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Sample records for european expert panel

  1. New strategies and designs in pancreatic cancer research: consensus guidelines report from a European expert panel.

    PubMed

    Van Laethem, J-L; Verslype, C; Iovanna, J L; Michl, P; Conroy, T; Louvet, C; Hammel, P; Mitry, E; Ducreux, M; Maraculla, T; Uhl, W; Van Tienhoven, G; Bachet, J B; Maréchal, R; Hendlisz, A; Bali, M; Demetter, P; Ulrich, F; Aust, D; Luttges, J; Peeters, M; Mauer, M; Roth, A; Neoptolemos, J P; Lutz, M

    2012-03-01

    Although the treatment of pancreatic ductal adenocarcinoma (PDAC) remains a huge challenge, it is entering a new era with the development of new strategies and trial designs. Because there is an increasing number of novel therapeutic agents and potential combinations available to test in patients with PDAC, the identification of robust prognostic and predictive markers and of new targets and relevant pathways is a top priority as well as the design of adequate trials incorporating molecular-driven hypothesis. We presently report a consensus strategy for research in pancreatic cancer that was developed by a multidisciplinary panel of experts from different European institutions and collaborative groups involved in pancreatic cancer. The expert panel embraces the concept of exploratory early proof of concept studies, based on the prediction of response to novel agents and combinations, and randomised phase II studies permitting the selection of the best therapeutic approach to go forward into phase III, where the recommended primary end point remains overall survival. Trials should contain as many translational components as possible, relying on standardised tissue and blood processing and robust biobanking, and including dynamic imaging. Attention should not only be paid to the pancreatic cancer cells but also to microenvironmental factors and stem/stellate cells.

  2. Expert Panels, Consumers, and Chemistry.

    ERIC Educational Resources Information Center

    Rehfeldt, Thomas K.

    2000-01-01

    Studied the attributes, properties, and consumer acceptance of antiperspirant products through responses of 400 consumers (consumer data), expert panel data, and analytical data about the products. Results show how the Rasch model can provide the tool necessary to combine data from several sources. (SLD)

  3. Boosted protease inhibitor monotherapy in HIV-infected adults: outputs from a pan-European expert panel meeting

    PubMed Central

    2013-01-01

    While the introduction of combination highly active antiretroviral therapy (HAART) regimens represents an important advance in the management of human immunodeficiency virus (HIV)-infected patients, tolerability can be an issue and the use of several different agents may produce problems. The switch of combination HAART to ritonavir-boosted protease inhibitor (PI) monotherapy may offer the opportunity to maintain antiviral efficacy while reducing treatment complexity and the risks of toxicity. Current European AIDS Clinical Society (EACS) guidelines recognise ritonavir-boosted PI monotherapy with twice-daily lopinavir/ritonavir or once-daily darunavir/ritonavir as a possible option in patients who have intolerance to nucleoside reverse transcriptase inhibitors, or for treatment simplification. Clinical trials data for PI boosted monotherapy are encouraging, showing substantial efficacy in the majority of patients; however, further data are required before this approach can be recommended as a routine treatment. Available data indicate that the most suitable candidates for the use of boosted PI monotherapy are long-term virologically suppressed patients who have demonstrated good adherence to antiretroviral therapy, who do not have chronic hepatitis B, have no history of treatment failure on PIs and are able to tolerate low-dose ritonavir. PMID:23347595

  4. A Virtual Panel of Expert Researchers.

    ERIC Educational Resources Information Center

    Hodges, Donald A.

    2000-01-01

    Presents the observations of a panel of research experts who have conducted research on music and the brain. States that the participants are Andrea Halpern, Larry Parsons, Ralph Spintge, and Sandra Trehub. After an introduction of each person, the participants characterized their principal findings. (CMK)

  5. Gender Equity Expert Panel: Exemplary & Promising Gender Equity Programs, 2000.

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC.

    The U.S. Department of Education developed the Gender Equity Expert Panel to identify promising and exemplary programs that promote gender equity in and through education. This panel of experts reviewed self-nominated programs to determine whether they met four criteria: evidence of success/effectiveness in promoting gender equity; quality of the…

  6. BCR-ABL kinase domain mutation analysis in chronic myeloid leukemia patients treated with tyrosine kinase inhibitors: recommendations from an expert panel on behalf of European LeukemiaNet.

    PubMed

    Soverini, Simona; Hochhaus, Andreas; Nicolini, Franck E; Gruber, Franz; Lange, Thoralf; Saglio, Giuseppe; Pane, Fabrizio; Müller, Martin C; Ernst, Thomas; Rosti, Gianantonio; Porkka, Kimmo; Baccarani, Michele; Cross, Nicholas C P; Martinelli, Giovanni

    2011-08-01

    Mutations in the Bcr-Abl kinase domain may cause, or contribute to, resistance to tyrosine kinase inhibitors (TKIs) in chronic myeloid leukemia patients. Recommendations aimed to rationalize the use of BCR-ABL mutation testing in chronic myeloid leukemia have been compiled by a panel of experts appointed by the European LeukemiaNet (ELN) and European Treatment and Outcome Study and are here reported. Based on a critical review of the literature and, whenever necessary, on panelists' experience, key issues were identified and discussed concerning: (1) when to perform mutation analysis, (2) how to perform it, and (3) how to translate results into clinical practice. In chronic phase patients receiving imatinib first-line, mutation analysis is recommended only in case of failure or suboptimal response according to the ELN criteria. In imatinib-resistant patients receiving an alternative TKI, mutation analysis is recommended in case of hematologic or cytogenetic failure as provisionally defined by the ELN. The recommended methodology is direct sequencing, although it may be preceded by screening with other techniques, such as denaturing-high performance liquid chromatography. In all the cases outlined within this abstract, a positive result is an indication for therapeutic change. Some specific mutations weigh on TKI selection. PMID:21562040

  7. Environmental factors and puberty timing: Expert panel research needs

    EPA Science Inventory

    An expert panel reviewed the literature on endocrine disrupting chemicals (EDCs), body size and puberty. The panel concluded that available experimental animal and human data support a possible role of EDCs and body size in relation to alterations in pubertal onset and progressio...

  8. Conducting Online Expert panels: a feasibility and experimental replicability study

    PubMed Central

    2011-01-01

    Background This paper has two goals. First, we explore the feasibility of conducting online expert panels to facilitate consensus finding among a large number of geographically distributed stakeholders. Second, we test the replicability of panel findings across four panels of different size. Method We engaged 119 panelists in an iterative process to identify definitional features of Continuous Quality Improvement (CQI). We conducted four parallel online panels of different size through three one-week phases by using the RAND's ExpertLens process. In Phase I, participants rated potentially definitional CQI features. In Phase II, they discussed rating results online, using asynchronous, anonymous discussion boards. In Phase III, panelists re-rated Phase I features and reported on their experiences as participants. Results 66% of invited experts participated in all three phases. 62% of Phase I participants contributed to Phase II discussions and 87% of them completed Phase III. Panel disagreement, measured by the mean absolute deviation from the median (MAD-M), decreased after group feedback and discussion in 36 out of 43 judgments about CQI features. Agreement between the four panels after Phase III was fair (four-way kappa = 0.36); they agreed on the status of five out of eleven CQI features. Results of the post-completion survey suggest that participants were generally satisfied with the online process. Compared to participants in smaller panels, those in larger panels were more likely to agree that they had debated each others' view points. Conclusion It is feasible to conduct online expert panels intended to facilitate consensus finding among geographically distributed participants. The online approach may be practical for engaging large and diverse groups of stakeholders around a range of health services research topics and can help conduct multiple parallel panels to test for the reproducibility of panel conclusions. PMID:22196011

  9. European expert consensus on rotational atherectomy.

    PubMed

    Barbato, Emanuele; Carrié, Didier; Dardas, Petros; Fajadet, Jean; Gaul, Georg; Haude, Michael; Khashaba, Ahmed; Koch, Karel; Meyer-Gessner, Markus; Palazuelos, Jorge; Reczuch, Krzysztof; Ribichini, Flavio L; Sharma, Samin; Sipötz, Johann; Sjögren, Iwar; Suetsch, Gabor; Szabó, György; Valdés-Chávarri, Mariano; Vaquerizo, Beatriz; Wijns, William; Windecker, Stephan; de Belder, Adam; Valgimigli, Marco; Byrne, Robert A; Colombo, Antonio; Di Mario, Carlo; Latib, Azeem; Hamm, Christian

    2015-05-01

    The interest in rotational atherectomy (RA) has increased over the past decade as a consequence of more complex and calcified coronary stenoses being attempted with percutaneous coronary interventions. Yet adoption of RA is hampered by several factors: amongst others, by the lack of a standardised protocol. This European expert consensus document stems from the awareness of the large heterogeneity in the protocols adopted to perform rotational atherectomy. The objective of the present document is to provide some points of consensus among highly experienced operators on the most controversial steps of RA in an attempt to build the basis of a standardised and universally accepted protocol.

  10. TWRS vadose zone contamination issue expert panel report

    SciTech Connect

    Shafer, D.S.

    1997-05-01

    When members were first canvassed for participation in the Vadose Zone Expert Panel the stated purpose for convening the Panel was to review a controversial draft report, the SX Tank Farm Report. This report was produced by a DOE Grand Junction Project Office (GJPO) contractor, RUST Geotech, now MACTEC-ERS, for the DOE Richland Office (DOERL). Three meetings were planned for June, July and August, 1995 to review the draft report and to complete a Panel report by mid-September. The Expert Panel has found its efforts confounded by various non-technical issues. The Expert Panel has chosen to address some of the non-technical issues in this Preface rather than to dilute the technical discussion that follows in the body of this independent expert panel status report (Panel Report). Rather than performing a straightforward manuscript review, the Panel was asked to resolve conflicting interpretations of gamma-ray logging measurements performed in vadose zone boreholes (drywells) surrounding the high-level radioactive wastes of the SX tank farm. There are numerous and complex technical issues that must be evaluated before the vertical and radial extent of contaminant migration at the SX tank farm can be accurately assessed. When the Panel first met in early June, 1996, it quickly became apparent that the scientific and technical issues were obscured by policy and institutional affairs which have polarized discussion among various segments of the Hanford organization. This situation reflects the kinds of institutional problems described separately in reports by the National Research Council of the National Academy of Sciences (NAS/NRC), The Hanford Tanks Environmental Impacts and Policy Choices and BmTiers to Science: Technical Management of the Department of Energy Environmental Remediation Program. The Vadose Zone Characterization Program, appears to be caught between conflicting pressures and organizational mandates, some imposed from outside DOE-RL and some self

  11. Cyanide poisoning by fire smoke inhalation: a European expert consensus.

    PubMed

    Anseeuw, Kurt; Delvau, Nicolas; Burillo-Putze, Guillermo; De Iaco, Fabio; Geldner, Götz; Holmström, Peter; Lambert, Yves; Sabbe, Marc

    2013-02-01

    Smoke inhalation is a common cause of cyanide poisoning during fires, resulting in injury and even death. In many cases of smoke inhalation, cyanide has increasingly been recognized as a significant toxicant. The diagnosis of cyanide poisoning remains very difficult, and failure to recognize it may result in inadequate or inappropriate treatment. Findings suggesting cyanide toxicity include the following: (a) a history of enclosed-space fire; (b) any alteration in the level of consciousness; (c) any cardiovascular changes (particularly inexplicable hypotension); and (d) elevated plasma lactate. The feasibility and safety of empiric treatment with hydroxocobalamin for fire smoke victims have been reported in the literature. On the basis of a literature review and a panel discussion, a group of European experts has proposed emergency management protocols for cyanide toxicity in fire smoke victims.

  12. Teaching statistics to nursing students: an expert panel consensus.

    PubMed

    Hayat, Matthew J; Eckardt, Patricia; Higgins, Melinda; Kim, MyoungJin; Schmiege, Sarah J

    2013-06-01

    Statistics education is a necessary element of nursing education, and its inclusion is recommended in the American Association of Colleges of Nursing guidelines for nurse training at all levels. This article presents a cohesive summary of an expert panel discussion, "Teaching Statistics to Nursing Students," held at the 2012 Joint Statistical Meetings. All panelists were statistics experts, had extensive teaching and consulting experience, and held faculty appointments in a U.S.-based nursing college or school. The panel discussed degree-specific curriculum requirements, course content, how to ensure nursing students understand the relevance of statistics, approaches to integrating statistics consulting knowledge, experience with classroom instruction, use of knowledge from the statistics education research field to make improvements in statistics education for nursing students, and classroom pedagogy and instruction on the use of statistical software. Panelists also discussed the need for evidence to make data-informed decisions about statistics education and training for nurses.

  13. Expert panel reviews of research centers: the site visit process.

    PubMed

    Lawrenz, Frances; Thao, Mao; Johnson, Kelli

    2012-08-01

    Site visits are used extensively in a variety of settings within the evaluation community. They are especially common in making summative value decisions about the quality and worth of research programs/centers. However, there has been little empirical research and guidance about how to appropriately conduct evaluative site visits of research centers. We review the processes of two site visit examples using an expert panel review: (1) a process to evaluate four university research centers and (2) a process to review a federally sponsored research center. A set of 14 categories describing the expert panel review process was obtained through content analysis and participant observation. Most categories were addressed differently through the two processes highlighting the need for more research about the most effective processes to use within different contexts. Decisions about how to structure site visits appear to depend on the research context, practical considerations, the level at which the review is being conducted and the intended impact of the report. Future research pertaining to the selection of site visitors, the autonomy of the visitors in data collection and report writing, and the amount and type of information provided would be particularly valuable.

  14. A qualitative risk assessment methodology for scientific expert panels.

    PubMed

    Dufour, B; Plée, L; Moutou, F; Boisseleau, D; Chartier, C; Durand, B; Ganière, J P; Guillotin, J; Lancelot, R; Saegerman, C; Thébault, A; Hattenberger, A M; Toma, B

    2011-12-01

    Risk assessment can be either quantitative, i.e. providing a numeric estimate of the probability of risk and the magnitude of the consequences, or qualitative, using a descriptive approach. The French Agency for Food, Environmental and Occupational Health and Safety (ANSES), formerly the French Food Safety Agency (AFSSA), bases its assessments on the opinions of scientific panels, such as the ANSES Animal Health Scientific Panel (AH-SP). Owing to the lack of relevant data and the very short period of time usually allowed to assess animal health risks on particular topics, this panel has been using a qualitative risk method for evaluating animal health risks or crises for the past few years. Some experts have drawn attention to the limitations of this method, such as the need to extend the range of adjectives used for the lower probabilities and to develop a way to assess consequences. The aim of this paper is to describe the improved method now established by the AH-SP, taking into account the limitations of the first version. The authors describe a new set of levels for probabilities, as well as the items considered when addressing either animal or human health consequences.

  15. Treatment Guidelines for Preoperative Radiation Therapy for Retroperitoneal Sarcoma: Preliminary Consensus of an International Expert Panel

    SciTech Connect

    Baldini, Elizabeth H.; Wang, Dian; Haas, Rick L.M.; Catton, Charles N.; Indelicato, Daniel J.; Kirsch, David G.; Roberge, David; Salerno, Kilian; Deville, Curtiland; Guadagnolo, B. Ashleigh; O'Sullivan, Brian; Petersen, Ivy A.; Le Pechoux, Cecile; Abrams, Ross A.; DeLaney, Thomas F.

    2015-07-01

    Purpose: Evidence for external beam radiation therapy (RT) as part of treatment for retroperitoneal sarcoma (RPS) is limited. Preoperative RT is the subject of a current randomized trial, but the results will not be available for many years. In the meantime, many practitioners use preoperative RT for RPS, and although this approach is used in practice, there are no radiation treatment guidelines. An international expert panel was convened to develop consensus treatment guidelines for preoperative RT for RPS. Methods and Materials: An expert panel of 15 academic radiation oncologists who specialize in the treatment of sarcoma was assembled. A systematic review of reports related to RT for RPS, RT for extremity sarcoma, and RT-related toxicities for organs at risk was performed. Due to the paucity of high-quality published data on the subject of RT for RPS, consensus recommendations were based largely on expert opinion derived from clinical experience and extrapolation of relevant published reports. It is intended that these clinical practice guidelines be updated as pertinent data become available. Results: Treatment guidelines for preoperative RT for RPS are presented. Conclusions: An international panel of radiation oncologists who specialize in sarcoma reached consensus guidelines for preoperative RT for RPS. Many of the recommendations are based on expert opinion because of the absence of higher level evidence and, thus, are best regarded as preliminary. We emphasize that the role of preoperative RT for RPS has not been proven, and we await data from the European Organization for Research and Treatment of Cancer (EORTC) study of preoperative radiotherapy plus surgery versus surgery alone for patients with RPS. Further data are also anticipated pertaining to normal tissue dose constraints, particularly for bowel tolerance. Nonetheless, as we await these data, the guidelines herein can be used to establish treatment uniformity to aid future assessments of efficacy

  16. NTP-CERHR EXPERT PANEL REPORT ON THE REPRODUCTIVE AND DEVELOPMENTAL TOXICITY OF ACRYLAMIDE

    EPA Science Inventory

    The National Toxicology Program Center for the Evaluation of Risks to Human Reproduction (NTP-CERHR) convened an expert panel in May 2004 to evaluate acrylamide. The report of the expert panel, prepared in accordance with CERHR Guidelines, provides a detailed summary of all publi...

  17. Expert Consensus Panel Guidelines on Geriatric Assessment in Oncology

    PubMed Central

    O'Donovan, A.; Mohile, S.G.; Leech, M.

    2015-01-01

    Introduction Despite consensus guidelines on best practice in the care of older patients with cancer, geriatric assessment (GA) has yet to be optimally integrated into the field of oncology in most countries. There is a relative lack of consensus in the published literature as to the best approach to take, and there is a degree of uncertainty as to how integration of geriatric medicine principles might optimally predict patient outcomes. The aim of the current study was to obtain consensus on GA in oncology to inform the implementation of a geriatric oncology programme. Methods A four round Delphi process was employed. The Delphi method is a structured group facilitation process, using multiple iterations in order to gain consensus on a given topic Results Consensus was reached on the optimal assessment method and interventions required for the commonly employed domains of GA. Other aspects of GA, such as screening methods and age cutoff for assessment represented a higher degree of disagreement. Discussion The expert panel employed in this study clearly identified the criteria that should be included in a clinical geriatric oncology programme. In the absence of evidence-based guidelines, this may prove useful in the care of older cancer patients. PMID:25757457

  18. Fifth Single-Shell Tank Integrity Project Expert Panel Meeting August 28-29, 2014

    SciTech Connect

    Martin, Todd M.; Boomer, Kayle D.

    2015-01-07

    On August 28th and 29th, 2014 the Single-Shell Tank Integrity Project (SSTIP) Expert Panel (Panel) convened in Richland, Washington. This was the Panel’s first meeting since 2011 and, as a result, was focused primarily on updating the Panel on progress in response to the past recommendations (Single-Shell Tank Integrity Expert Panel Report, RPP-RPT-45921, Rev 0, May 2010). This letter documents the Panel’s discussions and feedback on Phase I activities and results.

  19. Tamarisk beetle (Diorhabda spp.) in the Colorado River basin: Synthesis of an expert panel forum

    USGS Publications Warehouse

    Bloodworth, Benjamin R.; Shafroth, Patrick B.; Sher, Anna A.; Manners, Rebecca B.; Bean, Daniel W.; Johnson, Matthew J.; Hinojosa-Huerta, Osvel

    2016-01-01

    In January 2015, the Tamarisk Coalition convened a panel of experts to discuss and present information on probable ecological trajectories in the face of widespread beetle presence and to consider opportunities for restoration and management of riparian systems in the Colorado River Basin (CRB). An in-depth description of the panel discussion follows. 

  20. EXPERT PANEL OVERSIGHT COMMITTEE ASSESSMENT OF FY2008 CORROSION AND STRESS CORROSION CRACKING SIMULANT TESTING PROGRAM

    SciTech Connect

    BOOMER KD

    2009-01-08

    The Expert Panel Oversight Committee (EPOC) has been overseeing the implementation of selected parts of Recommendation III of the final report, Expert Panel workshop for Hanford Site Double-Shell Tank Waste Chemistry Optimization, RPP-RPT-22126. Recommendation III provided four specific requirements necessary for Panel approval of a proposal to revise the chemistry control limits for the Double-Shell Tanks (DSTs). One of the more significant requirements was successful performance of an accelerated stress corrosion cracking (SCC) experimental program. This testing program has evaluated the optimization of the chemistry controls to prevent corrosion in the interstitial liquid and supernatant regions of the DSTs.

  1. Elicitation of quantitative data from a heterogeneous expert panel: formal process and application in animal health.

    PubMed

    Van der Fels-Klerx, Ine H J; Goossens, Louis H J; Saatkamp, Helmut W; Horst, Suzan H S

    2002-02-01

    This paper presents a protocol for a formal expert judgment process using a heterogeneous expert panel aimed at the quantification of continuous variables. The emphasis is on the process's requirements related to the nature of expertise within the panel, in particular the heterogeneity of both substantive and normative expertise. The process provides the opportunity for interaction among the experts so that they fully understand and agree upon the problem at hand, including qualitative aspects relevant to the variables of interest, prior to the actual quantification task. Individual experts' assessments on the variables of interest, cast in the form of subjective probability density functions, are elicited with a minimal demand for normative expertise. The individual experts' assessments are aggregated into a single probability density function per variable, thereby weighting the experts according to their expertise. Elicitation techniques proposed include the Delphi technique for the qualitative assessment task and the ELI method for the actual quantitative assessment task. Appropriately, the Classical model was used to weight the experts' assessments in order to construct a single distribution per variable. Applying this model, the experts' quality typically was based on their performance on seed variables. An application of the proposed protocol in the broad and multidisciplinary field of animal health is presented. Results of this expert judgment process showed that the proposed protocol in combination with the proposed elicitation and analysis techniques resulted in valid data on the (continuous) variables of interest. In conclusion, the proposed protocol for a formal expert judgment process aimed at the elicitation of quantitative data from a heterogeneous expert panel provided satisfactory results. Hence, this protocol might be useful for expert judgment studies in other broad and/or multidisciplinary fields of interest.

  2. Management of acromegaly in Latin America: expert panel recommendations.

    PubMed

    Barkan, Ariel; Bronstein, Marcello D; Bruno, Oscar D; Cob, Alejandro; Espinosa-de-los-Monteros, Ana Laura; Gadelha, Monica R; Garavito, Gloria; Guitelman, Mirtha; Mangupli, Ruth; Mercado, Moisés; Portocarrero, Lesly; Sheppard, Michael

    2010-06-01

    Although there are international guidelines orienting physicians on how to manage patients with acromegaly, such guidelines should be adapted for use in distinct regions of the world. A panel of neuroendocrinologists convened in Mexico City in August of 2007 to discuss specific considerations in Latin America. Of major discussion was the laboratory evaluation of acromegaly, which requires the use of appropriate tests and the adoption of local institutional standards. As a general rule to ensure diagnosis, the patient's GH level during an oral glucose tolerance test and IGF-1 level should be evaluated. Furthermore, to guide treatment decisions, both GH and IGF-1 assessments are required. The treatment of patients with acromegaly in Latin America is influenced by local issues of cost, availability and expertise of pituitary neurosurgeons, which should dictate therapeutic choices. Such treatment has undergone profound changes because of the introduction of effective medical interventions that may be used after surgical debulking or as first-line medical therapy in selected cases. Surgical resection remains the mainstay of therapy for small pituitary adenomas (microadenomas), potentially resectable macroadenomas and invasive adenomas causing visual defects. Radiotherapy may be indicated in selected cases when no disease control is achieved despite optimal surgical debulking and medical therapy, when there is no access to somatostatin analogues, or when local issues of cost preclude other therapies. Since not all the diagnostic tools and treatment options are available in all Latin American countries, physicians need to adapt their clinical management decisions to the available local resources and therapeutic options.

  3. Treating Pain in Addicted Patients: Recommendations from an Expert Panel

    PubMed Central

    Cheatle, Martin; Wunsch, Martha; Skoufalos, Alexis; Reddy, Yeshwant

    2014-01-01

    Abstract Clinicians may face pragmatic, ethical, and legal issues when treating addicted patients. Equal pressures exist for clinicians to always address the health care needs of these patients in addition to their addiction. Although controversial, mainly because of the lack of evidence regarding their long-term efficacy, the use of opioids for the treatment of chronic pain management is widespread. Their use for pain management in the addicted population can present even more challenges, especially when evaluating the likelihood of drug-seeking behavior. As the misuse and abuse of opioids continues to burgeon, clinicians must be particularly vigilant when prescribing chronic opioid therapy. The purpose of this article is to summarize recommendations from a recent meeting of experts convened to recommend how primary care physicians should approach treatment of chronic pain for addicted patients when an addiction specialist is not available for a referral. As there is a significant gap in guidelines and recommendations in this specific area of care, this article serves to create a foundation for expanding chronic pain guidelines in the area of treating the addicted population. This summary is designed to be a practical how-to guide for primary care physicians, discussing risk assessment, patient stratification, and recommended therapeutic approaches. (Population Health Management 2014;17:79–89) PMID:24138341

  4. NTP-CERHR EXPERT PANEL REPORT ON THE REPRODUCTIVE AND DEVELOPMENTAL TOXICITY OF AMPHETAMINE AND METHAMPHETAMINE.

    EPA Science Inventory

    A manuscript describes the results of an expert panel meeting of the NTP Center for the Evaluation of Risks to Human Reproduction (CERHR). The purpose CERHR is to provide timely, unbiased, scientifically sound evaluations of human and experimental evidence for adverse effects ...

  5. NTP-CERHR EXPERT PANEL REPORT ON REPRODUCTIVE AND DEVELOPMENTAL TOXICITY OF METHYLPHENIDATE.

    EPA Science Inventory

    A manuscript describes the results of an expert panel meeting of the NTP Center for the Evaluation of Risks to Human Reproduction (CERHR). The purpose CERHR is to provide timely, unbiased, scientifically sound evaluations of human and experimental evidence for adverse effects on...

  6. Curriculum Reform in 3D: A Panel of Experts Discuss the New HPE Curriculum in Australia

    ERIC Educational Resources Information Center

    Hickey, Chris; Kirk, David; Macdonald, Doune; Penney, Dawn

    2014-01-01

    This paper was developed at the request of the Organising Committee for the 27th Australian Council for Health, Physical Education and Recreation International Conference, in Melbourne, 2013. Its genesis was as a feature forum, wherein a panel of curriculum experts were bought together to discuss the emergence of the Australian Health and Physical…

  7. Management of acromegaly in Latin America: expert panel recommendations

    PubMed Central

    Barkan, Ariel; Bronstein, Marcello D.; Bruno, Oscar D.; Cob, Alejandro; Espinosa-de-los-Monteros, Ana Laura; Gadelha, Monica R.; Garavito, Gloria; Guitelman, Mirtha; Mangupli, Ruth; Portocarrero, Lesly; Sheppard, Michael

    2009-01-01

    Although there are international guidelines orienting physicians on how to manage patients with acromegaly, such guidelines should be adapted for use in distinct regions of the world. A panel of neuroendocrinologists convened in Mexico City in August of 2007 to discuss specific considerations in Latin America. Of major discussion was the laboratory evaluation of acromegaly, which requires the use of appropriate tests and the adoption of local institutional standards. As a general rule to ensure diagnosis, the patient’s GH level during an oral glucose tolerance test and IGF-1 level should be evaluated. Furthermore, to guide treatment decisions, both GH and IGF-1 assessments are required. The treatment of patients with acromegaly in Latin America is influenced by local issues of cost, availability and expertise of pituitary neurosurgeons, which should dictate therapeutic choices. Such treatment has undergone profound changes because of the introduction of effective medical interventions that may be used after surgical debulking or as first-line medical therapy in selected cases. Surgical resection remains the mainstay of therapy for small pituitary adenomas (microadenomas), potentially resectable macroadenomas and invasive adenomas causing visual defects. Radiotherapy may be indicated in selected cases when no disease control is achieved despite optimal surgical debulking and medical therapy, when there is no access to somatostatin analogues, or when local issues of cost preclude other therapies. Since not all the diagnostic tools and treatment options are available in all Latin American countries, physicians need to adapt their clinical management decisions to the available local resources and therapeutic options. PMID:19882249

  8. Drugs foresight 2020: a Delphi expert panel study

    PubMed Central

    2014-01-01

    Background Historically substance misuse has been relatively common in western countries, but comparatively few Finns report drug use. The Drugs 2020 study aimed at foreseeing changes in the drug situation in Finland by the year 2020. Methods The Delphi method was used, utilizing drug experts of the EU national network in Finland. Results Marked growth was foreseen in drug use, especially in synthetic designer drugs and misuse of medicinal drugs. Significant increase was also expected in growing cannabis at home. However, the control of drug market was expected to shift more into the hands of organized crime. No consensus was reached on how drug prices will develop in the time period. Drug use is likely to remain punishable although the use and possession of cannabis may be treated less severely. It seems likely that health and social services resources will be directed towards medicinal treatment. Conclusions Foresight can be utilized in preparing for the future; desirable developments can be fostered, and measures can be taken to curb probable but undesirable lines of development. Based on the results of this study, the experts’ view is that it is highly likely that the Finnish society will have to prepare for an increase in the demand for drug-related care, both in terms of content of the care and financing the services. Also, the forecasted increase in the role of legal prescription medicine used as intoxicants will call for efforts not only in changing prescription practices but in border and police control measures, as well. Parallel developments have been foreseen in the UK and Sweden, and it is likely that similar trends will actualize also in other western countries. PMID:24885142

  9. QT Interval Screening in Methadone Maintenance Treatment: Report of a SAMHSA Expert Panel

    PubMed Central

    Martin, Judith A.; Campbell, Anthony; Killip, Thomas; Kotz, Margaret; Krantz, Mori J.; Kreek, Mary Jeanne; McCarroll, Brian A.; Mehta, Davendra; Payte, J. Thomas; Stimmel, Barry; Taylor, Trusandra; Wilford, Bonnie B.

    2014-01-01

    In an effort to enhance patient safety in Opioid Treatment Programs (OTPs), the Substance Abuse and Mental Health Services Administration (SAMHSA) convened a multi-disciplinary Expert Panel on the Cardiac Effects of Methadone. Panel members reviewed the literature, regulatory actions, professional guidances, and OTPs’ experiences regarding adverse cardiac events associated with methadone. The Panel concluded that, to the extent possible, every OTP should have a universal Cardiac Risk Management Plan (incorporating clinical assessment, ECG assessment, risk stratification, and prevention of drug interactions) for all patients, and should strongly consider patient-specific risk minimization strategies (such as careful patient monitoring, obtaining ECGs as indicated by a particular patient’s risk profile, and adjusting the methadone dose as needed) for patients with identified risk factors for adverse cardiac events. The Panel also suggested specific modifications to informed consent documents, patient education, staff education, and methadone protocols. PMID:22026519

  10. An expert panel report of a proposed scientific model demonstrating the effectiveness of antibacterial handwash products.

    PubMed

    Boyce, John M; Dupont, Herbert L; Massaro, Joseph; Sack, David; Schaffner, Donald W

    2012-10-01

    In 2005, a US Food and Drug Administration Nonprescription Drug Advisory Committee (NDAC) review of consumer antiseptic handwash product studies concluded that the data regarding existing products failed to demonstrate any association between specific log reductions of bacteria achieved by antiseptic handwashing and reduction of infection. The NDAC recommended that consumer antibacterial handwashing products should demonstrate a reduction in infection compared with non-antibacterial handwash products. In response to the NDAC review, a consumer product industry-sponsored expert panel meeting was held in October 2007 to review new methods for assessing the efficacy of antibacterial handwashes. The expert panel reviewed a newly proposed model for linking the effectiveness of antibacterial handwashing to infection reduction and made recommendations for conducting future studies designed to demonstrate the efficacy of antibacterial handwash formulations. The panel concluded that using the surrogate infection model to demonstrate efficacy has a sound scientific basis, that the use of Shigella flexneri as a test organism coupled with a modified hand contamination procedure is supported by published data, and that the model represents a realistic test for the efficacy of consumer antibacterial handwash products. This article summarizes the expert panel's deliberations, conclusions, and recommendations.

  11. An expert panel report of a proposed scientific model demonstrating the effectiveness of antibacterial handwash products.

    PubMed

    Boyce, John M; Dupont, Herbert L; Massaro, Joseph; Sack, David; Schaffner, Donald W

    2012-10-01

    In 2005, a US Food and Drug Administration Nonprescription Drug Advisory Committee (NDAC) review of consumer antiseptic handwash product studies concluded that the data regarding existing products failed to demonstrate any association between specific log reductions of bacteria achieved by antiseptic handwashing and reduction of infection. The NDAC recommended that consumer antibacterial handwashing products should demonstrate a reduction in infection compared with non-antibacterial handwash products. In response to the NDAC review, a consumer product industry-sponsored expert panel meeting was held in October 2007 to review new methods for assessing the efficacy of antibacterial handwashes. The expert panel reviewed a newly proposed model for linking the effectiveness of antibacterial handwashing to infection reduction and made recommendations for conducting future studies designed to demonstrate the efficacy of antibacterial handwash formulations. The panel concluded that using the surrogate infection model to demonstrate efficacy has a sound scientific basis, that the use of Shigella flexneri as a test organism coupled with a modified hand contamination procedure is supported by published data, and that the model represents a realistic test for the efficacy of consumer antibacterial handwash products. This article summarizes the expert panel's deliberations, conclusions, and recommendations. PMID:22300895

  12. European experts consensus statement on cystic tumours of the pancreas.

    PubMed

    Del Chiaro, Marco; Verbeke, Caroline; Salvia, Roberto; Klöppel, Gunter; Werner, Jens; McKay, Colin; Friess, Helmut; Manfredi, Riccardo; Van Cutsem, Eric; Löhr, Matthias; Segersvärd, Ralf

    2013-09-01

    Cystic lesions of the pancreas are increasingly recognized. While some lesions show benign behaviour (serous cystic neoplasm), others have an unequivocal malignant potential (mucinous cystic neoplasm, branch- and main duct intraductal papillary mucinous neoplasm and solid pseudo-papillary neoplasm). European expert pancreatologists provide updated recommendations: diagnostic computerized tomography and/or magnetic resonance imaging are indicated in all patients with cystic lesion of the pancreas. Endoscopic ultrasound with cyst fluid analysis may be used but there is no evidence to suggest this as a routine diagnostic method. The role of pancreatoscopy remains to be established. Resection should be considered in all symptomatic lesions, in mucinous cystic neoplasm, main duct intraductal papillary mucinous neoplasm and solid pseudo-papillary neoplasm as well as in branch duct intraductal papillary mucinous neoplasm with mural nodules, dilated main pancreatic duct >6mm and possibly if rapidly increasing in size. An oncological partial resection should be performed in main duct intraductal papillary mucinous neoplasm and in lesions with a suspicion of malignancy, otherwise organ preserving procedures may be considered. Frozen section of the transection margin in intraductal papillary mucinous neoplasm is suggested. Follow up after resection is recommended for intraductal papillary mucinous neoplasm, solid pseudo-papillary neoplasm and invasive cancer.

  13. Identification of recruitment and retention strategies for rehabilitation professionals in Ontario, Canada: results from expert panels

    PubMed Central

    Tran, Diem; Hall, Linda McGillis; Davis, Aileen; Landry, Michel D; Burnett, Dawn; Berg, Katherine; Jaglal, Susan

    2008-01-01

    Background Demand for rehabilitation services is expected to increase due to factors such as an aging population, workforce pressures, rise in chronic and complex multi-system disorders, advances in technology, and changes in interprofessional health service delivery models. However, health human resource (HHR) strategies for Canadian rehabilitation professionals are lagging behind other professional groups such as physicians and nurses. The objectives of this study were: 1) to identify recruitment and retention strategies of rehabilitation professionals including occupational therapists, physical therapists and speech language pathologists from the literature; and 2) to investigate both the importance and feasibility of the identified strategies using expert panels amongst HHR and education experts. Methods A review of the literature was conducted to identify recruitment and retention strategies for rehabilitation professionals. Two expert panels, one on Recruitment and Retention and the other on Education were convened to determine the importance and feasibility of the identified strategies. A modified-delphi process was used to gain consensus and to rate the identified strategies along these two dimensions. Results A total of 34 strategies were identified by the Recruitment and Retention and Education expert panels as being important and feasible for the development of a HHR plan for recruitment and retention of rehabilitation professionals. Seven were categorized under the Quality of Worklife and Work Environment theme, another seven in Financial Incentives and Marketing, two in Workload and Skill Mix, thirteen in Professional Development and five in Education and Training. Conclusion Based on the results from the expert panels, the three major areas of focus for HHR planning in the rehabilitation sector should include strategies addressing Quality of Worklife and Work Environment, Financial Incentives and Marketing and Professional Development. PMID:19068134

  14. Overview of the management of cough: CHEST Guideline and Expert Panel Report.

    PubMed

    Irwin, Richard S; French, Cynthia T; Lewis, Sandra Zelman; Diekemper, Rebecca L; Gold, Philip M

    2014-10-01

    This overview will demonstrate that cough is a common and potentially expensive health-care problem. Improvement in the quality of care of those with cough has been the focus of study for a variety of disciplines in medicine. The purpose of the Cough Guideline and Expert Panel is to synthesize current knowledge in a form that will aid clinical decision-making for the diagnosis and management of cough across disciplines and also identify gaps in knowledge and treatment options.

  15. Expert panel report on a study of Splenda in male rats.

    PubMed

    Brusick, David; Borzelleca, Joseph F; Gallo, Michael; Williams, Gary; Kille, John; Wallace Hayes, A; Xavier Pi-Sunyer, F; Williams, Christine; Burks, Wesley

    2009-10-01

    A recent study in rats investigated the retail sweetener product, Granulated SPLENDA No Calorie Sweetener (Splenda) (Abou-Donia et al., 2008. Splenda alters gut microflora and increases intestinal P-glycoprotein and cytochrome P-450 in male rats. J. Toxicol. Environ. Health A, 71, 1415-1429), which is composed of (by dry weight) maltodextrin ( approximately 99%) and sucralose ( approximately 1%). The investigators reported that Splenda increased body weight, decreased beneficial intestinal bacteria, and increased the expression of certain cytochrome P450 (CYP450) enzymes and the transporter protein, P-glycoprotein (P-gp), the latter of which was considered evidence that Splenda or sucralose might interfere with the absorption of nutrients and drugs. The investigators indicated that the reported changes were attributable to the sucralose present in the product tested. An Expert Panel conducted a rigorous evaluation of this study. In arriving at its conclusions, the Expert Panel considered the design and conduct of the study, its outcomes and the outcomes reported in other data available publicly. The Expert Panel found that the study was deficient in several critical areas and that its results cannot be interpreted as evidence that either Splenda, or sucralose, produced adverse effects in male rats, including effects on gastrointestinal microflora, body weight, CYP450 and P-gp activity, and nutrient and drug absorption. The study conclusions are not consistent with published literature and not supported by the data presented.

  16. Expert Groups in the Building of European Public Policy

    ERIC Educational Resources Information Center

    Robert, Cecile

    2012-01-01

    When it comes to building European public action, expertise is ubiquitous and polymorphic. This article intends to study the ways expertise is being used in the European Commission and the logics underlying its use. The massive use of expertise also has consequences for the practices and identities of actors with whom European institutions…

  17. Economic analysis of complementary, alternative, and integrative medicine: considerations raised by an expert panel

    PubMed Central

    2013-01-01

    Background An international panel of experts was convened to examine the challenges faced in conducting economic analyses of Complementary, Alternative and Integrative Medicine (CAIM). Methods A one and a half-day panel of experts was convened in early 2011 to discuss what was needed to bring about robust economic analysis of CAIM. The goals of the expert panel were to review the current state of the science of economic evaluations in health, and to discuss the issues involved in applying these methods to CAIM, recognizing its unique characteristics. The panel proceedings were audiotaped and a thematic analysis was conducted independently by two researchers. The results were then discussed and differences resolved. This manuscript summarizes the discussions held by the panel members on each theme. Results The panel identified seven major themes regarding economic evaluation that are particularly salient to determining the economics of CAIM: standardization (in order to compare CAIM with conventional therapies, the same basic economic evaluation methods and framework must be used); identifying the question being asked, the audience targeted for the results and whose perspective is being used (e.g., the patient perspective is especially relevant to CAIM because of the high level of self-referral and out-of-pocket payment); the analytic methods to be used (e.g., the importance of treatment description and fidelity); the outcomes to be measured (e.g., it is important to consider a broad range of outcomes, particularly for CAIM therapies, which often treat the whole person rather than a specific symptom or disease); costs (e.g., again because of treating the whole person, the impact of CAIM on overall healthcare costs, rather than only disease-specific costs, should be measured); implementation (e.g., highlighting studies where CAIM allows cost savings may help offset its image as an “add on” cost); and generalizability (e.g., proper reporting can enable study

  18. NTP-CERHR expert panel report on the developmental toxicity of soy infant formula.

    PubMed

    McCarver, Gail; Bhatia, Jatinder; Chambers, Christina; Clarke, Robert; Etzel, Ruth; Foster, Warren; Hoyer, Patricia; Leeder, J Steven; Peters, Jeffrey M; Rissman, Emilie; Rybak, Michael; Sherman, Claire; Toppari, Jorma; Turner, Katie

    2011-10-01

    Soy infant formula contains soy protein isolates and is fed to infants as a supplement to or replacement for human milk or cow milk. Soy protein isolates contains estrogenic isoflavones (phytoestrogens) that occur naturally in some legumes, especially soybeans. Phytoestrogens are nonsteroidal, estrogenic compounds. In plants, nearly all phytoestrogens are bound to sugar molecules and these phytoestrogen-sugar complexes are not generally considered hormonally active. Phytoestrogens are found in many food products in addition to soy infant formula, especially soy-based foods such as tofu, soy milk, and in some over-the-counter dietary supplements. Soy infant formula was selected for National Toxicology Program (NTP) evaluation because of (1) the availability of large number of developmental toxicity studies in laboratory animals exposed to the isoflavones found in soy infant formula (namely, genistein) or other soy products, as well as few studies on human infants fed soy infant formula, (2) the availability of information on exposures in infants fed soy infant formula, and (3) public concern for effects on infant or child development. On October 2, 2008 (73 FR 57360), the NTP Center for the Evaluation of Risks to Human Reproduction (CERHR) announced its intention to conduct an updated review of soy infant formula to complete a previous evaluation that was initiated in 2005. Both the current and previous evaluations relied on expert panels to assist the NTP in developing its conclusions on the potential developmental effects associated with the use of soy infant formula, presented in the NTP Brief on Soy Infant Formula. The initial expert panel met on March 15 to 17, 2006, to reach conclusions on the potential developmental and reproductive toxicities of soy infant formula and its predominant isoflavone constituent genistein. The expert panel reports were released for public comment on May 5, 2006 (71 FR 28368). On November 8, 2006 (71 FR 65537), CERHR staff released

  19. Training Future Physicians about Weapons of Mass Destruction: Report of the Expert Panel on Bioterrorism Education for Medical Students.

    ERIC Educational Resources Information Center

    Association of American Medical Colleges, Washington, DC.

    The Association of American Medical Colleges (AAMC) convened a multidisciplinary group of experts to share their insights about the learning objectives and educational experiences that they would recommend for the training of future physicians about bioterrorism. The expert panel broadened the scope of their discussion beyond bioterrorism to…

  20. The Expert System Programme of the European Space Agency

    NASA Astrophysics Data System (ADS)

    Lafay, J. F.; Allard, F.

    1992-08-01

    ESA's Expert System Demonstration (ESD) program is discussed in terms of its goals, structure, three-phase approach, and initial results. ESD is intended to demonstrate the benefits of AI and knowledge-based systems for in-orbit infrastructures by developing a strategic technology to contribute to ESA missions. Three phases were defined for: (1) program definition and review of existing work; (2) demonstration of applications prototypes; and (3) the development of operational systems from successful prototypes. Applications of 16 proposed expert-system candidates are grouped into payload-engineering and crew/operations categories. The candidates are to be evaluated in terms of their potential contribution to strategic goals such as improving scientific return and automating operator functions to eliminate human error.

  1. An algorithm for tailoring pharmacotherapy for smoking cessation: results from a Delphi panel of international experts

    PubMed Central

    Bader, P; McDonald, P; Selby, P

    2009-01-01

    Background: Evidence-based smoking cessation guidelines recommend nicotine replacement therapy (NRT), bupropion SR and varenicline as first-line therapy in combination with behavioural interventions. However, there are limited data to guide clinicians in recommending one form over another, using combinations, or matching individual smokers to particular forms. Objective: To develop decision rules for clinicians to guide differential prescribing practices and tailoring of pharmacotherapy for smoking cessation. Methods: A Delphi approach was used to build consensus among a panel of 37 international experts from various health disciplines. Through an iterative process, panellists responded to three rounds of questionnaires. Participants identified and ranked “best practices” used by them to tailor pharmacotherapy to aid smoking cessation. An independent panel of 10 experts provided cross-validation of findings. Results: There was a 100% response rate to all three rounds. A high level of consensus was achieved in determining the most important priorities: (1) factors to consider in prescribing pharmacotherapy: evidence, patient preference, patient experience; (2) combinations based on: failed attempt with monotherapy, patients with breakthrough cravings, level of tobacco dependence; (3) specific combinations, main categories: (a) two or more forms of NRT, (b) bupropion + form of NRT; (4) specific combinations, subcategories: (1a) patch + gum, (1b) patch + inhaler, (1c) patch + lozenge; (2a) bupropion + patch, (2b) bupropion + gum; (5) impact of comorbidities on selection of pharmacotherapy: contraindications, specific pharmacotherapy useful for certain comorbidities, dual purpose medications; (6) frequency of monitoring determined by patient needs and type of pharmacotherapy. Conclusion: An algorithm and guide were developed to assist clinicians in prescribing pharmacotherapy for smoking cessation. There appears to be good justification for “off-label” use such

  2. Assuring the quality of health care for older persons. An expert panel's priorities.

    PubMed

    Fink, A; Siu, A L; Brook, R H; Park, R E; Solomon, D H

    1987-10-01

    To select topics for quality assurance activities focusing on older patients, we convened a 14-member panel of physicians and experts in quality assurance. In two rounds of ratings, panelists rated 42 medical conditions (eg, pneumonia) in terms of their effects on patient outcomes, the availability of beneficial interventions, and the health benefits from improving current quality. They rated 27 health services (eg, adult day-care) on similar dimensions. The feasibility of doing quality assurance work on each condition and service also was rated. Using the ratings, the conditions selected for quality assurance work were congestive heart failure, hypertension, pneumonia, breast cancer, adverse effects of drugs, incontinence, and depression. Health care services selected were hospital discharge planning, acute inpatient care for the frail elderly, long-term-care facilities (intermediate-care facilities and skilled nursing facilities), home health care services, and case management. PMID:3656600

  3. Advancing Research on Endocrine Disrupting Chemicals in Breast Cancer: Expert Panel Recommendations

    PubMed Central

    Teitelbaum, Susan L.; Belpoggi, Fiorella; Reinlib, Les

    2015-01-01

    Breast cancer incidence continues to increase in the US and Europe, a reflection of the growing influence of environment factors that interact with personal genetics. The US Environmental Protection Agency estimates that over 85,000 endocrine disrupting chemicals are among the common daily exposures that could affect the risk of disease. The daunting tasks of identifying, characterizing, and elucidating the mechanisms of endocrine disrupting chemicals in breast cancer need to be addressed to produce a comprehensive model that will facilitate preventive strategies and public policy. An expert panel met to describe and bring attention to needs linking common environmental exposures, critical windows of exposure, and optimal times of assessment in investigating breast cancer risk. The group included investigators with extensive experience in the use of rodent models and in leading population studies and produced a set of recommendations for effective approaches to gaining insights into the environmental origins of breast cancer across the lifespan. PMID:25549947

  4. Health Economics of Dengue: A Systematic Literature Review and Expert Panel's Assessment

    PubMed Central

    Beatty, Mark E.; Beutels, Philippe; Meltzer, Martin I.; Shepard, Donald S.; Hombach, Joachim; Hutubessy, Raymond; Dessis, Damien; Coudeville, Laurent; Dervaux, Benoit; Wichmann, Ole; Margolis, Harold S.; Kuritsky, Joel N.

    2011-01-01

    Dengue vaccines are currently in development and policymakers need appropriate economic studies to determine their potential financial and public health impact. We searched five databases (PubMed, EMBASE, LILAC, EconLit, and WHOLIS) to identify health economics studies of dengue. Forty-three manuscripts were identified that provided primary data: 32 report economic burden of dengue and nine are comparative economic analyses assessing various interventions. The remaining two were a willingness-to-pay study and a policymaker survey. An expert panel reviewed the existing dengue economic literature and recommended future research to fill information gaps. Although dengue is an important vector-borne disease, the economic literature is relatively sparse and results have often been conflicting because of use of inconsistent assumptions. Health economic research specific to dengue is urgently needed to ensure informed decision making on the various options for controlling and preventing this disease. PMID:21363989

  5. Health economics of dengue: a systematic literature review and expert panel's assessment.

    PubMed

    Beatty, Mark E; Beutels, Philippe; Meltzer, Martin I; Shepard, Donald S; Hombach, Joachim; Hutubessy, Raymond; Dessis, Damien; Coudeville, Laurent; Dervaux, Benoit; Wichmann, Ole; Margolis, Harold S; Kuritsky, Joel N

    2011-03-01

    Dengue vaccines are currently in development and policymakers need appropriate economic studies to determine their potential financial and public health impact. We searched five databases (PubMed, EMBASE, LILAC, EconLit, and WHOLIS) to identify health economics studies of dengue. Forty-three manuscripts were identified that provided primary data: 32 report economic burden of dengue and nine are comparative economic analyses assessing various interventions. The remaining two were a willingness-to-pay study and a policymaker survey. An expert panel reviewed the existing dengue economic literature and recommended future research to fill information gaps. Although dengue is an important vector-borne disease, the economic literature is relatively sparse and results have often been conflicting because of use of inconsistent assumptions. Health economic research specific to dengue is urgently needed to ensure informed decision making on the various options for controlling and preventing this disease. PMID:21363989

  6. Advancing research on endocrine disrupting chemicals in breast cancer: Expert panel recommendations.

    PubMed

    Teitelbaum, Susan L; Belpoggi, Fiorella; Reinlib, Les

    2015-07-01

    Breast cancer incidence continues to increase in the US and Europe, a reflection of the growing influence of environment factors that interact with personal genetics. The US Environmental Protection Agency estimates that there are approximately 10,000 endocrine disrupting chemicals among the common daily exposures that could affect the risk of disease. The daunting tasks of identifying, characterizing, and elucidating the mechanisms of endocrine disrupting chemicals in breast cancer need to be addressed to produce a comprehensive model that will facilitate preventive strategies and public policy. An expert panel met to describe and bring attention to needs linking common environmental exposures, critical windows of exposure, and optimal times of assessment in investigating breast cancer risk. The group included investigators with extensive experience in the use of rodent models and in leading population studies and produced a set of recommendations for effective approaches to gaining insights into the environmental origins of breast cancer across the lifespan.

  7. External Collection Devices as an Alternative to the Indwelling Urinary Catheter: Evidence-Based Review and Expert Clinical Panel Deliberations.

    PubMed

    Gray, Mikel; Skinner, Claudia; Kaler, Wendy

    2016-01-01

    Multiple evidence-based guidelines have suggested clinicians consider external collection devices (ECD) as alternatives to indwelling catheters. Nevertheless, there is a dearth of evidence-based resources concerning their use. An expert consensus panel was convened to review the current state of the evidence, indications for ECDs as an alternative to an indwelling urinary catheter, identify knowledge gaps, and areas for future research. This article presents the results of the expert consensus panel meeting and a systematic literature review regarding ECD use in the clinical setting.

  8. External Collection Devices as an Alternative to the Indwelling Urinary Catheter: Evidence-Based Review and Expert Clinical Panel Deliberations.

    PubMed

    Gray, Mikel; Skinner, Claudia; Kaler, Wendy

    2016-01-01

    Multiple evidence-based guidelines have suggested clinicians consider external collection devices (ECD) as alternatives to indwelling catheters. Nevertheless, there is a dearth of evidence-based resources concerning their use. An expert consensus panel was convened to review the current state of the evidence, indications for ECDs as an alternative to an indwelling urinary catheter, identify knowledge gaps, and areas for future research. This article presents the results of the expert consensus panel meeting and a systematic literature review regarding ECD use in the clinical setting. PMID:26974963

  9. Education policy implications from the Expert Panel on Electronic Media and Youth Violence.

    PubMed

    Worthen, Maria R

    2007-12-01

    The research from the Expert Panel on Electronic Media and Youth Violence makes a compelling case for why educators and education policymakers should care about the effects of media on youth behavior, and the growing phenomenon of Internet bullying and harassment. The ability of the U.S. education system to respond is limited not only by competing instructional priorities but also by the governance structure of the education system itself. The federal role is limited to a proportionally small amount of funding for states and schools, to raising public awareness, and to providing research and data. States can set priorities, make requirements, and direct funding. Districts and schools ultimately have the most control over prevention program selection and setting social and behavioral norms. Key implications of the panel's research for educators and education policymakers include: Internet bullying is correlated with school behavior problems; Internet bullying behavior may peak in middle school; Internet bullying shares common predictors with verbal and, to some extent, physical bullying; Media literacy programs may mitigate the negative effects of electronic media on youth. Specific recommendations based on these conclusions are discussed, and research priorities for the prevention and education fields are identified. PMID:18047948

  10. The healthy food environment policy index: findings of an expert panel in New Zealand

    PubMed Central

    Dominick, Clare; Devi, Anandita; Swinburn, Boyd

    2015-01-01

    Abstract Objective To assess government actions to improve the healthiness of food environments in New Zealand, based on the healthy food environment policy index. Methods A panel of 52 public health experts rated the extent of government implementation against international best practice for 42 indicators of food environment policy and infrastructure support. Their ratings were informed by documented evidence, validated by government officials and international benchmarks. Findings There was a high level of implementation for some indicators: providing ingredient lists and nutrient declarations and regulating health claims on packaged foods; transparency in policy development; monitoring prevalence of noncommunicable diseases and monitoring risk factors for noncommunicable diseases. There was very little, if any implementation of the following indicators: restrictions on unhealthy food marketing to children; fiscal and food retail policies and protection of national food environments within trade agreements. Interrater reliability was 0.78 (95% confidence interval, CI: 0.76–0.79). Based on the implementation gaps, the experts recommended 34 actions, and prioritized seven of these. Conclusion The healthy food environment policy index provides a useful set of indicators that can focus attention on where government action is needed. It is anticipated that this policy index will increase accountability of governments, stimulate government action and support civil society advocacy efforts. PMID:26229200

  11. Fasting therapy - an expert panel update of the 2002 consensus guidelines.

    PubMed

    Wilhelmi de Toledo, Françoise; Buchinger, Andreas; Burggrabe, Hilmar; Hölz, Gunter; Kuhn, Christian; Lischka, Eva; Lischka, Norbert; Lützner, Hellmut; May, Wolfgang; Ritzmann-Widderich, Martha; Stange, Rainer; Wessel, Anna; Boschmann, Michael; Peper, Elisabeth; Michalsen, Andreas

    2013-01-01

    Fasting for medical purpose (fasting therapy) has a long tradition in Europe and is established as a defined therapeutic approach in specialized fasting hospitals or within clinical departments for integrative medicine. In 2002, the first guidelines for fasting therapy were published following an expert consensus conference; here we present a revised update elaborated by an expert panel. Historical aspects and definitions, indications, methods, forms, and accompanying procedures of fasting as well as safety and quality criteria of fasting interventions are described. Fasting has shown beneficial effects in various chronic diseases with highest level of evidence for rheumatic diseases. Preliminary clinical and observational data and recently revealed mechanisms of fasting and caloric restriction indicate beneficial effects of fasting also in other chronic conditions such as metabolic diseases, pain syndromes, hypertension, chronic inflammatory diseases, atopic diseases, and psychosomatic disorders. Fasting can also be applied for preventing diseases in healthy subjects. In order to guarantee successful use of fasting and to ensure adherence of all safety and quality standards it is mandatory that all interventions during fasting are guided/accompanied by physicians/therapists trained and certified in fasting therapy.

  12. Guidelines for field triage of injured patients. Recommendations of the National Expert Panel on Field Triage.

    PubMed

    Sasser, Scott M; Hunt, Richard C; Sullivent, Ernest E; Wald, Marlena M; Mitchko, Jane; Jurkovich, Gregory J; Henry, Mark C; Salomone, Jeffrey P; Wang, Stewart C; Galli, Robert L; Cooper, Arthur; Brown, Lawrence H; Sattin, Richard W

    2009-01-23

    four times. In 2005, with support from the National Highway Traffic Safety Administration, CDC began facilitating revision of the Decision Scheme by hosting a series of meetings of the National Expert Panel on Field Triage, which includes injury-care providers, public health professionals, automotive industry representatives, and officials from federal agencies. The Panel reviewed relevant literature, presented its findings, and reached consensus on necessary revisions. The revised Decision Scheme was published in 2006. This report describes the process and rationale used by the Expert Panel to revise the Decision Scheme.

  13. Practice Guidance for Buprenorphine for the Treatment of Opioid Use Disorders: Results of an Expert Panel Process

    PubMed Central

    Farmer, Carrie M.; Lindsay, Dawn; Williams, Jessica; Ayers, Amanda; Schuster, James; Cilia, Alyssa; Flaherty, Michael T.; Mandell, Todd; Gordon, Adam J.; Stein, Bradley D.

    2015-01-01

    Background Although numbers of physicians credentialed to prescribe buprenorphine has increased over time, many credentialed physicians may be reluctant to treat individuals with opioid use disorders due to discomfort with prescribing buprenorphine. Though prescribing physicians are required to complete a training course, many have questions about buprenorphine and treatment guidelines have not been updated to reflect clinical experience in recent years. We report on an expert panel process to update and expand buprenorphine guidelines. Methods We identified candidate guidelines through expert opinion and a review of the literature and used a modified RAND/UCLA Appropriateness Method to assess the validity of the candidate guidelines. An expert panel completed two rounds of rating, with a meeting to discuss the guidelines between the first and second rating. Results Through the rating process, expert panel members rated 90 candidate guideline statements across eight domains, including candidacy for buprenorphine treatment, dosing of buprenorphine, psychosocial counseling, and treatment of co-occurring depression and anxiety. A total of 65 guideline statements (72%) were rated as valid. Expert panel members had agreement in some areas, such as the treatment of co-occurring mental health problems, but disagreement in others, including the appropriate dosing of buprenorphine given patient complexities. Conclusions Through an expert panel process, we developed an updated and expanded set of buprenorphine treatment guidelines; this additional guidance may increase credentialed physicians’ comfort with prescribing buprenorphine to patients with opioid use disorders. Future efforts should focus on appropriate dosing guidance and ensuring that guidelines can be adapted to a variety of practice settings. PMID:25844527

  14. Challenges in the implementation of trastuzumab biosimilars: an expert panel's recommendations.

    PubMed

    Pivot, Xavier; Aulagner, Gilles; Blay, Jean Yves; Fumoleau, Pierre; Kaliski, Alexandre; Sarkozy, François; Limat, Samuel

    2015-11-01

    Trastuzumab has transformed the treatment of HER2-positive breast cancer. Because of impending European patent expiry in 2017, numerous trastuzumab biosimilars are currently undergoing comparability exercises for marketing authorization. Although biosimilar products have been approved in Europe since 2006, many obstacles are expected for trastuzumab, resulting from its nature as a monoclonal antibody, its impact on overall survival, and its extensive biochemical complexities. Unsolved questions need to be addressed for the evaluation of biosimilars' activity in terms of appropriate clinical endpoint definitions for such anticancer drugs, specific assessment pathways and comparative testing of biosimilars, untested ensuing de facto combination of trastuzumab biosimilars with cytotoxics, and immunogenicity monitoring among immunocompromised patients. In such a context of uncertainties, the recent approval by the French parliament of biosimilar substitution, which would allow dispensing trastuzumab biosimilars in place of the originator, should interrogate the oncological community. A think tank of experts was created to delineate specificities and challenges stemming from trastuzumab biosimilars. PMID:26352219

  15. The Social Cognition Psychometric Evaluation Study: Results of the Expert Survey and RAND Panel

    PubMed Central

    Pinkham, Amy E.; Penn, David L.; Green, Michael F.; Buck, Benjamin; Healey, Kristin; Harvey, Philip D.

    2014-01-01

    Background: In schizophrenia, social cognition is strongly linked to functional outcome and is increasingly seen as a viable treatment target. The goal of the Social Cognition Psychometric Evaluation (SCOPE) study is to identify and improve the best existing measures of social cognition so they can be suitably applied in large-scale treatment studies. Initial phases of this project sought to (1) develop consensus on critical domains of social cognition and (2) identify the best existing measures of social cognition for use in treatment studies. Methods: Experts in social cognition were invited to nominate key domains of social cognition and the best measures of those domains. Nominations for measures were reduced according to set criteria, and all available psychometric information about these measures was summarized and provided to RAND panelists. Panelists rated the quality of each measure on multiple criteria, and diverging ratings were discussed at the in-person meeting to obtain consensus. Results: Expert surveys identified 4 core domains of social cognition—emotion processing, social perception, theory of mind/mental state attribution, and attributional style/bias. Using RAND panel consensus ratings, the following measures were selected for further evaluation: Ambiguous Intentions Hostility Questionnaire, Bell Lysaker Emotion Recognition Task, Penn Emotion Recognition Test, Relationships Across Domains, Reading the Mind in the Eyes Test, The Awareness of Social Inferences Test, Hinting Task, and Trustworthiness Task. Discussion: While it was possible to establish consensus, only a limited amount of psychometric information is currently available for the candidate measures, which underscores the need for well-validated and standardized measures in this area. PMID:23728248

  16. The Appropriateness of Renal Angioplasty. The ANPARIA Software: A Multidisciplinary Expert Panel Approach

    SciTech Connect

    Gerbaud, Laurent; Manhes, Geraud; Debourse, Juliette; Gouby, Gerald Glanddier, Phyllis-Yvonne; Vader, John-Paul; Boyer, Louis Deteix, Patrice

    2008-11-15

    Percutaneous transluminal renal angioplasty (PTRA) is an invasive technique that is costly and involves the risk of complications and renal failure. The ability of PTRA to reduce the administration of antihypertensive drugs has been demonstrated. A potentially greater benefit, which nevertheless remains to be proven, is the deferral of the need for chronic dialysis. The aim of the study (ANPARIA) was to assess the appropriateness of PTRA to impact on the evolution of renal function. A standardized expert panel method was used to assess the appropriateness of medical treatment alone or medical treatment with revascularization in various clinical situations. The choice of revascularization by either PTRA or surgery was examined for each clinical situation. Analysis was based on a detailed literature review and on systematically elicited expert opinion, which were obtained during a two-round modified Delphi process. The study provides detailed responses on the appropriateness of PTRA for 1848 distinct clinical scenarios. Depending on the major clinical presentation, appropriateness of revascularization varied from 32% to 75% for individual scenarios (overal 48%). Uncertainty as to revascularization was 41% overall. When revascularization was appropriate, PTRA was favored over surgery in 94% of the scenarios, except in certain cases of aortic atheroma where sugery was the preferred choice. Kidney size >7 cm, absence of coexisting disease, acute renal failure, a high degree of stenosis ({>=}70%), and absence of multiple arteries were identified as predictive variables of favorable appropriateness ratings. Situations such as cardiac failure with pulmonary edema or acute thrombosis of the renal artery were defined as indications for PTRA. This study identified clinical situations in which PTRA or surgery are appropriate for renal artery disease. We built a decision tree which can be used via Internet: the ANPARIA software (http://www

  17. Clinical expert panel on monitoring potential lung toxicity of inhaled oligonucleotides: consensus points and recommendations.

    PubMed

    Alton, Eric W; Boushey, Homer A; Garn, Holger; Green, Francis H; Hodges, Michael; Martin, Richard J; Murdoch, Robert D; Renz, Harald; Shrewsbury, Stephen B; Seguin, Rosanne; Johnson, Graham; Parry, Joel D; Tepper, Jeff; Renzi, Paolo; Cavagnaro, Joy; Ferrari, Nicolay

    2012-08-01

    Oligonucleotides (ONs) are an emerging class of drugs being developed for the treatment of a wide variety of diseases including the treatment of respiratory diseases by the inhalation route. As a class, their toxicity on human lungs has not been fully characterized, and predictive toxicity biomarkers have not been identified. To that end, identification of sensitive methods and biomarkers that can detect toxicity in humans before any long term and/or irreversible side effects occur would be helpful. In light of the public's greater interests, the Inhalation Subcommittee of the Oligonucleotide Safety Working Group (OSWG) held expert panel discussions focusing on the potential toxicity of inhaled ONs and assessing the strengths and weaknesses of different monitoring techniques for use during the clinical evaluation of inhaled ON candidates. This white paper summarizes the key discussions and captures the panelists' perspectives and recommendations which, we propose, could be used as a framework to guide both industry and regulatory scientists in future clinical research to characterize and monitor the short and long term lung response to inhaled ONs.

  18. Future Directions for Postdoctoral Training in Cancer Prevention: Insights from a Panel of Experts

    PubMed Central

    Nelson, David E.; Faupel-Badger, Jessica; Phillips, Siobhan; Belcher, Britni; Chang, Shine; Abrams, David B.; Kramer, Barnett S.; White, Mary C.; O’Malley, Michael; Varanasi, Arti P.; Fabian, Carol J.; Wiest, Jonathan S.; Colditz, Graham A.; Hall, Kara; Shields, Peter G.; Weitzel, Jeffrey N.

