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Sample records for america expert panel

  1. Osteoporosis in Latin America: panel expert review

    Directory of Open Access Journals (Sweden)

    Patricia Clark

    2013-09-01

    Full Text Available Background. The Latin American region is undergoing a demographic and epidemiological transition, which is leading to an increase in chronic and degenerative diseases. Osteoporosis (OP and fragility fractures (FF are emerging as main causes of disease burden with great impact on health institutions. Purpose. This review article provides an updated overview of trends in the epidemiology and economic impact of OP and FF, as well as in diagnosis and available treatments in Latin America, including calcium, vitamin D and prevention programs. Methods. Expert panel. Conclusions. According to this review, there is a lack of epidemiological and economic information in the region. It is desirable to obtain information regarding quality of life in OP and FF as well as to highlight prevention as a tool to reduce FF.

  2. 21 CFR 516.141 - Qualified expert panels.

    Science.gov (United States)

    2010-04-01

    ... choose members for the qualified expert panel in accordance with selection criteria listed in paragraph... whether the proposed qualified expert panel meets the selection criteria prior to the panel beginning its... Committee Act, as amended, 5 U.S.C. App. (b) Criteria for the selection of a qualified expert panel. (1) A...

  3. Expert Opinion Is Necessary: Delphi Panel Methodology Facilitates a Scientific Approach to Consensus.

    Science.gov (United States)

    Hohmann, Erik; Brand, Jefferson C; Rossi, Michael J; Lubowitz, James H

    2018-02-01

    Our current trend and focus on evidence-based medicine is biased in favor of randomized controlled trials, which are ranked highest in the hierarchy of evidence while devaluing expert opinion, which is ranked lowest in the hierarchy. However, randomized controlled trials have weaknesses as well as strengths, and no research method is flawless. Moreover, stringent application of scientific research techniques, such as the Delphi Panel methodology, allows survey of experts in a high quality and scientific manner. Level V evidence (expert opinion) remains a necessary component in the armamentarium used to determine the answer to a clinical question. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  4. An expert panel approach to support risk-informed decision making

    International Nuclear Information System (INIS)

    Pulkkinen, U.; Simola, K.

    2000-01-01

    The report describes the expert panel methodology developed for supporting risk-informed decision making. The aim of an expert panel is to achieve a balanced utilisation of information and expertise from several disciplines in decision-making including probabilistic safety assessment as one decision criterion. We also summarise the application of the methodology in the STUK's RI-ISI (Risk-Informed In-Service Inspection) pilot study, where the expert panel approach was used to combine the deterministic information on degradation mechanisms and probabilistic information on pipe break consequences. The expert panel served both as a critical review of the preliminary results and as a decision support for the final definition of risk categories of piping. (orig.)

  5. TWRS vadose zone contamination issue expert panel report

    Energy Technology Data Exchange (ETDEWEB)

    Shafer, D.S.

    1997-05-01

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

  6. TWRS vadose zone contamination issue expert panel status report

    International Nuclear Information System (INIS)

    Shafer, D.S.

    1997-01-01

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

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

    Science.gov (United States)

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

  8. Environmental factors and puberty timing: expert panel research needs

    DEFF Research Database (Denmark)

    Louis, G.M. Buck; Jr, L.E. Gray; Marcus, M.

    2008-01-01

    Serono Symposia International convened an expert panel to review the impact of environmental influences on the regulation of pubertal onset and progression while identifying critical data gaps and future research priorities. An expert panel reviewed the literature on endocrine-disrupting chemicals......, body size, and puberty. The panel concluded that available experimental animal and human data support a possible role of endocrine-disrupting chemicals and body size in relation to alterations in pubertal onset and progression in boys and girls. Critical data gaps prioritized for future research......, and (3) basic research to identify the primary signal(s) for the onset of gonadotropin-releasing hormone-dependent/central puberty and gonadotropin-releasing hormone-independent/peripheral puberty. Prospective studies of couples who are planning pregnancies or pregnant women are needed to capture...

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

    Energy Technology Data Exchange (ETDEWEB)

    Martin, Todd M. [Washington River Protection Solutions, LLC, Richland, WA (United States; Gunter, Jason R. [Washington River Protection Solutions, LLC, Richland, WA (United States); Boomer, Kayle D. [Washington River Protection Solutions, LLC, Richland, WA (United States)

    2015-01-07

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

  10. Expert Panel Elicitation of Seismicity Following Glaciation in Sweden

    International Nuclear Information System (INIS)

    Hora, Stephen; Jensen, Mikael

    2005-12-01

    The Swedish Radiation Protection Authority, the Swedish Nuclear Power Inspectorate and the Swedish Nuclear Fuel and Waste Management Company have jointly carried out a project on expert panel elicitation on the issue of glacial induced Swedish earthquakes. Following a broad nomination procedure, 5 experts were chosen by a selection committee of 4 professors within Earth sciences disciplines. The 5 experts presented judgments about the frequency of earthquakes greater the magnitude 6 within 10 km for two Swedish sites, Oskarshamn and Forsmark, in connection with a glaciation cycle. The experts' median value vas 0,1 earthquakes for one glaciation cycle

  11. Expert Panel Elicitation of Seismicity Following Glaciation in Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Hora, Stephen; Jensen, Mikael (eds.)

    2005-12-15

    The Swedish Radiation Protection Authority, the Swedish Nuclear Power Inspectorate and the Swedish Nuclear Fuel and Waste Management Company have jointly carried out a project on expert panel elicitation on the issue of glacial induced Swedish earthquakes. Following a broad nomination procedure, 5 experts were chosen by a selection committee of 4 professors within Earth sciences disciplines. The 5 experts presented judgments about the frequency of earthquakes greater the magnitude 6 within 10 km for two Swedish sites, Oskarshamn and Forsmark, in connection with a glaciation cycle. The experts' median value vas 0,1 earthquakes for one glaciation cycle.

  12. Experts discuss unconventional conflicts in the Americas | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2015-07-10

    Jul 10, 2015 ... Experts discuss unconventional conflicts in the Americas ... in illicit activities — like drug smuggling and illegal mining — that destabilize societies and ruin lives. ... Social exclusion and "violences" in Central American cities.

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

    Science.gov (United States)

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

    2013-06-01

    Statistics education is a necessary element of nursing education, and its inclusion is recommended in the American Association of Colleges of Nursing guidelines for nurse training at all levels. This article presents a cohesive summary of an expert panel discussion, "Teaching Statistics to Nursing Students," held at the 2012 Joint Statistical Meetings. All panelists were statistics experts, had extensive teaching and consulting experience, and held faculty appointments in a U.S.-based nursing college or school. The panel discussed degree-specific curriculum requirements, course content, how to ensure nursing students understand the relevance of statistics, approaches to integrating statistics consulting knowledge, experience with classroom instruction, use of knowledge from the statistics education research field to make improvements in statistics education for nursing students, and classroom pedagogy and instruction on the use of statistical software. Panelists also discussed the need for evidence to make data-informed decisions about statistics education and training for nurses. Copyright 2013, SLACK Incorporated.

  14. A quick and selected overview of the expert panel on effective ways of investing in health.

    Science.gov (United States)

    Barros, Pedro Pita

    2017-01-01

    The European Commission created the Expert Panel on Effective Ways of Investing in Health (EXPH) in 2012. The EXPH started its activities in July 2013 and ended its first term in May 2016. A personal review of the Expert Panel contributions in its first term is provided.

  15. DELPHI expert panel evaluation of Hanford high level waste tank failure modes and release quantities

    Energy Technology Data Exchange (ETDEWEB)

    Dunford, G.L.; Han, F.C.

    1996-09-30

    The Failure Modes and Release Quantities of the Hanford High Level Waste Tanks due to postulated accident loads were established by a DELPHI Expert Panel consisting of both on-site and off-site experts in the field of Structure and Release. The Report presents the evaluation process, accident loads, tank structural failure conclusion reached by the panel during the two-day meeting.

  16. Analysis of core damage frequency from internal events: Expert judgment elicitation. Part 1: Expert panel results. Part 2: Project staff results

    Energy Technology Data Exchange (ETDEWEB)

    Wheeler, T A; Cramond, W R [Sandia National Laboratories, Albuquerque, NM (United States); Hora, S C [University of Hawii at Hilo (United States); Unwin, S D [Brookhaven National Laboratory (United States)

    1989-04-01

    Quantitative modeling techniques have limitations as to the resolution of important issues in probabilistic risk assessment (PRA). Not all issues can be resolved via the existing set of methods such as fault trees, event trees, statistical analyses, data collection, and computer simulation. Therefore, an expert judgment process was developed to address issues perceived as important to risk in the NUREG-1150 analysis but which could not be resolved with existing techniques. This process was applied to several issues that could significantly affect the internal event core damage frequencies of the PRAs performed on six light water reactors. Detailed descriptions of these issues and the results of the expert judgment elicitation are reported here, as well as an explanation of the methodology used and the procedure followed in performing the overall elicitation task. The process is time-consuming and expensive. However, the results are very useful, and represent an improvement over the draft NUREG-1150 analysis in the areas of expert selection, elicitation training, issue selection and presentation, elicitation of judgment and aggregation of results. The results are presented in two parts. Part documents the expert panel elicitations, where the most important issues were presented to a panel of experts convened from throughout the nuclear power risk assessment community. Part 2 documents the process by which the project staff performed expert judgment on other important issues, using the project staff as panel members. (author)

  17. Identification of component performance degradations caused by ageing using expert panels

    International Nuclear Information System (INIS)

    Nitoi, Mirela; Cristea, Dumitru; Pavelescu, Margarit

    2008-01-01

    Since the component ageing can be considered as one of the important causes of operating events reported, the identification of ageing effects and implementation of appropriate methods for mitigation of these effects represent an important preoccupation of many organizations and research activities. In the process of identification of ageing manifestation we can use either analysis of operational data or expert opinions, each of the methods having specific advantages and disadvantages. A reasonable combination of statistical, structural reliability and expert panel methods would be an appropriate approach in the failure probability assessments. In case when there are not enough operational data, the expert judgments represent the only viable alternative in the effort dedicated to identification of components and systems vulnerability to ageing. The panel use judgments to analyse the degradation produced by ageing, to score the components based on specific criteria and to rank them relative to one another. The paper presents the approach developed, including evaluation criteria and assigning indices for assessment of particular types of ageing degradation (the case of secondary system of TRIGA reactor). (authors)

  18. [Consensus statement on the clinical management of non-AIDS defining malignancies. GeSIDA expert panel].

    Science.gov (United States)

    Santos, Jesús; Valencia, Eulalia

    2014-10-01

    This consensus document has been prepared by a panel of experts appointed by GeSIDA. This paper reviews the recommendations on the most important non-AIDS defining malignancies that can affect patients living with AIDS. Lung cancer, hepatocellular carcinoma, anal carcinoma and other less frequent malignancies such as breast, prostate, vagina or colon cancers are reviewed. The aim of the recommendations is to make clinicians who attend to this patients aware of how to prevent, diagnose and treat this diseases. The recommendations for the use of antiretroviral therapy when the patient develops a malignancy are also presented. In support of the recommendations we have used the modified criteria of the Infectious Diseases Society of America. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  19. Toxicity management of angiogenesis inhibitors: resolution of expert panel

    Directory of Open Access Journals (Sweden)

    Pavel O. Rumiantsev

    2017-12-01

    Full Text Available On 22 June 2017 in St. Petersburg the expert panel was held on the topic “Management of toxicity of angiogenesis inhibitors”, which discussed current issues of systemic therapy of advanced differentiated thyroid cancer resistant to radioactive iodine therapy, advanced kidney cancer and questions of efficacy and safety of new target drugs in the treatment of these diseases. The reports and discussions of experts raised the following questions: 1. Own experience of using lenvatinib in patients with differentiated thyroid cancer refractory to therapy with radioactive iodine and kidney cancer. 2. Profile of efficacy and safety of modern targeted therapy with multikinase inhibitors. 3. Prophylaxis and management of predictable toxicity.

  20. Expert panel on hydrogeology; report to AECL Research (1992)

    International Nuclear Information System (INIS)

    Domenico, P.A.; Grisak, G.E.; Schwartz, F.W.

    1995-02-01

    In 1992 AECL Research convened a panel of external hydrogeological experts consisting of P.A. Domenico, G.E. Grisak, and F.W. Schwartz, to review AECL's proposed approach to siting a geological repository in the rocks of the Canadian Shield for the safe disposal of Canada's nuclear fuel wastes. In particular the panel was asked to provide its opinion on 1) the soundness of the technical approach developed to characterize the groundwater flow systems for the purpose of selecting a location for a disposal vault, 2) the validity and effectiveness of the geological case study used to demonstrate the performance assessment methodology based on the hydrogeological conditions observed at the Whiteshell Research Area, and 3) the adequacy of the hydrogeological information that AECL proposes to use in its Environmental Impact Statement (EIS) of the disposal concept. This report presents the findings, conclusions and recommendations of the hydrogeology review panel. The report was submitted to AECL Research in 1992 December. (author). 24 refs., 2 tabs., 4 figs

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

    Science.gov (United States)

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

    2011-10-01

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

  2. Development of a panel of genome-wide ancestry informative markers to study admixture throughout the Americas.

    Directory of Open Access Journals (Sweden)

    Joshua Mark Galanter

    Full Text Available Most individuals throughout the Americas are admixed descendants of Native American, European, and African ancestors. Complex historical factors have resulted in varying proportions of ancestral contributions between individuals within and among ethnic groups. We developed a panel of 446 ancestry informative markers (AIMs optimized to estimate ancestral proportions in individuals and populations throughout Latin America. We used genome-wide data from 953 individuals from diverse African, European, and Native American populations to select AIMs optimized for each of the three main continental populations that form the basis of modern Latin American populations. We selected markers on the basis of locus-specific branch length to be informative, well distributed throughout the genome, capable of being genotyped on widely available commercial platforms, and applicable throughout the Americas by minimizing within-continent heterogeneity. We then validated the panel in samples from four admixed populations by comparing ancestry estimates based on the AIMs panel to estimates based on genome-wide association study (GWAS data. The panel provided balanced discriminatory power among the three ancestral populations and accurate estimates of individual ancestry proportions (R² > 0.9 for ancestral components with significant between-subject variance. Finally, we genotyped samples from 18 populations from Latin America using the AIMs panel and estimated variability in ancestry within and between these populations. This panel and its reference genotype information will be useful resources to explore population history of admixture in Latin America and to correct for the potential effects of population stratification in admixed samples in the region.

  3. Application of Delphi expert panel in joint venture projects

    Science.gov (United States)

    Adnan, H.; Rosman, M. R.; Rashid, Z. Z. Ahmad; Mohamad Yusuwan, N.; Bakhary, N. A.

    2018-02-01

    This study was conducted with the aim to identify the application of the Delphi Technique in validating findings obtained from questionnaire surveys and interviews done in- depth on the subject of joint venture projects in Malaysia. The Delphi technique aims to achieve a consensus of opinion amongst expert panellist that were selected on the primary factors in JV projects. To achieve research objectives, a progressive series of questions was designed where a selected panel of expert to confirm and validate the final findings. The rationale, benefits, limitations and recommendations for the use of Delphi were given in this study. From the literature review done, twenty-one factors were identified as critical factors to the making any joint venture project successful. Detail information from contractors were obtained by using the questionnaire survey method and forty-three in-depth interviews were carried out. Trust between partners, mutual understanding, partner selection criteria, agreement of contract, objective compatibility, conflict, and commitment were confirmed by the Delphi panel to be the critical success factors besides another fourteen factors which were found to be the Failure Reduction Criteria. Delphi techniques has proven to successfully assist in recognising the main factors and would be beneficial in supplementing the success of joint venture arrangements application for construction projects in Malaysia.

  4. Expert panel evaluation of health information technology effects on adverse events.

    Science.gov (United States)

    Abramson, Erika L; Kern, Lisa M; Brenner, Samantha; Hufstader, Meghan; Patel, Vaishali; Kaushal, Rainu

    2014-08-01

    Adverse events (AEs) among hospitalized patients occur frequently and result in significant sequelae. Federal policy is incentivizing health information technology (HIT) use, although research demonstrating safety benefits from HIT is mixed. Our objective was to evaluate the potential effects of HIT on reducing 21 different inpatient AEs. Identifying AEs most likely to be reduced by HIT can inform the design of future studies evaluating its effectiveness. We conducted a modified Delphi panel of national experts in HIT and safety. We conducted a focused literature review to inform the experts. Using a novel framework, experts rated each AE as 'definitely reduced by health IT,' 'possibly reduced by health IT' and 'not likely to be reduced by health IT'. From our panel discussion, experts identified six AEs as 'definitely reduced by health IT': (1) adverse drug events (ADEs) associated with digoxin; (2) ADE associated with IV heparin; (3) ADE associated with hypoglycaemic agents; (4) ADE associated with low molecular weight heparin and factor Xa inhibitor; (5) contrast nephropathy associated with catheter angiography; and (6) ADE hospital-acquired antibiotic-associated Clostridium difficile. Understanding the effects of HIT on patient outcomes will be essential to ensuring that the significant federal investment results in anticipated improvements. This study serves as an important early step in helping with the design of future work evaluating level of HIT infrastructure and rates of inpatient AEs. © 2014 John Wiley & Sons, Ltd.

  5. Sensory analysis of characterising flavours: evaluating tobacco product odours using an expert panel.

    Science.gov (United States)

    Krüsemann, Erna J Z; Lasschuijt, Marlou P; de Graaf, C; de Wijk, René A; Punter, Pieter H; van Tiel, Loes; Cremers, Johannes W J M; van de Nobelen, Suzanne; Boesveldt, Sanne; Talhout, Reinskje

    2018-05-23

    Tobacco flavours are an important regulatory concept in several jurisdictions, for example in the USA, Canada and Europe. The European Tobacco Products Directive 2014/40/EU prohibits cigarettes and roll-your-own tobacco having a characterising flavour. This directive defines characterising flavour as 'a clearly noticeable smell or taste other than one of tobacco […]'. To distinguish between products with and without a characterising flavour, we trained an expert panel to identify characterising flavours by smelling. An expert panel (n=18) evaluated the smell of 20 tobacco products using self-defined odour attributes, following Quantitative Descriptive Analysis. The panel was trained during 14 attribute training, consensus training and performance monitoring sessions. Products were assessed during six test sessions. Principal component analysis, hierarchical clustering (four and six clusters) and Hotelling's T-tests (95% and 99% CIs) were used to determine differences and similarities between tobacco products based on odour attributes. The final attribute list contained 13 odour descriptors. Panel performance was sufficient after 14 training sessions. Products marketed as unflavoured that formed a cluster were considered reference products. A four-cluster method distinguished cherry-flavoured, vanilla-flavoured and menthol-flavoured products from reference products. Six clusters subdivided reference products into tobacco leaves, roll-your-own and commercial products. An expert panel was successfully trained to assess characterising odours in cigarettes and roll-your-own tobacco. This method could be applied to other product types such as e-cigarettes. Regulatory decisions on the choice of reference products and significance level are needed which directly influences the products being assessed as having a characterising odour. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use

  6. Genotoxicity Expert Panel review: weight of evidence evaluation of the genotoxicity of glyphosate, glyphosate-based formulations, and aminomethylphosphonic acid.

    Science.gov (United States)

    Brusick, David; Aardema, Marilyn; Kier, Larry; Kirkland, David; Williams, Gary

    2016-09-01

    In 2015, the International Agency for Research on Cancer (IARC) published a monograph concluding there was strong evidence for genotoxicity of glyphosate and glyphosate formulations and moderate evidence for genotoxicity of the metabolite aminomethylphosphonic acid (AMPA). These conclusions contradicted earlier extensive reviews supporting the lack of genotoxicity of glyphosate and glyphosate formulations. The IARC Monograph concluded there was strong evidence of induction of oxidative stress by glyphosate, glyphosate formulations, and AMPA. The Expert Panel reviewed the genotoxicity and oxidative stress data considered in the IARC Monograph, together with other available data not considered by IARC. The Expert Panel defined and used a weight of evidence (WoE) approach that included ranking of studies and endpoints by the strength of their linkage to events associated with carcinogenic mechanisms. Importantly, the Expert Panel concluded that there was sufficient information available from a very large number of regulatory genotoxicity studies that should have been considered by IARC. The WoE approach, the inclusion of all relevant regulatory studies, and some differences in interpretation of individual studies led to significantly different conclusions by the Expert Panel compared with the IARC Monograph. The Expert Panel concluded that glyphosate, glyphosate formulations, and AMPA do not pose a genotoxic hazard and the data do not support the IARC Monograph genotoxicity evaluation. With respect to carcinogenicity classification and mechanism, the Expert Panel concluded that evidence relating to an oxidative stress mechanism of carcinogenicity was largely unconvincing and that the data profiles were not consistent with the characteristics of genotoxic carcinogens.

  7. Glyphosate rodent carcinogenicity bioassay expert panel review.

    Science.gov (United States)

    Williams, Gary M; Berry, Colin; Burns, Michele; de Camargo, Joao Lauro Viana; Greim, Helmut

    2016-09-01

    Glyphosate has been rigorously and extensively tested for carcinogenicity by administration to mice (five studies) and to rats (nine studies). Most authorities have concluded that the evidence does not indicate a cancer risk to humans. The International Agency for Research on Cancer (IARC), however, evaluated some of the available data and concluded that glyphosate probably is carcinogenic to humans. The expert panel convened by Intertek assessed the findings used by IARC, as well as the full body of evidence and found the following: (1) the renal neoplastic effects in males of one mouse study are not associated with glyphosate exposure, because they lack statistical significance, strength, consistency, specificity, lack a dose-response pattern, plausibility, and coherence; (2) the strength of association of liver hemangiosarcomas in a different mouse study is absent, lacking consistency, and a dose-response effect and having in high dose males only a significant incidence increase which is within the historical control range; (3) pancreatic islet-cell adenomas (non-significant incidence increase), in two studies of male SD rats did not progress to carcinomas and lacked a dose-response pattern (the highest incidence is in the low dose followed by the high dose); (4) in one of two studies, a non-significant positive trend in the incidence of hepatocellular adenomas in male rats did not lead to progression to carcinomas; (5) in one of two studies, the non-significant positive trend in the incidence of thyroid C-cell adenomas in female rats was not present and there was no progression of adenomas to carcinomas at the end of the study. Application of criteria for causality considerations to the above mentioned tumor types and given the overall weight-of-evidence (WoE), the expert panel concluded that glyphosate is not a carcinogen in laboratory animals.

