Assessing Food Preferences in Dogs and Cats: A Review of the Current Methods.

PubMed

Tobie, Christelle; Péron, Franck; Larose, Claire

2015-03-18

Food is a major aspect of pet care; therefore, ensuring that pet foods are not only healthful but attractive to companion animals and their owners is essential. The petfood market remains active and requires ongoing evaluation of the adaptation and efficiency of the new products. Palatability-foods' characteristics enticing animals and leading them to consumption-is therefore a key element to look at. Based on the type of information needed, different pet populations (expert or naïve) can be tested to access their preference and acceptance for different food products. Classical techniques are the one-bowl and two-bowl tests, but complementary (i.e., operant conditioning) and novel (i.e., exploratory behavior) approaches are available to gather more information on the evaluation of petfood palatability.

Patient-Centered Tools for Medication Information Search

PubMed Central

Wilcox, Lauren; Feiner, Steven; Elhadad, Noémie; Vawdrey, David; Tran, Tran H.

2016-01-01

Recent research focused on online health information seeking highlights a heavy reliance on general-purpose search engines. However, current general-purpose search interfaces do not necessarily provide adequate support for non-experts in identifying suitable sources of health information. Popular search engines have recently introduced search tools in their user interfaces for a range of topics. In this work, we explore how such tools can support non-expert, patient-centered health information search. Scoping the current work to medication-related search, we report on findings from a formative study focused on the design of patient-centered, medication-information search tools. Our study included qualitative interviews with patients, family members, and domain experts, as well as observations of their use of Remedy, a technology probe embodying a set of search tools. Post-operative cardiothoracic surgery patients and their visiting family members used the tools to find information about their hospital medications and were interviewed before and after their use. Domain experts conducted similar search tasks and provided qualitative feedback on their preferences and recommendations for designing these tools. Findings from our study suggest the importance of four valuation principles underlying our tools: credibility, readability, consumer perspective, and topical relevance. PMID:28163972

Patient-Centered Tools for Medication Information Search.

PubMed

Wilcox, Lauren; Feiner, Steven; Elhadad, Noémie; Vawdrey, David; Tran, Tran H

2014-05-20

Recent research focused on online health information seeking highlights a heavy reliance on general-purpose search engines. However, current general-purpose search interfaces do not necessarily provide adequate support for non-experts in identifying suitable sources of health information. Popular search engines have recently introduced search tools in their user interfaces for a range of topics. In this work, we explore how such tools can support non-expert, patient-centered health information search. Scoping the current work to medication-related search, we report on findings from a formative study focused on the design of patient-centered, medication-information search tools. Our study included qualitative interviews with patients, family members, and domain experts, as well as observations of their use of Remedy, a technology probe embodying a set of search tools. Post-operative cardiothoracic surgery patients and their visiting family members used the tools to find information about their hospital medications and were interviewed before and after their use. Domain experts conducted similar search tasks and provided qualitative feedback on their preferences and recommendations for designing these tools. Findings from our study suggest the importance of four valuation principles underlying our tools: credibility, readability, consumer perspective, and topical relevance.

Implicit and Explicit Evaluation of Visual Symmetry as a Function of Art Expertise.

PubMed

Weichselbaum, Hanna; Leder, Helmut; Ansorge, Ulrich

2018-01-01

In perception, humans typically prefer symmetrical over asymmetrical patterns. Yet, little is known about differences in symmetry preferences depending on individuals' different past histories of actively reflecting upon pictures and patterns. To address this question, we tested the generality of the symmetry preference for different levels of individual art expertise. The preference for symmetrical versus asymmetrical abstract patterns was measured implicitly, by an Implicit Association Test (IAT), and explicitly, by a rating scale asking participants to evaluate pattern beauty. Participants were art history and psychology students. Art expertise was measured using a questionnaire. In the IAT, art expertise did not alter the preference for symmetrical over asymmetrical patterns. In contrast, the explicit rating scale showed that with higher art expertise, the ratings for the beauty of asymmetrical patterns significantly increased, but, again, participants preferred symmetrical over asymmetrical patterns. The results are discussed in light of different theories on the origins of symmetry preference. Evolutionary adaptation might play a role in symmetry preferences for art experts similarly to nonexperts, but experts tend to emphasize the beauty of asymmetrical depictions, eventually considering different criteria, when asked explicitly to indicate their preferences.

Implicit and Explicit Evaluation of Visual Symmetry as a Function of Art Expertise

PubMed Central

Leder, Helmut; Ansorge, Ulrich

2018-01-01

In perception, humans typically prefer symmetrical over asymmetrical patterns. Yet, little is known about differences in symmetry preferences depending on individuals’ different past histories of actively reflecting upon pictures and patterns. To address this question, we tested the generality of the symmetry preference for different levels of individual art expertise. The preference for symmetrical versus asymmetrical abstract patterns was measured implicitly, by an Implicit Association Test (IAT), and explicitly, by a rating scale asking participants to evaluate pattern beauty. Participants were art history and psychology students. Art expertise was measured using a questionnaire. In the IAT, art expertise did not alter the preference for symmetrical over asymmetrical patterns. In contrast, the explicit rating scale showed that with higher art expertise, the ratings for the beauty of asymmetrical patterns significantly increased, but, again, participants preferred symmetrical over asymmetrical patterns. The results are discussed in light of different theories on the origins of symmetry preference. Evolutionary adaptation might play a role in symmetry preferences for art experts similarly to nonexperts, but experts tend to emphasize the beauty of asymmetrical depictions, eventually considering different criteria, when asked explicitly to indicate their preferences. PMID:29755722

Expertise in unexpected places: Children's acceptance of information from gender counter-stereotypical experts.

PubMed

Boseovski, Janet J; Hughes, Chelsea; Miller, Stephanie E

2016-01-01

The current study examined children's willingness to accept novel information from expert informants with nontraditional gender role interests. Four- to 8-year-olds heard conflicting information about traditionally feminine or masculine domains from a gender counter-stereotypical expert (e.g., a boy with expertise in ballet) and a layperson of the other gender (e.g., a girl with little knowledge about ballet). Participants were asked which informant was correct, who they would prefer to learn from in the future, and to rate their liking of each informant. Overall, participants selected the gender counter-stereotypical expert as correct. Four- to 5-year-olds reported a preference to learn from same-gender participants in the future irrespective of expertise, whereas 6- to 8-year-olds reported wanting to learn from counter-stereotypical experts. Boys showed relatively greater acceptance of information from a male counter-stereotypical expert than from a female counter-stereotypical expert. Although participants reported greater liking of same-gender informants, liking evaluations were largely positive irrespective of gender norm deviations. Implications for children's acceptance of gender nonconforming activities are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

Breaking bad news: patients' preferences and health locus of control.

PubMed

Martins, Raquel Gomes; Carvalho, Irene Palmares

2013-07-01

To identify patients' preferences for models of communicating bad news and to explore how such preferences, and the reasons for the preferences, relate with personality characteristics, specifically patients' health locus of control (HLC): internal/external and 'powerful others' (PO). Seventy-two patients from an oncology clinic watched videotaped scenarios of a breaking bad news moment, selected the model they preferred, filled an HLC scale and were interviewed about their choices. Data were analyzed with Chi-square, Kruskal-Wallis and Mann-Whitney tests. Interviews were content-analyzed. 77.8% preferred an "empathic professional", 12.5% a "distanced expert" and 9.7% an "emotionally burdened expert". Preferences varied significantly with HLC scores (patients with higher internal locus of control (ILC) and lower PO preferred the empathic model), presence of cancer, age and education. Patients explained their preferences through aspects of Caring, Professionalism, Wording, Time and Hope. ILC registered significant differences in regards to Wording and Time, whereas PO was associated with Hope and Time. HLC is an important dimension that can help doctors to better know their patients. Knowing whether patients attribute their health to their own behaviors or to chance/others can help tailor the disclosure of bad news to their specific preferences. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Bridge esthetic guidelines.

DOT National Transportation Integrated Search

1975-01-01

As esthetics is not an exact science, differences of opinion occur, even between experts; however, studies had found that in most cases there were statistical preferences. These preferences are presented. For the convenience of the designer, a format...

Priority of a Hesitant Fuzzy Linguistic Preference Relation with a Normal Distribution in Meteorological Disaster Risk Assessment.

PubMed

Wang, Lihong; Gong, Zaiwu

2017-10-10

As meteorological disaster systems are large complex systems, disaster reduction programs must be based on risk analysis. Consequently, judgment by an expert based on his or her experience (also known as qualitative evaluation) is an important link in meteorological disaster risk assessment. In some complex and non-procedural meteorological disaster risk assessments, a hesitant fuzzy linguistic preference relation (HFLPR) is often used to deal with a situation in which experts may be hesitant while providing preference information of a pairwise comparison of alternatives, that is, the degree of preference of one alternative over another. This study explores hesitation from the perspective of statistical distributions, and obtains an optimal ranking of an HFLPR based on chance-restricted programming, which provides a new approach for hesitant fuzzy optimisation of decision-making in meteorological disaster risk assessments.

A clinical decision support system prototype for cardiovascular intensive care.

PubMed

Lau, F

1994-08-01

This paper describes the development and validation of a decision-support system prototype that can help manage hypovolemic hypotension in the Cardiovascular Intensive Care Unit (CVICU). The prototype uses physiologic pattern-matching, therapeutic protocols, computational drug-dosage response modeling and expert reasoning heuristics in its selection of intervention strategies and choices. As part of model testing, the prototype simulated real-time operation by processing historical physiologic and intervention data on a patient sequentially, generating alerts on questionable data, critiques of interventions instituted and recommendations on preferred interventions. Bench-testing with 399 interventions from 13 historical cases showed therapies for bleeding and fluid replacement proposed by the prototype were significantly more consistent (p < 0.0001) than those instituted by the staff when compared against expert critiques (80% versus 44%). This study has demonstrated the feasibility of formalizing hemodynamic management of CVICU patients in a manner that may be implemented and evaluated in a clinical setting.

Veterans' Preferences for Exchanging Information Using Veterans Affairs Health Information Technologies: Focus Group Results and Modeling Simulations.

PubMed

Haun, Jolie N; Chavez, Margeaux; Nazi, Kim; Antinori, Nicole; Melillo, Christine; Cotner, Bridget A; Hathaway, Wendy; Cook, Ashley; Wilck, Nancy; Noonan, Abigail

2017-10-23

The Department of Veterans Affairs (VA) has multiple health information technology (HIT) resources for veterans to support their health care management. These include a patient portal, VetLink Kiosks, mobile apps, and telehealth services. The veteran patient population has a variety of needs and preferences that can inform current VA HIT redesign efforts to meet consumer needs. This study aimed to describe veterans' experiences using the current VA HIT and identify their vision for the future of an integrated VA HIT system. Two rounds of focus group interviews were conducted with a single cohort of 47 veterans and one female caregiver recruited from Bedford, Massachusetts, and Tampa, Florida. Focus group interviews included simulation modeling activities and a self-administered survey. This study also used an expert panel group to provide data and input throughout the study process. High-fidelity, interactive simulations were created and used to facilitate collection of qualitative data. The simulations were developed based on system requirements, data collected through operational efforts, and participants' reported preferences for using VA HIT. Pairwise comparison activities of HIT resources were conducted with both focus groups and the expert panel. Rapid iterative content analysis was used to analyze qualitative data. Descriptive statistics summarized quantitative data. Data themes included (1) current use of VA HIT, (2) non-VA HIT use, and (3) preferences for future use of VA HIT. Data indicated that, although the Secure Messaging feature was often preferred, a full range of HIT options are needed. These data were then used to develop veteran-driven simulations that illustrate user needs and expectations when using a HIT system and services to access VA health care services. Patient participant redesign processes present critical opportunities for creating a human-centered design. Veterans value virtual health care options and prefer standardized, integrated, and synchronized user-friendly interface designs. ©Jolie N. Haun, Margeaux Chavez, Kim Nazi, Nicole Antinori, Christine Melillo, Bridget A Cotner, Wendy Hathaway, Ashley Cook, Nancy Wilck, Abigail Noonan. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 23.10.2017.

Usefulness of video-laryngoscopy with the Airway Scope for intubation performance and learning: an experimental manikin controlled study.

PubMed

Declercq, Pierre-Louis; Bubenheim, Michael; Gelinotte, Stéphanie; Guernon, Kévin; Michot, Jean-Baptiste; Royon, Vincent; Carpentier, Dorothée; Béduneau, Gaëtan; Tamion, Fabienne; Girault, Christophe

2016-12-01

Different video-laryngoscopes (VDLs) for endotracheal intubation (ETI) have recently been developed. We compared the performance of the VDL Airway Scope (AWS) with the direct laryngoscopy by Macintosh (DLM) for ETI success, time and learning. We performed an experimental manikin controlled study. Twenty experienced (experts) and 40 inexperienced operators (novices) for DLM-ETI were enrolled. None of them had experience with the use of AWS-VDL. Novices were assigned to start learning with DLM or AWS, and two sub-groups of 20 novices were formed. Experts group constituted the control group. Each participant performed 10 ETI attempts with each device on the same standard manikin. The primary endpoint was the ETI success probability. Secondary endpoints were ETI time, technical validity and qualitative evaluation for each technique. We also assessed the learning order and the successive attempts effects for these parameters. Overall, 1200 ETI attempts were performed. ETI success probability was higher with the AWS than with the DLM for all operators (98 vs. 81 %; p < 0.0001) and for experts compared to novices using devices in the same order (97 vs. 83 %; p = 0.0002). Overall ETI time was shorter with the AWS than with the DLM (13 vs. 20 s; p < 0.0001) and for experts compared to novices using devices in the same order (11 vs. 21 s; p < 0.0001). Among novices, those starting learning with AWS had higher ETI success probability (89 vs. 83 %; p = 0.03) and shorter ETI time (18 vs. 21 s; p = 0.02). Technical validity was found better with the AWS than DLM for all operators. Novices expressed global satisfaction and device preference for the AWS, whereas experts were indifferent. AWS-VDL permits faster, easier and more reliable ETI compared to the DLM whatever the previous airway ETI experience and could be a useful device for DLM-ETI learning.

BASES OF SCHOOL CHILDREN'S ESTHETIC JUDGMENT AND ESTHETIC PREFERENCE.

ERIC Educational Resources Information Center

CHILD, IRVIN L.; AND OTHERS

RESEARCH INTO CHILDREN'S ART PREFERENCES AND THEIR RELATION TO THE ESTHETIC MERIT OF ART AS JUDGED BY EXPERTS WAS DESCRIBED IN THIS REPORT THAT IS MADE UP OF NINE ARTICLES, ORIGINALLY PREPARED FOR PUBLICATION IN SCHOLARLY JOURNALS, AND A SUMMARY OF THE FINDINGS. THE GENERAL TOPICS CONSIDERED WERE (1) REASONS CHILDREN GIVE FOR THEIR PREFERENCES,…

Comparison of small diameter stone baskets in an in vitro caliceal and ureteral model.

PubMed

Korman, Emily; Hendlin, Kari; Chotikawanich, Ekkarin; Monga, Manoj

2011-01-01

Three small diameter (<1.5F) stone baskets have recently been introduced. Our objective was to evaluate the stone capture rate of these baskets in an in vitro ureteral model and an in vitro caliceal model using novice, resident, and expert operators. Sacred Heart Medical Halo™ (1.5F), Cook N-Circle(®) Nitinol Tipless Stone Extractor (1.5F), and Boston Scientific OptiFlex(®) (1.3F) stone baskets were tested in an in vitro ureteral and a caliceal model by three novices, three residents, and three experts. The caliceal model consisted of a 7-cm length of 10-mm O.D. plastic tubing with a convex base. Each operator was timed during removal of a 3-mm calculus from each model with three repetitions for each basket. Data were analyzed by analysis of variance single factor tests and t tests assuming unequal variances. In the ureteral model, the Halo had the fastest average rate of stone extraction for experts and novices (0:02 ± 0:01 and 0:08 ± 0:04 min, respectively), as well as the overall fastest average stone extraction rate (0:08 ± 0:06 min). No statistical significant differences in extraction times between baskets were identified in the resident group. In the novice group, the Halo stone extraction rate was significantly faster than the OptiFlex (P=0.029). In the expert group, the OptiFlex had statistically significant slower average extraction rates compared with the Halo (P=0.005) and the N-Circle (P=0.017). In the caliceal model, no statistically significant differences were noted. While no significant differences were noted in extraction times for the caliceal model, the extraction times for the ureteral model were slowest with the OptiFlex basket. Other variables important in selection of the appropriate basket include operator preference, clinical setting, and cost.

Nature Disaster Risk Evaluation with a Group Decision Making Method Based on Incomplete Hesitant Fuzzy Linguistic Preference Relations.

PubMed

Tang, Ming; Liao, Huchang; Li, Zongmin; Xu, Zeshui

2018-04-13

Because the natural disaster system is a very comprehensive and large system, the disaster reduction scheme must rely on risk analysis. Experts' knowledge and experiences play a critical role in disaster risk assessment. The hesitant fuzzy linguistic preference relation is an effective tool to express experts' preference information when comparing pairwise alternatives. Owing to the lack of knowledge or a heavy workload, information may be missed in the hesitant fuzzy linguistic preference relation. Thus, an incomplete hesitant fuzzy linguistic preference relation is constructed. In this paper, we firstly discuss some properties of the additive consistent hesitant fuzzy linguistic preference relation. Next, the incomplete hesitant fuzzy linguistic preference relation, the normalized hesitant fuzzy linguistic preference relation, and the acceptable hesitant fuzzy linguistic preference relation are defined. Afterwards, three procedures to estimate the missing information are proposed. The first one deals with the situation in which there are only n-1 known judgments involving all the alternatives; the second one is used to estimate the missing information of the hesitant fuzzy linguistic preference relation with more known judgments; while the third procedure is used to deal with ignorance situations in which there is at least one alternative with totally missing information. Furthermore, an algorithm for group decision making with incomplete hesitant fuzzy linguistic preference relations is given. Finally, we illustrate our model with a case study about flood disaster risk evaluation. A comparative analysis is presented to testify the advantage of our method.

Hand preference patterns in expert basketball players: interrelations between basketball-specific and everyday life behavior.

PubMed

Stöckel, Tino; Vater, Christian

2014-12-01

In the present study we examined the interrelation of everyday life handedness and hand preference in basketball, as an area of expertise that requires individuals being proficient with both their non-dominant and dominant hand. A secondary aim was to elucidate the link between basketball-specific practice, hand preference in basketball and everyday life handedness. Therefore, 176 expert basketball players self-reported their hand preference for activities of daily living and for basketball-specific behavior as well as details about their basketball-specific history via questionnaire. We found that compared to the general population the one-hand bias was significantly reduced for both everyday life and basketball-specific hand preference (i.e., a higher prevalence of mixed-handed individuals), and that both concepts were significantly related. Moreover, only preference scores for lay-up and dribbling skills were significantly related to measures of basketball-specific practice. Consequently, training-induced modulations of lateral preference seem to be very specific to only a few basketball-specific skills, and do not generalize to other skills within the domain of basketball nor do they extend into everyday life handedness. The results are discussed in terms of their relevance regarding theories of handedness and their practical implications for the sport of basketball. Copyright © 2014 Elsevier B.V. All rights reserved.

Integrating expert- and algorithm-derived data to generate a hemispheric ice edge

NASA Astrophysics Data System (ADS)

Tsatsoulis, C.; Komp, E.

The Arctic ice edge is the area of the Arctic where sea ice concentration is less than 15%, and is considered navigable by most vessels. Experts at the National Ice Center generate a daily ice edge product that is available to the public. Data of preference is that of active, high resolution satellite sensors such as RADARSAT which yields all-weather images of 100m resolution, and a second source is OLS data with 550m resolution. Unfortunately, RADARSAT does not provide full, daily coverage of the Arctic and OLS can be obscured by clouds. The SSM/I sensor provides complete coverage of the Arctic at 25km resolution and is independent of cloud cover and solar illumination during the Arctic winter. SSM/I data is analyzed by the NASA Team algorithm to establish ice concentration. Our work integrates the ice edge created by experts using high resolution data with the ice edge generated out of the coarser SSM/I microwave data. The result is a product that combines human and algorithmic outputs, deals with gross differences in resolution of the underlying data sets, and results in a useful, operational product.

Models Used to Select Strategic Planning Experts for High Technology Productions

NASA Astrophysics Data System (ADS)

Zakharova, Alexandra A.; Grigorjeva, Antonina A.; Tseplit, Anna P.; Ozgogov, Evgenij V.

2016-04-01

The article deals with the problems and specific aspects in organizing works of experts involved in assessment of companies that manufacture complex high-technology products. A model is presented that is intended for evaluating competences of experts in individual functional areas of expertise. Experts are selected to build a group on the basis of tables used to determine a competence level. An expert selection model based on fuzzy logic is proposed and additional requirements for the expert group composition can be taken into account, with regard to the needed quality and competence related preferences of decision-makers. A Web-based information system model is developed for the interaction between experts and decision-makers when carrying out online examinations.

Survey Questions Answered Only by Medication Experts.

ERIC Educational Resources Information Center

American Journal on Mental Retardation, 2000

2000-01-01

Fifty-eight tables provide a breakdown of answers to a survey responded to by 45 experts in the medication treatment of psychiatric and behavioral problems in people with mental retardation. Questions address treatment of specific disorders, ratings of various medications for specific disorders or symptoms, and preferences in mood stabilizers,…

Effective Partnering in Conducting Benefit-Risk Patient Preference Studies: Perspectives From a Patient Advocacy Organization, a Pharmaceutical Company, and Academic Stated-Preference Researchers.

PubMed

Wolka, Anne M; Fairchild, Angelyn O; Reed, Shelby D; Anglin, Greg; Johnson, F Reed; Siegel, Michael; Noel, Rebecca

2017-01-01

Formal incorporation of patients' perspectives is becoming increasingly important in medical product development and decision making. This article shares practical advice regarding how patient advocacy organizations, the pharmaceutical industry, and academic experts in stated-preference research can effectively partner on benefit-risk patient preference studies. The authors partnered on a benefit-risk patient preference study related to the treatment of psoriasis. The authors from Duke Clinical Research Institute also share their experiences in collaborating with numerous other organizations in conducting benefit-risk patient preference studies. Upon initiation of the study partnership with appropriate experts, training is important to ensure all collaborators have a common understanding of the methodology, what objectives stated-preference methods can support, and expectations for the project. To the extent possible, partners should align on and document relevant clinical and logistical details prior to study implementation. During study implementation, partners should use good communication practices and document and maintain a record of any changes to the original plan. Presentation of the study results should be tailored to the particular audience, with the appropriate partner leading the presentation based on its format and audience. Partners from patient advocacy organizations, the pharmaceutical industry, and academia can effectively collaborate on benefit-risk patient preference studies with sufficient planning and ongoing communication. This article is a call for action for other organizations to engage in sharing of experiences regarding effective partnering in quantifying patient preferences in medical product development.

Utilization of a cognitive task analysis for laparoscopic appendectomy to identify differentiated intraoperative teaching objectives.

PubMed

Smink, Douglas S; Peyre, Sarah E; Soybel, David I; Tavakkolizadeh, Ali; Vernon, Ashley H; Anastakis, Dimitri J

2012-04-01

Experts become automated when performing surgery, making it difficult to teach complex procedures to trainees. Cognitive task analysis (CTA) enables experts to articulate operative steps and cognitive decisions in complex procedures such as laparoscopic appendectomy, which can then be used to identify central teaching points. Three local surgeon experts in laparoscopic appendectomy were interviewed using critical decision method-based CTA methodology. Interview transcripts were analyzed, and a cognitive demands table (CDT) was created for each expert. The individual CDTs were reviewed by each expert for completeness and then combined into a master CDT. Percentage agreement on operative steps and decision points was calculated for each expert. The experts then participated in a consensus meeting to review the master CDT. Each surgeon expert was asked to identify in the master CDT the most important teaching objectives for junior-level and senior-level residents. The experts' responses for junior-level and senior-level residents were compared using a χ(2) test. The surgeon experts identified 24 operative steps and 27 decision points. Eighteen of the 24 operative steps (75%) were identified by all 3 surgeon experts. The percentage of operative steps identified was high for each surgeon expert (96% for surgeon 1, 79% for surgeon 2, and 83% for surgeon 3). Of the 27 decision points, only 5 (19%) were identified by all 3 surgeon experts. The percentage of decision points identified varied by surgeon expert (78% for surgeon 1, 59% for surgeon 2, and 48% for surgeon 3). When asked to identify key teaching points, the surgeon experts were more likely to identify operative steps for junior residents (9 operative steps and 6 decision points) and decision points for senior residents (4 operative steps and 13 decision points) (P < .01). CTA can deconstruct the essential operative steps and decision points associated with performing a laparoscopic appendectomy. These results provide a framework to identify key teaching principles to guide intraoperative instruction. These learning objectives could be used to guide resident level-appropriate teaching of an essential general surgery procedure. Copyright © 2012 Elsevier Inc. All rights reserved.

Student Preferences for Different Sources of Scientific Information

ERIC Educational Resources Information Center

Fraser, Barry J.; Northfield, Jeffrey R.

1978-01-01

Uses four measures of attitude towards different sources of scientific information, namely experiments, experts, books and teachers, to investigate the relative preferences for the different sources among a sample of 7th grade students in Melbourne. Also explores relationships between student changes in attitude to these sources and a number of…

Preferences and Willingness for Participating MOOCs in Turkish

ERIC Educational Resources Information Center

Erdem-Aydin, Irem

2015-01-01

The goal of this study is to explore preferences of the experts, students, faculty, and administrators in the field of academic computing regarding the Massive Open Online Courses (MOOCs). This descriptive study was conducted during the Academic Informatics 2015 Conference help during 31 January-6 February 2015, Anadolu University, Eskisehir,…

An active learning approach for rapid characterization of endothelial cells in human tumors.

PubMed

Padmanabhan, Raghav K; Somasundar, Vinay H; Griffith, Sandra D; Zhu, Jianliang; Samoyedny, Drew; Tan, Kay See; Hu, Jiahao; Liao, Xuejun; Carin, Lawrence; Yoon, Sam S; Flaherty, Keith T; Dipaola, Robert S; Heitjan, Daniel F; Lal, Priti; Feldman, Michael D; Roysam, Badrinath; Lee, William M F

2014-01-01

Currently, no available pathological or molecular measures of tumor angiogenesis predict response to antiangiogenic therapies used in clinical practice. Recognizing that tumor endothelial cells (EC) and EC activation and survival signaling are the direct targets of these therapies, we sought to develop an automated platform for quantifying activity of critical signaling pathways and other biological events in EC of patient tumors by histopathology. Computer image analysis of EC in highly heterogeneous human tumors by a statistical classifier trained using examples selected by human experts performed poorly due to subjectivity and selection bias. We hypothesized that the analysis can be optimized by a more active process to aid experts in identifying informative training examples. To test this hypothesis, we incorporated a novel active learning (AL) algorithm into FARSIGHT image analysis software that aids the expert by seeking out informative examples for the operator to label. The resulting FARSIGHT-AL system identified EC with specificity and sensitivity consistently greater than 0.9 and outperformed traditional supervised classification algorithms. The system modeled individual operator preferences and generated reproducible results. Using the results of EC classification, we also quantified proliferation (Ki67) and activity in important signal transduction pathways (MAP kinase, STAT3) in immunostained human clear cell renal cell carcinoma and other tumors. FARSIGHT-AL enables characterization of EC in conventionally preserved human tumors in a more automated process suitable for testing and validating in clinical trials. The results of our study support a unique opportunity for quantifying angiogenesis in a manner that can now be tested for its ability to identify novel predictive and response biomarkers.

CLEAR: Communications Link Expert Assistance Resource

NASA Technical Reports Server (NTRS)

Hull, Larry G.; Hughes, Peter M.

1987-01-01

Communications Link Expert Assistance Resource (CLEAR) is a real time, fault diagnosis expert system for the Cosmic Background Explorer (COBE) Mission Operations Room (MOR). The CLEAR expert system is an operational prototype which assists the MOR operator/analyst by isolating and diagnosing faults in the spacecraft communication link with the Tracking and Data Relay Satellite (TDRS) during periods of realtime data acquisition. The mission domain, user requirements, hardware configuration, expert system concept, tool selection, development approach, and system design were discussed. Development approach and system implementation are emphasized. Also discussed are system architecture, tool selection, operation, and future plans.

Patient preferences versus physicians' judgement: does it make a difference in healthcare decision making?

PubMed

Mühlbacher, Axel C; Juhnke, Christin

2013-06-01

Clinicians and public health experts make evidence-based decisions for individual patients, patient groups and even whole populations. In addition to the principles of internal and external validity (evidence), patient preferences must also influence decision making. Great Britain, Australia and Germany are currently discussing methods and procedures for valuing patient preferences in regulatory (authorization and pricing) and in health policy decision making. However, many questions remain on how to best balance patient and public preferences with physicians' judgement in healthcare and health policy decision making. For example, how to define evaluation criteria regarding the perceived value from a patient's perspective? How do physicians' fact-based opinions also reflect patients' preferences based on personal values? Can empirically grounded theories explain differences between patients and experts-and, if so, how? This article aims to identify and compare studies that used different preference elicitation methods and to highlight differences between patient and physician preferences. Therefore, studies comparing patient preferences and physician judgements were analysed in a review. This review shows a limited amount of literature analysing and comparing patient and physician preferences for healthcare interventions and outcomes. Moreover, it shows that methodology used to compare preferences is diverse. A total of 46 studies used the following methods-discrete-choice experiments, conjoint analyses, standard gamble, time trade-offs and paired comparisons-to compare patient preferences with doctor judgements. All studies were published between 1985 and 2011. Most studies reveal a disparity between the preferences of actual patients and those of physicians. For most conditions, physicians underestimated the impact of intervention characteristics on patients' decision making. Differentiated perceptions may reflect ineffective communication between the provider and the patient. This in turn may keep physicians from fully appreciating the impact of certain medical conditions on patient preferences. Because differences exist between physicians' judgement and patient preferences, it is important to incorporate the needs and wants of the patient into treatment decisions.

Assessment of Leisure Preferences for Students with Severe Developmental Disabilities and Communication Difficulties

ERIC Educational Resources Information Center

Kreiner, Janice; Flexer, Robert

2009-01-01

The purpose of this study was to develop and to evaluate the Preferences for Leisure Attributes (PLA) Assessment, a forced-choice computer software program for students with severe disabilities and communication difficulties. In order to determine content validity of the PLA Assessment, four experts in related fields assigned critical attributes…

Hospital-Based Physicians' Intubation Decisions and Associated Mental Models when Managing a Critically and Terminally Ill Older Patient.

PubMed

Haliko, Shannon; Downs, Julie; Mohan, Deepika; Arnold, Robert; Barnato, Amber E

2018-04-01

Variation in the intensity of acute care treatment at the end of life is influenced more strongly by hospital and provider characteristics than patient preferences. We sought to describe physicians' mental models (i.e., thought processes) when encountering a simulated critically and terminally ill older patient, and to compare those models based on whether their treatment plan was patient preference-concordant or preference-discordant. Seventy-three hospital-based physicians from 3 academic medical centers engaged in a simulated patient encounter and completed a mental model interview while watching the video recording of their encounter. We used an "expert" model to code the interviews. We then used Kruskal-Wallis tests to compare the weighted mental model themes of physicians who provided preference-concordant treatment with those who provided preference-discordant treatment. Sixty-six (90%) physicians provided preference-concordant treatment and 7 (10%) provided preference-discordant treatment (i.e., they intubated the patient). Physicians who intubated the patient were more likely to emphasize the reversible and emergent nature of the patient situation (z = -2.111, P = 0.035), their own comfort (z = -2.764, P = 0.006), and rarely focused on explicit patient preferences (z = 2.380, P = 0.017). Post-decisional interviewing with audio/video prompting may induce hindsight bias. The expert model has not yet been validated and may not be exhaustive. The small sample size limits generalizability and power. Hospital-based physicians providing preference-discordant used a different mental model for decision making for a critically and terminally ill simulated case. These differences may offer targets for future interventions to promote preference-concordant care for seriously ill patients.

76 FR 62072 - Center for Devices and Radiological Health; Standard Operating Procedures for Network of Experts...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

...] Center for Devices and Radiological Health; Standard Operating Procedures for Network of Experts; Request... procedures (SOPs) for a new ``Network of Experts.'' The draft SOPs describe a new process for staff at the... FDA is announcing the availability of two draft SOPs, one entitled, ``Network of Experts--Expert...

Objective criteria ranking framework for renewable energy policy decisions in Nigeria

NASA Astrophysics Data System (ADS)

K, Nwofor O.; N, Dike V.

2016-08-01

We present a framework that seeks to improve the objectivity of renewable energy policy decisions in Nigeria. It consists of expert ranking of resource abundance, resource efficiency and resource environmental comfort in the choice of renewable energy options for large scale power generation. The rankings are converted to a more objective function called Resource Appraisal Function (RAF) using dependence operators derived from logical relationships amongst the various criteria. The preferred option is that with the highest average RAF coupled with the least RAF variance. The method can be extended to more options, more criteria, and more opinions and can be adapted for similar decisions in education, environment and health sectors.

Decision-making in irrigation networks: Selecting appropriate canal structures using multi-attribute decision analysis.

PubMed

Hosseinzade, Zeinab; Pagsuyoin, Sheree A; Ponnambalam, Kumaraswamy; Monem, Mohammad J

2017-12-01

The stiff competition for water between agriculture and non-agricultural production sectors makes it necessary to have effective management of irrigation networks in farms. However, the process of selecting flow control structures in irrigation networks is highly complex and involves different levels of decision makers. In this paper, we apply multi-attribute decision making (MADM) methodology to develop a decision analysis (DA) framework for evaluating, ranking and selecting check and intake structures for irrigation canals. The DA framework consists of identifying relevant attributes for canal structures, developing a robust scoring system for alternatives, identifying a procedure for data quality control, and identifying a MADM model for the decision analysis. An application is illustrated through an analysis for automation purposes of the Qazvin irrigation network, one of the oldest and most complex irrigation networks in Iran. A survey questionnaire designed based on the decision framework was distributed to experts, managers, and operators of the Qazvin network and to experts from the Ministry of Power in Iran. Five check structures and four intake structures were evaluated. A decision matrix was generated from the average scores collected from the survey, and was subsequently solved using TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) method. To identify the most critical structure attributes for the selection process, optimal attribute weights were calculated using Entropy method. For check structures, results show that the duckbill weir is the preferred structure while the pivot weir is the least preferred. Use of the duckbill weir can potentially address the problem with existing Amil gates where manual intervention is required to regulate water levels during periods of flow extremes. For intake structures, the Neyrpic® gate and constant head orifice are the most and least preferred alternatives, respectively. Some advantages of the Neyrpic® gate are ease of operation and capacity to measure discharge flows. Overall, the application to the Qazvin irrigation network demonstrates the utility of the proposed DA framework in selecting appropriate structures for regulating water flows in irrigation canals. This framework systematically aids the decision process by capturing decisions made at various levels (individual farmers to high-level management). It can be applied to other cases where a new irrigation network is being designed, or where changes in irrigation structures need to be identified to improve flow control in existing networks. Copyright © 2017 Elsevier B.V. All rights reserved.

Communication about colorectal cancer screening in Britain: public preferences for an expert recommendation.

PubMed

Waller, J; Macedo, A; von Wagner, C; Simon, A E; Jones, C; Hammersley, V; Weller, D; Wardle, J; Campbell, C

2012-12-04

Informed decision-making approaches to cancer screening emphasise the importance of decisions being determined by individuals' own values and preferences. However, advice from a trusted source may also contribute to autonomous decision-making. This study examined preferences regarding a recommendation from the NHS and information provision in the context of colorectal cancer (CRC) screening. In face-to-face interviews, a population-based sample of adults across Britain (n=1964; age 50-80 years) indicated their preference between: (1) a strong recommendation to participate in CRC screening, (2) a recommendation alongside advice to make an individual decision, and (3) no recommendation but advice to make an individual decision. Other measures included trust in the NHS and preferences for information on benefits and risks. Most respondents (84%) preferred a recommendation (47% strong recommendation, 37% recommendation plus individual decision-making advice), but the majority also wanted full information on risks (77%) and benefits (78%). Men were more in favour of a recommendation than women (86% vs 81%). Trust in the NHS was high overall, but the minority who expressed low trust were less likely to want a recommendation. Most British adults want full information on risks and benefits of screening but they also want a recommendation from an authoritative source. An 'expert' view may be an important part of autonomous health decision-making.

Expert system verification concerns in an operations environment

NASA Technical Reports Server (NTRS)

Goodwin, Mary Ann; Robertson, Charles C.

1987-01-01

The Space Shuttle community is currently developing a number of knowledge-based tools, primarily expert systems, to support Space Shuttle operations. It is proposed that anticipating and responding to the requirements of the operations environment will contribute to a rapid and smooth transition of expert systems from development to operations, and that the requirements for verification are critical to this transition. The paper identifies the requirements of expert systems to be used for flight planning and support and compares them to those of existing procedural software used for flight planning and support. It then explores software engineering concepts and methodology that can be used to satisfy these requirements, to aid the transition from development to operations and to support the operations environment during the lifetime of expert systems. Many of these are similar to those used for procedural hardware.

Heuristic Model Of The Composite Quality Index Of Environmental Assessment

NASA Astrophysics Data System (ADS)

Khabarov, A. N.; Knyaginin, A. A.; Bondarenko, D. V.; Shepet, I. P.; Korolkova, L. N.

2017-01-01

The goal of the paper is to present the heuristic model of the composite environmental quality index based on the integrated application of the elements of utility theory, multidimensional scaling, expert evaluation and decision-making. The composite index is synthesized in linear-quadratic form, it provides higher adequacy of the results of the assessment preferences of experts and decision-makers.

Use of Medication for the Management of Behavior Problems among Adults with Intellectual Disabilities: A Clinicians' Consensus Survey

ERIC Educational Resources Information Center

Unwin, Gemma Louise; Deb, Shoumitro

2008-01-01

Current prescribing preferences among relevant experts regarding the use of psychotropic medication for the management of behavior problems in adults with intellectual disabilities in the absence of a diagnosed psychiatric illness was defined. We used a questionnaire design to synthesize the preferences of a large group, namely, clinical…

Creating a quality-improvement dialogue: utilizing knowledge from frontline staff, managers, and experts to foster health care quality improvement.

PubMed

Parker, Louise E; Kirchner, JoAnn E; Bonner, Laura M; Fickel, Jacqueline J; Ritchie, Mona J; Simons, Carol E; Yano, Elizabeth M

2009-02-01

There is a growing consensus that a hybrid of two common approaches to quality improvement (QI), local participatory QI and expert QI, might be the best method for achieving quality care. Achieving such a hybrid requires that content experts establish an ongoing dialogue with both frontline staff members and managers. In this study we examined frontline staff members' and managers' preferences regarding how to conduct such a dialogue, and we provide practical suggestions for implementation. The two groups shared a number of preferences (e.g., verbal face-to-face exchanges, discussions focused on quality of care). There were also some differences. For example, although managers were interested in discussions of business aspects (e.g., costs), frontline staff members were concerned with workload issues. Finally, although informants acknowledged that engaging in a QI dialogue was time consuming, they also believed it was essential if health care organizations are to improve the quality of care they provide.

An expert system to manage the operation of the Space Shuttle's fuel cell cryogenic reactant tanks

NASA Technical Reports Server (NTRS)

Murphey, Amy Y.

1990-01-01

This paper describes a rule-based expert system to manage the operation of the Space Shuttle's cryogenic fuel system. Rules are based on standard fuel tank operating procedures described in the EECOM Console Handbook. The problem of configuring the operation of the Space Shuttle's fuel tanks is well-bounded and well defined. Moreover, the solution of this problem can be encoded in a knowledge-based system. Therefore, a rule-based expert system is the appropriate paradigm. Furthermore, the expert system could be used in coordination with power system simulation software to design operating procedures for specific missions.

Kidney volume measurement methods for clinical studies on autosomal dominant polycystic kidney disease

PubMed Central

Sharma, Kanishka; Caroli, Anna; Quach, Le Van; Petzold, Katja; Bozzetto, Michela; Serra, Andreas L.; Remuzzi, Giuseppe; Remuzzi, Andrea

2017-01-01

Background In autosomal dominant polycystic kidney disease (ADPKD), total kidney volume (TKV) is regarded as an important biomarker of disease progression and different methods are available to assess kidney volume. The purpose of this study was to identify the most efficient kidney volume computation method to be used in clinical studies evaluating the effectiveness of treatments on ADPKD progression. Methods and findings We measured single kidney volume (SKV) on two series of MR and CT images from clinical studies on ADPKD (experimental dataset) by two independent operators (expert and beginner), twice, using all of the available methods: polyline manual tracing (reference method), free-hand manual tracing, semi-automatic tracing, Stereology, Mid-slice and Ellipsoid method. Additionally, the expert operator also measured the kidney length. We compared different methods for reproducibility, accuracy, precision, and time required. In addition, we performed a validation study to evaluate the sensitivity of these methods to detect the between-treatment group difference in TKV change over one year, using MR images from a previous clinical study. Reproducibility was higher on CT than MR for all methods, being highest for manual and semiautomatic contouring methods (planimetry). On MR, planimetry showed highest accuracy and precision, while on CT accuracy and precision of both planimetry and Stereology methods were comparable. Mid-slice and Ellipsoid method, as well as kidney length were fast but provided only a rough estimate of kidney volume. The results of the validation study indicated that planimetry and Stereology allow using an importantly lower number of patients to detect changes in kidney volume induced by drug treatment as compared to other methods. Conclusions Planimetry should be preferred over fast and simplified methods for accurately monitoring ADPKD progression and assessing drug treatment effects. Expert operators, especially on MR images, are required for performing reliable estimation of kidney volume. The use of efficient TKV quantification methods considerably reduces the number of patients to enrol in clinical investigations, making them more feasible and significant. PMID:28558028

Confluence and Contours: Reflexive Management of Environmental Risk

PubMed Central

Schubert, Iljana; Pollard, Simon; Rocks, Sophie; Black, Edgar

2015-01-01

Government institutions have responsibilities to distribute risk management funds meaningfully and to be accountable for their choices. We took a macro‐level sociological approach to understanding the role of government in managing environmental risks, and insights from micro‐level psychology to examine individual‐level risk‐related perceptions and beliefs. Survey data from 2,068 U.K. citizens showed that lay people's funding preferences were associated positively with beliefs about responsibility and trust, yet associations with perception varied depending on risk type. Moreover, there were risk‐specific differences in the funding preferences of the lay sample and 29 policymakers. A laboratory‐based study of 109 participants examined funding allocation in more detail through iterative presentation of expert information. Quantitative and qualitative data revealed a meso‐level framework comprising three types of decisionmakers who varied in their willingness to change funding allocation preferences following expert information: adaptors, responders, and resistors. This research highlights the relevance of integrated theoretical approaches to understanding the policy process, and the benefits of reflexive dialogue to managing environmental risks. PMID:26720858

Expert operator's associate: A knowledge based system for spacecraft control

NASA Technical Reports Server (NTRS)

Nielsen, Mogens; Grue, Klaus; Lecouat, Francois

1991-01-01

The Expert Operator's Associate (EOA) project is presented which studies the applicability of expert systems for day-to-day space operations. A prototype expert system is developed, which operates on-line with an existing spacecraft control system at the European Space Operations Centre, and functions as an 'operator's assistant' in controlling satellites. The prototype is demonstrated using an existing real-time simulation model of the MARECS-B2 telecommunication satellite. By developing a prototype system, the extent to which reliability and effectivens of operations can be enhanced by AI based support is examined. In addition the study examines the questions of acquisition and representation of the 'knowledge' for such systems, and the feasibility of 'migration' of some (currently) ground-based functions into future spaceborne autonomous systems.

Facial profile preferences, self-awareness and perception among groups of people in the United Arab Emirates

PubMed Central

Al Taki, Amjad; Guidoum, Amina

2014-01-01

Objectives: The objective of this study is to assess the differences in facial profile preference among different layers of people in the United Arab Emirates. Facial profile self-awareness among the different groups was also evaluated. Materials and Methods: A total sample of 222 participants (mean [standard deviation] age = 25.71 [8.3] years, almost 80% of the participants were of Arab origin and 55% were males); consisting of 60 laypersons, 60 dental students, 60 general practitioners, 16 oral surgeons, and 26 orthodontists. Facial profile photographs of a male and female adult with straight profiles and a Class I skeletal relationship were used as a baseline template. Computerized photographic image modification was carried out on the templates to obtain seven different facial profile silhouettes for each gender. To assess differences in facial profile perception, participants were asked to rank the profiles of each gender on a scale from most to least attractive (1 [highest score] and 7 [least score]). Awareness and satisfaction with the facial appearance on a profile view was assessed using questionnaires completed by the non-expert groups. Results: The straight facial profile was perceived to be highly attractive by all five groups. The least attractive profiles were the bimaxillary protrusion and the mandibular retrusion for the male and the female profiles, respectively. Lip protrusion was more esthetically acceptable in females. Significant differences in perception existed among groups. The female profile esthetic perception was highly correlated between the expert groups (P > 0.05). Overall agreement between the non-expert group's perceptions of their own profiles and evaluation by the expert orthodontist was 51% (κ = 0.089). Candidates who perceived themselves as having a Class III facial profile were the least satisfied with their profile. Conclusions: Dental professionals, dental students, and laypersons had a similar perception trends in female and male aesthetic preference. Laypersons were more tolerant to profiles with bi-maxillary retrusion. The expert group's esthetic perception was highly correlated only for the female profiles. Most of the non-experts were unable to correctly identify their facial profile. PMID:24987664

Scuba diving & underwater cultural resources: differences in environmental beliefs, ascriptions of responsibility, and management preferences based on level of development

Treesearch

Sharon L. Todd; Tiffany Cooper; Alan R. Graefe

2001-01-01

This study examined SCUBA divers' level of development in relationship to environmental beliefs, ascriptions of responsibility, and management preferences concerning the use and management of New York's Great Lakes' underwater cultural resources. More than 850 New York State divers were surveyed during the fall of 1999, ranging from novices to experts...

Sensory profiling and consumer acceptability of new dark cocoa bars containing Tuscan autochthonous food products.

PubMed

Cantini, Claudio; Salusti, Patrizia; Romi, Marco; Francini, Alessandra; Sebastiani, Luca

2018-03-01

A new set of cocoa bars named Toscolata ® were developed containing top-quality extra virgin olive oil, dried apples cultivars, and chestnut flour. The present work has been conducted to define the sensory profile of these products through tasting by trained experts and consumers to study the acceptability, preference, and quality perception. The four sensorial profiles of the bars differed in the level of persistence, bitterness, aromaticity, acidity, astringency, and tastiness. In particular, the sour attribute could be traced to the presence of dried apple. Bars containing apple and chestnut flour obtained higher acceptance ratings, compared to those with extra virgin olive oil. The bar with chestnut flour was preferred by consumers who considered it to be sweeter due to the presence of natural sugars, which lowered the bitter sensation of cocoa. These results showed that the selection of the preferred bar by consumers was mainly based on the level of bitterness and, in particular, elderly consumers expressed a strong preference for the sweetest product. As far as we know, this is the first study comparing the results of a panel of expert tasters with that of consumers in the tasting of dark chocolate.

Analysing pseudoephedrine/methamphetamine policy options in Australia using multi-criteria decision modelling.

PubMed

Manning, Matthew; Wong, Gabriel T W; Ransley, Janet; Smith, Christine

2016-06-01

In this paper we capture and synthesize the unique knowledge of experts so that choices regarding policy measures to address methamphetamine consumption and dependency in Australia can be strengthened. We examine perceptions of the: (1) influence of underlying factors that impact on the methamphetamine problem; (2) importance of various models of intervention that have the potential to affect the success of policies; and (3) efficacy of alternative pseudoephedrine policy options. We adopt a multi-criteria decision model to unpack factors that affect decisions made by experts and examine potential variations on weight/preference among groups. Seventy experts from five groups (i.e. academia (18.6%), government and policy (27.1%), health (18.6%), pharmaceutical (17.1%) and police (18.6%)) in Australia participated in the survey. Social characteristics are considered the most important underlying factor, prevention the most effective strategy and Project STOP the most preferred policy option with respect to reducing methamphetamine consumption and dependency in Australia. One-way repeated ANOVAs indicate a statistically significant difference with regards to the influence of underlying factors (F(2.3, 144.5)=11.256, p<.001), effectiveness of interventions (F(2.4, 153.1)=28.738, p<.001) and policy options (F(2.8, 175.5)=70.854, p<.001). A majority of respondents believed that genetic, biological, emotional, cognitive and social factors are the most influential explanatory variables in terms of methamphetamine consumption and dependency. Most experts support the use of preventative mechanisms to inhibit drug initiation and delayed drug uptake. Compared to other policies, Project STOP (which aims to disrupt the initial diversion of pseudoephedrine) appears to be a more preferable preventative mechanism to control the production and subsequent sale and use of methamphetamine. This regulatory civil law lever engages third parties in controlling drug-related crime. The literature supports third-party partnerships as it engages experts who have knowledge and expertise with respect to prevention and harm minimization. Copyright © 2016 Elsevier B.V. All rights reserved.

Ultrasound Fracture Diagnosis in Space

NASA Technical Reports Server (NTRS)

Dulchavsky, Scott A.; Amponsah, David; Sargsyan, Ashot E.; Garcia, Kathleen M.; Hamilton, Douglas R.; vanHolsbeeck, Marnix

2010-01-01

Introduction: This ground-based investigation accumulated high-level clinical evidence on the sensitivity and specificity of point of care ultrasound performed by expert and novice users for the rapid diagnosis of musculoskeletal (MSK) injuries. We developed preliminary educational methodologies to provide just-in-time training of novice users by creating multi-media training tools and imaging procedures for non expert operators and evaluated the sensitivity and specificity of non-expert performed musculoskeletal ultrasound to diagnose acute injuries in a Level 1 Trauma Center. Methods: Patients with potential MSK injuries were identified in the emergency room. A focused MSK ultrasound was performed by expert operators and compared to standard radiographs. A repeat examination was performed by non-expert operators who received a short, just-in-time multimedia education aid. The sensitivity and specificity of the expert and novice ultrasound examinations were compared to gold standard radiography. Results: Over 800 patients were enrolled in this study. The sensitivity and specificity of expert performed ultrasound exceeded 98% for MSK injuries. Novice operators achieved 97% sensitivity and 99% specificity for targeted examinations with the greatest error in fractures involving the hand and foot. Conclusion: Point of care ultrasound is a sensitive and specific diagnostic test for MSK injury when performed by experts and just-in-time trained novice operators.

Operation and Structure of an Artificial Intelligence Expert Consultative System for Reading and Learning.

ERIC Educational Resources Information Center

Balajthy, Ernest

1989-01-01

The article examines decision-making expert systems and discusses their implications for diagnosis and prescription of reading difficulties. A detailed description of how a reading diagnostic expert system might operate to aid classroom teachers is followed by a discussion of advantages and limitations of expert systems for educational use.…

Expanding choices in intranasal steroid therapy: summary of a roundtable meeting.

PubMed

Blaiss, Michael S; Benninger, Michael S; Fromer, Len; Gross, Gary; Mabry, Richard; Mahr, Todd; Marple, Bradley; Stoloff, Stuart

2006-01-01

Intranasal steroids (INSs) are recommended as first-line treatment for allergic rhinitis (AR) and a wealth of data exist supporting them as safe and effective. Our goal was to develop a consensus to help physicians choose between INSs by focusing on clinical profiles and patient preferences and providing expert advice on choosing the appropriate INS for each patient. Experts from specialties that manage patients with AR attended a roundtable meeting to discuss INS therapy. Besides comparisons with other pharmacologic agents, they examined the effects of INS on nasal anatomy, patient preferences for INS, and benefits of product selection based on patient profile. The literature on INSs in AR was reviewed, examining properties of the various drugs, delivery devices, formulations, and patient preference data. Nasal anatomy and physiology must be considered to optimize INS deposition in the nose. Teaching patients proper technique for using INS devices is important to prevent nasal injury and may help concentrate drug effect on affected tissues. INS therapies differ somewhat in biological properties and specific formulation; however, all are considered safe and effective treatment for AR. Patients exhibit different clinical profiles, which play a role in INS selection. Patients can clearly identify sensory characteristics of INS and therefore establish product preference. Patient preference also can guide physicians in choosing the appropriate agent for each patient. Control of AR requires a systematic approach to treatment selection and follow-up. Treatment selection should be matched with clinical profile and patient preferences.

Real Time Data System (RTDS)

NASA Technical Reports Server (NTRS)

Muratore, John F.

1991-01-01

Lessons learned from operational real time expert systems are examined. The basic system architecture is discussed. An expert system is any software that performs tasks to a standard that would normally require a human expert. An expert system implies knowledge contained in data rather than code. And an expert system implies the use of heuristics as well as algorithms. The 15 top lessons learned by the operation of a real time data system are presented.

Expert system development methodology and the transition from prototyping to operations: FIESTA, a case study

NASA Technical Reports Server (NTRS)

Happell, Nadine; Miksell, Steve; Carlisle, Candace

1989-01-01

A major barrier in taking expert systems from prototype to operational status involves instilling end user confidence in the operational system. The software of different life cycle models is examined and the advantages and disadvantages of each when applied to expert system development are explored. The Fault Isolation Expert System for Tracking and data relay satellite system Applications (FIESTA) is presented as a case study of development of an expert system. The end user confidence necessary for operational use of this system is accentuated by the fact that it will handle real-time data in a secure environment, allowing little tolerance for errors. How FIESTA is dealing with transition problems as it moves from an off-line standalone prototype to an on-line real-time system is discussed.

Expert system development methodology and the transition from prototyping to operations - Fiesta, a case study

NASA Technical Reports Server (NTRS)

Happell, Nadine; Miksell, Steve; Carlisle, Candace

1989-01-01

A major barrier in taking expert systems from prototype to operational status involves instilling end user confidence in the operational system. The software of different life cycle models is examined and the advantages and disadvantages of each when applied to expert system development are explored. The Fault Isolation Expert System for Tracking and data relay satellite system Applications (FIESTA) is presented as a case study of development of an expert system. The end user confidence necessary for operational use of this system is accentuated by the fact that it will handle real-time data in a secure environment, allowing little tolerance for errors. How FIESTA is dealing with transition problems as it moves from an off-line standalone prototype to an on-line real-time system is discussed.

The Development of Selective Copying: Children's Learning from an Expert versus Their Mother

ERIC Educational Resources Information Center

Lucas, Amanda J.; Burdett, Emily R. R.; Burgess, Vanessa; Wood, Lara A.; McGuigan, Nicola; Harris, Paul L.; Whiten, Andrew

2017-01-01

This study tested the prediction that, with age, children should rely less on familiarity and more on expertise in their selective social learning. Experiment 1 (N = 50) found that 5- to 6-year-olds copied the technique their mother used to extract a prize from a novel puzzle box, in preference to both a stranger and an established expert. This…

Disarmament Education, Education for International Understanding, Global Education, Peace Education and Other Related Terms: Comments and Preferences in a Group of Experts. Peace Education Miniprints No. 61.

ERIC Educational Resources Information Center

Bjerstedt, Ake

Fifty experts, representing 22 countries provide their comments and views on the use of terms such as "disarmament education" and "peace education" in international debates. Part 1 of the report presents a summarization of the major characteristics of the answers. Some of the interviewees emphasize that the terms are not…

Formal analysis of the surgical pathway and development of a new software tool to assist surgeons in the decision making in primary breast surgery.

PubMed

Catanuto, Giuseppe; Pappalardo, Francesco; Rocco, Nicola; Leotta, Marco; Ursino, Venera; Chiodini, Paolo; Buggi, Federico; Folli, Secondo; Catalano, Francesca; Nava, Maurizio B

2016-10-01

The increased complexity of the decisional process in breast cancer surgery is well documented. With this study we aimed to create a software tool able to assist patients and surgeons in taking proper decisions. We hypothesized that the endpoints of breast cancer surgery could be addressed combining a set of decisional drivers. We created a decision support system software tool (DSS) and an interactive decision tree. A formal analysis estimated the information gain derived from each feature in the process. We tested the DSS on 52 patients and we analyzed the concordance of decisions obtained by different users and between the DSS suggestions and the actual surgery. We also tested the ability of the system to prevent post breast conservation deformities. The information gain revealed that patients preferences are the root of our decision tree. An observed concordance respectively of 0.98 and 0.88 was reported when the DSS was used twice by an expert operator or by a newly trained operator vs. an expert one. The observed concordance between the DSS suggestion and the actual decision was 0.69. A significantly higher incidence of post breast conservation defects was reported among patients who did not follow the DSS decision (Type III of Fitoussi, N = 4; 33.3%, p = 0.004). The DSS decisions can be reproduced by operators with different experience. The concordance between suggestions and actual decision is quite low, however the DSS is able to prevent post- breast conservation deformities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Some Effects on Beliefs about Work Performance of Administrators of Different Sex, Sexual Preference and Administrative Locus.

ERIC Educational Resources Information Center

Logiudice, Angelo J.

This document reports on a study in which 96 administrators, 4 authorities, 5 experts, and 16 individuals were sampled to isolate and identify some typologies of belief that administrators may have toward gay people in the workplace and to see how those typologies are affected by sex, sexual preference, and worksetting. A detailed description of…

Emergency contraceptive use in Addis Ababa, Ethiopia: Challenging common assumptions about young people's contraceptive practices.

PubMed

Both, Rosalijn

2015-05-01

Drawing on an ethnographic case study of young people's (aged 18-29) use of emergency contraceptives (ECs) in Addis Ababa, Ethiopia, this article highlights areas of disconnect between how reproductive health experts envision EC use and local meanings ascribed to ECs by young people. ECs - designed by reproductive health experts to be used only in case of emergency - were preferred by study participants over other contraceptive methods because of their ease of use, discreetness, perceived minimal side effects on beauty and future fertility, and usefulness in navigating reproductive intentions. The findings point to features that young people find desirable when it comes to contraceptive methods and suggest that common assumptions of reproductive health experts about young people's contraceptive practices need to be reconsidered, namely: 1) that young people can plan for prevention of unwanted pregnancy by buying a contraceptive method in advance; 2) that existing contraceptive technologies are appropriate for young people; 3) that young people prefer to use modern contraceptive methods; and 4) that young people in premarital relationships aim to prevent unplanned pregnancy. Copyright © 2015. Published by Elsevier Ltd.

Do Children Copy an Expert or a Majority? Examining Selective Learning in Instrumental and Normative Contexts.

PubMed

Burdett, Emily R R; Lucas, Amanda J; Buchsbaum, Daphna; McGuigan, Nicola; Wood, Lara A; Whiten, Andrew

2016-01-01

This study examined whether instrumental and normative learning contexts differentially influence 4- to 7-year-old children's social learning strategies; specifically, their dispositions to copy an expert versus a majority consensus. Experiment 1 (N = 44) established that children copied a relatively competent "expert" individual over an incompetent individual in both kinds of learning context. In experiment 2 (N = 80) we then tested whether children would copy a competent individual versus a majority, in each of the two different learning contexts. Results showed that individual children differed in strategy, preferring with significant consistency across two different test trials to copy either the competent individual or the majority. This study is the first to show that children prefer to copy more competent individuals when shown competing methods of achieving an instrumental goal (Experiment 1) and provides new evidence that children, at least in our "individualist" culture, may consistently express either a competency or majority bias in learning both instrumental and normative information (Experiment 2). This effect was similar in the instrumental and normative learning contexts we applied.

PREFERED SURGICAL TECHNIQUE USED BY ORTHOPEDISTS IN ACUTE ACROMIOCLAVICULAR DISLOCATION

PubMed Central

NISHIMI, ALEXANDRE YUKIO; ARBEX, DEMETRIO SIMÃO; MARTINS, DIOGO LUCAS CAMPOS; GUSMÃO, CARLOS VINICIUS BUARQUE DE; BONGIOVANNI, ROBERTO RANGEL; PASCARELLI, LUCIANO

2016-01-01

ABSTRACT Objective: To determine whether training on shoulder and elbow surgery influences the orthopedist surgeons' preferred technique to address acute acromioclavicular joint dislocation (ACD). Methods: A survey was conducted with shoulder and elbow specialists and general orthopedists on their preferred technique to address acute ACD. Results: Thirty specialists and forty-five general orthopedists joined the study. Most specialists preferred the endobutton technique, while most general orthopedists preferred the modified Phemister procedure for coracoclavicular ligament repair using anchors. We found no difference between specialists and general orthopedists in the number of tunnels used to repair the coracoclavicular ligament; preferred method for wire insertion through the clavicular tunnels; buried versus unburied Kirschner wire insertion for acromioclavicular temporary fixation; and time for its removal; and regarding the suture thread used for deltotrapezoidal fascia closure. Conclusion: Training on shoulder and elbow surgery influences the surgeons' preferred technique to address acute ACD. Level of Evidence V, Expert Opinion. PMID:28149190

Confluence and Contours: Reflexive Management of Environmental Risk.

PubMed

Soane, Emma; Schubert, Iljana; Pollard, Simon; Rocks, Sophie; Black, Edgar

2016-06-01

Government institutions have responsibilities to distribute risk management funds meaningfully and to be accountable for their choices. We took a macro-level sociological approach to understanding the role of government in managing environmental risks, and insights from micro-level psychology to examine individual-level risk-related perceptions and beliefs. Survey data from 2,068 U.K. citizens showed that lay people's funding preferences were associated positively with beliefs about responsibility and trust, yet associations with perception varied depending on risk type. Moreover, there were risk-specific differences in the funding preferences of the lay sample and 29 policymakers. A laboratory-based study of 109 participants examined funding allocation in more detail through iterative presentation of expert information. Quantitative and qualitative data revealed a meso-level framework comprising three types of decisionmakers who varied in their willingness to change funding allocation preferences following expert information: adaptors, responders, and resistors. This research highlights the relevance of integrated theoretical approaches to understanding the policy process, and the benefits of reflexive dialogue to managing environmental risks. © 2015 Society for Risk Analysis.

Storytelling of co-operative team meetings in acute psychiatric care.

PubMed

Vuokila-Oikkonen, Päivi; Janhonen, Sirpa; Saarento, Outi; Harri, Marja

2002-10-01

One of the goals of co-operative psychiatric nursing and co-operative team meetings is to improve patients' and significant others' participation and thus, to enhance patients' resources outside the hospital. The objective of this paper is to describe the different expert interventions that either enabled or prevented patient and his/her significant others participation in co-operative team meetings in acute psychiatric wards. The data consisted of 11 videotaped team meetings. The participants were voluntary patients, significant others and experts in health and social care. A narrative approach focused on the storytelling of all members in the meetings. The method of modified dialogue analysis was used to identify the ideas of the stories. The same topic of discussion was shared in active participation. The experts asked open-ended questions, the patient and his/her significant others' were free to express their viewpoints and the experts' interpretation was based on their stories. The experts presented the reasons for their questions, and the contents of the questions were verbalized. In passive participation, the experts questions were based on their own point of view, and the patient and his significant others merely answered these questions. If the expert opinion appeared too dominating at the co-operative team meeting, the patient's and his/her significant others' participation was in jeopardy. The physician either dominates the storytelling or gives space for free expressions of various viewpoints during the co-operative team meetings.

Mapping on complex neutrosophic soft expert sets

NASA Astrophysics Data System (ADS)

Al-Quran, Ashraf; Hassan, Nasruddin

2018-04-01

We introduce the mapping on complex neutrosophic soft expert sets. Further, we investigated the basic operations and other related properties of complex neutrosophic soft expert image and complex neutrosophic soft expert inverse image of complex neutrosophic soft expert sets.

Research on an expert system for database operation of simulation-emulation math models. Volume 2, Phase 1: Results

NASA Technical Reports Server (NTRS)

Kawamura, K.; Beale, G. O.; Schaffer, J. D.; Hsieh, B. J.; Padalkar, S.; Rodriguez-Moscoso, J. J.

1985-01-01

A reference manual is provided for NESS, a simulation expert system. This manual gives user information regarding starting and operating NASA expert simulation system (NESS). This expert system provides an intelligent interface to a generic simulation program for spacecraft attitude control problems. A menu of the functions the system can perform is provided. Control repeated returns to this menu after executing each user request.

Antenatal management of twin-twin transfusion syndrome and twin anemia-polycythemia sequence.

PubMed

Slaghekke, Femke; Zhao, Depeng P; Middeldorp, Johanna M; Klumper, Frans J; Haak, Monique C; Oepkes, Dick; Lopriore, Enrico

2016-08-01

Twin-twin transfusion syndrome (TTTS) and twin anemia polycythemia sequence (TAPS) are severe complications in monochorionic twin pregnancies associated with high mortality and morbidity risk if left untreated. Both diseases result from imbalanced inter-twin blood transfusion through placental vascular anastomoses. This review focuses on the differences in antenatal management between TTTS and TAPS. Expert commentary: The optimal management for TTTS is fetoscopic laser coagulation of the vascular anastomoses, preferably using the Solomon technique in which the whole vascular equator is coagulated. The Solomon technique is associated with a reduction of residual anastomosis and a reduction in post-operative complications. The optimal management for TAPS is not clear and includes expectant management, intra-uterine transfusion with or without partial exchange transfusion and fetoscopic laser surgery.

Comparison of two multi-criteria decision techniques for eliciting treatment preferences in people with neurological disorders.

