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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Optimizing Semantic Enrichment of Biomedical Content through Knowledge Sharing</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Asim Abbas</string-name>
          <email>abbasa@stjohns.edu</email>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Steve Mbouadeu</string-name>
          <email>steve.mbouadeu19@stjohns.edu</email>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Avinash Bisram</string-name>
          <email>avinash.bisram19@stjohns.edu</email>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Nadeem Iqbal</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Fazel Keshtkar</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Syed Ahmad Chan Bukhari</string-name>
          <email>bukharis@stjohns.edu</email>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Division Of Computer Science, Math &amp; Science, Collins College of Professional Studies, St. John's University</institution>
          ,
          <addr-line>Queens, NYC</addr-line>
          ,
          <country country="US">USA</country>
        </aff>
        <aff id="aff1">
          <label>1</label>
          <institution>Workshop Proce dings</institution>
        </aff>
      </contrib-group>
      <abstract>
        <p>Each day a vast amount of unstructured content is generated in the biomedical domain from various sources such as clinical notes, research articles and medical reports. Such content contain a suficient amount of eficient and meaningful information that needs to be converted into actionable knowledge for secondary use. However, accessing precise biomedical content is quite challenging because of content heterogeneity, missing and imprecise metadata and unavailability of associated semantic tags required for search engine optimization. We have introduced a socio-technical semantic annotation optimization approach that enhance the semantic search of biomedical contents. The proposed approach consist of layered architecture. At First layer (Preliminary Semantic Enrichment), it annotates the biomedical contents with the ontological concepts from NCBO BioPortal. With the growing biomedical information, the suggested semantic annotations from NCBO Bioportal are not always correct. Therefore, in the second layer (Optimizing the Enriched Semantic Information), we introduce a knowledge sharing scheme through which authors/users could request for recommendations from other users to optimize the semantic enrichment process. To guage the credibility of the the human recommended, our systems records the recommender confidence score, collects community voting against previous recommendations, stores percentage of correctly suggested annotation and translates that into an index to later connect right users to get suggestions to optimize the semantic enrichment of biomedical contents. At the preliminary layer of annotation from NCBO, we analyzed the n-gram strategy for biomedical word boundary identification. We have found that NCBO recognizes biomedical terms for n-gram-1 more than for n-gram-2 to n-gram-5. Similarly, a statistical measure conducted on significant features using the Wilson score and data normalization. In contrast, the proposed methodology achieves an suitable accuracy of ≈90% for the semantic optimization approach.</p>
      </abstract>
      <kwd-group>
        <kwd>Structured data</kwd>
        <kwd>Biomedical semantic enrichment</kwd>
        <kwd>Annotation optimization</kwd>
        <kwd>Recommendation</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>1. Introduction</title>
      <p>tal unstructured textual content has been generated in
Over the last few decades, a huge volume of the digi- require the metadata to properly index contents in a
context-aware fashion for the precise search of
biomedibiomedical research and practice, including various con- cal literature and to foster secondary activities such as
tent types such as scientific papers, medical reports, and
physician notes. This explosive growth in the biomedical
domain has introduced several access-level challenges
for researchers and practitioners. These valuable
information are available in the web contents but still opaque
to information retrieval and knowledge extraction search
(A. Bisram); https://bukharilab.org (N. Iqbal); https://bukharilab.org
(F. Keshtkar); https://bukharilab.org (S. A. C. Bukhari)</p>
      <p>
        0000-0001-6374-0397 (A. Abbas); 0000-0002-6517-5261
metadata (semantic annotations) [
        <xref ref-type="bibr" rid="ref5">1</xref>
        ]. Search engines
automatic integration for meta-analysis [
        <xref ref-type="bibr" rid="ref6">2</xref>
        ].
Incorporating machine-interpretable semantic annotations at
the pre-publication stage (while first-time drafting) of
biomedical contents and preserving them during online
publishing is desirable and will be a great value addition
to the broader semantic web vision [
        <xref ref-type="bibr" rid="ref7">3</xref>
        ]. However, both
these processes are complex and require deep technical
and/or domain knowledge. Therefore, a state-of-the-art,
freely accessible biomedical semantic content authoring
framework would be a game-changer.