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

    Science.gov (United States)

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

    2008-12-09

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

  9. Expert Panel Elicitation

    Energy Technology Data Exchange (ETDEWEB)

    Jensen, M. [Swedish Radiation Protection Authority, Stockholm (Sweden). Dept. of Waste Management and Environmental Protection; Hora, S.C. [Univ. of Hawaii, Hilo, HI (United States)

    2005-09-15

    Scientists are now frequently in a situation where data cannot be easily assessed, since they may have conflicting or uncertain sources. While expert judgment reflects private choices, it is possible both reduce the personal aspect as well as in crease confidence in the judgments by using formal protocols for choice and elicitation of experts. A full-scale elicitation made on seismicity following glaciation, now in its late phase and presented here in a preliminary form, illustrates the value of the technique and some essential issues in connection with the decision to launch such a project. The results show an unusual low variation between the experts.

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

    Directory of Open Access Journals (Sweden)

    Landry Michel D

    2008-12-01

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

  11. RAND-like appropriateness methodology consensus for primary open-angle glaucoma in Latin America.

    Science.gov (United States)

    Lerner, S Fabian; Singh, Kuldev; Susanna, Remo; Wilson, M Roy; Lee, Brian L; Maul, Eugenio

    2012-09-01

    To report the results of a Latin American consensus panel regarding the diagnosis and management of primary open-angle glaucoma and to compare these results with those from a similar panel in the United States. A RAND-like (Research and Development) appropriateness methodology was used to assess glaucoma practice in Latin America. The 148 polling statements created for the RAND- like analysis in the United States and 10 additional statements specific to glaucoma care in Latin America were presented to a panel of Latin American glaucoma experts. Panelists were polled in private using the RAND- like methodology before and after the panel meeting. Consensus agreement or disagreement among Latin American experts was reached for 51.3% of statements before the meeting and increased to 66.5% in the private, anonymous meeting after polling (79.0% agreement, 21.0% disagreement). Although there was a high degree of concordance (111 of 148 statements; 75%) between the results of this Latin American panel and the United States panel, there were some notable exceptions relating to diagnostic and therapeutic decision making. This RAND-like consensus methodology provides a perspective of how Latin American glaucoma practitioners view many aspects of glaucoma and compares these results with those obtained using a similar methodology from practitioners in the United States. These findings may be helpful to ophthalmologists providing glaucoma care in Latin America and in other regions of the world. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Measurements of Radioactivity in Body Organs. Report of a Panel of Experts

    International Nuclear Information System (INIS)

    1970-01-01

    Measurements of radioactivity in body organs in vivo entail physical and other problems which do not arise in measurements of radioactivity in vitro. From 8-12 December 1969 the International Atomic Energy Agency convened at its Headquarters in Vienna a panel of experts to review the existing status of techniques for such measurements

  13. Expert panels as a reference standard in orthodontic research: An assessment of published methods and reporting.

    Science.gov (United States)

    Lempesi, Evangelia; Toulia, Electra; Pandis, Nikolaos

    2017-04-01

    The aim of this study was to investigate the expert panel methodology applied in orthodontics and its reporting quality. Additionally, the relationship between the reporting quality and a range of variables was explored. PubMed was searched for orthodontic studies in which the final diagnosis or assessment was made by 2 or more experts published up to March 16, 2015. Reporting quality assessment was conducted using an established modified checklist. The relationship between potential predictors and the total score was assessed using univariable linear regression. We identified 237 studies with a mean score of 9.97 (SD, 1.12) out of a maximum of 15. Critical information about panel methodology was missing in all studies. The panel composition differed substantially across studies, ranging from 2 to 646 panel members, with large variations in the expertise represented. Only 17 studies (7.2%) reported sample size calculations to justify the panel size. Panel members were partly blinded in 65 (27.4%) studies. Most studies failed to report which statistic was used to compute intrarater (65.8%) and interrater (66.2%) agreements. Journal type (nonorthodontic: β, 0.23; 95% CI, -0.07 to 0.54 compared with orthodontic), publication year (β, 0; 95% CI, -0.02 to 0.02 for each additional year), number of authors (1-3: β, 0.30; 95% CI, -0.13 to 0.74 compared with at least 6; 4-5: β, 0.18; 95% CI, -0.29 to 0.33 compared with at least 6), and number of centers involved (single: β, 0.20; 95% CI, -0.14 to 0.54 compared with multicenter) were not significant predictors of improved reporting. Studies published in Asia and Australia had significantly lower scores compared with those published in Europe (β, -0.54; 95% CI, -0.92 to -0.17). Formal guidelines on methodology and reporting of studies involving expert panels are required. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  14. Building America Expert Meeting Report: Transitioning Traditional HVAC Contractors to Whole House Performance Contractors

    Energy Technology Data Exchange (ETDEWEB)

    Burdick, A.

    2011-10-01

    This report outlines findings resulting from a U.S. Department of Energy Building America expert meeting to determine how HVAC companies can transition from a traditional contractor status to a service provider for whole house energy upgrade contracting. IBACOS has embarked upon a research effort under the Building America Program to understand business impacts and change management strategies for HVAC companies. HVAC companies can implement these strategies in order to quickly transition from a 'traditional' heating and cooling contractor to a service provider for whole house energy upgrade contracting. Due to HVAC service contracts, which allow repeat interaction with homeowners, HVAC companies are ideally positioned in the marketplace to resolve homeowner comfort issues through whole house energy upgrades. There are essentially two primary ways to define the routes of transition for an HVAC contractor taking on whole house performance contracting: (1) Sub-contracting out the shell repair/upgrade work; and (2) Integrating the shell repair/upgrade work into their existing business. IBACOS held an Expert Meeting on the topic of Transitioning Traditional HVAC Contractors to Whole House Performance Contractors on March 29, 2011 in San Francisco, CA. The major objectives of the meeting were to: Review and validate the general business models for traditional HVAC companies and whole house energy upgrade companies Review preliminary findings on the differences between the structure of traditional HVAC Companies and whole house energy upgrade companies Seek industry input on how to structure information so it is relevant and useful for traditional HVAC contractors who are transitioning to becoming whole house energy upgrade contractors Seven industry experts identified by IBACOS participated in the session along with one representative from the National Renewable Energy Laboratory (NREL). The objective of the meeting was to validate the general operational

  15. Sensory analysis of characterizing flavors in tobacco products using a trained expert panel

    Directory of Open Access Journals (Sweden)

    Erna Krüsemann

    2018-03-01

    Using a trained expert panel is a successful example of assessing characterizing flavors in tobacco products. Regulatory decisions should be made on significance level and products representing the reference space, as these directly influence strictness of the method and thus the number of products that imparts a characterizing flavor compared to the reference space.

  16. ACR Appropriateness Criteria on Induction and Adjuvant Therapy for Stage N2 Non-Small-Cell Lung Cancer: Expert Panel on Radiation Oncology-Lung

    International Nuclear Information System (INIS)

    Gopal, Ramesh S.; Dubey, Sarita; Rosenzweig, Kenneth E.; Chang, Joe Yujiao; Decker, Roy; Gewanter, Richard M.; Kong Fengming; Lally, Brian E.; Langer, Corey J.; Lee, Hoon Ku; Movsas, Benjamin M.D.

    2010-01-01

    'The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply society endorsement of the final document.'

  17. What is case management in palliative care? An expert panel study

    Directory of Open Access Journals (Sweden)

    van der Plas Annicka G M

    2012-06-01

    Full Text Available Abstract Background Case management is a heterogeneous concept of care that consists of assessment, planning, implementing, coordinating, monitoring, and evaluating the options and services required to meet the client's health and service needs. This paper describes the result of an expert panel procedure to gain insight into the aims and characteristics of case management in palliative care in the Netherlands. Methods A modified version of the RAND®/University of California at Los Angeles (UCLA appropriateness method was used to formulate and rate a list of aims and characteristics of case management in palliative care. A total of 76 health care professionals, researchers and policy makers were invited to join the expert panel, of which 61% participated in at least one round. Results Nine out of ten aims of case management were met with agreement. The most important areas of disagreement with regard to characteristics of case management were hands-on nursing care by the case manager, target group of case management, performance of other tasks besides case management and accessibility of the case manager. Conclusions Although aims are agreed upon, case management in palliative care shows a high level of variability in implementation choices. Case management should aim at maintaining continuity of care to ensure that patients and those close to them experience care as personalised, coherent and consistent.

  18. Building America Expert Meeting Report. Transitioning Traditional HVAC Contractors to Whole House Performance Contractors

    Energy Technology Data Exchange (ETDEWEB)

    Burdick, Arlan [IBACOS Inc., Pittsburgh, PA (United States)

    2011-10-01

    This expert meeting was hosted by the IBACOS Building America research team to determine how HVAC companies can transition from a traditional contractor status to a service provider for whole house energy upgrade contracting.

  19. Key considerations for preventing suicide in older adults: consensus opinions of an expert panel

    DEFF Research Database (Denmark)

    Erlangsen, Annette; Nordentoft, Merete; Conwell, Yeates

    2011-01-01

    BACKGROUND: The number of older adults is growing rapidly. This fact, combined with the high rates of suicide in later life, indicates that many more older adults will die by their own hands before rigorous trials can be conducted to fully understand the best approaches to prevent late life suicide....... AIMS: To disseminate key considerations for interventions addressing senior suicidal behavior. METHODS: An international expert panel has reviewed and discussed key considerations for interventions against suicide in older adults based on existing evidence, where available, and expert opinion. RESULTS...

  20. SERDP/ESTCP Expert Panel Workshop on Research and Development Needs for Cleanup of Chlorinated Solvent Sites

    National Research Council Canada - National Science Library

    2001-01-01

    ...) perform its mission. These programs together conducted an expert panel workshop on August 6-7, 2001 to evaluate the needs for research and development in the general area of chlorinated solvent site cleanup...

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

    Science.gov (United States)

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

  2. Establishment of Reference Doses for residues of allergenic foods: Report of the VITAL Expert Panel

    NARCIS (Netherlands)

    Taylor, S.L.; Baumert, J.L.; Kruizinga, A.G.; Remington, B.C.; Crevel, R.W.R.; Brooke-Taylor, S.; Allen, K.J.; Houben, G.

    2014-01-01

    In 2011, an expert panel was assembled to establish appropriate Reference Doses for allergenic food residues as a part of the VITAL (Voluntary Incidental Trace Allergen Labeling) program of The Allergen Bureau of Australia & New Zealand (ABA). These Reference Doses would guide advisory labeling

  3. Developing a HACCP-like system for improving animal health and welfare in organic egg production - based on an expert panel analysis.

    Science.gov (United States)

    Hegelund, L; Sørensen, J T

    2007-08-01

    In the process of developing a generic Hazard Analysis and Critical Control Point (HACCP)-like system for securing animal health and welfare in organic egg production, an expert panel analysis was used to perform the initial hazard analysis. Eighteen advisers and researchers in organic egg production were included in the expert panel. In a series of four questionnaires, the expert panel first scored 34 health and welfare problems seen in Danish organic egg production. Based on scorings of severity and occurrence, 10 problems were selected for further analysis. The experts subsequently suggested and scored risk factors for those problems and finally suggested control points, alarm values indicating the need for corrective actions in order to control the risk factors and monitoring frequencies of these. The 10 selected problems were hunger, thirst, piling, crop impaction, blackhead, pasteurellosis, bone fractures, cannibalism, predators and red mites. A total of 154 different risk factors were suggested for these problems. The 41 risk factors which rated highest in a combined scoring of importance and occurrence were selected for further analysis. There was a high degree of consensus between experts when scoring both problems and risk factors. The level of consensus, as defined by an interquartile range 1, was 79% to 100% when scoring the health and welfare problems (scale 1-5) and 77% to 95% when scoring the risk factors (scale 1-4). On average, 5.8 control points were suggested for every risk factor. Alarm values were often not detailed enough to be of practical significance and further analysis is needed in order to define these. The experts were highly diverse in their suggested monitoring frequencies and establishment of monitoring schemes should be part of developing the farm specific systems. An expert panel analysis based on questionnaires was a useful tool during the first steps of developing a HACCP plan, conducting a hazard analysis and suggesting control

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

    Energy Technology Data Exchange (ETDEWEB)

    Baldini, Elizabeth H., E-mail: ebaldini@partners.org [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Wang, Dian [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); Haas, Rick L.M. [Department of Radiotherapy, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Catton, Charles N. [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Indelicato, Daniel J. [Department of Radiation Oncology, University of Florida Medical Center, Jacksonville, Florida (United States); Kirsch, David G. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Roberge, David [Department of Radiation Oncology, Centre Hospitalier de l' Université de Montreal, Montreal, Quebec (Canada); Salerno, Kilian [Department of Radiation Oncology, Roswell Park Cancer Institute, Buffalo, New York (United States); Deville, Curtiland [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Sidney Kimmel Cancer Center, Washington, DC (United States); Guadagnolo, B. Ashleigh [Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States); O' Sullivan, Brian [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Petersen, Ivy A. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Le Pechoux, Cecile [Department of Radiotherapy, Institut Gustave-Roussy, Villejuif (France); Abrams, Ross A. [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); DeLaney, Thomas F. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2015-07-01

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

  5. Developing a HACCP-like system for improving animal health and welfare in organic egg production - based on an expert panel analysis

    DEFF Research Database (Denmark)

    Hegelund, Lene; Sørensen, Jan Tind

    2007-01-01

    In the process of developing a generic Hazard Analysis and Critical Control Point (HACCP)-like system for securing animal health and welfare in organic egg production, an expert panel analysis was used to perform the initial hazard analysis. Eighteen advisers and researchers in organic egg...... specific systems. An expert panel analysis based on questionnaires was a useful tool during the first steps of developing a HACCP plan, conducting a hazard analysis and suggesting control points. However, care should be taken regarding the panel's size and fields of expertise in order to assure...... that the panel fully covers the field of interest throughout the study. A further development of the hazard analysis into a farm-specific HACCP system would include assembling an on-farm HACCP team consisting of farmers and advisors for the practical application of control points, alarm values and monitoring...

  6. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America.

    NARCIS (Netherlands)

    Pappas, P.G.; Kauffman, C.A.; Andes, D.; Benjamin Jr., D.K.; Calandra, T; Edwards, J.E.; Filler, S.G.; Fisher, J.F.; Kullberg, B.J.; Ostrosky-Zeichner, L.; Reboli, A.C.; Rex, J.H.; Walsh, T.J.; Sobel, J.D.

    2009-01-01

    Guidelines for the management of patients with invasive candidiasis and mucosal candidiasis were prepared by an Expert Panel of the Infectious Diseases Society of America. These updated guidelines replace the previous guidelines published in the 15 January 2004 issue of Clinical Infectious Diseases

  7. Sensory evaluation of irradiated hake (Merluccius merluccius hubbsi) by an expert trade panel

    International Nuclear Information System (INIS)

    Lescano, G.

    1989-01-01

    Commercial high quality hake (Merluccius merluccius hubbsi) scaled, headless and eviscerated, caught in the South Atlantic Ocean, was analyzed by an expert testing panel. The samples were the following: one lot vacuum packed, another lot previously dipped in 10% sodium poliphosphate, both irradiated with 3.3 kGy and then stored at 0deg C±1deg C, and a third lot, air-packed, frozen, kept at -20deg C±2 deg C, and used as control. The analysis was made on day 36 after catch. The evaluations were performed by a panel of 5 experts in buying fish to export. The following attributes were analyzed: on raw fish: external appearance, muscle elasticity, shine, bone adhesion, muscle cohesion, odor, natural odor, unpleasant odor and purchase acceptability. On oven cooked samples: odor, natural odor, unpleasant odor, flavor, natural flavor, unpleasant flavor, oral texture and general acceptability. Data were analyzed by student test (p ≤ 0.05). The results showed that the raw irradiated fish (with and without dip in polyphosphate) were generally significantly better than the raw frozen hake; and cooked frozen hake was better than the irradiated one but not significantly different. An undesirable off odor on cooked irradiated samples was detected, that would be an irradiation effect. It could be minimized with a lower dose. The polyphosphate dip did not modify the amount of drip loss. (Author) [es

  8. Gold standards and expert panels: a pulmonary nodule case study with challenges and solutions

    Science.gov (United States)

    Miller, Dave P.; O'Shaughnessy, Kathryn F.; Wood, Susan A.; Castellino, Ronald A.

    2004-05-01

    Comparative evaluations of reader performance using different modalities, e.g. CT with computer-aided detection (CAD) vs. CT without CAD, generally require a "truth" definition based on a gold standard. There are many situations in which a true invariant gold standard is impractical or impossible to obtain. For instance, small pulmonary nodules are generally not assessed by biopsy or resection. In such cases, it is common to use a unanimous consensus or majority agreement from an expert panel as a reference standard for actionability in lieu of the unknown gold standard for disease. Nonetheless, there are three major concerns about expert panel reference standards: (1) actionability is not synonymous with disease (2) it may be possible to obtain different conclusions about which modality is better using different rules (e.g. majority vs. unanimous consensus), and (3) the variability associated with the panelists is not formally captured in the p-values or confidence intervals that are generally produced for estimating the extent to which one modality is superior to the other. A multi-reader-multi-case (MRMC) receiver operating characteristic (ROC) study was performed using 90 cases, 15 readers, and a reference truth based on 3 experienced panelists. The primary analyses were conducted using a reference truth of unanimous consensus regarding actionability (3 out of 3 panelists). To assess the three concerns noted above: (1) additional data from the original radiology reports were compared to the panel (2) the complete analysis was repeated using different definitions of truth, and (3) bootstrap analyses were conducted in which new truth panels were constructed by picking 1, 2, or 3 panelists at random. The definition of the reference truth affected the results for each modality (CT with CAD and CT without CAD) considered by itself, but the effects were similar, so the primary analysis comparing the modalities was robust to the choice of the reference truth.

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

    Science.gov (United States)

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

    2014-01-01

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

  10. Recommendations for radioembolisation after liver surgery using yttrium-90 resin microspheres based on a survey of an international expert panel

    International Nuclear Information System (INIS)

    Samim, Morsal; Veenendaal, Linde M. van; Braat, Manon N.G.J.A.; Hoven, Andor F. van den; Bosch, Maurice A.A.J. van den; Lam, Marnix G.E.H.; Hillegersberg, Richard van; Sangro, Bruno; Kao, Yung Hsiang; Liu, Dave; Louie, John D.; Sze, Daniel Y.; Rose, Steven C.; Brown, Daniel B.; Ahmadzadehfar, Hojjat; Kim, Edward

    2017-01-01

    Guidelines on how to adjust activity in patients with a history of liver surgery who are undergoing yttrium-90 radioembolisation ( 90 Y-RE) are lacking. The aim was to study the variability in activity prescription in these patients, between centres with extensive experience using resin microspheres 90 Y-RE, and to draw recommendations on activity prescription based on an expert consensus. The variability in activity prescription between centres was investigated by a survey of international experts in the field of 90 Y-RE. Six representative post-surgical patients (i.e. comparable activity prescription, different outcome) were selected. Information on patients' disease characteristics and data needed for activity calculation was presented to the expert panel. Reported was the used method for activity prescription and whether, how and why activity reduction was found indicated. Ten experts took part in the survey. Recommendations on activity reduction were highly variable between the expert panel. The median intra-patient range was 44 Gy (range 18-55 Gy). Reductions in prescribed activity were recommended in 68% of the cases. In consensus, a maximum D Target of 50 Gy was recommended. With a current lack of guidelines, large variability in activity prescription in post-surgical patients undergoing 90 Y-RE exists. In consensus, D Target ≤50 Gy is recommended. (orig.)

  11. Medical genetic services in Latin America: report of a meeting of experts

    Directory of Open Access Journals (Sweden)

    Penchaszadeh Víctor B

    1998-01-01

    Full Text Available During the Ninth International Congress of Human Genetics which was held in Rio de Janeiro, Brazil, from 16 to 18 August 1996, a group of experts under the coordination of the authors discussed at length the state of medical genetics in Latin America. The facts and ideas presented at the meeting, which was sponsored by the Human Genetics Program of the World Health Organization (WHO and the Maternal and Child Health Program of the Pan American Health Organization, are examined in this document under three broad headings. The first verses on the history and current status of medical genetics in selected Latin American countries. This is followed by a discussion of the general features of medical genetics in the Region and by a final section of recommendations for promoting medical genetics in Latin America.

  12. Government of Canada response to the report of the Expert Review Panel on medical isotope production

    International Nuclear Information System (INIS)

    Paradis, C.

    2010-01-01

    Recent supply disruptions have highlighted the fragility of the supply chain that delivers essential medical isotopes to patients globally. A new and more reliable way of supplying isotopes to Canadians needs to be found. That is why the Government of Canada established the Expert Review Panel on Medical Isotope Production (the Panel) in June 2009. The Government recognizes the relatively long lead times associated with the development of any new source of medical. isotopes. To ensure that appropriate action is taken now for the long term, the Government tasked the Panel with reporting to the Minister. of Natural Resources on its assessment of the most viable options for securing supplies of technetium-99m (Tc99r) for the Canadian health care system over the medium and long term and the actions that may be required by governments and others to facilitate realization of these options. The Panel reported to the Minister of Natural Resources on November 30, 2009. Since then, the Government has been carefully considering the recommendations of the Panel within the context of the broader nuclear and health care landscape. What follows is the Government's response to the Panel's thoughtful, comprehensive and insightful report, including actions that are planned based on its recommendations. (author)

  13. Breaking Bad News: Different Approaches in Different Countries of Iran and Germany- an Expert Panel

    Directory of Open Access Journals (Sweden)

    Carl Eduard Scheidt

    2017-10-01

    Full Text Available In this expert panel report which was held in Isfahan, Iran, the participants were Carl Eduard Scheidt, Alexander Wunsch, Hamid Afshar, Farzad Goli, Azadeh Malekian, Mohammad Reza Sharbafchi, Masoud Ferdosi, Farzad Taslimi, and Mitra Molaeinezhad. Professor Scheidt was the facilitator and coordinator of the discussion. Therefore, he started it with a brief introduction. After all is said and done, he ended the discussion with a conclusion.

