Expediting evidence synthesis for healthcare decision-making: exploring attitudes and perceptions towards rapid reviews using Q methodology

PubMed Central

Moher, David; Clifford, Tammy J.

2016-01-01

Background Rapid reviews expedite the knowledge synthesis process with the goal of providing timely information to healthcare decision-makers who want to use evidence-informed policy and practice approaches. A range of opinions and viewpoints on rapid reviews is thought to exist; however, no research to date has formally captured these views. This paper aims to explore evidence producer and knowledge user attitudes and perceptions towards rapid reviews. Methods A Q methodology study was conducted to identify central viewpoints about rapid reviews based on a broad topic discourse. Participants rank-ordered 50 text statements and explained their Q-sort in free-text comments. Individual Q-sorts were analysed using Q-Assessor (statistical method: factor analysis with varimax rotation). Factors, or salient viewpoints on rapid reviews, were identified, interpreted and described. Results Analysis of the 11 individual Q sorts identified three prominent viewpoints: Factor A cautions against the use of study design labels to make judgements. Factor B maintains that rapid reviews should be the exception and not the rule. Factor C focuses on the practical needs of the end-user over the review process. Conclusion Results show that there are opposing viewpoints on rapid reviews, yet some unity exists. The three factors described offer insight into how and why various stakeholders act as they do and what issues may need to be resolved before increase uptake of the evidence from rapid reviews can be realized in healthcare decision-making environments. PMID:27761324

A validation study of a rapid field-based rating system for discriminating among flow permanence classes of headwater streams in South Carolina

Treesearch

William Wenerick; Ken M. Fritz; Mitchell S. Kostich

2016-01-01

Classifying streams according to permanence is important in determining regulatory jurisdiction and in implementing pollution control programs. Administrators of these programs need rapid methods for making timely and defensible decisions.

Gray matter volume and rapid decision-making in major depressive disorder.

PubMed

Nakano, Masayuki; Matsuo, Koji; Nakashima, Mami; Matsubara, Toshio; Harada, Kenichiro; Egashira, Kazuteru; Masaki, Hiroaki; Takahashi, Kanji; Watanabe, Yoshifumi

2014-01-03

Reduced motivation and blunted decision-making are key features of major depressive disorder (MDD). Patients with MDD show abnormal decision-making when given negative feedback regarding a reward. The brain mechanisms underpinning this behavior remain unclear. In the present study, we examined the association between rapid decision-making with negative feedback and brain volume in MDD. Thirty-six patients with MDD and 54 age-, sex- and IQ-matched healthy subjects were studied. Subjects performed a rapid decision-making monetary task in which participants could make high- or low-risk choices. We compared between the 2 groups the probability that a high-risk choice followed negative feedback. In addition, we used voxel-based morphometry (VBM) to compare between group differences in gray matter volume, and the correlation between the probability for high-risk choices and brain volume. Compared to the healthy group, the MDD group showed significantly lower probabilities for high-risk choices following negative feedback. VBM analysis revealed that the MDD group had less gray matter volume in the right medial prefrontal cortex and orbitofrontal cortex (OFC) compared to the healthy group. The right OFC volume was negatively correlated with the probability that a high-risk choice followed negative feedback in patients with MDD. We did not observe these trends in healthy subjects. Patients with MDD show reduced motivation for monetary incentives when they were required to make rapid decisions following negative feedback. We observed a correlation between this reduced motivation and gray matter volume in the medial and ventral prefrontal cortex, which suggests that these brain regions are likely involved in the pathophysiology of aberrant decision-making in MDD. © 2013.

Instructional Design for Advanced Learners: Training Recognition Skills to Hasten Expertise

ERIC Educational Resources Information Center

Fadde, Peter Jae

2009-01-01

Expertise in domains ranging from sports to surgery involves a process of recognition-primed decision-making (RPD) in which experts make rapid, intuitive decisions based on recognizing critical features of dynamic performance situations. While the development of expert RPD is assumed to require years of domain experience, the transition from…

Development of a decision support system for tsunami evacuation: application to the Jiyang District of Sanya city in China

NASA Astrophysics Data System (ADS)

Hou, Jingming; Yuan, Ye; Wang, Peitao; Ren, Zhiyuan; Li, Xiaojuan

2017-03-01

Major tsunami disasters often cause great damage in the first few hours following an earthquake. The possible severity of such events requires preparations to prevent tsunami disasters or mitigate them. This paper is an attempt to develop a decision support system for rapid tsunami evacuation for local decision makers. Based on the numerical results database of tsunami disasters, this system can quickly obtain the tsunami inundation and travel time. Because numerical models are calculated in advance, this system can reduce decision-making time. Population distribution, as a vulnerability factor, was analyzed to identify areas of high risk for tsunami disasters. Combined with spatial data, this system can comprehensively analyze the dynamic and static evacuation process and identify problems that negatively impact evacuation, thus supporting the decision-making for tsunami evacuation in high-risk areas. When an earthquake and tsunami occur, this system can rapidly obtain the tsunami inundation and travel time and provide information to assist with tsunami evacuation operations.

Data warehousing: toward knowledge management.

PubMed

Shams, K; Farishta, M

2001-02-01

With rapid changes taking place in the practice and delivery of health care, decision support systems have assumed an increasingly important role. More and more health care institutions are deploying data warehouse applications as decision support tools for strategic decision making. By making the right information available at the right time to the right decision makers in the right manner, data warehouses empower employees to become knowledge workers with the ability to make the right decisions and solve problems, creating strategic leverage for the organization. Health care management must plan and implement data warehousing strategy using a best practice approach. Through the power of data warehousing, health care management can negotiate bettermanaged care contracts based on the ability to provide accurate data on case mix and resource utilization. Management can also save millions of dollars through the implementation of clinical pathways in better resource utilization and changing physician behavior to best practices based on evidence-based medicine.

Response time distributions in rapid chess: a large-scale decision making experiment.

PubMed

Sigman, Mariano; Etchemendy, Pablo; Slezak, Diego Fernández; Cecchi, Guillermo A

2010-01-01

Rapid chess provides an unparalleled laboratory to understand decision making in a natural environment. In a chess game, players choose consecutively around 40 moves in a finite time budget. The goodness of each choice can be determined quantitatively since current chess algorithms estimate precisely the value of a position. Web-based chess produces vast amounts of data, millions of decisions per day, incommensurable with traditional psychological experiments. We generated a database of response times (RTs) and position value in rapid chess games. We measured robust emergent statistical observables: (1) RT distributions are long-tailed and show qualitatively distinct forms at different stages of the game, (2) RT of successive moves are highly correlated both for intra- and inter-player moves. These findings have theoretical implications since they deny two basic assumptions of sequential decision making algorithms: RTs are not stationary and can not be generated by a state-function. Our results also have practical implications. First, we characterized the capacity of blunders and score fluctuations to predict a player strength, which is yet an open problem in chess softwares. Second, we show that the winning likelihood can be reliably estimated from a weighted combination of remaining times and position evaluation.

Response Time Distributions in Rapid Chess: A Large-Scale Decision Making Experiment

PubMed Central

Sigman, Mariano; Etchemendy, Pablo; Slezak, Diego Fernández; Cecchi, Guillermo A.

2010-01-01

Rapid chess provides an unparalleled laboratory to understand decision making in a natural environment. In a chess game, players choose consecutively around 40 moves in a finite time budget. The goodness of each choice can be determined quantitatively since current chess algorithms estimate precisely the value of a position. Web-based chess produces vast amounts of data, millions of decisions per day, incommensurable with traditional psychological experiments. We generated a database of response times (RTs) and position value in rapid chess games. We measured robust emergent statistical observables: (1) RT distributions are long-tailed and show qualitatively distinct forms at different stages of the game, (2) RT of successive moves are highly correlated both for intra- and inter-player moves. These findings have theoretical implications since they deny two basic assumptions of sequential decision making algorithms: RTs are not stationary and can not be generated by a state-function. Our results also have practical implications. First, we characterized the capacity of blunders and score fluctuations to predict a player strength, which is yet an open problem in chess softwares. Second, we show that the winning likelihood can be reliably estimated from a weighted combination of remaining times and position evaluation. PMID:21031032

Expert System Shells for Rapid Clinical Decision Support Module Development: An ESTA Demonstration of a Simple Rule-Based System for the Diagnosis of Vaginal Discharge

PubMed Central

2012-01-01

Objectives This study demonstrates the feasibility of using expert system shells for rapid clinical decision support module development. Methods A readily available expert system shell was used to build a simple rule-based system for the crude diagnosis of vaginal discharge. Pictures and 'canned text explanations' are extensively used throughout the program to enhance its intuitiveness and educational dimension. All the steps involved in developing the system are documented. Results The system runs under Microsoft Windows and is available as a free download at http://healthcybermap.org/vagdisch.zip (the distribution archive includes both the program's executable and the commented knowledge base source as a text document). The limitations of the demonstration system, such as the lack of provisions for assessing uncertainty or various degrees of severity of a sign or symptom, are discussed in detail. Ways of improving the system, such as porting it to the Web and packaging it as an app for smartphones and tablets, are also presented. Conclusions An easy-to-use expert system shell enables clinicians to rapidly become their own 'knowledge engineers' and develop concise evidence-based decision support modules of simple to moderate complexity, targeting clinical practitioners, medical and nursing students, as well as patients, their lay carers and the general public (where appropriate). In the spirit of the social Web, it is hoped that an online repository can be created to peer review, share and re-use knowledge base modules covering various clinical problems and algorithms, as a service to the clinical community. PMID:23346475

"Teacher, Teacher, Tell Us about the Brain!" Sharing Decision Making about Curriculum in Preschool

ERIC Educational Resources Information Center

Verwys, Susan K.

2007-01-01

In this article, the author presents a discussion regarding the sharing of decision making regarding curriculum in preschool. The preschool where she teaches is housed in a diverse, faith-based elementary school in the heart of Grand Rapids, Michigan, a midsize, midwestern city. It offers full-day, half-day, and two-and-a-half-hour preschool…

Five shared decision-making tools in 5 months: use of rapid reviews to develop decision boxes for seniors living with dementia and their caregivers.

PubMed

Lawani, Moulikatou Adouni; Valéra, Béatriz; Fortier-Brochu, Émilie; Légaré, France; Carmichael, Pierre-Hugues; Côté, Luc; Voyer, Philippe; Kröger, Edeltraut; Witteman, Holly; Rodriguez, Charo; Giguere, Anik M C

2017-03-15

Decision support tools build upon comprehensive and timely syntheses of literature. Rapid reviews may allow supporting their development by omitting certain components of traditional systematic reviews. We thus aimed to describe a rapid review approach underlying the development of decision support tools, i.e., five decision boxes (DB) for shared decision-making between seniors living with dementia, their caregivers, and healthcare providers. We included studies based on PICO questions (Participant, Intervention, Comparison, Outcome) describing each of the five specific decision. We gave priority to higher quality evidence (e.g., systematic reviews). For each DB, we first identified secondary sources of literature, namely, clinical summaries, clinical practice guidelines, and systematic reviews. After an initial extraction, we searched for primary studies in academic databases and grey literature to fill gaps in evidence. We extracted study designs, sample sizes, populations, and probabilities of benefits/harms of the health options. A single reviewer conducted the literature search and study selection. The data extracted by one reviewer was verified by a second experienced reviewer. Two reviewers assessed the quality of the evidence. We converted all probabilities into absolute risks for ease of understanding. Two to five experts validated the content of each DB. We conducted descriptive statistical analyses on the review processes and resources required. The approach allowed screening of a limited number of references (range: 104 to 406/review). For each review, we included 15 to 26 studies, 2 to 10 health options, 11 to 62 health outcomes and we conducted 9 to 47 quality assessments. A team of ten reviewers with varying levels of expertise was supported at specific steps by an information specialist, a biostatistician, and a graphic designer. The time required to complete a rapid review varied from 7 to 31 weeks per review (mean ± SD, 19 ± 10 weeks). Data extraction required the most time (8 ± 6.8 weeks). The average estimated cost of a rapid review was C$11,646 (SD = C$10,914). This approach enabled the development of clinical tools more rapidly than with a traditional systematic review. Future studies should evaluate the applicability of this approach to other teams/tools.

Displaying Geographically-Based Domestic Statistics

NASA Technical Reports Server (NTRS)

Quann, J.; Dalton, J.; Banks, M.; Helfer, D.; Szczur, M.; Winkert, G.; Billingsley, J.; Borgstede, R.; Chen, J.; Chen, L.;

[Treatment Decision-Making Process of Cancer Patients].

PubMed

Lee, Shiu-Yu C Katie

2016-10-01

The decision-making process that is used by cancer patients to determine their treatment has become more multi-foci, difficult and complicated in recent years. This has in part been attributed to the increasing incidence rate of cancer in Taiwan and the rapid development of medical technologies and treatment modalities. Oncology nurses must assist patients and family to make informed and value-based treatment decisions. Decision-making is an information process that involves appraising one's own expectation and values based on his/her knowledge on cancer and treatment options. Because cancer treatment involves risks and uncertainties, and impacts quality of life, the treatment decision-making for cancer is often stressful, or even conflicting. This paper discusses the decision-making behaviors of cancer patients and the decisional conflict, participation, and informational needs that are involved in cancer treatment. The trend toward shared decision-making and decisional support will be also explored in order to facilitate the future development of appropriate clinical interventions and research.

NASA E-DECIDER Rapid Disaster Decision Support Products

NASA Image and Video Library

2014-09-03

A NASA-funded disaster decision support system, provided a number of rapid response map data products to decision makers at the California Earthquake Clearinghouse following its activation for the Aug. 24, 2014 magnitude 6.0 earthquake in Napa, California

Launching a virtual decision lab: development and field-testing of a web-based patient decision support research platform.

PubMed

Hoffman, Aubri S; Llewellyn-Thomas, Hilary A; Tosteson, Anna N A; O'Connor, Annette M; Volk, Robert J; Tomek, Ivan M; Andrews, Steven B; Bartels, Stephen J

2014-12-12

Over 100 trials show that patient decision aids effectively improve patients' information comprehension and values-based decision making. However, gaps remain in our understanding of several fundamental and applied questions, particularly related to the design of interactive, personalized decision aids. This paper describes an interdisciplinary development process for, and early field testing of, a web-based patient decision support research platform, or virtual decision lab, to address these questions. An interdisciplinary stakeholder panel designed the web-based research platform with three components: a) an introduction to shared decision making, b) a web-based patient decision aid, and c) interactive data collection items. Iterative focus groups provided feedback on paper drafts and online prototypes. A field test assessed a) feasibility for using the research platform, in terms of recruitment, usage, and acceptability; and b) feasibility of using the web-based decision aid component, compared to performance of a videobooklet decision aid in clinical care. This interdisciplinary, theory-based, patient-centered design approach produced a prototype for field-testing in six months. Participants (n = 126) reported that: the decision aid component was easy to use (98%), information was clear (90%), the length was appropriate (100%), it was appropriately detailed (90%), and it held their interest (97%). They spent a mean of 36 minutes using the decision aid and 100% preferred using their home/library computer. Participants scored a mean of 75% correct on the Decision Quality, Knowledge Subscale, and 74 out of 100 on the Preparation for Decision Making Scale. Completing the web-based decision aid reduced mean Decisional Conflict scores from 31.1 to 19.5 (p < 0.01). Combining decision science and health informatics approaches facilitated rapid development of a web-based patient decision support research platform that was feasible for use in research studies in terms of recruitment, acceptability, and usage. Within this platform, the web-based decision aid component performed comparably with the videobooklet decision aid used in clinical practice. Future studies may use this interactive research platform to study patients' decision making processes in real-time, explore interdisciplinary approaches to designing web-based decision aids, and test strategies for tailoring decision support to meet patients' needs and preferences.

Rapid decision support tool based on novel ecosystem service variables for retrofitting of permeable pavement systems in the presence of trees.

PubMed

Scholz, Miklas; Uzomah, Vincent C

2013-08-01

The retrofitting of sustainable drainage systems (SuDS) such as permeable pavements is currently undertaken ad hoc using expert experience supported by minimal guidance based predominantly on hard engineering variables. There is a lack of practical decision support tools useful for a rapid assessment of the potential of ecosystem services when retrofitting permeable pavements in urban areas that either feature existing trees or should be planted with trees in the near future. Thus the aim of this paper is to develop an innovative rapid decision support tool based on novel ecosystem service variables for retrofitting of permeable pavement systems close to trees. This unique tool proposes the retrofitting of permeable pavements that obtained the highest ecosystem service score for a specific urban site enhanced by the presence of trees. This approach is based on a novel ecosystem service philosophy adapted to permeable pavements rather than on traditional engineering judgement associated with variables based on quick community and environment assessments. For an example case study area such as Greater Manchester, which was dominated by Sycamore and Common Lime, a comparison with the traditional approach of determining community and environment variables indicates that permeable pavements are generally a preferred SuDS option. Permeable pavements combined with urban trees received relatively high scores, because of their great potential impact in terms of water and air quality improvement, and flood control, respectively. The outcomes of this paper are likely to lead to more combined permeable pavement and tree systems in the urban landscape, which are beneficial for humans and the environment. Copyright © 2013 Elsevier B.V. All rights reserved.

Multiattribute selection of acute stroke imaging software platform for Extending the Time for Thrombolysis in Emergency Neurological Deficits (EXTEND) clinical trial.

PubMed

Churilov, Leonid; Liu, Daniel; Ma, Henry; Christensen, Soren; Nagakane, Yoshinari; Campbell, Bruce; Parsons, Mark W; Levi, Christopher R; Davis, Stephen M; Donnan, Geoffrey A

2013-04-01

The appropriateness of a software platform for rapid MRI assessment of the amount of salvageable brain tissue after stroke is critical for both the validity of the Extending the Time for Thrombolysis in Emergency Neurological Deficits (EXTEND) Clinical Trial of stroke thrombolysis beyond 4.5 hours and for stroke patient care outcomes. The objective of this research is to develop and implement a methodology for selecting the acute stroke imaging software platform most appropriate for the setting of a multi-centre clinical trial. A multi-disciplinary decision making panel formulated the set of preferentially independent evaluation attributes. Alternative Multi-Attribute Value Measurement methods were used to identify the best imaging software platform followed by sensitivity analysis to ensure the validity and robustness of the proposed solution. Four alternative imaging software platforms were identified. RApid processing of PerfusIon and Diffusion (RAPID) software was selected as the most appropriate for the needs of the EXTEND trial. A theoretically grounded generic multi-attribute selection methodology for imaging software was developed and implemented. The developed methodology assured both a high quality decision outcome and a rational and transparent decision process. This development contributes to stroke literature in the area of comprehensive evaluation of MRI clinical software. At the time of evaluation, RAPID software presented the most appropriate imaging software platform for use in the EXTEND clinical trial. The proposed multi-attribute imaging software evaluation methodology is based on sound theoretical foundations of multiple criteria decision analysis and can be successfully used for choosing the most appropriate imaging software while ensuring both robust decision process and outcomes. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

Applying Bayesian belief networks in rapid response situations

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

Gibson, William L; Deborah, Leishman, A.; Van Eeckhout, Edward

2008-01-01

The authors have developed an enhanced Bayesian analysis tool called the Integrated Knowledge Engine (IKE) for monitoring and surveillance. The enhancements are suited for Rapid Response Situations where decisions must be made based on uncertain and incomplete evidence from many diverse and heterogeneous sources. The enhancements extend the probabilistic results of the traditional Bayesian analysis by (1) better quantifying uncertainty arising from model parameter uncertainty and uncertain evidence, (2) optimizing the collection of evidence to reach conclusions more quickly, and (3) allowing the analyst to determine the influence of the remaining evidence that cannot be obtained in the time allowed.more » These extended features give the analyst and decision maker a better comprehension of the adequacy of the acquired evidence and hence the quality of the hurried decisions. They also describe two example systems where the above features are highlighted.« less

Development of a decision aid for cardiopulmonary resuscitation and invasive mechanical ventilation in the intensive care unit employing user-centered design and a wiki platform for rapid prototyping

PubMed Central

Witteman, Holly O.; LeBlanc, Annie; Kryworuchko, Jennifer; Heyland, Daren Keith; Ebell, Mark H.; Blair, Louisa; Tapp, Diane; Dupuis, Audrey; Lavoie-Bérard, Carole-Anne; McGinn, Carrie Anna; Légaré, France; Archambault, Patrick Michel

2018-01-01

Background Upon admission to an intensive care unit (ICU), all patients should discuss their goals of care and express their wishes concerning life-sustaining interventions (e.g., cardiopulmonary resuscitation (CPR)). Without such discussions, interventions that prolong life at the cost of decreasing its quality may be used without appropriate guidance from patients. Objectives To adapt an existing decision aid about CPR to create a wiki-based decision aid individually adapted to each patient’s risk factors; and to document the use of a wiki platform for this purpose. Methods We conducted three weeks of ethnographic observation in our ICU to observe intensivists and patients discussing goals of care and to identify their needs regarding decision making. We interviewed intensivists individually. Then we conducted three rounds of rapid prototyping involving 15 patients and 11 health professionals. We recorded and analyzed all discussions, interviews and comments, and collected sociodemographic data. Using a wiki, a website that allows multiple users to contribute or edit content, we adapted the decision aid accordingly and added the Good Outcome Following Attempted Resuscitation (GO-FAR) prediction rule calculator. Results We added discussion of invasive mechanical ventilation. The final decision aid comprises values clarification, risks and benefits of CPR and invasive mechanical ventilation, statistics about CPR, and a synthesis section. We added the GO-FAR prediction calculator as an online adjunct to the decision aid. Although three rounds of rapid prototyping simplified the information in the decision aid, 60% (n = 3/5) of the patients involved in the last cycle still did not understand its purpose. Conclusions Wikis and user-centered design can be used to adapt decision aids to users’ needs and local contexts. Our wiki platform allows other centers to adapt our tools, reducing duplication and accelerating scale-up. Physicians need training in shared decision making skills about goals of care and in using the decision aid. A video version of the decision aid could clarify its purpose. PMID:29447297

Cognitive processes in anesthesiology decision making.

PubMed

Stiegler, Marjorie Podraza; Tung, Avery

2014-01-01

The quality and safety of health care are under increasing scrutiny. Recent studies suggest that medical errors, practice variability, and guideline noncompliance are common, and that cognitive error contributes significantly to delayed or incorrect diagnoses. These observations have increased interest in understanding decision-making psychology.Many nonrational (i.e., not purely based in statistics) cognitive factors influence medical decisions and may lead to error. The most well-studied include heuristics, preferences for certainty, overconfidence, affective (emotional) influences, memory distortions, bias, and social forces such as fairness or blame.Although the extent to which such cognitive processes play a role in anesthesia practice is unknown, anesthesia care frequently requires rapid, complex decisions that are most susceptible to decision errors. This review will examine current theories of human decision behavior, identify effects of nonrational cognitive processes on decision making, describe characteristic anesthesia decisions in this context, and suggest strategies to improve decision making.

[The added value of information summaries supporting clinical decisions at the point-of-care.

PubMed

Banzi, Rita; González-Lorenzo, Marien; Kwag, Koren Hyogene; Bonovas, Stefanos; Moja, Lorenzo

2016-11-01

Evidence-based healthcare requires the integration of the best research evidence with clinical expertise and patients' values. International publishers are developing evidence-based information services and resources designed to overcome the difficulties in retrieving, assessing and updating medical information as well as to facilitate a rapid access to valid clinical knowledge. Point-of-care information summaries are defined as web-based medical compendia that are specifically designed to deliver pre-digested, rapidly accessible, comprehensive, and periodically updated information to health care providers. Their validity must be assessed against marketing claims that they are evidence-based. We periodically evaluate the content development processes of several international point-of-care information summaries. The number of these products has increased along with their quality. The last analysis done in 2014 identified 26 products and found that three of them (Best Practice, Dynamed e Uptodate) scored the highest across all evaluated dimensions (volume, quality of the editorial process and evidence-based methodology). Point-of-care information summaries as stand-alone products or integrated with other systems, are gaining ground to support clinical decisions. The choice of one product over another depends both on the properties of the service and the preference of users. However, even the most innovative information system must rely on transparent and valid contents. Individuals and institutions should regularly assess the value of point-of-care summaries as their quality changes rapidly over time.

Conducting Rapid, Relevant Research

PubMed Central

Glasgow, Russell E.; Kessler, Rodger S.; Ory, Marcia G.; Roby, Dylan; Gorin, Sherri Sheinfeld; Krist, Alex

2015-01-01

The lengthy and uncertain translation of research into clinical practice is well documented. Much of the current “gold standard” clinical research is slow, expensive, and lacks perceived relevance for practitioners and decision makers. In contrast, we summarize experiences conducting the My Own Health Report (MOHR) project to collect and address patient reported measures using principles of rapid, relevant pragmatic research. The methods used for rapid design and fielding of the MOHR project to improve attention to health behaviors and mental health are detailed. Within the multisite, pragmatic, implementation–focused MOHR study, we describe the four phases of the research and the key decisions made and actions taken within each. We provide concrete examples of how relevant research can be conducted transparently to rapidly provide information to practitioners. Data were collected and analyzed in 2013. The multisite (seven research centers partnered with 18 clinics) cluster randomized pragmatic delayed intervention trial was conducted in less than 18 months from receipt of funding applications to completion of data collection. Phases that were especially accelerated included funding and review, and recruitment and implementation. Conducting complex studies rapidly and efficiently is a realistic goal. Key lessons learned for prevention research include: use of existing research networks; use of web-based assessment/feedback tools that are tailored to fit local needs; engaging relevant stakeholders early on and throughout the process to minimize need for redesign; and making pragmatic decisions that balance internal and external validity concerns rather than waiting for perfect solutions. PMID:24953520

Conducting rapid, relevant research: lessons learned from the My Own Health Report project.

PubMed

Glasgow, Russell E; Kessler, Rodger S; Ory, Marcia G; Roby, Dylan; Gorin, Sherri Sheinfeld; Krist, Alex

2014-08-01

The lengthy and uncertain translation of research into clinical practice is well documented. Much of the current "gold standard" clinical research is slow, expensive, and lacks perceived relevance for practitioners and decision makers. In contrast, we summarize experiences conducting the My Own Health Report (MOHR) project to collect and address patient reported measures using principles of rapid, relevant pragmatic research. The methods used for rapid design and fielding of the MOHR project to improve attention to health behaviors and mental health are detailed. Within the multisite, pragmatic, implementation-focused MOHR study, we describe the four phases of the research and the key decisions made and actions taken within each. We provide concrete examples of how relevant research can be conducted transparently to rapidly provide information to practitioners. Data were collected and analyzed in 2013. The multisite (seven research centers partnered with 18 clinics) cluster randomized pragmatic delayed intervention trial was conducted in less than 18 months from receipt of funding applications to completion of data collection. Phases that were especially accelerated included funding and review, and recruitment and implementation. Conducting complex studies rapidly and efficiently is a realistic goal. Key lessons learned for prevention research include use of existing research networks; use of web-based assessment/feedback tools that are tailored to fit local needs; engaging relevant stakeholders early on and throughout the process to minimize need for redesign; and making pragmatic decisions that balance internal and external validity concerns rather than waiting for perfect solutions. Published by Elsevier Inc.

Evaluating soil risks associated with severe wildfire and ground-based logging

Treesearch

Keith M. Reynolds; Paul F. Hessburg; Richard E. Miller; Robert T. Meurisse

2011-01-01

Rehabilitation and timber-salvage activities after wildfire require rapid planning and rational decisions. Identifying areas with high risk for erosion and soil productivity losses is important. Moreover, allocation of corrective and mitigative efforts must be rational and prioritized. Our logic-based analysis of forested soil polygons on the Okanogan-Wenatchee...

Implementing Competency-Based Education: Challenges, Strategies, and a Decision-Making Framework

ERIC Educational Resources Information Center

Dragoo, Amie; Barrows, Richard

2016-01-01

The number of competency-based education (CBE) degree programs has increased rapidly over the past five years, yet there is little research on CBE program development. This study utilized conceptual models of higher education change and a qualitative methodology to analyze the strategies and challenges in implementing CBE business degree programs…

Assessing the Benefits of Wetland Restoration: A Rapid Benefit Indicators Approach for Decision Makers

EPA Science Inventory

This guide presents the Rapid Benefits Indicators (RBI) Approach, a rapid process for assessing the social benefits of ecosystem restoration. Created for those who conduct, advocate for, or support restoration, the RBI approach consists of five steps: (1) Describe the decision co...

NASA Wrangler: Automated Cloud-Based Data Assembly in the RECOVER Wildfire Decision Support System

NASA Technical Reports Server (NTRS)

Schnase, John; Carroll, Mark; Gill, Roger; Wooten, Margaret; Weber, Keith; Blair, Kindra; May, Jeffrey; Toombs, William

2017-01-01

NASA Wrangler is a loosely-coupled, event driven, highly parallel data aggregation service designed to take advantageof the elastic resource capabilities of cloud computing. Wrangler automatically collects Earth observational data, climate model outputs, derived remote sensing data products, and historic biophysical data for pre-, active-, and post-wildfire decision making. It is a core service of the RECOVER decision support system, which is providing rapid-response GIS analytic capabilities to state and local government agencies. Wrangler reduces to minutes the time needed to assemble and deliver crucial wildfire-related data.

Variability in visual working memory ability limits the efficiency of perceptual decision making.

PubMed

Ester, Edward F; Ho, Tiffany C; Brown, Scott D; Serences, John T

2014-04-02

The ability to make rapid and accurate decisions based on limited sensory information is a critical component of visual cognition. Available evidence suggests that simple perceptual discriminations are based on the accumulation and integration of sensory evidence over time. However, the memory system(s) mediating this accumulation are unclear. One candidate system is working memory (WM), which enables the temporary maintenance of information in a readily accessible state. Here, we show that individual variability in WM capacity is strongly correlated with the speed of evidence accumulation in speeded two-alternative forced choice tasks. This relationship generalized across different decision-making tasks, and could not be easily explained by variability in general arousal or vigilance. Moreover, we show that performing a difficult discrimination task while maintaining a concurrent memory load has a deleterious effect on the latter, suggesting that WM storage and decision making are directly linked.

A Decision Analytic Approach to Exposure-Based Chemical Prioritization

PubMed Central

Mitchell, Jade; Pabon, Nicolas; Collier, Zachary A.; Egeghy, Peter P.; Cohen-Hubal, Elaine; Linkov, Igor; Vallero, Daniel A.

2013-01-01

The manufacture of novel synthetic chemicals has increased in volume and variety, but often the environmental and health risks are not fully understood in terms of toxicity and, in particular, exposure. While efforts to assess risks have generally been effective when sufficient data are available, the hazard and exposure data necessary to assess risks adequately are unavailable for the vast majority of chemicals in commerce. The US Environmental Protection Agency has initiated the ExpoCast Program to develop tools for rapid chemical evaluation based on potential for exposure. In this context, a model is presented in which chemicals are evaluated based on inherent chemical properties and behaviorally-based usage characteristics over the chemical’s life cycle. These criteria are assessed and integrated within a decision analytic framework, facilitating rapid assessment and prioritization for future targeted testing and systems modeling. A case study outlines the prioritization process using 51 chemicals. The results show a preliminary relative ranking of chemicals based on exposure potential. The strength of this approach is the ability to integrate relevant statistical and mechanistic data with expert judgment, allowing for an initial tier assessment that can further inform targeted testing and risk management strategies. PMID:23940664

Rapid shape detection signals in area V4

PubMed Central

Weiner, Katherine F.; Ghose, Geoffrey M.

2014-01-01

Vision in foveate animals is an active process that requires rapid and constant decision-making. For example, when a new object appears in the visual field, we can quickly decide to inspect it by directing our eyes to the object's location. We studied the contribution of primate area V4 to these types of rapid foveation decisions. Animals performed a reaction time task that required them to report when any shape appeared within a peripherally-located noisy stimulus by making a saccade to the stimulus location. We found that about half of the randomly sampled V4 neurons not only rapidly and precisely represented the appearance of this shape, but they were also predictive of the animal's saccades. A neuron's ability to predict the animal's saccades was not related to the specificity with which the cell represented a single type of shape but rather to its ability to signal whether any shape was present. This relationship between sensory sensitivity and behavioral predictiveness was not due to global effects such as alertness, as it was equally likely to be observed for cells with increases and decreases in firing rate. Careful analysis of the timescales of reliability in these neurons implies that they reflect both feedforward and feedback shape detecting processes. In approximately 7% of our recorded sample, individual neurons were able to predict both the delay and precision of the animal's shape detection performance. This suggests that a subset of V4 neurons may have been directly and causally contributing to task performance and that area V4 likely plays a critical role in guiding rapid, form-based foveation decisions. PMID:25278828

Eradicating the grey squirrel Sciurus carolinensis from urban areas: an innovative decision-making approach based on lessons learnt in Italy.

PubMed

La Morgia, Valentina; Paoloni, Daniele; Genovesi, Piero

2017-02-01

Eradication of invasive alien species supports the recovery of native biodiversity. A new European Union Regulation introduces obligations to eradicate the most harmful invasive species. However, eradications of charismatic mammals may encounter strong opposition. Considering the case study of the eastern grey squirrel (Sciurus carolinensis Gmelin, 1788) in central Italy, we developed a structured decision-making technique based on a Bayesian decision network model and explicitly considering the plurality of environmental values of invasive species management to reduce potential social conflicts. The model identified priority areas for management activities. These areas corresponded to the core of the grey squirrel range, but they also included peripheral zones, where rapid eradication is fundamental to prevent the spread of squirrels. However, when the model was expanded to integrate the attitude of citizens towards the project, the intervention strategy slightly changed. In some areas, the citizens' support was limited, and this resulted in a reduced overall utility of intervention. The suggested approach extends the scientific basis for management decisions, evaluated in terms of technical efficiency, feasibility and social impact. Here, the Bayesian decision network model analysed the potential technical and social consequences of management actions, and it responded to the need for transparency in the decision-making process, but it can easily be extended to consider further issues that are common in many mammal eradication programmes. Owing to its flexibility and comprehensiveness, it provides an innovative example of how to plan rapid eradication or control activities, as required by the new EU Regulation. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Science and intuition: do both have a place in clinical decision making?

PubMed

Pearson, Helen

Intuition is widely used in clinical decision making yet its use is underestimated compared to scientific decision-making methods. Information processing is used within scientific decision making and is methodical and analytical, whereas intuition relies more on a practitioner's perception. Intuition is an unconscious process and may be referred to as a 'sixth sense', 'hunch' or 'gut feeling'. It is not underpinned by valid and reliable measures. Expert health professionals use a rapid, automatic process to recognise familiar problems instantly. Intuition could therefore involve pattern recognition, where experts draw on experiences, so could be perceived as a cognitive skill rather than a perception or knowing without knowing how. The NHS places great importance on evidence-based practice but intuition is seemingly becoming an acceptable way of thinking and knowing in clinical decision making. Recognising nursing as an art allows intuition to be used and the environment or situation to be interpreted to help inform decision making. Intuition can be used in conjunction with evidence-based practice and to achieve good outcomes and deserves to be acknowledged within clinical practice.

Ethical dimensions of paediatric nursing: A rapid evidence assessment.

PubMed

Bagnasco, Annamaria; Cadorin, Lucia; Barisone, Michela; Bressan, Valentina; Iemmi, Marina; Prandi, Marzia; Timmins, Fiona; Watson, Roger; Sasso, Loredana

2018-02-01

Paediatric nurses often face complex situations requiring decisions that sometimes clash with their own values and beliefs, or with the needs of the children they care for and their families. Paediatric nurses often use new technology that changes the way they provide care, but also reduces their direct interaction with the child. This may generate ethical issues, which nurses should be able to address in the full respect of the child. Research question and objectives: The purpose of this review is to describe the main ethical dimensions of paediatric nursing. Our research question was, 'What are the most common ethical dimensions and competences related to paediatric nursing?' A rapid evidence assessment. According to the principles of the rapid evidence assessment, we searched the PubMed, SCOPUS and CINAHL databases for papers published between January 2001 and March 2015. These papers were then independently read by two researchers and analysed according to the inclusion criteria. Ethical considerations: Since this was a rapid evidence assessment, no approval from the ethics committee was required. Ten papers met our inclusion criteria. Ethical issues in paediatric nursing were grouped into three areas: (a) ethical issues in paediatric care, (b) social responsibility and (c) decision-making process. Few studies investigate the ethical dimensions and aspects of paediatric nursing, and they are mainly qualitative studies conducted in critical care settings based on nurses' perceptions and experiences. Paediatric nurses require specific educational interventions to help them resolve ethical issues, contribute to the decision-making process and fulfil their role as advocates of a vulnerable population (i.e. sick children and their families). Further research is needed to investigate how paediatric nurses can improve the involvement of children and their families in decision-making processes related to their care plan.

Effects of Mindfulness-Based Interventions on Disruptive Behavior: A Meta-Analysis of Single-Case Research

ERIC Educational Resources Information Center

Klingbeil, David A.; Fischer, Aaron J.; Renshaw, Tyler L.; Bloomfield, Bradley S.; Polakoff, Ben; Willenbrink, Jessica B.; Copek, Rebecca A.; Chan, Kai Tai

2017-01-01

The popularity of mindfulness-based interventions (MBIs) is growing rapidly in schools. Decisions regarding the use of these interventions must be based on empirical evidence. There is robust evidence for the use of MBIs with adults, but research on MBIs with youth is nascent. The purpose of this meta-analytic review was to add to the literature…

The Enigma of Rapid Repeat Pregnancy: A Qualitative Study of Teen Mothers.

PubMed

Conroy, K N; Engelhart, T G; Martins, Y; Huntington, N L; Snyder, A F; Coletti, K D; Cox, J E

2016-06-01

Rapid repeat pregnancy accounts for 18% of teen pregnancies and leads to adverse health, economic, and developmental outcomes for teen mothers and their children. Few interventions have been successful in reducing rapid repeat pregnancy. In this qualitative study we examined adolescent mothers' perceptions of their decision-making and behaviors that helped prevent or promote a rapid repeat pregnancy. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Semistructured interviews were conducted with 31 adolescent mothers, aged 16-21 years; 15 of these subjects experienced a repeat pregnancy within a year of their first child's birth and 16 had not. Two researchers used a grounded, inductive technique to identify emergent themes; interviews were subsequently coded accordingly. Counts were tabulated of the number of times themes were endorsed among those with or without a repeat pregnancy. Four overarching themes emerged from the interviews: intentionality regarding pregnancy planning, patients' degree of independence in making contraceptive choices, sense of control over life experience, and barriers to follow-through on contraceptive planning. Teens who had not experienced a rapid repeat pregnancy more often endorsed themes of intentionality in preventing or promoting a pregnancy, independence in decision-making, and feelings of control over their experience. Ambivalence and lack of decision-making about seeking another pregnancy were frequently endorsed by mothers who had experienced a second pregnancy. Decision-making regarding seeking or preventing a rapid repeat pregnancy is complex for teen mothers; techniques to help support decision-making or to delay pregnancy until decision-repeat making is complete might be important in reducing rapid pregnancy. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Reclaiming Rapid Cognition: Improving Decision-making in Command and Control Agencies by Understanding and Enabling Rapid Cognition

DTIC Science & Technology

2007-06-01

Cognition Topics : Intro What is Rapid Cognition? Training Rapid Cognition Decision-Makers Getting Back to Basics—Enabling the Executors Why It...for public release; distribution unlimited 13. SUPPLEMENTARY NOTES Twelfth International Command and Control Research and Technology Symposium (12th...making process . . . when you have the time to do it. Scientists have found that high -stress, quick reaction jobs like firefighting, police officers, ER

Development of a New Decision Tree to Rapidly Screen Chemical Estrogenic Activities of Xenopus laevis.

PubMed

Wang, Ting; Li, Weiying; Zheng, Xiaofeng; Lin, Zhifen; Kong, Deyang

2014-02-01

During the last past decades, there is an increasing number of studies about estrogenic activities of the environmental pollutants on amphibians and many determination methods have been proposed. However, these determination methods are time-consuming and expensive, and a rapid and simple method to screen and test the chemicals for estrogenic activities to amphibians is therefore imperative. Herein is proposed a new decision tree formulated not only with physicochemical parameters but also a biological parameter that was successfully used to screen estrogenic activities of the chemicals on amphibians. The biological parameter, CDOCKER interaction energy (Ebinding ) between chemicals and the target proteins was calculated based on the method of molecular docking, and it was used to revise the decision tree formulated by Hong only with physicochemical parameters for screening estrogenic activity of chemicals in rat. According to the correlation between Ebinding of rat and Xenopus laevis, a new decision tree for estrogenic activities in Xenopus laevis is finally proposed. Then it was validated by using the randomly 8 chemicals which can be frequently exposed to Xenopus laevis, and the agreement between the results from the new decision tree and the ones from experiments is generally satisfactory. Consequently, the new decision tree can be used to screen the estrogenic activities of the chemicals, and combinational use of the Ebinding and classical physicochemical parameters can greatly improves Hong's decision tree. Copyright © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Balancing efficiency, equity and feasibility of HIV treatment in South Africa – development of programmatic guidance

PubMed Central

2013-01-01

South Africa, the country with the largest HIV epidemic worldwide, has been scaling up treatment since 2003 and is rapidly expanding its eligibility criteria. The HIV treatment programme has achieved significant results, and had 1.8 million people on treatment per 2011. Despite these achievements, it is now facing major concerns regarding (i) efficiency: alternative treatment policies may save more lives for the same budget; (ii) equity: there are large inequalities in who receives treatment; (iii) feasibility: still only 52% of the eligible population receives treatment. Hence, decisions on the design of the present HIV treatment programme in South Africa can be considered suboptimal. We argue there are two fundamental reasons to this. First, while there is a rapidly growing evidence-base to guide priority setting decisions on HIV treatment, its included studies typically consider only one criterion at a time and thus fail to capture the broad range of values that stakeholders have. Second, priority setting on HIV treatment is a highly political process but it seems no adequate participatory processes are in place to incorporate stakeholders’ views and evidences of all sorts. We propose an alternative approach that provides a better evidence base and outlines a fair policy process to improve priority setting in HIV treatment. The approach integrates two increasingly important frameworks on health care priority setting: accountability for reasonableness (A4R) to foster procedural fairness, and multi-criteria decision analysis (MCDA) to construct an evidence-base on the feasibility, efficiency, and equity of programme options including trade-offs. The approach provides programmatic guidance on the choice of treatment strategies at various decisions levels based on a sound conceptual framework, and holds large potential to improve HIV priority setting in South Africa. PMID:24107435

A knowledge-based patient assessment system: conceptual and technical design.

PubMed Central

Reilly, C. A.; Zielstorff, R. D.; Fox, R. L.; O'Connell, E. M.; Carroll, D. L.; Conley, K. A.; Fitzgerald, P.; Eng, T. K.; Martin, A.; Zidik, C. M.; Segal, M.

2000-01-01

This paper describes the design of an inpatient patient assessment application that captures nursing assessment data using a wireless laptop computer. The primary aim of this system is to capture structured information for facilitating decision support and quality monitoring. The system also aims to improve efficiency of recording patient assessments, reduce costs, and improve discharge planning and early identification of patient learning needs. Object-oriented methods were used to elicit functional requirements and to model the proposed system. A tools-based development approach is being used to facilitate rapid development and easy modification of assessment items and rules for decision support. Criteria for evaluation include perceived utility by clinician users, validity of decision support rules, time spent recording assessments, and perceived utility of aggregate reports for quality monitoring. PMID:11079970

A knowledge-based patient assessment system: conceptual and technical design.

PubMed

Reilly, C A; Zielstorff, R D; Fox, R L; O'Connell, E M; Carroll, D L; Conley, K A; Fitzgerald, P; Eng, T K; Martin, A; Zidik, C M; Segal, M

2000-01-01

This paper describes the design of an inpatient patient assessment application that captures nursing assessment data using a wireless laptop computer. The primary aim of this system is to capture structured information for facilitating decision support and quality monitoring. The system also aims to improve efficiency of recording patient assessments, reduce costs, and improve discharge planning and early identification of patient learning needs. Object-oriented methods were used to elicit functional requirements and to model the proposed system. A tools-based development approach is being used to facilitate rapid development and easy modification of assessment items and rules for decision support. Criteria for evaluation include perceived utility by clinician users, validity of decision support rules, time spent recording assessments, and perceived utility of aggregate reports for quality monitoring.

ABC estimation of unit costs for emergency department services.

PubMed

Holmes, R L; Schroeder, R E

1996-04-01

Rapid evolution of the health care industry forces managers to make cost-effective decisions. Typical hospital cost accounting systems do not provide emergency department managers with the information needed, but emergency department settings are so complex and dynamic as to make the more accurate activity-based costing (ABC) system prohibitively expensive. Through judicious use of the available traditional cost accounting information and simple computer spreadsheets. managers may approximate the decision-guiding information that would result from the much more costly and time-consuming implementation of ABC.

Challenges and Research Agenda of School Leadership in Taiwan

ERIC Educational Resources Information Center

Pan, Hui-Ling Wendy; Chen, Peiying

2011-01-01

Throughout the world, rapid political and economic change has applied enormous pressure on educators addressing leadership and accountability measures to improve instructional practices and student performance. Decentralisation of central authority regarding school site-based decision-making has drastically changed the educational environment in…

Gaps in the Body of Knowledge of Systems Engineering

DTIC Science & Technology

2012-07-01

practices, agile development, Kanban , risk management, and decision management. This focus is being driven by the need to reduce time for delivery of...to incorporate Kanban approaches to scheduling the SE activities based on value. Rapid Fielding. In this situation, there is a short time to

Development of an Automated Emergency Response System (AERS) for Rail Transit Systems

DOT National Transportation Integrated Search

1984-10-01

As a result of a fire in 1979 at the Bay Area Rapid Transit District (BART), a microprocessor-based information retrieval system was developed to aid in the emergency decision-making process. This system was proposed, designed and programmed by a sup...

Noise, cost and speed-accuracy trade-offs: decision-making in a decentralized system

PubMed Central

Marshall, James A.R.; Dornhaus, Anna; Franks, Nigel R.; Kovacs, Tim

2005-01-01

Many natural and artificial decision-making systems face decision problems where there is an inherent compromise between two or more objectives. One such common compromise is between the speed and accuracy of a decision. The ability to exploit the characteristics of a decision problem in order to vary between the extremes of making maximally rapid, or maximally accurate decisions, is a useful property of such systems. Colonies of the ant Temnothorax albipennis (formerly Leptothorax albipennis) are a paradigmatic decentralized decision-making system, and have been shown flexibly to compromise accuracy for speed when making decisions during house-hunting. During emigration, a colony must typically evaluate and choose between several possible alternative new nest sites of differing quality. In this paper, we examine this speed-accuracy trade-off through modelling, and conclude that noise and time-cost of assessing alternative choices are likely to be significant for T. albipennis. Noise and cost of such assessments are likely to mean that T. albipennis' decision-making mechanism is Pareto-optimal in one crucial regard; increasing the willingness of individuals to change their decisions cannot improve collective accuracy overall without impairing speed. We propose that a decentralized control algorithm based on this emigration behaviour may be derived for applications in engineering domains and specify the characteristics of the problems to which it should be suited, based on our new results. PMID:16849234

Improved Accuracy Using Recursive Bayesian Estimation Based Language Model Fusion in ERP-Based BCI Typing Systems

PubMed Central

Orhan, U.; Erdogmus, D.; Roark, B.; Oken, B.; Purwar, S.; Hild, K. E.; Fowler, A.; Fried-Oken, M.

2013-01-01

RSVP Keyboard™ is an electroencephalography (EEG) based brain computer interface (BCI) typing system, designed as an assistive technology for the communication needs of people with locked-in syndrome (LIS). It relies on rapid serial visual presentation (RSVP) and does not require precise eye gaze control. Existing BCI typing systems which uses event related potentials (ERP) in EEG suffer from low accuracy due to low signal-to-noise ratio. Henceforth, RSVP Keyboard™ utilizes a context based decision making via incorporating a language model, to improve the accuracy of letter decisions. To further improve the contributions of the language model, we propose recursive Bayesian estimation, which relies on non-committing string decisions, and conduct an offline analysis, which compares it with the existing naïve Bayesian fusion approach. The results indicate the superiority of the recursive Bayesian fusion and in the next generation of RSVP Keyboard™ we plan to incorporate this new approach. PMID:23366432

Decision-making in crisis: Applying a healthcare triage methodology to business continuity management.

PubMed

Moore, Bethany; Bone, Eric A

2017-01-01

The concept of triage in healthcare has been around for centuries and continues to be applied today so that scarce resources are allocated according to need. A business impact analysis (BIA) is a form of triage in that it identifies which processes are most critical, which to address first and how to allocate limited resources. On its own, however, the BIA provides only a roadmap of the impacts and interdependencies of an event. When disaster strikes, organisational decision-makers often face difficult decisions with regard to allocating limited resources between multiple 'mission-critical' functions. Applying the concept of triage to business continuity provides those decision-makers navigating a rapidly evolving and unpredictable event with a path that protects the fundamental priorities of the organisation. A business triage methodology aids decision-makers in times of crisis by providing a simplified framework for decision-making based on objective, evidence-based criteria, which is universally accepted and understood. When disaster strikes, the survival of the organisation depends on critical decision-making and quick actions to stabilise the incident. This paper argues that organisations need to supplement BIA processes with a decision-making triage methodology that can be quickly applied during the chaos of an actual event.

Dashboard visualizations: Supporting real-time throughput decision-making.

PubMed

Franklin, Amy; Gantela, Swaroop; Shifarraw, Salsawit; Johnson, Todd R; Robinson, David J; King, Brent R; Mehta, Amit M; Maddow, Charles L; Hoot, Nathan R; Nguyen, Vickie; Rubio, Adriana; Zhang, Jiajie; Okafor, Nnaemeka G

2017-07-01

Providing timely and effective care in the emergency department (ED) requires the management of individual patients as well as the flow and demands of the entire department. Strategic changes to work processes, such as adding a flow coordination nurse or a physician in triage, have demonstrated improvements in throughput times. However, such global strategic changes do not address the real-time, often opportunistic workflow decisions of individual clinicians in the ED. We believe that real-time representation of the status of the entire emergency department and each patient within it through information visualizations will better support clinical decision-making in-the-moment and provide for rapid intervention to improve ED flow. This notion is based on previous work where we found that clinicians' workflow decisions were often based on an in-the-moment local perspective, rather than a global perspective. Here, we discuss the challenges of designing and implementing visualizations for ED through a discussion of the development of our prototype Throughput Dashboard and the potential it holds for supporting real-time decision-making. Copyright © 2017. Published by Elsevier Inc.

Predicting honey bee sensitivity based on the conservation of the pesticide molecular initiating event

EPA Science Inventory

Concern surrounding the potential adverse impacts of pesticides to honey bee colonies has led to the need for rapid/cost efficient methods for aiding decision making relative to the protection of this important pollinator species. Neonicotinoids represent a class of pesticides th...

Scenario-based carbon footprint inventory tool for urban sustainable development decision support: The Cincinnati Case Study

EPA Science Inventory

Rapid growing of travel demand and transportation activities and co-occurring land use changes have resulted in traffic congestion and negative impacts on the environment, energy consumption and green house gas (GHG) emissions in an urban environment. The challenge lies in quanti...

Using exposure bands for rapid decision making in the RISK21 tiered exposureassessment

EPA Science Inventory

The ILSI Health and Environmental Sciences Institute (HESI) Risk Assessment in the 21st Century (RISK21) project was initiated to address and catalyze improvements in human health risk assessment. RISK21 is a problem formulation-based conceptual roadmap and risk matrix visualizat...

Rapid model-based inter-disciplinary design of a CubeSat mission

NASA Astrophysics Data System (ADS)

Lowe, C. J.; Macdonald, M.

2014-12-01

With an increase in the use of small, modular, resource-limited satellites for Earth orbiting applications, the benefit to be had from a model-based architecture that rapidly searches the mission trade-space and identifies near-optimal designs is greater than ever. This work presents an architecture that identifies trends between conflicting objectives (e.g. lifecycle cost and performance) and decision variables (e.g. orbit altitude and inclination) such that informed assessment can be made as to which design/s to take on for further analysis. The models within the architecture exploit analytic methods where possible, in order avoid computationally expensive numerical propagation, and achieve rapid convergence. Two mission cases are studied; the first is an Earth observation satellite and presents a trade-off between ground sample distance and revisit time over a ground target, given altitude as the decision variable. The second is a satellite with a generic scientific payload and shows a more involved trade-off, between data return to a ground station and cost of the mission, given variations in the orbit altitude, inclination and ground station latitude. Results of each case are presented graphically and it is clear that non-intuitive results are captured that would typically be missed using traditional, point-design methods, where only discrete scenarios are examined.

Cardiopulmonary resuscitation decisions in the emergency department: An ethnography of tacit knowledge in practice.

PubMed

Brummell, Stephen P; Seymour, Jane; Higginbottom, Gina

2016-05-01

Despite media images to the contrary, cardiopulmonary resuscitation in emergency departments is often unsuccessful. The purpose of this ethnographic study was to explore how health care professionals working in two emergency departments in the UK, make decisions to commence, continue or stop resuscitation. Data collection involved participant observation of resuscitation attempts and in-depth interviews with nurses, medical staff and paramedics who had taken part in the attempts. Detailed case examples were constructed for comparative analysis. Findings show that emergency department staff use experience and acquired tacit knowledge to construct a typology of cardiac arrest categories that help them navigate decision making. Categorisation is based on 'less is more' heuristics which combine explicit and tacit knowledge to facilitate rapid decisions. Staff then work as a team to rapidly assimilate and interpret information drawn from observations of the patient's body and from technical, biomedical monitoring data. The meaning of technical data is negotiated during staff interaction. This analysis was informed by a theory of 'bodily' and 'technical' trajectory alignment that was first developed from an ethnography of death and dying in intensive care units. The categorisation of cardiac arrest situations and trajectory alignment are the means by which staff achieve consensus decisions and determine the point at which an attempt should be withdrawn. This enables them to construct an acceptable death in highly challenging circumstances. Copyright © 2016 Elsevier Ltd. All rights reserved.

Ensuring Adequate Health and Safety Information for Decision Makers during Large-Scale Chemical Releases

NASA Astrophysics Data System (ADS)

Petropoulos, Z.; Clavin, C.; Zuckerman, B.

2015-12-01

The 2014 4-Methylcyclohexanemethanol (MCHM) spill in the Elk River of West Virginia highlighted existing gaps in emergency planning for, and response to, large-scale chemical releases in the United States. The Emergency Planning and Community Right-to-Know Act requires that facilities with hazardous substances provide Material Safety Data Sheets (MSDSs), which contain health and safety information on the hazardous substances. The MSDS produced by Eastman Chemical Company, the manufacturer of MCHM, listed "no data available" for various human toxicity subcategories, such as reproductive toxicity and carcinogenicity. As a result of incomplete toxicity data, the public and media received conflicting messages on the safety of the contaminated water from government officials, industry, and the public health community. Two days after the governor lifted the ban on water use, the health department partially retracted the ban by warning pregnant women to continue avoiding the contaminated water, which the Centers for Disease Control and Prevention deemed safe three weeks later. The response in West Virginia represents a failure in risk communication and calls to question if government officials have sufficient information to support evidence-based decisions during future incidents. Research capabilities, like the National Science Foundation RAPID funding, can provide a solution to some of the data gaps, such as information on environmental fate in the case of the MCHM spill. In order to inform policy discussions on this issue, a methodology for assessing the outcomes of RAPID and similar National Institutes of Health grants in the context of emergency response is employed to examine the efficacy of research-based capabilities in enhancing public health decision making capacity. The results of this assessment highlight potential roles rapid scientific research can fill in ensuring adequate health and safety data is readily available for decision makers during large-scale chemical releases.

Role of Big Data and Machine Learning in Diagnostic Decision Support in Radiology.

PubMed

Syeda-Mahmood, Tanveer

2018-03-01

The field of diagnostic decision support in radiology is undergoing rapid transformation with the availability of large amounts of patient data and the development of new artificial intelligence methods of machine learning such as deep learning. They hold the promise of providing imaging specialists with tools for improving the accuracy and efficiency of diagnosis and treatment. In this article, we will describe the growth of this field for radiology and outline general trends highlighting progress in the field of diagnostic decision support from the early days of rule-based expert systems to cognitive assistants of the modern era. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

3D printing of an aortic aneurysm to facilitate decision making and device selection for endovascular aneurysm repair in complex neck anatomy.

PubMed

Tam, Matthew D B S; Laycock, Stephen D; Brown, James R I; Jakeways, Matthew

2013-12-01

To describe rapid prototyping or 3-dimensional (3D) printing of aneurysms with complex neck anatomy to facilitate endovascular aneurysm repair (EVAR). A 75-year-old man had a 6.6-cm infrarenal aortic aneurysm that appeared on computed tomographic angiography to have a sharp neck angulation of ~90°. However, although the computed tomography (CT) data were analyzed using centerline of flow, the true neck length and relations of the ostial origins were difficult to determine. No multidisciplinary consensus could be reached as to which stent-graft to use owing to these borderline features of the neck anatomy. Based on past experience with rapid prototyping technology, a decision was taken to print a model of the aneurysm to aid in visualization of the neck anatomy. The CT data were segmented, processed, and converted into a stereolithographic format representing the lumen as a 3D volume, from which a full-sized replica was printed within 24 hours. The model demonstrated that the neck was adequate for stent-graft repair using the Aorfix device. Rapid prototyping of aortic aneurysms is feasible and can aid decision making and device delivery. Further work is required to test the value of 3D replicas in planning procedures and their impact on procedure time, radiation dose, and procedure cost.

KNOW ESSENTIALS: a tool for informed decisions in the absence of formal HTA systems.

PubMed

Mathew, Joseph L

2011-04-01

Most developing countries and resource-limited settings lack robust health technology assessment (HTA) systems. Because the development of locally relevant HTA is not immediately viable, and the extrapolation of external HTA is inappropriate, a new model for evaluating health technologies is required. The aim of this study was to describe the development and application of KNOW ESSENTIALS, a tool facilitating evidence-based decisions on health technologies by stakeholders in settings lacking formal HTA systems. Current HTA methodology was examined through literature search. Additional issues relevant to resource-limited settings, but not adequately addressed in current methodology, were identified through further literature search, appraisal of contextually relevant issues, discussion with healthcare professionals familiar with the local context, and personal experience. A set of thirteen elements important for evidence-based decisions was identified, selected and combined into a tool with the mnemonic KNOW ESSENTIALS. Detailed definitions for each element, coding for the elements, and a system to evaluate a given health technology using the tool were developed. Developing countries and resource-limited settings face several challenges to informed decision making. Models that are relevant and applicable in high-income countries are unlikely in such settings. KNOW ESSENTIALS is an alternative that facilitates evidence-based decision making by stakeholders without formal expertise in HTA. The tool could be particularly useful, as an interim measure, in healthcare systems that are developing HTA capacity. It could also be useful anywhere when rapid evidence-based decisions on health technologies are required.

Application of Pyrosequencing® in Food Biodefense.

PubMed

Amoako, Kingsley Kwaku

2015-01-01

The perpetration of a bioterrorism attack poses a significant risk for public health with potential socioeconomic consequences. It is imperative that we possess reliable assays for the rapid and accurate identification of biothreat agents to make rapid risk-informed decisions on emergency response. The development of advanced methodologies for the detection of biothreat agents has been evolving rapidly since the release of the anthrax spores in the mail in 2001, and recent advances in detection and identification techniques could prove to be an essential component in the defense against biological attacks. Sequence-based approaches such as Pyrosequencing(®), which has the capability to determine short DNA stretches in real time using biotinylated PCR amplicons, have potential biodefense applications. Using markers from the virulence plasmids and chromosomal regions, my laboratory has demonstrated the power of this technology in the rapid, specific, and sensitive detection of B. anthracis spores and Yersinia pestis in food. These are the first applications for the detection of the two organisms in food. Furthermore, my lab has developed a rapid assay to characterize the antimicrobial resistance (AMR) gene profiles for Y. pestis using Pyrosequencing. Pyrosequencing is completed in about 60 min (following PCR amplification) and yields accurate and reliable results with an added layer of confidence, thus enabling rapid risk-informed decisions to be made. A typical run yields 40-84 bp reads with 94-100 % identity to the expected sequence. It also provides a rapid method for determining the AMR profile as compared to the conventional plate method which takes several days. The method described is proposed as a novel detection system for potential application in food biodefense.

A Rapid Decision Sampling Plan for Implementing Area—Wide Management of the Red Palm Weevil, Rhynchophorus ferrugineus, in Coconut Plantations of India

PubMed Central

Faleiro, J. R.; Ashok Kumar, J.

2008-01-01

The red palm weevil Rhynchophorus ferrugineus Olivier (Curculionidae/Rhynchophoridae/Dryophthoridae) is a lethal pest of young coconut palms, Cocos nucifera L. (Arecales: Arecaceae), with a highly aggregated population distribution pattern. R. ferrugineus is managed in several coconut growing countries using area-wide pheromone based programmes that need a substantial commitment of funds over a period of time. Often, decisions to implement area-wide management of R. ferrugineus are based on pheromone trap captures in surveillance traps and or infestation reports. Implementing area-wide management of this pest on the basis of such data can be inaccurate, as it may either under or over estimate the pest intensity in the field. This study presents sampling plans for rapid and accurate classification of R. ferrugineus infestation in coconut plantations of India by inspecting palms to detect infestation in a sequence until a decision to either implement or not to initiate area-wide management of R. ferrugineus can be made. The sampling plans are based on a common aggregation index of 3.45, assumed action threshold values of either 1.0 (plan A) or 0.5 (plan B) per cent infested palms and a risk factor of making the wrong decision set at 0.05. Using plans A and B, if the cummulative number of infested palms in a young 1 hectare coconut plantation is zero out of 150 palms for both plans, then area-wide management is not required, while on the other hand, if the cummulative number of infested palms for the same area is 6 (plan A), or 5 (plan B), then area-wide management of R. ferrugineus is essential. The proposed sampling plans are efficient tools in decision making, particularly at very low and high levels of infestation and can also be used to assess the performance of R. ferrugineus IPM programmes that are in progress. These plans not only save time and money as only a small area needs to be sampled to arrive at a correct decision, but are also efficient in rating the infestation level accurately. PMID:20337561

A rapid decision sampling plan for implementing area-wide management of the red palm weevil, Rhynchophorus ferrugineus, in coconut plantations of India.

PubMed

Faleiro, J R; Ashok Kumar, J

2008-01-01

The red palm weevil Rhynchophorus ferrugineus Olivier (Curculionidae/Rhynchophoridae/Dryophthoridae) is a lethal pest of young coconut palms, Cocos nucifera L. (Arecales: Arecaceae), with a highly aggregated population distribution pattern. R. ferrugineus is managed in several coconut growing countries using area-wide pheromone based programmes that need a substantial commitment of funds over a period of time. Often, decisions to implement area-wide management of R. ferrugineus are based on pheromone trap captures in surveillance traps and or infestation reports. Implementing area-wide management of this pest on the basis of such data can be inaccurate, as it may either under or over estimate the pest intensity in the field. This study presents sampling plans for rapid and accurate classification of R. ferrugineus infestation in coconut plantations of India by inspecting palms to detect infestation in a sequence until a decision to either implement or not to initiate area-wide management of R. ferrugineus can be made. The sampling plans are based on a common aggregation index of 3.45, assumed action threshold values of either 1.0 (plan A) or 0.5 (plan B) per cent infested palms and a risk factor of making the wrong decision set at 0.05. Using plans A and B, if the cumulative number of infested palms in a young 1 hectare coconut plantation is zero out of 150 palms for both plans, then area-wide management is not required, while on the other hand, if the cumulative number of infested palms for the same area is 6 (plan A), or 5 (plan B), then area-wide management of R. ferrugineus is essential. The proposed sampling plans are efficient tools in decision making, particularly at very low and high levels of infestation and can also be used to assess the performance of R. ferrugineus IPM programmes that are in progress. These plans not only save time and money as only a small area needs to be sampled to arrive at a correct decision, but are also efficient in rating the infestation level accurately.

A decision framework for identifying models to estimate forest ecosystem services gains from restoration

USGS Publications Warehouse

Christin, Zachary; Bagstad, Kenneth J.; Verdone, Michael

2016-01-01

Restoring degraded forests and agricultural lands has become a global conservation priority. A growing number of tools can quantify ecosystem service tradeoffs associated with forest restoration. This evolving “tools landscape” presents a dilemma: more tools are available, but selecting appropriate tools has become more challenging. We present a Restoration Ecosystem Service Tool Selector (RESTS) framework that describes key characteristics of 13 ecosystem service assessment tools. Analysts enter information about their decision context, services to be analyzed, and desired outputs. Tools are filtered and presented based on five evaluative criteria: scalability, cost, time requirements, handling of uncertainty, and applicability to benefit-cost analysis. RESTS uses a spreadsheet interface but a web-based interface is planned. Given the rapid evolution of ecosystem services science, RESTS provides an adaptable framework to guide forest restoration decision makers toward tools that can help quantify ecosystem services in support of restoration.

What are the best methodologies for rapid reviews of the research evidence for evidence-informed decision making in health policy and practice: a rapid review.

PubMed

Haby, Michelle M; Chapman, Evelina; Clark, Rachel; Barreto, Jorge; Reveiz, Ludovic; Lavis, John N

2016-11-25

Rapid reviews have the potential to overcome a key barrier to the use of research evidence in decision making, namely that of the lack of timely and relevant research. This rapid review of systematic reviews and primary studies sought to answer the question: What are the best methodologies to enable a rapid review of research evidence for evidence-informed decision making in health policy and practice? This rapid review utilised systematic review methods and was conducted according to a pre-defined protocol including clear inclusion criteria (PROSPERO registration: CRD42015015998). A comprehensive search strategy was used, including published and grey literature, written in English, French, Portuguese or Spanish, from 2004 onwards. Eleven databases and two websites were searched. Two review authors independently applied the eligibility criteria. Data extraction was done by one reviewer and checked by a second. The methodological quality of included studies was assessed independently by two reviewers. A narrative summary of the results is presented. Five systematic reviews and one randomised controlled trial (RCT) that investigated methodologies for rapid reviews met the inclusion criteria. None of the systematic reviews were of sufficient quality to allow firm conclusions to be made. Thus, the findings need to be treated with caution. There is no agreed definition of rapid reviews in the literature and no agreed methodology for conducting rapid reviews. While a wide range of 'shortcuts' are used to make rapid reviews faster than a full systematic review, the included studies found little empirical evidence of their impact on the conclusions of either rapid or systematic reviews. There is some evidence from the included RCT (that had a low risk of bias) that rapid reviews may improve clarity and accessibility of research evidence for decision makers. Greater care needs to be taken in improving the transparency of the methods used in rapid review products. There is no evidence available to suggest that rapid reviews should not be done or that they are misleading in any way. We offer an improved definition of rapid reviews to guide future research as well as clearer guidance for policy and practice.

People adopt optimal policies in simple decision-making, after practice and guidance.

PubMed

Evans, Nathan J; Brown, Scott D

2017-04-01

Organisms making repeated simple decisions are faced with a tradeoff between urgent and cautious strategies. While animals can adopt a statistically optimal policy for this tradeoff, findings about human decision-makers have been mixed. Some studies have shown that people can optimize this "speed-accuracy tradeoff", while others have identified a systematic bias towards excessive caution. These issues have driven theoretical development and spurred debate about the nature of human decision-making. We investigated a potential resolution to the debate, based on two factors that routinely differ between human and animal studies of decision-making: the effects of practice, and of longer-term feedback. Our study replicated the finding that most people, by default, are overly cautious. When given both practice and detailed feedback, people moved rapidly towards the optimal policy, with many participants reaching optimality with less than 1 h of practice. Our findings have theoretical implications for cognitive and neural models of simple decision-making, as well as methodological implications.

Predicting adverse hemodynamic events in critically ill patients.

PubMed

Yoon, Joo H; Pinsky, Michael R

2018-06-01

The art of predicting future hemodynamic instability in the critically ill has rapidly become a science with the advent of advanced analytical processed based on computer-driven machine learning techniques. How these methods have progressed beyond severity scoring systems to interface with decision-support is summarized. Data mining of large multidimensional clinical time-series databases using a variety of machine learning tools has led to our ability to identify alert artifact and filter it from bedside alarms, display real-time risk stratification at the bedside to aid in clinical decision-making and predict the subsequent development of cardiorespiratory insufficiency hours before these events occur. This fast evolving filed is primarily limited by linkage of high-quality granular to physiologic rationale across heterogeneous clinical care domains. Using advanced analytic tools to glean knowledge from clinical data streams is rapidly becoming a reality whose clinical impact potential is great.

E-DECIDER Disaster Response and Decision Support Cyberinfrastructure: Technology and Challenges

NASA Astrophysics Data System (ADS)

Glasscoe, M. T.; Parker, J. W.; Pierce, M. E.; Wang, J.; Eguchi, R. T.; Huyck, C. K.; Hu, Z.; Chen, Z.; Yoder, M. R.; Rundle, J. B.; Rosinski, A.

2014-12-01

Timely delivery of critical information to decision makers during a disaster is essential to response and damage assessment. Key issues to an efficient emergency response after a natural disaster include rapidly processing and delivering this critical information to emergency responders and reducing human intervention as much as possible. Essential elements of information necessary to achieve situational awareness are often generated by a wide array of organizations and disciplines, using any number of geospatial and non-geospatial technologies. A key challenge is the current state of practice does not easily support information sharing and technology interoperability. NASA E-DECIDER (Emergency Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response) has worked with the California Earthquake Clearinghouse and its partners to address these issues and challenges by adopting the XChangeCore Web Service Data Orchestration technology and participating in several earthquake response exercises. The E-DECIDER decision support system provides rapid delivery of advanced situational awareness data products to operations centers and emergency responders in the field. Remote sensing and hazard data, model-based map products, information from simulations, damage detection, and crowdsourcing is integrated into a single geospatial view and delivered through a service oriented architecture for improved decision-making and then directly to mobile devices of responders. By adopting a Service Oriented Architecture based on Open Geospatial Consortium standards, the system provides an extensible, comprehensive framework for geospatial data processing and distribution on Cloud platforms and other distributed environments. While the Clearinghouse and its partners are not first responders, they do support the emergency response community by providing information about the damaging effects earthquakes. It is critical for decision makers to maintain a situational awareness that is knowledgeable of potential and current conditions, possible impacts on populations and infrastructure, and other key information. E-DECIDER and the Clearinghouse have worked together to address many of these issues and challenges to deliver interoperable, authoritative decision support products.

