Computerized Expert System Research Articles

INNOVATION AND DIGITAL TRANSFORMATION IN HEALTHCARE. PROCESS OPTIMIZATION OF REHABILITATION ACTIVITIES IN IN REHABILITATION CARDIOLOGY IN SUPPORT OF PATIENT AND TEAM

Abstract Physical activity is a treatment for preventing and treating a wide range of diseases; its prescription must be precise and accurate in order to optimize the effects avoiding at the same time clinical risks due to frequent patients’ frailty.To deploy a “comprehensive digital rehabilitation” means to digitalize the whole process: from clinical and instrumental evaluations to the subsequent coherent prescriptions of the rehabilitation and care–related activities, from the case management planning – described in the individual rehabilitative project – to the individual rehabilitative program – that takes shape in semi–automated scheduling and in digitalized reporting. The deployed software must be easy to use and reliable, and must ensure safety, guaranteeing the exchange of clinical information among the team members. For all these reasons, we have pre–set pathways that, starting from the main and secondary clinical diagnosis (using the ICD classification) and based thereafter on the WHO ICF classification, the rehabilitation processes are governed in a standardized tailored granularity for each single patient by the aid of a computerized expert system. Even if it what just stated appears an oxymoron, thanks to the digital transformation and the adoption of the Internet of Things, it is possible to easily implement a personalized rehabilitation program through a shared and standardized ontology, providing benefits both to the patient and to the rehabilitation team. Based on this, the rehabilitation services that can be provided have been defined, providing not only those provided for by national and regional nomenclators but also those peculiar to the activities in our Institutes. The digital gym goes beyond the concept of equipment in a gym space; the gym space becomes both physical and virtual. The goal is the networking of "basic" and innovative rehabilitation equipment, even placed in different environments, through the philosophy of IoT, that path of technological development whereby, through the Internet network, potentially every object of daily experience acquires its own identity in the digital world. All this will allow for real–time feedback of data and measurements for the development of a personalized digital record. The digital platform, telemedicine and cloud computing, begin to enable an integration of people, equipment and data.

Using computer expert system to solve complications primarily due to low and excessive birth weights at delivery: Strategies to reviving the ageing and diminishing population

The world now lives in an ageing society. Significant empirical evidence from the literature revealed that the world’s total fertility rate (TFR) estimate has experienced a declining trend from 5.30 in 1963 to 2.3 in 2020. The TFR for 2023 for the United States was 1.84, Canada 1.57, United Kingdom 1.63, Germany 1.58, Japan 1.39, China 1.45, Nigeria 4.57, India 2.07, Ghana 3.61, with Taiwan 1.09 and Niger 6.73 having the least and highest respectively. Non-adherence to God's childbearing principles, a female's age when she has her first child, educational opportunities, access to family planning, and government acts and policies affecting childbearing are all factors that may influence TFR. Despite the danger posed by the declining TFR trend, childbearing challenges and complications primarily due to low and excessive birth weights at delivery have heightened this danger. This study highlights strategies to leverage the provision of a computerized expert system (ES) solution to the problems of complications primarily due to low and excessive birth weights at delivery. A Knowledge-Based System (KBS) framework to simulate the problem-solving behavior of an expert in a narrow domain or discipline to unite the accumulated expertise of individual disciplines such as gynecology, ultrasonography, computer software design, and engineering was adopted. Fetal weight has been found to be a function of fetal head circumference (HC), femur length (FL), abdominal circumference (AC), and biparietal diameter (BPD) and predictable with a polynomial equation. Also, fetal age has been found to be a function of fetal weight and predictable by an equation. The equations for the determination of conception date and delivery dates were derived. The Expert System (ES) primarily estimates fetal parameters (fetal weight, fetal age or gestational age, conception date, and delivery date) in the first trimester using ultrasonographic fetal biometric data. The result of this study may eliminate or reduce the occurrence of potential complications associated with the birth of both small and excessively large fetuses, thereby contributing to reviving the world declining population.

