Intelligence across humans and machines: a joint perspective.

This paper aims to address the divergences and contradictions in the definition of intelligence across different areas of knowledge, particularly in computational intelligence and psychology, where the concept is of significant interest. Despite the differences in motivation and approach, both fields have contributed to the rise of cognitive science. However, the lack of a standardized definition, empirical evidence, or measurement strategy for intelligence is a hindrance to cross-fertilization between these areas, particularly for semantic-based applications. This paper seeks to equalize the definitions of intelligence from the perspectives of computational intelligence and psychology, and offer an overview of the methods used to measure intelligence. We argue that there is no consensus for intelligence, and the term is interchangeably used with similar, opposed, or even contradictory definitions in many fields. This paper concludes with a summary of its central considerations and contributions, where we state intelligence is an agent's ability to process external and internal information to find an optimum adaptation (decision-making) to the environment according to its ontology and then decode this information as an output action.

Video Laryngoscope Assistance in Button Battery Retrieval.

Foreign body ingestion remains a common cause of pediatric emergency surgery with button battery ingestion of particular concern. Newer, higher power lithium batteries can cause catastrophic damage of the gastrointestinal tract through erosion of mucosa into surrounding structures. Prompt diagnosis and treatment are paramount. We present a case of an 11-month-old with a button battery lodged in the proximal esophagus. The extraction was difficult and only made possible with the assistance of a video laryngoscope. We make the case for more routine usage of video laryngoscopy for removal of foreign bodies in the upper esophagus.

Perfil e vozes dos participantes de pesquisas clínicas no Brasil / Profiles and voices of participants in clinical research in Brazil / Perfil y voces de los participantes de investigaciones clínicas en Brasil

Resumo Este estudo de caso buscou traçar o perfil socioeconômico de participantes de ensaios clínicos em centro de pesquisa brasileiro, analisando suas decisões, motivações e experiências, seu conhecimento sobre riscos, benefícios e cuidados dispensados e o processo de consentimento. Dados de 327 participantes foram coletados, realizando-se entrevistas semiestruturadas com 19 deles. Nas pesquisas executadas no centro estudado houve maior participação de homens, de pessoas com poucos anos de estudo formal e de baixa renda. A maioria é aposentada, não tem assistência privada à saúde e tende a não perceber os efeitos da investigação ou superestimar os benefícios médicos diretos. A busca pelo tratamento médico foi o principal fator que influenciou suas decisões/participação, e a assinatura do termo de consentimento livre e esclarecido não garantiu a expressão da autonomia. Conclui-se que o perfil e o conteúdo dos discursos dos participantes são sensíveis indicadores de vulnerabilidade e desigualdade social.

Abstract This case study aimed to trace the socioeconomic profile of participants in clinical research at a Brazilian research center, analyzing their decisions, motivations, experiences, knowledge of risks, benefits and health care provided, and the consent process. The data of 327 participants were collected, and semi-structured interviews conducted with 19 of them. In the research carried out at the center studied there was a greater participation of men and of people with few years of formal education and low income. Most are retired and have no private health plan, tend not to notice the effects of the investigation, or to overestimate its direct medical benefits. The search for medical treatment was the main factor influencing their decisions/participation, and signing the informed consent form did not guarantee the expression of autonomy. We concluded that the participants' profile and speeches content are sensitive indicators of vulnerability and social inequality.

Resumen Este estudio de caso trató de esbozar el perfil socioeconómico de participantes de ensayos clínicos en un centro de investigación brasileño, analizando sus decisiones, motivaciones y experiencias, su conocimiento sobre los riesgos, beneficios y cuidados prestados y el proceso de consentimiento. Se recopilaron datos de 327 participantes y se realizaron entrevistas semiestructuradas con 19 de ellos. En las investigaciones realizadas en el centro estudiado hubo una mayor participación de hombres, de personas con pocos años de educación formal y con bajos ingresos. La mayoría es jubilada y no tiene asistencia sanitaria privada, tiende a no percibir los efectos de la investigación o a sobrestimar los beneficios médicos directos. La búsqueda de tratamiento médico fue el factor principal que influyó en sus decisiones/participación, y la firma del término de consentimiento libre e informado no garantizó la expresión de la autonomía. Se concluye que el perfil y el contenido de los discursos de los participantes son sensibles indicadores de vulnerabilidad y desigualdad social.