  14. Recommendations for radioembolisation after liver surgery using yttrium-90 resin microspheres based on a survey of an international expert panel

    Energy Technology Data Exchange (ETDEWEB)

    Samim, Morsal [University Medical Center Utrecht, Department of Surgery, Utrecht (Netherlands); University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Veenendaal, Linde M. van; Braat, Manon N.G.J.A.; Hoven, Andor F. van den; Bosch, Maurice A.A.J. van den; Lam, Marnix G.E.H. [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Hillegersberg, Richard van [University Medical Center Utrecht, Department of Surgery, Utrecht (Netherlands); Sangro, Bruno [Clinica Universidad de Navarra-IDISNA and CIBEREHD, Liver Unit, Pamplona (Spain); Kao, Yung Hsiang [Cabrini Hospital, Department of Nuclear Medicine, Melbourne (Australia); Liu, Dave [Vancouver General Hospital, University of British Columbia, Department of Radiology, Vancouver, British Columbia (Canada); Louie, John D.; Sze, Daniel Y. [Stanford University Medical Center, Division of Interventional Radiology, Stanford (United States); Rose, Steven C. [University of California, Department of Radiology, San Diego (United States); Brown, Daniel B. [Vanderbilt University, Medical Center North, Department of Radiology, Nashville (United States); Ahmadzadehfar, Hojjat [University Hospital Bonn, Department of Nuclear Medicine, Bonn (Germany); Kim, Edward [Icahn School of Medicine at Mount Sinai, Division of Vascular and Interventional Radiology, New York (United States)

    2017-12-15

    Guidelines on how to adjust activity in patients with a history of liver surgery who are undergoing yttrium-90 radioembolisation ({sup 90}Y-RE) are lacking. The aim was to study the variability in activity prescription in these patients, between centres with extensive experience using resin microspheres {sup 90}Y-RE, and to draw recommendations on activity prescription based on an expert consensus. The variability in activity prescription between centres was investigated by a survey of international experts in the field of {sup 90}Y-RE. Six representative post-surgical patients (i.e. comparable activity prescription, different outcome) were selected. Information on patients' disease characteristics and data needed for activity calculation was presented to the expert panel. Reported was the used method for activity prescription and whether, how and why activity reduction was found indicated. Ten experts took part in the survey. Recommendations on activity reduction were highly variable between the expert panel. The median intra-patient range was 44 Gy (range 18-55 Gy). Reductions in prescribed activity were recommended in 68% of the cases. In consensus, a maximum D{sub Target} of 50 Gy was recommended. With a current lack of guidelines, large variability in activity prescription in post-surgical patients undergoing {sup 90}Y-RE exists. In consensus, D{sub Target} ≤50 Gy is recommended. (orig.)

  15. Implications of the Recommendations of the Expert Panel on Federal Support to Research and Development

    Directory of Open Access Journals (Sweden)

    Preston Manning

    2012-03-01

    Full Text Available Canada lags behind many of its First World counterparts when it comes to business innovation, and urgently needs to improve its performance if it is to remain competitive and attractive to investment. The Expert Panel Report on Federal Support to Research and Development has recommended several policy initiatives that governments need to enact to close the gap. This paper reviews all six major recommendations made by the Expert Panel and provides thorough assessments of each, with ample consideration given to their implications for the private sector. The two most promising are: (1 the consolidation of research and development spending programs at the federal level and (2 the adoption of smart procurement as a means of spurring innovation in the non-government sector. While some of the other recommendations need refinement and raise concerns about their impact on the economy, the message for government and business is clear: the former can and should facilitate Canadian business innovation by removing tax and regulatory burdens and facilitating better public-private cooperation, while the latter must make innovation a major part of corporate culture. This paper explains the consequences of the Panel’s recommendations for both sectors, identifies the deficiencies, and offers clear-eyed guidance for ameliorating them.

  16. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America

    NARCIS (Netherlands)

    Hooton, Thomas M.; Bradley, Suzanne F.; Cardenas, Diana D.; Colgan, Richard; Geerlings, Suzanne E.; Rice, James C.; Saint, Sanjay; Schaeffer, Anthony J.; Tambayh, Paul A.; Tenke, Peter; Nicolle, Lindsay E.

    2010-01-01

    Guidelines for the diagnosis, prevention, and management of persons with catheter-associated urinary tract infection (CA-UTI), both symptomatic and asymptomatic, were prepared by an Expert Panel of the Infectious Diseases Society of America. The evidence-based guidelines encompass diagnostic

  17. Expert Cold Structure Development

    Science.gov (United States)

    Atkins, T.; Demuysere, P.

    2011-05-01

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

  18. Comprehensive embryo testing. Experts' opinions regarding future directions: an expert panel study on comprehensive embryo testing.

    Science.gov (United States)

    Hens, Kristien; Dondorp, Wybo J; Geraedts, Joep P M; de Wert, Guido M

    2013-05-01

    What do scientists in the field of preimplantation genetic diagnosis (PGD) and preimplantation genetic screening (PGS) consider to be the future direction of comprehensive embryo testing? Although there are many biological and technical limitations, as well as uncertainties regarding the meaning of genetic variation, comprehensive embryo testing will impact the IVF/PGD practice and a timely ethical reflection is needed. Comprehensive testing using microarrays is currently being introduced in the context of PGD and PGS, and it is to be expected that whole-genome sequencing will also follow. Current ethical and empirical sociological research on embryo testing focuses on PGD as it is practiced now. However, empirical research and systematic reflection regarding the impact of comprehensive techniques for embryo testing is missing. In order to understand the potential of this technology and to be able to adequately foresee its implications, we held an expert panel with seven pioneers in PGD. We conducted an expert panel in October 2011 with seven PGD pioneers from Belgium, The Netherlands, Germany and the UK. Participants expected the use of comprehensive techniques in the context of PGD. However, the introduction of these techniques in embryo testing requires timely ethical reflection as it involves a shift from choosing an embryo without a particular genetic disease (i.e. PGD) or most likely to result in a successful pregnancy (i.e. PGS) to choosing the best embryo based on a much wider set of criteria. Such ethical reflection should take account of current technical and biological limitations and also of current uncertainties with regard to the meaning of genetic variance. However, ethicists should also not be afraid to look into the future. There was a general agreement that embryo testing will be increasingly preceded by comprehensive preconception screening, thus enabling smart combinations of genetic testing. The group was composed of seven participants from

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

    Science.gov (United States)

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

    2010-01-01

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

  20. Indonesian dengue burden estimates: review of evidence by an expert panel.

    Science.gov (United States)

    Wahyono, T Y M; Nealon, J; Beucher, S; Prayitno, A; Moureau, A; Nawawi, S; Thabrany, H; Nadjib, M

    2017-08-01

    Routine, passive surveillance systems tend to underestimate the burden of communicable diseases such as dengue. When empirical methods are unavailable, complimentary opinion-based or extrapolative methods have been employed. Here, an expert Delphi panel estimated the proportion of dengue captured by the Indonesian surveillance system, and associated health system parameters. Following presentation of medical and epidemiological data and subsequent discussions, the panel made iterative estimates from which expansion factors (EF), the ratio of total:reported cases, were calculated. Panelists estimated that of all symptomatic Indonesian dengue episodes, 57·8% (95% confidence interval (CI) 46·6-59·8) enter healthcare facilities to seek treatment; 39·3% (95% CI 32·8-42·0) are diagnosed as dengue; and 20·3% (95% CI 16·1-24·3) are subsequently reported in the surveillance system. They estimated most hospitalizations occur in the public sector, while ~55% of ambulatory episodes are seen privately. These estimates gave an overall EF of 5·00; hospitalized EF of 1·66; and ambulatory EF of 34·01 which, when combined with passive surveillance data, equates to an annual average (2006-2015) of 612 005 dengue cases, and 183 297 hospitalizations. These estimates are lower than those published elsewhere, perhaps due to case definitions, local clinical perceptions and treatment-seeking behavior. These findings complement global burden estimates, support health economic analyses, and can be used to inform decision-making.

  1. Creation and Implementation of an Outpatient Pathway for Atrial Fibrillation in the Emergency Department Setting: Results of an Expert Panel.

    Science.gov (United States)

    Baugh, Christopher W; Clark, Carol L; Wilson, Jason W; Stiell, Ian G; Kocheril, Abraham G; Luck, Krista K; Myers, Troy D; Pollack, Charles V; Roumpf, Steven K; Tomassoni, Gery F; Williams, James M; Patel, Brian B; Wu, Fred; Pines, Jesse M

    2018-03-10

    Atrial fibrillation and flutter (AF) is a common condition among emergency department (ED) patients in the United States. Traditionally, ED care for primary complaints related to AF focus on rate control, and patients are often admitted to an inpatient setting for further care. Inpatient care may include further telemetry monitoring and diagnostic testing, rhythm control, a search for identification of AF etiology, and stroke prophylaxis. However, many patients are eligible for safe and effective outpatient management pathways. They are widely used in Canada and other countries but less widely adopted in the United States. In this project, we convened an expert panel to create a practical framework for the process of creating, implementing, and maintaining an outpatient AF pathway for emergency physicians to assess and treat AF patients, safely reduce hospitalization rates, ensure appropriate stroke prophylaxis, and effectively transition patients to longitudinal outpatient treatment settings from the ED and/or observation unit. To support local pathway creation, the panel also reached agreement on a protocol development plan, a sample pathway, consensus recommendations for pathway components, sample pathway metrics, and a structured literature review framework using a modified Delphi technique by a technical expert panel of emergency medicine, cardiology, and other stakeholder groups. © 2018 by the Society for Academic Emergency Medicine.

  2. Risk management and post-marketing surveillance for the abuse of medications acting on the central nervous system: expert panel report.

    Science.gov (United States)

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

    2009-12-01

    The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and 11 recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized.

  3. Patient engagement with surgical site infection prevention: an expert panel perspective

    Directory of Open Access Journals (Sweden)

    E. Tartari

    2017-05-01

    Full Text Available Abstract Despite remarkable developments in the use of surgical techniques, ergonomic advancements in the operating room, and implementation of bundles, surgical site infections (SSIs remain a substantial burden, associated with increased morbidity, mortality and healthcare costs. National and international recommendations to prevent SSIs have been published, including recent guidelines by the World Health Organization, but implementation into clinical practice remains an unresolved issue. SSI improvement programs require an integrative approach with measures taken during the pre-, intra- and postoperative care from the numerous stakeholders involved. The current SSI prevention strategies have focused mainly on the role of healthcare workers (HCWs and procedure related risk factors. The importance and influence of patient participation is becoming an increasingly important concept and advocated as a means to improve patient safety. Novel interventions supporting an active participative role within SSI prevention programs have not been assessed. Empowering patients with information they require to engage in the process of SSI prevention could play a major role for the implementation of recommendations. Based on available scientific evidence, a panel of experts evaluated options for patient involvement in order to provide pragmatic recommendations for pre-, intra- and postoperative activities for the prevention of SSIs. Recommendations were based on existing guidelines and expert opinion. As a result, 9 recommendations for the surgical patient are presented here, including a practice brief in the form of a patient information leaflet. HCWs can use this information to educate patients and allow patient engagement.

  4. Patient engagement with surgical site infection prevention: an expert panel perspective.

    Science.gov (United States)

    Tartari, E; Weterings, V; Gastmeier, P; Rodríguez Baño, J; Widmer, A; Kluytmans, J; Voss, A

    2017-01-01

    Despite remarkable developments in the use of surgical techniques, ergonomic advancements in the operating room, and implementation of bundles, surgical site infections (SSIs) remain a substantial burden, associated with increased morbidity, mortality and healthcare costs. National and international recommendations to prevent SSIs have been published, including recent guidelines by the World Health Organization, but implementation into clinical practice remains an unresolved issue. SSI improvement programs require an integrative approach with measures taken during the pre-, intra- and postoperative care from the numerous stakeholders involved. The current SSI prevention strategies have focused mainly on the role of healthcare workers (HCWs) and procedure related risk factors. The importance and influence of patient participation is becoming an increasingly important concept and advocated as a means to improve patient safety. Novel interventions supporting an active participative role within SSI prevention programs have not been assessed. Empowering patients with information they require to engage in the process of SSI prevention could play a major role for the implementation of recommendations. Based on available scientific evidence, a panel of experts evaluated options for patient involvement in order to provide pragmatic recommendations for pre-, intra- and postoperative activities for the prevention of SSIs. Recommendations were based on existing guidelines and expert opinion. As a result, 9 recommendations for the surgical patient are presented here, including a practice brief in the form of a patient information leaflet. HCWs can use this information to educate patients and allow patient engagement.

  5. Establishing research priorities for patient safety in emergency medicine: a multidisciplinary consensus panel.

    Science.gov (United States)

    Plint, Amy C; Stang, Antonia S; Calder, Lisa A

    2015-01-01

    Patient safety in the context of emergency medicine is a relatively new field of study. To date, no broad research agenda for patient safety in emergency medicine has been established. The objective of this study was to establish patient safety-related research priorities for emergency medicine. These priorities would provide a foundation for high-quality research, important direction to both researchers and health-care funders, and an essential step in improving health-care safety and patient outcomes in the high-risk emergency department (ED) setting. A four-phase consensus procedure with a multidisciplinary expert panel was organized to identify, assess, and agree on research priorities for patient safety in emergency medicine. The 19-member panel consisted of clinicians, administrators, and researchers from adult and pediatric emergency medicine, patient safety, pharmacy, and mental health; as well as representatives from patient safety organizations. In phase 1, we developed an initial list of potential research priorities by electronically surveying a purposeful and convenience sample of patient safety experts, ED clinicians, administrators, and researchers from across North America using contact lists from multiple organizations. We used simple content analysis to remove duplication and categorize the research priorities identified by survey respondents. Our expert panel reached consensus on a final list of research priorities through an in-person meeting (phase 3) and two rounds of a modified Delphi process (phases 2 and 4). After phases 1 and 2, 66 unique research priorities were identified for expert panel review. At the end of phase 4, consensus was reached for 15 research priorities. These priorities represent four themes: (1) methods to identify patient safety issues (five priorities), (2) understanding human and environmental factors related to patient safety (four priorities), (3) the patient perspective (one priority), and (4) interventions for

  6. Exploring the role and function of trial steering committees: results of an expert panel meeting.

    Science.gov (United States)

    Harman, Nicola L; Conroy, Elizabeth J; Lewis, Steff C; Murray, Gordon; Norrie, John; Sydes, Matt R; Lane, J Athene; Altman, Douglas G; Baigent, Colin; Bliss, Judith M; Campbell, Marion K; Elbourne, Diana; Evans, Stephen; Sandercock, Peter; Gamble, Carrol

    2015-12-30

    The independent oversight of clinical trials, which is recommended by the Medical Research Council (MRC) Guidelines for Good Clinical Practice, is typically provided by an independent advisory Data Monitoring Committee (DMC) and an independent executive committee, to whom the DMC makes recommendations. The detailed roles and function of this executive committee, known as the Trial Steering Committee (TSC), have not previously been studied or reviewed since those originally proposed by the MRC in 1998. An expert panel (n = 7) was convened comprising statisticians, clinicians and trial methodologists with prior TSC experience. Twelve questions about the role and responsibilities of the TSC were discussed by the panel at two full-day meetings. Each meeting was transcribed in full and the discussions were summarised. The expert panel reached agreement on the role of the TSC, to which it was accountable, the membership, the definition of independence, and the experience and training needed. The management of ethical issues, difficult/complex situations and issues the TSC should not ask the DMC to make recommendations on were more difficult to discuss without specific examples, but support existed for further work to help share issues and to provide appropriate training for TSC members. Additional topics discussed, which had not been identified by previous work relating to the DMCs but were pertinent to the role of the TSC, included the following: review of data sharing requests, indemnity, lifespan of the TSC, general TSC administration, and the roles of both the Funder and the Sponsor. This paper presents recommendations that will contribute to the revision and update of the MRC TSC terms of reference. Uncertainty remains in some areas due to the absence of real-life examples; future guidance on these issues would benefit from a repository of case studies. Notably, the role of a patient and public involvement (PPI) contributor was not discussed, and further work is

  7. Leveraging geospatial data, technology, and methods for improving the health of communities: priorities and strategies from an expert panel convened by the CDC.

    Science.gov (United States)

    Elmore, Kim; Flanagan, Barry; Jones, Nicholas F; Heitgerd, Janet L

    2010-04-01

    In 2008, CDC convened an expert panel to gather input on the use of geospatial science in surveillance, research and program activities focused on CDC's Healthy Communities Goal. The panel suggested six priorities: spatially enable and strengthen public health surveillance infrastructure; develop metrics for geospatial categorization of community health and health inequity; evaluate the feasibility and validity of standard metrics of community health and health inequities; support and develop GIScience and geospatial analysis; provide geospatial capacity building, training and education; and, engage non-traditional partners. Following the meeting, the strategies and action items suggested by the expert panel were reviewed by a CDC subcommittee to determine priorities relative to ongoing CDC geospatial activities, recognizing that many activities may need to occur either in parallel, or occur multiple times across phases. Phase A of the action items centers on developing leadership support. Phase B focuses on developing internal and external capacity in both physical (e.g., software and hardware) and intellectual infrastructure. Phase C of the action items plan concerns the development and integration of geospatial methods. In summary, the panel members provided critical input to the development of CDC's strategic thinking on integrating geospatial methods and research issues across program efforts in support of its Healthy Communities Goal.

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

    Science.gov (United States)

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

    2015-04-01

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

  9. Identification and management of comorbidity in psoriatic arthritis: evidence- and expert-based recommendations from a multidisciplinary panel from Spain.

    Science.gov (United States)

    Torre-Alonso, Juan Carlos; Carmona, Loreto; Moreno, Mireia; Galíndez, Eva; Babío, Jesús; Zarco, Pedro; Linares, Luis; Collantes-Estevez, Eduardo; Barrial, Manuel Fernández; Hermosa, Juan Carlos; Coto, Pablo; Suárez, Carmen; Almodóvar, Raquel; Luelmo, Jesús; Castañeda, Santos; Gratacós, Jordi

    2017-08-01

    The objective is to establish recommendations, based on evidence and expert opinion, for the identification and management of comorbidities in patients with psoriatic arthritis (PsA). The following techniques were applied: discussion group, systematic review, and Delphi survey for agreement. A panel of professionals from four specialties defined the users, the sections of the document, possible recommendations, and what systematic reviews should be performed. A second discussion was held with the results of the systematic reviews. Recommendations were formulated in the second meeting and voted online from 1 (total disagreement) to 10 (total agreement). Agreement was considered if at least 70% voted ≥7. The level of evidence and grade of recommendation were assigned using the Oxford Centre for Evidence-Based Medicine guidance. The full document was critically appraised by the experts, and the project was supervised at all times by a methodologist. In a final step, the document was reviewed and commented by a patient and a health management specialist. Fourteen recommendations were produced, together with a checklist to facilitate the implementation. The items with the largest support from evidence were those related to cardiovascular disease and risk factors. The panel recommends paying special attention to obesity, smoking, and alcohol consumption, as they are all modifiable factors with an impact on treatment response or complications of PsA. Psychological and organizational aspects were also deemed important. We herein suggest practical recommendations for the management of comorbidities in PsA based on evidence and expert opinion.

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

    Science.gov (United States)

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

    2011-01-01

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

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

    DEFF Research Database (Denmark)

    Aspinall, W. P.; Cooke, R. M.; Havelaar, A. H.

    2016-01-01

    . This paper presents new findings from a large-scale international SEJ study intended to estimate the global burden of foodborne disease on behalf of WHO. The study involved 72 experts distributed over 134 expert panels, with panels comprising thirteen experts on average. Elicitations were conducted in five...... languages. Performance-based weighted solutions for target questions of interest were formed for each panel. These weights were based on individual expert's statistical accuracy and informativeness, determined using between ten and fifteen calibration variables from the experts' field with known values...

  12. An expert panel approach to assessing potential effects of bull trout reintroduction on federally listed salmonids in the Clackamas River, Oregon

    Science.gov (United States)

    Bruce G. Marcot; Chris S. Allen; Steve Morey; Dan Shively; Rollie. White

    2012-01-01

    The bull trout Salvelinus confluentus is an apex predator in native fish communities in the western USA and is listed as threatened under the U.S. Endangered Species Act (ESA). Restoration of this species has raised concerns over its potential predatory impacts on native fish fauna. We held a five-person expert panel to help determine potential...

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

    Science.gov (United States)

    Vandevijvere, Stefanie; Dominick, Clare; Devi, Anandita; Swinburn, Boyd

    2015-05-01

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

  14. Cognitive and Physical Demands of Activities of Daily Living in Older Adults: Validation of Expert Panel Ratings.

    Science.gov (United States)

    Fong, Tamara G; Gleason, Lauren J; Wong, Bonnie; Habtemariam, Daniel; Jones, Richard N; Schmitt, Eva M; de Rooij, Sophia E; Saczynski, Jane S; Gross, Alden L; Bean, Jonathan F; Brown, Cynthia J; Fick, Donna M; Gruber-Baldini, Ann L; O'Connor, Margaret; Tabloski, Patrica A; Marcantonio, Edward R; Inouye, Sharon K

    2015-07-01

    Difficulties with performance of functional activities may result from cognitive and/or physical impairments. To date, there has not been a clear delineation of the physical and cognitive demands of activities of daily living. To quantify the relative physical and cognitive demands required to complete typical functional activities in older adults. Expert panel survey. Web-based platform. Eleven experts from 8 academic medical centers and 300 community-dwelling elderly adults age 70 and older scheduled for elective noncardiac surgery from 2 academic medical centers. Sum scores of expert ratings were calculated and then validated against objective data collected from a prospective longitudinal study. Correlation between expert ratings and objective neuropsychologic tests (memory, language, complex attention) and physical measures (gait speed and grip strength) for performance-based tasks. Managing money, self-administering medications, using the telephone, and preparing meals were rated as requiring significantly more cognitive demand, whereas walking and transferring, moderately strenuous activities, and climbing stairs were assessed as more physically demanding. Largely cognitive activities correlated with objective neuropsychologic performance (r = 0.13-0.23, P cognitive and/or physical demand for completing a specific task adds an additional dimension to standard measures of functional assessment. This additional information may significantly influence decisions about rehabilitation, postacute care needs, treatment plans, and caregiver education. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  15. Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel.

