Score Calculation in Informatics Contests Using Multiple Criteria Decision Methods

ERIC Educational Resources Information Center

Skupiene, Jurate

2011-01-01

The Lithuanian Informatics Olympiad is a problem solving contest for high school students. The work of each contestant is evaluated in terms of several criteria, where each criterion is measured according to its own scale (but the same scale for each contestant). Several jury members are involved in the evaluation. This paper analyses the problem…

An Intuitionistic Multiplicative ORESTE Method for Patients’ Prioritization of Hospitalization

PubMed Central

Zhang, Cheng; Wu, Xingli; Wu, Di; Luo, Li; Herrera-Viedma, Enrique

2018-01-01

The tension brought about by sickbeds is a common and intractable issue in public hospitals in China due to the large population. Assigning the order of hospitalization of patients is difficult because of complex patient information such as disease type, emergency degree, and severity. It is critical to rank the patients taking full account of various factors. However, most of the evaluation criteria for hospitalization are qualitative, and the classical ranking method cannot derive the detailed relations between patients based on these criteria. Motivated by this, a comprehensive multiple criteria decision making method named the intuitionistic multiplicative ORESTE (organísation, rangement et Synthèse dedonnées relarionnelles, in French) was proposed to handle the problem. The subjective and objective weights of criteria were considered in the proposed method. To do so, first, considering the vagueness of human perceptions towards the alternatives, an intuitionistic multiplicative preference relation model is applied to represent the experts’ preferences over the pairwise alternatives with respect to the predetermined criteria. Then, a correlation coefficient-based weight determining method is developed to derive the objective weights of criteria. This method can overcome the biased results caused by highly-related criteria. Afterwards, we improved the general ranking method, ORESTE, by introducing a new score function which considers both the subjective and objective weights of criteria. An intuitionistic multiplicative ORESTE method was then developed and further highlighted by a case study concerning the patients’ prioritization. PMID:29673212

Utilizing Multifaceted Rasch Measurement through Facets to Evaluate Science Education Data Sets Composed of Judges, Respondents, and Rating Scale Items: An Exemplar Utilizing the Elementary Science Teaching Analysis Matrix Instrument

ERIC Educational Resources Information Center

Boone, William J.; Townsend, J. Scott; Staver, John R.

2016-01-01

When collecting data, science education researchers frequently have multiple respondents evaluate multiple artifacts using multiple criteria. Herein, the authors introduce Multifaceted Rasch Measurement (MFRM) analysis and explain why MFRM must be used when "judges'" data are collected. The authors use data from elementary science…

Prediction of a multiple sclerosis diagnosis in patients with clinically isolated syndrome using the 2016 MAGNIMS and 2010 McDonald criteria: a retrospective study.

PubMed

Filippi, Massimo; Preziosa, Paolo; Meani, Alessandro; Ciccarelli, Olga; Mesaros, Sarlota; Rovira, Alex; Frederiksen, Jette; Enzinger, Christian; Barkhof, Frederik; Gasperini, Claudio; Brownlee, Wallace; Drulovic, Jelena; Montalban, Xavier; Cramer, Stig P; Pichler, Alexander; Hagens, Marloes; Ruggieri, Serena; Martinelli, Vittorio; Miszkiel, Katherine; Tintorè, Mar; Comi, Giancarlo; Dekker, Iris; Uitdehaag, Bernard; Dujmovic-Basuroski, Irena; Rocca, Maria A

2018-02-01

In 2016, the Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS) network proposed modifications to the MRI criteria to define dissemination in space (DIS) and time (DIT) for the diagnosis of multiple sclerosis in patients with clinically isolated syndrome (CIS). Changes to the DIS definition included removal of the distinction between symptomatic and asymptomatic lesions, increasing the number of lesions needed to define periventricular involvement to three, combining cortical and juxtacortical lesions, and inclusion of optic nerve evaluation. For DIT, removal of the distinction between symptomatic and asymptomatic lesions was suggested. We compared the performance of the 2010 McDonald and 2016 MAGNIMS criteria for multiple sclerosis diagnosis in a large multicentre cohort of patients with CIS to provide evidence to guide revisions of multiple sclerosis diagnostic criteria. Brain and spinal cord MRI and optic nerve assessments from patients with typical CIS suggestive of multiple sclerosis done less than 3 months from clinical onset in eight European multiple sclerosis centres were included in this retrospective study. Eligible patients were 16-60 years, and had a first CIS suggestive of CNS demyelination and typical of relapsing-remitting multiple sclerosis, a complete neurological examination, a baseline brain and spinal cord MRI scan obtained less than 3 months from clinical onset, and a follow-up brain scan obtained less than 12 months from CIS onset. We recorded occurrence of a second clinical attack (clinically definite multiple sclerosis) at months 36 and 60. We evaluated MRI criteria performance for DIS, DIT, and DIS plus DIT with a time-dependent receiver operating characteristic curve analysis. Between June 16, 1995, and Jan 27, 2017, 571 patients with CIS were screened, of whom 368 met all study inclusion criteria. At the last evaluation (median 50·0 months [IQR 27·0-78·4]), 189 (51%) of 368 patients developed clinically definite multiple sclerosis. At 36 months, the two DIS criteria showed high sensitivity (2010 McDonald 0·91 [95% CI 0·85-0·94] and 2016 MAGNIMS 0·93 [0·88-0·96]), similar specificity (0·33 [0·25-0·42] and 0·32 [0·24-0·41]), and similar area under the curve values (AUC; 0·62 [0·57-0·67] and 0·63 [0·58-0·67]). Performance was not affected by inclusion of symptomatic lesions (sensitivity 0·92 [0·87-0·96], specificity 0·31 [0·23-0·40], AUC 0·62 [0·57-0·66]) or cortical lesions (sensitivity 0·92 [0·87-0·95], specificity 0·32 [0·24-0·41], AUC 0·62 [0·57-0·67]). Requirement of three periventricular lesions resulted in slightly lower sensitivity (0·85 [0·78-0·90], slightly higher specificity (0·40 [0·32-0·50], and similar AUC (0·63 [0·57-0·68]). Inclusion of optic nerve evaluation resulted in similar sensitivity (0·92 [0·87-0·96]), and slightly lower specificity (0·26 [0·18-0·34]) and AUC (0·59 [0·55-0·64]). AUC values were also similar for DIT (2010 McDonald 0·61 [0·55-0·67] and 2016 MAGNIMS 0·61 [0·55-0·66]) and DIS plus DIT (0·62 [0·56-0·67] and 0·64 [0·58-0·69]). The 2016 MAGNIMS criteria showed similar accuracy to the 2010 McDonald criteria in predicting the development of clinically definite multiple sclerosis. Inclusion of symptomatic lesions is expected to simplify the clinical use of MRI criteria without reducing accuracy, and our findings suggest that needing three lesions to define periventricular involvement might slightly increase specificity, suggesting that these two factors could be considered during further revisions of multiple sclerosis diagnostic criteria. UK MS Society, National Institute for Health Research University College London Hospitals Biomedical Research Centre, Dutch MS Research Foundation. Copyright © 2018 Elsevier Ltd. All rights reserved.

A Profile of the Multiple Evaluating Environments within a College.

ERIC Educational Resources Information Center

Hackman, Judith D.; Taber, Thomas D.

The paper demonstrates an approach for describing educational organizations in terms of their multiple evaluating environments. A college profile is drawn based on the diverse criteria that students, faculty, administrators, admissions staff, and athletics staff use to assess the success or failure of undergraduates. The relative values that 377…

Multiple stakeholders in multi-criteria decision-making in the context of Municipal Solid Waste Management: A review

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

Soltani, Atousa; Hewage, Kasun; Reza, Bahareh

2015-01-15

Highlights: • We review Municipal Solid Waste Management studies with focus on multiple stakeholders. • We focus on studies with multi-criteria decision analysis methods and discover their trends. • Most studies do not offer solutions for situations where stakeholders compete for more benefits or have unequal voting powers. • Governments and experts are the most participated stakeholders and AHP is the most dominant method. - Abstract: Municipal Solid Waste Management (MSWM) is a complicated process that involves multiple environmental and socio-economic criteria. Decision-makers look for decision support frameworks that can guide in defining alternatives, relevant criteria and their weights, andmore » finding a suitable solution. In addition, decision-making in MSWM problems such as finding proper waste treatment locations or strategies often requires multiple stakeholders such as government, municipalities, industries, experts, and/or general public to get involved. Multi-criteria Decision Analysis (MCDA) is the most popular framework employed in previous studies on MSWM; MCDA methods help multiple stakeholders evaluate the often conflicting criteria, communicate their different preferences, and rank or prioritize MSWM strategies to finally agree on some elements of these strategies and make an applicable decision. This paper reviews and brings together research on the application of MCDA for solving MSWM problems with more focus on the studies that have considered multiple stakeholders and offers solutions for such problems. Results of this study show that AHP is the most common approach in consideration of multiple stakeholders and experts and governments/municipalities are the most common participants in these studies.« less

A green chemistry-based classification model for the synthesis of silver nanoparticles

EPA Science Inventory

The assessment of implementation of green chemistry principles in the synthesis of nanomaterials is a complex decision-making problem that necessitates integration of several evaluation criteria. Multiple Criteria Decision Aiding (MCDA) provides support for such a challenge. One ...

Structural optimization of large structural systems by optimality criteria methods

NASA Technical Reports Server (NTRS)

Berke, Laszlo

1992-01-01

The fundamental concepts of the optimality criteria method of structural optimization are presented. The effect of the separability properties of the objective and constraint functions on the optimality criteria expressions is emphasized. The single constraint case is treated first, followed by the multiple constraint case with a more complex evaluation of the Lagrange multipliers. Examples illustrate the efficiency of the method.

DEVELOPMENT OF AN IMPROVED ARBORLOO TO PROMOTE SANITATION IN RURAL ENVIRONMENTS

EPA Science Inventory

Multiple designs will be generated. They will be evaluated against appropriate criteria as identified by the design teams in consultation with advisors and likely users. Such criteria will, at a minimum include the ability to sequester waste material, structural robustness,...

Evolution of evaluation criteria in the College of American Pathologists Surveys.

PubMed

Ross, J W

1988-04-01

This review of the evolution of evaluation criteria in the College of American Pathologists Survey and of theoretical grounds proposed for evaluation criteria explores the complex nature of the evaluation process. Survey professionals balance multiple variables to seek relevant and meaningful evaluations. These include the state of the art, the reliability of target values, the nature of available control materials, the perceived medical "nonusefulness" of the extremes of performance (good or poor), this extent of laboratory services provided, and the availability of scientific data and theory by which clinically relevant criteria of medical usefulness may be established. The evaluation process has consistently sought peer concensus, to stimulate improvement in state of the art, to increase medical usefulness, and to monitor the state of the art. Recent factors that are likely to promote change from peer group evaluation to fixed criteria evaluation are the high degree of proficiency in the state of the art for many analytes, accurate target values, increased knowledge of biologic variation, and the availability of statistical modeling techniques simulating biologic and diagnostic processes as well as analytic processes.

Application of multiple criteria decision methods in space exploration initiative design and planning

NASA Technical Reports Server (NTRS)

Masud, Abu S. M.

1991-01-01

Fellowship activities were directed towards the identification of opportunities for application of the Multiple Criteria Decision Making (MCDM) techniques in the Space Exploration Initiative (SEI) domain. I identified several application possibilities and proposed demonstration application in these three areas: evaluation and ranking of SEI architectures, space mission planning and selection, and space system design. Here, only the first problem is discussed. The most meaningful result of the analysis is the wide separation between the two top ranked architectures, indicating a significant preference difference between them. It must also be noted that the final ranking reflects, to some extent, the biases of the evaluators and their understanding of the architecture.

Assessment of Communications-related Admissions Criteria in a Three-year Pharmacy Program

PubMed Central

Tejada, Frederick R.; Lang, Lynn A.; Purnell, Miriam; Acedera, Lisa; Ngonga, Ferdinand

2015-01-01

Objective. To determine if there is a correlation between TOEFL and other admissions criteria that assess communications skills (ie, PCAT variables: verbal, reading, essay, and composite), interview, and observational scores and to evaluate TOEFL and these admissions criteria as predictors of academic performance. Methods. Statistical analyses included two sample t tests, multiple regression and Pearson’s correlations for parametric variables, and Mann-Whitney U for nonparametric variables, which were conducted on the retrospective data of 162 students, 57 of whom were foreign-born. Results. The multiple regression model of the other admissions criteria on TOEFL was significant. There was no significant correlation between TOEFL scores and academic performance. However, significant correlations were found between the other admissions criteria and academic performance. Conclusion. Since TOEFL is not a significant predictor of either communication skills or academic success of foreign-born PharmD students in the program, it may be eliminated as an admissions criterion. PMID:26430273

Assessment of Communications-related Admissions Criteria in a Three-year Pharmacy Program.

PubMed

Parmar, Jayesh R; Tejada, Frederick R; Lang, Lynn A; Purnell, Miriam; Acedera, Lisa; Ngonga, Ferdinand

2015-08-25

To determine if there is a correlation between TOEFL and other admissions criteria that assess communications skills (ie, PCAT variables: verbal, reading, essay, and composite), interview, and observational scores and to evaluate TOEFL and these admissions criteria as predictors of academic performance. Statistical analyses included two sample t tests, multiple regression and Pearson's correlations for parametric variables, and Mann-Whitney U for nonparametric variables, which were conducted on the retrospective data of 162 students, 57 of whom were foreign-born. The multiple regression model of the other admissions criteria on TOEFL was significant. There was no significant correlation between TOEFL scores and academic performance. However, significant correlations were found between the other admissions criteria and academic performance. Since TOEFL is not a significant predictor of either communication skills or academic success of foreign-born PharmD students in the program, it may be eliminated as an admissions criterion.

Criteria for Authorship in Bioethics

PubMed Central

Resnik, David B.; Master, Zubin

2011-01-01

Multiple authorship is becoming increasingly common in bioethics research. There are well-established criteria for authorship in empirical bioethics research but not for conceptual research. It is important to develop criteria for authorship in conceptual publications to prevent undeserved authorship and uphold standards of fairness and accountability. This article explores the issue of multiple authorship in bioethics and develops criteria for determining who should be an author on a conceptual publication in bioethics. Authorship in conceptual research should be based on contributing substantially to: (1) identifying a topic, problem, or issue to study; (2) reviewing and interpreting the relevant literature; (3) formulating, analyzing, and evaluating arguments that support one or more theses; (4) responding to objections and counterarguments; and (5) drafting the manuscript and approving the final version. Authors of conceptual publications should participate substantially in at least two of areas (1)–(5). PMID:21943265

Criteria for authorship in bioethics.

PubMed

Resnik, David B; Master, Zubin

2011-10-01

Multiple authorship is becoming increasingly common in bioethics research. There are well-established criteria for authorship in empirical bioethics research but not for conceptual research. It is important to develop criteria for authorship in conceptual publications to prevent undeserved authorship and uphold standards of fairness and accountability. This article explores the issue of multiple authorship in bioethics and develops criteria for determining who should be an author on a conceptual publication in bioethics. Authorship in conceptual research should be based on contributing substantially to: (1) identifying a topic, problem, or issue to study; (2) reviewing and interpreting the relevant literature; (3) formulating, analyzing, and evaluating arguments that support one or more theses; (4) responding to objections and counterarguments; and (5) drafting the manuscript. Authors of conceptual publications should participate substantially in at least two of areas (1)-(5) and also approve the final version. [corrected].

The Development Evaluation of Economic Zones in China.

PubMed

Liu, Wei; Shi, Hong-Bo; Zhang, Zhe; Tsai, Sang-Bing; Zhai, Yuming; Chen, Quan; Wang, Jiangtao

2018-01-02

After the Chinese reform and opening up, the construction of economic zones, such as Special Economic Zones, Hi-tech Zones and Bonded Zones, has played an irreplaceable role in China's economic development. Currently, against the background of Chinese economic transition, research on development evaluation of economic zones has become popular and necessary. Similar research usually focuses on one specific field, and the methods that are used to evaluate it are simple. This research aims to analyse the development evaluation of zones by synthesis. A new hybrid multiple criteria decision making (MCDM) model that combines the DEMATEL technique and the DANP method is proposed. After establishing the evaluation criterion system and acquiring data, the influential weights of dimensions and criteria can be calculated, which will be a guide for forming measures of development. Shandong Peninsula Blue Economic Zone is used in the empirical case analysis. The results show that Transportation Conditions, Industrial Structure and Business Climate are the main influencing criteria and measures based on these criteria are proposed.

The Development Evaluation of Economic Zones in China

PubMed Central

Shi, Hong-Bo; Zhang, Zhe; Zhai, Yuming; Chen, Quan; Wang, Jiangtao

2018-01-01

After the Chinese reform and opening up, the construction of economic zones, such as Special Economic Zones, Hi-tech Zones and Bonded Zones, has played an irreplaceable role in China’s economic development. Currently, against the background of Chinese economic transition, research on development evaluation of economic zones has become popular and necessary. Similar research usually focuses on one specific field, and the methods that are used to evaluate it are simple. This research aims to analyse the development evaluation of zones by synthesis. A new hybrid multiple criteria decision making (MCDM) model that combines the DEMATEL technique and the DANP method is proposed. After establishing the evaluation criterion system and acquiring data, the influential weights of dimensions and criteria can be calculated, which will be a guide for forming measures of development. Shandong Peninsula Blue Economic Zone is used in the empirical case analysis. The results show that Transportation Conditions, Industrial Structure and Business Climate are the main influencing criteria and measures based on these criteria are proposed. PMID:29301304

An Evaluation Framework and Instrument for Evaluating e-Assessment Tools

ERIC Educational Resources Information Center

Singh, Upasana Gitanjali; de Villiers, Mary Ruth

2017-01-01

e-Assessment, in the form of tools and systems that deliver and administer multiple choice questions (MCQs), is used increasingly, raising the need for evaluation and validation of such systems. This research uses literature and a series of six empirical action research studies to develop an evaluation framework of categories and criteria called…

Learning Content and Software Evaluation and Personalisation Problems

ERIC Educational Resources Information Center

Kurilovas, Eugenijus; Serikoviene, Silvija

2010-01-01

The paper aims to analyse several scientific approaches how to evaluate, implement or choose learning content and software suitable for personalised users/learners needs. Learning objects metadata customisation method as well as the Method of multiple criteria evaluation and optimisation of learning software represented by the experts' additive…

Evaluating oversight of human drugs and medical devices: a case study of the FDA and implications for nanobiotechnology.

PubMed

Paradise, Jordan; Tisdale, Alison W; Hall, Ralph F; Kokkoli, Efrosini

2009-01-01

This article evaluates the oversight of drugs and medical devices by the U.S. Food and Drug Administration (FDA) using an integration of public policy, law, and bioethics approaches and employing multiple assessment criteria, including economic, social, safety, and technological. Criteria assessment and expert elicitation are combined with existing literature, case law, and regulations in an integrative historical case studies approach. We then use our findings as a tool to explore possibilities for effective oversight and regulatory mechanisms for nanobiotechnology. Section I describes oversight mechanisms for human drugs and medical devices and presents current nanotechnology products. Section II describes the results of expert elicitation research. Section III highlights key criteria and relates them to the literature and larger debate. We conclude with broad lessons for the oversight of nanobiotechnology informed by Sections I-III in order to provide useful analysis from multiple disciplines and perspectives to guide discussions regarding appropriate FDA oversight.

Screening of groundwater remedial alternatives for brownfield sites: a comprehensive method integrated MCDA with numerical simulation.

PubMed

Li, Wei; Zhang, Min; Wang, Mingyu; Han, Zhantao; Liu, Jiankai; Chen, Zhezhou; Liu, Bo; Yan, Yan; Liu, Zhu

2018-06-01

Brownfield sites pollution and remediation is an urgent environmental issue worldwide. The screening and assessment of remedial alternatives is especially complex owing to its multiple criteria that involves technique, economy, and policy. To help the decision-makers selecting the remedial alternatives efficiently, the criteria framework conducted by the U.S. EPA is improved and a comprehensive method that integrates multiple criteria decision analysis (MCDA) with numerical simulation is conducted in this paper. The criteria framework is modified and classified into three categories: qualitative, semi-quantitative, and quantitative criteria, MCDA method, AHP-PROMETHEE (analytical hierarchy process-preference ranking organization method for enrichment evaluation) is used to determine the priority ranking of the remedial alternatives and the solute transport simulation is conducted to assess the remedial efficiency. A case study was present to demonstrate the screening method in a brownfield site in Cangzhou, northern China. The results show that the systematic method provides a reliable way to quantify the priority of the remedial alternatives.

Evaluating options for U.S. greenhouse-gas mitigation using multiple criteria

DOT National Transportation Integrated Search

2009-01-01

Choosing a set of policy responses to mitigate greenhouse gases (GHGs) responsible for climate change is one of the great challenges that the United States faces in the coming years. This paper develops a framework for evaluating GHG-mitigation polic...

Screening and Evaluation Tool (SET) Users Guide

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

Pincock, Layne

This document is the users guide to using the Screening and Evaluation Tool (SET). SET is a tool for comparing multiple fuel cycle options against a common set of criteria and metrics. It does this using standard multi-attribute utility decision analysis methods.

Fuzzy decision-making framework for treatment selection based on the combined QUALIFLEX-TODIM method

NASA Astrophysics Data System (ADS)

Ji, Pu; Zhang, Hong-yu; Wang, Jian-qiang

2017-10-01

Treatment selection is a multi-criteria decision-making problem of significant concern in the medical field. In this study, a fuzzy decision-making framework is established for treatment selection. The framework mitigates information loss by introducing single-valued trapezoidal neutrosophic numbers to denote evaluation information. Treatment selection has multiple criteria that remarkably exceed the alternatives. In consideration of this characteristic, the framework utilises the idea of the qualitative flexible multiple criteria method. Furthermore, it considers the risk-averse behaviour of a decision maker by employing a concordance index based on TODIM (an acronym in Portuguese of interactive and multi-criteria decision-making) method. A sensitivity analysis is performed to illustrate the robustness of the framework. Finally, a comparative analysis is conducted to compare the framework with several extant methods. Results indicate the advantages of the framework and its better performance compared with the extant methods.

Optimal Contractor Selection in Construction Industry: The Fuzzy Way

NASA Astrophysics Data System (ADS)

Krishna Rao, M. V.; Kumar, V. S. S.; Rathish Kumar, P.

2018-02-01

A purely price-based approach to contractor selection has been identified as the root cause for many serious project delivery problems. Therefore, the capability of the contractor to execute the project should be evaluated using a multiple set of selection criteria including reputation, past performance, performance potential, financial soundness and other project specific criteria. An industry-wide questionnaire survey was conducted with the objective of identifying the important criteria for adoption in the selection process. In this work, a fuzzy set based model was developed for contractor prequalification/evaluation, by using effective criteria obtained from the percept of construction professionals, taking subjective judgments of decision makers also into consideration. A case study consisting of four alternatives (contractors in the present case) solicited from a public works department of Pondicherry in India, is used to illustrate the effectiveness of the proposed approach. The final selection of contractor is made based on the integrated score or Overall Evaluation Score of the decision alternative in prequalification as well as bid evaluation stages.

Post Pareto optimization-A case

NASA Astrophysics Data System (ADS)

Popov, Stoyan; Baeva, Silvia; Marinova, Daniela

2017-12-01

Simulation performance may be evaluated according to multiple quality measures that are in competition and their simultaneous consideration poses a conflict. In the current study we propose a practical framework for investigating such simulation performance criteria, exploring the inherent conflicts amongst them and identifying the best available tradeoffs, based upon multi-objective Pareto optimization. This approach necessitates the rigorous derivation of performance criteria to serve as objective functions and undergo vector optimization. We demonstrate the effectiveness of our proposed approach by applying it with multiple stochastic quality measures. We formulate performance criteria of this use-case, pose an optimization problem, and solve it by means of a simulation-based Pareto approach. Upon attainment of the underlying Pareto Frontier, we analyze it and prescribe preference-dependent configurations for the optimal simulation training.

Evaluating governance for sustainable development - Insights from experiences in the Dutch fen landscape.

PubMed

den Uyl, Roos M; Driessen, Peter P J

2015-11-01

Prominent strands of discussion in the literature on governance for sustainable development debate how change can be induced to enhance sustainability, and how to evaluate the interventions aimed at prompting such change. Strikingly, there are few contributions about how prominent ideas of inducing change deal with multiple governance criteria for pursuing sustainable development. Moreover, the way ideas about inducing change relate to criteria of governance for sustainable development is not yet studied in an empirical context. This paper therefore comparatively analyses how three prominent modes of sustainable development governance - adaptive management, transition management and payments for environmental services - relate to a set of five prominent criteria reported in the literature, namely: equity, democracy, legitimacy, the handling of scale issues and the handling of uncertainty issues. It finds that the academic debates on these three modes address these criteria with varying attention and rather fragmented, while in the empirical setting of the Dutch fen landscape several aspects relating to the studied criteria were present and substantially influenced the functioning of the three modes of sustainable development. Together, the analysis of the literature debate and the empirical data are able to show that a narrow evaluation perspective may fail to diagnose and capture relevant struggles and complexities coming along with governance for sustainable development relevant issues. The study shows that in order to advance our understanding of governance for sustainable development, it is indeed important to include multiple criteria in studying these modes. Moreover, the study shows the importance of including empirical experiences which manifest when different modes for sustainable development are applied in real-world settings. Copyright © 2015 Elsevier Ltd. All rights reserved.

Application of risk-based multiple criteria decision analysis for selection of the best agricultural scenario for effective watershed management.

PubMed

Javidi Sabbaghian, Reza; Zarghami, Mahdi; Nejadhashemi, A Pouyan; Sharifi, Mohammad Bagher; Herman, Matthew R; Daneshvar, Fariborz

2016-03-01

Effective watershed management requires the evaluation of agricultural best management practice (BMP) scenarios which carefully consider the relevant environmental, economic, and social criteria involved. In the Multiple Criteria Decision-Making (MCDM) process, scenarios are first evaluated and then ranked to determine the most desirable outcome for the particular watershed. The main challenge of this process is the accurate identification of the best solution for the watershed in question, despite the various risk attitudes presented by the associated decision-makers (DMs). This paper introduces a novel approach for implementation of the MCDM process based on a comparative neutral risk/risk-based decision analysis, which results in the selection of the most desirable scenario for use in the entire watershed. At the sub-basin level, each scenario includes multiple BMPs with scores that have been calculated using the criteria derived from two cases of neutral risk and risk-based decision-making. The simple additive weighting (SAW) operator is applied for use in neutral risk decision-making, while the ordered weighted averaging (OWA) and induced OWA (IOWA) operators are effective for risk-based decision-making. At the watershed level, the BMP scores of the sub-basins are aggregated to calculate each scenarios' combined goodness measurements; the most desirable scenario for the entire watershed is then selected based on the combined goodness measurements. Our final results illustrate the type of operator and risk attitudes needed to satisfy the relevant criteria within the number of sub-basins, and how they ultimately affect the final ranking of the given scenarios. The methodology proposed here has been successfully applied to the Honeyoey Creek-Pine Creek watershed in Michigan, USA to evaluate various BMP scenarios and determine the best solution for both the stakeholders and the overall stream health. Copyright © 2015 Elsevier Ltd. All rights reserved.

Smoking and multiple sclerosis: A systematic review and meta-analysis using the Bradford Hill criteria for causation.

PubMed

Degelman, Michelle L; Herman, Katya M

2017-10-01

Despite being one of the most common neurological disorders globally, the cause(s) of multiple sclerosis (MS) remain unknown. Cigarette smoking has been studied with regards to both the development and progression of MS. The Bradford Hill criteria for causation can contribute to a more comprehensive evaluation of a potentially causal risk factor-disease outcome relationship. The objective of this systematic review and meta-analysis was to assess the relationship between smoking and both MS risk and MS progression, subsequently applying Hill's criteria to further evaluate the likelihood of causal associations. The Medline, EMBASE, CINAHL, PsycInfo, and Cochrane Library databases were searched for relevant studies up until July 28, 2015. A random-effects meta-analysis was conducted for three outcomes: MS risk, conversion from clinically isolated syndrome (CIS) to clinically definite multiple sclerosis (CDMS), and progression from relapsing-remitting multiple sclerosis (RRMS) to secondary-progressive multiple sclerosis (SPMS). Dose-response relationships and risk factor interactions, and discussions of mechanisms and analogous associations were noted. Hill's criteria were applied to assess causality of the relationships between smoking and each outcome. The effect of second-hand smoke exposure was also briefly reviewed. Smoking had a statistically significant association with both MS risk (conservative: OR/RR 1.54, 95% CI [1.46-1.63]) and SPMS risk (HR 1.80, 95% CI [1.04-3.10]), but the association with progression from CIS to CDMS was non-significant (HR 1.13, 95% CI [0.73-1.76]). Using Hill's criteria, there was strong evidence of a causal role of smoking in MS risk, but only moderate evidence of a causal association between smoking and MS progression. Heterogeneity in study designs and target populations, inconsistent results, and an overall scarcity of studies point to the need for more research on second-hand smoke exposure in relation to MS prior to conducting a detailed meta-analysis. This first review to supplement systematic review and meta-analytic methods with Hill's criteria to analyze the smoking-MS association provides evidence supporting the causal involvement of smoking in the development and progression of MS. Smoking prevention and cessation programs and policies should consider MS as an additional health risk when aiming to reduce smoking prevalence in the population. Copyright © 2017 Elsevier B.V. All rights reserved.

Prioritizing sewer rehabilitation projects using AHP-PROMETHEE II ranking method.

PubMed

Kessili, Abdelhak; Benmamar, Saadia

2016-01-01

The aim of this paper is to develop a methodology for the prioritization of sewer rehabilitation projects for Algiers (Algeria) sewer networks to support the National Sanitation Office in its challenge to make decisions on prioritization of sewer rehabilitation projects. The methodology applies multiple-criteria decision making. The study includes 47 projects (collectors) and 12 criteria to evaluate them. These criteria represent the different issues considered in the prioritization of the projects, which are structural, hydraulic, environmental, financial, social and technical. The analytic hierarchy process (AHP) is used to determine weights of the criteria and the Preference Ranking Organization Method for Enrichment Evaluations (PROMETHEE II) method is used to obtain the final ranking of the projects. The model was verified using the sewer data of Algiers. The results have shown that the method can be used for prioritizing sewer rehabilitation projects.

Hierarchical semi-numeric method for pairwise fuzzy group decision making.

PubMed

Marimin, M; Umano, M; Hatono, I; Tamura, H

2002-01-01

Gradual improvements to a single-level semi-numeric method, i.e., linguistic labels preference representation by fuzzy sets computation for pairwise fuzzy group decision making are summarized. The method is extended to solve multiple criteria hierarchical structure pairwise fuzzy group decision-making problems. The problems are hierarchically structured into focus, criteria, and alternatives. Decision makers express their evaluations of criteria and alternatives based on each criterion by using linguistic labels. The labels are converted into and processed in triangular fuzzy numbers (TFNs). Evaluations of criteria yield relative criteria weights. Evaluations of the alternatives, based on each criterion, yield a degree of preference for each alternative or a degree of satisfaction for each preference value. By using a neat ordered weighted average (OWA) or a fuzzy weighted average operator, solutions obtained based on each criterion are aggregated into final solutions. The hierarchical semi-numeric method is suitable for solving a larger and more complex pairwise fuzzy group decision-making problem. The proposed method has been verified and applied to solve some real cases and is compared to Saaty's (1996) analytic hierarchy process (AHP) method.

Performance Evaluation of Extension Education Centers in Universities Based on the Balanced Scorecard

ERIC Educational Resources Information Center

Wu, Hung-Yi; Lin, Yi-Kuei; Chang, Chi-Hsiang

2011-01-01

This study aims at developing a set of appropriate performance evaluation indices mainly based on balanced scorecard (BSC) for extension education centers in universities by utilizing multiple criteria decision making (MCDM). Through literature reviews and experts who have real practical experiences in extension education, adequate performance…

Criteria for Evaluating Alternative Network and Link Layer Protocols for the NASA Constellation Program Communication Architecture

NASA Technical Reports Server (NTRS)

Benbenek, Daniel; Soloff, Jason; Lieb, Erica

2010-01-01

Selecting a communications and network architecture for future manned space flight requires an evaluation of the varying goals and objectives of the program, development of communications and network architecture evaluation criteria, and assessment of critical architecture trades. This paper uses Cx Program proposed exploration activities as a guideline; lunar sortie, outpost, Mars, and flexible path options are described. A set of proposed communications network architecture criteria are proposed and described. They include: interoperability, security, reliability, and ease of automating topology changes. Finally a key set of architecture options are traded including (1) multiplexing data at a common network layer vs. at the data link layer, (2) implementing multiple network layers vs. a single network layer, and (3) the use of a particular network layer protocol, primarily IPv6 vs. Delay Tolerant Networking (DTN). In summary, the protocol options are evaluated against the proposed exploration activities and their relative performance with respect to the criteria are assessed. An architectural approach which includes (a) the capability of multiplexing at both the network layer and the data link layer and (b) a single network layer for operations at each program phase, as these solutions are best suited to respond to the widest array of program needs and meet each of the evaluation criteria.

45 CFR 1308.8 - Eligibility criteria: Emotional/behavioral disorders.

Code of Federal Regulations, 2010 CFR

2010-10-01

... or emotional functioning in multiple settings. (c) The evaluation process must include a review of the child's regular Head Start physical examination to eliminate the possibility of misdiagnosis due to an underlying physical condition. ...

Use of the 2010 McDonald criteria can facilitate early diagnosis of pediatric multiple sclerosis in a predominantly black cohort.

PubMed

Williams, Mitchel T; Tapos, Daniela O; Juhász, Csaba

2014-12-01

Pediatric-onset multiple sclerosis represents around 3-5% of all patients with multiple sclerosis. Both the 2005 and 2010 McDonald criteria for multiple sclerosis have been suggested for the possible use in pediatric-onset multiple sclerosis. Modifications incorporated into the 2010 criteria enabled the fulfillment of dissemination in time to be met with the initial magnetic resonance imaging. The present study was designed to compare the diagnostic sensitivity of these criteria at initial presentation, the time to fulfilling them, and secondary effects of ethnicity in pediatric-onset multiple sclerosis. Twenty-five children with clinically definite multiple sclerosis (mean age, 14.6 ± 3.1 years; 15 girls) from a single center between 2005 and 2012 were analyzed using both the 2005 and 2010 McDonald criteria based on initial clinical presentation and neuroimaging findings comparing diagnostic sensitivity, time interval to meet diagnosis, and ethnicity. Initial multiple sclerosis diagnosis rates applying the 2005 McDonald criteria were 32% compared with 92% for the 2010 criteria (P = 0.0003). The mean time after initial signs until the 2005 and 2010 McDonald criteria for multiple sclerosis were met was 5.0 vs 0.7 months, respectively (P = 0.001). Time to diagnosis using the 2010 criteria was shorter in black children than the European white (P = 0.005). The 2010 McDonald criteria are an appropriate tool for the timely diagnosis of pediatric multiple sclerosis, especially in black children, potentially allowing an earlier initiation of disease-modifying therapy. Copyright © 2014 Elsevier Inc. All rights reserved.

Evaluation of an Agricultural Meteorological Disaster Based on Multiple Criterion Decision Making and Evolutionary Algorithm

PubMed Central

Yu, Xiaobing; Yu, Xianrui; Lu, Yiqun

2018-01-01

The evaluation of a meteorological disaster can be regarded as a multiple-criteria decision making problem because it involves many indexes. Firstly, a comprehensive indexing system for an agricultural meteorological disaster is proposed, which includes the disaster rate, the inundated rate, and the complete loss rate. Following this, the relative weights of the three criteria are acquired using a novel proposed evolutionary algorithm. The proposed algorithm consists of a differential evolution algorithm and an evolution strategy. Finally, a novel evaluation model, based on the proposed algorithm and the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS), is presented to estimate the agricultural meteorological disaster of 2008 in China. The geographic information system (GIS) technique is employed to depict the disaster. The experimental results demonstrated that the agricultural meteorological disaster of 2008 was very serious, especially in Hunan and Hubei provinces. Some useful suggestions are provided to relieve agriculture meteorological disasters. PMID:29597243

Most Scottish neurologists do not apply the 2010 McDonald criteria when diagnosing multiple sclerosis.

PubMed

Lumley, R; Davenport, R; Williams, A

2015-03-01

The diagnostic criteria for multiple sclerosis have evolved over time and currently the 2010 McDonald criteria are the most widely accepted. These criteria allow the diagnosis of multiple sclerosis to be made at the clinically isolated syndrome stage provided certain criteria are met on a single magnetic resonance brain scan. Our hypothesis was that neurologists in Scotland did not use these criteria routinely. We sent a SurveyMonkey questionnaire to all Scottish neurologists (consultants and trainees) regarding the diagnosis of multiple sclerosis. Our questionnaire response rate was 65/99 (66%). Most Scottish neurologists were aware of the criteria and 31/58 (53%) felt that they were using these routinely. However, in a clinical vignette designed to test the application of these criteria, only 5/57 (9%) of neurologists appeared to use them. Scottish neurologists' use of the 2010 McDonald criteria for diagnosis of multiple sclerosis varies from practitioners' perception of their use of these criteria.

A Critical Review of Research on the Alert Program®

ERIC Educational Resources Information Center

Gill, Kamaldeep; Thompson-Hodgetts, Sandra; Rasmussen, Carmen

2018-01-01

To evaluate the strength of evidence for the effectiveness, feasibility, and appropriateness of the Alert Program®. Multiple databases were systematically searched for peer-reviewed, English-language articles that evaluated the Alert Program®. Six articles met the inclusion criteria. The strength of evidence ranged from weak to moderate using the…

Analysis, Modeling, and Simulation (AMS) Testbed Development and Evaluation to Support Dynamic Mobility Applications (DMA) and Active Transportation and Demand Management (ATDM) Programs - AMS Testbed Selection Criteria

DOT National Transportation Integrated Search

2016-06-16

The primary objective of this project is to develop multiple simulation Testbeds/transportation models to evaluate the impacts of DMA connected vehicle applications and the active and dynamic transportation management (ATDM) strategies. The outputs (...

Performance evaluation of receive-diversity free-space optical communications over correlated Gamma-Gamma fading channels.

PubMed

Yang, Guowei; Khalighi, Mohammad-Ali; Ghassemlooy, Zabih; Bourennane, Salah

2013-08-20

The efficacy of spatial diversity in practical free-space optical communication systems is impaired by the fading correlation among the underlying subchannels. We consider in this paper the generation of correlated Gamma-Gamma random variables in view of evaluating the system outage probability and bit-error-rate under the condition of correlated fading. Considering the case of receive-diversity systems with intensity modulation and direct detection, we propose a set of criteria for setting the correlation coefficients on the small- and large-scale fading components based on scintillation theory. We verify these criteria using wave-optics simulations and further show through Monte Carlo simulations that we can effectively neglect the correlation corresponding to the small-scale turbulence in most practical systems, irrespective of the specific turbulence conditions. This has not been clarified before, to the best of our knowledge. We then present some numerical results to illustrate the effect of fading correlation on the system performance. Our conclusions can be generalized to the cases of multiple-beam and multiple-beam multiple-aperture systems.

Geospatial Optimization of Siting Large-Scale Solar Projects

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

Macknick, Jordan; Quinby, Ted; Caulfield, Emmet

2014-03-01

Recent policy and economic conditions have encouraged a renewed interest in developing large-scale solar projects in the U.S. Southwest. However, siting large-scale solar projects is complex. In addition to the quality of the solar resource, solar developers must take into consideration many environmental, social, and economic factors when evaluating a potential site. This report describes a proof-of-concept, Web-based Geographical Information Systems (GIS) tool that evaluates multiple user-defined criteria in an optimization algorithm to inform discussions and decisions regarding the locations of utility-scale solar projects. Existing siting recommendations for large-scale solar projects from governmental and non-governmental organizations are not consistent withmore » each other, are often not transparent in methods, and do not take into consideration the differing priorities of stakeholders. The siting assistance GIS tool we have developed improves upon the existing siting guidelines by being user-driven, transparent, interactive, capable of incorporating multiple criteria, and flexible. This work provides the foundation for a dynamic siting assistance tool that can greatly facilitate siting decisions among multiple stakeholders.« less

Multiple Criteria Decision Analysis (MCDA) for evaluating new medicines in Health Technology Assessment and beyond: The Advance Value Framework.

PubMed

Angelis, Aris; Kanavos, Panos

2017-09-01

Escalating drug prices have catalysed the generation of numerous "value frameworks" with the aim of informing payers, clinicians and patients on the assessment and appraisal process of new medicines for the purpose of coverage and treatment selection decisions. Although this is an important step towards a more inclusive Value Based Assessment (VBA) approach, aspects of these frameworks are based on weak methodologies and could potentially result in misleading recommendations or decisions. In this paper, a Multiple Criteria Decision Analysis (MCDA) methodological process, based on Multi Attribute Value Theory (MAVT), is adopted for building a multi-criteria evaluation model. A five-stage model-building process is followed, using a top-down "value-focused thinking" approach, involving literature reviews and expert consultations. A generic value tree is structured capturing decision-makers' concerns for assessing the value of new medicines in the context of Health Technology Assessment (HTA) and in alignment with decision theory. The resulting value tree (Advance Value Tree) consists of three levels of criteria (top level criteria clusters, mid-level criteria, bottom level sub-criteria or attributes) relating to five key domains that can be explicitly measured and assessed: (a) burden of disease, (b) therapeutic impact, (c) safety profile (d) innovation level and (e) socioeconomic impact. A number of MAVT modelling techniques are introduced for operationalising (i.e. estimating) the model, for scoring the alternative treatment options, assigning relative weights of importance to the criteria, and combining scores and weights. Overall, the combination of these MCDA modelling techniques for the elicitation and construction of value preferences across the generic value tree provides a new value framework (Advance Value Framework) enabling the comprehensive measurement of value in a structured and transparent way. Given its flexibility to meet diverse requirements and become readily adaptable across different settings, the Advance Value Framework could be offered as a decision-support tool for evaluators and payers to aid coverage and reimbursement of new medicines. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Scaling issues in multi-criteria evaluation of combinations of measures for integrated river basin management

NASA Astrophysics Data System (ADS)

Dietrich, Jörg

2016-05-01

In integrated river basin management, measures for reaching the environmental objectives can be evaluated at different scales, and according to multiple criteria of different nature (e.g. ecological, economic, social). Decision makers, including responsible authorities and stakeholders, follow different interests regarding criteria and scales. With a bottom up approach, the multi criteria assessment could produce a different outcome than with a top down approach. The first assigns more power to the local community, which is a common principle of IWRM. On the other hand, the development of an overall catchment strategy could potentially make use of synergetic effects of the measures, which fulfils the cost efficiency requirement at the basin scale but compromises local interests. Within a joint research project for the 5500 km2 Werra river basin in central Germany, measures have been planned to reach environmental objectives of the European Water Framework directive (WFD) regarding ecological continuity and nutrient loads. The main criteria for the evaluation of the measures were costs of implementation, reduction of nutrients, ecological benefit and social acceptance. The multi-criteria evaluation of the catchment strategies showed compensation between positive and negative performance of criteria within the catchment, which in the end reduced the discriminative power of the different strategies. Furthermore, benefit criteria are partially computed for the whole basin only. Both ecological continuity and nutrient load show upstream-downstream effects in opposite direction. The principles of "polluter pays" and "overall cost efficiency" can be followed for the reduction of nutrient losses when financial compensations between upstream and downstream users are made, similar to concepts of emission trading.

Fuzzy MCDM Technique for Planning the Environment Watershed

NASA Astrophysics Data System (ADS)

Chen, Yi-Chun; Lien, Hui-Pang; Tzeng, Gwo-Hshiung; Yang, Lung-Shih; Yen, Leon

In the real word, the decision making problems are very vague and uncertain in a number of ways. The most criteria have interdependent and interactive features so they cannot be evaluated by conventional measures method. Such as the feasibility, thus, to approximate the human subjective evaluation process, it would be more suitable to apply a fuzzy method in environment-watershed plan topic. This paper describes the design of a fuzzy decision support system in multi-criteria analysis approach for selecting the best plan alternatives or strategies in environmentwatershed. The Fuzzy Analytic Hierarchy Process (FAHP) method is used to determine the preference weightings of criteria for decision makers by subjective perception. A questionnaire was used to find out from three related groups comprising fifteen experts. Subjectivity and vagueness analysis is dealt with the criteria and alternatives for selection process and simulation results by using fuzzy numbers with linguistic terms. Incorporated the decision makers’ attitude towards preference, overall performance value of each alternative can be obtained based on the concept of Fuzzy Multiple Criteria Decision Making (FMCDM). This research also gives an example of evaluating consisting of five alternatives, solicited from a environmentwatershed plan works in Taiwan, is illustrated to demonstrate the effectiveness and usefulness of the proposed approach.

The Influence of Teacher Emotion on Grading Practices: A Preliminary Look at the Evaluation of Student Writing

ERIC Educational Resources Information Center

Brackett, Marc A.; Floman, James L.; Ashton-James, Claire; Cherkasskiy, Lillia; Salovey, Peter

2013-01-01

The evaluation of student work is a central aspect of the teaching profession that can affect students in significant ways. Although teachers use multiple criteria for assessing student work, it is not yet known if emotions are a factor in their grading decisions as has been found in other instances of professional evaluations. Reason to believe…

Is the Evaluation of the Students' Values Possible? An Integrated Approach to Determining the Weights of Students' Personal Goals Using Multiple-Criteria Methods

ERIC Educational Resources Information Center

Dadelo, Stanislav; Turskis, Zenonas; Zavadskas, Edmundas Kazimieras; Kacerauskas, Tomas; Dadeliene, Ruta

2016-01-01

To maximize the effectiveness of a decision, it is necessary to support decision-making with integrated methods. It can be assumed that subjective evaluation (considering only absolute values) is only remotely connected with the evaluation of real processes. Therefore, relying solely on these values in process management decision-making would be a…

Application of ecological criteria in selecting marine reserves and developing reserve networks

USGS Publications Warehouse

Roberts, Callum M.; Branch, George; Bustamante, Rodrigo H.; Castilla, Juan Carlos; Dugan, Jenifer; Halpern, Benjamin S.; Lafferty, Kevin D.; Leslie, Heather; McArdle, Deborah; Ruckelshaus, Mary; Warner, Robert R.

2003-01-01

Marine reserves are being established worldwide in response to a growing recognition of the conservation crisis that is building in the oceans. However, designation of reserves has been largely opportunistic, or protective measures have been implemented (often overlapping and sometimes in conflict) by different entities seeking to achieve different ends. This has created confusion among both users and enforcers, and the proliferation of different measures provides a false sense of protection where little is offered. This paper sets out a procedure grounded in current understanding of ecological processes, that allows the evaluation and selection of reserve sites in order to develop functional, interconnected networks of fully protected reserves that will fulfill multiple objectives. By fully protected we mean permanently closed to fishing and other resource extraction. We provide a framework that unifies the central aims of conservation and fishery management, while also meeting other human needs such as the provision of ecosystem services (e.g., maintenance of coastal water quality, shoreline protection, and recreational opportunities). In our scheme, candidate sites for reserves are evaluated against 12 criteria focused toward sustaining the biological integrity and productivity of marine systems at both local and regional scales. While a limited number of sites will be indispensable in a network, many will be of similar value as reserves, allowing the design of numerous alternative, biologically adequate networks. Devising multiple network designs will help ensure that ecological functionality is preserved throughout the socioeconomic evaluation process. Too often, socioeconomic criteria have dominated the process of reserve selection, potentially undermining their efficacy. We argue that application of biological criteria must precede and inform socioeconomic evaluation, since maintenance of ecosystem functioning is essential for meeting all of the goals for reserves. It is critical that stakeholders are fully involved throughout this process. Application of the proposed criteria will lead to networks whose multifunctionality will help unite the objectives of different management entities, so accelerating progress toward improved stewardship of the oceans.

Video Modeling and Observational Learning to Teach Gaming Access to Students with ASD

ERIC Educational Resources Information Center

Spriggs, Amy D.; Gast, David L.; Knight, Victoria F.

2016-01-01

The purpose of this study was to evaluate both video modeling and observational learning to teach age-appropriate recreation and leisure skills (i.e., accessing video games) to students with autism spectrum disorder. Effects of video modeling were evaluated via a multiple probe design across participants and criteria for mastery were based on…

Transshipment site selection using the AHP and TOPSIS approaches under fuzzy environment.

PubMed

Onüt, Semih; Soner, Selin

2008-01-01

Site selection is an important issue in waste management. Selection of the appropriate solid waste site requires consideration of multiple alternative solutions and evaluation criteria because of system complexity. Evaluation procedures involve several objectives, and it is often necessary to compromise among possibly conflicting tangible and intangible factors. For these reasons, multiple criteria decision-making (MCDM) has been found to be a useful approach to solve this kind of problem. Different MCDM models have been applied to solve this problem. But most of them are basically mathematical and ignore qualitative and often subjective considerations. It is easier for a decision-maker to describe a value for an alternative by using linguistic terms. In the fuzzy-based method, the rating of each alternative is described using linguistic terms, which can also be expressed as triangular fuzzy numbers. Furthermore, there have not been any studies focused on the site selection in waste management using both fuzzy TOPSIS (technique for order preference by similarity to ideal solution) and AHP (analytical hierarchy process) techniques. In this paper, a fuzzy TOPSIS based methodology is applied to solve the solid waste transshipment site selection problem in Istanbul, Turkey. The criteria weights are calculated by using the AHP.

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

Onuet, Semih; Soner, Selin

Site selection is an important issue in waste management. Selection of the appropriate solid waste site requires consideration of multiple alternative solutions and evaluation criteria because of system complexity. Evaluation procedures involve several objectives, and it is often necessary to compromise among possibly conflicting tangible and intangible factors. For these reasons, multiple criteria decision-making (MCDM) has been found to be a useful approach to solve this kind of problem. Different MCDM models have been applied to solve this problem. But most of them are basically mathematical and ignore qualitative and often subjective considerations. It is easier for a decision-maker tomore » describe a value for an alternative by using linguistic terms. In the fuzzy-based method, the rating of each alternative is described using linguistic terms, which can also be expressed as triangular fuzzy numbers. Furthermore, there have not been any studies focused on the site selection in waste management using both fuzzy TOPSIS (technique for order preference by similarity to ideal solution) and AHP (analytical hierarchy process) techniques. In this paper, a fuzzy TOPSIS based methodology is applied to solve the solid waste transshipment site selection problem in Istanbul, Turkey. The criteria weights are calculated by using the AHP.« less

The Problem of Multiple Criteria Selection of the Surface Mining Haul Trucks

NASA Astrophysics Data System (ADS)

Bodziony, Przemysław; Kasztelewicz, Zbigniew; Sawicki, Piotr

2016-06-01

Vehicle transport is a dominant type of technological processes in rock mines, and its profit ability is strictly dependent on overall cost of its exploitation, especially on diesel oil consumption. Thus, a rational design of transportation system based on haul trucks should result from thorough analysis of technical and economic issues, including both cost of purchase and its further exploitation, having a crucial impact on the cost of minerals extraction. Moreover, off-highway trucks should be selected with respect to all specific exploitation conditions and even the user's preferences and experience. In this paper a development of universal family of evaluation criteria as well as application of evaluation method for haul truck selection process for a specific exploitation conditions in surface mining have been carried out. The methodology presented in the paper is based on the principles of multiple criteria decision aiding (MCDA) using one of the ranking method, i.e. ELECTRE III. The applied methodology has been allowed for ranking of alternative solution (variants), on the considered set of haul trucks. The result of the research is a universal methodology, and it consequently may be applied in other surface mines with similar exploitation parametres.

Cloud E-Learning Service Strategies for Improving E-Learning Innovation Performance in a Fuzzy Environment by Using a New Hybrid Fuzzy Multiple Attribute Decision-Making Model

ERIC Educational Resources Information Center

Su, Chiu Hung; Tzeng, Gwo-Hshiung; Hu, Shu-Kung

2016-01-01

The purpose of this study was to address this problem by applying a new hybrid fuzzy multiple criteria decision-making model including (a) using the fuzzy decision-making trial and evaluation laboratory (DEMATEL) technique to construct the fuzzy scope influential network relationship map (FSINRM) and determine the fuzzy influential weights of the…

Early Intervention for Children at Risk for Reading Disabilities: The Impact of Grade at Intervention and Individual Differences on Intervention Outcomes

ERIC Educational Resources Information Center

Lovett, Maureen W.; Frijters, Jan C.; Wolf, Maryanne; Steinbach, Karen A.; Sevcik, Rose A.; Morris, Robin D.

2017-01-01

Across multiple schools and sites, the impact of grade-at-intervention was evaluated for children at risk or meeting criteria for reading disabilities. A multiple-component reading intervention with demonstrated efficacy was offered to small groups of children in 1st, 2nd, or 3rd grade. In a quasi-experimental design, 172 children received the…

Application of ANP and DEMATEL to evaluate the decision-making of municipal solid waste management in Metro Manila.

PubMed

Tseng, Ming-Lang

2009-09-01

A municipal solid waste management (MSW) expert group was consulted in order to mirror how government officials might reach an effective solution regarding municipal solid waste management in Metro Manila. A critical issue regarding this is how the expert group can better evaluate and select a favorable MSW management solution using a series of criteria. MSW management solution selection is a multiple criteria decision-making (MCDM) problem, which requires the consideration of a large number of complex criteria. A robust MCDM method should consider the interactions among these criteria. The analytic network process (ANP) is a relatively new MCDM method which can deal with all kinds of interactions systematically. The Decision Making Trial and Evaluation Laboratory (DEMATEL) not only can convert the relations between cause and effect of criteria into a structural model, but also can be used as a way to handle the inner dependences within a set of criteria. Hence, this paper applies an effective solution based on a combined ANP and DEMATEL method to assist the expert group evaluating different MSW management solutions. According to the results, the best solution is for each city to have its own type of thermal process technology and resource recovery facility before landfill rather than entering a joint venture with enterprises or going into build-operate-transfer projects in order to be able to construct thermal process technologies and resource recovery facilities.

Is it the time to rethink clinical decision-making strategies? From a single clinical outcome evaluation to a Clinical Multi-criteria Decision Assessment (CMDA).

PubMed

Migliore, Alberto; Integlia, Davide; Bizzi, Emanuele; Piaggio, Tomaso

2015-10-01

There are plenty of different clinical, organizational and economic parameters to consider in order having a complete assessment of the total impact of a pharmaceutical treatment. In the attempt to follow, a holistic approach aimed to provide an evaluation embracing all clinical parameters in order to choose the best treatments, it is necessary to compare and weight multiple criteria. Therefore, a change is required: we need to move from a decision-making context based on the assessment of one single criteria towards a transparent and systematic framework enabling decision makers to assess all relevant parameters simultaneously in order to choose the best treatment to use. In order to apply the MCDA methodology to clinical decision making the best pharmaceutical treatment (or medical devices) to use to treat a specific pathology, we suggest a specific application of the Multiple Criteria Decision Analysis for the purpose, like a Clinical Multi-criteria Decision Assessment CMDA. In CMDA, results from both meta-analysis and observational studies are used by a clinical consensus after attributing weights to specific domains and related parameters. The decision will result from a related comparison of all consequences (i.e., efficacy, safety, adherence, administration route) existing behind the choice to use a specific pharmacological treatment. The match will yield a score (in absolute value) that link each parameter with a specific intervention, and then a final score for each treatment. The higher is the final score; the most appropriate is the intervention to treat disease considering all criteria (domain an parameters). The results will allow the physician to evaluate the best clinical treatment for his patients considering at the same time all relevant criteria such as clinical effectiveness for all parameters and administration route. The use of CMDA model will yield a clear and complete indication of the best pharmaceutical treatment to use for patients, helping physicians to choose drugs with a complete set of information, imputed in the model. Copyright © 2015 Elsevier Ltd. All rights reserved.

EliXR-TIME: A Temporal Knowledge Representation for Clinical Research Eligibility Criteria.

PubMed

Boland, Mary Regina; Tu, Samson W; Carini, Simona; Sim, Ida; Weng, Chunhua

2012-01-01

Effective clinical text processing requires accurate extraction and representation of temporal expressions. Multiple temporal information extraction models were developed but a similar need for extracting temporal expressions in eligibility criteria (e.g., for eligibility determination) remains. We identified the temporal knowledge representation requirements of eligibility criteria by reviewing 100 temporal criteria. We developed EliXR-TIME, a frame-based representation designed to support semantic annotation for temporal expressions in eligibility criteria by reusing applicable classes from well-known clinical temporal knowledge representations. We used EliXR-TIME to analyze a training set of 50 new temporal eligibility criteria. We evaluated EliXR-TIME using an additional random sample of 20 eligibility criteria with temporal expressions that have no overlap with the training data, yielding 92.7% (76 / 82) inter-coder agreement on sentence chunking and 72% (72 / 100) agreement on semantic annotation. We conclude that this knowledge representation can facilitate semantic annotation of the temporal expressions in eligibility criteria.

Diagnostic accuracy of an ultrasonic multiple transducer cardiac imaging system

NASA Technical Reports Server (NTRS)

Popp, R. L.; Brown, O. R.; Harrison, D. C.

1975-01-01

An ultrasonic multiple-transducer imaging system for intracardiac structure visualization is developed in order to simplify visualization of the human heart in vivo without radiation hazard or invasion of the body. Results of the evaluation of the diagnostic accuracy of the devised system in a clinical setting for adult patients are presented and discussed. Criteria are presented for recognition of mitral valva prolapse, mitral stenosis, pericardial effusion, atrial septal defect, and left ventricular dyssynergy. The probable cause for false-positive and false-negative diagnoses is discussed. However, hypertrophic myopathy and congestive myopathy were unable to be detected. Since only qualitative criteria were used, it was not possible to differentiate patients with left ventricular volume overload from patients without cardiac pathology.

An Evaluation of Alternative Screening Procedures.

ERIC Educational Resources Information Center

Reid, Carol; Romanoff, Brenda; Algozzine, Bob; Udall, Ann

2000-01-01

This study compared the Problem Solving Assessment (PSA) procedure, an application based on Gardner's theory of multiple intelligences, with more traditional criteria for the identification of minority students for gifted education programs. Although positive correlations among approaches and intelligences were observed, different groups of…

Evaluations of indoor noise criteria systems based on human response

NASA Astrophysics Data System (ADS)

Bowden, Erica E.; Wang, Lily M.

2005-09-01

The goal of this research is to examine human response to background noise, and relate results to indoor noise criteria. In previous work by the authors, subjects completed perception surveys, typing tasks, and proofreading tasks under typical heating, ventilating, and air-conditioning (HVAC) noise conditions. Results were correlated with commonly used indoor noise criteria systems including noise criteria (NC), room criteria (RC) and others. The findings suggested that the types of tasks used and the length of exposure can impact the results. To examine these two issues, the authors conducted a new study in which each test subject completed 38 total hours of testing over multiple days. Subjects were exposed to several background noise exposures over 20, 40, 80, and 240 minute trials. During the trials, subjects completed a variety of performance tasks and answered questions about their perception of the noise, the thermal environment, and various other factors. Findings from this study were used to determine optimum testing conditions for on-going research examining the effects of tonal or fluctuating background noise on performance, annoyance, and spectral perception. Results are being used to evaluate the effectiveness of commonly used indoor noise criteria systems. [Work supported by INCE and ASHRAE.

Integrating multi-criteria evaluation techniques with geographic information systems for landfill site selection: a case study using ordered weighted average.

PubMed

Gorsevski, Pece V; Donevska, Katerina R; Mitrovski, Cvetko D; Frizado, Joseph P

2012-02-01

This paper presents a GIS-based multi-criteria decision analysis approach for evaluating the suitability for landfill site selection in the Polog Region, Macedonia. The multi-criteria decision framework considers environmental and economic factors which are standardized by fuzzy membership functions and combined by integration of analytical hierarchy process (AHP) and ordered weighted average (OWA) techniques. The AHP is used for the elicitation of attribute weights while the OWA operator function is used to generate a wide range of decision alternatives for addressing uncertainty associated with interaction between multiple criteria. The usefulness of the approach is illustrated by different OWA scenarios that report landfill suitability on a scale between 0 and 1. The OWA scenarios are intended to quantify the level of risk taking (i.e., optimistic, pessimistic, and neutral) and to facilitate a better understanding of patterns that emerge from decision alternatives involved in the decision making process. Copyright © 2011 Elsevier Ltd. All rights reserved.

Data Science in the Research Domain Criteria Era: Relevance of Machine Learning to the Study of Stress Pathology, Recovery, and Resilience

PubMed Central

Galatzer-Levy, Isaac R.; Ruggles, Kelly; Chen, Zhe

2017-01-01

Diverse environmental and biological systems interact to influence individual differences in response to environmental stress. Understanding the nature of these complex relationships can enhance the development of methods to: (1) identify risk, (2) classify individuals as healthy or ill, (3) understand mechanisms of change, and (4) develop effective treatments. The Research Domain Criteria (RDoC) initiative provides a theoretical framework to understand health and illness as the product of multiple inter-related systems but does not provide a framework to characterize or statistically evaluate such complex relationships. Characterizing and statistically evaluating models that integrate multiple levels (e.g. synapses, genes, environmental factors) as they relate to outcomes that a free from prior diagnostic benchmarks represents a challenge requiring new computational tools that are capable to capture complex relationships and identify clinically relevant populations. In the current review, we will summarize machine learning methods that can achieve these goals. PMID:29527592

Experimental and evaluated photoneutron cross sections for 197Au

NASA Astrophysics Data System (ADS)

Varlamov, V.; Ishkhanov, B.; Orlin, V.

2017-10-01

There is a serious well-known problem of noticeable disagreements between the partial photoneutron cross sections obtained in various experiments. Such data were mainly determined using quasimonoenergetic annihilation photon beams and the method of neutron multiplicity sorting at Lawrence Livermore National Laboratory (USA) and Centre d'Etudes Nucleaires of Saclay (France). The analysis of experimental cross sections employing new objective physical data reliability criteria has shown that many of those are not reliable. The IAEA Coordinated Research Project (CRP) on photonuclear data evaluation was approved. The experimental and previously evaluated cross sections of the partial photoneutron reactions (γ ,1 n ) and (γ ,2 n ) on 197Au were analyzed using the new data reliability criteria. The data evaluated using the new experimental-theoretical method noticeably differ from both experimental data and data previously evaluated using nuclear modeling codes gnash, gunf, alice-f, and others. These discrepancies needed to be resolved.

A Decision Support System for Solving Multiple Criteria Optimization Problems

ERIC Educational Resources Information Center

Filatovas, Ernestas; Kurasova, Olga

2011-01-01

In this paper, multiple criteria optimization has been investigated. A new decision support system (DSS) has been developed for interactive solving of multiple criteria optimization problems (MOPs). The weighted-sum (WS) approach is implemented to solve the MOPs. The MOPs are solved by selecting different weight coefficient values for the criteria…

User-Centric Multi-Criteria Information Retrieval

NASA Technical Reports Server (NTRS)

Wolfe, Shawn R.; Zhang, Yi

2009-01-01

Information retrieval models usually represent content only, and not other considerations, such as authority, cost, and recency. How could multiple criteria be utilized in information retrieval, and how would it affect the results? In our experiments, using multiple user-centric criteria always produced better results than a single criteria.

Incorporating ecosystem function concept in environmental planning and decision making by means of multi-criteria evaluation: the case-study of Kalloni, Lesbos, Greece.

PubMed

Oikonomou, Vera; Dimitrakopoulos, Panayiotis G; Troumbis, Andreas Y

2011-01-01

Nature provides life-support services which do not merely constitute the basis for ecosystem integrity but also benefit human societies. The importance of such multiple outputs is often ignored or underestimated in environmental planning and decision making. The economic valuation of ecosystem functions or services has been widely used to make these benefits economically visible and thus address this deficiency. Alternatively, the relative importance of the components of ecosystem value can be identified and compared by means of multi-criteria evaluation. Hereupon, this article proposes a conceptual framework that couples ecosystem function analysis, multi criteria evaluation and social research methodologies for introducing an ecosystem function-based planning and management approach. The framework consists of five steps providing the structure of a participative decision making process which is then tested and ratified, by applying the discrete multi-criteria method NAIADE, in the Kalloni Natura 2000 site, on Lesbos, Greece. Three scenarios were developed and evaluated with regard to their impacts on the different types of ecosystem functions and the social actors' value judgements. A conflict analysis permitted the better elaboration of the different views, outlining the coalitions formed in the local community and shaping the way towards reaching a consensus.

Multiple-objective evaluation of wastewater treatment plant control alternatives.

PubMed

Flores-Alsina, Xavier; Gallego, Alejandro; Feijoo, Gumersindo; Rodriguez-Roda, Ignasi

2010-05-01

Besides the evaluation of the environmental issues, the correct assessment of wastewater treatment plants (WWTP) should take into account several objectives such as: economic e.g. operation costs; technical e.g. risk of suffering microbiology-related TSS separation problems; or legal e.g. accomplishment with the effluent standards in terms of the different pollution loads. For this reason, the main objective of this paper is to show the benefits of complementing the environmental assessment carried out by life cycle assessment with economical, technical and legal criteria. Using a preliminary version of the BSM2 as a case study, different combinations of controllers are implemented, simulated and evaluated. In the following step, the resulting multi-criteria matrix is mined using multivariate statistical techniques. The results showed that the presence of an external carbon source addition, the type of aeration system and the TSS controller are the key elements creating the differences amongst the alternatives. Also, it was possible to characterize the different control strategies according to a set of aggregated criteria. Additionally, the existing synergies amongst different objectives and their consequent trade-offs were identified. Finally, it was discovered that from the initial extensive list of evaluation criteria, only a small set of five are really discriminant, being useful to differentiate within the generated alternatives. Copyright 2010 Elsevier Ltd. All rights reserved.

Incorporating Ecosystem Function Concept in Environmental Planning and Decision Making by Means of Multi-Criteria Evaluation: The Case-Study of Kalloni, Lesbos, Greece

NASA Astrophysics Data System (ADS)

Oikonomou, Vera; Dimitrakopoulos, Panayiotis G.; Troumbis, Andreas Y.

2011-01-01

Nature provides life-support services which do not merely constitute the basis for ecosystem integrity but also benefit human societies. The importance of such multiple outputs is often ignored or underestimated in environmental planning and decision making. The economic valuation of ecosystem functions or services has been widely used to make these benefits economically visible and thus address this deficiency. Alternatively, the relative importance of the components of ecosystem value can be identified and compared by means of multi-criteria evaluation. Hereupon, this article proposes a conceptual framework that couples ecosystem function analysis, multi criteria evaluation and social research methodologies for introducing an ecosystem function-based planning and management approach. The framework consists of five steps providing the structure of a participative decision making process which is then tested and ratified, by applying the discrete multi-criteria method NAIADE, in the Kalloni Natura 2000 site, on Lesbos, Greece. Three scenarios were developed and evaluated with regard to their impacts on the different types of ecosystem functions and the social actors' value judgements. A conflict analysis permitted the better elaboration of the different views, outlining the coalitions formed in the local community and shaping the way towards reaching a consensus.

A COMPARISON OF INTERCELL METRICS ON DISCRETE GLOBAL GRID SYSTEMS

EPA Science Inventory

A discrete global grid system (DGGS) is a spatial data model that aids in global research by serving as a framework for environmental modeling, monitoring and sampling across the earth at multiple spatial scales. Topological and geometric criteria have been proposed to evaluate a...

Comparison of Species Sensitivity Distributions Derived from Interspecies Correlation Models to Distributions used to Derive Water Quality Criteria

EPA Science Inventory

Species sensitivity distributions (SSD) require a large number of measured toxicity values to define a chemical’s toxicity to multiple species. This investigation comprehensively evaluated the accuracy of SSDs generated from toxicity values predicted from interspecies correlation...

Are symptoms of spirit possessed patients covered by the DSM-IV or DSM-5 criteria for possession trance disorder? A mixed-method explorative study in Uganda.

PubMed

van Duijl, Marjolein; Kleijn, Wim; de Jong, Joop

2013-09-01

As in many cultures, spirit possession is a common idiom of distress in Uganda. The DSM-IV contains experimental research criteria for dissociative and possession trance disorder (DTD and PTD), which are under review for the DSM-5. In the current proposed categories of the DSM-5, PTD is subsumed under dissociative identity disorder (DID) and DTD under dissociative disorders not elsewhere classified. Evaluation of these criteria is currently urgently required. This study explores the match between local symptoms of spirit possession in Uganda and experimental research criteria for PTD in the DSM-IV and proposed criteria for DID in the DSM-5. A mixed-method approach was used combining qualitative and quantitative research methods. Local symptoms were explored of 119 spirit possessed patients, using illness narratives and a cultural dissociative symptoms' checklist. Possible meaningful clusters of symptoms were inventoried through multiple correspondence analysis. Finally, local symptoms were compared with experimental criteria for PTD in the DSM-IV and proposed criteria for DID in the DSM-5. Illness narratives revealed different phases of spirit possession, with passive-influence experiences preceding the actual possession states. Multiple correspondence analysis of symptoms revealed two dimensions: 'passive' and 'active' symptoms. Local symptoms, such as changes in consciousness, shaking movements, and talking in a voice attributed to spirits, match with DSM-IV-PTD and DSM-5-DID criteria. Passive-influence experiences, such as feeling influenced or held by powers from outside, strange dreams, and hearing voices, deserve to be more explicitly described in the proposed criteria for DID in the DSM-5. The suggested incorporation of PTD in DID in the DSM-5 and the envisioned separation of DTD and PTD in two distinctive categories have disputable aspects.

Modeling Errors in Daily Precipitation Measurements: Additive or Multiplicative?

NASA Technical Reports Server (NTRS)

Tian, Yudong; Huffman, George J.; Adler, Robert F.; Tang, Ling; Sapiano, Matthew; Maggioni, Viviana; Wu, Huan

2013-01-01

The definition and quantification of uncertainty depend on the error model used. For uncertainties in precipitation measurements, two types of error models have been widely adopted: the additive error model and the multiplicative error model. This leads to incompatible specifications of uncertainties and impedes intercomparison and application.In this letter, we assess the suitability of both models for satellite-based daily precipitation measurements in an effort to clarify the uncertainty representation. Three criteria were employed to evaluate the applicability of either model: (1) better separation of the systematic and random errors; (2) applicability to the large range of variability in daily precipitation; and (3) better predictive skills. It is found that the multiplicative error model is a much better choice under all three criteria. It extracted the systematic errors more cleanly, was more consistent with the large variability of precipitation measurements, and produced superior predictions of the error characteristics. The additive error model had several weaknesses, such as non constant variance resulting from systematic errors leaking into random errors, and the lack of prediction capability. Therefore, the multiplicative error model is a better choice.

[Reflections about the efficiency criteria for cancer treatments during marketing authorization application].

PubMed

Jeannin, Noémie; Blois-Da Conceição, Stéphanie; Protière, Christel

2013-03-01

Although clear and validated recommendations exist concerning the evaluation of cancer treatments at the international level, the criteria retained to obtain the marketing authorization (MA) are multiple and heterogeneous. This qualitative survey explores the opinion related to the assessment of cancer treatment among the several concerned population. By the way of semi-structured interviews, our aim was to elicit perceptions toward the criteria which should be retained during the process of MA, by patients, oncologists, members of the pharmaceutical industry, health decision-makers and general population. Our survey emphasizes the variability of the significations associated with the criteria of efficiency of cancer treatments according to the characteristics of the respondents. We also have observed some common expectations from patients and oncologists toward the economic and political aspect, but also from the whole respondents toward the importance of the comfort of the patients. Lastly, the necessity to define specific criteria related to clinical cases emerges.