Personalized Surgical Risk Assessment Using Population-Based Data Analysis

ERIC Educational Resources Information Center

AbuSalah, Ahmad Mohammad

2013-01-01

The volume of information generated by healthcare providers is growing at a relatively high speed. This tremendous growth has created a gap between knowledge and clinical practice that experts say could be narrowed with the proper use of healthcare data to guide clinical decisions and tools that support rapid information availability at the…

Estimation of census and effective population sizes: the increasing usefulness of DNA-based approaches

Treesearch

Gordon Luikart; Nils Ryman; David A. Tallmon; Michael K. Schwartz; Fred W. Allendorf

2010-01-01

Population census size (NC) and effective population sizes (Ne) are two crucial parameters that influence population viability, wildlife management decisions, and conservation planning. Genetic estimators of both NC and Ne are increasingly widely used because molecular markers are increasingly available, statistical methods are improving rapidly, and genetic estimators...

Using Emotional Intelligence in Training Crisis Managers: The Pandora Approach

ERIC Educational Resources Information Center

Mackinnon, Lachian; Bacon, Liz; Cortellessa, Gabriella; Cesta, Amedeo

2013-01-01

Multi-agency crisis management represents one of the most complex of real-world situations, requiring rapid negotiation and decision-making under extreme pressure. However, the training offered to strategic planners, called Gold Commanders, does not place them under any such pressure. It takes the form of paper-based, table-top exercises, or…

COMPARATIVE EVALUATION OF ELISAS FOR DETECTING VITELLOGENIN IN THE FATHEAD MINNOW (PIMEPHALES PROMELAS)- A RESPONSE TO TYLER ET AL

EPA Science Inventory

Measurement of vitellogenin (VTG) in fish is rapidly moving from being an endpoint of concern mostly to reproductive physiology/endocrinology, to an endpoint on which international regulatory decision-making could well be based. Changes in VTG are of particular utility for the id...

Comparing wavefront-optimized, wavefront-guided and topography-guided laser vision correction: clinical outcomes using an objective decision tree.

PubMed

Stonecipher, Karl; Parrish, Joseph; Stonecipher, Megan

2018-05-18

This review is intended to update and educate the reader on the currently available options for laser vision correction, more specifically, laser-assisted in-situ keratomileusis (LASIK). In addition, some related clinical outcomes data from over 1000 cases performed over a 1-year are presented to highlight some differences between the various treatment profiles currently available including the rapidity of visual recovery. The cases in question were performed on the basis of a decision tree to segregate patients on the basis of anatomical, topographic and aberrometry findings; the decision tree was formulated based on the data available in some of the reviewed articles. Numerous recent studies reported in the literature provide data related to the risks and benefits of LASIK; alternatives to a laser refractive procedure are also discussed. The results from these studies have been used to prepare a decision tree to assist the surgeon in choosing the best option for the patient based on the data from several standard preoperative diagnostic tests. The data presented here should aid surgeons in understanding the effects of currently available LASIK treatment profiles. Surgeons should also be able to appreciate how the findings were used to create a decision tree to help choose the most appropriate treatment profile for patients. Finally, the retrospective evaluation of clinical outcomes based on the decision tree should provide surgeons with a realistic expectation for their own outcomes should they adopt such a decision tree in their own practice.

From "Somatic Scandals" to "A Constant Potential for Violence"? The Culture of Dissection, Brain-Based Learning, and the Rewriting/Rewiring of "The Child"

ERIC Educational Resources Information Center

Baker, Bernadette

2015-01-01

Within educational research across Europe and the US, one of the most rapidly traveling discourses and highly funded pursuits of the moment is brain-based learning (BBL). BBL is an approach to curriculum and pedagogical decision-making that is located within the new field of educational neuroscience. In some strands of BBL research the structure…

Use of Lean response to improve pandemic influenza surge in public health laboratories.

PubMed

Isaac-Renton, Judith L; Chang, Yin; Prystajecky, Natalie; Petric, Martin; Mak, Annie; Abbott, Brendan; Paris, Benjamin; Decker, K C; Pittenger, Lauren; Guercio, Steven; Stott, Jeff; Miller, Joseph D

2012-01-01

A novel influenza A (H1N1) virus detected in April 2009 rapidly spread around the world. North American provincial and state laboratories have well-defined roles and responsibilities, including providing accurate, timely test results for patients and information for regional public health and other decision makers. We used the multidisciplinary response and rapid implementation of process changes based on Lean methods at the provincial public health laboratory in British Columbia, Canada, to improve laboratory surge capacity in the 2009 influenza pandemic. Observed and computer simulating evaluation results from rapid processes changes showed that use of Lean tools successfully expanded surge capacity, which enabled response to the 10-fold increase in testing demands.

Do Children Who Experience Regret Make Better Decisions? A Developmental Study of the Behavioral Consequences of Regret

PubMed Central

O’Connor, Eimear; McCormack, Teresa; Feeney, Aidan

2014-01-01

Although regret is assumed to facilitate good decision making, there is little research directly addressing this assumption. Four experiments (N = 326) examined the relation between children's ability to experience regret and the quality of their subsequent decision making. In Experiment 1 regret and adaptive decision making showed the same developmental profile, with both first appearing at about 7 years. In Experiments 2a and 2b, children aged 6–7 who experienced regret decided adaptively more often than children who did not experience regret, and this held even when controlling for age and verbal ability. Experiment 3 ruled out a memory-based interpretation of these findings. These findings suggest that the experience of regret facilitates children's ability to learn rapidly from bad outcomes. PMID:24773388

Rapid Decision-Making with Side-Specific Perceptual Discrimination in Ants

PubMed Central

Stroeymeyt, Nathalie; Guerrieri, Fernando J.; van Zweden, Jelle S.; d'Ettorre, Patrizia

2010-01-01

Background Timely decision making is crucial for survival and reproduction. Organisms often face a speed-accuracy trade-off, as fully informed, accurate decisions require time-consuming gathering and treatment of information. Optimal strategies for decision-making should therefore vary depending on the context. In mammals, there is mounting evidence that multiple systems of perceptual discrimination based on different neural circuits emphasize either fast responses or accurate treatment of stimuli depending on the context. Methodology/Principal Findings We used the ant Camponotus aethiops to test the prediction that fast information processing achieved through direct neural pathways should be favored in situations where quick reactions are adaptive. Social insects discriminate readily between harmless group-members and dangerous strangers using easily accessible cuticular hydrocarbons as nestmate recognition cues. We show that i) tethered ants display rapid aggressive reactions upon presentation of non-nestmate odor (120 to 160 ms); ii) ants' aggressiveness towards non-nestmates can be specifically reduced by exposure to non-nestmate odor only, showing that social interactions are not required to alter responses towards non-nestmates; iii) decision-making by ants does not require information transfer between brain hemispheres, but relies on side-specific decision rules. Conclusions/Significance Our results strongly suggest that first-order olfactory processing centers (up to the antennal lobes) are likely to play a key role in ant nestmate recognition. We hypothesize that the coarse level of discrimination achieved in the antennal lobes early in odor processing provides enough information to determine appropriate behavioral responses towards non-nestmates. This asks for a reappraisal of the mechanisms underlying social recognition in insects. PMID:20808782

Modelling and Decision Support of Clinical Pathways

NASA Astrophysics Data System (ADS)

Gabriel, Roland; Lux, Thomas

The German health care market is under a rapid rate of change, forcing especially hospitals to provide high-quality services at low costs. Appropriate measures for more effective and efficient service provision are process orientation and decision support by information technology of clinical pathway of a patient. The essential requirements are adequate modelling of clinical pathways as well as usage of adequate systems, which are capable of assisting the complete path of a patient within a hospital, and preferably also outside of it, in a digital way. To fulfil these specifications the authors present a suitable concept, which meets the challenges of well-structured clinical pathways as well as rather poorly structured diagnostic and therapeutic decisions, by interplay of process-oriented and knowledge-based hospital information systems.

Contextual influences on animal decision-making: Significance for behavior-based wildlife conservation and management.

PubMed

Owen, Megan A; Swaisgood, Ronald R; Blumstein, Daniel T

2017-01-01

Survival and successful reproduction require animals to make critical decisions amidst a naturally dynamic environmental and social background (i.e. "context"). However, human activities have pervasively, and rapidly, extended contextual variation into evolutionarily novel territory, potentially rendering evolved animal decision-making mechanisms and strategies maladaptive. We suggest that explicitly focusing on animal decision-making (ADM), by integrating and applying findings from studies of sensory ecology, cognitive psychology, behavioral economics and eco-evolutionary strategies, may enhance our understanding of, and our ability to predict how, human-driven changes in the environment and population demography will influence animal populations. Fundamentally, the decisions animals make involve evolved mechanisms, and behaviors emerge from the combined action of sensory integration, cognitive mechanisms and strategic rules of thumb, and any of these processes may have a disproportionate influence on behavior. Although there is extensive literature exploring ADM, it generally reflects a canalized, discipline-specific approach that lacks a unified conceptual framework. As a result, there has been limited application of ADM theory and research findings into predictive models that can enhance management outcomes, even though it is likely that the relative resilience of species to rapid environmental change is fundamentally a result of how ADM is linked to contextual variation. Here, we focus on how context influences ADM, and highlight ideas and results that may be most applicable to conservation biology. © 2016 International Society of Zoological Sciences, Institute of Zoology/Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

Fit for purpose: perspectives on rapid reviews from end-user interviews.

PubMed

Hartling, Lisa; Guise, Jeanne-Marie; Hempel, Susanne; Featherstone, Robin; Mitchell, Matthew D; Motu'apuaka, Makalapua L; Robinson, Karen A; Schoelles, Karen; Totten, Annette; Whitlock, Evelyn; Wilt, Timothy J; Anderson, Johanna; Berliner, Elise; Gozu, Aysegul; Kato, Elisabeth; Paynter, Robin; Umscheid, Craig A

2017-02-17

There is increasing demand for rapid reviews and timely evidence synthesis. The goal of this project was to understand end-user perspectives on the utility and limitations of rapid products including evidence inventories, rapid responses, and rapid reviews. Interviews were conducted with key informants representing: guideline developers (n = 3), health care providers/health system organizations (n = 3), research funders (n = 1), and payers/health insurers (n = 1). We elicited perspectives on important characteristics of systematic reviews, acceptable methods to streamline reviews, and uses of rapid products. We analyzed content of the interview transcripts and identified themes and subthemes. Key informants identified the following as critical features of evidence reviews: (1) originating from a reliable source (i.e., conducted by experienced reviewers from an established research organization), (2) addressing clinically relevant questions, and (3) trusted relationship between the user and producer. Key informants expressed strong preference for the following review methods and characteristics: use of evidence tables, quality rating of studies, assessments of total evidence quality/strength, and use of summary tables for results and conclusions. Most acceptable trade-offs to increase efficiencies were limiting the literature search (e.g., limiting search dates or language) and performing single screening of citations and full texts for relevance. Key informants perceived rapid products (particularly evidence inventories and rapid responses) as useful interim products to inform downstream investigation (e.g., whether to proceed with a full review or guideline, direction for future research). Most key informants indicated that evidence analysis/synthesis and quality/strength of evidence assessments were important for decision-making. They reported that rapid reviews in particular were useful for guideline development on narrow topics, policy decisions when a quick turn-around is needed, decision-making for practicing clinicians in nuanced clinical settings, and decisions about coverage by payers/health insurers. Rapid reviews may be more relevant within specific clinical settings or health systems; whereas, broad/national guidelines often need a traditional systematic review. Key informants interviewed in our study indicated that evidence inventories, rapid responses, and rapid reviews have utility in specific decisions and contexts. They indicated that the credibility of the review producer, relevance of key questions, and close working relationship between the end-user and producer are critical for any rapid product. Our findings are limited by the sample size which may have been too small to reach saturation for the themes described.

Web Based Decision Support Tools for Selection of Condition Assessment and Rehabilitation Methods for Laterals (WERF Report INFR2SG09)

EPA Science Inventory

Abstract: It has been observed that the majority of older sewer laterals made of concrete or terracotta pipe are deteriorating rapidly. Wastewater agencies, typically responsible for maintaining the portion of the sewer lateral located in the public right-of-way, and property o...

Targeting and Structuring Information Resource Use: A Path toward Informed Clinical Decisions

ERIC Educational Resources Information Center

Mangrulkar, Rajesh S.

2004-01-01

A core skill for all physicians to master is that of information manager. Despite a rapidly expanding set of electronic and print-based information resources, clinicians continue to answer their clinical queries predominantly through informal or formal consultation. Even as new tools are brought to market, the majority of them present information…

Factors Associated with Iowa Rural Hospitals' Decision to Convert to Critical Access Hospital Status

ERIC Educational Resources Information Center

Li, Pengxiang; Ward, Marcia M.; Schneider, John E.

2009-01-01

Context: The Balanced Budget Act (BBA) of 1997 allowed some rural hospitals meeting certain requirements to convert to Critical Access Hospitals (CAHs) and changed their Medicare reimbursement from prospective to cost-based. Some subsequent CAH-related laws reduced restrictions and increased payments, and the number of CAHs grew rapidly. Purpose:…

A Crime Analysis Decision Support System for Crime Report Classification and Visualization

ERIC Educational Resources Information Center

Ku, Chih-Hao

2012-01-01

Today's Internet-based crime reporting systems make timely and anonymous crime reporting possible. However, these reports also result in a rapidly growing set of unstructured text files. Complicating the problem is that the information has not been filtered or guided in a detective-led interview resulting in much irrelevant information. To…

Project Real World: Economic Living Skills for High School Students. Module II, Your Economic Decisions and You.

ERIC Educational Resources Information Center

Federal/Provincial Consumer Education and Plain Language Task Force (Canada).

Project Real World, a self-contained, activity-based Canadian consumer science program, provides students with systematic instruction in economic living skills. It gives students in grades 10-12 an orientation to the economic realities and opportunities in society. The program helps students function effectively within the rapidly changing…

Modelling Complexity: Making Sense of Leadership Issues in 14-19 Education

ERIC Educational Resources Information Center

Briggs, Ann R. J.

2008-01-01

Modelling of statistical data is a well established analytical strategy. Statistical data can be modelled to represent, and thereby predict, the forces acting upon a structure or system. For the rapidly changing systems in the world of education, modelling enables the researcher to understand, to predict and to enable decisions to be based upon…

Evaluation of work-related diseases by the Italian Institute of Insurance for Professional Illness and Injuries (INAIL).

PubMed

Bracci, Carlo; Norcia, Gabriele

2005-01-01

Based on a predetermined list of job-related diseases, INAIL makes compensation decisions in cases of work-related diseases in Italy. Its functioning is somewhat hampered by imprecision in the disease classification and infrequency of updating the list, as well as rapid turnover of workers in some categories of jobs.

Molecular tools for bathing water assessment in Europe: Balancing social science research with a rapidly developing environmental science evidence-base.

PubMed

Oliver, David M; Hanley, Nick D; van Niekerk, Melanie; Kay, David; Heathwaite, A Louise; Rabinovici, Sharyl J M; Kinzelman, Julie L; Fleming, Lora E; Porter, Jonathan; Shaikh, Sabina; Fish, Rob; Chilton, Sue; Hewitt, Julie; Connolly, Elaine; Cummins, Andy; Glenk, Klaus; McPhail, Calum; McRory, Eric; McVittie, Alistair; Giles, Amanna; Roberts, Suzanne; Simpson, Katherine; Tinch, Dugald; Thairs, Ted; Avery, Lisa M; Vinten, Andy J A; Watts, Bill D; Quilliam, Richard S

2016-02-01

The use of molecular tools, principally qPCR, versus traditional culture-based methods for quantifying microbial parameters (e.g., Fecal Indicator Organisms) in bathing waters generates considerable ongoing debate at the science-policy interface. Advances in science have allowed the development and application of molecular biological methods for rapid (~2 h) quantification of microbial pollution in bathing and recreational waters. In contrast, culture-based methods can take between 18 and 96 h for sample processing. Thus, molecular tools offer an opportunity to provide a more meaningful statement of microbial risk to water-users by providing near-real-time information enabling potentially more informed decision-making with regard to water-based activities. However, complementary studies concerning the potential costs and benefits of adopting rapid methods as a regulatory tool are in short supply. We report on findings from an international Working Group that examined the breadth of social impacts, challenges, and research opportunities associated with the application of molecular tools to bathing water regulations.

Calcium dynamics regulating the timing of decision-making in C. elegans.

PubMed

Tanimoto, Yuki; Yamazoe-Umemoto, Akiko; Fujita, Kosuke; Kawazoe, Yuya; Miyanishi, Yosuke; Yamazaki, Shuhei J; Fei, Xianfeng; Busch, Karl Emanuel; Gengyo-Ando, Keiko; Nakai, Junichi; Iino, Yuichi; Iwasaki, Yuishi; Hashimoto, Koichi; Kimura, Koutarou D

2017-05-23

Brains regulate behavioral responses with distinct timings. Here we investigate the cellular and molecular mechanisms underlying the timing of decision-making during olfactory navigation in Caenorhabditis elegans . We find that, based on subtle changes in odor concentrations, the animals appear to choose the appropriate migratory direction from multiple trials as a form of behavioral decision-making. Through optophysiological, mathematical and genetic analyses of neural activity under virtual odor gradients, we further find that odor concentration information is temporally integrated for a decision by a gradual increase in intracellular calcium concentration ([Ca 2+ ] i ), which occurs via L-type voltage-gated calcium channels in a pair of olfactory neurons. In contrast, for a reflex-like behavioral response, [Ca 2+ ] i rapidly increases via multiple types of calcium channels in a pair of nociceptive neurons. Thus, the timing of neuronal responses is determined by cell type-dependent involvement of calcium channels, which may serve as a cellular basis for decision-making.

Calcium dynamics regulating the timing of decision-making in C. elegans

PubMed Central

Tanimoto, Yuki; Yamazoe-Umemoto, Akiko; Fujita, Kosuke; Kawazoe, Yuya; Miyanishi, Yosuke; Yamazaki, Shuhei J; Fei, Xianfeng; Busch, Karl Emanuel; Gengyo-Ando, Keiko; Nakai, Junichi; Iino, Yuichi; Iwasaki, Yuishi; Hashimoto, Koichi; Kimura, Koutarou D

2017-01-01

Brains regulate behavioral responses with distinct timings. Here we investigate the cellular and molecular mechanisms underlying the timing of decision-making during olfactory navigation in Caenorhabditis elegans. We find that, based on subtle changes in odor concentrations, the animals appear to choose the appropriate migratory direction from multiple trials as a form of behavioral decision-making. Through optophysiological, mathematical and genetic analyses of neural activity under virtual odor gradients, we further find that odor concentration information is temporally integrated for a decision by a gradual increase in intracellular calcium concentration ([Ca2+]i), which occurs via L-type voltage-gated calcium channels in a pair of olfactory neurons. In contrast, for a reflex-like behavioral response, [Ca2+]i rapidly increases via multiple types of calcium channels in a pair of nociceptive neurons. Thus, the timing of neuronal responses is determined by cell type-dependent involvement of calcium channels, which may serve as a cellular basis for decision-making. DOI: http://dx.doi.org/10.7554/eLife.21629.001 PMID:28532547

Use of Lean Response to Improve Pandemic Influenza Surge in Public Health Laboratories

PubMed Central

Chang, Yin; Prystajecky, Natalie; Petric, Martin; Mak, Annie; Abbott, Brendan; Paris, Benjamin; Decker, K.C.; Pittenger, Lauren; Guercio, Steven; Stott, Jeff; Miller, Joseph D.

2012-01-01

A novel influenza A (H1N1) virus detected in April 2009 rapidly spread around the world. North American provincial and state laboratories have well-defined roles and responsibilities, including providing accurate, timely test results for patients and information for regional public health and other decision makers. We used the multidisciplinary response and rapid implementation of process changes based on Lean methods at the provincial public health laboratory in British Columbia, Canada, to improve laboratory surge capacity in the 2009 influenza pandemic. Observed and computer simulating evaluation results from rapid processes changes showed that use of Lean tools successfully expanded surge capacity, which enabled response to the 10-fold increase in testing demands. PMID:22257385

Presenting quantitative information about decision outcomes: a risk communication primer for patient decision aid developers.

PubMed

Trevena, Lyndal J; Zikmund-Fisher, Brian J; Edwards, Adrian; Gaissmaier, Wolfgang; Galesic, Mirta; Han, Paul K J; King, John; Lawson, Margaret L; Linder, Suzanne K; Lipkus, Isaac; Ozanne, Elissa; Peters, Ellen; Timmermans, Danielle; Woloshin, Steven

2013-01-01

Making evidence-based decisions often requires comparison of two or more options. Research-based evidence may exist which quantifies how likely the outcomes are for each option. Understanding these numeric estimates improves patients' risk perception and leads to better informed decision making. This paper summarises current "best practices" in communication of evidence-based numeric outcomes for developers of patient decision aids (PtDAs) and other health communication tools. An expert consensus group of fourteen researchers from North America, Europe, and Australasia identified eleven main issues in risk communication. Two experts for each issue wrote a "state of the art" summary of best evidence, drawing on the PtDA, health, psychological, and broader scientific literature. In addition, commonly used terms were defined and a set of guiding principles and key messages derived from the results. The eleven key components of risk communication were: 1) Presenting the chance an event will occur; 2) Presenting changes in numeric outcomes; 3) Outcome estimates for test and screening decisions; 4) Numeric estimates in context and with evaluative labels; 5) Conveying uncertainty; 6) Visual formats; 7) Tailoring estimates; 8) Formats for understanding outcomes over time; 9) Narrative methods for conveying the chance of an event; 10) Important skills for understanding numerical estimates; and 11) Interactive web-based formats. Guiding principles from the evidence summaries advise that risk communication formats should reflect the task required of the user, should always define a relevant reference class (i.e., denominator) over time, should aim to use a consistent format throughout documents, should avoid "1 in x" formats and variable denominators, consider the magnitude of numbers used and the possibility of format bias, and should take into account the numeracy and graph literacy of the audience. A substantial and rapidly expanding evidence base exists for risk communication. Developers of tools to facilitate evidence-based decision making should apply these principles to improve the quality of risk communication in practice.

Presenting quantitative information about decision outcomes: a risk communication primer for patient decision aid developers

PubMed Central

2013-01-01

Background Making evidence-based decisions often requires comparison of two or more options. Research-based evidence may exist which quantifies how likely the outcomes are for each option. Understanding these numeric estimates improves patients’ risk perception and leads to better informed decision making. This paper summarises current “best practices” in communication of evidence-based numeric outcomes for developers of patient decision aids (PtDAs) and other health communication tools. Method An expert consensus group of fourteen researchers from North America, Europe, and Australasia identified eleven main issues in risk communication. Two experts for each issue wrote a “state of the art” summary of best evidence, drawing on the PtDA, health, psychological, and broader scientific literature. In addition, commonly used terms were defined and a set of guiding principles and key messages derived from the results. Results The eleven key components of risk communication were: 1) Presenting the chance an event will occur; 2) Presenting changes in numeric outcomes; 3) Outcome estimates for test and screening decisions; 4) Numeric estimates in context and with evaluative labels; 5) Conveying uncertainty; 6) Visual formats; 7) Tailoring estimates; 8) Formats for understanding outcomes over time; 9) Narrative methods for conveying the chance of an event; 10) Important skills for understanding numerical estimates; and 11) Interactive web-based formats. Guiding principles from the evidence summaries advise that risk communication formats should reflect the task required of the user, should always define a relevant reference class (i.e., denominator) over time, should aim to use a consistent format throughout documents, should avoid “1 in x” formats and variable denominators, consider the magnitude of numbers used and the possibility of format bias, and should take into account the numeracy and graph literacy of the audience. Conclusion A substantial and rapidly expanding evidence base exists for risk communication. Developers of tools to facilitate evidence-based decision making should apply these principles to improve the quality of risk communication in practice. PMID:24625237

The Use of Rapid Review Methods for the U.S. Preventive Services Task Force.

PubMed

Patnode, Carrie D; Eder, Michelle L; Walsh, Emily S; Viswanathan, Meera; Lin, Jennifer S

2018-01-01

Rapid review products are intended to synthesize available evidence in a timely fashion while still meeting the needs of healthcare decision makers. Various methods and products have been applied for rapid evidence syntheses, but no single approach has been uniformly adopted. Methods to gain efficiency and compress the review time period include focusing on a narrow clinical topic and key questions; limiting the literature search; performing single (versus dual) screening of abstracts and full-text articles for relevance; and limiting the analysis and synthesis. In order to maintain the scientific integrity, including transparency, of rapid evidence syntheses, it is imperative that procedures used to streamline standard systematic review methods are prespecified, based on sound review principles and empiric evidence when possible, and provide the end user with an accurate and comprehensive synthesis. The collection of clinical preventive service recommendations maintained by the U.S. Preventive Services Task Force, along with its commitment to rigorous methods development, provide a unique opportunity to refine, implement, and evaluate rapid evidence synthesis methods and add to an emerging evidence base on rapid review methods. This paper summarizes the U.S. Preventive Services Task Force's use of rapid review methodology, its criteria for selecting topics for rapid evidence syntheses, and proposed methods to streamline the review process. Copyright © 2018 American Journal of Preventive Medicine. All rights reserved.

Data acquisition and path selection decision making for an autonomous roving vehicle

NASA Technical Reports Server (NTRS)

Frederick, D. K.; Shen, C. N.; Yerazunis, S. W.

1976-01-01

Problems related to the guidance of an autonomous rover for unmanned planetary exploration were investigated. Topics included in these studies were: simulation on an interactive graphics computer system of the Rapid Estimation Technique for detection of discrete obstacles; incorporation of a simultaneous Bayesian estimate of states and inputs in the Rapid Estimation Scheme; development of methods for estimating actual laser rangefinder errors and their application to date provided by Jet Propulsion Laboratory; and modification of a path selection system simulation computer code for evaluation of a hazard detection system based on laser rangefinder data.

A Web-Based Search Service to Support Imaging Spectrometer Instrument Operations

NASA Technical Reports Server (NTRS)

Smith, Alexander; Thompson, David R.; Sayfi, Elias; Xing, Zhangfan; Castano, Rebecca

2013-01-01

Imaging spectrometers yield rich and informative data products, but interpreting them demands time and expertise. There is a continual need for new algorithms and methods for rapid first-draft analyses to assist analysts during instrument opera-tions. Intelligent data analyses can summarize scenes to draft geologic maps, searching images to direct op-erator attention to key features. This validates data quality while facilitating rapid tactical decision making to select followup targets. Ideally these algorithms would operate in seconds, never grow bored, and be free from observation bias about the kinds of mineral-ogy that will be found.

USING THE HEALTH TECHNOLOGY ASSESSMENT TOOLBOX TO FACILITATE PROCUREMENT: THE CASE OF SMART PUMPS IN A CANADIAN HOSPITAL.

PubMed

Poder, Thomas G

2017-01-01

The aim of this study was to present the experience of a Canadian hospital-based health technology assessment (HTA) unit that performed the traditional functions of the HTA process along with many other activities to facilitate the choice of smart pumps. A rapid literature review was initiated, but little evidence was found. Moreover, the evidence provided was too far from our hospital context. To help our decision makers, we offered them a list of various services based on the skills of our HTA unit staff. To involve our HTA unit in the choice of the new smart pumps led to a strong collaboration between hospital services. After a rapid review on smart pumps, we proceeded to establish the clinical needs, followed by an evaluation of technical features. To ascertain clinical needs, we participated in the establishment of a conformity list for the tender, a failure and mode-effect analysis, an audit on the use of actual smart pumps, and simulation exercises with nurses and doctors to evaluate the ease of use and ergonomics. With regard to technical tests, these were mainly conducted to identify potential dysfunction and to assess the efficiency of the pump. This experience with smart pumps was useful for evidence-based procurement and led to the formulation of a nine-step process to guide future work. HTA units and agencies are faced with rapid development of new technologies that may not be supported by sufficient amount of pertinent published evidence. Under these circumstances, approaches other than evidence-based selection might provide useful information. Because these activities may be different from those related to classic HTA, this widens the scope of what can be done in HTA to support decision making.

From evidence-based medicine to genomic medicine

PubMed Central

2007-01-01

The concept of ‘evidence-based medicine’ dates back to mid-19th century or even earlier. It remains pivotal in planning, funding and in delivering the health care. Clinicians, public health practitioners, health commissioners/purchasers, health planners, politicians and public seek formal ‘evidence’ in approving any form of health care provision. Essentially ‘evidence-based medicine’ aims at the conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients. It is in fact the ‘personalised medicine’ in practice. Since the completion of the human genome project and the rapid accumulation of huge amount of data, scientists and physicians alike are excited on the prospect of ‘personalised health care’ based on individual’s genotype and phenotype. The first decade of the new millennium now witnesses the transition from ‘evidence-based medicine’ to the ‘genomic medicine’. The practice of medicine, including health promotion and prevention of disease, stands now at a wide-open road as the scientific and medical community embraces itself with the rapidly expanding and revolutionising field of genomic medicine. This article reviews the rapid transformation of modern medicine from the ‘evidence-based medicine’ to ‘genomic medicine’. PMID:18923934

Improving Resident Performance Through a Simulated Rapid Response Team: A Pilot Study.

PubMed

Burke, Peter A; Vest, Michael T; Kher, Hemant; Deutsch, Joseph; Daya, Sneha

2015-07-01

The Joint Commission requires hospitals to develop systems in which a team of clinicians can rapidly recognize and respond to changes in a patient's condition. The rapid response team (RRT) concept has been widely adopted as the solution to this mandate. The role of house staff in RRTs and the impact on resident education has been controversial. At Christiana Care Health System, eligible residents in their second through final years lead the RRTs. To evaluate the use of a team-based, interdisciplinary RRT training program for educating and training first-year residents in an effort to improve global RRT performance before residents start their second year. This pilot study was administered in 3 phases. Phase 1 provided residents with classroom-based didactic sessions using case-based RRT scenarios. Multiple choice examinations were administered, as well as a confidence survey based on a Likert scale before and after phase 1 of the program. Phase 2 involved experiential training in which residents engaged as mentored participants in actual RRT calls. A qualitative survey was used to measure perceived program effectiveness after phase 2. In phase 3, led by senior residents, simulated RRTs using medical mannequins were conducted. Participants were divided into 5 teams, in which each resident would rotate in the roles of leader, nurse, and respiratory therapist. This phase measured resident performance with regard to medical decision making, data gathering, and team behaviors during the simulated RRT scenarios. Performance was scored by an attending and a senior resident. A total of 18 residents were eligible (N=18) for participation. The average multiple choice test score improved by 20% after didactic training. The average confidence survey score before training was 3.44 out of 5 (69%) and after training was 4.13 (83%), indicating a 14% improvement. High-quality team behaviors correlated with medical decision making (0.92) more closely than did high-quality data gathering (0.11). This difference narrowed during high-pressure scenarios (0.84 and 0.72, respectively). Our data suggest that resident training using a team-based, interdisciplinary RRT training program may improve resident education, interdisciplinary team-based dynamics, and global RRT performance. In turn, data gathering and medical decision making may be enhanced, which may result in better patient outcomes during RRT scenarios.

Decision-Making Amplification under Uncertainty: An Exploratory Study of Behavioral Similarity and Intelligent Decision Support Systems

ERIC Educational Resources Information Center

Campbell, Merle Wayne

2013-01-01

Intelligent decision systems have the potential to support and greatly amplify human decision-making across a number of industries and domains. However, despite the rapid improvement in the underlying capabilities of these "intelligent" systems, increasing their acceptance as decision aids in industry has remained a formidable challenge.…

Imaging informatics-based multimedia ePR system for data management and decision support in rehabilitation research

NASA Astrophysics Data System (ADS)

Wang, Ximing; Verma, Sneha; Qin, Yi; Sterling, Josh; Zhou, Alyssa; Zhang, Jeffrey; Martinez, Clarisa; Casebeer, Narissa; Koh, Hyunwook; Winstein, Carolee; Liu, Brent

2013-03-01

With the rapid development of science and technology, large-scale rehabilitation centers and clinical rehabilitation trials usually involve significant volumes of multimedia data. Due to the global aging crisis, millions of new patients with age-related chronic diseases will produce huge amounts of data and contribute to soaring costs of medical care. Hence, a solution for effective data management and decision support will significantly reduce the expenditure and finally improve the patient life quality. Inspired from the concept of the electronic patient record (ePR), we developed a prototype system for the field of rehabilitation engineering. The system is subject or patient-oriented and customized for specific projects. The system components include data entry modules, multimedia data presentation and data retrieval. To process the multimedia data, the system includes a DICOM viewer with annotation tools and video/audio player. The system also serves as a platform for integrating decision-support tools and data mining tools. Based on the prototype system design, we developed two specific applications: 1) DOSE (a phase 1 randomized clinical trial to determine the optimal dose of therapy for rehabilitation of the arm and hand after stroke.); and 2) NEXUS project from the Rehabilitation Engineering Research Center(RERC, a NIDRR funded Rehabilitation Engineering Research Center). Currently, the system is being evaluated in the context of the DOSE trial with a projected enrollment of 60 participants over 5 years, and will be evaluated by the NEXUS project with 30 subjects. By applying the ePR concept, we developed a system in order to improve the current research workflow, reduce the cost of managing data, and provide a platform for the rapid development of future decision-support tools.

Point-of-care testing (POCT) and evidence-based laboratory medicine (EBLM) - does it leverage any advantage in clinical decision making?

PubMed

Florkowski, Christopher; Don-Wauchope, Andrew; Gimenez, Nuria; Rodriguez-Capote, Karina; Wils, Julien; Zemlin, Annalise

Point-of-care testing (POCT) is the analysis of patient specimens outside the clinical laboratory, near or at the site of patient care, usually performed by clinical staff without laboratory training, although it also encompasses patient self-monitoring. It is able to provide a rapid result near the patient and which can be acted upon immediately. The key driver is the concept that clinical decision making may be delayed when samples are sent to the clinical laboratory. Balanced against this are considerations of increased costs for purchase and maintenance of equipment, staff training, connectivity to the laboratory information system (LIS), quality control (QC) and external quality assurance (EQA) procedures, all required for accreditation under ISO 22870. The justification for POCT depends upon being able to demonstrate that a more timely result (shorter turnaround times (TATs)) is able to leverage a clinically important advantage in decision making compared with the central laboratory (CL). In the four decades since POCT was adapted for the self-monitoring of blood glucose levels by subjects with diabetes, numerous new POCT methodologies have become available, enabling the clinician to receive results and initiate treatment more rapidly. However, these instruments are often operated by staff not trained in laboratory medicine and hence are prone to errors in the analytical phase (as opposed to laboratory testing where the analytical phase has the least errors). In some environments, particularly remote rural settings, the CL may be at a considerable distance and timely availability of cardiac troponins and other analytes can triage referrals to the main centers, thus avoiding expensive unnecessary patient transportation costs. However, in the Emergency Department, availability of more rapid results with POCT does not always translate into shorter stays due to other barriers to implementation of care. In this review, we apply the principles of evidence-based laboratory medicine (EBLM) looking for high quality systematic reviews and meta-analyses, ideally underpinned by randomized controlled trials (RCTs), looking for evidence of whether POCT confers any advantage in clinical decision making in different scenarios.

Shared decision making: empowering the bedside nurse.

PubMed

Slack, Stephanie M; Boguslawski, Jean M; Eickhoff, Rachel M; Klein, Kristi A; Pepin, Teresa M; Schrandt, Kevin; Wise, Carrie A; Zylstra, Jody A

2005-12-01

Shared decision making is a process that has empowered specialty nurses at the Mayo Clinic in Rochester, MN, to solve a practice concern. Staff nurses recognized a lack of concise, collated information available that described what nurses need to know when caring for patients receiving chemotherapy. Many aspects of the administration process were knowledge and experience based and not easily retrievable. The Hematology/Oncology/Blood and Marrow Transplant Clinical Practice Committee identified this as a significant practice issue. Ideas were brainstormed regarding how to make the information available to nursing colleagues. The Chemotherapy Yellow Pages is a resource that was developed to facilitate the rapid retrieval of pertinent information for bedside nurses. The content of this article outlines a'model of shared decision making and the processes used to address and resolve the practice concern.

Pathogen profiling for disease management and surveillance.

PubMed

Sintchenko, Vitali; Iredell, Jonathan R; Gilbert, Gwendolyn L

2007-06-01

The usefulness of rapid pathogen genotyping is widely recognized, but its effective interpretation and application requires integration into clinical and public health decision-making. How can pathogen genotyping data best be translated to inform disease management and surveillance? Pathogen profiling integrates microbial genomics data into communicable disease control by consolidating phenotypic identity-based methods with DNA microarrays, proteomics, metabolomics and sequence-based typing. Sharing data on pathogen profiles should facilitate our understanding of transmission patterns and the dynamics of epidemics.

Completing the Link between Exposure Science and Toxicology for Improved Environmental Health Decision Making: The Aggregate Exposure Pathway Framework.

PubMed

Teeguarden, Justin G; Tan, Yu-Mei; Edwards, Stephen W; Leonard, Jeremy A; Anderson, Kim A; Corley, Richard A; Kile, Molly L; Simonich, Staci M; Stone, David; Tanguay, Robert L; Waters, Katrina M; Harper, Stacey L; Williams, David E

2016-05-03

Driven by major scientific advances in analytical methods, biomonitoring, computation, and a newly articulated vision for a greater impact in public health, the field of exposure science is undergoing a rapid transition from a field of observation to a field of prediction. Deployment of an organizational and predictive framework for exposure science analogous to the "systems approaches" used in the biological sciences is a necessary step in this evolution. Here we propose the aggregate exposure pathway (AEP) concept as the natural and complementary companion in the exposure sciences to the adverse outcome pathway (AOP) concept in the toxicological sciences. Aggregate exposure pathways offer an intuitive framework to organize exposure data within individual units of prediction common to the field, setting the stage for exposure forecasting. Looking farther ahead, we envision direct linkages between aggregate exposure pathways and adverse outcome pathways, completing the source to outcome continuum for more meaningful integration of exposure assessment and hazard identification. Together, the two frameworks form and inform a decision-making framework with the flexibility for risk-based, hazard-based, or exposure-based decision making.

LiDAR based biomass and crop nitrogen estimates for rapid, non-destructive assessment of wheat nitrogen status

USDA-ARS?s Scientific Manuscript database

Optical remote sensing of crop nitrogen (N) status is developing into a powerful diagnostic tool that can improve N management decisions. Crop N status is a function of dry mass per unit area (W) and N concentration (%Na), which can be used to calculate N nutrition index (NNI),where NNI is %Na/%Nc (...

Fuels planning: science synthesis and integration; economic uses fact sheet 04: My Fuel Treatment Planner

Treesearch

Rocky Mountain Research Station USDA Forest Service

2004-01-01

In the face of rapidly changing public and political attitudes toward fire and fuel planning, one thing remains constant: the fuel planner is ultimately responsible for making decisions on the land. This fact sheet discusses the options for fuel treatments, and the need, development, and use of the MS Excel-based tool, My Fuel Treatment Planner.

The Model of ICT-Based Career Information Services and Decision-Making Ability of Learners

ERIC Educational Resources Information Center

Syakir, Muhammad; Mahmud, Alimuddin; Achmad, Arifin

2016-01-01

One of the impacts of information technology in guidance counseling is in the implementation of the support system. Entering the world of globalization and rapid technological breadth of information requires counseling to adjust to the environment in order to meet the needs of learners. Therefore, cyber-counseling is now developing. It is one of…

Dorsomedial prefrontal cortex mediates rapid evaluations predicting the outcome of romantic interactions

PubMed Central

Cooper, Jeffrey C.; Dunne, Simon; Furey, Teresa; O’Doherty, John P.

2012-01-01

Humans frequently make real-world decisions based on rapid evaluations of minimal information – for example, should we talk to an attractive stranger at a party? Little is known, however, about how the brain makes rapid evaluations with real and immediate social consequences. To address this question, we scanned participants with FMRI while they viewed photos of individuals that they subsequently met at real-life “speed-dating” events. Neural activity in two areas of dorsomedial prefrontal cortex, paracingulate cortex and rostromedial prefrontal cortex (RMPFC), was predictive of whether each individual would be ultimately pursued for a romantic relationship or rejected. Activity in these areas was attributable to two distinct components of romantic evaluation: either consensus judgments about physical beauty (paracingulate cortex) or individualized preferences based on a partner’s perceived personality (RMPFC). These data identify novel computational roles for these regions of the dorsomedial prefrontal cortex in even very rapid social evaluations. Even a first glance, then, can accurately predict romantic desire, but that glance involves a mix of physical and psychological judgments that depend on specific regions of dorsomedial prefrontal cortex. PMID:23136406

Tuning the speed-accuracy trade-off to maximize reward rate in multisensory decision-making.

PubMed

Drugowitsch, Jan; DeAngelis, Gregory C; Angelaki, Dora E; Pouget, Alexandre

2015-06-19

For decisions made under time pressure, effective decision making based on uncertain or ambiguous evidence requires efficient accumulation of evidence over time, as well as appropriately balancing speed and accuracy, known as the speed/accuracy trade-off. For simple unimodal stimuli, previous studies have shown that human subjects set their speed/accuracy trade-off to maximize reward rate. We extend this analysis to situations in which information is provided by multiple sensory modalities. Analyzing previously collected data (Drugowitsch et al., 2014), we show that human subjects adjust their speed/accuracy trade-off to produce near-optimal reward rates. This trade-off can change rapidly across trials according to the sensory modalities involved, suggesting that it is represented by neural population codes rather than implemented by slow neuronal mechanisms such as gradual changes in synaptic weights. Furthermore, we show that deviations from the optimal speed/accuracy trade-off can be explained by assuming an incomplete gradient-based learning of these trade-offs.

Design and implementation of intelligent electronic warfare decision making algorithm

NASA Astrophysics Data System (ADS)

Peng, Hsin-Hsien; Chen, Chang-Kuo; Hsueh, Chi-Shun

2017-05-01

Electromagnetic signals and the requirements of timely response have been a rapid growth in modern electronic warfare. Although jammers are limited resources, it is possible to achieve the best electronic warfare efficiency by tactical decisions. This paper proposes the intelligent electronic warfare decision support system. In this work, we develop a novel hybrid algorithm, Digital Pheromone Particle Swarm Optimization, based on Particle Swarm Optimization (PSO), Ant Colony Optimization (ACO) and Shuffled Frog Leaping Algorithm (SFLA). We use PSO to solve the problem and combine the concept of pheromones in ACO to accumulate more useful information in spatial solving process and speed up finding the optimal solution. The proposed algorithm finds the optimal solution in reasonable computation time by using the method of matrix conversion in SFLA. The results indicated that jammer allocation was more effective. The system based on the hybrid algorithm provides electronic warfare commanders with critical information to assist commanders in effectively managing the complex electromagnetic battlefield.

The neural representation of unexpected uncertainty during value-based decision making.

PubMed

Payzan-LeNestour, Elise; Dunne, Simon; Bossaerts, Peter; O'Doherty, John P

2013-07-10

Uncertainty is an inherent property of the environment and a central feature of models of decision-making and learning. Theoretical propositions suggest that one form, unexpected uncertainty, may be used to rapidly adapt to changes in the environment, while being influenced by two other forms: risk and estimation uncertainty. While previous studies have reported neural representations of estimation uncertainty and risk, relatively little is known about unexpected uncertainty. Here, participants performed a decision-making task while undergoing functional magnetic resonance imaging (fMRI), which, in combination with a Bayesian model-based analysis, enabled us to separately examine each form of uncertainty examined. We found representations of unexpected uncertainty in multiple cortical areas, as well as the noradrenergic brainstem nucleus locus coeruleus. Other unique cortical regions were found to encode risk, estimation uncertainty, and learning rate. Collectively, these findings support theoretical models in which several formally separable uncertainty computations determine the speed of learning. Copyright © 2013 Elsevier Inc. All rights reserved.

SketchBio: a scientist's 3D interface for molecular modeling and animation.

PubMed

Waldon, Shawn M; Thompson, Peter M; Hahn, Patrick J; Taylor, Russell M

2014-10-30

Because of the difficulties involved in learning and using 3D modeling and rendering software, many scientists hire programmers or animators to create models and animations. This both slows the discovery process and provides opportunities for miscommunication. Working with multiple collaborators, a tool was developed (based on a set of design goals) to enable them to directly construct models and animations. SketchBio is presented, a tool that incorporates state-of-the-art bimanual interaction and drop shadows to enable rapid construction of molecular structures and animations. It includes three novel features: crystal-by-example, pose-mode physics, and spring-based layout that accelerate operations common in the formation of molecular models. Design decisions and their consequences are presented, including cases where iterative design was required to produce effective approaches. The design decisions, novel features, and inclusion of state-of-the-art techniques enabled SketchBio to meet all of its design goals. These features and decisions can be incorporated into existing and new tools to improve their effectiveness.

Optimal management of adults with pharyngitis – a multi-criteria decision analysis

PubMed Central

Singh, Sonal; Dolan, James G; Centor, Robert M

2006-01-01

Background Current practice guidelines offer different management recommendations for adults presenting with a sore throat. The key issue is the extent to which the clinical likelihood of a Group A streptococcal infection should affect patient management decisions. To help resolve this issue, we conducted a multi-criteria decision analysis using the Analytic Hierarchy Process. Methods We defined optimal patient management using four criteria: 1) reduce symptom duration; 2) prevent infectious complications, local and systemic; 3) minimize antibiotic side effects, minor and anaphylaxis; and 4) achieve prudent use of antibiotics, avoiding both over-use and under-use. In our baseline analysis we assumed that all criteria and sub-criteria were equally important except minimizing anaphylactic side effects, which was judged very strongly more important than minimizing minor side effects. Management strategies included: a) No test, No treatment; b) Perform a rapid strep test and treat if positive; c) Perform a throat culture and treat if positive; d) Perform a rapid strep test and treat if positive; if negative obtain a throat culture and treat if positive; and e) treat without further tests. We defined four scenarios based on the likelihood of group A streptococcal infection using the Centor score, a well-validated clinical index. Published data were used to estimate the likelihoods of clinical outcomes and the test operating characteristics of the rapid strep test and throat culture for identifying group A streptococcal infections. Results Using the baseline assumptions, no testing and no treatment is preferred for patients with Centor scores of 1; two strategies – culture and treat if positive and rapid strep with culture of negative results – are equally preferable for patients with Centor scores of 2; and rapid strep with culture of negative results is the best management strategy for patients with Centor scores 3 or 4. These results are sensitive to the priorities assigned to the decision criteria, especially avoiding over-use versus under-use of antibiotics, and the population prevalence of Group A streptococcal pharyngitis. Conclusion The optimal clinical management of adults with sore throat depends on both the clinical probability of a group A streptococcal infection and clinical judgments that incorporate individual patient and practice circumstances. PMID:16533386

Using basic geographic information systems functionality to support sustainable forest management decision making and post-decision assessments

Treesearch

Ronald E. McRoberts; R. James Barbour; Krista M. Gebert; Greg C. Liknes; Mark D. Nelson; Dacia M. Meneguzzo; et al.

2006-01-01

Sustainable management of natural resources requires informed decision making and post-decision assessments of the results of those decisions. Increasingly, both activities rely on analyses of spatial data in the forms of maps and digital data layers. Fortunately, a variety of supporting maps and data layers rapidly are becoming available. Unfortunately, however, user-...

NASA'S SERVIR Gulf of Mexico Project: The Gulf of Mexico Regional Collaborative (GoMRC)

NASA Technical Reports Server (NTRS)

Quattrochi, Dale A.; Irwin, Daniel; Presson, Joan; Estes, Maury; Estes, Sue; Judd, Kathleen

2006-01-01

The Gulf of Mexico Regional Collaborative (GoMRC) is a NASA-funded project that has as its goal to develop an integrated, working, prototype IT infrastructure for Earth science data, knowledge and models for the five Gulf U.S. states and Mexico, and to demonstrate its ability to help decision-makers better understand critical Gulf-scale issues. Within this preview, the mission of this project is to provide cross cutting solution network and rapid prototyping capability for the Gulf of Mexico region, in order to demonstrate substantial, collaborative, multi-agency research and transitional capabilities using unique NASA data sets and models to address regional problems. SERVIR Mesoamerica is seen as an excellent existing framework that can be used to integrate observational and GIs data bases, provide a sensor web interface, visualization and interactive analysis tools, archival functions, data dissemination and product generation within a Rapid Prototyping concept to assist decision-makers in better understanding Gulf-scale environmental issues.

Dissociated neural processing for decisions in managers and non-managers.

PubMed

Caspers, Svenja; Heim, Stefan; Lucas, Marc G; Stephan, Egon; Fischer, Lorenz; Amunts, Katrin; Zilles, Karl

2012-01-01

Functional neuroimaging studies of decision-making so far mainly focused on decisions under uncertainty or negotiation with other persons. Dual process theory assumes that, in such situations, decision making relies on either a rapid intuitive, automated or a slower rational processing system. However, it still remains elusive how personality factors or professional requirements might modulate the decision process and the underlying neural mechanisms. Since decision making is a key task of managers, we hypothesized that managers, facing higher pressure for frequent and rapid decisions than non-managers, prefer the heuristic, automated decision strategy in contrast to non-managers. Such different strategies may, in turn, rely on different neural systems. We tested managers and non-managers in a functional magnetic resonance imaging study using a forced-choice paradigm on word-pairs. Managers showed subcortical activation in the head of the caudate nucleus, and reduced hemodynamic response within the cortex. In contrast, non-managers revealed the opposite pattern. With the head of the caudate nucleus being an initiating component for process automation, these results supported the initial hypothesis, hinting at automation during decisions in managers. More generally, the findings reveal how different professional requirements might modulate cognitive decision processing.

Dissociated Neural Processing for Decisions in Managers and Non-Managers

PubMed Central

Caspers, Svenja; Heim, Stefan; Lucas, Marc G.; Stephan, Egon; Fischer, Lorenz; Amunts, Katrin; Zilles, Karl

2012-01-01

Functional neuroimaging studies of decision-making so far mainly focused on decisions under uncertainty or negotiation with other persons. Dual process theory assumes that, in such situations, decision making relies on either a rapid intuitive, automated or a slower rational processing system. However, it still remains elusive how personality factors or professional requirements might modulate the decision process and the underlying neural mechanisms. Since decision making is a key task of managers, we hypothesized that managers, facing higher pressure for frequent and rapid decisions than non-managers, prefer the heuristic, automated decision strategy in contrast to non-managers. Such different strategies may, in turn, rely on different neural systems. We tested managers and non-managers in a functional magnetic resonance imaging study using a forced-choice paradigm on word-pairs. Managers showed subcortical activation in the head of the caudate nucleus, and reduced hemodynamic response within the cortex. In contrast, non-managers revealed the opposite pattern. With the head of the caudate nucleus being an initiating component for process automation, these results supported the initial hypothesis, hinting at automation during decisions in managers. More generally, the findings reveal how different professional requirements might modulate cognitive decision processing. PMID:22927984

Event-based knowledge elicitation of operating room management decision-making using scenarios adapted from information systems data

PubMed Central

2011-01-01

Background No systematic process has previously been described for a needs assessment that identifies the operating room (OR) management decisions made by the anesthesiologists and nurse managers at a facility that do not maximize the efficiency of use of OR time. We evaluated whether event-based knowledge elicitation can be used practically for rapid assessment of OR management decision-making at facilities, whether scenarios can be adapted automatically from information systems data, and the usefulness of the approach. Methods A process of event-based knowledge elicitation was developed to assess OR management decision-making that may reduce the efficiency of use of OR time. Hypothetical scenarios addressing every OR management decision influencing OR efficiency were created from published examples. Scenarios are adapted, so that cues about conditions are accurate and appropriate for each facility (e.g., if OR 1 is used as an example in a scenario, the listed procedure is a type of procedure performed at the facility in OR 1). Adaptation is performed automatically using the facility's OR information system or anesthesia information management system (AIMS) data for most scenarios (43 of 45). Performing the needs assessment takes approximately 1 hour of local managers' time while they decide if their decisions are consistent with the described scenarios. A table of contents of the indexed scenarios is created automatically, providing a simple version of problem solving using case-based reasoning. For example, a new OR manager wanting to know the best way to decide whether to move a case can look in the chapter on "Moving Cases on the Day of Surgery" to find a scenario that describes the situation being encountered. Results Scenarios have been adapted and used at 22 hospitals. Few changes in decisions were needed to increase the efficiency of use of OR time. The few changes were heterogeneous among hospitals, showing the usefulness of individualized assessments. Conclusions Our technical advance is the development and use of automated event-based knowledge elicitation to identify suboptimal OR management decisions that decrease the efficiency of use of OR time. The adapted scenarios can be used in future decision-making. PMID:21214905

Event-based knowledge elicitation of operating room management decision-making using scenarios adapted from information systems data.

PubMed

Dexter, Franklin; Wachtel, Ruth E; Epstein, Richard H

2011-01-07

No systematic process has previously been described for a needs assessment that identifies the operating room (OR) management decisions made by the anesthesiologists and nurse managers at a facility that do not maximize the efficiency of use of OR time. We evaluated whether event-based knowledge elicitation can be used practically for rapid assessment of OR management decision-making at facilities, whether scenarios can be adapted automatically from information systems data, and the usefulness of the approach. A process of event-based knowledge elicitation was developed to assess OR management decision-making that may reduce the efficiency of use of OR time. Hypothetical scenarios addressing every OR management decision influencing OR efficiency were created from published examples. Scenarios are adapted, so that cues about conditions are accurate and appropriate for each facility (e.g., if OR 1 is used as an example in a scenario, the listed procedure is a type of procedure performed at the facility in OR 1). Adaptation is performed automatically using the facility's OR information system or anesthesia information management system (AIMS) data for most scenarios (43 of 45). Performing the needs assessment takes approximately 1 hour of local managers' time while they decide if their decisions are consistent with the described scenarios. A table of contents of the indexed scenarios is created automatically, providing a simple version of problem solving using case-based reasoning. For example, a new OR manager wanting to know the best way to decide whether to move a case can look in the chapter on "Moving Cases on the Day of Surgery" to find a scenario that describes the situation being encountered. Scenarios have been adapted and used at 22 hospitals. Few changes in decisions were needed to increase the efficiency of use of OR time. The few changes were heterogeneous among hospitals, showing the usefulness of individualized assessments. Our technical advance is the development and use of automated event-based knowledge elicitation to identify suboptimal OR management decisions that decrease the efficiency of use of OR time. The adapted scenarios can be used in future decision-making.

Namibian Flood Early Warning SensorWeb Pilot

NASA Technical Reports Server (NTRS)

Mandl, Daniel; Policelli, Fritz; Frye, Stuart; Cappelare, Pat; Langenhove, Guido Van; Szarzynski, Joerg; Sohlberg, Rob

2010-01-01

The major goal of the Namibia SensorWeb Pilot Project is a scientifically sound, operational trans-boundary flood management decision support system for Southern African region to provide useful flood and waterborne disease forecasting tools for local decision makers. The Pilot Project established under the auspices of: Namibian Ministry of Agriculture Water and Forestry (MAWF), Department of Water Affairs; Committee on Earth Observing Satellites (CEOS), Working Group on Information Systems and Services (WGISS); and moderated by the United Nations Platform for Space-based Information for Disaster Management and Emergency Response (UN-SPIDER). The effort consists of identifying and prototyping technology which enables the rapid gathering and dissemination of both space-based and ground sensor data and data products for the purpose of flood disaster management and water-borne disease management.

Information Needs Assessment for Coastal and Marine Management and Policy: Ecosystem Services Under Changing Climatic, Land Use, and Demographic Conditions.

PubMed

Goldsmith, Kaitlin A; Granek, Elise F; Lubitow, Amy

2015-12-01

Changing climatic, demographic, and land use conditions are projected to alter the provisioning of ecosystem services in estuarine, coastal, and nearshore marine ecosystems, necessitating mitigation and adaptation policies and management. The current paradigm of research efforts occurring in parallel to, rather than in collaboration with, decision makers will be insufficient for the rapid responses required to adapt to and mitigate for projected changing conditions. Here, we suggest a different paradigm: one where research begins by engaging decision makers in the identification of priority data needs (biophysical, economic, and social). This paper uses synthesized interview data to provide insight into the varied demands for scientific research as described by decision makers working on coastal issues in Oregon, USA. The findings highlight the need to recognize (1) the differing framing of ecosystem services by decision makers versus scientists; and (2) the differing data priorities relevant to inland versus coastal decision makers. The findings further serve to highlight the need for decision makers, scientists, and funders to engage in increased communication. This research is an important first step in advancing efforts toward evidence-based decision making in Oregon and provides a template for further research across the US.

The role of decision analytic modeling in the health economic assessment of spinal intervention.

PubMed

Edwards, Natalie C; Skelly, Andrea C; Ziewacz, John E; Cahill, Kevin; McGirt, Matthew J

2014-10-15

Narrative review. To review the common tenets, strengths, and weaknesses of decision modeling for health economic assessment and to review the use of decision modeling in the spine literature to date. For the majority of spinal interventions, well-designed prospective, randomized, pragmatic cost-effectiveness studies that address the specific decision-in-need are lacking. Decision analytic modeling allows for the estimation of cost-effectiveness based on data available to date. Given the rising demands for proven value in spine care, the use of decision analytic modeling is rapidly increasing by clinicians and policy makers. This narrative review discusses the general components of decision analytic models, how decision analytic models are populated and the trade-offs entailed, makes recommendations for how users of spine intervention decision models might go about appraising the models, and presents an overview of published spine economic models. A proper, integrated, clinical, and economic critical appraisal is necessary in the evaluation of the strength of evidence provided by a modeling evaluation. As is the case with clinical research, all options for collecting health economic or value data are not without their limitations and flaws. There is substantial heterogeneity across the 20 spine intervention health economic modeling studies summarized with respect to study design, models used, reporting, and general quality. There is sparse evidence for populating spine intervention models. Results mostly showed that interventions were cost-effective based on $100,000/quality-adjusted life-year threshold. Spine care providers, as partners with their health economic colleagues, have unique clinical expertise and perspectives that are critical to interpret the strengths and weaknesses of health economic models. Health economic models must be critically appraised for both clinical validity and economic quality before altering health care policy, payment strategies, or patient care decisions. 4.

User Oriented Techniques to Support Interaction and Decision Making with Large Educational Databases

ERIC Educational Resources Information Center

Hartley, Roger; Almuhaidib, Saud M. Y.

2007-01-01

Information Technology is developing rapidly and providing policy/decision makers with large amounts of information that require processing and analysis. Decision support systems (DSS) aim to provide tools that not only help such analyses, but enable the decision maker to experiment and simulate the effects of different policies and selection…

Potential Effects of Health Care Policy Decisions on Physician Availability

NASA Technical Reports Server (NTRS)

Garcia, Christopher; Goodrich, Michael

2011-01-01

Many regions in America are experiencing downward trends in the number of practicing physicians and the number of available physician hours, resulting in a worrisome decrease in the availability of health care services. Recent changes in American health care legislation may induce a rapid change in the demand for health care services, which in turn will result in a new supply-demand equilibrium . In this paper we develop a system dynamics model linking physician availability to health care demand and profitability. We use this model to explore scenarios based on different initial conditions and describe possible outcomes for a range of different policy decisions.

Rapid Review Summit: an overview and initiation of a research agenda.

PubMed

Polisena, Julie; Garritty, Chantelle; Umscheid, Craig A; Kamel, Chris; Samra, Kevin; Smith, Jeannette; Vosilla, Ann

2015-09-26

The demand for accelerated forms of evidence synthesis is on the rise, largely in response to requests by health care decision makers for expeditious assessment and up-to-date information about health care technologies and health services and programs. As a field, rapid review evidence synthesis is marked by a tension between the strategic priority to inform health care decision-making and the scientific imperative to produce robust, high-quality research that soundly supports health policy and practice. In early 2015, the Canadian Agency for Drugs and Technologies in Health convened a forum in partnership with the British Columbia Ministry of Health, the British Columbia Centre for Clinical Epidemiology and Evaluation, the Ottawa Hospital Research Institute, and the University of Pennsylvania. More than 150 evidence synthesis producers and end users attended the Rapid Review Summit: Then, Now and in the Future. The Summit program focused on the evolving role and practices of rapid reviews to support informed health care policy and clinical decision-making, including the uptake and use of health technology assessment. Our discussion paper highlights the important discussions that occurred during the Rapid Review Summit. It focuses on the initial development of a research agenda that resulted from the Summit presentations and discussions. The research topics centered on three key areas of interest: (1) how to conduct a rapid review; (2) investigating the validity and utility of rapid reviews; and (3) how to improve access to rapid reviews.

Expert Knowledge-Based Automatic Sleep Stage Determination by Multi-Valued Decision Making Method

NASA Astrophysics Data System (ADS)

Wang, Bei; Sugi, Takenao; Kawana, Fusae; Wang, Xingyu; Nakamura, Masatoshi

In this study, an expert knowledge-based automatic sleep stage determination system working on a multi-valued decision making method is developed. Visual inspection by a qualified clinician is adopted to obtain the expert knowledge database. The expert knowledge database consists of probability density functions of parameters for various sleep stages. Sleep stages are determined automatically according to the conditional probability. Totally, four subjects were participated. The automatic sleep stage determination results showed close agreements with the visual inspection on sleep stages of awake, REM (rapid eye movement), light sleep and deep sleep. The constructed expert knowledge database reflects the distributions of characteristic parameters which can be adaptive to variable sleep data in hospitals. The developed automatic determination technique based on expert knowledge of visual inspection can be an assistant tool enabling further inspection of sleep disorder cases for clinical practice.

Nanotoxicology and nanomedicine: making development decisions in an evolving governance environment

NASA Astrophysics Data System (ADS)

Rycroft, Taylor; Trump, Benjamin; Poinsatte-Jones, Kelsey; Linkov, Igor

2018-02-01

The fields of nanomedicine, risk analysis, and decision science have evolved considerably in the past decade, providing developers of nano-enabled therapies and diagnostic tools with more complete information than ever before and shifting a fundamental requisite of the nanomedical community from the need for more information about nanomaterials to the need for a streamlined method of integrating the abundance of nano-specific information into higher-certainty product design decisions. The crucial question facing nanomedicine developers that must select the optimal nanotechnology in a given situation has shifted from "how do we estimate nanomaterial risk in the absence of good risk data?" to "how can we derive a holistic characterization of the risks and benefits that a given nanomaterial may pose within a specific nanomedical application?" Many decision support frameworks have been proposed to assist with this inquiry; however, those based in multicriteria decision analysis have proven to be most adaptive in the rapidly evolving field of nanomedicine—from the early stages of the field when conditions of significant uncertainty and incomplete information dominated, to today when nanotoxicology and nano-environmental health and safety information is abundant but foundational paradigms such as chemical risk assessment, risk governance, life cycle assessment, safety-by-design, and stakeholder engagement are undergoing substantial reformation in an effort to address the needs of emerging technologies. In this paper, we reflect upon 10 years of developments in nanomedical engineering and demonstrate how the rich knowledgebase of nano-focused toxicological and risk assessment information developed over the last decade enhances the capability of multicriteria decision analysis approaches and underscores the need to continue the transition from traditional risk assessment towards risk-based decision-making and alternatives-based governance for emerging technologies.

An evaluation of rapid methods for monitoring vegetation characteristics of wetland bird habitat

USGS Publications Warehouse

Tavernia, Brian G.; Lyons, James E.; Loges, Brian W.; Wilson, Andrew; Collazo, Jaime A.; Runge, Michael C.

2016-01-01

Wetland managers benefit from monitoring data of sufficient precision and accuracy to assess wildlife habitat conditions and to evaluate and learn from past management decisions. For large-scale monitoring programs focused on waterbirds (waterfowl, wading birds, secretive marsh birds, and shorebirds), precision and accuracy of habitat measurements must be balanced with fiscal and logistic constraints. We evaluated a set of protocols for rapid, visual estimates of key waterbird habitat characteristics made from the wetland perimeter against estimates from (1) plots sampled within wetlands, and (2) cover maps made from aerial photographs. Estimated percent cover of annuals and perennials using a perimeter-based protocol fell within 10 percent of plot-based estimates, and percent cover estimates for seven vegetation height classes were within 20 % of plot-based estimates. Perimeter-based estimates of total emergent vegetation cover did not differ significantly from cover map estimates. Post-hoc analyses revealed evidence for observer effects in estimates of annual and perennial covers and vegetation height. Median time required to complete perimeter-based methods was less than 7 percent of the time needed for intensive plot-based methods. Our results show that rapid, perimeter-based assessments, which increase sample size and efficiency, provide vegetation estimates comparable to more intensive methods.

Diagnostic Tests to Support Late-Stage Control Programs for Schistosomiasis and Soil-Transmitted Helminthiases.

PubMed

Hawkins, Kenneth R; Cantera, Jason L; Storey, Helen L; Leader, Brandon T; de Los Santos, Tala

2016-12-01

Global efforts to address schistosomiasis and soil-transmitted helminthiases (STH) include deworming programs for school-aged children that are made possible by large-scale drug donations. Decisions on these mass drug administration (MDA) programs currently rely on microscopic examination of clinical specimens to determine the presence of parasite eggs. However, microscopy-based methods are not sensitive to the low-intensity infections that characterize populations that have undergone MDA. Thus, there has been increasing recognition within the schistosomiasis and STH communities of the need for improved diagnostic tools to support late-stage control program decisions, such as when to stop or reduce MDA. Failure to adequately address the need for new diagnostics could jeopardize achievement of the 2020 London Declaration goals. In this report, we assess diagnostic needs and landscape potential solutions and determine appropriate strategies to improve diagnostic testing to support control and elimination programs. Based upon literature reviews and previous input from experts in the schistosomiasis and STH communities, we prioritized two diagnostic use cases for further exploration: to inform MDA-stopping decisions and post-MDA surveillance. To this end, PATH has refined target product profiles (TPPs) for schistosomiasis and STH diagnostics that are applicable to these use cases. We evaluated the limitations of current diagnostic methods with regards to these use cases and identified candidate biomarkers and diagnostics with potential application as new tools. Based on this analysis, there is a need to develop antigen-detecting rapid diagnostic tests (RDTs) with simplified, field-deployable sample preparation for schistosomiasis. Additionally, there is a need for diagnostic tests that are more sensitive than the current methods for STH, which may include either a field-deployable molecular test or a simple, low-cost, rapid antigen-detecting test.

Data collection and information presentation for optimal decision making by clinical managers--the Autocontrol Project.

PubMed Central

Grant, A. M.; Richard, Y.; Deland, E.; Després, N.; de Lorenzi, F.; Dagenais, A.; Buteau, M.

1997-01-01

The Autocontrol methodology has been developed in order to support the optimisation of decision-making and the use of resources in the context of a clinical unit. The theoretical basis relates to quality assurance and information systems and is influenced by management and cognitive research in the health domain. The methodology uses population rather than individual decision making and because of its dynamic feedback design promises to have rapid and profound effect on practice. Most importantly the health care professional is the principle user of the Autocontrol system. In this methodology we distinguish three types of evidence necessary for practice change: practice based or internal evidence, best evidence derived from the literature or external evidence concerning the practice in question, and process based evidence on how to optimise the process of practice change. The software used by the system is of the executive decision support type which facilitates interrogation of large databases. The Autocontrol system is designed to interrogate the data of the patient medical record however the latter often lacks data on concomitant resource use and this must be supplemented. This paper reviews the Autocontrol methodology and gives examples from current studies. PMID:9357733

Data collection and information presentation for optimal decision making by clinical managers--the Autocontrol Project.

PubMed

Grant, A M; Richard, Y; Deland, E; Després, N; de Lorenzi, F; Dagenais, A; Buteau, M

1997-01-01

The Autocontrol methodology has been developed in order to support the optimisation of decision-making and the use of resources in the context of a clinical unit. The theoretical basis relates to quality assurance and information systems and is influenced by management and cognitive research in the health domain. The methodology uses population rather than individual decision making and because of its dynamic feedback design promises to have rapid and profound effect on practice. Most importantly the health care professional is the principle user of the Autocontrol system. In this methodology we distinguish three types of evidence necessary for practice change: practice based or internal evidence, best evidence derived from the literature or external evidence concerning the practice in question, and process based evidence on how to optimise the process of practice change. The software used by the system is of the executive decision support type which facilitates interrogation of large databases. The Autocontrol system is designed to interrogate the data of the patient medical record however the latter often lacks data on concomitant resource use and this must be supplemented. This paper reviews the Autocontrol methodology and gives examples from current studies.

Ada and the rapid development lifecycle

NASA Technical Reports Server (NTRS)

Deforrest, Lloyd; Gref, Lynn

1991-01-01

JPL is under contract, through NASA, with the US Army to develop a state-of-the-art Command Center System for the US European Command (USEUCOM). The Command Center System will receive, process, and integrate force status information from various sources and provide this integrated information to staff officers and decision makers in a format designed to enhance user comprehension and utility. The system is based on distributed workstation class microcomputers, VAX- and SUN-based data servers, and interfaces to existing military mainframe systems and communication networks. JPL is developing the Command Center System utilizing an incremental delivery methodology called the Rapid Development Methodology with adherence to government and industry standards including the UNIX operating system, X Windows, OSF/Motif, and the Ada programming language. Through a combination of software engineering techniques specific to the Ada programming language and the Rapid Development Approach, JPL was able to deliver capability to the military user incrementally, with comparable quality and improved economies of projects developed under more traditional software intensive system implementation methodologies.

Collaborative Brain-Computer Interface for Aiding Decision-Making

PubMed Central

Poli, Riccardo; Valeriani, Davide; Cinel, Caterina

2014-01-01

We look at the possibility of integrating the percepts from multiple non-communicating observers as a means of achieving better joint perception and better group decisions. Our approach involves the combination of a brain-computer interface with human behavioural responses. To test ideas in controlled conditions, we asked observers to perform a simple matching task involving the rapid sequential presentation of pairs of visual patterns and the subsequent decision as whether the two patterns in a pair were the same or different. We recorded the response times of observers as well as a neural feature which predicts incorrect decisions and, thus, indirectly indicates the confidence of the decisions made by the observers. We then built a composite neuro-behavioural feature which optimally combines the two measures. For group decisions, we uses a majority rule and three rules which weigh the decisions of each observer based on response times and our neural and neuro-behavioural features. Results indicate that the integration of behavioural responses and neural features can significantly improve accuracy when compared with the majority rule. An analysis of event-related potentials indicates that substantial differences are present in the proximity of the response for correct and incorrect trials, further corroborating the idea of using hybrids of brain-computer interfaces and traditional strategies for improving decision making. PMID:25072739

Assessment of Scientific Literacy of Estonian Gymnasium Students during the Operation of a Competence-Based Science Curriculum

ERIC Educational Resources Information Center

Laius, Anne; Post, Aveliis; Rannikmäe, Miia

2016-01-01

Sustainable societies need a workforce with a very creative and flexible nature to be able cope with rapidly changing situations making creative and reasonable decisions. The only suggested way to obtain this is through education that is oriented to competences. The goal of this research is to determine the influence of a new competence-based…

Population-dynamics focussed rapid rural mapping and characterisation of the peri-urban interface of Kampala, Uganda

PubMed Central

Makita, K.; Fèvre, E.M.; Waiswa, C.; Bronsvoort, M.D.C.; Eisler, M.C.; Welburn, S.C.

