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Sample records for group consensus opinion

  1. Non-consensus Opinion Models on Complex Networks

    NASA Astrophysics Data System (ADS)

    Li, Qian; Braunstein, Lidia A.; Wang, Huijuan; Shao, Jia; Stanley, H. Eugene; Havlin, Shlomo

    2013-04-01

    only within single networks but also between networks, and because the rules of opinion formation within a network may differ from those between networks, we study here the opinion dynamics in coupled networks. Each network represents a social group or community and the interdependent links joining individuals from different networks may be social ties that are unusually strong, e.g., married couples. We apply the non-consensus opinion (NCO) rule on each individual network and the global majority rule on interdependent pairs such that two interdependent agents with different opinions will, due to the influence of mass media, follow the majority opinion of the entire population. The opinion interactions within each network and the interdependent links across networks interlace periodically until a steady state is reached. We find that the interdependent links effectively force the system from a second order phase transition, which is characteristic of the NCO model on a single network, to a hybrid phase transition, i.e., a mix of second-order and abrupt jump-like transitions that ultimately becomes, as we increase the percentage of interdependent agents, a pure abrupt transition. We conclude that for the NCO model on coupled networks, interactions through interdependent links could push the non-consensus opinion model to a consensus opinion model, which mimics the reality that increased mass communication causes people to hold opinions that are increasingly similar. We also find that the effect of interdependent links is more pronounced in interdependent scale free networks than in interdependent Erdős Rényi networks.

  2. A Self-Categorization Explanation for Opinion Consensus Perceptions

    ERIC Educational Resources Information Center

    Zhang, Jinguang; Reid, Scott A.

    2013-01-01

    The public expression of opinions (and related communicative activities) hinges upon the perception of opinion consensus. Current explanations for opinion consensus perceptions typically focus on egocentric and other biases, rather than functional cognitions. Using self-categorization theory we showed that opinion consensus perceptions flow from…

  3. Boltzmann-type control of opinion consensus through leaders

    PubMed Central

    Albi, G.; Pareschi, L.; Zanella, M.

    2014-01-01

    The study of formations and dynamics of opinions leading to the so-called opinion consensus is one of the most important areas in mathematical modelling of social sciences. Following the Boltzmann-type control approach recently introduced by the first two authors, we consider a group of opinion leaders who modify their strategy accordingly to an objective functional with the aim of achieving opinion consensus. The main feature of the Boltzmann-type control is that, owing to an instantaneous binary control formulation, it permits the minimization of the cost functional to be embedded into the microscopic leaders’ interactions of the corresponding Boltzmann equation. The related Fokker–Planck asymptotic limits are also derived, which allow one to give explicit expressions of stationary solutions. The results demonstrate the validity of the Boltzmann-type control approach and the capability of the leaders’ control to strategically lead the followers’ opinion. PMID:25288820

  4. Boltzmann-type control of opinion consensus through leaders.

    PubMed

    Albi, G; Pareschi, L; Zanella, M

    2014-11-13

    The study of formations and dynamics of opinions leading to the so-called opinion consensus is one of the most important areas in mathematical modelling of social sciences. Following the Boltzmann-type control approach recently introduced by the first two authors, we consider a group of opinion leaders who modify their strategy accordingly to an objective functional with the aim of achieving opinion consensus. The main feature of the Boltzmann-type control is that, owing to an instantaneous binary control formulation, it permits the minimization of the cost functional to be embedded into the microscopic leaders' interactions of the corresponding Boltzmann equation. The related Fokker-Planck asymptotic limits are also derived, which allow one to give explicit expressions of stationary solutions. The results demonstrate the validity of the Boltzmann-type control approach and the capability of the leaders' control to strategically lead the followers' opinion.

  5. Prediction of collective opinion in consensus formation

    NASA Astrophysics Data System (ADS)

    Hou, Lei; Liu, Jianguo; Pan, Xue; Song, Wen-Jun; Li, Xu-Dong

    2014-12-01

    In the consensus formation dynamics, the effect of leaders and interventions have been widely studied for it has many applications such as in politics and commerce. However, the problem is how to know if it is necessary for one to make an intervention. In this paper, we theoretically propose a method for predicting the tendency and final state of collective opinion. By giving each agent a conviction ci which measures the ability to insist on his opinion, we present an opinion formation model in which agents with high convictions naturally show up properties of the opinion leaders. Results reveal that, although each agent initially gets an opinion evenly distributed in the range [-1, 1], the collective opinion of the steady-state may deviate to the positive or negative direction because of the initial bias of the leaders' opinions. We further get the correlation coefficient of the linear relationship between the collective opinion and the initial bias according to both the experimental and theoretical analysis. Thus, we could predict the final state at the very beginning of the dynamic only if we get the opinions of a small portion of the population. The prediction would afford us more time and opportunities to make reactions and interventions.

  6. A consensus opinion model based on the evolutionary game

    NASA Astrophysics Data System (ADS)

    Yang, Han-Xin

    2016-08-01

    We propose a consensus opinion model based on the evolutionary game. In our model, both of the two connected agents receive a benefit if they have the same opinion, otherwise they both pay a cost. Agents update their opinions by comparing payoffs with neighbors. The opinion of an agent with higher payoff is more likely to be imitated. We apply this model in scale-free networks with tunable degree distribution. Interestingly, we find that there exists an optimal ratio of cost to benefit, leading to the shortest consensus time. Qualitative analysis is obtained by examining the evolution of the opinion clusters. Moreover, we find that the consensus time decreases as the average degree of the network increases, but increases with the noise introduced to permit irrational choices. The dependence of the consensus time on the network size is found to be a power-law form. For small or larger ratio of cost to benefit, the consensus time decreases as the degree exponent increases. However, for moderate ratio of cost to benefit, the consensus time increases with the degree exponent. Our results may provide new insights into opinion dynamics driven by the evolutionary game theory.

  7. Bias, belief, and consensus: Collective opinion formation on fluctuating networks

    NASA Astrophysics Data System (ADS)

    Ngampruetikorn, Vudtiwat; Stephens, Greg J.

    2016-11-01

    With the advent of online networks, societies have become substantially more interconnected with individual members able to easily both maintain and modify their own social links. Here, we show that active network maintenance exposes agents to confirmation bias, the tendency to confirm one's beliefs, and we explore how this bias affects collective opinion formation. We introduce a model of binary opinion dynamics on a complex, fluctuating network with stochastic rewiring and we analyze these dynamics in the mean-field limit of large networks and fast link rewiring. We show that confirmation bias induces a segregation of individuals with different opinions and stabilizes the consensus state. We further show that bias can have an unusual, nonmonotonic effect on the time to consensus and this suggests a novel avenue for large-scale opinion manipulation.

  8. Persistence of opinion in the Sznajd consensus model: computer simulation

    NASA Astrophysics Data System (ADS)

    Stauffer, D.; de Oliveira, P. M. C.

    2002-12-01

    The density of never changed opinions during the Sznajd consensus-finding process decays with time t as 1/t^θ. We find θ simeq 3/8 for a chain, compatible with the exact Ising result of Derrida et al. In higher dimensions, however, the exponent differs from the Ising θ. With simultaneous updating of sublattices instead of the usual random sequential updating, the number of persistent opinions decays roughly exponentially. Some of the simulations used multi-spin coding.

  9. Terms, definitions and measurements to describe the sonographic features of the endometrium and intrauterine lesions: a consensus opinion from the International Endometrial Tumor Analysis (IETA) group.

    PubMed

    Leone, F P G; Timmerman, D; Bourne, T; Valentin, L; Epstein, E; Goldstein, S R; Marret, H; Parsons, A K; Gull, B; Istre, O; Sepulveda, W; Ferrazzi, E; Van den Bosch, T

    2010-01-01

    The IETA (International Endometrial Tumor Analysis group) statement is a consensus statement on terms, definitions and measurements that may be used to describe the sonographic features of the endometrium and uterine cavity on gray-scale sonography, color flow imaging and sonohysterography. The relationship between the ultrasound features described and the presence or absence of pathology is not known. However, the IETA terms and definitions may form the basis for prospective studies to predict the risk of different endometrial pathologies based on their ultrasound appearance.

  10. Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group.

    PubMed

    Guerriero, S; Condous, G; van den Bosch, T; Valentin, L; Leone, F P G; Van Schoubroeck, D; Exacoustos, C; Installé, A J F; Martins, W P; Abrao, M S; Hudelist, G; Bazot, M; Alcazar, J L; Gonçalves, M O; Pascual, M A; Ajossa, S; Savelli, L; Dunham, R; Reid, S; Menakaya, U; Bourne, T; Ferrero, S; Leon, M; Bignardi, T; Holland, T; Jurkovic, D; Benacerraf, B; Osuga, Y; Somigliana, E; Timmerman, D

    2016-09-01

    The IDEA (International Deep Endometriosis Analysis group) statement is a consensus opinion on terms, definitions and measurements that may be used to describe the sonographic features of the different phenotypes of endometriosis. Currently, it is difficult to compare results between published studies because authors use different terms when describing the same structures and anatomical locations. We hope that the terms and definitions suggested herein will be adopted in centers around the world. This would result in consistent use of nomenclature when describing the ultrasound location and extent of endometriosis. We believe that the standardization of terminology will allow meaningful comparisons between future studies in women with an ultrasound diagnosis of endometriosis and should facilitate multicenter research. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

  11. Using Consensus Groups in Online Learning

    ERIC Educational Resources Information Center

    Smith, Regina O.; Dirkx, John M.

    2007-01-01

    This chapter describes online consensus group work, a form of collaborative learning. It discusses collaborative learning, small group work, and consensus learning, with recommendations for their use in online contexts.

  12. Terms, definitions and measurements to describe sonographic features of myometrium and uterine masses: a consensus opinion from the Morphological Uterus Sonographic Assessment (MUSA) group.

    PubMed

    Van den Bosch, T; Dueholm, M; Leone, F P G; Valentin, L; Rasmussen, C K; Votino, A; Van Schoubroeck, D; Landolfo, C; Installé, A J F; Guerriero, S; Exacoustos, C; Gordts, S; Benacerraf, B; D'Hooghe, T; De Moor, B; Brölmann, H; Goldstein, S; Epstein, E; Bourne, T; Timmerman, D

    2015-09-01

    The MUSA (Morphological Uterus Sonographic Assessment) statement is a consensus statement on terms, definitions and measurements that may be used to describe and report the sonographic features of the myometrium using gray-scale sonography, color/power Doppler and three-dimensional ultrasound imaging. The terms and definitions described may form the basis for prospective studies to predict the risk of different myometrial pathologies, based on their ultrasound appearance, and thus should be relevant for the clinician in daily practice and for clinical research. The sonographic features and use of terminology for describing the two most common myometrial lesions (fibroids and adenomyosis) and uterine smooth muscle tumors are presented.

  13. Opinions, Conflicts, and Consensus: Modeling Social Dynamics in a Collaborative Environment

    NASA Astrophysics Data System (ADS)

    Török, János; Iñiguez, Gerardo; Yasseri, Taha; San Miguel, Maxi; Kaski, Kimmo; Kertész, János

    2013-02-01

    Information-communication technology promotes collaborative environments like Wikipedia where, however, controversy and conflicts can appear. To describe the rise, persistence, and resolution of such conflicts, we devise an extended opinion dynamics model where agents with different opinions perform a single task to make a consensual product. As a function of the convergence parameter describing the influence of the product on the agents, the model shows spontaneous symmetry breaking of the final consensus opinion represented by the medium. In the case when agents are replaced with new ones at a certain rate, a transition from mainly consensus to a perpetual conflict occurs, which is in qualitative agreement with the scenarios observed in Wikipedia.

  14. Interplay between consensus and coherence in a model of interacting opinions

    NASA Astrophysics Data System (ADS)

    Battiston, Federico; Cairoli, Andrea; Nicosia, Vincenzo; Baule, Adrian; Latora, Vito

    2016-06-01

    The formation of agents' opinions in a social system is the result of an intricate equilibrium among several driving forces. On the one hand, the social pressure exerted by peers favors the emergence of local consensus. On the other hand, the concurrent participation of agents to discussions on different topics induces each agent to develop a coherent set of opinions across all the topics in which he/she is active. Moreover, the pervasive action of external stimuli, such as mass media, pulls the entire population towards a specific configuration of opinions on different topics. Here we propose a model in which agents with interrelated opinions, interacting on several layers representing different topics, tend to spread their own ideas to their neighborhood, strive to maintain internal coherence, due to the fact that each agent identifies meaningful relationships among its opinions on the different topics, and are at the same time subject to external fields, resembling the pressure of mass media. We show that the presence of heterogeneity in the internal coupling assigned by agents to their different opinions allows to obtain states with mixed levels of consensus, still ensuring that all the agents attain a coherent set of opinions. Furthermore, we show that all the observed features of the model are preserved in the presence of thermal noise up to a critical temperature, after which global consensus is no longer attainable. This suggests the relevance of our results for real social systems, where noise is inevitably present in the form of information uncertainty and misunderstandings. The model also demonstrates how mass media can be effectively used to favor the propagation of a chosen set of opinions, thus polarizing the consensus of an entire population.

  15. Collective learning and optimal consensus decisions in social animal groups.

    PubMed

    Kao, Albert B; Miller, Noam; Torney, Colin; Hartnett, Andrew; Couzin, Iain D

    2014-08-01

    Learning has been studied extensively in the context of isolated individuals. However, many organisms are social and consequently make decisions both individually and as part of a collective. Reaching consensus necessarily means that a single option is chosen by the group, even when there are dissenting opinions. This decision-making process decouples the otherwise direct relationship between animals' preferences and their experiences (the outcomes of decisions). Instead, because an individual's learned preferences influence what others experience, and therefore learn about, collective decisions couple the learning processes between social organisms. This introduces a new, and previously unexplored, dynamical relationship between preference, action, experience and learning. Here we model collective learning within animal groups that make consensus decisions. We reveal how learning as part of a collective results in behavior that is fundamentally different from that learned in isolation, allowing grouping organisms to spontaneously (and indirectly) detect correlations between group members' observations of environmental cues, adjust strategy as a function of changing group size (even if that group size is not known to the individual), and achieve a decision accuracy that is very close to that which is provably optimal, regardless of environmental contingencies. Because these properties make minimal cognitive demands on individuals, collective learning, and the capabilities it affords, may be widespread among group-living organisms. Our work emphasizes the importance and need for theoretical and experimental work that considers the mechanism and consequences of learning in a social context.

  16. Non-consensus opinion model with a neutral view on complex networks

    NASA Astrophysics Data System (ADS)

    Tian, Zihao; Dong, Gaogao; Du, Ruijin; Ma, Jing

    2016-05-01

    A nonconsensus opinion (NCO) model was introduced recently, which allows the stable coexistence of minority and majority opinions. However, due ​to disparities in the knowledge, experiences, and personality or self-protection of agents, they often remain ​neutral when faced with some opinions in real scenarios. ​To address this issue, we propose a general non-consensus opinion model with neutral view (NCON) ​and we define the dynamic opinion ​change process. We applied the NCON model to different topological networks and studied the formation of opinion clusters. In the case of random graphs, random regular networks, and scale-free (SF) networks, we found that the system moved from a continuous phase transition to a discontinuous phase transition as the connectivity density and exponent of the SF network λ ​decreased and increased in the steady state, respectively. Moreover, the initial proportions of neutral opinions were found to have little effect on the proportional structure of opinions at the steady state. These results suggest that the majority choice between positive and negative opinions depends on the initial proportion of each opinion. The NCON model may have potential applications for decision makers.

  17. Current opinion and consensus statement regarding the diagnosis, prognosis, and treatment of patients with essential thrombocythemia: a survey of the Spanish Group of Ph-negative Myeloproliferative Neoplasms (GEMFIN) using the Delphi method.

    PubMed

    Besses, C; Hernández-Boluda, J C; Pérez Encinas, M; Raya, J M; Hernández-Rivas, J M; Jiménez Velasco, A; Martínez Lopez, J; Vicente, V; Burgaleta, C

    2016-04-01

    The current consensus on the diagnosis, prognosis, and treatment of essential thrombocythemia (ET) is based on experts' recommendations. However, several aspects of the diagnosis of, prognosis of, and therapy for ET are still controversial. The Delphi method was employed with an expert panel of members of the Spanish Group of Ph-negative Myeloproliferative Neoplasms in order to identify the degree of agreement on the diagnosis, prognosis, and treatment of ET. Nine leading experts selected a total of 41 clinical hematologists with well-known expertise in ET. An electronic questionnaire was used to collect the questions rated in a four-step scale. The questions were grouped into four blocks: diagnosis, risk stratification, goals of therapy, and treatment strategy. After the first round consisting of 80 questions, a second round including 14 additional questions focused on the recommendations advocated by experts of the European LeukemiaNet in 2011 was analyzed. The median and mean values for the first and second rounds were calculated. A summary of the conclusions considered as the most representative of each block of questions is presented. The Delphi method is a powerful instrument to address the current approaches and controversies surrounding ET.

  18. Contradictions and Consensus--Clusters of Opinions on E-Books

    ERIC Educational Resources Information Center

    Shrimplin, Aaron K.; Revelle, Andy; Hurst, Susan; Messner, Kevin

    2011-01-01

    Q methodology was used to determine attitudes and opinions about e-books among a group of faculty, graduate students, and undergraduates at Miami University of Ohio. Oral interviews formed the basis for a collection of opinion statements concerning e-books versus print. These statements were then ranked by a second group of research participants.…

  19. An opinion diffusion model with decision-making groups: The influence of the opinion's acceptability

    NASA Astrophysics Data System (ADS)

    Cheng, Zhichao; Xiong, Yang; Xu, Yiwen

    2016-11-01

    An opinion dynamic model with decision-making groups was proposed to study the process of adopting new opinions or ideas by individuals. The opinion's acceptability is introduced to distinguish the general character of different opinions. The simulation results on a free-scale network demonstrate that when two opinions have similar acceptability, the opinion supported by more decision-making groups in the beginning will eventually win the support of more agents, whereas an opinion supported by fewer decision-making groups in the beginning may be supported by the majority at the end only if it has better acceptability, and if the tolerance threshold of the society is higher than a specific value.

  20. Consensus versus persistence of disagreement in opinion formation: the role of zealots

    NASA Astrophysics Data System (ADS)

    Colaiori, Francesca; Castellano, Claudio

    2016-03-01

    We consider a general class of three-state models where individuals hold one of two opposite opinions, or are neutral, and exchange opinions in generic pairwise interactions. We show that when opinions spread in a population where a fraction of individuals (zealots) unshakably maintain their view, one of four qualitatively distinct kinds of collective dynamics arises, depending on the specific rules governing the social interactions. Unsurprisingly, when their density is high, zealots drive the whole population to consensus on their opinion. For low densities a rich phase diagram emerges: a finite population of dissenters can survive and be the only stationary state or may need a critical initial mass of dissenters to be sustained; the critical mass may vanish or not as the density is reduced; the transition to the high density regime can be smooth or abrupt, and shows interesting hysteretic effects. For each choice of the interaction rules we calculate the critical density of zealots above which diverse opinions cannot survive.

  1. Consensus Emerging from the Bottom-up: the Role of Cognitive Variables in Opinion Dynamics

    NASA Astrophysics Data System (ADS)

    Giardini, Francesca; Vilone, Daniele; Conte, Rosaria

    2015-09-01

    The study of opinions - e.g., their formation and change, and their effects on our society - by means of theoretical and numerical models has been one of the main goals of sociophysics until now, but it is one of the defining topics addressed by social psychology and complexity science. Despite the flourishing of different models and theories, several key questions still remain unanswered. The aim of this paper is to provide a cognitively grounded computational model of opinions in which they are described as mental representations and defined in terms of distinctive mental features. We also define how these representations change dynamically through different processes, describing the interplay between mental and social dynamics of opinions. We present two versions of the model, one with discrete opinions (voter model-like), and one with continuous ones (Deffuant-like). By means of numerical simulations, we compare the behaviour of our cognitive model with the classical sociophysical models, and we identify interesting differences in the dynamics of consensus for each of the models considered.

  2. Symmetry breaking in the opinion dynamics of a multi-group project organization

    NASA Astrophysics Data System (ADS)

    Zhu, Zhen-Tao; Zhou, Jing; Li, Ping; Chen, Xing-Guang

    2012-10-01

    A bounded confidence model of opinion dynamics in multi-group projects is presented in which each group's opinion evolution is driven by two types of forces: (i) the group's cohesive force which tends to restore the opinion back towards the initial status because of its company culture; and (ii) nonlinear coupling forces with other groups which attempt to bring opinions closer due to collaboration willingness. Bifurcation analysis for the case of a two-group project shows a cusp catastrophe phenomenon and three distinctive evolutionary regimes, i.e., a deadlock regime, a convergence regime, and a bifurcation regime in opinion dynamics. The critical value of initial discord between the two groups is derived to discriminate which regime the opinion evolution belongs to. In the case of a three-group project with a symmetric social network, both bifurcation analysis and simulation results demonstrate that if each pair has a high initial discord, instead of symmetrically converging to consensus with the increase of coupling scale as expected by Gabbay's result (Physica A 378 (2007) p. 125 Fig. 5), project organization (PO) may be split into two distinct clusters because of the symmetry breaking phenomenon caused by pitchfork bifurcations, which urges that apart from divergence in participants' interests, nonlinear interaction can also make conflict inevitable in the PO. The effects of two asymmetric level parameters are tested in order to explore the ways of inducing dominant opinion in the whole PO. It is found that the strong influence imposed by a leader group with firm faith on the flexible and open minded follower groups can promote the formation of a positive dominant opinion in the PO.

  3. Return to Play after Cervical Spine Injuries: A Consensus of Opinion

    PubMed Central

    France, John C.; Karsy, Michael; Harrop, James S.; Dailey, Andrew T.

    2016-01-01

    Study Design Survey. Objective Sports-related spinal cord injury (SCI) represents a growing proportion of total SCIs but lacks evidence or guidelines to guide clinical decision-making on return to play (RTP). Our objective is to offer the treating physician a consensus analysis of expert opinion regarding RTP that can be incorporated with the unique factors of a case for clinical decision-making. Methods Ten common clinical scenarios involving neurapraxia and stenosis, atlantoaxial injury, subaxial injury, and general cervical spine injury were presented to 25 spine surgeons from level 1 trauma centers for whom spine trauma is a significant component of their practice. We evaluated responses to questions about patient RTP, level of contact, imaging required for a clinical decision, and time to return for each scenario. The chi-square test was used for statistical analysis, with p < 0.05 considered significant. Results Evaluation of the surgeons' responses to these cases showed significant consensus regarding return to high-contact sports in cases of cervical cord neurapraxia without symptoms or stenosis, surgically repaired herniated disks, and nonoperatively healed C1 ring or C2 hangman's fractures. Greater variability was found in recommendations for patients showing persistent clinical symptomatology. Conclusion This survey suggests a consensus among surgeons for allowing patients with relatively normal imaging and resolution of symptoms to return to high-contact activities; however, patients with cervical stenosis or clinical symptoms continue to be a challenge for management. This survey may serve as a basis for future clinical trials and consensus guidelines. PMID:27853664

  4. How peer pressure shapes consensus, leadership, and innovations in social groups.

    PubMed

    Estrada, Ernesto; Vargas-Estrada, Eusebio

    2013-10-09

    What is the effect of the combined direct and indirect social influences--peer pressure (PP)--on a social group's collective decisions? We present a model that captures PP as a function of the socio-cultural distance between individuals in a social group. Using this model and empirical data from 15 real-world social networks we found that the PP level determines how fast a social group reaches consensus. More importantly, the levels of PP determine the leaders who can achieve full control of their social groups. PP can overcome barriers imposed upon a consensus by the existence of tightly connected communities with local leaders or the existence of leaders with poor cohesiveness of opinions. A moderate level of PP is also necessary to explain the rate at which innovations diffuse through a variety of social groups.

  5. How Peer Pressure Shapes Consensus, Leadership, and Innovations in Social Groups

    NASA Astrophysics Data System (ADS)

    Estrada, Ernesto; Vargas-Estrada, Eusebio

    2013-10-01

    What is the effect of the combined direct and indirect social influences--peer pressure (PP)--on a social group's collective decisions? We present a model that captures PP as a function of the socio-cultural distance between individuals in a social group. Using this model and empirical data from 15 real-world social networks we found that the PP level determines how fast a social group reaches consensus. More importantly, the levels of PP determine the leaders who can achieve full control of their social groups. PP can overcome barriers imposed upon a consensus by the existence of tightly connected communities with local leaders or the existence of leaders with poor cohesiveness of opinions. A moderate level of PP is also necessary to explain the rate at which innovations diffuse through a variety of social groups.

  6. How Peer Pressure Shapes Consensus, Leadership, and Innovations in Social Groups

    PubMed Central

    Estrada, Ernesto; Vargas-Estrada, Eusebio

    2013-01-01

    What is the effect of the combined direct and indirect social influences—peer pressure (PP)—on a social group's collective decisions? We present a model that captures PP as a function of the socio-cultural distance between individuals in a social group. Using this model and empirical data from 15 real-world social networks we found that the PP level determines how fast a social group reaches consensus. More importantly, the levels of PP determine the leaders who can achieve full control of their social groups. PP can overcome barriers imposed upon a consensus by the existence of tightly connected communities with local leaders or the existence of leaders with poor cohesiveness of opinions. A moderate level of PP is also necessary to explain the rate at which innovations diffuse through a variety of social groups. PMID:24104951

  7. Regional consensus opinion for the management of Beta thalassemia major in the Arabian Gulf area

    PubMed Central

    2013-01-01

    Thalassemia syndrome has diverse clinical presentations and a global spread that has far exceeded the classical Mediterranean basin where the mutations arose. The mutations that give rise to either alpha or beta thalassemia are numerous, resulting in a wide spectrum of clinical severity ranging from carrier state to life-threatening, inherited hemolytic anemia that requires regular blood transfusion. Beta thalassemia major constitutes a remarkable challenge to health care providers. The complications arising due to the anemia, transfusional iron overload, as well as other therapy-related complications add to the complexity of this condition. To produce this consensus opinion manuscript, a PubMed search was performed to gather evidence-based original articles, review articles, as well as published work reflecting the experience of physicians and scientists in the Arabian Gulf region in an effort to standardize the management protocol. PMID:24044606

  8. ABC3 Consensus: Assessment by a German Group of Experts

    PubMed Central

    Thomssen, Christoph; Augustin, Doris; Ettl, Johannes; Haidinger, Renate; Lück, Hans-Joachim; Lüftner, Diana; Marmé, Frederik; Marschner, Norbert; Müller, Lothar; Overkamp, Friedrich; Ruckhäberle, Eugen; Thill, Marc; Untch, Michael; Wuerstlein, Rachel; Harbeck, Nadia

    2016-01-01

    Summary The Advanced Breast Cancer Third International Consensus Conference on the diagnosis and treatment of advanced breast cancer took place in Lisbon, Portugal, on November 5-7, 2015. This year's conference (ABC3) was focused on the treatment of metastatic breast cancer (stage IV), as it was 4 years ago at the first consensus meeting (ABC1). A matter of particular interest was the patients’ perspective. Thus, patient-relevant issues were addressed by the consensus discussions, such as those on treatment goals, quality of life, care of long-term survivors (‘survivorship issues’), and coping with disease-related symptoms and the side effects of treatment. Further important issues on the agenda were the use of standardized instruments for the assessment of individual treatment success (‘patient-reported outcome measures’) and the evaluation of the benefit of novel drugs (e.g. the European Society for Medical Oncology (ESMO) Magnitude of Clinical Benefit Scale). Diagnosis and treatment of inoperable locally advanced breast cancer had already been discussed 2 years earlier at the ABC2 Consensus and were not dealt with in the framework of this year's ABC3 Consensus. With regard to country-specific peculiarities, which unavoidably found their way into the ABC Consensus, a working group of German breast cancer experts commented on the voting results of the ABC panelists. As for the past consensus, the group specially considered the German guidelines for the diagnosis and treatment of breast cancer (AGO (Gyneco-Oncology Working Group), S3, DGHO (German Society of Hematology and Medical Oncology)) in order to adapt the ABC3 consensus for everyday therapy in Germany. PMID:27051399

  9. Can journalistic "false balance" distort public perception of consensus in expert opinion?

    PubMed

    Koehler, Derek J

    2016-03-01

    Media critics have expressed concern that journalistic "false balance" can distort the public's perceptions of what ought to be noncontroversial subjects (e.g., climate change). I report several experiments testing the influence of presenting conflicting comments from 2 experts who disagree on an issue (balance condition) in addition to a complete count of the number of experts on a panel who favor either side. Compared with a control condition, who received only the complete count, participants in the balance condition gave ratings of the perceived agreement among the experts that did not discriminate as clearly between issues with and without strong expert consensus. Participants in the balance condition also perceived less agreement among the experts in general, and were less likely to think that there was enough agreement among experts on the high-consensus issues to guide government policy. Evidently, "false balance" can distort perceptions of expert opinion even when participants would seem to have all the information needed to correct for its influence.

  10. Standardised neonatal parenteral nutrition formulations - an Australasian group consensus 2012.

    PubMed

    Bolisetty, Srinivas; Osborn, David; Sinn, John; Lui, Kei

    2014-02-18

    Standardised parenteral nutrition formulations are routinely used in the neonatal intensive care units in Australia and New Zealand. In 2010, a multidisciplinary group was formed to achieve a consensus on the formulations acceptable to majority of the neonatal intensive care units. Literature review was undertaken for each nutrient and recommendations were developed in a series of meetings held between November 2010 and April 2011. Three standard and 2 optional amino acid/dextrose formulations and one lipid emulsion were agreed by majority participants in the consensus. This has a potential to standardise neonatal parenteral nutrition guidelines, reduce costs and prescription errors.

  11. Syndrome Differentiation of Diabetes by the Traditional Chinese Medicine according to Evidence-Based Medicine and Expert Consensus Opinion

    PubMed Central

    Guo, Jing; Chen, Hongdong; Song, Jun; Wang, Jia; Zhao, Linhua; Tong, Xiaolin

    2014-01-01

    In Chinese medicine, diabetes belongs to the category of “Xiaoke disease (disease with symptoms of frequent drinking and urination)”; in the traditional sense, its pathogenesis is “Yin deficiency and dryness-heat.” However, over time, changes in the social environment and lifestyle have also changed the use of traditional Chinese medicine (TCM) in diabetes. In this study, we performed diabetes syndrome differentiation using TCM according to evidence-based medicine and expert consensus opinion. PMID:25132859

  12. Primary Therapy of Patients with Early Breast Cancer: Evidence, Controversies, Consensus: Opinions of German Specialists to the 14th St. Gallen International Breast Cancer Conference 2015 (Vienna 2015).

    PubMed

    Untch, M; Harbeck, N; Huober, J; von Minckwitz, G; Gerber, B; Kreipe, H-H; Liedtke, C; Marschner, N; Möbus, V; Scheithauer, H; Schneeweiss, A; Thomssen, C; Jackisch, C; Beckmann, M W; Blohmer, J-U; Costa, S-D; Decker, T; Diel, I; Fasching, P A; Fehm, T; Janni, W; Lück, H-J; Maass, N; Scharl, A; Loibl, S

    2015-06-01

    For the first time, this year's St. Gallen International Consensus Conference on the treatment of patients with primary breast cancer, which takes place every two years, was held not in St. Gallen (Switzerland) but - for logistical reasons - in Vienna (Austria) under its usual name. The 2015 St. Gallen International Consensus Conference was the 14th of its kind. As the international panel of the St. Gallen conference consists of experts from different countries, the consensus mirrors an international cross-section of opinions. From a German perspective, it was considered useful to translate the results of the votes of the St. Gallen conference into practical suggestions, particularly in light of the recently updated treatment guideline of the Gynecologic Oncology Group (AGO-Mamma 2015) in Germany. A German group consisting of 14 breast cancer experts, three of whom are members of the international St. Gallen panel, has therefore provided comments on the results of this year's votes at the 2015 St. Gallen Consensus Conference and their impact on clinical care in Germany. The 14th St. Gallen conference once again focused on surgery of the breast and the axilla, radio-oncologic and systemic treatment options for primary breast cancer depending on tumor biology, and the clinical use of multigene assays. The conference also considered targeted therapies for older and for younger patients, including the diagnosis/treatment of breast cancer during and after pregnancy and the preservation of fertility.

  13. Opinion dynamics within a virtual small group: the stubbornness effect

    NASA Astrophysics Data System (ADS)

    Guazzini, Andrea; Cini, Alessandro; Bagnoli, Franco; Ramasco, José

    2015-09-01

    The modeling of opinion dynamics is social systems has attracted a good deal of attention in the last decade. Even though based on intuition and observation, the mechanisms behind many of these models need solid empirical grounding. In this work, we investigate the relation among subjective variables (such as the personality), the dynamics of the affinity network dynamics, the communication patterns emerging throughout the social interactions and the opinions dynamics in a series of experiments with five small groups of ten people each. In order to ignite the discussion, the polemic topic of animal experimentation was proposed. The groups essentially polarized in two factions with a set of stubborn individuals (those not changing their opinions in time) playing the role of anchors. Our results suggest that the different layers present in the group dynamics (i.e., individual level, group dynamics and meso-communication) are deeply intermingled, specifically the stubbornness effect appears to be related to the dynamical features of the network topologies, and only in an undirected way to the personality of the participants.

  14. Spurious Consensus and Opinion Revision: Why Might People Be More Confident in Their Less Accurate Judgments?

    ERIC Educational Resources Information Center

    Yaniv, Ilan; Choshen-Hillel, Shoham; Milyavsky, Maxim

    2009-01-01

    In the interest of improving their decision making, individuals revise their opinions on the basis of samples of opinions obtained from others. However, such a revision process may lead decision makers to experience greater confidence in their less accurate judgments. The authors theorize that people tend to underestimate the informative value of…

  15. Opinion dynamics of modified Hegselmann-Krause model in a group-based population with heterogeneous bounded confidence

    NASA Astrophysics Data System (ADS)

    Fu, Guiyuan; Zhang, Weidong; Li, Zhijun

    2015-02-01

    Continuous opinion dynamics in a group-based population with heterogeneous bounded confidences is considered in this paper. A slightly modified Hegselmann-Krause model is proposed, and agents are classified into three categories: open-minded-, moderate-minded-, and closed-minded-agents, while the whole population is divided into three subgroups accordingly. We study how agents of each category and the population size can affect opinion dynamics. It is observed that the number of final opinion clusters is dominated by the closed-minded agents; open-minded agents cannot contribute to forming opinion consensus and the existence of open-minded agents may diversify the final opinions instead; for the fixed population size and proportion of closed-minded agents, the relative size of the largest final opinion cluster varies along concave-parabola-like curve as the proportion of open-minded agents increases, and there is a tipping point when the number of open-minded agents is almost equal to that of moderate-minded agents; for the fixed proportion of the three categories in the population, as the population size becomes larger, the number of final opinion clusters will reach a plateau. Some of the results are different from the previous studies.

  16. Oxytocin enhances implicit social conformity to both in-group and out-group opinions.

    PubMed

    Huang, Yi; Kendrick, Keith M; Zheng, Huimin; Yu, Rongjun

    2015-10-01

    People often alter their own preferences when facing conflicting opinions expressed by others. This is known as the social conformity effect and tends to be stronger in response to opinions expressed by in-group relative to out-group members. The hypothalamic neuropeptide oxytocin promotes in-group favoritism, elicits parochial altruism, and stimulates in-group conformity under explicit social pressure. In a double-blind, placebo-controlled design experiment using a facial attractiveness judgment task, we therefore investigated whether social conformity to either in-group or out-group opinions is influenced by intranasal oxytocin treatment when social pressure is implicit. After oxytocin or placebo treatment, male participants were asked to rate the attractiveness of unfamiliar Chinese female faces, and then they were informed of ratings given by peers from an in-group (Chinese) and out-group (Japanese) simultaneously. They were subsequently asked unexpectedly to re-rate the same faces. Results showed that oxytocin increased conformity to both in- and out-group opinions. Thus oxytocin promotes conformity to opinions of both in- and out-group members when social pressure is implicit, suggesting that it facilitates 'tend and befriend' behaviors by increasing the general level of social conformity.

  17. Multidisciplinary Management of Mastocytosis: Nordic Expert Group Consensus.

    PubMed

    Broesby-Olsen, Sigurd; Dybedal, Ingunn; Gülen, Theo; Kristensen, Thomas K; Møller, Michael B; Ackermann, Leena; Sääf, Maria; Karlsson, Maria A; Agertoft, Lone; Brixen, Kim; Hermann, Pernille; Stylianou, Eva; Mortz, Charlotte G; Torfing, Trine; Havelund, Troels; Sander, Birgitta; Bergström, Anna; Bendix, Marie; Garvey, Lene H; Bjerrum, Ole Weis; Valent, Peter; Bindslev-Jensen, Carsten; Nilsson, Gunnar; Vestergaard, Hanne; Hägglund, Hans

    2016-06-15

    Mastocytosis is a heterogeneous group of diseases defined by an increased number and accumulation of mast cells, and often also by signs and symptoms of mast cell activation. Disease subtypes range from indolent to rare aggressive forms. Mastocytosis affects people of all ages and has been considered rare; however, it is probably underdiagnosed with potential severe implications. Diagnosis can be challenging and symptoms may be complex and involve multiple organ-systems. In general it is advised that patients should be referred to centres with experience in the disease offering an individualized, multidisciplinary approach. We present here consensus recommendations from a Nordic expert group for the diagnosis and general management of patients with mastocytosis.

  18. The Spanish human papillomavirus vaccine consensus group: a working model.

    PubMed

    Cortés-Bordoy, Javier; Martinón-Torres, Federico

    2010-08-01

    Successful implementation of Human Papillomavirus (HPV) vaccine in each country can only be achieved from a complementary and synergistic perspective, integrating all the different points of view of the diverse related professionals. It is this context where the Spanish HPV Vaccine Consensus Group (Grupo Español de Consenso sobre la Vacuna VPH, GEC-VPH) was created. GEC-VPH philosophy, objectives and experience are reported in this article, with particular attention to the management of negative publicity and anti-vaccine groups. Initiatives as GEC-VPH--adapted to each country's particular idiosyncrasies--might help to overcome the existing barriers and to achieve wide and early implementation of HPV vaccination.

  19. Melanoma: diagnosis, staging, and treatment. Consensus group recommendations.

    PubMed

    Berrocal, Alfonso; Cabañas, Luis; Espinosa, Enrique; Fernández-de-Misa, Ricardo; Martín-Algarra, Salvador; Martínez-Cedres, José Carlos; Ríos-Buceta, Luis; Rodríguez-Peralto, José Luis

    2014-09-01

    The incidence of malignant melanoma is increasing worldwide. In Spain, its incidence is increasing faster than any other cancer type, with a 5-year survival rate of about 85%. The impact and characteristics of malignant melanoma in the Spanish population can be ascertained from the national melanoma registry of the Academia Española de Dermatología y Venereología. This review presents consensus group recommendations for the diagnosis, staging and treatment of malignant melanoma in Spain. Incidence and mortality are discussed, as well as evaluation of various prevention and treatment strategies. Prognostic factors, such as BRAF and C-KIT mutations, which are expected to become routine staging procedures over the next few years, are outlined, especially in relation to treatment options. The use of recently approved targeted agents such as ipilimumab, a cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) inhibitor, and vemurafenib, a BRAF inhibitor, in metastatic disease are also discussed.

  20. [Early viscoelasticity-based coagulation therapy for severely injured bleeding patients: Report of the consensus group on the consensus conference 2014 for formulation of S2k guidelines].

    PubMed

    Maegele, M; Inaba, K; Rizoli, S; Veigas, P; Callum, J; Davenport, R; Fröhlich, M; Hess, J

    2015-10-01

    Although there is increasing interest in the use of a viscoelastic test procedure (ROTEM/TEG) for diagnostics and therapy guidance of severely injured and bleeding patients, currently no uniformly accepted guidelines exist for how this technology should be integrated into clinical treatment. In September 2014 an international multidisciplinary group of opinion leaders in the field of trauma-induced coagulopathy and other disciplines involved in the treatment of severely injured patients were assembled for a 2-day consensus conference in Philadelphia (USA). This panel included trauma/accident surgeons, general/abdominal surgeons, vascular surgeons, emergency/intensive care surgeons, hematologists, transfusion specialists, anesthesiologists, laboratory physicians, pathobiologists/pathophysiologists and the lay public. A total of nine questions regarding the impact of viscoelastic testing in the early treatment of trauma patients were developed prior to the conference by a panel consensus. Early use was defined as baseline viscoelastic test result thresholds obtained within the first minutes of hospital arrival, when conventional laboratory results are not yet available. The available data for each question were then reviewed in person using standardized presentations by the expert panel. A consensus summary document was then developed and reviewed by the panel in an open forum. Finally, a 2-round Delphi poll was administered to the panel of experts regarding viscoelastic thresholds for triggering the initiation of specific treatments including fibrinogen (concentrates), platelet concentrates, blood plasma products and prothrombin complex concentrates (PCC). This report summarizes the findings and recommendations of this consensus conference, which correspond to a S2k guideline according to the system of the Association of the Scientific Medical Societies in Germany (AWMF) and taking formal consensus findings including Delphi methods into consideration.

  1. The Peace Mediator effect: Heterogeneous agents can foster consensus in continuous opinion models

    NASA Astrophysics Data System (ADS)

    Vilone, Daniele; Carletti, Timoteo; Bagnoli, Franco; Guazzini, Andrea

    2016-11-01

    Statistical mechanics has proven to be able to capture the fundamental rules underlying phenomena of social aggregation and opinion dynamics, well studied in disciplines like sociology and psychology. This approach is based on the underlying paradigm that the interesting dynamics of multi-agent systems emerge from the correct definition of few parameters governing the evolution of each individual. In this context, we propose a particular model of opinion dynamics based on the psychological construct named "cognitive dissonance". Our system is made of interacting individuals, the agents, each bearing only two dynamical variables (respectively "opinion" and "affinity") self-consistently adjusted during time evolution. We also define two special classes of interacting entities, both acting for a peace mediation process but via different course of action: "diplomats" and "auctoritates". The behavior of the system with and without peace mediators (PMs) is investigated and discussed with reference to corresponding psychological and social implications.

  2. Nurse Educators' Consensus Opinion on Using an Academic Electronic Health Record: A Delphi Study

    ERIC Educational Resources Information Center

    Hanson, Darlene S.

    2013-01-01

    The purpose of this study was to determine the opinions of nurse educators in the state of North Dakota (ND) who were using the academic Electronic Health Record (EHR) known as SimChart. In this dissertation research study, factors that either hindered or facilitated the introduction of SimChart in nursing programs in ND were examined.…

  3. The use, publication and future directions of immunocytochemistry in veterinary medicine: a consensus of the Oncology-Pathology Working Group.

    PubMed

    Priest, H L; Hume, K R; Killick, D; Kozicki, A; Rizzo, V L; Seelig, D; Snyder, L A; Springer, N L; Wright, Z M; Robat, C

    2016-03-22

    One of the primary objectives of the Oncology Pathology Working Group (OPWG), a joint initiative of the Veterinary Cancer Society and the American College of Veterinary Pathologists, is for oncologists and pathologists to collaboratively generate consensus documents to standardize aspects of and provide guidelines for oncologic pathology. Consensus is established through review of relevant peer-reviewed literature relative to a subgroup's particular focus. In this document, the authors provide descriptions of the literature reviewed, the review process, and a summary of the information gathered on immunocytochemistry. The intent of this publication is to help educate practitioners and pathologists on the process of immunocytochemistry and to provide a guide for the use of this technique in veterinary medicine. This document represents the opinions of the working group and the authors and does not constitute a formal endorsement by the American College of Veterinary Pathologists or the Veterinary Cancer Society.

  4. Global Aesthetics Consensus: Avoidance and Management of Complications from Hyaluronic Acid Fillers—Evidence- and Opinion-Based Review and Consensus Recommendations

    PubMed Central

    Liew, Steven; Sundaram, Hema; De Boulle, Koenraad L.; Goodman, Greg J.; Monheit, Gary; Wu, Yan; Trindade de Almeida, Ada R.; Swift, Arthur; Vieira Braz, André

    2016-01-01

    Background: Although the safety profile of hyaluronic acid fillers is favorable, adverse reactions can occur. Clinicians and patients can benefit from ongoing guidance on adverse reactions to hyaluronic acid fillers and their management. Methods: A multinational, multidisciplinary group of experts in cosmetic medicine convened the Global Aesthetics Consensus Group to review the properties and clinical uses of Hylacross and Vycross hyaluronic acid products and develop updated consensus recommendations for early and late complications associated with hyaluronic acid fillers. Results: The consensus panel provided specific recommendations focusing on early and late complications of hyaluronic acid fillers and their management. The impact of patient-, product-, and technique-related factors on such reactions was described. Most of these were noted to be mild and transient. Serious adverse events are rare. Early adverse reactions to hyaluronic acid fillers include vascular infarction and compromise; inflammatory reactions; injection-related events; and inappropriate placement of filler material. Among late reactions are nodules, granulomas, and skin discoloration. Most adverse events can be avoided with proper planning and technique. Detailed understanding of facial anatomy, proper patient and product selection, and appropriate technique can further reduce the risks. Should adverse reactions occur, the clinician must be prepared and have tools available for effective treatment. Conclusions: Adverse reactions with hyaluronic acid fillers are uncommon. Clinicians should take steps to further reduce the risk and be prepared to treat any complications that arise. PMID:27219265

  5. Group consensus of multi-agent systems in directed networks with noises and time delays

    NASA Astrophysics Data System (ADS)

    Shang, Yilun

    2015-10-01

    In this paper, group consensus problems in fixed directed networks of dynamic agents are investigated. Group consensus means that the agents in each group share a consistent value while there is no agreement between any two groups. Based on algebraic graph theory, sufficient conditions guaranteeing group consensus under the proposed control protocol in the presence of random noises and communication delays are derived. The analysis uses a stability result of Mao for stochastic differential delay equations, which ensures the consensus can be achieved almost surely and exponentially fast. Numerical examples are provided to demonstrate the availability of the obtained results as well as the effect of time delay/noise intensity.

  6. Group consensus control for heterogeneous multi-agent systems with fixed and switching topologies

    NASA Astrophysics Data System (ADS)

    Wen, Guoguang; Huang, Jun; Wang, Chunyan; Chen, Zhi; Peng, Zhaoxia

    2016-02-01

    In this paper, the group consensus problems of heterogeneous multi-agent systems with fixed and switching topologies are investigated. First, a class of distributed group consensus protocol is proposed for achieving the group consensus of heterogeneous multi-agent systems by using the neighbours' information. Then, some corresponding sufficient conditions are obtained to guarantee the achievement of group consensus. Rigorous proofs are given by using graph theory, matrix theory and Lyapunov theory. Finally, numerical simulations are also given to verify the theoretical analysis.

  7. Two-species-coagulation approach to consensus by group level interactions

    NASA Astrophysics Data System (ADS)

    Escudero, Carlos; Macià, Fabricio; Velázquez, Juan J. L.

    2010-07-01

    We explore the self-organization dynamics of a set of entities by considering the interactions that affect the different subgroups conforming the whole. To this end, we employ the widespread example of coagulation kinetics, and characterize which interaction types lead to consensus formation and which do not, as well as the corresponding different macroscopic patterns. The crucial technical point is extending the usual one species coagulation dynamics to the two species one. This is achieved by means of introducing explicitly solvable kernels which have a clear physical meaning. The corresponding solutions are calculated in the long time limit, in which consensus may or may not be reached. The lack of consensus is characterized by means of scaling limits of the solutions. The possible applications of our results to some topics in which consensus reaching is fundamental, such as collective animal motion and opinion spreading dynamics, are also outlined.

  8. An Analysis of the Opinions of Thirteen Client Groups Concerning the Harrison County Teacher Education Center.

    ERIC Educational Resources Information Center

    Curran, John

    This study is an analysis of the opinions of 13 client groups concerning the Harrison County Teacher Education Center (HCTEC) and is a sequel to a previous study. This study concentrated on two major questions: (1) what are the opinions of 13 client groups about the perceived needs for the HCTEC; and (2) how do these client groups differ in their…

  9. Opinion Spirals, Silent and Otherwise: Applying Small-Group Research to Public Opinion Phenomena (Review Essay).

    ERIC Educational Resources Information Center

    Price, Vincent; Allen, Scott

    1990-01-01

    Reviews E. Noelle-Neumann's "spiral of silence" theory, which holds that, when a person learns through the mass media that public opinion has shifted away from the person's views, that person withdraws from expressing those views. Points to conflicting empirical evidence on Neumann's theory. Summarizes criticisms advanced against the…

  10. Dynamical phase transitions in Hegselmann-Krause model of opinion dynamics and consensus

    NASA Astrophysics Data System (ADS)

    Slanina, F.

    2011-01-01

    The dynamics of the model of agents with limited confidence introduced by Hegselmann and Krause exhibits multiple well-separated regimes characterised by the number of distinct clusters in the stationary state. We present indications that there are genuine dynamical phase transitions between these regimes. The main indicator is the divergence of the average evolution time required to reach the stationary state. The slowdown close to the transition is connected with the emergence of the groups of mediator agents which are very small but have decisive role in the process of social convergence. More detailed study shows that the histogram of the evolution times is composed of several peaks. These peaks are unambiguously interpreted as corresponding to mediator groups consisting of one, two, three etc. agents. Detailed study reveals that each transition possesses also an internal fine structure.

  11. Consistency and consensus models for group decision-making with uncertain 2-tuple linguistic preference relations

    NASA Astrophysics Data System (ADS)

    Zhang, Zhen; Guo, Chonghui

    2016-08-01

    Due to the uncertainty of the decision environment and the lack of knowledge, decision-makers may use uncertain linguistic preference relations to express their preferences over alternatives and criteria. For group decision-making problems with preference relations, it is important to consider the individual consistency and the group consensus before aggregating the preference information. In this paper, consistency and consensus models for group decision-making with uncertain 2-tuple linguistic preference relations (U2TLPRs) are investigated. First of all, a formula which can construct a consistent U2TLPR from the original preference relation is presented. Based on the consistent preference relation, the individual consistency index for a U2TLPR is defined. An iterative algorithm is then developed to improve the individual consistency of a U2TLPR. To help decision-makers reach consensus in group decision-making under uncertain linguistic environment, the individual consensus and group consensus indices for group decision-making with U2TLPRs are defined. Based on the two indices, an algorithm for consensus reaching in group decision-making with U2TLPRs is also developed. Finally, two examples are provided to illustrate the effectiveness of the proposed algorithms.

  12. MEG Signatures of a Perceived Match or Mismatch between Individual and Group Opinions

    PubMed Central

    Zubarev, Ivan; Klucharev, Vasily; Ossadtchi, Alexei; Moiseeva, Victoria; Shestakova, Anna

    2017-01-01

    Humans often adjust their opinions to the perceived opinions of others. Neural responses to a perceived match or mismatch between individual and group opinions have been investigated previously, but some findings are inconsistent. In this study, we used magnetoencephalographic source imaging to investigate further neural responses to the perceived opinions of others. We found that group opinions mismatching with individual opinions evoked responses in the anterior and posterior medial prefrontal cortices, as well as in the temporoparietal junction and ventromedial prefrontal cortex in the 220–320 and 380–530 ms time windows. Evoked responses were accompanied by an increase in the power of theta oscillations (4–8 Hz) over a number of frontal cortical sites. Group opinions matching with individual opinions evoked an increase in amplitude of beta oscillations (13–30 Hz) in the anterior cingulate and ventral medial prefrontal cortices. Based on these results, we argue that distinct valuation and performance-monitoring neural circuits in the medial cortices of the brain may monitor compliance of individual behavior to the perceived group norms. PMID:28167897

  13. Strategy of competition between two groups based on an inflexible contrarian opinion model

    NASA Astrophysics Data System (ADS)

    Li, Qian; Braunstein, Lidia A.; Havlin, Shlomo; Stanley, H. Eugene

    2011-12-01

    We introduce an inflexible contrarian opinion (ICO) model in which a fraction p of inflexible contrarians within a group holds a strong opinion opposite to the opinion held by the rest of the group. At the initial stage, stable clusters of two opinions, A and B, exist. Then we introduce inflexible contrarians which hold a strong B opinion into the opinion A group. Through their interactions, the inflexible contrarians are able to decrease the size of the largest A opinion cluster and even destroy it. We see this kind of method in operation, e.g., when companies send free new products to potential customers in order to convince them to adopt their products and influence others to buy them. We study the ICO model, using two different strategies, on both Erdös-Rényi and scale-free networks. In strategy I, the inflexible contrarians are positioned at random. In strategy II, the inflexible contrarians are chosen to be the highest-degree nodes. We find that for both strategies the size of the largest A cluster decreases to 0 as p increases as in a phase transition. At a critical threshold value, pc, the system undergoes a second-order phase transition that belongs to the same universality class of mean-field percolation. We find that even for an Erdös-Rényi type model, where the degrees of the nodes are not so distinct, strategy II is significantly more effective in reducing the size of the largest A opinion cluster and, at very small values of p, the largest A opinion cluster is destroyed.

  14. The Effects of Assigned Role Versus Non-Assigned Role on Group Consensus.

    ERIC Educational Resources Information Center

    Gray, Philip A.

    1972-01-01

    Students in speech classes at Northern Illinois University participated in tests to determine what assumption of roles in discussion groups impairs participation and prohibits consensus. Students were randomly assigned to one of twelve discussion groups of five members each. The topic and materials for discussion were excerpted from the local…

  15. Definition of a COPD self-management intervention: International Expert Group consensus.

    PubMed

    Effing, Tanja W; Vercoulen, Jan H; Bourbeau, Jean; Trappenburg, Jaap; Lenferink, Anke; Cafarella, Paul; Coultas, David; Meek, Paula; van der Valk, Paul; Bischoff, Erik W M A; Bucknall, Christine; Dewan, Naresh A; Early, Frances; Fan, Vincent; Frith, Peter; Janssen, Daisy J A; Mitchell, Katy; Morgan, Mike; Nici, Linda; Patel, Irem; Walters, Haydn; Rice, Kathryn L; Singh, Sally; Zuwallack, Richard; Benzo, Roberto; Goldstein, Roger; Partridge, Martyn R; van der Palen, Job

    2016-07-01

    There is an urgent need for consensus on what defines a chronic obstructive pulmonary disease (COPD) self-management intervention. We aimed to obtain consensus regarding the conceptual definition of a COPD self-management intervention by engaging an international panel of COPD self-management experts using Delphi technique features and an additional group meeting.In each consensus round the experts were asked to provide feedback on the proposed definition and to score their level of agreement (1=totally disagree; 5=totally agree). The information provided was used to modify the definition for the next consensus round. Thematic analysis was used for free text responses and descriptive statistics were used for agreement scores.In total, 28 experts participated. The consensus round response rate varied randomly over the five rounds (ranging from 48% (n=13) to 85% (n=23)), and mean definition agreement scores increased from 3.8 (round 1) to 4.8 (round 5) with an increasing percentage of experts allocating the highest score of 5 (round 1: 14% (n=3); round 5: 83% (n=19)).In this study we reached consensus regarding a conceptual definition of what should be a COPD self-management intervention, clarifying the requisites for such an intervention. Operationalisation of this conceptual definition in the near future will be an essential next step.

  16. Experts reviews of the multidisciplinary consensus conference colon and rectal cancer 2012: science, opinions and experiences from the experts of surgery.

    PubMed

    van de Velde, C J H; Boelens, P G; Tanis, P J; Espin, E; Mroczkowski, P; Naredi, P; Pahlman, L; Ortiz, H; Rutten, H J; Breugom, A J; Smith, J J; Wibe, A; Wiggers, T; Valentini, V

    2014-04-01

    The first multidisciplinary consensus conference on colon and rectal cancer was held in December 2012, achieving a majority of consensus for diagnostic and treatment decisions using the Delphi Method. This article will give a critical appraisal of the topics discussed during the meeting and in the consensus document by well-known leaders in surgery that were involved in this multidisciplinary consensus process. Scientific evidence, experience and opinions are collected to support multidisciplinary teams (MDT) with arguments for medical decision-making in diagnosis, staging and treatment strategies for patients with colon or rectal cancer. Surgery is the cornerstone of curative treatment for colon and rectal cancer. Standardizing treatment is an effective instrument to improve outcome of multidisciplinary cancer care for patients with colon and rectal cancer. In this article, a review of the following focuses; Perioperative care, age and colorectal surgery, obstructive colorectal cancer, stenting, surgical anatomical considerations, total mesorectal excision (TME) surgery and training, surgical considerations for locally advanced rectal cancer (LARC) and local recurrent rectal cancer (LRRC), surgery in stage IV colorectal cancer, definitions of quality of surgery, transanal endoscopic microsurgery (TEM), laparoscopic colon and rectal surgery, preoperative radiotherapy and chemoradiotherapy, and how about functional outcome after surgery?

  17. Food Parenting Measurement Issues: Working Group Consensus Report

    PubMed Central

    Frankel, Leslie A.; Beltran, Alicia; Hodges, Eric; Hoerr, Sharon; Lumeng, Julie; Tovar, Alison; Kremers, Stef

    2013-01-01

    Abstract Childhood obesity is a growing problem. As more researchers become involved in the study of parenting influences on childhood obesity, there appears to be a lack of agreement regarding the most important parenting constructs of interest, definitions of those constructs, and measurement of those constructs in a consistent manner across studies. This article aims to summarize findings from a working group that convened specifically to discuss measurement issues related to parental influences on childhood obesity. Six subgroups were formed to address key measurement issues. The conceptualization subgroup proposed to define and distinguish constructs of general parenting styles, feeding styles, and food parenting practices with the goal of understanding interrelating levels of parental influence on child eating behaviors. The observational subgroup identified the need to map constructs for use in coding direct observations and create observational measures that can capture the bidirectional effects of parent–child interactions. The self-regulation subgroup proposed an operational definition of child self-regulation of energy intake and suggested future measures of self-regulation across different stages of development. The translational/community involvement subgroup proposed the involvement of community in the development of surveys so that measures adequately reflect cultural understanding and practices of the community. The qualitative methods subgroup proposed qualitative methods as a way to better understand the breadth of food parenting practices and motivations for the use of such practices. The longitudinal subgroup stressed the importance of food parenting measures sensitive to change for use in longitudinal studies. In the creation of new measures, it is important to consider cultural sensitivity and context-specific food parenting domains. Moderating variables such as child temperament and child food preferences should be considered in models

  18. Convergence to consensus in heterogeneous groups and the emergence of informal leadership

    PubMed Central

    Gavrilets, Sergey; Auerbach, Jeremy; van Vugt, Mark

    2016-01-01

    When group cohesion is essential, groups must have efficient strategies in place for consensus decision-making. Recent theoretical work suggests that shared decision-making is often the most efficient way for dealing with both information uncertainty and individual variation in preferences. However, some animal and most human groups make collective decisions through particular individuals, leaders, that have a disproportionate influence on group decision-making. To address this discrepancy between theory and data, we study a simple, but general, model that explicitly focuses on the dynamics of consensus building in groups composed by individuals who are heterogeneous in preferences, certain personality traits (agreeability and persuasiveness), reputation, and social networks. We show that within-group heterogeneity can significantly delay democratic consensus building as well as give rise to the emergence of informal leaders, i.e. individuals with a disproportionately large impact on group decisions. Our results thus imply strong benefits of leadership particularly when groups experience time pressure and significant conflict of interest between members (due to various between-individual differences). Overall, our models shed light on why leadership and decision-making hierarchies are widespread, especially in human groups. PMID:27412692

  19. In Pursuit of Consensus: Disagreement and legitimization during small-group argumentation

    NASA Astrophysics Data System (ADS)

    Berland, Leema K.; Lee, Victor R.

    2012-08-01

    In recent years, an emphasis on scientific argumentation in classrooms has brought into focus collaborative consensus-building as an instructional strategy. In these situations, students with differing and competing arguments are asked to work with one another in order to establish a shared perspective. However, the literature suggests that consensus-building can be challenging for students because their interpretations of the argumentative task and context may not enable their productive engagement with counter-arguments and evidence. In this paper, our goal is to explore the ways in which interactions of students support or inhibit their consensus-building. To that end, we examine and describe three cases that represent different ways in which initially dissenting students try to work towards a consensus with their peers. Through these cases, we demonstrate that legitimization of disparate or incorrect ideas can enable students whose arguments rely on incorrect ideas to feel that their ideas were heard and valued by the rest of their group. As such, we suggest that this legitimization is important because it can help students 'save face'. This enables students to move away from the competitive and persuasive aspects of argumentation towards interactions that align more closely with sensemaking and consensus-building.

  20. Consensus-oriented group peer review: a new process to review radiologist work output.

    PubMed

    Alkasab, Tarik K; Harvey, H Benjamin; Gowda, Vrushab; Thrall, James H; Rosenthal, Daniel I; Gazelle, G Scott

    2014-02-01

    The Joint Commission and other regulatory bodies have mandated that health care organizations implement processes for ongoing physician performance review. Software solutions, such as RADPEER™, have been created to meet this need efficiently. However, the authors believe that available systems are not optimally designed to produce changes in practice and overlook many important aspects of quality by excessive focus on diagnosis. The authors present a new model of peer review known as consensus-oriented group review, which is based on group discussion of cases in a conference setting and places greater emphasis on feedback than traditional systems of radiology peer review. By focusing on the process of peer review, consensus-oriented group review is intended to optimize performance improvement and foster group standards of practice. The authors also describe the software tool developed to implement this process of enriched peer review.

  1. Consensus or Deadlock? Consequences of Simple Behavioral Rules for Coordination in Group Decisions

    PubMed Central

    McCreery, Helen F.; Correll, Nikolaus; Breed, Michael D.

    2016-01-01

    Coordinated collective behaviors often emerge from simple rules governing the interactions of individuals in groups. We model mechanisms of coordination among ants during cooperative transport, a challenging task that requires a consensus on travel direction. Our goal is to determine whether groups following simple behavioral rules can reach a consensus using minimal information. Using deterministic and stochastic models, we investigate behavioral factors that affect coordination. We define and investigate three types of behavioral rules governing individual behavior that differ in the information available: individuals either 1) have no information, 2) can measure transport success, or 3) measure success while also knowing whether they are aligned with the majority. We find that groups break deadlocks only if individuals more readily give up when they are going against the majority, corresponding to rule type 3 –such groups are “informed.” These behavioral rules succeed through positive and negative feedbacks that are implemented in our model via a single mechanism: individuals only need to measure the relative group sizes to make effective decisions. We also find that groups reach consensus more quickly if they have either a shared bias, high sensitivity to group behavior, or finely tuned persistence. Each of these is a potential adaptation for efficient cooperative transport. This flexibility makes the behavioral rules in the informed case relatively robust to deficiencies in the individuals’ capabilities. While inspired by ants, our results are generalizable to other collective decisions with deadlocks, and demonstrate that groups of behaviorally simple individuals with no memory and extremely limited information can break symmetry and reach a consensus in a decision between two equal options. PMID:27682983

  2. International consensus for neuroblastoma molecular diagnostics: report from the International Neuroblastoma Risk Group (INRG) Biology Committee.

    PubMed

    Ambros, P F; Ambros, I M; Brodeur, G M; Haber, M; Khan, J; Nakagawara, A; Schleiermacher, G; Speleman, F; Spitz, R; London, W B; Cohn, S L; Pearson, A D J; Maris, J M

    2009-05-05

    Neuroblastoma serves as a paradigm for utilising tumour genomic data for determining patient prognosis and treatment allocation. However, before the establishment of the International Neuroblastoma Risk Group (INRG) Task Force in 2004, international consensus on markers, methodology, and data interpretation did not exist, compromising the reliability of decisive genetic markers and inhibiting translational research efforts. The objectives of the INRG Biology Committee were to identify highly prognostic genetic aberrations to be included in the new INRG risk classification schema and to develop precise definitions, decisive biomarkers, and technique standardisation. The review of the INRG database (n=8800 patients) by the INRG Task Force finally enabled the identification of the most significant neuroblastoma biomarkers. In addition, the Biology Committee compared the standard operating procedures of different cooperative groups to arrive at international consensus for methodology, nomenclature, and future directions. Consensus was reached to include MYCN status, 11q23 allelic status, and ploidy in the INRG classification system on the basis of an evidence-based review of the INRG database. Standardised operating procedures for analysing these genetic factors were adopted, and criteria for proper nomenclature were developed. Neuroblastoma treatment planning is highly dependant on tumour cell genomic features, and it is likely that a comprehensive panel of DNA-based biomarkers will be used in future risk assignment algorithms applying genome-wide techniques. Consensus on methodology and interpretation is essential for uniform INRG classification and will greatly facilitate international and cooperative clinical and translational research studies.

  3. Terminology for pregnancy loss prior to viability: a consensus statement from the ESHRE early pregnancy special interest group.

    PubMed

    Kolte, A M; Bernardi, L A; Christiansen, O B; Quenby, S; Farquharson, R G; Goddijn, M; Stephenson, M D

    2015-03-01

    Pregnancy loss prior to viability is common and research in the field is extensive. Unfortunately, terminology in the literature is inconsistent. The lack of consensus regarding nomenclature and classification of pregnancy loss prior to viability makes it difficult to compare study results from different centres. In our opinion, terminology and definitions should be based on clinical findings, and when possible, transvaginal ultrasound. With this Early Pregnancy Consensus Statement, it is our goal to provide clear and consistent terminology for pregnancy loss prior to viability.

  4. Evolution of opinions on social networks in the presence of competing committed groups.

    PubMed

    Xie, Jierui; Emenheiser, Jeffrey; Kirby, Matthew; Sreenivasan, Sameet; Szymanski, Boleslaw K; Korniss, Gyorgy

    2012-01-01

    Public opinion is often affected by the presence of committed groups of individuals dedicated to competing points of view. Using a model of pairwise social influence, we study how the presence of such groups within social networks affects the outcome and the speed of evolution of the overall opinion on the network. Earlier work indicated that a single committed group within a dense social network can cause the entire network to quickly adopt the group's opinion (in times scaling logarithmically with the network size), so long as the committed group constitutes more than about 10% of the population (with the findings being qualitatively similar for sparse networks as well). Here we study the more general case of opinion evolution when two groups committed to distinct, competing opinions A and B, and constituting fractions pA and pB of the total population respectively, are present in the network. We show for stylized social networks (including Erdös-Rényi random graphs and Barabási-Albert scale-free networks) that the phase diagram of this system in parameter space (pA,pB) consists of two regions, one where two stable steady-states coexist, and the remaining where only a single stable steady-state exists. These two regions are separated by two fold-bifurcation (spinodal) lines which meet tangentially and terminate at a cusp (critical point). We provide further insights to the phase diagram and to the nature of the underlying phase transitions by investigating the model on infinite (mean-field limit), finite complete graphs and finite sparse networks. For the latter case, we also derive the scaling exponent associated with the exponential growth of switching times as a function of the distance from the critical point.

  5. [Consensus on the detection and management of prediabetes. Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society].

    PubMed

    Mata-Cases, M; Artola, S; Escalada, J; Ezkurra-Loyola, P; Ferrer-García, J C; Fornos, J A; Girbés, J; Rica, I

    2015-01-01

    In Spain, according to the Di@bet.es study, 13.8% of the adult population suffers from diabetes and 14.8% from some form of prediabetes (impaired glucose tolerance, impaired fasting glucose or both). Since early detection of prediabetes can facilitate the implementation of therapeutic measures to prevent its progression to diabetes, we believe that preventive strategies in primary care and specialized clinical settings should be agreed. Screening for diabetes and prediabetes using a specific questionnaire (FINDRISC) and/or the measurement of fasting plasma glucose in high risk patients leads to detecting patients at risk of developing diabetes and it is necessary to consider how they should be managed. The intervention in lifestyle can reduce the progression to diabetes and reverse a prediabetic state to normal and is a cost-effective intervention. Some drugs, such as metformin, have also been shown effective in reducing the progression to diabetes but are not superior to non-pharmacological interventions. Finally, an improvement in some cardiovascular risk factors has been observed although there is no strong evidence supporting the effectiveness of screening in terms of morbility and mortality. The Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society has issued some recommendations that have been agreed by the Sociedad Española de Endocrinología y Nutrición, Sociedad Española de Endocrinología Pediátrica, Sociedad Española de Farmacia Comunitaria, Sociedad Española de Medicina Familiar y Comunitaria, Sociedad Española de Médicos Generales, Sociedad Española de Médicos de Atención Primaria, Sociedad Española de Medicina Interna, Asociación de Enfermería Comunitaria and Red de Grupos de Estudio de la Diabetes en Atención Primaria.

  6. [Consensus on the detection and management of prediabetes. Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society].

    PubMed

    Mata-Cases, M; Artola, S; Escalada, J; Ezkurra-Loyola, P; Ferrer-García, J C; Fornos, J A; Girbés, J; Rica, I

    2015-03-01

    In Spain, according to the Di@bet.es study, 13.8% of the adult population suffers from diabetes and 14.8% from some form of prediabetes (impaired glucose tolerance, impaired fasting glucose or both). Since early detection of prediabetes can facilitate the implementation of therapeutic measures to prevent its progression to diabetes, we believe that preventive strategies in primary care and specialized clinical settings should be agreed. Screening for diabetes and prediabetes using a specific questionnaire (FINDRISC) and/or the measurement of fasting plasma glucose in high risk patients leads to detecting patients at risk of developing diabetes and it is necessary to consider how they should be managed. The intervention in lifestyle can reduce the progression to diabetes and reverse a prediabetic state to normal and is a cost-effective intervention. Some drugs, such as metformin, have also been shown effective in reducing the progression to diabetes but are not superior to non-pharmacological interventions. Finally, an improvement in some cardiovascular risk factors has been observed although there is no strong evidence supporting the effectiveness of screening in terms of morbility and mortality. The Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society has issued some recommendations that have been agreed by the Sociedad Española de Endocrinología y Nutrición, Sociedad Española de Endocrinología Pediátrica, Sociedad Española de Farmacia Comunitaria, Sociedad Española de Medicina Familiar y Comunitaria, Sociedad Española de Médicos Generales, Sociedad Española de Médicos de Atención Primaria, Sociedad Española de Medicina Interna, Asociación de Enfermería Comunitaria and Red de Grupos de Estudio de la Diabetes en Atención Primaria.

  7. Consensus on the detection and management of prediabetes. Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society.

    PubMed

    Mata-Cases, M; Artola, S; Escalada, J; Ezkurra-Loyola, P; Ferrer-García, J C; Fornos, J A; Girbés, J; Rica, I

    2015-03-01

    In Spain, according to the Di@bet.es study, 13.8% of the adult population suffers from diabetes and 14.8% from some form of prediabetes (impaired glucose tolerance, impaired fasting glucose or both). Since early detection of prediabetes can facilitate the implementation of therapeutic measures to prevent its progression to diabetes, we believe that preventive strategies in primary care and specialized clinical settings should be agreed. Screening for diabetes and prediabetes using a specific questionnaire (FINDRISC) and/or the measurement of fasting plasma glucose in high risk patients leads to detecting patients at risk of developing diabetes and it is necessary to consider how they should be managed. The intervention in lifestyle can reduce the progression to diabetes and reverse a prediabetic state to normal and is a cost-effective intervention. Some drugs, such as metformin, have also been shown effective in reducing the progression to diabetes but are not superior to non-pharmacological interventions. Finally, an improvement in some cardiovascular risk factors has been observed although there is no strong evidence supporting the effectiveness of screening in terms of morbility and mortality. The Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society has issued some recommendations that have been agreed by the Sociedad Española de Endocrinología y Nutrición, Sociedad Española de Endocrinología Pediátrica, Sociedad Española de Farmacia Comunitaria, Sociedad Española de Medicina Familiar y Comunitaria, Sociedad Española de Médicos Generales, Sociedad Española de Médicos de Atención Primaria, Sociedad Española de Medicina Interna, Asociación de Enfermería Comunitaria and Red de Grupos de Estudio de la Diabetes en Atención Primaria.