Evaluating New Technology.

PubMed

Carniol, Paul J; Heffelfinger, Ryan N; Grunebaum, Lisa D

2018-05-01

There are multiple complex issues to consider when evaluating any new technology. First evaluate the efficacy of the device. Then considering your patient population decide whether this technology brings an added benefit to your patients. If it meets these 2 criteria, then proceed to the financial analysis of acquiring this technology. The complete financial analysis has several important components that include but are not limited to cost, value, alternatives, return on investment, and associated marketing expense. Copyright © 2018 Elsevier Inc. All rights reserved.

Clinical consequences of the revised DSM-5 definition of agoraphobia in treatment-seeking anxious youth

PubMed Central

Cornacchio, Danielle; Chou, Tommy; Sacks, Hayley; Pincus, Donna; Comer, Jonathan

2015-01-01

Background In DSM-5, the agoraphobia core symptom criterion has been revised to require fear about multiple situations from across at least two distinct domains in which escape might be difficult or panic-like symptoms might develop. The present study examined patterns and correlates of the recent change in a sample of anxious youth with symptom presentations consistent with the DSM-IV agoraphobia definition and/or specific phobia (SP) to consider how the recent diagnostic change impacts the prevalence and composition of agoraphobia in children and adolescents. Method Analyses (N=151) evaluated impairment and correlates of agoraphobic youth who no longer meet the DSM-5 agoraphobia criteria relative to agoraphobic youth who do meet the new DSM-5 criteria. Secondary analyses compared agoraphobic youth not meeting DSM-5 criteria to SP youth. Results One-quarter of youth with symptom presentations consistent with the DSM-IV agoraphobia definition no longer met criteria for DSM-5 agoraphobia, but showed comparable severity and impairment across most domains to youth who do meet criteria for DSM-5 agoraphobia. Further, these youth showed higher levels of anxiety sensitivity and internalizing psychopathology relative to youth with SP. Conclusions A substantial proportion of impaired youth with considerable agoraphobic symptom presentations have been left without a specified anxiety diagnosis by the DSM-5, which may affect their ability to receive and/or get coverage for services and their representation in treatment evaluations. Future DSM iterations may do well to include a “circumscribed” agoraphobia specifier that would characterize presentations of fear or anxiety about multiple situations, but that do not span across at least two distinct situational domains. PMID:25845579

CLINICAL CONSEQUENCES OF THE REVISED DSM-5 DEFINITION OF AGORAPHOBIA IN TREATMENT-SEEKING ANXIOUS YOUTH.

PubMed

Cornacchio, Danielle; Chou, Tommy; Sacks, Hayley; Pincus, Donna; Comer, Jonathan

2015-07-01

In DSM-5, the agoraphobia core symptom criterion has been revised to require fear about multiple situations from across at least two distinct domains in which escape might be difficult or panic-like symptoms might develop. The present study examined patterns and correlates of the recent change in a sample of anxious youth with symptom presentations consistent with the DSM-IV agoraphobia definition and/or specific phobia (SP) to consider how the recent diagnostic change impacts the prevalence and composition of agoraphobia in children and adolescents. Analyses (N = 151) evaluated impairment and correlates of agoraphobic youth who no longer meet the DSM-5 agoraphobia criteria relative to agoraphobic youth who do meet the new DSM-5 criteria. Secondary analyses compared agoraphobic youth not meeting DSM-5 criteria to SP youth. One-quarter of youth with symptom presentations consistent with the DSM-IV agoraphobia definition no longer met criteria for DSM-5 agoraphobia, but showed comparable severity and impairment across most domains to youth who do meet criteria for DSM-5 agoraphobia. Further, these youth showed higher levels of anxiety sensitivity and internalizing psychopathology relative to youth with SP. A substantial proportion of impaired youth with considerable agoraphobic symptom presentations have been left without a specified anxiety diagnosis by the DSM-5, which may affect their ability to receive and/or get coverage for services and their representation in treatment evaluations. Future DSM iterations may do well to include a "circumscribed" agoraphobia specifier that would characterize presentations of fear or anxiety about multiple situations, but that do not span across at least two distinct situational domains. © 2015 Wiley Periodicals, Inc.

Preliminary criteria for the definition of allergic rhinitis: a systematic evaluation of clinical parameters in a disease cohort (I).

PubMed

Ng, M L; Warlow, R S; Chrishanthan, N; Ellis, C; Walls, R

2000-09-01

The aim of this study is to formulate criteria for the definition of allergic rhinitis. Other studies have sought to develop scoring systems to categorize the severity of allergic rhinitis symptoms but it was never used for the formulation of diagnostic criteria. These other scoring systems were arbitrarily chosen and were not derived by any statistical analysis. To date, a study of this kind has not been performed. The hypothesis of this study is that it is possible to formulate criteria for the definition of allergic rhinitis. This is the first study to systematically examine and evaluate the relative importance of symptoms, signs and investigative tests in allergic rhinitis. We sought to statistically rank, from the most to the least important, the multiplicity of symptoms, signs and test results. Forty-seven allergic rhinitis and 23 normal subjects were evaluated with a detailed questionnaire and history, physical examination, serum total immunoglobulin E, skin prick tests and serum enzyme allergosorbent tests (EAST). Statistical ranking of variables indicated rhinitis symptoms (nasal, ocular and oronasal) were the most commonly occurring, followed by a history of allergen provocation, then serum total IgE, positive skin prick tests and positive EAST's to house dust mite, perennial rye and bermuda/couch grass. Throat symptoms ranked even lower whilst EAST's to cat epithelia, plantain and cockroach were the least important. Not all symptoms, signs and tests evaluated proved to be statistically significant when compared to a control group; this included symtoms and signs which had been considered historically to be traditionally associated with allergic rhinitis, e.g. sore throat and bleeding nose. In performing statistical analyses, we were able to rank from most to least important, the multiplicity of symptoms signs and test results. The most important symptoms and signs were identified for the first time, even though some of these were not included in our original selection criteria for defining the disease cohort i.e. sniffing, postnasal drip, oedematous nasal mucosa, impaired sense of smell, mouth breathing, itchy nose and many of the specific provocation factors.

The qualitative assessment of pneumatic actuators operation in terms of vibration criteria

NASA Astrophysics Data System (ADS)

Hetmanczyk, M. P.; Michalski, P.

2015-11-01

The work quality of pneumatic actuators can be assessed in terms of multiple criteria. In the case of complex systems with pneumatic actuators retained at end positions (with occurrence of piston impact in cylinder covers) the vibration criteria constitute the most reliable indicators. The paper presents an impact assessment on the operating condition of the rodless pneumatic cylinder regarding to selected vibrational symptoms. On the basis of performed analysis the authors had shown meaningful premises allowing an evaluation of the performance and tuning of end position damping piston movement with usage the most common diagnostic tools (portable vibration analyzers). The presented method is useful in tuning of parameters in industrial conditions.

Developing Scientific Reasoning Through Drawing Cross-Sections

NASA Astrophysics Data System (ADS)

Hannula, K. A.

2012-12-01

Cross-sections and 3D models of subsurface geology are typically based on incomplete information (whether surface geologic mapping, well logs, or geophysical data). Creating and evaluating those models requires spatial and quantitative thinking skills (including penetrative thinking, understanding of horizontality, mental rotation and animation, and scaling). However, evaluating the reasonableness of a cross-section or 3D structural model also requires consideration of multiple possible geometries and geologic histories. Teaching students to create good models requires application of the scientific methods of the geosciences (such as evaluation of multiple hypotheses and combining evidence from multiple techniques). Teaching these critical thinking skills, especially combined with teaching spatial thinking skills, is challenging. My Structural Geology and Advanced Structural Geology courses have taken two different approaches to developing both the abilities to visualize and to test multiple models. In the final project in Structural Geology (a 3rd year course with a pre-requisite sophomore mapping course), students create a viable cross-section across part of the Wyoming thrust belt by hand, based on a published 1:62,500 geologic map. The cross-section must meet a number of geometric criteria (such as the template constraint), but is not required to balance. Each student tries many potential geometries while trying to find a viable solution. In most cases, the students don't visualize the implications of the geometries that they try, but have to draw them and then erase their work if it does not meet the criteria for validity. The Advanced Structural Geology course used Midland Valley's Move suite to test the cross-sections that they made in Structural Geology, mostly using the flexural slip unfolding algorithm and testing whether the resulting line lengths balanced. In both exercises, students seemed more confident in the quality of their cross-sections when the sections were easy to visualize. Students in Structural Geology are proud of their cross-sections once they were inked and colored. Students in Advanced Structural Geology were confident in their digitized cross-sections, even before they had tried to balance them or had tested whether they were kinematically plausible. In both cases, visually attractive models seemed easier to believe. Three-dimensional models seemed even more convincing: if students could visualize the model, they also thought it should work geometrically and kinematically, whether they had tested it or not. Students were more inclined to test their models when they had a clear set of criteria that would indicate success or failure. However, future development of new ideas about the kinematic and/or mechanical development of structures may force the students to also decide which criteria fit their problem the best. Combining both kinds of critical thinking (evaluating techniques and evaluating their results) in the same assignment may be challenging.

Predictive Modeling of Microbial Indicators for Timely Beach Notifications and Advisories at Marine Beaches

EPA Science Inventory

Marine beaches are occasionally contaminated by unacceptably high levels of fecal indicator bacteria (FIB) that exceed EPA water quality criteria. Here we describe application of a recent version of the software package Virtual Beach tool (VB 3.0.6) to build and evaluate multiple...

Model For Marketing Strategy Decision Based On Multicriteria Decicion Making: A Case Study In Batik Madura Industry

NASA Astrophysics Data System (ADS)

Anna, I. D.; Cahyadi, I.; Yakin, A.

2018-01-01

Selection of marketing strategy is a prominent competitive advantage for small and medium enterprises business development. The selection process is is a multiple criteria decision-making problem, which includes evaluation of various attributes or criteria in a process of strategy formulation. The objective of this paper is to develop a model for the selection of a marketing strategy in Batik Madura industry. The current study proposes an integrated approach based on analytic network process (ANP) and technique for order preference by similarity to ideal solution (TOPSIS) to determine the best strategy for Batik Madura marketing problems. Based on the results of group decision-making technique, this study selected fourteen criteria, including consistency, cost, trend following, customer loyalty, business volume, uniqueness manpower, customer numbers, promotion, branding, bussiness network, outlet location, credibility and the inovation as Batik Madura marketing strategy evaluation criteria. A survey questionnaire developed from literature review was distributed to a sample frame of Batik Madura SMEs in Pamekasan. In the decision procedure step, expert evaluators were asked to establish the decision matrix by comparing the marketing strategy alternatives under each of the individual criteria. Then, considerations obtained from ANP and TOPSIS methods were applied to build the specific criteria constraints and range of the launch strategy in the model. The model in this study demonstrates that, under current business situation, Straight-focus marketing strategy is the best marketing strategy for Batik Madura SMEs in Pamekasan.

Giant Malignant Pheochromocytoma with Palpable Rib Metastases

PubMed Central

Gokce, Gokhan; Kilicli, Fatih; Elagoz, Sahande; Ayan, Semih; Gultekin, Emin Yener

2014-01-01

Pheochromocytoma is a rare and usually benign neuroendocrine neoplasm. Only 10% of all these tumors are malignant and there are no definitive histological or cytological criteria of malignancy. Single malignancy criteria are the presence of advanced locoregional disease or metastases. We report a case, with a giant retroperitoneal tumor having multiple metastases including palpable rib metastases, who was diagnosed as a malignant pheochromocytoma. The patient was treated with surgery. The literature was reviewed to evaluate tumor features and current diagnostic and therapeutic approaches for patients with metastatic or potentially malignant pheochromocytoma. PMID:25152826

Evaluation of animal models of neurobehavioral disorders

PubMed Central

van der Staay, F Josef; Arndt, Saskia S; Nordquist, Rebecca E

2009-01-01

Animal models play a central role in all areas of biomedical research. The process of animal model building, development and evaluation has rarely been addressed systematically, despite the long history of using animal models in the investigation of neuropsychiatric disorders and behavioral dysfunctions. An iterative, multi-stage trajectory for developing animal models and assessing their quality is proposed. The process starts with defining the purpose(s) of the model, preferentially based on hypotheses about brain-behavior relationships. Then, the model is developed and tested. The evaluation of the model takes scientific and ethical criteria into consideration. Model development requires a multidisciplinary approach. Preclinical and clinical experts should establish a set of scientific criteria, which a model must meet. The scientific evaluation consists of assessing the replicability/reliability, predictive, construct and external validity/generalizability, and relevance of the model. We emphasize the role of (systematic and extended) replications in the course of the validation process. One may apply a multiple-tiered 'replication battery' to estimate the reliability/replicability, validity, and generalizability of result. Compromised welfare is inherent in many deficiency models in animals. Unfortunately, 'animal welfare' is a vaguely defined concept, making it difficult to establish exact evaluation criteria. Weighing the animal's welfare and considerations as to whether action is indicated to reduce the discomfort must accompany the scientific evaluation at any stage of the model building and evaluation process. Animal model building should be discontinued if the model does not meet the preset scientific criteria, or when animal welfare is severely compromised. The application of the evaluation procedure is exemplified using the rat with neonatal hippocampal lesion as a proposed model of schizophrenia. In a manner congruent to that for improving animal models, guided by the procedure expounded upon in this paper, the developmental and evaluation procedure itself may be improved by careful definition of the purpose(s) of a model and by defining better evaluation criteria, based on the proposed use of the model. PMID:19243583

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

Huang, Yang; Liu, Zhiqiang, E-mail: lzq@semi.ac.cn, E-mail: spring@semi.ac.cn; Yi, Xiaoyan, E-mail: lzq@semi.ac.cn, E-mail: spring@semi.ac.cn

To evaluate electron leakage in InGaN/GaN multiple quantum well (MQW) light emitting diodes (LEDs), analytic models of ballistic and quasi-ballistic transport are developed. With this model, the impact of critical variables effecting electron leakage, including the electron blocking layer (EBL), structure of multiple quantum wells (MQWs), polarization field, and temperature are explored. The simulated results based on this model shed light on previously reported experimental observations and provide basic criteria for suppressing electron leakage, advancing the design of InGaN/GaN LEDs.

Adaptation and Evaluation of a Multi-Criteria Decision Analysis Model for Lyme Disease Prevention

PubMed Central

Aenishaenslin, Cécile; Gern, Lise; Michel, Pascal; Ravel, André; Hongoh, Valérie; Waaub, Jean-Philippe; Milord, François; Bélanger, Denise

2015-01-01

Designing preventive programs relevant to vector-borne diseases such as Lyme disease (LD) can be complex given the need to include multiple issues and perspectives into prioritizing public health actions. A multi-criteria decision aid (MCDA) model was previously used to rank interventions for LD prevention in Quebec, Canada, where the disease is emerging. The aim of the current study was to adapt and evaluate the decision model constructed in Quebec under a different epidemiological context, in Switzerland, where LD has been endemic for the last thirty years. The model adaptation was undertaken with a group of Swiss stakeholders using a participatory approach. The PROMETHEE method was used for multi-criteria analysis. Key elements and results of the MCDA model are described and contrasted with the Quebec model. All criteria and most interventions of the MCDA model developed for LD prevention in Quebec were directly transferable to the Swiss context. Four new decision criteria were added, and the list of proposed interventions was modified. Based on the overall group ranking, interventions targeting human populations were prioritized in the Swiss model, with the top ranked action being the implementation of a large communication campaign. The addition of criteria did not significantly alter the intervention rankings, but increased the capacity of the model to discriminate between highest and lowest ranked interventions. The current study suggests that beyond the specificity of the MCDA models developed for Quebec and Switzerland, their general structure captures the fundamental and common issues that characterize the complexity of vector-borne disease prevention. These results should encourage public health organizations to adapt, use and share MCDA models as an effective and functional approach to enable the integration of multiple perspectives and considerations in the prevention and control of complex public health issues such as Lyme disease or other vector-borne and zoonotic diseases. PMID:26295344

Adaptation and Evaluation of a Multi-Criteria Decision Analysis Model for Lyme Disease Prevention.

PubMed

Aenishaenslin, Cécile; Gern, Lise; Michel, Pascal; Ravel, André; Hongoh, Valérie; Waaub, Jean-Philippe; Milord, François; Bélanger, Denise

2015-01-01

Designing preventive programs relevant to vector-borne diseases such as Lyme disease (LD) can be complex given the need to include multiple issues and perspectives into prioritizing public health actions. A multi-criteria decision aid (MCDA) model was previously used to rank interventions for LD prevention in Quebec, Canada, where the disease is emerging. The aim of the current study was to adapt and evaluate the decision model constructed in Quebec under a different epidemiological context, in Switzerland, where LD has been endemic for the last thirty years. The model adaptation was undertaken with a group of Swiss stakeholders using a participatory approach. The PROMETHEE method was used for multi-criteria analysis. Key elements and results of the MCDA model are described and contrasted with the Quebec model. All criteria and most interventions of the MCDA model developed for LD prevention in Quebec were directly transferable to the Swiss context. Four new decision criteria were added, and the list of proposed interventions was modified. Based on the overall group ranking, interventions targeting human populations were prioritized in the Swiss model, with the top ranked action being the implementation of a large communication campaign. The addition of criteria did not significantly alter the intervention rankings, but increased the capacity of the model to discriminate between highest and lowest ranked interventions. The current study suggests that beyond the specificity of the MCDA models developed for Quebec and Switzerland, their general structure captures the fundamental and common issues that characterize the complexity of vector-borne disease prevention. These results should encourage public health organizations to adapt, use and share MCDA models as an effective and functional approach to enable the integration of multiple perspectives and considerations in the prevention and control of complex public health issues such as Lyme disease or other vector-borne and zoonotic diseases.

Applying voting theory in natural resource management: a case of multiple-criteria group decision support.

PubMed

Laukkanen, Sanna; Kangas, Annika; Kangas, Jyrki

2002-02-01

Voting theory has a lot in common with utility theory, and especially with group decision-making. An expected-utility-maximising strategy exists in voting situations, as well as in decision-making situations. Therefore, it is natural to utilise the achievements of voting theory also in group decision-making. Most voting systems are based on a single criterion or holistic preference information on decision alternatives. However, a voting scheme called multicriteria approval is specially developed for decision-making situations with multiple criteria. This study considers the voting theory from the group decision support point of view and compares it with some other methods applied to similar purposes in natural resource management. A case study is presented, where the approval voting approach is introduced to natural resources planning and tested in a forestry group decision-making process. Applying multicriteria approval method was found to be a potential approach for handling some challenges typical for forestry group decision support. These challenges include (i) utilising ordinal information in the evaluation of decision alternatives, (ii) being readily understandable for and treating equally all the stakeholders in possession of different levels of knowledge on the subject considered, (iii) fast and cheap acquisition of preference information from several stakeholders, and (iv) dealing with multiple criteria.

Diagnostic value of multiple café-au-lait macules for neurofibromatosis 1 in Chinese children.

PubMed

Yao, Ruen; Wang, Lili; Yu, Yongguo; Wang, Jian; Shen, Yiping

2016-05-01

Neurofibromatosis 1 (NF1) is a common autosomal dominant condition caused by mutations in the NF1 gene. The appearance of multiple café-au-lait macules is an early sign of the condition, which often alert physicians to follow up and further examine the patient for the possibility of NF1. In order to determine the predictive value of multiple café-au-lait macules at early age for NF1 in Chinese patients, we recruited 19 children who shared the common sign of multiple café-au-lait macules from a general pediatric clinic in Shanghai. All the patients were clinically evaluated following the National Institutes of Health criteria for NF1 and molecular tested for sequence variants and copy number changes. Nine children met the clinical diagnostic criteria of NF1, and molecular tests confirmed all nine patients with pathogenic variants including two genomic deletions, two novel frame-shift variants, four novel nonsense and a splicing variants. In addition, four children who did not meet the diagnostic criteria were also found to carry pathogenic NF1 variants. Overall, 68.4% (13/19) of children with café-au-lait macules and various other clinical presentations were molecularly confirmed with NF1. This study demonstrated that the majority of Chinese children with multiple café-au-lait macules who came to seek for medical attention had NF1. Molecular testing is necessary to be used as an adjunct and sometimes as the main tool for confirming and diagnosing children of NF1 at early age. © 2015 Japanese Dermatological Association.

Potentially Inappropriate Prescribing in Disabled Older Patients with Chronic Diseases: A Screening Tool of Older Persons' Potentially Inappropriate Prescriptions versus Beers 2012 Criteria.

PubMed

Yang, Po-Jen; Lee, Yuan-Ti; Tzeng, Shu-Ling; Lee, Huei-Chao; Tsai, Chin-Feng; Chen, Chun-Chieh; Chen, Shiuan-Chih; Lee, Meng-Chih

2015-01-01

To evaluate the prescription of potentially inappropriate medications (PIM), using the Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) and Beers criteria, to disabled older people. One hundred and forty-one patients aged ≥65 years with Barthel scale scores ≤60 and a regular intake of medication for chronic diseases at Chung Shan Medical University Hospital from July to December 2012 were included, and their medical records were reviewed. Comprehensive patient information was extracted from the patients' medical notes. The STOPP and Beers 2012 criteria were used separately to identify PIM, and logistic regression analyses were performed to identify risk factors for PIM. The optimal cutoff for the number of medications prescribed for predicting PIM was estimated using the Youden index. Of the 141 patients, 94 (66.7%) and 94 (66.7%) had at least one PIM identified by the STOPP and Beers criteria, respectively. In multivariate analysis, PIM identified by the Beers criteria were associated with the prescription of multiple medications (p = 0.013) and the presence of psychiatric diseases (p < 0.001), whereas PIM identified by the STOPP criteria were only associated with the prescription of multiple medications (p = 0.008). The optimal cutoff for the number of medications prescribed for predicting PIM by using the STOPP or Beers criteria was 6. After adjustment for covariates, patients prescribed ≥6 medications had a significantly higher risk of PIM, identified using the STOPP or Beers criteria, compared to patients prescribed <6 medications (both p < 0.05). This study revealed a high frequency of PIM in disabled older patients with chronic diseases, particularly those prescribed ≥6 medications. © 2015 S. Karger AG, Basel.

Potentially Inappropriate Prescribing in Disabled Older Patients with Chronic Diseases: A Screening Tool of Older Persons' Potentially Inappropriate Prescriptions versus Beers 2012 Criteria

PubMed Central

Yang, Po-Jen; Lee, Yuan-Ti; Tzeng, Shu-Ling; Lee, Huei-Chao; Tsai, Chin-Feng; Chen, Chun-Chieh; Chen, Shiuan-Chih; Lee, Meng-Chih

2015-01-01

Objective To evaluate the prescription of potentially inappropriate medications (PIM), using the Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) and Beers criteria, to disabled older people. Subjects and Methods One hundred and forty-one patients aged ≥65 years with Barthel scale scores ≤60 and a regular intake of medication for chronic diseases at Chung Shan Medical University Hospital from July to December 2012 were included, and their medical records were reviewed. Comprehensive patient information was extracted from the patients' medical notes. The STOPP and Beers 2012 criteria were used separately to identify PIM, and logistic regression analyses were performed to identify risk factors for PIM. The optimal cutoff for the number of medications prescribed for predicting PIM was estimated using the Youden index. Results Of the 141 patients, 94 (66.7%) and 94 (66.7%) had at least one PIM identified by the STOPP and Beers criteria, respectively. In multivariate analysis, PIM identified by the Beers criteria were associated with the prescription of multiple medications (p = 0.013) and the presence of psychiatric diseases (p < 0.001), whereas PIM identified by the STOPP criteria were only associated with the prescription of multiple medications (p = 0.008). The optimal cutoff for the number of medications prescribed for predicting PIM by using the STOPP or Beers criteria was 6. After adjustment for covariates, patients prescribed ≥6 medications had a significantly higher risk of PIM, identified using the STOPP or Beers criteria, compared to patients prescribed <6 medications (both p < 0.05). Conclusion This study revealed a high frequency of PIM in disabled older patients with chronic diseases, particularly those prescribed ≥6 medications. PMID:26279164

Combining analytical hierarchy process and agglomerative hierarchical clustering in search of expert consensus in green corridors development management.

PubMed

Shapira, Aviad; Shoshany, Maxim; Nir-Goldenberg, Sigal

2013-07-01

Environmental management and planning are instrumental in resolving conflicts arising between societal needs for economic development on the one hand and for open green landscapes on the other hand. Allocating green corridors between fragmented core green areas may provide a partial solution to these conflicts. Decisions regarding green corridor development require the assessment of alternative allocations based on multiple criteria evaluations. Analytical Hierarchy Process provides a methodology for both a structured and consistent extraction of such evaluations and for the search for consensus among experts regarding weights assigned to the different criteria. Implementing this methodology using 15 Israeli experts-landscape architects, regional planners, and geographers-revealed inherent differences in expert opinions in this field beyond professional divisions. The use of Agglomerative Hierarchical Clustering allowed to identify clusters representing common decisions regarding criterion weights. Aggregating the evaluations of these clusters revealed an important dichotomy between a pragmatist approach that emphasizes the weight of statutory criteria and an ecological approach that emphasizes the role of the natural conditions in allocating green landscape corridors.

Reporting Qualitative Research: Standards, Challenges, and Implications for Health Design.

PubMed

Peditto, Kathryn

2018-04-01

This Methods column describes the existing reporting standards for qualitative research, their application to health design research, and the challenges to implementation. Intended for both researchers and practitioners, this article provides multiple perspectives on both reporting and evaluating high-quality qualitative research. Two popular reporting standards exist for reporting qualitative research-the Consolidated Criteria for Reporting Qualitative Research (COREQ) and the Standards for Reporting Qualitative Research (SRQR). Though compiled using similar procedures, they differ in their criteria and the methods to which they apply. Creating and applying reporting criteria is inherently difficult due to the undefined and fluctuating nature of qualitative research when compared to quantitative studies. Qualitative research is expansive and occasionally controversial, spanning many different methods of inquiry and epistemological approaches. A "one-size-fits-all" standard for reporting qualitative research can be restrictive, but COREQ and SRQR both serve as valuable tools for developing responsible qualitative research proposals, effectively communicating research decisions, and evaluating submissions. Ultimately, tailoring a set of standards specific to health design research and its frequently used methods would ensure quality research and aid reviewers in their evaluations.

Combining Analytical Hierarchy Process and Agglomerative Hierarchical Clustering in Search of Expert Consensus in Green Corridors Development Management

NASA Astrophysics Data System (ADS)

Shapira, Aviad; Shoshany, Maxim; Nir-Goldenberg, Sigal

2013-07-01

Environmental management and planning are instrumental in resolving conflicts arising between societal needs for economic development on the one hand and for open green landscapes on the other hand. Allocating green corridors between fragmented core green areas may provide a partial solution to these conflicts. Decisions regarding green corridor development require the assessment of alternative allocations based on multiple criteria evaluations. Analytical Hierarchy Process provides a methodology for both a structured and consistent extraction of such evaluations and for the search for consensus among experts regarding weights assigned to the different criteria. Implementing this methodology using 15 Israeli experts—landscape architects, regional planners, and geographers—revealed inherent differences in expert opinions in this field beyond professional divisions. The use of Agglomerative Hierarchical Clustering allowed to identify clusters representing common decisions regarding criterion weights. Aggregating the evaluations of these clusters revealed an important dichotomy between a pragmatist approach that emphasizes the weight of statutory criteria and an ecological approach that emphasizes the role of the natural conditions in allocating green landscape corridors.

Coverage criteria for test case generation using UML state chart diagram

NASA Astrophysics Data System (ADS)

Salman, Yasir Dawood; Hashim, Nor Laily; Rejab, Mawarny Md; Romli, Rohaida; Mohd, Haslina

2017-10-01

To improve the effectiveness of test data generation during the software test, many studies have focused on the automation of test data generation from UML diagrams. One of these diagrams is the UML state chart diagram. Test cases are generally evaluated according to coverage criteria. However, combinations of multiple criteria are required to achieve better coverage. Different studies used various number and types of coverage criteria in their methods and approaches. The objective of this paper to propose suitable coverage criteria for test case generation using UML state chart diagram especially in handling loops. In order to achieve this objective, this work reviewed previous studies to present the most practical coverage criteria combinations, including all-states, all-transitions, all-transition-pairs, and all-loop-free-paths coverage. Calculation to determine the coverage percentage of the proposed coverage criteria were presented together with an example has they are applied on a UML state chart diagram. This finding would be beneficial in the area of test case generating especially in handling loops in UML state chart diagram.

Applicability of McDonald 2010 and Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS) 2016 Magnetic Resonance Imaging Criteria for the Diagnosis of Multiple Sclerosis in Sri Lanka.

PubMed

Gamage, Sujani Madhurika Kodagoda; Wijeweera, Indunil; Wijesinghe, Priyangi; Adikari, Sanjaya Bandara; Fink, Katharina; Sominanda, Herath Mudiyanselage Ajith

2018-05-31

The magnetic resonance imaging in multiple sclerosis (MAGNIMS) group recently proposed guidelines to replace the existing dissemination-in-space criteria in McDonald 2010 magnetic resonance imaging (MRI) criteria for diagnosing multiple sclerosis. There has been insufficient research regarding their applicability in Asians. Objective of this study was to determine the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of McDonald 2010 and MAGNIMS 2016 MRI criteria with the aim of verifying their applicability in Sri Lankan patients. Patients with clinically isolated syndrome diagnosed by consultant neurologists were recruited from five major neurology centers. Baseline and follow-up MRI scans were performed within 3 months from the initial presentation and at one year after baseline MRI, respectively. McDonald 2010 and MAGNIMS 2016 MRI criteria were applied to all MRI scans. Patients were followed-up for 2 years to assess the conversion to clinically definite multiple sclerosis (CDMS). The sensitivity, specificity, accuracy, PPV, and NPV for predicting the conversion to CDMS were calculated. Forty-two of 66 patients converted to CDMS. Thirty-seven fulfilled the McDonald 2010 MRI criteria, and 33 converted to CDMS. MAGNIMS 2016 MRI criteria were fulfilled by 29, with 28 converting to CDMS. The sensitivity, specificity, accuracy, PPV, and NPV were 78%, 83%, 64%, 89%, and 69%, respectively, for the McDonald 2010 criteria, and 67%, 96%, 77%, 96%, and 62% for the MAGNIMS 2016 MRI criteria. MAGNIMS 2016 MRI criteria were superior to McDonald 2010 MRI criteria in specificity, accuracy, and PPV, but inferior in sensitivity and NPV. Copyright © 2018 Korean Neurological Association.

Recent advances in applying decision science to managing national forests

Treesearch

Bruce G. Marcot; Matthew P. Thompson; Michael C. Runge; Frank R. Thompson; Steven McNulty; David Cleaves; Monica Tomosy; Larry A. Fisher; Andrew Bliss

2012-01-01

Management of federal public forests to meet sustainability goals and multiple use regulations is an immense challenge. To succeed, we suggest use of formal decision science procedures and tools in the context of structured decision making (SDM). SDM entails four stages: problem structuring (framing the problem and defining objectives and evaluation criteria), problem...

A Comparison of Two Scoring Methods for an Automated Speech Scoring System

ERIC Educational Resources Information Center

Xi, Xiaoming; Higgins, Derrick; Zechner, Klaus; Williamson, David

2012-01-01

This paper compares two alternative scoring methods--multiple regression and classification trees--for an automated speech scoring system used in a practice environment. The two methods were evaluated on two criteria: construct representation and empirical performance in predicting human scores. The empirical performance of the two scoring models…

Operational military helicopter interior noise and vibration measurements with comparisons to ride quality criteria

NASA Technical Reports Server (NTRS)

Clevenson, S. A.; Leatherwood, J. D.; Hollenbaugh, D. D.

1983-01-01

Balka (1981) has identified the attainment of a 'jet-smooth' ride as a primary goal of the helicopter industry for commercial and certain military helicopters. It was noted that criteria accounting for both multiple axis vibration and interior noise are needed. The present investigation has the objective to present a vibration and interior noise data base in a format suitable for direct evaluation of aircraft ride quality. The investigation is also concerned with an assessment of the measured environment against available criteria as an indication of the state-of-the-art for current machines. Interior noise and vibration measurements were obtained on eight military helicopters during routine operational flights. The data are presented in the form of a number of parameters.

Strengths, Limitations, and Geographical Discrepancies in the Eligibility Criteria for Sport Participation in Young Patients With Congenital Heart Disease.

PubMed

Cantinotti, Massimiliano; Giordano, Raffaele; Assanta, Nadia; Murzi, Bruno; Melo, Manuel; Franchi, Eliana; Crocetti, Maura; Iervasi, Giorgio; Kutty, Shelby

2017-07-21

Benefits of physical activity has been shown in children with congenital heart disease (CHD). In several forms of CHD, the risk of sudden death remains a major concern both for parents and clinicians, who in turn will have to consider the risk-benefit ratio of sport participation versus restriction. A literature search was performed within the National Library of Medicine using the keywords: Sport, CHD, and Eligibility. The search was further refined by adding the keywords: Children, Adult, and Criteria. Fifteen published studies evaluating sport eligibility criteria in CHD were included. Seven documents from various scientific societies have been published in the past decade but which of them should be adopted remains unclear. Our research highlighted accuracy and consistency of the latest documents; however, differences have emerged between the US and European recommendations. Eligibility criteria were consistent between countries for simple congenital heart defects, whereas there are discrepancies for borderline conditions including moderate valvular lesions and mild or moderate residual defects after CHD repair. Furthermore, some of the more severe defects were not evaluated. Multiple recommendations have been made for the same CHD, and cut-off values used to define disease severity have varied. Published eligibility criteria have mainly focused on competitive sports. Little attention was paid to recreational activities, and the psychosocial consequences of activity restriction were seldom evaluated. Comprehensive consensus recommendations for sport eligibility evaluating all CHD types and stages of repair are needed. These should include competitive and recreational activities, use standardized classifications to grade disease severity, and address the consequences of restriction.

Quantity and Quality of Economic Evaluations in U.S. Nursing Research, 1997-2015: A Systematic Review.

PubMed

Cook, Wendy A; Morrison, Megan L; Eaton, Linda H; Theodore, Brian R; Doorenbos, Ardith Z

The United States has a complex healthcare system that is undergoing substantial reformations. There is a need for high-quality, economic evaluations of nursing practice. An updated review of completed economic evaluations relevant to the field of nursing within the U.S. healthcare system is timely and needed. The purpose of this study was to evaluate and describe the quantity and quality of economic evaluations in nursing-relevant research performed in the United States between 1997 and 2015. Four databases were searched. Titles, abstracts, and full-text content were reviewed to identify studies that analyzed both costs and outcomes, relevant to nursing, performed in the United States, and used the quality-adjusted life year to measure effectiveness. For included studies, data were extracted from full-text articles using criteria from U.S. Public Health Service's Panel on Cost-Effectiveness in Health and Medicine. Twenty-eight studies met the inclusion criteria. Most (n = 25, 89%) were published in the last decade of the analysis, from 2006 to 2015. Assessment of quality, based on selected items from the panel guidelines, found that the evaluations did not consistently use the recommended societal perspective, use multiple resource utilization categories, use constant dollars, discount future costs and outcomes, use a lifetime horizon, or include an indication of uncertainty in results. The only resource utilization category consistently included across studies was healthcare resources. Only 28 nursing-related studies meeting the inclusion criteria were identified as meeting robust health economic evaluation methodological criteria, and most did not include all important guideline items. Despite increases in absolute numbers of published studies over the past decade, economic evaluation has been underutilized in U.S. nursing-relevant research in the past two decades.

Application of decentralized cooperative problem solving in dynamic flexible scheduling

NASA Astrophysics Data System (ADS)

Guan, Zai-Lin; Lei, Ming; Wu, Bo; Wu, Ya; Yang, Shuzi

1995-08-01

The object of this study is to discuss an intelligent solution to the problem of task-allocation in shop floor scheduling. For this purpose, the technique of distributed artificial intelligence (DAI) is applied. Intelligent agents (IAs) are used to realize decentralized cooperation, and negotiation is realized by using message passing based on the contract net model. Multiple agents, such as manager agents, workcell agents, and workstation agents, make game-like decisions based on multiple criteria evaluations. This procedure of decentralized cooperative problem solving makes local scheduling possible. And by integrating such multiple local schedules, dynamic flexible scheduling for the whole shop floor production can be realized.

Evaluation of Eligibility Criteria Used to Identify Patients for Medication Therapy Management Services: A Retrospective Cohort Study in a Medicare Advantage Part D Population.

PubMed

Lee, Janet S; Yang, Jianing; Stockl, Karen M; Lew, Heidi; Solow, Brian K

2016-01-01

General eligibility criteria used by the Centers for Medicare & Medicaid Services (CMS) to identify patients for medication therapy management (MTM) services include having multiple chronic conditions, taking multiple Part D drugs, and being likely to incur annual drug costs that exceed a predetermined threshold. The performance of these criteria in identifying patients in greatest need of MTM services is unknown. Although there are numerous possible versions of MTM identification algorithms that satisfy these criteria, there are limited data that evaluate the performance of MTM services using eligibility thresholds representative of those used by the majority of Part D sponsors. To (a) evaluate the performance of the 2013 CMS MTM eligibility criteria thresholds in identifying Medicare Advantage Prescription Drug (MAPD) plan patients with at least 2 drug therapy problems (DTPs) relative to alternative criteria threshold levels and (b) identify additional patient risk factors significantly associated with the number of DTPs for consideration as potential future MTM eligibility criteria. All patients in the Medicare Advantage Part D population who had pharmacy eligibility as of December 31, 2013, were included in this retrospective cohort study. Study outcomes included 7 different types of DTPs: use of high-risk medications in the elderly, gaps in medication therapy, medication nonadherence, drug-drug interactions, duplicate therapy, drug-disease interactions, and brand-to-generic conversion opportunities. DTPs were identified for each member based on 6 months of most recent pharmacy claims data and 14 months of most recent medical claims data. Risk factors examined in this study included patient demographics and prior health care utilization in the most recent 6 months. Descriptive statistics were used to summarize patient characteristics and to evaluate unadjusted relationships between the average number of DTPs identified per patient and each risk factor. Quartile values identified in the study population for number of diseases, number of drugs, and annual spend were used as potential new criteria thresholds, resulting in 27 new MTM criteria combinations. The performance of each eligibility criterion was evaluated using sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs). Patients identified with at least 2 DTPs were defined as those who would benefit from MTM services and were used as the gold standard. As part of a sensitivity analysis, patients identified with at least 1 DTP were used as the gold standard. Lastly, a multivariable negative binomial regression model was used to evaluate the relationship between each risk factor and the number of identified DTPs per patient while controlling for the patients' number of drugs, number of chronic diseases, and annual drug spend. A total of 2,578,336 patients were included in the study. The sensitivity, specificity, PPV, and NPV of CMS MTM criteria for the 2013 plan year were 15.3%, 95.6%, 51.3%, and 78.8%, respectively. Sensitivity and PPV improved when the drug count threshold increased from 8 to 10, and when the annual drug cost decreased from $3,144 to $2,239 or less. Results were consistent when at least 1 DTP was used as the gold standard. The adjusted rate of DTPs was significantly greater among patients identified with higher drug and disease counts, annual drug spend, and prior ER or outpatient or hospital visits. Patients with higher median household incomes who were male, younger, or white had significantly lower rates of DTPs. The performance of MTM eligibility criteria can be improved by increasing the threshold values for drug count while decreasing the threshold value for annual drug spend. Furthermore, additional risk factors, such as a recent ER or hospital visit, may be considered as potential MTM eligibility criteria.

Application of the McDonald MRI criteria in multiple sclerosis.

PubMed

Chan, Ling Ling; Sitoh, Yih Yian; Chong, June; See, Siew Ju; Umapathi, Thirugnanam N; Lim, Shih Hui; Ong, Benjamin

2007-08-01

The aim of this study was to assess the sensitivity of McDonald's magnetic resonance imaging (MRI) criteria for the diagnosis of multiple sclerosis (MS) in a group of Asian patients diagnosed with clinically definite MS, based on lesion characterisation on MRI scans. Forty-nine patients from 3 major neurological institutions were classified as having Asian- or Western-type MS based on clinical assessment. Each MRI scan was reviewed by 2 neuroradiologists for the presence and characteristics of brain and spinal lesions. The McDonald's MRI criteria were then applied and its sensitivity evaluated. Nine patients were excluded, leaving 34 females and 6 males who were dominantly Chinese (90%), with a mean age of 36.2 years. The MRI brain and spinal findings were detailed and tabulated. Statistically significant differences (P <0.01) in MRI brain findings and sensitivity of McDonald's MRI criteria were found between our Asian- and Western-type MS patients. The diagnostic yield of McDonald's MRI criteria increased by 20% when we substituted a cord for a brain lesion, and applied the substitution for enhancing cord lesions as well. The diagnosis is more likely to be made when using McDonald MRI criteria based on brain findings, in a patient who presents clinically with Western-type MS. The provision for substitution of "one brain for a spinal lesion" is helpful in Asian-type MS, where there is preponderance of spinal lesion load. Our findings suggest that minor modifications in the interpretation of McDonald's MRI criteria have significant impact on the diagnosis in patients clinically presenting as Asian-type MS, with potential bearing on their subsequent management.

Governing Academic Medical Center Systems: Evaluating and Choosing Among Alternative Governance Approaches.

PubMed

Chari, Ramya; O'Hanlon, Claire; Chen, Peggy; Leuschner, Kristin; Nelson, Christopher

2018-02-01

The ability of academic medical centers (AMCs) to fulfill their triple mission of patient care, medical education, and research is increasingly being threatened by rising financial pressures and resource constraints. Many AMCs are, therefore, looking to expand into academic medical systems, increasing their scale through consolidation or affiliation with other health care systems. As clinical operations grow, though, the need for effective governance becomes even more critical to ensure that the business of patient care does not compromise the rest of the triple mission. Multi-AMC systems, a model in which multiple AMCs are governed by a single body, pose a particular challenge in balancing unity with the needs of component AMCs, and therefore offer lessons for designing AMC governance approaches. This article describes the development and application of a set of criteria to evaluate governance options for one multi-AMC system-the University of California (UC) and its five AMCs. Based on a literature review and key informant interviews, the authors identified criteria for evaluating governance approaches (structures and processes), assessed current governance approaches using the criteria, identified alternative governance options, and assessed each option using the identified criteria. The assessment aided UC in streamlining governance operations to enhance their ability to respond efficiently to change and to act collectively. Although designed for UC and a multi-AMC model, the criteria may provide a systematic way for any AMC to assess the strengths and weaknesses of its governance approaches.

Behçet's disease patients with multiple sclerosis-like features: discriminative value of Barkhof criteria.

PubMed

Akman-Demir, Gulsen; Mutlu, Melike; Kiyat-Atamer, Asli; Shugaiv, Erkingul; Kurtuncu, Murat; Tugal-Tutkun, Ilknur; Tuzun, Erdem; Eraksoy, Mefkure; Bahar, Sara

2015-01-01

Behçet's disease (BD) is a systemic auto-inflammatory disorder of unknown cause, which may affect the central nervous system in around 5% of the patients [neuro-BD (NBD)], usually causing large lesions encompassing brainstem, diencephalon and basal ganglia regions. Occasionally NBD patients present with white matter lesions necessitating differential diagnosis from multiple sclerosis (MS). In this study, the efficacy of Barkhof criteria was tested in diagnostic differentiation of NBD and MS. Charts and MRIs of 84 NBD patients were retrospectively evaluated. Clinical and radiological features of NBD patients fulfilling (Barkhof+) and not fulfilling Barkhof criteria (Barkhof-) were compared. While the Barkhof- patients (n=73) mostly displayed typical large lesions covering brainstem, diencephalon and basal ganglia regions and neurological findings consistent with brainstem involvement, all Barkhof+ (n=11) patients demonstrated MS-like white matter lesions, fulfilled McDonald's criteria and showed reduced frequency of brainstem symptoms and increased frequency of hemiparesis, hemihypesthesia and spinal cord symptoms. Moreover, the Barkhof+ group had more female patients, increased number of attacks, higher rate of oligoclonal band positivity and less patients with cerebrospinal fluid pleocytosis. A subgroup of BD patients with neurological complaints displays MS-like lesions, fulfills the clinical and radiological criteria of MS and presents with clinical and laboratory features resembling those of MS rather than NBD. These results suggest that Barkhof+ patients are either an overlapping group between NBD and MS, or they represent MS patients with concomitant systemic findings of BD, rather than NBD. Barkhof criteria appear to be effective in discriminating these patients.

ICT-Based Learning Personalization Affordance in the Context of Implementation of Constructionist Learning Activities

ERIC Educational Resources Information Center

Ignatova, Natalija; Dagiene, Valentina; Kubilinskiene, Svetlana

2015-01-01

How to enable students to create a personalized learning environment? What are the criteria of evaluation of the ICT-based learning process personalization affordance? These questions are answered by conducting multiple case study research of the innovative ICT-based learning process in iTEC (Innovative Technologies for Engaging Classrooms)…

78 FR 69324 - Revised Medical Criteria for Evaluating Hematological Disorders

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-19

.... ADDRESSES: You may submit comments by one of three methods--Internet, fax, or mail. Do not submit the same comments multiple times or by more than one method. Regardless of which method you choose, please state... hematological disorder. In proposed sections 7.00B1 and B2, we provide two methods for establishing the...

Some Useful Cost-Benefit Criteria for Evaluating Computer-Based Test Delivery Models and Systems

ERIC Educational Resources Information Center

Luecht, Richard M.

2005-01-01

Computer-based testing (CBT) is typically implemented using one of three general test delivery models: (1) multiple fixed testing (MFT); (2) computer-adaptive testing (CAT); or (3) multistage testing (MSTs). This article reviews some of the real cost drivers associated with CBT implementation--focusing on item production costs, the costs…

Online Learning Era: Exploring the Most Decisive Determinants of MOOCs in Taiwanese Higher Education

ERIC Educational Resources Information Center

Hsieh, Ming-Yuan

2016-01-01

Because the development of Taiwanese Massive Open Online Course (MOOCs) websites is at this moment full of vitality, this research employs a series of analytical cross-measurements of Quality Function Deployment method of House of Quality (QFD-HOQ) model and Multiple Criteria Decision Making (MCDM) methodology to cross-evaluate the weighted…

76 FR 66006 - Revised Medical Criteria for Evaluating Congenital Disorders That Affect Multiple Body Systems

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-25

... definitive test that documents your disorder (for example, genetic analysis or evidence of biochemical... testing, and We will not accept the fluorescence in situ hybridization (FISH) test--a screening test--and... results even if the person did have a test. Because we do not have definitive test results, we would...

Statistical approach for selection of biologically informative genes.

PubMed

Das, Samarendra; Rai, Anil; Mishra, D C; Rai, Shesh N

2018-05-20

Selection of informative genes from high dimensional gene expression data has emerged as an important research area in genomics. Many gene selection techniques have been proposed so far are either based on relevancy or redundancy measure. Further, the performance of these techniques has been adjudged through post selection classification accuracy computed through a classifier using the selected genes. This performance metric may be statistically sound but may not be biologically relevant. A statistical approach, i.e. Boot-MRMR, was proposed based on a composite measure of maximum relevance and minimum redundancy, which is both statistically sound and biologically relevant for informative gene selection. For comparative evaluation of the proposed approach, we developed two biological sufficient criteria, i.e. Gene Set Enrichment with QTL (GSEQ) and biological similarity score based on Gene Ontology (GO). Further, a systematic and rigorous evaluation of the proposed technique with 12 existing gene selection techniques was carried out using five gene expression datasets. This evaluation was based on a broad spectrum of statistically sound (e.g. subject classification) and biological relevant (based on QTL and GO) criteria under a multiple criteria decision-making framework. The performance analysis showed that the proposed technique selects informative genes which are more biologically relevant. The proposed technique is also found to be quite competitive with the existing techniques with respect to subject classification and computational time. Our results also showed that under the multiple criteria decision-making setup, the proposed technique is best for informative gene selection over the available alternatives. Based on the proposed approach, an R Package, i.e. BootMRMR has been developed and available at https://cran.r-project.org/web/packages/BootMRMR. This study will provide a practical guide to select statistical techniques for selecting informative genes from high dimensional expression data for breeding and system biology studies. Published by Elsevier B.V.

Usefulness of the Wechsler Intelligence Scale short form for assessing functional outcomes in patients with schizophrenia.

PubMed

Sumiyoshi, Chika; Fujino, Haruo; Sumiyoshi, Tomiki; Yasuda, Yuka; Yamamori, Hidenaga; Ohi, Kazutaka; Fujimoto, Michiko; Takeda, Masatoshi; Hashimoto, Ryota

2016-11-30

The Wechsler Adult Intelligence Scale (WAIS) has been widely used to assess intellectual functioning not only in healthy adults but also people with psychiatric disorders. The purpose of the study was to develop an optimal WAIS-3 short form (SF) to evaluate intellectual status in patients with schizophrenia. One hundred and fifty patients with schizophrenia and 221 healthy controls entered the study. To select subtests for SFs, following criteria were considered: 1) predictability for the full IQ (FIQ), 2) representativeness for the IQ structure, 3) consistency of subtests across versions, 4) sensitivity to functional outcome measures, 5) conciseness in administration time. First, exploratory factor analysis (EFA) and multiple regression analysis were conducted to select subtests satisfying the first and the second criteria. Then, candidate SFs were nominated based on the third criterion and the coverage of verbal IQ and performance IQ. Finally, the optimality of candidate SFs was evaluated in terms of the fourth and fifth criteria. The results suggest that the dyad of Similarities and Symbol Search was the most optimal satisfying the above criteria. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Hybrid MCDA Methods to Integrate Multiple Ecosystem Services in Forest Management Planning: A Critical Review

NASA Astrophysics Data System (ADS)

Uhde, Britta; Andreas Hahn, W.; Griess, Verena C.; Knoke, Thomas

2015-08-01

Multi-criteria decision analysis (MCDA) is a decision aid frequently used in the field of forest management planning. It includes the evaluation of multiple criteria such as the production of timber and non-timber forest products and tangible as well as intangible values of ecosystem services (ES). Hence, it is beneficial compared to those methods that take a purely financial perspective. Accordingly, MCDA methods are increasingly popular in the wide field of sustainability assessment. Hybrid approaches allow aggregating MCDA and, potentially, other decision-making techniques to make use of their individual benefits and leading to a more holistic view of the actual consequences that come with certain decisions. This review is providing a comprehensive overview of hybrid approaches that are used in forest management planning. Today, the scientific world is facing increasing challenges regarding the evaluation of ES and the trade-offs between them, for example between provisioning and regulating services. As the preferences of multiple stakeholders are essential to improve the decision process in multi-purpose forestry, participatory and hybrid approaches turn out to be of particular importance. Accordingly, hybrid methods show great potential for becoming most relevant in future decision making. Based on the review presented here, the development of models for the use in planning processes should focus on participatory modeling and the consideration of uncertainty regarding available information.

Hybrid MCDA Methods to Integrate Multiple Ecosystem Services in Forest Management Planning: A Critical Review.

PubMed

Uhde, Britta; Hahn, W Andreas; Griess, Verena C; Knoke, Thomas

2015-08-01

Multi-criteria decision analysis (MCDA) is a decision aid frequently used in the field of forest management planning. It includes the evaluation of multiple criteria such as the production of timber and non-timber forest products and tangible as well as intangible values of ecosystem services (ES). Hence, it is beneficial compared to those methods that take a purely financial perspective. Accordingly, MCDA methods are increasingly popular in the wide field of sustainability assessment. Hybrid approaches allow aggregating MCDA and, potentially, other decision-making techniques to make use of their individual benefits and leading to a more holistic view of the actual consequences that come with certain decisions. This review is providing a comprehensive overview of hybrid approaches that are used in forest management planning. Today, the scientific world is facing increasing challenges regarding the evaluation of ES and the trade-offs between them, for example between provisioning and regulating services. As the preferences of multiple stakeholders are essential to improve the decision process in multi-purpose forestry, participatory and hybrid approaches turn out to be of particular importance. Accordingly, hybrid methods show great potential for becoming most relevant in future decision making. Based on the review presented here, the development of models for the use in planning processes should focus on participatory modeling and the consideration of uncertainty regarding available information.

Statin Selection in Qatar Based on Multi-indication Pharmacotherapeutic Multi-criteria Scoring Model, and Clinician Preference.

PubMed

Al-Badriyeh, Daoud; Fahey, Michael; Alabbadi, Ibrahim; Al-Khal, Abdullatif; Zaidan, Manal

2015-12-01

Statin selection for the largest hospital formulary in Qatar is not systematic, not comparative, and does not consider the multi-indication nature of statins. There are no reports in the literature of multi-indication-based comparative scoring models of statins or of statin selection criteria weights that are based primarily on local clinicians' preferences and experiences. This study sought to comparatively evaluate statins for first-line therapy in Qatar, and to quantify the economic impact of this. An evidence-based, multi-indication, multi-criteria pharmacotherapeutic model was developed for the scoring of statins from the perspective of the main health care provider in Qatar. The literature and an expert panel informed the selection criteria of statins. Relative weighting of selection criteria was based on the input of the relevant local clinician population. Statins were comparatively scored based on literature evidence, with those exceeding a defined scoring threshold being recommended for use. With 95% CI and 5% margin of error, the scoring model was successfully developed. Selection criteria comprised 28 subcriteria under the following main criteria: clinical efficacy, best publish evidence and experience, adverse effects, drug interaction, dosing time, and fixed dose combination availability. Outcome measures for multiple indications were related to effects on LDL cholesterol, HDL cholesterol, triglyceride, total cholesterol, and C-reactive protein. Atorvastatin, pravastatin, and rosuvastatin exceeded defined pharmacotherapeutic thresholds. Atorvastatin and pravastatin were recommended as first-line use and rosuvastatin as a nonformulary alternative. It was estimated that this would produce a 17.6% cost savings in statins expenditure. Sensitivity analyses confirmed the robustness of the evaluation's outcomes against input uncertainties. Incorporating a comparative evaluation of statins in Qatari practices based on a locally developed, transparent, multi-indication, multi-criteria scoring model has the potential to considerably reduce expenditures on statins. Atorvastatin and pravastatin should be the first-line statin therapies in the main Qatari health care provider, with rosuvastatin as an alternative. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

Process evaluation of the implementation of scorecard-based antenatal risk assessment, care pathways and interdisciplinary consultation: the Healthy Pregnancy 4 All study.

PubMed

Vos, A A; van Voorst, S F; Posthumus, A G; Waelput, A J M; Denktaş, S; Steegers, E A P

2017-09-01

To evaluate the implementation of a complex intervention in the antenatal healthcare field in 14 Dutch municipalities. The intervention consisted of the implementation of a systematic scorecard-based risk assessment in pregnancy, subsequent patient-tailored care pathways, and consultations of professionals from different medical and social disciplines. Saunders's seven-step method was used for the development of a programme implementation monitoring plan, with specific attention to the setting and context of the programme. Data were triangulated from multiple sources, and prespecified criteria were applied to examine the evidence for implementation. Six out of 11 municipalities (54%) met the implementation criteria for the entire risk assessment programme, whereas three municipalities (27%) met the criteria if the three components of implementation were analysed separately. A process evaluation of implementation of a complex intervention is possible. The results can be used to improve understanding of the associations between specific programme elements and programme outcomes on effectiveness of the intervention. Additionally, the results are important for formative purposes to assess how future implementation of antenatal risk assessment can be improved in comparable contexts. Copyright © 2017. Published by Elsevier Ltd.

Automated design synthesis of robotic/human workcells for improved manufacturing system design in hazardous environments

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

Williams, Joshua M.

Manufacturing tasks that are deemed too hazardous for workers require the use of automation, robotics, and/or other remote handling tools. The associated hazards may be radiological or nonradiological, and based on the characteristics of the environment and processing, a design may necessitate robotic labor, human labor, or both. There are also other factors such as cost, ergonomics, maintenance, and efficiency that also effect task allocation and other design choices. Handling the tradeoffs of these factors can be complex, and lack of experience can be an issue when trying to determine if and what feasible automation/robotics options exist. To address thismore » problem, we utilize common engineering design approaches adapted more for manufacturing system design in hazardous environments. We limit our scope to the conceptual and embodiment design stages, specifically a computational algorithm for concept generation and early design evaluation. In regard to concept generation, we first develop the functional model or function structure for the process, using the common 'verb-noun' format for describing function. A common language or functional basis for manufacturing was developed and utilized to formalize function descriptions and guide rules for function decomposition. Potential components for embodiment are also grouped in terms of this functional language and are stored in a database. The properties of each component are given as quantitative and qualitative criteria. Operators are also rated for task-relevant criteria which are used to address task compatibility. Through the gathering of process requirements/constraints, construction of the component database, and development of the manufacturing basis and rule set, design knowledge is stored and available for computer use. Thus, once the higher level process functions are defined, the computer can automate the synthesis of new design concepts through alternating steps of embodiment and function structure updates/decomposition. In the process, criteria guide function allocation of components/operators and help ensure compatibility and feasibility. Through multiple function assignment options and varied function structures, multiple design concepts are created. All of the generated designs are then evaluated based on a number of relevant evaluation criteria: cost, dose, ergonomics, hazards, efficiency, etc. These criteria are computed using physical properties/parameters of each system based on the qualities an engineer would use to make evaluations. Nuclear processes such as oxide conversion and electrorefining are utilized to aid algorithm development and provide test cases for the completed program. Through our approach, we capture design knowledge related to manufacturing and other operations in hazardous environments to enable a computational program to automatically generate and evaluate system design concepts.« less

Interpretation criteria for FDG PET/CT in multiple myeloma (IMPeTUs): final results. IMPeTUs (Italian myeloma criteria for PET USe).

PubMed

Nanni, Cristina; Versari, Annibale; Chauvie, Stephane; Bertone, Elisa; Bianchi, Andrea; Rensi, Marco; Bellò, Marilena; Gallamini, Andrea; Patriarca, Francesca; Gay, Francesca; Gamberi, Barbara; Ghedini, Pietro; Cavo, Michele; Fanti, Stefano; Zamagni, Elena

2018-05-01

ᅟ: FDG PET/CT ( 18 F-fluoro-deoxy-glucose positron emission tomography/computed tomography) is a useful tool to image multiple myeloma (MM). However, simple and reproducible reporting criteria are still lacking and there is the need for harmonization. Recently, a group of Italian nuclear medicine experts defined new visual descriptive criteria (Italian Myeloma criteria for Pet Use: IMPeTUs) to standardize FDG PET/CT evaluation in MM patients. The aim of this study was to assess IMPeTUs reproducibility on a large prospective cohort of MM patients. Patients affected by symptomatic MM who had performed an FDG PET/CT at baseline (PET0), after induction (PET-AI), and the end of treatment (PET-EoT) were prospectively enrolled in a multicenter trial (EMN02)(NCT01910987; MMY3033). After anonymization, PET images were uploaded in the web platform WIDEN® and hence distributed to five expert nuclear medicine reviewers for a blinded independent central review according to the IMPeTUs criteria. Consensus among reviewers was measured by the percentage of agreement and the Krippendorff's alpha. Furthermore, on a patient-based analysis, the concordance among all the reviewers in terms of positivity or negativity of the FDG PET/CT scan was tested for different thresholds of positivity (Deauville score (DS 2, 3, 4, 5) for the main parameters (bone marrow, focal score, extra-medullary disease). Eighty-six patients (211 FDG PET/CT scans) were included in this analysis. Median patient age was 58 years (range, 35-66 years), 45% were male, 15% of them were in stage ISS (International Staging System) III, and 42% had high-risk cytogenetics. The percentage agreement was superior to 75% for all the time points, reaching 100% of agreement in assessing the presence skull lesions after therapy. Comparable results were obtained when the agreement analysis was performed using the Krippendorff's alpha coefficient, either in every single time point of scanning (PET0, PET-AI or PET-EoT) or overall for all the scans together. DS proved highly reproducible with the highest reproducibility for score 4. IMPeTUs criteria proved highly reproducible and could therefore be considered as a base for harmonizing PET interpretation in multiple myeloma. A prospective clinical validation of IMPeTUs criteria is underway.

Characterisation of the Context-Dependence of the Gene Concept in Research Articles: Possible Consequences for Teaching Concepts with Multiple Meanings

ERIC Educational Resources Information Center

Flodin, Veronica S.

2017-01-01

The purpose of this study is to interpret and qualitatively characterise the content in some research articles and evaluate cases of possible difference in meanings of the gene concept used. Using a reformulation of Hirst's criteria of forms of knowledge, articles from five different sub-disciplines in biology (transmission genetic, molecular…

Two approaches to incorporate clinical data uncertainty into multiple criteria decision analysis for benefit-risk assessment of medicinal products.

PubMed

Wen, Shihua; Zhang, Lanju; Yang, Bo

2014-07-01

The Problem formulation, Objectives, Alternatives, Consequences, Trade-offs, Uncertainties, Risk attitude, and Linked decisions (PrOACT-URL) framework and multiple criteria decision analysis (MCDA) have been recommended by the European Medicines Agency for structured benefit-risk assessment of medicinal products undergoing regulatory review. The objective of this article was to provide solutions to incorporate the uncertainty from clinical data into the MCDA model when evaluating the overall benefit-risk profiles among different treatment options. Two statistical approaches, the δ-method approach and the Monte-Carlo approach, were proposed to construct the confidence interval of the overall benefit-risk score from the MCDA model as well as other probabilistic measures for comparing the benefit-risk profiles between treatment options. Both approaches can incorporate the correlation structure between clinical parameters (criteria) in the MCDA model and are straightforward to implement. The two proposed approaches were applied to a case study to evaluate the benefit-risk profile of an add-on therapy for rheumatoid arthritis (drug X) relative to placebo. It demonstrated a straightforward way to quantify the impact of the uncertainty from clinical data to the benefit-risk assessment and enabled statistical inference on evaluating the overall benefit-risk profiles among different treatment options. The δ-method approach provides a closed form to quantify the variability of the overall benefit-risk score in the MCDA model, whereas the Monte-Carlo approach is more computationally intensive but can yield its true sampling distribution for statistical inference. The obtained confidence intervals and other probabilistic measures from the two approaches enhance the benefit-risk decision making of medicinal products. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Ecosystem Modeling Applied to Nutrient Criteria Development in Rivers

NASA Astrophysics Data System (ADS)

Carleton, James N.; Park, Richard A.; Clough, Jonathan S.

2009-09-01

Threshold concentrations for biological impairment by nutrients are difficult to quantify in lotic systems, yet States and Tribes in the United States are charged with developing water quality criteria to protect these ecosystems from excessive enrichment. The analysis described in this article explores the use of the ecosystem model AQUATOX to investigate impairment thresholds keyed to biological indexes that can be simulated. The indexes selected for this exercise include percentage cyanobacterial biomass of sestonic algae, and benthic chlorophyll a. The calibrated model was used to analyze responses of these indexes to concurrent reductions in phosphorus, nitrogen, and suspended sediment in an enriched upper Midwestern river. Results suggest that the indexes would respond strongly to changes in phosphorus and suspended sediment, and less strongly to changes in nitrogen concentration. Using simulated concurrent reductions in all three water quality constituents, a total phosphorus concentration of 0.1 mg/l was identified as a threshold concentration, and therefore a hypothetical water quality criterion, for prevention of both excessive periphyton growth and sestonic cyanobacterial blooms. This kind of analysis is suggested as a way to evaluate multiple contrasting impacts of hypothetical nutrient and sediment reductions and to define nutrient criteria or target concentrations that balance multiple management objectives concurrently.

Use of a modified Delphi panel to identify and weight criteria for prioritization of zoonotic diseases in Switzerland.

PubMed

Stebler, N; Schuepbach-Regula, G; Braam, P; Falzon, L C

2015-09-01

Zoonotic diseases have a significant impact on public health globally. To prevent or reduce future zoonotic outbreaks, there is a constant need to invest in research and surveillance programs while updating risk management strategies. However, given the limited resources available, disease prioritization based on the need for their control and surveillance is important. This study was performed to identify and weight disease criteria for the prioritization of zoonotic diseases in Switzerland using a semi-quantitative research method based on expert opinion. Twenty-eight criteria relevant for disease control and surveillance, classified under five domains, were selected following a thorough literature review, and these were evaluated and weighted by seven experts from the Swiss Federal Veterinary Office using a modified Delphi panel. The median scores assigned to each criterion were then used to rank 16 notifiable and/or emerging zoonoses in Switzerland. The experts weighted the majority of the criteria similarly, and the top three criteria were Severity of disease in humans, incidence and prevalence of the disease in humans and treatment in humans. Based on these weightings, the three highest ranked diseases were Avian Influenza, Bovine Spongiform Encephalitis, and Bovine Tuberculosis. Overall, this study provided a preliminary list of criteria relevant for disease prioritization in Switzerland. These were further evaluated in a companion study which involved a quantitative prioritization method and multiple stakeholders. Copyright © 2015 Elsevier B.V. All rights reserved.

[Revision of McDonald's new diagnostic criteria for multiple sclerosis].

PubMed

Wiendl, H; Kieseier, B C; Gold, R; Hohlfeld, R; Bendszus, M; Hartung, H-P

2006-10-01

In 2001, an international panel suggested new diagnostic criteria for multiple sclerosis (MS). These criteria integrate clinical, imaging (MRI), and paraclinical results in order to facilitate diagnosis. Since then, these so-called McDonald criteria have been broadly accepted and widely propagated. In the meantime a number of publications have dealt with the sensitivity and specificity for MS diagnosis and with implementing these new criteria in clinical practice. Based on these empirical values and newer data on MS, an international expert group recently proposed a revision of the criteria. Substantial changes affect (1) MRI criteria for the dissemination of lesions over time, (2) the role of spinal cord lesions in the MRI and (3) diagnosis of primary progressive MS. In this article we present recent experiences with the McDonald and revised criteria.

An item response theory analysis of DSM-IV criteria for hallucinogen abuse and dependence in adolescents

PubMed Central

Wu, Li-Tzy; Pan, Jeng-Jong; Yang, Chongming; Reeve, Bryce B.; Blazer, Dan G.

2009-01-01

Aim This study applied both item response theory (IRT) and multiple indicators–multiple causes (MIMIC) methods to evaluate item-level psychometric properties of diagnostic questions for hallucinogen use disorders (HUDs), differential item functioning (DIF), and predictors of latent HUD. Methods Data were drawn from 2004–2006 National Surveys on Drug Use and Health. Analyses were based on 1548 past-year hallucinogen users aged 12–17 years. Substance use and symptoms were assessed by audio computer-assisted self-interviewing methods. Results Abuse and dependence criteria empirically were arrayed along a single continuum of severity. All abuse criteria indicated middle-to-high severity on the IRT-defined HUD continuum, while dependence criteria captured a wider range from the lowest (tolerance and time spent) to the highest (taking larger amounts and inability to cut down) severity levels. There was indication of DIF by hallucinogen users’ age, gender, race/ethnicity, and ecstasy use status. Adjusting for DIF, ecstasy users (vs. non-ecstasy hallucinogen users), females (vs. males), and whites (vs. Hispanics) exhibited increased odds of HUD. Conclusions Symptoms of hallucinogen abuse and dependence empirically do not reflect two discrete conditions in adolescents. Trends and problems related to hallucinogen use among girls and whites should be examined further to inform the designs of effective gender-appropriate and culturally sensitive prevention programs. PMID:19896773

Evaluating integrated watershed management using multiple criteria analysis--a case study at Chittagong Hill Tracts in Bangladesh.

PubMed

Biswas, Shampa; Vacik, Harald; Swanson, Mark E; Haque, S M Sirajul

2012-05-01

Criteria and indicators assessment is one of the ways to evaluate management strategies for mountain watersheds. One framework for this, Integrated Watershed Management (IWM), was employed at Chittagong Hill Tracts region of Bangladesh using a multi-criteria analysis approach. The IWM framework, consisting of the design and application of principles, criteria, indicators, and verifiers (PCIV), facilitates active participation by diverse professionals, experts, and interest groups in watershed management, to explicitly address the demands and problems to measure the complexity of problems in a transparent and understandable way. Management alternatives are developed to fulfill every key component of IWM considering the developed PCIV set and current situation of the study area. Different management strategies, each focusing on a different approach (biodiversity conservation, flood control, soil and water quality conservation, indigenous knowledge conservation, income generation, watershed conservation, and landscape conservation) were assessed qualitatively on their potential to improve the current situation according to each verifier of the criteria and indicator set. Analytic Hierarchy Process (AHP), including sensitivity analysis, was employed to identify an appropriate management strategy according to overall priorities (i.e., different weights of each principle) of key informants. The AHP process indicated that a strategy focused on conservation of biodiversity provided the best option to address watershed-related challenges in the Chittagong Hill Tracts, Bangladesh.

The DLESE Evaluation Toolkit Project

NASA Astrophysics Data System (ADS)

Buhr, S. M.; Barker, L. J.; Marlino, M.

2002-12-01

The Evaluation Toolkit and Community project is a new Digital Library for Earth System Education (DLESE) collection designed to raise awareness of project evaluation within the geoscience education community, and to enable principal investigators, teachers, and evaluators to implement project evaluation more readily. This new resource is grounded in the needs of geoscience educators, and will provide a virtual home for a geoscience education evaluation community. The goals of the project are to 1) provide a robust collection of evaluation resources useful for Earth systems educators, 2) establish a forum and community for evaluation dialogue within DLESE, and 3) disseminate the resources through the DLESE infrastructure and through professional society workshops and proceedings. Collaboration and expertise in education, geoscience and evaluation are necessary if we are to conduct the best possible geoscience education. The Toolkit allows users to engage in evaluation at whichever level best suits their needs, get more evaluation professional development if desired, and access the expertise of other segments of the community. To date, a test web site has been built and populated, initial community feedback from the DLESE and broader community is being garnered, and we have begun to heighten awareness of geoscience education evaluation within our community. The web site contains features that allow users to access professional development about evaluation, search and find evaluation resources, submit resources, find or offer evaluation services, sign up for upcoming workshops, take the user survey, and submit calendar items. The evaluation resource matrix currently contains resources that have met our initial review. The resources are currently organized by type; they will become searchable on multiple dimensions of project type, audience, objectives and evaluation resource type as efforts to develop a collection-specific search engine mature. The peer review criteria and process for ensuring that the site contains robust and useful resources has been drafted and received initial feedback from the project advisory board, which consists of members of every segment of the target audience. The review criteria are based upon DLESE peer review criteria, the MERLOT digital library peer review criteria, digital resource evaluation criteria, and evaluation best practices. In geoscience education, as in most endeavors, improvements are made by asking questions and acting upon information about successes and failures; project evaluation can be thought of as the systematic process of asking these questions and gathering the right information. The Evaluation Toolkit seeks to help principal investigators, teachers, and evaluators use the evaluation process to improve our projects and our field.

Multiple victimizations before and after leaving home associated with PTSD, depression, and substance use disorder among homeless youth.