2010-01-01

In developing countries, cities are rapidly expanding and urban and peri-urban agriculture (UPA) has an important role in feeding these growing urban populations; however such agriculture also carries public health risks such as zoonotic disease transmission. It is important to assess the role of UPA in food security and public health risks to make evidence-based decisions on policies. Describing and mapping the peri-urban interface (PUI) are the essential first steps for such an assessment. Kampala, the capital city of Uganda is a rapidly expanding city where the PUI has not previously been mapped or properly described. In this paper we provide a spatial representation of the entire PUI of Kampala economic zone and determine the socio-economic factors related with peri-urbanicity using a population-dynamics focussed rapid rural mapping. This fills a technical gap of rapid rural mapping and offers a simple and rapid methodology for describing the PUI which can be applied in any city in developing countries for wide range of studies. PMID:22210972

Rapid Benefit Indicators (RBI) Spatial Analysis Tools

EPA Science Inventory

The Rapid Benefit Indicators (RBI) approach consists of five steps and is outlined in Assessing the Benefits of Wetland Restoration - A Rapid Benefits Indicators Approach for Decision Makers. This spatial analysis tool is intended to be used to analyze existing spatial informatio...

Towards biomarker-based tests that can facilitate decisions about prevention and management of preeclampsia in low-resource settings.

PubMed

Acestor, Nathalie; Goett, Jane; Lee, Arthur; Herrick, Tara M; Engelbrecht, Susheela M; Harner-Jay, Claudia M; Howell, Bonnie J; Weigl, Bernhard H

2016-01-01

In recent years, an increasing amount of literature is emerging on candidate urine and blood-based biomarkers associated with incidence and severity of preeclampsia (PE) in pregnant women. While enthusiasm on the usefulness of several of these markers in predicting PE is evolving, essentially all work so far has focused on the needs of high-resource settings and high-income countries, resulting primarily in multi-parameter laboratory assays based on proteomic and metabolomics analysis techniques. These highly complex methods, however, require laboratory capabilities that are rarely available or affordable in low-resource settings (LRS). The importance of quantifying maternal and perinatal risks and identifying which pregnancies can be safely prolonged is also much greater in LRS, where intensive care facilities that can rapidly respond to PE-related health threats for women and infants are limited. For these reasons, simple, low cost, sensitive, and specific point-of-care (POC) tests are needed that can be performed by antenatal health care providers in LRS and that can facilitate decisions about detection and management of PE. Our study aims to provide a comprehensive systematic review of current and emerging blood and urine biomarkers for PE, not only on the basis of their clinical performance, but also of their suitability to be used in LRS-compatible test formats, such as lateral flow and other variants of POC rapid assays.

GLIMPSE: a rapid decision framework for energy and environmental policy.

PubMed

Akhtar, Farhan H; Pinder, Robert W; Loughlin, Daniel H; Henze, Daven K

2013-01-01

Over the coming decades, new energy production technologies and the policies that oversee them will affect human health, the vitality of our ecosystems, and the stability of the global climate. The GLIMPSE decision model framework provides insights about the implications of technology and policy decisions on these outcomes. Using GLIMPSE, decision makers can identify alternative techno-policy futures, examining their air quality, health, and short- and long-term climate impacts. Ultimately, GLIMPSE will support the identification of cost-effective strategies for simultaneously achieving performance goals for these metrics. Here, we demonstrate the utility of GLIMPSE by analyzing several future energy scenarios under existing air quality regulations and potential CO2 emission reduction policies. We find opportunities for substantial cobenefits in setting both climate change mitigation and health-benefit based air quality improvement targets. Though current policies which prioritize public health protection increase near-term warming, establishing policies that also reduce greenhouse gas emissions may offset warming in the near-term and lead to significant reductions in long-term warming.

Rapid Benefit Indicators (RBI) Spatial Analysis Toolset - Manual

EPA Science Inventory

The Rapid Benefit Indicators (RBI) approach consists of five steps and is outlined in Assessing the Benefits of Wetland Restoration - A Rapid Benefits Indicators Approach for Decision Makers. This spatial analysis tool is intended to be used to analyze existing spatial informatio...

77 FR 6092 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-07

... systems which provide a way to compare surveillance and detection equipment and make informed purchasing decisions. Due to rapid changes and inventions in technology, the market survey must be updated to ensure... will be analyzed by a team of subject matter experts in detection and decision analysis. Decision...

A PC-Based Free Text DSS for Health Care

NASA Technical Reports Server (NTRS)

Grams, Ralph R.; Buchanan, Paul; Massey, James K.; Jin, Ming

1987-01-01

A free Decision Support System(DST) has been constructed for health care professional that allows the analysis of complex medical cases and the creation of diagnostic list of potential diseases for clinical evaluation.The system uses a PC-based text management system specifically designed for desktop operation. The texts employed in the decision support package include the Merck Manual (published by Merck Sharpe & Dohme) and Control of Communicable Diseas in Man (published by the American Public Health Association). The background and design of the database are discussed along with a structured analysis procedure for handling free text DSS system. A case study is presented to show the application of this technology and conclusions are drawn in the summary that point to expanded areas of professional intention and new frontiers yet to be explored in this rapidly progressing field.

Rapid evidence assessment: increasing the transparency of an emerging methodology.

PubMed

Varker, Tracey; Forbes, David; Dell, Lisa; Weston, Adele; Merlin, Tracy; Hodson, Stephanie; O'Donnell, Meaghan

2015-12-01

Within the field of evidence-based practice, policy makers, health care professionals and consumers require timely reviews to inform decisions on efficacious health care and treatments. Rapid evidence assessment (REA), also known as rapid review, has emerged in recent years as a literature review methodology that fulfils this need. It highlights what is known in a clinical area to the target audience in a relatively short time frame. This article discusses the lack of transparency and limited critical appraisal that can occur in REA, and goes on to propose general principles for conducting a REA. The approach that we describe is consistent with the principles underlying systematic review methodology, but also makes allowances for the rapid delivery of information as required while utilizing explicit and reproducible methods at each stage. Our method for conducting REA includes: developing an explicit research question in consultation with the end-users; clear definition of the components of the research question; development of a thorough and reproducible search strategy; development of explicit evidence selection criteria; and quality assessments and transparent decisions about the level of information to be obtained from each study. In addition, the REA may also include an assessment of the quality of the total body of evidence. Transparent reporting of REA methodologies will provide greater clarity to end-users about how the information is obtained and about the trade-offs that are made between speed and rigour. © 2015 John Wiley & Sons, Ltd.

Reaching for the Unknown: Multiple Target Encoding and Real-Time Decision-Making in a Rapid Reach Task

ERIC Educational Resources Information Center

Chapman, Craig S.; Gallivan, Jason P.; Wood, Daniel K.; Milne, Jennifer L.; Culham, Jody C.; Goodale, Melvyn A.

2010-01-01

Decision-making is central to human cognition. Fundamental to every decision is the ability to internally represent the available choices and their relative costs and benefits. The most basic and frequent decisions we make occur as our motor system chooses and executes only those actions that achieve our current goals. Although these interactions…

RAPID-N: Assessing and mapping the risk of natural-hazard impact at industrial installations

NASA Astrophysics Data System (ADS)

Girgin, Serkan; Krausmann, Elisabeth

2015-04-01

Natural hazard-triggered technological accidents (so-called Natech accidents) at hazardous installations can have major consequences due to the potential for release of hazardous materials, fires and explosions. Effective Natech risk reduction requires the identification of areas where this risk is high. However, recent studies have shown that there are hardly any methodologies and tools that would allow authorities to identify these areas. To work towards closing this gap, the European Commission's Joint Research Centre has developed the rapid Natech risk assessment and mapping framework RAPID-N. The tool, which is implemented in an online web-based environment, is unique in that it contains all functionalities required for running a full Natech risk analysis simulation (natural hazards severity estimation, equipment damage probability and severity calculation, modeling of the consequences of loss of containment scenarios) and for visualizing its results. The output of RAPID-N are risk summary reports and interactive risk maps which can be used for decision making. Currently, the tool focuses on Natech risk due to earthquakes at industrial installations. However, it will be extended to also analyse and map Natech risk due to floods in the near future. RAPID-N is available at http://rapidn.jrc.ec.europa.eu. This presentation will discuss the results of case-study calculations performed for selected flammable and toxic substances to test the capabilities of RAPID-N both for single- and multi-site earthquake Natech risk assessment. For this purpose, an Istanbul earthquake scenario provided by the Turkish government was used. The results of the exercise show that RAPID-N is a valuable decision-support tool that assesses the Natech risk and maps the consequence end-point distances. These end-point distances are currently defined by 7 kPa overpressure for Vapour Cloud Explosions, 2nd degree burns for pool fire (which is equivalent to a heat radiation of 5 kW/m2 for 40s), or the ERPG-2 concentration for atmospheric dispersion of toxic substances).

Completing the Link between Exposure Science and Toxicology for Improved Environmental Health Decision Making: The Aggregate Exposure Pathway Framework

PubMed Central

Teeguarden, Justin. G.; Tan, Yu-Mei; Edwards, Stephen W.; Leonard, Jeremy A.; Anderson, Kim A.; Corley, Richard A.; Harding, Anna K; Kile, Molly L.; Simonich, Staci M; Stone, David; Tanguay, Robert L.; Waters, Katrina M.; Harper, Stacey L.; Williams, David E.

2016-01-01

Synopsis Driven by major scientific advances in analytical methods, biomonitoring, computational tools, and a newly articulated vision for a greater impact in public health, the field of exposure science is undergoing a rapid transition from a field of observation to a field of prediction. Deployment of an organizational and predictive framework for exposure science analogous to the “systems approaches” used in the biological sciences is a necessary step in this evolution. Here we propose the Aggregate Exposure Pathway (AEP) concept as the natural and complementary companion in the exposure sciences to the Adverse Outcome Pathway (AOP) concept in the toxicological sciences. Aggregate exposure pathways offer an intuitive framework to organize exposure data within individual units of prediction common to the field, setting the stage for exposure forecasting. Looking farther ahead, we envision direct linkages between aggregate exposure pathways and adverse outcome pathways, completing the source to outcome continuum for more efficient integration of exposure assessment and hazard identification. Together, the two pathways form and inform a decision-making framework with the flexibility for risk-based, hazard-based, or exposure-based decision making. PMID:26759916

Completing the link between exposure science and toxicology for improved environmental health decision making: The aggregate exposure pathway framework

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

Teeguarden, Justin G.; Tan, Yu -Mei; Edwards, Stephen W.

Here, driven by major scientific advances in analytical methods, biomonitoring, computation, and a newly articulated vision for a greater impact in public health, the field of exposure science is undergoing a rapid transition from a field of observation to a field of prediction. Deployment of an organizational and predictive framework for exposure science analogous to the “systems approaches” used in the biological sciences is a necessary step in this evolution. Here we propose the aggregate exposure pathway (AEP) concept as the natural and complementary companion in the exposure sciences to the adverse outcome pathway (AOP) concept in the toxicological sciences.more » Aggregate exposure pathways offer an intuitive framework to organize exposure data within individual units of prediction common to the field, setting the stage for exposure forecasting. Looking farther ahead, we envision direct linkages between aggregate exposure pathways and adverse outcome pathways, completing the source to outcome continuum for more meaningful integration of exposure assessment and hazard identification. Together, the two frameworks form and inform a decision-making framework with the flexibility for risk-based, hazard-based, or exposure-based decision making.« less

Completing the link between exposure science and toxicology for improved environmental health decision making: The aggregate exposure pathway framework

DOE PAGES

Teeguarden, Justin G.; Tan, Yu -Mei; Edwards, Stephen W.; ...

2016-01-13

Here, driven by major scientific advances in analytical methods, biomonitoring, computation, and a newly articulated vision for a greater impact in public health, the field of exposure science is undergoing a rapid transition from a field of observation to a field of prediction. Deployment of an organizational and predictive framework for exposure science analogous to the “systems approaches” used in the biological sciences is a necessary step in this evolution. Here we propose the aggregate exposure pathway (AEP) concept as the natural and complementary companion in the exposure sciences to the adverse outcome pathway (AOP) concept in the toxicological sciences.more » Aggregate exposure pathways offer an intuitive framework to organize exposure data within individual units of prediction common to the field, setting the stage for exposure forecasting. Looking farther ahead, we envision direct linkages between aggregate exposure pathways and adverse outcome pathways, completing the source to outcome continuum for more meaningful integration of exposure assessment and hazard identification. Together, the two frameworks form and inform a decision-making framework with the flexibility for risk-based, hazard-based, or exposure-based decision making.« less

EEG Classification with a Sequential Decision-Making Method in Motor Imagery BCI.

PubMed

Liu, Rong; Wang, Yongxuan; Newman, Geoffrey I; Thakor, Nitish V; Ying, Sarah

2017-12-01

To develop subject-specific classifier to recognize mental states fast and reliably is an important issue in brain-computer interfaces (BCI), particularly in practical real-time applications such as wheelchair or neuroprosthetic control. In this paper, a sequential decision-making strategy is explored in conjunction with an optimal wavelet analysis for EEG classification. The subject-specific wavelet parameters based on a grid-search method were first developed to determine evidence accumulative curve for the sequential classifier. Then we proposed a new method to set the two constrained thresholds in the sequential probability ratio test (SPRT) based on the cumulative curve and a desired expected stopping time. As a result, it balanced the decision time of each class, and we term it balanced threshold SPRT (BTSPRT). The properties of the method were illustrated on 14 subjects' recordings from offline and online tests. Results showed the average maximum accuracy of the proposed method to be 83.4% and the average decision time of 2.77[Formula: see text]s, when compared with 79.2% accuracy and a decision time of 3.01[Formula: see text]s for the sequential Bayesian (SB) method. The BTSPRT method not only improves the classification accuracy and decision speed comparing with the other nonsequential or SB methods, but also provides an explicit relationship between stopping time, thresholds and error, which is important for balancing the speed-accuracy tradeoff. These results suggest that BTSPRT would be useful in explicitly adjusting the tradeoff between rapid decision-making and error-free device control.

[Why controlled studies may lead to misleading and unconfirmed therapeutic concepts--a critical view of evidence-based medicine].

PubMed

Flachskampf, F A

2002-03-01

The concept of evidence-based medicine has gathered widespread support during recent years. While this concept has clear merits in compiling and qualifying up-to-date information for clinical decisions, it should be viewed with caution as the sole valid knowledge source for clinical decision-making. The limitations of such an approach are particularly striking when reviewing two key developments in modern cardiology, fibrinolysis and acute percutaneous intervention in acute myocardial infarction. In both cases, early studies and meta-analyses showed no benefit for these therapeutic interventions over earlier treatment. Only after further refinement (mainly in dosage, time window, concomitant heparin therapy for fibrinolysis, and the introduction of stents and IIb/IIIa inhibitors for acute intervention) did these therapies become universally acknowledged. It is therefore crucial to understand that especially for physicians actively participating in the development of a clinical field clinical decisions cannot be exclusively based on published evidence. Another important problem to consider is the time gap between the emergence of new therapies and the publication and reception by the medical audience, in particular in rapidly evolving fields as cardiology. While it is clear that clinical decision-making must be backed by solid knowledge of the published evidence, in particular the specialist involved in-depth in the field may use not yet proven therapeutic concepts and measures to the patient's advantage.

FDI based on Artificial Neural Network for Low-Voltage-Ride-Through in DFIG-based Wind Turbine.

PubMed

Adouni, Amel; Chariag, Dhia; Diallo, Demba; Ben Hamed, Mouna; Sbita, Lassaâd

2016-09-01

As per modern electrical grid rules, Wind Turbine needs to operate continually even in presence severe grid faults as Low Voltage Ride Through (LVRT). Hence, a new LVRT Fault Detection and Identification (FDI) procedure has been developed to take the appropriate decision in order to develop the convenient control strategy. To obtain much better decision and enhanced FDI during grid fault, the proposed procedure is based on voltage indicators analysis using a new Artificial Neural Network architecture (ANN). In fact, two features are extracted (the amplitude and the angle phase). It is divided into two steps. The first is fault indicators generation and the second is indicators analysis for fault diagnosis. The first step is composed of six ANNs which are dedicated to describe the three phases of the grid (three amplitudes and three angle phases). Regarding to the second step, it is composed of a single ANN which analysis the indicators and generates a decision signal that describes the function mode (healthy or faulty). On other hand, the decision signal identifies the fault type. It allows distinguishing between the four faulty types. The diagnosis procedure is tested in simulation and experimental prototype. The obtained results confirm and approve its efficiency, rapidity, robustness and immunity to the noise and unknown inputs. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

Intuition: A Concept Analysis.

PubMed

Chilcote, Deborah R

2017-01-01

The purpose of this article is to conceptually examine intuition; identify the importance of intuition in nursing education, clinical practice, and patient care; encourage acceptance of the use of intuition; and add to the body of nursing knowledge. Nurses often report using intuition when making clinical decisions. Intuition is a rapid, unconscious process based in global knowledge that views the patient holistically while synthesizing information to improve patient outcomes. However, with the advent of evidence-based practice (EBP), the use of intuition has become undervalued in nursing. Walker and Avant's framework was used to analyze intuition. A literature search from 1987 to 2014 was conducted using the following keywords: intuition, intuition and nursing, clinical decision making, clinical decision making and intuition, patient outcomes, EBP, and analytical thinking. The use of intuition is reported by nurses, but is not legitimized within the nursing profession. Defining attributes of intuition are an unconscious, holistic knowledge gathered without using an analytical process and knowledge derived through synthesis, not analysis. Consequences include verification of intuition through an analytical process and translating that knowledge into a course of action. This article supports the use of intuition in nursing by offering clarity to the concept, adds to the nursing knowledge base, encourages a holistic view of the patient during clinical decision making, and encourages nurse educators to promote the use of intuition. © 2016 Wiley Periodicals, Inc.

Information Technology in a Developing Country: An Exploration of the Factors Associated with Attitudes of Decision Makers in Jordanian Government Institutions toward the Utilization of Computer-Based Technology

ERIC Educational Resources Information Center

Khasawneh, Saleh

2010-01-01

In this era of rapidly advancing technologies, many governments around the globe are spending a great amount of money on these technologies, in order to increase their work performance. Therefore, the Jordanian government decided to implement IT in its public organizations. However, the picture is unclear about users' attitudes toward this…

Employing Intelligence, Surveillance, and Reconnaissance: Organizing, Training, and Equipping to Get It Right

DTIC Science & Technology

2014-02-01

facilitate effective employment across all spectra and that an adequate ISR- specific C2 structure be established. Lastly, it addresses artificial seams...becomes too great. Thus, unless an individual is specifically tasked to perform a tactical controller role under the senior intelli - gence duty...into joint operations enabling rapid decisions based on actionable intelli - gence.൚ It also highlights the requirement of synchronizing all actions

mPLR-Loc: an adaptive decision multi-label classifier based on penalized logistic regression for protein subcellular localization prediction.

PubMed

Wan, Shibiao; Mak, Man-Wai; Kung, Sun-Yuan

2015-03-15

Proteins located in appropriate cellular compartments are of paramount importance to exert their biological functions. Prediction of protein subcellular localization by computational methods is required in the post-genomic era. Recent studies have been focusing on predicting not only single-location proteins but also multi-location proteins. However, most of the existing predictors are far from effective for tackling the challenges of multi-label proteins. This article proposes an efficient multi-label predictor, namely mPLR-Loc, based on penalized logistic regression and adaptive decisions for predicting both single- and multi-location proteins. Specifically, for each query protein, mPLR-Loc exploits the information from the Gene Ontology (GO) database by using its accession number (AC) or the ACs of its homologs obtained via BLAST. The frequencies of GO occurrences are used to construct feature vectors, which are then classified by an adaptive decision-based multi-label penalized logistic regression classifier. Experimental results based on two recent stringent benchmark datasets (virus and plant) show that mPLR-Loc remarkably outperforms existing state-of-the-art multi-label predictors. In addition to being able to rapidly and accurately predict subcellular localization of single- and multi-label proteins, mPLR-Loc can also provide probabilistic confidence scores for the prediction decisions. For readers' convenience, the mPLR-Loc server is available online (http://bioinfo.eie.polyu.edu.hk/mPLRLocServer). Copyright © 2014 Elsevier Inc. All rights reserved.

A Decision Mixture Model-Based Method for Inshore Ship Detection Using High-Resolution Remote Sensing Images

PubMed Central

Bi, Fukun; Chen, Jing; Zhuang, Yin; Bian, Mingming; Zhang, Qingjun

2017-01-01

With the rapid development of optical remote sensing satellites, ship detection and identification based on large-scale remote sensing images has become a significant maritime research topic. Compared with traditional ocean-going vessel detection, inshore ship detection has received increasing attention in harbor dynamic surveillance and maritime management. However, because the harbor environment is complex, gray information and texture features between docked ships and their connected dock regions are indistinguishable, most of the popular detection methods are limited by their calculation efficiency and detection accuracy. In this paper, a novel hierarchical method that combines an efficient candidate scanning strategy and an accurate candidate identification mixture model is presented for inshore ship detection in complex harbor areas. First, in the candidate region extraction phase, an omnidirectional intersected two-dimension scanning (OITDS) strategy is designed to rapidly extract candidate regions from the land-water segmented images. In the candidate region identification phase, a decision mixture model (DMM) is proposed to identify real ships from candidate objects. Specifically, to improve the robustness regarding the diversity of ships, a deformable part model (DPM) was employed to train a key part sub-model and a whole ship sub-model. Furthermore, to improve the identification accuracy, a surrounding correlation context sub-model is built. Finally, to increase the accuracy of candidate region identification, these three sub-models are integrated into the proposed DMM. Experiments were performed on numerous large-scale harbor remote sensing images, and the results showed that the proposed method has high detection accuracy and rapid computational efficiency. PMID:28640236

A Decision Mixture Model-Based Method for Inshore Ship Detection Using High-Resolution Remote Sensing Images.

PubMed

Bi, Fukun; Chen, Jing; Zhuang, Yin; Bian, Mingming; Zhang, Qingjun

2017-06-22

With the rapid development of optical remote sensing satellites, ship detection and identification based on large-scale remote sensing images has become a significant maritime research topic. Compared with traditional ocean-going vessel detection, inshore ship detection has received increasing attention in harbor dynamic surveillance and maritime management. However, because the harbor environment is complex, gray information and texture features between docked ships and their connected dock regions are indistinguishable, most of the popular detection methods are limited by their calculation efficiency and detection accuracy. In this paper, a novel hierarchical method that combines an efficient candidate scanning strategy and an accurate candidate identification mixture model is presented for inshore ship detection in complex harbor areas. First, in the candidate region extraction phase, an omnidirectional intersected two-dimension scanning (OITDS) strategy is designed to rapidly extract candidate regions from the land-water segmented images. In the candidate region identification phase, a decision mixture model (DMM) is proposed to identify real ships from candidate objects. Specifically, to improve the robustness regarding the diversity of ships, a deformable part model (DPM) was employed to train a key part sub-model and a whole ship sub-model. Furthermore, to improve the identification accuracy, a surrounding correlation context sub-model is built. Finally, to increase the accuracy of candidate region identification, these three sub-models are integrated into the proposed DMM. Experiments were performed on numerous large-scale harbor remote sensing images, and the results showed that the proposed method has high detection accuracy and rapid computational efficiency.

Knowledge-based commodity distribution planning

NASA Technical Reports Server (NTRS)

Saks, Victor; Johnson, Ivan

1994-01-01

This paper presents an overview of a Decision Support System (DSS) that incorporates Knowledge-Based (KB) and commercial off the shelf (COTS) technology components. The Knowledge-Based Logistics Planning Shell (KBLPS) is a state-of-the-art DSS with an interactive map-oriented graphics user interface and powerful underlying planning algorithms. KBLPS was designed and implemented to support skilled Army logisticians to prepare and evaluate logistics plans rapidly, in order to support corps-level battle scenarios. KBLPS represents a substantial advance in graphical interactive planning tools, with the inclusion of intelligent planning algorithms that provide a powerful adjunct to the planning skills of commodity distribution planners.

Spatially explicit multi-criteria decision analysis for managing vector-borne diseases

PubMed Central

2011-01-01

The complex epidemiology of vector-borne diseases creates significant challenges in the design and delivery of prevention and control strategies, especially in light of rapid social and environmental changes. Spatial models for predicting disease risk based on environmental factors such as climate and landscape have been developed for a number of important vector-borne diseases. The resulting risk maps have proven value for highlighting areas for targeting public health programs. However, these methods generally only offer technical information on the spatial distribution of disease risk itself, which may be incomplete for making decisions in a complex situation. In prioritizing surveillance and intervention strategies, decision-makers often also need to consider spatially explicit information on other important dimensions, such as the regional specificity of public acceptance, population vulnerability, resource availability, intervention effectiveness, and land use. There is a need for a unified strategy for supporting public health decision making that integrates available data for assessing spatially explicit disease risk, with other criteria, to implement effective prevention and control strategies. Multi-criteria decision analysis (MCDA) is a decision support tool that allows for the consideration of diverse quantitative and qualitative criteria using both data-driven and qualitative indicators for evaluating alternative strategies with transparency and stakeholder participation. Here we propose a MCDA-based approach to the development of geospatial models and spatially explicit decision support tools for the management of vector-borne diseases. We describe the conceptual framework that MCDA offers as well as technical considerations, approaches to implementation and expected outcomes. We conclude that MCDA is a powerful tool that offers tremendous potential for use in public health decision-making in general and vector-borne disease management in particular. PMID:22206355

Lessons learned from implementing service-oriented clinical decision support at four sites: A qualitative study.

PubMed

Wright, Adam; Sittig, Dean F; Ash, Joan S; Erickson, Jessica L; Hickman, Trang T; Paterno, Marilyn; Gebhardt, Eric; McMullen, Carmit; Tsurikova, Ruslana; Dixon, Brian E; Fraser, Greg; Simonaitis, Linas; Sonnenberg, Frank A; Middleton, Blackford

2015-11-01

To identify challenges, lessons learned and best practices for service-oriented clinical decision support, based on the results of the Clinical Decision Support Consortium, a multi-site study which developed, implemented and evaluated clinical decision support services in a diverse range of electronic health records. Ethnographic investigation using the rapid assessment process, a procedure for agile qualitative data collection and analysis, including clinical observation, system demonstrations and analysis and 91 interviews. We identified challenges and lessons learned in eight dimensions: (1) hardware and software computing infrastructure, (2) clinical content, (3) human-computer interface, (4) people, (5) workflow and communication, (6) internal organizational policies, procedures, environment and culture, (7) external rules, regulations, and pressures and (8) system measurement and monitoring. Key challenges included performance issues (particularly related to data retrieval), differences in terminologies used across sites, workflow variability and the need for a legal framework. Based on the challenges and lessons learned, we identified eight best practices for developers and implementers of service-oriented clinical decision support: (1) optimize performance, or make asynchronous calls, (2) be liberal in what you accept (particularly for terminology), (3) foster clinical transparency, (4) develop a legal framework, (5) support a flexible front-end, (6) dedicate human resources, (7) support peer-to-peer communication, (8) improve standards. The Clinical Decision Support Consortium successfully developed a clinical decision support service and implemented it in four different electronic health records and four diverse clinical sites; however, the process was arduous. The lessons identified by the Consortium may be useful for other developers and implementers of clinical decision support services. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A web-based spatial decision support system for spatial planning and governance in the Guangdong Province

NASA Astrophysics Data System (ADS)

Wu, Qitao; Zhang, Hong-ou; Chen, Fengui; Dou, Jie

2008-10-01

After three decades' rapid economic development, Guangdong province faces to thorny problems related to pollution, resource shortage and environmental deterioration. What is worse, the future accelerated development, urbanization and industrialization also comes at the cost of regional imbalance with economic gaps growing and the quality of life in different regions degrading. Development and Reform Commission of Guangdong Province (GDDRC) started a spatial planning project under the national frame in 2007. The prospective project is expected to enhance the equality of different regions and balance the economic development with environmental protection and improved sustainability. This manuscript presents the results of scientific research aiming to develop a Spatial Decision Support System (SDSS) for this spatial planning project. The system composes four modules include the User interface module (UIM), Spatial Analyze module (SAM), Database management module (DMM) and Help module (HM) base on ArcInfo, JSP/Servlet, JavaScript, MapServer, Visual C++ and Visual Basic technologies. The web-based SDSS provides a user-friendly tool for local decision makers, regional planners and other stakeholders in understanding and visualizing the different territorial dimensions of economic development against sustainable environmental and exhausted resources, and in defining, comparing and prioritizing specific territorially-based actions in order to prevent non-sustainable development and implement relevant politics.

Rapid Benefit Indicator (RBI) Checklist Tool - Quick Start Manual

EPA Science Inventory

The Rapid Benefits Indicators (RBI) approach consists of five steps and is outlined in Assessing the Benefits of Wetland Restoration – A Rapid Benefits Indicators Approach for Decision Makers. This checklist tool is intended to be used to record information as you answer the ques...

An Integrated Decision Support System for Water Quality Management of Songhua River Basin

NASA Astrophysics Data System (ADS)

Zhang, Haiping; Yin, Qiuxiao; Chen, Ling

2010-11-01

In the Songhua River Basin of China, many water resource and water environment conflicts interact. A Decision Support System (DSS) for the water quality management has been established for the Basin. The System is featured by the incorporation of a numerical water quality model system into a conventional water quality management system which usually consists of geographic information system (GIS), WebGIS technology, database system and network technology. The model system is built based on DHI MIKE software comprising of a basin rainfall-runoff module, a basin pollution load evaluation module, a river hydrodynamic module and a river water quality module. The DSS provides a friendly graphical user interface that enables the rapid and transparent calculation of various water quality management scenarios, and also enables the convenient access and interpretation of the modeling results to assist the decision-making.

Salience driven value integration explains decision biases and preference reversal

PubMed Central

Tsetsos, Konstantinos; Chater, Nick; Usher, Marius

2012-01-01

Human choice behavior exhibits many paradoxical and challenging patterns. Traditional explanations focus on how values are represented, but little is known about how values are integrated. Here we outline a psychophysical task for value integration that can be used as a window on high-level, multiattribute decisions. Participants choose between alternative rapidly presented streams of numerical values. By controlling the temporal distribution of the values, we demonstrate that this process underlies many puzzling choice paradoxes, such as temporal, risk, and framing biases, as well as preference reversals. These phenomena can be explained by a simple mechanism based on the integration of values, weighted by their salience. The salience of a sampled value depends on its temporal order and momentary rank in the decision context, whereas the direction of the weighting is determined by the task framing. We show that many known choice anomalies may arise from the microstructure of the value integration process. PMID:22635271

Chemical alternatives assessment: the case of flame retardants.

PubMed

Howard, Gregory J

2014-12-01

Decisions on chemical substitution are made rapidly and by many stakeholders; these decisions may have a direct impact on consumer exposures, and, when a hazard exists, to consumer risks. Flame retardants (FRs) represent particular challenges, including very high production volumes, designed-in persistence, and often direct consumer exposure. Newer FR products, as with other industrial chemicals, typically lack data on hazard and exposure, and in many cases even basic information on structure and use in products is unknown. Chemical alternatives assessment (CAA) provides a hazard-focused approach to distinguishing between possible substitutions; variations on this process are used by several government and numerous corporate entities. By grouping chemicals according to functional use, some information on exposure potential can be inferred, allowing for decisions based on those hazard properties that are most distinguishing. This approach can help prevent the "regrettable substitution" of one chemical with another of equal, or even higher, risk. Copyright © 2014 Elsevier Ltd. All rights reserved.

Prostate specific antigen velocity as a measure of the natural history of prostate cancer: defining a 'rapid riser' subset.

PubMed

Nam, R K; Klotz, L H; Jewett, M A; Danjoux, C; Trachtenberg, J

1998-01-01

To study the rate of change in prostate specific antigen (PSA velocity) in patients with prostate cancer initially managed by 'watchful waiting'. Serial PSA levels were determined in 141 patients with prostate cancer confirmed by biopsy, who were initially managed expectantly and enrolled between May 1990 and December 1995. Sixty-seven patients eventually underwent surgery (mean age 59 years) because they chose it (the decision for surgery was not based on PSA velocity). A cohort of 74 patients remained on 'watchful waiting' (mean age 69 years). Linear regression and logarithmic transformations were used to segregate those patients who showed a rapid rise, defined as a > 50% rise in PSA per year (or a doubling time of < 2 years) and designated 'rapid risers'. An initial analysis based on a minimum of two PSA values showed that 31% were rapid risers. Only 15% of patients with more than three serial PSA determinations over > or = 6 months showed a rapid rise in PSA level. There was no advantage of log-linear analysis over linear regression models. Three serial PSA determinations over > or = 6 months in patients with clinically localized prostate cancer identifies a subset (15%) of patients with a rapidly rising PSA level. Shorter PSA surveillance with fewer PSA values may falsely identify patients with rapid rises in PSA level. However, further follow-up is required to determine if a rapid rise in PSA level identifies a subset of patients with an aggressive biological phenotype who are either still curable or who have already progressed to incurability through metastatic disease.

The appropriateness of, and compliance with, telephone triage decisions: a systematic review and narrative synthesis.

PubMed

Blank, Lindsay; Coster, Joanne; O'Cathain, Alicia; Knowles, Emma; Tosh, Jonathan; Turner, Janette; Nicholl, Jon

2012-12-01

This paper is a report of the synthesis of evidence on the appropriateness of, and compliance with, telephone triage decisions. Telephone triage plays an important role in managing demand for health care. Important questions are whether triage decisions are appropriate and patients comply with them. CINAHL, Cochrane Clinical Trials Database, Medline, Embase, Web of Science, and Psyc Info were searched between 1980-June 2010. Rapid Evidence Synthesis. The principles of rapid evidence assessment were followed. We identified 54 relevant papers: 26 papers reported appropriateness of triage decision, 26 papers reported compliance with triage decision, and 2 papers reported both. Nurses triaged calls in most of the studies (n=49). Triage decisions rated as appropriate varied between 44-98% and compliance ranged from 56-98%. Variation could not be explained by type of service or method of assessing appropriateness. However, inconsistent definitions of appropriateness may explain some variation. Triage decisions to contact primary care may have lower compliance than decisions to contact emergency services or self care. Telephone triage services can offer appropriate decisions and decisions that callers comply with. However, the association between the appropriateness of a decision and subsequent compliance requires further investigation and further consideration needs to be given to the minority of calls which are inappropriately managed. We suggest that a definition of appropriateness incorporating both accuracy and adequacy of triage decision should be encouraged. © 2012 Blackwell Publishing Ltd.

Developing a rapid-response program for health system decision-makers in Canada: findings from an issue brief and stakeholder dialogue.

PubMed

Wilson, Michael G; Lavis, John N; Gauvin, Francois-Pierre

2015-03-11

There is currently no mechanism in place outside of government to provide rapid syntheses of the best available research evidence about problems, options and/or implementation considerations related to a specific health system challenge that Canadian health system decision-makers need to address in a timely manner. A 'rapid-response' program could address this gap by providing access to optimally packaged, relevant and high-quality research evidence over short periods of time (i.e. days or weeks). We prepared an issue brief that describes the best available research evidence related to the problem, three broad features of a program that addresses the problem and implementation considerations. We identified systematic reviews by searching for organization-targeted implementation strategies in Health Systems Evidence ( www.healthsystemsevidence.org ) and drew on an existing analytical framework for how knowledge-brokering organizations can organize themselves to operationalize the program features. The issue brief was then used to inform a half-day stakeholder dialogue about whether and how to develop a rapid-response program for health system decision-makers in Canada. We thematically synthesized the deliberations. We found very few relevant systematic reviews but used frameworks and examples from existing programs to 1) outline key considerations for organizing a rapid-response program,, 2) determine what can be done in timelines ranging from 3 to 10 and 30 business days, and 3) define success and measure it. The 11 dialogue participants from across Canada largely agreed with the content presented in the brief, but noted two key challenges to consider: securing stable, long-term funding and finding a way to effectively and equitably manage the expected demand. Recommendations and suggestions for next steps from dialogue participants included taking an 'organic' approach to developing a pan-Canadian network and including jurisdictional scans as a type of product to deliver through the program (rather than only syntheses of research evidence). Dialogue participants clearly signalled that there is an appetite for a rapid-response program for health system decision-makers in Canada. To 'organically' build such a program, we are currently engaging in efforts to build partnerships and secure funding to support the creation of a pan-Canadian network for conducting rapid syntheses for health system decision-makers in Canada.

AppBuilder for DSSTools; an application development environment for developing decision support systems in Prolog

Treesearch

Geneho Kim; Donald Nute; H. Michael Rauscher; David L. Loftis

2000-01-01

A programming environment for developing complex decision support systems (DSSs) should support rapid prototyping and modular design, feature a flexible knowledge representation scheme and sound inference mechanisms, provide project management, and be domain independent. We have previously developed DSSTools (Decision Support System Tools), a reusable, domain-...

The Role of Low-Spatial Frequencies in Lexical Decision and Masked Priming

ERIC Educational Resources Information Center

Boden, C.; Giaschi, D.

2009-01-01

Spatial frequency filtering was used to test the hypotheses that low-spatial frequency information in printed text can: (1) lead to a rapid lexical decision or (2) facilitate word recognition. Adult proficient readers made lexical decisions in unprimed and masked repetition priming experiments with unfiltered, low-pass, high-pass and notch…

A Rapid Diagnostic Technique to Discriminate between Two Pests of Palms, Brontispa longissima and Octodonta nipae (Coleoptera: Chrysomelidae), for Quarantine Applications.

PubMed

Zhang, X; Tang, B; Hou, Y

2015-02-01

Octodonta nipae (Maulik) is morphologically and biologically similar to Brontispa longissima (Gestro), one of the most damaging pests of coconut. The two species share several palm hosts and produce similar symptoms. They are easily confused when they invade a new area, and without professional taxonomic expertise accurate identification is arduous and time-consuming. Thus, a method of rapidly distinguishing these two invasive insects rapidly is critical for quarantine. Based on the first internal transcribed spacer and the mitochondrial cytochrome oxidase I gene, two pairs of special primers and corresponding polymerase chain reaction processes have been developed to enhance a single objective band only from the O. nipae DNA template. This will quickly discriminate between these two species. The present results provide a rapid method of distinguishing O. nipae from B. longissima to help avoid misidentification, and furthermore, to facilitate rapid and appropriate quarantine decisions and effective treatments to the pest. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Electronic health records (EHRs): supporting ASCO's vision of cancer care.

PubMed

Yu, Peter; Artz, David; Warner, Jeremy

2014-01-01

ASCO's vision for cancer care in 2030 is built on the expanding importance of panomics and big data, and envisions enabling better health for patients with cancer by the rapid transformation of systems biology knowledge into cancer care advances. This vision will be heavily dependent on the use of health information technology for computational biology and clinical decision support systems (CDSS). Computational biology will allow us to construct models of cancer biology that encompass the complexity of cancer panomics data and provide us with better understanding of the mechanisms governing cancer behavior. The Agency for Healthcare Research and Quality promotes CDSS based on clinical practice guidelines, which are knowledge bases that grow too slowly to match the rate of panomic-derived knowledge. CDSS that are based on systems biology models will be more easily adaptable to rapid advancements and translational medicine. We describe the characteristics of health data representation, a model for representing molecular data that supports data extraction and use for panomic-based clinical research, and argue for CDSS that are based on systems biology and are algorithm-based.

Software for rapid prototyping in the pharmaceutical and biotechnology industries.

PubMed

Kappler, Michael A

2008-05-01

The automation of drug discovery methods continues to develop, especially techniques that process information, represent workflow and facilitate decision-making. The magnitude of data and the plethora of questions in pharmaceutical and biotechnology research give rise to the need for rapid prototyping software. This review describes the advantages and disadvantages of three solutions: Competitive Workflow, Taverna and Pipeline Pilot. Each of these systems processes large amounts of data, integrates diverse systems and assists novice programmers and human experts in critical decision-making steps.

Efficacy of an evidence-based clinical decision support in primary care practices: a randomized clinical trial.

PubMed

McGinn, Thomas G; McCullagh, Lauren; Kannry, Joseph; Knaus, Megan; Sofianou, Anastasia; Wisnivesky, Juan P; Mann, Devin M

2013-09-23

There is consensus that incorporating clinical decision support into electronic health records will improve quality of care, contain costs, and reduce overtreatment, but this potential has yet to be demonstrated in clinical trials. To assess the influence of a customized evidence-based clinical decision support tool on the management of respiratory tract infections and on the effectiveness of integrating evidence at the point of care. In a randomized clinical trial, we implemented 2 well-validated integrated clinical prediction rules, namely, the Walsh rule for streptococcal pharyngitis and the Heckerling rule for pneumonia. INTERVENTIONS AND MAIN OUTCOMES AND MEASURES: The intervention group had access to the integrated clinical prediction rule tool and chose whether to complete risk score calculators, order medications, and generate progress notes to assist with complex decision making at the point of care. The intervention group completed the integrated clinical prediction rule tool in 57.5% of visits. Providers in the intervention group were significantly less likely to order antibiotics than the control group (age-adjusted relative risk, 0.74; 95% CI, 0.60-0.92). The absolute risk of the intervention was 9.2%, and the number needed to treat was 10.8. The intervention group was significantly less likely to order rapid streptococcal tests compared with the control group (relative risk, 0.75; 95% CI, 0.58-0.97; P= .03). The integrated clinical prediction rule process for integrating complex evidence-based clinical decision report tools is of relevant importance for national initiatives, such as Meaningful Use. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01386047.

A dynamic model of reasoning and memory.

PubMed

Hawkins, Guy E; Hayes, Brett K; Heit, Evan

2016-02-01

Previous models of category-based induction have neglected how the process of induction unfolds over time. We conceive of induction as a dynamic process and provide the first fine-grained examination of the distribution of response times observed in inductive reasoning. We used these data to develop and empirically test the first major quantitative modeling scheme that simultaneously accounts for inductive decisions and their time course. The model assumes that knowledge of similarity relations among novel test probes and items stored in memory drive an accumulation-to-bound sequential sampling process: Test probes with high similarity to studied exemplars are more likely to trigger a generalization response, and more rapidly, than items with low exemplar similarity. We contrast data and model predictions for inductive decisions with a recognition memory task using a common stimulus set. Hierarchical Bayesian analyses across 2 experiments demonstrated that inductive reasoning and recognition memory primarily differ in the threshold to trigger a decision: Observers required less evidence to make a property generalization judgment (induction) than an identity statement about a previously studied item (recognition). Experiment 1 and a condition emphasizing decision speed in Experiment 2 also found evidence that inductive decisions use lower quality similarity-based information than recognition. The findings suggest that induction might represent a less cautious form of recognition. We conclude that sequential sampling models grounded in exemplar-based similarity, combined with hierarchical Bayesian analysis, provide a more fine-grained and informative analysis of the processes involved in inductive reasoning than is possible solely through examination of choice data. PsycINFO Database Record (c) 2016 APA, all rights reserved.

The Restoration Rapid Assessment Tool: An Access/Visual Basic application

USGS Publications Warehouse

Hiebert, Ron; Larson, D.L.; Thomas, K.; Tancreto, N.; Haines, D.; Richey, A.; Dow, T.; Drees, L.

2009-01-01

Managers of parks and natural areas are increasingly faced with difficult decisions concerning restoration of disturbed lands. Financial and workforce resources often limit these restoration efforts, and rarely can a manager afford to address all concerns within the region of interest. With limited resources, managers and scientists have to decide which areas will be targeted for restoration and the restoration treatments to use in these areas. A broad range of approaches are used to make such decisions, from well-researched expert opinions (Cipollini et al. 2005) to gut feeling, with variable degrees of input from site visits, data collection, and data analysis used to support the decision. A standardized approach including an analytical assessment of site characteristics based on the best information available, with a written or electronic record of all the steps taken along the way, would make comparisons among a group of sites easier and lend credibility through use of common, documented criteria at all sites. In response to these concerns, we have developed the Restoration Rapid Assessment Tool (RRAT). RRAT is based on field observations of key indicators of site degradation, stressors influencing the site, value of the site with respect to larger management objectives, likelihood of achieving the management goals, and logistical constraints to restoration. The purpose of RRAT is not to make restoration decisions or prescribe methods, but rather to ensure that a basic set of pertinent issues are considered for each site and to facilitate comparisons among sites. Several concepts have been central to the development of RRAT. First, the management goal (also known as desired future condition) of any site under evaluation should be defined before the field evaluation begins. Second, the evaluation should be based upon readily observable indicators so as to avoid cumbersome field methods. Third, the ease with which site stressors can be ameliorated must be factored into the evaluation. Fourth, intrinsic site value must be assessed independently of current condition. Finally, logistical considerations must also be addressed. Our initial focus has been on riparian areas because they are among the most heavily impacted habitat types, and RRAT indicators reflect this focus.

Energy-Aware Computation Offloading of IoT Sensors in Cloudlet-Based Mobile Edge Computing.

PubMed

Ma, Xiao; Lin, Chuang; Zhang, Han; Liu, Jianwei

2018-06-15

Mobile edge computing is proposed as a promising computing paradigm to relieve the excessive burden of data centers and mobile networks, which is induced by the rapid growth of Internet of Things (IoT). This work introduces the cloud-assisted multi-cloudlet framework to provision scalable services in cloudlet-based mobile edge computing. Due to the constrained computation resources of cloudlets and limited communication resources of wireless access points (APs), IoT sensors with identical computation offloading decisions interact with each other. To optimize the processing delay and energy consumption of computation tasks, theoretic analysis of the computation offloading decision problem of IoT sensors is presented in this paper. In more detail, the computation offloading decision problem of IoT sensors is formulated as a computation offloading game and the condition of Nash equilibrium is derived by introducing the tool of a potential game. By exploiting the finite improvement property of the game, the Computation Offloading Decision (COD) algorithm is designed to provide decentralized computation offloading strategies for IoT sensors. Simulation results demonstrate that the COD algorithm can significantly reduce the system cost compared with the random-selection algorithm and the cloud-first algorithm. Furthermore, the COD algorithm can scale well with increasing IoT sensors.

Fatigue modulates dopamine availability and promotes flexible choice reversals during decision making.

PubMed

Iodice, Pierpaolo; Ferrante, Claudio; Brunetti, Luigi; Cabib, Simona; Protasi, Feliciano; Walton, Mark E; Pezzulo, Giovanni

2017-04-03

During decisions, animals balance goal achievement and effort management. Despite physical exercise and fatigue significantly affecting the levels of effort that an animal exerts to obtain a reward, their role in effort-based choice and the underlying neurochemistry are incompletely known. In particular, it is unclear whether fatigue influences decision (cost-benefit) strategies flexibly or only post-decision action execution and learning. To answer this question, we trained mice on a T-maze task in which they chose between a high-cost, high-reward arm (HR), which included a barrier, and a low-cost, low-reward arm (LR), with no barrier. The animals were parametrically fatigued immediately before the behavioural tasks by running on a treadmill. We report a sharp choice reversal, from the HR to LR arm, at 80% of their peak workload (PW), which was temporary and specific, as the mice returned to choose the HC when the animals were successively tested at 60% PW or in a two-barrier task. These rapid reversals are signatures of flexible choice. We also observed increased subcortical dopamine levels in fatigued mice: a marker of individual bias to use model-based control in humans. Our results indicate that fatigue levels can be incorporated in flexible cost-benefits computations that improve foraging efficiency.

A multiobjective decision support/numerical modeling approach for design and evaluation of shallow landfill burial systems

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

Ascough, II, James Clifford

1992-05-01

The capability to objectively evaluate design performance of shallow landfill burial (SLB) systems is of great interest to diverse scientific disciplines, including hydrologists, engineers, environmental scientists, and SLB regulators. The goal of this work was to develop and validate a procedure for the nonsubjective evaluation of SLB designs under actual or simulated environmental conditions. A multiobjective decision module (MDM) based on scoring functions (Wymore, 1988) was implemented to evaluate SLB design performance. Input values to the MDM are provided by hydrologic models. The MDM assigns a total score to each SLB design alternative, thereby allowing for rapid and repeatable designmore » performance evaluation. The MDM was validated for a wide range of SLB designs under different climatic conditions. Rigorous assessment of SLB performance also requires incorporation of hydrologic probabilistic analysis and hydrologic risk into the overall design. This was accomplished through the development of a frequency analysis module. The frequency analysis module allows SLB design event magnitudes to be calculated based on the hydrologic return period. The multiobjective decision and freqeuncy anslysis modules were integrated in a decision support system (DSS) framework, SLEUTH (Shallow Landfill Evaluation Using Transport and Hydrology). SLEUTH is a Microsoft Windows {trademark} application, and is written in the Knowledge Pro Windows (Knowledge Garden, Inc., 1991) development language.« less

The integrated information architecture: a pilot study approach to leveraging logistics management with regard to influenza preparedness.

PubMed

Lin, Chinho; Lin, Chun-Mei; Yen, David C; Wu, Wu-Han

2012-02-01

Pandemic influenza is considered catastrophic to global health, with severe economic and social effects. Consequently, a strategy for the rapid deployment of essential medical supplies used for the prevention of influenza transmission and to alleviate public panic caused by the expected shortage of such supplies needs to be developed. Therefore, we employ integrated information concepts to develop a simulated influenza medical material supply system to facilitate a rapid response to such a crisis. Various scenarios are analyzed to estimate the appropriate inventory policy needed under different pandemic influenza outbreaks, and to establish a mechanism to evaluate the necessary stockpiles of medications and other requirements in the different phases of the pandemic. This study constructed a web-based decision support system framework prototype that displayed transparent data related to medical stockpiles in each district and integrated expert opinion about the best distribution of these supplies in the influenza pandemic scenarios. A data collection system was also designed to gather information through a daily VPN transmitted into one central repository for reporting and distribution purposes. This study provides timely and transparent medical supplies distribution information that can help decision makers to make the appropriate decisions under different pandemic influenza outbreaks, and also attempts to establish a mechanism of evaluating the stockpiles and requirements in the different phases of the pandemic.

The Challenges of Human-Autonomy Teaming

NASA Technical Reports Server (NTRS)

Vera, Alonso

2017-01-01

Machine intelligence is improving rapidly based on advances in big data analytics, deep learning algorithms, networked operations, and continuing exponential growth in computing power (Moores Law). This growth in the power and applicability of increasingly intelligent systems will change the roles humans, shifting them to tasks where adaptive problem solving, reasoning and decision-making is required. This talk will address the challenges involved in engineering autonomous systems that function effectively with humans in aeronautics domains.

Enabling Real-time Water Decision Support Services Using Model as a Service

NASA Astrophysics Data System (ADS)

Zhao, T.; Minsker, B. S.; Lee, J. S.; Salas, F. R.; Maidment, D. R.; David, C. H.

2014-12-01

Through application of computational methods and an integrated information system, data and river modeling services can help researchers and decision makers more rapidly understand river conditions under alternative scenarios. To enable this capability, workflows (i.e., analysis and model steps) are created and published as Web services delivered through an internet browser, including model inputs, a published workflow service, and visualized outputs. The RAPID model, which is a river routing model developed at University of Texas Austin for parallel computation of river discharge, has been implemented as a workflow and published as a Web application. This allows non-technical users to remotely execute the model and visualize results as a service through a simple Web interface. The model service and Web application has been prototyped in the San Antonio and Guadalupe River Basin in Texas, with input from university and agency partners. In the future, optimization model workflows will be developed to link with the RAPID model workflow to provide real-time water allocation decision support services.

A Framework for Modeling Emerging Diseases to Inform Management

PubMed Central

Katz, Rachel A.; Richgels, Katherine L.D.; Walsh, Daniel P.; Grant, Evan H.C.

2017-01-01

The rapid emergence and reemergence of zoonotic diseases requires the ability to rapidly evaluate and implement optimal management decisions. Actions to control or mitigate the effects of emerging pathogens are commonly delayed because of uncertainty in the estimates and the predicted outcomes of the control tactics. The development of models that describe the best-known information regarding the disease system at the early stages of disease emergence is an essential step for optimal decision-making. Models can predict the potential effects of the pathogen, provide guidance for assessing the likelihood of success of different proposed management actions, quantify the uncertainty surrounding the choice of the optimal decision, and highlight critical areas for immediate research. We demonstrate how to develop models that can be used as a part of a decision-making framework to determine the likelihood of success of different management actions given current knowledge. PMID:27983501

A Framework for Modeling Emerging Diseases to Inform Management.

PubMed

Russell, Robin E; Katz, Rachel A; Richgels, Katherine L D; Walsh, Daniel P; Grant, Evan H C

2017-01-01

The rapid emergence and reemergence of zoonotic diseases requires the ability to rapidly evaluate and implement optimal management decisions. Actions to control or mitigate the effects of emerging pathogens are commonly delayed because of uncertainty in the estimates and the predicted outcomes of the control tactics. The development of models that describe the best-known information regarding the disease system at the early stages of disease emergence is an essential step for optimal decision-making. Models can predict the potential effects of the pathogen, provide guidance for assessing the likelihood of success of different proposed management actions, quantify the uncertainty surrounding the choice of the optimal decision, and highlight critical areas for immediate research. We demonstrate how to develop models that can be used as a part of a decision-making framework to determine the likelihood of success of different management actions given current knowledge.

A framework for modeling emerging diseases to inform management

USGS Publications Warehouse

Russell, Robin E.; Katz, Rachel A.; Richgels, Katherine L. D.; Walsh, Daniel P.; Grant, Evan H. Campbell

2017-01-01

The rapid emergence and reemergence of zoonotic diseases requires the ability to rapidly evaluate and implement optimal management decisions. Actions to control or mitigate the effects of emerging pathogens are commonly delayed because of uncertainty in the estimates and the predicted outcomes of the control tactics. The development of models that describe the best-known information regarding the disease system at the early stages of disease emergence is an essential step for optimal decision-making. Models can predict the potential effects of the pathogen, provide guidance for assessing the likelihood of success of different proposed management actions, quantify the uncertainty surrounding the choice of the optimal decision, and highlight critical areas for immediate research. We demonstrate how to develop models that can be used as a part of a decision-making framework to determine the likelihood of success of different management actions given current knowledge.

Assessing the Benefits of Wetland Restoration: A Rapid ...

EPA Pesticide Factsheets

This guide presents the Rapid Benefits Indicators (RBI) Approach, a rapid process for assessing the social benefits of ecosystem restoration. Created for those who conduct, advocate for, or support restoration, the RBI approach consists of five steps: (1) Describe the decision context, (2) Select ecosystem services and describe benefits, (3) Compile benefit indicators, (4) Summarize the indicators, and (5) Use the results in decision making. The RBI Approach can be used for many types of assessments and ecosystems. In this guide, we focus on freshwater wetlands in urbanizing areas, and highlight their particular features and benefits through an example application in the Woonasquatucket River Watershed in Rhode Island, USA. The RBI Approach is a multidimensional and disaggregated method, which compiles information in a systematic way to inform decisions. It may be used as a first step towards monetary valuation or towards a single score, but can be used on its own in many contexts, including: prioritizing sites or projects, deciding which projects to fund, initial screening of projects, assessing who may benefit, or informing people about the benefits of restoration. The rapid benefits indicators (RBI) approach presented in this report is intended to be used by resource managers, watershed groups, or others interested in a rapid approach to assessing the benefits of restoration using non-monetary benefits indicators. The RBI approach provides a way to compile in

A rapid evidence-based service by librarians provided information to answer primary care clinical questions.

PubMed

McGowan, Jessie; Hogg, William; Rader, Tamara; Salzwedel, Doug; Worster, Danielle; Cogo, Elise; Rowan, Margo

2010-03-01

A librarian consultation service was offered to 88 primary care clinicians during office hours. This included a streamlined evidence-based process to answer questions in fewer than 20 min. This included a contact centre accessed through a Web-based platform and using hand-held devices and computers with Web access. Librarians were given technical training in evidence-based medicine, including how to summarise evidence. To describe the process and lessons learned from developing and operating a rapid response librarian consultation service for primary care clinicians. Evaluation included librarian interviews and a clinician exit satisfaction survey. Clinicians were positive about its impact on their clinical practice and decision making. The project revealed some important 'lessons learned' in the clinical use of hand-held devices, knowledge translation and training for clinicians and librarians. The Just-in-Time Librarian Consultation Service showed that it was possible to provide evidence-based answers to clinical questions in 15 min or less. The project overcame a number of barriers using innovative solutions. There are many opportunities to build on this experience for future joint projects of librarians and healthcare providers.

A point of view: why point-of-care places are not free marketplaces.

PubMed

Rambur, B; Mooney, M M

1998-01-01

Current wisdom holds that health care is a business and "as such must abide by market principles." Most nurses are not well enough versed in economic theories to credibly critique health care delivery decisions based on economic theories. The relationship of market principles to health care realities is described in basic terms to encourage nurses to "optimize patient care and influence health care policy." Physicians, who control all access points to the health care system, have enjoyed a 40-year market dominance that is "rapidly being replaced by insurance companies and for-profit investors." Providers' decisions to treat or not to treat are strongly influenced by whether the patient is in a fee-for-service or capitated payment environment.

Disaster Emergency Rapid Assessment Based on Remote Sensing and Background Data

NASA Astrophysics Data System (ADS)

Han, X.; Wu, J.

2018-04-01

The period from starting to the stable conditions is an important stage of disaster development. In addition to collecting and reporting information on disaster situations, remote sensing images by satellites and drones and monitoring results from disaster-stricken areas should be obtained. Fusion of multi-source background data such as population, geography and topography, and remote sensing monitoring information can be used in geographic information system analysis to quickly and objectively assess the disaster information. According to the characteristics of different hazards, the models and methods driven by the rapid assessment of mission requirements are tested and screened. Based on remote sensing images, the features of exposures quickly determine disaster-affected areas and intensity levels, and extract key disaster information about affected hospitals and schools as well as cultivated land and crops, and make decisions after emergency response with visual assessment results.

A secure and efficient password-based user authentication scheme using smart cards for the integrated EPR information system.

PubMed

Lee, Tian-Fu; Chang, I-Pin; Lin, Tsung-Hung; Wang, Ching-Cheng

2013-06-01

The integrated EPR information system supports convenient and rapid e-medicine services. A secure and efficient authentication scheme for the integrated EPR information system provides safeguarding patients' electronic patient records (EPRs) and helps health care workers and medical personnel to rapidly making correct clinical decisions. Recently, Wu et al. proposed an efficient password-based user authentication scheme using smart cards for the integrated EPR information system, and claimed that the proposed scheme could resist various malicious attacks. However, their scheme is still vulnerable to lost smart card and stolen verifier attacks. This investigation discusses these weaknesses and proposes a secure and efficient authentication scheme for the integrated EPR information system as alternative. Compared with related approaches, the proposed scheme not only retains a lower computational cost and does not require verifier tables for storing users' secrets, but also solves the security problems in previous schemes and withstands possible attacks.

Iterative evaluation in a mobile counseling and testing program to reach people of color at risk for HIV--new strategies improve program acceptability, effectiveness, and evaluation capabilities.

PubMed

Spielberg, Freya; Kurth, Ann; Reidy, William; McKnight, Teka; Dikobe, Wame; Wilson, Charles

2011-06-01

This article highlights findings from an evaluation that explored the impact of mobile versus clinic-based testing, rapid versus central-lab based testing, incentives for testing, and the use of a computer counseling program to guide counseling and automate evaluation in a mobile program reaching people of color at risk for HIV. The program's results show that an increased focus on mobile outreach using rapid testing, incentives and health information technology tools may improve program acceptability, quality, productivity and timeliness of reports. This article describes program design decisions based on continuous quality assessment efforts. It also examines the impact of the Computer Assessment and Risk Reduction Education computer tool on HIV testing rates, staff perception of counseling quality, program productivity, and on the timeliness of evaluation reports. The article concludes with a discussion of implications for programmatic responses to the Centers for Disease Control and Prevention's HIV testing recommendations.

ITERATIVE EVALUATION IN A MOBILE COUNSELING AND TESTING PROGRAM TO REACH PEOPLE OF COLOR AT RISK FOR HIV—NEW STRATEGIES IMPROVE PROGRAM ACCEPTABILITY, EFFECTIVENESS, AND EVALUATION CAPABILITIES

PubMed Central

Spielberg, Freya; Kurth, Ann; Reidy, William; McKnight, Teka; Dikobe, Wame; Wilson, Charles

2016-01-01

This article highlights findings from an evaluation that explored the impact of mobile versus clinic-based testing, rapid versus central-lab based testing, incentives for testing, and the use of a computer counseling program to guide counseling and automate evaluation in a mobile program reaching people of color at risk for HIV. The program’s results show that an increased focus on mobile outreach using rapid testing, incentives and health information technology tools may improve program acceptability, quality, productivity and timeliness of reports. This article describes program design decisions based on continuous quality assessment efforts. It also examines the impact of the Computer Assessment and Risk Reduction Education computer tool on HIV testing rates, staff perception of counseling quality, program productivity, and on the timeliness of evaluation reports. The article concludes with a discussion of implications for programmatic responses to the Centers for Disease Control and Prevention’s HIV testing recommendations. PMID:21689041

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

Phillips, Laurence R.; Jordan, Danyelle N.; Bauer, Travis L.

The large number of government and industry activities supporting the Unit of Action (UA), with attendant documents, reports and briefings, can overwhelm decision-makers with an overabundance of information that hampers the ability to make quick decisions often resulting in a form of gridlock. In particular, the large and rapidly increasing amounts of data and data formats stored on UA Advanced Collaborative Environment (ACE) servers has led to the realization that it has become impractical and even impossible to perform manual analysis leading to timely decisions. UA Program Management (PM UA) has recognized the need to implement a Decision Support Systemmore » (DSS) on UA ACE. The objective of this document is to research the commercial Knowledge Discovery and Data Mining (KDDM) market and publish the results in a survey. Furthermore, a ranking mechanism based on UA ACE-specific criteria has been developed and applied to a representative set of commercially available KDDM solutions. In addition, an overview of four R&D areas identified as critical to the implementation of DSS on ACE is provided. Finally, a comprehensive database containing detailed information on surveyed KDDM tools has been developed and is available upon customer request.« less

[Benefit Assessment for Examination and Treatment Methods with Medical Devices of High Hisk: Trade-off between Patient Benefit, Evidence and Access].

PubMed

Mühlbacher, Axel C; Juhnke, Christin

2018-03-01

The lately inured § 137 h SGB V aims to assess the benefit of new examination and treatment methods with medical devices of class IIb and III. In the future, the decision on the reimbursement eligibility will be marked by high requirements in terms of documentation of benefits and harm. The objective of benefit assessment is the operationalization of benefit to patients. A comparative determination of benefit enables rational decision by regulatory authorities. The process of benefit assessment should guarantee transparent decision-making, and the underlying medical and health economic fundamentals should be documented. In principle, benefit assessment can be divided into 3 phases: measuring causal effects of an intervention, assessment of the measured effects and decision on reimbursement based on the aggregation of an overall benefit. To address the peculiarities of medical devices in this process, adaptive study designs, MCDA and adaptive benefit assessment provide a sustainable concept for rapid access by patients to innovative treatments of high quality and safety. © Georg Thieme Verlag KG Stuttgart · New York.

Decision based on big data research for non-small cell lung cancer in medical artificial system in developing country.

PubMed

Wu, Jia; Tan, Yanlin; Chen, Zhigang; Zhao, Ming

2018-06-01

Non-small cell lung cancer (NSCLC) is a high risk cancer and is usually scanned by PET-CT for testing, predicting and then give the treatment methods. However, in the actual hospital system, at least 640 images must be generated for each patient through PET-CT scanning. Especially in developing countries, a huge number of patients in NSCLC are attended by doctors. Artificial system can predict and make decision rapidly. According to explore and research artificial medical system, the selection of artificial observations also can result in low work efficiency for doctors. In this study, data information of 2,789,675 patients in three hospitals in China are collected, compiled, and used as the research basis; these data are obtained through image acquisition and diagnostic parameter machine decision-making method on the basis of the machine diagnosis and medical system design model of adjuvant therapy. By combining image and diagnostic parameters, the machine decision diagnosis auxiliary algorithm is established. Experimental result shows that the accuracy has reached 77% in NSCLC. Copyright © 2018 Elsevier B.V. All rights reserved.

Metacognitive Control of Categorial Neurobehavioral Decision Systems

PubMed Central

Foxall, Gordon R.

2016-01-01

The competing neuro-behavioral decision systems (CNDS) model proposes that the degree to which an individual discounts the future is a function of the relative hyperactivity of an impulsive system based on the limbic and paralimbic brain regions and the relative hypoactivity of an executive system based in prefrontal cortex (PFC). The model depicts the relationship between these categorial systems in terms of the antipodal neurophysiological, behavioral, and decision (cognitive) functions that engender normal and addictive responding. However, a case may be made for construing several components of the impulsive and executive systems depicted in the model as categories (elements) of additional systems that are concerned with the metacognitive control of behavior. Hence, this paper proposes a category-based structure for understanding the effects on behavior of CNDS, which includes not only the impulsive and executive systems of the basic model but a superordinate level of reflective or rational decision-making. Following recent developments in the modeling of cognitive control which contrasts Type 1 (rapid, autonomous, parallel) processing with Type 2 (slower, computationally demanding, sequential) processing, the proposed model incorporates an arena in which the potentially conflicting imperatives of impulsive and executive systems are examined and from which a more appropriate behavioral response than impulsive choice emerges. This configuration suggests a forum in which the interaction of picoeconomic interests, which provide a cognitive dimension for CNDS, can be conceptualized. This proposition is examined in light of the resolution of conflict by means of bundling. PMID:26925004

Exploring Agricultural Livelihood Transitions with an Agent-Based Virtual Laboratory: Global Forces to Local Decision-Making

PubMed Central

Magliocca, Nicholas R.; Brown, Daniel G.; Ellis, Erle C.

2013-01-01

Rural populations are undergoing rapid changes in both their livelihoods and land uses, with associated impacts on ecosystems, global biogeochemistry, and climate change. A primary challenge is, thus, to explain these shifts in terms of the actors and processes operating within a variety of land systems in order to understand how land users might respond locally to future changes in broader-scale environmental and economic conditions. Using ‘induced intensification’ theory as a benchmark, we develop a generalized agent-based model to investigate mechanistic explanations of relationships between agricultural intensity and population density, environmental suitability, and market influence. Land-use and livelihood decisions modeled from basic micro-economic theories generated spatial and temporal patterns of agricultural intensification consistent with predictions of induced intensification theory. Further, agent actions in response to conditions beyond those described by induced intensification theory were explored, revealing that interactions among environmental constraints, population pressure, and market influence may produce transitions to multiple livelihood regimes of varying market integration. The result is new hypotheses that could modify and enrich understanding of the classic relationship between agricultural intensity and population density. The strength of this agent-based model and the experimental results is the generalized form of the decision-making processes underlying land-use and livelihood transitions, creating the prospect of a virtual laboratory for systematically generating hypotheses of how agent decisions and interactions relate to observed land-use and livelihood patterns across diverse land systems. PMID:24039892

Dynamic Excitatory and Inhibitory Gain Modulation Can Produce Flexible, Robust and Optimal Decision-making

PubMed Central

Niyogi, Ritwik K.; Wong-Lin, KongFatt

2013-01-01

Behavioural and neurophysiological studies in primates have increasingly shown the involvement of urgency signals during the temporal integration of sensory evidence in perceptual decision-making. Neuronal correlates of such signals have been found in the parietal cortex, and in separate studies, demonstrated attention-induced gain modulation of both excitatory and inhibitory neurons. Although previous computational models of decision-making have incorporated gain modulation, their abstract forms do not permit an understanding of the contribution of inhibitory gain modulation. Thus, the effects of co-modulating both excitatory and inhibitory neuronal gains on decision-making dynamics and behavioural performance remain unclear. In this work, we incorporate time-dependent co-modulation of the gains of both excitatory and inhibitory neurons into our previous biologically based decision circuit model. We base our computational study in the context of two classic motion-discrimination tasks performed in animals. Our model shows that by simultaneously increasing the gains of both excitatory and inhibitory neurons, a variety of the observed dynamic neuronal firing activities can be replicated. In particular, the model can exhibit winner-take-all decision-making behaviour with higher firing rates and within a significantly more robust model parameter range. It also exhibits short-tailed reaction time distributions even when operating near a dynamical bifurcation point. The model further shows that neuronal gain modulation can compensate for weaker recurrent excitation in a decision neural circuit, and support decision formation and storage. Higher neuronal gain is also suggested in the more cognitively demanding reaction time than in the fixed delay version of the task. Using the exact temporal delays from the animal experiments, fast recruitment of gain co-modulation is shown to maximize reward rate, with a timescale that is surprisingly near the experimentally fitted value. Our work provides insights into the simultaneous and rapid modulation of excitatory and inhibitory neuronal gains, which enables flexible, robust, and optimal decision-making. PMID:23825935

Digital technology and clinical decision making in depression treatment: Current findings and future opportunities.

PubMed

Hallgren, Kevin A; Bauer, Amy M; Atkins, David C

2017-06-01

Clinical decision making encompasses a broad set of processes that contribute to the effectiveness of depression treatments. There is emerging interest in using digital technologies to support effective and efficient clinical decision making. In this paper, we provide "snapshots" of research and current directions on ways that digital technologies can support clinical decision making in depression treatment. Practical facets of clinical decision making are reviewed, then research, design, and implementation opportunities where technology can potentially enhance clinical decision making are outlined. Discussions of these opportunities are organized around three established movements designed to enhance clinical decision making for depression treatment, including measurement-based care, integrated care, and personalized medicine. Research, design, and implementation efforts may support clinical decision making for depression by (1) improving tools to incorporate depression symptom data into existing electronic health record systems, (2) enhancing measurement of treatment fidelity and treatment processes, (3) harnessing smartphone and biosensor data to inform clinical decision making, (4) enhancing tools that support communication and care coordination between patients and providers and within provider teams, and (5) leveraging treatment and outcome data from electronic health record systems to support personalized depression treatment. The current climate of rapid changes in both healthcare and digital technologies facilitates an urgent need for research, design, and implementation of digital technologies that explicitly support clinical decision making. Ensuring that such tools are efficient, effective, and usable in frontline treatment settings will be essential for their success and will require engagement of stakeholders from multiple domains. © 2017 Wiley Periodicals, Inc.

