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Personalising e-learning modules: targeting Rasmussen levels using XML.

The development of Internet technologies has made it possible to increase the number and the diversity of on-line resources for teachers and students. Initiatives like the French-speaking Virtual Medical University Project (UMVF) try to organise the access to these resources. But both teachers and students are working on a partly redundant subset of knowledge. From the analysis of some French courses we propose a model for knowledge organisation derived from Rasmussen's stepladder. In the context of decision-making Rasmussen has identified skill-based, rule-based and knowledge-based levels for the mental process. In the medical context of problem-solving, we apply these three levels to the definition of three students levels: beginners, intermediate-level learners, experts. Based on our model, we build a representation of the hierarchical structure of data using XML language. We use XSLT Transformation Language in order to filter relevant data according to student level and to propose an appropriate display on students' terminal. The model and the XML implementation we define help to design tools for building personalised e-learning modules.

Academic Medical Centers↗

An electronic patient record implementation using clinical document architecture.

Electronic patient records (EPRs) provide the means for integrated access to patient information that may be scattered across dispersed healthcare organizations that, in general, use heterogeneous systems in order to support their internal functions. XML language and Clinical Document Architecture (CDA) provides a mechanism for defining, structuring, manipulating and visualizing patient medical data using the same semantics through web. In this paper, a prototype implementation of a web-based electronic patient record (EPR) system using XML for data format and CDA for defining and structuring patient clinical documents is presented.

Databases as Topic↗

Using spreadsheet languages to understand sequence analysis algorithms.

Spreadsheet languages have gained enormous popularity for simple numerical computations, but their power in non-numerical contexts has not been widely recognized. This paper presents spreadsheet implementations of several familiar sequence analysis tools. In many cases, spreadsheet notation clarifies the underlying algorithm, facilitating understanding of existing algorithms and promoting spontaneous experimentation. Spreadsheets also reveal, through their visible parallelism, opportunities for applying parallel processors to computationally challenging problems.

Algorithms↗

Extracting clinical cases from XML-based electronic patient records for use in web-based medical case based reasoning systems.

Development and usage of Case Based Reasoning (CBR) driven medical diagnostic system requires a large volume of clinical cases that depict the problem-solving methodology of medical experts. Successful usage of CBR based systems in healthcare is constrained by the need for a continuous supply of current and correct clinical cases (in an electronic medium) from medical experts. To address this constraint we present a strategy to pro-actively transform generic Electronic Patient Records (EPR) to Operable CBR-oriented Cases (OCC) that are compliant to specialised CBR-based medical systems. EPR-OCC transformation methodology is based on XML parse-trees, Unified Medical Language Source (UMLS) meta-thesauri and medical knowledge ontologies. The featured work involves the implementation of a Java-based computer system for the automatic transformation of XML-based EPR-originating from heterogeneous EPR repositories accessible over the Internet/WWW-to specialised OCC that can then be seamlessly incorporated within Intelligent CBR-based Medical Diagnostic Systems.

Diagnosis, Computer-Assisted↗

XML syntax for clinical laboratory procedure manuals.

We have developed a document type description (DTD) in Extensable Markup Language (XML) for clinical laboratory procedures. Our XML syntax can adequately structure a variety of procedure types across different laboratories and is compatible with current procedure standards. The combination of this format with an XML content management system and appropriate style sheets will allow efficient procedure maintenance, distributed access, customized display and effective searching across a large body of test information.

Clinical Laboratory Techniques↗

A methodology for modular representation of guidelines.

Computer-based clinical practice guidelines often need to be modified when medical knowledge evolves or when guidelines are implemented in a local setting with specific constraints and preferences. To enable easy modifications to guidelines and maintain their integrity, we have developed a methodology for modular representation of guidelines. Using this approach, we create guidelines in a hierarchical and modular manner. We use the Axiomatic Design methodology to facilitate the development of independent modules. Design matrices capture the interactions among modules. The design matrices can be used during guideline modification to create a change process and to enable identification of other modules that are affected by a change to a module. We implemented this modular knowledge representation approach by incorporating it into the Guideline Interchange Format (GLIF) language. We applied this approach to encode parts of three outdated guidelines released during 2000-2001, and we revised these designs to model updated releases of the guideline. Qualitative and quantitative metrics were developed to assess the types of changes made to the encoded guidelines.