PubMed

Ijzerman, Maarten J; van Til, Janine A; Snoek, Govert J

2008-12-01

To present and compare two multi-criteria decision techniques (analytic hierarchy process [AHP] and conjoint analysis [CA]) for eliciting preferences in patients with cervical spinal cord injury (SCI) who are eligible for surgical augmentation of hand function, either with or without implantation of a neuroprosthesis. The methods were compared in respect to attribute weights, overall preference, and practical experiences. Two previously designed and administered multi-criteria decision surveys in patients with SCI were compared and further analysed. Attributes and their weights in the AHP experiment were determined by an expert panel, followed by determination of the weights in the patient group. Attributes for the CA were selected and validated using an expert panel, piloted in six patients with SCI and subsequently administered to the same group of patients as participated in the AHP experiment. Both experiments showed the importance of non-outcome-related factors such as inpatient stay and number of surgical procedures. In particular, patients were less concerned with clinical outcomes in actual decision making. Overall preference in both the AHP and CA was in favor of tendon reconstruction (0.6 vs 0.4 for neuroprosthetic implantation). Both methods were easy to apply, but AHP was less easily explained and understood. Both the AHP and CA methods produced similar outcomes, which may have been caused by the obvious preferences of patients. CA may be preferred because of the holistic approach of considering all treatment attributes simultaneously and, hence, its power in simulating real market decisions. On the other hand, the AHP method is preferred as a hands-on, easy-to-implement task with immediate feedback to the respondent. This flexibility allows AHP to be used in shared decision making. However, the way the technique is composed results in many inconsistencies. Patients preferred CA but complained about the number of choice tasks.

A decision support tool for selecting the optimal sewage sludge treatment.

PubMed

Turunen, Ville; Sorvari, Jaana; Mikola, Anna

2018-02-01

Sewage sludge contains significant amounts of resources, such as nutrients and organic matter. At the same time, the organic contaminants (OC) found in sewage sludge are of growing concern. Consequently, in many European countries incineration is currently favored over recycling in agriculture. This study presents a Multi-Attribute Value Theory (MAVT)-based decision support tool (DST) for facilitating sludge treatment decisions. Essential decision criteria were recognized and prioritized, i.e., weighted, by experts from water utilities. Since the fate of organic contaminants was in focus, a simple scoring method was developed to take into account their environmental risks. The final DST assigns each sludge treatment method a preference score expressing its superiority compared to alternative methods. The DST was validated by testing it with data from two Finnish municipal wastewater treatment plants (WWTP). The validation results of the first case study preferred sludge pyrolysis (preference score: 0.629) to other alternatives: composting and incineration (score 0.580, and 0.484 respectively). The preference scores were influenced by WWTP dependent factors, i.e., the operating environment and the weighting of the criteria. A lack of data emerged as the main practical limitation. Therefore, not all of the relevant criteria could be included in the value tree. More data are needed on the effects of treatment methods on the availability of nutrients, the quality of organic matter and sludge-borne OCs. Despite these shortcomings, the DST proved useful and adaptable in decision-making. It can also help achieve a more transparent, understandable and comprehensive decision-making process. Copyright © 2017 Elsevier Ltd. All rights reserved.

The expert consensus guideline series. Optimizing pharmacologic treatment of psychotic disorders. Introduction: methods, commentary, and summary.

PubMed

Kane, John M; Leucht, Stefan; Carpenter, Daniel; Docherty, John P

2003-01-01

A growing number of atypical antipsychotics are available for clinicians to choose from in the treatment of psychotic disorders. However, a number of important questions concerning medication selection, dosing and dose equivalence, and the management of inadequate response, compliance problems, and relapse have not been adequately addressed by clinical trials. To aid clinical decision-making, a consensus survey of expert opinion on the pharmacologic treatment of psychotic disorders was undertaken to address questions not definitively answered in the research literature. Based on a literature review, a written survey was developed with 60 questions and 994 options. Approximately half of the options were scored using a modified version of the RAND 9-point scale for rating the appropriateness of medical decisions. For the other options, the experts were asked to write in answers (e.g., average doses) or check a box to indicate their preferred answer. The survey was sent to 50 national experts on the pharmacologic treatment of psychotic disorders, 47 (94%) of whom completed it. In analyzing the responses to items rated on the 9-point scale, consensus on each option was defined as a non random distribution of scores by chi-square "goodness-of-fit"test. We assigned a categorical rank (first line/preferred choice,second line/alternate choice, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean rating. Guideline tables indicating preferred treatment strategies were then developed for key clinical situations. The expert panel reached consensus on 88% of the options rated on the 9-point scale. The experts overwhelmingly endorsed the atypical antipsychotics for the treatment of psychotic disorders. Risperidone was the top choice for first-episode and multi-episode patients, with the other newer atypicals rated first line or high second line depending on the clinical situation. Clozapine and a long-acting injectable atypical (when available)were other high second line options for multi-episode patients. The expert's dosing recommendations agreed closely with the package inserts for the drugs, and their estimates of dose equivalence among the antipsychotics followed a linear pattern. The experts considered 3-6 weeks an adequate antipsychotic trial, but would wait a little longer (4-10 weeks) before making a major change in treatment regimen if there is a partial response. The experts recommended trying to improve response by increasing the dose of atypical and depot antipsychotics before switching to a different agent; there was less agreement about increasing the dose of conventional antipsychotics before switching, probably because of concern about side effects at higher doses. If it is decided to switch because of inadequate response, risperidone was the expert's first choice to switch to, no matter what drug was initially tried. Although there was some disparity in the expert's recommendations concerning how many agents to try before switching to clozapine, the expert's responses suggest that switching to clozapine should be Clozapine was also the antipsychotic of choice for patients with suicidal behavior. When switching oral antipsychotics,the experts considered cross-titration the preferred strategy. When switching to an injectable antipsychotic, the experts stressed the importance of continuing the oral antipsychotic until therapeutic levels of the injectable agent are achieved. The experts considered psychosocial interventions the first choice strategy for partially compliant patients, with pharmacologic interventions the first choice for patients with clear evidence of noncompliance. However, because it can be difficult to distinguish partially compliant from noncompliant patients, the editors recommended combining psychosocial and pharmacologic interventions to improve compliance whenever possible. When patients relapse because of compliance problems or if there is any doubt about compliance, the experts recommended the use of a long-acting injectable antipsychotic and would select an injectable atypical when this option becomes available. The experts would also consider using an injectable atypical antipsychotic (when available) in many clinical situations that do not involve compliance problems. The experts stressed the importance of monitoring for health problems-especially obesity, diabetes, cardiovascular problems,HIV risk behaviors, medical complications of substance abuse, heavy smoking and its effects, hypertension, and amenorrhea-in patients being treated with antipsychotics. Although many patients are prescribed adjunctive treatments,multiple antipsychotics, and combinations of different classes of drugs (e.g., antipsychotics plus mood stabilizers or antidepressants) in an effort to enhance response, the experts gave little support to any of these strategies, with the exception of antidepressants for patients with dysphoria/depression, antidepressants or ECT for patients with suicidal behavior, and mood stabilizers for patients with aggression/violence. When asked about indicators of remission and recovery, the experts considered acute improvement in psychotic symptoms the most important indicator of remission, whereas they considered more sustained improvement in multiple outcome domains (e.g., occupational/educational functioning, peer relationships,independent living) important in assessing recovery. The experts reached a high level of consensus on many of the key treatment questions in the survey. Within the limits of expert opinion and with the expectation that future research data will take precedence, these guidelines provide direction for addressing common clinical dilemmas that arise in the pharmacologic treatment of psychotic disorders. They can be used to inform clinicians and educate patients regarding the relative merits of a variety of interventions. Clinicians should keep in mind that no guidelines can address the complexities involved in the care of each individual patient and that sound clinical judgment based on clinical experience should be used in applying these recommendations.

Participatory flood vulnerability assessment: a multi-criteria approach

NASA Astrophysics Data System (ADS)

Madruga de Brito, Mariana; Evers, Mariele; Delos Santos Almoradie, Adrian

2018-01-01

This paper presents a participatory multi-criteria decision-making (MCDM) approach for flood vulnerability assessment while considering the relationships between vulnerability criteria. The applicability of the proposed framework is demonstrated in the municipalities of Lajeado and Estrela, Brazil. The model was co-constructed by 101 experts from governmental organizations, universities, research institutes, NGOs, and private companies. Participatory methods such as the Delphi survey, focus groups, and workshops were applied. A participatory problem structuration, in which the modellers work closely with end users, was used to establish the structure of the vulnerability index. The preferences of each participant regarding the criteria importance were spatially modelled through the analytical hierarchy process (AHP) and analytical network process (ANP) multi-criteria methods. Experts were also involved at the end of the modelling exercise for validation. The final product is a set of individual and group flood vulnerability maps. Both AHP and ANP proved to be effective for flood vulnerability assessment; however, ANP is preferred as it considers the dependences among criteria. The participatory approach enabled experts to learn from each other and acknowledge different perspectives towards social learning. The findings highlight that to enhance the credibility and deployment of model results, multiple viewpoints should be integrated without forcing consensus.

Emerging Technologies for Environmental Remediation: Integrating Data and Judgment.

PubMed

Bates, Matthew E; Grieger, Khara D; Trump, Benjamin D; Keisler, Jeffrey M; Plourde, Kenton J; Linkov, Igor

2016-01-05

Emerging technologies present significant challenges to researchers, decision-makers, industry professionals, and other stakeholder groups due to the lack of quantitative risk, benefit, and cost data associated with their use. Multi-criteria decision analysis (MCDA) can support early decisions for emerging technologies when data is too sparse or uncertain for traditional risk assessment. It does this by integrating expert judgment with available quantitative and qualitative inputs across multiple criteria to provide relative technology scores. Here, an MCDA framework provides preliminary insights on the suitability of emerging technologies for environmental remediation by comparing nanotechnology and synthetic biology to conventional remediation methods. Subject matter experts provided judgments regarding the importance of criteria used in the evaluations and scored the technologies with respect to those criteria. The results indicate that synthetic biology may be preferred over nanotechnology and conventional methods for high expected benefits and low deployment costs but that conventional technology may be preferred over emerging technologies for reduced risks and development costs. In the absence of field data regarding the risks, benefits, and costs of emerging technologies, structuring evidence-based expert judgment through a weighted hierarchy of topical questions may be helpful to inform preliminary risk governance and guide emerging technology development and policy.

Relationship between automation trust and operator performance for the novice and expert in spacecraft rendezvous and docking (RVD).

PubMed

Niu, Jianwei; Geng, He; Zhang, Yijing; Du, Xiaoping

2018-09-01

Operator trust in automation is a crucial factor influencing its use and operational performance. However, the relationship between automation trust and performance remains poorly understood and requires further investigation. The objective of this paper is to explore the difference in trust and performance on automation-aided spacecraft rendezvous and docking (RVD) between the novice and the expert and to investigate the relationship between automation trust and performance as well. We employed a two-factor mixed design, with training skill (novice and expert) and automation mode (manual RVD and automation aided RVD) serving as the two factors. Twenty participants, 10 novices and 10 experts, were recruited to conduct six RVD tasks for two automation levels. After the tasks, operator performance was recorded by the desktop hand-held docking training equipment. Operator trust was also measured by a 12-items questionnaire at the beginning and end of each trial. As a result, automation narrowed the performance gap significantly between the novice and the expert, and the automation trust showed a marginally significant difference between the novice and the expert. Furthermore, the result demonstrated that the attitude angle control error of the expert was related to the total trust score, whereas other automation performance indicators were not related to the total score of trust. However, automation performance was related to the dimensions of trust, such as entrust, harmful, and dependable. Copyright © 2018 Elsevier Ltd. All rights reserved.

Notification of real-time clinical alerts generated by pharmacy expert systems.

PubMed Central

Miller, J. E.; Reichley, R. M.; McNamee, L. A.; Steib, S. A.; Bailey, T. C.

1999-01-01

We developed and implemented a strategy for notifying clinical pharmacists of alerts generated in real-time by two pharmacy expert systems: one for drug dosing and the other for adverse drug event prevention. Display pagers were selected as the preferred notification method and a concise, yet readable, format for displaying alert data was developed. This combination of real-time alert generation and notification via display pagers was shown to be efficient and effective in a 30-day trial. PMID:10566374

Evaluating progressive-rendering algorithms in appearance design tasks.

PubMed

Jiawei Ou; Karlik, Ondrej; Křivánek, Jaroslav; Pellacini, Fabio

2013-01-01

Progressive rendering is becoming a popular alternative to precomputational approaches to appearance design. However, progressive algorithms create images exhibiting visual artifacts at early stages. A user study investigated these artifacts' effects on user performance in appearance design tasks. Novice and expert subjects performed lighting and material editing tasks with four algorithms: random path tracing, quasirandom path tracing, progressive photon mapping, and virtual-point-light rendering. Both the novices and experts strongly preferred path tracing to progressive photon mapping and virtual-point-light rendering. None of the participants preferred random path tracing to quasirandom path tracing or vice versa; the same situation held between progressive photon mapping and virtual-point-light rendering. The user workflow didn’t differ significantly with the four algorithms. The Web Extras include a video showing how four progressive-rendering algorithms converged (at http://youtu.be/ck-Gevl1e9s), the source code used, and other supplementary materials.

Identifying and Modeling Dynamic Preference Evolution in Multipurpose Water Resources Systems

NASA Astrophysics Data System (ADS)

Mason, E.; Giuliani, M.; Castelletti, A.; Amigoni, F.

2018-04-01

Multipurpose water systems are usually operated on a tradeoff of conflicting operating objectives. Under steady state climatic and socioeconomic conditions, such tradeoff is supposed to represent a fair and/or efficient preference. Extreme variability in external forcing might affect water operators' risk aversion and force a change in her/his preference. Properly accounting for these shifts is key to any rigorous retrospective assessment of the operator's behaviors, and to build descriptive models for projecting the future system evolution. In this study, we explore how the selection of different preferences is linked to variations in the external forcing. We argue that preference selection evolves according to recent, extreme variations in system performance: underperforming in one of the objectives pushes the preference toward the harmed objective. To test this assumption, we developed a rational procedure to simulate the operator's preference selection. We map this selection onto a multilateral negotiation, where multiple virtual agents independently optimize different objectives. The agents periodically negotiate a compromise policy for the operation of the system. Agents' attitudes in each negotiation step are determined by the recent system performance measured by the specific objective they maximize. We then propose a numerical model of preference dynamics that implements a concept from cognitive psychology, the availability bias. We test our modeling framework on a synthetic lake operated for flood control and water supply. Results show that our model successfully captures the operator's preference selection and dynamic evolution driven by extreme wet and dry situations.

Objective Assessment of the Interfrontal Angle for Severity Grading and Operative Decision-Making in Metopic Synostosis.

PubMed

Anolik, Rachel A; Allori, Alexander C; Pourtaheri, Navid; Rogers, Gary F; Marcus, Jeffrey R

2016-05-01

The purpose of this study was to evaluate the utility of a previously validated interfrontal angle for classification of severity of metopic synostosis and as an aid to operative decision-making. An expert panel was asked to study 30 cases ranging from minor to severe metopic synostosis. Based on computed tomographic images of the skull and clinical photographs, they classified the severity of trigonocephaly (1 = normal, 2 = mild, 3 = moderate, and 4 = severe) and management (0 = nonoperative and 1 = operative). The severity scores and management reported by experts were then pooled and matched with the interfrontal angle computed from each respective computed tomographic scan. A threshold was identified at which most experts agree on operative management. Expert severity scores were higher for more acute interfrontal angles. There was a high concordance at the extremes of classifications, severe (4) and normal (1) (p < 0.0001); however, between interfrontal angles of 114.3 and 136.1 degrees, there exists a "gray zone," with severe discordance in expert rankings. An operative threshold of 118.2 degrees was identified, with the interfrontal angle able to predict the expert panel's decision to proceed with surgery 87.6 percent of the time. The interfrontal angle has been previously validated as a simple, accurate, and reproducible means for diagnosing trigonocephaly, but must be obtained from computed tomographic data. In this article, the authors demonstrate that the interfrontal angle can be used to further characterize the severity of trigonocephaly. It also correlated with expert decision-making for operative versus nonoperative management. This tool may be used as an adjunct to clinical decision-making when the decision to proceed with surgery may not be straightforward. Diagnostic, V.

The Influence of Art Expertise and Training on Emotion and Preference Ratings for Representational and Abstract Artworks

PubMed Central

van Paasschen, Jorien; Bacci, Francesca; Melcher, David P.

2015-01-01

Across cultures and throughout recorded history, humans have produced visual art. This raises the question of why people report such an emotional response to artworks and find some works more beautiful or compelling than others. In the current study we investigated the interplay between art expertise, and emotional and preference judgments. Sixty participants (40 novices, 20 art experts) rated a set of 150 abstract artworks and portraits during two occasions: in a laboratory setting and in a museum. Before commencing their second session, half of the art novices received a brief training on stylistic and art historical aspects of abstract art and portraiture. Results showed that art experts rated the artworks higher than novices on aesthetic facets (beauty and wanting), but no group differences were observed on affective evaluations (valence and arousal). The training session made a small effect on ratings of preference compared to the non-trained group of novices. Overall, these findings are consistent with the idea that affective components of art appreciation are less driven by expertise and largely consistent across observers, while more cognitive aspects of aesthetic viewing depend on viewer characteristics such as art expertise. PMID:26244368

The Influence of Art Expertise and Training on Emotion and Preference Ratings for Representational and Abstract Artworks.

PubMed

van Paasschen, Jorien; Bacci, Francesca; Melcher, David P

2015-01-01

Across cultures and throughout recorded history, humans have produced visual art. This raises the question of why people report such an emotional response to artworks and find some works more beautiful or compelling than others. In the current study we investigated the interplay between art expertise, and emotional and preference judgments. Sixty participants (40 novices, 20 art experts) rated a set of 150 abstract artworks and portraits during two occasions: in a laboratory setting and in a museum. Before commencing their second session, half of the art novices received a brief training on stylistic and art historical aspects of abstract art and portraiture. Results showed that art experts rated the artworks higher than novices on aesthetic facets (beauty and wanting), but no group differences were observed on affective evaluations (valence and arousal). The training session made a small effect on ratings of preference compared to the non-trained group of novices. Overall, these findings are consistent with the idea that affective components of art appreciation are less driven by expertise and largely consistent across observers, while more cognitive aspects of aesthetic viewing depend on viewer characteristics such as art expertise.

Web-based Weather Expert System (WES) for Space Shuttle Launch

NASA Technical Reports Server (NTRS)

Bardina, Jorge E.; Rajkumar, T.

2003-01-01

The Web-based Weather Expert System (WES) is a critical module of the Virtual Test Bed development to support 'go/no go' decisions for Space Shuttle operations in the Intelligent Launch and Range Operations program of NASA. The weather rules characterize certain aspects of the environment related to the launching or landing site, the time of the day or night, the pad or runway conditions, the mission durations, the runway equipment and landing type. Expert system rules are derived from weather contingency rules, which were developed over years by NASA. Backward chaining, a goal-directed inference method is adopted, because a particular consequence or goal clause is evaluated first, and then chained backward through the rules. Once a rule is satisfied or true, then that particular rule is fired and the decision is expressed. The expert system is continuously verifying the rules against the past one-hour weather conditions and the decisions are made. The normal procedure of operations requires a formal pre-launch weather briefing held on Launch minus 1 day, which is a specific weather briefing for all areas of Space Shuttle launch operations. In this paper, the Web-based Weather Expert System of the Intelligent Launch and range Operations program is presented.

Korean Medication Algorithm Project for Bipolar Disorder: third revision

PubMed Central

Woo, Young Sup; Lee, Jung Goo; Jeong, Jong-Hyun; Kim, Moon-Doo; Sohn, Inki; Shim, Se-Hoon; Jon, Duk-In; Seo, Jeong Seok; Shin, Young-Chul; Min, Kyung Joon; Yoon, Bo-Hyun; Bahk, Won-Myong

2015-01-01

Objective To constitute the third revision of the guidelines for the treatment of bipolar disorder issued by the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP 2014). Methods A 56-item questionnaire was used to obtain the consensus of experts regarding pharmacological treatment strategies for the various phases of bipolar disorder and for special populations. The review committee included 110 Korean psychiatrists and 38 experts for child and adolescent psychiatry. Of the committee members, 64 general psychiatrists and 23 child and adolescent psychiatrists responded to the survey. Results The treatment of choice (TOC) for euphoric, mixed, and psychotic mania was the combination of a mood stabilizer (MS) and an atypical antipsychotic (AAP); the TOC for acute mild depression was monotherapy with MS or AAP; and the TOC for moderate or severe depression was MS plus AAP/antidepressant. The first-line maintenance treatment following mania or depression was MS monotherapy or MS plus AAP; the first-line treatment after mania was AAP monotherapy; and the first-line treatment after depression was lamotrigine (LTG) monotherapy, LTG plus MS/AAP, or MS plus AAP plus LTG. The first-line treatment strategy for mania in children and adolescents was MS plus AAP or AAP monotherapy. For geriatric bipolar patients, the TOC for mania was AAP/MS monotherapy, and the TOC for depression was AAP plus MS or AAP monotherapy. Conclusion The expert consensus in the KMAP-BP 2014 differed from that in previous publications; most notably, the preference for AAP was increased in the treatment of acute mania, depression, and maintenance treatment. There was increased expert preference for the use of AAP and LTG. The major limitation of the present study is that it was based on the consensus of Korean experts rather than on experimental evidence. PMID:25750530

Korean Medication Algorithm Project for Bipolar Disorder: third revision.

PubMed

Woo, Young Sup; Lee, Jung Goo; Jeong, Jong-Hyun; Kim, Moon-Doo; Sohn, Inki; Shim, Se-Hoon; Jon, Duk-In; Seo, Jeong Seok; Shin, Young-Chul; Min, Kyung Joon; Yoon, Bo-Hyun; Bahk, Won-Myong

2015-01-01

To constitute the third revision of the guidelines for the treatment of bipolar disorder issued by the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP 2014). A 56-item questionnaire was used to obtain the consensus of experts regarding pharmacological treatment strategies for the various phases of bipolar disorder and for special populations. The review committee included 110 Korean psychiatrists and 38 experts for child and adolescent psychiatry. Of the committee members, 64 general psychiatrists and 23 child and adolescent psychiatrists responded to the survey. The treatment of choice (TOC) for euphoric, mixed, and psychotic mania was the combination of a mood stabilizer (MS) and an atypical antipsychotic (AAP); the TOC for acute mild depression was monotherapy with MS or AAP; and the TOC for moderate or severe depression was MS plus AAP/antidepressant. The first-line maintenance treatment following mania or depression was MS monotherapy or MS plus AAP; the first-line treatment after mania was AAP monotherapy; and the first-line treatment after depression was lamotrigine (LTG) monotherapy, LTG plus MS/AAP, or MS plus AAP plus LTG. The first-line treatment strategy for mania in children and adolescents was MS plus AAP or AAP monotherapy. For geriatric bipolar patients, the TOC for mania was AAP/MS monotherapy, and the TOC for depression was AAP plus MS or AAP monotherapy. The expert consensus in the KMAP-BP 2014 differed from that in previous publications; most notably, the preference for AAP was increased in the treatment of acute mania, depression, and maintenance treatment. There was increased expert preference for the use of AAP and LTG. The major limitation of the present study is that it was based on the consensus of Korean experts rather than on experimental evidence.

Expert systems and advanced automation for space missions operations

NASA Technical Reports Server (NTRS)

Durrani, Sajjad H.; Perkins, Dorothy C.; Carlton, P. Douglas

1990-01-01

Increased complexity of space missions during the 1980s led to the introduction of expert systems and advanced automation techniques in mission operations. This paper describes several technologies in operational use or under development at the National Aeronautics and Space Administration's Goddard Space Flight Center. Several expert systems are described that diagnose faults, analyze spacecraft operations and onboard subsystem performance (in conjunction with neural networks), and perform data quality and data accounting functions. The design of customized user interfaces is discussed, with examples of their application to space missions. Displays, which allow mission operators to see the spacecraft position, orientation, and configuration under a variety of operating conditions, are described. Automated systems for scheduling are discussed, and a testbed that allows tests and demonstrations of the associated architectures, interface protocols, and operations concepts is described. Lessons learned are summarized.

Analysis of methods of processing of expert information by optimization of administrative decisions

NASA Astrophysics Data System (ADS)

Churakov, D. Y.; Tsarkova, E. G.; Marchenko, N. D.; Grechishnikov, E. V.

2018-03-01

In the real operation the measure definition methodology in case of expert estimation of quality and reliability of application-oriented software products is offered. In operation methods of aggregation of expert estimates on the example of a collective choice of an instrumental control projects in case of software development of a special purpose for needs of institutions are described. Results of operation of dialogue decision making support system are given an algorithm of the decision of the task of a choice on the basis of a method of the analysis of hierarchies and also. The developed algorithm can be applied by development of expert systems to the solution of a wide class of the tasks anyway connected to a multicriteria choice.

Controlling Real-Time Processes On The Space Station With Expert Systems

NASA Astrophysics Data System (ADS)

Leinweber, David; Perry, John

1987-02-01

Many aspects of space station operations involve continuous control of real-time processes. These processes include electrical power system monitoring, propulsion system health and maintenance, environmental and life support systems, space suit checkout, on-board manufacturing, and servicing of attached vehicles such as satellites, shuttles, orbital maneuvering vehicles, orbital transfer vehicles and remote teleoperators. Traditionally, monitoring of these critical real-time processes has been done by trained human experts monitoring telemetry data. However, the long duration of space station missions and the high cost of crew time in space creates a powerful economic incentive for the development of highly autonomous knowledge-based expert control procedures for these space stations. In addition to controlling the normal operations of these processes, the expert systems must also be able to quickly respond to anomalous events, determine their cause and initiate corrective actions in a safe and timely manner. This must be accomplished without excessive diversion of system resources from ongoing control activities and any events beyond the scope of the expert control and diagnosis functions must be recognized and brought to the attention of human operators. Real-time sensor based expert systems (as opposed to off-line, consulting or planning systems receiving data via the keyboard) pose particular problems associated with sensor failures, sensor degradation and data consistency, which must be explicitly handled in an efficient manner. A set of these systems must also be able to work together in a cooperative manner. This paper describes the requirements for real-time expert systems in space station control, and presents prototype implementations of space station expert control procedures in PICON (process intelligent control). PICON is a real-time expert system shell which operates in parallel with distributed data acquisition systems. It incorporates a specialized inference engine with a specialized scheduling portion specifically designed to match the allocation of system resources with the operational requirements of real-time control systems. Innovative knowledge engineering techniques used in PICON to facilitate the development of real-time sensor-based expert systems which use the special features of the inference engine are illustrated in the prototype examples.

Expert Systems for United States Navy Shore Facilities Utility Operations.

DTIC Science & Technology

1988-03-01

of expertise when assessing the applicability of an expert system. Each of the tasks as similarly ranked to reflect subjective judgement on the...United States Navy Shore Facilities Utility Operations ABSTRACT A technology assessment of expert systems as they might be used in Navy utility...of these applications include design, fault diagnoses, training, data base management, and real-time monitoring. An assessment is given of each

Setting priorities for non-regulatory animal health in Ireland: results from an expert Policy Delphi study and a farmer priority identification survey.

PubMed

More, Simon J; McKenzie, Ken; O'Flaherty, Joe; Doherty, Michael L; Cromie, Andrew R; Magan, Mike J

2010-07-01

Agriculture is a very important contributor to the Irish economy. In Ireland, national animal health services have been a government, rather than an industry, responsibility. In 2009, Animal Health Ireland (AHI) was established to provide a partnership approach to national leadership of non-regulatory animal health issues (those not subject to national and/or EU regulation). The objectives of this study were to elicit opinion from experts and farmers about non-regulatory animal health issues facing Irish livestock industries, including prioritisation of animal health issues and identification of opportunities to maximise the effective use of AHI resources. The study was conducted with experts using Policy Delphi methodology over three rounds, and with farmers using a priority identification survey. Non-regulatory bovine diseases/conditions were prioritised by both experts and farmers based on impact and international competitiveness. For each high-priority disease/condition, experts were asked to provide an assessment based on cost, impact, international perception, impediment to international market access and current resource usage effectiveness. Further information was also sought from experts about resource allocation preferences, methods to improve education and coordination, and innovative measures to improve prevention and management. There was close agreement between responses from experts and dairy farmers: each gave highest priority to 3 diseases with a biosecurity risk (subsequently termed 'biosecure diseases') (bovine viral diarrhoea [BVD], infectious bovine rhinotracheitis [IBR], paratuberculosis) and 4 diseases/conditions generally without a biosecurity risk ('non-biosecure diseases/conditions') (fertility, udder health/milk quality, lameness, calf health). Beef farmers also prioritised parasitic conditions and weanling pneumonia. The adverse impact of biosecure diseases is currently considered relatively minor by experts, but would increase substantially in time. There are already substantial costs to farms and agribusiness from non-biosecure diseases/conditions. Experts preferred an equal allocation of resources between these biosecure and non-biosecure diseases/conditions, with emphasis on adopting/adapting international models, education and awareness-raising. The results from this study provide robust insights about non-regulatory animal health priorities in Ireland, as perceived by experts and farmers, using methodologies that are both transparent and inclusive. They have already been extremely influential in shaping national policy, as a foundation for interdisciplinary (and multi-agency) cooperation, as a contribution to efforts to encourage stakeholder responsibility-taking, and to ongoing development of postgraduate and undergraduate veterinary education in Ireland. Copyright (c) 2010. Published by Elsevier B.V.

Thresholds of Principle and Preference: Exploring Procedural Variation in Postgraduate Surgical Education.

PubMed

Apramian, Tavis; Cristancho, Sayra; Watling, Chris; Ott, Michael; Lingard, Lorelei

2015-11-01

Expert physicians develop their own ways of doing things. The influence of such practice variation in clinical learning is insufficiently understood. Our grounded theory study explored how residents make sense of, and behave in relation to, the procedural variations of faculty surgeons. We sampled senior postgraduate surgical residents to construct a theoretical framework for how residents make sense of procedural variations. Using a constructivist grounded theory approach, we used marginal participant observation in the operating room across 56 surgical cases (146 hours), field interviews (38), and formal interviews (6) to develop a theoretical framework for residents' ways of dealing with procedural variations. Data analysis used constant comparison to iteratively refine the framework and data collection until theoretical saturation was reached. The core category of the constructed theory was called thresholds of principle and preference and it captured how faculty members position some procedural variations as negotiable and others not. The term thresholding was coined to describe residents' daily experiences of spotting, mapping, and negotiating their faculty members' thresholds and defending their own emerging thresholds. Thresholds of principle and preference play a key role in workplace-based medical education. Postgraduate medical learners are occupied on a day-to-day level with thresholding and attempting to make sense of the procedural variations of faculty. Workplace-based teaching and assessment should include an understanding of the integral role of thresholding in shaping learners' development. Future research should explore the nature and impact of thresholding in workplace-based learning beyond the surgical context.

Enhancing an adaptive e-learning system with didactic test assessment using an expert system

NASA Astrophysics Data System (ADS)

Bradáč, Vladimír; Kostolányová, Kateřina

2017-07-01

The paper deals with a follow-up research on intelligent tutoring systems that were studied in authors' previous papers from the point of view of describing their advantages. In this paper, the authors make use of the fuzzy logic expert system, which assesses student's knowledge, and integrate it into the intelligent tutoring system called Barborka. The goal is to create an even more personal student's study plan, which is tailored both to student's sensory/learning preferences and the level of knowledge of the given subject.

Artificial intelligence in a mission operations and satellite test environment

NASA Technical Reports Server (NTRS)

Busse, Carl

1988-01-01

A Generic Mission Operations System using Expert System technology to demonstrate the potential of Artificial Intelligence (AI) automated monitor and control functions in a Mission Operations and Satellite Test environment will be developed at the National Aeronautics and Space Administration (NASA) Jet Propulsion Laboratory (JPL). Expert system techniques in a real time operation environment are being studied and applied to science and engineering data processing. Advanced decommutation schemes and intelligent display technology will be examined to develop imaginative improvements in rapid interpretation and distribution of information. The Generic Payload Operations Control Center (GPOCC) will demonstrate improved data handling accuracy, flexibility, and responsiveness in a complex mission environment. The ultimate goal is to automate repetitious mission operations, instrument, and satellite test functions by the applications of expert system technology and artificial intelligence resources and to enhance the level of man-machine sophistication.

Incorporation of Socio-Economic Features' Ranking in Multicriteria Analysis Based on Ecosystem Services for Marine Protected Area Planning

PubMed Central

Portman, Michelle E.; Shabtay-Yanai, Ateret; Zanzuri, Asaf

2016-01-01

Developed decades ago for spatial choice problems related to zoning in the urban planning field, multicriteria analysis (MCA) has more recently been applied to environmental conflicts and presented in several documented cases for the creation of protected area management plans. Its application is considered here for the development of zoning as part of a proposed marine protected area management plan. The case study incorporates specially-explicit conservation features while considering stakeholder preferences, expert opinion and characteristics of data quality. It involves the weighting of criteria using a modified analytical hierarchy process. Experts ranked physical attributes which include socio-economically valued physical features. The parameters used for the ranking of (physical) attributes important for socio-economic reasons are derived from the field of ecosystem services assessment. Inclusion of these feature values results in protection that emphasizes those areas closest to shore, most likely because of accessibility and familiarity parameters and because of data biases. Therefore, other spatial conservation prioritization methods should be considered to supplement the MCA and efforts should be made to improve data about ecosystem service values farther from shore. Otherwise, the MCA method allows incorporation of expert and stakeholder preferences and ecosystem services values while maintaining the advantages of simplicity and clarity. PMID:27183224

Incorporation of Socio-Economic Features' Ranking in Multicriteria Analysis Based on Ecosystem Services for Marine Protected Area Planning.

PubMed

Portman, Michelle E; Shabtay-Yanai, Ateret; Zanzuri, Asaf

2016-01-01

Developed decades ago for spatial choice problems related to zoning in the urban planning field, multicriteria analysis (MCA) has more recently been applied to environmental conflicts and presented in several documented cases for the creation of protected area management plans. Its application is considered here for the development of zoning as part of a proposed marine protected area management plan. The case study incorporates specially-explicit conservation features while considering stakeholder preferences, expert opinion and characteristics of data quality. It involves the weighting of criteria using a modified analytical hierarchy process. Experts ranked physical attributes which include socio-economically valued physical features. The parameters used for the ranking of (physical) attributes important for socio-economic reasons are derived from the field of ecosystem services assessment. Inclusion of these feature values results in protection that emphasizes those areas closest to shore, most likely because of accessibility and familiarity parameters and because of data biases. Therefore, other spatial conservation prioritization methods should be considered to supplement the MCA and efforts should be made to improve data about ecosystem service values farther from shore. Otherwise, the MCA method allows incorporation of expert and stakeholder preferences and ecosystem services values while maintaining the advantages of simplicity and clarity.

Creating a roadmap for delivering gender-sensitive comprehensive care for women Veterans: results of a national expert panel.

PubMed

deKleijn, Miriam; Lagro-Janssen, Antoine L M; Canelo, Ismelda; Yano, Elizabeth M

2015-04-01

Women Veterans are a significant minority of users of the VA healthcare system, limiting provider and staff experience meeting their needs in environments historically designed for men. The VA is nonetheless committed to ensuring that women Veterans have access to comprehensive care in environments sensitive to their needs. We sought to determine what aspects of care need to be tailored to the needs of women Veterans in order for the VA to deliver gender-sensitive comprehensive care. Modified Delphi expert panel process. Eleven clinicians and social scientists with expertise in women's health, primary care, and mental health. Importance of tailoring over 100 discrete aspects of care derived from the Institute of Medicine's definition of comprehensive care and literature-based domains of sex-sensitive care on a 5-point scale. Panelists rated over half of the aspects of care as very-to-extremely important (median score 4+) to tailor to the needs of women Veterans. The panel arrived at 14 priority recommendations that broadly encompassed the importance of (1) the design/delivery of services sensitive to trauma histories, (2) adapting to women's preferences and information needs, and (3) sex awareness and cultural transformation in every facet of VA operations. We used expert panel methods to arrive at consensus on top priority recommendations for improving delivery of sex-sensitive comprehensive care in VA settings. Accomplishment of their breadth will require national, regional, and local strategic action and multilevel stakeholder engagement, and will support VA's national efforts at improving customer service for all Veterans.

Familiarity Vs Trust: A Comparative Study of Domain Scientists' Trust in Visual Analytics and Conventional Analysis Methods.

PubMed

Dasgupta, Aritra; Lee, Joon-Yong; Wilson, Ryan; Lafrance, Robert A; Cramer, Nick; Cook, Kristin; Payne, Samuel

2017-01-01

Combining interactive visualization with automated analytical methods like statistics and data mining facilitates data-driven discovery. These visual analytic methods are beginning to be instantiated within mixed-initiative systems, where humans and machines collaboratively influence evidence-gathering and decision-making. But an open research question is that, when domain experts analyze their data, can they completely trust the outputs and operations on the machine-side? Visualization potentially leads to a transparent analysis process, but do domain experts always trust what they see? To address these questions, we present results from the design and evaluation of a mixed-initiative, visual analytics system for biologists, focusing on analyzing the relationships between familiarity of an analysis medium and domain experts' trust. We propose a trust-augmented design of the visual analytics system, that explicitly takes into account domain-specific tasks, conventions, and preferences. For evaluating the system, we present the results of a controlled user study with 34 biologists where we compare the variation of the level of trust across conventional and visual analytic mediums and explore the influence of familiarity and task complexity on trust. We find that despite being unfamiliar with a visual analytic medium, scientists seem to have an average level of trust that is comparable with the same in conventional analysis medium. In fact, for complex sense-making tasks, we find that the visual analytic system is able to inspire greater trust than other mediums. We summarize the implications of our findings with directions for future research on trustworthiness of visual analytic systems.

Revenue Risk Modelling and Assessment on BOT Highway Project

NASA Astrophysics Data System (ADS)

Novianti, T.; Setyawan, H. Y.

2018-01-01

The infrastructure project which is considered as a public-private partnership approach under BOT (Build-Operate-Transfer) arrangement, such as a highway, is risky. Therefore, assessment on risk factors is essential as the project have a concession period and is influenced by macroeconomic factors and consensus period. In this study, pre-construction risks of a highway were examined by using a Delphi method to create a space for offline expert discussions; a fault tree analysis to map intuition of experts and to create a model from the underlying risk events; a fuzzy logic to interpret the linguistic data of risk models. The loss of revenue for risk tariff, traffic volume, force majeure, and income were then measured. The results showed that the loss of revenue caused by the risk tariff was 10.5% of the normal total revenue. The loss of revenue caused by the risk of traffic volume was 21.0% of total revenue. The loss of revenue caused by the force majeure was 12.2% of the normal income. The loss of income caused by the non-revenue events was 6.9% of the normal revenue. It was also found that the volume of traffic was the major risk of a highway project because it related to customer preferences.

Hispanic women's preferences for breast health information: subjective cultural influences on source, message, and channel.

PubMed

Oetzel, John; De Vargas, Felicia; Ginossar, Tamar; Sanchez, Christina

2007-01-01

The purpose of this study was to investigate the influence of 3 subjective cultural variables--self-construals (independence and interdependence), ethnic identity (bicultural, assimilation, traditional, and marginal), and cultural health attributions (equity and behavioral-environmental attributions)--on source, message, and channel preferences for receiving breast health information by Hispanic women age 35 or older. Subjective cultural variables collectively accounted for 2% to 28% of the variance in communication preferences. In addition, several associations were discovered: (a) having an interdependent self-construal was associated positively with preferences for significant other as a source, family sources, fear messages, media channels, and face-to-face channels; (b) having a bicultural identity was associated positively with preferences for family sources and media channels, but negatively with a desire for no information; and (c) having a marginal identity and equity attributions were associated positively with preferences for fear messages and a desire for no information, but negatively with preferences for expert sources. These findings are discussed in the context of tailoring breast health information to Hispanic women using computer technology and entertainment-education.

An evidence-based recommendation on bed head elevation for mechanically ventilated patients.

PubMed

Niël-Weise, Barbara S; Gastmeier, Petra; Kola, Axel; Vonberg, Ralf P; Wille, Jan C; van den Broek, Peterhans J

2011-01-01

A semi-upright position in ventilated patients is recommended to prevent ventilator-associated pneumonia (VAP) and is one of the components in the Ventilator Bundle of the Institute for Health Care Improvement. This recommendation, however, is not an evidence-based one. A systematic review on the benefits and disadvantages of semi-upright position in ventilated patients was done according to PRISMA guidelines. Then a European expert panel developed a recommendation based on the results of the systematic review and considerations beyond the scientific evidence in a three-round electronic Delphi procedure. Three trials (337 patients) were included in the review. The results showed that it was uncertain whether a 45° bed head elevation was effective or harmful with regard to the occurrence of clinically suspected VAP, microbiologically confirmed VAP, decubitus and mortality, and that it was unknown whether 45° elevation for 24 hours a day increased the risk for thromboembolism or hemodynamic instability. A group of 22 experts recommended elevating the head of the bed of mechanically ventilated patients to a 20 to 45° position and preferably to a ≥ 30° position as long as it does not pose risks or conflicts with other nursing tasks, medical interventions or patients' wishes. Although the review failed to prove clinical benefits of bed head elevation, experts prefer this position in ventilated patients. They made clear that the position of a ventilated patient in bed depended on many determinants. Therefore, given the scientific uncertainty about the benefits and harms of a semi-upright position, this position could only be recommended as the preferred position with the necessary restrictions.

Improved operator agreement and efficiency using the minimum area contour change method for delineation of hyperintense multiple sclerosis lesions on FLAIR MRI

PubMed Central

2013-01-01

Background Activity of disease in patients with multiple sclerosis (MS) is monitored by detecting and delineating hyper-intense lesions on MRI scans. The Minimum Area Contour Change (MACC) algorithm has been created with two main goals: a) to improve inter-operator agreement on outlining regions of interest (ROIs) and b) to automatically propagate longitudinal ROIs from the baseline scan to a follow-up scan. Methods The MACC algorithm first identifies an outer bound for the solution path, forms a high number of iso-contour curves based on equally spaced contour values, and then selects the best contour value to outline the lesion. The MACC software was tested on a set of 17 FLAIR MRI images evaluated by a pair of human experts and a longitudinal dataset of 12 pairs of T2-weighted Fluid Attenuated Inversion Recovery (FLAIR) images that had lesion analysis ROIs drawn by a single expert operator. Results In the tests where two human experts evaluated the same MRI images, the MACC program demonstrated that it could markedly reduce inter-operator outline error. In the longitudinal part of the study, the MACC program created ROIs on follow-up scans that were in close agreement to the original expert’s ROIs. Finally, in a post-hoc analysis of 424 follow-up scans 91% of propagated MACC were accepted by an expert and only 9% of the final accepted ROIS had to be created or edited by the expert. Conclusion When used with an expert operator's verification of automatically created ROIs, MACC can be used to improve inter- operator agreement and decrease analysis time, which should improve data collected and analyzed in multicenter clinical trials. PMID:24004511

Knowledge engineering for PACES, the particle accelerator control expert system

NASA Astrophysics Data System (ADS)

Lind, P. C.; Poehlman, W. F. S.; Stark, J. W.; Cousins, T.

1992-04-01

The KN-3000 used at Defense Research Establishment Ottawa is a Van de Graaff particle accelerator employed primarily to produce monoenergetic neutrons for calibrating radiation detectors. To provide training and assistance for new operators, it was decided to develop an expert system for accelerator operation. Knowledge engineering aspects of the expert system are reviewed. Two important issues are involved: the need to encapsulate expert knowledge into the system in a form that facilitates automatic accelerator operation and to partition the system so that time-consuming inferencing is minimized in favor of faster, more algorithmic control. It is seen that accelerator control will require fast, narrowminded decision making for rapid fine tuning, but slower and broader reasoning for machine startup, shutdown, fault diagnosis, and correction. It is also important to render the knowledge base in a form conducive to operator training. A promising form of the expert system involves a hybrid system in which high level reasoning is performed on the host machine that interacts with the user, while an embedded controller employs neural networks for fast but limited adjustment of accelerator performance. This partitioning of duty facilitates a hierarchical chain of command yielding an effective mixture of speed and reasoning ability.

Expert system for on-board satellite scheduling and control

NASA Technical Reports Server (NTRS)

Barry, John M.; Sary, Charisse

1988-01-01

An Expert System is described which Rockwell Satellite and Space Electronics Division (S&SED) is developing to dynamically schedule the allocation of on-board satellite resources and activities. This expert system is the Satellite Controller. The resources to be scheduled include power, propellant and recording tape. The activities controlled include scheduling satellite functions such as sensor checkout and operation. The scheduling of these resources and activities is presently a labor intensive and time consuming ground operations task. Developing a schedule requires extensive knowledge of the system and subsystems operations, operational constraints, and satellite design and configuration. This scheduling process requires highly trained experts anywhere from several hours to several weeks to accomplish. The process is done through brute force, that is examining cryptic mnemonic data off line to interpret the health and status of the satellite. Then schedules are formulated either as the result of practical operator experience or heuristics - that is rules of thumb. Orbital operations must become more productive in the future to reduce life cycle costs and decrease dependence on ground control. This reduction is required to increase autonomy and survivability of future systems. The design of future satellites require that the scheduling function be transferred from ground to on board systems.

Millennial Perspectives and Priorities

ERIC Educational Resources Information Center

Therrell, James A.; Dunneback, Staci K.

2015-01-01

Through prioritizing student voice, this study investigated the perspectives of millennial students in relation to their preferences and priorities for how they desired to experience teaching and learning. While not experts, our assumption was that undergraduate students, because of their relatively long experience as students, would be closely in…

Min and max are the only continuous ampersand-, V-operations for finite logics

NASA Technical Reports Server (NTRS)

Kreinovich, Vladik

1992-01-01

Experts usually express their degrees of belief in their statements by the words of a natural language (like 'maybe', 'perhaps', etc.). If an expert system contains the degrees of beliefs t(A) and t(B) that correspond to the statements A and B, and a user asks this expert system whether 'A&B' is true, then it is necessary to come up with a reasonable estimate for the degree of belief of A&B. The operation that processes t(A) and t(B) into such an estimate t(A&B) is called an &-operation. Many different &-operations have been proposed. Which of them to choose? This can be (in principle) done by interviewing experts and eliciting a &-operation from them, but such a process is very time-consuming and therefore, not always possible. So, usually, to choose a &-operation, the finite set of actually possible degrees of belief is extended to an infinite set (e.g., to an interval (0,1)), define an operation there, and then restrict this operation to the finite set. Only this original finite set is considered. It is shown that a reasonable assumption that an &-operation is continuous (i.e., that gradual change in t(A) and t(B) must lead to a gradual change in t(A&B)), uniquely determines min as an &-operation. Likewise, max is the only continuous V-operation. These results are in good accordance with the experimental analysis of 'and' and 'or' in human beliefs.

Expert diagnostics system as a part of analysis software for power mission operations

NASA Technical Reports Server (NTRS)

Harris, Jennifer A.; Bahrami, Khosrow A.

1993-01-01

The operation of interplanetary spacecraft at JPL has become an increasingly complex activity. This complexity is due to advanced spacecraft designs and ambitious mission objectives which lead to operations requirements that are more demanding than those of any previous mission. For this reason, several productivity enhancement measures are underway at JPL within mission operations, particularly in the spacecraft analysis area. These measures aimed at spacecraft analysis include: the development of a multi-mission, multi-subsystem operations environment; the introduction of automated tools into this environment; and the development of an expert diagnostics system. This paper discusses an effort to integrate the above mentioned productivity enhancement measures. A prototype was developed that integrates an expert diagnostics system into a multi-mission, multi-subsystem operations environment using the Galileo Power / Pyro Subsystem as a testbed. This prototype will be discussed in addition to background information associated with it.

Reliable assessment of laparoscopic performance in the operating room using videotape analysis.

PubMed

Chang, Lily; Hogle, Nancy J; Moore, Brianna B; Graham, Mark J; Sinanan, Mika N; Bailey, Robert; Fowler, Dennis L

2007-06-01

The Global Operative Assessment of Laparoscopic Skills (GOALS) is a valid assessment tool for objectively evaluating the technical performance of laparoscopic skills in surgery residents. We hypothesized that GOALS would reliably differentiate between an experienced (expert) and an inexperienced (novice) laparoscopic surgeon (construct validity) based on a blinded videotape review of a laparoscopic cholecystectomy procedure. Ten board-certified surgeons actively engaged in the practice and teaching of laparoscopy reviewed and evaluated the videotaped operative performance of one novice and one expert laparoscopic surgeon using GOALS. Each reviewer recorded a score for both the expert and the novice videotape reviews in each of the 5 domains in GOALS (depth perception, bimanual dexterity, efficiency, tissue handling, and overall competence). The scores for the expert and the novice were compared and statistically analyzed using single-factor analysis of variance (ANOVA). The expert scored significantly higher than the novice did in the domains of depth perception (p = .005), bimanual dexterity (p = .001), efficiency (p = .001), and overall competence ( p = .001). Interrater reliability for the reviewers of the novice tape was Cronbach alpha = .93 and the expert tape was Cronbach alpha = .87. There was no difference between the two for tissue handling. The Global Operative Assessment of Laparoscopic Skills is a valid, objective assessment tool for evaluating technical surgical performance when used to blindly evaluate an intraoperative videotape recording of a laparoscopic procedure.

Ultrasound detection of simulated intra-ocular foreign bodies by minimally trained personnel.

PubMed

Sargsyan, Ashot E; Dulchavsky, Alexandria G; Adams, James; Melton, Shannon; Hamilton, Douglas R; Dulchavsky, Scott A

2008-01-01

To test the ability of non-expert ultrasound operators of divergent backgrounds to detect the presence, size, location, and composition of foreign bodies in an ocular model. High school students (N = 10) and NASA astronauts (N = 4) completed a brief ultrasound training session which focused on basic ultrasound principles and the detection of foreign bodies. The operators used portable ultrasound devices to detect foreign objects of varying location, size (0.5-2 mm), and material (glass, plastic, metal) in a gelatinous ocular model. Operator findings were compared to known foreign object parameters and ultrasound experts (N = 2) to determine accuracy across and between groups. Ultrasound had high sensitivity (astronauts 85%, students 87%, and experts 100%) and specificity (astronauts 81%, students 83%, and experts 95%) for the detection of foreign bodies. All user groups were able to accurately detect the presence of foreign bodies in this model (astronauts 84%, students 81%, and experts 97%). Astronaut and student sensitivity results for material (64% vs. 48%), size (60% vs. 46%), and position (77% vs. 64%) were not statistically different. Experts' results for material (85%), size (90%), and position (98%) were higher; however, the small sample size precluded statistical conclusions. Ultrasound can be used by operators with varying training to detect the presence, location, and composition of intraocular foreign bodies with high sensitivity, specificity, and accuracy.

Undergraduate prosthetics and orthotics teaching methods: A baseline for international comparison.

PubMed

Aminian, Gholamreza; O'Toole, John M; Mehraban, Afsoon Hassani

2015-08-01

Education of Prosthetics and Orthotics is a relatively recent professional program. While there has been some work on various teaching methods and strategies in international medical education, limited publication exists within prosthetics and orthotics. To identify the teaching and learning methods that are used in Bachelor-level prosthetics and orthotics programs that are given highest priority by expert prosthetics and orthotics instructors from regions enjoying a range of economic development. Mixed method. The study partly documented by this article utilized a mixed method approach (qualitative and quantitative methods) within which each phase provided data for other phases. It began with analysis of prosthetics and orthotics curricula documents, which was followed by a broad survey of instructors in this field and then a modified Delphi process. The expert instructors who participated in this study gave high priority to student-centered, small group methods that encourage critical thinking and may lead to lifelong learning. Instructors from more developed nations placed higher priority on student's independent acquisition of prosthetics and orthotics knowledge, particularly in clinical training. Application of student-centered approaches to prosthetics and orthotics programs may be preferred by many experts, but there appeared to be regional differences in the priority given to different teaching methods. The results of this study identify the methods of teaching that are preferred by expert prosthetics and orthotics instructors from a variety of regions. This treatment of current instructional techniques may inform instructor choice of teaching methods that impact the quality of education and improve the professional skills of students. © The International Society for Prosthetics and Orthotics 2014.

Knowledge-based operation and management of communications systems

NASA Technical Reports Server (NTRS)

Heggestad, Harold M.

1988-01-01

Expert systems techniques are being applied in operation and control of the Defense Communications System (DCS), which has the mission of providing reliable worldwide voice, data and message services for U.S. forces and commands. Thousands of personnel operate DCS facilities, and many of their functions match the classical expert system scenario: complex, skill-intensive environments with a full spectrum of problems in training and retention, cost containment, modernization, and so on. Two of these functions are: (1) fault isolation and restoral of dedicated circuits at Tech Control Centers, and (2) network management for the Defense Switched Network (the modernized dial-up voice system currently replacing AUTOVON). An expert system for the first of these is deployed for evaluation purposes at Andrews Air Force Base, and plans are being made for procurement of operational systems. In the second area, knowledge obtained with a sophisticated simulator is being embedded in an expert system. The background, design and status of both projects are described.

Knowledge-based operation and management of communications systems

NASA Astrophysics Data System (ADS)

Heggestad, Harold M.

1988-11-01

Expert systems techniques are being applied in operation and control of the Defense Communications System (DCS), which has the mission of providing reliable worldwide voice, data and message services for U.S. forces and commands. Thousands of personnel operate DCS facilities, and many of their functions match the classical expert system scenario: complex, skill-intensive environments with a full spectrum of problems in training and retention, cost containment, modernization, and so on. Two of these functions are: (1) fault isolation and restoral of dedicated circuits at Tech Control Centers, and (2) network management for the Defense Switched Network (the modernized dial-up voice system currently replacing AUTOVON). An expert system for the first of these is deployed for evaluation purposes at Andrews Air Force Base, and plans are being made for procurement of operational systems. In the second area, knowledge obtained with a sophisticated simulator is being embedded in an expert system. The background, design and status of both projects are described.

Quantifying Novice and Expert Differences in Visual Diagnostic Reasoning in Veterinary Pathology Using Eye-Tracking Technology.

PubMed

Warren, Amy L; Donnon, Tyrone L; Wagg, Catherine R; Priest, Heather; Fernandez, Nicole J

2018-01-18

Visual diagnostic reasoning is the cognitive process by which pathologists reach a diagnosis based on visual stimuli (cytologic, histopathologic, or gross imagery). Currently, there is little to no literature examining visual reasoning in veterinary pathology. The objective of the study was to use eye tracking to establish baseline quantitative and qualitative differences between the visual reasoning processes of novice and expert veterinary pathologists viewing cytology specimens. Novice and expert participants were each shown 10 cytology images and asked to formulate a diagnosis while wearing eye-tracking equipment (10 slides) and while concurrently verbalizing their thought processes using the think-aloud protocol (5 slides). Compared to novices, experts demonstrated significantly higher diagnostic accuracy (p<.017), shorter time to diagnosis (p<.017), and a higher percentage of time spent viewing areas of diagnostic interest (p<.017). Experts elicited more key diagnostic features in the think-aloud protocol and had more efficient patterns of eye movement. These findings suggest that experts' fast time to diagnosis, efficient eye-movement patterns, and preference for viewing areas of interest supports system 1 (pattern-recognition) reasoning and script-inductive knowledge structures with system 2 (analytic) reasoning to verify their diagnosis.

Knowledge acquisition and representation for the Systems Test and Operations Language (STOL) Intelligent Tutoring System (ITS)

NASA Technical Reports Server (NTRS)

Seamster, Thomas L.; Eike, David R.; Ames, Troy J.

1990-01-01

This presentation concentrates on knowledge acquisition and its application to the development of an expert module and a user interface for an Intelligent Tutoring System (ITS). The Systems Test and Operations Language (STOL) ITS is being developed to assist NASA control center personnel in learning a command and control language as it is used in mission operations rooms. The objective of the tutor is to impart knowledge and skills that will permit the trainee to solve command and control problems in the same way that the STOL expert solves those problems. The STOL ITS will achieve this object by representing the solution space in such a way that the trainee can visualize the intermediate steps, and by having the expert module production rules parallel the STOL expert's knowledge structures.

How to select combination operators for fuzzy expert systems using CRI

NASA Technical Reports Server (NTRS)

Turksen, I. B.; Tian, Y.

1992-01-01

A method to select combination operators for fuzzy expert systems using the Compositional Rule of Inference (CRI) is proposed. First, fuzzy inference processes based on CRI are classified into three categories in terms of their inference results: the Expansion Type Inference, the Reduction Type Inference, and Other Type Inferences. Further, implication operators under Sup-T composition are classified as the Expansion Type Operator, the Reduction Type Operator, and the Other Type Operators. Finally, the combination of rules or their consequences is investigated for inference processes based on CRI.

Using Dissimilarity Metrics to Identify Interesting Designs

NASA Technical Reports Server (NTRS)

Feather, Martin; Kiper, James

2006-01-01

A computer program helps to blend the power of automated-search software, which is able to generate large numbers of design solutions, with the insight of expert designers, who are able to identify preferred designs but do not have time to examine all the solutions. From among the many automated solutions to a given design problem, the program selects a smaller number of solutions that are worthy of scrutiny by the experts in the sense that they are sufficiently dissimilar from each other. The program makes the selection in an interactive process that involves a sequence of data-mining steps interspersed with visual displays of results of these steps to the experts. At crucial points between steps, the experts provide directives to guide the process. The program uses heuristic search techniques to identify nearly optimal design solutions and uses dissimilarity metrics defined by the experts to characterize the degree to which solutions are interestingly different. The search, data-mining, and visualization features of the program were derived from previously developed risk-management software used to support a risk-centric design methodology

Automated information retrieval using CLIPS

NASA Technical Reports Server (NTRS)

Raines, Rodney Doyle, III; Beug, James Lewis

1991-01-01

Expert systems have considerable potential to assist computer users in managing the large volume of information available to them. One possible use of an expert system is to model the information retrieval interests of a human user and then make recommendations to the user as to articles of interest. At Cal Poly, a prototype expert system written in the C Language Integrated Production System (CLIPS) serves as an Automated Information Retrieval System (AIRS). AIRS monitors a user's reading preferences, develops a profile of the user, and then evaluates items returned from the information base. When prompted by the user, AIRS returns a list of items of interest to the user. In order to minimize the impact on system resources, AIRS is designed to run in the background during periods of light system use.

End effector monitoring system: An illustrated case of operational prototyping

NASA Technical Reports Server (NTRS)

Malin, Jane T.; Land, Sherry A.; Thronesbery, Carroll

1994-01-01

Operational prototyping is introduced to help developers apply software innovations to real-world problems, to help users articulate requirements, and to help develop more usable software. Operational prototyping has been applied to an expert system development project. The expert system supports fault detection and management during grappling operations of the Space Shuttle payload bay arm. The dynamic exchanges among operational prototyping team members are illustrated in a specific prototyping session. We discuss the requirements for operational prototyping technology, types of projects for which operational prototyping is best suited and when it should be applied to those projects.

Multiage Grouping and Student Collaboration

ERIC Educational Resources Information Center

Cowan, Matthew

2014-01-01

The aim of this action research project was to investigate students' social preferences and pro-social interactions in a multiage, high school classroom in order to better understand how to group students to maximize learning and collaboration. According to many educational experts and previous inquiries, mixed-age learning groups introduce…

PREFERENCE FOR FLUENT VERSUS DISFLUENT WORK SCHEDULES

PubMed Central

Fienup, Daniel M; Ahlers, Ashley A; Pace, Gary

2011-01-01

Two studies were conducted that examined the preference of a student diagnosed with a brain injury. In Study 1, a preference assessment was followed by a three-choice concurrent-operants reinforcer assessment. Two choices resulted in access to preferred activities for completing work, and a third choice resulted in access to nothing (i.e., no activity). Unpredictably, the participant consistently chose the no-activity option. Study 2 examined why this student preferred work associated with no activity over preferred activities. Through a variety of concurrent-operants procedures, it was determined that she preferred fluent work followed by reinforcers rather than work that was broken up by access to preferred activities. Implications for research on preference are discussed. PMID:22219534

Decision making in prioritization of required operational capabilities

NASA Astrophysics Data System (ADS)

Andreeva, P.; Karev, M.; Kovacheva, Ts.

2015-10-01

The paper describes an expert heuristic approach to prioritization of required operational capabilities in the field of defense. Based on expert assessment and by application of the method of Analytical Hierarchical Process, a methodology for their prioritization has been developed. It has been applied to practical simulation decision making games.

Potential applications of expert systems and operations research to space station logistics functions

NASA Technical Reports Server (NTRS)

Lippiatt, Thomas F.; Waterman, Donald

1985-01-01

The applicability of operations research, artificial intelligence, and expert systems to logistics problems for the space station were assessed. Promising application areas were identified for space station logistics. A needs assessment is presented and a specific course of action in each area is suggested.

THE USE OF COMPUTER MODELING PACKAGES TO ILLUSTRATE UNCERTAINTY IN RISK ASSESSMENTS: AN EASE OF USE AND INTERPRETATION COMPARISON

EPA Science Inventory

Consistent improvements in processor speed and computer access have substantially increased the use of computer modeling by experts and non-experts alike. Several new computer modeling packages operating under graphical operating systems (i.e. Microsoft Windows or Macintosh) m...

Research and development for Onboard Navigation (ONAV) ground based expert/trainer system: ONAV entry expert system code

NASA Technical Reports Server (NTRS)

Bochsler, Daniel C.

1988-01-01

A complete listing is given of the expert system rules for the Entry phase of the Onboard Navigation (ONAV) Ground Based Expert Trainer System for aircraft/space shuttle navigation. These source listings appear in the same format as utilized and required by the C Language Integrated Production System (CLIPS) expert system shell which is the basis for the ONAV entry system. A schematic overview is given of how the rules are organized. These groups result from a partitioning of the rules according to the overall function which a given set of rules performs. This partitioning was established and maintained according to that established in the knowledge specification document. In addition, four other groups of rules are specified. The four groups (control flow, operator inputs, output management, and data tables) perform functions that affect all the other functional rule groups. As the name implies, control flow ensures that the rule groups are executed in the order required for proper operation; operator input rules control the introduction into the CLIPS fact base of various kinds of data required by the expert system; output management rules control the updating of the ONAV expert system user display screen during execution of the system; and data tables are static information utilized by many different rule sets gathered in one convenient place.

A real-time navigation monitoring expert system for the Space Shuttle Mission Control Center

NASA Technical Reports Server (NTRS)

Wang, Lui; Fletcher, Malise

1993-01-01

The ONAV (Onboard Navigation) Expert System has been developed as a real time console assistant for use by ONAV flight controllers in the Mission Control Center at the Johnson Space Center. This expert knowledge based system is used to monitor the Space Shuttle onboard navigation system, detect faults, and advise flight operations personnel. This application is the first knowledge-based system to use both telemetry and trajectory data from the Mission Operations Computer (MOC). To arrive at this stage, from a prototype to real world application, the ONAV project has had to deal with not only AI issues but operating environment issues. The AI issues included the maturity of AI languages and the debugging tools, verification, and availability, stability and size of the expert pool. The environmental issues included real time data acquisition, hardware suitability, and how to achieve acceptance by users and management.

A Conjoint Analysis Framework for Evaluating User Preferences in Machine Translation

PubMed Central

Kirchhoff, Katrin; Capurro, Daniel; Turner, Anne M.

2013-01-01

Despite much research on machine translation (MT) evaluation, there is surprisingly little work that directly measures users’ intuitive or emotional preferences regarding different types of MT errors. However, the elicitation and modeling of user preferences is an important prerequisite for research on user adaptation and customization of MT engines. In this paper we explore the use of conjoint analysis as a formal quantitative framework to assess users’ relative preferences for different types of translation errors. We apply our approach to the analysis of MT output from translating public health documents from English into Spanish. Our results indicate that word order errors are clearly the most dispreferred error type, followed by word sense, morphological, and function word errors. The conjoint analysis-based model is able to predict user preferences more accurately than a baseline model that chooses the translation with the fewest errors overall. Additionally we analyze the effect of using a crowd-sourced respondent population versus a sample of domain experts and observe that main preference effects are remarkably stable across the two samples. PMID:24683295

Knowledge discovery from data and Monte-Carlo DEA to evaluate technical efficiency of mental health care in small health areas

PubMed Central

García-Alonso, Carlos; Pérez-Naranjo, Leonor

2009-01-01

Introduction Knowledge management, based on information transfer between experts and analysts, is crucial for the validity and usability of data envelopment analysis (DEA). Aim To design and develop a methodology: i) to assess technical efficiency of small health areas (SHA) in an uncertainty environment, and ii) to transfer information between experts and operational models, in both directions, for improving expert’s knowledge. Method A procedure derived from knowledge discovery from data (KDD) is used to select, interpret and weigh DEA inputs and outputs. Based on KDD results, an expert-driven Monte-Carlo DEA model has been designed to assess the technical efficiency of SHA in Andalusia. Results In terms of probability, SHA 29 is the most efficient being, on the contrary, SHA 22 very inefficient. 73% of analysed SHA have a probability of being efficient (Pe) >0.9 and 18% <0.5. Conclusions Expert knowledge is necessary to design and validate any operational model. KDD techniques make the transfer of information from experts to any operational model easy and results obtained from the latter improve expert’s knowledge.

Active Surveillance for Low and Intermediate Risk Prostate Cancer: Opinions of North American Genitourinary Oncology Expert Radiation Oncologists.