Building the Evidence Base for Decision-making in Cancer Genomic Medicine Using Comparative Effectiveness Research

PubMed Central

Goddard, Katrina A.B.; Knaus, William A.; Whitlock, Evelyn; Lyman, Gary H.; Feigelson, Heather Spencer; Schully, Sheri D.; Ramsey, Scott; Tunis, Sean; Freedman, Andrew N.; Khoury, Muin J.; Veenstra, David L.

2013-01-01

Background The clinical utility is uncertain for many cancer genomic applications. Comparative effectiveness research (CER) can provide evidence to clarify this uncertainty. Objectives To identify approaches to help stakeholders make evidence-based decisions, and to describe potential challenges and opportunities using CER to produce evidence-based guidance. Methods We identified general CER approaches for genomic applications through literature review, the authors’ experiences, and lessons learned from a recent, seven-site CER initiative in cancer genomic medicine. Case studies illustrate the use of CER approaches. Results Evidence generation and synthesis approaches include comparative observational and randomized trials, patient reported outcomes, decision modeling, and economic analysis. We identified significant challenges to conducting CER in cancer genomics: the rapid pace of innovation, the lack of regulation, the limited evidence for clinical utility, and the beliefs that genomic tests could have personal utility without having clinical utility. Opportunities to capitalize on CER methods in cancer genomics include improvements in the conduct of evidence synthesis, stakeholder engagement, increasing the number of comparative studies, and developing approaches to inform clinical guidelines and research prioritization. Conclusions CER offers a variety of methodological approaches to address stakeholders’ needs. Innovative approaches are needed to ensure an effective translation of genomic discoveries. PMID:22516979

Completing the Link between Exposure Science and Toxicology for Improved Environmental Health Decision Making: The Aggregate Exposure Pathway Framework

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

Teeguarden, Justin G.; Tan, Yu-Mei; Edwards, Stephen W.

Driven by major scientific advances in analytical methods, biomonitoring, and computational exposure assessment, and a newly articulated vision for a greater impact in public health, the field of exposure science is undergoing a rapid transition from a field of observation to a field of prediction. Deployment of an organizational and predictive framework for exposure science analogous to the computationally enabled “systems approaches” used in the biological sciences is a necessary step in this evolution. Here we propose the aggregate exposure pathway (AEP) concept as the natural and complementary companion in the exposure sciences to the adverse outcome pathway (AOP) conceptmore » in the toxicological sciences. The AEP framework offers an intuitive approach to successful organization of exposure science data within individual units of prediction common to the field, setting the stage for exposure forecasting. Looking farther ahead, we envision direct linkages between aggregate exposure pathway and adverse outcome pathways, completing the source to outcome continuum and setting the stage for more efficient integration of exposure science and toxicity testing information. Together these frameworks form and inform a decision making framework with the flexibility for risk-based, hazard-based or exposure-based decisions.« less

Science Autonomy in Robotic Exploration

NASA Technical Reports Server (NTRS)

Roush, Ted L.; DeVincenzi, Donald (Technical Monitor)

2001-01-01

Historical mission operations have involved: (1) return of scientific data; (2) evaluation of these data by scientists; (3) recommendations for future mission activity by scientists; (4) commands for these transmitted to the craft; and (5) the activity being undertaken. This cycle is repeated throughout the mission with command opportunities once or twice per day. For a rover, this historical cycle is not amenable to rapid long range traverses or rapid response to any novel or unexpected situations. In addition to real-time response issues, imaging and/or spectroscopic devices can produce tremendous data volumes during a traverse. However, such data volumes can rapidly exceed on-board memory capabilities prior to the ability to transmit it to Earth. Additionally, the necessary communication band-widths are restrictive enough so that only a small portion of these data can actually be returned to Earth. Such scenarios suggest enabling some science decisions to be made on-board the robots. These decisions involve automating various aspects of scientific discovery instead of the electromechanical control, health, and navigation issues associated with robotic operations. The robot retains access to the full data fidelity obtained by its scientific sensors, and is in the best position to implement actions based upon these data. Such an approach would eventually enable the robot to alter observations and assure only the highest quality data is obtained for analysis. Additionally, the robot can begin to understand what is scientifically interesting and implement alternative observing sequences, because the observed data deviate from expectations based upon current theories/models of planetary processes. Such interesting data and/or conclusions can then be prioritized and selectively transmitted to Earth; reducing memory and communications demands. Results of Ames' current work in this area will be presented.

Robotic Exploration: The Role of Science Autonomy

NASA Technical Reports Server (NTRS)

Roush, Ted L.; DeVincenzi, Donald (Technical Monitor)

2001-01-01

Historical mission operations have involved: (1) return of scientific data; (2) evaluation of these data by scientists; (3) recommendations for future mission activity by scientists; (4) commands for these transmitted to the craft; and (5) the activity being, undertaken. This cycle is repeated throughout the mission with command opportunities once or twice per day. For a rover, this historical cycle is not amenable to rapid long range traverses or rapid response to any novel or unexpected situations. In addition to real-time response issues, imaging and/or spectroscopic devices can produce tremendous data volumes during a traverse. However, such data volumes can rapidly exceed on-board memory capabilities prior to the ability to transmit it to Earth. Additionally, the necessary communication band-widths are restrictive enough so that only a small portion of these data can actually be returned to Earth. Such scenarios suggest enabling some science decisions to be made on-board the robots. These decisions involve automating various aspects of scientific discovery instead of the electromechanical control, health, and navigation issues associated with robotic operations. The robot retains access to the full data fidelity obtained by its scientific sensors, and is in the best position to implement actions based upon these data. Such an approach would eventually enable the robot to alter observations and assure only the highest quality data is obtained for analysis. Additionally, the robot can begin to understand what is scientifically interesting and implement alternative observing sequences, because the observed data deviate from expectations based upon current theories/models of planetary processes. Such interesting data and/or conclusions can then be prioritized and selectively transmitted to Earth; reducing memory and communications demands. Results of Ames' current work in this area will be presented.

Temporal Dynamics of Sensorimotor Networks in Effort-Based Cost-Benefit Valuation: Early Emergence and Late Net Value Integration.

PubMed

Harris, Alison; Lim, Seung-Lark

2016-07-06

Although physical effort can impose significant costs on decision-making, when and how effort cost information is incorporated into choice remains contested, reflecting a larger debate over the role of sensorimotor networks in specifying behavior. Serial information processing models, in which motor circuits simply implement the output of cognitive systems, hypothesize that effort cost factors into decisions relatively late, via integration with stimulus values into net (combined) value signals in dorsomedial frontal cortex (dmFC). In contrast, ethology-inspired approaches suggest a more active role for the dorsal sensorimotor stream, with effort cost signals emerging rapidly after stimulus onset. Here we investigated the time course of effort cost integration using event-related potentials in hungry human subjects while they made decisions about expending physical effort for appetitive foods. Consistent with the ethological perspective, we found that effort cost was represented from as early as 100-250 ms after stimulus onset, localized to dorsal sensorimotor regions including middle cingulate, somatosensory, and motor/premotor cortices. However, examining the same data time-locked to motor output revealed net value signals combining stimulus value and effort cost approximately -400 ms before response, originating from sensorimotor areas including dmFC, precuneus, and posterior parietal cortex. Granger causal connectivity analysis of the motor effector signal in the time leading to response showed interactions between these sensorimotor regions and ventrolateral prefrontal cortex, a structure associated with adjusting behavior-response mappings. These results suggest that rapid activation of sensorimotor regions interacts with cognitive valuation systems, producing a net value signal reflecting both physical effort and reward contingencies. Although physical effort imposes a cost on choice, when and how effort cost influences neural correlates of decision-making remains contested. This dispute reflects a larger disagreement between cognitive neuroscience and ethology over the role of sensorimotor systems in behavior: are sensorimotor circuits merely implementing the late-stage output of cognitive systems, or engaged rapidly and interactively from early in decision-making? We find that, although early representation of effort cost is associated with sensorimotor regions, these signals are also integrated with cognitive stimulus value representations in the time leading up to motor response. These data suggest that sensorimotor networks interact dynamically with cognitive systems to guide decision-making, providing a first step toward reconciling differing perspectives on sensorimotor roles in valuation and choice. Copyright © 2016 the authors 0270-6474/16/367167-17$15.00/0.

Psychological model for judicial decision making in emergency or temporary child placement.

PubMed

Ballou, M; Barry, J; Billingham, K; Boorstein, B W; Butler, C; Gershberg, R; Heim, J; Lirianio, D; McGovern, S; Nicastro, S; Romaniello, J; Vazquez-Nuttall, K; White, C

2001-10-01

In emergencies, family court judges must often make rapid decisions, without benefit of thorough information, that have significant impact on people's lives. Action-oriented research was used to develop a model that would bring psychosocial factors to the legal system for the purpose of enhancing the judicial decision-making process in emergency and temporary child placement cases.

Planning applications of remote sensing in Arizona

NASA Technical Reports Server (NTRS)

Clark, R. B.; Mouat, D. A.

1976-01-01

Planners in Arizona have been experiencing the inevitable problems which occur when large areas of rural and remote lands are converted to urban-recreational uses over a relatively short period of time. Among the planning problems in the state are unplanned and illegal subdivisions, surburban sprawl, surface hydrologic problems related to ephemeral stream overflow, rapidly changing land use patterns, large size of administrative units, and lack of land use inventory data upon which to base planning decisions.

Evidence-based prosthodontics: fundamental considerations, limitations, and guidelines.

PubMed

Bidra, Avinash S

2014-01-01

Evidence-based dentistry is rapidly emerging to become an integral part of patient care, dental education, and research. Prosthodontics is a unique dental specialty that encompasses art, philosophy, and science and includes reversible and irreversible treatments. It not only affords good applicability of many principles of evidence-based dentistry but also poses numerous limitations. This article describes the epidemiologic background, fundamental considerations, scrutiny of levels of evidence, limitations, guidelines, and future perspectives of evidence-based prosthodontics. Understanding these principles can aid clinicians in appropriate appraisal of the prosthodontics literature and use the best available evidence for making confident clinical decisions and optimizing patient care. Copyright © 2014 Elsevier Inc. All rights reserved.

Rapid e-Learning Tools Selection Process for Cognitive and Psychomotor Learning Objectives

ERIC Educational Resources Information Center

Ku, David Tawei; Huang, Yung-Hsin

2012-01-01

This study developed a decision making process for the selection of rapid e-learning tools that could match different learning domains. With the development of the Internet, the speed of information updates has become faster than ever. E-learning has rapidly become the mainstream for corporate training and academic instruction. In order to reduce…

Introduction of human papillomavirus (HPV) vaccination into national immunisation schedules in Europe: Results of the VENICE 2007 survey.

PubMed

King, L A; Lévy-Bruhl, D; O'Flanagan, D; Bacci, S; Lopalco, P L; Kudjawu, Y; Salmaso, S

2008-08-14

The European Union Member States are simultaneously considering introducing HPV vaccination into their national immunisation schedules. The Vaccine European New Integrated Collaboration Effort (VENICE) project aims to develop a collaborative European vaccination network. A survey was undertaken to describe the decision status and the decision-making process regarding the potential introduction of human papillomavirus (HPV) vaccination in to their national immunisation schedules. A web-based questionnaire was developed and completed online in 2007 by 28 countries participating in VENICE. As of 31 October 2007,five countries had decided to introduce HPV vaccination into the national immunisation schedule, while another seven had started the decision-making process with a recommendation favouring introduction. Varying target populations were selected by the five countries which had introduced the vaccination. Half of the surveyed countries had undertaken at least one ad hoc study to support the decision-making process. According to an update of the decision-status from January 2008, the number of countries which had made a decision or recommendation changed to 10 and 5 respectively. This survey demonstrates the rapidly evolving nature of HPV vaccine introduction in Europe and the existence of expertise and experience among EU Member States. The VENICE network is capable of following this process and supporting countries in making vaccine introduction decisions. A VENICE collaborative web-space is being developed as a European resource for the decision-making process for vaccine introduction.

Rapid Magnetic Resonance Imaging for Diagnosing Cancer-related Low Back Pain

PubMed Central

Hollingworth, William; Gray, Darryl T; Martin, Brook I; Sullivan, Sean D; Deyo, Richard A; Jarvik, Jeffrey G

2003-01-01

OBJECTIVES This study compared the relative efficiency of lumbar x-ray and rapid magnetic resonance (MR) imaging for diagnosing cancer-related low back pain (LBP) in primary care patients. DESIGN We developed a decision model with Markov state transitions to calculate the cost per case detected and cost per quality-adjusted life year (QALY) of rapid MR imaging. Model parameters were estimated from the medical literature. The costs of x-ray and rapid MR were calculated in an activity-based costing study. SETTING AND PATIENTS A hypothetical cohort of primary care patients with LBP referred for imaging to exclude cancer as the cause of their pain. MAIN RESULTS The rapid MR strategy was more expensive due to higher initial imaging costs and larger numbers of patients requiring conventional MR and biopsy. The overall sensitivity of the rapid MR strategy was higher than that of the x-ray strategy (62% vs 55%). However, because of low pre-imaging prevalence of cancer-related LBP, this generates <1 extra case per 1,000 patients imaged. Therefore, the incremental cost per case detected using rapid MR was high ($213,927). The rapid MR strategy resulted in a small increase in quality-adjusted survival (0.00043 QALYs). The estimated incremental cost per QALY for the rapid MR strategy was $296,176. CONCLUSIONS There is currently not enough evidence to support the routine use of rapid MR to detect cancer as a cause of LBP in primary care patients. PMID:12709099

Using rapid reviews: an example from a study conducted to inform policy-making.

PubMed

O'Leary, Denise F; Casey, Mary; O'Connor, Laserina; Stokes, Diarmuid; Fealy, Gerard M; O'Brien, Denise; Smith, Rita; McNamara, Martin S; Egan, Claire

2017-03-01

A discussion of the potential use of rapid review approaches in nursing and midwifery research which presents a worked example from a study conducted to inform policy decision-making. Rapid reviews, which can be defined as outputs of a knowledge synthesis approach that involves modifying or omitting elements of a systematic review process due to limited time or resources, are becoming increasingly popular in health research. This paper provides guidance on how a rapid review can be undertaken and discusses the strengths and challenges of the approach. Data from a rapid review of the literature undertaken in 2015 is used as a worked example to highlight one method of undertaking a rapid review. Seeking evidence to inform health policy-making or evidence based practice is a process that can be limited by time constraints, making it difficult to conduct comprehensive systematic reviews. Rapid reviews provide a solution as they are a systematic method of synthesizing evidence quickly. There is no single best way to conduct a rapid review but researchers can ensure they are adhering to best practice by being systematic, having subject and methodological expertise on the review team, reporting the details of the approach they took, highlighting the limitations of the approach, engaging in good evidence synthesis and communicating regularly with end users, other team members and experts. © 2016 John Wiley & Sons Ltd.

Displaying contextual information reduces the costs of imperfect decision automation in rapid retasking of ISR assets.

PubMed

Rovira, Ericka; Cross, Austin; Leitch, Evan; Bonaceto, Craig

2014-09-01

The impact of a decision support tool designed to embed contextual mission factors was investigated. Contextual information may enable operators to infer the appropriateness of data underlying the automation's algorithm. Research has shown the costs of imperfect automation are more detrimental than perfectly reliable automation when operators are provided with decision support tools. Operators may trust and rely on the automation more appropriately if they understand the automation's algorithm. The need to develop decision support tools that are understandable to the operator provides the rationale for the current experiment. A total of 17 participants performed a simulated rapid retasking of intelligence, surveillance, and reconnaissance (ISR) assets task with manual, decision automation, or contextual decision automation differing in two levels of task demand: low or high. Automation reliability was set at 80%, resulting in participants experiencing a mixture of reliable and automation failure trials. Dependent variables included ISR coverage and response time of replanning routes. Reliable automation significantly improved ISR coverage when compared with manual performance. Although performance suffered under imperfect automation, contextual decision automation helped to reduce some of the decrements in performance. Contextual information helps overcome the costs of imperfect decision automation. Designers may mitigate some of the performance decrements experienced with imperfect automation by providing operators with interfaces that display contextual information, that is, the state of factors that affect the reliability of the automation's recommendation.

A systematic and critical review of the evolving methods and applications of value of information in academia and practice.

PubMed

Steuten, Lotte; van de Wetering, Gijs; Groothuis-Oudshoorn, Karin; Retèl, Valesca

2013-01-01

This article provides a systematic and critical review of the evolving methods and applications of value of information (VOI) in academia and practice and discusses where future research needs to be directed. Published VOI studies were identified by conducting a computerized search on Scopus and ISI Web of Science from 1980 until December 2011 using pre-specified search terms. Only full-text papers that outlined and discussed VOI methods for medical decision making, and studies that applied VOI and explicitly discussed the results with a view to informing healthcare decision makers, were included. The included papers were divided into methodological and applied papers, based on the aim of the study. A total of 118 papers were included of which 50 % (n = 59) are methodological. A rapidly accumulating literature base on VOI from 1999 onwards for methodological papers and from 2005 onwards for applied papers is observed. Expected value of sample information (EVSI) is the preferred method of VOI to inform decision making regarding specific future studies, but real-life applications of EVSI remain scarce. Methodological challenges to VOI are numerous and include the high computational demands, dealing with non-linear models and interdependency between parameters, estimations of effective time horizons and patient populations, and structural uncertainties. VOI analysis receives increasing attention in both the methodological and the applied literature bases, but challenges to applying VOI in real-life decision making remain. For many technical and methodological challenges to VOI analytic solutions have been proposed in the literature, including leaner methods for VOI. Further research should also focus on the needs of decision makers regarding VOI.

Artificial Intelligence in Autonomous Telescopes

NASA Astrophysics Data System (ADS)

Mahoney, William; Thanjavur, Karun

2011-03-01

Artificial Intelligence (AI) is key to the natural evolution of today's automated telescopes to fully autonomous systems. Based on its rapid development over the past five decades, AI offers numerous, well-tested techniques for knowledge based decision making essential for real-time telescope monitoring and control, with minimal - and eventually no - human intervention. We present three applications of AI developed at CFHT for monitoring instantaneous sky conditions, assessing quality of imaging data, and a prototype for scheduling observations in real-time. Closely complementing the current remote operations at CFHT, we foresee further development of these methods and full integration in the near future.

Coastal livelihood transitions under globalization with implications for trans-ecosystem interactions.

PubMed

Kramer, Daniel B; Stevens, Kara; Williams, Nicholas E; Sistla, Seeta A; Roddy, Adam B; Urquhart, Gerald R

2017-01-01

Anthropogenic threats to natural systems can be exacerbated due to connectivity between marine, freshwater, and terrestrial ecosystems, complicating the already daunting task of governance across the land-sea interface. Globalization, including new access to markets, can change social-ecological, land-sea linkages via livelihood responses and adaptations by local people. As a first step in understanding these trans-ecosystem effects, we examined exit and entry decisions of artisanal fishers and smallholder farmers on the rapidly globalizing Caribbean coast of Nicaragua. We found that exit and entry decisions demonstrated clear temporal and spatial patterns and that these decisions differed by livelihood. In addition to household characteristics, livelihood exit and entry decisions were strongly affected by new access to regional and global markets. The natural resource implications of these livelihood decisions are potentially profound as they provide novel linkages and spatially-explicit feedbacks between terrestrial and marine ecosystems. Our findings support the need for more scientific inquiry in understanding trans-ecosystem tradeoffs due to linked-livelihood transitions as well as the need for a trans-ecosystem approach to natural resource management and development policy in rapidly changing coastal regions.

Multirobot autonomous landmine detection using distributed multisensor information aggregation

NASA Astrophysics Data System (ADS)

Jumadinova, Janyl; Dasgupta, Prithviraj

2012-06-01

We consider the problem of distributed sensor information fusion by multiple autonomous robots within the context of landmine detection. We assume that different landmines can be composed of different types of material and robots are equipped with different types of sensors, while each robot has only one type of landmine detection sensor on it. We introduce a novel technique that uses a market-based information aggregation mechanism called a prediction market. Each robot is provided with a software agent that uses sensory input of the robot and performs calculations of the prediction market technique. The result of the agent's calculations is a 'belief' representing the confidence of the agent in identifying the object as a landmine. The beliefs from different robots are aggregated by the market mechanism and passed on to a decision maker agent. The decision maker agent uses this aggregate belief information about a potential landmine and makes decisions about which other robots should be deployed to its location, so that the landmine can be confirmed rapidly and accurately. Our experimental results show that, for identical data distributions and settings, using our prediction market-based information aggregation technique increases the accuracy of object classification favorably as compared to two other commonly used techniques.

Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas

PubMed Central

2013-01-01

Background In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension—the delivery of patient decision aids on the Internet—is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. Methods An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. Results The updated definition distinguishes Internet-delivery of patient decision aids from online health information and clinical practice guidelines. Theories in cognitive psychology, decision psychology, communication, and education support the value of Internet features for providing interactive information and deliberative support. Dissemination and implementation theories support Internet-delivery for providing the right information (rapidly updated), to the right person (tailored), at the right time (the appropriate point in the decision making process). Additional efforts are needed to integrate the theoretical rationale and empirical evidence from health technology perspectives, such as consumer health informatics, user experience design, and human-computer interaction. Despite Internet usage ranging from 74% to 85% in developed countries and 80% of users searching for health information, it is unknown how many individuals specifically seek patient decision aids on the Internet. Among the 86 randomized controlled trials in the 2011 Cochrane Collaboration’s review of patient decision aids, only four studies focused on Internet-delivery. Given the limited number of published studies, this paper particularly focused on identifying gaps in the empirical evidence base and identifying emerging areas of research. Conclusions As of 2012, the updated theoretical rationale and emerging evidence suggest potential benefits to delivering patient decision aids on the Internet. However, additional research is needed to identify best practices and quality metrics for Internet-based development, evaluation, and dissemination, particularly in the areas of interactivity, multimedia components, socially-generated information, and implementation strategies. PMID:24625064

Rapid Benefit Indicator (RBI) Checklist Tool - Quick Start ...

EPA Pesticide Factsheets

The Rapid Benefits Indicators (RBI) approach consists of five steps and is outlined in Assessing the Benefits of Wetland Restoration – A Rapid Benefits Indicators Approach for Decision Makers. This checklist tool is intended to be used to record information as you answer the questions in that guide. When performing a Rapid Benefits Indicator (RBI) assessment on wetlands restoration site(s) results can be recorded and reviewed using this VBA enabled MS Excel Checklist Tool.

A scalable satellite-based crop yield mapper: Integrating satellites and crop models for field-scale estimation in India

NASA Astrophysics Data System (ADS)

Jain, M.; Singh, B.; Srivastava, A.; Lobell, D. B.

2015-12-01

Food security will be challenged over the upcoming decades due to increased food demand, natural resource degradation, and climate change. In order to identify potential solutions to increase food security in the face of these changes, tools that can rapidly and accurately assess farm productivity are needed. With this aim, we have developed generalizable methods to map crop yields at the field scale using a combination of satellite imagery and crop models, and implement this approach within Google Earth Engine. We use these methods to examine wheat yield trends in Northern India, which provides over 15% of the global wheat supply and where over 80% of farmers rely on wheat as a staple food source. In addition, we identify the extent to which farmers are shifting sow date in response to heat stress, and how well shifting sow date reduces the negative impacts of heat stress on yield. To identify local-level decision-making, we map wheat sow date and yield at a high spatial resolution (30 m) using Landsat satellite imagery from 1980 to the present. This unique dataset allows us to examine sow date decisions at the field scale over 30 years, and by relating these decisions to weather experienced over the same time period, we can identify how farmers learn and adapt cropping decisions based on weather through time.

Improving Adolescent Judgment and Decision Making

PubMed Central

Dansereau, Donald F.; Knight, Danica K.; Flynn, Patrick M.

2013-01-01

Human judgment and decision making (JDM) has substantial room for improvement, especially among adolescents. Increased technological and social complexity “ups the ante” for developing impactful JDM interventions and aids. Current explanatory advances in this field emphasize dual processing models that incorporate both experiential and analytic processing systems. According to these models, judgment and decisions based on the experiential system are rapid and stem from automatic reference to previously stored episodes. Those based on the analytic system are viewed as slower and consciously developed. These models also hypothesize that metacognitive (self-monitoring) activities embedded in the analytic system influence how and when the two systems are used. What is not included in these models is the development of an intersection between the two systems. Because such an intersection is strongly suggested by memory and educational research as the basis of wisdom/expertise, the present paper describes an Integrated Judgment and Decision-Making Model (IJDM) that incorporates this component. Wisdom/expertise is hypothesized to contain a collection of schematic structures that can emerge from the accumulation of similar episodes or repeated analytic practice. As will be argued, in comparisons to dual system models, the addition of this component provides a broader basis for selecting and designing interventions to improve adolescent JDM. Its development also has implications for generally enhancing cognitive interventions by adopting principles from athletic training to create automated, expert behaviors. PMID:24391350

Decision-theoretic approach to data acquisition for transit operations planning

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

Ritchie, S.G.

The most costly element of transportation planning and modeling activities in the past has usually been that of data acquisition. This is even truer today when the unit costs of data collection are increasing rapidly and at the same time budgets are severely limited by continuing policies of fiscal austerity in the public sector. The overall objectives of this research were to improve the decisions and decision-making capabilities of transit operators or planners in short-range transit planning, and to improve the quality and cost-effectiveness of associated route or corridor-level data collection and service monitoring activities. A new approach was presentedmore » for sequentially updating the parameters of both simple and multiple linear regression models with stochastic regressors, and for determining the expected value of sample information and expected net gain of sampling for associated sample designs. A new approach was also presented for estimating and updating (both spatially and temporally) the parameters of multinomial logit discrete choice models, and for determining associated optimal sample designs for attribute-based and choice-based sampling methods. The approach provides an effective framework for addressing the issue of optimal sampling method and sample size, which to date have been largely unresolved. The application of these methodologies and the feasibility of the decision-theoretic approach was illustrated with a hypothetical case study example.« less

Rapid Decision Making on the Fire Ground

DTIC Science & Technology

1988-06-01

Virtually all of the longer decisions are from incidents #30--32, a pumping station fire. This was a unique case in our interviews. First, it took almost...select one. In other words, we found virtually no Instances of the standard laboratory paradigm for decision making: conscious and deliberate...Heidi L. (1985). Eyewitness Memory Enhancement in the Police Interview: Cognitive Retrieval Mnemonics Versus Hypnosis . Journal of Applied Psychology, 70

Climate modeling with decision makers in mind

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

Jones, Andrew; Calvin, Katherine; Lamarque, Jean -Francois

The need for regional- and local-scale climate information is increasing rapidly as decision makers seek to anticipate and manage a variety of context-specific climate risks over the next several decades. Furthermore, global climate models are not developed with these user needs in mind, and they typically operate at resolutions that are too coarse to provide information that could be used to support regional and local decisions.

Climate modeling with decision makers in mind

DOE PAGES

Jones, Andrew; Calvin, Katherine; Lamarque, Jean -Francois

2016-04-27

The need for regional- and local-scale climate information is increasing rapidly as decision makers seek to anticipate and manage a variety of context-specific climate risks over the next several decades. Furthermore, global climate models are not developed with these user needs in mind, and they typically operate at resolutions that are too coarse to provide information that could be used to support regional and local decisions.

Information needs for the rapid response team electronic clinical tool.

PubMed

Barwise, Amelia; Caples, Sean; Jensen, Jeffrey; Pickering, Brian; Herasevich, Vitaly

2017-10-02

Information overload in healthcare is dangerous. It can lead to critical errors and delays. During Rapid Response Team (RRT) activations providers must make decisions quickly to rescue patients from physiological deterioration. In order to understand the clinical data required and how best to present that information in electronic systems we aimed to better assess the data needs of providers on the RRT when they respond to an event. A web based survey to evaluate clinical data requirements was created and distributed to all RRT providers at our institution. Participants were asked to rate the importance of each data item in guiding clinical decisions during a RRT event response. There were 96 surveys completed (24.5% response rate) with fairly even distribution throughout all clinical roles on the RRT. Physiological data including heart rate, respiratory rate, and blood pressure were ranked by more than 80% of responders as being critical information. Resuscitation status was also considered critically useful by more than 85% of providers. There is a limited dataset that is considered important during an RRT. The data is widely available in EMR. The findings from this study could be used to improve user-centered EMR interfaces.

Opinion paper on utility of point-of-care biomarkers in the emergency department pathways decision making.

PubMed

Di Somma, Salvatore; Zampini, Giorgio; Vetrone, Francesco; Soto-Ruiz, Karina M; Magrini, Laura; Cardelli, Patrizia; Ronco, Claudio; Maisel, Alan; Peacock, Frank W

2014-10-01

Overcrowding of the emergency department (ED) is rapidly becoming a global challenge and a major source of concern for emergency physicians. The evaluation of cardiac biomarkers is critical for confirming diagnoses and expediting treatment decisions to reduce overcrowding, however, physicians currently face the dilemma of choosing between slow and accurate central-based laboratory tests, or faster but imprecise assays. With improvements in technology, point-of-care testing (POCT) systems facilitate the efficient and high-throughput evaluation of biomarkers, such as troponin (cTn), brain natriuretic peptide (BNP) and neutrophil gelatinase-associated lipocalin (NGAL). In this context, POCT may help ED physicians to confirm a diagnosis of conditions, such as acute coronary syndrome, heart failure or kidney damage. Compared with classic laboratory methods, the use of cTn, BNP, and NGAL POCT has shown comparable sensitivity, specificity and failure rate, but with the potential to provide prompt and accurate diagnosis, shorten hospital stay, and alleviate the burden on the ED. Despite this potential, the full advantages of rapid delivery results will only be reached if POCT is implemented within hospital standardized procedures and ED staff receive appropriate training.

Rapid Response Risk Assessment in New Project Development

NASA Technical Reports Server (NTRS)

Graber, Robert R.

2010-01-01

A capability for rapidly performing quantitative risk assessments has been developed by JSC Safety and Mission Assurance for use on project design trade studies early in the project life cycle, i.e., concept development through preliminary design phases. A risk assessment tool set has been developed consisting of interactive and integrated software modules that allow a user/project designer to assess the impact of alternative design or programmatic options on the probability of mission success or other risk metrics. The risk and design trade space includes interactive options for selecting parameters and/or metrics for numerous design characteristics including component reliability characteristics, functional redundancy levels, item or system technology readiness levels, and mission event characteristics. This capability is intended for use on any project or system development with a defined mission, and an example project will used for demonstration and descriptive purposes, e.g., landing a robot on the moon. The effects of various alternative design considerations and their impact of these decisions on mission success (or failure) can be measured in real time on a personal computer. This capability provides a high degree of efficiency for quickly providing information in NASA s evolving risk-based decision environment

Artificial Intelligence (AI), Operations Research (OR), and Decision Support Systems (DSS): A conceptual framework

NASA Technical Reports Server (NTRS)

Parnell, Gregory S.; Rowell, William F.; Valusek, John R.

1987-01-01

In recent years there has been increasing interest in applying the computer based problem solving techniques of Artificial Intelligence (AI), Operations Research (OR), and Decision Support Systems (DSS) to analyze extremely complex problems. A conceptual framework is developed for successfully integrating these three techniques. First, the fields of AI, OR, and DSS are defined and the relationships among the three fields are explored. Next, a comprehensive adaptive design methodology for AI and OR modeling within the context of a DSS is described. These observations are made: (1) the solution of extremely complex knowledge problems with ill-defined, changing requirements can benefit greatly from the use of the adaptive design process, (2) the field of DSS provides the focus on the decision making process essential for tailoring solutions to these complex problems, (3) the characteristics of AI, OR, and DSS tools appears to be converging rapidly, and (4) there is a growing need for an interdisciplinary AI/OR/DSS education.

The current state of introduction of HPV vaccination into national immunisation schedules in Europe: results of the VENICE 2008 survey.

PubMed

Lévy-Bruhl, D; Bousquet, V; King, L A; O'Flanagan, D; Bacci, S; Lopalco, P L; Salmaso, S

2009-10-01

Three surveys have been undertaken in European Union (EU) member states since January 2007, within the European Commission funded Vaccine European New Integrated Collaboration Effort (VENICE) project, to monitor the decision status regarding the introduction of human papillomavirus (HPV) vaccination into national immunisation schedules. A web-based questionnaire was developed and completed online by the 28 countries participating in VENICE. According to the last update (31st December 2008), 15 countries have decided to introduce HPV vaccination into their national immunisation schedule, while another six have started the decision-making process with a recommendation favouring introduction. Varying target populations have been selected by the countries which have introduced vaccination. The number of countries which have made a decision or recommendation has increased from 12 to 21 between October 2007 and December 2008. This survey demonstrates the rapidly evolving nature of HPV vaccine introduction in Europe. A further update should be available in the second half of 2009.

System for decision analysis support on complex waste management issues

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

Shropshire, D.E.

1997-10-01

A software system called the Waste Flow Analysis has been developed and applied to complex environmental management processes for the United States Department of Energy (US DOE). The system can evaluate proposed methods of waste retrieval, treatment, storage, transportation, and disposal. Analysts can evaluate various scenarios to see the impacts to waste slows and schedules, costs, and health and safety risks. Decision analysis capabilities have been integrated into the system to help identify preferred alternatives based on a specific objectives may be to maximize the waste moved to final disposition during a given time period, minimize health risks, minimize costs,more » or combinations of objectives. The decision analysis capabilities can support evaluation of large and complex problems rapidly, and under conditions of variable uncertainty. The system is being used to evaluate environmental management strategies to safely disposition wastes in the next ten years and reduce the environmental legacy resulting from nuclear material production over the past forty years.« less

Rapid Development: A Content Analysis Comparison of Literature and Purposive Sampling of AFRL Rapid Reaction Projects

DTIC Science & Technology

2011-12-01

systems engineering technical and technical management processes. Technical Planning, Stakeholders Requirements Development, and Architecture Design were...Stakeholder Requirements Definition, Architecture Design and Technical Planning. A purposive sampling of AFRL rapid development program managers and engineers...emphasize one process over another however Architecture Design , Implementation scored higher among Technical Processes. Decision Analysis, Technical

Toward sensor modular autonomy for persistent land intelligence surveillance and reconnaissance (ISR)

NASA Astrophysics Data System (ADS)

Thomas, Paul A.; Marshall, Gillian; Faulkner, David; Kent, Philip; Page, Scott; Islip, Simon; Oldfield, James; Breckon, Toby P.; Kundegorski, Mikolaj E.; Clark, David J.; Styles, Tim

2016-05-01

Currently, most land Intelligence, Surveillance and Reconnaissance (ISR) assets (e.g. EO/IR cameras) are simply data collectors. Understanding, decision making and sensor control are performed by the human operators, involving high cognitive load. Any automation in the system has traditionally involved bespoke design of centralised systems that are highly specific for the assets/targets/environment under consideration, resulting in complex, non-flexible systems that exhibit poor interoperability. We address a concept of Autonomous Sensor Modules (ASMs) for land ISR, where these modules have the ability to make low-level decisions on their own in order to fulfil a higher-level objective, and plug in, with the minimum of preconfiguration, to a High Level Decision Making Module (HLDMM) through a middleware integration layer. The dual requisites of autonomy and interoperability create challenges around information fusion and asset management in an autonomous hierarchical system, which are addressed in this work. This paper presents the results of a demonstration system, known as Sensing for Asset Protection with Integrated Electronic Networked Technology (SAPIENT), which was shown in realistic base protection scenarios with live sensors and targets. The SAPIENT system performed sensor cueing, intelligent fusion, sensor tasking, target hand-off and compensation for compromised sensors, without human control, and enabled rapid integration of ISR assets at the time of system deployment, rather than at design-time. Potential benefits include rapid interoperability for coalition operations, situation understanding with low operator cognitive burden and autonomous sensor management in heterogenous sensor systems.

Describing care coordination of gynecologic oncology in western healthcare settings: a rapid review.

PubMed

Grant, Sean; Motala, Aneesa; Chrystal, Joya G; Shanman, Roberta; Zuchowski, Jessica; Zephyrin, Laurie; Cordasco, Kristina M

2018-05-23

Caring for women with gynecologic malignancies requires multidisciplinary communication and coordination across multiple providers. This article discusses a rapid review of the literature on characteristics of care coordination for gynecologic malignancies. Five electronic databases (from inception through March 2015) were searched for empirical studies on coordinated care models for female adults with gynecologic malignancies. A single reviewer extracted and synthesized information on how care was coordinated, how care teams made decisions, who performed what tasks, how care teams communicated information to coordinate care, and potential impact of the characteristic on delivering coordinated care. From 26 included studies, predominant characteristics of coordinated care were identified: multidisciplinary teams, patient navigators, scheduled follow-ups, survivorship care plans, and colocated services. Decision-making was best documented for studies that utilized teams that had periodic scheduled meetings with set agendas and consistent procedures. Providers' roles in coordinating care were numerous, reflecting professional backgrounds: oncologists had most authority in making treatment decisions; radiologists and pathologists shared vital biomedical information; and nurses coordinated care and communicated with patients. Communication tools and strategies across studies included having shared medical records, integrated treatment plans, and telephone-based or teleconferencing communication. There was limited information available on the impact of characteristics and accompanying strategies or tools. Several characteristics of care coordination models for gynecologic cancers have been published in the literature. Further investigation is needed to understand the relative effectiveness of these ways to coordinate care.

The Role of Applied Epidemiology Methods in the Disaster Management Cycle

PubMed Central

Heumann, Michael; Perrotta, Dennis; Wolkin, Amy F.; Schnall, Amy H.; Podgornik, Michelle N.; Cruz, Miguel A.; Horney, Jennifer A.; Zane, David; Roisman, Rachel; Greenspan, Joel R.; Thoroughman, Doug; Anderson, Henry A.; Wells, Eden V.; Simms, Erin F.

2014-01-01

Disaster epidemiology (i.e., applied epidemiology in disaster settings) presents a source of reliable and actionable information for decision-makers and stakeholders in the disaster management cycle. However, epidemiological methods have yet to be routinely integrated into disaster response and fully communicated to response leaders. We present a framework consisting of rapid needs assessments, health surveillance, tracking and registries, and epidemiological investigations, including risk factor and health outcome studies and evaluation of interventions, which can be practiced throughout the cycle. Applying each method can result in actionable information for planners and decision-makers responsible for preparedness, response, and recovery. Disaster epidemiology, once integrated into the disaster management cycle, can provide the evidence base to inform and enhance response capability within the public health infrastructure. PMID:25211748

The Role of Public Opinion in Shaping Trajectories of Agricultural Biotechnology.

PubMed

Malyska, Aleksandra; Bolla, Robert; Twardowski, Tomasz

2016-07-01

Science and technology are not autonomous entities and research trajectories are largely influenced by public opinion. The role of political decisions becomes especially evident in light of rapidly developing new breeding techniques (NBTs) and other genome editing methods for crop improvement. Decisions on how those new techniques should be regulated may not be based entirely on scientific rationale, and even if it is decided that crops produced by NBTs do not fall under the umbrella of genetically modified organisms (GMOs), their commercialization is by no means certain at this time. If and when adopted regulations do not comply with the public's perception of risks, policy makers will find themselves under pressure to ban or restrict the use of the respective products. Copyright © 2016 Elsevier Ltd. All rights reserved.

Data acquisition and path selection decision making for an autonomous roving vehicle. [laser pointing control system for vehicle guidance

NASA Technical Reports Server (NTRS)

Shen, C. N.; YERAZUNIS

1979-01-01

The feasibility of using range/pointing angle data such as might be obtained by a laser rangefinder for the purpose of terrain evaluation in the 10-40 meter range on which to base the guidance of an autonomous rover was investigated. The decision procedure of the rapid estimation scheme for the detection of discrete obstacles has been modified to reinforce the detection ability. With the introduction of the logarithmic scanning scheme and obstacle identification scheme, previously developed algorithms are combined to demonstrate the overall performance of the intergrated route designation system using laser rangefinder. In an attempt to cover a greater range, 30 m to 100 mm, the problem estimating gradients in the presence of positioning angle noise at middle range is investigated.

Evidence-based medicine: what has happened in the past 50 years?

PubMed

Mellis, Craig

2015-01-01

Although the phrase 'evidence-based medicine' (EBM) was used for the first time in the medical literature less than 25 years ago, the history of EBM goes back for centuries. What is remarkable is how popular and how globally accepted the EBM movement has become in such a short time. Many famous, past clinicians have played major roles in the disciplines that preceded EBM, particularly 'clinical epidemiology'. It soon became clear to the early EBM champions that 'evidence' was only part of the clinical decision-making process. Consequently, both clinical expertise and the patient's values and preferences were rapidly incorporated into the concept we now know as 'EBM'. The current need for high-quality, easily accessible 'evidence-based summaries' for busy clinicians is now apparent, as traditional EBM requires both considerable time and skill. Consequently, there is a progressive move away from the primary literature (such as randomised controlled trials) to systematic reviews and other 'evidence-based summaries'. The future of EBM will almost certainly involve widespread utilisation of 'clinical (computer)-based decision support systems'. © 2014 The Author. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

GLIMPSE: a rapid decision framework for energy and environmental policy

EPA Science Inventory

Over the coming decades, new energy production technologies and the policies that oversee them will affect human health, the vitality of our ecosystems, and the stability of the global climate. The GLIMPSE decision model framework provides insights about the implications of techn...

The role of low-spatial frequencies in lexical decision and masked priming.

PubMed

Boden, C; Giaschi, D

2009-04-01

Spatial frequency filtering was used to test the hypotheses that low-spatial frequency information in printed text can: (1) lead to a rapid lexical decision or (2) facilitate word recognition. Adult proficient readers made lexical decisions in unprimed and masked repetition priming experiments with unfiltered, low-pass, high-pass and notch filtered letter strings. In the unprimed experiments, a filtered target was presented for 105 or 400 ms followed by a pattern mask. Sensitivity (d') was lowest for the low-pass filtered targets at both durations with a bias towards a 'non-word' response. Sensitivity was higher in the high-pass and notch filter conditions. In the priming experiments, a forward mask was followed by a filtered prime then an unfiltered target. Primed words, but not non-words, were identified faster than unprimed words in both the low-pass and high-pass filtered conditions. These results do not support a unique role for low-spatial frequency information in either facilitating or making rapid lexical decisions.

Rapid Assessment of Ecosystem Service Co-Benefits of Biodiversity Priority Areas in Madagascar

PubMed Central

Andriamaro, Luciano; Cano, Carlos Andres; Grantham, Hedley S.; Hole, David; Juhn, Daniel; McKinnon, Madeleine; Rasolohery, Andriambolantsoa; Steininger, Marc; Wright, Timothy Max

2016-01-01

The importance of ecosystems for supporting human well-being is increasingly recognized by both the conservation and development sectors. Our ability to conserve ecosystems that people rely on is often limited by a lack of spatially explicit data on the location and distribution of ecosystem services (ES), the benefits provided by nature to people. Thus there is a need to map ES to guide conservation investments, to ensure these co-benefits are maintained. To target conservation investments most effectively, ES assessments must be rigorous enough to support conservation planning, rapid enough to respond to decision-making timelines, and often must rely on existing data. We developed a framework for rapid spatial assessment of ES that relies on expert and stakeholder consultation, available data, and spatial analyses in order to rapidly identify sites providing multiple benefits. We applied the framework in Madagascar, a country with globally significant biodiversity and a high level of human dependence on ecosystems. Our objective was to identify the ES co-benefits of biodiversity priority areas in order to guide the investment strategy of a global conservation fund. We assessed key provisioning (fisheries, hunting and non-timber forest products, and water for domestic use, agriculture, and hydropower), regulating (climate mitigation, flood risk reduction and coastal protection), and cultural (nature tourism) ES. We also conducted multi-criteria analyses to identify sites providing multiple benefits. While our approach has limitations, including the reliance on proximity-based indicators for several ES, the results were useful for targeting conservation investments by the Critical Ecosystem Partnership Fund (CEPF). Because our approach relies on available data, standardized methods for linking ES provision to ES use, and expert validation, it has the potential to quickly guide conservation planning and investment decisions in other data-poor regions. PMID:28006005

The Role of Habituation and Sensitization in Understanding the Annoyance of Community Exposures to Impulsive Noise

DTIC Science & Technology

2009-05-15

an orienting re- sponse followed by a defense response at 64 dBA ( impulse ). The 80 dB ERDC/CERL TR-09-14 25 impulses produced by the small firearm...literature, shorter response latencies are generally attributed to a greater degree of arousal. With impulsive sounds repeated in rapid succession...ERDC–CERL, SERDP-funded project focusing on evaluating responses to military noise. The research team’s decision was based on time burden

Strategic Grassland Bird Conservation throughout the Annual Cycle: Linking Policy Alternatives, Landowner Decisions, and Biological Population Outcomes.

PubMed

Drum, Ryan G; Ribic, Christine A; Koch, Katie; Lonsdorf, Eric; Grant, Evan; Ahlering, Marissa; Barnhill, Laurel; Dailey, Thomas; Lor, Socheata; Mueller, Connie; Pavlacky, David C; Rideout, Catherine; Sample, David

2015-01-01

Grassland bird habitat has declined substantially in the United States. Remaining grasslands are increasingly fragmented, mostly privately owned, and vary greatly in terms of habitat quality and protection status. A coordinated strategic response for grassland bird conservation is difficult, largely due to the scope and complexity of the problem, further compounded by biological, sociological, and economic uncertainties. We describe the results from a collaborative Structured Decision Making (SDM) workshop focused on linking social and economic drivers of landscape change to grassland bird population outcomes. We identified and evaluated alternative strategies for grassland bird conservation using a series of rapid prototype models. We modeled change in grassland and agriculture cover in hypothetical landscapes resulting from different landowner decisions in response to alternative socio-economic conservation policy decisions. Resulting changes in land cover at all three stages of the annual cycle (breeding, wintering, and migration) were used to estimate changes in grassland bird populations. Our results suggest that successful grassland bird conservation may depend upon linkages with ecosystem services on working agricultural lands and grassland-based marketing campaigns to engage the public. With further development, spatial models that link landowner decisions with biological outcomes can be essential tools for making conservation policy decisions. A coordinated non-traditional partnership will likely be necessary to clearly understand and systematically respond to the many conservation challenges facing grassland birds.

Strategic Grassland Bird Conservation throughout the Annual Cycle: Linking Policy Alternatives, Landowner Decisions, and Biological Population Outcomes

PubMed Central

Drum, Ryan G.; Ribic, Christine A.; Koch, Katie; Lonsdorf, Eric; Grant, Evan; Ahlering, Marissa; Barnhill, Laurel; Dailey, Thomas; Lor, Socheata; Mueller, Connie; Pavlacky, David C.; Rideout, Catherine; Sample, David

2015-01-01

Grassland bird habitat has declined substantially in the United States. Remaining grasslands are increasingly fragmented, mostly privately owned, and vary greatly in terms of habitat quality and protection status. A coordinated strategic response for grassland bird conservation is difficult, largely due to the scope and complexity of the problem, further compounded by biological, sociological, and economic uncertainties. We describe the results from a collaborative Structured Decision Making (SDM) workshop focused on linking social and economic drivers of landscape change to grassland bird population outcomes. We identified and evaluated alternative strategies for grassland bird conservation using a series of rapid prototype models. We modeled change in grassland and agriculture cover in hypothetical landscapes resulting from different landowner decisions in response to alternative socio-economic conservation policy decisions. Resulting changes in land cover at all three stages of the annual cycle (breeding, wintering, and migration) were used to estimate changes in grassland bird populations. Our results suggest that successful grassland bird conservation may depend upon linkages with ecosystem services on working agricultural lands and grassland-based marketing campaigns to engage the public. With further development, spatial models that link landowner decisions with biological outcomes can be essential tools for making conservation policy decisions. A coordinated non-traditional partnership will likely be necessary to clearly understand and systematically respond to the many conservation challenges facing grassland birds. PMID:26569108

Strategic Grassland Bird Conservation throughout the annual cycle: Linking policy alternatives, landowner decisions, and biological population outcomes

USGS Publications Warehouse

Drum, Ryan G.; Ribic, Christine; Koch, Katie; Lonsdorf, Eric V.; Grant, Edward C.; Ahlering, Marissa; Barnhill, Laurel; Dailey, Thomas; Lor, Socheata; Mueller, Connie; Pavlacky, D.C.; Rideout, Catherine; Sample, David W.

2015-01-01

Grassland bird habitat has declined substantially in the United States. Remaining grasslands are increasingly fragmented, mostly privately owned, and vary greatly in terms of habitat quality and protection status. A coordinated strategic response for grassland bird conservation is difficult, largely due to the scope and complexity of the problem, further compounded by biological, sociological, and economic uncertainties. We describe the results from a collaborative Structured Decision Making (SDM) workshop focused on linking social and economic drivers of landscape change to grassland bird population outcomes. We identified and evaluated alternative strategies for grassland bird conservation using a series of rapid prototype models. We modeled change in grassland and agriculture cover in hypothetical landscapes resulting from different landowner decisions in response to alternative socio-economic conservation policy decisions. Resulting changes in land cover at all three stages of the annual cycle (breeding, wintering, and migration) were used to estimate changes in grassland bird populations. Our results suggest that successful grassland bird conservation may depend upon linkages with ecosystem services on working agricultural lands and grassland-based marketing campaigns to engage the public. With further development, spatial models that link landowner decisions with biological outcomes can be essential tools for making conservation policy decisions. A coordinated non-traditional partnership will likely be necessary to clearly understand and systematically respond to the many conservation challenges facing grassland birds.

A Web-based Tool for Transparent, Collaborative Urban Water System Planning for Monterrey, Mexico

NASA Astrophysics Data System (ADS)

Rheinheimer, D. E.; Medellin-Azuara, J.; Garza Díaz, L. E.; Ramírez, A. I.

2017-12-01

Recent rapid advances in web technologies and cloud computing show great promise for facilitating collaboration and transparency in water planning efforts. Water resources planning is increasingly in the context of a rapidly urbanizing world, particularly in developing countries. In such countries with democratic traditions, the degree of transparency and collaboration in water planning can mean the difference between success and failure of water planning efforts. This is exemplified in the city of Monterrey, Mexico, where an effort to build a new long-distance aqueduct to increase water supply to the city dramatically failed due to lack of transparency and top-down planning. To help address, we used a new, web-based water system modeling platform, called OpenAgua, to develop a prototype decision support system for water planning in Monterrey. OpenAgua is designed to promote transparency and collaboration, as well as provide strong, cloud-based, water system modeling capabilities. We developed and assessed five water management options intended to increase water supply yield and/or reliability, a dominant water management concern in Latin America generally: 1) a new long-distance source (the previously-rejected project), 2) a new nearby reservoir, 3) expansion/re-operation of an existing major canal, 4) desalination, and 5) industrial water reuse. Using the integrated modeling and analytic capabilities of OpenAgua, and some customization, we assessed the performance of these options for water supply yield and reliability to help identify the most promising ones. In presenting this assessment, we demonstrate the viability of using online, cloud-based modeling systems for improving transparency and collaboration in decision making, reducing the gap between citizens, policy makers and water managers, and future directions.

A Rapidly Prototyped Vegetation Dryness Index Evaluated for Wildfire Risk Assessment at Stennis Space Center

NASA Technical Reports Server (NTRS)

Ross, Kenton; Graham, William; Prados, Don; Spruce, Joseph

2007-01-01

MVDI, which effectively involves the differencing of NDMI and NDVI, appears to display increased noise that is consistent with a differencing technique. This effect masks finer variations in vegetation moisture, preventing MVDI from fulfilling the requirement of giving decision makers insight into spatial variation of fire risk. MVDI shows dependencies on land cover and phenology which also argue against its use as a fire risk proxy in an area of diverse and fragmented land covers. The conclusion of the rapid prototyping effort is that MVDI should not be implemented for SSC decision support.

The 9-11 Commission's invitation to imagine: a pathophysiology-based approach to critical care of nuclear explosion victims.

PubMed

Manthous, Constantine A; Jackson, William L

2007-03-01

The successful management of mass casualties arising from detonation of a nuclear device (NDD) would require significant preparation at all levels of the healthcare system. This article briefly outlines previously published models of destruction and casualties, details approaches to on-site triage and medical evacuation, and offers pathophysiology-based suggestions for treatment of the critically injured. Documentation from previous bomb blasts and nuclear accidents is reviewed to assist in forecasting needs of both systems and patients in the event of an NDD in a major metropolitan area. This review extracts data from previously published models of destruction and casualties projected from an NDD, the primary literature detailing observations of patients' pathophysiology following NDDs in Japan and relevant nuclear accidents, and available contemporary resources for first responders and healthcare providers. The blast and radiation exposures that accompany an NDD will significantly affect local and regional public resources. Morbidity and mortality likely to arise in the setting of dose-dependent organ dysfunction may be minimized by rigorous a priori planning/training for field triage decisions, coordination of medical and civil responses to effect rapid responses and medical evacuation routes, radiation-specific interventions, and modern intensive care. Although the responses of emergency and healthcare systems following NDD will vary depending on the exact mechanism, magnitude, and location of the event, dose exposures and individual pathophysiology evolution are reasonably predictable. Triage decisions, resource requirements, and bedside therapeutic plans can be evidence-based and can be developed rapidly with appropriate preparation and planning.

Development of spatial density maps based on geoprocessing web services: application to tuberculosis incidence in Barcelona, Spain.

PubMed

Dominkovics, Pau; Granell, Carlos; Pérez-Navarro, Antoni; Casals, Martí; Orcau, Angels; Caylà, Joan A

2011-11-29

Health professionals and authorities strive to cope with heterogeneous data, services, and statistical models to support decision making on public health. Sophisticated analysis and distributed processing capabilities over geocoded epidemiological data are seen as driving factors to speed up control and decision making in these health risk situations. In this context, recent Web technologies and standards-based web services deployed on geospatial information infrastructures have rapidly become an efficient way to access, share, process, and visualize geocoded health-related information. Data used on this study is based on Tuberculosis (TB) cases registered in Barcelona city during 2009. Residential addresses are geocoded and loaded into a spatial database that acts as a backend database. The web-based application architecture and geoprocessing web services are designed according to the Representational State Transfer (REST) principles. These web processing services produce spatial density maps against the backend database. The results are focused on the use of the proposed web-based application to the analysis of TB cases in Barcelona. The application produces spatial density maps to ease the monitoring and decision making process by health professionals. We also include a discussion of how spatial density maps may be useful for health practitioners in such contexts. In this paper, we developed web-based client application and a set of geoprocessing web services to support specific health-spatial requirements. Spatial density maps of TB incidence were generated to help health professionals in analysis and decision-making tasks. The combined use of geographic information tools, map viewers, and geoprocessing services leads to interesting possibilities in handling health data in a spatial manner. In particular, the use of spatial density maps has been effective to identify the most affected areas and its spatial impact. This study is an attempt to demonstrate how web processing services together with web-based mapping capabilities suit the needs of health practitioners in epidemiological analysis scenarios.

Development of spatial density maps based on geoprocessing web services: application to tuberculosis incidence in Barcelona, Spain

PubMed Central

2011-01-01

Background Health professionals and authorities strive to cope with heterogeneous data, services, and statistical models to support decision making on public health. Sophisticated analysis and distributed processing capabilities over geocoded epidemiological data are seen as driving factors to speed up control and decision making in these health risk situations. In this context, recent Web technologies and standards-based web services deployed on geospatial information infrastructures have rapidly become an efficient way to access, share, process, and visualize geocoded health-related information. Methods Data used on this study is based on Tuberculosis (TB) cases registered in Barcelona city during 2009. Residential addresses are geocoded and loaded into a spatial database that acts as a backend database. The web-based application architecture and geoprocessing web services are designed according to the Representational State Transfer (REST) principles. These web processing services produce spatial density maps against the backend database. Results The results are focused on the use of the proposed web-based application to the analysis of TB cases in Barcelona. The application produces spatial density maps to ease the monitoring and decision making process by health professionals. We also include a discussion of how spatial density maps may be useful for health practitioners in such contexts. Conclusions In this paper, we developed web-based client application and a set of geoprocessing web services to support specific health-spatial requirements. Spatial density maps of TB incidence were generated to help health professionals in analysis and decision-making tasks. The combined use of geographic information tools, map viewers, and geoprocessing services leads to interesting possibilities in handling health data in a spatial manner. In particular, the use of spatial density maps has been effective to identify the most affected areas and its spatial impact. This study is an attempt to demonstrate how web processing services together with web-based mapping capabilities suit the needs of health practitioners in epidemiological analysis scenarios. PMID:22126392

AdaBoost-based algorithm for network intrusion detection.

PubMed

Hu, Weiming; Hu, Wei; Maybank, Steve

2008-04-01

Network intrusion detection aims at distinguishing the attacks on the Internet from normal use of the Internet. It is an indispensable part of the information security system. Due to the variety of network behaviors and the rapid development of attack fashions, it is necessary to develop fast machine-learning-based intrusion detection algorithms with high detection rates and low false-alarm rates. In this correspondence, we propose an intrusion detection algorithm based on the AdaBoost algorithm. In the algorithm, decision stumps are used as weak classifiers. The decision rules are provided for both categorical and continuous features. By combining the weak classifiers for continuous features and the weak classifiers for categorical features into a strong classifier, the relations between these two different types of features are handled naturally, without any forced conversions between continuous and categorical features. Adaptable initial weights and a simple strategy for avoiding overfitting are adopted to improve the performance of the algorithm. Experimental results show that our algorithm has low computational complexity and error rates, as compared with algorithms of higher computational complexity, as tested on the benchmark sample data.

Dynamic and adaptive policy models for coalition operations

NASA Astrophysics Data System (ADS)

Verma, Dinesh; Calo, Seraphin; Chakraborty, Supriyo; Bertino, Elisa; Williams, Chris; Tucker, Jeremy; Rivera, Brian; de Mel, Geeth R.

2017-05-01

It is envisioned that the success of future military operations depends on the better integration, organizationally and operationally, among allies, coalition members, inter-agency partners, and so forth. However, this leads to a challenging and complex environment where the heterogeneity and dynamism in the operating environment intertwines with the evolving situational factors that affect the decision-making life cycle of the war fighter. Therefore, the users in such environments need secure, accessible, and resilient information infrastructures where policy-based mechanisms adopt the behaviours of the systems to meet end user goals. By specifying and enforcing a policy based model and framework for operations and security which accommodates heterogeneous coalitions, high levels of agility can be enabled to allow rapid assembly and restructuring of system and information resources. However, current prevalent policy models (e.g., rule based event-condition-action model and its variants) are not sufficient to deal with the highly dynamic and plausibly non-deterministic nature of these environments. Therefore, to address the above challenges, in this paper, we present a new approach for policies which enables managed systems to take more autonomic decisions regarding their operations.

Academic Decision Making: Faculty Appointments and Reappointments.

ERIC Educational Resources Information Center

Renner, K. Edward

1987-01-01

The rapidly rising costs of the academic salary budget and the lack of flexibility for making new academic appointments or for reallocating resources to new and emerging educational demands are discussed. Personnel decisions made in the Faculty of Arts and Science at Dalhousie University are described. (MLW)

Fifth Dimension Parallel Thinking and Velocity Squared

DTIC Science & Technology

2006-12-20

whether people can make rapid decisions. Regarding time, C.R. Gallistel and Rochel Gelman show that even pigeons can make decisions that require time...Facility may lead to uncharacteristic or illegal behavioral choices, even if these emotions are caused by unrelated incidents. 35 R.J. Gallistel and

A Hybrid-Cloud Science Data System Enabling Advanced Rapid Imaging & Analysis for Monitoring Hazards

NASA Astrophysics Data System (ADS)

Hua, H.; Owen, S. E.; Yun, S.; Lundgren, P.; Moore, A. W.; Fielding, E. J.; Radulescu, C.; Sacco, G.; Stough, T. M.; Mattmann, C. A.; Cervelli, P. F.; Poland, M. P.; Cruz, J.

2012-12-01

Volcanic eruptions, landslides, and levee failures are some examples of hazards that can be more accurately forecasted with sufficient monitoring of precursory ground deformation, such as the high-resolution measurements from GPS and InSAR. In addition, coherence and reflectivity change maps can be used to detect surface change due to lava flows, mudslides, tornadoes, floods, and other natural and man-made disasters. However, it is difficult for many volcano observatories and other monitoring agencies to process GPS and InSAR products in an automated scenario needed for continual monitoring of events. Additionally, numerous interoperability barriers exist in multi-sensor observation data access, preparation, and fusion to create actionable products. Combining high spatial resolution InSAR products with high temporal resolution GPS products--and automating this data preparation & processing across global-scale areas of interests--present an untapped science and monitoring opportunity. The global coverage offered by satellite-based SAR observations, and the rapidly expanding GPS networks, can provide orders of magnitude more data on these hazardous events if we have a data system that can efficiently and effectively analyze the voluminous raw data, and provide users the tools to access data from their regions of interest. Currently, combined GPS & InSAR time series are primarily generated for specific research applications, and are not implemented to run on large-scale continuous data sets and delivered to decision-making communities. We are developing an advanced service-oriented architecture for hazard monitoring leveraging NASA-funded algorithms and data management to enable both science and decision-making communities to monitor areas of interests via seamless data preparation, processing, and distribution. Our objectives: * Enable high-volume and low-latency automatic generation of NASA Solid Earth science data products (InSAR and GPS) to support hazards monitoring. * Facilitate NASA-USGS collaborations to share NASA InSAR and GPS data products, which are difficult to process in high-volume and low-latency, for decision-support. * Enable interoperable discovery, access, and sharing of NASA observations and derived actionable products, and between the observation and decision-making communities. * Enable their improved understanding through visualization, mining, and cross-agency sharing. Existing InSAR & GPS processing packages and other software are integrated for generating geodetic decision support monitoring products. We employ semantic and cloud-based data management and processing techniques for handling large data volumes, reducing end product latency, codifying data system information with semantics, and deploying interoperable services for actionable products to decision-making communities.

Use of online health information to manage children's health care: a prospective study investigating parental decisions.

PubMed

Walsh, Anne M; Hamilton, Kyra; White, Katherine M; Hyde, Melissa K

2015-04-02

The use of the internet to access information is rapidly increasing; however, the quality of health information provided on various online sites is questionable. We aimed to examine the underlying factors that guide parents' decisions to use online information to manage their child's health care, a behaviour which has not yet been explored systematically. Parents (N = 391) completed a questionnaire assessing the standard theory of planned behaviour (TPB) measures of attitude, subjective norm, perceived behavioural control (PBC), and intention as well as the underlying TPB belief-based items (i.e., behavioural, normative, and control beliefs) in addition to a measure of perceived risk and demographic variables. Two months later, consenting parents completed a follow-up telephone questionnaire which assessed the decisions they had made regarding their use of online information to manage their child's health care during the previous 2 months. We found support for the TPB constructs of attitude, subjective norm, and PBC as well as the additional construct of perceived risk in predicting parents' intentions to use online information to manage their child's health care, with further support found for intentions, but not PBC, in predicting parents' behaviour. The results of the TPB belief-based analyses also revealed important information about the critical beliefs that guide parents' decisions to engage in this child health management behaviour. This theory-based investigation to understand parents' motivations and online information-seeking behaviour is key to developing recommendations and policies to guide more appropriate help-seeking actions among parents.

Providing Climate Policy Makers With a Strong Scientific Base (Invited)

NASA Astrophysics Data System (ADS)

Struzik, E.

2009-12-01

Scientists can and should inform public policy decisions in the Arctic. But the pace of climate change in the polar world has been occurring far more quickly than most scientists have been able to predict. This creates problems for decision-makers who recognize that difficult management decisions have to be made in matters pertaining to wildlife management, cultural integrity and economic development. With sea ice melting, glaciers receding, permafrost thawing, forest fires intensifying, and disease and invasive species rapidly moving north, the challenge for scientists to provide climate policy makers with a strong scientific base has been daunting. Clashing as this data sometimes does with the “traditional knowledge” of indigenous peoples in the north, it can also become very political. As a result the need to effectively communicate complex data is more imperative now than ever before. Here, the author describes how the work of scientists can often be misinterpreted or exploited in ways that were not intended. Examples include the inappropriate use of scientific data in decision-making on polar bears, caribou and other wildlife populations; the use of scientific data to debunk the fact that greenhouse gases are driving climate change, and the use of scientific data to position one scientist against another when there is no inherent conflict. This work will highlight the need for climate policy makers to increase support for scientists working in the Arctic, as well as illustrate why it is important to find new and more effective ways of communicating scientific data. Strategies that might be considered by granting agencies, scientists and climate policy decision-makers will also be discussed.

Utility of hand-held echocardiography in outpatient pediatric cardiology management.

PubMed

Riley, Alan; Sable, Craig; Prasad, Aparna; Spurney, Christopher; Harahsheh, Ashraf; Clauss, Sarah; Colyer, Jessica; Gierdalski, Marcin; Johnson, Ashley; Pearson, Gail D; Rosenthal, Joanna

2014-12-01

Adult patient series have shown hand-held echocardiography (echo) units (HHE) to be accurate for rapid diagnosis and triage. This is the first study to evaluate the ability of HHE to inform decision making in outpatient pediatric cardiology. New pediatric cardiology patients in outpatient clinics staffed by six pediatric cardiologists (experience 1-17 years) were prospectively enrolled if an echocardiogram (echo) was ordered during their initial visit. After history and physical examination and before a standard echo, the cardiologists performed a bedside HHE examination (GE Vscan 1.7-3.8 MHz), documented findings, and made a clinical decision. Diagnoses and decisions based on HHE were compared with final management after the standard echo. The study enrolled 101 subjects (ages 9 days to 19 years). The cardiologists considered HHE imaging adequate for decision making for 80 of the 101 subjects. For 77 of the 80 subjects with acceptable HHE imaging (68/68 normal and 9/12 abnormal standard echoes), the HHE-based primary diagnoses and decisions agreed with the final management. The sensitivity of HHE was 75 % (95 % confidence interval [CI] 43-94 %) and the positive predictive value 100 % (95 % CI 66-100 %) for pediatric heart disease. The agreement between standard echocardiography and HHE imaging was substantial (κ = 0.82). Excluding one of the least experienced cardiologists, HHE provided the basis for correct cardiac diagnoses and management for all the subjects with acceptable HHE imaging (58/58 normal and 9/9 abnormal echoes). In outpatient pediatric cardiology, HHE has potential as a tool to complement physical examination. Further investigation is needed to evaluate how value improves with clinical experience.

Rapid Accurate Identification of Tuberculous Meningitis Among South African Children Using a Novel Clinical Decision Tool.

PubMed

Goenka, Anu; Jeena, Prakash M; Mlisana, Koleka; Solomon, Tom; Spicer, Kevin; Stephenson, Rebecca; Verma, Arpana; Dhada, Barnesh; Griffiths, Michael J

2018-03-01

Early diagnosis of tuberculous meningitis (TBM) is crucial to achieve optimum outcomes. There is no effective rapid diagnostic test for use in children. We aimed to develop a clinical decision tool to facilitate the early diagnosis of childhood TBM. Retrospective case-control study was performed across 7 hospitals in KwaZulu-Natal, South Africa (2010-2014). We identified the variables most predictive of microbiologically confirmed TBM in children (3 months to 15 years) by univariate analysis. These variables were modelled into a clinical decision tool and performance tested on an independent sample group. Of 865 children with suspected TBM, 3% (25) were identified with microbiologically confirmed TBM. Clinical information was retrieved for 22 microbiologically confirmed cases of TBM and compared with 66 controls matched for age, ethnicity, sex and geographical origin. The 9 most predictive variables among the confirmed cases were used to develop a clinical decision tool (CHILD TB LP): altered Consciousness; caregiver HIV infected; Illness length >7 days; Lethargy; focal neurologic Deficit; failure to Thrive; Blood/serum sodium <132 mmol/L; CSF >10 Lymphocytes ×10/L; CSF Protein >0.65 g/L. This tool successfully classified an independent sample of 7 cases and 21 controls with a sensitivity of 100% and specificity of 90%. The CHILD TB LP decision tool accurately classified microbiologically confirmed TBM. We propose that CHILD TB LP is prospectively evaluated as a novel rapid diagnostic tool for use in the initial evaluation of children with suspected neurologic infection presenting to hospitals in similar settings.

Scientific basis for risk analysis of food-related substances with particular reference to health effects on children.

PubMed

Hayashi, Yuzo

2009-01-01

Based on the advance of toxicology and related sciences, a regulatory regime for the safety of chemicals related to daily life has been rapidly established. Especially for the food-related substances, the process of risk analysis has facilitated the collaboration by all the players including consumers toward the security of their safety. On the other hand, except for pharmaceuticals, science-based decisions and governmental actions on safety issues have not always gained confidence of the public. One of the reasons was the inadequacy in the way of use of scientific knowledge, or in other words, inappropriateness of decision making by "the regulatory science". Regulatory science is a science to warrant the decision making processes for governmental acts (Mitsuru Uchiyama). In the case of chemical safety, it can be redefined as a theoretical concept to complements the uncertainty of scientific knowledge for the decision of governmental acts that is adequate in both scientific and social ways. Therefore, the regulatory science is an indispensable discipline to effectively apply risk analysis. Here, the significance of the regulatory science for the hazard assessment of the chemicals, especially for children is described. In the past, the hazard effects of chemicals have been assessed for adults. Recently, however, the importance of the assessment for children has gained international emphases. Not only for pharmaceuticals, but for food-related substances, the acceptable daily intake (ADI) and tolerable daily intake (TDI) are often set differently for adults and children. The child-specific responses against chemicals are related not only to the physiological factors such as body weight, basal metabolism, but also rapid growth of the body with developmental status of various organs. General knowledge on these issues will be discussed mainly referring the World Health Organization (WHO) documents. Although the cutting edge technology backs up the development of toxicology, it would appear that it is reaching a turning point from technology-centrism to look toward the direction for contribution to society from the stand point of regulatory science.

Evaluation of image quality

NASA Technical Reports Server (NTRS)

Pavel, M.

1993-01-01

This presentation outlines in viewgraph format a general approach to the evaluation of display system quality for aviation applications. This approach is based on the assumption that it is possible to develop a model of the display which captures most of the significant properties of the display. The display characteristics should include spatial and temporal resolution, intensity quantizing effects, spatial sampling, delays, etc. The model must be sufficiently well specified to permit generation of stimuli that simulate the output of the display system. The first step in the evaluation of display quality is an analysis of the tasks to be performed using the display. Thus, for example, if a display is used by a pilot during a final approach, the aesthetic aspects of the display may be less relevant than its dynamic characteristics. The opposite task requirements may apply to imaging systems used for displaying navigation charts. Thus, display quality is defined with regard to one or more tasks. Given a set of relevant tasks, there are many ways to approach display evaluation. The range of evaluation approaches includes visual inspection, rapid evaluation, part-task simulation, and full mission simulation. The work described is focused on two complementary approaches to rapid evaluation. The first approach is based on a model of the human visual system. A model of the human visual system is used to predict the performance of the selected tasks. The model-based evaluation approach permits very rapid and inexpensive evaluation of various design decisions. The second rapid evaluation approach employs specifically designed critical tests that embody many important characteristics of actual tasks. These are used in situations where a validated model is not available. These rapid evaluation tests are being implemented in a workstation environment.