    Science.gov (United States)

    Döhner, Hartmut; Estey, Elihu; Grimwade, David; Amadori, Sergio; Appelbaum, Frederick R; Büchner, Thomas; Dombret, Hervé; Ebert, Benjamin L; Fenaux, Pierre; Larson, Richard A; Levine, Ross L; Lo-Coco, Francesco; Naoe, Tomoki; Niederwieser, Dietger; Ossenkoppele, Gert J; Sanz, Miguel; Sierra, Jorge; Tallman, Martin S; Tien, Hwei-Fang; Wei, Andrew H; Löwenberg, Bob; Bloomfield, Clara D

    2017-01-26

    The first edition of the European LeukemiaNet (ELN) recommendations for diagnosis and management of acute myeloid leukemia (AML) in adults, published in 2010, has found broad acceptance by physicians and investigators caring for patients with AML. Recent advances, for example, in the discovery of the genomic landscape of the disease, in the development of assays for genetic testing and for detecting minimal residual disease (MRD), as well as in the development of novel antileukemic agents, prompted an international panel to provide updated evidence- and expert opinion-based recommendations. The recommendations include a revised version of the ELN genetic categories, a proposal for a response category based on MRD status, and criteria for progressive disease. © 2017 by The American Society of Hematology.

  16. The role of tramadol in pain management in Latin America: a report by the Change Pain Latin America Advisory Panel.

    Science.gov (United States)

    Santos Garcia, Joäo Batista; Lech, Osvandré; Campos Kraychete, Durval; Rico, María Antonieta; Hernández-Castro, John Jairo; Colimon, Frantz; Guerrero, Carlos; Sempértegui Gallegos, Manuel; Lara-Solares, Argelia; Flores Cantisani, José Alberto; Amescua-Garcia, César; Guillén Núñez, María Del Rocío; Berenguel Cook, María Del Rosario; Jreige Iskandar, Aziza; Bonilla Sierra, Patricia

    2017-09-01

    Change Pain Latin America (CPLA) was created to enhance chronic pain understanding and develop pain management improving strategies in this region. During its seventh meeting (August 2016), the main objective was to discuss tramadol's role in treating pain in Latin America. Furthermore, potential pain management consequences were considered, if tramadol was to become more stringently controlled. Key topics discussed were: main indications for prescribing tramadol, its pharmacological characteristics, safety and tolerability, effects of restrictions on its availability and use, and consequent impact on pain care quality. The experts agreed that tramadol is used to treat a wide spectrum of non-oncological pain conditions (e.g. post-surgical, musculoskeletal, post-traumatic, neuropathic, fibromyalgia), as well as cancer pain. Its relevance when treating special patient groups (e.g. the elderly) is recognized. The main reasons for tramadol's high significance as a treatment option are: its broad efficacy, an inconspicuous safety profile and its availability, considering that access to strong analgesics - mainly controlled drugs (classical opioids) - is highly restricted in some countries. The CPLA also agreed that tramadol is well tolerated, without the safety issues associated with long-term nonsteroidal anti-inflammatory drug (NSAID) use, with fewer opioid-like side effects than classical opioids and lower abuse risk. In Latin America, tramadol is a valuable and frequently used medication for treating moderate to severe pain. More stringent regulations would have significant impact on its availability, especially for outpatients. This could cause regression to older and frequently inadequate pain management methods, resulting in unnecessary suffering for many Latin American patients.

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

    Science.gov (United States)

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

    2009-01-01

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

  18. Improved inter-observer agreement of an expert review panel in an oncology treatment trial--Insights from a structured interventional process.

    Science.gov (United States)

    Nestle, Ursula; Rischke, Hans Christian; Eschmann, Susanne Martina; Holl, Gabriele; Tosch, Marco; Miederer, Matthias; Plotkin, Michail; Essler, Markus; Puskas, Cornelia; Schimek-Jasch, Tanja; Duncker-Rohr, Viola; Rühl, Friederike; Leifert, Anja; Mix, Michael; Grosu, Anca-Ligia; König, Jochem; Vach, Werner

    2015-11-01

    Oncologic imaging is a key for successful cancer treatment. While the quality assurance (QA) of image acquisition protocols has already been focussed, QA of reading and reporting offers still room for improvement. The latter was addressed in the context of a prospective multicentre trial on fluoro-deoxyglucose (FDG)-positron-emission tomography (PET)/CT-based chemoradiotherapy for locally advanced non-small cell lung cancer (NSCLC). An expert panel was prospectively installed performing blinded reviews of mediastinal NSCLC involvement in FDG-PET/CT. Due to a high initial reporting inter-observer disagreement, the independent data monitoring committee (IDMC) triggered an interventional harmonisation process, which overall involved 11 experts uttering 6855 blinded diagnostic statements. After assessing the baseline inter-observer agreement (IOA) of a blinded re-review (phase 1), a discussion process led to improved reading criteria (phase 2). Those underwent a validation study (phase 3) and were then implemented into the study routine. After 2 months (phase 4) and 1 year (phase 5), the IOA was reassessed. The initial overall IOA was moderate (kappa 0.52 CT; 0.53 PET). After improvement of reading criteria, the kappa values improved substantially (kappa 0.61 CT; 0.66 PET), which was retained until the late reassessment (kappa 0.71 CT; 0.67 PET). Subjective uncertainty was highly predictive for low IOA. The IOA of an expert panel was significantly improved by a structured interventional harmonisation process which could be a model for future clinical trials. Furthermore, the low IOA in reporting nodal involvement in NSCLC may bear consequences for individual patient care. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Governing by Testing: Circulation, Psychometric Knowledge, Experts and the "Alliance for Progress" in Latin America during the 1960s and 1970s

    Science.gov (United States)

    Alarcón, Cristina

    2015-01-01

    This paper analyzes the activities, members, and effects of an inter-American expert network for the diffusion of psychometric knowledge, specifically of standardized aptitude testing for university admission in Latin America during the 1960s and 1970s. Within the framework of educational transfer studies, the role of international,…

  20. Caring for Our Future: The Content of Prenatal Care. A Report of the Public Health Service Expert Panel on the Content of Prenatal Care.

    Science.gov (United States)

    National Institutes of Health (DHHS), Bethesda, MD.

    This report describes effective approaches for enhancing maternal, infant, and family outcomes based on the scientific and systematic assessment of the content of prenatal care conducted by the Public Health Service's Expert Panel on the Content of Prenatal Care. The range of risks, both medical and psychosocial, that the prenatal care provider…

  1. Poor Agreement Among Expert Witnesses in Bile Duct Injury Malpractice Litigation An Expert Panel Survey

    NARCIS (Netherlands)

    de Reuver, Philip R.; Dijkgraaf, Marcel G. W.; Gevers, Sjef K. M.; Gouma, Dirk J.

    2008-01-01

    Objective: To determine the inter-rater agreement of expert witness testimonies in bile duct injury malpractice litigation. Background Data: Malpractice litigation is an increasing concern in modem surgical practice. As most of the lawyers are not educated in medicine, expert witnesses are asked to

  2. Poor agreement among expert witnesses in bile duct injury malpractice litigation: an expert panel survey.

    NARCIS (Netherlands)

    Reuver, P.R. de; Dijkgraaf, M.G.; Gevers, S.K.; Gouma, D.J.; Bleichrodt, R.P.; Cuesta, M.A.; Erp, W.F. van; Gerritsen, J.; Hesselink, E.J.; Laarhoven, C.J.H.M. van; Lange, J. de; Obertop, H.; Stassen, L.P.; Terpstra, O.T.; Tilanus, H.W.; Vroonhoven, T.J.; Wit, L. de

    2008-01-01

    OBJECTIVE: To determine the inter-rater agreement of expert witness testimonies in bile duct injury malpractice litigation. BACKGROUND DATA: Malpractice litigation is an increasing concern in modern surgical practice. As most of the lawyers are not educated in medicine, expert witnesses are asked to

  3. Heart Failure Society of America

    Science.gov (United States)

    ... MACRA Resource Portal The Heart Failure Society of America, Inc. (HFSA) represents the first organized effort by heart failure experts from the Americas to provide a forum for all those interested ...

  4. Microbiological specifications and testing methods for irradiated food. Report of a panel of experts

    International Nuclear Information System (INIS)

    1970-01-01

    In recent years there has been increased interest in the development of food items processed by means of ionizing radiation, wherever that form of preservation might show advantage over other methods. If this method becomes successful, the various items will be commercially exploited; it would then be convenient to have similar legislation in many countries of the world to control this type of processing and to facilitate international trade. To gather information and suggestions in order to devise legislation on irradiated food, a Joint FAO/IAEA/ WHO Expert Committee on the Technical Basis for Legislation on Irradiated Food was held in Rome on 21-28 April 1964. The Committee's report, 'The technical basis for legislation on irradiated food', was published as FAO Atomic Energy Series No.6 and WHO Technical Series No. 316. The Committee's terms of reference were to consider the available evidence on the effect on food of treatment with ionizing radiation in the context of wholesomeness and safety for consumption. Nutritional aspects were taken into account, but microbiological safety and microbiological methods for irradiated food were excluded since these subjects were believed to be too broad for adequate coverage in the working time available at the meeting. However, realizing the importance of radiation microbiology and the need for guidance in formulating regulations in this field, the committee drafted the following recommendation: 'The methods and standards used to ensure the microbiological safety of the irradiated product should, as a matter of urgency, be subject to review by competent international bodies in order that internationally acceptable methods and standards may be agreed upon'. In response to this recommendation an FAO/IAEA Panel on Microbiological Standards and Testing Methods for Irradiated Food was held in Vienna on 22-26 June 1965, in collaboration with the International Association of Microbiological Societies (IAMS). This was a working

  5. Microbiological specifications and testing methods for irradiated food. Report of a panel of experts

    International Nuclear Information System (INIS)

    1971-01-01

    In recent years there has been increased interest in the development of food items processed by means of ionizing radiation, wherever that form of preservation might show advantage over other methods. If this method becomes successful, the various items will be commercially exploited; it would then be convenient to have similar legislation in many countries of the world to control this type of processing and to facilitate international trade. To gather information and suggestions in order to devise legislation on irradiated food, a Joint FAO/IAEA/ WHO Expert Committee on the Technical Basis for Legislation on Irradiated Food was held in Rome on 21-28 April 1964. The Committee's report, 'The technical basis for legislation on irradiated food', was published as FAO Atomic Energy Series No.6 and WHO Technical Series No. 316. The Committee's terms of reference were to consider the available evidence on the effect on food of treatment with ionizing radiation in the context of wholesomeness and safety for consumption. Nutritional aspects were taken into account, but microbiological safety and microbiological methods for irradiated food were excluded since these subjects were believed to be too broad for adequate coverage in the working time available at the meeting. However, realizing the importance of radiation microbiology and the need for guidance in formulating regulations in this field, the committee drafted the following recommendation: 'The methods and standards used to ensure the microbiological safety of the irradiated product should, as a matter of urgency, be subject to review by competent international bodies in order that internationally acceptable methods and standards may be agreed upon'. In response to this recommendation an FAO/IAEA Panel on Microbiological Standards and Testing Methods for Irradiated Food was held in Vienna on 22-26 June 1965, in collaboration with the International Association of Microbiological Societies (IAMS). This was a working

  6. Microbiological specifications and testing methods for irradiated food. Report of a panel of experts

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1970-04-01

    In recent years there has been increased interest in the development of food items processed by means of ionizing radiation, wherever that form of preservation might show advantage over other methods. If this method becomes successful, the various items will be commercially exploited; it would then be convenient to have similar legislation in many countries of the world to control this type of processing and to facilitate international trade. To gather information and suggestions in order to devise legislation on irradiated food, a Joint FAO/IAEA/ WHO Expert Committee on the Technical Basis for Legislation on Irradiated Food was held in Rome on 21-28 April 1964. The Committee's report, 'The technical basis for legislation on irradiated food', was published as FAO Atomic Energy Series No.6 and WHO Technical Series No. 316. The Committee's terms of reference were to consider the available evidence on the effect on food of treatment with ionizing radiation in the context of wholesomeness and safety for consumption. Nutritional aspects were taken into account, but microbiological safety and microbiological methods for irradiated food were excluded since these subjects were believed to be too broad for adequate coverage in the working time available at the meeting. However, realizing the importance of radiation microbiology and the need for guidance in formulating regulations in this field, the committee drafted the following recommendation: 'The methods and standards used to ensure the microbiological safety of the irradiated product should, as a matter of urgency, be subject to review by competent international bodies in order that internationally acceptable methods and standards may be agreed upon'. In response to this recommendation an FAO/IAEA Panel on Microbiological Standards and Testing Methods for Irradiated Food was held in Vienna on 22-26 June 1965, in collaboration with the International Association of Microbiological Societies (IAMS). This was a working

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

    OpenAIRE

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

    2013-01-01

    Despite the fact that seizures are commonly associated with autism spectrum disorder (ASD), the effectiveness of treatments for seizures has not been well studied in individuals with ASD. This manuscript reviews both traditional and novel treatments for seizures associated with ASD. Studies were selected by systematically searching major electronic databases and by a panel of experts that treat ASD individuals. Only a few anti-epileptic drugs (AEDs) have undergone carefully controlled trials ...

  8. Earthquakes and Tectonics Expert Judgment Elicitation Project

    International Nuclear Information System (INIS)

    Coppersmith, K.J.; Perman, R.C.; Youngs, R.R.

    1993-02-01

    This report summarizes the results of the Earthquakes and Tectonics Expert Judgement Excitation Project sponsored by the Electric Power Research Institute (EPRI). The objectives of this study were two-fold: (1) to demonstrate methods for the excitation of expert judgement, and (2) to quantify the uncertainties associated with earthquake and tectonics issues for use in the EPRI-HLW performance assessment. Specifically, the technical issue considered is the probability of differential fault displacement through the proposed repository at Yucca Mountain, Nevada. For this study, a strategy for quantifying uncertainties was developed that relies on the judgements of multiple experts. A panel of seven geologists and seismologists was assembled to quantify the uncertainties associated with earthquake and tectonics issues for the performance assessment model. A series of technical workshops focusing on these issues were conducted. Finally, each expert was individually interviewed in order to elicit his judgement regarding the technical issues and to provide the technical basis for his assessment. This report summarizes the methodologies used to elicit the judgements of the earthquakes and tectonics experts (termed ''specialists''), and summarizes the technical assessments made by the expert panel

  9. Patient/Family Education for Newly Diagnosed Pediatric Oncology Patients: Consensus Recommendations from a Children’s Oncology Group Expert Panel

    Science.gov (United States)

    Landier, Wendy; Ahern, JoAnn; Barakat, Lamia P.; Bhatia, Smita; Bingen, Kristin M.; Bondurant, Patricia G.; Cohn, Susan L.; Dobrozsi, Sarah K.; Haugen, Maureen; Herring, Ruth Anne; Hooke, Mary C.; Martin, Melissa; Murphy, Kathryn; Newman, Amy R.; Rodgers, Cheryl C.; Ruccione, Kathleen S.; Sullivan, Jeneane; Weiss, Marianne; Withycombe, Janice; Yasui, Lise; Hockenberry, Marilyn

    2016-01-01

    There is a paucity of data to support evidence-based practices in the provision of patient/family education in the context of a new childhood cancer diagnosis. Since the majority of children with cancer are treated on pediatric oncology clinical trials, lack of effective patient/family education has the potential to negatively affect both patient and clinical trial outcomes. The Children’s Oncology Group Nursing Discipline convened an interprofessional expert panel from within and beyond pediatric oncology to review available and emerging evidence and develop expert consensus recommendations regarding harmonization of patient/family education practices for newly diagnosed pediatric oncology patients across institutions. Five broad principles, with associated recommendations, were identified by the panel, including recognition that (1) in pediatric oncology, patient/family education is family-centered; (2) a diagnosis of childhood cancer is overwhelming and the family needs time to process the diagnosis and develop a plan for managing ongoing life demands before they can successfully learn to care for the child; (3) patient/family education should be an interprofessional endeavor with 3 key areas of focus: (a) diagnosis/treatment, (b) psychosocial coping, and (c) care of the child; (4) patient/family education should occur across the continuum of care; and (5) a supportive environment is necessary to optimize learning. Dissemination and implementation of these recommendations will set the stage for future studies that aim to develop evidence to inform best practices, and ultimately to establish the standard of care for effective patient/family education in pediatric oncology. PMID:27385664

  10. Expert Meeting: Optimized Heating Systems Using Condensing Boilers and Baseboard Convectors

    Energy Technology Data Exchange (ETDEWEB)

    Arena, L.

    2013-01-01

    On August 11, 2011, in Denver, CO, a Building America Expert Meeting was held in conjunction with the Building America Residential Energy Efficiency Technical Update Meeting, to review and discuss results and future plans for research to improve the performance of hydronic heating systems using condensing boilers and baseboard convectors. A meeting objective was to provide an opportunity for other Building America teams and industry experts to provide feedback and specific suggestions for the planned research.

  11. Expert panel on additional cross subsidisation. Considering arguments and providing expert opinion

    International Nuclear Information System (INIS)

    Faber, J.; Nelissen, D.; Lowe, S.; Mason, A.

    2007-10-01

    market share on markets where they compete directly with EU based airlines by undercutting fares on these markets, subsidising potential losses on these markets by increased prices on routes at which they do not compete with EU airlines, and thus increase their total profits. As part of the project, a panel of experts will be contacted to provide input to the study. This note elaborates the input that we ask for. But first, it provides an analytical background on the study

  12. Combining NDE and fracture mechanics by artifical intelligence expert systems techniques

    International Nuclear Information System (INIS)

    Mucciardi, A.N.; Riccardella, P.C.

    1986-01-01

    This paper reports on the development of a PC-based expert system for non-destructive evaluation. Software tools from the expert systems subfield of artificial intelligence are being used to combine both NDE and fracture mechanics algorithms into one, unified package. The system incorporates elements of computer-enhanced ultrasonic signal processing, featuring artificial intelligence learning capability, state-of-the-art fracture mechanics analytical tools, and all relevant metallurgical and design data necessary to emulate the decisions of the panel(s) of experts typically involved in generating and dispositioning NDE data

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-01-01

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

  14. Waste disposal experts meet

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1959-01-15

    Problems connected with the disposal into the sea of radioactive wastes from peaceful uses of atomic energy are being examined by a panel of experts, convened by the International Atomic Energy Agency. These experts from eight different countries held a first meeting at IAEA headquarters in Vienna from 4-9 December 1958, under the chairmanship of Dr. Harry Brynielsson, Director General of the Swedish Atomic Energy Company. The countries represented are: Canada, Czechoslovakia, France, Japan, Netherlands, United Kingdom and United States. The group will meet again in 1959. (author)

  15. Building America Expert Meeting. Combustion Safety

    Energy Technology Data Exchange (ETDEWEB)

    Brand, Larry [Partnership for Advanced Residential Retrofit (PARR), Des Plaines, IL (United States)

    2013-03-01

    This is an overview of "The Best Approach to Combustion Safety in a Direct Vent World," held June 28, 2012, in San Antonio, TX. The objective of this Expert Meeting was to identify gaps and barriers that need to be addressed by future research, and to develop data-driven technical recommendations for code updates so that a common approach for combustion safety can be adopted by all members of the building energy efficiency and code communities.

  16. Building America Expert Meeting: Combustion Safety

    Energy Technology Data Exchange (ETDEWEB)

    Brand, L.

    2013-03-01

    This is a meeting overview of 'The Best Approach to Combustion Safety in a Direct Vent World', held June 28, 2012, in San Antonio, Texas. The objective of this Expert Meeting was to identify gaps and barriers that need to be addressed by future research, and to develop data-driven technical recommendations for code updates so that a common approach for combustion safety can be adopted by all members of the building energy efficiency and code communities.

  17. Seismic hazard analysis. Review panel, ground motion panel, and feedback results

    International Nuclear Information System (INIS)

    Bernreuter, D.L.

    1981-10-01

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

  18. Geothermal Technologies Program Blue Ribbon Panel Recommendations

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2011-06-17

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

  19. Validation of consensus panel diagnosis in dementia.

    Science.gov (United States)

    Gabel, Matthew J; Foster, Norman L; Heidebrink, Judith L; Higdon, Roger; Aizenstein, Howard J; Arnold, Steven E; Barbas, Nancy R; Boeve, Bradley F; Burke, James R; Clark, Christopher M; Dekosky, Steven T; Farlow, Martin R; Jagust, William J; Kawas, Claudia H; Koeppe, Robert A; Leverenz, James B; Lipton, Anne M; Peskind, Elaine R; Turner, R Scott; Womack, Kyle B; Zamrini, Edward Y

    2010-12-01

    The clinical diagnosis of dementing diseases largely depends on the subjective interpretation of patient symptoms. Consensus panels are frequently used in research to determine diagnoses when definitive pathologic findings are unavailable. Nevertheless, research on group decision making indicates that many factors can adversely affect panel performance. To determine conditions that improve consensus panel diagnosis. Comparison of neuropathologic diagnoses with individual and consensus panel diagnoses based on clinical scenarios only, fludeoxyglucose F 18 positron emission tomography images only, and scenarios plus images. Expert and trainee individual and consensus panel deliberations using a modified Delphi method in a pilot research study of the diagnostic utility of fludeoxyglucose F 18 positron emission tomography. Forty-five patients with pathologically confirmed Alzheimer disease or frontotemporal dementia. Statistical measures of diagnostic accuracy, agreement, and confidence for individual raters and panelists before and after consensus deliberations. The consensus protocol using trainees and experts surpassed the accuracy of individual expert diagnoses when clinical information elicited diverse judgments. In these situations, consensus was 3.5 times more likely to produce positive rather than negative changes in the accuracy and diagnostic certainty of individual panelists. A rule that forced group consensus was at least as accurate as majority and unanimity rules. Using a modified Delphi protocol to arrive at a consensus diagnosis is a reasonable substitute for pathologic information. This protocol improves diagnostic accuracy and certainty when panelist judgments differ and is easily adapted to other research and clinical settings while avoiding the potential pitfalls of group decision making.

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

    International Nuclear Information System (INIS)

    Kerr, R.A.