PubMed

McClelland, Shearwood; Sandler, Kiri A; Degnin, Catherine; Chen, Yiyi; Mitin, Timur

2018-04-01

The ProtecT trial has provided level 1 evidence supporting active surveillance for prostate cancer patients with low-risk and intermediate-risk disease. The effect of these findings on the opinions of North American genitourinary (GU) experts regarding the role of active surveillance for these patients has not been previously examined. A survey was distributed to 88 practicing North American GU physicians serving on decision-making committees of cooperative group research organizations. Questions pertained to appropriateness of active surveillance in patients with low-risk and intermediate-risk (Gleason 3+4) disease. Opinions regarding active surveillance were correlated with practice patterns using Fisher exact test. Forty-two radiation oncologists completed the survey. Forty percent had been in practice for more than 20 years; 90% practice at an academic center. Forty-five percent see ≥ 20 patients per month in consultation. More than 95% (40 of 42) recommended active surveillance for Gleason 6 disease, whereas only 17% recommended active surveillance for Gleason 3+4 disease. There were no demographic differences between supporters or opponents regarding active surveillance with regard to monthly patient volume, practice type, likelihood of self-identifying as an expert brachytherapist, belief in advanced imaging techniques, or preferred default external beam radiation therapy dose/fractionation for either low-risk or intermediate-risk disease. However, there was a trend toward greater support of active surveillance for Gleason 3+4 disease among experts having practiced < 10 years versus ≥ 10 years (P = .085). Active surveillance is almost universally supported by North American GU expert radiation oncologists for low-risk prostate cancer. However, there is very weak support for this strategy in Gleason 3+4 disease despite the ProtecT trial providing level 1 evidentiary support in both risk groups. There were no significant differences between experts supporting versus opposing active surveillance for either low-risk or intermediate-risk disease. These preferences might affect the design of future clinical studies, influencing the adoption of active surveillance in North American clinical practice. Copyright © 2017 Elsevier Inc. All rights reserved.

Interactive Inverse Groundwater Modeling - Addressing User Fatigue

NASA Astrophysics Data System (ADS)

Singh, A.; Minsker, B. S.

2006-12-01

This paper builds on ongoing research on developing an interactive and multi-objective framework to solve the groundwater inverse problem. In this work we solve the classic groundwater inverse problem of estimating a spatially continuous conductivity field, given field measurements of hydraulic heads. The proposed framework is based on an interactive multi-objective genetic algorithm (IMOGA) that not only considers quantitative measures such as calibration error and degree of regularization, but also takes into account expert knowledge about the structure of the underlying conductivity field expressed as subjective rankings of potential conductivity fields by the expert. The IMOGA converges to the optimal Pareto front representing the best trade- off among the qualitative as well as quantitative objectives. However, since the IMOGA is a population-based iterative search it requires the user to evaluate hundreds of solutions. This leads to the problem of 'user fatigue'. We propose a two step methodology to combat user fatigue in such interactive systems. The first step is choosing only a few highly representative solutions to be shown to the expert for ranking. Spatial clustering is used to group the search space based on the similarity of the conductivity fields. Sampling is then carried out from different clusters to improve the diversity of solutions shown to the user. Once the expert has ranked representative solutions from each cluster a machine learning model is used to 'learn user preference' and extrapolate these for the solutions not ranked by the expert. We investigate different machine learning models such as Decision Trees, Bayesian learning model, and instance based weighting to model user preference. In addition, we also investigate ways to improve the performance of these models by providing information about the spatial structure of the conductivity fields (which is what the expert bases his or her rank on). Results are shown for each of these machine learning models and the advantages and disadvantages for each approach are discussed. These results indicate that using the proposed two-step methodology leads to significant reduction in user-fatigue without deteriorating the solution quality of the IMOGA.

Food parenting practices for 5 to 12 year old children: a concept map analysis of parenting and nutrition experts input.

PubMed

O'Connor, Teresia M; Mâsse, Louise C; Tu, Andrew W; Watts, Allison W; Hughes, Sheryl O; Beauchamp, Mark R; Baranowski, Tom; Pham, Truc; Berge, Jerica M; Fiese, Barbara; Golley, Rebecca; Hingle, Melanie; Kremers, Stef P J; Rhee, Kyung E; Skouteris, Helen; Vaughn, Amber

2017-09-11

Parents are an important influence on children's dietary intake and eating behaviors. However, the lack of a conceptual framework and inconsistent assessment of food parenting practices limits our understanding of which food parenting practices are most influential on children. The aim of this study was to develop a food parenting practice conceptual framework using systematic approaches of literature reviews and expert input. A previously completed systematic review of food parenting practice instruments and a qualitative study of parents informed the development of a food parenting practice item bank consisting of 3632 food parenting practice items. The original item bank was further reduced to 110 key food parenting concepts using binning and winnowing techniques. A panel of 32 experts in parenting and nutrition were invited to sort the food parenting practice concepts into categories that reflected their perceptions of a food parenting practice conceptual framework. Multi-dimensional scaling produced a point map of the sorted concepts and hierarchical cluster analysis identified potential solutions. Subjective modifications were used to identify two potential solutions, with additional feedback from the expert panel requested. The experts came from 8 countries and 25 participated in the sorting and 23 provided additional feedback. A parsimonious and a comprehensive concept map were developed based on the clustering of the food parenting practice constructs. The parsimonious concept map contained 7 constructs, while the comprehensive concept map contained 17 constructs and was informed by a previously published content map for food parenting practices. Most of the experts (52%) preferred the comprehensive concept map, while 35% preferred to present both solutions. The comprehensive food parenting practice conceptual map will provide the basis for developing a calibrated Item Response Modeling (IRM) item bank that can be used with computerized adaptive testing. Such an item bank will allow for more consistency in measuring food parenting practices across studies to better assess the impact of food parenting practices on child outcomes and the effect of interventions that target parents as agents of change.

Use of glucocorticoids in rheumatoid arthritis - pratical modalities of glucocorticoid therapy: recommendations for clinical practice based on data from the literature and expert opinion.

PubMed

Dernis, Emmanuelle; Ruyssen-Witrand, Adeline; Mouterde, Gaël; Maillefert, Jean-Francis; Tebib, Jacques; Cantagrel, Alain; Claudepierre, Pascal; Fautrel, Bruno; Gaudin, Philippe; Pham, Thao; Schaeverbeke, Thierry; Wendling, Daniel; Saraux, Alain; Loët, Xavier Le

2010-10-01

To develop recommendations about the use of glucocorticoids in patients with established rheumatoid arthritis (RA) managed in everyday practice, using the evidence-based approach and expert opinion. A three-step procedure was used: a scientific committee used a Delphi procedure to select five questions, which formed the basis for developing the recommendations; a systematic literature review was conducted by searching the Medline and Embase databases and the abstracts of meetings held by the Société Française de Rhumatologie (SFR), American College of Rheumatology (ACR), and European League Against Rheumatism (EULAR); and recommendations were developed and validated by a panel of experts based on the data from the literature review and on their experience. For each recommendation, the level of evidence and extent of agreement among experts were determined. The five questions pertained to the use of glucocorticoids in RA patients: role for intravenous glucocorticoid bolus therapy, role for intraarticular injections, and practical modalities of glucocorticoid administration and discontinuation. From the literature search, 93 articles were selected based on their titles and abstracts. Of these, 50 were selected for the literature review. Eight recommendations about the use of glucocorticoid therapy in everyday practice in patients with established RA were validated by a vote among all participating experts: bolus glucocorticoid therapy should be reserved for highly selected situations; triamcinolone hexacetonide is the preferred glucocorticoid for intraarticular therapy, and the joint should be rested for about 24h after the injection; for oral glucocorticoid therapy, agents with a short half-life taken once daily should be preferred; and when discontinuing glucocorticoid therapy, the patient and usual physician should be informed of the risk of adrenal insufficiency. Copyright © 2010 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

The development and initial validation of a clinical tool for patients' preferences on patient participation--The 4Ps.

PubMed

Eldh, Ann Catrine; Luhr, Kristina; Ehnfors, Margareta

2015-12-01

To report on the development and initial testing of a clinical tool, The Patient Preferences for Patient Participation tool (The 4Ps), which will allow patients to depict, prioritize, and evaluate their participation in health care. While patient participation is vital for high quality health care, a common definition incorporating all stakeholders' experience is pending. In order to support participation in health care, a tool for determining patients' preferences on participation is proposed, including opportunities to evaluate participation while considering patient preferences. Exploratory mixed methods studies informed the development of the tool, and descriptive design guided its initial testing. The 4Ps tool was tested with 21 Swedish researcher experts (REs) and patient experts (PEs) with experience of patient participation. Individual Think Aloud interviews were employed to capture experiences of content, response process, and acceptability. 'The 4Ps' included three sections for the patient to depict, prioritize, and evaluate participation using 12 items corresponding to 'Having Dialogue', 'Sharing Knowledge', 'Planning', and 'Managing Self-care'. The REs and PEs considered 'The 4Ps' comprehensible, and that all items corresponded to the concept of patient participation. The tool was perceived to facilitate patient participation whilst requiring amendments to content and layout. A tool like The 4Ps provides opportunities for patients to depict participation, and thus supports communication and collaboration. Further patient evaluation is needed to understand the conditions for patient participation. While The 4Ps is promising, revision and testing in clinical practice is required. © 2014 John Wiley & Sons Ltd.

Electronic-Imen-Delphi (EID): An Online Conferencing Procedure.

ERIC Educational Resources Information Center

Passig, David; Sharbat, Aviva

2000-01-01

Examines the efficiency of the Imen-Delphi (ID) technique as an electronic procedure for conferencing that helps participants clarify their opinions and expectations regarding preferable and possible futures. Describes an electronic version of the original ID procedure and tested its efficiency among a group of experts on virtual reality and…

Classroom Structuring Methods and Strategies for Children and Youth with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Ganz, Jennifer B.

2007-01-01

Autism experts and individuals with high-functioning autism contend that many individuals with autism spectrum disorders (ASDs) respond most favorably to information that is presented visually. Accordingly, strategies capitalizing on this visual preference have received significant recent attention in both ASD research and practitioner-related…

77 FR 52330 - Request for Additional Nominations of Candidates for the EPA's Science Advisory Board (SAB...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-29

... person or organization may nominate qualified persons to be considered for appointment to this advisory committee. Individuals may self-nominate. Nominations should be submitted in electronic format (preferred) following the instructions for ``Nominating Experts to the Chemical Assessment Advisory Committee'' provided...

76 FR 71561 - Request for Nominations of Candidates to the EPA's Science Advisory Board (SAB) Chemical...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-18

... nominate qualified persons to be considered for appointment to this advisory committee. Individuals may self-nominate. Nominations should be submitted in electronic format (preferred) following the instructions for ``Nominating Experts to the Chemical Assessment Advisory Committee'' provided on the SAB Web...

A Learning Model to Guide Research and Practice for Teaching of Elder Clients.

ERIC Educational Resources Information Center

Theis, Saundra L.; Merritt, Sharon L.

1994-01-01

In first study 40 adults over 65 completed the Mental Status Questionnaire; in a second, 134 elderly heart patients completed the Patient Learning Styles Questionnaire. Results showed use of crystallized intelligence enhanced learning. Older subjects preferred structure; authoritarian, expert teaching; and listening to presentations supplemented…

Construct Validation of Content Standards for Teaching

ERIC Educational Resources Information Center

van der Schaaf, Marieke F.; Stokking, Karel M.

2011-01-01

Current international demands to strengthen the teaching profession have led to an increased development and use of professional content standards. The study aims to provide insight in the construct validity of content standards by researching experts' underlying assumptions and preferences when participating in a delphi method. In three rounds 21…

Perception and Attention for Visualization

ERIC Educational Resources Information Center

Haroz, Steve

2013-01-01

This work examines how a better understanding of visual perception and attention can impact visualization design. In a collection of studies, I explore how different levels of the visual system can measurably affect a variety of visualization metrics. The results show that expert preference, user performance, and even computational performance are…

Experienced Online Instructors: Beliefs and Preferred Supports Regarding Online Teaching

ERIC Educational Resources Information Center

McGee, Patricia; Windes, Deborah; Torres, Maria

2017-01-01

While online courses are becoming a mainstay of college course offerings administrators, staff, instructors and students have different perceptions about how online courses should work. While faculty members are expert in their discipline and institutions provide support for acquiring content expertise, how instructors develop skills in online…

Education versus Family: Institutional Logics in the Early Care and Education Field

ERIC Educational Resources Information Center

Colaner, Anna C.

2016-01-01

Non-parental arrangements for young children serve a dual function as supports for parental activities and educational inputs for children. However, arrangements that are suited to meet families' specific needs and preferences are sometimes in tension with experts' definitions of "quality." Researchers and policymakers increasingly…

Sexual Preference Similarity, Attitude Similarity, and Perceived Counselor Credibility and Attractiveness.

ERIC Educational Resources Information Center

Atkinson, Donald R.; And Others

1981-01-01

Examined the effect of membership group and attitudinal similarity on perceived counselor credibility and attractiveness. Homosexual men (N=84) rated the counselor's credibility and attractiveness after listening to a recorded counseling interview. The counselor was rated more expert, trustworthy, and attractive when he stated a sexual preference…

Elicitation Support Requirements of Multi-Expertise Teams

ERIC Educational Resources Information Center

Bitter-Rijpkema, Marlies; Martens, Rob; Jochems, Wim

2005-01-01

Tools to support knowledge elicitation are used more and more in situations where employees or students collaborate using the computer. Studies indicate that differences exist between experts and novices regarding their methods of work and reasoning. However, the commonly preferred approach tends to deal with team members as a single system with…

A Cognitive Architecture for Human Performance Process Model Research

DTIC Science & Technology

1992-11-01

individually defined, updatable world representation which is a description of the world as the operator knows it. It contains rules for decisions, an...operate it), and rules of engagement (knowledge about the operator’s expected behavior). The HPP model works in the following way. Information enters...based models depict the problem-solving processes of experts. The experts’ knowledge is represented in symbol structures, along with rules for

Fast Fuzzy Arithmetic Operations

NASA Technical Reports Server (NTRS)

Hampton, Michael; Kosheleva, Olga

1997-01-01

In engineering applications of fuzzy logic, the main goal is not to simulate the way the experts really think, but to come up with a good engineering solution that would (ideally) be better than the expert's control, In such applications, it makes perfect sense to restrict ourselves to simplified approximate expressions for membership functions. If we need to perform arithmetic operations with the resulting fuzzy numbers, then we can use simple and fast algorithms that are known for operations with simple membership functions. In other applications, especially the ones that are related to humanities, simulating experts is one of the main goals. In such applications, we must use membership functions that capture every nuance of the expert's opinion; these functions are therefore complicated, and fuzzy arithmetic operations with the corresponding fuzzy numbers become a computational problem. In this paper, we design a new algorithm for performing such operations. This algorithm is applicable in the case when negative logarithms - log(u(x)) of membership functions u(x) are convex, and reduces computation time from O(n(exp 2))to O(n log(n)) (where n is the number of points x at which we know the membership functions u(x)).

PVDaCS - A prototype knowledge-based expert system for certification of spacecraft data

NASA Technical Reports Server (NTRS)

Wharton, Cathleen; Shiroma, Patricia J.; Simmons, Karen E.

1989-01-01

On-line data management techniques to certify spacecraft information are mandated by increasing telemetry rates. Knowledge-based expert systems offer the ability to certify data electronically without the need for time-consuming human interaction. Issues of automatic certification are explored by designing a knowledge-based expert system to certify data from a scientific instrument, the Orbiter Ultraviolet Spectrometer, on an operating NASA planetary spacecraft, Pioneer Venus. The resulting rule-based system, called PVDaCS (Pioneer Venus Data Certification System), is a functional prototype demonstrating the concepts of a larger system design. A key element of the system design is the representation of an expert's knowledge through the usage of well ordered sequences. PVDaCS produces a certification value derived from expert knowledge and an analysis of the instrument's operation. Results of system performance are presented.

Utilization of artificial intelligence techniques for the Space Station power system

NASA Technical Reports Server (NTRS)

Evatt, Thomas C.; Gholdston, Edward W.

1988-01-01

Due to the complexity of the Space Station Electrical Power System (EPS) as currently envisioned, artificial intelligence/expert system techniques are being investigated to automate operations, maintenance, and diagnostic functions. A study was conducted to investigate this technology as it applies to failure detection, isolation, and reconfiguration (FDIR) and health monitoring of power system components and of the total system. Control system utilization of expert systems for load scheduling and shedding operations was also researched. A discussion of the utilization of artificial intelligence/expert systems for Initial Operating Capability (IOC) for the Space Station effort is presented along with future plans at Rocketdyne for the utilization of this technology for enhanced Space Station power capability.

Does expert opinion match the operational definition of the Lupus Low Disease Activity State (LLDAS)? A case-based construct validity study.

PubMed

Golder, Vera; Huq, Molla; Franklyn, Kate; Calderone, Alicia; Lateef, Aisha; Lau, Chak Sing; Lee, Alfred Lok Hang; Navarra, Sandra Teresa V; Godfrey, Timothy; Oon, Shereen; Hoi, Alberta Yik Bun; Morand, Eric Francis; Nikpour, Mandana

2017-06-01

To evaluate the construct validity of the Lupus Low Disease Activity State (LLDAS), a treatment target in systemic lupus erythematosus (SLE). Fifty SLE case summaries based on real patients were prepared and assessed independently for meeting the operational definition of LLDAS. Fifty international rheumatologists with expertise in SLE, but with no prior involvement in the LLDAS project, responded to a survey in which they were asked to categorize the disease activity state of each case as remission, low, moderate, or high. Agreement between expert opinion and LLDAS was assessed using Cohen's kappa. Overall agreement between expert opinion and the operational definition of LLDAS was 77.96% (95% CI: 76.34-79.58%), with a Cohen's kappa of 0.57 (95% CI: 0.55-0.61). Of the cases (22 of 50) that fulfilled the operational definition of LLDAS, only 5.34% (59 of 22 × 50) of responses classified the cases as moderate/high activity. Of the cases that did not fulfill the operational definition of LLDAS (28 of 50), 35.14% (492 of 28 × 50) of responses classified the cases as remission/low activity. Common reasons for discordance were assignment to remission/low activity of cases with higher corticosteroid doses than defined in LLDAS (prednisolone ≤ 7.5mg) or with SLEDAI-2K >4 due to serological activity (high anti-dsDNA antibody and/or low complement). LLDAS has good construct validity with high overall agreement between the operational definition of LLDAS and expert opinion. Discordance of results suggests that the operational definition of LLDAS is more stringent than expert opinion at defining a low disease activity state. Copyright © 2017 Elsevier Inc. All rights reserved.

Developing a driving Safety Index using a Delphi stated preference experiment.

PubMed

Jamson, Samantha; Wardman, Mark; Batley, Richard; Carsten, Oliver

2008-03-01

Whilst empirical evidence is available concerning the effect of some aspects of driving behaviour on safety (e.g. speed choice), there is scant knowledge about safety thresholds, i.e. the point at which behaviour can be considered unsafe. Furthermore, it is almost impossible to ascertain the interaction between various aspects of driving behaviour. For example, how might drivers' lateral control of a vehicle be mediated by their speed choice-are the effects additive or do they cancel each other out. Complex experimental or observational studies would need to be undertaken to establish the nature of such effects. As an alternative, a Delphi study was undertaken to use expert judgement as a way of deriving a first approximation of these threshold and combinatory effects. Using a stated preference technique, road safety professionals make judgements about drivers' safe or unsafe behaviour. The aim was to understand the relative weightings that are assigned to a number of driver behaviours and thereby to construct a Safety Index. As expected, experts were able to establish thresholds, above (or below) which changes to the behavioural parameters had minimal impact on safety. This provided us with a Safety Index, based on a model that had face validity and a convincing range of values. However, the experts found the task of combining these driver behaviours more difficult, reflecting the elusive nature of safety estimates. Suggestions for future validation of our Safety Index are provided.

Thresholds of Principle and Preference: Exploring Procedural Variation in Postgraduate Surgical Education

PubMed Central

Apramian, Tavis; Cristancho, Sayra; Watling, Chris; Ott, Michael; Lingard, Lorelei

2017-01-01

Background Expert physicians develop their own ways of doing things. The influence of such practice variation in clinical learning is insufficiently understood. Our grounded theory study explored how residents make sense of, and behave in relation to, the procedural variations of faculty surgeons. Method We sampled senior postgraduate surgical residents to construct a theoretical framework for how residents make sense of procedural variations. Using a constructivist grounded theory approach, we used marginal participant observation in the operating room across 56 surgical cases (146 hours), field interviews (38), and formal interviews (6) to develop a theoretical framework for residents’ ways of dealing with procedural variations. Data analysis used constant comparison to iteratively refine the framework and data collection until theoretical saturation was reached. Results The core category of the constructed theory was called thresholds of principle and preference and it captured how faculty members position some procedural variations as negotiable and others not. The term thresholding was coined to describe residents’ daily experiences of spotting, mapping, and negotiating their faculty members’ thresholds and defending their own emerging thresholds. Conclusions Thresholds of principle and preference play a key role in workplace-based medical education. Postgraduate medical learners are occupied on a day-to-day level with thresholding and attempting to make sense of the procedural variations of faculty. Workplace-based teaching and assessment should include an understanding of the integral role of thresholding in shaping learners’ development. Future research should explore the nature and impact of thresholding in workplace-based learning beyond the surgical context. PMID:26505105

Expert training with standardized operative technique helps establish a successful penile prosthetics program for urologic resident education.

PubMed

King, Ashley B; Klausner, Adam P; Johnson, Corey M; Moore, Blake W; Wilson, Steven K; Grob, B Mayer

2011-10-01

The challenge of resident education in urologic surgery programs is to overcome disparity imparted by diverse patient populations, limited training times, and inequalities in the availability of expert surgical educators. Specifically, in the area of prosthetic urology, only a small proportion of programs have full-time faculty available to train residents in this discipline. To examine whether a new model using yearly training sessions from a recognized expert can establish a successful penile prosthetics program and result in better outcomes, higher case volumes, and willingness to perform more complex surgeries. A recognized expert conducted one to two operative training sessions yearly to teach standardized technique for penile prosthetics to residents. Each session consisted of three to four operative cases performed under the direct supervision of the expert. Retrospective data were collected from all penile prosthetic operations before (February, 2000 to June, 2004: N = 44) and after (July, 2004 to October, 2007: N = 79) implementation of these sessions. Outcomes reviewed included patient age, race, medical comorbidities, operative time, estimated blood loss, type of prosthesis, operative approach, drain usage, length of stay, and complications including revision/explantation rates. Statistical analysis was performed using Student's t-tests, Fisher's tests, and survival curves using the Kaplan-Meier technique (P value ≤ 0.05 to define statistical significance). Patient characteristics were not significantly different pre- vs. post-training. Operative time and estimated blood loss significantly decreased. Inflatable implants increased from 19/44 (43.2%, pre-training) to 69/79 (87.3%, post-training) (P < 0.01). Operations per year increased from 9.96 (pre-training) to 24 (post-training) (P < 0.01). Revision/explantation occurred in 11/44 patients (25%, pre-training) vs. 7/79 (8.9%, post-training) (P < 0.05). These data demonstrate that yearly sessions with a recognized expert can improve surgical outcomes, type, and volume of implants and can reduce explantation/revision rates. This represents an excellent model for improved training of urologic residents in penile prosthetics surgery. © 2011 International Society for Sexual Medicine.

Development of an instructional expert system for hole drilling processes

NASA Technical Reports Server (NTRS)

Al-Mutawa, Souhaila; Srinivas, Vijay; Moon, Young Bai

1990-01-01

An expert system which captures the expertise of workshop technicians in the drilling domain was developed. The expert system is aimed at novice technicians who know how to operate the machines but have not acquired the decision making skills that are gained with experience. This paper describes the domain background and the stages of development of the expert system.

Innovation on Energy Power Technology (22)Challenge to Development of Expert System stored Knowledge of Expert Power Network Operators

NASA Astrophysics Data System (ADS)

Sakaguchi, Hideharu

Do you remember an expert system? I think there are various impressions about the system. For example, some might say “It reminds me of old days”. On the other hand, some might say “It was really troublesome”. About 25 years ago, from late 1980s to the middle of 1990s, when the Showa era was about to change into the Heisei Era, artificial intelligence boomed. Research and development for an expert system which was equipped with expertise and worked as smart as expert, was advanced in various fields. Our company also picked up the system as the new system which covered weak point of conventional computer technology. We started research and development in 1984, and installed an expert system in a SCADA system, which started operating in March 1990 in the Fukuoka Integrated Control Center. In this essay, as an electric power engineer who involved in development at that time, I introduce the situation and travail story about developing an expert system which support restorative actions from the outage and overload condition of power networks.

The Management and Security Expert (MASE)

NASA Technical Reports Server (NTRS)

Miller, Mark D.; Barr, Stanley J.; Gryphon, Coranth D.; Keegan, Jeff; Kniker, Catherine A.; Krolak, Patrick D.

1991-01-01

The Management and Security Expert (MASE) is a distributed expert system that monitors the operating systems and applications of a network. It is capable of gleaning the information provided by the different operating systems in order to optimize hardware and software performance; recognize potential hardware and/or software failure, and either repair the problem before it becomes an emergency, or notify the systems manager of the problem; and monitor applications and known security holes for indications of an intruder or virus. MASE can eradicate much of the guess work of system management.

Expert System For Heat Exchanger

NASA Technical Reports Server (NTRS)

Bagby, D. Gordon; Cormier, Reginald A.

1991-01-01

Diagnosis simplified for non-engineers. Developmental expert-system computer program assists operator in controlling, monitoring operation, diagnosing malfunctions, and ordering repairs of heat-exchanger system dissipating heat generated by 20-kW radio transmitter. System includes not only heat exchanger but also pumps, fans, sensors, valves, reservoir, and associated plumbing. Program conceived to assist operator while avoiding cost of keeping engineer in full-time attendance. Similar programs developed for heating, ventilating, and air-conditioning systems.

76 FR 17629 - Applications for New Awards; Transition to Teaching Grant Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-30

... teachers in high-need schools operated by high-need local educational agencies (LEAs), including charter schools that operate as high-need LEAs. Priorities: This notice contains two competitive preference... Preference Priorities: Competitive Preference Priority 1 is from section 2313(c) of the Elementary and...

Fruit and vegetable purchasing patterns and preferences in South Delhi

PubMed Central

FINZER, LAUREN E.; AJAY, VAMADEVAN S.; ALI, MOHAMMED K.; SHIVASHANKAR, ROOPA; GOENKA, SHIFALIKA; PILLAI, DIVYA S.; KHANDELWAL, SHWETA; TANDON, NIKHIL; REDDY, K. SRINATH; NARAYAN, K.M. VENKAT; PRABHAKARAN, DORAIRAJ

2017-01-01

This study examines associations between consumer characteristics, beliefs, and preferences and fruit and vegetable (FV) purchasing and intake in South Delhi, India. Home interviews were conducted with 245 households, using a structured questionnaire to assess FV consumption and purchasing frequency, spending, place of purchase, mode of travel, knowledge and attitudes towards organics, and beliefs about barriers to FV consumption. In-depth interviews with 62 experts and key informants validated survey findings that street vendors and markets are currently the dominant source of FV in South Delhi and that affordability, not accessibility, is the main barrier to increasing FV intake. PMID:23282188

Use of a FORTH-based PROLOG for real-time expert systems. 1: Spacelab life sciences experiment application

NASA Technical Reports Server (NTRS)

Paloski, William H.; Odette, Louis L.; Krever, Alfred J.; West, Allison K.

1987-01-01

A real-time expert system is being developed to serve as the astronaut interface for a series of Spacelab vestibular experiments. This expert system is written in a version of Prolog that is itself written in Forth. The Prolog contains a predicate that can be used to execute Forth definitions; thus, the Forth becomes an embedded real-time operating system within the Prolog programming environment. The expert system consists of a data base containing detailed operational instructions for each experiment, a rule base containing Prolog clauses used to determine the next step in an experiment sequence, and a procedure base containing Prolog goals formed from real-time routines coded in Forth. In this paper, we demonstrate and describe the techniques and considerations used to develop this real-time expert system, and we conclude that Forth-based Prolog provides a viable implementation vehicle for this and similar applications.

Learning Aggregation Operators for Preference Modeling

NASA Astrophysics Data System (ADS)

Torra, Vicenç

Aggregation operators are useful tools for modeling preferences. Such operators include weighted means, OWA and WOWA operators, as well as some fuzzy integrals, e.g. Choquet and Sugeno integrals. To apply these operators in an effective way, their parameters have to be properly defined. In this chapter, we review some of the existing tools for learning these parameters from examples.

A CLIPS expert system for maximizing alfalfa (Medicago Sativa L.) production

NASA Technical Reports Server (NTRS)

Engel, B. A.; Jones, D. D.; Rhykerd, R. L.; Rhykerd, L. M.; Rhykerd, C. L., Jr.; Rhykerd, C. L.

1990-01-01

An alfalfa management expert system originally developed by Purdue University agricultural scientists on the PC Plus expert system shell from Texas Instrument has been updated and successfully converted to CLIPS (C Language Integrated Production System). This reduces the cost and legal restrictions associated with making the expert system available to agribusiness industries, extension personnel and farm managers and operators. The expert system includes recommendations concerning soil drainage, liming, P and K fertilization, weed control, variety selection and seeding rate including pure live seeds.

Experts and the Operational Bias of Television News: The Case of the Persian Gulf War.

ERIC Educational Resources Information Center

Steele, Janet E.

1995-01-01

Finds that news organizations chose expert sources to interpret the news during the Persian Gulf War according to how well their specialized knowledge conformed with television's "operational bias," or an emphasis on players, policies, and predictions of what will happen next. Argues that these processes undermine the ideals of balance…

Distributed expert systems for ground and space applications

NASA Technical Reports Server (NTRS)

Buckley, Brian; Wheatcraft, Louis

1992-01-01

Presented here is the Spacecraft Command Language (SCL) concept of the unification of ground and space operations using a distributed approach. SCL is a hybrid software environment borrowing from expert system technology, fifth generation language development, and multitasking operating system environments. Examples of potential uses for the system and current distributed applications of SCL are given.

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.

Expert System Detects Power-Distribution Faults

NASA Technical Reports Server (NTRS)

Walters, Jerry L.; Quinn, Todd M.

1994-01-01

Autonomous Power Expert (APEX) computer program is prototype expert-system program detecting faults in electrical-power-distribution system. Assists human operators in diagnosing faults and deciding what adjustments or repairs needed for immediate recovery from faults or for maintenance to correct initially nonthreatening conditions that could develop into faults. Written in Lisp.

Processes in construction of failure management expert systems from device design information

NASA Technical Reports Server (NTRS)

Malin, Jane T.; Lance, Nick

1987-01-01

This paper analyzes the tasks and problem solving methods used by an engineer in constructing a failure management expert system from design information about the device to te diagnosed. An expert test engineer developed a trouble-shooting expert system based on device design information and experience with similar devices, rather than on specific expert knowledge gained from operating the device or troubleshooting its failures. The construction of the expert system was intensively observed and analyzed. This paper characterizes the knowledge, tasks, methods, and design decisions involved in constructing this type of expert system, and makes recommendations concerning tools for aiding and automating construction of such systems.

Teaching Undergraduate Marketing Students Using "Hot Seating through Puppetry": An Exploratory Study

ERIC Educational Resources Information Center

Pearce, Glenn; Hardiman, Nigel

2012-01-01

Changes in preferred methods of learning among many students in recent years have challenged educators to introduce more interactive and experiential teaching methods. "Hot seating"--where a person, such as an invited subject expert is interviewed by an audience--is a well-established interactive method of learning, but is often limited…

Apple Stack Cake for Dessert: Appalachian Regional Foods

ERIC Educational Resources Information Center

Shortridge, Barbara G.

2005-01-01

How is the culture of Appalachia conveyed through its foods? Local experts in Appalachian counties were asked to create a hypothetical menu for a meal that was representative of their home region. Fried chicken and ham were the preferred main dishes and dessert selections focused on apple pie and peach or blackberry cobbler. Virtually everyone…

Single-Gender Schools Scrutinized

ERIC Educational Resources Information Center

Zubrzycki, Jaclyn

2012-01-01

This article reports on a study on publicly run schools in the Republic of Trinidad and Tobago which has found that, while single-sex schools may benefit female students who prefer a single-sex environment, they are not inherently beneficial for boys or most girls. While the findings are based on data from one Caribbean nation, experts say they…

Diversity and Affirmative Action: The State of Campus Opinion

ERIC Educational Resources Information Center

Rothman, Stanley; Lipset, S. M.; Nevitte, Neil

2002-01-01

In December 2000, a U.S. District Court judge ruled that the University of Michigan could provide preference in admission policies to minority students. He relied partly on expert social science testimony, which concluded that such policies advance racial and ethnic diversity and improve the education of all students, not just the minority…

Doing It Old School: Peer-Led Occupational Safety Training in the U.S. Construction Industry

ERIC Educational Resources Information Center

Sinyai, Clayton; Stafford, Pete; Trahan, Chris

2013-01-01

Many labour organizations that sponsor occupational health and safety training champion "peer training," preferring instructors drawn from the shopfloor over academically credentialed experts. But peer training is hardly new: in the skilled trades, master craftsmen have instructed apprentices since the Middle Ages. Building on the…

Disconnects between the enabling legislation and management planning

Treesearch

Christopher Hawkins; David K. Loomis

2007-01-01

The natural resource management paradigm in place for the past century has favored an expert-client approach, whereby managers have used wise biological principles in conjunction with clientele preferences to enable local, regional, and national decision-making. This paradigm, though acceptable when the primary clients were direct resource consumers (e.g., fishermen,...

Student Career Preferences: In Support of a New Learning Paradigm

ERIC Educational Resources Information Center

Atamian, Rubik; Mansouri, Hossein

2013-01-01

According to the Bureau of Labor Statistics, throughout their careers, college graduates change multiple jobs and several careers, often remotely related to one another or to their major field of study. Experts project that the majority of newly created jobs requiring college education would involve extensive and prolonged on-the-job training of…

Using Data Mining for Wine Quality Assessment

NASA Astrophysics Data System (ADS)

Cortez, Paulo; Teixeira, Juliana; Cerdeira, António; Almeida, Fernando; Matos, Telmo; Reis, José

Certification and quality assessment are crucial issues within the wine industry. Currently, wine quality is mostly assessed by physicochemical (e.g alcohol levels) and sensory (e.g. human expert evaluation) tests. In this paper, we propose a data mining approach to predict wine preferences that is based on easily available analytical tests at the certification step. A large dataset is considered with white vinho verde samples from the Minho region of Portugal. Wine quality is modeled under a regression approach, which preserves the order of the grades. Explanatory knowledge is given in terms of a sensitivity analysis, which measures the response changes when a given input variable is varied through its domain. Three regression techniques were applied, under a computationally efficient procedure that performs simultaneous variable and model selection and that is guided by the sensitivity analysis. The support vector machine achieved promising results, outperforming the multiple regression and neural network methods. Such model is useful for understanding how physicochemical tests affect the sensory preferences. Moreover, it can support the wine expert evaluations and ultimately improve the production.

Do Children Copy an Expert or a Majority? Examining Selective Learning in Instrumental and Normative Contexts

PubMed Central

Lucas, Amanda J.; Buchsbaum, Daphna; McGuigan, Nicola; Wood, Lara A.; Whiten, Andrew

2016-01-01

This study examined whether instrumental and normative learning contexts differentially influence 4- to 7-year-old children’s social learning strategies; specifically, their dispositions to copy an expert versus a majority consensus. Experiment 1 (N = 44) established that children copied a relatively competent “expert” individual over an incompetent individual in both kinds of learning context. In experiment 2 (N = 80) we then tested whether children would copy a competent individual versus a majority, in each of the two different learning contexts. Results showed that individual children differed in strategy, preferring with significant consistency across two different test trials to copy either the competent individual or the majority. This study is the first to show that children prefer to copy more competent individuals when shown competing methods of achieving an instrumental goal (Experiment 1) and provides new evidence that children, at least in our “individualist” culture, may consistently express either a competency or majority bias in learning both instrumental and normative information (Experiment 2). This effect was similar in the instrumental and normative learning contexts we applied. PMID:27768716

Multispectral, Fluorescent and Photoplethysmographic Imaging for Remote Skin Assessment

PubMed Central

Spigulis, Janis

2017-01-01

Optical tissue imaging has several advantages over the routine clinical imaging methods, including non-invasiveness (it does not change the structure of tissues), remote operation (it avoids infections) and the ability to quantify the tissue condition by means of specific image parameters. Dermatologists and other skin experts need compact (preferably pocket-size), self-sustaining and easy-to-use imaging devices. The operational principles and designs of ten portable in-vivo skin imaging prototypes developed at the Biophotonics Laboratory of Institute of Atomic Physics and Spectroscopy, University of Latvia during the recent five years are presented in this paper. Four groups of imaging devices are considered. Multi-spectral imagers offer possibilities for distant mapping of specific skin parameters, thus facilitating better diagnostics of skin malformations. Autofluorescence intensity and photobleaching rate imagers show a promising potential for skin tumor identification and margin delineation. Photoplethysmography video-imagers ensure remote detection of cutaneous blood pulsations and can provide real-time information on cardiovascular parameters and anesthesia efficiency. Multimodal skin imagers perform several of the abovementioned functions by taking a number of spectral and video images with the same image sensor. Design details of the developed prototypes and results of clinical tests illustrating their functionality are presented and discussed. PMID:28534815

The Generic Spacecraft Analyst Assistant (GenSAA): A tool for automating spacecraft monitoring with expert systems

NASA Technical Reports Server (NTRS)

Hughes, Peter M.; Luczak, Edward C.

1991-01-01

Flight Operations Analysts (FOAs) in the Payload Operations Control Center (POCC) are responsible for monitoring a satellite's health and safety. As satellites become more complex and data rates increase, FOAs are quickly approaching a level of information saturation. The FOAs in the spacecraft control center for the COBE (Cosmic Background Explorer) satellite are currently using a fault isolation expert system named the Communications Link Expert Assistance Resource (CLEAR), to assist in isolating and correcting communications link faults. Due to the success of CLEAR and several other systems in the control center domain, many other monitoring and fault isolation expert systems will likely be developed to support control center operations during the early 1990s. To facilitate the development of these systems, a project was initiated to develop a domain specific tool, named the Generic Spacecraft Analyst Assistant (GenSAA). GenSAA will enable spacecraft analysts to easily build simple real-time expert systems that perform spacecraft monitoring and fault isolation functions. Lessons learned during the development of several expert systems at Goddard, thereby establishing the foundation of GenSAA's objectives and offering insights in how problems may be avoided in future project, are described. This is followed by a description of the capabilities, architecture, and usage of GenSAA along with a discussion of its application to future NASA missions.

Spacelab data processing facility (SLDPF) quality assurance (QA)/data accounting (DA) expert systems - Transition from prototypes to operational systems

NASA Technical Reports Server (NTRS)

Basile, Lisa

1988-01-01

The SLDPF is responsible for the capture, quality monitoring processing, accounting, and shipment of Spacelab and/or Attached Shuttle Payloads (ASP) telemetry data to various user facilities. Expert systems will aid in the performance of the quality assurance and data accounting functions of the two SLDPF functional elements: the Spacelab Input Processing System (SIPS) and the Spacelab Output Processing System (SOPS). Prototypes were developed for each as independent efforts. The SIPS Knowledge System Prototype (KSP) used the commercial shell OPS5+ on an IBM PC/AT; the SOPS Expert System Prototype used the expert system shell CLIPS implemented on a Macintosh personal computer. Both prototypes emulate the duties of the respective QA/DA analysts based upon analyst input and predetermined mission criteria parameters, and recommended instructions and decisions governing the reprocessing, release, or holding for further analysis of data. These prototypes demonstrated feasibility and high potential for operational systems. Increase in productivity, decrease of tedium, consistency, concise historical records, and a training tool for new analyses were the principal advantages. An operational configuration, taking advantage of the SLDPF network capabilities, is under development with the expert systems being installed on SUN workstations. This new configuration in conjunction with the potential of the expert systems will enhance the efficiency, in both time and quality, of the SLDPF's release of Spacelab/AST data products.

Spacelab data processing facility (SLDPF) Quality Assurance (QA)/Data Accounting (DA) expert systems: Transition from prototypes to operational systems

NASA Technical Reports Server (NTRS)

Basile, Lisa

1988-01-01

The SLDPF is responsible for the capture, quality monitoring processing, accounting, and shipment of Spacelab and/or Attached Shuttle Payloads (ASP) telemetry data to various user facilities. Expert systems will aid in the performance of the quality assurance and data accounting functions of the two SLDPF functional elements: the Spacelab Input Processing System (SIPS) and the Spacelab Output Processing System (SOPS). Prototypes were developed for each as independent efforts. The SIPS Knowledge System Prototype (KSP) used the commercial shell OPS5+ on an IBM PC/AT; the SOPS Expert System Prototype used the expert system shell CLIPS implemented on a Macintosh personal computer. Both prototypes emulate the duties of the respective QA/DA analysts based upon analyst input and predetermined mission criteria parameters, and recommended instructions and decisions governing the reprocessing, release, or holding for further analysis of data. These prototypes demonstrated feasibility and high potential for operational systems. Increase in productivity, decrease of tedium, consistency, concise historial records, and a training tool for new analyses were the principal advantages. An operational configuration, taking advantage of the SLDPF network capabilities, is under development with the expert systems being installed on SUN workstations. This new configuration in conjunction with the potential of the expert systems will enhance the efficiency, in both time and quality, of the SLDPF's release of Spacelab/AST data products.

Needs analysis for developing a virtual-reality NOTES simulator.

PubMed

Sankaranarayanan, Ganesh; Matthes, Kai; Nemani, Arun; Ahn, Woojin; Kato, Masayuki; Jones, Daniel B; Schwaitzberg, Steven; De, Suvranu

2013-05-01

INTRODUCTION AND STUDY AIM: Natural orifice translumenal endoscopic surgery (NOTES) is an emerging surgical technique that requires a cautious adoption approach to ensure patient safety. High-fidelity virtual-reality-based simulators allow development of new surgical procedures and tools and train medical personnel without risk to human patients. As part of a project funded by the National Institutes of Health, we are developing the virtual transluminal endoscopic surgery trainer (VTEST) for this purpose. The objective of this study is to conduct a structured needs analysis to identify the design parameters for such a virtual-reality-based simulator for NOTES. A 30-point questionnaire was distributed at the 2011 National Orifice Surgery Consortium for Assessment and Research meeting to obtain responses from experts. Ordinal logistic regression and the Wilcoxon rank-sum test were used for analysis. A total of 22 NOTES experts participated in the study. Cholecystectomy (CE, 68 %) followed by appendectomy (AE, 63 %) (CE vs AE, p = 0.0521) was selected as the first choice for simulation. Flexible (FL, 47 %) and hybrid (HY, 47 %) approaches were equally favorable compared with rigid (RI, 6 %) with p < 0.001 for both FL versus RI and HY versus RI. The transvaginal approach was preferred 3 to 1 to the transgastric. Most participants preferred two-channel (2C) scopes (65 %) compared with single (1C) or three (3C) or more channels with p < 0.001 for both 2C versus 1C and 2C versus 3C. The importance of force feedback and the utility of a virtual NOTES simulator in training and testing new tools for NOTES were rated very high by the participants. Our study reinforces the importance of developing a virtual NOTES simulator and clearly presents expert preferences. The results of this analysis will direct our initial development of the VTEST platform.

Amplifying Each Patient's Voice: A Systematic Review of Multi-criteria Decision Analyses Involving Patients.

PubMed

Marsh, Kevin; Caro, J Jaime; Hamed, Alaa; Zaiser, Erica

2017-04-01

Qualitative methods tend to be used to incorporate patient preferences into healthcare decision making. However, for patient preferences to be given adequate consideration by decision makers they need to be quantified. Multi-criteria decision analysis (MCDA) is one way to quantify and capture the patient voice. The objective of this review was to report on existing MCDAs involving patients to support the future use of MCDA to capture the patient voice. MEDLINE and EMBASE were searched in June 2014 for English-language papers with no date restriction. The following search terms were used: 'multi-criteria decision*', 'multiple criteria decision*', 'MCDA', 'benefit risk assessment*', 'risk benefit assessment*', 'multicriteri* decision*', 'MCDM', 'multi-criteri* decision*'. Abstracts were included if they reported the application of MCDA to assess healthcare interventions where patients were the source of weights. Abstracts were excluded if they did not apply MCDA, such as discussions of how MCDA could be used; or did not evaluate healthcare interventions, such as MCDAs to assess the level of health need in a locality. Data were extracted on weighting method, variation in patient and expert preferences, and discussion on different weighting techniques. The review identified ten English-language studies that reported an MCDA to assess healthcare interventions and involved patients as a source of weights. These studies reported 12 applications of MCDA. Different methods of preference elicitation were employed: direct weighting in workshops; discrete choice experiment surveys; and the analytical hierarchy process using both workshops and surveys. There was significant heterogeneity in patient responses and differences between patients, who put greater weight on disease characteristics and treatment convenience, and experts, who put more weight on efficacy. The studies highlighted cognitive challenges associated with some weighting methods, though patients' views on their ability to undertake weighting tasks was positive. This review identified several recent examples of MCDA used to elicit patient preferences, which support the feasibility of using MCDA to capture the patient voice. Challenges identified included, how best to reflect the heterogeneity of patient preferences in decision making and how to manage the cognitive burden associated with some MCDA tasks.

Appendicectomy deferred to a CEPOD list: the patients' opinion.

PubMed

Sideso, E; Richards, T; Galland, R B

2008-08-01

Implementation of NCEPOD guidelines to avoid out-of-hours operating, Junior doctors' 'New Deal' and EWTD have significantly altered surgical practice. Patients admitted 'out of hours', who need an emergency procedure, are often deferred until the next day. We have attempted to assess patients' opinions of this management plan. Consecutive patients admitted with uncomplicated appendicitis and operation deferred to the next day according to NCEPOD guidelines were studied. A surgeon, other than the one carrying out the initial assessment, performed the operation on a scheduled morning emergency list. A full explanation was given to patients regarding reasons for deferring operation, and they found out that a different surgeon would be performing their operation. Patients completed a questionnaire post-operatively. 42 patients were studied; median age 24 years (range 17-69); 32 men, 10 women. Thirty presented after 6 p.m. and eight after midnight. The remaining four were admitted during the day. Only one third of the patients recalled reasons for deferred operation with seven not remembering being given an explanation. Two thirds (n=27) of the patients slept poorly pre-operatively, principally due to pain (17) and ward noise (10). Operation on the same night as their admission was the preferred option in 24 patients. All of these slept poorly. Some 22 patients would have preferred the admitting surgeon to have performed their operation; 16 expressed no preference. Only four patients preferred a 'new' surgeon the following day. Of the 42 patients, 28 did not know who had performed their operation. Despite being told why their operation was delayed most patients would prefer not to have their procedure delayed. Lack of sleep pre-operatively is a major determinant of patient opinion. Few patients wanted a 'new' surgeon to perform their operation.

The Advantages of Abstract Control Knowledge in Expert System Design. Technical Report #7.

ERIC Educational Resources Information Center

Clancey, William J.

This paper argues that an important design principle for building expert systems is to represent all control knowledge abstractly and separately from the domain knowledge upon which it operates. Abstract control knowledge is defined as the specifications of when and how a program is to carry out its operations, such as pursuing a goal, focusing,…

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. © 2010 Institute of Food Technologists®

Smart electric vehicle (EV) charging and grid integration apparatus and methods

DOEpatents

Gadh, Rajit; Mal, Siddhartha; Prabhu, Shivanand; Chu, Chi-Cheng; Sheikh, Omar; Chung, Ching-Yen; He, Lei; Xiao, Bingjun; Shi, Yiyu

2015-05-05

An expert system manages a power grid wherein charging stations are connected to the power grid, with electric vehicles connected to the charging stations, whereby the expert system selectively backfills power from connected electric vehicles to the power grid through a grid tie inverter (if present) within the charging stations. In more traditional usage, the expert system allows for electric vehicle charging, coupled with user preferences as to charge time, charge cost, and charging station capabilities, without exceeding the power grid capacity at any point. A robust yet accurate state of charge (SOC) calculation method is also presented, whereby initially an open circuit voltage (OCV) based on sampled battery voltages and currents is calculated, and then the SOC is obtained based on a mapping between a previously measured reference OCV (ROCV) and SOC. The OCV-SOC calculation method accommodates likely any battery type with any current profile.

Centers for Disease Control and Prevention Expert Panel Meetings on Prevention and Treatment of Anthrax in Adults

PubMed Central

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.

2014-01-01

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. PMID:24447897

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.

Knowledge acquisition for a simple expert controller

NASA Technical Reports Server (NTRS)

Bieker, B.

1987-01-01

A method is presented for process control which has the properties of being incremental, cyclic and top-down. It is described on the basis of the development of an expert controller for a simple, but nonlinear control route. A quality comparison between expert controller and process operator shows the ability of the method for knowledge acquisition.

User Documentation; POTW EXPERT v1.1; An Advisory System for Improving the Performance of Wastewater Treatment Facilities

EPA Science Inventory

POTW Expert is a PCX-based software program modeled after EPA/s Handbook Retrofitting POTWs (EPA-625/6-89/020) (formerly, Handbook for Improving POTW Performance Using the Composite Correction Program Approach). POTW Expert assists POTW owners and operators, state and local regu...

Enhanced use of CLIPS at the Los Alamos National Laboratory

NASA Technical Reports Server (NTRS)

Duerre, K. H.; Parkinson, W. J.; Osowski, J. J.

1991-01-01

Early efforts for producing expert systems for engineering applications used a limited subset of C Language Integrated Production System (CLIPS) features. The implementation details of previous expert systems and of the current expert system, which is used for training operators in the control of the Isotope Separation System, are discussed.

Distributed Web-Based Expert System for Launch Operations

NASA Technical Reports Server (NTRS)

Bardina, Jorge E.; Thirumalainambi, Rajkumar

2005-01-01

The simulation and modeling of launch operations is based on a representation of the organization of the operations suitable to experiment of the physical, procedural, software, hardware and psychological aspects of space flight operations. The virtual test bed consists of a weather expert system to advice on the effect of weather to the launch operations. It also simulates toxic gas dispersion model, and the risk impact on human health. Since all modeling and simulation is based on the internet, it could reduce the cost of operations of launch and range safety by conducting extensive research before a particular launch. Each model has an independent decision making module to derive the best decision for launch.

Effects of test method and participant musical training on preference ratings of stimuli with different reverberation times.

PubMed

Lawless, Martin S; Vigeant, Michelle C

2017-10-01

Selecting an appropriate listening test design for concert hall research depends on several factors, including listening test method and participant critical-listening experience. Although expert listeners afford more reliable data, their perceptions may not be broadly representative. The present paper contains two studies that examined the validity and reliability of the data obtained from two listening test methods, a successive and a comparative method, and two types of participants, musicians and non-musicians. Participants rated their overall preference of auralizations generated from eight concert hall conditions with a range of reverberation times (0.0-7.2 s). Study 1, with 34 participants, assessed the two methods. The comparative method yielded similar results and reliability as the successive method. Additionally, the comparative method was rated as less difficult and more preferable. For study 2, an additional 37 participants rated the stimuli using the comparative method only. An analysis of variance of the responses from both studies revealed that musicians are better than non-musicians at discerning their preferences across stimuli. This result was confirmed with a k-means clustering analysis on the entire dataset that revealed five preference groups. Four groups exhibited clear preferences to the stimuli, while the fifth group, predominantly comprising non-musicians, demonstrated no clear preference.

Sleep-deprived motor vehicle operators are unfit to drive: a multidisciplinary expert consensus statement on drowsy driving.

PubMed

Czeisler, Charles A; Wickwire, Emerson M; Barger, Laura K; Dement, William C; Gamble, Karen; Hartenbaum, Natalie; Ohayon, Maurice M; Pelayo, Rafael; Phillips, Barbara; Strohl, Kingman; Tefft, Brian; Rajaratnam, Shantha M W; Malhotra, Raman; Whiton, Kaitlyn; Hirshkowitz, Max

2016-06-01

This article presents the consensus findings of the National Sleep Foundation Drowsy Driving Consensus Working Group, which was an expert panel assembled to establish a consensus statement regarding sleep-related driving impairment. The National Sleep Foundation assembled a expert panel comprised of experts from the sleep community and experts appointed by stakeholder organizations. A systematic literature review identified 346 studies that were abstracted and provided to the panelists for review. A modified Delphi RAND/UCLA Appropriateness Method with 2 rounds of voting was used to reach consensus. A final consensus was reached that sleep deprivation renders motorists unfit to drive a motor vehicle. After reviewing growing evidence of impairment and increased crash risk among drivers who obtained less than optimal sleep duration in the preceding 24 hours, the panelists recognized the need for public policy guidance as to when it is certainly unsafe to drive. Toward this end, the panelists agreed upon the following expert consensus statement: "Drivers who have slept for two hours or less in the preceding 24 hours are not fit to operate a motor vehicle." Panelists further agreed that most healthy drivers would likely be impaired with only 3 to 5 hours of sleep during the prior 24 hours. There is consensus among experts that healthy individuals who have slept for 2 hours or less in the preceding 24 hours are too impaired to safely operate a motor vehicle. Prevention of drowsy driving will require sustained and collaborative effort from multiple stakeholders. Implications and limitations of the consensus recommendations are discussed. Copyright © 2016. Published by Elsevier Inc.

Validation of the VBLaST: A Virtual Peg Transfer Task in Gynecologic Surgeons.

PubMed

Awtrey, Christopher; Chellali, Amine; Schwaitzberg, Steven; De, Suvranu; Jones, Daniel; Cao, Caroline

2015-01-01

To validate the Virtual Basic Laparoscopic Skill Trainer (VBLaST-PT; the peg transfer task) for concurrent validity based on its ability to differentiate between novice, intermediate, and expert groups of gynecologists, and the gynecologists' subjective preference between the physical Fundamentals of Laparoscopic Surgery (FLS) system and the virtual reality system. Prospective study (Canadian Task Force II-2). Academic medical center. Obstetrics and gynecology residents (n = 18) and attending gynecologists (n = 9). Twenty-seven subjects were divided into 3 groups: novices (n = 9), intermediates (n = 9), and experts (n = 9). All subjects performed 10 trials of the peg transfer on each simulator. Assessment of laparoscopic performance was based on FLS scoring, whereas a questionnaire was used for subjective evaluation. The performance scores in the 2 simulators were nearly identical. Experts performed better than intermediates and novices in both the FLS trainer and the VBLAST, and intermediates performed better than novices in both simulators. The results also show a significant learning effect on both trainers for all subgroups; however, the greatest learning effect was in the novice group for both trainers. Subjectively, 74% participants preferred the FLS over the VBLaST for training laparoscopic surgical skills. This study demonstrates that the peg transfer task was reproduced well in the VBLaST in gynecologic surgeons and trainees. The VBLaST has the potential to be a valuable tool in laparoscopic training for gynecologic surgeons. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

The influence of expert opinions on the selection of wastewater treatment alternatives: a group decision-making approach.

PubMed

Kalbar, Pradip P; Karmakar, Subhankar; Asolekar, Shyam R

2013-10-15

The application of multiple-attribute decision-making (MADM) to real life decision problems suggests that avoiding the loss of information through scenario-based approaches and including expert opinions in the decision-making process are two major challenges that require more research efforts. Recently, a wastewater treatment technology selection effort has been made with a 'scenario-based' method of MADM. This paper focuses on a novel approach to incorporate expert opinions into the scenario-based decision-making process, as expert opinions play a major role in the selection of treatment technologies. The sets of criteria and the indicators that are used consist of both qualitative and quantitative criteria. The group decision-making (GDM) approach that is implemented for aggregating expert opinions is based on an analytical hierarchy process (AHP), which is the most widely used MADM method. The pairwise comparison matrices (PCMs) for qualitative criteria are formed based on expert opinions, whereas, a novel approach is proposed for generating PCMs for quantitative criteria. It has been determined that the experts largely prefer natural treatment systems because they are more sustainable in any scenario. However, PCMs based on expert opinions suggest that advanced technologies such as the sequencing batch reactor (SBR) can also be appropriate for a given decision scenario. The proposed GDM approach is a rationalized process that will be more appropriate in realistic scenarios where multiple stakeholders with local and regional societal priorities are involved in the selection of treatment technology. Copyright © 2013 Elsevier Ltd. All rights reserved.

Scientists versus regulators: precaution, novelty & regulatory oversight as predictors of perceived risks of engineered nanomaterials.

PubMed

Beaudrie, Christian E H; Satterfield, Terre; Kandlikar, Milind; Harthorn, Barbara H

2014-01-01

Engineered nanoscale materials (ENMs) present a difficult challenge for risk assessors and regulators. Continuing uncertainty about the potential risks of ENMs means that expert opinion will play an important role in the design of policies to minimize harmful implications while supporting innovation. This research aims to shed light on the views of 'nano experts' to understand which nanomaterials or applications are regarded as more risky than others, to characterize the differences in risk perceptions between expert groups, and to evaluate the factors that drive these perceptions. Our analysis draws from a web-survey (N = 404) of three groups of US and Canadian experts: nano-scientists and engineers, nano-environmental health and safety scientists, and regulatory scientists and decision-makers. Significant differences in risk perceptions were found across expert groups; differences found to be driven by underlying attitudes and perceptions characteristic of each group. Nano-scientists and engineers at the upstream end of the nanomaterial life cycle perceived the lowest levels of risk, while those who are responsible for assessing and regulating risks at the downstream end perceived the greatest risk. Perceived novelty of nanomaterial risks, differing preferences for regulation (i.e. the use of precaution versus voluntary or market-based approaches), and perceptions of the risk of technologies in general predicted variation in experts' judgments of nanotechnology risks. Our findings underscore the importance of involving a diverse selection of experts, particularly those with expertise at different stages along the nanomaterial lifecycle, during policy development.

Expert database system for quality control

NASA Astrophysics Data System (ADS)

Wang, Anne J.; Li, Zhi-Cheng

1993-09-01

There are more competitors today. Markets are not homogeneous they are fragmented into increasingly focused niches requiring greater flexibility in the product mix shorter manufacturing production runs and above allhigher quality. In this paper the author identified a real-time expert system as a way to improve plantwide quality management. The quality control expert database system (QCEDS) by integrating knowledge of experts in operations quality management and computer systems use all information relevant to quality managementfacts as well as rulesto determine if a product meets quality standards. Keywords: expert system quality control data base

Improved cardiovascular diagnostic accuracy by pocket size imaging device in non-cardiologic outpatients: the NaUSiCa (Naples Ultrasound Stethoscope in Cardiology) study

PubMed Central

2010-01-01

Miniaturization has evolved in the creation of a pocket-size imaging device which can be utilized as an ultrasound stethoscope. This study assessed the additional diagnostic power of pocket size device by both experts operators and trainees in comparison with physical examination and its appropriateness of use in comparison with standard echo machine in a non-cardiologic population. Three hundred four consecutive non cardiologic outpatients underwent a sequential assessment including physical examination, pocket size imaging device and standard Doppler-echo exam. Pocket size device was used by both expert operators and trainees (who received specific training before the beginning of the study). All the operators were requested to give only visual, qualitative insights on specific issues. All standard Doppler-echo exams were performed by expert operators. One hundred two pocket size device exams were performed by experts and two hundred two by trainees. The time duration of the pocket size device exam was 304 ± 117 sec. Diagnosis of cardiac abnormalities was made in 38.2% of cases by physical examination and in 69.7% of cases by physical examination + pocket size device (additional diagnostic power = 31.5%, p < 0.0001). The overall K between pocket size device and standard Doppler-echo was 0.67 in the pooled population (0.84 by experts and 0.58 by trainees). K was suboptimal for trainees in the eyeball evaluation of ejection fraction, left atrial dilation and right ventricular dilation. Overall sensitivity was 91% and specificity 76%. Sensitivity and specificity were lower in trainees than in experts. In conclusion, pocket size device showed a relevant additional diagnostic value in comparison with physical examination. Sensitivity and specificity were good in experts and suboptimal in trainees. Specificity was particularly influenced by the level of experience. Training programs are needed for pocket size device users. PMID:21110840

On Consistency Test Method of Expert Opinion in Ecological Security Assessment.

PubMed

Gong, Zaiwu; Wang, Lihong

2017-09-04

To reflect the initiative design and initiative of human security management and safety warning, ecological safety assessment is of great value. In the comprehensive evaluation of regional ecological security with the participation of experts, the expert's individual judgment level, ability and the consistency of the expert's overall opinion will have a very important influence on the evaluation result. This paper studies the consistency measure and consensus measure based on the multiplicative and additive consistency property of fuzzy preference relation (FPR). We firstly propose the optimization methods to obtain the optimal multiplicative consistent and additively consistent FPRs of individual and group judgments, respectively. Then, we put forward a consistency measure by computing the distance between the original individual judgment and the optimal individual estimation, along with a consensus measure by computing the distance between the original collective judgment and the optimal collective estimation. In the end, we make a case study on ecological security for five cities. Result shows that the optimal FPRs are helpful in measuring the consistency degree of individual judgment and the consensus degree of collective judgment.

A knowledge acquisition process to analyse operational problems in solid waste management facilities.

PubMed

Dokas, Ioannis M; Panagiotakopoulos, Demetrios C

2006-08-01

The available expertise on managing and operating solid waste management (SWM) facilities varies among countries and among types of facilities. Few experts are willing to record their experience, while few researchers systematically investigate the chains of events that could trigger operational failures in a facility; expertise acquisition and dissemination, in SWM, is neither popular nor easy, despite the great need for it. This paper presents a knowledge acquisition process aimed at capturing, codifying and expanding reliable expertise and propagating it to non-experts. The knowledge engineer (KE), the person performing the acquisition, must identify the events (or causes) that could trigger a failure, determine whether a specific event could trigger more than one failure, and establish how various events are related among themselves and how they are linked to specific operational problems. The proposed process, which utilizes logic diagrams (fault trees) widely used in system safety and reliability analyses, was used for the analysis of 24 common landfill operational problems. The acquired knowledge led to the development of a web-based expert system (Landfill Operation Management Advisor, http://loma.civil.duth.gr), which estimates the occurrence possibility of operational problems, provides advice and suggests solutions.

Asking the Experts: What Children Have to Say about Their Reading Preferences

ERIC Educational Resources Information Center

Davila, Denise; Patrick, Lisa

2010-01-01

Ironically, adults control most of the world of children's literature: adults write the books; adults choose which books to publish; adults review the books, adults bestow the awards on books and adults purchase the books for bookstores, libraries, and their children. In this paradigm of adult control, children's opinions are often overlooked. The…

Urban Teens in the Library: Research and Practice

ERIC Educational Resources Information Center

Agosto, Denise E., Ed.; Hughes-Hassell, Sandra, Ed.

2009-01-01

"Urban Teens in the Library" is the perfect solution for the concerns and uncertainty many librarians face when supporting this group of patrons and students. From a team of experts who have researched the information habits and preferences of urban teens to build better and more effective school and public library programs, this book will show…

Angels and Demons: Using Behavioral Types in a Real-Effort Moral Dilemma to Identify Expert Traits.

PubMed

Bejarano, Hernán D; Green, Ellen P; Rassenti, Stephen J

2016-01-01

In this article, we explore how independently reported measures of subjects' cognitive capabilities, preferences, and sociodemographic characteristics relate to their behavior in a real-effort moral dilemma experiment. To do this, we use a unique dataset, the Chapman Preferences and Characteristics Instrument Set (CPCIS), which contains over 30 standardized measures of preferences and characteristics. We find that simple correlation analysis provides an incomplete picture of how individual measures relate to behavior. In contrast, clustering subjects into groups based on observed behavior in the real-effort task reveals important systematic differences in individual characteristics across groups. However, while we find more differences, these differences are not systematic and difficult to interpret. These results indicate a need for more comprehensive theory explaining how combinations of different individual characteristics impact behavior is needed.

Angels and Demons: Using Behavioral Types in a Real-Effort Moral Dilemma to Identify Expert Traits

PubMed Central

Bejarano, Hernán D.; Green, Ellen P.; Rassenti, Stephen J.

2016-01-01

In this article, we explore how independently reported measures of subjects' cognitive capabilities, preferences, and sociodemographic characteristics relate to their behavior in a real-effort moral dilemma experiment. To do this, we use a unique dataset, the Chapman Preferences and Characteristics Instrument Set (CPCIS), which contains over 30 standardized measures of preferences and characteristics. We find that simple correlation analysis provides an incomplete picture of how individual measures relate to behavior. In contrast, clustering subjects into groups based on observed behavior in the real-effort task reveals important systematic differences in individual characteristics across groups. However, while we find more differences, these differences are not systematic and difficult to interpret. These results indicate a need for more comprehensive theory explaining how combinations of different individual characteristics impact behavior is needed. PMID:27826258

[Complications after laser hair removal: the standpoint of a dermatological legal expert regarding liability].