  8. Gynecologic Cancer InterGroup (GCIG) consensus review for cervical adenocarcinoma.

    PubMed

    Fujiwara, Hiroyuki; Yokota, Harushige; Monk, Bradley; Treilleux, Isabelle; Devouassoux-Shisheboran, Mojgan; Davis, Alison; Kim, Jae-Weon; Mahner, Sven; Stany, Michael; Pignata, Sandro; Ray-Coquard, Isabelle; Fujiwara, Keiichi

    2014-11-01

    Cervical adenocarcinoma is known to be less common than squamous cell carcinoma of the cervix comprising approximately 25% of all cervical carcinomas. Differences in associated human papillomavirus types, patterns of spread, and prognosis call for treatments that are not always like those for squamous cancers. In this review, we report a consensus developed by the Gynecologic Cancer InterGroup surrounding cervical adenocarcinoma for epidemiology, pathology, treatment, and unanswered questions. Prospective clinical trials are needed to help develop treatment guidelines.

  9. Portal hypertension in children: expert pediatric opinion on the report of the Baveno v Consensus Workshop on Methodology of Diagnosis and Therapy in Portal Hypertension.

    PubMed

    Shneider, Benjamin L; Bosch, Jaime; de Franchis, Roberto; Emre, Sukru H; Groszmann, Roberto J; Ling, Simon C; Lorenz, Jonathan M; Squires, Robert H; Superina, Riccardo A; Thompson, Ann E; Mazariegos, George V

    2012-08-01

    Complications of portal hypertension in children lead to significant morbidity and are a leading indication for consideration of liver transplantation. Approaches to the management of sequelae of portal hypertension are well described for adults and evidence-based approaches have been summarized in numerous meta-analyses and conferences. In contrast, there is a paucity of data to guide the management of complications of portal hypertension in children. An international panel of experts was convened on April 8, 2011 at The Children's Hospital of Pittsburgh of UPMC to review and adapt the recent report of the Baveno V Consensus Workshop on the Methodology of Diagnosis and Therapy in Portal Hypertension to the care of children. The opinions of that expert panel are reported.

  10. Emerging treatments in neurogastroenterology: a multidisciplinary working group consensus statement on opioid-induced constipation

    PubMed Central

    CAMILLERI, M.; DROSSMAN, D. A.; BECKER, G.; WEBSTER, L. R.; DAVIES, A. N.; MAWE, G. M.

    2015-01-01

    Background Opioids are effective for acute and chronic pain conditions, but their use is associated with often difficult-to-manage constipation and other gastrointestinal (GI) effects due to effects on peripheral μ-opioid receptors in the gut. The mechanism of opioid-induced constipation (OIC) differs from that of functional constipation (FC), and OIC may not respond as well to most first-line treatments for FC. The impact of OIC on quality of life (QoL) induces some patients to decrease or stop their opioid therapy to relieve or avoid constipation. Purpose At a roundtable meeting on OIC, a working group developed a consensus definition for OIC diagnosis across disciplines and reviewed current OIC treatments and the potential of treatments in development. By consensus, OIC is defined as follows: ‘A change when initiating opioid therapy from baseline bowel habits that is characterized by any of the following: reduced bowel movement frequency, development or worsening of straining to pass bowel movements, a sense of incomplete rectal evacuation, or harder stool consistency’. The working group noted the prior validation of a patient response outcome and end point for clinical trials and recommended future efforts to create treatment guidelines and QoL measures specific for OIC. Details from the working group’s discussion and consensus recommendations for patient care and research are presented in this article. PMID:25164154

  11. Mucoactive and antioxidant medicines for COPD: consensus of a group of Chinese pulmonary physicians

    PubMed Central

    Yan, Xixin; Song, Yuanlin; Shen, Ce; Xu, Wenbing; Chen, Liangan; Zhang, Jian; Liu, Huiguo; Huang, Mao; Lai, Guoxiang; Qian, Guishen; Wang, Jing; Ye, Xianwei; Zheng, Jinping; Bai, Chunxue

    2017-01-01

    Airway mucus hypersecretion is a frequent symptom associated with acute and chronic airway disease. Inhibition of mucus production or promotion of mucolysis not only relieved symptoms but also improved disease outcomes. There are numerous available mucoactive medicines for prescription, and how to select them properly for different diseases is important for clinical practice. So far, there is no one consensus or guideline reported. A group of Chinese pulmonary physicians worked together to complete this consensus based on literature review, summarized mechanism and usage of each classical mucoactive medicine. In general, antioxidant mucoactive medicines play an important role in chronic airway disease, including but not limited to airway mucus clearance, reduced acute exacerbation and improved pulmonary function.

  12. [Therapeutic drug monitoring (TDM) of psychotropic drugs: a consensus guideline of the AGNP-TDM group].

    PubMed

    Baumann, P; Hiemke, C; Ulrich, S; Eckermann, G; Kuss, H L; Laux, G; Müller-Oerlingenhausen, B; Rao, M L; Riederer, P; Zernig, G

    2006-05-24

    In psychiatry, therapeutic drug monitoring (TDM) is an established procedure for most psychotropic drugs. However, as its use in everyday clinical practice is far from optimal, the AGNP-TDM group has worked out consensus guidelines to assist psychiatrists and laboratories involved in drug analysis. Based on a thorough analysis of available literature, 5 levels of recommendation were defined with regard to TDM of psychoactive drugs, from 1) (strongly recommended) to 5) (not recommended). A list of indications for TDM, alone or in combination with pharmacogenetic tests is presented. Instructions are given with regard to preparation of TDM, analytical procedures, reporting and interpretation of results and the use of information for patient treatment. Using the consensus guideline will help to ensure optimal clinical benefit of TDM.

  13. Consensus definitions and application guidelines for control groups in cerebrospinal fluid biomarker studies in multiple sclerosis.

    PubMed

    Teunissen, Charlotte; Menge, Til; Altintas, Ayse; Álvarez-Cermeño, José C; Bertolotto, Antonio; Berven, Frode S; Brundin, Lou; Comabella, Manuel; Degn, Matilde; Deisenhammer, Florian; Fazekas, Franz; Franciotta, Diego; Frederiksen, Jette L; Galimberti, Daniela; Gnanapavan, Sharmilee; Hegen, Harald; Hemmer, Bernhard; Hintzen, Rogier; Hughes, Steve; Iacobaeus, Ellen; Kroksveen, Ann C; Kuhle, Jens; Richert, John; Tumani, Hayrettin; Villar, Luisa M; Drulovic, Jelena; Dujmovic, Irena; Khalil, Michael; Bartos, Ales

    2013-11-01

    The choice of appropriate control group(s) is critical in cerebrospinal fluid (CSF) biomarker research in multiple sclerosis (MS). There is a lack of definitions and nomenclature of different control groups and a rationalized application of different control groups. We here propose consensus definitions and nomenclature for the following groups: healthy controls (HCs), spinal anesthesia subjects (SASs), inflammatory neurological disease controls (INDCs), peripheral inflammatory neurological disease controls (PINDCs), non-inflammatory neurological controls (NINDCs), symptomatic controls (SCs). Furthermore, we discuss the application of these control groups in specific study designs, such as for diagnostic biomarker studies, prognostic biomarker studies and therapeutic response studies. Application of these uniform definitions will lead to better comparability of biomarker studies and optimal use of available resources. This will lead to improved quality of CSF biomarker research in MS and related disorders.

  14. A Consensus-Based Grouping Algorithm for Multi-agent Cooperative Task Allocation with Complex Requirements.

    PubMed

    Hunt, Simon; Meng, Qinggang; Hinde, Chris; Huang, Tingwen

    2014-01-01

    This paper looks at consensus algorithms for agent cooperation with unmanned aerial vehicles. The foundation is the consensus-based bundle algorithm, which is extended to allow multi-agent tasks requiring agents to cooperate in completing individual tasks. Inspiration is taken from the cognitive behaviours of eusocial animals for cooperation and improved assignments. Using the behaviours observed in bees and ants inspires decentralised algorithms for groups of agents to adapt to changing task demand. Further extensions are provided to improve task complexity handling by the agents with added equipment requirements and task dependencies. We address the problems of handling these challenges and improve the efficiency of the algorithm for these requirements, whilst decreasing the communication cost with a new data structure. The proposed algorithm converges to a conflict-free, feasible solution of which previous algorithms are unable to account for. Furthermore, the algorithm takes into account heterogeneous agents, deadlocking and a method to store assignments for a dynamical environment. Simulation results demonstrate reduced data usage and communication time to come to a consensus on multi-agent tasks.

  15. Histopathologic diagnosis of chronic graft-versus-host disease: National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: II. Pathology Working Group Report.

    PubMed

    Shulman, Howard M; Kleiner, David; Lee, Stephanie J; Morton, Thomas; Pavletic, Steven Z; Farmer, Evan; Moresi, J Margaret; Greenson, Joel; Janin, Anne; Martin, Paul J; McDonald, George; Flowers, Mary E D; Turner, Maria; Atkinson, Jane; Lefkowitch, Jay; Washington, M Kay; Prieto, Victor G; Kim, Stella K; Argenyi, Zsolt; Diwan, A Hafeez; Rashid, Asif; Hiatt, Kim; Couriel, Dan; Schultz, Kirk; Hymes, Sharon; Vogelsang, Georgia B

    2006-01-01

    This consensus document provides an update for pathologists and clinicians about the interpretation of biopsy results and use of this information in the management of hematopoietic cell transplantation patients. Optimal sampling and tissue preparation are discussed. Minimal criteria for the diagnosis of graft-versus-host disease (GVHD) are proposed, together with specific requirements for the diagnosis of chronic GVHD. Four final diagnostic categories (no GVHD, possible GVHD, consistent with GVHD, and definite GVHD) reflect the integration of histopathology with clinical, laboratory, and radiographic information. Finally, the Working Group developed a set of worksheets to facilitate communication of clinical information to the interpreting pathologist and to aid in clinicopathologic correlation studies. Forms are available at . The recommendations of the Working Group represent a consensus opinion supplemented by evaluation of available peer-reviewed literature. Consensus recommendations and suggested data-capture forms should be validated in prospective clinicopathologic studies.

  16. Multi-Attribute Consensus Building Tool

    ERIC Educational Resources Information Center

    Shyyan, Vitaliy; Christensen, Laurene; Thurlow, Martha; Lazarus, Sheryl

    2013-01-01

    The Multi-Attribute Consensus Building (MACB) method is a quantitative approach for determining a group's opinion about the importance of each item (strategy, decision, recommendation, policy, priority, etc.) on a list (Vanderwood, & Erickson, 1994). This process enables a small or large group of participants to generate and discuss a set…

  17. Pelvic Normal Tissue Contouring Guidelines for Radiation Therapy: A Radiation Therapy Oncology Group Consensus Panel Atlas

    SciTech Connect

    Gay, Hiram A.; Barthold, H. Joseph; O'Meara, Elizabeth; Bosch, Walter R.; El Naqa, Issam; Al-Lozi, Rawan; Rosenthal, Seth A.; Lawton, Colleen; Lee, W. Robert; Sandler, Howard; Zietman, Anthony; Myerson, Robert; Dawson, Laura A.; Willett, Christopher; Kachnic, Lisa A.; Jhingran, Anuja; Portelance, Lorraine; Ryu, Janice; and others

    2012-07-01

    Purpose: To define a male and female pelvic normal tissue contouring atlas for Radiation Therapy Oncology Group (RTOG) trials. Methods and Materials: One male pelvis computed tomography (CT) data set and one female pelvis CT data set were shared via the Image-Guided Therapy QA Center. A total of 16 radiation oncologists participated. The following organs at risk were contoured in both CT sets: anus, anorectum, rectum (gastrointestinal and genitourinary definitions), bowel NOS (not otherwise specified), small bowel, large bowel, and proximal femurs. The following were contoured in the male set only: bladder, prostate, seminal vesicles, and penile bulb. The following were contoured in the female set only: uterus, cervix, and ovaries. A computer program used the binomial distribution to generate 95% group consensus contours. These contours and definitions were then reviewed by the group and modified. Results: The panel achieved consensus definitions for pelvic normal tissue contouring in RTOG trials with these standardized names: Rectum, AnoRectum, SmallBowel, Colon, BowelBag, Bladder, UteroCervix, Adnexa{sub R}, Adnexa{sub L}, Prostate, SeminalVesc, PenileBulb, Femur{sub R}, and Femur{sub L}. Two additional normal structures whose purpose is to serve as targets in anal and rectal cancer were defined: AnoRectumSig and Mesorectum. Detailed target volume contouring guidelines and images are discussed. Conclusions: Consensus guidelines for pelvic normal tissue contouring were reached and are available as a CT image atlas on the RTOG Web site. This will allow uniformity in defining normal tissues for clinical trials delivering pelvic radiation and will facilitate future normal tissue complication research.

  18. Prescribing attitudes, behaviors and opinions regarding metformin for patients with diabetes: a focus group study

    PubMed Central

    Trinkley, Katy E.; Malone, Daniel C.; Nelson, Jennifer A.; Saseen, Joseph J.

    2016-01-01

    Background: The purpose of this study was to identify the reasons why metformin prescribing is suboptimal. Methods: Two semi-structured focus groups with attitudinal questionnaires and a brief educational presentation were held in two US cities. Participants included providers (physicians, pharmacists, midlevel practitioners) caring for patients with type 2 diabetes mellitus (T2DM) in an ambulatory setting. Outcome measures included provider attitudes, behaviors and opinions regarding the use of metformin. Results: Participants identified three main themes influencing the use of metformin, including the appropriate timing of metformin initiation, known risks associated with metformin, and procedures to manage safety concerns and mitigate adverse effects associated with metformin. Participant prescribing behaviors of metformin were not consistent with the best available evidence in the settings of renal insufficiency, heart failure, hepatic dysfunction, alcohol use, and lactic acidosis. With minimal education, provider prescribing behaviors appeared to change by the end of the focus group to align more closely with the best available evidence. Conclusions: Provider attitudes, behaviors and opinions regarding the use of metformin for T2DM reveals the need for further education to improve appropriate use of metformin. Educational interventions should target prescribing behaviors and opinions identified to be inconsistent with the evidence. PMID:27583122

  19. Tuberculosis control in big cities and urban risk groups in the European Union: a consensus statement.

    PubMed

    van Hest, N A; Aldridge, R W; de Vries, G; Sandgren, A; Hauer, B; Hayward, A; Arrazola de Oñate, W; Haas, W; Codecasa, L R; Caylà, J A; Story, A; Antoine, D; Gori, A; Quabeck, L; Jonsson, J; Wanlin, M; Orcau, Å; Rodes, A; Dedicoat, M; Antoun, F; van Deutekom, H; Keizer, St; Abubakar, I

    2014-03-06

    In low-incidence countries in the European Union (EU), tuberculosis (TB) is concentrated in big cities, especially among certain urban high-risk groups including immigrants from TB high-incidence countries, homeless people, and those with a history of drug and alcohol misuse. Elimination of TB in European big cities requires control measures focused on multiple layers of the urban population. The particular complexities of major EU metropolises, for example high population density and social structure, create specific opportunities for transmission, but also enable targeted TB control interventions, not efficient in the general population, to be effective or cost effective. Lessons can be learnt from across the EU and this consensus statement on TB control in big cities and urban risk groups was prepared by a working group representing various EU big cities, brought together on the initiative of the European Centre for Disease Prevention and Control. The consensus statement describes general and specific social, educational, operational, organisational, legal and monitoring TB control interventions in EU big cities, as well as providing recommendations for big city TB control, based upon a conceptual TB transmission and control model.

  20. CTSA Consortium Consensus Scientific Review Committee (SRC) Working Group Report on the SRC Processes

    PubMed Central

    Buse, John B.; Califf, Robert M.; Carter, Robert; Cooper, Dan M.; Davis, Jonathan; Ford, Daniel E.; Galassetti, Pietro; Guay‐Woodford, Lisa; Huggins, Gordon S.; Kasper, Amanda; Kieburtz, Karl; Kirby, Aaron; Klein, Andreas K.; Kline, Joel; O’ Neill, Robert T.; Rape, Marie; Reichgott, Douglas J.; Rojevsky, Svetlana; Rosenthal, Gary E.; Rubinstein, Eric P.; Shepherd, Amy; Stacy, Mark; Terrin, Norma; Wallace, Mark; Welch, Lisa

    2015-01-01

    Abstract Human research projects must have a scientifically valid study design, analytic plan, and be operationally feasible in order to be successfully completed and thus to have translational impact. To ensure this, institutions that conduct clinical research should have a scientific review process prior to submission to the Institutional Review Committee (IRB). This paper reports the Clinical and Translational Science Award (CTSA) Consortium Scientific Review Committee (SRC) Consensus Working Group's proposed framework for a SRC process. Recommendations are provided for institutional support and roles of CTSAs, multisite research, criteria for selection of protocols that should be reviewed, roles of committee members, application process, and committee process. Additionally, to support the SCR process effectively, and to ensure efficiency, the Working Group recommends information technology infrastructures and evaluation metrics to determine outcomes are provided. PMID:26184433

  1. Opinion formation with time-varying bounded confidence.

    PubMed

    Zhang, YunHong; Liu, QiPeng; Zhang, SiYing

    2017-01-01

    When individuals in social groups communicate with one another and are under the influence of neighbors' opinions, they typically revise their own opinions to adapt to such peer opinions. The individual threshold of bounded confidence will thus be affected by both a change in individual confidence and by neighbor influence. Individuals thus update their own opinions with new bounded confidence, while their updated opinions also influence their neighbors' opinions. Based on this reasoned factual assumption, we propose an opinion dynamics model with time-varying bounded confidence. A directed network is formed by the rule of the individual bounded confidence threshold. The threshold of individual bounded confidence involves both confidence variation and the in/out degree of the individual node. When the confidence variation is greater, an individual's confidence in persisting in his own opinion in interactions is weaker, and the individual is more likely to adopt neighbors' opinions. In networks, the in/out degree is determined by individual neighbors. Our main research involves the process of opinion evolution and the basic laws of opinion cluster formation. Group opinions converge exponentially to consensus with stable neighbors. An individual opinion evolution is determined by the average neighbor opinion effect strength. We also explore the conditions involved in forming a stable neighbor relationship and the influence of the confidence variation in the convergence of the threshold of bounded confidence. The results show that the influence on opinion evolution is greater with increased confidence variation.

  2. Opinion formation with time-varying bounded confidence

    PubMed Central

    Liu, QiPeng; Zhang, SiYing

    2017-01-01

    When individuals in social groups communicate with one another and are under the influence of neighbors’ opinions, they typically revise their own opinions to adapt to such peer opinions. The individual threshold of bounded confidence will thus be affected by both a change in individual confidence and by neighbor influence. Individuals thus update their own opinions with new bounded confidence, while their updated opinions also influence their neighbors’ opinions. Based on this reasoned factual assumption, we propose an opinion dynamics model with time-varying bounded confidence. A directed network is formed by the rule of the individual bounded confidence threshold. The threshold of individual bounded confidence involves both confidence variation and the in/out degree of the individual node. When the confidence variation is greater, an individual’s confidence in persisting in his own opinion in interactions is weaker, and the individual is more likely to adopt neighbors’ opinions. In networks, the in/out degree is determined by individual neighbors. Our main research involves the process of opinion evolution and the basic laws of opinion cluster formation. Group opinions converge exponentially to consensus with stable neighbors. An individual opinion evolution is determined by the average neighbor opinion effect strength. We also explore the conditions involved in forming a stable neighbor relationship and the influence of the confidence variation in the convergence of the threshold of bounded confidence. The results show that the influence on opinion evolution is greater with increased confidence variation. PMID:28264038

  3. Recommendations of the Canadian Consensus Group on the Management of Chronic Myeloid Leukemia

    PubMed Central

    Laneuville, P.; Barnett, M.J.; Bélanger, R.; Couban, S.; Forrest, D.L.; Roy, D.C.; Lipton, J.H.

    2006-01-01

    Chronic myelogenous leukemia (cml) is a disease characterized by the expression of Bcr/Abl, an oncogenic protein tyrosine kinase, and by evolution over time from a relatively benign chronic phase to a rapidly fatal cml blast crisis. Until recently, the standard of care included potentially curative therapy with allogeneic stem cell transplantation, available only to a minority (about 10%) of patients, or medical therapy with interferon-α with or without cytarabine, which helped to prolong the chronic phase of the disease in a minority of patients. The availability of imatinib mesylate, a selective inhibitor of Bcr/Abl approved by Health Canada in 2001, has profoundly altered the clinical and laboratory management of cml. This change in practice has been reviewed by the Canadian Consensus Group on the Management of Chronic Myelogenous Leukemia and has resulted in a new set of recommendations for the optimal care of cml patients. PMID:22792021

  4. The AGNP-TDM expert group consensus guidelines: therapeutic drug monitoring in psychiatry.

    PubMed

    Baumann, P; Hiemke, C; Ulrich, S; Eckermann, G; Gaertner, I; Gerlach, M; Kuss, H-J; Laux, G; Müller-Oerlinghausen, B; Rao, M L; Riederer, P; Zernig, G

    2004-11-01

    Therapeutic Drug Monitoring (TDM) is a valid tool to optimise pharmacotherapy. It enables the clinician to adjust the dosage of drugs according to the characteristics of the individual patient. In psychiatry, TDM is an established procedure for lithium, some antidepressants and antipsychotics. In spite of its obvious advantages, however, the use of TDM in everyday clinical practice is far from optimal. The interdisciplinary TDM group of the Arbeitsgemeinschaft fur Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) has therefore worked out consensus guidelines to assist psychiatrists and laboratories involved in psychotropic drug analysis to optimise the use of TDM of psychotropic drugs. Five research-based levels of recommendation were defined with regard to routine monitoring of plasma concentrations for dose titration of 65 psychoactive drugs: (1) strongly recommended, (2) recommended, (3) useful, (4) probably useful and (5) not recommended. A second approach defined indications to use TDM, e. g. control of compliance, lack of clinical response or adverse effects at recommended doses, drug interactions, pharmacovigilance programs, presence of a genetic particularity concerning the drug metabolism, children, adolescents and elderly patients. Indications for TDM are relevant for all drugs either with or without validated therapeutic ranges. When studies on therapeutic ranges are lacking, target ranges should be plasma concentrations that are normally observed at therapeutic doses of the drug. Therapeutic ranges of plasma concentrations that are considered to be optimal for treatment are proposed for those drugs, for which the evaluation of the literature demonstrated strong evidence. Moreover, situations are defined when pharmacogenetic (phenotyping or genotyping) tests are informative in addition to TDM. Finally, practical instructions are given how to use TDM. They consider preparation of TDM, analytical procedures, reporting and interpretation of results

  5. The AGNP-TDM Expert Group Consensus Guidelines: focus on therapeutic monitoring of antidepressants.

    PubMed

    Baumann, Pierre; Ulrich, Sven; Eckermann, Gabriel; Gerlach, Manfred; Kuss, Hans-Joachim; Laux, Gerd; Müller-Oerlinghausen, Bruno; Rao, Marie Luise; Riederer, Peter; Zernig, Gerald; Hiemke, Christoph

    2005-01-01

    Therapeutic drug monitoring (TDM) of psychotropic drugs such as antidepressants has been widely introduced for optimization of pharmacotherapy in psychiatric patients. The interdisciplinary TDM group of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) has worked out consensus guidelines with the aim of providing psychiatrists and TDM laboratories with a tool to optimize the use of TDM. Five research-based levels of recommendation were defined with regard to routine monitoring of drug plasma concentrations: (i) strongly recommended; (ii) recommended; (iii) useful; (iv) probably useful; and (v) not recommended. In addition, a list of indications that justify the use of TDM is presented, eg, control of compliance, lack of clinical response or adverse effects at recommended doses, drug interactions, pharmacovigilance programs, presence of a genetic particularity concerning drug metabolism, and children, adolescents, and elderly patients. For some drugs, studies on therapeutic ranges are lacking, but target ranges for clinically relevant plasma concentrations are presented for most drugs, based on pharmacokinetic studies reported in the literature. For many antidepressants, a thorough analysis of the literature on studies dealing with the plasma concentration-clinical effectiveness relationship allowed inclusion of therapeutic ranges of plasma concentrations. In addition, recommendations are made with regard to the combination of pharmacogenetic (phenotyping or genotyping) tests with TDM. Finally, practical instructions are given for the laboratory practitioners and the treating physicians how to use TDM: preparation of TDM, drug analysis, reporting and interpretation of results, and adequate use of information for patient treatment TDM is a complex process that needs optimal interdisciplinary coordination of a procedure implicating patients, treating physicians, clinical pharmacologists, and clinical laboratory specialists. These

  6. The AGNP-TDM Expert Group Consensus Guidelines: focus on therapeutic monitoring of antidepressants

    PubMed Central

    Baumann, Pierre; Ulrich, Sven; Eckermann, Gabriel; Gerlach, Manfred; Kuss, Hans-Joachim; Laux, Gerd; Müller-Oerlinghausen, Bruno; Rao, Marie Luise; Riederer, Peter; Zernig, Gerald; Hiemke, Christoph

    2005-01-01

    Therapeutic drug monitoring (TDM) of psychotropic drugs such as antidepressants has been widely introduced for optimization of pharmacotherapy in psychiatric patients. The interdisciplinary TDM group of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) has worked out consensus guidelines with the aim of providing psychiatrists and TDM laboratories with a tool to optimize the use of TDM. Five research-based levels of recommendation were defined with regard to routine monitoring of drug plasma concentrations: (i) strongly recommended; (ii) recommended; (iii) useful; (iv) probably useful; and (v) not recommended. In addition, a list of indications that justify the use of TDM is presented, eg, control of compliance, lack of clinical response or adverse effects at recommended doses, drug interactions, pharmacovigilance programs, presence of a genetic particularity concerning drug metabolism, and children, adolescents, and elderly patients. For some drugs, studies on therapeutic ranges are lacking, but target ranges for clinically relevant plasma concentrations are presented for most drugs, based on pharmacokinetic studies reported in the literature. For many antidepressants, a thorough analysis of the literature on studies dealing with the plasma concentration–clinical effectiveness relationship allowed inclusion of therapeutic ranges of plasma concentrations. In addition, recommendations are made with regard to the combination of pharmacogenetic (phenotyping or genotyping) tests with TDM, Finally, practical instructions are given for the laboratory practitioners and the treating physicians how to use TDM: preparation of TDM, drug analysis, reporting and interpretation of results, and adequate use of information for patient treatment. TDM is a complex process that needs optimal interdisciplinary coordination of a procedure implicating patients, treating physicians, clinical pharmacologists, and clinical laboratory specialists. These

  7. Anterolateral Ligament Expert Group consensus paper on the management of internal rotation and instability of the anterior cruciate ligament - deficient knee.

    PubMed

    Sonnery-Cottet, Bertrand; Daggett, Matthew; Fayard, Jean-Marie; Ferretti, Andrea; Helito, Camilo Partezani; Lind, Martin; Monaco, Edoardo; de Pádua, Vitor Barion Castro; Thaunat, Mathieu; Wilson, Adrian; Zaffagnini, Stefano; Zijl, Jacco; Claes, Steven

    2017-02-20

    Purpose of this paper is to provide an overview of the latest research on the anterolateral ligament (ALL) and present the consensus of the ALL Expert Group on the anatomy, radiographic landmarks, biomechanics, clinical and radiographic diagnosis, lesion classification, surgical technique and clinical outcomes. A consensus on controversial subjects surrounding the ALL and anterolateral knee instability has been established based on the opinion of experts, the latest publications on the subject and an exchange of experiences during the ALL Experts Meeting (November 2015, Lyon, France). The ALL is found deep to the iliotibial band. The femoral origin is just posterior and proximal to the lateral epicondyle; the tibial attachment is 21.6 mm posterior to Gerdy's tubercle and 4-10 mm below the tibial joint line. On a lateral radiographic view the femoral origin is located in the postero-inferior quadrant and the tibial attachment is close to the centre of the proximal tibial plateau. Favourable isometry of an ALL reconstruction is seen when the femoral position is proximal and posterior to the lateral epicondyle, with the ALL being tight upon extension and lax upon flexion. The ALL can be visualised on ultrasound, or on T2-weighted coronal MRI scans with proton density fat-suppressed evaluation. The ALL injury is associated with a Segond fracture, and often occurs in conjunction with acute anterior cruciate ligament (ACL) injury. Recognition and repair of the ALL lesions should be considered to improve the control of rotational stability provided by ACL reconstruction. For high-risk patients, a combined ACL and ALL reconstruction improves rotational control and reduces the rate of re-rupture, without increased postoperative complication rates compared to ACL-only reconstruction. In conclusion this paper provides a contemporary consensus on all studied features of the ALL. The findings warrant future research in order to further test these early observations, with the

  8. TOPSIS-based consensus model for group decision-making with incomplete interval fuzzy preference relations.

    PubMed

    Liu, Fang; Zhang, Wei-Guo

    2014-08-01

    Due to the vagueness of real-world environments and the subjective nature of human judgments, it is natural for experts to estimate their judgements by using incomplete interval fuzzy preference relations. In this paper, based on the technique for order preference by similarity to ideal solution method, we present a consensus model for group decision-making (GDM) with incomplete interval fuzzy preference relations. To do this, we first define a new consistency measure for incomplete interval fuzzy preference relations. Second, a goal programming model is proposed to estimate the missing interval preference values and it is guided by the consistency property. Third, an ideal interval fuzzy preference relation is constructed by using the induced ordered weighted averaging operator, where the associated weights of characterizing the operator are based on the defined consistency measure. Fourth, a similarity degree between complete interval fuzzy preference relations and the ideal one is defined. The similarity degree is related to the associated weights, and used to aggregate the experts' preference relations in such a way that more importance is given to ones with the higher similarity degree. Finally, a new algorithm is given to solve the GDM problem with incomplete interval fuzzy preference relations, which is further applied to partnership selection in formation of virtual enterprises.

  9. Diagnosis, prevention, and management of statin adverse effects and intolerance: Canadian Working Group Consensus update.

    PubMed

    Mancini, G B John; Tashakkor, A Yashar; Baker, Steven; Bergeron, Jean; Fitchett, David; Frohlich, Jiri; Genest, Jacques; Gupta, Milan; Hegele, Robert A; Ng, Dominic S; Pearson, Glen J; Pope, Janet

    2013-12-01

    The Proceedings of a Canadian Working Group Consensus Conference, first published in 2011, provided a summary of statin-associated adverse effects and intolerance and management suggestions. In this update, new clinical studies identified since then that provide further insight into effects on muscle, cognition, cataracts, diabetes, kidney disease, and cancer are discussed. Of these, the arenas of greatest controversy pertain to purported effects on cognition and the emergence of diabetes during long-term therapy. Regarding cognition, the available evidence is not strongly supportive of a major adverse effect of statins. In contrast, the linkage between statin therapy and incident diabetes is more firm. However, this risk is more strongly associated with traditional risk factors for new-onset diabetes than with statin itself and any possible negative effect of new-onset diabetes during statin treatment is far outweighed by the cardiovascular risk reduction benefits. Additional studies are also discussed, which support the principle that systematic statin rechallenge, and lower or intermittent statin dosing strategies are the main methods for dealing with suspected statin intolerance at this time.

  10. Eliciting Neutralizing Antibodies with gp120 Outer Domain Constructs Based on M-Group Consensus Sequence

    PubMed Central

    Qin, Yali; Banasik, Marisa; Kim, SoonJeung; Penn-Nicholson, Adam; Habte, Habtom H; Labranche, Celia; Montefiori, David C; Wang, Chong; Cho, Michael W

    2014-01-01

    One strategy being evaluated for HIV-1 vaccine development is focusing immune responses towards neutralizing epitopes on the gp120 outer domain (OD) by removing the immunodominant, but non-neutralizing, inner domain. Previous OD constructs have not elicited strong neutralizing antibodies (nAbs). We constructed two immunogens, a monomeric gp120-OD and a trimeric gp120-OD×3, based on an M group consensus sequence (MCON6). Their biochemical and immunological properties were compared with intact gp120. Results indicated better preservation of critical neutralizing epitopes on gp120-OD×3. In contrast to previous studies, our immunogens induced potent, cross-reactive nAbs in rabbits. Although nAbs primarily targeted Tier 1 viruses, they exhibited significant breadth. Epitope mapping analyses indicated that nAbs primarily targeted conserved V3 loop elements. Although the potency and breadth of nAbs were similar for all three immunogens, nAb induction kinetics indicated that gp120-OD×3 was superior to gp120-OD, suggesting that gp120-OD×3 is a promising prototype for further gp120 OD-based immunogen development. PMID:25046154

  11. Physician executive promotes process for managing change. Building consensus for group plan is key to successful transitions.

    PubMed

    Carrigan, V M

    2001-01-01

    Thrust into a leadership position after years in solo practice demanded quick thinking for one physician executive. Faced with a need for change, he developed his own process for turning an individual's idea into a plan of action for an entire group. Learn the steps he took to build consensus and ease resistance to change.

  12. Consensus Statement on medication use in multiple sclerosis by the Spanish Society of Neurology's study group for demyelinating diseases.

    PubMed

    García-Merino, A; Fernández, O; Montalbán, X; de Andrés, C; Oreja-Guevara, C; Rodríguez-Antigüedad, A; Arbizu, T

    2013-01-01

    Treatments for multiple sclerosis therapy are rapidly evolving. It is believed that new drugs will be approved in the near future, thereby changing current indications for treatment. In this context, the Spanish Society of Neurology's study group on demyelinating diseases, which evaluates medication use in MS, has decided to draw up a consensus statement on the current indications and guidelines for multiple sclerosis treatment.

  13. A Multi-Peer Assessment Platform for Programming Language Learning: Considering Group Non-Consensus and Personal Radicalness

    ERIC Educational Resources Information Center

    Wang, Yanqing; Liang, Yaowen; Liu, Luning; Liu, Ying

    2016-01-01

    Multi-peer assessment has often been used by teachers to reduce personal bias and make the assessment more reliable. This study reviews the design and development of multi-peer assessment systems that detect and solve two common issues in such systems: non-consensus among group members and personal radicalness in some assessments. A multi-peer…

  14. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia.

    PubMed

    Chen, Liang-Kung; Liu, Li-Kuo; Woo, Jean; Assantachai, Prasert; Auyeung, Tung-Wai; Bahyah, Kamaruzzaman Shahrul; Chou, Ming-Yueh; Chen, Liang-Yu; Hsu, Pi-Shan; Krairit, Orapitchaya; Lee, Jenny S W; Lee, Wei-Ju; Lee, Yunhwan; Liang, Chih-Kuang; Limpawattana, Panita; Lin, Chu-Sheng; Peng, Li-Ning; Satake, Shosuke; Suzuki, Takao; Won, Chang Won; Wu, Chih-Hsing; Wu, Si-Nan; Zhang, Teimei; Zeng, Ping; Akishita, Masahiro; Arai, Hidenori

    2014-02-01

    Sarcopenia, a newly recognized geriatric syndrome, is characterized by age-related decline of skeletal muscle plus low muscle strength and/or physical performance. Previous studies have confirmed the association of sarcopenia and adverse health outcomes, such as falls, disability, hospital admission, long term care placement, poorer quality of life, and mortality, which denotes the importance of sarcopenia in the health care for older people. Despite the clinical significance of sarcopenia, the operational definition of sarcopenia and standardized intervention programs are still lacking. It is generally agreed by the different working groups for sarcopenia in the world that sarcopenia should be defined through a combined approach of muscle mass and muscle quality, however, selecting appropriate diagnostic cutoff values for all the measurements in Asian populations is challenging. Asia is a rapidly aging region with a huge population, so the impact of sarcopenia to this region is estimated to be huge as well. Asian Working Group for Sarcopenia (AWGS) aimed to promote sarcopenia research in Asia, and we collected the best available evidences of sarcopenia researches from Asian countries to establish the consensus for sarcopenia diagnosis. AWGS has agreed with the previous reports that sarcopenia should be described as low muscle mass plus low muscle strength and/or low physical performance, and we also recommend outcome indicators for further researches, as well as the conditions that sarcopenia should be assessed. In addition to sarcopenia screening for community-dwelling older people, AWGS recommends sarcopenia assessment in certain clinical conditions and healthcare settings to facilitate implementing sarcopenia in clinical practice. Moreover, we also recommend cutoff values for muscle mass measurements (7.0 kg/m(2) for men and 5.4 kg/m(2) for women by using dual X-ray absorptiometry, and 7.0 kg/m(2) for men and 5.7 kg/m(2) for women by using bioimpedance analysis

  15. Survival of extreme opinions

    NASA Astrophysics Data System (ADS)

    Hsu, Jiann-wien; Huang, Ding-wei

    2009-12-01

    We study the survival of extreme opinions in various processes of consensus formation. All the opinions are treated equally and subjected to the same rules of changing. We investigate three typical models to reach a consensus in each case: (A) personal influence, (B) influence from surroundings, and (C) influence to surroundings. Starting with uniformly distributed random opinions, our calculated results show that the extreme opinions can survive in both models (A) and (B), but not in model (C). We obtain a conclusion that both personal influence and passive adaptation to the environment are not sufficient enough to eradicate all the extreme opinions. Only the active persuasion to change the surroundings eliminates the extreme opinions completely.

  16. Expert and Advocacy Group Consensus Findings on the Horizon of Public Health Genetic Testing

    PubMed Central

    Modell, Stephen M.; Greendale, Karen; Citrin, Toby; Kardia, Sharon L. R.

    2016-01-01

    Description: Among the two leading causes of death in the United States, each responsible for one in every four deaths, heart disease costs Americans $300 billion, while cancer costs Americans $216 billion per year. They also rank among the top three causes of death in Europe and Asia. In 2012 the University of Michigan Center for Public Health and Community Genomics and Genetic Alliance, with the support of the Centers for Disease Control and Prevention Office of Public Health Genomics, hosted a conference in Atlanta, Georgia to consider related action strategies based on public health genomics. The aim of the conference was consensus building on recommendations to implement genetic screening for three major heritable contributors to these mortality and cost figures: hereditary breast and ovarian cancer (HBOC), familial hypercholesterolemia (FH), and Lynch syndrome (LS). Genetic applications for these three conditions are labeled with a “Tier 1” designation by the U.S. Centers for Disease Control and Prevention because they have been fully validated and clinical practice guidelines based on systematic review support them. Methodology: The conference followed a deliberative sequence starting with nationally recognized clinical and public health presenters for each condition, followed by a Patient and Community Perspectives Panel, working group sessions for each of the conditions, and a final plenary session. The 74 conference participants represented disease research and advocacy, public health, medicine and nursing, genetics, governmental health agencies, and industry. Participants drew on a public health framework interconnecting policy, clinical intervention, surveillance, and educational functions for their deliberations. Results: Participants emphasized the importance of collaboration between clinical, public health, and advocacy groups in implementing Tier 1 genetic screening. Advocacy groups could help with individual and institutional buy-in of Tier 1

  17. Dynamical model for competing opinions

    NASA Astrophysics Data System (ADS)

    Souza, S. R.; Gonçalves, S.

    2012-05-01

    We propose an opinion model based on agents located at the vertices of a regular lattice. Each agent has an independent opinion (among an arbitrary, but fixed, number of choices) and its own degree of conviction. The latter changes every time two agents which have different opinions interact with each other. The dynamics leads to size distributions of clusters (made up of agents which have the same opinion and are located at contiguous spatial positions) which follow a power law, as long as the range of the interaction between the agents is not too short; i.e., the system self-organizes into a critical state. Short range interactions lead to an exponential cutoff in the size distribution and to spatial correlations which cause agents which have the same opinion to be closely grouped. When the diversity of opinions is restricted to two, a nonconsensus dynamic is observed, with unequal population fractions, whereas consensus is reached if the agents are also allowed to interact with those located far from them. The individual agents' convictions, the preestablished interaction range, and the locality of the interaction between a pair of agents (their neighborhood has no effect on the interaction) are the main characteristics which distinguish our model from previous ones.

  18. Consensus development for healthcare professionals.

    PubMed

    Kea, Bory; Sun, Benjamin Chih-An

    2015-04-01

    Consensus development sprang from a desire to synthesize clinician and expert opinions on clinical practice and research agendas in the 1950s. And since the American Institute of Medicine formally defined "guidelines" in 1990, there has been a proliferation of clinical practice guidelines (CPG) both formally and informally. This modern decision-making tool used by both physicians and patients, requires extensive planning to overcome the challenges of consensus development while reaping its rewards. Consensus allows for a group approach of multiple experts sharing ideas to form consensus on topics ranging from appropriateness of procedures to research agenda development. Disagreements can shed light on areas of controversy and launch further discussions. It has five main components: three inputs (defining the task, participant identification and recruitment, and information synthesis), the approach (consensus development by explicit or implicit means), and the output (dissemination of results). Each aspect requires extensive planning a priori as they influence the entire process, from how information will be interpreted, the interaction of participants, the resulting judgment, to whether there will be uptake of results. Implicit approaches utilize qualitative methods and/or a simple voting structure of majority wins, and are used in informal consensus development methods and consensus development conferences. Explicit approaches aggregate results or judgments using explicit rules set a priori with definitions of "agreement" or consensus. Because the implicit process can be more opaque, unforeseen challenges can emerge such as the undue influence of a minority. And yet, the logistics of explicit approaches may be more time consuming and not appropriate when speed is a priority. In determining which method to use, it is important to understand the pros and cons of different approaches and how it will affect the overall input, approach, and outcome.

  19. Consensus development for healthcare professionals

    PubMed Central

    Kea, Bory; Sun, Benjamin C.

    2015-01-01

    Consensus development sprang from a desire to synthesize clinician and expert opinions on clinical practice and research agendas in the 1950s. And since the American Institute of Medicine formally defined “guidelines” in 1990, there has been a proliferation of clinical practice guidelines (CPG) both formally and informally. This modern decision making tool used by both physicians and patients, requires extensive planning to meet the challenges of consensus development while reaping its rewards. Consensus allows for a group approach with multiple experts sharing ideas to form consensus on topics ranging from appropriateness of procedures to research agenda development. Disagreements can shed light on areas of controversy and launch further discussions. It has five main components: three inputs (defining the task, participant identification and recruitment, and information synthesis), the approach (consensus development by explicit or implicit means), and the output (dissemination of results). Each aspect requires extensive planning a priori as they influence the entire process, from how information will be interpreted, the interaction of participants, the resulting judgment, to whether there will be uptake of results. Implicit approaches utilize qualitative methods and/or a simple voting structure of majority wins, and are used in informal consensus development methods and consensus development conferences. Explicit approaches aggregate results or judgments using explicit rules set a priori with definitions of “agreement” or consensus. Because the implicit process can be more opaque, unforeseen challenges can emerge such as the undue influence of a minority. And yet, the logistics of explicit approaches may be more time consuming and not appropriate when speed is a priority. In determining which method to use, it is important to understand the pros and cons of the different approaches and how it will affect the overall input, approach, and outcome. PMID

  20. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 4: seminal vesicles and lymph nodes.

    PubMed

    Berney, Daniel M; Wheeler, Thomas M; Grignon, David J; Epstein, Jonathan I; Griffiths, David F; Humphrey, Peter A; van der Kwast, Theo; Montironi, Rodolfo; Delahunt, Brett; Egevad, Lars; Srigley, John R

    2011-01-01

    The 2009 International Society of Urological Pathology Consensus Conference in Boston made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to the infiltration of tumor into the seminal vesicles and regional lymph nodes were coordinated by working group 4. There was a consensus that complete blocking of the seminal vesicles was not necessary, although sampling of the junction of the seminal vesicles and prostate was mandatory. There was consensus that sampling of the vas deferens margins was not obligatory. There was also consensus that muscular wall invasion of the extraprostatic seminal vesicle only should be regarded as seminal vesicle invasion. Categorization into types of seminal vesicle spread was agreed by consensus to be not necessary. For examination of lymph nodes, there was consensus that special techniques such as frozen sectioning were of use only in high-risk cases. There was no consensus on the optimal sampling method for pelvic lymph node dissection specimens, although there was consensus that all lymph nodes should be completely blocked as a minimum. There was also a consensus that a count of the number of lymph nodes harvested should be attempted. In view of recent evidence, there was consensus that the diameter of the largest lymph node metastasis should be measured. These consensus decisions will hopefully clarify the difficult areas of pathological assessment in radical prostatectomy evaluation and improve the concordance of research series to allow more accurate assessment of patient prognosis.

  1. Recommended Minimal Emergency Equipment and Resources for Schools: National Consensus Group Report

    ERIC Educational Resources Information Center

    Bobo, Nichole; Hallenbeck, Paula; Robinson, Judith

    2003-01-01

    Providing an environment that is responsive to emergency health needs of students is essential to creating a safe setting for children in schools. The question of what minimal essential emergency equipment and resources should be available in schools brings with it many and varied opinions, issues, and concerns. Through funding from the Emergency…

  2. Focus Group Study of Public Opinion About Paying Living Kidney Donors in Australia

    PubMed Central

    Ralph, Angelique F.; Chapman, Jeremy R.; Wong, Germaine; Gill, John S.; Josephson, Michelle A.; Craig, Jonathan C.

    2015-01-01

    Background and objectives The unmet demand for kidney transplantation has generated intense controversy about introducing incentives for living kidney donors to increase donation rates. Such debates may affect public perception and acceptance of living kidney donation. This study aims to describe the range and depth of public opinion on financial reimbursement, compensation, and incentives for living kidney donors. Design, setting, participants, & measurements Twelve focus groups were conducted with 113 participants recruited from the general public in three Australian states in February 2013. Thematic analysis was used to analyze the transcripts. Results Five themes were identified: creating ethical impasses (commodification of the body, quandary of kidney valuation, pushing moral boundaries), corrupting motivations (exposing the vulnerable, inevitable abuse, supplanting altruism), determining justifiable risk (compromising kidney quality, undue harm, accepting a confined risk, trusting protective mechanisms, right to autonomy), driving access (urgency of organ shortage, minimizing disadvantage, guaranteeing cost-efficiency, providing impetus, counteracting black markets), and honoring donor deservingness (fairness and reason, reassurance and rewards, merited recompense). Reimbursement and justifiable recompense are considered by the Australian public as a legitimate way of supporting donors and reducing disadvantage. Financial payment beyond reimbursement is regarded as morally reprehensible, with the potential for exploitative commercialism. Some contend that regulated compensation could be a defensible strategy to increased donation rates provided that mechanisms are in place to protect donors. Conclusions The perceived threat to community values of human dignity, goodwill, and fairness suggests that there could be strong public resistance to any form of financial inducements for living kidney donors. Policy priorities addressing the removal of disincentives

  3. Practice guidelines for the management of low back pain. Consensus Group of Practice Parameters to Manage Low Back Pain.

    PubMed

    Guevara-López, Uría; Covarrubias-Gómez, Alfredo; Elías-Dib, Jorge; Reyes-Sánchez, Alejandro; Rodríguez-Reyna, Tatiana Sofía

    2011-01-01

    It has been documented that pain in its diverse modalities is the most common cause of medical attention. In Mexico, an increase in its frequency has promoted its consideration in several health programs. On the other hand, inadequate pain management will cause severe physical, psychoaffective, and socioeconomic repercussions for patients, families, and public health services. Despite this panorama, there has not been an agreement to establish better diagnostic and therapeutic methods for the management of chronic pain. A consensus group was reunited and was integrated by medical experts from private and public institutions and from various states of the Mexican Republic. To assure the development of these practice guidelines, these experts had experience in the assessment and treatment of conditions causing pain. With the guidelines used by other consensus groups, meetings were held to analyze and discuss published literary evidence for the management of low back pain. The recommendations were classified according to their methodological strength. As a result of this meeting, consensus recommendations were based on evidence and operational conclusions of such proactive educational plans, institutional policies and diagnostic recommendations for pharmacological and nonpharmacological treatment in order for Mexican physicians to provide a better therapeutic approach to low back pain.

  4. Response evaluation criteria for solid tumours in dogs (v1.0): a Veterinary Cooperative Oncology Group (VCOG) consensus document.

    PubMed

    Nguyen, S M; Thamm, D H; Vail, D M; London, C A

    2015-09-01

    In veterinary medical oncology, there is currently no standardized protocol for assessing response to therapy in solid tumours. The lack of such a formalized guideline makes it challenging to critically compare outcome measures across various treatment protocols. The Veterinary Cooperative Oncology Group (VCOG) membership consensus document presented here is based on the recommendations of a subcommittee of American College of Veterinary Internal Medicine (ACVIM) board-certified veterinary oncologists. This consensus paper has used the human response evaluation criteria in solid tumours (RECIST v1.1) as a framework to establish standard procedures for response assessment in canine solid tumours that is meant to be easy to use, repeatable and applicable across a variety of clinical trial structures in veterinary oncology. It is hoped that this new canine RECIST (cRECIST v1.0) will be adopted within the veterinary oncology community and thereby facilitate the comparison of current and future treatment protocols used for companion animals with cancer.

  5. The 1st Baltic Osseointegration Academy and Lithuanian University of Health Sciences Consensus Conference 2016. Summary and Consensus Statements: Group II - Peri-Implantitis Diagnostics and Decision Tree

    PubMed Central

    Dursun, Erhan; Galindo-Moreno, Pablo; Juodzbalys, Gintaras; López-Martínez, Jesús; O'Valle, Francisco; Padial-Molina, Miguel; Ramanauskaite, Ausra

    2016-01-01

    ABSTRACT Introduction The task of Group 2 was to review and update the existing data concerning clinical and genetic methods of diagnostics of peri-implantitis. Special interest was paid to the peri-implant crevicular fluid (PICF) overview including analysis of enzymes and biomarkers and microbial profiles from implants. Material and Methods The main areas of interest were as follows: effect of smoking and history of periodontitis, prosthetic treatment mistakes, excess cement, overloading, general diseases influence on peri-implantitis development. The systematic review and/or meta-analysis were registered in PROSPERO, an international prospective register of systematic reviews: http://www.crd.york.ac.uk/PROSPERO/. The literature in the corresponding areas of interest was searched and reported using the PRISMA (Preferred Reporting Item for Systematic Review and Meta-Analysis) Statement: http://www.prisma-statement.org/. The method of preparation of systematic reviews of the literature based on comprehensive search strategies was discussed and standardized. The summary of the materials and methods employed by the authors in preparing the systematic review and/or meta-analysis is presented in Preface chapter. Results The results and conclusions of the review process are presented in the respective papers. The group′s general commentaries, consensus statements, clinical recommendations and implications for research are presented in this article. PMID:27833736

  6. The 1st Baltic Osseointegration Academy and Lithuanian University of Health Sciences Consensus Conference 2016. Summary and Consensus Statements: Group III - Peri-Implantitis Treatment

    PubMed Central

    Faria e Almeida, Ricardo; Cicciù, Marco; Daugela, Povilas; Ramanauskaite, Ausra; Saulacic, Nikola; Tervonen, Tellervo; Wang, Hom-Lay; Yu, Shan-Huey

    2016-01-01

    ABSTRACT Introduction The task of Group 3 was to review and update the existing data concerning non-surgical, surgical non-regenerative and surgical regenerative treatment of peri-implantitis. Special interest was paid to the preventive and supporting therapy in case of peri-implantitis. Material and Methods The main areas of interest were as follows: effect of smoking and history of periodontitis, prosthetic treatment mistakes, excess cement, overloading, general diseases influence on peri-implantitis development. The systematic review and/or meta-analysis were registered in PROSPERO, an international prospective register of systematic reviews: http://www.crd.york.ac.uk/PROSPERO/. The literature in the corresponding areas of interest was searched and reported using the PRISMA (Preferred Reporting Item for Systematic Review and Meta-Analysis) Statement: http://www.prisma-statement.org/. The method of preparation of systematic reviews of the literature based on comprehensive search strategies was discussed and standardized. The summary of the materials and methods employed by the authors in preparing the systematic review and/or meta-analysis is presented in Preface chapter. Results The results and conclusions of the review process are presented in the respective papers. The group′s general commentaries, consensus statements, clinical recommendations and implications for research are presented in this article. PMID:27833741

  7. 14th St. Gallen International Breast Cancer Conference 2015: Evidence, Controversies, Consensus – Primary Therapy of Early Breast Cancer: Opinions Expressed by German Experts

    PubMed Central

    Jackisch, Christian; Harbeck, Nadia; Huober, Jens; von Minckwitz, Gunter; Gerber, Bernd; Kreipe, Hans-Heinrich; Liedtke, Cornelia; Marschner, Norbert; Möbus, Volker; Scheithauer, Heike; Schneeweiss, Andreas; Thomssen, Christoph; Loibl, Sibylle; Beckmann, Matthias W.; Blohmer, Jens-Uwe; Costa, Serban-Dan; Decker, Thomas; Diel, Ingo; Fasching, Peter A.; Fehm, Tanja; Janni, Wolfgang; Lück, Hans-Joachim; Maass, Nicolai; Scharl, Anton; Untch, Michael

    2015-01-01

    Summary The key topics of this year's 14th St. Gallen Consensus Conference on the diagnosis and therapy of primary breast cancer were again questions about breast surgery and axillary surgery, radio-oncology and systemic therapy options in consideration of tumor biology, and the clinical application of multigene assays. This year, the consensus conference took place in Vienna. From a German perspective, it makes sense to substantiate the results of the vote of the international panel representing 19 countries in light of the updated national therapy recommendations of the AGO (Arbeitsgemeinschaft Gynäkologische Onkologie). Therefore, 14 German breast cancer experts, 3 of whom are members of the International St. Gallen Panel, have commented on the voting results of the St. Gallen Consensus Conference 2015 in relation to clinical routine in Germany. PMID:26557827

  8. Guidelines for the diagnosis and management of neuropathic pain: consensus of a group of Latin American experts.

    PubMed

    Acevedo, Juan Carlos; Amaya, Abraham; Casasola, Oscar de León; Chinchilla, Nelson; De Giorgis, Marcelo; Florez, Sandra; Genis, Miguel Angel; Gomez-Barrios, Juan Vicente; Hernández, John Jairo; Ibarra, Eduardo; Moreno, Carlos; Orrillo, Enrique; Pasternak, Danilo; Romero, Sabina; Vallejo, Mariana; Velasco, Maritza; Villalobos, Alberto

    2009-01-01

    These consensus guidelines have been developed by a group of Latin American experts in pain management, to point out patterns and make practical recommendations to guide the diagnosis, identify warning signs (yellow and red flags), and establish comprehensive medical management (pharmacologic and nonpharmacologic treatment) and monitoring plans for patients enduring neuropathic pain. From the viewpoint of pharmacologic management, drugs are classified into groups according to efficacy, availability/accessibility, and safety criteria. Drugs are recommended for use depending on the disease and particular circumstances of each patient, with an approach that favors multimodal treatment while taking into consideration the idiosyncrasies of medical practice in Latin America.

  9. Opinion dynamics with similarity-based random neighbors

    NASA Astrophysics Data System (ADS)

    Liu, Qipeng; Wang, Xiaofan

    2013-10-01

    A typical assumption made in the existing opinion formation models is that two individuals can communicate with each other only if the distance between their opinions is less than a threshold called bound of confidence. However, in the real world it is quite possible that people may also have a few friends with quite different opinions. To model this situation, we propose a bounded confidence plus random selection model, in which each agent has several long-range neighbors outside the bound who are selected according to a similarity-based probability rule. We find that the opinions of all agents can reach a consensus in bounded time. We further consider the situation when agents ignore the bound of confidence and select all their neighbors randomly according to the similarity-based probability rule. We prove that in this scenario the whole group could also reach a consensus but in the probability sense.

  10. Reaching Consensus by Allowing Moments of Indecision

    NASA Astrophysics Data System (ADS)

    Svenkeson, A.; Swami, A.

    2015-10-01

    Group decision-making processes often turn into a drawn out and costly battle between two opposing subgroups. Using analytical arguments based on a master equation description of the opinion dynamics occurring in a three-state model of cooperatively interacting units, we show how the capability of a social group to reach consensus can be enhanced when there is an intermediate state for indecisive individuals to pass through. The time spent in the intermediate state must be relatively short compared to that of the two polar states in order to create the beneficial effect. Furthermore, the cooperation between individuals must not be too low, as the benefit to consensus is possible only when the cooperation level exceeds a specific threshold. We also discuss how zealots, agents that remain in one state forever, can affect the consensus among the rest of the population by counteracting the benefit of the intermediate state or making it virtually impossible for an opposition to form.

  11. Reaching Consensus by Allowing Moments of Indecision

    PubMed Central

    Svenkeson, A.; Swami, A.

    2015-01-01

    Group decision-making processes often turn into a drawn out and costly battle between two opposing subgroups. Using analytical arguments based on a master equation description of the opinion dynamics occurring in a three-state model of cooperatively interacting units, we show how the capability of a social group to reach consensus can be enhanced when there is an intermediate state for indecisive individuals to pass through. The time spent in the intermediate state must be relatively short compared to that of the two polar states in order to create the beneficial effect. Furthermore, the cooperation between individuals must not be too low, as the benefit to consensus is possible only when the cooperation level exceeds a specific threshold. We also discuss how zealots, agents that remain in one state forever, can affect the consensus among the rest of the population by counteracting the benefit of the intermediate state or making it virtually impossible for an opposition to form. PMID:26439503

  12. A consensus reaching model for 2-tuple linguistic multiple attribute group decision making with incomplete weight information

    NASA Astrophysics Data System (ADS)

    Zhang, Wancheng; Xu, Yejun; Wang, Huimin

    2016-01-01

    The aim of this paper is to put forward a consensus reaching method for multi-attribute group decision-making (MAGDM) problems with linguistic information, in which the weight information of experts and attributes is unknown. First, some basic concepts and operational laws of 2-tuple linguistic label are introduced. Then, a grey relational analysis method and a maximising deviation method are proposed to calculate the incomplete weight information of experts and attributes respectively. To eliminate the conflict in the group, a weight-updating model is employed to derive the weights of experts based on their contribution to the consensus reaching process. After conflict elimination, the final group preference can be obtained which will give the ranking of the alternatives. The model can effectively avoid information distortion which is occurred regularly in the linguistic information processing. Finally, an illustrative example is given to illustrate the application of the proposed method and comparative analysis with the existing methods are offered to show the advantages of the proposed method.

  13. Recommendations for Solid Organ Transplantation for Transplant Candidates With a Pretransplant Diagnosis of Cutaneous Squamous Cell Carcinoma, Merkel Cell Carcinoma and Melanoma: A Consensus Opinion From the International Transplant Skin Cancer Collaborative (ITSCC).

    PubMed

    Zwald, F; Leitenberger, J; Zeitouni, N; Soon, S; Brewer, J; Arron, S; Bordeaux, J; Chung, C; Abdelmalek, M; Billingsley, E; Vidimos, A; Stasko, T

    2016-02-01

    Advancements in solid organ transplantation successfully extend the lives of thousands of patients annually. The tenet of organ stewardship aims to prevent the futile expenditure of scarce donor organs in patient populations with high mortality risk, to the detriment of potential recipients with greater predicted life expectancy. The development of skin cancer posttransplantation portends tremendous morbidity, adversely affecting quality of life for many transplant recipients. This special article, provided by of members of the International Transplant Skin Cancer Collaborative (ITSCC), will provide the transplant professional with a consensus opinion and recommendations as to an appropriate wait period pretransplantation for transplant candidates with a history of either cutaneous squamous cell carcinoma, malignant melanoma, or Merkel cell carcinoma.

  14. Exploring abortion knowledge and opinion among lawyers, an important yet overlooked stakeholder group in Mexico.

    PubMed

    Wilson, Kate S; Garcia, Sandra G; Olavarrieta, Claudia Díaz; McMurtrie, Stephanie M; Valencia, Jorge Armando; Diaz de Leon, Fernanda; Sanchez Fuentes, Maria Luisa

    2012-01-01

    Lawyers are important actors shaping the abortion debate in Mexico. Of 250 private and public sector criminal lawyers surveyed from four regions, the majority knew about abortion laws in their states. At least 80% agreed with abortion in cases of rape, risk to a woman's life or health, and fetal malformations. Overall, 61% agreed with the Mexico City law and 84% would defend a woman denied a legal abortion. In multivariate analysis, being very knowledgeable of abortion laws was a significant predictor of more "progressive" abortion opinions, support for the Mexico City law, and support for the health indication.

  15. Phenotyping animal models of diabetic neuropathy: a consensus statement of the diabetic neuropathy study group of the EASD (Neurodiab)

    PubMed Central

    Biessels, G.J.; Bril, V.; Calcutt, N.A.; Cameron, N.E.; Cotter, M.A.; Dobrowsky, R.; Feldman, E.L.; Fernyhough, P.; Jakobsen, J.; Malik, R.A.; Mizisin, A.P.; Oates, P.J.; Obrosova, I.G.; Pop-Busui, R.; Russell, J.W.; Sima, A.A.; Stevens, M.J.; Schmidt, R.E.; Tesfaye, S.; Veves, A.; Vinik, A.I.; Wright, D.E.; Yagihashi, S.; Yorek, M.A.; Ziegler, D.; Zochodne, D.W.

    2015-01-01

    NIDDK, JDRF, and the Diabetic Neuropathy Study Group of EASD sponsored a meeting to explore the current status of animal models of diabetic peripheral neuropathy. The goal of the workshop was to develop a set of consensus criteria for the phenotyping of rodent models of diabetic neuropathy. The discussion was divided into five areas: (1) status of commonly used rodent models of diabetes, (2) nerve structure, (3) electrophysiological assessments of nerve function, (4) behavioral assessments of nerve function, and (5) the role of biomarkers in disease phenotyping. Participants discussed the current understanding of each area, gold standards (if applicable) for assessments of function, improvements of existing techniques, and utility of known and exploratory biomarkers. The research opportunities in each area were outlined, providing a possible roadmap for future studies. The meeting concluded with a discussion on the merits and limitations of a unified approach to phenotyping rodent models of diabetic neuropathy and a consensus formed on the definition of the minimum criteria required for establishing the presence of the disease. A neuropathy phenotype in rodents was defined as the presence of statistically different values between diabetic and control animals in 2 of 3 assessments (nocifensive behavior, nerve conduction velocities, or nerve structure). The participants propose that this framework would allow different research groups to compare and share data, with an emphasis on data targeted toward the therapeutic efficacy of drug interventions. PMID:24934510

  16. Guidelines for the management of Helicobacter pylori infection in Italy: The III Working Group Consensus Report 2015.

    PubMed

    Zagari, Rocco Maurizio; Romano, Marco; Ojetti, Veronica; Stockbrugger, Reinhold; Gullini, Sergio; Annibale, Bruno; Farinati, Fabio; Ierardi, Enzo; Maconi, Giovanni; Rugge, Massimo; Calabrese, Carlo; Di Mario, Francesco; Luzza, Francesco; Pretolani, Stefano; Savio, Antonella; Gasbarrini, Giovanni; Caselli, Michele

    2015-11-01

    Knowledge on the role of Helicobacter pylori (HP) infection is continually evolving, and treatment is becoming more challenging due to increasing bacterial resistance. Since the management of HP infection is changing, an update of the national Italian guidelines delivered in 2007 was needed. In the III Working Group Consensus Report 2015, a panel of 17 experts from several Italian regions reviewed current evidence on different topics relating to HP infection. Four working groups examined the following topics: (1) "open questions" on HP diagnosis and treatment (focusing on dyspepsia, gastro-oesophageal reflux disease, non-steroidal anti-inflammatory drugs or aspirin use and extra-gastric diseases); (2) non-invasive and invasive diagnostic tests; (3) treatment of HP infection; (4) role of HP in the prevention of gastric cancer. Statements and recommendations were discussed and a consensus reached in a final plenary session held in February 2015 in Bologna. Recommendations are based on the best current evidence to help physicians manage HP infection in Italy. The guidelines have been endorsed by the Italian Society of Gastroenterology and the Italian Society of Digestive Endoscopy.

  17. Phenotyping animal models of diabetic neuropathy: a consensus statement of the diabetic neuropathy study group of the EASD (Neurodiab).

    PubMed

    Biessels, G J; Bril, V; Calcutt, N A; Cameron, N E; Cotter, M A; Dobrowsky, R; Feldman, E L; Fernyhough, P; Jakobsen, J; Malik, R A; Mizisin, A P; Oates, P J; Obrosova, I G; Pop-Busui, R; Russell, J W; Sima, A A; Stevens, M J; Schmidt, R E; Tesfaye, S; Veves, A; Vinik, A I; Wright, D E; Yagihashi, S; Yorek, M A; Ziegler, D; Zochodne, D W

    2014-06-01

    NIDDK, JDRF, and the Diabetic Neuropathy Study Group of EASD sponsored a meeting to explore the current status of animal models of diabetic peripheral neuropathy. The goal of the workshop was to develop a set of consensus criteria for the phenotyping of rodent models of diabetic neuropathy. The discussion was divided into five areas: (1) status of commonly used rodent models of diabetes, (2) nerve structure, (3) electrophysiological assessments of nerve function, (4) behavioral assessments of nerve function, and (5) the role of biomarkers in disease phenotyping. Participants discussed the current understanding of each area, gold standards (if applicable) for assessments of function, improvements of existing techniques, and utility of known and exploratory biomarkers. The research opportunities in each area were outlined, providing a possible roadmap for future studies. The meeting concluded with a discussion on the merits and limitations of a unified approach to phenotyping rodent models of diabetic neuropathy and a consensus formed on the definition of the minimum criteria required for establishing the presence of the disease. A neuropathy phenotype in rodents was defined as the presence of statistically different values between diabetic and control animals in 2 of 3 assessments (nocifensive behavior, nerve conduction velocities, or nerve structure). The participants propose that this framework would allow different research groups to compare and share data, with an emphasis on data targeted toward the therapeutic efficacy of drug interventions.

  18. Treatment of multiple myeloma with high-risk cytogenetics: a consensus of the International Myeloma Working Group

    PubMed Central

    Avet-Loiseau, Hervé; Lonial, Sagar; Usmani, Saad; Siegel, David; Anderson, Kenneth C.; Chng, Wee-Joo; Moreau, Philippe; Attal, Michel; Kyle, Robert A.; Caers, Jo; Hillengass, Jens; San Miguel, Jesús; van de Donk, Niels W. C. J.; Einsele, Hermann; Bladé, Joan; Durie, Brian G. M.; Goldschmidt, Hartmut; Mateos, María-Victoria; Palumbo, Antonio; Orlowski, Robert

    2016-01-01

    The International Myeloma Working Group consensus updates the definition for high-risk (HR) multiple myeloma based on cytogenetics Several cytogenetic abnormalities such as t(4;14), del(17/17p), t(14;16), t(14;20), nonhyperdiploidy, and gain(1q) were identified that confer poor prognosis. The prognosis of patients showing these abnormalities may vary with the choice of therapy. Treatment strategies have shown promise for HR cytogenetic diseases, such as proteasome inhibition in combination with lenalidomide/pomalidomide, double autologous stem cell transplant plus bortezomib, or combination of immunotherapy with lenalidomide or pomalidomide. Careful analysis of cytogenetic subgroups in trials comparing different treatments remains an important goal. Cross-trial comparisons may provide insight into the effect of new drugs in patients with cytogenetic abnormalities. However, to achieve this, consensus on definitions of analytical techniques, proportion of abnormal cells, and treatment regimens is needed. Based on data available today, bortezomib and carfilzomib treatment appear to improve complete response, progression-free survival, and overall survival in t(4;14) and del(17/17p), whereas lenalidomide may be associated with improved progression-free survival in t(4;14) and del(17/17p). Patients with multiple adverse cytogenetic abnormalities do not benefit from these agents. FISH data are implemented in the revised International Staging System for risk stratification. PMID:27002115

  19. Testing the Stability of Experts' Opinions between Successive Rounds of Delphi Studies.

    ERIC Educational Resources Information Center

    Yang, Yu Nu

    The Delphi method is a means of structuring group communication process so that a group of experts can gather information or forecast future problems effectively. A primary objective of a Delphi study is to obtain consensual and consistent opinions from a group of experts in two or more successive rounds on a given research subject. Consensus and…

  20. Dynamics of bounded confidence opinion in heterogeneous social networks: Concord against partial antagonism

    NASA Astrophysics Data System (ADS)

    Kurmyshev, Evguenii; Juárez, Héctor A.; González-Silva, Ricardo A.

    2011-08-01

    Bounded confidence models of opinion dynamics in social networks have been actively studied in recent years, in particular, opinion formation and extremism propagation along with other aspects of social dynamics. In this work, after an analysis of limitations of the Deffuant-Weisbuch (DW) bounded confidence, relative agreement model, we propose the mixed model that takes into account two psychological types of individuals. Concord agents (C-agents) are friendly people; they interact in a way that their opinions always get closer. Agents of the other psychological type show partial antagonism in their interaction (PA-agents). Opinion dynamics in heterogeneous social groups, consisting of agents of the two types, was studied on different social networks: Erdös-Rényi random graphs, small-world networks and complete graphs. Limit cases of the mixed model, pure C- and PA-societies, were also studied. We found that group opinion formation is, qualitatively, almost independent of the topology of networks used in this work. Opinion fragmentation, polarization and consensus are observed in the mixed model at different proportions of PA- and C-agents, depending on the value of initial opinion tolerance of agents. As for the opinion formation and arising of “dissidents”, the opinion dynamics of the C-agents society was found to be similar to that of the DW model, except for the rate of opinion convergence. Nevertheless, mixed societies showed dynamics and bifurcation patterns notably different to those of the DW model. The influence of biased initial conditions over opinion formation in heterogeneous social groups was also studied versus the initial value of opinion uncertainty, varying the proportion of the PA- to C-agents. Bifurcation diagrams showed an impressive evolution of collective opinion, in particular, radical changes of left to right consensus or vice versa at an opinion uncertainty value equal to 0.7 in the model with the PA/C mixture of population near 50/50.

  1. Composition of a Vision Screen for Servicemembers With Traumatic Brain Injury: Consensus Using a Modified Nominal Group Technique

    PubMed Central

    Finkelstein, Marsha; Llanos, Imelda; Scheiman, Mitchell; Wagener, Sharon Gowdy

    2014-01-01

    Vision impairment is common in the first year after traumatic brain injury (TBI), including among service members whose brain injuries occurred during deployment in Iraq and Afghanistan. Occupational therapy practitioners provide routine vision screening to inform treatment planning and referral to vision specialists, but existing methods are lacking because many tests were developed for children and do not screen for vision dysfunction typical of TBI. An expert panel was charged with specifying the composition of a vision screening protocol for servicemembers with TBI. A modified nominal group technique fostered discussion and objective determinations of consensus. After considering 29 vision tests, the panel recommended a nine-test vision screening that examines functional performance, self-reported problems, far–near acuity, reading, accommodation, convergence, eye alignment and binocular vision, saccades, pursuits, and visual fields. Research is needed to develop reliable, valid, and clinically feasible vision screening protocols to identify TBI-related vision disorders in adults. PMID:25005505

  2. Composition of a vision screen for servicemembers with traumatic brain injury: consensus using a modified nominal group technique.

    PubMed

    Radomski, Mary Vining; Finkelstein, Marsha; Llanos, Imelda; Scheiman, Mitchell; Wagener, Sharon Gowdy

    2014-01-01

    Vision impairment is common in the first year after traumatic brain injury (TBI), including among service members whose brain injuries occurred during deployment in Iraq and Afghanistan. Occupational therapy practitioners provide routine vision screening to inform treatment planning and referral to vision specialists, but existing methods are lacking because many tests were developed for children and do not screen for vision dysfunction typical of TBI. An expert panel was charged with specifying the composition of a vision screening protocol for servicemembers with TBI. A modified nominal group technique fostered discussion and objective determinations of consensus. After considering 29 vision tests, the panel recommended a nine-test vision screening that examines functional performance, self-reported problems, far-near acuity, reading, accommodation, convergence, eye alignment and binocular vision, saccades, pursuits, and visual fields. Research is needed to develop reliable, valid, and clinically feasible vision screening protocols to identify TBI-related vision disorders in adults.

  3. Spread of consensus in self-organized groups of individuals: Hydrodynamics matters

    NASA Astrophysics Data System (ADS)

    De Rosis, A.; Lévêque, E.; Ubertini, S.; Succi, S.

    2016-01-01

    Nature routinely presents us with spectacular demonstrations of organization and orchestrated motion in living species. Efficient information transfer among the individuals is known to be instrumental to the emergence of spatial patterns (e.g. V-shaped formations for birds or diamond-like shapes for fishes), responding to a specific functional goal such as predatory avoidance or energy savings. Such functional patterns materialize whenever individuals appoint one of them as a leader with the task of guiding the group towards a prescribed target destination. It is here shown that, under specific conditions, the surrounding hydrodynamics plays a critical role in shaping up a successful group dynamics to reach the desired target.

  4. Offender experiences and opinions of mixed-gender group work in the community: a qualitative study.

    PubMed

    Burrowes, Nina; Day, Jo

    2011-10-01

    The National Probation Service in England and Wales currently delivers community-based accredited offending behavior programs in mixed-gender groups. There is at present a lack of research on the potential impact of mixed-gender group work on female offenders, who are often the minority within the group. This study aimed to improve our understanding of the area using qualitative methods. Sixteen offenders who had participated in a mixed-gender offending behavior program were interviewed as part of this study. Themes from the interviews were analyzed using Grounded Theory techniques. The findings illustrated an overall preference among all participants for mixed-gender rather than single-gender group work. The specific advantages of mixed-gender group work included increased learning about the opposite sex and a more relaxed atmosphere within the group. Although this study reflects positive attitudes to mixed-gender group work, the findings need to be tested further using empirical methodology.

  5. Pathology as the cornerstone of human tissue banking: European consensus expert group report.

    PubMed

    Hainaut, Pierre; Caboux, Elodie; Bevilacqua, Generoso; Bosman, Fref; Dassesse, Thibaut; Hoefler, Heinz; Janin, Anne; Langer, Rupert; Larsimont, Denis; Morente, Manuel; Riegman, Peter; Schirmacher, Peter; Stanta, Giorgio; Zatloukal, Kurt

    2009-09-01

    Aside from ethical considerations, the primary requirement for usage of human tissues in basic or translational research is the thorough characterization of tissues. The second, but equally essential, requirement is that tissues be collected, processed, annotated, and preserved in optimal conditions. These requirements put the pathologist at the center of tissue banking activities and of research aimed at discovering new biomarkers. Pathologists not only provide information identifying the specimen but also make decisions on what materials should be biobanked, on the preservation conditions, and on the timeline of events that precede preservation and storage. This central position calls for increased recognition of the role of the pathologist by the biomolecular community and places new demands on the pathologist's workload and scope of scientific activities. These questions were addressed by an Expert Group Meeting of the European Biological and Biomolecular Research Infrastructure (BBMRI). While detailed recommendations are published elsewhere (Bevilacqua et al., Virchows Archivs, 2010, in press), this article outlines the strategic and technological issues identified by the Expert Group and identifies ways forward for better integration of pathology in the current thrust for development of biomarker-based "personalized medicine."

  6. Current European concepts in the management of Helicobacter pylori infection. The Maastricht Consensus Report. European Helicobacter Pylori Study Group.

    PubMed Central

    1997-01-01

    There is considerable confusion over the management of Helicobacter pylori infection, particularly among primary care physicians, and numerous European countries lack national guidelines in this rapidly growing area of medicine. The European Helicobacter Pylori Study Group therefore organised a meeting in Maastricht of H pylori experts, primary care physicians and representatives of National Societies of Gastroenterology from Europe to establish consensus guidelines on the management of H pylori at the primary care and specialist levels, and to consider general health care issues associated with the infection. As in previous guidelines, eradication therapy was recommended in all H pylori positive patients with peptic ulcer disease. Additionally, at the primary care level in dyspeptic patients < 45 years old and with no alarm symptoms, diagnosis is recommended by non-invasive means (13C urea breath test, serology) and if H pylori positive the patient should be treated. Moreover, at the specialist level the indications for eradication of H pylori were also broadened to include H pylori positive patients with functional dyspepsia in whom no other possible causes of symptoms are identified by the specialist (after a full investigation including endoscopy, ultrasound and other necessary investigations), patients with low grade gastric mucosa associated lymphoid tissue (MALT) lymphoma (managed in specialised centres) and those with gastritis with severe macro- or microscopic abnormalities. There was consensus that treatment regimens should be simple, well tolerated and achieve an eradication rate of over 80% on an intention to treat basis. It was strongly recommended, therefore, that eradication treatment should be with proton pump inhibitor based triple therapy for seven days, using a proton pump inhibitor and two of the following: clarithromycin, a nitroimidazole (metronidazole or tinidazole) and amoxycillin. PMID:9274464

  7. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia.

    PubMed

    Fielding, Roger A; Vellas, Bruno; Evans, William J; Bhasin, Shalender; Morley, John E; Newman, Anne B; Abellan van Kan, Gabor; Andrieu, Sandrine; Bauer, Juergen; Breuille, Denis; Cederholm, Tommy; Chandler, Julie; De Meynard, Capucine; Donini, Lorenzo; Harris, Tamara; Kannt, Aimo; Keime Guibert, Florence; Onder, Graziano; Papanicolaou, Dimitris; Rolland, Yves; Rooks, Daniel; Sieber, Cornel; Souhami, Elisabeth; Verlaan, Sjors; Zamboni, Mauro

    2011-05-01

    Sarcopenia, the age-associated loss of skeletal muscle mass and function, has considerable societal consequences for the development of frailty, disability, and health care planning. A group of geriatricians and scientists from academia and industry met in Rome, Italy, on November 18, 2009, to arrive at a consensus definition of sarcopenia. The current consensus definition was approved unanimously by the meeting participants and is as follows: Sarcopenia is defined as the age-associated loss of skeletal muscle mass and function. The causes of sarcopenia are multifactorial and can include disuse, altered endocrine function, chronic diseases, inflammation, insulin resistance, and nutritional deficiencies. Although cachexia may be a component of sarcopenia, the 2 conditions are not the same. The diagnosis of sarcopenia should be considered in all older patients who present with observed declines in physical function, strength, or overall health. Sarcopenia should specifically be considered in patients who are bedridden, cannot independently rise from a chair, or who have a measured gait speed less that 1 m/s(-1). Patients who meet these criteria should further undergo body composition assessment using dual energy x-ray absorptiometry with sarcopenia being defined using currently validated definitions. A diagnosis of sarcopenia is consistent with a gait speed of less than 1 m·s(-1) and an objectively measured low muscle mass (eg, appendicular mass relative to ht(2) that is ≤ 7.23 kg/m(2) in men and ≤ 5.67 kg/m(2) in women). Sarcopenia is a highly prevalent condition in older persons that leads to disability, hospitalization, and death.

  8. Assessing the Utility of the Nominal Group Technique as a Consensus-Building Tool in Extension-Led Avian Influenza Response Planning

    ERIC Educational Resources Information Center

    Kline, Terence R.

    2013-01-01

    The intent of the project described was to apply the Nominal Group Technique (NGT) to achieve a consensus on Avian Influenza (AI) planning in Northeastern Ohio. Nominal Group Technique is a process first developed by Delbecq, Vande Ven, and Gustafsen (1975) to allow all participants to have an equal say in an open forum setting. A very diverse…

  9. Entropic determination of the phase transition in a coevolving opinion-formation model

    NASA Astrophysics Data System (ADS)

    Burgos, E.; Hernández, Laura; Ceva, H.; Perazzo, R. P. J.

    2015-03-01

    We study an opinion formation model by the means of a coevolving complex network where the vertices represent the individuals, characterized by their evolving opinions, and the edges represent the interactions among them. The network adapts to the spreading of opinions in two ways: not only connected agents interact and eventually change their thinking but an agent may also rewire one of its links to a neighborhood holding the same opinion as his. The dynamics, based on a global majority rule, depends on an external parameter that controls the plasticity of the network. We show how the information entropy associated to the distribution of group sizes allows us to locate the phase transition between a phase of full consensus and another, where different opinions coexist. We also determine the minimum size of the most informative sampling. At the transition the distribution of the sizes of groups holding the same opinion is scale free.

  10. Report: Stem cell applications in neurological practice, an expert group consensus appraisal

    PubMed Central

    Devi, M. Gourie; Sharma, Alka; Mohanty, Sujata; Jain, Neeraj; Verma, Kusum; Padma, M. Vasantha; Pal, Pramod; Chabbra, H. S.; Khadilkar, Satish; Prabhakar, Sudesh; Singh, Gagandeep

    2016-01-01

    Introduction: Neurologists in their clinical practice are faced with inquiries about the suitability of stem cell approaches by patients with a variety of acute and chronic (namely neurodegenerative) disorders. The challenge is to provide these patients with accurate information about the scope of stem cell use as well as at the same time, empowering patients with the capacity to make an autonomous decision regarding the use of stem cells. Methods: The Indian Academy of Neurology commissioned an Expert Group Meeting to formulate an advisory to practicing neurologists to counsel patients seeking information and advice about stem cell approaches. Results and Conclusions: In the course of such counselling, it should be emphasized that the information provided by many lay websites might be unsubstantiated. Besides, standard recommendations for the stem cell research, in particular, the application of several layers of oversight should be strictly adhered in order to ensure safety and ethical use of stem cells in neurological disorders. PMID:27570390

  11. The role of the pathologist in tissue banking: European Consensus Expert Group Report.

    PubMed

    Bevilacqua, Generoso; Bosman, Fred; Dassesse, Thibaut; Höfler, Heinz; Janin, Anne; Langer, Rupert; Larsimont, Denis; Morente, Manuel M; Riegman, Peter; Schirmacher, Peter; Stanta, Giorgio; Zatloukal, Kurt; Caboux, Elodie; Hainaut, Pierre

    2010-04-01

    Human tissue biobanking encompasses a wide range of activities and study designs and is critical for application of a wide range of new technologies (-"omics") to the discovery of molecular patterns of disease and for implementation of novel biomarkers into clinical trials. Pathology is the cornerstone of hospital-based tissue biobanking. Pathologists not only provide essential information identifying the specimen but also make decisions on what should be biobanked, making sure that the timing of all operations is consistent with both the requirements of clinical diagnosis and the optimal preservation of biological products. This document summarizes the conclusions of a Pathology Expert Group Meeting within the European Biological and Biomolecular Research Infrastructure (BBMRI) Program. These recommendations are aimed at providing guidance for pathologists as well as for institutions hosting biobanks on how to better integrate and support pathological activities within the framework of biobanks that fulfill international standards.

  12. International Working Group consensus response evaluation criteria in lymphoma (RECIL 2017).

    PubMed

    Younes, A; Hilden, P; Coiffier, B; Hagenbeek, A; Salles, G; Wilson, W; Seymour, J F; Kelly, K; Gribben, J; Pfreunschuh, M; Morschhauser, F; Schoder, H; Zelenetz, A D; Rademaker, J; Advani, R; Valente, N; Fortpied, C; Witzig, T E; Sehn, L H; Engert, A; Fisher, R I; Zinzani, P-L; Federico, M; Hutchings, M; Bollard, C; Trneny, M; Elsayed, Y A; Tobinai, K; Abramson, J S; Fowler, N; Goy, A; Smith, M; Ansell, S; Kuruvilla, J; Dreyling, M; Thieblemont, C; Little, R F; Aurer, I; Van Oers, M H J; Takeshita, K; Gopal, A; Rule, S; de Vos, S; Kloos, I; Kaminski, M S; Meignan, M; Schwartz, L H; Leonard, J P; Schuster, S J; Seshan, V E

    2017-04-03

    In recent years, the number of approved and investigational agents that can be safely administered for the treatment of lymphoma patients for a prolonged period of time has substantially increased. Many of these novel agents are evaluated in early-phase clinical trials in patients with a wide range of malignancies, including solid tumors and lymphoma. Furthermore, with the advances in genome sequencing, new "basket" clinical trial designs have emerged that select patients based on the presence of specific genetic alterations across different types of solid tumors and lymphoma. The standard response criteria currently in use for lymphoma are the Lugano Criteria which are based on 18-Fluoro-deoxyglucose positron emission tomography (FDG-PET) or bidimensional tumor measurements on computerized tomography (CT) scans. These differ from the RECIST criteria used in solid tumors, which use unidimensional measurements. The RECIL group hypothesized that single dimension measurement could be used to assess response to therapy in lymphoma patients, producing results similar to the standard criteria. We tested this hypothesis by analyzing 47,828 imaging measurements from 2983 individual adult and pediatric lymphoma patients enrolled on 10 multicenter clinical trials, and developed new lymphoma response criteria (RECIL 2017). We demonstrate that assessment of tumor burden in lymphoma clinical trials can use the sum of longest diameters of a maximum of three target lesions. Furthermore, we introduced a new provisional category of a minor response. We also clarified response assessment in patients receiving novel immune therapy and targeted agents that generate unique imaging situations.

  13. Guidelines for Group Experiences in the College and University Counseling Center: A Statement of Opinion

    ERIC Educational Resources Information Center

    Conyne, Robert K.

    1973-01-01

    This article is one attempt to relate the general suggestions of the 1972 ACPA proposed statement on the use of group experiences in higher education to the college and university counseling center. (Author)

  14. Collective opinion formation on fluctuating networks

    NASA Astrophysics Data System (ADS)

    Ngampruetikorn, Vudtiwat; Stephens, Greg

    Thanks to the advent of online social networks, not only are we more connected than ever but we are also able to design and maintain our own social networks. An insight into this phenomenon will be key to understanding modern societies. To this end, we argue that active network maintenance exposes individuals to selective exposure (preference for agreeing information sources) and we explore how this could affect the structure of social networks and collective opinion formation. More technically, we investigate opinion dynamics on a complex network with fast stochastic rewiring. We show that selective exposure while inducing segregation of agents with different opinions, stabilises consensus state regardless of opinion update rules. We argue further that selective exposure can lead to a shorter time to consensus. The time to consensus has non-trivial dependence on the magnitude of selective exposure. Moreover, we find for some opinion updating rules, selective exposure can increase the lifetime of opinion segregation (polarisation of opinions).

  15. Standard operating procedures for serum and plasma collection: early detection research network consensus statement standard operating procedure integration working group.

    PubMed

    Tuck, Melissa K; Chan, Daniel W; Chia, David; Godwin, Andrew K; Grizzle, William E; Krueger, Karl E; Rom, William; Sanda, Martin; Sorbara, Lynn; Stass, Sanford; Wang, Wendy; Brenner, Dean E

    2009-01-01

    Specimen collection is an integral component of clinical research. Specimens from subjects with various stages of cancers or other conditions, as well as those without disease, are critical tools in the hunt for biomarkers, predictors, or tests that will detect serious diseases earlier or more readily than currently possible. Analytic methodologies evolve quickly. Access to high-quality specimens, collected and handled in standardized ways that minimize potential bias or confounding factors, is key to the "bench to bedside" aim of translational research. It is essential that standard operating procedures, "the how" of creating the repositories, be defined prospectively when designing clinical trials. Small differences in the processing or handling of a specimen can have dramatic effects in analytical reliability and reproducibility, especially when multiplex methods are used. A representative working group, Standard Operating Procedures Internal Working Group (SOPIWG), comprised of members from across Early Detection Research Network (EDRN) was formed to develop standard operating procedures (SOPs) for various types of specimens collected and managed for our biomarker discovery and validation work. This report presents our consensus on SOPs for the collection, processing, handling, and storage of serum and plasma for biomarker discovery and validation.

  16. Consensus statement on standard of care for congenital muscular dystrophies.

    PubMed

    Wang, Ching H; Bonnemann, Carsten G; Rutkowski, Anne; Sejersen, Thomas; Bellini, Jonathan; Battista, Vanessa; Florence, Julaine M; Schara, Ulrike; Schuler, Pamela M; Wahbi, Karim; Aloysius, Annie; Bash, Robert O; Béroud, Christophe; Bertini, Enrico; Bushby, Kate; Cohn, Ronald D; Connolly, Anne M; Deconinck, Nicolas; Desguerre, Isabelle; Eagle, Michelle; Estournet-Mathiaud, Brigitte; Ferreiro, Ana; Fujak, Albert; Goemans, Nathalie; Iannaccone, Susan T; Jouinot, Patricia; Main, Marion; Melacini, Paola; Mueller-Felber, Wolfgang; Muntoni, Francesco; Nelson, Leslie L; Rahbek, Jes; Quijano-Roy, Susana; Sewry, Caroline; Storhaug, Kari; Simonds, Anita; Tseng, Brian; Vajsar, Jiri; Vianello, Andrea; Zeller, Reinhard

    2010-12-01

    Congenital muscular dystrophies are a group of rare neuromuscular disorders with a wide spectrum of clinical phenotypes. Recent advances in understanding the molecular pathogenesis of congenital muscular dystrophy have enabled better diagnosis. However, medical care for patients with congenital muscular dystrophy remains very diverse. Advances in many areas of medical technology have not been adopted in clinical practice. The International Standard of Care Committee for Congenital Muscular Dystrophy was established to identify current care issues, review literature for evidence-based practice, and achieve consensus on care recommendations in 7 areas: diagnosis, neurology, pulmonology, orthopedics/rehabilitation, gastroenterology/ nutrition/speech/oral care, cardiology, and palliative care. To achieve consensus on the care recommendations, 2 separate online surveys were conducted to poll opinions from experts in the field and from congenital muscular dystrophy families. The final consensus was achieved in a 3-day workshop conducted in Brussels, Belgium, in November 2009. This consensus statement describes the care recommendations from this committee.

  17. Consensus Statement on Standard of Care for Congenital Muscular Dystrophies

    PubMed Central

    Wang, Ching H.; Bonnemann, Carsten G.; Rutkowski, Anne; Sejersen, Thomas; Bellini, Jonathan; Battista, Vanessa; Florence, Julaine M.; Schara, Ulrike; Schuler, Pamela M.; Wahbi, Karim; Aloysius, Annie; Bash, Robert O.; Béroud, Christophe; Bertini, Enrico; Bushby, Kate; Cohn, Ronald D.; Connolly, Anne M.; Deconinck, Nicolas; Desguerre, Isabelle; Eagle, Michelle; Estournet-Mathiaud, Brigitte; Ferreiro, Ana; Fujak, Albert; Goemans, Nathalie; Iannaccone, Susan T.; Jouinot, Patricia; Main, Marion; Melacini, Paola; Mueller-Felber, Wolfgang; Muntoni, Francesco; Nelson, Leslie L.; Rahbek, Jes; Quijano-Roy, Susana; Sewry, Caroline; Storhaug, Kari; Simonds, Anita; Tseng, Brian; Vajsar, Jiri; Vianello, Andrea; Zeller, Reinhard

    2016-01-01

    Congenital muscular dystrophies are a group of rare neuromuscular disorders with a wide spectrum of clinical phenotypes. Recent advances in understanding the molecular pathogenesis of congenital muscular dystrophy have enabled better diagnosis. However, medical care for patients with congenital muscular dystrophy remains very diverse. Advances in many areas of medical technology have not been adopted in clinical practice. The International Standard of Care Committee for Congenital Muscular Dystrophy was established to identify current care issues, review literature for evidence-based practice, and achieve consensus on care recommendations in 7 areas: diagnosis, neurology, pulmonology, orthopedics/rehabilitation, gastroenterology/ nutrition/speech/oral care, cardiology, and palliative care. To achieve consensus on the care recommendations, 2 separate online surveys were conducted to poll opinions from experts in the field and from congenital muscular dystrophy families. The final consensus was achieved in a 3-day workshop conducted in Brussels, Belgium, in November 2009. This consensus statement describes the care recommendations from this committee. PMID:21078917

  18. Lignes directrices pour le suivi des cardiostimulateurs au canada : consensus du groupe de travail canadien sur la cardiostimulation

    PubMed

    D Fraser JD; M Gillis AM; Irwin; Nishimura; Tyers; Philippon

    2000-03-01

    Un sondage sur les pratiques de cardiostimulation au Canada effectue en 1997 a revele un profond desir pour des lignes directrices nationales sur le suivi des cardiostimulateurs. Ces lignes directrices sur le suivi des cardiostimulateurs representent une declaration de consensus du Groupe de travail canadien sur la cardiostimulation. Le suivi des patients en personne plutot que par moyens transtelephoniques est preferable. Les patients devraient etre examines au minimum dans les 72 heures suivant l'implantation, 2 a 12 semaines et 6 mois apres l'implantation, et annuellement par la suite. Des examens plus frequents peuvent etre requis pour certains patients. Ceci dependra des problemes cardiovasculaires associes et des appareils en particulier. Une visite de suivi typique devrait comprendre un examen cardiovasculaire oriente, l'interrogation du systeme de cardiostimulation et une revue des donnees de telemetrie, un examen du rythme sous-jacent, un examen des seuils de stimulation et de detection et une reprogrammation adequate des parametres pour optimaliser le fonctionnement et la longevite de l'appareil.

  19. Myeloproliferative neoplasms working group consensus recommendations for diagnosis and management of primary myelofibrosis, polycythemia vera, and essential thrombocythemia

    PubMed Central

    Agarwal, M. B.; Malhotra, Hemant; Chakrabarti, Prantar; Varma, Neelam; Mathews, Vikram; Bhattacharyya, Jina; Seth, Tulika; Gayathri, K.; Menon, Hari; Subramanian, P. G.; Sharma, Ajay; Bhattacharyya, Maitreyee; Mehta, Jay; Vaid, A. K.; Shah, Sandeep; Aggarwal, Shyam; Gogoi, P. K.; Nair, Reena; Agarwal, Usha; Varma, Subhash; Prasad, S. V. S. S.; Manipadam, Marie Therese

    2015-01-01

    According to the 2008 revision of the World Health Organization (WHO) classification of myeloid malignancies, philadelphia chromosome (Ph)-negative myeloproliferative neoplasms (MPNs) include clonal, hematologic disorders such as polycythemia vera, primary myelofibrosis, and essential thrombocythemia.Recent years have witnessed major advances in the understanding of the molecular pathophysiology of these rare subgroups of chronic, myeloproliferative disorders. Identification of somatic mutations in genes associated with pathogenesis and evolution of these myeloproliferative conditions (Janus Kinase 2; myeloproliferative leukemia virus gene; calreticulin) led to substantial changes in the international guidelines for diagnosis and treatment of Ph-negative MPN during the last few years.The MPN-Working Group (MPN-WG), a panel of hematologists with expertise in MPN diagnosis and treatment from various parts of India, examined applicability of this latest clinical and scientific evidence in the context of hematology practice in India.This manuscript summarizes the consensus recommendations formulated by the MPN-WG that can be followed as a guideline for management of patients with Ph-negative MPN in the context of clinical practice in India. PMID:25810569

  20. Intrathecal Baclofen therapy in Germany: Proceedings of the IAB-Interdisciplinary Working Group for Movement Disorders Consensus Meeting.

    PubMed

    Dressler, D; Berweck, S; Chatzikalfas, A; Ebke, M; Frank, B; Hesse, S; Huber, M; Krauss, J K; Mücke, K-H; Nolte, A; Oelmann, H-D; Schönle, P W; Schmutzler, M; Pickenbrock, H; Van der Ven, C; Veelken, N; Vogel, M; Vogt, T; Saberi, F Adib

    2015-11-01

    Continuous intrathecal Baclofen application (ITB) through an intracorporeal pump system is widely used in adults and children with spasticity of spinal and supraspinal origin. Currently, about 1200 new ITB pump systems are implanted in Germany each year. ITB is based on an interdisciplinary approach with neurologists, rehabilitation specialists, paediatricians and neurosurgeons. We are presenting the proceedings of a consensus meeting organised by IAB-Interdisciplinary Working Group for Movement Disorders. The ITB pump system consists of the implantable pump with its drug reservoir, the refill port, an additional side port and a flexible catheter. Non-programmable pumps drive the Baclofen flow by the reservoir pressure. Programmable pumps additionally contain a radiofrequency control unit, an electrical pump and a battery. They have major advantages during the dose-finding phase. ITB doses vary widely between 10 and 2000 μg/day. For spinal spasticity, they are typically in the order of 100-300 μg/day. Hereditary spastic paraplegia seems to require particularly low doses, while dystonia and brain injury require particularly high ones. Best effects are documented for tonic paraspasticity of spinal origin and the least effects for phasic muscle hyperactivity disorders of supraspinal origin. Oral antispastics are mainly effective in mild spasticity. Botulinum toxin is most effective in focal spasticity. Myotomies and denervation operations are restricted to selected cases of focal spasticity. Due to its wide-spread distribution within the cerebrospinal fluid, ITB can tackle wide-spread and severe spasticity.

  1. European consensus on diagnosis and treatment of germ cell cancer: a report of the European Germ Cell Cancer Consensus Group (EGCCCG).

    PubMed

    Schmoll, H J; Souchon, R; Krege, S; Albers, P; Beyer, J; Kollmannsberger, C; Fossa, S D; Skakkebaek, N E; de Wit, R; Fizazi, K; Droz, J P; Pizzocaro, G; Daugaard, G; de Mulder, P H M; Horwich, A; Oliver, T; Huddart, R; Rosti, G; Paz Ares, L; Pont, O; Hartmann, J T; Aass, N; Algaba, F; Bamberg, M; Bodrogi, I; Bokemeyer, C; Classen, J; Clemm, S; Culine, S; de Wit, M; Derigs, H G; Dieckmann, K P; Flasshove, M; Garcia del Muro, X; Gerl, A; Germa-Lluch, J R; Hartmann, M; Heidenreich, A; Hoeltl, W; Joffe, J; Jones, W; Kaiser, G; Klepp, O; Kliesch, S; Kisbenedek, L; Koehrmann, K U; Kuczyk, M; Laguna, M P; Leiva, O; Loy, V; Mason, M D; Mead, G M; Mueller, R P; Nicolai, N; Oosterhof, G O N; Pottek, T; Rick, O; Schmidberger, H; Sedlmayer, F; Siegert, W; Studer, U; Tjulandin, S; von der Maase, H; Walz, P; Weinknecht, S; Weissbach, L; Winter, E; Wittekind, C

    2004-09-01

    Germ cell tumour is the most frequent malignant tumour type in young men with a 100% rise in the incidence every 20 years. Despite this, the high sensitivity of germ cell tumours to platinum-based chemotherapy, together with radiation and surgical measures, leads to the high cure rate of > or = 99% in early stages and 90%, 75-80% and 50% in advanced disease with 'good', 'intermediate' and 'poor' prognostic criteria (IGCCCG classification), respectively. The high cure rate in patients with limited metastatic disease allows the reduction of overall treatment load, and therefore less acute and long-term toxicity, e.g. organ sparing surgery for specific cases, reduced dose and treatment volume of irradiation or substitution of node dissection by surveillance or adjuvant chemotherapy according to the presence or absence of vascular invasion. Thus, different treatment options according to prognostic factors including histology, stage and patient factors and possibilities of the treating centre as well may be used to define the treatment strategy which is definitively chosen for an individual patient. However, this strategy of reduction of treatment load as well as the treatment itself require very high expertise of the treating physician with careful management and follow-up and thorough cooperation by the patient as well to maintain the high rate for cure. Treatment decisions must be based on the available evidence which has been the basis for this consensus guideline delivering a clear proposal for diagnostic and treatment measures in each stage of gonadal and extragonadal germ cell tumour and individual clinical situations. Since this guideline is based on the highest evidence level available today, a deviation from these proposals should be a rare and justified exception.

  2. Constraints to microbial food safety policy: opinions from stakeholder groups along the farm to fork continuum.

    PubMed

    Sargeant, J M; Ramsingh, B; Wilkins, A; Travis, R G; Gavrus, D; Snelgrove, J W

    2007-01-01

    This exploratory qualitative study was conducted to identify constraints to microbial food safety policy in Canada and the USA from the perspective of stakeholder groups along the farm to fork continuum. Thirty-seven stakeholders participated in interviews or a focus group where semi-structured questions were used to facilitate discussion about constraints to policy development and implementation. An emergent grounded theory approach was used to determine themes and concepts that arose from the data (versus fitting the data to a hypothesis or a priori classification). Despite the plurality of stakeholders and the range of content expertise, participant perceptions emerged into five common themes, although, there were often disagreements as to the positive or negative attributes of specific concepts. The five themes included challenges related to measurement and objectives of microbial food safety policy goals, challenges arising from lack of knowledge, or problems with communication of knowledge coupled with current practices, beliefs and traditions; the complexity of the food system and the plurality of stakeholders; the economics of producing safe food and the limited resources to address the problem; and, issues related to decision-making and policy, including ownership of the problem and inappropriate inputs to the decision-making process. Responsibilities for food safety and for food policy failure were attributed to all stakeholders along the farm to fork continuum. While challenges regarding the biology of food safety were identified as constraints, a broader range of policy inputs encompassing social, economic and political considerations were also highlighted as critical to the development and implementation of effective food safety policy. Strategies to address these other inputs may require new, transdisciplinary approaches as an adjunct to the traditional science-based risk assessment model.

  3. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 1: specimen handling.

    PubMed

    Samaratunga, Hemamali; Montironi, Rodolfo; True, Lawrence; Epstein, Jonathan I; Griffiths, David F; Humphrey, Peter A; van der Kwast, Theo; Wheeler, Thomas M; Srigley, John R; Delahunt, Brett; Egevad, Lars

    2011-01-01

    The 2009 International Society of Urological Pathology Consensus Conference in Boston made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to the handling and processing of radical prostatectomy specimens were coordinated by working group 1. Most uropathologists followed similar procedures for fixation of radical prostatectomy specimens, with 51% of respondents transporting tissue in formalin. There was also consensus that the prostate weight without the seminal vesicles should be recorded. There was consensus that the surface of the prostate should be painted. It was agreed that both the prostate apex and base should be examined by the cone method with sagittal sectioning of the tissue sample. There was consensus that the gland should be fully fixed before sectioning. Both partial and complete embedding of prostates was considered to be acceptable as long as the method of partial embedding is stated. No consensus was determined regarding the necessity of weighing and measuring the length of the seminal vesicles, the preparation of whole mounts rather than standardized blocks and the methodology for sampling of fresh tissue for research purposes, and it was agreed that these should be left to the discretion of the working pathologist.

  4. Recommended implementation of arterial spin-labeled perfusion MRI for clinical applications: A consensus of the ISMRM perfusion study group and the European consortium for ASL in dementia.

    PubMed

    Alsop, David C; Detre, John A; Golay, Xavier; Günther, Matthias; Hendrikse, Jeroen; Hernandez-Garcia, Luis; Lu, Hanzhang; MacIntosh, Bradley J; Parkes, Laura M; Smits, Marion; van Osch, Matthias J P; Wang, Danny J J; Wong, Eric C; Zaharchuk, Greg

    2015-01-01

    This review provides a summary statement of recommended implementations of arterial spin labeling (ASL) for clinical applications. It is a consensus of the ISMRM Perfusion Study Group and the European ASL in Dementia consortium, both of whom met to reach this consensus in October 2012 in Amsterdam. Although ASL continues to undergo rapid technical development, we believe that current ASL methods are robust and ready to provide useful clinical information, and that a consensus statement on recommended implementations will help the clinical community to adopt a standardized approach. In this review, we describe the major considerations and trade-offs in implementing an ASL protocol and provide specific recommendations for a standard approach. Our conclusion is that as an optimal default implementation, we recommend pseudo-continuous labeling, background suppression, a segmented three-dimensional readout without vascular crushing gradients, and calculation and presentation of both label/control difference images and cerebral blood flow in absolute units using a simplified model.

  5. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People.

    PubMed

    Cruz-Jentoft, Alfonso J; Baeyens, Jean Pierre; Bauer, Jürgen M; Boirie, Yves; Cederholm, Tommy; Landi, Francesco; Martin, Finbarr C; Michel, Jean-Pierre; Rolland, Yves; Schneider, Stéphane M; Topinková, Eva; Vandewoude, Maurits; Zamboni, Mauro

    2010-07-01

    The European Working Group on Sarcopenia in Older People (EWGSOP) developed a practical clinical definition and consensus diagnostic criteria for age-related sarcopenia. EWGSOP included representatives from four participant organisations, i.e. the European Geriatric Medicine Society, the European Society for Clinical Nutrition and Metabolism, the International Association of Gerontology and Geriatrics-European Region and the International Association of Nutrition and Aging. These organisations endorsed the findings in the final document. The group met and addressed the following questions, using the medical literature to build evidence-based answers: (i) What is sarcopenia? (ii) What parameters define sarcopenia? (iii) What variables reflect these parameters, and what measurement tools and cut-off points can be used? (iv) How does sarcopenia relate to cachexia, frailty and sarcopenic obesity? For the diagnosis of sarcopenia, EWGSOP recommends using the presence of both low muscle mass + low muscle function (strength or performance). EWGSOP variously applies these characteristics to further define conceptual stages as 'presarcopenia', 'sarcopenia' and 'severe sarcopenia'. EWGSOP reviewed a wide range of tools that can be used to measure the specific variables of muscle mass, muscle strength and physical performance. Our paper summarises currently available data defining sarcopenia cut-off points by age and gender; suggests an algorithm for sarcopenia case finding in older individuals based on measurements of gait speed, grip strength and muscle mass; and presents a list of suggested primary and secondary outcome domains for research. Once an operational definition of sarcopenia is adopted and included in the mainstream of comprehensive geriatric assessment, the next steps are to define the natural course of sarcopenia and to develop and define effective treatment.

  6. Older drivers' opinions of criteria that inform the cars they buy: A focus group study.

    PubMed

    Zhan, Jenny; Porter, Michelle M; Polgar, Jan; Vrkljan, Brenda

    2013-12-01

    Safe driving in older adulthood depends not only on health and driving ability, but also on the driving environment itself, including the type of vehicle. However, little is known about how safety figures into the older driver's vehicle selection criteria and how it ranks among other criteria, such as price and comfort. For this purpose, six focus groups of older male and female drivers (n=33) aged 70-87 were conducted in two Canadian cities to explore vehicle purchasing decisions and the contribution of safety in this decision. Themes emerged from the data in these categories: vehicle features that keep them feeling safe, advanced vehicular technologies, factors that influence their car buying decisions, and resources that inform this decision. Results indicate older drivers have gaps with respect to their knowledge of safety features and do not prioritize safety at the time of vehicle purchase. To maximize the awareness and uptake of safety innovations, older consumers would benefit from a vehicle design rating system that highlights safety as well as other features to help ensure that the vehicle purchased fits their lifestyle and needs.

  7. [Nutritional status assessment in Geriatrics: Consensus declaration by the Spanish Society of Geriatrics and Gerontology NutritionWork Group].

    PubMed

    Camina-Martín, María Alicia; de Mateo-Silleras, Beatriz; Malafarina, Vincenzo; Lopez-Mongil, Rosa; Niño-Martín, Virtudes; López-Trigo, José Antonio; Redondo-Del-Río, María Paz

    2016-01-01

    Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, as elderly people are a vulnerable group due to their biological, psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología [SEGG]) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition, or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories is intended to help in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment, combined with laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is for further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status, which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics.

  8. Nutritional status assessment in geriatrics: Consensus declaration by the Spanish Society of Geriatrics and Gerontology Nutrition Work Group.

    PubMed

    Camina-Martín, M Alicia; de Mateo-Silleras, Beatriz; Malafarina, Vincenzo; Lopez-Mongil, Rosa; Niño-Martín, Virtudes; López-Trigo, J Antonio; Redondo-del-Río, M Paz

    2015-07-01

    Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, because elderly people are a vulnerable group due to their biological, psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología, SEGG) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories seeks to aid in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment associated to laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is to further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics.

  9. Consensus document on the evaluation and treatment of moderate-to-severe psoriasis: Psoriasis Group of the Spanish Academy of Dermatology and Venereology.

    PubMed

    Daudén, E; Puig, L; Ferrándiz, C; Sánchez-Carazo, J L; Hernanz-Hermosa, J M

    2016-03-01

    Psoriasis is a highly prevalent disease with a major impact on quality of life; therefore, appropriate patient management is mandatory. Given that many issues in psoriasis are controversial and not clearly defined by evidence-based medicine, management of psoriasis is very variable. Expert consensus can generate practical guidelines for optimization of patient care. Much has changed since 2009, when the Consensus Document on the Evaluation and Treatment of Moderate to Severe Psoriasis was published by the Spanish Psoriasis Group (GEP) of the Spanish Academy of Dermatology and Venereology (AEDV). The objective of the present consensus document is to provide the dermatologist with updated recommendations for the evaluation and treatment of patients with moderate-to-severe plaque psoriasis. All active members of the GEP of the AEDV were invited to participate in the survey. The final group comprised 46 members from various areas of Spain and with substantial experience in managing psoriasis. A 3-round Delphi process was used to reach consensus. Consistent agreement and consistent disagreement (consensus) required the achievement of at least two of the following three criteria: Criterion 1, which was based on the position occupied by the mean on a scale of 1-9 and an SD <2; Criterion 2, which was based on the median and interquartile range (IQR) on a scale of 1-9; Criterion 3, which considered the percentage of the voting experts on a scale of 1-9. The items studied were definition of severity, therapeutic objectives, indications for systemic treatment and biologic therapy, induction and maintenance periods, therapeutic failure, loss of response, relapse and rebound, continuous and intermittent therapy, screening of patients before treatment, adherence to therapy, follow-up of treatment outcome, combination of drugs, transitioning and associated comorbidities. Consistent agreement or disagreement (consensus) was achieved for 198 items (agreement, 3 criteria 146 items

  10. Interobserver Variability in Target Definition for Hepatocellular Carcinoma With and Without Portal Vein Thrombus: Radiation Therapy Oncology Group Consensus Guidelines

    SciTech Connect

    Hong, Theodore S.; Bosch, Walter R.; Krishnan, Sunil; Kim, Tae K.; Mamon, Harvey J.; Ben-Josef, Edgar; Seong, Jinsil; Haddock, Michael G.; Cheng, Jason C.; Feng, Mary U.; Stephans, Kevin L.; Roberge, David; and others

    2014-07-15

    Purpose: Defining hepatocellular carcinoma (HCC) gross tumor volume (GTV) requires multimodal imaging, acquired in different perfusion phases. The purposes of this study were to evaluate the variability in contouring and to establish guidelines and educational recommendations for reproducible HCC contouring for treatment planning. Methods and Materials: Anonymous, multiphasic planning computed tomography scans obtained from 3 patients with HCC were identified and distributed to a panel of 11 gastrointestinal radiation oncologists. Panelists were asked the number of HCC cases they treated in the past year. Case 1 had no vascular involvement, case 2 had extensive portal vein involvement, and case 3 had minor branched portal vein involvement. The agreement between the contoured total GTVs (primary + vascular GTV) was assessed using the generalized kappa statistic. Agreement interpretation was evaluated using Landis and Koch's interpretation of strength of agreement. The S95 contour, defined using the simultaneous truth and performance level estimation (STAPLE) algorithm consensus at the 95% confidence level, was created for each case. Results: Of the 11 panelists, 3 had treated >25 cases in the past year, 2 had treated 10 to 25 cases, 2 had treated 5 to 10 cases, 2 had treated 1 to 5 cases, 1 had treated 0 cases, and 1 did not respond. Near perfect agreement was seen for case 1, and substantial agreement was seen for cases 2 and 3. For case 2, there was significant heterogeneity in the volume identified as tumor thrombus (range 0.58-40.45 cc). For case 3, 2 panelists did not include the branched portal vein thrombus, and 7 panelists contoured thrombus separately from the primary tumor, also showing significant heterogeneity in volume of tumor thrombus (range 4.52-34.27 cc). Conclusions: In a group of experts, excellent agreement was seen in contouring total GTV. Heterogeneity exists in the definition of portal vein thrombus that may impact treatment planning

  11. Dose calculation formalisms and consensus dosimetry parameters for intravascular brachytherapy dosimetry: Recommendations of the AAPM Therapy Physics Committee Task Group No. 149

    SciTech Connect

    Chiu-Tsao, Sou-Tung; Schaart, Dennis R.; Soares, Christopher G.; Nath, Ravinder

    2007-11-15

    Since the publication of AAPM Task Group 60 report in 1999, a considerable amount of dosimetry data for the three coronary brachytherapy systems in use in the United States has been reported. A subgroup, Task Group 149, of the AAPM working group on Special Brachytherapy Modalities (Bruce Thomadsen, Chair) was charged to develop recommendations for dose calculation formalisms and the related consensus dosimetry parameters. The recommendations of this group are presented here. For the Cordis {sup 192}Ir and Novoste {sup 90}Sr/{sup 90}Y systems, the original TG-43 formalism in spherical coordinates should be used along with the consensus values of the dose rate constant, geometry function, radial dose function, and anisotropy function for the single seeds. Contributions from the single seeds should be added linearly for the calculation of dose distributions from a source train. For the Guidant {sup 32}P wire system, the modified TG-43 formalism in cylindrical coordinates along with the recommended data for the 20 and 27 mm wires should be used. Data tables for the 6, 10, 14, 18, and 22 seed trains of the Cordis system, 30, 40, and 60 mm seed trains of the Novoste system, and the 20 and 27 mm wires of the Guidant system are presented along with our rationale and methodology for selecting the consensus data. Briefly, all available datasets were compared with each other and the consensus dataset was either an average of available data or the one obtained from the most densely populated study; in most cases this was a Monte Carlo calculation.

  12. Chest electrical impedance tomography examination, data analysis, terminology, clinical use and recommendations: consensus statement of the TRanslational EIT developmeNt stuDy group.

    PubMed

    Frerichs, Inéz; Amato, Marcelo B P; van Kaam, Anton H; Tingay, David G; Zhao, Zhanqi; Grychtol, Bartłomiej; Bodenstein, Marc; Gagnon, Hervé; Böhm, Stephan H; Teschner, Eckhard; Stenqvist, Ola; Mauri, Tommaso; Torsani, Vinicius; Camporota, Luigi; Schibler, Andreas; Wolf, Gerhard K; Gommers, Diederik; Leonhardt, Steffen; Adler, Andy

    2017-01-01

    Electrical impedance tomography (EIT) has undergone 30 years of development. Functional chest examinations with this technology are considered clinically relevant, especially for monitoring regional lung ventilation in mechanically ventilated patients and for regional pulmonary function testing in patients with chronic lung diseases. As EIT becomes an established medical technology, it requires consensus examination, nomenclature, data analysis and interpretation schemes. Such consensus is needed to compare, understand and reproduce study findings from and among different research groups, to enable large clinical trials and, ultimately, routine clinical use. Recommendations of how EIT findings can be applied to generate diagnoses and impact clinical decision-making and therapy planning are required. This consensus paper was prepared by an international working group, collaborating on the clinical promotion of EIT called TRanslational EIT developmeNt stuDy group. It addresses the stated needs by providing (1) a new classification of core processes involved in chest EIT examinations and data analysis, (2) focus on clinical applications with structured reviews and outlooks (separately for adult and neonatal/paediatric patients), (3) a structured framework to categorise and understand the relationships among analysis approaches and their clinical roles, (4) consensus, unified terminology with clinical user-friendly definitions and explanations, (5) a review of all major work in thoracic EIT and (6) recommendations for future development (193 pages of online supplements systematically linked with the chief sections of the main document). We expect this information to be useful for clinicians and researchers working with EIT, as well as for industry producers of this technology.

  13. Chest electrical impedance tomography examination, data analysis, terminology, clinical use and recommendations: consensus statement of the TRanslational EIT developmeNt stuDy group

    PubMed Central

    Frerichs, Inéz; Amato, Marcelo B P; van Kaam, Anton H; Tingay, David G; Zhao, Zhanqi; Grychtol, Bartłomiej; Bodenstein, Marc; Gagnon, Hervé; Böhm, Stephan H; Teschner, Eckhard; Stenqvist, Ola; Mauri, Tommaso; Torsani, Vinicius; Camporota, Luigi; Schibler, Andreas; Wolf, Gerhard K; Gommers, Diederik; Leonhardt, Steffen; Adler, Andy

    2017-01-01

    Electrical impedance tomography (EIT) has undergone 30 years of development. Functional chest examinations with this technology are considered clinically relevant, especially for monitoring regional lung ventilation in mechanically ventilated patients and for regional pulmonary function testing in patients with chronic lung diseases. As EIT becomes an established medical technology, it requires consensus examination, nomenclature, data analysis and interpretation schemes. Such consensus is needed to compare, understand and reproduce study findings from and among different research groups, to enable large clinical trials and, ultimately, routine clinical use. Recommendations of how EIT findings can be applied to generate diagnoses and impact clinical decision-making and therapy planning are required. This consensus paper was prepared by an international working group, collaborating on the clinical promotion of EIT called TRanslational EIT developmeNt stuDy group. It addresses the stated needs by providing (1) a new classification of core processes involved in chest EIT examinations and data analysis, (2) focus on clinical applications with structured reviews and outlooks (separately for adult and neonatal/paediatric patients), (3) a structured framework to categorise and understand the relationships among analysis approaches and their clinical roles, (4) consensus, unified terminology with clinical user-friendly definitions and explanations, (5) a review of all major work in thoracic EIT and (6) recommendations for future development (193 pages of online supplements systematically linked with the chief sections of the main document). We expect this information to be useful for clinicians and researchers working with EIT, as well as for industry producers of this technology. PMID:27596161

  14. Achieving consensus in environmental programs

    SciTech Connect

    Kurstedt, Jr., H. A.; Jones, R. M.; Walker, J. A.; Middleman, L. I.

    1989-01-01

    In this paper, we describe a new research effort on consensus tied to the Environmental Restoration Program (ERP) within the US Department of Energy's Office of Defense Waste and Transportation Management (DWTM). We define consensus and explain why consensus decisions are not merely desirable but necessary in furthering ERP activities. As examples of our planned applied research, we first discuss Nominal Group Technique as a representative consensus-generating tool, and we conclude by describing the consensus-related mission of the Waste Management Review Group, established at Virginia Tech to conduct independent, third-party review of DWTM/ERP plans and activities. 10 refs.

  15. Defining responses to therapy and study outcomes in clinical trials of invasive fungal diseases: Mycoses Study Group and European Organization for Research and Treatment of Cancer consensus criteria.

    PubMed

    Segal, Brahm H; Herbrecht, Raoul; Stevens, David A; Ostrosky-Zeichner, Luis; Sobel, Jack; Viscoli, Claudio; Walsh, Thomas J; Maertens, Johan; Patterson, Thomas F; Perfect, John R; Dupont, Bertrand; Wingard, John R; Calandra, Thierry; Kauffman, Carol A; Graybill, John R; Baden, Lindsey R; Pappas, Peter G; Bennett, John E; Kontoyiannis, Dimitrios P; Cordonnier, Catherine; Viviani, Maria Anna; Bille, Jacques; Almyroudis, Nikolaos G; Wheat, L Joseph; Graninger, Wolfgang; Bow, Eric J; Holland, Steven M; Kullberg, Bart-Jan; Dismukes, William E; De Pauw, Ben E

    2008-09-01

    Invasive fungal diseases (IFDs) have become major causes of morbidity and mortality among highly immunocompromised patients. Authoritative consensus criteria to diagnose IFD have been useful in establishing eligibility criteria for antifungal trials. There is an important need for generation of consensus definitions of outcomes of IFD that will form a standard for evaluating treatment success and failure in clinical trials. Therefore, an expert international panel consisting of the Mycoses Study Group and the European Organization for Research and Treatment of Cancer was convened to propose guidelines for assessing treatment responses in clinical trials of IFDs and for defining study outcomes. Major fungal diseases that are discussed include invasive disease due to Candida species, Aspergillus species and other molds, Cryptococcus neoformans, Histoplasma capsulatum, and Coccidioides immitis. We also discuss potential pitfalls in assessing outcome, such as conflicting clinical, radiological, and/or mycological data and gaps in knowledge.

  16. Prospective Randomized Double-Blind Pilot Study of Site-Specific Consensus Atlas Implementation for Rectal Cancer Target Volume Delineation in the Cooperative Group Setting

    SciTech Connect

    Fuller, Clifton D.; Nijkamp, Jasper; Duppen, Joop C.; Rasch, Coen R.N.; Thomas, Charles R.; Wang, Samuel J.; Okunieff, Paul; Jones, William E.; Baseman, Daniel; Patel, Shilpen; Demandante, Carlo G.N.; Harris, Anna M.; Smith, Benjamin D.; Katz, Alan W.; McGann, Camille

    2011-02-01

    Purpose: Variations in target volume delineation represent a significant hurdle in clinical trials involving conformal radiotherapy. We sought to determine the effect of a consensus guideline-based visual atlas on contouring the target volumes. Methods and Materials: A representative case was contoured (Scan 1) by 14 physician observers and a reference expert with and without target volume delineation instructions derived from a proposed rectal cancer clinical trial involving conformal radiotherapy. The gross tumor volume (GTV), and two clinical target volumes (CTVA, including the internal iliac, presacral, and perirectal nodes, and CTVB, which included the external iliac nodes) were contoured. The observers were randomly assigned to receipt (Group A) or nonreceipt (Group B) of a consensus guideline and atlas for anorectal cancers and then instructed to recontour the same case/images (Scan 2). Observer variation was analyzed volumetrically using the conformation number (CN, where CN = 1 equals total agreement). Results: Of 14 evaluable contour sets (1 expert and 7 Group A and 6 Group B observers), greater agreement was found for the GTV (mean CN, 0.75) than for the CTVs (mean CN, 0.46-0.65). Atlas exposure for Group A led to significantly increased interobserver agreement for CTVA (mean initial CN, 0.68, after atlas use, 0.76; p = .03) and increased agreement with the expert reference (initial mean CN, 0.58; after atlas use, 0.69; p = .02). For the GTV and CTVB, neither the interobserver nor the expert agreement was altered after atlas exposure. Conclusion: Consensus guideline atlas implementation resulted in a detectable difference in interobserver agreement and a greater approximation of expert volumes for the CTVA but not for the GTV or CTVB in the specified case. Visual atlas inclusion should be considered as a feature in future clinical trials incorporating conformal RT.

  17. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 3: extraprostatic extension, lymphovascular invasion and locally advanced disease.

    PubMed

    Magi-Galluzzi, Cristina; Evans, Andrew J; Delahunt, Brett; Epstein, Jonathan I; Griffiths, David F; van der Kwast, Theo H; Montironi, Rodolfo; Wheeler, Thomas M; Srigley, John R; Egevad, Lars L; Humphrey, Peter A

    2011-01-01

    The International Society of Urological Pathology Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens in Boston made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to extraprostatic extension (pT3a disease), bladder neck invasion, lymphovascular invasion and the definition of pT4 were coordinated by working group 3. It was agreed that prostate cancer can be categorized as pT3a in the absence of adipose tissue involvement when cancer bulges beyond the contour of the gland or beyond the condensed smooth muscle of the prostate at posterior and posterolateral sites. Extraprostatic extension can also be identified anteriorly. It was agreed that the location of extraprostatic extension should be reported. Although there was consensus that the amount of extraprostatic extension should be quantitated, there was no agreement as to which method of quantitation should be employed. There was overwhelming consensus that microscopic urinary bladder neck invasion by carcinoma should be reported as stage pT3a and that lymphovascular invasion by carcinoma should be reported. It is recommended that these elements are considered in the development of practice guidelines and in the daily practice of urological surgical pathology.

  18. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 5: surgical margins.

    PubMed

    Tan, Puay Hoon; Cheng, Liang; Srigley, John R; Griffiths, David; Humphrey, Peter A; van der Kwast, Theodore H; Montironi, Rodolfo; Wheeler, Thomas M; Delahunt, Brett; Egevad, Lars; Epstein, Jonathan I

    2011-01-01

    The 2009 International Society of Urological Pathology Consensus Conference in Boston, made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to surgical margin assessment were coordinated by working group 5. Pathologists agreed that tumor extending close to the 'capsular' margin, yet not to it, should be reported as a negative margin, and that locations of positive margins should be indicated as either posterior, posterolateral, lateral, anterior at the prostatic apex, mid-prostate or base. Other items of consensus included specifying the extent of any positive margin as millimeters of involvement; tumor in skeletal muscle at the apical perpendicular margin section, in the absence of accompanying benign glands, to be considered organ confined; and that proximal and distal margins be uniformly referred to as bladder neck and prostatic apex, respectively. Grading of tumor at positive margins was to be left to the discretion of the reporting pathologists. There was no consensus as to how the surgical margin should be regarded when tumor is present at the inked edge of the tissue, in the absence of transected benign glands at the apical margin. Pathologists also did not achieve agreement on the reporting approach to benign prostatic glands at an inked surgical margin in which no carcinoma is present.

  19. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 2: T2 substaging and prostate cancer volume.

    PubMed

    van der Kwast, Theo H; Amin, Mahul B; Billis, Athanase; Epstein, Jonathan I; Griffiths, David; Humphrey, Peter A; Montironi, Rodolfo; Wheeler, Thomas M; Srigley, John R; Egevad, Lars; Delahunt, Brett

    2011-01-01

    The 2009 International Society of Urological Pathology consensus conference in Boston made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to the substaging of pT2 prostate cancers according to the TNM 2002/2010 system, reporting of tumor size/volume and zonal location of prostate cancers were coordinated by working group 2. A survey circulated before the consensus conference demonstrated that 74% of the 157 participants considered pT2 substaging of prostate cancer to be of clinical and/or academic relevance. The survey also revealed a considerable variation in the frequency of reporting of pT2b substage prostate cancer, which was likely a consequence of the variable methodologies used to distinguish pT2a from pT2b tumors. Overview of the literature indicates that current pT2 substaging criteria lack clinical relevance and the majority (65.5%) of conference attendees wished to discontinue pT2 substaging. Therefore, the consensus was that reporting of pT2 substages should, at present, be optional. Several studies have shown that prostate cancer volume is significantly correlated with other clinicopathological features, including Gleason score and extraprostatic extension of tumor; however, most studies fail to demonstrate this to have prognostic significance on multivariate analysis. Consensus was reached with regard to the reporting of some quantitative measure of the volume of tumor in a prostatectomy specimen, without prescribing a specific methodology. Incorporation of the zonal and/or anterior location of the dominant/index tumor in the pathology report was accepted by most participants, but a formal definition of the identifying features of the dominant/index tumor remained undecided.

  20. Sznajd Opinion Dynamics with Global and Local Neighborhood

    NASA Astrophysics Data System (ADS)

    Schulze, Christian

    In this modification of the Sznajd consensus model on the square lattice, two people of arbitrary distance who agree in their opinions convince their nearest neighbors of this opinion. Similarly to the mean field theory of Slanina and Lavicka, the times needed to reach consensus are distributed exponentially and are quite small. The width of the phase transition vanishes reciprocally to the linear lattice dimension. Advertising has effects independent of the system size. For more than two opinions, three opinions reach a consensus in roughly half of the samples, and four only rarely and only for small lattices. Up to 109 agents were simulated.

  1. Coexistence of interacting opinions in a generalized Sznajd model

    NASA Astrophysics Data System (ADS)

    Timpanaro, André M.; Prado, Carmen P. C.

    2011-08-01

    The Sznajd model is a sociophysics model that mimics the propagation of opinions in a closed society, where the interactions favor groups of agreeing people. It is based in the Ising and Potts ferromagnetic models and, although the original model used only linear chains, it has since been adapted to general networks. This model has a very rich transient, which has been used to model several aspects of elections, but its stationary states are always consensus states. In order to model more complex behaviors, we have, in a recent work, introduced the idea of biases and prejudices to the Sznajd model by generalizing the bounded confidence rule, which is common to many continuous opinion models, to what we called confidence rules. In that work we have found that the mean field version of this model (corresponding to a complete network) allows for stationary states where noninteracting opinions survive, but never for the coexistence of interacting opinions. In the present work, we provide networks that allow for the coexistence of interacting opinions for certain confidence rules. Moreover, we show that the model does not become inactive; that is, the opinions keep changing, even in the stationary regime. This is an important result in the context of understanding how a rule that breeds local conformity is still able to sustain global diversity while avoiding a frozen stationary state. We also provide results that give some insights on how this behavior approaches the mean field behavior as the networks are changed.

  2. Canadian asthma consensus report, 1999

    PubMed Central

    Boulet, L P; Becker, A; Bérubé, D; Beveridge, R; Ernst, P

    1999-01-01

    OBJECTIVES: To provide physicians with current guidelines for the diagnosis and optimal management of asthma in children and adults, including pregnant women and the elderly, in office, emergency department, hospital and clinic settings. OPTIONS: The consensus group considered the roles of education, avoidance of provocative environmental and other factors, diverse pharmacotherapies, delivery devices and emergency and in-hospital management of asthma. OUTCOMES: Provision of the best control of asthma by confirmation of the diagnosis using objective measures, rapid achievement and maintenance of control and regular follow-up. EVIDENCE: The key diagnostic and therapeutic recommendations are based on the 1995 Canadian guidelines and a critical review of the literature by small groups before a full meeting of the consensus group. Recommendations are graded according to 5 levels of evidence. Differences of opinion were resolved by consensus following discussion. VALUES: Respirologists, immunoallergists, pediatricians and emergency and family physicians gave prime consideration to the achievement and maintenance of optimal control of asthma through avoidance of environmental inciters, education of patients and the lowest effective regime of pharmacotherapy to reduce morbidity and mortality. BENEFITS, HARMS AND COSTS: Adherence to the guidelines should be accompanied by significant reduction in patients' symptoms, reduced morbidity and mortality, fewer emergency and hospital admissions, fewer adverse side-effects from medications, better quality of life for patients and reduced costs. RECOMMENDATIONS: Recommendations are included in each section of the report. In summary, after a diagnosis of asthma is made based on clinical evaluation, including demonstration of variable airflow obstruction, and contributing factors are identified, a treatment plan is established to obtain and maintain optimal asthma control. The main components of treatment are patient education

  3. Opinion evolution influenced by informed agents

    NASA Astrophysics Data System (ADS)

    Fan, Kangqi; Pedrycz, Witold

    2016-11-01

    Guiding public opinions toward a pre-set target by informed agents can be a strategy adopted in some practical applications. The informed agents are common agents who are employed or chosen to spread the pre-set opinion. In this work, we propose a social judgment based opinion (SJBO) dynamics model to explore the opinion evolution under the influence of informed agents. The SJBO model distinguishes between inner opinions and observable choices, and incorporates both the compromise between similar opinions and the repulsion between dissimilar opinions. Three choices (support, opposition, and remaining undecided) are considered in the SJBO model. Using the SJBO model, both the inner opinions and the observable choices can be tracked during the opinion evolution process. The simulation results indicate that if the exchanges of inner opinions among agents are not available, the effect of informed agents is mainly dependent on the characteristics of regular agents, including the assimilation threshold, decay threshold, and initial opinions. Increasing the assimilation threshold and decay threshold can improve the guiding effectiveness of informed agents. Moreover, if the initial opinions of regular agents are close to null, the full and unanimous consensus at the pre-set opinion can be realized, indicating that, to maximize the influence of informed agents, the guidance should be started when regular agents have little knowledge about a subject under consideration. If the regular agents have had clear opinions, the full and unanimous consensus at the pre-set opinion cannot be achieved. However, the introduction of informed agents can make the majority of agents choose the pre-set opinion.

  4. [Narrowband UV-B, monochromatic excimer laser, and photodynamic therapy in psoriasis: a consensus statement of the Spanish Psoriasis Group].

    PubMed

    Carrascosa, J M; López-Estebaranz, J L; Carretero, G; Daudén, E; Ferrándiz, C; Vidal, D; Belinchón, I; Sánchez-Regaña, M; Puig, L

    2011-04-01

    Novel treatment strategies and new information concerning the management of moderate to severe psoriasis justify a reassessment of the role of the classic therapies in this setting. This consensus statement evaluates narrowband UV-B therapy, which is currently considered the phototherapy option of choice in psoriasis because of its risk-to-benefit ratio. The role of excimer laser and photodynamic therapies are also discussed. These targeted therapies are still only available in a small number of centers in Spain and are used principally in the treatment of localized and recalcitrant forms of psoriasis. We discuss the efficacy and safety of phototherapy as well as treatment regimens, combination therapy, and clinical considerations relating to the characteristics of the patient or the disease.

  5. Classification, diagnosis, and approach to treatment for angioedema: consensus report from the Hereditary Angioedema International Working Group.

    PubMed

    Cicardi, M; Aberer, W; Banerji, A; Bas, M; Bernstein, J A; Bork, K; Caballero, T; Farkas, H; Grumach, A; Kaplan, A P; Riedl, M A; Triggiani, M; Zanichelli, A; Zuraw, B

    2014-05-01

    Angioedema is defined as localized and self-limiting edema of the subcutaneous and submucosal tissue, due to a temporary increase in vascular permeability caused by the release of vasoactive mediator(s). When angioedema recurs without significant wheals, the patient should be diagnosed to have angioedema as a distinct disease. In the absence of accepted classification, different types of angioedema are not uniquely identified. For this reason, the European Academy of Allergy and Clinical Immunology gave its patronage to a consensus conference aimed at classifying angioedema. Four types of acquired and three types of hereditary angioedema were identified as separate forms from the analysis of the literature and were presented in detail at the meeting. Here, we summarize the analysis of the data and the resulting classification of angioedema.

  6. Plasma cell leukemia: consensus statement on diagnostic requirements, response criteria and treatment recommendations by the International Myeloma Working Group.

    PubMed

    Fernández de Larrea, C; Kyle, R A; Durie, B G M; Ludwig, H; Usmani, S; Vesole, D H; Hajek, R; San Miguel, J F; Sezer, O; Sonneveld, P; Kumar, S K; Mahindra, A; Comenzo, R; Palumbo, A; Mazumber, A; Anderson, K C; Richardson, P G; Badros, A Z; Caers, J; Cavo, M; LeLeu, X; Dimopoulos, M A; Chim, C S; Schots, R; Noeul, A; Fantl, D; Mellqvist, U-H; Landgren, O; Chanan-Khan, A; Moreau, P; Fonseca, R; Merlini, G; Lahuerta, J J; Bladé, J; Orlowski, R Z; Shah, J J

    2013-04-01

    Plasma cell leukemia (PCL) is a rare and aggressive variant of myeloma characterized by the presence of circulating plasma cells. It is classified as either primary PCL occurring at diagnosis or as secondary PCL in patients with relapsed/refractory myeloma. Primary PCL is a distinct clinic-pathological entity with different cytogenetic and molecular findings. The clinical course is aggressive with short remissions and survival duration. The diagnosis is based upon the percentage (≥ 20%) and absolute number (≥ 2 × 10(9)/l) of plasma cells in the peripheral blood. It is proposed that the thresholds for diagnosis be re-examined and consensus recommendations are made for diagnosis, as well as, response and progression criteria. Induction therapy needs to begin promptly and have high clinical activity leading to rapid disease control in an effort to minimize the risk of early death. Intensive chemotherapy regimens and bortezomib-based regimens are recommended followed by high-dose therapy with autologous stem cell transplantation if feasible. Allogeneic transplantation can be considered in younger patients. Prospective multicenter studies are required to provide revised definitions and better understanding of the pathogenesis of PCL.

  7. Management goals for type 1 Gaucher disease: An expert consensus document from the European working group on Gaucher disease.

    PubMed

    Biegstraaten, M; Cox, T M; Belmatoug, N; Berger, M G; Collin-Histed, T; Vom Dahl, S; Di Rocco, M; Fraga, C; Giona, F; Giraldo, P; Hasanhodzic, M; Hughes, D A; Iversen, P O; Kiewiet, A I; Lukina, E; Machaczka, M; Marinakis, T; Mengel, E; Pastores, G M; Plöckinger, U; Rosenbaum, H; Serratrice, C; Symeonidis, A; Szer, J; Timmerman, J; Tylki-Szymańska, A; Weisz Hubshman, M; Zafeiriou, D I; Zimran, A; Hollak, C E M

    2016-10-24

    Gaucher Disease type 1 (GD1) is a lysosomal disorder that affects many systems. Therapy improves the principal manifestations of the condition and, as a consequence, many patients show a modified phenotype which reflects manifestations of their disease that are refractory to treatment. More generally, it is increasingly recognised that information as to how a patient feels and functions [obtained by patient- reported outcome measurements (PROMs)] is critical to any comprehensive evaluation of treatment. A new set of management goals for GD1 in which both trends are reflected is needed. To this end, a modified Delphi procedure among 25 experts was performed. Based on a literature review and with input from patients, 65 potential goals were formulated as statements. Consensus was considered to be reached when ≥75% of the participants agreed to include that specific statement in the management goals. There was agreement on 42 statements. In addition to the traditional goals concerning haematological, visceral and bone manifestations, improvement in quality of life, fatigue and social participation, as well as early detection of long-term complications or associated diseases were included. When applying this set of goals in medical practice, the clinical status of the individual patient should be taken into account.

  8. The Undecided Have the Key: Interaction-Driven Opinion Dynamics in a Three State Model

    PubMed Central

    2015-01-01

    The effects of interpersonal interactions on individual’s agreements result in a social aggregation process which is reflected in the formation of collective states, as for instance, groups of individuals with a similar opinion about a given issue. This field, which has been a longstanding concern of sociologists and psychologists, has been extended into an area of experimental social psychology, and even has attracted the attention of physicists and mathematicians. In this article, we present a novel model of opinion formation in which agents may either have a strict preference for a choice, or be undecided. The opinion shift emerges, in a threshold process, as a consequence of a cumulative persuasion for either one of the two opinions in repeated interactions. There are two main ingredients which play key roles in determining the steady states: the initial fraction of undecided agents and the change in agents’ persuasion after each interaction. As a function of these two parameters, the model presents a wide range of solutions, among which there are consensus of each opinion and bi-polarization. We found that a minimum fraction of undecided agents is not crucial for reaching consensus only, but also to determine a dominant opinion in a polarized situation. In order to gain a deeper comprehension of the dynamics, we also present the theoretical framework of the model. The master equations are of special interest for their nontrivial properties and difficulties in being solved analytically. PMID:26436421

  9. The Undecided Have the Key: Interaction-Driven Opinion Dynamics in a Three State Model.

    PubMed

    Balenzuela, Pablo; Pinasco, Juan Pablo; Semeshenko, Viktoriya

    2015-01-01

    The effects of interpersonal interactions on individual's agreements result in a social aggregation process which is reflected in the formation of collective states, as for instance, groups of individuals with a similar opinion about a given issue. This field, which has been a longstanding concern of sociologists and psychologists, has been extended into an area of experimental social psychology, and even has attracted the attention of physicists and mathematicians. In this article, we present a novel model of opinion formation in which agents may either have a strict preference for a choice, or be undecided. The opinion shift emerges, in a threshold process, as a consequence of a cumulative persuasion for either one of the two opinions in repeated interactions. There are two main ingredients which play key roles in determining the steady states: the initial fraction of undecided agents and the change in agents' persuasion after each interaction. As a function of these two parameters, the model presents a wide range of solutions, among which there are consensus of each opinion and bi-polarization. We found that a minimum fraction of undecided agents is not crucial for reaching consensus only, but also to determine a dominant opinion in a polarized situation. In order to gain a deeper comprehension of the dynamics, we also present the theoretical framework of the model. The master equations are of special interest for their nontrivial properties and difficulties in being solved analytically.

  10. Opinion: Mycopedagogy

    ERIC Educational Resources Information Center

    Dworkin, Craig

    2004-01-01

    A teacher at the university of Utah describes his opinion by citing examples of experimental, innovative, avant-garde, a number of literary traditions adopted in college classrooms. The advantages and the dangers of these being pedagogy are explained.

  11. [Consensus document on the evaluation and treatment of moderate-to-severe psoriasis. Spanish psoriasis group of the Spanish Academy of Dermatology and Venereology].

    PubMed

    Puig, L; Bordas, X; Carrascosa, J M; Daudén, E; Ferrándiz, C; Hernanz, J M; López-Estebaranz, J L; Moreno, J C; Sánchez-Carazo, J L; Vanaclocha, F; Vázquez-Veiga, H

    2009-05-01

    The treatment of psoriasis has been revolutionized by the introduction of biologic agents; these agents achieve skin clearance and long-term improvement without the risk of toxicity that has limited use of the classic systemic treatments. The role of systemic treatment in the management of psoriasis is being reviewed on the basis of a large volume of scientific evidence on the efficacy and safety of biologic agents, and new therapeutic goals and strategies are being devised for patients with moderate-to-severe psoriasis. This has led to the need to establish severity criteria that will provide the rationale for the indication of the different systemic agents currently available for the treatment of moderate-to-severe psoriasis, as well as therapeutic goals, efficacy measures, therapeutic strategies, screening protocols, and choice of treatment based on the risk-benefit ratio of the different agents. These criteria must be established through consensus by experienced dermatologists and based on available scientific evidence. The present document reflects the consensus of the Spanish Psoriasis Group on these different issues in the management of moderate-to-severe psoriasis.

  12. The therapeutic potential of mesenchymal stem cell transplantation as a treatment for multiple sclerosis: consensus report of the International MSCT Study Group.

    PubMed

    Freedman, Mark S; Bar-Or, Amit; Atkins, Harold L; Karussis, Dimitrios; Frassoni, Francesco; Lazarus, Hillard; Scolding, Neil; Slavin, Shimon; Le Blanc, Katarina; Uccelli, Antonio

    2010-04-01

    Current therapies for multiple sclerosis effectively reduce inflammation, but do little in terms of repair to the damaged central nervous system. Cell-based therapies may provide a new strategy for bolstering regeneration and repair through neuro-axonal protection or remyelination. Mesenchymal stem cells modulate pathological responses in experimental autoimmune encephalitis, alleviating disease, but also stimulate repair of the central nervous system through the release of soluble factors. Autologous and allogeneic mesenchymal stem cells have been safely administered to individuals with hemato-oncological diseases and in a limited number of patients with multiple sclerosis. It is therefore reasonable to move mesenchymal stem cells transplantation into properly controlled human studies to explore their potential as a treatment for multiple sclerosis. Since it is likely that the first such studies will probably involve only small numbers of patients in a few centers, we formed an international panel comprising multiple sclerosis neurology and stem cell experts, as well as immunologists. The aims were to derive a consensus on the utilization of mesenchymal stem cells for the treatment of multiple sclerosis, along with protocols for the culture of the cells and the treatment of patients. This article reviews the consensus derived from our group on the rationale for mesenchymal stem cell transplantation, the methodology for generating mesenchymal stem cells and the first treatment protocol for multiple sclerosis patients.

  13. The 1st Baltic Osseointegration Academy and Lithuanian University of Health Sciences Consensus Conference 2016. Summary and Consensus Statements: Group I - Peri-Implantitis Aetiology, Risk Factors and Pathogenesis

    PubMed Central

    Andolsek, Francesca; Astramskaite, Inesa; Berton, Federico; Di Lenarda, Roberto; Fernandes, Maria Helena; Frassetto, Andrea; Gomes, Pedro de Sousa; Guobis, Zygimantas; Jimbo, Ryo; Juodzbalys, Gintaras; Khoury, Aiman; Kubilius, Ricardas; Kuoppala, Ritva; Lombardi, Teresa; Maminskas, Julius; Pacauskiene, Ingrida; Perinetti, Giuseppe; Poskevicius, Lukas; Pranskunas, Mindaugas; Puisys, Algirdas; Raustia, Aune

    2016-01-01

    ABSTRACT Introduction The task of Group 1 was to review and update the existing data concerning aetiology, risk factors and pathogenesis of peri-implantitis. Previous history of periodontitis, poor oral hygiene, smoking and presence of general diseases have been considered among the aetiological risk factors for the onset of peri-implant pathologies, while late dental implant failures are commonly associated with peri-implantitis and/or with the application of incorrect biomechanical forces. Special interest was paid to the bone cells dynamics as part of the pathogenesis of peri-implantitis. Material and Methods The main areas indagated by this group were as follows: influence of smoking, history of periodontitis and general diseases on peri-implantitis development, bio-mechanics of implant loading and its influence on peri-implant bone and cellular dynamics related to the pathogenesis of peri-implantitis. The systematic reviews and/or meta-analyses were registered in PROSPERO, an international prospective register of systematic reviews: http://www.crd.york.ac.uk/PROSPERO/. The literature in the corresponding areas of interest was screened and reported following the PRISMA (Preferred Reporting Item for Systematic Review and Meta-Analysis) Statement: http://www.prisma-statement.org/. Method of preparation of the systematic reviews, based on comprehensive search strategies, was discussed and standardized. The summary of the materials and methods employed by the authors in preparing the systematic reviews and/or meta-analyses is presented in Preface chapter. Results The results and conclusions of the review process are presented in the respective papers. One systematic review with meta-analysis, three systematic reviews and one theoretical analysis were performed. The group′s general commentaries, consensus statements, clinical recommendations and implications for research are presented in this article. PMID:27833732

  14. Revised Definitions of Invasive Fungal Disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group

    PubMed Central

    De Pauw, Ben; Walsh, Thomas J.; Donnelly, J. Peter; Stevens, David A.; Edwards, John E.; Calandra, Thierry; Pappas, Peter G.; Maertens, Johan; Lortholary, Olivier; Kauffman, Carol A.; Denning, David W.; Patterson, Thomas F.; Maschmeyer, Georg; Bille, Jacques; Dismukes, William E.; Herbrecht, Raoul; Hope, William W.; Kibbler, Christopher C.; Kullberg, Bart Jan; Marr, Kieren A.; Muñoz, Patricia; Odds, Frank C.; Perfect, John R.; Restrepo, Angela; Ruhnke, Markus; Segal, Brahm H.; Sobel, Jack D.; Sorrell, Tania C.; Viscoli, Claudio; Wingard, John R.; Zaoutis, Theoklis; Bennett, John E.

    2009-01-01

    Background Invasive fungal diseases are important causes of morbidity and mortality. Clarity and uniformity in defining these infections are important factors in improving the quality of clinical studies. A standard set of definitions strengthens the consistency and reproducibility of such studies. Methods After the introduction of the original European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group definitions, advances in diagnostic technology and the recognition of areas in need of improvement led to a revision of this document. The revision process started with a meeting of participants in 2003, to decide on the process and to draft the proposal. This was followed by several rounds of consultation until a final draft was approved in 2005. This was made available for 6 months to allow public comment, and then the manuscript was prepared and approved. Results The revised definitions retain the original classifications of “proven,” “probable,” and “possible” invasive fungal disease, but the definition of “probable” has been expanded, whereas the scope of the category “possible” has been diminished. The category of proven invasive fungal disease can apply to any patient, regardless of whether the patient is immunocompromised, whereas the probable and possible categories are proposed for immunocompromised patients only. Conclusions These revised definitions of invasive fungal disease are intended to advance clinical and epidemiological research and may serve as a useful model for defining other infections in high-risk patients. PMID:18462102

  15. Diagnosis and management of symptoms associated with vulvovaginal atrophy: expert opinion on behalf of the Italian VVA study group *

    PubMed Central

    Nappi, Rossella E.; Biglia, Nicoletta; Cagnacci, Angelo; Di Carlo, Costantino; Luisi, Stefano; Paoletti, Anna Maria

    2016-01-01

    Abstract Vulvovaginal atrophy (VVA) is a chronic disorder that commonly occurs in postmenopausal women, whose symptoms are recognized among the most frequent and bothersome symptoms associated with menopause. The principal therapeutic goal in managing VVA is to relieve symptoms as well as to restore the vaginal environment to a healthy state. However, despite its high prevalence and negative impact on quality of life, VVA is underreported by women, underrecognized by gynecologists, and therefore, undertreated. In the light of the new development of treatment options for VVA, we here provide an updated expert opinion on the management of VVA. In particular, we strongly recommend that HCPs proactively start an open discussion with their postmenopausal patients about urogenital symptoms. Treatment should be started as early as the first symptoms of VVA occur and should be maintained over time, due to the chronicity of the conditions. Many treatment options are now available and therapy should be individualized, taking the woman’s preference in consideration. PMID:27187159

  16. Consensus document on the prevention of methylmercury exposure in Spain: Study group for the prevention of Me-Hg exposure in Spain (GEPREM-Hg).

    PubMed

    González-Estecha, Montserrat; Bodas-Pinedo, Andrés; Guillén-Pérez, José Jesús; Rubio-Herrera, Miguel Ángel; Martínez-Álvarez, Jesús Román; Herráiz-Martínez, Miguel Ángel; Martell-Claros, Nieves; Ordóñez-Iriarte, José M; Sáinz-Martín, María; Farré-Rovira, Rosaura; Martínez-Astorquiza, Txantón; García-Donaire, José Antonio; Calvo-Manuel, Elpidio; Bretón-Lesmes, Irene; Prieto-Menchero, Santiago; Llorente-Ballesteros, M Teresa; Martínez-García, M José; Moreno-Rojas, Rafael; Salas-Salvadó, Jordi; Bermejo-Barrera, Pilar; Cuadrado-Cenzual, M Ángeles; Gallardo-Pino, Carmen; Fuentes, María Blanco; Torres-Moreno, Miriam; Trasobares-Iglesias, Elena M; Martín, Bernardino Barceló; Arroyo-Fernández, Manuel; Calle-Pascual, Alfonso

    2015-10-01

    The beneficial effects of fish consumption in both children and adults are well known. However, the intake of methylmercury, mainly from contaminated fish and shellfish, can have adverse health effects. The study group on the prevention of exposure to methylmercury (GEPREM-Hg), made up of representatives from different Spanish scientific societies, has prepared a consensus document in a question and answer format, containing the group's main conclusions, recommendations and proposals. The objective of the document is to provide broader knowledge of factors associated with methylmercury exposure, its possible effects on health amongst the Spanish population, methods of analysis, interpretation of the results and economic costs, and to then set recommendations for fish and shellfish consumption. The group sees the merit of all initiatives aimed at reducing or prohibiting the use of mercury as well as the need to be aware of the results of contaminant analyses performed on fish and shellfish marketed in Spain. In addition, the group believes that biomonitoring systems should be set up in order to follow the evolution of methylmercury exposure in children and adults and perform studies designed to learn more about the possible health effects of concentrations found in the Spanish population, taking into account the lifestyle, eating patterns and the Mediterranean diet.

  17. Consensus time and conformity in the adaptive voter model

    NASA Astrophysics Data System (ADS)

    Rogers, Tim; Gross, Thilo

    2013-09-01

    The adaptive voter model is a paradigmatic model in the study of opinion formation. Here we propose an extension for this model, in which conflicts are resolved by obtaining another opinion, and analytically study the time required for consensus to emerge. Our results shed light on the rich phenomenology of both the original and extended adaptive voter models, including a dynamical phase transition in the scaling behavior of the mean time to consensus.

  18. [AIDS Study Group/Spanish AIDS Consensus Plan Document on sexually transmitted infections in HIV-infected patients].

    PubMed

    2011-04-01

    Sexually transmitted infections (STI) are a major public health problem. Considering their high morbidity and potential short and long term after effects, physicians must have enough knowledge on the management of these infections for a correct prevention, diagnosis and treatment. HIV infection is associated with STI, not only because they share route of transmission, but also because they lead to an increased risk of HIV transmission. In this article, we summarise the updated clinical practice guidelines, for the evaluation, management and prevention of STI in HIV-infected patients, from a panel of experts in HIV, dermatologists, proctologic surgeons, and microbiologists on behalf of the Spanish AIDS Study Group (GESIDA) and the National AIDS Plan (PNS).

  19. ISPMD consensus on the management of premenstrual disorders

    PubMed Central

    O’Brien, Patrick Michael Shaughn; Bäckström, Torbjorn; Brown, Candace; Dennerstein, Lorraine; Endicott, Jean; Epperson, C. Neill; Eriksson, Elias; Freeman, Ellen W.; Halbreich, Uriel; Ismail, Khalid; Panay, Nicholas; Pearlstein, Teri; Rapkin, Andrea; Reid, Robert; Rubinow, David; Schmidt, Peter; Steiner, Meir; Studd, John; Sundström-Poromaa, Inger; Yonkers, Kimberly

    2014-01-01

    The second consensus meeting of the International Society for Premenstrual Disorders (ISPMD) took place in London during March 2011. The primary goal was to evaluate the published evidence and consider the expert opinions of the ISPMD members to reach a consensus on advice for the management of premenstrual disorders. Gynaecologists, psychiatrists, psychologists and pharmacologists each formally presented the evidence within their area of expertise; this was followed by an in-depth discussion leading to consensus recommendations. This article provides a comprehensive review of the outcomes from the meeting. The group discussed and agreed that careful diagnosis based on the recommendations and classification derived from the first ISPMD consensus conference is essential and should underlie the appropriate management strategy. Options for the management of premenstrual disorders fall under two broad categories, (a) those influencing central nervous activity, particularly the modulation of the neurotransmitter serotonin and (b) those that suppress ovulation. Psychotropic medication, such as selective serotonin reuptake inhibitors, probably acts by dampening the influence of sex steroids on the brain. Oral contraceptives, gonadotropin-releasing hormone agonists, danazol and estradiol all most likely function by ovulation suppression. The role of oophorectomy was also considered in this respect. Alternative therapies are also addressed, with, e.g. cognitive behavioural therapy, calcium supplements and Vitex agnus castus warranting further exploration. PMID:23624686

  20. [Prevention of Neonatal Group B Sreptococcal Infection. Spanish Recommendations. Update 2012. SEIMC/SEGO/SEN/SEQ/SEMFYC Consensus Document].

    PubMed

    Alós Cortés, Juan Ignacio; Andreu Domingo, Antonia; Arribas Mir, Lorenzo; Cabero Roura, Luis; de Cueto López, Marina; López Sastre, José; Melchor Marcos, Juan Carlos; Puertas Prieto, Alberto; de la Rosa Fraile, Manuel; Salcedo Abizanda, Salvador; Sánchez Luna, Manuel; Sanchez Pérez, María José; Torrejon Cardoso, Rafael

    2013-03-01

    Group B streptococci (GBS) remain the most common cause of early onset neonatal sepsis. In 2003 the Spanish Societies of Obstetrics and Gynaecology, Neonatology, Infectious Diseases and Clinical Microbiology, Chemotherapy, and Family and Community Medicine published updated recommendations for the prevention of early onset neonatal GBS infection. It was recommended to study all pregnant women at 35-37 weeks gestation to determine whether they were colonised by GBS, and to administer intrapartum antibiotic prophylaxis (IAP) to all colonised women. There has been a significant reduction in neonatal GBS infection in Spain following the widespread application of IAP. Today most cases of early onset GBS neonatal infection are due to false negative results in detecting GBS, to the lack of communication between laboratories and obstetric units, and to failures in implementing the prevention protocol. In 2010, new recommendations were published by the CDC, and this fact, together with the new knowledge and experience available, has led to the publishing of these new recommendations. The main changes in these revised recommendations include: microbiological methods to identify pregnant GBS carriers and for testing GBS antibiotic sensitivity, and the antibiotics used for IAP are updated; The significance of the presence of GBS in urine, including criteria for the diagnosis of UTI and asymptomatic bacteriuria in pregnancy are clarified; IAP in preterm labour and premature rupture of membranes, and the management of the newborn in relation to GBS carrier status of the mother are also revised. These recommendations are only addressed to the prevention of GBS early neonatal infection, are not effective against late neonatal infection.

  1. Modelling Adaptive Learning Behaviours for Consensus Formation in Human Societies

    NASA Astrophysics Data System (ADS)

    Yu, Chao; Tan, Guozhen; Lv, Hongtao; Wang, Zhen; Meng, Jun; Hao, Jianye; Ren, Fenghui

    2016-06-01

    Learning is an important capability of humans and plays a vital role in human society for forming beliefs and opinions. In this paper, we investigate how learning affects the dynamics of opinion formation in social networks. A novel learning model is proposed, in which agents can dynamically adapt their learning behaviours in order to facilitate the formation of consensus among them, and thus establish a consistent social norm in the whole population more efficiently. In the model, agents adapt their opinions through trail-and-error interactions with others. By exploiting historical interaction experience, a guiding opinion, which is considered to be the most successful opinion in the neighbourhood, can be generated based on the principle of evolutionary game theory. Then, depending on the consistency between its own opinion and the guiding opinion, a focal agent can realize whether its opinion complies with the social norm (i.e., the majority opinion that has been adopted) in the population, and adapt its behaviours accordingly. The highlight of the model lies in that it captures the essential features of people’s adaptive learning behaviours during the evolution and formation of opinions. Experimental results show that the proposed model can facilitate the formation of consensus among agents, and some critical factors such as size of opinion space and network topology can have significant influences on opinion dynamics.

  2. Modelling Adaptive Learning Behaviours for Consensus Formation in Human Societies

    PubMed Central

    Yu, Chao; Tan, Guozhen; Lv, Hongtao; Wang, Zhen; Meng, Jun; Hao, Jianye; Ren, Fenghui

    2016-01-01

    Learning is an important capability of humans and plays a vital role in human society for forming beliefs and opinions. In this paper, we investigate how learning affects the dynamics of opinion formation in social networks. A novel learning model is proposed, in which agents can dynamically adapt their learning behaviours in order to facilitate the formation of consensus among them, and thus establish a consistent social norm in the whole population more efficiently. In the model, agents adapt their opinions through trail-and-error interactions with others. By exploiting historical interaction experience, a guiding opinion, which is considered to be the most successful opinion in the neighbourhood, can be generated based on the principle of evolutionary game theory. Then, depending on the consistency between its own opinion and the guiding opinion, a focal agent can realize whether its opinion complies with the social norm (i.e., the majority opinion that has been adopted) in the population, and adapt its behaviours accordingly. The highlight of the model lies in that it captures the essential features of people’s adaptive learning behaviours during the evolution and formation of opinions. Experimental results show that the proposed model can facilitate the formation of consensus among agents, and some critical factors such as size of opinion space and network topology can have significant influences on opinion dynamics. PMID:27282089

  3. Outcomes in Women Treated With MammoSite Brachytherapy or Whole Breast Irradiation Stratified by ASTRO Accelerated Partial Breast Irradiation Consensus Statement Groups

    SciTech Connect

    Zauls, A. Jason; Watkins, John M.; Wahlquist, Amy E.; Brackett, N. Craig; Aguero, Eric G.; Baker, Megan K.; Jenrette, Joseph M.; Garrett-Mayer, Elizabeth; Harper, Jennifer L.

    2012-01-01

    Purpose: The American Society for Radiation Oncology published a Consensus Statement for accelerated partial breast irradiation identifying three groups: Suitable, Cautionary, and Unsuitable. The objective of this study was to compare oncologic outcomes in women treated with MammoSite brachytherapy (MB) vs. whole breast irradiation (WBI) after stratification into Statement groups. Methods: Eligible women had invasive carcinoma or ductal carcinoma in situ (DCIS) {<=}3 cm, and {<=}3 lymph nodes positive. Women were stratified by radiation modality and Statement groups. Survival analysis methods including Kaplan-Meier estimation, Cox regression, and competing risks analysis were used to assess overall survival (OS), disease-free survival (DFS), time to local failure (TTLF), and tumor bed failure (TBF). Results: A total of 459 (183 MB and 276 WBI) patients were treated from 2002 to 2009. After a median follow-up of 45 months, we found no statistical differences by stratification group or radiation modality with regard to OS and DFS. At 4 years TTLF or TBF were not statistically different between the cohorts. Univariate analysis in the MB cohort revealed that nodal positivity (pN1 vs. pN0) was related to TTLF (hazard ratio 6.39, p = 0.02). There was a suggestion that DCIS histology had an increased risk of failure when compared with invasive ductal carcinoma (hazard ratio 3.57, p = 0.06). Conclusions: MB and WBI patients stratified by Statement groups seem to combine women who will have similar outcomes regardless of radiation modality. Although outcomes were similar, we remain guarded in overinterpretation of these preliminary results until further analysis and long-term follow-up data become available. Caution should be used in treating women with DCIS or pN1 disease with MB.

  4. A Systematic Review of Therapeutic Alliance, Group Cohesion, Empathy, and Goal Consensus/Collaboration in Psychotherapeutic Interventions in Cancer: Uncommon Factors?

    PubMed Central

    Schnur, Julie B.; Montgomery, Guy H.

    2010-01-01

    The effects of four empirically supported therapeutic relationship factors (therapeutic alliance, empathy, goal consensus/collaboration, and group cohesion) on the outcome of psychotherapeutic interventions conducted with individuals living with cancer were systematically reviewed. PubMed, PsycINFO, and CINAHL were searched from their inception through November 13, 2008. Studies of psychotherapeutic interventions targeted to individuals living with cancer, which also empirically assessed the association between any of these therapeutic relationship factors and psychotherapy outcome were included in the review (8 of 742 papers initially reviewed). Information on study methodology and results were abstracted independently by the authors using a standardized form. Results indicated that therapist-rated rapport and group cohesion were significantly related to positive psychotherapeutic outcomes. No studies examined empathy. The literature on collaboration was mixed, but showed some support for increased collaboration being related to positive therapeutic outcomes. Overall the current literature on the role of therapeutic relationship factors in the context of individuals living with cancer is scant, and much more research is needed to determine the overall contribution of these four relationship elements to the outcomes of psychotherapeutic interventions for individuals living with cancer. Results of such studies could have important clinical and research implications. PMID:20006414

  5. The role of fanatics in consensus formation

    NASA Astrophysics Data System (ADS)

    Gündüç, Semra

    2015-08-01

    A model of opinion dynamics with two types of agents as social actors are presented, using the Ising thermodynamic model as the dynamics template. The agents are considered as opportunists which live at sites and interact with the neighbors, or fanatics/missionaries which move from site to site randomly in persuasion of converting agents of opposite opinion with the help of opportunists. Here, the moving agents act as an external influence on the opportunists to convert them to the opposite opinion. It is shown by numerical simulations that such dynamics of opinion formation may explain some details of consensus formation even when one of the opinions are held by a minority. Regardless the distribution of the opinion, different size societies exhibit different opinion formation behavior and time scales. In order to understand general behavior, the scaling relations obtained by comparing opinion formation processes observed in societies with varying population and number of randomly moving agents are studied. For the proposed model two types of scaling relations are observed. In fixed size societies, increasing the number of randomly moving agents give a scaling relation for the time scale of the opinion formation process. The second type of scaling relation is due to the size dependent information propagation in finite but large systems, namely finite-size scaling.

  6. Consensus among Economists--An Update

    ERIC Educational Resources Information Center

    Fuller, Dan; Geide-Stevenson, Doris

    2014-01-01

    In this article, the authors explore consensus among economists on specific propositions based on a fall 2011 survey of American Economic Association members. Results are based on 568 responses and provide evidence of changes in opinion over time by including propositions from earlier studies in 2000 (Fuller and Geide-Stevenson 2003) and 1992…

  7. Consensus among Economics Teachers from Transition Economies

    ERIC Educational Resources Information Center

    Leet, Don R.; Lang, Nancy A.

    2010-01-01

    The authors analyze the economic opinions of teachers and economists from the former Soviet Union who participated in economic education programs sponsored by the U.S. Department of Education under the auspices of the National Council on Economic Education from 1995-2001. They sought to determine the level of consensus on economic topics among the…

  8. Landmark opinions

    SciTech Connect

    Julian Levy

    2007-08-15

    On April 2, 2007, the U.S. Supreme Court issued two landmark opinions affecting the regulation of air quality in the United States. The first addressed one facet of what constitutes a modification under New Source Review (NSR) and the second addressed the issue of global climate change, specifically carbon dioxide emissions. For this month's issue, EM invited five leaders in the field of air quality to give their perspectives on these court opinions to gauge what they might mean for future air quality regulations. Titles of the five features are: Two landmark interpretations of the Clean Air Act: EPA authority to regulate greenhouse gases and increases in annual emissions trigger NSR (pp 6-10); Court examines EPA's interpretation of the Clean Air Act (pp 11,13); New Jersey: a state's perspective (pp 14-15); Supreme Court delivers historic environmental rulings (pp 17-18); and an industry perspective on the Supreme Court rulings (pp 20-21).

  9. Public opinion and interest group positions on open-space issues in Albuquerque, New Mexico, USA: Implications for resource management

    NASA Astrophysics Data System (ADS)

    Tannery, Thomas Allan

    1987-07-01

    The purpose of this research was to elicit and compare the open-space preferences of citizens and openspace experts in Albuquerque, New Mexico, USA. A randomly selected sample of 492 citizens and 35 open-space experts participated in a telephone survey during May 5 18, 1986. The following hypothesis was tested and used as a guideline for the study: HO1: There is no significant difference between respondents' status and preference for open space in Albuquerque, New Mexico. The hypothesis was rejected. Findings confirmed respondents' status affected preference for open space. Of the eight issues on which the citizen and expert groups were compared, five recorded significant differences in response profiles. The open-space expert group was significantly more supportive of using open space to accommodate offroad vehicle facilities, wildlife preserves, a citywide recreational trail, and a trail system along the arroyos and city ditches. The citizen sample was significantly more supportive of using open space to accommodate overnight camping facilities. Both groups equally supported using open space to accommodate an outdoor amphitheater, outdoor education facilities, and rafting, kayaking, and canoeing facilities. The finding indicated that expert preferences did not represent an aggregate of citizen preferences for managing open-space resources. Understanding both expert and citizen positions will facilitate decision-making processes and help resolve environmental disputes.

  10. C1 inhibitor deficiency: 2014 United Kingdom consensus document.

    PubMed

    Longhurst, H J; Tarzi, M D; Ashworth, F; Bethune, C; Cale, C; Dempster, J; Gompels, M; Jolles, S; Seneviratne, S; Symons, C; Price, A; Edgar, D

    2015-06-01

    C1 inhibitor deficiency is a rare disorder manifesting with recurrent attacks of disabling and potentially life-threatening angioedema. Here we present an updated 2014 United Kingdom consensus document for the management of C1 inhibitor-deficient patients, representing a joint venture between the United Kingdom Primary Immunodeficiency Network and Hereditary Angioedema UK. To develop the consensus, we assembled a multi-disciplinary steering group of clinicians, nurses and a patient representative. This steering group first met in 2012, developing a total of 48 recommendations across 11 themes. The statements were distributed to relevant clinicians and a representative group of patients to be scored for agreement on a Likert scale. All 48 statements achieved a high degree of consensus, indicating strong alignment of opinion. The recommendations have evolved significantly since the 2005 document, with particularly notable developments including an improved evidence base to guide dosing and indications for acute treatment, greater emphasis on home therapy for acute attacks and a strong focus on service organization.

  11. C1 inhibitor deficiency: 2014 United Kingdom consensus document

    PubMed Central

    Longhurst, H J; Tarzi, M D; Ashworth, F; Bethune, C; Cale, C; Dempster, J; Gompels, M; Jolles, S; Seneviratne, S; Symons, C; Price, A; Edgar, D

    2015-01-01

    C1 inhibitor deficiency is a rare disorder manifesting with recurrent attacks of disabling and potentially life-threatening angioedema. Here we present an updated 2014 United Kingdom consensus document for the management of C1 inhibitor-deficient patients, representing a joint venture between the United Kingdom Primary Immunodeficiency Network and Hereditary Angioedema UK. To develop the consensus, we assembled a multi-disciplinary steering group of clinicians, nurses and a patient representative. This steering group first met in 2012, developing a total of 48 recommendations across 11 themes. The statements were distributed to relevant clinicians and a representative group of patients to be scored for agreement on a Likert scale. All 48 statements achieved a high degree of consensus, indicating strong alignment of opinion. The recommendations have evolved significantly since the 2005 document, with particularly notable developments including an improved evidence base to guide dosing and indications for acute treatment, greater emphasis on home therapy for acute attacks and a strong focus on service organization. PMID:25605519

  12. Characteristics of successful opinion leaders in a bounded confidence model

    NASA Astrophysics Data System (ADS)

    Chen, Shuwei; Glass, David H.; McCartney, Mark

    2016-05-01

    This paper analyses the impact of competing opinion leaders on attracting followers in a social group based on a bounded confidence model in terms of four characteristics: reputation, stubbornness, appeal and extremeness. In the model, reputation differs among leaders and normal agents based on the weights assigned to them, stubbornness of leaders is reflected by their confidence towards normal agents, appeal of the leaders is represented by the confidence of followers towards them, and extremeness is captured by the opinion values of leaders. Simulations show that increasing reputation, stubbornness or extremeness makes it more difficult for the group to achieve consensus, but increasing the appeal will make it easier. The results demonstrate that successful opinion leaders should generally be less stubborn, have greater appeal and be less extreme in order to attract more followers in a competing environment. Furthermore, the number of followers can be very sensitive to small changes in these characteristics. On the other hand, reputation has a more complicated impact: higher reputation helps the leader to attract more followers when the group bound of confidence is high, but can hinder the leader from attracting followers when the group bound of confidence is low.

  13. Cardiovascular–renal axis disorders in the domestic dog and cat: a veterinary consensus statement

    PubMed Central

    Pouchelon, J L; Atkins, C E; Bussadori, C; Oyama, M A; Vaden, S L; Bonagura, J D; Chetboul, V; Cowgill, L D; Elliot, J; Francey, T; Grauer, G F; Luis Fuentes, V; Sydney Moise, N; Polzin, D J; Van Dongen, A M; Van Israël, N

    2015-01-01

    OBJECTIVES There is a growing understanding of the complexity of interplay between renal and cardiovascular systems in both health and disease. The medical profession has adopted the term “cardiorenal syndrome” (CRS) to describe the pathophysiological relationship between the kidney and heart in disease. CRS has yet to be formally defined and described by the veterinary profession and its existence and importance in dogs and cats warrant investigation. The CRS Consensus Group, comprising nine veterinary cardiologists and seven nephrologists from Europe and North America, sought to achieve consensus around the definition, pathophysiology, diagnosis and management of dogs and cats with “cardiovascular-renal disorders” (CvRD). To this end, the Delphi formal methodology for defining/building consensus and defining guidelines was utilised. METHODS Following a literature review, 13 candidate statements regarding CvRD in dogs and cats were tested for consensus, using a modified Delphi method. As a new area of interest, well-designed studies, specific to CRS/CvRD, are lacking, particularly in dogs and cats. Hence, while scientific justification of all the recommendations was sought and used when available, recommendations were largely reliant on theory, expert opinion, small clinical studies and extrapolation from data derived from other species. RESULTS Of the 13 statements, 11 achieved consensus and 2 did not. The modified Delphi approach worked well to achieve consensus in an objective manner and to develop initial guidelines for CvRD. DISCUSSION The resultant manuscript describes consensus statements for the definition, classification, diagnosis and management strategies for veterinary patients with CvRD, with an emphasis on the pathological interplay between the two organ systems. By formulating consensus statements regarding CvRD in veterinary medicine, the authors hope to stimulate interest in and advancement of the understanding and management of CvRD in

  14. Radiation Therapy Oncology Group Consensus Panel Guidelines for the Delineation of the Clinical Target Volume in the Postoperative Treatment of Pancreatic Head Cancer

    SciTech Connect

    Goodman, Karyn A.; Regine, William F.; Dawson, Laura A.; Ben-Josef, Edgar; Haustermans, Karin; Bosch, Walter R.; Turian, Julius; Abrams, Ross A.

    2012-07-01

    Purpose: To develop contouring guidelines to be used in the Radiation Therapy Oncology Group protocol 0848, a Phase III randomized trial evaluating the benefit of adjuvant chemoradiation in patients with resected head of pancreas cancer. Methods and Materials: A consensus committee of six radiation oncologists with expertise in gastrointestinal radiotherapy developed stepwise contouring guidelines and an atlas for the delineation of the clinical target volume (CTV) in the postoperative treatment of pancreas cancer, based on identifiable regions of interest and margin expansions. Areas at risk for subclinical disease to be included in the CTV were defined, including nodal regions, anastomoses, and the preoperative primary tumor location. Regions of interest that could be reproducibly contoured on postoperative imaging after a pancreaticoduodenectomy were identified. Standardized expansion margins to encompass areas at risk were developed after multiple iterations to determine the optimal margin expansions. Results: New contouring recommendations based on CT anatomy were established. Written guidelines for the delineation of the postoperative CTV and normal tissues, as well as a Web-based atlas, were developed. Conclusions: The postoperative abdomen has been a difficult area for effective radiotherapy. These new guidelines will help physicians create fields that better encompass areas at risk and minimize dose to normal tissues.

  15. Consensus report on the radiological management of patients with gastrointestinal stromal tumours (GIST): recommendations of the German GIST Imaging Working Group.

    PubMed

    Kalkmann, Janine; Zeile, Martin; Antoch, Gerald; Berger, Frank; Diederich, Stefan; Dinter, Dietmar; Fink, Christian; Janka, Rolf; Stattaus, Jörg

    2012-05-07

    The aim was to reach consensus in imaging for staging and follow-up as well as for therapy response assessment in patients with gastrointestinal stromal tumours (GIST). The German GIST Imaging Working Group was formed by 9 radiologists engaged in assessing patients with GIST treated with targeted therapy. The following topics were discussed: indication and optimal acquisition techniques of computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET)/CT; tumour response assessment considering response criteria and measurement techniques on CT, MRI and PET/CT; result interpretation; staging interval and pitfalls. Contrast-enhanced CT is the standard method for GIST imaging. MRI is the method of choice in case of liver-specific questions or contraindications to CT. PET/CT should be used for early response assessment or inconclusive results on morphologic imaging. All imaging techniques should be standardized allowing a reliable response assessment. Response has to be assessed with respect to lesion size, lesion density and appearance of new lesions. A critical issue is pseudoprogression due to myxoid degeneration or intratumoural haemorrhage. The management of patients with GIST receiving a targeted therapy requires a standardized algorithm for imaging and an appropriate response assessment with respect to changes in lesion size and density.

  16. Assessment of antibody responses against gp41 in HIV-1-infected patients using soluble gp41 fusion proteins and peptides derived from M group consensus envelope

    PubMed Central

    Penn-Nicholson, Adam; Han, Dong P.; Kim, Soon J.; Park, Hanna; Ansari, Rais; Montefiori, David C.; Cho, Michael W.

    2008-01-01

    Human immunodeficiency virus type 1 (HIV-1) transmembrane glycoprotein gp41 is targeted by broadly-reactive neutralizing antibodies 2F5 and 4E10, making it an attractive target for vaccine development. To better assess immunogenic properties of gp41, we generated five soluble glutathione S-transferase fusion proteins encompassing C-terminal 30, 64, 100, 142, or 172 (full-length) amino acids of gp41 ectodomain from M group consensus envelope sequence. Antibody responses in HIV-1-infected patients were evaluated using these proteins and overlapping peptides. We found (i) antibody responses against different regions of gp41 varied tremendously among individual patients, (ii) patients with stronger antibody responses against membrane-proximal external region exhibit broader and more potent neutralizing activity, and (iii) several patients mounted antibodies against epitopes that are near, or overlap with, those targeted by 2F5 or 4E10. These soluble gp41 fusion proteins could be an important source of antigens for future vaccine development efforts. PMID:18068750

  17. Assessment of antibody responses against gp41 in HIV-1-infected patients using soluble gp41 fusion proteins and peptides derived from M group consensus envelope

    SciTech Connect

    Penn-Nicholson, Adam; Han, Dong P.; Kim, Soon J.; Park, Hanna; Ansari, Rais; Montefiori, David C.; Cho, Michael W.

    2008-03-15

    Human immunodeficiency virus type 1 (HIV-1) transmembrane glycoprotein gp41 is targeted by broadly-reactive neutralizing antibodies 2F5 and 4E10, making it an attractive target for vaccine development. To better assess immunogenic properties of gp41, we generated five soluble glutathione S-transferase fusion proteins encompassing C-terminal 30, 64, 100, 142, or 172 (full-length) amino acids of gp41 ectodomain from M group consensus envelope sequence. Antibody responses in HIV-1-infected patients were evaluated using these proteins and overlapping peptides. We found (i) antibody responses against different regions of gp41 varied tremendously among individual patients, (ii) patients with stronger antibody responses against membrane-proximal external region exhibit broader and more potent neutralizing activity, and (iii) several patients mounted antibodies against epitopes that are near, or overlap with, those targeted by 2F5 or 4E10. These soluble gp41 fusion proteins could be an important source of antigens for future vaccine development efforts.

  18. Consensus definitions of 14 severe acute toxic effects for childhood lymphoblastic leukaemia treatment: a Delphi consensus.

    PubMed

    Schmiegelow, Kjeld; Attarbaschi, Andishe; Barzilai, Shlomit; Escherich, Gabriele; Frandsen, Thomas Leth; Halsey, Christina; Hough, Rachael; Jeha, Sima; Kato, Motohiro; Liang, Der-Cherng; Mikkelsen, Torben Stamm; Möricke, Anja; Niinimäki, Riitta; Piette, Caroline; Putti, Maria Caterina; Raetz, Elizabeth; Silverman, Lewis B; Skinner, Roderick; Tuckuviene, Ruta; van der Sluis, Inge; Zapotocka, Ester

    2016-06-01

    Although there are high survival rates for children with acute lymphoblastic leukaemia, their outcome is often counterbalanced by the burden of toxic effects. This is because reported frequencies vary widely across studies, partly because of diverse definitions of toxic effects. Using the Delphi method, 15 international childhood acute lymphoblastic leukaemia study groups assessed acute lymphoblastic leukaemia protocols to address toxic effects that were to be considered by the Ponte di Legno working group. 14 acute toxic effects (hypersensitivity to asparaginase, hyperlipidaemia, osteonecrosis, asparaginase-associated pancreatitis, arterial hypertension, posterior reversible encephalopathy syndrome, seizures, depressed level of consciousness, methotrexate-related stroke-like syndrome, peripheral neuropathy, high-dose methotrexate-related nephrotoxicity, sinusoidal obstructive syndrome, thromboembolism, and Pneumocystis jirovecii pneumonia) that are serious but too rare to be addressed comprehensively within any single group, or are deemed to need consensus definitions for reliable incidence comparisons, were selected for assessment. Our results showed that none of the protocols addressed all 14 toxic effects, that no two protocols shared identical definitions of all toxic effects, and that no toxic effect definition was shared by all protocols. Using the Delphi method over three face-to-face plenary meetings, consensus definitions were obtained for all 14 toxic effects. In the overall assessment of outcome of acute lymphoblastic leukaemia treatment, these expert opinion-based definitions will allow reliable comparisons of frequencies and severities of acute toxic effects across treatment protocols, and facilitate international research on cause, guidelines for treatment adaptation, preventive strategies, and development of consensus algorithms for reporting on acute lymphoblastic leukaemia treatment.

  19. Canadian Helicobacter Study Group Consensus Conference: Update on the approach to Helicobacter pylori infection in children and adolescents--an evidence-based evaluation.

    PubMed

    Bourke, Billy; Ceponis, Peter; Chiba, Naoki; Czinn, Steve; Ferraro, Richard; Fischbach, Lori; Gold, Ben; Hyunh, Hien; Jacobson, Kevan; Jones, Nicola L; Koletzko, Sibylle; Lebel, Sylvie; Moayyedi, Paul; Ridell, Robert; Sherman, Philip; van Zanten, Sander; Beck, Ivan; Best, Linda; Boland, Margaret; Bursey, Ford; Chaun, Hugh; Cooper, Geraldine; Craig, Brian; Creuzenet, Carole; Critch, Jeffrey; Govender, Krishnasamy; Hassall, Eric; Kaplan, Alan; Keelan, Monica; Noad, Garth; Robertson, Marli; Smith, Lesley; Stein, Markus; Taylor, Diane; Walters, Thomas; Persaud, Robin; Whitaker, Scott; Woodland, Robert

    2005-07-01

    As an update to previously published recommendations for the management of Helicobacter pylori infection, an evidence-based appraisal of 14 topics was undertaken in a consensus conference sponsored by the Canadian Helicobacter Study Group. The goal was to update guidelines based on the best available evidence using an established and uniform methodology to address and formulate recommendations for each topic. The degree of consensus for each recommendation is also presented. The clinical issues addressed and recommendations made were: population-based screening for H. pylori in asymptomatic children to prevent gastric cancer is not warranted; testing for H. pylori in children should be considered if there is a family history of gastric cancer; the goal of diagnostic interventions should be to determine the cause of presenting gastrointestinal symptoms and not the presence of H. pylori infection; recurrent abdominal pain of childhood is not an indication to test for H. pylori infection; H. pylori testing is not required in patients with newly diagnosed gastroesophageal reflux disease; H. pylori testing may be considered before the use of long-term proton pump inhibitor therapy; testing for H. pylori infection should be considered in children with refractory iron deficiency anemia when no other cause has been found; when investigation of pediatric patients with persistent or severe upper abdominal symptoms is indicated, upper endoscopy with biopsy is the investigation of choice; the 13C-urea breath test is currently the best noninvasive diagnostic test for H. pylori infection in children; there is currently insufficient evidence to recommend stool antigen tests as acceptable diagnostic tools for H. pylori infection; serological antibody tests are not recommended as diagnostic tools for H. pylori infection in children; first-line therapy for H. pylori infection in children is a twice-daily, triple-drug regimen comprised of a proton pump inhibitor plus two antibiotics

  20. Opinion formation models on a gradient.

    PubMed

    Gastner, Michael T; Markou, Nikolitsa; Pruessner, Gunnar; Draief, Moez

    2014-01-01

    Statistical physicists have become interested in models of collective social behavior such as opinion formation, where individuals change their inherently preferred opinion if their friends disagree. Real preferences often depend on regional cultural differences, which we model here as a spatial gradient g in the initial opinion. The gradient does not only add reality to the model. It can also reveal that opinion clusters in two dimensions are typically in the standard (i.e., independent) percolation universality class, thus settling a recent controversy about a non-consensus model. However, using analytical and numerical tools, we also present a model where the width of the transition between opinions scales proportional g(-1/4), not proportional g(-4/7) as in independent percolation, and the cluster size distribution is consistent with first-order percolation.

  1. Consensus on consensus: a synthesis of consensus estimates on human-caused global warming

    NASA Astrophysics Data System (ADS)

    Cook, John; Oreskes, Naomi; Doran, Peter T.; Anderegg, William R. L.; Verheggen, Bart; Maibach, Ed W.; Carlton, J. Stuart; Lewandowsky, Stephan; Skuce, Andrew G.; Green, Sarah A.; Nuccitelli, Dana; Jacobs, Peter; Richardson, Mark; Winkler, Bärbel; Painting, Rob; Rice, Ken

    2016-04-01

    The consensus that humans are causing recent global warming is shared by 90%-100% of publishing climate scientists according to six independent studies by co-authors of this paper. Those results are consistent with the 97% consensus reported by Cook et al (Environ. Res. Lett. 8 024024) based on 11 944 abstracts of research papers, of which 4014 took a position on the cause of recent global warming. A survey of authors of those papers (N = 2412 papers) also supported a 97% consensus. Tol (2016 Environ. Res. Lett. 11 048001) comes to a different conclusion using results from surveys of non-experts such as economic geologists and a self-selected group of those who reject the consensus. We demonstrate that this outcome is not unexpected because the level of consensus correlates with expertise in climate science. At one point, Tol also reduces the apparent consensus by assuming that abstracts that do not explicitly state the cause of global warming (‘no position’) represent non-endorsement, an approach that if applied elsewhere would reject consensus on well-established theories such as plate tectonics. We examine the available studies and conclude that the finding of 97% consensus in published climate research is robust and consistent with other surveys of climate scientists and peer-reviewed studies.

  2. National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: V. The 2014 Ancillary Therapy and Supportive Care Working Group Report

    PubMed Central

    Carpenter, Paul A.; Kitko, Carrie L.; Elad, Sharon; Flowers, Mary E.D.; Gea-Banacloche, Juan C.; Halter, Jörg P.; Hoodin, Flora; Johnston, Laura; Lawitschka, Anita; McDonald, George B.; Opipari, Anthony W.; Savani, Bipin N.; Schultz, Kirk R.; Smith, Sean R.; Syrjala, Karen L.; Treister, Nathaniel; Vogelsang, Georgia B.; Williams, Kirsten M.; Pavletic, Steven Z.; Martin, Paul J.; Lee, Stephanie J.; Couriel, Daniel R.

    2016-01-01

    The 2006 National Institutes of Health (NIH) Consensus paper presented recommendations by the Ancillary Therapy and Supportive Care Working Group to support clinical research trials in chronic graft-versus-host disease (GVHD). Topics covered in that inaugural effort included the prevention and management of infections and common complications of chronic GVHD, as well as recommendations for patient education and appropriate follow-up. Given the new literature that has emerged during the past 8 years, we made further organ-specific refinements to these guidelines. Minimum frequencies are suggested for monitoring key parameters relevant to chronic GVHD during systemic immunosuppressive therapy and, thereafter, referral to existing late effects consensus guidelines is advised. Using the framework of the prior consensus, the 2014 NIH recommendations are organized by organ or other relevant systems and graded according to the strength and quality of supporting evidence. PMID:25838185

  3. Patient resources in the therapeutic education of haemophiliacs in France: their skills and roles as defined by consensus of a working group.

    PubMed

    Wintz, L; Sannié, T; Ayçaguer, S; Guerois, C; Bernhard, J-P; Valluet, D; Borel-Derlon, A; Guillon, P; Fondanesche, C; Lambert, T; Meunier, S; Alliaume, N; Gagnayre, R

    2010-05-01

    The activities of 'expert patients' or 'patient tutors', who help educate their peers, are gaining recognition in the health care system. This study investigates the role played by such patients in therapeutic education programmes organized by caregivers to validate the role of patients in implementing the therapeutic education of haemophilic patients and to define the skills required for such activities. This study employs the consensus methodology recommended by France's National Authority for Health. The working group includes seven caregivers from Hemophiliac Treatment Centers (HTCs) and three patients from the French Association of Hemophiliacs (FAH). The role of patients in haemophilia education is recognized. Patients participating in the education of their peers are referred to as 'patient resources'. A patient resource should be an adult, a volunteer and live in the same region as his peers. Candidates are chosen by the FAH and the HTCs to serve based on their motivation to facilitate the education of other patients as well as on their psychological and pedagogical aptitudes. A patient resource participates in the conception and administration of therapeutic education programmes. He also mediates between the caregivers and the patients. He ensures that the patients understand the material and are able to apply their knowledge in daily life. His activities are governed by professional ethics. Seven categories of skills were defined, permitting the group to determine precisely which skills are required to function as a patient resource. Supervision of the patients is planned to reinforce reflexive practices in the patients. Evolution of the health care system has led patients to become involved in therapeutic education. This phenomenon calls for a framework to be developed and an evaluation of its eventual effects.

  4. The clinical utility of CA125/MUC16 in pancreatic cancer: A consensus of diagnostic, prognostic and predictive updates by the Chinese Study Group for Pancreatic Cancer (CSPAC).

    PubMed

    Liu, Liang; Xiang, Jinfeng; Chen, Rufu; Fu, Deliang; Hong, Defei; Hao, Jihui; Li, Yixiong; Li, Jiangtao; Li, Shengping; Mou, Yiping; Mai, Gang; Ni, Quanxing; Peng, Li; Qin, Renyi; Qian, Honggang; Shao, Chenghao; Sun, Bei; Sun, Yongwei; Tao, Min; Tian, Bole; Wang, Hongxia; Wang, Jian; Wang, Liwei; Wang, Wei; Wang, Weilin; Zhang, Jun; Zhao, Gang; Zhou, Jun; Yu, Xianjun

    2016-03-01

    The prognosis for pancreatic cancer (PC) is poor; however, the timely and accurate treatment of this disease will significantly improve prognosis. Serum biomarkers involve non-invasive tests that facilitate the early detection of tumors, predict outcomes and assess responses to therapy, so that the patient can be continuously monitored and receive the most appropriate therapy. Studies have reported that cancer antigen (CA)125 [also known as mucin 16 (MUC16)] has functional significance in the tumorigenic, metastatic and drug resistant properties of PC. Our aim was to use this biomarker in the diagnosis, detection of metastasis, prognosis and in the monitoring of the treatment effects of PC. Members of the Chinese Study Group for Pancreatic Cancer (CSPAC) reviewed the literature on CA125/MUC16 and developed an objective consensus on the clinical utility of CA125/MUC16 for PC. They confirmed the role of CA125/MUC16 in tumorigenesis and the progression of PC, and recommended monitoring CA125/MUC16 levels in all aspects of the diagnosis and treatment of PC, particularly those that involve the monitoring of treatments. In addition, they suggested that the combination of other biomarkers and imaging techniques, together with CA125/MUC16, would improve the accuracy of the clinical decision-making process, thereby facilitating the optimization of treatment strategies. Periodic clinical updates of the use of CA125/MUC16 have been established, which are important for further analyses and comparisons of clinical results from affiliates and countries, particularly as regards the in-depth biological function and clinical translational research of this biomarker.

  5. National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: I. The 2014 Diagnosis and Staging Working Group Report

    PubMed Central

    Jagasia, Madan H.; Greinix, Hildegard T.; Arora, Mukta; Williams, Kirsten M.; Wolff, Daniel; Cowen, Edward W.; Palmer, Jeanne; Weisdorf, Daniel; Treister, Nathaniel S.; Cheng, Guang-Shing; Kerr, Holly; Stratton, Pamela; Duarte, Rafael F.; McDonald, George B.; Inamoto, Yoshihiro; Vigorito, Afonso; Arai, Sally; Datiles, Manuel B.; Jacobsohn, David; Heller, Theo; Kitko, Carrie L.; Mitchell, Sandra A.; Martin, Paul J.; Shulman, Howard; Wu, Roy S.; Cutler, Corey S.; Vogelsang, Georgia B.; Lee, Stephanie J.; Pavletic, Steven Z.; Flowers, Mary E.D.

    2015-01-01

    The 2005 National Institutes of Health (NIH) Consensus Conference proposed new criteria for diagnosing and scoring the severity of chronic GVHD. The 2014 NIH consensus maintains the framework of the prior consensus with further refinement based on new evidence. Revisions have been made to address areas of controversy or confusion, such as the overlap chronic GVHD subcategory and the distinction between active disease and past tissue damage. Diagnostic criteria for involvement of mouth, eyes, genitalia, and lungs have been revised. Categories of chronic GVHD should be defined in ways that indicate prognosis, guide treatment, and define eligibility for clinical trials. Revisions have been made to focus attention on the causes of organ-specific abnormalities. Attribution of organ-specific abnormalities to chronic GVHD has been addressed. This paradigm shift provides greater specificity, more accurately measures the global burden of disease attributed to GVHD, and will facilitate biomarker association studies. PMID:25529383

  6. Is There a Consensus on Consensus Methodology? Descriptions and Recommendations for Future Consensus Research.

    PubMed

    Waggoner, Jane; Carline, Jan D; Durning, Steven J

    2016-05-01

    The authors of this article reviewed the methodology of three common consensus methods: nominal group process, consensus development panels, and the Delphi technique. The authors set out to determine how a majority of researchers are conducting these studies, how they are analyzing results, and subsequently the manner in which they are reporting their findings. The authors conclude with a set of guidelines and suggestions designed to aid researchers who choose to use the consensus methodology in their work.Overall, researchers need to describe their inclusion criteria. In addition to this, on the basis of the current literature the authors found that a panel size of 5 to 11 members was most beneficial across all consensus methods described. Lastly, the authors agreed that the statistical analyses done in consensus method studies should be as rigorous as possible and that the predetermined definition of consensus must be included in the ultimate manuscript. More specific recommendations are given for each of the three consensus methods described in the article.

  7. Consensus on the management of advanced radioactive iodine-refractory differentiated thyroid cancer on behalf of the Spanish Society of Endocrinology Thyroid Cancer Working Group (GTSEEN) and Spanish Rare Cancer Working Group (GETHI).

    PubMed

    Capdevila, J; Galofré, J C; Grande, E; Zafón Llopis, C; Ramón Y Cajal Asensio, T; Navarro González, E; Jiménez-Fonseca, P; Santamaría Sandi, J; Gómez Sáez, J M; Riesco Eizaguirre, G

    2017-03-01

    Thyroid cancer is the single most prevalent endocrine malignancy; differentiated thyroid cancer (DTC) accounts for more than 90 % of all malignancies and its incidence has been rising steadily. For more patients, surgical treatment, radioactive iodine (RAI) ablation, and thyroid-stimulating hormone (TSH) suppressive therapy achieve an overall survival (OS) rate of 97.7 % at 5 years. Nevertheless, locoregional recurrence occurs in up to 20 % and distant metastases in approximately 10 % at 10 years. Two-thirds of these patients will never be cured with radioactive iodine therapy and will become RAI-refractory, with a 3-year OS rate of less than 50 %. Over the last decade, substantial progress has been made in the management of RAI-refractory DTC. Given the controversy in some areas, the Spanish Task Force for Thyroid Cancer on behalf of Spanish Society of Endocrinology Thyroid Cancer Working Group (GTSEEN) and the Spanish Rare Cancer Working Group (GETHI) have created a national joint task force to reach a consensus addressing the most challenging aspects of management in these patients. In this way, multidisciplinary management should be mandatory and nuclear medicine targeted therapy, novel molecular targeted agents, and combinations are currently changing the natural history of RAI-refractory DTC.

  8. International Consensus Document (ICON): Common Variable Immunodeficiency Disorders

    PubMed Central

    Bonilla, Francisco A.; Barlan, Isil; Chapel, Helen; Costa-Carvalho, Beatriz T.; Cunningham-Rundles, Charlotte; de la Morena, M. Teresa; Espinosa-Rosales, Francisco J.; Hammarström, Lennart; Nonoyama, Shigeaki; Quinti, Isabella; Routes, John M.; Tang, Mimi L.K.; Warnatz, Klaus

    2016-01-01

    The International Collaboration in Asthma, Allergy and Immunology initiated an international coalition among the American Academy of Allergy, Asthma & Immunology; the European Academy of Allergy and Clinical Immunology; the World Allergy Organization; and the American College of Allergy, Asthma & Immunology on common variable immunodeficiency. An author group was formed and then divided into individual committees. Within the committee, teams of authors were subgrouped to generate content for specific sections of the document. Content was derived from literature searches, relevant published guidelines, and clinical experience. After a draft of the document was assembled, it was collectively reviewed and revised by the authors. Where evidence was lacking or conflicting, the information presented represents the consensus expert opinion of the group. The full document was then independently reviewed by 5 international experts in the field, none of whom was among the authors of the original. The comments of these reviewers were incorporated before submission for publication. PMID:26563668

  9. Social opinion dynamics is not chaotic

    NASA Astrophysics Data System (ADS)

    Lim, Chjan; Zhang, Weituo

    2016-08-01

    Motivated by the research on social opinion dynamics over large and dense networks, a general framework for verifying the monotonicity property of multi-agent dynamics is introduced. This allows a derivation of sociologically meaningful sufficient conditions for monotonicity that are tailor-made for social opinion dynamics, which typically have high nonlinearity. A direct consequence of monotonicity is that social opinion dynamics is nonchaotic. A key part of this framework is the definition of a partial order relation that is suitable for a large class of social opinion dynamics such as the generalized naming games. Comparisons are made to previous techniques to verify monotonicity. Using the results obtained, we extend many of the consequences of monotonicity to this class of social dynamics, including several corollaries on their asymptotic behavior, such as global convergence to consensus and tipping points of a minority fraction of zealots or leaders.

  10. Populism vs. elitism: social consensus and social status as bases of attitude certainty.

    PubMed

    Prislin, Radmila; Shaffer, Emily; Crowder, Marisa

    2012-01-01

    This study examined the effects of social consensus and social status on attitude certainty that is conceptualized multi-dimensionally as perceived clarity and correctness of one's attitude. In a mock opinion exchange about a social issue, participants were either supported (high consensus) or opposed (low consensus) by most of the confederates. They were informed that their opinion (high status) or their opponents' opinion (low status) had the alleged psychological significance indicative of future success. Post-experimental attitude clarity was significantly greater when attitudinal position was associated with high rather than low status. Attitude correctness was interactively affected by social status and social consensus. Supporting the compensatory effect hypothesis, attitude correctness was comparable across the levels of social consensus as long as they were associated with high status, and across the levels of social status as long as they were associated with high social consensus.

  11. C3 glomerulopathy: consensus report.

    PubMed

    Pickering, Matthew C; D'Agati, Vivette D; Nester, Carla M; Smith, Richard J; Haas, Mark; Appel, Gerald B; Alpers, Charles E; Bajema, Ingeborg M; Bedrosian, Camille; Braun, Michael; Doyle, Mittie; Fakhouri, Fadi; Fervenza, Fernando C; Fogo, Agnes B; Frémeaux-Bacchi, Véronique; Gale, Daniel P; Goicoechea de Jorge, Elena; Griffin, Gene; Harris, Claire L; Holers, V Michael; Johnson, Sally; Lavin, Peter J; Medjeral-Thomas, Nicholas; Paul Morgan, B; Nast, Cynthia C; Noel, Laure-Hélène; Peters, D Keith; Rodríguez de Córdoba, Santiago; Servais, Aude; Sethi, Sanjeev; Song, Wen-Chao; Tamburini, Paul; Thurman, Joshua M; Zavros, Michael; Cook, H Terence

    2013-12-01

    C3 glomerulopathy is a recently introduced pathological entity whose original definition was glomerular pathology characterized by C3 accumulation with absent or scanty immunoglobulin deposition. In August 2012, an invited group of experts (comprising the authors of this document) in renal pathology, nephrology, complement biology, and complement therapeutics met to discuss C3 glomerulopathy in the first C3 Glomerulopathy Meeting. The objectives were to reach a consensus on: the definition of C3 glomerulopathy, appropriate complement investigations that should be performed in these patients, and how complement therapeutics should be explored in the condition. This meeting report represents the current consensus view of the group.

  12. Management of sporadic desmoid-type fibromatosis: a European consensus approach based on patients' and professionals' expertise - a sarcoma patients EuroNet and European Organisation for Research and Treatment of Cancer/Soft Tissue and Bone Sarcoma Group initiative.

    PubMed

    Kasper, B; Baumgarten, C; Bonvalot, S; Haas, R; Haller, F; Hohenberger, P; Moreau, G; van der Graaf, W T A; Gronchi, A

    2015-01-01

    Desmoid-type fibromatosis (DF) is a rare monoclonal, fibroblastic proliferation characterised by a variable and often unpredictable clinical course. It may affect nearly all parts of the body including extremities, trunk and abdomen. Considering the variable clinical presentations, anatomic locations and biological behaviours, an individualised treatment approach is required. No established or evidence-based approach for the treatment of this neoplasm is available as of today. Therefore, we propose a consensus treatment algorithm based on a round table meeting bringing together sarcoma experts from the European Organisation for Research and Treatment of Cancer (EORTC) Soft Tissue and Bone Sarcoma Group (STBSG) with patient advocates from Sarcoma Patients EuroNet (SPAEN). The aim of the meeting was to develop - for the first time ever - a consensus approach based on professionals' AND patients' expertise. As a fundamental prerequisite, all patients should be discussed in a multidisciplinary setting in centres or professional networks with a specific expertise in the disease.

  13. Microscopic enteritis: Bucharest consensus.

    PubMed

    Rostami, Kamran; Aldulaimi, David; Holmes, Geoffrey; Johnson, Matt W; Robert, Marie; Srivastava, Amitabh; Fléjou, Jean-François; Sanders, David S; Volta, Umberto; Derakhshan, Mohammad H; Going, James J; Becheanu, Gabriel; Catassi, Carlo; Danciu, Mihai; Materacki, Luke; Ghafarzadegan, Kamran; Ishaq, Sauid; Rostami-Nejad, Mohammad; Peña, A Salvador; Bassotti, Gabrio; Marsh, Michael N; Villanacci, Vincenzo

    2015-03-07

    Microscopic enteritis (ME) is an inflammatory condition of the small bowel that leads to gastrointestinal symptoms, nutrient and micronutrient deficiency. It is characterised by microscopic or sub-microscopic abnormalities such as microvillus changes and enterocytic alterations in the absence of definite macroscopic changes using standard modern endoscopy. This work recognises a need to characterize disorders with microscopic and submicroscopic features, currently regarded as functional or non-specific entities, to obtain further understanding of their clinical relevance. The consensus working party reviewed statements about the aetiology, diagnosis and symptoms associated with ME and proposes an algorithm for its investigation and treatment. Following the 5(th) International Course in Digestive Pathology in Bucharest in November 2012, an international group of 21 interested pathologists and gastroenterologists formed a working party with a view to formulating a consensus statement on ME. A five-step agreement scale (from strong agreement to strong disagreement) was used to score 21 statements, independently. There was strong agreement on all statements about ME histology (95%-100%). Statements concerning diagnosis achieved 85% to 100% agreement. A statement on the management of ME elicited agreement from the lowest rate (60%) up to 100%. The remaining two categories showed general agreement between experts on clinical presentation (75%-95%) and pathogenesis (80%-90%) of ME. There was strong agreement on the histological definition of ME. Weaker agreement on management indicates a need for further investigations, better definitions and clinical trials to produce quality guidelines for management. This ME consensus is a step toward greater recognition of a significant entity affecting symptomatic patients previously labelled as non-specific or functional enteropathy.

  14. Italian consensus conference for colonic diverticulosis and diverticular disease.

    PubMed

    Cuomo, Rosario; Barbara, Giovanni; Pace, Fabio; Annese, Vito; Bassotti, Gabrio; Binda, Gian Andrea; Casetti, Tino; Colecchia, Antonio; Festi, Davide; Fiocca, Roberto; Laghi, Andrea; Maconi, Giovanni; Nascimbeni, Riccardo; Scarpignato, Carmelo; Villanacci, Vincenzo; Annibale, Bruno

    2014-10-01

    The statements produced by the Consensus Conference on Diverticular Disease promoted by GRIMAD (Gruppo Italiano Malattia Diverticolare, Italian Group on Diverticular Diseases) are reported. Topics such as epidemiology, risk factors, diagnosis, medical and surgical treatment of diverticular disease (DD) in patients with uncomplicated and complicated DD were reviewed by a scientific board of experts who proposed 55 statements graded according to level of evidence and strength of recommendation, and approved by an independent jury. Each topic was explored focusing on the more relevant clinical questions. Comparison and discussion of expert opinions, pertinent statements and replies to specific questions, were presented and approved based on a systematic literature search of the available evidence. Comments were added explaining the basis for grading the evidence, particularly for controversial areas.

  15. Italian consensus conference for colonic diverticulosis and diverticular disease

    PubMed Central

    Barbara, Giovanni; Pace, Fabio; Annese, Vito; Bassotti, Gabrio; Binda, Gian Andrea; Casetti, Tino; Colecchia, Antonio; Festi, Davide; Fiocca, Roberto; Laghi, Andrea; Maconi, Giovanni; Nascimbeni, Riccardo; Scarpignato, Carmelo; Villanacci, Vincenzo; Annibale, Bruno

    2014-01-01

    The statements produced by the Consensus Conference on Diverticular Disease promoted by GRIMAD (Gruppo Italiano Malattia Diverticolare, Italian Group on Diverticular Diseases) are reported. Topics such as epidemiology, risk factors, diagnosis, medical and surgical treatment of diverticular disease (DD) in patients with uncomplicated and complicated DD were reviewed by a scientific board of experts who proposed 55 statements graded according to level of evidence and strength of recommendation, and approved by an independent jury. Each topic was explored focusing on the more relevant clinical questions. Comparison and discussion of expert opinions, pertinent statements and replies to specific questions, were presented and approved based on a systematic literature search of the available evidence. Comments were added explaining the basis for grading the evidence, particularly for controversial areas. PMID:25360320

  16. Primary Therapy of Patients with Early Breast Cancer: Evidence, Controversies, Consensus

    PubMed Central

    Untch, M.; Harbeck, N.; Huober, J.; von Minckwitz, G.; Gerber, B.; Kreipe, H.-H.; Liedtke, C.; Marschner, N.; Möbus, V.; Scheithauer, H.; Schneeweiss, A.; Thomssen, C.; Jackisch, C.; Beckmann, M. W.; Blohmer, J.-U.; Costa, S.-D.; Decker, T.; Diel, I.; Fasching, P. A.; Fehm, T.; Janni, W.; Lück, H.-J.; Maass, N.; Scharl, A.; Loibl, S.

    2015-01-01

    For the first time, this yearʼs St. Gallen International Consensus Conference on the treatment of patients with primary breast cancer, which takes place every two years, was held not in St. Gallen (Switzerland) but – for logistical reasons – in Vienna (Austria) under its usual name. The 2015 St. Gallen International Consensus Conference was the 14th of its kind. As the international panel of the St. Gallen conference consists of experts from different countries, the consensus mirrors an international cross-section of opinions. From a German perspective, it was considered useful to translate the results of the votes of the St. Gallen conference into practical suggestions, particularly in light of the recently updated treatment guideline of the Gynecologic Oncology Group (AGO-Mamma 2015) in Germany. A German group consisting of 14 breast cancer experts, three of whom are members of the international St. Gallen panel, has therefore provided comments on the results of this yearʼs votes at the 2015 St. Gallen Consensus Conference and their impact on clinical care in Germany. The 14th St. Gallen conference once again focused on surgery of the breast and the axilla, radio-oncologic and systemic treatment options for primary breast cancer depending on tumor biology, and the clinical use of multigene assays. The conference also considered targeted therapies for older and for younger patients, including the diagnosis/treatment of breast cancer during and after pregnancy and the preservation of fertility. PMID:26166836

  17. Executive summary of the consensus statement on assistance to women with HIV infection in the health care sector. National AIDS Plan (PNS) and AIDS Study Group (GeSIDA).

    PubMed

    2014-02-01

    The aim of this paper was to develop a consensus on clinical recommendations for health care assistance for women with HIV infection. To this end, a panel of experts, appointed by the Secretariat of the National AIDS Plan and GeSIDA was assembled, that included internal medicine physicians with expertise in the field of HIV infection, gynecologists, pediatricians and psychologists, with two members of the panel acting as coordinators. Scientific information was reviewed in publications and conference reports up to October 2012. In keeping with the criteria of the Infectious Disease Society of America, two levels of evidence were applied to support the proposed recommendations: the strength of the recommendation according to expert opinion (A, B, C) and the level of empirical evidence (I, II, III), already used in previous documents from SPNS/GESIDA. Multiple recommendations are provided for the clinical management of women with HIV infection, considering both the diagnostic and possible therapeutic strategies. This document presents recommendations for the treatment of women with HIV infection. This must be multidisciplinary, taking into account the differences that can be found in the diagnosis, development of disease and treatment between men and women.

  18. A Consensus for Classification and Pathologic Reporting of Pseudomyxoma Peritonei and Associated Appendiceal Neoplasia: The Results of the Peritoneal Surface Oncology Group International (PSOGI) Modified Delphi Process.

    PubMed

    Carr, Norman J; Cecil, Thomas D; Mohamed, Faheez; Sobin, Leslie H; Sugarbaker, Paul H; González-Moreno, Santiago; Taflampas, Panos; Chapman, Sara; Moran, Brendan J

    2016-01-01

    Pseudomyxoma peritonei (PMP) is a complex disease with unique biological behavior that usually arises from appendiceal mucinous neoplasia. The classification of PMP and its primary appendiceal neoplasia is contentious, and an international modified Delphi consensus process was instigated to address terminology and definitions. A classification of mucinous appendiceal neoplasia was developed, and it was agreed that "mucinous adenocarcinoma" should be reserved for lesions with infiltrative invasion. The term "low-grade appendiceal mucinous neoplasm" was supported and it was agreed that "cystadenoma" should no longer be recommended. A new term of "high-grade appendiceal mucinous neoplasm" was proposed for lesions without infiltrative invasion but with high-grade cytologic atypia. Serrated polyp with or without dysplasia was preferred for tumors with serrated features confined to the mucosa with an intact muscularis mucosae. Consensus was achieved on the pathologic classification of PMP, defined as the intraperitoneal accumulation of mucus due to mucinous neoplasia characterized by the redistribution phenomenon. Three categories of PMP were agreed-low grade, high grade, and high grade with signet ring cells. Acellular mucin should be classified separately. It was agreed that low-grade and high-grade mucinous carcinoma peritonei should be considered synonymous with disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis, respectively. A checklist for the pathologic reporting of PMP and appendiceal mucinous neoplasms was also developed. By adopting the classifications and definitions that were agreed, different centers will be able to use uniform terminology that will allow meaningful comparison of their results.

  19. A consensus approach to wound care in epidermolysis bullosa

    PubMed Central

    Pope, Elena; Lara-Corrales, Irene; Mellerio, Jemima; Martinez, Anna; Schultz, Gregory; Burrell, Robert; Goodman, Laurie; Coutts, Patricia; Wagner, John; Allen, Upton; Sibbald, Gary

    2013-01-01

    Background Wound care is the cornerstone of treatment for patients with epidermolysis bullosa (EB); however, there are currently no guidelines to help practitioners care for these patients. Objectives The objective of this study was to generate a list of recommendations that will enable practitioners to better care for patients with EB. Methods An expert panel generated a list of recommendations based on the best evidence available. The recommendations were translated into a survey, and sent to other EB experts to generate consensus using an online-based modified Delphi method. The list was refined and grouped into themes and specific recommendations. Results There were15 respondents (45% response rate), with significant experience in the EB field (>10 years [67%]). Respondents included physicians (67%), nurses (17%), and allied health professionals (7%). There was more than 85% agreement for all the proposed items. These were further refined and grouped into 5 main themes (assessment and management of factors that impair healing, patient-centered concerns, local wound care, development of an individualized care plan, and organizational support) and 17 specific recommendations. Limitations There is a paucity of scientific evidence with most recommendations based on expert opinion. Conclusions These recommendations will provide practitioners with a framework for caring for these patients. Additional scientific research including effectiveness studies for everyday practice and expert consensus, may further refine these recommendations. PMID:22387035

  20. Human opinion dynamics: An inspiration to solve complex optimization problems

    PubMed Central

    Kaur, Rishemjit; Kumar, Ritesh; Bhondekar, Amol P.; Kapur, Pawan

    2013-01-01

    Human interactions give rise to the formation of different kinds of opinions in a society. The study of formations and dynamics of opinions has been one of the most important areas in social physics. The opinion dynamics and associated social structure leads to decision making or so called opinion consensus. Opinion formation is a process of collective intelligence evolving from the integrative tendencies of social influence with the disintegrative effects of individualisation, and therefore could be exploited for developing search strategies. Here, we demonstrate that human opinion dynamics can be utilised to solve complex mathematical optimization problems. The results have been compared with a standard algorithm inspired from bird flocking behaviour and the comparison proves the efficacy of the proposed approach in general. Our investigation may open new avenues towards understanding the collective decision making. PMID:24141795

  1. Evaluation of Nine Consensus Indices in Delphi Foresight Research and Their Dependency on Delphi Survey Characteristics: A Simulation Study and Debate on Delphi Design and Interpretation

    PubMed Central

    Birko, Stanislav; Dove, Edward S.; Özdemir, Vural

    2015-01-01

    The extent of consensus (or the lack thereof) among experts in emerging fields of innovation can serve as antecedents of scientific, societal, investor and stakeholder synergy or conflict. Naturally, how we measure consensus is of great importance to science and technology strategic foresight. The Delphi methodology is a widely used anonymous survey technique to evaluate consensus among a panel of experts. Surprisingly, there is little guidance on how indices of consensus can be influenced by parameters of the Delphi survey itself. We simulated a classic three-round Delphi survey building on the concept of clustered consensus/dissensus. We evaluated three study characteristics that are pertinent for design of Delphi foresight research: (1) the number of survey questions, (2) the sample size, and (3) the extent to which experts conform to group opinion (the Group Conformity Index) in a Delphi study. Their impacts on the following nine Delphi consensus indices were then examined in 1000 simulations: Clustered Mode, Clustered Pairwise Agreement, Conger’s Kappa, De Moivre index, Extremities Version of the Clustered Pairwise Agreement, Fleiss’ Kappa, Mode, the Interquartile Range and Pairwise Agreement. The dependency of a consensus index on the Delphi survey characteristics was expressed from 0.000 (no dependency) to 1.000 (full dependency). The number of questions (range: 6 to 40) in a survey did not have a notable impact whereby the dependency values remained below 0.030. The variation in sample size (range: 6 to 50) displayed the top three impacts for the Interquartile Range, the Clustered Mode and the Mode (dependency = 0.396, 0.130, 0.116, respectively). The Group Conformity Index, a construct akin to measuring stubbornness/flexibility of experts’ opinions, greatly impacted all nine Delphi consensus indices (dependency = 0.200 to 0.504), except the Extremity CPWA and the Interquartile Range that were impacted only beyond the first decimal point (dependency

  2. Evaluation of Nine Consensus Indices in Delphi Foresight Research and Their Dependency on Delphi Survey Characteristics: A Simulation Study and Debate on Delphi Design and Interpretation.

    PubMed

    Birko, Stanislav; Dove, Edward S; Özdemir, Vural

    2015-01-01

    The extent of consensus (or the lack thereof) among experts in emerging fields of innovation can serve as antecedents of scientific, societal, investor and stakeholder synergy or conflict. Naturally, how we measure consensus is of great importance to science and technology strategic foresight. The Delphi methodology is a widely used anonymous survey technique to evaluate consensus among a panel of experts. Surprisingly, there is little guidance on how indices of consensus can be influenced by parameters of the Delphi survey itself. We simulated a classic three-round Delphi survey building on the concept of clustered consensus/dissensus. We evaluated three study characteristics that are pertinent for design of Delphi foresight research: (1) the number of survey questions, (2) the sample size, and (3) the extent to which experts conform to group opinion (the Group Conformity Index) in a Delphi study. Their impacts on the following nine Delphi consensus indices were then examined in 1000 simulations: Clustered Mode, Clustered Pairwise Agreement, Conger's Kappa, De Moivre index, Extremities Version of the Clustered Pairwise Agreement, Fleiss' Kappa, Mode, the Interquartile Range and Pairwise Agreement. The dependency of a consensus index on the Delphi survey characteristics was expressed from 0.000 (no dependency) to 1.000 (full dependency). The number of questions (range: 6 to 40) in a survey did not have a notable impact whereby the dependency values remained below 0.030. The variation in sample size (range: 6 to 50) displayed the top three impacts for the Interquartile Range, the Clustered Mode and the Mode (dependency = 0.396, 0.130, 0.116, respectively). The Group Conformity Index, a construct akin to measuring stubbornness/flexibility of experts' opinions, greatly impacted all nine Delphi consensus indices (dependency = 0.200 to 0.504), except the Extremity CPWA and the Interquartile Range that were impacted only beyond the first decimal point (dependency = 0

  3. Interplay between media and social influence in the collective behavior of opinion dynamics

    NASA Astrophysics Data System (ADS)

    Colaiori, Francesca; Castellano, Claudio

    2015-10-01

    Messages conveyed by media act as a major drive in shaping attitudes and inducing opinion shift. On the other hand, individuals are strongly affected by peer pressure while forming their own judgment. We solve a general model of opinion dynamics where individuals either hold one of two alternative opinions or are undecided and interact pairwise while exposed to an external influence. As media pressure increases, the system moves from pluralism to global consensus; four distinct classes of collective behavior emerge, crucially depending on the outcome of direct interactions among individuals holding opposite opinions. Observed nontrivial behaviors include hysteretic phenomena and resilience of minority opinions. Notably, consensus could be unachievable even when media and microscopic interactions are biased in favor of the same opinion: The unfavored opinion might even gain the support of the majority.

  4. Interplay between media and social influence in the collective behavior of opinion dynamics.

    PubMed

    Colaiori, Francesca; Castellano, Claudio

    2015-10-01

    Messages conveyed by media act as a major drive in shaping attitudes and inducing opinion shift. On the other hand, individuals are strongly affected by peer pressure while forming their own judgment. We solve a general model of opinion dynamics where individuals either hold one of two alternative opinions or are undecided and interact pairwise while exposed to an external influence. As media pressure increases, the system moves from pluralism to global consensus; four distinct classes of collective behavior emerge, crucially depending on the outcome of direct interactions among individuals holding opposite opinions. Observed nontrivial behaviors include hysteretic phenomena and resilience of minority opinions. Notably, consensus could be unachievable even when media and microscopic interactions are biased in favor of the same opinion: The unfavored opinion might even gain the support of the majority.

  5. Thrombotic Microangiopathy Care Pathway: A Consensus Statement for the Mayo Clinic Complement Alternative Pathway-Thrombotic Microangiopathy (CAP-TMA) Disease-Oriented Group.

    PubMed

    Go, Ronald S; Winters, Jeffrey L; Leung, Nelson; Murray, David L; Willrich, Maria A; Abraham, Roshini S; Amer, Hatem; Hogan, William J; Marshall, Ariela L; Sethi, Sanjeev; Tran, Cheryl L; Chen, Dong; Pruthi, Rajiv K; Ashrani, Aneel A; Fervenza, Fernando C; Cramer, Carl H; Rodriguez, Vilmarie; Wolanskyj, Alexandra P; Thomé, Stephan D; Hook, C Christopher

    2016-09-01

    Thrombotic microangiopathies (TMAs) comprise a heterogeneous set of conditions linked by a common histopathologic finding of endothelial damage resulting in microvascular thromboses and potentially serious complications. The typical clinical presentation is microangiopathic hemolytic anemia accompanied by thrombocytopenia with varying degrees of organ ischemia. The differential diagnoses are generally broad, while the workup is frequently complex and can be confusing. This statement represents the joint recommendations from a multidisciplinary team of Mayo Clinic physicians specializing in the management of TMA. It comprises a series of evidence- and consensus-based clinical pathways developed to allow a uniform approach to the spectrum of care including when to suspect TMA, what differential diagnoses to consider, which diagnostic tests to order, and how to provide initial empiric therapy, as well as some guidance on subsequent management.

  6. Diagnosis and management of non-alcoholic fatty liver disease and related metabolic disorders: consensus statement from the Study Group of Liver and Metabolism, Chinese Society of Endocrinology.

    PubMed

    Gao, Xin; Fan, Jian-Gao

    2013-12-01

    Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in Western countries, affecting 20%-33% of the general population. Large population-based surveys in China indicate a prevalence of approximately 15%-30%. Worldwide, including in China, the prevalence of NAFLD has increased rapidly in parallel with regional trends of obesity, type 2 diabetes and metabolic syndrome. In addition, NAFLD has contributed significantly to increased overall, as well as cardiovascular and liver-related, mortality in the general population. In view of rapid advances in research into NAFLD in recent years, this consensus statement provides a brief update on the progress in the field and suggests preferred approaches for the comprehensive management of NAFLD and its related metabolic diseases.

  7. Consensus formation on adaptive networks

    NASA Astrophysics Data System (ADS)

    Kozma, Balazs; Barrat, Alain

    2008-01-01

    The structure of a network can significantly influence the properties of the dynamical processes that take place on them. While many studies have been paid to this influence, much less attention has been devoted to the interplay and feedback mechanisms between dynamical processes and network topology on adaptive networks. Adaptive rewiring of links can happen in real life systems such as acquaintance networks, where people are more likely to maintain a social connection if their views and values are similar. In our study, we consider different variants of a model for consensus formation. Our investigations reveal that the adaptation of the network topology fosters cluster formation by enhancing communication between agents of similar opinion, although it also promotes the division of these clusters. The temporal behavior is also strongly affected by adaptivity: while, on static networks, it is influenced by percolation properties, on adaptive networks, both the early and late time evolutions of the system are determined by the rewiring process. The investigation of a variant of the model reveals that the scenarios of transitions between consensus and polarized states are more robust on adaptive networks.

  8. 5th Ovarian Cancer Consensus Conference of the Gynecologic Cancer InterGroup (GCIG): Clinical trial design for rare ovarian tumours.

    PubMed

    Leary, A F; Quinn, M; Fujiwara, K; Coleman, R L; Kohn, E; Sugiyama, T; Glasspool, R; Ray-Coquard, I; Colombo, N; Bacon, M; Zeimet, A; Westermann, A; Gomez-Garcia, E; Provencher, D; Welch, S; Small, W; Millan, D; Okamoto, A; Stuart, G; Ochiai, K

    2016-12-19

    This manuscript reports the consensus statements on designing clinical trials in rare ovarian tumours reached at the 5th Ovarian Cancer Consensus Conference (OCCC) held in Tokyo, November 2015. Three important questions were identified concerning rare ovarian tumours (rare epithelial ovarian cancers (eOC), sex-cord stromal tumours (SCST) and germ cell tumours (GCT)): (1) What are the research and trial issues that are unique to rare ovarian tumours? There is a lack of randomised phase III data defining standards of care which makes it difficult to define control arms, but identifies unmet needs that merit investigation. Internationally agreed upon diagnostic criteria, expert pathological review, and translational research are crucial. (2) What should be investigated in rare eOC, GCT and SCST? Trials dedicated to each rare ovarian tumour should be encouraged. Nonetheless, where the question is relevant, rare eOC can be included in eOC trials but with rigorous stratification. Although there is emerging evidence suggesting that rare eOC have different molecular profiles, trials are needed to define new type-specific standards for each rare eOC (clear cell, low grade serous and mucinous). For GCTs, a priority is reducing toxicities from treatment while maintaining cure rates. Both a robust prognostic scoring system and more effective treatments for de novo poor prognosis and relapsed GCTs are needed. For SCSTs, validated prognostic markers as well as alternatives to the current standard of bleomycin/etoposide/cisplatin (BEP) should be identified. (3) Are randomised trials feasible? Randomised controlled trials (RCT) should be feasible in any of the rare tumours through international collaboration. Ongoing trials have already demonstrated the feasibility of RCT in rare eOC and SCST. Mucinous OC may be considered for inclusion, stratified, into RCTs of non-gynaecological mucinous tumours, while RCTs in high risk or relapsed GCT may be performed as a subset of male and

  9. Consensus, Polarization and Clustering of Opinions in Social Networks

    DTIC Science & Technology

    2013-06-01

    over a period of nine months. 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT Same as Report (SAR) 18. NUMBER OF...network ( WLAN ) access points within a certain range. We use the location data to study how social interactions shape individuals preferences in terms...of how frequently they visit a place. There are 32724 identified WLAN access points; we choose to use the top 100 most frequently visited access points

  10. Public Opinion in America.

    ERIC Educational Resources Information Center

    Monroe, Alan D.

    The purposes of this book are to summarize and analyze the nature of public opinion in contemporary America and to examine the implications of that nature for the possibility of a functioning democracy. Material in the four sections covers the following topics: "The Study of Public Opinion: Political Theory and Methodology"--opinions and…

  11. Opinion Integration and Summarization

    ERIC Educational Resources Information Center

    Lu, Yue

    2011-01-01

    As Web 2.0 applications become increasingly popular, more and more people express their opinions on the Web in various ways in real time. Such wide coverage of topics and abundance of users make the Web an extremely valuable source for mining people's opinions about all kinds of topics. However, since the opinions are usually expressed as…

  12. Diagnosis and management of acute appendicitis. EAES consensus development conference 2015.

    PubMed

    Gorter, Ramon R; Eker, Hasan H; Gorter-Stam, Marguerite A W; Abis, Gabor S A; Acharya, Amish; Ankersmit, Marjolein; Antoniou, Stavros A; Arolfo, Simone; Babic, Benjamin; Boni, Luigi; Bruntink, Marlieke; van Dam, Dieuwertje A; Defoort, Barbara; Deijen, Charlotte L; DeLacy, F Borja; Go, Peter Mnyh; Harmsen, Annelieke M K; van den Helder, Rick S; Iordache, Florin; Ket, Johannes C F; Muysoms, Filip E; Ozmen, M Mahir; Papoulas, Michail; Rhodes, Michael; Straatman, Jennifer; Tenhagen, Mark; Turrado, Victor; Vereczkei, Andras; Vilallonga, Ramon; Deelder, Jort D; Bonjer, Jaap

    2016-11-01

    Unequivocal international guidelines regarding the diagnosis and management of patients with acute appendicitis are lacking. The aim of the consensus meeting 2015 of the EAES was to generate a European guideline based on best available evidence and expert opinions of a panel of EAES members. After a systematic review of the literature by an international group of surgical research fellows, an expert panel with extensive clinical experience in the management of appendicitis discussed statements and recommendations. Statements and recommendations with more than 70 % agreement by the experts were selected for a web survey and the consensus meeting of the EAES in Bucharest in June 2015. EAES members and attendees at the EAES meeting in Bucharest could vote on these statements and recommendations. In the case of more than 70 % agreement, the statement or recommendation was defined as supported by the scientific community. Results from both the web survey and the consensus meeting in Bucharest are presented as percentages. In total, 46 statements and recommendations were selected for the web survey and consensus meeting. More than 232 members and attendees voted on them. In 41 of 46 statements and recommendations, more than 70 % agreement was reached. All 46 statements and recommendations are presented in this paper. They comprise topics regarding the diagnostic work-up, treatment indications, procedural aspects and post-operative care. The consensus meeting produced 46 statements and recommendations on the diagnostic work-up and management of appendicitis. The majority of the EAES members supported these statements. These consensus proceedings provide additional guidance to surgeons and surgical residents providing care to patients with appendicitis.

  13. Opinion evolution in open community

    NASA Astrophysics Data System (ADS)

    Pan, Qiuhui; Qin, Yao; Xu, Yiqun; Tong, Mengfei; He, Mingfeng

    We consider a dynamic group composed with a constant number of people and the people will change periodically. Every member in the community owns a value of confidence — a mechanism that measures the agent’s coherence to his or her own attitude. Based on Cellular Automata, the opinions of all agents are synchronously updated. As long as the updating frequency and updating proportion are appropriate, the open system can reach a democracy-like steady state. The majority of agents in the community will hold the same opinion.

  14. Balancer effects in opinion dynamics

    NASA Astrophysics Data System (ADS)

    Cheon, Taksu; Morimoto, Jun

    2016-01-01

    We introduce a novel type of contrarian agent, the balancer, to the Galam model of opinion dynamics, which features group-majority update, in order to account for the existence of social skepticism over one-sidedness. We find that, along with majoritarian floaters and single-sided inflexibles, the inclusion of balancers, who normally act as floaters but oppose inflexibles in their presence, brings about the emergence of a critical point on parametric plane of the dynamical system. Around the critical point, three distinct phases of opinion dynamics separated by discontinuous changes are found.

  15. Intergroup Consensus/Disagreement in Support of Group-Based Hierarchy: An Examination of Socio-Structural and Psycho-Cultural Factors

    ERIC Educational Resources Information Center

    Lee, I-Ching; Pratto, Felicia; Johnson, Blair T.

    2011-01-01

    A meta-analysis examined the extent to which socio-structural and psycho-cultural characteristics of societies correspond with how much gender and ethnic/racial groups differ on their support of group-based hierarchy. Robustly, women opposed group-based hierarchy more than men did, and members of lower power ethnic/racial groups opposed…

  16. Analysis of a cultural consensus model of two good-life sub-domains--health & well-being and migration & socioeconomic milieu--in three population groups in Croatia.

    PubMed

    Peternel, Lana; Malnar, Ana; Klarić, Irena Martinović

    2015-07-01

    In this study the construct of a 'good life' was explored among upper secondary school senior pupils and their parents and teachers by applying cultural consensus model analysis. A total of 469 students, 474 parents and 158 teachers from four Croatian cities participated in the study, which was conducted in 2011/2012. The information collected through interviewing and free-listing during the first phase of the study was used to create a set of structured questionnaire questions as a part of the survey in the second phase of data collection. The results are reported on two good-life sub-domains: 'health & well-being' and 'migration & socioeconomic milieu'. The results indicate heterogeneity of the sample groups, incomplete inter-generational transmission of cultural values and examples of two sub-groups that resist cultural norms and do not comply with the dominant 'competence-as-sharing' paradigm. The value of testing the cultural consensus model based on the emic approach and locally significant phenomena is demonstrated for planning and conducting holistic anthropological research.

  17. Defining an International Standard Set of Outcome Measures for Patients With Hip or Knee Osteoarthritis: Consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group

    PubMed Central

    Wissig, Stephanie; van Maasakkers, Lisa; Stowell, Caleb; Ackerman, Ilana; Ayers, David; Barber, Thomas; Benzakour, Thami; Bozic, Kevin; Budhiparama, Nicolaas; Caillouette, James; Conaghan, Philip G.; Dahlberg, Leif; Dunn, Jennifer; Grady‐Benson, John; Ibrahim, Said A.; Lewis, Sally; Malchau, Henrik; Manzary, Mojieb; March, Lyn; Nassif, Nader; Nelissen, Rob; Smith, Noel; Franklin, Patricia D.

    2016-01-01

    Objective To define a minimum Standard Set of outcome measures and case‐mix factors for monitoring, comparing, and improving health care for patients with clinically diagnosed hip or knee osteoarthritis (OA), with a focus on defining the outcomes that matter most to patients. Methods An international working group of patients, arthroplasty register experts, orthopedic surgeons, primary care physicians, rheumatologists, and physiotherapists representing 10 countries was assembled to review existing literature and practices for assessing outcomes of pharmacologic and nonpharmacologic OA therapies, including surgery. A series of 8 teleconferences, incorporating a modified Delphi process, were held to reach consensus. Results The working group reached consensus on a concise set of outcome measures to evaluate patients’ joint pain, physical functioning, health‐related quality of life, work status, mortality, reoperations, readmissions, and overall satisfaction with treatment result. To support analysis of these outcome measures, pertinent baseline characteristics and risk factor metrics were defined. Annual outcome measurement is recommended for all patients. Conclusion We have defined a Standard Set of outcome measures for monitoring the care of people with clinically diagnosed hip or knee OA that is appropriate for use across all treatment and care settings. We believe this Standard Set provides meaningful, comparable, and easy to interpret measures ready to implement in clinics and/or registries globally. We view this set as an initial step that, when combined with cost data, will facilitate value‐based health care improvements in the treatment of hip and knee OA. PMID:26881821

  18. Myocardial T1 mapping and extracellular volume quantification: a Society for Cardiovascular Magnetic Resonance (SCMR) and CMR Working Group of the European Society of Cardiology consensus statement.

    PubMed

    Moon, James C; Messroghli, Daniel R; Kellman, Peter; Piechnik, Stefan K; Robson, Matthew D; Ugander, Martin; Gatehouse, Peter D; Arai, Andrew E; Friedrich, Matthias G; Neubauer, Stefan; Schulz-Menger, Jeanette; Schelbert, Erik B

    2013-10-14

    Rapid innovations in cardiovascular magnetic resonance (CMR) now permit the routine acquisition of quantitative measures of myocardial and blood T1 which are key tissue characteristics. These capabilities introduce a new frontier in cardiology, enabling the practitioner/investigator to quantify biologically important myocardial properties that otherwise can be difficult to ascertain clinically. CMR may be able to track biologically important changes in the myocardium by: a) native T1 that reflects myocardial disease involving the myocyte and interstitium without use of gadolinium based contrast agents (GBCA), or b) the extracellular volume fraction (ECV)-a direct GBCA-based measurement of the size of the extracellular space, reflecting interstitial disease. The latter technique attempts to dichotomize the myocardium into its cellular and interstitial components with estimates expressed as volume fractions. This document provides recommendations for clinical and research T1 and ECV measurement, based on published evidence when available and expert consensus when not. We address site preparation, scan type, scan planning and acquisition, quality control, visualisation and analysis, technical development. We also address controversies in the field. While ECV and native T1 mapping appear destined to affect clinical decision making, they lack multi-centre application and face significant challenges, which demand a community-wide approach among stakeholders. At present, ECV and native T1 mapping appear sufficiently robust for many diseases; yet more research is required before a large-scale application for clinical decision-making can be recommended.

  19. Myocardial T1 mapping and extracellular volume quantification: a Society for Cardiovascular Magnetic Resonance (SCMR) and CMR Working Group of the European Society of Cardiology consensus statement

    PubMed Central

    2013-01-01

    Rapid innovations in cardiovascular magnetic resonance (CMR) now permit the routine acquisition of quantitative measures of myocardial and blood T1 which are key tissue characteristics. These capabilities introduce a new frontier in cardiology, enabling the practitioner/investigator to quantify biologically important myocardial properties that otherwise can be difficult to ascertain clinically. CMR may be able to track biologically important changes in the myocardium by: a) native T1 that reflects myocardial disease involving the myocyte and interstitium without use of gadolinium based contrast agents (GBCA), or b) the extracellular volume fraction (ECV)–a direct GBCA-based measurement of the size of the extracellular space, reflecting interstitial disease. The latter technique attempts to dichotomize the myocardium into its cellular and interstitial components with estimates expressed as volume fractions. This document provides recommendations for clinical and research T1 and ECV measurement, based on published evidence when available and expert consensus when not. We address site preparation, scan type, scan planning and acquisition, quality control, visualisation and analysis, technical development. We also address controversies in the field. While ECV and native T1 mapping appear destined to affect clinical decision making, they lack multi-centre application and face significant challenges, which demand a community-wide approach among stakeholders. At present, ECV and native T1 mapping appear sufficiently robust for many diseases; yet more research is required before a large-scale application for clinical decision-making can be recommended. PMID:24124732

  20. [GEITDAH consensus on attention deficit hyperactivity disorder].

    PubMed

    Montañés-Rada, F; Gastaminza-Pérez, X; Catalá, M A; Ruiz-Sanz, F; Ruiz-Lázaro, P M; Herreros-Rodríguez, O; García-Giral, M; Ortiz-Guerra, J; Alda-Díez, J A; Mojarro-Práxedes, D; Cantó-Díez, T; Mardomingo-Sanz, M J; Sasot-Llevadot, J; Pàmias, M; Rey-Sánchez, F

    2010-11-16

    In this article, the GEITDAH -the Spanish abbreviation of the Special Interest Group on Attention Deficit Hyper-activity Disorder (ADHD)- presents a consensus reached by experts in the management of ADHD from all over Spain. The consensus concerns fundamental aspects that should be the starting point for future local or regional consensus guides. Another aim of this consensus is also to reduce the amount of variability that occurs in the health care offered to patients with ADHD in our country, as well as to act as a stimulus in educational matters. That fact that it is not very long will make it more popular among greater numbers of people and this will allow these goals to be reached more effectively. The conclusions in the consensus guide have been constructed around an introduction dealing with basic aspects and recommendations for diagnosis, treatment (both pharmacological and psychotherapeutic), patient flow and organisational aspects.

  1. Obstetricians’ Opinions of the Optimal Caesarean Rate: A Global Survey

    PubMed Central

    Cavallaro, Francesca L.; Cresswell, Jenny A.; Ronsmans, Carine

    2016-01-01

    Background The debate surrounding the optimal caesarean rate has been ongoing for several decades, with the WHO recommending an “acceptable” rate of 5–15% since 1997, despite a weak evidence base. Global expert opinion from obstetric care providers on the optimal caesarean rate has not been documented. The objective of this study was to examine providers’ opinions of the optimal caesarean rate worldwide, among all deliveries and within specific sub-groups of deliveries. Methods A global online survey of medical doctors who had performed at least one caesarean in the last five years was conducted between August 2013 and January 2014. Respondents were asked to report their opinion of the optimal caesarean rate—defined as the caesarean rate that would minimise poor maternal and perinatal outcomes—at the population level and within specific sub-groups of deliveries (including women with demographic and clinical risk factors for caesareans). Median reported optimal rates and corresponding inter-quartile ranges (IQRs) were calculated for the sample, and stratified according to national caesarean rate, institutional caesarean rate, facility level, and respondent characteristics. Results Responses were collected from 1,057 medical doctors from 96 countries. The median reported optimal caesarean rate was 20% (IQR: 15–30%) for all deliveries. Providers in private for-profit facilities and in facilities with high institutional rates reported optimal rates of 30% or above, while those in Europe, in public facilities and in facilities with low institutional rates reported rates of 15% or less. Reported optimal rates were lowest among low-risk deliveries and highest for Absolute Maternal Indications (AMIs), with wide IQRs observed for most categories other than AMIs. Conclusions Three-quarters of respondents reported an optimal caesarean rate above the WHO 15% upper threshold. There was substantial variation in responses, highlighting a lack of consensus around

  2. RTOG Sarcoma Radiation Oncologists Reach Consensus on Gross Tumor Volume and Clinical Target Volume on Computed Tomographic Images for Preoperative Radiotherapy of Primary Soft Tissue Sarcoma of Extremity in Radiation Therapy Oncology Group Studies

    SciTech Connect

    Wang Dian; Bosch, Walter; Roberge, David; Finkelstein, Steven E.; Petersen, Ivy; Haddock, Michael; Chen, Yen-Lin E.; Saito, Naoyuki G.; Kirsch, David G.; Hitchcock, Ying J.; Wolfson, Aaron H.; DeLaney, Thomas F.

    2011-11-15

    Objective: To develop a Radiation Therapy Oncology Group (RTOG) atlas delineating gross tumor volume (GTV) and clinical target volume (CTV) to be used for preoperative radiotherapy of primary extremity soft tissue sarcoma (STS). Methods and Materials: A consensus meeting was held during the RTOG meeting in January 2010 to reach agreement about GTV and CTV delineation on computed tomography (CT) images for preoperative radiotherapy of high-grade large extremity STS. Data were presented to address the local extension of STS. Extensive discussion ensued to develop optimal criteria for GTV and CTV delineation on CT images. Results: A consensus was reached on appropriate CT-based GTV and CTV. The GTV is gross tumor defined by T1 contrast-enhanced magnetic resonance images. Fusion of magnetic resonance and images is recommended to delineate the GTV. The CTV for high-grade large STS typically includes the GTV plus 3-cm margins in the longitudinal directions. If this causes the field to extend beyond the compartment, the field can be shortened to include the end of a compartment. The radial margin from the lesion should be 1.5 cm, including any portion of the tumor not confined by an intact fascial barrier, bone, or skin surface. Conclusion: The consensus on GTV and CTV for preoperative radiotherapy of high-grade large extremity STS is available as web-based images and in a descriptive format through the RTOG. This is expected to improve target volume consistency and allow for rigorous evaluation of the benefits and risks of such treatment.

  3. The pivotal role of perceived scientific consensus in acceptance of science

    NASA Astrophysics Data System (ADS)

    Lewandowsky, Stephan; Gignac, Gilles E.; Vaughan, Samuel

    2013-04-01

    Although most experts agree that CO2 emissions are causing anthropogenic global warming (AGW), public concern has been declining. One reason for this decline is the `manufacture of doubt' by political and vested interests, which often challenge the existence of the scientific consensus. The role of perceived consensus in shaping public opinion is therefore of considerable interest: in particular, it is unknown whether consensus determines people's beliefs causally. It is also unclear whether perception of consensus can override people's `worldviews', which are known to foster rejection of AGW. Study 1 shows that acceptance of several scientific propositions--from HIV/AIDS to AGW--is captured by a common factor that is correlated with another factor that captures perceived scientific consensus. Study 2 reveals a causal role of perceived consensus by showing that acceptance of AGW increases when consensus is highlighted. Consensus information also neutralizes the effect of worldview.

  4. Choice Shift in Opinion Network Dynamics

    NASA Astrophysics Data System (ADS)

    Gabbay, Michael

    Choice shift is a phenomenon associated with small group dynamics whereby group discussion causes group members to shift their opinions in a more extreme direction so that the mean post-discussion opinion exceeds the mean pre-discussion opinion. Also known as group polarization, choice shift is a robust experimental phenomenon and has been well-studied within social psychology. In opinion network models, shifts toward extremism are typically produced by the presence of stubborn agents at the extremes of the opinion axis, whose opinions are much more resistant to change than moderate agents. However, we present a model in which choice shift can arise without the assumption of stubborn agents; the model evolves member opinions and uncertainties using coupled nonlinear differential equations. In addition, we briefly describe the results of a recent experiment conducted involving online group discussion concerning the outcome of National Football League games are described. The model predictions concerning the effects of network structure, disagreement level, and team choice (favorite or underdog) are in accord with the experimental results. This research was funded by the Office of Naval Research and the Defense Threat Reduction Agency.

  5. Intergroup consensus/disagreement in support of group-based hierarchy: an examination of socio-structural and psycho-cultural factors.

    PubMed

    Lee, I-Ching; Pratto, Felicia; Johnson, Blair T

    2011-11-01

    A meta-analysis examined the extent to which socio-structural and psycho-cultural characteristics of societies correspond with how much gender and ethnic/racial groups differ on their support of group-based hierarchy. Robustly, women opposed group-based hierarchy more than men did, and members of lower power ethnic/racial groups opposed group-based hierarchy more than members of higher power ethnic/racial groups did. As predicted by social dominance theory, gender differences were larger, more stable, and less variable from sample to sample than differences between ethnic/racial groups. Subordinate gender and ethnic/racial group members disagreed more with dominants in their views of group-based hierarchy in societies that can be considered more liberal and modern (e.g., emphasizing individualism and change from traditions), as well as in societies that enjoyed greater gender equality. The relations between gender and ethnic/racial groups are discussed, and implications are developed for social dominance theory, social role theory, biosocial theory, social identity theory, system justification theory, realistic group conflict theory, and relative deprivation theory. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

  6. Intergroup Consensus/Disagreement in Support of Group Based Hierarchy: An Examination of Socio-Structural and Psycho-Cultural Factors

    PubMed Central

    Lee, I-Ching; Pratto, Felicia; Johnson, Blair T.

    2011-01-01

    A meta-analysis examined the extent to which socio-structural and psycho-cultural characteristics of societies correspond with how much gender and ethnic/racial groups differ on their support of group-based hierarchy. Robustly, women opposed group-based hierarchy more than men did and members of lower-power ethnic/racial groups opposed group-based hierarchy more than members of higher-power ethnic/racial groups. As predicted by social dominance theory, gender differences were larger, more stable, and less variable from sample to sample than differences between ethnic/racial groups. Subordinate gender and ethnic/racial group members disagreed more with dominants in their views of group-based hierarchy in societies that can be considered more liberal and modern (e.g., emphasizing individualism and change from traditions), as well as in societies that enjoyed greater gender equality. The relations between gender and ethnic/racial groups are discussed and implications are developed for social dominance theory, social role theory and biosocial theory, social identity theory, system justification theory, realistic group conflict theory and relative deprivation theory. PMID:22023142

  7. Political opinion formation: Initial opinion distribution and individual heterogeneity of tolerance

    NASA Astrophysics Data System (ADS)

    Jin, Cheng; Li, Yifu; Jin, Xiaogang

    2017-02-01

    Opinion dynamics on networks have received serious attention for its profound prospects in social behaviours and self-organized systems. However, political opinion formation, as one typical and significant case, remains lacking in discussion. Previous agent-based simulations propose various models that are based on different mechanisms like the coevolution between network topology and status transition. Nonetheless, even under the same network topology and with the same simple mechanism, forming opinions can still be uncertain. In this work, we propose two features, the initial distribution of opinions and the individual heterogeneity of tolerances on opinion changing, in political opinion formation. These two features are imbedded in the network construction phase of a classical model. By comparing multi simple-party systems, along with a detailed analysis on the two-party system, we capture the critical phenomenon of fragmentation, polarization and consensus both in the persistent stable stage and in-process. We further introduce the average ratio of nearest neighbours to characterize the stage of opinion formation. The results show that the initial distribution of opinions leads to different evolution results on similar random networks. In addition, the existence of stubborn nodes plays a special role: only nodes that are extremely stubborn can cause the change of final opinion distribution while in other cases they only delay the time to reach stability. If stubborn nodes are small in number, their effects are confined within a small range. This theoretical work goes deeper on an existing model, it is an early exploration on qualitative and quantitative simulation of party competition.

  8. Correlation between information diffusion and opinion evolution on social media

    NASA Astrophysics Data System (ADS)

    Xiong, Fei; Liu, Yun; Zhang, Zhenjiang

    2014-12-01

    Information diffusion and opinion evolution are often treated as two independent processes. Opinion models assume the topic reaches each agent and agents initially have their own ideas. In fact, the processes of information diffusion and opinion evolution often intertwine with each other. Whether the influence between these two processes plays a role in the system state is unclear. In this paper, we collected more than one million real data from a well-known social platform, and analysed large-scale user diffusion behaviour and opinion formation. We found that user inter-event time follows a two-scaling power-law distribution with two different power exponents. Public opinion stabilizes quickly and evolves toward the direction of convergence, but the consensus state is prevented by a few opponents. We propose a three-state opinion model accompanied by information diffusion. Agents form and exchange their opinions during information diffusion. Conversely, agents' opinions also influence their diffusion actions. Simulations show that the model with a correlation of the two processes produces similar statistical characteristics as empirical results. A fast epidemic process drives individual opinions to converge more obviously. Unlike previous epidemic models, the number of infected agents does not always increase with the update rate, but has a peak with an intermediate value of the rate.

  9. Opinion Dynamics Driven by Leaders, Media, Viruses and Worms

    NASA Astrophysics Data System (ADS)

    Tuncay, Çağlar

    A model on the effects of leader, media, viruses, worms, and other agents on the opinion of individuals is developed and utilized to simulate the formation of consensus in society and price in market via excess between supply and demand. The effects of some time varying drives (harmonic and hyperbolic) are also investigated.

  10. Consensus protein design

    PubMed Central

    Porebski, Benjamin T.; Buckle, Ashley M.

    2016-01-01

    A popular and successful strategy in semi-rational design of protein stability is the use of evolutionary information encapsulated in homologous protein sequences. Consensus design is based on the hypothesis that at a given position, the respective consensus amino acid contributes more than average to the stability of the protein than non-conserved amino acids. Here, we review the consensus design approach, its theoretical underpinnings, successes, limitations and challenges, as well as providing a detailed guide to its application in protein engineering. PMID:27274091

  11. Team consensus concerning important outcomes for augmentative and alternative communication assistive technologies: a pilot study.

    PubMed

    Lamontagne, Marie-Eve; Routhier, François; Auger, Claudine

    2013-06-01

    Obstacles to assistive device outcome measurement include a lack of consensus about which outcomes should be evaluated. This article reports a case study of the use of a structured consensus-building approach called Technique for Research of Information by Animation of a Group of Experts (TRIAGE) to develop agreement among key professional team members with regard to outcome measurement. We also describe the changes in key professional team members' perspectives on outcome measurement over time. Initially, participants expressed preferences for the measurement of about 33 different outcomes. Subsequent discussions and the TRIAGE process led to the choice of the five most important outcomes. Our case study provides evidence that professional team consensus could successfully be reached through the individual reflections and group sharing proposed by the TRIAGE technique. Future research directions include the development of strategies to give prominence to the opinions of individuals who use augmentative and alternative communication (AAC) in the identification of important outcomes, and for aggregating and interpreting data gathered at local, regional, or national levels.

  12. Aljoya Consensus Statement

    EPA Pesticide Factsheets

    A consensus statement of 100 experts meeting at the Aljoya Conference Center in Seattle, Washington in July 2000 for the First International Conference on Trans-Pacific Transport of Atmospheric Contaminants.

  13. Using Nominal Group Technique to Develop a Consensus Derived Model for Peer Review of Teaching across a Multi-School Faculty

    ERIC Educational Resources Information Center

    Burrows, Tracy; Findlay, Naomi; Killen, Chloe; Dempsey, Shane E.; Hunter, Sharyn; Chiarelli, Pauline; Snodgrass, Suzanne

    2011-01-01

    This paper describes the development of a peer review of teaching model for the Faculty of Health at the University of Newcastle, Australia. The process involved using the nominal group technique to engage Faculty academic staff to consider seven key decision points that informed the development of the peer review of teaching model. Use of the…

  14. Part Two: Infantile Spasms--The New Consensus

    ERIC Educational Resources Information Center

    Pellock, John M.; O'Hara, Kathryn

    2011-01-01

    This article presents the conclusion made by the consensus group regarding infantile spasms. The consensus group concluded that "infantile spasms are a major form of severe epileptic encephalopathy of early childhood that results in neurodevelopmental regression and imposes a significant health burden." The entire group agrees that the best…

  15. [Diagnosis and treatment of gastroesophageal reflux disease in the mentally retarded: guidelines of a multidisciplinary consensus work group. Dutch Association of Physicians in Care of Mentally Handicapped].

    PubMed

    Gimbel, H

    2000-06-10

    Gastroesophageal reflux disease (GORD) is more frequent among people with intellectual disability than among the intellectually normal population. Also GORD is more serious in this population. The diagnosis is often missed, because most intellectually disabled cannot express their complaints of GORD. For that reason a multidisciplinary working group of the Dutch Association of physicians active in the care of persons with a mental handicap has developed guidelines. The working group recommends endoscopy in case of a (alarm) symptoms: haematemesis, prolonged vomiting, irondeficiency anaemia e.c.i., and a 24 hour oesophageal pH test in case of b (aspecific) symptoms: recurrent pneumonia, refusal of food, regurgitation, rumination, dental erosions. In general most patients are cured with drug treatment (omeprazol or another proton pump inhibitor). If symptoms are not improved after 6 months of optimal treatment, surgical treatment may be considered.

  16. Scientists Are from Mars, Laypeople Are from Venus: An Evidence-Based Approach to Consensus Messaging

    NASA Astrophysics Data System (ADS)

    Cook, J.; Jacobs, P.; Nuccitelli, D.

    2014-12-01

    Laypeople use expert opinion as a mental shortcut to form views on complex scientific issues. This heuristic is particularly relevant in the case of climate change, where perception of consensus is one of the main predictors of public support for climate action. A low public perception of consensus (around 60% compared to the actual 97% consensus) is a significant stumbling block to meaningful climate action, underscoring the importance of closing the "consensus gap". However, some scientists question the efficacy or appropriateness of emphasizing consensus in climate communication. I'll summarize the social science research examining the importance and effectiveness of consensus messaging. I'll also present several case studies of consensus messaging employed by the team of communicators at the Skeptical Science website.

  17. Microevolution in lower Central America: genetic characterization of the Chibcha-speaking groups of Costa Rica and Panama, and a consensus taxonomy based on genetic and linguistic affinity.

    PubMed Central

    Barrantes, R; Smouse, P E; Mohrenweiser, H W; Gershowitz, H; Azofeifa, J; Arias, T D; Neel, J V

    1990-01-01

    There is evidence that Amerindians have continuously occupied the lower Central American Isthmus for as long as 10,000 years. There remains some doubt about the relationships of these original colonizers to the resident peoples of this zone at the time of European contact (approximately A.D. 1500). We present new genetic data for up to 48 genetic loci for 570 members of six Chibcha-speaking tribes of lower Central America--the Boruca, Bribri, Cabecar, and Guatuso of Costa Rica and the Kuna and Teribe of Panama--and delineate the genetic affinities among the various groups (these six tribes and the Guaymi and Bokota) of lower Central America. We convert standard genetic distance metrics into a form that is linear with the effective time since divergence, and we compare the genetic distances with linguistic distances for the same groups (r = .74, P less than .001). Geographic affinity accounts for some of the genetic divergence among groups (r = .49, P less than .084) and for some of the linguistic divergence (r = .53, P less than .037), but the correspondence between geographic position and taxonomic affinity is not high. We combine all of the genetic and linguistic data to construct a synthetic overview taxonomy of the lower Central American Chibcha. Both the genetic and linguistic data exhibit hierarchical organization of tribal groups, showing a general east-to-west pattern of grouping, with greater affinities between close neighbors. The presence of private genetic variants of some antiquity within the region and their absence outside the zone, coupled with the essential absence of the DI*A polymorphism of mongoloid origin that is widespread outside the zone, argue for a relatively isolated development of the Central American Chibcha. Our results do not support the old view of lower Central America as a frontier between more advanced cultures to the north and south. Any such explanation would require recent waves of migration from outside the region, migration

  18. Maintaining success, reducing treatment burden, focusing on survivorship: highlights from the third European consensus conference on diagnosis and treatment of germ-cell cancer.

    PubMed

    Beyer, J; Albers, P; Altena, R; Aparicio, J; Bokemeyer, C; Busch, J; Cathomas, R; Cavallin-Stahl, E; Clarke, N W; Claßen, J; Cohn-Cedermark, G; Dahl, A A; Daugaard, G; De Giorgi, U; De Santis, M; De Wit, M; De Wit, R; Dieckmann, K P; Fenner, M; Fizazi, K; Flechon, A; Fossa, S D; Germá Lluch, J R; Gietema, J A; Gillessen, S; Giwercman, A; Hartmann, J T; Heidenreich, A; Hentrich, M; Honecker, F; Horwich, A; Huddart, R A; Kliesch, S; Kollmannsberger, C; Krege, S; Laguna, M P; Looijenga, L H J; Lorch, A; Lotz, J P; Mayer, F; Necchi, A; Nicolai, N; Nuver, J; Oechsle, K; Oldenburg, J; Oosterhuis, J W; Powles, T; Rajpert-De Meyts, E; Rick, O; Rosti, G; Salvioni, R; Schrader, M; Schweyer, S; Sedlmayer, F; Sohaib, A; Souchon, R; Tandstad, T; Winter, C; Wittekind, C

    2013-04-01

    In November 2011, the Third European Consensus Conference on Diagnosis and Treatment of Germ-Cell Cancer (GCC) was held in Berlin, Germany. This third conference followed similar meetings in 2003 (Essen, Germany) and 2006 (Amsterdam, The Netherlands) [Schmoll H-J, Souchon R, Krege S et al. European consensus on diagnosis and treatment of germ-cell cancer: a report of the European Germ-Cell Cancer Consensus Group (EGCCCG). Ann Oncol 2004; 15: 1377-1399; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of germ-cell cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part I. Eur Urol 2008; 53: 478-496; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of germ-cell cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part II. Eur Urol 2008; 53: 497-513]. A panel of 56 of 60 invited GCC experts from all across Europe discussed all aspects on diagnosis and treatment of GCC, with a particular focus on acute and late toxic effects as well as on survivorship issues. The panel consisted of oncologists, urologic surgeons, radiooncologists, pathologists and basic scientists, who are all actively involved in care of GCC patients. Panelists were chosen based on the publication activity in recent years. Before the meeting, panelists were asked to review the literature published since 2006 in 20 major areas concerning all aspects of diagnosis, treatment and follow-up of GCC patients, and to prepare an updated version of the previous recommendations to be discussed at the conference. In addition, ∼50 E-vote questions were drafted and presented at the conference to address the most controversial areas for a poll of expert opinions. Here, we present the main recommendations and controversies of this meeting. The votes of the panelists are added as online supplements.

  19. Clustering and asymptotic behavior in opinion formation

    NASA Astrophysics Data System (ADS)

    Jabin, Pierre-Emmanuel; Motsch, Sebastien

    2014-12-01

    We investigate the long time behavior of models of opinion formation. We consider the case of compactly supported interactions between agents which are also non-symmetric, including for instance the so-called Krause model. Because of the finite range of interaction, convergence to a unique consensus is not expected in general. We are nevertheless able to prove the convergence to a final equilibrium state composed of possibly several local consensus. This result had so far only been conjectured through numerical evidence. Because of the non-symmetry in the model, the analysis is delicate and is performed in two steps: First using entropy estimates to prove the formation of stable clusters and then studying the evolution in each cluster. We study both discrete and continuous in time models and give rates of convergence when those are available.

  20. Comparison of Immunogenicity in Rhesus Macaques of Transmitted-Founder, HIV-1 Group M Consensus, and Trivalent Mosaic Envelope Vaccines Formulated as a DNA Prime, NYVAC, and Envelope Protein Boost

    PubMed Central

    Hulot, Sandrine L.; Korber, Bette; Giorgi, Elena E.; Vandergrift, Nathan; Saunders, Kevin O.; Balachandran, Harikrishnan; Mach, Linh V.; Lifton, Michelle A.; Pantaleo, Giuseppe; Tartaglia, Jim; Phogat, Sanjay; Jacobs, Bertram; Kibler, Karen; Perdiguero, Beatriz; Gomez, Carmen E.; Esteban, Mariano; Rosati, Margherita; Felber, Barbara K.; Pavlakis, George N.; Parks, Robert; Lloyd, Krissey; Sutherland, Laura; Scearce, Richard; Letvin, Norman L.; Seaman, Michael S.; Alam, S. Munir; Montefiori, David; Liao, Hua-Xin; Haynes, Barton F.

    2015-01-01

    ABSTRACT An effective human immunodeficiency virus type 1 (HIV-1) vaccine must induce protective antibody responses, as well as CD4+ and CD8+ T cell responses, that can be effective despite extraordinary diversity of HIV-1. The consensus and mosaic immunogens are complete but artificial proteins, computationally designed to elicit immune responses with improved cross-reactive breadth, to attempt to overcome the challenge of global HIV diversity. In this study, we have compared the immunogenicity of a transmitted-founder (T/F) B clade Env (B.1059), a global group M consensus Env (Con-S), and a global trivalent mosaic Env protein in rhesus macaques. These antigens were delivered using a DNA prime-recombinant NYVAC (rNYVAC) vector and Env protein boost vaccination strategy. While Con-S Env was a single sequence, mosaic immunogens were a set of three Envs optimized to include the most common forms of potential T cell epitopes. Both Con-S and mosaic sequences retained common amino acids encompassed by both antibody and T cell epitopes and were central to globally circulating strains. Mosaics and Con-S Envs expressed as full-length proteins bound well to a number of neutralizing antibodies with discontinuous epitopes. Also, both consensus and mosaic immunogens induced significantly higher gamma interferon (IFN-γ) enzyme-linked immunosorbent spot assay (ELISpot) responses than B.1059 immunogen. Immunization with these proteins, particularly Con-S, also induced significantly higher neutralizing antibodies to viruses than B.1059 Env, primarily to tier 1 viruses. Both Con-S and mosaics stimulated more potent CD8-T cell responses against heterologous Envs than did B.1059. Both antibody and cellular data from this study strengthen the concept of using in silico-designed centralized immunogens for global HIV-1 vaccine development strategies. IMPORTANCE There is an increasing appreciation for the importance of vaccine-induced anti-Env antibody responses for preventing HIV-1

  1. The Nature of Public Opinion on Education in Norway, Sweden and Finland--Measuring the Degree of Political Polarization at the Mass Level

    ERIC Educational Resources Information Center

    Fladmoe, Audun

    2012-01-01

    The aim of this article is to investigate public opinion on education in Norway, Sweden and Finland. Two questions are investigated: (1) whether there is a "Nordic model" of public opinion, and (2) whether public opinion is characterized by political consensus or conflict. Large-scale surveys from 1981 to 2009 are analyzed. The findings…

  2. Expert consensus document: A consensus on the medical treatment of acromegaly.

    PubMed

    Giustina, Andrea; Chanson, Philippe; Kleinberg, David; Bronstein, Marcello D; Clemmons, David R; Klibanski, Anne; van der Lely, Aart J; Strasburger, Christian J; Lamberts, Steven W; Ho, Ken K Y; Casanueva, Felipe F; Melmed, Shlomo

    2014-04-01

    In March 2013, the Acromegaly Consensus Group met to revise and update guidelines for the medical treatment of acromegaly. The meeting comprised experts skilled in the medical management of acromegaly. The group considered treatment goals covering biochemical, clinical and tumour volume outcomes, and the place in guidelines of somatostatin receptor ligands, growth hormone receptor antagonists and dopamine agonists, and alternative modalities for treatment including combination therapy and novel treatments. This document represents the conclusions of the workshop consensus.

  3. Energy strategy: Roadmap to consensus

    SciTech Connect

    Not Available

    1990-11-01

    The United States lacks a comprehensive approach to policy-making in the energy realm. Today, as in the past, individual constituency groups tend to focus on their particular aspect of the energy challenge. Many employ a ``decide-announce-defend`` approach to policy-making, setting out to secure a unilateral advantage for themselves. By so doing, they inevitably pit interest against interest. The result is a polarization of constituencies, and shortsighted policies designed to address the issue of the moment. The American Energy Assurance Council (AEAC) is a non-profit organization founded in 1987 for the sole purpose of facilitating progress toward a fair efficient wise, stable, and consensus-based national energy strategy. AEAC does not have a substantive policy agencies. Rather, we are committed to supporting a process whereby the many stakeholders and policy makers concerned with energy-related issues can come together in productive discourse, thereby overcoming ignorance of each other`s positions. The Council seeks to act as a facilitative body, providing a ``safe`` context for inventive and creative thinking. We attempt to build a store of common knowledge, and to build on that store according to mutually agreed-upon groundrules, and employing sophisticated approaches to facilitation and mediation. This report, the National Energy Consensus Experiment (NECE), was an ambitious experiment in consensus-building. We learned a great deal from it, both in terms of substance and process, and we are convinced that it holds important lessons for others who may seek to build consensus in the public policy realm.

  4. Energy strategy: Roadmap to consensus

    SciTech Connect

    Not Available

    1990-11-01

    The United States lacks a comprehensive approach to policy-making in the energy realm. Today, as in the past, individual constituency groups tend to focus on their particular aspect of the energy challenge. Many employ a decide-announce-defend'' approach to policy-making, setting out to secure a unilateral advantage for themselves. By so doing, they inevitably pit interest against interest. The result is a polarization of constituencies, and shortsighted policies designed to address the issue of the moment. The American Energy Assurance Council (AEAC) is a non-profit organization founded in 1987 for the sole purpose of facilitating progress toward a fair efficient wise, stable, and consensus-based national energy strategy. AEAC does not have a substantive policy agencies. Rather, we are committed to supporting a process whereby the many stakeholders and policy makers concerned with energy-related issues can come together in productive discourse, thereby overcoming ignorance of each other's positions. The Council seeks to act as a facilitative body, providing a safe'' context for inventive and creative thinking. We attempt to build a store of common knowledge, and to build on that store according to mutually agreed-upon groundrules, and employing sophisticated approaches to facilitation and mediation. This report, the National Energy Consensus Experiment (NECE), was an ambitious experiment in consensus-building. We learned a great deal from it, both in terms of substance and process, and we are convinced that it holds important lessons for others who may seek to build consensus in the public policy realm.

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

    PubMed

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

    2013-11-01

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

  6. International Working Group-Myeloproliferative Neoplasms Research and Treatment (IWG-MRT) & European Competence Network on Mastocytosis (ECNM) consensus response criteria in advanced systemic mastocytosis

    PubMed Central

    Pardanani, Animesh; Akin, Cem; Reiter, Andreas; George, Tracy; Hermine, Olivier; Kluin-Nelemans, Hanneke; Hartmann, Karin; Sperr, Wolfgang R.; Brockow, Knut; Schwartz, Lawrence B.; Orfao, Alberto; DeAngelo, Daniel J.; Arock, Michel; Sotlar, Karl; Horny, Hans-Peter; Metcalfe, Dean D.; Escribano, Luis; Verstovsek, Srdan; Tefferi, Ayalew; Valent, Peter

    2013-01-01

    Systemic mastocytosis (SM) is characterized by accumulation of neoplastic mast cells and is classified into indolent and aggressive forms. The latter include aggressive SM (ASM), mast cell leukemia (MCL), and SM associated with a myeloid neoplasm wherein 1 or both disease compartments exhibit advanced features. These variants, henceforth collectively referred to as advanced SM for the purposes of this report, are typically characterized by organ damage and shortened survival duration. In contrast to indolent SM, in which symptoms are usually managed by noncytotoxic antimediator therapy, cytoreduction is usually necessary for disease control in advanced SM. Unfortunately, current drug treatment of these patients rarely results in complete clinical and histopathologic remissions or improved survival time. Previously defined response criteria were adapted to the heterogeneous presentations of advanced SM and the limited effects of available drugs. However, recent advances in understanding the molecular pathogenesis of SM and the corresponding prospect in targeted therapy make it a priority to modify these criteria. Our current study is the product of an international group of experts and summarizes the challenges in accomplishing this task and forwards a new proposal for response criteria, which builds on prior proposals and should facilitate response evaluation in clinical trials. PMID:23325841

  7. International Working Group-Myeloproliferative Neoplasms Research and Treatment (IWG-MRT) & European Competence Network on Mastocytosis (ECNM) consensus response criteria in advanced systemic mastocytosis.

    PubMed

    Gotlib, Jason; Pardanani, Animesh; Akin, Cem; Reiter, Andreas; George, Tracy; Hermine, Olivier; Kluin-Nelemans, Hanneke; Hartmann, Karin; Sperr, Wolfgang R; Brockow, Knut; Schwartz, Lawrence B; Orfao, Alberto; Deangelo, Daniel J; Arock, Michel; Sotlar, Karl; Horny, Hans-Peter; Metcalfe, Dean D; Escribano, Luis; Verstovsek, Srdan; Tefferi, Ayalew; Valent, Peter

    2013-03-28

    Systemic mastocytosis (SM) is characterized by accumulation of neoplastic mast cells and is classified into indolent and aggressive forms. The latter include aggressive SM (ASM), mast cell leukemia (MCL), and SM associated with a myeloid neoplasm wherein 1 or both disease compartments exhibit advanced features. These variants, henceforth collectively referred to as advanced SM for the purposes of this report, are typically characterized by organ damage and shortened survival duration. In contrast to indolent SM, in which symptoms are usually managed by noncytotoxic antimediator therapy, cytoreduction is usually necessary for disease control in advanced SM. Unfortunately, current drug treatment of these patients rarely results in complete clinical and histopathologic remissions or improved survival time. Previously defined response criteria were adapted to the heterogeneous presentations of advanced SM and the limited effects of available drugs. However, recent advances in understanding the molecular pathogenesis of SM and the corresponding prospect in targeted therapy make it a priority to modify these criteria. Our current study is the product of an international group of experts and summarizes the challenges in accomplishing this task and forwards a new proposal for response criteria, which builds on prior proposals and should facilitate response evaluation in clinical trials.

  8. Ten key points for the appropriate use of antibiotics in hospitalised patients: a consensus from the Antimicrobial Stewardship and Resistance Working Groups of the International Society of Chemotherapy.

    PubMed

    Levy Hara, Gabriel; Kanj, Souha S; Pagani, Leonardo; Abbo, Lilian; Endimiani, Andrea; Wertheim, Heiman F L; Amábile-Cuevas, Carlos; Tattevin, Pierre; Mehtar, Shaheen; Lopes Cardoso, Fernando; Unal, Serhat; Gould, Ian

    2016-09-01

    The Antibiotic Stewardship and Resistance Working Groups of the International Society for Chemotherapy propose ten key points for the appropriate use of antibiotics in hospital settings. (i) Get appropriate microbiological samples before antibiotic administration and carefully interpret the results: in the absence of clinical signs of infection, colonisation rarely requires antimicrobial treatment. (ii) Avoid the use of antibiotics to 'treat' fever: use them to treat infections, and investigate the root cause of fever prior to starting treatment. (iii) Start empirical antibiotic treatment after taking cultures, tailoring it to the site of infection, risk factors for multidrug-resistant bacteria, and the local microbiology and susceptibility patterns. (iv) Prescribe drugs at their optimal dosing and for an appropriate duration, adapted to each clinical situation and patient characteristics. (v) Use antibiotic combinations only where the current evidence suggests some benefit. (vi) When possible, avoid antibiotics with a higher likelihood of promoting drug resistance or hospital-acquired infections, or use them only as a last resort. (vii) Drain the infected foci quickly and remove all potentially or proven infected devices: control the infection source. (viii) Always try to de-escalate/streamline antibiotic treatment according to the clinical situation and the microbiological results. (ix) Stop unnecessarily prescribed antibiotics once the absence of infection is likely. And (x) Do not work alone: set up local teams with an infectious diseases specialist, clinical microbiologist, hospital pharmacist, infection control practitioner or hospital epidemiologist, and comply with hospital antibiotic policies and guidelines.

  9. National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-Versus-Host Disease: III. The 2014 Biomarker Working Group Report

    PubMed Central

    Paczesny, Sophie; Hakim, Frances T.; Pidala, Joseph; Cooke, Kenneth; Lathrop, Julia; Griffith, Linda M.; Hansen, John; Jagasia, Madan; Miklos, David; Pavletic, Steven; Parkman, Robertson; Russek-Cohen, Estelle; Flowers, Mary E.D.; Lee, Stephanie; Martin, Paul; Vogelsang, Georgia; Walton, Marc; Schultz, Kirk R.

    2015-01-01

    Biology-based markers to confirm or aid in the diagnosis or prognosis of chronic GVHD after allogeneic hematopoietic cell transplantation (HCT) or monitor its progression are critically needed to facilitate evaluation of new therapies. Biomarkers have been defined as any characteristic that is objectively measured and evaluated as an indicator of a normal biological or pathogenic process, a pharmacologic response to a therapeutic intervention. Applications of biomarkers in chronic GVHD clinical trials or patient management include: a) diagnosis and assessment of chronic GVHD disease activity, including distinguishing irreversible damage from continued disease activity, b) prognostic risk to develop chronic GVHD, and c) prediction of response to therapy. Sample collection for chronic GVHD biomarkers studies should be well-documented following established quality control guidelines for sample acquisition, processing, preservation and testing, at intervals that are both calendar- and event-driven. The consistent therapeutic treatment of subjects and standardized documentation needed to support biomarker studies are most likely to be provided in prospective clinical trials. To date, no chronic GVHD biomarkers have been qualified for utilization in clinical applications. Since our previous chronic GVHD Biomarkers Working Group report in 2005, an increasing number of chronic GVHD candidate biomarkers are available for further investigation. This paper provides a four-part framework for biomarker investigations: identification, verification, qualification, and application with terminology based on Food and Drug Administration and European Medicines Agency guidelines. PMID:25644957

  10. Revision of the venous clinical severity score: venous outcomes consensus statement: special communication of the American Venous Forum Ad Hoc Outcomes Working Group.

    PubMed

    Vasquez, Michael A; Rabe, Eberhard; McLafferty, Robert B; Shortell, Cynthia K; Marston, William A; Gillespie, David; Meissner, Mark H; Rutherford, Robert B

    2010-11-01

    In response to the need for a disease severity measurement, the American Venous Forum committee on outcomes assessment developed the Venous Severity Scoring system in 2000. There are three components of this scoring system, the Venous Disability Score, the Venous Segmental Disease Score, and the Venous Clinical Severity Score (VCSS). The VCSS was developed from elements of the CEAP classification (clinical grade, etiology, anatomy, pathophysiology), which is the worldwide standard for describing the clinical features of chronic venous disease. However, as a descriptive instrument, the CEAP classification responds poorly to change. The VCSS was subsequently developed as an evaluative instrument that would be responsive to changes in disease severity over time and in response to treatment. Based on initial experiences with the VCSS, an international ad hoc working group of the American Venous Forum was charged with updating the instrument. This revision of the VCSS is focused on clarifying ambiguities, updating terminology, and simplifying application. The specific language of proven quality-of-life instruments was used to better address the issues of patients at the lower end of the venous disease spectrum. Periodic review and revision are necessary for generating more universal applicability and for comparing treatment outcomes in a meaningful way.

  11. Cardiovascular risk assessment in low-resource settings: a consensus document of the European Society of Hypertension Working Group on Hypertension and Cardiovascular Risk in Low Resource Settings

    PubMed Central

    Modesti, Pietro A.; Agostoni, Piergiuseppe; Agyemang, Charles; Basu, Sanjay; Benetos, Athanase; Cappuccio, Francesco P.; Ceriello, Antonio; Del Prato, Stefano; Kalyesubula, Robert; O’Brien, Eoin; Kilama, Michael O.; Perlini, Stefano; Picano, Eugenio; Reboldi, Gianpaolo; Remuzzi, Giuseppe; Stuckler, David; Twagirumukiza, Marc; Van Bortel, Luc M.; Watfa, Ghassan; Zhao, Dong; Parati, Gianfranco

    2014-01-01

    The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 confirms ischemic heart disease and stroke as the leading cause of death and that hypertension is the main associated risk factor worldwide. How best to respond to the rising prevalence of hypertension in resource-deprived settings is a topic of ongoing public-health debate and discussion. In low-income and middle-income countries, socioeconomic inequality and cultural factors play a role both in the development of risk factors and in the access to care. In Europe, cultural barriers and poor communication between health systems and migrants may limit migrants from receiving appropriate prevention, diagnosis, and treatment. To use more efficiently resources available and to make treatment cost-effective at the patient level, cardiovascular risk approach is now recommended. In 2011, The European Society of Hypertension established a Working Group on ‘Hypertension and Cardiovascular risk in low resource settings’, which brought together cardiologists, diabetologists, nephrologists, clinical trialists, epidemiologists, economists, and other stakeholders to review current strategies for cardiovascular risk assessment in population studies in low-income and middle-income countries, their limitations, possible improvements, and future interests in screening programs. This report summarizes current evidence and presents highlights of unmet needs. PMID:24577410

  12. Bifurcation Phenomena of Opinion Dynamics in Complex Networks

    NASA Astrophysics Data System (ADS)

    Guo, Long; Cai, Xu

    In this paper, we study the opinion dynamics of Improved Deffuant model (IDM), where the convergence parameter μ is a function of the opposite’s degree K according to the celebrity effect, in small-world network (SWN) and scale-free network (SFN). Generically, the system undergoes a phase transition from the plurality state to the polarization state and to the consensus state as the confidence parameter ɛ increasing. Furthermore, the evolution of the steady opinion s * as a function of ɛ, and the relation between the minority steady opinion s_{*}^{min} and the individual connectivity k also have been analyzed. Our present work shows the crucial role of the confidence parameter and the complex system topology in the opinion dynamics of IDM.

  13. Your opinion on climate change might not be as common as you think

    NASA Astrophysics Data System (ADS)

    Leviston, Z.; Walker, I.; Morwinski, S.

    2013-04-01

    Political and media debate on the existence and causes of climate change has become increasingly factious in several western countries, often resting on claims and counter-claims about what most citizens really think. There are several well-established phenomena in psychology about how people perceive the prevalence of opinions, including the false consensus effect (a tendency to overestimate how common one's `own' opinion is) and pluralistic ignorance (where most people privately reject an opinion, but assume incorrectly that most others accept it). We investigated these biases in people's opinions about the existence and causes of climate change. In two surveys conducted 12 months apart in Australia (n=5,036 n=5,030), respondents were asked their own opinion about the nature of climate change, and then asked to estimate levels of opinion among the general population. We demonstrate that opinions about climate change are subject to strong false consensus effects, that people grossly overestimate the numbers of people who reject the existence of climate change in the broader community, and that people with high false consensus bias are less likely to change their opinions.

  14. Chaotic Modes in Scale Free Opinion Networks

    NASA Astrophysics Data System (ADS)

    Kusmartsev, Feo V.; Kürten, Karl E.

    2010-12-01

    In this paper, we investigate processes associated with formation of public opinion in varies directed random, scale free and small-world social networks. The important factor of the opinion formation is the existence of contrarians which were discovered by Granovetter in various social psychology experiments1,2,3 long ago and later introduced in sociophysics by Galam.4 When the density of contrarians increases the system behavior drastically changes at some critical value. At high density of contrarians the system can never arrive to a consensus state and periodically oscillates with different periods depending on specific structure of the network. At small density of the contrarians the behavior is manifold. It depends primary on the initial state of the system. If initially the majority of the population agrees with each other a state of stable majority may be easily reached. However when originally the population is divided in nearly equal parts consensus can never be reached. We model the emergence of collective decision making by considering N interacting agents, whose opinions are described by two state Ising spin variable associated with YES and NO. We show that the dynamical behaviors are very sensitive not only to the density of the contrarians but also to the network topology. We find that a phase of social chaos may arise in various dynamical processes of opinion formation in many realistic models. We compare the prediction of the theory with data describing the dynamics of the average opinion of the USA population collected on a day-by-day basis by varies media sources during the last six month before the final Obama-McCain election. The qualitative ouctome is in reasonable agreement with the prediction of our theory. In fact, the analyses of these data made within the paradigm of our theory indicates that even in this campaign there were chaotic elements where the public opinion migrated in an unpredictable chaotic way. The existence of such a phase

  15. Chaotic Modes in Scale Free Opinion Networks

    NASA Astrophysics Data System (ADS)

    Kusmartsev, Feo V.; Kürten, Karl E.

    In this paper, we investigate processes associated with formation of public opinion in varies directed random, scale free and small-world social networks. The important factor of the opinion formation is the existence of contrarians which were discovered by Granovetter in various social psychology experiments1,2,3 long ago and later introduced in sociophysics by Galam.4 When the density of contrarians increases the system behavior drastically changes at some critical value. At high density of contrarians the system can never arrive to a consensus state and periodically oscillates with different periods depending on specific structure of the network. At small density of the contrarians the behavior is manifold. It depends primary on the initial state of the system. If initially the majority of the population agrees with each other a state of stable majority may be easily reached. However when originally the population is divided in nearly equal parts consensus can never be reached. We model the emergence of collective decision making by considering N interacting agents, whose opinions are described by two state Ising spin variable associated with YES and NO. We show that the dynamical behaviors are very sensitive not only to the density of the contrarians but also to the network topology. We find that a phase of social chaos may arise in various dynamical processes of opinion formation in many realistic models. We compare the prediction of the theory with data describing the dynamics of the average opinion of the USA population collected on a day-by-day basis by varies media sources during the last six month before the final Obama-McCain election. The qualitative ouctome is in reasonable agreement with the prediction of our theory. In fact, the analyses of these data made within the paradigm of our theory indicates that even in this campaign there were chaotic elements where the public opinion migrated in an unpredictable chaotic way. The existence of such a phase

  16. Measuring therapeutic response in chronic graft-versus-host disease. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: IV. The 2014 Response Criteria Working Group report.

    PubMed

    Lee, Stephanie J; Wolff, Daniel; Kitko, Carrie; Koreth, John; Inamoto, Yoshihiro; Jagasia, Madan; Pidala, Joseph; Olivieri, Attilio; Martin, Paul J; Przepiorka, Donna; Pusic, Iskra; Dignan, Fiona; Mitchell, Sandra A; Lawitschka, Anita; Jacobsohn, David; Hall, Anne M; Flowers, Mary E D; Schultz, Kirk R; Vogelsang, Georgia; Pavletic, Steven

    2015-06-01

    In 2005, the National Institutes of Health (NIH) Chronic Graft-versus-Host Disease (GVHD) Consensus Response Criteria Working Group recommended several measures to document serial evaluations of chronic GVHD organ involvement. Provisional definitions of complete response, partial response, and progression were proposed for each organ and for overall outcome. Based on publications over the last 9 years, the 2014 Working Group has updated its recommendations for measures and interpretation of organ and overall responses. Major changes include elimination of several clinical parameters from the determination of response, updates to or addition of new organ scales to assess response, and the recognition that progression excludes minimal, clinically insignificant worsening that does not usually warrant a change in therapy. The response definitions have been revised to reflect these changes and are expected to enhance reliability and practical utility of these measures in clinical trials. Clarification is provided about response assessment after the addition of topical or organ-targeted treatment. Ancillary measures are strongly encouraged in clinical trials. Areas suggested for additional research include criteria to identify irreversible organ damage and validation of the modified response criteria, including in the pediatric population.

  17. Best practices recommendations in the application of immunohistochemistry in urologic pathology: report from the International Society of Urological Pathology consensus conference.

    PubMed

    Amin, Mahul B; Epstein, Jonathan I; Ulbright, Thomas M; Humphrey, Peter A; Egevad, Lars; Montironi, Rodolfo; Grignon, David; Trpkov, Kiril; Lopez-Beltran, Antonio; Zhou, Ming; Argani, Pedram; Delahunt, Brett; Berney, Daniel M; Srigley, John R; Tickoo, Satish K; Reuter, Victor E

    2014-08-01

    Members of the International Society of Urological Pathology (ISUP) participated in a half-day consensus conference to discuss guidelines and recommendations regarding best practice approaches to use of immunohistochemistry (IHC) in differential diagnostic situations in urologic pathology, including bladder, prostate, testis and, kidney lesions. Four working groups, selected by the ISUP leadership, identified several high-interest topics based on common or relevant challenging diagnostic situations and proposed best practice recommendations, which were discussed by the membership. The overall summary of the discussions and the consensus opinion forms the basis of a series of articles, one for each organ site. This Special Article summarizes the overall recommendations made by the four working groups. It is anticipated that this ISUP effort will be valuable to the entire practicing community in the appropriate use of IHC in diagnostic urologic pathology.

  18. Critique, Contextualism and Consensus

    ERIC Educational Resources Information Center

    Green, Jane

    2004-01-01

    In an epistemology of contextualism, how robust does consensus need to be for critique to be practically effective? In 'Relativism and the Critical Potential of Philosophy of Education,' Frieda Heyting proposes a form of contextualism, but her argument raises a number of problems. The kinds of criteria that her version of contextualism will…

  19. Bounded Confidence under Preferential Flip: A Coupled Dynamics of Structural Balance and Opinions

    PubMed Central

    Parravano, Antonio; Andina-Díaz, Ascensión; Meléndez-Jiménez, Miguel A.

    2016-01-01

    In this work we study the coupled dynamics of social balance and opinion formation. We propose a model where agents form opinions under bounded confidence, but only considering the opinions of their friends. The signs of social ties -friendships and enmities- evolve seeking for social balance, taking into account how similar agents’ opinions are. We consider both the case where opinions have one and two dimensions. We find that our dynamics produces the segregation of agents into two cliques, with the opinions of agents in one clique differing from those in the other. Depending on the level of bounded confidence, the dynamics can produce either consensus of opinions within each clique or the coexistence of several opinion clusters in a clique. For the uni-dimensional case, the opinions in one clique are all below the opinions in the other clique, hence defining a “left clique” and a “right clique”. In the two-dimensional case, our numerical results suggest that the two cliques are separated by a hyperplane in the opinion space. We also show that the phenomenon of unidimensional opinions identified by DeMarzo, Vayanos and Zwiebel (Q J Econ 2003) extends partially to our dynamics. Finally, in the context of politics, we comment about the possible relation of our results to the fragmentation of an ideology and the emergence of new political parties. PMID:27716815

  20. Bounded Confidence under Preferential Flip: A Coupled Dynamics of Structural Balance and Opinions.

    PubMed

    Parravano, Antonio; Andina-Díaz, Ascensión; Meléndez-Jiménez, Miguel A

    2016-01-01

    In this work we study the coupled dynamics of social balance and opinion formation. We propose a model where agents form opinions under bounded confidence, but only considering the opinions of their friends. The signs of social ties -friendships and enmities- evolve seeking for social balance, taking into account how similar agents' opinions are. We consider both the case where opinions have one and two dimensions. We find that our dynamics produces the segregation of agents into two cliques, with the opinions of agents in one clique differing from those in the other. Depending on the level of bounded confidence, the dynamics can produce either consensus of opinions within each clique or the coexistence of several opinion clusters in a clique. For the uni-dimensional case, the opinions in one clique are all below the opinions in the other clique, hence defining a "left clique" and a "right clique". In the two-dimensional case, our numerical results suggest that the two cliques are separated by a hyperplane in the opinion space. We also show that the phenomenon of unidimensional opinions identified by DeMarzo, Vayanos and Zwiebel (Q J Econ 2003) extends partially to our dynamics. Finally, in the context of politics, we comment about the possible relation of our results to the fragmentation of an ideology and the emergence of new political parties.

  1. Opinion Formation by Social Influence: From Experiments to Modeling

    PubMed Central

    Chacoma, Andrés; Zanette, Damián H.

    2015-01-01

    Predicting different forms of collective behavior in human populations, as the outcome of individual attitudes and their mutual influence, is a question of major interest in social sciences. In particular, processes of opinion formation have been theoretically modeled on the basis of a formal similarity with the dynamics of certain physical systems, giving rise to an extensive collection of mathematical models amenable to numerical simulation or even to exact solution. Empirical ground for these models is however largely missing, which confine them to the level of mere metaphors of the real phenomena they aim at explaining. In this paper we present results of an experiment which quantifies the change in the opinions given by a subject on a set of specific matters under the influence of others. The setup is a variant of a recently proposed experiment, where the subject’s confidence on his or her opinion was evaluated as well. In our realization, which records the quantitative answers of 85 subjects to 20 questions before and after an influence event, the focus is put on characterizing the change in answers and confidence induced by such influence. Similarities and differences with the previous version of the experiment are highlighted. We find that confidence changes are to a large extent independent of any other recorded quantity, while opinion changes are strongly modulated by the original confidence. On the other hand, opinion changes are not influenced by the initial difference with the reference opinion. The typical time scales on which opinion varies are moreover substantially longer than those of confidence change. Experimental results are then used to estimate parameters for a dynamical agent-based model of opinion formation in a large population. In the context of the model, we study the convergence to full consensus and the effect of opinion leaders on the collective distribution of opinions. PMID:26517825

  2. Opinion Formation by Social Influence: From Experiments to Modeling.

    PubMed

    Chacoma, Andrés; Zanette, Damián H

    2015-01-01

    Predicting different forms of collective behavior in human populations, as the outcome of individual attitudes and their mutual influence, is a question of major interest in social sciences. In particular, processes of opinion formation have been theoretically modeled on the basis of a formal similarity with the dynamics of certain physical systems, giving rise to an extensive collection of mathematical models amenable to numerical simulation or even to exact solution. Empirical ground for these models is however largely missing, which confine them to the level of mere metaphors of the real phenomena they aim at explaining. In this paper we present results of an experiment which quantifies the change in the opinions given by a subject on a set of specific matters under the influence of others. The setup is a variant of a recently proposed experiment, where the subject's confidence on his or her opinion was evaluated as well. In our realization, which records the quantitative answers of 85 subjects to 20 questions before and after an influence event, the focus is put on characterizing the change in answers and confidence induced by such influence. Similarities and differences with the previous version of the experiment are highlighted. We find that confidence changes are to a large extent independent of any other recorded quantity, while opinion changes are strongly modulated by the original confidence. On the other hand, opinion changes are not influenced by the initial difference with the reference opinion. The typical time scales on which opinion varies are moreover substantially longer than those of confidence change. Experimental results are then used to estimate parameters for a dynamical agent-based model of opinion formation in a large population. In the context of the model, we study the convergence to full consensus and the effect of opinion leaders on the collective distribution of opinions.

