Temporal detection and analysis of guideline interactions

Background Clinical practice guidelines (CPGs) are assuming a major role in the medical area, to grant the quality of medical assistance, supporting physicians with evidence-based information of interventions in the treatment of single pathologies. The treatment of patients affected by multiple diseases (comorbid patients) is one of the main challenges for the modern healthcare. It requires the development of new methodologies, supporting physicians in the treatment of interactions between CPGs. Several approaches have started to face such a challenging problem. However, they suffer from a substantial limitation: they do not take into account the temporal dimension. Indeed, practically speaking, interactions occur in time. For instance, the effects of two actions taken from different guidelines may potentially conflict, but practical conflicts happen only if the times of execution of such actions are such that their effects overlap in time. Objectives We aim at devising a methodology to detect and analyse interactions between CPGs that considers the temporal dimension. Methods In this paper, we first extend our previous ontological model to deal with the fact that actions, goals, effects and interactions occur in time, and to model both qualitative and quantitative temporal constraints between them. Then, we identify different application scenarios, and, for each of them, we propose different types of facilities for user physicians, useful to support the temporal detection of interactions. Results We provide a modular approach in which different Artificial Intelligence temporal reasoning techniques, based on temporal constraint propagation, are widely exploited to provide users with such facilities. We applied our methodology to two cases of comorbidities, using simplified versions of CPGs. Conclusion We propose an innovative approach to the detection and analysis of interactions between CPGs considering different sources of temporal information (CPGs, ontological knowledge and execution logs), which is the first one in the literature that takes into account the temporal issues, and accounts for different application scenarios

A Cognitive Framework to Secure Smart Cities

The advancement in technology has transformed Cyber Physical Systems and their interface with IoT into a more sophisticated and challenging paradigm. As a result, vulnerabilities and potential attacks manifest themselves considerably more than before, forcing researchers to rethink the conventional strategies that are currently in place to secure such physical systems. This manuscript studies the complex interweaving of sensor networks and physical systems and suggests a foundational innovation in the field. In sharp contrast with the existing IDS and IPS solutions, in this paper, a preventive and proactive method is employed to stay ahead of attacks by constantly monitoring network data patterns and identifying threats that are imminent. Here, by capitalizing on the significant progress in processing power (e.g. petascale computing) and storage capacity of computer systems, we propose a deep learning approach to predict and identify various security breaches that are about to occur. The learning process takes place by collecting a large number of files of different types and running tests on them to classify them as benign or malicious. The prediction model obtained as such can then be used to identify attacks. Our project articulates a new framework for interactions between physical systems and sensor networks, where malicious packets are repeatedly learned over time while the system continually operates with respect to imperfect security mechanisms

GLARE-SSCPM: an Intelligent System to Support the Treatment of Comorbid Patients

The development of software tools supporting physicians in the treatment of comorbid patients is a challenging goal and a hot topic in Medical Informatics and Artificial Intelligence. Computer Interpretable Guidelines (CIGs) are consolidated tools to support physicians with evidence-based recommendations in the treatment of patients affected by a specific disease. However, the applications of two or more CIGs on comorbid patients is critical, since dangerous interactions between (the effects of) actions from different CIGs may arise. GLARE-SSCPM is the first tool supporting, in an integrated way, (i) the knowledge-based detection of interactions, (ii) the management of the interactions, and (iii) the final merge of (part of) the CIGs operating on the patient. GLARE-SSCPM is characterized by being very supportive to physicians, providing them support for focusing, interaction detection, and for an hypothesize and test approach to manage the detected interactions. To achieve such goals, it provides advanced Artificial Intelligence techniques. Preliminary tests in the educational context, within the RoPHS project, have provided encouraging results

GUARDIANS final report

Emergencies in industrial warehouses are a major concern for firefghters. The large dimensions together with the development of dense smoke that drastically reduces visibility, represent major challenges. The Guardians robot swarm is designed to assist fire fighters in searching a large warehouse. In this report we discuss the technology developed for a swarm of robots searching and assisting fire fighters. We explain the swarming algorithms which provide the functionality by which the robots react to and follow humans while no communication is required. Next we discuss the wireless communication system, which is a so-called mobile ad-hoc network. The communication network provides also one of the means to locate the robots and humans. Thus the robot swarm is able to locate itself and provide guidance information to the humans. Together with the re ghters we explored how the robot swarm should feed information back to the human fire fighter. We have designed and experimented with interfaces for presenting swarm based information to human beings

Computerization of workflows, guidelines and care pathways: a review of implementation challenges for process-oriented health information systems

There is a need to integrate the various theoretical frameworks and formalisms for modeling clinical guidelines, workflows, and pathways, in order to move beyond providing support for individual clinical decisions and toward the provision of process-oriented, patient-centered, health information systems (HIS). In this review, we analyze the challenges in developing process-oriented HIS that formally model guidelines, workflows, and care pathways. A qualitative meta-synthesis was performed on studies published in English between 1995 and 2010 that addressed the modeling process and reported the exposition of a new methodology, model, system implementation, or system architecture. Thematic analysis, principal component analysis (PCA) and data visualisation techniques were used to identify and cluster the underlying implementation ‘challenge’ themes. One hundred and eight relevant studies were selected for review. Twenty-five underlying ‘challenge’ themes were identified. These were clustered into 10 distinct groups, from which a conceptual model of the implementation process was developed. We found that the development of systems supporting individual clinical decisions is evolving toward the implementation of adaptable care pathways on the semantic web, incorporating formal, clinical, and organizational ontologies, and the use of workflow management systems. These architectures now need to be implemented and evaluated on a wider scale within clinical settings