Medical information extraction in European Portuguese

The electronic storage of medical patient data is becoming a daily experience in most of the practices and hospitals worldwide. However, much of the data available is in free-form text, a convenient way of expressing concepts and events, but especially challenging if one wants to perform automatic searches, summarization or statistical analysis. Information Extraction can relieve some of these problems by offering a semantically informed interpretation and abstraction of the texts. MedInX, the Medical Information eXtraction system presented in this document, is the first information extraction system developed to process textual clinical discharge records written in Portuguese. The main goal of the system is to improve access to the information locked up in unstructured text, and, consequently, the efficiency of the health care process, by allowing faster and reliable access to quality information on health, for both patient and health professionals. MedInX components are based on Natural Language Processing principles, and provide several mechanisms to read, process and utilize external resources, such as terminologies and ontologies, in the process of automatic mapping of free text reports onto a structured representation. However, the flexible and scalable architecture of the system, also allowed its application to the task of Named Entity Recognition on a shared evaluation contest focused on Portuguese general domain free-form texts. The evaluation of the system on a set of authentic hospital discharge letters indicates that the system performs with 95% F-measure, on the task of entity recognition, and 95% precision on the task of relation extraction. Example applications, demonstrating the use of MedInX capabilities in real applications in the hospital setting, are also presented in this document. These applications were designed to answer common clinical problems related with the automatic coding of diagnoses and other health-related conditions described in the documents, according to the international classification systems ICD-9-CM and ICF. The automatic review of the content and completeness of the documents is an example of another developed application, denominated MedInX Clinical Audit system.

Integrating information literacy in health sciences curricula: a case study from Québec

Objective: To portray an information literacy programme demonstrating a high level of integration in health sciences curricula and a teaching orientation aiming towards the development of lifelong learning skills. The setting is a French-speaking North American university. Methods: The offering includes standard workshops such as MEDLINE searching and specialised sessions such as pharmaceutical patents searching. A contribution to an international teaching collaboration in Haiti where workshops had to be thoroughly adapted to the clientele is also presented. Online guides addressing information literacy topics complement the programme. Results and evaluation: A small team of librarians and technicians taught 276 hours of library instruction during the 2011-2012 academic year. Methods used for evaluating information skills include scoring features of literature searches and user satisfaction surveys. Discussion: Privileged contacts between librarians and faculty resulting from embedded library instruction as well as from active participation in library committees result in a growing reputation of library services across academic departments and bring forth collaboration opportunities. Sustainability and evolution of the library instruction programme is warranted by frequent communication with partners in the clinical field, active involvement in academic networks and health library associations, and reflective professional strategies.

Novel Application of 2D and 3D-Similarity Searches To Identify Substrates among Cytochrome P450 2C9, 2D6, and 3A4

Cytochrome P450 (CYP450) is a class of enzymes where the substrate identification is particularly important to know. It would help medicinal chemists to design drugs with lower side effects due to drug-drug interactions and to extensive genetic polymorphism. Herein, we discuss the application of the 2D and 3D-similarity searches in identifying reference Structures with higher capacity to retrieve Substrates of three important CYP enzymes (CYP2C9, CYP2D6, and CYP3A4). On the basis of the complementarities of multiple reference structures selected by different similarity search methods, we proposed the fusion of their individual Tanimoto scores into a consensus Tanimoto score (T(consensus)). Using this new score, true positive rates of 63% (CYP2C9) and 81% (CYP2D6) were achieved with false positive rates of 4% for the CYP2C9-CYP2D6 data Set. Extended similarity searches were carried out oil a validation data set, and the results showed that by using the T(consensus) score, not only the area of a ROC graph increased, but also more substrates were recovered at the beginning of a ranked list.