PubMed

Bender, Kimberly; Brown, Samantha M; Thompson, Sanna J; Ferguson, Kristin M; Langenderfer, Lisa

2015-05-01

Exposure to multiple forms of maltreatment during childhood is associated with serious mental health consequences among youth in the general population, but limited empirical attention has focused on homeless youth-a population with markedly high rates of childhood maltreatment followed by elevated rates of street victimization. This study investigated the rates of multiple childhood abuses (physical, sexual, and emotional abuse) and multiple street victimizations (robbery, physical assault, and sexual assault) and examined their relative relationships to mental health outcomes (meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria for post-traumatic stress disorder [PTSD], depression, and substance use disorder) among a large (N = 601) multisite sample of homeless youth. Approximately 79% of youth retrospectively reported multiple childhood abuses (two or more types) and 28% reported multiple street victimizations (two or more types). Each additional type of street victimization nearly doubled youths' odds for meeting criteria for substance use disorder. Furthermore, each additional type of childhood abuse experienced more than doubled youths' odds for meeting criteria for PTSD. Both multiple abuses and multiple street victimizations were associated with an approximate twofold increase in meeting depression criteria. Findings suggest the need for screening, assessment, and trauma-informed services for homeless youth who consider multiple types of abuse and victimization experiences. © The Author(s) 2014.

Selection of remedial alternatives for mine sites: a multicriteria decision analysis approach.

PubMed

Betrie, Getnet D; Sadiq, Rehan; Morin, Kevin A; Tesfamariam, Solomon

2013-04-15

The selection of remedial alternatives for mine sites is a complex task because it involves multiple criteria and often with conflicting objectives. However, an existing framework used to select remedial alternatives lacks multicriteria decision analysis (MCDA) aids and does not consider uncertainty in the selection of alternatives. The objective of this paper is to improve the existing framework by introducing deterministic and probabilistic MCDA methods. The Preference Ranking Organization Method for Enrichment Evaluation (PROMETHEE) methods have been implemented in this study. The MCDA analysis involves processing inputs to the PROMETHEE methods that are identifying the alternatives, defining the criteria, defining the criteria weights using analytical hierarchical process (AHP), defining the probability distribution of criteria weights, and conducting Monte Carlo Simulation (MCS); running the PROMETHEE methods using these inputs; and conducting a sensitivity analysis. A case study was presented to demonstrate the improved framework at a mine site. The results showed that the improved framework provides a reliable way of selecting remedial alternatives as well as quantifying the impact of different criteria on selecting alternatives. Copyright © 2013 Elsevier Ltd. All rights reserved.

Influence of diagnostic criteria on the interpretation of adrenal vein sampling.

PubMed

Lethielleux, Gaëlle; Amar, Laurence; Raynaud, Alain; Plouin, Pierre-François; Steichen, Olivier

2015-04-01

Guidelines promote the use of adrenal vein sampling (AVS) to document lateralized aldosterone hypersecretion in primary aldosteronism. However, there are large discrepancies between institutions in the criteria used to interpret its results. This study evaluates the consequences of these differences on the classification and management of patients. The results of all 537 AVS procedures performed between January 2001 and July 2010 in our institution were interpreted with 4 diagnostic criteria used in experienced institutions where AVS is performed without cosyntropin (Brisbane, Padua, Paris, and Turin) and with criteria proposed by a recent consensus statement. AVS procedures were classified as unsuccessful, lateralized, or not lateralized according to each set of criteria. Almost 5× more AVS procedures were classified as unsuccessful with the strictest criteria than with the least strict criteria (18% versus 4%, respectively). Similarly, over 2× more AVS procedures were classified as lateralized with the least stringent criteria than with the most stringent criteria (60% versus 26%, respectively). Multiple samples were available from ≥1 side for 155 AVS procedures. These procedures were classified differently by ≥2 right-left sample pairs in 12% to 20% of cases. Thus, different sets of criteria used to interpret AVS in experienced institutions translate into heterogeneous classifications and hence management decisions, for patients with primary aldosteronism. Defining the most appropriate procedures and diagnostic criteria is needed for AVS to achieve optimal performance and fully justify its status as a gold standard. © 2015 American Heart Association, Inc.

Review of reviews on exposures to synthetic organic chemicals and children's neurodevelopment: Methodological and interpretation challenges.

PubMed

LaKind, Judy S; Anthony, Laura G; Goodman, Michael

2017-01-01

Environmental epidemiology data are becoming increasingly important in public health decision making, which commonly incorporates a systematic review of multiple studies. This review addresses two fundamental questions: What is the quality of available reviews on associations between exposure to synthetic organic chemicals and neurodevelopmental outcomes? What is the value (e.g., quality and consistency) of the underlying literature? Published reviews on associations between synthetic organic environmental chemical exposures and neurodevelopmental outcomes in children were systematically evaluated. Seventy-four relevant reviews were identified, and these were evaluated with respect to four methodological characteristics: (1) systematic inclusion/exclusion criteria and reproducible methods for search and retrieval of studies; (2) structured evaluation of underlying data quality; (3) systematic assessment of consistency across specific exposure-outcome associations; and (4) evaluation of reporting/publication bias. None of the 74 reviews fully met the criteria for all four methodological characteristics. Only four reviews met two criteria, and six reviews fulfilled only one criterion. Perhaps more importantly, the higher quality reviews were not able to meet all of the criteria owing to the shortcomings of underlying studies, which lacked comparability in terms of specific research question of interest, overall design, exposure assessment, outcome ascertainment, and analytic methods. Thus, even the most thoughtful and rigorous review may be of limited value if the underlying literature includes investigations that address different hypotheses and are beset by methodological inconsistencies and limitations. Issues identified in this review of reviews illustrate considerable challenges that are facing assessments of epidemiological evidence.

Evaluation and selection of decision-making methods to assess landfill mining projects.

PubMed

Hermann, Robert; Baumgartner, Rupert J; Vorbach, Stefan; Ragossnig, Arne; Pomberger, Roland

2015-09-01

For the first time in Austria, fundamental technological and economic studies on recovering secondary raw materials from large landfills have been carried out, based on the 'LAMIS - Landfill Mining Austria' pilot project. A main focus of the research - and the subject of this article - was to develop an assessment or decision-making procedure that allows landfill owners to thoroughly examine the feasibility of a landfill mining project in advance. Currently there are no standard procedures that would sufficiently cover all the multiple-criteria requirements. The basic structure of the multiple attribute decision making process was used to narrow down on selection, conceptual design and assessment of suitable procedures. Along with a breakdown into preliminary and main assessment, the entire foundation required was created, such as definitions of requirements to an assessment method, selection and accurate description of the various assessment criteria and classification of the target system for the present 'landfill mining' vs. 'retaining the landfill in after-care' decision-making problem. Based on these studies, cost-utility analysis and the analytical-hierarchy process were selected from the range of multiple attribute decision-making procedures and examined in detail. Overall, both methods have their pros and cons with regard to their use for assessing landfill mining projects. Merging these methods or connecting them with single-criteria decision-making methods (like the net present value method) may turn out to be reasonable and constitute an appropriate assessment method. © The Author(s) 2015.

Reliability of the ADI-R for the Single Case-Part II: Clinical versus Statistical Significance

ERIC Educational Resources Information Center

Cicchetti, Domenic V.; Lord, Catherine; Koenig, Kathy; Klin, Ami; Volkmar, Fred R.

2014-01-01

In an earlier investigation, the authors assessed the reliability of the ADI-R when multiple clinicians evaluated a single case, here a female 3 year old toddler suspected of having an autism spectrum disorder (Cicchetti et al. in "J Autism Dev Disord" 38:764-770, 2008). Applying the clinical criteria of Cicchetti and Sparrow ("Am J…

FY04 Advanced Life Support Architecture and Technology Studies: Mid-Year Presentation

NASA Technical Reports Server (NTRS)

Lange, Kevin; Anderson, Molly; Duffield, Bruce; Hanford, Tony; Jeng, Frank

2004-01-01

Long-Term Objective: Identify optimal advanced life support system designs that meet existing and projected requirements for future human spaceflight missions. a) Include failure-tolerance, reliability, and safe-haven requirements. b) Compare designs based on multiple criteria including equivalent system mass (ESM), technology readiness level (TRL), simplicity, commonality, etc. c) Develop and evaluate new, more optimal, architecture concepts and technology applications.

Evaluating Equating Results in the Non-Equivalent Groups with Anchor Test Design Using Equipercentile and Equity Criteria

ERIC Educational Resources Information Center

Duong, Minh Quang

2011-01-01

Testing programs often use multiple test forms of the same test to control item exposure and to ensure test security. Although test forms are constructed to be as similar as possible, they often differ. Test equating techniques are those statistical methods used to adjust scores obtained on different test forms of the same test so that they are…

Smoothing and Equating Methods Applied to Different Types of Test Score Distributions and Evaluated with Respect to Multiple Equating Criteria. Research Report. ETS RR-11-20

ERIC Educational Resources Information Center

Moses, Tim; Liu, Jinghua

2011-01-01

In equating research and practice, equating functions that are smooth are typically assumed to be more accurate than equating functions with irregularities. This assumption presumes that population test score distributions are relatively smooth. In this study, two examples were used to reconsider common beliefs about smoothing and equating. The…

Tackling Complex Emergency Response Solutions Evaluation Problems in Sustainable Development by Fuzzy Group Decision Making Approaches with Considering Decision Hesitancy and Prioritization among Assessing Criteria.

PubMed

Qi, Xiao-Wen; Zhang, Jun-Ling; Zhao, Shu-Ping; Liang, Chang-Yong

2017-10-02

In order to be prepared against potential balance-breaking risks affecting economic development, more and more countries have recognized emergency response solutions evaluation (ERSE) as an indispensable activity in their governance of sustainable development. Traditional multiple criteria group decision making (MCGDM) approaches to ERSE have been facing simultaneous challenging characteristics of decision hesitancy and prioritization relations among assessing criteria, due to the complexity in practical ERSE problems. Therefore, aiming at the special type of ERSE problems that hold the two characteristics, we investigate effective MCGDM approaches by hiring interval-valued dual hesitant fuzzy set (IVDHFS) to comprehensively depict decision hesitancy. To exploit decision information embedded in prioritization relations among criteria, we firstly define an fuzzy entropy measure for IVDHFS so that its derivative decision models can avoid potential information distortion in models based on classic IVDHFS distance measures with subjective supplementing mechanism; further, based on defined entropy measure, we develop two fundamental prioritized operators for IVDHFS by extending Yager's prioritized operators. Furthermore, on the strength of above methods, we construct two hesitant fuzzy MCGDM approaches to tackle complex scenarios with or without known weights for decision makers, respectively. Finally, case studies have been conducted to show effectiveness and practicality of our proposed approaches.

Classifying distinct basal cell carcinoma subtype by means of dermatoscopy and reflectance confocal microscopy.

PubMed

Longo, Caterina; Lallas, Aimilios; Kyrgidis, Athanassios; Rabinovitz, Harold; Moscarella, Elvira; Ciardo, Silvana; Zalaudek, Iris; Oliviero, Margaret; Losi, Amanda; Gonzalez, Salvador; Guitera, Pascale; Piana, Simonetta; Argenziano, Giuseppe; Pellacani, Giovanni

2014-10-01

The current guidelines for the management of basal cell carcinoma (BCC) suggest a different therapeutic approach according to histopathologic subtype. Although dermatoscopic and confocal criteria of BCC have been investigated, no specific studies were performed to evaluate the distinct reflectance confocal microscopy (RCM) aspects of BCC subtypes. To define the specific dermatoscopic and confocal criteria for delineating different BCC subtypes. Dermatoscopic and confocal images of histopathologically confirmed BCCs were retrospectively evaluated for the presence of predefined criteria. Frequencies of dermatoscopic and confocal parameters are provided. Univariate and adjusted odds ratios were calculated. Discriminant analyses were performed to define the independent confocal criteria for distinct BCC subtypes. Eighty-eight BCCs were included. Dermatoscopically, superficial BCCs (n=44) were primarily typified by the presence of fine telangiectasia, multiple erosions, leaf-like structures, and revealed cords connected to the epidermis and epidermal streaming upon RCM. Nodular BCCs (n=22) featured the classic dermatoscopic features and well outlined large basaloid islands upon RCM. Infiltrative BCCs (n=22) featured structureless, shiny red areas, fine telangiectasia, and arborizing vessels on dermatoscopy and dark silhouettes upon RCM. The retrospective design. Dermatoscopy and confocal microscopy can reliably classify different BCC subtypes. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Tackling Complex Emergency Response Solutions Evaluation Problems in Sustainable Development by Fuzzy Group Decision Making Approaches with Considering Decision Hesitancy and Prioritization among Assessing Criteria

PubMed Central

Qi, Xiao-Wen; Zhang, Jun-Ling; Zhao, Shu-Ping; Liang, Chang-Yong

2017-01-01

In order to be prepared against potential balance-breaking risks affecting economic development, more and more countries have recognized emergency response solutions evaluation (ERSE) as an indispensable activity in their governance of sustainable development. Traditional multiple criteria group decision making (MCGDM) approaches to ERSE have been facing simultaneous challenging characteristics of decision hesitancy and prioritization relations among assessing criteria, due to the complexity in practical ERSE problems. Therefore, aiming at the special type of ERSE problems that hold the two characteristics, we investigate effective MCGDM approaches by hiring interval-valued dual hesitant fuzzy set (IVDHFS) to comprehensively depict decision hesitancy. To exploit decision information embedded in prioritization relations among criteria, we firstly define an fuzzy entropy measure for IVDHFS so that its derivative decision models can avoid potential information distortion in models based on classic IVDHFS distance measures with subjective supplementing mechanism; further, based on defined entropy measure, we develop two fundamental prioritized operators for IVDHFS by extending Yager’s prioritized operators. Furthermore, on the strength of above methods, we construct two hesitant fuzzy MCGDM approaches to tackle complex scenarios with or without known weights for decision makers, respectively. Finally, case studies have been conducted to show effectiveness and practicality of our proposed approaches. PMID:28974045

Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteria

PubMed Central

Polman, Chris H; Reingold, Stephen C; Banwell, Brenda; Clanet, Michel; Cohen, Jeffrey A; Filippi, Massimo; Fujihara, Kazuo; Havrdova, Eva; Hutchinson, Michael; Kappos, Ludwig; Lublin, Fred D; Montalban, Xavier; O'Connor, Paul; Sandberg-Wollheim, Magnhild; Thompson, Alan J; Waubant, Emmanuelle; Weinshenker, Brian; Wolinsky, Jerry S

2011-01-01

New evidence and consensus has led to further revision of the McDonald Criteria for diagnosis of multiple sclerosis. The use of imaging for demonstration of dissemination of central nervous system lesions in space and time has been simplified, and in some circumstances dissemination in space and time can be established by a single scan. These revisions simplify the Criteria, preserve their diagnostic sensitivity and specificity, address their applicability across populations, and may allow earlier diagnosis and more uniform and widespread use. Ann Neurol 2011 PMID:21387374

Multiple sleep latency test in narcolepsy type 1 and narcolepsy type 2: A 5-year follow-up study.

PubMed

Huang, Yu-Shu; Guilleminault, Christian; Lin, Cheng-Hui; Chen, Chia-Hsiang; Chin, Wei-Chih; Chen, Tzu-Shuang

2018-05-29

Excessively sleepy teenagers and young adults without sleep-disordered breathing are diagnosed with either narcolepsy type 1 or narcolepsy type 2, or hypersomnia, based on the presence/absence of cataplexy and the results of a multiple sleep latency test. However, there is controversy surrounding this nomenclature. We will try to find the differences between different diagnoses of hypersomnia from the results of the long-term follow-up evaluation of a sleep study. We diagnosed teenagers who had developed excessive daytime sleepiness based on the criteria of the International Classification of Sleep Disorders, 3rd edition. Each individual received the same clinical neurophysiologic testing every year for 5 years after the initial diagnosis of narcolepsy type 1 (n = 111) or type 2 (n = 46). The follow-up evaluation demonstrated that narcolepsy type 1 (narcolepsy-cataplexy) is a well-defined clinical entity, with very reproducible clinical neurophysiologic findings over time, whereas patients with narcolepsy type 2 presented clear clinical and test variability. By the fifth year of the follow-up evaluation, 17.6% of subjects did not meet the diagnostic criteria of narcolepsy type 2, and 23.9% didn't show any two sleep-onset rapid eye movement periods in multiple sleep latency during the 5-year follow-up. Therefore narcolepsy type 1 (narcolepsy-cataplexy) is a well-defined syndrome, with the presentation clearly related to the known consequences of destruction of hypocretin/orexin neurons. Narcolepsy type 2 covers patients with clinical and test variability over time, thus bringing into question the usage of the term "narcolepsy" to label these patients. © 2018 European Sleep Research Society.

Self-rated health appraisal as cultural and identity process: African American elders' health and evaluative rationales.

PubMed

McMullen, Carmit K; Luborsky, Mark R

2006-08-01

We explored self-rated health by using a meaning-centered theoretical foundation. Self-appraisals, such as self-rated health, reflect a cultural process of identity formation, whereby identities are multiple, simultaneously individual and collective, and produced by specific historical formations. Anthropological research in Philadelphia determined (a) how African American elders appraise their health, and (b) how health evaluations reflect cultural and historical experiences within a community. We interviewed and observed 35 adults aged 65 to 80, stratified by gender and self-rated health. We validated theme analysis of focused interview questions against the larger data set of field notes and transcripts. Health appraisal reflected a complex process of adaptation and identity. Criteria for health included: independent functioning, physical condition, control and responsibility for health, and overall feeling. Evaluative rationales that shaped health appraisals were comparisons, restricted possibilities for self-evaluation, and ways of handling adversity. Evaluative rationales mitigated undesirable health identities (including low self-reported health) and provided mechanisms for claiming desired health identities despite adversity. Describing the criteria and evaluative rationales underlying self-appraisals of health extends current understandings of self-rated health and illustrates the sociohistorical context of individual assessments of well-being.

Overall gloss evaluation in the presence of multiple cues to surface glossiness.

PubMed

Leloup, Frédéric B; Pointer, Michael R; Dutré, Philip; Hanselaer, Peter

2012-06-01

Human observers use the information offered by various visual cues when evaluating the glossiness of a surface. Several studies have demonstrated the effect of each single cue to glossiness, but little has been reported on how multiple cues are integrated for the perception of surface gloss. This paper reports on a psychophysical study with real stimuli that are different regarding multiple visual gloss criteria. Four samples were presented to 15 observers under different conditions of illumination in a light booth, resulting in a series of 16 stimuli. Through pairwise comparisons, an overall gloss scale was derived, from which it could be concluded that both differences in the distinctness of the reflected image and differences in luminance affect gloss perception. However, an investigation of the observers' strategy to evaluate gloss indicated a dichotomy among observers. One group of observers used the distinctness-of-image as a principal cue to glossiness, while the second group evaluated gloss primarily from differences in luminance of both the specular highlight and the diffuse background. It could therefore be questioned whether surface gloss can be characterized with one single quantity, or that a set of quantities is necessary to describe the gloss differences between objects.

Importance of cerebrospinal fluid analysis in the era of McDonald 2010 criteria: a German-Austrian retrospective multicenter study in patients with a clinically isolated syndrome.

PubMed

Huss, André M; Halbgebauer, Steffen; Öckl, Patrick; Trebst, Corinna; Spreer, Annette; Borisow, Nadja; Harrer, Andrea; Brecht, Isabel; Balint, Bettina; Stich, Oliver; Schlegel, Sabine; Retzlaff, Nele; Winkelmann, Alexander; Roesler, Romy; Lauda, Florian; Yildiz, Özlem; Voß, Elke; Muche, Rainer; Rauer, Sebastian; Bergh, Florian Then; Otto, Markus; Paul, Friedemann; Wildemann, Brigitte; Kraus, Jörg; Ruprecht, Klemens; Stangel, Martin; Buttmann, Mathias; Zettl, Uwe K; Tumani, Hayrettin

2016-12-01

The majority of patients presenting with a first clinical symptom suggestive of multiple sclerosis (MS) do not fulfill the MRI criteria for dissemination in space and time according to the 2010 revision of the McDonald diagnostic criteria for MS and are thus classified as clinically isolated syndrome (CIS). To re-evaluate the utility of cerebrospinal fluid (CSF) analysis in the context of the revised McDonald criteria from 2010, we conducted a retrospective multicenter study aimed at determining the prevalence and predictive value of oligoclonal IgG bands (OCBs) in patients with CIS. Patients were recruited from ten specialized MS centers in Germany and Austria. We collected data from 406 patients; at disease onset, 44/406 (11 %) fulfilled the McDonald 2010 criteria for MS. Intrathecal IgG OCBs were detected in 310/362 (86 %) of CIS patients. Those patients were twice as likely to convert to MS according to McDonald 2010 criteria as OCB-negative individuals (hazard ratio = 2.1, p = 0.0014) and in a shorter time period of 25 months (95 % CI 21-34) compared to 47 months in OCB-negative individuals (95 % CI 36-85). In patients without brain lesions at first attack and presence of intrathecal OCBs (30/44), conversion rate to MS was 60 % (18/30), whereas it was only 21 % (3/14) in those without OCBs. Our data confirm that in patients with CIS the risk of conversion to MS substantially increases if OCBs are present at onset. CSF analysis definitely helps to evaluate the prognosis in patients who do not have MS according to the revised McDonald criteria.

Evaluation of Wheel Loaders in Open Pit Marble Quarrying by Using the AHP and Topsis Approaches / Ocena pracy ładowarki na podwoziu kołowym w odkrywkowej kopalni marmuru w oparciu o metody AHP i topsis

NASA Astrophysics Data System (ADS)

Kun, Mete; Topaloǧlu, Şeyda; Malli, Tahir

2013-03-01

The marble mining in Turkey has been rising since the early 80's. In relation to that, the marble income has become noticeably bigger than those of other mining sectors. In recent years, marble and natural stone export composes half of the total mine export with a value of two billion dollars. This rapid development observed in marble operation has increased the importance of mining economics, income-expenditure balance and cost analysis. The most important cost elements observed in marble quarrying are machinery and equipment, labor costs and geological structures of the field. The aim of this study is to is to propose a multi-criteria decision making (MCDM) approach to evaluate the wheel loader alternatives and select the best loader under multiple criteria. A two-step methodology based on two MCDM methods, which are namely the Analytic Hierarchy Process (AHP) and the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS), are used in the evaluation procedure. More precisely, AHP is applied to determine the relative weights of evaluation criteria and TOPSIS is applied to rank the wheel loader alternatives. The proposed approach also provides a relatively simple and very well suited decision making tool for this type of decision making problems.

Multiple definitions of reading disability: implications for preschool screening.

PubMed

Colligan, R C; Bajuniemi, L E

1984-10-01

A preschool screening battery was evaluated for effectiveness in identifying children who later would be found to have reading disabilities. The battery was used to evaluate 165 preschool children; 95 of these children were available for 3-yr. follow-up assessment. The battery was effective in identifying children at risk for later reading disability by using four different diagnostic criteria. The data suggest that intervention should be directed toward the immature or young boy who shows weaknesses in the preschool acquisition of number concepts and symbol recognition.

Design criteria for a PC-based common user interface to remote information systems

NASA Technical Reports Server (NTRS)

Dominick, Wayne D. (Editor); Hall, Philip P.

1984-01-01

A set of design criteria are presented which will allow the implementation of an interface to multiple remote information systems on a microcomputer. The focus of the design description is on providing the user with the functionality required to retrieve, store and manipulate data residing in remote information systems through the utilization of a standardized interface system. The intent is to spare the user from learning the details of retrieval from specific systems while retaining the full capabilities of each system. The system design includes multi-level capabilities to enhance usability by a wide range of users and utilizes microcomputer graphics capabilities where applicable. A data collection subsystem for evaluation purposes is also described.

A dimensional approach to understanding severity estimates and risk correlates of marijuana abuse and dependence in adults

PubMed Central

WU, LI-TZY; WOODY, GEORGE E.; YANG, CHONGMING; PAN, JENG-JONG; REEVE, BRYCE B.; BLAZER, DAN G.

2012-01-01

While item response theory (IRT) research shows a latent severity trait underlying response patterns of substance abuse and dependence symptoms, little is known about IRT-based severity estimates in relation to clinically relevant measures. In response to increased prevalences of marijuana-related treatment admissions, an elevated level of marijuana potency, and the debate on medical marijuana use, we applied dimensional approaches to understand IRT-based severity estimates for marijuana use disorders (MUDs) and their correlates while simultaneously considering gender- and race/ethnicity-related differential item functioning (DIF). Using adult data from the 2008 National Survey on Drug Use and Health (N=37,897), DSM-IV criteria for MUDs among past-year marijuana users were examined by IRT, logistic regression, and multiple indicators–multiple causes (MIMIC) approaches. Among 6,917 marijuana users, 15% met criteria for a MUD; another 24% exhibited subthreshold dependence. Abuse criteria were highly correlated with dependence criteria (correlation=0.90), indicating unidimensionality; item information curves revealed redundancy in multiple criteria. MIMIC analyses showed that MUD criteria were positively associated with weekly marijuana use, early marijuana use, other substance use disorders, substance abuse treatment, and serious psychological distress. African Americans and Hispanics showed higher levels of MUDs than whites, even after adjusting for race/ethnicity-related DIF. The redundancy in multiple criteria suggests an opportunity to improve efficiency in measuring symptom-level manifestations by removing low-informative criteria. Elevated rates of MUDs among African Americans and Hispanics require research to elucidate risk factors and improve assessments of MUDs for different racial/ethnic groups. PMID:22351489

Adaptation policies to increase terrestrial ecosystem resilience. Potential utility of a multicriteria approach

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

de Bremond, Ariane; Engle, Nathan L.

2014-01-30

Climate change is rapidly undermining terrestrial ecosystem resilience and capacity to continue providing their services to the benefit of humanity and nature. Because of the importance of terrestrial ecosystems to human well-being and supporting services, decision makers throughout the world are busy creating policy responses that secure multiple development and conservation objectives- including that of supporting terrestrial ecosystem resilience in the context of climate change. This article aims to advance analyses on climate policy evaluation and planning in the area of terrestrial ecosystem resilience by discussing adaptation policy options within the ecology-economy-social nexus. The paper evaluates these decisions in themore » realm of terrestrial ecosystem resilience and evaluates the utility of a set of criteria, indicators, and assessment methods, proposed by a new conceptual multi-criteria framework for pro-development climate policy and planning developed by the United Nations Environment Programme. Potential applications of a multicriteria approach to climate policy vis-A -vis terrestrial ecosystems are then explored through two hypothetical case study examples. The paper closes with a brief discussion of the utility of the multi-criteria approach in the context of other climate policy evaluation approaches, considers lessons learned as a result efforts to evaluate climate policy in the realm of terrestrial ecosystems, and reiterates the role of ecosystem resilience in creating sound policies and actions that support the integration of climate change and development goals.« less

Systematic review on the evaluation criteria of orphan medicines in Central and Eastern European countries.

PubMed

Zelei, Tamás; Molnár, Mária J; Szegedi, Márta; Kaló, Zoltán

2016-06-04

In case of orphan drugs applicability of the standard health technology assessment (HTA) process is limited due to scarcity of good clinical and health economic evidence. Financing these premium priced drugs is more controversial in the Central and Eastern European (CEE) region where the public funding resources are more restricted, and health economic justification should be an even more important aspect of policy decisions than in higher income European countries. To explore and summarize the recent scientific evidence on value drivers related to the health technology assessment of ODs with a special focus on the perspective of third party payers in CEE countries. The review aims to list all potentially relevant value drivers in the reimbursement process of orphan drugs. A systematic literature review was performed; PubMed and Scopus databases were systematically searched for relevant publications until April 2015. Extracted data were summarized along key HTA elements. From the 2664 identified publications, 87 contained relevant information on the evaluation criteria of orphan drugs, but only 5 had direct information from the CEE region. The presentation of good clinical evidence seems to play a key role especially since this should be the basis of cost-effectiveness analyses, which have more importance in resource-constrained economies. Due to external price referencing of pharmaceuticals, the relative budget impact of orphan drugs is expected to be higher in CEE than in Western European (WE) countries unless accessibility of patients remains more limited in poorer European regions. Equity principles based on disease prevalence and non-availability of alternative treatment options may increase the price premium, however, societies must have some control on prices and a rationale based on multiple criteria in reimbursement decisions. The evaluation of orphan medicines should include multiple criteria to appropriately measure the clinical added value of orphan drugs. The search found only a small number of studies coming from CEE, therefore European policies on orphan drugs may be based largely on experiences in WE countries. More research should be done in the future in CEE because financing high-priced orphan drugs involves a greater burden for these countries.

Magnetic resonance appearance of monoclonal gammopathies of unknown significance and multiple myeloma. The GRI Study Group.

PubMed

Bellaïche, L; Laredo, J D; Lioté, F; Koeger, A C; Hamze, B; Ziza, J M; Pertuiset, E; Bardin, T; Tubiana, J M

1997-11-01

A prospective multicenter study. To evaluate the use of magnetic resonance imaging, in the differentiation between monoclonal gammopathies of unknown significance and multiple myeloma. Although multiple myeloma has been studied extensively with magnetic resonance imaging, to the authors' knowledge, no study has evaluated the clinical interest of magnetic resonance imaging in the differentiation between monoclonal gammopathies of unknown significance and multiple myeloma. The magnetic resonance examinations of the thoracolumbar spine in 24 patients with newly diagnosed monoclonal gammopathies of unknown significance were compared with those performed in 44 patients with newly diagnosed nontreated multiple myeloma. All findings on magnetic resonance examination performed in patients with monoclonal gammopathies of unknown significance were normal, whereas findings on 38 (86%) of the 44 magnetic resonance examinations performed in patients with multiple myeloma were abnormal. Magnetic resonance imaging can be considered as an additional diagnostic tool in differentiating between monoclonal gammopathies of unknown significance and multiple myeloma, which may be helpful when routine criteria are not sufficient. An abnormal finding on magnetic resonance examination in a patient with monoclonal gammopathies of unknown significance should suggest the diagnosis of multiple myeloma after other causes of marrow signal abnormalities are excluded. Magnetic resonance imaging also may be proposed in the long-term follow-up of monoclonal gammopathies of unknown significance when a new biologic or clinical event suggests the diagnosis of malignant monoclonal gammopathy.

Assessment of health-care waste disposal methods using a VIKOR-based fuzzy multi-criteria decision making method

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

Liu, Hu-Chen; Department of Industrial Engineering and Management, Tokyo Institute of Technology, Tokyo 152-8552; Wu, Jing

Highlights: • Propose a VIKOR-based fuzzy MCDM technique for evaluating HCW disposal methods. • Linguistic variables are used to assess the ratings and weights for the criteria. • The OWA operator is utilized to aggregate individual opinions of decision makers. • A case study is given to illustrate the procedure of the proposed framework. - Abstract: Nowadays selection of the appropriate treatment method in health-care waste (HCW) management has become a challenge task for the municipal authorities especially in developing countries. Assessment of HCW disposal alternatives can be regarded as a complicated multi-criteria decision making (MCDM) problem which requires considerationmore » of multiple alternative solutions and conflicting tangible and intangible criteria. The objective of this paper is to present a new MCDM technique based on fuzzy set theory and VIKOR method for evaluating HCW disposal methods. Linguistic variables are used by decision makers to assess the ratings and weights for the established criteria. The ordered weighted averaging (OWA) operator is utilized to aggregate individual opinions of decision makers into a group assessment. The computational procedure of the proposed framework is illustrated through a case study in Shanghai, one of the largest cities of China. The HCW treatment alternatives considered in this study include “incineration”, “steam sterilization”, “microwave” and “landfill”. The results obtained using the proposed approach are analyzed in a comparative way.« less

Robustness analysis of a green chemistry-based model for the ...

EPA Pesticide Factsheets

This paper proposes a robustness analysis based on Multiple Criteria Decision Aiding (MCDA). The ensuing model was used to assess the implementation of green chemistry principles in the synthesis of silver nanoparticles. Its recommendations were also compared to an earlier developed model for the same purpose to investigate concordance between the models and potential decision support synergies. A three-phase procedure was adopted to achieve the research objectives. Firstly, an ordinal ranking of the evaluation criteria used to characterize the implementation of green chemistry principles was identified through relative ranking analysis. Secondly, a structured selection process for an MCDA classification method was conducted, which ensued in the identification of Stochastic Multi-Criteria Acceptability Analysis (SMAA). Lastly, the agreement of the classifications by the two MCDA models and the resulting synergistic role of decision recommendations were studied. This comparison showed that the results of the two models agree between 76% and 93% of the simulation set-ups and it confirmed that different MCDA models provide a more inclusive and transparent set of recommendations. This integrative research confirmed the beneficial complementary use of MCDA methods to aid responsible development of nanosynthesis, by accounting for multiple objectives and helping communication of complex information in a comprehensive and traceable format, suitable for stakeholders and

Calculating and controlling the error of discrete representations of Pareto surfaces in convex multi-criteria optimization.

PubMed

Craft, David

2010-10-01

A discrete set of points and their convex combinations can serve as a sparse representation of the Pareto surface in multiple objective convex optimization. We develop a method to evaluate the quality of such a representation, and show by example that in multiple objective radiotherapy planning, the number of Pareto optimal solutions needed to represent Pareto surfaces of up to five dimensions grows at most linearly with the number of objectives. The method described is also applicable to the representation of convex sets. Copyright © 2009 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

A palliative care hotline for multiple sclerosis: A pilot feasibility study.

PubMed

Knies, Andrea K; Golla, Heidrun; Strupp, Julia; Galushko, Maren; Schipper, Sabine; Voltz, Raymond

2015-08-01

Research findings suggest that patients severely affected by multiple sclerosis benefit from palliative care. Our objectives were to (1) implement a pilot palliative care counseling hotline for severely affected multiple sclerosis patients and their caregivers in order to connect them to palliative care, and (2) evaluate its preliminary feasibility through a pilot study. The hotline was designed in cooperation with the local state association of the German Multiple Sclerosis Society and based on a review of the literature. The initial study setting for the hotline was the broader region of the cities Cologne and Bonn in Germany. The hotline was introduced through a magazine published by the German Multiple Sclerosis Society and leaflets sent to local healthcare providers. Calls were conducted using a semistructured interview guide and documented by a standardized case report form. Measures to assess feasibility were both quantitative (e.g., number of calls) and qualitative (e.g., criteria for eligibility for palliative care). During its pilot year, the hotline received 18 calls. Some 15 callers were included in the analysis, and 10 of these 15 were deemed eligible for palliative care due to such criteria as medical characteristics, care or nursing conditions, caregiver strain, and concerns regarding death and dying. Access to palliative care services could be provided for all 10 callers. Based on our pilot feasibility study, the hotline seems to be a valuable service for patients severely affected by multiple sclerosis (MS) and their caregivers in order to gain information about and access to palliative care. It will be extended on a nationwide scale through a grant of the German Multiple Sclerosis Society. Awareness of the hotline needs to be enhanced in order to attract and support a significant number of new callers.

Can the Cancer-related Fatigue Case-definition Criteria Be Applied to Chronic Medical Illness? A Comparison between Breast Cancer and Systemic Sclerosis.

PubMed

Kwakkenbos, Linda; Minton, Ollie; Stone, Patrick C; Alexander, Susanna; Baron, Murray; Hudson, Marie; Thombs, Brett D

2015-07-01

Fatigue is a crucial determinant of quality of life across rheumatic diseases, but the lack of agreed-upon standards for identifying clinically significant fatigue hinders research and clinical management. Case definition criteria for cancer-related fatigue were proposed for inclusion in the International Classification of Diseases. The objective was to evaluate whether the cancer-related fatigue case definition performed equivalently in women with breast cancer and systemic sclerosis (SSc) and could be used to identify patients with chronic illness-related fatigue. The cancer-related fatigue interview (case definition criteria met if ≥ 5 of 9 fatigue-related symptoms present with functional impairment) was completed by 291 women with SSc and 278 women successfully treated for breast cancer. Differential item functioning was assessed with the multiple indicator multiple cause model. Items 3 (concentration) and 10 (short-term memory) were endorsed significantly less often by women with SSc compared with cancer, controlling for responses on other items. Omitting these 2 items from the case definition and requiring 4 out of the 7 remaining symptoms resulted in a similar overall prevalence of cancer-related fatigue in the cancer sample compared with the original criteria (37.4% vs 37.8%, respectively), with 97.5% of patients diagnosed identically with both definitions. Prevalence of chronic illness-related fatigue was 36.1% in SSc using 4 of 7 symptoms. The cancer-related fatigue criteria can be used equivalently to identify patients with chronic illness-related fatigue when 2 cognitive fatigue symptoms are omitted. Harmonized definitions and measurement of clinically significant fatigue will advance research and clinical management of fatigue in rheumatic diseases and other conditions.

Multi-criteria decision analysis in conservation planning: Designing conservation area networks in San Diego County

NASA Astrophysics Data System (ADS)

MacDonald, Garrick Richard

To limit biodiversity loss caused by human activity, conservation planning must protect biodiversity while considering socio-economic cost criteria. This research aimed to determine the effects of socio-economic criteria and spatial configurations on the development of CANs for three species with different distribution patterns, while simultaneously attempting to address the uncertainty and sensitivity of CANs produced by ConsNet. The socio-economic factors and spatial criteria included the cost of land, population density, agricultural output value, area, average cluster area, number of clusters, shape, and perimeter. Three sensitive mammal species with different distribution patterns were selected and included the Bobcat, Ringtail, and a custom created mammal distribution. Forty problems and the corresponding number of CANs were formulated and computed by running each predicted presence species model with and without the four different socioeconomic threshold groups at two different resolutions. Thirty-two percent less area was conserved after considering multiple socio-economic constraints and spatial configurations in comparison to CANs that did not consider multiple socio-economic constraints and spatial configurations. Without including socio-economic costs, ConsNet's ALL_CELLS heuristic solution was the highest ranking CAN. After considering multiple socio-economic costs, the number one ranking CAN was no longer the ALL_CELLS heuristic solution, but a spatially different meta-heuristic solution. The effects of multiple constraints and objectives on the design of CANs with different distribution patterns did not vary significantly across the criteria. The CANs produced by ConsNet appeared to demonstrate some uncertainty surrounding particular criteria, but did not demonstrate substantial uncertainty across all criteria used to rank the CANs. Similarly, the range of socio-economic criteria thresholds did not have a substantial impact. ConsNet was very applicable to the research project, however, it did exhibit a few limitations. Both the advantages and disadvantages of ConsNet should be considered before using ConsNet for future conservation planning projects. The research project is an example of a large data scenario undertaken with a multiple criteria decision analysis (MCDA) approach.

Interrater reliability of the new criteria for behavioral variant frontotemporal dementia.

PubMed

Lamarre, Amanda K; Rascovsky, Katya; Bostrom, Alan; Toofanian, Parnian; Wilkins, Sarah; Sha, Sharon J; Perry, David C; Miller, Zachary A; Naasan, Georges; Laforce, Robert; Hagen, Jayne; Takada, Leonel T; Tartaglia, Maria Carmela; Kang, Gail; Galasko, Douglas; Salmon, David P; Farias, Sarah Tomaszewski; Kaur, Berneet; Olichney, John M; Quitania Park, Lovingly; Mendez, Mario F; Tsai, Po-Heng; Teng, Edmond; Dickerson, Bradford Clark; Domoto-Reilly, Kimiko; McGinnis, Scott; Miller, Bruce L; Kramer, Joel H

2013-05-21

To evaluate the interrater reliability of the new International Behavioural Variant FTD Criteria Consortium (FTDC) criteria for behavioral variant frontotemporal dementia (bvFTD). Twenty standardized clinical case modules were developed for patients with a range of neurodegenerative diagnoses, including bvFTD, primary progressive aphasia (nonfluent, semantic, and logopenic variant), Alzheimer disease, and Lewy body dementia. Eighteen blinded raters reviewed the modules and 1) rated the presence or absence of core diagnostic features for the FTDC criteria, and 2) provided an overall diagnostic rating. Interrater reliability was determined by κ statistics for multiple raters with categorical ratings. The mean κ value for diagnostic agreement was 0.81 for possible bvFTD and 0.82 for probable bvFTD ("almost perfect agreement"). Interrater reliability for 4 of the 6 core features had "substantial" agreement (behavioral disinhibition, perseverative/compulsive, sympathy/empathy, hyperorality; κ = 0.61-0.80), whereas 2 had "moderate" agreement (apathy/inertia, neuropsychological; κ = 0.41-0.6). Clinician years of experience did not significantly influence rater accuracy. The FTDC criteria show promise for improving the diagnostic accuracy and reliability of clinicians and researchers. As disease-altering therapies are developed, accurate differential diagnosis between bvFTD and other neurodegenerative diseases will become increasingly important.

Do differences in profiling criteria bias performance measurements? Economic profiling of medical clinics under the Korea National Health Insurance program: an observational study using claims data.

PubMed

Kang, Hee-Chung; Hong, Jae-Seok

2011-08-16

With a greater emphasis on cost containment in many health care systems, it has become common to evaluate each physician's relative resource use. This study explored the major factors that influence the economic performance rankings of medical clinics in the Korea National Health Insurance (NHI) program by assessing the consistency between cost-efficiency indices constructed using different profiling criteria. Data on medical care benefit costs for outpatient care at medical clinics nationwide were collected from the NHI claims database. We calculated eight types of cost-efficiency index with different profiling criteria for each medical clinic and investigated the agreement between the decile rankings of each index pair using the weighted kappa statistic. The exclusion of pharmacy cost lowered agreement between rankings to the lowest level, and differences in case-mix classification also lowered agreement considerably. A medical clinic may be identified as either cost-efficient or cost-inefficient, even when using the same index, depending on the profiling criteria applied. Whether a country has a single insurance or a multiple-insurer system, it is very important to have standardized profiling criteria for the consolidated management of health care costs.

Methodological Challenges in Cross-Language Qualitative Research: A Research Review

PubMed Central

Squires, Allison

2009-01-01

Objectives Cross-language qualitative research occurs when a language barrier is present between researchers and participants. The language barrier is frequently mediated through the use of a translator or interpreter. The purpose of this critical review of cross-language qualitative research was three fold: 1) review the methods literature addressing cross language research; 2) synthesize the methodological recommendations from the literature into a list of criteria that could evaluate how researchers methodologically managed translators and interpreters in their qualitative studies; and 3) test these criteria on published cross-language qualitative studies. Data sources A group of 40 purposively selected cross-language qualitative studies found in nursing and health sciences journals. Review methods The synthesis of the cross-language methods literature produced 14 criteria to evaluate how qualitative researchers managed the language barrier between themselves and their study participants. To test the criteria, the researcher conducted a summative content analysis framed by discourse analysis techniques of the 40 cross-language studies. Results The evaluation showed that only 6 out of 40 studies met all the criteria recommended by the cross-language methods literature for the production of trustworthy results in cross-language qualitative studies. Multiple inconsistencies, reflecting disadvantageous methodological choices by cross-language researchers, appeared in the remaining 33 studies. To name a few, these included rendering the translator or interpreter as an invisible part of the research process, failure to pilot test interview questions in the participant’s language, no description of translator or interpreter credentials, failure to acknowledge translation as a limitation of the study, and inappropriate methodological frameworks for cross-language research. Conclusions The finding about researchers making the role of the translator or interpreter invisible during the research process supports studies completed by other authors examining this issue. The analysis demonstrated that the criteria produced by this study may provide useful guidelines for evaluating cross-language research and for novice cross-language researchers designing their first studies. Finally, the study also indicates that researchers attempting cross-language studies need to address the methodological issues surrounding language barriers between researchers and participants more systematically. PMID:18789799

Methodological challenges in cross-language qualitative research: a research review.

PubMed

Squires, Allison

2009-02-01

Cross-language qualitative research occurs when a language barrier is present between researchers and participants. The language barrier is frequently mediated through the use of a translator or interpreter. The purpose of this analysis of cross-language qualitative research was threefold: (1) review the methods literature addressing cross-language research; (2) synthesize the methodological recommendations from the literature into a list of criteria that could evaluate how researchers methodologically managed translators and interpreters in their qualitative studies; (3) test these criteria on published cross-language qualitative studies. A group of 40 purposively selected cross-language qualitative studies found in nursing and health sciences journals. The synthesis of the cross-language methods literature produced 14 criteria to evaluate how qualitative researchers managed the language barrier between themselves and their study participants. To test the criteria, the researcher conducted a summative content analysis framed by discourse analysis techniques of the 40 cross-language studies. The evaluation showed that only 6 out of 40 studies met all the criteria recommended by the cross-language methods literature for the production of trustworthy results in cross-language qualitative studies. Multiple inconsistencies, reflecting disadvantageous methodological choices by cross-language researchers, appeared in the remaining 33 studies. To name a few, these included rendering the translator or interpreter as an invisible part of the research process, failure to pilot test interview questions in the participant's language, no description of translator or interpreter credentials, failure to acknowledge translation as a limitation of the study, and inappropriate methodological frameworks for cross-language research. The finding about researchers making the role of the translator or interpreter invisible during the research process supports studies completed by other authors examining this issue. The analysis demonstrated that the criteria produced by this study may provide useful guidelines for evaluating cross-language research and for novice cross-language researchers designing their first studies. Finally, the study also indicates that researchers attempting cross-language studies need to address the methodological issues surrounding language barriers between researchers and participants more systematically.

Effect of craniosacral therapy on lower urinary tract signs and symptoms in multiple sclerosis.

PubMed

Raviv, Gil; Shefi, Shai; Nizani, Dalia; Achiron, Anat

2009-05-01

To examine whether craniosacral therapy improves lower urinary tract symptoms of multiple sclerosis (MS) patients. A prospective cohort study. Out-patient clinic of multiple sclerosis center in a referral medical center. Hands on craniosacral therapy (CST). Change in lower urinary tract symptoms, post voiding residual volume and quality of life. Patients from our multiple sclerosis clinic were assessed before and after craniosacral therapy. Evaluation included neurological examination, disability status determination, ultrasonographic post voiding residual volume estimation and questionnaires regarding lower urinary tract symptoms and quality of life. Twenty eight patients met eligibility criteria and were included in this study. Comparison of post voiding residual volume, lower urinary tract symptoms and quality of life before and after craniosacral therapy revealed a significant improvement (0.001>p>0.0001). CST was found to be an effective means for treating lower urinary tract symptoms and improving quality of life in MS patients.

Ranking Schools' Academic Performance Using a Fuzzy VIKOR

NASA Astrophysics Data System (ADS)

Musani, Suhaina; Aziz Jemain, Abdul

2015-06-01

Determination rank is structuring alternatives in order of priority. It is based on the criteria determined for each alternative involved. Evaluation criteria are performed and then a composite index composed of each alternative for the purpose of arranging in order of preference alternatives. This practice is known as multiple criteria decision making (MCDM). There are several common approaches to MCDM, one of the practice is known as VIKOR (Multi-criteria Optimization and Compromise Solution). The objective of this study is to develop a rational method for school ranking based on linguistic information of a criterion. The school represents an alternative, while the results for a number of subjects as the criterion. The results of the examination for a course, is given according to the student percentage of each grade. Five grades of excellence, honours, average, pass and fail is used to indicate a level of achievement in linguistics. Linguistic variables are transformed to fuzzy numbers to form a composite index of school performance. Results showed that fuzzy set theory can solve the limitations of using MCDM when there is uncertainty problems exist in the data.

Assessment of health-care waste disposal methods using a VIKOR-based fuzzy multi-criteria decision making method.

PubMed

Liu, Hu-Chen; Wu, Jing; Li, Ping

2013-12-01

Nowadays selection of the appropriate treatment method in health-care waste (HCW) management has become a challenge task for the municipal authorities especially in developing countries. Assessment of HCW disposal alternatives can be regarded as a complicated multi-criteria decision making (MCDM) problem which requires consideration of multiple alternative solutions and conflicting tangible and intangible criteria. The objective of this paper is to present a new MCDM technique based on fuzzy set theory and VIKOR method for evaluating HCW disposal methods. Linguistic variables are used by decision makers to assess the ratings and weights for the established criteria. The ordered weighted averaging (OWA) operator is utilized to aggregate individual opinions of decision makers into a group assessment. The computational procedure of the proposed framework is illustrated through a case study in Shanghai, one of the largest cities of China. The HCW treatment alternatives considered in this study include "incineration", "steam sterilization", "microwave" and "landfill". The results obtained using the proposed approach are analyzed in a comparative way. Copyright © 2013. Published by Elsevier Ltd.

Sensitivity of single-domain versus multiple-domain outcome measures to identify responders in chronic low-back pain: pooled analysis of 2 placebo-controlled trials of etoricoxib.

PubMed

Jensen, Mark P; Schnitzer, Thomas J; Wang, Hongwei; Smugar, Steven S; Peloso, Paul M; Gammaitoni, Arnold

2012-01-01

A composite responder index for chronic low-back pain (CLBP) has recently been proposed to evaluate the efficacy of CLBP treatments in clinical trials. We compared the responsiveness of this composite measure with a number of single-item responder definitions. We pooled data from 2 placebo-controlled studies of etoricoxib in CLBP to evaluate 5 response criteria: 30% pain intensity (PI) reduction; 50% PI reduction; 20 mm absolute reduction (100 mm PI visual analog scale); patient global assessment of response to therapy (PGART); and the composite criteria of 30% reduction in PI+30% improvement in PGART of disease status+no worsening in function. We used bootstrap analysis and logistic regression to assess the ability to differentiate etoricoxib and placebo, and the κ coefficient to assess agreement among the responder criteria. The criterion of a 20 mm improvement in PI resulted in the greatest proportion (71.5%) of patients being classified as responders and all criteria separated etoricoxib from placebo (P≤0.0001). PGART had the highest discriminant ability (odds ratio 5.90), and was significantly (P<0.05) more discriminant than the 20 mm and ≥30% improvements and the composite criteria. After adjusting for all other measures, only PGART continued to show a significant treatment effect for etoricoxib versus placebo (P=0.0003). Kappa values contrasting the composite criteria and the single-item measures ranged from 0.59 to 0.85. These findings do not support the superiority of a composite index over single-item ratings of PI and PGART ratings, but do suggest that PGART ratings may be more responsive to treatment, perhaps because they measure something in addition to change in PI.

Myth 6: Cosmetic Use of Multiple Selection Criteria

ERIC Educational Resources Information Center

Friedman-Nimz, Reva

2009-01-01

Twenty-five years ago, armed with the courage of her convictions and a respectable collection of empirical evidence, the author articulated what she considered to be a compelling argument against the cosmetic use of multiple selection criteria as a guiding principle for identifying children and youth with high potential. To assess the current…

Successive equimarginal approach for optimal design of a pump and treat system

NASA Astrophysics Data System (ADS)

Guo, Xiaoniu; Zhang, Chuan-Mian; Borthwick, John C.

2007-08-01

An economic concept-based optimization method is developed for groundwater remediation design. Design of a pump and treat (P&T) system is viewed as a resource allocation problem constrained by specified cleanup criteria. An optimal allocation of resources requires that the equimarginal principle, a fundamental economic principle, must hold. The proposed method is named successive equimarginal approach (SEA), which continuously shifts a pumping rate from a less effective well to a more effective one until equal marginal productivity for all units is reached. Through the successive process, the solution evenly approaches the multiple inequality constraints that represent the specified cleanup criteria in space and in time. The goal is to design an equal protection system so that the distributed contaminant plumes can be equally contained without bypass and overprotection is minimized. SEA is a hybrid of the gradient-based method and the deterministic heuristics-based method, which allows flexibility in dealing with multiple inequality constraints without using a penalty function and in balancing computational efficiency with robustness. This method was applied to design a large-scale P&T system for containment of multiple plumes at the former Blaine Naval Ammunition Depot (NAD) site, near Hastings, Nebraska. To evaluate this method, the SEA results were also compared with those using genetic algorithms.

Selection of the open pit mining cut-off grade strategy under price uncertainty using a risk based multi-criteria ranking system / Wybór strategii określania warunku opłacalności wydobycia w kopalniach odkrywkowych w warunkach niepewności cen w oparciu o wielokryterialny system rankingowy z uwzględnieniem czynników ryzyka

NASA Astrophysics Data System (ADS)

Azimi, Yousue; Osanloo, Montza; Esfahanipour, Akbar

2012-12-01

Cut-off Grade Strategy (COGS) is a concept that directly influences the financial, technical, economic, environmental, and legal issues in relation to exploitation of a mineral resource. A decision making system is proposed to select the best technically feasible COGS under price uncertainty. In the proposed system both the conventional discounted cash flow and modern simulation based real option valuations are used to evaluate the alternative strategies. Then the conventional expected value criterion and a multiple criteria ranking system were used to rank the strategies based on the two valuation methods. In the multiple criteria ranking system besides the expected value other stochastic orders expressing abilities of strategies in producing extra profits, minimizing losses and achieving the predefined goals of the exploitation strategy are considered. Finally, the best strategy is selected based on the overall average rank of strategies through all ranking systems. The proposed system was examined using the data of Sungun Copper Mine. To assess the merits of the alternatives better, ranking process was done at both high (prevailing economic condition) and low price conditions. Ranking results revealed that at different price conditions and valuation methods, different results would be obtained. It is concluded that these differences are due to the different behavior of the embedded option to close the mine early, which is more likely to be exercised under low price condition rather than high price condition. The proposed system would enhance the quality of decision making process by providing a more informative and certain platform for project evaluation.

Evaluation of Direct Infusion-Multiple Reaction Monitoring Mass Spectrometry for Quantification of Heat Shock Proteins

PubMed Central

Xiang, Yun; Koomen, John M.

2012-01-01

Protein quantification with liquid chromatography-multiple reaction monitoring mass spectrometry (LC-MRM) has emerged as a powerful platform for assessing panels of biomarkers. In this study, direct infusion, using automated, chip-based nanoelectrospray ionization, coupled with MRM (DI-MRM) is used for protein quantification. Removal of the LC separation step increases the importance of evaluating the ratios between the transitions. Therefore, the effects of solvent composition, analyte concentration, spray voltage, and quadrupole resolution settings on fragmentation patterns have been studied using peptide and protein standards. After DI-MRM quantification was evaluated for standards, quantitative assays for the expression of heat shock proteins (HSPs) were translated from LC-MRM to DI-MRM for implementation in cell line models of multiple myeloma. Requirements for DI-MRM assay development are described. Then, the two methods are compared; criteria for effective DI-MRM analysis are reported based on the analysis of HSP expression in digests of whole cell lysates. The increased throughput of DI-MRM analysis is useful for rapid analysis of large batches of similar samples, such as time course measurements of cellular responses to therapy. PMID:22293045

Drilling deeper into the core: an analysis of journal evaluation methodologies used to create the "Basic List of Veterinary Medical Serials," third edition.

PubMed

Ugaz, Ana G

2011-04-01

The paper analyzes the journal evaluation criteria used to create the third edition of a core list of veterinary serials to determine the impact of each criterion on the final composition of the list in order to assess the value of using multiple criteria in creating a core list. Three additional lists were generated from criteria that were previously combined to prepare the third edition of the "Basic List of Veterinary Medical Serials": a list based on journal recommendations from veterinary specialty organizations, another list based on journals selected by veterinary librarians, and a list based on both indexing coverage and scholarly rank. The top fifteen journals in each of the three lists were then compared to reveal potential biases. Subject representation on the full lists generated by each of these methods was also compared. The list based on journal recommendations from veterinary specialty organizations exhibited a focus on clinically relevant titles. The list based on veterinary librarian recommendations resulted in the broadest subject coverage. The list based on indexing and scholarly rank, while emphasizing research titles, produced the largest number of unique titles. A combination approach that includes objective evaluation measures and practical input, whether from librarians or discipline experts, can improve coverage and can result in a list that balances research-based with clinical practice journals.

Selecting at-risk populations for sexually transmitted disease/HIV intervention studies.

PubMed

Wu, Zunyou; Rotheram-Borus, Mary Jane; Detels, Roger; Li, Li; Guan, Jihui; Liang, Guojun; Yap, Lorraine

2007-12-01

This paper describes one option to select populations for randomized, controlled trials (RCT). We used a popular opinion leader intervention in Fuzhou, China, to: (1) identify population selection criteria; (2) systematically examine the suitability of potential target populations and settings; (3) briefly evaluate risk and stability in the population; and (4) evaluate regional and organizational support among administrators and government officials. After comparing migrant villagers, truck drivers, factory workers, construction workers, and market employees in five regions of China, market employees in Fuzhou were identified as the optimal target population. Markets were the optimal sites for several reasons: (1) the population demonstrated a sufficient base rate of sexually transmitted diseases; (2) the population was stable over time; (3) a sufficient number of sites of manageable sizes were available; (4) stable networks existed; (5) local gatekeepers/stakeholders supported the intervention; (6) there was organizational capacity in the local health department to mount the intervention; (7) the demographic profile was similar across potential sites; and (8) the sites were sufficiently distanced to minimize contamination. Evaluating intervention efficacy in an RCT requires a time-consuming and rigorous process that systematically and routinely documents selection criteria, evaluates multiple populations, sites, and organizations for their appropriateness.

Photoneutron cross sections for 59Co : Systematic uncertainties of data from various experiments

NASA Astrophysics Data System (ADS)

Varlamov, V. V.; Davydov, A. I.; Ishkhanov, B. S.

2017-09-01

Data on partial photoneutron reaction cross sections (γ ,1n), (γ ,2n), and (γ ,3n) for 59Co obtained in two experiments carried out at Livermore (USA) were analyzed. The sources of radiation in both experiments were the monoenergetic photon beams from the annihilation in flight of relativistic positrons. The total yield was sorted by the neutron multiplicity, taking into account the difference in the neutron energy spectra for different multiplicity. The two quoted studies differ in the method of determining the neutron. Significant systematic disagreements between the results of the two experiments exist. They are considered to be caused by large systematic uncertainties in partial cross sections, since they do not satisfy physical criteria for reliability of the data. To obtain reliable cross sections of partial and total photoneutron reactions a new method combining experimental data and theoretical evaluation was used. It is based on the experimental neutron yield cross section which is rather independent of neutron multiplicity and the transitional neutron multiplicity functions of the combined photonucleon reaction model (CPNRM). The model transitional multiplicity functions were used for the decomposition of the neutron yield cross section into the contributions of partial reactions. The results of the new evaluation noticeably differ from the partial cross sections obtained in the two experimental studies are under discussion.

Virtual reality in multiple sclerosis - A systematic review.

PubMed

Massetti, Thais; Trevizan, Isabela Lopes; Arab, Claudia; Favero, Francis Meire; Ribeiro-Papa, Denise Cardoso; de Mello Monteiro, Carlos Bandeira

2016-07-01

Multiple sclerosis (MS) is an inflammatory disease in which the insulating cover of nerve cells in the brain and spinal cord are damaged. The methods used for motor rehabilitation of patients with neurological problems require the performance of several rehabilitation exercises. Recently, studies related to the use of video game consoles have proliferated in the field of motor rehabilitation. Virtual reality (VR) has been proposed as a potentially useful tool for motoring assessment and rehabilitation. The purpose of this study was to investigate the results shown in previous studies on "Multiple Sclerosis" and "Virtual Reality". A bibliographic review was performed without time limitations. The research was carried out using PubMed and BVS databases. Considering keywords, we included articles that showed the terms "Multiple Sclerosis" and "Virtual Reality". The review was according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines The initial search yielded 41 articles. After the duplicates were removed, two authors independently evaluated the title and abstract of each of the articles with the study inclusion criteria. From these, 31 articles were excluded based on the title and abstract. Finally, 10 articles were isolated that met the inclusion criteria. VR represents a motivational and effective alternative to traditional motor rehabilitation for MS patients. The results showed that VR programs could be an effective method of patients with MS rehabilitation in multiple cognitive and / or motor deficits. Additional research is needed to support the rehabilitation protocols with VR and increase the effects of treatment. Copyright © 2016 Elsevier B.V. All rights reserved.

Forecasting the discomfort levels within the greater Athens area, Greece using artificial neural networks and multiple criteria analysis

NASA Astrophysics Data System (ADS)

Vouterakos, P. A.; Moustris, K. P.; Bartzokas, A.; Ziomas, I. C.; Nastos, P. T.; Paliatsos, A. G.

2012-12-01

In this work, artificial neural networks (ANNs) were developed and applied in order to forecast the discomfort levels due to the combination of high temperature and air humidity, during the hot season of the year, in eight different regions within the Greater Athens area (GAA), Greece. For the selection of the best type and architecture of ANNs-forecasting models, the multiple criteria analysis (MCA) technique was applied. Three different types of ANNs were developed and tested with the MCA method. Concretely, the multilayer perceptron, the generalized feed forward networks (GFFN), and the time-lag recurrent networks were developed and tested. Results showed that the best ANNs type performance was achieved by using the GFFN model for the prediction of discomfort levels due to high temperature and air humidity within GAA. For the evaluation of the constructed ANNs, appropriate statistical indices were used. The analysis proved that the forecasting ability of the developed ANNs models is very satisfactory at a significant statistical level of p < 0.01.

The importance of multiple performance criteria for understanding trust in risk managers.

PubMed

Johnson, Branden B; White, Mathew P

2010-07-01

Effective risk management requires balancing several, sometimes competing, goals, such as protecting public health and ensuring cost control. Research examining public trust of risk managers has largely focused on trust that is unspecified or for a single goal. Yet it can be reasonable to have a high level of trust in one aspect of a target's performance but not another. Two studies involving redevelopment of contaminated land (Study 1) and drinking water standards (Study 2) present preliminary evidence on the value of distinguishing between performance criteria for understanding of trust. Study 1 assessed perceptions of several trust targets (councilors, developers, scientists, residents) on their competence (capacity to achieve goals) and willingness to take action under uncertainty for four criteria. Study 2 assessed competence, willingness, and trust for five criteria regarding a single government agency. In both studies overall trust in each target was significantly better explained by considering perceptions of their performance on multiple criteria than on the single criterion of public health. In Study 1, the influence of criteria also varied plausibly across trust targets (e.g., willingness to act under uncertainty increased trust in developers on cost control and councilors on local economic improvement, but decreased it for both targets on environmental protection). Study 2 showed that explained variance in trust increased with both dimension- and trust-based measures of criteria. Further conceptual and methodological development of the notion of multiple trust criteria could benefit our understanding of stated trust judgments.

A Tool for the Automated Design and Evaluation of Habitat Interior Layouts

NASA Technical Reports Server (NTRS)

Simon, Matthew A.; Wilhite, Alan W.

2013-01-01

The objective of space habitat design is to minimize mass and system size while providing adequate space for all necessary equipment and a functional layout that supports crew health and productivity. Unfortunately, development and evaluation of interior layouts is often ignored during conceptual design because of the subjectivity and long times required using current evaluation methods (e.g., human-in-the-loop mockup tests and in-depth CAD evaluations). Early, more objective assessment could prevent expensive design changes that may increase vehicle mass and compromise functionality. This paper describes a new interior design evaluation method to enable early, structured consideration of habitat interior layouts. This interior layout evaluation method features a comprehensive list of quantifiable habitat layout evaluation criteria, automatic methods to measure these criteria from a geometry model, and application of systems engineering tools and numerical methods to construct a multi-objective value function measuring the overall habitat layout performance. In addition to a detailed description of this method, a C++/OpenGL software tool which has been developed to implement this method is also discussed. This tool leverages geometry modeling coupled with collision detection techniques to identify favorable layouts subject to multiple constraints and objectives (e.g., minimize mass, maximize contiguous habitable volume, maximize task performance, and minimize crew safety risks). Finally, a few habitat layout evaluation examples are described to demonstrate the effectiveness of this method and tool to influence habitat design.

Purchasing a Used Car Using Multiple Criteria Decision Making

ERIC Educational Resources Information Center

Edwards, Thomas G.; Chelst, Kenneth R.

2007-01-01

When studying mathematics, students often ask the age-old question, "When will I ever use this in my future?" The activities described in this article demonstrate for students a process that brings the power of mathematical reasoning to bear on a difficult decision involving multiple criteria that is sure to resonate with the interests of many of…

Exploring multicriteria decision strategies in GIS with linguistic quantifiers: A case study of residential quality evaluation

NASA Astrophysics Data System (ADS)

Malczewski, Jacek; Rinner, Claus

2005-06-01

Commonly used GIS combination operators such as Boolean conjunction/disjunction and weighted linear combination can be generalized to the ordered weighted averaging (OWA) family of operators. This multicriteria evaluation method allows decision-makers to define a decision strategy on a continuum between pessimistic and optimistic strategies. Recently, OWA has been introduced to GIS-based decision support systems. We propose to extend a previous implementation of OWA with linguistic quantifiers to simplify the definition of decision strategies and to facilitate an exploratory analysis of multiple criteria. The linguistic quantifier-guided OWA procedure is illustrated using a dataset for evaluating residential quality of neighborhoods in London, Ontario.

Use of Information Technology Tools in Source Selection Decision Making: A Study on USAF’s KC-X Tanker Replacement Program

DTIC Science & Technology

2008-06-01

The most common outranking methods are the preference ranking organization method for enrichment evaluation ( PROMETHEE ) and the elimination and...Brans and Ph. Vincke, “A Preference Ranking Organization Method: (The PROMETHEE Method for Multiple Criteria Decision-Making),” Management Science 31... PROMETHEE ). This method needs a preference function for each criterion to compute the degree of preference.72 “The credibility of the outranking

Development of a clinical score system for the diagnosis of photoallergic contact dermatitis using a consensus process: item selection and reliability.

PubMed

Cazzaniga, S; Lecchi, S; Bruze, M; Chosidow, O; Diepgen, T; Gonçalo, M; Hercogova, J; Pigatto, P D; Naldi, L

2015-07-01

Photoallergic contact dermatitis (PACD) is an uncommon condition, and there is a lack of validated criteria for its diagnosis. To identify a set of relevant criteria to be considered when suspecting a diagnosis of PACD and to assess the reproducibility of these criteria. This was a diagnostic item selection and reliability study performed between July 2012 and October 2012. A panel of seven recognized experts was invited to consecutive rounds of a Delphi survey and to a conclusive face-to-face meeting with the aim of obtaining an agreement on criteria for the diagnosis of PACD. The panel was also provided with a series of 16 reports of suspected PACDs to be classified according to a five-point likelihood scale. Identified criteria with the weights attributed by experts were used to develop a score system for the diagnosis of PACD. Consensus was measured by calculating the Intraclass Correlation Coefficient (ICC). The performance of the score system was evaluated in terms of overall classification accuracy. Seven criteria were identified by experts as relevant for the diagnosis of PACD. The criteria were related to the type of skin lesions, accompanying symptoms, skin area involved, general medical history, modality of exposure to the culprit substance, history of exposure to the sun or other light sources and photopatch test results. Experts reached a moderate agreement on PACD cases classification, with ICC = 0.69 (95% Confidence Interval, CI, 0.50-0.86). The score system enabled discrimination of probable and definite PACD cases from possible and unlikely or excluded ones, with a nearly perfect agreement being observed between the score system classification and judgment by experts. A diagnostic score was proposed. The score should receive a comprehensive validation on a larger series of cases and with multiple evaluators. © 2014 European Academy of Dermatology and Venereology.

What is in a name? Comparing diagnostic criteria for chronic fatigue syndrome with or without fibromyalgia.

PubMed

Meeus, Mira; Ickmans, Kelly; Struyf, Filip; Kos, Daphne; Lambrecht, Luc; Willekens, Barbara; Cras, Patrick; Nijs, Jo

2016-01-01

The current study had two objectives. (1) to compare objective and self-report measures in patients with chronic fatigue syndrome (CFS) according to the 1994 Center for Disease Control (CDC) criteria, patients with multiple sclerosis (MS), and healthy controls, and (2) to contrast CFS patients who only fulfill CDC criteria to those who also fulfill the criteria for myalgic encephalomyelitis (ME), the 2003 Canadian criteria for ME/CFS, or the comorbid diagnosis of fibromyalgia (FM). One hundred six participants (48 CFS patients diagnosed following the 1994 CDC criteria, 19 MS patients, and 39 healthy controls) completed questionnaires assessing symptom severity, quality of life, daily functioning, and psychological factors. Objective measures consisted of activity monitoring, evaluation of maximal voluntary contraction and muscle recovery, and cognitive performance. CFS patients were screened whether they also fulfilled ME criteria, the Canadian criteria, and the diagnosis of FM. CFS patients scored higher on symptom severity, lower on quality of life, and higher on depression and kinesiophobia and worse on MVC, muscle recovery, and cognitive performance compared to the MS patients and the healthy subjects. Daily activity levels were also lower compared to healthy subjects. Only one difference was found between those fulfilling the ME criteria and those who did not regarding the degree of kinesiophobia (lower in ME), while comorbidity for FM significantly increased the symptom burden. CFS patients report more severe symptoms and are more disabled compared to MS patients and healthy controls. Based on the present study, fulfillment of the ME or Canadian criteria did not seem to give a clinically different picture, whereas a diagnosis of comorbid FM selected symptomatically worse and more disabled patients.

How to Assess the Value of Medicines?

PubMed Central

Simoens, Steven

2010-01-01

This study aims to discuss approaches to assessing the value of medicines. Economic evaluation assesses value by means of the incremental cost-effectiveness ratio (ICER). Health is maximized by selecting medicines with increasing ICERs until the budget is exhausted. The budget size determines the value of the threshold ICER and vice versa. Alternatively, the threshold value can be inferred from pricing/reimbursement decisions, although such values vary between countries. Threshold values derived from the value-of-life literature depend on the technique used. The World Health Organization has proposed a threshold value tied to the national GDP. As decision makers may wish to consider multiple criteria, variable threshold values and weighted ICERs have been suggested. Other approaches (i.e., replacement approach, program budgeting and marginal analysis) have focused on improving resource allocation, rather than maximizing health subject to a budget constraint. Alternatively, the generalized optimization framework and multi-criteria decision analysis make it possible to consider other criteria in addition to value. PMID:21607066

How to assess the value of medicines?

PubMed

Simoens, Steven

2010-01-01

This study aims to discuss approaches to assessing the value of medicines. Economic evaluation assesses value by means of the incremental cost-effectiveness ratio (ICER). Health is maximized by selecting medicines with increasing ICERs until the budget is exhausted. The budget size determines the value of the threshold ICER and vice versa. Alternatively, the threshold value can be inferred from pricing/reimbursement decisions, although such values vary between countries. Threshold values derived from the value-of-life literature depend on the technique used. The World Health Organization has proposed a threshold value tied to the national GDP. As decision makers may wish to consider multiple criteria, variable threshold values and weighted ICERs have been suggested. Other approaches (i.e., replacement approach, program budgeting and marginal analysis) have focused on improving resource allocation, rather than maximizing health subject to a budget constraint. Alternatively, the generalized optimization framework and multi-criteria decision analysis make it possible to consider other criteria in addition to value.

Alpha-synuclein levels in patients with multiple system atrophy: a meta-analysis.