    1996-01-01

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

  1. Use of questionnaires and an expert panel to judge the environmental consequences of chemical spills for the development of an environment-accident index.

    Science.gov (United States)

    Andersson, Asa Scott; Stjernström, Olof; Fängmark, Ingrid

    2005-05-01

    Assessing the environmental consequences of a chemical accident is a complex task. To date, the methods used to evaluate the environmental effects of an acute release of a chemical have often been based on measurements of chemical and physical variables deemed to be important, such as the concentration of the chemical. However, a broader strategy is needed to predict the environmental consequences of potential accidents during the planning process. An Environment-Accident Index (EAI), a simple tool based on such a strategy, has been developed to facilitate the consideration of a multitude of influential variables. The objectives of this study were to evaluate whether questionnaire-based expert panel's judgements could provide useful data on the environmental consequences of chemical spills, and an effective basis for further development of the EAI. As expected, the judgements did not agree perfectly, but they do give rough indications of the environmental effects, and highlight consistent trends that should be useful inputs for planning, prevention and decontamination processes. The different accidents were also judged to have caused everything from minor to very major effects in the environment, implying that a wide range of accident scenarios were represented in the material and covered by the EAI. Therefore, questionnaires and expert panel judgements can be used to collect useful data for estimating the likely environmental consequences of chemical accidents and for further development of the EAI.

  2. Panel 5: Microbiology and Immunology Panel

    Science.gov (United States)

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

    2014-01-01

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

  3. Curricula for Media Literacy Education According to International Experts

    Science.gov (United States)

    Fedorov, Alexander; Levitskaya, Anastasia; Camarero, Emma

    2016-01-01

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

  4. Lightweight panel study 2012: Perceptions and usage by North American wood products manufacturers

    Science.gov (United States)

    Urs Buehlmann; Matt Bumgardner; Karl D. Forth

    2012-01-01

    Lightweight panels (panels made of two thin panels on the outside and a lightweight material in the core) can offer enhanced performance, reduced material use, and new design opportunities over traditional types of panels. Opportunities exist for the adoption of lightweight panels by the secondary wood industry in North America, as 62 percent of respondents to a recent...

  5. Environmental Performance of North American Wood Panel Manufacturing

    Science.gov (United States)

    R. Bergman; D. Kaestner; A. Taylor

    2015-01-01

    Manufacturing building products such as wood panels has environmental impacts, including contributions to climate change. This paper is a compilation of four studies quantifying these impacts using the life-cycle assessment (LCA) method on five wood-based panel products made in North America during 2012. LCA is an internationally accepted and standardized method for...

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  7. Comprehensive review of the evidence regarding the effectiveness of community-based primary health care in improving maternal, neonatal and child health: 8. summary and recommendations of the Expert Panel.

    Science.gov (United States)

    Black, Robert E; Taylor, Carl E; Arole, Shobha; Bang, Abhay; Bhutta, Zulfiqar A; Chowdhury, A Mushtaque R; Kirkwood, Betty R; Kureshy, Nazo; Lanata, Claudio F; Phillips, James F; Taylor, Mary; Victora, Cesar G; Zhu, Zonghan; Perry, Henry B

    2017-06-01

    The contributions that community-based primary health care (CBPHC) and engaging with communities as valued partners can make to the improvement of maternal, neonatal and child health (MNCH) is not widely appreciated. This unfortunate reality is one of the reasons why so few priority countries failed to achieve the health-related Millennium Development Goals by 2015. This article provides a summary of a series of articles about the effectiveness of CBPHC in improving MNCH and offers recommendations from an Expert Panel for strengthening CBPHC that were formulated in 2008 and have been updated on the basis of more recent evidence. An Expert Panel convened to guide the review of the effectiveness of community-based primary health care (CBPHC). The Expert Panel met in 2008 in New York City with senior UNICEF staff. In 2016, following the completion of the review, the Panel considered the review's findings and made recommendations. The review consisted of an analysis of 661 unique reports, including 583 peer-reviewed journal articles, 12 books/monographs, 4 book chapters, and 72 reports from the gray literature. The analysis consisted of 700 assessments since 39 were analyzed twice (once for an assessment of improvements in neonatal and/or child health and once for an assessment in maternal health). The Expert Panel recommends that CBPHC should be a priority for strengthening health systems, accelerating progress in achieving universal health coverage, and ending preventable child and maternal deaths. The Panel also recommends that expenditures for CBPHC be monitored against expenditures for primary health care facilities and hospitals and reflect the importance of CBPHC for averting mortality. Governments, government health programs, and NGOs should develop health systems that respect and value communities as full partners and work collaboratively with them in building and strengthening CBPHC programs - through engagement with planning, implementation (including the

  8. TU Delft expert judgment data base

    International Nuclear Information System (INIS)

    Cooke, Roger M.; Goossens, Louis L.H.J.

    2008-01-01

    We review the applications of structured expert judgment uncertainty quantification using the 'classical model' developed at the Delft University of Technology over the last 17 years [Cooke RM. Experts in uncertainty. Oxford: Oxford University Press; 1991; Expert judgment study on atmospheric dispersion and deposition. Report Faculty of Technical Mathematics and Informatics No.01-81, Delft University of Technology; 1991]. These involve 45 expert panels, performed under contract with problem owners who reviewed and approved the results. With a few exceptions, all these applications involved the use of seed variables; that is, variables from the experts' area of expertise for which the true values are available post hoc. Seed variables are used to (1) measure expert performance, (2) enable performance-based weighted combination of experts' distributions, and (3) evaluate and hopefully validate the resulting combination or 'decision maker'. This article reviews the classical model for structured expert judgment and the performance measures, reviews applications, comparing performance-based decision makers with 'equal weight' decision makers, and collects some lessons learned

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

    International Nuclear Information System (INIS)

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

    2016-01-01

    Private wells serving fewer than 25 people are federally unregulated, and their users may be exposed to naturally occurring agents of concern such as arsenic and radionuclides, as well as anthropogenic contaminants. The Centers for Disease Control and Prevention's Clean Water for Health Program works to protect private wells and prevent adverse health outcomes for the roughly 15% of Americans who rely on them. To understand current and emerging challenges to the private drinking water supply, an interdisciplinary expert panel workshop on “Future and Emerging Issues for Private Wells” was organized to inform strategic planning for the Clean Water for Health Program. The panel assessed current conditions of ground water as a source for private wells, identified emerging threats, critical gaps in knowledge, and public health needs, and recommended strategies to guide future activities to ensure the safety of private drinking water wells. These strategies addressed topics of broad interest to the environmental public health community including: development of new methods to support citizen science; addressing contaminant mixtures; expanding capacity for well testing; evaluating treatment technologies; building an evidence base on best practices on well owner outreach and stewardship; and research and data needs. - Highlights: • About 43 million Americans use federally unregulated private wells for drinking water. • Private wells may be contaminated with naturally occurring and man-made chemicals. • Protecting well water requires an “infrastructure for stewardship”. • Recommendations to advance private well protection are offered.

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

    Energy Technology Data Exchange (ETDEWEB)

    Fox, Mary A., E-mail: mfox9@jhu.edu [Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Room 407, Baltimore, MD 21205 (United States); Risk Sciences and Public Policy Institute, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Room 429, Baltimore, MD 21205 (United States); Nachman, Keeve E. [Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Room 407, Baltimore, MD 21205 (United States); Risk Sciences and Public Policy Institute, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Room 429, Baltimore, MD 21205 (United States); Center for a Livable Future, Johns Hopkins University, 615 North Wolfe Street, Room W7010, Baltimore, MD 21205 (United States); Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205 (United States); Anderson, Breeana [Risk Sciences and Public Policy Institute, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Room 429, Baltimore, MD 21205 (United States); Department of Pharmacology and Molecular Sciences, The Johns Hopkins University School of Medicine, 725 North Wolfe Street, Baltimore, MD 21205 (United States); Lam, Juleen [Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Room 407, Baltimore, MD 21205 (United States); Risk Sciences and Public Policy Institute, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Room 429, Baltimore, MD 21205 (United States); University of California at San Francisco, Department of Obstetrics, Gynecology & Reproductive Sciences, Mailstop 0132, 550 16th Street, 7th Floor, San Francisco, CA 94143 (United States); and others

    2016-06-01

    Private wells serving fewer than 25 people are federally unregulated, and their users may be exposed to naturally occurring agents of concern such as arsenic and radionuclides, as well as anthropogenic contaminants. The Centers for Disease Control and Prevention's Clean Water for Health Program works to protect private wells and prevent adverse health outcomes for the roughly 15% of Americans who rely on them. To understand current and emerging challenges to the private drinking water supply, an interdisciplinary expert panel workshop on “Future and Emerging Issues for Private Wells” was organized to inform strategic planning for the Clean Water for Health Program. The panel assessed current conditions of ground water as a source for private wells, identified emerging threats, critical gaps in knowledge, and public health needs, and recommended strategies to guide future activities to ensure the safety of private drinking water wells. These strategies addressed topics of broad interest to the environmental public health community including: development of new methods to support citizen science; addressing contaminant mixtures; expanding capacity for well testing; evaluating treatment technologies; building an evidence base on best practices on well owner outreach and stewardship; and research and data needs. - Highlights: • About 43 million Americans use federally unregulated private wells for drinking water. • Private wells may be contaminated with naturally occurring and man-made chemicals. • Protecting well water requires an “infrastructure for stewardship”. • Recommendations to advance private well protection are offered.

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

    Science.gov (United States)

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

    2010-01-01

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

  12. Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 8. summary and recommendations of the Expert Panel

    Science.gov (United States)

    Black, Robert E; Taylor, Carl E; Arole, Shobha; Bang, Abhay; Bhutta, Zulfiqar A; Chowdhury, A Mushtaque R; Kirkwood, Betty R; Kureshy, Nazo; Lanata, Claudio F; Phillips, James F; Taylor, Mary; Victora, Cesar G; Zhu, Zonghan; Perry, Henry B

    2017-01-01

    Background The contributions that community–based primary health care (CBPHC) and engaging with communities as valued partners can make to the improvement of maternal, neonatal and child health (MNCH) is not widely appreciated. This unfortunate reality is one of the reasons why so few priority countries failed to achieve the health–related Millennium Development Goals by 2015. This article provides a summary of a series of articles about the effectiveness of CBPHC in improving MNCH and offers recommendations from an Expert Panel for strengthening CBPHC that were formulated in 2008 and have been updated on the basis of more recent evidence. Methods An Expert Panel convened to guide the review of the effectiveness of community–based primary health care (CBPHC). The Expert Panel met in 2008 in New York City with senior UNICEF staff. In 2016, following the completion of the review, the Panel considered the review’s findings and made recommendations. The review consisted of an analysis of 661 unique reports, including 583 peer–reviewed journal articles, 12 books/monographs, 4 book chapters, and 72 reports from the gray literature. The analysis consisted of 700 assessments since 39 were analyzed twice (once for an assessment of improvements in neonatal and/or child health and once for an assessment in maternal health). Results The Expert Panel recommends that CBPHC should be a priority for strengthening health systems, accelerating progress in achieving universal health coverage, and ending preventable child and maternal deaths. The Panel also recommends that expenditures for CBPHC be monitored against expenditures for primary health care facilities and hospitals and reflect the importance of CBPHC for averting mortality. Governments, government health programs, and NGOs should develop health systems that respect and value communities as full partners and work collaboratively with them in building and strengthening CBPHC programs – through engagement with

  13. Strategic environmental assessment quality assurance: evaluating and improving the consistency of judgments in assessment panels

    International Nuclear Information System (INIS)

    Noble, Bram F.

    2004-01-01

    Assessment panels and expert judgment are playing increasing roles in the practice of strategic environmental assessment (SEA). Thus, the quality of an SEA decision rests considerably on the quality of the judgments of the assessment panel. However, there exists very little guidance in the SEA literature for practitioners concerning the treatment and integration of expert judgment into SEA decision-making processes. Subsequently, the performance of SEAs based on expert judgment is often less than satisfactory, and quality improvements are required in the SEA process. Based on the lessons learned from strategic- and project-level impact assessment practices, this paper outlines a number of principles concerning the use of assessment panels in SEA decision-making, and attempts to provide some guidance for SEA practitioners in this regard. Particular attention is given to the notion and value of consistency in assessment panel judgments

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

    International Nuclear Information System (INIS)

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

    1984-11-01

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

  15. Latin America: how a region surprised the experts.

    Science.gov (United States)

    De Sherbinin, A

    1993-02-01

    In 1960-1970, family planning specialists and demographers worried that poverty, limited education, Latin machismo, and strong catholic ideals would obstruct family planning efforts to reduce high fertility in Latin America. It had the highest annual population growth rate in the world (2.8%), which would increase the population 2-fold in 25 years. Yet, the UN's 1992 population projection for Latin America and the Caribbean in the year 2000 was about 20% lower than its 1963 projection (just over 500 vs. 638 million). Since life expectancy increased simultaneously from 57 to 68 years, this reduced projection was caused directly by a large decline in fertility from 5.9 to 3. A regression analysis of 11 Latin American and Caribbean countries revealed that differences in the contraceptive prevalence rates accounted for 90% of the variation in the total fertility rate between countries. Thus, contraception played a key role in the fertility decline. The second most significant determinant of fertility decline was an increase in the average age at first marriage from about 20 to 23 years. Induced abortion and breast feeding did not contribute significantly to fertility decline. The major socioeconomic factors responsible for the decline included economic development and urbanization, resulting in improvements in health care, reduced infant and child mortality, and increases in female literacy, education, and labor force participation. Public and private family planning programs also contributed significantly to the decline. They expanded from cities to remote rural areas, thereby increasing access to contraception. By the early 1990s, Brazil, Mexico, and Colombia had among the lowest levels of unmet need (13-24%) in developing countries. Other key factors of fertility decline were political commitment, strong communication efforts, and stress on quality services. Latin America provides hope to other regions where religion and culture promote a large family size.

  16. Technical Aspects of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: CHEST Guideline and Expert Panel Report.

    Science.gov (United States)

    Wahidi, Momen M; Herth, Felix; Yasufuku, Kazuhiro; Shepherd, Ray Wesley; Yarmus, Lonny; Chawla, Mohit; Lamb, Carla; Casey, Kenneth R; Patel, Sheena; Silvestri, Gerard A; Feller-Kopman, David J

    2016-03-01

    Endobronchial ultrasound (EBUS) was introduced in the last decade, enabling real-time guidance of transbronchial needle aspiration (TBNA) of mediastinal and hilar structures and parabronchial lung masses. The many publications produced about EBUS-TBNA have led to a better understanding of the performance characteristics of this procedure. The goal of this document was to examine the current literature on the technical aspects of EBUS-TBNA as they relate to patient, technology, and proceduralist factors to provide evidence-based and expert guidance to clinicians. Rigorous methodology has been applied to provide a trustworthy evidence-based guideline and expert panel report. A group of approved panelists developed key clinical questions by using the PICO (population, intervention, comparator, and outcome) format that addressed specific topics on the technical aspects of EBUS-TBNA. MEDLINE (via PubMed) and the Cochrane Library were systematically searched for relevant literature, which was supplemented by manual searches. References were screened for inclusion, and well-recognized document evaluation tools were used to assess the quality of included studies, to extract meaningful data, and to grade the level of evidence to support each recommendation or suggestion. Our systematic review and critical analysis of the literature on 15 PICO questions related to the technical aspects of EBUS-TBNA resulted in 12 statements: 7 evidence-based graded recommendations and 5 ungraded consensus-based statements. Three questions did not have sufficient evidence to generate a statement. Evidence on the technical aspects of EBUS-TBNA varies in strength but is satisfactory in certain areas to guide clinicians on the best conditions to perform EBUS-guided tissue sampling. Additional research is needed to enhance our knowledge regarding the optimal performance of this effective procedure. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-06-29

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

  18. Royal Society of Canada expert panel report : environmental and health impacts of Canada's oil sands industry

    International Nuclear Information System (INIS)

    Gosselin, P.; Hrudey, S.E.; Naeth, M.A.; Plourde, A.; Therrien, R.; Laval Univ., Quebec City, PQ; Van Der Kraak, G.; Guelph Univ., ON; Xu, Z.

    2010-12-01

    This expert panel report was commissioned by the Royal Society of Canada to provide a comprehensive evidence-based assessment of the environmental and health impacts of Canada's oil sands industry. The report evaluated the feasibility of land reclamation and the impacts of oil sands contaminants on downstream residents. Health impacts on residents living in the Regional Municipality of Wood Buffalo were assessed, and the impacts on regional water supplies were evaluated. Regional water and ground water quantities were examined, and issues related to tailing pond operations and reclamation were examined. Ambient air quality impacts were assessed, as well as potential impacts of the oil sands industry on greenhouse gas (GHG) emissions. The environmental regulatory performance of operators in the industry was also evaluated. A summary of economic and policy issues related to the industry was also provided. The study identified major gaps in the process of assessment, prevention, and mitigation of the health impacts of oil sands exploitation, as as major indirect health impacts linked to past exploitation activities. 672 refs., 11 tabs., 11 figs. 10 appendices.

  19. A review of the carcinogenic potential of glyphosate by four independent expert panels and comparison to the IARC assessment.

    Science.gov (United States)

    Williams, Gary M; Aardema, Marilyn; Acquavella, John; Berry, Sir Colin; Brusick, David; Burns, Michele M; de Camargo, Joao Lauro Viana; Garabrant, David; Greim, Helmut A; Kier, Larry D; Kirkland, David J; Marsh, Gary; Solomon, Keith R; Sorahan, Tom; Roberts, Ashley; Weed, Douglas L

    2016-09-01

    The International Agency for Research on Cancer (IARC) published a monograph in 2015 concluding that glyphosate is "probably carcinogenic to humans" (Group 2A) based on limited evidence in humans and sufficient evidence in experimental animals. It was also concluded that there was strong evidence of genotoxicity and oxidative stress. Four Expert Panels have been convened for the purpose of conducting a detailed critique of the evidence in light of IARC's assessment and to review all relevant information pertaining to glyphosate exposure, animal carcinogenicity, genotoxicity, and epidemiologic studies. Two of the Panels (animal bioassay and genetic toxicology) also provided a critique of the IARC position with respect to conclusions made in these areas. The incidences of neoplasms in the animal bioassays were found not to be associated with glyphosate exposure on the basis that they lacked statistical strength, were inconsistent across studies, lacked dose-response relationships, were not associated with preneoplasia, and/or were not plausible from a mechanistic perspective. The overall weight of evidence from the genetic toxicology data supports a conclusion that glyphosate (including GBFs and AMPA) does not pose a genotoxic hazard and therefore, should not be considered support for the classification of glyphosate as a genotoxic carcinogen. The assessment of the epidemiological data found that the data do not support a causal relationship between glyphosate exposure and non-Hodgkin's lymphoma while the data were judged to be too sparse to assess a potential relationship between glyphosate exposure and multiple myeloma. As a result, following the review of the totality of the evidence, the Panels concluded that the data do not support IARC's conclusion that glyphosate is a "probable human carcinogen" and, consistent with previous regulatory assessments, further concluded that glyphosate is unlikely to pose a carcinogenic risk to humans.

  20. Energy market integration in South America

    International Nuclear Information System (INIS)

    Hammons, T.J.; Franco, N. de; Sbertoli, L.V.; Khelil, C.; Rudnick, H.; Clerici, A.; Longhi, A.

    1997-01-01

    This article is a summary of presentations made during the 1997 Winter Meeting panel session on Power and Natural Gas in Latin America: Towards an Integrated Market. Reregulation and demand for energy resources to support economic growth are driving international natural gas and electricity exchange initiatives. Panelists focused on the gas and electric power industry in Latin America in terms of the: transport of gas or transmission of electricity; energy market integration in the southern cone of South America; and issues on gas use for electricity generation in South America countries. Countries such as Argentina, Bolivia, and Peru will export natural gas to Brazil, Uruguay, Paraguay and Chile, an the energy matrices of these countries will change

  1. Expert advisory services to other countries

    International Nuclear Information System (INIS)

    Orstein, Roberto M.

    1998-01-01

    Argentina has provided expert services in the nuclear field to almost all the countries of Latin America and to many countries of other continents, in the framework of bilateral and multilateral cooperation agreements. A short history of these services is outlined and some statistical data are presented

  2. Use of Internet panels to conduct surveys.

    Science.gov (United States)

    Hays, Ron D; Liu, Honghu; Kapteyn, Arie

    2015-09-01

    The use of Internet panels to collect survey data is increasing because it is cost-effective, enables access to large and diverse samples quickly, takes less time than traditional methods to obtain data for analysis, and the standardization of the data collection process makes studies easy to replicate. A variety of probability-based panels have been created, including Telepanel/CentERpanel, Knowledge Networks (now GFK KnowledgePanel), the American Life Panel, the Longitudinal Internet Studies for the Social Sciences panel, and the Understanding America Study panel. Despite the advantage of having a known denominator (sampling frame), the probability-based Internet panels often have low recruitment participation rates, and some have argued that there is little practical difference between opting out of a probability sample and opting into a nonprobability (convenience) Internet panel. This article provides an overview of both probability-based and convenience panels, discussing potential benefits and cautions for each method, and summarizing the approaches used to weight panel respondents in order to better represent the underlying population. Challenges of using Internet panel data are discussed, including false answers, careless responses, giving the same answer repeatedly, getting multiple surveys from the same respondent, and panelists being members of multiple panels. More is to be learned about Internet panels generally and about Web-based data collection, as well as how to evaluate data collected using mobile devices and social-media platforms.

  3. Expert Study to Select Indicators of the Occurence of Emerging Mycotoxin Hazards

    NARCIS (Netherlands)

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

    2011-01-01

    This article describes a Delphi-based expert judgment study aimed at the selection of indicators to identify the occurrence of emerging mycotoxin hazards related to Fusarium spp. in wheat supply chains. A panel of 29 experts from 12 European countries followed a holistic approach to evaluate the

  4. Expert Meeting Report: Transforming Existing Buildings through New Media - An Idea Exchange

    Energy Technology Data Exchange (ETDEWEB)

    Hunt, Stacy [Building Media and the Building America Retrofit Alliance (BARA), Wilmington, DE (United States)

    2012-05-01

    This report describes results of a Building America expert meeting on September 13, 2011, in Las Vegas, Nevada, hosted by the Building America Retrofit Alliance (BARA). This meeting provided a forum for presentations and discussions on the use of new media to work with remodelers and retrofit projects to improve energy efficiency and deliver research results from the Building America program to remodelers.