Using Prior Information from the Medical Literature in GWAS of Oral Cancer Identifies Novel Susceptibility Variant on Chromosome 4-the AdAPT Method

Background: Genome-wide association studies (GWAS) require large sample sizes to obtain adequate statistical power, but it may be possible to increase the power by incorporating complementary data. In this study we investigated the feasibility of automatically retrieving information from the medical literature and leveraging this information in GWAS. Methods: We developed a method that searches through PubMed abstracts for pre-assigned keywords and key concepts, and uses this information to assign prior probabilities of association for each single nucleotide polymorphism (SNP) with the phenotype of interest - the Adjusting Association Priors with Text (AdAPT) method. Association results from a GWAS can subsequently be ranked in the context of these priors using the Bayes False Discovery Probability (BFDP) framework. We initially tested AdAPT by comparing rankings of known susceptibility alleles in a previous lung cancer GWAS, and subsequently applied it in a two-phase GWAS of oral cancer. Results: Known lung cancer susceptibility SNPs were consistently ranked higher by AdAPT BFDPs than by p-values. In the oral cancer GWAS, we sought to replicate the top five SNPs as ranked by AdAPT BFDPs, of which rs991316, located in the ADH gene region of 4q23, displayed a statistically significant association with oral cancer risk in the replication phase (per-rare-allele log additive p-value [p(trend)] = 2.5 x 10(-3)). The combined OR for having one additional rare allele was 0.83 (95% CI: 0.76-0.90), and this association was independent of previously identified susceptibility SNPs that are associated with overall UADT cancer in this gene region. We also investigated if rs991316 was associated with other cancers of the upper aerodigestive tract (UADT), but no additional association signal was found. Conclusion: This study highlights the potential utility of systematically incorporating prior knowledge from the medical literature in genome-wide analyses using the AdAPT methodology. AdAPT is available online (url: http://services.gate.ac.uk/lld/gwas/service/config).

THE INTERACTION BETWEEN INTERNAL AND EXTERNAL INFORMATION ON RELATIONAL DATA SEARCH

People often use tools to search for information. In order to improve the quality of an information search, it is important to understand how internal information, which is stored in user’s mind, and external information, represented by the interface of tools interact with each other. How information is distributed between internal and external representations significantly affects information search performance. However, few studies have examined the relationship between types of interface and types of search task in the context of information search. For a distributed information search task, how data are distributed, represented, and formatted significantly affects the user search performance in terms of response time and accuracy. Guided by UFuRT (User, Function, Representation, Task), a human-centered process, I propose a search model, task taxonomy. The model defines its relationship with other existing information models. The taxonomy clarifies the legitimate operations for each type of search task of relation data. Based on the model and taxonomy, I have also developed prototypes of interface for the search tasks of relational data. These prototypes were used for experiments. The experiments described in this study are of a within-subject design with a sample of 24 participants recruited from the graduate schools located in the Texas Medical Center. Participants performed one-dimensional nominal search tasks over nominal, ordinal, and ratio displays, and searched one-dimensional nominal, ordinal, interval, and ratio tasks over table and graph displays. Participants also performed the same task and display combination for twodimensional searches. Distributed cognition theory has been adopted as a theoretical framework for analyzing and predicting the search performance of relational data. It has been shown that the representation dimensions and data scales, as well as the search task types, are main factors in determining search efficiency and effectiveness. In particular, the more external representations used, the better search task performance, and the results suggest the ideal search performance occurs when the question type and corresponding data scale representation match. The implications of the study lie in contributing to the effective design of search interface for relational data, especially laboratory results, which are often used in healthcare activities.

Job-shadowing: Swiss health librarians observing experienced search specialists and information skills trainers in London

Abstract As librarians of the Social & Preventive Medicine Library in Bern, we help researchers perform systematic literature searches and teach students to use medical databases. We developed our skills mainly “on the job”, and we wondered how other health librarians in Europe were trained to become experts in searching. We had a great opportunity to “job shadow” specialists in this area of library service during a 5-day-internship at the Royal Free Hospital Medical Library in London, Great Britain.

