INTRODUCTION TO THE SPECIAL ISSUE ON CASE-BASED REASONING IN THE HEALTH SCIENCES

There has been an explosion of interest in health sciences applications of case-based reasoning (CBR), not only in the traditional CBR in medicine domain, but also in bioinformatics, enabling home health-care technologies, CBR integration, and synergies between CBR and knowledge discovery. This special issue features the best papers from the third workshop on CBR in the health sciences, held at ICCBR-05 in Madrid. It is the third in a series of exciting workshops, the first two of which were held at ICCBR-03, in Trondheim, Norway, and at ECCBR-04, in Madrid, Spain. The nine high-quality papers introduced here represent the research and experience of twenty-two authors working in eight different countries on a wide range of problems and projects. These papers illustrate some of the major trends of current research in CBR in the health sciences, and represent overall an excellent sample of the most recent advances of CBR in the health sciences.     

Ultraviolet ion laser performance and spectroscopy--Part I: New strong noble-gas transitions below 2500 Å

The performance and spectroscopy of UV ion lasers have been investigated to 1850 Å, the limit of available mirrors. New anomalously strong transitions of about 1-kW peak power were found in Xe IV? at 2315.357 Å and Kr IV at 2191.916 Å. The shortest wavelength new laser transition was Kr IV at 1949.623 Å. Wavelengths were measured for 25 new and many previously known UV laser transitions to about 0.006 Å. Optimum output in watts was also measured as a function of bore current density and gas pressure. All measurements were taken from a 7-mm-bore 150-cm-arc-length tube designed for low electrical inductance providing current excitation pulses with 250-ns full width at half maximum (FWHM).     

Effect of oxygen on flashlamp-pumped organic-dye lasers

Dissolved oxygen was found to dramatically influence the intensity of flashlamp-pumped organic-dye lasers. The relative energy per laser pulse was measured for nine new and 19 previously reported dye solutions in equilibrium with partial pressures of oxygen ranging from 0 to 1 atmosphere.     

1.05-1.44 µm tunability and performance of the CW Nd3+:YAG laser

The Nd³⁺:YAG laser pumped by a CW 5-kW krypton arc-lamp was tuned to 19 different transitions from 1.052 to 1.444 μm by means of intracavity thin solid etalons and appropriately coated resonator mirrors. Each transition was tunable over 6-12 wavenumbers and most exhibited 10-30-W CW output, attaining 37 W at 1.319 μm and 52 W at 1.112 μm. The 1.061-μm line is 90 percent as strong as at 1.064 μm, and wavelength shift with temperature variation was measured for both. TEM00output of 20 W was available by using apertures, and compensation of thermal lensing resulted in 60 W combined TEM00+ TEM01output.     

The 21st-Century Welfare City: Aalborg + Copenhagen,Denmark

Under the scientific eye of satellite surveillance, the world's urban conglomerations often appear heterogeneous. On the ground, differences and special features of a city remain of utmost importance to the quality of life of its citizens. Hans Kiib and Gitte Marling assess how the welfare system in Denmark, which is so dear to many Danes, is holding up. If the physical, Modernist urban model of the welfare city is to endure, can it withstand the irresistible, less tangible pull of consumption and aspirational individualised lifestyles that are penetrating the globe worldwide? Copyright © 2005 John Wiley & Sons, Ltd.     

Latex coatings containing antifeedants: Formulation,characterization, and application for protection of conifer seedlings against pine weevil feeding

Latex-based coatings for protection of tree seedlings against pest insect feeding are evaluated with respect to surface-, mechanical-, and release properties and antifeedant activity. The latex dispersion Eudragit copolymer (EC) was used to form the coatings, 2,6-di-tert-butyl-4-methylphenol (BHT) and cis-dihydropinidine (Alk) as antifeedants, and a thickener and a alkylglucoside based nonionic surfactant were used as additives to optimize the release- and mechanical properties of coatings. Coating characterization was performed with respect to surface morphology (atomic force microscopy, AFM) and surface wetting (contact angle), as well as to mechanical (tensile stress- and tensile strain at break) properties. Surface smoothness and wettability as well as elasticity increased with addition of the surfactant. The optimized coatings were found to be elastic and water resistant at 3–6 wt.% of BHT and 3 wt.% of surfactant. BHT was released into SDS/water at very low rates. Several formulations of BHT and Alk were efficient in preventing the feeding on conifer bark by a pine insect, Hylobius abietis both in laboratory (no-choice) and in field (3 months) tests.     