  3. [Preliminary evaluation of Chile's First Citizen Consensus Conference].

    PubMed

    Pellegrini Filho, Alberto; Zurita, Laura

    2004-05-01

    This piece provides an initial assessment of the First Citizen Consensus Conference, an event held in the city of Santiago, Chile, from 22-24 November 2003, on the subject of "The Management of My Medical Record." This conference was the first citizen consensus conference that has been held in Chile as well as the first such conference in Latin America. Consensus conferences were devised by the Danish Board of Technology in 1987 as a way to assess science and technology issues through discussions between experts and a panel of lay persons. At the end of a consensus conference, the lay persons express their opinions and recommendations in a consensus report that is directed at policymakers, decision-makers, and the public in general. The objective of a consensus conference is to bridge the gaps that routinely exist among the general public, experts, and elected officials. So far, the Danish Board of Technology has organized more than 20 of these conferences, using a methodology that has become established as a model. Taking into account the changes that have occurred in the relationship between science and society at large, the Pan American Health Organization has decided to support the holding of consensus conferences in Latin America and the Caribbean. The First Citizen Consensus Conference adapted the Danish methodology to conditions in Chile, and this piece assesses the modifications that were made. In addition, some 6 to 12 months after the conference, there will be an external evaluation of the outcomes and impact of the conference, especially in the communications media, public debate, decision-making, and perceptions of the persons who were involved. Despite the criticisms made in this piece and some shortcomings that are pointed out, the First Citizen Consensus Conference achieved all of its objectives and will serve as an excellent model for similar conferences in other countries of the Americas.

  4. A STUDY ON THE STRUCTURE OF CONSENSUS BUILDING PROCESSES IN SOCIAL INFRASTRUCTURE DEVELOPMENT

    NASA Astrophysics Data System (ADS)

    Takada, Tomoki; Toyoda, Mitsuyo; Sago, Junzo; Seki, Motoi; Akiyama, Kazuya; Kuwako, Toshio

    The assessment of stakeholders' interests is a critical step in consensus building processes in social infrastructure development. The coordinator of these processes needs to pay attention to both concrete interests and deeper concerns behind them for successful consensus building. The authors have engaged in the management of the consensus building process for the Ten-noh river restoration project carried out on Sado Island, Niigata, and have successfully developed a restoration plan by combining voices from different perspectives. One of the key conditions for the successful consensus building is to incorporate stepby-step problem solving processes responding to the issues identified by stakeholders. Such a steady approach leads to the consensus of the project as a whole. The authors have developed a framework to analyze the structure of consensus building processes in details by establishing a chart that layouts stakeholder's opinions, interests, deeper concerns, and concrete issues that arise when promoting a project of social infrastructure development.

  5. The "golden section" and bias in perceptions of social consensus.

    PubMed

    Gross, S R; Miller, N

    1997-01-01

    Meta-analytic examination of I28 false consensus effect issues supports the hypothesis that the "Golden Section" (61.8% group size) approximates the level of actual consensus that separates overestimation of consensus (group size < 61.8%) from underestimation (group size > 61.8%). Overestimation of the actual percentage of others who endorse one's own view increases as actual consensus decreases from 61.8%, and underestimation increases as it exceeds 61.8%. The form of the response (viz, a yes or no answer to a question) moderates this conclusion. The Golden Section holds for majorities and minorities defined by agreement with an issue. For majority and minority groups defined by disagreement, the inflection point is higher. Contrary to Mullen and Hu (1988), for agreeing majorities, the slope for consensus underestimation as a function of increased majority size does not differ from that of minority overestimation.

  6. The long-term treatment of restless legs syndrome/Willis-Ekbom disease: evidence-based guidelines and clinical consensus best practice guidance: a report from the International Restless Legs Syndrome Study Group.

    PubMed

    Garcia-Borreguero, Diego; Kohnen, Ralf; Silber, Michael H; Winkelman, John W; Earley, Christopher J; Högl, Birgit; Manconi, Mauro; Montplaisir, Jacques; Inoue, Yuichi; Allen, Richard P

    2013-07-01

    A Task Force was established by the International Restless Legs Syndrome Study Group (IRLSSG) to develop evidence-based and consensus-based recommendations for the long-term pharmacologic treatment of restless legs syndrome/Willis-Ekbom disease (RLS/WED). The Task Force reviewed the results of all studies of RLS/WED treatments with durations of 6 months or longer presented at meetings over the past 2 years, posted on Web sites of pharmaceutical companies, or published in peer-reviewed journals, asking the questions, "What is the efficacy of this treatment in patients with RLS/WED?" and "What is the safety of this treatment in patients with RLS/WED?" The Task Force developed guidelines based on their review of 61 papers meeting inclusion criteria, and using a modified evidence-grading scheme. Pregabalin has been established as effective for up to 1 year in treating RLS/WED (Level A evidence). Pramipexole, ropinirole, and rotigotine have been established as effective for up to 6 months in treating RLS/WED (Level A). The following drugs have been established as probably effective (Level B) in treating RLS/WED for durations ranging from 1 to 5 years: gabapentin enacarbil, pramipexole, and ropinirole (1 year); levodopa (2 years); and rotigotine (5 years). Because of associated safety concerns, pergolide and cabergoline should not be used in the treatment of RLS/WED unless the benefits clearly outweigh the risks. Other pharmacologic therapies have insufficient evidence to support their long-term use in treating RLS/WED. The IRLSSG Task Force also developed consensus-based strategies for the prevention and treatment of complications (such as augmentation, loss of efficacy, excessive daytime sleepiness, and impulse control disorders) that may develop with the long-term pharmacologic treatment of RLS/WED. The use of either a dopamine-receptor agonist or α2δ calcium-channel ligand is recommended as the first-line treatment of RLS/WED for most patients, with the choice of

  7. OpinionSeer: interactive visualization of hotel customer feedback.

    PubMed

    Wu, Yingcai; Wei, Furu; Liu, Shixia; Au, Norman; Cui, Weiwei; Zhou, Hong; Qu, Huamin

    2010-01-01

    The rapid development of Web technology has resulted in an increasing number of hotel customers sharing their opinions on the hotel services. Effective visual analysis of online customer opinions is needed, as it has a significant impact on building a successful business. In this paper, we present OpinionSeer, an interactive visualization system that could visually analyze a large collection of online hotel customer reviews. The system is built on a new visualization-centric opinion mining technique that considers uncertainty for faithfully modeling and analyzing customer opinions. A new visual representation is developed to convey customer opinions by augmenting well-established scatterplots and radial visualization. To provide multiple-level exploration, we introduce subjective logic to handle and organize subjective opinions with degrees of uncertainty. Several case studies illustrate the effectiveness and usefulness of OpinionSeer on analyzing relationships among multiple data dimensions and comparing opinions of different groups. Aside from data on hotel customer feedback, OpinionSeer could also be applied to visually analyze customer opinions on other products or services.

  8. Consensus in controversy: The modified Delphi method applied to Gynecologic Oncology practice

    PubMed Central

    Cohn, David E.; Havrilesky, Laura J.; Osann, Kathryn; Lipscomb, Joseph; Hsieh, Susie; Walker, Joan L.; Wright, Alexi A.; Alvarez, Ronald D.; Karlan, Beth Y.; Bristow, Robert E.; DiSilvestro, Paul A.; Wakabayashi, Mark T.; Morgan, Robert; Mukamel, Dana B.; Wenzel, Lari

    2016-01-01

    Objectives To determine the degree of consensus regarding the probabilities of outcomes associated with IP/IV and IV chemotherapy. Methods A survey was administered to an expert panel using the Delphi method. Ten ovarian cancer experts were asked to estimate outcomes for patients receiving IP/IV or IV chemotherapy. The clinical estimates were: 1) probability of completing six cycles of chemotherapy, 2) probability of surviving five years, 3) median survival, and 4) probability of ER/hospital visits during treatment. Estimates for two patients, one with a low comorbidity index (patient 1) and the other with a moderate index (patient 2), were included. The survey was administered in three rounds, and panelists could revise their subsequent responses based on review of the anonymous opinions of their peers. Results The ranges were smaller for IV compared with IP/IV therapy. Ranges decreased with each round. Consensus converged around outcomes related to IP/IV chemotherapy for: 1) completion of 6 cycles of therapy (type 1 patient, 62%, type 2 patient, 43%); 2) percentage of patients surviving 5 years (type 1 patient, 66%, type 2 patient, 47%); and 3) median survival (type 1 patient, 83 months, type 2 patient, 58 months). The group required three rounds to achieve consensus on the probabilities of ER/hospital visits (type 1 patient, 24%, type 2 patient, 35%). Conclusions Initial estimates of survival and adverse events associated with IP/IV chemotherapy differ among experts. The Delphi process works to build consensus and may be a pragmatic tool to inform patients of their expected outcomes. PMID:26177553

  9. Order of blood draw: Opinion Paper by the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for the Preanalytical Phase (WG-PRE).

    PubMed

    Cornes, Michael; van Dongen-Lases, Edmée; Grankvist, Kjell; Ibarz, Mercedes; Kristensen, Gunn; Lippi, Giuseppe; Nybo, Mads; Simundic, Ana-Maria

    2017-01-01

    It has been well reported over recent years that most errors within the total testing process occur in the pre-analytical phase (46%-68.2%), an area that is usually outside of the direct control of the laboratory and which includes sample collection (phlebotomy). National and international (WHO, CLSI) guidelines recommend that the order of draw of blood during phlebotomy should be blood culture/sterile tubes, then plain tubes/gel tubes, then tubes containing additives. This prevents contamination of sample tubes with additives from previous tubes that could cause erroneous results. There have been a number of studies recently looking at whether order of draw remains a problem with modern phlebotomy techniques and materials, or it is an outdated practice followed simply because of historical reasons. In the following article, the European Federation of Clinical Chemistry and Laboratory Medicine Working Group for the Preanalytical Phase (EFLM WG-PRE) provides an overview and summary of the literature with regards to order of draw in venous blood collection. Given the evidence presented in this article, the EFLM WG-PRE herein concludes that a significant frequency of sample contamination does occur if order of draw is not followed during blood collection and when performing venipuncture under less than ideal circumstances, thus putting patient safety at risk. Moreover, given that order of draw is not difficult to follow and knowing that ideal phlebotomy conditions and protocols are not always followed or possible, EFLM WG-PRE supports the continued recommendation of ensuring a correct order of draw for venous blood collection.

  10. Consensus Statement Immunonutrition and Exercise.

    PubMed

    Bermon, Stephane; Castell, Lindy M; Calder, Philip C; Bishop, Nicolette C; Blomstrand, Eva; Mooren, Frank C; Krüger, Karsten; Kavazis, Andreas N; Quindry, John C; Senchina, David S; Nieman, David C; Gleeson, Michael; Pyne, David B; Kitic, Cecilia M; Close, Graeme L; Larson-Meyer, D Enette; Marcos, Ascension; Meydani, Simin N; Walsh, Neil P; Nagatomi, Ryochi

    2017-01-01

    In this consensus statement on immunonutrition and exercise, a panel of knowledgeable contributors from across the globe provides a consensus of updated science, including the background, the aspects for which a consensus actually exists, the controversies and, when possible, suggested directions for future research.

  11. Development of a Definition for the Alcohol Hangover: Consumer Descriptions and Expert Consensus.

    PubMed

    Van Schrojenstein Lantman, Marith; van de Loo, A J A E; Mackus, Marlou; Verster, Joris C

    2017-02-16

    Up to now there is no adequate definition of the alcohol hangover. The purpose of the current study was to develop a useful definition, and consensus among those who will use it in scientific publications. A survey was conducted among N=1099 social drinkers who recently had a hangover. They were asked to provide their definition of the alcohol hangover. Text mining and content analysis revealed 3 potential definitions. These were submitted to members of the Alcohol Hangover Research Group, who were asked to give their expert opinion on the proposed definitions. Taking into account their comments and suggestions, the following definition for the alcohol hangover was formulated: "The alcohol hangover refers to the combination of cognitive and physical symptoms, experienced the day after a single episode of heavy drinking, starting when blood alcohol concentration approaches zero."

  12. Towards Consensus Gene Ages

    PubMed Central

    Liebeskind, Benjamin J.; McWhite, Claire D.; Marcotte, Edward M.

    2016-01-01

    Correctly estimating the age of a gene or gene family is important for a variety of fields, including molecular evolution, comparative genomics, and phylogenetics, and increasingly for systems biology and disease genetics. However, most studies use only a point estimate of a gene’s age, neglecting the substantial uncertainty involved in this estimation. Here, we characterize this uncertainty by investigating the effect of algorithm choice on gene-age inference and calculate consensus gene ages with attendant error distributions for a variety of model eukaryotes. We use 13 orthology inference algorithms to create gene-age datasets and then characterize the error around each age-call on a per-gene and per-algorithm basis. Systematic error was found to be a large factor in estimating gene age, suggesting that simple consensus algorithms are not enough to give a reliable point estimate. We also found that different sources of error can affect downstream analyses, such as gene ontology enrichment. Our consensus gene-age datasets, with associated error terms, are made fully available at so that researchers can propagate this uncertainty through their analyses (geneages.org). PMID:27259914

  13. Spanish Consensus Statement

    PubMed Central

    Rey, Guillermo Álvarez; Cuesta, Jordi Ardevol; Loureda, Rafael Arriaza; España, Fernando Ávila; Matas, Ramón Balius; Pazos, Fernando Baró; de Dios Beas Jiménez, Juan; Rosell, Jorge Candel; Fernandez, César Cobián; Ros, Francisco Esparza; Colmenero, Josefina Espejo; de Prado, Jorge Fernández; Cota, Juan José García; González, Jose Ignacio Garrido; Santander, Manuela González; Munilla, Miguel Ángel Herrador; Ruiz, Francisco Ivorra; Díaz, Fernando Jiménez; Marqueta, Pedro Manonelles; Fernandez, Antonio Maestro; Benito, Juan José Muñoz; Vilás, Ramón Olivé; Teres, Xavier Peirau; Amaro, José Peña; Roque, Juan Pérez San; Parenteu, Christophe Ramírez; Serna, Juan Ribas; Álvarez, Mikel Sánchez; Marchori, Carlos Sanchez; Soto, Miguel del Valle; Alonso, José María Villalón; García, Pedro Guillen; de la Iglesia, Nicolas Hugo; Alcorocho, Juan Manuel Lopez

    2015-01-01

    On the 21st of March, 2015, experts met at Clínica CEMTRO in Madrid, Spain, under the patronage of The Spanish Society for Sports Traumatology (SETRADE), The Spanish Federation of Sports Medicine (FEMEDE), The Spanish Association of Medical Services for Football Clubs (AEMEF), and The Spanish Association of Medical Services for Basketball Clubs (AEMB) with the aim of establishing a round table that would allow specialists to consider the most appropriate current general actions to be taken when treating muscle tears in sport, based on proven scientific data described in the medical literature. Each expert received a questionnaire prior to the aforementioned meeting comprising a set of questions concerning therapeutic indications generally applied in the different stages present during muscle repair. The present Consensus Document is the result of the answers to the questionnaire and resulting discussion and consensus over which are the best current indications in the treatment of muscle tears in sport. Avoiding immobilization, not taking nonsteroidal anti-inflammatory drugs (NSAIDs) randomly, fostering early mobilization, increasing vascularization of injured, site and regulating inflammatory mechanisms—without inhibiting these from the early stages of the recovery period—all stood out as main points of the Consensus Document. Additionally, there is controversy concerning cell stimulation techniques and the use of growth factors or cell inhibitors. The decision concerning discharge was unanimous, as was the criteria considered when it came to performing sport techniques without pain. PMID:27213161

  14. Asian Consensus Report on Functional Dyspepsia

    PubMed Central

    Miwa, Hiroto; Ghoshal, Uday C; Gonlachanvit, Sutep; Gwee, Kok-Ann; Ang, Tiing-Leong; Chang, Full-Young; Fock, Kwong Ming; Hongo, Michio; Hou, Xiaohua; Kachintorn, Udom; Ke, Meiyun; Lai, Kwok-Hung; Lee, Kwang Jae; Lu, Ching-Liang; Mahadeva, Sanjiv; Miura, Soichiro; Park, Hyojin; Rhee, Poong-Lyul; Sugano, Kentaro; Vilaichone, Ratha-korn; Wong, Benjamin CY

    2012-01-01

    Background/Aims Environmental factors such as food, lifestyle and prevalence of Helicobacter pylori infection are widely different in Asian countries compared to the West, and physiological functions and genetic factors of Asians may also be different from those of Westerners. Establishing an Asian consensus for functional dyspepsia is crucial in order to attract attention to such data from Asian countries, to articulate the experience and views of Asian experts, and to provide a relevant guide on management of functional dyspepsia for primary care physicians working in Asia. Methods Consensus team members were selected from Asian experts and consensus development was carried out using a modified Delphi method. Consensus teams collected published papers on functional dyspepsia especially from Asia and developed candidate consensus statements based on the generated clinical questions. At the first face-to-face meeting, each statement was reviewed and e-mail voting was done twice. At the second face-to-face meeting, final voting on each statement was done using keypad voting system. A grade of evidence and a strength of recommendation were applied to each statement according to the method of the GRADE Working Group. Results Twenty-nine consensus statements were finalized, including 7 for definition and diagnosis, 5 for epidemiology, 9 for pathophysiology and 8 for management. Algorithms for diagnosis and management of functional dyspepsia were added. Conclusions This consensus developed by Asian experts shows distinctive features of functional dyspepsia in Asia and will provide a guide to the diagnosis and management of functional dyspepsia for Asian primary care physicians. PMID:22523724

  15. Photopatch testing: a consensus methodology for Europe.

    PubMed

    Bruynzeel, D P; Ferguson, J; Andersen, K; Gonçalo, M; English, John; Goossens, A; Holzle, E; Ibbotson, S H; Lecha, M; Lehmann, P; Leonard, F; Moseley, Harry; Pigatto, P; Tanew, A

    2004-11-01

    A group of interested European Contact Dermatologists/Photobiologists met to produce a consensus statement on methodology, test materials and interpretation of photopatch testing. While it is recognized that a range of local variables operate throughout Europe, the underlying purpose of the work is to act as an essential preamble to a Pan European Photopatch Test Study focusing particularly on sunscreen chemicals.

  16. Quorum responses and consensus decision making

    PubMed Central

    Sumpter, David J.T.; Pratt, Stephen C.

    2008-01-01

    Animal groups are said to make consensus decisions when group members come to agree on the same option. Consensus decisions are taxonomically widespread and potentially offer three key benefits: maintenance of group cohesion, enhancement of decision accuracy compared with lone individuals and improvement in decision speed. In the absence of centralized control, arriving at a consensus depends on local interactions in which each individual's likelihood of choosing an option increases with the number of others already committed to that option. The resulting positive feedback can effectively direct most or all group members to the best available choice. In this paper, we examine the functional form of the individual response to others' behaviour that lies at the heart of this process. We review recent theoretical and empirical work on consensus decisions, and we develop a simple mathematical model to show the central importance to speedy and accurate decisions of quorum responses, in which an animal's probability of exhibiting a behaviour is a sharply nonlinear function of the number of other individuals already performing this behaviour. We argue that systems relying on such quorum rules can achieve cohesive choice of the best option while also permitting adaptive tuning of the trade-off between decision speed and accuracy. PMID:19073480

  17. Critical Resources for Hospital Surge Capacity: An Expert Consensus Panel

    PubMed Central

    Bayram, Jamil D.; Sauer, Lauren M.; Catlett, Christina; Levin, Scott; Cole, Gai; Kirsch, Thomas D.; Toerper, Matthew; Kelen, Gabor

    2013-01-01

    Background: Hospital surge capacity (HSC) is dependent on the ability to increase or conserve resources. The hospital surge model put forth by the Agency for Healthcare Research and Quality (AHRQ) estimates the resources needed by hospitals to treat casualties resulting from 13 national planning scenarios. However, emergency planners need to know which hospital resource are most critical in order to develop a more accurate plan for HSC in the event of a disaster. Objective: To identify critical hospital resources required in four specific catastrophic scenarios; namely, pandemic influenza, radiation, explosive, and nerve gas. Methods: We convened an expert consensus panel comprised of 23 participants representing health providers (i.e., nurses and physicians), administrators, emergency planners, and specialists. Four disaster scenarios were examined by the panel. Participants were divided into 4 groups of five or six members, each of which were assigned two of four scenarios. They were asked to consider 132 hospital patient care resources- extracted from the AHRQ's hospital surge model- in order to identify the ones that would be critical in their opinion to patient care. The definition for a critical hospital resource was the following: absence of the resource is likely to have a major impact on patient outcomes, i.e., high likelihood of untoward event, possibly death. For items with any disagreement in ranking, we conducted a facilitated discussion (modified Delphi technique) until consensus was reached, which was defined as more than 50% agreement. Intraclass Correlation Coefficients (ICC) were calculated for each scenario, and across all scenarios as a measure of participant agreement on critical resources. For the critical resources common to all scenarios, Kruskal-Wallis test was performed to measure the distribution of scores across all scenarios. Results: Of the 132 hospital resources, 25 were considered critical for all four scenarios by more than 50% of

  18. Opinion formation and bi-polarization with biased assimilation and homophily

    NASA Astrophysics Data System (ADS)

    Fu, Guiyuan; Zhang, Weidong

    2016-02-01

    An agent-based model incorporating biased assimilation is proposed in this paper to investigate opinion dynamics over a connected social network. The opinion of each agent is represented by a sequence of arguments, and it evolves through the interactions between agents. The probability that one agent chooses another to communicate depends on the similarity of their opinions. During every interaction, interacting agents exchange the argument randomly selected from the corresponding arguments sequence. Theoretical analysis reveals that this model results in consensus on either extreme positive opinion or extreme negative opinion, or generates bi-polarization. Numerical simulations are carried out to investigate the dynamics of the model over different networks. Results are obtained in terms of the effect of homophily, biased assimilation and network topology on opinion formation.

  19. [Consensus document by the Spanish Society of Paediatric Infectious Diseases and the advisory committee on vaccines of the Spanish Paediatrics Association on vaccination in immunocompromised children].

    PubMed

    Mellado Peña, M J; Moreno-Pérez, D; Ruíz Contreras, J; Hernández-Sampelayo Matos, T; Navarro Gómez, M L

    2011-12-01

    Vaccination in immunocompromised infants, children and adolescents is a major aspect in the follow-up of this complex pathology in specific Paediatric Units. Vaccination is also an important prevention tool, as this can, to a certain extent, determine the morbidity and mortality in these patients. This consensus document was jointly prepared by Working Groups of the Spanish Society of Paediatric Infectious Diseases and the Advisory Committee on Vaccines of the Spanish Paediatric Association, who are usually involved in updating the management of vaccinations in immunocompromised children, and reflects their opinions. The consensus specifically summarises indications for vaccination in the following special paediatric populations: Solid organ and haematopoietic transplant-recipients; primary immunodeficiency; asplenic children; non-previously transplanted immunocompromised patients; chronically ill patients; HIV-infected children and also the vaccines recommended for immunodeficient children who travel.

  20. Anisotropic opinion dynamics

    NASA Astrophysics Data System (ADS)

    Neirotti, Juan

    2016-07-01

    We consider the process of opinion formation in a society of interacting agents, where there is a set B of socially accepted rules. In this scenario, we observed that agents, represented by simple feed-forward, adaptive neural networks, may have a conservative attitude (mostly in agreement with B ) or liberal attitude (mostly in agreement with neighboring agents) depending on how much their opinions are influenced by their peers. The topology of the network representing the interaction of the society's members is determined by a graph, where the agents' properties are defined over the vertexes and the interagent interactions are defined over the bonds. The adaptability of the agents allows us to model the formation of opinions as an online learning process, where agents learn continuously as new information becomes available to the whole society (online learning). Through the application of statistical mechanics techniques we deduced a set of differential equations describing the dynamics of the system. We observed that by slowly varying the average peer influence in such a way that the agents attitude changes from conservative to liberal and back, the average social opinion develops a hysteresis cycle. Such hysteretic behavior disappears when the variance of the social influence distribution is large enough. In all the cases studied, the change from conservative to liberal behavior is characterized by the emergence of conservative clusters, i.e., a closed knitted set of society members that follow a leader who agrees with the social status quo when the rule B is challenged.

  1. Anisotropic opinion dynamics.

    PubMed

    Neirotti, Juan

    2016-07-01

    We consider the process of opinion formation in a society of interacting agents, where there is a set B of socially accepted rules. In this scenario, we observed that agents, represented by simple feed-forward, adaptive neural networks, may have a conservative attitude (mostly in agreement with B) or liberal attitude (mostly in agreement with neighboring agents) depending on how much their opinions are influenced by their peers. The topology of the network representing the interaction of the society's members is determined by a graph, where the agents' properties are defined over the vertexes and the interagent interactions are defined over the bonds. The adaptability of the agents allows us to model the formation of opinions as an online learning process, where agents learn continuously as new information becomes available to the whole society (online learning). Through the application of statistical mechanics techniques we deduced a set of differential equations describing the dynamics of the system. We observed that by slowly varying the average peer influence in such a way that the agents attitude changes from conservative to liberal and back, the average social opinion develops a hysteresis cycle. Such hysteretic behavior disappears when the variance of the social influence distribution is large enough. In all the cases studied, the change from conservative to liberal behavior is characterized by the emergence of conservative clusters, i.e., a closed knitted set of society members that follow a leader who agrees with the social status quo when the rule B is challenged.

  2. Public authority control strategy for opinion evolution in social networks

    NASA Astrophysics Data System (ADS)

    Chen, Xi; Xiong, Xi; Zhang, Minghong; Li, Wei

    2016-08-01

    This paper addresses the need to deal with and control public opinion and rumors. Existing strategies to control public opinion include degree, random, and adaptive bridge control strategies. In this paper, we use the HK model to present a public opinion control strategy based on public authority (PA). This means utilizing the influence of expert or high authority individuals whose opinions we control to obtain the optimum effect in the shortest time possible and thus reach a consensus of public opinion. Public authority (PA) is only influenced by individuals' attributes (age, economic status, and education level) and not their degree distribution; hence, in this paper, we assume that PA complies with two types of public authority distribution (normal and power-law). According to the proposed control strategy, our experiment is based on random, degree, and public authority control strategies in three different social networks (small-world, scale-free, and random) and we compare and analyze the strategies in terms of convergence time (T), final number of controlled agents (C), and comprehensive efficiency (E). We find that different network topologies and the distribution of the PA in the network can influence the final controlling effect. While the effect of PA strategy differs in different network topology structures, all structures achieve comprehensive efficiency with any kind of public authority distribution in any network. Our findings are consistent with several current sociological phenomena and show that in the process of public opinion/rumor control, considerable attention should be paid to high authority individuals.

  3. 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

  4. Damage spreading and opinion dynamics on scale-free networks

    NASA Astrophysics Data System (ADS)

    Fortunato, Santo

    2005-03-01

    We study damage spreading among the opinions of a system of agents, subjected to the dynamics of the Krause-Hegselmann consensus model. The damage consists in a sharp change of the opinion of one or more agents in the initial random opinion configuration, supposedly due to some external factors and/or events. This may help to understand for instance under which conditions special shocking events or targeted propaganda are able to influence the results of elections. For agents lying on the nodes of a Barabási-Albert network, there is a damage spreading transition at a low value εd of the confidence bound parameter. Interestingly, we find as well that there is some critical value εs above which the initial perturbation manages to propagate to all other agents.

  5. Advertising and Irreversible Opinion Spreading in Complex Social Networks

    NASA Astrophysics Data System (ADS)

    Candia, Julián

    Irreversible opinion spreading phenomena are studied on small-world and scale-free networks by means of the magnetic Eden model, a nonequilibrium kinetic model for the growth of binary mixtures in contact with a thermal bath. In this model, the opinion of an individual is affected by those of their acquaintances, but opinion changes (analogous to spin flips in an Ising-like model) are not allowed. We focus on the influence of advertising, which is represented by external magnetic fields. The interplay and competition between temperature and fields lead to order-disorder transitions, which are found to also depend on the link density and the topology of the complex network substrate. The effects of advertising campaigns with variable duration, as well as the best cost-effective strategies to achieve consensus within different scenarios, are also discussed.

  6. Consensus of microbiology reporting of ear swab results to primary care clinicians in patients with otitis externa.

    PubMed

    Geyer, M; Howell-Jones, R; Cunningham, R; McNulty, C

    2011-01-01

    Otitis externa is a ubiquitous inflammatory disease; although it arises most commonly from an infection, there is no consensus in the UK for the reporting of ear swab culture results. This study aims to review current microbiology laboratory reporting of ear swab specimens to primary care and reach an evidence-based consensus for a reporting policy. Fifty consecutive ear swab reports were reviewed from each of 12 laboratories in the South West region to determine and discuss reporting practice. The Health Protection Agency (HPA) GP Microbiology Laboratory Use Group reviewed the underlying evidence and worked towards a consensus of expert microbiology opinion for laboratory reporting of ear swab results using a modified version of the Delphi technique. A total of 487 reports from primary care were reviewed (54% female; 46% male). Cultures most commonly yielded Pseudomonas species (36%), Staphylococcus species (21%), Streptococcus species (15%) and fungi (11%). Five reporting policies were agreed: Policy 1: Common pathogens such as group A beta-haemolytic streptococci, Streptococcus pneumoniae, Staphylococcus aureus - Always reported by name with antibiotic susceptibilities. Policy 2: Pseudomonas species - Always reported, but antibiotic susceptibilities only reported in severe disease. Policy 3: Aspergillus, Candida, coliforms and Proteus species, as well as non-group A streptococci and anaerobes - Only reported if moderate numbers of colonies and it is the predominant organism present; if appropriate report antibiotic susceptibilities. Policy 4: Coagulase-negative staphylococci, diphtheroids and enterococci - Not reported by name; generic terms used and antibiotic susceptibilities not reported. Policy 5: When antibiotic susceptibilities reported these must include susceptibility to a topical antibiotic. It is suggested that laboratories should consider adopting this evidence-based reporting consensus for ear swab culture results from primary care patients with

  7. [SECOT consensus on painful knee replacement].

    PubMed

    Vaquero, J; Macule, F; Bello, S; Chana, F; Forriol, F

    2013-01-01

    The opinions of 21 experts in knee surgery were evaluated in this study, using a DELPHI questionnaire method in two successive rounds, on 64 controversial scenarios that covered both the diagnosis and possible treatment of painful knee replacements. The level of consensus was significantly unanimous in 42 items and of the design in 5, with no agreement in 17 of the questions presented. light of the published scientific evidence, the surgeons who took part showed to have a notable level of information on the most effective diagnostic tests, although, it should be pointed out that there was a lack of confidence in the possibility of ruling out an infection when the erythrocyte sedimentation rate and the C-reactive protein were within normal values, which have been demonstrated in the literature to have a high negative predictive value As regards the treatments to employ in the different situations, the responses of the expert panel were mainly in agreement with the data in the literature. The conclusions of this consensus may help other surgeons when they are faced with a painful knee prosthesis.

  8. Harry and Louise and health care reform: romancing public opinion.

    PubMed

    Goldsteen, R L; Goldsteen, K; Swan, J H; Clemeña, W

    2001-12-01

    The question whether the "Harry and Louise" campaign ads, sponsored by the Health Insurance Association of America (HIAA) during the 1993-1994 health care reform debate, influenced public opinion has particular relevance today since interest groups are increasingly choosing commercial-style mass media campaigns to sway public opinion about health policy issues. Our study revisits the issue of the Harry and Louise campaign's influence on public opinion, comparing the ad campaign's messages to changes in opinion about health care reform over a twenty-six-month period in Oklahoma. Looking at the overall trends just prior to the introduction of the Harry and Louise campaign, public opinion was going in the "wrong" direction, from the HIAA perspective. Moreover, public opinion continued in the wrong direction until the mid-point of the campaign. However, in either the turning point of the campaign in terms of message content and tone or in the lag period following it, public opinion reversed on each health reform issue and returned to pre-campaign levels. It appears from these findings that the campaign captured public opinion when support for issues that were unfavorable to HIAA members was increasing and turned public opinion back to pre-campaign levels. The campaign may result in many more such marriages of political interest groups and commercial advertisers for the purpose of demobilizing public support for health policy initiatives that are unfavorable to special interests.

  9. Necessary and sufficient conditions of stationary average consensus for second-order multi-agent systems

    NASA Astrophysics Data System (ADS)

    Pei, Yongquan; Sun, Jitao

    2016-11-01

    This paper investigates the stationary average consensus problem for second-order discrete-time multi-agent systems (SDMAS). A stationary consensus problem is to find a control algorithm that brings the state of a group of agents to a common constant value which is called the collective decision. We introduce the concept of stationary average consensus of SDMAS and propose a consensus algorithm. Based on the polynomial stability and the graph theory, we obtain two necessary and sufficient conditions of stationary average consensus of SDMAS. The last theorem provides an algebraic criterion of stationary average consensus, and can help us to determine the parameters in the consensus algorithm. Furthermore, in this consensus algorithm, only the states of the agents are transferred among the agents. Therefore, this algorithm can not only solve the stationary average consensus problem but also reduce the amount of transferred data. A numerical example is provided to illustrate the efficiency of our results.

  10. Developing biodiversity indicators on a stakeholders' opinions basis: the gypsum industry Key Performance Indicators framework.

    PubMed

    Pitz, Carline; Mahy, Grégory; Vermeulen, Cédric; Marlet, Christine; Séleck, Maxime

    2016-07-01

    This study aims to establish a common Key Performance Indicators (KPIs) framework for reporting about the gypsum industry biodiversity at the European level. In order to integrate different opinions and to reach a consensus framework, an original participatory process approach has been developed among different stakeholder groups: Eurogypsum, European and regional authorities, university scientists, consulting offices, European and regional associations for the conservation of nature, and the extractive industry. The strategy is developed around four main steps: (1) building of a maximum set of indicators to be submitted to stakeholders based on the literature (Focus Group method); (2) evaluating the consensus about indicators through a policy Delphi survey aiming at the prioritization of indicator classes using the Analytic Hierarchy Process method (AHP) and of individual indicators; (3) testing acceptability and feasibility through analysis of Environmental Impact Assessments (EIAs) and visits to three European quarries; (4) Eurogypsum final decision and communication. The resulting framework contains a set of 11 indicators considered the most suitable for all the stakeholders. Our KPIs respond to European legislation and strategies for biodiversity. The framework aims at improving sustainability in quarries and at helping to manage biodiversity as well as to allow the creation of coherent reporting systems. The final goal is to allow for the definition of the actual biodiversity status of gypsum quarries and allow for enhancing it. The framework is adaptable to the local context of each gypsum quarry.

  11. University Opinion Poll 9: Child Care, MPIRG, Lettuce. Preliminary Report.

    ERIC Educational Resources Information Center

    Matross, Ronald; And Others

    The University Opinion Poll conducted a survey of student opinion on issues related to University-sponsored day care, the role of the Minnesota Public Interest Research Group (MPIRG) and the University's policy on buying lettuce for its food services. Four hundred fifty-two respondents, 76% of a random sample of University of Minnesota students,…

  12. Opinions of the Geography Teacher Candidates toward Mind Maps

    ERIC Educational Resources Information Center

    Seyihoglu, Aysegul

    2013-01-01

    The purpose of this study is to reveal the opinions of the teacher candidates about mind mapping technique used in Geography education of undergraduate program. In this study, the qualitative research techniques were used. The study group consists of 55 teacher candidates. The teacher candidates have been asked for their opinions about the process…

  13. National turnaround time survey: professional consensus standards for optimal performance and thresholds considered to compromise efficient and effective clinical management.

    PubMed

    McKillop, Derek J; Auld, Peter

    2017-01-01

    Background Turnaround time can be defined as the time from receipt of a sample by the laboratory to the validation of the result. The Royal College of Pathologists recommends that a number of performance indicators for turnaround time should be agreed with stakeholders. The difficulty is in arriving at a goal which has some evidence base to support it other than what may simply be currently achievable technically. This survey sought to establish a professional consensus on the goals and meaning of targets for laboratory turnaround time. Methods A questionnaire was circulated by the National Audit Committee to 173 lead consultants for biochemistry in the UK. The survey asked each participant to state their current target turnaround time for core investigations in a broad group of clinical settings. Each participant was also asked to provide a professional opinion on what turnaround time would pose an unacceptable risk to patient safety for each departmental category. A super majority (2/3) was selected as the threshold for consensus. Results The overall response rate was 58% ( n = 100) with a range of 49-72% across the individual Association for Clinical Biochemistry and Laboratory Medicine regions. The consensus optimal turnaround time for the emergency department was <1 h with >2 h considered unacceptable. The times for general practice and outpatient department were <24 h and >48 h and for Wards <4 h and >12 h, respectively. Conclusions We consider that the figures provide a useful benchmark of current opinion, but clearly more empirical standards will have to develop alongside other aspects of healthcare delivery.

  14. Bruxism defined and graded: an international consensus.

    PubMed

    Lobbezoo, F; Ahlberg, J; Glaros, A G; Kato, T; Koyano, K; Lavigne, G J; de Leeuw, R; Manfredini, D; Svensson, P; Winocur, E

    2013-01-01

    To date, there is no consensus about the definition and diagnostic grading of bruxism. A written consensus discussion was held among an international group of bruxism experts as to formulate a definition of bruxism and to suggest a grading system for its operationalisation. The expert group defined bruxism as a repetitive jaw-muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. Bruxism has two distinct circadian manifestations: it can occur during sleep (indicated as sleep bruxism) or during wakefulness (indicated as awake bruxism). For the operationalisation of this definition, the expert group proposes a diagnostic grading system of 'possible', 'probable' and 'definite' sleep or awake bruxism. The proposed definition and grading system are suggested for clinical and research purposes in all relevant dental and medical domains.

  15. A Commentary on Content and Process of the Interdisciplinary Consensus Statement.

    ERIC Educational Resources Information Center

    Reed, L. Dennison

    1994-01-01

    Lauds the efforts of those involved in the international conference on child sexual abuse, citing a dearth of information and conflicting opinions in the field. The author supports his contention of lack of consensus by discussing reactions to Michael Jackson's child sexual abuse litigation by mental health professionals. (JPS)

  16. Consensus Paper: Pathological Mechanisms Underlying Neurodegeneration in Spinocerebellar Ataxias

    PubMed Central

    Matilla-Dueñas, A.; Ashizawa, T.; Brice, A.; Magri, S.; McFarland, K. N.; Pandolfo, M.; Pulst, S. M.; Riess, O.; Rubinsztein, D. C.; Schmidt, J.; Schmidt, T.; Scoles, D. R.; Stevanin, G.; Taroni, F.; Underwood, B. R.; Sánchez, I.

    2014-01-01

    Intensive scientific research devoted in the recent years to understand the molecular mechanisms or neurodegeneration in spinocerebellar ataxias (SCAs) are identifying new pathways and targets providing new insights and a better understanding of the molecular pathogenesis in these diseases. In this consensus manuscript, the authors discuss their current views on the identified molecular processes causing or modulating the neurodegenerative phenotype in spinocerebellar ataxias with the common opinion of translating the new knowledge acquired into candidate targets for therapy. The following topics are discussed: transcription dysregulation, protein aggregation, autophagy, ion channels, the role of mitochondria, RNA toxicity, modulators of neurodegeneration and current therapeutic approaches. Overall point of consensus includes the common vision of neurodegeneration in SCAs as a multifactorial, progressive and reversible process, at least in early stages. Specific points of consensus include the role of the dysregulation of protein folding, transcription, bioenergetics, calcium handling and eventual cell death with apoptotic features of neurons during SCA disease progression. Unresolved questions include how the dysregulation of these pathways triggers the onset of symptoms and mediates disease progression since this understanding may allow effective treatments of SCAs within the window of reversibility to prevent early neuronal damage. Common opinions also include the need for clinical detection of early neuronal dysfunction, for more basic research to decipher the early neurodegenerative process in SCAs in order to give rise to new concepts for treatment strategies and for the translation of the results to preclinical studies and, thereafter, in clinical practice. PMID:24307138

  17. A consensus document for the selection of lung transplant candidates: 2014--an update from the Pulmonary Transplantation Council of the International Society for Heart and Lung Transplantation.

    PubMed

    Weill, David; Benden, Christian; Corris, Paul A; Dark, John H; Davis, R Duane; Keshavjee, Shaf; Lederer, David J; Mulligan, Michael J; Patterson, G Alexander; Singer, Lianne G; Snell, Greg I; Verleden, Geert M; Zamora, Martin R; Glanville, Allan R

    2015-01-01

    The appropriate selection of lung transplant recipients is an important determinant of outcomes. This consensus document is an update of the recipient selection guidelines published in 2006. The Pulmonary Council of the International Society for Heart and Lung Transplantation (ISHLT) organized a Writing Committee of international experts to provide consensus opinion regarding the appropriate timing of referral and listing of candidates for lung transplantation. A comprehensive search of the medical literature was conducted with the assistance of a medical librarian. Writing Committee members were assigned specific topics to research and discuss. The Chairs of the Writing Committee were responsible for evaluating the completeness of the literature search, providing editorial support for the manuscript, and organizing group discussions regarding its content. The consensus document makes specific recommendations regarding the timing of referral and of listing for lung transplantation. These recommendations include discussions not present in previous ISHLT guidelines, including lung allocation scores, bridging to transplant with mechanical circulatory and ventilator support, and expanded indications for lung transplantation. In the absence of high-grade evidence to support decision making, these consensus guidelines remain part of a continuum of expert opinion based on available studies and personal experience. Some positions are immutable. Although transplant is rightly a treatment of last resort for end-stage lung disease, early referral allows proper evaluation and thorough patient education. Subsequent waiting list activation implies a tacit agreement that transplant offers a significant individual survival advantage. It is both the challenge and the responsibility of the transplant community globally to ensure organ allocation maximizes the potential benefits of a scarce resource, thereby achieving that advantage.

  18. Methodological Quality of Consensus Guidelines in Implant Dentistry

    PubMed Central

    Faggion, Clovis Mariano; Apaza, Karol; Ariza-Fritas, Tania; Málaga, Lilian; Giannakopoulos, Nikolaos Nikitas; Alarcón, Marco Antonio

    2017-01-01

    Background Consensus guidelines are useful to improve clinical decision making. Therefore, the methodological evaluation of these guidelines is of paramount importance. Low quality information may guide to inadequate or harmful clinical decisions. Objective To evaluate the methodological quality of consensus guidelines published in implant dentistry using a validated methodological instrument. Methods The six implant dentistry journals with impact factors were scrutinised for consensus guidelines related to implant dentistry. Two assessors independently selected consensus guidelines, and four assessors independently evaluated their methodological quality using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument. Disagreements in the selection and evaluation of guidelines were resolved by consensus. First, the consensus guidelines were analysed alone. Then, systematic reviews conducted to support the guidelines were included in the analysis. Non-parametric statistics for dependent variables (Wilcoxon signed rank test) was used to compare both groups. Results Of 258 initially retrieved articles, 27 consensus guidelines were selected. Median scores in four domains (applicability, rigour of development, stakeholder involvement, and editorial independence), expressed as percentages of maximum possible domain scores, were below 50% (median, 26%, 30.70%, 41.70%, and 41.70%, respectively). The consensus guidelines and consensus guidelines + systematic reviews data sets could be compared for 19 guidelines, and the results showed significant improvements in all domain scores (p < 0.05). Conclusions Methodological improvement of consensus guidelines published in major implant dentistry journals is needed. The findings of the present study may help researchers to better develop consensus guidelines in implant dentistry, which will improve the quality and trust of information needed to make proper clinical decisions. PMID:28107405

  19. A Method for Consensus Reaching in Product Kansei Evaluation Using Advanced Particle Swarm Optimization

    PubMed Central

    2017-01-01

    Consumers' opinions toward product design alternatives are often subjective and perceptual, which reflect their perception about a product and can be described using Kansei adjectives. Therefore, Kansei evaluation is often employed to determine consumers' preference. However, how to identify and improve the reliability of consumers' Kansei evaluation opinions toward design alternatives has an important role in adding additional insurance and reducing uncertainty to successful product design. To solve this problem, this study employs a consensus model to measure consistence among consumers' opinions, and an advanced particle swarm optimization (PSO) algorithm combined with Linearly Decreasing Inertia Weight (LDW) method is proposed for consensus reaching by minimizing adjustment of consumers' opinions. Furthermore, the process of the proposed method is presented and the details are illustrated using an example of electronic scooter design evaluation. The case study reveals that the proposed method is promising for reaching a consensus through searching optimal solutions by PSO and improving the reliability of consumers' evaluation opinions toward design alternatives according to Kansei indexes. PMID:28316619

  20. A Method for Consensus Reaching in Product Kansei Evaluation Using Advanced Particle Swarm Optimization.

    PubMed

    Yang, Yan-Pu

    2017-01-01

    Consumers' opinions toward product design alternatives are often subjective and perceptual, which reflect their perception about a product and can be described using Kansei adjectives. Therefore, Kansei evaluation is often employed to determine consumers' preference. However, how to identify and improve the reliability of consumers' Kansei evaluation opinions toward design alternatives has an important role in adding additional insurance and reducing uncertainty to successful product design. To solve this problem, this study employs a consensus model to measure consistence among consumers' opinions, and an advanced particle swarm optimization (PSO) algorithm combined with Linearly Decreasing Inertia Weight (LDW) method is proposed for consensus reaching by minimizing adjustment of consumers' opinions. Furthermore, the process of the proposed method is presented and the details are illustrated using an example of electronic scooter design evaluation. The case study reveals that the proposed method is promising for reaching a consensus through searching optimal solutions by PSO and improving the reliability of consumers' evaluation opinions toward design alternatives according to Kansei indexes.

  1. Adaptive bipartite consensus on coopetition networks

    NASA Astrophysics Data System (ADS)

    Hu, Jiangping; Zhu, Hong

    2015-07-01

    In this paper, a bipartite consensus tracking problem is considered for a group of autonomous agents on a coopetition network, on which the agents interact cooperatively and competitively simultaneously. The coopetition network involves positive and negative edges and is conveniently modeled by a signed graph. Additionally, the dynamics of all the agents are subjected to unknown disturbances, which are represented by linearly parameterized models. An adaptive estimation scheme is designed for each agent by virtue of the relative position measurements and the relative velocity measurements from its neighbors. Then a consensus tracking law is proposed for a new distributed system, which uses the relative measurements as the new state variables. The convergence of the consensus tracking error and the parameter estimation are analyzed even when the coopetition network is time-varying and no more global information about the bounds of the unknown disturbances is available to all the agents. Finally, some simulation results are provided to demonstrate the formation of the bipartite consensus on the coopetition network.

  2. Report on the consensus workshop on formaldehyde

    SciTech Connect

    Gough, M.; Hart, R.; Karrh, B.W.; Koestner, A.; Neal, R.; Parkinson, D.; Perera, F.; Powell, K.E.; Rosenkranz, S.

    1984-01-01

    The Consensus Workshop on Formaldehyde consisted of bringing together scientists from academia, government, industry and public interest groups to address some important toxicological questions concerning the health effects of formaldehyde. The participants in the workshop, the Executive Panel which coordinated the meeting, and the questions posed, all were chosen through a broadly based nomination process in order to achieve as comprehensive a consensus as possible. The subcommittees considered the toxicological problems associated with formaldehyde in the areas of exposure, epidemiology, carcinogenicity/histology/genotoxicity, immunology/sensitization/irritation, structure activity/biochemistry metabolism, reproduction/teratology, behavior/neurotoxicity/psychology and risk estimation. Some questions considered included the possible human carcinogenicity of formaldehyde, as well as other human health effects, and the interpretation of pathology induced by formaldehyde. These reports, plus introductory material on the procedures used in setting up the Consensus Workshop are presented here. Additionally, there is included a listing of the data base that was made available to the panel chairmen prior to the meeting and was readily accessible to the participants during their deliberations in the meeting. This data base, since it was computerized, was also capable of being searched for important terms. These materials were supplemented by information brought by the panelists. The workshop has defined the consensus concerning a number of major points in formaldehyde toxicology and has identified a number of major deficits in understanding which are important guides to future research. 264 references.

  3. Report on the Consensus Workshop on Formaldehyde.

    PubMed Central

    1984-01-01

    The Consensus Workshop on Formaldehyde consisted of bringing together scientists from academia, government, industry and public interest groups to address some important toxicological questions concerning the health effects of formaldehyde. The participants in the workshop, the Executive Panel which coordinated the meeting, and the questions posed, all were chosen through a broadly based nomination process in order to achieve as comprehensive a consensus as possible. The subcommittees considered the toxicological problems associated with formaldehyde in the areas of exposure, epidemiology, carcinogenicity/histology/genotoxicity, immunology/sensitization/irritation, structure activity/biochemistry/metabolism, reproduction/teratology, behavior/neurotoxicity/psychology and risk estimation. Some questions considered included the possible human carcinogenicity of formaldehyde, as well as other human health effects, and the interpretation of pathology induced by formaldehyde. These reports, plus introductory material on the procedures used in setting up the Consensus Workshop are presented here. Additionally, there is included a listing of the data base that was made available to the panel chairmen prior to the meeting and was readily accessible to the participants during their deliberations in the meeting. This data base, since it was computerized, was also capable of being searched for important terms. These materials were supplemented by information brought by the panelists. The workshop has defined the consensus concerning a number of major points in formaldehyde toxicology and has identified a number of major deficits in understanding which are important guides to future research. PMID:6525992

  4. The role of persuasion power on the consensus formation

    NASA Astrophysics Data System (ADS)

    Gündüç, Semra; Eryiğit, Recep

    2015-05-01

    An opinion dynamics model which is based on a version of two dimensional Sznajd model is introduced. According to this model the dynamics is governed by the interactions between four agents which live on the corners of a plaquette and their neighbors. The distinctive feature of the model is that each individual is identified by two parameters, namely, opinion and persuasion ability. The united group may persuade the individuals living at the neighboring sites according to both the number and their persuasion ability. This form of the model is used to discuss opinion dynamics processes in societies where a campaign is conducted by the principle being united and putting forward arguments which are commonly accepted by the members of the society. It is seen that persuasion parameter plays the major role in the societies where a minority opinion gains ground to be the major opinion of the society. The model has been applied to the Scottish referendum opinion poles data since 2011. The model in its simplicity, predicts that the arguments of the minority opinion ("YES" votes) are more appealing despite the observed win of the "NO" votes. This result may be due to the abundance of the "NO" opinion supporters at the beginning of the campaign.

  5. The development of a consensus definition for healthcare improvement science (HIS) in seven European countries: A consensus methods approach

    PubMed Central

    Macrae, Rhoda; Lillo-Crespo, Manuel; Rooney, Kevin D

    2017-01-01

    Abstract Introduction There is a limited body of research in the field of healthcare improvement science (HIS). Quality improvement and ‘change making’ should become an intrinsic part of everyone’s job, every day in all parts of the healthcare system. The lack of theoretical grounding may partly explain the minimal transfer of health research into health policy. Methods This article seeks to present the development of the definition for healthcare improvement science. A consensus method approach was adopted with a two-stage Delphi process, expert panel and consensus group techniques. A total of 18 participants were involved in the expert panel and consensus group, and 153 answers were analysed as a part of the Delphi survey. Participants were researchers, educators and healthcare professionals from Scotland, Slovenia, Spain, Italy, England, Poland, and Romania. Results A high level of consensus was achieved for the broad definition in the 2nd Delphi iteration (86%). The final definition was agreed on by the consensus group: ‘Healthcare improvement science is the generation of knowledge to cultivate change and deliver person-centred care that is safe, effective, efficient, equitable and timely. It improves patient outcomes, health system performance and population health.’ Conclusions The process of developing a consensus definition revealed different understandings of healthcare improvement science between the participants. Having a shared consensus definition of healthcare improvement science is an important step forward, bringing about a common understanding in order to advance the professional education and practice of healthcare improvement science. PMID:28289467

  6. After seven years, where's the consensus

    SciTech Connect

    Norman, M.R.

    1993-04-01

    It has been 7 years since the discovery of copper oxide superconductors, yet there is no consensus on the correct theory for this phenomenon. The theory can be divided into 3 groups: ordinary (phonons), exotic (AF spin fluctuations, nested Fermi liquid, excitons, spin bags, odd frequency pairing), and revolutionary (Luttinger liquid, spin-charge separation, gauge theories, anyons, marginal Fermi liquid). C-axis dispersion, dHvA, and magneto-oscillations are also discussed.

  7. Shoulder biomechanics: today's consensus and tomorrow's perspectives.

    PubMed

    Cutti, Andrea Giovanni; Veeger, H E J DirkJan

    2009-05-01

    Shoulder biomechanics is a fast growing field, which is progressively expanding its focus to include more applied research. The papers included in this Special Issue confirm this trend. After a classification of the papers as dealing with fundamental or applied research through theoretical or experimental methods, in this Editorial we tried to summarize the elements of consensus and the open issues discussed during the last International Shoulder Group meeting, held in Bologna (Italy) in 2008.

  8. Designing Graduate-Level Plant Breeding Curriculum: A Delphi Study of Private Sector Stakeholder Opinions

    ERIC Educational Resources Information Center

    Miller, Jane K.; Repinski, Shelby L.; Hayes, Kathryn N.; Bliss, Frederick A.; Trexler, Cary J.

    2011-01-01

    A broad-based survey using the Delphi method was conducted to garner current information from private sector stakeholders and build consensus opinions supporting key ideas for enhancing plant breeder education and training. This study asked respondents to suggest and rate topics and content they deemed most important to plant breeding graduate…

  9. Molecular subgroups of medulloblastoma: the current consensus.

    PubMed

    Taylor, Michael D; Northcott, Paul A; Korshunov, Andrey; Remke, Marc; Cho, Yoon-Jae; Clifford, Steven C; Eberhart, Charles G; Parsons, D Williams; Rutkowski, Stefan; Gajjar, Amar; Ellison, David W; Lichter, Peter; Gilbertson, Richard J; Pomeroy, Scott L; Kool, Marcel; Pfister, Stefan M

    2012-04-01

    Medulloblastoma, a small blue cell malignancy of the cerebellum, is a major cause of morbidity and mortality in pediatric oncology. Current mechanisms for clinical prognostication and stratification include clinical factors (age, presence of metastases, and extent of resection) as well as histological subgrouping (classic, desmoplastic, and large cell/anaplastic histology). Transcriptional profiling studies of medulloblastoma cohorts from several research groups around the globe have suggested the existence of multiple distinct molecular subgroups that differ in their demographics, transcriptomes, somatic genetic events, and clinical outcomes. Variations in the number, composition, and nature of the subgroups between studies brought about a consensus conference in Boston in the fall of 2010. Discussants at the conference came to a consensus that the evidence supported the existence of four main subgroups of medulloblastoma (Wnt, Shh, Group 3, and Group 4). Participants outlined the demographic, transcriptional, genetic, and clinical differences between the four subgroups. While it is anticipated that the molecular classification of medulloblastoma will continue to evolve and diversify in the future as larger cohorts are studied at greater depth, herein we outline the current consensus nomenclature, and the differences between the medulloblastoma subgroups.

  10. Brazilian consensus on photoprotection.

    PubMed

    Schalka, Sérgio; Steiner, Denise; Ravelli, Flávia Naranjo; Steiner, Tatiana; Terena, Aripuanã Cobério; Marçon, Carolina Reato; Ayres, Eloisa Leis; Addor, Flávia Alvim Sant'anna; Miot, Helio Amante; Ponzio, Humberto; Duarte, Ida; Neffá, Jane; Cunha, José Antônio Jabur da; Boza, Juliana Catucci; Samorano, Luciana de Paula; Corrêa, Marcelo de Paula; Maia, Marcus; Nasser, Nilton; Leite, Olga Maria Rodrigues Ribeiro; Lopes, Otávio Sergio; Oliveira, Pedro Dantas; Meyer, Renata Leal Bregunci; Cestari, Tânia; Reis, Vitor Manoel Silva dos; Rego, Vitória Regina Pedreira de Almeida

    2014-01-01

    Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of non-melanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection.

  11. Between consensus and contestation.

    PubMed

    Weale, Albert

    2016-08-15

    Purpose - Noting that discussions of public participation and priority setting typically presuppose certain political theories of democracy, the purpose of this paper is to discuss two theories: the consensual and the agonistic. The distinction is illuminating when considering the difference between institutionalized public participation and contestatory participation. Design/methodology/approach - The approach is a theoretical reconstruction of two ways of thinking about public participation in relation to priority setting in health care, drawing on the work of Habermas, a deliberative theorist, and Mouffe, a theorist of agonism. Findings - The different theoretical approaches can be associated with different ways of understanding priority setting. In particular, agonistic democratic theory would understand priority setting as system of inclusions and exclusions rather than the determination of a consensus of social values, which is the typical deliberative way of thinking about the issues. Originality/value - The paper shows the value of drawing out explicitly the tacit assumptions of practices of political participation in order to reveal their scope and limitations. It suggests that making such theoretical presuppositions explicit has value for health services management in recognizing these implicit choices.

  12. Brazilian Consensus on Photoprotection

    PubMed Central

    Schalka, Sérgio; Steiner, Denise; Ravelli, Flávia Naranjo; Steiner, Tatiana; Terena, Aripuanã Cobério; Marçon, Carolina Reato; Ayres, Eloisa Leis; Addor, Flávia Alvim Sant'anna; Miot, Helio Amante; Ponzio, Humberto; Duarte, Ida; Neffá, Jane; da Cunha, José Antônio Jabur; Boza, Juliana Catucci; Samorano, Luciana de Paula; Corrêa, Marcelo de Paula; Maia, Marcus; Nasser, Nilton; Leite, Olga Maria Rodrigues Ribeiro; Lopes, Otávio Sergio; Oliveira, Pedro Dantas; Meyer, Renata Leal Bregunci; Cestari, Tânia; dos Reis, Vitor Manoel Silva; Rego, Vitória Regina Pedreira de Almeida

    2014-01-01

    Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of non-melanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection. PMID:25761256

  13. Expert opinion vs. empirical evidence

    PubMed Central

    Herman, Rod A; Raybould, Alan

    2014-01-01

    Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years spurred by examples where evidence indicated that certain treatments recommended by expert opinions increased death rates. We suggest that scientific evidence should also take priority over expert opinion in the regulation of genetically modified crops (GM). Examples of regulatory data requirements that are not justified based on the mass of evidence are described, and it is suggested that expertise in risk assessment should guide evidence-based regulation of GM crops. PMID:24637724

  14. [Neuroendocrine dysfunction and brain damage. A consensus statement].

    PubMed

    Leal-Cerro, Alfonso; Rincón, María Dolores; Domingo, Manel Puig

    2009-01-01

    This consensus statement aims to enhance awareness of the incidence and risks of hypopituitarism in patients with traumatic brain injury (TBI) and/or brain hemorrhages among physicians treating patients with brain damage. The importance of this problem is related not only to the frequency of TBI but also to its prevalence in younger populations. The consequences of TBI are characterized by a series of symptoms that depend on the type of sequels related to neuroendocrine dysfunction. The signs and symptoms of hypopituitarism are often confused with those of other sequels of TBI. Consequently, patients with posttraumatic hypopituitarism may receive suboptimal rehabilitation unless the underlying hormone deficiency is identified and treated. This consensus is based on the recommendation supported by expert opinion that patients with a TBI and/or brain hemorrhage should undergo endocrine evaluation in order to assess pituitary function and, if deficiency is detected, should receive hormone replacement therapy.

  15. Does the weather influence public opinion about climate change?

    NASA Astrophysics Data System (ADS)

    Donner, S. D.; McDaniel, J.

    2010-12-01

    Public opinion in North America about the science of anthropogenic climate change and the motivation for policy action has been variable over the past twenty years. The trends in public opinion over time have been attributed the general lack of pressing public concern about climate change to a range of political, economic and psychological factors. One driving force behind the variability in polling data from year to year may be the weather itself. The difference between what we “expect” - the climate - and what we “get” - the weather - can be a major source of confusion and obfuscation in the public discourse about climate change. For example, reaction to moderate global temperatures in 2007 and 2008 may have helped prompt the spread of a “global cooling” meme in the public and the news media. At the same time, a decrease in the belief in the science of climate change and the need for action has been noted in opinion polls. This study analyzes the relationship between public opinion about climate change and the weather in the U.S. since the mid-1980s using historical polling data from several major organizations (e.g. Gallup, Pew, Harris Interactive, ABC News), historical monthly air temperature (NCDC) and a survey of opinion articles from major U.S. newspapers (Washington Post, New York Times, Wall Street Journal, Houston Chronicle, USA Today). Seasonal and annual monthly temperature anomalies for the northeastern U.S and the continental U.S are compared with available national opinion data for three general categories of questions: i) Is the climate warming?, ii) Is the observed warming due to human activity?, and iii) Are you concerned about climate change? The variability in temperature and public opinion over time is also compared with the variability in the fraction of opinion articles in the newspapers (n ~ 7000) which express general agreement or disagreement with IPCC Summary for Policymakers consensus statements on climate change (“most of

  16. Communications and Public Opinion: A Public Opinion Quarterly Reader.

    ERIC Educational Resources Information Center

    Carlson, Robert O., Ed.

    The phenomenon of the close relationship between communication and public opinion is shown in this book to have played a major role historically in the measurement of support for political policies, officials, and candidates. The communications media influence public opinion and are subject to it; yet the precise nature and definition of public…

  17. [Argentine Consensus of Respiratory Rehabilitation].

    PubMed

    Sívori, Martín; Benzo, Roberto; Rhodius, Edgardo; Jolly, Enrique; Boim, Clarisa; Saadia, Marcela; Conti, Ernesto; Guevara, Ivan; Carles, Daniel; Victorio, Carlos; Santini, Fabian; Ratto, Patricia; Capparelli, Ignacio; Prieto, Ernesto; Azvalinsky, Marcos; Alais, Maria

    2004-01-01

    A group of pulmonologists and physical therapists from the Asociacion Argentina de Medicina Respiratoria revised the scientific literature on Respiratory Rehabilitation (RR) to elaborate evidence-based national recommendations to promote its use. RR is a multidisciplinary program of care for patients with chronic respiratory impairment, individually tailored, designed to optimize physical and social performance and autonomy of patients. It is particularly indicated in patients with Chronic Obstructive Pulmonary Disease (COPD) with exercise intolerance. Inclusion and exclusion criteria, guidelines for initial evaluation and follow up have been defined. The resources needed were defined. It was recommended a hospital ambulatory program with domiciliary complement. A pulmonologist and physical therapist were required for the program as minimum. Aerobic training was recommended for lower limb (LL) (Evidence A) and upper limb (UL) (Evidence B), strength training for LL and UL (Evidence C), as well as respiratory muscles training by resistive inspiratory threshold load (Evidence D) and other physiotherapy techniques were recommended for specific patients. In addition recommendations have been made for educational objectives of the program, nutritional and psychological support. The positive impact of RR on health care was analyzed through the reduction in exacerbation of COPD, length of hospital stay and cost. RR is a key component in the treatment of COPD patients. This evidenced-based consensus statement was prepared to provide recommendations to be implemented nationally.

  18. [Consensus on safe infant's furniture: brief version].

    PubMed

    2016-04-01

    Several products that are used for support, transportation or recreation in infants and children can cause non intentional injuries. This consensus tries to provide pediatricians and families with the necessary elements to recognize and choose safe infant's furniture. A group of 24 experts developed a consensus according to Delphi's method, which consists in successiverounds of questions. Recommendations are supported with bibliography. Infant walkers are not recommended, as they are considered useless and dangerous. Guidelines are given to choose appropriate child restraint systems, when and how to use them, and how to install them in a safe way. Injuries and prevention measures related to strollers, high chairs, cribs and bunk beds are described. Risks and the way to avoid them are diagrammed in figures that can be used to transmit recommendations to families.

  19. Maintaining success, reducing treatment burden, focusing on survivorship: highlights from the third European consensus conference on diagnosis and treatment of germ-cell cancer

    PubMed Central

    Beyer, J.; Albers, P.; Altena, R.; Aparicio, J.; Bokemeyer, C.; Busch, J.; Cathomas, R.; Cavallin-Stahl, E.; Clarke, N. W.; Claßen, J.; Cohn-Cedermark, G.; Dahl, A. A.; Daugaard, G.; De Giorgi, U.; De Santis, M.; De Wit, M.; De Wit, R.; Dieckmann, K. P.; Fenner, M.; Fizazi, K.; Flechon, A.; Fossa, S. D.; Germá Lluch, J. R.; Gietema, J. A.; Gillessen, S.; Giwercman, A.; Hartmann, J. T.; Heidenreich, A.; Hentrich, M.; Honecker, F.; Horwich, A.; Huddart, R. A.; Kliesch, S.; Kollmannsberger, C.; Krege, S.; Laguna, M. P.; Looijenga, L. H. J.; Lorch, A.; Lotz, J. P.; Mayer, F.; Necchi, A.; Nicolai, N.; Nuver, J.; Oechsle, K.; Oldenburg, J.; Oosterhuis, J. W.; Powles, T.; Rajpert-De Meyts, E.; Rick, O.; Rosti, G.; Salvioni, R.; Schrader, M.; Schweyer, S.; Sedlmayer, F.; Sohaib, A.; Souchon, R.; Tandstad, T.; Winter, C.; Wittekind, C.

    2013-01-01

    In November 2011, the Third European Consensus Conference on Diagnosis and Treatment of Germ-Cell Cancer (GCC) was held in Berlin, Germany. This third conference followed similar meetings in 2003 (Essen, Germany) and 2006 (Amsterdam, The Netherlands) [Schmoll H-J, Souchon R, Krege S et al. European consensus on diagnosis and treatment of germ-cell cancer: a report of the European Germ-Cell Cancer Consensus Group (EGCCCG). Ann Oncol 2004; 15: 1377–1399; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of germ-cell cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part I. Eur Urol 2008; 53: 478–496; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of germ-cell cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part II. Eur Urol 2008; 53: 497–513]. A panel of 56 of 60 invited GCC experts from all across Europe discussed all aspects on diagnosis and treatment of GCC, with a particular focus on acute and late toxic effects as well as on survivorship issues. The panel consisted of oncologists, urologic surgeons, radiooncologists, pathologists and basic scientists, who are all actively involved in care of GCC patients. Panelists were chosen based on the publication activity in recent years. Before the meeting, panelists were asked to review the literature published since 2006 in 20 major areas concerning all aspects of diagnosis, treatment and follow-up of GCC patients, and to prepare an updated version of the previous recommendations to be discussed at the conference. In addition, ∼50 E-vote questions were drafted and presented at the conference to address the most controversial areas for a poll of expert opinions. Here, we present the main recommendations and controversies of this meeting. The votes of the panelists are added as online supplements. PMID:23152360

  20. Consensus Algorithms Over Fading Channels

    DTIC Science & Technology

    2010-10-01

    studying the effect of fading and collisions on the performance of wireless consensus gossiping and in comparing its cost (measured in terms of number of...not assumed to be symmetric under A2. III. RELATED WORK There has been a resurgence of interest in characterizing consen- sus and gossip algorithms...tree, and then distribute the consensus value, with a finite number of exchanges. The price paid is clearly that of finding the appropriate routing

  1. A model of the effects of authority on consensus formation in adaptive networks: Impact on network topology and robustness

    NASA Astrophysics Data System (ADS)

    Prettejohn, Brenton J.; Berryman, Matthew J.; McDonnell, Mark D.

    2013-02-01

    Opinions of individuals in real social networks are arguably strongly influenced by external determinants, such as the opinions of those perceived to have the highest levels of authority. In order to model this, we have extended an existing model of consensus formation in an adaptive network by the introduction of a parameter representing each agent’s level of ‘authority’, based on their opinion relative to the overall opinion distribution. We found that introducing this model, along with a randomly varying opinion convergence factor, significantly impacts the final state of converged opinions and the number of interactions required to reach that state. We also determined the relationship between initial and final network topologies for this model, and whether the final topology is robust to node removals. Our results indicate firstly that the process of consensus formation with a model of authority consistently transforms the network from an arbitrary initial topology to one with distinct measurements in mean shortest path, clustering coefficient, and degree distribution. Secondly, we found that subsequent to the consensus formation process, the mean shortest path and clustering coefficient are less affected by both random and targeted node disconnection. Speculation on the relevance of these results to real world applications is provided.

  2. The influence of persuasion in opinion formation and polarization

    NASA Astrophysics Data System (ADS)

    La Rocca, C. E.; Braunstein, L. A.; Vazquez, F.

    2014-05-01

    We present a model that explores the influence of persuasion in a population of agents with positive and negative opinion orientations. The opinion of each agent is represented by an integer number k that expresses its level of agreement on a given issue, from totally against k=-M to totally in favor k = M. Same-orientation agents persuade each other with probability p, becoming more extreme, while opposite-orientation agents become more moderate as they reach a compromise with probability q. The population initially evolves to (a) a polarized state for r=p/q\\gt 1 , where opinions' distribution is peaked at the extreme values k=+/- M , or (b) a centralized state for r < 1, with most opinions around k=+/- 1 . When r \\gg 1 , polarization lasts for a time that diverges as r^M \\ln N , where N is the population's size. Finally, an extremist consensus (k = M or -M ) is reached in a time that scales as r^{-1} for r \\ll 1 .

  3. Stochastic model of agent interaction with opinion leaders

    NASA Astrophysics Data System (ADS)

    Ellero, Andrea; Fasano, Giovanni; Sorato, Annamaria

    2013-04-01

    We analyze the problem of agents' interactions in a given population. The purpose of this paper is twofold. Starting from a scheme proposed by Galam [Physica A0378-437110.1016/S0378-4371(02)01582-0 320, 571 (2003)], which is based on a majority rule to treat the individuals’ interactions, we first study some of its relevant properties. Then, we introduce special individuals, called opinion leaders, who play a key role in information spreading in several practical applications. Opinion leaders have the special feature of strongly interfering with the process based on the majority rule, speeding up the diffusion. We consider a model describing agents’ interactions, which encompasses Galam's proposal, where opinion leaders are included as special agents. Then we study its specific properties which significantly recast and extend some conclusions drawn for the models given by Galam and Ellero, Fasano, and Sorato [Physica A0378-437110.1016/j.physa.2009.06.002 388, 3901 (2009)]. Finally, we provide theoretical and numerical results concerning the dynamics of our model, showing that a small percentage of opinion leaders may both accelerate and/or even reverse the overall consensus among all the agents.

