A Generic Approach and Framework for Managing Complex Information

Several application domains, such as healthcare, incorporate domain knowledge into their day-to-day activities to standardise and enhance their performance. Such incorporation produces complex information, which contains two main clusters (active and passive) of information that have internal connections between them. The active cluster determines the recommended procedure that should be taken as a reaction to specific situations. The passive cluster determines the information that describes these situations and other descriptive information plus the execution history of the complex information. In the healthcare domain, a medical patient plan is an example for complex information produced during the disease management activity from specific clinical guidelines. This thesis investigates the complex information management at an application domain level in order to support the day-to-day organization activities. In this thesis, a unified generic approach and framework, called SIM (Specification, Instantiation and Maintenance), have been developed for computerising the complex information management. The SIM approach aims at providing a conceptual model for the complex information at different abstraction levels (generic and entity-specific). In the SIM approach, the complex information at the generic level is referred to as a skeletal plan from which several entity-specific plans are generated. The SIM framework provides comprehensive management aspects for managing the complex information. In the SIM framework, the complex information goes through three phases, specifying the skeletal plans, instantiating entity-specific plans, and then maintaining these entity-specific plans during their lifespan. In this thesis, a language, called AIM (Advanced Information Management), has been developed to support the main functionalities of the SIM approach and framework. AIM consists of three components: AIMSL, AIM ESPDoc model, and AIMQL. The AIMSL is the AIM specification component that supports the formalisation process of the complex information at a generic level (skeletal plans). The AIM ESPDoc model is a computer-interpretable model for the entity-specific plan. AIMQL is the AIM query component that provides support for manipulating and querying the complex information, and provides special manipulation operations and query capabilities, such as replay query support. The applicability of the SIM approach and framework is demonstrated through developing a proof-of-concept system, called AIMS, using the available technologies, such as XML and DBMS. The thesis evaluates the the AIMS system using a clinical case study, which has applied to a medical test request application

Linked Data Science Powered by Knowledge Graphs

In recent years, we have witnessed a growing interest in data science not only from academia but particularly from companies investing in data science platforms to analyze large amounts of data. In this process, a myriad of data science artifacts, such as datasets and pipeline scripts, are created. Yet, there has so far been no systematic attempt to holistically exploit the collected knowledge and experiences that are implicitly contained in the specification of these pipelines, e.g., compatible datasets, cleansing steps, ML algorithms, parameters, etc. Instead, data scientists still spend a considerable amount of their time trying to recover relevant information and experiences from colleagues, trial and error, lengthy exploration, etc. In this paper, we, therefore, propose a scalable system (KGLiDS) that employs machine learning to extract the semantics of data science pipelines and captures them in a knowledge graph, which can then be exploited to assist data scientists in various ways. This abstraction is the key to enabling Linked Data Science since it allows us to share the essence of pipelines between platforms, companies, and institutions without revealing critical internal information and instead focusing on the semantics of what is being processed and how. Our comprehensive evaluation uses thousands of datasets and more than thirteen thousand pipeline scripts extracted from data discovery benchmarks and the Kaggle portal and shows that KGLiDS significantly outperforms state-of-the-art systems on related tasks, such as dataset recommendation and pipeline classification.Comment: 11 pages, 6 figure

Geothermal studies in oilfield districts of Eastern Margin of the Gulf of Suez, Egypt

AbstractResults of geothermal studies carried out at 149 onshore oil wells have been used in evaluation of temperature gradient and heat flow values of the eastern shore of the Gulf of Suez. The investigations included temperature logs in boreholes, calculation of amplitude temperature, geothermal gradients and heat flow. The results obtained indicate that geothermal gradient values are in the ranges of 0.02–0.044°C/m and regionally averaged mean heat flow values are found to fall in the interval of 45–120mW/m2. Temperature gradients and heat flow values change from low values eastward to high values toward the axial of Gulf of Suez rift. The result of this research work has been highly successful in identifying new geothermal resources eastward of the Gulf of Suez. Additionally, this study shows that the areas with relatively higher temperature gradients have lower oil window, mature earlier, than those with low gradient values. Thus, high temperature gradients cause to expedite the formation of oil at relatively shallow depths and narrow oil windows. On the other hand, low temperature gradient makes the oil window to be quite broad when locate at high depths

An Event-Driven Approach to Computerizing Clinical Guidelines Using XML

Clinical events form the basis of patient care practice. Their computerization is an important aid to the work of clinicians. Clinical guidelines or protocols direct clinicians and patients on when and how to handle clinical problems. Thus, clinical guidelines are an encapsulation of clinical events. Hence, an event-driven approach to computerizing the management of clinical guidelines is worthy of investigation. In our framework, called SpEM, the main clinical guideline management dimensions are specification, execution, and manipulation. This paper presents an event-driven approach, within the context of the SpEM framework, to manage clinical guidelines. The event-driven approach is based on the event-condition-action (ECA) rule paradigm in which the ECA rules are specified using an XML-based language over an electronic healthcare record (EHCR) implemented using an XML-enabled DBMS. This approach facilitates the easy querying, operations and execution replay for clinical guidelines. The approach provides a ready solution to the problem of the integration of clinical guideline management systems (CGMS) and the EHCR. This creates an “active EHCR” in which reactivity is defined by the medical logic in the clinical guideline. The paper practices the approach presented here by using a simplified clinical guideline/protocol from the domain of clinical laboratory investigation for microalbuminuria screening