      </p>
      <p>
        The main components of the semantic annotation
process are ontologies which are sets of machine-readable
controlled vocabularies that provide the “explicit
specifimantic annotators are designed to facilitate
tagging/annotating the related ontology concepts with pre-defined
terminologies in a manual, automatic, or hybrid way [
        <xref ref-type="bibr" rid="ref8">4</xref>
        ]. As
a result, users produce semantically richer content when
compared with traditional composing processes e.g.,
usthe semantic annotation process in biomedical
informat2. Proposed Methodology
ics research and retrieval, the scientific community has
invested considerable resources in the development of
semantic annotators. Whereas the biomedical annota- This section presents the biomedical semantic annotation
tors predominantly use term-to-concept matching with recommendation and optimization processes. We
develor without machine learning-based methods [
        <xref ref-type="bibr" rid="ref1">5</xref>
        ]. Like- oped a system through which users access a biomedical
wise, biomedical annotators such as NOBLE Coder [
        <xref ref-type="bibr" rid="ref2">6</xref>
        ], content authoring interface analogous to the MS Word
ConceptMapper [
        <xref ref-type="bibr" rid="ref3">7</xref>
        ], Neji [
        <xref ref-type="bibr" rid="ref4">8</xref>
        ], and Open Biomedical An- editor to type or import biomedical contents for their
notator [9] use machine learning and annotate text with semantic enrichment. The system generates the first
an acceptable processing speed. However, they lack a layer of semantic annotation utilizing the NCBO
Bioporstrong disambiguation capacity, i.e., the ability to iden- tal API [10] Figure 1(a). However, the correctness of the
tify the correct biomedical concept for a given piece of acquired semantic annotation varies as one annotation is
text among several candidate concepts. Whereas NCBO available to multiple ontologies. Furthermore, the
linguisAnnotator [10] and MGrep services are quite slow, Rysan- tic mapping mechanism of the Bioportal recommender
nMd annotator claims to balance speed and accuracy in often ignores the sentence and paragraph-level context.
the annotation process. However, on the flip side its Therefore, the suggested annotations might be correct
knowledge base is limited to certain ontologies available at the content level. However, they may be entirely
inin UMLS (Unified Medical Language System) and does not correctly contextually in a particular setting. Only the
provide full coverage of all biomedical sub-domains [11]. original author knows in which context they used a
speOther than the technical challenges as stated above, one cific concept. Therefore a state-of-the-art knowledge
of the main reasons why semantic authoring is still in sharing approach is designated as it provides a system
infancy and researchers have not been able to achieve that allows the author to query peers for more specific
the desired objectives is because researchers did not re- semantic annotation against the biomedical term to
opalize the importance of original content creator (author) timize the annotation quality. In the following sections,
involvement and heavily focused on technology sophis- we explain 1) Preliminary Semantic Enrichment, 2)
Optitication where systems interactions were limited to the mizing Semantic Enrichment, and an Example Scenario
technical persons. Typically, only the author knows why in an annotation optimization environment Figure 1.
Adthey used a particular term to explain a concept. Third- ditionally, in an Example Scenario below, we categorize
party developers are naturally not privy to such tacit the role as author who posted a query,   =  1,  2,  3…. 
knowledge. Researchers and practitioners face access- represents responder or expert, and   =  1,  2,  3….  is
level issues due to the dissonance between those who community users.
authored the original work and those who added
semantic annotations and published it. The majority of the 2.1. Preliminary Semantic Enrichment
authors lack of technical and/or domain knowledge, and
there is a steep learning curve that necessitates substan- A biomedical annotator is an essential component of
setial time to develop critical skills that are not the primary mantic annotation or enrichment [12]. Available
biomedjob of the majority of the authors. To overcome the afore- ical annotators use publicly available biomedical
ontolomentioned challenges, we propose a semantic annotation gies, such as Bioportal [10] and UMLS [
        <xref ref-type="bibr" rid="ref8">4</xref>
        ], to help the
optimization approach that adopts a knowledge-sharing biomedical community researcher to structure and
annostrategy and presents a framework through which users tate their data with ontology concepts for better
inforcan seek and provide suggestions to optimize the an- mation retrieval and indexing. However, the semantic
notation quality. Our systems keep track of the recom- annotation and enhancement process is tedious and
remender confidence score, gather community feedback quires expert curators. With our developed systems, we
regarding prior recommendations, store the percentage automate the semantic annotations assignment process.