  4. Opinion dynamics and synchronization in a network of scientific collaborations

    NASA Astrophysics Data System (ADS)

    Pluchino, Alessandro; Boccaletti, Stefano; Latora, Vito; Rapisarda, Andrea

    2006-12-01

    In this paper we discuss opinion dynamics in the opinion changing rate ( OCR) model, recently proposed in Pluchino et al. [Int. J. Mod. Phys. C 16(4) (2005) 515-531]. The OCR model allows to study whether and how a group of social agents, with a different intrinsic tendency ( rate) to change opinion, finds agreement. In particular, we implement the OCR model on a small graph describing the topology of a real social system. The nodes of the graph are scientists participating in the Tepoztlán conference, celebrating Alberto Robledo's 60th birthday, and the links are based on coauthorship in scientific papers. We study how opinions evolve in time according to the frequency rates of the nodes, to the coupling term, and also to the presence of group structures.

  5. Social Influence and the Collective Dynamics of Opinion Formation

    PubMed Central

    Moussaïd, Mehdi; Kämmer, Juliane E.; Analytis, Pantelis P.; Neth, Hansjörg

    2013-01-01

    Social influence is the process by which individuals adapt their opinion, revise their beliefs, or change their behavior as a result of social interactions with other people. In our strongly interconnected society, social influence plays a prominent role in many self-organized phenomena such as herding in cultural markets, the spread of ideas and innovations, and the amplification of fears during epidemics. Yet, the mechanisms of opinion formation remain poorly understood, and existing physics-based models lack systematic empirical validation. Here, we report two controlled experiments showing how participants answering factual questions revise their initial judgments after being exposed to the opinion and confidence level of others. Based on the observation of 59 experimental subjects exposed to peer-opinion for 15 different items, we draw an influence map that describes the strength of peer influence during interactions. A simple process model derived from our observations demonstrates how opinions in a group of interacting people can converge or split over repeated interactions. In particular, we identify two major attractors of opinion: (i) the expert effect, induced by the presence of a highly confident individual in the group, and (ii) the majority effect, caused by the presence of a critical mass of laypeople sharing similar opinions. Additional simulations reveal the existence of a tipping point at which one attractor will dominate over the other, driving collective opinion in a given direction. These findings have implications for understanding the mechanisms of public opinion formation and managing conflicting situations in which self-confident and better informed minorities challenge the views of a large uninformed majority. PMID:24223805

  6. Eating Disorders: Cultural Model and Consensus Regarding Food.

    PubMed

    Manochio-Pina, Marina; Dos Santos, José Ernesto; Dressler, William W; Pessa Ribeiro, Rosane Pilot

    2015-01-01

    The cultural model of food was applied to 112 adult patients with eating disorders (PG) and 36 healthy adult women (CG) of similar age. The Free List and Ranking of Foods was used to group foods and verify consensus and cultural aspects. Calories, health, and taste were the dimensions used by the participants to group the foods, and strong consensus was achieved in regard to calories and health. There were, however, inter- and intra-group divergences in regard to these ideas, especially in the PG. The CG used distinct criteria, showing a more complex model.

  7. Recommendations for meeting the pediatric patient's need for a clinical pharmacist: a joint opinion of the Pediatrics Practice and Research Network of the American College of Clinical Pharmacy and the Pediatric Pharmacy Advocacy Group.

    PubMed

    Bhatt-Mehta, Varsha; Buck, Marcia L; Chung, Allison M; Farrington, Elizabeth A; Hagemann, Tracy M; Hoff, David S; LaRochelle, Joseph M; Pettit, Rebecca S; Phan, Hanna; Potts, Amy L; Smith, Katherine P; Parrish, Richard H

    2013-02-01

    Children warrant access to care from clinical pharmacists trained in pediatrics. The American College of Clinical Pharmacy Pediatrics Practice and Research Network (ACCP Pediatrics PRN) released an opinion paper in 2005 with recommendations for improving the quality and quantity of pediatric pharmacy education in colleges of pharmacy, residency programs, and fellowships. Although progress has been made in increasing the availability of pediatric residencies, there is still much to be done to meet the direct care needs of pediatric patients. The purpose of this joint opinion paper is to outline strategies and recommendations for expanding the quality and capacity of pediatric clinical pharmacy practitioners by elevating the minimum expectations for pharmacists entering pediatric practice, standardizing pediatric pharmacy education, expanding the current number of pediatric clinical pharmacists, and creating an infrastructure for development of pediatric clinical pharmacists and clinical scientists. These recommendations may be used to provide both a conceptual framework and action items for schools of pharmacy, health care systems, and policymakers to work together to increase the quality and quantity of pediatric training, practice, and research initiatives.

  8. Alport syndrome: facts and opinions

    PubMed Central

    Kashtan, Clifford

    2017-01-01

    In this commentary, I review recent advances in Alport syndrome genetics, diagnostics, and therapeutics. I also offer some opinions regarding strategies to optimize the early identification of affected individuals to promote early therapeutic intervention. PMID:28163907

  9. Lack of consensus on tests and criteria for generalized joint hypermobility, Ehlers-Danlos syndrome: hypermobile type and joint hypermobility syndrome.

    PubMed

    Remvig, Lars; Flycht, Lise; Christensen, Karl B; Juul-Kristensen, Birgit

    2014-03-01

    The objectives of this study were to register clinicians performance and opinion of importance of clinical tests for generalized joint hypermobility (GJH), Ehlers-Danlos syndrome, hypermobility type (EDS-HT) and joint hypermobility syndrome (JHS), and to reach a consensus among clinicians on criteria for diagnosing GJH, EDS-HT and JHS. A panel of clinicians answered questions about how to perform and interpret clinical tests and rated test importance on an 11-box scale. The questionnaire was developed on the basis of information from focus groups and the literature. Cronbach's α was used as a measure of internal consistency/consensus among the panelists. The results showed Cronbach's α on importance score of items for diagnosing GJH, EDS-HT and JHS was 0.61, 0.79, and 0.44, respectively. Panelist-group correlation for the three conditions varied substantially (-0.46 to 0.89, 0.03 to 0.68, and -0.07 to 0.68) indicating heterogeneity among the panelists. There was agreement on which tests to use, but performance of the tests (i.e., the specific maneuvers) varied considerably inclusive use of tests with unknown reliability. Furthermore, agreement on the diagnostic criteria varied. We conclude that the level of consensus for the importance of various items for diagnosing GJH, EDS-HT and JHS, was below the required limit (Cronbach's α >0.90) for clinical decision-making and diagnosing. Consensus on tests and criteria through a Delphi process could not be reached. Better descriptions of, and reliability studies on, test maneuvers and criteria sets for these conditions are needed. Subsequent intensive training and implementation of these tests and criteria, nationally as well as internationally should be established.

  10. Colorectal cancer: consensus for CRC screening, but who addresses the controversies?

    PubMed

    Hoff, Geir

    2014-06-01

    In an update on recommendations for colorectal cancer screening, an Asia–Pacific consensus group has set a good standard for presenting level of agreement to recommendation levels. However, this update also exposes how consensus groups might concentrate on the less controversial issues—leaving the tricky questions in the dark.

  11. Consensus statement on viscosupplementation with hyaluronic acid for the management of osteoarthritis.

    PubMed

    Henrotin, Yves; Raman, Raghu; Richette, Pascal; Bard, Hervé; Jerosch, Jörg; Conrozier, Thierry; Chevalier, Xavier; Migliore, Alberto

    2015-10-01

    Viscosupplementation (VS) with hyaluronic acid is currently used by physicians to treat osteoarthritis. However, many aspects of this treatment remain questionable and subject of controversy. A group of 8 experts in this field, from European countries, met to debate on 24 statements previously listed by the group members. Based on an extensive research of the literature and expert opinion, a consensus position has been proposed for each statement. Agreement was achieved on some recommendations. In particular, the expert achieved unanimous agreement in favor of the following statements: VS is an effective treatment for mild to moderate knee OA; VS is not an alternative to surgery in advanced hip OA; VS is a well-tolerated treatment of knee and other joints OA; VS should not be used only in patients who have failed to respond adequately to analgesics and NSAIDs; VS is a "positive" indication but not a "lack of anything better" indication; the dosing regimen must be supported by evidence-based medicine; cross-linking is a proven means for prolonging IA residence time of HA; the best approach to inject accurately knee joint is the lateral mid-patellar one; when VS is performed under fluoroscopy, the amount of radiopaque contrast agent must be as low as possible to avoid viscosupplement dilution. These clear recommendations have been established to help practitioners in the use of viscosupplementation.

  12. A novel opinion dynamics model based on expanded observation ranges and individuals’ social influences in social networks

    NASA Astrophysics Data System (ADS)

    Diao, Su-Meng; Liu, Yun; Zeng, Qing-An; Luo, Gui-Xun; Xiong, Fei

    2014-12-01

    In this paper, we propose an opinion dynamics model in order to investigate opinion evolution and interactions and the behavior of individuals. By introducing social influence and its feedback mechanism, the proposed model can highlight the heterogeneity of individuals and reproduce realistic online opinion interactions. It can also expand the observation range of affected individuals. Combining psychological studies on the social impact of majorities and minorities, affected individuals update their opinions by balancing social impact from both supporters and opponents. It can be seen that complete consensus is not always obtained. When the initial density of either side is greater than 0.8, the enormous imbalance leads to complete consensus. Otherwise, opinion clusters consisting of a set of tightly connected individuals who hold similar opinions appear. Moreover, a tradeoff is discovered between high interaction intensity and low stability with regard to observation ranges. The intensity of each interaction is negatively correlated with observation range, while the stability of each individual’s opinion positively affects the correlation. Furthermore, the proposed model presents the power-law properties in the distribution of individuals’ social influences, which is in agreement with people’s daily cognition. Additionally, it is proven that the initial distribution of individuals’ social influences has little effect on the evolution.

  13. [Reactions to infliximab infusions in dermatologic patients: consensus statement and treatment protocol. Working Group of the Grupo Español de Psoriasis de la Academia Española de Dermatología y Venereología ].

    PubMed

    Puig Sanz, Lluís; Sáez, E; Lozano, M J; Bordas, X; Carrascosa, J M; Gallardo, F; Luelmo, J; Sánchez-Regaña, M; Alsina, M; García-Patos, V

    2009-03-01

    Infliximab is a chimeric monoclonal antibody that binds to and blocks tumor necrosis factor alpha and is the most effective biologic agent approved for the treatment of moderate-to-severe psoriasis. It is administered by intravenous infusion, usually in day hospitals on an outpatient basis. The main problem with the administration of infliximab is the possibility of infusion reactions, which may be immediate or delayed; these reactions are related to the immunogenicity of this monoclonal antibody, leading to the production of anti-infliximab antibodies. Infusion reactions to infliximab are not usually anaphylactic (ie, they are not mediated by immunoglobulin E), and re-exposure of the patient using specific protocols to prevent and treat these reactions is therefore possible. The extensive experience in the use of infliximab for the treatment of rheumatic conditions and chronic inflammatory bowel disease has made it possible to develop infusion reaction management protocols; these can be applied to dermatologic patients, who constitute a growing proportion of patients treated with intravenous biological agents. The aim of this review is to draw up a consensus protocol for the treatment of infusion reactions in dermatologic patients treated with infliximab.

  14. International consensus on allergy immunotherapy.

    PubMed

    Jutel, Marek; Agache, Ioana; Bonini, Sergio; Burks, A Wesley; Calderon, Moises; Canonica, Walter; Cox, Linda; Demoly, Pascal; Frew, Antony J; O'Hehir, Robin; Kleine-Tebbe, Jörg; Muraro, Antonella; Lack, Gideon; Larenas, Désirée; Levin, Michael; Nelson, Harald; Pawankar, Ruby; Pfaar, Oliver; van Ree, Ronald; Sampson, Hugh; Santos, Alexandra F; Du Toit, George; Werfel, Thomas; Gerth van Wijk, Roy; Zhang, Luo; Akdis, Cezmi A

    2015-09-01

    Allergen immunotherapy (AIT) has been used to treat allergic disease since the early 1900s. Despite numerous clinical trials and meta-analyses proving AIT efficacious, it remains underused and is estimated to be used in less than 10% of patients with allergic rhinitis or asthma worldwide. In addition, there are large differences between regions, which are not only due to socioeconomic status. There is practically no controversy about the use of AIT in the treatment of allergic rhinitis and allergic asthma, but for atopic dermatitis or food allergy, the indications for AIT are not well defined. The elaboration of a wider consensus is of utmost importance because AIT is the only treatment that can change the course of allergic disease by preventing the development of asthma and new allergen sensitizations and by inducing allergen-specific immune tolerance. Safer and more effective AIT strategies are being continuously developed both through elaboration of new allergen preparations and adjuvants and alternate routes of administration. A number of guidelines, consensus documents, or both are available on both the international and national levels. The international community of allergy specialists recognizes the need to develop a comprehensive consensus report to harmonize, disseminate, and implement the best AIT practice. Consequently, the International Collaboration in Asthma, Allergy and Immunology, formed by the European Academy of Allergy and Clinical Immunology; the American Academy of Allergy, Asthma & Immunology; the American College of Allergy, Asthma & Immunology; and the World Allergy Organization, has decided to issue an international consensus on AIT.

  15. Consensus standard requirements and guidance

    SciTech Connect

    Putman, V.L.

    1995-12-01

    This report presents information from the ANS Criticality Alarm System Workshop relating to the consensus standard requirements and guidance. Topics presented include: definition; nomenclature; requirements and recommendations; purpose of criticality alarms; design criteria; signal characteristics; reliability, dependability and durability; tests; and emergency preparedness and planning.

  16. Confrontation--Catalyst for Consensus.

    ERIC Educational Resources Information Center

    Barnett, Vincent M., Jr.

    The main question discussed in this paper is whether the confrontations which have been taking place on college campuses these past few years provide the basis for a new consensus which will enable all to move forward with confidence and a renewed sense of achievement. In discussing these confrontations, however, several fallacies need to be…

  17. Extracorporeal life support for patients with acute respiratory distress syndrome: report of a Consensus Conference.

    PubMed

    Richard, Christian; Argaud, Laurent; Blet, Alice; Boulain, Thierry; Contentin, Laetitia; Dechartres, Agnès; Dejode, Jean-Marc; Donetti, Laurence; Fartoukh, Muriel; Fletcher, Dominique; Kuteifan, Khaldoun; Lasocki, Sigismond; Liet, Jean-Michel; Lukaszewicz, Anne-Claire; Mal, Hervé; Maury, Eric; Osman, David; Outin, Hervé; Richard, Jean-Christophe; Schneider, Francis; Tamion, Fabienne

    2014-01-01

    The influenza H1N1 epidemics in 2009 led a substantial number of people to develop severe acute respiratory distress syndrome and refractory hypoxemia. In these patients, extracorporeal membrane oxygenation was used as rescue oxygenation therapy. Several randomized clinical trials and observational studies suggested that extracorporeal membrane oxygenation associated with protective mechanical ventilation could improve outcome, but its efficacy remains uncertain. Organized by the Société de Réanimation de Langue Française (SRLF) in conjunction with the Société Française d'Anesthésie et de Réanimation (SFAR), the Société de Pneumologie de Langue Française (SPLF), the Groupe Francophone de Réanimation et d'Urgences Pédiatriques (GFRUP), the Société Française de Perfusion (SOFRAPERF), the Société Française de Chirurgie Thoracique et Cardiovasculaire (SFCTV) et the Sociedad Española de Medecina Intensiva Critica y Unidades Coronarias (SEMICYUC), a Consensus Conference was held in December 2013 and a jury of 13 members wrote 65 recommendations to answer the five following questions regarding the place of extracorporeal life support for patients with acute respiratory distress syndrome: 1) What are the available techniques?; 2) Which patients could benefit from extracorporeal life support?; 3) How to perform extracorporeal life support?; 4) How and when to stop extracorporeal life support?; 5) Which organization should be recommended? To write the recommendations, evidence-based medicine (GRADE method), expert panel opinions, and shared decisions taken by all the thirteen members of the jury of the Consensus Conference were taken into account.

  18. Extracorporeal life support for patients with acute respiratory distress syndrome: report of a Consensus Conference

    PubMed Central

    2014-01-01

    The influenza H1N1 epidemics in 2009 led a substantial number of people to develop severe acute respiratory distress syndrome and refractory hypoxemia. In these patients, extracorporeal membrane oxygenation was used as rescue oxygenation therapy. Several randomized clinical trials and observational studies suggested that extracorporeal membrane oxygenation associated with protective mechanical ventilation could improve outcome, but its efficacy remains uncertain. Organized by the Société de Réanimation de Langue Française (SRLF) in conjunction with the Société Française d’Anesthésie et de Réanimation (SFAR), the Société de Pneumologie de Langue Française (SPLF), the Groupe Francophone de Réanimation et d’Urgences Pédiatriques (GFRUP), the Société Française de Perfusion (SOFRAPERF), the Société Française de Chirurgie Thoracique et Cardiovasculaire (SFCTV) et the Sociedad Española de Medecina Intensiva Critica y Unidades Coronarias (SEMICYUC), a Consensus Conference was held in December 2013 and a jury of 13 members wrote 65 recommendations to answer the five following questions regarding the place of extracorporeal life support for patients with acute respiratory distress syndrome: 1) What are the available techniques?; 2) Which patients could benefit from extracorporeal life support?; 3) How to perform extracorporeal life support?; 4) How and when to stop extracorporeal life support?; 5) Which organization should be recommended? To write the recommendations, evidence-based medicine (GRADE method), expert panel opinions, and shared decisions taken by all the thirteen members of the jury of the Consensus Conference were taken into account. PMID:24936342

  19. Initiation and use of propranolol for infantile hemangioma: report of a consensus conference.

    PubMed

    Drolet, Beth A; Frommelt, Peter C; Chamlin, Sarah L; Haggstrom, Anita; Bauman, Nancy M; Chiu, Yvonne E; Chun, Robert H; Garzon, Maria C; Holland, Kristen E; Liberman, Leonardo; MacLellan-Tobert, Susan; Mancini, Anthony J; Metry, Denise; Puttgen, Katherine B; Seefeldt, Marcia; Sidbury, Robert; Ward, Kendra M; Blei, Francine; Baselga, Eulalia; Cassidy, Laura; Darrow, David H; Joachim, Shawna; Kwon, Eun-Kyung M; Martin, Kari; Perkins, Jonathan; Siegel, Dawn H; Boucek, Robert J; Frieden, Ilona J

    2013-01-01

    Infantile hemangiomas (IHs) are common neoplasms composed of proliferating endothelial-like cells. Despite the relative frequency of IH and the potential severity of complications, there are currently no uniform guidelines for treatment. Although propranolol has rapidly been adopted, there is significant uncertainty and divergence of opinion regarding safety monitoring, dose escalation, and its use in PHACE syndrome (PHACE = posterior fossa, hemangioma, arterial lesions, cardiac abnormalities, eye abnormalities; a cutaneous neurovascular syndrome characterized by large, segmental hemangiomas of the head and neck along with congenital anomalies of the brain, heart, eyes and/or chest wall). A consensus conference was held on December 9, 2011. The multidisciplinary team reviewed existing data on the pharmacologic properties of propranolol and all published reports pertaining to the use of propranolol in pediatric patients. Workgroups were assigned specific topics to propose protocols on the following subjects: contraindications, special populations, pretreatment evaluation, dose escalation, and monitoring. Consensus protocols were recorded during the meeting and refined after the meeting. When appropriate, protocol clarifications and revision were made and agreed upon by the group via teleconference. Because of the absence of high-quality clinical research data, evidence-based recommendations are not possible at present. However, the team agreed on a number of recommendations that arose from a review of existing evidence, including when to treat complicated IH; contraindications and pretreatment evaluation protocols; propranolol use in PHACE syndrome; formulation, target dose, and frequency of propranolol; initiation of propranolol in infants; cardiovascular monitoring; ongoing monitoring; and prevention of hypoglycemia. Where there was considerable controversy, the more conservative approach was selected. We acknowledge that the recommendations are conservative in

  20. Opinion dynamics: Kinetic modelling with mass media, application to the Scottish independence referendum

    NASA Astrophysics Data System (ADS)

    Boudin, Laurent; Salvarani, Francesco

    2016-02-01

    We consider a kinetic model describing some mechanisms of opinion formation in the framework of referendums, where the individuals, who can interact between themselves and modify their opinion by means of spontaneous self-thinking, are moreover under the influence of mass media. We study, at the numerical level, both the transient and the asymptotic regimes. In particular, we point out that a plurality of media, with different orientations, is a key ingredient to allow pluralism and prevent consensus. The forecasts of the model are compared to some surveys related to the Scottish independence referendum of 2014.

  1. Disorder-induced phase transition in an opinion dynamics model: Results in two and three dimensions

    NASA Astrophysics Data System (ADS)

    Mukherjee, Sudip; Chatterjee, Arnab

    2016-12-01

    We study a model of continuous opinion dynamics with both positive and negative mutual interactions. The model shows a continuous phase transition between a phase with consensus (order) and a phase having no consensus (disorder). The mean field version of the model was already studied. Using extensive numerical simulations, we study the same model in two and three dimensions. The critical points of the phase transitions for various cases and the associated critical exponents have been estimated. The universality class of the phase transitions in the model is found to be same as Ising model in the respective dimensions.

  2. Opinion Dynamics with Confirmation Bias

    PubMed Central

    Allahverdyan, Armen E.; Galstyan, Aram

    2014-01-01

    Background Confirmation bias is the tendency to acquire or evaluate new information in a way that is consistent with one's preexisting beliefs. It is omnipresent in psychology, economics, and even scientific practices. Prior theoretical research of this phenomenon has mainly focused on its economic implications possibly missing its potential connections with broader notions of cognitive science. Methodology/Principal Findings We formulate a (non-Bayesian) model for revising subjective probabilistic opinion of a confirmationally-biased agent in the light of a persuasive opinion. The revision rule ensures that the agent does not react to persuasion that is either far from his current opinion or coincides with it. We demonstrate that the model accounts for the basic phenomenology of the social judgment theory, and allows to study various phenomena such as cognitive dissonance and boomerang effect. The model also displays the order of presentation effect–when consecutively exposed to two opinions, the preference is given to the last opinion (recency) or the first opinion (primacy) –and relates recency to confirmation bias. Finally, we study the model in the case of repeated persuasion and analyze its convergence properties. Conclusions The standard Bayesian approach to probabilistic opinion revision is inadequate for describing the observed phenomenology of persuasion process. The simple non-Bayesian model proposed here does agree with this phenomenology and is capable of reproducing a spectrum of effects observed in psychology: primacy-recency phenomenon, boomerang effect and cognitive dissonance. We point out several limitations of the model that should motivate its future development. PMID:25007078

  3. Is expert opinion reliable when estimating transition probabilities? The case of HCV-related cirrhosis in Egypt

    PubMed Central

    2014-01-01

    Background Data on HCV-related cirrhosis progression are scarce in developing countries in general, and in Egypt in particular. The objective of this study was to estimate the probability of death and transition between different health stages of HCV (compensated cirrhosis, decompensated cirrhosis and hepatocellular carcinoma) for an Egyptian population of patients with HCV-related cirrhosis. Methods We used the “elicitation of expert opinions” method to obtain collective knowledge from a panel of 23 Egyptian experts (among whom 17 were hepatologists or gastroenterologists and 2 were infectiologists). The questionnaire was based on virtual medical cases and asked the experts to assess probability of death or probability of various cirrhosis complications. The design was a Delphi study: we attempted to obtain a consensus between experts via a series of questionnaires interspersed with group response feedback. Results We found substantial disparity between experts’ answers, and no consensus was reached at the end of the process. Moreover, we obtained high death probability and high risk of hepatocellular carcinoma. The annual transition probability to death was estimated at between 10.1% and 61.5% and the annual probability of occurrence of hepatocellular carcinoma was estimated at between 16.8% and 58.9% (depending on age, gender, time spent in cirrhosis and cirrhosis severity). Conclusions Our results show that eliciting expert opinions is not suited for determining the natural history of diseases due to practitioners’ difficulties in evaluating quantities. Cognitive bias occurring during this type of study might explain our results. PMID:24635942

  4. International consensus guidelines on the management of cytomegalovirus in solid organ transplantation.

    PubMed

    Kotton, Camille N; Kumar, Deepali; Caliendo, Angela M; Asberg, Anders; Chou, Sunwen; Snydman, David R; Allen, Upton; Humar, Atul

    2010-04-15

    Cytomegalovirus (CMV) remains one of the most common infections after solid organ transplantation, resulting in significant morbidity, graft loss, and occasional mortality. Management of CMV varies considerably among transplant centers. A panel of experts on CMV and solid organ transplant was convened by The Infectious Diseases Section of The Transplantation Society to develop evidence and expert opinion-based consensus guidelines on CMV management including diagnostics, immunology, prevention, treatment, drug resistance, and pediatric issues.

  5. The American College of Hyperbaric Medicine consensus statement on physician credentialing for hyperbaric oxygen therapy.

    PubMed

    Serena, Thomas E; Gelly, Helen; Bohn, Gregory A; Niezgoda, Jeffrey A

    2014-08-01

    The American College of Hyperbaric Medicine provides this document for hospital credentialing committees as national standards for credentialing hyperbaric physicians. These recommendations represent the consensus opinion of expert leaders in the field of hyperbaric medicine. The principles set forth in this document are intended to serve as a guideline to assist healthcare organizations. This document applies to both hospital-based and nonhospital-affiliated centers.

  6. Consensus in networks of mobile communicating agents

    NASA Astrophysics Data System (ADS)

    Baronchelli, Andrea; Díaz-Guilera, Albert

    2012-01-01

    Populations of mobile and communicating agents describe a vast array of technological and natural systems, ranging from sensor networks to animal groups. Here, we investigate how a group-level agreement may emerge in the continuously evolving network defined by the local interactions of the moving individuals. We adopt a general scheme of motion in two dimensions and we let the individuals interact through the minimal naming game, a prototypical scheme to investigate social consensus. We distinguish different regimes of convergence determined by the emission range of the agents and by their mobility, and we identify the corresponding scaling behaviors of the consensus time. In the same way, we rationalize also the behavior of the maximum memory used during the convergence process, which determines the minimum cognitive/storage capacity needed by the individuals. Overall, we believe that the simple and general model presented in this paper can represent a helpful reference for a better understanding of the behavior of populations of mobile agents.

  7. Consensus in evolving networks of mobile agents

    NASA Astrophysics Data System (ADS)

    Baronchelli, Andrea; Díaz-Guilera, Albert

    2012-02-01

    Populations of mobile and communicating agents describe a vast array of technological and natural systems, ranging from sensor networks to animal groups. Here, we investigate how a group-level agreement may emerge in the continuously evolving networks defined by the local interactions of the moving individuals. We adopt a general scheme of motion in two dimensions and we let the individuals interact through the minimal naming game, a prototypical scheme to investigate social consensus. We distinguish different regimes of convergence determined by the emission range of the agents and by their mobility, and we identify the corresponding scaling behaviors of the consensus time. In the same way, we rationalize also the behavior of the maximum memory used during the convergence process, which determines the minimum cognitive/storage capacity needed by the individuals. Overall, we believe that the simple and general model presented in this talk can represent a helpful reference for a better understanding of the behavior of populations of mobile agents.

  8. Frailty Consensus: A Call to Action

    PubMed Central

    Morley, John E.; Vellas, Bruno; van Kan, G. Abellan; Anker, Stefan D.; Bauer, Juergen M.; Bernabei, Roberto; Cesari, Matteo; Chumlea, W.C.; Doehner, Wolfram; Evans, Jonathan; Fried, Linda P.; Guralnik, Jack M.; Katz, Paul R.; Malmstrom, Theodore K.; McCarter, Roger J.; Gutierrez Robledo, Luis M.; Rockwood, Ken; von Haehling, Stephan; Vandewoude, Maurits F.; Walston, Jeremy

    2014-01-01

    Frailty is a clinical state in which there is an increase in an individual’s vulnerability for developing increased dependency and/or mortality when exposed to a stressor. Frailty can occur as the result of a range of diseases and medical conditions. A consensus group consisting of delegates from 6 major international, European, and US societies created 4 major consensus points on a specific form of frailty: physical frailty. Physical frailty is an important medical syndrome. The group defined physical frailty as “a medical syndrome with multiple causes and contributors that is characterized by diminished strength, endurance, and reduced physiologic function that increases an individual’s vulnerability for developing increased dependency and/or death.”Physical frailty can potentially be prevented or treated with specific modalities, such as exercise, protein-calorie supplementation, vitamin D, and reduction of polypharmacy.Simple, rapid screening tests have been developed and validated, such as the simple FRAIL scale, to allow physicians to objectively recognize frail persons.For the purposes of optimally managing individuals with physical frailty, all persons older than 70 years and all individuals with significant weight loss (≥5%) due to chronic disease should be screened for frailty. PMID:23764209

  9. Consensus and stratification in the affective meaning of human sociality

    PubMed Central

    Ambrasat, Jens; von Scheve, Christian; Conrad, Markus; Schauenburg, Gesche; Schröder, Tobias

    2014-01-01

    We investigate intrasocietal consensus and variation in affective meanings of concepts related to authority and community, two elementary forms of human sociality. Survey participants (n = 2,849) from different socioeconomic status (SES) groups in German society provided ratings of 909 social concepts along three basic dimensions of affective meaning. Results show widespread consensus on these meanings within society and demonstrate that a meaningful structure of socially shared knowledge emerges from organizing concepts according to their affective similarity. The consensus finding is further qualified by evidence for subtle systematic variation along SES differences. In relation to affectively neutral words, high-status individuals evaluate intimacy-related and socially desirable concepts as less positive and powerful than middle- or low-status individuals, while perceiving antisocial concepts as relatively more threatening. This systematic variation across SES groups suggests that the affective meaning of sociality is to some degree a function of social stratification. PMID:24843121

  10. Consensus and stratification in the affective meaning of human sociality.

    PubMed

    Ambrasat, Jens; von Scheve, Christian; Conrad, Markus; Schauenburg, Gesche; Schröder, Tobias

    2014-06-03

    We investigate intrasocietal consensus and variation in affective meanings of concepts related to authority and community, two elementary forms of human sociality. Survey participants (n = 2,849) from different socioeconomic status (SES) groups in German society provided ratings of 909 social concepts along three basic dimensions of affective meaning. Results show widespread consensus on these meanings within society and demonstrate that a meaningful structure of socially shared knowledge emerges from organizing concepts according to their affective similarity. The consensus finding is further qualified by evidence for subtle systematic variation along SES differences. In relation to affectively neutral words, high-status individuals evaluate intimacy-related and socially desirable concepts as less positive and powerful than middle- or low-status individuals, while perceiving antisocial concepts as relatively more threatening. This systematic variation across SES groups suggests that the affective meaning of sociality is to some degree a function of social stratification.

  11. Modelling Influence and Opinion Evolution in Online Collective Behaviour

    PubMed Central

    Gend, Pascal; Rentfrow, Peter J.; Hendrickx, Julien M.; Blondel, Vincent D.

    2016-01-01

    Opinion evolution and judgment revision are mediated through social influence. Based on a large crowdsourced in vitro experiment (n = 861), it is shown how a consensus model can be used to predict opinion evolution in online collective behaviour. It is the first time the predictive power of a quantitative model of opinion dynamics is tested against a real dataset. Unlike previous research on the topic, the model was validated on data which did not serve to calibrate it. This avoids to favor more complex models over more simple ones and prevents overfitting. The model is parametrized by the influenceability of each individual, a factor representing to what extent individuals incorporate external judgments. The prediction accuracy depends on prior knowledge on the participants’ past behaviour. Several situations reflecting data availability are compared. When the data is scarce, the data from previous participants is used to predict how a new participant will behave. Judgment revision includes unpredictable variations which limit the potential for prediction. A first measure of unpredictability is proposed. The measure is based on a specific control experiment. More than two thirds of the prediction errors are found to occur due to unpredictability of the human judgment revision process rather than to model imperfection. PMID:27336834

  12. Cost Sensitive Moving Target Consensus

    SciTech Connect

    Duan, Sisi; Li, Yun; Levitt, Karl N.

    2016-01-01

    Consensus is a fundamental approach to implementing fault-tolerant services through replication where there exists a tradeoff between the cost and the resilience. For instance, Crash Fault Tolerant (CFT) protocols have a low cost but can only handle crash failures while Byzantine Fault Tolerant (BFT) protocols handle arbitrary failures but have a higher cost. Hybrid protocols enjoy the benefits of both high performance without failures and high resiliency under failures by switching among different subprotocols. However, it is challenging to determine which subprotocols should be used. We propose a moving target approach to switch among protocols according to the existing system and network vulnerability. At the core of our approach is a formalized cost model that evaluates the vulnerability and performance of consensus protocols based on real-time Intrusion Detection System (IDS) signals. Based on the evaluation results, we demonstrate that a safe, cheap, and unpredictable protocol is always used and a high IDS error rate can be tolerated.

  13. The Consensus Molecular Subtypes of Colorectal Cancer

    PubMed Central

    Guinney, Justin; Dienstmann, Rodrigo; Wang, Xin; de Reyniès, Aurélien; Schlicker, Andreas; Soneson, Charlotte; Marisa, Laetitia; Roepman, Paul; Nyamundanda, Gift; Angelino, Paolo; Bot, Brian M.; Morris, Jeffrey S.; Simon, Iris M.; Gerster, Sarah; Fessler, Evelyn; de Sousa e Melo, Felipe; Missiaglia, Edoardo; Ramay, Hena; Barras, David; Homicsko, Krisztian; Maru, Dipen; Manyam, Ganiraju C.; Broom, Bradley; Boige, Valerie; Perez-Villamil, Beatriz; Laderas, Ted; Salazar, Ramon; Gray, Joe W.; Hanahan, Douglas; Tabernero, Josep; Bernards, Rene; Friend, Stephen H.; Laurent-Puig, Pierre; Medema, Jan Paul; Sadanandam, Anguraj; Wessels, Lodewyk; Delorenzi, Mauro; Kopetz, Scott; Vermeulen, Louis; Tejpar, Sabine

    2015-01-01

    Colorectal cancer (CRC) is a frequently lethal disease with heterogeneous outcomes and drug responses. To resolve inconsistencies among the reported gene expression–based CRC classifications and facilitate clinical translation, we formed an international consortium dedicated to large-scale data sharing and analytics across expert groups. We show marked interconnectivity between six independent classification systems coalescing into four consensus molecular subtypes (CMS) with distinguishing features: CMS1 (MSI Immune, 14%), hypermutated, microsatellite unstable, strong immune activation; CMS2 (Canonical, 37%), epithelial, chromosomally unstable, marked WNT and MYC signaling activation; CMS3 (Metabolic, 13%), epithelial, evident metabolic dysregulation; and CMS4 (Mesenchymal, 23%), prominent transforming growth factor β activation, stromal invasion, and angiogenesis. Samples with mixed features (13%) possibly represent a transition phenotype or intra-tumoral heterogeneity. We consider the CMS groups the most robust classification system currently available for CRC – with clear biological interpretability – and the basis for future clinical stratification and subtype–based targeted interventions. PMID:26457759

  14. American Burn Association Consensus Statements

    DTIC Science & Technology

    2013-08-01

    finally allow us to follow the ACS program in bariatric surgery and link quality-based purchasing with verification. For this col- laborative...University of Washington Medicine Department of Surgery , Seattle, Washington. See under consensus statements for author affiliations. The 2012 ABA burn...correspondence to Nicole S. Gibran MD, FACS, UW Medicine Regional Burn Center, UW Medicine Department of Surgery , Seattle, Washington 98104. Copyright

  15. Utilizing electronic health records to predict acute kidney injury risk and outcomes: workgroup statements from the 15(th) ADQI Consensus Conference.

    PubMed

    Sutherland, Scott M; Chawla, Lakhmir S; Kane-Gill, Sandra L; Hsu, Raymond K; Kramer, Andrew A; Goldstein, Stuart L; Kellum, John A; Ronco, Claudio; Bagshaw, Sean M

    2016-01-01

    The data contained within the electronic health record (EHR) is "big" from the standpoint of volume, velocity, and variety. These circumstances and the pervasive trend towards EHR adoption have sparked interest in applying big data predictive analytic techniques to EHR data. Acute kidney injury (AKI) is a condition well suited to prediction and risk forecasting; not only does the consensus definition for AKI allow temporal anchoring of events, but no treatments exist once AKI develops, underscoring the importance of early identification and prevention. The Acute Dialysis Quality Initiative (ADQI) convened a group of key opinion leaders and stakeholders to consider how best to approach AKI research and care in the "Big Data" era. This manuscript addresses the core elements of AKI risk prediction and outlines potential pathways and processes. We describe AKI prediction targets, feature selection, model development, and data display.

  16. Community Size, Perceptions of Majority Opinion and Opinion Expression.

    ERIC Educational Resources Information Center

    Salmon, Charles T.; Oshagan, Hayg

    A study examined structural determinants of opinion expression by merging two theoretical perspectives: the "spiral of silence" model advanced by Elisabeth Noelle-Neumann, and the structural approach to communication research offered by Phillip Tichenor, George Donohue, and Clarice Olien. The study also distinguished between different…

  17. Multicentre consensus recommendations for skin care in inherited epidermolysis bullosa

    PubMed Central

    2014-01-01

    Background Inherited epidermolysis bullosa (EB) comprises a highly heterogeneous group of rare diseases characterized by fragility and blistering of skin and mucous membranes. Clinical features combined with immunofluorescence antigen mapping and/or electron microscopy examination of a skin biopsy allow to define the EB type and subtype. Molecular diagnosis is nowadays feasible in all EB subtypes and required for prenatal diagnosis. The extent of skin and mucosal lesions varies greatly depending on EB subtype and patient age. In the more severe EB subtypes lifelong generalized blistering, chronic ulcerations and scarring sequelae lead to multiorgan involvement, major morbidity and life-threatening complications. In the absence of a cure, patient management remains based on preventive measures, together with symptomatic treatment of cutaneous and extracutaneous manifestations and complications. The rarity and complexity of EB challenge its appropriate care. Thus, the aim of the present study has been to generate multicentre, multidisciplinary recommendations on global skin care addressed to physicians, nurses and other health professionals dealing with EB, both in centres of expertise and primary care setting. Methods Almost no controlled trials for EB treatment have been performed to date. For this reason, recommendations were prepared by a multidisciplinary team of experts from different European EB centres based on available literature and expert opinion. They have been subsequently revised by a panel of external experts, using an online-modified Delphi method to generate consensus. Results Recommendations are reported according to the age of the patients. The major topics treated comprise the multidisciplinary approach to EB patients, global skin care including wound care, management of itching and pain, and early diagnosis of squamous cell carcinoma. Aspects of therapeutic patient education, care of disease burden and continuity of care are also developed

  18. Brain Hemispheric Consensus and the Quality of Investment Decisions.

    ERIC Educational Resources Information Center

    Boyd, Michael

    This on-going study explores the hypothesis that stock fund managers who underperform do so because they make bad decisions, and examines whether their choices can be improved by using a decision model that invokes principles of brain hemispheric consensus. The study, begun in fall 1999, involves two groups of business students: the control group…

  19. When Consensus Decision-Making Fails: A Case Study.

    ERIC Educational Resources Information Center

    Savage, Grant T.

    Habermas's theory of dialogue was used to evaluate the process of decision making that occurred in a labor-management committee's meeting to discuss flextime. The study attempted to determine why, at that meeting, the committee's consensus process of decision making failed. W.R. Bion's theory of unconscious group motives was also used to…

  20. [GEITDAH consensus on conduct disorders in children and adolescents].

    PubMed

    Sasot-Llevadot, Jordi; Ibáñez-Bordas, Rosa M; Soto-López, Antonio; Montañés-Rada, Francisco; Gastaminza-Pérez, Xavier; Alda-Díez, José A; Cantó-Díez, Tomás; Catalá, Miguel A; Ferrin-Erdozáin, Maite; García-Giral, Marta; Graell-Bernal, Montserrat; Granada-Jiménez, Olvido; Herreros-Rodríguez, Óscar; Mardomingo-Sanz, María J; Mojarro-Práxedes, Dolores; Morey-Canyelles, Jaume; Ortiz-Guerra, Juan; Pàmies-Massana, Montserrat; Rey-Sánchez, Francisco; Romera-Torrens, María; Rubio-Morell, Belén; Ruiz-Lázaro, Pedro M; Ruiz-Sanz, Francisco

    2015-08-16

    In this paper, the Special Interest Group on Attention Deficit Hyperactivity Disorder (GEITDAH, from its name in Spanish) presents a consensus reached by experts from all over Spain on conduct disorders in children and adolescents. Following the initial work by the team at the Pedopsychiatry Unit at the Quiron-Teknon Hospital in Barcelona, agreements have been reached on a number of basic aspects that could be the starting point for future consensuses. A top priority aim of the work was also to update the criteria in the Diagnostic and statistical manual of mental disorders, fifth edition, for conduct disorders in children and adolescents, together with their comorbidity with attention deficit hyperactivity disorder.

  1. Opinion Summarizationof CustomerComments

    NASA Astrophysics Data System (ADS)

    Fan, Miao; Wu, Guoshi

    Web 2.0 technologies have enabled more and more customers to freely comment on different kinds of entities, such as sellers, products and services. The large scale of information poses the need and challenge of automatic summarization. In many cases, each of the user-generated short comments implies the opinions which rate the target entity. In this paper, we aim to mine and to summarize all the customer comments of a product. The algorithm proposed in this researchis more reliable on opinion identification because it is unsupervised and the accuracy of the result improves as the number of comments increases. Our research is performed in four steps: (1) mining the frequent aspects of a product that have been commented on by customers; (2) mining the infrequent aspects of a product which have been commented by customers (3) identifying opinion words in each comment and deciding whether each opinion word is positive, negative or neutral; (4) summarizing the comments. This paper proposes several novel techniques to perform these tasks. Our experimental results using comments of a number of products sold online demonstrate the effectiveness of the techniques.

  2. Opinion: Writing for the Public

    ERIC Educational Resources Information Center

    Rose, Mike

    2010-01-01

    For the past twenty years or so, the author has been fortunate to write for a fairly broad audience. While he was teaching, or running an educational program, or doing research, he was also composing opinion pieces or commentaries about the work he was doing. This process of writing with part of his attention on the classroom or research site and…

  3. Big cat phylogenies, consensus trees, and computational thinking.

    PubMed

    Sul, Seung-Jin; Williams, Tiffani L

    2011-07-01

    Phylogenetics seeks to deduce the pattern of relatedness between organisms by using a phylogeny or evolutionary tree. For a given set of organisms or taxa, there may be many evolutionary trees depicting how these organisms evolved from a common ancestor. As a result, consensus trees are a popular approach for summarizing the shared evolutionary relationships in a group of trees. We examine these consensus techniques by studying how the pantherine lineage of cats (clouded leopard, jaguar, leopard, lion, snow leopard, and tiger) evolved, which is hotly debated. While there are many phylogenetic resources that describe consensus trees, there is very little information, written for biologists, regarding the underlying computational techniques for building them. The pantherine cats provide us with a small, relevant example to explore the computational techniques (such as sorting numbers, hashing functions, and traversing trees) for constructing consensus trees. Our hope is that life scientists enjoy peeking under the computational hood of consensus tree construction and share their positive experiences with others in their community.

  4. Expert Consensus Panel Guidelines on Geriatric Assessment in Oncology

    PubMed Central

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

    2015-01-01

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

  5. Role of social environment and social clustering in spread of opinions in coevolving networks

    PubMed Central

    Malik, Nishant; Mucha, Peter J.

    2013-01-01

    Taking a pragmatic approach to the processes involved in the phenomena of collective opinion formation, we investigate two specific modifications to the coevolving network voter model of opinion formation studied by Holme and Newman [Phys. Rev. E 74, 056108 (2006)]. First, we replace the rewiring probability parameter by a distribution of probability of accepting or rejecting opinions between individuals, accounting for heterogeneity and asymmetric influences in relationships between individuals. Second, we modify the rewiring step by a path-length-based preference for rewiring that reinforces local clustering. We have investigated the influences of these modifications on the outcomes of simulations of this model. We found that varying the shape of the distribution of probability of accepting or rejecting opinions can lead to the emergence of two qualitatively distinct final states, one having several isolated connected components each in internal consensus, allowing for the existence of diverse opinions, and the other having a single dominant connected component with each node within that dominant component having the same opinion. Furthermore, more importantly, we found that the initial clustering in the network can also induce similar transitions. Our investigation also indicates that these transitions are governed by a weak and complex dependence on system size. We found that the networks in the final states of the model have rich structural properties including the small world property for some parameter regimes. PMID:24387562

  6. Early Gnathostome Phylogeny Revisited: Multiple Method Consensus

    PubMed Central

    Qiao, Tuo; King, Benedict; Long, John A.; Ahlberg, Per E.; Zhu, Min

    2016-01-01

    A series of recent studies recovered consistent phylogenetic scenarios of jawed vertebrates, such as the paraphyly of placoderms with respect to crown gnathostomes, and antiarchs as the sister group of all other jawed vertebrates. However, some of the phylogenetic relationships within the group have remained controversial, such as the positions of Entelognathus, ptyctodontids, and the Guiyu-lineage that comprises Guiyu, Psarolepis and Achoania. The revision of the dataset in a recent study reveals a modified phylogenetic hypothesis, which shows that some of these phylogenetic conflicts were sourced from a few inadvertent miscodings. The interrelationships of early gnathostomes are addressed based on a combined new dataset with 103 taxa and 335 characters, which is the most comprehensive morphological dataset constructed to date. This dataset is investigated in a phylogenetic context using maximum parsimony (MP), Bayesian inference (BI) and maximum likelihood (ML) approaches in an attempt to explore the consensus and incongruence between the hypotheses of early gnathostome interrelationships recovered from different methods. Our findings consistently corroborate the paraphyly of placoderms, all ‘acanthodians’ as a paraphyletic stem group of chondrichthyans, Entelognathus as a stem gnathostome, and the Guiyu-lineage as stem sarcopterygians. The incongruence using different methods is less significant than the consensus, and mainly relates to the positions of the placoderm Wuttagoonaspis, the stem chondrichthyan Ramirosuarezia, and the stem osteichthyan Lophosteus—the taxa that are either poorly known or highly specialized in character complement. Given that the different performances of each phylogenetic approach, our study provides an empirical case that the multiple phylogenetic analyses of morphological data are mutually complementary rather than redundant. PMID:27649538

  7. Examining the Gap between Science and Public Opinion about Genetically Modified Food and Global Warming

    PubMed Central

    McFadden, Brandon R.

    2016-01-01

    There is great uncertainty due to challenges of escalating population growth and climate change. Public perception that diverges from the scientific community may decrease the effectiveness of scientific inquiry and innovation as tools to solve these challenges. The objective of this study was to identify the factors associated with the divergence of public opinion from scientific consensus regarding the safety of genetically modified (GM) foods and human involvement in global warming (GW). Results indicate that the effects of knowledge on public opinion are complex and non-uniform across types of knowledge (i.e., perceived and actual) or issues. Political affiliation affects agreement with science; Democrats were more likely to agree that GM food is safe and human actions cause GW. Respondents who had relatively higher cognitive function or held illusionary correlations about GM food or GW were more likely to have an opinion that differed from the scientific community. PMID:27829008

  8. Examining the Gap between Science and Public Opinion about Genetically Modified Food and Global Warming.

    PubMed

    McFadden, Brandon R

    2016-01-01

    There is great uncertainty due to challenges of escalating population growth and climate change. Public perception that diverges from the scientific community may decrease the effectiveness of scientific inquiry and innovation as tools to solve these challenges. The objective of this study was to identify the factors associated with the divergence of public opinion from scientific consensus regarding the safety of genetically modified (GM) foods and human involvement in global warming (GW). Results indicate that the effects of knowledge on public opinion are complex and non-uniform across types of knowledge (i.e., perceived and actual) or issues. Political affiliation affects agreement with science; Democrats were more likely to agree that GM food is safe and human actions cause GW. Respondents who had relatively higher cognitive function or held illusionary correlations about GM food or GW were more likely to have an opinion that differed from the scientific community.

  9. Peer-to-peer and mass communication effect on opinion shifts

    NASA Astrophysics Data System (ADS)

    Kindler, A.; Solomon, S.; Stauffer, D.

    2013-02-01

    Opinion dynamics is studied through a minimal Ising model with three main influences (fields): personal conservatism (power-law distributed), inter-personal and group pressure, and a global field incorporating peer-to-peer and mass communications, which is generated bottom-up from the faction supporting the new opinion. A rich phase diagram appears separating possible terminal stages of the opinion diffusion, characterizing failure phases by the features of the individuals who had changed their opinion. An exhaustive solution of the model is produced, allowing predictions to be made on the opinion’s assimilation in the society.

  10. Nonconformity defines the self: the role of minority opinion status in self-concept clarity.

    PubMed

    Morrison, Kimberly Rios; Wheeler, S Christian

    2010-03-01

    Drawing on distinctiveness and social identity theories, the present studies tested whether minority opinion holders would have a more clearly defined sense of self than majority opinion holders. In Study 1, participants who were induced to believe that they held a minority opinion on a controversial issue had higher subsequent self-concept clarity scores than did those who were induced to believe that they held a majority opinion, controlling for self-esteem. Furthermore, the relationship between minority opinion status and self-concept clarity was strongest among participants whose opinions were highly expressive of their values (Studies 2 and 3), as well as among participants who identified strongly with the group in which they were a minority (Study 3). Theoretical and practical implications of these results are discussed.

  11. Phase transitions in Nowak Sznajd opinion dynamics

    NASA Astrophysics Data System (ADS)

    Wołoszyn, Maciej; Stauffer, Dietrich; Kułakowski, Krzysztof

    2007-05-01

    The Nowak modification of the Sznajd opinion dynamics model on the square lattice assumes that with probability β the opinions flip due to mass-media advertising from down to up, and vice versa. Besides, with probability α the Sznajd rule applies that a neighbour pair agreeing in its two opinions convinces all its six neighbours of that opinion. Our Monte Carlo simulations and mean-field theory find sharp phase transitions in the parameter space.

  12. Consensus document on the radial approach in percutaneous cardiovascular interventions: position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on Acute Cardiac Care** and Thrombosis of the European Society of Cardiology.

    PubMed

    Hamon, Martial; Pristipino, Christian; Di Mario, Carlo; Nolan, James; Ludwig, Josef; Tubaro, Marco; Sabate, Manel; Mauri-Ferré, Josepa; Huber, Kurt; Niemelä, Kari; Haude, Michael; Wijns, William; Dudek, Dariusz; Fajadet, Jean; Kiemeneij, Ferdinand

    2013-03-01

    Radial access use has been growing steadily but, despite encouraging results, still varies greatly among operators, hospitals, countries and continents. Twenty years from its introduction, it was felt that the time had come to develop a common evidence-based view on the technical, clinical and organisational implications of using the radial approach for coronary angiography and interventions. The European Association of Percutaneous Cardiovascular Interventions (EAPCI) has, therefore, appointed a core group of European and non-European experts, including pioneers of radial angioplasty and operators with different practices in vascular access supported by experts nominated by the Working Groups on Acute Cardiac Care and Thrombosis of the European Society of Cardiology (ESC). Their goal was to define the role of the radial approach in modern interventional practice and give advice on technique, training needs, and optimal clinical indications.

  13. Current level of consensus on probiotic science

    PubMed Central

    Capurso, Lucio; Collins, Kevin; Cummings, John; Delzenne, Nathalie; Goulet, Olivier; Guarner, Francisco; Marteau, Philippe; Meier, Rémy

    2010-01-01

    The present paper summarizes the consensus views of a group of 9 European clinicians and scientists on the current state of scientific knowledge on probiotics, covering those areas where there is substantial evidence for beneficial effects and those where the evidence base is poor or inconsistent. There was general agreement that probiotic effects were species and often strain specific. The experts agreed that some probiotics were effective in reducing the incidence and duration of rotavirus diarrhea in infants, antibiotic-associated diarrhea in adults and, for certain probiotics, Clostridium difficile infections. Some probiotics are associated with symptomatic improvements in irritable bowel syndrome and alleviation of digestive discomfort. Probiotics can reduce the frequency and severity of necrotizing enterocolitis in premature infants and have been shown to regulate intestinal immunity. Several other clinical effects of probiotics, including their role in inflammatory bowel disease, atopic dermatitis, respiratory or genito-urinary infections or H. pylori adjuvant treatment were thought promising but inconsistent. PMID:21637035

  14. Opinion Expression as a Rational Behavior.

    ERIC Educational Resources Information Center

    Kim, Sei-Hill

    This study looks at individuals' opinion expressions as a rational behavior based on a conscious calculus of expected benefits and costs (economic analysis). The influences of "issue benefit,""opinion congruence," and "issue knowledge," as sources of benefits and costs on opinion expression were hypothesized and tested. The study also examined the…

  15. Identifying Opinion Leaders to Promote Behavior Change

    ERIC Educational Resources Information Center

    Valente, Thomas W.; Pumpuang, Patchareeya

    2007-01-01

    This article reviews 10 techniques used to identify opinion leaders to promote behavior change. Opinion leaders can act as gatekeepers for interventions, help change social norms, and accelerate behavior change. Few studies document the manner in which opinion leaders are identified, recruited, and trained to promote health. The authors categorize…

  16. Consensus Paper: Pathological Role of the Cerebellum in Autism

    PubMed Central

    Fatemi, S. Hossein; Aldinger, Kimberly A.; Ashwood, Paul; Bauman, Margaret L.; Blaha, Charles D.; Blatt, Gene J.; Chauhan, Abha; Chauhan, Ved; Dager, Stephen R.; Dickson, Price E.; Estes, Annette M.; Goldowitz, Dan; Heck, Detlef H.; Kemper, Thomas L.; King, Bryan H.; Martin, Loren A.; Millen, Kathleen J.; Mittleman, Guy; Mosconi, Matthew W.; Persico, Antonio M.; Sweeney, John A.; Webb, Sara J.; Welsh, John P.

    2013-01-01

    There has been significant advancement in various aspects of scientific knowledge concerning the role of cerebellum in the etiopathogenesis of autism. In the current consensus paper, we will observe the diversity of opinions regarding the involvement of this important site in the pathology of autism. Recent emergent findings in literature related to cerebellar involvement in autism are discussed, including: cerebellar pathology, cerebellar imaging and symptom expression in autism, cerebellar genetics, cerebellar immune function, oxidative stress and mitochondrial dysfunction, GABAergic and glutamatergic systems, cholinergic, dopaminergic, serotonergic, and oxytocin related changes in autism, motor control and cognitive deficits, cerebellar coordination of movements and cognition, gene-environment interactions, therapeutics in autism and relevant animal models of autism. Points of consensus include presence of abnormal cerebellar anatomy, abnormal neurotransmitter systems, oxidative stress, cerebellar motor and cognitive deficits, and neuroinflammation in subjects with autism. Undefined areas or areas requiring further investigation include lack of treatment options for core symptoms of autism, vermal hypoplasia and other vermal abnormalities as a consistent feature of autism, mechanisms underlying cerebellar contributions to cognition, and unknown mechanisms underlying neuroinflammation. PMID:22370873

  17. The Vocational Homemaking Teacher Opinion Leader as a Referent in the Communication of Change.

    ERIC Educational Resources Information Center

    Parker, Frances Yoakam

    To investigate the feasibility of using opinion leaders to introduce new ideas in vocational homemaking, 124 vocational homemaking teachers and three regional supervisors of three representative regions in Ohio were surveyed by group-interview technique to determine if vocational homemaking opinion leaders were selected as sources of advice and…

  18. Voices from the Unvoiced: A Comparative Study of Hidden Values and Attitudes in Opinion-Giving

    ERIC Educational Resources Information Center

    Murata, Kumiko

    2011-01-01

    This paper explores difficulties students may experience in giving opinions in class, drawing on data gleaned from the administration of questionnaires and interviews to Japanese and British students. The results show that the students from both groups regard highly of giving and exchanging opinions in class; however, there is a marked difference…

  19. Text of the Supreme Court's Opinion in the Selective Service System Case.

    ERIC Educational Resources Information Center

    Burger, Warren E.; And Others

    1984-01-01

    The texts are presented of the Supreme Court opinions in the case of the Selective Service System vs. Minnesota Public Interest Research Group, which upheld a federal law requiring college students to register for the draft before receiving federal student aid. Included are the majority opinion by Chief Justice Warren E. Burger and dissenting…

  20. Case definitions integrating empiric and consensus perspectives

    PubMed Central

    Jason, Leonard A.; McManimen, Stephanie; Sunnquist, Madison; Brown, Abigail; Furst, Jacob; Newton, Julia L.; Strand, Elin Bolle

    2016-01-01

    Background There has been considerable controversy regarding how to name and define the illnesses known as myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS). The IOM report has proposed a new clinical criteria and name for this illness, but aspects of these recommendations have been scrutinized by patients and scientists. Purpose It is possible that both empiric and consensus approaches could be used to help settle some of these diagnostic challenges. Using patient samples collected in the United States, Great Britain, and Norway (N=556), the current study attempted to categorize patients using more general as well as more restricted case definitions. Results Overall, the outcomes suggest that there might be four groupings of patients, with the broadest category involving those with chronic fatigue (N=62), defined by 6 or more months of fatigue which can be cannot be explained by medical or psychiatric conditions. A second category involves those patients that have chronic fatigue that can be explained by a medical or psychiatric condition (N=47). A third category involves more specific criteria that have been posited both by the IOM report, a Canadian Clinical Case criteria, a ME-ICC criteria and a more empiric approach. These efforts have specified domains of substantial reductions of activity, post-exertional malaise, neurocognitive impairment, and sleep dysfunction (N=346). Patients with these characteristics were more functionally impaired than those meeting just chronic fatigue criteria, p < .05. Finally, those meeting even more restrictive ME criteria proposed by Ramsay, identified a smaller and even more impaired group, p < .05. Discussion The advantages of using such empirical and consensus approaches to develop reliable classification and diagnostic efforts are discussed. PMID:27088059

  1. Advanced nuclear reactor public opinion project

    SciTech Connect

    Benson, B.

    1991-07-25

    This Interim Report summarizes the findings of our first twenty in-depth interviews in the Advanced Nuclear Reactor Public Opinion Project. We interviewed 6 industry trade association officials, 3 industry attorneys, 6 environmentalists/nuclear critics, 3 state officials, and 3 independent analysts. In addition, we have had numerous shorter discussions with various individuals concerned about nuclear power. The report is organized into the four categories proposed at our April, 1991, Advisory Group meeting: safety, cost-benefit analysis, science education, and communications. Within each category, some change of focus from that of the Advisory Group has been required, to reflect the findings of our interviews. This report limits itself to describing our findings. An accompanying memo draws some tentative conclusions.

  2. Nationwide Techer Opinion Poll, 1979. NEA Research Memo, September 1979.

    ERIC Educational Resources Information Center

    National Education Association, Washington, DC.

    The 1979 Nationwide Teacher Opinion Poll conducted by the National Education Association was sent to 2,148 of the nation's approximately 2,185,000 public school teachers. The response rate to the poll was 82.7 percent. In this report the analysis of the responses are grouped according to the following topical areas: (1) teacher demographics; (2)…

  3. The Impact of Mass Media Upon Public Opinion.

    DTIC Science & Technology

    The history of public opinion and mass media is briefly covered to set the background for a closer look at the factors which influence the formation...family church, school and peer groups. The primary mass media instruments, television, radio and the newspaper are examined to determine if a

  4. The Opinions of Prospective Teachers on Peer Assessment

    ERIC Educational Resources Information Center

    Özdemir, Serpil

    2016-01-01

    This research was conducted to determine the opinions of prospective teachers on peer assessment. The study was carried out at a university in the West Black sea with forty-one prospective Turkish teachers. The prospective teachers presented a lesson on a subject they had decided on formerly, and were evaluated by their peers. The groups consisted…

  5. Dynamic behavior of a social model for opinion formation

    NASA Astrophysics Data System (ADS)

    Bordogna, Clelia M.; Albano, Ezequiel V.

    2007-12-01

    The dynamic behavior of a social group influenced by both a strong leader and the mass media, which is modeled according to the social impact theory, is studied under two situations: (i) The strong leader changes his/her state of opinion periodically while the mass media are not considered. In this case, the leader is capable of driving the group between a dynamically ordered state with a weak leader-group coupling (high-frequency regime) and a dynamically disordered state where the group follows the opinion of the leader (low-frequency regime). (ii) The mass-media change periodically their message and have to compete with a strong leader that keeps his/her state of opinion unchanged. In this case, the mass media require an amplitude threshold in order to overcome the influence of the leader and drive the system into a dynamically disordered state. The dynamic behavior characteristic of the studied social opinion model shares many features of physical systems that are relevant in the fields of statistical mechanics and condensed matter.

  6. Opinions about the Roles of Secondary and Postsecondary Vocational Education.

    ERIC Educational Resources Information Center

    Starr, Harold; And Others

    This report describes the opinions of a number of groups on five roles attributed to vocational education (i.e., employability skills development, occupational skills development, work experience, job placement, and basic skills development). The findings were based on a secondary analysis of data from five completed National Center for Research…

  7. Opinions of Counselor Candidates Regarding Counseling Skills Training

    ERIC Educational Resources Information Center

    Aladag, Mine; Yaka, Baris; Koç, Ismet

    2014-01-01

    The aim of this study is to contribute to the enhancement of the quality of counseling skills training and counselor education through the medium of understanding the opinions of counselor candidates regarding counseling skills training. The research group consisted of 67 counselor candidates who voluntarily participated in the study. The research…

  8. The impact of variable commitment in the Naming Game on consensus formation.

    PubMed

    Niu, Xiang; Doyle, Casey; Korniss, Gyorgy; Szymanski, Boleslaw K

    2017-02-02

    The Naming Game has proven to be an important model of opinion dynamics in complex networks. It is significantly enriched by the introduction of nodes committed to a single opinion. The resulting model is still simple but captures core concepts of opinion dynamics in networks. This model limitation is rigid commitment which never changes. Here we study the effect that making commitment variable has on the dynamics of the system. Committed nodes are assigned a commitment strength, w, defining their willingness to lose (in waning), gain (for increasing) or both (in variable) commitment to an opinion. Such model has committed nodes that can stick to a single opinion for some time without losing their flexibility to change it in the long run. The traditional Naming Game corresponds to setting w at infinity. A change in commitment strength impacts the critical fraction of population necessary for a minority consensus. Increasing w lowers critical fraction for waning commitment but increases this fraction for increasing commitment. Further, we show that if different nodes have different values of w, higher standard deviation of w increases the critical fraction for waning commitment and decrease this fraction for increasing commitment.

  9. The impact of variable commitment in the Naming Game on consensus formation

    NASA Astrophysics Data System (ADS)

    Niu, Xiang; Doyle, Casey; Korniss, Gyorgy; Szymanski, Boleslaw K.

    2017-02-01

    The Naming Game has proven to be an important model of opinion dynamics in complex networks. It is significantly enriched by the introduction of nodes committed to a single opinion. The resulting model is still simple but captures core concepts of opinion dynamics in networks. This model limitation is rigid commitment which never changes. Here we study the effect that making commitment variable has on the dynamics of the system. Committed nodes are assigned a commitment strength, w, defining their willingness to lose (in waning), gain (for increasing) or both (in variable) commitment to an opinion. Such model has committed nodes that can stick to a single opinion for some time without losing their flexibility to change it in the long run. The traditional Naming Game corresponds to setting w at infinity. A change in commitment strength impacts the critical fraction of population necessary for a minority consensus. Increasing w lowers critical fraction for waning commitment but increases this fraction for increasing commitment. Further, we show that if different nodes have different values of w, higher standard deviation of w increases the critical fraction for waning commitment and decrease this fraction for increasing commitment.

  10. The impact of variable commitment in the Naming Game on consensus formation

    PubMed Central

    Niu, Xiang; Doyle, Casey; Korniss, Gyorgy; Szymanski, Boleslaw K.

    2017-01-01

    The Naming Game has proven to be an important model of opinion dynamics in complex networks. It is significantly enriched by the introduction of nodes committed to a single opinion. The resulting model is still simple but captures core concepts of opinion dynamics in networks. This model limitation is rigid commitment which never changes. Here we study the effect that making commitment variable has on the dynamics of the system. Committed nodes are assigned a commitment strength, w, defining their willingness to lose (in waning), gain (for increasing) or both (in variable) commitment to an opinion. Such model has committed nodes that can stick to a single opinion for some time without losing their flexibility to change it in the long run. The traditional Naming Game corresponds to setting w at infinity. A change in commitment strength impacts the critical fraction of population necessary for a minority consensus. Increasing w lowers critical fraction for waning commitment but increases this fraction for increasing commitment. Further, we show that if different nodes have different values of w, higher standard deviation of w increases the critical fraction for waning commitment and decrease this fraction for increasing commitment. PMID:28150714

  11. First update of the international ASAS consensus statement for the use of anti‐TNF agents in patients with ankylosing spondylitis

    PubMed Central

    Braun, J; Davis, J; Dougados, M; Sieper, J; van der Linden, S; van der Heijde, D

    2006-01-01

    Objective To update the international recommendations for use of anti‐tumour necrosis factor (TNF) agents in the treatment of ankylosing spondylitis. Methods The published recommendations on anti‐TNF treatment in ankylosing spondylitis formed the basis of the update. A questionnaire was sent to the ASAS (assessment in ankylosing spondylitis) members before the final decisions were agreed upon at an international meeting of the ASAS working group. Results Only minor changes to the original consensus statement were required. For the initiation of anti‐TNF treatment, there should be: a diagnosis of definitive ankylosing spondylitis (normally based on modified New York criteria); active disease for at least four weeks, as defined by a sustained Bath ankylosing spondylitis disease activity index (BASDAI) of ⩾4 on a 0–10 scale and expert opinion based on clinical findings; refractory disease, defined by failure of at least two non‐steroidal anti‐inflammatory drugs during a three month period, failure of intra‐articular steroids (if indicated), and failure of sulfasalazine in patients with predominantly peripheral arthritis; and application of the usual precautions and contraindications for biological treatment. For monitoring anti‐TNF treatment: both the ASAS core set for clinical practice and the BASDAI should be followed after the initiation of treatment. Discontinuation of anti‐TNF treatment in non‐responders should be considered after 6–12 weeks. Response is defined by improvement of at least 50% or 2 units (on a 0–10 scale) of the BASDAI. Conclusions This updated consensus statement is recommended in guiding clinical practice and as a basis for developing national guidelines. Evaluation and regular update of this consensus statement is subject to further research by the ASAS group. PMID:16096329

  12. European Society for Paediatric Endocrinology Consensus Guidelines on Screening, Diagnosis, and Management of Congenital Hypothyroidism

    PubMed Central

    Léger, Juliane; Olivieri, Antonella; Donaldson, Malcolm; Torresani, Toni; Krude, Heiko; van Vliet, Guy; Polak, Michel

    2014-01-01

    Objective: The aim was to formulate practice guidelines for the diagnosis and management of congenital hypothyroidism (CH). Evidence: A systematic literature search was conducted to identify key articles relating to the screening, diagnosis, and management of CH. The evidence-based guidelines were developed with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system, describing both the strength of recommendations and the quality of evidence. In the absence of sufficient evidence, conclusions were based on expert opinion. Consensus Process: Thirty-two participants drawn from the European Society for Paediatric Endocrinology and five other major scientific societies in the field of pediatric endocrinology were allocated to working groups with assigned topics and specific questions. Each group searched the literature, evaluated the evidence, and developed a draft document. These papers were debated and finalized by each group before presentation to the full assembly for further discussion and agreement. Recommendations: The recommendations include: worldwide neonatal screening, approaches to assess the cause (including genotyping) and the severity of the disorder, the immediate initiation of appropriate L-T4 supplementation and frequent monitoring to ensure dose adjustments to keep thyroid hormone levels in the target ranges, a trial of treatment in patients suspected of transient CH, regular assessments of developmental and neurosensory functions, consulting health professionals as appropriate, and education about CH. The harmonization of diagnosis, management, and routine health surveillance would not only optimize patient outcomes, but should also facilitate epidemiological studies of the disorder. Individuals with CH require monitoring throughout their lives, particularly during early childhood and pregnancy. PMID:24446653

  13. Methodology of evaluation of morphology of the spine and the trunk in idiopathic scoliosis and other spinal deformities - 6th SOSORT consensus paper

    PubMed Central

    2009-01-01

    Background Comprehensive evaluation of the morphology of the spine and of the whole body is essential in order to correctly manage patients suffering from progressive idiopathic scoliosis. Although methodology of clinical and radiological examination is well described in manuals of orthopaedics, there is deficit of data which clinical and radiological parameters are considered in everyday practise. Recently, an increasing tendency to extend scoliosis examination beyond the measure of the Cobb angle can be observed, reflecting a more patient-oriented approach. Such evaluation often involves surface parameters, aesthetics, function and quality of life. Aim of the study To investigate current recommendations of experts on methodology of evaluation of the patient with spinal deformity, essentially idiopathic scoliosis. Methods Structured Delphi procedure for collecting and processing knowledge from a group of experts with a series of questionnaires and controlled opinion feedback was performed. Experience and opinions of the professionals - physicians and physiotherapists managing scoliosis patients - were studied. According to Delphi method a Meeting Questionnaire (MQ) has been developed, resulting from a preliminary Pre-Meeting Questionnaire (PMQ) which had been previously discussed and approved on line. The MQ was circulated among the SOSORT experts during Consensus Session on "Measurements" which took place at the Annual Meeting of the Society, totally 23 panellists being engaged. Clinical, radiological and surface topography parameters were checked for agreement. Results 90% agreement or more was reached in 35 items and superior than 75% agreement was reached in further 25 items. An evaluation form was proposed to be used by clinicians and researchers. Conclusion The consensus was reached on evaluation of the morphology of the patient with idiopathic scoliosis, comprising clinical, radiological and, to less extend, surface topography assessment. Considering the

  14. Clinical Information System Services and Capabilities Desired for Scalable, Standards-Based, Service-oriented Decision Support: Consensus Assessment of the Health Level 7 Clinical Decision Support Work Group

    PubMed Central

    Kawamoto, Kensaku; Jacobs, Jason; Welch, Brandon M.; Huser, Vojtech; Paterno, Marilyn D.; Del Fiol, Guilherme; Shields, David; Strasberg, Howard R.; Haug, Peter J.; Liu, Zhijing; Jenders, Robert A.; Rowed, David W.; Chertcoff, Daryl; Fehre, Karsten; Adlassnig, Klaus-Peter; Curtis, A. Clayton

    2012-01-01

    A standards-based, service-oriented architecture for clinical decision support (CDS) has the potential to significantly enhance CDS scalability and robustness. To enable such a CDS architecture, the Health Level 7 CDS Work Group reviewed the literature, hosted multi-stakeholder discussions, and consulted domain experts to identify and prioritize the services and capabilities required from clinical information systems (CISs) to enable service-oriented CDS. In addition, relevant available standards were identified. Through this process, ten CIS services and eight CIS capabilities were identified as being important for enabling scalable, service-oriented CDS. In particular, through a survey of 46 domain experts, five services and capabilities were identified as being especially critical: 1) the use of standard information models and terminologies; 2) the ability to leverage a Decision Support Service (DSS); 3) support for a clinical data query service; 4) support for an event subscription and notification service; and 5) support for a user communication service. PMID:23304315

  15. A model of multi-agent consensus for vague and uncertain beliefs

    PubMed Central

    Crosscombe, Michael; Lawry, Jonathan

    2016-01-01

    Consensus formation is investigated for multi-agent systems in which agents’ beliefs are both vague and uncertain. Vagueness is represented by a third truth state meaning borderline. This is combined with a probabilistic model of uncertainty. A belief combination operator is then proposed, which exploits borderline truth values to enable agents with conflicting beliefs to reach a compromise. A number of simulation experiments are carried out, in which agents apply this operator in pairwise interactions, under the bounded confidence restriction that the two agents’ beliefs must be sufficiently consistent with each other before agreement can be reached. As well as studying the consensus operator in isolation, we also investigate scenarios in which agents are influenced either directly or indirectly by the state of the world. For the former, we conduct simulations that combine consensus formation with belief updating based on evidence. For the latter, we investigate the effect of assuming that the closer an agent’s beliefs are to the truth the more visible they are in the consensus building process. In all cases, applying the consensus operators results in the population converging to a single shared belief that is both crisp and certain. Furthermore, simulations that combine consensus formation with evidential updating converge more quickly to a shared opinion, which is closer to the actual state of the world than those in which beliefs are only changed as a result of directly receiving new evidence. Finally, if agent interactions are guided by belief quality measured as similarity to the true state of the world, then applying the consensus operator alone results in the population converging to a high-quality shared belief. PMID:27547020

  16. Medication dispensing errors in Palestinian community pharmacy practice: a formal consensus using the Delphi technique.