Improving flexible databases searches using machine learning

El objetivo principal de este proyecto ha sido introducir aprendizaje automático en la aplicación FleSe. FleSe es una aplicación web que permite realizar consultas borrosas sobre bases de datos nítidos. Para llevar a cabo esta función la aplicación utiliza unos criterios para definir los conceptos borrosos usados para llevar a cabo las consultas. FleSe además permite que el usuario cambie estas personalizaciones. Es aquí donde introduciremos el aprendizaje automático, de tal manera que los criterios por defecto cambien y aprendan en función de las personalizaciones que van realizando los usuarios. Los objetivos secundarios han sido familiarizarse con el desarrollo y diseño web, al igual que recordar y ampliar el conocimiento sobre lógica borrosa y el lenguaje de programación lógica Ciao-Prolog. A lo largo de la realización del proyecto y sobre todo después del estudio de los resultados se demuestra que la agrupación de los usuarios marca la diferencia con la última versión de la aplicación. Esto se basa en la siguiente idea, podemos usar un algoritmo de aprendizaje automático sobre las personalizaciones de los criterios de todos los usuarios, pero la gran diversidad de opiniones de los usuarios puede llevar al algoritmo a concluir criterios erróneos o no representativos. Para solucionar este problema agrupamos a los usuarios intentando que cada grupo tengan la misma opinión o mismo criterio sobre el concepto. Y después de haber realizado las agrupaciones usar el algoritmo de aprendizaje automático para precisar el criterio por defecto de cada grupo de usuarios. Como posibles mejoras para futuras versiones de la aplicación FleSe sería un mejor control y manejo del ejecutable plserver. Este archivo se encarga de permitir a la aplicación web usar el lenguaje de programación lógica Ciao-Prolog para llevar a cabo la lógica borrosa relacionada con las consultas. Uno de los problemas más importantes que ofrece plserver es que bloquea el hilo de ejecución al intentar cargar un archivo con errores y en caso de ocurrir repetidas veces bloquea todas las peticiones siguientes bloqueando la aplicación. Pensando en los usuarios y posibles clientes, sería también importante permitir que FleSe trabajase con bases de datos de SQL en vez de almacenar la base de datos en los archivos de Prolog. Otra posible mejora basarse en distintas características a la hora de agrupar los usuarios dependiendo de los conceptos borrosos que se van ha utilizar en las consultas. Con esto se conseguiría que para cada concepto borroso, se generasen distintos grupos de usuarios, los cuales tendrían opiniones distintas sobre el concepto en cuestión. Así se generarían criterios por defecto más precisos para cada usuario y cada concepto borroso.---ABSTRACT---The main objective of this project has been to introduce machine learning in the application FleSe. FleSe is a web application that makes fuzzy queries over databases with precise information, using defined criteria to define the fuzzy concepts used by the queries. The application allows the users to change and custom these criteria. On this point is where the machine learning would be introduced, so FleSe learn from every new user customization of the criteria in order to generate a new default value of it. The secondary objectives of this project were get familiar with web development and web design in order to understand the how the application works, as well as refresh and improve the knowledge about fuzzy logic and logic programing. During the realization of the project and after the study of the results, I realized that clustering the users in different groups makes the difference between this new version of the application and the previous. This conclusion follows the next idea, we can use an algorithm to introduce machine learning over the criteria that people have, but the problem is the diversity of opinions and judgements that exists, making impossible to generate a unique correct criteria for all the users. In order to solve this problem, before using the machine learning methods, we cluster the users in order to make groups that have the same opinion, and afterwards, use the machine learning methods to precise the default criteria of each users group. The future improvements that could be important for the next versions of FleSe will be to control better the behaviour of the plserver file, that cost many troubles at the beginning of this project and it also generate important errors in the previous version. The file plserver allows the web application to use Ciao-Prolog, a logic programming language that control and manage all the fuzzy logic. One of the main problems with plserver is that when the user uploads a file with errors, it will block the thread and when this happens multiple times it will start blocking all the requests. Oriented to the customer, would be important as well to allow FleSe to manage and work with SQL databases instead of store the data in the Prolog files. Another possible improvement would that the cluster algorithm would be based on different criteria depending on the fuzzy concepts that the selected Prolog file have. This will generate more meaningful clusters, and therefore, the default criteria offered to the users will be more precise.

