The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

Harrison's Principles of Internal Medicine

What do a seventeenth-century mortality table (whose causes of death include "fainted in a bath," "frighted," and "itch"); the identification of South Africans during apartheid as European, Asian, colored, or black; and the separation of machine- from hand-washables have in common? All are examples of classification -- the scaffolding of information infrastructures. In Sorting Things Out, Geoffrey C. Bowker and Susan Leigh Star explore the role of categories and standards in shaping the modern world. In a clear and lively style, they investigate a variety of classification systems, including the International Classification of Diseases, the Nursing Interventions Classification, race classification under apartheid in South Africa, and the classification of viruses and of tuberculosis. The authors emphasize the role of invisibility in the process by which classification orders human interaction. They examine how categories are made and kept invisible, and how people can change this invisibility when necessary. They also explore systems of classification as part of the built information environment. Much as an urban historian would review highway permits and zoning decisions to tell a city's story, the authors review archives of classification design to understand how decisions have been made. Sorting Things Out has a moral agenda, for each standard and category valorizes some point of view and silences another. Standards and classifications produce advantage or suffering. Jobs are made and lost; some regions benefit at the expense of others. How these choices are made and how we think about that process are at the moral and political core of this work. The book is an important empirical source for understanding the building of information infrastructures.

https://www.reciis.icict.fiocruz.br/index.php/reciis/article/download/794/1436

Sorting Things Out: Classification and Its Consequences

The UMLS Metathesaurus, the largest thesaurus in the biomedical domain, provides a representation of biomedical knowledge consisting of concepts classified by semantic type and both hierarchical and non-hierarchical relationships among the concepts. This knowledge has proved useful for many applications including decision support systems, management of patient records, information retrieval (IR) and data mining. Gaining effective access to the knowledge is critical to the success of these applications. This paper describes MetaMap, a program developed at the National Library of Medicine (NLM) to map biomedical text to the Metathesaurus or, equivalently, to discover Metathesaurus concepts referred to in text. MetaMap uses a knowledge intensive approach based on symbolic, natural language processing (NLP) and computational linguistic techniques. Besides being applied for both IR and data mining applications, MetaMap is one of the foundations of NLM's Indexing Initiative System which is being applied to both semi-automatic and fully automatic indexing of the biomedical literature at the library.

Effective mapping of biomedical text to the UMLS Metathesaurus: the MetaMap program

This introduction presents the main motivations for the development of Description Logics (DLs) as a formalism for representing knowledge, as well as some important basic notions underlying all systems that have been created in the DL tradition. In addition, we provide the reader with an overview of the entire book and some guidelines for reading it. We first address the relationship between Description Logics and earlier semantic network and frame systems, which represent the original heritage of the field. We delve into some of the key problems encountered with the older efforts. Subsequently, we introduce the basic features of DL languages and related reasoning techniques. DL languages are then viewed as the core of knowledge representation systems, considering both the structure of a DL knowledge base and its associated reasoning services. The development of some implemented knowledge representation systems based on Description Logics and the first applications built with such systems are then reviewed. Finally, we address the relationship of Description Logics to other fields of Computer Science.We also discuss some extensions of the basic representation language machinery; these include features proposed for incorporation in the formalism that originally arose in implemented systems, and features proposed to cope with the needs of certain application domains.

https://assets.cambridge.org/97805218/76254/frontmatter/9780521876254_frontmatter.pdf

The Description Logic Handbook

https://www.acilci.net/wp-content/uploads/2014/02/Guidelines-for-reporting-reliability-and-agreement-studies-GRRAS-were-proposed.pdf

Guidelines for Reporting Reliability and Agreement Studies (GRRAS) were proposed.

The Informatics for Diabetes Education and Telemedicine (IDEATel) project has demonstrated significant changes in clinical outcome measures over the past years. This report describes upgrades and innovations in the system that allow a much more rapid upload of data and thus significant system improvement.