Improving older adults’ accessibility to the web using real-time online interactive guides

Internet use by older adults is increasing and has the potential to improve their mental and social wellbeing, however it is still low compared to other age groups for various online activities. The objective of this study was to develop and evaluate a computerized expert system, GoldNet, which functions as a human expert and guides the user, step-by-step and in real time, when performing online operations. A user study was conducted on 30 older adults (over 65 years old) that attend an adult daycare center. The participants were all novice users with no prior experience using the Internet. A stratified randomized between participants experimental design was used to evaluate users' performance and satisfaction before and after receiving guidance, after practice, and after a two-week period without controlled practice. Participants were assigned to one of three study groups according to the guidance they received: GoldNet guides, video guidance, or guidance from a personal human tutor. During the experiment participants’ eye movements were monitored. The results indicate that by using GoldNet's automated guides, older adults can perform online tasks with high effectiveness, efficiency, and user satisfaction, performing comparably to users trained by a personal human tutor and significantly better than users relying on video guidance. GoldNet was also found beneficial as a refresher tool after a period without controlled training.

Development and clinical success of novel soft drugs

Retrometabolic drug design combines the structure-activity and structure-metabolism relationships, allowing the effective separation of drug action and side effects. This combination results in significant improvement of the therapeutic index. The main aim is not only to study the metabolism but to build into the drug molecule the desired metabolic route, in addition to the therapeutic activity. There are two basically different approaches to achieve this aim. Both use designed-in metabolism. The 1. chemical drug-targeting systems (CDS) and 2. soft drug, both control the drug targeting and action by strategically designed metabolism. In the case of the soft drugs, we want to rely on hydrolytic enzymes, avoiding the oxidative processes. In the present work, we focus on the clinical successes of the soft drugs designed in our laboratories. In order to show the difference, we briefly present a brain-targeted delivery system, where the originally inactive molecular construct undergoes sequential metabolism to allow specific concentration of the active drug in the brain. Among the soft drugs first we present the highly successful soft corticosteroids. Loteprednol etabonate has been used worldwide for over twenty years, and its use is constantly growing. In addition to the dramatically improved therapeutic index, the specific, serious ophthalmic side effects (elevation of intraocular pressure; glaucoma and cataract formation) were completely eliminated. Similarly designed second generation of soft corticosteroids are also presented, where the soft pharmacophore is structurally unexpected. The most recent soft drug design involves anticholinergics. Sofpironium bromide, a highly effective molecule but without the typical anticholinergic side effects, was first developed to treat hyperhidrosis, an unmet need. Phase III clinical studies were successfully completed and its marketing approval is pending. Since the soft drug design principles, methods and rules are general and specific in nature, a computerized expert system was also developed. Orv Hetil. 2020; 161(10): 363-373.

PREDICTING DAYTIME MANIFESTATIONS OF CHALLENGING BEHAVIOURS IN ADVANCED STAGES OF DEMENTIA USING PRE-DAYTIME ACCELEROMETRY: POST-HOC ANALYSIS OF THE DZNE ROSTOCK INSIDEDEM STUDY

Behavioral disturbances such as night-day shift, agitation and aggression occur frequently in advanced stages of Alzheimer's disease and other dementias, and are summarized as “challenging behaviors” (CB). Previous studies have used actimetry to detect some of these characteristic behavioural changes. It has also been shown that accelerometric motion features allow detection of agitation levels among people in mild to moderate stages of dementia. The InsideDem study aimed to develop a computerized expert system to support assessment of CB and intervention selection. By extension, a post-hoc exploratory analysis was done to explore the potential of predicting the occurrence of CB using accelerometric motion scores (AMS) from late hours and night time of a preceding day, and early hours of a concurrent day. The study involved 4 weeks of real-time observation of daytime naturally occurring activities of 17 residents with moderate to very severe dementia (Global Deterioration Scale score of >3), in two nursing homes units. Behaviour of a subsample of 8 participants was also recorded by videotaping. Accelerometers were mounted on the participants’ wrist and ankle which measured their motion features. CB measures were obtained either in real-time by trained observers using both the DCM and a basic annotation scheme in unit-1, or from video recordings using only the basic annotation scheme in unit-2. Hierarchical Linear Mixed Models controlling for age, gender and nursing home unit, were applied to ascertain if the AMS from time windows: 6pm-10pm, 10pm-6am and 6am-8am, robustly predicts the occurrence (frequency or duration) of daytime CB (Figure 1). AMS significantly predicted the daily sum of frequency of CB across units for time frames 6pm-10pm (ß=1.50, p<0.05) and 6am-8am (ß=1.48, p<0.05). Furthermore, significant differences were found for daily sum of frequency of CB between gender (Figure 2) and unit (Figure 3). Lastly, age was also significantly correlated with daily sum of frequency of CB (r=0.23, p<0.001).

