Integrating heterogeneous data into electronic medical record analysis

Electronic medical records (EMRs) are the digital equivalent of paper records at a clinician's office. They contain patient information such as treatment and medical history, and have been shown to have a wide variety of benefits. However, EMRs typically contain a multitude of diverse data, including images, doctor notes, medical test results, and genomic data. This heterogeneity generates high dimensionality and data sparsity, which are two of the most prevalent culprits that exacerbate already difficult computational problems. Additionally, domain-specific characteristics, such as the existence of synonyms in the medical vocabulary, introduce ambiguity. This can further reduce the data mining potential of EMRs. This thesis is a systematic study that addresses these issues associated with EMRs. In particular, I utilized heterogeneous data sources that are typically incompatible, and then developed frameworks in which these data sources complement one another. As a result, these methods have the potential for direct clinical translation, paving the way for improving healthcare from a data-driven perspective. To improve a variety of downstream healthcare applications, such as patient subcategorization, survival analysis, and visualization, I used external networks of domain knowledge consisting of drug-symptom relationships, protein-protein interactions, and genetic information to enhance patient records. I found that this enhancement process increased the data mining capabilities as well as the interpretability of the EMRs. To improve EMR retrieval systems, I developed a query expansion method that frames symptoms and treatments as two different languages. I found that a topic modeling method that follows this dual-language framework yielded the highest performance. Lastly, I showed that due to pathological similarities, jointly studying Alzheimer's disease and Parkinson's disease resulted in higher computational power by effectively increasing the size of the training datasets. This allowed for the accurate prediction of the onset of dementia in both diseases. Each of these results can lay the groundwork for applications that have the potential to be implemented directly in clinical practice, improving the safety and quality of patient care

Front-Line Physicians' Satisfaction with Information Systems in Hospitals

Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe

Bioassays guided in vitro investigations on skin-active plants from traditional Chinese medicine

Die bioaktivitätsgeleitete Untersuchung von wundheilungsaktiven Pflanzen aus der traditionellen chinesischen Medizin wurde mit Hilfe eines breitgefächerten Screenings durchgeführt. Ein EtOH-H2O (6:4) Extrakt aus Moutan cortex (Paeoniae suffructicosa Andr.) zeigte eine signifikante stimulierende Aktivität auf die Zellvitalität von normalen humanen dermalen Fibroblasten und humanen Keratinocyten. Die weitere bioaktivitätsgeleitete Fraktionierung ergab 7 Verbindungen, von denen (-)-epicatechin-3-O-gallat, die oligomeren Proanthocyanidine (-)-epicatechin-(4β→8)-catechin und Epicatechin-3-O-gallat-(4→8)-catechin zum ersten Mal neben Pentagalloylglucose für diese Droge beschrieben wurden. Die zellvitalitätsstimulierenden Eigenschaften wurden weiterhin bei einigen tannin-reichen Fraktionen beobachtet. Auch Pentagalloylglucose erhöhte in einer Konzentration von 1.1 x 10 -4 mol/L die Zellvitalität und die zelluläre Proliferation. Bioassays guided investigation on skin-active plants from Traditional Chinese Medicine were performed within a broad screening. A ethanol-water (6:4) extract from Moutan cortex (Paeoniae suffruticosa Andr.) was proven to have significant stimulating activities on the cell viability of normal human dermal fibroblasts and human kerationcytes. Further bioassay-guided fractionation yielded 7 compounds from which (-)-epicatechin-3-O-gallate, the oligomeric proanthocyanidins (-)-epicatechin-(4β→8)-catechin and epicatechin-3-O-gallate-(4→8)-catechin were firstly reported for this herbal drug beside pentagalloylglucose. The cell viability stimulating function was further obtained from some tannin-rich fractions. Also pentagalloylglucose enhanced cell viability and cellular proliferation at concentration of 1.1×10-4 mol/L

The Narration of a 'traditional' Medicine in China's Political Discourse

This PhD dissertation analyses and explains various narratives that exist on the modern concept of a Traditional Chinese Medicine. Thereafter it is shown how the globally known TCM is rather a new invention and a new corpus of contents which serve as means to certain political, economic, and cultural goals. The book thereby also uncovers how Chinese medicine as a cultural object functions as an element to constitute and re-invent Chinese culture as a whole

Timely and reliable evaluation of the effects of interventions: a framework for adaptive meta-analysis (FAME)

Most systematic reviews are retrospective and use aggregate data AD) from publications, meaning they can be unreliable, lag behind therapeutic developments and fail to influence ongoing or new trials. Commonly, the potential influence of unpublished or ongoing trials is overlooked when interpreting results, or determining the value of updating the meta-analysis or need to collect individual participant data (IPD). Therefore, we developed a Framework for Adaptive Metaanalysis (FAME) to determine prospectively the earliest opportunity for reliable AD meta-analysis. We illustrate FAME using two systematic reviews in men with metastatic (M1) and non-metastatic (M0)hormone-sensitive prostate cancer (HSPC)

The brain of the smart transportation system : exploring the role of future expectations and sociotechnical imaginaries in cutting-edge science and technology policymaking in China

The brain of the smart transportation system: exploring the role of future expectations and sociotechnical imaginaries in cutting-edge science and technology policymaking In recent years, Big Data has developed rapidly, improving the efficiency and safety of the transportation system, but varied understandings of Big Data have shaped contextualised expectations and imaginaries, which has introduced new tension in the policymaking of technology. Additionally the mixed use of concepts such as “future expectation” and “sociotechnical imaginary” in future-oriented STS studies makes the relevant case studies unclear at the theoretical level. Thus, this thesis endeavours to distinguish these concepts within a specific situated context, to shed light on how they work in China’s science and technology policymaking process, and to understand the nature of Big Data. To do so it explores a new technology that emerged in China since the 2000s – the Smart Transportation System – a hybrid of the traditional transportation system and Big Data. This thesis draws on a mixed-methods approach, including an analysis of governmental policy documents from 2016 to 2020, 29 semi-structured qualitative interviews with engineers, academics, and local government officials, conducted in seven Chinese cities. This thesis contributes three advances to knowledge of future-oriented studies, science and technology policymaking studies, and Big Data studies in the Chinese context: 1) by showing that future expectation is related to the paradigms and the interests of two scientific communities of the Smart Transportation System field, while sociotechnical imaginary links to the epistemology and knowledge used in the decision-making process; 2) by outlining a two-way, dynamic circle in which the sociotechnical imaginary of the central government creates an intended institutional void, leaving space for local governments interpretations, and these interpretations in turn drive the birth of a new sociotechnical imaginary of central government; 3) by furthering our understanding of Big Data and Artificial Intelligence via revisiting the nature of Big Data from the perspective of traditional Chinese culture