My main objective in this article will be to compare Heidegger’s description of the way we perceive our environment in everyday coping – which is based on the concept of equipment (Zeug) – and James Gibson’s theory of affordance perception. More precisely, I will discuss whether equipment and affordance can be equated. In contrast to some interpretations, I will defend that they cannot: equipment and affordances refer to different ontological kinds and the perceptual or cognitive processes that are implied in each case have nothing in common. In addition, I will defend that distinguishing equipment and affordances is a key step towards a more comprehensive account of the way we perceive and deal with the possibilities offered by our environment, and that Heidegger’s and Gibson’s accounts, far from being mutually exclusive, complement each other. Some work has however to be done in order to articulate them in a coherent theoretical framework.

In spite of the extensive usage of the concept of possibility found in Being and Time and the precautions taken by Heidegger to differentiate the possible of Dasein from its traditional meanings, the sense in which the term is used remains fairly obscure. There is no indication that could help to grasp positively what kind of possibility is meant. Above all, Heidegger never justifies the use of this term : why qualify as possibilities that with which Dasein maintains a relationship of being in understanding (Verstehen) ? In what sense precisely are these projected possibilities possible ? My main aim in this article will be to clarify the meaning of this concept of possibility. On the one hand, I will inquire into the phenomenological characteristics that Heidegger seeks to grasp by means of this concept and the role he wants it to play in the overall economy of the existential analytic. On the other hand, I will attempt to identify the characteristics that authorise us to qualify as possibilities that which Dasein relates itself to in understanding and that justify resorting to this modal status. I will show that the concept of possibility does not have a univocal meaning in the analytic of Dasein, but that Heidegger makes varying uses of it, ranging in particular from a Kantian usage that derives from the transcendental perspective running through Being and Time, and a usage that emphasises the historic and situated character of the possibilities projected, as well as their counterfactual and contingent character (transl. J. Dudley).

Background: Searching into the MedDRA terminology is usually limited to a hierarchical search, and/or a string search. Our objective was to compare user performances when using a new kind of user interface enabling semantic queries versus classical methods, and evaluating term selection improvement in MedDRA. Methods: We implemented a forms-based web interface: OntoADR Query Tools (OQT). It relies on OntoADR, a formal resource describing MedDRA terms using SNOMED CT concepts and corresponding semantic relations, enabling terminological reasoning. We then compared time spent on five examples of medical conditions using OQT or the MedDRA web-based browser (MWB), and precision and recall of the term selection. Results: OntoADR Query Tools allows the user to search in MedDRA: One may enter search criteria by selecting one semantic property from a dropdown list and one or more SNOMED CT concepts related to the range of the chosen property. The user is assisted in building his query: he can add criteria and combine them. Then, the interface displays the set of MedDRA terms matching the query. Meanwhile, on average, the time spent on OQT (about 4 min 30 s) is significantly lower (-35%; p < 0.001) than time spent on MWB (about 7 min). The results of the System Usability Scale (SUS) gave a score of 62.19 for OQT (rated as good). We also demonstrated increased precision (+27%; p = 0.01) and recall (+34%; p = 0.02). Computed "performance" (correct terms found per minute) is more than three times better with OQT than with MWB. Discussion: This pilot study establishes the feasibility of our approach based on our initial assumption: performing MedDRA queries on the five selected medical conditions, using terminological reasoning, expedites term selection, and improves search capabilities for pharmacovigilance end users. Evaluation with a larger number of users and medical conditions are required in order to establish if OQT is appropriate for the needs of different user profiles, and to check if conclusions can be extended to other kinds of medical conditions. The application is currently limited by the non-exhaustive coverage of MedDRA by OntoADR, but nevertheless shows good performance which encourages continuing in the same direction.