PubMed

Bayle, P; Saval, F; Rougé, D; Telmon, N

2015-03-01

Laser hair removal is widely used, including outside medical settings. Potential complications, notably burns, may engage the operator's liability. In this case, investigations by medical experts are frequently requested. We describe 6 expert examinations carried out by the same legal dermatology expert between 2012 and 2014. They concerned burns of varying severity caused by laser hair removal procedures carried out by a doctor, a physiotherapist and 4 beauticians. Laser hair removal is carried out in many beauty centres, although in France it is restricted by law to medical use. This practice is thus currently the subject of legal and economic controversy. The analysis of 6 medical expert investigations of accidents involving laser hair removal illustrates the various types of fault in which the operator's liability may be engaged and it also serves to redefine the legal framework of this act within the realm of aesthetic medicine. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Using Ada to implement the operations management system in a community of experts

NASA Technical Reports Server (NTRS)

Frank, M. S.

1986-01-01

An architecture is described for the Space Station Operations Management System (OMS), consisting of a distributed expert system framework implemented in Ada. The motivation for such a scheme is based on the desire to integrate the very diverse elements of the OMS while taking maximum advantage of knowledge based systems technology. Part of the foundation of an Ada based distributed expert system was accomplished in the form of a proof of concept prototype for the KNOMES project (Knowledge-based Maintenance Expert System). This prototype successfully used concurrently active experts to accomplish monitoring and diagnosis for the Remote Manipulator System. The basic concept of this software architecture is named ACTORS for Ada Cognitive Task ORganization Scheme. It is when one considers the overall problem of integrating all of the OMS elements into a cooperative system that the AI solution stands out. By utilizing a distributed knowledge based system as the framework for OMS, it is possible to integrate those components which need to share information in an intelligent manner.

Ranking experts' preferences regarding measures and methods of assessment of welfare in dairy herds using Adaptive Conjoint Analysis.

PubMed

Lievaart, J J; Noordhuizen, J P T M

2011-07-01

Welfare in dairy herds can be addressed using different concepts. The difficulty is to extract which measures are the most important to practically address welfare at the herd level and the methods to assess traits considered most important. Therefore, the preferences of 24 acknowledged European welfare experts were ranked regarding 70 measures suitable to assess dairy cattle welfare at herd level using the Adaptive Conjoint Analysis (ACA; Sawtooth Software, Inc., Sequim, WA) technique. The experts were selected on the basis of 3 criteria: at least 5 yr experience in animal welfare research; recent scientific publications in the field of animal welfare; and, at the most, 3 animal species including dairy cattle as their field of expertise. The 70 traits were ranked by using the median ACA questionnaire utility scores and the range between the answers of the 24 experts. A high utility score with a low range between the answers of the experts was considered as suitable to assess welfare at farm level. Measures meeting these criteria were prevalence of lameness cases (107.3±11.7), competition for feed and water (96.4±13.9), and number of freestalls per 10 cows (84.8±13.3). Based on the utility score alone, these former measures were replaced by stereotypic behavior (111.7±17.1), prevalence of lameness cases (107.3±11.7), body condition score (108.0±18.9), and hock lesions (104.7±16.1). Subsequently, to demonstrate that the ACA technique can be used to rank either well-known or inconclusive methods of assessment, the methods for the traits lameness cases and the hygiene of the calving pen were ranked using another 2 ACA questionnaires. The results are based on the opinions of selected, internationally acknowledged dairy cattle welfare experts within the European Union. In the future, other parties like dairy farmers and farmers' organization should be included to achieve consensus about the most suitable traits applicable in practice. The currently investigated traits do not always apply to all dairy husbandry systems across the world, but are based on a system that includes indoor housing during winter. It is concluded that ACA is a useful technique to rank the different scientific opinions of experts regarding suitable traits and methods of assessment of dairy cattle at the herd level. Copyright © 2011 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

36 CFR 251.124 - Preferred operator competitive special use authorization procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... entrepreneurship, nonprofit entity, or other form of organization shall be considered valid only when the... entrepreneurship, nonprofit entity, or other form of organization. (f) A qualified preferred operator shall be...

36 CFR 251.124 - Preferred operator competitive special use authorization procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... entrepreneurship, nonprofit entity, or other form of organization shall be considered valid only when the... entrepreneurship, nonprofit entity, or other form of organization. (f) A qualified preferred operator shall be...

Post Game Analysis: Using Video-Based Coaching for Continuous Professional Development

PubMed Central

Hu, Yue-Yung; Peyre, Sarah E.; Arriaga, Alexander F.; Osteen, Robert T.; Corso, Katherine A.; Weiser, Thomas G.; Swanson, Richard S.; Ashley, Stanley W.; Raut, Chandrajit P.; Zinner, Michael J.; Gawande, Atul A.; Greenberg, Caprice C.

2011-01-01

Background The surgical learning curve persists for years after training, yet existing CME efforts targeting this are limited. We describe a pilot study of a scalable video-based intervention, providing individualized feedback on intra-operative performance. Study Design Four complex operations performed by surgeons of varying experience – a chief resident accompanied by the operating senior surgeon, a surgeon with <10 years in practice, another with 20–30 years, and a surgeon with >30 years of experience – were video-recorded. Video playback formed the basis of 1-hour coaching sessions with a peer-judged surgical expert. These sessions were audio-recorded, transcribed, and thematically coded. Results The sessions focused on operative technique, both technical aspects and decision-making. With increasing seniority, more discussion was devoted to the optimization of teaching and facilitation of the resident’s technical performance. Coaching sessions with senior surgeons were peer-to-peer interactions, with each discussing his preferred approach. The coach alternated between directing the session (asking probing questions) and responding to specific questions brought by the surgeons, depending on learning style. At all experience levels, video review proved valuable in identifying episodes of failure-to-progress and troubleshooting alternative approaches. All agreed this tool is a powerful one. Inclusion of trainees seems most appropriate when coaching senior surgeons; it may restrict the dialogue of more junior attendings. Conclusions Video-based coaching is an educational modality that targets intra-operative judgment, technique, and teaching. Surgeons of all levels found it highly instructive. This may provide a practical, much needed approach for continuous professional development. PMID:22192924

Towards an operational fault isolation expert system for French telecommunication satellite Telecom 2

NASA Astrophysics Data System (ADS)

Haziza, M.

1990-10-01

The DIAMS satellite fault isolation expert system shell concept is described. The project, initiated in 1985, has led to the development of a prototype Expert System (ES) dedicated to the Telecom 1 attitude and orbit control system. The prototype ES has been installed in the Telecom 1 satellite control center and evaluated by Telecom 1 operations. The development of a fault isolation ES covering a whole spacecraft (the French telecommunication satellite Telecom 2) is currently being undertaken. Full scale industrial applications raise stringent requirements in terms of knowledge management and software development methodology. The approach used by MATRA ESPACE to face this challenge is outlined.

Evaluation of infectious diseases and clinical microbiology specialists' preferences for hand hygiene: analysis using the multi-attribute utility theory and the analytic hierarchy process methods.

PubMed

Suner, Aslı; Oruc, Ozlem Ege; Buke, Cagri; Ozkaya, Hacer Deniz; Kitapcioglu, Gul

2017-08-31

Hand hygiene is one of the most effective attempts to control nosocomial infections, and it is an important measure to avoid the transmission of pathogens. However, the compliance of healthcare workers (HCWs) with hand washing is still poor worldwide. Herein, we aimed to determine the best hand hygiene preference of the infectious diseases and clinical microbiology (IDCM) specialists to prevent transmission of microorganisms from one patient to another. Expert opinions regarding the criteria that influence the best hand hygiene preference were collected through a questionnaire via face-to-face interviews. Afterwards, these opinions were examined with two widely used multi-criteria decision analysis (MCDA) methods, the Multi-Attribute Utility Theory (MAUT) and the Analytic Hierarchy Process (AHP). A total of 15 IDCM specialist opinions were collected from diverse private and public hospitals located in İzmir, Turkey. The mean age of the participants was 49.73 ± 8.46, and the mean experience year of the participants in their fields was 17.67 ± 11.98. The findings that we obtained through two distinct decision making methods, the MAUT and the AHP, suggest that alcohol-based antiseptic solution (ABAS) has the highest utility (0.86) and priority (0.69) among the experts' choices. In conclusion, the MAUT and the AHP, decision models developed here indicate that rubbing the hands with ABAS is the most favorable choice for IDCM specialists to prevent nosocomial infection.

Developing standardised treatment for adults with myositis and different phenotypes: an international survey of current prescribing preferences.

PubMed

Tansley, Sarah; Shaddick, Gavin; Christopher-Stine, Lisa; Sharp, Charlotte; Dourmishev, Lyubomir; Maurer, Britta; Chinoy, Hector; McHugh, Neil

2016-01-01

The evidence base for treatment of the idiopathic inflammatory myopathies is extremely limited. The rarity and heterogeneity of these diseases has hampered the development of good quality clinical trials and while a range of immunomodulatory treatments are commonly used in clinical practice, as yet there are no clear guidelines directing their use. We aimed to establish current prescribing regimens used to treat adults with myositis internationally. An electronic survey based on different clinical scenarios was distributed internationally to clinicians involved in the treatment of patients with myositis. Participants were asked to select their first-line treatment preferences in each situation. A multinomial regression analysis was used to assess the influence of clinical scenario, respondent expertise and country of origin on first-line treatment choice. 107 survey responses were received. 57% of respondents considered themselves an expert in myositis and the majority of respondents were rheumatologists although responses from other specialities were also received. Pharmacological treatment with steroids and additional immunotherapy was the preference in most scenarios. First-line immunosuppressant choice was significantly influenced by the clinical scenario, the expertise of the treating physician and country of practice. Azathioprine, methotrexate and mycophenolate mofetil were the most commonly chosen agents. In the absence of available evidence, clinical experience and expert consensus often forms the basis of treatment guidelines. These results suggest that an international consensus approach would be possible in myositis and would overcome an urgent, yet unmet need for patients suffering with this difficult disease.

From the Medical Board of the National Psoriasis Foundation: Treatment targets for plaque psoriasis.

PubMed

Armstrong, April W; Siegel, Michael P; Bagel, Jerry; Boh, Erin E; Buell, Megan; Cooper, Kevin D; Callis Duffin, Kristina; Eichenfield, Lawrence F; Garg, Amit; Gelfand, Joel M; Gottlieb, Alice B; Koo, John Y M; Korman, Neil J; Krueger, Gerald G; Lebwohl, Mark G; Leonardi, Craig L; Mandelin, Arthur M; Menter, M Alan; Merola, Joseph F; Pariser, David M; Prussick, Ronald B; Ryan, Caitriona; Shah, Kara N; Weinberg, Jeffrey M; Williams, MaryJane O U; Wu, Jashin J; Yamauchi, Paul S; Van Voorhees, Abby S

2017-02-01

An urgent need exists in the United States to establish treatment goals in psoriasis. We aim to establish defined treatment targets toward which clinicians and patients with psoriasis can strive to inform treatment decisions, reduce disease burden, and improve outcomes in practice. The National Psoriasis Foundation conducted a consensus-building study among psoriasis experts using the Delphi method. The process consisted of: (1) literature review, (2) pre-Delphi question selection and input from general dermatologists and patients, and (3) 4 Delphi rounds. A total of 25 psoriasis experts participated in the Delphi process. The most preferred instrument was body surface area (BSA). The most preferred time for evaluating patient response after starting new therapies was at 3 months. The acceptable response at 3 months postinitiation was either BSA 3% or less or BSA improvement 75% or more from baseline. The target response at 3 months postinitiation was BSA 1% or less. During the maintenance period, evaluation every 6 months was most preferred. The target response at every 6 months maintenance evaluation is BSA 1% or less. Although BSA is feasible in practice, it does not encompass health-related quality of life, costs, and risks of side effects. With defined treatment targets, clinicians and patients can regularly evaluate treatment responses and perform benefit-risk assessments of therapeutic options individualized to the patient. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Identifying User Preferences for a Digital Educational Solution for Young Seniors With Diabetes.

PubMed

van der Molen, Pieta; Maas, Anne H; Chen, Wei; van Pul, Carola; Cottaar, Eduardus J E; van Riel, Natal A W; Hilbers, Peter A J; Haak, Harm R

2017-08-01

The Eindhoven Diabetes Education Simulator project was initiated to develop an educational solution that helps diabetes patients understand and learn more about their diabetes. This article describes the identification of user preferences for the development of such solutions. Young seniors (aged 50-65 years) with type 2 diabetes were chosen as the target group because they are likely to have more affinity with digital devices than older people and because 88% of the Dutch diabetes population is >50 years of age. Data about the target group were gathered through literature research and interviews. The literature research covered data about their device use and education preferences. To gain insight into the daily life of diabetes patients and current diabetes education processes, 20 diabetes patients and 10 medical experts were interviewed. The interviews were analyzed using affinity diagrams. Those diagrams, together with the literature data, formed the basis for two personas and corresponding customer journey maps. Literature showed that diabetes prevalence is inversely correlated to educational level. Computer and device use is relatively low within the target group, but is growing. The interviews showed that young seniors like to play board, card, and computer games, with others or alone. Family and loved ones play an important role in their lives. Medical experts are crucial in the diabetes education of young senior diabetes patients. These findings are translated into a list of design aspects that can be used for creating educational solutions.

Identifying and prioritizing the preference criteria using analytical hierarchical process for a student-lecturer allocation problem of internship programme

NASA Astrophysics Data System (ADS)

Faudzi, Syakinah; Abdul-Rahman, Syariza; Rahman, Rosshairy Abd; Hew, Jafri Hj. Zulkepli

2016-10-01

This paper discusses on identifying and prioritizing the student's preference criteria towards supervisor using Analytical Hierarchical Process (AHP) for student-lecturer allocation problem of internship programme. Typically a wide number of students undertake internship every semester and many preferences criteria may involve when assigning students to lecturer for supervision. Thus, identifying and prioritizing the preference criteria of assigning students to lecturer is critically needed especially when involving many preferences. AHP technique is used to prioritize the seven criteria which are capacity, specialization, academic position, availability, professional support, relationship and gender. Student's preference alternative is classified based on lecturer's academic position which are lecturer, senior lecturer, associate professor and professor. Criteria are ranked to find the best preference criteria and alternatives of the supervisor that students prefer to have. This problem is solved using Expert Choice 11 software. A sample of 30 respondents who are from semester 6 and above are randomly selected to participate in the study. By using questionnaire as our medium in collecting the student's data, consistency index is produced to validate the proposed study. Findings and result showed that, the most important preference criteria is professional support. It is followed by specialization, availability, relationship, gender, academic position and capacity. This study found that student would like to have a supportive supervisor because lack of supervision can lead the students to achieve low grade and knowledge from the internship session.

Research on an expert system for database operation of simulation-emulation math models. Volume 1, Phase 1: Results

NASA Technical Reports Server (NTRS)

Kawamura, K.; Beale, G. O.; Schaffer, J. D.; Hsieh, B. J.; Padalkar, S.; Rodriguez-Moscoso, J. J.

1985-01-01

The results of the first phase of Research on an Expert System for Database Operation of Simulation/Emulation Math Models, is described. Techniques from artificial intelligence (AI) were to bear on task domains of interest to NASA Marshall Space Flight Center. One such domain is simulation of spacecraft attitude control systems. Two related software systems were developed to and delivered to NASA. One was a generic simulation model for spacecraft attitude control, written in FORTRAN. The second was an expert system which understands the usage of a class of spacecraft attitude control simulation software and can assist the user in running the software. This NASA Expert Simulation System (NESS), written in LISP, contains general knowledge about digital simulation, specific knowledge about the simulation software, and self knowledge.

Automatic, semi-automatic and manual validation of urban drainage data.

PubMed

Branisavljević, N; Prodanović, D; Pavlović, D

2010-01-01

Advances in sensor technology and the possibility of automated long distance data transmission have made continuous measurements the preferable way of monitoring urban drainage processes. Usually, the collected data have to be processed by an expert in order to detect and mark the wrong data, remove them and replace them with interpolated data. In general, the first step in detecting the wrong, anomaly data is called the data quality assessment or data validation. Data validation consists of three parts: data preparation, validation scores generation and scores interpretation. This paper will present the overall framework for the data quality improvement system, suitable for automatic, semi-automatic or manual operation. The first two steps of the validation process are explained in more detail, using several validation methods on the same set of real-case data from the Belgrade sewer system. The final part of the validation process, which is the scores interpretation, needs to be further investigated on the developed system.

Construction risk assessment of deep foundation pit in metro station based on G-COWA method

NASA Astrophysics Data System (ADS)

You, Weibao; Wang, Jianbo; Zhang, Wei; Liu, Fangmeng; Yang, Diying

2018-05-01

In order to get an accurate understanding of the construction safety of deep foundation pit in metro station and reduce the probability and loss of risk occurrence, a risk assessment method based on G-COWA is proposed. Firstly, relying on the specific engineering examples and the construction characteristics of deep foundation pit, an evaluation index system based on the five factors of “human, management, technology, material and environment” is established. Secondly, the C-OWA operator is introduced to realize the evaluation index empowerment and weaken the negative influence of expert subjective preference. The gray cluster analysis and fuzzy comprehensive evaluation method are combined to construct the construction risk assessment model of deep foundation pit, which can effectively solve the uncertainties. Finally, the model is applied to the actual project of deep foundation pit of Qingdao Metro North Station, determine its construction risk rating is “medium”, evaluate the model is feasible and reasonable. And then corresponding control measures are put forward and useful reference are provided.

Overview of different available chemotherapy regimens combined with radiotherapy for the neoadjuvant and definitive treatment of esophageal cancer.

PubMed

Tomasello, Gianluca; Ghidini, Michele; Barni, Sandro; Passalacqua, Rodolfo; Petrelli, Fausto

2017-06-01

Neoadjuvant chemoradiotherapy (CTRT) is the current standard of care for treatment of locally advanced cancer of the esophagus or gastroesophageal junction. Many efforts have been made over the last years to identify the best chemotherapy and radiotherapy combination regimen, but specific randomized trials addressing this issue are still lacking. Areas covered: A systematic review of the literature was performed searching in PubMed all published studies of combinations CTRT regimens for operable or unresectable esophageal cancer to describe activity and toxicity. Studies considered were prospective series or clinical phase II-III trials including at least 40 patients and published in English language. Expert commentary: Long-term results of CROSS trial have established RT combined with carboplatin plus paclitaxel chemotherapy as the preferred neoadjuvant treatment option for both squamous and adenocarcinoma of the esophagus. More effective multimodal treatment strategies integrating novel biological agents including immunotherapy and based on an extensive molecular tumor characterization are eagerly awaited.

How to Conduct Multimethod Field Studies in the Operating Room: The iPad Combined With a Survey App as a Valid and Reliable Data Collection Tool

PubMed Central

Tscholl, David W; Weiss, Mona; Spahn, Donat R

2016-01-01

Background Tablet computers such as the Apple iPad are progressively replacing traditional paper-and-pencil-based data collection. We combined the iPad with the ready-to-use survey software, iSurvey (from Harvestyourdata), to create a straightforward tool for data collection during the Anesthesia Pre-Induction Checklist (APIC) study, a hospital-wide multimethod intervention study involving observation of team performance and team member surveys in the operating room (OR). Objective We aimed to provide an analysis of the factors that led to the use of the iPad- and iSurvey-based tool for data collection, illustrate our experiences with the use of this data collection tool, and report the results of an expert survey about user experience with this tool. Methods We used an iPad- and iSurvey-based tool to observe anesthesia inductions conducted by 205 teams (N=557 team members) in the OR. In Phase 1, expert raters used the iPad- and iSurvey-based tool to rate team performance during anesthesia inductions, and anesthesia team members were asked to indicate their perceptions after the inductions. In Phase 2, we surveyed the expert raters about their perceptions regarding the use of the iPad- and iSurvey-based tool to observe, rate, and survey teams in the ORs. Results The results of Phase 1 showed that training data collectors on the iPad- and iSurvey-based data collection tool was effortless and there were no serious problems during data collection, upload, download, and export. Interrater agreement of the combined data collection tool was found to be very high for the team observations (median Fleiss’ kappa=0.88, 95% CI 0.78-1.00). The results of the follow-up expert rater survey (Phase 2) showed that the raters did not prefer a paper-and-pencil-based data collection method they had used during other earlier studies over the iPad- and iSurvey-based tool (median response 1, IQR 1-1; 1=do not agree, 2=somewhat disagree, 3=neutral, 4=somewhat agree, 5=fully agree). They found the iPad (median 5, IQR 4.5-5) and iSurvey (median 4, IQR 4-5) to be working flawlessly and easy to use (median 5, IQR 4-5). Expert ratings also showed that the anesthesia team members (ie, the surveyed doctors and nurses) who used the iPad- and iSurvey-based tool in the OR liked it (median 4, IQR 3-4.5). Conclusions The combination of the iPad and iSurvey provides an efficient and unobtrusive method to observe teams in their natural environment in the OR and to survey team members immediately after completing their task (ie, anesthesia induction). The expert raters positively evaluated the use of the device and user perceptions. Considering these comprehensive results, we can recommend the use of the iPad- and iSurvey-based tool for studying team performance and team member perceptions in the OR. PMID:26732090

Visualising probabilistic flood forecast information: expert preferences and perceptions of best practice in uncertainty communication

NASA Astrophysics Data System (ADS)

Pappenberger, F.; Stephens, E. M.; Thielen, J.; Salomon, P.; Demeritt, D.; van Andel, S.; Wetterhall, F.; Alfieri, L.

2011-12-01

The aim of this paper is to understand and to contribute to improved communication of the probabilistic flood forecasts generated by Hydrological Ensemble Prediction Systems (HEPS) with particular focus on the inter expert communication. Different users are likely to require different kinds of information from HEPS and thus different visualizations. The perceptions of this expert group are important both because they are the designers and primary users of existing HEPS. Nevertheless, they have sometimes resisted the release of uncertainty information to the general public because of doubts about whether it can be successfully communicated in ways that would be readily understood to non-experts. In this paper we explore the strengths and weaknesses of existing HEPS visualization methods and thereby formulate some wider recommendations about best practice for HEPS visualization and communication. We suggest that specific training on probabilistic forecasting would foster use of probabilistic forecasts with a wider range of applications. The result of a case study exercise showed that there is no overarching agreement between experts on how to display probabilistic forecasts and what they consider essential information that should accompany plots and diagrams. In this paper we propose a list of minimum properties that, if consistently displayed with probabilistic forecasts, would make the products more easily understandable.

Space Transportation System Meteorological Expert

NASA Technical Reports Server (NTRS)

Beller, Arthur E.; Stafford, Sue P.

1987-01-01

The STS Meteorological Expert (STSMET) is a long-term project to acquire general Shuttle operational weather forecasting expertise specific to the launch locale, to apply it to Shuttle operational weather forecasting tasks at the Cape Canaveral Forecast Facility, and ultimately to provide an on-line real-time operational aid to the duty forecasters in performing their tasks. Particular attention is given to the development of an approach called scenario-based reasoning, with specific application to summer thunderstorms; this type of reasoning can also be applied to frontal weather phenomena, visibility including fog, and wind shear.

FIESTA: An operational decision aid for space network fault isolation

NASA Technical Reports Server (NTRS)

Lowe, Dawn; Quillin, Bob; Matteson, Nadine; Wilkinson, Bill; Miksell, Steve

1987-01-01

The Fault Tolerance Expert System for Tracking and Data Relay Satellite System (TDRSS) Applications (FIESTA) is a fault detection and fault diagnosis expert system being developed as a decision aid to support operations in the Network Control Center (NCC) for NASA's Space Network. The operational objectives which influenced FIESTA development are presented and an overview of the architecture used to achieve these goals are provided. The approach to the knowledge engineering effort and the methodology employed are also presented and illustrated with examples drawn from the FIESTA domain.

Decision Support Systems for Launch and Range Operations Using Jess

NASA Technical Reports Server (NTRS)

Thirumalainambi, Rajkumar

2007-01-01

The virtual test bed for launch and range operations developed at NASA Ames Research Center consists of various independent expert systems advising on weather effects, toxic gas dispersions and human health risk assessment during space-flight operations. An individual dedicated server supports each expert system and the master system gather information from the dedicated servers to support the launch decision-making process. Since the test bed is based on the web system, reducing network traffic and optimizing the knowledge base is critical to its success of real-time or near real-time operations. Jess, a fast rule engine and powerful scripting environment developed at Sandia National Laboratory has been adopted to build the expert systems providing robustness and scalability. Jess also supports XML representation of knowledge base with forward and backward chaining inference mechanism. Facts added - to working memory during run-time operations facilitates analyses of multiple scenarios. Knowledge base can be distributed with one inference engine performing the inference process. This paper discusses details of the knowledge base and inference engine using Jess for a launch and range virtual test bed.

Advanced Technology Training System on Motor-Operated Valves

NASA Technical Reports Server (NTRS)

Wiederholt, Bradley J.; Widjaja, T. Kiki; Yasutake, Joseph Y.; Isoda, Hachiro

1993-01-01

This paper describes how features from the field of Intelligent Tutoring Systems are applied to the Motor-Operated Valve (MOV) Advanced Technology Training System (ATTS). The MOV ATTS is a training system developed at Galaxy Scientific Corporation for the Central Research Institute of Electric Power Industry in Japan and the Electric Power Research Institute in the United States. The MOV ATTS combines traditional computer-based training approaches with system simulation, integrated expert systems, and student and expert modeling. The primary goal of the MOV ATTS is to reduce human errors that occur during MOV overhaul and repair. The MOV ATTS addresses this goal by providing basic operational information of the MOV, simulating MOV operation, providing troubleshooting practice of MOV failures, and tailoring this training to the needs of each individual student. The MOV ATTS integrates multiple expert models (functional and procedural) to provide advice and feedback to students. The integration also provides expert model validation support to developers. Student modeling is supported by two separate student models: one model registers and updates the student's current knowledge of basic MOV information, while another model logs the student's actions and errors during troubleshooting exercises. These two models are used to provide tailored feedback to the student during the MOV course.

Applications of advanced data analysis and expert system technologies in the ATLAS Trigger-DAQ Controls framework

NASA Astrophysics Data System (ADS)

Avolio, G.; Corso Radu, A.; Kazarov, A.; Lehmann Miotto, G.; Magnoni, L.

2012-12-01

The Trigger and Data Acquisition (TDAQ) system of the ATLAS experiment is a very complex distributed computing system, composed of more than 20000 applications running on more than 2000 computers. The TDAQ Controls system has to guarantee the smooth and synchronous operations of all the TDAQ components and has to provide the means to minimize the downtime of the system caused by runtime failures. During data taking runs, streams of information messages sent or published by running applications are the main sources of knowledge about correctness of running operations. The huge flow of operational monitoring data produced is constantly monitored by experts in order to detect problems or misbehaviours. Given the scale of the system and the rates of data to be analyzed, the automation of the system functionality in the areas of operational monitoring, system verification, error detection and recovery is a strong requirement. To accomplish its objective, the Controls system includes some high-level components which are based on advanced software technologies, namely the rule-based Expert System and the Complex Event Processing engines. The chosen techniques allow to formalize, store and reuse the knowledge of experts and thus to assist the shifters in the ATLAS control room during the data-taking activities.

Supplement to a Methodology for Succession Planning for Technical Experts

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kirk, Bernadette Lugue; Cain, Ronald A.; Agreda, Carla L.

This report complements A Methodology for Succession Planning for Technical Experts (Ron Cain, Shaheen Dewji, Carla Agreda, Bernadette Kirk, July 2017), which describes a draft methodology for identifying and evaluating the loss of key technical skills at nuclear operations facilities. This report targets the methodology for identifying critical skills, and the methodology is tested through interviews with selected subject matter experts.

Expert system for analyzing eddy current measurements

DOEpatents

Levy, Arthur J.; Oppenlander, Jane E.; Brudnoy, David M.; Englund, James M.; Loomis, Kent C.

1994-01-01

A method and apparatus (called DODGER) analyzes eddy current data for heat exchanger tubes or any other metallic object. DODGER uses an expert system to analyze eddy current data by reasoning with uncertainty and pattern recognition. The expert system permits DODGER to analyze eddy current data intelligently, and obviate operator uncertainty by analyzing the data in a uniform and consistent manner.

Fingernail Injuries and NASA's Integrated Medical Model

NASA Technical Reports Server (NTRS)

Kerstman, Eric; Butler, Doug

2008-01-01

The goal of space medicine is to optimize both crew health and performance. Currently, expert opinion is primarily relied upon for decision-making regarding medical equipment and supplies flown in space. Evidence-based decisions are preferred due to mass and volume limitations and the expense of space flight. The Integrated Medical Model (IMM) is an attempt to move us in that direction!

Determination of Secondary Students' Preferences Regarding Design Features Used in Digital Textbooks

ERIC Educational Resources Information Center

Öngöz, Sakine; Mollamehmetoglu, Mehmet Zülküf

2017-01-01

The aim of this study was to determine secondary school students' choice of design features for digital textbooks. As a part of the research--which was conducted using a mixed technique--a literature review was carried out to source points to consider in the designing of digital textbooks and experts' opinions were obtained. Based on the results,…

Middle-aged women's preferred theory-based features in mobile physical activity applications.

PubMed

Ehlers, Diane K; Huberty, Jennifer L

2014-09-01

The purpose of this study was to describe which theory-based behavioral and technological features middle-aged women prefer to be included in a mobile application designed to help them adopt and maintain regular physical activity (PA). Women aged 30 to 64 years (N = 120) completed an online survey measuring their demographics and mobile PA application preferences. The survey was developed upon behavioral principles of Social Cognitive Theory, recent mobile app research, and technology adoption principles of the Unified Theory of Acceptance and Use of Technology. Frequencies were calculated and content analyses conducted to identify which features women most preferred. Behavioral features that help women self-regulate their PA (PA tracking, goal-setting, progress monitoring) were most preferred. Technological features that enhance perceived effort expectancy and playfulness were most preferred. Many women reported the desire to interact and compete with others through the application. Theory-based PA self-regulation features and theory-based design features that improve perceived effort expectancy and playfulness may be most beneficial in a mobile PA application for middle-aged women. Opportunities to interact with other people and the employment of social, game-like activities may also be attractive. Interdisciplinary engagement of experts in PA behavior change, technology adoption, and software development is needed.

Who decides and what are people willing-to-pay for whole genome sequencing information?

PubMed Central

Marshall, DA; Gonzalez, JM; Johnson, FR; MacDonald, KV; Pugh, A; Douglas, MP; Phillips, KA

2016-01-01

PURPOSE Whole genome sequencing (WGS) can be used as a powerful diagnostic tool which could also be used for screening but may generate anxiety, unnecessary testing and overtreatment. Current guidelines suggest reporting clinically actionable secondary findings when diagnostic testing is performed. We estimated preferences for receiving WGS results. METHODS A US nationally representative survey (n=410 adults) was used to rank preferences for who decides (expert panel, your doctor, you) which WGS results are reported. We estimated the value of information about variants with varying levels of clinical usefulness using willingness-to-pay contingent valuation questions. RESULTS 43% preferred to decide themselves what information is included in the WGS report. 38% (95% CI:33–43%) would not pay for actionable variants, and 3% (95% CI:1–5%) would pay more than $1000. 55% (95% CI:50–60%) would not pay for variants in which medical treatment is currently unclear, and 7% (95% CI:5–9%) would pay more than $400. CONCLUSION Most people prefer to decide what WGS results are reported. Despite valuing actionable information more, some respondents perceive that genetic information could negatively impact them. Preference heterogeneity for WGS information should be considered in the development of policies, particularly to integrate patient preferences with personalized medicine and shared decision making. PMID:27253734

Preferences and needs of patients with a rheumatic disease regarding the structure and content of online self-management support.

PubMed

Ammerlaan, Judy W; van Os-Medendorp, Harmieke; de Boer-Nijhof, Nienke; Maat, Bertha; Scholtus, Lieske; Kruize, Aike A; Bijlsma, Johannes W J; Geenen, Rinie

2017-03-01

Aim of this study was to investigate preferences and needs regarding the structure and content of a person-centered online self-management support intervention for patients with a rheumatic disease. A four step procedure, consisting of online focus group interviews, consensus meetings with patient representatives, card sorting task and hierarchical cluster analysis was used to identify the preferences and needs. Preferences concerning the structure involved 1) suitability to individual needs and questions, 2) fit to the life stage 3) creating the opportunity to share experiences, be in contact with others, 4) have an expert patient as trainer, 5) allow for doing the training at one's own pace and 6) offer a brief intervention. Hierarchical cluster analysis of 55 content needs comprised eleven clusters: 1) treatment knowledge, 2) societal procedures, 3) physical activity, 4) psychological distress, 5) self-efficacy, 6) provider, 7) fluctuations, 8) dealing with rheumatic disease, 9) communication, 10) intimate relationship, and 11) having children. A comprehensive assessment of preferences and needs in patients with a rheumatic disease is expected to contribute to motivation, adherence to and outcome of self-management-support programs. The overview of preferences and needs can be used to build an online-line self-management intervention. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A survey of supervised machine learning models for mobile-phone based pathogen identification and classification

NASA Astrophysics Data System (ADS)

Ceylan Koydemir, Hatice; Feng, Steve; Liang, Kyle; Nadkarni, Rohan; Tseng, Derek; Benien, Parul; Ozcan, Aydogan

2017-03-01

Giardia lamblia causes a disease known as giardiasis, which results in diarrhea, abdominal cramps, and bloating. Although conventional pathogen detection methods used in water analysis laboratories offer high sensitivity and specificity, they are time consuming, and need experts to operate bulky equipment and analyze the samples. Here we present a field-portable and cost-effective smartphone-based waterborne pathogen detection platform that can automatically classify Giardia cysts using machine learning. Our platform enables the detection and quantification of Giardia cysts in one hour, including sample collection, labeling, filtration, and automated counting steps. We evaluated the performance of three prototypes using Giardia-spiked water samples from different sources (e.g., reagent-grade, tap, non-potable, and pond water samples). We populated a training database with >30,000 cysts and estimated our detection sensitivity and specificity using 20 different classifier models, including decision trees, nearest neighbor classifiers, support vector machines (SVMs), and ensemble classifiers, and compared their speed of training and classification, as well as predicted accuracies. Among them, cubic SVM, medium Gaussian SVM, and bagged-trees were the most promising classifier types with accuracies of 94.1%, 94.2%, and 95%, respectively; we selected the latter as our preferred classifier for the detection and enumeration of Giardia cysts that are imaged using our mobile-phone fluorescence microscope. Without the need for any experts or microbiologists, this field-portable pathogen detection platform can present a useful tool for water quality monitoring in resource-limited-settings.

Keyword extraction, ranking, and organization for the neuroinformatics platform.

PubMed

Usui, S; Palmes, P; Nagata, K; Taniguchi, T; Ueda, N

2007-04-01

Brain-related researches encompass many fields of studies and usually involve worldwide collaborations. Recognizing the value of these international collaborations for efficient use of resources and improving the quality of brain research, the International Neuroinformatics Coordinating Facility (INCF) started to coordinate the effort of establishing neuroinformatics (NI) centers and portal sites among the different participating countries. These NI centers and portal sites will serve as the conduit for the interchange of information and brain-related resources among different countries. In Japan, several NI platforms under the support of NIJC (NI Japan Center) are being developed with one platform called, Visiome, already operating and publicly accessible at "http://www.platform.visiome.org". Each of these platforms requires their own set of keywords that represent important terms covering their respective fields of study. One important function of this predefined keyword list is to help contributors classify the contents of their contributions and group related resources. It is vital, therefore, that this predefined list should be properly chosen to cover the necessary areas. Currently, the process of identifying these appropriate keywords relies on the availability of human experts which does not scale well considering that different areas are rapidly evolving. This problem prompted us to develop a tool to automatically filter the most likely terms preferred by human experts. We tested the effectiveness of the proposed approach using the abstracts of the Vision Research Journal (VR) and Investigative Ophthalmology and Visual Science Journal (IOVS) as source files.

Quality assessment of structure and language elements of written responses given by seven Scandinavian drug information centres.

PubMed

Reppe, Linda Amundstuen; Spigset, Olav; Kampmann, Jens Peter; Damkier, Per; Christensen, Hanne Rolighed; Böttiger, Ylva; Schjøtt, Jan

2017-05-01

The aim of this study was to identify structure and language elements affecting the quality of responses from Scandinavian drug information centres (DICs). Six different fictitious drug-related queries were sent to each of seven Scandinavian DICs. The centres were blinded for which queries were part of the study. The responses were assessed qualitatively by six clinical pharmacologists (internal experts) and six general practitioners (GPs, external experts). In addition, linguistic aspects of the responses were evaluated by a plain language expert. The quality of responses was generally judged as satisfactory to good. Presenting specific advice and conclusions were considered to improve the quality of the responses. However, small nuances in language formulations could affect the individual judgments of the experts, e.g. on whether or not advice was given. Some experts preferred the use of primary sources to the use of secondary and tertiary sources. Both internal and external experts criticised the use of abbreviations, professional terminology and study findings that was left unexplained. The plain language expert emphasised the importance of defining and explaining pharmacological terms to ensure that enquirers understand the response as intended. In addition, more use of active voice and less compressed text structure would be desirable. This evaluation of responses to DIC queries may give some indications on how to improve written responses on drug-related queries with respect to language and text structure. Giving specific advice and precise conclusions and avoiding too compressed language and non-standard abbreviations may aid to reach this goal.

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.

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.

An expert system executive for automated assembly of large space truss structures

NASA Technical Reports Server (NTRS)

Allen, Cheryl L.

1993-01-01

Langley Research Center developed a unique test bed for investigating the practical problems associated with the assembly of large space truss structures using robotic manipulators. The test bed is the result of an interdisciplinary effort that encompasses the full spectrum of assembly problems - from the design of mechanisms to the development of software. The automated structures assembly test bed and its operation are described, the expert system executive and its development are detailed, and the planned system evolution is discussed. Emphasis is on the expert system implementation of the program executive. The executive program must direct and reliably perform complex assembly tasks with the flexibility to recover from realistic system errors. The employment of an expert system permits information that pertains to the operation of the system to be encapsulated concisely within a knowledge base. This consolidation substantially reduced code, increased flexibility, eased software upgrades, and realized a savings in software maintenance costs.

Advance care planning in dementia: recommendations for healthcare professionals.

PubMed

Piers, Ruth; Albers, Gwenda; Gilissen, Joni; De Lepeleire, Jan; Steyaert, Jan; Van Mechelen, Wouter; Steeman, Els; Dillen, Let; Vanden Berghe, Paul; Van den Block, Lieve

2018-06-21

Advance care planning (ACP) is a continuous, dynamic process of reflection and dialogue between an individual, those close to them and their healthcare professionals, concerning the individual's preferences and values concerning future treatment and care, including end-of-life care. Despite universal recognition of the importance of ACP for people with dementia, who gradually lose their ability to make informed decisions themselves, ACP still only happens infrequently, and evidence-based recommendations on when and how to perform this complex process are lacking. We aimed to develop evidence-based clinical recommendations to guide professionals across settings in the practical application of ACP in dementia care. Following the Belgian Centre for Evidence-Based Medicine's procedures, we 1) performed an extensive literature search to identify international guidelines, articles reporting heterogeneous study designs and grey literature, 2) developed recommendations based on the available evidence and expert opinion of the author group, and 3) performed a validation process using written feedback from experts, a survey for end users (healthcare professionals across settings), and two peer-review groups (with geriatricians and general practitioners). Based on 67 publications and validation from ten experts, 51 end users and two peer-review groups (24 participants) we developed 32 recommendations covering eight domains: initiation of ACP, evaluation of mental capacity, holding ACP conversations, the role and importance of those close to the person with dementia, ACP with people who find it difficult or impossible to communicate verbally, documentation of wishes and preferences, including information transfer, end-of-life decision-making, and preconditions for optimal implementation of ACP. Almost all recommendations received a grading representing low to very low-quality evidence. No high-quality guidelines are available for ACP in dementia care. By combining evidence with expert and user opinions, we have defined a unique set of recommendations for ACP in people living with dementia. These recommendations form a valuable tool for educating healthcare professionals on how to perform ACP across settings.

The development of human social learning across seven societies.

PubMed

van Leeuwen, Edwin J C; Cohen, Emma; Collier-Baker, Emma; Rapold, Christian J; Schäfer, Marie; Schütte, Sebastian; Haun, Daniel B M

2018-05-25

Social information use is a pivotal characteristic of the human species. Avoiding the cost of individual exploration, social learning confers substantial fitness benefits under a wide variety of environmental conditions, especially when the process is governed by biases toward relative superiority (e.g., experts, the majority). Here, we examine the development of social information use in children aged 4-14 years (n = 605) across seven societies in a standardised social learning task. We measured two key aspects of social information use: general reliance on social information and majority preference. We show that the extent to which children rely on social information depends on children's cultural background. The extent of children's majority preference also varies cross-culturally, but in contrast to social information use, the ontogeny of majority preference follows a U-shaped trajectory across all societies. Our results demonstrate both cultural continuity and diversity in the realm of human social learning.

Virtual building environments (VBE) - Applying information modeling to buildings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bazjanac, Vladimir

2004-06-21

A Virtual Building Environment (VBE) is a ''place'' where building industry project staffs can get help in creating Building Information Models (BIM) and in the use of virtual buildings. It consists of a group of industry software that is operated by industry experts who are also experts in the use of that software. The purpose of a VBE is to facilitate expert use of appropriate software applications in conjunction with each other to efficiently support multidisciplinary work. This paper defines BIM and virtual buildings, and describes VBE objectives, set-up and characteristics of operation. It informs about the VBE Initiative andmore » the benefits from a couple of early VBE projects.« less

Validation of the VBLaST: A Virtual Peg Transfer Task in Gynecologic Surgeons

PubMed Central

Awtrey, CS; Chellali, A; Schwaitzberg, SD; De, S; Jones, DB; Cao, CGL

2016-01-01

Study Objective To validate the virtual reality VBLaST-PT (the peg transfer task) for concurrent validity based on its ability to differentiate between novice, intermediate and expert groups of gynecologists, and the gynecologists’ subjective preference between the physical FLS system and the virtual reality system. Design Prospective study (Canadian Task Force II-2) Setting Academic medical center. Participants Obstetrics and gynecology residents (n = 18), and attending gynecologists (n = 9) Interventions Twenty-seven subjects were divided into three groups: novices (PGY1-2, n = 9), intermediates (PGY3-4, n = 9), and experts (attendings, n = 9). All subjects performed ten trials of the peg transfer on each simulator. Assessment of laparoscopic performance was based on FLS scoring while a questionnaire was used for subjective evaluation. Measurements and Main Results The results show that the performance scores in the two simulators were nearly identical. Experts performed better than intermediates and novices in both the FLS trainer and the VBLAST© and intermediates performed better than novices in both simulators as well. The results also show a significant learning effect on both trainers for all subgroups however the greatest learning effect was in the novice group for both trainers. Subjectively 74% participants preferred the FLS over the VBLaST© for training laparoscopic surgical skills. Conclusion This study demonstrates that the peg transfer task was reproduced well in the VBLaST in gynecologic surgeons and trainee’s. The VBLaST© has the potential to be a valuable tool in laparoscopic training for gynecologic surgeons. PMID:26216094

Third Annual Workshop on Space Operations Automation and Robotics (SOAR 1989)

NASA Technical Reports Server (NTRS)

Griffin, Sandy (Editor)

1990-01-01

Papers presented at the Third Annual Workshop on Space Operations Automation and Robotics (SOAR '89), hosted by the NASA Lyndon B. Johnson Space Center at Houston, Texas, on July 25 to 27, 1989, are given. Approximately 100 technical papers were presented by experts from NASA, the USAF, universities, and technical companies. Also held were panel discussions on Air Force/NASA Artificial Intelligence Overview and Expert System Verification and Validation.

Handbook for Operating the OWLKNEST Technology

DTIC Science & Technology

1992-06-01

D . A. (Ed.). (1988). Expert systems [Special issue]. Human Factors, 30(4), 377-443. Byers, J . C., Hill, S. G., Zaklad, A. L., & Christ, R. E. (1989...Sons. Harmon, P., & King, D . (1985). Expert systems: Artificial intelligence in business. New York, NY: John Wiley & Sons. Hill, S. G., Byers, J . C...Plamondon, B. D ., Linton, P. M., Wierwille, W. W., Zaklad, A. L., Bittner, A. C., Jr., & Wherry, R. J ., Jr. (1989). Operator workload: Comprehensive

A comparison of two methods for expert elicitation in health technology assessments.

PubMed

Grigore, Bogdan; Peters, Jaime; Hyde, Christopher; Stein, Ken

2016-07-26

When data needed to inform parameters in decision models are lacking, formal elicitation of expert judgement can be used to characterise parameter uncertainty. Although numerous methods for eliciting expert opinion as probability distributions exist, there is little research to suggest whether one method is more useful than any other method. This study had three objectives: (i) to obtain subjective probability distributions characterising parameter uncertainty in the context of a health technology assessment; (ii) to compare two elicitation methods by eliciting the same parameters in different ways; (iii) to collect subjective preferences of the experts for the different elicitation methods used. Twenty-seven clinical experts were invited to participate in an elicitation exercise to inform a published model-based cost-effectiveness analysis of alternative treatments for prostate cancer. Participants were individually asked to express their judgements as probability distributions using two different methods - the histogram and hybrid elicitation methods - presented in a random order. Individual distributions were mathematically aggregated across experts with and without weighting. The resulting combined distributions were used in the probabilistic analysis of the decision model and mean incremental cost-effectiveness ratios and the expected values of perfect information (EVPI) were calculated for each method, and compared with the original cost-effectiveness analysis. Scores on the ease of use of the two methods and the extent to which the probability distributions obtained from each method accurately reflected the expert's opinion were also recorded. Six experts completed the task. Mean ICERs from the probabilistic analysis ranged between £162,600-£175,500 per quality-adjusted life year (QALY) depending on the elicitation and weighting methods used. Compared to having no information, use of expert opinion decreased decision uncertainty: the EVPI value at the £30,000 per QALY threshold decreased by 74-86 % from the original cost-effectiveness analysis. Experts indicated that the histogram method was easier to use, but attributed a perception of more accuracy to the hybrid method. Inclusion of expert elicitation can decrease decision uncertainty. Here, choice of method did not affect the overall cost-effectiveness conclusions, but researchers intending to use expert elicitation need to be aware of the impact different methods could have.

Laparoscopic assistance by operating room nurses: Results of a virtual-reality study.

PubMed

Paschold, M; Huber, T; Maedge, S; Zeissig, S R; Lang, H; Kneist, W

2017-04-01

Laparoscopic assistance is often entrusted to a less experienced resident, medical student, or operating room nurse. Data regarding laparoscopic training for operating room nurses are not available. The aim of the study was to analyse the initial performance level and learning curves of operating room nurses in basic laparoscopic surgery compared with medical students and surgical residents to determine their ability to assist with this type of procedure. The study was designed to compare the initial virtual reality performance level and learning curves of user groups to analyse competence in laparoscopic assistance. The study subjects were operating room nurses, medical students, and first year residents. Participants performed three validated tasks (camera navigation, peg transfer, fine dissection) on a virtual reality laparoscopic simulator three times in 3 consecutive days. Laparoscopic experts were enrolled as a control group. Participants filled out questionnaires before and after the course. Nurses and students were comparable in their initial performance (p>0.05). Residents performed better in camera navigation than students and nurses and reached the expert level for this task. Residents, students, and nurses had comparable bimanual skills throughout the study; while, experts performed significantly better in bimanual manoeuvres at all times (p<0.05). The included user groups had comparable skills for bimanual tasks. Residents with limited experience reached the expert level in camera navigation. With training, nurses, students, and first year residents are equally capable of assisting in basic laparoscopic procedures. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Group Decision Framework with Intuitionistic Preference Relations and Its Application to Low Carbon Supplier Selection.

PubMed

Tong, Xiayu; Wang, Zhou-Jing

2016-09-19

This article develops a group decision framework with intuitionistic preference relations. An approach is first devised to rectify an inconsistent intuitionistic preference relation to derive an additive consistent one. A new aggregation operator, the so-called induced intuitionistic ordered weighted averaging (IIOWA) operator, is proposed to aggregate individual intuitionistic fuzzy judgments. By using the mean absolute deviation between the original and rectified intuitionistic preference relations as an order inducing variable, the rectified consistent intuitionistic preference relations are aggregated into a collective preference relation. This treatment is presumably able to assign different weights to different decision-makers' judgments based on the quality of their inputs (in terms of consistency of their original judgments). A solution procedure is then developed for tackling group decision problems with intuitionistic preference relations. A low carbon supplier selection case study is developed to illustrate how to apply the proposed decision model in practice.

A Group Decision Framework with Intuitionistic Preference Relations and Its Application to Low Carbon Supplier Selection

PubMed Central

Tong, Xiayu; Wang, Zhou-Jing

2016-01-01

This article develops a group decision framework with intuitionistic preference relations. An approach is first devised to rectify an inconsistent intuitionistic preference relation to derive an additive consistent one. A new aggregation operator, the so-called induced intuitionistic ordered weighted averaging (IIOWA) operator, is proposed to aggregate individual intuitionistic fuzzy judgments. By using the mean absolute deviation between the original and rectified intuitionistic preference relations as an order inducing variable, the rectified consistent intuitionistic preference relations are aggregated into a collective preference relation. This treatment is presumably able to assign different weights to different decision-makers’ judgments based on the quality of their inputs (in terms of consistency of their original judgments). A solution procedure is then developed for tackling group decision problems with intuitionistic preference relations. A low carbon supplier selection case study is developed to illustrate how to apply the proposed decision model in practice. PMID:27657097

Scientists versus Regulators: Precaution, Novelty & Regulatory Oversight as Predictors of Perceived Risks of Engineered Nanomaterials

PubMed Central

Beaudrie, Christian E. H.; Satterfield, Terre; Kandlikar, Milind; Harthorn, Barbara H.

2014-01-01

Engineered nanoscale materials (ENMs) present a difficult challenge for risk assessors and regulators. Continuing uncertainty about the potential risks of ENMs means that expert opinion will play an important role in the design of policies to minimize harmful implications while supporting innovation. This research aims to shed light on the views of ‘nano experts’ to understand which nanomaterials or applications are regarded as more risky than others, to characterize the differences in risk perceptions between expert groups, and to evaluate the factors that drive these perceptions. Our analysis draws from a web-survey (N = 404) of three groups of US and Canadian experts: nano-scientists and engineers, nano-environmental health and safety scientists, and regulatory scientists and decision-makers. Significant differences in risk perceptions were found across expert groups; differences found to be driven by underlying attitudes and perceptions characteristic of each group. Nano-scientists and engineers at the upstream end of the nanomaterial life cycle perceived the lowest levels of risk, while those who are responsible for assessing and regulating risks at the downstream end perceived the greatest risk. Perceived novelty of nanomaterial risks, differing preferences for regulation (i.e. the use of precaution versus voluntary or market-based approaches), and perceptions of the risk of technologies in general predicted variation in experts' judgments of nanotechnology risks. Our findings underscore the importance of involving a diverse selection of experts, particularly those with expertise at different stages along the nanomaterial lifecycle, during policy development. PMID:25222742

Adaptive neuro-fuzzy and expert systems for power quality analysis and prediction of abnormal operation

NASA Astrophysics Data System (ADS)

Ibrahim, Wael Refaat Anis

The present research involves the development of several fuzzy expert systems for power quality analysis and diagnosis. Intelligent systems for the prediction of abnormal system operation were also developed. The performance of all intelligent modules developed was either enhanced or completely produced through adaptive fuzzy learning techniques. Neuro-fuzzy learning is the main adaptive technique utilized. The work presents a novel approach to the interpretation of power quality from the perspective of the continuous operation of a single system. The research includes an extensive literature review pertaining to the applications of intelligent systems to power quality analysis. Basic definitions and signature events related to power quality are introduced. In addition, detailed discussions of various artificial intelligence paradigms as well as wavelet theory are included. A fuzzy-based intelligent system capable of identifying normal from abnormal operation for a given system was developed. Adaptive neuro-fuzzy learning was applied to enhance its performance. A group of fuzzy expert systems that could perform full operational diagnosis were also developed successfully. The developed systems were applied to the operational diagnosis of 3-phase induction motors and rectifier bridges. A novel approach for learning power quality waveforms and trends was developed. The technique, which is adaptive neuro fuzzy-based, learned, compressed, and stored the waveform data. The new technique was successfully tested using a wide variety of power quality signature waveforms, and using real site data. The trend-learning technique was incorporated into a fuzzy expert system that was designed to predict abnormal operation of a monitored system. The intelligent system learns and stores, in compressed format, trends leading to abnormal operation. The system then compares incoming data to the retained trends continuously. If the incoming data matches any of the learned trends, an alarm is instigated predicting the advent of system abnormal operation. The incoming data could be compared to previous trends as well as matched to trends developed through computer simulations and stored using fuzzy learning.

Expert networks in CLIPS

NASA Technical Reports Server (NTRS)

Hruska, S. I.; Dalke, A.; Ferguson, J. J.; Lacher, R. C.

1991-01-01

Rule-based expert systems may be structurally and functionally mapped onto a special class of neural networks called expert networks. This mapping lends itself to adaptation of connectionist learning strategies for the expert networks. A parsing algorithm to translate C Language Integrated Production System (CLIPS) rules into a network of interconnected assertion and operation nodes has been developed. The translation of CLIPS rules to an expert network and back again is illustrated. Measures of uncertainty similar to those rules in MYCIN-like systems are introduced into the CLIPS system and techniques for combining and hiring nodes in the network based on rule-firing with these certainty factors in the expert system are presented. Several learning algorithms are under study which automate the process of attaching certainty factors to rules.

Automated planning of MRI scans of knee joints

NASA Astrophysics Data System (ADS)

Bystrov, Daniel; Pekar, Vladimir; Young, Stewart; Dries, Sebastian P. M.; Heese, Harald S.; van Muiswinkel, Arianne M.

2007-03-01

A novel and robust method for automatic scan planning of MRI examinations of knee joints is presented. Clinical knee examinations require acquisition of a 'scout' image, in which the operator manually specifies the scan volume orientations (off-centres, angulations, field-of-view) for the subsequent diagnostic scans. This planning task is time-consuming and requires skilled operators. The proposed automated planning system determines orientations for the diagnostic scan by using a set of anatomical landmarks derived by adapting active shape models of the femur, patella and tibia to the acquired scout images. The expert knowledge required to position scan geometries is learned from previous manually planned scans, allowing individual preferences to be taken into account. The system is able to automatically discriminate between left and right knees. This allows to use and merge training data from both left and right knees, and to automatically transform all learned scan geometries to the side for which a plan is required, providing a convenient integration of the automated scan planning system in the clinical routine. Assessment of the method on the basis of 88 images from 31 different individuals, exhibiting strong anatomical and positional variability demonstrates success, robustness and efficiency of all parts of the proposed approach, which thus has the potential to significantly improve the clinical workflow.

Human Factors Operability Timeline Analysis to Improve the Processing Flow of the Orion Spacecraft

NASA Technical Reports Server (NTRS)

Schlierf, Roland; Stambolian, Damon B.; Miller, Darcy; Posanda, Juan; Haddock, Mike; Haddad, Mike; Tran, Donald; Henderson, Gena; Barth, Tim

2010-01-01

The Constellation Program (CxP) Orion vehicle goes through several areas and stages of processing before its launched at the Kennedy Space Center. In order to have efficient and effective processing, all of the activities need to be analyzed. This was accomplished by first developing a timeline of events that included each activity, and then each activity was analyzed by operability experts and human factors experts with spacecraft processing experience. This papers focus is to explain the results and the process for developing this human factors operability timeline analysis to improve the processing flow of Orion.

Virtual Ultrasound Guidance for Inexperienced Operators

NASA Technical Reports Server (NTRS)

Caine, Timothy; Martin, Davis

2012-01-01

Medical ultrasound or echocardiographic studies are highly operator-dependent and generally require lengthy training and internship to perfect. To obtain quality echocardiographic images in remote environments, such as on-orbit, remote guidance of studies has been employed. This technique involves minimal training for the user, coupled with remote guidance from an expert. When real-time communication or expert guidance is not available, a more autonomous system of guiding an inexperienced operator through an ultrasound study is needed. One example would be missions beyond low Earth orbit, in which the time delay inherent with communication will make remote guidance impractical.

The Right Place at the Right Time: Medical Oncology Outpatients' Perceptions of Location of End-of-Life Care.

PubMed

Waller, Amy; Sanson-Fisher, Rob; Zdenkowski, Nicholas; Douglas, Charles; Hall, Alix; Walsh, Justin

2018-01-01

Background: Helping people achieve their preferred location of care is an important indicator of quality end-of-life (EOL) care. Using a sample of Australian medical oncology outpatients, this study examined (1) their preferred location of EOL care; (2) their perceived benefits and worries of receiving care in that location; (3) the percentage who had discussed preferences with their doctor and/or support person; and (4) whether they wanted their doctor to ask them where they wanted to die. Methods: Adults with a confirmed diagnosis of cancer were approached between September 2015 and January 2016 in the waiting room of an Australian oncology outpatient clinic. Consenting participants completed a home-based pen-and-paper survey indicating preferred location of care, perceived benefits and worries of that location, whether they had discussed preferences with their doctors, and whether they were willing to be asked about their preferences. Results: A total of 203 patients returned the survey (47% of those eligible). Less than half preferred to be cared for at home (47%), 34% preferred a hospice/palliative care unit, and 19% preferred the hospital. Common benefits and worries associated with locations included perceived burden on others, familiarity of environment, availability of expert medical care, symptom management, and likelihood of having wishes respected. More patients had discussed preferences with their support persons (41%) than doctors (7%). Most wanted a doctor to ask them about preferred location of care (87%) and thought it was important to die in the location of their choice (93%). Conclusions: Patients were willing to have clinicians to ask them where they wanted to die, although few had discussed their preferences with doctors. Although home was the most preferred location for many patients, the overall variation suggests that clinicians should adopt a systematic approach to eliciting patient preferences. Copyright © 2018 by the National Comprehensive Cancer Network.

The Role of Context in the Evaluation of Reinforcer Efficacy: Implications for the Preference Assessment Outcomes

ERIC Educational Resources Information Center

Mangum, Aphrodite; Fredrick, Laura; Pabico, Robert; Roane, Henry

2012-01-01

Highly preferred stimuli were identified via two preference assessments (based on Fisher et al., 1992), the second of which included stimuli that were ranked low in the initial preference assessment. Following the preference assessments, a subset of stimuli was evaluated as reinforcers in single- and concurrent-operant arrangements. In general,…

Survey of expert practice and perceptions of the supporting clinical evidence for the management of uveitis-related cataract and cystoid macular oedema.

PubMed

Sreekantam, Sreekanth; Denniston, Alastair K O; Murray, Philip I

2011-10-01

To survey the practice of uveitis experts in the management of uveitic cataract and cystoid macular oedema (CMO). A structured questionnaire containing two clinical scenarios was sent to members of the International Uveitis Study Group (IUSG). The questionnaire surveyed both respondents' current practice and their perception of the supporting clinical evidence. For uveitic cataract, 70% required a 3-month inflammation-free period before surgery, and 76% gave a prophylactic preoperative systemic corticosteroid. For uveitic CMO, 87% gave corticosteroids, usually orally. Preferred second-line agents were methotrexate (39%), cyclosporin (24%), azathioprine (17%), and mycophenolate (7%). Respondents suggested the evidence underlying their decisions was either absent or relatively weak (levels III or IV), and in most cases personal experience was a factor. This survey highlights areas of consensus and variation among uveitis experts in managing uveitic cataract and CMO, and emphasizes the need for further clinical trials to establish the best practice.

Does training of fellows affect peri-operative outcomes of robot-assisted partial nephrectomy?

PubMed

Khene, Zine-Eddine; Peyronnet, Benoit; Bosquet, Elise; Pradère, Benjamin; Robert, Corentin; Fardoun, Tarek; Kammerer-Jacquet, Solène-Florence; Verhoest, Grégory; Rioux-Leclercq, Nathalie; Mathieu, Romain; Bensalah, Karim

2017-10-01

To evaluate the impact of fellows' involvement on the peri-operative outcomes of robot-assisted partial nephrectomy (RAPN). We analysed 216 patients who underwent RAPN for a small renal tumour. We stratified our cohort into two groups according to the involvement of a fellow surgeon during the procedure: expert surgeon operating alone (expert group) and fellow operating under the supervision of the expert surgeon (fellow group). Peri-operative data were compared between the two groups. Linear and logistic regression analyses were performed to assess the impact of fellows' involvement on peri-operative and postoperative outcomes. Trifecta and margins ischaemia complications (MIC) score achievement rates were used to assess the quality of surgery in both the expert and fellow groups. Trifecta was defined as a combination of warm ischaemia time <25 min, negative surgical margins and no peri-operative complications. MIC score was defined as negative surgical margins, ischaemia time <20 min, and absence of complications grade ≥3. Fellows were involved in a total of 89 procedures (41%). Patients' characteristics were similar in the two groups. Operating time and warm ischaemia time (WIT) were longer in the fellow group (180 vs 120 min, P < 0.001, and 18 vs 14 min, P = 0.002, respectively). Length of hospital stay (LOS) was longer in the fellow group (5 vs 4.3 days; P = 0.05) and patients in this group had higher estimated blood loss (EBL; 400 vs 300 mL; P = 0.01), but this had no impact on transfusion rate (14% vs 11%; P = 0.43). Positive surgical margin rates were similar in the fellow and expert groups (2.2% vs 3.1%; P = 0.70). Major complications were more frequent in the fellow group (12.3% vs 6.3%), but the difference was not significant (P = 0.10). In multivariable analysis, fellow involvement was predictive of longer WIT (β = 0.22; P = 0.003) and operating time (β = 0.49; P < 0.001), but was not associated with EBL (β = 0.12, P = 0.09) or LOS (β = 0.12, P = 0.11). Finally, fellow involvement was associated with a lower rate of trifecta and MIC score accomplishment (odds ratio [OR] 0.53, P = 0.05 and OR 0.46, P = 0.01, respectively). Training fellows to perform RAPN is associated with longer operating time and WIT but does not appear to compromise other peri-operative outcomes. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

Risk analysis for autonomous underwater vehicle operations in extreme environments.

PubMed

Brito, Mario Paulo; Griffiths, Gwyn; Challenor, Peter

2010-12-01

Autonomous underwater vehicles (AUVs) are used increasingly to explore hazardous marine environments. Risk assessment for such complex systems is based on subjective judgment and expert knowledge as much as on hard statistics. Here, we describe the use of a risk management process tailored to AUV operations, the implementation of which requires the elicitation of expert judgment. We conducted a formal judgment elicitation process where eight world experts in AUV design and operation were asked to assign a probability of AUV loss given the emergence of each fault or incident from the vehicle's life history of 63 faults and incidents. After discussing methods of aggregation and analysis, we show how the aggregated risk estimates obtained from the expert judgments were used to create a risk model. To estimate AUV survival with mission distance, we adopted a statistical survival function based on the nonparametric Kaplan-Meier estimator. We present theoretical formulations for the estimator, its variance, and confidence limits. We also present a numerical example where the approach is applied to estimate the probability that the Autosub3 AUV would survive a set of missions under Pine Island Glacier, Antarctica in January-March 2009. © 2010 Society for Risk Analysis.

Vapor Compression Distillation Subsystem (VCDS) Component Enhancement, Testing and Expert Fault Diagnostics Development, Volume 2

NASA Technical Reports Server (NTRS)

Mallinak, E. S.

1987-01-01

A wide variety of Space Station functions will be managed via computerized controls. Many of these functions are at the same time very complex and very critical to the operation of the Space Station. The Environmental Control and Life Support System is one group of very complex and critical subsystems which directly affects the ability of the crew to perform their mission. Failure of the Environmental Control and Life Support Subsystems are to be avoided and, in the event of failure, repair must be effected as rapidly as possible. Due to the complex and diverse nature of the subsystems, it is not possible to train the Space Station crew to be experts in the operation of all of the subsystems. By applying the concepts of computer-based expert systems, it may be possible to provide the necessary expertise for these subsystems in dedicated controllers. In this way, an expert system could avoid failures and extend the operating time of the subsystems even in the event of failure of some components, and could reduce the time to repair by being able to pinpoint the cause of a failure when one cannot be avoided.

Integration of an expert system into a user interface language demonstration

NASA Technical Reports Server (NTRS)

Stclair, D. C.

1986-01-01

The need for a User Interface Language (UIL) has been recognized by the Space Station Program Office as a necessary tool to aid in minimizing the cost of software generation by multiple users. Previous history in the Space Shuttle Program has shown that many different areas of software generation, such as operations, integration, testing, etc., have each used a different user command language although the types of operations being performed were similar in many respects. Since the Space Station represents a much more complex software task, a common user command language--a user interface language--is required to support the large spectrum of space station software developers and users. To assist in the selection of an appropriate set of definitions for a UIL, a series of demonstration programs was generated with which to test UIL concepts against specific Space Station scenarios using operators for the astronaut and scientific community. Because of the importance of expert system in the space station, it was decided that an expert system should be embedded in the UIL. This would not only provide insight into the UIL components required but would indicate the effectiveness with which an expert system could function in such an environment.

Timesharing performance as an indicator of pilot mental workload

NASA Technical Reports Server (NTRS)

Casper, Patricia A.; Kantowitz, Barry H.; Sorkin, Robert D.

1988-01-01

Attentional deficits (workloads) were evaluated in a timesharing task. The results from this and other experiments were incorporated into an expert system designed to provide workload metric selection advice to non-experts in the field interested in operator workload.

An expert systems application to space base data processing

NASA Technical Reports Server (NTRS)

Babb, Stephen M.

