Tracing and cataloguing knowledge in an e-health cardiology environment

AbstractIn an e-health cardiology environment, the current knowledge engineering systems can support two knowledge processes; the knowledge tracing, and the knowledge cataloguing.We have developed an n-tier system capable of supporting these processes by enabling human collaboration in each phase along with, a prototype scalable knowledge engineering tactic. A knowledge graph is used as a dynamic information structure. Biosignal data (values of HR, QRS, and ST variables) from 86 patients were used; two general practitioners defined and updated the patients’ clinical management protocols; and feedback was inserted retrospectively. Several calibration tests were also performed.The system succeeded in formulating three knowledge catalogues per patient, namely, the “patient in life”, the “patient in time”, and the “patient in action”.For each patient the clinically accepted normal limits of each variable were predicted with an accuracy of approximately 95%. The patients’ risk-levels were identified accurately, and in turn, the errors were reduced. The data and the expert-oriented feedback were also time-stamped correctly and synchronized under a common time-framework.Knowledge processes optimization necessitates human collaboration and scalable knowledge engineering tactics. Experts should be responsible for resenting or rejecting a process if it downgrades the provided healthcare quality

C-Reactive Protein Polymorphism and Serum Levels as an Independent Risk Factor in Sickle Cell Disease

This study explored the relationship of a dinucleotide repeat polymorphism in the intron of the CRP gene and serum CRP levels as independent risk factors for end-organ dysfunction (mild vs. severe) in adults with sickle cell disease. The pathogenesis of secondary complications of sickle cell disease is complex and poorly understood. Predicting the severity of these complications could assist in therapeutic decision-making. The study measured serum CRP levels and the number of CA intron repeats located on the CRP gene in 29 adults (31.74 ± 11.54 years) with sickle cell disease The hemoglobin genotypes were distributed as Hgb SS 48.6% (17 of n = 29), Hgb SC 20.0% (7 of n = 29), Sβ° 10.3% (3 of n = 29), and Sβ+ 6.9% (2 of n = 29). The sample was categorized as mild (n = 9) no end-organ dysfunction vs. severe (n = 21) documented end-organ dysfunction. The severe group was sub-categorized by specific organ dysfunctions, 9 with pulmonary hypertension, 6 with renal dysfunction and 6 with cerebral vascular accident. Examination of serum CRP levels found no significant association with severe end-stage organ dysfunction. There was no significant association between serum CRP level and the polymorphism. However, a significant negative correlation (rho = -0.401, p = 0.031) was found between glomerular filtration rates and CAhigh repeats (≥17). Previous studies have found an association of genetic variations in the CRP gene polymorphism to serum CRP levels. While this pilot study found no evidence of this association, the findings provide some rationale for further investigation of the repeat polymorphism in the CRP gene and its association with renal end-organ dysfunction

Patient-Centric Knowledge Graphs: A Survey of Current Methods, Challenges, and Applications

Patient-Centric Knowledge Graphs (PCKGs) represent an important shift in healthcare that focuses on individualized patient care by mapping the patient's health information in a holistic and multi-dimensional way. PCKGs integrate various types of health data to provide healthcare professionals with a comprehensive understanding of a patient's health, enabling more personalized and effective care. This literature review explores the methodologies, challenges, and opportunities associated with PCKGs, focusing on their role in integrating disparate healthcare data and enhancing patient care through a unified health perspective. In addition, this review also discusses the complexities of PCKG development, including ontology design, data integration techniques, knowledge extraction, and structured representation of knowledge. It highlights advanced techniques such as reasoning, semantic search, and inference mechanisms essential in constructing and evaluating PCKGs for actionable healthcare insights. We further explore the practical applications of PCKGs in personalized medicine, emphasizing their significance in improving disease prediction and formulating effective treatment plans. Overall, this review provides a foundational perspective on the current state-of-the-art and best practices of PCKGs, guiding future research and applications in this dynamic field

Experts on e-learning: insights gained from listening to the student voice!

The Student Experience of e-Learning Laboratory (SEEL) project at the University of Greenwich was designed to explore and then implement a number of approaches to investigate learners’ experiences of using technology to support their learning. In this paper members of the SEEL team present initial findings from a University-wide survey of nearly a 1000 students. A selection of 90 ‘cameos’, drawn from the survey data, offer further insights into personal perceptions of e-learning and illustrate the diversity of students experiences. The cameos provide a more coherent picture of individual student experience based on the totality of each person’s responses to the questionnaire. Finally, extracts from follow-up case studies, based on interviews with a small number of students, allow us to ‘hear’ the student voice more clearly. Issues arising from an analysis of the data include student preferences for communication and social networking tools, views on the ‘smartness’ of their tutors’ uses of technology and perceptions of the value of e-learning. A primary finding and the focus of this paper, is that students effectively arrive at their own individualised selection, configuration and use of technologies and software that meets their perceived needs. This ‘personalisation’ does not imply that such configurations are the most efficient, nor does it automatically suggest that effective learning is occurring. SEEL reminds us that learners are individuals, who approach learning both with and without technology in their own distinctive ways. Hearing, understanding and responding to the student voice is fundamental in maximising learning effectiveness. Institutions should consider actively developing the capacity of academic staff to advise students on the usefulness of particular online tools and resources in support of learning and consider the potential benefits of building on what students already use in their everyday lives. Given the widespread perception that students tend to be ‘digital natives’ and academic staff ‘digital immigrants’ (Prensky, 2001), this could represent a considerable cultural challenge

