals have seen an increasingly growing number of application areas, leading to the collection of large volumes of data. One of the difficulties in dealing with these data sets, and in the development of automated machine learning systems which use them as input, is the lack of reliable ground truth information. In this paper we present a new web-based platform for visualization, retrieval and annotation of biosignals by non-technical users, aimed at improving the process of ground truth collection for biomedical applications. Moreover, a novel extendable and scalable data representation model and persistency framework is presented. The results of the experimental evaluation with possible users has further confirmed the potential of the presented framework.     

Catkin liked nano-Co3O4 catalyst built-in organic microreactor by PEMOCVD method for trace CO oxidation at room temperature

In this paper, tricobalt tetraoxide (Co₃O₄) catalyst was coated on the polydimethylsiloxane microchannel by the plasma-enhanced metal-organic chemical vapor deposition technology. The obtained Co₃O₄ film was characterized by SEM, XRD, XPS, and TEM, and the results show that the as-deposited Co₃O₄ film was initially composed of many cauliflowers-shaped microclusters. Also, the microcauliflower was transformed from an amorphous phase to a crystal phase when the Co₃O₄ film was treated by Ar and O₂ plasma for more than 20 min, and the crystal lattice line occurred on the surface of nano-sized-Co₃O₄ particles. Meanwhile, the interface of Co₃O₄ particles with diameter between 3 and 12 nm became obvious and some nano-catkin structures were also formed on the Co₃O₄ film. The ratio of Co³⁺/Co²⁺ in the spinel-type Co₃O₄ was nearly 2, and the nano-particles predominantly expose their {311}, {111}, and {220} planes. These morphologies and structure characteristics were found to be ideal for increasing the catalytic activity efficiency of Co₃O₄ for CO oxidation, and the catalytic stability of Co₃O₄ coated on the organic microreactor lasted nearly 85 h for trace CO oxidation at room temperature.     

Design methodology of piezoelectric energy-harvesting skin using topology optimization

This paper describes a design methodology for piezoelectric energy harvesters that thinly encapsulate the mechanical devices and exploit resonances from higher-order vibrational modes. The direction of polarization determines the sign of the piezoelectric tensor to avoid cancellations of electric fields from opposite polarizations in the same circuit. The resultant modified equations of state are solved by finite element method (FEM). Combining this method with the solid isotropic material with penalization (SIMP) method for piezoelectric material, we have developed an optimization methodology that optimizes the piezoelectric material layout and polarization direction. Updating the density function of the SIMP method is performed based on sensitivity analysis, the sequential linear programming on the early stage of the optimization, and the phase field method on the latter stage of the optimization to obtain clear optimal shapes without intermediate density. Numerical examples are provided that illustrate the validity and utility of the proposed method.     

Highly potent germination inhibitors in aqueous eluate of fruits of Bishop's weed (Ammi majus L.) and avoidance of autoinhibition

The aqueous eluate from fruits ofAmmi majus (Bishop's weed, Umbelliferae) remarkably inhibited germination of adjacent seeds ofAnastatica hierochuntica, lettuce, or tomato but had no effect on intact fruits ofAmmi. Similar inhibition was found in dark or in light, except that seeds ofA. hierochuntica were significantly more inhibited in the dark than in the light. Xanthotoxin was isolated, identified, and found to account for about a sixth of the inhibitory activity of the eluate. After fruits ofAmmi were submerged in a large volume of water for 4 days, the fruits still exuded enough inhibitors to prevent germination ofA. hierochuntica, lettuce, or tomato. Data support also the proposal that the phytotoxins are compartmentalized between the inner and the outer fruit envelopes. The inner layer excludes inhibitors from the embryo and autotoxicity is thus avoided, whereas the outer one ensures a gradual liberation of the phytotoxic compounds. This, as well as the high reactivity of the eluate, the high densities ofAmmi fruits in nature, and their relatively limited annual germination, suggest chemical inhibition of neighboring plant species other thanAmmi. Hence, in addition to their chemical protection against predators of either lower or higher organisms, furanocoumarins in fruits ofAmmi majus may contribute to its success as a weed.     