PathMolD-AB: Spatiotemporal pathways of protein folding using parallel molecular dynamics with a coarse-grained model.

Solving the protein folding problem (PFP) is one of the grand challenges still open in computational biophysics. Globular proteins are believed to evolve from initial configurations through folding pathways connecting several thermodynamically accessible states in a free energy landscape until reaching its minimum, inhabited by the stable native structures. Despite its huge computational burden, molecular dynamics (MD) is the leading approach in the PFP studies by preserving the Newtonian temporal evolution in the canonical ensemble. Non-trivial improvements are provided by highly parallel implementations of MD in cost-effective GPUs, concomitant to multiscale descriptions of proteins by coarse-grained minimalist models. In this vein, we present the PathMolD-AB framework, a comprehensive software package for massively parallel MD simulations using the canonical ensemble, structural analysis, and visualization of the folding pathways using the minimalist AB-model. It has, also, a tool to compare the results with proteins re-scaled from the PDB. We simulate and analyze, as case studies, the folding of four proteins: 13FIBO, 2GB1, 1PLC and 5ANZ, with 13, 55, 99 and 223 amino acids, respectively. The datasets generated from simulations correspond to the MD evolution of 3500 folding pathways, encompassing 35×106 states, which contains the spatial amino acid positions, the protein free energies and radii of gyration at each time step. Results indicate that the speedup of our approach grows logarithmically with the protein length and, therefore, it is suited for most of the proteins in the PDB. The predicted structures simulated by PathMolD-AB were similar to the re-scaled biological structures, indicating that it is promising for the study of the PFP study.

A benchmark of optimally folded protein structures using integer programming and the 3D-HP-SC model.

The Protein Structure Prediction (PSP) problem comprises, among other issues, forecasting the three-dimensional native structure of proteins using only their primary structure information. Most computational studies in this area use synthetic data instead of real biological data. However, the closer to the real-world, the more the impact of results and their applicability. This work presents 17 real protein sequences extracted from the Protein Data Bank for a benchmark to the PSP problem using the tri-dimensional Hydrophobic-Polar with Side-Chains model (3D-HP-SC). The native structure of these proteins was found by maximizing the number of hydrophobic contacts between the side-chains of amino acids. The problem was treated as an optimization problem and solved by means of an Integer Programming approach. Although the method optimally solves the problem, the processing time has an exponential trend. Therefore, due to computational limitations, the method is a proof-of-concept and it is not applicable to large sequences. For unknown sequences, an upper bound of the number of hydrophobic contacts (using this model) can be found, due to a linear relationship with the number of hydrophobic residues. The comparison between the predicted and the biological structures showed that the highest similarity between them was found with distance thresholds around 5.2-8.2 Å. Both the dataset and the programs developed will be freely available to foster further research in the area.

Participantes de ensaios clínicos em oncologia: perfil e aspectos envolvidos nas suas decisões / Participants of oncologic clinical trials: profile and aspects involved in their decisions / Participantes de ensayos clínicos en oncología: perfil y aspectos implicados en sus decisiones

Resumo Estudo sobre os participantes de ensaios clínicos na área de oncologia, discutindo o paradoxo entre progresso científico e iniquidade social. Buscou-se conhecer quem são essas pessoas e analisar aspectos envolvidos nas suas decisões, com base em entrevistas e documentos. Houve maior participação feminina. Os participantes tendem a ter poucos anos de estudo formal e baixa renda. A maioria é aposentada e do lar e não tem assistência à saúde privada. Suas decisões giraram em torno da busca pela cura ou melhora, e pela garantia de acesso regular a cuidados integrais de saúde e medicamentos. A assinatura do termo de consentimento livre e esclarecido não garantiu a expressão da autonomia, pois informações essenciais como os objetivos, riscos e cuidados pós-estudo são praticamente desconhecidas. Os participantes da pesquisa tendem a não compreender os objetivos da investigação, ou superestimam os benefícios médicos diretos de sua participação, sem consciência dos riscos envolvidos e do que significa uma pesquisa. Os resultados deveriam incitar ao exercício e ao diálogo mais críticos entre os diferentes atores e instituições envolvidos na área da pesquisa com seres humanos, objetivando promover uma ciência consciente e responsável, que impeça que pessoas sejam colocadas em situação de desigualdade, vulnerabilidade e sofrimento moral.

Abstract This is a study about the participants of clinical trials in the field of oncology that discusses the paradox between scientific advances and social inequality. We sought to get to know these people and to analyze the aspects involved in their decisions based on interviews and documents. Female participation was more expressive. The participants tend to have low schooling and low income. Most of them are retirees and housewives, and do not get assistance from the private health system. Their decisions revolved around the search for cure or recovery, as well as for the assurance of regular access to comprehensive health care and medicines. Signing the free and informed consent form did not guarantee the expression of autonomy, because crucial information, such as the goals, risks and post-study care are virtually unknown. The research participants tend to not understand the goals of the investigation, or they overestimate the direct medical benefits of their participation, and they tend to be unaware of the risks involved and of what does a research mean. The results should stimulate more critical practices and dialogues among the different players and institutions involved in the field of the research with human subjects, with the goal of promoting a science that is conscious and responsible, and that prevents people from being put in situations of inequality, vulnerability and moral suffering.

Resumen Estudio sobre los participantes de ensayos clínicos en el área de oncología, discutiendo la paradoja entre avance científico y desigualdad social. Se buscó conocer quiénes son esas personas y analizar los aspectos involucrados en sus decisiones, con base en entrevistas y documentos. Hubo mayor participación femenina. La tendencia es que los participantes tienen pocos años de estudio formal y bajos ingresos. La mayoría es jubilada y ama de casa, y no tiene asistencia médica privada. Sus decisiones giraron en torno a la búsqueda de la cura o una mejora, y el acceso regular garantizado a la atención médica integral y a los medicamentos. La firma del formulario de consentimiento voluntario e informado no constituyó una expresión de autonomía, ya que información esencial como objetivos, riesgos y cuidados posteriores al estudio es prácticamente desconocida. Los participantes de la investigación tienden a no comprender los objetivos de la investigación, o sobreestiman los beneficios médicos directos de su participación, sin ser conscientes de los riesgos implicados y lo que significa una investigación. Los resultados deberían incitar al ejercicio y al diálogo más críticos entre los diferentes actores e instituciones involucrados en el área de la investigación con seres humanos, a fin de promover un entendimiento consciente y responsable, que impida que las personas sean colocadas en situación de desigualdad, vulnerabilidad y sufrimiento moral.

Proposta de residência em Atenção Domiciliar como área de atuação / Proposal of Home Care Residency as actuation field / Propuesta de residencia en Atención Domiciliar como área de actuación

Home Care (HC) is an expertise area for several specialists, such as Family Physicians, Geriatricians, Pediatricians and Internal Medicine. Due to its specificities and within its practice field, it demands competences that are not contemplated apart in any medical specialty, and the time and structure required to acquire them surpasses the insertion capacity in the current programs. This care type expansion represents a growing demand for training, requiring HC inclusion as a potential field of work for these specialists, conceiving the need for an additional year for the formation of specific features as an activity area. We discuss training strategies, practice fields and programmatic structure required to consolidate this proposal. We expect that this article can subsidize the natural construction of this specialty within the scope of health medical practice.

La Atención Domiciliaria (AD) se configura en un área de actuación de diversos especialistas, como Médicos de Familia, Geriatras, Pediatras y Medicina Interna. Debido a sus especificidades y dentro de su campo de práctica, exige competencias que no están contempladas aisladamente en cualquier especialidad médica, y el tiempo y la estructura necesaria para adquirirlas sobrepasa la capacidad de inserción en los programas actuales. La expansión de este tipo de atención representa una demanda creciente de capacitación, requiriendo la inclusión de la AD como un potencial campo de trabajo para estos especialistas, concibiendo la necesidad un año adicional para la formación en las especificidades de esta área de actuación. Se discuten las estrategias de formación, los campos de práctica y la estructura programática necesaria para la consolidación de esta propuesta. Se espera que este artículo pueda subsidiar la natural construcción de esta especialidad en el ámbito de la actuación médica en salud.

A Atenção Domiciliar (AD) configura-se numa área de atuação de diversos especialistas, como Médicos de Família e Comunidade, Geriatras, Pediatras e Internistas. Por suas especificidades e dentro do seu campo de práticas, demanda competências que não estão contempladas isoladamente em nenhuma especialidade médica, sendo que o tempo e a estrutura necessários para a aquisição destas ultrapassa a capacidade de inserção ao longo dos programas atuais. A expansão desta modalidade de cuidados representa uma demanda crescente de formação, exigindo a inclusão da AD como potencial campo de trabalho destes especialistas, concebendo a necessidade de terceiro ano de residência, enquanto área de atuação. Discutem-se as estratégias de formação, campos da prática e estrutura programática, necessários para a consolidação desta proposta. Espera-se que este artigo possa subsidiar a natural construção desta especialidade no âmbito da atuação médica em saúde.

Burnout and occupational stress in the medical residents of Oncology, Haematology and Radiotherapy: a prevalence and predictors study in Portugal.

Burnout is a professional syndrome associated with stress caused by overwork. Our aim was to calculate the prevalence of burnout and stress on medical residents of Oncology, Haematology and Radiotherapy in Portugal, as well as to determine predictors of burnout and stress. An anonymous questionnaire was applied (n = 118). Statistical analysis consisted of a descriptive and inferential analysis. The prevalence of burnout and stress was calculated to be 45.2 and 50%, respectively. The dimensions that generated higher levels of stress were 'dealing with patients' and 'overwork'. Burnout was directly related with stress dimension 'overwork'. The prevalence of burnout in Portuguese oncological residents is high as in other European countries and in the U.S. Therefore, interventional strategies can be designed.

Stress and Psychological Health: Testing the Mediating Role of Cognitive Appraisal.

This study tested the mediating role of primary (e.g., threat and challenge perceptions) and secondary (e.g., coping potential and control perception) cognitive appraisal in the relationship between occupational stress and psychological health. This mediation was tested using a cross-sectional study based on self-reported measures. The total sample consisted of 2,302 nurses, 1,895 females (82.3%) and 407 males (17.7%), who completed an evaluation protocol with measures of occupational stress, cognitive appraisal, and psychological health. To test the mediating role of cognitive appraisal in the relationship between cognitive appraisal and psychological health, we used Structural Equation Modeling (SEM). The results confirmed that primary and secondary cognitive appraisals partially mediated the relationship between occupational stress and psychological health; however, the direct effects of stress on psychological health cannot be ignored. The findings indicated that cognitive appraisal is an important underlying mechanism in explaining adaptation at work.

Design of a complex bioimpedance spectrometer using DFT and undersampling for neural networks diagnostics.

Electrical impedance spectroscopy offers many applications in the medical field due the fast response, non-invasiveness and low cost. One promising area is the use of this method for diagnostics. This paper describes the design and experimental evaluation of a multifrequencial complex bioimpedance analyzer. Impedance amplitude and phase were calculated using Discrete Fourier Transform (DFT) and high frequency signals were measured with undersampling. The prototype was able to measure values from 1 Ω to 50 kΩ (frequency range from 50 Hz to 500 kHz). The accuracy of the technique was compared with a commercial equipment. The analysis of passive components resulted in a mean error of 2.9% for the magnitude and 0.69 degrees for the phase. Besides, an initial study for head and neck cancer detection through neural networks is shown. One used bioimpedance values as well as gender, age and body mass index as inputs. The network used 120 training and 40 validation data and was able to simulate 77.5% of the two types of diagnostic correctly.

Evaluation of dynamic behavior forecasting parameters in the process of transition rule induction of unidimensional cellular automata.

The simulation of the dynamics of a cellular systems based on cellular automata (CA) can be computationally expensive. This is particularly true when such simulation is part of a procedure of rule induction to find suitable transition rules for the CA. Several efforts have been described in the literature to make this problem more treatable. This work presents a study about the efficiency of dynamic behavior forecasting parameters (DBFPs) used for the induction of transition rules of CA for a specific problem: the classification by the majority rule. A total of 8 DBFPs were analyzed for the 31 best-performing rules found in the literature. Some of these DBFPs were highly correlated each other, meaning they yield the same information. Also, most rules presented values of the DBFPs very close each other. An evolutionary algorithm, based on gene expression programming, was developed for finding transition rules according a given preestablished behavior. The simulation of the dynamic behavior of the CA is not used to evaluate candidate transition rules. Instead, the average values for the DBFPs were used as reference. Experiments were done using the DBFPs separately and together. In both cases, the best induced transition rules were not acceptable solutions for the desired behavior of the CA. We conclude that, although the DBFPs represent interesting aspects of the dynamic behavior of CAs, the transition rule induction process still requires the simulation of the dynamics and cannot rely only on the DBFPs.

A dose-response model for the conventional phototherapy of the newborn.

Jaundice of the newborn is a common problem as a consequence of the rapid increment of blood bilirubin in the first days of live. In most cases, it is considered a physiological transient situation, but unmanaged hyperbilirubinemia can lead to death or serious injuries for the survivors. For decades, phototherapy has been used as the main method for prevention and treatment of hyperbilirubinaemia of the newborn. This work aims at finding a predictive model for the decrement of blood bilirubin for patients submitted to conventional phototherapy. Data from the phototherapy of 90 term newborns were collected and used in a multiple regression method. A rigorous statistical analysis was done in order to guarantee a correct and valid model. The obtained model was able to explain 78% of the variation of the dependent variable. We show that it is possible to predict the total serum bilirubin of the patient under conventional phototherapy by knowing its birth weight, bilirubin level at the beginning of treatment and the radiant energy density (dose). Besides, it is possible to infer the time necessary for a given decrement of bilirubin, under approximately constant irradiance. Statistical analysis of the obtained model shows that it is valid for several ranges of birth weight, initial bilirubin level, and radiant energy density. It is expected that the proposed model can be useful in the clinical management of hyperbilirubinemia of the newborn.

Avaliação do ensino-aprendizagem em ventilação mecânica nos cursos de fisioterapia no Paraná / Assessment of mechanical ventilation training in physical therapy schools of Paraná

Com o crescente interesse dos fisioterapeutas em se especializar e trabalhar na área de fisioterapia respiratória, torna-se necessário uma formação acadêmica mais completa. Durante a formação destes futuros profissionais observa-se que o tempo de estagio em uma Unidade de Terapia Intensiva e, em geral, insuficiente para adquirir os conhecimentos suficientes sobre ventilação mecânica. Alem disto, realizar na Universidade a pratica do funcionamento de um ventilador mecânico e inviável por falta de infra-estrutura. Devido a estas dificuldades, o aluno termina sua formação acadêmica com pouco conhecimento e embasamento sobre ventilação mecânica. Este estudo mostra que realmente existe um déficit em relação ao ensino e aprendizado dos alunos de fisioterapia, no que diz respeito a ventilação mecânica.

With the increasing interest of physical therapists in specializing and working in the area of respiratory physical therapy, a more complete academic instruction has become increasingly necessary. During the instruction of these future professionals, it has been observed that the time of training in an Intensive Care Unit is general insufficient to acquire the sufficient knowledge of ventilation mechanics. Besides, to practice the use of a mechanical ventilator in the University is unviable since there is lack of infrastructure. Because of these difficulties, the student finishes their academic instruction with little knowledge and basing on mechanical ventilation. This study shows that there is a deficit in the process of teaching mechanical ventilation to physical therapy students.

Reconstruction of phylogenetic trees using the ant colony optimization paradigm.

We developed a new approach for the reconstruction of phylogenetic trees using ant colony optimization metaheuristics. A tree is constructed using a fully connected graph and the problem is approached similarly to the well-known traveling salesman problem. This methodology was used to develop an algorithm for constructing a phylogenetic tree using a pheromone matrix. Two data sets were tested with the algorithm: complete mitochondrial genomes from mammals and DNA sequences of the p53 gene from several eutherians. This new methodology was found to be superior to other well-known softwares, at least for this data set. These results are very promising and suggest more efforts for further developments.

Desmame da prótese ventilatória de recém-nascidos: uma questão em aberto / Weaning from mechanical ventilation in new-born: an open question

Atualmente, pouco se sabe sobre a prevalência da falha na extubação em neonatologia. Grande número de pacientes acaba retornando ao respirador, provavelmente, em virtude da inexistência de um protocolo para desmame da ventilação mecânica em recém-nascidos. Não existem critérios que garantam o sucesso na extubação em neonatos, como podemos obter em adultos. A definição de que o neonato é capaz de manter a sua ventilação espontânea ainda é controversa e de difícil mensuração. Por esse motivo, o índice de falha na extubação em adulto situase entre 3 e 19%, enquanto que no neonato é bem maior, situandose entre 22 e 30%. Esta revisão bibliográfica tem como objetivo caracterizar as diferenças anatômicas e fisiológicas do recém-nascido pré-termo, bem como a dificuldade em adaptá-lo na modalidade assistida, as quais prolongam a retirada do respirador, reforçando a real necessidade da criação de protocolos específicos de desmame.