Research tools for design. Spatial layout and patterns of users' behaviour

The publication proposes a critical reading of the results emerging from the Seminar organised in January 2010 by the Department of Architectural and Design Technology on research tools for the architectural project. The spatial layout of buildings and urban spaces influences behaviour and the relations of the users, and in this displays the social nature of the architectural function in comparison to other spheres of design. Space Syntax (theory, methodology and techniques for the analysis of complex systems) takes this theory as the basis for its research. The seminar, attended by leading academic and professional figures, offered the opportunity for exchange between its own research and the experiences carried forward by the Space Syntax research and consultancy group

Clinical Genetics in Britain: Origins and development

Annotated and edited transcript of a Witness Seminar held on 23 September 2008. Introduction by Professor Sir John Bell, Uiversity of Oxford.First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2010.©The Trustee of the Wellcome Trust, London, 2010.All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 23 September 2008. Introduction by Professor Sir John Bell, Uiversity of Oxford.Annotated and edited transcript of a Witness Seminar held on 23 September 2008. Introduction by Professor Sir John Bell, Uiversity of Oxford.Annotated and edited transcript of a Witness Seminar held on 23 September 2008. Introduction by Professor Sir John Bell, Uiversity of Oxford.Annotated and edited transcript of a Witness Seminar held on 23 September 2008. Introduction by Professor Sir John Bell, Uiversity of Oxford.Annotated and edited transcript of a Witness Seminar held on 23 September 2008. Introduction by Professor Sir John Bell, Uiversity of Oxford.Annotated and edited transcript of a Witness Seminar held on 23 September 2008. Introduction by Professor Sir John Bell, Uiversity of Oxford.Clinical genetics has become a major medical specialty in Britain since its beginnings with Lionel Penrose’s work on mental handicap and phenylketonuria (PKU) and John Fraser Robert’s first genetic clinic in 1946. Subsequent advances in diagnosis and prediction have had key impacts on families with inherited disorders and prospective parents concerned about their unborn children. The Witness Seminar focused on the beginnings of British clinical genetics in London, Oxford, Liverpool and Manchester, the development of subspecialties, such as dysmorphology, and also the roles of the Royal College of Physicians, the Clinical Genetics Society and the Department of Health in the establishment of clinical genetics as a specialty in 1980. Specialist non-medical genetic counsellors, initially from the fields of nursing and social work, progressively became a more significant part of genetic services, while lay societies also developed an important influence on services. Prenatal diagnosis became possible with the introduction of new genetic tools in regional centres to identify fetal anomalies and chromosomal disorders. This volume complements the 2001 Witness Seminar on genetic testing which emphasizes laboratory aspects of medical genetics, with limited coverage of clinical genetics. Participants include: Ms Chris Barnes, Dr Caroline Berry, Professor Martin Bobrow (chair), Professor Sir John Burn, Dr Ian Lister Cheese, Professor Angus Clarke, Dr Clare Davison, Professor Joy Delhanty, Dr Nick Dennis, Professor Dian Donnai, Professor Alan Emery, Professor George Fraser, Mrs Margaret Fraser Roberts, Professor Peter Harper, Dr Hilary Harris, Professor Rodney Harris, Professor Shirley Hodgson, Dr Alan Johnston, Mrs Ann Kershaw, Mrs Lauren Kerzin-Storrar, Professor Michael Laurence, Professor Ursula Mittwoch, Professor Michael Modell, Professor Marcus Pembrey, Professor Sue Povey, Professor Heather Skirton, Professor Sir David Weatherall. Harper P A, Reynolds L A, Tansey E M. (eds) (2010) Clinical genetics in Britain: Origins and development. Wellcome Witnesses to Twentieth Century Medicine, vol. 39. London: The Wellcome Trust Centre for the History of Medicine at UCL.The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

Information Systems and Healthcare XXXIV: Clinical Knowledge Management Systems—Literature Review and Research Issues for Information Systems

Knowledge Management (KM) has emerged as a possible solution to many of the challenges facing U.S. and international healthcare systems. These challenges include concerns regarding the safety and quality of patient care, critical inefficiency, disparate technologies and information standards, rapidly rising costs and clinical information overload. In this paper, we focus on clinical knowledge management systems (CKMS) research. The objectives of the paper are to evaluate the current state of knowledge management systems diffusion in the clinical setting, assess the present status and focus of CKMS research efforts, and identify research gaps and opportunities for future work across the medical informatics and information systems disciplines. The study analyzes the literature along two dimensions: (1) the knowledge management processes of creation, capture, transfer, and application, and (2) the clinical processes of diagnosis, treatment, monitoring and prognosis. The study reveals that the vast majority of CKMS research has been conducted by the medical and health informatics communities. Information systems (IS) researchers have played a limited role in past CKMS research. Overall, the results indicate that there is considerable potential for IS researchers to contribute their expertise to the improvement of clinical process through technology-based KM approaches