Background: Formal definitions allow selecting terms (e.g., identifying all terms related to "Infectious disease" using the query "has causative agent organism") and terminological reasoning (e.g., "hepatitis B" is a "hepatitis" and is an "infectious disease"). However, the standard international terminology Medical Dictionary for Regulatory Activities (MedDRA) used for coding adverse drug reactions in pharmacovigilance databases does not beneficiate from such formal definitions. Our objective was to evaluate the potential of reuse of ontological and non-ontological resources for generating such definitions for MedDRA. Methods: We developed several methods that collectively allow a semiautomatic semantic enrichment of MedDRA: 1) using MedDRA-to-SNOMED Clinical Terms (SNOMED CT) mappings (available in the Unified Medical Language System metathesaurus or other mapping resources, e.g., the MedDRA preferred term "hepatitis B" is associated to the SNOMED CT concept "type B viral hepatitis") to extract term definitions (e.g., "hepatitis B" is associated with the following properties: has finding site liver structure, has associated morphology inflammation morphology, and has causative agent hepatitis B virus); 2) using MedDRA labels and lexical/syntactic methods for automatic decomposition of complex MedDRA terms (e.g., the MedDRA systems organ class "blood and lymphatic system disorders" is decomposed in blood system disorders and lymphatic system disorders) or automatic suggestions of properties (e.g., the string "cyclic" in preferred term "cyclic neutropenia" leads to the property has clinical course cyclic). Results: The Unified Medical Language System metathesaurus was the main ontological resource reusable for generating formal definitions for MedDRA terms. The non-ontological resources (another mapping resource provided by Nadkarni and Darer in 2010 and MedDRA labels) allowed defining few additional preferred terms. While the Ci4SeR tool helped the curator to define 1,935 terms by suggesting potential supplemental relations based on the parents' and siblings' semantic definition, defining manually all MedDRA terms remains expensive in time. Discussion: Several ontological and non-ontological resources are available for associating MedDRA terms to SNOMED CT concepts with semantic properties, but providing manual definitions is still necessary. The ontology of adverse events is a possible alternative but does not cover all MedDRA terms either. Perspectives are to implement more efficient techniques to find more logical relations between SNOMED CT and MedDRA in an automated way.

L’ambition des technologies dites de « téléprésence » étant d’assurer une interaction à distance en « temps réel », la gestion des délais temporels constitue un enjeu de premier plan. Afin d’évaluer leur impact sur l’expérience de la présence d’autrui dans une situation d’interaction, nous avons repris le paradigme du croisement perceptif en situation minimaliste (Auvray et al., 2009), en introduisant des délais (300 ms et 600 ms) sur le déclenchement de la stimulation. Les participants déplaçaient un champ récepteur dans un environnement 1D avec pour tâche d’identifier l'avatar de l’autre, en le distinguant d’un objet fixe et d’un leurre mobile. Une stimulation tactile en tout-ou-rien les informait du contact de leur avatar avec un des trois objets. Les résultats montrent que l’introduction de délais s’accompagne de plus d’erreurs de discrimination et d’une détérioration notable des dynamiques d’interaction, appuyant l’hypothèse que les délais induisent une altération de l’expérience de la présence d’autrui.

The aim of this narrow-focused text is to argue against the claim that the appresentation of unperceived features of objects that is implied in perceptual intentionality presupposes a reference to perceptions other subjects could have of these objects. This claim, as it has been defended by Dan Zahavi, rests upon an erroneous supposition about the modal status of the perceptual possibilities to which the perceived object refers, which shall not be interpreted as effectively realizable but as mere de jure possibilities, perceptions that could have been realized in principle, but that are maybe beyond one's reach considering one's concrete factual powers and opportunities. Horizontal intentionality is better accounted for in terms of perceptions that one could have had because of one's embodied character and the always open possibility of occupying another position with respect to the object. This modal ubiquity which is inherent to one's being-in-space is what supports the field of de jure possibilities that is implied in horizontal intentionality. The co-presence of the parts and features one does not perceive from here is a counterpoint to one's being-possibly-there.

Alva Noë’s strategy to solve the puzzle of perceptual presence entirely relies on the principle of presence as access. Unaccessed or unattended parts or details of objects are perceptually present insofar as they are accessible, and they are accessible insofar as one possesses sensorimotor skills that can secure their access. In this paper, I consider several arguments that can be opposed to this claim and that are chiefly related to the modal status of action, i.e. the fact that the action that would secure access to the absent aspects is a possibility, something that can (or maybe could) be done. The main difficulty Noë’s account must face is –as several situations demonstrate– that the action that should be performed for the absent aspects to be actually accessed does not have to be itself available for these aspects to be perceptually present. What matters for the absent aspects to be present is not their de facto (i.e. effective) accessibility, but their de jure accessibility. To overcome those difficulties, I propose to rely on a ternary model of the role of action possibilities in perceptual awareness. This model builds on Husserl’s analysis of the role of perceptual circumstances in perception and connection between sense (Sinn) registering and horizontal intentionality.