TOWARD CASE-BASED REASONING FOR DIABETES MANAGEMENT: A PRELIMINARY CLINICAL STUDY AND DECISION SUPPORT SYSTEM PROTOTYPE

This paper presents a case-based decision support system prototype to assist patients with Type 1 diabetes on insulin pump therapy. These patients must vigilantly maintain blood glucose levels within prescribed target ranges to prevent serious disease complications, including blindness, neuropathy, and heart failure. Case-based reasoning (CBR) was selected for this domain because (a) existing guidelines for managing diabetes are general and must be tailored to individual patient needs; (b) physical and lifestyle factors combine to influence blood glucose levels; and (c) CBR has been successfully applied to the management of other long-term medical conditions. An institutional review board (IRB) approved preliminary clinical study, involving 20 patients, was conducted to assess the feasibility of providing case-based decision support for these patients. Fifty cases were compiled in a case library, situation assessment routines were encoded to detect common problems in blood glucose control, and retrieval metrics were developed to find the most relevant past cases for solving current problems. Preliminary results encourage continued research and work toward development of a practical tool for patients.     

Long-pulse dye-laser emission across the visible spectrum

Long-pulse laser emission has been obtained across the visible spectrum using six different organic dyes in solution with triplet-state quenching additives, suggesting many new candidates for CW dye-laser operation.     

Integrating Case-Based and Rule-Based Reasoning to Meet Multiple Design Constraints

Although case-based reasoning (CBR) was introduced as an alternative to rule-based reasoning (RBR), there is a growing interest in integrating it with other reasoning paradigms, including RBR. New hybrid approaches are being piloted to achieve new synergies and improve problem-solving capabilities. In our approach to integration, CBR is used to satisfy multiple numeric constraints, and RBR allows the performance of "what if" analysis needed for creative design.
The domain of our investigation is nutritional menu planning. The task of designing nutritious, yet appetizing, menus is one at which human experts consistently outperform computer systems. Tailoring a menu to the needs of an individual requires satisfaction of multiple numeric nutrition constraints plus personal preference goals and aesthetic criteria.
We first constructed and evaluated independent CBR and RBR menu planning systems, then built a hybrid system incorporating the strengths of each system. The hybrid outperforms either single strategy system, designing superior menus, while synergistically providing functionality that neither single strategy system could provide. In this paper, we present our hybrid approach, which has applicability to other design tasks in which both physical constraints and aesthetic criteria must be met.     

An artificial intelligence system for computer-assisted menu planning

BACKGROUND: The role of P-glycoprotein (Pgp) associated multidrug resistance for neuroblastoma patients is controversial. Therefore we asked whether at all the typical functional features of the multidrug resistance phenotype could be found in neuroblastoma cells and studied the prognostic relevance of Pgp expression. PATIENTS AND METHODS: Tumor touch preparations and tumor cell infiltrated bone marrow smears of 62 neuroblastoma patients were investigated. The expression of Pgp was determined by a highly sensitive immunosandwich technique. Drug resistance studies were performed by exposing cells to Pgp-dependent cytostatic drugs in tissue cultures. Intracellular drug accumulation was examined by rhodamine-123 fluorescence microscopy. RESULTS: Pgp expression was demonstrable for the SK-N-SH cell line, but not detectable in CHP-100 and ten other neuroblastoma cell lines by immunocytochemistry. In tissue cultures, SK-N-SH cells showed a relative resistance to vincristine and adriamycin (45.1 and 12.7-fold resp.) and reduced intracellular accumulation of rhodamine-123 which could be normalized by the Pgp blocker verapamil. Pgp expression was detected by immunocytochemistry in 14 out of 62 tumors (22.6%). No correlation was found to the stage of the disease (P = 0.33), histopathological grading (P = 0.82), N-myc oncoprotein expression (P = 0.76) or N-myc oncogene amplification (P = 0.20). Kaplan-Meier analysis of event free survival for stage 4 tumors revealed a weak trend of inferior survival for patients with Pgp positive tumors (log-rank analysis: P = 0.069). CONCLUSIONS: Though Pgp expression is detectable and functional in neuroblastoma cells, but its presence does not provide much information to the complex phenomenon of chemotherapy resistance in patients.