Adult↗

Modelling clinical goals: a corpus of examples and a tentative ontology.

Knowledge of clinical goals and the means to achieve them are either not represented in most current guideline representation systems or are encoded procedurally (e.g. as clinical algorithms, condition-action rules). There would be a number of major benefits if guideline enactment systems could reason explicitly about clinical objectives (e.g. whether a goal has been successfully achieved or not, whether it is consistent with prevailing conditions, or how the system should adapt to circumstances where a recommended action has failed to achieve the intended result). Our own guideline specification language, PROforma, includes a simple goal construct to address this need, but the interpretation is unsatisfactory in current enactment engines, and goals have yet to be included in the language semantics. This paper discusses some of the challenges involved in developing an explicit, declarative formalism for goals. As part of this, we report on a study we have undertaken which has identified over 200 goals in the routine management of breast cancer, and outline a tentative formal structure for this corpus.

Breast Neoplasms↗

Metabolic pathways in three dimensions.

MOTIVATION: Currently a substantial research effort is devoted to automated representation of metabolic and gene networks. Automatic visualization plays a significant role in such efforts, and becomes an important problem on its own. Graphical visualization of metabolic pathways has to be information dense and not 'overloaded', recognizable and unified, close to traditional and algebraically consistent. The use of three-dimensional 'virtual reality' visualizations may help to understand better the intricate topology of metabolic and regulatory networks. RESULTS: A system of visualizing metabolic networks as graphs in three-dimensional space by means of Virtual Reality Modeling Language (VRML) is presented. The system is based on an XML-compliant MNV ('Metabolic Network Visualizer') language, and comprises MNV language standard and parser, MNV to VRML translator, and interactive pathway constructor, all unified by the HTML graphic user interface. AVAILABILITY: The MNV can be accessed in viewer mode at http://www.patronov.net/sciencevr/mnv/indexview.html or in constructor mode at http://www.patronov.net/sciencevr/mnv/indexmake.html SUPPLEMENTARY INFORMATION: The figures for the paper as well as the Appendices may be found at http://www.patronov.net/sciencevr/mnv/screenshots.html

Computer Graphics↗

The use of VRML in chemical education.

The Virtual Reality Modelling Language can be used for molecular modelling. The language provides some significant advantages in the area of chemical education; it can be used to communicate 3D concepts not normally covered by existing modelling packages, the data can be distributed to a large number of students over the web, and the viewers are free to students. The strengths and weakness of VRML in various aspects of molecular modelling are discussed.

Chemistry↗

Semantics-based information modeling for the health-care administration sector: the citation platform.

An information brokerage environment for effective information structuring, indexing, and retrieval in the health-care administration sector is presented. The system is based on ontology modeling, natural language processing, extensible markup language, semantics analysis, and behavioral description. Semantics-based information acquisition is achieved through the uniform modeling, representation, and handling of domain-specific knowledge, both content-based and procedural. The system has been validated using information located on several repositories in the web and its performance is reported in terms of precision and recall.

Artificial Intelligence↗

Communicating the logic of a treatment plan formulated in Asbru to domain experts.

This paper presents an interactive visualization for medical treatment plans that are formulated in the plan representation language Asbru. So far, most attention of the protocol-based care community was focused towards formal guideline representation and authoring partly supported by graphical tools. The intention of this work is to go the opposite way and communicate the logic of a computerized treatment plan to physicians, nursing-, and other medical personnel visually. The visualization is based on the idea of flow-chart algorithms widely used in medical education and practice. This concept has been extended in order to cope with the powerful and expressive guideline representation language Asbru. Furthermore, a number of interactive navigational and overview extensions are used to intuitively support the understanding of the logic of plans. The user-centered development approach applied for these interactive visualization methods has been guided by user input gathered via a user study, design reviews, and prototype evaluations as described in this document.

Algorithms↗

Maryland MIRRORS/II: a connectionist model simulator.