Introduction: Efficient searching and coding in databases that use terminological resources requires that they support efficient data retrieval. The Medical Dictionary for Regulatory Activities (MedDRA) is a reference terminology for several countries and organizations to code adverse drug reactions (ADRs) for pharmacovigilance. Ontologies that are available in the medical domain provide several advantages such as reasoning to improve data retrieval. The field of pharmacovigilance does not yet benefit from a fully operational ontology to formally represent the MedDRA terms. Our objective was to build a semantic resource based on formal description logic to improve MedDRA term retrieval and aid the generation of on-demand custom groupings by appropriately and efficiently selecting terms: OntoADR.Methods: The method consists of the following steps: (1) mapping between MedDRA terms and SNOMED-CT, (2) generation of semantic definitions using semi-automatic methods, (3) storage of the resource and (4) manual curation by pharmacovigilance experts.Results: We built a semantic resource for ADRs enabling a new type of semantics-based term search. OntoADR adds new search capabilities relative to previous approaches, overcoming the usual limitations of computation using lightweight description logic, such as the intractability of unions or negation queries, bringing it closer to user needs. Our automated approach for defining MedDRA terms enabled the association of at least one defining relationship with 67% of preferred terms. The curation work performed on our sample showed an error level of 14% for this automated approach. We tested OntoADR in practice, which allowed us to build custom groupings for several medical topics of interest.Discussion: The methods we describe in this article could be adapted and extended to other terminologies which do not benefit from a formal semantic representation, thus enabling better data retrieval performance. Our custom groupings of MedDRA terms were used while performing signal detection, which suggests that the graphical user interface we are currently implementing to process OntoADR could be usefully integrated into specialized pharmacovigilance software that rely on MedDRA. (C) 2016 Elsevier Inc. All rights reserved.

Objective: To propose a method to build customized sets of MedDRA terms for the description of a medical condition. We illustrate this method with upper gastrointestinal bleedings (UGIB).Research design and methods: We created a broad list of MedDRA terms related to UGIB and defined a gold standard with the help of experts. MedDRA terms were formally described in a semantic resource named OntoADR. We report the use of two semantic queries that automatically select candidate terms for UGIB. Query 1 is a combination of two SNOMED CT concepts describing both morphology 'Hemorrhage' and finding site 'Upper digestive tract structure'. Query 2 complements Query 1 by taking into account MedDRA terms associated to SNOMED CT concepts describing clinical manifestations 'Melena' or 'Hematemesis'.Results: We compared terms in queries and our gold standard achieving a recall of 71.0% and a precision of 81.4% for query 1 (F1 score 0.76); and a recall of 96.7% and a precision of 77.0% for query 2 (F1 score 0.86).Conclusions: Our results demonstrate the feasibility of applying knowledge engineering techniques for building customized sets of MedDRA terms. Additional work is necessary to improve precision and recall, and confirm the interest of the proposed strategy.

Summary Introduction: This article is part of the Focus Theme of Methods of Information in Medicine on “Managing Interoperability and Complexity in Health Systems”. Background: SALUS project aims at building an interoperability platform and a dedicated toolkit to enable secondary use of electronic health records (EHR) data for post marketing drug surveillance. An important component of this toolkit is a drug-related adverse events (AE) reporting system designed to facilitate and accelerate the reporting process using automatic prepopulation mechanisms. Objective: To demonstrate SALUS approach for establishing syntactic and semantic inter-operability for AE reporting. Method: Standard (e.g. HL7 CDA-CCD) and proprietary EHR data models are mapped to the E2B(R2) data model via SALUS Common Information Model. Terminology mapping and terminology reasoning services are designed to ensure the automatic conversion of source EHR terminologies (e.g. ICD-9-CM, ICD-10, LOINC or SNOMED-CT) to the target terminology MedDRA which is expected in AE reporting forms. A validated set of terminology mappings is used to ensure the reliability of the reasoning mechanisms. Results: The percentage of data elements of a standard E2B report that can be completed automatically has been estimated for two pilot sites. In the best scenario (i.e. the avail able fields in the EHR have actually been filled), only 36% (pilot site 1) and 38% (pilot site 2) of E2B data elements remain to be filled manually. In addition, most of these data elements shall not be filled in each report. Conclusion: SALUS platform’s interopera bility solutions enable partial automation of the AE reporting process, which could con tribute to improve current spontaneous reporting practices and reduce under-report ing, which is currently one major obstacle in the process of acquisition of pharmacovigilance data.

