A hybrid knowledge and ensemble classification approach for prediction of venous thromboembolism

Clinical narratives such as progress summaries, lab reports, surgical reports, and other narrative texts contain key biomarkers about a patient's health. Evidence-based preventive medicine needs accurate semantic and sentiment analysis to extract and classify medical features as the input to appropriate machine learning classifiers. However, the traditional approach of using single classifiers is limited by the need for dimensionality reduction techniques, statistical feature correlation, a faster learning rate, and the lack of consideration of the semantic relations among features. Hence, extracting semantic and sentiment-based features from clinical text and combining multiple classifiers to create an ensemble intelligent system overcomes many limitations and provides a more robust prediction outcome. The selection of an appropriate approach and its interparameter dependency becomes key for the success of the ensemble method. This paper proposes a hybrid knowledge and ensemble learning framework for prediction of venous thromboembolism (VTE) diagnosis consisting of the following components: a VTE ontology, semantic extraction and sentiment assessment of risk factor framework, and an ensemble classifier. Therefore, a component-based analysis approach was adopted for evaluation using a data set of 250 clinical narratives where knowledge and ensemble achieved the following results with and without semantic extraction and sentiment assessment of risk factor, respectively: a precision of 81.8% and 62.9%, a recall of 81.8% and 57.6%, an F measure of 81.8% and 53.8%, and a receiving operating characteristic of 80.1% and 58.5% in identifying cases of VTE.     

OWL‐based acquisition and editing of computer‐interpretable guidelines with the CompGuide editor

Computer‐Interpretable Guidelines (CIGs) are the dominant medium for the delivery of clinical decision support, given the evidence‐based nature of their source material. Therefore, these machine‐readable versions have the ability to improve practitioner performance and conformance to standards, with availability at the point and time of care. The formalisation of Clinical Practice Guideline knowledge in a machine‐readable format is a crucial task to make it suitable for the integration in Clinical Decision Support Systems. However, the current tools for this purpose reveal shortcomings with respect to their ease of use and the support offered during CIG acquisition and editing. In this work, we characterise the current landscape of CIG acquisition tools based on the properties of guideline visualisation, organisation, simplicity, automation, manipulation of knowledge elements, and guideline storage and dissemination. Additionally, we describe the CompGuide Editor, a tool for the acquisition of CIGs in the CompGuide model for Clinical Practice Guidelines that also allows the editing of previously encoded guidelines. The Editor guides the users throughout the process of guideline encoding and does not require proficiency in any programming language. The features of the CIG encoding process are revealed through a comparison with already established tools for CIG acquisition.     

Migraine: Calcium Channels and Glia

Migraine is a common neurological disease that affects about 11% of the adult population. The disease is divided into two main clinical subtypes: migraine with aura and migraine without aura. According to the neurovascular theory of migraine, the activation of the trigeminovascular system (TGVS) and the release of numerous neuropeptides, including calcitonin gene-related peptide (CGRP) are involved in headache pathogenesis. TGVS can be activated by cortical spreading depression (CSD), a phenomenon responsible for the aura. The mechanism of CSD, stemming in part from aberrant interactions between neurons and glia have been studied in models of familial hemiplegic migraine (FHM), a rare monogenic form of migraine with aura. The present review focuses on those interactions, especially as seen in FHM type 1, a variant of the disease caused by a mutation in CACNA1A, which encodes the α1A subunit of the P/Q-type voltage-gated calcium channel.     

A knowledge construction methodology to automate case-based learning using clinical documents

The case-based learning (CBL) approach has gained attention in medical education as an alternative to traditional learning methodology. However, current CBL systems do not facilitate and provide computer-based domain knowledge to medical students for solving real-world clinical cases during CBL practice. To automate CBL, clinical documents are beneficial for constructing domain knowledge. In the literature, most systems and methodologies require a knowledge engineer to construct machine-readable knowledge. Keeping in view these facts, we present a knowledge construction methodology (KCM-CD) to construct domain knowledge ontology (i.e., structured declarative knowledge) from unstructured text in a systematic way using artificial intelligence techniques, with minimum intervention from a knowledge engineer. To utilize the strength of humans and computers, and to realize the KCM-CD methodology, an interactive case-based learning system(iCBLS) was developed. Finally, the developed ontological model was evaluated to evaluate the quality of domain knowledge in terms of coherence measure. The results showed that the overall domain model has positive coherence values, indicating that all words in each branch of the domain ontology are correlated with each other and the quality of the developed model is acceptable.     

