16 resultados para clinical reasoning

em Greenwich Academic Literature Archive - UK


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Guest editorial

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Little attention has been given to the relation between fever and the severity of bronchiolitis. Therefore, the relation between fever and the clinical course of 90 infants (59 boys, 31 girls) hospitalised during one season with bronchiolitis was studied prospectively. Fever (defined as a single recording > 38.0°C or two successive recording > 37.8°C) was present in 28 infants. These infants were older (mean age, 5.3 v 4.0 months), had a longer mean hospital stay (4.2 v2.7 days), and a more severe clinical course (71.0%v 29.0%) than those infants without fever. Radiological abnormalities (collapse/consolidation) were found in 60.7% of the febrile group compared with 14.8% of the afebrile infants. These results suggest that monitoring of body temperature is important in bronchiolitis and that fever is likely to be associated with a more severe clinical course and radiological abnormalities.

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This paper describes the architecture of the case based reasoning (CBR) component of Smartfire, a fire field modelling tool for use by members of the Fire Safety Engineering community who are not expert in modelling techniques. The CBR system captures the qualitative reasoning of an experienced modeller in the assessment of room geometries so as to set up the important initial parameters of the problem. The system relies on two important reasoning principles obtained from the expert: 1) there is a natural hierarchical retrieval mechanism which may be employed; and 2) much of the reasoning on a qualitative level is linear in nature, although the computational solution of the problem is non-linear. The paper describes the qualitative representation of geometric room information on which the system is based, and the principles on which the CBR system operates.

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This paper describes the approach to the modelling of experiential knowledge in an industrial application of Case-Based Reasoning (CBR). The CBR involves retrieval techniques in conjunction with a relational database. The database is especially designed as a repository of experiential knowledge, and includes qualitative search indices. The system is intended to help design engineers and material engineers in the submarine cable industry. It consists of three parts: a materials database; a database of experiential knowledge; and a CBR system used to retrieve similar past designs based upon component and material qualitative descriptions. The system is currently undergoing user testing at the Alcatel Submarine Networks site in Greenwich.

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This paper describes the architecture of the knowledge based system (KBS) component of Smartfire, a fire field modelling tool for use by members of the fire safety engineering community who are not expert in modelling techniques. The KBS captures the qualitative reasoning of an experienced modeller in the assessment of room geometries, so as to set up the important initial parameters of the problem. Fire modelling expertise is an example of geometric and spatial reasoning, which raises representational problems. The approach taken in this project is a qualitative representation of geometric room information based on Forbus’ concept of a metric diagram. This takes the form of a coarse grid, partitioning the domain in each of the three spatial dimensions. Inference over the representation is performed using a case-based reasoning (CBR) component. The CBR component stores example partitions with key set-up parameters; this paper concentrates on the key parameter of grid cell distribution.

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This paper presents a framework for Historical Case-Based Reasoning (HCBR) which allows the expression of both relative and absolute temporal knowledge, representing case histories in the real world. The formalism is founded on a general temporal theory that accommodates both points and intervals as primitive time elements. A case history is formally defined as a collection of (time-independent) elemental cases, together with its corresponding temporal reference. Case history matching is two-fold, i.e., there are two similarity values need to be computed: the non-temporal similarity degree and the temporal similarity degree. On the one hand, based on elemental case matching, the non-temporal similarity degree between case histories is defined by means of computing the unions and intersections of the involved elemental cases. On the other hand, by means of the graphical presentation of temporal references, the temporal similarity degree in case history matching is transformed into conventional graph similarity measurement.

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Numerical models are important tools used in engineering fields to predict the behaviour and the impact of physical elements. There may be advantages to be gained by combining Case-Based Reasoning (CBR) techniques with numerical models. This paper considers how CBR can be used as a flexible query engine to improve the usability of numerical models. Particularly they can help to solve inverse and mixed problems, and to solve constraint problems. We discuss this idea with reference to the illustrative example of a pneumatic conveyor problem. The paper describes example problems faced by design engineers in this context and the issues that need to be considered in this approach. Solution of these problems require methods to handle constraints in both the retrieval phase and the adaptation phase of a typical CBR cycle. We show approaches to the solution of these problesm via a CBR tool.