PubMed

Yang, Fei; Li, Wan-Jun; Huang, Xu-Sheng

2018-05-01

This study evaluates the relationship between multiple system atrophy and α-synuclein levels in the cerebrospinal fluid, plasma and neural tissue. Literature search for relevant research articles was undertaken in electronic databases and study selection was based on a priori eligibility criteria. Random-effects meta-analyses of standardized mean differences in α-synuclein levels between multiple system atrophy patients and normal controls were conducted to obtain the overall and subgroup effect sizes. Meta-regression analyses were performed to evaluate the effect of age, gender and disease severity on standardized mean differences. Data were obtained from 11 studies involving 378 multiple system atrophy patients and 637 healthy controls (age: multiple system atrophy patients 64.14 [95% confidence interval 62.05, 66.23] years; controls 64.16 [60.06, 68.25] years; disease duration: 44.41 [26.44, 62.38] months). Cerebrospinal fluid α-synuclein levels were significantly lower in multiple system atrophy patients than in controls but in plasma and neural tissue, α-synuclein levels were significantly higher in multiple system atrophy patients (standardized mean difference: -0.99 [-1.65, -0.32]; p = 0.001). Percentage of male multiple system atrophy patients was significantly positively associated with the standardized mean differences of cerebrospinal fluid α-synuclein levels (p = 0.029) whereas the percentage of healthy males was not associated with the standardized mean differences of cerebrospinal fluid α-synuclein levels (p = 0.920). In multiple system atrophy patients, α-synuclein levels were significantly lower in the cerebrospinal fluid and were positively associated with the male gender.

An integrated decision making approach for assessing healthcare waste treatment technologies from a multiple stakeholder.

PubMed

Shi, Hua; Liu, Hu-Chen; Li, Ping; Xu, Xue-Guo

2017-01-01

With increased worldwide awareness of environmental issues, healthcare waste (HCW) management has received much attention from both researchers and practitioners over the past decade. The task of selecting the optimum treatment technology for HCWs is a challenging decision making problem involving conflicting evaluation criteria and multiple stakeholders. In this paper, we develop an integrated decision making framework based on cloud model and MABAC method for evaluating and selecting the best HCW treatment technology from a multiple stakeholder perspective. The introduced framework deals with uncertain linguistic assessments of alternatives by using interval 2-tuple linguistic variables, determines decision makers' relative weights based on the uncertainty and divergence degrees of every decision maker, and obtains the ranking of all HCW disposal alternatives with the aid of an extended MABAC method. Finally, an empirical example from Shanghai, China, is provided to illustrate the feasibility and effectiveness of the proposed approach. Results indicate that the methodology being proposed is more suitable and effective to handle the HCW treatment technology selection problem under vague and uncertain information environment. Copyright © 2016 Elsevier Ltd. All rights reserved.

INFLUENCE OF ALTERNATE INDICATORS OF EXPOSURE TO PM (OR PM COMPONENTS) IN STATISTICAL CORRELATIONS OF EXPOSURE WITH MORTALITY AND MORBIDITY (PHILADELPHIA DATA BASE)

EPA Science Inventory

At the time the 1996 Air Quality Criteria for Particulate Matter Criteria Document was prepared there were several epidemiologic studies using multiple years of TSP and PM10 data for the exposure estimate but only one epidemiologic study using multiple years of PM2.5 data. That ...

[Consensus document on spasticity in patients with multiple sclerosis. Grupo de Enfermedades Desmielinizantes de la Sociedad Española de Neurología].

PubMed

Oreja-Guevara, Celia; Montalban, Xavier; de Andrés, Clara; Casanova-Estruch, Bonaventura; Muñoz-García, Delicias; García, Inmaculada; Fernández, Óscar

2013-10-16

Multiple sclerosis is a chronic neurological inflammatory demyelinating disease. Specialists involved in the symptomatic treatment of this disease tend to apply heterogeneous diagnostic and treatment criteria. To establish homogeneous criteria for treating spasticity based on available scientific knowledge, facilitating decision-making in regular clinical practice. A group of multiple sclerosis specialists from the Spanish Neurological Society demyelinating diseases working group met to review aspects related to spasticity in this disease and draw up the consensus. After an exhaustive bibliographic search and following a metaplan technique, a number of preliminary recommendations were established to incorporate into the document. Finally, each argument was classified depending on the degree of recommendation according to the SIGN (Scottish Intercollegiate Guidelines Network) system. The resulting text was submitted for review by the demyelinating disease group. An experts' consensus was reached regarding spasticity triggering factors, related symptoms, diagnostic criteria, assessment methods, quality of life and therapeutic management (drug and non-drug) criteria. The recommendations included in this consensus can be a useful tool for improving the quality of life of multiple sclerosis patients, as they enable improved diagnosis and treatment of spasticity.

Psychiatric disorders in single and multiple sexual murderers.

PubMed

Hill, Andreas; Habermann, Niels; Berner, Wolfgang; Briken, Peer

2007-01-01

Sexual homicides - and particularly offenders with multiple victims - receive much attention in the general public as well as among forensic experts. The aim of this study was to assess psychiatric disorders in a large sample of sexual murderers and to identify disorders related to multiple sexual homicides. Psychiatric court reports from 20 German forensic psychiatrists on 166 men who had committed a sexual homicide were evaluated for psychiatric disorders according to DSM-IV, including standardized instruments for personality disorders (criteria from the Structured Clinical Interview) and psychopathy (Psychopathy Checklist-Revised). Offenders with a single sexual homicide victim (n = 130) were compared to those with multiple victims (n = 36). High lifetime prevalence rates were found for substance abuse or dependence, paraphilias (especially sexual sadism), sexual dysfunctions and personality disorders (especially antisocial, borderline, sadistic and schizoid). In the multiple sexual murderer group sexual sadism, voyeurism, sadistic, antisocial and schizoid personality disorders were more frequent than in the single-victim group; none of the multiple offenders was diagnosed with a mood disorder. Multiple sexual murderers are characterized by disorders in three major psychopathological domains: sexual as well as 'character' sadism, antisociality and schizoid personality. A thorough diagnostic evaluation of Axis I as well as Axis II disorders should be part of risk assessments in sexual homicide perpetrators. Although the study was a retrospective investigation on psychiatric court reports, the size of the sample and consistency with results from previous studies give confidence that the identified group differences are unlikely to be due to methodological limitations.

Evaluating the performance of free-formed surface parts using an analytic network process

NASA Astrophysics Data System (ADS)

Qian, Xueming; Ma, Yanqiao; Liang, Dezhi

2018-03-01

To successfully design parts with a free-formed surface, the critical issue of how to evaluate and select a favourable evaluation strategy before design is raised. The evaluation of free-formed surface parts is a multiple criteria decision-making (MCDM) problem that requires the consideration of a large number of interdependent factors. The analytic network process (ANP) is a relatively new MCDM method that can systematically deal with all kinds of dependences. In this paper, the factors, which come from the life-cycle and influence the design of free-formed surface parts, are proposed. After analysing the interdependence among these factors, a Hybrid ANP (HANP) structure for evaluating the part’s curved surface is constructed. Then, a HANP evaluation of an impeller is presented to illustrate the application of the proposed method.

The Compelling and Persistent Problem of Bipolar Disorder Disguised as Major Depression Disorder: An Integrative Review [Formula: see text].

PubMed

Stiles, Brandie M; Fish, Anne F; Vandermause, Roxanne; Malik, Azfar M

2018-06-01

Up to 40% of patients with bipolar disorder are misdiagnosed, usually with major depression disorder. The purpose was to describe the current state of the science of the misdiagnosis of bipolar disorder, with the ultimate goal of improving psychiatric diagnostic workups including screening. An integrative review was conducted using standard criteria for evaluating research articles. Forty-nine articles met the eligibility criteria. Articles explored patient-related and health care provider-related factors contributing to the misdiagnosis of bipolar disorder as well as consequences of misdiagnosis. Clinically oriented, reliable, and valid screening tools for bipolar disorder also were reviewed. Awareness of multiple, challenging patient-related factors and more comprehensive assessment and screening by health care providers may reduce misdiagnosis.

Evaluation of the ADHD rating scale in youth with autism

PubMed Central

Yerys, Benjamin E.; Nissley-Tsiopinis, Jenelle; de Marchena, Ashley; Watkins, Marley W.; Antezana, Ligia; Power, Thomas J.; Schultz, Robert T.

2016-01-01

Scientists and clinicians regularly use clinical screening tools for attention deficit/hyperactivity disorder (ADHD) to assess comorbidity without empirical evidence that these measures are valid in youth with autism spectrum disorder (ASD). We examined the prevalence of youth meeting ADHD criteria on the ADHD rating scale fourth edition (ADHD-RS-IV), the relationship of ADHD-RS-IV ratings with participant characteristics and behaviors, and its underlying factor structure in 386 7-17 year olds with ASD without intellectual disability. Expected parent prevalence rates, relationships with age and externalizing behaviors were observed, but confirmatory factor analyses revealed unsatisfactory fits for one-, two-, three-factor models. Exploratory analyses revealed several items cross-loading on multiple factors. Implications of screening ADHD in youth with ASD using current diagnostic criteria are discussed. PMID:27738853

Capacity development for knowledge translation: evaluation of an experiential approach through secondment opportunities.

PubMed

Gerrish, Kate; Piercy, Hilary

2014-06-01

Experiential approaches to skills development using secondment models are shown to benefit healthcare organizations more generally, but little is known about the potential of this approach to develop capacity for knowledge translation (KT). To evaluate the success of KT capacity development secondments from the perspective of multiple stakeholders. A pluralistic evaluation design was used. Data were collected during 2011-2012 using focus group and individual interviews with 14 clinical and academic secondees, and five managers from host and seconding organizations to gain insight into participants' perceptions of the success of secondments and the criteria by which they judged success. Six After Action Reviews were undertaken with KT project teams to explore participants' perceptions of the contribution secondees made to KT projects. Semistructured interviews were undertaken with three healthcare managers on completion of projects to explore the impact of secondments on the organization, staff, and patients. Qualitative content analysis was used to identify criteria for success. The criteria provided a framework through which the overall success of secondments could be judged. Six criteria for judging the success of the secondments at individual, team, and organization level were identified: KT skills development, effective workload management, team working, achieving KT objectives, enhanced care delivery, and enhanced education delivery. Benefits to the individual, KT team, seconding, and host organizations were identified. Hosting teams should provide mentorship support to secondees, and be flexible to accommodate secondees' needs as team members. Ongoing support of managers from seconding organizations is needed to maximize the benefits to individual secondees and the organization. Experiential approaches to KT capacity development using secondments can benefit individual secondees, project teams, seconding, and host organizations. © 2014 Sigma Theta Tau International.

Multi-objective calibration and uncertainty analysis of hydrologic models; A comparative study between formal and informal methods

NASA Astrophysics Data System (ADS)

Shafii, M.; Tolson, B.; Matott, L. S.

2012-04-01

Hydrologic modeling has benefited from significant developments over the past two decades. This has resulted in building of higher levels of complexity into hydrologic models, which eventually makes the model evaluation process (parameter estimation via calibration and uncertainty analysis) more challenging. In order to avoid unreasonable parameter estimates, many researchers have suggested implementation of multi-criteria calibration schemes. Furthermore, for predictive hydrologic models to be useful, proper consideration of uncertainty is essential. Consequently, recent research has emphasized comprehensive model assessment procedures in which multi-criteria parameter estimation is combined with statistically-based uncertainty analysis routines such as Bayesian inference using Markov Chain Monte Carlo (MCMC) sampling. Such a procedure relies on the use of formal likelihood functions based on statistical assumptions, and moreover, the Bayesian inference structured on MCMC samplers requires a considerably large number of simulations. Due to these issues, especially in complex non-linear hydrological models, a variety of alternative informal approaches have been proposed for uncertainty analysis in the multi-criteria context. This study aims at exploring a number of such informal uncertainty analysis techniques in multi-criteria calibration of hydrological models. The informal methods addressed in this study are (i) Pareto optimality which quantifies the parameter uncertainty using the Pareto solutions, (ii) DDS-AU which uses the weighted sum of objective functions to derive the prediction limits, and (iii) GLUE which describes the total uncertainty through identification of behavioral solutions. The main objective is to compare such methods with MCMC-based Bayesian inference with respect to factors such as computational burden, and predictive capacity, which are evaluated based on multiple comparative measures. The measures for comparison are calculated both for calibration and evaluation periods. The uncertainty analysis methodologies are applied to a simple 5-parameter rainfall-runoff model, called HYMOD.

SU-E-J-70: Evaluation of Multiple Isocentric Intensity Modulated and Volumetric Modulated Arc Therapy Techniques Using Portal Dosimetry

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

Muralidhar, K Raja; Pangam, S; Kolla, J

2015-06-15

Purpose: To develop a method for verification of dose distribution in a patient during treatment using multiple isocentric Intensity modulated and volumetric modulated arc therapy techniques with portal dosimetry. Methods: Varian True Beam accelerator, equipped with an aS1000 megavoltage electronic portal imaging device (EPID) has an integrated image mode for portal dosimetry (PD). The source-to-imager distance was taken at 150 cm to avoid collision to the table. Fourteen fractions were analyzed for this study. During shift in a single plan from one isocenter to another isocenter, EPID also shifted longitudinally for each field by taking the extent of divergence ofmore » beam into the consideration for EPID distance of 150cm. Patients were given treatment everyday with EPID placed in proper position for each field. Several parameters were obtained by comparing the dose distribution between fractions to fraction. The impact of the intra-fraction and inter-fraction of the patient in combination with isocenter shift of the beams were observed. Results: During treatment, measurements were performed by EPID and were evaluated by the gamma method. Analysis was done between fractions for multiple isocenter treatments. The pass rates of the gamma analysis with a criterion of 3% and 3 mm for the 14 fractions were over 97.8% with good consistency. Whereas maximum gamma exceeded the criteria in few fractions (in<1 cc vol). Average gamma was observed in the criteria of 0.5%. Maximum dose difference and average dose differences were less than 0.22 CU and 0.01 CU for maximum tolerance of 1.0 CU and 0.2 CU respectively. Conclusion: EPID with extended distance is ideal method to verify the multiple isocentric dose distribution in patient during treatment, especially cold and hot spots in junction dose. Verification of shifts as well as the dose differences between each fraction due to inter-fraction and intra-fraction of the patient can be derived.« less

What information is provided in transcripts and Medical Student Performance Records from Canadian Medical Schools? A retrospective cohort study.

PubMed

Robins, Jason A; McInnes, Matthew D F; Esmail, Kaisra

2014-01-01

Resident selection committees must rely on information provided by medical schools in order to evaluate candidates. However, this information varies between institutions, limiting its value in comparing individuals and fairly assessing their quality. This study investigates what is included in candidates' documentation, the heterogeneity therein, as well as its objective data. Samples of recent transcripts and Medical Student Performance Records were anonymised prior to evaluation. Data were then extracted by two independent reviewers blinded to the submitting university, assessing for the presence of pre-selected criteria; disagreement was resolved through consensus. The data were subsequently analysed in multiple subgroups. Inter-rater agreement equalled 92%. Inclusion of important criteria varied by school, ranging from 22.2% inclusion to 70.4%; the mean equalled 47.4%. The frequency of specific criteria was highly variable as well. Only 17.7% of schools provided any basis for comparison of academic performance; the majority detailed only status regarding pass or fail, without any further qualification. Considerable heterogeneity exists in the information provided in official medical school documentation, as well as markedly little objective data. Standardization may be necessary in order to facilitate fair comparison of graduates from different institutions. Implementation of objective data may allow more effective intra- and inter-scholastic comparison.

Medicine, methodology, and values: trade-offs in clinical science and practice.

PubMed

Ho, Vincent K Y

2011-01-01

The current guidelines of evidence-based medicine (EBM) presuppose that clinical research and clinical practice should advance from rigorous scientific tests as they generate reliable, value-free knowledge. Under this presupposition, hypotheses postulated by doctors and patients in the process of their decision making are preferably tested in randomized clinical trials (RCTs), and in systematic reviews and meta-analyses summarizing outcomes from multiple RCTs. Since testing under this scheme is predominantly focused on the criteria of generality and precision achieved through methodological rigor, at the cost of the criterion of realism, translating test results to clinical practice is often problematic. Choices concerning which methodological criteria should have priority are inevitable, however, as clinical trials, and scientific research in general, cannot meet all relevant criteria at the same time. Since these choices may be informed by considerations external to science, we must acknowledge that science cannot be value-free in a strict sense, and this invites a more prominent role for value-laden considerations in evaluating clinical research. The urgency for this becomes even more apparent when we consider the important yet implicit role of scientific theories in EBM, which may also be subjected to methodological evaluation and for which selectiveness in methodological focus is likewise inevitable.

Optimization of Groundwater Abstraction in the Beijing Plain using a Fuzzy Pattern Recognition Approach

NASA Astrophysics Data System (ADS)

Guo, H.; Li, W.; Wang, L.; Cheng, G.; Zhu, J.; Wang, Y.; Chen, Y.

2016-12-01

Groundwater supply accounts for two-thirds of the water supply of the Beijing municipality, and groundwater resources play a fundamental role in assuring the security and sustainability of the regional economy in Beijing. In this report, ten groundwater abstraction scenarios were designed based on the water demand and the capacity of water supply in the Beijing plain, and the impacts of these scenarios on the groundwater storage and level were illustrated with a transient 3D groundwater model constructed with MODFLOW. In addition, a set of evaluation criteria was developed taking into account of a number of factors such as the amount of groundwater exploitation, the evaporation of unconfined groundwater, river outflow, regional average groundwater depth, drawdowns in depression cones and the ratio of storage to the total recharge. Based on this set of criteria, the ten proposed groundwater abstraction scenarios were compared using a multi-criteria fuzzy pattern recognition model, which is suitable for solving large-scale, transient groundwater management problems and also proven to be a useful scientific analysis tool to identify the optimal groundwater resource utilization scenario. The evaluation results show that the groundwater resources can be rationally and optimally used when multiple measures such as control of groundwater abstraction and increase of recharge are jointly implemented.

Set of Criteria for Efficiency of the Process Forming the Answers to Multiple-Choice Test Items

ERIC Educational Resources Information Center

Rybanov, Alexander Aleksandrovich

2013-01-01

Is offered the set of criteria for assessing efficiency of the process forming the answers to multiple-choice test items. To increase accuracy of computer-assisted testing results, it is suggested to assess dynamics of the process of forming the final answer using the following factors: loss of time factor and correct choice factor. The model…

10 CFR 420.36 - Evaluation criteria.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 3 2014-01-01 2014-01-01 false Evaluation criteria. 420.36 Section 420.36 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION STATE ENERGY PROGRAM Implementation of Special Projects Financial Assistance § 420.36 Evaluation criteria. The evaluation criteria, including program activity-specific...

10 CFR 420.36 - Evaluation criteria.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 3 2011-01-01 2011-01-01 false Evaluation criteria. 420.36 Section 420.36 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION STATE ENERGY PROGRAM Implementation of Special Projects Financial Assistance § 420.36 Evaluation criteria. The evaluation criteria, including program activity-specific...

10 CFR 420.36 - Evaluation criteria.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 3 2012-01-01 2012-01-01 false Evaluation criteria. 420.36 Section 420.36 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION STATE ENERGY PROGRAM Implementation of Special Projects Financial Assistance § 420.36 Evaluation criteria. The evaluation criteria, including program activity-specific...

10 CFR 420.36 - Evaluation criteria.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Evaluation criteria. 420.36 Section 420.36 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION STATE ENERGY PROGRAM Implementation of Special Projects Financial Assistance § 420.36 Evaluation criteria. The evaluation criteria, including program activity-specific...

10 CFR 420.36 - Evaluation criteria.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 3 2013-01-01 2013-01-01 false Evaluation criteria. 420.36 Section 420.36 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION STATE ENERGY PROGRAM Implementation of Special Projects Financial Assistance § 420.36 Evaluation criteria. The evaluation criteria, including program activity-specific...

Applying the Analytic Hierarchy Process in healthcare research: A systematic literature review and evaluation of reporting.

PubMed

Schmidt, Katharina; Aumann, Ines; Hollander, Ines; Damm, Kathrin; von der Schulenburg, J-Matthias Graf

2015-12-24

The Analytic Hierarchy Process (AHP), developed by Saaty in the late 1970s, is one of the methods for multi-criteria decision making. The AHP disaggregates a complex decision problem into different hierarchical levels. The weight for each criterion and alternative are judged in pairwise comparisons and priorities are calculated by the Eigenvector method. The slowly increasing application of the AHP was the motivation for this study to explore the current state of its methodology in the healthcare context. A systematic literature review was conducted by searching the Pubmed and Web of Science databases for articles with the following keywords in their titles or abstracts: "Analytic Hierarchy Process," "Analytical Hierarchy Process," "multi-criteria decision analysis," "multiple criteria decision," "stated preference," and "pairwise comparison." In addition, we developed reporting criteria to indicate whether the authors reported important aspects and evaluated the resulting studies' reporting. The systematic review resulted in 121 articles. The number of studies applying AHP has increased since 2005. Most studies were from Asia (almost 30%), followed by the US (25.6%). On average, the studies used 19.64 criteria throughout their hierarchical levels. Furthermore, we restricted a detailed analysis to those articles published within the last 5 years (n = 69). The mean of participants in these studies were 109, whereas we identified major differences in how the surveys were conducted. The evaluation of reporting showed that the mean of reported elements was about 6.75 out of 10. Thus, 12 out of 69 studies reported less than half of the criteria. The AHP has been applied inconsistently in healthcare research. A minority of studies described all the relevant aspects. Thus, the statements in this review may be biased, as they are restricted to the information available in the papers. Hence, further research is required to discover who should be interviewed and how, how inconsistent answers should be dealt with, and how the outcome and stability of the results should be presented. In addition, we need new insights to determine which target group can best handle the challenges of the AHP.

Evaluating and treating neurobehavioral symptoms in professional American football players

PubMed Central

Possin, Katherine L.; Hess, Christopher P.; Huang, Eric J.; Grinberg, Lea T.; Nolan, Amber L.; Cohn-Sheehy, Brendan I.; Ghosh, Pia M.; Lanata, Serggio; Merrilees, Jennifer; Kramer, Joel H.; Berger, Mitchel S.; Miller, Bruce L.; Yaffe, Kristine; Rabinovici, Gil D.

2015-01-01

Summary In the aftermath of multiple high-profile cases of chronic traumatic encephalopathy (CTE) in professional American football players, physicians in clinical practice are likely to face an increasing number of retired football players seeking evaluation for chronic neurobehavioral symptoms. Guidelines for the evaluation and treatment of these patients are sparse. Clinical criteria for a diagnosis of CTE are under development. The contribution of CTE vs other neuropathologies to neurobehavioral symptoms in these players remains unclear. Here we describe the experience of our academic memory clinic in evaluating and treating a series of 14 self-referred symptomatic players. Our aim is to raise awareness in the neurology community regarding the different clinical phenotypes, idiosyncratic but potentially treatable symptoms, and the spectrum of underlying neuropathologies in these players. PMID:26336629

Emerging Technologies for Environmental Remediation: Integrating Data and Judgment.

PubMed

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

2016-01-05

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

A Framework for the Development and Interpretation of Different Sepsis Definitions and Clinical Criteria

PubMed Central

Angus, Derek C.; Seymour, Christopher W.; Coopersmith, Craig M.; Deutschman, Clifford; Klompas, Michael; Levy, Mitchell M.; Martin, Greg S.; Osborn, Tiffany M.; Rhee, Chanu; Watson, R. Scott

2016-01-01

Although sepsis was described more than 2,000 years ago, and clinicians still struggle to define it, there is no “gold standard,” and multiple competing approaches and terms exist. Challenges include the ever-changing knowledge base that informs our understanding of sepsis, competing views on which aspects of any potential definition are most important, and the tendency of most potential criteria to be distributed in at-risk populations in such a way as to hinder separation into discrete sets of patients. We propose that the development and evaluation of any definition or diagnostic criteria should follow four steps: 1) define the epistemologic underpinning, 2) agree on all relevant terms used to frame the exercise, 3) state the intended purpose for any proposed set of criteria, and 4) adopt a scientific approach to inform on their usefulness with regard to the intended purpose. Usefulness can be measured across six domains: 1) reliability (stability of criteria during retesting, between raters, over time, and across settings), 2) content validity (similar to face validity), 3) construct validity (whether criteria measure what they purport to measure), 4) criterion validity (how new criteria fare compared to standards), 5) measurement burden (cost, safety, and complexity), and 6) timeliness (whether criteria are available concurrent with care decisions). The relative importance of these domains of usefulness depends on the intended purpose, of which there are four broad categories: 1) clinical care, 2) research, 3) surveillance, and 4) quality improvement and audit. This proposed methodologic framework is intended to aid understanding of the strengths and weaknesses of different approaches, provide a mechanism for explaining differences in epidemiologic estimates generated by different approaches, and guide the development of future definitions and diagnostic criteria. PMID:26901559

A Framework for the Development and Interpretation of Different Sepsis Definitions and Clinical Criteria.

PubMed

Angus, Derek C; Seymour, Christopher W; Coopersmith, Craig M; Deutschman, Clifford S; Klompas, Michael; Levy, Mitchell M; Martin, Gregory S; Osborn, Tiffany M; Rhee, Chanu; Watson, R Scott

2016-03-01

Although sepsis was described more than 2,000 years ago, and clinicians still struggle to define it, there is no "gold standard," and multiple competing approaches and terms exist. Challenges include the ever-changing knowledge base that informs our understanding of sepsis, competing views on which aspects of any potential definition are most important, and the tendency of most potential criteria to be distributed in at-risk populations in such a way as to hinder separation into discrete sets of patients. We propose that the development and evaluation of any definition or diagnostic criteria should follow four steps: 1) define the epistemologic underpinning, 2) agree on all relevant terms used to frame the exercise, 3) state the intended purpose for any proposed set of criteria, and 4) adopt a scientific approach to inform on their usefulness with regard to the intended purpose. Usefulness can be measured across six domains: 1) reliability (stability of criteria during retesting, between raters, over time, and across settings), 2) content validity (similar to face validity), 3) construct validity (whether criteria measure what they purport to measure), 4) criterion validity (how new criteria fare compared to standards), 5) measurement burden (cost, safety, and complexity), and 6) timeliness (whether criteria are available concurrent with care decisions). The relative importance of these domains of usefulness depends on the intended purpose, of which there are four broad categories: 1) clinical care, 2) research, 3) surveillance, and 4) quality improvement and audit. This proposed methodologic framework is intended to aid understanding of the strengths and weaknesses of different approaches, provide a mechanism for explaining differences in epidemiologic estimates generated by different approaches, and guide the development of future definitions and diagnostic criteria.

Placing symptoms in context: the role of contextual criteria in reducing false positives in Diagnostic and Statistical Manual of Mental Disorders diagnoses.

PubMed

Wakefield, Jerome C; First, Michael B

2012-02-01

The Diagnostic and Statistical Manual of Mental Disorders (DSM) definition of mental disorder requires that symptoms be caused by a dysfunction in the individual; when dysfunction is absent, symptoms represent normal-range distress or eccentricity and, if diagnosed as a mental disorder, are false positives. We hypothesized that because of psychiatry's lack of direct laboratory tests to distinguish dysfunction from normal-range distress, the context in which symptoms occur (eg, lack of imminent danger in a panic attack) is often essential to determining whether symptoms are caused by a dysfunction. If this is right, then the DSM diagnostic criteria should include many contextual criteria added to symptom syndromes to prevent dysfunction false positives. Despite their potential importance, such contextual criteria have not been previously reviewed. We, thus, systematically reviewed DSM categories to establish the extent of such uses of contextual criteria and created a typology of such uses. Of 111 sampled categories, 68 (61%) used context to prevent dysfunction false positives. Contextual criteria fell into 7 types: (1) exclusion of specific false-positive scenarios; (2) requiring that patients experience preconditions for normal responses (eg, requiring that individuals experience adequate sexual stimulation before being diagnosed with sexual dysfunctions); (3) requiring that symptoms be disproportionate relative to circumstances; (4) for childhood disorders, requiring that symptoms be developmentally inappropriate; (5) requiring that symptoms occur in multiple contexts; (6) requiring a substantial discrepancy between beliefs and reality; and (7) a residual category. Most DSM categories include contextual criteria to eliminate false-positive diagnoses and increase validity of descriptive criteria. Future revisions should systematically evaluate each category's need for contextual criteria. Copyright © 2012 Elsevier Inc. All rights reserved.

Evaluated Cross Sections of Photoneutron Reactions on the Isotope 116Sn and Spectra of Neutrons Originating from These Reactions

NASA Astrophysics Data System (ADS)

Varlamov, V. V.; Ishkhanov, B. S.; Orlin, V. N.

2017-11-01

With the aid of the results obtained by evaluating cross sections of partial photoneutron reactions on the isotope 116Sn and the energy spectra of neutrons originating from these reactions, the possible reasons for the well-known discrepancies between the results of different photonuclear experiments were studied on the basis of a combinedmodel of photonuclear reactions. On the basis of physical criteria of data reliability and an experimental-theoretical method for evaluating cross sections of partial reactions, it was found that these discrepancies were due to unreliably redistributing neutrons between ( γ, 1 n), ( γ, 2 n), and ( γ, 3 n) reactions because of nontrivial correlations between the experimentally measured energy of neutrons and their multiplicity.

Innovative neuro-fuzzy system of smart transport infrastructure for road traffic safety

NASA Astrophysics Data System (ADS)

Beinarovica, Anna; Gorobetz, Mikhail; Levchenkov, Anatoly

2017-09-01

The proposed study describes applying of neural network and fuzzy logic in transport control for safety improvement by evaluation of accidents’ risk by intelligent infrastructure devices. Risk evaluation is made by following multiple-criteria: danger, changeability and influence of changes for risk increasing. Neuro-fuzzy algorithms are described and proposed for task solution. The novelty of the proposed system is proved by deep analysis of known studies in the field. The structure of neuro-fuzzy system for risk evaluation and mathematical model is described in the paper. The simulation model of the intelligent devices for transport infrastructure is proposed to simulate different situations, assess the risks and propose the possible actions for infrastructure or vehicles to minimize the risk of possible accidents.

[Enhanced Recovery after Surgery from Theory to Practice
What do We Need to Do?

PubMed

Che, Guowei; Liu, Lunxu; Zhou, Qinghua

2017-04-20

Enhanced recovery after surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes, shorter length of hospital stay and cost savings. But the current ERAS either by application of breadth or depth is not enough, why? The main reason is the lack of "operability, evaluation, repetition" ERAS protocol and suitable for clinical extensive application protocol. How to form the clinical available protocol? Operational mainly refers to the clinical scheme is simple and feasible, and protocol compliance is good; Evaluate refers to the methods used before, during and after are the objective evaluation criteria and plan; Repeatable is clinical scheme repeatability in the process of single or multiple center.

Evaluation Criteria for the Educational Web-Information System

ERIC Educational Resources Information Center

Seok, Soonhwa; Meyen, Edward; Poggio, John C.; Semon, Sarah; Tillberg-Webb, Heather

2008-01-01

This article addresses how evaluation criteria improve educational Web-information system design, and the tangible and intangible benefits of using evaluation criteria, when implemented in an educational Web-information system design. The evaluation criteria were developed by the authors through a content validation study applicable to…

Multi-criteria clinical decision support: A primer on the use of multiple criteria decision making methods to promote evidence-based, patient-centered healthcare.

PubMed

Dolan, James G

2010-01-01

Current models of healthcare quality recommend that patient management decisions be evidence-based and patient-centered. Evidence-based decisions require a thorough understanding of current information regarding the natural history of disease and the anticipated outcomes of different management options. Patient-centered decisions incorporate patient preferences, values, and unique personal circumstances into the decision making process and actively involve both patients along with health care providers as much as possible. Fundamentally, therefore, evidence-based, patient-centered decisions are multi-dimensional and typically involve multiple decision makers.Advances in the decision sciences have led to the development of a number of multiple criteria decision making methods. These multi-criteria methods are designed to help people make better choices when faced with complex decisions involving several dimensions. They are especially helpful when there is a need to combine "hard data" with subjective preferences, to make trade-offs between desired outcomes, and to involve multiple decision makers. Evidence-based, patient-centered clinical decision making has all of these characteristics. This close match suggests that clinical decision support systems based on multi-criteria decision making techniques have the potential to enable patients and providers to carry out the tasks required to implement evidence-based, patient-centered care effectively and efficiently in clinical settings.The goal of this paper is to give readers a general introduction to the range of multi-criteria methods available and show how they could be used to support clinical decision-making. Methods discussed include the balance sheet, the even swap method, ordinal ranking methods, direct weighting methods, multi-attribute decision analysis, and the analytic hierarchy process (AHP).

Multi-criteria clinical decision support: A primer on the use of multiple criteria decision making methods to promote evidence-based, patient-centered healthcare

PubMed Central

Dolan, James G.

2010-01-01

Current models of healthcare quality recommend that patient management decisions be evidence-based and patient-centered. Evidence-based decisions require a thorough understanding of current information regarding the natural history of disease and the anticipated outcomes of different management options. Patient-centered decisions incorporate patient preferences, values, and unique personal circumstances into the decision making process and actively involve both patients along with health care providers as much as possible. Fundamentally, therefore, evidence-based, patient-centered decisions are multi-dimensional and typically involve multiple decision makers. Advances in the decision sciences have led to the development of a number of multiple criteria decision making methods. These multi-criteria methods are designed to help people make better choices when faced with complex decisions involving several dimensions. They are especially helpful when there is a need to combine “hard data” with subjective preferences, to make trade-offs between desired outcomes, and to involve multiple decision makers. Evidence-based, patient-centered clinical decision making has all of these characteristics. This close match suggests that clinical decision support systems based on multi-criteria decision making techniques have the potential to enable patients and providers to carry out the tasks required to implement evidence-based, patient-centered care effectively and efficiently in clinical settings. The goal of this paper is to give readers a general introduction to the range of multi-criteria methods available and show how they could be used to support clinical decision-making. Methods discussed include the balance sheet, the even swap method, ordinal ranking methods, direct weighting methods, multi-attribute decision analysis, and the analytic hierarchy process (AHP) PMID:21394218

Evaluation criteria for the district health management information systems: lessons from the Ministry of Health, Kenya.

PubMed

Odhiambo-Otieno, George W; Odero, Wilson W O

2005-03-01

The District Health Management Information Systems (DHMISs) were established by the Ministry of Health (MoH) in Kenya more than two decades ago. Since then, no comprehensive evaluation has been undertaken. This can partly be attributed to lack of defined criteria for evaluating them. To propose evaluation criteria for assessing the design, implementation and impact of DHMIS in the management of the District Health System (DHS) in Kenya. A descriptive cross-sectional study conducted in three DHSs in Kenya: Bungoma, Murang'a and Uasin Gishu districts. Data was collected through focus group discussions, key informant interviews, and documents' review. The respondents, purposely selected from the Ministry of Health headquarters and the three DHS districts, included designers, managers and end-users of the systems. A set of evaluation criteria for DHMISs was identified for each of the three phases of implementation: pre-implementation evaluation criteria (categorised as policy and objectives, technical feasibility, financial viability, political viability and administrative operability) to be applied at the design stage; concurrent implementation evaluation criteria to be applied during implementation of the new system; and post-implementation evaluation criteria (classified as internal - quality of information; external - resources and managerial support; ultimate - systems impact) to be applied after implementation of the system for at least three years. In designing a DHMIS model there is need to have built-in these three sets of evaluation criteria which should be used in a phased manner. Pre-implementation evaluation criteria should be used to evaluate the system's viability before more resources are committed to it; concurrent (operational) - implementation evaluation criteria should be used to monitor the process; and post-implementation evaluation criteria should be applied to assess the system's effectiveness.

A SUMMARY COMPARISON OF DESIGN EVALUATION TECHNIQUES

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

Spielman, Zachary; Hill, Rachael

The United States’ fleet of Nuclear Reactors is considering modernizing their control rooms and instrumentation as an effort to avoid component obsolescence, keep up with competing industries, and cater to a new work force among others. Multiple technologies have potential to improve the control room. In attempts to evaluate the available options researchers employ a variety of measures to ensure the best candidate is used in a modernizing effort. The NRC is in charge of ensuring any new design has been thoroughly vetted before approving a license. Laid out in NUREG-0711 “Human Factors Engineering Program Review Model” is the reviewmore » criteria for design validation. As there are a variety of measures currently used to evaluate candidate technologies, this paper seeks to identify weaknesses in the common measures used to design and validate technology in control room modernization efforts. Identifying where measurements are not meeting the criteria will help the control room modernization research platform identify where measurement development needs to occur. This will help ensure that current performance measurements are producing as reliable results as possible to select the right technology to integrate into nuclear operating control rooms.« less

Individuals with Single Versus Multiple Suicide Attempts Over 10 Years of Prospective Follow-Up

PubMed Central

Boisseau, Christina L.; Yen, Shirley; Markowitz, John C.; Grilo, Carlos M.; Sanislow, Charles A.; Shea, M. Tracie; Zanarini, Mary C.; Skodol, Andrew E.; Gunderson, John G.; Morey, Leslie C.; McGlashan, Thomas H.

2012-01-01

Background The study attempted to identify characteristics that differentiate multiple suicide attempters from single attempters in individuals with personality disorders (PDs) and/or major depression. Method Participants were 431 participants enrolled in the Collaborative Longitudinal Study of Personality Disorders from July 1996 to June 2008. Suicide attempts were assessed with the Longitudinal Interval Follow-up Evaluation at 6 and 12 months, then yearly through 10 years. Logistic regression was used to compare single attempters to multiple attempters on Axis I and II psychiatric disorders and personality trait variables. Results Twenty-one percent of participants attempted suicide during the 10 years of observation, with 39 (9.0%) reporting a single suicide attempt and 54 (12.5%) reporting multiple suicide attempts. Although no significant differences in were found in baseline Axis I disorders, multiple attempters were significantly more likely to meet criteria for borderline personality disorder and to have higher impulsivity scores than single attempters. Conclusion These results underscore the importance of considering both personality disorders and traits in the assessment of suicidality. PMID:22995448

Anti-synchronization control of BAM memristive neural networks with multiple proportional delays and stochastic perturbations

NASA Astrophysics Data System (ADS)

Wang, Weiping; Yuan, Manman; Luo, Xiong; Liu, Linlin; Zhang, Yao

2018-01-01

Proportional delay is a class of unbounded time-varying delay. A class of bidirectional associative memory (BAM) memristive neural networks with multiple proportional delays is concerned in this paper. First, we propose the model of BAM memristive neural networks with multiple proportional delays and stochastic perturbations. Furthermore, by choosing suitable nonlinear variable transformations, the BAM memristive neural networks with multiple proportional delays can be transformed into the BAM memristive neural networks with constant delays. Based on the drive-response system concept, differential inclusions theory and Lyapunov stability theory, some anti-synchronization criteria are obtained. Finally, the effectiveness of proposed criteria are demonstrated through numerical examples.

Standardizing the evaluation criteria on treatment outcomes of mandibular implant overdentures: a systematic review

PubMed Central

Kim, Ha-Young; Shin, Sang-Wan

2014-01-01

PURPOSE The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva level. It is also suggested that prosthetic evaluation criteria include loose matrix, female detachment, denture fracture, denture relining, abutment fracture, abutment screw loosening, and occlusal adjustment. Finally standardized criteria like OHIP-EDENT or VAS are required for patient satisfaction. PMID:25352954

Criteria used by nurses to evaluate practice-related information on the World Wide Web.

PubMed

Cader, Raffik; Campbell, Steve; Watson, Don

2003-01-01

Existing criteria used to evaluate information on the World Wide Web often are not related to nursing, especially in relation to clinical and evidence-based practice. Published criteria have been found orientated to the health-consumer, medicine, or general information. In this study, the process by which nurses evaluate practice-related information and the associated evaluative nursing criteria were investigated using a grounded theory approach. In the first stage of this ongoing investigation, semistructured interviews were used to collect data from UK postregistration nursing students. The findings from this initial study provided indications of the process and the criteria for evaluating information on the World Wide Web. Participating students identified intuition as part of the evaluative process. They identified some criteria similar to existing standards, but critically, with additional criteria that are nursing practice related. Because these new criteria are significant for evaluating nursing information, further refinement of these findings is being undertaken through the next stage of the research program.

Decision-analytic modeling studies: An overview for clinicians using multiple myeloma as an example.

PubMed

Rochau, U; Jahn, B; Qerimi, V; Burger, E A; Kurzthaler, C; Kluibenschaedl, M; Willenbacher, E; Gastl, G; Willenbacher, W; Siebert, U

2015-05-01

The purpose of this study was to provide a clinician-friendly overview of decision-analytic models evaluating different treatment strategies for multiple myeloma (MM). We performed a systematic literature search to identify studies evaluating MM treatment strategies using mathematical decision-analytic models. We included studies that were published as full-text articles in English, and assessed relevant clinical endpoints, and summarized methodological characteristics (e.g., modeling approaches, simulation techniques, health outcomes, perspectives). Eleven decision-analytic modeling studies met our inclusion criteria. Five different modeling approaches were adopted: decision-tree modeling, Markov state-transition modeling, discrete event simulation, partitioned-survival analysis and area-under-the-curve modeling. Health outcomes included survival, number-needed-to-treat, life expectancy, and quality-adjusted life years. Evaluated treatment strategies included novel agent-based combination therapies, stem cell transplantation and supportive measures. Overall, our review provides a comprehensive summary of modeling studies assessing treatment of MM and highlights decision-analytic modeling as an important tool for health policy decision making. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Evaluation of nucleus segmentation in digital pathology images through large scale image synthesis

NASA Astrophysics Data System (ADS)

Zhou, Naiyun; Yu, Xiaxia; Zhao, Tianhao; Wen, Si; Wang, Fusheng; Zhu, Wei; Kurc, Tahsin; Tannenbaum, Allen; Saltz, Joel; Gao, Yi

2017-03-01

Digital histopathology images with more than 1 Gigapixel are drawing more and more attention in clinical, biomedical research, and computer vision fields. Among the multiple observable features spanning multiple scales in the pathology images, the nuclear morphology is one of the central criteria for diagnosis and grading. As a result it is also the mostly studied target in image computing. Large amount of research papers have devoted to the problem of extracting nuclei from digital pathology images, which is the foundation of any further correlation study. However, the validation and evaluation of nucleus extraction have yet been formulated rigorously and systematically. Some researches report a human verified segmentation with thousands of nuclei, whereas a single whole slide image may contain up to million. The main obstacle lies in the difficulty of obtaining such a large number of validated nuclei, which is essentially an impossible task for pathologist. We propose a systematic validation and evaluation approach based on large scale image synthesis. This could facilitate a more quantitatively validated study for current and future histopathology image analysis field.

Selection to Ensure Study Success: Looking for Multiple Criteria in the Case of a European Master of Science Program in Business

ERIC Educational Resources Information Center

Fastre, Greet; Gijselaers, Wim H.; Segers, Mien

2008-01-01

The authors report relations between entrance criteria and study success in a program for a master of science in business. Based on the admission criteria broadly used in European business schools and the findings of prior research, the present authors measured eight criteria for study success in the master's degree program. The authors applied…

Quality of core collections for effective utilisation of genetic resources review, discussion and interpretation.

PubMed

Odong, T L; Jansen, J; van Eeuwijk, F A; van Hintum, T J L

2013-02-01

Definition of clear criteria for evaluation of the quality of core collections is a prerequisite for selecting high-quality cores. However, a critical examination of the different methods used in literature, for evaluating the quality of core collections, shows that there are no clear guidelines on the choices of quality evaluation criteria and as a result, inappropriate analyses are sometimes made leading to false conclusions being drawn regarding the quality of core collections and the methods to select such core collections. The choice of criteria for evaluating core collections appears to be based mainly on the fact that those criteria have been used in earlier publications rather than on the actual objectives of the core collection. In this study, we provide insight into different criteria used for evaluating core collections. We also discussed different types of core collections and related each type of core collection to their respective evaluation criteria. Two new criteria based on genetic distance are introduced. The consequences of the different evaluation criteria are illustrated using simulated and experimental data. We strongly recommend the use of the distance-based criteria since they not only allow the simultaneous evaluation of all variables describing the accessions, but they also provide intuitive and interpretable criteria, as compared with the univariate criteria generally used for the evaluation of core collections. Our findings will provide genebank curators and researchers with possibilities to make informed choices when creating, comparing and using core collections.

Applying network theory to prioritize multispecies habitat networks that are robust to climate and land-use change.

PubMed

Albert, Cécile H; Rayfield, Bronwyn; Dumitru, Maria; Gonzalez, Andrew

2017-12-01

Designing connected landscapes is among the most widespread strategies for achieving biodiversity conservation targets. The challenge lies in simultaneously satisfying the connectivity needs of multiple species at multiple spatial scales under uncertain climate and land-use change. To evaluate the contribution of remnant habitat fragments to the connectivity of regional habitat networks, we developed a method to integrate uncertainty in climate and land-use change projections with the latest developments in network-connectivity research and spatial, multipurpose conservation prioritization. We used land-use change simulations to explore robustness of species' habitat networks to alternative development scenarios. We applied our method to 14 vertebrate focal species of periurban Montreal, Canada. Accounting for connectivity in spatial prioritization strongly modified conservation priorities and the modified priorities were robust to uncertain climate change. Setting conservation priorities based on habitat quality and connectivity maintained a large proportion of the region's connectivity, despite anticipated habitat loss due to climate and land-use change. The application of connectivity criteria alongside habitat-quality criteria for protected-area design was efficient with respect to the amount of area that needs protection and did not necessarily amplify trade-offs among conservation criteria. Our approach and results are being applied in and around Montreal and are well suited to the design of ecological networks and green infrastructure for the conservation of biodiversity and ecosystem services in other regions, in particular regions around large cities, where connectivity is critically low. © 2017 Society for Conservation Biology.

A multiple criteria analysis for household solid waste management in the urban community of Dakar.

PubMed

Kapepula, Ka-Mbayu; Colson, Gerard; Sabri, Karim; Thonart, Philippe

2007-01-01

Household solid waste management is a severe problem in big cities of developing countries. Mismanaged solid waste dumpsites produce bad sanitary, ecological and economic consequences for the whole population, especially for the poorest urban inhabitants. Dealing with this problem, this paper utilizes field data collected in the urban community of Dakar, in view of ranking nine areas of the city with respect to multiple criteria of nuisance. Nine criteria are built and organized in three families that represent three classical viewpoints: the production of wastes, their collection and their treatment. Thanks to the method PROMETHEE and the software ARGOS, we do a pair-wise comparison of the nine areas, which allows their multiple criteria rankings according to each viewpoint and then globally. Finding the worst and best areas in terms of nuisance for a better waste management in the city is our final purpose, fitting as well as possible the needs of the urban community. Based on field knowledge and on the literature, we suggest applying general and area-specific remedies to the household solid waste problems.

The reliability of photoneutron cross sections for 90,91,92,94Zr

NASA Astrophysics Data System (ADS)

Varlamov, V. V.; Davydov, A. I.; Ishkhanov, B. S.; Orlin, V. N.

2018-05-01

Data on partial photoneutron reaction cross sections (γ,1n) and (γ,2n) for 90,91,92,94Zr obtained at Livermore (USA) and for 90Zr obtained at Saclay (France) were analyzed. Experimental data were obtained using quasimonoenergetic photon beams from the annihilation in flight of relativistic positrons. The method of photoneutron multiplicity sorting based on the neutron energy measuring was used to separate partial reactions. The research carried out is based on the objective of using the physical criteria of data reliability. The large systematic uncertainties were found in partial cross sections, since they do not satisfy those criteria. To obtain the reliable cross sections of the partial (γ,1n) and (γ,2n) and total (γ,1n) + (γ,2n) reactions on 90,91,92,94Zr and (γ,3n) reaction on 94Zr, the experimental-theoretical method was used. It is based on the experimental data for neutron yield cross section rather independent from the neutron multiplicity and theoretical equations of the combined photonucleon reaction model (CPNRM). Newly evaluated data are compared with experimental ones. The reasons of noticeable disagreements between those are discussed.

A combined MOIP-MCDA approach to building and screening atmospheric pollution control strategies in urban regions.

PubMed

Mavrotas, George; Ziomas, Ioannis C; Diakouaki, Danae

2006-07-01

This article presents a methodological approach for the formulation of control strategies capable of reducing atmospheric pollution at the standards set by European legislation. The approach was implemented in the greater area of Thessaloniki and was part of a project aiming at the compliance with air quality standards in five major cities in Greece. The methodological approach comprises two stages: in the first stage, the availability of several measures contributing to a certain extent to reducing atmospheric pollution indicates a combinatorial problem and favors the use of Integer Programming. More specifically, Multiple Objective Integer Programming is used in order to generate alternative efficient combinations of the available policy measures on the basis of two conflicting objectives: public expenditure minimization and social acceptance maximization. In the second stage, these combinations of control measures (i.e., the control strategies) are then comparatively evaluated with respect to a wider set of criteria, using tools from Multiple Criteria Decision Analysis, namely, the well-known PROMETHEE method. The whole procedure is based on the active involvement of local and central authorities in order to incorporate their concerns and preferences, as well as to secure the adoption and implementation of the resulting solution.

A Combined MOIP-MCDA Approach to Building and Screening Atmospheric Pollution Control Strategies in Urban Regions

NASA Astrophysics Data System (ADS)

Mavrotas, George; Ziomas, Ioannis C.; Diakouaki, Danae

2006-07-01

This article presents a methodological approach for the formulation of control strategies capable of reducing atmospheric pollution at the standards set by European legislation. The approach was implemented in the greater area of Thessaloniki and was part of a project aiming at the compliance with air quality standards in five major cities in Greece. The methodological approach comprises two stages: in the first stage, the availability of several measures contributing to a certain extent to reducing atmospheric pollution indicates a combinatorial problem and favors the use of Integer Programming. More specifically, Multiple Objective Integer Programming is used in order to generate alternative efficient combinations of the available policy measures on the basis of two conflicting objectives: public expenditure minimization and social acceptance maximization. In the second stage, these combinations of control measures (i.e., the control strategies) are then comparatively evaluated with respect to a wider set of criteria, using tools from Multiple Criteria Decision Analysis, namely, the well-known PROMETHEE method. The whole procedure is based on the active involvement of local and central authorities in order to incorporate their concerns and preferences, as well as to secure the adoption and implementation of the resulting solution.

Clinical presentation of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections in research and community settings.

PubMed

Swedo, Susan E; Seidlitz, Jakob; Kovacevic, Miro; Latimer, M Elizabeth; Hommer, Rebecca; Lougee, Lorraine; Grant, Paul

2015-02-01

The first cases of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) were described >15 years ago. Since that time, the literature has been divided between studies that successfully demonstrate an etiologic relationship between Group A streptococcal (GAS) infections and childhood-onset obsessive-compulsive disorder (OCD), and those that fail to find an association. One possible explanation for the conflicting reports is that the diagnostic criteria proposed for PANDAS are not specific enough to describe a unique and homogeneous cohort of patients. To evaluate the validity of the PANDAS criteria, we compared clinical characteristics of PANDAS patients identified in two community practices with a sample of children meeting full research criteria for PANDAS. A systematic review of clinical records was used to identify the presence or absence of selected symptoms in children evaluated for PANDAS by physicians in Hinsdale, Illinois (n=52) and Bethesda, Maryland (n=40). RESULTS were compared against data from participants in National Institute of Mental Health (NIMH) research investigations of PANDAS (n=48). As described in the original PANDAS cohort, males outnumbered females (95:45) by ∼ 2:1, and symptoms began in early childhood (7.3±2.7 years). Clinical presentations were remarkably similar across sites, with all children reporting acute onset of OCD symptoms and multiple comorbidities, including separation anxiety (86-92%), school issues (75-81%), sleep disruptions (71%), tics (60-65%), urinary symptoms (42-81%), and others. Twenty of the community cases (22%) failed to meet PANDAS criteria because of an absence of documentation of GAS infections. The diagnostic criteria for PANDAS can be used by clinicians to accurately identify patients with common clinical features and shared etiology of symptoms. Although difficulties in documenting an association between GAS infection and symptom onset/exacerbations may preclude a diagnosis of PANDAS in some children with acute-onset OCD, they do appear to meet criteria for pediatric acute-onset neuropsychiatric syndrome (PANS).

Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations

PubMed Central

Herman, Patricia M; Poindexter, Beth L; Witt, Claudia M; Eisenberg, David M

2012-01-01

Objective A comprehensive systematic review of economic evaluations of complementary and integrative medicine (CIM) to establish the value of these therapies to health reform efforts. Data sources PubMed, CINAHL, AMED, PsychInfo, Web of Science and EMBASE were searched from inception through 2010. In addition, bibliographies of found articles and reviews were searched, and key researchers were contacted. Eligibility criteria for selecting studies Studies of CIM were identified using criteria based on those of the Cochrane complementary and alternative medicine group. All studies of CIM reporting economic outcomes were included. Study appraisal methods All recent (and likely most cost-relevant) full economic evaluations published 2001–2010 were subjected to several measures of quality. Detailed results of higher-quality studies are reported. Results A total of 338 economic evaluations of CIM were identified, of which 204, covering a wide variety of CIM for different populations, were published 2001–2010. A total of 114 of these were full economic evaluations. And 90% of these articles covered studies of single CIM therapies and only one compared usual care to usual care plus access to multiple licensed CIM practitioners. Of the recent full evaluations, 31 (27%) met five study-quality criteria, and 22 of these also met the minimum criterion for study transferability (‘generalisability’). Of the 56 comparisons made in the higher-quality studies, 16 (29%) show a health improvement with cost savings for the CIM therapy versus usual care. Study quality of the cost-utility analyses (CUAs) of CIM was generally comparable to that seen in CUAs across all medicine according to several measures, and the quality of the cost-saving studies was slightly, but not significantly, lower than those showing cost increases (85% vs 88%, p=0.460). Conclusions This comprehensive review identified many CIM economic evaluations missed by previous reviews and emerging evidence of cost-effectiveness and possible cost savings in at least a few clinical populations. Recommendations are made for future studies. PMID:22945962

Criteria for opiate identification using liquid chromatography linked to tandem mass spectrometry: problems in routine practice.

PubMed

Fox, Elizabeth J; Twigger, Shirley; Allen, Keith R

2009-01-01

Liquid chromatography linked to tandem mass spectrometry (LC/MS/MS) is being increasingly used for drug confirmation. At present, no official criteria exist for drug identification using this technique although the European Union (EU) criteria for compound identification have been adopted. These criteria are evaluated with respect to opiate confirmation by LC/MS/MS and problems highlighted. Urine samples screened positive for opiates by immunoassay were subjected to confirmation by LC/MS/MS using multiple reaction monitoring (MRM) and two separate buffer systems of pH 6.8 and 8.0, respectively. The EU criteria for compound identification were applied for confirmation of morphine, 6-monoacetylmorphine (6MAM), codeine and dihydrocodeine (DHC). Using the pH 6.8 buffer, confirmation could be achieved for 84%, 94%, 96% and 95%, respectively, for samples demonstrating MRM chromatographic peaks at retention times for morphine, 6MAM, codeine and DHC. Failure to meet the EU criteria was mainly attributed to low signal-to-noise (S:N) ratios or excessively high drug concentrations. Isobaric interferences and poor chromatography were also contributing factors. The identification of morphine was considerably improved with chromatography at pH 8.0 owing to resolution of interferences. Oxycodone metabolites were a potential problem for the identification of DHC. Isobaric interferences can pose a problem with drug identification using LC/MS/MS. Optimizing chromatographic conditions is important to overcome these interferences. Consideration needs to be given to investigating drug metabolites as well as parent drugs in method development.

Palliative Care Processes Embedded in the ICU Workflow May Reserve Palliative Care Teams for Refractory Cases.

PubMed

Mun, Eluned; Umbarger, Lillian; Ceria-Ulep, Clementina; Nakatsuka, Craig

2018-01-01

Palliative Care Teams have been shown to be instrumental in the early identification of multiple aspects of advanced care planning. Despite an increased number of services to meet the rising consultation demand, it is conceivable that the numbers of palliative care consultations generated from an ICU alone could become overwhelming for an existing palliative care team. Improve end-of-life care in the ICU by incorporating basic palliative care processes into the daily routine ICU workflow, thereby reserving the palliative care team for refractory situations. A structured, palliative care, quality-improvement program was implemented and evaluated in the ICU at Kaiser Permanente Medical Center in Hawaii. This included selecting trigger criteria, a care model, forming guidelines, and developing evaluation criteria. These included the early identification of the multiple features of advanced care planning, numbers of proactive ICU and palliative care family meetings, and changes in code status and treatment upon completion of either meeting. Early identification of Goals-of-Care, advance directives, and code status by the ICU staff led to a proactive ICU family meeting with resultant increases in changes in code status and treatment. The numbers of palliative care consultations also rose, but not significantly. Palliative care processes could be incorporated into a daily ICU workflow allowing for integration of aspects of advanced care planning to be identified in a systematic and proactive manner. This reserved the palliative care team for situations when palliative care efforts performed by the ICU staff were ineffective.

Multi-objective, multiple participant decision support for water management in the Andarax catchment, Almeria

NASA Astrophysics Data System (ADS)

van Cauwenbergh, N.; Pinte, D.; Tilmant, A.; Frances, I.; Pulido-Bosch, A.; Vanclooster, M.

2008-04-01

Water management in the Andarax river basin (Almeria, Spain) is a multi-objective, multi-participant, long-term decision-making problem that faces several challenges. Adequate water allocation needs informed decisions to meet increasing socio-economic demands while respecting the environmental integrity of this basin. Key players in the Andarax water sector include the municipality of Almeria, the irrigators involved in the intensive greenhouse agricultural sector, and booming second residences. A decision support system (DSS) is developed to rank different sustainable planning and management alternatives according to their socio-economic and environmental performance. The DSS is intimately linked to sustainability indicators and is designed through a public participation process. Indicators are linked to criteria reflecting stakeholders concerns in the 2005 field survey, such as fulfilling water demand, water price, technical and economical efficiency, social and environmental impacts. Indicators can be partly quantified after simulating the operation of the groundwater reservoir over a 20-year planning period and partly through a parallel expert evaluation process. To predict the impact of future water demand in the catchment, several development scenarios are designed to be evaluated in the DSS. The successive multi-criteria analysis of the performance indicators permits the ranking of the different management alternatives according to the multiple objectives formulated by the different sectors/participants. This allows more informed and transparent decision-making processes for the Andarax river basin, recognizing both the socio-economic and environmental dimensions of water resources management.

Evaluating mixed samples as a source of error in non-invasive genetic studies using microsatellites

USGS Publications Warehouse

Roon, David A.; Thomas, M.E.; Kendall, K.C.; Waits, L.P.

2005-01-01

The use of noninvasive genetic sampling (NGS) for surveying wild populations is increasing rapidly. Currently, only a limited number of studies have evaluated potential biases associated with NGS. This paper evaluates the potential errors associated with analysing mixed samples drawn from multiple animals. Most NGS studies assume that mixed samples will be identified and removed during the genotyping process. We evaluated this assumption by creating 128 mixed samples of extracted DNA from brown bear (Ursus arctos) hair samples. These mixed samples were genotyped and screened for errors at six microsatellite loci according to protocols consistent with those used in other NGS studies. Five mixed samples produced acceptable genotypes after the first screening. However, all mixed samples produced multiple alleles at one or more loci, amplified as only one of the source samples, or yielded inconsistent electropherograms by the final stage of the error-checking process. These processes could potentially reduce the number of individuals observed in NGS studies, but errors should be conservative within demographic estimates. Researchers should be aware of the potential for mixed samples and carefully design gel analysis criteria and error checking protocols to detect mixed samples.

Immunoglobulin A multiple myeloma with cutaneous involvement in a dog.

PubMed

Mayer, Monique N; Kerr, Moira E; Grier, Candace K; Macdonald, Valerie S

2008-07-01

An 8-year-old rottweiler, diagnosed with multiple myeloma and multiple sites of cutaneous involvement, was treated with chemotherapy and radiation therapy. The diagnostic criteria for canine multiple myeloma, limitations of diagnostic testing for light chain proteinuria in dogs, and the role of radiation therapy in multiple myeloma patients is discussed.

Immunoglobulin A multiple myeloma with cutaneous involvement in a dog

PubMed Central

Mayer, Monique N.; Kerr, Moira E.; Grier, Candace K.; MacDonald, Valerie S.

2008-01-01

An 8-year-old rottweiler, diagnosed with multiple myeloma and multiple sites of cutaneous involvement, was treated with chemotherapy and radiation therapy. The diagnostic criteria for canine multiple myeloma, limitations of diagnostic testing for light chain proteinuria in dogs, and the role of radiation therapy in multiple myeloma patients is discussed. PMID:18827847

Blind predictions of protein interfaces by docking calculations in CAPRI.

PubMed

Lensink, Marc F; Wodak, Shoshana J

2010-11-15

Reliable prediction of the amino acid residues involved in protein-protein interfaces can provide valuable insight into protein function, and inform mutagenesis studies, and drug design applications. A fast-growing number of methods are being proposed for predicting protein interfaces, using structural information, energetic criteria, or sequence conservation or by integrating multiple criteria and approaches. Overall however, their performance remains limited, especially when applied to nonobligate protein complexes, where the individual components are also stable on their own. Here, we evaluate interface predictions derived from protein-protein docking calculations. To this end we measure the overlap between the interfaces in models of protein complexes submitted by 76 participants in CAPRI (Critical Assessment of Predicted Interactions) and those of 46 observed interfaces in 20 CAPRI targets corresponding to nonobligate complexes. Our evaluation considers multiple models for each target interface, submitted by different participants, using a variety of docking methods. Although this results in a substantial variability in the prediction performance across participants and targets, clear trends emerge. Docking methods that perform best in our evaluation predict interfaces with average recall and precision levels of about 60%, for a small majority (60%) of the analyzed interfaces. These levels are significantly higher than those obtained for nonobligate complexes by most extant interface prediction methods. We find furthermore that a sizable fraction (24%) of the interfaces in models ranked as incorrect in the CAPRI assessment are actually correctly predicted (recall and precision ≥50%), and that these models contribute to 70% of the correct docking-based interface predictions overall. Our analysis proves that docking methods are much more successful in identifying interfaces than in predicting complexes, and suggests that these methods have an excellent potential of addressing the interface prediction challenge. © 2010 Wiley-Liss, Inc.

ACR Appropriateness Criteria® Multiple Gestations.

PubMed

Glanc, Phyllis; Nyberg, David A; Khati, Nadia J; Deshmukh, Sandeep Prakash; Dudiak, Kika M; Henrichsen, Tara Lynn; Poder, Liina; Shipp, Thomas D; Simpson, Lynn; Weber, Therese M; Zelop, Carolyn M

2017-11-01

Women with twin or higher-order pregnancies will typically have more ultrasound examinations than women with a singleton pregnancy. Most women will have at minimum a first trimester scan, a nuchal translucency evaluation scan, fetal anatomy scan at 18 to 22 weeks, and one or more scans in the third trimester to evaluate growth. Multiple gestations are at higher risk for preterm delivery, congenital anomalies, fetal growth restriction, placenta previa, vasa previa, and velamentous cord insertion. Chorionicity and amnionicity should be determined as early as possible when a twin pregnancy is identified to permit triage of the monochorionic group into a closer surveillance model. Screening for congenital heart disease is warranted in monochorionic twins because they have an increased rate of congenital cardiac anomalies. In addition, monochorionic twins have a higher risk of developing cardiac abnormalities in later gestation related to right ventricular outflow obstruction, in particular the subgroups with twin-twin transfusion syndrome or selective intrauterine growth restriction. Monochorionic twins have unique complications including twin-to-twin transfusion syndrome, twin embolization syndrome, and acardius, or twin-reversed arterial perfusion sequence. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Determining the cost of implementing and operating a remote patient monitoring programme for the elderly with chronic conditions: A systematic review of economic evaluations.

PubMed

Peretz, Daniel; Arnaert, Antonia; Ponzoni, Norma N

2018-01-01

Introduction Remote patient monitoring (RPM) in conjunction with home nursing visits is becoming increasingly popular for the follow-up of patients with chronic conditions and evidence exists that it improves patients' health outcomes. Current cost data is reported inconsistently and often gathered from studies of poor methodological quality, making it difficult for decision-makers who consider implementing this service in their organizations. This study reviewed the cost of RPM programmes targeting elderly patients with chronic conditions. Methods After evaluation against the inclusion and exclusion criteria and appraisal against two criteria which are important for economic evaluations, data from selected studies were extracted and grouped into meaningful cost categories, then adjusted to reflect November 2015 US dollars. Results In the 13 selected studies, the newly-created cost category 'Combined intervention cost' (reflecting equipment purchasing, servicing and monitoring cost) for the various RPM programmes ranged from US$275-US$7963 per patient per year. The three main findings are: (a) RPM programme costs have decreased since 2004 due to cheaper technology; (b) monitoring a single vital sign is likely to be less costly than monitoring multiple vital signs; and (c) programmes targeting hypertension or congestive heart failure are less costly than those targeting respiratory diseases or multiple conditions. Conclusions This review recommends that future studies present their cost data with more granularity, that grouping of costs should be minimized and that any assumptions, such as amortization, should be made explicit. In addition, studies should compare programmes with similar characteristics in terms of type of conditions, number of vital signs monitored, etc. for more generalizable results.

23 CFR 636.205 - Can past performance be used as an evaluation criteria?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Can past performance be used as an evaluation criteria... past performance be used as an evaluation criteria? (a) Yes, past performance information is one... used as an evaluation criteria in either phase-one or phase-two solicitations. If you elect to use past...

Narrowed indications improve outcomes for hip resurfacing arthroplasty.

PubMed

Johnson, Aaron J; Zywiel, Michael G; Hooper, Hassan; Mont, Michael A

2011-01-01

Hip resurfacing arthroplasty has had excellent clinical outcomes from multiple centers. However, controversy exists regarding the most appropriate patient selection criteria. Many proponents of hip resurfacing believe that narrowing the patient indications with strict inclusion and exclusion criteria may lead to improved outcomes and decreased complication rates. The purpose of this study was to review the results of resurfacing performed by an experienced surgeon to determine if implant survival and complication rates were different between subgroups of patients with different demographic factors. We evaluated 311 patients who had a hip resurfacing arthroplasty performed after the initial learning curve and who had a minimum follow-up of 5 years (mean, 93 months). These patients were compared to a group of 93 patients (96 hips) who underwent resurfacings, with newer selection criteria based on the findings of the first cohort. Overall, there were 10 failures in the first patient cohort (97% survivorship), compared to no failures in the second cohort. Higher revision rates were associated with patients who had osteonecrosis or rheumatoid arthritis. Patients who had femoral component sizes larger than 50 millimeters had lower revision rates. There were no revisions in patients who were under 50 years of age, had head sizes greater than 50 millimeters, and who had a primary diagnosis of osteoarthritis. After evaluating our initial experience after the learning curve, the ideal patient selection criteria was determined to be young males who have femoral head sizes greater than 50 millimeters. The early results are encouraging in that, although resurfacing may not be appropriate for all patients, it can provide predictable, excellent survivorship in these patients.

Evaluation of expert criteria for preoperative magnetic resonance imaging of newly diagnosed breast cancer.

PubMed

Behrendt, Carolyn E; Tumyan, Lusine; Gonser, Laura; Shaw, Sara L; Vora, Lalit; Paz, I Benjamin; Ellenhorn, Joshua D I; Yim, John H

2014-08-01

Despite 2 randomized trials reporting no reduction in operations or local recurrence at 1 year, preoperative magnetic resonance imaging (MRI) is increasingly used in diagnostic workup of breast cancer. We evaluated 5 utilization criteria recently proposed by experts. Of women (n = 340) newly diagnosed with unilateral breast cancer who underwent bilateral MRI, most (69.4%) met at least 1 criterion before MRI: mammographic density (44.4%), under consideration for partial breast irradiation (PBI) (19.7%), genetic-familial risk (12.9%), invasive lobular carcinoma (11.8%), and multifocal/multicentric disease (10.6%). MRI detected occult malignant lesion or extension of index lesion in 21.2% of index, 3.3% of contralateral, breasts. No expert criterion was associated with MRI-detected malignant lesion, which associated instead with pre-MRI plan of lumpectomy without PBI (48.2% of subjects): Odds Ratio 3.05, 95% CI 1.57-5.91 (p adjusted for multiple hypothesis testing = 0.007, adjusted for index-vs-contralateral breast and covariates). The expert guidelines were not confirmed by clinical evidence. Copyright © 2014 Elsevier Ltd. All rights reserved.

Performance evaluation of restaurant food waste and biowaste to biogas pilot projects in China and implications for national policy.

PubMed

De Clercq, Djavan; Wen, Zongguo; Fan, Fei

2017-03-15

The objective of this research was to conduct a performance evaluation of three food waste/biowaste-to-biogas pilot projects across 7 scenarios in China based on multi-criteria decision analysis (MCDA) methodology. The projects ranked included a food waste-biogas project in Beijing, a food waste-biogas project in Suzhou and a co-digestion project producing biomethane in Hainan. The projects were ranked from best to worst based on technical, economic and environmental criteria under the MCDA framework. The results demonstrated that some projects are encountering operational problems. Based on these findings, six national policy recommendations were provided: (1) shift away from capital investment subsidies to performance-based subsidies; (2) re-design feed in tariffs; (3) promote bio-methane and project clustering; (4) improve collection efficiency by incentivizing FW producers to direct waste to biogas projects; (5) incentivize biogas projects to produce multiple outputs; (6) incentivize food waste-based projects to co-digest food waste with other substrates for higher gas output. Copyright © 2016 Elsevier Ltd. All rights reserved.

Multi-output decision trees for lesion segmentation in multiple sclerosis

NASA Astrophysics Data System (ADS)

Jog, Amod; Carass, Aaron; Pham, Dzung L.; Prince, Jerry L.

2015-03-01

Multiple Sclerosis (MS) is a disease of the central nervous system in which the protective myelin sheath of the neurons is damaged. MS leads to the formation of lesions, predominantly in the white matter of the brain and the spinal cord. The number and volume of lesions visible in magnetic resonance (MR) imaging (MRI) are important criteria for diagnosing and tracking the progression of MS. Locating and delineating lesions manually requires the tedious and expensive efforts of highly trained raters. In this paper, we propose an automated algorithm to segment lesions in MR images using multi-output decision trees. We evaluated our algorithm on the publicly available MICCAI 2008 MS Lesion Segmentation Challenge training dataset of 20 subjects, and showed improved results in comparison to state-of-the-art methods. We also evaluated our algorithm on an in-house dataset of 49 subjects with a true positive rate of 0.41 and a positive predictive value 0.36.

Evaluation criteria for district health management information systems: lessons from the Ministry of Health, Kenya.

PubMed

Odhiambo-Otieno, George W

2005-01-01

There has been no comprehensive evaluation of the district health management information systems (DHMISs) since the establishment of these systems by the Ministry of Health (MoH), in Kenya. This is partly due to lack of defined criteria for evaluating the systems. The objective of this study is to design evaluation criteria for assessing the viability, sustainability and ultimate contribution of DHMIS in the management of the district health system (DHS) in Kenya. This descriptive cross-sectional study was undertaken in three DHSs in Kenya. Empirical evidence was collected through interviews, complemented by a comprehensive review of relevant literature, reports and operational manuals of various health information systems in Kenya. A set of evaluation criteria for DHMISs in Kenya was designed for each of the three phases of implementation: phase one-pre-implementation evaluation criteria (categorized as policy and objectives, technical feasibility, financial viability, political viability and administrative operability) to be applied at the design stage; phase two-concurrent (operational) implementation evaluation criteria to be applied during implementation of the new system; phase three-post-implementation evaluation criteria (classified as internal-quality of information; external-resources and managerial support; ultimate-systems impact) to be applied after operating the implemented system for at least 3 years. In designing a DHMIS model there is need to have built-in these three sets of evaluation criteria which should be used in a phased manner. Pre-implementation evaluation criteria should be used to evaluate the system's viability before more resources are committed to its implementation; concurrent (operational) implementation evaluation criteria should be used to ascertain the status of the on-going implementation with the view to either fine-tune or abandon it altogether before more resources are used on it; and post-implementation evaluation criteria should be used to assess its overall effectiveness (if it has achieved its hypothesized benefits) towards the management of DHS.