化妆品功效评价(Ⅵ)——化妆品人体功效评价的实验设计

概述了化妆品人体功效评价实验设计的概念、基本要素和基本原则,介绍了常用实验设计类型和实验设计要点,提供了人体功效评价实验方案设计的思路,有助于提高研究者制定实验设计方案的水平。     

Sleep Disorders Reduce Health-Related Quality of Life in Multiple Sclerosis (Nottingham Health Profile Data in Patients with Multiple Sclerosis)

Quality of Life (QoL) is decreased in multiple sclerosis (MS), but studies about the impact of sleep disorders (SD) on health-related quality of Life (HRQoL) are lacking. From our original cohort, a cross-sectional polysomnographic (PSG) study in consecutive MS patients, we retrospectively analysed the previously unpublished data of the Nottingham Health Profile (NHP). Those MS patients suffering from sleep disorders (n = 49) showed significantly lower HRQoL compared to MS patients without sleep disorders (n = 17). Subsequently, we classified the patients into four subgroups: insomnia (n = 17), restless-legs syndrome, periodic limb movement disorder and SD due to leg pain (n = 24), obstructive sleep apnea (n = 8) and patients without sleep disorder (n = 17). OSA and insomnia patients showed significantly higher NHP values and decreased HRQoL not only for the sleep subscale but also for the “energy” and “emotional” area of the NHP. In addition, OSA patients also showed increased NHP values in the “physical abilities” area. Interestingly, we did not find a correlation between the objective PSG parameters and the subjective sleep items of the NHP. However, this study demonstrates that sleep disorders can reduce HRQoL in MS patients and should be considered as an important confounder in all studies investigating HRQoL in MS.     

油层水洗级别的热解气相色谱定量判别

应用热解气相色谱资料开展水淹层评价是储层地球化学研究的一个新领域，目前，这方面的研究尚处于定性评价阶段。文章选择位于渤海湾盆地黄骅坳陷的港东油田和羊二庄油田新近系开发层系（包括馆陶组和明化镇组）为研究目的层，以岩心热解气相色谱分析为手段，开展了油层水洗级别的气相色谱定量判别的尝试。在系统分析各气相色谱参数的地质意义及其与油层水洗的关系的基础上，优选出合理的评价参数，并采用交会图技术建立不同级别水洗油层的定量判别标准，通过其他评价方法的验证，表明该定量判别方法具有实际应用价值。     

Unresolved controversies concerning psychopathy: Implications for clinical and forensic decision making.

At some point in their careers, clinicians who work or consult in forensic and correctional settings will almost certainly encounter individuals who exhibit psychopathic personality features. Because of the widespread use of this disorder to inform legal and clinical decision making, psychologists should be exceedingly familiar with the relevant research literature on this topic before venturing into these settings. This article reviews the empirical bases of several clinically relevant claims and assertions regarding psychopathy and concludes that many areas of research are decidedly more equivocal in their findings than is commonly perceived. Although there is much to be gained by assessing psychopathy in various contexts, clinicians need to be cautious about drawing overzealous and empirically questionable conclusions about an important disorder that also has great potential for abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

柯克亚油气田混合来源天然气的地球化学特征

柯克亚油气田是我国开发比较早的一个油气田,但由于受混源和其他因素的影响,对气源的认识众说纷纭。通过对天然气的地球化学特征的分析,并参照国内外关于甲烷、乙烷、丙烷碳同位素关系方面的资料,提出了如下看法:柯克亚天然气碳同位素相对较重,与塔里木盆地下古生界海相天然气的碳同位素组成区别较大;根据天然气40Ar/36Ar组成,柯克亚油气田的气源不是单一来源;柯克亚油气田绝大多数天然气的甲烷和乙烷碳同位素值关系符合Faber推断的 型有机质方程直线关系,说明有机质属于较好的有机质类型,或者是由原油裂解形成的天然气;除了K2井和K18井天然气成熟度较低以外,绝大多数天然气的成熟度大约在1.8%～2.2%之间,属于高过成熟气,但也混有一些成熟度在0.9%～1.2%的源岩形成的天然气;推测天然气主要来源于石炭系―二叠系源岩,而混有成熟度低的源岩形成的天然气则有可能来自侏罗系源岩。     

北部湾盆地福山凹陷CO2气成因探讨

北部湾盆地福山凹陷油气钻探中发现了高含CO₂气的天然气气藏。对CO₂气稳定碳同位素、伴生稀有气体氦和氩同位素进行了分析研究，结果显示，福山凹陷CO₂气稳定碳同位素偏重，(13C_CO2为-5.01～-10.08‰，绝大多数样品大于-7.0‰，为无机成因CO₂气特征；伴生稀有气体氦同位素³He/⁴He值为(4.74~5.03)×10^-6，R/Ra值为3.38～3.59；伴生稀有气体氩同位素⁴⁰Ar/³⁶Ar值为1881～2190，也显示出幔源或壳幔混合CO₂气的特征。综合判定认为，福山凹陷CO₂为壳幔混合成因。始新统流沙港组岩浆岩体分布特征与CO₂气藏分布范围基本一致，也表明幔源-岩浆可能是福山凹陷CO₂气的主要来源。与南海北部边缘盆地其它地区如珠江口盆地西部、琼东南盆地东部CO₂气成因一致，都为幔源-岩浆来源，或壳幔混合来源。