    2014-01-01

    Cancer prevention postdoctoral fellowships have existed since the 1970s. The National Cancer Institute facilitated a meeting by a panel of experts in April 2013 to consider four important topics for future directions for cancer prevention postdoctoral training programs: 1) future research needs; 2) underrepresented disciplines; 3) curriculum; and 4) career preparation. Panelists proffered several areas needing more research or emphasis, ranging from computational science to culture. Health care providers, along with persons from non-traditional disciplines such as engineers and lawyers, were among disciplines recognized as being underrepresented in training programs. Curriculum suggestions were that fellows receive training in topics such as leadership and human relations, in addition to learning the principles of epidemiology, cancer biological mechanisms, and behavioral science. For career preparation, there was a clear recognition of the diversity of employment options available besides academic positions, and that program leaders should do more to help fellows identify and prepare for different career paths. The major topics and strategies covered at this meeting can help form the basis for cancer prevention training program leaders to consider modifications or new directions, and keep them current with the changing scientific and employment climate for doctoral degree recipients and postdoctoral fellows. PMID:24604827

  19. Italian Expert Panel on the management of patients with coexisting spondyloarthritis and inflammatory bowel disease.

    PubMed

    Olivieri, Ignazio; Cantini, Fabrizio; Castiglione, Fabiana; Felice, Carla; Gionchetti, Paolo; Orlando, Ambrogio; Salvarani, Carlo; Scarpa, Raffaele; Vecchi, Maurizio; Armuzzi, Alessandro

    2014-08-01

    Spondyloarthritis (SpA) is a group of diseases with similar clinical, radiologic and serologic features, including SpA associated with inflammatory bowel disease (IBD-associated SpA). Several studies have estimated the occurrence of SpA in IBD patients as ranging from 17% to 39%, confirming that SpA is the most frequent extra-intestinal manifestation in patients with IBD. In this paper, the expert panel presents some red flags to guide clinicians - both rheumatologists and gastroenterologists - to make a correct diagnosis of IBD-associated SpA in clinical practice. IBD-associated SpA classification, clinical presentation and diagnostic work-up are also presented. From the therapeutic point of view, only separate recommendations/guidelines are currently available for the treatment of Crohn's disease, ulcerative colitis and for both axial and peripheral SpA. However, when IBD and SpA coexist, the therapeutic strategy should be modulated to take into account the variable manifestations of IBD in terms of intestinal and extra-intestinal features, and the clinical manifestations of SpA, with particular attention to peripheral enthesitis, dactylitis and anterior uveitis. To our knowledge, this is the first attempt to define therapeutic algorithms for the integrated management of different IBD-associated SpA clinical scenarios. PMID:24726868

  20. Establishment of Reference Doses for residues of allergenic foods: report of the VITAL Expert Panel.

    PubMed

    Taylor, Steve L; Baumert, Joseph L; Kruizinga, Astrid G; Remington, Benjamin C; Crevel, Rene W R; Brooke-Taylor, Simon; Allen, Katrina J; Houben, Geert

    2014-01-01

    In 2011, an expert panel was assembled to establish appropriate Reference Doses for allergenic food residues as a part of the VITAL (Voluntary Incidental Trace Allergen Labeling) program of The Allergen Bureau of Australia & New Zealand (ABA). These Reference Doses would guide advisory labeling decisions for use on food labels. Individual NOAELs and LOAELs were obtained from clinical challenges of food-allergic subjects. Statistical dose-distribution models (log-normal, log-logistic, Weibull) were applied to the individual NOAELs and LOAELs for each allergenic food. The Reference Doses, in terms of mg of total protein from the allergenic food, were based upon either the ED01 (for peanut, cow's milk), the 95% lower confidence interval of the ED05 (for wheat, soybean, cashew, shrimp, sesame seed, mustard, and lupine), or both (egg, hazelnut) using all appropriate statistical dose-distribution models. Reference Doses were established for 11 allergenic foods ranging from 0.03 mg for egg protein to 10mg for shrimp protein. Reference Doses were not established for fish or celery due to poor model fits with existing data. Reference Doses were not established for other tree nuts beyond hazelnut and cashew because of the absence of data on NOAELs and LOAELs from individual subjects. PMID:24184597

  1. Management of neuropsychiatric symptoms of dementia in clinical settings: recommendations from a multidisciplinary expert panel.

    PubMed

    Kales, Helen C; Gitlin, Laura N; Lyketsos, Constantine G

    2014-04-01

    Noncognitive neuropsychiatric symptoms (NPS) of dementia (aggression, agitation, depression, anxiety, delusions, hallucinations, apathy, disinhibition) affect individuals with dementia nearly universally across dementia stages and etiologies. NPS are associated with poor outcomes for individuals with dementia and caregivers, including excess morbidity and mortality, greater healthcare use, and earlier nursing home placement, as well as caregiver stress, depression, and difficulty with employment. Although the Food and Drug Administration has not approved pharmacotherapy for NPS, psychotropic medications are frequently used to manage these symptoms, but in the few cases of proven pharmacological efficacy, significant risk of adverse effects may offset benefits. There is evidence of efficacy and limited potential for adverse effects of nonpharmacological treatments, typically considered first line, but their uptake as preferred treatments remains inadequate in real-world clinical settings. Thus, the field currently finds itself in a predicament in terms of management of these difficult symptoms. It was in this context that the University of Michigan Program for Positive Aging, working in collaboration with the Johns Hopkins Alzheimer's Disease Research Center and Center for Innovative Care in Aging sponsored and convened a multidisciplinary expert panel in Detroit, Michigan, in fall 2011 with three objectives: to define critical elements of care for NPS in dementia; to construct an approach describing the sequential and iterative steps of managing NPS in real-world clinical settings that can be used as a basis for integrating nonpharmacological and pharmacological approaches; and to discuss how the approach generated could be implemented in research and clinical care.

  2. Standardization of negative controls in diagnostic immunohistochemistry: recommendations from the international ad hoc expert panel.

    PubMed

    Torlakovic, Emina E; Francis, Glenn; Garratt, John; Gilks, Blake; Hyjek, Elizabeth; Ibrahim, Merdol; Miller, Rodney; Nielsen, Søren; Petcu, Eugen B; Swanson, Paul E; Taylor, Clive R; Vyberg, Mogens

    2014-04-01

    Standardization of controls, both positive and negative controls, is needed for diagnostic immunohistochemistry (dIHC). The use of IHC-negative controls, irrespective of type, although well established, is not standardized. As such, the relevance and applicability of negative controls continues to challenge both pathologists and laboratory budgets. Despite the clear theoretical notion that appropriate controls serve to demonstrate the sensitivity and specificity of the dIHC test, it remains unclear which types of positive and negative controls are applicable and/or useful in day-to-day clinical practice. There is a perceived need to provide "best practice recommendations" for the use of negative controls. This perception is driven not only by logistics and cost issues, but also by increased pressure for accurate IHC testing, especially when IHC is performed for predictive markers, the number of which is rising as personalized medicine continues to develop. Herein, an international ad hoc expert panel reviews classification of negative controls relevant to clinical practice, proposes standard terminology for negative controls, considers the total evidence of IHC specificity that is available to pathologists, and develops a set of recommendations for the use of negative controls in dIHC based on "fit-for-use" principles.

  3. Future directions for postdoctoral training in cancer prevention: insights from a panel of experts.

    PubMed

    Nelson, David E; Faupel-Badger, Jessica; Phillips, Siobhan; Belcher, Britni; Chang, Shine; Abrams, David B; Kramer, Barnett S; White, Mary C; O'Malley, Michael; Varanasi, Arti P; Fabian, Carol J; Wiest, Jonathan S; Colditz, Graham A; Hall, Kara; Shields, Peter G; Weitzel, Jeffrey N

    2014-04-01

    Cancer prevention postdoctoral fellowships have existed since the 1970s. The National Cancer Institute facilitated a meeting by a panel of experts in April 2013 to consider four important topics for future directions for cancer prevention postdoctoral training programs: (i) future research needs; (ii) underrepresented disciplines; (iii) curriculum; and (iv) career preparation. Panelists proffered several areas needing more research or emphasis, ranging from computational science to culture. Health care providers, along with persons from nontraditional disciplines in scientific training programs such as engineers and lawyers, were among those recognized as being underrepresented in training programs. Curriculum suggestions were that fellows receive training in topics such as leadership and human relations, in addition to learning the principles of epidemiology, cancer biologic mechanisms, and behavioral science. For career preparation, there was a clear recognition of the diversity of employment options available besides academic positions, and that program leaders should do more to help fellows identify and prepare for different career paths. The major topics and strategies covered at this meeting can help form the basis for cancer prevention training program leaders to consider modifications or new directions, and keep them updated with the changing scientific and employment climate for doctoral degree recipients and postdoctoral fellows.

  4. NTP-CERHR expert panel report on the reproductive anddevelopmental toxicity of hydroxyurea

    SciTech Connect

    Liebelt, E.L.; Balk, S.J.; Faber, W.; Fisher, J.W.; Hughes, C.L.; Lanzkron, S.M.; Lewis, K.M.; Marchetti, F.; Mehendale, H.M.; Rogers,J.M.; Shad, A.T.; Skalko, R.G.; Stanek, E.J.

    2007-01-01

    The National Toxicology Program (NTP) and the National Institute of Environmental Health Sciences (NIEHS) established the NTP Center for the Evaluation of Risks to Human Reproduction (CERHR) in June 1998. The purpose of CERHR is to provide timely, unbiased, scientifically sound evaluations of human and experimental evidence for adverse effects on reproduction and development caused by agents to which humans may be exposed. Hydroxyurea was selected for evaluation by a CERHR expert panel because of (1) its increasing use in the treatment of sickle cell disease in children and adults, (2) knowledge that it inhibits DNA synthesis and is cytotoxic, and (3) published evidence of its reproductive and developmental toxicity in rodents. Hydroxyurea is FDA-approved for reducing the frequency of painful crises and the need for blood transfusions in adults with sickle cell anemia who experience recurrent moderate-to-severe crises. Hydroxyurea is used in the treatment of cancer, sickle cell disease, and thalassemia. It is the only treatment for sickle cell disease aside from blood transfusion used in children. Hydroxyurea may be used in the treatment of children and adults with sickle cell disease for an extended period of time or for repeated cycles of therapy. Treatment with hydroxyurea may be associated with cytotoxic and myelosuppressive effects, and hydroxyurea is mutagenic.

  5. Centers for disease control and prevention expert panel meetings on prevention and treatment of anthrax in adults.

    PubMed

    Hendricks, Katherine A; Wright, Mary E; Shadomy, Sean V; Bradley, John S; Morrow, Meredith G; Pavia, Andy T; Rubinstein, Ethan; Holty, Jon-Erik C; Messonnier, Nancy E; Smith, Theresa L; Pesik, Nicki; Treadwell, Tracee A; Bower, William A

    2014-02-01

    The Centers for Disease Control and Prevention convened panels of anthrax experts to review and update guidelines for anthrax postexposure prophylaxis and treatment. The panels included civilian and military anthrax experts and clinicians with experience treating anthrax patients. Specialties represented included internal medicine, pediatrics, obstetrics, infectious disease, emergency medicine, critical care, pulmonology, hematology, and nephrology. Panelists discussed recent patients with systemic anthrax; reviews of published, unpublished, and proprietary data regarding antimicrobial drugs and anthrax antitoxins; and critical care measures of potential benefit to patients with anthrax. This article updates antimicrobial postexposure prophylaxis and antimicrobial and antitoxin treatment options and describes potentially beneficial critical care measures for persons with anthrax, including clinical procedures for infected nonpregnant adults. Changes from previous guidelines include an expanded discussion of critical care and clinical procedures and additional antimicrobial choices, including preferred antimicrobial drug treatment for possible anthrax meningitis.

  6. Charting the future of community health promotion: recommendations from the National Expert Panel on Community Health Promotion.

    PubMed

    Navarro, Amanda M; Voetsch, Karen P; Liburd, Leandris C; Giles, H Wayne; Collins, Janet L

    2007-07-01

    In the decades since chronic illnesses replaced infectious diseases as the leading causes of death, public health researchers, particularly those in the field of health promotion and chronic disease prevention, have shifted their focus from the individual to the community in recognition that community-level changes will foster and sustain individual behavior change. The former emphasis on individual lifestyle change has been broadened to include social and environmental factors, often without increased resources. To find new ways to support community health promotion at the national level, the National Center for Chronic Disease Prevention and Health Promotion and the Division of Adult and Community Health invited an external panel of experts to participate in the National Expert Panel on Community Health Promotion. This article highlights the process through which the expert panel developed its eight recommendations. The recommendations include issues related to community-based participatory research and surveillance, training and capacity building, new approaches for health and wellness, and changes in federal investments. They illustrate the steps needed to broaden the traditional scope of public health and to advance a new vision for improving community health and wellness.

  7. Toxicological significance of DNA adducts: summary of discussions with an expert panel.

    PubMed

    Nestmann, E R; Bryant, D W; Carr, C J

    1996-08-01

    A workshop was held to discuss the uses of data on DNA adduct measurement in humans and in experimental systems in vitro and in vivo. The discussions focused principally on the understanding of the toxicological significance of DNA adducts as provided by information from animal models. An Expert Panel concluded that human DNA adduct data have utility in several aspects of risk assessment. The presence and amount of specific adducts that can be correlated with a chemical exposure are relevant for hazard identification and risk evaluation. Data from experimental systems have established dose-response relationships between the level of adducts and exposure, but these remain complex and depend on metabolic fate. Although structure-activity relationships have been useful retrospectively to explain the DNA-reactive nature of some chemicals or classes of chemicals, there are currently no means outside the laboratory to specifically predict the adduct-producing potency of a compound. Analysis of DNA adducts in tissues of laboratory animals and humans has revealed sensitive subpopulations, a finding that has important relevance for human risk assessment. Adduct analysis may be one of the best tools available to characterize exposures to DNA from complex mixtures for purposes of epidemiological investigation. Consensus statements were developed based on presentations by R. Gupta, W. Lutz, R. Nath, and B. Singer [see Regul. Toxicol. Pharmacol. 23(1), 1996] and subsequent discussions. First, rigorous scientific criteria should be met for the detection and characterization of specific DNA adducts in vitro and in target tissues in vivo. Second, the use of adduct data in risk extrapolation has the greatest value when there is characterization of adduct structure, an understanding of the role of repair in DNA adduct removal, and demonstration of biological relevance for each adduct. Third, the detection of DNA adducts in a tissue does not necessarily indicate a specific

  8. Consensus standards for the process of cancer care: a modified expert panel method applied to head and neck cancer. South and West Expert Tumour Panel for Head and Neck Cancer.

    PubMed Central

    Birchall, M. A.

    1998-01-01

    There are many pressures to improve the standard of care delivered to cancer patients, including the reforms subsequent to the Calman-Hine report. The establishment of standards is a prerequisite for audit, benchmarking and certification of cancer centres and units. Randomized trials of head and neck cancer are uncommon, and other forms of evidence often conflicting. In the south and west of England, a multidisciplinary expert panel consensus method has been applied to the development of standards. A panel representative of specialties involved in the process of care at all three levels, plus social medicine and lay members, was constructed. A model for the process of care was developed consisting of activity areas. For each activity, a near exhaustive list of tasks and standards was established. A three-iteration method with statistical group response was then used to refine the standards. The same method was also applied to the production of a minimum data set for registration, recording and audit. The resulting standards will be regularly reviewed. We have developed a model of the care process, and an expert panel methodology that is applicable to a wide range of problems in clinical oncology. PMID:9667669

  9. Expert perspectives on Western European prison health services: do ageing prisoners receive equivalent care?

    PubMed

    Bretschneider, Wiebke; Elger, Bernice Simone

    2014-09-01

    Health care in prison and particularly the health care of older prisoners are increasingly important topics due to the growth of the ageing prisoner population. The aim of this paper is to gain insight into the approaches used in the provision of equivalent health care to ageing prisoners and to confront the intuitive definition of equivalent care and the practical and ethical challenges that have been experienced by individuals working in this field. Forty interviews took place with experts working in the prison setting from three Western European countries to discover their views on prison health care. Experts indicated that the provision of equivalent care in prison is difficult mostly due to four factors: variability of care in different prisons, gatekeeper systems, lack of personnel, and delays in providing access. This lack of equivalence can be fixed by allocating adequate budgets and developing standards for health care in prison.

  10. Expert perspectives on Western European prison health services: do ageing prisoners receive equivalent care?

    PubMed

    Bretschneider, Wiebke; Elger, Bernice Simone

    2014-09-01

    Health care in prison and particularly the health care of older prisoners are increasingly important topics due to the growth of the ageing prisoner population. The aim of this paper is to gain insight into the approaches used in the provision of equivalent health care to ageing prisoners and to confront the intuitive definition of equivalent care and the practical and ethical challenges that have been experienced by individuals working in this field. Forty interviews took place with experts working in the prison setting from three Western European countries to discover their views on prison health care. Experts indicated that the provision of equivalent care in prison is difficult mostly due to four factors: variability of care in different prisons, gatekeeper systems, lack of personnel, and delays in providing access. This lack of equivalence can be fixed by allocating adequate budgets and developing standards for health care in prison. PMID:24965437

  11. Risk Management Post-Marketing Surveillance for the Abuse of Medications Acting on the Central Nervous System: Expert Panel Report

    PubMed Central

    Johanson, Chris-Ellyn; Balster, Robert L.; Henningfield, Jack E.; Schuster, Charles R.; Anthony, James C.; Barthwell, Andrea G.; Coleman, John J.; Dart, Richard C.; Gorodetzky, Charles W.; O’Keeffe, Charles; Sellers, Edward M.; Vocci, Frank; Walsh, Sharon L.

    2010-01-01

    The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October, 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and eleven recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized. PMID:19783383

  12. The Report of the Expert Panel on the Sustainable Management of Groundwater in Canada: The Council of Canadian Academies

    NASA Astrophysics Data System (ADS)

    Bruce, J. P.

    2009-05-01

    The Expert Panel on Groundwater was established in response to a request from the Minister of Natural Resources Canada, asking the Council of Canadian Academies to assess what is needed to achieve sustainable management of Canada's groundwater resources, from a science perspective. To this end, the Council of Canadian Academies assembled an interdisciplinary panel of experts who interpreted science, in the context of this assessment, to include natural and social sciences as well as local, provincial, and federal governance. The panel's report, released on May 11th 2009, noted that nearly 10 million Canadians rely on groundwater for household purposes, in addition to uses for agriculture and industry. Both media and public have expressed many recent concerns about water supplies and their quality. The concept of groundwater sustainability developed by the panel encompasses five interrelated goals: three that involve primarily the physical sciences and engineering, and two that are essentially socio-economic in nature. These goals are as follows: i. Protection of groundwater supplies from depletion ii. Protection of groundwater quality from contamination iii. Protection of ecosystem viability iv. Achievement of economic and social well-being v. Application of good governance The achievement of groundwater sustainability requires a careful analysis and balancing of the five goals; a comprehensive sustainability framework for groundwater has not yet been implemented in Canada. Adoption by federal, provincial and local jurisdictions of such a framework, based on the goals outlined above, would be invaluable in guiding efforts to improve the understanding and management of groundwater. To contextualize the components of the sustainability framework, the panel examined a series of case studies that typify examples along a spectrum, from near-sustainable, to situations that are fail to meet the outlined criteria. The panel identified the fragmentation of water management

  13. Expert Panel Reaffirms Need for Colon Cancer Screen Beginning At Age 50

    MedlinePlus

    ... key, because a positive stool test plus stool DNA test (such as Cologuard), or a positive imaging test ( ... blood in stool); and the recently approved Cologuard DNA-based stool test. The panel said there were no comparison studies ...

  14. American Academy of Nursing Expert Panel on Global Nursing and Health: white paper on Global Nursing And Health.

    PubMed

    Rosenkoetter, Marlene M; Nardi, Deena A

    2007-10-01

    The American Academy of Nursing's (AAN) Expert Panel on Global Health's white paper examines critical issues in the international nursing arena, including the global shortage of nurses, legal and ethical issues in recruiting international students for nursing positions in developed countries, the nurse faculty shortage, faculty and student exchanges, effects of the U.S. Citizenship and Immigration Services law, and laws governing new practice within the public domain. Realistic models directed toward viable solutions to these issues are critically needed. It offers 13 recommendations to address issues from a global perspective, including hosting a conference on global nursing, health research, and faculty exchanges; annual meetings; and an international conference of world nurse leaders, the AAN, and Global Panel representatives to discuss this white paper and plan follow-up actions. The final white paper approved by the AAN in 2005 and is published here to stimulate discussion regarding current and future initiatives.

  15. An Experts Survey on Sustainability Across Twenty-Seven Extensive European Systems of Grassland Management

    NASA Astrophysics Data System (ADS)

    Caballero, Rafael; Gil, Ángel; Fernández-Santos, Xavier

    2008-08-01

    European Large Scale Grazing Systems (LSGS) are at a crossroad with environmental, agronomic, and social factors interacting on their future viability. This research assesses the current environmental and socio-economic status of a wide range of European LSGS according to an agreed subset of sustainability criteria and indicators, which have been recognized by corresponding experts and privileged observers on their respective case-study system. A survey questionnaire was drafted containing five main criteria (pastoral use, environmental, economic, social, and market and development), with four conceptual-scored variables (indicators) within each criterion. Descriptive, analytical and clustering statistical techniques helped to draw a synthesis of the main result and to standardize sustainability variables across different biogeographical regions and management situations. The results show large multicollinearity among the 20 variables proposed. This dependence was revealed by the reduction to six main factor-components, which accounted for about 73% of the total variance in responses. Aggregation of point-score indicators across criteria to obtain a sustainability index can be of less policy relevance than responses to specific criteria or indicators. Affinity between case-study systems, as judged by collaborative-expert responses, was not related to biogeographical location, operating livestock sector, or population density in their areas. The results show larger weaknesses and constraints in the economic and social criteria than in the pastoral and environmental criteria, and the large heterogeneity of responses appears in the social criterion.

  16. The European Union Committee of Experts on Rare Diseases: three productive years at the service of the rare disease community

    PubMed Central

    2014-01-01

    The European Union Committee of Experts on Rare Diseases was entrusted with aiding the European Commission in a number of tasks, ranging from the monitoring of initiatives, to recommending improvements and actions to be pursued in the future, in addition to helping strengthen liaison at both European and International levels in the field of rare diseases. The three-year mandate of the EUCERD drew to a close in July 2013 with an impressive record. The EUCERD has laid down the foundations for future work so as to continue to advance in the key areas that have been identified as of interest for the rare disease community at large: centres of expertise, European Reference Networks, patient registries and databases, newborn screening, and indicators for national rare disease plans/strategies. The work of the Committee should now be continued by the newly formed European Commission Expert Group on Rare Diseases. PMID:24580800

  17. The European Union Committee of Experts on Rare Diseases: three productive years at the service of the rare disease community.

    PubMed

    Aymé, Ségolène; Rodwell, Charlotte

    2014-02-28

    The European Union Committee of Experts on Rare Diseases was entrusted with aiding the European Commission in a number of tasks, ranging from the monitoring of initiatives, to recommending improvements and actions to be pursued in the future, in addition to helping strengthen liaison at both European and International levels in the field of rare diseases. The three-year mandate of the EUCERD drew to a close in July 2013 with an impressive record. The EUCERD has laid down the foundations for future work so as to continue to advance in the key areas that have been identified as of interest for the rare disease community at large: centres of expertise, European Reference Networks, patient registries and databases, newborn screening, and indicators for national rare disease plans/strategies. The work of the Committee should now be continued by the newly formed European Commission Expert Group on Rare Diseases.

  18. European Experimental Re-Entry Testbed EXPERT: Qualification of Payloads for Flight

    NASA Astrophysics Data System (ADS)

    Ratti, F.; Gavira, J.; Thirkettle, A. C.; Erba, F.; Muylaert, J.-M.; Walpot, L.; Rembiasz, J. M.

    2009-01-01

    The European Experimental Re-entry Test-bed EXPERT is developed by the European Space Agency (ESA) as part of its General Technological Research Program (GSTP). The aim of EXPERT is to improve the understanding of critical aero-thermodynamic phenomena associated with hypersonic re-entry flights. The EXPERT project provides an opportunity to the scientific community and industries throughout Europe to propose and perform experiments in order to obtain aero-thermodynamic data for the validation of numerical models and of ground to flight extrapolation methodologies. During the last years an intense activity has been performed at ESA in order to select the most suitable experiments, bring them to a mature design, manufacture the qualification model and qualify the experiments for flight. ESA staffs coordinated and supported the work of the principal investigators of the experiments from European institutions and industrial organizations in order to maximize the scientific output in compliance with the budget resources made available to the EXPERT project and the programmatic constraints. EXPERT is a re-entry capsule having the shape of a blunted cone. The front part consists of a nose made of ceramic material developed at DLR Stuttgart. No ablative material is implemented so as not to contaminate the specific measurements of Payloads on board. The ceramic nose hosts a set of experiments: the Flush Air Data System (FADS) developed by HTG aiming at collecting free flow data required for post flight analysis, the pyrometer PYREX developed at IRS in Stuttgart collecting data on the temperature and heat flux of the ceramic nose, and the IRS spectrometer RESPECT aiming at resolving the different species generated in the plasma region during re-entry. The sides of the blunted cone are protected by a metallic thermal protection system in which several experiments are located. Two Payloads developed by IRS and VKI are dedicated to the measurement of catalytic effects. One aims

  19. The health hazards posed by chromium-contaminated soils in residential and industrial areas: Conclusions of an expert panel

    SciTech Connect

    Paustenbach, D.J.; Rinehart, W.E.; Sheehan, P.J. )

    1991-04-01

    Between 1905 and 1971, over 2 million tons of residue from chromite ore processing was generated in Hudson County, New Jersey, of which substantial amounts were used as fill and tank diking. A panel of medical, toxicology, and risk assessment experts was convened in early 1990 to evaluate the potential health hazards posed by the resulting chromium contaminated soil. The Panel concluded that soils containing concentrations of 75 ppm hexavalent chromium (Cr(VI)) and 1000 ppm total chromium compounds (about 95% was trivalent chromium (Cr(III))) did not pose a significant health hazard to nearby residents and workers. They also determined that exposure to chromium from Hudson County sites posed a negligible cancer hazard to residents. Using risk assessment methods, the Panel estimated that the plausible incremental cancer risk to individuals at residential sites would be substantially less than 1 in 1,000,000. The average measured levels of airborne Cr(VI) at typical industrial sites were more than 1000-fold lower than the current OSHA Permissible Exposure Limit (PEL). The maximum plausible increased cancer risk for an average worker at a dusty industrial site was estimated to be less than 1 in 100,000. The Panel also concluded that chromium-containing crystals, which have occasionally been found in Hudson County buildings, do not pose a significant hazard. However, they suggested that were the concentration to exceed 5000 ppm Cr(VI) in the crystals, site-specific health risk assessments would be conducted and remediation considered. The Panel evaluated the dermal hazard posed by chromium-contaminated soil and acknowledged that there is a small group of persons ({approximately} 0.1% of the United States population) who currently have a dermal sensitization to Cr(VI) primarily through occupational exposure.

  20. Expert Panel Recommendations for Hanford Double-Shell Tank Life Extension

    SciTech Connect

    Stewart, Charles W; Bush, Spencer H; Berman, Herbert Stanton; Czajkowski, Carl J; Divine, James R; Posakony, Gerald J; Johnson, A B; Elmore, Monte R; Reynolds, D A; Anantatmula, Ramamohan P; Sindelar, Robert L; Zapp, Philip E

    2001-06-29

    Expert workshops were held in Richland in May 2001 to review the Hanford Double-Shell Tank Integrity Project and make recommendations to extend the life of Hanford's double-shell waste tanks. The workshop scope was limited to corrosion of the primary tank liner, and the main areas for review were waste chemistry control, tank inspection, and corrosion monitoring. Participants were corrosion experts from Hanford, Savannah River Site, Brookhaven National Lab., Pacific Northwest National Lab., and several consultants. This report describes the current state of the three areas of the program, the final recommendations of the workshop, and the rationale for their selection.

  1. Highlights of the Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents.

    ERIC Educational Resources Information Center

    National Heart, Lung, and Blood Inst. (DHHS/NIH), Bethesda, MD.

    Studies have shown that high blood cholesterol levels play a role in the development of coronary heart disease in adults, and that the process leading to atherosclerosis begins in childhood. To address the problem of high cholesterol levels in children, the Panel on Blood Cholesterol Levels recommends complementary approaches for individuals and…

  2. Heart Rhythm Monitoring in the Constellation Lunar and Launch/Landing EVA Suit: Recommendations from an Expert Panel

    NASA Technical Reports Server (NTRS)

    Scheuring, Richard A.; Hamilton, D.; Jones, J. A.; Alexander, D.

    2008-01-01

    Currently there are several physiological monitoring requirements for Extravehicular Activity (EVA) in the Human-Systems Interface Requirements (HSIR) document, including continuous heart rhythm monitoring. However, it is not known whether heart rhythm monitoring in the lunar surface space suit is a necessary capability for lunar surface operations or in launch/landing suit the event of a cabin depressurization enroute to or from the moon. Methods: Current US astronaut corps demographic information was provided to an expert panel of cardiovascular medicine experts, including specialists in electrophysiology, exercise physiology, interventional cardiology and arrhythmia. This information included averages for male/female age, body mass index (BMI), blood pressure, cholesterol, inflammatory markers, echocardiogram, ranges for coronary artery calcium (CAC) scores for long duration astronauts, and ranges for heart rate (HR) and metabolic (MET) rates obtained during microgravity and lunar EVA. Results: The panel determined that no uncontrolled hazard was likely to occur in the suit during lunar surface or contingency microgravity ops that would require ECG monitoring in the highly screened US astronaut population. However having the capability for rhythm monitoring inside the vehicle (IVA) was considered critical to manage an astronaut in distress. Discussion: Heart rate (HR) monitoring alone allows effective monitoring of astronaut health and function. Consequently, electrocardiographic (ECG) monitoring capability as a clinical tool is not essential in the lunar or launch/landing space suit. However, the panel considered that rhythm monitoring could be useful in certain clinical situations, it was not considered required for safe operations. Also, lunar vehicles should be required to have ECG monitoring capability with a minimum of 5-lead ECG (derived 12- lead) for IVA medical assessments.

  3. Expert Panel Consensus for and Analysis of Key Attributes on Websites Devoted to Weight Control

    ERIC Educational Resources Information Center

    Brown, Stephen L.; Land, Diane; Johnson, Chandrika; Miller, Kim

    2014-01-01

    Background: Obesity presents major challenges to public health in the United States. Trials of web-based interventions for weight control suggest that the Internet is a promising option for program delivery. Purpose: This study sought consensus among experts regarding critical components of successful weight control and to systematically examine…

  4. Heart Rhythm Monitoring in the Constellation Lunar and Launch/Landing EVA Suit: Recommendations from an Expert Panel

    NASA Technical Reports Server (NTRS)

    Scheuring, Richard A.; Hamilton, Doug; Jones, Jeffrey A.; Alexander, David

    2009-01-01

    There are currently several physiological monitoring requirements for EVA in the Human-Systems Interface Requirements (HSIR) document. There are questions as to whether the capability to monitor heart rhythm in the lunar surface space suit is a necessary capability for lunar surface operations. Similarly, there are questions as to whether the capability to monitor heart rhythm during a cabin depressurization scenario in the launch/landing space suit is necessary. This presentation seeks to inform space medicine personnel of recommendations made by an expert panel of cardiovascular medicine specialists regarding in-suit ECG heart rhythm monitoring requirements during lunar surface operations. After a review of demographic information and clinical cases and panel discussion, the panel recommended that ECG monitoring capability as a clinical tool was not essential in the lunar space suit; ECG monitoring was not essential in the launch/landing space suit for contingency scenarios; the current hear rate monitoring capability requirement for both launch/landing and lunar space suits should be maintained; lunar vehicles should be required to have ECG monitoring capability with a minimum of 5-lead ECG for IVA medical assessments; and, exercise stress testing for astronaut selection and retention should be changed from the current 85% maximum heart rate limit to maximal, exhaustive 'symptom-limited' testing to maximize diagnostic utility as a screening tool for evaluating the functional capacity of astronauts and their cardiovascular health.

  5. The role of nutrition for pressure ulcer management: national pressure ulcer advisory panel, European pressure ulcer advisory panel, and pan pacific pressure injury alliance white paper.

    PubMed

    Posthauer, Mary Ellen; Banks, Merrilyn; Dorner, Becky; Schols, Jos M G A

    2015-04-01

    Nutrition and hydration play an important role in preserving skin and tissue viability and in supporting tissue repair for pressure ulcer (PrU) healing. The majority of research investigating the relationship between nutrition and wounds focuses on PrUs. This white paper reviews the 2014 National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance Nutrition Guidelines and discusses nutrition strategies for PrU management.

  6. Advancing the future of physical activity guidelines in Canada: an independent expert panel interpretation of the evidence

    PubMed Central

    2010-01-01

    The Canadian Society for Exercise Physiology, in partnership with the Public Health Agency of Canada, has initiated a review of their physical activity guidelines to promote healthy active living for Canadian children, youth, adults and older adults; previous guidelines were released in 2002, 2002, 1998 and 1999 respectively. Several background papers from this project were published recently and provide foundation evidence upon which to base new guidelines. Furthermore, comprehensive systematic reviews were completed to ensure a rigorous evaluation of evidence informing the revision of physical activity guidelines for asymptomatic populations. The overall guideline development process is being guided and assessed by the AGREE II instrument. A meeting of experts was convened to present the evidence complied to inform the guideline revisions. An independent expert panel was assembled to review the background materials and systematic reviews; listen to the presentations and discussions at the expert meeting; ask for clarification; and produce the present paper representing their interpretation of the evidence including grading of the evidence and their identification of needs for future research. The paper includes also their recommendations for evidence-informed physical activity guidelines. PMID:20459785

  7. The view of European experts regarding health economics for medical nutrition in disease-related malnutrition.

    PubMed

    Freijer, K; Lenoir-Wijnkoop, I; Russell, C A; Koopmanschap, M A; Kruizenga, H M; Lhachimi, S K; Norman, K; Nuijten, M J C; Schols, J M G A

    2015-05-01

    Health-care systems are currently facing tremendous budget constraints resulting in growing pressure on decision makers and health-care providers to obtain the maximum possible health benefits of the resources available. Choices have to be made, and health economics can help in allocating limited health-care resources among unlimited wants and needs. Attempts to achieve cost reductions often focus on severe pathologies and chronic diseases as they commonly represent high health-care expenditures. In this context, awareness of the considerable financial burden caused by disease-related malnutrition (DRM) is lacking. Possibilities of reducing costs by optimising the management of DRM through medical nutrition will mostly not even be taken into account. During a European expert meeting, the total evaluation of medical nutrition was viewed and discussed. The aim of this meeting was to gain an experts' outline of the key issues relating to the health economic assessment of the use of medical nutrition. This article provides a summary of the observations per discussed item and describes the next steps suggested.

  8. Expert panel answers questions for Super Safety and Health Day at KSC.

    NASA Technical Reports Server (NTRS)

    1999-01-01

    A panel of NASA and contractor senior staff, plus officers from the 45th Space Wing, discuss safety- and health-related concerns in front of an audience of KSC employees as part of Super Safety and Health Day. Moderating at the podium is Loren Shriver, deputy director for Launch & Payload Processing. Seated left to right are Burt Summerfield, associate director of the Biomedical Office; Colonel William S. Swindling, commander, 45th Medical Group, Patrick Air Force Base, Fla.; Ron Dittemore, manager, Space Shuttle Programs, Johnson Space Center; Roy Bridges, Center Director; Col. Tom Deppe, vice commander, 45th Space Wing, Patrick Air Force Base; Jim Schoefield, program manager, Payload Ground Operations, Boeing; Bill Hickman, program manager, Space Gateway Support; and Ed Adamek, vice president and associate program manager for Ground Operations, United Space Alliance. Answering a question at the microphone on the floor is Dave King, director, Shuttle Processing. The panel was one of the presentations during KSC's second annual day-long dedication to safety. Most normal work activities were suspended to allow personnel to attend related activities. The theme, 'Safety and Health Go Hand in Hand,' emphasized KSC's commitment to place the safety and health of the public, astronauts, employees and space- related resources first and foremost. Events also included a keynote address, vendor exhibits, and safety training in work groups. The keynote address and panel session were also broadcast internally over NASA television.

  9. Expert panel answers questions for Super Safety and Health Day at KSC.

    NASA Technical Reports Server (NTRS)

    1999-01-01

    A panel of NASA and contractor senior staff, plus officers from the 45th Space Wing, discuss safety- and health-related concerns in front of an audience of KSC employees, as part of Super Safety and Health Day. Moderating at the podium is Loren Shriver, deputy director for Launch & Payload Processing. Seated left to right are Burt Summerfield, associate director of the Biomedical Office; Colonel William S. Swindling, commander, 45th Medical Group, Patrick Air Force Base, Fla.; Ron Dittemore, manager, Space Shuttle Programs, Johnson Space Center; Roy Bridges, Center Director; Col. Tom Deppe, vice commander, 45th Space Wing, Patrick Air Force Base; Jim Schoefield, program manager, Payload Ground Operations, Boeing; Bill Hickman, program manager, Space Gateway Support; and Ed Adamek, vice president and associate program manager for Ground Operations, United Space Alliance. The panel was one of the presentations during KSC's second annual day-long dedication to safety. Most normal work activities were suspended to allow personnel to attend related activities. The theme, 'Safety and Health Go Hand in Hand,' emphasized KSC's commitment to place the safety and health of the public, astronauts, employees and space-related resources first and foremost. Events also included a keynote address, vendor exhibits, and safety training in work groups. The keynote address and panel session were also broadcast internally over NASA television.

  10. Use of technical expert panels: Applications to probabilistic seismic hazard analysis

    SciTech Connect

    Budnitz, R.J.; Apostolakis, G.; Boore, D.M.; Cluff, L.S.; Coppersmith, K.J.; Cornell, C.A.; Morris, P.A.

    1998-08-01

    Probabilistic Seismic Hazard Analysis (PSHA) is a methodology that estimates the likelihood that various levels of earthquake-caused ground motions will be exceeded at a given location in a given future time period. Due to large uncertainties in all of the geosciences data and in their modeling, multiple model interpretations are often possible. This leads to disagreements among the experts, which in the past has led to disagreement on the selection of a ground motion for design at a given site. This paper reports on a project, co-sponsored by the US Nuclear Regulatory Commission, the US Department of Energy, and the Electric Power Research Institute, that was undertaken to review the state-of-the-art and improve on the overall stability of the PSHA process, by providing methodological guidance on how to perform a PSHA. The project reviewed past studies and examined ways to improve on the present state-of-the-art. In analyzing past PSHA studies, the most important conclusion is that differences in PSHA results are commonly due to process rather than technical differences. Thus, the project concentrated heavily on developing process recommendations, especially on the use of multiple experts, and this paper reports on those process recommendations. The problem of facilitating and integrating the judgments of a diverse group of experts is analyzed in detail. The authors believe that the concepts and process principles apply just as well to non-earthquake fields such as volcanic hazard, flood risk, nuclear-plant safety, and climate change.

  11. Enlargement Futures Project: Expert Panel on Technology, Knowledge and Learning. Final Report.

    ERIC Educational Resources Information Center

    Gourova, Elissaveta; Ducatel, Ken; Gavigan, James; Scapolo, Fabiana; Di Pietrogiacomo, Paola

    The next 10 years provide an opportunity for the European Union (EU) to renew the science and technology (S&T) base and build necessary knowledge-society capacities and capabilities in Pre-Accession Countries (PACs). Applied research has faced a major downsize; redressing the balance in the research and development systems is urgently needed.…

  12. Magmaris preliminary recommendation upon commercial launch: a consensus from the expert panel on 14 April 2016.

    PubMed

    Fajadet, Jean; Haude, Michael; Joner, Michael; Koolen, Jacques; Lee, Michael; Tölg, Ralph; Waksman, Ron

    2016-09-18

    Bioresorbable scaffolds represent an exciting milestone in the development of coronary stent technology with the potential to substantially improve the management of patients with coronary artery disease. In an attempt to provide first recommendations for the technology, experienced experts involved in the first-in-man studies met in Zurich on the 14 April 2016 in order to reach consensus on a responsible market introduction. This document will be updated regularly as new information from clinical trials becomes available and should be understood as a review of current data, opportunities, expectations, advice, and recommendations for future investigations.

  13. Magmaris preliminary recommendation upon commercial launch: a consensus from the expert panel on 14 April 2016.

    PubMed

    Fajadet, Jean; Haude, Michael; Joner, Michael; Koolen, Jacques; Lee, Michael; Tölg, Ralph; Waksman, Ron

    2016-09-18

    Bioresorbable scaffolds represent an exciting milestone in the development of coronary stent technology with the potential to substantially improve the management of patients with coronary artery disease. In an attempt to provide first recommendations for the technology, experienced experts involved in the first-in-man studies met in Zurich on the 14 April 2016 in order to reach consensus on a responsible market introduction. This document will be updated regularly as new information from clinical trials becomes available and should be understood as a review of current data, opportunities, expectations, advice, and recommendations for future investigations. PMID:27639734

  14. Conclusions of the expert panel: importance of erlotinib as a second-line therapeutic option

    PubMed Central

    Castagnari, Aldo

    2008-01-01

    During the Experts Meeting on Lung Cancer, participants emphasized the usefulness of erlotinib as second-line therapy for lung cancer. They noted that, although there are no comparative studies, erlotinib could be as effective as docetaxel and pemetrexed in second-line therapy. Regarding the toxicity profile of each of these drugs – one of the key issues considered in the meeting – specialists pointed out how important it is to clearly identify existing differences in this issue. Each drug has different degrees of toxicity, and this information is crucial at the time of choosing the therapeutic regimen. Erlotinib treatment could be an effective option for second-line therapy. PMID:18831720

  15. Final report of the Cosmetic Ingredient Review Expert Panel amended safety assessment of Calendula officinalis-derived cosmetic ingredients.

    PubMed

    Andersen, F Alan; Bergfeld, Wilma F; Belsito, Donald V; Hill, Ronald A; Klaassen, Curtis D; Liebler, Daniel C; Marks, James G; Shank, Ronald C; Slaga, Thomas J; Snyder, Paul W

    2010-01-01

    Calendula officinalis extract, C officinalis flower, C officinalis flower extract, C officinalis flower oil, and C officinalis seed oil are cosmetic ingredients derived from C officinalis. These ingredients may contain minerals, carbohydrates, lipids, phenolic acids, flavonoids, tannins, coumarins, sterols and steroids, monoterpenes, sesquiterpenes, triterpenes, tocopherols, quinones, amino acids, and resins. These ingredients were not significantly toxic in single-dose oral studies using animals. The absence of reproductive/developmental toxicity was inferred from repeat-dose studies of coriander oil, with a similar composition. Overall, these ingredients were not genotoxic. They also were not irritating, sensitizing, or photosensitizing in animal or clinical tests but may be mild ocular irritants. The Cosmetic Ingredient Review (CIR) Expert Panel concluded that these ingredients are safe for use in cosmetics in the practices of use and concentration given in this amended safety assessment. PMID:21164072

  16. Multi-criteria decision analysis for health technology assessment in Canada: insights from an expert panel discussion.

    PubMed

    Diaby, Vakaramoko; Goeree, Ron; Hoch, Jeffrey; Siebert, Uwe

    2015-02-01

    Multi-criteria decision analysis (MCDA), a decision-making tool, has received increasing attention in recent years, notably in the healthcare field. For Canada, it is unclear whether and how MCDA should be incorporated into the existing health technology assessment (HTA) decision-making process. To facilitate debate on improving HTA decision-making in Canada, a workshop was held in conjunction with the 8th World Congress on Health Economics of the International Health Economics Association in Toronto, Canada in July 2011. The objective of the workshop was to discuss the potential benefits and challenges related to the use of MCDA for HTA decision-making in Canada. This paper summarizes and discusses the recommendations of an expert panel convened at the workshop to discuss opportunities and concerns with reference to the implementation of MCDA in Canada.

  17. Toward Earlier Inclusion of Pregnant and Postpartum Women in Tuberculosis Drug Trials: Consensus Statements From an International Expert Panel.

    PubMed

    Gupta, Amita; Mathad, Jyoti S; Abdel-Rahman, Susan M; Albano, Jessica D; Botgros, Radu; Brown, Vikki; Browning, Renee S; Dawson, Liza; Dooley, Kelly E; Gnanashanmugam, Devasena; Grinsztejn, Beatriz; Hernandez-Diaz, Sonia; Jean-Philippe, Patrick; Kim, Peter; Lyerly, Anne D; Mirochnick, Mark; Mofenson, Lynne M; Montepiedra, Grace; Piper, Jeanna; Sahin, Leyla; Savic, Radojka; Smith, Betsy; Spiegel, Hans; Swaminathan, Soumya; Watts, D Heather; White, Amina

    2016-03-15

    Tuberculosis is a major cause of morbidity and mortality in women of childbearing age (15-44 years). Despite increased tuberculosis risk during pregnancy, optimal clinical treatment remains unclear: safety, tolerability, and pharmacokinetic data for many tuberculosis drugs are lacking, and trials of promising new tuberculosis drugs exclude pregnant women. To advance inclusion of pregnant and postpartum women in tuberculosis drug trials, the US National Institutes of Health convened an international expert panel. Discussions generated consensus statements (>75% agreement among panelists) identifying high-priority research areas during pregnancy, including: (1) preventing progression of latent tuberculosis infection, especially in women coinfected with human immunodeficiency virus; (2) evaluating new agents/regimens for treatment of multidrug-resistant tuberculosis; and (3) evaluating safety, tolerability and pharmacokinetics of tuberculosis drugs already in use during pregnancy and postpartum. Incorporating pregnant women into clinical trials would extend evidence-based tuberculosis prevention and treatment standards to this special population. PMID:26658057

  18. Final report of the Cosmetic Ingredient Review Expert Panel amended safety assessment of Calendula officinalis-derived cosmetic ingredients.

    PubMed

    Andersen, F Alan; Bergfeld, Wilma F; Belsito, Donald V; Hill, Ronald A; Klaassen, Curtis D; Liebler, Daniel C; Marks, James G; Shank, Ronald C; Slaga, Thomas J; Snyder, Paul W

    2010-01-01

    Calendula officinalis extract, C officinalis flower, C officinalis flower extract, C officinalis flower oil, and C officinalis seed oil are cosmetic ingredients derived from C officinalis. These ingredients may contain minerals, carbohydrates, lipids, phenolic acids, flavonoids, tannins, coumarins, sterols and steroids, monoterpenes, sesquiterpenes, triterpenes, tocopherols, quinones, amino acids, and resins. These ingredients were not significantly toxic in single-dose oral studies using animals. The absence of reproductive/developmental toxicity was inferred from repeat-dose studies of coriander oil, with a similar composition. Overall, these ingredients were not genotoxic. They also were not irritating, sensitizing, or photosensitizing in animal or clinical tests but may be mild ocular irritants. The Cosmetic Ingredient Review (CIR) Expert Panel concluded that these ingredients are safe for use in cosmetics in the practices of use and concentration given in this amended safety assessment.

  19. Levosimendan beyond inotropy and acute heart failure: Evidence of pleiotropic effects on the heart and other organs: An expert panel position paper.

    PubMed

    Farmakis, Dimitrios; Alvarez, Julian; Gal, Tuvia Ben; Brito, Dulce; Fedele, Francesco; Fonseca, Candida; Gordon, Anthony C; Gotsman, Israel; Grossini, Elena; Guarracino, Fabio; Harjola, Veli-Pekka; Hellman, Yaron; Heunks, Leo; Ivancan, Visnja; Karavidas, Apostolos; Kivikko, Matti; Lomivorotov, Vladimir; Longrois, Dan; Masip, Josep; Metra, Marco; Morelli, Andrea; Nikolaou, Maria; Papp, Zoltán; Parkhomenko, Alexander; Poelzl, Gerhard; Pollesello, Piero; Ravn, Hanne Berg; Rex, Steffen; Riha, Hynek; Ricksten, Sven-Erik; Schwinger, Robert H G; Vrtovec, Bojan; Yilmaz, M Birhan; Zielinska, Marzenna; Parissis, John

    2016-11-01

    Levosimendan is a positive inotrope with vasodilating properties (inodilator) indicated for decompensated heart failure (HF) patients with low cardiac output. Accumulated evidence supports several pleiotropic effects of levosimendan beyond inotropy, the heart and decompensated HF. Those effects are not readily explained by cardiac function enhancement and seem to be related to additional properties of the drug such as anti-inflammatory, anti-oxidative and anti-apoptotic ones. Mechanistic and proof-of-concept studies are still required to clarify the underlying mechanisms involved, while properly designed clinical trials are warranted to translate preclinical or early-phase clinical data into more robust clinical evidence. The present position paper, derived by a panel of 35 experts in the field of cardiology, cardiac anesthesiology, intensive care medicine, cardiac physiology, and cardiovascular pharmacology from 22 European countries, compiles the existing evidence on the pleiotropic effects of levosimendan, identifies potential novel areas of clinical application and defines the corresponding gaps in evidence and the required research efforts to address those gaps.

  20. Income Inequality and Self-Rated Health Status: Evidence from the European Community Household Panel

    PubMed Central

    HILDEBRAND, VINCENT; VAN KERM, PHILIPPE

    2009-01-01

    We examine the effect of income inequality on individuals’ self-rated health status in a pooled sample of 11 countries, using longitudinal data from the European Community Household Panel survey. Taking advantage of the longitudinal and cross-national nature of our data, and carefully modeling the self-reported health information, we avoid several of the pitfalls suffered by earlier studies on this topic. We calculate income inequality indices measured at two standard levels of geography (NUTS-0 and NUTS-1) and find consistent evidence that income inequality is negatively related to self-rated health status in the European Union for both men and women, particularly when measured at national level. However, despite its statistical significance, the magnitude of the impact of inequality on health is very small. PMID:20084830

  1. Income inequality and self-rated health status: evidence from the European Community Household Panel.

    PubMed

    Hildebrand, Vincent; Van Kerm, Philippe

    2009-11-01

    We examine the effect of income inequality on individuals' self-rated health status in a pooled sample of 11 countries, using longitudinal data from the European Community Household Panel survey. Taking advantage of the longitudinal and cross-national nature of our data, and carefully modeling the self-reported health information, we avoid several of the pitfalls suffered by earlier studies on this topic. We calculate income inequality indices measured at two standard levels of geography (NUTS-0 and NUTS-1) and find consistent evidence that income inequality is negatively related to self-rated health status in the European Union for both men and women, particularly when measured at national level. However, despite its statistical significance, the magnitude of the impact of inequality on health is very small.

  2. Improving Health Outcomes for Patients with Depression: A Population Health Imperative. Report on an Expert Panel Meeting

    PubMed Central

    Skoufalos, Alexis; Medalia, Alice; Fendrick, A. Mark

    2016-01-01

    Improving Health Outcomes for Patients with Depression: A Population Health Imperative. Report on an Expert Panel Meeting Janice L. Clarke, RN, Alexis Skoufalos, EdD, Alice Medalia, PhD, and A. Mark Fendrick, MD Editorial: A Call to Action: David B. Nash, MD, MBA   S-2 Overview: Depression and the Population Health Imperative   S-3 Promoting Awareness of the Issues and Opportunities for Improvement   S-5 Cognitive Dysfunction in Affective Disorders   S-5 Critical Role of Employers in Improving Health Outcomes for Employees with Depression   S-6 Closing the Behavioral Health Professional and Process Gaps   S-6 Achieving the Triple Aim for Patients with Depressive Disorders   S-6 Improving the Experience of Care for Patients with Depression   S-6 Improving Quality of Care and Health Outcomes for Patients with Depression   S-7 Changing the Cost of Care Discussion from How Much to How Well   S-8 Panel Insights and Recommendations   S-9 Conclusion   S-10 PMID:27636743

  3. Expert panel workshop consensus statement on the role of the environment in the development of autoimmune disease.

    PubMed

    Parks, Christine G; Miller, Frederick W; Pollard, Kenneth Michael; Selmi, Carlo; Germolec, Dori; Joyce, Kelly; Rose, Noel R; Humble, Michael C

    2014-08-15

    Autoimmune diseases include 80 or more complex disorders characterized by self-reactive, pathologic immune responses in which genetic susceptibility is largely insufficient to determine disease onset. In September 2010, the National Institute of Environmental Health Sciences (NIEHS) organized an expert panel workshop to evaluate the role of environmental factors in autoimmune diseases, and the state of the science regarding relevant mechanisms, animal models, and human studies. The objective of the workshop was to analyze the existing data to identify conclusions that could be drawn regarding environmental exposures and autoimmunity and to identify critical knowledge gaps and areas of uncertainty for future study. This consensus document summarizes key findings from published workshop monographs on areas in which "confident" and "likely" assessments were made, with recommendations for further research. Transcribed notes and slides were reviewed to synthesize an overview on exposure assessment and questions addressed by interdisciplinary panels. Critical advances in the field of autoimmune disease research have been made in the past decade. Collaborative translational and interdisciplinary research is needed to elucidate the role of environmental factors in autoimmune diseases. A focus on exposure assessment methodology is needed to improve the effectiveness of human studies, and more experimental studies are needed to focus on causal mechanisms underlying observed associations of environmental factors with autoimmune disease in humans.

  4. Improving Health Outcomes for Patients with Depression: A Population Health Imperative. Report on an Expert Panel Meeting.

    PubMed

    Clarke, Janice L; Skoufalos, Alexis; Medalia, Alice; Fendrick, A Mark

    2016-09-01

    Improving Health Outcomes for Patients with Depression: A Population Health Imperative. Report on an Expert Panel Meeting Janice L. Clarke, RN, Alexis Skoufalos, EdD, Alice Medalia, PhD, and A. Mark Fendrick, MD Editorial: A Call to Action : David B. Nash, MD, MBA   S-2 OVERVIEW: Depression and the Population Health Imperative    S-3 Promoting Awareness of the Issues and Opportunities for Improvement    S-5 Cognitive Dysfunction in Affective Disorders    S-5 Critical Role of Employers in Improving Health Outcomes for Employees with Depression    S-6 Closing the Behavioral Health Professional and Process Gaps    S-6 Achieving the Triple Aim for Patients with Depressive Disorders    S-6 Improving the Experience of Care for Patients with Depression    S-6 Improving Quality of Care and Health Outcomes for Patients with Depression    S-7 Changing the Cost of Care Discussion from How Much to How Well    S-8 Panel Insights and Recommendations    S-9 Conclusion    S-10. PMID:27636743

  5. Meeting the public health challenge of protecting private wells: Proceedings and recommendations from an expert panel workshop.

    PubMed

    Fox, Mary A; Nachman, Keeve E; Anderson, Breeana; Lam, Juleen; Resnick, Beth

    2016-06-01

    Private wells serving fewer than 25 people are federally unregulated, and their users may be exposed to naturally occurring agents of concern such as arsenic and radionuclides, as well as anthropogenic contaminants. The Centers for Disease Control and Prevention's Clean Water for Health Program works to protect private wells and prevent adverse health outcomes for the roughly 15% of Americans who rely on them. To understand current and emerging challenges to the private drinking water supply, an interdisciplinary expert panel workshop on "Future and Emerging Issues for Private Wells" was organized to inform strategic planning for the Clean Water for Health Program. The panel assessed current conditions of ground water as a source for private wells, identified emerging threats, critical gaps in knowledge, and public health needs, and recommended strategies to guide future activities to ensure the safety of private drinking water wells. These strategies addressed topics of broad interest to the environmental public health community including: development of new methods to support citizen science; addressing contaminant mixtures; expanding capacity for well testing; evaluating treatment technologies; building an evidence base on best practices on well owner outreach and stewardship; and research and data needs.

  6. Is this the new smoking? An expert panel review of the York University OHV health benefits study.

    PubMed

    Bissix, Glyn; MacCormick, Keith; Milburn, Chris

    2013-03-01

    Recently, a study by Burr and his associates culminating in three peer reviewed journal articles and a string of press releases emanating from the off-highway vehicle (OHV) industry claimed that increasing riding time on all terrain recreational vehicles (ATVs) and off road motorcycles (ORMs) could meet the basic guidelines of the American College of Sports Medicine and Health Canada for sufficient physical activity leading to positive health adaptations. Should this be true, this study could revolutionize the way that health professionals prescribe physical activity. To examine the efficacy of these claims, the authors convened an expert panel to examine these publications to particularly focus on the problem conceptualization, the research methodology including sample selection and controls, the presentation and interpretation of results and the veracity of their conclusions. The experts concluded, while never questioning the laboratory and field measurements, that there were a number of conceptual, methodological and interpretive limitations and errors that rendered the claims of health benefits indefensible. Furthermore, the researchers largely failed to take account of the healthcare costs associated with riding OHVs which according to the epidemiology literature, and particularly for ATVs, are considerable.

  7. Clinical practice guidelines for the management of invasive Candida infections in adults in the Middle East region: Expert panel recommendations.

    PubMed

    Alothman, Adel F; Al-Musawi, Tariq; Al-Abdely, Hail M; Salman, Jameela Al; Almaslamani, Muna; Yared, Nadine; Butt, Adeel A; Raghubir, Nirvana; Morsi, Waleed El; Al Thaqafi, Abdulhakeem O

    2014-02-01

    Invasive Candida infections contribute to significant morbidity and mortality in patients with healthcare-associated infections. They represent a major burden on the public health system, and are challenging to diagnose and treat. A multidisciplinary expert panel critically reviewed available evidence to provide consensus recommendations for the management of invasive Candida infections in the Middle East. Based on diagnosis, recommendations were provided for the management of Candida infections in non-neutropenic and neutropenic patients. Polyenes (amphotericin B-deoxycholate [AmB-d] and lipid formulations amphotericin B [LFAmB]), triazoles (fluconazole, itraconazole and voriconazole), echinocandins (caspofungin, anidulafungin, and micafungin) and flucytosine are the recommended categories of antifungal agents for treatment of Candida infections. Echinocandins are preferred for treatment of proven and suspected Candida infections, especially in critically ill patients or those with previous exposure to azoles. Recommendations were also provided for infections caused by specific Candida species as well as management of different disease conditions. The experts highlighted that the guidelines should be used along with clinical judgment. Given the paucity of published data from the region, research in the form of randomized clinical trials should be given priority. PMID:24035607

  8. Probability encoding of hydrologic parameters for basalt. Elicitation of expert opinions from a panel of five consulting hydrologists

    SciTech Connect

    Runchal, A.K.; Merkhofer, M.W.; Olmsted, E.; Davis, J.D.

    1984-11-01

    The Columbia River basalts underlying the Hanford Site in Washington State are being considered as a possible location for a geologic repository for high-level nuclear waste. To investigate the feasibility of a repository at this site, the hydrologic parameters of the site must be evaluated. Among hydrologic parameters of particular interest are the effective porosity of the Cohassett basalt flow top and flow interior and the vertical-to-horizontal hydraulic conductivity, or anisotropy ratio, of the Cohassett basalt flow interior. The Cohassett basalt flow is the prime candidate horizon for repository studies. Site-specific data for these hydrologic parameters are currently inadequate for the purpose of preliminary assessment of candidate repository performance. To obtain credible, auditable, and independently derived estimates of the specified hydrologic parameters, a panel of five nationally recognized hydrologists was assembled. Their expert judgments were quantified during two rounds of Delphi process by means of a probability encoding method developed to estimate the probability distributions of the selected hydrologic variables. The results indicate significant differences of expert opinion for cumulative probabilities of less than 10% and greater than 90%, but relatively close agreement in the middle ranges of values. The principal causes of the diversity of opinion are believed to be the lack of site-specific data and the absence of a single, widely accepted, conceptual or theoretical basis for analyzing these variables.

  9. Food, plant food, and vegetarian diets in the US dietary guidelines: conclusions of an expert panel.

    PubMed

    Jacobs, David R; Haddad, Ella H; Lanou, Amy Joy; Messina, Mark J

    2009-05-01

    We summarize conclusions drawn from a panel discussion at the "Fifth International Congress on Vegetarian Nutrition" about the roles of and emphasis on food, plant food, and vegetarianism in current and future US dietary guidelines. The most general recommendation of the panel was that future dietary guidelines, following the lead of the 2005 Dietary Guidelines Advisory Committee, should emphasize food-based recommendations and thinking to the full extent that evidence allows. Although nutrient-based thinking and Dietary Reference Intakes (DRIs) may help ensure an adequate diet in the sense that deficiency states are avoided, the emphasis on DRIs may not capture many important nutritional issues and may inhibit a focus on foods. More generally, in the context of the conference on vegetarian nutrition, this report focuses on the history and structure of the Dietary Guidelines Advisory Committee, on various plant food-oriented recommendations that are supported by literature evidence, and on mechanisms for participating in the process of forming dietary guidelines. Among recommendations that likely would improve health and the environment, some are oriented toward increased plant food consumption and some toward vegetarianism. The literature on health effects of individual foods and whole lifestyle diets is insufficient and justifies a call for future food-oriented research, including expanding the evidence base for plant-based and vegetarian diets. The Dietary Guidelines Advisory Committee's role should be carried forward to creation of a publicly accessible icon (eg, the current pyramid) and related materials to ensure that the science base is fully translated for the public.

  10. Food, plant food, and vegetarian diets in the US dietary guidelines: conclusions of an expert panel.

    PubMed

    Jacobs, David R; Haddad, Ella H; Lanou, Amy Joy; Messina, Mark J

    2009-05-01

    We summarize conclusions drawn from a panel discussion at the "Fifth International Congress on Vegetarian Nutrition" about the roles of and emphasis on food, plant food, and vegetarianism in current and future US dietary guidelines. The most general recommendation of the panel was that future dietary guidelines, following the lead of the 2005 Dietary Guidelines Advisory Committee, should emphasize food-based recommendations and thinking to the full extent that evidence allows. Although nutrient-based thinking and Dietary Reference Intakes (DRIs) may help ensure an adequate diet in the sense that deficiency states are avoided, the emphasis on DRIs may not capture many important nutritional issues and may inhibit a focus on foods. More generally, in the context of the conference on vegetarian nutrition, this report focuses on the history and structure of the Dietary Guidelines Advisory Committee, on various plant food-oriented recommendations that are supported by literature evidence, and on mechanisms for participating in the process of forming dietary guidelines. Among recommendations that likely would improve health and the environment, some are oriented toward increased plant food consumption and some toward vegetarianism. The literature on health effects of individual foods and whole lifestyle diets is insufficient and justifies a call for future food-oriented research, including expanding the evidence base for plant-based and vegetarian diets. The Dietary Guidelines Advisory Committee's role should be carried forward to creation of a publicly accessible icon (eg, the current pyramid) and related materials to ensure that the science base is fully translated for the public. PMID:19297463

  11. Towards earlier inclusion of Children in Tuberculosis (TB) drugs trials: Consensus statements from an Expert Panel

    PubMed Central

    Nachman, Sharon; Ahmed, Amina; Amanullah, Farhana; Becerra, Mercedes C; Botgros, Radu; Brigden, Grania; Browning, Renee; Gardiner, Elizabeth; Hafner, Richard; Hesseling, Anneke; How, Cleotilde; Jean-Philippe, Patrick; Lessem, Erica; Makhene, Mamodikoe; Mbelle, Nontombi; Marais, Ben; McIlleron, Helen; Mc Neeley, David F; Mendel, Carl; Murray, Stephen; Navarro, Eileen; Oramasionwu, Gloria E; Porcalla, Ariel R; Powell, Clydette; Powell, Mair; Rigaud, Mona; Rouzier, Vanessa; Samson, Pearl; Schaaf, H. Simon; Shah, Seema; Starke, Jeff; Swaminathan, Soumya; Wobudeya, Eric; Worrell, Carol

    2015-01-01

    Children represent a significant proportion of the global tuberculosis (TB) burden, and may be disproportionately more affected by its most severe clinical manifestations. Currently available treatments for pediatric drug-susceptible (DS) and drug-resistant (DR) TB, albeit generally effective, are hampered by high pill burden, long duration of treatment, coexistent toxicities, and an overall lack of suitable, child-friendly formulations. The complex and burdensome nature of administering the existing regimens to treat DS TB also contributes to the rise of DR TB strains. Despite the availability and use of these therapies for decades, a dearth of dosing evidence in children underscores the importance of sustained efforts for TB drug development to better meet the treatment needs of children with TB. Several new TB drugs and regimens with promising activity against both DS and DR TB strains have recently entered clinical development and are in various phases of clinical evaluation in adults or have received marketing authorization for adults. However, initiation of clinical trials to evaluate these drugs in children is often deferred, pending the availability of complete safety and efficacy data in adults or after drug approval. This document summarizes consensus statements from an international panel of childhood TB opinion leaders which support the initiation of evaluation of new TB drugs and regimens in children at earlier phases of the TB Drug development cycle. PMID:25957923

  12. European expert recommendations on the use of injectable poly-L-lactic acid for facial rejuvenation.

    PubMed

    Alessio, Redaelli; Rzany, Berthold; Eve, Linda; Grangier, Yann; Herranz, Pedro; Olivier-Masveyraud, Frédérique; Vleggaar, Danny

    2014-09-01

    Over the last few years, there have been a number of important changes in how we appreciate and understand the aging face. Volume loss is now recognized as a major component of facial aging. Treatment options that replace lost volume are increasingly used for recontouring and rejuvenation of the aging face. In this review we present and discuss the European Expert Group recommendations on the ideal use of the unique collagen stimulator, poly-L-lactic acid (PLLA, Sculptra®, Sinclair Pharmaceuticals) for facial rejuvenation lasting up to 25 months. Optimal results are achieved based on a detailed knowledge of facial anatomy, correct treatment procedure, specifically the right dilution, the correct injection technique, as well as appropriate patient aftercare. PLLA is an effective and safe collagen stimulator that treats the whole face. PLLA is simple to use, provides the foundation for facial rejuvenation, is easy to combine with other treatments, and gives long-lasting effects with a high level of patient satisfaction. PMID:25226006

  13. Quality assessment for three common conditions in primary care: validity and reliability of review criteria developed by expert panels for angina, asthma and type 2 diabetes

    PubMed Central

    Campbell, S; Hann, M; Hacker, J; Durie, A; Thapar, A; Roland, M

    2002-01-01

    Objectives: To field test the reliability, validity, and acceptability of review criteria for angina, asthma, and type 2 diabetes which had been developed by expert panels using a systematic process to combine evidence with expert opinion. Design: Statistical analysis of data derived from a clinical audit, and postal questionnaire and semi-structured interviews with general practitioners and practice nurses in a representative sample of general practices in England. Setting: 60 general practices in England. Main outcome measures: Clinical audit results for angina, asthma, and type 2 diabetes. General practitioner and practice nurse validity ratings from the postal questionnaire. Results: 54%, 59%, and 70% of relevant criteria rated valid by the expert panels for angina, asthma, and type 2 diabetes, respectively, were found to be usable, valid, reliable, and acceptable for assessing quality of care. General practitioners and practice nurses agreed with panellists that these criteria were valid but not that they should always be recorded in the medical record. Conclusion: Quality measures derived using expert panels need field testing before they can be considered valid, reliable, and acceptable for use in quality assessment. These findings provide additional evidence that the RAND panel method develops valid and reliable review criteria for assessing clinical quality of care. PMID:12448803

  14. Aflibercept in wet AMD beyond the first year of treatment: recommendations by an expert roundtable panel

    PubMed Central

    McKibbin, M; Devonport, H; Gale, R; Gavin, M; Lotery, A; Mahmood, S; Patel, P J; Ross, A; Sivaprasad, S; Talks, J; Walters, G

    2015-01-01

    This supplement has been sponsored by Bayer HealthCare. Please see acknowledgements for full disclaimer. Prescribing Information can be found in the appendices. L.GB.COM.05.2015.11280. Date of preparation: June 2015 This paper provides expert recommendations on administration of aflibercept in wet age-related macular degeneration (AMD) after Year 1 (Y1), based on a roundtable discussion held in London, UK in November 2014. The goals of treatment after Y1 are to maintain visual and anatomical gains whilst minimising treatment burden and using resources effectively. The treatment decision should be made at the seventh injection visit (assuming the label has been followed) in Y1, and three approaches are proposed: (a) eyes with active disease on imaging/examination but with stable visual acuity (VA) at the end of Y1 should continue with fixed 8-weekly dosing; (b) eyes with inactive disease on imaging/examination and stable VA should be managed using a ‘treat and extend' (T&E) regimen. T&E involves treating and then extending the interval until the next treatment, by 2-week intervals, to a maximum of 12 weeks, provided the disease remains inactive. If there is new evidence of disease activity, treatment is administered and the interval to the next treatment shortened; and (c) if there has been no disease activity for ≥3 consecutive visits, a trial of monitoring without treatment may be appropriate, initiated at the end of Y1 or at any time during Y2. Where possible, VA testing, OCT imaging and injection should be performed at the same visit. The second eye should be monitored to detect fellow eye involvement. In bilateral disease, the re-treatment interval should be driven by the better-seeing eye or, if the VA is similar, the eye with the more active disease. PMID:26156564

  15. From current status to optimization of HCV treatment: Recommendations from an expert panel.

    PubMed

    Craxì, Antonio; Perno, Carlo Federico; Viganò, Mauro; Ceccherini-Silberstein, Francesca; Petta, Salvatore

    2016-09-01

    Chronic hepatitis C virus (HCV) infection is a major public health problem at a global level, causing an enormous burden of hepatic and extra-hepatic morbidity and mortality. Treatment of chronic HCV (CHC) has been revolutionized in the last few years by the introduction of highly effective and well tolerated direct acting antiviral agents (DAAs) able to achieve >90% rates of sustained virological response (SVR) in many groups of patients, including those previously excluded from interferon-based regimens. For such reason interferon-free regimens are now the treatments of choice for all patients. Successful anti-HCV treatment can stop liver disease progression and can solve the HCV-related extra hepatic manifestations, eventually reducing both liver-related and overall mortality. Together with the rapidly accumulating data about the evolution of treatment landscape, different guidelines from national and international Liver Scientific Societies have been published until today. However, these recommendations may not be applied worldwide as, due to high treatment costs, most of them identify as priority groups only patients with advanced liver disease. Moreover some types of patients pose clinical management problems for which even the guidelines do not always provide useful answers. With the aim of treatment optimization by filling some of the gaps of the current guidelines and addressing the remaining unmet needs in practice, a group of Italian experts, experienced on treatment of HCV infection, met in Stresa in February 2016. The summary of all the considerations arising from this two-day meeting and the final statements are reported in this position paper.

