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PubMed1997

Basic Science in Medical Reasoning: An Artificial Intelligence Approach.

A new generation of intelligent systems is growing up in the community of Artificial Intelligence in Medicine. The main goal of these systems is the representation and use of real theory of diseases, as they are represented in medical textbooks or in scientific articles, rather than the heuristic shortcuts of human experts. In this paper, we will argue that the difficulties in the integration of basic science and clinical knowledge in intelligent systems arise from ontological differences between these kinds of knowledge and that the solution can be found in their dynamic integration during the reasoning process. In order to illustrate this point, we will first describe an epistemological analysis of the interplay between basic science knowledge and clinical knowledge, and then we will provide the example of a computational architecture implementing this view.

Journal Article↗
PubMed2003

Differential effects of left versus right mesial temporal lobe epilepsy on Wechsler intelligence factors.

This study investigates the effects of left versus right mesial temporal lobe epilepsy (MTLE) on Wechsler intelligence factors. In the left MTLE group, the Verbal Comprehension (VC) factor score was significantly lower than the Perceptual Organization (PO) factor score, whereas in the right MTLE group, the PO factor score was significantly lower than the VC factor score. The VC factor score was significantly lower for the left than the right MTLE group, whereas the PO factor score was significantly lower for the right than the left MTLE group. Thus, left versus right MTLE was associated with relative deficits in verbal versus nonverbal intelligence, respectively. These findings indicate that lateralized cognitive deficits in unilateral MTLE patients are not limited to the learning-memory domain but include more global intelligence functions.

Adult↗
PubMed1975

Intelligibility characteristics of superior esophageal speech presented under various levels of masking noise.

Broad-band masking of speech was used to assess the effects that broad-band masking noise had upon the recognition of consonants and vowels produced by esophageal speakers. Procedures were developed to compare the articulation functions of superior esophageal speech with those of normal speech under comparable levels of masking noise. Within the range of speech-to-noise ratios studied, articulation functions for vowels were essentially the same for esophageal and normal talkers (4% per dB). With respect to consonants, the intelligibility scores for esophageal speech were 12 to 14% lower than for normal speech under adverse noise conditions. Gains in the consonant articulation functions were 2.5%/dB and 4%/dB for normal and esophageal talkers, respectively. For adverse noise conditions, the lowered consonant scores for esophageal speakers were the result of poorer than normal intelligibility for liquid-glides and nasal and, secondarily, for stop consonants. Additional differences between the intelligibility characteristics of esophageal and normal speech were found in work-position and voicing features.

Adult↗
PubMed1996

Peaks in the frequency response of hearing aids: evaluation of the effects on speech intelligibility and sound quality.

In a series of experiments, we introduced peaks of 10, 20, and 30 dB, in various combinations, onto a smooth reference frequency response. For each of the conditions, we evaluated speech intelligibility in noise, using a test as developed by Plomp and Mimpen (1979), and sound quality (for both speech and music), using a rating-scale procedure. We performed the experiments with 26 listeners with sensorineurally impaired hearing and 10 listeners with normal hearing. Signal processing was accomplished digitally; for each listener, the stimuli were filtered and subsequently amplified so that the average speech spectrum was well above the threshold of hearing at all frequencies. The results show that, as a result of the introduction of peaks onto the frequency response, speech intelligibility is affected more for the listeners with impaired hearing than for those with normal hearing. Sound-quality judgments tend to be less different between the listener groups. Conditions with 30-dB peaks especially show serious effects on both speech intelligibility and sound quality.

Hearing Aids↗
PubMed2001

Artificial intelligence: a new approach for prescription and monitoring of hemodialysis therapy.

The effect of dialysis on patients is conventionally predicted using a formal mathematical model. This approach requires many assumptions of the processes involved, and validation of these may be difficult. The validity of dialysis urea modeling using a formal mathematical model has been challenged. Artificial intelligence using neural networks (NNs) has been used to solve complex problems without needing a mathematical model or an understanding of the mechanisms involved. In this study, we applied an NN model to study and predict concentrations of urea during a hemodialysis session. We measured blood concentrations of urea, patient weight, and total urea removal by direct dialysate quantification (DDQ) at 30-minute intervals during the session (in 15 chronic hemodialysis patients). The NN model was trained to recognize the evolution of measured urea concentrations and was subsequently able to predict hemodialysis session time needed to reach a target solute removal index (SRI) in patients not previously studied by the NN model (in another 15 chronic hemodialysis patients). Comparing results of the NN model with the DDQ model, the prediction error was 10.9%, with a not significant difference between predicted total urea nitrogen (UN) removal and measured UN removal by DDQ. NN model predictions of time showed a not significant difference with actual intervals needed to reach the same SRI level at the same patient conditions, except for the prediction of SRI at the first 30-minute interval, which showed a significant difference (P = 0.001). This indicates the sensitivity of the NN model to what is called patient clearance time; the prediction error was 8.3%. From our results, we conclude that artificial intelligence applications in urea kinetics can give an idea of intradialysis profiling according to individual clinical needs. In theory, this approach can be extended easily to other solutes, making the NN model a step forward to achieving artificial-intelligent dialysis control.

