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expert systems

Bradley Genovese, Steven Yin, Sohail Sareh, Michael DeVirgilio, Laith Mukdad, Jessica Davis, Veronica J Santos, Peyman Benharash
With changes in work hour limitations, there is an increasing need for objective determination of technical proficiency. Electromagnetic hand-motion analysis has previously shown only time to completion and number of movements to correlation with expertise. The present study was undertaken to evaluate the efficacy of hand-motion-tracking analysis in determining surgical skill proficiency. A nine-degree-of-freedom sensor was used and mounted on the superior aspect of a needle driver. A one-way analysis of variance and Welch's t test were performed to evaluate significance between subjects...
October 2016: American Surgeon
Carol A Marchant, Edward M Rosser, Jonathan D Vessey
The application of biotransformation dictionaries derived by expert evaluation of known metabolic pathways represents one approach to the prediction of both phase I and phase II xenobiotic metabolites. The ranking of metabolites generated by such dictionaries has previously been achieved through the use of qualitative reasoning rules and quantitative probability values. Using the biotransformation dictionary available in the Meteor expert system, we show that metabolite over-prediction by both of these methods can be reduced by the adoption of a k-nearest neighbours methodology in which the likelihood of a predicted biotransformation is determined based on comparison of a query chemical with structurally-similar substrates with known experimental metabolic data which activate the same biotransformation...
October 25, 2016: Molecular Informatics
Daniel Stern, Martin Richter, Livia Schrick, Peter Lasch, Kathrin Keeren, Angela Polleichtner, Karin Lemmer, Andreas Nitsche, Roland Grunow, Christian Herzog, Brigitte G Dorner, Lars Schaade
In Europe, besides the threat of terrorist attacks involving conventional methods such as explosive devices and automatic weapons, there is also a potential threat of terrorist groups using non-conventional material like biological agents in the scope of future attacks. Consequently, rapid and reliable detection systems for biological agents are being developed and tested continuously to inform crisis management. For environmental detection, a broad spectrum of different laboratory-based techniques has been developed for relevant biological agents...
October 24, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Cornelia Otto, Bertrand Hirl, Stefan Schweitzer, Sabine Gleich
BACKGROUND: On 4 August 2011 a modification of the infection protection act became law, meaning that antibiotic consumption surveillance and evaluation of data on the local resistance situation became obligatory for hospitals. Four years after the modification of the infection protection act became law, the Munich public health department aimed to evaluate the state of implementation of antibiotic consumption surveillance in Munich hospitals and to ascertain which antibiotic stewardship (ABS) structures have already been established...
October 24, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Hossein Fakhrzadeh, Shirin Djalalinia, Mojdeh Mirarefin, Tahereh Arefirad, Hamid Asayesh, Saeid Safiri, Elham Samami, Morteza Mansourian, Morteza Shamsizadeh, Mostafa Qorbani
Introduction: Physical inactivity is one of the most important risk factors for chronic diseases, including cardiovascular disease, cancer, and stroke. We aim to conduct a systematic review of the prevalence of physical inactivity in Iran. Methods: We searched international databases; ISI, PubMed/Medline, Scopus, and national databases Irandoc, Barakat knowledge network system, and Scientific Information Database (SID). We collected data for outcome measures of prevalence of physical inactivity by sex, age, province, and year...
2016: Journal of Cardiovascular and Thoracic Research
Takeshi Nishimura, Keisuke Kohama, Takaaki Osako, Taihei Yamada, Hiroyuki Tanaka, Atsunori Nakao, Joji Kotani
Advances in critical care medicine have made it possible to sustain vital organ systems in brain-dead patients. One clinical scenario besides donor organ retrieval in which a benefit may be gained from continuing life support is pregnancy. A pregnant woman in her late 30's at 23 weeks gestation exhibiting worsening depression was referred to the Department of Psychiatry. One day after admission she attempted suicide by hanging and suffered a cardiopulmonary arrest. A fetal heart beat and fetal motion was confirmed immediately after resuscitation...