  5. Expert Meeting Report: Transforming Existing Buildings through New Media--An Idea Exchange

    Energy Technology Data Exchange (ETDEWEB)

    Hunt, S.

    2012-05-01

    This report describes results of a Building America expert meeting on September 13, 2011, in Las Vegas, Nevada, hosted by the Building America Retrofit Alliance (BARA). This meeting provided a forum for presentations and discussions on the use of new media to work with remodelers and retrofit projects to improve energy efficiency and deliver research results from the Building America program to remodelers.

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

    International Nuclear Information System (INIS)

    Davis, J.D.

    1984-01-01

    The Columbia River Basalts Underlying the Hanford Site in Washington State are being considered as a possible location for a geologic repository for high-level nuclear waste. To investigate the feasibility of a repository at this site, the hydrologic parameters of the site must be evaluated. Among hydrologic parameters of particular interest are the effective porosity of the Cohassett flow top and flow interior and the vertical-to-horizontal hydraulic conductivity, or anisotropy ratio, of the Cohassett flow interior. Site-specific data for these hydrologic parameters are currently inadequate. To obtain credible, auditable, and independently derived estimates of the specified hydrologic parameters for the purpose of preliminary assessment of candidate repository performance, a panel of five nationally recognized hydrologists was assembled. Their expert judgments were quantified during two rounds of Delphi process by means of a probability encoding method developed to estimate the probability distributions of the selected hydrologic variables. 210 refs., 12 figs., 5 tabs

  7. Stability of response characteristics of a Delphi panel: application of bootstrap data expansion

    Directory of Open Access Journals (Sweden)

    Cole Bryan R

    2005-12-01

    Full Text Available Abstract Background Delphi surveys with panels of experts in a particular area of interest have been widely utilized in the fields of clinical medicine, nursing practice, medical education and healthcare services. Despite this wide applicability of the Delphi methodology, there is no clear identification of what constitutes a sufficient number of Delphi survey participants to ensure stability of results. Methods The study analyzed the response characteristics from the first round of a Delphi survey conducted with 23 experts in healthcare quality and patient safety. The panel members had similar training and subject matter understanding of the Malcolm Baldrige Criteria for Performance Excellence in Healthcare. The raw data from the first round sampling, which usually contains the largest diversity of responses, were augmented via bootstrap sampling to obtain computer-generated results for two larger samples obtained by sampling with replacement. Response characteristics (mean, trimmed mean, standard deviation and 95% confidence intervals for 54 survey items were compared for the responses of the 23 actual study participants and two computer-generated samples of 1000 and 2000 resampling iterations. Results The results from this study indicate that the response characteristics of a small expert panel in a well-defined knowledge area are stable in light of augmented sampling. Conclusion Panels of similarly trained experts (who possess a general understanding in the field of interest provide effective and reliable utilization of a small sample from a limited number of experts in a field of study to develop reliable criteria that inform judgment and support effective decision-making.

  8. Construction of a case for expert judgement of uncertainty in early health effects models

    International Nuclear Information System (INIS)

    Grupa, J.

    1997-11-01

    The contribution of ECN to a joint study of the European Commission (EC) and the US Nuclear Regulatory Commission (NRC), in which the uncertainty in risks and consequences of severe accidents at nuclear power plants are evaluated, is described. The procedure used to obtain these uncertainties is called expert judgement. In a formal expert judgement procedure a panel of experts has provided quantitative information about the uncertainty in given observables: a quantity that describes an observation concerning the phenomenon of interest, in this paper the relation between dose and health effects, without information or assumptions about any model describing this phenomenon. The observables are defined in a case structure, a questionnaire provided to all experts. ECN has contributed to the selection of the experts for the early health effects panel, and provided assistance for drafting the case structure for this panel. This paper describes the radiological information provided by ECN and the analyses necessary for constructing the case structure. The deliverables of the expert elicitation are uncertainty distributions of the observables requested in the case structure. The results are intended to be unbiased, i.e. it should be applicable to any model describing the relation between dose and health effects. They will be published by the project team in a joint publication of the NRC and the EC. In this way the resulting uncertainty distributions are available for further work in the joint project and available to a more general public. 2 figs., 4 refs

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

    Science.gov (United States)

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

    2012-05-15

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

  10. Evaluation of Tuberculosis Diagnostics in Children: 1. Proposed Clinical Case Definitions for Classification of Intrathoracic Tuberculosis Disease. Consensus From an Expert Panel

    Science.gov (United States)

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

    2012-01-01

    There is a critical need for improved diagnosis of tuberculosis in children, particularly in young children with intrathoracic disease as this represents the most common type of tuberculosis in children and the greatest diagnostic challenge. There is also a need for standardized clinical case definitions for the evaluation of diagnostics in prospective clinical research studies that include children in whom tuberculosis is suspected but not confirmed by culture of Mycobacterium tuberculosis. A panel representing a wide range of expertise and child tuberculosis research experience aimed to develop standardized clinical research case definitions for intrathoracic tuberculosis in children to enable harmonized evaluation of new tuberculosis diagnostic technologies in pediatric populations. Draft definitions and statements were proposed and circulated widely for feedback. An expert panel then considered each of the proposed definitions and statements relating to clinical definitions. Formal group consensus rules were established and consensus was reached for each statement. The definitions presented in this article are intended for use in clinical research to evaluate diagnostic assays and not for individual patient diagnosis or treatment decisions. A complementary article addresses methodological issues to consider for research of diagnostics in children with suspected tuberculosis. PMID:22448023

  11. [ANALYSIS USING AN EXPERT PANEL OF ACTIVITIES AND COMPETENCIES WHICH NURSING CLINICAL PRACTICE TUTORS IN THE COMUNIDAD AUTÓNOMA DE MADRID SHOULD POSSESS].

    Science.gov (United States)

    Argüello López, María Teresa; Palmar Santos, Ana María; Sellán Soto, Carmen

    2015-01-01

    Although practical training has always been important in Nursing, it has reached a new dimension in the European Higher Education Area. This has involved adapting the syllabus, where one of the new features is considering clinical practice as an independent subject and also including the concept of competence as a result of the students' learning. The figure of the tutor becomes one of the key factors and therefore their activities and competencies must be defined. To enumerate and prioritize, by agreement, the main activities and competences by the tutor of clinical practices in the Comunidad Autónoma de Madrid should posses. METHODOLOGY. Quantitative focus, analysis by group of experts between 2010 and 2013. RESULTS. A total of 510 nurses have participated, 17 panels of experts have met and consensus has been reached on 22 competencies and 12 activities. The description of activities and competencies can be extremely useful for selecting, evaluating and developing nursing clinical practice tutors, becoming a baseline and reducing the subjectivity in the development of tutors according to the new demands of the European Higher Education Area.

  12. Environmental factors and puberty timing: expert panel research needs

    DEFF Research Database (Denmark)

    Louis, G.M. Buck; Jr, L.E. Gray; Marcus, M.

    2008-01-01

    initiatives include (1) etiologic research that focus on environmentally relevant levels of endocrine-disrupting chemicals and body size in relation to normal puberty as well as its variants, (2) exposure assessment of relevant endocrine-disrupting chemicals during critical windows of human development......, body size, and puberty. The panel concluded that available experimental animal and human data support a possible role of endocrine-disrupting chemicals and body size in relation to alterations in pubertal onset and progression in boys and girls. Critical data gaps prioritized for future research...

  13. Energy from gas hydrates - assessing the opportunities and challenges for Canada: report of the expert panel on gas hydrates

    International Nuclear Information System (INIS)

    2008-09-01

    Gas hydrates form when water and natural gas combine at low temperatures and high pressures in regions of permafrost and in marine subseafloor sediments. Estimates suggest that the total amount of natural gas bound in hydrate form may exceed all conventional gas resources, or even the amount of all combined hydrocarbon energy. Gas from gas hydrate could provide a potentially vast new source of energy to offset declining supplies of conventional natural gas in North America and to provide greater energy security for countries such as Japan and India that have limited domestic sources. However, complex issues would need to be addressed if gas hydrate were to become a large part of the energy future of Canada. Natural Resources Canada asked the Council of Canadian Academies to assemble a panel of experts to examine the challenges for an acceptable operational extraction of gas hydrates in Canada. This report presented an overview of relevant contextual background, including some basic science; the medium-term outlook for supply and demand in markets for natural gas; broad environmental issues related to gas hydrate in its natural state and as a fuel; and an overview of Canada's contribution to knowledge about gas hydrate in the context of ongoing international research activity. The report also presented current information on the subject and what would be required to delineate and quantify the resource. Techniques for extracting gas from gas hydrate were also outlined. The report also addressed safety issues related to gas hydrate dissociation during drilling operations or release into the atmosphere; the environmental issues associated with potential leakage of methane into the atmosphere and with the large volumes of water produced during gas hydrate dissociation; and jurisdictional and local community issues that would need to be resolved in order to proceed with the commercial exploitation of gas hydrate. It was concluded that there does not appear to be

  14. Expert Consensus Contouring Guidelines for Intensity Modulated Radiation Therapy in Esophageal and Gastroesophageal Junction Cancer

    International Nuclear Information System (INIS)

    Wu, Abraham J.; Bosch, Walter R.; Chang, Daniel T.; Hong, Theodore S.; Jabbour, Salma K.; Kleinberg, Lawrence R.; Mamon, Harvey J.; Thomas, Charles R.; Goodman, Karyn A.

    2015-01-01

    Purpose/Objective(s): Current guidelines for esophageal cancer contouring are derived from traditional 2-dimensional fields based on bony landmarks, and they do not provide sufficient anatomic detail to ensure consistent contouring for more conformal radiation therapy techniques such as intensity modulated radiation therapy (IMRT). Therefore, we convened an expert panel with the specific aim to derive contouring guidelines and generate an atlas for the clinical target volume (CTV) in esophageal or gastroesophageal junction (GEJ) cancer. Methods and Materials: Eight expert academically based gastrointestinal radiation oncologists participated. Three sample cases were chosen: a GEJ cancer, a distal esophageal cancer, and a mid-upper esophageal cancer. Uniform computed tomographic (CT) simulation datasets and accompanying diagnostic positron emission tomographic/CT images were distributed to each expert, and the expert was instructed to generate gross tumor volume (GTV) and CTV contours for each case. All contours were aggregated and subjected to quantitative analysis to assess the degree of concordance between experts and to generate draft consensus contours. The panel then refined these contours to generate the contouring atlas. Results: The κ statistics indicated substantial agreement between panelists for each of the 3 test cases. A consensus CTV atlas was generated for the 3 test cases, each representing common anatomic presentations of esophageal cancer. The panel agreed on guidelines and principles to facilitate the generalizability of the atlas to individual cases. Conclusions: This expert panel successfully reached agreement on contouring guidelines for esophageal and GEJ IMRT and generated a reference CTV atlas. This atlas will serve as a reference for IMRT contours for clinical practice and prospective trial design. Subsequent patterns of failure analyses of clinical datasets using these guidelines may require modification in the future

  15. Panel warns of a crisis in american Physics

    CERN Multimedia

    Overbye, Dennis

    2006-01-01

    "Physics in America is at a crossroads and in crisis, just as humanity stands on the verge of great discoveries about the nature of matter and the universe, a panel from the National Academy of sciences concludes in a new report."

  16. Brain Injury Association of America

    Science.gov (United States)

    ... Only) 1-800-444-6443 Welcome to the Brain Injury Association of America (BIAA) Brain injury is not an event or an outcome. ... misunderstood, under-funded neurological disease. People who sustain brain injuries must have timely access to expert trauma ...

  17. Experience with citizens panels

    International Nuclear Information System (INIS)

    Selwyn, J.

    2002-01-01

    In May 1999, 200 delegates attended a four-day UK Consensus Conference on radioactive waste management, which was organised by the UK Centre for Economic and Environmental Development (UK CEED) and supported by the government, industry and environmental groups. The event brought together a Citizens' Panel of fifteen people, randomly selected to represent a cross section of the British public, together with the major players in the debate. The four-day conference saw the panel cross-examine expert witnesses from organisations such as NIREX, British Nuclear Fuels Limited, the Ministry of Defence, Greenpeace and Friends of the Earth. The findings of their investigations were put together in a report containing detailed recommendations for government and industry and presented to the Minister on the final day. (author)

  18. Social medicine and international expert networks in Latin America, 1930-1945.

    Science.gov (United States)

    Carter, Eric D

    2018-01-03

    This paper examines the international networks that influenced ideas and policy in social medicine in the 1930s and 1940s in Latin America, focusing on institutional networks organised by the League of Nations Health Organization, the International Labour Organization, and the Pan-American Sanitary Bureau. After examining the architecture of these networks, this paper traces their influence on social and health policy in two policy domains: social security and nutrition. Closer scrutiny of a series of international conferences and local media accounts of them reveals that international networks were not just 'conveyor belts' for policy ideas from the industrialised countries of the US and Europe into Latin America; rather, there was often contentious debate over the relevance and appropriateness of health and social policy models in the Latin American context. Recognition of difference between Latin America and the global economic core regions was a key impetus for seeking 'national solutions to national problems' in countries like Argentina and Chile, even as integration into these networks provided progressive doctors, scientists, and other intellectuals important international support for local political reforms.

  19. Current and Emerging Ethical Issues in Counseling: A Delphi Study of Expert Opinions

    Science.gov (United States)

    Herlihy, Barbara; Dufrene, Roxane L.

    2011-01-01

    A Delphi study was conducted to ascertain the opinions of panel experts regarding the most important current and emerging ethical issues facing the counseling profession. Expert opinions on ethical issues in counselor preparation also were sought. Eighteen panelists responded to 3 rounds of data collection interspersed with feedback. Themes that…

  20. The effectiveness of scoliosis screening programs: methods for systematic review and expert panel recommendations formulation

    Science.gov (United States)

    2013-01-01

    Background Literature on scoliosis screening is vast, however because of the observational nature of available data and methodological flaws, data interpretation is often complex, leading to incomplete and sometimes, somewhat misleading conclusions. The need to propose a set of methods for critical appraisal of the literature about scoliosis screening, a comprehensive summary and rating of the available evidence appeared essential. Methods To address these gaps, the study aims were: i) To propose a framework for the assessment of published studies on scoliosis screening effectiveness; ii) To suggest specific questions to be answered on screening effectiveness instead of trying to reach a global position for or against the programs; iii) To contextualize the knowledge through expert panel consultation and meaningful recommendations. The general methodological approach proceeds through the following steps: Elaboration of the conceptual framework; Formulation of the review questions; Identification of the criteria for the review; Selection of the studies; Critical assessment of the studies; Results synthesis; Formulation and grading of recommendations in response to the questions. This plan follows at best GRADE Group (Grades of Recommendation, Assessment, Development and Evaluation) requirements for systematic reviews, assessing quality of evidence and grading the strength of recommendations. Conclusions In this article, the methods developed in support of this work are presented since they may be of some interest for similar reviews in scoliosis and orthopaedic fields. PMID:23883346

  1. Curricular priorities for business ethics in medical practice and research: recommendations from Delphi consensus panels.

    Science.gov (United States)

    DuBois, James M; Kraus, Elena M; Gursahani, Kamal; Mikulec, Anthony; Bakanas, Erin

    2014-11-15

    No published curricula in the area of medical business ethics exist. This is surprising given that physicians wrestle daily with business decisions and that professional associations, the Institute of Medicine, Health and Human Services, Congress, and industry have issued related guidelines over the past 5 years. To fill this gap, the authors aimed (1) to identify the full range of medical business ethics topics that experts consider important to teach, and (2) to establish curricular priorities through expert consensus. In spring 2012, the authors conducted an online Delphi survey with two heterogeneous panels of experts recruited in the United States. One panel focused on business ethics in medical practice (n = 14), and 1 focused on business ethics in medical research (n = 12). Panel 1 generated an initial list of 14 major topics related to business ethics in medical practice, and subsequently rated 6 topics as very important or essential to teach. Panel 2 generated an initial list of 10 major topics related to business ethics in medical research, and subsequently rated 5 as very important or essential. In both domains, the panel strongly recommended addressing problems that conflicts of interest can cause, legal guidelines, and the goals or ideals of the profession. The Bander Center for Medical Business Ethics at Saint Louis University will use the results of the Delphi panel to develop online curricular resources for each of the highest rated topics.

  2. Assistance Focus: Latin America and the Caribbean Region

    Energy Technology Data Exchange (ETDEWEB)

    2017-05-17

    The Clean Energy Solutions Center, an initiative of the Clean Energy Ministerial, helps countries throughout the world create policies and programs that advance the deployment of clean energy technologies. Through the Solutions Center's no-cost Ask an Expert service, a team of international experts has delivered assistance to countries in all regions of the world, including Latin America and the Caribbean.

  3. High-level panel of experts to recommend future course for IAEA

    International Nuclear Information System (INIS)

    2008-01-01

    Full text: A high-level panel of experts, charged by IAEA Director General Mohamed ElBaradei with making an assessment of the challenges the IAEA will face up to the year 2020 and beyond, holds its initial meetings in Vienna 25 - 26 February. The Commission of Eminent Persons, under the chairmanship of former Mexican President, Ernesto Zedillo, includes 18 senior international figures, and will make recommendations on ways in which the Agency can prepare to meet its expanding workload. The Commission's findings are intended to stimulate further discussion - among Member States, between the States and the IAEA Secretariat, and by the broader public - about the future of the Agency and how best it can contribute in the coming years to the efforts of the international community to achieve development, peace and security, said IAEA Director General Mohamed ElBaradei. The members of the Commission are: Dr. Ernesto Zedillo (Chairman) - Director of the Yale Center for the Study of Globalization; former President of Mexico; Ambassador Oluyemi Adeniji - former Minister of Foreign Affairs, Nigeria; former Member of the Board of Governors of the IAEA; Lakhdar Brahimi - Visiting Scholar at the Institute for Advanced Study, Princeton, New Jersey; former UN Under-Secretary-General, Special Adviser to the Secretary-General, and Chair of the Panel on UN Peace Operations; Lajos Bokros - Professor of Economics and Public Policy, and Chief Operating Officer of the Central European University, Budapest, Hungary; Dr. Rajagopala Chidambaram - Principal Scientific Advisor to the Government of India; DAE Homi Bhabha Professor; former Chairman of the Atomic Energy Commission; former Director of the Bhabha Atomic Research Centre; Senator Lamberto Dini - President of the Foreign Affairs Committee of the Italian Senate; Gareth Evans - President and Chief Executive Officer, International Crisis Group, Brussels; former Australian Foreign Minister 1988-1998; former Minister for Resources and

  4. Saturated Zone Flow and Transport Expert Elicitation Project

    Energy Technology Data Exchange (ETDEWEB)

    Coppersmith, Kevin J.; Perman, Roseanne C.

    1998-01-01

    This report presents results of the Saturated Zone Flow and Transport Expert Elicitation (SZEE) project for Yucca Mountain, Nevada. This project was sponsored by the US Department of Energy (DOE) and managed by Geomatrix Consultants, Inc. (Geomatrix), for TRW Environmental Safety Systems, Inc. The DOE's Yucca Mountain Site Characterization Project (referred to as the YMP) is intended to evaluate the suitability of the site for construction of a mined geologic repository for the permanent disposal of spent nuclear fuel and high-level radioactive waste. The SZEE project is one of several that involve the elicitation of experts to characterize the knowledge and uncertainties regarding key inputs to the Yucca Mountain Total System Performance Assessment (TSPA). The objective of the current project was to characterize the uncertainties associated with certain key issues related to the saturated zone system in the Yucca Mountain area and downgradient region. An understanding of saturated zone processes is critical to evaluating the performance of the potential high-level nuclear waste repository at Yucca Mountain. A major goal of the project was to capture the uncertainties involved in assessing the saturated flow processes, including uncertainty in both the models used to represent the physical processes controlling saturated zone flow and transport, and the parameter values used in the models. So that the analysis included a wide range of perspectives, multiple individual judgments were elicited from members of an expert panel. The panel members, who were experts from within and outside the Yucca Mountain project, represented a range of experience and expertise. A deliberate process was followed in facilitating interactions among the experts, in training them to express their uncertainties, and in eliciting their interpretations. The resulting assessments and probability distributions, therefore, provide a reasonable aggregate representation of the knowledge and

  5. Tracheotomy in the intensive care unit: guidelines from a French expert panel.

    Science.gov (United States)

    Trouillet, Jean Louis; Collange, Olivier; Belafia, Fouad; Blot, François; Capellier, Gilles; Cesareo, Eric; Constantin, Jean-Michel; Demoule, Alexandre; Diehl, Jean-Luc; Guinot, Pierre-Grégoire; Jegoux, Franck; L'Her, Erwan; Luyt, Charles-Edouard; Mahjoub, Yazine; Mayaux, Julien; Quintard, Hervé; Ravat, François; Vergez, Sebastien; Amour, Julien; Guillot, Max

    2018-03-15

    Tracheotomy is widely used in intensive care units, albeit with great disparities between medical teams in terms of frequency and modality. Indications and techniques are, however, associated with variable levels of evidence based on inhomogeneous or even contradictory literature. Our aim was to conduct a systematic analysis of the published data in order to provide guidelines. We present herein recommendations for the use of tracheotomy in adult critically ill patients developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. These guidelines were conducted by a group of experts from the French Intensive Care Society (Société de Réanimation de Langue Française) and the French Society of Anesthesia and Intensive Care Medicine (Société Francaise d'Anesthésie Réanimation) with the participation of the French Emergency Medicine Association (Société Française de Médecine d'Urgence), the French Society of Otorhinolaryngology. Sixteen experts and two coordinators agreed to consider questions concerning tracheotomy and its practical implementation. Five topics were defined: indications and contraindications for tracheotomy in intensive care, tracheotomy techniques in intensive care, modalities of tracheotomy in intensive care, management of patients undergoing tracheotomy in intensive care, and decannulation in intensive care. The summary made by the experts and the application of GRADE methodology led to the drawing up of 8 formal guidelines, 10 recommendations, and 3 treatment protocols. Among the 8 formal guidelines, 2 have a high level of proof (Grade 1+/-) and 6 a low level of proof (Grade 2+/-). For the 10 recommendations, GRADE methodology was not applicable and instead 10 expert opinions were produced.