Radical SAM, a novel protein superfamily linking unresolved steps in familiar biosynthetic pathways with radical mechanisms: functional characterization using new analysis and information visualization methods

A novel protein superfamily with over 600 members was discovered by iterative profile searches and analyzed with powerful bioinformatics and information visualization methods. Evidence exists that these proteins generate a radical species by reductive cleavage of S-adenosylmethionine (SAM) through an unusual Fe-S center. The superfamily (named here Radical SAM) provides evidence that radical-based catalysis is important in a number of previously well- studied but unresolved biochemical pathways and reflects an ancient conserved mechanistic approach to difficult chemistries. Radical SAM proteins catalyze diverse reactions, including unusual methylations, isomerization, sulfur insertion, ring formation, anaerobic oxidation and protein radical formation. They function in DNA precursor, vitamin, cofactor, antibiotic and herbicide biosynthesis and in biodegradation pathways. One eukaryotic member is interferon-inducible and is considered a candidate drug target for osteoporosis; another is observed to bind the neuronal Cdk5 activator protein. Five defining members not previously recognized as homologs are lysine 2,3-aminomutase, biotin synthase, lipoic acid synthase and the activating enzymes for pyruvate formate-lyase and anaerobic ribonucleotide reductase. Two functional predictions for unknown proteins are made based on integrating other data types such as motif, domain, operon and biochemical pathway into an organized view of similarity relationships.

Searches and content of the OTseeker database: Informing research priorities

BACKGROUND. A strategic and prioritized approach to occupational therapy research is needed, particularly given the limited research funding available. Comparing occupational therapists' information needs with the research evidence available can potentially inform research debate within the profession. This study aimed to identify research topics most often sought by users of the OTseeker database and to compare these with the quantity of topics available in the database. METHOD. A random sample of keyword search terms submitted to OTseeker (n = 4,500) was coded according to diagnostic and intervention categories, and compared with the amount of research contained in OTseeker in 2004. RESULTS. Most frequently sought topics were relevant to the diagnostic categories of pediatric conditions (19%), neurology and neuromuscular disorders (17%), and mental health (17%). Most frequently sought intervention topics included modes of service delivery, sensory interventions, and physical modalities. Although many frequently sought topics had a correspondingly high volume of research in OTseeker, a few areas had very little content (e.g., fine motor skill acquisition, autistic spectrum disorder). This information is offered to inform discussions about research priorities and resource allocation for research within occupational therapy.

A generalized multidimensional index structure for multimedia data to support content-based similarity searches in a collaborative search environment

Since multimedia data, such as images and videos, are way more expressive and informative than ordinary text-based data, people find it more attractive to communicate and express with them. Additionally, with the rising popularity of social networking tools such as Facebook and Twitter, multimedia information retrieval can no longer be considered a solitary task. Rather, people constantly collaborate with one another while searching and retrieving information. But the very cause of the popularity of multimedia data, the huge and different types of information a single data object can carry, makes their management a challenging task. Multimedia data is commonly represented as multidimensional feature vectors and carry high-level semantic information. These two characteristics make them very different from traditional alpha-numeric data. Thus, to try to manage them with frameworks and rationales designed for primitive alpha-numeric data, will be inefficient. An index structure is the backbone of any database management system. It has been seen that index structures present in existing relational database management frameworks cannot handle multimedia data effectively. Thus, in this dissertation, a generalized multidimensional index structure is proposed which accommodates the atypical multidimensional representation and the semantic information carried by different multimedia data seamlessly from within one single framework. Additionally, the dissertation investigates the evolving relationships among multimedia data in a collaborative environment and how such information can help to customize the design of the proposed index structure, when it is used to manage multimedia data in a shared environment. Extensive experiments were conducted to present the usability and better performance of the proposed framework over current state-of-art approaches.