of correctly suggested annotations, and translate that For that, we utilized the NCBO Bioportal web-service
into an index to later connect the appropriate users to resources [10] that analyze the raw textual content and
receive suggestions to optimize the semantic enrichment tag them with relevant biomedical ontology concepts.
of biomedical contents. The rest of the paper is organized By pressing the ”Annotate” button, users can generate
as follows. The proposed methodology section covers a preliminary level of annotations without the need for
implementation details of catering preliminary seman- any technical knowledge. Initially, authors can either
tic annotation, semantic annotation optimization and import pre-existing content from research papers,
cliniexample scenarios in an annotation optimization envi- cal notes, and biomedical reports or start typing directly
ronment. Subsequently, the result and discussion include in the semantic text editor see Figure 1(a). Our systems
the dataset utilized, methodology for evaluation, and re- accept the user’s free text and feeds it forward as input
sults achieved at system-level. The conclusion section to a concept recognition engine. The engine identifies
summarizes the systems’ working and future plans. relevant ontologies, acronyms, definitions, and ontology
links for individual terminologies that are best matched 2.3. Optimizing the Enriched Semantic
based on the context by following the string matching Information
approach. This semantic information is displayed in our
system’s annotation panel for human interpretation and To optimize the newly harvested annotations through
understanding Figure 1(a). Authors may alter the gener- the knowledge-sharing process, authors are required to
ated semantic information based on their knowledge and select the existing annotation and then click to seek the
experience, such as choosing appropriate ontology from help option from the panel. A pop-up appears with a
the list, selecting suitable acronyms, removing seman- drop-down of question sets that authors may ask. For
tic information or annotating for explicit terminology, example, if authors are interested to know whether a
etc. Users without a technical background may easily particular prelimanary annotation or ontology is correct.
navigate a simplified interface, while more sophisticated They can select the questions and fill in the required
users may utilize advanced options to control the seman- information. Similarly, authors can seek peers help
posttic annotation and authoring process further. ing a question. All the posted questions will go to the
”Semantically Knowledge Cafe” forum style. The
”Semantically Knowledge Cafe” is a virtual social place where
2.2. Seeking Annotation people/users ask questions and seek help regarding their
      </p>
      <p>Recommendation annotation improvement. As soon authors receive a
reSubsequently at initial level semantic annotation, the sponse from the crowd, they are notified, and all
suggesauthor is enabled to approach and get recommendation tions start the display with the option to accept or reject.
from peer review for a correct and high quality anno- Here the authors decide to choose a particular
suggestation through seeking help module Figure 1(b). The tion based on social indexing. Our system calculates the
authors are required to select the biomedical term from social index and displays each suggestion based on its
the preliminary annotation interface for correct annota- index score in descending order. To gauge the credibility
tion by peer review. Additionally the author is facilitated of the human recommender, our systems record the
recwith an interface to smoothly query with available op- ommender confidence score, collect community voting
tions such as a drop down menu of recommended queries against previous recommendations, store the percentage
for an author. Similarly author can explain their query of correctly suggested annotation, and translate that into
and provide evidence and links to better convey their an index to later connect the right users to get
suggesquery to the expert   or peer review. Finally when the tions to optimize the semantic enrichment of biomedical
author submit their query, it is posted on “Semantically contents. All the process information is stored in the
Knowledge Cafe” forum for peer review response and a backend knowledge base.