/pdf/the-effects-of-redesigning-the-ideatel-architecture-on-ub2pte74d9.pdf

The effects of redesigning the IDEATel architecture on glucose uploads.

The clinical literature presents four different scoring systems (SS) for the diagnosis of disseminated intravascular coagulation (DIC) by four institutions: ISTH, JMHLW, JAAM and KSTH. In this study a Java program was written to retrieve medical records from the MIMIC-II database and apply the criteria of all four. The program then quantified the agreement of each DIC SS with each other and demonstrated notorious dissent. Furthermore, the average internal composition of each score was also quantified. All source code produced is available for download at https://github.com/fabkury/hedicim.

Computationally Comparing and Analyzing All Published Scoring Systems for Diagnosis of Disseminated Intravascular Coagulation.

The Unified Medical Language System combines many well established authoritative medical informatics terminologies in one system. Such a resource is very valuable to the healthcare industry. However, the UMLS is very large and complex and poses serious comprehension problems for users and maintenance personnel. Furthermore, the sets of concepts of semantic types are not semantically uniform and thus are difficult to study. We describe a method to represent two components of the UMLS, the Metathesaurus (META) and the Semantic Network, as an OODB. The resulting UMLS OODB schema is deeper and more refined than the Semantic Network. It offers semantically uniform classes, which improves support for comprehension and navigation of META. The UMLS OODB also exposes problems in the semantic type classifications.

Modeling the UMLS using an OODB.

An escalating global interest in traditional Chinese acupuncture (TCA) demands easy use and reuse of the medical knowledge associated with TCA points, which in turn require appropriate knowledge representation of TCA. A proper knowledge representation generally involves enumeration of conceptual symbols and arrangement of these symbols into some meaningful structure. This study uses the unified medical language system (UMLS) as the source of conceptual symbols and proposes a terminology model as the structure to arrange terms. The purpose is to systematically capture and represent appropriate TCA knowledge in practice. The initial terminology model is refined in an iterative process. The resulting terminology model captures and represents key aspects of TCA knowledge through properly designed model attributes and relations.

https://ieeexplore.ieee.org/iel5/9683/30567/01410523.pdf

Knowledge representation of traditional Chinese acupuncture points using the UMLS and a terminology model

Background. One role for generic Medical Decision Support Systems (MDDSS) is to serve as sentinels against diagnostic errors of omission. For such a task, MDDSS must be fully integrated into institutional Clinical Information Systems (CIS) and allow for automated transfer of data between the two. The abundance of available data in today’s CIS and the loss of contextual relationship in the process make the utilization of these large scale data sets more difficult. We identified two focal points for the submission of large scale data sets to MDDSS: Organization and Interpretation. Organizational issues stem from the occurrence of multiple instances of identical tests (i.e. Plasma Sodium Test, Plasma Sodium Ion Test...) and that for an MDDSS related tests may represent identical concepts (i.e. Serum Sodium Test, Plasma Sodium Test...). Interpretation issues result from the need to re-apply context to the data set to identify the “most representative” type of result among multiple instances of the same test. These processes are executed intuitively by physicians but are poorly understood, and are not incorporated into MDDSS. To cope with the first we utilized the hierarchic and semantic network of the controlled medical vocabulary in use at CPMC while for the second we applied two dedicated submission algorithms. We describe the differential effect of the two algorithms on the diagnoses lists produced by DXplain in a nonclinical evaluation.

James J. Cimino

Papers

The effects of redesigning the IDEATel architecture on glucose uploads.

Computationally Comparing and Analyzing All Published Scoring Systems for Diagnosis of Disseminated Intravascular Coagulation.

Modeling the UMLS using an OODB.

Knowledge representation of traditional Chinese acupuncture points using the UMLS and a terminology model

Automated Integration of a Diagnostic Decision Support System with a Large Scale Clinical Information System: Aspects of Feasibility.