  16. Statin intolerance - an attempt at a unified definition. Position paper from an International Lipid Expert Panel.

    PubMed

    Banach, Maciej; Rizzo, Manfredi; Toth, Peter P; Farnier, Michel; Davidson, Michael H; Al-Rasadi, Khalid; Aronow, Wilbert S; Athyros, Vasilis; Djuric, Dragan M; Ezhov, Marat V; Greenfield, Robert S; Hovingh, G Kees; Kostner, Karam; Serban, Corina; Lighezan, Daniel; Fras, Zlatko; Moriarty, Patrick M; Muntner, Paul; Goudev, Assen; Ceska, Richard; Nicholls, Stephen J; Broncel, Marlena; Nikolic, Dragana; Pella, Daniel; Puri, Raman; Rysz, Jacek; Wong, Nathan D; Bajnok, Laszlo; Jones, Steven R; Ray, Kausik K; Mikhailidis, Dimitri P

    2015-06-01

    Statins are one of the most commonly prescribed drugs in clinical practice. They are usually well tolerated and effectively prevent cardiovascular events. Most adverse effects associated with statin therapy are muscle-related. The recent statement of the European Atherosclerosis Society (EAS) has focused on statin-associated muscle symptoms (SAMS), and avoided the use of the term 'statin intolerance'. Although muscle syndromes are the most common adverse effects observed after statin therapy, excluding other side effects might underestimate the number of patients with statin intolerance, which might be observed in 10 - 15% of patients. In clinical practice, statin intolerance limits effective treatment of patients at risk of, or with, cardiovascular disease. Knowledge of the most common adverse effects of statin therapy that might cause statin intolerance and the clear definition of this phenomenon is crucial to effectively treat patients with lipid disorders. Therefore, the aim of this position paper was to suggest a unified definition of statin intolerance, and to complement the recent EAS statement on SAMS, where the pathophysiology, diagnosis and the management were comprehensively presented.

  17. Statin intolerance - an attempt at a unified definition. Position paper from an International Lipid Expert Panel.

    PubMed

    Banach, Maciej; Rizzo, Manfredi; Toth, Peter P; Farnier, Michel; Davidson, Michael H; Al-Rasadi, Khalid; Aronow, Wilbert S; Athyros, Vasilis; Djuric, Dragan M; Ezhov, Marat V; Greenfield, Robert S; Hovingh, G Kees; Kostner, Karam; Serban, Corina; Lighezan, Daniel; Fras, Zlatko; Moriarty, Patrick M; Muntner, Paul; Goudev, Assen; Ceska, Richard; Nicholls, Stephen J; Broncel, Marlena; Nikolic, Dragana; Pella, Daniel; Puri, Raman; Rysz, Jacek; Wong, Nathan D; Bajnok, Laszlo; Jones, Steven R; Ray, Kausik K; Mikhailidis, Dimitri P

    2015-03-16

    Statins are one of the most commonly prescribed drugs in clinical practice. They are usually well tolerated and effectively prevent cardiovascular events. Most adverse effects associated with statin therapy are muscle-related. The recent statement of the European Atherosclerosis Society (EAS) has focused on statin associated muscle symptoms (SAMS), and avoided the use of the term 'statin intolerance'. Although muscle syndromes are the most common adverse effects observed after statin therapy, excluding other side effects might underestimate the number of patients with statin intolerance, which might be observed in 10-15% of patients. In clinical practice, statin intolerance limits effective treatment of patients at risk of, or with, cardiovascular disease. Knowledge of the most common adverse effects of statin therapy that might cause statin intolerance and the clear definition of this phenomenon is crucial to effectively treat patients with lipid disorders. Therefore, the aim of this position paper was to suggest a unified definition of statin intolerance, and to complement the recent EAS statement on SAMS, where the pathophysiology, diagnosis and the management were comprehensively presented. PMID:25861286

  18. Executive summary and conclusions from the European Hydration Institute Expert Conference on human hydration, health, and performance.

    PubMed

    Benton, D; Braun, H; Cobo, J C; Edmonds, C; Elmadfa, I; El-Sharkawy, A; Feehally, J; Gellert, R; Holdsworth, J; Kapsokefalou, M; Kenney, W L; Leiper, J B; Macdonald, I A; Maffeis, C; Maughan, R J; Shirreffs, S M; Toth-Heyn, P; Watson, P

    2015-09-01

    On April 7-8, 2014, the European Hydration Institute hosted a small group of experts at Castle Combe Manor House, United Kingdom, to discuss a range of issues related to human hydration, health, and performance. The meeting included 18 recognized experts who brought a wealth of experience and knowledge to the topics under review. Eight selected topics were addressed, with the key issues being briefly presented before an in-depth discussion. Presented here is the executive summary and conclusions from this meeting.

  19. Ethical acceptability of research on human-animal chimeric embryos: summary of opinions by the Japanese Expert Panel on Bioethics.

    PubMed

    Mizuno, Hiroshi; Akutsu, Hidenori; Kato, Kazuto

    2015-01-01

    Human-animal chimeric embryos are embryos obtained by introducing human cells into a non-human animal embryo. It is envisaged that the application of human-animal chimeric embryos may make possible many useful research projects including producing three-dimensional human organs in animals and verification of the pluripotency of human ES cells or iPS cells in vivo. The use of human-animal chimeric embryos, however, raises several ethical and moral concerns. The most fundamental one is that human-animal chimeric embryos possess the potential to develop into organisms containing human-derived tissue, which may lead to infringing upon the identity of the human species, and thus impairing human dignity. The Japanese Expert Panel on Bioethics in the Cabinet Office carefully considered the scientific significance and ethical acceptability of the issue and released its "Opinions regarding the handling of research using human-animal chimeric embryos". The Panel proposed a framework of case-by-case review, and suggested that the following points must be carefully reviewed from the perspective of ethical acceptability: (a) Types of animal embryos and types of animals receiving embryo transfers, particularly in dealing with non-human primates; (b) Types of human cells and organs intended for production, particularly in dealing with human nerve or germ cells; and (c) Extent of the period required for post-transfer studies. The scientific knowledge that can be gained from transfer into an animal uterus and from the production of an individual must be clarified to avoid unnecessary generation of chimeric animals. The time is ripe for the scientific community and governments to start discussing the ethical issues for establishing a global consensus. PMID:26694481

  20. Ethical acceptability of research on human-animal chimeric embryos: summary of opinions by the Japanese Expert Panel on Bioethics.

    PubMed

    Mizuno, Hiroshi; Akutsu, Hidenori; Kato, Kazuto

    2015-01-01

    Human-animal chimeric embryos are embryos obtained by introducing human cells into a non-human animal embryo. It is envisaged that the application of human-animal chimeric embryos may make possible many useful research projects including producing three-dimensional human organs in animals and verification of the pluripotency of human ES cells or iPS cells in vivo. The use of human-animal chimeric embryos, however, raises several ethical and moral concerns. The most fundamental one is that human-animal chimeric embryos possess the potential to develop into organisms containing human-derived tissue, which may lead to infringing upon the identity of the human species, and thus impairing human dignity. The Japanese Expert Panel on Bioethics in the Cabinet Office carefully considered the scientific significance and ethical acceptability of the issue and released its "Opinions regarding the handling of research using human-animal chimeric embryos". The Panel proposed a framework of case-by-case review, and suggested that the following points must be carefully reviewed from the perspective of ethical acceptability: (a) Types of animal embryos and types of animals receiving embryo transfers, particularly in dealing with non-human primates; (b) Types of human cells and organs intended for production, particularly in dealing with human nerve or germ cells; and (c) Extent of the period required for post-transfer studies. The scientific knowledge that can be gained from transfer into an animal uterus and from the production of an individual must be clarified to avoid unnecessary generation of chimeric animals. The time is ripe for the scientific community and governments to start discussing the ethical issues for establishing a global consensus.

  1. Interventions to Mitigate Emergency Department and Hospital Crowding During an Infectious Respiratory Disease Outbreak: Results from an Expert Panel

    PubMed Central

    Dugas, Andrea Freyer; Morton, Melinda; Beard, Raphaelle; Pines, Jesse M.; Bayram, Jamil D.; Hsieh, Yu-Hsiang; Kelen, Gabor; Uscher-Pines, Lori; Jeng, Kevin; Cole, Gai; Rothman, Richard

    2013-01-01

    Objective: To identify and prioritize potential Emergency Department (ED) and hospital-based interventions which could mitigate the impact of crowding during patient surge from a widespread infectious respiratory disease outbreak and determine potential data sources that may be useful for triggering decisions to implement these high priority interventions. Design: Expert panel utilizing Nominal Group Technique to identify and prioritize interventions, and in addition, determine appropriate “triggers” for implementation of the high priority interventions in the context of four different infectious respiratory disease scenarios that vary by patient volumes (high versus low) and illness severity (high versus low). Setting: One day in-person conference held November, 2011. Participants: Regional and national experts representing the fields of public health, disease surveillance, clinical medicine, ED operations, and hospital operations. Main Outcome Measure: Prioritized list of potential interventions to reduce ED and hospital crowding, respectively. In addition, we created a prioritized list of potential data sources which could be useful to trigger interventions. Results: High priority interventions to mitigate ED surge included standardizing admission and discharge criteria and instituting infection control measures. To mitigate hospital crowding, panelists prioritized mandatory vaccination and an algorithm for antiviral use. Data sources identified for triggering implementation of these interventions were most commonly ED and hospital utilization metrics. Conclusions: We developed a prioritized list of potentially useful interventions to mitigate ED and hospital crowding in various outbreak scenarios. The data sources identified to “trigger” the implementation of these high priority interventions consist mainly of sources available at the local, institutional level. PMID:23856917

  2. Topical antifungal-corticosteroid combination therapy for the treatment of superficial mycoses: conclusions of an expert panel meeting.

    PubMed

    Schaller, Martin; Friedrich, Markus; Papini, Manuela; Pujol, Ramon M; Veraldi, Stefano

    2016-06-01

    Superficial fungal infections affect 20-25% of people worldwide and can cause considerable morbidity, particularly if an inflammatory component is present. As superficial fungal infections can be diverse, the treatment should be tailored to the individual needs of the patient and several factors should be taken into account when deciding on the most appropriate treatment option. These include the type, location and surface area of the infection, patient age, degree of inflammation and underlying comorbidities. Although several meta-analyses have shown that there are no significant differences between the numerous available topical antifungal agents with regard to mycological cure, agents differ in their specific intrinsic properties, which can affect their clinical use. The addition of a corticosteroid to an antifungal agent at the initiation of treatment can attenuate the inflammatory symptoms of the infection and is thought to increase patient compliance, reduce the risk of bacterial superinfection and enhance the efficacy of the antifungal agent. However, incorrect use of antifungal-corticosteroid therapy may be associated with treatment failure and adverse effects. This review summarises available treatment options for superficial fungal infections and provides general treatment recommendations based on the consensus outcomes of an Expert Panel meeting on the topical treatment of superficial mycoses. PMID:26916648

  3. Topical antifungal-corticosteroid combination therapy for the treatment of superficial mycoses: conclusions of an expert panel meeting.

    PubMed

    Schaller, Martin; Friedrich, Markus; Papini, Manuela; Pujol, Ramon M; Veraldi, Stefano

    2016-06-01

    Superficial fungal infections affect 20-25% of people worldwide and can cause considerable morbidity, particularly if an inflammatory component is present. As superficial fungal infections can be diverse, the treatment should be tailored to the individual needs of the patient and several factors should be taken into account when deciding on the most appropriate treatment option. These include the type, location and surface area of the infection, patient age, degree of inflammation and underlying comorbidities. Although several meta-analyses have shown that there are no significant differences between the numerous available topical antifungal agents with regard to mycological cure, agents differ in their specific intrinsic properties, which can affect their clinical use. The addition of a corticosteroid to an antifungal agent at the initiation of treatment can attenuate the inflammatory symptoms of the infection and is thought to increase patient compliance, reduce the risk of bacterial superinfection and enhance the efficacy of the antifungal agent. However, incorrect use of antifungal-corticosteroid therapy may be associated with treatment failure and adverse effects. This review summarises available treatment options for superficial fungal infections and provides general treatment recommendations based on the consensus outcomes of an Expert Panel meeting on the topical treatment of superficial mycoses.

  4. Socioeconomic inequalities in health: a comparative longitudinal analysis using the European Community Household Panel.

    PubMed

    Hernández-Quevedo, Cristina; Jones, Andrew M; López-Nicolás, Angel; Rice, Nigel

    2006-09-01

    This study measures socioeconomic inequalities in health across European Union Member States between 1994 and 2001. The analysis is based on the European Community Household Panel Users' Database (ECHP-UDB) and uses two binary indicators of health limitations for the full 8 waves of available data. Short- and long-run concentration indices together with mobility and health achievement indices are derived for indicators of severe health limitation and any health limitation. Results demonstrate the existence of socioeconomic inequality in health across Member States in both the short-term (1 year) and the long-term (up to 8 years), with health limitations concentrated among those with lower incomes. For all countries, the long-run indices show that income-related inequalities in health widen over time, in the sense that the longer the period over which an individual's health and income are measured the greater the measure of income-related health inequality. The ranking of countries according to their prevalence of illness differs from ranking by overall health achievement, which takes account of inequalities. This means that an equity-efficiency trade-off has to be faced in evaluating the performance of different countries and in comparing countries with diverse health and social welfare systems.

  5. European Expert Consensus Paper on the implementation of Article 14 of the WHO Framework Convention on Tobacco Control.

    PubMed

    Clancy, Luke

    2016-11-01

    On 24 November 2015, under the auspices of the European Policy Roundtable on Smoking Cessation, 15 experts on tobacco control and dependence from across the European Union, chaired by Professor Luke Clancy, met in Oslo, Norway, to discuss the implementation of the Tobacco Products Directive and the WHO Framework Convention on Tobacco Control, namely Article 14. On the occasion of the 10th anniversary of the Framework Convention on Tobacco Control, this paper reports the consensus reached by all Roundtable participants on the need to further advance the availability and access to services to support cessation of tobacco use. The implementation of services to support cessation of tobacco use in line with Article 14 can and should be significantly improved to protect the health of European citizens. The meeting was initiated and funded by Pfizer.

  6. European Expert Consensus Paper on the implementation of Article 14 of the WHO Framework Convention on Tobacco Control

    PubMed Central

    2016-01-01

    On 24 November 2015, under the auspices of the European Policy Roundtable on Smoking Cessation, 15 experts on tobacco control and dependence from across the European Union, chaired by Professor Luke Clancy, met in Oslo, Norway, to discuss the implementation of the Tobacco Products Directive and the WHO Framework Convention on Tobacco Control, namely Article 14. On the occasion of the 10th anniversary of the Framework Convention on Tobacco Control, this paper reports the consensus reached by all Roundtable participants on the need to further advance the availability and access to services to support cessation of tobacco use. The implementation of services to support cessation of tobacco use in line with Article 14 can and should be significantly improved to protect the health of European citizens. The meeting was initiated and funded by Pfizer. PMID:27548882

  7. Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma-Summary Report 2007.

    PubMed

    2007-11-01

    Highlights of the National Asthma Education and Prevention Program's Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma-Full Report 2007 are presented in this EPR-3 summary report. The updated guidelines emphasize the importance of asthma control. Asthma control is the degree to which the manifestations of asthma are minimized by therapeutic intervention and the goals of therapy are met. Because asthma is highly variable, the level of control must be monitored on a periodic basis to determine whether therapy should be maintained or adjusted (stepped up if necessary, stepped down if possible). On the other hand, asthma severity is the intrinsic intensity of the disease process, most easily and directly measured in a patient not receiving long-term control therapy. For managing asthma, the recommendation is to assess severity to initiate therapy and assess control to adjust therapy. Recommendations for managing asthma include an expanded section on childhood asthma with addition of an age group 5 to 11 years old (earlier guidelines combined this group with adults). The guidelines provide new recommendations on patient education in settings beyond the physician's office, and new advice for controlling environmental factors that can cause asthma symptoms. The concepts of current impairment (frequency and intensity of symptoms, low lung function, and limitations of daily activities) and future risk (likelihood of exacerbations, progressive loss of lung function, or adverse side effects from medications) support a new approach to assessing and monitoring the patient's level of asthma control through use of multiple measures. The guidelines stress that some patients can still be at high risk for frequent exacerbations even if they have few day-to-day effects of asthma.Moreover, EPR-3 confirms the importance of teaching patients skills to self-monitor and manage asthma and to use a written asthma action plan, which should include

  8. Regulatory considerations surrounding the deployment of Bt-expressing cowpea in Africa: report of the deliberations of an expert panel.

    PubMed

    Huesing, Joseph; Romeis, Jörg; Ellstrand, Norman; Raybould, Alan; Hellmich, Richard; Wolt, Jeff; Ehlers, Jeff; Dabiré, Clémentine; Fatokun, Christian; Hokanson, Karen; Ishiyaku, Mohammad F; Margam, Venu; Obokoh, Nompumelelo; Mignouna, Jacob; Nangayo, Francis; Ouedraogo, Jeremy; Pasquet, Rémy; Pittendrigh, Barry; Schaal, Barbara; Stein, Jeff; Tamò, Manuele; Murdock, Larry

    2011-01-01

    Cowpea (Vigna unguiculata spp unguiculata) is adapted to the drier agro-ecological zones of West Africa where it is a major source of dietary protein and widely used as a fodder crop. Improving the productivity of cowpea can enhance food availability and security in West Africa. Insect predation--predominately from the legume pod borer (Maruca vitrata), flower thrips (Megalurothrips sjostedti) and a complex of pod-sucking bugs (e.g., Clavigralla spp)--is a major yield-limiting factor in West African cowpea production. Dramatic increases in yield are shown when M. vitrata is controlled with insecticides. However, availability, costs, and safety considerations limit pesticides as a viable option for boosting cowpea production. Development of Bt-cowpea through genetic modification (GM) to control the legume pod borer is a promising approach to cowpea improvement. Cowpea expressing the lepidopteran-active Cry1Ab protein from Bacillus thuringiensis is being developed as a first generation Bt-cowpea crop for West Africa. Appropriate stewardship of Bt-cowpea to assure its sustainability under West African conditions is critical to its successful development. A first step in this process is an environmental risk assessment to determine the likelihood and magnitude of adverse effects of the Cry1Ab protein on key environmental protection goals in West Africa. Here we describe the results of an expert panel convened in 2009 to develop the problem formulation phase for Bt-cowpea and to address specific issues around gene flow, non-target arthropods, and insect resistance management.

  9. Prioritisation of wildlife pathogens to be targeted in European surveillance programmes: Expert-based risk analysis focus on ruminants.

    PubMed

    Ciliberti, Alexandre; Gavier-Widén, Dolores; Yon, Lisa; Hutchings, Mike R; Artois, Marc

    2015-03-01

    This study attempted to develop a list of priority pathogens. It is part of a European Union (EU) project dedicated to the surveillance of emerging or re-emerging pathogens of wildlife. Partners of the consortium established an initial list of 138 pathogens of concern, which was reduced to a smaller list of 65 pathogens likely to affect ruminants (i.e., the most costly animal group in the EU over the last 15 years). These 65 pathogens underwent a two-step, expert-based risk analysis: 92 experts graded them with respect to their global importance for animal welfare, species conservation, trade/economic impacts and public health. In step 2, the top 15 pathogens from step 1 were assessed by 69 experts considering seven weighted epidemiological criteria (pathogen variability, host specificity, potential for contagion, speed of spread, presence in Europe, difficulty of surveillance in wildlife and persistence in the environment) for which four options were possible. The responses concerned a wide geographic coverage. The resulting top-list pathogens were ranked as follows: 1. Salmonella enterica, 2. Coxiella burnetii, 3. foot-and-mouth disease virus, 4. Mycobacterium bovis, 5. bluetongue virus, and 6. European tick-borne encephalitis virus. The influence of the characteristics of the respondents, the importance of the levels of uncertainty/variability and the implication of the results are discussed. This work highlights the relevance of developing such lists for preparedness.

  10. Management of familial hypercholesterolemia: a review of the recommendations from the National Lipid Association Expert Panel on Familial Hypercholesterolemia.

    PubMed

    Robinson, Jennifer G

    2013-03-01

    Familial hypercholesterolemia (FH) is a genetic disorder of lipid metabolism that is characterized by a significant elevation in levels of low-density lipoprotein cholesterol (LDL-C), and patients are at very high risk for premature coronary heart disease (CHD). The etiology of FH includes known mutations in the gene of the LDL receptor, LDLR; the gene of apolipoprotein B, apo B; and the proprotein convertase subtilisin/kexin type 9 gene, PCSK9. The National Lipid Association Expert Panel on Familial Hypercholesterolemia has provided recommendations for the screening and treatment of patients with FH. Early identification and aggressive treatment of FH in individual patients, as well as screening of all first-degree relatives, are recommended to minimize the risk for premature CHD. Similar to patients with conventional hypercholesterolemia, patients with FH should receive statins as initial treatment, but patients with FH may require higher doses of statins, more potent statins, statin-based combination therapy, or adjunctive therapies. Patients with FH who have additional risk factors for, or existing, cardiovascular disease or those with an inadequate response to initial statin therapy should have access to higher doses of the most efficacious statins; statins used in combination with other LDL-C-lowering agents should also be supported by formularies; additional treatments, such as LDL-C apheresis or novel therapies, may also be required to achieve acceptable LDL-C levels. New treatment approaches include mipomersen, which was approved by the FDA in January 2013. Mipomersen is an oligonucleotide inhibitor of apolipoprotein B-100 synthesis (called an antisense inhibitor) indicated as an adjunct to lipid-lowering medications and diet to reduce LDL-C, apolipoprotein B, total cholesterol, and non-high density lipoprotein-cholesterol (non-HDL-C) levels in patients with homozygous FH (HoFH). The microsomal transfer protein lomitapide has also received FDA approval for

  11. Biofuels and Food Security. A report by the High Level Panel of Experts on Food Security and Nutrition

    SciTech Connect

    2013-06-15

    In October 2011, the UN Committee on World Food Security (CFS) recommended a ''review of biofuels policies -- where applicable and if necessary -- according to balanced science-based assessments of the opportunities and challenges that they may represent for food security so that biofuels can be produced where it is socially, economically and environmentally feasible to do so''. In line with this, the CFS requested the HLPE (High Level Panel of Experts) to ''conduct a science-based comparative literature analysis taking into consideration the work produced by the FAO and Global Bioenergy Partnership (GBEP) of the positive and negative effects of biofuels on food security''. Recommendations from the report include the following. Food security policies and biofuel policies cannot be separated because they mutually interact. Food security and the right to food should be priority concerns in the design of any biofuel policy. Governments should adopt the principle: biofuels shall not compromise food security and therefore should be managed so that food access or the resources necessary for the production of food, principally land, biodiversity, water and labour are not put at risk. The CFS should undertake action to ensure that this principle is operable in the very varied contexts in which all countries find themselves. Given the trend to the emergence of a global biofuels market, and a context moving from policy-driven to market-driven biofuels, there is an urgent need for close and pro-active coordination of food security, biofuel/bioenergy policies and energy policies, at national and international levels, as well as rapid response mechanisms in case of crisis. There is also an urgent need to create an enabling, responsible climate for food and non-food investments compatible with food security. The HLPE recommends that governments adopt a coordinated food security and energy security strategy, which would require articulation around the following five axes

  12. Sequencing an Ashkenazi reference panel supports population-targeted personal genomics and illuminates Jewish and European origins

    PubMed Central

    Carmi, Shai; Hui, Ken Y.; Kochav, Ethan; Liu, Xinmin; Xue, James; Grady, Fillan; Guha, Saurav; Upadhyay, Kinnari; Ben-Avraham, Dan; Mukherjee, Semanti; Bowen, B. Monica; Thomas, Tinu; Vijai, Joseph; Cruts, Marc; Froyen, Guy; Lambrechts, Diether; Plaisance, Stéphane; Van Broeckhoven, Christine; Van Damme, Philip; Van Marck, Herwig; Barzilai, Nir; Darvasi, Ariel; Offit, Kenneth; Bressman, Susan; Ozelius, Laurie J.; Peter, Inga; Cho, Judy H.; Ostrer, Harry; Atzmon, Gil; Clark, Lorraine N.; Lencz, Todd; Pe’er, Itsik

    2014-01-01

    The Ashkenazi Jewish (AJ) population is a genetic isolate close to European and Middle Eastern groups, with genetic diversity patterns conducive to disease mapping. Here we report high-depth sequencing of 128 complete genomes of AJ controls. Compared with European samples, our AJ panel has 47% more novel variants per genome and is eightfold more effective at filtering benign variants out of AJ clinical genomes. Our panel improves imputation accuracy for AJ SNP arrays by 28%, and covers at least one haplotype in ≈67% of any AJ genome with long, identical-by-descent segments. Reconstruction of recent AJ history from such segments confirms a recent bottleneck of merely ≈350 individuals. Modelling of ancient histories for AJ and European populations using their joint allele frequency spectrum determines AJ to be an even admixture of European and likely Middle Eastern origins. We date the split between the two ancestral populations to ≈12–25 Kyr, suggesting a predominantly Near Eastern source for the repopulation of Europe after the Last Glacial Maximum. PMID:25203624

  13. Sequencing an Ashkenazi reference panel supports population-targeted personal genomics and illuminates Jewish and European origins.

    PubMed

    Carmi, Shai; Hui, Ken Y; Kochav, Ethan; Liu, Xinmin; Xue, James; Grady, Fillan; Guha, Saurav; Upadhyay, Kinnari; Ben-Avraham, Dan; Mukherjee, Semanti; Bowen, B Monica; Thomas, Tinu; Vijai, Joseph; Cruts, Marc; Froyen, Guy; Lambrechts, Diether; Plaisance, Stéphane; Van Broeckhoven, Christine; Van Damme, Philip; Van Marck, Herwig; Barzilai, Nir; Darvasi, Ariel; Offit, Kenneth; Bressman, Susan; Ozelius, Laurie J; Peter, Inga; Cho, Judy H; Ostrer, Harry; Atzmon, Gil; Clark, Lorraine N; Lencz, Todd; Pe'er, Itsik

    2014-09-09

    The Ashkenazi Jewish (AJ) population is a genetic isolate close to European and Middle Eastern groups, with genetic diversity patterns conducive to disease mapping. Here we report high-depth sequencing of 128 complete genomes of AJ controls. Compared with European samples, our AJ panel has 47% more novel variants per genome and is eightfold more effective at filtering benign variants out of AJ clinical genomes. Our panel improves imputation accuracy for AJ SNP arrays by 28%, and covers at least one haplotype in ≈ 67% of any AJ genome with long, identical-by-descent segments. Reconstruction of recent AJ history from such segments confirms a recent bottleneck of merely ≈ 350 individuals. Modelling of ancient histories for AJ and European populations using their joint allele frequency spectrum determines AJ to be an even admixture of European and likely Middle Eastern origins. We date the split between the two ancestral populations to ≈ 12-25 Kyr, suggesting a predominantly Near Eastern source for the repopulation of Europe after the Last Glacial Maximum.

  14. Sequencing an Ashkenazi reference panel supports population-targeted personal genomics and illuminates Jewish and European origins.

    PubMed

    Carmi, Shai; Hui, Ken Y; Kochav, Ethan; Liu, Xinmin; Xue, James; Grady, Fillan; Guha, Saurav; Upadhyay, Kinnari; Ben-Avraham, Dan; Mukherjee, Semanti; Bowen, B Monica; Thomas, Tinu; Vijai, Joseph; Cruts, Marc; Froyen, Guy; Lambrechts, Diether; Plaisance, Stéphane; Van Broeckhoven, Christine; Van Damme, Philip; Van Marck, Herwig; Barzilai, Nir; Darvasi, Ariel; Offit, Kenneth; Bressman, Susan; Ozelius, Laurie J; Peter, Inga; Cho, Judy H; Ostrer, Harry; Atzmon, Gil; Clark, Lorraine N; Lencz, Todd; Pe'er, Itsik

    2014-01-01

    The Ashkenazi Jewish (AJ) population is a genetic isolate close to European and Middle Eastern groups, with genetic diversity patterns conducive to disease mapping. Here we report high-depth sequencing of 128 complete genomes of AJ controls. Compared with European samples, our AJ panel has 47% more novel variants per genome and is eightfold more effective at filtering benign variants out of AJ clinical genomes. Our panel improves imputation accuracy for AJ SNP arrays by 28%, and covers at least one haplotype in ≈ 67% of any AJ genome with long, identical-by-descent segments. Reconstruction of recent AJ history from such segments confirms a recent bottleneck of merely ≈ 350 individuals. Modelling of ancient histories for AJ and European populations using their joint allele frequency spectrum determines AJ to be an even admixture of European and likely Middle Eastern origins. We date the split between the two ancestral populations to ≈ 12-25 Kyr, suggesting a predominantly Near Eastern source for the repopulation of Europe after the Last Glacial Maximum. PMID:25203624

  15. Expert Views on the Implementation of Teacher Professional Development in European Countries

    ERIC Educational Resources Information Center

    Lipowski, Katrin; Jorde, Doris; Prenzel, Manfred; Seidel, Tina

    2011-01-01

    International comparisons in science (and mathematics) education show the relevance of teaching quality for learning outcomes. Teacher professional development (TPD) is hence considered particularly relevant for improving teaching and learning in science. The study at hand is part of a European network initiative named Mind the Gap that explores…

  16. Final report of the Cosmetic Ingredient Review Expert Panel safety assessment of polymethyl methacrylate (PMMA), methyl methacrylate crosspolymer, and methyl methacrylate/glycol dimethacrylate crosspolymer.

    PubMed

    Becker, Lillian C; Bergfeld, Wilma F; Belsito, Donald V; Hill, Ronald A; Klaassen, Curtis D; Liebler, Daniel C; Marks, James G; Shank, Ronald C; Slaga, Thomas J; Snyder, Paul W; Andersen, F Alan

    2011-05-01

    Polymethyl methacrylate (PMMA) and related cosmetic ingredients methyl methacrylate crosspolymer and methyl methacrylate/glycol dimethacrylate crosspolymer are polymers that function as film formers and viscosity-increasing agents in cosmetics. The Food and Drug Administration (FDA) determination of safety of PMMA use in several medical devices, which included human and animal safety data, was used as the basis of safety of PMMA and related polymers in cosmetics by the Cosmetic Ingredient Review (CIR) Expert Panel.  The PMMA used in cosmetics is substantially the same as in medical devices.  The Panel concluded that these ingredients are safe as cosmetic ingredients in the practices of use and concentrations as described in this safety assessment. PMID:21772027

  17. SUMMARY AND RECOMMENDATIONS OF THE EXPERT PANEL OVERSIGHT COMMITTEE MEETING ON DOUBLE-SHELL TANK CORROSION MONITORING AND TESTING HELD AUGUST 4-5 2008

    SciTech Connect

    BOOMER KD

    2009-01-08

    The Expert Panel Oversight Committee (EPOC) on Double-Shell Tank Corrosion Monitoring and Testing has been overseeing the Fiscal Year FY 2008 experimental program being performed at CC Technologies (CCT) to optimize the chemistry control for corrosion limits in Double-Shell Tanks (DSTs). The EPOC met at the M & D Professional Services Conference Facility on August 4 and 5, 2008 to discuss various aspects of that responsibility including FY 2009 planning. Formal presentations were made to update the EPOC on the these subjects.

  18. Catheter venography for the assessment of internal jugular veins and azygous vein: position statement by expert panel of the International Society for Neurovascular Disease.

    PubMed

    Simka, Marian; Hubbard, David; Siddiqui, Adnan H; Dake, Michael D; Sclafani, Salvatore J A; Al-Omari, Mamoon; Eisele, Carlos G; Haskal, Ziv J; Ludyga, Tomasz; Miloševič, Zoran V; Sievert, Horst; Stehling, Michael K; Zapf, Stefan; Zorc, Marjeta

    2013-05-01

    This document by an expert panel of the International Society for Neurovascular Disease is aimed at presenting current technique and interpretation of catheter venography of the internal jugular veins, azygous vein and other veins draining the central nervous system. Although interventionalists agree on general rules, significant differences exist in terms of details of venographic technique and interpretations of angiographic pictures. It is also suggested that debatable findings should be investigated using multimodal diagnostics. Finally, the authors recommend that any publication on chronic cerebrospinal venous insufficiency should include detailed description of venographic technique used, to facilitate a comparison of published results in this area.

  19. Studying implementation quality of a school-based prevention curriculum in frontier Alaska: application of video-recorded observations and expert panel judgment.

    PubMed

    Johnson, Knowlton W; Ogilvie, Kristen A; Collins, David A; Shamblen, Stephen R; Dirks, Lisa G; Ringwalt, Christopher L; Norland, Jennifer J

    2010-09-01

    This study assesses the implementation quality of Think Smart, a school-based drug prevention curriculum that was designed to reduce use of harmful legal products (HLPs; e.g., inhalants and over-the-counter drugs), alcohol, tobacco, and other drugs among 5th- and 6th-grade students in frontier Alaska. Participating in the study were eight communities that took part in a larger randomized control trial to assess the short-term effects of the Think Smart curriculum. Video-recorded observations of the 12 core and 3 booster lessons were conducted in 20 classrooms. Ninety-five sessions were randomly selected from 228 usable videodiscs, and two pairs of researchers observed each video recording to code level of dosage, adherence to curriculum design, and teachers' delivery skills. Inter-rater reliability for all implementation quality measures was very high. An expert panel consisting of 16 scientists reviewed the results of the implementation study and concluded that the level of dosage and adherence to the curriculum design was at least as high as those yielded by similar studies. However, the panel assessed the delivery quality to be only marginal in comparison to results of other studies. The experts concluded that the implementation quality of the Think Smart curriculum was adequate even though the teachers' delivery skills were only marginal. A bootstrapping analysis, in which 1,000 samples were drawn for each implementation quality result, found the expert judgments to be reliable. The authors conclude that despite some limitations, video-recorded observations, as well as expert judgment, provide strong methodologies that should be considered for future implementation quality studies.

  20. The effect of income growth and inequality on health inequality: Theory and empirical evidence from the European Panel.

    PubMed

    Van Ourti, Tom; van Doorslaer, Eddy; Koolman, Xander

    2009-05-01

    Governments of EU countries have declared that they would like to couple income growth with reductions in social inequalities in income and health. We show that, theoretically, both aims can be reconciled only under very specific conditions concerning the type of growth and the income responsiveness of health. We investigate whether these conditions were met in Europe in the 1990s using panel data from the European Community Household Panel. We demonstrate that (i) in most countries, the income elasticity of health was positive and increases with income, and (ii) that income growth was not pro-rich in most EU countries, resulting in small or negligible reductions in income inequality. The combination of both findings explains the modest increases we observe in income-related health inequality in the majority of countries.

  1. 77 FR 15753 - Request for Nominations of Experts for a Science Advisory Board Panel To Review EPA's Web-Based...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-16

    ... Report on the Environment AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: The EPA... panel to review the Agency's Web-based Report on the Environment. DATES: Nominations should be submitted... Web-based Report on the Environment (ROE) has been developed to provide a comprehensive online...

  2. Development of Cardiovascular Quality Indicators for Rheumatoid Arthritis: Results from an International Expert Panel Using a Novel Online Process

    PubMed Central

    Barber, Claire E. H.; Marshall, Deborah A; Alvarez, Nanette; John Mancini, G. B.; Lacaille, Diane; Keeling, Stephanie; Aviña-Zubieta, J. Antonio; Khodyakov, Dmitry; Barnabe, Cheryl; Faris, Peter; Smith, Alexa; Noormohamed, Raheem; Hazlewood, Glen; Martin, Liam O.; Esdaile, John M.

    2016-01-01

    Objective Patients with rheumatoid arthritis (RA) have a high risk of premature cardiovascular disease (CVD). We developed CVD quality indicators (QIs) for screening and use in Rheumatology clinics. Methods A systematic review of the literature on CVD risk reduction in RA and the general population was conducted. Based on the best practices identified from this review, a draft set of 12 candidate QIs were presented to a Canadian panel of rheumatologists and cardiologists (n=6) from three academic centers to achieve consensus on the QI specifications. The resulting 11 QIs were then evaluated by an online modified-Delphi panel of multidisciplinary health professionals and patients (n = 43) to determine their relevance, validity and feasibility in three rounds of online voting and threaded discussion using a modified RAND/UCLA Appropriateness Methodology. Results Response rates for the online panel were 86%. All 11 QIs were rated as highly relevant, valid and feasible (median rating ≥7 on a 1–9 scale) with no significant disagreement. The final QI set addresses the following themes: communication to primary care about increased CV risk in RA, CV risk assessment, defining smoking status and providing cessation counseling, screening and addressing hypertension, dyslipidemia and diabetes, exercise recommendations, body mass index screening and lifestyle counseling, minimizing corticosteroid use and communicating to patients at high risk of CVD about the risks/benefits of non-steroidal anti-inflammatory drugs. Conclusion Eleven QIs for CVD care in RA patients have been developed and are rated as highly relevant, valid and feasible by an international multidisciplinary panel. PMID:26178275

  3. Epidemic threats to the European Union: expert views on six virus groups.

    PubMed

    Kelly, L; Brouwer, A; Wilson, A; Gale, P; Snary, E; Ross, David; de Vos, C J

    2013-08-01

    In recent years, several animal disease epidemics have occurred within the European Union (EU). At the 4th Annual Meeting of the EPIZONE network (7-10 June 2010, St. Malo, France), an interactive session was run to elicit the opinions of delegates on a pre-defined list of epidemic threats to the EU. Responses from over 190 delegates, to questions relating to impact and likelihood, were used to rank six virus groups with respect to their perceived threat now (2010) and in 2020. The combined opinions of all delegates suggested that, from the pre-selected list of virus groups, foot-and-mouth disease and influenza are currently of most concern. Delegates thought that influenza would be less of a threat and zoonotic arboviruses would be more of a threat in 2020. Although the virus group rankings should not be taken as definitive, the results could be used in conjunction with experimental and field data, by scientists, policy-makers and stakeholders when assessing and managing risks associated with these virus groups.

  4. From diagnosis to therapy in lung cancer: management of CT detected pulmonary nodules, a summary of the 2015 Chinese-German Lung Cancer Expert Panel.

    PubMed

    Su, Chunxia; Meyer, Mathias; Pirker, Robert; Voigt, Wieland; Shi, Jingyun; Pilz, Lothar; Huber, Rudolf M; Wu, Yilong; Wang, Jinghong; He, Yonglan; Wang, Xuan; Zhang, Jian; Zhi, Xiuyi; Shi, Meiqi; Zhu, Bo; Schoenberg, Stefan S; Henzler, Thomas; Manegold, Christian; Zhou, Caicun; Roessner, Eric Dominic

    2016-08-01

    The first Chinese-German Lung Cancer Expert Panel was held in November 2015 one day after the 7th Chinese-German Lung Cancer Forum, Shanghai. The intention of the meeting was to discuss strategies for the diagnosis and treatment of lung cancer within the context of lung cancer screening. Improved risk classification criteria and novel imaging approaches for screening populations are highly required as more than half of lung cancer cases are false positive during the initial screening round if the National Lung Screening Trial (NLST) demographic criteria [≥30 pack years (PY) of cigarettes, age ≥55 years] are applied. Moreover, if the NLST criteria are applied to the Chinese population a high number of lung cancer patients are not diagnosed due to non-smoking related risk factors in China. The primary goal in the evaluation of pulmonary nodules (PN) is to determine whether they are malignant or benign. Volumetric based screening concepts such as investigated in the Dutch-Belgian randomized lung cancer screening trial (NELSON) seem to achieve higher specificity. Chest CT is the best imaging technique to identify the origin and location of the nodule since 20% of suspected PN found on chest X-ray turn out to be non-pulmonary lesions. Moreover, novel state-of-the-art CT systems can reduce the radiation dose for lung cancer screening acquisitions down to a level of 0.1 mSv with improved image quality to novel reconstruction techniques and thus reduce concerns related to chest CT as the primary screening technology. The aim of the first part of this manuscript was to summarize the current status of novel diagnostic techniques used for lung cancer screening and minimally invasive treatment techniques for progressive PNs that were discussed during the first Chinese-German Lung Cancer. This part should serve as an educational part for the readership of the techniques that were discussed during the Expert Panel. The second part summarizes the consensus recommendations

  5. From diagnosis to therapy in lung cancer: management of CT detected pulmonary nodules, a summary of the 2015 Chinese-German Lung Cancer Expert Panel.

    PubMed

    Su, Chunxia; Meyer, Mathias; Pirker, Robert; Voigt, Wieland; Shi, Jingyun; Pilz, Lothar; Huber, Rudolf M; Wu, Yilong; Wang, Jinghong; He, Yonglan; Wang, Xuan; Zhang, Jian; Zhi, Xiuyi; Shi, Meiqi; Zhu, Bo; Schoenberg, Stefan S; Henzler, Thomas; Manegold, Christian; Zhou, Caicun; Roessner, Eric Dominic

    2016-08-01

    The first Chinese-German Lung Cancer Expert Panel was held in November 2015 one day after the 7th Chinese-German Lung Cancer Forum, Shanghai. The intention of the meeting was to discuss strategies for the diagnosis and treatment of lung cancer within the context of lung cancer screening. Improved risk classification criteria and novel imaging approaches for screening populations are highly required as more than half of lung cancer cases are false positive during the initial screening round if the National Lung Screening Trial (NLST) demographic criteria [≥30 pack years (PY) of cigarettes, age ≥55 years] are applied. Moreover, if the NLST criteria are applied to the Chinese population a high number of lung cancer patients are not diagnosed due to non-smoking related risk factors in China. The primary goal in the evaluation of pulmonary nodules (PN) is to determine whether they are malignant or benign. Volumetric based screening concepts such as investigated in the Dutch-Belgian randomized lung cancer screening trial (NELSON) seem to achieve higher specificity. Chest CT is the best imaging technique to identify the origin and location of the nodule since 20% of suspected PN found on chest X-ray turn out to be non-pulmonary lesions. Moreover, novel state-of-the-art CT systems can reduce the radiation dose for lung cancer screening acquisitions down to a level of 0.1 mSv with improved image quality to novel reconstruction techniques and thus reduce concerns related to chest CT as the primary screening technology. The aim of the first part of this manuscript was to summarize the current status of novel diagnostic techniques used for lung cancer screening and minimally invasive treatment techniques for progressive PNs that were discussed during the first Chinese-German Lung Cancer. This part should serve as an educational part for the readership of the techniques that were discussed during the Expert Panel. The second part summarizes the consensus recommendations

  6. From diagnosis to therapy in lung cancer: management of CT detected pulmonary nodules, a summary of the 2015 Chinese-German Lung Cancer Expert Panel

    PubMed Central

    Su, Chunxia; Meyer, Mathias; Pirker, Robert; Voigt, Wieland; Shi, Jingyun; Pilz, Lothar; Huber, Rudolf M.; Wu, Yilong; Wang, Jinghong; He, Yonglan; Wang, Xuan; Zhang, Jian; Zhi, Xiuyi; Shi, Meiqi; Zhu, Bo; Schoenberg, Stefan S.; Henzler, Thomas; Roessner, Eric Dominic

    2016-01-01

    The first Chinese-German Lung Cancer Expert Panel was held in November 2015 one day after the 7th Chinese-German Lung Cancer Forum, Shanghai. The intention of the meeting was to discuss strategies for the diagnosis and treatment of lung cancer within the context of lung cancer screening. Improved risk classification criteria and novel imaging approaches for screening populations are highly required as more than half of lung cancer cases are false positive during the initial screening round if the National Lung Screening Trial (NLST) demographic criteria [≥30 pack years (PY) of cigarettes, age ≥55 years] are applied. Moreover, if the NLST criteria are applied to the Chinese population a high number of lung cancer patients are not diagnosed due to non-smoking related risk factors in China. The primary goal in the evaluation of pulmonary nodules (PN) is to determine whether they are malignant or benign. Volumetric based screening concepts such as investigated in the Dutch-Belgian randomized lung cancer screening trial (NELSON) seem to achieve higher specificity. Chest CT is the best imaging technique to identify the origin and location of the nodule since 20% of suspected PN found on chest X-ray turn out to be non-pulmonary lesions. Moreover, novel state-of-the-art CT systems can reduce the radiation dose for lung cancer screening acquisitions down to a level of 0.1 mSv with improved image quality to novel reconstruction techniques and thus reduce concerns related to chest CT as the primary screening technology. The aim of the first part of this manuscript was to summarize the current status of novel diagnostic techniques used for lung cancer screening and minimally invasive treatment techniques for progressive PNs that were discussed during the first Chinese-German Lung Cancer. This part should serve as an educational part for the readership of the techniques that were discussed during the Expert Panel. The second part summarizes the consensus recommendations

  7. From diagnosis to therapy in lung cancer: management of CT detected pulmonary nodules, a summary of the 2015 Chinese-German Lung Cancer Expert Panel

    PubMed Central

    Su, Chunxia; Meyer, Mathias; Pirker, Robert; Voigt, Wieland; Shi, Jingyun; Pilz, Lothar; Huber, Rudolf M.; Wu, Yilong; Wang, Jinghong; He, Yonglan; Wang, Xuan; Zhang, Jian; Zhi, Xiuyi; Shi, Meiqi; Zhu, Bo; Schoenberg, Stefan S.; Henzler, Thomas; Roessner, Eric Dominic

    2016-01-01

    The first Chinese-German Lung Cancer Expert Panel was held in November 2015 one day after the 7th Chinese-German Lung Cancer Forum, Shanghai. The intention of the meeting was to discuss strategies for the diagnosis and treatment of lung cancer within the context of lung cancer screening. Improved risk classification criteria and novel imaging approaches for screening populations are highly required as more than half of lung cancer cases are false positive during the initial screening round if the National Lung Screening Trial (NLST) demographic criteria [≥30 pack years (PY) of cigarettes, age ≥55 years] are applied. Moreover, if the NLST criteria are applied to the Chinese population a high number of lung cancer patients are not diagnosed due to non-smoking related risk factors in China. The primary goal in the evaluation of pulmonary nodules (PN) is to determine whether they are malignant or benign. Volumetric based screening concepts such as investigated in the Dutch-Belgian randomized lung cancer screening trial (NELSON) seem to achieve higher specificity. Chest CT is the best imaging technique to identify the origin and location of the nodule since 20% of suspected PN found on chest X-ray turn out to be non-pulmonary lesions. Moreover, novel state-of-the-art CT systems can reduce the radiation dose for lung cancer screening acquisitions down to a level of 0.1 mSv with improved image quality to novel reconstruction techniques and thus reduce concerns related to chest CT as the primary screening technology. The aim of the first part of this manuscript was to summarize the current status of novel diagnostic techniques used for lung cancer screening and minimally invasive treatment techniques for progressive PNs that were discussed during the first Chinese-German Lung Cancer. This part should serve as an educational part for the readership of the techniques that were discussed during the Expert Panel. The second part summarizes the consensus recommendations

  8. End-of-Life Decision-Making in Canada: The Report by the Royal Society of Canada Expert Panel on End-of-Life Decision-Making

    PubMed Central

    Schüklenk, Udo; Van Delden, Johannes J M; Downie, Jocelyn; Mclean, Sheila A M; Upshur, Ross; Weinstock, Daniel

    2011-01-01

    This report on end-of-life decision-making in Canada was produced by an international expert panel and commissioned by the Royal Society of Canada. It consists of five chapters. Chapter 1 reviews what is known about end-of-life care and opinions about assisted dying in Canada. Chapter 2 reviews the legal status quo in Canada with regard to various forms of assisted death. Chapter 3 reviews ethical issues pertaining to assisted death. The analysis is grounded in core values central to Canada's constitutional order. Chapter 4 reviews the experiences had in a number of jurisdictions that have decriminalized or recently reviewed assisted dying in some shape or form. Chapter 5 provides recommendations with regard to the provision of palliative care in Canada, as well as recommendations for reform with respect to the various forms of assisted death covered in this document. PMID:22085416

  9. Management of adult patients with Langerhans cell histiocytosis: recommendations from an expert panel on behalf of Euro-Histio-Net.

    PubMed

    Girschikofsky, Michael; Arico, Maurizio; Castillo, Diego; Chu, Anthony; Doberauer, Claus; Fichter, Joachim; Haroche, Julien; Kaltsas, Gregory A; Makras, Polyzois; Marzano, Angelo V; de Menthon, Mathilde; Micke, Oliver; Passoni, Emanuela; Seegenschmiedt, Heinrich M; Tazi, Abdellatif; McClain, Kenneth L

    2013-01-01

    Langerhans Cell Histiocytosis (LCH) is an orphan disease of clonal dendritic cells which may affect any organ of the body. Most of the knowledge about the diagnosis and therapy is based on pedriatic studies. Adult LCH patients are often evaluated by physicians who focus on only the most obviously affected organ without sufficient evaluation of other systems, resulting in patients being underdiagnosed and/or incompletely staged. Furthermore they may be treated with pediatric-based therapies which are less effective and sometimes more toxic for adults. The published literature on adult LCH cases lacks a comprehensive discussion on the differences between pediatric and adult patients and there are no recommendations for evaluation and comparative therapies. In order to fill this void, a number of experts in this field cooperated to develop the first recommendations for management of adult patients with LCH. Key questions were selected according to the clinical relevance focusing on diagnostic work up, therapy, and follow up. Based on the available literature up to December 2012, recommendations were established, drafts were commented by the entire group, and redrafted by the executive editor. The quality of evidence of the recommendations is predominantly attributed to the level of expert opinion. Final agreement was by consensus. PMID:23672541

  10. Management of adult patients with Langerhans cell histiocytosis: recommendations from an expert panel on behalf of Euro-Histio-Net

    PubMed Central

    2013-01-01

    Langerhans Cell Histiocytosis (LCH) is an orphan disease of clonal dendritic cells which may affect any organ of the body. Most of the knowledge about the diagnosis and therapy is based on pedriatic studies. Adult LCH patients are often evaluated by physicians who focus on only the most obviously affected organ without sufficient evaluation of other systems, resulting in patients being underdiagnosed and/or incompletely staged. Furthermore they may be treated with pediatric-based therapies which are less effective and sometimes more toxic for adults. The published literature on adult LCH cases lacks a comprehensive discussion on the differences between pediatric and adult patients and there are no recommendations for evaluation and comparative therapies. In order to fill this void, a number of experts in this field cooperated to develop the first recommendations for management of adult patients with LCH. Key questions were selected according to the clinical relevance focusing on diagnostic work up, therapy, and follow up. Based on the available literature up to December 2012, recommendations were established, drafts were commented by the entire group, and redrafted by the executive editor. The quality of evidence of the recommendations is predominantly attributed to the level of expert opinion. Final agreement was by consensus. PMID:23672541

  11. Revised guidelines for the clinical management of Lynch syndrome (HNPCC): recommendations by a group of European experts

    PubMed Central

    Vasen, Hans F A; Blanco, Ignacio; Aktan-Collan, Katja; Gopie, Jessica P; Alonso, Angel; Aretz, Stefan; Bernstein, Inge; Bertario, Lucio; Burn, John; Capella, Gabriel; Colas, Chrystelle; Engel, Christoph; Frayling, Ian M; Genuardi, Maurizio; Heinimann, Karl; Hes, Frederik J; Hodgson, Shirley V; Karagiannis, John A; Lalloo, Fiona; Lindblom, Annika; Mecklin, Jukka-Pekka; Møller, Pal; Myrhoj, Torben; Nagengast, Fokko M; Parc, Yann; Ponz de Leon, Maurizio; Renkonen-Sinisalo, Laura; Sampson, Julian R; Stormorken, Astrid; Sijmons, Rolf H; Tejpar, Sabine; Thomas, Huw J W; Rahner, Nils; Wijnen, Juul T; Järvinen, Heikki Juhani; Möslein, Gabriela

    2013-01-01

    Lynch syndrome (LS) is characterised by the development of colorectal cancer, endometrial cancer and various other cancers, and is caused by a mutation in one of the mismatch repair genes: MLH1, MSH2, MSH6 or PMS2. In 2007, a group of European experts (the Mallorca group) published guidelines for the clinical management of LS. Since then substantial new information has become available necessitating an update of the guidelines. In 2011 and 2012 workshops were organised in Palma de Mallorca. A total of 35 specialists from 13 countries participated in the meetings. The first step was to formulate important clinical questions. Then a systematic literature search was performed using the Pubmed database and manual searches of relevant articles. During the workshops the outcome of the literature search was discussed in detail. The guidelines described in this paper may be helpful for the appropriate management of families with LS. Prospective controlled studies should be undertaken to improve further the care of these families. PMID:23408351

  12. Evaluation of tuberculosis diagnostics in children: 1. Proposed clinical case definitions for classification of intrathoracic tuberculosis disease. Consensus from an expert panel.

    PubMed

    Graham, Stephen M; Ahmed, Tahmeed; Amanullah, Farhana; Browning, Renee; Cardenas, Vicky; Casenghi, Martina; Cuevas, Luis E; Gale, Marianne; Gie, Robert P; Grzemska, Malgosia; Handelsman, Ed; Hatherill, Mark; Hesseling, Anneke C; Jean-Philippe, Patrick; Kampmann, Beate; Kabra, Sushil Kumar; Lienhardt, Christian; Lighter-Fisher, Jennifer; Madhi, Shabir; Makhene, Mamodikoe; Marais, Ben J; McNeeley, David F; Menzies, Heather; Mitchell, Charles; Modi, Surbhi; Mofenson, Lynne; Musoke, Philippa; Nachman, Sharon; Powell, Clydette; Rigaud, Mona; Rouzier, Vanessa; Starke, Jeffrey R; Swaminathan, Soumya; Wingfield, Claire

    2012-05-15

    There is a critical need for improved diagnosis of tuberculosis in children, particularly in young children with intrathoracic disease as this represents the most common type of tuberculosis in children and the greatest diagnostic challenge. There is also a need for standardized clinical case definitions for the evaluation of diagnostics in prospective clinical research studies that include children in whom tuberculosis is suspected but not confirmed by culture of Mycobacterium tuberculosis. A panel representing a wide range of expertise and child tuberculosis research experience aimed to develop standardized clinical research case definitions for intrathoracic tuberculosis in children to enable harmonized evaluation of new tuberculosis diagnostic technologies in pediatric populations. Draft definitions and statements were proposed and circulated widely for feedback. An expert panel then considered each of the proposed definitions and statements relating to clinical definitions. Formal group consensus rules were established and consensus was reached for each statement. The definitions presented in this article are intended for use in clinical research to evaluate diagnostic assays and not for individual patient diagnosis or treatment decisions. A complementary article addresses methodological issues to consider for research of diagnostics in children with suspected tuberculosis.

  13. Estimates of the solubilities of waste element radionuclides in waste isolation pilot plant brines: A report by the expert panel on the source term

    SciTech Connect

    Hobart, D.E. |; Bruton, C.J. |; Millero, F.J. |; Chou, I.M. |; Trauth, K.M.; Anderson, D.R.

    1996-05-01

    Evaluation of the long-term performance of the WIPP includes estimation of the cumulative releases of radionuclide elements to the accessible environment. Nonradioactive lead is added because of the large quantity expected in WIPP wastes. To estimate the solubilities of these elements in WIPP brines, the Panel used the following approach. Existing thermodynamic data were used to identify the most likely aqueous species in solution through the construction of aqueous speciation diagrams. Existing thermodynamic data and expert judgment were used to identify potential solubility-limiting solid phases. Thermodynamic data were used to calculate the activities of the radionuclide aqueous species in equilibrium with each solid. Activity coefficients of the radionuclide-bearing aqueous species were estimated using Pitzer`s equations. These activity coefficients were then used to calculate the concentration of each radionuclide at the 0.1 and 0.9 fractiles. The 0.5 fractile was chosen to represent experimental data with activity coefficient corrections as described above. Expert judgment was used to develop the 0.0, 0.25, 0.75, and 1.0 fractiles by considering the sensitivity of solubility to the potential variability in the composition of brine and gas, and the extent of waste contaminants, and extending the probability distributions accordingly. The results were used in the 1991 and 1992 performance assessment calculations. 68 refs.

  14. WTEC panel report on European nuclear instrumentation and controls. Final report

    SciTech Connect

    White, J.D.; Lanning, D.D.; Johnson, P.M.H.; Shelton, R.D.

    1991-12-01

    A study of instrumentation and controls (I and C) technology used in nuclear power plants in Europe was conducted by a panel of US specialists. This study plants in Europe was conducted by a panel of US specialists. This study included a review of the literature on the subject, followed by a visit to some of the leading organizations in Europe in the field nuclear I and C. Areas covered are: (1) role of the operator and control room design; (2) transition from analog to digital technology; (3) computerized operator support systems for fault management; (4) control strategies and techniques; (5) Nuclear power plant I and C architecture; (6) instrumentation and (7) computer standards and tools. The finding relate to poor reactions.

  15. WTEC panel report on European nuclear instrumentation and controls. Final report

    SciTech Connect

    White, J.D.; Lanning, D.D.; Beltracchi, L.; Best, F.R.; Easter, J.R.

    1991-12-01

    A study of instrumentation and controls (I and C) technology used in nuclear power plants in Europe was conducted by a panel of American specialists. The study included a review of the literature on the subject, followed by a visit to some of the leading organizations in Europe in the field of nuclear I and C. The findings of the study are presented in the report. The scope is limited to pressurized water reactors in Czechoslovakia, France, Germany, Norway and Russia. Specific topics include: The role of the operator and control room design; the transition from analog to digital technology; computerized operator support systems for fault management; control strategies and techniques; an investigation of nuclear power plant I and C architecture; instrumentation; computer standards and tools. A companion study is JTEC Panel Report on Nuclear Power in Japan (PB90-215724).

  16. Placing patients in the queue for coronary revascularization: evidence for practice variations from an expert panel process.

    PubMed

    Naylor, C D; Basinski, A; Baigrie, R S; Goldman, B S; Lomas, J

    1990-10-01

    A panel of 16 cardiologists and cardiac surgeons rated 438 case scenarios for the maximum acceptable delay prior to revascularization, using a scale with seven interventional time frames and two nodes for designating dubious or inappropriate cases. If consensus was defined as agreement by 12 or more panelists, only 1.4 percent of the case scenarios showed consensus on a single rating. Dividing the scale into three broad clinical categories (revascularize promptly, place on a waiting list, or no intervention), 11.4 percent of scenarios showed all 16 panelists agreeing on a single category, rising to 59.4 percent of scenarios if agreement by 12 panelists was accepted as a consensus. The mean difference between the panelists' highest and lowest urgency ratings yielded waiting time differences of two weeks for scenarios of very unstable angina, and more than three months for those with stable angina. However, in a regression model, individual panelist factors on average had less effect than clinical features such as severity and stability of angina, or stenosis of major coronary arteries. These findings strongly support the need for consensus criteria to ensure that triage practices are consistent and fair, and also suggest that widespread adoption of a standardized approach to revascularization priorities may be feasible.

  17. A toxicological and dermatological assessment of macrocyclic ketones when used as fragrance ingredients: the RIFM Expert Panel.

    PubMed

    Belsito, D; Bickers, D; Bruze, M; Calow, P; Dagli, M L; Fryer, A D; Greim, H; Miyachi, Y; Saurat, J H; Sipes, I G

    2011-12-01

    The macrocyclic ketone (MK) group of fragrance ingredients was evaluated for safety following a complete literature search. For high end users, calculated maximum dermal exposures vary from 0.13% to 1.10%; systemic exposures vary from 0.0005 to 0.0441 mg/kg/day. The MKs had low acute toxicity and no significant repeat dose toxicity. Liver weight and blood biochemistry effects were reversible after 2 weeks. No genotoxicity in bacteria and mammalian cell lines was observed. Reproductive toxicity was not observed for 3-methylcyclopentadecenone in an OECD compliant study. In humans, MKs are generally not irritating after one application. Animal studies showed irritation for some materials at concentrations higher than current consumer exposure. At rates consistent with current human exposure, phototoxicity and photosensitization were not observed. In animals, some MKs are sensitizers only at concentrations of 20%, 30%, or 100%, which are higher than current consumer exposure. No evidence of sensitization was observed in human tests. In patients with fragrance allergy, reactions were seen with cyclopentadecanone (3/178). Based on these findings, the Panel is of the opinion that there are no safety concerns for the MKs at reported levels of use and exposure as fragrance ingredients.

  18. Risk assessment of gene flow from genetically engineered virus resistant cassava to wild relatives in Africa: an expert panel report.

    PubMed

    Hokanson, Karen E; Ellstrand, Norman C; Dixon, Alfred G O; Kulembeka, Heneriko P; Olsen, Kenneth M; Raybould, Alan

    2016-02-01

    The probability and consequences of gene flow to wild relatives is typically considered in the environmental risk assessment of genetically engineered crops. This is a report from a discussion by a group of experts who used a problem formulation approach to consider existing information for risk assessment of gene flow from cassava (Manihot esculenta) genetically engineered for virus resistance to the 'wild' (naturalized) relative M. glaziovii in East Africa. Two environmental harms were considered in this case: (1) loss of genetic diversity in the germplasm pool, and (2) loss of valued species, ecosystem resources, or crop yield and quality due to weediness or invasiveness of wild relatives. Based on existing information, it was concluded that gene flow will occur, but it is not likely that this will reduce the genetic diversity in the germplasm pool. There is little existing information about the impact of the virus in natural populations that could be used to inform a prediction about whether virus resistance would lead to an increase in reproduction or survival, hence abundance of M. glaziovii. However, an increase in the abundance of M. glaziovii should be manageable, and would not necessarily lead to the identified environmental harms.

  19. Learning from Consumer-Oriented Review Efforts To Guide the Development of a System of Expert Panels To Identify and Share Promising and Exemplary Products and Programs. Working Papers. Volumes One and Two.

    ERIC Educational Resources Information Center

    Office of Educational Research and Improvement (ED), Washington, DC. Office of Reform Assistance and Dissemination.

    These volumes contain working papers related to the development of the Office of Educational Research and Improvement (OERI) Facilitated System of Expert Panels. Introductory papers by Susan Klein, Michael Scriven, Sharon Bobbitt and Susan Klein, and Michael Scriven and Lois-ellin Datta (printed in both volumes) set the stage for the discussions…

  20. Pediatric cyanide poisoning by fire smoke inhalation: a European expert consensus. Toxicology Surveillance System of the Intoxications Working Group of the Spanish Society of Paediatric Emergencies.

    PubMed

    Mintegi, Santiago; Clerigue, Nuria; Tipo, Vincenzo; Ponticiello, Eduardo; Lonati, Davide; Burillo-Putze, Guillermo; Delvau, Nicolas; Anseeuw, Kurt

    2013-11-01

    Most fire-related deaths are attributable to smoke inhalation rather than burns. The inhalation of fire smoke, which contains not only carbon monoxide but also a complex mixture of gases, seems to be the major cause of morbidity and mortality in fire victims, mainly in enclosed spaces. Cyanide gas exposure is quite common during smoke inhalation, and cyanide is present in the blood of fire victims in most cases and may play an important role in death by smoke inhalation. Cyanide poisoning may, however, be difficult to diagnose and treat. In these children, hydrogen cyanide seems to be a major source of concern, and the rapid administration of the antidote, hydroxocobalamin, may be critical for these children.European experts recently met to formulate an algorithm for prehospital and hospital management of adult patients with acute cyanide poisoning. Subsequently, a group of European pediatric experts met to evaluate and adopt that algorithm for use in the pediatric population.

  1. Daily baseline skin care in the prevention, treatment, and supportive care of skin toxicity in oncology patients: recommendations from a multinational expert panel

    PubMed Central

    Bensadoun, René-Jean; Humbert, Phillipe; Krutman, Jean; Luger, Thomas; Triller, Raoul; Rougier, André; Seite, Sophie; Dreno, Brigitte

    2013-01-01

    Skin reactions due to radiotherapy and chemotherapy are a significant problem for an important number of cancer patients. While effective for treating cancer, they disturb cutaneous barrier function, causing a reaction soon after initiation of treatment that impacts patient quality of life. Managing these symptoms with cosmetics and nonpharmaceutical skin care products for camouflage or personal hygiene may be important for increasing patient self-esteem. However, inappropriate product choice or use could worsen side effects. Although recommendations exist for the pharmaceutical treatment of skin reactions, there are no recommendations for the choice or use of dermatologic skin care products for oncology patients. The present guidelines were developed by a board of European experts in dermatology and oncology to provide cancer care professionals with guidance for the appropriate use of non-pharmaceutical, dermocosmetic skin care management of cutaneous toxicities associated with radiotherapy and systemic chemotherapy, including epidermal growth factor inhibitors and monoclonal antibodies. The experts hope that these recommendations will improve the management of cutaneous side effects and hence quality of life for oncology patients. PMID:24353440

  2. Statin intolerance – an attempt at a unified definition. Position paper from an International Lipid Expert Panel

    PubMed Central

    Rizzo, Manfredi; Toth, Peter P.; Farnier, Michel; Davidson, Michael H.; Al-Rasadi, Khalid; Aronow, Wilbert S.; Athyros, Vasilis; Djuric, Dragan M.; Ezhov, Marat V.; Greenfield, Robert S.; Hovingh, G. Kees; Kostner, Karam; Serban, Corina; Lighezan, Daniel; Fras, Zlatko; Moriarty, Patrick M.; Muntner, Paul; Goudev, Assen; Ceska, Richard; Nicholls, Stephen J.; Broncel, Marlena; Nikolic, Dragana; Pella, Daniel; Puri, Raman; Rysz, Jacek; Wong, Nathan D.; Bajnok, Laszlo; Jones, Steven R.; Ray, Kausik K.; Mikhailidis, Dimitri P.

    2015-01-01

    Statins are one of the most commonly prescribed drugs in clinical practice. They are usually well tolerated and effectively prevent cardiovascular events. Most adverse effects associated with statin therapy are muscle-related. The recent statement of the European Atherosclerosis Society (EAS) has focused on statin associated muscle symptoms (SAMS), and avoided the use of the term ‘statin intolerance’. Although muscle syndromes are the most common adverse effects observed after statin therapy, excluding other side effects might underestimate the number of patients with statin intolerance, which might be observed in 10–15% of patients. In clinical practice, statin intolerance limits effective treatment of patients at risk of, or with, cardiovascular disease. Knowledge of the most common adverse effects of statin therapy that might cause statin intolerance and the clear definition of this phenomenon is crucial to effectively treat patients with lipid disorders. Therefore, the aim of this position paper was to suggest a unified definition of statin intolerance, and to complement the recent EAS statement on SAMS, where the pathophysiology, diagnosis and the management were comprehensively presented. PMID:25861286

  3. Adjuvant bisphosphonates in early breast cancer: consensus guidance for clinical practice from a European Panel.

    PubMed

    Hadji, P; Coleman, R E; Wilson, C; Powles, T J; Clézardin, P; Aapro, M; Costa, L; Body, J-J; Markopoulos, C; Santini, D; Diel, I; Di Leo, A; Cameron, D; Dodwell, D; Smith, I; Gnant, M; Gray, R; Harbeck, N; Thurlimann, B; Untch, M; Cortes, J; Martin, M; Albert, U-S; Conte, P-F; Ejlertsen, B; Bergh, J; Kaufmann, M; Holen, I

    2016-03-01

    Bisphosphonates have been studied in randomised trials in early breast cancer to investigate their ability to prevent cancer treatment-induced bone loss (CTIBL) and reduce the risk of disease recurrence and metastasis. Treatment benefits have been reported but bisphosphonates do not currently have regulatory approval for either of these potential indications. This consensus paper provides a review of the evidence and offers guidance to breast cancer clinicians on the use of bisphosphonates in early breast cancer. Using the nominal group methodology for consensus, a systematic review of the literature was augmented by a workshop held in October 2014 for breast cancer and bone specialists to present and debate the available pre-clinical and clinical evidence for the use of adjuvant bisphosphonates. This was followed by a questionnaire to all members of the writing committee to identify areas of consensus. The panel recommended that bisphosphonates should be considered as part of routine clinical practice for the prevention of CTIBL in all patients with a T score of <-2.0 or ≥2 clinical risk factors for fracture. Compelling evidence from a meta-analysis of trial data of >18,000 patients supports clinically significant benefits of bisphosphonates on the development of bone metastases and breast cancer mortality in post-menopausal women or those receiving ovarian suppression therapy. Therefore, the panel recommends that bisphosphonates (either intravenous zoledronic acid or oral clodronate) are considered as part of the adjuvant breast cancer treatment in this population and the potential benefits and risks discussed with relevant patients. PMID:26681681

  4. Performance of the FilmArray® blood culture identification panel utilized by non-expert staff compared with conventional microbial identification and antimicrobial resistance gene detection from positive blood cultures.

    PubMed

    McCoy, Morgan H; Relich, Ryan F; Davis, Thomas E; Schmitt, Bryan H

    2016-07-01

    Utilization of commercially available rapid platforms for microbial identification from positive blood cultures is useful during periods of, or in laboratories with, limited expert staffing. We compared the results of the FilmArray® BCID Panel performed by non-expert technologists to those of conventional methods for organism identification performed by skilled microbiologists. Within 8 h of signalling positive by a continuous monitoring blood culture system, positive bottles were analysed by the FilmArray BCID Panel. Data from these analyses were compared to standard-of-care testing, which included conventional and automated methods. To gauge the ease of use of the BCID Panel by non-expert staff, technologists unfamiliar with diagnostic bacteriology performed the testing without prior knowledge of the Gram stain results, or even whether organisms were detected. Identifications of 172/200 (86 %) positive blood cultures using the BCID Panel were consistent with identifications provided by standard-of-care methods. Standard-of-care testing identified organisms in 20 positive blood cultures, which were not represented on the BCID Panel. Seven (3.5 %) blood cultures demonstrated a discrepancy between the methods, which could not be attributed to either a lack of representation on the panel or unclear separate detection of organisms in a mixed blood culture of a shared genus or grouping of organisms, e.g. Staphylococcus or Enterobacteriaceae . One (0.5 %) blood culture yielded invalid results on two separate panels, so it was eliminated from the study. The easy-to-use FilmArray® technology shows good correlation with blood culture identification and antibiotic resistance detection performed by conventional methods. This technology may be particularly useful in laboratories with limited staffing or limited technical expertise. PMID:27170288

  5. Performance of the FilmArray® blood culture identification panel utilized by non-expert staff compared with conventional microbial identification and antimicrobial resistance gene detection from positive blood cultures.

    PubMed

    McCoy, Morgan H; Relich, Ryan F; Davis, Thomas E; Schmitt, Bryan H

    2016-07-01

    Utilization of commercially available rapid platforms for microbial identification from positive blood cultures is useful during periods of, or in laboratories with, limited expert staffing. We compared the results of the FilmArray® BCID Panel performed by non-expert technologists to those of conventional methods for organism identification performed by skilled microbiologists. Within 8 h of signalling positive by a continuous monitoring blood culture system, positive bottles were analysed by the FilmArray BCID Panel. Data from these analyses were compared to standard-of-care testing, which included conventional and automated methods. To gauge the ease of use of the BCID Panel by non-expert staff, technologists unfamiliar with diagnostic bacteriology performed the testing without prior knowledge of the Gram stain results, or even whether organisms were detected. Identifications of 172/200 (86 %) positive blood cultures using the BCID Panel were consistent with identifications provided by standard-of-care methods. Standard-of-care testing identified organisms in 20 positive blood cultures, which were not represented on the BCID Panel. Seven (3.5 %) blood cultures demonstrated a discrepancy between the methods, which could not be attributed to either a lack of representation on the panel or unclear separate detection of organisms in a mixed blood culture of a shared genus or grouping of organisms, e.g. Staphylococcus or Enterobacteriaceae . One (0.5 %) blood culture yielded invalid results on two separate panels, so it was eliminated from the study. The easy-to-use FilmArray® technology shows good correlation with blood culture identification and antibiotic resistance detection performed by conventional methods. This technology may be particularly useful in laboratories with limited staffing or limited technical expertise.

  6. Tailoring the dosing schedule of nab-paclitaxel in metastatic breast cancer according to patient and disease characteristics: Recommendations from a panel of experts.

    PubMed

    Arpino, G; Marmé, F; Cortés, J; Ricevuto, E; Leonard, R; Llombart-Cussac, A

    2016-03-01

    The choice of chemotherapy for patients with metastatic breast cancer (MBC) depends on disease- and patient-related factors, but there is little guidance on dosing modifications for patients unable to receive the licensed dose. Nab-paclitaxel is a solvent-free form of paclitaxel that uses albumin as a drug carrier and exploits endogenous albumin transport pathways to achieve enhanced drug targeting and tumour penetration with reduced toxicity. It is approved for use at a dose of 260 mg/m(2) every three weeks in adults who have failed first-line treatment for MBC and for whom standard anthracycline-based therapy is not indicated. Emerging data suggest that weekly dosing schedules of nab-paclitaxel may provide clinical benefit in some patients, but the utility of these alternative dosing schedules remains unclear. A panel of breast cancer experts convened to review available literature for nab-paclitaxel in MBC and, taking into account their clinical experience, recommended that alternative dosing schedules may be considered according to the aggressiveness of disease and patient condition as follows: 125 mg/m(2) QW 3/4 (aggressive disease and fit), 100mg/m(2) QW 3/4 (aggressive or indolent disease and unfit). All dosing schedules were considered acceptable for fit patients with indolent disease. These recommendations are based on current evidence, and emerging data from ongoing trials may reinforce or modify the recommendations provided. PMID:26712590

  7. Predicting and managing the risk of pulmonary haemorrhage in patients with NSCLC treated with bevacizumab: a consensus report from a panel of experts

    PubMed Central

    Reck, M.; Barlesi, F.; Crinò, L.; Henschke, C. I.; Isla, D.; Stiebeler, S.; Spigel, D. R.

    2012-01-01

    Background: Bevacizumab is a monoclonal antibody against vascular endothelial growth factor. Severe pulmonary haemorrhage (PH) is a rare but serious potential adverse event associated with bevacizumab therapy for advanced non-squamous non-small-cell lung cancer (NSCLC). Methods: A panel of expert oncologists, pulmonologists and radiologists reviewed the available data to identify predictive factors for PH in order to help guide physicians using bevacizumab in patients with NSCLC. Results: Patients with NSCLC are at an increased risk of PH owing to the underlying disease process. Patients with squamous histology and/or a history of grade ≥2 haemoptysis (≥2.5 ml per event) should not receive bevacizumab. No clinical or radiological features (including cavitation and central tumour location) reliably predict severe PH in bevacizumab-treated patients. Major blood vessel infiltration and bronchial vessel infiltration, encasement and abutting may predict PH; however, standardised radiological criteria for defining infiltration have not been established. Eligibility for bevacizumab is not affected by patient age, performance status or anticoagulation or antiplatelet therapy. Conclusions: An individualised risk–benefit assessment should be undertaken in all patients with NSCLC in whom bevacizumab is being considered. Further research is required to elucidate the mechanisms underlying PH and the clinical risk factors. PMID:22056855

  8. Derived Reference Doses (RfDs) for the environmental degradates of the herbicides alachlor and acetochlor: results of an independent expert panel deliberation.

    PubMed

    Gadagbui, Bernard; Maier, Andrew; Dourson, Michael; Parker, Ann; Willis, Alison; Christopher, John P; Hicks, Lebelle; Ramasamy, Santhini; Roberts, Stephen M

    2010-01-01

    An independent peer expert panel was convened under the auspices of the Alliance for Risk Assessment (ARA) to review toxicology data and derive oral Reference Doses (RfDs) for four environmental degradates of the acetanilide herbicides, alachlor and acetochlor. The degradates included in this evaluation were (1) alachlor tertiary-ethanesulfonic acid (ESA), (2) alachlor tertiary-oxanilic acid (OXA), (3) acetochlor ESA, and (4) acetochlor OXA. Each degradate was judged to have sufficient data for developing low to medium confidence RfD, with use of an additional uncertainty factor (UF) to cover data gaps. Body weight decreases were identified as the most sensitive treatment-related adverse effect for RfD development. A composite UF of 1000 (10 for human variability in sensitivity, 10 for interspecies differences in sensitivity, and 10 for subchronic to chronic and database deficiency combined; i.e., 10(A)x10(H)x10(S&D)) for each degradate was considered reasonable, while noting that an argument could be made for an UF of 3000 (10(A)x10(H)x30(S&D)). Based on the available data, an oral RfD of 0.2 mg/kg-day is recommended for both acetochlor ESA and acetochlor OXA and an oral RfD of 0.8 mg/kg-day is recommended for both alachlor ESA and alachlor OXA. PMID:20206657

  9. A Concise Set of Structure and Process Indicators to Assess and Compare Antimicrobial Stewardship Programs Among EU and US Hospitals: Results From a Multinational Expert Panel.

    PubMed

    Pollack, Lori A; Plachouras, Diamantis; Sinkowitz-Cochran, Ronda; Gruhler, Heidi; Monnet, Dominique L; Weber, J Todd

    2016-10-01

    OBJECTIVES To develop common indicators, relevant to both EU member states and the United States, that characterize and allow for meaningful comparison of antimicrobial stewardship programs among different countries and healthcare systems. DESIGN Modified Delphi process. PARTICIPANTS A multinational panel of 20 experts in antimicrobial stewardship. METHODS Potential indicators were rated on the perceived feasibility to implement and measure each indicator and clinical importance for optimizing appropriate antimicrobial prescribing. RESULTS The outcome was a set of 33 indicators developed to characterize the infrastructure and activities of hospital antimicrobial stewardship programs. Among them 17 indicators were considered essential to characterize an antimicrobial stewardship program and therefore were included in a core set of indicators. The remaining 16 indicators were considered optional indicators and included in a supplemental set. CONCLUSIONS The integration of these indicators in public health surveillance and special studies will lead to a better understanding of best practices in antimicrobial stewardship. Additionally, future studies can explore the association of hospital antimicrobial stewardship programs to antimicrobial use and resistance. Infect Control Hosp Epidemiol 2016:1-11.

  10. A Review of Traditional and Novel Treatments for Seizures in Autism Spectrum Disorder: Findings from a Systematic Review and Expert Panel

    PubMed Central

    Frye, Richard E.; Rossignol, Daniel; Casanova, Manuel F.; Brown, Gregory L.; Martin, Victoria; Edelson, Stephen; Coben, Robert; Lewine, Jeffrey; Slattery, John C.; Lau, Chrystal; Hardy, Paul; Fatemi, S. Hossein; Folsom, Timothy D.; MacFabe, Derrick; Adams, James B.

    2013-01-01

    Despite the fact that seizures are commonly associated with autism spectrum disorder (ASD), the effectiveness of treatments for seizures has not been well studied in individuals with ASD. This manuscript reviews both traditional and novel treatments for seizures associated with ASD. Studies were selected by systematically searching major electronic databases and by a panel of experts that treat ASD individuals. Only a few anti-epileptic drugs (AEDs) have undergone carefully controlled trials in ASD, but these trials examined outcomes other than seizures. Several lines of evidence point to valproate, lamotrigine, and levetiracetam as the most effective and tolerable AEDs for individuals with ASD. Limited evidence supports the use of traditional non-AED treatments, such as the ketogenic and modified Atkins diet, multiple subpial transections, immunomodulation, and neurofeedback treatments. Although specific treatments may be more appropriate for specific genetic and metabolic syndromes associated with ASD and seizures, there are few studies which have documented the effectiveness of treatments for seizures for specific syndromes. Limited evidence supports l-carnitine, multivitamins, and N-acetyl-l-cysteine in mitochondrial disease and dysfunction, folinic acid in cerebral folate abnormalities and early treatment with vigabatrin in tuberous sclerosis complex. Finally, there is limited evidence for a number of novel treatments, particularly magnesium with pyridoxine, omega-3 fatty acids, the gluten-free casein-free diet, and low-frequency repetitive transcranial magnetic simulation. Zinc and l-carnosine are potential novel treatments supported by basic research but not clinical studies. This review demonstrates the wide variety of treatments used to treat seizures in individuals with ASD as well as the striking lack of clinical trials performed to support the use of these treatments. Additional studies concerning these treatments for controlling seizures in individuals

  11. Sarcoma: concordance between initial diagnosis and centralized expert review in a population-based study within three European regions

    PubMed Central

    Ray-Coquard, I.; Montesco, M. C.; Coindre, J. M.; Dei Tos, A. P.; Lurkin, A.; Ranchère-Vince, D.; Vecchiato, A.; Decouvelaere, A. V.; Mathoulin-Pélissier, S.; Albert, S.; Cousin, P.; Cellier, D.; Toffolatti, L.; Rossi, C. R.; Blay, J. Y.

    2012-01-01

    Background Sarcomas represent a heterogeneous group of tumors. Accurate determination of histological diagnosis and prognostic factors is critical for the delineation of treatment strategies. The contribution of second opinion (SO) to improve diagnostic accuracy has been suggested for sarcoma but has never been established in population-based studies. Methods Histological data of patients diagnosed with sarcoma in Rhone-Alpes (France), Veneto (Italy) and Aquitaine (France) over a 2-year period were collected. Initial diagnoses were systematically compared with SO from regional and national experts. Results Of 2016 selected patients, 1463 (73%) matched the inclusion criteria and were analyzed. Full concordance between primary diagnosis and SO (the first pathologist and the expert reached identical conclusions) was observed in 824 (56%) cases, partial concordance (identical diagnosis of connective tumor but different grade or histological subtype) in 518 (35%) cases and complete discordance (benign versus malignant, different histological type or invalidation of the diagnosis of sarcoma) in 121 (8%) cases. The major discrepancies were related to histological grade (n = 274, 43%), histological type (n = 144, 24%), subtype (n = 18, 3%) and grade plus subtype or grade plus histological type (n = 178, 29%). Conclusion More than 40% of first histological diagnoses were modified at second reading, possibly resulting in different treatment decisions. PMID:22331640

  12. Expert Cold Structure Development

    NASA Astrophysics Data System (ADS)

    Atkins, T.; Demuysere, P.

    2011-05-01

    The EXPERT Program is funded by ESA. The objective of the EXPERT mission is to perform a sub-orbital flight during which measurements of critical aero- thermodynamic phenomena will be obtained by using state-of-the-art instrumentation. As part of the EXPERT Flight Segment, the responsibility of the Cold Structure Development Design, Manufacturing and Validation was committed to the Belgian industrial team SONACA/SABCA. The EXPERT Cold Structure includes the Launcher Adapter, the Bottom Panel, the Upper Panel, two Cross Panels and the Parachute Bay. An additional Launcher Adapter was manufactured for the separation tests. The selected assembly definition and manufacturing technologies ( machined parts and sandwich panels) were dictated classically by the mass and stiffness, but also by the CoG location and the sensitive separation interface. Used as support for the various on-board equipment, the Cold Structure is fixed to but thermally uncoupled from the PM 1000 thermal shield. It is protect on its bottom panel by a thermal blanket. As it is a protoflight, analysis was the main tool for the verification. Low level stiffness and modal analysis tests have also been performed on the Cold Structure equipped with its ballast. It allowed to complete its qualification and to prepare SONACA/SABCA support for the system dynamic tests foreseen in 2011. The structure was finally coated with a thermal control black painting and delivered on time to Thales Alenia Space-Italy end of March 201.

  13. Report of an Expert Panel on the reanalysis by of a 90-day study conducted by Monsanto in support of the safety of a genetically modified corn variety (MON 863).

    PubMed

    Doull, J; Gaylor, D; Greim, H A; Lovell, D P; Lynch, B; Munro, I C

    2007-11-01

    MON 863, a genetically engineered corn variety that contains the gene for modified Bacillus thuringiensis Cry3Bb1 protein to protect against corn rootworm, was tested in a 90-day toxicity study as part of the process to gain regulatory approval. This study was reanalyzed by Séralini et al. who contended that the study showed possible hepatorenal effects of MON 863. An Expert Panel was convened to assess the original study results as analyzed by the Monsanto Company and the reanalysis conducted by Séralini et al. The Expert Panel concludes that the Séralini et al. reanalysis provided no evidence to indicate that MON 863 was associated with adverse effects in the 90-day rat study. In each case, statistical findings reported by both Monsanto and Séralini et al. were considered to be unrelated to treatment or of no biological or clinical importance because they failed to demonstrate a dose-response relationship, reproducibility over time, association with other relevant changes (e.g., histopathology), occurrence in both sexes, difference outside the normal range of variation, or biological plausibility with respect to cause-and-effect. The Séralini et al. reanalysis does not advance any new scientific data to indicate that MON 863 caused adverse effects in the 90-day rat study.

  14. Probability encoding of hydrologic parameters for basalt. Elicitation of expert opinions from a panel of three basalt waste isolation project staff hydrologists

    SciTech Connect

    Runchal, A.K.; Merkhofer, M.W.; Olmsted, E.; Davis, J.D.

    1984-11-01

    The present study implemented a probability encoding method to estimate the probability distributions of selected hydrologic variables for the Cohassett basalt flow top and flow interior, and the anisotropy ratio of the interior of the Cohassett basalt flow beneath the Hanford Site. Site-speciic data for these hydrologic parameters are currently inadequate for the purpose of preliminary assessment of candidate repository performance. However, this information is required to complete preliminary performance assessment studies. Rockwell chose a probability encoding method developed by SRI International to generate credible and auditable estimates of the probability distributions of effective porosity and hydraulic conductivity anisotropy. The results indicate significant differences of opinion among the experts. This was especially true of the values of the effective porosity of the Cohassett basalt flow interior for which estimates differ by more than five orders of magnitude. The experts are in greater agreement about the values of effective porosity of the Cohassett basalt flow top; their estimates for this variable are generally within one to two orders of magnitiude of each other. For anisotropy ratio, the expert estimates are generally within two or three orders of magnitude of each other. Based on this study, the Rockwell hydrologists estimate the effective porosity of the Cohassett basalt flow top to be generally higher than do the independent experts. For the effective porosity of the Cohassett basalt flow top, the estimates of the Rockwell hydrologists indicate a smaller uncertainty than do the estimates of the independent experts. On the other hand, for the effective porosity and anisotropy ratio of the Cohassett basalt flow interior, the estimates of the Rockwell hydrologists indicate a larger uncertainty than do the estimates of the independent experts.

  15. MASSACHUSETTS DIVISION OF FISHERIES AND WILDLIFE ADAPTATION PLANNING USING AN EXPERT PANEL BASED HABITAT VULNERABLITY ASSESSMENT John O'Leary, MA Div. of Fisheries and Wildlife and Hector Galbraith, Ph d. Climate Change Initiative, Manomet Center for Conservation Sciences

    NASA Astrophysics Data System (ADS)

    O'Leary, J. A.; Galbraith, H.

    2010-12-01

    We are using the results from a recently completed Habitat Vulnerability Assessment (HVA) for adaptation planning within the Massachusetts Division of Fisheries and Wildlife. We used Regional Downscale Climate Projections to provide exposure information for the assessment and an Expert Panel of biologists to provide information on the sensitivity and adaptive capacity of the habitat types we assessed. We estimated the vulnerability of 22 key habitat types which were identified in the State Wildlife Action Plan (SWAP). Results of the expert panel based HVA include a relative ranking of vulnerability to climate change for these habitats within Massachusetts, a confidence score for the estimated vulnerability for each habitat type evaluated and a narrative identifying the factors which influence the vulnerability of the habitat. We also evaluated the vulnerability of the Species in Greatest Conservation Need (SGCN) from the SWAP to climate change conditions. The SGCN are linked to their primary habitat types. The HVA results along with recommendations from the National Academies Report: Adapting to the Impacts of Climate Change America’s Climate Choices: Panel on Adapting to the Impacts of Climate Change will inform “climate smart” adaptation strategies for agency management, acquisition, and research and monitoring programs that build on and do not replace existing implementation strategies. We believe that the adaptation planning process that we outline in this presentation could serve as a model for resource agencies and others who are in the process of developing their response to anticipated impacts from climate change conditions. We are also engaged in a collaborative effort to conduct a Regional Habitat Vulnerability Assessment (RHVA). Results form the RHVA will provide the MDFW with the ability to assess adaptation strategies based on regional need.

  16. Statin-associated muscle symptoms: impact on statin therapy—European Atherosclerosis Society Consensus Panel Statement on Assessment, Aetiology and Management

    PubMed Central

    Stroes, Erik S.; Thompson, Paul D.; Corsini, Alberto; Vladutiu, Georgirene D.; Raal, Frederick J.; Ray, Kausik K.; Roden, Michael; Stein, Evan; Tokgözoğlu, Lale; Nordestgaard, Børge G.; Bruckert, Eric; De Backer, Guy; Krauss, Ronald M.; Laufs, Ulrich; Santos, Raul D.; Hegele, Robert A.; Hovingh, G. Kees; Leiter, Lawrence A.; Mach, Francois; März, Winfried; Newman, Connie B.; Wiklund, Olov; Jacobson, Terry A.; Catapano, Alberico L.; Chapman, M. John; Ginsberg, Henry N.; Stroes, Erik; Thompson, Paul D.; Corsini, Alberto; Vladutiu, Georgirene D.; Raal, Frederick J.; Ray, Kausik K.; Roden, Michael; Stein, Evan; Tokgözoğlu, Lale; Nordestgaard, Børge G.; Bruckert, Eric; Krauss, Ronald M.; Laufs, Ulrich; Santos, Raul D.; März, Winfried; Newman, Connie B.; John Chapman, M.; Ginsberg, Henry N.; John Chapman, M.; Ginsberg, Henry N.; de Backer, Guy; Catapano, Alberico L.; Hegele, Robert A.; Kees Hovingh, G.; Jacobson, Terry A.; Leiter, Lawrence; Mach, Francois; Wiklund, Olov

    2015-01-01

    Statin-associated muscle symptoms (SAMS) are one of the principal reasons for statin non-adherence and/or discontinuation, contributing to adverse cardiovascular outcomes. This European Atherosclerosis Society (EAS) Consensus Panel overviews current understanding of the pathophysiology of statin-associated myopathy, and provides guidance for diagnosis and management of SAMS. Statin-associated myopathy, with significant elevation of serum creatine kinase (CK), is a rare but serious side effect of statins, affecting 1 per 1000 to 1 per 10 000 people on standard statin doses. Statin-associated muscle symptoms cover a broader range of clinical presentations, usually with normal or minimally elevated CK levels, with a prevalence of 7–29% in registries and observational studies. Preclinical studies show that statins decrease mitochondrial function, attenuate energy production, and alter muscle protein degradation, thereby providing a potential link between statins and muscle symptoms; controlled mechanistic and genetic studies in humans are necessary to further understanding. The Panel proposes to identify SAMS by symptoms typical of statin myalgia (i.e. muscle pain or aching) and their temporal association with discontinuation and response to repetitive statin re-challenge. In people with SAMS, the Panel recommends the use of a maximally tolerated statin dose combined with non-statin lipid-lowering therapies to attain recommended low-density lipoprotein cholesterol targets. The Panel recommends a structured work-up to identify individuals with clinically relevant SAMS generally to at least three different statins, so that they can be offered therapeutic regimens to satisfactorily address their cardiovascular risk. Further research into the underlying pathophysiological mechanisms may offer future therapeutic potential. PMID:25694464

  17. Statin-associated muscle symptoms: impact on statin therapy-European Atherosclerosis Society Consensus Panel Statement on Assessment, Aetiology and Management.

    PubMed

    Stroes, Erik S; Thompson, Paul D; Corsini, Alberto; Vladutiu, Georgirene D; Raal, Frederick J; Ray, Kausik K; Roden, Michael; Stein, Evan; Tokgözoğlu, Lale; Nordestgaard, Børge G; Bruckert, Eric; De Backer, Guy; Krauss, Ronald M; Laufs, Ulrich; Santos, Raul D; Hegele, Robert A; Hovingh, G Kees; Leiter, Lawrence A; Mach, Francois; März, Winfried; Newman, Connie B; Wiklund, Olov; Jacobson, Terry A; Catapano, Alberico L; Chapman, M John; Ginsberg, Henry N

    2015-05-01

    Statin-associated muscle symptoms (SAMS) are one of the principal reasons for statin non-adherence and/or discontinuation, contributing to adverse cardiovascular outcomes. This European Atherosclerosis Society (EAS) Consensus Panel overviews current understanding of the pathophysiology of statin-associated myopathy, and provides guidance for diagnosis and management of SAMS. Statin-associated myopathy, with significant elevation of serum creatine kinase (CK), is a rare but serious side effect of statins, affecting 1 per 1000 to 1 per 10 000 people on standard statin doses. Statin-associated muscle symptoms cover a broader range of clinical presentations, usually with normal or minimally elevated CK levels, with a prevalence of 7-29% in registries and observational studies. Preclinical studies show that statins decrease mitochondrial function, attenuate energy production, and alter muscle protein degradation, thereby providing a potential link between statins and muscle symptoms; controlled mechanistic and genetic studies in humans are necessary to further understanding. The Panel proposes to identify SAMS by symptoms typical of statin myalgia (i.e. muscle pain or aching) and their temporal association with discontinuation and response to repetitive statin re-challenge. In people with SAMS, the Panel recommends the use of a maximally tolerated statin dose combined with non-statin lipid-lowering therapies to attain recommended low-density lipoprotein cholesterol targets. The Panel recommends a structured work-up to identify individuals with clinically relevant SAMS generally to at least three different statins, so that they can be offered therapeutic regimens to satisfactorily address their cardiovascular risk. Further research into the underlying pathophysiological mechanisms may offer future therapeutic potential. PMID:25694464

  18. Statin-associated muscle symptoms: impact on statin therapy-European Atherosclerosis Society Consensus Panel Statement on Assessment, Aetiology and Management.

    PubMed

    Stroes, Erik S; Thompson, Paul D; Corsini, Alberto; Vladutiu, Georgirene D; Raal, Frederick J; Ray, Kausik K; Roden, Michael; Stein, Evan; Tokgözoğlu, Lale; Nordestgaard, Børge G; Bruckert, Eric; De Backer, Guy; Krauss, Ronald M; Laufs, Ulrich; Santos, Raul D; Hegele, Robert A; Hovingh, G Kees; Leiter, Lawrence A; Mach, Francois; März, Winfried; Newman, Connie B; Wiklund, Olov; Jacobson, Terry A; Catapano, Alberico L; Chapman, M John; Ginsberg, Henry N

    2015-05-01

    Statin-associated muscle symptoms (SAMS) are one of the principal reasons for statin non-adherence and/or discontinuation, contributing to adverse cardiovascular outcomes. This European Atherosclerosis Society (EAS) Consensus Panel overviews current understanding of the pathophysiology of statin-associated myopathy, and provides guidance for diagnosis and management of SAMS. Statin-associated myopathy, with significant elevation of serum creatine kinase (CK), is a rare but serious side effect of statins, affecting 1 per 1000 to 1 per 10 000 people on standard statin doses. Statin-associated muscle symptoms cover a broader range of clinical presentations, usually with normal or minimally elevated CK levels, with a prevalence of 7-29% in registries and observational studies. Preclinical studies show that statins decrease mitochondrial function, attenuate energy production, and alter muscle protein degradation, thereby providing a potential link between statins and muscle symptoms; controlled mechanistic and genetic studies in humans are necessary to further understanding. The Panel proposes to identify SAMS by symptoms typical of statin myalgia (i.e. muscle pain or aching) and their temporal association with discontinuation and response to repetitive statin re-challenge. In people with SAMS, the Panel recommends the use of a maximally tolerated statin dose combined with non-statin lipid-lowering therapies to attain recommended low-density lipoprotein cholesterol targets. The Panel recommends a structured work-up to identify individuals with clinically relevant SAMS generally to at least three different statins, so that they can be offered therapeutic regimens to satisfactorily address their cardiovascular risk. Further research into the underlying pathophysiological mechanisms may offer future therapeutic potential.

  19. Understanding obstacles to the recognition of and response to dementia in different European countries: a modified focus group approach using multinational, multi-disciplinary expert groups.

    PubMed

    Iliffe, S; De Lepeleire, J; Van Hout, H; Kenny, G; Lewis, A; Vernooij-Dassen, M

    2005-01-01

    Experts from eight European countries (Belgium, France, The Netherlands, Ireland, Italy, Portugal, Spain and the United Kingdom) and the disciplines of clinical psychology, general practice, geriatric medicine, old age psychiatry, medical sociology, nursing and voluntary body organisation met in 2003 to explore obstacles to recognition of and response to dementia in general practice within Europe. A modified focus group methodology was used in this exploratory process. Groups were conducted over a two-day period, with five sessions lasting 1-1.5 hours each. An adapted nominal group method was used to record themes arising from the group discussion, and these themes were used in a grounded theory approach to generate explanations for delayed recognition of and response to dementia. The overarching theme that arose from the focus groups was movement, which had three different expressions. These were: population movement and its consequences for localities, services and professional experience; the journey of the person with dementia along the disease process; and the referral pathway to access services and support. Change is the core issue in dementia care, with multiple pathways of change that need to be understood at clinical and organisational levels. Practitioners and people with dementia are engaged in managing emotional, social and physical risks, making explicit risk management a potentially important component of dementia care. The boundary between generalist and specialist services is a particular problem, with great potential for dysfunctionality. Stigma and ageism are variably distributed phenomena both within and between countries.

  20. [The scope of expert competence for the evaluation of non-compliance with the requirements of the departmental normative legal acts in the course of forensic medical panel examinations concerning "medical practice" in the criminal legal procedures].

    PubMed

    Kovalev, A V; Pletianova, I V; Fetisov, V A

    2014-01-01

    This article is devoted to the analysis of the problem of expert competence for the evaluation of non-compliance with the requirements of the departmental normative legal acts in the course of forensic medical panel examinations concerning "medical practice" in the criminal legal procedures. The approaches to the solution of his problem are exemplified by forensic medical expertise of selected cases from obstetric and gynecological practice. It is demonstrated that investigations into non-compliance events arising in the work of medical facilities must include the analysis of the departmental normative legal acts that govern the organizational and diagnostic processes. These documents should be regarded as pertaining to an additional direct object and considered to be one of the constituent elements of.the offence to be identified during forensic medical expertise. Such documents are very specific in terms of their content and can not be properly interpreted by independent specialists possessing juristic knowledge alone. Therefore, the expert judgments concerning these issues must include well-reasoned arguments and solidly established evidence of normative legal character.

  1. Breast Cancer Screening in the Era of Density Notification Legislation: Summary of 2014 Massachusetts Experience and Suggestion of An Evidence-Based Management Algorithm by Multi-disciplinary Expert Panel

    PubMed Central

    Freer, Phoebe E.; Slanetz, Priscilla J.; Haas, Jennifer S.; Tung, Nadine M.; Hughes, Kevin S.; Armstrong, Katrina; Semine, A. Alan; Troyan, Susan L.; Birdwell, Robyn L.

    2015-01-01

    Purpose Stemming from breast density notification legislation in Massachusetts effective 2015, we sought to develop a collaborative evidence-based approach to density notification that could be used by practitioners across the state. Our goal was to develop an evidence-based consensus management algorithm to help patients and health care providers follow best practices to implement a coordinated, evidence-based, cost-effective, sustainable practice and to standardize care in recommendations for supplemental screening. Methods We formed the Massachusetts Breast Risk Education and Assessment Task Force (MA-BREAST) a multi-institutional, multi-disciplinary panel of expert radiologists, surgeons, primary care physicians, and oncologists to develop a collaborative approach to density notification legislation. Using evidence-based data from the Institute for Clinical and Economic Review (ICER), the Cochrane review, National Comprehensive Cancer Network (NCCN) guidelines, American Cancer Society (ACS) recommendations, and American College of Radiology (ACR) appropriateness criteria, the group collaboratively developed an evidence-based best-practices algorithm. Results The expert consensus algorithm uses breast density as one element in the risk stratification to determine the need for supplemental screening. Women with dense breasts and otherwise low risk (<15% lifetime risk), do not routinely require supplemental screening per the expert consensus. Women of high risk (>20% lifetime) should consider supplemental screening MRI in addition to routine mammography regardless of breast density. Conclusion We report the development of the multi-disciplinary collaborative approach to density notification. We propose a risk stratification algorithm to assess personal level of risk to determine the need for supplemental screening for an individual woman. PMID:26290416

  2. Regulatory Considerations for the Clinical and Research Use of Transcranial Direct Current Stimulation (tDCS): review and recommendations from an expert panel

    PubMed Central

    Fregni, F; Nitsche, MA; Loo, C.K.; Brunoni, AR; Marangolo, P; Leite, J; Carvalho, S; Bolognini, N; Caumo, W; Paik, NJ; Simis, M; Ueda, K; Ekhitari, H; Luu, P; Tucker, DM; Tyler, WJ; Brunelin, J; Datta, A; Juan, CH; Venkatasubramanian, G; Boggio, PS; Bikson, M

    2014-01-01

    The field of transcranial electrical stimulation (tES) has experienced significant growth in the past 15 years. One of the tES techniques leading this increased interest is transcranial direct current stimulation (tDCS). Significant research efforts have been devoted to determining the clinical potential of tDCS in humans. Despite the promising results obtained with tDCS in basic and clinical neuroscience, further progress has been impeded by a lack of clarity on international regulatory pathways. We therefore convened a group of research and clinician experts on tDCS to review the research and clinical use of tDCS. In this report, we review the regulatory status of tDCS, and we summarize the results according to research, off-label and compassionate use of tDCS in the following countries: Australia, Brazil, France, Germany, India, Iran, Italy, Portugal, South Korea, Taiwan and United States. Research use, off label treatment and compassionate use of tDCS are employed in most of the countries reviewed in this study. It is critical that a global or local effort is organized to pursue definite evidence to either approve and regulate or restrict the use of tDCS in clinical practice on the basis of adequate randomized controlled treatment trials. PMID:25983531

  3. Susceptibility of the European common frog Rana temporaria to a panel of ranavirus isolates from fish and amphibian hosts.

    PubMed

    Bayley, Amanda E; Hill, Barry J; Feist, Stephen W

    2013-04-11

    Ranaviruses are an emerging group of viruses and have been implicated in an increase of epidemics in susceptible species. They have a wide host range, infecting fish, amphibians and reptiles, with some isolates able to infect multiple species from different animal classes. Whilst some information exists on the pathogenicity of ranaviruses to novel hosts, there is none on the pathogenicity of fish ranaviruses to amphibians; this information is needed to develop measures to prevent the further spread of ranaviral disease in the aquatic environment. We undertook bath infection trials to assess the susceptibility of the European common frog Rana temporaria to 9 ranavirus isolates comprising doctor fish virus (DFV), European sheatfish virus (ESV), epizootic haematopoietic necrosis virus (EHNV), guppy virus 6 (GV6), pike-perch iridovirus (PPIV) and short-finned eel ranavirus (SERV) from fish hosts, and Bohle iridovirus (BIV), frog virus 3 (FV3) and Rana esculenta virus 282/I02 (REV) from amphibians. Animals were challenged as tadpoles at 15 and 20°C and as recent metamorphs at room temperature (20 ± 1°C) to investigate the effect of temperature and amphibian developmental stage on virus pathogenicity. Tadpoles were susceptible to FV3, PPIV and REV, but refractory to the other ranaviruses. Post-metamorphs were susceptible to FV3 and REV but refractory to BIV (the other ranaviruses were not tested). Significant mortality occurred in post-metamorphs and in tadpoles challenged at 20°C but was low in tadpoles challenged at 15°C. This study presents the first evidence of mortality in an amphibian species after challenge with ranavirus originally isolated from fish.

  4. Multinational evidence-based recommendations for the diagnosis and management of gout: integrating systematic literature review and expert opinion of a broad panel of rheumatologists in the 3e initiative

    PubMed Central

    Sivera, Francisca; Andrés, Mariano; Carmona, Loreto; Kydd, Alison S R; Moi, John; Seth, Rakhi; Sriranganathan, Melonie; van Durme, Caroline; van Echteld, Irene; Vinik, Ophir; Wechalekar, Mihir D; Aletaha, Daniel; Bombardier, Claire; Buchbinder, Rachelle; Edwards, Christopher J; Landewé, Robert B; Bijlsma, Johannes W; Branco, Jaime C; Burgos-Vargas, Rubén; Catrina, Anca I; Elewaut, Dirk; Ferrari, Antonio J L; Kiely, Patrick; Leeb, Burkhard F; Montecucco, Carlomaurizio; Müller-Ladner, Ulf; Østergaard, Mikkel; Zochling, Jane; Falzon, Louise; van der Heijde, Désirée M

    2014-01-01

    We aimed to develop evidence-based multinational recommendations for the diagnosis and management of gout. Using a formal voting process, a panel of 78 international rheumatologists developed 10 key clinical questions pertinent to the diagnosis and management of gout. Each question was investigated with a systematic literature review. Medline, Embase, Cochrane CENTRAL and abstracts from 2010–2011 European League Against Rheumatism and American College of Rheumatology meetings were searched in each review. Relevant studies were independently reviewed by two individuals for data extraction and synthesis and risk of bias assessment. Using this evidence, rheumatologists from 14 countries (Europe, South America and Australasia) developed national recommendations. After rounds of discussion and voting, multinational recommendations were formulated. Each recommendation was graded according to the level of evidence. Agreement and potential impact on clinical practice were assessed. Combining evidence and clinical expertise, 10 recommendations were produced. One recommendation referred to the diagnosis of gout, two referred to cardiovascular and renal comorbidities, six focused on different aspects of the management of gout (including drug treatment and monitoring), and the last recommendation referred to the management of asymptomatic hyperuricaemia. The level of agreement with the recommendations ranged from 8.1 to 9.2 (mean 8.7) on a 1–10 scale, with 10 representing full agreement. Ten recommendations on the diagnosis and management of gout were established. They are evidence-based and supported by a large panel of rheumatologists from 14 countries, enhancing their utility in clinical practice. PMID:23868909

  5. A four-kallikrein panel predicts prostate cancer in men with recent screening: data from the European Randomized Study of Prostate Cancer Screening, Rotterdam

    PubMed Central

    Vickers, Andrew J.; Cronin, Angel M; Roobol, Monique J.; Savage, Caroline J.; Peltola, Mari; Pettersson, Kim; Scardino, Peter T.; Schröder, Fritz H.; Lilja, Hans

    2010-01-01

    Purpose We have developed a statistical prediction model for prostate cancer based on four kallikrein markers in blood: total, free, and intact prostate specific antigen (PSA) and kallikrein-related peptidase 2 (hK2). Although this model accurately predicts the result of biopsy in unscreened men, its properties for men with a history of PSA screening have not been fully characterized. Experimental Design 1501 previously screened men with elevated PSA underwent initial biopsy during rounds 2 and 3 of the European Randomized Study of Prostate Cancer Screening, Rotterdam, with 388 cancers diagnosed. Biomarker levels were measured in serum samples taken before biopsy. The prediction model developed on the unscreened cohort was then applied and predictions compared to biopsy outcome. Results The previously developed four-kallikrein prediction model had much higher predictive accuracy than PSA and age alone (area-under-the-curve of 0.711 vs. 0.585 and 0.713 vs. 0.557 with and without digital rectal exam, respectively; both p<0.001). Similar statistically significant enhancements were seen for high-grade cancer. Applying the model with a cut-off of 20% cancer risk as the criterion for biopsy would reduce the biopsy rate by 362 for every 1000 men with elevated PSA. Although diagnosis would be delayed for 47 cancers, these would be predominately low stage and low grade (83% Gleason 6 T1c). Conclusions A panel of four kallikreins can help predict the result of initial biopsy in previously screened men with elevated PSA. Use of a statistical model based on the panel would substantially decrease rates of unnecessary biopsy. PMID:20400522

  6. Neuropathic pain phenotyping by international consensus (NeuroPPIC) for genetic studies: a NeuPSIG systematic review, Delphi survey, and expert panel recommendations.

    PubMed

    van Hecke, Oliver; Kamerman, Peter R; Attal, Nadine; Baron, Ralf; Bjornsdottir, Gyda; Bennett, David L H; Bennett, Michael I; Bouhassira, Didier; Diatchenko, Luda; Freeman, Roy; Freynhagen, Rainer; Haanpää, Maija; Jensen, Troels S; Raja, Srinivasa N; Rice, Andrew S C; Seltzer, Zeʼev; Thorgeirsson, Thorgeir E; Yarnitsky, David; Smith, Blair H

    2015-11-01

    For genetic research to contribute more fully to furthering our knowledge of neuropathic pain, we require an agreed, valid, and feasible approach to phenotyping, to allow collaboration and replication in samples of sufficient size. Results from genetic studies on neuropathic pain have been inconsistent and have met with replication difficulties, in part because of differences in phenotypes used for case ascertainment. Because there is no consensus on the nature of these phenotypes, nor on the methods of collecting them, this study aimed to provide guidelines on collecting and reporting phenotypes in cases and controls for genetic studies. Consensus was achieved through a staged approach: (1) systematic literature review to identify all neuropathic pain phenotypes used in previous genetic studies; (2) Delphi survey to identify the most useful neuropathic pain phenotypes and their validity and feasibility; and (3) meeting of experts to reach consensus on the optimal phenotype(s) to be collected from patients with neuropathic pain for genetic studies. A basic "entry level" set of phenotypes was identified for any genetic study of neuropathic pain. This set identifies cases of "possible" neuropathic pain, and controls, and includes: (1) a validated symptom-based questionnaire to determine whether any pain is likely to be neuropathic; (2) body chart or checklist to identify whether the area of pain distribution is neuroanatomically logical; and (3) details of pain history (intensity, duration, any formal diagnosis). This NeuroPPIC "entry level" set of phenotypes can be expanded by more extensive and specific measures, as determined by scientific requirements and resource availability.

  7. The Evolving Role of Nivolumab in Non-Small-Cell Lung Cancer for Second-Line Treatment: A New Cornerstone for Our Treatment Algorithms. Results From an International Experts Panel Meeting of the Italian Association of Thoracic Oncology.

    PubMed

    Gridelli, Cesare; Besse, Benjamin; Brahmer, Julie Renee; Crinò, Lucio; Felip, Enriqueta; de Marinis, Filippo

    2016-05-01

    Lung cancer is the leading cause of death from cancer worldwide that currently has only a few available treatment options in patients with no driver mutations. The therapeutic options for patients with non-small-cell lung cancer (NSCLC) who progress after first-line chemotherapy have been limited from a long time. Docetaxel has remained a cornerstone of second-line treatment for more than 20 years, but it is associated with an unfavorable safety profile. Recently, the results from immunotherapy treatment with anti-PD1 and PD-L1 inhibitors has changed our current knowledge base and increased therapeutic options for patients with NSCLC in the second-line setting. The results of 2 randomized phase III trials assessing nivolumab in lung cancer, Check-Mate-017 and Check-Mate-057, have deeply changed our current clinical practice and raised several discussion points. This paper explores the recent findings about nivolumab for the treatment of NSCLC in the second-line setting by analyzing recent trial findings and discussing their implications in clinical practice and future directions. The paper also summarizes the conclusions from an International Experts Panel Meeting of the Italian Association of Thoracic Oncology. PMID:26908078

  8. Expert Biogeographers

    ERIC Educational Resources Information Center

    Bednarski, Marsha

    2006-01-01

    This article describes an alternative way of teaching about biomes by having students become expert biogeographers. In order to become experts students need to first find out what a biogeographer does. Doing an online search lets students find out for themselves what the responsibilities are of people who work in this field. A good place to visit…

  9. 40 CFR 766.28 - Expert review of protocols.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Expert review of protocols. EPA will gather a panel of experts in analysis of chemical matrices for HDDs... and/or of other U.S. Government agencies who have had experience in analysis of chemical matrices...

  10. Scientific and Technological Information for Development. Proceedings of the Ad-hoc Panel of Experts on Information Systems for Science and Technology for Development (Rome, Italy, January 21-25, 1985).

    ERIC Educational Resources Information Center

    United Nations, New York, NY.

    The report of the ad-hoc panel and the 25 papers in these proceedings cover a wide spectrum of issues and perspectives relating to information systems, services, and networks at both the national and international levels. The first part of this six-part volume presents the panel's report, which reviews the history of the panel and its purpose and…

  11. Metabolic Panel

    MedlinePlus

    A metabolic panel is a group of tests that measures different chemicals in the blood. These tests are usually ... kidneys and liver. There are two types: basic metabolic panel (BMP) and comprehensive metabolic panel (CMP). The ...

  12. Assessment of avionics technology in European aerospace organizations

    NASA Technical Reports Server (NTRS)

    Martinec, D. A.; Baumbick, Robert; Hitt, Ellis; Leondes, Cornelius; Mayton, Monica; Schwind, Joseph; Traybar, Joseph

    1992-01-01

    This report provides a summary of the observations and recommendations made by a technical panel formed by the National Aeronautics and Space Administration (NASA). The panel, comprising prominent experts in the avionics field, was tasked to visit various organizations in Europe to assess the level of technology planned for use in manufactured civil avionics in the future. The primary purpose of the study was to assess avionics systems planned for implementation or already employed on civil aircraft and to evaluate future research, development, and engineering (RD&E) programs, address avionic systems and aircraft programs. The ultimate goal is to ensure that the technology addressed by NASa programs is commensurate with the needs of the aerospace industry at an international level. The panel focused on specific technologies, including guidance and control systems, advanced cockpit displays, sensors and data networks, and fly-by-wire/fly-by-light systems. However, discussions the panel had with the European organizations were not limited to these topics.

  13. EURECCA consensus conference highlights about colorectal cancer clinical management: the pathologists expert review.

    PubMed

    Quirke, P; West, N P; Nagtegaal, I D

    2014-02-01

    Care for patients with colon and rectal cancer has improved in the last 20 years; however, a considerable variation still exists in cancer management and outcome between European countries. Large variation is also apparent between national guidelines and patterns of cancer care in Europe. Therefore, EURECCA, which is the acronym of European Registration of Cancer Care, is aiming at defining core treatment strategies and developing a European audit structure in order to improve the quality of care for all patients with colon and rectal cancer. In December 2012, the first multidisciplinary consensus conference about cancer of the colon and rectum was held. The expert panel consisted of representatives of European scientific organizations involved in cancer care of patients with colon and rectal cancer and representatives of national colorectal registries.

  14. Across the pond. Should HIE leaders in the U.S. look to European progress for clues going forward? Yes, with caveats, says one international IT expert.

    PubMed

    Hagland, Mark

    2010-04-01

    European nations such as the U.K., Denmark, and the Netherlands, have already spent several years developing nationwide health information exchange (HIE) systems, and working through policy, procedural, and technological issues. Issues around the creation of national patient identifier numbers, patient permissions for data-sharing, privacy and security of data, data standards, and others, have been and are being addressed in European healthcare systems. Given the fact that European healthcare systems are mostly or entirely government-run, there is no question that the resolution of some of these issues will prove more complex and time-consuming in the U.S. than has been the case in Europe. CIOs can begin now to think about infrastructure, data-sharing, patient permissions, standards, and other issues, as HIE begins to evolve forward at the local, state and regional levels in the U.S. PMID:20426237

  15. Expert Seeker

    NASA Technical Reports Server (NTRS)

    Fernandez, Becerra

    2003-01-01

    Expert Seeker is a computer program of the knowledge-management-system (KMS) type that falls within the category of expertise-locator systems. The main goal of the KMS system implemented by Expert Seeker is to organize and distribute knowledge of who are the domain experts within and without a given institution, company, or other organization. The intent in developing this KMS was to enable the re-use of organizational knowledge and provide a methodology for querying existing information (including structured, semistructured, and unstructured information) in a way that could help identify organizational experts. More specifically, Expert Seeker was developed to make it possible, by use of an intranet, to do any or all of the following: Assist an employee in identifying who has the skills needed for specific projects and to determine whether the experts so identified are available. Assist managers in identifying employees who may need training opportunities. Assist managers in determining what expertise is lost when employees retire or otherwise leave. Facilitate the development of new ways of identifying opportunities for innovation and minimization of duplicated efforts. Assist employees in achieving competitive advantages through the application of knowledge-management concepts and related systems. Assist external organizations in requesting speakers for specific engagements or determining from whom they might be able to request help via electronic mail. Help foster an environment of collaboration for rapid development in today's environment, in which it is increasingly necessary to assemble teams of experts from government, universities, research laboratories, and industries, to quickly solve problems anytime, anywhere. Make experts more visible. Provide a central repository of information about employees, including information that, heretofore, has typically not been captured by the human-resources systems (e.g., information about past projects, patents, or

  16. Weekly working hours for Norwegian hospital doctors since 1994 with special attention to postgraduate training, work–home balance and the European Working Time Directive: a panel study

    PubMed Central

    Rosta, Judith; Aasland, Olaf G

    2014-01-01

    Objectives To examine the weekly working hours of Norwegian hospital doctors from 1994 to 2012 with special emphasis on the quality of postgraduate training and work–home balance, and in relation to the requirements of the European Working Time Directive (EWTD). Design Panel study based on postal questionnaires. Setting Norway. Participants Unbalanced cohort of 1300–1600 doctors in 1994, 1995, 1996, 1997, 2000, 2002, 2004, 2006, 2008, 2010 and 2012. Outcome measures Self-reported total weekly working hours and whether 45 weekly working hours are too short, sufficient, or too long to meet the quality requirements of obligatory postgraduate training for junior doctors. Results From 1994 to 2012, the number of weekly working hours was stable for senior (46–47 h) and junior (45–46 h) hospital doctors. In 2012, significantly more senior (27–35%) than junior (11–20%) doctors reported suboptimal work–home balance, defined as working more than 48 h a week. The majority perceived the present situation with an average of 45 h per week for juniors as sufficient for obligatory postgraduate specialist training, but doctors of higher age (OR 1.04, 95% CI 1.01 to 1.08), senior doctors (1.07, 1.04 to 1.11) and doctors working in surgical specialties (OR 1 vs laboratory medicine 0.03, 0.01 to 0.25, internal medicine 0.31, 0.17 to 0.58, psychiatry 0.12, 0.04 to 0.36, paediatrics 0.36, 0.12 to 1.07, anaesthesiology 0.08, 0.02 to 0.39, gynaecology 0.07, 0.01 to 0.56 and others 0.39, 0.04 to 3.56) were more likely to want the work-week to be longer. Conclusions The weekly working hours of Norwegian hospital doctors were always below the EWTD requirements. A significant growth of hospital doctor density over the past two decades, national regulations and cultural values might be important factors. Specialty differences in perception of sufficient training time may call for more flexibility in working time regulations. PMID:25311038

  17. Particulate matter air pollution and respiratory symptoms in individuals having either asthma or chronic obstructive pulmonary disease: a European multicentre panel study

    PubMed Central

    2012-01-01

    Background Particulate matter air pollution has been associated with adverse health effects. The fraction of ambient particles that are mainly responsible for the observed health effects is still a matter of controversy. Better characterization of the health relevant particle fraction will have major implications for air quality policy since it will determine which sources should be controlled. The RUPIOH study, an EU-funded multicentre study, was designed to examine the distribution of various ambient particle metrics in four European cities (Amsterdam, Athens, Birmingham, Helsinki) and assess their health effects in participants with asthma or COPD, based on a detailed exposure assessment. In this paper the association of central site measurements with respiratory symptoms and restriction of activities is examined. Methods At each centre a panel of participants with either asthma or COPD recorded respiratory symptoms and restriction of activities in a diary for six months. Exposure assessment included simultaneous measurements of coarse, fine and ultrafine particles at a central site. Data on gaseous pollutants were also collected. The associations of the 24-hour average concentrations of air pollution indices with the health outcomes were assessed in a hierarchical modelling approach. A city specific analysis controlling for potential confounders was followed by a meta-analysis to provide overall effect estimates. Results A 10 μg/m3 increase in previous day coarse particles concentrations was positively associated with most symptoms (an increase of 0.6 to 0.7% in average) and limitation in walking (OR= 1.076, 95% CI: 1.026-1.128). Same day, previous day and previous two days ozone concentrations were positively associated with cough (OR= 1.061, 95% CI: 1.013-1.111; OR= 1.049, 95% CI: 1.016-1.083 and OR= 1.059, 95% CI: 1.027-1.091, respectively). No consistent associations were observed between fine particle concentrations, nitrogen dioxide and respiratory

  18. Influenza vaccination: key facts for general practitioners in Europe-a synthesis by European experts based on national guidelines and best practices in the United Kingdom and the Netherlands.

    PubMed

    Kassianos, George; Blank, Patricia; Falup-Pecurariu, Oana; Kuchar, Ernest; Kyncl, Jan; De Lejarazu, Raul Ortiz; Nitsch-Osuch, Aneta; van Essen, Gerrit A

    2016-01-01

    Currently there is no influenza vaccination guidance for European general practitioners. Furthermore, although the European Council recommends a target seasonal influenza vaccination rate of 75% in the elderly (65 years and above) and in anyone aged >6 months with a chronic medical condition, there remain wide discrepancies throughout Europe. A harmonised guideline regarding not only vaccination strategy but also for the consistent diagnosis of influenza across Europe is essential to support a common approach for the implementation of seasonal influenza vaccination across Europe. This document is based on pre-existing guidelines available in the UK and Netherlands and has been approved by a group of European experts for use throughout Europe. As well as providing a standardised influenza diagnosis, it also reviews the current recommendations for influenza vaccination, the types of vaccine available, the contraindications, vaccine use in special populations (in pregnancy, children, and in those with egg allergy), and concomitant administration with other vaccines. The effectiveness, safety, and timing of the seasonal influenza vaccine are also reviewed. A second section provides practical guidance for general practitioners for the implementation of a seasonal influenza vaccination program, including the selection and notification of those eligible for vaccination, as well as suggestions for the organisation of a vaccination programme. Finally, suggested responses to common patient misconceptions and frequently asked questions are included. The aim of this article is to harmonise the diagnosis of seasonal influenza and the approach of European general practitioners to seasonal influenza vaccination in order to better identify influenza outbreaks and to move towards reaching the target vaccination rate of 75% throughout Europe. PMID:27540408

  19. Influenza vaccination: key facts for general practitioners in Europe—a synthesis by European experts based on national guidelines and best practices in the United Kingdom and the Netherlands

    PubMed Central

    Kassianos, George; Blank, Patricia; Falup-Pecurariu, Oana; Kuchar, Ernest; Kyncl, Jan; De Lejarazu, Raul Ortiz; Nitsch-Osuch, Aneta; van Essen, Gerrit A

    2016-01-01

    Currently there is no influenza vaccination guidance for European general practitioners. Furthermore, although the European Council recommends a target seasonal influenza vaccination rate of 75% in the elderly (65 years and above) and in anyone aged >6 months with a chronic medical condition, there remain wide discrepancies throughout Europe. A harmonised guideline regarding not only vaccination strategy but also for the consistent diagnosis of influenza across Europe is essential to support a common approach for the implementation of seasonal influenza vaccination across Europe. This document is based on pre-existing guidelines available in the UK and Netherlands and has been approved by a group of European experts for use throughout Europe. As well as providing a standardised influenza diagnosis, it also reviews the current recommendations for influenza vaccination, the types of vaccine available, the contraindications, vaccine use in special populations (in pregnancy, children, and in those with egg allergy), and concomitant administration with other vaccines. The effectiveness, safety, and timing of the seasonal influenza vaccine are also reviewed. A second section provides practical guidance for general practitioners for the implementation of a seasonal influenza vaccination program, including the selection and notification of those eligible for vaccination, as well as suggestions for the organisation of a vaccination programme. Finally, suggested responses to common patient misconceptions and frequently asked questions are included. The aim of this article is to harmonise the diagnosis of seasonal influenza and the approach of European general practitioners to seasonal influenza vaccination in order to better identify influenza outbreaks and to move towards reaching the target vaccination rate of 75% throughout Europe. PMID:27540408

  20. Expert Systems: What Is an Expert System?

    ERIC Educational Resources Information Center

    Duval, Beverly K.; Main, Linda

    1994-01-01

    Describes expert systems and discusses their use in libraries. Highlights include parts of an expert system; expert system shells; an example of how to build an expert system; a bibliography of 34 sources of information on expert systems in libraries; and a list of 10 expert system shells used in libraries. (Contains five references.) (LRW)

  1. CDC Panel Says FluMist Nasal Flu Vaccine Ineffective

    MedlinePlus

    ... 159535.html CDC Panel Says FluMist Nasal Flu Vaccine Ineffective Agency advisors say the product has lost ... without the easier, nasal spray form of flu vaccine next flu season, a panel of experts decided ...

  2. [Homozygous familial hypercholesterolaemia: Spanish adaptation of the position paper from the Consensus Panel on Familial Hypercholesterolaemia of the European Atherosclerosis Society. Consensus document of the Spanish Society of Arteriosclerosis (SEA) and Familial Hypercholesterolaemia Foundation (FHF)].

    PubMed

    Ascaso, Juan F; Mata, Pedro; Arbona, Cristina; Civeira, Fernando; Valdivielso, Pedro; Masana, Luis

    2015-01-01

    Homozygous familial hypercholesterolaemia (HoFH) is a rare life-threatening disease characterized by markedly elevated circulating levels of low-density lipoprotein cholesterol (LDL-C) and accelerated, premature atherosclerotic cardiovascular disease (ACVD). The Consensus Panel on Familial Hypercholesterolaemia of the European Atherosclerosis Society (EAS) has recently published a clinical guide to diagnose and manage HoFH (Eur Heart J. 2014;35:2146-57). Both the Spanish Society of Atherosclerosis (SEA) and Familial Hypercholesterolaemia Foundation (FHF) consider this European Consensus document of great value and utility. However, there are particularities in our country which advise to have a Spanish adaptation of the European HoFH document in order to approximate this clinical guide to our environment. In Spain, chronic treatment with statins, ezetimibe and resins (colesevelam) has a reduced contribution in the National Health System (NHS) and is one of the few European countries where LDL apheresis is included in the Basic Service Portfolio coverage. This Spanish document also includes clinical experience in the management of these patients in our country. The Drafting Committee emphasizes the need for early identification of HoFH patients, prompt referral to specialized units, and an early and appropriate treatment. These recommendations will provide a guidance for HoFH patient management in Spain. PMID:25757840

  3. [Homozygous familial hypercholesterolaemia: Spanish adaptation of the position paper from the Consensus Panel on Familial Hypercholesterolaemia of the European Atherosclerosis Society. Consensus document of the Spanish Society of Arteriosclerosis (SEA) and Familial Hypercholesterolaemia Foundation (FHF)].

    PubMed

    Ascaso, Juan F; Mata, Pedro; Arbona, Cristina; Civeira, Fernando; Valdivielso, Pedro; Masana, Luis

    2015-01-01

    Homozygous familial hypercholesterolaemia (HoFH) is a rare life-threatening disease characterized by markedly elevated circulating levels of low-density lipoprotein cholesterol (LDL-C) and accelerated, premature atherosclerotic cardiovascular disease (ACVD). The Consensus Panel on Familial Hypercholesterolaemia of the European Atherosclerosis Society (EAS) has recently published a clinical guide to diagnose and manage HoFH (Eur Heart J. 2014;35:2146-57). Both the Spanish Society of Atherosclerosis (SEA) and Familial Hypercholesterolaemia Foundation (FHF) consider this European Consensus document of great value and utility. However, there are particularities in our country which advise to have a Spanish adaptation of the European HoFH document in order to approximate this clinical guide to our environment. In Spain, chronic treatment with statins, ezetimibe and resins (colesevelam) has a reduced contribution in the National Health System (NHS) and is one of the few European countries where LDL apheresis is included in the Basic Service Portfolio coverage. This Spanish document also includes clinical experience in the management of these patients in our country. The Drafting Committee emphasizes the need for early identification of HoFH patients, prompt referral to specialized units, and an early and appropriate treatment. These recommendations will provide a guidance for HoFH patient management in Spain.

  4. Expert judgment and expert systems

    SciTech Connect

    Mumpower, J.; Phillips, L.D.; Renn, O.; Uppuluri, V.R.R.

    1987-01-01

    This volume collects researchers from the fields of psychology, decision analysis, and artificial intelligence. The purposes were to assess similarities, differences, and complementarities among the three approaches to the study of expert judgment; to evaluate their relative strengths and weaknesses; and to propose profitable linkages between them. Each of the papers in the present volume is directed toward one or more of these goals.

  5. Expert consensus document: Cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the Study of Cholangiocarcinoma (ENS-CCA).

    PubMed

    Banales, Jesus M; Cardinale, Vincenzo; Carpino, Guido; Marzioni, Marco; Andersen, Jesper B; Invernizzi, Pietro; Lind, Guro E; Folseraas, Trine; Forbes, Stuart J; Fouassier, Laura; Geier, Andreas; Calvisi, Diego F; Mertens, Joachim C; Trauner, Michael; Benedetti, Antonio; Maroni, Luca; Vaquero, Javier; Macias, Rocio I R; Raggi, Chiara; Perugorria, Maria J; Gaudio, Eugenio; Boberg, Kirsten M; Marin, Jose J G; Alvaro, Domenico

    2016-05-01

    Cholangiocarcinoma (CCA) is a heterogeneous group of malignancies with features of biliary tract differentiation. CCA is the second most common primary liver tumour and the incidence is increasing worldwide. CCA has high mortality owing to its aggressiveness, late diagnosis and refractory nature. In May 2015, the "European Network for the Study of Cholangiocarcinoma" (ENS-CCA: www.enscca.org or www.cholangiocarcinoma.eu) was created to promote and boost international research collaboration on the study of CCA at basic, translational and clinical level. In this Consensus Statement, we aim to provide valuable information on classifications, pathological features, risk factors, cells of origin, genetic and epigenetic modifications and current therapies available for this cancer. Moreover, future directions on basic and clinical investigations and plans for the ENS-CCA are highlighted.

  6. Panel 5: Microbiology and Immunology Panel

    PubMed Central

    Murphy, Timothy F.; Chonmaitree, Tasnee; Barenkamp, Stephen; Kyd, Jennelle; Nokso-Koivisto, Johanna; Patel, Janak A.; Heikkinen, Terho; Yamanaka, Noboru; Ogra, Pearay; Swords, W. Edward; Sih, Tania; Pettigrew, Melinda M.

    2014-01-01

    Objective The objective is to perform a comprehensive review of the literature from January 2007 through June 2011 on the virology, bacteriology, and immunology related to otitis media. Data Sources PubMed database of the National Library of Medicine. Review Methods Three subpanels with co-chairs comprising experts in the virology, bacteriology, and immunology of otitis media were formed. Each of the panels reviewed the literature in their respective fields and wrote draft reviews. The reviews were shared with all panel members, and a second draft was created. The entire panel met at the 10th International Symposium on Recent Advances in Otitis Media in June 2011 and discussed the review and refined the content further. A final draft was created, circulated, and approved by the panel. Conclusion Excellent progress has been made in the past 4 years in advancing an understanding of the microbiology and immunology of otitis media. Advances include laboratory-based basic studies, cell-based assays, work in animal models, and clinical studies. Implications for Practice The advances of the past 4 years formed the basis of a series of short-term and long-term research goals in an effort to guide the field. Accomplishing these goals will provide opportunities for the development of novel interventions, including new ways to better treat and prevent otitis media. PMID:23536533

  7. Position paper on the management of patients with obstructive sleep apnea and hypertension: joint recommendations by the European Society of Hypertension, by the European Respiratory Society and by the members of European COST (COoperation in Scientific and Technological research) ACTION B26 on obstructive sleep apnea.

    PubMed

    Parati, Gianfranco; Lombardi, Carolina; Hedner, Jan; Bonsignore, Maria R; Grote, Ludger; Tkacova, Ruzena; Levy, Patrick; Riha, Renata; Bassetti, Claudio; Narkiewicz, Krzysztof; Mancia, Giuseppe; McNicholas, Walter T

    2012-04-01

    This article is aimed at addressing the current state of the art in epidemiology, pathophysiology, diagnostic procedures and treatment options for appropriate management of obstructive sleep apnea (OSA) in cardiovascular (particularly hypertensive) patients, as well as for the management of cardiovascular diseases (particularly arterial hypertension) in OSA patients. The present document is the result of the work done by a panel of experts participating in the European Union COST (COoperation in Scientific and Technological research) ACTION B26 on OSA, with the endorsement of the European Respiratory Society (ERS) and the European Society of Hypertension (ESH). These recommendations are particularly aimed at reminding cardiovascular experts to consider the occurrence of sleep-related breathing disorders in patients with high blood pressure. They are at the same time aimed at reminding respiration experts to consider the occurrence of hypertension in patients with respiratory problems at night.

  8. A four-kallikrein panel for the prediction of repeat prostate biopsy: data from the European Randomized Study of Prostate Cancer Screening in Rotterdam, Netherlands

    PubMed Central

    Gupta, A; Roobol, M J; Savage, C J; Peltola, M; Pettersson, K; Scardino, P T; Vickers, A J; Schröder, F H; Lilja, H

    2010-01-01

    Background: Most men with elevated levels of prostate-specific antigen (PSA) do not have prostate cancer, leading to a large number of unnecessary biopsies. A statistical model based on a panel of four kallikreins has been shown to predict the outcome of a first prostate biopsy. In this study, we apply the model to an independent data set of men with previous negative biopsy but persistently elevated PSA. Methods: The study cohort consisted of 925 men with a previous negative prostate biopsy and elevated PSA (⩾3 ng ml−1), with 110 prostate cancers detected (12%). A previously published statistical model was applied, with recalibration to reflect the lower positive biopsy rates on rebiopsy. Results: The full-kallikrein panel had higher discriminative accuracy than PSA and DRE alone, with area under the curve (AUC) improving from 0.58 (95% confidence interval (CI): 0.52, 0.64) to 0.68 (95% CI: 0.62, 0.74), P<0.001, and high-grade cancer (Gleason ⩾7) at biopsy with AUC improving from 0.76 (95% CI: 0.64, 0.89) to 0.87 (95% CI: 0.81, 0.94), P=0.003). Application of the panel to 1000 men with persistently elevated PSA after initial negative biopsy, at a 15% risk threshold would reduce the number of biopsies by 712; would miss (or delay) the diagnosis of 53 cancers, of which only 3 would be Gleason 7 and the rest Gleason 6 or less. Conclusions: Our data constitute an external validation of a previously published model. The four-kallikrein panel predicts the result of repeat prostate biopsy in men with elevated PSA while dramatically decreasing unnecessary biopsies. PMID:20664589

  9. Panel flutter

    NASA Technical Reports Server (NTRS)

    Dowell, E. H.

    1972-01-01

    Criteria are presented for the prediction of panel flutter, determination of its occurrence, design for its prevention, and evaluation of its severity. Theoretical analyses recommended for the prediction of flutter stability boundaries, vibration amplitudes, and frequencies for several types of panels are described. Vibration tests and wind tunnel tests are recommended for certain panels and environmental flow conditions to provide information for design of verification analysis. Appropriate design margins on flutter stability boundaries are given and general criteria are presented for evaluating the severity of possible short-duration, limited-amplitude panel flutter on nonreusable vehicles.

  10. Geothermal Technologies Program Blue Ribbon Panel Recommendations

    SciTech Connect

    none,

    2011-06-17

    The Geothermal Technologies Program assembled a geothermal Blue Ribbon Panel on March 22-23, 2011 in Albuquerque, New Mexico for a guided discussion on the future of geothermal energy in the United States and the role of the DOE Program. The Geothermal Blue Ribbon Panel Report captures the discussions and recommendations of the experts. An addendum is available here: http://www.eere.energy.gov/geothermal/pdfs/gtp_blue_ribbon_panel_report_addendum10-2011.pdf

  11. Joint USNRC/EC consequence uncertainty study: The ingestion pathway, dosimetry and health effects expert judgment elicitations and results

    SciTech Connect

    Harper, F.; Goossens, L.; Abbott, M.

    1996-08-01

    The US Nuclear Regulatory Commission (USNRC) and the European Commission (EC) have conducted a formal expert judgment elicitation jointly to systematically collect the quantitative information needed to perform consequence uncertainty analyses on a broad set of commercial nuclear power plants. Information from three sets of joint US/European expert panels was collected and processed. Information from the three sets of panels was collected in the following areas: in the phenomenological areas of atmospheric dispersion and deposition, in the areas of ingestion pathways and external dosimetry, and in the areas of health effects and internal dosimetry. This exercise has demonstrated that the uncertainty for particular issues as measured by the ratio of the 95th percentile to the 5th percentile can be extremely large (orders of magnitude), or rather small (factor of two). This information has already been used by many of the experts that were involved in this process in areas other than the consequence uncertainty field. The benefit to the field of radiological consequences is just beginning as the results of this study are published and made available to the consequence community.

  12. Expert Systems: An Overview.

    ERIC Educational Resources Information Center

    Adiga, Sadashiv

    1984-01-01

    Discusses: (1) the architecture of expert systems; (2) features that distinguish expert systems from conventional programs; (3) conditions necessary to select a particular application for the development of successful expert systems; (4) issues to be resolved when building expert systems; and (5) limitations. Examples of selected expert systems…

  13. Opioids and the management of chronic severe pain in the elderly: consensus statement of an International Expert Panel with focus on the six clinically most often used World Health Organization Step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone).

    PubMed

    Pergolizzi, Joseph; Böger, Rainer H; Budd, Keith; Dahan, Albert; Erdine, Serdar; Hans, Guy; Kress, Hans-Georg; Langford, Richard; Likar, Rudolf; Raffa, Robert B; Sacerdote, Paola

    2008-01-01

    SUMMARY OF CONSENSUS: 1. The use of opioids in cancer pain: The criteria for selecting analgesics for pain treatment in the elderly include, but are not limited to, overall efficacy, overall side-effect profile, onset of action, drug interactions, abuse potential, and practical issues, such as cost and availability of the drug, as well as the severity and type of pain (nociceptive, acute/chronic, etc.). At any given time, the order of choice in the decision-making process can change. This consensus is based on evidence-based literature (extended data are not included and chronic, extended-release opioids are not covered). There are various driving factors relating to prescribing medication, including availability of the compound and cost, which may, at times, be the main driving factor. The transdermal formulation of buprenorphine is available in most European countries, particularly those with high opioid usage, with the exception of France; however, the availability of the sublingual formulation of buprenorphine in Europe is limited, as it is marketed in only a few countries, including Germany and Belgium. The opioid patch is experimental at present in U.S.A. and the sublingual formulation has dispensing restrictions, therefore, its use is limited. It is evident that the population pyramid is upturned. Globally, there is going to be an older population that needs to be cared for in the future. This older population has expectations in life, in that a retiree is no longer an individual who decreases their lifestyle activities. The "baby-boomers" in their 60s and 70s are "baby zoomers"; they want to have a functional active lifestyle. They are willing to make trade-offs regarding treatment choices and understand that they may experience pain, providing that can have increased quality of life and functionality. Therefore, comorbidities--including cancer and noncancer pain, osteoarthritis, rheumatoid arthritis, and postherpetic neuralgia--and patient functional

  14. Opioids and the management of chronic severe pain in the elderly: consensus statement of an International Expert Panel with focus on the six clinically most often used World Health Organization Step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone).

    PubMed

    Pergolizzi, Joseph; Böger, Rainer H; Budd, Keith; Dahan, Albert; Erdine, Serdar; Hans, Guy; Kress, Hans-Georg; Langford, Richard; Likar, Rudolf; Raffa, Robert B; Sacerdote, Paola

    2008-01-01

    SUMMARY OF CONSENSUS: 1. The use of opioids in cancer pain: The criteria for selecting analgesics for pain treatment in the elderly include, but are not limited to, overall efficacy, overall side-effect profile, onset of action, drug interactions, abuse potential, and practical issues, such as cost and availability of the drug, as well as the severity and type of pain (nociceptive, acute/chronic, etc.). At any given time, the order of choice in the decision-making process can change. This consensus is based on evidence-based literature (extended data are not included and chronic, extended-release opioids are not covered). There are various driving factors relating to prescribing medication, including availability of the compound and cost, which may, at times, be the main driving factor. The transdermal formulation of buprenorphine is available in most European countries, particularly those with high opioid usage, with the exception of France; however, the availability of the sublingual formulation of buprenorphine in Europe is limited, as it is marketed in only a few countries, including Germany and Belgium. The opioid patch is experimental at present in U.S.A. and the sublingual formulation has dispensing restrictions, therefore, its use is limited. It is evident that the population pyramid is upturned. Globally, there is going to be an older population that needs to be cared for in the future. This older population has expectations in life, in that a retiree is no longer an individual who decreases their lifestyle activities. The "baby-boomers" in their 60s and 70s are "baby zoomers"; they want to have a functional active lifestyle. They are willing to make trade-offs regarding treatment choices and understand that they may experience pain, providing that can have increased quality of life and functionality. Therefore, comorbidities--including cancer and noncancer pain, osteoarthritis, rheumatoid arthritis, and postherpetic neuralgia--and patient functional

  15. Expert credibility in climate change.

    PubMed

    Anderegg, William R L; Prall, James W; Harold, Jacob; Schneider, Stephen H

    2010-07-01

    Although preliminary estimates from published literature and expert surveys suggest striking agreement among climate scientists on the tenets of anthropogenic climate change (ACC), the American public expresses substantial doubt about both the anthropogenic cause and the level of scientific agreement underpinning ACC. A broad analysis of the climate scientist community itself, the distribution of credibility of dissenting researchers relative to agreeing researchers, and the level of agreement among top climate experts has not been conducted and would inform future ACC discussions. Here, we use an extensive dataset of 1,372 climate researchers and their publication and citation data to show that (i) 97-98% of the climate researchers most actively publishing in the field surveyed here support the tenets of ACC outlined by the Intergovernmental Panel on Climate Change, and (ii) the relative climate expertise and scientific prominence of the researchers unconvinced of ACC are substantially below that of the convinced researchers.

  16. Management of neutropenic patients in the intensive care unit (NEWBORNS EXCLUDED) recommendations from an expert panel from the French Intensive Care Society (SRLF) with the French Group for Pediatric Intensive Care Emergencies (GFRUP), the French Society of Anesthesia and Intensive Care (SFAR), the French Society of Hematology (SFH), the French Society for Hospital Hygiene (SF2H), and the French Infectious Diseases Society (SPILF).

    PubMed

    Schnell, David; Azoulay, Elie; Benoit, Dominique; Clouzeau, Benjamin; Demaret, Pierre; Ducassou, Stéphane; Frange, Pierre; Lafaurie, Matthieu; Legrand, Matthieu; Meert, Anne-Pascale; Mokart, Djamel; Naudin, Jérôme; Pene, Frédéric; Rabbat, Antoine; Raffoux, Emmanuel; Ribaud, Patricia; Richard, Jean-Christophe; Vincent, François; Zahar, Jean-Ralph; Darmon, Michael

    2016-12-01

    Neutropenia is defined by either an absolute or functional defect (acute myeloid leukemia or myelodysplastic syndrome) of polymorphonuclear neutrophils and is associated with high risk of specific complications that may require intensive care unit (ICU) admission. Specificities in the management of critically ill neutropenic patients prompted the establishment of guidelines dedicated to intensivists. These recommendations were drawn up by a panel of experts brought together by the French Intensive Care Society in collaboration with the French Group for Pediatric Intensive Care Emergencies, the French Society of Anesthesia and Intensive Care, the French Society of Hematology, the French Society for Hospital Hygiene, and the French Infectious Diseases Society. Literature review and formulation of recommendations were performed using the Grading of Recommendations Assessment, Development and Evaluation system. Each recommendation was then evaluated and rated by each expert using a methodology derived from the RAND/UCLA Appropriateness Method. Six fields are covered by the provided recommendations: (1) ICU admission and prognosis, (2) protective isolation and prophylaxis, (3) management of acute respiratory failure, (4) organ failure and organ support, (5) antibiotic management and source control, and (6) hematological management. Most of the provided recommendations are obtained from low levels of evidence, however, suggesting a need for additional studies. Seven recommendations were, however, associated with high level of evidences and are related to protective isolation, diagnostic workup of acute respiratory failure, medical management, and timing surgery in patients with typhlitis.

  17. Management of neutropenic patients in the intensive care unit (NEWBORNS EXCLUDED) recommendations from an expert panel from the French Intensive Care Society (SRLF) with the French Group for Pediatric Intensive Care Emergencies (GFRUP), the French Society of Anesthesia and Intensive Care (SFAR), the French Society of Hematology (SFH), the French Society for Hospital Hygiene (SF2H), and the French Infectious Diseases Society (SPILF).

    PubMed

    Schnell, David; Azoulay, Elie; Benoit, Dominique; Clouzeau, Benjamin; Demaret, Pierre; Ducassou, Stéphane; Frange, Pierre; Lafaurie, Matthieu; Legrand, Matthieu; Meert, Anne-Pascale; Mokart, Djamel; Naudin, Jérôme; Pene, Frédéric; Rabbat, Antoine; Raffoux, Emmanuel; Ribaud, Patricia; Richard, Jean-Christophe; Vincent, François; Zahar, Jean-Ralph; Darmon, Michael

    2016-12-01

    Neutropenia is defined by either an absolute or functional defect (acute myeloid leukemia or myelodysplastic syndrome) of polymorphonuclear neutrophils and is associated with high risk of specific complications that may require intensive care unit (ICU) admission. Specificities in the management of critically ill neutropenic patients prompted the establishment of guidelines dedicated to intensivists. These recommendations were drawn up by a panel of experts brought together by the French Intensive Care Society in collaboration with the French Group for Pediatric Intensive Care Emergencies, the French Society of Anesthesia and Intensive Care, the French Society of Hematology, the French Society for Hospital Hygiene, and the French Infectious Diseases Society. Literature review and formulation of recommendations were performed using the Grading of Recommendations Assessment, Development and Evaluation system. Each recommendation was then evaluated and rated by each expert using a methodology derived from the RAND/UCLA Appropriateness Method. Six fields are covered by the provided recommendations: (1) ICU admission and prognosis, (2) protective isolation and prophylaxis, (3) management of acute respiratory failure, (4) organ failure and organ support, (5) antibiotic management and source control, and (6) hematological management. Most of the provided recommendations are obtained from low levels of evidence, however, suggesting a need for additional studies. Seven recommendations were, however, associated with high level of evidences and are related to protective isolation, diagnostic workup of acute respiratory failure, medical management, and timing surgery in patients with typhlitis. PMID:27638133

  18. Curricula for Media Literacy Education According to International Experts

    ERIC Educational Resources Information Center

    Fedorov, Alexander; Levitskaya, Anastasia; Camarero, Emma

    2016-01-01

    The article analyzes the results of the international experts' survey regarding the curriculum of media literacy education, which was administrated by the authors in September-October 2015. The expert panel includes specialists actively involved in the real process of media literacy education in schools, universities and other educational…

  19. Panel Sessions.

    ERIC Educational Resources Information Center

    Proceedings of the ASIS Mid-Year Meeting, 1992

    1992-01-01

    Lists the speakers and summarizes the issues addressed for 12 panel sessions on topics related to networking, including libraries and national networks, federal national resources and energy programs, multimedia issues, telecommuting, remote image serving, accessing the Internet, library automation, scientific information, applications of Z39.50,…

  20. Speech spectrogram expert

    SciTech Connect

    Johannsen, J.; Macallister, J.; Michalek, T.; Ross, S.

    1983-01-01

    Various authors have pointed out that humans can become quite adept at deriving phonetic transcriptions from speech spectrograms (as good as 90percent accuracy at the phoneme level). The authors describe an expert system which attempts to simulate this performance. The speech spectrogram expert (spex) is actually a society made up of three experts: a 2-dimensional vision expert, an acoustic-phonetic expert, and a phonetics expert. The visual reasoning expert finds important visual features of the spectrogram. The acoustic-phonetic expert reasons about how visual features relates to phonemes, and about how phonemes change visually in different contexts. The phonetics expert reasons about allowable phoneme sequences and transformations, and deduces an english spelling for phoneme strings. The speech spectrogram expert is highly interactive, allowing users to investigate hypotheses and edit rules. 10 references.

  1. Expert witness testimony: rules of engagement.

    PubMed

    Satiani, Bhagwan

    2006-01-01

    Overlooked in most legislative remedies to address the medical malpractice (MMP) crisis is stringent prohibition against the use of "junk science'' in the courtroom and defining the qualifications of an expert witness. Expert witnesses should be required to: (1) to disclose information materially related to the reliability of expert testimony. (2) Filing of a "Daubert brief'': a summary of the plaintiff's expert's opinion along with a resume outlining his/her knowledge, skill, experience, training and education, reputation in the field relevant to the litigation, and complete details of the methodology employed by the expert. (3) An oath or declaration that acknowledges the duty to disclose to the court all information known to the person to be material to the reliability of the expert witness. Rules of evidence: The "Frye test'' or the "general acceptance rule'' has been used by judges to exclude expert testimony unless it is "sufficiently established to have gained general acceptance in the particular field in which it belongs.'' Stricter standards need to be legislated at the state level. The mandatory use of scientific panels by judges in all MMP cases is needed. Legislative relief has been sought by the medical community to address the serious disconnect between negligence and MMP litigation. The use of junk science in the courtroom remains largely unaddressed in the judicial system. Medical societies and legislatures must act to define an expert witness and restrain plaintiff's attorneys from using junk science to influence juries.

  2. 61. Upper panel in cornerpower panel lcpa lower panel in ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    61. Upper panel in corner-power panel lcpa lower panel in corner-oxygen regeneration unit, at right-air conditioner control panel, on floor-bio-pack 45 for emergency breathing, looking northwest - Ellsworth Air Force Base, Delta Flight, Launch Control Facility, County Road CS23A, North of Exit 127, Interior, Jackson County, SD

  3. Architectural Panels

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Alliance Wall Corporation's Whyteboard, a porcelain enamel on steel panels wall board, owes its color stability to a KIAC engineering background study to identify potential technologies and manufacturers of equipment which could be used to detect surface flaws. One result of the data base search was the purchase of a spectrocolorimeter which enables the company to control some 250 standard colors, and match special colors.

  4. Homozygous familial hypercholesterolaemia: new insights and guidance for clinicians to improve detection and clinical management. A position paper from the Consensus Panel on Familial Hypercholesterolaemia of the European Atherosclerosis Society

    PubMed Central

    Cuchel, Marina; Bruckert, Eric; Ginsberg, Henry N.; Raal, Frederick J.; Santos, Raul D.; Hegele, Robert A.; Kuivenhoven, Jan Albert; Nordestgaard, Børge G.; Descamps, Olivier S.; Steinhagen-Thiessen, Elisabeth; Tybjærg-Hansen, Anne; Watts, Gerald F.; Averna, Maurizio; Boileau, Catherine; Borén, Jan; Catapano, Alberico L.; Defesche, Joep C.; Hovingh, G. Kees; Humphries, Steve E.; Kovanen, Petri T.; Masana, Luis; Pajukanta, Päivi; Parhofer, Klaus G.; Ray, Kausik K.; Stalenhoef, Anton F. H.; Stroes, Erik; Taskinen, Marja-Riitta; Wiegman, Albert; Wiklund, Olov; Chapman, M. John; Cuchel, Marina; Bruckert, Eric; Chapman, M. John; Descamps, Olivier S.; Ginsberg, Henry N.; Hegele, Robert A.; Kuivenhoven, Jan Albert; Nordestgaard, Børge G.; Raal, Frederick J.; Santos, Raul D.; Steinhagen-Thiessen, Elisabeth; Tybjærg-Hansen, Anne; Watts, Gerald F.; Chapman, M. John; Ginsberg, Henry N.; Averna, Maurizio; Boileau, Catherine; Borén, Jan; Catapano, Alberico L.; Defesche, Joep C.; Hovingh, G. Kees; Humphries, Steve E.; Kovanen, Petri T.; Masana, Luis; Pajukanta, Päivi; Parhofer, Klaus G.; Ray, Kausik K.; Stalenhoef, Anton F. H.; Stroes, Erik; Taskinen, Marja-Riitta; Wiegman, Albert; Wiklund, Olov

    2014-01-01

    Aims Homozygous familial hypercholesterolaemia (HoFH) is a rare life-threatening condition characterized by markedly elevated circulating levels of low-density lipoprotein cholesterol (LDL-C) and accelerated, premature atherosclerotic cardiovascular disease (ACVD). Given recent insights into the heterogeneity of genetic defects and clinical phenotype of HoFH, and the availability of new therapeutic options, this Consensus Panel on Familial Hypercholesterolaemia of the European Atherosclerosis Society (EAS) critically reviewed available data with the aim of providing clinical guidance for the recognition and management of HoFH. Methods and results Early diagnosis of HoFH and prompt initiation of diet and lipid-lowering therapy are critical. Genetic testing may provide a definitive diagnosis, but if unavailable, markedly elevated LDL-C levels together with cutaneous or tendon xanthomas before 10 years, or untreated elevated LDL-C levels consistent with heterozygous FH in both parents, are suggestive of HoFH. We recommend that patients with suspected HoFH are promptly referred to specialist centres for a comprehensive ACVD evaluation and clinical management. Lifestyle intervention and maximal statin therapy are the mainstays of treatment, ideally started in the first year of life or at an initial diagnosis, often with ezetimibe and other lipid-modifying therapy. As patients rarely achieve LDL-C targets, adjunctive lipoprotein apheresis is recommended where available, preferably started by age 5 and no later than 8 years. The number of therapeutic approaches has increased following approval of lomitapide and mipomersen for HoFH. Given the severity of ACVD, we recommend regular follow-up, including Doppler echocardiographic evaluation of the heart and aorta annually, stress testing and, if available, computed tomography coronary angiography every 5 years, or less if deemed necessary. Conclusion This EAS Consensus Panel highlights the need for early identification of Ho

  5. European Stroke Science Workshop

    PubMed Central

    Mattle, Heinrich P.; Brainin, Michael; Chamorro, Angel; Diener, Hans Christoph; Hacke, Werner; Leys, Didier; Norrving, Bo; Ward, Nick

    2012-01-01

    The European Stroke Organisation (ESO) held its first European Stroke Science Workshop in Garmisch-Partenkirchen, Germany (15-17 December 2011). Stroke experts based in Europe were invited to present and discuss their current research. The scope of the workshop was to review the most recent findings of selected topics in stroke, to exchange ideas, to stimulate new research and to enhance collaboration between European stroke research groups. Seven scientific sessions were held, each starting with a keynote lecture to review the state of the art of the given topic, followed by 4 or 5 short presentations by experts. They were asked to limit their presentations to 10 slides containing only recent information. The meeting was organized by the executive committee of the ESO (Heinrich Mattle, chairman, Michael Brainin, Angel Chamorro, Werner Hacke, Didier Leys) and supported by the European Stroke Conference (Michael Hennerici). In this article we summarize the main contents of this successful workshop. PMID:22836350

  6. What Are Expert Systems?

    ERIC Educational Resources Information Center

    d'Agapeyeff, A.

    1986-01-01

    Intended for potential business users, this paper describes the main characteristics of expert systems; discusses practical use considerations; presents a taxonomy of the systems; and reviews several expert system development projects in business and industry. (MBR)

  7. The Expert Witness

    ERIC Educational Resources Information Center

    Environmental Science and Technology, 1975

    1975-01-01

    As consumers organize and industry begins to feel the economic pinch of pollution control laws, litigation may increase as will the need for the expert witness. Discussed are the functions and preparations of expert witnesses, their role and conduct in judicial proceedings, and the techniques of being an expert witness. (BT)

  8. An expert system development methodology which supports verification and validation

    NASA Technical Reports Server (NTRS)

    Culbert, Chris; Riley, Gary; Savely, Robert T.

    1987-01-01

    Expert systems have demonstrated commercial viability in a wide range of applications, but still face some obstacles to widespread use. A major stumbling block is the lack of well defined verification and validation (V and V) techniques. The primary difficulty with expert system V and V is the use of development methodologies which do not support V and V. As with conventional code, the key to effective V and V is the development methodology. An expert system development methodology is described which is based upon a panel review approach, that allows input from all parties concerned with the expert system.

  9. Towards Horizon 2020: challenges and advances for clinical mental health research – outcome of an expert survey

    PubMed Central

    van der Feltz-Cornelis, Christina M; van Os, Jim; Knappe, Susanne; Schumann, Gunter; Vieta, Eduard; Wittchen, Hans-Ulrich; Lewis, Shôn W; Elfeddali, Iman; Wahlbeck, Kristian; Linszen, Donald; Obradors-Tarragó, Carla; Haro, Josep Maria

    2014-01-01

    Background The size and increasing burden of disease due to mental disorders in Europe poses substantial challenges to its population and to the health policy of the European Union. This warrants a specific research agenda concerning clinical mental health research as one of the cornerstones of sustainable mental health research and health policy in Europe. The aim of this research was to identify the top priorities needed to address the main challenges in clinical research for mental disorders. Methods The research was conducted as an expert survey and expert panel discussion during a scientific workshop. Results Eighty-nine experts in clinical research and representing most European countries participated in this survey. Identified top priorities were the need for new intervention studies, understanding the diagnostic and therapeutic implications of mechanisms of disease, and research in the field of somatic-psychiatric comorbidity. The “subjectivity gap” between basic neuroscience research and clinical reality for patients with mental disorders is considered the main challenge in psychiatric research, suggesting that a shift in research paradigms is required. Conclusion Innovations in clinical mental health research should bridge the gap between mechanisms underlying novel therapeutic interventions and the patient experience of mental disorder and, if present, somatic comorbidity. Clinical mental health research is relatively underfunded and should receive specific attention in Horizon 2020 funding programs. PMID:25061300

  10. Expert study to select indicators of the occurrence of emerging mycotoxin hazards.

    PubMed

    Kandhai, M C; Booij, C J H; Van der Fels-Klerx, H J

    2011-01-01

    This article describes a Delphi-based expert judgment study aimed at the selection of indicators to identify the occurrence of emerging mycotoxin hazards related to Fusarium spp. in wheat supply chains. A panel of 29 experts from 12 European countries followed a holistic approach to evaluate the most important indicators for different chain stages (growth, transport and storage, and processing) and their relative importance. After three e-mailing rounds, the experts reached consensus on the most important indicators for each of the three stages: wheat growth, transport and storage, and processing. For wheat growth, these indicators include: relative humidity/rainfall, crop rotation, temperature, tillage practice, water activity of the kernels, and crop variety/cultivar. For the transport and storage stage, they include water activity in the kernels, relative humidity, ventilation, temperature, storage capacity, and logistics. For wheat processing, indicators include quality data, fraction of the cereal used, water activity in the kernels, quality management and traceability systems, and carryover of contamination. The indicators selected in this study can be used in an identification system for the occurrence of emerging mycotoxin hazards in wheat supply chains. Such a system can be used by risk managers within governmental (related) organizations and/or the food and feed industry in order to react proactively to the occurrence of these emerging mycotoxins. PMID:20846166

  11. Panel Moves toward "Next Generation" Science Standards

    ERIC Educational Resources Information Center

    Robelen, Erik W.

    2010-01-01

    As part of a national effort to produce "next generation" science standards for K-12 education, a panel of experts convened by the National Research Council (NRC) has issued a draft of a conceptual framework designed to guide the standards and "move science education toward a more coherent vision." One key goal of the effort is to focus science…

  12. Heat exchanger panel

    NASA Technical Reports Server (NTRS)

    Warburton, Robert E. (Inventor); Cuva, William J. (Inventor)

    2005-01-01

    The present invention relates to a heat exchanger panel which has broad utility in high temperature environments. The heat exchanger panel has a first panel, a second panel, and at least one fluid containment device positioned intermediate the first and second panels. At least one of the first panel and the second panel have at least one feature on an interior surface to accommodate the at least one fluid containment device. In a preferred embodiment, each of the first and second panels is formed from a high conductivity, high temperature composite material. Also, in a preferred embodiment, the first and second panels are joined together by one or more composite fasteners.

  13. Testing expert systems

    NASA Technical Reports Server (NTRS)

    Chang, C. L.; Stachowitz, R. A.

    1988-01-01

    Software quality is of primary concern in all large-scale expert system development efforts. Building appropriate validation and test tools for ensuring software reliability of expert systems is therefore required. The Expert Systems Validation Associate (EVA) is a validation system under development at the Lockheed Artificial Intelligence Center. EVA provides a wide range of validation and test tools to check correctness, consistency, and completeness of an expert system. Testing a major function of EVA. It means executing an expert system with test cases with the intent of finding errors. In this paper, we describe many different types of testing such as function-based testing, structure-based testing, and data-based testing. We describe how appropriate test cases may be selected in order to perform good and thorough testing of an expert system.

  14. Panel Discussion

    NASA Astrophysics Data System (ADS)

    Langer, James

    1997-03-01

    Panelists: Arthur Bienenstock, Stanford University Cherry Ann Murray, Lucent Technologies Venkatesh Narayanamurti, University of California-Santa Barbara Paul Peercy, SEMI-SEMATECH Robert Richardson, Cornell University James Roberto, Oak Ridge National Laboratory The Board on Physics and Astronomy is undertaking a series of reassessments of all branches of physics as the foundation of a new physics survey. As part of this project, a Committee on Condensed Matter and Materials Physics has been established under the leadership of Venkatesh Narayanamurti of the University of California-Santa Barbara. The committee has been working since June on a study that will include an illustrative recounting of major recent achievements; identification of new opportunities and challenges facing the field; and articulation-for leaders in government, industry, universities, and the public at large-of the important roles played by the field in modern society. An especially urgent issue is how to maintain the intellectual vitality of condensed matter and materials physics, and its contributions to the well-being of the United States, in an era of limited resources. The forum will feature a panel of materials researchers who are members of the Committee on Condensed Matter and Materials Physics. They will give a brief report on the status of the study and engage in a dialogue with the audience about issues facing the condensed matter and materials physics community. Broad community input is vital to the success of the study. Please come and make your voice heard!

  15. Brazil to Join the European Southern Observatory

    NASA Astrophysics Data System (ADS)

    2010-12-01

    conducted where every aspect of this large project was scrutinised by an international panel of independent experts. The panel found that the E-ELT project is technically ready to enter the construction phase. The go-ahead for E-ELT construction is planned for 2011 and when operations start early in the next decade, European, Brazilian and Chilean astronomers will have access to this giant telescope. The president of ESO's governing body, the Council, Laurent Vigroux, concludes: "Astronomers in Brazil will benefit from collaborating with European colleagues, and naturally from having observing time at ESO's world-class observatories at La Silla and Paranal, as well as on ALMA, which ESO is constructing with its international partners." Notes [1] After ratification of Brazil's membership, the ESO Member States will be Austria, Belgium, Brazil, the Czech Republic, Denmark, France, Finland, Germany, Italy, the Netherlands, Portugal, Spain, Sweden, Switzerland and the United Kingdom. More information ESO, the European Southern Observatory, is the foremost intergovernmental astronomy organisation in Europe and the world's most productive astronomical observatory. It is supported by 14 countries: Austria, Belgium, the Czech Republic, Denmark, France, Finland, Germany, Italy, the Netherlands, Portugal, Spain, Sweden, Switzerland and the United Kingdom. ESO carries out an ambitious programme focused on the design, construction and operation of powerful ground-based observing facilities enabling astronomers to make important scientific discoveries. ESO also plays a leading role in promoting and organising cooperation in astronomical research. ESO operates three unique world-class observing sites in Chile: La Silla, Paranal and Chajnantor. At Paranal, ESO operates the Very Large Telescope, the world's most advanced visible-light astronomical observatory and VISTA, the world's largest survey telescope. ESO is the European partner of a revolutionary astronomical telescope ALMA, the

  16. 21 CFR 516.141 - Qualified expert panels.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    .... This information can be obtained from a comprehensive curriculum vitae or similar document. (v) Notify... participated in the design, manufacture, or distribution of any drug that will benefit from either a...

  17. 21 CFR 516.141 - Qualified expert panels.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL..., their spouse, their minor children, their general partners, or any organizations in which they serve as an officer, director, trustee, general partner or employee: (i) Is currently receiving or...

  18. Identifying Characteristics of Dissemination Success Using an Expert Panel

    ERIC Educational Resources Information Center

    Bourrie, David M.; Cegielski, Casey G.; Jones-Farmer, L. Allison; Sankar, Chetan S.

    2014-01-01

    Although considerable work has been done to develop new educational innovations, few have found widespread acceptance in the classroom. To improve the likelihood of adoption of educational innovations, researchers need to understand why some innovations are adopted and routinely used, while others are not. An initial aspect of the diffusion of…

  19. Expert Panel Reviews of Research Centers: The Site Visit Process

    ERIC Educational Resources Information Center

    Lawrenz, Frances; Thao, Mao; Johnson, Kelli

    2012-01-01

    Site visits are used extensively in a variety of settings within the evaluation community. They are especially common in making summative value decisions about the quality and worth of research programs/centers. However, there has been little empirical research and guidance about how to appropriately conduct evaluative site visits of research…

  20. 21 CFR 516.141 - Qualified expert panels.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... must not have a conflict of interest or the appearance of a conflict of interest, as described in... conflict of interest directly to FDA in a timely manner, as required in paragraph (e)(6) of this section... information relating to potential conflict of interest described in paragraph (g) of this section to FDA...

  1. Expert system technology

    NASA Technical Reports Server (NTRS)

    Prince, Mary Ellen

    1987-01-01

    The expert system is a computer program which attempts to reproduce the problem-solving behavior of an expert, who is able to view problems from a broad perspective and arrive at conclusions rapidly, using intuition, shortcuts, and analogies to previous situations. Expert systems are a departure from the usual artificial intelligence approach to problem solving. Researchers have traditionally tried to develop general modes of human intelligence that could be applied to many different situations. Expert systems, on the other hand, tend to rely on large quantities of domain specific knowledge, much of it heuristic. The reasoning component of the system is relatively simple and straightforward. For this reason, expert systems are often called knowledge based systems. The report expands on the foregoing. Section 1 discusses the architecture of a typical expert system. Section 2 deals with the characteristics that make a problem a suitable candidate for expert system solution. Section 3 surveys current technology, describing some of the software aids available for expert system development. Section 4 discusses the limitations of the latter. The concluding section makes predictions of future trends.

  2. Assessing the Lexile Framework: Results of a Panel Meeting. Working Paper No. 2001-08

    ERIC Educational Resources Information Center

    White, Sheida; Clement, John

    2001-01-01

    This working paper summarizes the results of an expert panel review of the Lexile Framework (LF). The review was conducted by five panel members through readings, the preparation of brief individual reports, and participation in a meeting held on April 26, 2001 in Washington, D.C. The list of panel members and invited observers, along with brief…

  3. Adaptive feature extraction expert

    SciTech Connect

    Yuschik, M.

    1983-01-01

    The identification of discriminatory features places an upper bound on the recognition rate of any automatic speech recognition (ASR) system. One way to structure the extraction of features is to construct an expert system which applies a set of rules to identify particular properties of the speech patterns. However, these patterns vary for an individual speaker and from speaker to speaker so that another expert is actually needed to learn the new variations. The author investigates the problem by using sets of discriminatory features that are suggested by a feature generation expert, improves the selectivity of these features with a training expert, and finally develops a minimally spanning feature set with a statistical selection expert. 12 references.

  4. Ethical Expert Systems

    PubMed Central

    Victoroff, Michael S.

    1985-01-01

    The title is a double entendre. The discussion approaches expert systems from two directions: “What ethical hazards are created by expert systems in medicine?” and “Would it be ethical to design an expert system for solving problems in bioethics?” Computers present new ethical problems to society, some of which are unprecedented. These can be categorized under several rubrics. The paper describes a rudimentary scheme for understanding ethical issues raised by computers, in general, and medical expert systems, in particular. It focuses on bioethical implications of AI in medicine; explores norms, assumptions and taboos; and highlights certain ethical pitfalls. Principles are elucidated, for building ethically sound systems. Finally, a proposal is discussed, for the design of an expert system for moral problem solving, and the ethical implications of this notion are analyzed.

  5. Evaluation of a Performance-Based Expert Elicitation: WHO Global Attribution of Foodborne Diseases.

    PubMed

    Aspinall, W P; Cooke, R M; Havelaar, A H; Hoffmann, S; Hald, T

    2016-01-01

    For many societally important science-based decisions, data are inadequate, unreliable or non-existent, and expert advice is sought. In such cases, procedures for eliciting structured expert judgments (SEJ) are increasingly used. This raises questions regarding validity and reproducibility. This paper presents new findings from a large-scale international SEJ study intended to estimate the global burden of foodborne disease on behalf of WHO. The study involved 72 experts distributed over 134 expert panels, with panels comprising thirteen experts on average. Elicitations were conducted in five languages. Performance-based weighted solutions for target questions of interest were formed for each panel. These weights were based on individual expert's statistical accuracy and informativeness, determined using between ten and fifteen calibration variables from the experts' field with known values. Equal weights combinations were also calculated. The main conclusions on expert performance are: (1) SEJ does provide a science-based method for attribution of the global burden of foodborne diseases; (2) equal weighting of experts per panel increased statistical accuracy to acceptable levels, but at the cost of informativeness; (3) performance-based weighting increased informativeness, while retaining accuracy; (4) due to study constraints individual experts' accuracies were generally lower than in other SEJ studies, and (5) there was a negative correlation between experts' informativeness and statistical accuracy which attenuated as accuracy improved, revealing that the least accurate experts drive the negative correlation. It is shown, however, that performance-based weighting has the ability to yield statistically accurate and informative combinations of experts' judgments, thereby offsetting this contrary influence. The present findings suggest that application of SEJ on a large scale is feasible, and motivate the development of enhanced training and tools for remote

  6. Evaluation of a Performance-Based Expert Elicitation: WHO Global Attribution of Foodborne Diseases.

    PubMed

    Aspinall, W P; Cooke, R M; Havelaar, A H; Hoffmann, S; Hald, T

    2016-01-01

    For many societally important science-based decisions, data are inadequate, unreliable or non-existent, and expert advice is sought. In such cases, procedures for eliciting structured expert judgments (SEJ) are increasingly used. This raises questions regarding validity and reproducibility. This paper presents new findings from a large-scale international SEJ study intended to estimate the global burden of foodborne disease on behalf of WHO. The study involved 72 experts distributed over 134 expert panels, with panels comprising thirteen experts on average. Elicitations were conducted in five languages. Performance-based weighted solutions for target questions of interest were formed for each panel. These weights were based on individual expert's statistical accuracy and informativeness, determined using between ten and fifteen calibration variables from the experts' field with known values. Equal weights combinations were also calculated. The main conclusions on expert performance are: (1) SEJ does provide a science-based method for attribution of the global burden of foodborne diseases; (2) equal weighting of experts per panel increased statistical accuracy to acceptable levels, but at the cost of informativeness; (3) performance-based weighting increased informativeness, while retaining accuracy; (4) due to study constraints individual experts' accuracies were generally lower than in other SEJ studies, and (5) there was a negative correlation between experts' informativeness and statistical accuracy which attenuated as accuracy improved, revealing that the least accurate experts drive the negative correlation. It is shown, however, that performance-based weighting has the ability to yield statistically accurate and informative combinations of experts' judgments, thereby offsetting this contrary influence. The present findings suggest that application of SEJ on a large scale is feasible, and motivate the development of enhanced training and tools for remote

  7. World Health Organization Estimates of the Relative Contributions of Food to the Burden of Disease Due to Selected Foodborne Hazards: A Structured Expert Elicitation

    PubMed Central

    Hald, Tine; Aspinall, Willy; Devleesschauwer, Brecht; Cooke, Roger; Corrigan, Tim; Havelaar, Arie H.; Gibb, Herman J.; Torgerson, Paul R.; Kirk, Martyn D.; Angulo, Fred J.; Lake, Robin J.; Speybroeck, Niko; Hoffmann, Sandra

    2016-01-01

    providing estimates for one or more subregions, depending on their experience in the region. The size of the 19 hazard-specific panels ranged from 6 to 15 persons with several experts serving on more than one panel. Pathogens with animal reservoirs (e.g. non-typhoidal Salmonella spp. and Toxoplasma gondii) were in general assessed by the experts to have a higher proportion of illnesses attributable to food than pathogens with mainly a human reservoir, where human-to-human transmission (e.g. Shigella spp. and Norovirus) or waterborne transmission (e.g. Salmonella Typhi and Vibrio cholerae) were judged to dominate. For many pathogens, the foodborne route was assessed relatively more important in developed subregions than in developing subregions. The main exposure routes for lead varied across subregions, with the foodborne route being assessed most important only in two subregions of the European region. Conclusions For the first time, we present worldwide estimates of the proportion of specific diseases attributable to food and other major transmission routes. These findings are essential for global burden of FBD estimates. While gaps exist, we believe the estimates presented here are the best current source of guidance to support decision makers when allocating resources for control and intervention, and for future research initiatives. PMID:26784029

  8. Food webs: experts consuming families of experts.

    PubMed

    Rossberg, A G; Matsuda, H; Amemiya, T; Itoh, K

    2006-08-01

    Food webs of habitats as diverse as lakes or desert valleys are known to exhibit common "food-web patterns", but the detailed mechanisms generating these structures have remained unclear. By employing a stochastic, dynamical model, we show that many aspects of the structure of predatory food webs can be understood as the traces of an evolutionary history where newly evolving species avoid direct competition with their relatives. The tendency to avoid sharing natural enemies (apparent competition) with related species is considerably weaker. Thus, "experts consuming families of experts" can be identified as the main underlying food-web pattern. We report the results of a systematic, quantitative model validation showing that the model is surprisingly accurate.

  9. Future Challenges in Higher Education--Bologna Experts' Community Case Study

    ERIC Educational Resources Information Center

    Yemini, Miri

    2012-01-01

    This work presents results from systematic analysis of the challenges for the future of higher education in European and neighboring countries as it was extracted from the Bologna experts and Higher Education Reform experts' opinions. Opinions of more than 100 experts from 35 countries were documented and analyzed. Significant differences in the…

  10. A European Sustainable Tourism Labels proposal using a composite indicator

    SciTech Connect

    Blancas, Francisco Javier; Lozano-Oyola, Macarena; González, Mercedes

    2015-09-15

    The tourism sector in Europe faces important challenges which it must deal with to promote its future development. In this context, the European Commission considers that two key issues must be addressed. On the one hand, a better base of socio-economic knowledge about tourism and its relationship with the environment is needed, and, on the other hand, it is necessary to improve the image of European areas as quality sustainable tourism destinations. In this paper we present analytical tools that cover these needs. Specifically, we define a system of sustainable tourism indicators and we obtain a composite indicator incorporating weights quantified using a panel of experts. Employing the values of this global indicator as a basis, we define a Sustainable Tourism Country-Brand Ranking which assesses the perception of each country-brand depending on its degree of sustainability, and a system of sustainable tourism labels which reward the management carried out. - Highlights: • We define a system of indicators to improve the knowledge about sustainable tourism. • We obtain composite indicators based on expert knowledge. • The Sustainable Tourism Country-Brand Ranking would improve the image of destinations. • We define a Sustainable Tourism Labels System to assess country-brands. • The conclusions of the empirical analysis can be extrapolated to other tourist areas.

  11. Cardiovascular risk reduction in high-risk pediatric patients: a scientific statement from the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics.

    PubMed

    Kavey, Rae-Ellen W; Allada, Vivek; Daniels, Stephen R; Hayman, Laura L; McCrindle, Brian W; Newburger, Jane W; Parekh, Rulan S; Steinberger, Julia

    2006-12-12

    Although for most children the process of atherosclerosis is subclinical, dramatically accelerated atherosclerosis occurs in some pediatric disease states, with clinical coronary events occurring in childhood and very early adult life. As with most scientific statements about children and the future risk for cardiovascular disease, there are no randomized trials documenting the effects of risk reduction on hard clinical outcomes. A growing body of literature, however, identifies the importance of premature cardiovascular disease in the course of certain pediatric diagnoses and addresses the response to risk factor reduction. For this scientific statement, a panel of experts reviewed what is known about very premature cardiovascular disease in 8 high-risk pediatric diagnoses and, from the science base, developed practical recommendations for management of cardiovascular risk.

  12. Cardiovascular risk reduction in high-risk pediatric patients: a scientific statement from the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics.

    PubMed

    Kavey, Rae-Ellen W; Allada, Vivek; Daniels, Stephen R; Hayman, Laura L; McCrindle, Brian W; Newburger, Jane W; Parekh, Rulan S; Steinberger, Julia

    2006-12-12

    Although for most children the process of atherosclerosis is subclinical, dramatically accelerated atherosclerosis occurs in some pediatric disease states, with clinical coronary events occurring in childhood and very early adult life. As with most scientific statements about children and the future risk for cardiovascular disease, there are no randomized trials documenting the effects of risk reduction on hard clinical outcomes. A growing body of literature, however, identifies the importance of premature cardiovascular disease in the course of certain pediatric diagnoses and addresses the response to risk factor reduction. For this scientific statement, a panel of experts reviewed what is known about very premature cardiovascular disease in 8 high-risk pediatric diagnoses and, from the science base, developed practical recommendations for management of cardiovascular risk. PMID:17130340

  13. The Remarkable Staying Power of "Death Panels".

    PubMed

    Frankford, David M

    2015-10-01

    Sarah Palin's phrase "death panels" derailed proposed provisions of the Affordable Care Act (ACA) to pay physicians for end-of-life discussions with patients, a policy designed to make dying more humane, something all Americans desire. Even now, "death panels" has truth-value for approximately half of Americans and is used to paint ACA components as threatening to "pull the plug on Grandma." How can this be? To some, the death panels claim is simply a lie, an improvised explosive device hurled against any ACA provision. To others, the phrase's power stems from the public's lack of a common vocabulary to discuss end-of-life care. "Death panels," however, taps into many Americans' fear of government involvement, that government's purchasing end-of-life discussions as commodities necessitates accountability and cost control. Standardization and reduction of humanity follows, something Americans already experience routinely in their health care system. Expert jargon, compelling among experts themselves, doesn't evoke people's images of chats with Marcus Welby. The jargon is unintelligible, off-putting. When that jargon enters the nonjargonized world, it mixes with common fears, extant experience of dehumanization and reduction, and awareness that someone's plug is getting pulled all the time. "Death panels" cannot be dismissed as delusional, but neither can it help fulfill Americans' aspirations for a humane last voyage. PMID:26195604

  14. Expert model process control of composite materials in a press

    NASA Astrophysics Data System (ADS)

    Saliba, Tony E.; Quinter, Suzanne R.; Abrams, Frances L.

    An expert model for the control of the press processing of thermoset composite materials has been developed. The knowledge base written using the PC PLUS expert system shell was interfaced with models written in FORTRAN. The expert model, which is running on a single computer with a single processor, takes advantage of the symbol-crunching capability of LISP and the number crunching capability of FORTRAN. The Expert Model control system is a qualitative-quantitative process automation (QQPA) system since it includes both quantitative model-based and qualitative rule-based expert system operations. Various physical and mechanical properties were measured from panels processed using the two cycles. Using QQPA, processing time has been reduced significantly without altering product quality.

  15. Pantex Falling Man - Independent Review Panel Report.

    SciTech Connect

    Bertolini, Louis; Brannon, Nathan; Olson, Jared; Price, Bernard; Wardle, Robert; Steinzig, Mike; Winfield, Michael

    2014-11-01

    Consolidated Nuclear Security (CNS) Pantex took the initiative to organize a Review Panel of subject matter experts to independently assess the adequacy of the Pantex Tripping Man Analysis methodology. The purpose of this report is to capture the details of the assessment including the scope, approach, results, and detailed Appendices. Along with the assessment of the analysis methodology, the panel evaluated the adequacy with which the methodology was applied as well as congruence with Department of Energy (DOE) standards 3009 and 3016. The approach included the review of relevant documentation, interactive discussion with Pantex staff, and the iterative process of evaluating critical lines of inquiry.

  16. Expert Consensus on Characteristics of Wisdom: A Delphi Method Study

    ERIC Educational Resources Information Center

    Jeste, Dilip V.; Ardelt, Monika; Blazer, Dan; Kraemer, Helena C.; Vaillant, George; Meeks, Thomas W.

    2010-01-01

    Purpose: Wisdom has received increasing attention in empirical research in recent years, especially in gerontology and psychology, but consistent definitions of wisdom remain elusive. We sought to better characterize this concept via an expert consensus panel using a 2-phase Delphi method. Design and Methods: A survey questionnaire comprised 53…

  17. A European Humus Forms Reference Base

    NASA Astrophysics Data System (ADS)

    Zanella, A.; Englisch, M.; Ponge, J.-F.; Jabiol, B.; Sartori, G.; Gardi, C.

    2012-04-01

    From 2003 on, a panel of experts in humus and humus dynamics (Humus group) has been working about a standardisation and improvement of existing national humus classifications. Some important goals have been reached, in order to share data and experiences: a) definition of specific terms; b) description of 15 types of diagnostic horizons; c) of 10 basic humus forms references; d) subdivision of each main reference in 2-4 sub-unities; e) elaboration of a general European Humus Form Reference Base (http://hal-agroparistech.archives-ouvertes.fr/docs/00/56/17/95/PDF/Humus_Forms_ERB_31_01_2011.pdf); f) publication of the scientific significance of this base of classification as an article [A European morpho-functional classification of humus forms. Geoderma, 164 (3-4), 138-145]. The classification will be updated every 2 years and presently the Humus group is assessing biological (general: soil, vegetation, biome; specific: fungi, bacteria, pedofauna), physical (air temperature, rainfall) and chemical (pH, mineral elements, organic matter, quality and quantity of humic components…) factors which characterize basic humus forms and their varieties. The content of the new version of the classification is planned to be more "practical", like an ecological manual which lists associated humus forms and environmental data in the aim to contribute to a more precise environmental diagnosis of every analysed terrestrial and semiterrestrial European ecosystem. The Humus group is also involved in an endeavour to include humus forms in the World Reference Base for Soils (WRB-FAO) according to nomenclatural principles erected for soil profiles. Thirty basic references have been defined, complemented by a set of qualifiers (prefixes and suffixes), allowing to classify European humus forms and probably a large majority of humus forms known worldwide. The principles of the classification, the diagnostic horizons and humus forms main references are presented at the General Assembly of

  18. Evaluation of a Performance-Based Expert Elicitation: WHO Global Attribution of Foodborne Diseases

    PubMed Central

    Aspinall, W. P.; Cooke, R. M.; Havelaar, A. H.; Hoffmann, S.; Hald, T.

    2016-01-01

    For many societally important science-based decisions, data are inadequate, unreliable or non-existent, and expert advice is sought. In such cases, procedures for eliciting structured expert judgments (SEJ) are increasingly used. This raises questions regarding validity and reproducibility. This paper presents new findings from a large-scale international SEJ study intended to estimate the global burden of foodborne disease on behalf of WHO. The study involved 72 experts distributed over 134 expert panels, with panels comprising thirteen experts on average. Elicitations were conducted in five languages. Performance-based weighted solutions for target questions of interest were formed for each panel. These weights were based on individual expert’s statistical accuracy and informativeness, determined using between ten and fifteen calibration variables from the experts' field with known values. Equal weights combinations were also calculated. The main conclusions on expert performance are: (1) SEJ does provide a science-based method for attribution of the global burden of foodborne diseases; (2) equal weighting of experts per panel increased statistical accuracy to acceptable levels, but at the cost of informativeness; (3) performance-based weighting increased informativeness, while retaining accuracy; (4) due to study constraints individual experts’ accuracies were generally lower than in other SEJ studies, and (5) there was a negative correlation between experts' informativeness and statistical accuracy which attenuated as accuracy improved, revealing that the least accurate experts drive the negative correlation. It is shown, however, that performance-based weighting has the ability to yield statistically accurate and informative combinations of experts' judgments, thereby offsetting this contrary influence. The present findings suggest that application of SEJ on a large scale is feasible, and motivate the development of enhanced training and tools for remote

  19. Diabetes mellitus in older people: position statement on behalf of the International Association of Gerontology and Geriatrics (IAGG), the European Diabetes Working Party for Older People (EDWPOP), and the International Task Force of Experts in Diabetes.

    PubMed

    Sinclair, Alan; Morley, John E; Rodriguez-Mañas, Leo; Paolisso, Giuseppe; Bayer, Tony; Zeyfang, Andrej; Bourdel-Marchasson, Isabelle; Vischer, Ulrich; Woo, Jean; Chapman, Ian; Dunning, Trisha; Meneilly, Graydon; Rodriguez-Saldana, Joel; Gutierrez Robledo, Luis Miguel; Cukierman-Yaffe, Tali; Gadsby, Roger; Schernthaner, Guntram; Lorig, Kate

    2012-07-01

    Diabetes mellitus is a highly prevalent metabolic condition in ageing societies associated with high levels of morbidity, multiple therapies, and functional deterioration that challenges even the best of health care systems to deliver high-quality, individualized care. Most international clinical guidelines have ignored the often-unique issues of frailty, functional limitation, changes in mental health, and increasing dependency that characterize many aged patients with diabetes. A collaborative Expert Group of the IAGG and EDWPOP and an International Task Force have explored the key issues that affect diabetes in older people using a robust method comprising a Delphi process and an evidence-based review of the literature. Eight domains of interest were initially agreed and discussed: hypoglycemia, therapy, care home diabetes, influence of comorbidities, glucose targets, family/carer perspectives, diabetes education, and patient safety. A set of "consensus" statements was produced in each domain of interest. These form a foundation for future policy development in this area and should influence the clinical behavior and approach of all health professionals engaged in delivering diabetes care to older people.

  20. Autonomous power expert system

    NASA Technical Reports Server (NTRS)

    Walters, Jerry L.; Petrik, Edward J.; Roth, Mary Ellen; Truong, Long Van; Quinn, Todd; Krawczonek, Walter M.

    1990-01-01

    The Autonomous Power Expert (APEX) system was designed to monitor and diagnose fault conditions that occur within the Space Station Freedom Electrical Power System (SSF/EPS) Testbed. APEX is designed to interface with SSF/EPS testbed power management controllers to provide enhanced autonomous operation and control capability. The APEX architecture consists of three components: (1) a rule-based expert system, (2) a testbed data acquisition interface, and (3) a power scheduler interface. Fault detection, fault isolation, justification of probable causes, recommended actions, and incipient fault analysis are the main functions of the expert system component. The data acquisition component requests and receives pertinent parametric values from the EPS testbed and asserts the values into a knowledge base. Power load profile information is obtained from a remote scheduler through the power scheduler interface component. The current APEX design and development work is discussed. Operation and use of APEX by way of the user interface screens is also covered.

  1. Seismic hazard analysis. Volume 5. Review panel, Ground Motion Panel, and feedback results

    SciTech Connect

    Bernreuter, D. L.

    1981-08-01

    The Site Specific Spectra Project (SSSP) was a multi-year study funded by the US Nuclear Regulatory Commission to provide estimates of the seismic hazards at a number of nuclear power plant sites in the Eastern US. A key element of our approach was the Peer Review Panel, which we formed in order to ensure that our use of expert opinion was reasonable. We discuss the Peer Review Panel results and provide the complete text of each member's report. In order to improve the ground motion model, an Eastern US Ground Motion Model Panel was formed. In Section 4 we tabulate the responses from the panel members to our feedback questionnaire and discuss the implications of changes introduced by them. We conclude that the net difference in seismic hazard values from those presented in Volume 4 is small and does not warrant a reanalysis. 22 figs.

  2. Advanced concentrator panels

    NASA Technical Reports Server (NTRS)

    Bell, D. M.; Bedard, R. J., Jr.

    1981-01-01

    The prototype fabrication of a lightweight, high-quality cellular glass substrate reflective panel for use in an advanced point-focusing solar concentrator was completed. The reflective panel is a gore shaped segment of an 11-m paraboloidal dish. The overall concentrator design and the design of the reflective panels are described. prototype-specific panel design modifications are discussed and the fabrication approach and procedure outlined.

  3. TRMM Solar Array Panels

    NASA Technical Reports Server (NTRS)

    1998-01-01

    This final report presents conclusions/recommendations concerning the TRMM Solar Array; deliverable list and schedule summary; waivers and deviations; as-shipped performance data, including flight panel verification matrix, panel output detail, shadow test summary, humidity test summary, reverse bias test panel; and finally, quality assurance summary.

  4. Computers Simulate Human Experts.

    ERIC Educational Resources Information Center

    Roberts, Steven K.

    1983-01-01

    Discusses recent progress in artificial intelligence in such narrowly defined areas as medical and electronic diagnosis. Also discusses use of expert systems, man-machine communication problems, novel programing environments (including comments on LISP and LISP machines), and types of knowledge used (factual, heuristic, and meta-knowledge). (JN)

  5. Capital Expert System

    NASA Astrophysics Data System (ADS)

    Dowell, Laurie; Gary, Jack; Illingworth, Bill; Sargent, Tom

    1987-05-01

    Gathering information, necessary forms, and financial calculations needed to generate a "capital investment proposal" is an extremely complex and difficult process. The intent of the capital investment proposal is to ensure management that the proposed investment has been thoroughly investigated and will have a positive impact on corporate goals. Meeting this requirement typically takes four or five experts a total of 12 hours to generate a "Capital Package." A Capital Expert System was therefore developed using "Personal Consultant." The completed system is hybrid and as such does not depend solely on rules but incorporates several different software packages that communicate through variables and functions passed from one to another. This paper describes the use of expert system techniques, methodology in building the knowledge base, contexts, LISP functions, data base, and special challenges that had to be overcome to create this system. The Capital Expert System is the successful result of a unique integration of artificial intelligence with business accounting, financial forms generation, and investment proposal expertise.

  6. Expert Systems Research.

    ERIC Educational Resources Information Center

    Duda, Richard O.; Shortliffe, Edward H.

    1983-01-01

    Discusses a class of artificial intelligence computer programs (often called "expert systems" because they address problems normally thought to require human specialists for their solution) intended to serve as consultants for decision making. Also discusses accomplishments (including information systematization in medical diagnosis and geology)…

  7. Robot environment expert system

    NASA Technical Reports Server (NTRS)

    Potter, J. L.

    1985-01-01

    The Robot Environment Expert System uses a hexidecimal tree data structure to model a complex robot environment where not only the robot arm moves, but also the robot itself and other objects may move. The hextree model allows dynamic updating, collision avoidance and path planning over time, to avoid moving objects.

  8. Experts, Dialects, and Discourse.

    ERIC Educational Resources Information Center

    Bhatt, Rakesh Mohan

    2002-01-01

    Examines "expert" discourse--complexes of signs and practices that organize and legitimize social existence and social reproduction--to demonstrate the ideological process involved in the manufacture of Standard English ideology and its continual duplication as necessitated by the three axiomatic conceptions of the English-sacred imagined…

  9. A new way to ask the experts: Rating radioactive waste risks

    SciTech Connect

    Kerr, R.A.

    1996-11-08

    The possible risks of a proposed nuclear waste repository at Yucca Mountain include the dozen or more young volcanos near by. Now some earth scientists have a new approach to evaluating hazards accounting for uncertainty at every step - `expert elicitation.` This pulls together a panel of experts, carefully assesses the uncertainties of each of their views then mathematically combines their risk estimates along with the accompanying uncertainties. The article goes on to describe just such a panel which considered seismic hazards to Yucca Mountain, how they came to their conclusions, the arguments about the conclusions, and the future of expert elicitation in evaluating the risks of nuclear waste disposal.

  10. Safety Panel Resources

    NASA Technical Reports Server (NTRS)

    Stewart, Christine E.

    2008-01-01

    The goal of this paper is to explore what resources are potentially available to safety panels and to provide some guidance on how to utilize those resources. While the examples used in this paper will concentrate on the Flight Equipment and Reliability Review Panel (FESRRP) and Extravehicular Activity (EVA) hardware that have come through that panel, as well as resources at Johnson Space Center, the paper will address how this applies to safety panels in general, and where possible cite examples for other safety panels.

  11. ICFA neutrino panel report

    NASA Astrophysics Data System (ADS)

    Long, K.

    2015-07-01

    In the summer of 2013 the International Committee on Future Accelerators (ICFA) established a Neutrino Panel with the mandate: "To promote international cooperation in the development of the accelerator-based neutrino-oscillation program and to promote international collaboration in the development of a neutrino factory as a future intense source of neutrinos for particle physics experiments." In its first year the Panel organised a series of regional Town Meetings to collect input from the community and to receive reports from the regional planning exercises. The Panel distilled its findings and presented them in a report to ICFA [1]. In this contribution the formation and composition of the Panel are presented together with a summary of the Panel's findings from the three Regional Town Meetings. The Panel's initial conclusions are then articulated and the steps that the Panel seeks to take are outlined.

  12. Quiet Honeycomb Panels

    NASA Technical Reports Server (NTRS)

    Palumbo, Daniel L.; Klos, Jacob

    2010-01-01

    Sandwich honeycomb composite panels are lightweight and strong, and, therefore, provide a reasonable alternative to the aluminum ring frame/stringer architecture currently used for most aircraft airframes. The drawback to honeycomb panels is that they radiate noise into the aircraft cabin veil- efficiently provoking the need for additional sound treatment which adds weight and reduces the material's cost advantage. A series of honeycomb panels was made -hick incorporated different design strategies aimed at reducing the honeycomb panels' radiation efficiency while at the same time maintaining their strength. The majority of the designs were centered around the concept of creating areas of reduced stiffness in the panel by adding voids and recesses to the core. The effort culminated with a reinforced/recessed panel which had 6 dB higher transmission loss than the baseline solid core panel while maintaining comparable strength.

  13. Interactive optical panel

    DOEpatents

    Veligdan, James T.

    1995-10-03

    An interactive optical panel assembly 34 includes an optical panel 10 having a plurality of ribbon optical waveguides 12 stacked together with opposite ends thereof defining panel first and second faces 16, 18. A light source 20 provides an image beam 22 to the panel first face 16 for being channeled through the waveguides 12 and emitted from the panel second face 18 in the form of a viewable light image 24a. A remote device 38 produces a response beam 40 over a discrete selection area 36 of the panel second face 18 for being channeled through at least one of the waveguides 12 toward the panel first face 16. A light sensor 42,50 is disposed across a plurality of the waveguides 12 for detecting the response beam 40 therein for providing interactive capability.

  14. Defining consensus norms for palliative care of people with intellectual disabilities in Europe, using Delphi methods: A White Paper from the European Association of Palliative Care

    PubMed Central

    Tuffrey-Wijne, Irene; McLaughlin, Dorry; Curfs, Leopold; Dusart, Anne; Hoenger, Catherine; McEnhill, Linda; Read, Sue; Ryan, Karen; Satgé, Daniel; Straßer, Benjamin; Westergård, Britt-Evy; Oliver, David

    2015-01-01

    Background: People with intellectual disabilities often present with unique challenges that make it more difficult to meet their palliative care needs. Aim: To define consensus norms for palliative care of people with intellectual disabilities in Europe. Design: Delphi study in four rounds: (1) a taskforce of 12 experts from seven European countries drafted the norms, based on available empirical knowledge and regional/national guidelines; (2) using an online survey, 34 experts from 18 European countries evaluated the draft norms, provided feedback and distributed the survey within their professional networks. Criteria for consensus were clearly defined; (3) modifications and recommendations were made by the taskforce; and (4) the European Association for Palliative Care reviewed and approved the final version. Setting and participants: Taskforce members: identified through international networking strategies. Expert panel: a purposive sample identified through taskforce members’ networks. Results: A total of 80 experts from 15 European countries evaluated 52 items within the following 13 norms: equity of access, communication, recognising the need for palliative care, assessment of total needs, symptom management, end-of-life decision making, involving those who matter, collaboration, support for family/carers, preparing for death, bereavement support, education/training and developing/managing services. None of the items scored less than 86% agreement, making a further round unnecessary. In light of respondents’ comments, several items were modified and one item was deleted. Conclusion: This White Paper presents the first guidance for clinical practice, policy and research related to palliative care for people with intellectual disabilities based on evidence and European consensus, setting a benchmark for changes in policy and practice. PMID:26346181

  15. Bioethics for Technical Experts

    NASA Astrophysics Data System (ADS)

    Asano, Shigetaka

    Along with rapidly expanding applications of life science and technology, technical experts have been implicated more and more often with ethical, social, and legal problems than before. It should be noted that in this background there are scientific and social uncertainty elements which are inevitable during the progress of life science in addition to the historically-established social unreliability to scientists and engineers. In order to solve these problems, therefore, we should establish the social governance with ‘relief’ and ‘reliance’ which enables for both citizens and engineers to share the awareness of the issues, to design social orders and criterions based on hypothetical sense of values for bioethics, to carry out practical use management of each subject carefully, and to improve the sense of values from hypothetical to universal. Concerning these measures, the technical experts can learn many things from the present performance in the medical field.

  16. ALICE Expert System

    NASA Astrophysics Data System (ADS)

    Ionita, C.; Carena, F.

    2014-06-01

    The ALICE experiment at CERN employs a number of human operators (shifters), who have to make sure that the experiment is always in a state compatible with taking Physics data. Given the complexity of the system and the myriad of errors that can arise, this is not always a trivial task. The aim of this paper is to describe an expert system that is capable of assisting human shifters in the ALICE control room. The system diagnoses potential issues and attempts to make smart recommendations for troubleshooting. At its core, a Prolog engine infers whether a Physics or a technical run can be started based on the current state of the underlying sub-systems. A separate C++ component queries certain SMI objects and stores their state as facts in a Prolog knowledge base. By mining the data stored in different system logs, the expert system can also diagnose errors arising during a run. Currently the system is used by the on-call experts for faster response times, but we expect it to be adopted as a standard tool by regular shifters during the next data taking period.

  17. Titanium honeycomb panel testing

    NASA Astrophysics Data System (ADS)

    Richards, W. L.; Thompson, Randolph C.

    The paper describes the procedures of thermal mechanical tests carried out at the NASA Dryden Flight Research Facility on two tianium honeycomb wing panels bonded using liquid interface diffusion (LID) technique, and presents the results of these tests. The 58.4 cm square panels consisted of two 0.152-cm-thick Ti 6-2-4-2 face sheets LID-bonded to a 1.9-cm-thick honeycomb core, with bearing plates fastened to the perimeter of the upper and the lower panel surfaces. The panels were instrumented with sensors for measuring surface temperature, strain, and deflections to 315 C and 482 C. Thermal stress levels representative of those encountered during aerodynamic heating were produced by heating the upper panel surface and restraining all four edges. After more than 100 thermal cycles from room temperature to 315 C and 50 cycles from room temperature to 482 C, no significant structural degradation was detected in the panels.

  18. Aerospace safety advisory panel

    NASA Technical Reports Server (NTRS)

    1994-01-01

    This report from the Aerospace Safety Advisory Panel (ASAP) contains findings, recommendations, and supporting material concerning safety issues with the space station program, the space shuttle program, aeronautics research, and other NASA programs. Section two presents findings and recommendations, section three presents supporting information, and appendices contain data about the panel membership, the NASA response to the March 1993 ASAP report, and a chronology of the panel's activities during the past year.

  19. Solar reflection panels

    DOEpatents

    Diver, Jr., Richard B.; Grossman, James W.; Reshetnik, Michael

    2006-07-18

    A solar collector comprising a glass mirror, and a composite panel, wherein the back of the mirror is affixed to a front surface of the composite panel. The composite panel comprises a front sheet affixed to a surface of a core material, preferably a core material comprising a honeycomb structure, and a back sheet affixed to an opposite surface of the core material. The invention may further comprise a sealing strip, preferably comprising EPDM, positioned between the glass mirror and the front surface of the composite panel. The invention also is of methods of making such solar collectors.

  20. PANEL LIBRARY AND EDITOR

    NASA Technical Reports Server (NTRS)

    Raible, E.

    1994-01-01

    The Panel Library and Editor is a graphical user interface (GUI) builder for the Silicon Graphics IRIS workstation family. The toolkit creates "widgets" which can be manipulated by the user. Its appearance is similar to that of the X-Windows System. The Panel Library is written in C and is used by programmers writing user-friendly mouse-driven applications for the IRIS. GUIs built using the Panel Library consist of "actuators" and "panels." Actuators are buttons, dials, sliders, or other mouse-driven symbols. Panels are groups of actuators that occupy separate windows on the IRIS workstation. The application user can alter variables in the graphics program, or fire off functions with a click on a button. The evolution of data values can be tracked with meters and strip charts, and dialog boxes with text processing can be built. Panels can be stored as icons when not in use. The Panel Editor is a program used to interactively create and test panel library interfaces in a simple and efficient way. The Panel Editor itself uses a panel library interface, so all actions are mouse driven. Extensive context-sensitive on-line help is provided. Programmers can graphically create and test the user interface without writing a single line of code. Once an interface is judged satisfactory, the Panel Editor will dump it out as a file of C code that can be used in an application. The Panel Library (v9.8) and Editor (v1.1) are written in C-Language (63%) and Scheme, a dialect of LISP, (37%) for Silicon Graphics 4D series workstations running IRIX 3.2 or higher. Approximately 10Mb of disk space is required once compiled. 1.5Mb of main memory is required to execute the panel editor. This program is available on a .25 inch streaming magnetic tape cartridge in UNIX tar format for an IRIS, and includes a copy of XScheme, the public-domain Scheme interpreter used by the Panel Editor. The Panel Library Programmer's Manual is included on the distribution media. The Panel Library and

  1. Expert and Knowledge Based Systems.

    ERIC Educational Resources Information Center

    Demaid, Adrian; Edwards, Lyndon

    1987-01-01

    Discusses the nature and current state of knowledge-based systems and expert systems. Describes an expert system from the viewpoints of a computer programmer and an applications expert. Addresses concerns related to materials selection and forecasts future developments in the teaching of materials engineering. (ML)

  2. Expert Systems and Special Education.

    ERIC Educational Resources Information Center

    Hofmeister, Alan M.; Ferrara, Joseph M.

    1986-01-01

    The article discusses the characteristics of expert systems (computer programs designed to replicate human expertise in a variety of areas), describes recently available expert system development tools, suggests applications within the field of special education, and reviews recent efforts to apply expert systems technology to special education…

  3. Expert systems development and application

    NASA Technical Reports Server (NTRS)

    Duke, E. L.; Regenie, V. A.

    1985-01-01

    Current research in the application of expert systems to problems in the flight research environment is discussed. In what is anticipated to be a broad research area, a real time expert system flight status monitor has been identified as the initial project. This real time expert system flight status monitor is described in terms of concept, application, development, and schedule.

  4. Perspectives for food research and European collaboration in the European Research Area and the new Framework Programme.

    PubMed

    Breslin, L

    2001-08-01

    Since 1987, successive framework programmes have contributed to strengthen European food research through the establishment of networks between research institutions, universities and companies from various European countries. In the FAIR programme (1994-1998), 118 research projects comprising nearly 1,000 participants from the European Union and Associated States have been supported in the food area with a European funding of about [symbol: see text] 108 million. Within the Quality of Life and Management of Living Resources programme (1998-2002), food research is mostly supported within the key action 'food, nutrition and health' with a budget of [symbol: see text] 290 million. After the first four deadlines, 735 eligible research proposals have already been received. Further to their evaluation by a panel of independent experts, 108 proposals have been funded or selected for funding representing a total contribution of about [symbol: see text] 168 million. Among those, several clusters of projects are now running on important topics such as probiotics, coeliac diseases, mycotoxins, GMO, safety and food for the elderly. In addition, technology stimulation measures are largely benefiting SMEs to foster their innovation potential. In January 2000, the European Commission adopted a Communication entitled "Towards the European Research Area (ERA)" with the objective to contribute to developing better framework conditions for research in Europe. On 21 February 2001, the Commission adopted proposals to be submitted to the European Parliament and Council for the next framework programme for research and innovation (2002-2006). The new framework programme that is becoming one of the financial instruments of the ERA aims at catalysing the integration of European research by: strengthening of links between the Community research effort and national and regional research policies; concentrating on a limited number of priority fields or research to which activities at the

  5. Perspectives for food research and European collaboration in the European Research Area and the new Framework Programme.

    PubMed

    Breslin, L

    2001-08-01

    Since 1987, successive framework programmes have contributed to strengthen European food research through the establishment of networks between research institutions, universities and companies from various European countries. In the FAIR programme (1994-1998), 118 research projects comprising nearly 1,000 participants from the European Union and Associated States have been supported in the food area with a European funding of about [symbol: see text] 108 million. Within the Quality of Life and Management of Living Resources programme (1998-2002), food research is mostly supported within the key action 'food, nutrition and health' with a budget of [symbol: see text] 290 million. After the first four deadlines, 735 eligible research proposals have already been received. Further to their evaluation by a panel of independent experts, 108 proposals have been funded or selected for funding representing a total contribution of about [symbol: see text] 168 million. Among those, several clusters of projects are now running on important topics such as probiotics, coeliac diseases, mycotoxins, GMO, safety and food for the elderly. In addition, technology stimulation measures are largely benefiting SMEs to foster their innovation potential. In January 2000, the European Commission adopted a Communication entitled "Towards the European Research Area (ERA)" with the objective to contribute to developing better framework conditions for research in Europe. On 21 February 2001, the Commission adopted proposals to be submitted to the European Parliament and Council for the next framework programme for research and innovation (2002-2006). The new framework programme that is becoming one of the financial instruments of the ERA aims at catalysing the integration of European research by: strengthening of links between the Community research effort and national and regional research policies; concentrating on a limited number of priority fields or research to which activities at the

  6. Sparks Fade, Knowledge Stays: The National Early Literacy Panel's Report Lacks Staying Power

    ERIC Educational Resources Information Center

    Neuman, Susan B.

    2010-01-01

    In this article, the author talks about "Developing Early Literacy," the report of the National Early Literacy Panel. The panel, which consisted of nine experts, was convened by the National Institute for Literacy to synthesize the research on the development of literacy from birth through age 5. Over the eight years of their work, only 190…

  7. 75 FR 35121 - Intergovernmental Panel on Climate Change Special Report Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-21

    ... Intergovernmental Panel on Climate Change Special Report Review ACTION: The United States Global Change Research and Climate Change Technology Programs request expert review of the Special Report on Renewable Energy Sources and Climate Change Mitigation (SRREN) of the Intergovernmental Panel on Climate Change (IPCC)....

  8. The imported forensic expert

    SciTech Connect

    Larson, C.P.

    1980-09-01

    A review of the experiences of one of the pioneer forensic pathologists in the United States offers an interesting insight into the possibilities of private forensic pathology in America. The author's experience includes serving as President of the National Boxing Association and the International Boxing Association, during which time he made many improvements in ring safety. His research into several areas of cases of product liability offer an insight to the wide scope of the potential of the forensic expert. This presentation reviews his activities in realms widely afield from medicine.

  9. Pharmacotherapy for Institutionalized Adolescents: Report of a Panel.

    ERIC Educational Resources Information Center

    Kalogerakis, Michael G., Ed.

    Presented are 34 guidelines and related charts developed by a New York panel of experts on psychotherapy with disturbed institutionalized adolescents. The guidelines are organized into general principles, specific indications (acute disturbances subacute, and chronic disturbances), and the patient's rights. Charts include a list of commonly used…

  10. A European Roadmap for Research in Astrobiology - The AstRoMap Roadmap

    NASA Astrophysics Data System (ADS)

    Gómez, F.; Walter, N.; Horneck, G.; Muller, C.; Rettberg, P.; Capria, M.; Palomba, E.

    2015-10-01

    AstRoMap (Astrobiology Road Mapping activity-www.astromap-eu.org) is a collaborative project which will provide the European Planetary Science Community with a road map in astrobiology. The goals of the project have been: (i) to pose big questions related to astrobiology; and (ii) the identification of experiments, new technology and/or those space missions to be developed in future programs and which could answer those big questions. This collaborative infrastructure includes the organization of expert panels and international workshops in order to discuss about those big questions and the science objectives by the community to be addressed. The main deliverable will be a Roadmap document. The project is steered by a consortium of six European and national research institutes and associations: -­- Centro de Astrobiologica (INTACSIC), Spain -­- European Science Foundation, France -­- Association pour un Réseau Européen d'Exo/Astrobiology (EANA), France -­- B-USOC, Belgium -­- Deutsches Zentrum für Luft- und Raumfahrt (DLR), Germany -­- National Institute for Astrophysics (INAF), ItalyOrigin and evolution of planetary systems -­- Origin of organic compounds in space -­- Rock-water-carbon interactions, organic synthesis, and steps to life -­- Life and habitability on Earth and in Space -­- -­- Biosignatures as facilitating life detection The key topics will focus on a limited number of strategic scientific objectives to be addressed in the next 20 years by European astrobiologists, and suggest research activities for future development.

  11. The psychiatric expert in court.

    PubMed

    Kenny, A

    1984-05-01

    The law about expert evidence is unsatisfactory: it gives scope for the expert to usurp the role of judge, jury and parliament; it brings the professions of the experts into disrepute; and it sets juries the impossible task of sorting pseudo sciences from genuine ones. The law should be reformed by changing statutes which force expert witnesses to testify beyond their science, by taking the provision of expert evidence out of the adversarial context, and by removing from the courts the decision whether a nascent discipline is or is not a science.

  12. Microgravity Science Research Panel

    NASA Technical Reports Server (NTRS)

    Carpenter, Bradley M.; Trinh, Eugene H.; DeLucas, Lawrence J.; Larson, David; Koss, Matthew; Ostrach, Simon

    2000-01-01

    This document is a transcription of the Microgravity Science Research Panel's discussion about their research and about some of the contributions that they feel have been important to the field during their time with the program. The panel includes Dr. Eugene Trinh, Dr. Lawrence DeLucas, Dr. Charles Bugg, Dr. David Larson, and Dr. Simon Ostrach.

  13. Technology Panel Reports

    NASA Technical Reports Server (NTRS)

    1984-01-01

    Results are presented from five technology panels which convened to identify relevant technologies within their discipline for the Large Deployable Reflector (LDR) and to assess the current and projected state of these technologies. The five panels considered the following topics: optics, materials and structure, sensing and control, science instruments, and systems and missions.

  14. How experts gain influence.

    PubMed

    Mikes, Anette; Hall, Matthew; Millo, Yuval

    2013-01-01

    In theory, the risk management groups of two British banks--Saxon and Anglo--had the same influence in their organizations. But in practice, they did not: Saxon's was engaged in critical work throughout the bank, while Anglo's had little visibility outside its areas of expertise. In their study of these two financial institutions, the authors identified four competencies--trailblazing, toolmaking, teamwork, and translation--that help functional leaders or groups compete for top management's limited attention and increase their impact. Anglo's risk managers were strong in only some of the competencies, but Saxon's were strong in all four. They consistently scanned the internal and external environment for important issues to which they could apply a risk management perspective (trailblazing) and then developed tools--such as quarterly risk reports--that spread their expertise (toolmaking). While controlling the tools' design and implementation, the risk managers incorporated business managers' insights (teamwork) and made sure everyone could understand the findings (translation). Ultimately, experts' roles must fit the organization's strategy and structural needs. In some situations, functional experts can raise their profile by cultivating just two of the competencies. But those who are strong in all four are likely to be the most influential. PMID:24730171

  15. Confessions and expert testimony.

    PubMed

    Weiss, Kenneth J

    2003-01-01

    In this clinical paper, the author discusses criminal confessions from the point of view of the expert witness who may be asked to comment on the reliability of the statement and waiver of rights. From the time a suspect is in police custody, constitutional protections against self-incrimination and for due process are in place. The Supreme Court set the standard for these situations in the 1966 Miranda v. Arizona decision. Although it has long been criticized by law enforcement, the decision was upheld in the 2000 decision in Dickerson v. U.S. For a waiver of rights to be valid, it must be a knowing, intelligent, and voluntary decision. Voluntariness is an equation of objective and subjective variables. Treatment by police, physical conditions of interrogation, the suspect's experience and mental state can alter the reliability of a confession. Accordingly, the author has devised a mnemonic for the recognition of conditions that may give rise to expert testimony. The conditions are: Mental illness, Intoxication, Retardation, Acquiescence, Narcotic withdrawal, Deception, and Abuse. These are discussed, supported by examples from the author's practice.

  16. How experts gain influence.

    PubMed

    Mikes, Anette; Hall, Matthew; Millo, Yuval

    2013-01-01

    In theory, the risk management groups of two British banks--Saxon and Anglo--had the same influence in their organizations. But in practice, they did not: Saxon's was engaged in critical work throughout the bank, while Anglo's had little visibility outside its areas of expertise. In their study of these two financial institutions, the authors identified four competencies--trailblazing, toolmaking, teamwork, and translation--that help functional leaders or groups compete for top management's limited attention and increase their impact. Anglo's risk managers were strong in only some of the competencies, but Saxon's were strong in all four. They consistently scanned the internal and external environment for important issues to which they could apply a risk management perspective (trailblazing) and then developed tools--such as quarterly risk reports--that spread their expertise (toolmaking). While controlling the tools' design and implementation, the risk managers incorporated business managers' insights (teamwork) and made sure everyone could understand the findings (translation). Ultimately, experts' roles must fit the organization's strategy and structural needs. In some situations, functional experts can raise their profile by cultivating just two of the competencies. But those who are strong in all four are likely to be the most influential.

  17. An expert consortium review of the EC-commissioned report "alternative (Non-Animal) methods for cosmetics testing: current status and future prospects - 2010".

    PubMed

    Hartung, Thomas; Blaauboer, Bas J; Bosgra, Sieto; Carney, Edward; Coenen, Joachim; Conolly, Rory B; Corsini, Emanuela; Green, Sidney; Faustman, Elaine M; Gaspari, Anthony; Hayashi, Makoto; Wallace Hayes, A; Hengstler, Jan G; Knudsen, Lisbeth E; Knudsen, Thomas B; McKim, James M; Pfaller, Walter; Roggen, Erwin L

    2011-01-01

    The European cosmetics legislation foresees a review in 2011 and possible postponement of the 2013 marketing ban to enforce the testing ban for systemic and repeated-dose animal tests. For this purpose, a 119-page report commissioned by the European Commission was published recently. Here, a group of 17 independent experts from the US, Europe, and Japan was brought together to evaluate the report. The expert panel strongly endorsed the report and its conclusions. A number of important options not considered were identified; these do not, however, affect the overall conclusions regarding the current lack of availability of a full replacement, especially for the areas of repeated dose toxicity, carcinogenicity testing, and reproductive toxicity, though a roadmap for change is emerging. However, some of these options may provide adequate data for replacement of some animal studies in the near future pending validation. Various recommendations expand the original report. The reviewers agree with the report that there is greater promise in the short term for the areas of sensitization and toxicokinetics. Additional opportunities lie in more global collaborations and the inclusion of other industry sectors.

  18. An expert consortium review of the EC-commissioned report "alternative (Non-Animal) methods for cosmetics testing: current status and future prospects - 2010".

    PubMed

    Hartung, Thomas; Blaauboer, Bas J; Bosgra, Sieto; Carney, Edward; Coenen, Joachim; Conolly, Rory B; Corsini, Emanuela; Green, Sidney; Faustman, Elaine M; Gaspari, Anthony; Hayashi, Makoto; Wallace Hayes, A; Hengstler, Jan G; Knudsen, Lisbeth E; Knudsen, Thomas B; McKim, James M; Pfaller, Walter; Roggen, Erwin L

    2011-01-01

    The European cosmetics legislation foresees a review in 2011 and possible postponement of the 2013 marketing ban to enforce the testing ban for systemic and repeated-dose animal tests. For this purpose, a 119-page report commissioned by the European Commission was published recently. Here, a group of 17 independent experts from the US, Europe, and Japan was brought together to evaluate the report. The expert panel strongly endorsed the report and its conclusions. A number of important options not considered were identified; these do not, however, affect the overall conclusions regarding the current lack of availability of a full replacement, especially for the areas of repeated dose toxicity, carcinogenicity testing, and reproductive toxicity, though a roadmap for change is emerging. However, some of these options may provide adequate data for replacement of some animal studies in the near future pending validation. Various recommendations expand the original report. The reviewers agree with the report that there is greater promise in the short term for the areas of sensitization and toxicokinetics. Additional opportunities lie in more global collaborations and the inclusion of other industry sectors. PMID:21993956

  19. ICFA neutrino panel report

    SciTech Connect

    Long, K.

    2015-07-15

    In the summer of 2013 the International Committee on Future Accelerators (ICFA) established a Neutrino Panel with the mandate: <<>>In its first year the Panel organised a series of regional Town Meetings to collect input from the community and to receive reports from the regional planning exercises. The Panel distilled its findings and presented them in a report to ICFA [1]. In this contribution the formation and composition of the Panel are presented together with a summary of the Panel’s findings from the three Regional Town Meetings. The Panel’s initial conclusions are then articulated and the steps that the Panel seeks to take are outlined.

  20. Aerospace Safety Advisory Panel

    NASA Technical Reports Server (NTRS)

    1993-01-01

    The Aerospace Safety Advisory Panel (ASAP) provided oversight on the safety aspects of many NASA programs. In addition, ASAP undertook three special studies. At the request of the Administrator, the panel assessed the requirements for an assured crew return vehicle (ACRV) for the space station and reviewed the organization of the safety and mission quality function within NASA. At the behest of Congress, the panel formed an independent, ad hoc working group to examine the safety and reliability of the space shuttle main engine. Section 2 presents findings and recommendations. Section 3 consists of information in support of these findings and recommendations. Appendices A, B, C, and D, respectively, cover the panel membership, the NASA response to the findings and recommendations in the March 1992 report, a chronology of the panel's activities during the reporting period, and the entire ACRV study report.

  1. Setting occupational exposure limits for sensory irritants: the approach in the European Union.

    PubMed

    Meldrum, M

    2001-01-01

    Beginning in 1990, the European Commission initiated a program to establish European Union (EU)-wide occupational exposure limits (OELs). As in the United States and other countries, a panel of experts known as the Scientific Committee on Occupational Exposure Limits (SCOEL) was identified and brought together to identify the proper values. This article describes the approach used by SCOEL to identify appropriate values for sensory irritants. The EU panel believes that irritant effects in the eyes and respiratory tract can produce symptoms that range from trivial to serious, and that responses to irritants may be viewed as belonging to a continuum. One of the interesting differences between the approach used by the ACGIH TLV committee and the SCOEL is the use of five grades of irritation to evaluate this class of chemicals. For purposes of setting an OEL, the SCOEL makes no distinction between irritation or nuisance and related somatic effects such as headache. How the committee established an OEL for ethyl acetate is offered as an illustrative example.

  2. Make Your Own Solar Panel.

    ERIC Educational Resources Information Center

    Suzuki, David

    1992-01-01

    Presents an activity in which students make a simulated solar panel to learn about the principles behind energy production using solar panels. Provides information about how solar panels function to produce energy. (MCO)

  3. Expert Recommended Strategies for Classroom Management for Beginning Teachers Placed in Hard-to-Staff Schools in Urban School Districts

    ERIC Educational Resources Information Center

    Alexis, Chelly C.

    2014-01-01

    Purpose: The purpose of this study was to get the opinion of a panel of experts as to which classroom management strategies should be implemented in urban school district mentoring programs to help beginning teachers who are placed in hard-to-staff schools in Los Angeles County, California. Methodology: This Delphi study included 20 expert mentors…

  4. The SIGNAL expert system

    SciTech Connect

    Struve, R.

    1996-12-31

    The SIGNAL insurance companies have developed an expert system for the support of its customer sales service. It was introduced at the end of 1993 and is currently used by approximately 500 customer service representatives. It involves a counseling system, which enables customer sales personnel to produce high-quality benefit analyses at the point of sale. It is not only an information system for the agent but involves the customer in an active role (through the implementation of sales talks, the conscious visualization of facts, the generation of natural language explanations etc.). Thus, the customer is not faced with a fait accompli but is actively involved in solving the problem. To meet these requirements, several Al techniques are used, as described further below. The application has increased sales efficiency, optimized customer contact time and decreased training requirements. The system is developed with KEE (and reimplemented in Allegro CL/PC) and runs on notebooks with 8 MB RAM.

  5. Flutter Research on Skin Panels

    NASA Technical Reports Server (NTRS)

    Kordes, Eldon E.; Tuovila, Weimer J.; Guy, Lawrence D.

    1960-01-01

    Representative experimental results are presented to show the current status of the panel flutter problem. Results are presented for unstiffened rectangular panels and for rectangular panels stiffened by corrugated backing. Flutter boundaries are established for all types of panels when considered on the basis of equivalent isotropic plates. The effects of Mach number, differential pressure, and aerodynamic heating on panel flutter are discussed. A flutter analysis of orthotropic panels is presented in the appendix.

  6. Expert Systems for the Analytical Laboratory.

    ERIC Educational Resources Information Center

    de Monchy, Allan R.; And Others

    1988-01-01

    Discusses two computer problem solving programs: rule-based expert systems and decision analysis expert systems. Explores the application of expert systems to automated chemical analyses. Presents six factors to consider before using expert systems. (MVL)

  7. Expert Systems as Tools for Technical Communicators.

    ERIC Educational Resources Information Center

    Grider, Daryl A.

    1994-01-01

    Discusses expertise, what an expert system is, what an expert system shell is, what expert systems can and cannot do, knowledge engineering and technical communicators, and planning and managing expert system projects. (SR)

  8. POPOVER Review Panel report

    SciTech Connect

    Davito, A.; Baker, C.J.; King, C.J.; Costerus, B.; Nelson, T.; Prokosch, D.; Pastrnak, J.; Grace, P.

    1996-04-10

    The POPOVER series of high explosive (HE) certification tests was conducted at the Big Explosives Experimental Facility (BEEF) in Area 4 of the Nevada Test Site (NTS). The two primary objectives of POPOVER were to certify that: (1) BEEF meets DOE requirements for explosives facilities and is safe for personnel-occupied operations during testing of large charges of conventional HE. (2) Facility structures and equipment will function as intended when subjected to the effects of these charges. After careful analysis of test results, the POPOVER Review Panel concludes that the POPOVER series met both objectives. Further details on the Review Panel`s conclusions are included in Section 7--Findings and Recommendations.

  9. Deploying expert systems in Ada

    NASA Technical Reports Server (NTRS)

    Lee, S. Daniel; Allen, Bradley P.

    1989-01-01

    As the Department of Defense Ada mandate begins to be enforced actively, interest in deploying expert systems in Ada has increased. A prototype Ada based expert system tool is introduced called ART/Ada. This prototype was built to support research into the language and operational issues of expert systems in Ada. ART/Ada allows applications of a conventional expert system tool called ART-IM (Automated Reasoning Tool for Information Management) to be deployed in various Ada environments with efficient use of time and space. ART-IM, a C-based expert system tool, is used to generate Ada source code which is compiled and linked with an Ada base inference engine to produce an Ada executable image. ART/Ada will be used to implement several prototype expert systems for the Space Station Freedom Program testbeds.

  10. Expert systems in seismic exploration

    SciTech Connect

    Denham, L.R.

    1985-02-01

    Artificial intelligence research has produced few practical results in most of its branches. However, expert systems in limited fields of expertise are potentially practical and cost-effective tools in many fields of exploration geophysics. Recent breakthroughs, such as writing expert systems in languages less exotic than Lisp, have made it possible to install a practical expert system on even the smallest computer. A recently published expert system written in Forth compiles a rule base into very compact code, and then uses it to reach decisions based on data supplied by the user. Such a system makes it possible for a small computer to be the geophysicist's advisor on many different subjects, because one expert system can use any number of rule bases. The expert system then becomes a practical tool for standardizing the decision-making process, even in comparatively trivial areas.

  11. ESG - EXPERT SCRIPT GENERATOR

    NASA Technical Reports Server (NTRS)

    Cooper, E. G.

    1994-01-01

    The Automation Technology Branch of NASA's Langley Research Center is employing increasingly complex degrees of operator/robot cooperation (telerobotics). A good relationship between the operator and computer is essential for smooth performance by a telerobotic system. ESG (Expert Script Generator) is a software package that automatically generates high-level task objective commands from the NASA Intelligent Systems Research Lab's (ISRL's) complex menu-driven language. ESG reduces errors and makes the telerobotics lab accessible to researchers who are not familiar with the comprehensive language developed by ISRL for interacting with the various systems of the ISRL testbed. ESG incorporates expert system technology to capture the typical rules of operation that a skilled operator would use. The result is an operator interface which optimizes the system's capability to perform a task remotely in a hazardous environment, in a timely manner, and without undue stress to the operator, while minimizing the chance for operator errors that may damage equipment. The intricate menu-driven command interface which provides for various control modes of both manipulators and their associated sensors in the TeleRobotic System Simulation (TRSS) has a syntax which is both irregular and verbose. ESG eliminates the following two problems with this command "language": 1) knowing the correct command sequence to accomplish a task, and 2) inputting a known command sequence without typos and other errors. ESG serves as an additional layer of interface, working in conjunction with the menu command processor, not supplanting it. By specifying task-level commands, such as GRASP, CONNECT, etc., ESG will generate the appropriate menu elements to accomplish the task. These elements will be collected in a script file which can then be executed by the ISRL menu command processor. In addition, the operator can extend the list of task-level commands to include customized tasks composed of sub

  12. Comprehensive metabolic panel

    MedlinePlus

    A comprehensive metabolic panel is a group of blood tests. They provide an overall picture of your body's chemical balance and metabolism. Metabolism refers to all the physical and chemical processes ...

  13. Blue Ribbon Panel Report

    Cancer.gov

    An NCI Cancer Currents blog by the NCI acting director thanking the cancer community for contributing to the Cancer Moonshot Blue Ribbon Panel report, which was presented to the National Cancer Advisory Board on September 7.

  14. Autoimmune liver disease panel

    MedlinePlus

    Liver disease test panel - autoimmune ... Autoimmune disorders are a possible cause of liver disease. The most common of these diseases are autoimmune hepatitis and primary biliary cirrhosis. This group of tests helps your health care provider ...

  15. Comprehensive Metabolic Panel

    MedlinePlus

    ... page helpful? Also known as: CMP; Chem 12; Chemistry Panel; Chemistry Screen; SMA 12; SMA 20; SMAC (somewhat outdated ... Health Professionals ©2001 - by American Association for Clinical Chemistry • Contact Us | Terms of Use | Privacy We comply ...

  16. BMP (Basic Metabolic Panel)

    MedlinePlus

    ... Was this page helpful? Also known as: BMP; Chemistry Panel; Chemistry Screen; Chem 7; SMA 7; SMAC7 (somewhat outdated ... Health Professionals ©2001 - by American Association for Clinical Chemistry • Contact Us | Terms of Use | Privacy We comply ...

  17. System Experts and Decision Making Experts in Transdisciplinary Projects

    ERIC Educational Resources Information Center

    Mieg, Harald A.

    2006-01-01

    Purpose: This paper aims at a better understanding of expert roles in transdisciplinary projects. Thus, the main purpose is the analysis of the roles of experts in transdisciplinary projects. Design/methodology/approach: The analysis of the ETH-UNS case studies from the point of view of the psychology of expertise and the sociology of professions…

  18. Online-Expert: An Expert System for Online Database Selection.

    ERIC Educational Resources Information Center

    Zahir, Sajjad; Chang, Chew Lik

    1992-01-01

    Describes the design and development of a prototype expert system called ONLINE-EXPERT that helps users select online databases and vendors that meet users' needs. Search strategies are discussed; knowledge acquisition and knowledge bases are described; and the Analytic Hierarchy Process (AHP), a decision analysis technique that ranks databases,…

  19. IncobotulinumtoxinA in aesthetics: Russian multidisciplinary expert consensus recommendations

    PubMed Central

    Yutskovskaya, Yana; Gubanova, Elena; Khrustaleva, Irina; Atamanov, Vasiliy; Saybel, Anastasiya; Parsagashvili, Elena; Dmitrieva, Irina; Sanchez, Elena; Lapatina, Natalia; Korolkova, Tatiana; Saromytskaya, Alena; Goltsova, Elena; Satardinova, Elmira

    2015-01-01

    Background Although there are various international consensus recommendations on the use of botulinum neurotoxin type A (BoNT/A) in facial aesthetics, there are no global or Russian guidelines on the optimal dose of incobotulinumtoxinA, free from complexing proteins, within specific aesthetic indications. This article reports the outcomes of two expert consensus meetings, conducted to review and analyze efficacy and tolerability data for incobotulinumtoxinA in various facial aesthetic indications and to give expert consensus recommendations to ensure best clinical practice among Russian clinicians. Methods Thirteen dermatology and/or plastic surgery experts attended meetings held in Paris, France (November 2013), and Moscow, Russia (March 2014). The expert group reviewed and analyzed the existing evidence, consensus recommendations, and Russian experts’ extensive practical experience of incobotulinumtoxinA in aesthetics to reach consensus on optimal doses, potential dose adjustments, and injection sites of incobotulinumtoxinA for facial aesthetics. Results All experts developed guidance on the optimal doses for incobotulinumtoxinA treatment of different regions of the upper and lower face. The expert panel agreed that there are no differences in the efficacy and duration of the effect between the four BoNT/As that are commercially available for facial aesthetic indications in Russia and that, when administered correctly, all BoNT/As can achieve optimal results. Experts also agreed that nonresponse to BoNT/A can be caused by neutralizing antibodies. Conclusion On the basis of the scientific and clinical evidence available for incobotulinumtoxinA, coupled with the extensive clinical experience of the consensus group, experts recommended the optimal doses of incobotulinumtoxinA effective for treatment of wrinkles of the upper and lower face to achieve the expected aesthetic outcome. These first Russian guidelines on the optimal use of incobotulinumtoxinA for

  20. Pop-Art Panels

    ERIC Educational Resources Information Center

    Alford, Joanna

    2012-01-01

    James Rosenquist's giant Pop-art panels included realistic renderings of well-known contemporary foods and objects, juxtaposed with famous people in the news--largely from the 1960s, '70s and '80s--and really serve as visual time capsules. In this article, eighth-graders focus on the style of James Rosenquist to create their own Pop-art panel that…

  1. Photovoltaic panel support assembly

    SciTech Connect

    Barker, J.M.; Underwood, J.C.; Shingleton, J.

    1993-07-20

    A solar energy electrical power source is described comprising in combination at least two flat photovoltaic panels disposed side-by-side in co-planar relation with one another, a pivot shaft extending transversely across the panels, at least two supports spaced apart lengthwise of the pivot shaft, means for connecting the pivot shaft to the at least two supports, attachment means for connecting the at least two panels to the pivot shaft so that the panels can pivot about the longitudinal axis of the shaft, coupling means mechanically coupling all of the panels together so as to form a unified flat array, and selectively operable drive means for mechanically pivoting the unified flat array about the axis; wherein each of the flat photovoltaic panels comprises at least two modules each comprising a plurality of electrically interconnected photovoltaic cells, the at least two modules being aligned along a line extending at a right angle to the pivot shaft, and the coupling means comprises (a) an elongate member extending parallel to and spaced from the pivot shaft and (b) means for attaching the elongate member to the panels; and further wherein each flat photovoltaic panel comprises a unitary frame consisting of a pair of end frame members extending parallel to the pivot shaft, a pair of side frame members extending between and connected to the end frame members, and a pair of spaced apart cross frame members, with one of the two modules being embraced by and secured to the side frame members and a first one of each of the end and cross frame members, and the other of the two modules being embraced by and secured to the side frame members and the second one of each of the end and cross frame members, whereby the gap created by the spaced apart cross frame members allow air to pass between them in order to reduce the sail effect when the solar array is subjected to buffeting winds.

  2. Gas filled panel insulation

    DOEpatents

    Griffith, Brent T.; Arasteh, Dariush K.; Selkowitz, Stephen E.

    1993-01-01

    A structural or flexible highly insulative panel which may be translucent, is formed from multi-layer polymeric material in the form of an envelope surrounding a baffle. The baffle is designed so as to minimize heat transfer across the panel, by using material which forms substantially closed spaces to suppress convection of the low conductivity gas fill. At least a portion of the baffle carries a low emissivity surface for suppression of infrared radiation.

  3. Gas filled panel insulation

    DOEpatents

    Griffith, B.T.; Arasteh, D.K.; Selkowitz, S.E.

    1993-12-14

    A structural or flexible highly insulative panel which may be translucent, is formed from multi-layer polymeric material in the form of an envelope surrounding a baffle. The baffle is designed so as to minimize heat transfer across the panel, by using material which forms substantially closed spaces to suppress convection of the low conductivity gas fill. At least a portion of the baffle carries a low emissivity surface for suppression of infrared radiation. 18 figures.

  4. Hexagon solar power panel

    DOEpatents

    Rubin, Irwin

    1978-01-01

    A solar energy panel comprises a support upon which silicon cells are arrayed. The cells are wafer thin and of two geometrical types, both of the same area and electrical rating, namely hexagon cells and hourglass cells. The hourglass cells are composites of half hexagons. A near perfect nesting relationship of the cells achieves a high density packing whereby optimum energy production per panel area is achieved.

  5. Integrated thermal treatment systems study. Internal review panel report

    SciTech Connect

    Cudahy, J.; Escarda, T.; Gimpel, R.

    1995-04-01

    The U.S. Department of Energy (DOE) Office of Technology Development (OTD) commissioned two studies to evaluate nineteen thermal treatment technologies for treatment of DOE mixed low-level waste. These studies were called the Integrated Thermal Treatment System (ITTS) Phase I and Phase II. With the help of the DOE Office of Environmental Management (EM) Mixed Waste Focus Group, OTD formed an ITTS Internal Review Panel to review and comment on the ITTS studies. This Panel was composed of scientists and engineers from throughout the DOE complex, the U.S. Environmental Protection Agency, the California EPA, and private experts. The Panel met from November 15-18, 1994 to review the ITTS studies and to make recommendations on the most promising thermal treatment systems for DOE mixed low-level wastes and on research and development necessary to prove the performance of the technologies. This report describes the findings and presents the recommendations of the Panel.

  6. US Cystic Fibrosis Foundation and European Cystic Fibrosis Society consensus recommendations for the management of non-tuberculous mycobacteria in individuals with cystic fibrosis: executive summary

    PubMed Central

    Olivier, Kenneth N; Saiman, Lisa; Daley, Charles L; Herrmann, Jean-Louis; Nick, Jerry A; Noone, Peadar G; Bilton, Diana; Corris, Paul; Gibson, Ronald L; Hempstead, Sarah E; Koetz, Karsten; Sabadosa, Kathryn A; Sermet-Gaudelus, Isabelle; Smyth, Alan R; van Ingen, Jakko; Wallace, Richard J; Winthrop, Kevin L; Marshall, Bruce C; Haworth, Charles S

    2016-01-01

    Non-tuberculous mycobacteria (NTM) are ubiquitous environmental organisms that can cause chronic pulmonary infection, particularly in individuals with pre-existing inflammatory lung disease, such as cystic fibrosis (CF). Pulmonary disease (PD) caused by NTM has emerged as a major threat to the health of individuals with CF, but remains difficult to diagnose and problematic to treat. In response to this challenge, the US Cystic Fibrosis Foundation (CFF) and the European Cystic Fibrosis Society (ECFS) convened a panel of 19 experts to develop consensus recommendations for the screening, investigation, diagnosis and management of NTM-PD in individuals with CF. PICO (population, intervention, comparison, outcome) methodology and systematic literature reviews were employed to inform draft recommendations, which were then modified to achieve consensus and subsequently circulated for public consultation within the USA and European CF communities. We have thus generated a series of pragmatic, evidence-based recommendations as an initial step in optimising management for this challenging condition. PMID:26678435

  7. US Cystic Fibrosis Foundation and European Cystic Fibrosis Society consensus recommendations for the management of non-tuberculous mycobacteria in individuals with cystic fibrosis: executive summary.

    PubMed

    Floto, R Andres; Olivier, Kenneth N; Saiman, Lisa; Daley, Charles L; Herrmann, Jean-Louis; Nick, Jerry A; Noone, Peadar G; Bilton, Diana; Corris, Paul; Gibson, Ronald L; Hempstead, Sarah E; Koetz, Karsten; Sabadosa, Kathryn A; Sermet-Gaudelus, Isabelle; Smyth, Alan R; van Ingen, Jakko; Wallace, Richard J; Winthrop, Kevin L; Marshall, Bruce C; Haworth, Charles S

    2016-01-01

    Non-tuberculous mycobacteria (NTM) are ubiquitous environmental organisms that can cause chronic pulmonary infection, particularly in individuals with pre-existing inflammatory lung disease, such as cystic fibrosis (CF). Pulmonary disease (PD) caused by NTM has emerged as a major threat to the health of individuals with CF, but remains difficult to diagnose and problematic to treat. In response to this challenge, the US Cystic Fibrosis Foundation (CFF) and the European Cystic Fibrosis Society (ECFS) convened a panel of 19 experts to develop consensus recommendations for the screening, investigation, diagnosis and management of NTM-PD in individuals with CF. PICO (population, intervention, comparison, outcome) methodology and systematic literature reviews were employed to inform draft recommendations, which were then modified to achieve consensus and subsequently circulated for public consultation within the USA and European CF communities. We have thus generated a series of pragmatic, evidence-based recommendations as an initial step in optimising management for this challenging condition.

  8. A genomewide admixture mapping panel for Hispanic/Latino populations.

    PubMed

    Mao, Xianyun; Bigham, Abigail W; Mei, Rui; Gutierrez, Gerardo; Weiss, Ken M; Brutsaert, Tom D; Leon-Velarde, Fabiola; Moore, Lorna G; Vargas, Enrique; McKeigue, Paul M; Shriver, Mark D; Parra, Esteban J

    2007-06-01

    Admixture mapping (AM) is a promising method for the identification of genetic risk factors for complex traits and diseases showing prevalence differences among populations. Efficient application of this method requires the use of a genomewide panel of ancestry-informative markers (AIMs) to infer the population of origin of chromosomal regions in admixed individuals. Genomewide AM panels with markers showing high frequency differences between West African and European populations are already available for disease-gene discovery in African Americans. However, no such a map is yet available for Hispanic/Latino populations, which are the result of two-way admixture between Native American and European populations or of three-way admixture of Native American, European, and West African populations. Here, we report a genomewide AM panel with 2,120 AIMs showing high frequency differences between Native American and European populations. The average intermarker genetic distance is ~1.7 cM. The panel was identified by genotyping, with the Affymetrix GeneChip Human Mapping 500K array, a population sample with European ancestry, a Mesoamerican sample comprising Maya and Nahua from Mexico, and a South American sample comprising Aymara/Quechua from Bolivia and Quechua from Peru. The main criteria for marker selection were both high information content for Native American/European ancestry (measured as the standardized variance of the allele frequencies, also known as "f value") and small frequency differences between the Mesoamerican and South American samples. This genomewide AM panel will make it possible to apply AM approaches in many admixed populations throughout the Americas. PMID:17503334

  9. A Genomewide Admixture Mapping Panel for Hispanic/Latino Populations

    PubMed Central

    Mao, Xianyun ; Bigham, Abigail W. ; Mei, Rui ; Gutierrez, Gerardo ; Weiss, Ken M. ; Brutsaert, Tom D. ; Leon-Velarde, Fabiola ; Moore, Lorna G. ; Vargas, Enrique ; McKeigue, Paul M. ; Shriver, Mark D. ; Parra, Esteban J. 

    2007-01-01

    Admixture mapping (AM) is a promising method for the identification of genetic risk factors for complex traits and diseases showing prevalence differences among populations. Efficient application of this method requires the use of a genomewide panel of ancestry-informative markers (AIMs) to infer the population of origin of chromosomal regions in admixed individuals. Genomewide AM panels with markers showing high frequency differences between West African and European populations are already available for disease-gene discovery in African Americans. However, no such a map is yet available for Hispanic/Latino populations, which are the result of two-way admixture between Native American and European populations or of three-way admixture of Native American, European, and West African populations. Here, we report a genomewide AM panel with 2,120 AIMs showing high frequency differences between Native American and European populations. The average intermarker genetic distance is ∼1.7 cM. The panel was identified by genotyping, with the Affymetrix GeneChip Human Mapping 500K array, a population sample with European ancestry, a Mesoamerican sample comprising Maya and Nahua from Mexico, and a South American sample comprising Aymara/Quechua from Bolivia and Quechua from Peru. The main criteria for marker selection were both high information content for Native American/European ancestry (measured as the standardized variance of the allele frequencies, also known as “f value”) and small frequency differences between the Mesoamerican and South American samples. This genomewide AM panel will make it possible to apply AM approaches in many admixed populations throughout the Americas. PMID:17503334

  10. Expert consultation on risk factors for introduction of infectious pathogens into fish farms.

    PubMed

    Oidtmann, Birgit C; Peeler, Edmund J; Thrush, Mark A; Cameron, Angus R; Reese, R Allan; Pearce, Fiona M; Dunn, Peter; Lyngstad, Trude M; Tavornpanich, Saraya; Brun, Edgar; Stärk, Katharina D C

    2014-08-01

    An expert consultation was conducted to provide quantitative parameters required to inform risk-based surveillance of aquaculture holdings for selected infectious hazards. The hazards were four fish diseases endemic in some or several European countries: infectious salmon anaemia (ISA), viral haemorrhagic septicaemia (VHS), infectious haematopoietic necrosis (IHN), and koi herpes virus disease (KHD). Experts were asked to provide estimates for the relative importance of 5 risk themes for the hazard to be introduced into and infect susceptible fish at the destination. The 5 risk themes were: (1) live fish and egg movements; (2) exposure via water; (3) on-site processing; (4) short distance mechanical transmission and (5) distance independent mechanical transmission. The experts also provided parameter estimates for hazard transmission pathways within the themes. The expert consultation was undertaken in a 2 step approach: an online survey followed by an expert consultation meeting. The expert opinion indicated that live fish movements and exposure via water were the major relevant risk themes. Experts were recruited from several European countries and thus covered a range of farming systems. Therefore, the outputs from the expert consultation have relevance for the European context.

  11. Aerospace Safety Advisory Panel

    NASA Technical Reports Server (NTRS)

    1998-01-01

    During 1997, the Aerospace Safety Advisory Panel (ASAP) continued its safety reviews of NASA's human space flight and aeronautics programs. Efforts were focused on those areas that the Panel believed held the greatest potential to impact safety. Continuing safe Space Shuttle operations and progress in the manufacture and testing of primary components for the International Space Station (ISS) were noteworthy. The Panel has continued to monitor the safety implications of the transition of Space Shuttle operations to the United Space Alliance (USA). One area being watched closely relates to the staffing levels and skill mix in both NASA and USA. Therefore, a section of this report is devoted to personnel and other related issues that are a result of this change in NASA's way of doing business for the Space Shuttle. Attention will continue to be paid to this important topic in subsequent reports. Even though the Panel's activities for 1997 were extensive, fewer specific recommendations were formulated than has been the case in recent years. This is indicative of the current generally good state of safety of NASA programs. The Panel does, however, have several longer term concerns that have yet to develop to the level of a specific recommendation. These are covered in the introductory material for each topic area in Section 11. In another departure from past submissions, this report does not contain individual findings and recommendations for the aeronautics programs. While the Panel devoted its usual efforts to examining NASA's aeronautic centers and programs, no specific recommendations were identified for inclusion in this report. In lieu of recommendations, a summary of the Panel's observations of NASA's safety efforts in aeronautics and future Panel areas of emphasis is provided. With profound sadness the Panel notes the passing of our Chairman, Paul M. Johnstone, on December 17, 1997, and our Staff Assistant, Ms. Patricia M. Harman, on October 5, 1997. Other

  12. Estimating Burden and Disease Costs of Exposure to Endocrine-Disrupting Chemicals in the European Union

    PubMed Central

    Zoeller, R. Thomas; Hass, Ulla; Kortenkamp, Andreas; Grandjean, Philippe; Myers, John Peterson; DiGangi, Joseph; Bellanger, Martine; Hauser, Russ; Legler, Juliette; Skakkebaek, Niels E.; Heindel, Jerrold J.

    2015-01-01

    Context: Rapidly increasing evidence has documented that endocrine-disrupting chemicals (EDCs) contribute substantially to disease and disability. Objective: The objective was to quantify a range of health and economic costs that can be reasonably attributed to EDC exposures in the European Union (EU). Design: A Steering Committee of scientists adapted the Intergovernmental Panel on Climate Change weight-of-evidence characterization for probability of causation based upon levels of available epidemiological and toxicological evidence for one or more chemicals contributing to disease by an endocrine disruptor mechanism. To evaluate the epidemiological evidence, the Steering Committee adapted the World Health Organization Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group criteria, whereas the Steering Committee adapted definitions recently promulgated by the Danish Environmental Protection Agency for evaluating laboratory and animal evidence of endocrine disruption. Expert panels used the Delphi method to make decisions on the strength of the data. Results: Expert panels achieved consensus at least for probable (>20%) EDC causation for IQ loss and associated intellectual disability, autism, attention-deficit hyperactivity disorder, childhood obesity, adult obesity, adult diabetes, cryptorchidism, male infertility, and mortality associated with reduced testosterone. Accounting for probability of causation and using the midpoint of each range for probability of causation, Monte Carlo simulations produced a median cost of €157 billion (or $209 billion, corresponding to 1.23% of EU gross domestic product) annually across 1000 simulations. Notably, using the lowest end of the probability range for each relationship in the Monte Carlo simulations produced a median range of €109 billion that differed modestly from base case probability inputs. Conclusions: EDC exposures in the EU are likely to contribute substantially to disease and

  13. Expert Systems: Instructional Design Potential.

    ERIC Educational Resources Information Center

    Pollock, Joellyn; Grabinger, R. Scott

    1989-01-01

    Description of the components of expert systems highlights their potential uses in the field of instructional design. Uses of expert systems are described for determining the cost-effectiveness of instructional media; as instructional management aids; as job aids; in helping to diagnose student problems; and as student feedback/evaluation systems.…

  14. Expert Systems in Reference Services.

    ERIC Educational Resources Information Center

    Roysdon, Christine, Ed.; White, Howard D., Ed.

    1989-01-01

    Eleven articles introduce expert systems applications in library and information science, and present design and implementation issues of system development for reference services. Topics covered include knowledge based systems, prototype development, the use of artificial intelligence to remedy current system inadequacies, and an expert system to…

  15. Expert Systems and Special Education.

    ERIC Educational Resources Information Center

    Hofmeister, Alan M.; Ferrara, Joseph M.

    The application of artificial intelligence to the problems of education is examined. One of the most promising areas in artificial intelligence is expert systems technology which engages the user in a problem-solving diaglogue. Some of the characteristics that make expert systems "intelligent" are identified and exemplified. The rise of expert…

  16. Energy Policy: Ask the Experts.

    ERIC Educational Resources Information Center

    Nuclear Industry, 1991

    1991-01-01

    Twelve U.S. experts on energy policies individually offer perspectives about which priorities should be enlisted with respect to the current energy policy of the United States. In their analyses, these experts unanimously agree that the biggest U.S. problem is an increasing dependence upon imported oil. (JJK)

  17. Expert Systems and Document Handling.

    ERIC Educational Resources Information Center

    Edmonds, Ernest

    1987-01-01

    Describes significant attributes of expert systems, contrasts them to conventional computer systems, and provides an overview of the R1 expert system used by Digital Equipment Corporation (DEC) to put together operational systems that meet customers' requirements. Document handling, particularly pictures and images in documents, is also briefly…

  18. Threat expert system technology advisor

    NASA Technical Reports Server (NTRS)

    Kurrasch, E. R.; Tripp, L. R.

    1987-01-01

    A prototype expert system was developed to determine the feasibility of using expert system technology to enhance the performance and survivability of helicopter pilots in a combat threat environment while flying NOE (Nap of the Earth) missions. The basis for the concept is the potential of using an Expert System Advisor to reduce the extreme overloading of the pilot who flies NOE mission below treetop level at approximately 40 knots while performing several other functions. The ultimate goal is to develop a Threat Expert System Advisor which provides threat information and advice that are better than even a highly experienced copilot. The results clearly show that the NOE pilot needs all the help in decision aiding and threat situation awareness that he can get. It clearly shows that heuristics are important and that an expert system for combat NOE helicopter missions can be of great help to the pilot in complex threat situations and in making decisions.

  19. Cognitive resources of physics experts

    NASA Astrophysics Data System (ADS)

    Jones, Darrick C.

    One important goal of physics education is to help students develop reasoning patterns similar to those of expert physicists. To achieve this goal, physics educators must know what makes physics experts so successful at solving challenging physics problems. However, this dimension of physics expertise has not been fully explored by the physics education research (PER) community. In this dissertation, I describe several studies I have conducted that further the PER community's understanding of physics expertise. In these studies, I investigate how expert physicists reason as they solve unfamiliar, challenging physics problems by using a resource-based model of cognition to analyze videotaped recordings of problem solving sessions. By developing a way to determine when experts are making conceptual breakthroughs I analyze what resources experts use during conceptual breakthroughs. In the first study, I show that physics conceptual breakthroughs are characterized by reasoning which combines resources related to intuitive knowledge, higher level physics based conceptual knowledge, and epistemological knowledge. In the second study, I develop a way to reliably code for epistemological resources and determine what epistemological resources experts rely on most during conceptual breakthroughs. My findings show that experts rely on contrasting cases more often than any other epistemological resource. In the third study, I use variation theory to investigate how experts use contrasting cases. I look for patterns across all instances when experts use contrasting cases to make a conceptual breakthrough and show how scientific epistemology can be used to better understand experts' use of contrasting cases. I discuss how the findings of each study can be used to inform physics education.

  20. 90. TILES OF THE NEW WORLD PANEL, NORTH WALL OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    90. TILES OF THE NEW WORLD PANEL, NORTH WALL OF THE INDIAN HOUSE. THE RELIEF BROCADE TILES ILLUSTRATE SCENES OF NATIVE AMERICAN HISTORY AND CULTURE, AND THE EARLY EUROPEAN EXPLORATION OF THE NEW WORLD. SAME VIEW AS PA-107-21. - Moravian Pottery & Tile Works, Southwest side of State Route 313 (Swamp Road), Northwest of East Court Street, Doylestown, Bucks County, PA

  1. 21. TILES OF THE NEW WORLD PANEL, NORTH WALL OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    21. TILES OF THE NEW WORLD PANEL, NORTH WALL OF THE INDIAN HOUSE. THE RELIEF BROCADE TILES ILLUSTRATE SCENES OF NATIVE AMERICAN HISTORY AND CULTURE, AND THE EARLY EUROPEAN EXPLORATION OF THE NEW WORLD. - Moravian Pottery & Tile Works, Southwest side of State Route 313 (Swamp Road), Northwest of East Court Street, Doylestown, Bucks County, PA

  2. Optimization of aircraft interior panels

    NASA Technical Reports Server (NTRS)

    Kourtides, Demetrius A.; Roper, Willard D.

    1986-01-01

    Eight different graphite composite panels were fabricated using four different resin matrices. The resin matrices included Hercules 71775, a blend of vinylpolystyrpyridine and bismaleimide, H795, a bismaleimide, Cycom 6162, a phenolic, and PSP 6022M, a polystyrylpyridine. Graphite panels were fabricated using fabric or unidirectional tape. This report describes the processes for preparing these panels and some of their mechanical, thermal and flammability properties. Panel properties are compared with state-of-the-art epoxy fiberglass composite panels.

  3. Panel methods: An introduction

    NASA Technical Reports Server (NTRS)

    Erickson, Larry L.

    1990-01-01

    Panel methods are numerical schemes for solving (the Prandtl-Glauert equation) for linear, inviscid, irrotational flow about aircraft flying at subsonic or supersonic speeds. The tools at the panel-method user's disposal are (1) surface panels of source-doublet-vorticity distributions that can represent nearly arbitrary geometry, and (2) extremely versatile boundary condition capabilities that can frequently be used for creative modeling. Panel-method capabilities and limitations, basic concepts common to all panel-method codes, different choices that were made in the implementation of these concepts into working computer programs, and various modeling techniques involving boundary conditions, jump properties, and trailing wakes are discussed. An approach for extending the method to nonlinear transonic flow is also presented. Three appendices supplement the main test. In appendix 1, additional detail is provided on how the basic concepts are implemented into a specific computer program (PANAIR). In appendix 2, it is shown how to evaluate analytically the fundamental surface integral that arises in the expressions for influence-coefficients, and evaluate its jump property. In appendix 3, a simple example is used to illustrate the so-called finite part of the improper integrals.

  4. Aerospace safety advisory panel

    NASA Technical Reports Server (NTRS)

    1995-01-01

    The Aerospace Safety Advisory Panel (ASAP) monitored NASA's activities and provided feedback to the NASA Administrator, other NASA officials and Congress throughout the year. Particular attention was paid to the Space Shuttle, its launch processing and planned and potential safety improvements. The Panel monitored Space Shuttle processing at the Kennedy Space Center (KSC) and will continue to follow it as personnel reductions are implemented. There is particular concern that upgrades in hardware, software, and operations with the potential for significant risk reduction not be overlooked due to the extraordinary budget pressures facing the agency. The authorization of all of the Space Shuttle Main Engine (SSME) Block II components portends future Space Shuttle operations at lower risk levels and with greater margins for handling unplanned ascent events. Throughout the year, the Panel attempted to monitor the safety activities related to the Russian involvement in both space and aeronautics programs. This proved difficult as the working relationships between NASA and the Russians were still being defined as the year unfolded. NASA's concern for the unique safety problems inherent in a multi-national endeavor appears appropriate. Actions are underway or contemplated which should be capable of identifying and rectifying problem areas. The balance of this report presents 'Findings and Recommendations' (Section 2), 'Information in Support of Findings and Recommendations' (Section 3) and Appendices describing Panel membership, the NASA response to the March 1994 ASAP report, and a chronology of the panel's activities during the reporting period (Section 4).

  5. Consumer preferences for fresh tomato at the European scale: a common segmentation on taste and firmness.

    PubMed

    Causse, Mathilde; Friguet, Chloé; Coiret, Clément; Lépicier, Mélanie; Navez, Brigitte; Lee, Monica; Holthuysen, Nancy; Sinesio, Fiorella; Moneta, Elisabetta; Grandillo, Silvana

    2010-01-01

    Although tomato flavor has not been a major goal for breeders, nowadays it becomes important as it is a subject of consumer complaint. A better knowledge of tomato consumer preferences, at the European level, should provide the basis for improvement of fruit quality and for market segmentation. In the framework of a large European project, 806 consumers from 3 countries, The Netherlands, France, and Italy, were presented with a set of 16 varieties representing the diversity of fresh tomato offer in order to evaluate their preferences. In parallel, sensory profiles were constructed by expert panels in each country. Preference maps were then constructed in each country revealing the structure of consumer preferences and allowing identification of the most important characteristics. Then a global analysis revealed that preferences were quite homogeneous across countries. This study identified the overall flavor and firmness as the most important traits for improving tomato fruit quality. It showed that consumer preferences from different European countries, with different cultures and food practices, are segmented following similar patterns when projected onto a common referential plan. Moreover, the results clearly showed that diversification of taste and texture is required to satisfy all consumers' expectations as some consumers preferred firm tomatoes, while others preferred melting ones and were more or less demanding in terms of sweetness and flavor intensity. Detailed comparisons also showed the importance of the fruit appearance in consumer preference. PMID:21535628

  6. Consumer preferences for fresh tomato at the European scale: a common segmentation on taste and firmness.

    PubMed

    Causse, Mathilde; Friguet, Chloé; Coiret, Clément; Lépicier, Mélanie; Navez, Brigitte; Lee, Monica; Holthuysen, Nancy; Sinesio, Fiorella; Moneta, Elisabetta; Grandillo, Silvana

    2010-01-01

    Although tomato flavor has not been a major goal for breeders, nowadays it becomes important as it is a subject of consumer complaint. A better knowledge of tomato consumer preferences, at the European level, should provide the basis for improvement of fruit quality and for market segmentation. In the framework of a large European project, 806 consumers from 3 countries, The Netherlands, France, and Italy, were presented with a set of 16 varieties representing the diversity of fresh tomato offer in order to evaluate their preferences. In parallel, sensory profiles were constructed by expert panels in each country. Preference maps were then constructed in each country revealing the structure of consumer preferences and allowing identification of the most important characteristics. Then a global analysis revealed that preferences were quite homogeneous across countries. This study identified the overall flavor and firmness as the most important traits for improving tomato fruit quality. It showed that consumer preferences from different European countries, with different cultures and food practices, are segmented following similar patterns when projected onto a common referential plan. Moreover, the results clearly showed that diversification of taste and texture is required to satisfy all consumers' expectations as some consumers preferred firm tomatoes, while others preferred melting ones and were more or less demanding in terms of sweetness and flavor intensity. Detailed comparisons also showed the importance of the fruit appearance in consumer preference.

  7. Surveillance of Disparities in Vision and Eye Health in the United States: An Expert Panel’s Opinions

    PubMed Central

    Lee, Paul P.; West, Sheila K.; Block, Sandra S.; Clayton, Janine; Cotch, Mary Frances; Flynn, Colin; Geiss, Linda S.; Klein, Ronald; Olsen, Timothy W.; Owsley, Cynthia; Primo, Susan A.; Rubin, Gary S.; Ryskulova, Asel; Sharma, Sanjay; Friedman, David S.; Zhang, Xinzhi; Crews, John E.; Saaddine, Jinan B.

    2013-01-01

    PURPOSE To define surveillance approaches and metrics to capture the burden of vision health disparities and to identify properties of a surveillance system to guide public health interventions. DESIGN Expert panel. METHODS Analysis of relevant literature and deliberations of expert panel. RESULTS The panel identified that the purpose of vision surveillance was to link data to public health interventions. Panel members noted the importance of assessing vision through self-reported and performance-based measures. Defined populations should be included in a surveillance system to assess disparities in utilization of eye care and vision loss. The panel suggested that ophthalmic/vision measures should be sustained in national surveys and suggested that a vision surveillance system should be forged among federal agencies. CONCLUSIONS Employing the 6 outlined strategies would improve vision surveillance and help reach the vision-related objectives of Healthy People 2020. PMID:23158221

  8. Origami of thick panels

    NASA Astrophysics Data System (ADS)

    Chen, Yan; Peng, Rui; You, Zhong

    2015-07-01

    Origami patterns, including the rigid origami patterns in which flat inflexible sheets are joined by creases, are primarily created for zero-thickness sheets. In order to apply them to fold structures such as roofs, solar panels, and space mirrors, for which thickness cannot be disregarded, various methods have been suggested. However, they generally involve adding materials to or offsetting panels away from the idealized sheet without altering the kinematic model used to simulate folding. We develop a comprehensive kinematic synthesis for rigid origami of thick panels that differs from the existing kinematic model but is capable of reproducing motions identical to that of zero-thickness origami. The approach, proven to be effective for typical origami, can be readily applied to fold real engineering structures.

  9. Oven wall panel construction

    DOEpatents

    Ellison, Kenneth; Whike, Alan S.

    1980-04-22

    An oven roof or wall is formed from modular panels, each of which comprises an inner fabric and an outer fabric. Each such fabric is formed with an angle iron framework and somewhat resilient tie-bars or welded at their ends to flanges of the angle irons to maintain the inner and outer frameworks in spaced disposition while minimizing heat transfer by conduction and permitting some degree of relative movement on expansion and contraction of the module components. Suitable thermal insulation is provided within the module. Panels or skins are secured to the fabric frameworks and each such skin is secured to a framework and projects laterally so as slidingly to overlie the adjacent frame member of an adjacent panel in turn to permit relative movement during expansion and contraction.

  10. Advanced solar panel designs

    NASA Technical Reports Server (NTRS)

    Ralph, E. L.; Linder, E.

    1995-01-01

    This paper describes solar cell panel designs that utilize new hgih efficiency solar cells along with lightweight rigid panel technology. The resulting designs push the W/kg and W/sq m parameters to new high levels. These new designs are well suited to meet the demand for higher performance small satellites. This paper reports on progress made on two SBIR Phase 1 contracts. One panel design involved the use of large area (5.5 cm x 6.5 cm) GaAs/Ge solar cells of 19% efficiency combined with a lightweight rigid graphite fiber epoxy isogrid substrate configuration. A coupon (38 cm x 38 cm) was fabricated and tested which demonstrated an array specific power level of 60 W/kg with a potential of reaching 80 W/kg. The second panel design involved the use of newly developed high efficiency (22%) dual junction GaInP2/GaAs/Ge solar cells combined with an advanced lightweight rigid substrate using aluminum honeycomb core with high strength graphite fiber mesh facesheets. A coupon (38 cm x 38 cm) was fabricated and tested which demonstrated an array specific power of 105 W/kg and 230 W/sq m. This paper will address the construction details of the panels and an a analysis of the component weights. A strawman array design suitable for a typical small-sat mission is described for each of the two panel design technologies being studied. Benefits in respect to weight reduction, area reduction, and system cost reduction are analyzed and compared to conventional arrays.

  11. Expert systems for personnel assignment

    SciTech Connect

    Hardee, J.L.; Liepins, G.

    1986-01-01

    In order to reduce stress on assignment personnel (detailers) and ensure maximum fairness and consistency in the Navy's personnel assignment process, The Navy Military Personnel Command (NMPC) has begun to explore the potential use of expert systems to supplement current manual and computerized distribution methods. The Detailer's Assistant expert system is being developed to improve the detailers' ability to satisfy the needs of their constituents and Navy management. An initial prototype of the Detailer's Assistant is now being evaluated. Numerous upgrades and extensions should lead to an operational system in the near future. Further development to a production system will involve additional research in machine learning, intelligent database methods, and cooperating expert systems.

  12. Expert Witness: A system for developing expert medical testimony

    NASA Technical Reports Server (NTRS)

    Lewandowski, Raymond; Perkins, David; Leasure, David

    1994-01-01

    Expert Witness in an expert system designed to assist attorneys and medical experts in determining the merit of medical malpractice claims in the area of obstetrics. It substitutes the time of the medical expert with the time of a paralegal assistant guided by the expert system during the initial investigation of the medical records and patient interviews. The product of the system is a narrative transcript containing important data, immediate conclusions from the data, and overall conclusions of the case that the attorney and medical expert use to make decisions about whether and how to proceed with the case. The transcript may also contain directives for gathering additional information needed for the case. The system is a modified heuristic classifier and is implemented using over 600 CLIPS rules together with a C-based user interface. The data abstraction and solution refinement are implemented directly using forward chaining production and matching. The use of CLIPS and C is essential to delivering a system that runs on a generic PC platform. The direct implementation in CLIPS together with locality of inference ensures that the system will scale gracefully. Two years of use has revealed no errors in the reasoning.

  13. PRSEUS Acoustic Panel Fabrication

    NASA Technical Reports Server (NTRS)

    Nicolette, Velicki; Yovanof, Nicolette P.; Baraja, Jaime; Mathur, Gopal; Thrash, Patrick; Pickell, Robert

    2011-01-01

    This report describes the development of a novel structural concept, Pultruded Rod Stitched Efficient Unitized Structure (PRSEUS), that addresses the demanding fuselage loading requirements for the Hybrid Wing or Blended Wing Body (BWB) airplane configuration with regards to acoustic response. A PRSEUS panel was designed and fabricated and provided to NASA-LaRC for acoustic response testing in the Structural Acoustics Loads and Transmission (SALT) facility). Preliminary assessments of the sound transmission characteristics of a PRSEUS panel subjected to a representative Hybrid Wing Body (HWB) operating environment were completed for the NASA Environmentally Responsible Aviation (ERA) Program.

  14. Panel 3 - characterization

    SciTech Connect

    Erck, R.A.; Erdemir, A.; Janghsing Hsieh; Lee, R.H.; Xian Zheng Pan; Deming Shu; Feldman, A.; Glass, J.T.; Kleimer, R.; Lawton, E.A.

    1993-01-01

    The task of this panel was to identify and prioritize needs in the area of characterization of diamond and diamond-like-carbon (DLC) films for use in the transportation industry. Until recent advances in production of inexpensive films of diamonds and DLC, it was not feasible that these materials could be mass produced. The Characterization Panel is restricting itself to identifying needs in areas that would be most useful to manufacturers and users in producing and utilizing diamond and DLC coatings in industry. These characterization needs include in-situ monitoring during growth, relation of structure to performance, and standards and definitions.

  15. Wisconsin Twin Panel.

    PubMed

    Van Hulle, Carol A; Lemery, Kathryn S; Goldsmith, H Hill

    2002-10-01

    The Wisconsin Twin Panel was initiated in 1994 to serve a study of the development of childhood mood and behavioral disorders. Families who give birth to twins within the state of Wisconsin are recruited within 6 months of the birth. The panel currently supports three ongoing, longitudinal research projects. Research foci include studying epigenetic contributions to emotional, physical, cognitive, and motoric development of infant and toddler twins; physiological concomitants of childhood temperament; and early risk and resiliency factors related to child psychopathology. All three studies include videotaped observational assessments and biological measures. PMID:12537886

  16. Using Expert System Job Aids: A Primer.

    ERIC Educational Resources Information Center

    Carr, Clay

    1989-01-01

    Explains how current commercial expert system technology can be used to create useful job aids. Expert systems are defined, situations in which an expert system job aid will be most effective are described, expert system shells are discussed, and three commercial expert system products are described. (LRW)

  17. Developing Literacy in Second-Language Learners: Report of the National Literacy Panel on Language-Minority Children and Youth

    ERIC Educational Resources Information Center

    August, Diane, Ed.; Shanahan, Timothy, Ed.

    2006-01-01

    This volume reports the findings of the National Literacy Panel on Language-Minority Children and Youth. The formal charge to the panel--a distinguished group of expert researchers in reading, language, bilingualism, research methods, and education--was to identify, assess, and synthesize research on the education of language-minority children and…

  18. Treatment for Addiction: Advancing the Common Good. Recommendations from a Join Together Policy Panel on Treatment and Recovery.

    ERIC Educational Resources Information Center

    Join Together, Boston, MA.

    Join Together convened a panel of experts to review U.S. policies for addiction treatment and recovery. Although the panel reached an agreement on six recommendations for policy changes that can make help more accessible and expand treatment to more people. These recommendations are: (1) treatment for alcoholism and other drug addiction must be…

  19. European Community.

    PubMed

    1987-05-01

    The European Community was established in 1951 to reconcile France and Germany after World War II and to make possible the eventual federation of Europe. By 1986, there were 12 member countries: France, Italy, Belgium, the Federal Republic of Germany, Luxembourg, the Netherlands, Denmark, Ireland, the United Kingdom, Greece, Spain, and Portugal. Principal areas of concern are internal and external trade, agriculture, monetary coordination, fisheries, common industrial and commercial policies, assistance, science and research, and common social and regional policies. The European Community has a budget of US$34.035 billion/year, funded by customs duties and 1.4% of each member's value-added tax. The treaties establishing the European Community call for members to form a common market, a common customs tariff, and common agricultural, transport, economic, and nuclear policies. Major European Community institutions include the Commission, Council of Ministers, European Parliament, Court of Justice, and Economic and Social Committee. The Community is the world's largest trading unit, accounting for 15% of world trade. The 2 main goals of the Community's industrial policy are to create an open internal market and to promote technological innovation in order to improve international competitiveness. The European Community aims to contribute to the economic and social development of Third World countries as well. PMID:12177941

  20. Expert systems in clinical microbiology.

    PubMed

    Winstanley, Trevor; Courvalin, Patrice

    2011-07-01

    This review aims to discuss expert systems in general and how they may be used in medicine as a whole and clinical microbiology in particular (with the aid of interpretive reading). It considers rule-based systems, pattern-based systems, and data mining and introduces neural nets. A variety of noncommercial systems is described, and the central role played by the EUCAST is stressed. The need for expert rules in the environment of reset EUCAST breakpoints is also questioned. Commercial automated systems with on-board expert systems are considered, with emphasis being placed on the "big three": Vitek 2, BD Phoenix, and MicroScan. By necessity and in places, the review becomes a general review of automated system performances for the detection of specific resistance mechanisms rather than focusing solely on expert systems. Published performance evaluations of each system are drawn together and commented on critically.

  1. Expert Systems in Clinical Microbiology

    PubMed Central

    Winstanley, Trevor; Courvalin, Patrice

    2011-01-01

    Summary: This review aims to discuss expert systems in general and how they may be used in medicine as a whole and clinical microbiology in particular (with the aid of interpretive reading). It considers rule-based systems, pattern-based systems, and data mining and introduces neural nets. A variety of noncommercial systems is described, and the central role played by the EUCAST is stressed. The need for expert rules in the environment of reset EUCAST breakpoints is also questioned. Commercial automated systems with on-board expert systems are considered, with emphasis being placed on the “big three”: Vitek 2, BD Phoenix, and MicroScan. By necessity and in places, the review becomes a general review of automated system performances for the detection of specific resistance mechanisms rather than focusing solely on expert systems. Published performance evaluations of each system are drawn together and commented on critically. PMID:21734247

  2. Expert opinion vs. empirical evidence

    PubMed Central

    Herman, Rod A; Raybould, Alan

    2014-01-01

    Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years spurred by examples where evidence indicated that certain treatments recommended by expert opinions increased death rates. We suggest that scientific evidence should also take priority over expert opinion in the regulation of genetically modified crops (GM). Examples of regulatory data requirements that are not justified based on the mass of evidence are described, and it is suggested that expertise in risk assessment should guide evidence-based regulation of GM crops. PMID:24637724

  3. The nutrition advisor expert system

    NASA Technical Reports Server (NTRS)

    Huse, Scott M.; Shyne, Scott S.

    1991-01-01

    The Nutrition Advisor Expert System (NAES) is an expert system written in the C Language Integrated Production System (CLIPS). NAES provides expert knowledge and guidance into the complex world of nutrition management by capturing the knowledge of an expert and placing it at the user's fingertips. Specifically, NAES enables the user to: (1) obtain precise nutrition information for food items; (2) perform nutritional analysis of meal(s), flagging deficiencies based upon the U.S. Recommended Daily Allowances; (3) predict possible ailments based upon observed nutritional deficiency trends; (4) obtain a top ten listing of food items for a given nutrient; and (5) conveniently upgrade the data base. An explanation facility for the ailment prediction feature is also provided to document the reasoning process.

  4. Expert consensus-building for developing guidelines: lessons learned from a dengue economics workshop.

    PubMed

    Constenla, Dagna; Lefcourt, Noah; Garcia, Cristina

    2013-09-01

    A workshop with 20 experts of diverse backgrounds from five countries in the Americas was convened for two-and-a-half days in March 2012 to discuss and develop a standardized methodology for assessing the economic cost of dengue. This article discusses a number of factors that contributed to the workshop's success, including: engaging the experts at various stages of the process; convening a multidisciplinary group to reduce expert bias and provide a more comprehensive and integrated approach; facilitating guided small- and large-group discussions; developing effective cross-cultural collectivism, trust, communication, and empathy across the expert panel; establishing clear lines of responsibilities within each group of experts; breaking down the complex issues into smaller and simpler ideas; providing ample background materials in multiple languages prior to the workshop. Challenges and areas for improvement are also covered.

  5. 42. Interior detail, parlor, paneled chimney breast. This paneling likely ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    42. Interior detail, parlor, paneled chimney breast. This paneling likely dates from the house's phase I construction spanning from 1728 into the 1730's. - John Bartram House & Garden, House, 54th Street & Lindbergh Boulevard, Philadelphia, Philadelphia County, PA

  6. 78. DETAIL OF COMMUNICATIONS PANEL ON LAUNCH ANALYST PANEL SHOWING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    78. DETAIL OF COMMUNICATIONS PANEL ON LAUNCH ANALYST PANEL SHOWING 20 CHANNEL-SELECTION SWITCHES, ROTARY DIAL, HEADSET, AND FOOT PEDAL - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  7. Stepped inlet optical panel

    DOEpatents

    Veligdan, James T.

    2001-01-01

    An optical panel includes stacked optical waveguides having stepped inlet facets collectively defining an inlet face for receiving image light, and having beveled outlet faces collectively defining a display screen for displaying the image light channeled through the waveguides by internal reflection.

  8. Parallel processing and expert systems

    NASA Technical Reports Server (NTRS)

    Lau, Sonie; Yan, Jerry C.

    1991-01-01

    Whether it be monitoring the thermal subsystem of Space Station Freedom, or controlling the navigation of the autonomous rover on Mars, NASA missions in the 1990s cannot enjoy an increased level of autonomy without the efficient implementation of expert systems. Merely increasing the computational speed of uniprocessors may not be able to guarantee that real-time demands are met for larger systems. Speedup via parallel processing must be pursued alongside the optimization of sequential implementations. Prototypes of parallel expert systems have been built at universities and industrial laboratories in the U.S. and Japan. The state-of-the-art research in progress related to parallel execution of expert systems is surveyed. The survey discusses multiprocessors for expert systems, parallel languages for symbolic computations, and mapping expert systems to multiprocessors. Results to date indicate that the parallelism achieved for these systems is small. The main reasons are (1) the body of knowledge applicable in any given situation and the amount of computation executed by each rule firing are small, (2) dividing the problem solving process into relatively independent partitions is difficult, and (3) implementation decisions that enable expert systems to be incrementally refined hamper compile-time optimization. In order to obtain greater speedups, data parallelism and application parallelism must be exploited.

  9. Parallel processing and expert systems

    NASA Technical Reports Server (NTRS)

    Yan, Jerry C.; Lau, Sonie

    1991-01-01

    Whether it be monitoring the thermal subsystem of Space Station Freedom, or controlling the navigation of the autonomous rover on Mars, NASA missions in the 90's cannot enjoy an increased level of autonomy without the efficient use of expert systems. Merely increasing the computational speed of uniprocessors may not be able to guarantee that real time demands are met for large expert systems. Speed-up via parallel processing must be pursued alongside the optimization of sequential implementations. Prototypes of parallel expert systems have been built at universities and industrial labs in the U.S. and Japan. The state-of-the-art research in progress related to parallel execution of expert systems was surveyed. The survey is divided into three major sections: (1) multiprocessors for parallel expert systems; (2) parallel languages for symbolic computations; and (3) measurements of parallelism of expert system. Results to date indicate that the parallelism achieved for these systems is small. In order to obtain greater speed-ups, data parallelism and application parallelism must be exploited.

  10. Identification and Treatment of Patients with Homozygous Familial Hypercholesterolaemia: Information and Recommendations from a Middle East Advisory Panel.

    PubMed

    Al-Ashwal, Abdullah; Alnouri, Fahad; Sabbour, Hani; Al-Mahfouz, Abdulraof; Al-Sayed, Nasreen; Razzaghy-Azar, Maryam; Al-Allaf, Faisal; Al-Waili, Khalid; Banerjee, Yajnavalka; Genest, Jacques; Santos, Raul D; Al-Rasadi, Khalid

    2015-01-01

    We present clinical practice guidelines for the diagnosis and treatment of homozygous familial hypercholesterolaemia (HoFH) in the Middle East region. While guidelines are broadly applicable in Europe, in the Middle East we experience a range of confounding factors that complicate disease management to a point whereby the European guidance cannot be applied without significant modification. Specifically, for disease prevalence, the Middle East region has an established epidemic of diabetes and metabolic syndrome that can complicate treatment and mask a clinical diagnosis of HoFH. We have also a high incidence of consanguineous marriages, which increase the risk of transmission of recessive and homozygous genetic disorders. This risk is further augmented in autosomal dominant disorders such as familial hypercholesterolaemia (FH), in which a range of defective genes can be transmitted, all of which contribute to the phenotypic expression of the disease. In terms of treatment, we do not have access to lipoprotein apheresis on the same scale as in Europe, and there remains a significant reliance on statins, ezetimibe and the older plasma exchange methods. Additionally, we do not have widespread access to anti-apolipoprotein B therapies and microsomal transfer protein inhibitors. In order to adapt existing global guidance documents on HoFH to the Middle East region, we convened a panel of experts from Oman, Saudi Arabia, UAE, Iran and Bahrain to draft a regional guidance document for HoFH. We also included selected experts from outside the region. This panel statement will form the foundation of a detailed appraisal of the current FH management in the Middle Eastern population and thereby provide a suitable set of guidelines tailored for the region. PMID:26311574

  11. Accelerating Struggling Readers' Progress: A Comparative Analysis of Expert Opinion and Current Research Recommendations

    ERIC Educational Resources Information Center

    Reutzel, D. Ray; Smith, John A.

    2004-01-01

    In this article, we review the findings of Rona Flippo's (1998) "Expert Study" within the comparative context of recently published reading research reports such as the National Reading Panel report (National Institute of Child Health and Human Development, 2000) and Preventing Reading Difficulties in Young Children (Snow, Burns, & Griffin, 1998).…

  12. Aerospace Safety Advisory Panel

    NASA Technical Reports Server (NTRS)

    1999-01-01

    This report covers the activities of the Aerospace Safety Advisory Panel (ASAP) for calendar year 1998-a year of sharp contrasts and significant successes at NASA. The year opened with the announcement of large workforce cutbacks. The slip in the schedule for launching the International Space Station (ISS) created a five-month hiatus in Space Shuttle launches. This slack period ended with the successful and highly publicized launch of the STS-95 mission. As the year closed, ISS assembly began with the successful orbiting and joining of the Functional Cargo Block (FGB), Zarya, from Russia and the Unity Node from the United States. Throughout the year, the Panel maintained its scrutiny of NASA's safety processes. Of particular interest were the potential effects on safety of workforce reductions and the continued transition of functions to the Space Flight Operations Contractor. Attention was also given to the risk management plans of the Aero-Space Technology programs, including the X-33, X-34, and X-38. Overall, the Panel concluded that safety is well served for the present. The picture is not as clear for the future. Cutbacks have limited the depth of talent available. In many cases, technical specialties are 'one deep.' The extended hiring freeze has resulted in an older workforce that will inevitably suffer significant departures from retirements in the near future. The resulting 'brain drain' could represent a future safety risk unless appropriate succession planning is started expeditiously. This and other topics are covered in the section addressing workforce. The major NASA programs are also limited in their ability to plan property for the future. This is of particular concern for the Space Shuttle and ISS because these programs are scheduled to operate well into the next century. In the case of the Space Shuttle, beneficial and mandatory safety and operational upgrades are being delayed because of a lack of sufficient present funding. Likewise, the ISS has

  13. Standards for evaluating expert system tools

    NASA Technical Reports Server (NTRS)

    Beach, Sharon S.; Gevarter, William

    1991-01-01

    A brief survey of the literature and proposal for a standard methodology for evaluating expert system building tools are discribed. Criteria for expert systems environmental factors and expert systems tool features are also discussed.

  14. 32 CFR 516.52 - Expert witnesses.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... States Has An Interest § 516.52 Expert witnesses. Requests for present or former DA personnel as expert... SJA or legal adviser. In no event, may present or former DA personnel furnish expert or...

  15. Identifying key conservation threats to Alpine birds through expert knowledge.

    PubMed

    Chamberlain, Dan E; Pedrini, Paolo; Brambilla, Mattia; Rolando, Antonio; Girardello, Marco

    2016-01-01

    Alpine biodiversity is subject to a range of increasing threats, but the scarcity of data for many taxa means that it is difficult to assess the level and likely future impact of a given threat. Expert opinion can be a useful tool to address knowledge gaps in the absence of adequate data. Experts with experience in Alpine ecology were approached to rank threat levels for 69 Alpine bird species over the next 50 years for the whole European Alps in relation to ten categories: land abandonment, climate change, renewable energy, fire, forestry practices, grazing practices, hunting, leisure, mining and urbanization. There was a high degree of concordance in ranking of perceived threats among experts for most threat categories. The major overall perceived threats to Alpine birds identified through expert knowledge were land abandonment, urbanization, leisure and forestry, although other perceived threats were ranked highly for particular species groups (renewable energy and hunting for raptors, hunting for gamebirds). For groups of species defined according to their breeding habitat, open habitat species and treeline species were perceived as the most threatened. A spatial risk assessment tool based on summed scores for the whole community showed threat levels were highest for bird communities of the northern and western Alps. Development of the approaches given in this paper, including addressing biases in the selection of experts and adopting a more detailed ranking procedure, could prove useful in the future in identifying future threats, and in carrying out risk assessments based on levels of threat to the whole bird community.

  16. West European magnetic confinement fusion research

    SciTech Connect

    McKenney, B.L.; McGrain, M. . Foreign Applied Sciences Assessment Center); Hazeltine, R.D. . Inst. for Fusion Studies); Gentle, K.W. ); Hogan, J.T. ); Porkolab, M. . Dept. of Physics); Sigmar

    1990-01-01

    This report presents a technical assessment and review of the West European program in magnetic confinement fusion by a panel of US scientists and engineers active in fusion research. Findings are based on the scientific and technical literature, on laboratory reports and preprints, and on the personal experiences and collaborations of the panel members. Concerned primarily with developments during the past 10 years, from 1979 to 1989, the report assesses West European fusion research in seven technical areas: tokamak experiments; magnetic confinement technology and engineering; fusion nuclear technology; alternate concepts; theory; fusion computations; and program organization. The main conclusion emerging from the analysis is that West European fusion research has attained a position of leadership in the international fusion program. This distinction reflects in large measure the remarkable achievements of the Joint European Torus (JET). However, West European fusion prominence extends beyond tokamak experimental physics: the program has demonstrated a breadth of skill in fusion science and technology that is not excelled in the international effort. It is expected that the West European primacy in central areas of confinement physics will be maintained or even increased during the early 1990s. The program's maturity and commitment kindle expectations of dramatic West European advances toward the fusion energy goal. For example, achievement of fusion breakeven is expected first in JET, before 1995.

  17. Report of Industry Panel Group

    NASA Technical Reports Server (NTRS)

    Gallimore, Simon; Gier, Jochen; Heitland, Greg; Povinelli, Louis; Sharma, Om; VandeWall, Allen

    2006-01-01

    A final report is presented from the industry panel group. The contents include: 1) General comments; 2) Positive progress since Minnowbrook IV; 3) Industry panel outcome; 4) Prioritized turbine projects; 5) Prioritized compressor projects; and 6) Miscellaneous.

  18. LCD Panels: The Electronic Wonder.

    ERIC Educational Resources Information Center

    Anderson, Glenn

    1994-01-01

    Describes Liquid Crystal Display (LCD) panels and their use in the classroom. Topics discussed include active versus passive matrix panels; the number of pixels; projectors, including transmissive or reflective overhead projectors; costs; and vendors that supply LCDs. (LRW)

  19. Introduction and Overview of the Industrial Interactive Panel Session

    NASA Astrophysics Data System (ADS)

    Seiler, David

    2014-03-01

    A unique industrial panel covering the challenges and needs of various industries and how being innovative is important. The session involves two invited industry speakers (24 minutes each) who will set the stage for the interactive round table panel session. The Panel, led by moderator Mark Bernius (Morgan Advanced Materials), consists of the two invited speakers plus an additional five industry panelists. The first thirty minutes of the panel session has the five additional panelists introducing themselves and their work/company. These introductions could include what they or their company does, sharing one or two technical highlights, listing some challenges or needs for physicists, and what innovation breakthroughs are needed in their industries. The final hour of the session will be highly interactive with questions to the panel coming from the moderator, the audience, and the panelists themselves. Questions that might be addressed include: how physicists are or could be critical in advancing innovation; how can AIP/APS/FIAP help industry get the physics help they need to be innovative (knowledge, the right staff, etc.); what role can students and post docs play in advancing industry's mission; etc. We invite you to participate in this interactive session and ask our industry experts your own interesting and challenging questions. The invited speakers are George Thompson, Intel, and Rick Watkins, Nike. The panel members also include Jason Cleveland, Asylum Research; Robert Doering, Texas Instruments; William Gallagher, IBM T.J. Watson Research Center; James Hollenhorst, Agilent Technologies; and Martin Poitzsch, Schlumberger-Doll Research.

  20. Requirements specification for nickel cadmium battery expert system

    NASA Technical Reports Server (NTRS)

    1986-01-01

    The requirements for performance, design, test, and qualification of a computer program identified as NICBES, Nickel Cadmium Battery Expert System, is established. The specific spacecraft power system configuration selected was the Hubble Space Telescope (HST) Electrical Power System (EPS) Testbed. Power for the HST comes from a system of 13 Solar Panel Arrays (SPAs) linked to 6 Nickel Cadmium Batteries which are connected to 3 Busses. An expert system, NICBES, will be developed at Martin Marietta Aerospace to recognize a testbed anomaly, identify the malfunctioning component and recommend a course of action. Besides fault diagnosis, NICBES will be able to evaluate battery status, give advice on battery status and provide decision support for the operator. These requirements are detailed.

  1. Diagnosing battery behavior with an expert system in PROLOG

    NASA Technical Reports Server (NTRS)

    Kirkwood, N.; Weeks, D. J.

    1986-01-01

    Power for the Hubble Space Telescope comes from a system of 20 solar panel assemblies (SPAs) and six nickel-cadmium batteries. The HST battery system is simulated by the HST Electrical Power System (EPS) testbed at Marshall Space Flight Center. The Nickel Cadmium Battery Expert System (NICBES) is being used to diagnose faults of the testbed system, evaluate battery status and provide decision support for the engineer. Extensive telemetry of system operating conditions is relayed through a DEC LSI-11. A BASIC program running on a PC monitors the flow of data, figures cell divergence and recharge ratio, and stores these values, along with other selected data, for use by the expert system.

  2. Establishing Yourself as an Expert in Nutrition Science: Advice for Young Professionals.

    PubMed

    Ciappio, Eric D; Lesser, Mary N R

    2016-01-01

    In today's world in which there is a surplus of both scientists and online nutrition "experts," how do young professionals establish themselves? Becoming established as an expert requires selling yourself and your ideas to your colleagues and the general public by using effective communication skills. Helping young professionals develop these skills was the goal of a panel held at the ASN Scientific Sessions and Annual Meeting at Experimental Biology 2015. This panel featured a set of distinguished speakers who discussed techniques and strategies to enhance professional reputations centered around effectively leveraging communication platforms and opportunities to engage with colleagues. Early-career nutrition scientists can use the guidance provided by the panelists to improve their visibility and be a champion for themselves in order to establish themselves as experts in the field.

  3. Nutritional advice for community patients: insights from a panel discussion.

    PubMed

    Thomas, Linda V; Jenkins, Gill; Belton, Julie; Clements, Suzie; Jacob, Ciara; Johnson, Naomi; Joy, Deirdre; Low, Jennifer; Munson, Eileen; Sheppard, Jessica

    2016-03-01

    This article describes the conclusions of an expert panel that discussed four case studies; these were examples of patients typically encountered by nurses working in the community. The panel considered the nutritional and lifestyle advice that could be given by nurses relating to conditions such as irritable bowel syndrome (IBS), depression, chronic fatigue syndrome, vulnerability to common infections, elderly care, recurrent urinary tract infection, antibiotic use, and risk of type 2 diabetes. A general conclusion was the importance of motivational interviewing techniques in achieving full understanding of patients' concerns and to determine the best health strategy. As well as specific guidance appropriate for each disorder, a range of information sources for both health professionals and patients are listed in the paper. The panel noted that, although general nutritional advice can be given by nurses working at GP surgeries and in the community, patients should always be referred to registered dietitians or nutritionists if significant dietary changes are considered. PMID:26940615

  4. Nutritional advice for community patients: insights from a panel discussion.

    PubMed

    Thomas, Linda V; Jenkins, Gill; Belton, Julie; Clements, Suzie; Jacob, Ciara; Johnson, Naomi; Joy, Deirdre; Low, Jennifer; Munson, Eileen; Sheppard, Jessica

    2016-03-01

    This article describes the conclusions of an expert panel that discussed four case studies; these were examples of patients typically encountered by nurses working in the community. The panel considered the nutritional and lifestyle advice that could be given by nurses relating to conditions such as irritable bowel syndrome (IBS), depression, chronic fatigue syndrome, vulnerability to common infections, elderly care, recurrent urinary tract infection, antibiotic use, and risk of type 2 diabetes. A general conclusion was the importance of motivational interviewing techniques in achieving full understanding of patients' concerns and to determine the best health strategy. As well as specific guidance appropriate for each disorder, a range of information sources for both health professionals and patients are listed in the paper. The panel noted that, although general nutritional advice can be given by nurses working at GP surgeries and in the community, patients should always be referred to registered dietitians or nutritionists if significant dietary changes are considered.

  5. Expert system application education project

    NASA Technical Reports Server (NTRS)

    Gonzelez, Avelino J.; Ragusa, James M.

    1988-01-01

    Artificial intelligence (AI) technology, and in particular expert systems, has shown potential applicability in many areas of operation at the Kennedy Space Center (KSC). In an era of limited resources, the early identification of good expert system applications, and their segregation from inappropriate ones can result in a more efficient use of available NASA resources. On the other hand, the education of students in a highly technical area such as AI requires an extensive hands-on effort. The nature of expert systems is such that proper sample applications for the educational process are difficult to find. A pilot project between NASA-KSC and the University of Central Florida which was designed to simultaneously address the needs of both institutions at a minimum cost. This project, referred to as Expert Systems Prototype Training Project (ESPTP), provided NASA with relatively inexpensive development of initial prototype versions of certain applications. University students likewise benefit by having expertise on a non-trivial problem accessible to them at no cost. Such expertise is indispensible in a hands-on training approach to developing expert systems.

  6. A gene mapping expert system.

    PubMed

    Galland, J; Skolnick, M H

    1990-08-01

    Expert systems are now commonly developed to solve practical problems. Nevertheless, genetics has just begun to benefit from this new technology, since genetic expert systems are extremely rare and often purely experimental. A prototype for risk calculation in pedigrees was developed at the University of Utah, using a commercial frames/rules developmental shell (Intelligence Compiler), which runs on an IBM PC. When small data sets were used, the implementation functioned well, but it could not handle larger data sets. Performance became a major issue, with two possible solutions. The first possibility would have been to port the system to a more powerful machine, and the second would have been to use several different shells or languages, each efficiently representing a specific type of knowledge. Neither of these solutions was applicable in this case. From this experience, we learned that performance, portability, and modifiability were three major requirements for genetic expert systems. To achieve these goals, we implemented the gene mapping expert system GMES: (GMES is unrelated to the gene mapping system, GMS in Lisp combined with a frame/object shell (FROBS). We were able to efficiently represent, control, and optimize a gene mapping experiment, achieving portability by building GMES on top of a C-based version of Common Lisp. Lisp combined with the FROBS expert system shell permitted a declarative representation of each of the components of the experiment, resulting in a transplant specification of the problem within a maintainable system. PMID:2394090

  7. Payload advisory panel recommendations

    NASA Technical Reports Server (NTRS)

    Moore, Berrien, III

    1991-01-01

    The Payload Advisory Panel proposes a restructured Earth Observing System (EOS) mission to address high-priority science and environmental policy issues in Earth System Science. These issues have been identified through studies conducted by the Intergovernmental Panel on Climate Change (IPCC), the United States Environmental Protection Agency (EPA), and the Committee on Earth and Environmental Sciences (CEES). The restructured EOS defers efforts to improve the understanding of the middle and upper stratosphere and solid earth geophysics. The strategy of the mission combines high priority new measurements with continuation of critical data sets begun by missions which precede EOS. Collaborative arrangements with international partners are an essential part of the program and additional arrangements are posed. The need for continuity in Earth observations and the urgency of environmental questions require launch of some EOS elements as soon as possible. They further require maintenance of the EOS objective of obtaining consistent 15-year measurement records.

  8. Medical Physics Panel Discussion

    NASA Astrophysics Data System (ADS)

    Guèye, Paul; Avery, Steven; Baird, Richard; Soares, Christopher; Amols, Howard; Tripuraneni, Prabhakar; Majewski, Stan; Weisenberger, Drew

    2006-03-01

    The panel discussion will explore opportunities and vistas in medical physics research and practice, medical imaging, teaching medical physics to undergraduates, and medical physics curricula as a recruiting tool for physics departments. Panel members consist of representatives from NSBP (Paul Guèye and Steven Avery), NIH/NIBIB (Richard Baird), NIST (Christopher Soares), AAPM (Howard Amols), ASTRO (Prabhakar Tripuraneni), and Jefferson Lab (Stan Majewski and Drew Weisenberger). Medical Physicists are part of Departments of Radiation Oncology at hospitals and medical centers. The field of medical physics includes radiation therapy physics, medical diagnostic and imaging physics, nuclear medicine physics, and medical radiation safety. It also ranges from basic researcher (at college institutions, industries, and laboratories) to applications in clinical environments.

  9. Expert Consensus Contouring Guidelines for Intensity Modulated Radiation Therapy in Esophageal and Gastroesophageal Junction Cancer

    SciTech Connect

    Wu, Abraham J.; Bosch, Walter R.; Chang, Daniel T.; Hong, Theodore S.; Jabbour, Salma K.; Kleinberg, Lawrence R.; Mamon, Harvey J.; Thomas, Charles R.; Goodman, Karyn A.

    2015-07-15

    Purpose/Objective(s): Current guidelines for esophageal cancer contouring are derived from traditional 2-dimensional fields based on bony landmarks, and they do not provide sufficient anatomic detail to ensure consistent contouring for more conformal radiation therapy techniques such as intensity modulated radiation therapy (IMRT). Therefore, we convened an expert panel with the specific aim to derive contouring guidelines and generate an atlas for the clinical target volume (CTV) in esophageal or gastroesophageal junction (GEJ) cancer. Methods and Materials: Eight expert academically based gastrointestinal radiation oncologists participated. Three sample cases were chosen: a GEJ cancer, a distal esophageal cancer, and a mid-upper esophageal cancer. Uniform computed tomographic (CT) simulation datasets and accompanying diagnostic positron emission tomographic/CT images were distributed to each expert, and the expert was instructed to generate gross tumor volume (GTV) and CTV contours for each case. All contours were aggregated and subjected to quantitative analysis to assess the degree of concordance between experts and to generate draft consensus contours. The panel then refined these contours to generate the contouring atlas. Results: The κ statistics indicated substantial agreement between panelists for each of the 3 test cases. A consensus CTV atlas was generated for the 3 test cases, each representing common anatomic presentations of esophageal cancer. The panel agreed on guidelines and principles to facilitate the generalizability of the atlas to individual cases. Conclusions: This expert panel successfully reached agreement on contouring guidelines for esophageal and GEJ IMRT and generated a reference CTV atlas. This atlas will serve as a reference for IMRT contours for clinical practice and prospective trial design. Subsequent patterns of failure analyses of clinical datasets using these guidelines may require modification in the future.

  10. Clinical Space Medicine Panel

    NASA Technical Reports Server (NTRS)

    Baisden, Denise L.; Billica, Roger (Technical Monitor)

    2000-01-01

    The practice of space medicine is diverse. It includes routine preventive medical care of astronauts and pilots, the development of inflight medical capability and training of flight crews as well as the preflight, inflight, and postflight medical assessment and monitoring. The Johnson Space Center Medical Operations Branch is a leader in the practice of space medicine. The papers presented in this panel will demonstrate some of the unique aspects of space medicine.

  11. Panel Reviews Benefits and Harms of CT Scans for Lung Cancer Screening | Division of Cancer Prevention

    Cancer.gov

    A panel of experts has reviewed the evidence regarding the benefits and harms of screening for lung cancer with low-dose computed tomography (CT) and concluded that the technology may benefit some individuals at high risk for lung cancer. But the panel cautioned that many questions remain about the potential harms of screening and how to translate screening into clinical practice. |

  12. European Education.

    ERIC Educational Resources Information Center

    Tapia, Ivan, Ed.; Blochmann, Georg M., Ed.

    1996-01-01

    A special six-article section of this journal is devoted to the theme of "European Education" (EU): (1) "Reform of EU Educational Policy" (Volker Thomas); (2) "Living in Europe, Working for Europe" (Volker Thomas); (3) "EURES Helps to Find Jobs" (Volker Thomas); (4) "Help for Higher Education Institutions in Central and Eastern Europe" (Siegbert…

  13. Register of hydrogen technology experts

    NASA Technical Reports Server (NTRS)

    Ludtke, P. R.

    1975-01-01

    This register presents the names of approximately 235 individuals who are considered experts, or very knowledgeable, in various fields of technology related to hydrogen. Approximately 90 organizations are represented. Each person is listed by organizational affiliation, address, and principal area of expertise. The criteria for selection of names for the register are extensive experience in a given field of work, participation in or supervision of relevant research programs, contributions to the literature, or being recognized as an expert in a particular field. The purpose of the register is to present, in easy form, sources of dependable information regarding highly technical areas of hydrogen technology, with particular emphasis on safety. The register includes two indexes: an alphabetical listing of the experts and an alphabetical listing of the organizations with which they are affiliated.

  14. Weather forecasting expert system study

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Weather forecasting is critical to both the Space Transportation System (STS) ground operations and the launch/landing activities at NASA Kennedy Space Center (KSC). The current launch frequency places significant demands on the USAF weather forecasters at the Cape Canaveral Forecasting Facility (CCFF), who currently provide the weather forecasting for all STS operations. As launch frequency increases, KSC's weather forecasting problems will be great magnified. The single most important problem is the shortage of highly skilled forecasting personnel. The development of forecasting expertise is difficult and requires several years of experience. Frequent personnel changes within the forecasting staff jeopardize the accumulation and retention of experience-based weather forecasting expertise. The primary purpose of this project was to assess the feasibility of using Artificial Intelligence (AI) techniques to ameliorate this shortage of experts by capturing aria incorporating the forecasting knowledge of current expert forecasters into a Weather Forecasting Expert System (WFES) which would then be made available to less experienced duty forecasters.

  15. [Medical expert assessment in psychiatry].

    PubMed

    Pietzcker, A

    1996-11-01

    Especially regarding two respects, the psychiatric expert assessment differs from the expert assessment of other medical specialties: (1) No laboratory tests or technical equipment are available for the psychiatrist except for mental disturbances due to physical impacts such as brain injuries or intoxications. The psychiatrist depends on a carefully compiled case history and a differentiated psychodiagnostic. This may lead to a wrong assessment due to a lack of objectiveness. (2) There are a lot of legal areas where only the psychiatric or psychological expert opinion is required: i.e., the question of criminal responsibility during a trial, the assessment of legal capacity and the capability to will, for decisions about the custody of children etc. This is demonstrated with some cases as an example.

  16. Expert witness and Jungian archetypes.

    PubMed

    Lallave, Juan Antonio; Gutheil, Thomas Gordon

    2012-01-01

    Jung's theories of archetype, shadow, and the personal and collective unconscious provide a postmodern framework in which to consider the role of the expert witness in judicial proceedings. Archetypal themes, motifs, and influences help to illuminate the shadow of the judicial system and projections and behaviors among the cast of the court in pursuing justice. This article speaks to archetypal influences and dialectical tensions encountered by the expert witness in this judicial drama. The archetype of Justice is born from the human need for order and relational fairness in a world of chaos. The persona of justice is the promise of truth in the drama. The shadow of justice is untruth, the need to win by any means. The dynamics of the trickster archetype serve and promote injustice. These influences are examined by means of a case example. This approach will deepen understanding of court proceedings and the role of the expert witness in the heroic quest for justice. PMID:23062586

  17. Heat pipe thermal conditioning panel

    NASA Technical Reports Server (NTRS)

    Saaski, E. W.; Loose, J. D.; Mccoy, K. E.

    1974-01-01

    Thermal control of electronic hardware and experiments on future space vehicles is critical to proper functioning and long life. Thermal conditioning panels (cold plates) are a baseline control technique in current conceptual studies. Heat generating components mounted on the panels are typically cooled by fluid flowing through integral channels within the panel. However, replacing the pumped fluid coolant loop within the panel with heat pipes offers attractive advantages in weight, reliability, and installation. This report describes the development and fabrication of two large 0.76 x 0.76 m heat pipe thermal conditioning panels to verify performance and establish the design concept.

  18. Lightweight, Thermally Insulating Structural Panels

    NASA Technical Reports Server (NTRS)

    Eisen, Howard J.; Hickey, Gregory; Wen, Liang-Chi; Layman, William E.; Rainen, Richard A.; Birur, Gajanana C.

    1996-01-01

    Lightweight, thermally insulating panels that also serve as structural members developed. Honeycomb-core panel filled with low-thermal-conductivity, opacified silica aerogel preventing convection and minimizes internal radiation. Copper coating on face sheets reduces radiation. Overall thermal conductivities of panels smaller than state-of-art commercial non-structurally-supporting foam and fibrous insulations. On Earth, panels suitable for use in low-air-pressure environments in which lightweight, compact, structurally supporting insulation needed; for example, aboard high-altitude aircraft or in partially evacuated panels in refrigerators.

  19. WTEC panel report on European nuclear instrumentation and controls

    NASA Technical Reports Server (NTRS)

    White, James D.; Lanning, David D.; Beltracchi, Leo; Best, Fred R.; Easter, James R.; Oakes, Lester C.; Sudduth, A. L.

    1991-01-01

    Control and instrumentation systems might be called the 'brain' and 'senses' of a nuclear power plant. As such they become the key elements in the integrated operation of these plants. Recent developments in digital equipment have allowed a dramatic change in the design of these instrument and control (I&C) systems. New designs are evolving with cathode ray tube (CRT)-based control rooms, more automation, and better logical information for the human operators. As these new advanced systems are developed, various decisions must be made about the degree of automation and the human-to-machine interface. Different stages of the development of control automation and of advanced digital systems can be found in various countries. The purpose of this technology assessment is to make a comparative evaluation of the control and instrumentation systems that are being used for commercial nuclear power plants in Europe and the United States. This study is limited to pressurized water reactors (PWR's). Part of the evaluation includes comparisons with a previous similar study assessing Japanese technology.

  20. Renal replacement therapy in adult and pediatric intensive care : Recommendations by an expert panel from the French Intensive Care Society (SRLF) with the French Society of Anesthesia Intensive Care (SFAR) French Group for Pediatric Intensive Care Emergencies (GFRUP) the French Dialysis Society (SFD).

    PubMed

    Vinsonneau, Christophe; Allain-Launay, Emma; Blayau, Clarisse; Darmon, Michael; Ducheyron, Damien; Gaillot, Theophile; Honore, Patrick M; Javouhey, Etienne; Krummel, Thierry; Lahoche, Annie; Letacon, Serge; Legrand, Matthieu; Monchi, Mehran; Ridel, Christophe; Robert, René; Schortgen, Frederique; Souweine, Bertrand; Vaillant, Patrick; Velly, Lionel; Osman, David; Van Vong, Ly

    2015-12-01

    Acute renal failure (ARF) in critically ill patients is currently very frequent and requires renal replacement therapy (RRT) in many patients. During the last 15 years, several studies have considered important issues regarding the use of RRT in ARF, like the time to initiate the therapy, the dialysis dose, the types of catheter, the choice of technique, and anticoagulation. However, despite an abundant literature, conflicting results do not provide evidence on RRT implementation. We present herein recommendations for the use of RRT in adult and pediatric intensive care developed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system by an expert group of French Intensive Care Society (SRLF), with the participation of the French Society of Anesthesia and Intensive Care (SFAR), the French Group for Pediatric Intensive Care and Emergencies (GFRUP), and the French Dialysis Society (SFD). The recommendations cover 4 fields: criteria for RRT initiation, technical aspects (access routes, membranes, anticoagulation, reverse osmosis water), practical aspects (choice of the method, peritoneal dialysis, dialysis dose, adjustments), and safety (procedures and training, dialysis catheter management, extracorporeal circuit set-up). These recommendations have been designed on a practical point of view to provide guidance for intensivists in their daily practice. PMID:26714808

  1. Renal replacement therapy in adult and pediatric intensive care : Recommendations by an expert panel from the French Intensive Care Society (SRLF) with the French Society of Anesthesia Intensive Care (SFAR) French Group for Pediatric Intensive Care Emergencies (GFRUP) the French Dialysis Society (SFD).

    PubMed

    Vinsonneau, Christophe; Allain-Launay, Emma; Blayau, Clarisse; Darmon, Michael; Ducheyron, Damien; Gaillot, Theophile; Honore, Patrick M; Javouhey, Etienne; Krummel, Thierry; Lahoche, Annie; Letacon, Serge; Legrand, Matthieu; Monchi, Mehran; Ridel, Christophe; Robert, René; Schortgen, Frederique; Souweine, Bertrand; Vaillant, Patrick; Velly, Lionel; Osman, David; Van Vong, Ly

    2015-12-01

    Acute renal failure (ARF) in critically ill patients is currently very frequent and requires renal replacement therapy (RRT) in many patients. During the last 15 years, several studies have considered important issues regarding the use of RRT in ARF, like the time to initiate the therapy, the dialysis dose, the types of catheter, the choice of technique, and anticoagulation. However, despite an abundant literature, conflicting results do not provide evidence on RRT implementation. We present herein recommendations for the use of RRT in adult and pediatric intensive care developed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system by an expert group of French Intensive Care Society (SRLF), with the participation of the French Society of Anesthesia and Intensive Care (SFAR), the French Group for Pediatric Intensive Care and Emergencies (GFRUP), and the French Dialysis Society (SFD). The recommendations cover 4 fields: criteria for RRT initiation, technical aspects (access routes, membranes, anticoagulation, reverse osmosis water), practical aspects (choice of the method, peritoneal dialysis, dialysis dose, adjustments), and safety (procedures and training, dialysis catheter management, extracorporeal circuit set-up). These recommendations have been designed on a practical point of view to provide guidance for intensivists in their daily practice.

  2. Expert model for intelligent control of composite materials processing in a press

    NASA Astrophysics Data System (ADS)

    Saliba, Tony E.; Quinter, Suzanne R.; Abrams, Frances L.

    1992-02-01

    An expert model for the in-process control of the press processing of thermoset composite materials has been developed. The knowledge base written using Personal Consultant Plus (PC Plus) expert system shell was interfaced with models written in FORTRAN. The expert model, which is running on a single computer with a single processor, takes advantage of the symbol crunching capability of the LISP computer language and the number crunching capability of FORTRAN. The expert model control system is a qualitative-quantitative process automation (QQPA) system since it includes both quantitative model-based and qualitative rule-based expert system operations. The feasibility of using models to determine the process state when sensors are not available or are malfunctioning was demonstrated. Hercules 3501-6/AS4 8-in x 8-in panels were processed in the heated-platens press, using both the standard cure cycle and the expert model control system. Various physical and mechanical properties were measured from panels processed using the two cycles. Using QQPA, processing time has been reduced significantly without altering product quality.

  3. Aerospace Safety Advisory Panel

    NASA Technical Reports Server (NTRS)

    2002-01-01

    This Annual Report of the Aerospace Safety Advisory Panel (ASAP) presents results of activities during calendar year 2001. The year was marked by significant achievements in the Space Shuttle and International Space Station (ISS) programs and encouraging accomplishments by the Aerospace Technology Enterprise. Unfortunately, there were also disquieting mishaps with the X-43, a LearJet, and a wind tunnel. Each mishap was analyzed in an orderly process to ascertain causes and derive lessons learned. Both these accomplishments and the responses to the mishaps led the Panel to conclude that safety and risk management is currently being well served within NASA. NASA's operations evidence high levels of safety consciousness and sincere efforts to place safety foremost. Nevertheless, the Panel's safety concerns have never been greater. This dichotomy has arisen because the focus of most NASA programs has been directed toward program survival rather than effective life cycle planning. Last year's Annual Report focused on the need for NASA to adopt a realistically long planning horizon for the aging Space Shuttle so that safety would not erode. NASA's response to the report concurred with this finding. Nevertheless, there has been a greater emphasis on current operations to the apparent detriment of long-term planning. Budget cutbacks and shifts in priorities have severely limited the resources available to the Space Shuttle and ISS for application to risk-reduction and life-extension efforts. As a result, funds originally intended for long-term safety-related activities have been used for operations. Thus, while safety continues to be well served at present, the basis for future safety has eroded. Section II of this report develops this theme in more detail and presents several important, overarching findings and recommendations that apply to many if not all of NASA's programs. Section III of the report presents other significant findings, recommendations and supporting

  4. Nickel cadmium battery expert system

    NASA Technical Reports Server (NTRS)

    1986-01-01

    The applicability of artificial intelligence methodologies for the automation of energy storage management, in this case, nickel cadmium batteries, is demonstrated. With the Hubble Space Telescope Electrical Power System (HST/EPS) testbed as the application domain, an expert system was developed which incorporates the physical characterization of the EPS, in particular, the nickel cadmium batteries, as well as the human's operational knowledge. The expert system returns not only fault diagnostics but also status and advice along with justifications and explanations in the form of decision support.

  5. Robotic planner expert system (RPLANES)

    NASA Technical Reports Server (NTRS)

    Grice, Ervin Oneal

    1987-01-01

    The Artificial Intelligence Section of the Mission Planning and Analysis of the Johnson Space Center has developed a prototype of an expert system for robotic planning. A robot is given a high level goal to perform an action (i.e., swap, adjust, or stow) on a component unit of an object such as a satellite and the Robotic Planner Expert System (RPLANES) generates the necessary goals for arm actions. RPLANES is designed using the Inference Corp. Automated Reasoning Tool (ART) development tool. It resides on a SYMBOLICS 3670. RPLANES and its evolution are described.

  6. User interfaces to expert systems

    SciTech Connect

    Agarwal, A.; Emrich, M.L.

    1988-10-01

    Expert Systems are becoming increasingly popular in environments where the user is not well versed in computers or the subject domain. They offer expert advice and can also explain their lines of reasoning. As these systems are applied to highly technical areas, they become complex and large. Therefore, User Systems Interfaces (USIs) become critical. This paper discusses recent technologies that can be applied to improved user communication. In particular, bar menus/graphics, mouse interfaces, touch screens, and voice links will be highlighted. Their applications in the context of SOFTMAN (The Software Manager Apprentice) a knowledge-based system are discussed. 18 refs., 2 figs.

  7. Large thermal protection system panel

    NASA Technical Reports Server (NTRS)

    Myers, Franklin K. (Inventor); Weinberg, David J. (Inventor); Tran, Tu T. (Inventor)

    2003-01-01

    A protective panel for a reusable launch vehicle provides enhanced moisture protection, simplified maintenance, and increased temperature resistance. The protective panel includes an outer ceramic matrix composite (CMC) panel, and an insulative bag assembly coupled to the outer CMC panel for isolating the launch vehicle from elevated temperatures and moisture. A standoff attachment system attaches the outer CMC panel and the bag assembly to the primary structure of the launch vehicle. The insulative bag assembly includes a foil bag having a first opening shrink fitted to the outer CMC panel such that the first opening and the outer CMC panel form a water tight seal at temperatures below a desired temperature threshold. Fibrous insulation is contained within the foil bag for protecting the launch vehicle from elevated temperatures. The insulative bag assembly further includes a back panel coupled to a second opening of the foil bag such that the fibrous insulation is encapsulated by the back panel, the foil bag, and the outer CMC panel. The use of a CMC material for the outer panel in conjunction with the insulative bag assembly eliminates the need for waterproofing processes, and ultimately allows for more efficient reentry profiles.

  8. Development of Quiet Honeycomb Panels

    NASA Technical Reports Server (NTRS)

    Palumbo, Daniel L.; Klos, Jacob

    2009-01-01

    Sandwich honeycomb composite panels are lightweight and strong, and, therefore, provide a reasonable alternative to the aluminum ring framelstringer architecture currently used for most aircraft airframes. The drawback to honeycomb panels is that they radiate noise into the aircraft cabin very efficiently provoking the need for additional sound treatment which adds weight and reduces the material's cost advantage. A series of honeycomb panels were made which incorporated different design strategies aimed at reducing the honeycomb panels' radiation efficiency while at the same time maintaining its strength. The majority of the desi gns were centered around the concept of creatin g areas of reduced stiffness in the panel by adding voids and recesses to the core. The effort culminated with a reinforced./recessed panel which had 6 dB higher transmission loss than the baseline solid core panel while maintaining comparable strength.

  9. Male Reproductive Disorders, Diseases, and Costs of Exposure to Endocrine-Disrupting Chemicals in the European Union

    PubMed Central

    Hauser, Russ; Skakkebaek, Niels E.; Hass, Ulla; Toppari, Jorma; Juul, Anders; Andersson, Anna Maria; Kortenkamp, Andreas; Heindel, Jerrold J.

    2015-01-01

    Introduction: Increasing evidence suggests that endocrine-disrupting chemicals (EDCs) contribute to male reproductive diseases and disorders. Purpose: To estimate the incidence/prevalence of selected male reproductive disorders/diseases and associated economic costs that can be reasonably attributed to specific EDC exposures in the European Union (EU). Methods: An expert panel evaluated evidence for probability of causation using the Intergovernmental Panel on Climate Change weight-of-evidence characterization. Exposure-response relationships and reference levels were evaluated, and biomarker data were organized from carefully identified studies from the peer-reviewed literature to represent European exposure and approximate burden of disease as it occurred in 2010. The cost-of-illness estimation utilized multiple peer-reviewed sources. Results: The expert panel identified low epidemiological and strong toxicological evidence for male infertility attributable to phthalate exposure, with a 40–69% probability of causing 618 000 additional assisted reproductive technology procedures, costing €4.71 billion annually. Low epidemiological and strong toxicological evidence was also identified for cryptorchidism due to prenatal polybrominated diphenyl ether exposure, resulting in a 40–69% probability that 4615 cases result, at a cost of €130 million (sensitivity analysis, €117–130 million). A much more modest (0–19%) probability of causation in testicular cancer by polybrominated diphenyl ethers was identified due to very low epidemiological and weak toxicological evidence, with 6830 potential cases annually and costs of €848 million annually (sensitivity analysis, €313–848 million). The panel assigned 40–69% probability of lower T concentrations in 55- to 64-year-old men due to phthalate exposure, with 24 800 associated deaths annually and lost economic productivity of €7.96 billion. Conclusions: EDCs may contribute substantially to male

  10. The Politics of the Economics of Education in the European Union

    ERIC Educational Resources Information Center

    Jones, Peter

    2010-01-01

    This article critically examines the work of the European Commission-sponsored network, the European Expert Network on Economics of Education (EENEE). The aim is to develop understanding of the context and significance of the mobilization of the economics of education research and policy paradigm within the European Union's Education and Training…

  11. Psychology of developing and designing expert systems

    SciTech Connect

    Tonn, B.; MacGregor, D.

    1986-01-01

    This paper discusses psychological problems relevant to developing and designing expert systems. With respect to the former, the psychological literature suggests that several cognitive biases may affect the elicitation of a valid knowledge base from the expert. The literature also suggests that common expert system inference engines may be quite inconsistent with reasoning heuristics employed by experts. With respect to expert system user interfaces, care should be taken when eliciting uncertainty estimates from users, presenting system conclusions, and ordering questions.

  12. Teen Experts Guide Makerspace Makeover

    ERIC Educational Resources Information Center

    Graves, Colleen

    2014-01-01

    A makerspace is a place where makers can envision a project, find an expert, and create something. Libraries have always held programming during which patrons were able to come in and create. The makerspace at the Lamar Middle School in Flower Mound, Texas, is available for students every day, so that they can daily create and play with innovative…

  13. Expert Systems for Reference Work.

    ERIC Educational Resources Information Center

    Parrot, James R.

    1986-01-01

    Discussion of library reference work that may be suitable for use of expert systems focuses on (1) information and literature searches, and (2) requests to interpret bibliographic references and locate items listed. Systems and computer-assisted instruction modules designed for information retrieval at the University of Waterloo Library are…

  14. Expert systems for superalloy studies

    NASA Technical Reports Server (NTRS)

    Workman, Gary L.; Kaukler, William F.

    1990-01-01

    There are many areas in science and engineering which require knowledge of an extremely complex foundation of experimental results in order to design methodologies for developing new materials or products. Superalloys are an area which fit well into this discussion in the sense that they are complex combinations of elements which exhibit certain characteristics. Obviously the use of superalloys in high performance, high temperature systems such as the Space Shuttle Main Engine is of interest to NASA. The superalloy manufacturing process is complex and the implementation of an expert system within the design process requires some thought as to how and where it should be implemented. A major motivation is to develop a methodology to assist metallurgists in the design of superalloy materials using current expert systems technology. Hydrogen embrittlement is disasterous to rocket engines and the heuristics can be very complex. Attacking this problem as one module in the overall design process represents a significant step forward. In order to describe the objectives of the first phase implementation, the expert system was designated Hydrogen Environment Embrittlement Expert System (HEEES).

  15. Plate-fin panel heat exchanger and panel components thereof

    SciTech Connect

    Heronemus, W.E.

    1985-02-05

    A plate-fin panel for a heat exchanger may be either formed as an aluminum extrusion or fabricated from a corrugated metal sheet sandwiched between two flat metal sheets. The extruded aluminum version may be clad with protective sheet metal jackets made of, or coated with, a corrosion resistant Cu-Ni alloy. Individual panel sections can be joined together by tongue and groove engagement to obtain a total desired panel width if available extrusion press or rolling mill capacity is insufficient. The plate-fin panels are assembled into slotted headering plates, and a layer of synthetic plastics potting compound seals dissimilar metal joints against electrolytic corrosion as well as leakage and provides sufficient adhesive strength to reduce or eliminate the need for welding the panels to the headers. Mechanical brush or hydraulic jet apparatus is capable of continuously or intermittently cleaning slime or encrustations from all panel surfaces exposed to seawater.

  16. Aerospace Safety Advisory Panel

    NASA Technical Reports Server (NTRS)

    1999-01-01

    This report covers the activities of the Aerospace Safety Advisory Panel (ASAP) for calendar year 1998-a year of sharp contrasts and significant successes at NASA. The year opened with the announcement of large workforce cutbacks. The slip in the schedule for launching the International Space Station (ISS) created a 5-month hiatus in Space Shuttle launches. This slack period ended with the successful and highly publicized launch of the STS-95 mission. As the year closed, ISS assembly began with the successful orbiting and joining of the Functional Cargo Block (FGB), Zarya, from Russia and the Unity Node from the United States. Throughout the year, the Panel maintained its scrutiny of NASAs safety processes. Of particular interest were the potential effects on safety of workforce reductions and the continued transition of functions to the Space Flight Operations Contractor. Attention was also given to the risk management plans of the Aero-Space Technology programs, including the X-33, X-34, and X-38. Overall, the Panel concluded that safety is well served for the present. The picture is not as clear for the future. Cutbacks have limited the depth of talent available. In many cases, technical specialties are "one deep." The extended hiring freeze has resulted in an older workforce that will inevitably suffer significant departures from retirements in the near future. The resulting "brain drain" could represent a future safety risk unless appropriate succession planning is started expeditiously. This and other topics are covered in the section addressing workforce. In the case of the Space Shuttle, beneficial and mandatory safety and operational upgrades are being delayed because of a lack of sufficient present funding. Likewise, the ISS has little flexibility to begin long lead-time items for upgrades or contingency planning.

  17. [Remarks about the position of the medico-legal expert in imperative regulations in the Penal and Civil Codes].

    PubMed

    Chowaniec, Czesław; Nowak, Agnieszka; Chowaniec, Małgorzata; Kobek, Mariusz

    2005-01-01

    In the monograph 'Medico-legal opinions--essays on theory', prof. K. Jaegermann wrote that 'the use of an expert requires theoretical or fairly clear knowledge about the mutual relationship between judge and expert'. In his opinion knowledge of this kind plays a significant role in estimating the usefulness of so-called expert evidence. Practical knowledge about the relationship between the judge and expert is necessary but not a decisive condition not only for a lawyer to be a judge but also for a physician to be a medico-legal expert. An expert can be not only a person appointed by the court but must also possess proper knowledge in a particular field, namely, the required professional and specialist qualifications and must also considered to be impartial. On the basis of the analysis of law in force and imperative regulations in Penal and Civil Codes, the authors have presented remarks relating to the expert's status as well as the lack of judicial control over the activity of experts appointed by court. Verification of professional qualifications in court experts and a reduction of those appointed 'ad hoc' are suggested. In the authors opinion co-operation between lawyers and experts should be improved. It is also essential to introduce statutory legal protection of court experts as well as to undertake activities leading to equaling the status of Polish court experts to that of other European countries.

  18. Photovoltaic panel clamp

    SciTech Connect

    Brown, Malcolm P.; Mittan, Margaret Birmingham; Miros, Robert H. J.; Stancel, Robert

    2013-03-19

    A photovoltaic panel clamp includes an upper and lower section. The interface between the assembled clamp halves and the module edge is filled by a flexible gasket material, such as EPDM rubber. The gasket preferably has small, finger like protrusions that allow for easy insertion onto the module edge while being reversed makes it more difficult to remove them from the module once installed. The clamp includes mounting posts or an integral axle to engage a bracket. The clamp also may include a locking tongue to secure the clamp to a bracket.

  19. Photovoltaic panel clamp

    DOEpatents

    Mittan, Margaret Birmingham; Miros, Robert H. J.; Brown, Malcolm P.; Stancel, Robert

    2012-06-05

    A photovoltaic panel clamp includes an upper and lower section. The interface between the assembled clamp halves and the module edge is filled by a flexible gasket material, such as EPDM rubber. The gasket preferably has small, finger like protrusions that allow for easy insertion onto the module edge while being reversed makes it more difficult to remove them from the module once installed. The clamp includes mounting posts or an integral axle to engage a bracket. The clamp also may include a locking tongue to secure the clamp to a bracket.

  20. Aerospace Safety Advisory Panel

    NASA Technical Reports Server (NTRS)

    1992-01-01

    The results of the Panel's activities are presented in a set of findings and recommendations. Highlighted here are both improvements in NASA's safety and reliability activities and specific areas where additional gains might be realized. One area of particular concern involves the curtailment or elimination of Space Shuttle safety and reliability enhancements. Several findings and recommendations address this area of concern, reflecting the opinion that safety and reliability enhancements are essential to the continued successful operation of the Space Shuttle. It is recommended that a comprehensive and continuing program of safety and reliability improvements in all areas of Space Shuttle hardware/software be considered an inherent component of ongoing Space Shuttle operations.

  1. Aerospace Safety Advisory Panel

    NASA Technical Reports Server (NTRS)

    2002-01-01

    This report presents the results of the Aerospace Safety Advisory Panel (ASAP) activities during 2002. The format of the report has been modified to capture a long-term perspective. Section II is new and highlights the Panel's view of NASA's safety progress during the year. Section III contains the pivotal safety issues facing NASA in the coming year. Section IV includes the program area findings and recommendations. The Panel has been asked by the Administrator to perform several special studies this year, and the resulting white papers appear in Appendix C. The year has been filled with significant achievements for NASA in both successful Space Shuttle operations and International Space Station (ISS) construction. Throughout the year, safety has been first and foremost in spite of many changes throughout the Agency. The relocation of the Orbiter Major Modifications (OMMs) from California to Kennedy Space Center (KSC) appears very successful. The transition of responsibilities for program management of the Space Shuttle and ISS programs from Johnson Space Center (JSC) to NASA Headquarters went smoothly. The decision to extend the life of the Space Shuttle as the primary NASA vehicle for access to space is viewed by the Panel as a prudent one. With the appropriate investments in safety improvements, in maintenance, in preserving appropriate inventories of spare parts, and in infrastructure, the Space Shuttle can provide safe and reliable support for the ISS for the foreseeable future. Indications of an aging Space Shuttle fleet occurred on more than one occasion this year. Several flaws went undetected in the early prelaunch tests and inspections. In all but one case, the problems were found prior to launch. These incidents were all handled properly and with safety as the guiding principle. Indeed, launches were postponed until the problems were fully understood and mitigating action could be taken. These incidents do, however, indicate the need to analyze the

  2. Concentrating photovoltaic solar panel

    DOEpatents

    Cashion, Steven A; Bowser, Michael R; Farrelly, Mark B; Hines, Braden E; Holmes, Howard C; Johnson, Jr., Richard L; Russell, Richard J; Turk, Michael F

    2014-04-15

    The present invention relates to photovoltaic power systems, photovoltaic concentrator modules, and related methods. In particular, the present invention features concentrator modules having interior points of attachment for an articulating mechanism and/or an articulating mechanism that has a unique arrangement of chassis members so as to isolate bending, etc. from being transferred among the chassis members. The present invention also features adjustable solar panel mounting features and/or mounting features with two or more degrees of freedom. The present invention also features a mechanical fastener for secondary optics in a concentrator module.

  3. Making a team of experts into an expert team.

    PubMed

    Charney, Carol

    2011-10-01

    Health care has traditionally been delivered primarily by experts working individually in a decentralized system lacking cohesive organization among professional disciplines. Only recently have the advantages of teamwork training been acknowledged in health care. This article explores the history, benefits, and recommendations for team training in neonatal care. TeamSTEPPS (Rockville, MD) and the revised Neonatal Resuscitation Program are cited as promising models for improved neonatal outcomes through professional teamwork.

  4. Microgap flat panel display

    DOEpatents

    Wuest, Craig R.

    1998-01-01

    A microgap flat panel display which includes a thin gas-filled display tube that utilizes switched X-Y "pixel" strips to trigger electron avalanches and activate a phosphor at a given location on a display screen. The panel utilizes the principal of electron multiplication in a gas subjected to a high electric field to provide sufficient electron current to activate standard luminescent phosphors located on an anode. The X-Y conductive strips of a few micron widths may for example, be deposited on opposite sides of a thin insulating substrate, or on one side of the adjacent substrates and function as a cathode. The X-Y strips are separated from the anode by a gap filled with a suitable gas. Electrical bias is selectively switched onto X and Y strips to activate a "pixel" in the region where these strips overlap. A small amount of a long-lived radioisotope is used to initiate an electron avalanche in the overlap region when bias is applied. The avalanche travels through the gas filled gap and activates a luminescent phosphor of a selected color. The bias is adjusted to give a proportional electron multiplication to control brightness for given pixel.

  5. Microgap flat panel display

    DOEpatents

    Wuest, C.R.