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The traditional approach of dealing with cases from Multiple Case Bases is to map these to one central case base that is used for knowledge extraction and problem solving. Accessing Multiple Case Bases should not require a change to their data structure. This paper presents an investigation into applying Case-Based Reasoning to Multiple Heterogeneous Case Bases. A case study is presented to illustrate and evaluate the approach.

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This paper introduces a mechanism for representing and recognizing case history patterns with rich internal temporal aspects. A case history is characterized as a collection of elemental cases as in conventional case-based reasoning systems, together with the corresponding temporal constraints that can be relative and/or with absolute values. A graphical representation for case histories is proposed as a directed, partially weighted and labeled simple graph. In terms of such a graphical representation, an eigen-decomposition graph matching algorithm is proposed for recognizing case history patterns.

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In this paper, we address the use of CBR in collaboration with numerical engineering models. This collaborative combination has a particular application in engineering domains where numerical models are used. We term this domain “Case Based Engineering” (CBE), and present the general architecture of a CBE system. We define and discuss the general characteristics of CBE and the special problems which arise. These are: the handling of engineering constraints of both continuous and nominal kind; interpolation over both continuous and nominal variables, and conformability for interpolation. In order to illustrate the utility of the method proposed, and to provide practical examples of the general theory, the paper describes a practical application of the CBE architecture, known as CBE-CONVEYOR, which has been implemented by the authors.Pneumatic conveying is an important transportation technology in the solid bulks conveying industry. One of the major industry concerns is the attrition of powders and granules during pneumatic conveying. To minimize the fraction of particles during pneumatic conveying, engineers want to know what design parameters they should use in building a conveyor system. To do this, engineers often run simulations in a repetitive manner to find appropriate input parameters. CBE-Conveyor is shown to speed up conventional methods for searching for solutions, and to solve problems directly that would otherwise require considerable intervention from the engineer.

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This paper presents an investigation into applying Case-Based Reasoning to Multiple Heterogeneous Case Bases using agents. The adaptive CBR process and the architecture of the system are presented. A case study is presented to illustrate and evaluate the approach. The process of creating and maintaining the dynamic data structures is discussed. The similarity metrics employed by the system are used to support the process of optimisation of the collaboration between the agents which is based on the use of a blackboard architecture. The blackboard architecture is shown to support the efficient collaboration between the agents to achieve an efficient overall CBR solution, while using case-based reasoning methods to allow the overall system to adapt and “learn” new collaborative strategies for achieving the aims of the overall CBR problem solving process.

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OBJECTIVES: This paper describes the chemistry and properties of polyacid-modified composite resins ("compomers") designed for use in clinical dentistry, and reviews the literature in this area. METHODS: Information has been obtained from over 50 published articles appearing in the dental and biomaterials literature, with studies being principally identified through MedLine. RESULTS: Published work shows that polyacid-modified composite resins constitute a discrete class of polymeric repair material for use in dentistry. Their distinction is that they contain hydrophilic components, and these cause water to be drawn into the material following cure. This triggers an acid-base reaction, and gives the materials certain clinically-desirable properties (fluoride release, buffering capability) that are also associated with glass-ionomer cements. The water uptake leads to a decline in certain, though not all, physical properties. However, clinical studies have shown these materials to perform acceptably in a variety of applications (Class I, Class II and Class V cavities, as fissure sealants and as orthodontic band cements), especially in children's teeth. CONCLUSIONS/SIGNIFICANCE: Polyacid-modified composite resins constitute a versatile class of dental repair material, whose bioactivity confers clinical advantages, and which are particularly useful in children's dentistry.