An empirical model of water quality for use in rapid management strategy evaluation in Southeast Queensland, Australia.

PubMed

de la Mare, William; Ellis, Nick; Pascual, Ricardo; Tickell, Sharon

2012-04-01

Simulation models have been widely adopted in fisheries for management strategy evaluation (MSE). However, in catchment management of water quality, MSE is hampered by the complexity of both decision space and the hydrological process models. Empirical models based on monitoring data provide a feasible alternative to process models; they run much faster and, by conditioning on data, they can simulate realistic responses to management actions. Using 10 years of water quality indicators from Queensland, Australia, we built an empirical model suitable for rapid MSE that reproduces the water quality variables' mean and covariance structure, adjusts the expected indicators through local management effects, and propagates effects downstream by capturing inter-site regression relationships. Empirical models enable managers to search the space of possible strategies using rapid assessment. They provide not only realistic responses in water quality indicators but also variability in those indicators, allowing managers to assess strategies in an uncertain world. Copyright © 2012 Elsevier Ltd. All rights reserved.

Knowledge discovery from patients' behavior via clustering-classification algorithms based on weighted eRFM and CLV model: An empirical study in public health care services.

PubMed

Zare Hosseini, Zeinab; Mohammadzadeh, Mahdi

2016-01-01

The rapid growing of information technology (IT) motivates and makes competitive advantages in health care industry. Nowadays, many hospitals try to build a successful customer relationship management (CRM) to recognize target and potential patients, increase patient loyalty and satisfaction and finally maximize their profitability. Many hospitals have large data warehouses containing customer demographic and transactions information. Data mining techniques can be used to analyze this data and discover hidden knowledge of customers. This research develops an extended RFM model, namely RFML (added parameter: Length) based on health care services for a public sector hospital in Iran with the idea that there is contrast between patient and customer loyalty, to estimate customer life time value (CLV) for each patient. We used Two-step and K-means algorithms as clustering methods and Decision tree (CHAID) as classification technique to segment the patients to find out target, potential and loyal customers in order to implement strengthen CRM. Two approaches are used for classification: first, the result of clustering is considered as Decision attribute in classification process and second, the result of segmentation based on CLV value of patients (estimated by RFML) is considered as Decision attribute. Finally the results of CHAID algorithm show the significant hidden rules and identify existing patterns of hospital consumers.

Knowledge discovery from patients’ behavior via clustering-classification algorithms based on weighted eRFM and CLV model: An empirical study in public health care services

PubMed Central

Zare Hosseini, Zeinab; Mohammadzadeh, Mahdi

2016-01-01

The rapid growing of information technology (IT) motivates and makes competitive advantages in health care industry. Nowadays, many hospitals try to build a successful customer relationship management (CRM) to recognize target and potential patients, increase patient loyalty and satisfaction and finally maximize their profitability. Many hospitals have large data warehouses containing customer demographic and transactions information. Data mining techniques can be used to analyze this data and discover hidden knowledge of customers. This research develops an extended RFM model, namely RFML (added parameter: Length) based on health care services for a public sector hospital in Iran with the idea that there is contrast between patient and customer loyalty, to estimate customer life time value (CLV) for each patient. We used Two-step and K-means algorithms as clustering methods and Decision tree (CHAID) as classification technique to segment the patients to find out target, potential and loyal customers in order to implement strengthen CRM. Two approaches are used for classification: first, the result of clustering is considered as Decision attribute in classification process and second, the result of segmentation based on CLV value of patients (estimated by RFML) is considered as Decision attribute. Finally the results of CHAID algorithm show the significant hidden rules and identify existing patterns of hospital consumers. PMID:27610177

Predicting quantitative and qualitative values of recreation participation

Treesearch

Elwood L., Jr. Shafer; George Moeller

1971-01-01

If future recreation consumption and associated intangible values can be predicted, the problem of rapid decision making in recreation-resource management can be reduced, and the problems of implementing those decisions can be anticipated. Management and research responsibilities for meeting recreation demand are discussed, and proved methods for forecasting recreation...

Coastal livelihood transitions under globalization with implications for trans-ecosystem interactions

PubMed Central

Stevens, Kara; Williams, Nicholas E.; Sistla, Seeta A.; Roddy, Adam B.; Urquhart, Gerald R.

2017-01-01

Anthropogenic threats to natural systems can be exacerbated due to connectivity between marine, freshwater, and terrestrial ecosystems, complicating the already daunting task of governance across the land-sea interface. Globalization, including new access to markets, can change social-ecological, land-sea linkages via livelihood responses and adaptations by local people. As a first step in understanding these trans-ecosystem effects, we examined exit and entry decisions of artisanal fishers and smallholder farmers on the rapidly globalizing Caribbean coast of Nicaragua. We found that exit and entry decisions demonstrated clear temporal and spatial patterns and that these decisions differed by livelihood. In addition to household characteristics, livelihood exit and entry decisions were strongly affected by new access to regional and global markets. The natural resource implications of these livelihood decisions are potentially profound as they provide novel linkages and spatially-explicit feedbacks between terrestrial and marine ecosystems. Our findings support the need for more scientific inquiry in understanding trans-ecosystem tradeoffs due to linked-livelihood transitions as well as the need for a trans-ecosystem approach to natural resource management and development policy in rapidly changing coastal regions. PMID:29077748

Poor Decision Making Is a Consequence of Cognitive Decline among Older Persons without Alzheimer’s Disease or Mild Cognitive Impairment

PubMed Central

Boyle, Patricia A.; Yu, Lei; Wilson, Robert S.; Gamble, Keith; Buchman, Aron S.; Bennett, David A.

2012-01-01

Objective Decision making is an important determinant of health and well-being across the lifespan but is critical in aging, when many influential decisions are made just as cognitive function declines. Increasing evidence suggests that older adults, even those without dementia, often make poor decisions and are selectively vulnerable to scams. To date, however, the factors associated with poor decision making in old age are unknown. The objective of this study was to test the hypothesis that poor decision making is a consequence of cognitive decline among older persons without Alzheimer’s disease or mild cognitive impairment. Methods Participants were 420 non-demented persons from the Memory and Aging Project, a longitudinal, clinical-pathologic cohort study of aging in the Chicago metropolitan area. All underwent repeated cognitive evaluations and subsequently completed assessments of decision making and susceptibility to scams. Decision making was measured using 12 items from a previously established performance-based measure and a self-report measure of susceptibility to scams. Results Cognitive function data were collected over an average of 5.5 years prior to the decision making assessment. Regression analyses were used to examine whether the prior rate of cognitive decline predicted the level of decision making and susceptibility to scams; analyses controlled for age, sex, education, and starting level of cognition. Among 420 persons without dementia, more rapid cognitive decline predicted poorer decision making and increased susceptibility to scams (p’s<0.001). Further, the relations between cognitive decline, decision making and scams persisted in analyses restricted to persons without any cognitive impairment (i.e., no dementia or even mild cognitive impairment). Conclusions Poor decision making is a consequence of cognitive decline among older persons without Alzheimer’s disease or mild cognitive impairment, those widely considered “cognitively healthy.” These findings suggest that even very subtle age-related changes in cognition have detrimental effects on judgment. PMID:22916287

Decision making technical support study for the US Army's Chemical Stockpile Disposal Program

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

Feldman, D.L.; Dobson, J.E.

1990-08-01

This report examines the adequacy of current command and control systems designed to make timely decisions that would enable sufficient warning and protective response to an accident at the Edgewood area of Aberdeen Proving Ground (APG), Maryland, and at Pine Bluff Arsenal (PBA), Arkansas. Institutional procedures designed to facilitate rapid accident assessment, characterization, warning, notification, and response after the onset of an emergency and computer-assisted decision-making aids designed to provide salient information to on- and-off-post emergency responders are examined. The character of emergency decision making at APG and PBA, as well as potential needs for improvements to decision-making practices, procedures,more » and automated decision-support systems (ADSSs), are described and recommendations are offered to guide equipment acquisition and improve on- and off-post command and control relationships. We recommend that (1) a continued effort be made to integrate on- and off-post command control, and decision-making procedures to permit rapid decision making; (2) the pathways for alert and notification among on- and off-post officials be improved and that responsibilities and chain of command among off-post agencies be clarified; (3) greater attention be given to organizational and social context factors that affect the adequacy of response and the likelihood that decision-making systems will work as intended; and (4) faster improvements be made to on-post ADSSs being developed at APG and PBA, which hold considerable promise for depicting vast amounts of information. Phased development and procurement of computer-assisted decision-making tools should be undertaken to balance immediate needs against available resources and to ensure flexibility, equity among sites, and compatibility among on- and off-post systems. 112 refs., 6 tabs.« less

Reason, emotion and decision-making: risk and reward computation with feeling.

PubMed

Quartz, Steven R

2009-05-01

Many models of judgment and decision-making posit distinct cognitive and emotional contributions to decision-making under uncertainty. Cognitive processes typically involve exact computations according to a cost-benefit calculus, whereas emotional processes typically involve approximate, heuristic processes that deliver rapid evaluations without mental effort. However, it remains largely unknown what specific parameters of uncertain decision the brain encodes, the extent to which these parameters correspond to various decision-making frameworks, and their correspondence to emotional and rational processes. Here, I review research suggesting that emotional processes encode in a precise quantitative manner the basic parameters of financial decision theory, indicating a reorientation of emotional and cognitive contributions to risky choice.

Range Process Simulation Tool

NASA Technical Reports Server (NTRS)

Phillips, Dave; Haas, William; Barth, Tim; Benjamin, Perakath; Graul, Michael; Bagatourova, Olga

2005-01-01

Range Process Simulation Tool (RPST) is a computer program that assists managers in rapidly predicting and quantitatively assessing the operational effects of proposed technological additions to, and/or upgrades of, complex facilities and engineering systems such as the Eastern Test Range. Originally designed for application to space transportation systems, RPST is also suitable for assessing effects of proposed changes in industrial facilities and large organizations. RPST follows a model-based approach that includes finite-capacity schedule analysis and discrete-event process simulation. A component-based, scalable, open architecture makes RPST easily and rapidly tailorable for diverse applications. Specific RPST functions include: (1) definition of analysis objectives and performance metrics; (2) selection of process templates from a processtemplate library; (3) configuration of process models for detailed simulation and schedule analysis; (4) design of operations- analysis experiments; (5) schedule and simulation-based process analysis; and (6) optimization of performance by use of genetic algorithms and simulated annealing. The main benefits afforded by RPST are provision of information that can be used to reduce costs of operation and maintenance, and the capability for affordable, accurate, and reliable prediction and exploration of the consequences of many alternative proposed decisions.

Controlling equine influenza: policy networks and decision-making during the 2007 Australian equine influenza outbreak.

PubMed

Schemann, K; Gillespie, J A; Toribio, J-A L M L; Ward, M P; Dhand, N K

2014-10-01

Rapid, evidence-based decision-making is critical during a disease outbreak response; however, compliance by stakeholders is necessary to ensure that such decisions are effective - especially if the response depends on voluntary action. This mixed method study evaluated technical policy decision-making processes during the 2007 outbreak of equine influenza in Australia by identifying and analysing the stakeholder network involved and the factors driving policy decision-making. The study started with a review of the outbreak literature and published policy documents. This identified six policy issues regarding policy modifications or differing interpretations by different state agencies. Data on factors influencing the decision-making process for these six issues and on stakeholder interaction were collected using a pre-tested, semi-structured questionnaire. Face-to-face interviews were conducted with 24 individuals representing 12 industry and government organizations. Quantitative data were analysed using social network analysis. Qualitative data were coded and patterns matched to test a pre-determined general theory using a method called theory-oriented process-tracing. Results revealed that technical policy decisions were framed by social, political, financial, strategic and operational considerations. Industry stakeholders had influence through formal pre-existing channels, yet specific gaps in stakeholder interaction were overcome by reactive alliances formed during the outbreak response but outside the established system. Overall, the crisis management system and response were seen as positive, and 75-100% of individuals interviewed were supportive of, had interest in and considered the outcome as good for the majority of policy decisions, yet only 46-75% of those interviewed considered that they had influence on these decisions. Training to increase awareness and knowledge of emergency animal diseases (EADs) and response systems will improve stakeholder participation in emergency disease management and preparedness for future EAD incursions. © 2012 Blackwell Verlag GmbH.

Administrative decision making: a stepwise method.

PubMed

Oetjen, Reid M; Oetjen, Dawn M; Rotarius, Timothy

2008-01-01

Today's health care organizations face tremendous challenges and fierce competition. These pressures impact the decisions that managers must execute on any given day, not to mention the ever-present constraints of time, personnel, competencies, and finances. The importance of making quality and informed decisions cannot be underestimated. Traditional decision making methods are inadequate for today's larger, more complex health care organizations and the rapidly changing health care environment. As a result, today's health care managers and their teams need new approaches to making decisions for their organizations. This article examines the managerial decision making process and offers a model that can be used as a decision making template to help managers successfully navigate the choppy health care seas. The administrative decision making model will enable health care managers and other key decision makers to avoid the common pitfalls of poor decision making and guide their organizations to success.

Resource allocation. The cost of care: two troublesome cases in health care ethics.

PubMed

Armstrong, C R; Whitlock, R

1998-01-01

With the cost of health care rising rapidly, both physicians and administrators regularly face resource allocation decisions. Under these conditions of relative scarcity, the equitable and appropriate distribution of limited resources becomes an ethical as well as a financial issue. Through ethical analysis, physician executives can assist their physician colleagues and fellow administrators to find rationally defensible answers to questions regarding the distribution of limited resources. Six criteria are frequently "weighted in the balance" by ethicists when analyzing whether justice is served in the distribution of a limited resource: need, equality, contribution, ability to pay, effort, and merit. The authors argue that, from an ethical standpoint, the best single criterion upon which one can base an allocation decision is that of merit, defined as the potential to benefit from the investment of additional resources.

Development and implementation of a mobile device-based pediatric electronic decision support tool as part of a national practice standardization project.

PubMed

McCulloh, Russell J; Fouquet, Sarah D; Herigon, Joshua; Biondi, Eric A; Kennedy, Brandan; Kerns, Ellen; DePorre, Adrienne; Markham, Jessica L; Chan, Y Raymond; Nelson, Krista; Newland, Jason G

2018-06-07

Implementing evidence-based practices requires a multi-faceted approach. Electronic clinical decision support (ECDS) tools may encourage evidence-based practice adoption. However, data regarding the role of mobile ECDS tools in pediatrics is scant. Our objective is to describe the development, distribution, and usage patterns of a smartphone-based ECDS tool within a national practice standardization project. We developed a smartphone-based ECDS tool for use in the American Academy of Pediatrics, Value in Inpatient Pediatrics Network project entitled "Reducing Excessive Variation in the Infant Sepsis Evaluation (REVISE)." The mobile application (app), PedsGuide, was developed using evidence-based recommendations created by an interdisciplinary panel. App workflow and content were aligned with clinical benchmarks; app interface was adjusted after usability heuristic review. Usage patterns were measured using Google Analytics. Overall, 3805 users across the United States downloaded PedsGuide from December 1, 2016, to July 31, 2017, leading to 14 256 use sessions (average 3.75 sessions per user). Users engaged in 60 442 screen views, including 37 424 (61.8%) screen views that displayed content related to the REVISE clinical practice benchmarks, including hospital admission appropriateness (26.8%), length of hospitalization (14.6%), and diagnostic testing recommendations (17.0%). Median user touch depth was 5 [IQR 5]. We observed rapid dissemination and in-depth engagement with PedsGuide, demonstrating feasibility for using smartphone-based ECDS tools within national practice improvement projects. ECDS tools may prove valuable in future national practice standardization initiatives. Work should next focus on developing robust analytics to determine ECDS tools' impact on medical decision making, clinical practice, and health outcomes.

From Population Databases to Research and Informed Health Decisions and Policy.

PubMed

Machluf, Yossy; Tal, Orna; Navon, Amir; Chaiter, Yoram

2017-01-01

In the era of big data, the medical community is inspired to maximize the utilization and processing of the rapidly expanding medical datasets for clinical-related and policy-driven research. This requires a medical database that can be aggregated, interpreted, and integrated at both the individual and population levels. Policymakers seek data as a lever for wise, evidence-based decision-making and information-driven policy. Yet, bridging the gap between data collection, research, and policymaking, is a major challenge. To bridge this gap, we propose a four-step model: (A) creating a conjoined task force of all relevant parties to declare a national program to promote collaborations; (B) promoting a national digital records project, or at least a network of synchronized and integrated databases, in an accessible transparent manner; (C) creating an interoperative national research environment to enable the analysis of the organized and integrated data and to generate evidence; and (D) utilizing the evidence to improve decision-making, to support a wisely chosen national policy. For the latter purpose, we also developed a novel multidimensional set of criteria to illuminate insights and estimate the risk for future morbidity based on current medical conditions. Used by policymakers, providers of health plans, caregivers, and health organizations, we presume this model will assist transforming evidence generation to support the design of health policy and programs, as well as improved decision-making about health and health care, at all levels: individual, communal, organizational, and national.

Artificial Neural Network Approach in Laboratory Test Reporting:  Learning Algorithms.

PubMed

Demirci, Ferhat; Akan, Pinar; Kume, Tuncay; Sisman, Ali Riza; Erbayraktar, Zubeyde; Sevinc, Suleyman

2016-08-01

In the field of laboratory medicine, minimizing errors and establishing standardization is only possible by predefined processes. The aim of this study was to build an experimental decision algorithm model open to improvement that would efficiently and rapidly evaluate the results of biochemical tests with critical values by evaluating multiple factors concurrently. The experimental model was built by Weka software (Weka, Waikato, New Zealand) based on the artificial neural network method. Data were received from Dokuz Eylül University Central Laboratory. "Training sets" were developed for our experimental model to teach the evaluation criteria. After training the system, "test sets" developed for different conditions were used to statistically assess the validity of the model. After developing the decision algorithm with three iterations of training, no result was verified that was refused by the laboratory specialist. The sensitivity of the model was 91% and specificity was 100%. The estimated κ score was 0.950. This is the first study based on an artificial neural network to build an experimental assessment and decision algorithm model. By integrating our trained algorithm model into a laboratory information system, it may be possible to reduce employees' workload without compromising patient safety. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Rapid-Learning System for Cancer Care

PubMed Central

Abernethy, Amy P.; Etheredge, Lynn M.; Ganz, Patricia A.; Wallace, Paul; German, Robert R.; Neti, Chalapathy; Bach, Peter B.; Murphy, Sharon B.

2010-01-01

Compelling public interest is propelling national efforts to advance the evidence base for cancer treatment and control measures and to transform the way in which evidence is aggregated and applied. Substantial investments in health information technology, comparative effectiveness research, health care quality and value, and personalized medicine support these efforts and have resulted in considerable progress to date. An emerging initiative, and one that integrates these converging approaches to improving health care, is “rapid-learning health care.” In this framework, routinely collected real-time clinical data drive the process of scientific discovery, which becomes a natural outgrowth of patient care. To better understand the state of the rapid-learning health care model and its potential implications for oncology, the National Cancer Policy Forum of the Institute of Medicine held a workshop entitled “A Foundation for Evidence-Driven Practice: A Rapid-Learning System for Cancer Care” in October 2009. Participants examined the elements of a rapid-learning system for cancer, including registries and databases, emerging information technology, patient-centered and -driven clinical decision support, patient engagement, culture change, clinical practice guidelines, point-of-care needs in clinical oncology, and federal policy issues and implications. This Special Article reviews the activities of the workshop and sets the stage to move from vision to action. PMID:20585094

Administrative Technology and the School Executive: Applying the Systems Approach to Educational Administration.

ERIC Educational Resources Information Center

Knezevich, Stephen J., Ed.

In this era of rapid social change, educational administrators have discovered that new approaches to problem solving and decision making are needed. Systems analysis could afford a promising approach to administrative problems by providing a number of systematic techniques designed to sharpen administrative decision making, enhance efficiency,…

Analysis of Operational Factors Towards Achievement of Space Control...Transforming the Familiar

DTIC Science & Technology

1998-02-13

unsuitable for the day when enemy forces are capable of Space denial actions, requiring a change of philosophy in force architeture . For protection of...34 phase of the commander’s decision cycle is grotesquely out of proportion to the nature of warfare. The rapidly accelerating decision capability

Stasis Theory as a Strategy for Workplace Teaming and Decision Making

ERIC Educational Resources Information Center

Brizee, H. Allen

2008-01-01

Current scholarship tells us that skills in teaming are essential for students and practitioners of professional communication. Writers must be able to cooperate with subject-matter experts and team members to make effective decisions and complete projects. Scholarship also suggests that rapid changes in technology and changes in teaming processes…

Quantitative Methods for Administrative Decision Making in Junior Colleges.

ERIC Educational Resources Information Center

Gold, Benjamin Knox

With the rapid increase in number and size of junior colleges, administrators must take advantage of the decision-making tools already used in business and industry. This study investigated how these quantitative techniques could be applied to junior college problems. A survey of 195 California junior college administrators found that the problems…

Public Health Surveillance via Template Management in Electronic Health Records: Tri-Service Workflow's Rapid Response to an Infectious Disease Crisis.

PubMed

Berkley, Holly; Barnes, Matthew; Carnahan, David; Hayhurst, Janet; Bockhorst, Archie; Neville, James

2017-03-01

To describe the use of template-based screening for risk of infectious disease exposure of patients presenting to primary care medical facilities during the 2014 West African Ebola virus outbreak. The Military Health System implemented an Ebola risk-screening tool in primary care settings in order to create early notifications and early responses to potentially infected persons. Three time-sensitive, evidence-based screening questions were developed and posted to Tri-Service Workflow (TSWF) AHLTA templates in conjunction with appropriate training. Data were collected in January 2015, to assess the adoption of the TSWF-based Ebola risk-screening tool. Among encounters documented using TSWF templates, 41% of all encounters showed use of the TSWF-based Ebola risk-screening questions by the fourth day. The screening rate increased over the next 3 weeks, and reached a plateau at approximately 50%. This report demonstrates the MHS capability to deploy a standardized, globally applicable decision support aid that could be seen the same day by all primary care clinics across the military health direct care system, potentially improving rapid compliance with screening directives. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Non-formal learning and tacit knowledge in professional work.

PubMed

Eraut, M

2000-03-01

This paper explores the conceptual and methodological problems arising from several empirical investigations of professional education and learning in the workplace. 1. To clarify the multiple meanings accorded to terms such as 'non-formal learning', 'implicit learning' and 'tacit knowledge', their theoretical assumptions and the range of phenomena to which they refer. 2. To discuss their implications for professional practice. A largely theoretical analysis of issues and phenomena arising from empirical investigations. The author's typology of non-formal learning distinguishes between implicit learning, reactive on-the-spot learning and deliberative learning. The significance of the last is commonly overemphasized. The problematic nature of tacit knowledge is discussed with respect to both detecting it and representing it. Three types of tacit knowledge are discussed: tacit understanding of people and situations, routinized actions and the tacit rules that underpin intuitive decision-making. They come together when professional performance involves sequences of routinized action punctuated by rapid intuitive decisions based on tacit understanding of the situation. Four types of process are involved--reading the situation, making decisions, overt activity and metacognition--and three modes of cognition--intuitive, analytic and deliberative. The balance between these modes depends on time, experience and complexity. Where rapid action dominates, periods of deliberation are needed to maintain critical control. Finally the role of both formal and informal social knowledge is discussed; and it is argued that situated learning often leads not to local conformity but to greater individual variation as people's careers take them through a series of different contexts. This abstract necessarily simplifies a more complex analysis in the paper itself.

A clinical decision rule for triage of children under 5 years of age with hydrocarbon (kerosene) aspiration in developing countries.

PubMed

Bond, G R; Pièche, S; Sonicki, Z; Gamaluddin, H; El Guindi, M; Sakr, M; El Seddawy, A; Abouzaid, M; Youssef, A

2008-03-01

Unintended hydrocarbon ingestion is a common reason for pediatric hospitalization in the developing world. To derive a clinical decision rule, to identify patients likely to require a higher level facility (resource-requiring cases), that can be used at primary health care facilities with limited diagnostic and therapeutic resources. A prospective study of children 2 to 59 months old presenting to a poison treatment facility within 2 hours of oral hydrocarbon exposure. History and objective signs were recorded at admission and at 6, 12, 24 and, if present, 48 hours. Inclusion in the resource-requiring outcome group required: oxygen saturation <94%; any CNS depression; any treatment with (salbutamol); any care in the ICU; or death. 256 met the inclusion criteria and completed the study. Of these, 170 had a course requiring resources unavailable at most primary health care facilities, and 86 did not. The presence of wheezing, any alteration in consciousness (lethargy or any restlessness), or a rapid respiratory rate for age (RR >or= 50/min if age < 12 mo, >or= 40/min if age >or= 12 mo) at presentation identified 167 of 170 of these patients (sensitivity 0.98). Thirty-six of 86 patients classified as non-resource requiring were correctly identified (specificity 0.42). No combination of clinical symptoms provided better discrimination while preserving sensitivity. This study suggests a triage decision rule based on the presence of wheezing, altered consciousness, or a rapid respiratory rate within 2 hours of hydrocarbon exposure. Such a rule requires validation in other settings.

Risky Group Decision-Making Method for Distribution Grid Planning

NASA Astrophysics Data System (ADS)

Li, Cunbin; Yuan, Jiahang; Qi, Zhiqiang

2015-12-01

With rapid speed on electricity using and increasing in renewable energy, more and more research pay attention on distribution grid planning. For the drawbacks of existing research, this paper proposes a new risky group decision-making method for distribution grid planning. Firstly, a mixing index system with qualitative and quantitative indices is built. On the basis of considering the fuzziness of language evaluation, choose cloud model to realize "quantitative to qualitative" transformation and construct interval numbers decision matrices according to the "3En" principle. An m-dimensional interval numbers decision vector is regarded as super cuboids in m-dimensional attributes space, using two-level orthogonal experiment to arrange points uniformly and dispersedly. The numbers of points are assured by testing numbers of two-level orthogonal arrays and these points compose of distribution points set to stand for decision-making project. In order to eliminate the influence of correlation among indices, Mahalanobis distance is used to calculate the distance from each solutions to others which means that dynamic solutions are viewed as the reference. Secondly, due to the decision-maker's attitude can affect the results, this paper defines the prospect value function based on SNR which is from Mahalanobis-Taguchi system and attains the comprehensive prospect value of each program as well as the order. At last, the validity and reliability of this method is illustrated by examples which prove the method is more valuable and superiority than the other.

The analysis of rapidly developing fog at the Kennedy Space Center

NASA Technical Reports Server (NTRS)

Wheeler, Mark M.; Atchison, Michael K.; Schumann, Robin; Taylor, Greg E.; Yersavich, Ann; Warburton, John D.

1994-01-01

This report documents fog precursors and fog climatology at Kennedy Space Center (KSC) Florida from 1986 to 1990. The major emphasis of this report focuses on rapidly developing fog events that would affect the less than 7-statute mile visibility rule for End-Of-Mission (EOM) Shuttle landing at KSC (Rule 4-64(A)). The Applied Meteorology Unit's (AMU's) work is to: develop a data base for study of fog associated weather conditions relating to violations of this landing constraint; develop forecast techniques or rules-of-thumb to determine whether or not current conditions are likely to result in an acceptable condition at landing; validate the forecast techniques; and transition techniques to operational use. As part of the analysis the fog events were categorized as either advection, pre-frontal or radiation. As a result of these analyses, the AMU developed a fog climatological data base, identified fog precursors and developed forecaster tools and decision trees. The fog climatological analysis indicates that during the fog season (October to April) there is a higher risk for a visibility violation at KSC during the early morning hours (0700 to 1200 UTC), while 95 percent of all fog events have dissipated by 1600 UTC. A high number of fog events are characterized by a westerly component to the surface wind at KSC (92 percent) and 83 percent of the fog events had fog develop west of KSC first (up to 2 hours). The AMU developed fog decision trees and forecaster tools that would help the forecaster identify fog precursors up to 12 hours in advance. Using the decision trees as process tools ensures the important meteorological data are not overlooked in the forecast process. With these tools and a better understanding of fog formation in the local KSC area, the Shuttle weather support forecaster should be able to give the Launch and Flight Directors a better KSC fog forecast with more confidence.

Rapid review programs to support health care and policy decision making: a descriptive analysis of processes and methods.

PubMed

Polisena, Julie; Garritty, Chantelle; Kamel, Chris; Stevens, Adrienne; Abou-Setta, Ahmed M

2015-03-14

Health care decision makers often need to make decisions in limited timeframes and cannot await the completion of a full evidence review. Rapid reviews (RRs), utilizing streamlined systematic review methods, are increasingly being used to synthesize the evidence with a shorter turnaround time. Our primary objective was to describe the processes and methods used internationally to produce RRs. In addition, we sought to understand the underlying themes associated with these programs. We contacted representatives of international RR programs from a broad realm in health care to gather information about the methods and processes used to produce RRs. The responses were summarized narratively to understand the characteristics associated with their processes and methods. The summaries were compared and contrasted to highlight potential themes and trends related to the different RR programs. Twenty-nine international RR programs were included in our sample with a broad organizational representation from academia, government, research institutions, and non-for-profit organizations. Responses revealed that the main objectives for RRs were to inform decision making with regards to funding health care technologies, services and policy, and program development. Central themes that influenced the methods used by RR programs, and report type and dissemination were the imposed turnaround time to complete a report, resources available, the complexity and sensitivity of the research topics, and permission from the requestor. Our study confirmed that there is no standard approach to conduct RRs. Differences in processes and methods across programs may be the result of the novelty of RR methods versus other types of evidence syntheses, customization of RRs for various decision makers, and definition of 'rapid' by organizations, since it impacts both the timelines and the evidence synthesis methods. Future research should investigate the impact of current RR methods and reporting to support informed health care decision making, the effects of potential biases that may be introduced with streamlined methods, and the effectiveness of RR reporting guidelines on transparency.

Responding to the refusal of care in the emergency department.

PubMed

Nelson, Jennifer; Venkat, Arvind; Davenport, Moira

2014-01-01

The emergency department (ED) serves as the primary gateway for acute care and the source of health care of last resort. Emergency physicians are commonly expected to rapidly assess and treat patients with a variety of life-threatening conditions. However, patients do refuse recommended therapy, even when the consequences are significant morbidity and even mortality. This raises the ethical dilemma of how emergency physicians and ED staff can rapidly determine whether patient refusal of treatment recommendations is based on intact decision-making capacity and how to respond in an appropriate manner when the declining of necessary care by the patient is lacking a basis in informed judgment. This article presents a case that illustrates the ethical tensions raised by the refusal of life-sustaining care in the ED and how such situations can be approached in an ethically appropriate manner.

Risk evaluation and monitoring in multiple sclerosis therapeutics.

PubMed

Clanet, Michel C; Wolinsky, Jerry S; Ashton, Raymond J; Hartung, Hans-Peter; Reingold, Stephen C

2014-09-01

Risk for multiple sclerosis (MS) disease-modifying therapies (DMT) must be assessed on an ongoing basis. Early concerns regarding the first-approved DMTs for MS have been mitigated, but recently licensed therapies have been linked to possibly greater risks. The objective of this review is to discuss risk assessment in MS therapeutics based on an international workshop and comprehensive literature search and recommend strategies for risk assessment/monitoring. Assessment and perception of therapeutic risks vary between patients, doctors and regulators. Acceptability of risk depends on the magnitude of risk and the demonstrated clinical benefits of any agent. Safety signals must be distinguishable from chance occurrences in a clinical trial and in long-term use of medications. Post-marketing research is crucial for assessing longer-term safety in large patient cohorts. Reporting of adverse events is becoming more proactive, allowing more rapid identification of risks. Communication about therapeutic risks and their relationship to clinical benefit must involve patients in shared decision making. It is difficult to produce a general risk-assessment algorithm for all MS therapies. Specific algorithms are required for each DMT in every treated-patient population. New and evolving risks must be evaluated and communicated rapidly to allow patients and physicians to be well informed and able to share treatment decisions. © The Author(s) 2013.

Connected Classroom Technology Facilitates Multiple Components of Formative Assessment Practice

NASA Astrophysics Data System (ADS)

Shirley, Melissa L.; Irving, Karen E.

2015-02-01

Formative assessment has been demonstrated to result in increased student achievement across a variety of educational contexts. When using formative assessment strategies, teachers engage students in instructional tasks that allow the teacher to uncover levels of student understanding so that the teacher may change instruction accordingly. Tools that support the implementation of formative assessment strategies are therefore likely to enhance student achievement. Connected classroom technologies (CCTs) include a family of devices that show promise in facilitating formative assessment. By promoting the use of interactive student tasks and providing both teachers and students with rapid and accurate data on student learning, CCT can provide teachers with necessary evidence for making instructional decisions about subsequent lessons. In this study, the experiences of four middle and high school science teachers in their first year of implementing the TI-Navigator™ system, a specific type of CCT, are used to characterize the ways in which CCT supports the goals of effective formative assessment. We present excerpts of participant interviews to demonstrate the alignment of CCT with several main phases of the formative assessment process. CCT was found to support implementation of a variety of instructional tasks that generate evidence of student learning for the teacher. The rapid aggregation and display of student learning evidence provided teachers with robust data on which to base subsequent instructional decisions.

FEMA's Earthquake Incident Journal: A Web-Based Data Integration and Decision Support Tool for Emergency Management

NASA Astrophysics Data System (ADS)

Jones, M.; Pitts, R.

2017-12-01

For emergency managers, government officials, and others who must respond to rapidly changing natural disasters, timely access to detailed information related to affected terrain, population and infrastructure is critical for planning, response and recovery operations. Accessing, analyzing and disseminating such disparate information in near real-time are critical decision support components. However, finding a way to handle a variety of informative yet complex datasets poses a challenge when preparing for and responding to disasters. Here, we discuss the implementation of a web-based data integration and decision support tool for earthquakes developed by the Federal Emergency Management Agency (FEMA) as a solution to some of these challenges. While earthquakes are among the most well- monitored and measured of natural hazards, the spatially broad impacts of shaking, ground deformation, landslides, liquefaction, and even tsunamis, are extremely difficult to quantify without accelerated access to data, modeling, and analytics. This web-based application, deemed the "Earthquake Incident Journal", provides real-time access to authoritative and event-specific data from external (e.g. US Geological Survey, NASA, state and local governments, etc.) and internal (FEMA) data sources. The journal includes a GIS-based model for exposure analytics, allowing FEMA to assess the severity of an event, estimate impacts to structures and population in near real-time, and then apply planning factors to exposure estimates to answer questions such as: What geographic areas are impacted? Will federal support be needed? What resources are needed to support survivors? And which infrastructure elements or essential facilities are threatened? This presentation reviews the development of the Earthquake Incident Journal, detailing the data integration solutions, the methodology behind the GIS-based automated exposure model, and the planning factors as well as other analytical advances that provide near real-time decision support to the federal government.

Bridging the gap. The separate worlds of evidence-based medicine and patient-centered medicine.

PubMed

Bensing, J

2000-01-01

Modern medical care is influenced by two paradigms: 'evidence-based medicine' and 'patient-centered medicine'. In the last decade, both paradigms rapidly gained in popularity and are now both supposed to affect the process of clinical decision making during the daily practice of physicians. However, careful analysis shows that they focus on different aspects of medical care and have, in fact, little in common. Evidence-based medicine is a rather young concept that entered the scientific literature in the early 1990s. It has basically a positivistic, biomedical perspective. Its focus is on offering clinicians the best available evidence about the most adequate treatment for their patients, considering medicine merely as a cognitive-rational enterprise. In this approach the uniqueness of patients, their individual needs and preferences, and their emotional status are easily neglected as relevant factors in decision-making. Patient-centered medicine, although not a new phenomenon, has recently attracted renewed attention. It has basically a humanistic, biopsychosocial perspective, combining ethical values on 'the ideal physician', with psychotherapeutic theories on facilitating patients' disclosure of real worries, and negotiation theories on decision making. It puts a strong focus on patient participation in clinical decision making by taking into account the patients' perspective, and tuning medical care to the patients' needs and preferences. However, in this approach the ideological base is better developed than its evidence base. In modern medicine both paradigms are highly relevant, but yet seem to belong to different worlds. The challenge for the near future is to bring these separate worlds together. The aim of this paper is to give an impulse to this integration. Developments within both paradigms can benefit from interchanging ideas and principles from which eventually medical care will benefit. In this process a key role is foreseen for communication and communication research.

Transforming home health nursing with telehealth technology.

PubMed

Farrar, Francisca Cisneros

2015-06-01

Telehealth technology is an evidence-based delivery model tool that can be integrated into the plan of care for mental health patients. Telehealth technology empowers access to health care, can help decrease or prevent hospital readmissions, assist home health nurses provide shared decision making, and focuses on collaborative care. Telehealth and the recovery model have transformed the role of the home health nurse. Nurses need to be proactive and respond to rapidly emerging technologies that are transforming their role in home care. Copyright © 2015 Elsevier Inc. All rights reserved.

Study on the key technology of grain logistics tracking system

NASA Astrophysics Data System (ADS)

Zhen, Tong; Ge, Hongyi; Jiang, Yuying; Che, Yi

2010-07-01

In recent year, with the rapid development of GIS technology, more and more programming problems depend on the GIS technology and professional model system. The solution of auxiliary programming problem by using GIS technology, which has become very popular. GIS is an important tool and technology, that captures, stores, analyzes, manages, and presents data that are linked to location. A grain logistics distribution system based on GIS is established, which provides a visualization scheme during the process of grain circulation and supports users making decision and analyzing for grain logistics enterprise.

Cost-effectiveness of rapid HCV testing and simultaneous rapid HCV and HIV testing in substance abuse treatment programs

PubMed Central

Schackman, Bruce R.; Leff, Jared A.; Barter, Devra M.; DiLorenzo, Madeline A.; Feaster, Daniel J.; Metsch, Lisa R.; Freedberg, Kenneth A.; Linas, Benjamin P.

2014-01-01

Aims To evaluate the cost-effectiveness of rapid hepatitis C virus (HCV) and simultaneous HCV/HIV antibody testing in substance abuse treatment programs. Design We used a decision analytic model to compare the cost-effectiveness of no HCV testing referral or offer, off-site HCV testing referral, on-site rapid HCV testing offer, and on-site rapid HCV and HIV testing offer. Base case inputs included 11% undetected chronic HCV, 0.4% undetected HIV, 35% HCV co-infection among HIV-infected, 53% linked to HCV care after testing antibody positive, and 67% linked to HIV care. Disease outcomes were estimated from established computer simulation models of HCV (HEP-CE) and HIV (CEPAC). Setting and Participants Data on test acceptance and costs were from a national randomized trial of HIV testing strategies conducted at 12 substance abuse treatment programs in the USA. Measurements Lifetime costs (2011 US dollars) and quality-adjusted life years (QALYs) discounted at 3% annually; incremental cost-effectiveness ratios (ICERs) Findings On-site rapid HCV testing had an ICER of $18,300/QALY compared with no testing, and was more efficient than (dominated) off-site HCV testing referral. On-site rapid HCV and HIV testing had an ICER of $64,500/QALY compared with on-site rapid HCV testing alone. In one and two-way sensitivity analyses, the ICER of on-site rapid HCV and HIV testing remained <$100,000/QALY, except when undetected HIV prevalence was <0.1% or when we assumed frequent HIV testing elsewhere. The ICER remained <$100,000/QALY in approximately 90% of probabilistic sensitivity analyses. Conclusions On-site rapid hepatitis C virus and HIV testing in substance abuse treatment programs is cost-effective at a <$100,000/ quality-adjusted life years threshold. PMID:25291977

Perceptual uncertainty and line-call challenges in professional tennis

PubMed Central

Mather, George

2008-01-01

Fast-moving sports such as tennis require both players and match officials to make rapid accurate perceptual decisions about dynamic events in the visual world. Disagreements arise regularly, leading to disputes about decisions such as line calls. A number of factors must contribute to these disputes, including lapses in concentration, bias and gamesmanship. Fundamental uncertainty or variability in the sensory information supporting decisions must also play a role. Modern technological innovations now provide detailed and accurate physical information that can be compared against the decisions of players and officials. The present paper uses this psychophysical data to assess the significance of perceptual limitations as a contributor to real-world decisions in professional tennis. A detailed analysis is presented of a large body of data on line-call challenges in professional tennis tournaments over the last 2 years. Results reveal that the vast majority of challenges can be explained in a direct highly predictable manner by a simple model of uncertainty in perceptual information processing. Both players and line judges are remarkably accurate at judging ball bounce position, with a positional uncertainty of less than 40 mm. Line judges are more reliable than players. Judgements are more difficult for balls bouncing near base and service lines than those bouncing near side and centre lines. There is no evidence for significant errors in localization due to image motion. PMID:18426755

Perceptual uncertainty and line-call challenges in professional tennis.

PubMed

Mather, George

2008-07-22

Fast-moving sports such as tennis require both players and match officials to make rapid accurate perceptual decisions about dynamic events in the visual world. Disagreements arise regularly, leading to disputes about decisions such as line calls. A number of factors must contribute to these disputes, including lapses in concentration, bias and gamesmanship. Fundamental uncertainty or variability in the sensory information supporting decisions must also play a role. Modern technological innovations now provide detailed and accurate physical information that can be compared against the decisions of players and officials. The present paper uses this psychophysical data to assess the significance of perceptual limitations as a contributor to real-world decisions in professional tennis. A detailed analysis is presented of a large body of data on line-call challenges in professional tennis tournaments over the last 2 years. Results reveal that the vast majority of challenges can be explained in a direct highly predictable manner by a simple model of uncertainty in perceptual information processing. Both players and line judges are remarkably accurate at judging ball bounce position, with a positional uncertainty of less than 40mm. Line judges are more reliable than players. Judgements are more difficult for balls bouncing near base and service lines than those bouncing near side and centre lines. There is no evidence for significant errors in localization due to image motion.

Evidence synthesis activities of a hospital evidence-based practice center and impact on hospital decision making.

PubMed

Jayakumar, Kishore L; Lavenberg, Julia A; Mitchell, Matthew D; Doshi, Jalpa A; Leas, Brian; Goldmann, David R; Williams, Kendal; Brennan, Patrick J; Umscheid, Craig A

2016-03-01

Hospital evidence-based practice centers (EPCs) synthesize and disseminate evidence locally, but their impact on institutional decision making is unclear. To assess the evidence synthesis activities and impact of a hospital EPC serving a large academic healthcare system. Descriptive analysis of the EPC's database of rapid systematic reviews since EPC inception (July 2006-June 2014), and survey of report requestors from the EPC's last 4 fiscal years. Descriptive analyses examined requestor and report characteristics; questionnaire examined report usability, impact, and requestor satisfaction (higher scores on 5-point Likert scales reflected greater agreement). The EPC completed 249 evidence reviews since inception. The most common requestors were clinical departments (29%, n = 72), chief medical officers (19%, n = 47), and purchasing committees (14%, n = 35). The most common technologies reviewed were drugs (24%, n = 60), devices (19%, n = 48), and care processes (12%, n = 31). Mean report completion time was 70 days. Thirty reports (12%) informed computerized decision support interventions. More than half of reports (56%, n = 139) were completed in the last 4 fiscal years for 65 requestors. Of the 64 eligible participants, 46 responded (72%). Requestors were satisfied with the report (mean = 4.4), and agreed it was delivered promptly (mean = 4.4), answered the questions posed (mean = 4.3), and informed their final decision (mean = 4.1). This is the first examination of evidence synthesis activities by a hospital EPC in the United States. Our findings suggest hospital EPCs can efficiently synthesize and disseminate evidence addressing a range of clinical topics for diverse stakeholders, and can influence local decision making. © 2015 Society of Hospital Medicine.

Healthcare providers' knowledge and attitudes about rapid tissue donation (RTD): phase one of establishing a rapid tissue donation programme in thoracic oncology.

PubMed

Schabath, Matthew B; McIntyre, Jessica; Pratt, Christie; Gonzalez, Luis E; Munoz-Antonia, Teresita; Haura, Eric B; Quinn, Gwendolyn P

2014-02-01

In preparation for the development of a rapid tissue donation (RTD) programme, we surveyed healthcare providers (HCPs) in our institution about knowledge and attitudes related to RTD with lung cancer patients. A 31-item web based survey was developed collecting data on demographics, knowledge and attitudes about RTD. The survey contained three items measuring participants' knowledge about RTD, five items assessing attitudes towards RTD recruitment and six items assessing HCPs' level of agreement with factors influencing decisions to discuss RTD. Response options were presented on a 5-point Likert scale. Ninety-one HCPs participated in the study. 66% indicated they had never heard of RTD prior to the survey, 78% rated knowledge of RTD as none or limited and 95.6% reported not having ethical or religious concerns about discussing RTD with patients. The majority were either not comfortable (17.8%) or not sure if they felt comfortable discussing RTD with cancer patients (42.2%). 56.1% indicated their knowledge of RTD would play an integral role in their decision to discuss RTD with patients. 71.4% reported concerns with RTD discussion and the emotional state of the patient. Physicians and nurses play an important role in initiating conversations about recruitment and donation to research that can ultimately influence uptake. Increasing HCP knowledge about RTD is a necessary step towards building an RTD programme. Our study provides important information about characteristics associated with low levels of knowledge and practice related to RTD where additional education and training may be warranted.

Integrating Remote Sensing Data, Hybrid-Cloud Computing, and Event Notifications for Advanced Rapid Imaging & Analysis (Invited)

NASA Astrophysics Data System (ADS)

Hua, H.; Owen, S. E.; Yun, S.; Lundgren, P.; Fielding, E. J.; Agram, P.; Manipon, G.; Stough, T. M.; Simons, M.; Rosen, P. A.; Wilson, B. D.; Poland, M. P.; Cervelli, P. F.; Cruz, J.

2013-12-01

Space-based geodetic measurement techniques such as Interferometric Synthetic Aperture Radar (InSAR) and Continuous Global Positioning System (CGPS) are now important elements in our toolset for monitoring earthquake-generating faults, volcanic eruptions, hurricane damage, landslides, reservoir subsidence, and other natural and man-made hazards. Geodetic imaging's unique ability to capture surface deformation with high spatial and temporal resolution has revolutionized both earthquake science and volcanology. Continuous monitoring of surface deformation and surface change before, during, and after natural hazards improves decision-making from better forecasts, increased situational awareness, and more informed recovery. However, analyses of InSAR and GPS data sets are currently handcrafted following events and are not generated rapidly and reliably enough for use in operational response to natural disasters. Additionally, the sheer data volumes needed to handle a continuous stream of InSAR data sets also presents a bottleneck. It has been estimated that continuous processing of InSAR coverage of California alone over 3-years would reach PB-scale data volumes. Our Advanced Rapid Imaging and Analysis for Monitoring Hazards (ARIA-MH) science data system enables both science and decision-making communities to monitor areas of interest with derived geodetic data products via seamless data preparation, processing, discovery, and access. We will present our findings on the use of hybrid-cloud computing to improve the timely processing and delivery of geodetic data products, integrating event notifications from USGS to improve the timely processing for response, as well as providing browse results for quick looks with other tools for integrative analysis.

Mechanisms underlying the influence of saliency on value-based decisions

PubMed Central

Chen, Xiaomo; Mihalas, Stefan; Niebur, Ernst; Stuphorn, Veit

2013-01-01

Objects in the environment differ in their low-level perceptual properties (e.g., how easily a fruit can be recognized) as well as in their subjective value (how tasty it is). We studied the influence of visual salience on value-based decisions using a two alternative forced choice task, in which human subjects rapidly chose items from a visual display. All targets were equally easy to detect. Nevertheless, both value and salience strongly affected choices made and reaction times. We analyzed the neuronal mechanisms underlying these behavioral effects using stochastic accumulator models, allowing us to characterize not only the averages of reaction times but their full distributions. Independent models without interaction between the possible choices failed to reproduce the observed choice behavior, while models with mutual inhibition between alternative choices produced much better results. Mutual inhibition thus is an important feature of the decision mechanism. Value influenced the amount of accumulation in all models. In contrast, increased salience could either lead to an earlier start (onset model) or to a higher rate (speed model) of accumulation. Both models explained the data from the choice trials equally well. However, salience also affected reaction times in no-choice trials in which only one item was present, as well as error trials. Only the onset model could explain the observed reaction time distributions of error trials and no-choice trials. In contrast, the speed model could not, irrespective of whether the rate increase resulted from more frequent accumulated quanta or from larger quanta. Visual salience thus likely provides an advantage in the onset, not in the processing speed, of value-based decision making. PMID:24167161

You Can't Think and Hit at the Same Time: Neural Correlates of Baseball Pitch Classification.

PubMed

Sherwin, Jason; Muraskin, Jordan; Sajda, Paul

2012-01-01

Hitting a baseball is often described as the most difficult thing to do in sports. A key aptitude of a good hitter is the ability to determine which pitch is coming. This rapid decision requires the batter to make a judgment in a fraction of a second based largely on the trajectory and spin of the ball. When does this decision occur relative to the ball's trajectory and is it possible to identify neural correlates that represent how the decision evolves over a split second? Using single-trial analysis of electroencephalography (EEG) we address this question within the context of subjects discriminating three types of pitches (fastball, curveball, slider) based on pitch trajectories. We find clear neural signatures of pitch classification and, using signal detection theory, we identify the times of discrimination on a trial-to-trial basis. Based on these neural signatures we estimate neural discrimination distributions as a function of the distance the ball is from the plate. We find all three pitches yield unique distributions, namely the timing of the discriminating neural signatures relative to the position of the ball in its trajectory. For instance, fastballs are discriminated at the earliest points in their trajectory, relative to the two other pitches, which is consistent with the need for some constant time to generate and execute the motor plan for the swing (or inhibition of the swing). We also find incorrect discrimination of a pitch (errors) yields neural sources in Brodmann Area 10, which has been implicated in prospective memory, recall, and task difficulty. In summary, we show that single-trial analysis of EEG yields informative distributions of the relative point in a baseball's trajectory when the batter makes a decision on which pitch is coming.

Goals of patient care system change with video-based education increases rates of advance cardiopulmonary resuscitation decision-making and discussions in hospitalised rehabilitation patients.

PubMed

Johnson, Claire E; Chong, Jeffrey C; Wilkinson, Anne; Hayes, Barbara; Tait, Sonia; Waldron, Nicholas

2017-07-01

Advance cardiopulmonary resuscitation (CPR) discussions and decision-making are not routine clinical practice in the hospital setting. Frail older patients may be at risk of non-beneficial CPR. To assess the utility and safety of two interventions to increase CPR decision-making, documentation and communication for hospitalised older patients. A pre-post study tested two interventions: (i) standard ward-based education forums with CPR content; and (ii) a combined, two-pronged strategy with 'Goals of Patient Care' (GoPC) system change and a structured video-based workshop; against usual practice (i.e. no formal training). Participants were a random sample of patients in a hospital rehabilitation unit. The outcomes were the proportion of patients documented as: (i) not for resuscitation (NFR); and (ii) eligible for rapid response team (RRT) calls, and rates of documented discussions with the patient, family and carer. When compared with usual practice, patients were more likely to be documented as NFR following the two-pronged intervention (adjusted odds ratio (aOR): 6.4, 95% confidence interval (CI): 3.0; 13.6). Documentation of discussions with patients was also more likely (aOR: 3.3, 95% CI:1.8; 6.2). Characteristics of patients documented NFR were similar between the phases, but were more likely for RRT calls following Phase 3 (P 0.03). An increase in advance CPR decisions occurred following GoPC system change with education. This appears safe as NFR patients had the same level of frailty between phases but were more likely to be eligible for RRT review. Increased documentation of discussions suggests routine use of the GoPC form may improve communication with patients about their care. © 2017 Royal Australasian College of Physicians.

Emotional see-saw affects rationality of decision-making: Evidence for metacognitive impairments.

PubMed

Folwarczny, Michał; Kaczmarek, Magdalena C; Doliński, Dariusz; Szczepanowski, Remigiusz

2018-05-01

This research investigated the cognitive mechanisms that underlie impairments in human reasoning triggered by the emotional see-saw technique. It has previously been stated that such manipulation is effective as it presumably induces a mindless state and cognitive deficits in compliant individuals. Based on the dual-system architecture of reasoning (system 2) and affective decision-making (system 1), we challenged the previous theoretical account by indicating that the main source of compliance is impairment of the meta-reasoning system when rapid affective changes occur. To examine this hypothesis, we manipulated affective feelings (system 1 processing) by violating participants' expectations regarding reward and performance in a go/no-go task in which individuals were to inhibit their responses to earn money. Aside from the go/no-go performance, we measured rationality (meta-reasoning system 2) in decision-making by asking participants to comply with a nonsensical request. We found that participants who were exposed to meta-reasoning impairments due to the emotional see-saw phenomenon exhibited mindless behavior. Copyright © 2018 Elsevier B.V. All rights reserved.

Barriers to electric energy efficiency in Ghana

NASA Astrophysics Data System (ADS)

Berko, Joseph Kofi, Jr.

Development advocates argue that sustainable development strategies are the best means to permanently improve living standards in developing countries. Advocates' arguments are based on the technical, financial, and environmental advantages of sustainable development. However, they have not addressed the organizational and administrative decision-making issues which are key to successful implementation of sustainable development in developing countries. Using the Ghanaian electricity industry as a case study, this dissertation identifies and analyzes organizational structures, administrative mechanisms, and decision-maker viewpoints that critically affect the success of adoption and implementation of energy efficiency within a sustainable development framework. Utilizing semi-structured interviews in field research, decision-makers' perceptions of the pattern of the industry's development, causes of the electricity supply shortfall, and barriers to electricity-use efficiency were identified. Based on the initial findings, the study formulated a set of policy initiatives to establish support for energy use efficiency. In a second set of interviews, these policy suggestions were presented to some of the top decision-makers to elicit their reactions. According to the decision-makers, the electricity supply shortfall is due to rapid urbanization and increased industrial consumption as a result of the structural adjustment program, rural electrification, and the sudden release of suppressed loads. The study found a lack of initiative and collaboration among industry decision-makers, and a related divergence in decision-makers' concerns and viewpoints. Also, lacking are institutional support systems and knowledge of proven energy efficiency strategies and technologies. As a result, planning, and even the range of perceived solutions to choose from are supply-side oriented. The final chapter of the study presents implications of its findings and proposes that any implementation strategy will have to address the different decision-makers' concerns and viewpoints. These include the need for national policies to promote electric energy efficiency and institutional development to provide support, guidance and direction to an energy efficiency effort. It also proposes structural changes within the industry to reduce government influence by creating an independent regulatory board. Finally, it proposes the adoption of integrated resource planning strategies and changes in the supply-side dominated culture within the electric utilities.

Application of Design of Experiments and Surrogate Modeling within the NASA Advanced Concepts Office, Earth-to-Orbit Design Process

NASA Technical Reports Server (NTRS)

Zwack, Matthew R.; Dees, Patrick D.; Holt, James B.

2016-01-01

Decisions made during early conceptual design can have a profound impact on life-cycle cost (LCC). Widely accepted that nearly 80% of LCC is committed. Decisions made during early design must be well informed. Advanced Concepts Office (ACO) at Marshall Space Flight Center aids in decision making for launch vehicles. Provides rapid turnaround pre-phase A and phase A studies. Provides customer with preliminary vehicle sizing information, vehicle feasibility, and expected performance.

Collaboration via E-Mail and Internet Relay Chat: Understanding Time and Technology.

ERIC Educational Resources Information Center

Duin, Ann Hill; Archee, Ray

1996-01-01

Examines how college students working across distances used e-mail and Internet Relay Chat (IRC) to facilitate their collaboration and decision-making processes. Finds that students came to a decision more quickly using e-mail than with IRC, and when IRC was slow, students reverted to a series of rapid-fire e-mail messages. (RS)

Identifying Key Features, Cutting Edge Cloud Resources, and Artificial Intelligence Tools to Achieve User-Friendly Water Science in the Cloud

NASA Astrophysics Data System (ADS)

Pierce, S. A.

2017-12-01

Decision making for groundwater systems is becoming increasingly important, as shifting water demands increasingly impact aquifers. As buffer systems, aquifers provide room for resilient responses and augment the actual timeframe for hydrological response. Yet the pace impacts, climate shifts, and degradation of water resources is accelerating. To meet these new drivers, groundwater science is transitioning toward the emerging field of Integrated Water Resources Management, or IWRM. IWRM incorporates a broad array of dimensions, methods, and tools to address problems that tend to be complex. Computational tools and accessible cyberinfrastructure (CI) are needed to cross the chasm between science and society. Fortunately cloud computing environments, such as the new Jetstream system, are evolving rapidly. While still targeting scientific user groups systems such as, Jetstream, offer configurable cyberinfrastructure to enable interactive computing and data analysis resources on demand. The web-based interfaces allow researchers to rapidly customize virtual machines, modify computing architecture and increase the usability and access for broader audiences to advanced compute environments. The result enables dexterous configurations and opening up opportunities for IWRM modelers to expand the reach of analyses, number of case studies, and quality of engagement with stakeholders and decision makers. The acute need to identify improved IWRM solutions paired with advanced computational resources refocuses the attention of IWRM researchers on applications, workflows, and intelligent systems that are capable of accelerating progress. IWRM must address key drivers of community concern, implement transdisciplinary methodologies, adapt and apply decision support tools in order to effectively support decisions about groundwater resource management. This presentation will provide an overview of advanced computing services in the cloud using integrated groundwater management case studies to highlight how Cloud CI streamlines the process for setting up an interactive decision support system. Moreover, advances in artificial intelligence offer new techniques for old problems from integrating data to adaptive sensing or from interactive dashboards to optimizing multi-attribute problems. The combination of scientific expertise, flexible cloud computing solutions, and intelligent systems opens new research horizons.

Geoillustrator - fast sketching of geological illustrations and animations

NASA Astrophysics Data System (ADS)

Patel, Daniel; Langeland, Tor; Solteszova, Veronika

2014-05-01

We present our research results in the Geoillustrator project. The project has been going for four years and is ending in March. It was aimed at developing a rapid sketching tool for generating geological illustrations and animations for understanding the processes that have led to a current subsurface configuration. The sketching tool facilitates effective dissemination of ideas, e.g. through generation of interactive geo-scientific illustrations for interdisciplinary communication and communication to decision makers, media and lay persons. This can improve work processes in early phases of oil and gas exploration where critical decisions have to be taken based on limited information. It is a challenge for involved specialists in early exploration phases to externalize their ideas, and effectively achieve consensus in multidisciplinary working groups. In these work processes, a tool for rapid sketching of geology would be very useful for expressing geological hypotheses and creating and comparing different evolution scenarios. Often, decisions are influenced by factors that are not relevant, e.g. the geologists who produce the most polished illustrations of their hypothesis have a higher probability for getting their theories through to decision makers as it is more clearly communicated. This results in a competitive advantage for geologists who are skilled in creating illustrations. Having a tool that would lift the ability of all geologists to express their ideas to an equal level would result in more alternatives and better foundation for decision making. Digital sketching will also allow capturing otherwise lost material which can constitute a large amount of mental work and ideas. The results of sketching are currently scrapped as paper or erased from the blackboard or exist only as rough personal sketches. By using a digital sketching tool, the sketches can be exported to a form usable in modelling tools used in later phases of exploration. Currently, no digital tool exists supporting the above mentioned requirements. However, in the Geoillustrator project, relevant visualization and sketching methods have been researched, and prototypes have been developed which demonstrate a set of the mentioned functionalities. Our published results in the project which we will present can be found on our website http://www.cmr.no/cmr_computing/index.cfm?id=313109

Use of a conformational switching aptamer for rapid and specific ex vivo identification of central nervous system lymphoma in a xenograft model

NASA Astrophysics Data System (ADS)

Georges, Joseph F.; Liu, Xiaowei; Eschbacher, Jennifer; Nichols, Joshua; Mooney, Michael A.; Joy, Anna; Spetzler, Robert F.; Feuerstein, Burt G.; Anderson, Trent; Preul, Mark C.; Yan, Hao; Nakaji, Peter

2018-02-01

Improved tools for providing specific intraoperative diagnoses could improve patient care. In neurosurgery, intraoperatively differentiating non-operative lesions can be challenging, often necessitating immunohistochemical (IHC) procedures which require up to 24-48 hours. Here, we evaluate the feasibility of generating rapid ex vivo specific labeling using a novel lymphoma-specific fluorescent switchable aptamer. Our B-cell lymphoma-specific switchable aptamer produced only low-level fluorescence in its unbound conformation and generated an 8-fold increase in fluorescence once bound to its target on CD20-positive lymphoma cells. The aptamer demonstrated strong binding to B-cell lymphoma cells within 10 minutes of incubation. We applied the switchable aptamer to ex vivo xenograft tissue harboring B-cell lymphoma and astrocytoma, and within one hour specific visual identification of lymphoma was routinely possible. In this proof-of-concept study in human cell culture and orthotopic xenografts, we conclude that a fluorescent switchable aptamer can provide rapid and specific labeling of B-cell lymphoma, and that developing aptamer-based labeling approaches could simplify tissue staining and drastically reduce time to histopathological diagnoses compared with IHC-based methods. We propose that switchable aptamers could enhance expeditious, accurate intraoperative decision-making.

A Comparative Study with RapidMiner and WEKA Tools over some Classification Techniques for SMS Spam

NASA Astrophysics Data System (ADS)

Foozy, Cik Feresa Mohd; Ahmad, Rabiah; Faizal Abdollah, M. A.; Chai Wen, Chuah

2017-08-01

SMS Spamming is a serious attack that can manipulate the use of the SMS by spreading the advertisement in bulk. By sending the unwanted SMS that contain advertisement can make the users feeling disturb and this against the privacy of the mobile users. To overcome these issues, many studies have proposed to detect SMS Spam by using data mining tools. This paper will do a comparative study using five machine learning techniques such as Naïve Bayes, K-NN (K-Nearest Neighbour Algorithm), Decision Tree, Random Forest and Decision Stumps to observe the accuracy result between RapidMiner and WEKA for dataset SMS Spam UCI Machine Learning repository.

Foraging decisions of bison for rapid energy gains can explain the relative risk to neighboring plants in complex swards.

PubMed

Courant, Sabrina; Fortin, Daniel

2010-06-01

Herbivores commonly base their foraging decisions not only on the intrinsic characteristics of plants, but also on the attributes of neighboring species. Although herbivores commonly orient their food choices toward the maximization of energy intake, the impact of such choices on neighboring plants remains largely unexplored. We evaluated whether foraging decisions by herbivores aiming at a rapid intake of digestible energy could explain multiple neighboring effects in complex swards. Specifically, we assessed how spatial patterns of occurrence of Carex atherodes, a highly profitable sedge species, could control the risk of bison (Bison bison) herbivory for seven other plant species. The foraging behavior of 70 free-ranging bison was evaluated in their natural environment during summer, and then related to plant characteristics. We used this information to estimate the instantaneous intake rate of digestible energy at individual feeding stations. We found that neighbor contrast defense and associational susceptibility can both be explained by simple foraging rules of energy maximization. Energy gains were higher when C. atherodes was consumed while avoiding the species for which we detected neighbor contrast defense. The lower intake rate associated with their consumption was due to an increase in handling time caused by their small size relative to C. atherodes. Bison also had higher energy gains by consuming instead of avoiding the plant species that experienced associational susceptibility. Because most of these plants were at least as tall as C. atherodes, their presence increased the heterogeneity of the grazed stratum. Avoiding their consumption increased handling time thereby reducing the instantaneous rate of energy intake. Overall, we found that bison adjust their fine-scale foraging decisions to vertical and horizontal sward structures in a way that maximizes their energy intake rate. Energy maximization principles thus provide a valuable framework to evaluate a broad-range of neighboring effects for prey faced with generalist consumers.

Achieving realistic performance and decison-making capabilities in computer-generated air forces

NASA Astrophysics Data System (ADS)

Banks, Sheila B.; Stytz, Martin R.; Santos, Eugene, Jr.; Zurita, Vincent B.; Benslay, James L., Jr.

1997-07-01

For a computer-generated force (CGF) system to be useful in training environments, it must be able to operate at multiple skill levels, exhibit competency at assigned missions, and comply with current doctrine. Because of the rapid rate of change in distributed interactive simulation (DIS) and the expanding set of performance objectives for any computer- generated force, the system must also be modifiable at reasonable cost and incorporate mechanisms for learning. Therefore, CGF applications must have adaptable decision mechanisms and behaviors and perform automated incorporation of past reasoning and experience into its decision process. The CGF must also possess multiple skill levels for classes of entities, gracefully degrade its reasoning capability in response to system stress, possess an expandable modular knowledge structure, and perform adaptive mission planning. Furthermore, correctly performing individual entity behaviors is not sufficient. Issues related to complex inter-entity behavioral interactions, such as the need to maintain formation and share information, must also be considered. The CGF must also be able to acceptably respond to unforeseen circumstances and be able to make decisions in spite of uncertain information. Because of the need for increased complexity in the virtual battlespace, the CGF should exhibit complex, realistic behavior patterns within the battlespace. To achieve these necessary capabilities, an extensible software architecture, an expandable knowledge base, and an adaptable decision making mechanism are required. Our lab has addressed these issues in detail. The resulting DIS-compliant system is called the automated wingman (AW). The AW is based on fuzzy logic, the common object database (CODB) software architecture, and a hierarchical knowledge structure. We describe the techniques we used to enable us to make progress toward a CGF entity that satisfies the requirements presented above. We present our design and implementation of an adaptable decision making mechanism that uses multi-layered, fuzzy logic controlled situational analysis. Because our research indicates that fuzzy logic can perform poorly under certain circumstances, we combine fuzzy logic inferencing with adversarial game tree techniques for decision making in strategic and tactical engagements. We describe the approach we employed to achieve this fusion. We also describe the automated wingman's system architecture and knowledge base architecture.

Project Delivery System Mode Decision Based on Uncertain AHP and Fuzzy Sets

NASA Astrophysics Data System (ADS)

Kaishan, Liu; Huimin, Li

2017-12-01

The project delivery system mode determines the contract pricing type, project management mode and the risk allocation among all participants. Different project delivery system modes have different characteristics and applicable scope. For the owners, the selection of the delivery mode is the key point to decide whether the project can achieve the expected benefits, it relates to the success or failure of project construction. Under the precondition of comprehensively considering the influence factors of the delivery mode, the model of project delivery system mode decision was set up on the basis of uncertain AHP and fuzzy sets, which can well consider the uncertainty and fuzziness when conducting the index evaluation and weight confirmation, so as to rapidly and effectively identify the most suitable delivery mode according to project characteristics. The effectiveness of the model has been verified via the actual case analysis in order to provide reference for the construction project delivery system mode.

Examining the Influence of Context and Professional Culture on Clinical Reasoning Through Rhetorical-Narrative Analysis.

PubMed

Peters, Amanda; Vanstone, Meredith; Monteiro, Sandra; Norman, Geoff; Sherbino, Jonathan; Sibbald, Matthew

2017-05-01

According to the dual process model of reasoning, physicians make diagnostic decisions using two mental systems: System 1, which is rapid, unconscious, and intuitive, and System 2, which is slow, rational, and analytical. Currently, little is known about physicians' use of System 1 or intuitive reasoning in practice. In a qualitative study of clinical reasoning, physicians were asked to tell stories about times when they used intuitive reasoning while working up an acutely unwell patient, and we combine socio-narratology and rhetorical theory to analyze physicians' stories. Our analysis reveals that in describing their work, physicians draw on two competing narrative structures: one that is aligned with an evidence-based medicine approach valuing System 2 and one that is aligned with cooperative decision making involving others in the clinical environment valuing System 1. Our findings support an understanding of clinical reasoning as distributed, contextual, and influenced by professional culture.

Communal Cooperation in Sensor Networks for Situation Management

NASA Technical Reports Server (NTRS)

Jones, Kennie H.; Lodding, Kenneth N.; Olariu, Stephan; Wilson, Larry; Xin,Chunsheng

2006-01-01

Situation management is a rapidly evolving science where managed sources are processed as realtime streams of events and fused in a way that maximizes comprehension, thus enabling better decisions for action. Sensor networks provide a new technology that promises ubiquitous input and action throughout an environment, which can substantially improve information available to the process. Here we describe a NASA program that requires improvements in sensor networks and situation management. We present an approach for massively deployed sensor networks that does not rely on centralized control but is founded in lessons learned from the way biological ecosystems are organized. In this approach, fully distributed data aggregation and integration can be performed in a scalable fashion where individual motes operate based on local information, making local decisions that achieve globally-meaningful results. This exemplifies the robust, fault-tolerant infrastructure required for successful situation management systems.

Risk-prone individuals prefer the wrong options on a rat version of the Iowa Gambling Task.

PubMed

Rivalan, Marion; Ahmed, Serge H; Dellu-Hagedorn, Françoise

2009-10-15

Decision making in complex and conflicting situations, as measured in the widely used Iowa Gambling Task (IGT), can be profoundly impaired in psychiatric disorders, such as attention-deficit/hyperactivity disorder, drug addiction, and also in healthy individuals for whom immediate gratification prevails over long-term gain. The cognitive processes underlying these deficits are poorly understood, in part due to a lack of suitable animal models assessing complex decision making with good construct validity. We developed a rat gambling task analogous to the IGT that tracks, for the first time, the ongoing decision process within a single session in an operant cage. Rats could choose between various options. Disadvantageous options, as opposed to advantageous ones, offered bigger immediate food reward but were followed by longer, unpredictable penalties (time-out). The majority of rats can evaluate and deduce favorable options more or less rapidly according to task complexity, whereas others systematically choose disadvantageously. These interindividual differences are stable over time and do not depend on task difficulty or on the level of food restriction. We find that poor decision making does not result from a failure to acquire relevant information but from hypersensitivity to reward and higher risk taking in anxiogenic situations. These results suggest that rats, as well as human poor performers, share similar traits to those observed in decision-making related psychiatric disorders. These traits could constitute risk factors of developing such disorders. The rapid identification of poor decision makers using the rat gambling task should promote the discovery of the specific brain dysfunctions that cause maladapted decision making.