October 2016: Acta Medica Okayama
Mohammad Abu-Hishmeh, Alamgir Sattar, Fnu Zarlasht, Mohamed Ramadan, Aisha Abdel-Rahman, Shante Hinson, Caroline Hwang
BACKGROUND Thrombotic thrombocytopenic purpura (TTP) is one of the thrombotic microangiopathic (TMA) syndromes, caused by severely reduced activity of the vWF-cleaving protease ADAMTS13. Systemic lupus erythematosus (SLE), on the other hand, is an autoimmune disease that affects various organs in the body, including the hematopoietic system. SLE can present with TMA, and differentiating between SLE and TTP in those cases can be very challenging, particularly in patients with no prior history of SLE. Furthermore, an association between these 2 diseases has been described in the literature, with most of the TTP cases occurring after the diagnosis of SLE...
October 25, 2016: American Journal of Case Reports
E Latif, M Nair
The unregulated market for e-cigarettes continues to grow, with debates on their efficacy and impact on global public health. E-cigarettes, or electronic nicotine delivery systems (ENDs), are marketed as a 'safe' alternative to tobacco products and a tool for 'harm reduction'. Some public health experts are calling it a 'game changer' and favour the 'harm reduction' strategy, while others dispute this claim. In our opinion, the debate needs to be broadened to encompass other related concerns and effects on non-users and affected stakeholders...
November 2016: International Journal of Tuberculosis and Lung Disease
G Besson, G Barragan-Jason, S J Thorpe, M Fabre-Thorpe, S Puma, M Ceccaldi, E J Barbeau
Verifying that a face is from a target person (e.g. finding someone in the crowd) is a critical ability of the human face processing system. Yet how fast this can be performed is unknown. The 'entry-level shift due to expertise' hypothesis suggests that - since humans are face experts - processing faces should be as fast - or even faster - at the individual than at superordinate levels. In contrast, the 'superordinate advantage' hypothesis suggests that faces are processed from coarse to fine, so that the opposite pattern should be observed...
October 21, 2016: Cognition
Jean-Louis Vincent, Marc Leone
Distributive shock is associated with decreased systemic vascular resistance and altered oxygen extraction. Septic shock is the most frequent form of distributive shock. In shock states, duration of hypotension is associated with poor outcomes. The speed at which treatment to restore adequate perfusion pressure is initiated is, therefore, important to improve survival. Areas covered: This review presents an overview of the literature related to the management of vasopressor-dependent distributive shock, and in particular the relationship between arterial pressure and organ perfusion and function...
October 24, 2016: Expert Review of Anti-infective Therapy
Lisa G Pont, Tessa K Morgan, Margaret Williamson, Flora M Haaijer, Mieke L van Driel
OBJECTIVES: The aim of this study was to assess the validity of a set of European quality indicators for assessing antimicrobial prescribing in Australian General Practice. METHODS: A modified UCLA/RAND appropriateness method was used to assess the validity of 30 antimicrobial prescribing indicators. An expert panel of 12 general practitioners scored the validity of each indicator for measuring quality in Australian general practice. Four quality domains were considered: monitoring antibiotic resistance, benefit to individual patients, value for money and value to policymakers...
October 24, 2016: International Journal of Pharmacy Practice
Melissa Cumming, Anthony Osinski, Lynne O'Hearn, Pamela Waksmonski, Michele Herman, Deborah Gordon, Elzbieta Griffiths, Kim Knox, Eileen McHale, Karen Quillen, Jorge Rios, Patricia Pisciotto, Lynne Uhl, Alfred DeMaria, Chester Andrzejewski
A collaboration that grew over time between local hemovigilance stakeholders and the Massachusetts Department of Public Health (MDPH) resulted in the change from a paper-based method of reporting adverse reactions and monthly transfusion activity for regulatory compliance purposes to statewide adoption of electronic reporting via the National Healthcare Safety Network (NHSN). The NHSN is a web-based surveillance system that offers the capacity to capture transfusion-related adverse events, incidents, and monthly transfusion statistics from participating facilities...
October 23, 2016: Transfusion
Robert A Jenders, Klaus-Peter Adlassnig, Karsten Fehre, Peter Haug
BACKGROUND: The initial version of the Arden Syntax for Medical Logic Systems was created to facilitate explicit representation of medical logic in a form that could be easily composed and interpreted by clinical experts in order to facilitate clinical decision support (CDS). Because of demand from knowledge engineers and programmers to improve functionality related to complex use cases, the Arden Syntax evolved to include features typical of general programming languages but that were specialized to meet the needs of the clinical decision support environment, including integration into a clinical information system architecture...