Statistical processing of transient parameters in biorhythms of cortex

Modern medicine is focused on the implementation of non-invasive diagnostic tools and forecasting body dysfunctions of operators in extreme activities. To evaluate psychophysical condition of operators, special software and expert systems are developed, but they have several disadvantages, the main of which are: the complexity of electroencephalographic data interpretation; imperfection of integral evaluation parameters of psychology health conditions of operators in extreme activities; usually no graphical interface designed for physician specialist. This paper presents a statistical approach to evaluating options of information and energy fields in cortex based on processing biopotentials of the cortex with accounting the psychological subgroups of operators. The present approach is a computerized expert system that provides medical-specialist to analyze quantitative parameters of stationary record signal and electroencephalogram transient, which in turn allows assessing and predicting psychophysiological cortex state of the operator. Algorithms of presented approach are based on the use of robust methods of data analysis and iterative simulation using Monte Carlo method. As a result of research it was obtained normalized values of cephalography, electroencephalography, blood tests for operators in extreme activity of a psychological subgroup, and graphical and analytical statistical regression model of tolerance, which is based on parameters of cephalography, electroencephalography and time. Due to the obtained results can not only assess the current psychophysiological state of the organism for operators in extreme activities, but also to predict its changes. The results of research can be used in the medical field of transplantology for donor selection or monitoring of the rehabilitation process after transplanting internal organs.

A computerized expert system for diagnosing primary headache based on International Classification of Headache Disorder (ICHD-II)

BackgroundThe authors developed a computerized program designed to diagnose primary headache based on international classification of headache disorders, 2nd edition (ICHD-II) criteria for use by physicians.MethodsAn appropriate questionnaire was designed according to the ICHD-II criteria for all types of primary headaches and the computerized system provided diagnosis based on the criteria. The software was tested by analyzing 80 patients, recruited from an outpatient headache clinic, affected by primary headache. Each patient with a unique card number was interviewed up to 15 minutes. At the end of each day, software and neurologist diagnoses were evaluated for each patient.ResultsOf 80 patients, the software was able to come up with correct results in 78 cases. The age of the patients ranged from 30 to 80 years old. Migraine headache accounted for 71 cases, five patients had tension type headache, and 2 had cluster headaches; all were correctly diagnosed by software. Two cases were not concordant with the neurologist’s diagnosis. The neurologist diagnosed these two cases as “Medical overuse syndrome headache” and “cluster headache”, which our software was not able to diagnosis them.ConclusionsThis software permitted the diagnosis of more than 97% of the patients similar to the physician's. We hope this questionnaire and applying the software to diagnose headache based on ICHD could be of help to better the diagnosis of headaches.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-2-199) contains supplementary material, which is available to authorized users.

Train-to-Code: An adaptive expert system for training systematic observation and coding skills

Problems in training behavioral observers to a high degree of interindividual accuracy and intraindividual stability are fundamental concerns in descriptive research, as well as in provisions of behavioral intervention services. This article presents design characteristics of and results from three formative evaluations of an adaptive computerized expert system that shapes observation and recording skills and maximizes both individual coding accuracy and stability. The system, called Train-to-Code, allows instructors or trainers to import their own video source files and to code those videos using any appropriate descriptive behavioral-coding scheme. This generates customized expert reference data that automate subsequent training on the basis of an operant response-shaping instructional design model. Successful training relies on transitions through alternative levels of prompting and feedback designed to optimize ongoing performance until stable expert-equivalent levels of interobserver accuracy are maintained without prompting or feedback.

