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BackgroundHealthcare services, particularly in patient-provider interaction, often involve highly emotional situations, and it is important for physicians to understand and respond to their patients’ emotions to best ensure their well-being.MethodsIn order to model the emotion domain, we have created the Visualized Emotion Ontology (VEO) to provide a semantic definition of 25 emotions based on established models, as well as visual representations of emotions utilizing shapes, lines, and colors.ResultsAs determined by ontology evaluation metrics, VEO exhibited better machine-readability (z=1.12), linguistic quality (z=0.61), and domain coverage (z=0.39) compared to a sample of cognitive ontologies. Additionally, a survey of 1082 participants through Amazon Mechanical Turk revealed that a significantly higher proportion of people agree than disagree with 17 out of our 25 emotion images, validating the majority of our visualizations.ConclusionFrom the development, evaluation, and serialization of the VEO, we have defined a set of 25 emotions using OWL that linked surveyed visualizations to each emotion. In the future, we plan to use the VEO in patient-facing software tools, such as embodied conversational agents, to enhance interactions between patients and providers in a clinical environment.

Background Previously, we introduced our Patient Health Information Dialogue Ontology (PHIDO) that manages the dialogue and contextual information of the session between an agent and a health consumer. In this study, we take the next step and introduce the Conversational Ontology Operator (COO), the software engine harnessing PHIDO. We also developed a question-answering subsystem called Frankenstein Ontology Question-Answering for User-centric Systems (FOQUS) to support the dialogue interaction. Methods We tested both the dialogue engine and the question-answering system using application-based competency questions and questions furnished from our previous Wizard of OZ simulation trials. Results Our results revealed that the dialogue engine is able to perform the core tasks of communicating health information and conversational flow. Inter-rater agreement and accuracy scores among four reviewers indicated perceived, acceptable responses to the questions asked by participants from the simulation studies, yet the composition of the responses was deemed mediocre by our evaluators. Conclusions Overall, we present some preliminary evidence of a functioning ontology-based system to manage dialogue and consumer questions. Future plans for this work will involve deploying this system in a speech-enabled agent to assess its usage with potential health consumer users.

CASE DESCRIPTION A 15-month-old male Newfoundland was examined because of an inability to urinate, lethargy, inappetence, and intermittent vomiting that first became evident after bilateral cryptorchidectomy 2 days previously. The patient was referred for further evaluation and treatment. CLINICAL FINDINGS Results of physical examination, serum biochemical analysis, and abdominocentesis led to a diagnosis of uroperitoneum. Retrograde cystography indicated urinary tract obstruction. In view of the history of recent elective cryptorchidectomy, a diagnosis of uroperitoneum with urethral obstruction secondary to iatrogenic prostatectomy and urethrectomy was made. TREATMENT AND OUTCOME During a ventral midline celiotomy, the inadvertent prostatectomy and urethrectomy were found to have resulted in insufficient urethral length for primary repair. Surgical repair of the urethral defect was achieved by means of a novel technique of bladder retroversion and neourethrocystostomy at the apex of the bladder. A urethral stricture evident 1.5 months after surgery was initially treated with balloon dilatation, followed by temporary and then permanent placement of a self-expanding metallic stent. At the last follow-up 6.6 years after stent placement, the dog remained continent while receiving phenylpropanolamine and the owner was highly satisfied with the outcome. CLINICAL RELEVANCE Caudal intraabdominal bladder retroversion with apex neourethrocystostomy may be a viable alternative to more complex urethral lengthening procedures in dogs and can potentially preserve lower urinary tract function. This treatment might be considered for patients with urethral trauma or malignant neoplasia necessitating extensive urethral resection. Urethral strictures may be effectively managed with stenting.

Background Understanding consumers’ health information needs across all stages of the pregnancy trajectory is crucial to the development of mechanisms that allow them to retrieve high-quality, customized, and layperson-friendly health information. Objective The objective of this study was to identify research gaps in pregnancy-related consumer information needs and available information from different sources. Methods We conducted a systematic review of CINAHL, Cochrane, PubMed, and Web of Science for relevant articles that were published from 2009 to 2019. The quality of the included articles was assessed using the Critical Appraisal Skills Program. A descriptive data analysis was performed on these articles. Based on the review result, we developed the Pregnancy Information Needs Ontology (PINO) and made it publicly available in GitHub and BioPortal. Results A total of 33 articles from 9 countries met the inclusion criteria for this review, of which the majority were published no earlier than 2016. Most studies were either descriptive (9/33, 27%), interviews (7/33, 21%), or surveys/questionnaires (7/33, 21%); 20 articles mentioned consumers’ pregnancy-related information needs. Half (9/18, 50%) of the human-subject studies were conducted in the United States. More than a third (13/33, 39%) of all studies focused on during-pregnancy stage; only one study (1/33, 3%) was about all stages of pregnancy. The most frequent consumer information needs were related to labor delivery (9/20, 45%), medication in pregnancy (6/20, 30%), newborn care (5/20, 25%), and lab tests (6/20, 30%). The most frequently available source of information was the internet (15/24, 63%). PINO consists of 267 classes, 555 axioms, and 271 subclass relationships. Conclusions Only a few articles assessed the barriers to access to pregnancy-related information and the quality of each source of information; further work is needed. Future work is also needed to address the gaps between the information needed and the information available.