Developing and evaluating connectionist models (also called neural models) is a difficult and time-consuming task. To address this issue, we designed a software system called Maryland MIRRORS/II for the construction of connectionist models in biomedicine and other fields. Maryland MIRRORS/II is distinguished from previous and current related systems by its support of a high-level nonprocedural language, a general-purpose event-handling mechanism, and an indexed library of system resources. These features make Maryland MIRRORS/II a convenient software tool for use in biomedicine. This paper describes Maryland MIRRORS/II and provides a simple example in which it uses error back propagation learning to select the appropriate treatment for a given set of manifestations.

Computer Simulation↗

Design of a description language for generating wrapper to collect biological data.

The biological data are scattered in various areas with various formats and they are changing continuously. Therefore, data integration becomes an important issue to provide researcher a dynamic access of data. In the data integration process, the method of extracting heterogeneous data dynamically from the data source is an essential part. Data extraction method using wrapper can provide flexibility and extensibility to an integration system.

Computational Biology↗

Knowledge representation in digital medical documents for efficient information access and retrieval.

Information access and retrieval are essential to serve the delivery and application of evidence-based medicine. The literature provides evidence for the effectiveness of computerization of medical knowledge for increasing compliance with current standards and improving patient outcomes. But all efforts in implementing knowledge-based functions remain limited in respect of either the prolonged exposure to live clinical use, the complexity of knowledge content supported, the dependencies on a technology platform and host system, or the proof of use and content sharing across multiple and varying environments. We have to face currently an information overload, especially in medicine. As a result, efficient ways of implementation of evidence-based care become more and more important. Most of the medical knowledge contained in textbooks, guidelines, journals as well as online resources is text-based. In order to present problem-specific information at the point of care the outlined concept relies on a document-based solution with the eXtensible Markup Language (XML). The adoption of XML as a standard for the publication and interchange of documents creates a great opportunity for better information retrieval. On the basis of structured data we are able to improve the search quality for clinical information which forms a crucial pre-requisite for the implementation of evidence-based care.

Diffusion of Innovation↗

[Basic data in informatics illustrated by their application in surgery].

As an introduction to a study day devoted to informatic in surgery, some basis knowledges are summarized: architecture and function of computers, programmation language, data bases. They are illustrated by various applications made in the "Cliniques St Luc" te Brussel namely patient monitoring, artificial pancreas, office system and operating room management system. The future use of local area network is proposed in order to achieve medical department independence and the needed cooperation between all users of medical and hospital informatic.

Belgium↗

MolDIA: XML based system of molecular diversity analysis towards virtual screening and QSPR.

In this paper a new chemoinformatics tool for Molecular Diversity Analysis (MolDIA) is introduced. The objective of this system is the analysis of molecular similarity and diversity through the treatment of structural and physicochemical information. Current needs for chemical databases include the analysis, the management and the retrieval of chemical information. The implementation of eXtended Markup Languages (XML) is proposed as a basis for representing and structuring the chemical information contained in data structures and databases. The adequate descriptor vector and related physicochemical properties have been defined and constructed. The benefits of XML in chemoinformatics are discussed, as well as, the applications of this system in a virtual screening environment.

Computational Biology↗

Modular representation of the guideline text: an approach for maintaining and updating the content of medical education.

One of the principal challenges in the medical practice is the update of their knowledge. One of the prime roles of the Continuing Medical Education is to train the medical practitioners with the latest advances in health care, specialized to their needs. Online courses and classroom teaching with computer-based representations have become an established mode of delivering medical education. This paper deals with the modularized representation of a medical text concerning clinical practice guidelines. The proposed system takes into consideration the semantics of the Unified Medical Language System and is based upon the marking up and display of the knowledge using the XML and XSLT languages. This modularization of the concepts leads to the determination of the context of a portion or the whole document. Thus, after marking up using our system, the text components can be exchanged, modified or reconstructed, which, in turn, would help to maintain the updates in medical knowledge.

Artificial Intelligence↗

RSS made easy: a basic guide for librarians.

Really Simple Syndication (RSS) uses extensive markup language (XML) to constantly scan the content of Web sites for updates, which will then be delivered to subscribers' desktops or mobile devices through an RSS feed. RSS helps professionals stay current while reducing workloads. Librarians need to get familiar with RSS to educate their users, to stay current in information technology, and to generate and disseminate selected information to target user groups. doi:10.1300/J115v26n01_04.

Access to Information↗