    PubMed

    Shawahna, Ramzi; Haddad, Aseel; Khawaja, Baraa; Raie, Rand; Zaneen, Sireen; Edais, Tasneem

    2016-10-01

    Background Medication dispensing errors (MDEs) are frequent in community pharmacy practice. A definition of MDEs and scenarios representing MDE situations in Palestinian community pharmacy practice were not previously approached using formal consensus techniques. Objective This study was conducted to achieve consensus on a definition of MDEs and a wide range of scenarios that should or should not be considered as MDEs in Palestinian community pharmacy practice by a panel of community pharmacists. Setting Community pharmacy practice in Palestine. Method This was a descriptive study using the Delphi technique. A panel of fifty community pharmacists was recruited from different geographical locations of the West Bank of Palestine. A three round Delphi technique was followed to achieve consensus on a proposed definition of MDEs and 83 different scenarios representing potential MDEs using a nine-point scale. Main outcome measure Agreement or disagreement of a panel of community pharmacists on a proposed definition of MDEs and a series of scenarios representing potential MDEs. Results In the first Delphi round, views of key contact community pharmacists on MDEs were explored and situations representing potential MDEs were collected. In the second Delphi round, consensus was achieved to accept the proposed definition and to include 49 (59 %) of the 83 proposed scenarios as MDEs. In the third Delphi round, consensus was achieved to include further 13 (15.7 %) scenarios as MDEs, exclude 9 (10.8 %) scenarios and the rest of 12 (14.5 %) scenarios were considered equivocal based on the opinions of the panelists. Conclusion Consensus on a definition of MDEs and scenarios representing MDE situations in Palestinian community pharmacy practice was achieved using a formal consensus technique. The use of consensual definitions and scenarios representing MDE situations in community pharmacy practice might minimize methodological variations and their significant effects on the

  17. Consensus of Hybrid Multi-Agent Systems.

    PubMed

    Zheng, Yuanshi; Ma, Jingying; Wang, Long

    2017-01-27

    In this brief, we consider the consensus problem of hybrid multiagent systems. First, the hybrid multiagent system is proposed, which is composed of continuous-time and discrete-time dynamic agents. Then, three kinds of consensus protocols are presented for the hybrid multiagent system. The analysis tool developed in this brief is based on the matrix theory and graph theory. With different restrictions of the sampling period, some necessary and sufficient conditions are established for solving the consensus of the hybrid multiagent system. The consensus states are also obtained under different protocols. Finally, simulation examples are provided to demonstrate the effectiveness of our theoretical results.

  18. Learning consensus in adversarial environments

    NASA Astrophysics Data System (ADS)

    Vamvoudakis, Kyriakos G.; García Carrillo, Luis R.; Hespanha, João. P.

    2013-05-01

    This work presents a game theory-based consensus problem for leaderless multi-agent systems in the presence of adversarial inputs that are introducing disturbance to the dynamics. Given the presence of enemy components and the possibility of malicious cyber attacks compromising the security of networked teams, a position agreement must be reached by the networked mobile team based on environmental changes. The problem is addressed under a distributed decision making framework that is robust to possible cyber attacks, which has an advantage over centralized decision making in the sense that a decision maker is not required to access information from all the other decision makers. The proposed framework derives three tuning laws for every agent; one associated with the cost, one associated with the controller, and one with the adversarial input.

  19. International Consensus on drug allergy.

    PubMed

    Demoly, P; Adkinson, N F; Brockow, K; Castells, M; Chiriac, A M; Greenberger, P A; Khan, D A; Lang, D M; Park, H-S; Pichler, W; Sanchez-Borges, M; Shiohara, T; Thong, B Y- H

    2014-04-01

    When drug reactions resembling allergy occur, they are called drug hypersensitivity reactions (DHRs) before showing the evidence of either drug-specific antibodies or T cells. DHRs may be allergic or nonallergic in nature, with drug allergies being immunologically mediated DHRs. These reactions are typically unpredictable. They can be life-threatening, may require or prolong hospitalization, and may necessitate changes in subsequent therapy. Both underdiagnosis (due to under-reporting) and overdiagnosis (due to an overuse of the term ‘allergy’) are common. A definitive diagnosis of such reactions is required in order to institute adequate treatment options and proper preventive measures. Misclassification based solely on the DHR history without further testing may affect treatment options, result in adverse consequences, and lead to the use of more-expensive or less-effective drugs, in contrast to patients who had undergone a complete drug allergy workup. Several guidelines and/or consensus documents on general or specific drug class-induced DHRs are available to support the medical decision process. The use of standardized systematic approaches for the diagnosis and management of DHRs carries the potential to improve outcomes and should thus be disseminated and implemented. Consequently, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), formed by the European Academy of Allergy and Clinical Immunology (EAACI), the American Academy of Allergy, Asthma and Immunology (AAAAI), the American College of Allergy, Asthma and Immunology (ACAAI), and the World Allergy Organization (WAO), has decided to issue an International CONsensus (ICON) on drug allergy. The purpose of this document is to highlight the key messages that are common to many of the existing guidelines, while critically reviewing and commenting on any differences and deficiencies of evidence, thus providing a comprehensive reference document for the diagnosis and management of

  20. Data publication consensus and controversies

    PubMed Central

    Kratz, John; Strasser, Carly

    2014-01-01

    The movement to bring datasets into the scholarly record as first class research products (validated, preserved, cited, and credited) has been inching forward for some time, but now the pace is quickening. As data publication venues proliferate, significant debate continues over formats, processes, and terminology. Here, we present an overview of data publication initiatives underway and the current conversation, highlighting points of consensus and issues still in contention. Data publication implementations differ in a variety of factors, including the kind of documentation, the location of the documentation relative to the data, and how the data is validated. Publishers may present data as supplemental material to a journal article, with a descriptive “data paper,” or independently. Complicating the situation, different initiatives and communities use the same terms to refer to distinct but overlapping concepts. For instance, the term published means that the data is publicly available and citable to virtually everyone, but it may or may not imply that the data has been peer-reviewed. In turn, what is meant by data peer review is far from defined; standards and processes encompass the full range employed in reviewing the literature, plus some novel variations. Basic data citation is a point of consensus, but the general agreement on the core elements of a dataset citation frays if the data is dynamic or part of a larger set. Even as data publication is being defined, some are looking past publication to other metaphors, notably “data as software,” for solutions to the more stubborn problems. PMID:25075301

  1. Recommendations for the Clinical Management of Hepatitis C in Iran: A Consensus-Based National Guideline

    PubMed Central

    Alavian, Seyed Moayed; Hajarizadeh, Behzad; Bagheri Lankarani, Kamran; Sharafi, Heidar; Ebrahimi Daryani, Nasser; Merat, Shahin; Mohraz, Minoo; Mardani, Masoud; Fattahi, Mohamad Reza; Poustchi, Hossein; Nikbin, Mehri; Nabavi, Mahmood; Adibi, Peyman; Ziaee, Masood; Behnava, Bita; Rezaee-Zavareh, Mohammad Saeid; Colombo, Massimo; Massoumi, Hatef; Bizri, Abdul Rahman; Eghtesad, Bijan; Amiri, Majid; Namvar, Ali; Hesamizadeh, Khashayar; Malekzadeh, Reza

    2016-01-01

    Context Hepatitis C virus (HCV) infection is a major public health issue worldwide, including Iran. The new direct-acting antiviral agents (DAAs) with high efficacy have changed the landscape of HCV treatment. This guideline provides updated recommendations for clinical management of HCV infection in Iran. Evidence Acquisition The recommendations of this guideline are based on international and national scientific evidences and consensus-based expert opinion. Scientific evidences were collected through a systematic review of studies that evaluated efficacy and safety of DAA regimens, using PubMed, Scopus and Web of Science. Expert opinion was based on the consensus of Iran Hepatitis Scientific Board (IHSB) in the 3rd national consensus on management of Hepatitis C in Iran, held on 22nd of July 2016. Results Pegylated Interferon alpha (PegIFN), Ribavirin (RBV), Sofosbuvir (SOF), Ledipasvir (LDV) and Daclatasvir (DCV) are currently available in Iran. Pre-treatment assessments include HCV RNA level, HCV genotype and resistance testing, assessment of liver fibrosis, and underlying diseases. In HCV genotype 1 and 4, DCV/SOF and LDV/SOF are recommended. In HCV genotype 2, SOF plus RBV and in HCV genotype 3, DCV/SOF is recommended. Additional care for underlying diseases should be considered. Conclusions Affordable new HCV treatment regimens are available in Iran, providing an opportunity for HCV elimination. Recommendations provided in this current national guideline can facilitate evidence-based management of HCV infection. PMID:27799966

  2. Dispelling the North American acid rain clouds: Developing a framework for political consensus through the identification of elite viewpoints

    SciTech Connect

    Bhatti, N.

    1988-01-01

    Acidic deposition has simultaneously been referred to as an environmental curiosity and as an ecological holocaust. This polarization of opinion on this pollutant has resulted in the policy stalemate in Congress over this issue and is responsible for the major part of the friction which currently besets Canada-United States relations. This study identified the distinctive viewpoints which characterize opposing attitudes. In addition, the specific areas of consensus and disagreement among these elite groups were determined. All of these objectives were carried out using the results of the Q-sort technique and interviews with members of the acid rain elite in both Canada and the United States (i.e. politicians, scientists, regulators, environmental/advocacy groups, and industry/utility personnel). Furthermore, a comprehensive, in-depth review of the scientific, legal, economic, social and political aspects of this tissue was conducted. Results show that implementation of the Acid Rain Experimental Control Program (ARECP) and the Clean Coal Technology project has the potential to break the existing stalemates over this issue and, at the same, could avert damage to many ecosystems, man-made structures and human health.

  3. Multidisciplinary consensus on the therapeutic recommendations for iatrogenic hyperprolactinemia secondary to antipsychotics.

    PubMed

    Montejo, Ángel L; Arango, Celso; Bernardo, Miquel; Carrasco, José L; Crespo-Facorro, Benidicto; Cruz, Juan J; Del Pino-Montes, Javier; García-Escudero, Miguel A; García-Rizo, Clemente; González-Pinto, Ana; Hernández, Ana I; Martín-Carrasco, Manuel; Mayoral-Cleries, Fermín; Mayoral-van Son, Jaqueline; Mories, M Teresa; Pachiarotti, Isabella; Pérez, Jesús; Ros, Salvador; Vieta, Eduard

    2017-04-01

    Hyperprolactinemia is an underappreciated/unknown adverse effects of antipsychotics. The consequences of hyperprolactinemia compromise therapeutic adherence and can be serious. We present the consensus recommendations made by a group of experts regarding the management of antipsychotic-induced hyperprolactinemia. The current consensus was developed in 3 phases: 1, review of the scientific literature; 2, subsequent round table discussion to attempt to reach a consensus among the experts; and 3, review by all of the authors of the final conclusions until reaching a complete consensus. We include recommendations on the appropriate time to act after hyperprolactinemia detection and discuss the evidence on available options: decreasing the dose of the antipsychotic drug, switching antipsychotics, adding aripiprazole, adding dopaminergic agonists, and other type of treatment. The consensus also included recommendations for some specific populations such as patients with a first psychotic episode and the pediatric-youth population, bipolar disorder, personality disorders and the elderly population.

  4. Allowable delay bound for consensus of linear multi-agent systems with communication delay

    NASA Astrophysics Data System (ADS)

    Zhang, Ya; Tian, Yu-Ping

    2014-10-01

    This paper studies the consensus of a group of linear dynamic agents with a uniform communication delay and focuses on searching an allowable delay bound. As long as the delay is less than this bound, there exist linear feedback consensus protocols driving the multi-agent system to achieve consensus. Both fixed and switching topology cases are investigated. In both cases, the consensus problem is converted to the robust stability problem of corresponding uncertain state-delayed systems. By using Lyapunov-Krasovskii functional analysis, consensus conditions which contain the feedback gain conditions and delay conditions are proposed for systems over fixed and switching topologies, respectively. Furthermore, allowable delay bounds are obtained for both systems by solving the optimal robust stabilisation problems. Numerical examples are given to illustrate the results.

  5. A recommended practical approach to the management of target therapy and angiogenesis inhibitors cardiotoxicity: an opinion paper of the working group on drug cardiotoxicity and cardioprotection, Italian Society of Cardiology

    PubMed Central

    Maurea, Nicola; Spallarossa, Paolo; Cadeddu, Christian; Madonna, Rosalinda; Mele, Donato; Monte, Ines; Novo, Giuseppina; Pagliaro, Pasquale; Pepe, Alessia; Tocchetti, Carlo G.; Zito, Concetta; Mercuro, Giuseppe

    2016-01-01

    The US National Cancer Institute estimates that cardiotoxicity (CTX) from target therapy refers mostly to four groups of drugs: epidermal growth factor receptor 2 inhibitors, angiogenic inhibitors, directed Abelson murine leukemia viral oncogene homolog inhibitors, and proteasome inhibitors. The main cardiotoxic side-effects related to antiepidermal growth factor receptor 2 therapy are left ventricular systolic dysfunction and heart failure. Angiogenesis inhibitors are associated with hypertension, left ventricular dysfunction/heart failure, myocardial ischemia, QT prolongation, and thrombosis. Moreover, other agents may be related to CTX induced by treatment. In this study, we review the guidelines for a practical approach for the management of CTX in patients under anticancer target therapy. PMID:27183530

  6. Questioning the Consensus Definition of Validity

    ERIC Educational Resources Information Center

    Newton, Paul E.

    2012-01-01

    This focus article provided the author with an opportunity to unpack the consensus definition of validity and to explore its implications in the light of recent debates. He proposed an elaboration of the consensus definition, which was intended to express the spirit of the "Standards for Educational and Psychological Testing" with increased…

  7. Posterior Probabilities for a Consensus Ordering.

    ERIC Educational Resources Information Center

    Fligner, Michael A.; Verducci, Joseph S.

    1990-01-01

    The concept of consensus ordering is defined, and formulas for exact and approximate posterior probabilities for consensus ordering are developed under the assumption of a generalized Mallows' model with a diffuse conjugate prior. These methods are applied to a data set concerning 98 college students. (SLD)

  8. Eastern Canadian Gastrointestinal Cancer Consensus Conference 2014

    PubMed Central

    Tsvetkova, E.; Sud, S.; Aucoin, N.; Biagi, J.; Burkes, R.; Samson, B.; Brule, S.; Cripps, C.; Colwell, B.; Falkson, C.; Dorreen, M.; Goel, R.; Halwani, F.; Maroun, J.; Michaud, N.; Tehfe, M.; Thirlwell, M.; Vickers, M.; Asmis, T.

    2015-01-01

    The annual Eastern Canadian Colorectal Cancer Consensus Conference was held in Montreal, Quebec, 23–25 October 2014. Expert radiation, medical, and surgical oncologists and pathologists involved in the management of patients with gastrointestinal malignancies participated in presentations and discussions resulting in consensus statements on such hot topics as management of neuroendocrine tumours, advanced and metastatic pancreatic cancer, and metastatic colorectal cancer. PMID:26300681

  9. The Importance of Consensus Information in Acceptance of Climate Change (Invited)

    NASA Astrophysics Data System (ADS)

    Cook, J.; Lewandowsky, S.

    2013-12-01

    In recent years, public perception of the scientific consensus on human-caused global warming has been disturbingly low, in contrast to the overwhelming level of agreement among climate scientists and in peer-reviewed research. The misperception is partly cultural, with a significant link between perceived consensus and political ideology, and partly informational with all cultural groups exhibiting the misperception to varying degrees. This universal 'consensus gap' is in large part due to a persistent and focused misinformation campaign casting doubt on the consensus, dating back as early as the 1980s. Opponents of climate action have long recognized that perception of scientific consensus is linked to support for climate policy, a link only acknowledged by social scientists in the last few years. How do we counter the all-too-effective misinformation campaign? Psychological research tells us that a crucial aspect of effective refutations is an alternative narrative. In this case, an important counter-narrative to the consensus story is the strategy to perpetuate the impression of ongoing scientific debate. I will also present recent research into the effect that consensus information has on climate beliefs of Australians and Americans. For both groups, the consensus message significantly increased beliefs about human-caused global warming and outperformed interventions that feature evidence or scientists' expertise. For the Australian sample, consensus information partially neutralised the biasing influence of ideology. However, for Americans, a backfire effect (reduced climate belief) was observed for a small minority holding strong conservative views. A psychological model employing Bayesian Networks indicates that a key element to the backfire effect is conspiratorial thinking, consistent with other research finding a link between rejection of climate science and conspiratorial ideation. Thus when presented to a general audience, consensus information has an

  10. Stochastic opinion formation in scale-free networks

    SciTech Connect

    M. Bartolozzi; D. B. Leinweber; A. W. Thomas

    2005-10-01

    The dynamics of opinion formation in large groups of people is a complex nonlinear phenomenon whose investigation is just beginning. Both collective behavior and personal views play an important role in this mechanism. In the present work we mimic the dynamics of opinion formation of a group of agents, represented by two states 1, as a stochastic response of each agent to the opinion of his/her neighbors in the social network and to feedback from the average opinion of the whole. In the light of recent studies, a scale-free Barabsi-Albert network has been selected to simulate the topology of the interactions. A turbulent-like dynamics, characterized by an intermittent behavior, is observed for a certain range of the model parameters. The problem of uncertainty in decision taking is also addressed both from a topological point of view, using random and targeted removal of agents from the network, and by implementing a three-state model, where the third state, zero, is related to the information available to each agent. Finally, the results of the model are tested against the best known network of social interactions: the stock market. A time series of daily closures of the Dow-Jones index has been used as an indicator of the possible applicability of our model in the financial context. Good qualitative agreement is found.

  11. Bladder Cancer Molecular Taxonomy: Summary from a Consensus Meeting.

    PubMed

    Lerner, Seth P; McConkey, David J; Hoadley, Katherine A; Chan, Keith S; Kim, William Y; Radvanyi, François; Höglund, Mattias; Real, Francisco X

    2016-01-07

    The advent of Omics technologies has been key to the molecular subclassification of urothelial bladder cancer. Several groups have used different strategies to this aim, with partially overlapping findings. The meeting at the Spanish National Cancer Research Center-CNIO was held to discuss such classifications and reach consensus where appropriate. After updated presentations on the work performed by the teams attending the meeting, a consensus was reached regarding the existence of a group of Basal-Squamous-like tumors - designated BASQ - charaterized the high expression of KRT5/6 and KRT14 and low/undetectable expression of FOXA1 and GATA3. An additional tumor subgroup with urothelial differentiation features was recognized whose optimal molecular definition is required. For other subtypes described, more work is needed to determine how robust they are and how to best define them at the molecular level.

  12. Myalgic encephalomyelitis: International Consensus Criteria

    PubMed Central

    Carruthers, B M; van de Sande, M I; De Meirleir, K L; Klimas, N G; Broderick, G; Mitchell, T; Staines, D; Powles, A C P; Speight, N; Vallings, R; Bateman, L; Baumgarten-Austrheim, B; Bell, D S; Carlo-Stella, N; Chia, J; Darragh, A; Jo, D; Lewis, D; Light, A R; Marshall-Gradisbik, S; Mena, I; Mikovits, J A; Miwa, K; Murovska, M; Pall, M L; Stevens, S

    2011-01-01

    , Japan; A. Kirchenstein Institute of Microbiology and Virology, Riga Stradins University, Riga, Latvia; Department of Biochemistry & Basic Medical Sciences, Washington State University, Portland, OR; Department of Sports Sciences, University of the Pacific, Stockton, CA USA). Myalgic encephalomyelitis: International Consensus Criteria (Review). J Intern Med 2011; 270: 327–338. The label ‘chronic fatigue syndrome’ (CFS) has persisted for many years because of the lack of knowledge of the aetiological agents and the disease process. In view of more recent research and clinical experience that strongly point to widespread inflammation and multisystemic neuropathology, it is more appropriate and correct to use the term ‘myalgic encephalomyelitis’ (ME) because it indicates an underlying pathophysiology. It is also consistent with the neurological classification of ME in the World Health Organization’s International Classification of Diseases (ICD G93.3). Consequently, an International Consensus Panel consisting of clinicians, researchers, teaching faculty and an independent patient advocate was formed with the purpose of developing criteria based on current knowledge. Thirteen countries and a wide range of specialties were represented. Collectively, members have approximately 400 years of both clinical and teaching experience, authored hundreds of peer-reviewed publications, diagnosed or treated approximately 50 000 patients with ME, and several members coauthored previous criteria. The expertise and experience of the panel members as well as PubMed and other medical sources were utilized in a progression of suggestions/drafts/reviews/revisions. The authors, free of any sponsoring organization, achieved 100% consensus through a Delphi-type process. The scope of this paper is limited to criteria of ME and their application. Accordingly, the criteria reflect the complex symptomatology. Operational notes enhance clarity and specificity by providing guidance in the

  13. After seven years, where`s the consensus?

    SciTech Connect

    Norman, M.R.

    1993-04-01

    It has been 7 years since the discovery of copper oxide superconductors, yet there is no consensus on the correct theory for this phenomenon. The theory can be divided into 3 groups: ordinary (phonons), exotic (AF spin fluctuations, nested Fermi liquid, excitons, spin bags, odd frequency pairing), and revolutionary (Luttinger liquid, spin-charge separation, gauge theories, anyons, marginal Fermi liquid). C-axis dispersion, dHvA, and magneto-oscillations are also discussed.

  14. The dynamics of opinion in hierarchical organizations

    NASA Astrophysics Data System (ADS)

    Laguna, M. F.; Risau Gusman, S.; Abramson, G.; Gonçalves, S.; Iglesias, J. R.

    2005-06-01

    We study the mutual influence of authority and persuasion in the flow of opinions. We describe a simple model with no social mobility, where each agent belongs to a class in the hierarchy and has also a persuasion capability. Agents use the force of its persuasion to propagate their opinions; however a high-rank agent can also use its authority to impose its opinion on other ones. The model is studied analytically within a mean field approximation and by means of numerical simulations. In the case of a three authority level hierarchy the agreement between the two approaches is excellent. We obtain a phase diagram identifying the relative frequency of the prevailing opinions, and find that the stratum where the dominant opinion arises from is strongly dependent on the relative population of each hierarchy level. The time evolution shows that conflicting opinions polarize after a short transient.

  15. Food parenting measurement issues: Working group consensus report

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Childhood obesity is a growing problem. As more researchers become involved in the study of parenting influences on childhood obesity, there appears to be a lack of agreement regarding the most important parenting constructs of interest, definitions of those constructs, and measurement of those cons...

  16. Geriatric assessment in daily oncology practice for nurses and allied health care professionals: Opinion paper of the Nursing and Allied Health Interest Group of the International Society of Geriatric Oncology (SIOG).

    PubMed

    Burhenn, Peggy S; McCarthy, Alexandra L; Begue, Aaron; Nightingale, Ginah; Cheng, Karis; Kenis, Cindy

    2016-09-01

    The management of older persons with cancer has become a major public health concern in developed countries because of the aging of the population and the steady increase in cancer incidence with advancing age. Nurses and allied health care professionals are challenged to address the needs of this growing population. The International Society of Geriatric Oncology (SIOG) Nursing and Allied Health (NAH) Interest Group described key issues that nurses and allied health care professionals face when caring for older persons with cancer. The domains of the Geriatric Assessment (GA) are used as a guiding framework. The following geriatric domains are described: demographic data and social support, functional status, cognition, mental health, nutritional status, fatigue, comorbidities, polypharmacy, and other geriatric syndromes (e.g. falls, delirium). In addition to these geriatric domains, quality of life (QoL) is described based on the overall importance in this particular population. Advice for integration of assessment of these geriatric domains into daily oncology practice is made. Research has mainly focused on the role of treating physicians but the involvement of nurses and allied health care professionals is crucial in the care of older persons with cancer through the GA process. The ability of nurses and allied health care professionals to perform this assessment requires specialized training and education beyond standard oncology knowledge.

  17. Insulin Resistance in Children: Consensus, Perspective, and Future Directions

    PubMed Central

    Levy-Marchal, Claire; Arslanian, Silva; Cutfield, Wayne; Sinaiko, Alan; Druet, Celine; Marcovecchio, M. Loredana; Chiarelli, Francesco

    2010-01-01

    Objective: Emerging data indicate that insulin resistance is common among children and adolescents and is related to cardiometabolic risk, therefore requiring consideration early in life. However, there is still confusion on how to define insulin resistance, how to measure it, what its risk factors are, and whether there are effective strategies to prevent and treat it. A consensus conference was organized in order to clarify these points. Participants: The consensus was internationally supported by all the major scientific societies in pediatric endocrinology and 37 participants. Evidence: An independent and systematic search of the literature was conducted to identify key articles relating to insulin resistance in children. Consensus Process: The conference was divided into five themes and working groups: background and definition; methods of measurement and screening; risk factors and consequences; prevention; and treatment. Each group selected key issues, searched the literature, and developed a draft document. During a 3-d meeting, these papers were debated and finalized by each group before presenting them to the full forum for further discussion and agreement. Conclusions: Given the current childhood obesity epidemic, insulin resistance in children is an important issue confronting health care professionals. There are no clear criteria to define insulin resistance in children, and surrogate markers such as fasting insulin are poor measures of insulin sensitivity. Based on current screening criteria and methodology, there is no justification for screening children for insulin resistance. Lifestyle interventions including diet and exercise can improve insulin sensitivity, whereas drugs should be implemented only in selected cases. PMID:20829185

  18. Consensus Paper: Cerebellum and Emotion.

    PubMed

    Adamaszek, M; D'Agata, F; Ferrucci, R; Habas, C; Keulen, S; Kirkby, K C; Leggio, M; Mariën, P; Molinari, M; Moulton, E; Orsi, L; Van Overwalle, F; Papadelis, C; Priori, A; Sacchetti, B; Schutter, D J; Styliadis, C; Verhoeven, J

    2017-04-01

    Over the past three decades, insights into the role of the cerebellum in emotional processing have substantially increased. Indeed, methodological refinements in cerebellar lesion studies and major technological advancements in the field of neuroscience are in particular responsible to an exponential growth of knowledge on the topic. It is timely to review the available data and to critically evaluate the current status of the role of the cerebellum in emotion and related domains. The main aim of this article is to present an overview of current facts and ongoing debates relating to clinical, neuroimaging, and neurophysiological findings on the role of the cerebellum in key aspects of emotion. Experts in the field of cerebellar research discuss the range of cerebellar contributions to emotion in nine topics. Topics include the role of the cerebellum in perception and recognition, forwarding and encoding of emotional information, and the experience and regulation of emotional states in relation to motor, cognitive, and social behaviors. In addition, perspectives including cerebellar involvement in emotional learning, pain, emotional aspects of speech, and neuropsychiatric aspects of the cerebellum in mood disorders are briefly discussed. Results of this consensus paper illustrate how theory and empirical research have converged to produce a composite picture of brain topography, physiology, and function that establishes the role of the cerebellum in many aspects of emotional processing.

  19. [Mexican consensus on portal hypertension].

    PubMed

    Narváez-Rivera, R M; Cortez-Hernández, C A; González-González, J A; Tamayo-de la Cuesta, J L; Zamarripa-Dorsey, F; Torre-Delgadillo, A; Rivera-Ramos, J F J; Vinageras-Barroso, J I; Muneta-Kishigami, J E; Blancas-Valencia, J M; Antonio-Manrique, M; Valdovinos-Andraca, F; Brito-Lugo, P; Hernández-Guerrero, A; Bernal-Reyes, R; Sobrino-Cossío, S; Aceves-Tavares, G R; Huerta-Guerrero, H M; Moreno-Gómez, N; Bosques-Padilla, F J

    2013-01-01

    The aim of the Mexican Consensus on Portal Hypertension was to develop documented guidelines to facilitate clinical practice when dealing with key events of the patient presenting with portal hypertension and variceal bleeding. The panel of experts was made up of Mexican gastroenterologists, hepatologists, and endoscopists, all distinguished professionals. The document analyzes themes of interest in the following modules: preprimary and primary prophylaxis, acute variceal hemorrhage, and secondary prophylaxis. The management of variceal bleeding has improved considerably in recent years. Current information indicates that the general management of the cirrhotic patient presenting with variceal bleeding should be carried out by a multidisciplinary team, with such an approach playing a major role in the final outcome. The combination of drug and endoscopic therapies is recommended for initial management; vasoactive drugs should be started as soon as variceal bleeding is suspected and maintained for 5 days. After the patient is stabilized, urgent diagnostic endoscopy should be carried out by a qualified endoscopist, who then performs the corresponding endoscopic variceal treatment. Antibiotic prophylaxis should be regarded as an integral part of treatment, started upon hospital admittance and continued for 5 days. If there is treatment failure, rescue therapies should be carried out immediately, taking into account that interventional radiology therapies are very effective in controlling refractory variceal bleeding. These guidelines have been developed for the purpose of achieving greater clinical efficacy and are based on the best evidence of portal hypertension that is presently available.

  20. Formal consensus method to evaluate the conformity of prescription of a recently approved chemotherapy treatment in an observatory study.

    PubMed

    Houédé, Nadine; Leutenegger, Eric; Lomma, Mariella; Bellera, Carine

    2015-01-01

    Cabazitaxel is a second line chemotherapy drug recently approved for the treatment of metastatic castration-resistant prostate cancer. A first panel of French experts and a second independent panel of European experts were convened to assess the conformity of prescription of cabazitaxel with a Delphi consensus method. A two-round modified Delphi consensus process was conducted. This methodology is based on experts' opinion obtained in a systematic manner. The process was divided into five steps: (i) elaboration of the questionnaire, (ii) rating, (iii) analysis, (iv) discussion of the points with absence of consensus following rating of the questionnaire, and (v) final reporting. Consensus was defined according to RAND method and all analyses were conducted according to the same methodology. At the end of the two rounds of rating and a synthesis meeting, of the 26 items included in the Summary of Product Characteristics (SPC), 11 items were judged appropriate with strong consensus by the two independent panels of experts. These items can therefore be considered of prime importance to evaluate conformity of cabazitaxel prescription in the context of observatory studies as well as in further clinical trials using this new taxane. Our findings further provide important evidence about the value of the Delphi consensus and highlight a requirement for "conformity" standards to assist practitioners in a safe chemotherapy drug prescription.

  1. Opinions and knowledge about climate change science in high school students.

    PubMed

    Harker-Schuch, Inez; Bugge-Henriksen, Christian

    2013-10-01

    This study investigates the influence of knowledge on opinions about climate change in the emerging adults' age group (16-17 years). Furthermore, the effects of a lecture in climate change science on knowledge and opinions were assessed. A survey was conducted in Austria and Denmark on 188 students in national and international schools before and after a lecture in climate change science. The results show that knowledge about climate change science significantly affects opinions about climate change. Students with a higher number of correct answers are more likely to have the opinion that humans are causing climate change and that both individuals and governments are responsible for addressing climate change. The lecture in climate change science significantly improved knowledge development but did not affect opinions. Knowledge was improved by 11 % after the lecture. However, the percentage of correct answers was still below 60 % indicating an urgent need for improving climate change science education.

  2. It Ain't (Just) the Heat, It's the Humanity: Increasing Public Understanding of Scientific Consensus and Its Role in Climate Literacy

    NASA Astrophysics Data System (ADS)

    Jacobs, P.; Cook, J.; Nuccitelli, D.

    2014-12-01

    An overwhelming scientific consensus exists on the issue of anthropogenic climate change. Unfortunately, public perception of expert agreement remains low- only around 1 in 10 Americans correctly estimates the actual level of consensus on the topic. Moreover, several recent studies have demonstrated the pivotal role that perceived consensus plays in the public's acceptance of key scientific facts about environmental problems, as well as their willingness to support policy to address them. This "consensus gap", between the high level of scientific agreement vs. the public's perception of it, has led to calls for increased consensus messaging. However this call has been challenged by a number of different groups: climate "skeptics" in denial about the existence and validity of the consensus; some social science researchers and journalists who believe that such messages will be ineffective or counterproductive; and even some scientists and science advocates who downplay the value of consensus in science generally. All of these concerns can be addressed by effectively communicating the role of consensus within science to the public, as well as the conditions under which consensus is likely to be correct. Here, we demonstrate that the scientific consensus on anthropogenic climate change satisfies these conditions, and discuss past examples of purported consensus that failed or succeeded to satisfy them as well. We conclude by discussing the way in which scientific consensus is interpreted by the public, and how consensus messaging can improve climate literacy.

  3. Successful Translation of Fluorescence Navigation During Oncologic Surgery: A Consensus Report

    PubMed Central

    Rosenthal, Eben L; Warram, Jason M; de Boer, Esther; Basilion, James P; Biel, Merrill A; Bogyo, Matthew; Bouvet, Michael; Brigman, Brian E; Colson, Yolonda L; DeMeester, Steven R; Gurtner, Geoffrey C; Ishizawa, Takeaki; Jacobs, Paula M; Keereweer, Stijn; Liao, Joseph C; Nguyen, Quyen T; Olson, Jim; Paulsen, Keith D; Rieves, Dwaine; Sumer, Baran D; Tweedle, Michael F; Vahrmeijer, Alexander L; Weichert, Jamey P; Wilson, Brian C; Zenn, Michael R; Zinn, Kurt R; van Dam, Gooitzen M

    2016-01-01

    Navigation with fluorescence guidance is emerging as a promising strategy to improve the efficacy of oncologic surgery in the last decade. The onus is on the surgical community to objectively assess the added value of this technique for routine use daily clinical practice, which will directly impact both the Food and Drug Administration (FDA) approval process and insurance reimbursement. In addition, it is critical to characterize the potential benefits over existing practices and to elucidate both the costs and safety risks. This report is the result a consensus meeting of the American Society of Image Guided Surgery (ASIGS) on February 6th, 2015 at Miami, Florida and reflects a consensus of the participant’s opinions. Our objective is to critically evaluate the platform technology and its optical imaging agents and make recommendations for successful clinical trial development for clinical implementation of this highly promising approach in oncologic surgery. PMID:26449839

  4. Consensus expert recommendations for identification and management of asparaginase hypersensitivity and silent inactivation.

    PubMed

    van der Sluis, Inge M; Vrooman, Lynda M; Pieters, Rob; Baruchel, Andre; Escherich, Gabriele; Goulden, Nicholas; Mondelaers, Veerle; Sanchez de Toledo, Jose; Rizzari, Carmelo; Silverman, Lewis B; Whitlock, James A

    2016-03-01

    L-asparaginase is an integral component of therapy for acute lymphoblastic leukemia. However, asparaginase-related complications, including the development of hypersensitivity reactions, can limit its use in individual patients. Of considerable concern in the setting of clinical allergy is the development of neutralizing antibodies and associated asparaginase inactivity. Also problematic in the use of asparaginase is the potential for the development of silent inactivation, with the formation of neutralizing antibodies and reduced asparaginase activity in the absence of a clinically evident allergic reaction. Here we present guidelines for the identification and management of clinical hypersensitivity and silent inactivation with Escherichia coli- and Erwinia chrysanthemi- derived asparaginase preparations. These guidelines were developed by a consensus panel of experts following a review of the available published data. We provide a consensus of expert opinions on the role of serum asparaginase level assessment, indications for switching asparaginase preparation, and monitoring after change in asparaginase preparation.

  5. Group X

    SciTech Connect

    Fields, Susannah

    2007-08-16

    This project is currently under contract for research through the Department of Homeland Security until 2011. The group I was responsible for studying has to remain confidential so as not to affect the current project. All dates, reference links and authors, and other distinguishing characteristics of the original group have been removed from this report. All references to the name of this group or the individual splinter groups has been changed to 'Group X'. I have been collecting texts from a variety of sources intended for the use of recruiting and radicalizing members for Group X splinter groups for the purpose of researching the motivation and intent of leaders of those groups and their influence over the likelihood of group radicalization. This work included visiting many Group X websites to find information on splinter group leaders and finding their statements to new and old members. This proved difficult because the splinter groups of Group X are united in beliefs, but differ in public opinion. They are eager to tear each other down, prove their superiority, and yet remain anonymous. After a few weeks of intense searching, a list of eight recruiting texts and eight radicalizing texts from a variety of Group X leaders were compiled.

  6. Consensus Document on Prevention and Treatment of Tuberculosis in Patients for Biological Treatment.

    PubMed

    Mir Viladrich, Isabel; Daudén Tello, Esteban; Solano-López, Guillermo; López Longo, Francisco Javier; Taxonera Samso, Carlos; Sánchez Martínez, Paquita; Martínez Lacasa, Xavier; García Gasalla, Mercedes; Dorca Sargatal, Jordi; Arias-Guillén, Miguel; García García, José Maria

    2016-01-01

    Tuberculosis risk is increased in patients with chronic inflammatory diseases receiving any immunosuppressive treatment, notably tumor necrosis factor (TNF) antagonists therapy. Screening for the presence of latent infection with Mycobacterium tuberculosis and targeted preventive treatment to reduce the risk of progression to TB is mandatory in these patients. This Consensus Document summarizes the current knowledge and expert opinion of biologic therapies including TNF-blocking treatments. It provides recommendations for the use of interferon-gamma release assays (IGRA) and tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection in these patients, and for the type and duration of preventive therapy.

  7. Determining the Criteria and Their Weights for Medical Schools' Ranking: A National Consensus.

    PubMed

    Mojtahedzadeh, Rita; Mohammadi, Aeen; Kohan, Noushin; Gharib, Mitra; Zolfaghari, Mitra

    2016-06-01

    Delphi as a consensus development technique enables anonymous, systematic refinement of expert opinion with the aim of arriving at a combined or consensual position. In this study, we determined the criteria and their weights for Iranian Medical Schools' ranking through a Delphi process. An expert committee devised 13 proposed criteria with 32 indicators with their weights, which were arranged hierarchically in the form of a tree diagram. We used the Delphi technique to reach a consensus on these criteria and weights among the deans of 38 public Iranian medical schools. For this purpose, we devised and sent a questionnaire to schools and asked them to suggest or correct the criteria and their weights. We repeated this process in two rounds till all the schools reached an acceptable consensus on them. All schools reached a consensus on the set of 13 criteria and 30 indicators and their weights in three main contexts of education, research and facilities, and equipment which were used for Medical Schools' ranking. Using Delphi technique for devising the criteria and their weights in evaluation processes such as ranking makes their results more acceptable among universities.

  8. Cluster consensus of second-order multi-agent systems via pinning control

    NASA Astrophysics Data System (ADS)

    Lu, Xiao-Qing; Francis, Austin; Chen, Shi-Hua

    2010-12-01

    This paper investigates the cluster consensus problem for second-order multi-agent systems by applying the pinning control method to a small collection of the agents. Consensus is attained independently for different agent clusters according to the community structure generated by the group partition of the underlying graph and sufficient conditions for both cluster and general consensus are obtained by using results from algebraic graph theory and the LaSalle Invariance Principle. Finally, some simple simulations are presented to illustrate the technique.

  9. Robust consensus tracking for an integrator-type multi-agent system with disturbances and unmodelled dynamics

    NASA Astrophysics Data System (ADS)

    Hu, Guoqiang

    2011-01-01

    In this article, a robust consensus tracking problem for a multi-agent system with integrator-type dynamics has been addressed in the presence of disturbances and unmodelled dynamics. The desired trajectory to be tracked is only provided to a small group of team members. An identifier is developed to estimate the unknown disturbances and unmodelled dynamics. A consensus controller is developed based on this identifier to achieve asymptotic consensus tracking using the local information obtained from neighbouring agents. The closed-loop stability is proved using the Lyapunov-based analysis and an invariance-like theorem. Numerical simulations are provided to demonstrate the effectiveness of the developed robust consensus controller.

  10. Consensus Paper: Language and the Cerebellum: an Ongoing Enigma

    PubMed Central

    Mariën, Peter; Ackermann, Herman; Adamaszek, Michael; Barwood, Caroline H. S.; Beaton, Alan; Desmond, John; De Witte, Elke; Fawcett, Angela J.; Hertrich, Ingo; Küper, Michael; Leggio, Maria; Marvel, Cherie; Molinari, Marco; Murdoch, Bruce E.; Nicolson, Roderick I.; Schmahmann, Jeremy D.; Stoodley, Catherine J.; Thürling, Markus; Timmann, Dagmar; Wouters, Ellen; Ziegler, Wolfram

    2014-01-01

    In less than three decades, the concept “cerebellar neurocognition” has evolved from a mere afterthought to an entirely new and multifaceted area of neuroscientific research. A close interplay between three main strands of contemporary neuroscience induced a substantial modification of the traditional view of the cerebellum as a mere coordinator of autonomic and somatic motor functions. Indeed, the wealth of current evidence derived from detailed neuroanatomical investigations, functional neuroimaging studies with healthy subjects and patients and in-depth neuropsychological assessment of patients with cerebellar disorders shows that the cerebellum has a cardinal role to play in affective regulation, cognitive processing, and linguistic function. Although considerable progress has been made in models of cerebellar function, controversy remains regarding the exact role of the “linguistic cerebellum” in a broad variety of nonmotor language processes. This consensus paper brings together a range of different viewpoints and opinions regarding the contribution of the cerebellum to language function. Recent developments and insights in the nonmotor modulatory role of the cerebellum in language and some related disorders will be discussed. The role of the cerebellum in speech and language perception, in motor speech planning including apraxia of speech, in verbal working memory, in phonological and semantic verbal fluency, in syntax processing, in the dynamics of language production, in reading and in writing will be addressed. In addition, the functional topography of the linguistic cerebellum and the contribution of the deep nuclei to linguistic function will be briefly discussed. As such, a framework for debate and discussion will be offered in this consensus paper. PMID:24318484

  11. European consensus conference on faecal microbiota transplantation in clinical practice.

    PubMed

    Cammarota, Giovanni; Ianiro, Gianluca; Tilg, Herbert; Rajilić-Stojanović, Mirjana; Kump, Patrizia; Satokari, Reetta; Sokol, Harry; Arkkila, Perttu; Pintus, Cristina; Hart, Ailsa; Segal, Jonathan; Aloi, Marina; Masucci, Luca; Molinaro, Antonio; Scaldaferri, Franco; Gasbarrini, Giovanni; Lopez-Sanroman, Antonio; Link, Alexander; de Groot, Pieter; de Vos, Willem M; Högenauer, Christoph; Malfertheiner, Peter; Mattila, Eero; Milosavljević, Tomica; Nieuwdorp, Max; Sanguinetti, Maurizio; Simren, Magnus; Gasbarrini, Antonio

    2017-04-01

    Faecal microbiota transplantation (FMT) is an important therapeutic option for Clostridium difficile infection. Promising findings suggest that FMT may play a role also in the management of other disorders associated with the alteration of gut microbiota. Although the health community is assessing FMT with renewed interest and patients are becoming more aware, there are technical and logistical issues in establishing such a non-standardised treatment into the clinical practice with safety and proper governance. In view of this, an evidence-based recommendation is needed to drive the practical implementation of FMT. In this European Consensus Conference, 28 experts from 10 countries collaborated, in separate working groups and through an evidence-based process, to provide statements on the following key issues: FMT indications; donor selection; preparation of faecal material; clinical management and faecal delivery and basic requirements for implementing an FMT centre. Statements developed by each working group were evaluated and voted by all members, first through an electronic Delphi process, and then in a plenary consensus conference. The recommendations were released according to best available evidence, in order to act as guidance for physicians who plan to implement FMT, aiming at supporting the broad availability of the procedure, discussing other issues relevant to FMT and promoting future clinical research in the area of gut microbiota manipulation. This consensus report strongly recommends the implementation of FMT centres for the treatment of C. difficile infection as well as traces the guidelines of technicality, regulatory, administrative and laboratory requirements.

  12. Consensus-based recommendations for the management of juvenile dermatomyositis

    PubMed Central

    Enders, Felicitas Bellutti; Bader-Meunier, Brigitte; Baildam, Eileen; Constantin, Tamas; Dolezalova, Pavla; Feldman, Brian M; Lahdenne, Pekka; Magnusson, Bo; Nistala, Kiran; Ozen, Seza; Pilkington, Clarissa; Ravelli, Angelo; Russo, Ricardo; Uziel, Yosef; van Brussel, Marco; van der Net, Janjaap; Vastert, Sebastiaan; Wedderburn, Lucy R; Wulffraat, Nicolaas; McCann, Liza J; van Royen-Kerkhof, Annet

    2017-01-01

    Background In 2012, a European initiative called Single Hub and Access point for pediatric Rheumatology in Europe (SHARE) was launched to optimise and disseminate diagnostic and management regimens in Europe for children and young adults with rheumatic diseases. Juvenile dermatomyositis (JDM) is a rare disease within the group of paediatric rheumatic diseases (PRDs) and can lead to significant morbidity. Evidence-based guidelines are sparse and management is mostly based on physicians' experience. Consequently, treatment regimens differ throughout Europe. Objectives To provide recommendations for diagnosis and treatment of JDM. Methods Recommendations were developed by an evidence-informed consensus process using the European League Against Rheumatism standard operating procedures. A committee was constituted, consisting of 19 experienced paediatric rheumatologists and 2 experts in paediatric exercise physiology and physical therapy, mainly from Europe. Recommendations derived from a validated systematic literature review were evaluated by an online survey and subsequently discussed at two consensus meetings using nominal group technique. Recommendations were accepted if >80% agreement was reached. Results In total, 7 overarching principles, 33 recommendations on diagnosis and 19 recommendations on therapy were accepted with >80% agreement among experts. Topics covered include assessment of skin, muscle and major organ involvement and suggested treatment pathways. Conclusions The SHARE initiative aims to identify best practices for treatment of patients suffering from PRD. Within this remit, recommendations for the diagnosis and treatment of JDM have been formulated by an evidence-informed consensus process to produce a standard of care for patients with JDM throughout Europe. PMID:27515057

  13. Inquiring, Giving Opinions, Deciding Democratically within Large Communities

    NASA Astrophysics Data System (ADS)

    Ibarra, A.; Gabriel, C.; Ponz, D.; Fernandes, E.

    2015-09-01

    Appgree is a new way of communicating that allows groups of any size to actively express themselves and by this means, allow them to participate in any communication scenario. This application improves communication with your members and followers to work with them, gathering large quantities of valuable information, exchange and listen opinions and finally take decisions. Scientific communities could adopt this revolutionary technology to enhance and speed-up the communication among their members, allowing them to react more efficiently to new discoveries. Up to now, several social platforms have been used to try to improve the communication in large communities (Twitter, Slack, Facebook, Whatsapps). None of these are able to process or analyze people opinions or offer to the group the possibility to take decisions based on the agreement of the majority.

  14. Consensus Guidelines for the Management and Treatment of Neuroendocrine Tumors

    PubMed Central

    Kunz, Pamela L.; Reidy-Lagunes, Diane; Anthony, Lowell B.; Bertino, Erin M.; Brendtro, Kari; Chan, Jennifer A.; Chen, Herbert; Jensen, Robert T.; Kim, Michelle Kang; Klimstra, David S.; Kulke, Matthew H.; Liu, Eric H.; Metz, David C.; Phan, Alexandria T.; Sippel, Rebecca S.; Strosberg, Jonathan R.; Yao, James C.

    2014-01-01

    Neuroendocrine tumors (NETs) are a heterogeneous group of tumors originating in various anatomic locations. The management of this disease poses a significant challenge because of the heterogeneous clinical presentations and varying degree of aggressiveness. The recent completion of several phase III trials, including those evaluating octreotide, sunitinib, and everolimus, demonstrate that rigorous evaluation of novel agents in this disease is possible and can lead to practice-changing outcomes. Nevertheless, there are many aspects to the treatment of NETs that remain unclear and controversial. The North American Neuroendocrine Tumor Society (NANETS) published a set of consensus guidelines in 2010 which provided an overview for the treatment of patients with these malignancies. Here, we present a set of consensus tables intended to complement these guidelines and serve as a quick, accessible reference for the practicing physician. PMID:23591432

  15. Expert Consensus for Discharge Referral Decisions Using Online Delphi

    PubMed Central

    Bowles, Kathy H.; Holmes, John H.; Naylor, Mary D.; Liberatore, Matthew; Nydick, Robert

    2003-01-01

    This paper describes the results of using a modified Delphi approach designed to achieve consensus from eight discharge planning experts regarding the decision to refer hospitalized older adults for post-discharge follow-up. Experts reviewed 150 cases using an online website designed to facilitate their interaction and efforts to reach agreement on the need for a referral for post-discharge care and the appropriate site for such care. In contrast to an average of eight weeks to complete just 50 cases using the traditional mail method, the first online Delphi round for 150 cases were completed in six weeks. Data provided by experts suggest that online Delphi is a time efficient and acceptable methodology for reaching group consensus. Other benefits include instant access to Delphi decision results, live knowledge of the time requirements and progress of each expert, and cost savings in postage, paper, copying, and storage of paper documents. This online Delphi methodology is highly recommended. PMID:14728143

  16. 24 CFR 1710.17 - Advisory opinion.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Advisory opinion. (a) General. A developer may request an opinion from the Secretary as to whether an... developer should at least cite the applicable statutory or regulatory basis for the exemption or lack of... outside the purview of the Act. (3) An affirmation as shown below: Developer's Affirmation Name...

  17. Internet Censorship in Turkey: University Students' Opinions

    ERIC Educational Resources Information Center

    Ozkan, Hasan; Arikan, Arda

    2009-01-01

    The aim of this paper is to study university students' opinions toward online censorship with references to their socio-political and economic variables. Considering the upwards trend and the increasing number of online restrictions in Turkey, the opinions of university students (n=138) are thought to give significant findings. The questionnaire…

  18. Environment and Public Opinion in Minnesota.

    ERIC Educational Resources Information Center

    Tichenor, P. J.; And Others

    Surveys conducted in Minnesota in 1969 and 1970 to obtain public opinion regarding environmental issues are discussed. Several generalizations are made about the state of public opinion about the environmental issue, as follows: (1) The environmental issue has reached public prominence through a sequence from professional and interest-group…

  19. Florida Employer Opinion Survey. Annual Report.

    ERIC Educational Resources Information Center

    Florida State Dept. of Education, Tallahassee. Div. of Vocational, Adult, and Community Education.

    Two surveys were directed to Florida employers that employed former vocational education students in 1988. The surveys obtained information describing employer opinions regarding general and specific vocational preparation of workers for employment. The 1989-90 employer general opinion survey examined hiring needs, general preparation, and…

  20. Developing Student Opinions on Agricultural Issues.

    ERIC Educational Resources Information Center

    Walter, Gerry; Reisner, Ann

    1992-01-01

    Presents early evidence from a longitudinal study suggesting that many agricultural college students lack opinions on soil and water conservation issues. Data also suggest encounters with conservation issues in the classroom and elsewhere encourage students, to learn about and form opinions on conservation. (27 references) (Author/MCO)

  1. Public Opinion Poll on Community Priorities: Sacramento

    ERIC Educational Resources Information Center

    Sierra Health Foundation, 2009

    2009-01-01

    The primary goal of this study was to measure public perceptions, opinions and priorities as they pertain to youth issues in Sacramento for the purposes of further developing public and private youth programming and public policy in the Sacramento region. By presenting a "statistically reliable" profile of public opinion on youth issues,…

  2. Public Opinion Poll Question Databases: An Evaluation

    ERIC Educational Resources Information Center

    Woods, Stephen

    2007-01-01

    This paper evaluates five polling resource: iPOLL, Polling the Nations, Gallup Brain, Public Opinion Poll Question Database, and Polls and Surveys. Content was evaluated on disclosure standards from major polling organizations, scope on a model for public opinion polls, and presentation on a flow chart discussing search limitations and usability.

  3. Cluster Consensus of Nonlinearly Coupled Multi-Agent Systems in Directed Graphs

    NASA Astrophysics Data System (ADS)

    Lu, Xiao-Qing; Francis, Austin; Chen, Shi-Hua

    2010-05-01

    We investigate the cluster consensus problem in directed networks of nonlinearly coupled multi-agent systems by using pinning control. Depending on the community structure generated by the group partition of the underlying digraph, various clusters can be made coherently independent by applying feedback injections to a fraction of the agents. Sufficient conditions for cluster consensus are obtained using algebraic graph theory and matrix theory and some simulations results are included to illustrate the method.

  4. Consensus of population systems with community structures.

    PubMed

    Wang, Jing; Wu, Bin; Wang, Long; Fu, Feng

    2008-11-01

    Multicommunity population systems may reach a consensus state where the fractions of each species in different communities agree on a common value. In this paper, by analyzing the evolutionary dynamics based on an extended replicator equation incorporating community effects, the consensus problem of population systems with n communities is studied. In particular, the simple case of two communities is investigated in detail. In general, for n communities, a sufficient and necessary condition for population systems to reach a consensus of coexistent state is provided. Regarding the population dynamics for the four different types of games, whether the population systems can achieve consensus is determined. The dynamics of community-structured populations shows richer features than nonstructured populations, and some nontrivial phenomena arising from different community-structured population systems are illustrated with concrete numerical examples.

  5. Leader selection for fast consensus in networks

    NASA Astrophysics Data System (ADS)

    Wang, Ying; Yang, Wen; Wang, Lin; Wang, Xiaofan

    2015-12-01

    This paper considers a leader-follower system with the aim to select an optimal leader so as to drive the remaining nodes to reach the desired consensus with the fastest convergence speed. An index called consensus centrality (CC) is proposed to quantify how fast a leader could guide the network to achieve the desired consensus. The experiment results explored the big similarities between the distributions of CC and degree in the network, which suggest that the suboptimal leader selected by the maximum degree can approximately approach the optimal leader in heterogeneous networks. Combining the degree-based k-shell decomposition with consensus centrality, a leader selection algorithm is proposed to reduce the computational complexity in large-scale networks. Finally, the convergence time of an equivalent discrete-time model is given to illustrate the properties of the suboptimal solutions.

  6. Opinion polls and the US civil space program

    NASA Technical Reports Server (NTRS)

    Fries, Sylvia Doughty

    1992-01-01

    An analysis of two public opinion poles that sought to determine NASA's level of support among the American people is presented. One pole models public participation in policy-making as a pyramid. The model provides for three levels of public participation: the attentive public, the interested public, and the non-attentive public. The three groups are discussed in the context of how to best promulgate NASA's mission throughout the American public.

  7. Diagnostic and therapeutic consensus on acromegaly.

    PubMed

    Doga, M; Bonadonna, S; Gola, M; Nuzzo, M; Giustina, A

    2005-01-01

    In February 1999 and May 2000, two workshops were held in Cortina, Italy and Montecarlo, respectively, to develop a consensus defining the diagnosis and treatment of acromegaly. The workshops were sponsored by the Italian Society of Endocrinology, the Pituitary Society and European Neuroendocrine Association. Partecipants from all over the world included endocrinologists, neurosurgeons and radiotherapists skilled in the management of acromegaly. This review paper summarizes the main points of the two consensus statements published following these two workshops.

  8. Expert opinions and scientific evidence for colonoscopy key performance indicators

    PubMed Central

    Rees, Colin J; Bevan, Roisin; Zimmermann-Fraedrich, Katharina; Rutter, Matthew D; Rex, Douglas; Dekker, Evelien; Ponchon, Thierry; Bretthauer, Michael; Regula, Jaroslaw; Saunders, Brian; Hassan, Cesare; Bourke, Michael J; Rösch, Thomas

    2016-01-01

    Colonoscopy is a widely performed procedure with procedural volumes increasing annually throughout the world. Many procedures are now performed as part of colorectal cancer screening programmes. Colonoscopy should be of high quality and measures of this quality should be evidence based. New UK key performance indicators and quality assurance standards have been developed by a working group with consensus agreement on each standard reached. This paper reviews the scientific basis for each of the quality measures published in the UK standards. PMID:27802153

  9. Inhaled treatment of COPD: a Delphi consensus statement

    PubMed Central

    Ninane, Vincent; Corhay, Jean-Louis; Germonpré, Paul; Janssens, Wim; Joos, Guy F; Liistro, Giuseppe; Vincken, Walter; Gurdain, Sandra; Vanvlasselaer, Evelyne; Lehouck, An

    2017-01-01

    Background Global Initiative for Chronic Obstructive Lung Disease (GOLD) global strategy (2015) provides guidance for the treatment of chronic obstructive pulmonary disease (COPD) with different first-choice options per GOLD category without specification. Objectives To evaluate the level of medical experts’ consensus on their preferred first-choice treatment within different COPD categories. Methods A two-round Delphi Panel consisting of 15 questions was completed by Belgian pulmonologists (n=31) and European (n=10) COPD experts. Results Good consensus was reached by both expert groups for long-acting bronchodilators instead of short-acting bronchodilators as first-choice treatment in GOLD A. Single bronchodilation with long-acting muscarinic antagonist (LAMA) was preferred over long-acting β2-agonist (LABA) and LABA/LAMA as first-choice treatment in GOLD B and GOLD C. For GOLD D patients based on the forced expiratory volume in 1 second (FEV1)<50%, a very good consensus was reached for LAMA/LABA as first-choice treatment. For GOLD D patients based on frequent or severe exacerbations, there was a good consensus for LABA/LAMA/inhaled corticosteroids (ICS) as first choice in the Belgian group. According to the European experts, both LABA/LAMA and LABA/LAMA/ICS could be the first choice for these patients. Conclusion Belgian and European experts recommend long-acting bronchodilators as first-choice treatment. Treatment containing ICS was found only appropriate in patients with FEV1<50% and ≥2 moderate exacerbations or 1 severe exacerbation/year. PMID:28293106

  10. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets

    PubMed Central

    Munns, Craig F.; Shaw, Nick; Kiely, Mairead; Specker, Bonny L.; Thacher, Tom D.; Ozono, Keiichi; Michigami, Toshimi; Tiosano, Dov; Mughal, M. Zulf; Mäkitie, Outi; Ramos-Abad, Lorna; Ward, Leanne; DiMeglio, Linda A.; Atapattu, Navoda; Cassinelli, Hamilton; Braegger, Christian; Pettifor, John M.; Seth, Anju; Idris, Hafsatu Wasagu; Bhatia, Vijayalakshmi; Fu, Junfen; Goldberg, Gail; Sävendahl, Lars; Khadgawat, Rajesh; Pludowski, Pawel; Maddock, Jane; Hyppönen, Elina; Oduwole, Abiola; Frew, Emma; Aguiar, Magda; Tulchinsky, Ted; Butler, Gary

    2016-01-01

    Background: Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to work toward its eradication. Evidence: A systematic literature search examining the definition, diagnosis, treatment, and prevention of nutritional rickets in children was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system that describe the strength of the recommendation and the quality of supporting evidence. Process: Thirty-three nominated experts in pediatric endocrinology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. Results: This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. Conclusion: Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required. PMID:26745253

  11. [Atherothrombotic carotid disease: towards a consensus on its prevention].

    PubMed

    Gil, A C

    2004-05-01

    This consensus document was one of the objectives of the I Meeting of the Spanish Society of Angiology and Vascular Surgery, the Spanish Interventional Neuroradiology Group of the Spanish Society of Neuroradiology, and the Cerebrovascular Disease Study Group of the Spanish Society of Neurology, which was held in October 2002 in Cordoba. Atherosclerosis is a chronic vascular disease of true epidemic proportions. It is the first cause of death in developed countries and responsible for one quarter of documented deaths worldwide. Atherothrombotic ischemic stroke, transient ischemic attack and atherothrombotic origin symptomatic or asymptomatic peripheral arterial disease are all associated with a high risk of vascular death, myocardial infarction and recurrent stroke. In this context, vascular disease represents a serious public health problem, particularly if we take into account current forecasts on population ageing. The prevention of atherosclerosis - and its consequences, if its clinical manifestations are already apparent - is therefore a priority. This multidisciplinary consensus document draws on the different medical specialties dealing with these patients and combines efforts to obtain the greatest possible benefit as regards this disease's management. The consensus document makes a global analysis of atherosclerosis prevention, basically in terms of therapeutic objectives, lifestyle change measures, high bloodpressure management, dyslipidemia, other vascular risk factors and platelet antiaggregation. Emphasis is placed on the frequent coexistence of cerebrovascular and peripheral arterial involvement, and the methods of detecting silent involvement. Lastly, consensus is reached on the diagnostic methods and specific management of atherothrombotic carotid disease, including the benefits and risks of and indications for carotid endarterectomy, and the current role of carotid angioplasty.

  12. Western and Japanese Discourse Style in a Consensus-Building Task Discussion

    ERIC Educational Resources Information Center

    Hirabayashi, Haruma; Long, Christopher

    2011-01-01

    The current study analyzes discourse style differences between western and Japanese interlocutors in a group consensus-building task discussion. Four discussants (American male, Japanese male, German female and Japanese female) first created a ranking of 5 life values and then participated in a group discussion to arrive at a common group ranking.…

  13. Population conference: consensus and conflict.

    PubMed

    Willson, P D

    1984-01-01

    The United Nations-sponsored International Conference on Population held in Mexico City was both a rejection and an affirmation of a new policy of the Reagan administration. The policy denies international family planning funds to nongovernmental organizations that perform or actively promote abortion as a family planning method in other nations. A compromise statement was accepted urging governments to take appropriate measures to discourage abortion as a family planning method and when possible to provide for the humane treatment and counseling of women ho resorted to abortion. The statement on abortion was 1 of 88 reccomendations approved by the conference. The commitment expressed in the 10-year-old World Population Plan of Action to the rights and responsiblity to all people as reaffirmed. The conference also endorsed family life education and sex education as well as suitable family planning, information and services for adolescents, with due consideration given to the role, rights and obligations of parents. Increased support for international population and family planning programs was urged and World Bank President, Clausen, urged a 4-fold increase in international funding by the year 2000. Most of the conference's recommendations re devoted to the broad range of population policy issues, including morbidity and mortality, international and internal migration, the relationship between population and economic development and the status of women. The purpose of the recommendations is to increase the momentum of international support. The Mexico City conference was characterized by a remarkable degree of consensus about population policies with respect to integration with economic development, the need to respect individual rights and the recognition that all nations have sovereign rights to develop and implement their own population policies. Conflict and controversy arose in the areas of the arms race and the Middle East. The US position on abortion funding

  14. The dynamics of minority opinions in democratic debate

    NASA Astrophysics Data System (ADS)

    Galam, Serge

    2004-05-01

    A model for the dynamics of opinion forming in democratic public debate is presented. Using concepts and techniques from the physics of disorder the dynamics of social refusal spreading is studied within a perfect world, where the minority holds neither better arguments nor lobbying backing. The one-person-one-vote rule, together with local majority rules, are used to determine the outcome of local group discussions. In case of a local tie, the group decides on keeping the Status Quo. The geometry of social life shaped by offices, houses, bars, and restaurants is shown to determine the distribution size of these discussion groups. It is found to yield very asymmetric unstable thresholds to the total spreading of one opinion at the benefit of the refusal one. The associated dynamics is rather quick and completed within few days. This democratic paradox of public debate driven majority opinion reversal is discussed in light of some European construction issues. The model may apply to rumor and fear propagation.

  15. Undescended testes: a consensus on management.

    PubMed

    Ritzén, E Martin

    2008-12-01

    The mode of treatment best for undescended testes is controversial, and local traditions often override knowledge gained from randomized controlled studies. In order to reach a consensus within the Nordic countries on the current state-of-the-art of treatment, a group of specialists in testicular physiology, paediatric surgery/urology, endocrinology, andrology, pathology and anaesthesiology from all the Nordic countries met for 2 days. Before the meeting, reviews of the literature had been prepared by the participants. Judging from published meta-analyses, hormonal treatment has low efficacy. Although 15-20% of retained testes descend during hormonal treatment, one-fifth of these re-ascend later on. Also, treatment with human chorionic gonadotropin (hCG) may be harmful to future spermatogenesis through increased apoptosis of germ cells. Orchiopexy, on the contrary, results in about 95% anatomical success, with a low (about 1%) risk of complications. The optimal time for orchiopexy has also been debated. However, a recent randomized controlled study shows that surgery at 9 months of age is followed by a better post-operative growth of the testes than surgery at 3 years, which supports previous arguments for early surgery. The unanimous conclusion of the group was that surgery is generally the preferred mode of treatment, rather than hCG or GnRH treatments. Orchiopexy should be performed between 6 and 12 months of age, or soon after diagnosis, if that occurs later. If a testis is found to be undescended at any age after 6 months, the patient should be referred for surgery. Referral should be to paediatric rather than general surgeons/urologists if the boy is less than 1 year old, if he has bilateral or non-palpable testes, or if he has got relapse of cryptorchidism.

  16. Are Opinions Based on Science: Modelling Social Response to Scientific Facts

    PubMed Central

    Iñiguez, Gerardo; Tagüeña-Martínez, Julia; Kaski, Kimmo K.; Barrio, Rafael A.

    2012-01-01

    As scientists we like to think that modern societies and their members base their views, opinions and behaviour on scientific facts. This is not necessarily the case, even though we are all (over-) exposed to information flow through various channels of media, i.e. newspapers, television, radio, internet, and web. It is thought that this is mainly due to the conflicting information on the mass media and to the individual attitude (formed by cultural, educational and environmental factors), that is, one external factor and another personal factor. In this paper we will investigate the dynamical development of opinion in a small population of agents by means of a computational model of opinion formation in a co-evolving network of socially linked agents. The personal and external factors are taken into account by assigning an individual attitude parameter to each agent, and by subjecting all to an external but homogeneous field to simulate the effect of the media. We then adjust the field strength in the model by using actual data on scientific perception surveys carried out in two different populations, which allow us to compare two different societies. We interpret the model findings with the aid of simple mean field calculations. Our results suggest that scientifically sound concepts are more difficult to acquire than concepts not validated by science, since opposing individuals organize themselves in close communities that prevent opinion consensus. PMID:22905117

  17. Are opinions based on science: modelling social response to scientific facts.

    PubMed

    Iñiguez, Gerardo; Tagüeña-Martínez, Julia; Kaski, Kimmo K; Barrio, Rafael A

    2012-01-01

    As scientists we like to think that modern societies and their members base their views, opinions and behaviour on scientific facts. This is not necessarily the case, even though we are all (over-) exposed to information flow through various channels of media, i.e. newspapers, television, radio, internet, and web. It is thought that this is mainly due to the conflicting information on the mass media and to the individual attitude (formed by cultural, educational and environmental factors), that is, one external factor and another personal factor. In this paper we will investigate the dynamical development of opinion in a small population of agents by means of a computational model of opinion formation in a co-evolving network of socially linked agents. The personal and external factors are taken into account by assigning an individual attitude parameter to each agent, and by subjecting all to an external but homogeneous field to simulate the effect of the media. We then adjust the field strength in the model by using actual data on scientific perception surveys carried out in two different populations, which allow us to compare two different societies. We interpret the model findings with the aid of simple mean field calculations. Our results suggest that scientifically sound concepts are more difficult to acquire than concepts not validated by science, since opposing individuals organize themselves in close communities that prevent opinion consensus.

  18. Beam dynamics group summary

    SciTech Connect

    Peggs, S.

    1994-12-31

    This paper summarizes the activities of the beam dynamics working group of the LHC Collective Effects Workshop that was held in Montreux in 1994. It reviews the presentations that were made to the group, the discussions that ensued, and the consensuses that evolved.

  19. Cross-correlation patterns in social opinion formation with sequential data

    NASA Astrophysics Data System (ADS)

    Chakrabarti, Anindya S.

    2016-11-01

    Recent research on large-scale internet data suggests existence of patterns in the collective behavior of billions of people even though each of them may pursue own activities. In this paper, we interpret online rating activity as a process of forming social opinion about individual items, where people sequentially choose a rating based on the current information set comprising all previous ratings and own preferences. We construct an opinion index from the sequence of ratings and we show that (1) movie-specific opinion converges much slower than an independent and identically distributed (i.i.d.) sequence of ratings, (2) rating sequence for individual movies shows lesser variation compared to an i.i.d. sequence of ratings, (3) the probability density function of the asymptotic opinions has more spread than that defined over opinion arising from i.i.d. sequence of ratings, (4) opinion sequences across movies are correlated with significantly higher and lower correlation compared to opinion constructed from i.i.d. sequence of ratings, creating a bimodal cross-correlation structure. By decomposing the temporal correlation structures from panel data of movie ratings, we show that the social effects are very prominent whereas group effects cannot be differentiated from those of surrogate data and individual effects are quite small. The former explains a large part of extreme positive or negative correlations between sequences of opinions. In general, this method can be applied to any rating data to extract social or group-specific effects in correlation structures. We conclude that in this particular case, social effects are important in opinion formation process.

  20. Opinions of the General Education Teachers on the Adaptations for Students with Special Needs in General Education Classrooms

    ERIC Educational Resources Information Center

    Kargin, Tevhide; Guldenoglu, Birkan; Sahin, Feyzullah

    2010-01-01

    The purpose of this study is to explore the opinions of general education teachers with regard to the instructional adaptations that need to be made for inclusion and to evaluate them against several variables. The study group consists of 126 general education teachers. The opinions of the teachers with regard to the adaptations in their…

  1. [Thyroid nodules and differentiated thyroid cancer: Brazilian consensus].

    PubMed

    Maia, Ana Luiza; Ward, Laura S; Carvalho, Gisah A; Graf, Hans; Maciel, Rui M B; Maciel, Léa M Zanini; Rosário, Pedro W; Vaisman, Mario

    2007-07-01

    Thyroid nodules are a common manifestation of thyroid diseases. It is estimated that approximately 10% of adults have palpable thyroid nodules with the frequency increasing throughout life. The major concern on nodule evaluation is the risk of malignancy (5-10%). Differentiated thyroid carcinoma accounts for 90% of all thyroid malignant neoplasias. Although most patients with cancer have a favorable outcome, some individuals present an aggressive form of the disease and poor prognostic despite recent advances in diagnosis and treatment. Here, a set of clinical guidelines for the evaluation and management of patients with thyroid nodules or differentiated thyroid cancer was developed through consensus by 8 member of the Department of Thyroid, Sociedade Brasileira de Endocrinologia e Metabologia. The participants are from different reference medical centers within Brazil, to reflect different practice patterns. Each committee participant was initially assigned to write a section of the document and to submit it to the chairperson, who revised and assembled the sections into a complete draft document, which was then circulated among all committee members for further revision. All committee members further revised and refined the document. The guidelines were developed based on the expert opinion of the committee participants, as well as on previously published information.

  2. Heterogeneous Preference and Local Nonlinearity in Consensus Decision Making

    NASA Astrophysics Data System (ADS)

    Hartnett,