1988-01-01

The advent of space vehicles with their increased data requirements are reflected in the complexity of future telemetry systems. Space based operations with its immense operating costs will shift the burden of data processing and routine analysis from the space station to the Orbital Transfer Vehicle (OTV). A research and development project is described which addresses the real time onboard data processing tasks associated with a space based vehicle, specifically focusing on an implementation of an expert system.

Creating adaptive web recommendation system based on user behavior

NASA Astrophysics Data System (ADS)

Walek, Bogdan

2018-01-01

The paper proposes adaptive web recommendation system based on user behavior. The proposed system uses expert system to evaluating and recommending suitable items of content. Relevant items are subsequently evaluated and filtered based on history of visited items and user´s preferred categories of items. Main parts of the proposed system are presented and described. The proposed recommendation system is verified on specific example.

Soviet Use of Spetznaz Forces

DTIC Science & Technology

1986-03-01

the remainder of the 12 team composed of functional specialists . These would include a demolitions expert» radio operator» weapons expert, and...reconnaissance expert. Cross-training is practiced to various degrees in case a specialist in one field is lost, another who has cross-*trained can take...vulnerable to assault by Spetznaz. (1: 12 > 23 V. SPET2NA2 VULNERABILITIES One of the flrat vulnerabilities Is the Spetznaz soldier himself. He Is

Face validation of the Simbionix LAP Mentor virtual reality training module and its applicability in the surgical curriculum.

PubMed

Ayodeji, I D; Schijven, M; Jakimowicz, J; Greve, J W

2007-09-01

The goal of our study was to determine expert and referent face validity of the LAP Mentor, the first procedural virtual reality (VR) laparoscopy trainer. In The Netherlands 49 surgeons and surgical trainees were given a hands-on introduction to the Simbionix LAP Mentor training module. Subsequently, a standardized five-point Likert-scale questionnaire was administered. Respondents who had performed over 50 laparoscopic procedures were classified as "experts." The others constituted the "referent" group, representing nonexperts such as surgical trainees. Of the experts, 90.5% (n = 21) judge themselves to be average or above-average laparoscopic surgeons, while 88.5% of referents (n = 28) feel themselves to be less-than-average laparoscopic surgeons (p = 0.000). There is agreement between both groups on all items concerning the simulator's performance and application. Respondents feel strongly about the necessity for training on basic skills before operating on patients and unanimously agree on the importance of procedural training. A large number (87.8%) of respondents expect the LAP Mentor to enhance a trainee's laparoscopic capability, 83.7% expect a shorter laparoscopic learning curve, and 67.3% even predict reduced complication rates in laparoscopic cholecystectomies among novice surgeons. The preferred stage for implementing the VR training module is during the surgeon's residency, and 59.2% of respondents feel the surgical curriculum is incomplete without VR training. Both potential surgical trainees and trainers stress the need for VR training in the surgical curriculum. Both groups believe the LAP Mentor to be a realistic VR module, with a powerful potential for training and monitoring basic laparoscopic skills as well as full laparoscopic procedures. Simulator training is perceived to be both informative and entertaining, and enthusiasm among future trainers and trainees is to be expected. Further validation of the system is required to determine whether the performance results agree with these favorable expectations.

Assessing Residents' Readiness for OR Autonomy: A Qualitative Descriptive Study of Expert Surgical Teachers' Best Practices.

PubMed

Chen, Xiaodong Phoenix; Sullivan, Amy M; Alseidi, Adnan; Kwakye, Gifty; Smink, Douglas S

Providing resident autonomy in the operating room (OR) is one of the major challenges for surgical educators today. The purpose of this study was to explore what approaches expert surgical teachers use to assess residents' readiness for autonomy in the OR. We particularly focused on the assessments that experts make prior to conducting the surgical time-out. We conducted semistructured in-depth interviews with expert surgical teachers from March 2016 to September 2016. Purposeful sampling and snowball sampling were applied to identify and recruit expert surgical teachers from general surgery residency programs across the United States to represent a range of clinical subspecialties. All interviews were audio-recorded, deidentified, and transcribed. We applied the Framework Method of content analysis, discussed and reached final consensus on the themes. We interviewed 15 expert teachers from 9 institutions. The majority (13/15) were Program or Associate Program Directors; 47% (7/15) primarily performed complex surgical operations (e.g., endocrine surgery). Five themes regarding how expert surgical teachers determine residents' readiness for OR autonomy before the surgical time-out emerged. These included 3 domains of evidence elicited about the resident (resident characteristics, medical knowledge, and beyond the current OR case), 1 variable relating to attending characteristics, and 1 variable composed of contextual factors. Experts obtained one or more examples of evidence, and adjusted residents' initial autonomy using factors from the attending variable and the context variable. Expert surgical teachers' assessments of residents' readiness for OR autonomy included 5 key components. Better understanding these inputs can contribute to both faculty and resident development, enabling increased resident autonomy and preparation for independent practice. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Induced seismicity hazard and risk by enhanced geothermal systems: an expert elicitation approach

NASA Astrophysics Data System (ADS)

Trutnevyte, Evelina; Azevedo, Inês L.

2018-03-01

Induced seismicity is a concern for multiple geoenergy applications, including low-carbon enhanced geothermal systems (EGS). We present the results of an international expert elicitation (n = 14) on EGS induced seismicity hazard and risk. Using a hypothetical scenario of an EGS plant and its geological context, we show that expert best-guess estimates of annualized exceedance probabilities of an M ≥ 3 event range from 0.2%-95% during reservoir stimulation and 0.2%-100% during operation. Best-guess annualized exceedance probabilities of M ≥ 5 event span from 0.002%-2% during stimulation and 0.003%-3% during operation. Assuming that tectonic M7 events could occur, some experts do not exclude induced (triggered) events of up to M7 too. If an induced M = 3 event happens at 5 km depth beneath a town with 10 000 inhabitants, most experts estimate a 50% probability that the loss is contained within 500 000 USD without any injuries or fatalities. In the case of an induced M = 5 event, there is 50% chance that the loss is below 50 million USD with the most-likely outcome of 50 injuries and one fatality or none. As we observe a vast diversity in quantitative expert judgements and underlying mental models, we conclude with implications for induced seismicity risk governance. That is, we suggest documenting individual expert judgements in induced seismicity elicitations before proceeding to consensual judgements, to convene larger expert panels in order not to cherry-pick the experts, and to aim for multi-organization multi-model assessments of EGS induced seismicity hazard and risk.

Choices in cancer treatment: a qualitative study of the older women's (>70 years) perspective.

PubMed

Husain, Lopa Sadia; Collins, Karen; Reed, Malcolm; Wyld, Lynda

2008-04-01

Primary endocrine therapy (PET) is the treatment of primary, operable breast cancer with drugs, such as tamoxifen, rather than surgery. It is in widespread use in the UK with 40% of women over 70 years old being treated in this way. PET is associated with inferior rates of local control compared with the standard surgical therapies, but there is no difference in overall survival. There has been no published research regarding the attitudes of older women concerning these two alternative approaches to treatment; what may influence their treatment choice or their experience of either treatment modality. This study aimed to address these questions. In-depth qualitative interviews were undertaken to explore the views of a group of 21 purposively selected older women (>70 years old), who had been treated by PET or surgery for breast cancer. The interviews were transcribed verbatim and analysed using Framework Analysis. Both surgery and PET were well tolerated and had high satisfaction ratings from most women. This was the case even for those who had complications following surgery or needed a change of management in the PET group. Older women expressed no age-specific fears for operative procedures. The women were passive information seekers and relied heavily on 'expert' advice in making their treatment choices. Neither social support or age were factors in their decision-making. Their main concern was to ensure that their quality of life and independence remained unaffected. Older women have no strong preference for either treatment option but are concerned that the treatment is effective and causes minimal disruption to their quality of life and independence. This study suggests that medical consultations may need to be adapted to reflect the passive acceptance of 'expert' advice in the majority of women in this age group. Copyright 2007 John Wiley & Sons, Ltd.

A pilot study comparing the effectiveness of conventional training and virtual reality simulation in the skills acquisition of junior dental students.

PubMed

Quinn, Frank; Keogh, Paul; McDonald, Ailbhe; Hussey, David

2003-02-01

The use of virtual reality (VR) in the training of operative dentistry is a recent innovation and little research has been published on its efficacy compared to conventional training methods. To evaluate possible benefits, junior undergraduate dental students were randomly assigned to one of three groups: group 1 as taught by conventional means only; group 2 as trained by conventional means combined with VR repetition and reinforcement (with access to a human instructor for operative advice); and group 3 as trained by conventional means combined with VR repetition and reinforcement, but without instructor evaluation/advice, which was only supplied via the VR-associated software. At the end of the research period, all groups executed two class 1 preparations that were evaluated blindly by 'expert' trainers, under traditional criteria (outline, retention, smoothness, depth, wall angulation and cavity margin index). Analyses of resulting scores indicated a lack of significant differences between the three groups except for scores for the category of 'outline form', for group 2, which produced significantly lower (i.e. better) scores than the conventionally trained group. A statistical comparison between scores from two 'expert' examiners indicated lack of agreement, despite identical written and visual criteria being used for evaluation by both. Both examiners, however, generally showed similar trends in evaluation. An anonymous questionnaire suggested that students recognized the benefits of VR training (e.g. ready access to assessment, error identification and how they can be corrected), but the majority felt that it would not replace conventional training methods (95%), although participants recognized the potential for development of VR systems in dentistry. The most common reasons cited for the preference of conventional training were excessive critical feedback (55%), lack of personal contact (50%) and technical hardware difficulties (20%) associated with VR-based training.

Technology and Policy Challenges in the Adoption and Operation of Health Information Exchange Systems.

PubMed

Ji, Hyerim; Yoo, Sooyoung; Heo, Eun-Young; Hwang, Hee; Kim, Jeong-Whun

2017-10-01

This study aimed to identify problems and issues that arise with the implementation of online health information exchange (HIE) systems in a medical environment and to identify solutions to facilitate the successful operation of future HIE systems in primary care clinics and hospitals. In this study, the issues that arose during the establishment and operation of an HIE system in a hospital were identified so that they could be addressed to enable the successful establishment and operation of a standard-based HIE system. After the issues were identified, they were reviewed and categorized by a group of experts that included medical information system experts, doctors, medical information standard experts, and HIE researchers. Then, solutions for the identified problems were derived based on the system development, operation, and improvement carried out during this work. Twenty-one issues were identified during the implementation and operation of an online HIE system. These issues were then divided into four categories: system architecture and standards, documents and data items, consent of HIE, and usability. We offer technical and policy recommendations for various stakeholders based on the experiences of operating and improving the online HIE system in the medical field. The issues and solutions identified in this study regarding the implementation and operate of an online HIE system can provide valuable insight for planners to enable them to successfully design and operate such systems at a national level in the future. In addition, policy support from governments is needed.

Surgical process improvement tools: defining quality gaps and priority areas in gastrointestinal cancer surgery.

PubMed

Wei, A C; Devitt, K S; Wiebe, M; Bathe, O F; McLeod, R S; Urbach, D R

2014-04-01

Surgery is a cornerstone of cancer treatment, but significant differences in the quality of surgery have been reported. Surgical process improvement tools (spits) modify the processes of care as a means to quality improvement (qi). We were interested in developing spits in the area of gastrointestinal (gi) cancer surgery. We report the recommendations of an expert panel held to define quality gaps and establish priority areas that would benefit from spits. The present study used the knowledge-to-action cycle was as a framework. Canadian experts in qi and in gi cancer surgery were assembled in a nominal group workshop. Participants evaluated the merits of spits, described gaps in current knowledge, and identified and ranked processes of care that would benefit from qi. A qualitative analysis of the workshop deliberations using modified grounded theory methods identified major themes. The expert panel consisted of 22 participants. Experts confirmed that spits were an important strategy for qi. The top-rated spits included clinical pathways, electronic information technology, and patient safety tools. The preferred settings for use of spits included preoperative and intraoperative settings and multidisciplinary contexts. Outcomes of interest were cancer-related outcomes, process, and the technical quality of surgery measures. Surgical process improvement tools were confirmed as an important strategy. Expert panel recommendations will be used to guide future research efforts for spits in gi cancer surgery.

Surgical process improvement tools: defining quality gaps and priority areas in gastrointestinal cancer surgery

PubMed Central

Wei, A.C.; Devitt, K.S.; Wiebe, M.; Bathe, O.F.; McLeod, R.S.; Urbach, D.R.

2014-01-01

Background Surgery is a cornerstone of cancer treatment, but significant differences in the quality of surgery have been reported. Surgical process improvement tools (spits) modify the processes of care as a means to quality improvement (qi). We were interested in developing spits in the area of gastrointestinal (gi) cancer surgery. We report the recommendations of an expert panel held to define quality gaps and establish priority areas that would benefit from spits. Methods The present study used the knowledge-to-action cycle was as a framework. Canadian experts in qi and in gi cancer surgery were assembled in a nominal group workshop. Participants evaluated the merits of spits, described gaps in current knowledge, and identified and ranked processes of care that would benefit from qi. A qualitative analysis of the workshop deliberations using modified grounded theory methods identified major themes. Results The expert panel consisted of 22 participants. Experts confirmed that spits were an important strategy for qi. The top-rated spits included clinical pathways, electronic information technology, and patient safety tools. The preferred settings for use of spits included preoperative and intraoperative settings and multidisciplinary contexts. Outcomes of interest were cancer-related outcomes, process, and the technical quality of surgery measures. Conclusions Surgical process improvement tools were confirmed as an important strategy. Expert panel recommendations will be used to guide future research efforts for spits in gi cancer surgery. PMID:24764704

NMESys: An expert system for network fault detection

NASA Technical Reports Server (NTRS)

Nelson, Peter C.; Warpinski, Janet

1991-01-01

The problem of network management is becoming an increasingly difficult and challenging task. It is very common today to find heterogeneous networks consisting of many different types of computers, operating systems, and protocols. The complexity of implementing a network with this many components is difficult enough, while the maintenance of such a network is an even larger problem. A prototype network management expert system, NMESys, implemented in the C Language Integrated Production System (CLIPS). NMESys concentrates on solving some of the critical problems encountered in managing a large network. The major goal of NMESys is to provide a network operator with an expert system tool to quickly and accurately detect hard failures, potential failures, and to minimize or eliminate user down time in a large network.

Allocation of surgical procedures to operating rooms.

PubMed

Ozkarahan, I

1995-08-01

Reduction of health care costs is of paramount importance in our time. This paper is a part of the research which proposes an expert hospital decision support system for resource scheduling. The proposed system combines mathematical programming, knowledge base, and database technologies, and what is more, its friendly interface is suitable for any novice user. Operating rooms in hospitals represent big investments and must be utilized efficiently. In this paper, first a mathematical model similar to job shop scheduling models is developed. The model loads surgical cases to operating rooms by maximizing room utilization and minimizing overtime in a multiple operating room setting. Then a prototype expert system which replaces the expertise of the operations research analyst for the model, drives the modelbase, database, and manages the user dialog is developed. Finally, an overview of the sequencing procedures for operations within an operating room is also presented.

Environmental Sensing of Expert Knowledge in a Computational Evolution System for Complex Problem Solving in Human Genetics

NASA Astrophysics Data System (ADS)

Greene, Casey S.; Hill, Douglas P.; Moore, Jason H.

The relationship between interindividual variation in our genomes and variation in our susceptibility to common diseases is expected to be complex with multiple interacting genetic factors. A central goal of human genetics is to identify which DNA sequence variations predict disease risk in human populations. Our success in this endeavour will depend critically on the development and implementation of computational intelligence methods that are able to embrace, rather than ignore, the complexity of the genotype to phenotype relationship. To this end, we have developed a computational evolution system (CES) to discover genetic models of disease susceptibility involving complex relationships between DNA sequence variations. The CES approach is hierarchically organized and is capable of evolving operators of any arbitrary complexity. The ability to evolve operators distinguishes this approach from artificial evolution approaches using fixed operators such as mutation and recombination. Our previous studies have shown that a CES that can utilize expert knowledge about the problem in evolved operators significantly outperforms a CES unable to use this knowledge. This environmental sensing of external sources of biological or statistical knowledge is important when the search space is both rugged and large as in the genetic analysis of complex diseases. We show here that the CES is also capable of evolving operators which exploit one of several sources of expert knowledge to solve the problem. This is important for both the discovery of highly fit genetic models and because the particular source of expert knowledge used by evolved operators may provide additional information about the problem itself. This study brings us a step closer to a CES that can solve complex problems in human genetics in addition to discovering genetic models of disease.

Objective assessment in residency-based training for transoral robotic surgery.

PubMed

Curry, Martin; Malpani, Anand; Li, Ryan; Tantillo, Thomas; Jog, Amod; Blanco, Ray; Ha, Patrick K; Califano, Joseph; Kumar, Rajesh; Richmon, Jeremy

2012-10-01

To develop a robotic surgery training regimen integrating objective skill assessment for otolaryngology and head and neck surgery trainees consisting of training modules of increasing complexity leading up to procedure-specific training. In particular, we investigated applications of such a training approach for surgical extirpation of oropharyngeal tumors via a transoral approach using the da Vinci robotic system. Prospective blinded data collection and objective evaluation (Objective Structured Assessment of Technical Skills [OSATS]) of three distinct phases using the da Vinci robotic surgical system in an academic university medical engineering/computer science laboratory setting. Between September 2010 and July 2011, eight otolaryngology-head and neck surgery residents and four staff experts from an academic hospital participated in three distinct phases of robotic surgery training involving 1) robotic platform operational skills, 2) set up of the patient side system, and 3) a complete ex vivo surgical extirpation of an oropharyngeal tumor located in the base of tongue. Trainees performed multiple (four) approximately equally spaced training sessions in each stage of the training. In addition to trainees, baseline performance data were obtained for the experts. Each surgical stage was documented with motion and event data captured from the application programming interfaces of the da Vinci system, as well as separate video cameras as appropriate. All data were assessed using automated skill measures of task efficiency and correlated with structured assessment (OSATS and similar Likert scale) from three experts to assess expert and trainee differences and compute automated and expert assessed learning curves. Our data show that such training results in an improved didactic robotic knowledge base and improved clinical efficiency with respect to the set up and console manipulation. Experts (e.g., average OSATS, 25; standard deviation [SD], 3.1; module 1, suturing) and trainees (average OSATS, 15.9; SD, 3.9; week 1) are well separated at the beginning of the training, and the separation reduces significantly (expert average OSATS, 27.6; SD, 2.7; trainee average OSATS, 24.2; SD, 6.8; module 3) at the conclusion of the training. Learning curves in each of the three stages show diminishing differences between the experts and trainees, which is also consistent with expert assessment. Subjective assessment by experts verified the clinical utility of the module 3 surgical environment, and a survey of trainees consistently rated the curriculum as very useful in progression to human operating room assistance. Structured curricular robotic surgery training with objective assessment promises to reduce the overhead for mentors, allow detailed assessment of human-machine interface skills, and create customized training models for individualized training. This preliminary study verifies the utility of such training in improving human-machine operations skills (module 1), and operating room and surgical skills (modules 2 and 3). In contrast to current coarse measures of total operating time and subjective assessment of error for short mass training sessions, these methods may allow individual tasks to be removed from the trainee regimen when skill levels are within the standard deviation of the experts for these tasks, which can greatly enhance overall efficiency of the training regimen and allow time for additional and more complex training to be incorporated in the same time frame. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

[Role-specific targets and teamwork in the operating room].

PubMed

Hoeper, K; Kriependorf, M; Felix, C; Nyhuis, P; Tecklenburg, A

2017-12-01

The primary goal of a surgical team is the successful performance of an operation on a patien; however, this primary goal can show discrepancies from the goals of individual team members. The main causes for differences of interests can be variations in subjective preferences and organizational differences. Subjective preferences are due to the values held by those involved. These values are of an intrinsic nature and therefore difficult to change. Another reason for individual goals is that hospitals and universities are professional bureaucracies. Experts working in professional bureaucracies are known to identify themselves to a greater extent with their respective profession than with their institution; however, teams in the operating room (OR) have to work together in multidisciplinary teams. The main goal of this analysis is to document role-specific targets and motivations within teams. This was a case study at a university hospital with 40 operating rooms. The data collection resulted from the three pillars of the goal documentation instrument, which includes expert interviews, a utility analysis and card placement as a basis for communicative validation. The results were analyzed with a systematic method as a qualitative content analysis. The four-pillar success model, which maps aspects of a successful hospital, was used as a deductive coding scheme. The four pillars represent the level of medical quality (process, structure and outcome quality), economy and efficiency, client satisfaction (patients and referring physicians) and employee satisfaction. At a university hospital an additional focus is on research and teaching. In addition to the four pillar success model as a deductive coding scheme, an inductive coding scheme was introduced. Approximately 10% of the employees from each professional group (surgeons, anesthesiologists, OR nurses, nurse anesthetists) were interviewed resulting in 65 interviews overall. The interviews were conducted within a time span of 4 months. Considering the main categories quality of medical care, economy and efficiency, patient satisfaction and employee satisfaction as well as research and teaching, surgeons thought the categories of economy and efficiency (37%) and quality of medical care (34%) to be the most important. For anesthesiologists, however, the category of employee satisfaction (38%) was most important, followed by the category of economy and efficiency (31%). For the OR nurses as well as for the nurse anesthetists the category of employee satisfaction was of highest priority (61% and 57%, respectively). The results show that considering the main categories no dimension is equally important for the participating professional groups. This can result in goal conflicts. Additionally, the ad hoc teams make it impossible for team building to occur, making it difficult for the professional groups to adapt to each other and the individual goals. This presents a high potential for conflict. The difference in the perception of the importance of employee satisfaction is a crucial factor for emerging conflicts in the OR, as employee satisfaction correlates with productivity and patient satisfaction. Knowing and communicating the different goals is a first step for optimizing the OR management system.

Assessment of using digital manipulation tools for diagnosing mandibular radiolucent lesions

PubMed Central

Raitz, R; Assunção Junior, JNR; Fenyo-Pereira, M; Correa, L; de Lima, LP

2012-01-01

Objective The purpose of this study was to analyse the use of digital tools for image enhancement of mandibular radiolucent lesions and the effects of this manipulation on the percentage of correct radiographic diagnoses. Methods 24 panoramic radiographs exhibiting radiolucent lesions were selected, digitized and evaluated by non-experts (undergraduate and newly graduated practitioners) and by professional experts in oral diagnosis. The percentages of correct and incorrect diagnoses, according to the use of brightness/contrast, sharpness, inversion, highlight and zoom tools, were compared. All dental professionals made their evaluations without (T1) and with (T2) a list of radiographic diagnostic parameters. Results Digital tools were used with low frequency mainly in T2. The most preferred tool was sharpness (45.2%). In the expert group, the percentage of correct diagnoses did not change when any of the digital tools were used. For the non-expert group, there was an increase in the frequency of correct diagnoses when brightness/contrast was used in T2 (p=0.008) and when brightness/contrast and sharpness were not used in T1 (p=0.027). The use or non-use of brightness/contrast, zoom and sharpness showed moderate agreement in the group of experts [kappa agreement coefficient (κ)=0.514, 0.425 and 0.335, respectively]. For the non-expert group there was slight agreement for all the tools used (κ≤0.237). Conclusions Consulting the list of radiographic parameters before image manipulation reduced the frequency of tool use in both groups of examiners. Consulting the radiographic parameters with the use of some digital tools was important for improving correct diagnosis only in the group of non-expert examiners. PMID:22116126

Assessment of using digital manipulation tools for diagnosing mandibular radiolucent lesions.

PubMed

Raitz, R; Assunção Junior, J N R; Fenyo-Pereira, M; Correa, L; de Lima, L P

2012-03-01

The purpose of this study was to analyse the use of digital tools for image enhancement of mandibular radiolucent lesions and the effects of this manipulation on the percentage of correct radiographic diagnoses. 24 panoramic radiographs exhibiting radiolucent lesions were selected, digitized and evaluated by non-experts (undergraduate and newly graduated practitioners) and by professional experts in oral diagnosis. The percentages of correct and incorrect diagnoses, according to the use of brightness/contrast, sharpness, inversion, highlight and zoom tools, were compared. All dental professionals made their evaluations without (T₁) and with (T₂) a list of radiographic diagnostic parameters. Digital tools were used with low frequency mainly in T₂. The most preferred tool was sharpness (45.2%). In the expert group, the percentage of correct diagnoses did not change when any of the digital tools were used. For the non-expert group, there was an increase in the frequency of correct diagnoses when brightness/contrast was used in T₂ (p=0.008) and when brightness/contrast and sharpness were not used in T₁ (p=0.027). The use or non-use of brightness/contrast, zoom and sharpness showed moderate agreement in the group of experts [kappa agreement coefficient (κ) = 0.514, 0.425 and 0.335, respectively]. For the non-expert group there was slight agreement for all the tools used (κ ≤ 0.237). Consulting the list of radiographic parameters before image manipulation reduced the frequency of tool use in both groups of examiners. Consulting the radiographic parameters with the use of some digital tools was important for improving correct diagnosis only in the group of non-expert examiners.

A participatory approach to designing and enhancing integrated health information technology systems for veterans: protocol.

PubMed

Haun, Jolie N; Nazi, Kim M; Chavez, Margeaux; Lind, Jason D; Antinori, Nicole; Gosline, Robert M; Martin, Tracey L

2015-02-27

The Department of Veterans Affairs (VA) has developed health information technologies (HIT) and resources to improve veteran access to health care programs and services, and to support a patient-centered approach to health care delivery. To improve VA HIT access and meaningful use by veterans, it is necessary to understand their preferences for interacting with various HIT resources to accomplish health management related tasks and to exchange information. The objective of this paper was to describe a novel protocol for: (1) developing a HIT Digital Health Matrix Model; (2) conducting an Analytic Hierarchy Process called pairwise comparison to understand how and why veterans want to use electronic health resources to complete tasks related to health management; and (3) developing visual modeling simulations that depict veterans' preferences for using VA HIT to manage their health conditions and exchange health information. The study uses participatory research methods to understand how veterans prefer to use VA HIT to accomplish health management tasks within a given context, and how they would like to interact with HIT interfaces (eg, look, feel, and function) in the future. This study includes two rounds of veteran focus groups with self-administered surveys and visual modeling simulation techniques. This study will also convene an expert panel to assist in the development of a VA HIT Digital Health Matrix Model, so that both expert panel members and veteran participants can complete an Analytic Hierarchy Process, pairwise comparisons to evaluate and rank the applicability of electronic health resources for a series of health management tasks. This protocol describes the iterative, participatory, and patient-centered process for: (1) developing a VA HIT Digital Health Matrix Model that outlines current VA patient-facing platforms available to veterans, describing their features and relevant contexts for use; and (2) developing visual model simulations based on direct veteran feedback that depict patient preferences for enhancing the synchronization, integration, and standardization of VA patient-facing platforms. Focus group topics include current uses, preferences, facilitators, and barriers to using electronic health resources; recommendations for synchronizing, integrating, and standardizing VA HIT; and preferences on data sharing and delegation within the VA system. This work highlights the practical, technological, and personal factors that facilitate and inhibit use of current VA HIT, and informs an integrated system redesign. The Digital Health Matrix Model and visual modeling simulations use knowledge of veteran preferences and experiences to directly inform enhancements to VA HIT and provide a more holistic and integrated user experience. These efforts are designed to support the adoption and sustained use of VA HIT to support patient self-management and clinical care coordination in ways that are directly aligned with veteran preferences.

A Participatory Approach to Designing and Enhancing Integrated Health Information Technology Systems for Veterans: Protocol

PubMed Central

Nazi, Kim M; Chavez, Margeaux; Lind, Jason D; Antinori, Nicole; Gosline, Robert M; Martin, Tracey L

2015-01-01

Background The Department of Veterans Affairs (VA) has developed health information technologies (HIT) and resources to improve veteran access to health care programs and services, and to support a patient-centered approach to health care delivery. To improve VA HIT access and meaningful use by veterans, it is necessary to understand their preferences for interacting with various HIT resources to accomplish health management related tasks and to exchange information. Objective The objective of this paper was to describe a novel protocol for: (1) developing a HIT Digital Health Matrix Model; (2) conducting an Analytic Hierarchy Process called pairwise comparison to understand how and why veterans want to use electronic health resources to complete tasks related to health management; and (3) developing visual modeling simulations that depict veterans’ preferences for using VA HIT to manage their health conditions and exchange health information. Methods The study uses participatory research methods to understand how veterans prefer to use VA HIT to accomplish health management tasks within a given context, and how they would like to interact with HIT interfaces (eg, look, feel, and function) in the future. This study includes two rounds of veteran focus groups with self-administered surveys and visual modeling simulation techniques. This study will also convene an expert panel to assist in the development of a VA HIT Digital Health Matrix Model, so that both expert panel members and veteran participants can complete an Analytic Hierarchy Process, pairwise comparisons to evaluate and rank the applicability of electronic health resources for a series of health management tasks. Results This protocol describes the iterative, participatory, and patient-centered process for: (1) developing a VA HIT Digital Health Matrix Model that outlines current VA patient-facing platforms available to veterans, describing their features and relevant contexts for use; and (2) developing visual model simulations based on direct veteran feedback that depict patient preferences for enhancing the synchronization, integration, and standardization of VA patient-facing platforms. Focus group topics include current uses, preferences, facilitators, and barriers to using electronic health resources; recommendations for synchronizing, integrating, and standardizing VA HIT; and preferences on data sharing and delegation within the VA system. Conclusions This work highlights the practical, technological, and personal factors that facilitate and inhibit use of current VA HIT, and informs an integrated system redesign. The Digital Health Matrix Model and visual modeling simulations use knowledge of veteran preferences and experiences to directly inform enhancements to VA HIT and provide a more holistic and integrated user experience. These efforts are designed to support the adoption and sustained use of VA HIT to support patient self-management and clinical care coordination in ways that are directly aligned with veteran preferences. PMID:25803324

Fault isolation detection expert (FIDEX). Part 1: Expert system diagnostics for a 30/20 Gigahertz satellite transponder

NASA Technical Reports Server (NTRS)

Durkin, John; Schlegelmilch, Richard; Tallo, Donald

1992-01-01

LeRC has recently completed the design of a Ka-band satellite transponder system, as part of the Advanced Communication Technology Satellite (ACTS) System. To enhance the reliability of this satellite, NASA funded the University of Akron to explore the application of an expert system to provide the transponder with an autonomous diagnosis capability. The results of this research was the development of a prototype diagnosis expert system called FIDEX (fault-isolation and diagnosis expert). FIDEX is a frame-based expert system that was developed in the NEXPERT Object development environment by Neuron Data, Inc. It is a MicroSoft Windows version 3.0 application, and was designed to operate on an Intel i80386 based personal computer system.

ATS displays: A reasoning visualization tool for expert systems

NASA Technical Reports Server (NTRS)

Selig, William John; Johannes, James D.

1990-01-01

Reasoning visualization is a useful tool that can help users better understand the inherently non-sequential logic of an expert system. While this is desirable in most all expert system applications, it is especially so for such critical systems as those destined for space-based operations. A hierarchical view of the expert system reasoning process and some characteristics of these various levels is presented. Also presented are Abstract Time Slice (ATS) displays, a tool to visualize the plethora of interrelated information available at the host inferencing language level of reasoning. The usefulness of this tool is illustrated with some examples from a prototype potable water expert system for possible use aboard Space Station Freedom.

An Expert System For Tuning Particle-Beam Accelerators

NASA Astrophysics Data System (ADS)

Lager, Darrel L.; Brand, Hal R.; Maurer, William J.; Searfus, Robert M.; Hernandez, Jose E.

1989-03-01

We have developed a proof-of-concept prototype of an expert system for tuning particle beam accelerators. It is designed to function as an intelligent assistant for an operator. In its present form it implements the strategies and reasoning followed by the operator for steering through the beam transport section of the Advanced Test Accelerator at Lawrence Livermore Laboratory's Site 300. The system is implemented in the language LISP using the Artificial Intelligence concepts of frames, daemons, and a representation we developed called a Monitored Decision Script.

Resident Autonomy in the Operating Room: How Faculty Assess Real-time Entrustability.

PubMed

Chen, Xiaodong Phoenix; Sullivan, Amy M; Smink, Douglas S; Alseidi, Adnan; Bengtson, Joan M; Kwakye, Gifty; Dalrymple, John L

2018-02-20

This study aimed to identify the empirical processes and evidence that expert surgical teachers use to determine whether to take over certain steps or entrust the resident with autonomy to proceed during an operation. Assessing real-time entrustability is inherent in attending surgeons' determinations of residents' intraoperative autonomy in the operating room. To promote residents' autonomy, it is necessary to understand how attending surgeons evaluate residents' performance and support opportunities for independent practice based on the assessment of their entrustability. We conducted qualitative semi-structured interviews with 43 expert surgical teachers from 21 institutions across 4 regions of the United States, using purposeful and snowball sampling. Participants represented a range of program types, program size, and clinical expertise. We applied the Framework Method of content analysis to iteratively analyze interview transcripts and identify emergent themes. We identified a 3-phase process used by most expert surgical teachers in determining whether to take over intraoperatively or entrust the resident to proceed, including 1) monitoring performance and "red flags," 2) assessing entrustability, and 3) granting autonomy. Factors associated with individual surgeons (eg, level of comfort, experience, leadership role) and the context (eg, patient safety, case, and time) influenced expert surgical teachers' determinations of entrustability and residents' final autonomy. Expert surgical teachers' 3-phase process of decisions on take-over provides a potential framework that may help surgeons identify appropriate opportunities to develop residents' progressive autonomy by engaging the resident in the determination of entrustability before deciding to take over.

Expert system for maintenance management of a boiling water reactor power plant

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hong Shen; Liou, L.W.; Levine, S.

1992-01-01

An expert system code has been developed for the maintenance of two boiling water reactor units in Berwick, Pennsylvania, that are operated by the Pennsylvania Power and Light Company (PP and L). The objective of this expert system code, where the knowledge of experienced operators and engineers is captured and implemented, is to support the decisions regarding which components can be safely and reliably removed from service for maintenance. It can also serve as a query-answering facility for checking the plant system status and for training purposes. The operating and maintenance information of a large number of support systems, whichmore » must be available for emergencies and/or in the event of an accident, is stored in the data base of the code. It identifies the relevant technical specifications and management rules for shutting down any one of the systems or removing a component from service to support maintenance. Because of the complexity and time needed to incorporate a large number of systems and their components, the first phase of the expert system develops a prototype code, which includes only the reactor core isolation coolant system, the high-pressure core injection system, the instrument air system, the service water system, and the plant electrical system. The next phase is scheduled to expand the code to include all other systems. This paper summarizes the prototype code and the design concept of the complete expert system code for maintenance management of all plant systems and components.« less

A neural network architecture for implementation of expert systems for real time monitoring

NASA Technical Reports Server (NTRS)

Ramamoorthy, P. A.

1991-01-01

Since neural networks have the advantages of massive parallelism and simple architecture, they are good tools for implementing real time expert systems. In a rule based expert system, the antecedents of rules are in the conjunctive or disjunctive form. We constructed a multilayer feedforward type network in which neurons represent AND or OR operations of rules. Further, we developed a translator which can automatically map a given rule base into the network. Also, we proposed a new and powerful yet flexible architecture that combines the advantages of both fuzzy expert systems and neural networks. This architecture uses the fuzzy logic concepts to separate input data domains into several smaller and overlapped regions. Rule-based expert systems for time critical applications using neural networks, the automated implementation of rule-based expert systems with neural nets, and fuzzy expert systems vs. neural nets are covered.

Field Test of the Methodology for Succession Planning for Technical Experts

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cain, Ronald A.; Kirk, Bernadette Lugue; Agreda, Carla L.

This report complements A Methodology for Succession Planning for Technical Experts (Ron Cain, Shaheen Dewji, Carla Agreda, Bernadette Kirk, July 2017), which describes a methodology for identifying and evaluating the loss of key technical skills at nuclear operations facilities. This report targets the methodology for identifying critical skills, hereafter referred to as “core competencies”. The methodology has been field tested by interviewing selected retiring subject matter experts (SMEs).

Physicians' preferences for asthma guidelines implementation.

PubMed

Kang, Min-Koo; Kim, Byung-Keun; Kim, Tae-Wan; Kim, Sae-Hoon; Kang, Hye-Ryun; Park, Heung-Woo; Chang, Yoon-Seok; Kim, Sun-Sin; Min, Kyung-Up; Kim, You-Young; Cho, Sang-Heon

2010-10-01

Patient care based on asthma guidelines is cost-effective and leads to improved treatment outcomes. However, ineffective implementation strategies interfere with the use of these recommendations in clinical practice. This study investigated physicians' preferences for asthma guidelines, including content, supporting evidence, learning strategies, format, and placement in the clinical workplace. We obtained information through a questionnaire survey. The questionnaire was distributed to physicians attending continuing medical education courses and sent to other physicians by airmail, e-mail, and facsimile. A total of 183 physicians responded (male to female ratio, 2.3:1; mean age, 40.4±9.9 years); 89.9% of respondents were internists or pediatricians, and 51.7% were primary care physicians. Physicians preferred information that described asthma medications, classified the disease according to severity and level of control, and provided methods of evaluation/treatment/monitoring and management of acute exacerbation. The most effective strategies for encouraging the use of the guidelines were through continuing medical education and discussions with colleagues. Physicians required supporting evidence in the form of randomized controlled trials and expert consensus. They preferred that the guidelines be presented as algorithms or flow charts/flow diagrams on plastic sheets, pocket cards, or in electronic medical records. This study identified the items of the asthma guidelines preferred by physicians in Korea. Asthma guidelines with physicians' preferences would encourage their implementation in clinical practice.

A Framework for Incorporating Patient Preferences Regarding Benefits and Risks into Regulatory Assessment of Medical Technologies.

PubMed

Ho, Martin; Saha, Anindita; McCleary, K Kimberly; Levitan, Bennett; Christopher, Stephanie; Zandlo, Kristen; Braithwaite, R Scott; Hauber, A Brett

In response to 2012 guidance in which the US Food and Drug Administration's (FDA) Center for Devices and Radiological Health (CDRH) stated the importance of patient-centric measures in regulatory benefit-risk assessments, the Medical Device Innovation Consortium (MDIC) initiated a project. The project was used to develop a framework to help the Food and Drug Administration (FDA) and industry sponsors understand how patient preferences regarding benefit and risk might be integrated into the review of innovative medical devices. A public-private partnership of experts from medical device industry, government, academia and non-profits collaborated on development of the MDIC patient centered benefit-risk framework. The MDIC Framework examines what patient preference information is and the potential use and value of patient preference information in the regulatory process and across the product development life cycle. The MDIC Framework also includes a catalog of patient preference assessment methods and an agenda for future research to advance the field. This article discusses key concepts in patient preference assessment of particular importance for regulators and researchers that are addressed in the MDIC Framework for patient centered benefit-risk assessment as well as the unique public-private collaboration that led its development. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

What are people willing to pay for whole-genome sequencing information, and who decides what they receive?

PubMed

Marshall, Deborah A; Gonzalez, Juan Marcos; Johnson, F Reed; MacDonald, Karen V; Pugh, Amy; Douglas, Michael P; Phillips, Kathryn A

2016-12-01

Whole-genome sequencing (WGS) can be used as a powerful diagnostic tool as well as for screening, but it may lead to anxiety, unnecessary testing, and overtreatment. Current guidelines suggest reporting clinically actionable secondary findings when diagnostic testing is performed. We examined preferences for receiving WGS results. A US nationally representative survey (n = 410 adults) was used to rank preferences for who decides (an expert panel, your doctor, you) which WGS results are reported. We estimated the value of information about variants with varying levels of clinical usefulness by using willingness to pay contingent valuation questions. The results were as follows: 43% preferred to decide themselves what information is included in the WGS report. 38% (95% confidence interval (CI): 33-43%) would not pay for actionable variants, and 3% (95% CI: 1-5%) would pay more than $1,000. 55% (95% CI: 50-60%) would not pay for variants for which medical treatment is currently unclear, and 7% (95% CI: 5-9%) would pay more than $400. Most people prefer to decide what WGS results are reported. Despite valuing actionable information more, some respondents perceive that genetic information could negatively impact them. Preference heterogeneity for WGS information should be considered in the development of policies, particularly to integrate patient preferences with personalized medicine and shared decision making.Genet Med 18 12, 1295-1302.

An expert system for benzole recovery plant

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ishiguro, H.; Matsumura, S.; Kawashima, A.

1993-01-01

In the By-Product Plant of NKK's Keihin Works, systematization efforts were made in 1988, including integration of the control rooms, introduction of computers and installation of automatic analyzers. This has however increased the burden on operators with a huge volume of data, and a delay in coping with an operational abnormality might expand risk and extent of damages. There is, on the other hand, a pressing need to take measures to accommodate sophisticated operations resulting from the pursuit of high productivity operation. For the purpose of avoiding these possible inconveniences, development of a real-time operation system has been tried inmore » an attempt to improve safety and operating techniques and productivity in the benzole recovery plant. An offline system based on manual entry of operating data for diagnosis of operation and abnormality was developed in 1990, and an online real-time system operating by incorporating real-time operating data was developed in 1991, which is now smoothly operating in commercial operations. This report presents an outline of the benzole recovery operation diagnosis control expert system.« less

Developing the Stroke Exercise Preference Inventory (SEPI)

PubMed Central

Bonner, Nicholas S.; O’Halloran, Paul D.; Bernhardt, Julie; Cumming, Toby B.

2016-01-01

Background Physical inactivity is highly prevalent after stroke, increasing the risk of poor health outcomes including recurrent stroke. Tailoring of exercise programs to individual preferences can improve adherence, but no tools exist for this purpose in stroke. Methods We identified potential questionnaire items for establishing exercise preferences via: (i) our preliminary Exercise Preference Questionnaire in stroke, (ii) similar tools used in other conditions, and (iii) expert panel consultations. The resulting 35-item questionnaire (SEPI-35) was administered to stroke survivors, along with measures of disability, depression, anxiety, fatigue and self-reported physical activity. Exploratory factor analysis was used to identify a factor structure in exercise preferences, providing a framework for item reduction. Associations between exercise preferences and personal characteristics were analysed using multivariable regression. Results A group of 134 community-dwelling stroke survivors (mean age 64.0, SD 13.3) participated. Analysis of the SEPI-35 identified 7 exercise preference factors (Supervision-support, Confidence-challenge, Health-wellbeing, Exercise context, Home-alone, Similar others, Music-TV). Item reduction processes yielded a 13-item version (SEPI-13); in analysis of this version, the original factor structure was maintained. Lower scores on Confidence-challenge were significantly associated with disability (p = 0.002), depression (p = 0.001) and fatigue (p = 0.001). Self-reported barriers to exercise were particularly prevalent in those experiencing fatigue and anxiety. Conclusions The SEPI-13 is a brief instrument that allows assessment of exercise preferences and barriers in the stroke population. This new tool can be employed by health professionals to inform the development of individually tailored exercise interventions. PMID:27711242

Technologies for user-preferred routing

NASA Astrophysics Data System (ADS)

McNally, B. D.; Sridhar, Banavar

1996-05-01

The 1995 report of the RTCA Board of Directors' Select Committee on Free Flight states that 'insufficient capacity, limited access, and excessive operating restrictions have escalated operating costs, increase delays, and decreased efficiency for all users' of the national airspace system. The Air Transport Association estimates the annual loss to be 3.5 billion dollars. The goal of the user preferred routing research is to develop integrated airborne and ground technologies that enable the highest possible level of unconstrained, user-preferred routing in enroute airspace.

European Nanotechnology Experts Visit NCL; Harmonize Best Practices for Nanomedicine Collaboration in Europe | FNLCR Staging

Cancer.gov

European nanotechnology experts visited the Nanotechnology Characterization Laboratory (NCL) to observe best practices and methods and to share their own knowledge with NCL scientists as they prepared to launch an NCL-like operation in Europe. The Eu

75 FR 32769 - Science Advisory Board Staff Office; Request for Nominations of Experts to Provide Scientific and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-09

... recognized experts with demonstrated research or operational experience assessing the environmental impacts... following disciplines: Chemistry; fate, transport and exposure assessment; toxicology; public health... biographical sketch of the nominee indicating current position, educational background, research activities...

NASA's Software Bank (CLIPS)

NASA Technical Reports Server (NTRS)

1992-01-01

C Language Integrated Production System (CLIPS) was used by Esse Systems to develop an expert system for clients who want to automate portions of their operations. The resulting program acts as a scheduling expert and automates routine, repetitive scheduling decisions, allowing employees to spend time on more creative projects.

12 CFR 615.5245 - Limitations on association preferred stock.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Limitations on association preferred stock. 615.5245 Section 615.5245 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM FUNDING AND FISCAL AFFAIRS, LOAN POLICIES AND OPERATIONS, AND FUNDING OPERATIONS Issuance of Equities § 615.5245...

26 CFR 1.707-4 - Disguised sales of property to partnership; special rules applicable to guaranteed payments...

Code of Federal Regulations, 2013 CFR

2013-04-01

...; special rules applicable to guaranteed payments, preferred returns, operating cash flow distributions, and... payments, preferred returns, operating cash flow distributions, and reimbursements of preformation... distribution of partnership cash flow to a partner with respect to capital contributed to the partnership by...

26 CFR 1.707-4 - Disguised sales of property to partnership; special rules applicable to guaranteed payments...

Code of Federal Regulations, 2012 CFR

2012-04-01

...; special rules applicable to guaranteed payments, preferred returns, operating cash flow distributions, and... payments, preferred returns, operating cash flow distributions, and reimbursements of preformation... distribution of partnership cash flow to a partner with respect to capital contributed to the partnership by...

26 CFR 1.707-4 - Disguised sales of property to partnership; special rules applicable to guaranteed payments...

Code of Federal Regulations, 2011 CFR

2011-04-01

...; special rules applicable to guaranteed payments, preferred returns, operating cash flow distributions, and... payments, preferred returns, operating cash flow distributions, and reimbursements of preformation... distribution of partnership cash flow to a partner with respect to capital contributed to the partnership by...

26 CFR 1.707-4 - Disguised sales of property to partnership; special rules applicable to guaranteed payments...

Code of Federal Regulations, 2014 CFR

2014-04-01

...; special rules applicable to guaranteed payments, preferred returns, operating cash flow distributions, and... payments, preferred returns, operating cash flow distributions, and reimbursements of preformation... distribution of partnership cash flow to a partner with respect to capital contributed to the partnership by...

Comparing the performance of expert user heuristics and an integer linear program in aircraft carrier deck operations.

PubMed

Ryan, Jason C; Banerjee, Ashis Gopal; Cummings, Mary L; Roy, Nicholas

2014-06-01

Planning operations across a number of domains can be considered as resource allocation problems with timing constraints. An unexplored instance of such a problem domain is the aircraft carrier flight deck, where, in current operations, replanning is done without the aid of any computerized decision support. Rather, veteran operators employ a set of experience-based heuristics to quickly generate new operating schedules. These expert user heuristics are neither codified nor evaluated by the United States Navy; they have grown solely from the convergent experiences of supervisory staff. As unmanned aerial vehicles (UAVs) are introduced in the aircraft carrier domain, these heuristics may require alterations due to differing capabilities. The inclusion of UAVs also allows for new opportunities for on-line planning and control, providing an alternative to the current heuristic-based replanning methodology. To investigate these issues formally, we have developed a decision support system for flight deck operations that utilizes a conventional integer linear program-based planning algorithm. In this system, a human operator sets both the goals and constraints for the algorithm, which then returns a proposed schedule for operator approval. As a part of validating this system, the performance of this collaborative human-automation planner was compared with that of the expert user heuristics over a set of test scenarios. The resulting analysis shows that human heuristics often outperform the plans produced by an optimization algorithm, but are also often more conservative.

A CLIPS-based expert system for the evaluation and selection of robots

NASA Technical Reports Server (NTRS)

Nour, Mohamed A.; Offodile, Felix O.; Madey, Gregory R.

1994-01-01

This paper describes the development of a prototype expert system for intelligent selection of robots for manufacturing operations. The paper first develops a comprehensive, three-stage process to model the robot selection problem. The decisions involved in this model easily lend themselves to an expert system application. A rule-based system, based on the selection model, is developed using the CLIPS expert system shell. Data about actual robots is used to test the performance of the prototype system. Further extensions to the rule-based system for data handling and interfacing capabilities are suggested.

Software Analyzes Complex Systems in Real Time

NASA Technical Reports Server (NTRS)

2008-01-01

Expert system software programs, also known as knowledge-based systems, are computer programs that emulate the knowledge and analytical skills of one or more human experts, related to a specific subject. SHINE (Spacecraft Health Inference Engine) is one such program, a software inference engine (expert system) designed by NASA for the purpose of monitoring, analyzing, and diagnosing both real-time and non-real-time systems. It was developed to meet many of the Agency s demanding and rigorous artificial intelligence goals for current and future needs. NASA developed the sophisticated and reusable software based on the experience and requirements of its Jet Propulsion Laboratory s (JPL) Artificial Intelligence Research Group in developing expert systems for space flight operations specifically, the diagnosis of spacecraft health. It was designed to be efficient enough to operate in demanding real time and in limited hardware environments, and to be utilized by non-expert systems applications written in conventional programming languages. The technology is currently used in several ongoing NASA applications, including the Mars Exploration Rovers and the Spacecraft Health Automatic Reasoning Pilot (SHARP) program for the diagnosis of telecommunication anomalies during the Neptune Voyager Encounter. It is also finding applications outside of the Space Agency.

A Bayesian Analysis of a Randomized Clinical Trial Comparing Antimetabolite Therapies for Non-Infectious Uveitis.

PubMed

Browne, Erica N; Rathinam, Sivakumar R; Kanakath, Anuradha; Thundikandy, Radhika; Babu, Manohar; Lietman, Thomas M; Acharya, Nisha R

2017-02-01

To conduct a Bayesian analysis of a randomized clinical trial (RCT) for non-infectious uveitis using expert opinion as a subjective prior belief. A RCT was conducted to determine which antimetabolite, methotrexate or mycophenolate mofetil, is more effective as an initial corticosteroid-sparing agent for the treatment of intermediate, posterior, and pan-uveitis. Before the release of trial results, expert opinion on the relative effectiveness of these two medications was collected via online survey. Members of the American Uveitis Society executive committee were invited to provide an estimate for the relative decrease in efficacy with a 95% credible interval (CrI). A prior probability distribution was created from experts' estimates. A Bayesian analysis was performed using the constructed expert prior probability distribution and the trial's primary outcome. A total of 11 of the 12 invited uveitis specialists provided estimates. Eight of 11 experts (73%) believed mycophenolate mofetil is more effective. The group prior belief was that the odds of treatment success for patients taking mycophenolate mofetil were 1.4-fold the odds of those taking methotrexate (95% CrI 0.03-45.0). The odds of treatment success with mycophenolate mofetil compared to methotrexate was 0.4 from the RCT (95% confidence interval 0.1-1.2) and 0.7 (95% CrI 0.2-1.7) from the Bayesian analysis. A Bayesian analysis combining expert belief with the trial's result did not indicate preference for one drug. However, the wide credible interval leaves open the possibility of a substantial treatment effect. This suggests clinical equipoise necessary to allow a larger, more definitive RCT.

Sorting Through the Safety Data Haystack: Using Machine Learning to Identify Individual Case Safety Reports in Social-Digital Media.

PubMed

Comfort, Shaun; Perera, Sujan; Hudson, Zoe; Dorrell, Darren; Meireis, Shawman; Nagarajan, Meenakshi; Ramakrishnan, Cartic; Fine, Jennifer

2018-06-01

There is increasing interest in social digital media (SDM) as a data source for pharmacovigilance activities; however, SDM is considered a low information content data source for safety data. Given that pharmacovigilance itself operates in a high-noise, lower-validity environment without objective 'gold standards' beyond process definitions, the introduction of large volumes of SDM into the pharmacovigilance workflow has the potential to exacerbate issues with limited manual resources to perform adverse event identification and processing. Recent advances in medical informatics have resulted in methods for developing programs which can assist human experts in the detection of valid individual case safety reports (ICSRs) within SDM. In this study, we developed rule-based and machine learning (ML) models for classifying ICSRs from SDM and compared their performance with that of human pharmacovigilance experts. We used a random sampling from a collection of 311,189 SDM posts that mentioned Roche products and brands in combination with common medical and scientific terms sourced from Twitter, Tumblr, Facebook, and a spectrum of news media blogs to develop and evaluate three iterations of an automated ICSR classifier. The ICSR classifier models consisted of sub-components to annotate the relevant ICSR elements and a component to make the final decision on the validity of the ICSR. Agreement with human pharmacovigilance experts was chosen as the preferred performance metric and was evaluated by calculating the Gwet AC1 statistic (gKappa). The best performing model was tested against the Roche global pharmacovigilance expert using a blind dataset and put through a time test of the full 311,189-post dataset. During this effort, the initial strict rule-based approach to ICSR classification resulted in a model with an accuracy of 65% and a gKappa of 46%. Adding an ML-based adverse event annotator improved the accuracy to 74% and gKappa to 60%. This was further improved by the addition of an additional ML ICSR detector. On a blind test set of 2500 posts, the final model demonstrated a gKappa of 78% and an accuracy of 83%. In the time test, it took the final model 48 h to complete a task that would have taken an estimated 44,000 h for human experts to perform. The results of this study indicate that an effective and scalable solution to the challenge of ICSR detection in SDM includes a workflow using an automated ML classifier to identify likely ICSRs for further human SME review.

General purpose architecture for intelligent computer-aided training

NASA Technical Reports Server (NTRS)

Loftin, R. Bowen (Inventor); Wang, Lui (Inventor); Baffes, Paul T. (Inventor); Hua, Grace C. (Inventor)

1994-01-01

An intelligent computer-aided training system having a general modular architecture is provided for use in a wide variety of training tasks and environments. It is comprised of a user interface which permits the trainee to access the same information available in the task environment and serves as a means for the trainee to assert actions to the system; a domain expert which is sufficiently intelligent to use the same information available to the trainee and carry out the task assigned to the trainee; a training session manager for examining the assertions made by the domain expert and by the trainee for evaluating such trainee assertions and providing guidance to the trainee which are appropriate to his acquired skill level; a trainee model which contains a history of the trainee interactions with the system together with summary evaluative data; an intelligent training scenario generator for designing increasingly complex training exercises based on the current skill level contained in the trainee model and on any weaknesses or deficiencies that the trainee has exhibited in previous interactions; and a blackboard that provides a common fact base for communication between the other components of the system. Preferably, the domain expert contains a list of 'mal-rules' which typifies errors that are usually made by novice trainees. Also preferably, the training session manager comprises an intelligent error detection means and an intelligent error handling means. The present invention utilizes a rule-based language having a control structure whereby a specific message passing protocol is utilized with respect to tasks which are procedural or step-by-step in structure. The rules can be activated by the trainee in any order to reach the solution by any valid or correct path.

Oral anticoagulant re-initiation following intracerebral hemorrhage in non-valvular atrial fibrillation: Global survey of the practices of neurologists, neurosurgeons and thrombosis experts.

PubMed

Xu, Yan; Shoamanesh, Ashkan; Schulman, Sam; Dowlatshahi, Dar; Al-Shahi Salman, Rustam; Moldovan, Ioana Doina; Wells, Philip Stephen; AlKherayf, Fahad

2018-01-01

While oral anticoagulants (OACs) are highly effective for ischemic stroke prevention in atrial fibrillation, intracerebral hemorrhage (ICH) remains the most feared complication of OAC. Clinical controversy remains regarding OAC resumption and its timing for ICH survivors with atrial fibrillation because the balance between risks and benefits has not been investigated in randomized trials. To survey the practice of stroke neurologists, thrombosis experts and neurosurgeons on OAC re-initiation following OAC-associated ICH. An online survey was distributed to members of the International Society for Thrombosis and Haemostasis, Canadian Stroke Consortium, NAVIGATE-ESUS trial investigators (Clinicatrials.gov identifier NCT02313909) and American Association of Neurological Surgeons. Demographic factors and 11 clinical scenarios were included. Two hundred twenty-eight participants from 38 countries completed the survey. Majority of participants were affiliated with academic centers, and >20% managed more than 15 OAC-associated ICH patients/year. Proportion of respondents suggesting OAC anticoagulant resumption varied from 30% (for cerebral amyloid angiopathy) to 98% (for traumatic ICH). Within this group, there was wide distribution in response for timing of resumption: 21.4% preferred to re-start OACs after 1-3 weeks of incident ICH, while 25.3% opted to start after 1-3 months. Neurosurgery respondents preferred earlier OAC resumption compared to stroke neurologists or thrombosis experts in 5 scenarios (p<0.05 by Kendall's tau). Wide variations in current practice exist among management of OAC-associated ICH, with decisions influenced by patient- and provider-related factors. As these variations likely reflect the lack of high quality evidence, randomized trials are direly needed in this population.

Drug- and Herb-Induced Liver Injury in Clinical and Translational Hepatology: Causality Assessment Methods, Quo Vadis?

PubMed Central

Eickhoff, Axel; Schulze, Johannes

2013-01-01

Drug-induced liver injury (DILI) and herb-induced liver injury (HILI) are typical diseases of clinical and translational hepatology. Their diagnosis is complex and requires an experienced clinician to translate basic science into clinical judgment and identify a valid causality algorithm. To prospectively assess causality starting on the day DILI or HILI is suspected, the best approach for physicians is to use the Council for International Organizations of Medical Sciences (CIOMS) scale in its original or preferably its updated version. The CIOMS scale is validated, liver-specific, structured, and quantitative, providing final causality grades based on scores of specific items for individual patients. These items include latency period, decline in liver values after treatment cessation, risk factors, co-medication, alternative diagnoses, hepatotoxicity track record of the suspected product, and unintentional re-exposure. Provided causality is established as probable or highly probable, data of the CIOMS scale with all individual items, a short clinical report, and complete raw data should be transmitted to the regulatory agencies, manufacturers, expert panels, and possibly to the scientific community for further refinement of the causality evaluation in a setting of retrospective expert opinion. Good-quality case data combined with thorough CIOMS-based assessment as a standardized approach should avert subsequent necessity for other complex causality assessment methods that may have inter-rater problems because of poor-quality data. In the future, the CIOMS scale will continue to be the preferred tool to assess causality of DILI and HILI cases and should be used consistently, both prospectively by physicians, and retrospectively for subsequent expert opinion if needed. For comparability and international harmonization, all parties assessing causality in DILI and HILI cases should attempt this standardized approach using the updated CIOMS scale. PMID:26357608

Treatment of oral mucosal manifestations of chronic graft-versus-host disease: dexamethasone vs. budesonide.

PubMed

Zadik, Yehuda; Elad, Sharon; Shapira, Anat; Shapira, Michael Y

2017-02-01

The oral mucosa is commonly involved in chronic graft-versus-host disease (cGVHD). Oral mucosal cGVHD markedly affect individual's daily function and wellbeing. In some cases, it might become a life threating complication. Areas covered: This article describes the rationale for treatment, method of topical application in the oral cavity, evidence supporting the topical administration of dexamethasone and budesonide for oral cGVHD, and their adverse effects. Expert opinion: Evidence supports the use of topical dexamethasone and budesonide for treatment of oral cGVHD. Topical corticosteroid choice for oral cGVHD, takes into consideration the potency, bioavailability, preferred concentration, and possible adverse effects. Budesonide's pharmacological characteristics mark it as a preferable topical agent for oral cGVHD.

Initial Development of C.A.T.E.S.: A Simulation-Based Competency Assessment Instrument for Neonatal Nurse Practitioners.

PubMed

Cates, Leigh Ann; Bishop, Sheryl; Armentrout, Debra; Verklan, Terese; Arnold, Jennifer; Doughty, Cara

2015-01-01

Determine content validity of global statements and operational definitions and choose scenarios for Competency, Assessment, Technology, Education, and Simulation (C.A.T.E.S.), instrument in development to evaluate multidimensional competency of neonatal nurse practitioners (NNPs). Real-time Delphi (RTD) method to pursue four specific aims (SAs): (1) identify which cognitive, technical, or behavioral dimension of NNP competency accurately reflects each global statement; (2) map the global statements to the National Association of Neonatal Nurse Practitioners (NANNP) core competency domains; (3) define operational definitions for the novice to expert performance subscales; and (4) determine the essential scenarios to assess NNPs. Twenty-five NNPs and nurses with competency and simulation experience Main outcome variable: One hundred percent of global statements correct for competency dimension and all but two correct for NANNP domain. One hundred percent novice to expert operational definitions and eight scenarios chosen. Content validity determined for global statements and novice to expert definitions and essential scenarios chosen.

A novel framework to alleviate the sparsity problem in context-aware recommender systems

NASA Astrophysics Data System (ADS)

Yu, Penghua; Lin, Lanfen; Wang, Jing

2017-04-01

Recommender systems have become indispensable for services in the era of big data. To improve accuracy and satisfaction, context-aware recommender systems (CARSs) attempt to incorporate contextual information into recommendations. Typically, valid and influential contexts are determined in advance by domain experts or feature selection approaches. Most studies have focused on utilizing the unitary context due to the differences between various contexts. Meanwhile, multi-dimensional contexts will aggravate the sparsity problem, which means that the user preference matrix would become extremely sparse. Consequently, there are not enough or even no preferences in most multi-dimensional conditions. In this paper, we propose a novel framework to alleviate the sparsity issue for CARSs, especially when multi-dimensional contextual variables are adopted. Motivated by the intuition that the overall preferences tend to show similarities among specific groups of users and conditions, we first explore to construct one contextual profile for each contextual condition. In order to further identify those user and context subgroups automatically and simultaneously, we apply a co-clustering algorithm. Furthermore, we expand user preferences in a given contextual condition with the identified user and context clusters. Finally, we perform recommendations based on expanded preferences. Extensive experiments demonstrate the effectiveness of the proposed framework.

Exploring the acceptability of the available pneumococcal conjugate vaccines in Canadian health care professionals and immunization experts.

PubMed

Berman, Melissa; Dubé, Eve; Quach, Caroline

2017-06-05

In children, the 13 and 10-valent pneumoccocal conjugate vaccines (PCV13/10) are currently approved for the prevention of invasive pneumococcal disease (IPD). Acceptability is a key consideration in the implementation of a vaccine program and it is recognized that health professional's attitudes and opinions towards vaccines are independent predictors of the success of an immunization program. We aimed to survey the beliefs and attitudes for the two available PCVs in health care professionals and immunization experts. We interviewed 21 members of Canadian immunization committees and/or participants working in frontline healthcare delivery. Overall, participants predominantly preferred PCV-13 over PCV10. For most, AOM should not be taken into considerations in decisions for pneumococcal vaccination programs implementation. AOM was considered an important endpoint of the program but an ineffective measure of program success due to the lack of surveillance for the condition. Recent evidence pertaining to PCV10 cross-protection against 19A did not affect preference but had an impact on perceptions regarding pricing. To consider implementing any changes to the current program, most participants would require more evidence regarding PCV10 cross-protection and effectiveness against OM. Decreasing vaccine price was cited as a positive outcome of funding both vaccines. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation and determination of soil remediation schemes using a modified AHP model and its application in a contaminated coking plant.

PubMed

Li, Xingang; Li, Jia; Sui, Hong; He, Lin; Cao, Xingtao; Li, Yonghong

2018-07-05

Soil remediation has been considered as one of the most difficult pollution treatment tasks due to its high complexity in contaminants, geological conditions, usage, urgency, etc. The diversity in remediation technologies further makes quick selection of suitable remediation schemes much tougher even the site investigation has been done. Herein, a sustainable decision support hierarchical model has been developed to select, evaluate and determine preferred soil remediation schemes comprehensively based on modified analytic hierarchy process (MAHP). This MAHP method combines competence model and the Grubbs criteria with the conventional AHP. It not only considers the competence differences among experts in group decision, but also adjusts the big deviation caused by different experts' preference through sample analysis. This conversion allows the final remediation decision more reasonable. In this model, different evaluation criteria, including economic effect, environmental effect and technological effect, are employed to evaluate the integrated performance of remediation schemes followed by a strict computation using above MAHP. To confirm the feasibility of this developed model, it has been tested by a benzene workshop contaminated site in Beijing coking plant. Beyond soil remediation, this MAHP model would also be applied in other fields referring to multi-criteria group decision making. Copyright © 2018 Elsevier B.V. All rights reserved.

Expert systems for automated maintenance of a Mars oxygen production system

NASA Technical Reports Server (NTRS)

Ash, Robert L.; Huang, Jen-Kuang; Ho, Ming-Tsang

1989-01-01

A prototype expert system was developed for maintaining autonomous operation of a Mars oxygen production system. Normal operation conditions and failure modes according to certain desired criteria are tested and identified. Several schemes for failure detection and isolation using forward chaining, backward chaining, knowledge-based and rule-based are devised to perform several housekeeping functions. These functions include self-health checkout, an emergency shut down program, fault detection and conventional control activities. An effort was made to derive the dynamic model of the system using Bond-Graph technique in order to develop the model-based failure detection and isolation scheme by estimation method. Finally, computer simulations and experimental results demonstrated the feasibility of the expert system and a preliminary reliability analysis for the oxygen production system is also provided.

Participation of industry experts in the elaboration of monographs and chapters of the European Pharmacopoeia.

PubMed

Rose, Ulrich

2016-10-10

The European Pharmacopoeia represents an important element in the European regulatory system for medicines. It is elaborated in a co-operation of experts from authorities, academia and industry, assisted by scientific staff from the European Directorate for the Quality of Medicines & HealthCare (EDQM). This article describes the principles of its elaboration with particular focus on the involvement of industry experts. Copyright © 2016 Elsevier B.V. All rights reserved.