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

    Science.gov (United States)

    Mizuno, Hiroshi; Akutsu, Hidenori; Kato, Kazuto

    2015-01-01

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

  7. [Assessment and training of strength and balance for fall prevention in the elderly: recommendations of an interdisciplinary expert panel].

    Science.gov (United States)

    Granacher, U; Muehlbauer, T; Gschwind, Y J; Pfenninger, B; Kressig, R W

    2014-08-01

    The proportion of elderly people in societies of western industrialized countries is continuously rising. Biologic aging induces deficits in balance and muscle strength/power in old age, which is responsible for an increased prevalence of falls. Therefore, nationwide and easy-to-administer fall prevention programs have to be developed in order to contribute to the autonomy and quality of life in old age and to help reduce the financial burden on the public health care system due to the treatment of fall-related injuries. This narrative (qualitative) literature review deals with a) the reasons for an increased prevalence of falls in old age, b) important clinical tests for fall-risk assessment, and c) evidence-based intervention/training programs for fall prevention in old age. The findings of this literature review are based on a cost-free practice guide that is available to the public (via the internet) and that was created by an expert panel (i.e., geriatricians, exercise scientists, physiotherapists, geriatric therapists). The present review provides the scientific foundation of the practice guide.

  8. Using Expert Panel Data to Guide Youth Agricultural Safety and Health Training Resources in the US

    Directory of Open Access Journals (Sweden)

    Andrew J. Mann

    2017-01-01

    Full Text Available The US Department of Labor (US DOL oversees the Agricultural Hazardous Occupations Orders (AgHOs, which identifies specific tasks that youth are prohibited from performing for hire on American farms and ranches. An educational exemption from this public policy is currently in place that allows youth, 14–15 years old, to complete a certification program prior to engaging in agricultural work involving tractors and machinery. However, limited guidance is provided in the legislation regarding the format or content of the tractor and machinery certification exemption. Four AgHOs (tractor and machinery studies were identified and included in this meta-analysis publication. The research goals of this analysis were to determine basic trends of learning outcomes, and identify educational content to be delivered as a result of these studies. Within each of the four studies, expert panels were used to identify educational learning outcomes. The analysis revealed that 48.0% (n = 184 of all learning outcome items fell within the Tractor-based (Tractor learning outcome category, 29.8% (n = 114 within General Safety and Health (General, and 22.2% (n = 85 of items in the Machinery-based (Machinery category. Ultimately, sound educational methods and understanding of fundamental student competence are essential components for any training program, including youth who complete AgHOs tractor and machinery certification programs.

  9. Pantex Falling Man - Independent Review Panel Report.

    Energy Technology Data Exchange (ETDEWEB)

    Brannon, Nathan Gregory; L. Bertolini, N. Brannon, J. Olsen, B. Price, M. Steinzig, R. Wardle, & M. Winfield

    2014-11-01

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

  10. Expert Recommendations on Treating Psoriasis in Special Circumstances (Part II).

    Science.gov (United States)

    Carrascosa, J M; Galán, M; de Lucas, R; Pérez-Ferriols, A; Ribera, M; Yanguas, I

    2016-11-01

    There is insufficient information on how best to treat moderate to severe psoriasis in difficult clinical circumstances. We considered 5 areas where there is conflicting or insufficient evidence: pediatric psoriasis, risk of infection in patients being treated with biologics, psoriasis in difficult locations, biologic drug survival, and impact of disease on quality of life. Following discussion of the issues by an expert panel of dermatologists specialized in the management of psoriasis, participants answered a questionnaire survey according to the Delphi method. Consensus was reached on 66 (70.9%) of the 93 items analyzed; the experts agreed with 49 statements and disagreed with 17. It was agreed that body mass index, metabolic comorbidities, and quality of life should be monitored in children with psoriasis. The experts also agreed that the most appropriate systemic treatment for this age group was methotrexate, while the most appropriate biologic treatment was etanercept. Although it was recognized that the available evidence was inconsistent and difficult to extrapolate, the panel agreed that biologic drug survival could be increased by flexible, individualized dosing regimens, continuous treatment, and combination therapies. Finally, consensus was reached on using the Dermatology Quality of Life Index to assess treatment effectiveness and aid decision-making in clinical practice. The structured opinion of experts guides decision-making regarding aspects of clinical practice for which there is incomplete or conflicting information. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. NCATE's Blue Ribbon Panel Report and NAPDS: Working Together

    Science.gov (United States)

    Van Scoy, Irma J.

    2012-01-01

    An expert panel including representatives from schools/districts, teacher education, and professional education associations was convened by the National Council for the Accreditation of Teacher Education (NCATE) to make recommendations regarding clinical preparation in teacher education. This article presents an analysis of how the ten design…

  12. Expert views on societal responses to different applications of nanotechnology: a comparative analysis of experts in countries with different economic and regulatory environments

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Nidhi, E-mail: guptanidhi12@gmail.com; Fischer, Arnout R. H., E-mail: arnout.fischer@wur.nl [Wageningen University, Marketing and Consumer Behaviour Group (Netherlands); George, Saji, E-mail: saji_george@nyp.gov.sg [Nanyang Polytechnic, Centre for Sustainable Nanotechnology, School of Chemical and Life Sciences (Singapore); Frewer, Lynn J., E-mail: lynn.frewer@newcastle.ac.uk [Newcastle University, School of Agriculture, Food and Rural Development (United Kingdom)

    2013-08-15

    The introduction of different applications of nanotechnology will be informed by expert views regarding which (types of) application will be most societally acceptable. Previous research in Northern Europe has indicated that experts believe that various factors will be influential, predominant among these being public perceptions of benefit, need and consumer concern about contact with nanomaterials. These factors are thought by experts to differentiate societal acceptance and rejection of nanotechnology applications. This research utilises a larger sample of experts (N = 67) drawn from Northern America, Europe, Australasia, India and Singapore to examine differences in expert opinion regarding societal acceptance of different applications of nanotechnology within different technological environments, consumer cultures and regulatory regimes. Perceived risk and consumer concerns regarding contact with nano-particles are thought by all experts to drive rejection, and perceived benefits to influence acceptance, independent of country. Encapsulation and delivery of nutrients in food was thought to be the most likely to raise societal concerns, while targeted drug delivery was thought most likely to be accepted. Lack of differentiation between countries suggests that expert views regarding social acceptance may be homogenous, independent of local contextual factors.

  13. Expert views on societal responses to different applications of nanotechnology: a comparative analysis of experts in countries with different economic and regulatory environments

    International Nuclear Information System (INIS)

    Gupta, Nidhi; Fischer, Arnout R. H.; George, Saji; Frewer, Lynn J.

    2013-01-01

    The introduction of different applications of nanotechnology will be informed by expert views regarding which (types of) application will be most societally acceptable. Previous research in Northern Europe has indicated that experts believe that various factors will be influential, predominant among these being public perceptions of benefit, need and consumer concern about contact with nanomaterials. These factors are thought by experts to differentiate societal acceptance and rejection of nanotechnology applications. This research utilises a larger sample of experts (N = 67) drawn from Northern America, Europe, Australasia, India and Singapore to examine differences in expert opinion regarding societal acceptance of different applications of nanotechnology within different technological environments, consumer cultures and regulatory regimes. Perceived risk and consumer concerns regarding contact with nano-particles are thought by all experts to drive rejection, and perceived benefits to influence acceptance, independent of country. Encapsulation and delivery of nutrients in food was thought to be the most likely to raise societal concerns, while targeted drug delivery was thought most likely to be accepted. Lack of differentiation between countries suggests that expert views regarding social acceptance may be homogenous, independent of local contextual factors

  14. 75 FR 7469 - Panel Member List for Hydropower Licensing Study Dispute Resolution; Notice Extending Filing Date...

    Science.gov (United States)

    2010-02-19

    ... List for Hydropower Licensing Study Dispute Resolution; Notice Extending Filing Date for Applications for Panel Member List for Hydropower Licensing Study Dispute Resolution February 4, 2010. On October... on a list of resource experts willing to serve as a third panel member in the Commission's hydropower...

  15. 76 FR 33765 - CHIPRA Pediatric Quality Measures Program: Request for Nominations for Expert Panelists

    Science.gov (United States)

    2011-06-09

    ... discrimination on the basis of age, race, ethnicity, gender, sexual orientation, disability, and cultural... women, all ethnic and racial groups, and people with disabilities are represented on expert panels and...

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

    Science.gov (United States)

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

    2010-01-01

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

  17. Sentinel node biopsy for prostate cancer: report from a consensus panel meeting.

    Science.gov (United States)

    van der Poel, Henk G; Wit, Esther M; Acar, Cenk; van den Berg, Nynke S; van Leeuwen, Fijs W B; Valdes Olmos, Renato A; Winter, Alexander; Wawroschek, Friedhelm; Liedberg, Fredrik; Maclennan, Steven; Lam, Thomas

    2017-08-01

    To explore the evidence and knowledge gaps in sentinel node biopsy (SNB) in prostate cancer through a consensus panel of experts. A two-round Delphi survey among experts was followed by a consensus panel meeting of 16 experts in February 2016. Agreement voting was performed using the research and development project/University of California, Los Angeles Appropriateness Methodology on 150 statements in nine domains. The disagreement index based on the interpercentile range, adjusted for symmetry score, was used to assess consensus and non-consensus among panel members. Consensus was obtained on 91 of 150 statements (61%). The main outcomes were: (1) the results from an extended lymph node dissection (eLND) are still considered the 'gold standard', and sentinel node (SN) detection should be combined with eLND, at least in patients with intermediate- and high-risk prostate cancer; (2) the role of SN detection in low-risk prostate cancer is unclear; and (3) future studies should contain oncological endpoints as number of positive nodes outside the eLND template, false-negative and false-positive SN procedures, and recurrence-free survival. A high rate of consensus was obtained regarding outcome measures of future clinical trials on SNB (89%). Consensus on tracer technology was only obtained in 47% of statements, reflecting a need for further research and standardization in this area. The low-level evidence in the available literature and the composition of mainly SNB users in the panel constitute the major limitations of the study. Consensus on a majority of elementary statements on SN detection in prostate cancer was obtained.; therefore, the results from this consensus report will provide a basis for the design of further studies in the field. A group of experts identified evidence and knowledge gaps on SN detection in prostate cancer and its application in daily practice. Information from the consensus statements can be used to direct further studies. © 2017 The

  18. Monitoring and control of microbioreactors: An expert opinion on development needs

    DEFF Research Database (Denmark)

    Gernaey, Krist; Baganz, Frank; Franco-Lara, Ezequiel

    2012-01-01

    This perspective article is based on an expert panel review on microbioreactor applications in biochemical and biomedical engineering that was organized by the M3C (measurement, monitoring, modelling and control) Working Group of the European Section of Biochemical Engineering Science (ESBES......) in the European Federation of Biotechnology (EFB). The aim of the panel was to provide an updated view on the present status of the subject and to identify critical needs and issues for furthering the successful development of microbioreactor monitoring and control. This will benefit future bioprocess development...

  19. The Art of Sharing the Diagnosis and Management of Alzheimer's Disease With Patients and Caregivers: Recommendations of an Expert Consensus Panel

    Science.gov (United States)

    Christensen, Daniel D.; Griffith, Patrick A.; Kerwin, Diana R.; Hunt, Gail; Hall, Eric J.

    2010-01-01

    Objective: To develop a set of recommendations for primary care physicians (PCPs) suggesting how best to communicate with patients, caregivers, and other family members regarding the diagnosis and management of Alzheimer's disease (AD). Participants: A national roundtable of 6 leading professionals involved in treating or advocating for patients with AD was convened on March 14, 2008. This roundtable included 4 leading academic physicians with diverse backgrounds (a geriatric psychiatrist, a neuropsychiatrist, a neurologist, and a geriatrician) from geographically diverse regions of the United States, who were invited on the basis of their national reputation in the field and experience working with minority populations with dementia; the executive director of a national AD advocacy organization; the executive director of a national advocacy organization for caregivers; and a medical correspondent with expertise in interviewing and small group leadership. Evidence: Expert opinion supported by academic literature (search limited to PubMed, English language, 1996–2008, search terms: Alzheimer's disease, primary care, diagnosis, management, caregiver, family, patient-physician relationship). Consensus Process: Moderated dialogue aimed at generating consensus opinion; only statements endorsed by all authors were included in the final article. Conclusions: Diagnosis and management of AD by PCPs, utilizing specialist consultation as needed, may contribute to earlier diagnosis and treatment, improved doctor-patient and doctor-caregiver communication, increased attention to caregiver needs, and better clinical and quality-of-life outcomes for patients and caregivers. A set of expert panel recommendations describing practical strategies for achieving these goals was successfully developed. PMID:20582302

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

    International Nuclear Information System (INIS)

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

    1995-04-01

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

  1. Occupational and Environmental Contributions to Chronic Cough in Adults: Chest Expert Panel Report.

    Science.gov (United States)

    Tarlo, Susan M; Altman, Kenneth W; Oppenheimer, John; Lim, Kaiser; Vertigan, Anne; Prezant, David; Irwin, Richard S

    2016-10-01

    In response to occupational and environmental exposures, cough can be an isolated symptom reflecting exposure to an irritant with little physiological consequence, or it can be a manifestation of more significant disease. This document reviews occupational and environmental contributions to chronic cough in adults, focusing on aspects not previously covered in the 2006 ACCP Cough Guideline or our more recent systematic review, and suggests an approach to investigation of these factors when suspected. MEDLINE and TOXLINE literature searches were supplemented by articles identified by the cough panel occupational and environmental subgroup members, to identify occupational and environmental aspects of chronic cough not previously covered in the 2006 ACCP Cough Guideline. Based on the literature reviews and the Delphi methodology, the cough panel occupational and environmental subgroup developed guideline suggestions that were approved after review and voting by the full cough panel. The literature review identified relevant articles regarding: mechanisms; allergic environmental causes; chronic cough and the recreational and involuntary inhalation of tobacco and marijuana smoke; nonallergic environmental triggers; laryngeal syndromes; and occupational diseases and exposures. Consensus-based statements were developed for the approach to diagnosis due to a lack of strong evidence from published literature. Despite increased understanding of cough related to occupational and environmental triggers, there remains a gap between the recommended assessment of occupational and environmental causes of cough and the reported systematic assessment of these factors. There is a need for further documentation of occupational and environmental causes of cough in the future. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  2. End-of-life decision-making in Canada: the report by the Royal Society of Canada expert panel on end-of-life decision-making.

    Science.gov (United States)

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

    2011-11-01

    This report on end-of-life decision-making in Canada was produced by an international expert panel and commissioned by the Royal Society of Canada. It consists of five chapters. Chapter 1 reviews what is known about end-of-life care and opinions about assisted dying in Canada. Chapter 2 reviews the legal status quo in Canada with regard to various forms of assisted death. Chapter 3 reviews ethical issues pertaining to assisted death. The analysis is grounded in core values central to Canada's constitutional order. Chapter 4 reviews the experiences had in a number of jurisdictions that have decriminalized or recently reviewed assisted dying in some shape or form. Chapter 5 provides recommendations with regard to the provision of palliative care in Canada, as well as recommendations for reform with respect to the various forms of assisted death covered in this document. © 2011 Blackwell Publishing Ltd.

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

    Science.gov (United States)

    Koehler, Derek J

    2016-03-01

    Media critics have expressed concern that journalistic "false balance" can distort the public's perceptions of what ought to be noncontroversial subjects (e.g., climate change). I report several experiments testing the influence of presenting conflicting comments from 2 experts who disagree on an issue (balance condition) in addition to a complete count of the number of experts on a panel who favor either side. Compared with a control condition, who received only the complete count, participants in the balance condition gave ratings of the perceived agreement among the experts that did not discriminate as clearly between issues with and without strong expert consensus. Participants in the balance condition also perceived less agreement among the experts in general, and were less likely to think that there was enough agreement among experts on the high-consensus issues to guide government policy. Evidently, "false balance" can distort perceptions of expert opinion even when participants would seem to have all the information needed to correct for its influence. (c) 2016 APA, all rights reserved).

  4. All-star sports medicine film panel

    International Nuclear Information System (INIS)

    Rogers, L.F.; Braunstein, E.M.; DeSmet, A.A.; Helms, C.A.; Pavlov, H.; Sukaer, J.R.; Torg, J.S.

    1987-01-01

    All Star Sports Panel cases are selected to test the mettle of the panelists and familiarize the audience with injuries peculiar to participation in a variety of sports. Match wits with the experts on the field. Gear up for the big game by previewing the clinical histories and initial radiographic examinations. Diagnosis requires familiarity with stresses incurred in the performance of various athletic pursuits, knowledge of specific radiographic findings, and awareness of imaging techniques that best demonstrate underlying injury

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

    International Nuclear Information System (INIS)

    Hobart, D.E.; Bruton, C.J.; Trauth, K.M.; Anderson, D.R.

    1996-05-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Hobart, D.E. [Sandia National Labs., Albuquerque, NM (United States)]|[Glenn T. Seaborg Inst. for Transactinium Science, Livermore, CA (United States); Bruton, C.J. [Sandia National Labs., Albuquerque, NM (United States)]|[Lawrence Livermore National Lab., CA (United States). Earth Sciences Dept.; Millero, F.J. [Sandia National Labs., Albuquerque, NM (United States)]|[Univ. of Miami, FL (United States). Rosenstiel School of Marine and Atmospheric Science; Chou, I.M. [Sandia National Labs., Albuquerque, NM (United States)]|[Geological Survey, Reston, VA (United States); Trauth, K.M.; Anderson, D.R. [Sandia National Labs., Albuquerque, NM (United States)

    1996-05-01

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

  7. Final report of the cosmetic ingredient review expert panel on the safety assessment of Polyisobutene and Hydrogenated Polyisobutene as used in cosmetics.

    Science.gov (United States)

    2008-01-01

    controls. Neither Polyisobutene nor Hydrogenated Polyisobutene were ocular irritants, nor were they dermal irritants or sensitizers. Polyisobutene was not comedogenic in a rabbit ear study. Polyisobutene did not induce transformation in the Syrian hamster embryo (SHE) cell transformation assay, but did enhance 3-methylcholanthrene-induced transformation of C3H/10T1/2 cells. In a carcinogenicity study in mice, Polyisobutene was not carcinogenic, nor did it promote the carcinogenicity of 7,12-dimethylbenz(alpha)anthracene. Clinical patch tests uncovered no evidence of dermal irritation and repeat-insult patch tests with a product containing 4% Hydrogenated Polyisobutene or 1.44% Hydrogenated Polyisobutene found no reactions greater than slight erythema. These products also were not phototoxic or photoallergenic. The product containing 4% Hydrogenated Polyisobutene was not an ocular irritant in a clinical test. The Cosmetic Ingredient Review (CIR) Expert Panel recognized that there are data gaps regarding use and concentration of these ingredients. However, the overall information available on the types of products in which these ingredients are used and at what concentrations indicate a pattern of use, which was considered by the Expert Panel in assessing safety. Although there is an absence of dermal absorption data for Polyisobutene and Hydrogenated Polyisobutene, the available octanol water partition coefficient data and the low solubility in water suggest very slow absorption, so additional data are not needed. Gastrointestinal absorption is also not a major concern due to the low solubility of these chemicals. Although one in vitro study did report that Polyisobutene did promote cellular transformation, a mouse study did not find evidence of tumor promotion. Because lifetime exposure studies using rats and dogs exposed to Polybutene failed to demonstrate any carcinogenic or tumor promotion effect, and a three-generation reproductive/developmental toxicity study produced

  8. Forest health conditions in North America

    International Nuclear Information System (INIS)

    Tkacz, Borys; Moody, Ben; Castillo, Jaime Villa; Fenn, Mark E.

    2008-01-01

    Some of the greatest forest health impacts in North America are caused by invasive forest insects and pathogens (e.g., emerald ash borer and sudden oak death in the US), by severe outbreaks of native pests (e.g., mountain pine beetle in Canada), and fires exacerbated by changing climate. Ozone and N and S pollutants continue to impact the health of forests in several regions of North America. Long-term monitoring of forest health indicators has facilitated the assessment of forest health and sustainability in North America. By linking a nationwide network of forest health plots with the more extensive forest inventory, forest health experts in the US have evaluated current trends for major forest health indicators and developed assessments of future risks. Canada and Mexico currently lack nationwide networks of forest health plots. Development and expansion of these networks is critical to effective assessment of future forest health impacts. - The forests of North America continue to face many biotic and abiotic stressors including fragmentation, fires, native and invasive pests, and air pollution

  9. Environmental effects of ozone depletion, UV radiation and interactions with climate change: UNEP Environmental Effects Assessment Panel, update 2017

    Science.gov (United States)

    The Environmental Effects Assessment Panel (EEAP) is one of three Panels of experts that inform the Parties to the Montreal Protocol. The EEAP focuses on the effects of UV radiation on human health, terrestrial and aquatic ecosystems, air quality, and materials, as well as on the...

  10. Expert Meeting Report: Retrofit Implementation - A Neighborhood at a Time

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, Dianne [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States)

    2012-04-01

    This report provides information about a Building America expert meeting hosted by research team Consortium for Advanced Residential Buildings (CARB) on October 25, 2011, in New York City. The meeting discussed several community residential retrofit projects underway across the United States, and included representatives from utilities, energy program implementation firms, affordable housing agencies, and the financing industry.

  11. Expert Meeting Report: Retrofit Implementation - A Neighborhood at a Time

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, D.

    2012-04-01

    This report provides information about a Building America expert meeting hosted by research team Consortium for Advanced Residential Buildings on October 25, 2011, in New York City. The meeting discussed several community residential retrofit projects underway across the United States, and included representatives from utilities, energy program implementation firms, affordable housing agencies, and the financing industry.

  12. Maintenance treatment of advanced non-small-cell lung cancer: results of an international expert panel meeting of the Italian association of thoracic oncology.