Adult↗
PubMed2001

[Differentiated short- and long-term effects of a "Training of Emotional Intelligence" and of the "Integrated Psychologic Therapy Program" for schizophrenic patients?].

Social cognition was shown as a rate limiting factor for both psychosocial outcome and response to psychosocial intervention in schizophrenia. In a randomized controlled trial a new cognitive-behavioral group treatment for schizophrenic inpatients (the "Training of Emotional Intelligence", TEI) was tested against the well evaluated "Integrated Psychological Therapy Program" (IPT) of H. Brenner. Within the framework of P. Salovey's work the Training of Emotional Intelligence focussed on three domains of deficits in schizophrenia: emotional perception, emotional understanding and emotional management. In the randomized controlled trial with 41 DSM-IV schizophrenic inpatients no differences were found in problem-solving and negative symptoms, both post treatment and in the 12 months-follow up. Additionally there was a better outcome in affect decoding capacity post treatment, and a progess in regulation of negative affects in the follow up. Emotional role taking behavior and social anxiety returned to baseline level, perhaps by reasons of no "booster sessions" in the follow up. Unfortunately in contrast to our hypotheses we failed to show treatment-specific effects, which may be due to an underpowered statistical testing. There was only one exception of this: While the Integrated Psychological Therapy Program showed a greater reduction of global psychopathology after treatment, the Training of Emotional Intelligence reduced psychopathology in the follow up more strongly. Possible reasons for these results are discussed.

Adult↗
PubMed1980

Comparison of expressive and receptive measures of intelligence.

The Revised Beta Examination (RBE) and the Peabody Picture Vocabulary Test (PPVT) were administered to 34 disabled male and female students (ages 15 to 20 years) in a special education rehabilitation unit in western Virginia; a correlation coefficient of .46 was found. It was concluded that since the two tests measured different facets of intelligence (the PPVT is a receptive measure, the RBE an expressive measure) each should be administered as part of a battery and that this would be more economical than administering the Wechsler Adult Intelligence Scale (WAIS). A significant difference between the mean scores of the two tests was verified through a t test. In making a choice between them researchers and test administrators will want to choose whether they want an expressive or receptive measure of intelligence.

Adolescent↗
PubMed2000

The role of job control as a moderator of emotional dissonance and emotional intelligence-outcome relationships.

Job control may be defined as the latitude to make decisions and the freedom to select the most appropriate skills to complete the task. Emotional dissonance may be defined as the conflict between expressed and experienced emotions. In this study, job control and self-efficacy were theorized to jointly affect emotional dissonance. Individuals with high self-efficacy were found to be more satisfied under conditions of little job control, whereas those with low self-efficacy favored high job control. The impact of job control on emotional intelligence was also studied. Emotional intelligence may be defined as the set of skills that contribute to accurate self-appraisal of emotion as well as the detection of emotional cues in others and the use of feelings to motivate and achieve in one's life. Emotional intelligence and job control explained significant amounts of the variance in both job satisfaction and organizational commitment. Theoretical and practical implications are discussed.

Adult↗
PubMed2001

Comparison of calculated, measured and self-assessed intelligibility of speech in noise for hearing-aid users.

The Speech Intelligibility Index (SII) was used along with paired-comparison judgements and speech recognition scores to compare the speech intelligibility provided by two hearing-aid frequency responses in two different background noises. The purpose was to validate an SII-based procedure. Test subjects were 26 hearing-aid users representing a wide range of hearing loss configurations. One hearing-aid setting was in close agreement with the NAL-R prescription, whereas the other setting was achieved by reducing the high-frequency gain by about 10 dB compared to NAL-R. There were good overall agreements between results of the three methods. Average speech recognition scores were about 4 percentage points higher for the NAL-R frequency response, which also was subjectively judged as significantly better in terms of speech intelligibility. The SII based procedure was found to be suitable for comparing hearing-aid characteristics within subjects.