    1998-12-08

    A microgap flat panel display is disclosed which includes a thin gas-filled display tube that utilizes switched X-Y ``pixel`` strips to trigger electron avalanches and activate a phosphor at a given location on a display screen. The panel utilizes the principal of electron multiplication in a gas subjected to a high electric field to provide sufficient electron current to activate standard luminescent phosphors located on an anode. The X-Y conductive strips of a few micron widths may for example, be deposited on opposite sides of a thin insulating substrate, or on one side of the adjacent substrates and function as a cathode. The X-Y strips are separated from the anode by a gap filled with a suitable gas. Electrical bias is selectively switched onto X and Y strips to activate a ``pixel`` in the region where these strips overlap. A small amount of a long-lived radioisotope is used to initiate an electron avalanche in the overlap region when bias is applied. The avalanche travels through the gas filled gap and activates a luminescent phosphor of a selected color. The bias is adjusted to give a proportional electron multiplication to control brightness for given pixel. 6 figs.

  6. Solar panel parallel mounting configuration

    NASA Technical Reports Server (NTRS)

    Mutschler, Jr., Edward Charles (Inventor)

    1998-01-01

    A spacecraft includes a plurality of solar panels interconnected with a power coupler and an electrically operated device to provide power to the device when the solar cells are insolated. The solar panels are subject to bending distortion when entering or leaving eclipse. Spacecraft attitude disturbances are reduced by mounting each of the solar panels to an elongated boom made from a material with a low coefficient of thermal expansion, so that the bending of one panel is not communicated to the next. The boom may be insulated to reduce its bending during changes in insolation. A particularly advantageous embodiment mounts each panel to the boom with a single mounting, which may be a hinge. The single mounting prevents transfer of bending moments from the panel to the boom.

  7. Expert consensus contouring guidelines for IMRT in esophageal and gastroesophageal junction cancer

    PubMed Central

    Wu, Abraham J.; Bosch, Walter R.; Chang, Daniel T.; Hong, Theodore S.; Jabbour, Salma K.; Kleinberg, Lawrence R.; Mamon, Harvey J.; Thomas, Charles R.; Goodman, Karyn A.

    2015-01-01

    Purpose/Objective(s) Current guidelines for esophageal cancer contouring are derived from traditional two-dimensional fields based on bony landmarks, and do not provide sufficient anatomical detail to ensure consistent contouring for more conformal radiotherapy techniques such as intensity-modulated radiation therapy (IMRT). Therefore, we convened an expert panel with the specific aim to derive contouring guidelines and generate an atlas for the clinical target volume (CTV) in esophageal or gastroesophageal junction (GEJ) cancer. Methods and Materials Eight expert academically-based gastrointestinal radiation oncologists participated. Three sample cases were chosen: a GEJ cancer, a distal esophageal cancer, and a mid-upper esophageal cancer. Uniform CT simulation datasets and an accompanying diagnostic PET-CT were distributed to each expert, and he/she was instructed to generate gross tumor volume (GTV) and CTV contours for each case. All contours were aggregated and subjected to quantitative analysis to assess the degree of concordance between experts and generate draft consensus contours. The panel then refined these contours to generate the contouring atlas. Results Kappa statistics indicated substantial agreement between panelists for each of the three test cases. A consensus CTV atlas was generated for the three test cases, each representing common anatomic presentations of esophageal cancer. The panel agreed on guidelines and principles to facilitate the generalizability of the atlas to individual cases. Conclusions This expert panel successfully reached agreement on contouring guidelines for esophageal and GEJ IMRT and generated a reference CTV atlas. This atlas will serve as a reference for IMRT contours for clinical practice and prospective trial design. Subsequent patterns of failure analyses of clinical datasets utilizing these guidelines may require modification in the future. PMID:26104943

  8. Obesity, Diabetes, and Associated Costs of Exposure to Endocrine-Disrupting Chemicals in the European Union

    PubMed Central

    Legler, Juliette; Fletcher, Tony; Govarts, Eva; Porta, Miquel; Blumberg, Bruce; Heindel, Jerrold J.

    2015-01-01

    Context: Obesity and diabetes are epidemic in the European Union (EU). Exposure to endocrine-disrupting chemicals (EDCs) is increasingly recognized as a contributor, independent of diet and physical activity. Objective: The objective was to estimate obesity, diabetes, and associated costs that can be reasonably attributed to EDC exposures in the EU. Design: An expert panel evaluated evidence for probability of causation using weight-of-evidence characterization adapted from that applied by the Intergovernmental Panel on Climate Change. Exposure-response relationships and reference levels were evaluated for relevant EDCs, and biomarker data were organized from peer-reviewed studies to represent European exposure and burden of disease. Cost estimation as of 2010 utilized published cost estimates for childhood obesity, adult obesity, and adult diabetes. Setting, Patients and Participants, and Intervention: Cost estimation was performed from the societal perspective. Results: The panel identified a 40% to 69% probability of dichlorodiphenyldichloroethylene causing 1555 cases of overweight at age 10 (sensitivity analysis: 1555–5463) in 2010 with associated costs of €24.6 million (sensitivity analysis: €24.6–86.4 million). A 20% to 39% probability was identified for dichlorodiphenyldichloroethylene causing 28 200 cases of adult diabetes (sensitivity analysis: 28 200–56 400) with associated costs of €835 million (sensitivity analysis: €835 million–16.6 billion). The panel also identified a 40% to 69% probability of phthalate exposure causing 53 900 cases of obesity in older women and €15.6 billion in associated costs. Phthalate exposure was also found to have a 40% to 69% probability of causing 20 500 new-onset cases of diabetes in older women with €607 million in associated costs. Prenatal bisphenol A exposure was identified to have a 20% to 69% probability of causing 42 400 cases of childhood obesity, with associated lifetime costs of €1.54 billion

  9. [The surgeon, the expert, the judge].

    PubMed

    Vayre, P

    1996-12-01

    A study of 125 medico-legal opinions and evaluation of the literature allows for: an appreciation of the evolution in the concept in the jurisprudence pertaining to the responsibility of the surgeon in France in present practice conditions, a definition of the role of the legal expert, an explanation of the development of paths outside the procedural setting. In the present state of our knowledge the responsibility related to a prejudicial error has a frequency of 25-30% all jurisdictions and disciplines considered together. In 66% of cases the error is the absence of a timely treatment decision or a defective postoperative follow up. A mishap without proven error is present 50% of the cases which justifies a decision of coverage outside the civil responsibility of the surgeon. The modern conditions of surgical practice, the implications of the new technologies, the evolution of economic and socio-cultural ideas must lead the political decision makers and health-professionals to rapidly define a clear line of conduct. In the absence of comprehensive statistics from the courts, the qualitative and quantitative information contained in the national database "Remedhos France", now available, will be useful to inform the surgical community on the risk and its prevention, as well as to orient a homogenous doctrine and its applications in view of a common European approach.

  10. Heat exchanger expert system logic

    NASA Technical Reports Server (NTRS)

    Cormier, R.

    1988-01-01

    The reduction is described of the operation and fault diagnostics of a Deep Space Network heat exchanger to a rule base by the application of propositional calculus to a set of logic statements. The value of this approach lies in the ease of converting the logic and subsequently implementing it on a computer as an expert system. The rule base was written in Process Intelligent Control software.

  11. Uncertainty reasoning in expert systems

    NASA Technical Reports Server (NTRS)

    Kreinovich, Vladik

    1993-01-01

    Intelligent control is a very successful way to transform the expert's knowledge of the type 'if the velocity is big and the distance from the object is small, hit the brakes and decelerate as fast as possible' into an actual control. To apply this transformation, one must choose appropriate methods for reasoning with uncertainty, i.e., one must: (1) choose the representation for words like 'small', 'big'; (2) choose operations corresponding to 'and' and 'or'; (3) choose a method that transforms the resulting uncertain control recommendations into a precise control strategy. The wrong choice can drastically affect the quality of the resulting control, so the problem of choosing the right procedure is very important. From a mathematical viewpoint these choice problems correspond to non-linear optimization and are therefore extremely difficult. In this project, a new mathematical formalism (based on group theory) is developed that allows us to solve the problem of optimal choice and thus: (1) explain why the existing choices are really the best (in some situations); (2) explain a rather mysterious fact that fuzzy control (i.e., control based on the experts' knowledge) is often better than the control by these same experts; and (3) give choice recommendations for the cases when traditional choices do not work.

  12. Expert disagreement in bitemark casework.

    PubMed

    Bowers, C Michael; Pretty, Iain A

    2009-07-01

    Bitemark cases continue to raise controversy due to the degree of expert disagreement which is frequently seen. Using a case mix of 49 bitemark cases from 2000 to 2007 each injury was independently assessed for its forensic significance using a previously described bitemark severity scale. Following the assessment, the mean value for the bites was categorized according to the crime type, the degree of expert agreement, and the judicial outcome. Results suggest that bitemarks found in child abuse cases have statistically significantly lower forensic value than those in other crime types, that bites where there is mutual agreement between experts will have higher forensic value than those where there is disagreement at trial, and that cases in which DNA has provided an exoneration will demonstrate similar quality to those where a conviction was secured. Forensic odontologists should carefully assess bitemark evidence and ensure that it meets certain minimums in relation to the presence of class and unique features before undertaking an analysis. PMID:19486248

  13. Expert searching in public health

    PubMed Central

    Alpi, Kristine M.

    2005-01-01

    Objective: The article explores the characteristics of public health information needs and the resources available to address those needs that distinguish it as an area of searching requiring particular expertise. Methods: Public health searching activities from reference questions and literature search requests at a large, urban health department library were reviewed to identify the challenges in finding relevant public health information. Results: The terminology of the information request frequently differed from the vocabularies available in the databases. Searches required the use of multiple databases and/or Web resources with diverse interfaces. Issues of the scope and features of the databases relevant to the search questions were considered. Conclusion: Expert searching in public health differs from other types of expert searching in the subject breadth and technical demands of the databases to be searched, the fluidity and lack of standardization of the vocabulary, and the relative scarcity of high-quality investigations at the appropriate level of geographic specificity. Health sciences librarians require a broad exposure to databases, gray literature, and public health terminology to perform as expert searchers in public health. PMID:15685281

  14. Onboard navigation rendezvous expert system

    NASA Astrophysics Data System (ADS)

    Kocen, Michelle

    The Onboard Navigation rendezvous expert system is designed to aid the ground flight controller in monitoring the shuttle onboard navigation system. The system is designed to keep track of the navigation sensors and relative state vectors. In addition, the system also keeps an event log and fills out forms usually handled by the flight controller. This expert system is one of the few rendezvous specific systems being developed for the Mission Control Center. The expert system has been in development for six years. Through these years the system has seen hardware, software, and personnel changes. Initial development was done by the Information Systems Directorate (ISD) and Mission Operations Directorate (MOD) at Johnson Space Center. As of October 1, 1991 the system has been turned over to MOD. The system is completely developed except for some minor adjustments to the user interface. The rule base is in the verification stage with total certification of the system due to be completed by May 1992. Test cases for verification are obtained by saving data used for flight controller integrated simulations. The actual data comes from both the shuttle mission simulator and the Mission Control Center Computer. So far no actual flight data has been available. This paper covers all aspects of the system from the development history to the current hardware, software, and use of the system.

  15. ISEA 2007 Panel: Integration of Better Exposure Characterizations into Disaster Preparedness for Responders and the Public

    EPA Science Inventory

    An expert panel was convened in October 2007 at the International Society for Exposure Analysis (ISEA) Annual Meeting in Durham, NC, entitled “The Path Forward in Disaster Preparedness Since WTC—Exposure Characterization and Mitigation: Substantial Unfinished Business!” The pane...

  16. Optics Alignment Panel

    NASA Technical Reports Server (NTRS)

    Schroeder, Daniel J.

    1992-01-01

    The Optics Alignment Panel (OAP) was commissioned by the HST Science Working Group to determine the optimum alignment of the OTA optics. The goal was to find the position of the secondary mirror (SM) for which there is no coma or astigmatism in the camera images due to misaligned optics, either tilt or decenter. The despace position was reviewed of the SM and the optimum focus was sought. The results of these efforts are as follows: (1) the best estimate of the aligned position of the SM in the notation of HDOS is (DZ,DY,TZ,TY) = (+248 microns, +8 microns, +53 arcsec, -79 arcsec), and (2) the best focus, defined to be that despace which maximizes the fractional energy at 486 nm in a 0.1 arcsec radius of a stellar image, is 12.2 mm beyond paraxial focus. The data leading to these conclusions, and the estimated uncertainties in the final results, are presented.

  17. ALDS 1980 panel review

    SciTech Connect

    Hall, D. L.

    1981-11-01

    The overall goal of PNL (Pacific Northwest Laboratory) Applied Mathematical Sciences Research is development of a DOE (Department of Energy) capability for Analysis of Large Data Sets (ALDS) and transfer of this capability to other DOE laboratories and contractors. This capability is needed to satisfy DOE's increasing requirements for handling and analyzing large volumes of diverse energy and environmental data. The integrated statistics and computer science research includes the development of improved methodologies in data definition, data management, data analysis, and visual display. The purpose of this document is three-fold. First, the document is the permanent record of the ALDS 1979 panel review. Second, the document provides the PNL staff with a benchmark of where we were at the end of the second year of ALDS. Third, the document is available to laboratories, universities, and DOE headquarters as detailed description of the ALDS project, as well as an example of the new direction of AMS-funded research.

  18. Introduction to the panel

    NASA Astrophysics Data System (ADS)

    Forrest, Gary T.

    1990-05-01

    The way the last part of this seminar was structured was originally as a panel. And based on your survey results that you're all going to turn in when you leave, we tried to estimate what are the areas that you really want to know more about. And they change. Two years ago, Rich Bravman from Symbol Technologies came and he was one of the top ranked people for the day as far as the interest level, the way the material was presented. And we watched that market carefully. When you start to see laser diode based bar code scanners in the market, we decided that was a good time to come back. ESI is a phenomenal success in the diode pumped YAG market in electronics. Just unbelievable success with a brand new product, hit the market at exactly the right time for memory repair, and thirdly there's a lot of concern about the cost of laser diodes.

  19. Aerospace Safety Advisory Panel

    NASA Technical Reports Server (NTRS)

    2001-01-01

    This annual report is based on the activities of the Aerospace Safety Advisory Panel in calendar year 2000. During this year, the construction of the International Space Station (ISS) moved into high gear. The launch of the Russian Service Module was followed by three Space Shuttle construction and logistics flights and the deployment of the Expedition One crew. Continuous habitation of the ISS has begun. To date, both the ISS and Space Shuttle programs have met or exceeded most of their flight objectives. In spite of the intensity of these efforts, it is clear that safety was always placed ahead of cost and schedule. This safety consciousness permitted the Panel to devote more of its efforts to examining the long-term picture. With ISS construction accelerating, demands on the Space Shuttle will increase. While Russian Soyuz and Progress spacecraft will make some flights, the Space Shuttle remains the primary vehicle to sustain the ISS and all other U.S. activities that require humans in space. Development of a next generation, human-rated vehicle has slowed due to a variety of technological problems and the absence of an approach that can accomplish the task significantly better than the Space Shuttle. Moreover, even if a viable design were currently available, the realities of funding and development cycles suggest that it would take many years to bring it to fruition. Thus, it is inescapable that for the foreseeable future the Space Shuttle will be the only human-rated vehicle available to the U.S. space program for support of the ISS and other missions requiring humans. Use of the Space Shuttle will extend well beyond current planning, and is likely to continue for the life of the ISS.

  20. Can journalistic "false balance" distort public perception of consensus in expert opinion?

    PubMed

    Koehler, Derek J

    2016-03-01

    Media critics have expressed concern that journalistic "false balance" can distort the public's perceptions of what ought to be noncontroversial subjects (e.g., climate change). I report several experiments testing the influence of presenting conflicting comments from 2 experts who disagree on an issue (balance condition) in addition to a complete count of the number of experts on a panel who favor either side. Compared with a control condition, who received only the complete count, participants in the balance condition gave ratings of the perceived agreement among the experts that did not discriminate as clearly between issues with and without strong expert consensus. Participants in the balance condition also perceived less agreement among the experts in general, and were less likely to think that there was enough agreement among experts on the high-consensus issues to guide government policy. Evidently, "false balance" can distort perceptions of expert opinion even when participants would seem to have all the information needed to correct for its influence.

  1. Assessing Educational Quality: Knowledge Production and the Role of Experts. ENQA Workshop Report 6

    ERIC Educational Resources Information Center

    Aas, Gro Hanne; Askling, Berit; Dittrich, Karl; Froestad, Wenche; Haug, Peder; Lycke, Kirsten Hofgaard; Moitus, Sirpa; Pyykko, Riitta; Sorskar, Anne Karine

    2009-01-01

    This report is a product of an European Association for Quality Assurance in Higher Education (ENQA) Workshop "Assessing educational quality: Knowledge production and the role of experts" hosted by the Norwegian Agency for Quality Assurance in Education (NOKUT) in Oslo in February, 2008. The workshop gathered representatives from higher education…

  2. Cataloging Expert Systems: Optimism and Frustrated Reality.

    ERIC Educational Resources Information Center

    Olmstadt, William J.

    2000-01-01

    Discusses artificial intelligence and attempts to catalog expert systems. Topics include the nature of expertise; examples of cataloging expert systems; barriers to implementation; and problems, including total automation, cataloging expertise, priorities, and system design. (LRW)

  3. Galaxy Classification: Citizen Scientists versus Experts

    NASA Astrophysics Data System (ADS)

    Kautsch, Stefan J.; Vazquez, Richard; Phung, Chau; VanHilst, Michael; Castro, Victor H.; Bizyaev, Dmitry

    2016-01-01

    We present the differences of morphological galaxy classification between non-experts and experts. The non-experts are represented by college students and a retired adult community, who use an online application to visually classify galaxies selected from a galaxy morphology catalog. We find that the non-expert group lags the expert classification by one Hubble type behind, for instance, the non-experts classify a set of galaxies with Sb, while the experts classify the same set as Sc. We believe the reason is because the Hubble sequence is increasing the asymmetric structures towards later types. Our results show that the experts have the ability to identify more detailed structures, which the laymen commonly do not recognize.

  4. SciVal Experts: a collaborative tool.

    PubMed

    Vardell, Emily; Feddern-Bekcan, Tanya; Moore, Mary

    2011-01-01

    SciVal Experts is a resource for finding experts and fostering collaboration. The tool creates researcher profiles with automatically updated publication and grant information and faculty-inputted curriculum vitae, more fully capturing a researcher's body of work. SciVal Experts indexes campus-based "experts" by research topic, allowing faculty to find potential research partners and mentors, furthering translational research opportunities and dissemination of knowledge.

  5. Expert systems applied to spacecraft fire safety

    NASA Technical Reports Server (NTRS)

    Smith, Richard L.; Kashiwagi, Takashi

    1989-01-01

    Expert systems are problem-solving programs that combine a knowledge base and a reasoning mechanism to simulate a human expert. The development of an expert system to manage fire safety in spacecraft, in particular the NASA Space Station Freedom, is difficult but clearly advantageous in the long-term. Some needs in low-gravity flammability characteristics, ventilating-flow effects, fire detection, fire extinguishment, and decision models, all necessary to establish the knowledge base for an expert system, are discussed.

  6. Identification and Treatment of Patients with Homozygous Familial 
Hypercholesterolaemia: Information and Recommendations from a 
Middle East Advisory Panel

    PubMed Central

    Al-Ashwal, Abdullah; Alnouri, Fahad; Sabbour, Hani; Al-Mahfouz, Abdulraof; Al-Sayed, Nasreen; Razzaghy-Azar, Maryam; Al-Allaf, Faisal; Al-Waili, Khalid; Banerjee, Yajnavalka; Genest, Jacques; Santos, Raul D.; Al-Rasadi, Khalid

    2015-01-01

    We present clinical practice guidelines for the diagnosis and treatment of homozygous familial hypercholesterolaemia (HoFH) in the Middle East region. While guidelines are broadly applicable in Europe, in the Middle East we experience a range of confounding factors that complicate disease management to a point whereby the European guidance cannot be applied without significant modification. Specifically, for disease prevalence, the Middle East region has an established epidemic of diabetes and metabolic syndrome that can complicate treatment and mask a clinical diagnosis of HoFH. We have also a high incidence of consanguineous marriages, which increase the risk of transmission of recessive and homozygous genetic disorders. This risk is further augmented in autosomal dominant disorders such as familial 
hypercholesterolaemia (FH), in which a range of defective genes can be transmitted, all of which contribute to the phenotypic expression of the disease. In terms of treatment, we do not have access to lipoprotein apheresis on the same scale as in Europe, and there remains a significant reliance on statins, ezetimibe and the older plasma exchange methods. Additionally, we do not have widespread access to anti-apolipoprotein B therapies and microsomal transfer protein inhibitors. In order to adapt existing global guidance documents on HoFH to the Middle East region, we convened a panel of experts from Oman, Saudi Arabia, UAE, Iran and Bahrain to draft a regional guidance document for HoFH. We also included selected experts from outside the region. This panel statement will form the foundation of a detailed appraisal of the current FH management in the Middle Eastern population and thereby provide a suitable set of guidelines tailored for the region. PMID:26311574

  7. Identifying key conservation threats to Alpine birds through expert knowledge

    PubMed Central

    Pedrini, Paolo; Brambilla, Mattia; Rolando, Antonio; Girardello, Marco

    2016-01-01

    Alpine biodiversity is subject to a range of increasing threats, but the scarcity of data for many taxa means that it is difficult to assess the level and likely future impact of a given threat. Expert opinion can be a useful tool to address knowledge gaps in the absence of adequate data. Experts with experience in Alpine ecology were approached to rank threat levels for 69 Alpine bird species over the next 50 years for the whole European Alps in relation to ten categories: land abandonment, climate change, renewable energy, fire, forestry practices, grazing practices, hunting, leisure, mining and urbanization. There was a high degree of concordance in ranking of perceived threats among experts for most threat categories. The major overall perceived threats to Alpine birds identified through expert knowledge were land abandonment, urbanization, leisure and forestry, although other perceived threats were ranked highly for particular species groups (renewable energy and hunting for raptors, hunting for gamebirds). For groups of species defined according to their breeding habitat, open habitat species and treeline species were perceived as the most threatened. A spatial risk assessment tool based on summed scores for the whole community showed threat levels were highest for bird communities of the northern and western Alps. Development of the approaches given in this paper, including addressing biases in the selection of experts and adopting a more detailed ranking procedure, could prove useful in the future in identifying future threats, and in carrying out risk assessments based on levels of threat to the whole bird community. PMID:26966659

  8. What Is An Expert System? ERIC Digest.

    ERIC Educational Resources Information Center

    Boss, Richard W.

    This digest describes and defines the various components of an expert system, e.g., a computerized tool designed to enhance the quality and availability of knowledge required by decision makers. It is noted that expert systems differ from conventional applications software in the following areas: (1) the existence of the expert systems shell, or…

  9. Differentiating Experts' Anticipatory Skills in Beach Volleyball

    ERIC Educational Resources Information Center

    Canal-Bruland, Rouwen; Mooren, Merel; Savelsbergh, Geert J. P.

    2011-01-01

    In this study, we examined how perceptual-motor expertise and watching experience contribute to anticipating the outcome of opponents' attacking actions in beach volleyball. To this end, we invited 8 expert beach volleyball players, 8 expert coaches, 8 expert referees, and 8 control participants with no beach volleyball experience to watch videos…

  10. Expert Systems and Intelligent Information Retrieval.

    ERIC Educational Resources Information Center

    Brooks, H. M.

    1987-01-01

    Explores what an intelligent information retrieval system involves and why expert system techniques might interest system designers. Expert systems research is reviewed with emphasis on components, architecture, and computer interaction, and it is concluded that information retrieval is not an ideal problem domain for expert system application at…

  11. 16 CFR 1025.44 - Expert witnesses.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Expert witnesses. 1025.44 Section 1025.44 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL RULES OF PRACTICE FOR ADJUDICATIVE PROCEEDINGS Hearings § 1025.44 Expert witnesses. (a) Definition. An expert witness is one who, by reason of education, training, experience,...

  12. 16 CFR 1025.44 - Expert witnesses.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Expert witnesses. 1025.44 Section 1025.44 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL RULES OF PRACTICE FOR ADJUDICATIVE PROCEEDINGS Hearings § 1025.44 Expert witnesses. (a) Definition. An expert witness is one who, by reason of education, training, experience,...

  13. Explanation production by expert planners

    NASA Technical Reports Server (NTRS)

    Bridges, Susan; Jhannes, James D.

    1988-01-01

    Although the explanation capability of expert systems is usually listed as one of the distinguishing characteristics of these systems, the explanation facilities of most existing systems are quite primitive. Computer generated explanations are typically produced from canned text or by direct translation of the knowledge structures. Explanations produced in this manner bear little resemblance to those produced by humans for similar tasks. The focus of our research in explanation is the production of justifications for decisions by expert planning systems. An analysis of justifications written by people for planning tasks has been taken as the starting point. The purpose of this analysis is two-fold. First, analysis of the information content of the justifications will provide a basis for deciding what knowledge must be represented if human-like justifications are to be produced. Second, an analysis of the textual organization of the justifications will be used in the development of a mechanism for selecting and organizing the knowledge to be included in a computer-produced explanation. This paper describes a preliminary analysis done of justifications written by people for a planning task. It is clear that these justifications differ significantly from those that would be produced by an expert system by tracing the firing of production rules. The results from the text analysis have been used to develop an augmented phrase structured grammar (APSG) describing the organization of the justifications. The grammar was designed to provide a computationally feasible method for determining textual organization that will allow the necessary information to be communicated in a cohesive manner.

  14. World Ocean Assessment experts needed

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    2012-07-01

    The United Nations (UN) is inviting interested scientists to apply to be members of an international pool of 1000-2000 experts who will be authors and reviewers of its first World Ocean Assessment (WOA) report, slated for completion in 2014. The UN anticipates that subsequent WOA reports will be generated on a 5-year cycle. The first report will include more than 50 subjects grouped within four main themes: marine environment and understanding of the ocean's role in the global integrated Earth system, food security and safety, human activities that influence the ocean or are influenced by the ocean, and marine biological diversity. A scientific and technical summary is also planned.

  15. Diet expert subsystem for CELSS

    NASA Technical Reports Server (NTRS)

    Yendler, Boris S.; Nguyen, Thoi K.; Waleh, Ahmad

    1991-01-01

    An account is given of the mathematical basis of a diet-controlling expert system, designated 'Ceres' for the human crews of a Controlled Ecological Life Support System (CELSS). The Ceres methodology can furnish both steady-state and dynamic diet solutions; the differences between Ceres and a conventional nutritional-modeling method is illustrated by the case of a three-component, potato-wheat-soybean food system. Attention is given to the role of food processing in furnishing flexibility in diet-planning management. Crew diet solutions based on simple optimizations are not necessarily the most suitable for optimum CELSS operation.

  16. Expert system for train control

    NASA Astrophysics Data System (ADS)

    Drish, William F., Jr.

    1995-08-01

    The train energy model (TEM), a general train simulator developed at the Association of American Railroads, is widely used in the railroad industry. Recently, a new train controller, the general automatic train-controller (GAT), has been developed for TEM. In the GAT, the 'intelligence' or 'expertise' is a set of 'if-then' train-handling rules in an external file. The expert system for train control presented in this paper is a slightly simplified version of the GAT. The main thesis of this paper is: simple, unchained rules are adequate for complex train control. Thus, an 'inference engine' using forward chaining is not required.

  17. Fuzzy expert systems using CLIPS

    NASA Technical Reports Server (NTRS)

    Le, Thach C.

    1994-01-01

    This paper describes a CLIPS-based fuzzy expert system development environment called FCLIPS and illustrates its application to the simulated cart-pole balancing problem. FCLIPS is a straightforward extension of CLIPS without any alteration to the CLIPS internal structures. It makes use of the object-oriented and module features in CLIPS version 6.0 for the implementation of fuzzy logic concepts. Systems of varying degrees of mixed Boolean and fuzzy rules can be implemented in CLIPS. Design and implementation issues of FCLIPS will also be discussed.

  18. 75 FR 27554 - Science Advisory Board Staff Office; Request for Nominations of Experts for the SAB Arsenic...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-17

    ... AGENCY Science Advisory Board Staff Office; Request for Nominations of Experts for the SAB Arsenic Review... SAB panel to review EPA's Integrated Risk Information System (IRIS) assessment for inorganic arsenic... INFORMATION: EPA is revising an assessment for arsenic in support of EPA's Integrated Risk Information...

  19. 75 FR 58383 - Science Advisory Board Staff Office Request for Nominations of Experts for the Review of Great...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-24

    ... experience in one or more of the following areas: Limnology, landscape ecology, restoration ecology... Lakes Restoration Initiative Action Plan AGENCY: Environmental Protection Agency (EPA). ACTION: Notice... experts to form an SAB panel to review the interagency Great Lakes Restoration Initiative (GLRI)...

  20. 76 FR 32957 - Hydrographic Services Review Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-07

    ... National Oceanic and Atmospheric Administration Hydrographic Services Review Panel AGENCY: National Ocean... membership solicitation for Hydrographic Services Review Panel. SUMMARY: This notice responds to the... on the Hydrographic Services Review Panel (HSRP). The HSRP, a Federal advisory committee, advises...

  1. Evaluation of proposed panel closure modifications at WIPP

    SciTech Connect

    Allen, Lawrence E.; Silva, Matthew K.; Channell, James K.; Abel, John F.; Morgan, Dudley R.

    2001-12-31

    A key component in the design of the WIPP repository is the installation of concrete structures as panel seals in the intake and exhaust drifts after a panel has been filled with waste containers. As noted in the EPA final rule, the panel seal closure system is intended to block brine flow between the waste panels at the WIPP. On April 17, 2001, the DOE proposed seven modifications to the EPA concerning the design of the panel closure system. EPA approval of these modifications is necessary since the details of the panel design are specified in EPA’s final rule as a condition for WIPP certification. However, the EPA has not determined whether a rulemaking would be required for these proposed design modifications. On September 4, 2001, the DOE withdrew the request, noting that it would be resubmitted on a future date. The Environmental Evaluation Group (EEG) contracted with two engineers, Dr. John Abel and Dr. Rusty Morgan, to evaluate the proposed modifications. The EEG has accepted the conclusions and recommendations from these two experts: 1) replacement of Salado Mass Concrete with a generic salt-based concrete; 2) replacement of the explosion wall with a construction wall; 3) replacement of freshwater grouting with salt-based grouting; 4) option to allow surface or underground mixing; and 5) option to allow up to one year for completion of closure. The proposed modification to allow local carbonate river rock as aggregate is acceptable pending demonstration that no problems will exist in the resulting concrete. The proposed modification to give the contractor discretion in removal of steel forms is not supported. Instead, several recommendations are made to specifically reduce the number of forms left, thereby reducing potential migration pathways.

  2. Aerospace Safety Advisory Panel

    NASA Astrophysics Data System (ADS)

    1989-03-01

    This report provides findings, conclusions and recommendations regarding the National Space Transportation System (NSTS), the Space Station Freedom Program (SSFP), aeronautical projects and other areas of NASA activities. The main focus of the Aerospace Safety Advisory Panel (ASAP) during 1988 has been monitoring and advising NASA and its contractors on the Space Transportation System (STS) recovery program. NASA efforts have restored the flight program with a much better management organization, safety and quality assurance organizations, and management communication system. The NASA National Space Transportation System (NSTS) organization in conjunction with its prime contractors should be encouraged to continue development and incorporation of appropriate design and operational improvements which will further reduce risk. The data from each Shuttle flight should be used to determine if affordable design and/or operational improvements could further increase safety. The review of Critical Items (CILs), Failure Mode Effects and Analyses (FMEAs) and Hazard Analyses (HAs) after the Challenger accident has given the program a massive data base with which to establish a formal program with prioritized changes.

  3. Aerospace Safety Advisory Panel

    NASA Technical Reports Server (NTRS)

    1989-01-01

    This report provides findings, conclusions and recommendations regarding the National Space Transportation System (NSTS), the Space Station Freedom Program (SSFP), aeronautical projects and other areas of NASA activities. The main focus of the Aerospace Safety Advisory Panel (ASAP) during 1988 has been monitoring and advising NASA and its contractors on the Space Transportation System (STS) recovery program. NASA efforts have restored the flight program with a much better management organization, safety and quality assurance organizations, and management communication system. The NASA National Space Transportation System (NSTS) organization in conjunction with its prime contractors should be encouraged to continue development and incorporation of appropriate design and operational improvements which will further reduce risk. The data from each Shuttle flight should be used to determine if affordable design and/or operational improvements could further increase safety. The review of Critical Items (CILs), Failure Mode Effects and Analyses (FMEAs) and Hazard Analyses (HAs) after the Challenger accident has given the program a massive data base with which to establish a formal program with prioritized changes.

  4. Consumer panel study on elderly people's wishes concerning services.

    PubMed

    Valkila, Noora; Litja, Heli; Aalto, Leena; Saari, Arto

    2010-01-01

    This study informs on the wishes and needs of elderly people themselves regarding services for the elderly. The data for the study were gathered using a consumer panel method. Elderly people desire assistance in heavy cleaning chores, in outdoor activities and in carrying out their personal business. Elderly people felt that there should be more recreational services available. Elderly people link aging with feelings of insecurity and loneliness. Becoming a service user for the first time is felt to be a very difficult step to take, and so this decision is postponed as long as possible. The elderly people desire a service for assessing their individual service needs in an organized, expert and objective fashion. The study indicates that elderly people value the human contact gained through service provision. The consumer panel method for collecting data was successful.

  5. Nickel hydrogen battery expert system

    NASA Technical Reports Server (NTRS)

    Shiva, Sajjan G.

    1991-01-01

    The Hubble Telescope Battery Testbed at MSFC uses the Nickel Cadmium (NiCd) Battery Expert System (NICBES-2) which supports the evaluation of performance of Hubble Telescope spacecraft batteries and provides alarm diagnosis and action advice. NICBES-2 provides a reasoning system along with a battery domain knowledge base to achieve this battery health management function. An effort is summarized which was used to modify NICBES-2 to accommodate Nickel Hydrogen (NiH2) battery environment now in MSFC testbed. The NICBES-2 is implemented on a Sun Microsystem and is written in SunOS C and Quintus Prolog. The system now operates in a multitasking environment. NICBES-2 spawns three processes: serial port process (SPP); data handler process (DHP); and the expert system process (ESP) in order to process the telemetry data and provide the status and action advice. NICBES-2 performs orbit data gathering, data evaluation, alarm diagnosis and action advice and status and history display functions. The adaptation of NICBES-2 to work with NiH2 battery environment required modification to all of the three component processes.

  6. Panelized wall system with foam core insulation

    DOEpatents

    Kosny, Jan; Gaskin, Sally

    2009-10-20

    A wall system includes a plurality of wall members, the wall members having a first metal panel, a second metal panel, and an insulating core between the first panel and the second panel. At least one of the first panel and the second panel include ridge portions. The insulating core can be a foam, such as a polyurethane foam. The foam can include at least one opacifier to improve the k-factor of the foam.

  7. Glass/Epoxy Door Panel for Automobiles

    NASA Technical Reports Server (NTRS)

    Bauer, J. L. JR.

    1985-01-01

    Lightweight panel cost-effective. Integrally-molded intrusion strap key feature of composite outer door panel. Strap replaces bulky and heavy steel instrusion beam of conventional door. Standard steel inner panel used for demonstration purposes. Door redesigned to exploit advantages of composite outer panel thinner. Outer panel for automobilie door, made of glass/epoxy composite material, lighter than conventional steel door panel, meets same strength requirements, and less expensive.

  8. Species identification by experts and non-experts: comparing images from field guides

    PubMed Central

    Austen, G. E.; Bindemann, M.; Griffiths, R. A.; Roberts, D. L.

    2016-01-01

    Accurate species identification is fundamental when recording ecological data. However, the ability to correctly identify organisms visually is rarely questioned. We investigated how experts and non-experts compared in the identification of bumblebees, a group of insects of considerable conservation concern. Experts and non-experts were asked whether two concurrent bumblebee images depicted the same or two different species. Overall accuracy was below 60% and comparable for experts and non-experts. However, experts were more consistent in their answers when the same images were repeated, and more cautious in committing to a definitive answer. Our findings demonstrate the difficulty of correctly identifying bumblebees using images from field guides. Such error rates need to be accounted for when interpreting species data, whether or not they have been collected by experts. We suggest that investigation of how experts and non-experts make observations should be incorporated into study design, and could be used to improve training in species identification. PMID:27644140

  9. Species identification by experts and non-experts: comparing images from field guides.

    PubMed

    Austen, G E; Bindemann, M; Griffiths, R A; Roberts, D L

    2016-01-01

    Accurate species identification is fundamental when recording ecological data. However, the ability to correctly identify organisms visually is rarely questioned. We investigated how experts and non-experts compared in the identification of bumblebees, a group of insects of considerable conservation concern. Experts and non-experts were asked whether two concurrent bumblebee images depicted the same or two different species. Overall accuracy was below 60% and comparable for experts and non-experts. However, experts were more consistent in their answers when the same images were repeated, and more cautious in committing to a definitive answer. Our findings demonstrate the difficulty of correctly identifying bumblebees using images from field guides. Such error rates need to be accounted for when interpreting species data, whether or not they have been collected by experts. We suggest that investigation of how experts and non-experts make observations should be incorporated into study design, and could be used to improve training in species identification. PMID:27644140

  10. Epistemology applied to conclusions of expert reports.

    PubMed

    Lucena-Molina, Jose-Juan

    2016-07-01

    It is believed that to build a robust reasoning logic to make probabilistic inferences in forensic science from a merely mathematical or logistical viewpoint is not enough. Mathematical logic is the positive science of reasoning and as for that it is only interested in the positive calculus of its validity, regardless any prior ontological assumption. But without a determined ontology and epistemology which imply to define the concepts that they will use, it seems difficult that the proposed scientifically correct mathematical solution be successful as a European standard for making conclusions in forensic reports because it has to be based on judicial language. Forensic experts and Courts are not interested in the development of a positive science but in a practical science: in clarifying whether certain known facts are related to a possible crime. Therefore, not only the coherence of the demonstrative logic reasoning used (logic of propositions) is important, but also the precision of the concepts used by language and consistency among them in reasoning (logic of concepts). There is a linguistic level essential for a successful communication between the forensic practitioner and the Court which is mainly related, in our opinion, to semantics and figures of speech. The first one is involved because words used in forensic conclusions often have different meanings - it is said that they are polysemic - and the second one because there is often metonymy as well. Besides, semantic differences among languages regarding words with the same etymological root add another difficulty for a better mutual understanding. The two main European judicial systems inherit a wide and deep culture related to evidence in criminal proceedings and each of them has coined their own terminology but there are other two more abstract levels such as logical and epistemological, where we can find solid arguments by which terms used at legal level on conclusions of forensic reports could be

  11. Epistemology applied to conclusions of expert reports.

    PubMed

    Lucena-Molina, Jose-Juan

    2016-07-01

    It is believed that to build a robust reasoning logic to make probabilistic inferences in forensic science from a merely mathematical or logistical viewpoint is not enough. Mathematical logic is the positive science of reasoning and as for that it is only interested in the positive calculus of its validity, regardless any prior ontological assumption. But without a determined ontology and epistemology which imply to define the concepts that they will use, it seems difficult that the proposed scientifically correct mathematical solution be successful as a European standard for making conclusions in forensic reports because it has to be based on judicial language. Forensic experts and Courts are not interested in the development of a positive science but in a practical science: in clarifying whether certain known facts are related to a possible crime. Therefore, not only the coherence of the demonstrative logic reasoning used (logic of propositions) is important, but also the precision of the concepts used by language and consistency among them in reasoning (logic of concepts). There is a linguistic level essential for a successful communication between the forensic practitioner and the Court which is mainly related, in our opinion, to semantics and figures of speech. The first one is involved because words used in forensic conclusions often have different meanings - it is said that they are polysemic - and the second one because there is often metonymy as well. Besides, semantic differences among languages regarding words with the same etymological root add another difficulty for a better mutual understanding. The two main European judicial systems inherit a wide and deep culture related to evidence in criminal proceedings and each of them has coined their own terminology but there are other two more abstract levels such as logical and epistemological, where we can find solid arguments by which terms used at legal level on conclusions of forensic reports could be

  12. AGU Sonar Data Restriction Panel

    NASA Astrophysics Data System (ADS)

    The AGU Council accepted the report of the panel set up in February to study the issue of restriction by the U.S. Navy of access to high-resolution sonar data for the U.S. Exclusive Economic Zone. Panel chairman John Bossier announced that “the Navy has acted in the best interests of the nation” in lifting the restriction order. Only two areas, egress routes to two submarine bases (see “Navy Defines Areas Under Sonar Ban,” in News, this issue), remain restricted.Panel members were Bruce Douglas, Alexander Malahoff, Donald Piepgras, Paul Richards, David Smith and Manik Talwani.

  13. European Population Substructure: Clustering of Northern and Southern Populations

    PubMed Central

    Seldin, Michael F; Shigeta, Russell; Villoslada, Pablo; Selmi, Carlo; Tuomilehto, Jaakko; Silva, Gabriel; Belmont, John W; Klareskog, Lars; Gregersen, Peter K

    2006-01-01

    Using a genome-wide single nucleotide polymorphism (SNP) panel, we observed population structure in a diverse group of Europeans and European Americans. Under a variety of conditions and tests, there is a consistent and reproducible distinction between “northern” and “southern” European population groups: most individual participants with southern European ancestry (Italian, Spanish, Portuguese, and Greek) have >85% membership in the “southern” population; and most northern, western, eastern, and central Europeans have >90% in the “northern” population group. Ashkenazi Jewish as well as Sephardic Jewish origin also showed >85% membership in the “southern” population, consistent with a later Mediterranean origin of these ethnic groups. Based on this work, we have developed a core set of informative SNP markers that can control for this partition in European population structure in a variety of clinical and genetic studies. PMID:17044734

  14. Expert Views on Innovative Future Uses for Contact Lenses.

    PubMed

    Jones, Lyndon W; Chauhan, Anuj; Di Girolamo, Nick; Sheedy, Jim; Smith, Earl

    2016-04-01

    Over the past 10 to 15 years, the availability of new materials and technologies has resulted in revolutionary concepts for contact lenses being proposed that go well beyond correcting vision. These novel uses include their prescribing to deliver topical ocular and systemic drugs, assist with ocular surface disease management, and limit the progression of myopia and novel methods to display visual information. How likely are these concepts to become commercially available, how successful will they be, and what are the potential issues to consider for them to come to market? To answer these questions, a panel of four experts were invited to discuss the benefits and pitfalls of these technologies and what challenges lay ahead of these concepts before their availability. Their responses provide a fascinating insight for the clinician into the likelihood of such revolutionary contact lenses being available in a clinical setting.

  15. Burden of disease and costs of exposure to endocrine disrupting chemicals in the European Union: an updated analysis.

    PubMed

    Trasande, L; Zoeller, R T; Hass, U; Kortenkamp, A; Grandjean, P; Myers, J P; DiGangi, J; Hunt, P M; Rudel, R; Sathyanarayana, S; Bellanger, M; Hauser, R; Legler, J; Skakkebaek, N E; Heindel, J J

    2016-07-01

    A previous report documented that endocrine disrupting chemicals contribute substantially to certain forms of disease and disability. In the present analysis, our main objective was to update a range of health and economic costs that can be reasonably attributed to endocrine disrupting chemical exposures in the European Union, leveraging new burden and disease cost estimates of female reproductive conditions from accompanying report. Expert panels evaluated the epidemiologic evidence, using adapted criteria from the WHO Grading of Recommendations Assessment, Development and Evaluation Working Group, and evaluated laboratory and animal evidence of endocrine disruption using definitions recently promulgated by the Danish Environmental Protection Agency. The Delphi method was used to make decisions on the strength of the data. Expert panels consensus was achieved for probable (>20%) endocrine disrupting chemical causation for IQ loss and associated intellectual disability; autism; attention deficit hyperactivity disorder; endometriosis; fibroids; childhood obesity; adult obesity; adult diabetes; cryptorchidism; male infertility, and mortality associated with reduced testosterone. Accounting for probability of causation, and using the midpoint of each range for probability of causation, Monte Carlo simulations produced a median annual cost of €163 billion (1.28% of EU Gross Domestic Product) across 1000 simulations. We conclude that endocrine disrupting chemical exposures in the EU are likely to contribute substantially to disease and dysfunction across the life course with costs in the hundreds of billions of Euros per year. These estimates represent only those endocrine disrupting chemicals with the highest probability of causation; a broader analysis would have produced greater estimates of burden of disease and costs.

  16. Burden of disease and costs of exposure to endocrine disrupting chemicals in the European Union: an updated analysis.

    PubMed

    Trasande, L; Zoeller, R T; Hass, U; Kortenkamp, A; Grandjean, P; Myers, J P; DiGangi, J; Hunt, P M; Rudel, R; Sathyanarayana, S; Bellanger, M; Hauser, R; Legler, J; Skakkebaek, N E; Heindel, J J

    2016-07-01

    A previous report documented that endocrine disrupting chemicals contribute substantially to certain forms of disease and disability. In the present analysis, our main objective was to update a range of health and economic costs that can be reasonably attributed to endocrine disrupting chemical exposures in the European Union, leveraging new burden and disease cost estimates of female reproductive conditions from accompanying report. Expert panels evaluated the epidemiologic evidence, using adapted criteria from the WHO Grading of Recommendations Assessment, Development and Evaluation Working Group, and evaluated laboratory and animal evidence of endocrine disruption using definitions recently promulgated by the Danish Environmental Protection Agency. The Delphi method was used to make decisions on the strength of the data. Expert panels consensus was achieved for probable (>20%) endocrine disrupting chemical causation for IQ loss and associated intellectual disability; autism; attention deficit hyperactivity disorder; endometriosis; fibroids; childhood obesity; adult obesity; adult diabetes; cryptorchidism; male infertility, and mortality associated with reduced testosterone. Accounting for probability of causation, and using the midpoint of each range for probability of causation, Monte Carlo simulations produced a median annual cost of €163 billion (1.28% of EU Gross Domestic Product) across 1000 simulations. We conclude that endocrine disrupting chemical exposures in the EU are likely to contribute substantially to disease and dysfunction across the life course with costs in the hundreds of billions of Euros per year. These estimates represent only those endocrine disrupting chemicals with the highest probability of causation; a broader analysis would have produced greater estimates of burden of disease and costs. PMID:27003928

  17. Thin film concentrator panel development

    NASA Technical Reports Server (NTRS)

    Zimmerman, D. K.

    1982-01-01

    The development and testing of a rigid panel concept that utilizes a thin film reflective surface for application to a low-cost point-focusing solar concentrator is discussed. It is shown that a thin film reflective surface is acceptable for use on solar concentrators, including 1500 F applications. Additionally, it is shown that a formed steel sheet substrate is a good choice for concentrator panels. The panel has good optical properties, acceptable forming tolerances, environmentally resistant substrate and stiffeners, and adaptability to low to mass production rates. Computer simulations of the concentrator optics were run using the selected reflector panel design. Experimentally determined values for reflector surface specularity and reflectivity along with dimensional data were used in the analysis. The simulations provided intercept factor and net energy into the aperture as a function of aperture size for different surface errors and pointing errors. Point source and Sun source optical tests were also performed.

  18. PRSEUS Panel Fabrication Final Report

    NASA Technical Reports Server (NTRS)

    Linton, Kim A.; Velicki, Alexander; Hoffman, Krishna; Thrash, Patrick; Pickell, Robert; Turley, Robert

    2014-01-01

    NASA and the Boeing Company have been working together under the Environmentally Responsible Aviation Project to develop stitched unitized structure for reduced weight, reduced fuel burn and reduced pollutants in the next generation of commercial aircraft. The structural concept being evaluated is PRSEUS (Pultruded Rod Stitched Efficient Unitized Structure). In the PRSEUS concept, dry carbon fabric, pultruded carbon rods, and foam are stitched together into large preforms. Then these preforms are infused with an epoxy resin into large panels in an out-of-autoclave process. These panels have stiffeners in the length-wise and width-wise directions but contain no fasteners because all stiffeners are stitched to the panel skin. This document contains a description of the fabrication of panels for use in the 30-foot-long Multi-Bay Box test article to be evaluated at NASA LaRC.

  19. Exascale Workshop Panel Report Meeting

    SciTech Connect

    Khaleel, Mohammad A.

    2010-07-01

    The Exascale Review Panel consists of 12 scientists and engineers with experience in various aspects of high-performance computing and its application, development, and management. The Panel hear presentations by several representatives of the workshops and town meetings convened over the past few years to examine the need for exascale computation capability and the justification for a U.S. Department of Energy (DOE) program to develop such capability. This report summarizes information provided by the presenters and substantial written reports to the Panel in advance of the meeting in Washington D.C. on January 19-20, 2010. The report also summarizes the Panel's conclusions with regard to the justification of a DOE-led exascale initiative.

  20. Panel to review EOSDIS plans

    NASA Technical Reports Server (NTRS)

    1994-01-01

    Formed in Jan. 1992, the Panel to Review EOSDIS Plans was charged with advising NASA on its plans for developing the Earth Observing System (EOS) Data and Information System (EOSDIS). Specifically, the panel was asked to do the following: assess the validity of the engineering and technical underpinnings of the EOSDIS; assess its potential value to scientific users; suggest how technical risk can be minimized; and assess whether current plans are sufficiently resilient to be adaptable to changing technology and requirements such as budget environments, data volumes, new users, and new databases. The panel completed an interim report (Addendum A) and transmitted it to NASA and other interested parties in the government on 9 Apr. 1992. Because of a delay in NASA's plans to select the contractor for EOSDIS, the panel was not able to complete its review of the program according to the original government request. With the issuance of a letter report (Addendum B) on 28 Sep. 1992, the panel became inactive until such time as NASA could release the details of the contractor's proposed architecture, schedule, and costs for developing EOSDIS. In early 1993, NASA awarded the contract for the EOSDIS Core System (ECS). On 20 Apr. 1993, NASA asked the panel to reconvene to do the following: ( 1) complete its review of NASA's approach to the EOSDIS architecture and implementation; (2) appraise NASA's responses to the panel's previous recommendations; and (3) review the planning for EOSDIS in the context of NASA's role in the Global Change Data and Information System (GCDIS) implementation plan. To respond to the NASA charge, the panel met three times in 1993 including sessions with NASA officials and the EOSDIS contractor. In addition, several of the panel members visited individual Distributed Active Archive Centers (DAAC's) to obtain additional views of EOSDIS. The panel has now obtained substantial information on the EOSDIS budget, contractor work program, and current

  1. Advances in the physics basis for the European DEMO design

    NASA Astrophysics Data System (ADS)

    Wenninger, R.; Arbeiter, F.; Aubert, J.; Aho-Mantila, L.; Albanese, R.; Ambrosino, R.; Angioni, C.; Artaud, J.-F.; Bernert, M.; Fable, E.; Fasoli, A.; Federici, G.; Garcia, J.; Giruzzi, G.; Jenko, F.; Maget, P.; Mattei, M.; Maviglia, F.; Poli, E.; Ramogida, G.; Reux, C.; Schneider, M.; Sieglin, B.; Villone, F.; Wischmeier, M.; Zohm, H.

    2015-06-01

    In the European fusion roadmap, ITER is followed by a demonstration fusion power reactor (DEMO), for which a conceptual design is under development. This paper reports the first results of a coherent effort to develop the relevant physics knowledge for that (DEMO Physics Basis), carried out by European experts. The program currently includes investigations in the areas of scenario modeling, transport, MHD, heating & current drive, fast particles, plasma wall interaction and disruptions.

  2. Policy relevant results from an expert elicitation on the health risks of phthalates

    PubMed Central

    2012-01-01

    Background The EU 6th Framework Program (FP)-funded Health and Environment Network (HENVINET) aimed to support informed policy making by facilitating the availability of relevant knowledge on different environmental health issues. An approach was developed by which scientific agreement, disagreement, and knowledge gaps could be efficiently identified, and expert advice prepared in a way that is usable for policy makers. There were two aims of the project: 1) to apply the tool to a relevant issue; the potential health impacts of the widely used plasticizers, phthalates, and 2) to evaluate the method and the tool by asking both scientific experts and the target audience, namely policy makers and stakeholders, for their opinions. Methods The tool consisted of an expert consultation in several steps on the issue of phthalates in environmental health. A diagram depicting the cause-effect chain, from the production and use of phthalates to potential health impacts, was prepared based on existing reviews. This was used as a basis for an online questionnaire, through which experts in the field were consulted. The results of this first round of consultation laid the foundation for a new questionnaire answered by an expert panel that, subsequently, also discussed approaches and results in a workshop. One major task of the expert panel was to pinpoint priorities from the cause-effect chain according to their impact on the extent of potential health risks and their relevance for reducing uncertainty. The results were condensed into a policy brief that was sent to policy makers and stakeholders for their evaluation. Results The experts agreed about the substantial knowledge gaps within the field of phthalates. The top three priorities for further research and policy action were: 1) intrauterine exposure, 2) reproductive toxicology, and 3) exposure from medical devices. Although not all relevant information from the cause-effect chain is known for phthalates, most experts

  3. Two Thick Microwave Dichroic Panels

    NASA Technical Reports Server (NTRS)

    Epp, Larry W.; Chen, Jacqueline C.; Stanton, Philip H.; Jorgenson, Roy E.

    1994-01-01

    Cross-shaped apertures enable relatively tight packing, eliminating some grating lobes. Two panels made of thin, honey-comblike metal walls constitute planar arrays of waveguidelike apertures designed to satisfy special requirements with respect to microwave transmittance and reflectance. Considered for use in multiplexing signals at various frequencies in microwave communication system. Both panels required to exhibit low insertion loss. Angle of incidence 30 degrees.

  4. A formal expert judgment procedure for performance assessments of the Waste Isolation Pilot Plant

    SciTech Connect

    Trauth, K.M.; Guzowski, R.V.; Hora, S.C.

    1993-12-31

    The Waste Isolation Pilot Plant (WIPP) is an experimental facility located in southeastern New Mexico. It has been designed to determine the feasibility of the geologic disposal of defense-generated transuranic waste in a deep bedded-salt formation. The WIPP was also designed for disposal and will operate in that capacity if approved. The WIPP Performance Assessment Department at Sandia National Laboratories has been conducting analyses to assess the long-term performance of the WIPP. These analyses sometimes require the use of expert judgment. This Department has convened several expert-judgment panels and from that experience has developed an internal quality-assurance procedure to guide the formal elicitation of expert judgment. This protocol is based on the principles found in the decision-analysis literature.

  5. A formal expert judgment procedure for performance assessments of the Waste Isolation Pilot Plant

    SciTech Connect

    Trauth, K.M.; Guzowski, R.V.; Hora, S.C.

    1994-09-01

    The Waste Isolation Pilot Plant (WIPP) is an experimental facility located in southeastern New Mexico. It has been designed to determine the feasibility of the geologic disposal of defense-generated transuranic waste in a deep bedded-salt formation. The WIPP was also designed for disposal and will operate in that capacity if approved. The WIPP Performance Assessment Department at Sandia National Laboratories has been conducting analyses to assess the long-term performance of the WIPP. These analyses sometimes require the use of expert judgment. This Department has convened several expert-judgment panels and from that experience has developed an internal quality-assurance procedure to guide the formal elicitation of expert judgment. This protocol is based on the principles found in the decision-analysis literature.

  6. Expert system technology for nondestructive waste assay

    SciTech Connect

    Becker, G.K.; Determan, J.C.

    1998-07-01

    Nondestructive assay waste characterization data generated for use in the National TRU Program must be of known and demonstrable quality. Each measurement is required to receive an independent technical review by a qualified expert. An expert system prototype has been developed to automate waste NDA data review of a passive/active neutron drum counter system. The expert system is designed to yield a confidence rating regarding measurement validity. Expert system rules are derived from data in a process involving data clustering, fuzzy logic, and genetic algorithms. Expert system performance is assessed against confidence assignments elicited from waste NDA domain experts. Performance levels varied for the active, passive shielded, and passive system assay modes of the drum counter system, ranging from 78% to 94% correct classifications.

  7. Expert Meeting Report: Foundations Research Results

    SciTech Connect

    Ojczyk, C.; Huelman, P.; Carmody, J.

    2013-05-01

    In the Expert Meeting Plan, the NorthernSTAR Team proposed to host two Expert Meetings in calendar year 2011. Invitees to the meetings would include experts in the current field of study, other BA team members, and representatives from DOE and NREL. They will invite leading industry experts to present at these meetings. The Expert Meetings will focus on key systems areas that will be required to meet the Building America performance goals and shall be sufficiently narrow in scope that specific conclusions, action items, and delegation of future tasks can be identified and completed. The two expert meeting topics are 'Foundations' and 'Window Retrofit.' The first session is designed as a webinar only and the second will be a live meeting.

  8. Brain response to birdsongs in bird experts.

    PubMed

    Chartrand, Jean-Pierre; Filion-Bilodeau, Sarah; Belin, Pascal

    2007-03-01

    Auditory expertise has mostly been studied in relation to musical processing, but expert auditory processing can also involve nonmusical auditory stimuli, such as birdsongs in bird experts. In this study, the neural correlates of bird expertise were investigated by using electroencephalography to measure auditory-evoked potentials in bird experts and novices. Auditory stimuli in three categories (birdsongs, environmental sounds and voices) were presented in a pseudo-random order while participants performed a simple target detection task (pure tone). We observed similar amplitudes and distributions of the N100-component in bird experts and novices. In contrast, the amplitude of the P200 component was significantly smaller in bird experts at the Pz and Cz electrodes, reflecting a more frontal topography of this positivity. Notably, this group difference was observed not only for birdsongs, but also for voices and environmental sounds, suggesting a general processing difference in bird experts, not restricted to the category of expertise.

  9. Brain response to birdsongs in bird experts.

    PubMed

    Chartrand, Jean-Pierre; Filion-Bilodeau, Sarah; Belin, Pascal

    2007-03-01

    Auditory expertise has mostly been studied in relation to musical processing, but expert auditory processing can also involve nonmusical auditory stimuli, such as birdsongs in bird experts. In this study, the neural correlates of bird expertise were investigated by using electroencephalography to measure auditory-evoked potentials in bird experts and novices. Auditory stimuli in three categories (birdsongs, environmental sounds and voices) were presented in a pseudo-random order while participants performed a simple target detection task (pure tone). We observed similar amplitudes and distributions of the N100-component in bird experts and novices. In contrast, the amplitude of the P200 component was significantly smaller in bird experts at the Pz and Cz electrodes, reflecting a more frontal topography of this positivity. Notably, this group difference was observed not only for birdsongs, but also for voices and environmental sounds, suggesting a general processing difference in bird experts, not restricted to the category of expertise. PMID:17435598

  10. Building the Information Society in Candidate Countries? A Prospective Analysis on Potential Trajectories To Realise the Lisbon Goals. IPTS Experts Workshop Report, February 23-25, 2003, Sevilla.

    ERIC Educational Resources Information Center

    Bogdanowicz, Marc; Burgelman, Jean-Claude; Centeno, Clara; Gourova, Elisavetta; Carat, Gerard

    Potential policies and strategies for building the information society (IS) in countries that are candidates for admission to the European Union were explored at a workshop attended by 39 experts from the European Commission (EC), the EC's Institute for Prospective and Technological Studies, and outside the EC. The workshop focused on the specific…

  11. Management of Sickle Cell Disease: Recommendations from the 2014 Expert Panel Report.

    PubMed

    Yawn, Barbara P; John-Sowah, Joylene

    2015-12-15

    Family physicians are the primary and sometimes only health care resource for families affected by sickle cell disease. Recently published guidelines provide important recommendations for health maintenance, acute care, and monitoring of disease-modifying therapy in persons with this condition. This overview highlights some of the most important clinical activities that can and should be carried out in the community care setting. Children with sickle cell anemia should receive prophylactic penicillin from birth through at least five years of age, and all persons with sickle cell disease require vaccination to prevent invasive pneumococcal disease. Annual screening with transcranial Doppler ultrasonography is recommended for all children with sickle cell disease beginning at two years of age and continuing through adolescence to evaluate the risk of stroke and to initiate transfusion therapy in those at high risk. Vasoocclusive crises require immediate and adequate analgesia appropriate to the level of patient-reported pain. Antibiotics, hospitalization, and incentive spirometry are indicated for those with acute chest syndrome. There is strong evidence to support the promotion and use of hydroxyurea therapy in patients nine months and older who have sickle cell anemia because its use can decrease the frequency of vasoocclusive crises and acute chest syndrome with limited adverse effects.

  12. Expert Panel: A New Strategy for Creating a Student-Centred Learning Environment for Software Applications

    ERIC Educational Resources Information Center

    Wang, Sy-Chyi

    2011-01-01

    Education reforms from teacher-centred to student-centred courses usually come with the adoption of new teaching strategies. However, following the growing design and development of student-centred teaching and learning innovations in many fields of study, not many efforts have been found in the field of software application teaching. Therefore,…

  13. NTP-CERHR EXPERT PANEL REPORT ON THE REPRODUCTIVE AND DEVELOPMENTAL TOXICITY OF 1-BROMOPROPANE

    EPA Science Inventory

    The National Toxicology Program (NTP) and the National Institute of Environmetnal Health Sciences (NIEHS) established the NTP Center for the Evaluation of Risks to Human Reproduction (CERHR) in order to provide timely, unbiased, scientifically sound evaluations of human and exper...

  14. NTP-CERHR EXPERT PANEL REPORT ON THE REPRODUCTIVE AND DEVELOPMENTAL TOXICITY OF 2-BROMOPROPANE

    EPA Science Inventory

    The National Toxicology Program (NTP) and the National Institute of Environmental Health Sciences (NIEHS) established the NTP Center for the Evaluation of Risks to Human Reproduction (CERHR) in order to provide timely, unbiased, scientifically sound evaluations of human and exper...

  15. Identifying a Core Set of Science Teaching Practices: A Delphi Expert Panel Approach

    ERIC Educational Resources Information Center

    Kloser, Matthew

    2014-01-01

    The "Framework for K-12 Science Education" details ambitious goals for students' learning of science content and practices. However, this document provides science teachers little guidance about instructional practices that are central to helping students achieve these goals. Research indicates that a teacher's instructional…

  16. Placebo use in vaccine trials: recommendations of a WHO expert panel.

    PubMed

    Rid, Annette; Saxena, Abha; Baqui, Abdhullah H; Bhan, Anant; Bines, Julie; Bouesseau, Marie-Charlotte; Caplan, Arthur; Colgrove, James; Dhai, Ames; Gomez-Diaz, Rita; Green, Shane K; Kang, Gagandeep; Lagos, Rosanna; Loh, Patricia; London, Alex John; Mulholland, Kim; Neels, Pieter; Pitisuttithum, Punee; Sarr, Samba Cor; Selgelid, Michael; Sheehan, Mark; Smith, Peter G

    2014-08-20

    Vaccines are among the most cost-effective interventions against infectious diseases. Many candidate vaccines targeting neglected diseases in low- and middle-income countries are now progressing to large-scale clinical testing. However, controversy surrounds the appropriate design of vaccine trials and, in particular, the use of unvaccinated controls (with or without placebo) when an efficacious vaccine already exists. This paper specifies four situations in which placebo use may be acceptable, provided that the study question cannot be answered in an active-controlled trial design; the risks of delaying or foregoing an efficacious vaccine are mitigated; the risks of using a placebo control are justified by the social and public health value of the research; and the research is responsive to local health needs. The four situations are: (1) developing a locally affordable vaccine, (2) evaluating the local safety and efficacy of an existing vaccine, (3) testing a new vaccine when an existing vaccine is considered inappropriate for local use (e.g. based on epidemiologic or demographic factors), and (4) determining the local burden of disease.

  17. At Student Seminar, Expert Panel Lauds HPV Vaccine for Cancer Prevention | Poster

    Cancer.gov

    Interns were promised pizza, but they got more than just food as they watched “Someone You Love: The HPV Epidemic” at this summer’s second student seminar. In the Building 549 auditorium, students learned about human papillomavirus (HPV) infection, the most common sexually transmitted infection (STI).

  18. NTP-CERHR Expert Panel Report on the reproductive and developmental toxicity of hydroxyurea

    EPA Science Inventory

    The National Toxicology Program (NTP) and the National Institute of Environmental Health Sciences (NIEHS) established the NTP Center for the Evaluation of Risks to Human Reproduction (CERHR) in June 1998. The purpose of CERHR is to provide timely, unbiased, scientifically sound e...

  19. Anatomy and neurophysiology of cough: CHEST Guideline and Expert Panel report.

    PubMed

    Canning, Brendan J; Chang, Anne B; Bolser, Donald C; Smith, Jaclyn A; Mazzone, Stuart B; McGarvey, Lorcan

    2014-12-01

    Bronchopulmonary C-fibers and a subset of mechanically sensitive, acid-sensitive myelinated sensory nerves play essential roles in regulating cough. These vagal sensory nerves terminate primarily in the larynx, trachea, carina, and large intrapulmonary bronchi. Other bronchopulmonary sensory nerves, sensory nerves innervating other viscera, as well as somatosensory nerves innervating the chest wall, diaphragm, and abdominal musculature regulate cough patterning and cough sensitivity. The responsiveness and morphology of the airway vagal sensory nerve subtypes and the extrapulmonary sensory nerves that regulate coughing are described. The brainstem and higher brain control systems that process this sensory information are complex, but our current understanding of them is considerable and increasing. The relevance of these neural systems to clinical phenomena, such as urge to cough and psychologic methods for treatment of dystussia, is high, and modern imaging methods have revealed potential neural substrates for some features of cough in the human.

  20. NTP-CERHR Expert Panel Report on the Reproductive and Developmental Toxicity of Bisphenol A

    EPA Science Inventory

    The National Toxicology Program (NTP)1 established the NTP Center for the Evaluation of Risks to Human Reproduction (CERHR) in June 1998. The purpose of the CERHR is to provide timely, unbiased, scientifically sound evaluations of the potential for adverse effects on reproduction...