ACETYLCHOLINESTERASE INHIBITION AND ANTIOXIDANT ACTIVITY OF SOME MEDICINAL PLANTS FOR TREATING NEURO DEGENARATIVE DISEASE

Background: Numerous plants in traditional practices of medicine have been used to treat cognitive disorders, including neurodegenerative diseases such as Alzheimer’s disease (AD) and other memory related disorders. Materials and Methods: We present here the evaluation of acetylcholinesterase (AChE) inhibitory and antioxidant activities of the aqueous methanol extracts of five traditional medicinal plants. Citrullus colocynthis, Emex spinosa, Rhazya stricta, Scrophularia hypericifolia and Caylusea hexagyna extracts were tested for their acetylcholinesterase inhibitory effect ant their antioxidant effect at different concentrations. Results: Citrullus colocynthis and Emex spinosa inhibited acetylthiocholinesterase at 400 µg/ ml by 83.54 and 81.92%. Emex spinosa and Scrophularia hypericifolia produced the maximum effect as DPPH radical scavenger (IC50= 10.89 and 11.88µg/ ml, respectively). Scrophularia hypericifolia showed the highest effect as superoxide radical scavenger (IC50= 20.83 µg/ ml)also it produced the highest ability to scavenge hydrogenperoxide radicals (IC50= 8.66 µg/ ml) while Emex spinosa and Caylusea hexagyna showed least IC50 for ferrous ion chelation (IC50≈15 µg/ ml) with powerful reduction capability. Conclusion:The determined antioxidant properties magnified the total antioxidant effect determined by ABTS assay that completely inhibited lipidperoxidation at 200 µg/ ml

Hydrometeorology: Review of Past, Present and Future Observation Methods

Hydrometeorology aims at measuring and understanding the physics, chemistry, energy and water fluxes of the atmosphere, and their coupling with the earth surface environmental parameters. Accurate hydrometeorological records and observations with different timelines are crucial to assess climate evolution and weather forecast. Historical records suggest that the first hydrometeorological observations date back to ca 3500 BC. Reviewing these observations in the light of our modern knowledge of the dynamic of atmospheres is critical as it can reduce the ambiguities associated to understanding major fluctuations or evolutions in the earth climate. Today, the ambiguities in hydrometeorological observations have significantly improved due to the advances in monitoring, modeling, and forecasting of processes related to the land-atmosphere coupling and forcing. Numerical models have been developed to forecast hydrometeorological phenomena in short-, medium- and long-term horizons, ranging from hourly to annual timescales. We provide herein a synthetic review of advances in hydrometeorological observations from their infancy to today. In particular, we discuss the role of hydrometeorological records, observations, and modeling in assessing the amplitude and time-scale for climate change and global warming

Inputs to quality: supervision, management, and community involvement in health facilities in Egypt in 2004

<p>Abstract</p> <p>Background</p> <p>As low- and middle-income countries experience economic development, ensuring quality of health care delivery is a central component of health reform. Nevertheless, health reforms in low- and middle-income countries have focused more on access to services rather than the quality of these services, and reporting on quality has been limited. In the present study, we sought to examine the prevalence and regional variation in key management practices in Egyptian health facilities within three domains: supervision of the facility from the Ministry of Health and Population (MOHP), managerial processes, and patient and community involvement in care.</p> <p>Methods</p> <p>We conducted a cross-sectional analysis of data from 559 facilities surveyed with the Egyptian Service Provision Assessment (ESPA) survey in 2004, the most recent such survey in Egypt. We registered on the Measure Demographic and Health Survey (DHS) website <url>http://legacy.measuredhs.com/login.cfm</url> to gain access to the survey data. From the ESPA sampled 559 MOHP facilities, we excluded a total of 79 facilities because they did not offer facility-based 24-hour care or have at least one physician working in the facility, resulting in a final sample of 480 facilities. The final sample included 76 general service hospitals, 307 rural health units, and 97 maternal and child health and urban health units (MCH/urban units). We used standard frequency analyses to describe facility characteristics and tested the statistical significance of regional differences using chi-square statistics.</p> <p>Results</p> <p>Nearly all facilities reported having external supervision within the 6 months preceding the interview. In contrast, key facility-level managerial processes, such as having routine and documented management meetings and applying quality assurance approaches, were uncommon. Involvement of communities and patients was also reported in a minority of facilities. Hospitals and health units located in Urban Egypt compared with more rural parts of Egypt were significantly more likely to have management committees that met at least monthly, to keep official records of the meetings, and to have an approach for reviewing quality assurance activities.</p> <p>Conclusions</p> <p>Although the data precede the recent reform efforts of the MOHP, they provide a baseline against which future progress can be measured. Targeted efforts to improve facility-level management are critical to supporting quality improvement initiatives directed at improving the quality of health care throughout the country.</p

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication