Developing a Novel Ontology for Cybersecurity in Internet of Medical Things-Enabled Remote Patient Monitoring.

IoT has seen remarkable growth, particularly in healthcare, leading to the rise of IoMT. IoMT integrates medical devices for real-time data analysis and transmission but faces challenges in data security and interoperability. This research identifies a significant gap in the existing literature regarding a comprehensive ontology for vulnerabilities in medical IoT devices. This paper proposes a fundamental domain ontology named MIoT (Medical Internet of Things) ontology, focusing on cybersecurity in IoMT (Internet of Medical Things), particularly in remote patient monitoring settings. This research will refer to similar-looking acronyms, IoMT and MIoT ontology. It is important to distinguish between the two. IoMT is a collection of various medical devices and their applications within the research domain. On the other hand, MIoT ontology refers to the proposed ontology that defines various concepts, roles, and individuals. MIoT ontology utilizes the knowledge engineering methodology outlined in Ontology Development 101, along with the structured life cycle, and establishes semantic interoperability among medical devices to secure IoMT assets from vulnerabilities and cyberattacks. By defining key concepts and relationships, it becomes easier to understand and analyze the complex network of information within the IoMT. The MIoT ontology captures essential key terms and security-related entities for future extensions. A conceptual model is derived from the MIoT ontology and validated through a case study. Furthermore, this paper outlines a roadmap for future research, highlighting potential impacts on security automation in healthcare applications.

Comprehensive mitigation framework for concurrent application of multiple clinical practice guidelines.

In this work we propose a comprehensive framework based on first-order logic (FOL) for mitigating (identifying and addressing) interactions between multiple clinical practice guidelines (CPGs) applied to a multi-morbid patient while also considering patient preferences related to the prescribed treatment. With this framework we respond to two fundamental challenges associated with clinical decision support: (1) concurrent application of multiple CPGs and (2) incorporation of patient preferences into the decision making process. We significantly expand our earlier research by (1) proposing a revised and improved mitigation-oriented representation of CPGs and secondary medical knowledge for addressing adverse interactions and incorporating patient preferences and (2) introducing a new mitigation algorithm. Specifically, actionable graphs representing CPGs allow for parallel and temporal activities (decisions and actions). Revision operators representing secondary medical knowledge support temporal interactions and complex revisions across multiple actionable graphs. The mitigation algorithm uses the actionable graphs, revision operators and available (and possibly incomplete) patient information represented in FOL. It relies on a depth-first search strategy to find a valid sequence of revisions and uses theorem proving and model finding techniques to identify applicable revision operators and to establish a management scenario for a given patient if one exists. The management scenario defines a safe (interaction-free) and preferred set of activities together with possible patient states. We illustrate the use of our framework with a clinical case study describing two patients who suffer from chronic kidney disease, hypertension, and atrial fibrillation, and who are managed according to CPGs for these diseases. While in this paper we are primarily concerned with the methodological aspects of mitigation, we also briefly discuss a high-level proof of concept implementation of the proposed framework in the form of a clinical decision support system (CDSS). The proposed mitigation CDSS "insulates" clinicians from the complexities of the FOL representations and provides semantically meaningful summaries of mitigation results. Ultimately we plan to implement the mitigation CDSS within our MET (Mobile Emergency Triage) decision support environment.

Using Semantic Components to Represent Dynamics of an Interdisciplinary Healthcare Team in a Multi-Agent Decision Support System.

In healthcare organizations, clinical workflows are executed by interdisciplinary healthcare teams (IHTs) that operate in ways that are difficult to manage. Responding to a need to support such teams, we designed and developed the MET4 multi-agent system that allows IHTs to manage patients according to presentation-specific clinical workflows. In this paper, we describe a significant extension of the MET4 system that allows for supporting rich team dynamics (understood as team formation, management and task-practitioner allocation), including selection and maintenance of the most responsible physician and more complex rules of selecting practitioners for the workflow tasks. In order to develop this extension, we introduced three semantic components: (1) a revised ontology describing concepts and relations pertinent to IHTs, workflows, and managed patients, (2) a set of behavioral rules describing the team dynamics, and (3) an instance base that stores facts corresponding to instances of concepts from the ontology and to relations between these instances. The semantic components are represented in first-order logic and they can be automatically processed using theorem proving and model finding techniques. We employ these techniques to find models that correspond to specific decisions controlling the dynamics of IHT. In the paper, we present the design of extended MET4 with a special focus on the new semantic components. We then describe its proof-of-concept implementation using the WADE multi-agent platform and the Z3 solver (theorem prover/model finder). We illustrate the main ideas discussed in the paper with a clinical scenario of an IHT managing a patient with chronic kidney disease.

Diagnosis knowledge constrained network based on first-order logic for syndrome differentiation.

Traditional Chinese medicine (TCM) has been recognized worldwide as a valuable asset of human medicine. The procedure of TCM is to treatment based on syndrome differentiation. However, the effect of TCM syndrome differentiation relies heavily on the experience of doctors. The gratifying progress of machine learning research in recent years has brought new ideas for TCM syndrome differentiation. In this paper, we propose a deep network model for TCM syndrome differentiation, which improves network performance by injecting TCM syndrome differentiation knowledge in the form of first-order logic into the deep network. Experimental results show that the accuracy of our proposed model reaches 89%, which is significantly better than the deep learning model MLP and other traditional machine learning models. In addition, we present the collected and formatted TCM syndrome differentiation (TSD) dataset, which contains more than 40,000 TCM clinical records. Moreover, 45 symptoms (""), 322 patterns(""), and more than 500 symptoms are labeled in TSD respectively. To the best of our knowledge, this is the first TCM syndrome differentiation dataset labeling diseases, syndromes and pattern. Such detailed labeling is helpful to explore the relationship between various elements of syndrome differentiation.

LollipopE: Bi-centered lollipop embedding for complex logic query on knowledge graph.

Answering complex First-Order Logic (FOL) query plays a vital role in multi-hop knowledge graph (KG) reasoning. Geometric methods have emerged as a promising category of approaches in this context. However, existing best-performing geometric query embedding (QE) model is still up against three-fold potential problems: (i) underutilization of embedding space, (ii) overreliance on angle information, (iii) uncaptured hierarchy structure. To bridge the gap, we propose a lollipop-like bi-centered query embedding method named LollipopE. To fully utilize embedding space, LollipopE employs learnable centroid positions to represent multiple entities distributed along the same axis. To address the potential overreliance on angular metrics, we design an angular-based and centroid-based metric. This involves calculating both an angular distance and a centroid-based geodesic distance, which empowers the model to make more informed selections of relevant answers from a wider perspective. To effectively capture the hierarchical relationships among entities within the KG, we incorporate dynamic moduli, which allows for the representation of the hierarchical structure among entities. Extensive experiments demonstrate that LollipopE surpasses the state-of-the-art geometric methods. Especially, on more hierarchical datasets, LollipopE achieves the most significant improvement.

Logic + probabilistic programming + causal laws.

Probabilistic planning attempts to incorporate stochastic models directly into the planning process, which is the problem of synthesizing a sequence of actions that achieves some objective for a putative agent. Probabilistic programming has rapidly emerged as a key paradigm to integrate probabilistic concepts with programming languages, which allows one to specify complex probabilistic models using programming primitives like recursion and loops. Probabilistic logic programming aims to further ease the specification of structured probability distributions using first-order logical artefacts. In this article, we briefly discuss the modelling of probabilistic planning through the lens of probabilistic (logic) programming. Although many flavours for such an integration are possible, we focus on two representative examples. The first is an extension to the popular probabilistic logic programming language PROBLOG, which permits the decoration of probabilities on Horn clauses-that is, prolog programs. The second is an extension to the popular agent programming language GOLOG, which permits the logical specification of dynamical systems via actions, effects and observations. The probabilistic extensions thereof emphasize different strengths of probabilistic programming that are particularly useful for non-trivial modelling issues raised in probabilistic planning. Among other things, one can instantiate planning problems with growing and shrinking state spaces, discrete and continuous probability distributions, and non-unique prior distributions in a first-order setting.

Medical knowledge embedding based on recursive neural network for multi-disease diagnosis.

The representation of knowledge based on first-order logic captures the richness of natural language and supports multiple probabilistic inference models. Although symbolic representation enables quantitative reasoning with statistical probability, it is difficult to utilize with machine learning models as they perform numerical operations. In contrast, knowledge embedding (i.e., high-dimensional and continuous vectors) is a feasible approach to complex reasoning that can not only retain the semantic information of knowledge, but also establish the quantifiable relationship among embeddings. In this paper, we propose a recursive neural knowledge network (RNKN), which combines medical knowledge based on first-order logic with a recursive neural network for multi-disease diagnosis. After the RNKN is efficiently trained using manually annotated Chinese Electronic Medical Records (CEMRs), diagnosis-oriented knowledge embeddings and weight matrixes are learned. The experimental results confirm that the diagnostic accuracy of the RNKN is superior to those of four machine learning models, four classical neural networks and Markov logic network. The results also demonstrate that the more explicit the evidence extracted from CEMRs, the better the performance. The RNKN gradually reveals the interpretation of knowledge embeddings as the number of training epochs increases.