From open source communications to knowledge

NASA Astrophysics Data System (ADS)

Preece, Alun; Roberts, Colin; Rogers, David; Webberley, Will; Innes, Martin; Braines, Dave

2016-05-01

Rapid processing and exploitation of open source information, including social media sources, in order to shorten decision-making cycles, has emerged as an important issue in intelligence analysis in recent years. Through a series of case studies and natural experiments, focussed primarily upon policing and counter-terrorism scenarios, we have developed an approach to information foraging and framing to inform decision making, drawing upon open source intelligence, in particular Twitter, due to its real-time focus and frequent use as a carrier for links to other media. Our work uses a combination of natural language (NL) and controlled natural language (CNL) processing to support information collection from human sensors, linking and schematising of collected information, and the framing of situational pictures. We illustrate the approach through a series of vignettes, highlighting (1) how relatively lightweight and reusable knowledge models (schemas) can rapidly be developed to add context to collected social media data, (2) how information from open sources can be combined with reports from trusted observers, for corroboration or to identify con icting information; and (3) how the approach supports users operating at or near the tactical edge, to rapidly task information collection and inform decision-making. The approach is supported by bespoke software tools for social media analytics and knowledge management.

Nip, Tuck and Click: Medical Tourism and the Emergence of Web-Based Health Information

PubMed Central

Lunt, Neil; Hardey, Mariann; Mannion, Russell

2010-01-01

An emerging trend is what has become commonly known as ‘Medical Tourism’ where patients travel to overseas destinations for specialised surgical treatments and other forms of medical care. With the rise of more affordable cross-border travel and rapid technological developments these movements are becoming more commonplace. A key driver is the platform provided by the internet for gaining access to healthcare information and advertising. There has been relatively little attention given to the role and impact of web-based information to inform Medical Tourism decisions. This article provides a brief overview of the most recent development in Medical Tourism and examines how this is linked to the emergence of specialized internet web sites. It produces a summary of the functionality of medical tourist sites, and situates Medical Tourism informatics within the broader literatures relating to information search, information quality and decision-making. This paper is both a call to strengthen the empirical evidence in this area, and also to advocate integrating Medical Tourism research within a broader conceptual framework. PMID:20517465

Nip, tuck and click: medical tourism and the emergence of web-based health information.

PubMed

Lunt, Neil; Hardey, Mariann; Mannion, Russell

2010-02-12

An emerging trend is what has become commonly known as 'Medical Tourism' where patients travel to overseas destinations for specialised surgical treatments and other forms of medical care. With the rise of more affordable cross-border travel and rapid technological developments these movements are becoming more commonplace. A key driver is the platform provided by the internet for gaining access to healthcare information and advertising. There has been relatively little attention given to the role and impact of web-based information to inform Medical Tourism decisions.This article provides a brief overview of the most recent development in Medical Tourism and examines how this is linked to the emergence of specialized internet web sites. It produces a summary of the functionality of medical tourist sites, and situates Medical Tourism informatics within the broader literatures relating to information search, information quality and decision-making.This paper is both a call to strengthen the empirical evidence in this area, and also to advocate integrating Medical Tourism research within a broader conceptual framework.

Instrumentation issues in implementation science.

PubMed

Martinez, Ruben G; Lewis, Cara C; Weiner, Bryan J

2014-09-04

Like many new fields, implementation science has become vulnerable to instrumentation issues that potentially threaten the strength of the developing knowledge base. For instance, many implementation studies report findings based on instruments that do not have established psychometric properties. This article aims to review six pressing instrumentation issues, discuss the impact of these issues on the field, and provide practical recommendations. This debate centers on the impact of the following instrumentation issues: use of frameworks, theories, and models; role of psychometric properties; use of 'home-grown' and adapted instruments; choosing the most appropriate evaluation method and approach; practicality; and need for decision-making tools. Practical recommendations include: use of consensus definitions for key implementation constructs; reporting standards (e.g., regarding psychometrics, instrument adaptation); when to use multiple forms of observation and mixed methods; and accessing instrument repositories and decision aid tools. This debate provides an overview of six key instrumentation issues and offers several courses of action to limit the impact of these issues on the field. With careful attention to these issues, the field of implementation science can potentially move forward at the rapid pace that is respectfully demanded by community stakeholders.

Covert rapid action-memory simulation (CRAMS): a hypothesis of hippocampal-prefrontal interactions for adaptive behavior.

PubMed

Wang, Jane X; Cohen, Neal J; Voss, Joel L

2015-01-01

Effective choices generally require memory, yet little is known regarding the cognitive or neural mechanisms that allow memory to influence choices. We outline a new framework proposing that covert memory processing of hippocampus interacts with action-generation processing of prefrontal cortex in order to arrive at optimal, memory-guided choices. Covert, rapid action-memory simulation (CRAMS) is proposed here as a framework for understanding cognitive and/or behavioral choices, whereby prefrontal-hippocampal interactions quickly provide multiple simulations of potential outcomes used to evaluate the set of possible choices. We hypothesize that this CRAMS process is automatic, obligatory, and covert, meaning that many cycles of action-memory simulation occur in response to choice conflict without an individual's necessary intention and generally without awareness of the simulations, leading to adaptive behavior with little perceived effort. CRAMS is thus distinct from influential proposals that adaptive memory-based behavior in humans requires consciously experienced memory-based construction of possible future scenarios and deliberate decisions among possible future constructions. CRAMS provides an account of why hippocampus has been shown to make critical contributions to the short-term control of behavior, and it motivates several new experimental approaches and hypotheses that could be used to better understand the ubiquitous role of prefrontal-hippocampal interactions in situations that require adaptively using memory to guide choices. Importantly, this framework provides a perspective that allows for testing decision-making mechanisms in a manner that translates well across human and nonhuman animal model systems. Copyright © 2014 Elsevier Inc. All rights reserved.

A Million Decisions: Life on the (Sustainable Business) Frontier

ERIC Educational Resources Information Center

Steketee, Deborah

2009-01-01

Innovation often happens at the margin. For the past 5 years, in the academic equivalent of an ecotone, Aquinas College in Grand Rapids, Michigan has built and continues to refine offerings in its 4-year Bachelor of Science degree in Sustainable Business. Emerging out of the demands of a rapidly changing business world and the sustainable business…

Rapid Acquisition in Concurrent Chains: Evidence for a Decision Model

ERIC Educational Resources Information Center

Grace, Randolph C.; McLean, Anthony P.

2006-01-01

Pigeons' choice in concurrent chains can adapt to rapidly changing contingencies. Grace, Bragason, and McLean (2003) found that relative initial-link response rate was sensitive to the immediacy ratio in the current session when one of the terminal-link fixed-interval schedules was changed daily according to a pseudorandom binary sequence (e.g.,…

Use of Knowledge Base Systems (EMDS) in Strategic and Tactical Forest Planning

NASA Astrophysics Data System (ADS)

Jensen, M. E.; Reynolds, K.; Stockmann, K.

2008-12-01

The USDA Forest Service 2008 Planning Rule requires Forest plans to provide a strategic vision for maintaining the sustainability of ecological, economic, and social systems across USFS lands through the identification of desired conditions and objectives. In this paper we show how knowledge-based systems can be efficiently used to evaluate disparate natural resource information to assess desired conditions and related objectives in Forest planning. We use the Ecosystem Management Decision Support (EMDS) system (http://www.institute.redlands.edu/emds/), which facilitates development of both logic-based models for evaluating ecosystem sustainability (desired conditions) and decision models to identify priority areas for integrated landscape restoration (objectives). The study area for our analysis spans 1,057 subwatersheds within western Montana and northern Idaho. Results of our study suggest that knowledge-based systems such as EMDS are well suited to both strategic and tactical planning and that the following points merit consideration in future National Forest (and other land management) planning efforts: 1) Logic models provide a consistent, transparent, and reproducible method for evaluating broad propositions about ecosystem sustainability such as: are watershed integrity, ecosystem and species diversity, social opportunities, and economic integrity in good shape across a planning area? The ability to evaluate such propositions in a formal logic framework also allows users the opportunity to evaluate statistical changes in outcomes over time, which could be very useful for regional and national reporting purposes and for addressing litigation; 2) The use of logic and decision models in strategic and tactical Forest planning provides a repository for expert knowledge (corporate memory) that is critical to the evaluation and management of ecosystem sustainability over time. This is especially true for the USFS and other federal resource agencies, which are likely to experience rapid turnover in tenured resource specialist positions within the next five years due to retirements; 3) Use of logic model output in decision models is an efficient method for synthesizing the typically large amounts of information needed to support integrated landscape restoration. Moreover, use of logic and decision models to design customized scenarios for integrated landscape restoration, as we have demonstrated with EMDS, offers substantial improvements to traditional GIS-based procedures such as suitability analysis. To our knowledge, this study represents the first attempt to link evaluations of desired conditions for ecosystem sustainability in strategic planning to tactical planning regarding the location of subwatersheds that best meet the objectives of integrated landscape restoration. The basic knowledge-based approach implemented in EMDS, with its logic (NetWeaver) and decision (Criterion Decision Plus) engines, is well suited both to multi-scale strategic planning and to multi-resource tactical planning.

Application of Design of Experiments and Surrogate Modeling within the NASA Advanced Concepts Office, Earth-to-Orbit Design Process

NASA Technical Reports Server (NTRS)

Zwack, Mathew R.; Dees, Patrick D.; Holt, James B.

2016-01-01

Decisions made during early conceptual design have a large impact upon the expected life-cycle cost (LCC) of a new program. It is widely accepted that up to 80% of such cost is committed during these early design phases [1]. Therefore, to help minimize LCC, decisions made during conceptual design must be based upon as much information as possible. To aid in the decision making for new launch vehicle programs, the Advanced Concepts Office (ACO) at NASA Marshall Space Flight Center (MSFC) provides rapid turnaround pre-phase A and phase A concept definition studies. The ACO team utilizes a proven set of tools to provide customers with a full vehicle mass breakdown to tertiary subsystems, preliminary structural sizing based upon worst-case flight loads, and trajectory optimization to quantify integrated vehicle performance for a given mission [2]. Although the team provides rapid turnaround for single vehicle concepts, the scope of the trade space can be limited due to analyst availability and the manpower requirements for manual execution of the analysis tools. In order to enable exploration of a broader design space, the ACO team has implemented an advanced design methods (ADM) based approach. This approach applies the concepts of design of experiments (DOE) and surrogate modeling to more exhaustively explore the trade space and provide the customer with additional design information to inform decision making. This paper will first discuss the automation of the ACO tool set, which represents a majority of the development effort. In order to fit a surrogate model within tolerable error bounds a number of DOE cases are needed. This number will scale with the number of variable parameters desired and the complexity of the system's response to those variables. For all but the smallest design spaces, the number of cases required cannot be produced within an acceptable timeframe using a manual process. Therefore, automation of the tools was a key enabler for the successful application of an ADM approach to an ACO design study. Following the overview of the tool set automation, an example problem will be given to illustrate the implementation of the ADM approach. The example problem will first cover the inclusion of ground rules and assumptions (GR&A) for a study. The GR&A are very important to the study as they determine the constraints within which a trade study can be conducted. These trades must ultimately reconcile with the customer's desired output and any anticipated "what if" questions.

SU-E-T-23: A Developing Australian Network for Datamining and Modelling Routine Radiotherapy Clinical Data and Radiomics Information for Rapid Learning and Clinical Decision Support

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

Thwaites, D; Holloway, L; Bailey, M

2015-06-15

Purpose: Large amounts of routine radiotherapy (RT) data are available, which can potentially add clinical evidence to support better decisions. A developing collaborative Australian network, with a leading European partner, aims to validate, implement and extend European predictive models (PMs) for Australian practice and assess their impact on future patient decisions. Wider objectives include: developing multi-institutional rapid learning, using distributed learning approaches; and assessing and incorporating radiomics information into PMs. Methods: Two initial standalone pilots were conducted; one on NSCLC, the other on larynx, patient datasets in two different centres. Open-source rapid learning systems were installed, for data extraction andmore » mining to collect relevant clinical parameters from the centres’ databases. The European DSSs were learned (“training cohort”) and validated against local data sets (“clinical cohort”). Further NSCLC studies are underway in three more centres to pilot a wider distributed learning network. Initial radiomics work is underway. Results: For the NSCLC pilot, 159/419 patient datasets were identified meeting the PM criteria, and hence eligible for inclusion in the curative clinical cohort (for the larynx pilot, 109/125). Some missing data were imputed using Bayesian methods. For both, the European PMs successfully predicted prognosis groups, but with some differences in practice reflected. For example, the PM-predicted good prognosis NSCLC group was differentiated from a combined medium/poor prognosis group (2YOS 69% vs. 27%, p<0.001). Stage was less discriminatory in identifying prognostic groups. In the good prognosis group two-year overall survival was 65% in curatively and 18% in palliatively treated patients. Conclusion: The technical infrastructure and basic European PMs support prognosis prediction for these Australian patient groups, showing promise for supporting future personalized treatment decisions, improved treatment quality and potential practice changes. The early indications from the distributed learning and radiomics pilots strengthen this. Improved routine patient data quality should strengthen such rapid learning systems.« less

Satellites, tweets, forecasts: the future of flood disaster management?

NASA Astrophysics Data System (ADS)

Dottori, Francesco; Kalas, Milan; Lorini, Valerio; Wania, Annett; Pappenberger, Florian; Salamon, Peter; Ramos, Maria Helena; Cloke, Hannah; Castillo, Carlos

2017-04-01

Floods have devastating effects on lives and livelihoods around the world. Structural flood defence measures such as dikes and dams can help protect people. However, it is the emerging science and technologies for flood disaster management and preparedness, such as increasingly accurate flood forecasting systems, high-resolution satellite monitoring, rapid risk mapping, and the unique strength of social media information and crowdsourcing, that are most promising for reducing the impacts of flooding. Here, we describe an innovative framework which integrates in real-time two components of the Copernicus Emergency mapping services, namely the European Flood Awareness System and the satellite-based Rapid Mapping, with new procedures for rapid risk assessment and social media and news monitoring. The integrated framework enables improved flood impact forecast, thanks to the real-time integration of forecasting and monitoring components, and increases the timeliness and efficiency of satellite mapping, with the aim of capturing flood peaks and following the evolution of flooding processes. Thanks to the proposed framework, emergency responders will have access to a broad range of timely and accurate information for more effective and robust planning, decision-making, and resource allocation.

De-escalating Antibiotic Use in the Inpatient Setting: Strategies, Controversies, and Challenges.

PubMed

Daniel Markley, J; Bernard, Shaina; Bearman, Gonzalo; Stevens, Michael P

2017-04-01

Antibiotic de-escalation (ADE) is widely accepted as an integral strategy to curtail the global antibiotic resistance crisis. However, there is significant uncertainty regarding the ideal ADE strategy and its true impact on antibiotic resistance. Rapid diagnostic testing has the potential to enhance ADE strategies. Herein, we aim to discuss the current strategies, controversies, and challenges of ADE in the inpatient setting. A consensus definition of ADE remains elusive at this time. Preliminary studies utilizing rapid diagnostic tests including matrix-assisted laser desorption/ionization time of flight (MALDI-TOF), procalcitonin, and other molecular techniques have demonstrated the potential to support ADE strategies. In the absence of evidence-based, highly specific ADE protocols, the likelihood that individual providers will make consistent, often challenging, decisions to de-escalate antibiotic therapy is low. Antimicrobial stewardship programs should support local physicians with ADE and develop innovative ways to integrate ADE into the broader construct of antimicrobial stewardship programs. The evolving field of rapid diagnostics has significant potential to improve ADE strategies, but more research is needed to fully realize this goal.

A Bottom-up Vulnerability Analysis of Water Systems with Decentralized Decision Making and Demographic Shifts- the Case of Jordan.

NASA Astrophysics Data System (ADS)

Lachaut, T.; Yoon, J.; Klassert, C. J. A.; Talozi, S.; Mustafa, D.; Knox, S.; Selby, P. D.; Haddad, Y.; Gorelick, S.; Tilmant, A.

2016-12-01

Probabilistic approaches to uncertainty in water systems management can face challenges of several types: non stationary climate, sudden shocks such as conflict-driven migrations, or the internal complexity and dynamics of large systems. There has been a rising trend in the development of bottom-up methods that place focus on the decision side instead of probability distributions and climate scenarios. These approaches are based on defining acceptability thresholds for the decision makers and considering the entire range of possibilities over which such thresholds are crossed. We aim at improving the knowledge on the applicability and relevance of this approach by enlarging its scope beyond climate uncertainty and single decision makers; thus including demographic shifts, internal system dynamics, and multiple stakeholders at different scales. This vulnerability analysis is part of the Jordan Water Project and makes use of an ambitious multi-agent model developed by its teams with the extensive cooperation of the Ministry of Water and Irrigation of Jordan. The case of Jordan is a relevant example for migration spikes, rapid social changes, resource depletion and climate change impacts. The multi-agent modeling framework used provides a consistent structure to assess the vulnerability of complex water resources systems with distributed acceptability thresholds and stakeholder interaction. A proof of concept and preliminary results are presented for a non-probabilistic vulnerability analysis that involves different types of stakeholders, uncertainties other than climatic and the integration of threshold-based indicators. For each stakeholder (agent) a vulnerability matrix is constructed over a multi-dimensional domain, which includes various hydrologic and/or demographic variables.

Integrated Model-Based Decisions for Water, Energy and Food Nexus

NASA Astrophysics Data System (ADS)

Zhang, X.; Vesselinov, V. V.

2015-12-01

Energy, water and food are critical resources for sustaining social development and human lives; human beings cannot survive without any one of them. Energy crises, water shortages and food security are crucial worldwide problems. The nexus of energy, water and food has received more and more attention in the past decade. Energy, water and food are closely interrelated; water is required in energy development such as electricity generation; energy is indispensable for collecting, treating, and transporting water; both energy and water are crucial inputs for food production. Changes of either of them can lead to substantial impacts on other two resources, and vice versa. Effective decisions should be based on thorough research efforts for better understanding of their complex nexus. Rapid increase of population has significantly intensified the pressures on energy, water and food. Addressing and quantifying their interactive relationships are important for making robust and cost-effective strategies for managing the three resources simultaneously. In addition, greenhouse gases (GHGs) are emitted in energy, water, food production, consequently making contributions to growing climate change. Reflecting environmental impacts of GHGs is also desired (especially, on the quality and quantity of fresh water resources). Thus, a socio-economic model is developed in this study to quantitatively address the complex connections among energy, water and food production. A synthetic problem is proposed to demonstrate the model's applicability and feasibility. Preliminary results related to integrated decisions on energy supply management, water use planning, electricity generation planning, energy facility capacity expansion, food production, and associated GHG emission control are generated for providing cost-effective supports for decision makers.

Adaptation pathways: ecoregion and land ownership influences on climate adaptation decision-making in forest management

Treesearch

Todd A. Ontl; Chris Swanston; Leslie A. Brandt; Patricia R. Butler; Anthony W. D’Amato; Stephen D. Handler; Maria K. Janowiak; P. Danielle Shannon

2018-01-01

Climate adaptation planning and implementation are likely to increase rapidly within the forest sector not only as climate continues to change but also as we intentionally learn from real-world examples. We sought to better understand how adaptation is being incorporated in land management decision-making across diverse land ownership types in the Midwest by evaluating...

RPA Field Simulations:Dilemma Training for Legal and Ethical Decision Making

DTIC Science & Technology

2015-11-07

Simulation  Two phases in RPA Field Simulation – classroom phase and field phase  Purpose: link theoretical understanding/ moral reasoning with...rapid, informed decision-making/ moral behavior IRREGULAR WARFARE  U.S. dominates conventional warfare, but irregular warfare falls under Things...aspects: Mental simulation of action Modify Implement Will it work? MORAL REASONING/BEHAVIOR Military-Leader Responsibility requires

Money matters: Rapid post-earthquake financial decision-making

USGS Publications Warehouse

Wald, David J.; Franco, Guillermo

2016-01-01

Post-earthquake financial decision-making is a realm beyond that of many people. In the immediate aftermath of a damaging earthquake, billions of dollars of relief, recovery, and insurance funds are in the balance through new financial instruments that allow those with resources to hedge against disasters and those at risk to limit their earthquake losses and receive funds for response and recovery.

Differentiation, Resistance and Courage: At Work in the Infant School

ERIC Educational Resources Information Center

Dixon, Annabelle

2013-01-01

It is self-evident that, given a group of very active young children and four walls within which to contain them, certain decisions have to be made fairly rapidly: what happens, where it happens, and when seem to be the most obviously pressing. When and how does differentiation come into play? Is it only when making decisions about grouping the…

Decision support system for the response to infectious disease emergencies based on WebGIS and mobile services in China.

PubMed

Li, Ya-pin; Fang, Li-qun; Gao, Su-qing; Wang, Zhen; Gao, Hong-wei; Liu, Peng; Wang, Ze-Rui; Li, Yan-Li; Zhu, Xu-Guang; Li, Xin-Lou; Xu, Bo; Li, Yin-Jun; Yang, Hong; de Vlas, Sake J; Shi, Tao-Xing; Cao, Wu-Chun

2013-01-01

For years, emerging infectious diseases have appeared worldwide and threatened the health of people. The emergence and spread of an infectious-disease outbreak are usually unforeseen, and have the features of suddenness and uncertainty. Timely understanding of basic information in the field, and the collection and analysis of epidemiological information, is helpful in making rapid decisions and responding to an infectious-disease emergency. Therefore, it is necessary to have an unobstructed channel and convenient tool for the collection and analysis of epidemiologic information in the field. Baseline information for each county in mainland China was collected and a database was established by geo-coding information on a digital map of county boundaries throughout the country. Google Maps was used to display geographic information and to conduct calculations related to maps, and the 3G wireless network was used to transmit information collected in the field to the server. This study established a decision support system for the response to infectious-disease emergencies based on WebGIS and mobile services (DSSRIDE). The DSSRIDE provides functions including data collection, communication and analyses in real time, epidemiological detection, the provision of customized epidemiological questionnaires and guides for handling infectious disease emergencies, and the querying of professional knowledge in the field. These functions of the DSSRIDE could be helpful for epidemiological investigations in the field and the handling of infectious-disease emergencies. The DSSRIDE provides a geographic information platform based on the Google Maps application programming interface to display information of infectious disease emergencies, and transfers information between workers in the field and decision makers through wireless transmission based on personal computers, mobile phones and personal digital assistants. After a 2-year practice and application in infectious disease emergencies, the DSSRIDE is becoming a useful platform and is a useful tool for investigations in the field carried out by response sections and individuals. The system is suitable for use in developing countries and low-income districts.

Process modeling and supply chain design for advanced biofuel production based on bio-oil gasification

NASA Astrophysics Data System (ADS)

Li, Qi

As a potential substitute for petroleum-based fuel, second generation biofuels are playing an increasingly important role due to their economic, environmental, and social benefits. With the rapid development of biofuel industry, there has been an increasing literature on the techno-economic analysis and supply chain design for biofuel production based on a variety of production pathways. A recently proposed production pathway of advanced biofuel is to convert biomass to bio-oil at widely distributed small-scale fast pyrolysis plants, then gasify the bio-oil to syngas and upgrade the syngas to transportation fuels in centralized biorefinery. This thesis aims to investigate two types of assessments on this bio-oil gasification pathway: techno-economic analysis based on process modeling and literature data; supply chain design with a focus on optimal decisions for number of facilities to build, facility capacities and logistic decisions considering uncertainties. A detailed process modeling with corn stover as feedstock and liquid fuels as the final products is presented. Techno-economic analysis of the bio-oil gasification pathway is also discussed to assess the economic feasibility. Some preliminary results show a capital investment of 438 million dollar and minimum fuel selling price (MSP) of $5.6 per gallon of gasoline equivalent. The sensitivity analysis finds that MSP is most sensitive to internal rate of return (IRR), biomass feedstock cost, and fixed capital cost. A two-stage stochastic programming is formulated to solve the supply chain design problem considering uncertainties in biomass availability, technology advancement, and biofuel price. The first-stage makes the capital investment decisions including the locations and capacities of the decentralized fast pyrolysis plants and the centralized biorefinery while the second-stage determines the biomass and biofuel flows. The numerical results and case study illustrate that considering uncertainties can be pivotal in this supply chain design and optimization problem. Also, farmers' participation has a significant effect on the decision making process.

Advantages of the rapid HIV-1 test in occupational accidents with potentially contaminated material among health workers.

PubMed

Machado, A A; Martinez, R; Haikal, A A; Rodrigues da Silva, M C

2001-01-01

In occupational accidents involving health professionals handling potentially contaminated material, the decision to start or to continue prophylactic medication against infection by Human Immunodeficiency Virus (HIV) has been based on the ELISA test applied to a blood sample from the source patient. In order to rationalize the prophylactic use of antiretroviral agents, a rapid serologic diagnostic test of HIV infection was tested by the enzymatic immunoabsorption method (SUDS HIV 1+2, MUREX) and compared to conventional ELISA (Abbott HIV-1/ HIV-2 3rd Generation plus EIA). A total of 592 cases of occupational accidents were recorded at the University Hospital of Ribeirão Preto from July 1998 to April 1999. Of these, 109 were simultaneously evaluated by the rapid test and by ELISA HIV. The rapid test was positive in three cases and was confirmed by ELISA and in one the result was inconclusive and later found to be negative by ELISA. In the 106 accidents in which the rapid test was negative no prophylactic medication was instituted, with an estimated reduction in costs of US$ 2,889.35. In addition to this advantage, the good correlation of the rapid test with ELISA, the shorter duration of stress and the absence of exposure of the health worker to the adverse effects of antiretroviral agents suggest the adoption of this test in Programs of Attention to Accidents with Potentially Contaminated Material.

A Cloud-based, Open-Source, Command-and-Control Software Paradigm for Space Situational Awareness (SSA)

NASA Astrophysics Data System (ADS)

Melton, R.; Thomas, J.

With the rapid growth in the number of space actors, there has been a marked increase in the complexity and diversity of software systems utilized to support SSA target tracking, indication, warning, and collision avoidance. Historically, most SSA software has been constructed with "closed" proprietary code, which limits interoperability, inhibits the code transparency that some SSA customers need to develop domain expertise, and prevents the rapid injection of innovative concepts into these systems. Open-source aerospace software, a rapidly emerging, alternative trend in code development, is based on open collaboration, which has the potential to bring greater transparency, interoperability, flexibility, and reduced development costs. Open-source software is easily adaptable, geared to rapidly changing mission needs, and can generally be delivered at lower costs to meet mission requirements. This paper outlines Ball's COSMOS C2 system, a fully open-source, web-enabled, command-and-control software architecture which provides several unique capabilities to move the current legacy SSA software paradigm to an open source model that effectively enables pre- and post-launch asset command and control. Among the unique characteristics of COSMOS is the ease with which it can integrate with diverse hardware. This characteristic enables COSMOS to serve as the command-and-control platform for the full life-cycle development of SSA assets, from board test, to box test, to system integration and test, to on-orbit operations. The use of a modern scripting language, Ruby, also permits automated procedures to provide highly complex decision making for the tasking of SSA assets based on both telemetry data and data received from outside sources. Detailed logging enables quick anomaly detection and resolution. Integrated real-time and offline data graphing renders the visualization of the both ground and on-orbit assets simple and straightforward.

Threshold and resilience management of coupled urbanization and water environmental system in the rapidly changing coastal region.

PubMed

Li, Yangfan; Li, Yi; Wu, Wei

2016-01-01

The concept of thresholds shows important implications for environmental and resource management. Here we derived potential landscape thresholds which indicated abrupt changes in water quality or the dividing points between exceeding and failing to meet national surface water quality standards for a rapidly urbanizing city on the Eastern Coast in China. The analysis of landscape thresholds was based on regression models linking each of the seven water quality variables to each of the six landscape metrics for this coupled land-water system. We found substantial and accelerating urban sprawl at the suburban areas between 2000 and 2008, and detected significant nonlinear relations between water quality and landscape pattern. This research demonstrated that a simple modeling technique could provide insights on environmental thresholds to support more-informed decision making in land use, water environmental and resilience management. Copyright © 2015 Elsevier Ltd. All rights reserved.

Technology assessment in healthcare: a review and description of a "best practice" technology assessment process.

PubMed

Fernandez, A M; Schrogie, J J; Wilson, W W; Nash, D B

1997-01-01

Technology assessment has become a rapidly growing component of the healthcare system. It has assumed a functional role in operational settings and is rapidly impacting decisions involving purchasing, coverage, and reimbursement. This review is intended to assist the healthcare decision maker in considering the application of technology assessment in healthcare, so as to maximize the efficiency of future purchasing decisions. This "best practice" was synthesized after identifying key institutions performing technology assessment in healthcare and analyzing their working processes, including literature review, consensus panel discussions, and expert opinion. We describe this best practice on a reiterative loop that consists of five processes: awareness, strategic appropriateness, analysis versus need, acquisition and implementation, and reassessment. Typical barriers to adoption of technology assessment are also identified and discussed. This review suggests a common terminology for the core processes involved in technology assessment, thereby facilitating a more uniform understanding among the different components of the healthcare system (i.e., payer, provider, and society) while recognizing their different perspectives.

Decision Making in Paediatric Cardiology. Are We Prone to Heuristics, Biases and Traps?

PubMed

Ryan, Aedin; Duignan, Sophie; Kenny, Damien; McMahon, Colin J

2018-01-01

Hidden traps in decision making have been long recognised in the behavioural economics community. Yet we spend very limited, if any time, analysing our decision-making processes in medicine and paediatric cardiology. Systems 1 and 2 thought processes differentiate between rapid emotional thoughts and slow deliberate rational thoughts. For fairly clear cut medical decisions, in-depth analysis may not be needed, but in our field of paediatric cardiology it is not uncommon for challenging cases and occasionally 'simple' cases to generate significant debate and uncertainty as to the best decision. Although morbidity and mortality meetings frequently highlight poor outcomes for our patients, they often neglect to analyse the process of thought which underlined those decisions taken. This article attempts to review commonly acknowledged traps in decision making in the behavioural economics world to ascertain whether these heuristics translate to decision making in the paediatric cardiology environment. We also discuss potential individual and collective solutions to pitfalls in decision making.

Do humans make good decisions?

PubMed Central

Summerfield, Christopher; Tsetsos, Konstantinos

2014-01-01

Human performance on perceptual classification tasks approaches that of an ideal observer, but economic decisions are often inconsistent and intransitive, with preferences reversing according to the local context. We discuss the view that suboptimal choices may result from the efficient coding of decision-relevant information, a strategy that allows expected inputs to be processed with higher gain than unexpected inputs. Efficient coding leads to ‘robust’ decisions that depart from optimality but maximise the information transmitted by a limited-capacity system in a rapidly-changing world. We review recent work showing that when perceptual environments are variable or volatile, perceptual decisions exhibit the same suboptimal context-dependence as economic choices, and propose a general computational framework that accounts for findings across the two domains. PMID:25488076

Consumer Health Informatics: Past, Present, and Future of a Rapidly Evolving Domain.

PubMed

Demiris, G

2016-05-20

Consumer Health Informatics (CHI) is a rapidly growing domain within the field of biomedical and health informatics. The objective of this paper is to reflect on the past twenty five years and showcase informatics concepts and applications that led to new models of care and patient empowerment, and to predict future trends and challenges for the next 25 years. We discuss concepts and systems based on a review and analysis of published literature in the consumer health informatics domain in the last 25 years. The field was introduced with the vision that one day patients will be in charge of their own health care using informatics tools and systems. Scientific literature in the field originally focused on ways to assess the quality and validity of available printed health information, only to grow significantly to cover diverse areas such as online communities, social media, and shared decision-making. Concepts such as home telehealth, mHealth, and the quantified-self movement, tools to address transparency of health care organizations, and personal health records and portals provided significant milestones in the field. Consumers are able to actively participate in the decision-making process and to engage in health care processes and decisions. However, challenges such as health literacy and the digital divide have hindered us from maximizing the potential of CHI tools with a significant portion of underserved populations unable to access and utilize them. At the same time, at a global scale consumer tools can increase access to care for underserved populations in developing countries. The field continues to grow and emerging movements such as precision medicine and the sharing economy will introduce new opportunities and challenges.

Consumer Health Informatics: Past, Present, and Future of a Rapidly Evolving Domain

PubMed Central

2016-01-01

Summary Objectives Consumer Health Informatics (CHI) is a rapidly growing domain within the field of biomedical and health informatics. The objective of this paper is to reflect on the past twenty five years and showcase informatics concepts and applications that led to new models of care and patient empowerment, and to predict future trends and challenges for the next 25 years. Methods We discuss concepts and systems based on a review and analysis of published literature in the consumer health informatics domain in the last 25 years. Results The field was introduced with the vision that one day patients will be in charge of their own health care using informatics tools and systems. Scientific literature in the field originally focused on ways to assess the quality and validity of available printed health information, only to grow significantly to cover diverse areas such as online communities, social media, and shared decision-making. Concepts such as home telehealth, mHealth, and the quantified-self movement, tools to address transparency of health care organizations, and personal health records and portals provided significant milestones in the field. Conclusion Consumers are able to actively participate in the decision-making process and to engage in health care processes and decisions. However, challenges such as health literacy and the digital divide have hindered us from maximizing the potential of CHI tools with a significant portion of underserved populations unable to access and utilize them. At the same time, at a global scale consumer tools can increase access to care for underserved populations in developing countries. The field continues to grow and emerging movements such as precision medicine and the sharing economy will introduce new opportunities and challenges. PMID:27199196

Interactive and Participatory Decision Support: Linking Cyberinfrastructure, Multi-Touch Interfaces, and Substantive Dialogue for Geothermal Systems

NASA Astrophysics Data System (ADS)

Malin, R.; Pierce, S. A.; Bass, B. J.

2012-12-01

Socio-technical approaches to complex, ill-structured decision problems are needed to identify adaptive responses for earth resource management. This research presents a hybrid approach to create decision tools and engender dialogue among stakeholders for geothermal development in Idaho, United States and El Tatio, Chile. Based on the scarcity of data, limited information availability, and tensions across stakeholder interests we designed and constructed a decision support model that allows stakeholders to rapidly collect, input, and visualize geoscientific data to assess geothermal system impacts and possible development strategies. We have integrated this decision support model into multi-touch interfaces that can be easily used by scientists and stakeholders alike. This toolkit is part of a larger cyberinfrastructure project designed to collect and present geoscientific information to support decision making processes. Consultation with stakeholders at the El Tatio geothermal complex of northern Chile—indigenous communities, local and national government agencies, developers, and geoscientists - informed the implementation of a sustained dialogue process. The El Tatio field case juxtaposes basic parameters such as pH, spring temperature, geochemical content, and FLIR imagery with stakeholder perceptions of risks due to mineral extraction and energy exploration efforts. The results of interviews and a participatory workshop are driving the creation of three initiatives within an indigenous community group; 1) microentrepreneurial efforts for science-based tourism, 2) design of a citizen-led environmental monitoring network in the Altiplano, and 3) business planning for an indigenous renewable energy cooperative. This toolkit is also being applied in the Snake River Plain of Idaho has as part of the DOE sponsored National Student Geothermal Competition. The Idaho case extends results from the Chilean case to implement a more streamlined system to analyze geothermal resource potential as well as integrate the decision support system with multi-touch interfaces which allow multiple stakeholders to view and interact with data. Beyond visual and tactile appeal, these interfaces also allow participants to dynamically update decision variables and decision preferences to create multiple scenarios and evaluate potential outcomes. Through this interactive scenario building, potential development sites can be targeted and stakeholders can interact with data to engage in substantive dialogue for related long-term planning or crisis response.

SensorDB: a virtual laboratory for the integration, visualization and analysis of varied biological sensor data.

PubMed

Salehi, Ali; Jimenez-Berni, Jose; Deery, David M; Palmer, Doug; Holland, Edward; Rozas-Larraondo, Pablo; Chapman, Scott C; Georgakopoulos, Dimitrios; Furbank, Robert T

2015-01-01

To our knowledge, there is no software or database solution that supports large volumes of biological time series sensor data efficiently and enables data visualization and analysis in real time. Existing solutions for managing data typically use unstructured file systems or relational databases. These systems are not designed to provide instantaneous response to user queries. Furthermore, they do not support rapid data analysis and visualization to enable interactive experiments. In large scale experiments, this behaviour slows research discovery, discourages the widespread sharing and reuse of data that could otherwise inform critical decisions in a timely manner and encourage effective collaboration between groups. In this paper we present SensorDB, a web based virtual laboratory that can manage large volumes of biological time series sensor data while supporting rapid data queries and real-time user interaction. SensorDB is sensor agnostic and uses web-based, state-of-the-art cloud and storage technologies to efficiently gather, analyse and visualize data. Collaboration and data sharing between different agencies and groups is thereby facilitated. SensorDB is available online at http://sensordb.csiro.au.

The origin of bursts and heavy tails in human dynamics.

PubMed

Barabási, Albert-László

2005-05-12

The dynamics of many social, technological and economic phenomena are driven by individual human actions, turning the quantitative understanding of human behaviour into a central question of modern science. Current models of human dynamics, used from risk assessment to communications, assume that human actions are randomly distributed in time and thus well approximated by Poisson processes. In contrast, there is increasing evidence that the timing of many human activities, ranging from communication to entertainment and work patterns, follow non-Poisson statistics, characterized by bursts of rapidly occurring events separated by long periods of inactivity. Here I show that the bursty nature of human behaviour is a consequence of a decision-based queuing process: when individuals execute tasks based on some perceived priority, the timing of the tasks will be heavy tailed, with most tasks being rapidly executed, whereas a few experience very long waiting times. In contrast, random or priority blind execution is well approximated by uniform inter-event statistics. These finding have important implications, ranging from resource management to service allocation, in both communications and retail.

airborne data analysis/monitor system

NASA Technical Reports Server (NTRS)

Stephison, D. B.

1981-01-01

An Airborne Data Analysis/Monitor System (ADAMS), a ROLM 1666 computer based system installed onboard test airplanes used during experimental testing is evaluated. In addition to the 1666 computer, the ADAMS hardware includes a DDC System 90 fixed head disk and a Miltape DD400 floppy disk. Boeing designed a DMA interface to the data acquisition system and an intelligent terminal to reduce system overhead and simplify operator commands. The ADAMS software includes RMX/RTOS and both ROLM FORTRAN and assembly language are used. The ADAMS provides real time displays that enable onboard test engineers to make rapid decisions about test conduct thus reducing the cost and time required to certify new model airplanes, and improved the quality of data derived from the test, leading to more rapid development of improvements resulting in quieter, safer, and more efficient airplanes. The availability of airborne data processing removes most of the weather and geographical restrictions imposed by telemetered flight test data systems. A data base is maintained to describe the airplane, the data acquisition system, the type of testing, and the conditions under which the test is performed.

Metabolic Toxicity Screening Using Electrochemiluminescence Arrays Coupled with Enzyme-DNA Biocolloid Reactors and Liquid Chromatography-Mass Spectrometry

NASA Astrophysics Data System (ADS)

Hvastkovs, Eli, G.; Schenkman, John B.; Rusling, James, F.

2012-07-01

New chemicals or drugs must be guaranteed safe before they can be marketed. Despite widespread use of bioassay panels for toxicity prediction, products that are toxic to a subset of the population often are not identified until clinical trials. This article reviews new array methodologies based on enzyme/DNA films that form and identify DNA-reactive metabolites that are indicators of potentially genotoxic species. This molecularly based methodology is designed in a rapid screening array that utilizes electrochemiluminescence (ECL) to detect metabolite-DNA reactions, as well as biocolloid reactors that provide the DNA adducts and metabolites for liquid chromatography-mass spectrometry (LC-MS) analysis. ECL arrays provide rapid toxicity screening, and the biocolloid reactor LC-MS approach provides a valuable follow-up on structure, identification, and formation rates of DNA adducts for toxicity hits from the ECL array screening. Specific examples using this strategy are discussed. Integration of high-throughput versions of these toxicity-screening methods with existing drug toxicity bioassays should allow for better human toxicity prediction as well as more informed decision making regarding new chemical and drug candidates.

RAPID and DDS

NASA Technical Reports Server (NTRS)

Utz, Hans Heinrich

2011-01-01

This talk gives an overview of the the Robot Applications Programmers Interface Delegate (RAPID) as well as the distributed systems middleware Data Distribution Service (DDS). DDS is an open software standard, RAPID is cleared for open-source release under NOSA. RAPID specifies data-structures and semantics for high-level telemetry published by NASA robotic software. These data-structures are supported by multiple robotic platforms at Johnson Space Center (JSC), Jet Propulsion Laboratory (JPL) and Ames Research Center (ARC), providing high-level interoperability between those platforms. DDS is used as the middleware for data transfer. The feature set of the middleware heavily influences the design decision made in the RAPID specification. So it is appropriate to discuss both in this introductory talk.

Mapping Natech risk due to earthquakes using RAPID-N

NASA Astrophysics Data System (ADS)

Girgin, Serkan; Krausmann, Elisabeth

2013-04-01

Natural hazard-triggered technological accidents (so-called Natech accidents) at hazardous installations are an emerging risk with possibly serious consequences due to the potential for release of hazardous materials, fires or explosions. For the reduction of Natech risk, one of the highest priority needs is the identification of Natech-prone areas and the systematic assessment of Natech risks. With hardly any Natech risk maps existing within the EU the European Commission's Joint Research Centre has developed a Natech risk analysis and mapping tool called RAPID-N, that estimates the overall risk of natural-hazard impact to industrial installations and its possible consequences. The results are presented as risk summary reports and interactive risk maps which can be used for decision making. Currently, RAPID-N focuses on Natech risk due to earthquakes at industrial installations. However, it will be extended to also analyse and map Natech risk due to floods in the near future. The RAPID-N methodology is based on the estimation of on-site natural hazard parameters, use of fragility curves to determine damage probabilities of plant units for various damage states, and the calculation of spatial extent, severity, and probability of Natech events potentially triggered by the natural hazard. The methodology was implemented as a web-based risk assessment and mapping software tool which allows easy data entry, rapid local or regional risk assessment and mapping. RAPID-N features an innovative property estimation framework to calculate on-site natural hazard parameters, industrial plant and plant unit characteristics, and hazardous substance properties. Custom damage states and fragility curves can be defined for different types of plant units. Conditional relationships can be specified between damage states and Natech risk states, which describe probable Natech event scenarios. Natech consequences are assessed using a custom implementation of U.S. EPA's Risk Management Program (RMP) Guidance for Offsite Consequence Analysis methodology. This custom implementation is based on the property estimation framework and allows the easy modification of model parameters and the substitution of equations with alternatives. RAPID-N can be applied at different stages of the Natech risk management process: It allows on the one hand the analysis of hypothetical Natech scenarios to prevent or prepare for a Natech accident by supporting land-use and emergency planning. On the other hand, once a natural disaster occurs RAPID-N can be used for rapidly locating facilities with potential Natech accident damage based on actual natural-hazard information. This provides a means to warn the population in the vicinity of the facilities in a timely manner. This presentation will introduce the specific features of RAPID-N and show the use of the tool by application to a case-study area.

Emotion and Deliberative Reasoning in Moral Judgment

PubMed Central

Cummins, Denise Dellarosa; Cummins, Robert C.

2012-01-01

According to an influential dual-process model, a moral judgment is the outcome of a rapid, affect-laden process and a slower, deliberative process. If these outputs conflict, decision time is increased in order to resolve the conflict. Violations of deontological principles proscribing the use of personal force to inflict intentional harm are presumed to elicit negative affect which biases judgments early in the decision-making process. This model was tested in three experiments. Moral dilemmas were classified using (a) decision time and consensus as measures of system conflict and (b) the aforementioned deontological criteria. In Experiment 1, decision time was either unlimited or reduced. The dilemmas asked whether it was appropriate to take a morally questionable action to produce a “greater good” outcome. Limiting decision time reduced the proportion of utilitarian (“yes”) decisions, but contrary to the model’s predictions, (a) vignettes that involved more deontological violations logged faster decision times, and (b) violation of deontological principles was not predictive of decisional conflict profiles. Experiment 2 ruled out the possibility that time pressure simply makes people more like to say “no.” Participants made a first decision under time constraints and a second decision under no time constraints. One group was asked whether it was appropriate to take the morally questionable action while a second group was asked whether it was appropriate to refuse to take the action. The results replicated that of Experiment 1 regardless of whether “yes” or “no” constituted a utilitarian decision. In Experiment 3, participants rated the pleasantness of positive visual stimuli prior to making a decision. Contrary to the model’s predictions, the number of deontological decisions increased in the positive affect rating group compared to a group that engaged in a cognitive task or a control group that engaged in neither task. These results are consistent with the view that early moral judgments are influenced by affect. But they are inconsistent with the view that (a) violation of deontological principles are predictive of differences in early, affect-based judgment or that (b) engaging in tasks that are inconsistent with the negative emotional responses elicited by such violations diminishes their impact. PMID:22973255

The speed of metacognition: taking time to get to know one's structural knowledge.

PubMed

Mealor, Andy D; Dienes, Zoltan

2013-03-01

The time course of different metacognitive experiences of knowledge was investigated using artificial grammar learning. Experiment 1 revealed that when participants are aware of the basis of their judgments (conscious structural knowledge) decisions are made most rapidly, followed by decisions made with conscious judgment but without conscious knowledge of underlying structure (unconscious structural knowledge), and guess responses (unconscious judgment knowledge) were made most slowly, even when controlling for differences in confidence and accuracy. In experiment 2, short response deadlines decreased the accuracy of unconscious but not conscious structural knowledge. Conversely, the deadline decreased the proportion of conscious structural knowledge in favour of guessing. Unconscious structural knowledge can be applied rapidly but becomes more reliable with additional metacognitive processing time whereas conscious structural knowledge is an all-or-nothing response that cannot always be applied rapidly. These dissociations corroborate quite separate theories of recognition (dual-process) and metacognition (higher order thought and cross-order integration). Copyright © 2012 Elsevier Inc. All rights reserved.

A fourth dimension in decision making in hepatology.

PubMed

Ilan, Yaron

2010-12-01

Today, the assessment of liver function in patients suffering from acute or chronic liver disease is based on liver biopsy and blood tests including synthetic function, liver enzymes and viral load, most of which provide only circumstantial evidence as to the degree of hepatic impairment. Most of these tests lack the degree of sensitivity to be useful for follow-up of these patients at the frequency that is needed for decision making in clinical hepatology. Accurate assessment of liver function is essential to determine both short- and long-term prognosis, and for making decisions about liver and non-liver surgery, TIPS, chemoembolization or radiofrequency ablation in patients with chronic liver disease. Liver function tests can serve as the basis for accurate decision-making regarding the need for liver transplantation in the setting of acute failure or in patients with chronic liver disease. The liver metabolic breath test relies on measuring exhaled (13) C tagged methacetin, which is metabolized only by the liver. Measuring this liver-specific substrate by means of molecular correlation spectroscopy is a rapid, non-invasive method for assessing liver function at the point-of-care. The (13) C methacetin breath test (MBT) is a powerful tool to aid clinical hepatologists in bedside decision-making. Our recent findings regarding the ability of point-of-care (13) C MBT to assess the hepatic functional reserve in patients with acute and chronic liver disease are reviewed along with suggested treatment algorithms for common liver disorders. © 2010 The Japan Society of Hepatology.

RECOVER: An Automated Cloud-Based Decision Support System for Post-fire Rehabilitation Planning

NASA Technical Reports Server (NTRS)

Schnase, John L.; Carroll, Mark; Weber, K. T.; Brown, Molly E.; Gill, Roger L.; Wooten, Margaret; May J.; Serr, K.; Smith, E.; Goldsby, R.;

RECOVER: An Automated, Cloud-Based Decision Support System for Post-Fire Rehabilitation Planning

NASA Astrophysics Data System (ADS)

Schnase, J. L.; Carroll, M. L.; Weber, K. T.; Brown, M. E.; Gill, R. L.; Wooten, M.; May, J.; Serr, K.; Smith, E.; Goldsby, R.; Newtoff, K.; Bradford, K.; Doyle, C.; Volker, E.; Weber, S.

2014-11-01

RECOVER is a site-specific decision support system that automatically brings together in a single analysis environment the information necessary for post-fire rehabilitation decision-making. After a major wildfire, law requires that the federal land management agencies certify a comprehensive plan for public safety, burned area stabilization, resource protection, and site recovery. These burned area emergency response (BAER) plans are a crucial part of our national response to wildfire disasters and depend heavily on data acquired from a variety of sources. Final plans are due within 21 days of control of a major wildfire and become the guiding document for managing the activities and budgets for all subsequent remediation efforts. There are few instances in the federal government where plans of such wide-ranging scope and importance are assembled on such short notice and translated into action more quickly. RECOVER has been designed in close collaboration with our agency partners and directly addresses their high-priority decision-making requirements. In response to a fire detection event, RECOVER uses the rapid resource allocation capabilities of cloud computing to automatically collect Earth observational data, derived decision products, and historic biophysical data so that when the fire is contained, BAER teams will have a complete and ready-to-use RECOVER dataset and GIS analysis environment customized for the target wildfire. Initial studies suggest that RECOVER can transform this information-intensive process by reducing from days to a matter of minutes the time required to assemble and deliver crucial wildfire-related data.

Pupil-linked arousal is driven by decision uncertainty and alters serial choice bias

NASA Astrophysics Data System (ADS)

Urai, Anne E.; Braun, Anke; Donner, Tobias H.

2017-03-01

While judging their sensory environments, decision-makers seem to use the uncertainty about their choices to guide adjustments of their subsequent behaviour. One possible source of these behavioural adjustments is arousal: decision uncertainty might drive the brain's arousal systems, which control global brain state and might thereby shape subsequent decision-making. Here, we measure pupil diameter, a proxy for central arousal state, in human observers performing a perceptual choice task of varying difficulty. Pupil dilation, after choice but before external feedback, reflects three hallmark signatures of decision uncertainty derived from a computational model. This increase in pupil-linked arousal boosts observers' tendency to alternate their choice on the subsequent trial. We conclude that decision uncertainty drives rapid changes in pupil-linked arousal state, which shape the serial correlation structure of ongoing choice behaviour.

Oil Spill Detection and their Impact on Climate in Shallow Coastal Areas in the Persian Gulf using Microwave Sensors

NASA Astrophysics Data System (ADS)

Kumar, P.; Katiyar, S.

2016-02-01

This paper is providing the study of geospatial technology to study the oil spill in various regions and develop oil spill risk management system to provide control and surveillance over large areas and provide tactical assistance in emergencies. Oil spill data which is been placed over GIS is interfaced with the relational database already been created for rapid access, retrieval and query, enhances strategic and strategic decision-making, potentially reducing incidence of spills by providing a deterrent factor and reducing the cost by providing rapid recovery solution. Microwave data are used to detect the oil spill in the shallow coastal region of Persian Gulf and spectral signatures are observed. Various observations can be extracted from this study like location of oil spill, quantity of oil spill and its distribution in effected coast or shoreline area. Satellite images with and without sun glint were studied as the spectral signature of oil slicks in the optical sphere of influence depends upon the viewing geometry and the solar angle in addition to the type of oil and its thickness. The oil slick with bright contrast observed by Microwave data showed lower temperature than oil-free areas. The GIS-based system can be used to establish the appropriate response and locate the dense areas in a slick and local surveillance, to permit clean-up vessels to detect the oil to be cleared in rapid circumstances. Oil spill verification has two parts: dark spot detection and feature extraction. The synergistic use of satellite observations and hydrodynamic modeling is recommended for establishing an early warning and decision support system for oil pollution response. Keywords: Oil Spill, Microwave data, GIS

Rapid learning in practice: A lung cancer survival decision support system in routine patient care data

PubMed Central

Dekker, Andre; Vinod, Shalini; Holloway, Lois; Oberije, Cary; George, Armia; Goozee, Gary; Delaney, Geoff P.; Lambin, Philippe; Thwaites, David

2016-01-01

Background and purpose A rapid learning approach has been proposed to extract and apply knowledge from routine care data rather than solely relying on clinical trial evidence. To validate this in practice we deployed a previously developed decision support system (DSS) in a typical, busy clinic for non-small cell lung cancer (NSCLC) patients. Material and methods Gender, age, performance status, lung function, lymph node status, tumor volume and survival were extracted without review from clinical data sources for lung cancer patients. With these data the DSS was tested to predict overall survival. Results 3919 lung cancer patients were identified with 159 eligible for inclusion, due to ineligible histology or stage, non-radical dose, missing tumor volume or survival. The DSS successfully identified a good prognosis group and a medium/poor prognosis group (2 year OS 69% vs. 27/30%, p < 0.001). Stage was less discriminatory (2 year OS 47% for stage I–II vs. 36% for stage IIIA–IIIB, p = 0.12) with most good prognosis patients having higher stage disease. The DSS predicted a large absolute overall survival benefit (~40%) for a radical dose compared to a non-radical dose in patients with a good prognosis, while no survival benefit of radical radiotherapy was predicted for patients with a poor prognosis. Conclusions A rapid learning environment is possible with the quality of clinical data sufficient to validate a DSS. It uses patient and tumor features to identify prognostic groups in whom therapy can be individualized based on predicted outcomes. Especially the survival benefit of a radical versus non-radical dose predicted by the DSS for various prognostic groups has clinical relevance, but needs to be prospectively validated. PMID:25241994

The role of rapid testing and clinical decision in the diagnosis of human influenza A H1N1 infection.

PubMed

BinSaeed, Abdulaziz A; Siddiqui, Amna R; Mandil, Ahmed M; Torchyan, Armen A; Tayel, Salwa A; Shaikh, Shaffi A; Habib, Hanan A; Al-Khattaf, Abdulaziz S

2014-03-01

To evaluate the role of the rapid influenza diagnostic test (RIDT) and clinical decision in the diagnosis of H1N1. In November 2009, 290 suspected influenza patients were examined for H1N1 during an outbreak in Riyadh, Saudi Arabia. Nasopharyngeal swabs were analyzed using Directigen EZ Flu A+B kit. Monoclonal anti-human influenza A/B and reverse transcription- polymerase chain reaction (RT-PCR) were used. Positive and negative controls were used in each run of specimens. Validity indices were calculated for RIDT and clinical diagnostic criteria. The sensitivity and specificity of RIDT were 40.5% (95% confidence interval [CI]: 33.0-48.5), and 94.5% (95% CI: 88.6-97.6). The sensitivity of clinical decision was 66.3% (95% CI: 58.4-73.4), and the specificity was 65.4% (95% CI: 56.3-73.4). The sensitivity of clinical decision was higher in early presenters (79.2%; 95% CI: 57.3-92.1). The RIDT sensitivity was higher in younger patients (48.4%; 95% CI: 35.7-61.3). The positive predictive value (PPV) was 90.4% (95% CI: 80.7-95.7) for RIDT, and 71.1% (95% CI: 63.1-78.0) for clinical decision. The PPV for RIDT was greater for older (94.7%; 95% CI: 80.9-99.1) and late (90.7%; 95% CI: 76.9-97.0) presenters. The adjusted odds ratio for clinical decision was significant for cough, headache, and fatigue. The RIDT can be useful in epidemics and high prevalence areas, whereas clinical decision, and RT-PCR complement the diagnosis of H1N1 in any setting.

The Urban Environmental Monitoring/100 Cities Project: Legacy of the First Phase and Next Steps

NASA Technical Reports Server (NTRS)

Stefanov, William L.; Wentz, Elizabeth A.; Brazel, Anthony; Netzband, Maik; Moeller, Matthias

2009-01-01

The Urban Environmental Monitoring (UEM) project, now known as the 100 Cities Project, at Arizona State University (ASU) is a baseline effort to collect and analyze remotely sensed data for 100 urban centers worldwide. Our overarching goal is to use remote sensing technology to better understand the consequences of rapid urbanization through advanced biophysical measurements, classification methods, and modeling, which can then be used to inform public policy and planning. Urbanization represents one of the most significant alterations that humankind has made to the surface of the earth. In the early 20th century, there were less than 20 cities in the world with populations exceeding 1 million; today, there are more than 400. The consequences of urbanization include the transformation of land surfaces from undisturbed natural environments to land that supports different forms of human activity, including agriculture, residential, commercial, industrial, and infrastructure such as roads and other types of transportation. Each of these land transformations has impacted, to varying degrees, the local climatology, hydrology, geology, and biota that predate human settlement. It is essential that we document, to the best of our ability, the nature of land transformations and the consequences to the existing environment. The focus in the UEM project since its inception has been on rapid urbanization. Rapid urbanization is occurring in hundreds of cities worldwide as population increases and people migrate from rural communities to urban centers in search of employment and a better quality of life. The unintended consequences of rapid urbanization have the potential to cause serious harm to the environment, to human life, and to the resulting built environment because rapid development constrains and rushes decision making. Such rapid decision making can result in poor planning, ineffective policies, and decisions that harm the environment and the quality of human life. Slower, more thought-out, decision making could result in more favorable outcomes. The harm to the environment includes poor air quality, soil erosion, polluted rivers and aquifers, and loss of wildlife habitat. Human life is then threatened because of increased potential for disease spreading, human conflict, environmental hazards, and diminished quality of life. The built environment is potentially threatened when cities are built in areas that can be impacted by events such as hurricanes, tsunamis, earthquakes, fires, and landslides. Our goals include assessing the threat of such events on cities and the people living there.

Future of Earthquake Early Warning: Quantifying Uncertainty and Making Fast Automated Decisions for Applications

NASA Astrophysics Data System (ADS)

Wu, Stephen

Earthquake early warning (EEW) systems have been rapidly developing over the past decade. Japan Meteorological Agency (JMA) has an EEW system that was operating during the 2011 M9 Tohoku earthquake in Japan, and this increased the awareness of EEW systems around the world. While longer-time earthquake prediction still faces many challenges to be practical, the availability of shorter-time EEW opens up a new door for earthquake loss mitigation. After an earthquake fault begins rupturing, an EEW system utilizes the first few seconds of recorded seismic waveform data to quickly predict the hypocenter location, magnitude, origin time and the expected shaking intensity level around the region. This early warning information is broadcast to different sites before the strong shaking arrives. The warning lead time of such a system is short, typically a few seconds to a minute or so, and the information is uncertain. These factors limit human intervention to activate mitigation actions and this must be addressed for engineering applications of EEW. This study applies a Bayesian probabilistic approach along with machine learning techniques and decision theories from economics to improve different aspects of EEW operation, including extending it to engineering applications. Existing EEW systems are often based on a deterministic approach. Often, they assume that only a single event occurs within a short period of time, which led to many false alarms after the Tohoku earthquake in Japan. This study develops a probability-based EEW algorithm based on an existing deterministic model to extend the EEW system to the case of concurrent events, which are often observed during the aftershock sequence after a large earthquake. To overcome the challenge of uncertain information and short lead time of EEW, this study also develops an earthquake probability-based automated decision-making (ePAD) framework to make robust decision for EEW mitigation applications. A cost-benefit model that can capture the uncertainties in EEW information and the decision process is used. This approach is called the Performance-Based Earthquake Early Warning, which is based on the PEER Performance-Based Earthquake Engineering method. Use of surrogate models is suggested to improve computational efficiency. Also, new models are proposed to add the influence of lead time into the cost-benefit analysis. For example, a value of information model is used to quantify the potential value of delaying the activation of a mitigation action for a possible reduction of the uncertainty of EEW information in the next update. Two practical examples, evacuation alert and elevator control, are studied to illustrate the ePAD framework. Potential advanced EEW applications, such as the case of multiple-action decisions and the synergy of EEW and structural health monitoring systems, are also discussed.

Evidence-Based Point-of-Care Diagnostics: Current Status and Emerging Technologies

NASA Astrophysics Data System (ADS)

Chan, Cangel Pui Yee; Mak, Wing Cheung; Cheung, Kwan Yee; Sin, King Keung; Yu, Cheuk Man; Rainer, Timothy H.; Renneberg, Reinhard

2013-06-01

Point-of-care (POC) diagnostics brings tests nearer to the site of patient care. The turnaround time is short, and minimal manual interference enables quick clinical management decisions. Growth in POC diagnostics is being continuously fueled by the global burden of cardiovascular and infectious diseases. Early diagnosis and rapid initiation of treatment are crucial in the management of such patients. This review provides the rationale for the use of POC tests in acute coronary syndrome, heart failure, human immunodeficiency virus, and tuberculosis. We also consider emerging technologies that are based on advanced nanomaterials and microfluidics, improved assay sensitivity, miniaturization in device design, reduced costs, and high-throughput multiplex detection, all of which may shape the future development of POC diagnostics.

The solution of target assignment problem in command and control decision-making behaviour simulation

NASA Astrophysics Data System (ADS)

Li, Ni; Huai, Wenqing; Wang, Shaodan

2017-08-01

C2 (command and control) has been understood to be a critical military component to meet an increasing demand for rapid information gathering and real-time decision-making in a dynamically changing battlefield environment. In this article, to improve a C2 behaviour model's reusability and interoperability, a behaviour modelling framework was proposed to specify a C2 model's internal modules and a set of interoperability interfaces based on the C-BML (coalition battle management language). WTA (weapon target assignment) is a typical C2 autonomous decision-making behaviour modelling problem. Different from most WTA problem descriptions, here sensors were considered to be available resources of detection and the relationship constraints between weapons and sensors were also taken into account, which brought it much closer to actual application. A modified differential evolution (MDE) algorithm was developed to solve this high-dimension optimisation problem and obtained an optimal assignment plan with high efficiency. In case study, we built a simulation system to validate the proposed C2 modelling framework and interoperability interface specification. Also, a new optimisation solution was used to solve the WTA problem efficiently and successfully.

Policymakers and mHealth: roles and expectations, with observations from Ethiopia, Ghana and Sweden

PubMed Central

Barkman, Catharina; Weinehall, Lars

2017-01-01

ABSTRACT The rapid increase in mobile phone use and other telecommunication technologies in health care during the past decade has paved the way for optimism. mHealth (mobile health) initiatives need to be integrated into national health systems and priorities and fit into the system that the country has already invested in. Partnership between government, regional governments, health care systems, Community Health Workers, the private sector and universities is considered as a precondition for success. In turn, this requires strategic and integrative policy decisions on the national/regional level to be defined in the action plans as concrete steps. Decision makers are calling for scale-up plans to be in place even in the pilot phases. Hope is expressed that the initial joy and curiosity that new technology generates in the implementation phase will be transferred to routine work. Standards and a common technical architecture that enables interoperability and upscaling are key issues. Based on publications on policy and national strategies, this paper highlights some key areas for decision makers’ role and expectations with regard to mHealth. The paper will also report some mHealth experiences from Ethiopia, Ghana and Sweden. PMID:28838303

Cross-species approaches to pathological gambling: a review targeting sex differences, adolescent vulnerability and ecological validity of research tools.

PubMed

van den Bos, Ruud; Davies, William; Dellu-Hagedorn, Francoise; Goudriaan, Anna E; Granon, Sylvie; Homberg, Judith; Rivalan, Marion; Swendsen, Joel; Adriani, Walter

2013-12-01

Decision-making plays a pivotal role in daily life as impairments in processes underlying decision-making often lead to an inability to make profitable long-term decisions. As a case in point, pathological gamblers continue gambling despite the fact that this disrupts their personal, professional or financial life. The prevalence of pathological gambling will likely increase in the coming years due to expanding possibilities of on-line gambling through the Internet and increasing liberal attitudes towards gambling. It therefore represents a growing concern for society. Both human and animal studies rapidly advance our knowledge on brain-behaviour processes relevant for understanding normal and pathological gambling behaviour. Here, we review in humans and animals three features of pathological gambling which hitherto have received relatively little attention: (1) sex differences in (the development of) pathological gambling, (2) adolescence as a (putative) sensitive period for (developing) pathological gambling and (3) avenues for improving ecological validity of research tools. Based on these issues we also discuss how research in humans and animals may be brought in line to maximize translational research opportunities. Copyright © 2013 Elsevier Ltd. All rights reserved.

Use of a conformational switching aptamer for rapid and specific ex vivo identification of central nervous system lymphoma in a xenograft model.

PubMed

Georges, Joseph F; Liu, Xiaowei; Eschbacher, Jennifer; Nichols, Joshua; Mooney, Michael A; Joy, Anna; Spetzler, Robert F; Feuerstein, Burt G; Preul, Mark C; Anderson, Trent; Yan, Hao; Nakaji, Peter

2015-01-01

Improved tools for providing specific intraoperative diagnoses could improve patient care. In neurosurgery, intraoperatively differentiating non-operative lesions such as CNS B-cell lymphoma from operative lesions can be challenging, often necessitating immunohistochemical (IHC) procedures which require up to 24-48 hours. Here, we evaluate the feasibility of generating rapid ex vivo specific labeling using a novel lymphoma-specific fluorescent switchable aptamer. Our B-cell lymphoma-specific switchable aptamer produced only low-level fluorescence in its unbound conformation and generated an 8-fold increase in fluorescence once bound to its target on CD20-positive lymphoma cells. The aptamer demonstrated strong binding to B-cell lymphoma cells within 15 minutes of incubation as observed by flow cytometry. We applied the switchable aptamer to ex vivo xenograft tissue harboring B-cell lymphoma and astrocytoma, and within one hour specific visual identification of lymphoma was routinely possible. In this proof-of-concept study in human cell culture and orthotopic xenografts, we conclude that a fluorescent switchable aptamer can provide rapid and specific labeling of B-cell lymphoma, and that developing aptamer-based labeling approaches could simplify tissue staining and drastically reduce time to histopathological diagnoses compared with IHC-based methods. We propose that switchable aptamers could enhance expeditious, accurate intraoperative decision-making.

Supporting Fisheries Management by Means of Complex Models: Can We Point out Isles of Robustness in a Sea of Uncertainty?

PubMed Central

Gasche, Loïc; Mahévas, Stéphanie; Marchal, Paul

2013-01-01

Ecosystems are usually complex, nonlinear and strongly influenced by poorly known environmental variables. Among these systems, marine ecosystems have high uncertainties: marine populations in general are known to exhibit large levels of natural variability and the intensity of fishing efforts can change rapidly. These uncertainties are a source of risks that threaten the sustainability of both fish populations and fishing fleets targeting them. Appropriate management measures have to be found in order to reduce these risks and decrease sensitivity to uncertainties. Methods have been developed within decision theory that aim at allowing decision making under severe uncertainty. One of these methods is the information-gap decision theory. The info-gap method has started to permeate ecological modelling, with recent applications to conservation. However, these practical applications have so far been restricted to simple models with analytical solutions. Here we implement a deterministic approach based on decision theory in a complex model of the Eastern English Channel. Using the ISIS-Fish modelling platform, we model populations of sole and plaice in this area. We test a wide range of values for ecosystem, fleet and management parameters. From these simulations, we identify management rules controlling fish harvesting that allow reaching management goals recommended by ICES (International Council for the Exploration of the Sea) working groups while providing the highest robustness to uncertainties on ecosystem parameters. PMID:24204873

Supporting fisheries management by means of complex models: can we point out isles of robustness in a sea of uncertainty?

PubMed

Gasche, Loïc; Mahévas, Stéphanie; Marchal, Paul

2013-01-01

Ecosystems are usually complex, nonlinear and strongly influenced by poorly known environmental variables. Among these systems, marine ecosystems have high uncertainties: marine populations in general are known to exhibit large levels of natural variability and the intensity of fishing efforts can change rapidly. These uncertainties are a source of risks that threaten the sustainability of both fish populations and fishing fleets targeting them. Appropriate management measures have to be found in order to reduce these risks and decrease sensitivity to uncertainties. Methods have been developed within decision theory that aim at allowing decision making under severe uncertainty. One of these methods is the information-gap decision theory. The info-gap method has started to permeate ecological modelling, with recent applications to conservation. However, these practical applications have so far been restricted to simple models with analytical solutions. Here we implement a deterministic approach based on decision theory in a complex model of the Eastern English Channel. Using the ISIS-Fish modelling platform, we model populations of sole and plaice in this area. We test a wide range of values for ecosystem, fleet and management parameters. From these simulations, we identify management rules controlling fish harvesting that allow reaching management goals recommended by ICES (International Council for the Exploration of the Sea) working groups while providing the highest robustness to uncertainties on ecosystem parameters.

Do small swarms have an advantage when house hunting? The effect of swarm size on nest-site selection by Apis mellifera.

PubMed

Schaerf, T M; Makinson, J C; Myerscough, M R; Beekman, M

2013-10-06

Reproductive swarms of honeybees are faced with the problem of finding a good site to establish a new colony. We examined the potential effects of swarm size on the quality of nest-site choice through a combination of modelling and field experiments. We used an individual-based model to examine the effects of swarm size on decision accuracy under the assumption that the number of bees actively involved in the decision-making process (scouts) is an increasing function of swarm size. We found that the ability of a swarm to choose the best of two nest sites decreases as swarm size increases when there is some time-lag between discovering the sites, consistent with Janson & Beekman (Janson & Beekman 2007 Proceedings of European Conference on Complex Systems, pp. 204-211.). However, when simulated swarms were faced with a realistic problem of choosing between many nest sites discoverable at all times, larger swarms were more accurate in their decisions than smaller swarms owing to their ability to discover nest sites more rapidly. Our experimental fieldwork showed that large swarms invest a larger number of scouts into the decision-making process than smaller swarms. Preliminary analysis of waggle dances from experimental swarms also suggested that large swarms could indeed discover and advertise nest sites at a faster rate than small swarms.

Do small swarms have an advantage when house hunting? The effect of swarm size on nest-site selection by Apis mellifera

PubMed Central

Schaerf, T. M.; Makinson, J. C.; Myerscough, M. R.; Beekman, M.

2013-01-01

Reproductive swarms of honeybees are faced with the problem of finding a good site to establish a new colony. We examined the potential effects of swarm size on the quality of nest-site choice through a combination of modelling and field experiments. We used an individual-based model to examine the effects of swarm size on decision accuracy under the assumption that the number of bees actively involved in the decision-making process (scouts) is an increasing function of swarm size. We found that the ability of a swarm to choose the best of two nest sites decreases as swarm size increases when there is some time-lag between discovering the sites, consistent with Janson & Beekman (Janson & Beekman 2007 Proceedings of European Conference on Complex Systems, pp. 204–211.). However, when simulated swarms were faced with a realistic problem of choosing between many nest sites discoverable at all times, larger swarms were more accurate in their decisions than smaller swarms owing to their ability to discover nest sites more rapidly. Our experimental fieldwork showed that large swarms invest a larger number of scouts into the decision-making process than smaller swarms. Preliminary analysis of waggle dances from experimental swarms also suggested that large swarms could indeed discover and advertise nest sites at a faster rate than small swarms. PMID:23904590

Autoimmunity: a decision theory model.