A computerized expert system for handling the output of the Technicon H1 haematology analyser.

A computer-based expert system is described which handles the output of the Technicon H1 in the haematology laboratory of a large teaching hospital. Using patient request data, analyser results, error and morphology flags, the expert system decides; whether to validate the main indices plus differential; whether a blood film is required for manual review; and which abnormal results require phoning to the requesting doctor. The results of this computer-assisted analysis are sent to a printer adjacent to the analyser. The print-out details any further action required of the operator before release of results to the main hospital computer, and serves as a log of all samples run on that analyser. Benefits of the expert system include greatly simplified interpretation of the large array of analyser flags, and consistency in sample handling for all operators over all shifts.

Development and validation of a computerized expert system for evaluation of automated visual fields from the Ischemic Optic Neuropathy Decompression Trial

BackgroundThe objective of this report is to describe the methods used to develop and validate a computerized system to analyze Humphrey visual fields obtained from patients with non-arteritic anterior ischemic optic neuropathy (NAION) and enrolled in the Ischemic Optic Neuropathy Decompression Trial (IONDT). The IONDT was a multicenter study that included randomized and non-randomized patients with newly diagnosed NAION in the study eye. At baseline, randomized eyes had visual acuity of 20/64 or worse and non-randomized eyes had visual acuity of better than 20/64 or were associated with patients refusing randomization. Visual fields were measured before treatment using the Humphrey Field Analyzer with the 24-2 program, foveal threshold, and size III stimulus.MethodsWe used visual fields from 189 non-IONDT eyes with NAION to develop the computerized classification system. Six neuro-ophthalmologists ("expert panel") described definitions for visual field patterns defects using 19 visual fields representing a range of pattern defect types. The expert panel then used 120 visual fields, classified using these definitions, to refine the rules, generating revised definitions for 13 visual field pattern defects and 3 levels of severity. These definitions were incorporated into a rule-based computerized classification system run on Excel® software. The computerized classification system was used to categorize visual field defects for an additional 95 NAION visual fields, and the expert panel was asked to independently classify the new fields and subsequently whether they agreed with the computer classification. To account for test variability over time, we derived an adjustment factor from the pooled short term fluctuation. We examined change in defects with and without adjustment in visual fields of study participants who demonstrated a visual acuity decrease within 30 days of NAION onset (progressive NAION).ResultsDespite an agreed upon set of rules, there was not good agreement among the expert panel when their independent visual classifications were compared. A majority did concur with the computer classification for 91 of 95 visual fields. Remaining classification discrepancies could not be resolved without modifying existing definitions.Without using the adjustment factor, visual fields of 63.6% (14/22) patients with progressive NAION and no central defect, and all (7/7) patients with a paracentral defect, worsened within 30 days of NAION onset. After applying the adjustment factor, the visual fields of the same patients with no initial central defect and 5/7 of the patients with a paracentral defect were seen to worsen.ConclusionThe IONDT developed a rule-based computerized system that consistently defines pattern and severity of visual fields of NAION patients for use in a research setting.

The possibilities of using the acoustic emission method in expert systems for the evaluation of insulation systems of power transformers

The paper presents the range and possibilities of using expert systems at diagnostic measurements of insulation systems of power appliances taken by the acoustic emission (AE) method. Multi-parametric descriptors characterizing the AE signals, which can be used in the knowledge base as criteria making the identification of basic partial discharge forms (PDs) possible, have been characterized in detail. The tables show descriptors describing the AE signals registered in time, frequency, time-frequency domains and statistical data. Moreover, computational tools that can be used in the process of conclusion drawing were suggested and the range of the research work done by the authors of the paper aiming at creating a computerized expert system was presented.