A software engineering approach to expert system design and verification

NASA Technical Reports Server (NTRS)

Bochsler, Daniel C.; Goodwin, Mary Ann

1988-01-01

Software engineering design and verification methods for developing expert systems are not yet well defined. Integration of expert system technology into software production environments will require effective software engineering methodologies to support the entire life cycle of expert systems. The software engineering methods used to design and verify an expert system, RENEX, is discussed. RENEX demonstrates autonomous rendezvous and proximity operations, including replanning trajectory events and subsystem fault detection, onboard a space vehicle during flight. The RENEX designers utilized a number of software engineering methodologies to deal with the complex problems inherent in this system. An overview is presented of the methods utilized. Details of the verification process receive special emphasis. The benefits and weaknesses of the methods for supporting the development life cycle of expert systems are evaluated, and recommendations are made based on the overall experiences with the methods.

Operator Performance Support System (OPSS)

NASA Technical Reports Server (NTRS)

Conklin, Marlen Z.

1993-01-01

In the complex and fast reaction world of military operations, present technologies, combined with tactical situations, have flooded the operator with assorted information that he is expected to process instantly. As technologies progress, this flow of data and information have both guided and overwhelmed the operator. However, the technologies that have confounded many operators today can be used to assist him -- thus the Operator Performance Support Team. In this paper we propose an operator support station that incorporates the elements of Video and Image Databases, productivity Software, Interactive Computer Based Training, Hypertext/Hypermedia Databases, Expert Programs, and Human Factors Engineering. The Operator Performance Support System will provide the operator with an integrating on-line information/knowledge system that will guide expert or novice to correct systems operations. Although the OPSS is being developed for the Navy, the performance of the workforce in today's competitive industry is of major concern. The concepts presented in this paper which address ASW systems software design issues are also directly applicable to industry. the OPSS will propose practical applications in how to more closely align the relationships between technical knowledge and equipment operator performance.

Creating a Roadmap for Delivering Gender-sensitive Comprehensive Care for Women Veterans

PubMed Central

deKleijn, Miriam; Lagro-Janssen, Antoine L.M.; Canelo, Ismelda

2015-01-01

Background: Women Veterans are a significant minority of users of the VA healthcare system, limiting provider and staff experience meeting their needs in environments historically designed for men. The VA is nonetheless committed to ensuring that women Veterans have access to comprehensive care in environments sensitive to their needs. Objectives: We sought to determine what aspects of care need to be tailored to the needs of women Veterans in order for the VA to deliver gender-sensitive comprehensive care. Research Design: Modified Delphi expert panel process. Subjects: Eleven clinicians and social scientists with expertise in women’s health, primary care, and mental health. Measures: Importance of tailoring over 100 discrete aspects of care derived from the Institute of Medicine’s definition of comprehensive care and literature-based domains of sex-sensitive care on a 5-point scale. Results: Panelists rated over half of the aspects of care as very-to-extremely important (median score 4+) to tailor to the needs of women Veterans. The panel arrived at 14 priority recommendations that broadly encompassed the importance of (1) the design/delivery of services sensitive to trauma histories, (2) adapting to women’s preferences and information needs, and (3) sex awareness and cultural transformation in every facet of VA operations. Conclusions: We used expert panel methods to arrive at consensus on top priority recommendations for improving delivery of sex-sensitive comprehensive care in VA settings. Accomplishment of their breadth will require national, regional, and local strategic action and multilevel stakeholder engagement, and will support VA’s national efforts at improving customer service for all Veterans. PMID:25767971

Self-management interventions: Proposal and validation of a new operational definition.

PubMed

Jonkman, Nini H; Schuurmans, Marieke J; Jaarsma, Tiny; Shortridge-Baggett, Lillie M; Hoes, Arno W; Trappenburg, Jaap C A

2016-12-01

Systematic reviews on complex interventions like self-management interventions often do not explicitly state an operational definition of the intervention studied, which may impact the review's conclusions. This study aimed to propose an operational definition of self-management interventions and determine its discriminative performance compared with other operational definitions. Systematic review of definitions of self-management interventions and consensus meetings with self-management research experts and practitioners. Self-management interventions were defined as interventions that aim to equip patients with skills to actively participate and take responsibility in the management of their chronic condition in order to function optimally through at least knowledge acquisition and a combination of at least two of the following: stimulation of independent sign/symptom monitoring, medication management, enhancing problem-solving and decision-making skills for medical treatment management, and changing their physical activity, dietary, and/or smoking behavior. This definition substantially reduced the number of selected studies (255 of 750). In two preliminary expert meetings (n = 6), the proposed definition was identifiable for self-management research experts and practitioners (80% and 60% agreement, respectively). Future systematic reviews must carefully consider the operational definition of the intervention studied because the definition influences the selection of studies on which conclusions and recommendations for clinical practice are based. Copyright © 2016 Elsevier Inc. All rights reserved.

Building damage assessment using airborne lidar

NASA Astrophysics Data System (ADS)

Axel, Colin; van Aardt, Jan

2017-10-01

The assessment of building damage following a natural disaster is a crucial step in determining the impact of the event itself and gauging reconstruction needs. Automatic methods for deriving damage maps from remotely sensed data are preferred, since they are regarded as being rapid and objective. We propose an algorithm for performing unsupervised building segmentation and damage assessment using airborne light detection and ranging (lidar) data. Local surface properties, including normal vectors and curvature, were used along with region growing to segment individual buildings in lidar point clouds. Damaged building candidates were identified based on rooftop inclination angle, and then damage was assessed using planarity and point height metrics. Validation of the building segmentation and damage assessment techniques were performed using airborne lidar data collected after the Haiti earthquake of 2010. Building segmentation and damage assessment accuracies of 93.8% and 78.9%, respectively, were obtained using lidar point clouds and expert damage assessments of 1953 buildings in heavily damaged regions. We believe this research presents an indication of the utility of airborne lidar remote sensing for increasing the efficiency and speed at which emergency response operations are performed.

The Effect of Non-technical Factors in B2C E-Commerce

NASA Astrophysics Data System (ADS)

Sanayei, Ali; Shafe'Ei, Reza

As e-commerce grows across industries worldwide , business are building web sites for presence as well as for online business. It is more than transferring current business operations to a new medium. This situation requires explaining main models, changing infrastructures, and notice to customer needs as their vital rights. Whilst increasing numbers of firms have launched themselves on the Internet, they are trying to consideration of the strategic implications of developing, implementing or running a Web site. Global competition, laws, and customer preferences are among the issues being affected by e-commerce. In this study many factors that effect on e-commerce are considered these factors have no technical issue in nature. Companies related factors, customers' knowledge, customers' trust and customers' behavior are the main effective factors in development of B2C e-commerce. In this research we surveyed the mentioned aspects by offering questionnaire to experts of e-commerce for companies. The results show there is a meaningful relationship between perception, knowledge, trust and attitude of customers and the company's capabilities in the other side with B2C e-commerce development.

A Fluid Mechanics Hypercourse

NASA Astrophysics Data System (ADS)

Fay, James A.; Sonwalkar, Nishikant

1996-05-01

This CD-ROM is designed to accompany James Fay's Introduction to Fluid Mechanics. An enhanced hypermedia version of the textbook, it offers a number of ways to explore the fluid mechanics domain. These include a complete hypertext version of the original book, physical-experiment video clips, excerpts from external references, audio annotations, colored graphics, review questions, and progressive hints for solving problems. Throughout, the authors provide expert guidance in navigating the typed links so that students do not get lost in the learning process. System requirements: Macintosh with 68030 or greater processor and with at least 16 Mb of RAM. Operating System 6.0.4 or later for 680x0 processor and System 7.1.2 or later for Power-PC. CD-ROM drive with 256- color capability. Preferred display 14 inches or above (SuperVGA with 1 megabyte of VRAM). Additional system font software: Computer Modern postscript fonts (CM/PS Screen Fonts, CMBSY10, and CMTT10) and Adobe Type Manager (ATM 3.0 or later). James A. Fay is Professor Emeritus and Senior Lecturer in the Department of Mechanical Engineering at MIT.

Analysis of Alternatives for Dismantling of the Equipment in Building 117/1 at Ignalina NPP - 13278

DOE Office of Scientific and Technical Information (OSTI.GOV)

Poskas, Povilas; Simonis, Audrius; Poskas, Gintautas

2013-07-01

Ignalina NPP was operating two RBMK-1500 reactors which are under decommissioning now. In this paper dismantling alternatives of the equipment in Building 117/1 are analyzed. After situation analysis and collection of the primary information related to components' physical and radiological characteristics, location and other data, two different alternatives for dismantling of the equipment are formulated - the first (A1), when major components (vessels and pipes of Emergency Core Cooling System - ECCS) are segmented/halved in situ using flame cutting (oxy-acetylene) and the second one (A2), when these components are segmented/halved at the workshop using CAMC (Contact Arc Metal Cutting) technique.more » To select the preferable alternative MCDA method - AHP (Analytic Hierarchy Process) is applied. Hierarchical list of decision criteria, necessary for assessment of alternatives performance, are formulated. Quantitative decision criteria values for these alternatives are calculated using software DECRAD, which was developed by Lithuanian Energy Institute Nuclear engineering laboratory. While qualitative decision criteria are evaluated using expert judgment. Analysis results show that alternative A1 is better than alternative A2. (authors)« less

European Nanotechnology Experts Visit NCL; Harmonize Best Practices for Nanomedicine Collaboration in Europe | Frederick National Laboratory for Cancer Research

Cancer.gov

European nanotechnology experts visited the Nanotechnology Characterization Laboratory (NCL) to observe best practices and methods and to share their own knowledge with NCL scientists as they prepared to launch an NCL-like operation in Europe. The Eu

Flexible Programmes in Higher Professional Education: Expert Validation of a Flexible Educational Model

ERIC Educational Resources Information Center

Schellekens, Ad; Paas, Fred; Verbraeck, Alexander; van Merrienboer, Jeroen J. G.

2010-01-01

In a preceding case study, a process-focused demand-driven approach for organising flexible educational programmes in higher professional education (HPE) was developed. Operations management and instructional design contributed to designing a flexible educational model by means of discrete-event simulation. Educational experts validated the model…

Applicability of the National Comprehensive Cancer Network/Multinational Association of Supportive Care in Cancer Guidelines for Prevention and Management of Chemotherapy-Induced Nausea and Vomiting in Southeast Asia: A Consensus Statement.

PubMed

Chan, Alexandre; Abdullah, Matin M; Ishak, Wan Zamaniah B Wan; Ong-Cornel, Annielyn B; Villalon, Antonio H; Kanesvaran, Ravindran

2017-12-01

A meeting of regional experts was convened in Manila, Philippines, to develop a resource-stratified chemotherapy-induced nausea and vomiting (CINV) management guideline. In patients treated with highly emetogenic chemotherapy in general clinical settings, triple therapy with a serotonin (5-hydroxytryptamine-3 [5-HT 3 ]) antagonist (preferably palonosetron), dexamethasone, and aprepitant is recommended for acute CINV prevention. In resource-restricted settings, triple therapy is still recommended, although a 5-HT 3 antagonist other than palonosetron may be used. In both general and resource-restricted settings, dual therapy with dexamethasone (days 2 to 4) and aprepitant (days 2 to 3) is recommended to prevent delayed CINV. In patients treated with moderately emetogenic chemotherapy, dual therapy with a 5-HT 3 antagonist, preferably palonosetron, and dexamethasone is recommended for acute CINV prevention in general settings; any 5-HT 3 antagonist can be combined with dexamethasone in resource-restricted environments. In general settings, for the prevention of delayed CINV associated with moderately emetogenic chemotherapy, corticosteroid monotherapy on days 2 and 3 is recommended. If aprepitant is used on day 1, it should be continued on days 2 and 3. Prevention of delayed CINV with corticosteroids is preferred in resource-restricted settings. The expert panel also developed CINV management guidelines for anthracycline plus cyclophosphamide combination schedules, multiday cisplatin, and chemotherapy with low or minimal emetogenic potential, and its recommendations are detailed in this review. Overall, these regional guidelines provide definitive guidance for CINV management in general and resource-restricted settings. These consensus recommendations are anticipated to contribute to collaborative efforts to improve CINV management in Southeast Asia.

Applicability of the National Comprehensive Cancer Network/Multinational Association of Supportive Care in Cancer Guidelines for Prevention and Management of Chemotherapy-Induced Nausea and Vomiting in Southeast Asia: A Consensus Statement

PubMed Central

Abdullah, Matin M.; Ishak, Wan Zamaniah B. Wan; Ong-Cornel, Annielyn B.; Villalon, Antonio H.; Kanesvaran, Ravindran

2017-01-01

A meeting of regional experts was convened in Manila, Philippines, to develop a resource-stratified chemotherapy-induced nausea and vomiting (CINV) management guideline. In patients treated with highly emetogenic chemotherapy in general clinical settings, triple therapy with a serotonin (5-hydroxytryptamine-3 [5-HT3]) antagonist (preferably palonosetron), dexamethasone, and aprepitant is recommended for acute CINV prevention. In resource-restricted settings, triple therapy is still recommended, although a 5-HT3 antagonist other than palonosetron may be used. In both general and resource-restricted settings, dual therapy with dexamethasone (days 2 to 4) and aprepitant (days 2 to 3) is recommended to prevent delayed CINV. In patients treated with moderately emetogenic chemotherapy, dual therapy with a 5-HT3 antagonist, preferably palonosetron, and dexamethasone is recommended for acute CINV prevention in general settings; any 5-HT3 antagonist can be combined with dexamethasone in resource-restricted environments. In general settings, for the prevention of delayed CINV associated with moderately emetogenic chemotherapy, corticosteroid monotherapy on days 2 and 3 is recommended. If aprepitant is used on day 1, it should be continued on days 2 and 3. Prevention of delayed CINV with corticosteroids is preferred in resource-restricted settings. The expert panel also developed CINV management guidelines for anthracycline plus cyclophosphamide combination schedules, multiday cisplatin, and chemotherapy with low or minimal emetogenic potential, and its recommendations are detailed in this review. Overall, these regional guidelines provide definitive guidance for CINV management in general and resource-restricted settings. These consensus recommendations are anticipated to contribute to collaborative efforts to improve CINV management in Southeast Asia. PMID:29244998

Should trained lay providers perform HIV testing? A systematic review to inform World Health Organization guidelines.

PubMed

Kennedy, C E; Yeh, P T; Johnson, C; Baggaley, R

2017-12-01

New strategies for HIV testing services (HTS) are needed to achieve UN 90-90-90 targets, including diagnosis of 90% of people living with HIV. Task-sharing HTS to trained lay providers may alleviate health worker shortages and better reach target groups. We conducted a systematic review of studies evaluating HTS by lay providers using rapid diagnostic tests (RDTs). Peer-reviewed articles were included if they compared HTS using RDTs performed by trained lay providers to HTS by health professionals, or to no intervention. We also reviewed data on end-users' values and preferences around lay providers preforming HTS. Searching was conducted through 10 online databases, reviewing reference lists, and contacting experts. Screening and data abstraction were conducted in duplicate using systematic methods. Of 6113 unique citations identified, 5 studies were included in the effectiveness review and 6 in the values and preferences review. One US-based randomized trial found patients' uptake of HTS doubled with lay providers (57% vs. 27%, percent difference: 30, 95% confidence interval: 27-32, p < 0.001). In Malawi, a pre/post study showed increases in HTS sites and tests after delegation to lay providers. Studies from Cambodia, Malawi, and South Africa comparing testing quality between lay providers and laboratory staff found little discordance and high sensitivity and specificity (≥98%). Values and preferences studies generally found support for lay providers conducting HTS, particularly in non-hypothetical scenarios. Based on evidence supporting using trained lay providers, a WHO expert panel recommended lay providers be allowed to conduct HTS using HIV RDTs. Uptake of this recommendation could expand HIV testing to more people globally.

Management of postoperative inflammation after cataract and complex ocular surgeries: a systematic review and Delphi survey.

PubMed

Aptel, Florent; Colin, Cyrille; Kaderli, Sema; Deloche, Catherine; Bron, Alain M; Stewart, Michael W; Chiquet, Christophe

2017-11-01

Prevention and management of postoperative ocular inflammation with corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs) have been evaluated in several randomised controlled trials (RCTs). However, neither consensus regarding the efficacies of different regimens nor established guidelines are currently available. This has resulted in different practice patterns throughout the world. A systematic literature review found that for the management of postcataract inflammation nepafenac produced a positive outcome in three of three RCTs (3/3), as did ketorolac (1/1), bromfenac (7/7), loteprednol (3/3) and difluprednate (6/6), but not flurbiprofen (0/1). A single study found that betamethasone produced inconclusive results after retinal detachment (RD) surgery; ketorolac was effective (1/1) after vitrectomy, but triamcinolone was ineffective (0/1) after trabeculectomy. A two-round Delphi survey asked 28 international experts to rate both the inflammatory potential of different eye surgeries and their agreement with different treatment protocols. They rated trabeculectomy, RD surgery and combined phacovitrectomy as more inflammatory than cataract surgery. Vitrectomies for macular hole or epiretinal membrane were not deemed more inflammatory than cataract surgery. For trabeculectomy, they preferred to treat longer than for cataract surgery (NSAID + corticosteroid three times a day for 2 months vs 1 month). For vitrectomy alone, RD surgery and combined phacovitrectomy, the panel preferred the same treatment as for cataract surgery (NSAID + corticosteroid three times a day for 1 month). The discrepancy between preferred treatment and perception of the eye's inflammatory status by the experts for RD and combined vitreoretinal surgeries highlights the need for RCTs to establish treatment guidelines. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Differences in gaze behaviour of expert and junior surgeons performing open inguinal hernia repair.

PubMed

Tien, Tony; Pucher, Philip H; Sodergren, Mikael H; Sriskandarajah, Kumuthan; Yang, Guang-Zhong; Darzi, Ara

2015-02-01

Various fields have used gaze behaviour to evaluate task proficiency. This may also apply to surgery for the assessment of technical skill, but has not previously been explored in live surgery. The aim was to assess differences in gaze behaviour between expert and junior surgeons during open inguinal hernia repair. Gaze behaviour of expert and junior surgeons (defined by operative experience) performing the operation was recorded using eye-tracking glasses (SMI Eye Tracking Glasses 2.0, SensoMotoric Instruments, Germany). Primary endpoints were fixation frequency (steady eye gaze rate) and dwell time (fixation and saccades duration) and were analysed for designated areas of interest in the subject's visual field. Secondary endpoints were maximum pupil size, pupil rate of change (change frequency in pupil size) and pupil entropy (predictability of pupil change). NASA TLX scale measured perceived workload. Recorded metrics were compared between groups for the entire procedure and for comparable procedural segments. Twenty-five cases were recorded, with 13 operations analysed, from 9 surgeons giving 630 min of data, recorded at 30 Hz. Experts demonstrated higher fixation frequency (median[IQR] 1.86 [0.3] vs 0.96 [0.3]; P = 0.006) and dwell time on the operative site during application of mesh (792 [159] vs 469 [109] s; P = 0.028), closure of the external oblique (1.79 [0.2] vs 1.20 [0.6]; P = 0.003) (625 [154] vs 448 [147] s; P = 0.032) and dwelled more on the sterile field during cutting of mesh (716 [173] vs 268 [297] s; P = 0.019). NASA TLX scores indicated experts found the procedure less mentally demanding than juniors (3 [2] vs 12 [5.2]; P = 0.038). No subjects reported problems with wearing of the device, or obstruction of view. Use of portable eye-tracking technology in open surgery is feasible, without impinging surgical performance. Differences in gaze behaviour during open inguinal hernia repair can be seen between expert and junior surgeons and may have uses for assessment of surgical skill.

A Systematic Approach for Obtaining Performance on Matrix-Like Operations

NASA Astrophysics Data System (ADS)

Veras, Richard Michael

Scientific Computation provides a critical role in the scientific process because it allows us ask complex queries and test predictions that would otherwise be unfeasible to perform experimentally. Because of its power, Scientific Computing has helped drive advances in many fields ranging from Engineering and Physics to Biology and Sociology to Economics and Drug Development and even to Machine Learning and Artificial Intelligence. Common among these domains is the desire for timely computational results, thus a considerable amount of human expert effort is spent towards obtaining performance for these scientific codes. However, this is no easy task because each of these domains present their own unique set of challenges to software developers, such as domain specific operations, structurally complex data and ever-growing datasets. Compounding these problems are the myriads of constantly changing, complex and unique hardware platforms that an expert must target. Unfortunately, an expert is typically forced to reproduce their effort across multiple problem domains and hardware platforms. In this thesis, we demonstrate the automatic generation of expert level high-performance scientific codes for Dense Linear Algebra (DLA), Structured Mesh (Stencil), Sparse Linear Algebra and Graph Analytic. In particular, this thesis seeks to address the issue of obtaining performance on many complex platforms for a certain class of matrix-like operations that span across many scientific, engineering and social fields. We do this by automating a method used for obtaining high performance in DLA and extending it to structured, sparse and scale-free domains. We argue that it is through the use of the underlying structure found in the data from these domains that enables this process. Thus, obtaining performance for most operations does not occur in isolation of the data being operated on, but instead depends significantly on the structure of the data.

The role of artificial intelligence and expert systems in increasing STS operations productivity

NASA Technical Reports Server (NTRS)

Culbert, C.

1985-01-01

Artificial Intelligence (AI) is discussed. A number of the computer technologies pioneered in the AI world can make significant contributions to increasing STS operations productivity. Application of expert systems, natural language, speech recognition, and other key technologies can reduce manpower while raising productivity. Many aspects of STS support lend themselves to this type of automation. The artificial intelligence section of the mission planning and analysis division has developed a number of functioning prototype systems which demonstrate the potential gains of applying AI technology.

A knowledge-based system for monitoring the electrical power system of the Hubble Space Telescope

NASA Technical Reports Server (NTRS)

Eddy, Pat

1987-01-01

The design and the prototype for the expert system for the Hubble Space Telescope's electrical power system are discussed. This prototype demonstrated the capability to use real time data from a 32k telemetry stream and to perform operational health and safety status monitoring, detect trends such as battery degradation, and detect anomalies such as solar array failures. This prototype, along with the pointing control system and data management system expert systems, forms the initial Telemetry Analysis for Lockheed Operated Spacecraft (TALOS) capability.

An fMRI study on the influence of sommeliers' expertise on the integration of flavor

PubMed Central

Pazart, Lionel; Comte, Alexandre; Magnin, Eloi; Millot, Jean-Louis; Moulin, Thierry

2014-01-01

Flavors guide consumers' choice of foodstuffs, preferring those that they like and meet their needs, and dismissing those for which they have a conditioned aversion. Flavor affects the learning and consumption of foods and drinks; what is already well-known is favored and what is new is apprehended. The flavor of foodstuffs is also crucial in explaining some eating behaviors such as overconsumption. The “blind” taste test of wine is a good model for assessing the ability of people to convert mouth feelings into flavor. To determine the relative importance of memory and sensory capabilities, we present the results of an fMRI neuro-imaging study involving 10 experts and 10 matched control subjects using wine as a stimulus in a blind taste test, focusing primarily on the assessment of flavor integration. The results revealed activations in the brain areas involved in sensory integration, both in experts and control subjects (insula, frontal operculum, orbitofrontal cortex, amygdala). However, experts were mainly characterized by a more immediate and targeted sensory reaction to wine stimulation with an economic mechanism reducing effort than control subjects. Wine experts showed brainstem and left-hemispheric activations in the hippocampal and parahippocampal formations and the temporal pole, whereas control subjects showed activations in different associative cortices, predominantly in the right hemisphere. These results also confirm that wine experts work simultaneously on sensory quality assessment and on label recognition of wine. PMID:25360093

Second-line treatment for metastatic clear cell renal cell cancer: experts' consensus algorithms.

PubMed

Rothermundt, C; von Rappard, J; Eisen, T; Escudier, B; Grünwald, V; Larkin, J; McDermott, D; Oldenburg, J; Porta, C; Rini, B; Schmidinger, M; Sternberg, C N; Putora, P M

2017-04-01

Second-line systemic treatment options for metastatic clear cell renal cell cancer (mccRCC) are diverse and treatment strategies are variable among experts. Our aim was to investigate the approach for the second-line treatment after first-line therapy with a tyrosine kinase inhibitor (TKI). Recently two phase III trials have demonstrated a potential role for nivolumab (NIV) and cabozantinib (CAB) in this setting. We aimed to estimate the impact of these trials on clinical decision making. Eleven international experts were asked to provide their treatment strategies for second-line systemic therapy for mccRCC in the current setting and once NIV and CAB will be approved and available. The treatment strategies were analyzed with the objective consensus approach. The analysis of the decision trees revealed everolimus (EVE), axitinib (AXI), NIV and TKI switch (sTKI) as therapeutic options after first-line TKI therapy in the current situation and mostly NIV and CAB in the future setting. The most commonly used criteria for treatment decisions were duration of response, TKI tolerance and zugzwang a composite of several related criteria. In contrast to the first-line setting, recommendations for second-line systemic treatment of mccRCC among experts were not as heterogeneous. The agents mostly used after disease progression on a first-line TKI included: EVE, AXI, NIV and sTKI. In the future setting of NIV and CAB availability, NIV was the most commonly chosen drug, whereas several experts identified situations where CAB would be preferred.

[Evaluation of practices in the management of scabies in children].

PubMed

Lê, M-S; Richard, M-A; Baumstarck, K; Hesse, S; Gaudy-Marqueste, C; Grob, J-J; Mallet, S

2017-05-01

Scabies has been on the rise in France in recent years and has posed therapeutic problems, mainly due to the withdrawal of benzyl benzoate. The objective of this study was to describe prescribing practices for scabies in children. A national survey was conducted by means of a standardized questionnaire covering various clinical situations of scabies and the drugs used preferentially according to age, which was sent out between December 2014 and March 2015 to members of the clinical research group of the French Society of Paediatric Dermatology. Of the 38 experts contacted, 20 replied. For a typical case of scabies, 55% of the experts initially prescribed oral ivermectin for children aged 6 years, 15% prescribed ivermectin in children aged 2 years, and 5% in infants aged 3 months. Ivermectin was more widely prescribed after failure of prior treatment or recurrence of scabies, on skin lesions or impetigo, if precarious, especially for profuse hyperkeratotic scabies. A total of 35% of the experts reported no prescribing restrictions with regard to patient age or weight. Discrepancies were observed concerning the mode of administration and the time between consecutive doses. Esdepallethrin remained the preferred local treatment among the experts (38% of all topical prescriptions) except in asthmatic children, while permethrin was the least-prescribed topical agent. This study confirms the heterogeneity of our practices. Formal expert recommendations are awaited, particularly concerning the use of ivermectin in infants. Copyright © 2017. Published by Elsevier Masson SAS.

On the reproducibility of expert-operated and robotic ultrasound acquisitions.

PubMed

Kojcev, Risto; Khakzar, Ashkan; Fuerst, Bernhard; Zettinig, Oliver; Fahkry, Carole; DeJong, Robert; Richmon, Jeremy; Taylor, Russell; Sinibaldi, Edoardo; Navab, Nassir

2017-06-01

We present the evaluation of the reproducibility of measurements performed using robotic ultrasound imaging in comparison with expert-operated sonography. Robotic imaging for interventional procedures may be a valuable contribution, but requires reproducibility for its acceptance in clinical routine. We study this by comparing repeated measurements based on robotic and expert-operated ultrasound imaging. Robotic ultrasound acquisition is performed in three steps under user guidance: First, the patient is observed using a 3D camera on the robot end effector, and the user selects the region of interest. This allows for automatic planning of the robot trajectory. Next, the robot executes a sweeping motion following the planned trajectory, during which the ultrasound images and tracking data are recorded. As the robot is compliant, deviations from the path are possible, for instance due to patient motion. Finally, the ultrasound slices are compounded to create a volume. Repeated acquisitions can be performed automatically by comparing the previous and current patient surface. After repeated image acquisitions, the measurements based on acquisitions performed by the robotic system and expert are compared. Within our case series, the expert measured the anterior-posterior, longitudinal, transversal lengths of both of the left and right thyroid lobes on each of the 4 healthy volunteers 3 times, providing 72 measurements. Subsequently, the same procedure was performed using the robotic system resulting in a cumulative total of 144 clinically relevant measurements. Our results clearly indicated that robotic ultrasound enables more repeatable measurements. A robotic ultrasound platform leads to more reproducible data, which is of crucial importance for planning and executing interventions.

A scheduling and diagnostic system for scientific satellite GEOTAIL using expert system

NASA Technical Reports Server (NTRS)

Nakatani, I; Hashimoto, M.; Mukai, T.; Obara, T.; Nishigori, N.

1994-01-01

The Intelligent Satellite Control Software (ISACS) for the geoMagnetic tail observation satellite named GEOTAIL (launched in July 1992) has been successfully developed. ISACS has made it possible by applying Artificial Intelligence (AI) technology including an expert system to autonomously generate a tracking schedule, which originally used to be conducted manually. Using ISACS, a satellite operator can generate a maximum four day period of stored command stream autonomously and can easily confirm its safety. The ISACS system has another function -- to diagnose satellite troubles and to suggest necessary remedies. The workload of satellite operators has drastically been reduced since ISACS has been introduced into the operations of GEOTAIL.

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.

Expert system isssues in automated, autonomous space vehicle rendezvous

NASA Technical Reports Server (NTRS)

Goodwin, Mary Ann; Bochsler, Daniel C.

1987-01-01

The problems involved in automated autonomous rendezvous are briefly reviewed, and the Rendezvous Expert (RENEX) expert system is discussed with reference to its goals, approach used, and knowledge structure and contents. RENEX has been developed to support streamlining operations for the Space Shuttle and Space Station program and to aid definition of mission requirements for the autonomous portions of rendezvous for the Mars Surface Sample Return and Comet Nucleus Sample return unmanned missions. The experience with REMEX to date and recommendations for further development are presented.

A Delphi study and ranking exercise to support commissioning services: future delivery of Thrombectomy services in England.

PubMed

Halvorsrud, Kristoffer; Flynn, Darren; Ford, Gary A; McMeekin, Peter; Bhalla, Ajay; Balami, Joyce; Craig, Dawn; White, Phil

2018-02-22

Intra-arterial thrombectomy is the gold standard treatment for large artery occlusive stroke. However, the evidence of its benefits is almost entirely based on trials delivered by experienced neurointerventionists working in established teams in neuroscience centres. Those responsible for the design and prospective reconfiguration of services need access to a comprehensive and complementary array of information on which to base their decisions. This will help to ensure the demonstrated effects from trials may be realised in practice and account for regional/local variations in resources and skill-sets. One approach to elucidate the implementation preferences and considerations of key experts is a Delphi survey. In order to support commissioning decisions, we aimed using an electronic Delphi survey to establish consensus on the options for future organisation of thrombectomy services among physicians with clinical experience in managing large artery occlusive stroke. A Delphi survey was developed with 12 options for future organisation of thrombectomy services in England. A purposive sampling strategy established an expert panel of stroke physicians from the British Association of Stroke Physicians (BASP) Clinical Standards and/or Executive Membership that deliver 24/7 intravenous thrombolysis. Options with aggregate scores falling within the lowest quartile were removed from the subsequent Delphi round. Options reaching consensus following the two Delphi rounds were then ranked in a final exercise by both the wider BASP membership and the British Society of Neuroradiologists (BSNR). Eleven stroke physicians from BASP completed the initial two Delphi rounds. Three options achieved consensus, with subsequently wider BASP (97%, n = 43) and BSNR members (86%, n = 21) assigning the highest approval rankings in the final exercise for transferring large artery occlusive stroke patients to nearest neuroscience centre for thrombectomy based on local CT/CT Angiography. The initial Delphi rounds ensured optimal reduction of options by an expert panel of stroke physicians, while subsequent ranking exercises allowed remaining options to be ranked by a wider group of experts within stroke to reach consensus. The preferred implementation option for thrombectomy is investigating suspected acute stroke patients by CT/CT Angiography and secondary transfer of large artery occlusive stroke patients to the nearest neuroscience (thrombectomy) centre.

Perceiving the affordance of string tension for power strokes in badminton: expertise allows effective use of all string tensions.

PubMed

Zhu, Qin

2013-01-01

Affordances mean opportunities for action. These affordances are important for sports performance and relevant to the abilities developed by skilled athletes. In racquet sports such as badminton, different players prefer widely different string tension because it is believed to provide opportunities for effective strokes. The current study examined whether badminton players can perceive the affordance of string tension for power strokes and whether the perception of affordance itself changed as a function of skill level. The results showed that string tension constrained the striking performance of both novice and recreational players, but not of expert players. When perceptual capability was assessed, perceptual mode did not affect perception of the optimal string tension. Skilled players successfully perceived the affordance of string tension, but only experts were concerned about saving energy. Our findings demonstrated that perception of the affordance of string tension in badminton was determined by action abilities. Furthermore, experts could adjust the action to maintain a superior level of performance based on the perception of affordance.

Good Thinking or Gut Feeling? Cognitive Reflection and Intuition in Traders, Bankers and Financial Non-Experts

PubMed Central

Thoma, Volker; White, Elliott; Panigrahi, Asha; Strowger, Vanessa; Anderson, Irina

2015-01-01

The current study investigated differences in decision-making style and risk-taking between financial traders, non-trading bank employees, and people not working in finance. Traders scored significantly higher than participants in the other two groups on the cognitive reflection test (CRT) which measures the tendency to inhibit automatic but frequently false responses in reasoning tasks. Scores for traders compared to people outside the banking sector were also higher on a self-rated scale for reflective thinking in decision-making, but there were no differences in self-rated intuitive thinking between groups. Financial risk-taking correlated with cognitive reflection scores and was significantly lower in the non-expert group compared to the other groups working in financial services. Traders in the current study showed no elevated preference to use ‘intuition’ in their decision-making compared to other groups. Overall, these results indicate that compared to non-expert participants financial traders have a higher self-rated tendency for reflective thinking and a greater propensity to inhibit the use of mental shortcuts (heuristics) in decision-making. PMID:25875674

Psychometric properties of a sign language version of the Mini International Neuropsychiatric Interview (MINI).

PubMed

Øhre, Beate; Saltnes, Hege; von Tetzchner, Stephen; Falkum, Erik

2014-05-22

There is a need for psychiatric assessment instruments that enable reliable diagnoses in persons with hearing loss who have sign language as their primary language. The objective of this study was to assess the validity of the Norwegian Sign Language (NSL) version of the Mini International Neuropsychiatric Interview (MINI). The MINI was translated into NSL. Forty-one signing patients consecutively referred to two specialised psychiatric units were assessed with a diagnostic interview by clinical experts and with the MINI. Inter-rater reliability was assessed with Cohen's kappa and "observed agreement". There was 65% agreement between MINI diagnoses and clinical expert diagnoses. Kappa values indicated fair to moderate agreement, and observed agreement was above 76% for all diagnoses. The MINI diagnosed more co-morbid conditions than did the clinical expert interview (mean diagnoses: 1.9 versus 1.2). Kappa values indicated moderate to substantial agreement, and "observed agreement" was above 88%. The NSL version performs similarly to other MINI versions and demonstrates adequate reliability and validity as a diagnostic instrument for assessing mental disorders in persons who have sign language as their primary and preferred language.

Dynamic virtual fixture on the Euclidean group for admittance-type manipulator in deforming environments.

PubMed

Zhang, Dongwen; Zhu, Qingsong; Xiong, Jing; Wang, Lei

2014-04-27

In a deforming anatomic environment, the motion of an instrument suffers from complex geometrical and dynamic constraints, robot assisted minimally invasive surgery therefore requires more sophisticated skills for surgeons. This paper proposes a novel dynamic virtual fixture (DVF) to enhance the surgical operation accuracy of admittance-type medical robotics in the deforming environment. A framework for DVF on the Euclidean Group SE(3) is presented, which unites rotation and translation in a compact form. First, we constructed the holonomic/non-holonomic constraints, and then searched for the corresponded reference to make a distinction between preferred and non-preferred directions. Second, different control strategies are employed to deal with the tasks along the distinguished directions. The desired spatial compliance matrix is synthesized from an allowable motion screw set to filter out the task unrelated components from manual input, the operator has complete control over the preferred directions; while the relative motion between the surgical instrument and the anatomy structures is actively tracked and cancelled, the deviation relative to the reference is compensated jointly by the operator and DVF controllers. The operator, haptic device, admittance-type proxy and virtual deforming environment are involved in a hardware-in-the-loop experiment, human-robot cooperation with the assistance of DVF controller is carried out on a deforming sphere to simulate beating heart surgery, performance of the proposed DVF on admittance-type proxy is evaluated, and both human factors and control parameters are analyzed. The DVF can improve the dynamic properties of human-robot cooperation in a low-frequency (0 ~ 40 rad/sec) deforming environment, and maintain synergy of orientation and translation during the operation. Statistical analysis reveals that the operator has intuitive control over the preferred directions, human and the DVF controller jointly control the motion along the non-preferred directions, the target deformation is tracked actively. The proposed DVF for an admittance-type manipulator is capable of assisting the operator to deal with skilled operations in a deforming environment.

Using Conditional Percentages During Free-Operant Stimulus Preference Assessments to Predict the Effects of Preferred Items on Stereotypy: Preliminary Findings.

PubMed

Frewing, Tyla M; Rapp, John T; Pastrana, Sarah J

2015-09-01

To date, researchers have not identified an efficient methodology for selecting items that will compete with automatically reinforced behavior. In the present study, we identified high preference, high stereotypy (HP-HS), high preference, low stereotypy (HP-LS), low preference, high stereotypy (LP-HS), and low preference, low stereotypy (LP-LS) items based on response allocation to items and engagement in stereotypy during one to three, 30-min free-operant competing stimulus assessments (CSAs). The results showed that access to HP-LS items decreased stereotypy for all four participants; however, the results for other items were only predictive for one participant. Reanalysis of the CSA results revealed that the HP-LS item was typically identified by (a) the combined results of the first 10 min of the three 30-min assessments or (b) the results of one 30-min assessment. The clinical implications for the use of this method, as well as future directions for research, are briefly discussed. © The Author(s) 2015.

An expert system for diagnostics and estimation of steam turbine components condition

NASA Astrophysics Data System (ADS)

Murmansky, B. E.; Aronson, K. E.; Brodov, Yu. M.

2017-11-01

The report describes an expert system of probability type for diagnostics and state estimation of steam turbine technological subsystems components. The expert system is based on Bayes’ theorem and permits to troubleshoot the equipment components, using expert experience, when there is a lack of baseline information on the indicators of turbine operation. Within a unified approach the expert system solves the problems of diagnosing the flow steam path of the turbine, bearings, thermal expansion system, regulatory system, condensing unit, the systems of regenerative feed-water and hot water heating. The knowledge base of the expert system for turbine unit rotors and bearings contains a description of 34 defects and of 104 related diagnostic features that cause a change in its vibration state. The knowledge base for the condensing unit contains 12 hypotheses and 15 evidence (indications); the procedures are also designated for 20 state parameters estimation. Similar knowledge base containing the diagnostic features and faults hypotheses are formulated for other technological subsystems of turbine unit. With the necessary initial information available a number of problems can be solved within the expert system for various technological subsystems of steam turbine unit: for steam flow path it is the correlation and regression analysis of multifactor relationship between the vibration parameters variations and the regime parameters; for system of thermal expansions it is the evaluation of force acting on the longitudinal keys depending on the temperature state of the turbine cylinder; for condensing unit it is the evaluation of separate effect of the heat exchange surface contamination and of the presence of air in condenser steam space on condenser thermal efficiency performance, as well as the evaluation of term for condenser cleaning and for tube system replacement and so forth. With a lack of initial information the expert system enables to formulate a diagnosis, calculating the probability of faults hypotheses, given the degree of the expert confidence in estimation of turbine components operation parameters.

Using patient values and preferences to inform the importance of health outcomes in practice guideline development following the GRADE approach.

PubMed

Zhang, Yuan; Coello, Pablo Alonso; Brożek, Jan; Wiercioch, Wojtek; Etxeandia-Ikobaltzeta, Itziar; Akl, Elie A; Meerpohl, Joerg J; Alhazzani, Waleed; Carrasco-Labra, Alonso; Morgan, Rebecca L; Mustafa, Reem A; Riva, John J; Moore, Ainsley; Yepes-Nuñez, Juan José; Cuello-Garcia, Carlos; AlRayees, Zulfa; Manja, Veena; Falavigna, Maicon; Neumann, Ignacio; Brignardello-Petersen, Romina; Santesso, Nancy; Rochwerg, Bram; Darzi, Andrea; Rojas, Maria Ximena; Adi, Yaser; Bollig, Claudia; Waziry, Reem; Schünemann, Holger J

2017-05-02

There are diverse opinions and confusion about defining and including patient values and preferences (i.e. the importance people place on the health outcomes) in the guideline development processes. This article aims to provide an overview of a process for systematically incorporating values and preferences in guideline development. In 2013 and 2014, we followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to adopt, adapt and develop 226 recommendations in 22 guidelines for the Ministry of Health of the Kingdom of Saudi Arabia. To collect context-specific values and preferences for each recommendation, we performed systematic reviews, asked clinical experts to provide feedback according to their clinical experience, and consulted patient representatives. We found several types of studies addressing the importance of outcomes, including those reporting utilities, non-utility measures of health states based on structured questionnaires or scales, and qualitative studies. Guideline panels used the relative importance of outcomes based on values and preferences to weigh the balance of desirable and undesirable consequences of alternative intervention options. However, we found few studies addressing local values and preferences. Currently there are different but no firmly established processes for integrating patient values and preferences in healthcare decision-making of practice guideline development. With GRADE Evidence-to-Decision (EtD) frameworks, we provide an empirical strategy to find and incorporate values and preferences in guidelines by performing systematic reviews and eliciting information from guideline panel members and patient representatives. However, more research and practical guidance are needed on how to search for relevant studies and grey literature, assess the certainty of this evidence, and best summarize and present the findings.

76 FR 14362 - Policies To Promote Rural Radio Service and To Streamline Allotment and Assignment Procedures

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-16

... set forth in the First R&O, the Priority is premised on the unique ability of Tribes and Tribal... services the Tribal Priority generally operates as a dispositive preference in the application process... Tribal Priority operates as a dispositive preference in the AM commercial and FM NCE application contexts...

Mission Operations Planning with Preferences: An Empirical Study

NASA Technical Reports Server (NTRS)

Bresina, John L.; Khatib, Lina; McGann, Conor

2006-01-01

This paper presents an empirical study of some nonexhaustive approaches to optimizing preferences within the context of constraint-based, mixed-initiative planning for mission operations. This work is motivated by the experience of deploying and operating the MAPGEN (Mixed-initiative Activity Plan GENerator) system for the Mars Exploration Rover Mission. Responsiveness to the user is one of the important requirements for MAPGEN, hence, the additional computation time needed to optimize preferences must be kept within reasonabble bounds. This was the primary motivation for studying non-exhaustive optimization approaches. The specific goals of rhe empirical study are to assess the impact on solution quality of two greedy heuristics used in MAPGEN and to assess the improvement gained by applying a linear programming optimization technique to the final solution.

Design of an Ada expert system shell for the VHSIC avionic modular flight processor

NASA Technical Reports Server (NTRS)

Fanning, F. Jesse

1992-01-01

The Embedded Computer System Expert System Shell (ES Shell) is an Ada-based expert system shell developed at the Avionics Laboratory for use on the VHSIC Avionic Modular Processor (VAMP) running under the Ada Avionics Real-Time Software (AARTS) Operating System. The ES Shell provides the interface between the expert system and the avionics environment, and controls execution of the expert system. Testing of the ES Shell in the Avionics Laboratory's Integrated Test Bed (ITB) has demonstrated its ability to control a non-deterministic software application executing on the VAMP's which can control the ITB's real-time closed-loop aircraft simulation. The results of these tests and the conclusions reached in the design and development of the ES Shell have played an important role in the formulation of the requirements for a production-quality expert system inference engine, an ingredient necessary for the successful use of expert systems on the VAMP embedded avionic flight processor.

OFMspert: An architecture for an operator's associate that evolves to an intelligent tutor

NASA Technical Reports Server (NTRS)

Mitchell, Christine M.

1991-01-01

With the emergence of new technology for both human-computer interaction and knowledge-based systems, a range of opportunities exist which enhance the effectiveness and efficiency of controllers of high-risk engineering systems. The design of an architecture for an operator's associate is described. This associate is a stand-alone model-based system designed to interact with operators of complex dynamic systems, such as airplanes, manned space systems, and satellite ground control systems in ways comparable to that of a human assistant. The operator function model expert system (OFMspert) architecture and the design and empirical validation of OFMspert's understanding component are described. The design and validation of OFMspert's interactive and control components are also described. A description of current work in which OFMspert provides the foundation in the development of an intelligent tutor that evolves to an assistant, as operator expertise evolves from novice to expert, is provided.

Don't Forget the Doctor: Gastroenterologists' Preferences on the Development of mHealth Tools for Inflammatory Bowel Disease.

PubMed

van Mierlo, Trevor; Fournier, Rachel; Fedorak, Richard

2015-01-21

Inflammatory bowel disease (IBD) encompasses a number of disorders of the gastrointestinal tract. Treatment for IBD is lifelong and complex, and the majority of IBD patients seek information on the Internet. However, research has found existing digital resources to be of questionable quality and that patients find content lacking. Gastroenterologists are frontline sources of information for North American IBD patients, but their opinions and preferences for digital content, design, and utility have not been investigated. The purpose of this study is to systematically explore gastroenterologists' perceptions of, and design preferences for, mHealth tools. Our goal was to critically assess these issues and elicit expert feedback by seeking consensus with Canadian gastroenterologists. Using a qualitative approach, a closed meeting with 7 gastroenterologists was audio recorded and field notes taken. To synthesize results, an anonymous questionnaire was collected at the end of the session. Participant-led discussion themes included methodological approaches to non-adherence, concordance, patient-centricity, and attributes of digital tools that would be actively supported and promoted. Survey results indicated that 4 of the 7 gastroenterologists had experienced patients bringing digital resources to a visit, but 5 found digital patient resources to be inaccurate or irrelevant. All participants agreed that digital tools were of increasing importance and could be leveraged to aid in consultations and save time. When asked to assess digital attributes that they would be confident to refer patients to, all seven indicated that the inclusion of evidence-based facts were of greatest importance. Patient peer-support networks were deemed an asset but only if closely monitored by experts. When asked about interventions, nearly all (6/7) preferred tools that addressed a mix of compliance and concordance, and only one supported the development of tools that focused on compliance. Participants confirmed that they would actively refer patients and other physicians to digital resources. However, while a number of digital IBD tools exist, gastroenterologists would be reluctant to endorse them. Gastroenterologists appear eager to use digital resources that they believe benefit the physician-patient relationship, but despite the trend of patient-centric tools that focus on concordance (shared decision making and enlightened communication between patients and their health care providers), they would prefer digital tools that highlight compliance (patient following orders). This concordance gap highlights an issue of disparity in digital health: patients may not use tools that physicians promote, and physicians may not endorse tools that patients will use. Further research investigating the concordance gap, and tensions between physician preferences and patient needs, is required.

Methods for optimizing solutions when considering group arguments by team of experts

NASA Astrophysics Data System (ADS)

Chernyi, Sergei; Budnik, Vlad

2017-11-01

The article is devoted to methods of expert evaluation. The technology of expert evaluation is presented from the standpoint of precedent structures. In this paper, an aspect of the mathematical basis for constructing a component of decision analysis is considered. In fact, this approach leaves out any identification of their knowledge and skills of simulating organizational and manufacturing situations and taking efficient managerial decisions; it doesn't enable any identification and assessment of their knowledge on the basis of multi-informational and least loss-making methods and information technologies. Hence the problem is to research and develop a methodology for systemic identification of professional problem-focused knowledge acquired by employees operating adaptive automated systems of training management (AASTM operators), which shall also further the theory and practice of the intelligence-related aspects thereof.

Real time data acquisition for expert systems in Unix workstations at Space Shuttle Mission Control

NASA Technical Reports Server (NTRS)

Muratore, John F.; Heindel, Troy A.; Murphy, Terri B.; Rasmussen, Arthur N.; Gnabasik, Mark; Mcfarland, Robert Z.; Bailey, Samuel A.

1990-01-01

A distributed system of proprietary engineering-class workstations is incorporated into NASA's Space Shuttle Mission-Control Center to increase the automation of mission control. The Real-Time Data System (RTDS) allows the operator to utilize expert knowledge in the display program for system modeling and evaluation. RTDS applications are reviewed including: (1) telemetry-animated communications schematics; (2) workstation displays of systems such as the Space Shuttle remote manipulator; and (3) a workstation emulation of shuttle flight instrumentation. The hard and soft real-time constraints are described including computer data acquisition, and the support techniques for the real-time expert systems include major frame buffers for logging and distribution as well as noise filtering. The incorporation of the workstations allows smaller programming teams to implement real-time telemetry systems that can improve operations and flight testing.

Displaced mid-shaft clavicular fractures: is conservative treatment still preferred?

PubMed

Brin, Yaron S; Palmanovich, Ezequiel; Dolev, Eran; Nyska, Meir; Kish, Benyamin J

2014-12-01

A clavicular fracture accounts for 2.6%-5% of adult fractures. Fractures in the middle-third (OTA 15-B) represent 69%-82% of all clavicular fractures. There is no consensus among orthopedic surgeons regarding treatment for these fractures: many support conservative treatment even for displaced middle-third clavicular fractures, while others choose operative treatment. To assess the attitudes of orthopedic surgeons regarding treatment of displaced mid-shaft clavicular fractures. We conducted a survey in which we interviewed orthopedic surgeons from various countries during the 2012 EFORT meeting in Berlin. The questionnaire included an X-ray of a displaced middle-third clavicular fracture, as well as questions regarding the surgeon's proposed treatment plan. A total of 177 orthopedic surgeons completed the questionnaire; 49% preferred operative treatment for a displaced middle-third clavicular fracture. Among the orthopedic trauma specialists, 58% suggested operative treatment, as did 82% of shoulder specialists. Most surgeons preferred a locking plate for fixation. The treatment approach for a displaced middle-third clavicular fracture seems to be evenly split between conservative and operative approaches. The tendency toward operative treatment was.even more remarkable among orthopedic trauma specialists and shoulder specialists who completed the questionnaire. Most surgeons prefer a locking plate as a fixation system for this type of fracture.

Learning styles and teaching/learning strategy preferences: implications for educating nurses in critical care, the operating room, and infection control.

PubMed

Goldrick, B; Gruendemann, B; Larson, E

1993-01-01

To assess the learning styles and educational strategy preferences among critical care nurses, operating room nurses, and infection control practitioners. Descriptive multicenter survey using a self-report questionnaire. 108 hospitals from nine geographic regions of the United States. A random sample of 303 (93%) nurses in the three specialties responded to the survey questionnaires. The majority of participants (64%) had an abstract learning style and preferred the self-directed, discovery approach to learning. Nurses may be more abstract in their learning styles than previously reported. Experiential learning theory is an effective means of identifying nurses' learning styles and teaching/learning preferences, which can then be used to plan basic and continuing educational programs.

Visual Cues for an Adaptive Expert System.

ERIC Educational Resources Information Center

Miller, Helen B.

NCR (National Cash Register) Corporation is pursuing opportunities to make their point of sale (POS) terminals easy to use and easy to learn. To approach the goal of making the technology invisible to the user, NCR has developed an adaptive expert prototype system for a department store POS operation. The structure for the adaptive system, the…

The influence of expertise on brain activation of the action observation network during anticipation of tennis and volleyball serves.

PubMed

Balser, Nils; Lorey, Britta; Pilgramm, Sebastian; Naumann, Tim; Kindermann, Stefan; Stark, Rudolf; Zentgraf, Karen; Williams, A Mark; Munzert, Jörn

2014-01-01

In many daily activities, and especially in sport, it is necessary to predict the effects of others' actions in order to initiate appropriate responses. Recently, researchers have suggested that the action-observation network (AON) including the cerebellum plays an essential role during such anticipation, particularly in sport expert performers. In the present study, we examined the influence of task-specific expertise on the AON by investigating differences between two expert groups trained in different sports while anticipating action effects. Altogether, 15 tennis and 16 volleyball experts anticipated the direction of observed tennis and volleyball serves while undergoing functional magnetic resonance imaging (fMRI). The expert group in each sport acted as novice controls in the other sport with which they had only little experience. When contrasting anticipation in both expertise conditions with the corresponding untrained sport, a stronger activation of AON areas (SPL, SMA), and particularly of cerebellar structures, was observed. Furthermore, the neural activation within the cerebellum and the SPL was linearly correlated with participant's anticipation performance, irrespective of the specific expertise. For the SPL, this relationship also holds when an expert performs a domain-specific anticipation task. Notably, the stronger activation of the cerebellum as well as of the SMA and the SPL in the expertise conditions suggests that experts rely on their more fine-tuned perceptual-motor representations that have improved during years of training when anticipating the effects of others' actions in their preferred sport. The association of activation within the SPL and the cerebellum with the task achievement suggests that these areas are the predominant brain sites involved in fast motor predictions. The SPL reflects the processing of domain-specific contextual information and the cerebellum the usage of a predictive internal model to solve the anticipation task.

Quantitative knowledge acquisition for expert systems

NASA Technical Reports Server (NTRS)

Belkin, Brenda L.; Stengel, Robert F.

1991-01-01

A common problem in the design of expert systems is the definition of rules from data obtained in system operation or simulation. While it is relatively easy to collect data and to log the comments of human operators engaged in experiments, generalizing such information to a set of rules has not previously been a direct task. A statistical method is presented for generating rule bases from numerical data, motivated by an example based on aircraft navigation with multiple sensors. The specific objective is to design an expert system that selects a satisfactory suite of measurements from a dissimilar, redundant set, given an arbitrary navigation geometry and possible sensor failures. The systematic development is described of a Navigation Sensor Management (NSM) Expert System from Kalman Filter convariance data. The method invokes two statistical techniques: Analysis of Variance (ANOVA) and the ID3 Algorithm. The ANOVA technique indicates whether variations of problem parameters give statistically different covariance results, and the ID3 algorithms identifies the relationships between the problem parameters using probabilistic knowledge extracted from a simulation example set. Both are detailed.

Expert systems built by the Expert: An evaluation of OPS5

NASA Technical Reports Server (NTRS)

Jackson, Robert

1987-01-01

Two expert systems were written in OPS5 by the expert, a Ph.D. astronomer with no prior experience in artificial intelligence or expert systems, without the use of a knowledge engineer. The first system was built from scratch and uses 146 rules to check for duplication of scientific information within a pool of prospective observations. The second system was grafted onto another expert system and uses 149 additional rules to estimate the spacecraft and ground resources consumed by a set of prospective observations. The small vocabulary, the IF this occurs THEN do that logical structure of OPS5, and the ability to follow program execution allowed the expert to design and implement these systems with only the data structures and rules of another OPS5 system as an example. The modularity of the rules in OPS5 allowed the second system to modify the rulebase of the system onto which it was grafted without changing the code or the operation of that system. These experiences show that experts are able to develop their own expert systems due to the ease of programming and code reusability in OPS5.

Communication Delays Impact Behavior and Performance Aboard the International Space Station.

PubMed

Kintz, Natalie M; Palinkas, Lawrence A

Long-duration space explorations will involve significant communication delays that will likely impact individual and team outcomes. However, the extent of these impacts and the appropriate countermeasures for their mitigation remain largely unknown. This study examined the feasibility and acceptability of utilizing the International Space Station (ISS) as a research platform to assess the impacts of communication delays on individual and team behavior and performance. For this study, 3 ISS crewmembers and 18 mission support personnel performed 10 tasks identified by subject matter experts as meeting study criteria, 6 tasks without a delay in communication and 4 tasks with a 50-s one-way delay. Assessments of individual and team performance and behavior were obtained after each task. The completion rate of posttask assessments and postmission interviews with astronauts were used to assess feasibility and acceptability. Posttask assessments were completed in 100% of the instances where a crewmember was assigned to a task and in 83% where mission support personnel were involved. Qualitative analysis of postmission interviews found the study to be important and acceptable to the three astronauts. However, they also reported the study was limited in the number and type of tasks included, limitations in survey questions, and preference for open-ended to scaled items. Although the ISS is considered a high fidelity analog for long-duration space missions, future studies of communication delays on the ISS must take into considerations the constraints imposed by mission operations and subject preferences and priorities. Kintz KM, Palinkas LA. Communication delays impact behavior and performance aboard the International Space Station. Aerosp Med Hum Perform. 2017; 87(11):940-946.

[Treatment of pulmonary arterial hypertension].

PubMed

Roman, Antonio; López-Meseguer, Manuel; Domingo, Enric

2015-06-22

Treatment of pulmonary arterial hypertension has achieved significant progress over the past 20 years. Currently, 3 groups of drugs have proven useful for the treatment of this disease: endothelin receptor antagonist, phosphodiesterase inhibitors and prostacyclin and its analogues. It is recommended to initiate treatment with one of these drugs, the choice depending on the initial severity of patient disease and the preferences of the treating physician. When the patient does not have a satisfactory response, new drugs acting at a different pathway are most commonly added. At this time, considering referral for lung transplantation could be an alternative. Most experts recommend grouping maximum experience in what is known as expert centers. Treatment has led to better survival in these patients, but there is still a long way to cure this life-threatening disease. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Accident diagnosis system based on real-time decision tree expert system

NASA Astrophysics Data System (ADS)

Nicolau, Andressa dos S.; Augusto, João P. da S. C.; Schirru, Roberto

2017-06-01

Safety is one of the most studied topics when referring to power stations. For that reason, sensors and alarms develop an important role in environmental and human protection. When abnormal event happens, it triggers a chain of alarms that must be, somehow, checked by the control room operators. In this case, diagnosis support system can help operators to accurately identify the possible root-cause of the problem in short time. In this article, we present a computational model of a generic diagnose support system based on artificial intelligence, that was applied on the dataset of two real power stations: Angra1 Nuclear Power Plant and Santo Antônio Hydroelectric Plant. The proposed system processes all the information logged in the sequence of events before a shutdown signal using the expert's knowledge inputted into an expert system indicating the chain of events, from the shutdown signal to its root-cause. The results of both applications showed that the support system is a potential tool to help the control room operators identify abnormal events, as accidents and consequently increase the safety.

Expert system training and control based on the fuzzy relation matrix

NASA Technical Reports Server (NTRS)

Ren, Jie; Sheridan, T. B.

1991-01-01

Fuzzy knowledge, that for which the terms of reference are not crisp but overlapped, seems to characterize human expertise. This can be shown from the fact that an experienced human operator can control some complex plants better than a computer can. Proposed here is fuzzy theory to build a fuzzy expert relation matrix (FERM) from given rules or/and examples, either in linguistic terms or in numerical values to mimic human processes of perception and decision making. The knowledge base is codified in terms of many implicit fuzzy rules. Fuzzy knowledge thus codified may also be compared with explicit rules specified by a human expert. It can also provide a basis for modeling the human operator and allow comparison of what a human operator says to what he does in practice. Two experiments were performed. In the first, control of liquid in a tank, demonstrates how the FERM knowledge base is elicited and trained. The other shows how to use a FERM, build up from linguistic rules, and to control an inverted pendulum without a dynamic model.

42 CFR 136.121 - Indian preference in training and employment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Indian preference in training and employment. 136... INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Grants for Development, Construction, and Operation of Facilities and Services § 136.121 Indian preference in training and employment...

Content validation of the operational definitions of the nursing diagnoses of activity intolerance, excess fluid volume, and decreased cardiac output in patients with heart failure.

PubMed

de Souza, Vanessa; Zeitoun, Sandra Salloum; Lopes, Camila Takao; de Oliveira, Ana Paula Dias; Lopes, Juliana de Lima; de Barros, Alba Lucia Botura Leite

2014-06-01

To consensually validate the operational definitions of the nursing diagnoses activity intolerance, excessive fluid volume, and decreased cardiac output in patients with decompensated heart failure. Consensual validation was performed in two stages: analogy by similarity of defining characteristics, and development of operational definitions and validation with experts. A total of 38 defining characteristics were found. Operational definitions were developed and content-validated. One hundred percent of agreement was achieved among the seven experts after five rounds. "Ascites" was added in the nursing diagnosis excessive fluid volume. The consensual validation improves interpretation of human response, grounding the selection of nursing interventions and contributing to improved nursing outcomes. Support the assessment of patients with decompensated heart failure. © 2013 NANDA International.

Apache Aviator Evaluation of Dual-Technology Night Vision Systems in Operation Iraqi Freedom (OIF) Urban Combat (Master’s Thesis)

DTIC Science & Technology

2008-01-01

figure 7), this range allowing for both near and far IR. In essence, the system allows the pilot to see what is normally invisible to the naked eye. 8...contributed to the mid- teen percentage (15.8%) preference for its use during reconnaissance operations. To help qualify preference for reconnaissance

Expert agreements and disagreements on induced seismicity by Enhanced Geothermal Systems

NASA Astrophysics Data System (ADS)

Trutnevyte, E.; Azevedo, I. L.

2016-12-01

Enhanced or Engineered Geothermal Systems (EGS) are at an early stage of development and only a handful of projects exist worldwide. In face of limited empirical evidence on EGS induced seismicity, expert elicitation provides a complementary view to quantitative assessments and basic science. We present the results of an international expert elicitation exercise with 14 experts from 6 countries. The elicitation aimed at evaluating induced seismicity hazard and risk for EGS and characterizing associated uncertainty. The state-of-the-art expert elicitation method was used: it combines technical analysis with behavioral science-informed elicitation of expert judgement in order to minimize subjectivity. The experts assessed a harmonized scenario of an EGS plant, its operational characteristics, geological context, and surrounding buildings and infrastructures. The experts provided quantitative estimates of exceedance probabilities of induced M>=3 and M>=5, maximum magnitudes that could be observed, and made judgements on economic loss, injuries, and fatalities in the case of M=3 and M=5. The experts also rated the importance of factors that influence induced seismicity hazard and risk (e.g. reservoir depth, injected volumes, exposed building stock etc.) and the potential uncertainty reductions through future research. We present the findings of this elicitation and highlight the points of expert agreements and disagreements.

Transformation reborn: A new generation expert system for planning HST operations

NASA Technical Reports Server (NTRS)

Gerb, Andrew

1991-01-01

The Transformation expert system (TRANS) converts proposals for astronomical observations with the Hubble Space Telescope (HST) into detailed observing plans. It encodes expert knowledge to solve problems faced in planning and commanding HST observations to enable their processing by the Science Operations Ground System (SOGS). Among these problems are determining an acceptable order of executing observations, grouping of observations to enhance efficiency and schedulability, inserting extra observations when necessary, and providing parameters for commanding HST instruments. TRANS is currently an operational system and plays a critical role in the HST ground system. It was originally designed using forward-chaining provided by the OPS5 expert system language, but has been reimplemented using a procedural knowledge base. This reimplementation was forced by the explosion in the amount of OPS5 code required to specify the increasingly complicated situations requiring expert-level intervention by the TRANS knowledge base. This problem was compounded by the difficulty of avoiding unintended interaction between rules. To support the TRANS knowledge base, XCL, a small but powerful extension to Commom Lisp was implemented. XCL allows a compact syntax for specifying assignments and references to object attributes. XCL also allows the capability to iterate over objects and perform keyed lookup. The reimplementation of TRANS has greatly diminished the effort needed to maintain and enhance it. As a result of this, its functions have been expanded to include warnings about observations that are difficult or impossible to schedule or command, providing data to aid SPIKE, an intelligent planning system used for HST long-term scheduling, and providing information to the Guide Star Selection System (GSSS) to aid in determination of the long range availability of guide stars.

Space shuttle onboard navigation console expert/trainer system

NASA Technical Reports Server (NTRS)

Wang, Lui; Bochsler, Dan

1987-01-01

A software system for use in enhancing operational performance as well as training ground controllers in monitoring onboard Space Shuttle navigation sensors is described. The Onboard Navigation (ONAV) development reflects a trend toward following a structured and methodical approach to development. The ONAV system must deal with integrated conventional and expert system software, complex interfaces, and implementation limitations due to the target operational environment. An overview of the onboard navigation sensor monitoring function is presented, along with a description of guidelines driving the development effort, requirements that the system must meet, current progress, and future efforts.

An operation support expert system based on on-line dynamics simulation and fuzzy reasoning for startup schedule optimization in fossil power plants

DOE Office of Scientific and Technical Information (OSTI.GOV)

Matsumoto, H.; Eki, Y.; Kaji, A.

1993-12-01

An expert system which can support operators of fossil power plants in creating the optimum startup schedule and executing it accurately is described. The optimum turbine speed-up and load-up pattern is obtained through an iterative manner which is based on fuzzy resonating using quantitative calculations as plant dynamics models and qualitative knowledge as schedule optimization rules with fuzziness. The rules represent relationships between stress margins and modification rates of the schedule parameters. Simulations analysis proves that the system provides quick and accurate plant startups.

Management Information Systems Design Implications: The Effect of Cognitive Style and Information Presentation on Problem Solving.