PubMed Central

Morris, J A

1987-01-01

Concepts from statistical decision theory were used to analyse the detection problem faced by the body's immune system in mounting immune responses to bacteria of the normal body flora. Given that these bacteria are potentially harmful, that there can be extensive cross reaction between bacterial antigens and host tissues, and that the decisions are made in uncertainty, there is a finite chance of error in immune response leading to autoimmune disease. A model of ageing in the immune system is proposed that is based on random decay in components of the decision process, leading to a steep age dependent increase in the probability of error. The age incidence of those autoimmune diseases which peak in early and middle life can be explained as the resultant of two processes: an exponentially falling curve of incidence of first contact with common bacteria, and a rapidly rising error function. Epidemiological data on the variation of incidence with social class, sibship order, climate and culture can be used to predict the likely site of carriage and mode of spread of the causative bacteria. Furthermore, those autoimmune diseases precipitated by common viral respiratory tract infections might represent reactions to nasopharyngeal bacterial overgrowth, and this theory can be tested using monoclonal antibodies to search the bacterial isolates for cross reacting antigens. If this model is correct then prevention of autoimmune disease by early exposure to low doses of bacteria might be possible. PMID:3818985

Decision making: rational or hedonic?

PubMed Central

Cabanac, Michel; Bonniot-Cabanac, Marie-Claude

2007-01-01

Three experiments studied the hedonicity of decision making. Participants rated their pleasure/displeasure while reading item-sentences describing political and social problems followed by different decisions (Questionnaire 1). Questionnaire 2 was multiple-choice, grouping the items from Questionnaire 1. In Experiment 1, participants answered Questionnaire 2 rapidly or slowly. Both groups selected what they had rated as pleasant, but the 'leisurely' group maximized pleasure less. In Experiment 2, participants selected the most rational responses. The selected behaviors were pleasant but less than spontaneous behaviors. In Experiment 3, Questionnaire 2 was presented once with items grouped by theme, and once with items shuffled. Participants maximized the pleasure of their decisions, but the items selected on Questionnaires 2 were different when presented in different order. All groups maximized pleasure equally in their decisions. These results support that decisions are made predominantly in the hedonic dimension of consciousness. PMID:17848195

Diagnostic criteria for cryopyrin-associated periodic syndrome (CAPS).

PubMed

Kuemmerle-Deschner, Jasmin B; Ozen, Seza; Tyrrell, Pascal N; Kone-Paut, Isabelle; Goldbach-Mansky, Raphaela; Lachmann, Helen; Blank, Norbert; Hoffman, Hal M; Weissbarth-Riedel, Elisabeth; Hugle, Boris; Kallinich, Tilmann; Gattorno, Marco; Gul, Ahmet; Ter Haar, Nienke; Oswald, Marlen; Dedeoglu, Fatma; Cantarini, Luca; Benseler, Susanne M

2017-06-01

Cryopyrin-associated periodic syndrome (CAPS) is a rare, heterogeneous disease entity associated with NLRP3 gene mutations and increased interleukin-1 (IL-1) secretion. Early diagnosis and rapid initiation of IL-1 inhibition prevent organ damage. The aim of the study was to develop and validate diagnostic criteria for CAPS. An innovative process was followed including interdisciplinary team building, item generation: review of CAPS registries, systematic literature review, expert surveys, consensus conferences for item refinement, item reduction and weighting using 1000Minds decision software. Resulting CAPS criteria were tested in large cohorts of CAPS cases and controls using correspondence analysis. Diagnostic models were explored using sensitivity analyses. The international team included 16 experts. Systematic literature and registry review identified 33 CAPS-typical items; the consensus conferences reduced these to 14. 1000Minds exercises ranked variables based on importance for the diagnosis. Correspondence analysis determined variables consistently associated with the diagnosis of CAPS using 284 cases and 837 controls. Seven variables were significantly associated with CAPS (p<0.001). The best diagnosis model included: Raised inflammatory markers (C-reactive protein/serum amyloid A) plus ≥two of six CAPS-typical symptoms: urticaria-like rash, cold-triggered episodes, sensorineural hearing loss, musculoskeletal symptoms, chronic aseptic meningitis and skeletal abnormalities. Sensitivity was 81%, specificity 94%. It performed well for all CAPS subtypes and regardless of NLRP3 mutation. The novel approach integrated traditional methods of evidence synthesis with expert consensus, web-based decision tools and innovative statistical methods and may serve as model for other rare diseases. These criteria will enable a rapid diagnosis for children and adults with CAPS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Modeling the long-term persistence of hepatitis A antibody after a two-dose vaccination schedule in Argentinean children.

PubMed

López, Eduardo L; Contrini, María Marta; Mistchenko, Alicia; Kieffer, Alexia; Baggaley, Rebecca F; Di Tanna, Gian Luca; Desai, Kamal; Rasuli, Anvar; Armoni, Judith

2015-04-01

Long-term seroprotection data are essential for decision-making on the need and timing of vaccine boosters. Based on data from longitudinal serological studies, modeling can provide estimates on long-term antibody persistence and inform such decision-making. We examined long-term anti-hepatitis A virus (anti-HAV) antibody persistence in Argentinean children ≤15 years after the initial study where they completed a 2-dose course of inactivated hepatitis A vaccine (Avaxim 80U Pediatric, Sanofi Pasteur, Lyon, France). Blood serum samples were taken at baseline, 2 weeks (post first dose), 6 months (pre-booster), 6.5 months (post-booster), 10 years and 14-15 years after first vaccine dose. We fitted 8 statistical model types, predominantly mixed effects models, to anti-HAV persistence data, to identify the most appropriate and best fitting models for our data set and to predict individuals' anti-HAV levels and seroprotection rates up to 30 years post vaccination. Fifty-four children (mean age at enrollment 30.4 months) were enrolled up to 15 years post first vaccine dose. There were 3 distinct periods of antibody concentration: rapid rise up to peak concentration post-booster, rapid decay from post-booster to 10 years, followed by slower decay. A 3-segmented linear mixed effects model was the most appropriate for the data set. Extrapolating based on the available 14-15-year follow-up, the analysis predicted that 88% of individuals anti-HAV seronegative prior to vaccination would remain seroprotected at 30 years post vaccination and lifelong seroprotection for vaccinees seropositive prior to vaccination. Currently available data demonstrate that Avaxim 80U Pediatric confers to most vaccinees a high level of seroprotection against hepatitis A infection for at least 20-30 years.

Meta-analysis: accuracy of rapid tests for malaria in travelers returning from endemic areas.

PubMed

Marx, Arthur; Pewsner, Daniel; Egger, Matthias; Nüesch, Reto; Bucher, Heiner C; Genton, Blaise; Hatz, Christoph; Jüni, Peter

2005-05-17

Microscopic diagnosis of malaria is unreliable outside specialized centers. Rapid tests have become available in recent years, but their accuracy has not been assessed systematically. To determine the accuracy of rapid diagnostic tests for ruling out malaria in nonimmune travelers returning from malaria-endemic areas. The authors searched MEDLINE, EMBASE, CAB Health, and CINAHL (1988 to September 2004); hand-searched conference proceedings; checked reference lists; and contacted experts and manufacturers. Diagnostic accuracy studies in nonimmune individuals with suspected malaria were included if they compared rapid tests with expert microscopic examination or polymerase chain reaction tests. Data on study and patient characteristics and results were extracted in duplicate. The main outcome was the likelihood ratio for a negative test result (negative likelihood ratio) for Plasmodium falciparum malaria. Likelihood ratios were combined by using random-effects meta-analysis, stratified by the antigen targeted (histidine-rich protein-2 [HRP-2] or parasite lactate dehydrogenase [LDH]) and by test generation. Nomograms of post-test probabilities were constructed. The authors included 21 studies and 5747 individuals. For P. falciparum, HRP-2-based tests were more accurate than parasite LDH-based tests: Negative likelihood ratios were 0.08 and 0.13, respectively (P = 0.019 for difference). Three-band HRP-2 tests had similar negative likelihood ratios but higher positive likelihood ratios compared with 2-band tests (34.7 vs. 98.5; P = 0.003). For P. vivax, negative likelihood ratios tended to be closer to 1.0 for HRP-2-based tests than for parasite LDH-based tests (0.24 vs. 0.13; P = 0.22), but analyses were based on a few heterogeneous studies. Negative likelihood ratios for the diagnosis of P. malariae or P. ovale were close to 1.0 for both types of tests. In febrile travelers returning from sub-Saharan Africa, the typical probability of P. falciparum malaria is estimated at 1.1% (95% CI, 0.6% to 1.9%) after a negative 3-band HRP-2 test result and 97% (CI, 92% to 99%) after a positive test result. Few studies evaluated 3-band HRP-2 tests. The evidence is also limited for species other than P. falciparum because of the few available studies and their more heterogeneous results. Further studies are needed to determine whether the use of rapid diagnostic tests improves outcomes in returning travelers with suspected malaria. Rapid malaria tests may be a useful diagnostic adjunct to microscopy in centers without major expertise in tropical medicine. Initial decisions on treatment initiation and choice of antimalarial drugs can be based on travel history and post-test probabilities after rapid testing. Expert microscopy is still required for species identification and confirmation.

Completing the Link between Exposure Science and ...

EPA Pesticide Factsheets

Driven by major scientific advances in analytical methods, biomonitoring, computation, and a newly articulated vision for a greater impact in public health, the field of exposure science is undergoing a rapid transition from a field of observation to a field of prediction. Deployment of an organizational and predictive framework for exposure science analogous to the “systems approaches” used in the biological sciences is a necessary step in this evolution. Here we propose the aggregate exposure pathway (AEP) concept as the natural and complementary companion in the exposure sciences to the adverse outcome pathway (AOP) concept in the toxicological sciences. Aggregate exposure pathways offer an intuitive framework to organize exposure data within individual units of prediction common to the field, setting the stage for exposure forecasting. Looking farther ahead, we envision direct linkages between aggregate exposure pathways and adverse outcome pathways, completing the source to outcome continuum for more meaningful integration of exposure assessment and hazard identification. Together, the two frameworks form and inform a decision-making framework with the flexibility for risk-based, hazard-based, or exposure-based decision making. The National Exposure Research Laboratory (NERL) Human Exposure and Atmospheric Sciences Division (HEASD) conducts research in support of EPA mission to protect human health and the environment. HEASD research program supports G

Investigation of Capabilities and Technologies Supporting Rapid UAV Launch System Development

DTIC Science & Technology

2015-06-01

NUMBERS 6. AUTHOR(S) Patrick Alan Livesay 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Naval Postgraduate School Monterey, CA 93943 8. PERFORMING ...to operate. This enabled the launcher design team to more clearly determine and articulate system require- ments and performance parameters. Next, a...Process (AHP) was performed to xvii prioritize the capabilities and assist in the decision-making process [1]. The AHP decision-analysis technique is

77 FR 35113 - Canadian National Railway Company-Abandonment Exemption-in Niagara County, NY

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-12

..., 0.10 mile of the rail line is located on the upper deck of the U.S. portion of the Whirlpool Rapids... proceeding pursuant to 49 U.S.C. 10502(b). A final decision will be issued by September 10, 2012. Any OFA under 49 CFR 1152.27(b)(2) will be due no later than 10 days after service of a decision granting the...

Knowledge Quality Functions for Rule Discovery

DTIC Science & Technology

1994-09-01

Managers in many organizations finding themselves in the possession of large and rapidly growing databases are beginning to suspect the information in their...missing values (Smyth and Goodman, 1992, p. 303). Decision trees "tend to grow very large for realistic applications and are thus difficult to interpret...by humans" (Holsheimer, 1994, p. 42). Decision trees also grow excessively complicated in the presence of noisy databases (Dhar and Tuzhilin, 1993, p

Anger in brain and body: the neural and physiological perturbation of decision-making by emotion

PubMed Central

Zorab, Emma; Navaratnam, Nakulan; Engels, Miriam; Mallorquí-Bagué, Núria; Minati, Ludovico; Dowell, Nicholas G.; Brosschot, Jos F.; Thayer, Julian F.; Critchley, Hugo D.

2016-01-01

Emotion and cognition are dynamically coupled to bodily arousal: the induction of anger, even unconsciously, can reprioritise neural and physiological resources toward action states that bias cognitive processes. Here we examine behavioural, neural and bodily effects of covert anger processing and its influence on cognition, indexed by lexical decision-making. While recording beat-to-beat blood pressure, the words ANGER or RELAX were presented subliminally just prior to rapid word/non-word reaction-time judgements of letter-strings. Subliminal ANGER primes delayed the time taken to reach rapid lexical decisions, relative to RELAX primes. However, individuals with high trait anger were speeded up by subliminal anger primes. ANGER primes increased systolic blood pressure and the magnitude of this increase predicted reaction time prolongation. Within the brain, ANGER trials evoked an enhancement of activity within dorsal pons and an attenuation of activity within visual occipitotemporal and attentional parietal cortices. Activity within periaqueductal grey matter, occipital and parietal regions increased linearly with evoked blood pressure changes, indicating neural substrates through which covert anger impairs semantic decisions, putatively through its expression as visceral arousal. The behavioural and physiological impact of anger states compromises the efficiency of cognitive processing through action-ready changes in autonomic response that skew regional neural activity. PMID:26253525

Distributed collaborative decision support environments for predictive awareness

NASA Astrophysics Data System (ADS)

McQuay, William K.; Stilman, Boris; Yakhnis, Vlad

2005-05-01

The past decade has produced significant changes in the conduct of military operations: asymmetric warfare, the reliance on dynamic coalitions, stringent rules of engagement, increased concern about collateral damage, and the need for sustained air operations. Mission commanders need to assimilate a tremendous amount of information, rapidly assess the enemy"s course of action (eCOA) or possible actions and promulgate their own course of action (COA) - a need for predictive awareness. Decision support tools in a distributed collaborative environment offer the capability of decomposing complex multitask processes and distributing them over a dynamic set of execution assets that include modeling, simulations, and analysis tools. Revolutionary new approaches to strategy generation and assessment such as Linguistic Geometry (LG) permit the rapid development of COA vs. enemy COA (eCOA). LG tools automatically generate and permit the operators to take advantage of winning strategies and tactics for mission planning and execution in near real-time. LG is predictive and employs deep "look-ahead" from the current state and provides a realistic, reactive model of adversary reasoning and behavior. Collaborative environments provide the framework and integrate models, simulations, and domain specific decision support tools for the sharing and exchanging of data, information, knowledge, and actions. This paper describes ongoing research efforts in applying distributed collaborative environments to decision support for predictive mission awareness.

Implementing a Commercial Rule Base as a Medication Order Safety Net

PubMed Central

Reichley, Richard M.; Seaton, Terry L.; Resetar, Ervina; Micek, Scott T.; Scott, Karen L.; Fraser, Victoria J.; Dunagan, W. Claiborne; Bailey, Thomas C.

2005-01-01

A commercial rule base (Cerner Multum) was used to identify medication orders exceeding recommended dosage limits at five hospitals within BJC HealthCare, an integrated health care system. During initial testing, clinical pharmacists determined that there was an excessive number of nuisance and clinically insignificant alerts, with an overall alert rate of 9.2%. A method for customizing the commercial rule base was implemented to increase rule specificity for problematic rules. The system was subsequently deployed at two facilities and achieved alert rates of less than 1%. Pharmacists screened these alerts and contacted ordering physicians in 21% of cases. Physicians made therapeutic changes in response to 38% of alerts presented to them. By applying simple techniques to customize rules, commercial rule bases can be used to rapidly deploy a safety net to screen drug orders for excessive dosages, while preserving the rule architecture for later implementations of more finely tuned clinical decision support. PMID:15802481

Study of Earthquake Disaster Prediction System of Langfang city Based on GIS

NASA Astrophysics Data System (ADS)

Huang, Meng; Zhang, Dian; Li, Pan; Zhang, YunHui; Zhang, RuoFei

2017-07-01

In this paper, according to the status of China’s need to improve the ability of earthquake disaster prevention, this paper puts forward the implementation plan of earthquake disaster prediction system of Langfang city based on GIS. Based on the GIS spatial database, coordinate transformation technology, GIS spatial analysis technology and PHP development technology, the seismic damage factor algorithm is used to predict the damage of the city under different intensity earthquake disaster conditions. The earthquake disaster prediction system of Langfang city is based on the B / S system architecture. Degree and spatial distribution and two-dimensional visualization display, comprehensive query analysis and efficient auxiliary decision-making function to determine the weak earthquake in the city and rapid warning. The system has realized the transformation of the city’s earthquake disaster reduction work from static planning to dynamic management, and improved the city’s earthquake and disaster prevention capability.

Risk approximation in decision making: approximative numeric abilities predict advantageous decisions under objective risk.

PubMed

Mueller, Silke M; Schiebener, Johannes; Delazer, Margarete; Brand, Matthias

2018-01-22

Many decision situations in everyday life involve mathematical considerations. In decisions under objective risk, i.e., when explicit numeric information is available, executive functions and abilities to handle exact numbers and ratios are predictors of objectively advantageous choices. Although still debated, exact numeric abilities, e.g., normative calculation skills, are assumed to be related to approximate number processing skills. The current study investigates the effects of approximative numeric abilities on decision making under objective risk. Participants (N = 153) performed a paradigm measuring number-comparison, quantity-estimation, risk-estimation, and decision-making skills on the basis of rapid dot comparisons. Additionally, a risky decision-making task with exact numeric information was administered, as well as tasks measuring executive functions and exact numeric abilities, e.g., mental calculation and ratio processing skills, were conducted. Approximative numeric abilities significantly predicted advantageous decision making, even beyond the effects of executive functions and exact numeric skills. Especially being able to make accurate risk estimations seemed to contribute to superior choices. We recommend approximation skills and approximate number processing to be subject of future investigations on decision making under risk.

Information systems in food safety management.

PubMed

McMeekin, T A; Baranyi, J; Bowman, J; Dalgaard, P; Kirk, M; Ross, T; Schmid, S; Zwietering, M H

2006-12-01

Information systems are concerned with data capture, storage, analysis and retrieval. In the context of food safety management they are vital to assist decision making in a short time frame, potentially allowing decisions to be made and practices to be actioned in real time. Databases with information on microorganisms pertinent to the identification of foodborne pathogens, response of microbial populations to the environment and characteristics of foods and processing conditions are the cornerstone of food safety management systems. Such databases find application in: Identifying pathogens in food at the genus or species level using applied systematics in automated ways. Identifying pathogens below the species level by molecular subtyping, an approach successfully applied in epidemiological investigations of foodborne disease and the basis for national surveillance programs. Predictive modelling software, such as the Pathogen Modeling Program and Growth Predictor (that took over the main functions of Food Micromodel) the raw data of which were combined as the genesis of an international web based searchable database (ComBase). Expert systems combining databases on microbial characteristics, food composition and processing information with the resulting "pattern match" indicating problems that may arise from changes in product formulation or processing conditions. Computer software packages to aid the practical application of HACCP and risk assessment and decision trees to bring logical sequences to establishing and modifying food safety management practices. In addition there are many other uses of information systems that benefit food safety more globally, including: Rapid dissemination of information on foodborne disease outbreaks via websites or list servers carrying commentary from many sources, including the press and interest groups, on the reasons for and consequences of foodborne disease incidents. Active surveillance networks allowing rapid dissemination of molecular subtyping information between public health agencies to detect foodborne outbreaks and limit the spread of human disease. Traceability of individual animals or crops from (or before) conception or germination to the consumer as an integral part of food supply chain management. Provision of high quality, online educational packages to food industry personnel otherwise precluded from access to such courses.

Review article: Methodology for the 'rapid review' series on musculoskeletal injuries in the emergency department.

PubMed

Strudwick, Kirsten; McPhee, Megan; Bell, Anthony; Martin-Khan, Melinda; Russell, Trevor

2018-02-01

Musculoskeletal injuries are a common presentation to the ED, with significant costs involved in the management of these injuries, variances in care within the ED and associated morbidity. A series of rapid review papers were completed to guide best practice for the assessment and management of common musculoskeletal injuries presenting to the ED. This paper presents the methodology used across the rapid reviews. PubMed, CINAHL, EMBASE, TRIP and the grey literature, including relevant organisational websites, were searched in 2015. The search was repeated consistently for each topic area (injuries of the foot and ankle, knee, hand and wrist, elbow, shoulder, lumbar spine and cervical spine). English-language primary studies, systematic reviews and guidelines that were published in the last 10 years and addressed acute musculoskeletal injury management were considered for inclusion. Data extraction of each included article was conducted, followed by a quality appraisal. The extracted data from each article was synthesised to group similar evidence together. For each rapid review, the evidence has been organised in a way that a clinician can direct their attention to a specific component of the clinical cycle of care in the ED, such as the assessment, diagnostic tests, management and follow-up considerations from ED. The series of rapid reviews are designed to foster evidence-based practice within the ED, targeting the injuries most commonly presenting. The reviews provide clinicians in EDs with rapid access to the best current evidence, which has been synthesised and organised to assist decision-making. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Building University Capacity to Visualize Solutions to Complex Problems in the Arctic

NASA Astrophysics Data System (ADS)

Broderson, D.; Veazey, P.; Raymond, V. L.; Kowalski, K.; Prakash, A.; Signor, B.

2016-12-01

Rapidly changing environments are creating complex problems across the globe, which are particular magnified in the Arctic. These worldwide challenges can best be addressed through diverse and interdisciplinary research teams. It is incumbent on such teams to promote co-production of knowledge and data-driven decision-making by identifying effective methods to communicate their findings and to engage with the public. Decision Theater North (DTN) is a new semi-immersive visualization system that provides a space for teams to collaborate and develop solutions to complex problems, relying on diverse sets of skills and knowledge. It provides a venue to synthesize the talents of scientists, who gather information (data); modelers, who create models of complex systems; artists, who develop visualizations; communicators, who connect and bridge populations; and policymakers, who can use the visualizations to develop sustainable solutions to pressing problems. The mission of Decision Theater North is to provide a cutting-edge visual environment to facilitate dialogue and decision-making by stakeholders including government, industry, communities and academia. We achieve this mission by adopting a multi-faceted approach reflected in the theater's design, technology, networking capabilities, user support, community relationship building, and strategic partnerships. DTN is a joint project of Alaska's National Science Foundation Experimental Program to Stimulate Competitive Research (NSF EPSCoR) and the University of Alaska Fairbanks (UAF), who have brought the facility up to full operational status and are now expanding its development space to support larger team science efforts. Based in Fairbanks, Alaska, DTN is uniquely poised to address changes taking place in the Arctic and subarctic, and is connected with a larger network of decision theaters that include the Arizona State University Decision Theater Network and the McCain Institute in Washington, DC.

Multiple Transient Signals in Human Visual Cortex Associated with an Elementary Decision

PubMed Central

Nolte, Guido

2017-01-01

The cerebral cortex continuously undergoes changes in its state, which are manifested in transient modulations of the cortical power spectrum. Cortical state changes also occur at full wakefulness and during rapid cognitive acts, such as perceptual decisions. Previous studies found a global modulation of beta-band (12–30 Hz) activity in human and monkey visual cortex during an elementary visual decision: reporting the appearance or disappearance of salient visual targets surrounded by a distractor. The previous studies disentangled neither the motor action associated with behavioral report nor other secondary processes, such as arousal, from perceptual decision processing per se. Here, we used magnetoencephalography in humans to pinpoint the factors underlying the beta-band modulation. We found that disappearances of a salient target were associated with beta-band suppression, and target reappearances with beta-band enhancement. This was true for both overt behavioral reports (immediate button presses) and silent counting of the perceptual events. This finding indicates that the beta-band modulation was unrelated to the execution of the motor act associated with a behavioral report of the perceptual decision. Further, changes in pupil-linked arousal, fixational eye movements, or gamma-band responses were not necessary for the beta-band modulation. Together, our results suggest that the beta-band modulation was a top-down signal associated with the process of converting graded perceptual signals into a categorical format underlying flexible behavior. This signal may have been fed back from brain regions involved in decision processing to visual cortex, thus enforcing a “decision-consistent” cortical state. SIGNIFICANCE STATEMENT Elementary visual decisions are associated with a rapid state change in visual cortex, indexed by a modulation of neural activity in the beta-frequency range. Such decisions are also followed by other events that might affect the state of visual cortex, including the motor command associated with the report of the decision, an increase in pupil-linked arousal, fixational eye movements, and fluctuations in bottom-up sensory processing. Here, we ruled out the necessity of these events for the beta-band modulation of visual cortex. We propose that the modulation reflects a decision-related state change, which is induced by the conversion of graded perceptual signals into a categorical format underlying behavior. The resulting decision signal may be fed back to visual cortex. PMID:28495972

Critical role for the mediodorsal thalamus in permitting rapid reward-guided updating in stochastic reward environments

PubMed Central

Chakraborty, Subhojit; Kolling, Nils; Walton, Mark E; Mitchell, Anna S

2016-01-01

Adaptive decision-making uses information gained when exploring alternative options to decide whether to update the current choice strategy. Magnocellular mediodorsal thalamus (MDmc) supports adaptive decision-making, but its causal contribution is not well understood. Monkeys with excitotoxic MDmc damage were tested on probabilistic three-choice decision-making tasks. They could learn and track the changing values in object-reward associations, but they were severely impaired at updating choices after reversals in reward contingencies or when there were multiple options associated with reward. These deficits were not caused by perseveration or insensitivity to negative feedback though. Instead, monkeys with MDmc lesions exhibited an inability to use reward to promote choice repetition after switching to an alternative option due to a diminished influence of recent past choices and the last outcome to guide future behavior. Together, these data suggest MDmc allows for the rapid discovery and persistence with rewarding options, particularly in uncertain or changing environments. DOI: http://dx.doi.org/10.7554/eLife.13588.001 PMID:27136677

Standardized reporting for rapid relative effectiveness assessments of pharmaceuticals.

PubMed

Kleijnen, Sarah; Pasternack, Iris; Van de Casteele, Marc; Rossi, Bernardette; Cangini, Agnese; Di Bidino, Rossella; Jelenc, Marjetka; Abrishami, Payam; Autti-Rämö, Ilona; Seyfried, Hans; Wildbacher, Ingrid; Goettsch, Wim G

2014-11-01

Many European countries perform rapid assessments of the relative effectiveness (RE) of pharmaceuticals as part of the reimbursement decision making process. Increased sharing of information on RE across countries may save costs and reduce duplication of work. The objective of this article is to describe the development of a tool for rapid assessment of RE of new pharmaceuticals that enter the market, the HTA Core Model® for Rapid Relative Effectiveness Assessment (REA) of Pharmaceuticals. Eighteen member organisations of the European Network of Health Technology Assessment (EUnetHTA) participated in the development of the model. Different versions of the model were developed and piloted in this collaboration and adjusted accordingly based on feedback on the content and feasibility of the model. The final model deviates from the traditional HTA Core Model® used for assessing other types of technologies. This is due to the limited scope (strong focus on RE), the timing of the assessment (just after market authorisation), and strict timelines (e.g. 90 days) required for performing the assessment. The number of domains and assessment elements was limited and it was decided that the primary information sources should preferably be a submission file provided by the marketing authorisation holder and the European Public Assessment Report. The HTA Core Model® for Rapid REA (version 3.0) was developed to produce standardised transparent RE information of pharmaceuticals. Further piloting can provide input for possible improvements, such as further refining the assessment elements and new methodological guidance on relevant areas.

Nurse managers' decision-making in daily unit operation in peri-operative settings: a cross-sectional descriptive study.

PubMed

Siirala, Eriikka; Peltonen, Laura-Maria; Lundgrén-Laine, Heljä; Salanterä, Sanna; Junttila, Kristiina

2016-09-01

To describe the tactical and the operational decisions made by nurse managers when managing the daily unit operation in peri-operative settings. Management is challenging as situations change rapidly and decisions are constantly made. Understanding decision-making in this complex environment helps to develop decision support systems to support nurse managers' operative and tactical decision-making. Descriptive cross-sectional design. Data were collected from 20 nurse managers with the think-aloud method during the busiest working hours and analysed using thematic content analysis. Nurse managers made over 700 decisions; either ad hoc (n = 289), near future (n = 268) or long-term (n = 187) by nature. Decisions were often made simultaneously with many interruptions. Ad hoc decisions covered staff allocation, ensuring adequate staff, rescheduling surgical procedures, confirmation tangible resources and following-up the daily unit operation. Decisions in the near future were: planning of surgical procedures and tangible resources, and planning staff allocation. Long-term decisions were: human recourses, nursing development, supplies and equipment, and finances in the unit. Decision-making was vulnerable to interruptions, which sometimes complicated the managing tasks. The results can be used when planning decision support systems and when defining the nurse managers' tasks in peri-operative settings. © 2016 John Wiley & Sons Ltd.

Technical challenges, past and future, in implementing THERESA: a one million patient, one billion item computer-based patient record and decision support system

NASA Astrophysics Data System (ADS)

Camp, Henry N.

1996-02-01

Challenges in implementing a computer-based patient record (CPR)--such as absolute data integrity, high availability, permanent on-line storage of very large complex records, rapid search times, ease of use, commercial viability, and portability to other hospitals and doctor's offices--are given along with their significance, the solutions, and their successes. The THERESA CPR has been used sine 1983 in direct patient care by a public hospital that is the primary care provider to 350,000 people. It has 1000 beds with 45,000 admissions and 750,000 outpatient visits annually. The system supports direct provider entry, including by physicians, of complete medical `documents'. Its demonstration site currently contains 1.1 billion data items on 1 million patients. It is also a clinical decision-aiding tool used for quality assurance and cost containment, for teaching as faculty and students can easily find and `thumb through' all cases similar to a particular study, and for research with over a billion medical items that can be searched and analyzed on-line within context and with continuity. The same software can also run in a desktop microcomputer managing a private practice physician's office.

Simulating the conversion of rural settlements to town land based on multi-agent systems and cellular automata.

PubMed

Liu, Yaolin; Kong, Xuesong; Liu, Yanfang; Chen, Yiyun

2013-01-01

Rapid urbanization in China has triggered the conversion of land from rural to urban use, particularly the conversion of rural settlements to town land. This conversion is the result of the joint effects of the geographic environment and agents involving the government, investors, and farmers. To understand the dynamic interaction dominated by agents and to predict the future landscape of town expansion, a small town land-planning model is proposed based on the integration of multi-agent systems (MAS) and cellular automata (CA). The MAS-CA model links the decision-making behaviors of agents with the neighbor effect of CA. The interaction rules are projected by analyzing the preference conflicts among agents. To better illustrate the effects of the geographic environment, neighborhood, and agent behavior, a comparative analysis between the CA and MAS-CA models in three different towns is presented, revealing interesting patterns in terms of quantity, spatial characteristics, and the coordinating process. The simulation of rural settlements conversion to town land through modeling agent decision and human-environment interaction is very useful for understanding the mechanisms of rural-urban land-use change in developing countries. This process can assist town planners in formulating appropriate development plans.

Visual graph query formulation and exploration: a new perspective on information retrieval at the edge

NASA Astrophysics Data System (ADS)

Kase, Sue E.; Vanni, Michelle; Knight, Joanne A.; Su, Yu; Yan, Xifeng

2016-05-01

Within operational environments decisions must be made quickly based on the information available. Identifying an appropriate knowledge base and accurately formulating a search query are critical tasks for decision-making effectiveness in dynamic situations. The spreading of graph data management tools to access large graph databases is a rapidly emerging research area of potential benefit to the intelligence community. A graph representation provides a natural way of modeling data in a wide variety of domains. Graph structures use nodes, edges, and properties to represent and store data. This research investigates the advantages of information search by graph query initiated by the analyst and interactively refined within the contextual dimensions of the answer space toward a solution. The paper introduces SLQ, a user-friendly graph querying system enabling the visual formulation of schemaless and structureless graph queries. SLQ is demonstrated with an intelligence analyst information search scenario focused on identifying individuals responsible for manufacturing a mosquito-hosted deadly virus. The scenario highlights the interactive construction of graph queries without prior training in complex query languages or graph databases, intuitive navigation through the problem space, and visualization of results in graphical format.

System importance measures: A new approach to resilient systems-of-systems

NASA Astrophysics Data System (ADS)

Uday, Payuna

Resilience is the ability to withstand and recover rapidly from disruptions. While this attribute has been the focus of research in several fields, in the case of system-of-systems (SoSs), addressing resilience is particularly interesting and challenging. As infrastructure SoSs, such as power, transportation, and communication networks, grow in complexity and interconnectivity, measuring and improving the resilience of these SoSs is vital in terms of safety and providing uninterrupted services. The characteristics of systems-of-systems make analysis and design of resilience challenging. However, these features also offer opportunities to make SoSs resilient using unconventional methods. In this research, we present a new approach to the process of resilience design. The core idea behind the proposed design process is a set of system importance measures (SIMs) that identify systems crucial to overall resilience. Using the results from the SIMs, we determine appropriate strategies from a list of design principles to improve SoS resilience. The main contribution of this research is the development of an aid to design that provides specific guidance on where and how resources need to be targeted. Based on the needs of an SoS, decision-makers can iterate through the design process to identify a set of practical and effective design improvements. We use two case studies to demonstrate how the SIM-based design process can inform decision-making in the context of SoS resilience. The first case study focuses on a naval warfare SoS and describes how the resilience framework can leverage existing simulation models to support end-to-end design. We proceed through stages of the design approach using an agent-based model (ABM) that enables us to demonstrate how simulation tools and analytical models help determine the necessary inputs for the design process and, subsequently, inform decision-making regarding SoS resilience. The second case study considers the urban transportation network in Boston. This case study focuses on interpreting the results of the resilience framework and on describing how they can be used to guide design choices in large infrastructure networks. We use different resilience maps to highlight the range of design-related information that can be obtained from the framework. Specific advantages of the SIM-based resilience design include: (1) incorporates SoS- specific features within existing risk-based design processes - the SIMs determine the relative importance of different systems based on their impacts on SoS-level performance, and suggestions for resilience improvement draw from design options that leverage SoS- specific characteristics, such as the ability to adapt quickly (such as add new systems or re-task existing ones) and to provide partial recovery of performance in the aftermath of a disruption; (2) allows rapid understanding of different areas of concern within the SoS - the visual nature of the resilience map (a key outcome of the SIM analysis) provides a useful way to summarize the current resilience of the SoS as well as point to key systems of concern; and (3) provides a platform for multiple analysts and decision- makers to study, modify, discuss and document options for SoS.

What Lies Beneath? An Evaluation of Rapid Assessment Tools for Management of Hull Fouling

NASA Astrophysics Data System (ADS)

Clarke Murray, Cathryn; Therriault, Thomas W.; Pakhomov, Evgeny

2013-08-01

Despite an increased understanding of marine invasions, non-indigenous species (NIS) continue to be redistributed at both global and regional scales. Since prevention is an important element of NIS programs, monitoring vectors responsible for NIS introductions and spread, such as hull fouling, has become a priority and methods should be selected carefully to balance accuracy, time, and cost. Two common fouling assessment tools for the marine recreational boating vector were evaluated for accuracy using a traditional underwater SCUBA survey in coastal British Columbia: a dockside level of fouling assessment and a behavioral questionnaire model. Results showed that although rapid, dockside assessments did not provide an accurate assessment of fouling present below the surface, at least not in this region. In contrast, a questionnaire-based model using four easily obtained variables (boat type, age of antifouling paint, storage type, and occurrence of long distance trips) reliably identified boats carrying macrofouling species, a proxy for risk of NIS transport. Once validated, this fouling model tool could be applied in border inspection or quarantine situations where decisions must be made quickly. Further development and refinement of rapid assessment tools would improve our ability to prevent new introductions and manage spread of existing invasive species.

A rapid approach for characterization of thiol-conjugated antibody-drug conjugates and calculation of drug-antibody ratio by liquid chromatography mass spectrometry.

PubMed

Firth, David; Bell, Leonard; Squires, Martin; Estdale, Sian; McKee, Colin

2015-09-15

We present the demonstration of a rapid "middle-up" liquid chromatography mass spectrometry (LC-MS)-based workflow for use in the characterization of thiol-conjugated maleimidocaproyl-monomethyl auristatin F (mcMMAF) and valine-citrulline-monomethyl auristatin E (vcMMAE) antibody-drug conjugates. Deconvoluted spectra were generated following a combination of deglycosylation, IdeS (immunoglobulin-degrading enzyme from Streptococcus pyogenes) digestion, and reduction steps that provide a visual representation of the product for rapid lot-to-lot comparison-a means to quickly assess the integrity of the antibody structure and the applied conjugation chemistry by mass. The relative abundance of the detected ions also offer information regarding differences in drug conjugation levels between samples, and the average drug-antibody ratio can be calculated. The approach requires little material (<100 μg) and, thus, is amenable to small-scale process development testing or as an early component of a complete characterization project facilitating informed decision making regarding which aspects of a molecule might need to be examined in more detail by orthogonal methodologies. Copyright © 2015 Elsevier Inc. All rights reserved.

What lies beneath? An evaluation of rapid assessment tools for management of hull fouling.

PubMed

Clarke Murray, Cathryn; Therriault, Thomas W; Pakhomov, Evgeny

2013-08-01

Despite an increased understanding of marine invasions, non-indigenous species (NIS) continue to be redistributed at both global and regional scales. Since prevention is an important element of NIS programs, monitoring vectors responsible for NIS introductions and spread, such as hull fouling, has become a priority and methods should be selected carefully to balance accuracy, time, and cost. Two common fouling assessment tools for the marine recreational boating vector were evaluated for accuracy using a traditional underwater SCUBA survey in coastal British Columbia: a dockside level of fouling assessment and a behavioral questionnaire model. Results showed that although rapid, dockside assessments did not provide an accurate assessment of fouling present below the surface, at least not in this region. In contrast, a questionnaire-based model using four easily obtained variables (boat type, age of antifouling paint, storage type, and occurrence of long distance trips) reliably identified boats carrying macrofouling species, a proxy for risk of NIS transport. Once validated, this fouling model tool could be applied in border inspection or quarantine situations where decisions must be made quickly. Further development and refinement of rapid assessment tools would improve our ability to prevent new introductions and manage spread of existing invasive species.

Cancer immunotherapy: Opportunities and challenges in the rapidly evolving clinical landscape.

PubMed

Emens, Leisha A; Ascierto, Paolo A; Darcy, Phillip K; Demaria, Sandra; Eggermont, Alexander M M; Redmond, William L; Seliger, Barbara; Marincola, Francesco M

2017-08-01

Cancer immunotherapy is now established as a powerful way to treat cancer. The recent clinical success of immune checkpoint blockade (antagonists of CTLA-4, PD-1 and PD-L1) highlights both the universal power of treating the immune system across tumour types and the unique features of cancer immunotherapy. Immune-related adverse events, atypical clinical response patterns, durable responses, and clear overall survival benefit distinguish cancer immunotherapy from cytotoxic cancer therapy. Combination immunotherapies that transform non-responders to responders are under rapid development. Current challenges facing the field include incorporating immunotherapy into adjuvant and neoadjuvant cancer therapy, refining dose, schedule and duration of treatment and developing novel surrogate endpoints that accurately capture overall survival benefit early in treatment. As the field rapidly evolves, we must prioritise the development of biomarkers to guide the use of immunotherapies in the most appropriate patients. Immunotherapy is already transforming cancer from a death sentence to a chronic disease for some patients. By making smart, evidence-based decisions in developing next generation immunotherapies, cancer should become an imminently treatable, curable and even preventable disease. Copyright © 2017 Elsevier Ltd. All rights reserved.

Rapid learning: a breakthrough agenda.

PubMed

Etheredge, Lynn M

2014-07-01

A "rapid-learning health system" was proposed in a 2007 thematic issue of Health Affairs. The system was envisioned as one that uses evidence-based medicine to quickly determine the best possible treatments for patients. It does so by drawing on electronic health records and the power of big data to access large volumes of information from a variety of sources at high speed. The foundation for a rapid-learning health system was laid during 2007-13 by workshops, policy papers, large public investments in databases and research programs, and developing learning systems. Challenges now include implementing a new clinical research system with several hundred million patients, modernizing clinical trials and registries, devising and funding research on national priorities, and analyzing genetic and other factors that influence diseases and responses to treatment. Next steps also should aim to improve comparative effectiveness research; build on investments in health information technology to standardize handling of genetic information and support information exchange through apps and software modules; and develop new tools, data, and information for clinical decision support. Further advances will require commitment, leadership, and public-private and global collaboration. Project HOPE—The People-to-People Health Foundation, Inc.

Transient extracellular glutamate events in the basolateral amygdala track reward seeking actions

PubMed Central

Wassum, KM; Tolosa, VM; Tseng, TC; Balleine, BW; Monbouquette, HG; Maidment, NT

2012-01-01

The ability to make rapid, informed decisions about whether or not to engage in a sequence of actions to earn reward is essential for survival. Modeling in rodents has demonstrated a critical role for the basolateral amygdala (BLA) in such reward-seeking actions, but the precise neurochemical underpinnings are not well understood. Taking advantage of recent advancements in biosensor technologies, we made spatially discrete near-real time extracellular recordings of the major excitatory transmitter, glutamate, in the BLA of rats performing a self-paced lever-pressing sequence task for sucrose reward. This allowed us to detect rapid transient fluctuations in extracellular BLA glutamate time-locked to action performance. These glutamate transients tended to precede lever pressing actions and were markedly increased in frequency when rats were engaged in such reward seeking actions. Based on muscimol and tetrodotoxin microinfusions these glutamate transients appeared to originate from the terminals of neurons with cell bodies in the orbital frontal cortex. Importantly, glutamate transient amplitude and frequency fluctuated with the value of the earned reward and positively predicted lever pressing rate. Such novel rapid glutamate recordings during instrumental performance identify a role for glutamatergic signaling within the BLA in instrumental reward-seeking actions. PMID:22357857

Light-sheet microscopy for slide-free non-destructive pathology of large clinical specimens

PubMed Central

Glaser, Adam K.; Reder, Nicholas P.; Chen, Ye; McCarty, Erin F.; Yin, Chengbo; Wei, Linpeng; Wang, Yu; True, Lawrence D.; Liu, Jonathan T.C.

2017-01-01

For the 1.7 million patients per year in the U.S. who receive a new cancer diagnosis, treatment decisions are largely made after a histopathology exam. Unfortunately, the gold standard of slide-based microscopic pathology suffers from high inter-observer variability and limited prognostic value due to sampling limitations and the inability to visualize tissue structures and molecular targets in their native 3D context. Here, we show that an open-top light-sheet microscope optimized for non-destructive slide-free pathology of clinical specimens enables the rapid imaging of intact tissues at high resolution over large 2D and 3D fields of view, with the same level of detail as traditional pathology. We demonstrate the utility of this technology for various applications: wide-area surface microscopy to triage surgical specimens (with ~200 μm surface irregularities), rapid intraoperative assessment of tumour-margin surfaces (12.5 sec/cm2), and volumetric assessment of optically cleared core–needle biopsies (1 mm in diameter, 2 cm in length). Light-sheet microscopy can be a versatile tool for both rapid surface microscopy and deep volumetric microscopy of human specimens. PMID:29750130

Multi-stage methodology to detect health insurance claim fraud.

PubMed

Johnson, Marina Evrim; Nagarur, Nagen

2016-09-01

Healthcare costs in the US, as well as in other countries, increase rapidly due to demographic, economic, social, and legal changes. This increase in healthcare costs impacts both government and private health insurance systems. Fraudulent behaviors of healthcare providers and patients have become a serious burden to insurance systems by bringing unnecessary costs. Insurance companies thus develop methods to identify fraud. This paper proposes a new multistage methodology for insurance companies to detect fraud committed by providers and patients. The first three stages aim at detecting abnormalities among providers, services, and claim amounts. Stage four then integrates the information obtained in the previous three stages into an overall risk measure. Subsequently, a decision tree based method in stage five computes risk threshold values. The final decision stating whether the claim is fraudulent is made by comparing the risk value obtained in stage four with the risk threshold value from stage five. The research methodology performs well on real-world insurance data.

Reversible RNA adenosine methylation in biological regulation

PubMed Central

Jia, Guifang; Fu, Ye; He, Chuan

2012-01-01

N6-methyladenosine (m6A) is a ubiquitous modification in messenger RNA (mRNA) and other RNAs across most eukaryotes. For many years, however, the exact functions of m6A were not clearly understood. The discovery that the fat mass and obesity associated protein (FTO) is an m6A demethylase indicates that this modification is reversible and dynamically regulated, suggesting it has regulatory roles. In addition, it has been shown that m6A affects cell fate decisions in yeast and plant development. Recent affinity-based m6A profiling in mouse and human cells further showed that this modification is a widespread mark in coding and non-coding RNA transcripts and is likely dynamically regulated throughout developmental processes. Therefore, reversible RNA methylation, analogous to reversible DNA and histone modifications, may affect gene expression and cell fate decisions by modulating multiple RNA-related cellular pathways, which potentially provides rapid responses to various cellular and environmental signals, including energy and nutrient availability in mammals. PMID:23218460

An attentional drift diffusion model over binary-attribute choice.

PubMed

Fisher, Geoffrey

2017-11-01

In order to make good decisions, individuals need to identify and properly integrate information about various attributes associated with a choice. Since choices are often complex and made rapidly, they are typically affected by contextual variables that are thought to influence how much attention is paid to different attributes. I propose a modification of the attentional drift-diffusion model, the binary-attribute attentional drift diffusion model (baDDM), which describes the choice process over simple binary-attribute choices and how it is affected by fluctuations in visual attention. Using an eye-tracking experiment, I find the baDDM makes accurate quantitative predictions about several key variables including choices, reaction times, and how these variables are correlated with attention to two attributes in an accept-reject decision. Furthermore, I estimate an attribute-based fixation bias that suggests attention to an attribute increases its subjective weight by 5%, while the unattended attribute's weight is decreased by 10%. Copyright © 2017 Elsevier B.V. All rights reserved.

Feature Statistics Modulate the Activation of Meaning During Spoken Word Processing.

PubMed

Devereux, Barry J; Taylor, Kirsten I; Randall, Billi; Geertzen, Jeroen; Tyler, Lorraine K

2016-03-01

Understanding spoken words involves a rapid mapping from speech to conceptual representations. One distributed feature-based conceptual account assumes that the statistical characteristics of concepts' features--the number of concepts they occur in (distinctiveness/sharedness) and likelihood of co-occurrence (correlational strength)--determine conceptual activation. To test these claims, we investigated the role of distinctiveness/sharedness and correlational strength in speech-to-meaning mapping, using a lexical decision task and computational simulations. Responses were faster for concepts with higher sharedness, suggesting that shared features are facilitatory in tasks like lexical decision that require access to them. Correlational strength facilitated responses for slower participants, suggesting a time-sensitive co-occurrence-driven settling mechanism. The computational simulation showed similar effects, with early effects of shared features and later effects of correlational strength. These results support a general-to-specific account of conceptual processing, whereby early activation of shared features is followed by the gradual emergence of a specific target representation. Copyright © 2015 The Authors. Cognitive Science published by Cognitive Science Society, Inc.

Prediction based proactive thermal virtual machine scheduling in green clouds.

PubMed

Kinger, Supriya; Kumar, Rajesh; Sharma, Anju

2014-01-01

Cloud computing has rapidly emerged as a widely accepted computing paradigm, but the research on Cloud computing is still at an early stage. Cloud computing provides many advanced features but it still has some shortcomings such as relatively high operating cost and environmental hazards like increasing carbon footprints. These hazards can be reduced up to some extent by efficient scheduling of Cloud resources. Working temperature on which a machine is currently running can be taken as a criterion for Virtual Machine (VM) scheduling. This paper proposes a new proactive technique that considers current and maximum threshold temperature of Server Machines (SMs) before making scheduling decisions with the help of a temperature predictor, so that maximum temperature is never reached. Different workload scenarios have been taken into consideration. The results obtained show that the proposed system is better than existing systems of VM scheduling, which does not consider current temperature of nodes before making scheduling decisions. Thus, a reduction in need of cooling systems for a Cloud environment has been obtained and validated.

The temporal dynamics of ambivalence: changes in positive and negative affect in relation to consumption of an "emotionally charged" food.

PubMed

Hormes, Julia M; Rozin, Paul

2011-08-01

Ambivalence is thought to impact consumption of food, alcohol and drugs, possibly via influences on craving, with cravers often being simultaneously drawn toward and repelled from ingestion. So far, little is known about the temporal dynamics of ambivalence, especially as it varies in relationship to consumption. Participants (n=482, 56.8% female) completed the Positive and Negative Affect Schedule prior to, immediately and 30 min after the opportunity to eat a bar of chocolate. Affective ambivalence was calculated based on the relative strengths of and discrepancy between ratings of positive and negative affect. Ambivalence peaked prior to a decision about consumption and subsequently decreased, whether or not the decision was in favor of or against consuming. Decreasing ambivalence was driven by a drop in positive affect over time; positivity decreased more rapidly in those who consumed chocolate. Findings represent a first step in characterizing the dynamics of ambivalence in interactions with a target stimulus. Copyright © 2011 Elsevier Ltd. All rights reserved.

Identification and Assessment of Potential Water Quality Impact Factors for Drinking-Water Reservoirs

PubMed Central

Gu, Qing; Deng, Jinsong; Wang, Ke; Lin, Yi; Li, Jun; Gan, Muye; Ma, Ligang; Hong, Yang

2014-01-01

Various reservoirs have been serving as the most important drinking water sources in Zhejiang Province, China, due to the uneven distribution of precipitation and severe river pollution. Unfortunately, rapid urbanization and industrialization have been continuously challenging the water quality of the drinking-water reservoirs. The identification and assessment of potential impacts is indispensable in water resource management and protection. This study investigates the drinking water reservoirs in Zhejiang Province to better understand the potential impact on water quality. Altogether seventy-three typical drinking reservoirs in Zhejiang Province encompassing various water storage levels were selected and evaluated. Using fifty-two reservoirs as training samples, the classification and regression tree (CART) method and sixteen comprehensive variables, including six sub-sets (land use, population, socio-economy, geographical features, inherent characteristics, and climate), were adopted to establish a decision-making model for identifying and assessing their potential impacts on drinking-water quality. The water quality class of the remaining twenty-one reservoirs was then predicted and tested based on the decision-making model, resulting in a water quality class attribution accuracy of 81.0%. Based on the decision rules and quantitative importance of the independent variables, industrial emissions was identified as the most important factor influencing the water quality of reservoirs; land use and human habitation also had a substantial impact on water quality. The results of this study provide insights into the factors impacting the water quality of reservoirs as well as basic information for protecting reservoir water resources. PMID:24919129

Classifying Nanomaterial Risks Using Multi-Criteria Decision Analysis

NASA Astrophysics Data System (ADS)

Linkov, I.; Steevens, J.; Chappell, M.; Tervonen, T.; Figueira, J. R.; Merad, M.

There is rapidly growing interest by regulatory agencies and stakeholders in the potential toxicity and other risks associated with nanomaterials throughout the different stages of the product life cycle (e.g., development, production, use and disposal). Risk assessment methods and tools developed and applied to chemical and biological material may not be readily adaptable for nanomaterials because of the current uncertainty in identifying the relevant physico-chemical and biological properties that adequately describe the materials. Such uncertainty is further driven by the substantial variations in the properties of the original material because of the variable manufacturing processes employed in nanomaterial production. To guide scientists and engineers in nanomaterial research and application as well as promote the safe use/handling of these materials, we propose a decision support system for classifying nanomaterials into different risk categories. The classification system is based on a set of performance metrics that measure both the toxicity and physico-chemical characteristics of the original materials, as well as the expected environmental impacts through the product life cycle. The stochastic multicriteria acceptability analysis (SMAA-TRI), a formal decision analysis method, was used as the foundation for this task. This method allowed us to cluster various nanomaterials in different risk categories based on our current knowledge of nanomaterial's physico-chemical characteristics, variation in produced material, and best professional judgement. SMAA-TRI uses Monte Carlo simulations to explore all feasible values for weights, criteria measurements, and other model parameters to assess the robustness of nanomaterial grouping for risk management purposes.1,2

Identification and assessment of potential water quality impact factors for drinking-water reservoirs.

PubMed

Gu, Qing; Deng, Jinsong; Wang, Ke; Lin, Yi; Li, Jun; Gan, Muye; Ma, Ligang; Hong, Yang

2014-06-10

Various reservoirs have been serving as the most important drinking water sources in Zhejiang Province, China, due to the uneven distribution of precipitation and severe river pollution. Unfortunately, rapid urbanization and industrialization have been continuously challenging the water quality of the drinking-water reservoirs. The identification and assessment of potential impacts is indispensable in water resource management and protection. This study investigates the drinking water reservoirs in Zhejiang Province to better understand the potential impact on water quality. Altogether seventy-three typical drinking reservoirs in Zhejiang Province encompassing various water storage levels were selected and evaluated. Using fifty-two reservoirs as training samples, the classification and regression tree (CART) method and sixteen comprehensive variables, including six sub-sets (land use, population, socio-economy, geographical features, inherent characteristics, and climate), were adopted to establish a decision-making model for identifying and assessing their potential impacts on drinking-water quality. The water quality class of the remaining twenty-one reservoirs was then predicted and tested based on the decision-making model, resulting in a water quality class attribution accuracy of 81.0%. Based on the decision rules and quantitative importance of the independent variables, industrial emissions was identified as the most important factor influencing the water quality of reservoirs; land use and human habitation also had a substantial impact on water quality. The results of this study provide insights into the factors impacting the water quality of reservoirs as well as basic information for protecting reservoir water resources.

Automatically updating predictive modeling workflows support decision-making in drug design.

PubMed

Muegge, Ingo; Bentzien, Jörg; Mukherjee, Prasenjit; Hughes, Robert O

2016-09-01

Using predictive models for early decision-making in drug discovery has become standard practice. We suggest that model building needs to be automated with minimum input and low technical maintenance requirements. Models perform best when tailored to answering specific compound optimization related questions. If qualitative answers are required, 2-bin classification models are preferred. Integrating predictive modeling results with structural information stimulates better decision making. For in silico models supporting rapid structure-activity relationship cycles the performance deteriorates within weeks. Frequent automated updates of predictive models ensure best predictions. Consensus between multiple modeling approaches increases the prediction confidence. Combining qualified and nonqualified data optimally uses all available information. Dose predictions provide a holistic alternative to multiple individual property predictions for reaching complex decisions.

Satellite-based emergency mapping using optical imagery: experience and reflections from the 2015 Nepal earthquakes

NASA Astrophysics Data System (ADS)

Williams, Jack G.; Rosser, Nick J.; Kincey, Mark E.; Benjamin, Jessica; Oven, Katie J.; Densmore, Alexander L.; Milledge, David G.; Robinson, Tom R.; Jordan, Colm A.; Dijkstra, Tom A.

2018-01-01

Landslides triggered by large earthquakes in mountainous regions contribute significantly to overall earthquake losses and pose a major secondary hazard that can persist for months or years. While scientific investigations of coseismic landsliding are increasingly common, there is no protocol for rapid (hours-to-days) humanitarian-facing landslide assessment and no published recognition of what is possible and what is useful to compile immediately after the event. Drawing on the 2015 Mw 7.8 Gorkha earthquake in Nepal, we consider how quickly a landslide assessment based upon manual satellite-based emergency mapping (SEM) can be realistically achieved and review the decisions taken by analysts to ascertain the timeliness and type of useful information that can be generated. We find that, at present, many forms of landslide assessment are too slow to generate relative to the speed of a humanitarian response, despite increasingly rapid access to high-quality imagery. Importantly, the value of information on landslides evolves rapidly as a disaster response develops, so identifying the purpose, timescales, and end users of a post-earthquake landslide assessment is essential to inform the approach taken. It is clear that discussions are needed on the form and timing of landslide assessments, and how best to present and share this information, before rather than after an earthquake strikes. In this paper, we share the lessons learned from the Gorkha earthquake, with the aim of informing the approach taken by scientists to understand the evolving landslide hazard in future events and the expectations of the humanitarian community involved in disaster response.

Development of a Decision Aid for Cardiopulmonary Resuscitation Involving Intensive Care Unit Patients' and Health Professionals' Participation Using User-Centered Design and a Wiki Platform for Rapid Prototyping: A Research Protocol

PubMed Central

Heyland, Daren Keith; Ebell, Mark H; Dupuis, Audrey; Lavoie-Bérard, Carole-Anne; Légaré, France; Archambault, Patrick Michel

2016-01-01

Background Cardiopulmonary resuscitation (CPR) is an intervention used in cases of cardiac arrest to revive patients whose heart has stopped. Because cardiac arrest can have potentially devastating outcomes such as severe neurological deficits even if CPR is performed, patients must be involved in determining in advance if they want CPR in the case of an unexpected arrest. Shared decision making (SDM) facilitates discussions about goals of care regarding CPR in intensive care units (ICUs). Patient decision aids (DAs) are proven to support the implementation of SDM. Many patient DAs about CPR exist, but they are not universally implemented in ICUs in part due to lack of context and cultural adaptation. Adaptation to local context is an important phase of implementing any type of knowledge tool such as patient DAs. User-centered design supported by a wiki platform to perform rapid prototyping has previously been successful in creating knowledge tools adapted to the needs of patients and health professionals (eg, asthma action plans). This project aims to explore how user-centered design and a wiki platform can support the adaptation of an existing DA for CPR to the local context. Objective The primary objective is to use an existing DA about CPR to create a wiki-based DA that is adapted to the context of a single ICU and tailorable to individual patient’s risk factors while employing user-centered design. The secondary objective is to document the use of a wiki platform for the adaptation of patient DAs. Methods This study will be conducted in a mixed surgical and medical ICU at Hôtel-Dieu de Lévis, Quebec, Canada. We plan to involve all 5 intensivists and recruit at least 20 alert and oriented patients admitted to the ICU and their family members if available. In the first phase of this study, we will observe 3 weeks of daily interactions between patients, families, intensivists, and other allied health professionals. We will specifically observe 5 dyads of attending intensivists and alert and oriented patients discussing goals of care concerning CPR to understand how a patient DA could support this decision. We will also conduct individual interviews with the 5 intensivists to identify their needs concerning the implementation of a DA. In the second phase of the study, we will build a first prototype based on the needs identified in Phase I. We will start by translating an existing DA entitled “Cardiopulmonary resuscitation: a decision aid for patients and their families.” We will then adapt this tool to the needs we identified in Phase I and archive this first prototype in a wiki. Building on the wiki’s programming architecture, we intend to integrate the Good Outcome Following Attempted Resuscitation risk calculator into our DA to determine personal risks and benefits of CPR for each patient. We will then present the first prototype to 5 new patient-intensivist dyads. Feedback about content and visual presentation will be collected from the intensivists through short interviews while longer interviews will be conducted with patients and their family members to inform the visual design and content of the next prototype. After each rapid prototyping cycle, 2 researchers will perform qualitative content analysis of data collected through interviews and direct observations. We will attempt to solve all content and visual design issues identified before moving to the next round of prototyping. In all, we will conduct 3 prototyping cycles with a total of 15 patient-intensivist dyads. Results We expect to develop a multimedia wiki-based DA to support goals of care discussions about CPR adapted to the local needs of patients, their family members, and intensivists and tailorable to individual patient risk factors. The final version of the DA as well as the development process will be housed in an open-access wiki and free to be adapted and used in other contexts. Conclusions This study will shed new light on the development of DAs adapted to local context and tailorable to individual patient risk factors employing user-centered design and a wiki to support rapid prototyping of content and visual design issues. PMID:26869137

Data-Driven Rightsizing: Integrating Preservation Into the Legacy Cities Landscape

NASA Astrophysics Data System (ADS)

Evans, E.; Grosicki, B.

2017-08-01

Legacy cities, whose built environments are undergoing transformations due to population loss, are at a critical juncture in their urban history and the historic preservation field has an important role to play. Rapid mobile surveys provide an opportunity for data collection that expands beyond traditional historic criteria, and positions preservationists to be proactive decision-makers and to align with multi-disciplinary partners. Rapid mobile surveys are being utilized in conjunction with in-depth data analysis of comprehensive livability metrics at the parcel, neighborhood, and citywide levels to develop recommendations for reactivating vacant properties. Historic preservationists are spearheading these efforts through a tool called Relocal, which uses 70-85 distinct metrics and a community priority survey to generate parcel-level recommendations for every vacant lot and vacant building in the areas in which it is applied. Local volunteer-led rapid mobile surveys are key to gathering on-the-ground, real-time metrics that serve as Relocal's foundation. These new survey techniques generate usable data sets for historic preservation practitioners, land banks, planners, and other entities to inform strategic rightsizing decisions across legacy cities.

The Science-Policy Link: Stakeholder Reactions to the Uncertainties of Future Sea Level Rise

NASA Astrophysics Data System (ADS)

Plag, H.; Bye, B.

2011-12-01

Policy makers and stakeholders in the coastal zone are equally challenged by the risk of an anticipated rise of coastal Local Sea Level (LSL) as a consequence of future global warming. Many low-lying and often densely populated coastal areas are under risk of increased inundation. More than 40% of the global population is living in or near the coastal zone and this fraction is steadily increasing. A rise in LSL will increase the vulnerability of coastal infrastructure and population dramatically, with potentially devastating consequences for the global economy, society, and environment. Policy makers are faced with a trade-off between imposing today the often very high costs of coastal protection and adaptation upon national economies and leaving the costs of potential major disasters to future generations. They are in need of actionable information that provides guidance for the development of coastal zones resilient to future sea level changes. Part of this actionable information comes from risk and vulnerability assessments, which require information on future LSL changes as input. In most cases, a deterministic approach has been applied based on predictions of the plausible range of future LSL trajectories as input. However, there is little consensus in the scientific community on how these trajectories should be determined, and what the boundaries of the plausible range are. Over the last few years, many publications in Science, Nature and other peer-reviewed scientific journals have revealed a broad range of possible futures and significant epistemic uncertainties and gaps concerning LSL changes. Based on the somewhat diffuse science input, policy and decision makers have made rather different choices for mitigation and adaptation in cases such as Venice, The Netherlands, New York City, and the San Francisco Bay area. Replacing the deterministic, prediction-based approach with a statistical one that fully accounts for the uncertainties and epistemic gaps would provide a different kind of science input to policy makers and stakeholders. Like in many other insurance problems (for example, earthquakes), where deterministic predictions are not possible and decisions have to be made on the basis of statistics and probabilities, the statistical approach to coastal resilience would require stakeholders to make decisions on the basis of probabilities instead of predictions. The science input for informed decisions on adaptation would consist of general probabilities of decadal to century scale sea level changes derived from paleo records, including the probabilities for large and rapid rises. Similar to other problems where the appearance of a hazard is associated with a high risk (like a fire in a house), this approach would also require a monitoring and warning system (a "smoke detector") capable of detecting any onset of a rapid sea level rise.

The Macro Dynamics of Weapon System Acquisition: Shaping Early Decisions to Get Better Outcomes

DTIC Science & Technology

2012-05-17

defects and rework •Design tools and processes •Lack of feedback to key design and SE processes •Lack of quantified risk and uncertainty at key... Tools for Rapid Exploration of the Physical Design Space Coupling Operability, Interoperability, and Physical Feasibility Analyses – a Game Changer...Interoperability •Training Quantified Margins and Uncertainties at Each Critical Decision Point M&S RDT&E A Continuum of Tools Underpinned with

The Development of a Rapid Prototyping Environment

DTIC Science & Technology

1989-12-01

constraints is a very complex, time- consuming and costly took. This situation can be iaproved by the use of adequate development methods and powerful support...was an essential factor in our decision . The previous development of CAPS tools utilized and assuumed the availa- bility of a Sun Workstation. There...the development of a production * 23 sys(tCm. An early decision was mIade to accept dependence upon the best locally avail- able resources. Portability

Spatial Patterns and Design Policies for Future American Cities

ERIC Educational Resources Information Center

Dutt, Ashok K.; Costa, Frank J.

1977-01-01

Describes plans for future urban development which take into account energy needs, mass transportation, technological innovations, high density settlement along the rapid transit spine, and rational decision making. (Author/DB)

Dynamic Interplay of Value and Sensory Information in High-Speed Decision Making.

PubMed

Afacan-Seref, Kivilcim; Steinemann, Natalie A; Blangero, Annabelle; Kelly, Simon P

2018-03-05

In dynamic environments, split-second sensorimotor decisions must be prioritized according to potential payoffs to maximize overall rewards. The impact of relative value on deliberative perceptual judgments has been examined extensively [1-6], but relatively little is known about value-biasing mechanisms in the common situation where physical evidence is strong but the time to act is severely limited. In prominent decision models, a noisy but statistically stationary representation of sensory evidence is integrated over time to an action-triggering bound, and value-biases are affected by starting the integrator closer to the more valuable bound. Here, we show significant departures from this account for humans making rapid sensory-instructed action choices. Behavior was best explained by a simple model in which the evidence representation-and hence, rate of accumulation-is itself biased by value and is non-stationary, increasing over the short decision time frame. Because the value bias initially dominates, the model uniquely predicts a dynamic "turn-around" effect on low-value cues, where the accumulator first launches toward the incorrect action but is then re-routed to the correct one. This was clearly exhibited in electrophysiological signals reflecting motor preparation and evidence accumulation. Finally, we construct an extended model that implements this dynamic effect through plausible sensory neural response modulations and demonstrate the correspondence between decision signal dynamics simulated from a behavioral fit of that model and the empirical decision signals. Our findings suggest that value and sensory information can exert simultaneous and dynamically countervailing influences on the trajectory of the accumulation-to-bound process, driving rapid, sensory-guided actions. Copyright © 2018 Elsevier Ltd. All rights reserved.

Development of solution-gated graphene transistor model for biosensors

NASA Astrophysics Data System (ADS)

Karimi, Hediyeh; Yusof, Rubiyah; Rahmani, Rasoul; Hosseinpour, Hoda; Ahmadi, Mohammad T.

2014-02-01

The distinctive properties of graphene, characterized by its high carrier mobility and biocompatibility, have stimulated extreme scientific interest as a promising nanomaterial for future nanoelectronic applications. In particular, graphene-based transistors have been developed rapidly and are considered as an option for DNA sensing applications. Recent findings in the field of DNA biosensors have led to a renewed interest in the identification of genetic risk factors associated with complex human diseases for diagnosis of cancers or hereditary diseases. In this paper, an analytical model of graphene-based solution gated field effect transistors (SGFET) is proposed to constitute an important step towards development of DNA biosensors with high sensitivity and selectivity. Inspired by this fact, a novel strategy for a DNA sensor model with capability of single-nucleotide polymorphism detection is proposed and extensively explained. First of all, graphene-based DNA sensor model is optimized using particle swarm optimization algorithm. Based on the sensing mechanism of DNA sensors, detective parameters ( I ds and V gmin) are suggested to facilitate the decision making process. Finally, the behaviour of graphene-based SGFET is predicted in the presence of single-nucleotide polymorphism with an accuracy of more than 98% which guarantees the reliability of the optimized model for any application of the graphene-based DNA sensor. It is expected to achieve the rapid, quick and economical detection of DNA hybridization which could speed up the realization of the next generation of the homecare sensor system.

Development of solution-gated graphene transistor model for biosensors

PubMed Central

2014-01-01

The distinctive properties of graphene, characterized by its high carrier mobility and biocompatibility, have stimulated extreme scientific interest as a promising nanomaterial for future nanoelectronic applications. In particular, graphene-based transistors have been developed rapidly and are considered as an option for DNA sensing applications. Recent findings in the field of DNA biosensors have led to a renewed interest in the identification of genetic risk factors associated with complex human diseases for diagnosis of cancers or hereditary diseases. In this paper, an analytical model of graphene-based solution gated field effect transistors (SGFET) is proposed to constitute an important step towards development of DNA biosensors with high sensitivity and selectivity. Inspired by this fact, a novel strategy for a DNA sensor model with capability of single-nucleotide polymorphism detection is proposed and extensively explained. First of all, graphene-based DNA sensor model is optimized using particle swarm optimization algorithm. Based on the sensing mechanism of DNA sensors, detective parameters (Ids and Vgmin) are suggested to facilitate the decision making process. Finally, the behaviour of graphene-based SGFET is predicted in the presence of single-nucleotide polymorphism with an accuracy of more than 98% which guarantees the reliability of the optimized model for any application of the graphene-based DNA sensor. It is expected to achieve the rapid, quick and economical detection of DNA hybridization which could speed up the realization of the next generation of the homecare sensor system. PMID:24517158

Information extraction with object based support vector machines and vegetation indices

NASA Astrophysics Data System (ADS)

Ustuner, Mustafa; Abdikan, Saygin; Balik Sanli, Fusun

2016-07-01

Information extraction through remote sensing data is important for policy and decision makers as extracted information provide base layers for many application of real world. Classification of remotely sensed data is the one of the most common methods of extracting information however it is still a challenging issue because several factors are affecting the accuracy of the classification. Resolution of the imagery, number and homogeneity of land cover classes, purity of training data and characteristic of adopted classifiers are just some of these challenging factors. Object based image classification has some superiority than pixel based classification for high resolution images since it uses geometry and structure information besides spectral information. Vegetation indices are also commonly used for the classification process since it provides additional spectral information for vegetation, forestry and agricultural areas. In this study, the impacts of the Normalized Difference Vegetation Index (NDVI) and Normalized Difference Red Edge Index (NDRE) on the classification accuracy of RapidEye imagery were investigated. Object based Support Vector Machines were implemented for the classification of crop types for the study area located in Aegean region of Turkey. Results demonstrated that the incorporation of NDRE increase the classification accuracy from 79,96% to 86,80% as overall accuracy, however NDVI decrease the classification accuracy from 79,96% to 78,90%. Moreover it is proven than object based classification with RapidEye data give promising results for crop type mapping and analysis.

A research on service quality decision-making of Chinese communications industry based on quantum game

NASA Astrophysics Data System (ADS)

Zhang, Cuihua; Xing, Peng

2015-08-01

In recent years, Chinese service industry is developing rapidly. Compared with developed countries, service quality should be the bottleneck for Chinese service industry. On the background of three major telecommunications service providers in China, the functions of customer perceived utilities are established. With the goal of consumer's perceived utility maximization, the classic Nash equilibrium solution and quantum equilibrium solution are obtained. Then a numerical example is studied and the changing trend of service quality and customer perceived utility is further analyzed by the influence of the entanglement operator. Finally, it is proved that quantum game solution is better than Nash equilibrium solution.

Bench-to-bedside review: Rapid molecular diagnostics for bloodstream infection - a new frontier?

PubMed Central

2012-01-01

Among critically ill patients, the diagnosis of bloodstream infection poses a major challenge. Current standard bacterial identification based on blood culture platforms is intrinsically time-consuming and slow. The continuous evolvement of molecular techniques has the potential of providing a faster, more sensitive and direct identification of causative pathogens without prior need for cultivation. This may ultimately impact clinical decision-making and antimicrobial treatment. This review summarises the currently available technologies, their strengths and limitations and the obstacles that have to be overcome in order to develop a satisfactory bedside point-of-care diagnostic tool for detection of bloodstream infection. PMID:22647543

The Evolving Role of Simulation in Teaching Surgery in Undergraduate Medical Education.