Nowadays, little is known about the prevalence of weaning failure in neonatology. A great number of pacients returns to the mechanical ventilation, probably, due to the inexistence of a protocol for weaning from mechanical ventilation in new-born. There are no criterium that assure the success of weaning in new-born as we have in adults. The definition that the new-born can maintain their own spontanous ventilation is still controversial and difficult to evaluate. Due to this reason, the weaning failure in adults is approximately betwen 3% to 19%, while in the new-born is much higher, around 22% to 30%. This literature review shows the physiological and anatomical differences of the new-born pre-term, as well as the difficulties of adapting them to the required modality. This is due to several reasons that lengthen the removal of the mechanical ventilation reinforcing the real need of creating specific weaning protocols for new-born.

Phototherapy of the newborn: a predictive model for the outcome.

Jaundice in one of the most common problems of the newborn. In most cases, jaundice is considered a physiological transient situation, but sometimes it can lead to death or serious injuries for the survivors. For decades, phototherapy has been used as the main method for prevention and treatment of hyperbilirubinaemia of the newborn. This work aims at finding a predictive model for the decrement of blood bilirubin followed conventional phototherapy. Data from 90 patients were collected and used in the multiple regression method. A rigorous statistical analysis was done in order to guarantee a correct and valid model. The obtained model was able to explain 78% of the variation of the dependent variable We found that it is possible to predict the total sugar bilirubin of the patient under phototherapy by knowing its birth weight, bilirubin level at the beginning of treatment, duration of exposition, and irradiance. Besides, it is possible to infer the time necessary for a given decrement of bilirubin, under approximately constant irradiance.

A distributed approach for a multiple sequence alignment algorithm using a parallel virtual machine.

Multiple sequence alignment is a central topic of extensive research in computational biology. Basically, two or more protein sequences are compared so as to evaluate their similarity. This work reports a methodology for parallel processing of a multiple sequence alignment algorithm (ClustalW) in an environment of networked computers. A detailed description of the modules that compose the distributed system is provided, giving special attention to the way a dynamic programming algorithm can be executed in parallel. Extensive experiments were done to evaluate performance and scalability of the method. Results show that the proposed method is efficient and offers a real advantage for large-scale multiple protein sequence alignment.

A constrained-syntax genetic programming system for discovering classification rules: application to medical data sets.

This paper proposes a new constrained-syntax genetic programming (GP) algorithm for discovering classification rules in medical data sets. The proposed GP contains several syntactic constraints to be enforced by the system using a disjunctive normal form representation, so that individuals represent valid rule sets that are easy to interpret. The GP is compared with C4.5, a well-known decision-tree-building algorithm, and with another GP that uses Boolean inputs (BGP), in five medical data sets: chest pain, Ljubljana breast cancer, dermatology, Wisconsin breast cancer, and pediatric adrenocortical tumor. For this last data set a new preprocessing step was devised for survival prediction. Computational experiments show that, overall, the GP algorithm obtained good results with respect to predictive accuracy and rule comprehensibility, by comparison with C4.5 and BGP.

Neural networks for protein classification.

This paper describes a biomolecular classification methodology based on multilayer perceptron neural networks. The system developed is used to classify enzymes found in the Protein Data Bank. The primary goal of classification, here, is to infer the function of an (unknown) enzyme by analysing its structural similarity to a given family of enzymes. A new codification scheme was devised to convert the primary structure of enzymes into a real-valued vector. The system was tested with a different number of neural networks, training set sizes and training epochs. For all experiments, the proposed system achieved a higher accuracy rate when compared with profile hidden Markov models. Results demonstrated the robustness of this approach and the possibility of implementing fast and efficient biomolecular classification using neural networks.

DoToR: um sistema especialista para apoio ao diagnóstico diferencial de dor torácica / DoTor: specialist system for differential diagnosis basis of toracic pain

Este trabalho descreve a implementação do sistema DoToR para o apoio ao diagnóstico de dor torácica aguda de origem não-traumática. O paradigma central utilizado é o raciocínio por analogia com protótipos de doenças, onde uma inferência é realizada computando-se o grau de similaridade entre um protótipo e um caso real. O sistema desenvolvido é capaz de diagnosticar 12 diferentes patologias, cujo sintoma comum é a dor torácica, incluindo diversas potencialmente letais. Um sistema de aprendizado é utilizado para aumentar o desempenho do sistema DoToR simulando o aprendizado qualitativo.