The Validity of the EASE Expert System for Inhalation Exposures

Estimation and Assessment of Substance Exposure (EASE) is a computerized expert system developed by the UK Health and Safety Executive to facilitate exposure assessments in the absence of exposure measurements. The system uses a number of rules to predict a range of likely exposures or an 'end-point' for a given work situation. The purpose of this study was to identify a number of inhalation exposure measurements covering a wide range of end-points in the EASE system to compare with the predicted exposures. Occupational exposure data sets were identified from previous research projects or from consultancy work. Available information for each set of measurements was retrieved from archive storage and reviewed to ensure that it was adequate to enable EASE (version 2) predictions to be obtained. Exposure measurements and other relevant contextual data were abstracted and entered into a computer spreadsheet. EASE predictions were then obtained for each task or job and entered into the spreadsheet. In addition, we generated a random exposure range for each data set for comparison with the EASE predictions. Finally, we produced exposure assessments for a subset of the data using a structured subjective assessment method. We were able to identify approximately 4000 inhalation exposure measurements covering 52 different scenarios and 28 EASE end-points. The data included measurements of solvent vapours, non-fibrous dusts and fibres. In 62% of the end-points the EASE predictions were generally greater than the exposure measurements and in 30% of the end-points the EASE estimates were comparable with the measurements. The random allocation of exposure ranges was, as expected, less reliable than EASE, although there were still about one-third of the cases where the randomly generated exposure ranges generally agreed with the measurements. The structured subjective assessments undertaken by a human expert produced exposure estimates in better agreement with the measurements with about two-thirds of the end-points derived from these assessments in good agreement with the data. We argue that the inhalation exposure estimates from EASE could be improved by incorporating some of the parameters included in the structured subjective assessment methodology.

Digestive health in the elderly: faecal incontinence in adults.

Digestive health in the elderly: faecal incontinence in adults.

Sorption behaviour of acetochlor, atrazine, carbendazim, diazinon, imidacloprid and isoproturon on Hungarian agricultural soil.

Laboratory studies were conducted to determine the sorption behaviour of six commonly used pesticides (acetochlor, atrazine, carbendazim, diazinon, imidacloprid and isoproturon) on Hungarian brown forest soil with clay alluviation (Luvisol) using the batch equilibrium technique. The sorption isotherms could be described by the Freundlich equation in non-linear form (n < 1) for all compounds, however in case of diazinon using the extended Freundlich equation proved to be a better approach. The adsorption constant related soil organic carbon content (Koc) calculated from Freundlich equation were 314 for acetochlor, 133 for atrazine, 2805 for carbendazim, 1589 for diazinon, 210 for imidacloprid and 174 for isoproturon. The octanol-water partition coefficients (Pow), which can be a useful parameter to predict of adsorption behaviour of a chemical on soil, and dissociation coefficients of these pesticides were calculated based on the chemical structure of them using a computerized expert system. The octanol-water partition coefficients were determined experimentally from high performance liquid chromatographic parameters as well. Good agreement was observed between experimental and the computer expert system estimated data. Computer estimated log Pow values ranged 0.5 and 3.86 for the examined pesticides, with imidacloprid and diazinon being the least and most hydrophobic respectively. Experimentally determined logPow ranged between 0.92 and 3.81 with the same tendency. It can be concluded that the Freundlich adsorption constants (Kf) are slightly related to the octanol-water partition coefficients of investigated chemicals, nevertheless no close correlation could be established because of the influence of further characteristics of solutes and soil.

Decision Support Systems: Quenching the Thirst.

A Decision Support System (DSS) integrates and organizes all types of information required for production decisions (19). It can be as simple as a tool for processing data or as complex as a computerized expert system. Figure 1 is a conceptual diagram of a DSS for disease or pest management. Each component can be thought of as a method with a set of associated tools. For example, the data component is associated with the collection method, which has several tools including automated weather stations and site-specific weather products. DSS tools vary in complexity. Examples include rules, schedules of management, equations, combinations of decision aids (23), and expert systems (25). The type of DSS is determined by the cooperative efforts of a multi-disciplinary team of knowledge specialists, the technical and financial resources available, the degree of industry organization and support, and the expectations of end users (25). The selection of an appropriate DSS for a given cropping situation often depends upon the pathogen-pest complex as it interacts with crop and grower preference factors.