PubMed

Acton, Robert D

2015-08-01

Simulation-based training (SBT) over the last 10 years has become a mainstay for surgical education at the graduate medical education (GME) level. More recently, however, the technique has rapidly become the standard for early efficient teaching of surgical skills and decision making at the undergraduate medical education (UME) level. The described benefits of SBT include its ability to compartmentalize education, to combine immediate assessment and feedback, and to accelerate knowledge and skill acquisition for the young learner. Consequently, SBT is now being adopted in multiple national medical student surgical educational initiatives. Copyright © 2015 Elsevier Inc. All rights reserved.

Airline Operations Aid

NASA Technical Reports Server (NTRS)

1993-01-01

C Language Integrated Production System (CLIPS), a NASA-developed expert systems program, is used by American Airlines for three purposes: as a rapid prototyping tool; to develop production prototypes; and to develop production application. An example of the latter is CLIPS' use in "Hub S1AAshing," a knowledge based system that recommends contingency plans when severe schedule reductions must be made. Hub S1AAshing has replaced a manual, labor intensive process. It saves time and allows Operations Control Coordinators to handle more difficult situations. Because the system assimilates much of the information necessary to facilitate educated decision making, it minimizes negative impact in situations where it is impossible to operate all flights.

China's emergence and the prospects for global sustainability

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

Grumbine, R.E.

2007-03-15

China's rapid development is influencing global patterns of resource use and their associated environmental and geopolitical impacts. Trend projections suggest that China's rise will have unprecedented impacts on the rest of the world. I examine three key drivers affecting China's emergence (scale of development, government policy decisions, and globalization), along with four factors that may constrain development (environmental degradation, political instability, coal and oil consumption, and carbon dioxide emissions). China's rise represents a tipping point between fossil fuel-based economies and still emergent sustainable alternatives. Policy precedents between the United States and China over the next decade may well determine themore » future course of global sustainability.« less

Clinical use of medical devices in the 'Bermuda Triangle'.

PubMed

Kessler, Larry; Ramsey, Scott D; Tunis, Sean; Sullivan, Sean D

2004-01-01

The pace of medical technological development shows no sign of abating. Analyzing the effect of major federal health agencies on the availability of such technology is critical. This paper describes functions of three government health agencies: the Centers for Medicare and Medicaid Services (CMS), the Food and Drug Administration (FDA), and the National Institutes of Health (NIH). Certain medical technologies fall into gaps between these agencies, which pose challenges in today's era of demand for evidence-based medicine. We suggest new policy and pragmatic strategies that can close the gaps and move decision making relevant to technology forward more rapidly than is now the case.

Implications of Contingency Planning Support for Weather and Icing Information

NASA Technical Reports Server (NTRS)

Vigeant-Langlois, Laurence; Hansman, R. John, Jr.

2003-01-01

A human-centered systems analysis was applied to the adverse aircraft weather encounter problem in order to identify desirable functions of weather and icing information. The importance of contingency planning was identified as emerging from a system safety design methodology as well as from results of other aviation decision-making studies. The relationship between contingency planning support and information on regions clear of adverse weather was investigated in a scenario- based analysis. A rapid prototype example of the key elements in the depiction of icing conditions was developed in a case study, and the implications for the components of the icing information system were articulated.

Towards ethical decision support and knowledge management in neonatal intensive care.

PubMed

Yang, L; Frize, M; Eng, P; Walker, R; Catley, C

2004-01-01

Recent studies in neonatal medicine, clinical nursing, and cognitive psychology have indicated the need to augment current decision-making practice in neonatal intensive care units with computerized, intelligent decision support systems. Rapid progress in artificial intelligence and knowledge management facilitates the design of collaborative ethical decision-support tools that allow clinicians to provide better support for parents facing inherently difficult choices, such as when to withdraw aggressive treatment. The appropriateness of using computers to support ethical decision-making is critically analyzed through research and literature review. In ethical dilemmas, multiple diverse participants need to communicate and function as a team to select the best treatment plan. In order to do this, physicians require reliable estimations of prognosis, while parents need a highly useable tool to help them assimilate complex medical issues and address their own value system. Our goal is to improve and structuralize the ethical decision-making that has become an inevitable part of modern neonatal care units. The paper contributes to clinical decision support by outlining the needs and basis for ethical decision support and justifying the proposed development efforts.

Rapid response learning of brand logo priming: Evidence that brand priming is not dominated by rapid response learning.

PubMed

Boehm, Stephan G; Smith, Ciaran; Muench, Niklas; Noble, Kirsty; Atherton, Catherine

2017-08-31

Repetition priming increases the accuracy and speed of responses to repeatedly processed stimuli. Repetition priming can result from two complementary sources: rapid response learning and facilitation within perceptual and conceptual networks. In conceptual classification tasks, rapid response learning dominates priming of object recognition, but it does not dominate priming of person recognition. This suggests that the relative engagement of network facilitation and rapid response learning depends on the stimulus domain. Here, we addressed the importance of the stimulus domain for rapid response learning by investigating priming in another domain, brands. In three experiments, participants performed conceptual decisions for brand logos. Strong priming was present, but it was not dominated by rapid response learning. These findings add further support to the importance of the stimulus domain for the relative importance of network facilitation and rapid response learning, and they indicate that brand priming is more similar to person recognition priming than object recognition priming, perhaps because priming of both brands and persons requires individuation.

Prospective Analysis of Decision Making During Joint Cardiology Cardiothoracic Conference in Treatment of 107 Consecutive Children with Congenital Heart Disease.

PubMed

Duignan, Sophie; Ryan, Aedin; O'Keeffe, Dara; Kenny, Damien; McMahon, Colin J

2018-05-12

The complexity and potential biases involved in decision making have long been recognised and examined in both the aviation and business industries. More recently, the medical community have started to explore this concept and its particular importance in our field. Paediatric cardiology is a rapidly expanding field and for many of the conditions we treat, there is limited evidence available to support our decision-making. Variability exists within decision-making in paediatric cardiology and this may influence outcomes. There are no validated tools available to support and examine consistent decision-making for various treatment strategies in children with congenital heart disease in a multidisciplinary cardiology and cardiothoracic institution. Our primary objective was to analyse the complexity of decision-making for children with cardiac conditions in the context of our joint cardiology and cardiothoracic conference (JCC). Two paediatric cardiologists acted as investigators by observing the weekly joint cardiology-cardiothoracic surgery conference and prospectively evaluating the degree of complexity of decision-making in the management of 107 sequential children with congenital heart disease discussed. Additionally, the group consensus on the same patients was prospectively assessed to compare this to the independent observers. Of 107 consecutive children discussed at our JCC conference 32 (27%) went on to receive surgical intervention, 20 (17%) underwent catheterisation and 65 (56%) received medical treatment. There were 53 (50%) cases rated as simple by one senior observer, while 54 (50%) were rated as complex to some degree. There was high inter-observer agreement with a Krippendorff's alpha of ≥ 0.8 between 2 observers and between 2 observers and the group consensus as a whole for grading of the complexity of decision-making. Different decisions were occasionally made on patients with the same data set. Discussions revisiting the same patient, in complex cases, resulted in different management decisions being reached in this series. Anchoring of decision-making was witnessed in certain cases. Potential application of decision making algorithms is discussed in making decisions in paediatric cardiology patients. Decision-making in our institution's joint cardiology-cardiothoracic conference proved to be complex in approximately half of our patients. Inconsistency in decision-making for patients with the same diagnosis, and different decisions made for the same complex patient at different time points confounds the reliability of the decision-making process. These novel data highlight the absence of evidence-based medicine for many decisions, occasional lack of consistency and the impact of anchoring, heuristics and other biases in complex cases. Validated decision-making algorithms may assist in providing consistency to decision-making in this setting.

An on-demand provision model for geospatial multisource information with active self-adaption services

NASA Astrophysics Data System (ADS)

Fan, Hong; Li, Huan

2015-12-01

Location-related data are playing an increasingly irreplaceable role in business, government and scientific research. At the same time, the amount and types of data are rapidly increasing. It is a challenge how to quickly find required information from this rapidly growing volume of data, as well as how to efficiently provide different levels of geospatial data to users. This paper puts forward a data-oriented access model for geographic information science data. First, we analyze the features of GIS data including traditional types such as vector and raster data and new types such as Volunteered Geographic Information (VGI). Taking into account these analyses, a classification scheme for geographic data is proposed and TRAFIE is introduced to describe the establishment of a multi-level model for geographic data. Based on this model, a multi-level, scalable access system for geospatial information is put forward. Users can select different levels of data according to their concrete application needs. Pull-based and push-based data access mechanisms based on this model are presented. A Service Oriented Architecture (SOA) was chosen for the data processing. The model of this study has been described by providing decision-making process of government departments with a simulation of fire disaster data collection. The use case shows this data model and the data provision system is flexible and has good adaptability.

The bioethics discussion forum--an implementation of an Internet-based bioethics information analysis resource.

PubMed Central

Derse, A. R.; Krogull, S. R.

1995-01-01

Ethical analysis is crucial to decision making in biomedicine and health care, necessitating both rapid access to diffusely disseminated sources of information pertinent to bioethics and promotion of analysis in the field of bioethics through a resource for information analysis. We developed the Bioethics Discussion Forum, an Internet-based information analysis resource, in order to supplement the Bioethics Online Service with an interactive information medium to meet the demand for such an interactive resource. The Bioethics Discussion Forum has shown promise for information analysis, providing an arena for the review and discussion of complex bioethical information, establishing a connection nationally and internationally among individuals with high levels of expertise in bioethics, and providing a template for future interactive informatics services. PMID:8563245

NASA Applied Sciences Program Rapid Prototyping Results and Conclusions

NASA Astrophysics Data System (ADS)

Cox, E. L.

2007-12-01

NASA's Applied Sciences Program seeks to expand the use of Earth science research results to benefit current and future operational systems tasked with making policy and management decisions. The Earth Science Division within the Science Mission Directorate sponsors over 1000 research projects annually to answer the fundamental research question: How is the Earth changing and what are the consequences for life on Earth? As research results become available, largely from satellite observations and Earth system model outputs, the Applied Sciences Program works diligently with scientists and researchers (internal and external to NASA) , and other government agency officials (USDA, EPA, CDC, DOE, US Forest Service, US Fish and Wildlife Service, DHS, USAID) to determine useful applications for these results in decision-making, ultimately benefiting society. The complexity of Earth science research results and the breadth of the Applied Sciences Program national priority areas dictate a broad scope and multiple approaches available to implement their use in decision-making. Over the past five years, the Applied Sciences Program has examined scientific and engineering practices and solicited the community for methods and steps that can lead to the enhancement of operational systems (Decision Support Systems - DSS) required for decision-making. In November 2006, the Applied Sciences Program launched an initiative aimed at demonstrating the applicability of NASA data (satellite observations, models, geophysical parameters from data archive centers) being incorporated into decision support systems and their related environments at a low cost and quick turnaround of results., i.e. designed rapid prototyping. Conceptually, an understanding of Earth science research (and results) coupled with decision-making requirements and needs leads to a demonstration (experiment) depicting enhancements or improvements to an operational decisions process through the use of NASA data. Five NASA centers (GSFC, LaRC, SSC, MSFC, ARC) participated and are currently conducting fifteen prototyping experiments covering eight of the twelve national priority applications - Energy, Coastal, Carbon, and Disaster Management; Agricultural Efficiency, Aviation, Air Quality, and Ecological Forecasting. Results from six experiments will be discussed highlighting purpose, expected results, enhancement to the decision-making process achieved, and the potential plans for future collaboration and sustainable projects.

Update Money Management Units in Terms of New Legislation.

ERIC Educational Resources Information Center

Manzer, John P.

1981-01-01

Provides basic business teachers with a current analysis of the rapidly changing topic of financial institutions and related functions. Elements discussed include recent financial legislation and students' money management decisions. (CT)

Final Report: Former Chesapeake Supply Brownfield Revitalization: Rapid Health Impact Assessment

EPA Pesticide Factsheets

documents the HIA analyses, findings, and recommendations for the City of Dover to consider health in decisions around its revitalization plans and outlines opportunities for further development and future assessments.

RapidTox Dashboard

EPA Pesticide Factsheets

The ToxCast Dashboard helps users examine high-throughput assay data to inform chemical safety decisions. To date, it has data on over 9,000 chemicals and information from more than 1,000 high-throughput assay endpoint components.

A rapid method for assessing social versus independent interest in health issues: a case study of 'bird flu' and 'swine flu'.

PubMed

Bentley, R Alexander; Ormerod, Paul

2010-08-01

Effective communication strategies regarding health issues are affected by the way in which the public obtain their knowledge, particularly whether people become interested independently, or through their social networks. This is often investigated through localized ethnography or surveys. In rapidly-evolving situations, however, there may also be a need for swift, case-specific assessment as a guide to initial strategy development. With this aim, we analyze real-time online data, provided by the new 'Google Trends' tool, concerning Internet search frequency for health-related issues. To these data we apply a simple model to characterise the effective degree of social transmission versus decisions made individually. As case examples, we explore two rapidly-evolved issues, namely the world-wide interest in avian influenza, or 'bird flu', in 2005, and in H1N1, or 'swine flu', from late April to early May 2009. The 2005 'bird flu' scare demonstrated almost pure imitation for two months initially, followed by a spike of independent decision that corresponded with an announcement by US president George Bush. For 'swine flu' in 2009, imitation was the more prevalent throughout. Overall, the results show how interest in health scares can spread primarily by social means, and that engaging more independent decisions at the population scale may require a dramatic announcement to push a populace over the 'tipping point'. Copyright 2010 Elsevier Ltd. All rights reserved.

[Educating health workers is key in congenital syphilis elimination in Colombia].

PubMed

Garcés, Juan Pablo; Rubiano, Luisa Consuelo; Orobio, Yenifer; Castaño, Martha; Benavides, Elizabeth; Cruz, Adriana

2017-09-01

Colombia promotes the diagnosis and treatment of gestational syphilis in a single visit using rapid diagnostic tests to prevent mother-to-child transmission. Additionally, integrated health programs pursue the coordinated prevention of mother-to-child transmission of syphilis/HIV. To identify knowledge gaps among health workers in the prevention of mother-to-child transmission of syphilis/HIV and to provide recommendations to support these programs. We conducted a descriptive study based on 306 surveys of health workers in 39 health institutions in the city of Cali. Surveys inquired about planning, management and implementation of services for pregnant women, clinical knowledge of HIV/syphilis rapid diagnostic tests, and prior training. Knowledge deficits in the management of gestational syphilis were detected among the surveyed health workers, including physicians. Rapid tests for syphilis are currently used in clinical laboratories in Cali, however, procedural deficiencies were observed in their use, including quality control assurance. During the two years prior to the survey, training of health workers in the prevention of mother-to-child transmission of syphilis/HIV had been limited. Health workers are interested in identifying and treating gestational syphilis in a single event, in using rapid diagnostic tests and in receiving training. Intensive training targeting health workers, policy/decision makers and academic groups is needed to ensure adequate implementation of new strategies for the prevention of mother-to-child transmission of syphilis/HIV.

Multi-hazard risk analysis using the FP7 RASOR Platform

NASA Astrophysics Data System (ADS)

Koudogbo, Fifamè N.; Duro, Javier; Rossi, Lauro; Rudari, Roberto; Eddy, Andrew

2014-10-01

Climate change challenges our understanding of risk by modifying hazards and their interactions. Sudden increases in population and rapid urbanization are changing exposure to risk around the globe, making impacts harder to predict. Despite the availability of operational mapping products, there is no single tool to integrate diverse data and products across hazards, update exposure data quickly and make scenario-based predictions to support both short and long-term risk-related decisions. RASOR (Rapid Analysis and Spatialization Of Risk) will develop a platform to perform multi-hazard risk analysis for the full cycle of disaster management, including targeted support to critical infrastructure monitoring and climate change impact assessment. A scenario-driven query system simulates future scenarios based on existing or assumed conditions and compares them with historical scenarios. RASOR will thus offer a single work environment that generates new risk information across hazards, across data types (satellite EO, in-situ), across user communities (global, local, climate, civil protection, insurance, etc.) and across the world. Five case study areas are considered within the project, located in Haiti, Indonesia, Netherlands, Italy and Greece. Initially available over those demonstration areas, RASOR will ultimately offer global services to support in-depth risk assessment and full-cycle risk management.

Genetic methods for detection of antibiotic resistance: focus on extended-spectrum β-lactamases.

PubMed

Chroma, Magdalena; Kolar, Milan

2010-12-01

In 1928, the first antibiotic, penicillin, was discovered. That was the beginning of a great era in the development and prescription of antibiotics. However, the introduction of these antimicrobial agents into clinical practice was accompanied by the problem of antibiotic resistance. Currently, bacterial resistance to antibiotics poses a major problem in both hospital and community settings throughout the world. This review provides examples of modern genetic methods and their practical application in the field of extended-spectrum β-lactamase detection. Since extended-spectrum β-lactamases are the main mechanism of Gram-negative bacterial resistance to oxyimino-cephalosporins, rapid and accurate detection is requested in common clinical practice. Currently, the detection of extended-spectrum β-lactamases is primarily based on the determination of bacterial phenotypes rather than genotypes. This is because therapeutic decisions are based on assessing the susceptibility rather than presence of resistance genes. One of the main disadvantages of genetic methods is high costs, including those of laboratory equipment. On the other hand, if these modern methods are introduced into diagnostics, they often help in rapid and accurate detection of certain microorganisms or their resistance and pathogenic determinants.

Real-Time Continuous Response Spectra Exceedance Calculation

NASA Astrophysics Data System (ADS)

Vernon, Frank; Harvey, Danny; Lindquist, Kent; Franke, Mathias

2017-04-01

A novel approach is presented for near real-time earthquake alarms for critical structures at distributed locations using real-time estimation of response spectra obtained from near free-field motions. Influential studies dating back to the 1980s identified spectral response acceleration as a key ground motion characteristic that correlates well with observed damage in structures. Thus, monitoring and reporting on exceedance of spectra-based thresholds are useful tools for assessing the potential for damage to facilities or multi-structure campuses based on input ground motions only. With as little as one strong-motion station per site, this scalable approach can provide rapid alarms on the damage status of remote towns, critical infrastructure (e.g., hospitals, schools) and points of interests (e.g., bridges) for a very large number of locations enabling better rapid decision making during critical and difficult immediate post-earthquake response actions. Real-time calculation of PSA exceedance and alarm dissemination are enabled with Bighorn, a module included in the Antelope software package that combines real-time spectral monitoring and alarm capabilities with a robust built-in web display server. Examples of response spectra from several M 5 events recorded by the ANZA seismic network in southern California will be presented.

Metabolic Toxicity Screening Using Electrochemiluminescence Arrays Coupled with Enzyme-DNA Biocolloid Reactors and Liquid Chromatography–Mass Spectrometry

PubMed Central

Hvastkovs, Eli G.; Schenkman, John B.; Rusling, James F.

2012-01-01

New chemicals or drugs must be guaranteed safe before they can be marketed. Despite widespread use of bioassay panels for toxicity prediction, products that are toxic to a subset of the population often are not identified until clinical trials. This article reviews new array methodologies based on enzyme/DNA films that form and identify DNA-reactive metabolites that are indicators of potentially genotoxic species. This molecularly based methodology is designed in a rapid screening array that utilizes electrochemiluminescence (ECL) to detect metabolite-DNA reactions, as well as biocolloid reactors that provide the DNA adducts and metabolites for liquid chromatography–mass spectrometry (LC-MS) analysis. ECL arrays provide rapid toxicity screening, and the biocolloid reactor LC-MS approach provides a valuable follow-up on structure, identification, and formation rates of DNA adducts for toxicity hits from the ECL array screening. Specific examples using this strategy are discussed. Integration of high-throughput versions of these toxicity-screening methods with existing drug toxicity bioassays should allow for better human toxicity prediction as well as more informed decision making regarding new chemical and drug candidates. PMID:22482786

Testing an innovative framework for flood forecasting, monitoring and mapping in Europe

NASA Astrophysics Data System (ADS)

Dottori, Francesco; Kalas, Milan; Lorini, Valerio; Wania, Annett; Pappenberger, Florian; Salamon, Peter; Ramos, Maria Helena; Cloke, Hannah; Castillo, Carlos

2017-04-01

Between May and June 2016, France was hit by severe floods, particularly in the Loire and Seine river basins. In this work, we use this case study to test an innovative framework for flood forecasting, mapping and monitoring. More in detail, the system integrates in real-time two components of the Copernicus Emergency mapping services, namely the European Flood Awareness System and the satellite-based Rapid Mapping, with new procedures for rapid risk assessment and social media and news monitoring. We explore in detail the performance of each component of the system, demonstrating the improvements in respect to stand-alone flood forecasting and monitoring systems. We show how the performances of the forecasting component can be refined using the real-time feedback from social media monitoring to identify which areas were flooded, to evaluate the flood intensity, and therefore to correct impact estimations. Moreover, we show how the integration with impact forecast and social media monitoring can improve the timeliness and efficiency of satellite based emergency mapping, and reduce the chances of missing areas where flooding is already happening. These results illustrate how the new integrated approach leads to a better and earlier decision making and a timely evaluation of impacts.

Real-time seismic monitoring needs of a building owner - And the solution: A cooperative effort

USGS Publications Warehouse

Celebi, M.; Sanli, A.; Sinclair, M.; Gallant, S.; Radulescu, D.

2004-01-01

A recently implemented advanced seismic monitoring system for a 24-story building facilitates recording of accelerations and computing displacements and drift ratios in near-real time to measure the earthquake performance of the building. The drift ratio is related to the damage condition of the specific building. This system meets the owner's needs for rapid quantitative input to assessments and decisions on post-earthquake occupancy. The system is now successfully working and, in absence of strong shaking to date, is producing low-amplitude data in real time for routine analyses and assessment. Studies of such data to date indicate that the configured monitoring system with its building specific software can be a useful tool in rapid assessment of buildings and other structures following an earthquake. Such systems can be used for health monitoring of a building, for assessing performance-based design and analyses procedures, for long-term assessment of structural characteristics, and for long-term damage detection.

VIPER: a web application for rapid expert review of variant calls.

PubMed

Wöste, Marius; Dugas, Martin

2018-06-01

With the rapid development in next-generation sequencing, cost and time requirements for genomic sequencing are decreasing, enabling applications in many areas such as cancer research. Many tools have been developed to analyze genomic variation ranging from single nucleotide variants to whole chromosomal aberrations. As sequencing throughput increases, the number of variants called by such tools also grows. Often employed manual inspection of such calls is thus becoming a time-consuming procedure. We developed the Variant InsPector and Expert Rating tool (VIPER) to speed up this process by integrating the Integrative Genomics Viewer into a web application. Analysts can then quickly iterate through variants, apply filters and make decisions based on the generated images and variant metadata. VIPER was successfully employed in analyses with manual inspection of more than 10 000 calls. VIPER is implemented in Java and Javascript and is freely available at https://github.com/MarWoes/viper. marius.woeste@uni-muenster.de. Supplementary data are available at Bioinformatics online.

New LightCycler PCR for Rapid and Sensitive Quantification of Parvovirus B19 DNA Guides Therapeutic Decision-Making in Relapsing Infections

PubMed Central

Harder, Timm C.; Hufnagel, Markus; Zahn, Katrin; Beutel, Karin; Schmitt, Heinz-Josef; Ullmann, Uwe; Rautenberg, Peter

2001-01-01

Detection of parvovirus B19 DNA offers diagnostic advantages over serology, particularly in persistent infections of immunocompromised patients. A rapid, novel method of B19 DNA detection and quantification is introduced. This method, a quantitative PCR assay, is based on real-time glass capillary thermocycling (LightCycler [LC]) and fluorescence resonance energy transfer (FRET). The PCR assay allowed quantification over a dynamic range of over 7 logs and could quantify as little as 250 B19 genome equivalents (geq) per ml as calculated for plasmid DNA (i.e., theoretically ≥5 geq per assay). Interrater agreement analysis demonstrated equivalence of LC-FRET PCR and conventional nested PCR in the diagnosis of an active B19 infection (kappa coefficient = 0.83). The benefit of the new method was demonstrated in an immunocompromised child with a relapsing infection, who required an attenuation of the immunosuppressive therapy in addition to repeated doses of immunoglobulin to eliminate the virus. PMID:11724854

Real-time Automatic Search for Multi-wavelength Counterparts of DWF Transients

NASA Astrophysics Data System (ADS)

Murphy, Christopher; Cucchiara, Antonino; Andreoni, Igor; Cooke, Jeff; Hegarty, Sarah

2018-01-01

The Deeper Wider Faster (DWF) survey aims to find and classify the fastest transients in the Universe. DWF utilizes the Dark Energy Camera (DECam), collecting a continuous sequence of 20s images over a 3 square degree field of view.Once an interesting transient is detected during DWF observations, the DWF collaboration has access to several facilities for rapid follow-up in multiple wavelengths (from gamma to radio).An online web tool has been designed to help with real-time visual classification of possible astrophysical transients in data collected by the DWF observing program. The goal of this project is to create a python-based code to improve the classification process by querying several existing archive databases. Given the DWF transient location and search radius, the developed code will extract a list of possible counterparts and all available information (e.g. magnitude, radio fluxes, distance separation).Thanks to this tool, the human classifier can make a quicker decision in order to trigger the collaboration rapid-response resources.

Prioritizing Arctic Observations with Limited Resources

NASA Astrophysics Data System (ADS)

Kelly, B.; Starkweather, S.

2012-12-01

U.S. Federal agencies recently completed a five-year research plan for the Arctic including plans to enhance efforts toward an Arctic Observing Network (AON). Following on numerous national and international planning efforts, the five-year plan identifies nine priority areas including enhancing observing system design, assessing priorities of local residents, and improving data access. AON progress to date has been realized through bottom-up funding decisions and some top-down design optimization approaches, which have resulted in valuable yet ad hoc progress towards Arctic research imperatives. We suggest that advancing AON beyond theoretical design and ad hoc efforts with the engagement of multiple U.S. Federal agencies will require a structured, input-based planning approach to prioritization that recognizes budget realities. Completing a long list of worthy observing efforts appears to be unsustainable and inadequate in responding to the rapid changes taking place in the Arctic. Society would be better served by more rapid implementation of sustained, long-term observations focused on those climate feedbacks with the greatest potential negative impacts. Several emerging theoretical frameworks have pointed to the need to enhance iterative, capacity-building dialog between observationalists, modelers, and stakeholders as a way to identify these broadest potential benefits. We concur and suggest that those dialogs need to be facilitated and sustained over long periods. Efforts to isolate observational programs from process research are, we believe, impeding progress. At the same time, we note that bottom-up funding decisions, while useful for prioritizing process research, are less appropriate to building observing systems.

Resource management and operations in southwest South Dakota: Climate change scenario planning workshop summary January 20-21, 2016, Rapid City, SD

USGS Publications Warehouse

Fisichelli, Nicholas A.; Schuurman, Gregor W.; Symstad, Amy J.; Ray, Andrea; Miller, Brian; Cross, Molly; Rowland, Erika

2016-01-01

The Scaling Climate Change Adaptation in the Northern Great Plains through Regional Climate Summaries and Local Qualitative-Quantitative Scenario Planning Workshops project synthesizes climate data into 3-5 distinct but plausible climate summaries for the northern Great Plains region; crafts quantitative summaries of these climate futures for two focal areas; and applies these local summaries by developing climate-resource-management scenarios through participatory workshops and, where possible, simulation models. The two focal areas are central North Dakota and southwest South Dakota (Figure 1). The primary objective of this project is to help resource managers and scientists in a focal area use scenario planning to make management and planning decisions based on assessments of critical future uncertainties.This report summarizes project work for public and tribal lands in the southwest South Dakota grasslands focal area, with an emphasis on Badlands National Park and Buffalo Gap National Grassland. The report explains scenario planning as an adaptation tool in general, then describes how it was applied to the focal area in three phases. Priority resource management and climate uncertainties were identified in the orientation phase. Local climate summaries for relevant, divergent, and challenging climate scenarios were developed in the second phase. In the final phase, a two-day scenario planning workshop held January 20-21, 2016 in Rapid City, South Dakota, featured scenario development and implications, testing management decisions, and methods for operationalizing scenario planning outcomes.

Decision Support System for the Response to Infectious Disease Emergencies Based on WebGIS and Mobile Services in China

PubMed Central

Gao, Su-qing; Wang, Zhen; Gao, Hong-wei; Liu, Peng; Wang, Ze-rui; Li, Yan-li; Zhu, Xu-guang; Li, Xin-lou; Xu, Bo; Li, Yin-jun; Yang, Hong; de Vlas, Sake J.; Shi, Tao-xing; Cao, Wu-chun

2013-01-01

Background For years, emerging infectious diseases have appeared worldwide and threatened the health of people. The emergence and spread of an infectious-disease outbreak are usually unforeseen, and have the features of suddenness and uncertainty. Timely understanding of basic information in the field, and the collection and analysis of epidemiological information, is helpful in making rapid decisions and responding to an infectious-disease emergency. Therefore, it is necessary to have an unobstructed channel and convenient tool for the collection and analysis of epidemiologic information in the field. Methodology/Principal Findings Baseline information for each county in mainland China was collected and a database was established by geo-coding information on a digital map of county boundaries throughout the country. Google Maps was used to display geographic information and to conduct calculations related to maps, and the 3G wireless network was used to transmit information collected in the field to the server. This study established a decision support system for the response to infectious-disease emergencies based on WebGIS and mobile services (DSSRIDE). The DSSRIDE provides functions including data collection, communication and analyses in real time, epidemiological detection, the provision of customized epidemiological questionnaires and guides for handling infectious disease emergencies, and the querying of professional knowledge in the field. These functions of the DSSRIDE could be helpful for epidemiological investigations in the field and the handling of infectious-disease emergencies. Conclusions/Significance The DSSRIDE provides a geographic information platform based on the Google Maps application programming interface to display information of infectious disease emergencies, and transfers information between workers in the field and decision makers through wireless transmission based on personal computers, mobile phones and personal digital assistants. After a 2-year practice and application in infectious disease emergencies, the DSSRIDE is becoming a useful platform and is a useful tool for investigations in the field carried out by response sections and individuals. The system is suitable for use in developing countries and low-income districts. PMID:23372780

Differentiating sepsis from non-infectious systemic inflammation based on microvesicle-bacteria aggregation

NASA Astrophysics Data System (ADS)

Herrmann, I. K.; Bertazzo, S.; O'Callaghan, D. J. P.; Schlegel, A. A.; Kallepitis, C.; Antcliffe, D. B.; Gordon, A. C.; Stevens, M. M.

2015-08-01

Sepsis is a severe medical condition and a leading cause of hospital mortality. Prompt diagnosis and early treatment has a significant, positive impact on patient outcome. However, sepsis is not always easy to diagnose, especially in critically ill patients. Here, we present a conceptionally new approach for the rapid diagnostic differentiation of sepsis from non-septic intensive care unit patients. Using advanced microscopy and spectroscopy techniques, we measure infection-specific changes in the activity of nano-sized cell-derived microvesicles to bind bacteria. We report on the use of a point-of-care-compatible microfluidic chip to measure microvesicle-bacteria aggregation and demonstrate rapid (<=1.5 hour) and reliable diagnostic differentiation of bacterial infection from non-infectious inflammation in a double-blind pilot study. Our study demonstrates the potential of microvesicle activities for sepsis diagnosis and introduces microvesicle-bacteria aggregation as a potentially useful parameter for making early clinical management decisions.Sepsis is a severe medical condition and a leading cause of hospital mortality. Prompt diagnosis and early treatment has a significant, positive impact on patient outcome. However, sepsis is not always easy to diagnose, especially in critically ill patients. Here, we present a conceptionally new approach for the rapid diagnostic differentiation of sepsis from non-septic intensive care unit patients. Using advanced microscopy and spectroscopy techniques, we measure infection-specific changes in the activity of nano-sized cell-derived microvesicles to bind bacteria. We report on the use of a point-of-care-compatible microfluidic chip to measure microvesicle-bacteria aggregation and demonstrate rapid (<=1.5 hour) and reliable diagnostic differentiation of bacterial infection from non-infectious inflammation in a double-blind pilot study. Our study demonstrates the potential of microvesicle activities for sepsis diagnosis and introduces microvesicle-bacteria aggregation as a potentially useful parameter for making early clinical management decisions. Electronic supplementary information (ESI) available: Fig. S1: Markers of inflammation and microvesicle characteristics in patient plasma samples, Fig. S2: Experimental sepsis model, Table S1: Patient characteristics. Table S2: Inclusion/exclusion criteria. See DOI: 10.1039/c5nr01851j

Distinct roles of dopamine and subthalamic nucleus in learning and probabilistic decision making.

PubMed

Coulthard, Elizabeth J; Bogacz, Rafal; Javed, Shazia; Mooney, Lucy K; Murphy, Gillian; Keeley, Sophie; Whone, Alan L

2012-12-01

Even simple behaviour requires us to make decisions based on combining multiple pieces of learned and new information. Making such decisions requires both learning the optimal response to each given stimulus as well as combining probabilistic information from multiple stimuli before selecting a response. Computational theories of decision making predict that learning individual stimulus-response associations and rapid combination of information from multiple stimuli are dependent on different components of basal ganglia circuitry. In particular, learning and retention of memory, required for optimal response choice, are significantly reliant on dopamine, whereas integrating information probabilistically is critically dependent upon functioning of the glutamatergic subthalamic nucleus (computing the 'normalization term' in Bayes' theorem). Here, we test these theories by investigating 22 patients with Parkinson's disease either treated with deep brain stimulation to the subthalamic nucleus and dopaminergic therapy or managed with dopaminergic therapy alone. We use computerized tasks that probe three cognitive functions-information acquisition (learning), memory over a delay and information integration when multiple pieces of sequentially presented information have to be combined. Patients performed the tasks ON or OFF deep brain stimulation and/or ON or OFF dopaminergic therapy. Consistent with the computational theories, we show that stopping dopaminergic therapy impairs memory for probabilistic information over a delay, whereas deep brain stimulation to the region of the subthalamic nucleus disrupts decision making when multiple pieces of acquired information must be combined. Furthermore, we found that when participants needed to update their decision on the basis of the last piece of information presented in the decision-making task, patients with deep brain stimulation of the subthalamic nucleus region did not slow down appropriately to revise their plan, a pattern of behaviour that mirrors the impulsivity described clinically in some patients with subthalamic nucleus deep brain stimulation. Thus, we demonstrate distinct mechanisms for two important facets of human decision making: first, a role for dopamine in memory consolidation, and second, the critical importance of the subthalamic nucleus in successful decision making when multiple pieces of information must be combined.

Efficient reinforcement learning of a reservoir network model of parametric working memory achieved with a cluster population winner-take-all readout mechanism.

PubMed

Cheng, Zhenbo; Deng, Zhidong; Hu, Xiaolin; Zhang, Bo; Yang, Tianming

2015-12-01

The brain often has to make decisions based on information stored in working memory, but the neural circuitry underlying working memory is not fully understood. Many theoretical efforts have been focused on modeling the persistent delay period activity in the prefrontal areas that is believed to represent working memory. Recent experiments reveal that the delay period activity in the prefrontal cortex is neither static nor homogeneous as previously assumed. Models based on reservoir networks have been proposed to model such a dynamical activity pattern. The connections between neurons within a reservoir are random and do not require explicit tuning. Information storage does not depend on the stable states of the network. However, it is not clear how the encoded information can be retrieved for decision making with a biologically realistic algorithm. We therefore built a reservoir-based neural network to model the neuronal responses of the prefrontal cortex in a somatosensory delayed discrimination task. We first illustrate that the neurons in the reservoir exhibit a heterogeneous and dynamical delay period activity observed in previous experiments. Then we show that a cluster population circuit decodes the information from the reservoir with a winner-take-all mechanism and contributes to the decision making. Finally, we show that the model achieves a good performance rapidly by shaping only the readout with reinforcement learning. Our model reproduces important features of previous behavior and neurophysiology data. We illustrate for the first time how task-specific information stored in a reservoir network can be retrieved with a biologically plausible reinforcement learning training scheme. Copyright © 2015 the American Physiological Society.

An ontology-driven clinical decision support system (IDDAP) for infectious disease diagnosis and antibiotic prescription.

PubMed

Shen, Ying; Yuan, Kaiqi; Chen, Daoyuan; Colloc, Joël; Yang, Min; Li, Yaliang; Lei, Kai

2018-03-01

The available antibiotic decision-making systems were developed from a physician's perspective. However, because infectious diseases are common, many patients desire access to knowledge via a search engine. Although the use of antibiotics should, in principle, be subject to a doctor's advice, many patients take them without authorization, and some people cannot easily or rapidly consult a doctor. In such cases, a reliable antibiotic prescription support system is needed. This study describes the construction and optimization of the sensitivity and specificity of a decision support system named IDDAP, which is based on ontologies for infectious disease diagnosis and antibiotic therapy. The ontology for this system was constructed by collecting existing ontologies associated with infectious diseases, syndromes, bacteria and drugs into the ontology's hierarchical conceptual schema. First, IDDAP identifies a potential infectious disease based on a patient's self-described disease state. Then, the system searches for and proposes an appropriate antibiotic therapy specifically adapted to the patient based on factors such as the patient's body temperature, infection sites, symptoms/signs, complications, antibacterial spectrum, contraindications, drug-drug interactions between the proposed therapy and previously prescribed medication, and the route of therapy administration. The constructed domain ontology contains 1,267,004 classes, 7,608,725 axioms, and 1,266,993 members of "SubClassOf" that pertain to infectious diseases, bacteria, syndromes, anti-bacterial drugs and other relevant components. The system includes 507 infectious diseases and their therapy methods in combination with 332 different infection sites, 936 relevant symptoms of the digestive, reproductive, neurological and other systems, 371 types of complications, 838,407 types of bacteria, 341 types of antibiotics, 1504 pairs of reaction rates (antibacterial spectrum) between antibiotics and bacteria, 431 pairs of drug interaction relationships and 86 pairs of antibiotic-specific population contraindicated relationships. Compared with the existing infectious disease-relevant ontologies in the field of knowledge comprehension, this ontology is more complete. Analysis of IDDAP's performance in terms of classifiers based on receiver operating characteristic (ROC) curve results (89.91%) revealed IDDAP's advantages when combined with our ontology. This study attempted to bridge the patient/caregiver gap by building a sophisticated application that uses artificial intelligence and machine learning computational techniques to perform data-driven decision-making at the point of primary care. The first level of decision-making is conducted by the IDDAP and provides the patient with a first-line therapy. Patients can then make a subjective judgment, and if any questions arise, should consult a physician for subsequent decisions, particularly in complicated cases or in cases in which the necessary information is not yet available in the knowledge base. Copyright © 2018 Elsevier B.V. All rights reserved.

Fast Tracking Data to Informed Decisions: An Advanced Information System to Improve Environmental Understanding and Management (Invited)

NASA Astrophysics Data System (ADS)

Minsker, B. S.; Myers, J.; Liu, Y.; Bajcsy, P.

2010-12-01

Emerging sensing and information technology are rapidly creating a new paradigm for environmental research and management, in which data from multiple sensors and information sources can guide real-time adaptive observation and decision making. This talk will provide an overview of emerging cyberinfrastructure and three case studies that illustrate their potential: combined sewer overflows in Chicago, hypoxia in Corpus Christi Bay, Texas, and sustainable agriculture in Illinois. An advanced information system for real-time decision making and visual geospatial analytics will be presented as an example of cyberinfrastructure that enables easier implementation of numerous real-time applications.

Impact of Robotic Surgery on Decision Making: Perspectives of Surgical Teams

PubMed Central

Randell, Rebecca; Alvarado, Natasha; Honey, Stephanie; Greenhalgh, Joanne; Gardner, Peter; Gill, Arron; Jayne, David; Kotze, Alwyn; Pearman, Alan; Dowding, Dawn

2015-01-01

There has been rapid growth in the purchase of surgical robots in both North America and Europe in recent years. Whilst this technology promises many benefits for patients, the introduction of such a complex interactive system into healthcare practice often results in unintended consequences that are difficult to predict. Decision making by surgeons during an operation is affected by variables including tactile perception, visual perception, motor skill, and instrument complexity, all of which are changed by robotic surgery, yet the impact of robotic surgery on decision making has not been previously studied. Drawing on the approach of realist evaluation, we conducted a multi-site interview study across nine hospitals, interviewing 44 operating room personnel with experience of robotic surgery to gather their perspectives on how robotic surgery impacts surgeon decision making. The findings reveal both potential benefits and challenges of robotic surgery for decision making. PMID:26958244

Applying predictive analytics to develop an intelligent risk detection application for healthcare contexts.

PubMed

Moghimi, Fatemeh Hoda; Cheung, Michael; Wickramasinghe, Nilmini

2013-01-01

Healthcare is an information rich industry where successful outcomes require the processing of multi-spectral data and sound decision making. The exponential growth of data and big data issues coupled with a rapid increase of service demands in healthcare contexts today, requires a robust framework enabled by IT (information technology) solutions as well as real-time service handling in order to ensure superior decision making and successful healthcare outcomes. Such a context is appropriate for the application of real time intelligent risk detection decision support systems using predictive analytic techniques such as data mining. To illustrate the power and potential of data science technologies in healthcare decision making scenarios, the use of an intelligent risk detection (IRD) model is proffered for the context of Congenital Heart Disease (CHD) in children, an area which requires complex high risk decisions that need to be made expeditiously and accurately in order to ensure successful healthcare outcomes.

Impact of Robotic Surgery on Decision Making: Perspectives of Surgical Teams.

PubMed

Randell, Rebecca; Alvarado, Natasha; Honey, Stephanie; Greenhalgh, Joanne; Gardner, Peter; Gill, Arron; Jayne, David; Kotze, Alwyn; Pearman, Alan; Dowding, Dawn

2015-01-01

There has been rapid growth in the purchase of surgical robots in both North America and Europe in recent years. Whilst this technology promises many benefits for patients, the introduction of such a complex interactive system into healthcare practice often results in unintended consequences that are difficult to predict. Decision making by surgeons during an operation is affected by variables including tactile perception, visual perception, motor skill, and instrument complexity, all of which are changed by robotic surgery, yet the impact of robotic surgery on decision making has not been previously studied. Drawing on the approach of realist evaluation, we conducted a multi-site interview study across nine hospitals, interviewing 44 operating room personnel with experience of robotic surgery to gather their perspectives on how robotic surgery impacts surgeon decision making. The findings reveal both potential benefits and challenges of robotic surgery for decision making.

Lessons learned from Ontario wind energy disputes

NASA Astrophysics Data System (ADS)

Fast, Stewart; Mabee, Warren; Baxter, Jamie; Christidis, Tanya; Driver, Liz; Hill, Stephen; McMurtry, J. J.; Tomkow, Melody

2016-02-01

Issues concerning the social acceptance of wind energy are major challenges for policy-makers, communities and wind developers. They also impact the legitimacy of societal decisions to pursue wind energy. Here we set out to identify and assess the factors that lead to wind energy disputes in Ontario, Canada, a region of the world that has experienced a rapid increase in the development of wind energy. Based on our expertise as a group comprising social scientists, a community representative and a wind industry advocate engaged in the Ontario wind energy situation, we explore and suggest recommendations based on four key factors: socially mediated health concerns, the distribution of financial benefits, lack of meaningful engagement and failure to treat landscape concerns seriously. Ontario's recent change from a feed-in-tariff-based renewable electricity procurement process to a competitive bid process, albeit with more attention to community engagement, will only partially address these concerns.

Explanation of asymmetric dynamics of human water consumption in arid regions: prospect theory versus expected utility theory

NASA Astrophysics Data System (ADS)

Tian, F.; Lu, Y.

2017-12-01

Based on socioeconomic and hydrological data in three arid inland basins and error analysis, the dynamics of human water consumption (HWC) are analyzed to be asymmetric, i.e., HWC increase rapidly in wet periods while maintain or decrease slightly in dry periods. Besides the qualitative analysis that in wet periods great water availability inspires HWC to grow fast but the now expanded economy is managed to sustain by over-exploitation in dry periods, two quantitative models are established and tested, based on expected utility theory (EUT) and prospect theory (PT) respectively. EUT states that humans make decisions based on the total expected utility, namely the sum of utility function multiplied by probability of each result, while PT states that the utility function is defined over gains and losses separately, and probability should be replaced by probability weighting function.

Real-time piloted simulation of fully automatic guidance and control for rotorcraft nap-of-the-earth (NOE) flight following planned profiles

NASA Technical Reports Server (NTRS)

Clement, Warren F.; Gorder, Pater J.; Jewell, Wayne F.; Coppenbarger, Richard

1990-01-01

Developing a single-pilot all-weather NOE capability requires fully automatic NOE navigation and flight control. Innovative guidance and control concepts are being investigated to (1) organize the onboard computer-based storage and real-time updating of NOE terrain profiles and obstacles; (2) define a class of automatic anticipative pursuit guidance algorithms to follow the vertical, lateral, and longitudinal guidance commands; (3) automate a decision-making process for unexpected obstacle avoidance; and (4) provide several rapid response maneuvers. Acquired knowledge from the sensed environment is correlated with the recorded environment which is then used to determine an appropriate evasive maneuver if a nonconformity is observed. This research effort has been evaluated in both fixed-base and moving-base real-time piloted simulations thereby evaluating pilot acceptance of the automated concepts, supervisory override, manual operation, and reengagement of the automatic system.

Intuition and evidence--uneasy bedfellows?

PubMed Central

Greenhalgh, Trisha

2002-01-01

Intuition is a decision-making method that is used unconsciously by experienced practitioners but is inaccessible to the novice. It is rapid, subtle, contextual, and does not follow simple, cause-and-effect logic. Evidence-based medicine offers exciting opportunities_for improving patient outcomes, but the 'evidence-burdened' approach of the inexperienced, protocol-driven clinician is well documented Intuition is not unscientific. It is a highly creative process, fundamental to hypothesis generation in science. The experienced practitioner should generate and follow clinical hunches as well as (not instead of applying the deductive principles of evidence-based medicine. The educational research literature suggests that we can improve our intuitive powers through systematic critical reflection about intuitive judgements--for example, through creative writing and dialogue with professional colleagues. It is time to revive and celebrate clinical storytelling as a method for professional education and development. The stage is surely set for a new, improved--and, indeed, evidence-based--'Balint'group. PMID:12014539

Anger in brain and body: the neural and physiological perturbation of decision-making by emotion.

PubMed

Garfinkel, Sarah N; Zorab, Emma; Navaratnam, Nakulan; Engels, Miriam; Mallorquí-Bagué, Núria; Minati, Ludovico; Dowell, Nicholas G; Brosschot, Jos F; Thayer, Julian F; Critchley, Hugo D

2016-01-01

Emotion and cognition are dynamically coupled to bodily arousal: the induction of anger, even unconsciously, can reprioritise neural and physiological resources toward action states that bias cognitive processes. Here we examine behavioural, neural and bodily effects of covert anger processing and its influence on cognition, indexed by lexical decision-making. While recording beat-to-beat blood pressure, the words ANGER or RELAX were presented subliminally just prior to rapid word/non-word reaction-time judgements of letter-strings. Subliminal ANGER primes delayed the time taken to reach rapid lexical decisions, relative to RELAX primes. However, individuals with high trait anger were speeded up by subliminal anger primes. ANGER primes increased systolic blood pressure and the magnitude of this increase predicted reaction time prolongation. Within the brain, ANGER trials evoked an enhancement of activity within dorsal pons and an attenuation of activity within visual occipitotemporal and attentional parietal cortices. Activity within periaqueductal grey matter, occipital and parietal regions increased linearly with evoked blood pressure changes, indicating neural substrates through which covert anger impairs semantic decisions, putatively through its expression as visceral arousal. The behavioural and physiological impact of anger states compromises the efficiency of cognitive processing through action-ready changes in autonomic response that skew regional neural activity. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Rapid genetic counseling and testing in newly diagnosed breast cancer: Patients' and health professionals' attitudes, experiences, and evaluation of effects on treatment decision making.

PubMed

Wevers, Marijke R; Aaronson, Neil K; Bleiker, Eveline M A; Hahn, Daniela E E; Brouwer, Titia; van Dalen, Thijs; Theunissen, Evert B; van Ooijen, Bart; de Roos, Marnix A; Borgstein, Paul J; Vrouenraets, Bart C; Vriens, Eline; Bouma, Wim H; Rijna, Herman; Vente, Johannes P; Kuenen, Marianne A; van der Sanden-Melis, Jacoline; Witkamp, Arjen J; Rutgers, Emiel J Th; Verhoef, Senno; Ausems, Margreet G E M

2017-12-01

Rapid genetic counseling and testing (RGCT) in newly diagnosed high-risk breast cancer (BC) patients may influence surgical treatment decisions. To successfully integrate RGCT in practice, knowledge of professionals', and patients' attitudes toward RGCT is essential. Between 2008 and 2010, we performed a randomized clinical trial evaluating the impact of RGCT. Attitudes toward and experience with RGCT were assessed in 265 patients (at diagnosis, 6- and 12-month follow-up) and 29 medical professionals (before and after the recruitment period). At 6-month follow-up, more patients who had been offered RGCT felt they had been actively involved in treatment decision-making than patients who had been offered usual care (67% vs 48%, P = 0.06). Patients who received DNA-test results before primary surgery reported more often that RGCT influenced treatment decisions than those who received results afterwards (P < 0.01). Eighty-seven percent felt that genetic counseling and testing (GCT) should preferably take place between diagnosis and surgery. Most professionals (72%) agreed that RGCT should be routinely offered to eligible patients. Most patients (74%) and professionals (85%) considered surgeons the most appropriate source for referral. RGCT is viewed as helpful for newly diagnosed high-risk BC patients in choosing their primary surgery and should be offered routinely by surgeons. © 2017 Wiley Periodicals, Inc.

Scenarios in Social-Ecological Systems: Co-Producing Futures in Arctic Alaska

NASA Astrophysics Data System (ADS)

Lovecraft, A. L.; Eicken, H.

2016-12-01

Companies use scenarios to gain the capacity to think ahead in rapidly changing complex competitive environments and make crucial decisions in absence of complete information about the future. Currently, at many regional scales of governance there is a growing need for tools that enable the actors at local-scales to address pressing concerns in the midst of uncertainty. This is particularly true of areas experiencing rapidly changing environments (e.g., drought, floods, diminishing sea ice, erosion) and complex social problems (e.g., remote communities, resource extraction, threatened cultures). Resilience theory and deliberative democracy both promote governance by informed actors in an effort to produce decisions that avoid social-environmental collapse. The former focusing on resilient ecosystems, the latter on informed social choices. Scenario exercises produce neither forecasts of what is to come nor are they visions of what participants would like to happen. Rather, they produce pertinent and accurate information related to questions of "what would happen if…" and thus provide the possibility of strategic decision-making to reduce risk and promote community resilience. Scenarios can be forms of social learning and among local-scale experts they create a deliberative process to make decisions about proactive adaptation. This talk represents the results from two projects from Alaska's Arctic Slope region. Resident expert participants from the Northwest Arctic and North Slope Boroughs addressed the focal question "What is needed for healthy sustainable communities by 2040?" Our findings reinforce the growing evidence from studies related to Arctic community sustainability and human development that indicate tight connections between fate-control, health, and environmental change. Our work differs, however, in using a future studies approach. The participants are addressing social-ecological resilience from a proactive standpoint thinking long-term about local and regional scale concerns rather than examining global-scale forecasts for near-term decision-making. The results contribute to a multi-disciplinary cross-cultural discussion of the importance of innovative thinking at the local scale and future directions for geophysical researchers in a rapidly changing Arctic.

On-Site Molecular Detection of Soil-Borne Phytopathogens Using a Portable Real-Time PCR System

PubMed Central

DeShields, Joseph B.; Bomberger, Rachel A.; Woodhall, James W.; Wheeler, David L.; Moroz, Natalia; Johnson, Dennis A.; Tanaka, Kiwamu

2018-01-01

On-site diagnosis of plant diseases can be a useful tool for growers for timely decisions enabling the earlier implementation of disease management strategies that reduce the impact of the disease. Presently in many diagnostic laboratories, the polymerase chain reaction (PCR), particularly real-time PCR, is considered the most sensitive and accurate method for plant pathogen detection. However, laboratory-based PCRs typically require expensive laboratory equipment and skilled personnel. In this study, soil-borne pathogens of potato are used to demonstrate the potential for on-site molecular detection. This was achieved using a rapid and simple protocol comprising of magnetic bead-based nucleic acid extraction, portable real-time PCR (fluorogenic probe-based assay). The portable real-time PCR approach compared favorably with a laboratory-based system, detecting as few as 100 copies of DNA from Spongospora subterranea. The portable real-time PCR method developed here can serve as an alternative to laboratory-based approaches and a useful on-site tool for pathogen diagnosis. PMID:29553557

Economic Consequence Analysis of Disasters: The ECAT Software Tool

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

Rose, Adam; Prager, Fynn; Chen, Zhenhua

This study develops a methodology for rapidly obtaining approximate estimates of the economic consequences from numerous natural, man-made and technological threats. This software tool is intended for use by various decision makers and analysts to obtain estimates rapidly. It is programmed in Excel and Visual Basic for Applications (VBA) to facilitate its use. This tool is called E-CAT (Economic Consequence Analysis Tool) and accounts for the cumulative direct and indirect impacts (including resilience and behavioral factors that significantly affect base estimates) on the U.S. economy. E-CAT is intended to be a major step toward advancing the current state of economicmore » consequence analysis (ECA) and also contributing to and developing interest in further research into complex but rapid turnaround approaches. The essence of the methodology involves running numerous simulations in a computable general equilibrium (CGE) model for each threat, yielding synthetic data for the estimation of a single regression equation based on the identification of key explanatory variables (threat characteristics and background conditions). This transforms the results of a complex model, which is beyond the reach of most users, into a "reduced form" model that is readily comprehensible. Functionality has been built into E-CAT so that its users can switch various consequence categories on and off in order to create customized profiles of economic consequences of numerous risk events. E-CAT incorporates uncertainty on both the input and output side in the course of the analysis.« less

Turning off the spigot: reducing drug-resistant tuberculosis transmission in resource-limited settings.

PubMed

Nardell, E; Dharmadhikari, A

2010-10-01

Ongoing transmission and re-infection, primarily in congregate settings, is a key factor fueling the global multidrug-resistant/extensively drug-resistant tuberculosis (MDR/XDR-TB) epidemic, especially in association with the human immunodeficiency virus. Even as efforts to broadly implement conventional TB transmission control measures begin, current strategies may be incompletely effective under the overcrowded conditions extant in high-burden, resource-limited settings. Longstanding evidence suggesting that TB patients on effective therapy rapidly become non-infectious and that unsuspected, untreated TB cases account for the most transmission makes a strong case for the implementation of rapid point-of-care diagnostics coupled with fully supervised effective treatment. Among the most important decisions affecting transmission, the choice of an MDR-TB treatment model that includes community-based treatment may offer important advantages over hospital or clinic-based care, not only in cost and effectiveness, but also in transmission control. In the community, too, rapid identification of infectious cases, especially drug-resistant cases, followed by effective, fully supervised treatment, is critical to stopping transmission. Among the conventional interventions available, we present a simple triage and separation strategy, point out that separation is intimately linked to the design and engineering of clinical space and call attention to the pros and cons of natural ventilation, simple mechanical ventilation systems, germicidal ultraviolet air disinfection, fit-tested respirators on health care workers and short-term use of masks on patients before treatment is initiated.

Turning off the spigot: reducing drug-resistant tuberculosis transmission in resource-limited settings

PubMed Central

Nardell, E.; Dharmadhikari, A.

2013-01-01

SUMMARY Ongoing transmission and re-infection, primarily in congregate settings, is a key factor fueling the global multidrug-resistant/extensively drug-resistant tuberculosis (MDR/XDR-TB) epidemic, especially in association with the human immunodeficiency virus. Even as efforts to broadly implement conventional TB transmission control measures begin, current strategies may be incompletely effective under the overcrowded conditions extant in high-burden, resource-limited settings. Longstanding evidence suggesting that TB patients on effective therapy rapidly become non-infectious and that unsuspected, untreated TB cases account for the most transmission makes a strong case for the implementation of rapid point-of-care diagnostics coupled with fully supervised effective treatment. Among the most important decisions affecting transmission, the choice of an MDR-TB treatment model that includes community-based treatment may offer important advantages over hospital or clinic-based care, not only in cost and effectiveness, but also in transmission control. In the community, too, rapid identification of infectious cases, especially drug-resistant cases, followed by effective, fully supervised treatment, is critical to stopping transmission. Among the conventional interventions available, we present a simple triage and separation strategy, point out that separation is intimately linked to the design and engineering of clinical space and call attention to the pros and cons of natural ventilation, simple mechanical ventilation systems, germicidal ultraviolet air disinfection, fit-tested respirators on health care workers and short-term use of masks on patients before treatment is initiated. PMID:20843413

Valuing flexibilities in the design of urban water management systems.

PubMed

Deng, Yinghan; Cardin, Michel-Alexandre; Babovic, Vladan; Santhanakrishnan, Deepak; Schmitter, Petra; Meshgi, Ali

2013-12-15

Climate change and rapid urbanization requires decision-makers to develop a long-term forward assessment on sustainable urban water management projects. This is further complicated by the difficulties of assessing sustainable designs and various design scenarios from an economic standpoint. A conventional valuation approach for urban water management projects, like Discounted Cash Flow (DCF) analysis, fails to incorporate uncertainties, such as amount of rainfall, unit cost of water, and other uncertainties associated with future changes in technological domains. Such approach also fails to include the value of flexibility, which enables managers to adapt and reconfigure systems over time as uncertainty unfolds. This work describes an integrated framework to value investments in urban water management systems under uncertainty. It also extends the conventional DCF analysis through explicit considerations of flexibility in systems design and management. The approach incorporates flexibility as intelligent decision-making mechanisms that enable systems to avoid future downside risks and increase opportunities for upside gains over a range of possible futures. A water catchment area in Singapore was chosen to assess the value of a flexible extension of standard drainage canals and a flexible deployment of a novel water catchment technology based on green roofs and porous pavements. Results show that integrating uncertainty and flexibility explicitly into the decision-making process can reduce initial capital expenditure, improve value for investment, and enable decision-makers to learn more about system requirements during the lifetime of the project. Copyright © 2013 Elsevier Ltd. All rights reserved.

Principles of educational outreach ('academic detailing') to improve clinical decision making.

PubMed

Soumerai, S B; Avorn, J

1990-01-26

With the efficacy and costs of medications rising rapidly, it is increasingly important to ensure that drugs be prescribed as rationally as possible. Yet, physicians' choices of drugs frequently fall short of the ideal of precise and cost-effective decision making. Evidence indicates that such decisions can be improved in a variety of ways. A number of theories and principles of communication and behavior changes can be found that underlie the success of pharmaceutical manufacturers in influencing prescribing practices. Based on this behavioral science and several field trials, it is possible to define the theory and practice of methods to improve physicians' clinical decision making to enhance the quality and cost-effectiveness of care. Some of the most important techniques of such "academic detailing" include (1) conducting interviews to investigate baseline knowledge and motivations for current prescribing patterns, (2) focusing programs on specific categories of physicians as well as on their opinion leaders, (3) defining clear educational and behavioral objectives, (4) establishing credibility through a respected organizational identity, referencing authoritative and unbiased sources of information, and presenting both sides of controversial issues, (5) stimulating active physician participation in educational interactions, (6) using concise graphic educational materials, (7) highlighting and repeating the essential messages, and (8) providing positive reinforcement of improved practices in follow-up visits. Used by the nonprofit sector, the above techniques have been shown to reduce inappropriate prescribing as well as unnecessary health care expenditures.

Bayesian methods to estimate urban growth potential

USGS Publications Warehouse

Smith, Jordan W.; Smart, Lindsey S.; Dorning, Monica; Dupéy, Lauren Nicole; Méley, Andréanne; Meentemeyer, Ross K.

2017-01-01

Urban growth often influences the production of ecosystem services. The impacts of urbanization on landscapes can subsequently affect landowners’ perceptions, values and decisions regarding their land. Within land-use and land-change research, very few models of dynamic landscape-scale processes like urbanization incorporate empirically-grounded landowner decision-making processes. Very little attention has focused on the heterogeneous decision-making processes that aggregate to influence broader-scale patterns of urbanization. We examine the land-use tradeoffs faced by individual landowners in one of the United States’ most rapidly urbanizing regions − the urban area surrounding Charlotte, North Carolina. We focus on the land-use decisions of non-industrial private forest owners located across the region’s development gradient. A discrete choice experiment is used to determine the critical factors influencing individual forest owners’ intent to sell their undeveloped properties across a series of experimentally varied scenarios of urban growth. Data are analyzed using a hierarchical Bayesian approach. The estimates derived from the survey data are used to modify a spatially-explicit trend-based urban development potential model, derived from remotely-sensed imagery and observed changes in the region’s socioeconomic and infrastructural characteristics between 2000 and 2011. This modeling approach combines the theoretical underpinnings of behavioral economics with spatiotemporal data describing a region’s historical development patterns. By integrating empirical social preference data into spatially-explicit urban growth models, we begin to more realistically capture processes as well as patterns that drive the location, magnitude and rates of urban growth.

Factors associated with Iowa rural hospitals' decision to convert to critical access hospital status.

PubMed

Li, Pengxiang; Ward, Marcia M; Schneider, John E

2009-01-01

The Balanced Budget Act (BBA) of 1997 allowed some rural hospitals meeting certain requirements to convert to Critical Access Hospitals (CAHs) and changed their Medicare reimbursement from prospective to cost-based. Some subsequent CAH-related laws reduced restrictions and increased payments, and the number of CAHs grew rapidly. To examine factors related to hospitals' decisions to convert and time to CAH conversion. Eighty-nine rural hospitals in Iowa were characterized and observed from 1998 to 2005. Cox proportional hazards models were used to identify the determinants of time to CAH conversion. T-test and one-covariate Cox regression indicated that, in 1998, Iowa rural hospitals with more staffed beds, discharges, and acute inpatient days, higher operating margin, lower skilled swing bed days relative to acute days, and located in relatively high density counties were more likely to convert later or not convert before 2006. Multiple Cox regression with baseline covariates indicated that lower number of discharges and average length of stay (ALOS) were significant after controlling all other covariates. Iowa rural hospitals' decisions regarding CAH conversion were influenced by hospital size, financial condition, skilled swing bed days relative to acute days, length of stay, proportion of Medicare acute days, and geographic factors. Although financial concerns are often cited in surveys as the main reason for conversion, lower number of discharges and ALOS are the most prominent factors affecting rural hospitals' decision on when to convert.

Optimization of replacement and inspection decisions for multiple components on a power system

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

Mauney, D.A.

1994-12-31

The use of optimization on the rescheduling of replacement dates provided a very proactive approach to deciding when components on individual units need to be addressed with a run/repair/replace decision. Including the effects of time value of money and taxes and unit need inside the spreadsheet model allowed the decision maker to concentrate on the effects of engineering input and replacement date decisions on the final net present value (NPV). The personal computer (PC)-based model was applied to a group of 140 forced outage critical fossil plant tube components across a power system. The estimated resulting NPV of the optimizationmore » was in the tens of millions of dollars. This PC spreadsheet model allows the interaction of inputs from structural reliability risk assessment models, plant foreman interviews, and actual failure history on a by component by unit basis across a complete power production system. This model includes not only the forced outage performance of these components caused by tube failures but, in addition, the forecasted need of the individual units on the power system and the expected cost of their replacement power if forced off line. The use of cash flow analysis techniques in the spreadsheet model results in the calculation of an NPV for a whole combination of replacement dates. This allows rapid assessments of {open_quotes}what if{close_quotes} scenarios of major maintenance projects on a systemwide basis and not just on a unit-by-unit basis.« less

Health impact assessment in the UK planning system: the possibilities and limits of community engagement.

PubMed

Chadderton, Chloe; Elliott, Eva; Hacking, Nick; Shepherd, Michael; Williams, Gareth

2013-12-01

This paper explores the use of health impact assessment (HIA) as a means of facilitating community engagement in spatial planning. The paper discusses the background to the development of HIA as a tool for assessing the likely impact of policies and wider changes on health with a view to building those into planning and decision-making, and describes the evolution of HIA into more participatory forms. It then goes on to describe a case-study of plans for a waste incinerator in an inner-city area in the UK, where HIA was used in response to community concerns about the development as a means of building in the views of local people to the decision-making around the plan. We describe in detail how the HIA was conducted and additional research undertaken within a timescale set by the planning processes. We discuss the difficulties involved in conducting any kind of research-based HIA so rapidly and in a situation of multiple, competing stakeholder interests. We argue that although the HIA failed to influence the final decisions in this particular instance it does, nonetheless, provide a model for how to create 'knowledge spaces' in which different perspectives and information can be brought around the table to create more democratic approaches to planning for waste.

Decision-making for foot-and-mouth disease control: Objectives matter

USGS Publications Warehouse

Probert, William J. M.; Shea, Katriona; Fonnesbeck, Christopher J.; Runge, Michael C.; Carpenter, Tim E.; Durr, Salome; Garner, M. Graeme; Harvey, Neil; Stevenson, Mark A.; Webb, Colleen T.; Werkman, Marleen; Tildesley, Michael J.; Ferrari, Matthew J.

2016-01-01

Formal decision-analytic methods can be used to frame disease control problems, the first step of which is to define a clear and specific objective. We demonstrate the imperative of framing clearly-defined management objectives in finding optimal control actions for control of disease outbreaks. We illustrate an analysis that can be applied rapidly at the start of an outbreak when there are multiple stakeholders involved with potentially multiple objectives, and when there are also multiple disease models upon which to compare control actions. The output of our analysis frames subsequent discourse between policy-makers, modellers and other stakeholders, by highlighting areas of discord among different management objectives and also among different models used in the analysis. We illustrate this approach in the context of a hypothetical foot-and-mouth disease (FMD) outbreak in Cumbria, UK using outputs from five rigorously-studied simulation models of FMD spread. We present both relative rankings and relative performance of controls within each model and across a range of objectives. Results illustrate how control actions change across both the base metric used to measure management success and across the statistic used to rank control actions according to said metric. This work represents a first step towards reconciling the extensive modelling work on disease control problems with frameworks for structured decision making.

Practical (?) considerations for implementing assisted migration strategies for trees in North America

NASA Astrophysics Data System (ADS)

McKenney, D.; Pedlar, J.

2011-12-01

Climate is one of the major influences on forests and much effort has gone into projecting the impacts of rapid climate change on forest distribution and productivity. Such efforts are premised on the notion that the current generation of Global Climate Models (GCMs) provide reasonably accurate representations of future climate. But what is the appropriate level of faith to put in these projections when making relatively fine-scale resource management decisions such as the movement of plant genetic material? In this talk we review recent outcomes of climate envelope models for North American tree species that suggest optimal climate regimes could move on average ~700km within the next 100 years. Newer generation GCMs seem to confirm these results but much uncertainty remains for practical decision-making. Despite these uncertainties, assisted migration has been suggested as a climate change adaptation tool wherein populations of trees are moved up to a few hundred kilometers north (or a few hundred meters upslope) to keep pace with the anticipated changes in optimal climate regimes. A continent-wide web based tool (SEEDWHERE) is presented, which assists in identifying appropriate translocation distances for assisted migration initiatives. We finish with some suggestions for future work on the topic of forest regeneration decisions under an evolving and uncertain future climate.

A Comparison of Four Software Programs for Implementing Decision Analytic Cost-Effectiveness Models.

PubMed

Hollman, Chase; Paulden, Mike; Pechlivanoglou, Petros; McCabe, Christopher

2017-08-01

The volume and technical complexity of both academic and commercial research using decision analytic modelling has increased rapidly over the last two decades. The range of software programs used for their implementation has also increased, but it remains true that a small number of programs account for the vast majority of cost-effectiveness modelling work. We report a comparison of four software programs: TreeAge Pro, Microsoft Excel, R and MATLAB. Our focus is on software commonly used for building Markov models and decision trees to conduct cohort simulations, given their predominance in the published literature around cost-effectiveness modelling. Our comparison uses three qualitative criteria as proposed by Eddy et al.: "transparency and validation", "learning curve" and "capability". In addition, we introduce the quantitative criterion of processing speed. We also consider the cost of each program to academic users and commercial users. We rank the programs based on each of these criteria. We find that, whilst Microsoft Excel and TreeAge Pro are good programs for educational purposes and for producing the types of analyses typically required by health technology assessment agencies, the efficiency and transparency advantages of programming languages such as MATLAB and R become increasingly valuable when more complex analyses are required.

Cost-Effectiveness of One-Time Hepatitis C Screening Strategies Among Adolescents and Young Adults in Primary Care Settings.

PubMed

Assoumou, Sabrina A; Tasillo, Abriana; Leff, Jared A; Schackman, Bruce R; Drainoni, Mari-Lynn; Horsburgh, C Robert; Barry, M Anita; Regis, Craig; Kim, Arthur Y; Marshall, Alison; Saxena, Sheel; Smith, Peter C; Linas, Benjamin P

2018-01-18

High hepatitis C virus (HCV) rates have been reported in young people who inject drugs (PWID). We evaluated the clinical benefit and cost-effectiveness of testing among youth seen in communities with a high overall number of reported HCV cases. We developed a decision analytic model to project quality-adjusted life years (QALYs), costs (2016 US$), and incremental cost-effectiveness ratios (ICERs) of 9 strategies for 1-time testing among 15- to 30-year-olds seen at urban community health centers. Strategies differed in 3 ways: targeted vs routine testing, rapid finger stick vs standard venipuncture, and ordered by physician vs by counselor/tester using standing orders. We performed deterministic and probabilistic sensitivity analyses (PSA) to evaluate uncertainty. Compared to targeted risk-based testing (current standard of care), routine testing increased the lifetime medical cost by $80 and discounted QALYs by 0.0013 per person. Across all strategies, rapid testing provided higher QALYs at a lower cost per QALY gained and was always preferred. Counselor-initiated routine rapid testing was associated with an ICER of $71000/QALY gained. Results were sensitive to offer and result receipt rates. Counselor-initiated routine rapid testing was cost-effective (ICER <$100000/QALY) unless the prevalence of PWID was <0.59%, HCV prevalence among PWID was <16%, reinfection rate was >26 cases per 100 person-years, or reflex confirmatory testing followed all reactive venipuncture diagnostics. In PSA, routine rapid testing was the optimal strategy in 90% of simulations. Routine rapid HCV testing among 15- to 30-year-olds may be cost-effective when the prevalence of PWID is >0.59%. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.