August 11, 2016: Artificial Intelligence in Medicine
Debabrata Dash
Despite the continuing developments of improved medical devices and increasing operator expertize, coronary chronic total occlusion (CTO) remains as one of the most challenging lesion subsets in interventional cardiology. Percutaneous coronary intervention (PCI) of CTO is a complex procedure carrying the risk of complications that are responsible for significant morbidity and mortality. The complications can be classified as coronary (such as coronary occlusion, perforation, device embolization, or entrapment); cardiac non-coronary (such as periprocedural myocardial infarction); extra cardiac (such as vascular access complications, systemic embolization, contrast-induced nephropathy, and radiation-induced injury)...
September 2016: Indian Heart Journal
Sunil Dogra, Rahul Mahajan, Tarun Narang, Sanjeev Handa
BACKGROUND: Data regarding the use of cyclosporine (CYC) in the treatment of childhood psoriasis is meager. MATERIALS AND METHODS: The records of all psoriasis patients aged less than 18 years and treated with systemic CYC at our institute were retrieved. Clinical status of patients was assessed at regular intervals and response to therapy was graded as good (50-75% decrease in PASI) and excellent (>75% decrease). Laboratory investigations to detect CYC-induced toxicity were done at regular intervals...
October 24, 2016: Journal of Dermatological Treatment
Sophie Sabherwal, Jane A English, Melanie Föcking, Gerard Cagney, David R Cotter
Recent evidence supports an association between systemic abnormalities and the pathology of psychotic disorders which has led to the search for peripheral blood-based biomarkers. Areas covered: Here, we summarize blood biomarker findings in schizophrenia from the literature identified by two methods currently driving biomarker discovery in the human proteome; mass spectrometry and multiplex immunoassay. From a total of 14 studies in the serum or plasma of drug-free schizophrenia patients; 47 proteins were found to be significantly altered twice or more, in the same direction...
October 22, 2016: Expert Review of Proteomics
Stephen Young, Barbara Body, Franklin Moore, Sherry Dunbar
The ARIES® HSV 1&2 Assay is a new FDA cleared real-time PCR test for detection and differentiation of HSV-1 and HSV-2 DNA from cutaneous and mucocutaneous lesions. The test is performed on the ARIES® System, an automated sample to answer real-time PCR instrument that provides a closed system and simple workflow for performing molecular testing. Areas Covered: This article reports the clinical performance of the ARIES® HSV 1&2 Assay assessed on 1963 prospectively collected specimens. Assay sensitivities were 91...
October 24, 2016: Expert Review of Molecular Diagnostics
Ankur Jindal, Archana Rastogi, Shiv Kumar Sarin
For over 20 years, acute-on-chronic liver failure (ACLF) has taken multiple definitions and/or classifications. The definition outlines the acute and chronic insults to include a homogenous patient group with liver failure and an expected outcome in a specific time frame. Early and accurate diagnosis is essential as this inflammation of the liver may tilt the balance of liver destruction and regeneration adversely. Various factors such as superadded systemic sepsis, liver reserve, cause of primary chronic liver disease, state of immune system or the state of gut microbial flora might determine the ultimate prognosis...
October 24, 2016: Expert Review of Gastroenterology & Hepatology
Renate Soellner, Norbert Lenartz, Georg Rudinger
Concept mapping served as the starting point for the aim of capturing the comprehensive structure of the construct of 'health literacy.' Ideas about health literacy were generated by 99 experts and resulted in 105 statements that were subsequently organized by 27 experts in an unstructured card sorting. Multidimensional scaling was applied to the sorting data and a two and three-dimensional solution was computed. The three dimensional solution was used in subsequent cluster analysis and resulted in a concept map of nine "clusters": (1) self-regulation, (2) self-perception, (3) proactive approach to health, (4) basic literacy and numeracy skills, (5) information appraisal, (6) information search, (7) health care system knowledge and acting, (8) communication and cooperation, and (9) beneficial personality traits...
October 11, 2016: Evaluation and Program Planning
Eduardo Galdón, Marta Casas, Manuel Gayango, Isidoro Caraballo
The deep understanding of products and processes has become a requirement for pharmaceutical industries to follow the Quality by Design principles promoted by the regulatory authorities. With this aim, SeDeM expert system was developed as a useful preformulation tool to predict the likelihood to process drugs and excipients through direct compression. SeDeM system is a step forward in the rational development of a formulation, allowing the normalisation of the rheological parameters and the identification of the weaknesses and strengths of a powder or a powder blend...
October 18, 2016: European Journal of Pharmaceutics and Biopharmaceutics
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