Evaluation of multiple comparison correction procedures in drug assessment studies using LORETA maps.

PubMed

Alonso, Joan Francesc; Romero, Sergio; Mañanas, Miguel Ángel; Rojas, Mónica; Riba, Jordi; Barbanoj, Manel José

2015-10-01

The identification of the brain regions involved in the neuropharmacological action is a potential procedure for drug development. These regions are commonly determined by the voxels showing significant statistical differences after comparing placebo-induced effects with drug-elicited effects. LORETA is an electroencephalography (EEG) source imaging technique frequently used to identify brain structures affected by the drug. The aim of the present study was to evaluate different methods for the correction of multiple comparisons in the LORETA maps. These methods which have been commonly used in neuroimaging and also simulated studies have been applied on a real case of pharmaco-EEG study where the effects of increasing benzodiazepine doses on the central nervous system measured by LORETA were investigated. Data consisted of EEG recordings obtained from nine volunteers who received single oral doses of alprazolam 0.25, 0.5, and 1 mg, and placebo in a randomized crossover double-blind design. The identification of active regions was highly dependent on the selected multiple test correction procedure. The combined criteria approach known as cluster mass was useful to reveal that increasing drug doses led to higher intensity and spread of the pharmacologically induced changes in intracerebral current density.

Uric acid, lung function, physical capacity and exacerbation frequency in patients with COPD: a multi-dimensional approach.

PubMed

Kahnert, Kathrin; Alter, Peter; Welte, Tobias; Huber, Rudolf M; Behr, Jürgen; Biertz, Frank; Watz, Henrik; Bals, Robert; Vogelmeier, Claus F; Jörres, Rudolf A

2018-06-04

Recent investigations showed single associations between uric acid levels, functional parameters, exacerbations and mortality in COPD patients. The aim of this study was to describe the role of uric acid within the network of multiple relationships between function, exacerbation and comorbidities. We used baseline data from the German COPD cohort COSYCONET which were evaluated by standard multiple regression analyses as well as path analysis to quantify the network of relations between parameters, particularly uric acid. Data from 1966 patients were analyzed. Uric acid was significantly associated with reduced FEV 1 , reduced 6-MWD, higher burden of exacerbations (GOLD criteria) and cardiovascular comorbidities, in addition to risk factors such as BMI and packyears. These associations remained significant after taking into account their multiple interdependences. Compared to uric acid levels the diagnosis of hyperuricemia and its medication played a minor role. Within the limits of a cross-sectional approach, our results strongly suggest that uric acid is a biomarker of high impact in COPD and plays a genuine role for relevant outcomes such as physical capacity and exacerbations. These findings suggest that more attention should be paid to uric acid in the evaluation of COPD disease status.

Non-stroke neurological syndromes associated with antiphospholipid antibodies: evaluation of clinical and experimental studies.

PubMed

Chapman, J; Rand, J H; Brey, R L; Levine, S R; Blatt, I; Khamashta, M A; Shoenfeld, Y

2003-01-01

Although many types of neurological disorders and events have been described in association with antiphospholipid antibodies (aPL) and the antiphospholipid syndrome (APS), only ischaemic stroke is reasonably well established and accepted as a diagnostic criterion for the syndrome. We propose to evaluate, classify and rank the association of other neurological manifestations as possible, probable, or definite according to the data available from clinical studies and animal models. By these criteria, none of the neurological disorders or events such as epilepsy, psychiatric disease, dementia, transverse myelitis, multiple sclerosis-like disease, chorea, migraine, Guillian-Barrè syndrome, and sensory-neural hearing loss, can be definitely associated with aPL or APS.

Evaluating Partnerships to Enhance Disaster Risk Management using Multi-Criteria Analysis: An Application at the Pan-European Level

NASA Astrophysics Data System (ADS)

Hochrainer-Stigler, Stefan; Lorant, Anna

2018-01-01

Disaster risk is increasingly recognized as a major development challenge. Recent calls emphasize the need to proactively engage in disaster risk reduction, as well as to establish new partnerships between private and public sector entities in order to decrease current and future risks. Very often such potential partnerships have to meet different objectives reflecting on the priorities of stakeholders involved. Consequently, potential partnerships need to be assessed on multiple criteria to determine weakest links and greatest threats in collaboration. This paper takes a supranational multi-sector partnership perspective, and considers possible ways to enhance disaster risk management in the European Union by better coordination between the European Union Solidarity Fund, risk reduction efforts, and insurance mechanisms. Based on flood risk estimates we employ a risk-layer approach to determine set of options for new partnerships and test them in a high-level workshop via a novel cardinal ranking based multi-criteria approach. Whilst transformative changes receive good overall scores, we also find that the incorporation of risk into budget planning is an essential condition for successful partnerships.

Photovoltaic system criteria documents. Volume 3: Environmental issues and evaluation criteria for photovoltaic applications

NASA Technical Reports Server (NTRS)

Koenig, John C.; Billitti, Joseph W.; Tallon, John M.

1979-01-01

The environmental issues and evaluation criteria relating to the suitability of sites proposed for photovoltaic (PV) system deployment are identified. The important issues are defined, briefly discussed and then developed into evaluation criteria. System designers are provided with information on the environmental sensitivity of PV systems in realistic applications, background material which indicates the applicability of the siting issues identified, and evaluation criteria are defined to facilitate the selection of sites that maximize PV system operation.

29 CFR 1926.1432 - Multiple-crane/derrick lifts-supplemental requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 8 2011-07-01 2011-07-01 false Multiple-crane/derrick lifts-supplemental requirements... Cranes and Derricks in Construction § 1926.1432 Multiple-crane/derrick lifts—supplemental requirements... implementation. (1) The multiple-crane/derrick lift must be directed by a person who meets the criteria for both...

Impact of radiotherapy in atypical meningioma recurrence: literature review.

PubMed

Pereira, Benedito Jamilson Araújo; de Almeida, Antônio Nogueira; Paiva, Wellingson Silva; Teixeira, Manoel Jacobsen; Marie, Suely Kazue Nagahashi

2018-03-19

Evaluate whether radiotherapy (RT) after the neurosurgical treatment of atypical meningiomas (AM) has an impact on the reduction rate of recurrence. A Medline search through October 2017 using "atypical meningioma" returned 1277 papers for initial review. Inclusion criteria were as follows. We analyzed the database and included articles in which the anatomic pathological classification of atypical meningiomas was in accordance with WHO 2007 or WHO 2016 criteria, patients > 18 years of age, and there was postoperative external beam radiation to the tumor bed. Exclusion criteria were WHO grade I or III meningioma, patients who underwent whole-brain radiation, RT used as salvage therapy for recurrence, palliative dose of RT (< 45 Gy), recurrent AMs, and multiple AMs. Papers reporting outcomes in which atypical and anaplastic meningiomas were analyzed together were rejected, as were papers with small samples that may compromise evaluation. After filtering our initial selection, only 17 papers were selected. After reviewing the seventeen articles including a total of 1761 patients (972 female and 799 male; 1.21 female/1.0 male), the difference in proportion of tumor recurrence between patients with and without radiotherapy after neurosurgical procedure was 1.0448, 95% CI [0.8318 to 1.3125], p value = 0.7062. On the basis of this review, there is no evidence to suggest that RT decreases the rate of recurrence in patients with atypical meningiomas.

Meta-Analysis of the Effect of Chest Shielding on Preventing Patent Ductus Arteriosus in Premature Infants.

PubMed

Mannan, Javed; Amin, Sanjiv B

2017-03-01

Objective  This study aims to perform a meta-analysis of randomized studies to evaluate if chest shielding during phototherapy is associated with decreased incidence of patent ductus arteriosus (PDA) in premature infants. Design/Methods  We used published guidelines for the meta-analysis of clinical trials. The search strategy included electronic searches of CINAHL, CENTRAL Cochrane Library, MEDLINE, PubMed, and abstracts presented at the Pediatric Academic Societies. Inclusion criteria were randomized controlled trials (RCTs), quasi-RCTs or cluster RCTs published in English and involving chest shielding during phototherapy in premature infants with PDA as an outcome. Exclusion criteria involved case reports, case series, and multiple publications from the same author. Heterogeneity testing using Q statistics was performed to evaluate the variance between studies. Results  Two RCTs met study criteria. There was heterogeneity (I 2 : 55.4%) between the two trials. Meta-analysis of RCTs using the random effect model demonstrated that chest shielding during phototherapy was associated with decreased incidence of PDA (odds ratio: 0.47, 95% confidence interval: 0.23-0.96). There was no publication bias on Eggers test. Heterogeneity was seen in gestational age, gender, prophylactic use of postnatal indomethacin, duration of phototherapy, and assessment of PDA. Conclusion  Chest shielding during phototherapy may be associated with decreased incidence of PDA among premature infants. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Depression research methodologies in the Journal of Personality and Social Psychology: a review and critique.

PubMed

Tennen, H; Hall, J A; Affleck, G

1995-05-01

Personality and social psychological studies of depression and depressive phenomena have become more methodologically sophisticated in recent years. In response to earlier problems in this literature, investigators have formulated sound suggestions for research designs. Studies of depression published in the Journal of Personality and Social Psychology (JPSP) between 1988 and 1993 were reviewed to evaluate how well these recommendations have been followed. Forty-one articles were examined for adherence to 3 suggestions appearing consistently in the literature: (a) multiple assessment periods, (b) multiple assessment methods, and (c) appropriate comparison groups. The studies published in JPSP have not adhered well to these standards. The authors recommend resetting minimum methodological criteria for studies of depression published in the premier journal in personality and social psychology.

Evaluating the Impacts of Mangrove Rehabilitation in Cogtong Bay, Philippines

NASA Astrophysics Data System (ADS)

Maliao, Ronald J.; Polohan, Bernice B.

2008-03-01

Marine Protected Areas (MPAs) have been hailed worldwide as vehicles toward sustainable development (SD) in coastal zones. The prominent model by which MPAs operate is through a comanagement approach, a shift from traditional top-down management. This paradigm shift must be reviewed continuously to evaluate its social and ecological impacts, thereby allowing adaptive management. We evaluated the perceived impacts of the Cogtong Bay Mangrove Rehabilitation Project (CBMRP; Philippines) by using 12 perception indicators categorized into 3 comanagement impact criteria (equity, efficiency, and sustainability). We also collected 16 contextual attributes of each respondent to determine the correlates of perceived impacts. Our results showed that there were significant improvements in all indicators under the efficiency criterion but mixed impacts in the equity and sustainability criteria. Access to resource and household income (equity) and fisheries abundance (sustainability) were perceived to have decreased during the last 15 years and were not expected to improve in the future. Stepwise multiple regression analysis showed that the asymmetries of the perceived impacts of the CBMRP were principally caused by disparities in perceptions by gender and by location (Candijay and Mabini). This highlighted the importance of cross-scale institutional linkages between Cogtong Bay municipalities to systematically address baywide management issues. Our results further demonstrated the necessity of integrating gender issues into the evaluation of MPA impacts to ensure a robust evaluation. Finally, we recommend that a rigorous evaluation of MPAs using a common set of impact indicators should be encouraged to allow comparison of studies both spatially and temporally.

Multiple Criteria and Multiple Periods Performance Analysis: The Comparison of North African Railways

NASA Astrophysics Data System (ADS)

Sabri, Karim; Colson, Gérard E.; Mbangala, Augustin M.

2008-10-01

Multi-period differences of technical and financial performances are analysed by comparing five North African railways over the period (1990-2004). A first approach is based on the Malmquist DEA TFP index for measuring the total factors productivity change, decomposed into technical efficiency change and technological changes. A multiple criteria analysis is also performed using the PROMETHEE II method and the software ARGOS. These methods provide complementary detailed information, especially by discriminating the technological and management progresses by Malmquist and the two dimensions of performance by Promethee: that are the service to the community and the enterprises performances, often in conflict.

MR imaging with i.v. superparamagnetic iron oxide: efficacy in the detection of focal hepatic lesions.

PubMed

Winter, T C; Freeny, P C; Nghiem, H V; Mack, L A; Patten, R M; Thomas, C R; Elliott, S

1993-12-01

The purpose of this study was to evaluate the efficacy of superparmagnetic iron oxide (SPIO) in the detection of focal hepatic lesions on MR images. The study included 21 patients with 115 focal hepatic lesions and eight patients without focal hepatic lesions. T1- and T2-weighted MR images were obtained at 1.5 T before and 60 min after the end of injection of an SPIO agent. Contrast-enhanced CT scans were obtained in all patients within 10 days after MR imaging. The effect of SPIO on the signal intensity of the liver and spleen was assessed by using quantitative analysis of the region of interest. Efficacy was evaluated by using multiple criteria and unenhanced and SPIO-enhanced images. Evaluations included subjective assessment of image quality, counting the number of lesions detected, and statistical analysis of quantitative changes in the signal intensity of lesions and of normal liver. By all criteria, SPIO-enhanced T2-weighted MR images were superior to unenhanced T2-weighted images and to contrast-enhanced CT scans. Conversely, by all criteria, SPIO-enhanced T1-weighted MR images were worse than unenhanced T1-weighted images and contrast-enhanced CT scans. The mean lesion-to-liver contrast on T2-weighted images was 317% on unenhanced images and 1745% on SPIO-enhanced images. For T1-weighted, the mean contrast was 26% on unenhanced images and 18% on SPIO-enhanced images. SPIO is an efficacious contrast agent for the detection of focal hepatic lesions when T2-weighted MR images are used.

Clinical and quantitative analysis of patients with crowned dens syndrome.

PubMed

Takahashi, Teruyuki; Tamura, Masato; Takasu, Toshiaki; Kamei, Satoshi

2017-05-15

Crowned dens syndrome (CDS) is a radioclinical entity defined by calcium deposition on the transverse ligament of atlas (TLA). In this study, the novel semi-quantitative diagnostic criteria for CDS to evaluate the degree of calcification on TLA by cervical CT are proposed. From January 2010 to September 2014, 35 patients who were diagnosed with CDS by cervical CT were adopted as subjects in this study. Based on novel criteria, calcium deposition on TLA was classified into "Stage" and "Grade", to make a score, which was evaluated semi-quantitatively. The correlation between calcification score and CRP level or pain score, and the effects of treatments, such as NSAIDs and corticosteroids, were statistically analyzed. The total calcification score from added "Stage" and "Grade" scores demonstrated a significantly strong and linear correlation with CRP level (R 2 =0.823, **p<0.01). In the multiple comparison test for the treatment effects, significant improvement of the CRP level and pain score were demonstrated after corticosteroid therapy (**p<0.01) compared with NSAIDs. In the conditional logistic regression analysis, the rapid end of corticosteroid therapy was an independent risk factor for relapse of cervico-occipital pain [OR=50.761, *p=0.0419]. The degree of calcification on TLA evaluated by the novel semi-quantitative criteria significantly correlated with CRP level. In the treatment of CDS, it is recommended that a low dosage (15-30mg) of corticosteroids be used as first-line drugs rather than conventional NSAID therapy. Additionally, it is also recommended to gradually decrease the dosage of corticosteroids. Copyright © 2017 Elsevier B.V. All rights reserved.

Impacts of education level and employment status on health-related quality of life in multiple sclerosis patients.

PubMed

Šabanagić-Hajrić, Selma; Alajbegović, Azra

2015-02-01

To evaluate the impacts of education level and employment status on health-related quality of life (HRQoL) in multiple sclerosis patients. This study included 100 multiple sclerosis patients treated at the Department of Neurology, Clinical Center of the University of Sarajevo. Inclusion criteria were the Expanded Disability Status Scale (EDSS) score between 1.0 and 6.5, age between 18 and 65 years, stable disease on enrollment. Quality of life (QoL) was evaluated by the Multiple Sclerosis Quality of Life-54 questionnaire (MSQoL-54). Mann-Whitney and Kruskal-Wallis test were used for comparisons. Linear regression analyses were performed to evaluate prediction value of educational level and employment status in predicting MSQOL-54 physical and mental composite scores. Full employment status had positive impact on physical health (54.85 vs. 37.90; p les than 0.001) and mental health (59.55 vs. 45.90; p les than 0.001) composite scores. Employment status retained its independent predictability for both physical (r(2)=0.105) and mental (r(2)=0.076) composite scores in linear regression analysis. Patients with college degree had slightly higher median value of physical (49.36 vs. 45.30) and mental health composite score (66.74 vs. 55.62) comparing to others, without statistically significant difference. Employment proved to be an important factor in predicting quality of life in multiple sclerosis patients. Higher education level may determine better QOL but without significant predictive value. Sustained employment and development of vocational rehabilitation programs for MS patients living in the country with high unemployment level is an important factor in improving both physical and mental health outcomes in MS patients.

[Magnetic Resonance Imaging Conversion Predictors of Clinically Isolated Syndrome to Multiple Sclerosis].

PubMed

Peixoto, Sara; Abreu, Pedro

2016-11-01

Clinically isolated syndrome may be the first manifestation of multiple sclerosis, a chronic demyelinating disease of the central nervous system, and it is defined by a single clinical episode suggestive of demyelination. However, patients with this syndrome, even with long term follow up, may not develop new symptoms or demyelinating lesions that fulfils multiple sclerosis diagnostic criteria. We reviewed, in clinically isolated syndrome, what are the best magnetic resonance imaging findings that may predict its conversion to multiple sclerosis. A search was made in the PubMed database for papers published between January 2010 and June 2015 using the following terms: 'clinically isolated syndrome', 'cis', 'multiple sclerosis', 'magnetic resonance imaging', 'magnetic resonance' and 'mri'. In this review, the following conventional magnetic resonance imaging abnormalities found in literature were included: lesion load, lesion location, Barkhof's criteria and brain atrophy related features. The non conventional magnetic resonance imaging techniques studied were double inversion recovery, magnetization transfer imaging, spectroscopy and diffusion tensor imaging. The number and location of demyelinating lesions have a clear role in predicting clinically isolated syndrome conversion to multiple sclerosis. On the other hand, more data are needed to confirm the ability to predict this disease development of non conventional techniques and remaining neuroimaging abnormalities. In forthcoming years, in addition to the established predictive value of the above mentioned neuroimaging abnormalities, different clinically isolated syndrome neuroradiological findings may be considered in multiple sclerosis diagnostic criteria and/or change its treatment recommendations.

Evaluation criteria for commercially oriented materials processing in space proposals

NASA Technical Reports Server (NTRS)

Moore, W. F.; Mcdowell, J. R.

1979-01-01

An approach and criteria for evaluating NASA funded experiments and demonstrations which have commercial potential were developed. Methods for insuring quick initial screening of commercial proposals are presented. Recommendations are given for modifying the current evaluation approach. New criteria for evaluating commercially orientated materials processing in space (MPS) proposals are introduced. The process for selection of qualified individuals to evaluate the phases of this approach and criteria is considered and guidelines are set for its implementation.

Physical activity and cognitive function in adults with multiple sclerosis: an integrative review.

PubMed

Morrison, Janet D; Mayer, Lori

2017-09-01

To identify and synthesize the research evidence concerning (1) the relationship between physical activity and cognitive performance in persons with multiple sclerosis (MS) and (2) to review the reported effects of physical activity interventions on neurocognitive performance conducted in this population. Relevant peer-reviewed journal articles were identified by searching PubMed, PsychINFO, and SPORTDiscus through May 2016. Full-text articles meeting the inclusion criteria were evaluated for quality using tools developed by the National Institutes of Health. Studies deemed to be of poor quality were excluded from the review. Nineteen studies meeting the inclusion/exclusion criteria were analyzed. Nine studies reported significant relationships between higher levels of physical activity or cardiorespiratory fitness and measures of cognitive function. Data extracted from 10 physical activity intervention studies reported mixed results on the effectiveness of physical activity to improve selected domains of cognitive function in persons with MS. Although correlational studies provide evidence to support a linkage between physical activity and cognitive function in persons with MS, this linkage is confounded by factors that may have influenced the studies' results. Evidence derived from intervention studies that could support a positive effect of physical activity on cognition in persons with MS is equivocal. Implications for Rehabilitation Physical activity has numerous benefits for persons with multiple sclerosis (MS) including improvements in balance, ambulation, depression, fatigue, and quality of life. Structured physical activity programs may contribute to cognitive function stability or improvement in persons with MS.

Mental health courts and their selection processes: modeling variation for consistency.

PubMed

Wolff, Nancy; Fabrikant, Nicole; Belenko, Steven

2011-10-01

Admission into mental health courts is based on a complicated and often variable decision-making process that involves multiple parties representing different expertise and interests. To the extent that eligibility criteria of mental health courts are more suggestive than deterministic, selection bias can be expected. Very little research has focused on the selection processes underpinning problem-solving courts even though such processes may dominate the performance of these interventions. This article describes a qualitative study designed to deconstruct the selection and admission processes of mental health courts. In this article, we describe a multi-stage, complex process for screening and admitting clients into mental health courts. The selection filtering model that is described has three eligibility screening stages: initial, assessment, and evaluation. The results of this study suggest that clients selected by mental health courts are shaped by the formal and informal selection criteria, as well as by the local treatment system.

Clustering and group selection of multiple criteria alternatives with application to space-based networks.

PubMed

Malakooti, Behnam; Yang, Ziyong

2004-02-01

In many real-world problems, the range of consequences of different alternatives are considerably different. In addition, sometimes, selection of a group of alternatives (instead of only one best alternative) is necessary. Traditional decision making approaches treat the set of alternatives with the same method of analysis and selection. In this paper, we propose clustering alternatives into different groups so that different methods of analysis, selection, and implementation for each group can be applied. As an example, consider the selection of a group of functions (or tasks) to be processed by a group of processors. The set of tasks can be grouped according to their similar criteria, and hence, each cluster of tasks to be processed by a processor. The selection of the best alternative for each clustered group can be performed using existing methods; however, the process of selecting groups is different than the process of selecting alternatives within a group. We develop theories and procedures for clustering discrete multiple criteria alternatives. We also demonstrate how the set of alternatives is clustered into mutually exclusive groups based on 1) similar features among alternatives; 2) ideal (or most representative) alternatives given by the decision maker; and 3) other preferential information of the decision maker. The clustering of multiple criteria alternatives also has the following advantages. 1) It decreases the set of alternatives to be considered by the decision maker (for example, different decision makers are assigned to different groups of alternatives). 2) It decreases the number of criteria. 3) It may provide a different approach for analyzing multiple decision makers problems. Each decision maker may cluster alternatives differently, and hence, clustering of alternatives may provide a basis for negotiation. The developed approach is applicable for solving a class of telecommunication networks problems where a set of objects (such as routers, processors, or intelligent autonomous vehicles) are to be clustered into similar groups. Objects are clustered based on several criteria and the decision maker's preferences.

International Association of Diabetes and Pregnancy Study Group criteria is suitable for gestational diabetes mellitus diagnosis: further evidence from China.

PubMed

Wei, Yumei; Yang, Huixia; Zhu, Weiwei; Yang, Hongyun; Li, Haixia; Yan, Jie; Zhang, Cuilin

2014-01-01

The International Association of Diabetes and Pregnancy Study Group (IADPSG) recommended new diagnostic criteria for gestational diabetes mellitus (GDM) after extensive analyses of the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study. Unfortunately, there was no data from mainland of China in this study. We evaluated the feasibility of IADPSG criteria for GDM diagnosis in China. A large prospective study was conducted. We reviewed medical records of a total of 25 674 pregnant women who underwent GDM screening and diagnosis between January 1, 2005 and December 31, 2012 in the Peking University First Hospital. The prevalence of gestational glucose metabolism abnormalities was calculated according to different cut off values defined by the National Diabetes Data Group (NDDG) or the IADPSG, and the incidence of adverse pregnancy outcomes related to GDM was analyzed. According to the cut off values of NDDG and IADPSG criteria, the prevalence of gestational glucose metabolism abnormalities was 8.4% and 18.9% (P < 0.01) respectively, and the prevalence of cesarean section (52.5% vs. 46.0%, P < 0.01), macrosomia (7.5% vs. 6.3%, P < 0.05), neonatal hypoglycemia (1.6% vs. 1.0%, P < 0.01), and perinatal death (0.5% vs. 0.2%, P < 0.01); the prevalence was significantly lower when IADPSG criteria were applied. The prevalence of macrosomia, cesarean section, neonatal hypoglycemia, pregnancy induced hypertension, etc. was also higher in the GDM group than in the normal group. The prevalence of cesarean section (62.3%) and macrosomia (14.8%) was the highest in untreated mild GDM patients. Our results indicated that treatment/intervention of women with GDM identified by IADPSG criteria was related to significantly lower risk of multiple adverse pregnancy outcomes. Such findings provide support for applying IADPSG criteria in China.

7 CFR 4290.370 - Evaluation criteria.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 15 2011-01-01 2011-01-01 false Evaluation criteria. 4290.370 Section 4290.370... Evaluation and Selection of RBICs § 4290.370 Evaluation criteria. Of those Applicants whose management team... following criteria— (a) Whether the Applicant's management team has the knowledge, experience, and...

Toward optimizing patient-specific IMRT QA techniques in the accurate detection of dosimetrically acceptable and unacceptable patient plans

PubMed Central

McKenzie, Elizabeth M.; Balter, Peter A.; Stingo, Francesco C.; Jones, Jimmy; Followill, David S.; Kry, Stephen F.

2014-01-01

Purpose: The authors investigated the performance of several patient-specific intensity-modulated radiation therapy (IMRT) quality assurance (QA) dosimeters in terms of their ability to correctly identify dosimetrically acceptable and unacceptable IMRT patient plans, as determined by an in-house-designed multiple ion chamber phantom used as the gold standard. A further goal was to examine optimal threshold criteria that were consistent and based on the same criteria among the various dosimeters. Methods: The authors used receiver operating characteristic (ROC) curves to determine the sensitivity and specificity of (1) a 2D diode array undergoing anterior irradiation with field-by-field evaluation, (2) a 2D diode array undergoing anterior irradiation with composite evaluation, (3) a 2D diode array using planned irradiation angles with composite evaluation, (4) a helical diode array, (5) radiographic film, and (6) an ion chamber. This was done with a variety of evaluation criteria for a set of 15 dosimetrically unacceptable and 9 acceptable clinical IMRT patient plans, where acceptability was defined on the basis of multiple ion chamber measurements using independent ion chambers and a phantom. The area under the curve (AUC) on the ROC curves was used to compare dosimeter performance across all thresholds. Optimal threshold values were obtained from the ROC curves while incorporating considerations for cost and prevalence of unacceptable plans. Results: Using common clinical acceptance thresholds, most devices performed very poorly in terms of identifying unacceptable plans. Grouping the detector performance based on AUC showed two significantly different groups. The ion chamber, radiographic film, helical diode array, and anterior-delivered composite 2D diode array were in the better-performing group, whereas the anterior-delivered field-by-field and planned gantry angle delivery using the 2D diode array performed less well. Additionally, based on the AUCs, there was no significant difference in the performance of any device between gamma criteria of 2%/2 mm, 3%/3 mm, and 5%/3 mm. Finally, optimal cutoffs (e.g., percent of pixels passing gamma) were determined for each device and while clinical practice commonly uses a threshold of 90% of pixels passing for most cases, these results showed variability in the optimal cutoff among devices. Conclusions: IMRT QA devices have differences in their ability to accurately detect dosimetrically acceptable and unacceptable plans. Field-by-field analysis with a MapCheck device and use of the MapCheck with a MapPhan phantom while delivering at planned rotational gantry angles resulted in a significantly poorer ability to accurately sort acceptable and unacceptable plans compared with the other techniques examined. Patient-specific IMRT QA techniques in general should be thoroughly evaluated for their ability to correctly differentiate acceptable and unacceptable plans. Additionally, optimal agreement thresholds should be identified and used as common clinical thresholds typically worked very poorly to identify unacceptable plans. PMID:25471949

Toward optimizing patient-specific IMRT QA techniques in the accurate detection of dosimetrically acceptable and unacceptable patient plans.

PubMed

McKenzie, Elizabeth M; Balter, Peter A; Stingo, Francesco C; Jones, Jimmy; Followill, David S; Kry, Stephen F

2014-12-01

The authors investigated the performance of several patient-specific intensity-modulated radiation therapy (IMRT) quality assurance (QA) dosimeters in terms of their ability to correctly identify dosimetrically acceptable and unacceptable IMRT patient plans, as determined by an in-house-designed multiple ion chamber phantom used as the gold standard. A further goal was to examine optimal threshold criteria that were consistent and based on the same criteria among the various dosimeters. The authors used receiver operating characteristic (ROC) curves to determine the sensitivity and specificity of (1) a 2D diode array undergoing anterior irradiation with field-by-field evaluation, (2) a 2D diode array undergoing anterior irradiation with composite evaluation, (3) a 2D diode array using planned irradiation angles with composite evaluation, (4) a helical diode array, (5) radiographic film, and (6) an ion chamber. This was done with a variety of evaluation criteria for a set of 15 dosimetrically unacceptable and 9 acceptable clinical IMRT patient plans, where acceptability was defined on the basis of multiple ion chamber measurements using independent ion chambers and a phantom. The area under the curve (AUC) on the ROC curves was used to compare dosimeter performance across all thresholds. Optimal threshold values were obtained from the ROC curves while incorporating considerations for cost and prevalence of unacceptable plans. Using common clinical acceptance thresholds, most devices performed very poorly in terms of identifying unacceptable plans. Grouping the detector performance based on AUC showed two significantly different groups. The ion chamber, radiographic film, helical diode array, and anterior-delivered composite 2D diode array were in the better-performing group, whereas the anterior-delivered field-by-field and planned gantry angle delivery using the 2D diode array performed less well. Additionally, based on the AUCs, there was no significant difference in the performance of any device between gamma criteria of 2%/2 mm, 3%/3 mm, and 5%/3 mm. Finally, optimal cutoffs (e.g., percent of pixels passing gamma) were determined for each device and while clinical practice commonly uses a threshold of 90% of pixels passing for most cases, these results showed variability in the optimal cutoff among devices. IMRT QA devices have differences in their ability to accurately detect dosimetrically acceptable and unacceptable plans. Field-by-field analysis with a MapCheck device and use of the MapCheck with a MapPhan phantom while delivering at planned rotational gantry angles resulted in a significantly poorer ability to accurately sort acceptable and unacceptable plans compared with the other techniques examined. Patient-specific IMRT QA techniques in general should be thoroughly evaluated for their ability to correctly differentiate acceptable and unacceptable plans. Additionally, optimal agreement thresholds should be identified and used as common clinical thresholds typically worked very poorly to identify unacceptable plans.

Aberrant gene promoter methylation associated with sporadic multiple colorectal cancer.

PubMed

Gonzalo, Victoria; Lozano, Juan José; Muñoz, Jenifer; Balaguer, Francesc; Pellisé, Maria; Rodríguez de Miguel, Cristina; Andreu, Montserrat; Jover, Rodrigo; Llor, Xavier; Giráldez, M Dolores; Ocaña, Teresa; Serradesanferm, Anna; Alonso-Espinaco, Virginia; Jimeno, Mireya; Cuatrecasas, Miriam; Sendino, Oriol; Castellví-Bel, Sergi; Castells, Antoni

2010-01-19

Colorectal cancer (CRC) multiplicity has been mainly related to polyposis and non-polyposis hereditary syndromes. In sporadic CRC, aberrant gene promoter methylation has been shown to play a key role in carcinogenesis, although little is known about its involvement in multiplicity. To assess the effect of methylation in tumor multiplicity in sporadic CRC, hypermethylation of key tumor suppressor genes was evaluated in patients with both multiple and solitary tumors, as a proof-of-concept of an underlying epigenetic defect. We examined a total of 47 synchronous/metachronous primary CRC from 41 patients, and 41 gender, age (5-year intervals) and tumor location-paired patients with solitary tumors. Exclusion criteria were polyposis syndromes, Lynch syndrome and inflammatory bowel disease. DNA methylation at the promoter region of the MGMT, CDKN2A, SFRP1, TMEFF2, HS3ST2 (3OST2), RASSF1A and GATA4 genes was evaluated by quantitative methylation specific PCR in both tumor and corresponding normal appearing colorectal mucosa samples. Overall, patients with multiple lesions exhibited a higher degree of methylation in tumor samples than those with solitary tumors regarding all evaluated genes. After adjusting for age and gender, binomial logistic regression analysis identified methylation of MGMT2 (OR, 1.48; 95% CI, 1.10 to 1.97; p = 0.008) and RASSF1A (OR, 2.04; 95% CI, 1.01 to 4.13; p = 0.047) as variables independently associated with tumor multiplicity, being the risk related to methylation of any of these two genes 4.57 (95% CI, 1.53 to 13.61; p = 0.006). Moreover, in six patients in whom both tumors were available, we found a correlation in the methylation levels of MGMT2 (r = 0.64, p = 0.17), SFRP1 (r = 0.83, 0.06), HPP1 (r = 0.64, p = 0.17), 3OST2 (r = 0.83, p = 0.06) and GATA4 (r = 0.6, p = 0.24). Methylation in normal appearing colorectal mucosa from patients with multiple and solitary CRC showed no relevant difference in any evaluated gene. These results provide a proof-of-concept that gene promoter methylation is associated with tumor multiplicity. This underlying epigenetic defect may have noteworthy implications in the prevention of patients with sporadic CRC.

Design, implementation and multisite evaluation of a system suitability protocol for the quantitative assessment of instrument performance in liquid chromatography-multiple reaction monitoring-MS (LC-MRM-MS).

PubMed

Abbatiello, Susan E; Mani, D R; Schilling, Birgit; Maclean, Brendan; Zimmerman, Lisa J; Feng, Xingdong; Cusack, Michael P; Sedransk, Nell; Hall, Steven C; Addona, Terri; Allen, Simon; Dodder, Nathan G; Ghosh, Mousumi; Held, Jason M; Hedrick, Victoria; Inerowicz, H Dorota; Jackson, Angela; Keshishian, Hasmik; Kim, Jong Won; Lyssand, John S; Riley, C Paige; Rudnick, Paul; Sadowski, Pawel; Shaddox, Kent; Smith, Derek; Tomazela, Daniela; Wahlander, Asa; Waldemarson, Sofia; Whitwell, Corbin A; You, Jinsam; Zhang, Shucha; Kinsinger, Christopher R; Mesri, Mehdi; Rodriguez, Henry; Borchers, Christoph H; Buck, Charles; Fisher, Susan J; Gibson, Bradford W; Liebler, Daniel; Maccoss, Michael; Neubert, Thomas A; Paulovich, Amanda; Regnier, Fred; Skates, Steven J; Tempst, Paul; Wang, Mu; Carr, Steven A

2013-09-01

Multiple reaction monitoring (MRM) mass spectrometry coupled with stable isotope dilution (SID) and liquid chromatography (LC) is increasingly used in biological and clinical studies for precise and reproducible quantification of peptides and proteins in complex sample matrices. Robust LC-SID-MRM-MS-based assays that can be replicated across laboratories and ultimately in clinical laboratory settings require standardized protocols to demonstrate that the analysis platforms are performing adequately. We developed a system suitability protocol (SSP), which employs a predigested mixture of six proteins, to facilitate performance evaluation of LC-SID-MRM-MS instrument platforms, configured with nanoflow-LC systems interfaced to triple quadrupole mass spectrometers. The SSP was designed for use with low multiplex analyses as well as high multiplex approaches when software-driven scheduling of data acquisition is required. Performance was assessed by monitoring of a range of chromatographic and mass spectrometric metrics including peak width, chromatographic resolution, peak capacity, and the variability in peak area and analyte retention time (RT) stability. The SSP, which was evaluated in 11 laboratories on a total of 15 different instruments, enabled early diagnoses of LC and MS anomalies that indicated suboptimal LC-MRM-MS performance. The observed range in variation of each of the metrics scrutinized serves to define the criteria for optimized LC-SID-MRM-MS platforms for routine use, with pass/fail criteria for system suitability performance measures defined as peak area coefficient of variation <0.15, peak width coefficient of variation <0.15, standard deviation of RT <0.15 min (9 s), and the RT drift <0.5min (30 s). The deleterious effect of a marginally performing LC-SID-MRM-MS system on the limit of quantification (LOQ) in targeted quantitative assays illustrates the use and need for a SSP to establish robust and reliable system performance. Use of a SSP helps to ensure that analyte quantification measurements can be replicated with good precision within and across multiple laboratories and should facilitate more widespread use of MRM-MS technology by the basic biomedical and clinical laboratory research communities.

Design, Implementation and Multisite Evaluation of a System Suitability Protocol for the Quantitative Assessment of Instrument Performance in Liquid Chromatography-Multiple Reaction Monitoring-MS (LC-MRM-MS)*

PubMed Central

Abbatiello, Susan E.; Mani, D. R.; Schilling, Birgit; MacLean, Brendan; Zimmerman, Lisa J.; Feng, Xingdong; Cusack, Michael P.; Sedransk, Nell; Hall, Steven C.; Addona, Terri; Allen, Simon; Dodder, Nathan G.; Ghosh, Mousumi; Held, Jason M.; Hedrick, Victoria; Inerowicz, H. Dorota; Jackson, Angela; Keshishian, Hasmik; Kim, Jong Won; Lyssand, John S.; Riley, C. Paige; Rudnick, Paul; Sadowski, Pawel; Shaddox, Kent; Smith, Derek; Tomazela, Daniela; Wahlander, Asa; Waldemarson, Sofia; Whitwell, Corbin A.; You, Jinsam; Zhang, Shucha; Kinsinger, Christopher R.; Mesri, Mehdi; Rodriguez, Henry; Borchers, Christoph H.; Buck, Charles; Fisher, Susan J.; Gibson, Bradford W.; Liebler, Daniel; MacCoss, Michael; Neubert, Thomas A.; Paulovich, Amanda; Regnier, Fred; Skates, Steven J.; Tempst, Paul; Wang, Mu; Carr, Steven A.

2013-01-01

Multiple reaction monitoring (MRM) mass spectrometry coupled with stable isotope dilution (SID) and liquid chromatography (LC) is increasingly used in biological and clinical studies for precise and reproducible quantification of peptides and proteins in complex sample matrices. Robust LC-SID-MRM-MS-based assays that can be replicated across laboratories and ultimately in clinical laboratory settings require standardized protocols to demonstrate that the analysis platforms are performing adequately. We developed a system suitability protocol (SSP), which employs a predigested mixture of six proteins, to facilitate performance evaluation of LC-SID-MRM-MS instrument platforms, configured with nanoflow-LC systems interfaced to triple quadrupole mass spectrometers. The SSP was designed for use with low multiplex analyses as well as high multiplex approaches when software-driven scheduling of data acquisition is required. Performance was assessed by monitoring of a range of chromatographic and mass spectrometric metrics including peak width, chromatographic resolution, peak capacity, and the variability in peak area and analyte retention time (RT) stability. The SSP, which was evaluated in 11 laboratories on a total of 15 different instruments, enabled early diagnoses of LC and MS anomalies that indicated suboptimal LC-MRM-MS performance. The observed range in variation of each of the metrics scrutinized serves to define the criteria for optimized LC-SID-MRM-MS platforms for routine use, with pass/fail criteria for system suitability performance measures defined as peak area coefficient of variation <0.15, peak width coefficient of variation <0.15, standard deviation of RT <0.15 min (9 s), and the RT drift <0.5min (30 s). The deleterious effect of a marginally performing LC-SID-MRM-MS system on the limit of quantification (LOQ) in targeted quantitative assays illustrates the use and need for a SSP to establish robust and reliable system performance. Use of a SSP helps to ensure that analyte quantification measurements can be replicated with good precision within and across multiple laboratories and should facilitate more widespread use of MRM-MS technology by the basic biomedical and clinical laboratory research communities. PMID:23689285

Health Benefits of Digital Videogames for Older Adults: A Systematic Review of the Literature.

PubMed

Hall, Amanda K; Chavarria, Enmanuel; Maneeratana, Vasana; Chaney, Beth H; Bernhardt, Jay M

2012-12-01

This article is a systematic review conducted of the research literature on digital videogames played by older adults and health outcomes associated with game play. Findings from each study meeting the inclusion criteria were analyzed and summarized into emergent themes to determine the impact of digital games in promoting healthy behaviors among older adults. A systematic review of the research literature was conducted through multiple academic databases for works, published between the years 2000 and 2011, looking at digital videogame interventions with adults 65 years of age and older. Multiple combinations of search terms and Boolean operators relevant to digital videogames and older adults were queried. A criteria matrix was created to code and evaluate studies. Thirteen studies met specific criteria for inclusion and were analyzed in the final review. Significant mental, physical, and social health factors, type of digital game platform, study design, and measurements are among emergent themes summarized from the reviewed research literature. Significant mental health outcomes of digital game interventions were found in the majority of the reviewed studies, followed by physical and lastly social health outcomes in older adults. A majority of the studies revealed significant positive effects on health outcomes associated with digital videogame play among older adults. With current advancements in technology, including advanced motion sensing, digital game platforms have significant potential for positive health impact among older populations. More robust and rigorous research designs are needed to increase validity and reliability of results and establish stronger causal relationships on the health benefits of digital videogame play for older adults.

Diagnosis and treatment of dementia: 2. Diagnosis

PubMed Central

Feldman, Howard H.; Jacova, Claudia; Robillard, Alain; Garcia, Angeles; Chow, Tiffany; Borrie, Michael; Schipper, Hyman M.; Blair, Mervin; Kertesz, Andrew; Chertkow, Howard

2008-01-01

Background Dementia can now be accurately diagnosed through clinical evaluation, cognitive screening, basic laboratory evaluation and structural imaging. A large number of ancillary techniques are also available to aid in diagnosis, but their role in the armamentarium of family physicians remains controversial. In this article, we provide physicians with practical guidance on the diagnosis of dementia based on recommendations from the Third Canadian Consensus Conference on the Diagnosis and Treatment of Dementia, held in March 2006. Methods We developed evidence-based guidelines using systematic literature searches, with specific criteria for study selection and quality assessment, and a clear and transparent decision-making process. We selected studies published from January 1996 to December 2005 that pertained to key diagnostic issues in dementia. We graded the strength of evidence using the criteria of the Canadian Task Force on Preventive Health Care. Results Of the 1591 articles we identified on all aspects of dementia diagnosis, 1095 met our inclusion criteria; 620 were deemed to be of good or fair quality. From a synthesis of the evidence in these studies, we made 32 recommendations related to the diagnosis of dementia. There are clinical criteria for diagnosing most forms of dementia. A standard diagnostic evaluation can be performd by family physicians over multiple visits. It involves a clinical history (from patient and caregiver), a physical examination and brief cognitive testing. A list of core laboratory tests is recommended. Structural imaging with computed tomography or magnetic resonance imaging is recommended in selected cases to rule out treatable causes of dementia or to rule in cerebrovascular disease. There is insufficient evidence to recommend routine functional imaging, measurement of biomarkers or neuropsychologic testing. Interpretation The diagnosis of dementia remains clinically integrative based on history, physical examination and brief cognitive testing. A number of core laboratory tests are also recommended. Structural neuroimaging is advised in selected cases. Other diagnostic approaches, including functional neuroimaging, neuropsychological testing and measurement of biomarkers, have shown promise but are not yet recommended for routine use by family physicians. PMID:18362376

Optimal site selection for sitting a solar park using multi-criteria decision analysis and geographical information systems

NASA Astrophysics Data System (ADS)

Georgiou, Andreas; Skarlatos, Dimitrios

2016-07-01

Among the renewable power sources, solar power is rapidly becoming popular because it is inexhaustible, clean, and dependable. It has also become more efficient since the power conversion efficiency of photovoltaic solar cells has increased. Following these trends, solar power will become more affordable in years to come and considerable investments are to be expected. Despite the size of solar plants, the sitting procedure is a crucial factor for their efficiency and financial viability. Many aspects influence such a decision: legal, environmental, technical, and financial to name a few. This paper describes a general integrated framework to evaluate land suitability for the optimal placement of photovoltaic solar power plants, which is based on a combination of a geographic information system (GIS), remote sensing techniques, and multi-criteria decision-making methods. An application of the proposed framework for the Limassol district in Cyprus is further illustrated. The combination of a GIS and multi-criteria methods produces an excellent analysis tool that creates an extensive database of spatial and non-spatial data, which will be used to simplify problems as well as solve and promote the use of multiple criteria. A set of environmental, economic, social, and technical constrains, based on recent Cypriot legislation, European's Union policies, and expert advice, identifies the potential sites for solar park installation. The pairwise comparison method in the context of the analytic hierarchy process (AHP) is applied to estimate the criteria weights in order to establish their relative importance in site evaluation. In addition, four different methods to combine information layers and check their sensitivity were used. The first considered all the criteria as being equally important and assigned them equal weight, whereas the others grouped the criteria and graded them according to their objective perceived importance. The overall suitability of the study region for sitting solar parks is appraised through the summation rule. Strict application of the framework depicts 3.0 % of the study region scoring a best-suitability index for solar resource exploitation, hence minimizing the risk in a potential investment. However, using different weighting schemes for criteria, suitable areas may reach up to 83 % of the study region. The suggested methodological framework applied can be easily utilized by potential investors and renewable energy developers, through a front end web-based application with proper GUI for personalized weighting schemes.

DISPOSITION PATHS FOR ROCKY FLATS GLOVEBOXES: EVALUATING OPTIONS

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

Lobdell, D.; Geimer, R.; Larsen, P.

2003-02-27

The Kaiser-Hill Company, LLC has the responsibility for closure activities at the Rocky Flats Environmental Technology Site (RFETS). One of the challenges faced for closure is the disposition of radiologically contaminated gloveboxes. Evaluation of the disposition options for gloveboxes included a detailed analysis of available treatment capabilities, disposal facilities, and lifecycle costs. The Kaiser-Hill Company, LLC followed several processes in determining how the gloveboxes would be managed for disposition. Currently, multiple disposition paths have been chosen to accommodate the needs of the varying styles and conditions of the gloveboxes, meet the needs of the decommissioning team, and to best managemore » lifecycle costs. Several challenges associated with developing a disposition path that addresses both the radiological and RCRA concerns as well as offering the most cost-effective solution were encountered. These challenges included meeting the radiological waste acceptance criteria of available disposal facilities, making a RCRA determination, evaluating treatment options and costs, addressing void requirements associated with disposal, and identifying packaging and transportation options. The varying disposal facility requirements affected disposition choices. Facility conditions that impacted decisions included radiological and chemical waste acceptance criteria, physical requirements, and measurement for payment options. The facility requirements also impacted onsite activities including management strategies, decontamination activities, and life-cycle cost.« less

Identification of key factors in consumers' adoption behavior of intelligent medical terminals based on a hybrid modified MADM model for product improvement.

PubMed

Liu, Yupeng; Chen, Yifei; Tzeng, Gwo-Hshiung

2017-09-01

As a new application technology of the Internet of Things (IoT), intelligent medical treatment has attracted the attention of both nations and industries through its promotion of medical informatisation, modernisation, and intelligentisation. Faced with a wide variety of intelligent medical terminals, consumers may be affected by various factors when making purchase decisions. To examine and evaluate the key influential factors (and their interrelationships) of consumer adoption behavior for improving and promoting intelligent medical terminals toward achieving set aspiration level in each dimension and criterion. A hybrid modified Multiple Attribute Decision-Making (MADM) model was used for this study, based on three components: (1) the Decision-Making Trial and Evaluation Laboratory (DEMATEL) technique, to build an influential network relationship map (INRM) at both 'dimensions' and 'criteria' levels; (2) the DEMATEL-based analytic network process (DANP) method, to determine the interrelationships and influential weights among the criteria and identify the source-influential factors; and (3) the modified Vlse Kriterijumska Optimizacija I Kompromisno Resenje (VIKOR) method, to evaluate and improve for reducing the performance gaps to meet the consumers' needs for continuous improvement and sustainable products-development. First, a consensus on the influential factors affecting consumers' adoption of intelligent medical terminals was collected from experts' opinion in practical experience. Next, the interrelationships and influential weights of DANP among dimensions/criteria based on the DEMATEL technique were determined. Finally, two intelligent medicine bottles (AdhereTech, A 1 alternative; and Audio/Visual Alerting Pillbox, A 2 alternative) were reviewed as the terminal devices to verify the accuracy of the MADM model and evaluate its performance on each criterion for improving the total certification gaps by systematics according to the modified VIKOR method based on an INRM. In this paper, the criteria and dimensions used to improve the evaluation framework are validated. The systematic evaluation in index system is constructed on the basis of five dimensions and corresponding ten criteria. Influential weights of all criteria ranges from 0.037 to 0.152, which shows the rank of criteria importance. The evaluative framework were validated synthetically and scientifically. INRM (influential network relation map) was obtained from experts' opinion through DEMATEL technique shows complex interrelationship among factors. At the dimension level, the environmental dimension influences other dimensions the most, whereas the security dimension is most influenced by others. So the improvement order of environmental dimension is prior to security dimension. The newly constructed approach was still further validated by the results of the empirical case, where performance gap improvement strategies were analyzed for decision-makers. The modified VIKOR method was especially validated for solving real-world problems in intelligent medical terminal improvement processes. For this paper, A 1 performs better than A 2 , however, promotion mix, brand factor, and market environment are shortcomings faced by both A 1 and A 2 . In addition, A 2 should be improved in the wireless network technology, and the objective contact with a high degree of gaps. Based on the evaluation index system and the integrated model proposed here, decision-makers in enterprises can identify gaps when promoting intelligent medical terminals, from which they can get valuable advice to improve consumer adoption. Additionally, an INRM and the influential weights of DANP can be combined using the modified VIKOR method as integrated weightings to determine how to reduce gaps and provide the best improvement strategies for reaching set aspiration levels. Copyright © 2017 Elsevier B.V. All rights reserved.

13 CFR 108.360 - Evaluation criteria.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Evaluation criteria. 108.360... (âNMVCâ) PROGRAM Evaluation and Selection of NMVC Companies § 108.360 Evaluation criteria. SBA will... criteria— (a) The quality of the Applicant's comprehensive business plan in terms of meeting the objectives...

43 CFR 2420.2 - Criteria.

Code of Federal Regulations, 2014 CFR

2014-10-01

... OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) MULTIPLE-USE MANAGEMENT CLASSIFICATIONS Criteria for...) Further the objectives of Federal natural resource legislation directed, among other things towards: (1...). (4) Realization of the beneficial utilization of the public lands through occupancy leases, such as...

43 CFR 2420.2 - Criteria.

Code of Federal Regulations, 2011 CFR

2011-10-01

... OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) MULTIPLE-USE MANAGEMENT CLASSIFICATIONS Criteria for...) Further the objectives of Federal natural resource legislation directed, among other things towards: (1...). (4) Realization of the beneficial utilization of the public lands through occupancy leases, such as...

43 CFR 2420.2 - Criteria.

Code of Federal Regulations, 2013 CFR

2013-10-01

... OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) MULTIPLE-USE MANAGEMENT CLASSIFICATIONS Criteria for...) Further the objectives of Federal natural resource legislation directed, among other things towards: (1...). (4) Realization of the beneficial utilization of the public lands through occupancy leases, such as...

43 CFR 2420.2 - Criteria.

Code of Federal Regulations, 2012 CFR

2012-10-01

... OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) MULTIPLE-USE MANAGEMENT CLASSIFICATIONS Criteria for...) Further the objectives of Federal natural resource legislation directed, among other things towards: (1...). (4) Realization of the beneficial utilization of the public lands through occupancy leases, such as...

Evaluation of trade-offs in costs and environmental impacts for returnable packaging implementation

NASA Astrophysics Data System (ADS)

Jarupan, Lerpong; Kamarthi, Sagar V.; Gupta, Surendra M.

2004-02-01

The main thrust of returnable packaging these days is to provide logistical services through transportation and distribution of products and be environmentally friendly. Returnable packaging and reverse logistics concepts have converged to mitigate the adverse effect of packaging materials entering the solid waste stream. Returnable packaging must be designed by considering the trade-offs between costs and environmental impact to satisfy manufacturers and environmentalists alike. The cost of returnable packaging entails such items as materials, manufacturing, collection, storage and disposal. Environmental impacts are explicitly linked with solid waste, air pollution, and water pollution. This paper presents a multi-criteria evaluation technique to assist decision-makers for evaluating the trade-offs in costs and environmental impact during the returnable packaging design process. The proposed evaluation technique involves a combination of multiple objective integer linear programming and analytic hierarchy process. A numerical example is used to illustrate the methodology.

7 CFR 1487.6 - What are the criteria for evaluating proposals?

Code of Federal Regulations, 2013 CFR

2013-01-01

... § 1487.6 What are the criteria for evaluating proposals? (a) Evaluation criteria. FAS will use the... representation. (b) Evaluation process. FAS will review all proposals for eligibility and completeness and will..., and submit the proposals and funding recommendations to appropriate officials within FAS for decision...

7 CFR 1487.6 - What are the criteria for evaluating proposals?

Code of Federal Regulations, 2012 CFR

2012-01-01

... § 1487.6 What are the criteria for evaluating proposals? (a) Evaluation criteria. FAS will use the... representation. (b) Evaluation process. FAS will review all proposals for eligibility and completeness and will..., and submit the proposals and funding recommendations to appropriate officials within FAS for decision...

7 CFR 1487.6 - What are the criteria for evaluating proposals?

Code of Federal Regulations, 2014 CFR

2014-01-01

... § 1487.6 What are the criteria for evaluating proposals? (a) Evaluation criteria. FAS will use the... representation. (b) Evaluation process. FAS will review all proposals for eligibility and completeness and will..., and submit the proposals and funding recommendations to appropriate officials within FAS for decision...

How Important are the Laws of Definite and Multiple Proportions in Chemistry and Teaching Chemistry? A History and Philosophy of Science Perspective

NASA Astrophysics Data System (ADS)

Niaz, Mansoor

The main objectives of this study are:(1) to elaborate a framework based on a rational reconstruction of developments that led to the formulation of the laws of definite and multiple proportions; (2) to ascertain students' views of the two laws; (3) to formulate criteria based on the framework for evaluating chemistry textbooks' treatment of the two laws; and (4) to provide a rationale for chemistry teachers to respond to the question: Can we teach chemistry without the laws of definite and multiple proportions? Results obtained show that most of the textbooks present the laws of definite and multiple proportions within an inductivist perspective, characterized by the following sequence: experimental findings showed that chemical elements combined in fixed/multiple proportions, followed by the formulation of the laws of definite and multiple proportions, and finally Dalton's atomic theory was postulated to explain the laws. Students were found to be reluctant to question the laws that they learnt as the building blocks of chemistry. It is concluded that by emphasizing the laws of definite and multiple proportions, textbooks inevitably endorse the dichotomy between theories and laws, which is questioned by philosophers of science (Lakatos 1970; Giere 1995a, b). An alternative approach is presented which shows that we can teach chemistry without the laws of definite and multiple proportions.

[Effects of nutritional status on the multiple sclerosis disease: systematic review].

PubMed

Ródenas Esteve, Irene; Wanden-Berghe, Carmina; Sanz-Valero, Javier

2018-01-19

To review the available scientific literature about the effects of nutritional status on the multiple sclerosis disease. A systematic review of the scientific literature in the Medline (PubMed), Scopus, Cochrane Library and Web of Science databases through November 2016. Search equation: ("Multiple Sclerosis"[Mesh] OR "Multiple Sclerosis"[Title/Abstract] OR "Disseminated Sclerosis"[Title/Abstract] OR "Multiple Sclerosis Acute Fulminating"[Title/Abstract]) AND ("Nutritional Status"[Mesh] OR "Nutritional Status"[Title/Abstract] OR "Nutrition Status"[Title/Abstract]). The quality of the selected articles was discussed using the STROBE questionnaire. The search was completed through experts inquiry and additional review of the bibliographic references included in the selected papers. The concordance between authors (Kappa index) had to be higher than 80% for inclusion in this review. Of the 160 references recovered, after applying inclusion and exclusion criteria, 29 articles were selected for review. Concordance between evaluators was 100.00%. The most studies established vitamin D levels. Others focused their research on finding out which nutrient deficits might be related to the multiple sclerosis development. Vitamin D may influence multiple sclerosis improvement. Sunlight and physical activity would be important factors, with nutritional status, in the course of this disease. It is necessary to produce new specific works that will delve into the subject to find out more about the relationship between nutritional status and multiple sclerosis.

An Examination of Fluoxetine for the Treatment of Selective Mutism Using a Nonconcurrent Multiple-Baseline Single-Case Design Across 5 Cases.

PubMed

Barterian, Justin A; Sanchez, Joel M; Magen, Jed; Siroky, Allison K; Mash, Brittany L; Carlson, John S

2018-01-01

This study examined the utility of fluoxetine in the treatment of 5 children, aged 5 to 14 years, diagnosed with selective mutism who also demonstrated symptoms of social anxiety. A nonconcurrent, randomized, multiple-baseline, single-case design with a single-blind placebo-controlled procedure was used. Parents and the study psychiatrist completed multiple methods of assessment including Direct Behavior Ratings and questionnaires. Treatment outcomes were evaluated by calculating effect sizes for each participant as an individual and for the participants as a group. Information regarding adverse effects with an emphasis on behavioral disinhibition and ratings of parental acceptance of the intervention was gathered. All 5 children experienced improvement in social anxiety, responsive speech, and spontaneous speech with medium to large effect sizes; however, children still met criteria for selective mutism at the end of the study. Adverse events were minimal, with only 2 children experiencing brief occurrences of minor behavioral disinhibition. Parents found the treatment highly acceptable.

Serum-free light-chain analysis in diagnosis and management of multiple myeloma and related conditions.

PubMed

Milani, Paolo; Palladini, Giovanni; Merlini, Giampaolo

2016-01-01

The introduction of the serum-free light-chain (S-FLC) assay has been a breakthrough in the diagnosis and management of plasma cell dyscrasias, particularly monoclonal light-chain diseases. The first method, proposed in 2001, quantifies serum-free light-chains using polyclonal antibodies. More recently, assays based on monoclonal antibodies have entered into clinical practice. S-FLC measurement plays a central role in the screening for multiple myeloma and related conditions, in association with electrophoretic techniques. Analysis of S-FLC is essential in assessing the risk of progression of precursor diseases to overt plasma cell dyscrasias. It is also useful for risk stratification in solitary plasmacytoma and AL amyloidosis. The S-FLC measurement is part of the new diagnostic criteria for multiple myeloma, and provides a marker to follow changes in clonal substructure over time. Finally, the evaluation of S-FLC is fundamental for assessing the response to treatment in monoclonal light chain diseases.

The use of multiple imputation for the accurate measurements of individual feed intake by electronic feeders.

PubMed

Jiao, S; Tiezzi, F; Huang, Y; Gray, K A; Maltecca, C

2016-02-01

Obtaining accurate individual feed intake records is the key first step in achieving genetic progress toward more efficient nutrient utilization in pigs. Feed intake records collected by electronic feeding systems contain errors (erroneous and abnormal values exceeding certain cutoff criteria), which are due to feeder malfunction or animal-feeder interaction. In this study, we examined the use of a novel data-editing strategy involving multiple imputation to minimize the impact of errors and missing values on the quality of feed intake data collected by an electronic feeding system. Accuracy of feed intake data adjustment obtained from the conventional linear mixed model (LMM) approach was compared with 2 alternative implementations of multiple imputation by chained equation, denoted as MI (multiple imputation) and MICE (multiple imputation by chained equation). The 3 methods were compared under 3 scenarios, where 5, 10, and 20% feed intake error rates were simulated. Each of the scenarios was replicated 5 times. Accuracy of the alternative error adjustment was measured as the correlation between the true daily feed intake (DFI; daily feed intake in the testing period) or true ADFI (the mean DFI across testing period) and the adjusted DFI or adjusted ADFI. In the editing process, error cutoff criteria are used to define if a feed intake visit contains errors. To investigate the possibility that the error cutoff criteria may affect any of the 3 methods, the simulation was repeated with 2 alternative error cutoff values. Multiple imputation methods outperformed the LMM approach in all scenarios with mean accuracies of 96.7, 93.5, and 90.2% obtained with MI and 96.8, 94.4, and 90.1% obtained with MICE compared with 91.0, 82.6, and 68.7% using LMM for DFI. Similar results were obtained for ADFI. Furthermore, multiple imputation methods consistently performed better than LMM regardless of the cutoff criteria applied to define errors. In conclusion, multiple imputation is proposed as a more accurate and flexible method for error adjustments in feed intake data collected by electronic feeders.

Crew Transportation Technical Standards and Design Evaluation Criteria

NASA Technical Reports Server (NTRS)

Lueders, Kathryn L.; Thomas, Rayelle E. (Compiler)

2015-01-01

Crew Transportation Technical Standards and Design Evaluation Criteria contains descriptions of technical, safety, and crew health medical processes and specifications, and the criteria which will be used to evaluate the acceptability of the Commercial Providers' proposed processes and specifications.

34 CFR 225.11 - What selection criteria does the Secretary use in evaluating an application for a Credit...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 1 2011-07-01 2011-07-01 false What selection criteria does the Secretary use in... Secretary Award a Grant? § 225.11 What selection criteria does the Secretary use in evaluating an... criteria to evaluate an application for a Credit Enhancement for Charter School Facilities grant: (a...

Integration of ecological-biological thresholds in conservation decision making.

PubMed

Mavrommati, Georgia; Bithas, Kostas; Borsuk, Mark E; Howarth, Richard B

2016-12-01

In the Anthropocene, coupled human and natural systems dominate and only a few natural systems remain relatively unaffected by human influence. On the one hand, conservation criteria based on areas of minimal human impact are not relevant to much of the biosphere. On the other hand, conservation criteria based on economic factors are problematic with respect to their ability to arrive at operational indicators of well-being that can be applied in practice over multiple generations. Coupled human and natural systems are subject to economic development which, under current management structures, tends to affect natural systems and cross planetary boundaries. Hence, designing and applying conservation criteria applicable in real-world systems where human and natural systems need to interact and sustainably coexist is essential. By recognizing the criticality of satisfying basic needs as well as the great uncertainty over the needs and preferences of future generations, we sought to incorporate conservation criteria based on minimal human impact into economic evaluation. These criteria require the conservation of environmental conditions such that the opportunity for intergenerational welfare optimization is maintained. Toward this end, we propose the integration of ecological-biological thresholds into decision making and use as an example the planetary-boundaries approach. Both conservation scientists and economists must be involved in defining operational ecological-biological thresholds that can be incorporated into economic thinking and reflect the objectives of conservation, sustainability, and intergenerational welfare optimization. © 2016 Society for Conservation Biology.

Modern status of photonuclear data

NASA Astrophysics Data System (ADS)

Varlamov, V. V.; Ishkhanov, B. S.

2017-09-01

The reliability of experimental cross sections obtained for (γ, 1 n), (γ, 2 n), and (γ, 3 n) partial photoneutron reactions using beams of quasimonoenergetic annihilation photons and bremsstrahlung is analyzed by employing data for a large number of medium-heavy and heavy nuclei, including those of 63,65Cu, 80Se, 90,91,94Zr, 115In, 112-124Sn, 133Cs, 138Ba, 159Tb, 181Ta, 186-192Os, 197Au, 208Pb, and 209Bi. The ratios of the cross sections of definite partial reactions to the cross section of the neutron-yield reaction, F i = σ(γ, in)/ σ(γ, xn), are used as criteria of experimental-data reliability. By definition, positive values of these ratios should not exceed the upper limits of 1.00, 0.50, 0.33,... for i = 1, 2, 3,..., respectively. For many nuclei, unreliable values of the above ratios were found to correlate clearly in various photon-energy regions F i with physically forbidden negative values of cross sections of partial reactions. On this basis, one can conclude that correspondent experimental data are unreliable. Significant systematic uncertainties of the methods used to determine photoneutron multiplicity are shown to be the main reason for this. New partial-reaction cross sections that satisfy the above data-reliability criteria were evaluated within an experimental-theoretical method [ σ eval(γ, in) = F i theor (γ, in) × σ expt(γ, xn)] by employing the ratios F i theor (γ, in) calculated on the basis of a combined photonuclear-reaction model. It was obtained that cross sections evaluated in this way deviate substantially from the results of many experiments performed via neutron-multiplicity sorting, but, at the same time, agree with the results of alternative activation experiments. Prospects of employing methods that would provide, without recourse to photoneutron-multiplicity sorting, reliable data on cross sections of partial photoneutron reactions are discussed.

Everyday memory measures in multiple sclerosis: a systematic review.

PubMed

dasNair, Roshan; Griffiths, Holly; Clarke, Sara; Methley, Abigail; Kneebone, Ian; Topcu, Gogem

2018-03-02

Everyday memory is one of the most affected cognitive functions in multiple sclerosis (MS). Assessing everyday memory problems is crucial for monitoring the impact of memory deficits on individuals' day-to-day lives and evaluating the effectiveness of interventions that aim to improve cognitive functions. The aim of this systematic review was to identify the research literature on everyday memory measures used with people with MS, describe the types of measures used, and summarise their psychometric properties. Empirical studies of cognitive function in MS using standardised everyday memory measures were included. Online databases (MEDLINE, PsycINFO, PsycARTICLES, Embase) and Google Scholar were searched. Forty-four studies met the inclusion criteria. A total of 12 measures were identified, with varied uses and administration methods. The majority of papers did not report any psychometric properties for MS populations. The few papers that did, reported that the measures have good reliability and appear to have good face, concurrent, and ecological validity, but these need to be evaluated further. This review presents researchers and clinicians with an overview of the various everyday memory measures used in studies with people with MS, to help them choose the appropriate measure for their evaluations.

Comparison of the sequential organ failure assessment score with the King's College Hospital criteria and the model for end-stage liver disease score for the prognosis of acetaminophen-induced acute liver failure.

PubMed

Cholongitas, Evangelos; Theocharidou, Eleni; Vasianopoulou, Panayota; Betrosian, Alex; Shaw, Steve; Patch, David; O'Beirne, James; Agarwal, Banwari; Burroughs, Andrew K

2012-04-01

Acetaminophen-induced acute liver failure (ALF) is a complex multiorgan illness. An assessment of the prognosis is essential for the accurate identification of patients for whom survival without liver transplantation (LT) is unlikely. The aims of this study were the comparison of prognostic models [King's College Hospital (KCH), Model for End-Stage Liver Disease, Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health Evaluation II (APACHE II)] and the identification of independent prognostic indicators of outcome. We evaluated consecutive patients with severe acetaminophen-induced ALF who were admitted to the intensive care unit. At admission, demographic, clinical, and laboratory parameters were recorded. The discriminative ability of each prognostic score at the baseline was evaluated with the area under the receiver operating characteristic curve (AUC). In addition, using a multiple logistic regression, we assessed independent factors associated with outcome. In all, 125 consecutive patients with acetaminophen-induced ALF were evaluated: 67 patients (54%) survived with conservative medical management (group 1), and 58 patients (46%) either died without LT (28%) or underwent LT (18%; group 2). Group 1 patients had significantly lower median APACHE II (10 versus 14) and SOFA scores (9 versus 12) than group 2 patients (P < 0.001). The independent indicators associated with death or LT were a longer prothrombin time (P = 0.007), the inspiratory oxygen concentration (P = 0.005), and the lactate level at 12 hours (P < 0.001). The KCH criteria had the highest specificity (83%) but the lowest sensitivity (47%), and the SOFA score had the best discriminative ability (AUC = 0.79). In conclusion, for patients with acetaminophen-induced ALF, the SOFA score performed better than the other prognostic scores, and this reflected the presence of multiorgan dysfunction. A further evaluation of SOFA with the KCH criteria is warranted. Copyright © 2012 American Association for the Study of Liver Diseases.

Critical analysis of the stringent complete response in multiple myeloma: contribution of sFLC and bone marrow clonality

PubMed Central

Paiva, Bruno; López-Anglada, Lucía; Mateos, María-Victoria; Cedena, Teresa; Vidríales, María-Belén; Sáez-Gómez, María Auxiliadora; Contreras, Teresa; Oriol, Albert; Rapado, Inmaculada; Teruel, Ana-Isabel; Cordón, Lourdes; Blanchard, María Jesús; Bengoechea, Enrique; Palomera, Luis; de Arriba, Felipe; Cueto-Felgueroso, Cecilia; Orfao, Alberto; Bladé, Joan; San Miguel, Jesús F.; Lahuerta, Juan José

2015-01-01

Stringent complete response (sCR) criteria are used in multiple myeloma as a deeper response category compared with CR, but prospective validation is lacking, it is not always clear how evaluation of clonality is performed, and is it not known what the relative clinical influence is of the serum free light chain ratio (sFLCr) and bone marrow (BM) clonality to define more sCR. To clarify this controversy, we focused on 94 patients that reached CR, of which 69 (73%) also fulfilled the sCR criteria. Patients with sCR displayed slightly longer time to progression (median, 62 vs 53 months, respectively; P = .31). On analyzing this contribution to the prognosis of sFLCr or clonality, it was found that the sFLCr does not identify patients in CR at distinct risk; by contrast, low-sensitive multiparametric flow cytometry (MFC) immunophenotyping (2 colors), which is equivalent to immunohistochemistry, identifies a small number of patients (5 cases) with high residual tumor burden and dismal outcome; nevertheless, using traditional 4-color MFC, persistent clonal BM disease was detectable in 36% of patients, who, compared with minimal residual disease-negative cases, had a significantly inferior outcome. These results show that the current definition of sCR should be revised. PMID:26089396

Identifying neuropathic pain in patients with multiple sclerosis: a cross-sectional multicenter study using highly specific criteria.

PubMed

Solaro, Claudio; Cella, M; Signori, Alessio; Martinelli, Vittorio; Radaelli, Marta; Centonze, D; Sica, F; Grasso, M G; Clemenzi, A; Bonavita, S; Esposito, S; Patti, F; D'Amico, E; Cruccu, G; Truini, A

2018-04-01

Pain is a common and heterogeneous complication of multiple sclerosis (MS). In this multicenter, cross sectional study, we aimed at investigating the prevalence of pain in MS using highly specific criteria for distinguishing the different types of pain. After a structured interview, in patients with pain, clinical examination and DN4 questionnaire were used for distinguishing neuropathic and nociceptive pain. In subjects with neuropathic pain, the Neuropathic Pain Symptom Inventory was used for differentiating neuropathic pain symptoms. We enrolled 1249 participants (832 F, 417 M, mean age 33.9 years, mean disease duration 8 years, mean EDSS 3.2); based on clinical evaluation and DN4 score 429 patients (34.34%) were classified with pain (470 pain syndromes): 286 nociceptive pain syndromes and 184 neuropathic pain syndromes. Multivariate analysis showed that pain was associated with age, gender and disease severity and that neuropathic pain was distinctly associated with EDSS. Our study, providing definite information on the prevalence, characteristics and variables associated with neuropathic pain due to MS, shows that a more severe disease course is associated with a higher risk of neuropathic pain. Our findings might, therefore, provide a basis for improving the clinical management of this common MS complication.

Discordance Between Appropriate Use Criteria for Nuclear Myocardial Perfusion Imaging From Different Specialty Societies: A Potential Concern for Health Policy.