A decision support system for the management of accidental mushroom and plant poisoning

In this paper the discussion focuses on a decision support system to be used as a tool in the treatment of poisoning cases attributable to mushrooms, plants and animals. In this first release, attention is focused on the risks related to fungi. Problems involved with mushroom poisoning and identification are analyzed to highlight which elements or characters must be taken into account in devising a computerized expert system. The components of such a system are presented, the different approaches are discussed and the choices made are motivated. Some preliminary results are also presented.

Computerized expert systems and investigation of outbreaks of hospital-acquired infections

Our computerized epidemiological expert system (SIR, I2A, Montpellier, France) facilitated both detection and investigation of an outbreak of postsurgical infections with multiresistant Pseudomonas aeruginosa involving 10 patients over 16 months. An inappropriate antibioprophylaxis facilitated the emergence of bacterial multiresistance to antibiotics but also delayed the detection of the infected patients. The usefulness of our computerized expert system is emphasized as well as its limitations, thus stressing the importance of an efficient cooperation between hygienic and surgical teams that could be based upon a change of the traditional rules in our hospital. The role of expert systems in such a change is also suggested. © 1997 John Wiley & Sons, Inc.

Development of An Expert System for Transportation of Hazardous and Radioactive Materials

Under the sponsorship of the US Department of Energy`s (DOE`s) Transportation Management Division (EM-261), the Transportation Technologies Group at Oak Ridge National Laboratory (ORNL) has designed and developed an expert system prototype application of the hazardous materials transportation regulations. The objective of this task was to provide a proof-of-concept for developing a computerized expert system that will ensure straightforward, consistent, and error-free application of the hazardous materials transportation regulations. The expert system prototype entailed the analysis of what an expert in hazardous materials shipping information could/should do. From the analysis of the different features required for the expert system prototype, it was concluded that the developmental efforts should be directed to a Windows{trademark} 3.1 hypermedia environment. Hypermedia technology usually works as an interactive software system that gives personal computer users the ability to organize, manage, and present information in a number of formats--text, graphics, sound, and full-motion video.

The tribological failure diagnosis of spur gear by an expert system

The failure of tribo-elements at an early stage, before the designed lifetime, is attributable to the complex interaction of many factors, which can be diagnosed by various techniques. These techniques can be learned in a certain period of time, while the knowledge of failure analysis must have accumulated from a long experience of practical work. For this reason, a computerized expert system program, developed from artificial intelligence (PC Plus, an inference engine shell), was constructed for spur gear tribological failure diagnosis. The knowledge was expressed as many “if-then” rules and a “frame” structure of inheritance. Note that the certainty factor of the rules is itself a special characteristic of this system and the “man-machine” interface is very friendly, the graphical interpretation being an example. The system was finally validated by the twin roller wear test which can be recognized as the motion of a spur gear near the pitch-line region. The failure characteristics of the worn rollers were transferred to the expert system by means of a “user-friendly” interface to deduce the reason for the failure.

An Expert System for Guiding Selection of Direct-Reading Air Monitoring Instruments

Abstract There is a broad range of commercially available direct-reading instruments for monitoring workplace airborne gases and vapors. When selecting an instrument for a particular application, the industrial hygienist must consider a number of parameters related to the instruments' analytical capacities and field conditions. The current study was directed toward evaluating the feasibility of developing a computerized expert system for guiding selection of monitoring instruments. As the first step in developing a knowledge base for the model expert system, documented information about nine classes of direct-reading instruments was collected and assembled in a computerized manual designed as a hypertext. A hypertext consists of structured information stored in the form of text frames, and includes navigational methods for moving between sections and levels of the text. The hypertext was programmed to allow a user to read about the properties of each instrument, or to compare alternative instruments, by navigating among the different screens using hypertext methods such as menus, buttons, and hotwords. A model expert system for guiding instrument selection was then designed, based on the information in the hypertext. It was possible to access the expert system from any point within the hypertext. During its development, issues in instrument selection were investigated, including the logic involved, the availability and validity of evaluative information for selection of monitoring instruments, the gaps in our knowledge, and the relative importance of parameters considered when selecting an instrument. Grafstein, O.; Levine, S.P.: An Expert System for Guiding Selection of Direct-Reading Air Monitoring Instruments. Appl. Occup. Environ. Hyg. 8(3):157-167; 1993.