notification is send to the community users as shown in Consider an author is required to find correct ontology
Figure 1(c). annotations from peer review for the biomedical term
“worsening shortness of breath” as shown in Figure 2. The
author posts the query on a “Semantically Knowledge
Cafe” forum such as “Which Ontology should I use for
medical content ‘worsening shortness of breath’”? and
receives replies from fellow users or experts   . We
categorized users who replied as expert users as   with “No
of Reply-post” and suggested the correct annotation for a
required biomedical content as “Expert Annotation” see
(0.458, 0.381, 0.518 ). Finally,  (
self confidence and author credibility score for each
expert   that suggested annotation as “aggregate score” of
 ) function is
applied on the aggregate score to obtain the maximum
and each expert suggested the annotation as (“RCD”,”UP- score earned by each expert   annotation which is 0.518.</p>
      <sec id="sec-1-1">
        <title>HENO” and “NCIT”). We also asked experts to provide</title>
        <p>their confidence score which they recorded as of (4,6
Eventually, the high proficient and ranking annotation
is recommended to the author as “NCIT” and
“Replyand 7) out of a scale from 1 to 10. The community user- post=3” for the biomedical content “worsening shortness
s/crowd   at ’Semantically Knowledge Cafe’ can observe
the suggested recommendation and record their up and
of breath”, see Figure 2. The same process is applied for
another biomedical content, “Acute Flaccid Myelitis”, yet
down voting about a particular suggestions. From users the scenario or query can be changed.
  , we recorded upvotes (9,10,11) and downvotes (9,8,7)
to the expert recommended annotation. Whenever the
author accepts recommended annotation from experts   ,
a credibility score is recorded. We used Wilson score
conifdence interval for a Bernoulli parameter to normalize
and aggregate the recorded scores, see Equ. (1).</p>
        <p />
        <p>=
Where,
( +̂
 2
22 ±  
[ ̂ (1 −  ̂)+ 42 ])</p>
        <p>2
2 √</p>
        <p>2
(1 +  2 )

=1
 
1.</p>
        <p>= (  − ())/(() − ()) ∗ 
Where   is the  ℎ normalized value in the dataset. Where
  is the  ℎ value in the dataset e.g the user confidence
score. Similarly, ()</p>
        <p>is the minimum value in the
dataset, e.g the minimum value between 1 and 10 is 1,
so the () = 1
and ()</p>
        <p>is the maximum value
in the dataset, e.g the maximum value between 1 and
10 is 10, so the () = 10</p>
        <p>. Consequently, a mean
 ̂=

=0   applied on Wilson score, normalize the
(1)
(2)
(4)</p>
      </sec>
    </sec>
    <sec id="sec-2">
      <title>3. Results and Discussion</title>
      <p>30 people participated in our proposed model. We
recruited participants by via social media request and
asking them to participate in the study. Further, We
categorize participants as the most graduate-level
students with computer and biological science backgrounds.</p>
      <p>Accordingly, We considered a set of 30 articles from
pubmed.org [13] and randomly distributed it to the
participants. Similarly, We provided a user manual of
systems along with a pre-recorded video about system
usage. Afterward, We asked each participant to generate
queries on the “Semantically Knowledge Cafe” about the
biomedical content annotation about which they like to
seek social help. Collectively, our participants post 140
questions to the system. All the participants have also
(3) recorded their confidence scores between 1 and 10 from
the suggestions they received as a satisfaction score.
Consequently, Our system recorded 421 responses against
140 questions from expert users. Similarly, 2929 and 3149
up and down votes were also recorded against the
suggestions annotations. Table 1 illustrates participants and
their responses.