DTIC Science & Technology

1987-12-01

my thesis advisor, Dr Dennis E Campbell. Without his expert advice and extreme patience with an INTP like myself, this research would not have been...research was to identify a relationship between psychological type and mode of presentation of information. The * type theory developed ty Carl Jung and...preference rankings for seven differewnt modes of presentation of data. The statistical analyses showed no relationship betveen personality type and

Affirmative Action in American Law Schools: A Briefing before the United States Commission on Civil Rights Held in Washington, D.C., June 16, 2006. Briefing Report

ERIC Educational Resources Information Center

US Commission on Civil Rights, 2007

2007-01-01

On June 16, 2006, a panel of experts briefed members of the U.S. Commission on Civil Rights on affirmative action in American law schools. The panel convened to debate the empirical strength of the research on the effects of racial preferences in law school admissions and the legal and policy implications of the American Bar Association's…

International study of expert judgment on therapeutic use of benzodiazepines and other psychotherapeutic medications: VI. Trends in recommendations for the pharmacotherapy of anxiety disorders, 1992-1997.

PubMed

Uhlenhuth, E H; Balter, M B; Ban, T A; Yang, K

1999-01-01

To assemble expert clinical experience and judgment regarding the treatment of anxiety disorders in a systematic, quantitative manner, particularly with respect to changes during the preceding five years. A panel of 73 internationally recognized experts in the pharmacotherapy of anxiety and depression was constituted by multistage peer nomination. Sixty-six completed a questionnaire in 1992, and 51 of those completed a follow-up questionnaire in 1997. This report focuses on the experts' responses to questions about therapeutic options relevant to seven vignettes describing typical cases of different anxiety disorders. The preferred initial treatment strategy in 1992 was a combination of medication with a psychological therapy for all vignettes except simple phobia, where a psychological procedure alone was favored. There was little change in 1997, primarily some decrease in the choice of psychological therapy and some increase in the choice of medication for social phobia. Experts recommending a medication in 1992 most often chose as first-line treatment a benzodiazepine anxiolytic (BZ) for panic disorder (PD), generalized anxiety disorder (GAD), simple phobia, and adjustment disorder. They recommended a beta-blocker most often for social phobia and a tricyclic anti-depressant (TCA) for agoraphobia and obsessive-compulsive disorder (OCD). Nearly a fourth chose a combination of medications, usually a TCA plus a BZ. In 1997, the expert panel's most frequent recommendation for agoraphobia, PD, and OCD changed to a specific serotonin reuptake inhibitor (SSRI); and they also recommended these compounds more often for GAD, social phobia, and simple phobia. Fewer experts chose BZs or TCAs. However, in 1997 many again chose a combination of medications, often a BZ plus a SSRI, so that, overall, there was only a small decline in recommendations for BZs. As second-line medications (1997 only), the experts recommended SSRIs most often for most vignettes, but a TCA for PD and GAD. Recommendations for a combination of medications rose substantially for most vignettes, usually a BZ plus an antidepressant. Combined cognitive-behavioral therapy plus medication was highly favored by the experts as the initial treatment strategy for anxiety disorders. During the preceding five years, SSRIs displaced older antidepressants as the experts' first-line choices for the pharmacotherapy of anxiety disorders. In case of an unsatisfactory response, the experts' second-line choices more often were an older antidepressant or a combination of an antidepressant plus a BZ. According to the experts' judgements, the BZs, especially combined with an antidepressant, remain mainstays of pharmacotherapy for anxiety disorders.

Expert mission planning and replanning scheduling system for NASA KSC payload operations

NASA Technical Reports Server (NTRS)

Pierce, Roger

1987-01-01

EMPRESS (Expert Mission Planning and REplanning Scheduling System) is an expert system created to assist payload mission planners at Kennedy in the long range planning and scheduling of horizontal payloads for space shuttle flights. Using the current flight manifest, these planners develop mission and payload schedules detailing all processing to be performed in the Operations and Checkout building at Kennedy. With the EMPRESS system, schedules are generated quickly using standard flows that represent the tasks and resources required to process a specific horizontal carrier. Resources can be tracked and resource conflicts can be determined and resolved interactively. Constraint relationships between tasks are maintained and can be enforced when a task is moved or rescheduled. The domain, structure, and functionality of the EMPRESS system is briefly designed. The limitations of the EMPRESS system are described as well as improvements expected with the EMPRESS-2 development.

Mate preferences and infectious disease: theoretical considerations and evidence in humans

PubMed Central

Tybur, Joshua M.; Gangestad, Steven W.

2011-01-01

Mate preferences may operate in part to mitigate the threats posed by infectious disease. In this paper, we outline various ways in which preferring healthy mates can offer direct benefits in terms of pathogen avoidance and indirect benefits in terms of heritable immunity to offspring, as well as the costs that may constrain mate preferences for health. We then pay special attention to empirical work on mate preferences in humans given the depth and breadth of research on human mating. We review this literature and comment on the degree to which human mate preferences may reflect preferences for health. PMID:22042915

Expert systems tools for Hubble Space Telescope observation scheduling

NASA Technical Reports Server (NTRS)

Miller, Glenn; Rosenthal, Don; Cohen, William; Johnston, Mark

1987-01-01

The utility of expert systems techniques for the Hubble Space Telescope (HST) planning and scheduling is discussed and a plan for development of expert system tools which will augment the existing ground system is described. Additional capabilities provided by these tools will include graphics-oriented plan evaluation, long-range analysis of the observation pool, analysis of optimal scheduling time intervals, constructing sequences of spacecraft activities which minimize operational overhead, and optimization of linkages between observations. Initial prototyping of a scheduler used the Automated Reasoning Tool running on a LISP workstation.

Dynamic array processing for computationally intensive expert systems in CLIPS

NASA Technical Reports Server (NTRS)

Athavale, N. N.; Ragade, R. K.; Fenske, T. E.; Cassaro, M. A.

1990-01-01

This paper puts forth an architecture for implementing a loop for advanced data structure of arrays in CLIPS. An attempt is made to use multi-field variables in such an architecture to process a set of data during the decision making cycle. Also, current limitations on the expert system shells are discussed in brief in this paper. The resulting architecture is designed to circumvent the current limitations set by the expert system shell and also by the operating environment. Such advanced data structures are needed for tightly coupling symbolic and numeric computation modules.

An Expert-System Engine With Operative Probabilities

NASA Technical Reports Server (NTRS)

Orlando, N. E.; Palmer, M. T.; Wallace, R. S.

1986-01-01

Program enables proof-of-concepts tests of expert systems under development. AESOP is rule-based inference engine for expert system, which makes decisions about particular situation given user-supplied hypotheses, rules, and answers to questions drawn from rules. If knowledge base containing hypotheses and rules governing environment is available to AESOP, almost any situation within that environment resolved by answering questions asked by AESOP. Questions answered with YES, NO, MAYBE, DON'T KNOW, DON'T CARE, or with probability factor ranging from 0 to 10. AESOP written in Franz LISP for interactive execution.

Evaluation of Fuzzy Rulemaking for Expert Systems for Failure Detection

NASA Technical Reports Server (NTRS)

Laritz, F.; Sheridan, T. B.

1984-01-01

Computer aids in expert systems were proposed to diagnose failures in complex systems. It is shown that the fuzzy set theory of Zadeh offers a new perspective for modeling for humans thinking and language use. It is assumed that real expert human operators of aircraft, power plants and other systems do not think of their control tasks or failure diagnosis tasks in terms of control laws in differential equation form, but rather keep in mind a set of rules of thumb in fuzzy form. Fuzzy set experiments are described.

75 FR 34769 - The University of Wisconsin; Facility Operating License No. R-74; Notice of Acceptance for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-18

... specific statement of the issue of law or fact to be raised or controverted. In addition, the petitioner... alleged facts or expert opinion which support the contention and on which the petitioner intends to rely... to establish those facts or expert opinion. The petition must include sufficient information to show...

Preferred strategies for workforce development: feedback from aged care workers.

PubMed

Choy, Sarojni; Henderson, Amanda

2016-11-01

Objective The aim of the present study was to investigate how aged care workers prefer to learn and be supported in continuing education and training activities. Methods Fifty-one workers in aged care facilities from metropolitan and rural settings across two states of Australia participated in a survey and interviews. Survey responses were analysed for frequencies and interview data provided explanations to the survey findings. Results The three most common ways workers were currently learning and prefer to continue to learn are: (1) everyday learning through work individually; (2) everyday learning through work individually assisted by other workers; and (3) everyday learning plus group training courses at work from the employer. The three most common types of provisions that supported workers in their learning were: (1) working and sharing with another person on the job; (2) direct teaching in a group (e.g. a trainer in a classroom at work); and (3) direct teaching by a workplace expert. Conclusions A wholly practice-based continuing education and training model is best suited for aged care workers. Two variations of this model could be considered: (1) a wholly practice-based model for individual learning; and (2) a wholly practice-based model with guidance from coworkers or other experts. Although the model is preferred by workers and convenient for employers, it needs to be well resourced. What is known about the topic? Learning needs for aged care workers are increasing significantly because of an aging population that demands more care workers. Workforce development is largely 'episodic', based on organisational requirements rather than systematic life-long learning. This study is part of a larger 3-year Australian research to investigate models of continuing education training. What does this paper add? Based on an analysis of survey and interview data from 51 workers, the present study suggests effective models of workforce development for aged care workers. What are the implications for practitioners? The effectiveness of the suggested models necessitates a culture where aged care workers' advancement in the workplace is valued and supported. Those responsible for the development of these workers need to be adequately prepared for mentoring and coaching in the workplace.

Wastewater Plant Operation and Maintenance--A Matter of Growing Concern

ERIC Educational Resources Information Center

Water and Wastes Engineering, 1978

1978-01-01

Responses of two experts to questions concerning wastewater plant operation and maintenance are presented. The responses discuss the scarcity of good personnel, training education available, and examples of existing improvement projects. (MA)

Acceptability and design preferences of supervised injection services among people who inject drugs in a mid-sized Canadian City.

PubMed

Mitra, Sanjana; Rachlis, Beth; Scheim, Ayden; Bardwell, Geoff; Rourke, Sean B; Kerr, Thomas

2017-07-14

Supervised injection services (SIS) have been shown to reduce the public- and individual-level harms associated with injection drug use. While SIS feasibility research has been conducted in large urban centres, little is known about the acceptability of these services among people who inject drugs (PWID) in mid-sized cities. We assessed the prevalence and correlates of willingness to use SIS as well as design and operational preferences among PWID in London, Canada. Between March and April 2016, peer research associates administered a cross-sectional survey to PWID in London. Socio-demographic characteristics, drug-use patterns, and behaviours associated with willingness to use SIS were estimated using bivariable and multivariable logistic regression models. Chi-square tests were used to compare characteristics with expected frequency of SIS use among those willing to use SIS. Design and operational preferences are also described. Of 197 PWID included in this analysis (median age, 39; interquartile range (IQR), 33-50; 38% female), 170 (86%) reported willingness to use SIS. In multivariable analyses, being female (adjusted odds ratio (AOR) 0.29; 95% confidence interval (CI) 0.11-0.75) was negatively associated with willingness to use, while public injecting in the last 6 months (AOR 2.76; 95% CI 1.00-7.62) was positively associated with willingness to use. Participants living in unstable housing, those injecting in public, and those injecting opioids and crystal methamphetamine daily reported higher expected frequency of SIS use (p < 0.05). A majority preferred private cubicles for injecting spaces and daytime operational hours, while just under half preferred PWID involved in service operations. High levels of willingness to use SIS were found among PWID in this setting, suggesting that these services may play a role in addressing the harms associated with injection drug use. To maximize the uptake of SIS, programme planners and policy makers should consider the effects of gender and views of PWID regarding SIS design and operational preferences.

Operator adaptation to changes in system reliability under adaptable automation.

PubMed

Chavaillaz, Alain; Sauer, Juergen

2017-09-01

This experiment examined how operators coped with a change in system reliability between training and testing. Forty participants were trained for 3 h on a complex process control simulation modelling six levels of automation (LOA). In training, participants either experienced a high- (100%) or low-reliability system (50%). The impact of training experience on operator behaviour was examined during a 2.5 h testing session, in which participants either experienced a high- (100%) or low-reliability system (60%). The results showed that most operators did not often switch between LOA. Most chose an LOA that relieved them of most tasks but maintained their decision authority. Training experience did not have a strong impact on the outcome measures (e.g. performance, complacency). Low system reliability led to decreased performance and self-confidence. Furthermore, complacency was observed under high system reliability. Overall, the findings suggest benefits of adaptable automation because it accommodates different operator preferences for LOA. Practitioner Summary: The present research shows that operators can adapt to changes in system reliability between training and testing sessions. Furthermore, it provides evidence that each operator has his/her preferred automation level. Since this preference varies strongly between operators, adaptable automation seems to be suitable to accommodate these large differences.

Social interaction, food, scent or toys? A formal assessment of domestic pet and shelter cat (Felis silvestris catus) preferences.

PubMed

Vitale Shreve, Kristyn R; Mehrkam, Lindsay R; Udell, Monique A R

2017-08-01

Domestic cats (Felis silvestris catus) engage in a variety of relationships with humans and can be conditioned to engage in numerous behaviors using Pavlovian and operant methods Increasingly cat cognition research is providing evidence of their complex socio-cognitive and problem solving abilities. Nonetheless, it is still common belief that cats are not especially sociable or trainable. This disconnect may be due, in part, to a lack of knowledge of what stimuli cats prefer, and thus may be most motivated to work for. The current study investigated domestic cat preferences at the individual and population level using a free operant preference assessment. Adult cats from two populations (pet and shelter) were presented with three stimuli within each of the following four categories: human social interaction, food, toy, and scent. Proportion of time interacting with each stimulus was recorded. The single most-preferred stimulus from each of the four categories were simultaneously presented in a final session to determine each cat's most-preferred stimulus overall. Although there was clear individual variability in cat preference, social interaction with humans was the most-preferred stimulus category for the majority of cats, followed by food. This was true for cats in both the pet and shelter population. Future research can examine the use of preferred stimuli as enrichment in applied settings and assess individual cats' motivation to work for their most-preferred stimulus as a measure of reinforcer efficacy. Copyright © 2017 Elsevier B.V. All rights reserved.

Alternatives Generation and Analysis for Heat Removal from High Level Waste Tanks

DOE Office of Scientific and Technical Information (OSTI.GOV)

WILLIS, W.L.

This document addresses the preferred combination of design and operational configurations to provide heat removal from high-level waste tanks during Phase 1 waste feed delivery to prevent the waste temperature from exceeding tank safety requirement limits. An interim decision for the preferred method to remove the heat from the high-level waste tanks during waste feed delivery operations is presented herein.

Esophageal cancer screening in achalasia: is there a consensus?

PubMed

Ravi, K; Geno, D M; Katzka, D A

2015-04-01

Achalasia is an important but relatively uncommon disorder. While highly effective therapeutic options exist, esophageal cancer remains a long-term potential complication. The risk of esophageal cancer in achalasia remains unclear, with current guidelines recommending against routine endoscopic screening. However, given limited data and conflicting opinion, it is unknown whether consensus regarding screening practices in achalasia among experts exists. A 10-question survey to assess screening practices in achalasia was created and distributed to 28 experts in the area of achalasia. Experts were identified based on publications and meeting presentations in the field. Survey responses were received from 17 of 28 (61%) experts. Wide geographic distribution was seen among respondents, with eight (47%) from Europe or Australia, seven (41%) from the United States, and two (12%) from Asia. Screening for esophageal cancer was inconsistent, with nine (53%) experts endorsing the practice and eight (47%) not. Screening practices did not differ among geographic regions. No consensus regarding the risk for esophageal cancer in achalasia was seen, with three experts reporting no increased risk compared with the general population, eight experts a lifetime risk of 0.1-0.5%, three experts a 0.5-1% risk, two experts a 1-2% risk, and one expert a 3-5% risk. However, these differences in perception of risk did not influence screening practices. Upper endoscopy was utilized among all experts who endorsed screening. However, practices still varied with screening commencing at or within 1 year of diagnosis in two practices compared with 5 and 10 years in three respective practices each. Surveillance intervals also varied, performed every 2 years in four practices, every 3 years in four practices, and every 5 years in one practice. Practice variation in the management of achalasia itself was also seen, with initial treatment with Heller myotomy endorsed by eight experts, pneumatic dilation by five experts, and two each endorsing peroral endoscopic myotomy or no specific preference. In addition, while 82% (14/17) of experts endorsed long-term follow up of patients, no consensus regarding long-term follow up existed, with annual follow up in eight practices, every 3-6 months in three practices, and every 2 years in three practices. Large practice variation in the long-term management of achalasia exists among experts in the field. Only a slight majority of experts endorse screening for esophageal cancer in achalasia, and no consensus exists regarding how surveillance should be structured even among this group. Interestingly, the lack of consensus on cancer screening parallels a lack of agreement on initial treatment of achalasia. These findings suggest a need for greater homogeneity in the management of longstanding achalasia and cancer screening. Further, this study highlights the need for more data on this topic to foster greater agreement. © 2014 International Society for Diseases of the Esophagus.

Example-based learning: effects of model expertise in relation to student expertise.

PubMed

Boekhout, Paul; van Gog, Tamara; van de Wiel, Margje W J; Gerards-Last, Dorien; Geraets, Jacques

2010-12-01

Worked examples are very effective for novice learners. They typically present a written-out ideal (didactical) solution for learners to study. This study used worked examples of patient history taking in physiotherapy that presented a non-didactical solution (i.e., based on actual performance). The effects of model expertise (i.e., worked example based on advanced, third-year student model or expert physiotherapist model) in relation to students' expertise (i.e., first- or second-year) were investigated. One hundred and thirty-four physiotherapy students (61 first-year and 73 second-year). Design was 2 × 2 factorial with factors 'Student Expertise' (first-year vs. second-year) and 'Model Expertise' (expert vs. advanced student). Within expertise levels, students were randomly assigned to the Expert Example or the Advanced Student Example condition. All students studied two examples (content depending on their assigned condition) and then completed a retention and test task. They rated their invested mental effort after each example and test task. Second-year students invested less mental effort in studying the examples, and in performing the retention and transfer tasks than first-year students. They also performed better on the retention test, but not on the transfer test. In contrast to our hypothesis, there was no interaction between student expertise and model expertise: all students who had studied the Expert examples performed better on the transfer test than students who had studied Advanced Student Examples. This study suggests that when worked examples are based on actual performance, rather than an ideal procedure, expert models are to be preferred over advanced student models.

Using VARK Approach for Assessing Preferred Learning Styles of First Year Medical Sciences Students: A Survey from Iran.

PubMed

Peyman, Hadi; Sadeghifar, Jamil; Khajavikhan, Javaher; Yasemi, Masood; Rasool, Mohammad; Yaghoubi, Yasemi Monireh; Nahal, Monireh Mohammad Hassan; Karim, Hemati

2014-08-01

Preferred learning styles of learners are different, which depend on tastes, mentality preparedness, as well as physical condition, in terms of sensory modalities. Identifying and employing appropriate learning styles could play an important role in selecting teaching styles, which can improve education ultimately. The present study aimed to assess the diversity of learning styles amongst medical students of a medical sciences university which was located west of Iran, in 2010. A cross-sectional study which employed VARK learning style's questionnaire was done on 141 first year medical sciences students at Ilam University of Medical Sciences in 2010. Data was collected with use of VARK questionnaire. The validity of the questionnaire was assessed on basis of experts' views and its reliability was calculated by using Cronbach's alpha coefficients (α=0.86). Data were analysed by using SPSS software and Chi-square test. Overall, 41.6% of the samples preferred to use a single learning style (Uni-modal). Of these, 17.7% preferred the Aural style, 17% preferred Reading and Writing, 6.4% preferred Kinesthetic style and 0.7% preferred Visual styles. Among the rest of the 82 students who preferred more than one style (multimodal), 17% chose two modes (bimodal), 13.5% chose three modes (tri-modal), and 27.6% chose four modes (quad-modal). There was a significant difference between educational levels and majors on one hand and choice of quad modal of VARK styles on the other hand (p=0.008). A significant association was also found between participants' genders and selection of visual and reading/writing styles (p=0.03). The preferred learning styles of medical students in the present study were aural and reading/writing. It is suggested that all medical students must be tested to determine their desired learning styles by using VARK questionnaire, also to choose appropriate teaching methods and to improve educational goals.

Techniques and implementation of the embedded rule-based expert system using Ada

NASA Technical Reports Server (NTRS)

Liberman, Eugene M.; Jones, Robert E.

1991-01-01

Ada is becoming an increasingly popular programming language for large Government-funded software projects. Ada with its portability, transportability, and maintainability lends itself well to today's complex programming environment. In addition, expert systems have also assured a growing role in providing human-like reasoning capability and expertise for computer systems. The integration of expert system technology with Ada programming language, specifically a rule-based expert system using an ART-Ada (Automated Reasoning Tool for Ada) system shell is discussed. The NASA Lewis Research Center was chosen as a beta test site for ART-Ada. The test was conducted by implementing the existing Autonomous Power EXpert System (APEX), a Lisp-base power expert system, in ART-Ada. Three components, the rule-based expert system, a graphics user interface, and communications software make up SMART-Ada (Systems fault Management with ART-Ada). The main objective, to conduct a beta test on the ART-Ada rule-based expert system shell, was achieved. The system is operational. New Ada tools will assist in future successful projects. ART-Ada is one such tool and is a viable alternative to the straight Ada code when an application requires a rule-based or knowledge-based approach.

12 CFR 1101.3 - Organization and methods of operation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Organization and methods of operation. 1101.3..., PROCEDURES, PUBLIC INFORMATION § 1101.3 Organization and methods of operation. (a) Statutory requirements... securing the services, as needed, of staff experts from the five agencies; supervising research and other...

Robust nonlinear system identification: Bayesian mixture of experts using the t-distribution

NASA Astrophysics Data System (ADS)

Baldacchino, Tara; Worden, Keith; Rowson, Jennifer

2017-02-01

A novel variational Bayesian mixture of experts model for robust regression of bifurcating and piece-wise continuous processes is introduced. The mixture of experts model is a powerful model which probabilistically splits the input space allowing different models to operate in the separate regions. However, current methods have no fail-safe against outliers. In this paper, a robust mixture of experts model is proposed which consists of Student-t mixture models at the gates and Student-t distributed experts, trained via Bayesian inference. The Student-t distribution has heavier tails than the Gaussian distribution, and so it is more robust to outliers, noise and non-normality in the data. Using both simulated data and real data obtained from the Z24 bridge this robust mixture of experts performs better than its Gaussian counterpart when outliers are present. In particular, it provides robustness to outliers in two forms: unbiased parameter regression models, and robustness to overfitting/complex models.

The Generic Spacecraft Analyst Assistant (gensaa): a Tool for Developing Graphical Expert Systems

NASA Technical Reports Server (NTRS)

Hughes, Peter M.

1993-01-01

During numerous contacts with a satellite each day, spacecraft analysts must closely monitor real-time data. The analysts must watch for combinations of telemetry parameter values, trends, and other indications that may signify a problem or failure. As the satellites become more complex and the number of data items increases, this task is becoming increasingly difficult for humans to perform at acceptable performance levels. At NASA GSFC, fault-isolation expert systems are in operation supporting this data monitoring task. Based on the lessons learned during these initial efforts in expert system automation, a new domain-specific expert system development tool named the Generic Spacecraft Analyst Assistant (GenSAA) is being developed to facilitate the rapid development and reuse of real-time expert systems to serve as fault-isolation assistants for spacecraft analysts. Although initially domain-specific in nature, this powerful tool will readily support the development of highly graphical expert systems for data monitoring purposes throughout the space and commercial industry.

Tracking and data relay satellite fault isolation and correction using PACES: Power and attitude control expert system

NASA Technical Reports Server (NTRS)

Erikson, Carol-Lee; Hooker, Peggy

1989-01-01

The Power and Attitude Control Expert System (PACES) is an object oriented and rule based expert system which provides spacecraft engineers with assistance in isolating and correcting problems within the Power and Attitude Control Subsystems of the Tracking and Data Relay Satellites (TDRS). PACES is designed to act in a consultant role. It will not interface to telemetry data, thus preserving full operator control over spacecraft operations. The spacecraft engineer will input requested information. This information will include telemetry data, action being performed, problem characteristics, spectral characteristics, and judgments of spacecraft functioning. Questions are answered either by clicking on appropriate responses (for text), or entering numeric values. A context sensitive help facility allows access to additional information when the user has difficulty understanding a question or deciding on an answer. The major functionality of PACES is to act as a knowledge rich system which includes block diagrams, text, and graphics, linked using hypermedia techniques. This allows easy movement among pieces of the knowledge. Considerable documentation of the spacecraft Power and Attitude Control Subsystems is embedded within PACES. The development phase of TDRSS expert system technology is intended to provide NASA with the necessary expertise and capability to define requirements, evaluate proposals, and monitor the development progress of a highly competent expert system for NASA's Tracking and Data Relay Satellite Program.

Hospital operations management: improving organizational efficiency.

PubMed

2013-08-01

Reducing operational inefficiencies represents one of the most promising sources of potential savings in hospitals today. Health Forum convened a panel of hospital executives and industry experts to discuss the daunting challenges and big opportunities that lie ahead.

Development of casthouse expert system for tapping

DOE Office of Scientific and Technical Information (OSTI.GOV)

Takihira, K.; Ino, K.; Yamana, S.

1993-01-01

Although the standardization of casting operations is necessary to secure stable blast furnace operation, intuitive practices (which are by definition non-quantifiable) and experience are prevalent. Because BF operation is a field which is difficult to standardize and reduce to documentary form, the present work had as its goal the standardization of judgments and systematization of information related to taphole opening and closing. The project was carried out in the highly computerized environment at Mizushima No. 3 BF, where the authors introduced an expert system guidance function in February, 1992. Standardization of operations through the use of this guidance system andmore » the completion of guidance function development resulted in better consistency in taphole depths and optimization of the size of the taphole (taphole volume), which have in turn led to improvement in the pig/slag balance and a reduction in the time required for taphole opening.« less

Engaging communication experts in a Delphi process to identify patient behaviors that could enhance communication in medical encounters

PubMed Central

2010-01-01

Background The communication literature currently focuses primarily on improving physicians' verbal and non-verbal behaviors during the medical interview. The Four Habits Model is a teaching and research framework for physician communication that is based on evidence linking specific communication behaviors with processes and outcomes of care. The Model conceptualizes basic communication tasks as "Habits" and describes the sequence of physician communication behaviors during the clinical encounter associated with improved outcomes. Using the Four Habits Model as a starting point, we asked communication experts to identify the verbal communication behaviors of patients that are important in outpatient encounters. Methods We conducted a 4-round Delphi process with 17 international experts in communication research, medical education, and health care delivery. All rounds were conducted via the internet. In round 1, experts reviewed a list of proposed patient verbal communication behaviors within the Four Habits Model framework. The proposed patient verbal communication behaviors were identified based on a review of the communication literature. The experts could: approve the proposed list; add new behaviors; or modify behaviors. In rounds 2, 3, and 4, they rated each behavior for its fit (agree or disagree) with a particular habit. After each round, we calculated the percent agreement for each behavior and provided these data in the next round. Behaviors receiving more than 70% of experts' votes (either agree or disagree) were considered as achieving consensus. Results Of the 14 originally-proposed patient verbal communication behaviors, the experts modified all but 2, and they added 20 behaviors to the Model in round 1. In round 2, they were presented with 59 behaviors and 14 options to remove specific behaviors for rating. After 3 rounds of rating, the experts retained 22 behaviors. This set included behaviors such as asking questions, expressing preferences, and summarizing information. Conclusion The process identified communication tasks and verbal communication behaviors for patients similar to those outlined for physicians in the Four Habits Model. This represents an important step in building a single model that can be applied to teaching patients and physicians the communication skills associated with improved satisfaction and positive outcomes of care. PMID:20403173

Potential-dependent, switchable ion selectivity in aqueous media using titanium disulfide.

PubMed

Srimuk, Pattarachai; Lee, Juhan; Fleischmann, Simon; Aslan, Mesut; Kim, Choonsoo; Presser, Volker

2018-05-01

Selective removal of ions by electrochemical processes is a promising approach to enable various water treatment applications such as water softening or heavy metal removal. Ion intercalation materials have been investigated for their intrinsic ability to prefer one specific ion over others, showing a preference for (small) monovalent ions over multivalent species. In this work, we present for the first time a fundamentally different approach: tunable ion selectivity not by modifying the electrode material, but by changing the operational voltage. We used titanium disulfide which shows distinctly different potentials for the intercalation of different cations and formed thereof binder-free composite electrodes with carbon nanotubes. Capitalizing on this potential difference, we demonstrate controllable cation selectivity by online monitoring the effluent stream during electrochemical operation by inductively coupled plasma optical emission spectrometry for aqueous 50 mM CsCl and MgCl2. We obtained a molar selectivity of Mg2+ over Cs+ of 31 (strong Mg preference) in the potential range between -396 mV and -220 mV vs. Ag/AgCl. By adjusting the operational potential window to -219 mV to +26 mV vs. Ag/AgCl, Cs+ is preferred over Mg2+ by 1.7-times (Cs preference). © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

[Patient-related color preference and color design in the hospital].

PubMed

Schuschke, G; Christiansen, H

1994-06-01

Colour-physiological studies involving volunteers and colour-psychological interviewing of patients with varied diagnoses revealed that, currently, no compelling scientific reasons can be given for coloration in the hospital. Interviewing 68 patients from a number of clinics on the coloration of sick-rooms yielded the following preferred colours, irrespective of the patients' classing into groups by various criteria: Light colours were consistently preferred for all objects such as ceiling, walls, floor, curtains, furniture, and bed linen. It should be emphasized that even white was a desirable colour for ceilings and bed linen. Beige was found to rank first for walls, floors, curtains, and furniture, whereas the colours of wood and grey shared the second rank for floors and furniture. Green and pink ranked second for bed linen. White and green ranked second for walls and curtains, respectively. In view of the heterogeneity, the findings may not be converted into an absolute just as the recommendations by other workers. Still, the patients' wish should be given priority over decreed recommendations by experts when basic considerations of illumination (reflectance!) are allowed for in the particular overall colour design project.

General public knowledge, preferred dosage forms, and beliefs toward medicines in western Saudi Arabia.

PubMed

Alhaddad, Mahmoud S; Abdallah, Qasem M; Alshakhsheer, Sami M; Alosaimi, Salman B; Althmali, Ahmed R; Alahmari, Solaiman A

2014-06-01

To measure general public knowledge, source of knowledge, preferred dosage forms, and beliefs toward medicines. A cross-sectional study design using convenience-sampling technique was used. A pre-validated questionnaire was designed and distributed to the general public through face-to-face interviews. All data were analyzed, and p-values less than 0.05 were considered significant. The study took place in the Clinical Pharmacy Department, Taif University, Taif, Kingdom of Saudi Arabia between August 2012 and February 2013 RESULTS: Nine hundred participants successfully responded to this study. Males represented two-thirds of the respondents (66.8%). In addition, 52% of respondents were of high education level. Modern (74.2%) and alternative medicines (88.7%) were understood by most respondents. Tablets (69.6%) and capsules (37.6%) represented the highest preferred dosage forms. In addition, physicians (66.6%) and pharmacists (46.2%) were the main sources of information regarding medicines. In terms of beliefs, respondents showed wrong beliefs in many statements used in this study. There is a need to improve public knowledge and beliefs toward medicines as well as utilizing public preferred dosage forms. In addition, pharmacists should play a major role in these programs since they are experts on medicines and play a more active role in patient education and counseling.

Automation technology for aerospace power management

NASA Technical Reports Server (NTRS)

Larsen, R. L.

1982-01-01

The growing size and complexity of spacecraft power systems coupled with limited space/ground communications necessitate increasingly automated onboard control systems. Research in computer science, particularly artificial intelligence has developed methods and techniques for constructing man-machine systems with problem-solving expertise in limited domains which may contribute to the automation of power systems. Since these systems perform tasks which are typically performed by human experts they have become known as Expert Systems. A review of the current state of the art in expert systems technology is presented, and potential applications in power systems management are considered. It is concluded that expert systems appear to have significant potential for improving the productivity of operations personnel in aerospace applications, and in automating the control of many aerospace systems.

Advancing satellite operations with intelligent graphical monitoring systems

NASA Technical Reports Server (NTRS)

Hughes, Peter M.; Shirah, Gregory W.; Luczak, Edward C.

1993-01-01

For nearly twenty-five years, spacecraft missions have been operated in essentially the same manner: human operators monitor displays filled with alphanumeric text watching for limit violations or other indicators that signal a problem. The task is performed predominately by humans. Only in recent years have graphical user interfaces and expert systems been accepted within the control center environment to help reduce operator workloads. Unfortunately, the development of these systems is often time consuming and costly. At the NASA Goddard Space Flight Center (GSFC), a new domain specific expert system development tool called the Generic Spacecraft Analyst Assistant (GenSAA) has been developed. Through the use of a highly graphical user interface and point-and-click operation, GenSAA facilitates the rapid, 'programming-free' construction of intelligent graphical monitoring systems to serve as real-time, fault-isolation assistants for spacecraft analysts. Although specifically developed to support real-time satellite monitoring, GenSAA can support the development of intelligent graphical monitoring systems in a variety of space and commercial applications.

75 FR 71702 - Science Advisory Board Staff Office; Request for Nominations of Experts for Review of EPA's Draft...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-24

... Nominations of Experts for Review of EPA's Draft Technical Report Pertaining to Uranium and Thorium In-Situ... expectation is that In-Situ Leach Recovery (ISL/ISR) operations will be the most common type of new uranium... pertaining to Uranium In-Situ Leach Recovery--Post-Closure Stability Monitoring can be found at the following...

Use of the self-organising map network (SOMNet) as a decision support system for regional mental health planning.

PubMed

Chung, Younjin; Salvador-Carulla, Luis; Salinas-Pérez, José A; Uriarte-Uriarte, Jose J; Iruin-Sanz, Alvaro; García-Alonso, Carlos R

2018-04-25

Decision-making in mental health systems should be supported by the evidence-informed knowledge transfer of data. Since mental health systems are inherently complex, involving interactions between its structures, processes and outcomes, decision support systems (DSS) need to be developed using advanced computational methods and visual tools to allow full system analysis, whilst incorporating domain experts in the analysis process. In this study, we use a DSS model developed for interactive data mining and domain expert collaboration in the analysis of complex mental health systems to improve system knowledge and evidence-informed policy planning. We combine an interactive visual data mining approach, the self-organising map network (SOMNet), with an operational expert knowledge approach, expert-based collaborative analysis (EbCA), to develop a DSS model. The SOMNet was applied to the analysis of healthcare patterns and indicators of three different regional mental health systems in Spain, comprising 106 small catchment areas and providing healthcare for over 9 million inhabitants. Based on the EbCA, the domain experts in the development team guided and evaluated the analytical processes and results. Another group of 13 domain experts in mental health systems planning and research evaluated the model based on the analytical information of the SOMNet approach for processing information and discovering knowledge in a real-world context. Through the evaluation, the domain experts assessed the feasibility and technology readiness level (TRL) of the DSS model. The SOMNet, combined with the EbCA, effectively processed evidence-based information when analysing system outliers, explaining global and local patterns, and refining key performance indicators with their analytical interpretations. The evaluation results showed that the DSS model was feasible by the domain experts and reached level 7 of the TRL (system prototype demonstration in operational environment). This study supports the benefits of combining health systems engineering (SOMNet) and expert knowledge (EbCA) to analyse the complexity of health systems research. The use of the SOMNet approach contributes to the demonstration of DSS for mental health planning in practice.

Expert overseer for mass spectrometer system

DOEpatents

Filby, Evan E.; Rankin, Richard A.

1991-01-01

An expert overseer for the operation and real-time management of a mass spectrometer and associated laboratory equipment. The overseer is a computer-based expert diagnostic system implemented on a computer separate from the dedicated computer used to control the mass spectrometer and produce the analysis results. An interface links the overseer to components of the mass spectrometer, components of the laboratory support system, and the dedicated control computer. Periodically, the overseer polls these devices and as well as itself. These data are fed into an expert portion of the system for real-time evaluation. A knowledge base used for the evaluation includes both heuristic rules and precise operation parameters. The overseer also compares current readings to a long-term database to detect any developing trends using a combination of statistical and heuristic rules to evaluate the results. The overseer has the capability to alert lab personnel whenever questionable readings or trends are observed and provide a background review of the problem and suggest root causes and potential solutions, or appropriate additional tests that could be performed. The overseer can change the sequence or frequency of the polling to respond to an observation in the current data.

NASA systems autonomy demonstration project: Advanced automation demonstration of Space Station Freedom thermal control system

NASA Technical Reports Server (NTRS)

Dominick, Jeffrey; Bull, John; Healey, Kathleen J.

1990-01-01

The NASA Systems Autonomy Demonstration Project (SADP) was initiated in response to Congressional interest in Space station automation technology demonstration. The SADP is a joint cooperative effort between Ames Research Center (ARC) and Johnson Space Center (JSC) to demonstrate advanced automation technology feasibility using the Space Station Freedom Thermal Control System (TCS) test bed. A model-based expert system and its operator interface were developed by knowledge engineers, AI researchers, and human factors researchers at ARC working with the domain experts and system integration engineers at JSC. Its target application is a prototype heat acquisition and transport subsystem of a space station TCS. The demonstration is scheduled to be conducted at JSC in August, 1989. The demonstration will consist of a detailed test of the ability of the Thermal Expert System to conduct real time normal operations (start-up, set point changes, shut-down) and to conduct fault detection, isolation, and recovery (FDIR) on the test article. The FDIR will be conducted by injecting ten component level failures that will manifest themselves as seven different system level faults. Here, the SADP goals, are described as well as the Thermal Control Expert System that has been developed for demonstration.

Non-technical skills for obstetricians conducting forceps and vacuum deliveries: qualitative analysis by interviews and video recordings.

PubMed

Bahl, Rachna; Murphy, Deirdre J; Strachan, Bryony

2010-06-01

Non-technical skills are cognitive and social skills required in an operational task. These skills have been identified and taught in the surgical domain but are of particular relevance to obstetrics where the patient is awake, the partner is present and the clinical circumstances are acute and often stressful. The aim of this study was to define the non-technical skills of an operative vaginal delivery (forceps or vacuum) to facilitate transfer of skills from expert obstetricians to trainee obstetricians. Qualitative study using interviews and video recordings. The study was conducted at two university teaching hospitals (St. Michael's Hospital, Bristol and Ninewells Hospital, Dundee). Participants included 10 obstetricians and eight midwives identified as experts in conducting or supporting operative vaginal deliveries. Semi-structured interviews were carried out using routine clinical scenarios. The experts were also video recorded conducting forceps and vacuum deliveries in a simulation setting. The interviews and video recordings were transcribed verbatim and analysed using thematic coding. The anonymised data were independently coded by the three researchers and then compared for consistency of interpretation. The experts reviewed the coded data for respondent validation and clarification. The themes that emerged were used to identify the non-technical skills required for conducting an operative vaginal delivery. The final skills list was classified into seven main categories. Four categories (situational awareness, decision making, task management, and team work and communication) were similar to the categories identified in surgery. Three further categories unique to obstetrics were also identified (professional relationship with the woman, maintaining professional behaviour and cross-monitoring of performance). This explicitly defined skills taxonomy could aid trainees' understanding of the non-technical skills to be considered when conducting an operative vaginal delivery and potentially reduce morbidity and improve the experience of delivery for the mother. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Knowing the operative game plan: a novel tool for the assessment of surgical procedural knowledge.

PubMed

Balayla, Jacques; Bergman, Simon; Ghitulescu, Gabriela; Feldman, Liane S; Fraser, Shannon A

2012-08-01

What is the source of inadequate performance in the operating room? Is it a lack of technical skills, poor judgment or a lack of procedural knowledge? We created a surgical procedural knowledge (SPK) assessment tool and evaluated its use. We interviewed medical students, residents and training program staff on SPK assessment tools developed for 3 different common general surgery procedures: inguinal hernia repair with mesh in men, laparoscopic cholecystectomy and right hemicolectomy. The tools were developed as a step-wise assessment of specific surgical procedures based on techniques described in a current surgical text. We compared novice (medical student to postgraduate year [PGY]-2) and expert group (PGY-3 to program staff) scores using the Mann-Whitney U test. We calculated the total SPK score and defined a cut-off score using receiver operating characteristic analysis. In all, 5 participants in 7 different training groups (n = 35) underwent an interview. Median scores for each procedure and overall SPK scores increased with experience. The median SPK for novices was 54.9 (95% confidence interval [CI] 21.6-58.8) compared with 98.05 (95% CP 94.1-100.0) for experts (p = 0.012). The SPK cut-off score of 93.1 discriminates between novice and expert surgeons. Surgical procedural knowledge can reliably be assessed using our SPK assessment tool. It can discriminate between novice and expert surgeons for common general surgical procedures. Future studies are planned to evaluate its use for more complex procedures.

Autonomous Diagnostic Imaging Performed by Untrained Operators using Augmented Reality as a Form of "Just-in-Time" Training

NASA Technical Reports Server (NTRS)

Martin, D. S.; Wang, L.; Laurie, S. S.; Lee, S. M. C.; Fleischer, A. C.; Gibson, C. R.; Stenger, M. B.

2017-01-01

We will address the Human Factors and Performance Team, "Risk of performance errors due to training deficiencies" by improving the JIT training materials for ultrasound and OCT imaging by providing advanced guidance in a detailed, timely, and user-friendly manner. Specifically, we will (1) develop an audio-visual tutorial using AR that guides non-experts through an abdominal trauma ultrasound protocol; (2) develop an audio-visual tutorial using AR to guide an untrained operator through the acquisition of OCT images; (3) evaluate the quality of abdominal ultrasound and OCT images acquired by untrained operators using AR guidance compared to images acquired using traditional JIT techniques (laptop-based training conducted before image acquisition); and (4) compare the time required to complete imaging studies using AR tutorials with images acquired using current JIT practices to identify areas for time efficiency improvements. Two groups of subjects will be recruited to participate in this study. Operator-subjects, without previous experience in ultrasound or OCT, will be asked to perform both procedures using either the JIT training with AR technology or the traditional JIT training via laptop. Images acquired by inexperienced operator-subjects will be scored by experts in that imaging modality for diagnostic and research quality; experts will be blinded to the form of JIT used to acquire the images. Operator-subjects also will be asked to submit feedback to improve the training modules used during the scans to improve future training modules. Scanned-subjects will be a small group individuals from whom all images will be acquired.

Autonomous Diagnostic Imaging Performed by Untrained Operator Using Augmented Reality as a Form of "Just-in-Time" Training

NASA Technical Reports Server (NTRS)

Martin, David S.; Wang, Lui; Laurie, Steven S.; Lee, Stuart M. C.; Stenger, Michael B.

2017-01-01

We will address the Human Factors and Performance Team, "Risk of performance errors due to training deficiencies" by improving the JIT training materials for ultrasound and OCT imaging by providing advanced guidance in a detailed, timely, and user-friendly manner. Specifically, we will (1) develop an audio-visual tutorial using AR that guides non-experts through an abdominal trauma ultrasound protocol; (2) develop an audio-visual tutorial using AR to guide an untrained operator through the acquisition of OCT images; (3) evaluate the quality of abdominal ultrasound and OCT images acquired by untrained operators using AR guidance compared to images acquired using traditional JIT techniques (laptop-based training conducted before image acquisition); and (4) compare the time required to complete imaging studies using AR tutorials with images acquired using current JIT practices to identify areas for time efficiency improvements. Two groups of subjects will be recruited to participate in this study. Operator-subjects, without previous experience in ultrasound or OCT, will be asked to perform both procedures using either the JIT training with AR technology or the traditional JIT training via laptop. Images acquired by inexperienced operator-subjects will be scored by experts in that imaging modality for diagnostic and research quality; experts will be blinded to the form of JIT used to acquire the images. Operator-subjects also will be asked to submit feedback to improve the training modules used during the scans to improve future training modules. Scanned-subjects will be a small group individuals from whom all images will be acquired.

43 CFR 4110.2-3 - Transfer of grazing preference.

Code of Federal Regulations, 2012 CFR

2012-10-01

... property and the grazing preference, in animal unit months, attached to that base property. (c) If a... the transfer. (e) If an unqualified transferee acquires rights in base property through operation of...

43 CFR 4110.2-3 - Transfer of grazing preference.

Code of Federal Regulations, 2013 CFR

2013-10-01

... property and the grazing preference, in animal unit months, attached to that base property. (c) If a... the transfer. (e) If an unqualified transferee acquires rights in base property through operation of...

The Pathway to a Safe and Effective Spaceflight Medication Formulary: Expert Review Panel Recommendations

NASA Technical Reports Server (NTRS)

Daniels, V. R.; Bayuse, T. M.; Mulcahy, R. A.; McGuire, R. K. M.; Antonsen, E. L.

2018-01-01

Exploration spaceflight poses several challenges to the provision of a comprehensive medication formulary. This formulary must accommodate the size and space limitations of the spacecraft, while addressing individual medication needs and preferences of the crew, consequences of a degrading inventory over time, the inability to resupply used or expired medications, and the need to forecast the best possible medication candidates to treat conditions that may occur. The Exploration Medical Capability (ExMC) Element's Pharmacy Project Team has developed a research plan (RP) that is focused on evidence-based models and theories as well as new diagnostic tools, treatments, or preventive measures aimed to ensure an available, safe, and effective pharmacy sufficient to manage potential medical threats during exploration spaceflight. Here, we will discuss the ways in which the ExMC Pharmacy Project Team pursued expert evaluation and guidance, and incorporated acquired insight into an achievable research pathway, reflected in the revised RP.

Dose Adjustment for Normal Eating: A Role for the Expert Patient?

PubMed Central

2014-01-01

The Dose Adjustment for Normal Eating (DAFNE) programme of intensive insulin therapy for type 1 diabetes provides a structured educational intervention to improve glycemic control, reduce hypoglycemia and improve quality of life. Enhancement of self-management skills is a key element of DAFNE and patients acquire detailed skills in insulin dose adjustment. Following DAFNE training, patients report improved confidence in their ability to manage their own insulin dosing, but generally still seek and require the assistance of health professionals when making substantial changes to their insulin regimens. Some DAFNE trained patients may be able to assist their peers in aspects of diabetes management within a group environment, but widespread introduction of the expert patient/peer educator role in the self-management of type 1 diabetes, in particular related to insulin dose management, would require formal and detailed evaluation, preferably in randomized controlled clinical trials, before being introduced into routine clinical practice. PMID:24851201

Education Creates Welcoming Environment for Transgender Patients.

PubMed

Ehrenfeld, Jesse; Gridley, Samantha

2016-08-01

The ED often is the access point of choice for transgender patients who may be reluctant to interact with providers. Experts say there is a need for training and education of how to present a gender-affirming healthcare environment. Recommended steps include a review of policies, along with corresponding changes to electronic and paper intake forms to ensure that the language used is inclusive of all genders. While blanket discrimination may be declining, experts note that some providers are uncertain about how to interact with a transgender patient. It's always best to ask patients for their preferred name and pronoun and to repeat this exercise every three to six months for return patients, as gender identify can be fluid. To ease anxiety for transgender patients, consider developing a navigator program that will pair any transgender patient who requests the service with a trained advocate who can support and guide the patient through the system.

Modelling efforts needed to advance herpes simplex virus (HSV) vaccine development: Key findings from the World Health Organization Consultation on HSV Vaccine Impact Modelling.

PubMed

Gottlieb, Sami L; Giersing, Birgitte; Boily, Marie-Claude; Chesson, Harrell; Looker, Katharine J; Schiffer, Joshua; Spicknall, Ian; Hutubessy, Raymond; Broutet, Nathalie

2017-06-21

Development of a vaccine against herpes simplex virus (HSV) is an important goal for global sexual and reproductive health. In order to more precisely define the health and economic burden of HSV infection and the theoretical impact and cost-effectiveness of an HSV vaccine, in 2015 the World Health Organization convened an expert consultation meeting on HSV vaccine impact modelling. The experts reviewed existing model-based estimates and dynamic models of HSV infection to outline critical future modelling needs to inform development of a comprehensive business case and preferred product characteristics for an HSV vaccine. This article summarizes key findings and discussions from the meeting on modelling needs related to HSV burden, costs, and vaccine impact, essential data needs to carry out those models, and important model components and parameters. Copyright © 2017. Published by Elsevier Ltd.

Infrastructure Vulnerability Assessment Model (I-VAM).

PubMed

Ezell, Barry Charles

2007-06-01

Quantifying vulnerability to critical infrastructure has not been adequately addressed in the literature. Thus, the purpose of this article is to present a model that quantifies vulnerability. Vulnerability is defined as a measure of system susceptibility to threat scenarios. This article asserts that vulnerability is a condition of the system and it can be quantified using the Infrastructure Vulnerability Assessment Model (I-VAM). The model is presented and then applied to a medium-sized clean water system. The model requires subject matter experts (SMEs) to establish value functions and weights, and to assess protection measures of the system. Simulation is used to account for uncertainty in measurement, aggregate expert assessment, and to yield a vulnerability (Omega) density function. Results demonstrate that I-VAM is useful to decisionmakers who prefer quantification to qualitative treatment of vulnerability. I-VAM can be used to quantify vulnerability to other infrastructures, supervisory control and data acquisition systems (SCADA), and distributed control systems (DCS).

Expert systems for automated maintenance of a Mars oxygen production system

NASA Astrophysics Data System (ADS)

Huang, Jen-Kuang; Ho, Ming-Tsang; Ash, Robert L.

1992-08-01

Application of expert system concepts to a breadboard Mars oxygen processor unit have been studied and tested. The research was directed toward developing the methodology required to enable autonomous operation and control of these simple chemical processors at Mars. Failure detection and isolation was the key area of concern, and schemes using forward chaining, backward chaining, knowledge-based expert systems, and rule-based expert systems were examined. Tests and simulations were conducted that investigated self-health checkout, emergency shutdown, and fault detection, in addition to normal control activities. A dynamic system model was developed using the Bond-Graph technique. The dynamic model agreed well with tests involving sudden reductions in throughput. However, nonlinear effects were observed during tests that incorporated step function increases in flow variables. Computer simulations and experiments have demonstrated the feasibility of expert systems utilizing rule-based diagnosis and decision-making algorithms.

How Biobanks Are Assessing and Measuring Their Financial Sustainability.

PubMed

Brown, Tony; Kelly, Devon D; Vercauteren, Suzanne M; Wilson, William H; Werner, Alexander

2017-02-01

As guest editors of this sustainability issue of Biopreservation and Biobanking focused on business planning, utilization, and marketing, we invited a number of experts from different sectors of the biobanking arena to provide their views on business planning issues. Each expert was asked to provide a brief background statement on their biobanks, to build a context to understand their answers to the sustainability questions. We hope that these insights and experiences can provide valuable considerations and ideas for other biobanks who wish to develop or refine their own business plans, measure their utilization rates, and work toward financial sustainability. In addition, after the expert input was gathered, the guest editors invited an additional expert to provide summary comments and observations on cost and operational optimization strategies. The broad experiences from all of the experts included and scope of the biobanks they represent should provide a level of relevant representation for all interested parties.

Psychological Type and Analysis of Preferred Negotiation Strategies and Tactics of United States Air Force Contract Negotiators.

DTIC Science & Technology

1986-09-01

industrial engineering to property management (6:7A8- 7A13). Not until a coordinated position among these experts and management is achieved does the...friendship in the structuring and expression of this thesis. I will never forget their many kindnesses. I thank the men and women of Aeronautical...defense industry . 11 ,-U. _ ".- II. Literature Review A person’s day-to-day transactions form strong habits that are likely to be carried into the negoti

Organization and Management of Construction in Developing Countries,

DTIC Science & Technology

1982-02-01

ing a paper on any or on all of the issues of the Terms of Reference or on any other issues that they might prefer. The responses by letter were...consider- able, but the papers received were not many. Some experts though had promised to send a paper at a later time. To facilitate responses a...Since this material was not very much, research was facilitated by other published papers and reports, such as papers presented at the previous CIB W-65

"Irreconcilable differences" between parent and child: a case report of interactional pathology.

PubMed

Tooley, K M

1978-10-01

Certain parents use their child as a representative of their own unacceptable impulses, perceiving the youngster as evil and seeking experts to confirm their opinion. They come to mental health clinics for diagnoses but not treatment; evidence that contradicts their view is ignored out of a need to protect their own precarious psychological balance. The child, in spite of good early adjustment, tends to conform to the parents' preferred perception. Legal and ethical implications for professionals working with such cases are discussed.

OntoBrowser: a collaborative tool for curation of ontologies by subject matter experts.

PubMed

Ravagli, Carlo; Pognan, Francois; Marc, Philippe

2017-01-01

The lack of controlled terminology and ontology usage leads to incomplete search results and poor interoperability between databases. One of the major underlying challenges of data integration is curating data to adhere to controlled terminologies and/or ontologies. Finding subject matter experts with the time and skills required to perform data curation is often problematic. In addition, existing tools are not designed for continuous data integration and collaborative curation. This results in time-consuming curation workflows that often become unsustainable. The primary objective of OntoBrowser is to provide an easy-to-use online collaborative solution for subject matter experts to map reported terms to preferred ontology (or code list) terms and facilitate ontology evolution. Additional features include web service access to data, visualization of ontologies in hierarchical/graph format and a peer review/approval workflow with alerting. The source code is freely available under the Apache v2.0 license. Source code and installation instructions are available at http://opensource.nibr.com This software is designed to run on a Java EE application server and store data in a relational database. philippe.marc@novartis.com. © The Author 2016. Published by Oxford University Press.

OntoBrowser: a collaborative tool for curation of ontologies by subject matter experts

PubMed Central

Ravagli, Carlo; Pognan, Francois

2017-01-01

Summary: The lack of controlled terminology and ontology usage leads to incomplete search results and poor interoperability between databases. One of the major underlying challenges of data integration is curating data to adhere to controlled terminologies and/or ontologies. Finding subject matter experts with the time and skills required to perform data curation is often problematic. In addition, existing tools are not designed for continuous data integration and collaborative curation. This results in time-consuming curation workflows that often become unsustainable. The primary objective of OntoBrowser is to provide an easy-to-use online collaborative solution for subject matter experts to map reported terms to preferred ontology (or code list) terms and facilitate ontology evolution. Additional features include web service access to data, visualization of ontologies in hierarchical/graph format and a peer review/approval workflow with alerting. Availability and implementation: The source code is freely available under the Apache v2.0 license. Source code and installation instructions are available at http://opensource.nibr.com. This software is designed to run on a Java EE application server and store data in a relational database. Contact: philippe.marc@novartis.com PMID:27605099

Position Statement of the Israeli Society for Musculoskeletal Medicine on Intramuscular Stimulation for Myofascial Pain Syndrome-A Delphi Process.

PubMed

Ratmansky, Motti; Minerbi, Amir; Kalichman, Leonid; Kent, John; Wende, Osnat; Finestone, Aharon S; Vulfsons, Simon

2017-04-01

To develop consensus on a position paper on the use of intramuscular stimulation (IMS) for the treatment of myofascial pain syndrome (MPS) by physicians in Israel. The Israeli Society of Musculoskeletal Medicine ran a modified Delphi process to gather opinions from a multidisciplinary expert panel. Eight experts in the treatment of MPS were chosen and asked to participate, and six participated. The position paper was iterated three times. After three iterations, general consensus was reached by all six experts. The general statement that was agreed on was: "IMS is one of the preferred treatments for myofascial pain syndrome. The treatment is evidence-based, effective, safe, and inexpensive. The position of the Israeli Society of Musculoskeletal Medicine is that the treatment should be taught and used by all primary care physicians and those physicians in other areas of medicine who deal with pain in their work." The position paper is a basis for clinical work and education programs for physicians interested in a better understanding and ability to treat patients with a musculoskeletal complaint or manifestation of disease. © 2016 World Institute of Pain.

Perception Gaps on Food Additives among Various Groups in Korea: Food Experts, Teachers, Nutrition Teachers, Nongovernmental Organization Members, and General Consumers.

PubMed

Kang, Hee-Jin; Kim, Suna; Lee, Gunyoung; Lim, Ho Soo; Yun, Sang Soon; Kim, Jeong-Weon

2017-06-01

The purpose of this study was to determine the perceptions and information needs of food experts, teachers, nutrition teachers, members of nongovernmental organizations, and general consumers concerning food additives. Questions in a survey format included perceptions, information needs, and preferred communication channels. The survey was conducted both off-line and on-line via e-mail and Google Drive in March 2015. The results indicated that most Korean consumers are concerned about the safety of using food additives in processed foods and do not recognize these additives as safe and useful materials as part of a modern diet. We also identified perception gaps among different groups regarding food additives. Nutrition teachers and members of nongovernmental organizations in Korea appeared to have a biased perception of food additives, which may cause general consumers to have a negative perception of food additives. The group of food experts did not have this bias. Governmental institutions must overcome the low confidence levels of various groups as an information provider about food additives. Based on the findings in this study, it will be possible to develop a strategy for risk communication about food additives for each group.

Developing Effective Communications about Extreme Weather Risks.

NASA Astrophysics Data System (ADS)

Bruine de Bruin, W.

2014-12-01

Members of the general public often face complex decisions about the risks that they face, including those associated with extreme weather and climate change adaptation. Scientific experts may be asked to develop communications with the goal of improving people's understanding of weather and climate risks, and informing people's decisions about how to protect against these risks. Unfortunately, scientific experts' communication efforts may fail if they lack information about what people need or want to know to make more informed decisions or what wording people prefer use to describe relevant concepts. This presentation provides general principles for developing effective risk communication materials that aim for widespread dissemination, such as brochures and websites. After a brief review of the social science evidence on how to design effective risk communication materials, examples will focus on communications about extreme weather events and climate change. Specifically, data will be presented from ongoing projects on flood risk perception, public preparedness for heat waves, and public perceptions of climate change. The presentation will end with specific recommendations about how to improve recipients' understanding about risks and inform decisions. These recommendations should be useful to scientific experts who aim to communicate about extreme weather, climate change, or other risks.

Science-based HRA: experimental comparison of operator performance to IDAC (Information-Decision-Action Crew) simulations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shirley, Rachel; Smidts, Carol; Boring, Ronald

Information-Decision-Action Crew (IDAC) operator model simulations of a Steam Generator Tube Rupture are compared to student operator performance in studies conducted in the Ohio State University’s Nuclear Power Plant Simulator Facility. This study is presented as a prototype for conducting simulator studies to validate key aspects of Human Reliability Analysis (HRA) methods. Seven student operator crews are compared to simulation results for crews designed to demonstrate three different decision-making strategies. The IDAC model used in the simulations is modified slightly to capture novice behavior rather that expert operators. Operator actions and scenario pacing are compared. A preliminary review of availablemore » performance shaping factors (PSFs) is presented. After the scenario in the NPP Simulator Facility, student operators review a video of the scenario and evaluate six PSFs at pre-determined points in the scenario. This provides a dynamic record of the PSFs experienced by the OSU student operators. In this preliminary analysis, Time Constraint Load (TCL) calculated in the IDAC simulations is compared to TCL reported by student operators. We identify potential modifications to the IDAC model to develop an “IDAC Student Operator Model.” This analysis provides insights into how similar experiments could be conducted using expert operators to improve the fidelity of IDAC simulations.« less

Risk for suicide and risk for violence: a case for separating the current violence diagnoses.

PubMed

Smith, J E; Early, J A; Green, P T; Lauck, D L; Oblaczynski, C; Smochek, M R; Wright, G

1997-01-01

To identify accurate descriptive terms for risk for violence and risk for suicide and to provide operational definitions for these terms The Delphi technique, with two rounds, was used to differentiate the operational definitions that represent risk for suicide from those that represent risk for violence. The expert panel consisted of 23 healthcare professionals with a minimum of a master's degree. In addition to the expert panel, a control group (N = 11) participated to assess content validity. Thirty-six definitions were agreed upon for suicide, 39 for violence. These definitions represent the basic distinctions between the two behavioral manifestations.

The load shedding advisor: An example of a crisis-response expert system

NASA Technical Reports Server (NTRS)

Bollinger, Terry B.; Lightner, Eric; Laverty, John; Ambrose, Edward

1987-01-01

A Prolog-based prototype expert system is described that was implemented by the Network Operations Branch of the NASA Goddard Space Flight Center. The purpose of the prototype was to test whether a small, inexpensive computer system could be used to host a load shedding advisor, a system which would monitor major physical environment parameters in a computer facility, then recommend appropriate operator reponses whenever a serious condition was detected. The resulting prototype performed significantly to efficiency gains achieved by replacing a purely rule-based design methodology with a hybrid approach that combined procedural, entity-relationship, and rule-based methods.

The numerical modelling and process simulation for the fault diagnosis of rotary kiln incinerator.

PubMed

Roh, S D; Kim, S W; Cho, W S

2001-10-01

The numerical modelling and process simulation for the fault diagnosis of rotary kiln incinerator were accomplished. In the numerical modelling, two models applied to the modelling within the kiln are the combustion chamber model including the mass and energy balance equations for two combustion chambers and 3D thermal model. The combustion chamber model predicts temperature within the kiln, flue gas composition, flux and heat of combustion. Using the combustion chamber model and 3D thermal model, the production-rules for the process simulation can be obtained through interrelation analysis between control and operation variables. The process simulation of the kiln is operated with the production-rules for automatic operation. The process simulation aims to provide fundamental solutions to the problems in incineration process by introducing an online expert control system to provide an integrity in process control and management. Knowledge-based expert control systems use symbolic logic and heuristic rules to find solutions for various types of problems. It was implemented to be a hybrid intelligent expert control system by mutually connecting with the process control systems which has the capability of process diagnosis, analysis and control.

Advanced automation of a prototypic thermal control system for Space Station

NASA Technical Reports Server (NTRS)

Dominick, Jeff

1990-01-01

Viewgraphs on an advanced automation of a prototypic thermal control system for space station are presented. The Thermal Expert System (TEXSYS) was initiated in 1986 as a cooperative project between ARC and JCS as a way to leverage on-going work at both centers. JSC contributed Thermal Control System (TCS) hardware and control software, TCS operational expertise, and integration expertise. ARC contributed expert system and display expertise. The first years of the project were dedicated to parallel development of expert system tools, displays, interface software, and TCS technology and procedures by a total of four organizations.

An expert system that performs a satellite station keepimg maneuver

NASA Technical Reports Server (NTRS)

Linesbrowning, M. Kate; Stone, John L., Jr.

1987-01-01

The development and characteristics of a prototype expert system, Expert System for Satellite Orbit Control (ESSOC), capable of providing real-time spacecraft system analysis and command generation for a geostationary satellite are described. The ESSOC recommends appropriate commands that reflect both the changing spacecraft condition and previous procedural action. An internal knowledge base stores satellite status information and is updated with processed spacecraft telemetry. Procedural structure data are encoded in production rules. Structural methods of knowledge acquisition and the design and performance-enhancing techniques that enable ESSOC to operate in real time are also considered.

ART/Ada design project, phase 1

NASA Technical Reports Server (NTRS)

1989-01-01

An Ada-Based Expert System Building Tool Design Research Project was conducted. The goal was to investigate various issues in the context of the design of an Ada-based expert system building tool. An attempt was made to achieve a comprehensive understanding of the potential for embedding expert systems in Ada systems for eventual application in future projects. The current status of the project is described by introducing an operational prototype, ART/Ada. How the project was conducted is explained. The performance of the prototype is analyzed and compared with other related works. Future research directions are suggested.

Attending Surgeons' Leadership Style in the Operating Room: Comparing Junior Residents' Experiences and Preferences.

PubMed

Kissane-Lee, Nicole A; Yule, Steven; Pozner, Charles N; Smink, Douglas S

2016-01-01

Recent studies have focused on surgeons' nontechnical skills in the operating room (OR), especially leadership. In an attempt to identify trainee preferences, we explored junior residents' opinions about the OR leadership style of teaching faculty. Overall, 20 interns and 20 mid-level residents completed a previously validated survey on the style of leadership they encountered, the style they preferred to receive, and the style they personally employed in the OR. In all, 4 styles were explored; authoritative: leader makes decisions and communicates them firmly; explanatory: leader makes decisions promptly, but explains them fully; consultative: leader consults with trainees when important decisions are made, and delegative: leader puts the problem before the group and makes decisions by majority opinion. Comparisons were completed using chi-square analysis. Junior resident preference for leadership style of attending surgeons in the OR differed from what they encountered. Overall, 62% of residents encountered an authoritative leadership style; however, only 9% preferred this (p < 0.001). Instead, residents preferred explanatory (53%) or consultative styles (41%). Preferences differed by postgraduate year. Although 40% of interns preferred a consultative style, 50% of mid-level residents preferred explanatory leadership. Junior resident preference of leadership style in the OR differs from what they actually encounter. This has the potential to create unwanted tension and may erode team performance. Awareness of this difference provides an opportunity for an educational intervention directed at both attendings and trainees. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Preferences for technology versus human assistance and control over technology in the performance of kitchen and personal care tasks in baby boomers and older adults.

PubMed

Beach, Scott R; Schulz, Richard; Matthews, Judith T; Courtney, Karen; Dabbs, Annette DeVito

2014-11-01

Quality of Life technology (QoLT) stresses humans and technology as mutually dependent and aware, working together to improve task performance and quality of life. This study examines preferences for technology versus human assistance and control in the context of QoLT. Data are from a nationally representative, cross-sectional web-based sample of 416 US baby boomers (45-64) and 114 older adults (65+) on preferences for technology versus human assistance and control in the performance of kitchen and personal care tasks. Multinomial logistic regression and ordinary least squares regression were used to determine predictors of these preferences. Respondents were generally accepting of technology assistance but wanted to maintain control over its' operation. Baby boomers were more likely to prefer technology than older adults, and those with fewer QoLT privacy concerns and who thought they were more likely to need future help were more likely to prefer technology over human assistance and more willing to relinquish control to technology. Results suggest the need for design of person- and context-aware QoLT systems that are responsive to user desires for level of control over operation of the technology. The predictors of these preferences suggest potentially receptive markets for the targeting of QoLT systems.