PubMed

Winchester, David E; Wolinsky, David; Beyth, Rebecca J; Shaw, Leslee J

2016-05-01

Appropriate use criteria (AUC) assist health care professionals in making decisions about procedures and diagnostic testing. In some cases, multiple AUC exist for a single procedure or test. To date, the extent of agreement between multiple AUC has not been evaluated. To measure discordance between the American College of Cardiology Foundation (ACCF) AUC and the American College of Radiology (ACR) Appropriateness Criteria for gauging the appropriateness of nuclear myocardial perfusion imaging. Retrospective cohort study at an academically affiliated Veterans Affairs medical center. Participants were Veteran patients who underwent nuclear myocardial perfusion imaging between December 2010 and July 2011 with rating of appropriateness by the ACCF and ACR criteria. Analysis was performed in March 2015. The primary outcome was the agreement of appropriateness category as measured by κ statistic. The secondary outcome was a comparison of nuclear myocardial perfusion imaging results and frequency of ischemia across appropriateness categories for the 2 rating methods. Of 67 indications in the ACCF AUC, 35 (52.2%) could not be matched to an ACR rating, 18 (26.9%) had the same appropriateness category, and 14 (20.9%) disagreed on appropriateness. The study cohort comprised 592 individuals. Their mean (SD) age was 62.6 (9.4) years, and 570 of 592 (96.2%) were male. When applied to the patient cohort, 111 patients (18.8%) could not be matched to an ACR rating, 349 patients (59.0%) had the same appropriateness category for the ACR and ACCF methods, and 132 patients (22.3%) were discordant. Overall, the agreement of appropriateness between the 2 methods was poor (κ = 0.34, P < .001). Ischemia was rare among patients rated as "inappropriate" by the ACCF AUC (1 of 39 patients [2.6%]), while ischemia was more common among patients rated as "usually not appropriate" by the ACR Appropriateness Criteria (14 of 80 patients [17.5%]). Substantial discordance may exist between methods for assessing the appropriateness of advanced imaging tests. Discordance in methods may translate into differences in clinically relevant outcomes, such as the detection of myocardial ischemia.

Multiple Criteria Decision Analysis for Health Care Decision Making--Emerging Good Practices: Report 2 of the ISPOR MCDA Emerging Good Practices Task Force.

PubMed

Marsh, Kevin; IJzerman, Maarten; Thokala, Praveen; Baltussen, Rob; Boysen, Meindert; Kaló, Zoltán; Lönngren, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Devlin, Nancy

2016-01-01

Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making. A set of techniques, known under the collective heading, multiple criteria decision analysis (MCDA), are useful for this purpose. In 2014, ISPOR established an Emerging Good Practices Task Force. The task force's first report defined MCDA, provided examples of its use in health care, described the key steps, and provided an overview of the principal methods of MCDA. This second task force report provides emerging good-practice guidance on the implementation of MCDA to support health care decisions. The report includes: a checklist to support the design, implementation and review of an MCDA; guidance to support the implementation of the checklist; the order in which the steps should be implemented; illustrates how to incorporate budget constraints into an MCDA; provides an overview of the skills and resources, including available software, required to implement MCDA; and future research directions. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Framework for evaluating disease severity measures in older adults with comorbidity.

PubMed

Boyd, Cynthia M; Weiss, Carlos O; Halter, Jeff; Han, K Carol; Ershler, William B; Fried, Linda P

2007-03-01

Accounting for the influence of concurrent conditions on health and functional status for both research and clinical decision-making purposes is especially important in older adults. Although approaches to classifying severity of individual diseases and conditions have been developed, the utility of these classification systems has not been evaluated in the presence of multiple conditions. We present a framework for evaluating severity classification systems for common chronic diseases. The framework evaluates the: (a) goal or purpose of the classification system; (b) physiological and/or functional criteria for severity graduation; and (c) potential reliability and validity of the system balanced against burden and costs associated with classification. Approaches to severity classification of individual diseases were not originally conceived for the study of comorbidity. Therefore, they vary greatly in terms of objectives, physiological systems covered, level of severity characterization, reliability and validity, and costs and burdens. Using different severity classification systems to account for differing levels of disease severity in a patient with multiple diseases, or, assessing global disease burden may be challenging. Most approaches to severity classification are not adequate to address comorbidity. Nevertheless, thoughtful use of some existing approaches and refinement of others may advance the study of comorbidity and diagnostic and therapeutic approaches to patients with multimorbidity.

Assessing regional environmental quality by integrated use of remote sensing, GIS, and spatial multi-criteria evaluation for prioritization of environmental restoration.

PubMed

Rahman, Md Rejaur; Shi, Z H; Chongfa, Cai

2014-11-01

This study was an attempt to analyse the regional environmental quality with the application of remote sensing, geographical information system, and spatial multiple criteria decision analysis and, to project a quantitative method applicable to identify the status of the regional environment of the study area. Using spatial multi-criteria evaluation (SMCE) approach with expert knowledge in this study, an integrated regional environmental quality index (REQI) was computed and classified into five levels of regional environment quality viz. worse, poor, moderate, good, and very good. During the process, a set of spatial criteria were selected (here, 15 criterions) together with the degree of importance of criteria in sustainability of the regional environment. Integrated remote sensing and GIS technique and models were applied to generate the necessary factors (criterions) maps for the SMCE approach. The ranking, along with expected value method, was used to standardize the factors and on the other hand, an analytical hierarchy process (AHP) was applied for calculating factor weights. The entire process was executed in the integrated land and water information system (ILWIS) software tool that supports SMCE. The analysis showed that the overall regional environmental quality of the area was at moderate level and was partly determined by elevation. Areas under worse and poor quality of environment indicated that the regional environmental status showed decline in these parts of the county. The study also revealed that the human activities, vegetation condition, soil erosion, topography, climate, and soil conditions have serious influence on the regional environment condition of the area. Considering the regional characteristics of environmental quality, priority, and practical needs for environmental restoration, the study area was further regionalized into four priority areas which may serve as base areas of decision making for the recovery, rebuilding, and protection of the environment.

Performance characteristics of magnetic resonance imaging without contrast agents or sedation in pediatric appendicitis.

PubMed

Didier, Ryne A; Hopkins, Katharine L; Coakley, Fergus V; Krishnaswami, Sanjay; Spiro, David M; Foster, Bryan R

2017-09-01

Magnetic resonance imaging (MRI) has emerged as a promising modality for evaluating pediatric appendicitis. However optimal imaging protocols, including roles of contrast agents and sedation, have not been established and diagnostic criteria have not been fully evaluated. To investigate performance characteristics of rapid MRI without contrast agents or sedation in the diagnosis of pediatric appendicitis. We included patients ages 4-18 years with suspicion of appendicitis who underwent rapid MRI between October 2013 and March 2015 without contrast agent or sedation. After two-radiologist review, we determined performance characteristics of individual diagnostic criteria and aggregate diagnostic criteria by comparing MRI results to clinical outcomes. We used receiver operating characteristic (ROC) curves to determine cut-points for appendiceal diameter and wall thickness for optimization of predictive power, and we calculated area under the curve (AUC) as a measure of test accuracy. Ninety-eight MRI examinations were performed in 97 subjects. Overall, MRI had a 94% sensitivity, 95% specificity, 91% positive predictive value and 97% negative predictive value. Optimal cut-points for appendiceal diameter and wall thickness were ≥7 mm and ≥2 mm, respectively. Independently, those cut-points produced sensitivities of 91% and 84% and specificities of 84% and 43%. Presence of intraluminal fluid (30/33) or localized periappendiceal fluid (32/33) showed a significant association with acute appendicitis (P<0.01), with sensitivities of 91% and 97% and specificities of 60% and 50%. For examinations in which the appendix was not identified by one or both reviewers (23/98), the clinical outcome was negative. Rapid MRI without contrast agents or sedation is accurate for diagnosis of pediatric appendicitis when multiple diagnostic criteria are considered in aggregate. Individual diagnostic criteria including optimized cut-points of ≥7 mm for diameter and ≥2 mm for wall thickness demonstrate high sensitivities but relatively low specificities. Nonvisualization of the appendix favors a negative diagnosis.

Video Modeling and Observational Learning to Teach Gaming Access to Students with ASD.

PubMed

Spriggs, Amy D; Gast, David L; Knight, Victoria F

2016-09-01

The purpose of this study was to evaluate both video modeling and observational learning to teach age-appropriate recreation and leisure skills (i.e., accessing video games) to students with autism spectrum disorder. Effects of video modeling were evaluated via a multiple probe design across participants and criteria for mastery were based on these results. Secondary measures were collected on observational learning across participants and behaviors. Participants included 4 children with autism, ages 8-11, who were served in self-contained special education classrooms. Results indicated a functional relation between video modeling and increased independence in gaming; observational learning occurred for at least some steps across students. Results, implications for practitioners, limitations, and ideas for future research are discussed.

Evaluation models and criteria of the quality of hospital websites: a systematic review study

PubMed Central

Jeddi, Fatemeh Rangraz; Gilasi, Hamidreza; Khademi, Sahar

2017-01-01

Introduction Hospital websites are important tools in establishing communication and exchanging information between patients and staff, and thus should enjoy an acceptable level of quality. The aim of this study was to identify proper models and criteria to evaluate the quality of hospital websites. Methods This research was a systematic review study. The international databases such as Science Direct, Google Scholar, PubMed, Proquest, Ovid, Elsevier, Springer, and EBSCO together with regional database such as Magiran, Scientific Information Database, Persian Journal Citation Report (PJCR) and IranMedex were searched. Suitable keywords including website, evaluation, and quality of website were used. Full text papers related to the research were included. The criteria and sub criteria of the evaluation of website quality were extracted and classified. Results To evaluate the quality of the websites, various models and criteria were presented. The WEB-Q-IM, Mile, Minerva, Seruni Luci, and Web-Qual models were the designed models. The criteria of accessibility, content and apparent features of the websites, the design procedure, the graphics applied in the website, and the page’s attractions have been mentioned in the majority of studies. Conclusion The criteria of accessibility, content, design method, security, and confidentiality of personal information are the essential criteria in the evaluation of all websites. It is suggested that the ease of use, graphics, attractiveness and other apparent properties of websites are considered as the user-friendliness sub criteria. Further, the criteria of speed and accessibility of the website should be considered as sub criterion of efficiency. When determining the evaluation criteria of the quality of websites, attention to major differences in the specific features of any website is essential. PMID:28465807

Evaluation models and criteria of the quality of hospital websites: a systematic review study.

PubMed

Jeddi, Fatemeh Rangraz; Gilasi, Hamidreza; Khademi, Sahar

2017-02-01

Hospital websites are important tools in establishing communication and exchanging information between patients and staff, and thus should enjoy an acceptable level of quality. The aim of this study was to identify proper models and criteria to evaluate the quality of hospital websites. This research was a systematic review study. The international databases such as Science Direct, Google Scholar, PubMed, Proquest, Ovid, Elsevier, Springer, and EBSCO together with regional database such as Magiran, Scientific Information Database, Persian Journal Citation Report (PJCR) and IranMedex were searched. Suitable keywords including website, evaluation, and quality of website were used. Full text papers related to the research were included. The criteria and sub criteria of the evaluation of website quality were extracted and classified. To evaluate the quality of the websites, various models and criteria were presented. The WEB-Q-IM, Mile, Minerva, Seruni Luci, and Web-Qual models were the designed models. The criteria of accessibility, content and apparent features of the websites, the design procedure, the graphics applied in the website, and the page's attractions have been mentioned in the majority of studies. The criteria of accessibility, content, design method, security, and confidentiality of personal information are the essential criteria in the evaluation of all websites. It is suggested that the ease of use, graphics, attractiveness and other apparent properties of websites are considered as the user-friendliness sub criteria. Further, the criteria of speed and accessibility of the website should be considered as sub criterion of efficiency. When determining the evaluation criteria of the quality of websites, attention to major differences in the specific features of any website is essential.

A Multi-criteria Decision Analysis System for Prioritizing Sites and Types of Low Impact Development Practices

NASA Astrophysics Data System (ADS)

Song, Jae Yeol; Chung, Eun-Sung

2017-04-01

This study developed a multi-criteria decision analysis framework to prioritize sites and types of low impact development (LID) practices. This framework was systemized as a web-based system coupled with the Storm Water Management Model (SWMM) from the Environmental Protection Agency (EPA). Using the technique for order of preference by similarity to ideal solution (TOPSIS), which is a type of multi-criteria decision-making (MCDM) method, multiple types and sites of designated LID practices are prioritized. This system is named the Water Management Prioritization Module (WMPM) and is an improved version of the Water Management Analysis Module (WMAM) that automatically generates and simulates multiple scenarios of LID design and planning parameters for a single LID type. WMPM can simultaneously determine the priority of multiple LID types and sites. In this study, an infiltration trench and permeable pavement were considered for multiple sub-catchments in South Korea to demonstrate the WMPM procedures. The TOPSIS method was manually incorporated to select the vulnerable target sub-catchments and to prioritize the LID planning scenarios for multiple types and sites considering socio-economic, hydrologic and physical-geometric factors. In this application, the Delphi method and entropy theory were used to determine the subjective and objective weights, respectively. Comparing the ranks derived by this system, two sub-catchments, S16 and S4, out of 18 were considered to be the most suitable places for installing an infiltration trench and porous pavement to reduce the peak and total flow, respectively, considering both socio-economic factors and hydrological effectiveness. WMPM can help policy-makers to objectively develop urban water plans for sustainable development. Keywords: Low Impact Development, Multi-Criteria Decision Analysis, SWMM, TOPSIS, Water Management Prioritization Module (WMPM)

Economic evaluation of vaccines in Canada: A systematic review.

PubMed

Chit, Ayman; Lee, Jason K H; Shim, Minsup; Nguyen, Van Hai; Grootendorst, Paul; Wu, Jianhong; Van Exan, Robert; Langley, Joanne M

2016-05-03

Economic evaluations should form part of the basis for public health decision making on new vaccine programs. While Canada's national immunization advisory committee does not systematically include economic evaluations in immunization decision making, there is increasing interest in adopting them. We therefore sought to examine the extent and quality of economic evaluations of vaccines in Canada. We conducted a systematic review of economic evaluations of vaccines in Canada to determine and summarize: comprehensiveness across jurisdictions, studied vaccines, funding sources, study designs, research quality, and changes over time. Searches in multiple databases were conducted using the terms "vaccine," "economics" and "Canada." Descriptive data from eligible manuscripts was abstracted and three authors independently evaluated manuscript quality using a 7-point Likert-type scale scoring tool based on criteria from the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). 42/175 articles met the search criteria. Of these, Canada-wide studies were most common (25/42), while provincial studies largely focused on the three populous provinces of Ontario, Quebec and British Columbia. The most common funding source was industry (17/42), followed by government (7/42). 38 studies used mathematical models estimating expected economic benefit while 4 studies examined post-hoc data on established programs. Studies covered 10 diseases, with 28/42 addressing pediatric vaccines. Many studies considered cost-utility (22/42) and the majority of these studies reported favorable economic results (16/22). The mean quality score was 5.9/7 and was consistent over publication date, funding sources, and disease areas. We observed diverse approaches to evaluate vaccine economics in Canada. Given the increased complexity of economic studies evaluating vaccines and the impact of results on public health practice, Canada needs improved, transparent and consistent processes to review and assess the findings of the economic evaluations of vaccines.

Classification of maxillectomy defects: a systematic review and criteria necessary for a universal description.

PubMed

Bidra, Avinash S; Jacob, Rhonda F; Taylor, Thomas D

2012-04-01

Maxillectomy defects are complex and involve a number of anatomic structures. Several maxillectomy defect classifications have been proposed with no universal acceptance among surgeons and prosthodontists. Established criteria for describing the maxillectomy defect are lacking. This systematic review aimed to evaluate classification systems in the available literature, to provide a critical appraisal, and to identify the criteria necessary for a universal description of maxillectomy and midfacial defects. An electronic search of the English language literature between the periods of 1974 and June 2011 was performed by using PubMed, Scopus, and Cochrane databases with predetermined inclusion criteria. Key terms included in the search were maxillectomy classification, maxillary resection classification, maxillary removal classification, maxillary reconstruction classification, midfacial defect classification, and midfacial reconstruction classification. This was supplemented by a manual search of selected journals. After application of predetermined exclusion criteria, the final list of articles was reviewed in-depth to provide a critical appraisal and identify criteria for a universal description of a maxillectomy defect. The electronic database search yielded 261 titles. Systematic application of inclusion and exclusion criteria resulted in identification of 14 maxillectomy and midfacial defect classification systems. From these articles, 6 different criteria were identified as necessary for a universal description of a maxillectomy defect. Multiple deficiencies were noted in each classification system. Though most articles described the superior-inferior extent of the defect, only a small number of articles described the anterior-posterior and medial-lateral extent of the defect. Few articles listed dental status and soft palate involvement when describing maxillectomy defects. No classification system has accurately described the maxillectomy defect, based on criteria that satisfy both surgical and prosthodontic needs. The 6 criteria identified in this systematic review for a universal description of a maxillectomy defect are: 1) dental status; 2) oroantral/nasal communication status; 3) soft palate and other contiguous structure involvement; 4) superior-inferior extent; 5) anterior-posterior extent; and 6) medial-lateral extent of the defect. A criteria-based description appears more objective and amenable for universal use than a classification-based description. Copyright © 2012 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Effect of fenfluramine-derivative diet pills on cardiac valves: a meta-analysis of observational studies.

PubMed

Sachdev, Molly; Miller, William C; Ryan, Thomas; Jollis, James G

2002-12-01

Fenfluramine-derivative diet pills were withdrawn from the market in 1997 because of an association with valvular regurgitation, but subsequent estimates of the prevalence of this condition have varied widely. We systematically reviewed evidence regarding the prevalence of valvular disease after fenfluramine exposure. We searched multiple databases with multiple search terms. Conference proceedings from 1997 onward were searched by index. Authors of eligible studies were contacted to identify unpublished works. Selection criteria were liberally determined. Ten of the identified 11 articles met these criteria. Reviewers assessed the studies' methodologic quality by use of a standard form to evaluate selection, attrition, performance, and detection bias. The studies were analyzed in 2 groups on the basis of length of exposure (<90 days or >90 days). The Mantel-Haenszel method was used to summarize data. Quantitative and qualitative tests for heterogeneity were performed. Tests for publication bias were also done. Tests for heterogeneity were nonsignificant after removing 1 outlier trial. The pooled prevalence of valvular regurgitation meeting Food and Drug Administration criteria (at least mild aortic regurgitation or at least moderate mitral regurgitation) among patients treated for >90 days was 12.0% compared with 5.9% for the unexposed group (prevalence odds ratio 2.2, 95% CI 1.7-2.7). The combined analyses also identified a small but statistically significant increase in mitral regurgitation not previously identified by individual studies (exposed 3.5%, unexposed 1.8%, prevalence odds ratio 1.6, 95% CI 1.05-2.3). Among patients exposed for <90 days, a trend toward more regurgitation was not statistically significant by either combined Food and Drug Administration criteria (exposed 6.8%, unexposed 5.8%, prevalence odds ratio 1.4, 95% CI 0.8-2.4) or by individual valve. These data indicate that fenfluramine-associated valvular regurgitation is less common than initially reported, but still present in 1 of 8 patients treated for >90 days.

7 CFR 3430.34 - Evaluation criteria.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Evaluation criteria. 3430.34 Section 3430.34 Agriculture Regulations of the Department of Agriculture (Continued) COOPERATIVE STATE RESEARCH, EDUCATION... appropriations language. The review criteria are described in the RFA and shall not include criteria concerning...

A new surgical technique for medial collateral ligament balancing: multiple needle puncturing.

PubMed

Bellemans, Johan; Vandenneucker, Hilde; Van Lauwe, Johan; Victor, Jan

2010-10-01

In this article, we present our experience with a new technique for medial soft tissue balancing, where we make multiple punctures in the medial collateral ligament (MCL) using a 19-gauge needle, to progressively stretch the MCL until a correct ligament balance is achieved. Ligament status was evaluated both before and after the procedure using computer navigation and mediolateral stress testing. The procedure was considered successful when 2 to 4-mm mediolateral joint line opening was obtained in extension and 2 to 6 mm in flexion. In 34 of 35 cases, a progressive correction of medial tightness was achieved according to the above described criteria. One case was considered overreleased in extension. Needle puncturing is a new, effective, and safe technique for progressive correction of MCL tightness in the varus knee. Copyright © 2010 Elsevier Inc. All rights reserved.

Natural phenomena hazards design and evaluation criteria for Department of Energy Facilities

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

NONE

1996-01-01

The Department of Energy (DOE) has issued an Order 420.1 which establishes policy for its facilities in the event of natural phenomena hazards (NPH) along with associated NPH mitigation requirements. This DOE Standard gives design and evaluation criteria for NPH effects as guidance for implementing the NPH mitigation requirements of DOE Order 420.1 and the associated implementation Guides. These are intended to be consistent design and evaluation criteria for protection against natural phenomena hazards at DOE sites throughout the United States. The goal of these criteria is to assure that DOE facilities can withstand the effects of natural phenomena suchmore » as earthquakes, extreme winds, tornadoes, and flooding. These criteria apply to the design of new facilities and the evaluation of existing facilities. They may also be used for modification and upgrading of existing facilities as appropriate. The design and evaluation criteria presented herein control the level of conservatism introduced in the design/evaluation process such that earthquake, wind, and flood hazards are treated on a consistent basis. These criteria also employ a graded approach to ensure that the level of conservatism and rigor in design/evaluation is appropriate for facility characteristics such as importance, hazards to people on and off site, and threat to the environment. For each natural phenomena hazard covered, these criteria consist of the following: Performance Categories and target performance goals as specified in the DOE Order 420.1 NPH Implementation Guide, and DOE-STD-1 021; specified probability levels from which natural phenomena hazard loading on structures, equipment, and systems is developed; and design and evaluation procedures to evaluate response to NPH loads and criteria to assess whether or not computed response is permissible.« less

Integrating Fuel Treatments into Comprehensive Ecosystem Management

Treesearch

Kevin Hyde; Greg Jones; Robin Silverstein; Keith Stockmann; Dan Loeffler

2006-01-01

To plan fuel treatments in the context of comprehensive ecosystem management, forest managers must meet multiple-use and environmental objectives, address administrative and budget constraints, and reconcile performance measures from multiple policy directives. We demonstrate a multiple criteria approach to measuring success of fuel treatments used in the Butte North...

Clinical Presentation of Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections in Research and Community Settings

PubMed Central

Seidlitz, Jakob; Kovacevic, Miro; Latimer, M. Elizabeth; Hommer, Rebecca; Lougee, Lorraine; Grant, Paul

2015-01-01

Abstract Background: The first cases of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) were described>15 years ago. Since that time, the literature has been divided between studies that successfully demonstrate an etiologic relationship between Group A streptococcal (GAS) infections and childhood-onset obsessive-compulsive disorder (OCD), and those that fail to find an association. One possible explanation for the conflicting reports is that the diagnostic criteria proposed for PANDAS are not specific enough to describe a unique and homogeneous cohort of patients. To evaluate the validity of the PANDAS criteria, we compared clinical characteristics of PANDAS patients identified in two community practices with a sample of children meeting full research criteria for PANDAS. Methods: A systematic review of clinical records was used to identify the presence or absence of selected symptoms in children evaluated for PANDAS by physicians in Hinsdale, Illinois (n=52) and Bethesda, Maryland (n=40). Results were compared against data from participants in National Institute of Mental Health (NIMH) research investigations of PANDAS (n=48). Results: As described in the original PANDAS cohort, males outnumbered females (95:45) by ∼ 2:1, and symptoms began in early childhood (7.3±2.7 years). Clinical presentations were remarkably similar across sites, with all children reporting acute onset of OCD symptoms and multiple comorbidities, including separation anxiety (86–92%), school issues (75–81%), sleep disruptions (71%), tics (60–65%), urinary symptoms (42–81%), and others. Twenty of the community cases (22%) failed to meet PANDAS criteria because of an absence of documentation of GAS infections. Conclusions: The diagnostic criteria for PANDAS can be used by clinicians to accurately identify patients with common clinical features and shared etiology of symptoms. Although difficulties in documenting an association between GAS infection and symptom onset/exacerbations may preclude a diagnosis of PANDAS in some children with acute-onset OCD, they do appear to meet criteria for pediatric acute-onset neuropsychiatric syndrome (PANS). PMID:25695941

An integrated approach of AHP and DEMATEL methods in evaluating the criteria of auto spare parts industry

NASA Astrophysics Data System (ADS)

Wu, Hsin-Hung; Tsai, Ya-Ning

2012-11-01

This study uses both analytic hierarchy process (AHP) and decision-making trial and evaluation laboratory (DEMATEL) methods to evaluate the criteria in auto spare parts industry in Taiwan. Traditionally, AHP does not consider indirect effects for each criterion and assumes that criteria are independent without further addressing the interdependence between or among the criteria. Thus, the importance computed by AHP can be viewed as short-term improvement opportunity. On the contrary, DEMATEL method not only evaluates the importance of criteria but also depicts the causal relations of criteria. By observing the causal diagrams, the improvement based on cause-oriented criteria might improve the performance effectively and efficiently for the long-term perspective. As a result, the major advantage of integrating AHP and DEMATEL methods is that the decision maker can continuously improve suppliers' performance from both short-term and long-term viewpoints.

Evaluating shrub-associated spatial patterns of soil properties in a shrub-steppe ecosystem using multiple-variable geostatistics

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

Halvorson, J.J.; Smith, J.L.; Bolton, H. Jr.

1995-09-01

Geostatistics are often calculated for a single variable at a time, even though many natural phenomena are functions of several variables. The objective of this work was to demonstrate a nonparametric approach for assessing the spatial characteristics of multiple-variable phenomena. Specifically, we analyzed the spatial characteristics of resource islands in the soil under big sagebrush (Artemisia tridentala Nutt.), a dominant shrub in the intermountain western USA. For our example, we defined resource islands as a function of six soil variables representing concentrations of soil resources, populations of microorganisms, and soil microbial physiological variables. By collectively evaluating the indicator transformations ofmore » these individual variables, we created a new data set, termed a multiple-variable indicator transform or MVIT. Alternate MVITs were obtained by varying the selection criteria. Each MVIT was analyzed with variography to characterize spatial continuity, and with indicator kriging to predict the combined probability of their occurrence at unsampled locations in the landscape. Simple graphical analysis and variography demonstrated spatial dependence for all individual soil variables. Maps derived from ordinary kriging of MVITs suggested that the combined probabilities for encountering zones of above-median resources were greatest near big sagebrush. 51 refs., 5 figs., 1 tab.« less

32 CFR 203.8 - Evaluation criteria.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Evaluation criteria. 203.8 Section 203.8 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED... ACTIVITIES § 203.8 Evaluation criteria. The Department of Defense will begin the TAPP procurement process...

Balancing effluent quality, economic cost and greenhouse gas emissions during the evaluation of (plant-wide) control/operational strategies in WWTPs.

PubMed

Flores-Alsina, Xavier; Arnell, Magnus; Amerlinck, Youri; Corominas, Lluís; Gernaey, Krist V; Guo, Lisha; Lindblom, Erik; Nopens, Ingmar; Porro, Jose; Shaw, Andy; Snip, Laura; Vanrolleghem, Peter A; Jeppsson, Ulf

2014-01-01

The objective of this paper was to show the potential additional insight that result from adding greenhouse gas (GHG) emissions to plant performance evaluation criteria, such as effluent quality (EQI) and operational cost (OCI) indices, when evaluating (plant-wide) control/operational strategies in wastewater treatment plants (WWTPs). The proposed GHG evaluation is based on a set of comprehensive dynamic models that estimate the most significant potential on-site and off-site sources of CO₂, CH₄ and N₂O. The study calculates and discusses the changes in EQI, OCI and the emission of GHGs as a consequence of varying the following four process variables: (i) the set point of aeration control in the activated sludge section; (ii) the removal efficiency of total suspended solids (TSS) in the primary clarifier; (iii) the temperature in the anaerobic digester; and (iv) the control of the flow of anaerobic digester supernatants coming from sludge treatment. Based upon the assumptions built into the model structures, simulation results highlight the potential undesirable effects of increased GHG production when carrying out local energy optimization of the aeration system in the activated sludge section and energy recovery from the AD. Although off-site CO₂ emissions may decrease, the effect is counterbalanced by increased N₂O emissions, especially since N₂O has a 300-fold stronger greenhouse effect than CO₂. The reported results emphasize the importance and usefulness of using multiple evaluation criteria to compare and evaluate (plant-wide) control strategies in a WWTP for more informed operational decision making. © 2013.

Hospital site selection using fuzzy AHP and its derivatives.

PubMed

Vahidnia, Mohammad H; Alesheikh, Ali A; Alimohammadi, Abbas

2009-07-01

Environmental managers are commonly faced with sophisticated decisions, such as choosing the location of a new facility subject to multiple conflicting criteria. This paper considers the specific problem of creating a well-distributed network of hospitals that delivers its services to the target population with minimal time, pollution and cost. We develop a Multi-Criteria Decision Analysis process that combines Geographical Information System (GIS) analysis with the Fuzzy Analytical Hierarchy Process (FAHP), and use this process to determine the optimum site for a new hospital in the Tehran urban area. The GIS was used to calculate and classify governing criteria, while FAHP was used to evaluate the decision factors and their impacts on alternative sites. Three methods were used to estimate the total weights and priorities of the candidate sites: fuzzy extent analysis, center-of-area defuzzification, and the alpha-cut method. The three methods yield identical priorities for the five alternatives considered. Fuzzy extent analysis provides less discriminating power, but is simpler to implement and compute than the other two methods. The alpha-cut method is more complicated, but integrates the uncertainty and overall attitude of the decision-maker. The usefulness of the new hospital site is evaluated by computing an accessibility index for each pixel in the GIS, defined as the ratio of population density to travel time. With the addition of a new hospital at the optimum site, this index improved over about 6.5 percent of the geographical area.

Multi Criteria Decision Making to evaluate control strategies of contagious animal diseases.

PubMed

Mourits, M C M; van Asseldonk, M A P M; Huirne, R B M

2010-09-01

The decision on which strategy to use in the control of contagious animal diseases involves complex trade-offs between multiple objectives. This paper describes a Multi Criteria Decision Making (MCDM) application to illustrate its potential support to policy makers in choosing the control strategy that best meets all of the conflicting interests. The presented application focused on the evaluation of alternative strategies to control Classical Swine Fever (CSF) epidemics within the European Union (EU) according to the preferences of the European Chief Veterinary Officers (CVO). The performed analysis was centred on the three high-level objectives of epidemiology, economics and social ethics. The appraised control alternatives consisted of the EU compulsory control strategy, a pre-emptive slaughter strategy, a protective vaccination strategy and a suppressive vaccination strategy. Using averaged preference weights of the elicited CVOs, the preference ranking of the control alternatives was determined for six EU regions. The obtained results emphasized the need for EU region-specific control. Individual CVOs differed in their views on the relative importance of the various (sub)criteria by which the performance of the alternatives were judged. Nevertheless, the individual rankings of the control alternatives within a region appeared surprisingly similar. Based on the results of the described application it was concluded that the structuring feature of the MCDM technique provides a suitable tool in assisting the complex decision making process of controlling contagious animal diseases. 2010 Elsevier B.V. All rights reserved.

Analyzing Two-Phase Single-Case Data with Non-overlap and Mean Difference Indices: Illustration, Software Tools, and Alternatives.

PubMed

Manolov, Rumen; Losada, José L; Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana

2016-01-01

Two-phase single-case designs, including baseline evaluation followed by an intervention, represent the most clinically straightforward option for combining professional practice and research. However, unless they are part of a multiple-baseline schedule, such designs do not allow demonstrating a causal relation between the intervention and the behavior. Although the statistical options reviewed here cannot help overcoming this methodological limitation, we aim to make practitioners and applied researchers aware of the available appropriate options for extracting maximum information from the data. In the current paper, we suggest that the evaluation of behavioral change should include visual and quantitative analyses, complementing the substantive criteria regarding the practical importance of the behavioral change. Specifically, we emphasize the need to use structured criteria for visual analysis, such as the ones summarized in the What Works Clearinghouse Standards, especially if such criteria are complemented by visual aids, as illustrated here. For quantitative analysis, we focus on the non-overlap of all pairs and the slope and level change procedure, as they offer straightforward information and have shown reasonable performance. An illustration is provided of the use of these three pieces of information: visual, quantitative, and substantive. To make the use of visual and quantitative analysis feasible, open source software is referred to and demonstrated. In order to provide practitioners and applied researchers with a more complete guide, several analytical alternatives are commented on pointing out the situations (aims, data patterns) for which these are potentially useful.

Analyzing Two-Phase Single-Case Data with Non-overlap and Mean Difference Indices: Illustration, Software Tools, and Alternatives

PubMed Central

Manolov, Rumen; Losada, José L.; Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana

2016-01-01

Two-phase single-case designs, including baseline evaluation followed by an intervention, represent the most clinically straightforward option for combining professional practice and research. However, unless they are part of a multiple-baseline schedule, such designs do not allow demonstrating a causal relation between the intervention and the behavior. Although the statistical options reviewed here cannot help overcoming this methodological limitation, we aim to make practitioners and applied researchers aware of the available appropriate options for extracting maximum information from the data. In the current paper, we suggest that the evaluation of behavioral change should include visual and quantitative analyses, complementing the substantive criteria regarding the practical importance of the behavioral change. Specifically, we emphasize the need to use structured criteria for visual analysis, such as the ones summarized in the What Works Clearinghouse Standards, especially if such criteria are complemented by visual aids, as illustrated here. For quantitative analysis, we focus on the non-overlap of all pairs and the slope and level change procedure, as they offer straightforward information and have shown reasonable performance. An illustration is provided of the use of these three pieces of information: visual, quantitative, and substantive. To make the use of visual and quantitative analysis feasible, open source software is referred to and demonstrated. In order to provide practitioners and applied researchers with a more complete guide, several analytical alternatives are commented on pointing out the situations (aims, data patterns) for which these are potentially useful. PMID:26834691

Patient-reported outcomes in neurofibromatosis and schwannomatosis clinical trials.

PubMed

Wolters, Pamela L; Martin, Staci; Merker, Vanessa L; Gardner, Kathy L; Hingtgen, Cynthia M; Tonsgard, James H; Schorry, Elizabeth K; Baldwin, Andrea

2013-11-19

Neurofibromatosis (NF) is a genetic disease with multiple clinical manifestations that can significantly impact quality of life (QOL). Clinical trials should include patient-reported outcomes (PROs) as endpoints to assess treatment effects on various aspects of QOL, but there is no consensus on the selection and use of such measures in NF. This article describes the PRO Working Group of the Response Evaluation in Neurofibromatosis and Schwannomatosis (REiNS) Collaboration, its main goals, methods for identifying appropriate PRO measures for NF clinical trials, and recommendations for assessing pain intensity. The REiNS PRO group selected core endpoint domains important to assess in NF. The members developed criteria to rate PRO measures, including patient characteristics, psychometric properties, and feasibility, and utilized a systematic process to evaluate PROs for NF clinical trials. Within the subdomain of pain intensity, the group reviewed the Numerical Rating Scale-11 (NRS-11), the Visual Analogue Scale, and the Faces Pain Scale-Revised using this process. Based on the review criteria, each of these pain intensity scales is brief, reliable, valid, and widely used. However, the NRS-11 was given the highest rating for use in NF clinical trials due to recommendations from pain experts and other consensus groups, its extensive use in research, strong psychometric data including sensitivity to change, and excellent feasibility in ages ≥ 8 years. The systematic review criteria and process are effective for identifying appropriate PRO measures and provide information utilized by the REiNS Collaboration to achieve consensus regarding PROs in NF clinical trials.

Evaluation by Citation: Trends in Publication Behavior, Evaluation Criteria, and the Strive for High Impact Publications.

PubMed

van Wesel, Maarten

2016-02-01

Criteria for the evaluation of most scholars' work have recently received wider attention due to high-profile cases of scientific misconduct which are perceived to be linked to these criteria. However, in the competition for career advancement and funding opportunities almost all scholars are subjected to the same criteria. Therefore these evaluation criteria act as 'switchmen', determining the tracks along which scholarly work is pushed by the dynamic interplay of interests of both scholars and their institutions. Currently one of the most important criteria is the impact of publications. In this research, the extent to which publish or perish, a long standing evaluation criterion, led to scientific misconduct is examined briefly. After this the strive for high impact publications will be examined, firstly by identifying the period in which this became an important evaluation criterion, secondly by looking at variables contributing to the impact of scholarly papers by means of a non-structured literature study, and lastly by combining these data into a quantitative analysis.

Entropy production rate as a criterion for inconsistency in decision theory

NASA Astrophysics Data System (ADS)

Dixit, Purushottam D.

2018-05-01

Individual and group decisions are complex, often involving choosing an apt alternative from a multitude of options. Evaluating pairwise comparisons breaks down such complex decision problems into tractable ones. Pairwise comparison matrices (PCMs) are regularly used to solve multiple-criteria decision-making problems, for example, using Saaty’s analytic hierarchy process (AHP) framework. However, there are two significant drawbacks of using PCMs. First, humans evaluate PCMs in an inconsistent manner. Second, not all entries of a large PCM can be reliably filled by human decision makers. We address these two issues by first establishing a novel connection between PCMs and time-irreversible Markov processes. Specifically, we show that every PCM induces a family of dissipative maximum path entropy random walks (MERW) over the set of alternatives. We show that only ‘consistent’ PCMs correspond to detailed balanced MERWs. We identify the non-equilibrium entropy production in the induced MERWs as a metric of inconsistency of the underlying PCMs. Notably, the entropy production satisfies all of the recently laid out criteria for reasonable consistency indices. We also propose an approach to use incompletely filled PCMs in AHP. Potential future avenues are discussed as well.

Quality of Smartphone Apps Related to Alcohol Use Disorder.

PubMed

Penzenstadler, Louise; Chatton, Anne; Van Singer, Mathias; Khazaal, Yasser

2016-01-01

Apps for smartphones are opening an important range of opportunities for improving the care of people with alcohol use disorders (AUDs). This study aimed to evaluate the quality of English language apps for AUDs and to compare paid and free apps. The keywords 'alcohol', 'alcohol addiction', 'alcohol help' and 'stop drinking' were entered into the iTunes Store search engine. Apps were evaluated using a standardized assessment designed to rate the quality of apps in terms of accountability, interactivity, self-help score and evidence-based content. The Brief DISCERN score and the criteria of the 'Health on the Net' label were also used as content quality indicators. Of the 137 unique apps identified, 52 met the inclusion criteria. Overall, the content quality and self-help scores of these AUD apps were poor. The main quality indicators were not linked to payment status. Multiple linear regressions showed that the Brief DISCERN score significantly predicted content quality. Poor content quality and self-help scores of AUD smartphone apps underline the gap between their potential promises and the overall quality of available products in stores. The quality indicators used in the present study may be used for further app developments. © 2016 S. Karger AG, Basel.

Evaluation of efficiency of aircraft liquid waste treatment and identification of daily inspection indices: a case study in Changchun, China.

PubMed

Xu, Jianling; Yang, Jiaqi; Zhao, Nan; Sheng, Lianxi; Zhao, Yuanhui; Tang, Zhanhui

2013-07-01

Evaluation of the efficiency of aircraft liquid waste treatment has previously been conducted to prevent pollution of the environment. The current study aimed to provide a set of practical methods for efficient airport sanitary supervision. Aircraft liquid waste was collected at Longjia International Airport, Changchun from multiple flights. The efficiency of liquid waste treatment as well as the water quality of the wastewater processed via a second-stage wastewater facility were examined by measuring a number of physical, chemical, and biological indices. Our results indicated that treatment solely via resolvable sanitizing liquid was not sufficient. Although the contents of first-class pollutants all met the requirements of the standard criteria, the contents of a number of second-class pollutants did not satisfy these criteria. However, after further treatment via a second-stage wastewater facility installed at the airport, all indices reached second-grade requirements of the discharge standard. We suggest that daily inspection and quarantine indices at airports should include the suspension content, biological oxygen demands after 5 days, chemical oxygen demand total organic carbon content, amino nitrogen content, total phosphorous content, and the level of fecal coliforms.

Raster-based outranking method: a new approach for municipal solid waste landfill (MSW) siting.

PubMed

Hamzeh, Mohamad; Abbaspour, Rahim Ali; Davalou, Romina

2015-08-01

MSW landfill siting is a complicated process because it requires integration of several factors. In this paper, geographic information system (GIS) and multiple criteria decision analysis (MCDA) were combined to handle the municipal solid waste (MSW) landfill siting. For this purpose, first, 16 input data layers were prepared in GIS environment. Then, the exclusionary lands were eliminated and potentially suitable areas for the MSW disposal were identified. These potentially suitable areas, in an innovative approach, were further examined by deploying Preference Ranking Organization Method for Enrichment Evaluations (PROMETHEE) II and analytic network process (ANP), which are two of the most recent MCDA methods, in order to determine land suitability for landfilling. PROMETHEE II was used to determine a complete ranking of the alternatives, while ANP was employed to quantify the subjective judgments of evaluators as criteria weights. The resulting land suitability was reported on a grading scale of 1-5 from 1 to 5, which is the least to the most suitable area, respectively. Finally, three optimal sites were selected by taking into consideration the local conditions of 15 sites, which were candidates for MSW landfilling. Research findings show that the raster-based method yields effective results.

Testing the Multiple in the Multiple Read-Out Model of Visual Word Recognition

ERIC Educational Resources Information Center

De Moor, Wendy; Verguts, Tom; Brysbaert, Marc

2005-01-01

This study provided a test of the multiple criteria concept used for lexical decision, as implemented in J. Grainger and A. M. Jacobs's (1996) multiple read-out model. This account predicts more inhibition (or less facilitation) from a masked neighbor when accuracy is stressed more but more facilitation (or less inhibition) when the speed of…

Evaluating methods to establish habitat suitability criteria: A case study in the upper Delaware River Basin, USA

USGS Publications Warehouse

Galbraith, Heather S.; Blakeslee, Carrie J.; Cole, Jeffrey C.; Talbert, Colin; Maloney, Kelly O.

2016-01-01

Defining habitat suitability criteria (HSC) of aquatic biota can be a key component to environmental flow science. HSC can be developed through numerous methods; however, few studies have evaluated the consistency of HSC developed by different methodologies. We directly compared HSC for depth and velocity developed by the Delphi method (expert opinion) and by two primary literature meta-analyses (literature-derived range and interquartile range) to assess whether these independent methods produce analogous criteria for multiple species (rainbow trout, brown trout, American shad, and shallow fast guild) and life stages. We further evaluated how these two independently developed HSC affect calculations of habitat availability under three alternative reservoir management scenarios in the upper Delaware River at a mesohabitat (main channel, stream margins, and flood plain), reach, and basin scale. In general, literature-derived HSC fell within the range of the Delphi HSC, with highest congruence for velocity habitat. Habitat area predicted using the Delphi HSC fell between the habitat area predicted using two literature-derived HSC, both at the basin and the site scale. Predicted habitat increased in shallow regions (stream margins and flood plain) using literature-derived HSC while Delphi-derived HSC predicted increased channel habitat. HSC generally favoured the same reservoir management scenario; however, no favoured reservoir management scenario was the most common outcome when applying the literature range HSC. The differences found in this study lend insight into how different methodologies can shape HSC and their consequences for predicted habitat and water management decisions. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Telangiectatic variant of hepatic adenoma: clinicopathologic features and correlation between liver needle biopsy and resection.

PubMed

Mounajjed, Taofic; Wu, Tsung-Teh

2011-09-01

Telangiectatic hepatic adenoma (THA) is a benign neoplasm treated by resection. The role of liver needle biopsy in identifying THA before resection has not been evaluated. We identified 55 patients who have undergone resection for hepatic adenoma (HA), THA, or focal nodular hyperplasia (FNH) after needle biopsy. Needle biopsies and resections were evaluated for the following: (1) abortive portal tracts; (2) sinusoidal dilatation; (3) ductular reaction; (4) inflammation; (5) aberrant naked vessels; (6) nodules, fibrous septa, and/or central stellate scar. THA diagnosis was made if the lesion had the first 4 criteria and lacked criterion 6. Most patients (36 of 55), including patients with THA (12 of 16), had multiple lesions (0.2 to 14.4 cm). Patients with THA showed no difference in age, body mass index, prevalence of diabetes or glucose intolerance, or presence of oral contraceptive (OCP) use from patients with HA or FNH, but patients with THA had longer periods of OCP use than patients with HA. Thirty-one percent of THAs had tumor hemorrhage. Of sampled THAs, 27% showed steatosis compared with 76% of sampled HAs (P<0.05). All resected HAs and FNHs were correctly diagnosed on needle biopsy. Of 14 patients with resected THA, 3 histologic patterns were noted on needle biopsy: (1) All THA criteria and naked vessels were present in 6 patients (43%). (2) Consistent with HA: naked vessels only were present in 4 patients (29%). (3) Suggestive of THA: some but not all THA criteria were present in 4 patients (29%). No needle biopsy of a THA was misdiagnosed as FNH. Although evaluation of resection specimens is the gold standard for diagnosis of THA, liver needle biopsy is a useful diagnostic tool that leads to adequate treatment.

Systematic Review and Quality Appraisal of Practice Guidelines for Self-Harm in Children and Adolescents.

PubMed

Courtney, Darren B; Duda, Stephanie; Szatmari, Peter; Henderson, Joanna; Bennett, Kathryn

2018-05-02

This study aimed to systematically identify and appraise clinical practice guidelines (CPGs) relating to the assessment and management of suicide risk and self-harm in children and adolescents. Our research question is as follows: For young people (under 18 years old) presenting to clinical care with suicide ideation or a history of self-harm, what is the quality of up-to-date CPGs? Using the PRISMA format, we systematically identified CPGs meeting our inclusion and exclusion criteria. Subsequently, two independent raters conducted appraisals of the eligible CPGs using the Appraisal of Guidelines for Research and Evaluation II instrument. CPGs were then classified as "poor quality," "minimum quality," and "high quality" using operationally defined criteria developed a priori. We identified 10 eligible CPGs published or renewed between 2005 and May 2017. Only the long-term management of self-harm CPGs produced by the National Institute for Health and Care Excellence met "high-quality" criteria. Despite multiple options of CPGs published to choose from, only one was identified as "high quality," where bias is adequately minimized. Clinicians are advised to direct resources to implementing the "high-quality" CPG. © 2018 The American Association of Suicidology.

Geospatial optimization of siting large-scale solar projects

USGS Publications Warehouse

Macknick, Jordan; Quinby, Ted; Caulfield, Emmet; Gerritsen, Margot; Diffendorfer, James E.; Haines, Seth S.

2014-01-01

guidelines by being user-driven, transparent, interactive, capable of incorporating multiple criteria, and flexible. This work provides the foundation for a dynamic siting assistance tool that can greatly facilitate siting decisions among multiple stakeholders.

Simulation-based process windows simultaneously considering two and three conflicting criteria in injection molding

PubMed Central

Rodríguez-Yáñez, Alicia Berenice; Méndez-Vázquez, Yaileen

2014-01-01

Process windows in injection molding are habitually built with only one performance measure in mind. In reality, a more realistic picture can be obtained when considering multiple performance measures at a time, especially in the presence of conflict. In this work, the construction of process windows for injection molding (IM) is undertaken considering two and three performance measures in conflict simultaneously. The best compromises between the criteria involved are identified through the direct application of the concept of Pareto-dominance in multiple criteria optimization. The aim is to provide a formal and realistic strategy to set processing conditions in IM operations. The resulting optimization approach is easily implementable in MS Excel. The solutions are presented graphically to facilitate their use in manufacturing plants. PMID:25530927

Diagnostic Criteria, Classification and Treatment Goals in Multiple Sclerosis: The Chronicles of Time and Space.

PubMed

Ntranos, Achilles; Lublin, Fred

2016-10-01

Multiple sclerosis (MS) is one of the most diverse human diseases. Since its first description by Charcot in the nineteenth century, the diagnostic criteria, clinical course classification, and treatment goals for MS have been constantly revised and updated to improve diagnostic accuracy, physician communication, and clinical trial design. These changes have improved the clinical outcomes and quality of life for patients with the disease. Recent technological and research breakthroughs will almost certainly further change how we diagnose, classify, and treat MS in the future. In this review, we summarize the key events in the history of MS, explain the reasoning behind the current criteria for MS diagnosis, classification, and treatment, and provide suggestions for further improvements that will keep enhancing the clinical practice of MS.

Simulation-based process windows simultaneously considering two and three conflicting criteria in injection molding.

PubMed

Rodríguez-Yáñez, Alicia Berenice; Méndez-Vázquez, Yaileen; Cabrera-Ríos, Mauricio

2014-01-01

Process windows in injection molding are habitually built with only one performance measure in mind. In reality, a more realistic picture can be obtained when considering multiple performance measures at a time, especially in the presence of conflict. In this work, the construction of process windows for injection molding (IM) is undertaken considering two and three performance measures in conflict simultaneously. The best compromises between the criteria involved are identified through the direct application of the concept of Pareto-dominance in multiple criteria optimization. The aim is to provide a formal and realistic strategy to set processing conditions in IM operations. The resulting optimization approach is easily implementable in MS Excel. The solutions are presented graphically to facilitate their use in manufacturing plants.

Criteria for the use of regression analysis for remote sensing of sediment and pollutants

NASA Technical Reports Server (NTRS)

Whitlock, C. H.; Kuo, C. Y.; Lecroy, S. R.

1982-01-01

An examination of limitations, requirements, and precision of the linear multiple-regression technique for quantification of marine environmental parameters is conducted. Both environmental and optical physics conditions have been defined for which an exact solution to the signal response equations is of the same form as the multiple regression equation. Various statistical parameters are examined to define a criteria for selection of an unbiased fit when upwelled radiance values contain error and are correlated with each other. Field experimental data are examined to define data smoothing requirements in order to satisfy the criteria of Daniel and Wood (1971). Recommendations are made concerning improved selection of ground-truth locations to maximize variance and to minimize physical errors associated with the remote sensing experiment.

Combined predictive value of the expanded donor criteria for long-term graft survival of kidneys from donors after cardiac death: A single-center experience over three decades.

PubMed

Kusaka, Mamoru; Kubota, Yusuke; Sasaki, Hitomi; Fukami, Naohiko; Fujita, Tamio; Hirose, Yuichi; Takahashi, Hiroshi; Kenmochi, Takashi; Shiroki, Ryoichi; Hoshinaga, Kiyotaka

2016-04-01

Kidneys procured from the deceased hold great potential for expanding the donor pool. The aims of the present study were to investigate the post-transplant outcomes of renal allografts recovered from donors after cardiac death, to identify risk factors affecting the renal prognosis and to compare the long-term survival from donors after cardiac death according to the number of risk factors shown by expanded criteria donors. A total of 443 grafts recovered using an in situ regional cooling technique from 1983 to 2011 were assessed. To assess the combined predictive value of the significant expanded criteria donor risk criteria, the patients were divided into three groups: those with no expanded criteria donor risk factors (no risk), one expanded criteria donor risk factor (single-risk) and two or more expanded criteria donor risk factors (multiple-risk). Among the donor factors, age ≥50 years, hypertension, maximum serum creatinine level ≥1.5 mg/dL and a warm ischemia time ≥30 min were identified as independent predictors of long-term graft failure on multivariate analysis. Regarding the expanded criteria donors criteria for marginal donors, cerebrovascular disease, hypertension and maximum serum creatinine level ≥1.5 mg/dL were identified as significant predictors on univariate analysis. The single- and multiple-risk groups showed 2.01- and 2.40-fold higher risks of graft loss, respectively. Renal grafts recovered from donors after cardiac death donors have a good renal function with an excellent long-term graft survival. However, an increased number of expanded criteria donors risk factors increase the risk of graft loss. © 2016 The Japanese Urological Association.

Nurse-led immunotreatment DEcision Coaching In people with Multiple Sclerosis (DECIMS) - Feasibility testing, pilot randomised controlled trial and mixed methods process evaluation.

PubMed

Rahn, A C; Köpke, S; Backhus, I; Kasper, J; Anger, K; Untiedt, B; Alegiani, A; Kleiter, I; Mühlhauser, I; Heesen, C

2018-02-01

Treatment decision-making is complex for people with multiple sclerosis. Profound information on available options is virtually not possible in regular neurologist encounters. The "nurse decision coach model" was developed to redistribute health professionals' tasks in supporting immunotreatment decision-making following the principles of informed shared decision-making. To test the feasibility of a decision coaching programme and recruitment strategies to inform the main trial. Feasibility testing and parallel pilot randomised controlled trial, accompanied by a mixed methods process evaluation. Two German multiple sclerosis university centres. People with suspected or relapsing-remitting multiple sclerosis facing immunotreatment decisions on first line drugs were recruited. Randomisation to the intervention (n = 38) or control group (n = 35) was performed on a daily basis. Quantitative and qualitative process data were collected from people with multiple sclerosis, nurses and physicians. We report on the development and piloting of the decision coaching programme. It comprises a training course for multiple sclerosis nurses and the coaching intervention. The intervention consists of up to three structured nurse-led decision coaching sessions, access to an evidence-based online information platform (DECIMS-Wiki) and a final physician consultation. After feasibility testing, a pilot randomised controlled trial was performed. People with multiple sclerosis were randomised to the intervention or control group. The latter had also access to the DECIMS-Wiki, but received otherwise care as usual. Nurses were not blinded to group assignment, while people with multiple sclerosis and physicians were. The primary outcome was 'informed choice' after six months including the sub-dimensions' risk knowledge (after 14 days), attitude concerning immunotreatment (after physician consultation), and treatment uptake (after six months). Quantitative process evaluation data were collected via questionnaires. Qualitative interviews were performed with all nurses and a convenience sample of nine people with multiple sclerosis. 116 people with multiple sclerosis fulfilled the inclusion criteria and 73 (63%) were included. Groups were comparable at baseline. Data of 51 people with multiple sclerosis (70%) were available for the primary endpoint. In the intervention group 15 of 31 (48%) people with multiple sclerosis achieved an informed choice after six months and 6 of 20 (30%) in the control group. Process evaluation data illustrated a positive response towards the coaching programme as well as good acceptance. The pilot-phase showed promising results concerning acceptability and feasibility of the intervention, which was well perceived by people with multiple sclerosis, most nurses and physicians. Delegating parts of the immunotreatment decision-making process to trained nurses has the potential to increase informed choice and participation as well as effectiveness of patient-physician consultations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Is reflexology an effective intervention? A systematic review of randomised controlled trials.

PubMed

Ernst, Edzard

2009-09-07

To evaluate the evidence for and against the effectiveness of reflexology for treating any medical condition. Six electronic databases were searched from their inception to February 2009 to identify all relevant randomised controlled trials (RCTs). No language restrictions were applied. RCTs of reflexology delivered by trained reflexologists to patients with specific medical conditions. Condition studied, study design and controls, primary outcome measures, follow-up, and main results were extracted. 18 RCTs met all the inclusion criteria. The studies examined a range of conditions: anovulation, asthma, back pain, dementia, diabetes, cancer, foot oedema in pregnancy, headache, irritable bowel syndrome, menopause, multiple sclerosis, the postoperative state and premenstrual syndrome. There were > 1 studies for asthma, the postoperative state, cancer palliation and multiple sclerosis. Five RCTs yielded positive results. Methodological quality was evaluated using the Jadad scale. The methodological quality was often poor, and sample sizes were generally low. Most higher-quality trials did not generate positive findings. The best evidence available to date does not demonstrate convincingly that reflexology is an effective treatment for any medical condition.

Evaluation of a Pair-Wise Conflict Detection and Resolution Algorithm in a Multiple Aircraft Scenario

NASA Technical Reports Server (NTRS)

Carreno, Victor A.

2002-01-01

The KB3D algorithm is a pairwise conflict detection and resolution (CD&R) algorithm. It detects and generates trajectory vectoring for an aircraft which has been predicted to be in an airspace minima violation within a given look-ahead time. It has been proven, using mechanized theorem proving techniques, that for a pair of aircraft, KB3D produces at least one vectoring solution and that all solutions produced are correct. Although solutions produced by the algorithm are mathematically correct, they might not be physically executable by an aircraft or might not solve multiple aircraft conflicts. This paper describes a simple solution selection method which assesses all solutions generated by KB3D and determines the solution to be executed. The solution selection method and KB3D are evaluated using a simulation in which N aircraft fly in a free-flight environment and each aircraft in the simulation uses KB3D to maintain separation. Specifically, the solution selection method filters KB3D solutions which are procedurally undesirable or physically not executable and uses a predetermined criteria for selection.

Multiple Café au Lait Spots in a Group of Fair-Skinned Children without Signs or Symptoms of Neurofibromatosis Type 1.

PubMed

St John, Jessica; Summe, Heather; Csikesz, Courtney; Wiss, Karen; Hay, Beverly; Belazarian, Leah

2016-09-01

The presence of six or more café au lait (CAL) spots is a criterion for the diagnosis of neurofibromatosis type 1 (NF-1). Children with multiple CAL spots are often referred to dermatologists for NF-1 screening. The objective of this case series is to characterize a subset of fair-complected children with red or blond hair and multiple feathery CAL spots who did not meet the criteria for NF-1 at the time of their last evaluation. We conducted a chart review of eight patients seen in our pediatric dermatology clinic who were previously identified as having multiple CAL spots and no other signs or symptoms of NF-1. We describe eight patients ages 2 to 9 years old with multiple, irregular CAL spots with feathery borders and no other signs or symptoms of NF-1. Most of these patients had red or blond hair and were fair complected. All patients were evaluated in our pediatric dermatology clinic, some with a geneticist. The number of CAL spots per patient ranged from 5 to 15 (mean 9.4, median 9). A subset of children, many with fair complexions and red or blond hair, has an increased number of feathery CAL spots and appears unlikely to develop NF-1, although genetic testing was not conducted. It is important to recognize the benign nature of CAL spots in these patients so that appropriate screening and follow-up recommendations may be made. © 2016 Wiley Periodicals, Inc.

Air Pollution Monitoring Site Selection by Multiple Criteria Decision Analysis

EPA Science Inventory

Criteria air pollutants (particulate matter, sulfur dioxide, oxides of nitrogen, volatile organic compounds, and carbon monoxide) as well as toxic air pollutants are a global concern. A particular scenario that is receiving increased attention in the research is the exposure to t...

MRI CRITERIA FOR THE DIAGNOSIS OF MULTIPLE SCLEROSIS: MAGNIMS CONSENSUS GUIDELINES

PubMed Central

Filippi, M.; Rocca, M.A.; Ciccarelli, O.; De Stefano, N.; Evangelou, N.; Kappos, L.; Rovira, A.; Sastre-Garriga, J.; Tintorè, M.; Frederiksen, J.L.; Gasperini, C.; Palace, J.; Reich, D.S.; Banwell, B.; Montalban, X.; Barkhof, F.

2016-01-01

Summary In patients presenting with a clinically isolated syndrome (CIS), magnetic resonance imaging (MRI) can support and substitute clinical information for multiple sclerosis (MS) diagnosis demonstrating disease dissemination in space (DIS) and time (DIT) and helping to rule out other conditions that can mimic MS. From their inclusion in the diagnostic work-up for MS in 2001, several modifications of MRI diagnostic criteria have been proposed, in the attempt to simplify lesion-count models for demonstrating DIS, change the timing of MRI scanning for demonstrating DIT, and increase the value of spinal cord imaging. Since the last update of these criteria, new data regarding the application of MRI for demonstrating DIS and DIT have become available and improvement in MRI technology has occurred. State-of-the-art MRI findings in these patients were discussed in a MAGNIMS workshop, the goal of which was to provide an evidence-based and expert-opinion consensus on diagnostic MRI criteria modifications. PMID:26822746

Development of a methodology for selecting criteria and indicators of sustainable forest management: a case study on participatory assessment.

PubMed

Mendoza, G A; Prabhu, R

2000-12-01

This paper describes an application of multiple criteria analysis (MCA) in assessing criteria and indicators adapted for a particular forest management unit. The methods include: ranking, rating, and pairwise comparisons. These methods were used in a participatory decision-making environment where a team representing various stakeholders and professionals used their expert opinions and judgements in assessing different criteria and indicators (C&I) on the one hand, and how suitable and applicable they are to a forest management unit on the other. A forest concession located in Kalimantan, Indonesia, was used as the site for the case study. Results from the study show that the multicriteria methods are effective tools that can be used as structured decision aids to evaluate, prioritize, and select sets of C&I for a particular forest management unit. Ranking and rating approaches can be used as a screening tool to develop an initial list of C&I. Pairwise comparison, on the other hand, can be used as a finer filter to further reduce the list. In addition to using these three MCA methods, the study also examines two commonly used group decision-making techniques, the Delphi method and the nominal group technique. Feedback received from the participants indicates that the methods are transparent, easy to implement, and provide a convenient environment for participatory decision-making.

Psychosocial functioning in consultation-liaison psychiatry patients: influence of psychosomatic syndromes, psychopathology and somatization.

PubMed

Porcelli, Piero; Bellomo, Antonello; Quartesan, Roberto; Altamura, Mario; Iuso, Salvatore; Ciannameo, Ida; Piselli, Massimiliano; Elisei, Sandro

2009-01-01

This study investigated whether the Diagnostic Criteria for Psychosomatic Research (DCPR) were able to predict psychosocial functioning in addition to psychiatric diagnoses and somatization in consultation-liaison psychiatry (CLP) patients. A consecutive sample of 208 CLP patients were recruited and assessed for sociodemographic and medical data, psychopathology (SCID), psychosomatic syndromes (DCPR structured interview) and somatization (SCL-90-R SOM scale and multisomatoform disorder, MSD). The main endpoints were the mental and physical components of psychosocial functioning (SF-36). A total of 185 (89%) patients had any psychiatric diagnosis, 51 (25%) had MSD positive criteria, 176 (85%) had any DCPR syndrome, and 105 (51%) had multiple DCPR syndromes. Although psychiatric and psychosomatic syndromes were variously associated with psychosocial functioning, hierarchical regression and effect size analyses showed that only DCPR syndromes, particularly demoralization and health anxiety, with somatization but not DSM-IV psychopathology independently predicted poor psychosocial functioning. The presence of psychosomatic syndromes, assessed with DCPR criteria, and high levels of somatization had larger effect size and were independent predictors of the mental and physical components of psychosocial dysfunction, over and above psychopathology. The DCPR classification can provide CLP professionals with a set of sensitive diagnostic criteria for a comprehensive clinical evaluation of psychosomatic syndromes that might play a significant mediating role in the course and the outcome of medical patients referred for psychiatric consultation. Copyright 2009 S. Karger AG, Basel.

Proposed Criteria for Reimbursing eVisits: Content Analysis of Secure Patient Messages in a Personal Health Record System

PubMed Central

Tang, Paul C.; Black, William; Young, Charles Y.

2006-01-01

The Institute of Medicine called for healthcare organizations to provide care whenever needed, using the Internet as appropriate. Few organizations currently offer clinical electronic messaging services for their patients. Many believe that broader adoption of online services will not occur without a change in reimbursement policies. We propose modified Evaluation and Management (eVisit E&M) criteria derived from the current office-based E&M codes as a means of qualifying whether an online encounter should be reimbursed. Physician reviewers applied the proposed eVisit criteria to 120 randomly selected electronic messages sent by 112 patients to 69 physicians through a personal health record system. Twenty-two percent of clinical messages to physicians contained sufficient patient-history data and medical decision-making components to warrant reimbursement according to our eVisit criteria. Among a subset of patients with multiple chronic diseases, this would have generated an estimated 1.2 eVisits per patient annually. Across a broader patient population, we estimate that 0.7 eVisit encounters would be generated annually per patient. Sixty-five percent (65%) of patients felt that electronic communication with their physicians saved one or more office visits per year. Reimbursing for qualified eVisits may encourage broader use of electronic communication to improve access to care and reduce overall healthcare costs. PMID:17238444

EnRICH: Extraction and Ranking using Integration and Criteria Heuristics.

PubMed

Zhang, Xia; Greenlee, M Heather West; Serb, Jeanne M

2013-01-15

High throughput screening technologies enable biologists to generate candidate genes at a rate that, due to time and cost constraints, cannot be studied by experimental approaches in the laboratory. Thus, it has become increasingly important to prioritize candidate genes for experiments. To accomplish this, researchers need to apply selection requirements based on their knowledge, which necessitates qualitative integration of heterogeneous data sources and filtration using multiple criteria. A similar approach can also be applied to putative candidate gene relationships. While automation can assist in this routine and imperative procedure, flexibility of data sources and criteria must not be sacrificed. A tool that can optimize the trade-off between automation and flexibility to simultaneously filter and qualitatively integrate data is needed to prioritize candidate genes and generate composite networks from heterogeneous data sources. We developed the java application, EnRICH (Extraction and Ranking using Integration and Criteria Heuristics), in order to alleviate this need. Here we present a case study in which we used EnRICH to integrate and filter multiple candidate gene lists in order to identify potential retinal disease genes. As a result of this procedure, a candidate pool of several hundred genes was narrowed down to five candidate genes, of which four are confirmed retinal disease genes and one is associated with a retinal disease state. We developed a platform-independent tool that is able to qualitatively integrate multiple heterogeneous datasets and use different selection criteria to filter each of them, provided the datasets are tables that have distinct identifiers (required) and attributes (optional). With the flexibility to specify data sources and filtering criteria, EnRICH automatically prioritizes candidate genes or gene relationships for biologists based on their specific requirements. Here, we also demonstrate that this tool can be effectively and easily used to apply highly specific user-defined criteria and can efficiently identify high quality candidate genes from relatively sparse datasets.

Evaluation of Flagging Criteria of United States Kidney Transplant Center Performance: How to Best Define Outliers?

PubMed

Schold, Jesse D; Miller, Charles M; Henry, Mitchell L; Buccini, Laura D; Flechner, Stuart M; Goldfarb, David A; Poggio, Emilio D; Andreoni, Kenneth A

2017-06-01

Scientific Registry of Transplant Recipients report cards of US organ transplant center performance are publicly available and used for quality oversight. Low center performance (LP) evaluations are associated with changes in practice including reduced transplant rates and increased waitlist removals. In 2014, Scientific Registry of Transplant Recipients implemented new Bayesian methodology to evaluate performance which was not adopted by Center for Medicare and Medicaid Services (CMS). In May 2016, CMS altered their performance criteria, reducing the likelihood of LP evaluations. Our aims were to evaluate incidence, survival rates, and volume of LP centers with Bayesian, historical (old-CMS) and new-CMS criteria using 6 consecutive program-specific reports (PSR), January 2013 to July 2015 among adult kidney transplant centers. Bayesian, old-CMS and new-CMS criteria identified 13.4%, 8.3%, and 6.1% LP PSRs, respectively. Over the 3-year period, 31.9% (Bayesian), 23.4% (old-CMS), and 19.8% (new-CMS) of centers had 1 or more LP evaluation. For small centers (<83 transplants/PSR), there were 4-fold additional LP evaluations (52 vs 13 PSRs) for 1-year mortality with Bayesian versus new-CMS criteria. For large centers (>183 transplants/PSR), there were 3-fold additional LP evaluations for 1-year mortality with Bayesian versus new-CMS criteria with median differences in observed and expected patient survival of -1.6% and -2.2%, respectively. A significant proportion of kidney transplant centers are identified as low performing with relatively small survival differences compared with expected. Bayesian criteria have significantly higher flagging rates and new-CMS criteria modestly reduce flagging. Critical appraisal of performance criteria is needed to assess whether quality oversight is meeting intended goals and whether further modifications could reduce risk aversion, more efficiently allocate resources, and increase transplant opportunities.

Transportation systems evaluation methodology development and applications, phase 3

NASA Technical Reports Server (NTRS)

Kuhlthau, A. R.; Jacobson, I. D.; Richards, L. C.

1981-01-01

Transportation systems or proposed changes in current systems are evaluated. Four principal evaluation criteria are incorporated in the process, operating performance characteristics as viewed by potential users, decisions based on the perceived impacts of the system, estimating what is required to reduce the system to practice; and predicting the ability of the concept to attract financial support. A series of matrix multiplications in which the various matrices represent evaluations in a logical sequence of the various discrete steps in a management decision process is used. One or more alternatives are compared with the current situation, and the result provides a numerical rating which determines the desirability of each alternative relative to the norm and to each other. The steps in the decision process are isolated so that contributions of each to the final result are readily analyzed. The ability to protect against bias on the part of the evaluators, and the fact that system parameters which are basically qualitative in nature can be easily included are advantageous.

Prioritization of engineering support requests and advanced technology projects using decision support and industrial engineering models

NASA Technical Reports Server (NTRS)

Tavana, Madjid

1995-01-01

The evaluation and prioritization of Engineering Support Requests (ESR's) is a particularly difficult task at the Kennedy Space Center (KSC) -- Shuttle Project Engineering Office. This difficulty is due to the complexities inherent in the evaluation process and the lack of structured information. The evaluation process must consider a multitude of relevant pieces of information concerning Safety, Supportability, O&M Cost Savings, Process Enhancement, Reliability, and Implementation. Various analytical and normative models developed over the past have helped decision makers at KSC utilize large volumes of information in the evaluation of ESR's. The purpose of this project is to build on the existing methodologies and develop a multiple criteria decision support system that captures the decision maker's beliefs through a series of sequential, rational, and analytical processes. The model utilizes the Analytic Hierarchy Process (AHP), subjective probabilities, the entropy concept, and Maximize Agreement Heuristic (MAH) to enhance the decision maker's intuition in evaluating a set of ESR's.

Building Bridges to a Brighter Tomorrow: A Systematic Evidence Review of Interventions That Prepare Adolescents for Adulthood

PubMed Central

Krieger, Kathleen; Rutledge, Regina; Rabre, Alexander; Axelson, Sarah; Miller, Audra; White, LeBretia; Jackson, Christine

2018-01-01

Background. Data suggest that adverse social determinants during adolescence can set in motion a lifetime of poor social and health outcomes. Vulnerable youths are at particularly high risk in this regard. Objectives. To identify and assess the current evidence base for adolescent-focused interventions designed to influence adulthood preparation that could affect longer-term social determinants. Search Methods. Using a systematic review methodology, we conducted an initial assessment of intervention evaluations targeting 6 adulthood preparation subject (APS) areas to assess the quality and character of the evidence base. The review is specific to evaluated interventions that address at least 1 of the 6 APS areas: healthy relationships, adolescent development, financial literacy, parent–child communication, educational and career success, and healthy life skills. Selection Criteria. The inclusion criteria were as follows: (1) published in English in an independent, peer-reviewed journal; (2) conducted in developed, English-speaking countries; (3) implemented an intervention that addressed at least 1 of the 6 APS areas, delivered in an in-person setting; (4) included youths at the 5th- through 12th-grade levels or aged 10 to 18 years at some point during intervention implementation; (5) included an evaluation component with a comparison group and baseline and follow-up measures; (6) included behavioral measures as outcomes; and (7) reported statistical significance levels for the behavioral outcome measures. Data Collection and Analysis. We developed an abstraction form to capture details from each article, including key details of the intervention, such as services, implementer characteristics, and timing; adulthood preparation foci; evaluation design, methods, and key behavioral measures; and results, including key statistically significant results for behavior-based outcome measures. We assessed study quality by using several key factors, including randomization, baseline equivalence of treatment and control groups, attrition, and confounding factors. We characterized the quality of evidence as high, moderate, or low on the basis of the described design and execution of the research. Our assessment included only information stated explicitly in the manuscript. Main Results. A total of 36 independent intervention evaluations met the criteria for inclusion. Of these, 27 (75%) included significant findings for behavioral outcomes related to adulthood preparation. Quality was mixed across studies. Of the 36 studies reviewed, 27 used a randomized controlled design (15 group randomization, 12 individual randomization), whereas the others used observational pre–post designs. Ten studies used mixed-methods approaches. Most (n = 32) studies used self-report questionnaires at baseline with a follow-up questionnaire, and 14 studies included multiple follow-up points. Of the studies reviewed, 7 studies received a high-quality rating, indicating no significant issues identified within our quality criteria. We rated 23 studies as moderate quality, indicating methodological challenges within 1 of the quality criteria categories. The most common reasons studies were down-rated were poor baseline equivalency across treatment groups (or no discussion of baseline equivalency) and high levels of attrition. Finally, 6 studies received a low-quality rating because of methodological challenges across multiple quality domains. The studies broadly represented the APS areas. We identified no systematic differences in study quality across the APS areas. Author’s Conclusions. Although some of the intervention results indicate behavioral changes that may be linked to adulthood preparation skills, many of the extant findings are derived from moderate- or poor-quality studies. Additional work is needed to build the evidence base by using methodologically rigorous implementation and evaluation designs and execution. Public Health Implications. Interventions designed to help adolescents better prepare for adulthood may have the potential to affect their longer-term social determinants of health and well-being. More theory-driven approaches and rigorously evaluated interventions could strengthen the evidence base and improve the effectiveness of these adulthood preparation interventions. PMID:29443561

7 CFR 3406.20 - Evaluation criteria for research proposals.

Code of Federal Regulations, 2011 CFR

2011-01-01

... current faculty in the natural or social sciences; provide a better research environment, state-of-the-art... 7 Agriculture 15 2011-01-01 2011-01-01 false Evaluation criteria for research proposals. 3406.20... Research Proposal § 3406.20 Evaluation criteria for research proposals. The maximum score a research...