According to the motor simulation theory, the knowledge we possess of what we can do is based on simulation mechanisms triggered by an off-line activation of the brain areas involved in motor control. Action capabilities memory does not work by storing some content, but consists in the capacity, rooted in sensory-motor systems, to reenact off-line action sequences exhibiting the range of our powers. In this paper, I present several arguments from cognitive neuropsychology, but also first-person analysis of experience, against this hypothesis. The claim that perceptual access to affordances is mediated by motor simulation processes rests on a misunderstanding of what affordances are, and comes up against a computational reality principle. Motor simulation cannot provide access to affordances because (i) the affordances we are aware of at each moment are too many for their realization to be simulated by the brain and (ii) affordances are not equivalent to currently or personally feasible actions. The explanatory significance of the simulation theory must then be revised downwards compared to what is claimed by most of its advocates. One additional challenge is to determine the prerequisite, in terms of cognitive processing, for the motor simulation mechanisms to work. To overcome the limitations of the simulation theory, I propose a new approach: the direct content specification hypothesis. This hypothesis states that, at least for the most basic actions of our behavioral repertoire, the action possibilities we are aware of through perception are directly specified by perceptual variables characterizing the content of our experience. The cognitive system responsible for the perception of action possibilities is consequently far more direct, in terms of cognitive processing, than what is stated by the simulation theory. To support this hypothesis I review evidence from current neuropsychological research, in particular data suggesting a phenomenon of 'fossilization' of affordances. Fossilization can be defined as a gap between the capacities that are treated as available by the cognitive system and the capacities this system really has at its disposal. These considerations do not mean that motor simulation cannot contribute to explain how we gain perceptual knowledge of what we can do based on the memory of our past performances. However, when precisely motor simulation plays a role and what it is for exactly currently remain largely unknown.

Robust alignments between ICD and MedDRA are essential to enable the secondary use of clinical data for pharmacovigilance research. UMLS makes available ICD-to-MedDRA mappings, but they are only poorly specified, which introduces difficulties when exploited in an automatic way. SKOS vocabulary can help achieve quality and machine-processable mappings. We have developed an algorithm based on several simple rules which annotates automatically ICD-to-MedDRA mappings with SKOS predicates. The method was tested and evaluated on a sample of ICD-10-to MedDRA mappings extracted from UMLS. The algorithm demonstrated satisfying performances, especially for skos:exactMatch properties, which suggests that automatic methods can be used to improve the quality of terminology mappings.

Le projet de représenter la sémantique des termes et concepts humains à l’aide de langages formels ne date pas d’hier, mais il connait aujourd’hui un regain d’intérêt avec le développement des ontologies computationnelles. Fer de lance du Web sémantique, la principale ambition de ces systèmes de représentation est de permettre aux machines d’accéder au «sens » des données qu’elles manipulent. Les langages formels ont toujours eu leurs détracteurs et l’usage qui en est fait en ingénierie ontologique ne fait pas exception. Différents auteurs dénoncent le projet de soumettre notre sémantique naïve à des formalismes logiques, trop rigides et trop mécaniques pour en capter la mobilité et l’adaptabilité, et proposent de leur substituer des approches et modèles alternatifs, censés être plus proches des mécanismes de conceptualisation et de représentation «naturels » de l’humain. L’objet de cet article est de montrer que ces critiques sont pour la plupart infondées, et en tout cas hors sujet, en ce qu’elles présupposent la subordination des ontologies à une exigence épistémique (modéliser de manière fidèle un référent) plutôt qu’opérationnelle (fonctionner et rendre service). Elles perdent leur raison d’être dès lors que l’on considère que la fonction des ontologies n’est pas (i) de représenter de manière fidèle le mobilier et les structures constitutives de la réalité (réalisme) ou la manière dont l’esprit se représente cette réalité (conceptualisme), mais (ii) d’augmenter les capacités de catégorisation, d’accès à l’information et de manipulation de données et documents, et (iii) de normaliser les pratiques de catégorisation et d’encodage. Considérer les ontologies computationnelles dans la perspective de l’augmentation cognitive et de l’instrumentation des pratiques exige un nouveau cadre épistémologique pour leur conception. Nous en décrivons ici les principes de base et proposons de qualifier cette nouvelle approche d’instrumentaliste.

Although MedDRA has obvious advantages over previous terminologies for coding adverse drug reactions and discovering potential signals using data mining techniques, its terminological organization constrains users to search terms according to predefined categories. Adding formal definitions to MedDRA would allow retrieval of terms according to a case definition that may correspond to novel categories that are not currently available in the terminology. To achieve semantic reasoning with MedDRA, we have associated formal definitions to MedDRA terms in an OWL file named OntoADR that is the result of our first step for providing an “ontologized” version of MedDRA. MedDRA five-levels original hierarchy was converted into a subsumption tree and formal definitions of MedDRA terms were designed using several methods: mappings to SNOMED-CT, semi-automatic definition algorithms or a fully manual way. This article presents the main steps of OntoADR conception process, its structure and content, and discusses problems and limits raised by this attempt to “ontologize” MedDRA.