Use of the Nasicon/Na2SO4 couple in a solid state sensor for SO x (x=2,3)

The e.m.f. of a concentration cell for SO _x (x=2,3)-O₂ incorporating Nasicon as the main solid electrolyte has been measured in the temperature range 720 to 1080 K. The cell arrangement can be represented as, $$Pt, O'_2 + SO'_2 + SO'_3 \left| {Na_2 SO_4 \left\| {\left. {Nasicon} \right\|} \right.} \right.\left. {Na_2 SO_4 } \right|SO''_3 + SO''_2 + O''_2 , Pt$$ The Na₂SO₄ acts both as an auxiliary electrode, converting chemical potentials of SO _x and O₂ to equivalent sodium potentials, and as an electrolyte. The presence of Na₂SO₄ provides partial protection of Nasicon from chemical reaction with gas mixtures containing SO _x . The open circuit e.m.f. of the cell is in close agreement with values given by the Nernst equation. For certain fixed inlet gas compositions of SO₂+O₂, the e.m.f. varies non-linearly with temperature. The intrinsic response time of the cell to step changes in gas composition is estimated to vary from ～2.0 ksec at 723K to ～ 0.2 ksec at 1077K. The cell functions well for large differences in partial pressures of SO₃(p″_{SO 3}/p′_{SO 3}≈10⁴) at the electrodes.     

Variability for oil and fatty acid composition in castorbean varieties

Thirty-six castorbean varieties were surveyed for oil and fatty acid composition, in order to determine variability of these seed compounds. A large variability of seed oil percentage was observed, ranging from 39.6 to 59.5%. Concerning the fatty acids, little variability was observed for ricinoleic acid, which was the most abundant in the oil, ranging from 83.65 to 90.00%. The other fatty acids appeared in small concentrations and showed a small range: 0.87 to 2.35, 0.68 to 1.84, 2.96 to 5.64, 3.19 to 5.98, and 0.34 to 0.91%, for palmitic, stearic, oleic, linoleic, and linolenic acid, respectively. Non-significant correlations were observed between fatty acids and seed oil percentage. However, significant correlations were observed among fatty acid concentrations: positive and negative ones. These significant correlations could be associated with the biosynthetic pathways of the fatty acids, which are not fully elucidated. They suggest, however, that selection for a particular fatty acid will tend to increase those positively correlated, and decrease those negative ones. Selection and plant breeding techniques could then be applied to modify the oil content of the castorbean seeds, considering the variability observed. For the fatty acid composition, however, the variability was not large enough to make substantial changes in their concentrations by selection procedures. More varieties should be surveyed to find out if such variability is available.     

Model falsification using set‐valued observers for a class of discrete‐time dynamic systems: a coprime factorization approach

This article introduces a new method for model falsification using set‐valued observers, which can be applied to a class of discrete linear time‐invariant dynamic systems with time‐varying model uncertainties. In comparison with previous results, the main advantages of this approach are as follows: The computation of the convex hull of the set‐valued estimates of the state can be avoided under certain circumstances; to guarantee convergence of the set‐valued estimates of the state, the required number of previous steps is at most as large as the number of states of the nominal plant; and it provides a straightforward nonconservative method to falsify uncertain models of dynamic systems, including open‐loop unstable plants. The results obtained are illustrated in simulation, emphasizing the advantages and shortcomings of the suggested method. Copyright © 2013 John Wiley & Sons, Ltd.     

Thermal analysis of styrene–alkyl methacrylate polymers. I. Glass transition temperatures

The glass transition temperatures (T_g's) of several polystyrenes and styrene–alkyl methacrylate copolymers and terpolymers were measured using thermomechanical analysis (TMA) and differential scanning calorimetry (DSC). The polymers studied had number-average molecular weights from 3000 to 250,000 g/mole. The results indicate that the composition dependence of the T_g's for the copolymers and terpolymers can be satisfactorily described by a general Fox equation. In general, the measured T_g's of the copolymer and terpolymer samples depend more on the steric effects of the constituent pendent groups than on their molecular weights. The chain flexibility rather than the size of the pendent group is the determining factor in the glass transition properties of the styrene polymers.     

Ablation of ice-solids and wax-solids mixtures in turbulent axisymmetric water jets

The ablation rate of frozen mixtures of water or wax with finely divided solids subjected to a turbulent axisymmetric water jet was investigated both experimentally and theoretically. The range of the water jet Reynolds number was 8700–29300 and the jet temperature varied between 22 and 60°C. The solids used were very fine kaolinite clay, titanium oxide and aluminium powder. The type of solids and their concentration were found to affect the ablation rate of ice-solids and wax-solids mixtures. This is mainly due to changes in the physical properties of the melt layer of the water-solids or wax-solids mixtures which forms between the impinging jet and the frozen mixtures.