Aged↗
PubMed2005

Active and intelligent packaging for food: is it the future?

This paper gives an overview of the legal consequences of a new EU framework regulation on food contact materials which includes controls on active and intelligent packaging. Recent developments in active and intelligent packaging systems are described, two examples of which aim at achieving improvements in quality and safety of food products. The first one is an on-command preservative-releasing packaging system. The second system is an intelligent concept, based on the development of a non-invasive microbial growth sensor to monitor the sterility of food products.

Environmental Exposure↗
PubMedDate not supplied

Using intelligent search for finding medical sites.

In this paper we present an intelligent search tool, which we developed in order to automate search and evaluation of websites. We used TFIDF heuristics to determine term frequency and decision trees to evaluate the quality of sites. Training set for the decision tree contained manually evaluated websites. Each website was described by the combination of various attributes, complexity metrics and the evaluation. The intelligent search tool is equipped with a user-friendly interface, which enables people to exploit the tool to its limits with minimum effort, in their quest for information. For testing purposes, we looked for sites with telemedical content. The set of sites, which was the result of using the intelligent search tool, has been evaluated by a group of students.

Decision Trees↗
PubMed2006

The role of silent intervals for sentence intelligibility in fluctuating noise in hearing-impaired listeners.

Fluctuating interfering noises are highly suitable for speech audiometry because of the large inter-individual variability in intelligibility results. This study explores the maximum duration of silent intervals in the masker as an important factor underlying sentence intelligibility in fluctuating noise. Three versions of speech-simulating fluctuating interfering noises based on the icra noises (Dreschler et al, 2001) were explored: The original noise which simulates one interfering speaker and contains pause durations up to two seconds, as well as two modified versions with pause durations limited to 250 ms and 62.5 ms, respectively. In addition, a stationary speech-shaped noise was used. Test-retest reliability as well as speech reception threshold (SRT) and speech intelligibility function slope were determined with hearing-impaired subjects. All fluctuating noises differentiated very well between subjects. Partial rank correlation analysis showed that SRTs in fluctuating noise with longest maximum pause durations mostly depended on SRTs in quiet. SRTs in fluctuating noises with smaller maximum pause durations correlated both with SRTs in quiet and in stationary noise.

Acoustic Stimulation↗
PubMed2004

Aspects of plant intelligence: an answer to Firn.

In a recent 'Invited Review', I stated the case for plant intelligence, provided definitions and outlined some of the consequences, illustrating them with examples. A short critique of this concept by Firn is given in the preceding 'Viewpoint' and rebuttals of the criticisms it contains are presented in the present article. The importance of plant intelligence as an emergent property resulting from interactions and communication of the component tissues is re-stated. The contentions made by Firn that plants are collectives of physically joined organs but acting in relative isolation of each other is subject to critical analysis and found to be contradicted by much established literature. Viewing plants as expressing intelligent behaviour should lead to better understanding of their ecological success and indicate experiments to test the basic concept.

Adaptation, Physiological↗
PubMed1982

Stimulus size and performance on two subtests of the Wechsler Adult Intelligence Scale by younger and older adults.

Younger and older adults performed the picture completion and picture arrangement subtests of the Wechsler Adult Intelligence Scale under three conditions of stimuli size; standard, larger than standard, and smaller than standard. Although the commonly observed age differences on these two performance tests of intelligence were obtained, the size of the stimuli did not influence the test scores of either younger or older adults. It would appear that visual acuity does not contribute in a significant way to the classic pattern of age-related deficits in perceptual-integrative intelligence.

Adult↗
PubMed2005

An intelligent remote monitoring system for artificial heart.

A web-based database system for intelligent remote monitoring of an artificial heart has been developed. It is important for patients with an artificial heart implant to be discharged from the hospital after an appropriate stabilization period for better recovery and quality of life. Reliable continuous remote monitoring systems for these patients with life support devices are gaining practical meaning. The authors have developed a remote monitoring system for this purpose that consists of a portable/desktop monitoring terminal, a database for continuous recording of patient and device status, a web-based data access system with which clinicians can access real-time patient and device status data and past history data, and an intelligent diagnosis algorithm module that noninvasively estimates blood pump output and makes automatic classification of the device status. The system has been tested with data generation emulators installed on remote sites for simulation study, and in two cases of animal experiments conducted at remote facilities. The system showed acceptable functionality and reliability. The intelligence algorithm also showed acceptable practicality in an application to animal experiment data.