Don’t Forget the Doctor: Gastroenterologists’ Preferences on the Development of mHealth Tools for Inflammatory Bowel Disease

PubMed Central

2015-01-01

Background Inflammatory bowel disease (IBD) encompasses a number of disorders of the gastrointestinal tract. Treatment for IBD is lifelong and complex, and the majority of IBD patients seek information on the Internet. However, research has found existing digital resources to be of questionable quality and that patients find content lacking. Gastroenterologists are frontline sources of information for North American IBD patients, but their opinions and preferences for digital content, design, and utility have not been investigated. The purpose of this study is to systematically explore gastroenterologists’ perceptions of, and design preferences for, mHealth tools. Objective Our goal was to critically assess these issues and elicit expert feedback by seeking consensus with Canadian gastroenterologists. Methods Using a qualitative approach, a closed meeting with 7 gastroenterologists was audio recorded and field notes taken. To synthesize results, an anonymous questionnaire was collected at the end of the session. Participant-led discussion themes included methodological approaches to non-adherence, concordance, patient-centricity, and attributes of digital tools that would be actively supported and promoted. Results Survey results indicated that 4 of the 7 gastroenterologists had experienced patients bringing digital resources to a visit, but 5 found digital patient resources to be inaccurate or irrelevant. All participants agreed that digital tools were of increasing importance and could be leveraged to aid in consultations and save time. When asked to assess digital attributes that they would be confident to refer patients to, all seven indicated that the inclusion of evidence-based facts were of greatest importance. Patient peer-support networks were deemed an asset but only if closely monitored by experts. When asked about interventions, nearly all (6/7) preferred tools that addressed a mix of compliance and concordance, and only one supported the development of tools that focused on compliance. Participants confirmed that they would actively refer patients and other physicians to digital resources. However, while a number of digital IBD tools exist, gastroenterologists would be reluctant to endorse them. Conclusions Gastroenterologists appear eager to use digital resources that they believe benefit the physician-patient relationship, but despite the trend of patient-centric tools that focus on concordance (shared decision making and enlightened communication between patients and their health care providers), they would prefer digital tools that highlight compliance (patient following orders). This concordance gap highlights an issue of disparity in digital health: patients may not use tools that physicians promote, and physicians may not endorse tools that patients will use. Further research investigating the concordance gap, and tensions between physician preferences and patient needs, is required. PMID:25608628

Comparing preference assessments: selection- versus duration-based preference assessment procedures.

PubMed

Kodak, Tiffany; Fisher, Wayne W; Kelley, Michael E; Kisamore, April

2009-01-01

In the current investigation, the results of a selection- and a duration-based preference assessment procedure were compared. A Multiple Stimulus With Replacement (MSW) preference assessment [Windsor, J., Piché, L. M., & Locke, P. A. (1994). Preference testing: A comparison of two presentation methods. Research in Developmental Disabilities, 15, 439-455] and a variation of a Free-Operant (FO) preference assessment procedure [Roane, H. S., Vollmer, T. R., Ringdahl, J. E., & Marcus, B. A. (1998). Evaluation of a brief stimulus preference assessment. Journal of Applied Behavior Analysis, 31, 605-620] were conducted with four participants. A reinforcer assessment was conducted to determine which preference assessment procedure identified the item that produced the highest rates of responding. The items identified as most highly preferred were different across preference assessment procedures for all participants. Results of the reinforcer assessment showed that the MSW identified the item that functioned as the most effective reinforcer for two participants.

The key actor: a qualitative study of patient participation in the handover process in Europe

PubMed Central

Flink, Maria; Hesselink, Gijs; Pijnenborg, Loes; Wollersheim, Hub; Vernooij-Dassen, Myrra; Dudzik-Urbaniak, Ewa; Orrego, Carola; Toccafondi, Giulio; Schoonhoven, Lisette; Gademan, Petra J; Johnson, Julie K; Öhlén, Gunnar; Hansagi, Helen; Olsson, Mariann; Barach, Paul

2012-01-01

Background Patient safety experts have postulated that increasing patient participation in communications during patient handovers will improve the quality of patient transitions, and that this may reduce hospital readmissions. Choosing strategies that enhance patient safety through improved handovers requires better understanding of patient experiences and preferences for participation. Objective The aim of this paper is to explore the patients’ experiences and perspectives related to the handovers between their primary care providers and the inpatient hospital. Methods A qualitative secondary analysis was performed, based on individual and focus group patient interviews with 90 patients in five European countries. Results The analysis revealed three themes: patient positioning in the handover process; prerequisites for patient participation and patient preferences for the handover process. Patients’ participation ranged from being the key actor, to sharing the responsibility with healthcare professional(s), to being passive participants. For active participation patients required both personal and social resources as well as prerequisites such as information and respect. Some patients preferred to be the key actor in charge; others preferred their healthcare professionals to be the key actors in the handover. Conclusions Patients’ participation is related to the healthcare system, the activity of healthcare professionals’ and patients’ capacity for participation. Patients prefer a handover process where the responsibility is clear and unambiguous. Healthcare organisations need a clear and well-considered system of responsibility for handover processes, that takes into account the individual patient's need of clarity, and support in relation to his/hers own recourses. PMID:23112290

Making objective decisions in mechanical engineering problems

NASA Astrophysics Data System (ADS)

Raicu, A.; Oanta, E.; Sabau, A.

2017-08-01

Decision making process has a great influence in the development of a given project, the goal being to select an optimal choice in a given context. Because of its great importance, the decision making was studied using various science methods, finally being conceived the game theory that is considered the background for the science of logical decision making in various fields. The paper presents some basic ideas regarding the game theory in order to offer the necessary information to understand the multiple-criteria decision making (MCDM) problems in engineering. The solution is to transform the multiple-criteria problem in a one-criterion decision problem, using the notion of utility, together with the weighting sum model or the weighting product model. The weighted importance of the criteria is computed using the so-called Step method applied to a relation of preferences between the criteria. Two relevant examples from engineering are also presented. The future directions of research consist of the use of other types of criteria, the development of computer based instruments for decision making general problems and to conceive a software module based on expert system principles to be included in the Wiki software applications for polymeric materials that are already operational.

Early Evaluation of the Fetal Heart.

PubMed

Hernandez-Andrade, Edgar; Patwardhan, Manasi; Cruz-Lemini, Mónica; Luewan, Suchaya

2017-01-01

Evaluation of the fetal heart at 11-13 + 6 weeks of gestation is indicated for women with a family history of congenital heart defects (CHD), a previous child with CDH, or an ultrasound finding associated with cardiac anomalies. The accuracy for early detection of CHD is highly related to the experience of the operator. The 4-chamber view and outflow tracts are the most important planes for identification of an abnormal heart, and can be obtained in the majority of fetuses from 11 weeks of gestation onward. Transvaginal ultrasound is the preferred route for fetal cardiac examination prior to 12 weeks of gestation, whereas, after 12 weeks, the fetal heart can be reliably evaluated by transabdominal ultrasound. Cardiac defects, such as ventricular septal defects, tetralogy of Fallot, Ebstein's anomaly, or cardiac tumors, are unlikely to be identified at ≤14 weeks of gestation. Additional ultrasound techniques such as spatiotemporal image correlation and the evaluation of volumes by a fetal-heart expert can improve the detection of congenital heart disease. The evaluation of the fetal cardiac function at 11-13 + 6 weeks of gestation can be useful for early identification of fetuses at risk of anemia due to hemoglobinopathies, such as hemoglobin Bart's disease. © 2017 S. Karger AG, Basel.

Space station payload operations scheduling with ESP2

NASA Technical Reports Server (NTRS)

Stacy, Kenneth L.; Jaap, John P.

1988-01-01

The Mission Analysis Division of the Systems Analysis and Integration Laboratory at the Marshall Space Flight Center is developing a system of programs to handle all aspects of scheduling payload operations for Space Station. The Expert Scheduling Program (ESP2) is the heart of this system. The task of payload operations scheduling can be simply stated as positioning the payload activities in a mission so that they collect their desired data without interfering with other activities or violating mission constraints. ESP2 is an advanced version of the Experiment Scheduling Program (ESP) which was developed by the Mission Integration Branch beginning in 1979 to schedule Spacelab payload activities. The automatic scheduler in ESP2 is an expert system that embodies the rules that expert planners would use to schedule payload operations by hand. This scheduler uses depth-first searching, backtracking, and forward chaining techniques to place an activity so that constraints (such as crew, resources, and orbit opportunities) are not violated. It has an explanation facility to show why an activity was or was not scheduled at a certain time. The ESP2 user can also place the activities in the schedule manually. The program offers graphical assistance to the user and will advise when constraints are being violated. ESP2 also has an option to identify conflict introduced into an existing schedule by changes to payload requirements, mission constraints, and orbit opportunities.

Research Needs for Human Factors

DTIC Science & Technology

1983-01-01

their relative merits. Until such comparisons are made, practitioners will continue to advocate their own products without a basis for choice among ...judgments among a group of experts; (2) formulating questions for "experts in a way that is compatible with their mental structures or "cognitive...system* Typically the operators work in teams and control compute3, which in turn mediate information flow among various automatic components. Other

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.

Hematology Expert System (HES) For Tonsillectomy/Adenoidectomy Patients

NASA Astrophysics Data System (ADS)

Pizzi, Nicolino J.; Kapoor, Sandhya; Gerrard, Jon M.

1989-03-01

The purpose of this expert system is to assess a predisposition to bleeding in a patient undergoing a tonsillectomy and/or adenoidectomy as may occur with patients who have certain blood conditions such as hemophilia and von Willebrand's disease. This goal is achieved by establishing a correlation between the patients' responses to a medical questionnaire and the relative quantities of blood lost during the operation.

Factors associated with preferences for long-term care settings in old age: evidence from a population-based survey in Germany.

PubMed

Hajek, André; Lehnert, Thomas; Wegener, Annemarie; Riedel-Heller, Steffi G; König, Hans-Helmut

2017-02-21

Long-term care is one of the most pressing health policy issues in Germany. It is expected that the need for long-term care will increase markedly in the next decades due to demographic shifts. The purpose of this study was to investigate the factors associated with preferences for long-term care settings in old age individuals in Germany. Based on expert interviews and a systematic review, a questionnaire was developed to quantify long-term care preferences. Data were drawn from a population-based survey of the German population aged 65 and over in 2015 (n = 1006). In multiple logistic regressions, preferences for home care were positively associated with providing care for family/friends [OR: 1.6 (1.0-2.5)], lower self-rated health [OR: 1.3 (1.0-1.6)], and no current need of care [OR: 5.5 (1.2-25.7)]. Preferences for care in relatives' homes were positively associated with being male [OR: 2.0 (1.4-2.7)], living with partner or spouse [OR: 1.8 (1.3-2.4)], having children [OR: 1.6 (1.0-2.5)], private health insurance [OR: 1.6 (1.1-2.3)], providing care for family/friends [OR: 1.5 (1.1-2.0)], and higher self-rated health [OR: 1.2 (1.0-1.4)]. Preferences for care in assisted living were positively associated with need of care [OR: 1.9 (1.0-3.5)] and higher education [for example, University, OR: 3.5 (1.9-6.5)]. Preferences for care in nursing home/old age home were positively associated with being born in Germany [OR: 1.8 (1.0-3.1)] and lower self-rated health [OR: 1.2 (1.0-1.4)]. Preferences for care in a foreign country were positively associated with lower age [OR: 1.1 (1.0-1.2)] and being born abroad [OR: 5.5 (2.7-11.2)]. Numerous variables used are sporadically significant, underlining the complex nature of long-term care preferences. A better understanding of factors associated with preferences for care settings might contribute to improving long-term care health services.

Tools and technologies for expert systems: A human factors perspective

NASA Technical Reports Server (NTRS)

Rajaram, Navaratna S.

1987-01-01

It is widely recognized that technologies based on artificial intelligence (AI), especially expert systems, can make significant contributions to the productivity and effectiveness of operations of information and knowledge intensive organizations such as NASA. At the same time, these being relatively new technologies, there is the problem of transfering technology to key personnel of such organizations. The problems of examining the potential of expert systems and of technology transfer is addressed in the context of human factors applications. One of the topics of interest was the investigation of the potential use of expert system building tools, particularly NEXPERT as a technology transfer medium. Two basic conclusions were reached in this regard. First, NEXPERT is an excellent tool for rapid prototyping of experimental expert systems, but not ideal as a delivery vehicle. Therefore, it is not a substitute for general purpose system implementation languages such a LISP or C. This assertion probably holds for nearly all such tools on the market today. Second, an effective technology transfer mechanism is to formulate and implement expert systems for problems which members of the organization in question can relate to. For this purpose, the LIghting EnGineering Expert (LIEGE) was implemented using NEXPERT as the tool for technology transfer and to illustrate the value of expert systems to the activities of the Man-System Division.

MOORE: A prototype expert system for diagnosing spacecraft problems

NASA Technical Reports Server (NTRS)

Howlin, Katherine; Weissert, Jerry; Krantz, Kerry

1988-01-01

MOORE is a rule-based, prototype expert system that assists in diagnosing operational Tracking and Data Relay Satellite (TDRS) problems. It is intended to assist spacecraft engineers at the TDRS ground terminal in trouble shooting problems that are not readily solved with routine procedures, and without expert counsel. An additional goal of the prototype system is to develop in-house expert system and knowledge engineering skills. The prototype system diagnoses antenna pointing and earth pointing problems that may occur within the TDRS Attitude Control System (ACS). Plans include expansion to fault isolation of problems in the most critical subsystems of the TDRS spacecraft. Long term benefits are anticipated with use of an expert system during future TDRS programs with increased mission support time, reduced problem solving time, and retained expert knowledge and experience. Phase 2 of the project is intended to provide NASA the necessary expertise and capability to define requirements, evaluate proposals, and monitor the development progress of a highly competent expert system for NASA's Tracking Data Relay Satellite. Phase 2 also envisions addressing two unexplored applications for expert systems, spacecraft integration and tests (I and T) and support to launch activities. The concept, goals, domain, tools, knowledge acquisition, developmental approach, and design of the expert system. It will explain how NASA obtained the knowledge and capability to develop the system in-house without assistance from outside consultants. Future plans will also be presented.

Teaching children with autism spectrum disorders to mand for the removal of stimuli that prevent access to preferred items.

PubMed

Shillingsburg, M Alice; Powell, Nicole M; Bowen, Crystal N

2013-01-01

Mand training is often a primary focus in early language instruction and typically includes mands that are positively reinforced. However, mands maintained by negative reinforcement are also important skills to teach. These include mands to escape aversive demands or unwanted items. Another type of negatively reinforced mand important to teach involves the removal of a stimulus that prevents access to a preferred activity. We taught 5 participants diagnosed with autism spectrum disorders to mand for the removal of a stimulus in order to access a preferred item that had been blocked. An evaluation was conducted to determine if participants responded differentially when the establishing operations for the preferred item were present versus absent. All participants learned to mand for the removal of the stimulus exclusively under conditions when the establishing operation was present.

The adversarial court system and the expert medical witness: 'The truth the whole truth and nothing but the truth?'.

PubMed

Ryan, Matthew

2003-06-01

This discussion aims to provide the occasional medical expert witness with background knowledge of the adversarial court system and the role of the medical expert witness within it. The parallel evolution of the adversarial and inquisitorial legal systems has been more out of tradition rather than any systematic review of the effectiveness of one system or the other. Both legal systems have their merits and limitations. Witnesses within the adversarial system are required to present evidence in a structured and highly stylized format consisting of 'evidence in chief' followed by 'cross-examination'. This format is an attempt to exclude unreliable evidence. The medical witness is an 'expert' by means of specialized knowledge not possessed by the general public. This distinction allows the expert medical witness to offer his or her opinion as evidence. There remain several limitations to the expert's evidence and these relate to common knowledge, field of expertise and the 'ultimate issue'. The current practice of selection of expert medical witnesses is seriously flawed with several pressures operating to maximise bias and inaccurate testimony. Doctors should not only anticipate change in this area they should lead reform in this area.

A knowledge creation info-structure to acquire and crystallize the tacit knowledge of health-care experts.

PubMed

Abidi, Syed Sibte Raza; Cheah, Yu-N; Curran, Janet

2005-06-01

Tacit knowledge of health-care experts is an important source of experiential know-how, yet due to various operational and technical reasons, such health-care knowledge is not entirely harnessed and put into professional practice. Emerging knowledge-management (KM) solutions suggest strategies to acquire the seemingly intractable and nonarticulated tacit knowledge of health-care experts. This paper presents a KM methodology, together with its computational implementation, to 1) acquire the tacit knowledge possessed by health-care experts; 2) represent the acquired tacit health-care knowledge in a computational formalism--i.e., clinical scenarios--that allows the reuse of stored knowledge to acquire tacit knowledge; and 3) crystallize the acquired tacit knowledge so that it is validated for health-care decision-support and medical education systems.

An expert system/ion trap mass spectrometry approach for life support systems monitoring

NASA Technical Reports Server (NTRS)

Palmer, Peter T.; Wong, Carla M.; Yost, Richard A.; Johnson, Jodie V.; Yates, Nathan A.; Story, Michael

1992-01-01

Efforts to develop sensor and control system technology to monitor air quality for life support have resulted in the development and preliminary testing of a concept based on expert systems and ion trap mass spectrometry (ITMS). An ITMS instrument provides the capability to identify and quantitate a large number of suspected contaminants at trace levels through the use of a variety of multidimensional experiments. An expert system provides specialized knowledge for control, analysis, and decision making. The system is intended for real-time, on-line, autonomous monitoring of air quality. The key characteristics of the system, performance data and analytical capabilities of the ITMS instrument, the design and operation of the expert system, and results from preliminary testing of the system for trace contaminant monitoring are described.

Strategies for adding adaptive learning mechanisms to rule-based diagnostic expert systems

NASA Technical Reports Server (NTRS)

Stclair, D. C.; Sabharwal, C. L.; Bond, W. E.; Hacke, Keith

1988-01-01

Rule-based diagnostic expert systems can be used to perform many of the diagnostic chores necessary in today's complex space systems. These expert systems typically take a set of symptoms as input and produce diagnostic advice as output. The primary objective of such expert systems is to provide accurate and comprehensive advice which can be used to help return the space system in question to nominal operation. The development and maintenance of diagnostic expert systems is time and labor intensive since the services of both knowledge engineer(s) and domain expert(s) are required. The use of adaptive learning mechanisms to increment evaluate and refine rules promises to reduce both time and labor costs associated with such systems. This paper describes the basic adaptive learning mechanisms of strengthening, weakening, generalization, discrimination, and discovery. Next basic strategies are discussed for adding these learning mechanisms to rule-based diagnostic expert systems. These strategies support the incremental evaluation and refinement of rules in the knowledge base by comparing the set of advice given by the expert system (A) with the correct diagnosis (C). Techniques are described for selecting those rules in the in the knowledge base which should participate in adaptive learning. The strategies presented may be used with a wide variety of learning algorithms. Further, these strategies are applicable to a large number of rule-based diagnostic expert systems. They may be used to provide either immediate or deferred updating of the knowledge base.

Expert system decision support for low-cost launch vehicle operations

NASA Technical Reports Server (NTRS)

Szatkowski, G. P.; Levin, Barry E.

1991-01-01

Progress in assessing the feasibility, benefits, and risks associated with AI expert systems applied to low cost expendable launch vehicle systems is described. Part one identified potential application areas in vehicle operations and on-board functions, assessed measures of cost benefit, and identified key technologies to aid in the implementation of decision support systems in this environment. Part two of the program began the development of prototypes to demonstrate real-time vehicle checkout with controller and diagnostic/analysis intelligent systems and to gather true measures of cost savings vs. conventional software, verification and validation requirements, and maintainability improvement. The main objective of the expert advanced development projects was to provide a robust intelligent system for control/analysis that must be performed within a specified real-time window in order to meet the demands of the given application. The efforts to develop the two prototypes are described. Prime emphasis was on a controller expert system to show real-time performance in a cryogenic propellant loading application and safety validation implementation of this system experimentally, using commercial-off-the-shelf software tools and object oriented programming techniques. This smart ground support equipment prototype is based in C with imbedded expert system rules written in the CLIPS protocol. The relational database, ORACLE, provides non-real-time data support. The second demonstration develops the vehicle/ground intelligent automation concept, from phase one, to show cooperation between multiple expert systems. This automated test conductor (ATC) prototype utilizes a knowledge-bus approach for intelligent information processing by use of virtual sensors and blackboards to solve complex problems. It incorporates distributed processing of real-time data and object-oriented techniques for command, configuration control, and auto-code generation.

[Evaluation of the standard application of Delphi in the diagnosis of chronic obstructive pulmonary disease caused by occupational irritant chemicals].

PubMed

Zhao, L; Yan, Y J

2017-11-20

Objective: To investigate the problems encountered in the application of the standard (hereinafter referred to as standard) for the diagnosis of chronic obstructive pulmonary disease caused by occu-pational irritant chemicals, to provide reference for the revision of the new standard, to reduce the number of missed patients in occupational COPD, and to get rid of the working environment of those who suffer from chronic respiratory diseases due to long-term exposure to poisons., slowing the progression of the disease. Methods: Using Delphi (Delphi) Expert research method, after the senior experts to demonstrate, to under-stand the GBZ 237-2011 "occupational irritant chemicals to the diagnosis of chronic obstructive pulmonary dis-ease" standard evaluation of the system encountered problems, to seek expert advice, The problems encoun-tered during the clinical implementation of the standards promulgated in 2011 are presented. Results: Through the Delphi Expert investigation method, it is found that experts agree on the content evaluation and implemen-tation evaluation in the standard, but the operational evaluation of the standard is disputed. According to the clinical experience, the experts believe that the range of occupational irritant gases should be expanded, and the operation of the problem of smoking, seniority determination and occupational contact history should be challenged during the diagnosis. Conclusions: Since the promulgation in 2011 of the criteria for the diagnosis of chronic obstructive pulmonary disease caused by occupational stimulant chemicals, there have been some problems in the implementation process, which have caused many occupationally exposed to irritating gases to suffer from "occupational chronic respiratory Diseases" without a definitive diagnosis.

Discus: investigating subjective judgment of optic disc damage.

PubMed

Denniss, Jonathan; Echendu, Damian; Henson, David B; Artes, Paul H

2011-01-01

To describe a software package (Discus) for investigating clinicians' subjective assessment of optic disc damage [diagnostic accuracy in detecting visual field (VF) damage, decision criteria, and agreement with a panel of experts] and to provide reference data from a group of expert observers. Optic disc images were selected from patients with manifest or suspected glaucoma or ocular hypertension who attended the Manchester Royal Eye Hospital. Eighty images came from eyes without evidence of VF loss in at least four consecutive tests (VF negatives), and 20 images from eyes with repeatable VF loss (VF positives). Software was written to display these images in randomized order, for up to 60 s. Expert observers (n = 12) rated optic disc damage on a 5-point scale (definitely healthy, probably healthy, not sure, probably damaged, and definitely damaged). Optic disc damage as determined by the expert observers predicted VF loss with less than perfect accuracy (mean area under receiver-operating characteristic curve, 0.78; range, 0.72 to 0.85). When the responses were combined across the panel of experts, the area under receiver-operating characteristic curve reached 0.87, corresponding to a sensitivity of ∼60% at 90% specificity. Although the observers' performances were similar, there were large differences between the criteria they adopted (p < 0.001), even though all observers had been given identical instructions. Discus provides a simple and rapid means for assessing important aspects of optic disc interpretation. The data from the panel of expert observers provide a reference against which students, trainees, and clinicians may compare themselves. The program and the analyses described in this article are freely accessible from http://www.discusproject.blogspot.com/.

Multimodal hybrid reasoning methodology for personalized wellbeing services.

PubMed

Ali, Rahman; Afzal, Muhammad; Hussain, Maqbool; Ali, Maqbool; Siddiqi, Muhammad Hameed; Lee, Sungyoung; Ho Kang, Byeong

2016-02-01

A wellness system provides wellbeing recommendations to support experts in promoting a healthier lifestyle and inducing individuals to adopt healthy habits. Adopting physical activity effectively promotes a healthier lifestyle. A physical activity recommendation system assists users to adopt daily routines to form a best practice of life by involving themselves in healthy physical activities. Traditional physical activity recommendation systems focus on general recommendations applicable to a community of users rather than specific individuals. These recommendations are general in nature and are fit for the community at a certain level, but they are not relevant to every individual based on specific requirements and personal interests. To cover this aspect, we propose a multimodal hybrid reasoning methodology (HRM) that generates personalized physical activity recommendations according to the user׳s specific needs and personal interests. The methodology integrates the rule-based reasoning (RBR), case-based reasoning (CBR), and preference-based reasoning (PBR) approaches in a linear combination that enables personalization of recommendations. RBR uses explicit knowledge rules from physical activity guidelines, CBR uses implicit knowledge from experts׳ past experiences, and PBR uses users׳ personal interests and preferences. To validate the methodology, a weight management scenario is considered and experimented with. The RBR part of the methodology generates goal, weight status, and plan recommendations, the CBR part suggests the top three relevant physical activities for executing the recommended plan, and the PBR part filters out irrelevant recommendations from the suggested ones using the user׳s personal preferences and interests. To evaluate the methodology, a baseline-RBR system is developed, which is improved first using ranged rules and ultimately using a hybrid-CBR. A comparison of the results of these systems shows that hybrid-CBR outperforms the modified-RBR and baseline-RBR systems. Hybrid-CBR yields a 0.94% recall, a 0.97% precision, a 0.95% f-score, and low Type I and Type II errors. Copyright © 2015 Elsevier Ltd. All rights reserved.

Portuguese Coaches' Perceptions of and Preferences for Knowledge Sources Related to their Professional Background.

PubMed

Mesquita, Isabel; Isidro, Sofia; Rosado, António

2010-01-01

The purpose of this study was to analyse Portuguese coaches' perceptions of, and preferences for, knowledge sources as related to professional background; namely academic education level, coach education level and coaching experience. The study's participants comprised 336 Portuguese coaches from twenty-two sports. A questionnaire was used to identify coaches' demographic characteristics and representations about their preferred sources of coaching knowledge. MANOVA using Tukey's HSD test was used to compare groups. The results highlighted that coaches perceived that coaching knowledge is built from a broad range of sources from personal coaching and playing experiences to more explicit formal, informal and non-formal learning situations. Results indicated that the coaches ascribed more importance to experiential sources such as working with experts, learning by doing, interacting with peer coaches and attending informal seminars and clinics, than to the formal learning situations provided by the national coaching certification programs. Differences, however, were found in that coaches who had a greater background within higher education (physical) and sport valued informal and non-formal learning sources more than did coaches who were defined as not coming from an academic background. The findings point to the importance of developing new learning, experientially-based, opportunities within the Portuguese context, where curricula content continues to be delivered via didactic means. Key pointsCoaches recognized that learning is obtained from a broad range of sources of coaching knowledge and each source has a particular role in the development of a coach.Experiential guided sources reached more importance to coaches as working with experts, learning by doing, attending seminars/clinics outside of the formal system and interaction with peers were the most acknowledged.The only source that is related to formal learning, national certification programs, was recognized as the less importance than all informal and non-formal learning situations.The profile of the source of coaching knowledge showed to be stable among coaches as only the academic education level differentiated the coaches' perceptions.

Portuguese Coaches’ Perceptions of and Preferences for Knowledge Sources Related to their Professional Background

PubMed Central

Mesquita, Isabel; Isidro, Sofia; Rosado, António

2010-01-01

The purpose of this study was to analyse Portuguese coaches’ perceptions of, and preferences for, knowledge sources as related to professional background; namely academic education level, coach education level and coaching experience. The study’s participants comprised 336 Portuguese coaches from twenty-two sports. A questionnaire was used to identify coaches’ demographic characteristics and representations about their preferred sources of coaching knowledge. MANOVA using Tukey’s HSD test was used to compare groups. The results highlighted that coaches perceived that coaching knowledge is built from a broad range of sources from personal coaching and playing experiences to more explicit formal, informal and non-formal learning situations. Results indicated that the coaches ascribed more importance to experiential sources such as working with experts, learning by doing, interacting with peer coaches and attending informal seminars and clinics, than to the formal learning situations provided by the national coaching certification programs. Differences, however, were found in that coaches who had a greater background within higher education (physical) and sport valued informal and non-formal learning sources more than did coaches who were defined as not coming from an academic background. The findings point to the importance of developing new learning, experientially-based, opportunities within the Portuguese context, where curricula content continues to be delivered via didactic means. Key points Coaches recognized that learning is obtained from a broad range of sources of coaching knowledge and each source has a particular role in the development of a coach. Experiential guided sources reached more importance to coaches as working with experts, learning by doing, attending seminars/clinics outside of the formal system and interaction with peers were the most acknowledged. The only source that is related to formal learning, national certification programs, was recognized as the less importance than all informal and non-formal learning situations. The profile of the source of coaching knowledge showed to be stable among coaches as only the academic education level differentiated the coaches’ perceptions. PMID:24149644

Feasibility of Population Health Analytics and Data Visualization for Decision Support in the Infectious Diseases Domain

PubMed Central

Del Fiol, Guilherme; Butler, Jorie; Livnat, Yarden; Mayer, Jeanmarie; Samore, Matthew; Jones, Makoto; Weir, Charlene

2016-01-01

Summary Objective Big data or population-based information has the potential to reduce uncertainty in medicine by informing clinicians about individual patient care. The objectives of this study were: 1) to explore the feasibility of extracting and displaying population-based information from an actual clinical population’s database records, 2) to explore specific design features for improving population display, 3) to explore perceptions of population information displays, and 4) to explore the impact of population information display on cognitive outcomes. Methods We used the Veteran’s Affairs (VA) database to identify similar complex patients based on a similar complex patient case. Study outcomes measures were 1) preferences for population information display 2) time looking at the population display, 3) time to read the chart, and 4) appropriateness of plans with pre- and post-presentation of population data. Finally, we redesigned the population information display based on our findings from this study. Results The qualitative data analysis for preferences of population information display resulted in four themes: 1) trusting the big/population data can be an issue, 2) embedded analytics is necessary to explore patient similarities, 3) need for tools to control the view (overview, zoom and filter), and 4) different presentations of the population display can be beneficial to improve the display. We found that appropriateness of plans was at 60% for both groups (t9=-1.9; p=0.08), and overall time looking at the population information display was 2.3 minutes versus 3.6 minutes with experts processing information faster than non-experts (t8= -2.3, p=0.04). Conclusion A population database has great potential for reducing complexity and uncertainty in medicine to improve clinical care. The preferences identified for the population information display will guide future health information technology system designers for better and more intuitive display. PMID:27437065

The needs and preferences of pregnant smokers regarding tailored Internet-based smoking cessation interventions: a qualitative interview study.

PubMed

Herbec, Aleksandra; Beard, Emma; Brown, Jamie; Gardner, Benjamin; Tombor, Ildiko; West, Robert

2014-10-14

Internet-based Smoking Cessation Interventions (ISCIs) may help pregnant smokers who are unable, or unwilling, to access face-to-face stop smoking support. Targeting ISCIs to specific groups of smokers could increase their uptake and effectiveness. The current study explored the needs and preferences of pregnant women seeking online stop smoking support with an aim to identify features and components of ISCIs that might be most attractive to this population. We conducted qualitative interviews with thirteen pregnant women who completed the intervention arm of a pilot randomized controlled trial of a novel ISCI for pregnant smokers ('MumsQuit'). The interviews explored women's views towards MumsQuit and online support with quitting smoking in general, as well as their suggestions for how ISCIs could be best targeted to pregnancy. Interview transcripts were analyzed using Framework Analysis. Participants expressed preferences for an accessible, highly engaging and targeted to pregnancy smoking cessation website, tailored to individuals' circumstances as well as use of cessation medication, offering comprehensive and novel information on smoking and quitting smoking in pregnancy, ongoing support with cravings management, as well as additional support following relapse to smoking. Participants also viewed as important targeting of the feedback and progress reports to baby's health and development, offering personal support from experts, and providing a discussion forum allowing for communication with other pregnant women wanting to quit . The present study has identified a number of potential building blocks for ISCIs targeted to quitting smoking in pregnancy. Pregnant smokers willing to try using ISCI may particularly value an engaging intervention offering a high degree of targeting of comprehensive information to them as a group and tailoring support and advice to their individual needs, as well as one providing post-relapse support, peer-to-peer communication and personal support from experts.

What should be done about policy on alcohol pricing and promotions? Australian experts' views of policy priorities: a qualitative interview study.

PubMed

Fogarty, Andrea S; Chapman, Simon

2013-06-25

Alcohol policy priorities in Australia have been set by the National Preventative Health Task Force, yet significant reform has not occurred. News media coverage of these priorities has not reported public health experts as in agreement and Government has not acted upon the legislative recommendations made. We investigate policy experts' views on alcohol policy priorities with a view to establishing levels of accord and providing suggestions for future advocates. We conducted semi-structured in depth interviews with alcohol policy experts and advocates around Australia. Open-ended questions examined participants' thoughts on existing policy recommendations, obvious policy priorities and specifically, the future of national reforms to price and promotions policies. All transcripts were analysed for major themes and points of agreement or disagreement. Twenty one alcohol policy experts agreed that pricing policies are a top national priority and most agreed that "something should be done" about alcohol advertising. Volumetric taxation and minimum pricing were regarded as the most important price policies, yet differences emerged in defining the exact form of a proposed volumetric tax. Important differences in perspective emerged regarding alcohol promotions, with lack of agreement about the preferred form regulations should take, where to start and who the policy should be directed at. Very few discussed online advertising and social networks. Despite existing policy collaborations, a clear 'cut through' message is yet to be endorsed by all alcohol control advocates. There is a need to articulate and promote in greater detail the specifics of policy reforms to minimum pricing, volumetric taxation and restrictions on alcohol advertising, particularly regarding sporting sponsorships and new media.

Capturing Intuition Through Interactive Inverse Methods: Examples Drawn From Mechanical Non-Linearities in Structural Geology

NASA Astrophysics Data System (ADS)

Moresi, L.; May, D.; Peachey, T.; Enticott, C.; Abramson, D.; Robinson, T.

2004-12-01

Can you teach intuition ? Obviously we think that this is possible (though it's still just a hunch). People undoubtedly develop intuition for non-linear systems through painstaking repetition of complex tasks until they have sufficient feedback to begin to "see" the emergent behaviour. The better the exploration of the system can be exposed, the quicker the potential for developing an intuitive understanding. We have spent some time considering how to incorporate the intuitive knowledge of field geologists into mechanical modeling of geological processes. Our solution has been to allow expert geologist to steer (via a GUI) a genetic algorithm inversion of a mechanical forward model towards "structures" or patterns which are plausible in nature. The expert knowledge is then captured by analysis of the individual model parameters which are constrained by the steering (and by analysis of those which are unconstrained). The same system can also be used in reverse to expose the influence of individual parameters to the non-expert who is trying to learn just what does make a good match between model and observation. The ``distance'' between models preferred by experts, and those by an individual can be shown graphically to provide feedback. The examples we choose are from numerical models of extensional basins. We will first try to give each person some background information on the scientific problem from the poster and then we will let them loose on the numerical modeling tools with specific tasks to achieve. This will be an experiment in progress - we will later analyse how people use the GUI and whether there is really any significant difference between so-called experts and self-styled novices.

“Can It Read My Mind?” – What Do the Public and Experts Think of the Current (Mis)Uses of Neuroimaging?

PubMed Central

Wardlaw, Joanna M.; O'Connell, Garret; Shuler, Kirsten; DeWilde, Janet; Haley, Jane; Escobar, Oliver; Murray, Shaun; Rae, Robert; Jarvie, Donald; Sandercock, Peter; Schafer, Burkhard

2011-01-01

Emerging applications of neuroimaging outside medicine and science have received intense public exposure through the media. Media misrepresentations can create a gulf between public and scientific understanding of the capabilities of neuroimaging and raise false expectations. To determine the extent of this effect and determine public opinions on acceptable uses and the need for regulation, we designed an electronic survey to obtain anonymous opinions from as wide a range of members of the public and neuroimaging experts as possible. The surveys ran from 1st June to 30 September 2010, asked 10 and 21 questions, respectively, about uses of neuroimaging outside traditional medical diagnosis, data storage, science communication and potential methods of regulation. We analysed the responses using descriptive statistics; 660 individuals responded to the public and 303 individuals responded to the expert survey. We found evidence of public skepticism about the use of neuroimaging for applications such as lie detection or to determine consumer preferences and considerable disquiet about use by employers or government and about how their data would be stored and used. While also somewhat skeptical about new applications of neuroimaging, experts grossly underestimated how often neuroimaging had been used as evidence in court. Although both the public and the experts rated highly the importance of a better informed public in limiting the inappropriate uses to which neuroimaging might be put, opinions differed on the need for, and mechanism of, actual regulation. Neuroscientists recognized the risks of inaccurate reporting of neuroimaging capabilities in the media but showed little motivation to engage with the public. The present study also emphasizes the need for better frameworks for scientific engagement with media and public education. PMID:21991367

Developing a framework for ankle function: a delphi study.

PubMed

Snyder, Kelli R; Evans, Todd A; Neibert, Peter J

2014-01-01

Addressing clinical outcomes is paramount to providing effective health care, yet there is no consensus regarding the appropriate outcomes to address after ankle injuries. Compounding the problem is the repetitive nature of lateral ankle sprains, referred to as functional (FAI) or chronic (CAI) ankle instability. Although they are commonly used terms in practice and research, FAI and CAI are inconsistently defined and assessed. To establish definitions of a healthy/normal/noninjured ankle, FAI, and CAI, as well as their characteristics and assessment techniques. Delphi study. Telephone interviews and electronic surveys. Sixteen experts representing the fields of ankle function and treatment, ankle research, and outcomes assessment and research were selected as panelists. A telephone interview produced feedback regarding the definition of, functional characteristics of, and assessment techniques for a healthy/normal/noninjured ankle, an unhealthy/acutely injured ankle, and FAI/CAI. Those data were compiled, reduced, and returned through electronic surveys and were either included by reaching consensus (80% agreement) or excluded. The definitions of a healthy/normal/noninjured ankle and FAI reached consensus. Experts did not agree on a definition of CAI. Eleven functional characteristics of a healthy/normal/noninjured ankle, 32 functional characteristics of an unhealthy/acutely injured ankle, and 13 characteristics of FAI were agreed upon. Although a consensus was reached regarding the definitions and functional characteristics of a healthy/normal/noninjured ankle and FAI, the experts could only agree on 1 characteristic to include in the FAI definition. Several experts did, however, provide additional comments that reinforced the differences in the interpretation of those concepts. Although the experts could not agree on the definition of CAI, its characteristics, or the preferred use of the terms FAI and CAI, our findings provide progress toward establishing consistency in those concepts.

A Bayesian Analysis of a Randomized Clinical Trial Comparing Antimetabolite Therapies for Non-Infectious Uveitis

PubMed Central

Browne, Erica N; Rathinam, Sivakumar R; Kanakath, Anuradha; Thundikandy, Radhika; Babu, Manohar; Lietman, Thomas M; Acharya, Nisha R

2017-01-01

Purpose To conduct a Bayesian analysis of a randomized clinical trial (RCT) for non-infectious uveitis using expert opinion as a subjective prior belief. Methods A RCT was conducted to determine which antimetabolite, methotrexate or mycophenolate mofetil, is more effective as an initial corticosteroid-sparing agent for the treatment of intermediate, posterior, and pan- uveitis. Before the release of trial results, expert opinion on the relative effectiveness of these two medications was collected via online survey. Members of the American Uveitis Society executive committee were invited to provide an estimate for the relative decrease in efficacy with a 95% credible interval (CrI). A prior probability distribution was created from experts’ estimates. A Bayesian analysis was performed using the constructed expert prior probability distribution and the trial’s primary outcome. Results 11 of 12 invited uveitis specialists provided estimates. Eight of 11 experts (73%) believed mycophenolate mofetil is more effective. The group prior belief was that the odds of treatment success for patients taking mycophenolate mofetil were 1.4-fold the odds of those taking methotrexate (95% CrI 0.03 – 45.0). The odds of treatment success with mycophenolate mofetil compared to methotrexate was 0.4 from the RCT (95% confidence interval 0.1–1.2) and 0.7 (95% CrI 0.2–1.7) from the Bayesian analysis. Conclusions A Bayesian analysis combining expert belief with the trial’s result did not indicate preference for one drug. However, the wide credible interval leaves open the possibility of a substantial treatment effect. This suggests clinical equipoise necessary to allow a larger, more definitive RCT. PMID:27982726

PI-in-a-box: An expert system to advise astronauts during experiments

NASA Technical Reports Server (NTRS)

Young, Laurence R.

1990-01-01

Perhaps the scarcest resource for manned flight experiments - on Spacelab or on Space Station Freedom - will continue to be crew time. To maximize the efficiency of the crew, and to make use of their abilities to work as scientist collaborators as well as equipment operators, normally requires more training in a wide variety of disciplines than is practical. The successful application of on-board expert systems, as envisioned by the 'Principal Investigator (PI)-in-a-Box' program, should alleviate the training bottleneck and provide the astronaut with the guidance and coaching needed to permit him or her to operate an experiment according to the desires and knowledge of the PI, despite changes in conditions. In addition to the functions of providing expert devise concerning scheduling and repair, the program should bring the astronaut into the scientific evaluation phase of an experiment by sharing with him the guidance and observations regarding the relevance and importance of data as it is being generated. Initial reaction from the astronaut community has been positive.

The operating room of the future: white paper summation.

PubMed

Moses, Gerald R; Farr, James O

2003-01-01

On November 8 and 9, 2001, leading experts in patient safety, medical informatics, advanced surgical devices, telesurgery, and surgical facilities met to formulate strategic directions for the "OR of the Future" in both military and civilian healthcare. The meeting was co-hosted by the Telemedicine and Advanced Technology Research Center (TATRC) part of the U.S. Army Medical Research and Materiel Command at Fort Detrick, and the University of Maryland Medical Center. Researchers, surgeons, and experts in the field of operating room (OR) technology addressed the current state of research and technological developments. Experts in (1) patient safety, (2) medical informatics, (3) advanced surgical devices, (4) telesurgery, and (5) surgical facilities met in focused work groups to develop a proposed research agenda for each content area. Afterwards, each focused group agreed to develop a 'White Paper' on each specific area, addressing the current and future prospectus. In addition, they attempted to provide a recommended research roadmap for the 'OR of the Future.'

Patient safety issues in office-based surgery and anaesthesia in Switzerland: a qualitative study.

PubMed

McLennan, Stuart; Schwappach, David; Harder, Yves; Staender, Sven; Elger, Bernice

2017-08-01

To identify the spectrum of patient safety issues in office-based surgery and anaesthesia in Switzerland. Purposive sample of 23 experts in surgery and anaesthesia and quality and regulation in Switzerland. Data were collected via individual qualitative interviews using a researcher-developed semi-structured interview guide between March 2016 and September 2016. Interviews were transcribed and analysed using conventional content analysis. Issues were categorised under the headings "structure", "process", and "outcome". Experts identified two key overarching patient safety and regulatory issues in relation to office-based surgery and anaesthesia in Switzerland. First, experts repeatedly raised the current lack of data and transparency of the setting. It is unknown how many surgeons are operating in offices, how many and what types of operations are being done, and what the outcomes are. Secondly, experts also noted the limited oversight and regulation of the setting. While some standards exists, most experts felt that more minimal safety standards are needed regarding the requirements that must be met to do office-based surgery and what can and cannot be done in the office-based setting are needed, but they advocated a self-regulatory approach. There is a lack of empirical data regarding the quantity and quality office-based surgery and anaesthesia in Switzerland. Further research is needed to address these research gaps and inform health policy in relation to patient safety in office-based surgery and anaesthesia in Switzerland. Copyright © 2017. Published by Elsevier GmbH.

Optimal operating rules definition in complex water resource systems combining fuzzy logic, expert criteria and stochastic programming

NASA Astrophysics Data System (ADS)

Macian-Sorribes, Hector; Pulido-Velazquez, Manuel

2016-04-01

This contribution presents a methodology for defining optimal seasonal operating rules in multireservoir systems coupling expert criteria and stochastic optimization. Both sources of information are combined using fuzzy logic. The structure of the operating rules is defined based on expert criteria, via a joint expert-technician framework consisting in a series of meetings, workshops and surveys carried out between reservoir managers and modelers. As a result, the decision-making process used by managers can be assessed and expressed using fuzzy logic: fuzzy rule-based systems are employed to represent the operating rules and fuzzy regression procedures are used for forecasting future inflows. Once done that, a stochastic optimization algorithm can be used to define optimal decisions and transform them into fuzzy rules. Finally, the optimal fuzzy rules and the inflow prediction scheme are combined into a Decision Support System for making seasonal forecasts and simulate the effect of different alternatives in response to the initial system state and the foreseen inflows. The approach presented has been applied to the Jucar River Basin (Spain). Reservoir managers explained how the system is operated, taking into account the reservoirs' states at the beginning of the irrigation season and the inflows previewed during that season. According to the information given by them, the Jucar River Basin operating policies were expressed via two fuzzy rule-based (FRB) systems that estimate the amount of water to be allocated to the users and how the reservoir storages should be balanced to guarantee those deliveries. A stochastic optimization model using Stochastic Dual Dynamic Programming (SDDP) was developed to define optimal decisions, which are transformed into optimal operating rules embedding them into the two FRBs previously created. As a benchmark, historical records are used to develop alternative operating rules. A fuzzy linear regression procedure was employed to foresee future inflows depending on present and past hydrological and meteorological variables actually used by the reservoir managers to define likely inflow scenarios. A Decision Support System (DSS) was created coupling the FRB systems and the inflow prediction scheme in order to give the user a set of possible optimal releases in response to the reservoir states at the beginning of the irrigation season and the fuzzy inflow projections made using hydrological and meteorological information. The results show that the optimal DSS created using the FRB operating policies are able to increase the amount of water allocated to the users in 20 to 50 Mm3 per irrigation season with respect to the current policies. Consequently, the mechanism used to define optimal operating rules and transform them into a DSS is able to increase the water deliveries in the Jucar River Basin, combining expert criteria and optimization algorithms in an efficient way. This study has been partially supported by the IMPADAPT project (CGL2013-48424-C2-1-R) with Spanish MINECO (Ministerio de Economía y Competitividad) and FEDER funds. It also has received funding from the European Union's Horizon 2020 research and innovation programme under the IMPREX project (grant agreement no: 641.811).

Improving Human/Autonomous System Teaming Through Linguistic Analysis

NASA Technical Reports Server (NTRS)

Meszaros, Erica L.

2016-01-01

An area of increasing interest for the next generation of aircraft is autonomy and the integration of increasingly autonomous systems into the national airspace. Such integration requires humans to work closely with autonomous systems, forming human and autonomous agent teams. The intention behind such teaming is that a team composed of both humans and autonomous agents will operate better than homogenous teams. Procedures exist for licensing pilots to operate in the national airspace system and current work is being done to define methods for validating the function of autonomous systems, however there is no method in place for assessing the interaction of these two disparate systems. Moreover, currently these systems are operated primarily by subject matter experts, limiting their use and the benefits of such teams. Providing additional information about the ongoing mission to the operator can lead to increased usability and allow for operation by non-experts. Linguistic analysis of the context of verbal communication provides insight into the intended meaning of commonly heard phrases such as "What's it doing now?" Analyzing the semantic sphere surrounding these common phrases enables the prediction of the operator's intent and allows the interface to supply the operator's desired information.

An Expert System for Developing a Full Scale Development Statement of Work

DTIC Science & Technology

1989-09-01

Transportability: 3.5.1.3* Specialty Engineering System Safety: Aerospace Meteorlogical Environment: Preservation, Packaging, and Packing... METEORLOGICAL ENVIRONMENT:’,tn). area is ’AEROSPACE METEORLOGICAL ENVIRONMENT’ ASK ( ’The system will require operation, non-operation, transport, and/or

Strain differences in ethanol preference and reinforced behaviour: a comparison of two-bottle choice and operant self-administration paradigms.

PubMed

Wilson, A W; Neill, J C; Costall, B

1997-02-01

An animal's volitional consumption of ethanol may be influenced by both genetic and environmental factors. In addition, genetic control of ethanol intake may depend on the test paradigm used. In the present study, performance for, and intake of ethanol in a limited access oral operant paradigm, and preference for ethanol in a two-bottle free choice test in the home-cage were compared in female rats of the heterogeneous Sprague Dawley (SD) and inbred Lewis strains. A smaller proportion of SD rats reached criterion on the self-administration task (four of 10 SD vs eight of 10 Lewis), but those SD rats that did achieve criterion maintained higher levels of responding and greater ethanol intake, relative to the Lewis strain, in the operant self-administration paradigm. Additionally, SD but not Lewis rats exhibited increased locomotor activity and an increase in performance for ethanol compared with water. In marked contrast, Lewis rats exhibited a greater preference for 10% ethanol over water in the two-bottle choice test compared with the SD strain, which preferred water to ethanol. These results suggest that both genotype and test paradigm are involved in the extent to which ethanol serves as a positive reinforcer and that unlike two-bottle choice preference tests, self-administration studies are more highly predictive of the reinforcing properties of ethanol.

Evaluating the Effect of Display Realism on Natural Resource Decision Making

NASA Astrophysics Data System (ADS)

Chong, Steven S.

2018-05-01

Geographic information systems (GIS) facilitate location-based decision making. Despite the improved availability of GIS software to non-professionals, training in cartographic design has not followed suit. Prior research indicates that when presented with map choices, users are influenced by naïve realism, a preference for realistic displays cotaining irrelevant, extraneous details, leading to decreased task efficiency. This study investigated the role of naïve realism in decision making for natural resource management, a field that often employs geospatial tools. Data was collected through a GIS user ability test, a questionnaire and direct observation. Forty volunteer expert and non-expert resource managers evaluated the suitability of different sites for a land management scenario. Each participant was tested on two map display treatments containing different levels of realism - a simpler 2D display and a more complex 3D display - to compare task performance. Performance was measured by task accuracy and task completion time. User perceptions and preferences about the displays were also recorded. Display realism had an impact on performance and there were indications naïve realism was present. Users completed tasks significantly faster on the 2D display and many individuals misjudged which display they were most accurate or fastest with. The results are informative for designing information systems containing interactive maps, particularly for resource management applications. The results also suggest that the order displays were presented had a significant effect and may have implications for teaching users map-based tasks.

Timing of anticoagulant re-initiation following intracerebral hemorrhage in mechanical heart valves: Survey of neurosurgeons and thrombosis experts.

PubMed

AlKherayf, Fahad; Xu, Yan; Westwick, Harrison; Moldovan, Ioana Doina; Wells, Philip S

2017-03-01

While oral anticoagulation (OAC) is universally indicated for patients with mechanical heart valves (MHVs), OAC resumption following anticoagulant-associated intracerebral hemorrhage (ICH) is an area of uncertainty. We sought to determine the practice preferences of North American neurosurgeons and thrombosis experts on optimal timing of OAC re-initiation. A cross-sectional survey was disseminated to North American members of the American Association of Neurological Surgeons and the International Society for Thrombosis and Haemostasis. Demographic factors, as well as a clinical scenario with 14 modifiable clinical risk factors were included in the survey. 504 physicians completed our survey (response rate 34.3%). Majority of participants were affiliated with academic centres, and managed≤10 ICH patients with MHV per year. There was wide distribution in response in optimal timing for OAC resumption following an ICH: 59% and 60% preferred to re-start OAC between 3 and 14 days following the hemorrhagic event (median of 6-7 days). Smaller hemorrhages (<30cm 2 ). CHADS 2 score ≥2, concomitant venous thromboembolism, mitral valve prosthesis, caged-ball valves and multiple valves prompted earlier OAC resumption. Wide variation in the current practice of neurosurgeons and thrombosis specialists exist when they encounter patients with ICH and MHV, though decisions were influenced by patient- and valve-related factors. As our observed variation likely reflects the immense gap in current evidence, prospective randomized trials in this population are therefore urgently needed. Copyright © 2017 Elsevier B.V. All rights reserved.

Update of the Dutch manual for costing studies in health care

PubMed Central

Kanters, Tim A.; Bouwmans, Clazien A. M.; van der Linden, Naomi; Tan, Siok Swan; Hakkaart-van Roijen, Leona

2017-01-01

Objectives Dutch health economic guidelines include a costing manual, which describes preferred research methodology for costing studies and reference prices to ensure high quality studies and comparability between study outcomes. This paper describes the most important revisions of the costing manual compared to the previous version. Methods An online survey was sent out to potential users of the costing manual to identify topics for improvement. The costing manual was aligned with contemporary health economic guidelines. All methodology sections and parameter values needed for costing studies, particularly reference prices, were updated. An expert panel of health economists was consulted several times during the review process. The revised manual was reviewed by two members of the expert panel and by reviewers of the Dutch Health Care Institute. Results The majority of survey respondents was satisfied with content and usability of the existing costing manual. Respondents recommended updating reference prices and adding some particular commonly needed reference prices. Costs categories were adjusted to the international standard: 1) costs within the health care sector; 2) patient and family costs; and 3) costs in other sectors. Reference prices were updated to reflect 2014 values. The methodology chapter was rewritten to match the requirements of the costing manual and preferences of the users. Reference prices for nursing days of specific wards, for diagnostic procedures and nurse practitioners were added. Conclusions The usability of the costing manual was increased and parameter values were updated. The costing manual became integrated in the new health economic guidelines. PMID:29121647

Update of the Dutch manual for costing studies in health care.

PubMed

Kanters, Tim A; Bouwmans, Clazien A M; van der Linden, Naomi; Tan, Siok Swan; Hakkaart-van Roijen, Leona

2017-01-01

Dutch health economic guidelines include a costing manual, which describes preferred research methodology for costing studies and reference prices to ensure high quality studies and comparability between study outcomes. This paper describes the most important revisions of the costing manual compared to the previous version. An online survey was sent out to potential users of the costing manual to identify topics for improvement. The costing manual was aligned with contemporary health economic guidelines. All methodology sections and parameter values needed for costing studies, particularly reference prices, were updated. An expert panel of health economists was consulted several times during the review process. The revised manual was reviewed by two members of the expert panel and by reviewers of the Dutch Health Care Institute. The majority of survey respondents was satisfied with content and usability of the existing costing manual. Respondents recommended updating reference prices and adding some particular commonly needed reference prices. Costs categories were adjusted to the international standard: 1) costs within the health care sector; 2) patient and family costs; and 3) costs in other sectors. Reference prices were updated to reflect 2014 values. The methodology chapter was rewritten to match the requirements of the costing manual and preferences of the users. Reference prices for nursing days of specific wards, for diagnostic procedures and nurse practitioners were added. The usability of the costing manual was increased and parameter values were updated. The costing manual became integrated in the new health economic guidelines.

Quality of doctor-patient communication through the eyes of the patient: variation according to the patient's educational level.

PubMed

Aelbrecht, Karolien; Rimondini, Michela; Bensing, Jozien; Moretti, Francesca; Willems, Sara; Mazzi, Mariangela; Fletcher, Ian; Deveugele, Myriam

2015-10-01

Good doctor-patient communication may lead to better compliance, higher patient satisfaction, and finally, better health. Although the social variance in how physicians and patients communicate is clearly demonstrated, little is known about what patients with different educational attainments actually prefer in doctor-patient communication. In this study we describe patients' perspective in doctor-patient communication according to their educational level, and to what extent these perspectives lean towards the expert opinion on doctor-patient communication. In a multi-center study (Belgium, The Netherlands, UK and Italy), focus group discussions were organised using videotaped medical consultations. A mixed methods approach was used to analyse the data. Firstly, a difference in perspective in communication style was found between the lower educated participants versus the middle and higher educated participants. Secondly, lower educated participants referred positively most to aspects related to the affective/emotional area of the medical consultation, followed by the task-oriented/problem-focused area. Middle and higher educated participants positively referred most to the task-oriented/problem-focused area. The competency of the physician was an important category of communication for all participants, independent of social background. The results indicate that the preferences of lower educated participants lean more towards the expert opinion in doctor-patient communication than the middle and higher educated participants. Patients' educational level seems to influence their perspective on communication style and should be taken into account by physicians. Further quantitative research is needed to confirm these results.

Does the community want devolved authority? Results of deliberative polling in Ontario.

PubMed Central

Abelson, J; Lomas, J; Eyles, J; Birch, S; Veenstra, G

1995-01-01

OBJECTIVE: To obtain and contrast the informed opinions of people in five decision-making groups that could have a role in devolved governance of health care and social services. DESIGN: Deliberative polling. SETTING: Three rural and three urban communities selected from the 32 areas covered by a district health council in Ontario. PARTICIPANTS: A total of 280 citizens from five potential decision-making groups: randomly selected citizens, attendees at town-hall meetings, appointees to district health councils, elected officials and experts in health care and social services. INTERVENTION: Participants' opinions were polled during 29 structured 2-hour meetings. MAIN OUTCOME MEASURES: Participants' opinions on their personal willingness and their group's suitability to be involved in devolved decision making, desired type of decision-making involvement, information preferences, preferred areas of decision-making involvement and preferred composition of decision-making bodies. RESULTS: Mean attendance at each meeting was 9.6 citizens. Although there were some significant differences in opinion among the five potential decision-making groups, there were few differences among citizens from different geographic areas. A total of 189 (72%) of people polled were personally willing to take on a role involving responsibility for overall decision-making, but far fewer thought that their group was suited to taking on responsibility (30%) or a consulting role (55%). Elected officials were the most willing (85% personally willing, 50% thought their group was suitable) and randomly selected citizens the least willing (60% personally willing, 17% thought their group was suitable) to take responsibility for overall decision making. Most citizens polled indicated less interest in involvement in specific types of decisions, except for planning and setting priorities, than in overall decision making. Only 24 participants (9%) rated their own group as suitable to take responsibility for raising revenue, 91 (33%) deemed their group suited to distribution of funds and 108 (39%) felt their group was suitable for management of services. People in all five groups ranked health care needs (mean rank 1.5 out of four options) as the most important and preferences (mean rank 3.6) as the least important information. They rated a combination body involving several community groups as the most suitable overall decision-making body (8.8 on 10-point scale). Participants favoured the representation of elected officials, the provincial government and experts on combination bodies responsible for the specific types of decisions. Overall, as the complexity of devolved decision making became clear, participants tended to assign authority to traditional decision makers such as elected officials, experts and the provincial government, but also favoured a consulting role for attendees at town-hall meetings (i.e., interested citizens). CONCLUSION: There are significant differences among groups in the community in their willingness to be involved, desired roles and representation in devolved decision making on health care and social services in Ontario. PMID:7634217

Surgical Strategies for Management of Mitral Regurgitation: Recent Evidence from Randomized Controlled Trials.

PubMed

Tolis, George; Sundt, Thoralf M

2015-12-01

In contrast to mitral regurgitation (MR) caused by structural abnormality of the valve ("primary" MR), about which there is increasing consensus regarding treatment, there is increasing controversy around the management of functional or "secondary" MR, of which "ischemic mitral regurgitation" (IMR) is a common cause. While the trend in the management of primary MR is increasingly aggressive, with wide agreement on the preference for repair over replacement such that debate centers on earlier and earlier repair even among asymptomatic patients, the situation is reversed in the setting of secondary MR with uncertainly beyond the mode of management (repair or replacement) to the value of intervening at all. This is, in part, because the term IMR has been somewhat loosely applied by the medical and surgical communities to include regurgitation secondary to active myocardial ischemia, as well as that resulting from a completed myocardial infarct. As a result, there is considerable variability in reported outcomes of surgical interventions for IMR. In addition, the natural history of IMR is quite adverse-more so than that of many solid organ malignancies-and its surgical treatment has traditionally carried a higher operative mortality than many cardiac surgical procedures, including similar operations for primary MR and incidental coronary artery disease. Added to this, with recent advances in both the medical and surgical treatment of heart failure improving nonoperative outcomes and simultaneously reducing operative risk compared to reports from previous decades, the landscape has been quite dynamic. Here, we review the issues surrounding surgical treatment for IMR, along with available evidence supporting different approaches, to lend an informed perspective on the divergent opinions among experts in this field and guide the appropriate management of the individual patient.

A perverse quality incentive in surgery: implications of reimbursing surgeons less for doing laparoscopic surgery.

PubMed

Fader, Amanda N; Xu, Tim; Dunkin, Brian J; Makary, Martin A

2016-11-01

Surgery is one of the highest priced services in health care, and complications from surgery can be serious and costly. Recently, advances in surgical techniques have allowed surgeons to perform many common operations using minimally invasive methods that result in fewer complications. Despite this, the rates of open surgery remain high across multiple surgical disciplines. This is an expert commentary and review of the contemporary literature regarding minimally invasive surgery practices nationwide, the benefits of less invasive approaches, and how minimally invasive compared with open procedures are differentially reimbursed in the United States. We explore the incentive of the current surgeon reimbursement fee schedule and its potential implications. A surgeon's preference to perform minimally invasive compared with open surgery remains highly variable in the U.S., even after adjustment for patient comorbidities and surgical complexity. Nationwide administrative claims data across several surgical disciplines demonstrates that minimally invasive surgery utilization in place of open surgery is associated with reduced adverse events and cost savings. Reducing surgical complications by increasing adoption of minimally invasive operations has significant cost implications for health care. However, current U.S. payment structures may perversely incentivize open surgery and financially reward physicians who do not necessarily embrace newer or best minimally invasive surgery practices. Utilization of minimally invasive surgery varies considerably in the U.S., representing one of the greatest disparities in health care. Existing physician payment models must translate the growing body of research in surgical care into physician-level rewards for quality, including choice of operation. Promoting safe surgery should be an important component of a strong, value-based healthcare system. Resolving the potentially perverse incentives in paying for surgical approaches may help address disparities in surgical care, reduce the prevalent problem of variation, and help contain health care costs.

Care management of the agitation or aggressiveness crisis in patients with TBI. Systematic review of the literature and practice recommendations.

PubMed

Luauté, Jacques; Plantier, David; Wiart, Laurent; Tell, Laurence

2016-02-01

The agitation crisis in the awakening phase after traumatic brain injury (TBI) is one of the most difficult behavioral disorders to alleviate. Current treatment options are heterogeneous and may involve excessive sedation. Practice guidelines are required by professionals in charge of TBI patients. Few reviews were published but those are old and based on expert opinions. The purpose of this work is to propose evidence-based guidelines to treat the agitation crisis. The elaboration of these guidelines followed the procedure validated by the French health authority for good practice recommendations, close to the Prisma statement. Guidelines were elaborated on the basis of a systematic and critical review of the literature. Twenty-eight articles concerning 376 patients were analyzed. Recommendations are: when faced with an agitation crisis, the management strategy implies to search for an underlying factor that should be treated such as pain, acute sepsis, and drug adverse effect (expert opinion). Physical restraints should be discarded when possible (expert opinion). Neuroleptic agent with a marketing authorization can be used in order to obtain a quick sedation so as to protect the patient from himself, closed ones or the healthcare team but the duration should be as short as possible (expert opinion). The efficacy of beta-blockers and antiepileptics with mood regulation effects like carbamazepine and valproate yield the most compelling evidence and should be preferably used when a background regimen is envisioned (grade B for beta-blocker and C for antiepileptics). Neuroleptics, antidepressants, benzodiazepines, buspirone may be prescribed but are considered second-line treatments (expert opinion). This study provides a strategy for treating the agitation crisis based on scientific data and expert opinion. The level of evidence remains low and published data are often old. New studies are essential to validate results from previous studies and test new drugs and non-pharmaceutical therapies. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Defining and identifying concepts of medication literacy: An international perspective.

PubMed

Pouliot, Annie; Vaillancourt, Régis; Stacey, Danielle; Suter, Philippe

2017-11-08

Multiple concepts to define health literacy in the context of medication use exist, such as medication literacy, pharmacotherapy literacy, pharmacy health literacy; however, no studies have looked at consensus among experts internationally. A Delphi process was used to achieve consensus on the statements about medication literacy. Experts for the Delphi were selected from a review of the literature and suggestions from an international survey conducted with members of the International Pharmaceutical Federation on medication literacy. The preliminary Delphi questionnaire was built using the statements about medication literacy found in the scientific literature. Responses and comments were analyzed using a pre-established method and communicated to the experts after each round of Delphi. Statements with an agreement of at least 80% were accepted and used to develop a definition of medication literacy. The Delphi process started with 21 experts and included 4 rounds. Overall, 30 statements regarding medication literacy were accepted and divided into 4 clusters representing: (1) type of information necessary for optimal and safe use of medication, (2) skills and abilities, (3) format of information, and (4) outcomes. These statements were used to propose 2 different definitions of medication literacy. One of the definitions was preferred by 75% of the expert panel, which provided further comments for improvements. Of the 11 experts who answered the final questionnaire, nine strongly agreed with the refined definition. Medication literacy is the degree to which individuals can obtain, comprehend, communicate, calculate and process patient-specific information about their medications to make informed medication and health decisions in order to safely and effectively use their medications, regardless of the mode by which the content is delivered (e.g. written, oral and visual). Future studies should focus on how this definition can be operationalized to support the role that pharmacists and other healthcare providers. Copyright © 2017 Elsevier Inc. All rights reserved.