Scaling geospatial searches in large spatial databases

Modern geographical databases, which are at the core of geographic information systems (GIS), store a rich set of aspatial attributes in addition to geographic data. Typically, aspatial information comes in textual and numeric format. Retrieving information constrained on spatial and aspatial data from geodatabases provides GIS users the ability to perform more interesting spatial analyses, and for applications to support composite location-aware searches; for example, in a real estate database: “Find the nearest homes for sale to my current location that have backyard and whose prices are between $50,000 and $80,000”. Efficient processing of such queries require combined indexing strategies of multiple types of data. Existing spatial query engines commonly apply a two-filter approach (spatial filter followed by nonspatial filter, or viceversa), which can incur large performance overheads. On the other hand, more recently, the amount of geolocation data has grown rapidly in databases due in part to advances in geolocation technologies (e.g., GPS-enabled smartphones) that allow users to associate location data to objects or events. The latter poses potential data ingestion challenges of large data volumes for practical GIS databases. In this dissertation, we first show how indexing spatial data with R-trees (a typical data pre-processing task) can be scaled in MapReduce—a widely-adopted parallel programming model for data intensive problems. The evaluation of our algorithms in a Hadoop cluster showed close to linear scalability in building R-tree indexes. Subsequently, we develop efficient algorithms for processing spatial queries with aspatial conditions. Novel techniques for simultaneously indexing spatial with textual and numeric data are developed to that end. Experimental evaluations with real-world, large spatial datasets measured query response times within the sub-second range for most cases, and up to a few seconds for a small number of cases, which is reasonable for interactive applications. Overall, the previous results show that the MapReduce parallel model is suitable for indexing tasks in spatial databases, and the adequate combination of spatial and aspatial attribute indexes can attain acceptable response times for interactive spatial queries with constraints on aspatial data.

Estimating Bat and Bird Mortality Occurring at Wind Energy Turbines from Covariates and Carcass Searches Using Mixture Models

Environmental impacts of wind energy facilities increasingly cause concern, a central issue being bats and birds killed by rotor blades. Two approaches have been employed to assess collision rates: carcass searches and surveys of animals prone to collisions. Carcass searches can provide an estimate for the actual number of animals being killed but they offer little information on the relation between collision rates and, for example, weather parameters due to the time of death not being precisely known. In contrast, a density index of animals exposed to collision is sufficient to analyse the parameters influencing the collision rate. However, quantification of the collision rate from animal density indices (e.g. acoustic bat activity or bird migration traffic rates) remains difficult. We combine carcass search data with animal density indices in a mixture model to investigate collision rates. In a simulation study we show that the collision rates estimated by our model were at least as precise as conventional estimates based solely on carcass search data. Furthermore, if certain conditions are met, the model can be used to predict the collision rate from density indices alone, without data from carcass searches. This can reduce the time and effort required to estimate collision rates. We applied the model to bat carcass search data obtained at 30 wind turbines in 15 wind facilities in Germany. We used acoustic bat activity and wind speed as predictors for the collision rate. The model estimates correlated well with conventional estimators. Our model can be used to predict the average collision rate. It enables an analysis of the effect of parameters such as rotor diameter or turbine type on the collision rate. The model can also be used in turbine-specific curtailment algorithms that predict the collision rate and reduce this rate with a minimal loss of energy production.

Guiding Monte Carlo tree searches with neural networks in the game of go

A dissertation submitted in fulfillment of the requirements to the degree of Master in Computer Science and Computer Engineering