cal word or concept boundary detection process. A set of
30 pubmed.org [13] articles is processed at the initial level, 3.2. Performance Measurement:
consequently obtaining annotated biomedical terms in Knowledge-sharing based Semantic
the range of n-gram-5. Subsequently scrutinized, we Enrichment Optimization
found the proposed annotation system identifies
biomedical terms of n-gram-1 quantitatively higher than n-gram- A domain expert from the academia at the professor level
2 to n-gram-5. A very few biomedical terms identify of is engaged to evaluate these results manually based on
n-gram-5 see Figure 3. However, the biomedical terms their knowledge and experience. After that, calculate
of  −   &gt; 1 deliver extra meaningful and coher- the system level accuracy for semantic annotation
beent information to the user contextually. For example, fore socio-techinical semantic annotation optimization
“blood pressure is high”, “he has coronary artery disease”, and after socio-technical semantic annotation
optimizaand “liver function test is normal” are more meaningful tion approach Figure 4. A document’s level accuracy
terms as compared to a single term such as “pressure”, is recorded with-out a socio-technical and with a
socio“blood”, “coronary”, and others. As the  −   word technical approach. The Figure 4 on X-axis represents
size increases, the accuracy of composite terms decreases, the number of 30 documents processed. In contrast, the
as shown in Figure 3. Because the proposed system em- Y-axis at the left represents the level of accuracy with-out
ploys exact word matching to the terminology (Bioportal) a socio-technical approach, and the Y-axis at the right
approach, the primary characteristic of the exact word represents the level of accuracy with a socio-technical
matching approach is that a single word matches more approach. Consequently, scrutinizing the results of a
accurately than a combined or compound word. system with a socio-technical approach performed better
than with-out a socio-technical at document level. Until
high accuracy of 90% has been gained by nine documents
and lower accuracy of 87% has gained by three documents
and maximum number of documents has gained accuracy
between 87% and 90% with socio-technical approach see</p>
      <sec id="sec-2-1">
        <title>3.3. Semantically Workspace: Semantic</title>
      </sec>
      <sec id="sec-2-2">
        <title>Annotation Optimization Demonstration</title>
        <p>interface with possible option is available to the expert
for reply post. Subsequently reply by the expert to the
author post with precise annotation, same while other
community users   are enable to give up-vote or
downvote to the expert reply post shown in Figure 5(e). Finally
a high quality annotation recommendation notification
is generated to the author by aggregating wilson score,
and expert self confidence score as shown in Figure 5(f).</p>
        <p>Whenever the author click on ”New Recommendation”
link, a high quality expert recommended annotation is
pop-up see Figure 5(g). Now here author is allow
either accept the recommended annotation or reject, while
accepting annotation a credibility score is recorded to
the author profile between 1-5, vise versa no score is
recorded to the author profile. Similarly by accepting
recommended annotation, initial annotation for specific
terminology is replaced by recommended one and thus
annotation optimization process is completed Figure 5(g).</p>
        <p>Initially the author is enable to import or write the
biomedical content in the editor and click on annotation
button to get preliminary annotation see Figure 5. The
underline word with green color presented annotated term,
subsequently when author select any term the underline
color change to pink and ”Need Help” option is appeared
on left side panel to the author see Figure 5(a). After click 4. Conclusion
on ”Need Help” an interface is open, where author can
write there query from expert for recommended anno- This research advances state-of-the-art biomedical
setation to explicit terminology Figure 5(b). Additionally mantic research and systems, enabling various
biomedauthor is facilitated with primary options for quick query. ical users to author context-aware content with no
When the author click on ” ” button, the query is prior technical skills needed. An out-of-the-box
socioposted on the ”Semantically Knowledge Cafe” forum and technical semantic annotation optimization approach is
a new post notification received to the community users presented to automate the semantic enrichment
mecha  as shown in Figure 5(c). Whenever users   click on nism and discover the precise semantic annotation while
”Semantically Knowledge Cafe” , the new posted query is keeping the original content creator in the loop. The
appeared as shown in Figure 5(d). Now that if user know end user is facilitated with an authoring interface similar
the answer of the posted query, he/she is enable to click to the MS Word editor type/write biomedical contents.
on ”  ” button to reply author post/query as shown To cater the preliminary semantic annotation or
enrichin Figure 5(d). Subsequently reply to the post by user ment at the content level, we utilized Bioportal endpoint
with record self confidence score, now the role of this APIs and automated the configuration process for
auuser is consider as a domain expert. Similarly, a smooth</p>
      </sec>
    </sec>
    <sec id="sec-3">
      <title>Acknowledgments</title>
      <sec id="sec-3-1">
        <title>This work is supported by the National Science Foundation grant ID: 2101350.</title>
        <p>thors. Similarly, the semantic annotation optimization
approach is designed where the author can post their
query for optimized annotation recommendation. In our
future work, we plan to expand the backend knowledge
graph and apply the neural graph networks. The
semantic annotation optimization system is available at
https://gosemantically.com.
2022 IEEE 16th International Conference on
Semantic Computing (ICSC), IEEE, 2022, pp. 175–176.
[13] PubMed, National Center for Biotechnology In-
formation, 2022. https://pubmed.ncbi.nlm.nih.gov/.</p>
      </sec>
    </sec>
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