Multi-criteria group decision making for evaluating the performance of e-waste recycling programs under uncertainty.

PubMed

Wibowo, Santoso; Deng, Hepu

2015-06-01

This paper presents a multi-criteria group decision making approach for effectively evaluating the performance of e-waste recycling programs under uncertainty in an organization. Intuitionistic fuzzy numbers are used for adequately representing the subjective and imprecise assessments of the decision makers in evaluating the relative importance of evaluation criteria and the performance of individual e-waste recycling programs with respect to individual criteria in a given situation. An interactive fuzzy multi-criteria decision making algorithm is developed for facilitating consensus building in a group decision making environment to ensure that all the interest of individual decision makers have been appropriately considered in evaluating alternative e-waste recycling programs with respect to their corporate sustainability performance. The developed algorithm is then incorporated into a multi-criteria decision support system for making the overall performance evaluation process effectively and simple to use. Such a multi-criteria decision making system adequately provides organizations with a proactive mechanism for incorporating the concept of corporate sustainability into their regular planning decisions and business practices. An example is presented for demonstrating the applicability of the proposed approach in evaluating the performance of e-waste recycling programs in organizations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Impaired driving from medical conditions: A 70-year-old man trying to decide if he should continue driving

PubMed Central

Rizzo, Matthew

2012-01-01

Some medical disorders can impair performance, increasing the risk of driving safety errors that can lead to vehicle crashes. The causal pathway often involves a concatenation of factors or events, some of which can be prevented or controlled. Effective interventions can operate before, during, or after a crash occurs at the levels of driver capacity, vehicle and road design, and public policy. A variety of systemic, neurological, psychiatric, and developmental disorders put drivers at potential increased risk of a car crash in the short or long term. Medical diagnosis and age alone are usually insufficient criteria for determining fitness to drive. Strategies are needed for determining what types and levels of reduced function provide a threshold for disqualification in drivers with medical disorders. Evidence of decreased mileage, self-restriction to driving in certain situations, collisions, moving violations, aggressive driving, sleepiness, alcohol abuse, metabolic disorders, and multiple medications may trigger considerations of driver safety. A general framework for evaluating driver fitness relies on a functional evaluation of multiple domains (cognitive, motor, perceptual, and psychiatric) that are important for safe driving and can be applied across many disorders, including conditions that have rarely been studied with respect to driving, and in patients with multiple conditions and medications. Neurocognitive tests, driving simulation, and road tests provide complementary sources of evidence to evaluate driver safety. No single test is sufficient to determine who should drive and who should not. PMID:21364126

Impaired driving from medical conditions: a 70-year-old man trying to decide if he should continue driving.

PubMed

Rizzo, Matthew

2011-03-09

Some medical disorders can impair performance, increasing the risk of driving safety errors that can lead to vehicle crashes. The causal pathway often involves a concatenation of factors or events, some of which can be prevented or controlled. Effective interventions can operate before, during, or after a crash occurs at the levels of driver capacity, vehicle and road design, and public policy. A variety of systemic, neurological, psychiatric, and developmental disorders put drivers at potential increased risk of a car crash in the short or long term. Medical diagnosis and age alone are usually insufficient criteria for determining fitness to drive. Strategies are needed for determining what types and levels of reduced function provide a threshold for disqualification in drivers with medical disorders. Evidence of decreased mileage, self-restriction to driving in certain situations, collisions, moving violations, aggressive driving, sleepiness, alcohol abuse, metabolic disorders, and multiple medications may trigger considerations of driver safety. A general framework for evaluating driver fitness relies on a functional evaluation of multiple domains (cognitive, motor, perceptual, and psychiatric) that are important for safe driving and can be applied across many disorders, including conditions that have rarely been studied with respect to driving, and in patients with multiple conditions and medications. Neurocognitive tests, driving simulation, and road tests provide complementary sources of evidence to evaluate driver safety. No single test is sufficient to determine who should drive and who should not.

MULTIPLE PERSONALITY DISORDER FOLLOWING CONVERSION AND DISSOCIATIVE DISORDER NOS : A CASE REPORT

PubMed Central

Jhingan, Harsh Prem; Aggarwal, Neeruj; Saxena, Shekhar; Gupta, Dhanesh K.

2000-01-01

A case progressing from symptoms of conversion disorder to dissociative disorder and then to multiple personality disorder as per DSM-III-R criteria is being reported. The clinical implications are discussed. PMID:21407917

29 CFR 1926.753 - Hoisting and rigging.

Code of Federal Regulations, 2010 CFR

2010-07-01

... lift rigging procedure. (1) A multiple lift shall only be performed if the following criteria are met: (i) A multiple lift rigging assembly is used; (ii) A maximum of five members are hoisted per lift... multiple lift have been trained in these procedures in accordance with § 1926.761(c)(1). (v) No crane is...

Primary progressive multiple sclerosis diagnostic criteria: a reappraisal.

PubMed

Montalban, X; Sastre-Garriga, J; Filippi, M; Khaleeli, Z; Téllez, N; Vellinga, M M; Tur, C; Brochet, B; Barkhof, F; Rovaris, M; Miller, D H; Polman, C H; Rovira, A; Thompson, A J

2009-12-01

The diagnostic criteria used in primary progressive (PP) and relapsing-remitting (RR) multiple sclerosis (MS) show substantial differences. This introduces complexity in the diagnosis of MS which could be resolved if these criteria could be unified in terms of the requirements for dissemination in space (DIS). The aim of this study was to assess whether a single algorithm may be used to demonstrate DIS in all forms of MS. Five sets of RRMS criteria for DIS were applied to a cohort of 145 patients with established PPMS (mean disease duration: 11 years - PPMS-1): C1: Barkhof-Tintoré (as in 2005 McDonald's criteria); C2: Swanton et al. (as in JNNP 2006); C3: presence of oligoclonal bands plus two lesions (as in McDonald's criteria); C4 and C5: a two-step approach was also followed (patients not fulfilling C1 or C2 were then assessed for C3). Two sets of PPMS criteria for DIS were applied: C6: Thompson et al. (as in 2001 McDonald's criteria); C7: 2005 McDonald criteria. A second sample of 55 patients with less than 5 years of disease duration (PPMS-2) was also analysed using an identical approach. For PPMS-1/PPMS-2, fulfilment was: C1:73.8%/66.7%; C2:72.1%/59.3%; C3:89%/79.2%; C4:96%/92.3%; C5:96%/85.7%; C6:85.8%/78.7%; C7:91%/80.4%. Levels of fulfilment suggest that the use of a single set of criteria for DIS in RRMS and PPMS might be feasible, and reinforce the added value of cerebrospinal fluid (CSF) findings to increase fulfilment in PPMS. Unification of the DIS criteria for both RRMS and PPMS could be considered in further revisions of the MS diagnostic criteria.

Extracorporeal treatment for barbiturate poisoning: recommendations from the EXTRIP Workgroup.

PubMed

Mactier, Robert; Laliberté, Martin; Mardini, Joelle; Ghannoum, Marc; Lavergne, Valery; Gosselin, Sophie; Hoffman, Robert S; Nolin, Thomas D

2014-09-01

The EXTRIP (Extracorporeal Treatments in Poisoning) Workgroup conducted a systematic review of barbiturate poisoning using a standardized evidence-based process to provide recommendations on the use of extracorporeal treatment (ECTR) in patients with barbiturate poisoning. The authors reviewed all articles, extracted data, summarized key findings, and proposed structured voting statements following a predetermined format. A 2-round modified Delphi method was used to reach a consensus on voting statements, and the RAND/UCLA Appropriateness Method was used to quantify disagreement. 617 articles met the search inclusion criteria. Data for 538 patients were abstracted and evaluated. Only case reports, case series, and nonrandomized observational studies were identified, yielding a low quality of evidence for all recommendations. Using established criteria, the workgroup deemed that long-acting barbiturates are dialyzable and short-acting barbiturates are moderately dialyzable. Four key recommendations were made. (1) The use of ECTR should be restricted to cases of severe long-acting barbiturate poisoning. (2) The indications for ECTR in this setting are the presence of prolonged coma, respiratory depression necessitating mechanical ventilation, shock, persistent toxicity, or increasing or persistently elevated serum barbiturate concentrations despite treatment with multiple-dose activated charcoal. (3) Intermittent hemodialysis is the preferred mode of ECTR, and multiple-dose activated charcoal treatment should be continued during ECTR. (4) Cessation of ECTR is indicated when clinical improvement is apparent. This report provides detailed descriptions of the rationale for all recommendations. In summary, patients with long-acting barbiturate poisoning should be treated with ECTR provided at least one of the specific criteria in the first recommendation is present. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Clinical Amyloid Imaging.

PubMed

Mallik, Atul; Drzezga, Alex; Minoshima, Satoshi

2017-01-01

Amyloid plaques, along with neurofibrillary tangles, are a neuropathologic hallmark of Alzheimer disease (AD). Recently, amyloid PET radiotracers have been developed and approved for clinical use in the evaluation of suspected neurodegenerative disorders. In both research and clinical settings, amyloid PET imaging has provided important diagnostic and prognostic information for the management of patients with possible AD, mild cognitive impairment (MCI), and other challenging diagnostic presentations. Although the overall impact of amyloid imaging is still being evaluated, the Society of Nuclear Medicine and Molecular Imaging and Alzheimer's Association Amyloid Imaging Task Force have created appropriate use criteria for the standard clinical use of amyloid PET imaging. By the appropriate use criteria, amyloid imaging is appropriate for patients with (1) persistent or unexplained MCI, (2) AD as a possible but still uncertain diagnosis after expert evaluation and (3) atypically early-age-onset progressive dementia. To better understand the clinical and economic effect of amyloid imaging, the Imaging Dementia-Evidence for Amyloid Scanning (IDEAS) study is an ongoing large multicenter study in the United States, which is evaluating how amyloid imaging affects diagnosis, management, and outcomes for cognitively impaired patients who cannot be completely evaluated by clinical assessment alone. Multiple other large-scale studies are evaluating the prognostic role of amyloid PET imaging for predicting MCI progression to AD in general and high-risk populations. At the same time, amyloid imaging is an important tool for evaluating potential disease-modifying therapies for AD. Overall, the increased use of amyloid PET imaging has led to a better understanding of the strengths and limitations of this imaging modality and how it may best be used with other clinical, molecular, and imaging assessment techniques for the diagnosis and management of neurodegenerative disorders. Copyright © 2017 Elsevier Inc. All rights reserved.

Making objective decisions in mechanical engineering problems

NASA Astrophysics Data System (ADS)

Raicu, A.; Oanta, E.; Sabau, A.

2017-08-01

Decision making process has a great influence in the development of a given project, the goal being to select an optimal choice in a given context. Because of its great importance, the decision making was studied using various science methods, finally being conceived the game theory that is considered the background for the science of logical decision making in various fields. The paper presents some basic ideas regarding the game theory in order to offer the necessary information to understand the multiple-criteria decision making (MCDM) problems in engineering. The solution is to transform the multiple-criteria problem in a one-criterion decision problem, using the notion of utility, together with the weighting sum model or the weighting product model. The weighted importance of the criteria is computed using the so-called Step method applied to a relation of preferences between the criteria. Two relevant examples from engineering are also presented. The future directions of research consist of the use of other types of criteria, the development of computer based instruments for decision making general problems and to conceive a software module based on expert system principles to be included in the Wiki software applications for polymeric materials that are already operational.

Multiple Criteria Decision Analysis for Health Care Decision Making--An Introduction: Report 1 of the ISPOR MCDA Emerging Good Practices Task Force.

PubMed

Thokala, Praveen; Devlin, Nancy; Marsh, Kevin; Baltussen, Rob; Boysen, Meindert; Kalo, Zoltan; Longrenn, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Ijzerman, Maarten

2016-01-01

Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting, objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making and a set of techniques, known under the collective heading multiple criteria decision analysis (MCDA), are useful for this purpose. MCDA methods are widely used in other sectors, and recently there has been an increase in health care applications. In 2014, ISPOR established an MCDA Emerging Good Practices Task Force. It was charged with establishing a common definition for MCDA in health care decision making and developing good practice guidelines for conducting MCDA to aid health care decision making. This initial ISPOR MCDA task force report provides an introduction to MCDA - it defines MCDA; provides examples of its use in different kinds of decision making in health care (including benefit risk analysis, health technology assessment, resource allocation, portfolio decision analysis, shared patient clinician decision making and prioritizing patients' access to services); provides an overview of the principal methods of MCDA; and describes the key steps involved. Upon reviewing this report, readers should have a solid overview of MCDA methods and their potential for supporting health care decision making. Copyright © 2016. Published by Elsevier Inc.

Agriculture, food, and nutrition interventions that facilitate sustainable food production and impact health: an overview of systematic reviews.

PubMed

Haby, Michelle M; Chapman, Evelina; Clark, Rachel; Galvão, Luiz A C

2016-08-01

Objectives To identify the agriculture, food, and nutrition security interventions that facilitate sustainable food production and have a positive impact on health. Methods Systematic review methods were used to synthesize evidence from multiple systematic reviews and economic evaluations through a comprehensive search of 17 databases and 10 websites. The search employed a pre-defined protocol with clear inclusion criteria. Both grey and peer-reviewed literature published in English, Spanish, and Portuguese between 1 January 1997 and November 2013 were included. To classify as "sustainable," interventions needed to aim to positively impact at least two dimensions of the integrated framework for sustainable development and include measures of health impact. Results Fifteen systematic reviews and seven economic evaluations met the inclusion criteria. All interventions had some impact on health or on risk factors for health outcomes, except those related to genetically modified foods. Impact on health inequalities was rarely measured. All interventions with economic evaluations were very cost-effective, had cost savings, or net benefits. In addition to impacting health (inclusive social development), all interventions had the potential to impact on inclusive economic development, and some, on environmental sustainability, though these effects were rarely assessed. Conclusions What is needed now is careful implementation of interventions with expected positive health impacts but with concurrent, rigorous evaluation. Possible impact on health inequalities needs to be considered and measured by future primary studies and systematic reviews, as does impact of interventions on all dimensions of sustainable development.

Multi-criteria evaluation methods in the production scheduling

NASA Astrophysics Data System (ADS)

Kalinowski, K.; Krenczyk, D.; Paprocka, I.; Kempa, W.; Grabowik, C.

2016-08-01

The paper presents a discussion on the practical application of different methods of multi-criteria evaluation in the process of scheduling in manufacturing systems. Among the methods two main groups are specified: methods based on the distance function (using metacriterion) and methods that create a Pareto set of possible solutions. The basic criteria used for scheduling were also described. The overall procedure of evaluation process in production scheduling was presented. It takes into account the actions in the whole scheduling process and human decision maker (HDM) participation. The specified HDM decisions are related to creating and editing a set of evaluation criteria, selection of multi-criteria evaluation method, interaction in the searching process, using informal criteria and making final changes in the schedule for implementation. According to need, process scheduling may be completely or partially automated. Full automatization is possible in case of metacriterion based objective function and if Pareto set is selected - the final decision has to be done by HDM.

An Analysis of Criteria for the Evaluation of Educational Web Sites.

ERIC Educational Resources Information Center

Bantjes, L.; Cronje, J. C.

2000-01-01

Proposes a set of 50 criteria in seven categories for evaluating educational Internet information sources. Compares these indicators against a number of acknowledged Internet evaluation sites and identifies the most used criteria. Finds that currency, graphic design, and browsability are the most highly rated aspects to consider when evaluating…

44 CFR 152.5 - Review process and evaluation criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... criteria and the program priorities. Eligible applicants that best address the priorities will advance to a... Review process and evaluation criteria. (a) Every application will be evaluated based on the answers to... screening will be in the “competitive range” and subject to a second level of review. We will use the...

Guidelines as rationing tools: a qualitative analysis of psychosocial patient selection criteria for cardiac procedures

PubMed Central

Giacomini, Mita K.; Cook, Deborah J.; Streiner, David L.; Anand, Sonia S.

2001-01-01

Background Cardiac procedure guidelines often include psychosocial criteria for selecting patients that potentially introduce social value judgements into clinical decisions and decisions about the rationing of care. The aim of this study was to investigate the terms and justifications for and the meanings of psychosocial patient characteristics used in cardiac procedure guidelines. Methods We selected English-language guidelines published since 1990 and chapters in textbooks published since 1989. These guidelines amalgamated multiple sources of evidence and expertise and made recommendations regarding patient selection for specific procedures. A multidisciplinary team of physicians and social scientists extracted passages regarding psychosocial criteria and developed categories and conceptual relationships to describe and interpret their content. Results Sixty-five papers met the criteria for inclusion in the study. Forty-five (69%) mentioned psychosocial criteria as procedure indications or contraindications. The latter fell into several categories, including behavioural and psychological issues, relationships with significant others, financial resources, social roles and environmental circumstances. Interpretation Psychosocial characteristics are portrayed as having 2 roles in patient selection: as risk factors intrinsic to the candidate or as indicators of need for special intervention. Guidelines typically simply list psychosocial contraindications without clarifying their specific nature or providing any justification for their use. Psychosocial considerations can help in the evaluation of patients for cardiac procedures, but they become ethically controversial when used to restrict access. The use of psychosocial indications and contraindications could be improved by more precise descriptions of the psychosocial problem at issue, explanations regarding why the criterion matters and justification of the characteristic using a biological rationale or research evidence. PMID:11258209

Plasma cell quantification in bone marrow by computer-assisted image analysis.

PubMed

Went, P; Mayer, S; Oberholzer, M; Dirnhofer, S

2006-09-01

Minor and major criteria for the diagnosis of multiple meloma according to the definition of the WHO classification include different categories of the bone marrow plasma cell count: a shift from the 10-30% group to the > 30% group equals a shift from a minor to a major criterium, while the < 10% group does not contribute to the diagnosis. Plasma cell fraction in the bone marrow is therefore critical for the classification and optimal clinical management of patients with plasma cell dyscrasias. The aim of this study was (i) to establish a digital image analysis system able to quantify bone marrow plasma cells and (ii) to evaluate two quantification techniques in bone marrow trephines i.e. computer-assisted digital image analysis and conventional light-microscopic evaluation. The results were compared regarding inter-observer variation of the obtained results. Eighty-seven patients, 28 with multiple myeloma, 29 with monoclonal gammopathy of undetermined significance, and 30 with reactive plasmocytosis were included in the study. Plasma cells in H&E- and CD138-stained slides were quantified by two investigators using light-microscopic estimation and computer-assisted digital analysis. The sets of results were correlated with rank correlation coefficients. Patients were categorized according to WHO criteria addressing the plasma cell content of the bone marrow (group 1: 0-10%, group 2: 11-30%, group 3: > 30%), and the results compared by kappa statistics. The degree of agreement in CD138-stained slides was higher for results obtained using the computer-assisted image analysis system compared to light microscopic evaluation (corr.coeff. = 0.782), as was seen in the intra- (corr.coeff. = 0.960) and inter-individual results correlations (corr.coeff. = 0.899). Inter-observer agreement for categorized results (SM/PW: kappa 0.833) was in a high range. Computer-assisted image analysis demonstrated a higher reproducibility of bone marrow plasma cell quantification. This might be of critical importance for diagnosis, clinical management and prognostics when plasma cell numbers are low, which makes exact quantifications difficult.

Presenting an Evaluation Model for the Cancer Registry Software.

PubMed

Moghaddasi, Hamid; Asadi, Farkhondeh; Rabiei, Reza; Rahimi, Farough; Shahbodaghi, Reihaneh

2017-12-01

As cancer is increasingly growing, cancer registry is of great importance as the main core of cancer control programs, and many different software has been designed for this purpose. Therefore, establishing a comprehensive evaluation model is essential to evaluate and compare a wide range of such software. In this study, the criteria of the cancer registry software have been determined by studying the documents and two functional software of this field. The evaluation tool was a checklist and in order to validate the model, this checklist was presented to experts in the form of a questionnaire. To analyze the results of validation, an agreed coefficient of %75 was determined in order to apply changes. Finally, when the model was approved, the final version of the evaluation model for the cancer registry software was presented. The evaluation model of this study contains tool and method of evaluation. The evaluation tool is a checklist including the general and specific criteria of the cancer registry software along with their sub-criteria. The evaluation method of this study was chosen as a criteria-based evaluation method based on the findings. The model of this study encompasses various dimensions of cancer registry software and a proper method for evaluating it. The strong point of this evaluation model is the separation between general criteria and the specific ones, while trying to fulfill the comprehensiveness of the criteria. Since this model has been validated, it can be used as a standard to evaluate the cancer registry software.

A spatial web/agent-based model to support stakeholders' negotiation regarding land development.

PubMed

Pooyandeh, Majeed; Marceau, Danielle J

2013-11-15

Decision making in land management can be greatly enhanced if the perspectives of concerned stakeholders are taken into consideration. This often implies negotiation in order to reach an agreement based on the examination of multiple alternatives. This paper describes a spatial web/agent-based modeling system that was developed to support the negotiation process of stakeholders regarding land development in southern Alberta, Canada. This system integrates a fuzzy analytic hierarchy procedure within an agent-based model in an interactive visualization environment provided through a web interface to facilitate the learning and negotiation of the stakeholders. In the pre-negotiation phase, the stakeholders compare their evaluation criteria using linguistic expressions. Due to the uncertainty and fuzzy nature of such comparisons, a fuzzy Analytic Hierarchy Process is then used to prioritize the criteria. The negotiation starts by a development plan being submitted by a user (stakeholder) through the web interface. An agent called the proposer, which represents the proposer of the plan, receives this plan and starts negotiating with all other agents. The negotiation is conducted in a step-wise manner where the agents change their attitudes by assigning a new set of weights to their criteria. If an agreement is not achieved, a new location for development is proposed by the proposer agent. This process is repeated until a location is found that satisfies all agents to a certain predefined degree. To evaluate the performance of the model, the negotiation was simulated with four agents, one of which being the proposer agent, using two hypothetical development plans. The first plan was selected randomly; the other one was chosen in an area that is of high importance to one of the agents. While the agents managed to achieve an agreement about the location of the land development after three rounds of negotiation in the first scenario, seven rounds were required in the second scenario. The proposed web/agent-based model facilitates the interaction and learning among stakeholders when facing multiple alternatives. Copyright © 2013 Elsevier Ltd. All rights reserved.

The sequence of disease-modifying therapies in relapsing multiple sclerosis: safety and immunologic considerations.

PubMed

Pardo, Gabriel; Jones, David E

2017-12-01

The treatment landscape for relapsing forms of multiple sclerosis (RMS) has expanded considerably over the last 10 years with the approval of multiple new disease-modifying therapies (DMTs), and others in late-stage clinical development. All DMTs for RMS are believed to reduce central nervous system immune-mediated inflammatory processes, which translate into demonstrable improvement in clinical and radiologic outcomes. However, some DMTs are associated with long-lasting effects on the immune system and/or serious adverse events, both of which may complicate the use of subsequent therapies. When customizing a treatment program, a benefit-risk assessment must consider multiple factors, including the efficacy of the DMT to reduce disease activity, the short- and long-term safety and immunologic profiles of each DMT, the criteria used to define switching treatment, and the risk tolerance of each patient. A comprehensive benefit-risk assessment can only be achieved by evaluating the immunologic, safety, and efficacy data for DMTs in the controlled clinical trial environment and the postmarketing clinical practice setting. This review is intended to help neurologists make informed decisions when treating RMS by summarizing the known data for each DMT and raising awareness of the multiple considerations involved in treating people with RMS throughout the entire course of their disease.

Classification of air quality using fuzzy synthetic multiplication.

PubMed

Abdullah, Lazim; Khalid, Noor Dalina

2012-11-01

Proper identification of environment's air quality based on limited observations is an essential task to meet the goals of environmental management. Various classification methods have been used to estimate the change of air quality status and health. However, discrepancies frequently arise from the lack of clear distinction between each air quality, the uncertainty in the quality criteria employed and the vagueness or fuzziness embedded in the decision-making output values. Owing to inherent imprecision, difficulties always exist in some conventional methodologies when describing integrated air quality conditions with respect to various pollutants. Therefore, this paper presents two fuzzy multiplication synthetic techniques to establish classification of air quality. The fuzzy multiplication technique empowers the max-min operations in "or" and "and" in executing the fuzzy arithmetic operations. Based on a set of air pollutants data carbon monoxide, sulfur dioxide, nitrogen dioxide, ozone, and particulate matter (PM(10)) collected from a network of 51 stations in Klang Valley, East Malaysia, Sabah, and Sarawak were utilized in this evaluation. The two fuzzy multiplication techniques consistently classified Malaysia's air quality as "good." The findings indicated that the techniques may have successfully harmonized inherent discrepancies and interpret complex conditions. It was demonstrated that fuzzy synthetic multiplication techniques are quite appropriate techniques for air quality management.

Using a Mixed Model to Explore Evaluation Criteria for Bank Supervision: A Banking Supervision Law Perspective

PubMed Central

Tsai, Sang-Bing; Chen, Kuan-Yu; Zhao, Hongrui; Wei, Yu-Min; Wang, Cheng-Kuang; Zheng, Yuxiang; Chang, Li-Chung; Wang, Jiangtao

2016-01-01

Financial supervision means that monetary authorities have the power to supervise and manage financial institutions according to laws. Monetary authorities have this power because of the requirements of improving financial services, protecting the rights of depositors, adapting to industrial development, ensuring financial fair trade, and maintaining stable financial order. To establish evaluation criteria for bank supervision in China, this study integrated fuzzy theory and the decision making trial and evaluation laboratory (DEMATEL) and proposes a fuzzy-DEMATEL model. First, fuzzy theory was applied to examine bank supervision criteria and analyze fuzzy semantics. Second, the fuzzy-DEMATEL model was used to calculate the degree to which financial supervision criteria mutually influenced one another and their causal relationship. Finally, an evaluation criteria model for evaluating bank and financial supervision was established. PMID:27992449

Using a Mixed Model to Explore Evaluation Criteria for Bank Supervision: A Banking Supervision Law Perspective.

PubMed

Tsai, Sang-Bing; Chen, Kuan-Yu; Zhao, Hongrui; Wei, Yu-Min; Wang, Cheng-Kuang; Zheng, Yuxiang; Chang, Li-Chung; Wang, Jiangtao

2016-01-01

Financial supervision means that monetary authorities have the power to supervise and manage financial institutions according to laws. Monetary authorities have this power because of the requirements of improving financial services, protecting the rights of depositors, adapting to industrial development, ensuring financial fair trade, and maintaining stable financial order. To establish evaluation criteria for bank supervision in China, this study integrated fuzzy theory and the decision making trial and evaluation laboratory (DEMATEL) and proposes a fuzzy-DEMATEL model. First, fuzzy theory was applied to examine bank supervision criteria and analyze fuzzy semantics. Second, the fuzzy-DEMATEL model was used to calculate the degree to which financial supervision criteria mutually influenced one another and their causal relationship. Finally, an evaluation criteria model for evaluating bank and financial supervision was established.

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

Miller, N. J.; Koltai, R. N.; McGowan, T. K.

The GATEWAY program followed two pedestrian-scale lighting projects that required multiple mockups – one at Stanford University in California and the other at Chautauqua Institution in upstate New York. The report provides insight into pedestrian lighting criteria, how they differ from street and area lighting criteria, and how solid-state lighting can be better applied in pedestrian applications.

Multiple Rapid Swallow Maneuver Enhances the Clinical Utility of High-Resolution Manometry in Patients Showing Ineffective Esophageal Motility

PubMed Central

Min, Yang Won; Shin, Inseub; Son, Hee Jung; Rhee, Poong-Lyul

2015-01-01

Abstract The clinical significance of ineffective esophageal motility (IEM) together with multiple rapid swallow (MRS) has not been yet evaluated in the Chicago Classification v3.0. This study evaluated the adjunctive role of MRS in IEM and determined the criteria of abnormal MRS to maximize the utility of IEM. We analyzed 186 patients showing IEM or normal esophageal motility (NEM), who underwent esophageal high-resolution impedance–manometry for esophageal symptoms. Two different criteria for abnormal MRS were applied to IEM subjects, resulting in 2 corresponding subgroups: IEM-A when distal contractile integral (DCI) ratio between an average wet swallows and MRS contraction was <1 and IEM-B when MRS contraction DCI was <450 mm Hg-s-cm. One IEM subject inadequately performed MRS. Among the remaining 52 IEM subjects, 18 (34.6%) were classified into IEM-A and 23 (44.2%) into IEM-B. IEM subjects showed less complete bolus transit (median 0.0%, interquartile range 0.0–20.0% vs 60.0%, 30.0–80.0; P < 0.001) resulting in higher impaired bolus transit than NEM subjects (98.1% vs 66.9%, P = 0.001). IEM-B subjects showed additionally higher pathologic bolus exposure than NEM subjects (55.6% vs 29.3%, P = 0.001), whereas IEM-A subjects could not. Although IEM-B subjects had the highest prevalence of gastroesophageal reflux disease among the subjects groups, it did not reach statistical significance. In conclusion, IEM patients with abnormal MRS contraction have an increased risk of prolonged bolus clearance, poor bolus transit, and pathologic bolus exposure. IEM patients need to be assessed concerning whether MRS contraction DCI is <450 mm Hg-s-cm to segregate clinically relevant patients. PMID:26448010

Oligoclonal bands in patients with multiple myeloma: Its emergence per se could not be translated to improved survival

PubMed Central

Fujisawa, Manabu; Seike, Keisuke; Fukumoto, Kouta; Suehara, Yasuhito; Fukaya, Masafumi; Sugihara, Hiroki; Takeuchi, Masami; Matsue, Kosei

2014-01-01

The emergence of oligoclonal bands (OB) has been reported in patients with multiple myeloma (MM) after stem cell transplantation (SCT) or successful chemotherapy. However, their clinical relevance remains unclear. We reviewed the clinical records of MM patients from January 2006 to May 2014. Treatment response was evaluated by International Working Group (IMWG) criteria. Serum immunofixation tests were performed at least every 3 months if the patient achieved more than very good partial response (VGPR). Free light chain (FLC) and minimal residual disease measurement by multicolor flow cytometry (MFC) were performed to evaluate the response to treatment. Among the 163 patients included in the study, 40 developed OB. Detection rates of OB in patients with complete response (CR), VGPR and partial response (PR) or less were 51.8, 36.3 and 0%, respectively. Patients with OB showed better progression-free survival (PFS) and overall survival (OS) rates than those without OB (P = 0.028 and P < 0.001, respectively). However, if the patients were limited to ≥VGPR or CR, development of OB did not affect PFS (P = 0.621 and P = 0.646, respectively) or OS (P = 0.189 and P = 0.766, respectively). OB was observed in 60% of patients after SCT, and in 36.6% of patients with more than VGPR without SCT (P < 0.001). Patients with OB tended to have less minimal residual disease than those without OB (P = 0.054) and its presence may affect the stringent CR criteria. In conclusion, the emergence of OB was seen exclusively in patients with favorable responses, but its emergence per se could not be translated to improved survival. PMID:25182124

oligoclonal bands in patients with multiple myeloma: its emergence per se could not be translated to improved survival.

PubMed

Fujisawa, Manabu; Seike, Keisuke; Fukumoto, Kouta; Suehara, Yasuhito; Fukaya, Masafumi; Sugihara, Hiroki; Takeuchi, Masami; Matsue, Kosei

2014-11-01

The emergence of oligoclonal bands (OB) has been reported in patients with multiple myeloma (MM) after stem cell transplantation (SCT) or successful chemotherapy. However, their clinical relevance remains unclear. We reviewed the clinical records of MM patients from January 2006 to May 2014. Treatment response was evaluated by International Working Group (IMWG) criteria. Serum immunofixation tests were performed at least every 3 months if the patient achieved more than very good partial response (VGPR). Free light chain (FLC) and minimal residual disease measurement by multicolor flow cytometry (MFC) were performed to evaluate the response to treatment. Among the 163 patients included in the study, 40 developed OB. Detection rates of OB in patients with complete response (CR), VGPR and partial response (PR) or less were 51.8, 36.3 and 0%, respectively. Patients with OB showed better progression-free survival (PFS) and overall survival (OS) rates than those without OB (P = 0.028 and P < 0.001, respectively). However, if the patients were limited to ≥VGPR or CR, development of OB did not affect PFS (P = 0.621 and P = 0.646, respectively) or OS (P = 0.189 and P = 0.766, respectively). OB was observed in 60% of patients after SCT, and in 36.6% of patients with more than VGPR without SCT (P < 0.001). Patients with OB tended to have less minimal residual disease than those without OB (P = 0.054) and its presence may affect the stringent CR criteria. In conclusion, the emergence of OB was seen exclusively in patients with favorable responses, but its emergence per se could not be translated to improved survival. © 2014 The Authors. Cancer Science published by Wiley Publishing Asia Pty Ltd on behalf of Japanese Cancer Association.

Medium wave exposure characterisation using exposure quotients.

PubMed

Paniagua, Jesús M; Rufo, Montaña; Jiménez, Antonio; Antolín, Alicia; Pinar, Iván

2010-06-01

One of the aspects considered in the International Commission on Non-Ionizing Radiation Protection guidelines is that, in situations of simultaneous exposure to fields of different frequencies, exposure quotients for thermal and electrical stimulation effects should be examined. The aim of the present work was to analyse the electromagnetic radiation levels and exposure quotients for exposure to multiple-frequency sources in the vicinity of medium wave radio broadcasting antennas. The measurements were made with a spectrum analyser and a monopole antenna. Kriging interpolation was used to prepare contour maps and to estimate the levels in the towns and villages of the zone. The results showed that the exposure quotient criterion based on electrical stimulation effects to be more stringent than those based on thermal effects or power density levels. Improvement of dosimetry evaluations requires the spectral components of the radiation to be quantified, followed by application of the criteria for exposure to multiple-frequency sources.

Stem cell plasticity.

PubMed

Lakshmipathy, Uma; Verfaillie, Catherine

2005-01-01

The central dogma in stem cell biology has been that cells isolated from a particular tissue can renew and differentiate into lineages of the tissue it resides in. Several studies have challenged this idea by demonstrating that tissue specific cell have considerable plasticity and can cross-lineage restriction boundary and give rise to cell types of other lineages. However, the lack of a clear definition for plasticity has led to confusion with several reports failing to demonstrate that a single cell can indeed differentiate into multiple lineages at significant levels. Further, differences between results obtained in different labs has cast doubt on some results and several studies still await independent confirmation. In this review, we critically evaluate studies that report stem cell plasticity using three rigid criteria to define stem cell plasticity; differentiation of a single cell into multiple cell lineages, functionality of differentiated cells in vitro and in vivo, robust and persistent engraft of transplanted cells.

Development and Assessment of the Multiple Mini-Interview in a School of Pharmacy Admissions Model

PubMed Central

McLaughlin, Jacqueline E.; Singer, David; Lewis, Margaret; Dinkins, Melissa M.

2015-01-01

Objective. To describe the development, implementation, and evaluation of the multiple mini-interview (MMI) within a doctor of pharmacy (PharmD) admissions model. Methods. Demographic data and academic indicators were collected for all candidates who participated in Candidates’ Day (n=253), along with the score for each MMI station criteria (7 stations). A survey was administered to all candidates who completed the MMI, and another survey was administered to all interviewers to examine perceptions of the MMI. Results. Analyses suggest that MMI stations assessed different attributes as designed, with Cronbach alpha for each station ranging from 0.90 to 0.95. All correlations between MMI station scores and academic indicators were negligible. No significant differences in average station scores were found based on age, gender, or race. Conclusion. This study provides additional support for the use of the MMI as an admissions tool in pharmacy education. PMID:26089562

Making Good Decisions in Healthcare with Multi-Criteria Decision Analysis: The Use, Current Research and Future Development of MCDA.

PubMed

Mühlbacher, Axel C; Kaczynski, Anika

2016-02-01

Healthcare decision making is usually characterized by a low degree of transparency. The demand for transparent decision processes can be fulfilled only when assessment, appraisal and decisions about health technologies are performed under a systematic construct of benefit assessment. The benefit of an intervention is often multidimensional and, thus, must be represented by several decision criteria. Complex decision problems require an assessment and appraisal of various criteria; therefore, a decision process that systematically identifies the best available alternative and enables an optimal and transparent decision is needed. For that reason, decision criteria must be weighted and goal achievement must be scored for all alternatives. Methods of multi-criteria decision analysis (MCDA) are available to analyse and appraise multiple clinical endpoints and structure complex decision problems in healthcare decision making. By means of MCDA, value judgments, priorities and preferences of patients, insurees and experts can be integrated systematically and transparently into the decision-making process. This article describes the MCDA framework and identifies potential areas where MCDA can be of use (e.g. approval, guidelines and reimbursement/pricing of health technologies). A literature search was performed to identify current research in healthcare. The results showed that healthcare decision making is addressing the problem of multiple decision criteria and is focusing on the future development and use of techniques to weight and score different decision criteria. This article emphasizes the use and future benefit of MCDA.

Management of a granulomatous lesion in a patient with Kindler's Syndrome

PubMed Central

Bhatsange, Anuradha; Khadse, Yugandhara; Deshmukh, Sabina; Karwa, Swapnil

2018-01-01

Kindler's syndrome is a rare vesiculobullous dermatological disorder sometimes involving multiple organs. First described by Kindler. The differential diagnosis includes Rothmund-Thomson syndrome and epidermolysis bullosa. Fisher's criteria have simplified the diagnosis with major and minor criteria. Oral manifestation of this syndrome includes multiple painful oral ulcers in the mucosa, periodontal attachment loss, gingival bleeding, and fragile mucosa. These manifestations may impair proper nutrition intake, may cause growth and development problems. This case report deals with the management of oral and gingival manifestations in a 12-year-old female child patient diagnosed with Kindler's syndrome. PMID:29568175

Criteria for evaluation of reflective surface for parabolic dish concentrators

NASA Technical Reports Server (NTRS)

Bouquet, F.

1980-01-01

Commercial, second surface glass mirror are emphasized, but aluminum and metallized polymeric films are also included. Criteria for sealing solar mirrors in order to prevent environmental degradation and criteria for bonding sagged or bent mirrors to substrate materials are described. An overview of the technical areas involved in evaluating small mirror samples, sections, and entire large gores is presented. A basis for mirror criteria was established that eventually may become part of inspection and evaluation techniques for three dimensional parabolic reflective surfaces.

Evaluation of a New Grading System for Clinical Skills in Dental Student Clinics.

PubMed

Bodenmann, Aurel D; Bühler, Julia M; Amato, Mauro; Weiger, Ronald; Zitzmann, Nicola U

2017-05-01

Several evaluation systems for clinical exams have been suggested over the years, but no systematic analysis of checklists or criteria-based exam forms has yet been undertaken. The aims of this study were to analyze criteria-based evaluation forms and to identify areas in the teaching process potentially requiring improvements. All evaluation forms introduced in 2012 at the Clinic for Periodontology, Endodontology, and Cariology at the University Center of Dental Medicine in Basel, Switzerland, and applied over a three-year period (n=1,093 in 2015) were analyzed using predefined criteria. The authors investigated how well clinical tasks were examined with the given criteria and which criteria were preferably evaluated with a grading system (0-2) or a yes/no choice. The average final grades ranged from 0.89 (n=92) for gold inlay preparation to 1.76 (n=46) for periodontal treatment. Comments were made in 38.5% (n=356) of all exams, mainly highlighting specific aspects of existing criteria. Overall, 13 criteria out of 66 should be checked instead of graded. This methodological analysis of exam forms assessing tasks in operative dentistry yielded valuable information on areas with potential for improvement in the dental curriculum and the evaluation process. Aspects that require more theoretical background and/or hands-on recommendations from experienced clinicians were identified, and ways of further refining and redesigning the evaluation forms were proposed.

Using the arthroscopic surgery skill evaluation tool as a pass-fail examination.

PubMed

Koehler, Ryan J; Nicandri, Gregg T

2013-12-04

Examination of arthroscopic skill requires evaluation tools that are valid and reliable with clear criteria for passing. The Arthroscopic Surgery Skill Evaluation Tool was developed as a video-based assessment of technical skill with criteria for passing established by a panel of experts. The purpose of this study was to test the validity and reliability of the Arthroscopic Surgery Skill Evaluation Tool as a pass-fail examination of arthroscopic skill. Twenty-eight residents and two sports medicine faculty members were recorded performing diagnostic knee arthroscopy on a left and right cadaveric specimen in our arthroscopic skills laboratory. Procedure videos were evaluated with use of the Arthroscopic Surgery Skill Evaluation Tool by two raters blind to subject identity. Subjects were considered to pass the Arthroscopic Surgery Skill Evaluation Tool when they attained scores of ≥ 3 on all eight assessment domains. The raters agreed on a pass-fail rating for fifty-five of sixty videos rated with an interclass correlation coefficient value of 0.83. Ten of thirty participants were assigned passing scores by both raters for both diagnostic arthroscopies performed in the laboratory. Receiver operating characteristic analysis demonstrated that logging more than eighty arthroscopic cases or performing more than thirty-five arthroscopic knee cases was predictive of attaining a passing Arthroscopic Surgery Skill Evaluation Tool score on both procedures performed in the laboratory. The Arthroscopic Surgery Skill Evaluation Tool is valid and reliable as a pass-fail examination of diagnostic arthroscopy of the knee in the simulation laboratory. This study demonstrates that the Arthroscopic Surgery Skill Evaluation Tool may be a useful tool for pass-fail examination of diagnostic arthroscopy of the knee in the simulation laboratory. Further study is necessary to determine whether the Arthroscopic Surgery Skill Evaluation Tool can be used for the assessment of multiple arthroscopic procedures and whether it can be used to evaluate arthroscopic procedures performed in the operating room.

Evaluating stakeholder participation in water management: intermediary outcomes as potential indicators for future resource management outcomes

NASA Astrophysics Data System (ADS)

Carr, Gemma; Bloeschl, Guenter; Loucks, Daniel Pete

2013-04-01

Evaluation of participation programmes, projects and activities is essential to identify whether stakeholder involvement has been successful in achieving its aims. Aims may include an improvement in water resource management such as enhanced ecological functioning, an improvement in human wellbeing and economic conditions, or overcoming a conflict between interest groups. Evaluating against "interest-based" resource management criteria requires that a desirable outcome can be identified, agreed upon and be measured at the time of evaluation. In many water management situations where collaborative approaches are applied, multiple interests and objectives are present, or stakeholders have not yet identified their own positions and priorities. Even if a resource management objective has been identified and strategy agreed upon, resource management changes tend to emerge over longer timescales and evaluation frequently takes place before they can be recognised. Evaluating against resource management criteria may lead evaluators to conclude that a programme has failed because it has not achieved a resource management objective at the time of evaluation. This presents a critical challenge to researchers assessing the effectiveness of stakeholder participation programmes. One strategy to overcome this is to conduct "goal-free" evaluation to identify what the programme is actually achieving. An evaluation framework that includes intermediary outcomes that are both tangible achievements such as innovation, creation of new organisations, and shared information and knowledge, as well as intangible achievements such as trust and network development can be applied to more broadly assess a programme's success. Analysis of case-studies in the published literature for which a resource management outcome has been achieved shows that intermediary outcomes frequently precede resource management outcomes. They seem to emerge over shorter timescales than resource management outcomes. Furthermore, failure to achieve intermediary outcomes correlates to failure to achieve resource management outcomes. Evaluating intermediary outcomes leads to both a broader assessment of a programme's achievements at the time of evaluation, and can indicate whether a programme will go on to achieve resource management objectives in the future.

Advanced warfighter machine interface (Invited Paper)

NASA Astrophysics Data System (ADS)

Franks, Erin

2005-05-01

Future military crewmen may have more individual and shared tasks to complete throughout a mission as a result of smaller crew sizes and an increased number of technology interactions. To maintain reasonable workload levels, the Warfighter Machine Interface (WMI) must provide information in a consistent, logical manner, tailored to the environment in which the soldier will be completing their mission. This paper addresses design criteria for creating an advanced, multi-modal warfighter machine interface for on-the-move mounted operations. The Vetronics Technology Integration (VTI) WMI currently provides capabilities such as mission planning and rehearsal, voice and data communications, and manned/unmanned vehicle payload and mobility control. A history of the crewstation and more importantly, the WMI software will be provided with an overview of requirements and criteria used for completing the design. Multiple phases of field and laboratory testing provide the opportunity to evaluate the design and hardware in stationary and motion environments. Lessons learned related to system usability and user performance are presented with mitigation strategies to be tested in the future.

Using the analytical hierarchy process to assess the environmental vulnerabilities of basins in Taiwan.

PubMed

Chang, Chia-Ling; Chao, Yu-Chi

2012-05-01

Every year, Taiwan endures typhoons and earthquakes; these natural hazards often induce landslides and debris flows. Therefore, watershed management strategies must consider the environmental vulnerabilities of local basins. Because many factors affect basin ecosystems, this study applied multiple criteria analysis and the analytical hierarchy process (AHP) to evaluate seven criteria in three phases (geographic phase, hydrologic phase, and societal phase). This study focused on five major basins in Taiwan: the Tan-Shui River Basin, the Ta-Chia River Basin, the Cho-Shui River Basin, the Tseng-Wen River Basin, and the Kao-Ping River Basin. The objectives were a comprehensive examination of the environmental characteristics of these basins and a comprehensive assessment of their environmental vulnerabilities. The results of a survey and AHP analysis showed that landslide area is the most important factor for basin environmental vulnerability. Of all these basins, the Cho-Shui River Basin in central Taiwan has the greatest environmental vulnerability.

Assessing the Hydraulic Criticality of Deep Ocean Overflows

NASA Astrophysics Data System (ADS)

Pratt, L. J.; Helfrich, K. R.

2004-12-01

Two methods for assessing the hydraulic criticality of a modelled or observed deep overflow are discussed. The methods should be of use in determining the position of the control section, which is needed to establish the transport relation helpful for long-term monitoring from upstream. Both approaches are based on a multiple streamtube idealization in which the observed flow at a particular section is divided up into subsections (streamtubes). There are no restrictions on the bottom topography or potential vorticity distribution. The first criteria involves evauation of a generalized Jacobian condition based on the conservation laws for each streamtube; the second involves direct calculation of the long-wave phase speeds. We also comment on the significance of the local Froude number F of the flow and argue that F must pass through unity across a section of hydraulic control. These criteria are applied to some numerically modelled flows and are used in the companion presentation (Girton, et al.) to evaluate the hydraulic criticality of the Faroe Bank Channel.

Web-site evaluation tools: a case study in reproductive health information.

PubMed

Aslani, Azam; Pournik, Omid; Abu-Hanna, Ameen; Eslami, Saeid

2014-01-01

Internet forms an opportunity to inform, teach, and connect professionals and patients. However, much information on Internet is incomplete, inaccurate, or misleading, and not only in the medical domain. Because of the potential for damage from misleading and inaccurate health information, many organizations and individuals have published or implemented scoring tools for evaluating the appropriateness or quality of these resources. The objective of this study is to identify and summarize scoring tools that have evaluated web-sites providing reproductive health information in order to compare them and recommend an overarching evaluation tool. We searched Ovid MEDLINE(R) (1946 to July 2013) and OVID Embase (1980 to July 2013); and included English language studies that have evaluated the quality of websites providing reproductive health information. Studies only assessing the content of websites were excluded. We identified 5 scoring tools: 1-The HON (health on the net) Code of Conduct for medical and health Web sites, 2-Silberg scores, 3-Hogne Sandvik scale, 4-Jim Kapoun's Criteria for Evaluating Web Pages, and 5-The Health Information Technology Institute (HITI) criteria. We have compared these scales and identified 14 criteria: authorship, ownership, currency, objectivity/content, transparency/source, interactivity, privacy/ethics, financial disclosure, navigability/links, complementarity, advertising policy, design, quantity, and accessibility. We integrated these criteria and introduced a new tool with 10 criteria. Website evaluation tools differ in their evaluation criteria and there is a lack of consensus about which to use; therefore, an integrated easy to use set of criteria is needed.

Criteria for Evaluating Oral History Interviews.

ERIC Educational Resources Information Center

Fonsino, Frank J.

1980-01-01

Discusses the rationale for establishing criteria for evaluating oral history interviews. Presents seven evaluation categories relating to oral history tapes and three categories relating to typescripts. (CK)

40 CFR 227.14 - Criteria for evaluating the need for ocean dumping and alternatives to ocean dumping.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ocean dumping and alternatives to ocean dumping. 227.14 Section 227.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING CRITERIA FOR THE EVALUATION OF PERMIT APPLICATIONS FOR OCEAN DUMPING OF MATERIALS Need for Ocean Dumping § 227.14 Criteria for evaluating the need for ocean...

40 CFR 227.14 - Criteria for evaluating the need for ocean dumping and alternatives to ocean dumping.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ocean dumping and alternatives to ocean dumping. 227.14 Section 227.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING CRITERIA FOR THE EVALUATION OF PERMIT APPLICATIONS FOR OCEAN DUMPING OF MATERIALS Need for Ocean Dumping § 227.14 Criteria for evaluating the need for ocean...

40 CFR 227.14 - Criteria for evaluating the need for ocean dumping and alternatives to ocean dumping.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ocean dumping and alternatives to ocean dumping. 227.14 Section 227.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING CRITERIA FOR THE EVALUATION OF PERMIT APPLICATIONS FOR OCEAN DUMPING OF MATERIALS Need for Ocean Dumping § 227.14 Criteria for evaluating the need for ocean...

40 CFR 227.14 - Criteria for evaluating the need for ocean dumping and alternatives to ocean dumping.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ocean dumping and alternatives to ocean dumping. 227.14 Section 227.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING CRITERIA FOR THE EVALUATION OF PERMIT APPLICATIONS FOR OCEAN DUMPING OF MATERIALS Need for Ocean Dumping § 227.14 Criteria for evaluating the need for ocean...

40 CFR 227.14 - Criteria for evaluating the need for ocean dumping and alternatives to ocean dumping.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ocean dumping and alternatives to ocean dumping. 227.14 Section 227.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING CRITERIA FOR THE EVALUATION OF PERMIT APPLICATIONS FOR OCEAN DUMPING OF MATERIALS Need for Ocean Dumping § 227.14 Criteria for evaluating the need for ocean...

Developing Multi-Dimensional Evaluation Criteria for English Learning Websites with University Students and Professors

ERIC Educational Resources Information Center

Liu, Gi-Zen; Liu, Zih-Hui; Hwang, Gwo-Jen

2011-01-01

Many English learning websites have been developed worldwide, but little research has been conducted concerning the development of comprehensive evaluation criteria. The main purpose of this study is thus to construct a multi-dimensional set of criteria to help learners and teachers evaluate the quality of English learning websites. These…

WATER QUALITY IN SOURCE WATER, TREATMENT, AND DISTRIBUTION SYSTEMS

EPA Science Inventory

Most drinking water utilities practice the multiple-barrier concept as the guiding principle for providing safe water. This chapter discusses multiple barriers as they relate to the basic criteria for selecting and protecting source waters, including known and potential sources ...

Criteria for implementing interventions to reduce health inequalities in primary care settings in European regions.

PubMed

Daponte, Antonio; Bernal, Mariola; Bolívar, Julia; Mateo, Inmaculada; Salmi, Louis-Rachid; Barsanti, Sara; Berghmans, Luc; Piznal, Ewelina; Bourgueil, Yann; Marquez, Soledad; González, Ingrid; Carriazo, Ana; Maros-Szabo, Zsuzsanna; Ménival, Solange

2014-12-01

The current social and political context is generating socio-economic inequalities between and within countries, causing and widening health inequalities. The development and implementation of interventions in primary health care (PHC) settings seem unavoidable. Attempts have been made to draw up adequate criteria to guide and evaluate interventions but none for the specific case of PHC. This methodological article aims to contribute to this field by developing and testing a set of criteria for guiding and evaluating real-life interventions to reduce health inequalities in PHC settings in European regions. A literature review, nominal group technique, survey and evaluation template were used to design and test a set of criteria. The questionnaire was answered by professionals in charge of 46 interventions carried out in 12 European countries, and collected detailed information about each intervention. Third-party experts scored the interventions using the set of evaluation criteria proposed. Nine criteria to guide and evaluate interventions were proposed: relevance, appropriateness, applicability, innovation, quality assurance, adequacy of resources, effectiveness in the process, effectiveness in results and mainstreaming. A working definition was drawn up for each one. These criteria were then used to evaluate the interventions identified. The set of criteria drawn up to guide the design, implementation and evaluation of interventions to reduce health inequalities in PHC will be a useful instrument to be applied to interventions under development for culturally, politically and socio-economically diverse PHC contexts throughout Europe. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Critical analysis of the stringent complete response in multiple myeloma: contribution of sFLC and bone marrow clonality.

PubMed

Martínez-López, Joaquín; Paiva, Bruno; López-Anglada, Lucía; Mateos, María-Victoria; Cedena, Teresa; Vidríales, María-Belén; Sáez-Gómez, María Auxiliadora; Contreras, Teresa; Oriol, Albert; Rapado, Inmaculada; Teruel, Ana-Isabel; Cordón, Lourdes; Blanchard, María Jesús; Bengoechea, Enrique; Palomera, Luis; de Arriba, Felipe; Cueto-Felgueroso, Cecilia; Orfao, Alberto; Bladé, Joan; San Miguel, Jesús F; Lahuerta, Juan José

2015-08-13

Stringent complete response (sCR) criteria are used in multiple myeloma as a deeper response category compared with CR, but prospective validation is lacking, it is not always clear how evaluation of clonality is performed, and is it not known what the relative clinical influence is of the serum free light chain ratio (sFLCr) and bone marrow (BM) clonality to define more sCR. To clarify this controversy, we focused on 94 patients that reached CR, of which 69 (73%) also fulfilled the sCR criteria. Patients with sCR displayed slightly longer time to progression (median, 62 vs 53 months, respectively; P = .31). On analyzing this contribution to the prognosis of sFLCr or clonality, it was found that the sFLCr does not identify patients in CR at distinct risk; by contrast, low-sensitive multiparametric flow cytometry (MFC) immunophenotyping (2 colors), which is equivalent to immunohistochemistry, identifies a small number of patients (5 cases) with high residual tumor burden and dismal outcome; nevertheless, using traditional 4-color MFC, persistent clonal BM disease was detectable in 36% of patients, who, compared with minimal residual disease-negative cases, had a significantly inferior outcome. These results show that the current definition of sCR should be revised. © 2015 by The American Society of Hematology.

Use of fingolimod in patients with relapsing remitting multiple sclerosis in Kuwait.

PubMed

Alroughani, R; Ahmed, S F; Behbehani, R; Al-Hashel, J

2014-04-01

Post-marketing studies are important to confirm what was established in clinical trials, and to assess the intermediate and long-term efficacy and safety. To assess efficacy and safety of fingolimod in multiple sclerosis (MS) in Kuwait. We retrospectively evaluated MS patients using the MS registries in 3 MS clinics. Relapsing remitting MS patients according to revised 2010 McDonald criteria who had been treated with fingolimod for at least 12 months were included. Primary endpoint was proportion of relapse-free patients at last follow-up. Secondary endpoints were mean change in EDSS and proportion of patients with MRI activity (gadolinium-enhancing or new/enlarging T2 lesions). 76 patients met the inclusion criteria. Mean age and mean disease duration were 34.43 and 7.82 years respectively. Mean duration of exposure to fingolimod was 18.50 months. Proportion of relapse-free patients was 77.6% at last follow-up. Mean EDSS score significantly improved (2.93 versus 1.95; p<0.0001) while 17.1% of patients continued to have MRI activity versus 77.6% at baseline (p<0.0001). Four patients stopped fingolimod due to disease breakthrough (n=3) and lymphadenitis (n=1). Fingolimod is safe and effective in reducing clinical and radiological disease activity in relapsing remitting MS patients. Our results are comparable to reported results of phase III studies. Copyright © 2014 Elsevier B.V. All rights reserved.

Multi-criteria decision analysis of breast cancer control in low- and middle- income countries: development of a rating tool for policy makers.

PubMed

Venhorst, Kristie; Zelle, Sten G; Tromp, Noor; Lauer, Jeremy A

2014-01-01

The objective of this study was to develop a rating tool for policy makers to prioritize breast cancer interventions in low- and middle- income countries (LMICs), based on a simple multi-criteria decision analysis (MCDA) approach. The definition and identification of criteria play a key role in MCDA, and our rating tool could be used as part of a broader priority setting exercise in a local setting. This tool may contribute to a more transparent priority-setting process and fairer decision-making in future breast cancer policy development. First, an expert panel (n = 5) discussed key considerations for tool development. A literature review followed to inventory all relevant criteria and construct an initial set of criteria. A Delphi study was then performed and questionnaires used to discuss a final list of criteria with clear definitions and potential scoring scales. For this Delphi study, multiple breast cancer policy and priority-setting experts from different LMICs were selected and invited by the World Health Organization. Fifteen international experts participated in all three Delphi rounds to assess and evaluate each criterion. This study resulted in a preliminary rating tool for assessing breast cancer interventions in LMICs. The tool consists of 10 carefully crafted criteria (effectiveness, quality of the evidence, magnitude of individual health impact, acceptability, cost-effectiveness, technical complexity, affordability, safety, geographical coverage, and accessibility), with clear definitions and potential scoring scales. This study describes the development of a rating tool to assess breast cancer interventions in LMICs. Our tool can offer supporting knowledge for the use or development of rating tools as part of a broader (MCDA based) priority setting exercise in local settings. Further steps for improving the tool are proposed and should lead to its useful adoption in LMICs.

Criteria for prioritization of HIV programs in Viet Nam: a discrete choice experiment.

PubMed

Safarnejad, Ali; Pavlova, Milena; Son, Vo Hai; Phuong, Huynh Lan; Groot, Wim

2017-11-13

With the decline in funding for Viet Nam's response to the HIV epidemic, there is a need for evidence on the criteria to guide the prioritization of HIV programs. There is a gap in the research on the relative importance of multiple criteria for prioritizing a package of interventions. This study elicits preferences and the trade-offs made between different HIV programs by relevant stakeholders and decision-makers in Viet Nam. It also pays attention to how differences in social and professional characteristics of stakeholders and their agency affiliations shape preferences for HIV program criteria in Viet Nam. This study uses self-explicated ranking and discrete choice experiments to determine the relative importance of five criteria - effectiveness, feasibility, cost-effectiveness, rate of investment and prevention/treatment investment ratio - to stakeholders when they evaluate and select hypothetical HIV programs. The study includes 69 participants from government, civil society, and international development partners. Results of the discrete choice experiment show that overall the feasibility criterion is ranked highest in importance to the participants when choosing a hypothetical HIV program, followed by sustainability, treatment to prevention spending ratio, and effectiveness. The participant's work in management, programming, or decision-making has a significant effect on the importance of some criteria to the participant. In the self-explicated ranking effectiveness is the most important criterion and the cost-effectiveness criterion ranks low in importance across all groups. This study has shown that the preferred HIV program in Viet Nam is feasible, front-loaded for sustainability, has a higher proportion of investment on prevention, saves more lives and prevents more infections. Similarities in government and civil society rankings of criteria can create common grounds for future policy dialogues between stakeholders. Innovative models of planning should be utilized to allow inputs of informed stakeholders at relevant stages of the HIV program planning process.

Self Evaluation of Organizations.

ERIC Educational Resources Information Center

Pooley, Richard C.

Evaluation within human service organizations is defined in terms of accepted evaluation criteria, with reasonable expectations shown and structured into a model of systematic evaluation practice. The evaluation criteria of program effort, performance, adequacy, efficiency and process mechanisms are discussed, along with measurement information…

Pythagorean fuzzy analytic hierarchy process to multi-criteria decision making

NASA Astrophysics Data System (ADS)

Mohd, Wan Rosanisah Wan; Abdullah, Lazim

2017-11-01

A numerous approaches have been proposed in the literature to determine the criteria of weight. The weight of criteria is very significant in the process of decision making. One of the outstanding approaches that used to determine weight of criteria is analytic hierarchy process (AHP). This method involves decision makers (DMs) to evaluate the decision to form the pair-wise comparison between criteria and alternatives. In classical AHP, the linguistic variable of pairwise comparison is presented in terms of crisp value. However, this method is not appropriate to present the real situation of the problems because it involved the uncertainty in linguistic judgment. For this reason, AHP has been extended by incorporating the Pythagorean fuzzy sets. In addition, no one has found in the literature proposed how to determine the weight of criteria using AHP under Pythagorean fuzzy sets. In order to solve the MCDM problem, the Pythagorean fuzzy analytic hierarchy process is proposed to determine the criteria weight of the evaluation criteria. Using the linguistic variables, pairwise comparison for evaluation criteria are made to the weights of criteria using Pythagorean fuzzy numbers (PFNs). The proposed method is implemented in the evaluation problem in order to demonstrate its applicability. This study shows that the proposed method provides us with a useful way and a new direction in solving MCDM problems with Pythagorean fuzzy context.

Management of high-risk Myeloma: an evidence-based review of treatment strategies.

PubMed

Lehners, Nicola; Hayden, Patrick J; Goldschmidt, Hartmut; Raab, Marc-Steffen

2016-08-01

Despite the progress made in the treatment of patients with multiple myeloma over recent decades, a significant cohort with high-risk disease as defined by specific clinical and genetic criteria continue to respond poorly to standard treatment. These patients represent a particular challenge to the treating physician and require early identification as well as personalized treatment strategies. In this review, we discuss the prognostic impact of adverse clinical, radiological and genetic factors, evaluate available scoring systems and highlight key aspects of the therapeutic management of high-risk myeloma. MEDLINE and recent scientific meetings' databases were searched for the keywords 'high-risk' and 'multiple myeloma' and relevant studies relating to both diagnostic and therapeutic approaches were identified. Expert commentary: A case is made for intensive induction using combinations of novel agents, early high-dose therapy supported by autologous stem cell transplantation and the widespread use of maintenance therapies. Novel therapeutic options, especially in the field of immunotherapy, are currently explored in clinical trials and have the potential to further improve outcomes for patients with high-risk multiple myeloma.

Multi-criteria development and incorporation into decision tools for health technology adoption.

PubMed

Poulin, Paule; Austen, Lea; Scott, Catherine M; Waddell, Cameron D; Dixon, Elijah; Poulin, Michelle; Lafrenière, René

2013-01-01

When introducing new health technologies, decision makers must integrate research evidence with local operational management information to guide decisions about whether and under what conditions the technology will be used. Multi-criteria decision analysis can support the adoption or prioritization of health interventions by using criteria to explicitly articulate the health organization's needs, limitations, and values in addition to evaluating evidence for safety and effectiveness. This paper seeks to describe the development of a framework to create agreed-upon criteria and decision tools to enhance a pre-existing local health technology assessment (HTA) decision support program. The authors compiled a list of published criteria from the literature, consulted with experts to refine the criteria list, and used a modified Delphi process with a group of key stakeholders to review, modify, and validate each criterion. In a workshop setting, the criteria were used to create decision tools. A set of user-validated criteria for new health technology evaluation and adoption was developed and integrated into the local HTA decision support program. Technology evaluation and decision guideline tools were created using these criteria to ensure that the decision process is systematic, consistent, and transparent. This framework can be used by others to develop decision-making criteria and tools to enhance similar technology adoption programs. The development of clear, user-validated criteria for evaluating new technologies adds a critical element to improve decision-making on technology adoption, and the decision tools ensure consistency, transparency, and real-world relevance.

Multiple personality disorder among female inpatients in a state hospital.

PubMed

Latz, T T; Kramer, S I; Hughes, D L

1995-09-01

Professional skepticism and concerns regarding diagnostic reliability hinder research in dissociative disorders and multiple personality disorder. The reported frequency of multiple personality disorder in different psychiatric settings ranges from 2.4% to 35%. The authors conducted a replication study of multiple personality disorder ascertainment in women admitted to a state hospital over a 5.5-month period. Responses to the Dissociative Experiences Scale and to the Dissociative Disorders Interview Schedule were obtained, along with data on length of stay, county of admission referral, admission commitment status, and discharge diagnoses, for 176 female inpatients in a state hospital. Of 421 women representing 483 consecutive admissions, 121 were discharged before they could be assessed for study, 64 were excluded, 60 declined to participate, 176 enrolled in the study, and 175 completed the research procedures. Twenty-one women (12%) met criteria for multiple personality disorder based on the Dissociative Disorders Interview Schedule; these women were significantly younger than the women without multiple personality disorder. Scores on the Dissociative Experiences Scale of the women with multiple personality disorder (mean = 59.5, SD = 19.6) were significantly higher than the scores of women without multiple personality disorder (mean = 22.5, SD = 20.1), but considerable overlap occurred. There was no significant difference between groups in length of stay or admission status. The authors conclude that 1) the wide variability in multiple personality disorder detection is partially due to site-specific ascertainment biases and 2) despite its apparent usefulness for screening purposes, the Dissociative Experiences Scale requires more comprehensive evaluation before it can be applied broadly.

Evaluation of High-Speed Civil Transport Handling Qualities Criteria with Supersonic Flight Data

NASA Technical Reports Server (NTRS)

Cox, Timothy H.; Jackson, Dante W.

1997-01-01

Most flying qualities criteria have been developed from data in the subsonic flight regime. Unique characteristics of supersonic flight raise questions about whether these criteria successfully extend into the supersonic flight regime. Approximately 25 years ago NASA Dryden Flight Research Center addressed this issue with handling qualities evaluations of the XB-70 and YF-12. Good correlations between some of the classical handling qualities parameters, such as the control anticipation parameter as a function of damping, were discovered. More criteria have been developed since these studies. Some of these more recent criteria are being used in designing the High-Speed Civil Transport (HSCT). A second research study recently addressed this issue through flying qualities evaluations of the SR-71 at Mach 3. The research goal was to extend the high-speed flying qualities experience of large airplanes and to evaluate more recent MIL-STD-1797 criteria against pilot comments and ratings. Emphasis was placed on evaluating the criteria used for designing the HSCT. XB-70 and YF-12 data from the previous research supplemented the SR-71 data. The results indicate that the criteria used in the HSCT design are conservative and should provide good flying qualities for typical high-speed maneuvering. Additional results show correlation between the ratings and comments and criteria for gradual maneuvering with precision control. Correlation is shown between ratings and comments and an extension of the Neal/Smith criterion using normal acceleration instead of pitch rate.

Evaluation Criteria for Nursing Student Application of Evidence-Based Practice: A Delphi Study.

PubMed

Bostwick, Lina; Linden, Lois

2016-06-01

Core clinical evaluation criteria do not exist for measuring prelicensure baccalaureate nursing students' application of evidence-based practice (EBP) during direct care assignments. The study objective was to achieve consensus among EBP nursing experts to create clinical criteria for faculty to use in evaluating students' application of EBP principles. A three-round Delphi method was used. Experts were invited to participate in Web-based surveys. Data were analyzed using qualitative coding and categorizing. Quantitative analyses were descriptive calculations for rating and ranking. Expert consensus occurred in the Delphi rounds. The study provides a set of 10 core clinical evaluation criteria for faculty evaluating students' progression toward competency in their application of EBP. A baccalaureate program curriculum requiring the use of Bostwick's EBP Core Clinical Evaluation Criteria will provide a clear definition for understanding basic core EBP competence as expected for the assessment of student learning. [J Nurs Educ. 2016;55(5):336-341.]. Copyright 2016, SLACK Incorporated.

Evaluating supplier quality performance using fuzzy analytical hierarchy process

NASA Astrophysics Data System (ADS)

Ahmad, Nazihah; Kasim, Maznah Mat; Rajoo, Shanmugam Sundram Kalimuthu

2014-12-01

Evaluating supplier quality performance is vital in ensuring continuous supply chain improvement, reducing the operational costs and risks towards meeting customer's expectation. This paper aims to illustrate an application of Fuzzy Analytical Hierarchy Process to prioritize the evaluation criteria in a context of automotive manufacturing in Malaysia. Five main criteria were identified which were quality, cost, delivery, customer serviceand technology support. These criteria had been arranged into hierarchical structure and evaluated by an expert. The relative importance of each criteria was determined by using linguistic variables which were represented as triangular fuzzy numbers. The Center of Gravity defuzzification method was used to convert the fuzzy evaluations into their corresponding crisps values. Such fuzzy evaluation can be used as a systematic tool to overcome the uncertainty evaluation of suppliers' performance which usually associated with human being subjective judgments.

Comparison of (11)C-4'-thiothymidine, (11)C-methionine, and (18)F-FDG PET/CT for the detection of active lesions of multiple myeloma.

PubMed

Okasaki, Momoko; Kubota, Kazuo; Minamimoto, Ryogo; Miyata, Yoko; Morooka, Miyako; Ito, Kimiteru; Ishiwata, Kiichi; Toyohara, Jun; Inoue, Tomio; Hirai, Risen; Hagiwara, Shotaro; Miwa, Akiyoshi

2015-04-01

The aims of this study were to evaluate the possibility of using (11)C-methionine ((11)C-MET) and (11)C-4'-thiothymidine ((11)C-4DST) whole-body PET/CT for the imaging of amino acid metabolism and DNA synthesis, respectively, when searching for bone marrow involvement in patients with multiple myeloma (MM) and to compare these findings with those for (18)F-FDG PET/CT and aspiration cytology. A total of 64 patients with MM, solitary plasmacytoma, monoclonal gammopathy of undetermined significance, or an unspecified diagnosis were prospectively enrolled. All the patients underwent three whole-body PET/CT examinations within a period of 1 week. First, the tracer accumulation was visually evaluated as positive, equivocal, or negative for 55 focal lytic lesions visualized using CT in 24 patients. Second, the percentages of marrow plasma cells as calculated using a bone marrow aspiration smear and tracer accumulation were evaluated in the posterior iliac crests of 36 patients. Among the 55 lytic lesions, the (11)C-MET and (11)C-4DST findings tended to reveal more positive findings than the (18)F-FDG findings. Based on the standard criteria for the diagnosis of active myeloma using the percentage of marrow plasma cells, significant differences were found between the (18)F-FDG and (11)C-MET findings and between the (18)F-FDG and (11)C-4DST findings, but no significant difference was observed between the (11)C-MET and (11)C-4DST findings. The addition of (11)C-MET and (11)C-4DST to (18)F-FDG when performing PET/CT enabled clearer evaluations of equivocal lesions. Based on cytological diagnostic criteria, (11)C-MET and (11)C-4DST were more sensitive than (18)F-FDG for the detection of active lesions. (11)C-MET and (11)C-4DST were more useful than (18)F-FDG for the detection of active lesions, especially during the early stage of disease.