Decision Support Systems, Clinical↗
PubMed2002

Learning difficulties, social intelligence, and self-concept: connections to bully-victim problems.

Learning skills, social intelligence, and self-concept were related to each other and to bully-victim problems among fifth-grade children (79 boys and 62 girls, aged 11-12 years). In addition to exploring connections between single variables, a person-oriented approach was applied in order to analyze children's value patterns with respect to learning skills, self-concept, and social intelligence, and how these value patterns are related to bully-victim problems. Social intelligence was found to be positively correlated with learning skills, but negatively related to victimization. Bullying was positively correlated with self-concept scores. However, this was true only of boys. According to cross-tabulations, there were significantly more bullies among children with learning difficulties (LD) than would have been expected by chance. Victimization, on the other hand, was not related to LD. LD children's proposed victim status was in some degree supported by cluster analysis: a group of LD children emerged, who not only scored high on bullying, but also tended to be victimized by others. In addition, two groups of bullies appeared: one whose members could be interpreted as socially unskilled and another as socially skilled. This finding is in line with recent theoretical reasoning, which calls into question the idea of bullies as a unified group, lacking in social skills.

Aggression↗
PubMed1995

A multicentre comparative study of 17 experts and an intelligent computer system for managing labour using the cardiotocogram.

OBJECTIVES: To investigate 1. whether an intelligent computer system could obtain a performance in labour management comparable with experts when using cardiotocograms (CTGs), patient information, and fetal blood sampling and 2. whether experts could be consistent and agree in their management of labour. SUBJECTS: An intelligent computer system and 17 clinicians experienced in fetal monitoring from 16 centres in the UK. DESIGN: Fifty cases with complete intrapartum CTGs and clinical data were reviewed by each expert and the system independently on two occasions, at least one month apart. Each CTG was scored in 15 min segments according to a protocol and estimates of the cervical dilatation and fetal scalp blood pH were given when requested. MAIN OUTCOME MEASURES: Consistency and agreement in the recorded scores, agreement and timing of cases recommended for caesarean sections, fetal blood sampling rates, intervention in cases with poor outcome and intervention in cases with good clinical outcome. RESULTS: The system: 1. Agreed with experts well and significantly better than chance (67.33%, kappa = 0.31, P << 0.001). 2. Was highly consistent (99.16%, kappa = 0.98, P << 0.001) when used by two operators independently. 3. Recommended no unnecessary intervention in cases with normal delivery and good condition (cord artery pH > 7.15, vein pH > 7.20, 5 min Apgar > or = 9 and no resuscitation). This was better than all but two of the experts. 4. Recommended delivery by caesarean section in 11 cases; at least 15 of the 17 experts in each review also recommended caesarean section delivery in these cases. The majority did so within 15 min of the system and two-thirds did so within 30 min. 5. Identified as many of the birth asphyxiated cases (cord arterial pH < 7.05 and BDecf > or = 12, and Apgar score at 5 min < or = 7 with neonatal morbidity) as the majority of experts and one more than was acted upon clinically. The experts were found to be consistent and to agree. There was good agreement in the cases and the timing of caesarean section recommendations. The majority of experts did not recommend operative intervention in cases which had a normal delivery and good outcome, but did recommend operative interventions in 10 of 12 cases delivered with cord arterial pH < 7.05. However, in one of the cases delivered with birth asphyxia, 14 of the 17 experts and the system failed to recommend intervention. CONCLUSIONS: The system's performance was found to be indistinguishable from the experts' in the 50 cases examined, but it was more consistent. This demonstrates the potential for an intelligent computer system to improve the interpretation of the CTG and decrease intervention. Furthermore, the good performance of most experts in this study demonstrates the potential effectiveness of the CTG and raises important questions regarding why the CTG has fallen short of expectations in current practice.

Cardiotocography↗
PubMed1995

"Intelligent" polymers in medicine and biotechnology.

One can define "intelligent" polymers as those polymers that respond with large property changes to small physical or chemical stimuli. These polymers may be in various forms, such as in solution, on surfaces, or as solids. One may also combine intelligent aqueous polymer systems with biomolecules to yield a large family of polymers that respond intelligently to physical, chemical, or biological stimuli. This article overviews such interesting and versatile polymer systems.

Biochemical Phenomena↗