New simple radiological criteria proposed for multiple primary lung cancers.

PubMed

Matsunaga, Takeshi; Suzuki, Kenji; Takamochi, Kazuya; Oh, Shiaki

2017-11-01

Controversies remain as to the differential diagnosis between multiple primary lung cancer (MPLC) and intrapulmonary metastasis (IM) in lung cancers. We have investigated the clinical criteria for MPLC and here propose a set of new and simple criteria from the stand point of prognosis. A retrospective study was conducted on 588 consecutive patients with resected lung cancer of clinical Stage IA between 2009 and 2012. Multiple lung cancers (MLCs) were observed in 103 (17.5%) of the 588 patients. All main and other tumors were divided into solid tumor (ST) and non-solid tumor (non-ST). We defined Group A as MLCs having at least one non-ST and Group B as all tumors being ST. Cox's proportional hazard model was used for the multivariate analyses to investigate the preoperative prognostic factors. We divided the MLCs into MPLC and IM based on the preoperative prognostic factors, and survival was estimated by the Kaplan-Meier method. A multivariate analysis with Cox's proportional hazards model revealed that Group A independently predicted good overall survival (HR = 0.165, 95% CI: 0.041-0.672).Differences in the 3- and 5-year overall survivals between Groups A and B were statistically significant (96.3%/92.2% vs. 70.0%/60.0%, Pvalue = 0.0002). We suggest that Group A, defined as the presence of at least one tumor with a ground glass opacity component and clinical N0, should be excluded from the conventional concept of multiple lung cancers based on the criteria of Martini and Melamed as it has a very good prognosis. This group would be considered to be radiological MPLC. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Selecting an E-(Text)Book: Evaluation Criteria

ERIC Educational Resources Information Center

Marczak, Mariusz

2013-01-01

This paper aims to propose a repository of pre-use evaluation criteria for language teachers who wish to introduce e-books or e-textbooks to their own teaching practices. By selectively using a set of such criteria, they will be able to evaluate to what extent a given e-book/e-textbook lends itself to utilisation within their own teaching context.…

49 CFR Appendix A to Subpart E of... - Explanation of Pre-Authorization Safety Audit Evaluation Criteria for Mexico-Domiciled Motor...

Code of Federal Regulations, 2010 CFR

2010-10-01

... Evaluation Criteria for Mexico-Domiciled Motor Carriers A Appendix A to Subpart E of Part 365 Transportation... OPERATING AUTHORITY Special Rules for Certain Mexico-domiciled Carriers Pt. 365, Subpt. E, App. A Appendix A to Subpart E of Part 365—Explanation of Pre-Authorization Safety Audit Evaluation Criteria for Mexico...

Perceived Importance of District Developed Teacher Evaluation Standards and Criteria as Measured by Teacher Values Survey

ERIC Educational Resources Information Center

Davis, Jan Ellen Pfeiffer

2011-01-01

In 2009, a PK-12 public school district board of education approved a teacher evaluation tool developed by a volunteer team of teachers and administrators. The Learning Based Teacher Evaluation (LBTE) was constructed with six broad standards and fifteen specific criteria. The standards and criteria were assumed important to professional practice,…

49 CFR Appendix A to Subpart E of... - Explanation of Pre-Authorization Safety Audit Evaluation Criteria for Mexico-Domiciled Motor...

Code of Federal Regulations, 2012 CFR

2012-10-01

... Evaluation Criteria for Mexico-Domiciled Motor Carriers A Appendix A to Subpart E of Part 365 Transportation... OPERATING AUTHORITY Special Rules for Certain Mexico-domiciled Carriers Pt. 365, Subpt. E, App. A Appendix A to Subpart E of Part 365—Explanation of Pre-Authorization Safety Audit Evaluation Criteria for Mexico...

49 CFR Appendix A to Subpart E of... - Explanation of Pre-Authorization Safety Audit Evaluation Criteria for Mexico-Domiciled Motor...

Code of Federal Regulations, 2011 CFR

2011-10-01

... Evaluation Criteria for Mexico-Domiciled Motor Carriers A Appendix A to Subpart E of Part 365 Transportation... OPERATING AUTHORITY Special Rules for Certain Mexico-domiciled Carriers Pt. 365, Subpt. E, App. A Appendix A to Subpart E of Part 365—Explanation of Pre-Authorization Safety Audit Evaluation Criteria for Mexico...

49 CFR Appendix A to Subpart E of... - Explanation of Pre-Authorization Safety Audit Evaluation Criteria for Mexico-Domiciled Motor...

Code of Federal Regulations, 2014 CFR

2014-10-01

... Evaluation Criteria for Mexico-Domiciled Motor Carriers A Appendix A to Subpart E of Part 365 Transportation... OPERATING AUTHORITY Special Rules for Certain Mexico-domiciled Carriers Pt. 365, Subpt. E, App. A Appendix A to Subpart E of Part 365—Explanation of Pre-Authorization Safety Audit Evaluation Criteria for Mexico...

49 CFR Appendix A to Subpart E of... - Explanation of Pre-Authorization Safety Audit Evaluation Criteria for Mexico-Domiciled Motor...

Code of Federal Regulations, 2013 CFR

2013-10-01

... Evaluation Criteria for Mexico-Domiciled Motor Carriers A Appendix A to Subpart E of Part 365 Transportation... OPERATING AUTHORITY Special Rules for Certain Mexico-domiciled Carriers Pt. 365, Subpt. E, App. A Appendix A to Subpart E of Part 365—Explanation of Pre-Authorization Safety Audit Evaluation Criteria for Mexico...

33 CFR 155.1052 - Response plan development and evaluation criteria for vessels carrying group V petroleum oil as a...

Code of Federal Regulations, 2011 CFR

2011-07-01

... evaluation criteria for vessels carrying group V petroleum oil as a primary cargo. 155.1052 Section 155.1052....1052 Response plan development and evaluation criteria for vessels carrying group V petroleum oil as a primary cargo. (a) Owners and operators of vessels that carry group V petroleum oil as a primary cargo...

25 CFR 1200.17 - What special criteria will be used to evaluate management plans for judgment or settlement funds?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false What special criteria will be used to evaluate management... FOR AMERICAN INDIANS, DEPARTMENT OF THE INTERIOR AMERICAN INDIAN TRUST FUND MANAGEMENT REFORM ACT Withdrawing Tribal Funds From Trust § 1200.17 What special criteria will be used to evaluate management plans...

49 CFR Appendix to Subpart H of... - Explanation of Pre-Authorization Safety Audit Evaluation Criteria for Non-North America-Domiciled...

Code of Federal Regulations, 2010 CFR

2010-10-01

... Evaluation Criteria for Non-North America-Domiciled Motor Carriers Appendix to Subpart H of Part 385... Special Rules for New Entrant Non-North America-Domiciled Carriers Pt. 385, Subpt. H, App. Appendix to Subpart H of Part 385—Explanation of Pre-Authorization Safety Audit Evaluation Criteria for Non-North...

Early life adversity and telomere length: a meta-analysis.

PubMed

Ridout, K K; Levandowski, M; Ridout, S J; Gantz, L; Goonan, K; Palermo, D; Price, L H; Tyrka, A R

2018-04-01

Early adversity, in the form of abuse, neglect, socioeconomic status and other adverse experiences, is associated with poor physical and mental health outcomes. To understand the biologic mechanisms underlying these associations, studies have evaluated the relationship between early adversity and telomere length, a marker of cellular senescence. Such results have varied in regard to the size and significance of this relationship. Using meta-analytic techniques, we aimed to clarify the relationship between early adversity and telomere length while exploring factors affecting the association, including adversity type, timing and study design. A comprehensive search in July 2016 of PubMed/MEDLINE, PsycINFO and Web of Science identified 2462 studies. Multiple reviewers appraised studies for inclusion or exclusion using a priori criteria; 3.9% met inclusion criteria. Data were extracted into a structured form; the Newcastle-Ottawa Scale assessed study quality, validity and bias. Forty-one studies (N=30 773) met inclusion criteria. Early adversity and telomere length were significantly associated (Cohen's d effect size=-0.35; 95% CI, -0.46 to -0.24; P<0.0001). Sensitivity analyses revealed no outlier effects. Adversity type and timing significantly impacted the association with telomere length (P<0.0001 and P=0.0025, respectively). Subgroup and meta-regression analyses revealed that medication use, medical or psychiatric conditions, case-control vs longitudinal study design, methodological factors, age and smoking significantly affected the relationship. Comprehensive evaluations of adversity demonstrated more extensive telomere length changes. These results suggest that early adversity may have long-lasting physiological consequences contributing to disease risk and biological aging.

Patient-reported outcomes in neurofibromatosis and schwannomatosis clinical trials

PubMed Central

Martin, Staci; Merker, Vanessa L.; Gardner, Kathy L.; Hingtgen, Cynthia M.; Tonsgard, James H.; Schorry, Elizabeth K.; Baldwin, Andrea

2013-01-01

Objectives: Neurofibromatosis (NF) is a genetic disease with multiple clinical manifestations that can significantly impact quality of life (QOL). Clinical trials should include patient-reported outcomes (PROs) as endpoints to assess treatment effects on various aspects of QOL, but there is no consensus on the selection and use of such measures in NF. This article describes the PRO Working Group of the Response Evaluation in Neurofibromatosis and Schwannomatosis (REiNS) Collaboration, its main goals, methods for identifying appropriate PRO measures for NF clinical trials, and recommendations for assessing pain intensity. Methods: The REiNS PRO group selected core endpoint domains important to assess in NF. The members developed criteria to rate PRO measures, including patient characteristics, psychometric properties, and feasibility, and utilized a systematic process to evaluate PROs for NF clinical trials. Within the subdomain of pain intensity, the group reviewed the Numerical Rating Scale-11 (NRS-11), the Visual Analogue Scale, and the Faces Pain Scale-Revised using this process. Results: Based on the review criteria, each of these pain intensity scales is brief, reliable, valid, and widely used. However, the NRS-11 was given the highest rating for use in NF clinical trials due to recommendations from pain experts and other consensus groups, its extensive use in research, strong psychometric data including sensitivity to change, and excellent feasibility in ages ≥8 years. Conclusions: The systematic review criteria and process are effective for identifying appropriate PRO measures and provide information utilized by the REiNS Collaboration to achieve consensus regarding PROs in NF clinical trials. PMID:24249806

Deriving Criteria-supporting Benchmark Values from Empirical Response Relationships: Comparison of Statistical Techniques and Effect of Log-transforming the Nutrient Variable

EPA Science Inventory

In analyses supporting the development of numeric nutrient criteria, multiple statistical techniques can be used to extract critical values from stressor response relationships. However there is little guidance for choosing among techniques, and the extent to which log-transfor...

Use of soft data for multi-criteria calibration and validation of APEX: Impact on model simulations

USDA-ARS?s Scientific Manuscript database

It is widely known that the use of soft data and multiple model performance criteria in model calibration and validation is critical to ensuring the model capture major hydrologic and water quality processes. The Agricultural Policy/Environmental eXtender (APEX) is a hydrologic and water quality mod...

SU-F-T-491: Photon Beam Matching Analysis at Multiple Sites Up to Twelve Years Post Installation

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

Able, C; Zakikhani, R; Yan, K

Purpose: To determine if the photon beams associated with several models of accelerators are matched with ‘Golden Beam’ data (VGBD) to assess treatment planning modeling and delivery. Methods: Six accelerators’ photon beams were evaluated to determine if they matched the manufacturer’s (Varian Medical Systems, Inc.) VGBD. Additional direct comparisons of the 6X and 18X beams using the manufacturer’s specification of Basic and Fine beam matching were also performed. The Cseries accelerator models were 21 EX (3), IX (2), and a IX Trilogy, ranging from three to twelve years post installation. Computerized beam scanning was performed (IBA Blue Phantom 2) withmore » 2 CC13 ion chambers in water at 100 cm SSD. Dmax (10 cm2 field size), percentage depth dose (6 cm2, 10 cm2, 20 cm2, and 30 cm2 field sizes) and beam uniformity (10 cm2, 30 cm2 and 40 cm2 field sizes) were evaluated. Results: When comparing the beams with VGBD using the ‘Basic’ matching criteria, all beams were within the specifications ( 1.5mm at dmax, 1% PDD, and 2% Profiles). When considering the “Fine” matching criteria ( 1.5mm at dmax, 0.5% PDD, and 2% Profiles), only three of six 6MV beams and two of six high energy (five 18MV & one 15MV) beams passed. Direct comparisons between accelerators using the Clinac IX (installed 2012) as the reference beam datasets resulted in all 6 MV and 18MV beams meeting both the “Basic” and “Fine” criterion with the exception of two accelerators. Conclusion: Linear accelerators installed up to nine years apart are capable of meeting the manufacturers beam matching criteria for “Basic” matching. Without any adjustments most beams, when evaluated, may meet the “Fine” match criteria. The use of a single dataset (VGBD or designated accelerator reference data) for treatment planning commissioning is acceptable and can provide quality treatment delivery.« less

Consistency of the Performance and Nonperformance Methods in Gifted Identification

ERIC Educational Resources Information Center

Acar, Selcuk; Sen, Sedat; Cayirdag, Nur

2016-01-01

Current approaches to gifted identification suggest collecting multiple sources of evidence. Some gifted identification guidelines allow for the interchangeable use of "performance" and "nonperformance" identification methods. This multiple criteria approach lacks a strong overlap between the assessment tools; however,…

An Integrated Method for Airfoil Optimization

NASA Astrophysics Data System (ADS)

Okrent, Joshua B.

Design exploration and optimization is a large part of the initial engineering and design process. To evaluate the aerodynamic performance of a design, viscous Navier-Stokes solvers can be used. However this method can prove to be overwhelmingly time consuming when performing an initial design sweep. Therefore, another evaluation method is needed to provide accurate results at a faster pace. To accomplish this goal, a coupled viscous-inviscid method is used. This thesis proposes an integrated method for analyzing, evaluating, and optimizing an airfoil using a coupled viscous-inviscid solver along with a genetic algorithm to find the optimal candidate. The method proposed is different from prior optimization efforts in that it greatly broadens the design space, while allowing the optimization to search for the best candidate that will meet multiple objectives over a characteristic mission profile rather than over a single condition and single optimization parameter. The increased design space is due to the use of multiple parametric airfoil families, namely the NACA 4 series, CST family, and the PARSEC family. Almost all possible airfoil shapes can be created with these three families allowing for all possible configurations to be included. This inclusion of multiple airfoil families addresses a possible criticism of prior optimization attempts since by only focusing on one airfoil family, they were inherently limiting the number of possible airfoil configurations. By using multiple parametric airfoils, it can be assumed that all reasonable airfoil configurations are included in the analysis and optimization and that a global and not local maximum is found. Additionally, the method used is amenable to customization to suit any specific needs as well as including the effects of other physical phenomena or design criteria and/or constraints. This thesis found that an airfoil configuration that met multiple objectives could be found for a given set of nominal operational conditions from a broad design space with the use of minimal computational resources on both an absolute and relative scale to traditional analysis techniques. Aerodynamicists, program managers, aircraft configuration specialist, and anyone else in charge of aircraft configuration, design studies, and program level decisions might find the evaluation and optimization method proposed of interest.

a New Multi-Criteria Evaluation Model Based on the Combination of Non-Additive Fuzzy Ahp, Choquet Integral and Sugeno λ-MEASURE

NASA Astrophysics Data System (ADS)

Nadi, S.; Samiei, M.; Salari, H. R.; Karami, N.

2017-09-01

This paper proposes a new model for multi-criteria evaluation under uncertain condition. In this model we consider the interaction between criteria as one of the most challenging issues especially in the presence of uncertainty. In this case usual pairwise comparisons and weighted sum cannot be used to calculate the importance of criteria and to aggregate them. Our model is based on the combination of non-additive fuzzy linguistic preference relation AHP (FLPRAHP), Choquet integral and Sugeno λ-measure. The proposed model capture fuzzy preferences of users and fuzzy values of criteria and uses Sugeno λ -measure to determine the importance of criteria and their interaction. Then, integrating Choquet integral and FLPRAHP, all the interaction between criteria are taken in to account with least number of comparison and the final score for each alternative is determined. So we would model a comprehensive set of interactions between criteria that can lead us to more reliable result. An illustrative example presents the effectiveness and capability of the proposed model to evaluate different alternatives in a multi-criteria decision problem.

Presenting an evaluation model of the trauma registry software.

PubMed

Asadi, Farkhondeh; Paydar, Somayeh

2018-04-01

Trauma is a major cause of 10% death in the worldwide and is considered as a global concern. This problem has made healthcare policy makers and managers to adopt a basic strategy in this context. Trauma registry has an important and basic role in decreasing the mortality and the disabilities due to injuries resulted from trauma. Today, different software are designed for trauma registry. Evaluation of this software improves management, increases efficiency and effectiveness of these systems. Therefore, the aim of this study is to present an evaluation model for trauma registry software. The present study is an applied research. In this study, general and specific criteria of trauma registry software were identified by reviewing literature including books, articles, scientific documents, valid websites and related software in this domain. According to general and specific criteria and related software, a model for evaluating trauma registry software was proposed. Based on the proposed model, a checklist designed and its validity and reliability evaluated. Mentioned model by using of the Delphi technique presented to 12 experts and specialists. To analyze the results, an agreed coefficient of %75 was determined in order to apply changes. Finally, when the model was approved by the experts and professionals, the final version of the evaluation model for the trauma registry software was presented. For evaluating of criteria of trauma registry software, two groups were presented: 1- General criteria, 2- Specific criteria. General criteria of trauma registry software were classified into four main categories including: 1- usability, 2- security, 3- maintainability, and 4-interoperability. Specific criteria were divided into four main categories including: 1- data submission and entry, 2- reporting, 3- quality control, 4- decision and research support. The presented model in this research has introduced important general and specific criteria of trauma registry software and sub criteria related to each main criteria separately. This model was validated by experts in this field. Therefore, this model can be used as a comprehensive model and a standard evaluation tool for measuring efficiency and effectiveness and performance improvement of trauma registry software. Copyright © 2018 Elsevier B.V. All rights reserved.

High-temperature earth-storable propellant acoustic cavity technology. [for combustion stability

NASA Technical Reports Server (NTRS)

Oberg, C. L.; Hines, W. S.; Falk, A. Y.

1974-01-01

Design criteria, methods and data, were developed to permit effective design of acoustic cavities for use in regeneratively cooled OME-type engines. This information was developed experimentally from two series of motor firings with high-temperature fuel during which the engine stability was evaluated under various conditions and with various cavity configurations. Supplementary analyses and acoustic model testing were used to aid cavity design and interpretation of results. Results from this program clearly indicate that dynamic stability in regeneratively cooled OME-type engines can be ensured through the use of acoustic cavities. Moreover, multiple modes of instability were successfully suppressed with the cavity.

A community health report card: comprehensive assessment for tracking community health (CATCH).

PubMed

Studnicki, J; Steverson, B; Myers, B; Hevner, A R; Berndt, D J

1997-01-01

A systematic method for assessing the health status of communities has been under development at the University of South Florida since 1991. The system, known as CATCH, draws 226 indicators from multiple sources and uses an innovative comparative framework and weighted evaluation criteria to produce a rank-ordered community problem list. The CATCH results from II Floridian counties have focused attention on high priority health problems and provided a framework for measuring the impact of health expenditures on community health status outcomes. The method and plans to create an automated data warehouse to support its expansion and enrichment are described.

Variations in mature market consumer behavior within a health care product: implications for marketing strategy.

PubMed

Hopper, J A; Busbin, J W

1995-01-01

America is undergoing a profound age shift in its demographic make-up with people 55 and over comprising an increasing proportion of the population. Marketers may need to increase their response rate to this shift, especially in refining the application of marketing theory and practice to older age consumers. To this end, a survey of older couple buying behavior for health insurance coverage is reported here. Results clarify evaluative criteria and the viability of multiple market segmentation for health care coverage among older consumers as couples. Commentary on the efficacy of present health coverage marketing programs is provided.

A Brokering Protocol for Agent-Based Grid Resource Discovery

NASA Astrophysics Data System (ADS)

Kang, Jaeyong; Sim, Kwang Mong

Resource discovery is one of the basic and key aspects in grid resource management, which aims at searching for the suitable resources for satisfying the requirement of users' applications. This paper introduces an agent-based brokering protocol which connects users and providers in grid environments. In particular, it focuses on addressing the problem of connecting users and providers. A connection algorithm that matches advertisements of users and requests from providers based on pre-specified multiple criteria is devised and implemented. The connection algorithm mainly consists of four stages: selection, evaluation, filtering, and recommendation. A series of experiments that were carried out in executing the protocol, and favorable results were obtained.

Sexual Dysfunction Management and Expectations Assessment in Multiple Sclerosis-Female (SEA-MS-F): creation and validation of a specific questionnaire.

PubMed

Bisseriex, Hélène; Guinet-Lacoste, Amandine; Chevret-Méasson, Marie; Costa, Pierre; Sheikh Ismael, Samer; Rousseau, Alexandra; Amarenco, Gerard

2014-12-01

Until now, no questionnaire has been developed to study specific expectations concerning sexual dysfunction management and the availability of information on sexuality in the female population affected by multiple sclerosis (MS). Understanding and meeting the patient's expectations is an issue of considerable importance in the evaluation of medical care. We present the development and validation of a specific questionnaire designed for women with MS in order to assess their expectations in terms of sexual dysfunction management: the SEA-MS-F (Sexual Dysfunction Management and Expectations Assessment in Multiple Sclerosis-Female). This questionnaire was created and validated by an expert panel, using the Delphi method. The psychometric evaluation was obtained with a sample of 40 female MS patients. Cronbach's alpha index and principal component analysis were used to measure the questionnaire's internal consistency. A consensus on the questionnaire was reached with the Delphi method. The SEA-MS-F is fully compliant with the criteria for psychometric validation among female MS patients, and its internal consistency is excellent (Cronbach's alpha 0.948). The SEA-MS-F appears to be a useful tool that could be used either in routine medical situations or in prospective studies of MS in order to ascertain women's expectations concerning the management of their sexual dysfunction. © 2014 International Society for Sexual Medicine.

Glyphosate epidemiology expert panel review: a weight of evidence systematic review of the relationship between glyphosate exposure and non-Hodgkin's lymphoma or multiple myeloma.

PubMed

Acquavella, John; Garabrant, David; Marsh, Gary; Sorahan, Tom; Weed, Douglas L

2016-09-01

We conducted a systematic review of the epidemiologic literature for glyphosate focusing on non-Hodgkin's lymphoma (NHL) and multiple myeloma (MM) - two cancers that were the focus of a recent review by an International Agency for Research on Cancer Working Group. Our approach was consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews. We evaluated each relevant study according to a priori criteria for study quality: adequacy of study size, likelihood of confounding, potential for other biases and adequacy of the statistical analyses. Our evaluation included seven unique studies for NHL and four for MM, all but one of which were case control studies for each cancer. For NHL, the case-control studies were all limited by the potential for recall bias and the lack of adequate multivariate adjustment for multiple pesticide and other farming exposures. Only the Agricultural Health (cohort) Study met our a priori quality standards and this study found no evidence of an association between glyphosate and NHL. For MM, the case control studies shared the same limitations as noted for the NHL case-control studies and, in aggregate, the data were too sparse to enable an informed causal judgment. Overall, our review did not find support in the epidemiologic literature for a causal association between glyphosate and NHL or MM.

Configuration evaluation and criteria plan. Volume 2: Evaluation critera plan (preliminary). Space Transportation Main Engine (STME) configuration study

NASA Technical Reports Server (NTRS)

Bair, E. K.

1986-01-01

The unbiased selection of the Space Transportation Main Engine (STME) configuration requires that the candidate engines be evaluated against a predetermined set of criteria which must be properly weighted to emphasize critical requirements defined prior to the actual evaluation. The evaluation and selection process involves the following functions: (1) determining if a configuration can satisfy basic STME requirements (yes/no); (2) defining the evaluation criteria; (3) selecting the criteria relative importance or weighting; (4) determining the weighting sensitivities; and (5) establishing a baseline for engine evaluation. The criteria weighting and sensitivities are cost related and are based on mission models and vehicle requirements. The evaluation process is used as a coarse screen to determine the candidate engines for the parametric studies and as a fine screen to determine concept(s) for conceptual design. The criteria used for the coarse and fine screen evaluation process is shown. The coarse screen process involves verifying that the candidate engines can meet the yes/no screening requirements and a semi-subjective quantitative evaluation. The fine screen engines have to meet all of the yes/no screening gates and are then subjected to a detailed evaluation or assessment using the quantitative cost evaluation processes. The option exists for re-cycling a concept through the quantitative portion of the screening and allows for some degree of optimization. The basic vehicle is a two stage LOX/HC, LOX/LH2 parallel burn vehicle capable of placing 150,000 lbs in low Earth orbit (LEO).

Empirical evaluation of interest-level criteria

NASA Astrophysics Data System (ADS)

Sahar, Sigal; Mansour, Yishay

1999-02-01

Efficient association rule mining algorithms already exist, however, as the size of databases increases, the number of patterns mined by the algorithms increases to such an extent that their manual evaluation becomes impractical. Automatic evaluation methods are, therefore, required in order to sift through the initial list of rules, which the datamining algorithm outputs. These evaluation methods, or criteria, rank the association rules mined from the dataset. We empirically examined several such statistical criteria: new criteria, as well as previously known ones. The empirical evaluation was conducted using several databases, including a large real-life dataset, acquired from an order-by-phone grocery store, a dataset composed from www proxy logs, and several datasets from the UCI repository. We were interested in discovering whether the ranking performed by the various criteria is similar or easily distinguishable. Our evaluation detected, when significant differences exist, three patterns of behavior in the eight criteria we examined. There is an obvious dilemma in determining how many association rules to choose (in accordance with support and confidence parameters). The tradeoff is between having stringent parameters and, therefore, few rules, or lenient parameters and, thus, a multitude of rules. In many cases, our empirical evaluation revealed that most of the rules found by the comparably strict parameters ranked highly according to the interestingness criteria, when using lax parameters (producing significantly more association rules). Finally, we discuss the association rules that ranked highest, explain why these results are sound, and how they direct future research.

A Multicriteria Decision Making Approach for Estimating the Number of Clusters in a Data Set

PubMed Central

Peng, Yi; Zhang, Yong; Kou, Gang; Shi, Yong

2012-01-01

Determining the number of clusters in a data set is an essential yet difficult step in cluster analysis. Since this task involves more than one criterion, it can be modeled as a multiple criteria decision making (MCDM) problem. This paper proposes a multiple criteria decision making (MCDM)-based approach to estimate the number of clusters for a given data set. In this approach, MCDM methods consider different numbers of clusters as alternatives and the outputs of any clustering algorithm on validity measures as criteria. The proposed method is examined by an experimental study using three MCDM methods, the well-known clustering algorithm–k-means, ten relative measures, and fifteen public-domain UCI machine learning data sets. The results show that MCDM methods work fairly well in estimating the number of clusters in the data and outperform the ten relative measures considered in the study. PMID:22870181

An efficient approach for inverse kinematics and redundancy resolution scheme of hyper-redundant manipulators

NASA Astrophysics Data System (ADS)

Chembuly, V. V. M. J. Satish; Voruganti, Hari Kumar

2018-04-01

Hyper redundant manipulators have a large number of degrees of freedom (DOF) than the required to perform a given task. Additional DOF of manipulators provide the flexibility to work in highly cluttered environment and in constrained workspaces. Inverse kinematics (IK) of hyper-redundant manipulators is complicated due to large number of DOF and these manipulators have multiple IK solutions. The redundancy gives a choice of selecting best solution out of multiple solutions based on certain criteria such as obstacle avoidance, singularity avoidance, joint limit avoidance and joint torque minimization. This paper focuses on IK solution and redundancy resolution of hyper-redundant manipulator using classical optimization approach. Joint positions are computed by optimizing various criteria for a serial hyper redundant manipulators while traversing different paths in the workspace. Several cases are addressed using this scheme to obtain the inverse kinematic solution while optimizing the criteria like obstacle avoidance, joint limit avoidance.

Age, Body Mass Index, and Frequency of Sexual Activity are Independent Predictors of Testosterone Deficiency in Men With Erectile Dysfunction.

PubMed

Pagano, Matthew J; De Fazio, Adam; Levy, Alison; RoyChoudhury, Arindam; Stahl, Peter J

2016-04-01

To identify clinical predictors of testosterone deficiency (TD) in men with erectile dysfunction (ED), thereby identifying subgroups that are most likely to benefit from targeted testosterone screening. Retrospective review was conducted on 498 men evaluated for ED between January 2013 and July 2014. Testing for TD by early morning serum measurement was offered to all eligible men. Patients with history of prostate cancer or testosterone replacement were excluded. Univariable linear regression was conducted to analyze 19 clinical variables for associations with serum total testosterone (TT), calculated free testosterone (cFT), and TD (T <300 ng/dL or cFT <6.5 ng/dL). Variables significant on univariable analysis were included in multiple regression models. A total of 225 men met inclusion criteria. Lower TT levels were associated with greater body mass index (BMI), less frequent sexual activity, and absence of clinical depression on multiple regression analysis. TT decreased by 49.5 ng/dL for each 5-point increase in BMI. BMI and age were the only independent predictors of cFT levels on multivariable analysis. Overall, 62 subjects (27.6%) met criteria for TD. Older age, greater BMI, and less frequent sexual activity were the only independent predictors of TD on multiple regression. We observed a 2.2-fold increase in the odds of TD for every 5-point increase in BMI, and a 1.8-fold increase for every 10 year increase in age. Men with ED and elevated BMI, advanced age, or infrequent sexual activity appear to be at high risk of TD, and such patients represent excellent potential candidates for targeted testosterone screening. Copyright © 2016 Elsevier Inc. All rights reserved.

[Changes in hazardous drinking in Spanish adolescent population in the last decade (2004-2013) using a quantitative and qualitative design].

PubMed

Pérez-Milena, Alejandro; Redondo-Olmedilla, Manuel de Dios; Martínez-Fernández, María Luz; Jiménez-Pulido, Idoia; Mesa-Gallardo, Inmaculada; Leal-Helmling, Francisco Javier

2017-11-01

To determine the changes in hazardous drinking in adolescents in the last decade, as well as their motivations and experiences. Firstly, a descriptive design using a self-report questionnaire, and secondly an explanatory qualitative design, with video recordings of discussion groups with content analysis (coding, triangulation of categories and verification of results). Pupils from an urban High School, administering a questionnaire every 3 years from 2004 to 2013. Purposive sampling was used to elect groups in qualitative design. Homogeneity criteria: education level; heterogeneity criteria: age, gender, and drug use. Questionnaire: age, gender, drug use, and the CAGE test. Interviews: semi-structured on a previous script, evaluating experiences and expectations. Descriptive design: A total of 1,558 questionnaires, age 14.2±0.3years, 50% female. The prevalence of alcohol drinking decreases (13%), but its hazardous use increases (11%; P<.001, χ 2 ). This is associated with being female (P<.01 χ 2 ), higher alcohol consumption (>6 standard drink units weekly; P<.001, ANOVA), during the weekend (56%; P<.01, χ 2 ) and multiple drug use (P<.01, χ 2 ). CAGE questionnaire: 37% ≥1positive response (related to hazardous drinking, P<.05 χ 2 ), 18% ≥2answers. A total of 48 respondents, classified into 4 categories: personal factors (age, gender), social influences (family, friends), consumption standards (accessibility, nightlife), and addiction (risk, multiple drug use). Despite the decrease in the prevalence of alcohol drinking, the increase in the percentage of the hazardous drinking is a public health problem. It is related to being female, binge-drinking, and multiple drug use. Nightlife and social standards are the main reasons given by adolescents, who have no perception of risk. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Approach to developing numeric water quality criteria for ...

EPA Pesticide Factsheets

Human activities on land increase nutrient loads to coastal waters, which can increase phytoplankton production and biomass and potentially cause harmful ecological effects. States can adopt numeric water quality criteria into their water quality standards to protect the designated uses of their coastal waters from eutrophication impacts. The first objective of this study was to provide an approach for developing numeric water quality criteria for coastal waters based on archived SeaWiFS ocean color satellite data. The second objective was to develop an approach for transferring water quality criteria assessments to newer ocean color satellites such as MODIS and MERIS. Spatial and temporal measures of SeaWiFS, MODIS, and MERIS chlorophyll-a (ChlRS-a, mg m-3) were resolved across Florida’s coastal waters between 1998 and 2009. Annual geometric means of SeaWiFS ChlRS-a were evaluated to determine a quantitative reference baseline from the 90th percentile of the annual geometric means. A method for transferring to multiple ocean color sensors was implemented with SeaWiFS as the reference instrument. The ChlRS-a annual geometric means for each coastal segment from MODIS and MERIS were regressed against SeaWiFS to provide a similar response among all three satellites. Standardization factors for each coastal segment were calculated based on differences between 90th percentiles from SeaWiFS to MODIS and SeaWiFS to MERIS. This transfer approach allowed for futu

Gene selection with multiple ordering criteria.

PubMed

Chen, James J; Tsai, Chen-An; Tzeng, Shengli; Chen, Chun-Houh

2007-03-05

A microarray study may select different differentially expressed gene sets because of different selection criteria. For example, the fold-change and p-value are two commonly known criteria to select differentially expressed genes under two experimental conditions. These two selection criteria often result in incompatible selected gene sets. Also, in a two-factor, say, treatment by time experiment, the investigator may be interested in one gene list that responds to both treatment and time effects. We propose three layer ranking algorithms, point-admissible, line-admissible (convex), and Pareto, to provide a preference gene list from multiple gene lists generated by different ranking criteria. Using the public colon data as an example, the layer ranking algorithms are applied to the three univariate ranking criteria, fold-change, p-value, and frequency of selections by the SVM-RFE classifier. A simulation experiment shows that for experiments with small or moderate sample sizes (less than 20 per group) and detecting a 4-fold change or less, the two-dimensional (p-value and fold-change) convex layer ranking selects differentially expressed genes with generally lower FDR and higher power than the standard p-value ranking. Three applications are presented. The first application illustrates a use of the layer rankings to potentially improve predictive accuracy. The second application illustrates an application to a two-factor experiment involving two dose levels and two time points. The layer rankings are applied to selecting differentially expressed genes relating to the dose and time effects. In the third application, the layer rankings are applied to a benchmark data set consisting of three dilution concentrations to provide a ranking system from a long list of differentially expressed genes generated from the three dilution concentrations. The layer ranking algorithms are useful to help investigators in selecting the most promising genes from multiple gene lists generated by different filter, normalization, or analysis methods for various objectives.

The efficacy of cladribine tablets in CIS patients retrospectively assigned the diagnosis of MS using modern criteria: Results from the ORACLE-MS study.

PubMed

Freedman, Mark S; Leist, Thomas P; Comi, Giancarlo; Cree, Bruce Ac; Coyle, Patricia K; Hartung, Hans-Peter; Vermersch, Patrick; Damian, Doris; Dangond, Fernando

2017-01-01

Multiple sclerosis (MS) diagnostic criteria have changed since the ORACLE-MS study was conducted; 223 of 616 patients (36.2%) would have met the diagnosis of MS vs clinically isolated syndrome (CIS) using the newer criteria. The objective of this paper is to assess the effect of cladribine tablets in patients with a first clinical demyelinating attack fulfilling newer criteria (McDonald 2010) for MS vs CIS. A post hoc analysis for subgroups of patients retrospectively classified as fulfilling or not fulfilling newer criteria at the first clinical demyelinating attack was conducted. Cladribine tablets 3.5 mg/kg ( n  = 68) reduced the risk of next attack or three-month confirmed Expanded Disability Status Scale (EDSS) worsening by 74% vs placebo ( n  = 72); p  = 0.0009 in patients meeting newer criteria for MS at baseline. Cladribine tablets 5.25 mg/kg ( n  = 83) reduced the risk of next attack or three-month confirmed EDSS worsening by 37%, but nominal significance was not reached ( p  = 0.14). In patients who were still CIS after applying newer criteria, cladribine tablets 3.5 mg/kg ( n  = 138) reduced the risk of conversion to clinically definite multiple sclerosis (CDMS) by 63% vs placebo ( n  = 134); p  = 0.0003. Cladribine tablets 5.25 mg/kg ( n  = 121) reduced the risk of conversion by 75% vs placebo ( n  = 134); p  < 0.0001. Regardless of the criteria used to define CIS or MS, 3.5 mg/kg cladribine tablets are effective in patients with a first clinical demyelinating attack. ClinicalTrials.gov registration: The ORACLE-MS study (NCT00725985).

Variable criteria sequential stopping rule: Validity and power with repeated measures ANOVA, multiple correlation, MANOVA and relation to Chi-square distribution.

PubMed

Fitts, Douglas A

2017-09-21

The variable criteria sequential stopping rule (vcSSR) is an efficient way to add sample size to planned ANOVA tests while holding the observed rate of Type I errors, α o , constant. The only difference from regular null hypothesis testing is that criteria for stopping the experiment are obtained from a table based on the desired power, rate of Type I errors, and beginning sample size. The vcSSR was developed using between-subjects ANOVAs, but it should work with p values from any type of F test. In the present study, the α o remained constant at the nominal level when using the previously published table of criteria with repeated measures designs with various numbers of treatments per subject, Type I error rates, values of ρ, and four different sample size models. New power curves allow researchers to select the optimal sample size model for a repeated measures experiment. The criteria held α o constant either when used with a multiple correlation that varied the sample size model and the number of predictor variables, or when used with MANOVA with multiple groups and two levels of a within-subject variable at various levels of ρ. Although not recommended for use with χ 2 tests such as the Friedman rank ANOVA test, the vcSSR produces predictable results based on the relation between F and χ 2 . Together, the data confirm the view that the vcSSR can be used to control Type I errors during sequential sampling with any t- or F-statistic rather than being restricted to certain ANOVA designs.

Evaluation of breastfeeding Web sites for patient education.

PubMed

Dornan, Barbara A; Oermann, Marilyn H

2006-01-01

To evaluate the quality of Web sites on breastfeeding for patient education. Descriptive study of 30 Web sites on breastfeeding for patient education, evaluated based on the Health Information Technology Institute (HITI) criteria, readability, and eight content criteria from the American Academy of Pediatrics (AAP) policy statement on breastfeeding. The mean Flesch-Kincaid Grade Level for readability of the 30 sites was 9.2. Seven of the sites included all eight of the content criteria from the AAP, and three sites did not include any of the information recommended by the AAP content criteria. Nurses should be able to recommend best patient education materials for their patients. The five best Web sites for breastfeeding education are identified for patient teaching, and the HITI criteria are explained for nurses to learn how to evaluate Web sites for themselves and their patients.

[Treatment of multi-segment fracture of complex femoral shaft with instrument-assisted reduction combined with intramedullary interlocking nail fixation].

PubMed

Fan, Ke-Jie; Chen, Ke; Ma, Wen-Long; Tian, Ke-Wei; Ye, Ye; Chen, Hong-Gan; Tang, Yan-Feng; Cai, Hong-Min

2018-05-25

To investigate the effect of minimally invasive mini-incision and instrumented reduction combined with interlocking intramedullary nailing in the treatment of patients with multi-segment fracture of complex femoral shaft. From January 2013 to January 2016, 32 patients with multiple fractures segments of femoral shaft were treated with instrumentation-assisted reduction combined with interlocking intramedullary nailing, including 22 males and 10 females with an average age of 45 years old ranging 17 to 68 years old. The time from injured to operation was 5 to 10 days with an average of 7 days. After admission, routine tibial tubercle or supracondylar bone traction was performed. The patient's general condition was evaluated, the operation time and intraoperative blood loss were recorded. According to Thorsen femoral fracture morphology evaluation criteria and Hohl knee function evaluation of postoperative efficacy, postoperative fracture healing, complications and postoperative recovery of limb function were observed. All patients were followed up for 6 to 24 months with an average of 12 months. The operative time ranged from 48 to 76 minutes with an average of 67 min. The intraoperative blood loss was 150 to 400 ml with an average of 220 ml. The surgical incisions all achieved grade A healing. The fractures reached the clinical standard of healing. The fracture healing time ranged from 4.2 to 10.8 months with an average of 5.7 months. There were no nonunion, incision infection and internal fixation fracture, failure and other complications. According to Thorsen femoral fracture morphology evaluation criteria, the result was excellent in 28 cases, good in 3 cases, fair in 1 case. According to Hohl knee function evaluation criteria, the result was excellent in 30 cases, good in 2 cases. Instrument-assisted reduction combined with interlocking intramedullary nail fixation is a safe and effective method for the treatment of complex femoral shaft fractures. It has advantages of small trauma, fixed fixation, quick recovery, early postoperative functional exercise. Copyright© 2018 by the China Journal of Orthopaedics and Traumatology Press.

A new approach to formulating and appraising drug policy: A multi-criterion decision analysis applied to alcohol and cannabis regulation.

PubMed

Rogeberg, Ole; Bergsvik, Daniel; Phillips, Lawrence D; van Amsterdam, Jan; Eastwood, Niamh; Henderson, Graeme; Lynskey, Micheal; Measham, Fiona; Ponton, Rhys; Rolles, Steve; Schlag, Anne Katrin; Taylor, Polly; Nutt, David

2018-02-16

Drug policy, whether for legal or illegal substances, is a controversial field that encompasses many complex issues. Policies can have effects on a myriad of outcomes and stakeholders differ in the outcomes they consider and value, while relevant knowledge on policy effects is dispersed across multiple research disciplines making integrated judgements difficult. Experts on drug harms, addiction, criminology and drug policy were invited to a decision conference to develop a multi-criterion decision analysis (MCDA) model for appraising alternative regulatory regimes. Participants collectively defined regulatory regimes and identified outcome criteria reflecting ethical and normative concerns. For cannabis and alcohol separately, participants evaluated each regulatory regime on each criterion and weighted the criteria to provide summary scores for comparing different regimes. Four generic regulatory regimes were defined: absolute prohibition, decriminalisation, state control and free market. Participants also identified 27 relevant criteria which were organised into seven thematically related clusters. State control was the preferred regime for both alcohol and cannabis. The ranking of the regimes was robust to variations in the criterion-specific weights. The MCDA process allowed the participants to deconstruct complex drug policy issues into a set of simpler judgements that led to consensus about the results. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

WeightLifter: Visual Weight Space Exploration for Multi-Criteria Decision Making.

PubMed

Pajer, Stephan; Streit, Marc; Torsney-Weir, Thomas; Spechtenhauser, Florian; Muller, Torsten; Piringer, Harald

2017-01-01

A common strategy in Multi-Criteria Decision Making (MCDM) is to rank alternative solutions by weighted summary scores. Weights, however, are often abstract to the decision maker and can only be set by vague intuition. While previous work supports a point-wise exploration of weight spaces, we argue that MCDM can benefit from a regional and global visual analysis of weight spaces. Our main contribution is WeightLifter, a novel interactive visualization technique for weight-based MCDM that facilitates the exploration of weight spaces with up to ten criteria. Our technique enables users to better understand the sensitivity of a decision to changes of weights, to efficiently localize weight regions where a given solution ranks high, and to filter out solutions which do not rank high enough for any plausible combination of weights. We provide a comprehensive requirement analysis for weight-based MCDM and describe an interactive workflow that meets these requirements. For evaluation, we describe a usage scenario of WeightLifter in automotive engineering and report qualitative feedback from users of a deployed version as well as preliminary feedback from decision makers in multiple domains. This feedback confirms that WeightLifter increases both the efficiency of weight-based MCDM and the awareness of uncertainty in the ultimate decisions.

The Prevalence of Metabolic Syndrome and Its Components among People with Type 2 Diabetes in the Ho Municipality, Ghana: A Cross-Sectional Study

PubMed Central

2017-01-01

The cooccurrence of diabetes mellitus and metabolic syndrome potentiates the cardiovascular risk associated with each of the conditions; therefore characterizing metabolic syndrome among people with type 2 diabetes is beneficial for the purpose of cardiovascular disease prevention. This study aims at evaluating the prevalence of metabolic syndrome and its components among 162 patients with type 2 diabetes attending the diabetic clinic of the Ho Municipal Hospital, Ghana. Data obtained included anthropometric indices, blood pressure, serum lipids, glucose, and sociodemographics and clinical information. The overall prevalence of metabolic syndrome among the study population was 43.83%, 63.58%, and 69.14% using the NCEP-ATP III, the WHO, and the IDF criteria, respectively. The most predominant component among the study population was high blood pressure using the NCEP-ATP III (108 (66.67%)) and WHO (102 (62.96)) criteria and abdominal obesity (112 (69.14%)) for IDF criteria. High blood pressure was the most prevalent component among the males while abdominal obesity was the principal component among the females. In this population with type 2 diabetes, high prevalence of metabolic syndrome exists. Gender vulnerability to metabolic syndrome and multiple cluster components were skewed towards the female subpopulation with type 2 diabetes. PMID:28293668

Practical Guide for the Selection of Audio Visual Media. General Criteria System and Evaluation Procedure for Educational Media Decisions.

ERIC Educational Resources Information Center

Klepzig, H. J.; Weiss, M.

Designed to aid in making concrete decisions on the acquisition and use of media, the criteria system and evaluation procedure described is a multiphase, objective-based decision making process. This report includes guidelines for setting up goal systems and developing criteria for the evaluation of media based on a goal system; an outline of…

The Development of E-Portfolio Evaluation Criteria and Application to the Blackboard LMS E-Portfolio

ERIC Educational Resources Information Center

McKenna, Gary F.; Stansfield, Mark H.

2012-01-01

The purpose of this paper is to develop e-portfolio evaluation criteria which will be used to review the Blackboard LMS e-portfolio being used at one Higher Education (HE) institution in the UK as evaluation criteria for reviewing e-portfolio provision does not exist in the literature. The approach taken was to initiate a wide literature search…

23 CFR Appendix D to Subpart A of... - Guidance Criteria for Evaluating Requests for Modifications to the National Highway System

Code of Federal Regulations, 2010 CFR

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Guidance Criteria for Evaluating Requests for Modifications to the National Highway System D Appendix D to Subpart A of Part 470 Highways FEDERAL HIGHWAY.... 470, Subpt. A, App. D Appendix D to Subpart A of Part 470—Guidance Criteria for Evaluating Requests...

Clinical utility of new bleeding criteria: a prospective study of evaluation for the Bleeding Academic Research Consortium definition of bleeding in patients undergoing percutaneous coronary intervention.

PubMed

Choi, Jae-Hyuk; Seo, Jeong-Min; Lee, Dong Hyun; Park, Kyungil; Kim, Young-Dae

2015-04-01

The aim of this study was to evaluate the clinical utility of the new bleeding criteria, proposed by the Bleeding Academic Research Consortium (BARC), compared with the old criteria for determining the action of physicians in contact with bleeding events, after percutaneous coronary intervention (PCI). The BARC criteria were independently associated with an increased risk of 1-year mortality after PCI, and provided a predictive value, in regard to 1-year mortality. The standardized bleeding definitions will be expected to help the physician to correctly analyze the bleeding events, to select an optimal treatment, and to objectively compare the results of multiple trials and registries. All the patients undergoing PCI from June to September 2012 were prospectively enrolled. Patients who experienced a bleeding event were further classified, based on three different bleeding severity criteria: BARC, Thrombolysis In Myocardial Infarction (TIMI), and Global Use of Strategies To Open coronary arteries (GUSTO). The primary outcome was the occurrence of bleeding events requiring interruption of antiplatelet therapy (IAT) by physicians. A total of 376 consecutive patients were included in this study. Total bleeding events occurred in 46 patients (12.2%). BARC type ≥2 bleeding occurred in 30 patients (8.0%); however, TIMI major or minor bleeding, and GUSTO moderate or severe bleeding occurred in 6 (1.6%) and 11 patients (2.9%), respectively. Of the 46 patients, 28 (60.9% of patients) required IAT. On receiver-operating characteristic curve analysis, bleeding defined BARC type ≥2 effectively predicted IAT, with a sensitivity of 89.3%, and a specificity of 98.5% (p<0.001), compared with TIMI (sensitivity, 21.4%; specificity, 100%; p<0.001), and GUSTO (sensitivity, 39.3%; specificity, 100%; p<0.001). Compared with TIMI and GUSTO, the BARC definition may be a more useful tool for the detection of bleeding with clinical relevance, for patients undergoing PCI. Copyright © 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

A decision tool for selecting trench cap designs

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

Paige, G.B.; Stone, J.J.; Lane, L.J.

1995-12-31

A computer based prototype decision support system (PDSS) is being developed to assist the risk manager in selecting an appropriate trench cap design for waste disposal sites. The selection of the {open_quote}best{close_quote} design among feasible alternatives requires consideration of multiple and often conflicting objectives. The methodology used in the selection process consists of: selecting and parameterizing decision variables using data, simulation models, or expert opinion; selecting feasible trench cap design alternatives; ordering the decision variables and ranking the design alternatives. The decision model is based on multi-objective decision theory and uses a unique approach to order the decision variables andmore » rank the design alternatives. Trench cap designs are evaluated based on federal regulations, hydrologic performance, cover stability and cost. Four trench cap designs, which were monitored for a four year period at Hill Air Force Base in Utah, are used to demonstrate the application of the PDSS and evaluate the results of the decision model. The results of the PDSS, using both data and simulations, illustrate the relative advantages of each of the cap designs and which cap is the {open_quotes}best{close_quotes} alternative for a given set of criteria and a particular importance order of those decision criteria.« less

ACR appropriateness Criteria® second and third trimester bleeding.

PubMed

Podrasky, Ann E; Javitt, Marcia C; Glanc, Phyllis; Dubinsky, Theodore; Harisinghani, Mukesh G; Harris, Robert D; Khati, Nadia J; Mitchell, Donald G; Pandharipande, Pari V; Pannu, Harpreet K; Shipp, Thomas D; Siegel, Cary Lynn; Simpson, Lynn; Wall, Darci J; Wong-You-Cheong, Jade J; Zelop, Carolyn M

2013-12-01

Vaginal bleeding occurring in the second or third trimesters of pregnancy can variably affect perinatal outcome, depending on whether it is minor (i.e. a single, mild episode) or major (heavy bleeding or multiple episodes.) Ultrasound is used to evaluate these patients. Sonographic findings may range from marginal subchorionic hematoma to placental abruption. Abnormal placentations such as placenta previa, placenta accreta and vasa previa require accurate diagnosis for clinical management. In cases of placenta accreta, magnetic resonance imaging is useful as an adjunct to ultrasound and is often appropriate for evaluation of the extent of placental invasiveness and potential involvement of adjacent structures. MRI is useful for preplanning for cases of complex delivery, which may necessitate a multi-disciplinary approach for optimal care.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every two years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

A web-based multicriteria evaluation of spatial trade-offs between environmental and economic implications from hydraulic fracturing in a shale gas region in Ohio.

PubMed

Liu, X; Gorsevski, P V; Yacobucci, M M; Onasch, C M

2016-06-01

Planning of shale gas infrastructure and drilling sites for hydraulic fracturing has important spatial implications. The evaluation of conflicting and competing objectives requires an explicit consideration of multiple criteria as they have important environmental and economic implications. This study presents a web-based multicriteria spatial decision support system (SDSS) prototype with a flexible and user-friendly interface that could provide educational or decision-making capabilities with respect to hydraulic fracturing site selection in eastern Ohio. One of the main features of this SDSS is to emphasize potential trade-offs between important factors of environmental and economic ramifications from hydraulic fracturing activities using a weighted linear combination (WLC) method. In the prototype, the GIS-enabled analytical components allow spontaneous visualization of available alternatives on maps which provide value-added features for decision support processes and derivation of final decision maps. The SDSS prototype also facilitates nonexpert participation capabilities using a mapping module, decision-making tool, group decision module, and social media sharing tools. The logical flow of successively presented forms and standardized criteria maps is used to generate visualization of trade-off scenarios and alternative solutions tailored to individual user's preferences that are graphed for subsequent decision-making.

Technical Note: Relationships between gamma criteria and action levels: Results of a multicenter audit of gamma agreement index results.

PubMed

Crowe, Scott B; Sutherland, Bess; Wilks, Rachael; Seshadri, Venkatakrishnan; Sylvander, Steven; Trapp, Jamie V; Kairn, Tanya

2016-03-01

The aim of this work was to use a multicenter audit of modulated radiotherapy quality assurance (QA) data to provide a practical examination of gamma evaluation criteria and action level selection. The use of the gamma evaluation method for patient-specific pretreatment QA is widespread, with most commercial solutions implementing the method. Gamma agreement indices were calculated using the criteria 1%/1 mm, 2%/2 mm, 2%/3 mm, 3%/2 mm, 3%/3 mm, and 5%/3 mm for 1265 pretreatment QA measurements, planned at seven treatment centers, using four different treatment planning systems, delivered using three different delivery systems (intensity-modulated radiation therapy, volumetric-modulated arc therapy, and helical tomotherapy) and measured using three different dose measurement systems. The sensitivity of each pair of gamma criteria was evaluated relative to the gamma agreement indices calculated using 3%/3 mm. A linear relationship was observed for 2%/2 mm, 2%/3 mm, and 3%/2 mm. This result implies that most beams failing at 3%/3 mm would also fail for those criteria, if the action level was adjusted appropriately. Some borderline plans might be passed or failed depending on the relative priority (tighter tolerance) used for dose difference or distance to agreement evaluation. Dosimeter resolution and treatment modality were found to have a smaller effect on the results of QA measurements than the number of dimensions (2D or 3D) over which the gamma evaluation was calculated. This work provides a method (and a large sample of results) for calculating equivalent action levels for different gamma evaluation criteria. This work constitutes a valuable guide for clinical decision making and a means to compare published gamma evaluation results from studies using different evaluation criteria. More generally, the data provided by this work support the recommendation that gamma criteria that specifically prioritize the property of greatest clinical importance for each treatment modality of anatomical site should be selected when using gamma evaluations for modulated radiotherapy QA. It is therefore suggested that departments using the gamma evaluation as a QA analysis tool should consider the relative importance of dose difference and distance to agreement, when selecting gamma evaluation criteria.

Using Geographic Information Systems to Determine Site Suitability for a Low-Level Radioactive Waste Storage Facility.

PubMed

Wilson, Charles A; Matthews, Kennith; Pulsipher, Allan; Wang, Wei-Hsung

2016-02-01

Radioactive waste is an inevitable product of using radioactive material in education and research activities, medical applications, energy generation, and weapons production. Low-level radioactive waste (LLW) makes up a majority of the radioactive waste produced in the United States. In 2010, over two million cubic feet of LLW were shipped to disposal sites. Despite efforts from several states and compacts as well as from private industry, the options for proper disposal of LLW remain limited. New methods for quickly identifying potential storage locations could alleviate current challenges and eventually provide additional sites and allow for adequate regional disposal of LLW. Furthermore, these methods need to be designed so that they are easily communicated to the public. A Geographic Information Systems (GIS) based method was developed to determine suitability of potential LLW disposal (or storage) sites. Criteria and other parameters of suitability were based on the Code of Federal Regulation (CFR) requirements as well as supporting literature and reports. The resultant method was used to assess areas suitable for further evaluation as prospective disposal sites in Louisiana. Criteria were derived from the 10 minimum requirements in 10 CFR Part 61.50, the Nuclear Regulatory Commission's Regulatory Guide 0902, and studies at existing disposal sites. A suitability formula was developed permitting the use of weighting factors and normalization of all criteria. Data were compiled into GIS data sets and analyzed on a cell grid of approximately 14,000 cells (covering 181,300 square kilometers) using the suitability formula. Requirements were analyzed for each cell using multiple criteria/sub-criteria as well as surrogates for unavailable datasets. Additional criteria were also added when appropriate. The method designed in this project proved to be sufficient for initial screening tests in determining the most suitable areas for prospective disposal (or storage) sites. Cells above 90%, 95%, and 99% suitability include respectively 404, 88, and 4 cells suitable for further analysis. With these areas identified, the next step in siting a LLW storage facility would be on-site analysis using additional requirements as specified by relevant regulatory guidelines. The GIS based method provides an easy, economic, efficient and effective means in evaluating potential sites for LLW storage facilities where sufficient GIS data exist.

[Criteria of scientific validity in research].

PubMed

Pelletier, Céline; Pagé, Ginette

2002-03-01

The purpose of this article is to present the evaluative criteria of qualitative and quantitative research. Philosophical foundations of positivism, postpositivism and constructivism are explored. Triangulation and crystallization expose the controversies about them. Finally, Lincoln and Guba criteria are retained for the evaluation of qualitative and quantitative research.

Premise to Implement a Grading System to Evaluate the Sanitary Level in Food Service Establishments in Milan, Italy

PubMed Central

Razzini, Katia

2015-01-01

The regulatory framework of the official controls on food safety, the criteria and methods from the planning of interventions in the field of official control to the management of information flows, and the standards described in the operation manual of the local competent authorities drafted by the Lombardy Region (2011) were evaluated. A questionnaire consisting of n. 10 questions with multiple answers draft in partnership with EPAM (the Association of Provincial Public Retail and catering businesses in Milan) to n. 107 Food service establishments of Milan shows that 92% of managers approve the introduction of a grading system. The regulatory framework is planned to support the implementation of risk assignment, unfortunately the attribution of risk category of retail and catering businesses is still different among regions. PMID:27800403

Practice Guidelines for Cardiovascular Fitness and Strengthening Exercise Prescription After Burn Injury.

PubMed

Nedelec, Bernadette; Parry, Ingrid; Acharya, Hernish; Benavides, Lynne; Bills, Sara; Bucher, Janelle L; Cheal, Joanne; Chouinard, Annick; Crump, Donna; Duch, Sarah; Godleski, Matthew; Guenther, Jennifer; Knox, Catherine; LaBonte, Eric; Lorello, David; Lucio, J Xavier; Macdonald, Lori E; Kemp-Offenberg, Jennifer; Osborne, Candice; Pontius, Kara; Yelvington, Miranda; de Oliveira, Ana; Kloda, Lorie A

The objective of this review was to systematically evaluate the available clinical evidence for the prescription of strength training and cardiovascular endurance exercise programs for pediatric and adult burn survivors so that practice guidelines could be proposed. This review provides evidence-based recommendations specifically for rehabilitation professionals who are responsible for burn survivor rehabilitation. Summary recommendations were made after the literature was retrieved by systematic review, was critically appraised by multiple authors and the level of evidence determined in accordance with the Oxford Centre for Evidence-based Medicine criteria. Although gaps in the literature persist and should be addressed in future research projects, currently, strong research evidence supports the prescription of strength training and aerobic conditioning exercise programs for both adult and pediatric burn survivors when in the presence of strength limitations and/or decreased cardiovascular endurance after evaluation.

Measurement of sustainability index among paper manufacturing plants

NASA Astrophysics Data System (ADS)

Sharathkumar Reddy, V.; Jayakrishna, K.; Lal, Babu

2017-11-01

The paper manufacturing companies are facing challenges to implement sustainable manufacturing into their products and processes. Paper manufacturing has remarked as an intensive consumer of natural raw materials, energy and a major source of multiple pollutants. Thus, evaluating the sustainable manufacturing in these companies has become a necessity. This paper proposes a set of Performance Indicators (PIs) for evaluating the sustainable manufacturing appropriate to the paper manufacturing companies based on the triple bottom line of sustainability. The Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS), a multi-criteria decision analysis method is applied to prioritize the performance indicators by summarizing the opinions of stakeholders. It is hoped that the proposed PIs enables and assists the paper manufacturing companies to achieve the higher performance in sustainable manufacturing and so as to increase their competitiveness.

Radiological Determination of Postoperative Cervical Fusion: A Systematic Review.

PubMed

Rhee, John M; Chapman, Jens R; Norvell, Daniel C; Smith, Justin; Sherry, Ned A; Riew, K Daniel

2015-07-01

Systematic review. To determine best criteria for radiological determination of postoperative subaxial cervical fusion to be applied to current clinical practice and ongoing future research assessing fusion to standardize assessment and improve comparability. Despite availability of multiple imaging modalities and criteria, there remains no method of determining cervical fusion with absolute certainty, nor clear consensus on specific criteria to be applied. A systematic search in MEDLINE/Cochrane Collaboration Library (through March 2014). Included studies assessed C2 to C7 via anterior or posterior approach, at 12 weeks or more postoperative, with any graft or implant. Overall body of evidence with respect to 6 posited key questions was determined using Grading of Recommendations Assessment, Development and Evaluation and Agency for Healthcare Research and Quality precepts. Of plain radiographical modalities, there is moderate evidence that the interspinous process motion method (<1 mm) is more accurate than the Cobb angle method for assessing anterior cervical fusion. Of the advanced imaging modalities, there is moderate evidence that computed tomography (CT) is more accurate and reliable than magnetic resonance imaging in assessing anterior cervical fusion. There is insufficient evidence regarding the optimal modality and criteria for assessing posterior cervical fusions and insufficient evidence to support a single time point after surgery as being optimal for determining fusion, although some evidence suggest that reliability of radiography and CT improves with increasing time postoperatively. We recommend using less than 1-mm motion as the initial modality for determining anterior cervical arthrodesis for both clinical and research applications. If further imaging is needed because of indeterminate radiographical evaluation, we recommend CT, which has relatively high accuracy and reliability, but due to greater radiation exposure and cost, it is not routinely suggested. We recommend that plain radiographs also be the initial method of determining posterior cervical fusion but suggest a lower threshold for obtaining CT scans because dynamic radiographs may not be as useful if spinous processes have been removed by laminectomy. 1.

Phase II Study of Chemoembolization With Drug-Eluting Beads in Patients With Hepatic Neuroendocrine Metastases: High Incidence of Biliary Injury

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

Bhagat, Nikhil, E-mail: nbhagat1@jhmi.edu; Reyes, Diane K., E-mail: dreyes@jhmi.edu; Lin, Mingde, E-mail: ming.lin@philips.com

2013-04-15

To evaluate safety in an interim analysis of transarterial chemoembolization (TACE) with doxorubicin-eluting beads (DEB) in 13 patients with hepatic metastases from neuroendocrine tumors (NETs) as part of a phase II trial. Institutional Review Board approval and informed consent were obtained. Thirteen patients completed preliminary safety analysis. Their mean age was 65 years, Eastern Cooperative Oncology Group status was 0/1, tumor burden range was 4-75 %, and mean targeted tumor size was 5.9 cm. Up to four DEB-TACE sessions (100-300 {mu}m beads loaded with {<=}100 mg doxorubicin) within 6 months were allowed. Tumor response was assessed by magnetic resonance imagingmore » 1 month after treatment using contrast-enhancement [European Association for the Study of the Liver (EASL) and size Response Evaluation Criteria in Solid Tumors (RECIST)] criteria. Safety was assessed by National Cancer Institute Common Terminology Criteria. DEB-TACE was successfully performed in all 13 patients. At 1 month follow-up, there was a mean 12 % decrease in tumor size (p < 0.0003) and a 56 % decrease in tumor enhancement (p < 0.0001). By EASL criteria, the targeted lesion objective response rate was 78 %. Grade 3 to 4 toxicities were fatigue (23 %), increased alanine amino transferase (15 %), hyperglycemia (15 %), and abdominal pain (8 %). Seven patients developed bilomas (54 %); all of these patients had multiple small (<4 cm) lesions. Subsequently, four underwent percutaneous drainage, three for abscess formation and one for symptoms related to mass effect. Although biloma and liver abscess are known risks after TACE, the high incidence in our study population was unexpected and forced interruption of the trial. Although this occurred in a small group of patients, we have changed our technique and patient selection as a result of these findings, thus allowing resumption of the trial.« less

Evaluating and Comparing the Effects of Group Contingencies on Mathematics Accuracy in a First-Grade Classroom: Class Average Criteria versus Unknown Small-Group Average Criteria

ERIC Educational Resources Information Center

Scott, Katelyn C.; Skinner, Christopher H.; Moore, Tara C.; McCurdy, Merilee; Ciancio, Dennis; Cihak, David F.

2017-01-01

An adapted alternating treatments design was used to evaluate and compare the effects of two group contingency interventions on mathematics assignment accuracy in an intact first-grade classroom. Both an interdependent contingency with class-average criteria (16 students) and a dependent contingency with criteria based on the average of a smaller,…

Economic evaluation of vaccines in Canada: A systematic review

PubMed Central

Chit, Ayman; Lee, Jason K. H.; Shim, Minsup; Nguyen, Van Hai; Grootendorst, Paul; Wu, Jianhong; Van Exan, Robert; Langley, Joanne M.

2016-01-01

ABSTRACT Background: Economic evaluations should form part of the basis for public health decision making on new vaccine programs. While Canada's national immunization advisory committee does not systematically include economic evaluations in immunization decision making, there is increasing interest in adopting them. We therefore sought to examine the extent and quality of economic evaluations of vaccines in Canada. Objective: We conducted a systematic review of economic evaluations of vaccines in Canada to determine and summarize: comprehensiveness across jurisdictions, studied vaccines, funding sources, study designs, research quality, and changes over time. Methods: Searches in multiple databases were conducted using the terms “vaccine,” “economics” and “Canada.” Descriptive data from eligible manuscripts was abstracted and three authors independently evaluated manuscript quality using a 7-point Likert-type scale scoring tool based on criteria from the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Results: 42/175 articles met the search criteria. Of these, Canada-wide studies were most common (25/42), while provincial studies largely focused on the three populous provinces of Ontario, Quebec and British Columbia. The most common funding source was industry (17/42), followed by government (7/42). 38 studies used mathematical models estimating expected economic benefit while 4 studies examined post-hoc data on established programs. Studies covered 10 diseases, with 28/42 addressing pediatric vaccines. Many studies considered cost-utility (22/42) and the majority of these studies reported favorable economic results (16/22). The mean quality score was 5.9/7 and was consistent over publication date, funding sources, and disease areas. Conclusions: We observed diverse approaches to evaluate vaccine economics in Canada. Given the increased complexity of economic studies evaluating vaccines and the impact of results on public health practice, Canada needs improved, transparent and consistent processes to review and assess the findings of the economic evaluations of vaccines. PMID:26890128

42 CFR 483.128 - PASARR evaluation criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PASARR program must use at least the evaluative criteria of § 483.130 (if one or both determinations can... of all data concerning the individual. (g) Preexisting data. Evaluators may use relevant evaluative... determinations, findings must be issued in the form of a written evaluative report which— (1) Identifies the name...

42 CFR 483.128 - PASARR evaluation criteria.

Code of Federal Regulations, 2014 CFR

2014-10-01

... PASARR program must use at least the evaluative criteria of § 483.130 (if one or both determinations can... of all data concerning the individual. (g) Preexisting data. Evaluators may use relevant evaluative... determinations, findings must be issued in the form of a written evaluative report which— (1) Identifies the name...

42 CFR 483.128 - PASARR evaluation criteria.

Code of Federal Regulations, 2013 CFR

2013-10-01

... PASARR program must use at least the evaluative criteria of § 483.130 (if one or both determinations can... of all data concerning the individual. (g) Preexisting data. Evaluators may use relevant evaluative... determinations, findings must be issued in the form of a written evaluative report which— (1) Identifies the name...

42 CFR 483.128 - PASARR evaluation criteria.

Code of Federal Regulations, 2011 CFR

2011-10-01

... PASARR program must use at least the evaluative criteria of § 483.130 (if one or both determinations can... of all data concerning the individual. (g) Preexisting data. Evaluators may use relevant evaluative... determinations, findings must be issued in the form of a written evaluative report which— (1) Identifies the name...

42 CFR 483.128 - PASARR evaluation criteria.

Code of Federal Regulations, 2012 CFR

2012-10-01

... PASARR program must use at least the evaluative criteria of § 483.130 (if one or both determinations can... of all data concerning the individual. (g) Preexisting data. Evaluators may use relevant evaluative... determinations, findings must be issued in the form of a written evaluative report which— (1) Identifies the name...

Ovulation induction with clomiphene citrate and metformin in women with polycystic ovary syndrome.

PubMed

Leanza, V; Coco, L; Grasso, F; Leanza, G; Zarbo, G; Palumbo, M

2014-06-01

Polycystic ovary syndrome (PCOS) is one of the most common causes of ovulatory infertility. It is an endocrine disorders characterized by a high level of male hormones (androgens) and frequent anovulatory cycles associated with multiple ovarian microcysts. The aim of this paper was to evaluate effects of a Clomiphene citrate alone versus a combined treatment (Metformin and Clomiphene citrate). A total of 60 women with PCOS and infertility were evaluated. Inclusions criteria were: age 26-34 years, nulliparity, above 3 years of sterility, multiple ovarian microcysts, BMI>27.5, oligomenorrhea/amenorrhea, hyperandrogenism and normal male fertility. Four patients were excluded (renal damage 2, tubal occlusion 1 and Pelvic Inflammatory Disease 1). The remaining 56 were divided into 2 groups: group A were inducted with Clomiphene Citrate alone, while group B were inducted with Clomiphene citrate and Metformin. In group A we obtained ovulation in 20 women (71.4%), 8 pregnancies (28.5%) and one (3.5%) spontaneous abortion. In group B we obtained ovulation in 24 women (85.7%), 15 pregnancies (53.5%) and no spontaneous abortions. Combined treatment was found to be more effective (53.5) in improving pregnancy rate compared to monotherapy (28.5%).

An Unsupervised Online Spike-Sorting Framework.

PubMed

Knieling, Simeon; Sridharan, Kousik S; Belardinelli, Paolo; Naros, Georgios; Weiss, Daniel; Mormann, Florian; Gharabaghi, Alireza

2016-08-01

Extracellular neuronal microelectrode recordings can include action potentials from multiple neurons. To separate spikes from different neurons, they can be sorted according to their shape, a procedure referred to as spike-sorting. Several algorithms have been reported to solve this task. However, when clustering outcomes are unsatisfactory, most of them are difficult to adjust to achieve the desired results. We present an online spike-sorting framework that uses feature normalization and weighting to maximize the distinctiveness between different spike shapes. Furthermore, multiple criteria are applied to either facilitate or prevent cluster fusion, thereby enabling experimenters to fine-tune the sorting process. We compare our method to established unsupervised offline (Wave_Clus (WC)) and online (OSort (OS)) algorithms by examining their performance in sorting various test datasets using two different scoring systems (AMI and the Adamos metric). Furthermore, we evaluate sorting capabilities on intra-operative recordings using established quality metrics. Compared to WC and OS, our algorithm achieved comparable or higher scores on average and produced more convincing sorting results for intra-operative datasets. Thus, the presented framework is suitable for both online and offline analysis and could substantially improve the quality of microelectrode-based data evaluation for research and clinical application.