    Science.gov (United States)

    Gridelli, Cesare; de Marinis, Filippo; Di Maio, Massimo; Ardizzoni, Andrea; Belani, Chandra P; Cappuzzo, Federico; Ciardiello, Fortunato; Fidias, Panagiotis; Paz-Ares, Luis; Perrone, Francesco; Pirker, Robert; De Petris, Luigi; Stahel, Rolf

    2012-06-01

    Several randomized trials have recently investigated the role of maintenance treatment for patients with advanced non-small-cell lung cancer (NSCLC) with responding or stable disease after completion of first-line chemotherapy. Maintenance strategy has relevant implications in terms of potential toxicity, logistics and costs, and all of these aspects should be taken into account, together with the magnitude of benefit for the patient. In order to assess the strengths and limitations of available evidence, to help clinical practice, and to suggest priorities for future clinical research, the Italian Association of Thoracic Oncology (AIOT) organized an International Experts Panel Meeting on maintenance treatment of advanced NSCLC, which took place in Sperlonga (Italy) in May 2011. Based on the available evidence, panelists agreed that maintenance therapy represents a treatment option in advanced NSCLC. Maintenance should be discussed with patients not progressed after 4-6 cycles of first-line chemotherapy, who are fit (performance status 0-1) and without persistent chemotherapy-induced toxicity. Patients need to be well informed about potential advantages and disadvantages of accepting additional therapy without a "treatment-free period". Two different strategies, switch or continuation maintenance, are supported by available evidence. At the moment, there is no direct comparison between switch maintenance and continuation maintenance. For future trials, the panel recommends the use of overall survival as the primary endpoint, with pre-defined second-line treatment. Translational research is essential to identify predictive factors, and should be performed, whenever feasible, in order to achieve treatment optimization with proper patient selection. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  13. An evidence-based approach to interactive health communication: a challenge to medicine in the information age. Science Panel on Interactive Communication and Health.

    Science.gov (United States)

    Robinson, T N; Patrick, K; Eng, T R; Gustafson, D

    1998-10-14

    To examine the current status of interactive health communication (IHC) and propose evidence-based approaches to improve the quality of such applications. The Science Panel on Interactive Communication and Health, a 14-member, nonfederal panel with expertise in clinical medicine and nursing, public health, media and instructional design, health systems engineering, decision sciences, computer and communication technologies, and health communication, convened by the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services. Published studies, online resources, expert panel opinions, and opinions from outside experts in fields related to IHC. The panel met 9 times during more than 2 years. Government agencies and private-sector experts provided review and feedback on the panel's work. Interactive health communication applications have great potential to improve health, but they may also cause harm. To date, few applications have been adequately evaluated. Physicians and other health professionals should promote and participate in an evidence-based approach to the development and diffusion of IHC applications and endorse efforts to rigorously evaluate the safety, quality, and utility of these resources. A standardized reporting template is proposed to help developers and evaluators of IHC applications conduct evaluations and disclose their results and to help clinicians, purchasers, and consumers judge the quality of IHC applications.

  14. WHO Dengue Case Classification 2009 and its usefulness in practice: an expert consensus in the Americas

    Science.gov (United States)

    Horstick, Olaf; Martinez, Eric; Guzman, Maria Guadalupe; Martin, Jose Luis San; Ranzinger, Silvia Runge

    2015-01-01

    epidemiological surveillance, D/SD allows to (1) identify severity of dengue cases in real time, for any decision-making on actions, (2) measure and compare morbidity and mortality in countries, and also globally, and (3) trigger contingency plans early, not only based on the number of reported cases but also on the reported severity of cases. Conclusion: The expert panel recommends to (1) update ICD10, (2) include D/SD in country epidemiological reports, and (3) implement studies improving sensitivity/specificity of the dengue case definition. PMID:25630344

  15. Migratory Fishes of South America: Biology, Fisheries, and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2004-01-01

    Jan 1, 2004 ... Fish species that migrate within the great rivers of South America support important local fisheries but are little known outside their native range. This book represents the first collection of the work of local scientific experts on these remarkable fish. The authors cover the Upper Paraná, Paraguay-Paraná, ...

  16. Flammable gas project expert elicitation results for Hanford Site double-shell tanks

    International Nuclear Information System (INIS)

    Bratzel, D.R.

    1998-01-01

    This report documents the results of the second phase of parameter quantification by the flammable gas expert panel. This second phase is focused on the analysis of flammable gas accidents in the Hanford Site double-shell tanks. The first phase of parameter quantification, performed in 1997 was focused on the analysis of Hanford single-shell tanks

  17. Critical thinking traits of top-tier experts and implications for computer science education

    Science.gov (United States)

    Bushey, Dean E.

    A documented shortage of technical leadership and top-tier performers in computer science jeopardizes the technological edge, security, and economic well-being of the nation. The 2005 President's Information and Technology Advisory Committee (PITAC) Report on competitiveness in computational sciences highlights the major impact of science, technology, and innovation in keeping America competitive in the global marketplace. It stresses the fact that the supply of science, technology, and engineering experts is at the core of America's technological edge, national competitiveness and security. However, recent data shows that both undergraduate and postgraduate production of computer scientists is falling. The decline is "a quiet crisis building in the United States," a crisis that, if allowed to continue unchecked, could endanger America's well-being and preeminence among the world's nations. Past research on expert performance has shown that the cognitive traits of critical thinking, creativity, and problem solving possessed by top-tier performers can be identified, observed and measured. The studies show that the identified attributes are applicable across many domains and disciplines. Companies have begun to realize that cognitive skills are important for high-level performance and are reevaluating the traditional academic standards they have used to predict success for their top-tier performers in computer science. Previous research in the computer science field has focused either on programming skills of its experts or has attempted to predict the academic success of students at the undergraduate level. This study, on the other hand, examines the critical-thinking skills found among experts in the computer science field in order to explore the questions, "What cognitive skills do outstanding performers possess that make them successful?" and "How do currently used measures of academic performance correlate to critical-thinking skills among students?" The results

  18. Panel 3: Genetics and Precision Medicine of Otitis Media.

    Science.gov (United States)

    Lin, Jizhen; Hafrén, Hena; Kerschner, Joseph; Li, Jian-Dong; Brown, Steve; Zheng, Qing Y; Preciado, Diego; Nakamura, Yoshihisa; Huang, Qiuhong; Zhang, Yan

    2017-04-01

    Objective The objective is to perform a comprehensive review of the literature up to 2015 on the genetics and precision medicine relevant to otitis media. Data Sources PubMed database of the National Library of Medicine. Review Methods Two subpanels were formed comprising experts in the genetics and precision medicine of otitis media. Each of the panels reviewed the literature in their respective fields and wrote draft reviews. The reviews were shared with all panel members, and a merged draft was created. The entire panel met at the 18th International Symposium on Recent Advances in Otitis Media in June 2015 and discussed the review and refined the content. A final draft was made, circulated, and approved by the panel members. Conclusion Many genes relevant to otitis media have been identified in the last 4 years in advancing our knowledge regarding the predisposition of the middle ear mucosa to commensals and pathogens. Advances include mutant animal models and clinical studies. Many signaling pathways are involved in the predisposition of otitis media. Implications for Practice New knowledge on the genetic background relevant to otitis media forms a basis of novel potential interventions, including potential new ways to treat otitis media.

  19. Use of Opioids in Latin America: The Need of an Evidence-Based Change.

    Science.gov (United States)

    Rico, María Antonieta; Kraychete, Durval Campos; Iskandar, Aziza Jreige; Colimon, Frantz; Lara-Solares, Argelia; Cantisani, José Alberto Flores; Amescua-García, César; Núñez, María del Rocío Guillén; Bonilla, Patricia; Lech, Osvandré; Hernández-Castro, John Jairo; Guerrero, Carlos; Barrera, William Delgado; Gallegos, Manuel Sempértegui; Cook, María Berenguel; Garcia, João Batista Santos; Hernández, Concepción Pérez

    2016-04-01

    The subject of this publication has been focused on local considerations for facilitating regional best practice, including identifying and uniformly adopting the most relevant international guidelines on opioid use (OU) in chronic pain management. The Change Pain Latin America (CPLA) Advisory Panel conducted a comprehensive, robust, and critical analysis of published national and international reviews and guidelines of OU, considering those most appropriate for Latin America. A PubMed search was conducted using the terms "opioid," "chronic," and "pain" and then refined using the filters "practice guidelines" and "within the last 5 years" (2007-2012). Once the publications were identified, they were selected using five key criteria: "Evidence based," "Comprehensive," "From a well-recognized source," "Current publications," and "Based on best practice" and then critically analyzed considering 10 key criteria for determining the most relevant guidelines to be applied in Latin America. The initial PubMed search identified 177 reviews and guidelines, which was reduced to 16 articles using the five preliminary criteria. After a secondary analysis according to the 10 key criteria specific to OU in Latin America, 10 publications were selected for critical review and discussion. The CPLA advisory panel considered the "Safe and effective use of opioids for chronic non-cancer pain" (published in 2010 by the NOUGG of Canada) to be valid, relevant to Latin America, practical, evidence-based, concise, unambiguous, and sufficiently educational to provide clear instruction on OU and pain management and, thus, recommended for uniform adoption across the Latin America region. © 2015 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Targeted temperature management in the ICU: guidelines from a French expert panel.

    Science.gov (United States)

    Cariou, Alain; Payen, Jean-François; Asehnoune, Karim; Audibert, Gerard; Botte, Astrid; Brissaud, Olivier; Debaty, Guillaume; Deltour, Sandrine; Deye, Nicolas; Engrand, Nicolas; Francony, Gilles; Legriel, Stéphane; Levy, Bruno; Meyer, Philippe; Orban, Jean-Christophe; Renolleau, Sylvain; Vigue, Bernard; De Saint Blanquat, Laure; Mathien, Cyrille; Velly, Lionel

    2017-12-01

    Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method. Indications are, however, associated with variable levels of evidence based on inhomogeneous or even contradictory literature. Our aim was to conduct a systematic analysis of the published data in order to provide guidelines. We present herein recommendations for the use of TTM in adult and paediatric critically ill patients developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. These guidelines were conducted by a group of experts from the French Intensive Care Society (Société de Réanimation de Langue Française [SRLF]) and the French Society of Anesthesia and Intensive Care Medicine (Société Francaise d'Anesthésie Réanimation [SFAR]) with the participation of the French Emergency Medicine Association (Société Française de Médecine d'Urgence [SFMU]), the French Group for Pediatric Intensive Care and Emergencies (Groupe Francophone de Réanimation et Urgences Pédiatriques [GFRUP]), the French National Association of Neuro-Anesthesiology and Critical Care (Association Nationale de Neuro-Anesthésie Réanimation Française [ANARLF]), and the French Neurovascular Society (Société Française Neurovasculaire [SFNV]). Fifteen experts and two coordinators agreed to consider questions concerning TTM and its practical implementation in five clinical situations: cardiac arrest, traumatic brain injury, stroke, other brain injuries, and shock. This resulted in 30 recommendations

  1. Which model of truth and reconciliation applies to former Yugoslavia?: Some thoughts on the closing panel discussion

    Directory of Open Access Journals (Sweden)

    Tošić Jelena

    2002-01-01

    Full Text Available This paper represents a reflection on the final panel discussion of the conference "Which Model of Truth and Reconciliation applies to ex-Yugoslavia?". By the means of sequential and hierarchical analysis of the argumentative structure of the discussion, the author «extracts» key dimensions of the expert discourse on truth and reconciliation using the case of the mentioned panel discussion. By identifying the points of consensus the author seeks to describe the notion of truth and reconciliation as it emerged in the closing panel discussion of the conference.

  2. Human factors inspection of current control room panel in Jose Cabrera NPP

    International Nuclear Information System (INIS)

    Almeida, P.; O'Hara, J.; Higgins, J.

    2002-01-01

    Within the process of renewal of Exploitation Permit of Jose Cabrera Nuclear Power Plant, UNION FENOSA GENERACIO, S. A. (UFG) has carried out an analysis and evaluation project regarding human factors implications of current control room panel arrangement. The project has been developed in two phases. In the first phase, leaded by EPRI and carried out by experts from SAIC, an independent review from a double viewpoint of human reliability and human factors was developed. In the second phase, a multidisciplinary team (composed by human factors, risk analysis, operation, engineering, training and instrumentation and controls experts) has developed a study on human factors implications of current panel arrangement, following the methodology pointed out in NUREG-0711. The project has been developed under the direction of Brookhaven National Laboratory (BNL), organisation that has authored the aforementioned methodology, with the participation of UFG and SOLUZIONA Ingenieria. For the development of the second study the following steps were taken: Firstly, the potential effects of panel arrangement on crew performance were identified its real evidence was analysed and the goals for the improvement of control room operation were established; following NUREG-0711. After this, several design alternatives that addressed these goals were identified and were analysed along three dimensions: human factors, risk analysis and economic costs. Finally the results of these evaluations were combined using a multi-attribute decision method to arrive at a recommended alternative as he best proposal to incorporate human factors criteria and good practices in the design of control room panels. (Author)

  3. An ancestry informative marker set for determining continental origin: validation and extension using human genome diversity panels

    Directory of Open Access Journals (Sweden)

    Gregersen Peter K

    2009-07-01

    Full Text Available Abstract Background Case-control genetic studies of complex human diseases can be confounded by population stratification. This issue can be addressed using panels of ancestry informative markers (AIMs that can provide substantial population substructure information. Previously, we described a panel of 128 SNP AIMs that were designed as a tool for ascertaining the origins of subjects from Europe, Sub-Saharan Africa, Americas, and East Asia. Results In this study, genotypes from Human Genome Diversity Panel populations were used to further evaluate a 93 SNP AIM panel, a subset of the 128 AIMS set, for distinguishing continental origins. Using both model-based and relatively model-independent methods, we here confirm the ability of this AIM set to distinguish diverse population groups that were not previously evaluated. This study included multiple population groups from Oceana, South Asia, East Asia, Sub-Saharan Africa, North and South America, and Europe. In addition, the 93 AIM set provides population substructure information that can, for example, distinguish Arab and Ashkenazi from Northern European population groups and Pygmy from other Sub-Saharan African population groups. Conclusion These data provide additional support for using the 93 AIM set to efficiently identify continental subject groups for genetic studies, to identify study population outliers, and to control for admixture in association studies.

  4. Expert Meeting. Recommended Approaches to Humidity Control in High Performance Homes

    Energy Technology Data Exchange (ETDEWEB)

    Rudd, Armin [Building Science Corporation (BSC), Somerville, MA (United States)

    2013-07-01

    This meeting was held on October 16, 2012, in Westford, MA, and brought together experts in the field of residential humidity control to address modeling issues for dehumidification. The presentations and discussions centered on computer simulation and field experience with these systems, with the goal of developing foundational information to support the development of a Building America Measure Guideline on this topic.

  5. Perception and description of premium beers by panels with different degrees of product expertise

    DEFF Research Database (Denmark)

    Giacalone, Davide; Ribeiro, Leticia Machado; Frøst, Michael Bom

    2016-01-01

    The present study compares subjects with varying degrees of product expertise with regards to their ability to provide a sensory profile of beverages. Eight premium beers were evaluated by three different panels using a Napping® test, followed by a descriptive task. Two panels were constituted of...... were all above 0.90, indicating high configurational similarity. In contrast, PLS-DA showed significant differences in the use of attributes, particularly between Experts and Novices, suggesting that product expertise is more associated with descriptive, rather than perceptual, ability....

  6. A formal expert judgment procedure for performance assessments of the Waste Isolation Pilot Plant

    International Nuclear Information System (INIS)

    Trauth, K.M.; Guzowski, R.V.; Hora, S.C.

    1994-09-01

    The Waste Isolation Pilot Plant (WIPP) is an experimental facility located in southeastern New Mexico. It has been designed to determine the feasibility of the geologic disposal of defense-generated transuranic waste in a deep bedded-salt formation. The WIPP was also designed for disposal and will operate in that capacity if approved. The WIPP Performance Assessment Department at Sandia National Laboratories has been conducting analyses to assess the long-term performance of the WIPP. These analyses sometimes require the use of expert judgment. This Department has convened several expert-judgment panels and from that experience has developed an internal quality-assurance procedure to guide the formal elicitation of expert judgment. This protocol is based on the principles found in the decision-analysis literature

  7. A formal expert judgment procedure for performance assessments of the Waste Isolation Pilot Plant

    Energy Technology Data Exchange (ETDEWEB)

    Trauth, K.M. [Sandia National Labs., Albuquerque, NM (United States); Guzowski, R.V. [Science Applications International Corp., Albuquerque, NM (United States); Hora, S.C. [Univ. of Hawaii, Hilo, HI (United States). Business Administration & Economics Div.

    1994-09-01

    The Waste Isolation Pilot Plant (WIPP) is an experimental facility located in southeastern New Mexico. It has been designed to determine the feasibility of the geologic disposal of defense-generated transuranic waste in a deep bedded-salt formation. The WIPP was also designed for disposal and will operate in that capacity if approved. The WIPP Performance Assessment Department at Sandia National Laboratories has been conducting analyses to assess the long-term performance of the WIPP. These analyses sometimes require the use of expert judgment. This Department has convened several expert-judgment panels and from that experience has developed an internal quality-assurance procedure to guide the formal elicitation of expert judgment. This protocol is based on the principles found in the decision-analysis literature.

  8. A formal expert judgment procedure for performance assessments of the Waste Isolation Pilot Plant

    International Nuclear Information System (INIS)

    Trauth, K.M.; Guzowski, R.V.; Hora, S.C.

    1993-01-01

    The Waste Isolation Pilot Plant (WIPP) is an experimental facility located in southeastern New Mexico. It has been designed to determine the feasibility of the geologic disposal of defense-generated transuranic waste in a deep bedded-salt formation. The WIPP was also designed for disposal and will operate in that capacity if approved. The WIPP Performance Assessment Department at Sandia National Laboratories has been conducting analyses to assess the long-term performance of the WIPP. These analyses sometimes require the use of expert judgment. This Department has convened several expert-judgment panels and from that experience has developed an internal quality-assurance procedure to guide the formal elicitation of expert judgment. This protocol is based on the principles found in the decision-analysis literature

  9. Expert Systems: What Is an Expert System?

    Science.gov (United States)

    Duval, Beverly K.; Main, Linda

    1994-01-01

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

  10. Outcomes and Recommendations of an Indian Expert Panel for Improved Practice in Controlled Ovarian Stimulation for Assisted Reproductive Technology

    Directory of Open Access Journals (Sweden)

    Baiju Ahemmed

    2017-01-01

    Full Text Available Purpose. To improve success of in vitro fertilization (IVF, assisted reproductive technology (ART experts addressed four questions. What is optimum oocytes number leading to highest live birth rate (LBR? Are cohort size and embryo quality correlated? Does gonadotropin type affect oocyte yield? Should “freeze-all” policy be adopted in cycles with progesterone >1.5 ng/mL on day of human chorionic gonadotropin (hCG administration? Methods. Electronic database search included ten studies on which panel gave opinions for improving current practice in controlled ovarian stimulation for ART. Results. Strong association existed between retrieved oocytes number (RON and LBRs. RON impacted likelihood of ovarian hyperstimulation syndrome (OHSS. Embryo euploidy decreased with age, not with cohort size. Progesterone > 1.5 ng/dL did not impair cycle outcomes in patients with high cohorts and showed disparate results on day of hCG administration. Conclusions. Ovarian stimulation should be designed to retrieve 10–15 oocytes/treatment. Accurate dosage, gonadotropin type, should be selected as per prediction markers of ovarian response. Gonadotropin-releasing hormone (GnRH antagonist based protocols are advised to avoid OHSS. Cumulative pregnancy rate was most relevant pregnancy endpoint in ART. Cycles with serum progesterone ≥1.5 ng/dL on day of hCG administration should not adopt “freeze-all” policy. Further research is needed due to lack of data availability on progesterone threshold or index.

  11. Outcomes and Recommendations of an Indian Expert Panel for Improved Practice in Controlled Ovarian Stimulation for Assisted Reproductive Technology

    Science.gov (United States)

    Ahemmed, Baiju; Sundarapandian, Vani; Gutgutia, Rohit; Balasubramanyam, Sathya; Jagtap, Richa; Biliangady, Reeta; Gupta, Priti; Jadhav, Sachin; Satwik, Ruma; Thakor, Priti

    2017-01-01

    Purpose. To improve success of in vitro fertilization (IVF), assisted reproductive technology (ART) experts addressed four questions. What is optimum oocytes number leading to highest live birth rate (LBR)? Are cohort size and embryo quality correlated? Does gonadotropin type affect oocyte yield? Should “freeze-all” policy be adopted in cycles with progesterone >1.5 ng/mL on day of human chorionic gonadotropin (hCG) administration? Methods. Electronic database search included ten studies on which panel gave opinions for improving current practice in controlled ovarian stimulation for ART. Results. Strong association existed between retrieved oocytes number (RON) and LBRs. RON impacted likelihood of ovarian hyperstimulation syndrome (OHSS). Embryo euploidy decreased with age, not with cohort size. Progesterone > 1.5 ng/dL did not impair cycle outcomes in patients with high cohorts and showed disparate results on day of hCG administration. Conclusions. Ovarian stimulation should be designed to retrieve 10–15 oocytes/treatment. Accurate dosage, gonadotropin type, should be selected as per prediction markers of ovarian response. Gonadotropin-releasing hormone (GnRH) antagonist based protocols are advised to avoid OHSS. Cumulative pregnancy rate was most relevant pregnancy endpoint in ART. Cycles with serum progesterone ≥1.5 ng/dL on day of hCG administration should not adopt “freeze-all” policy. Further research is needed due to lack of data availability on progesterone threshold or index. PMID:28246628

  12. Providing culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent: development of expert consensus guidelines

    Science.gov (United States)

    2014-01-01

    Background It is estimated that the prevalence of mental illness is higher in Aboriginal and Torres Strait Islander adolescents compared to non-Aboriginal adolescents. Despite this, only a small proportion of Aboriginal youth have contact with mental health services, possibly due to factors such as remoteness, language barriers, affordability and cultural sensitivity issues. This research aimed to develop culturally appropriate guidelines for anyone who is providing first aid to an Australian Aboriginal or Torres Strait Islander adolescent who is experiencing a mental health crisis or developing a mental illness. Methods A panel of Australian Aboriginal people who are experts in Aboriginal youth mental health, participated in a Delphi study investigating how members of the public can be culturally appropriate when helping an Aboriginal or Torres Strait Islander adolescent with mental health problems. The panel varied in size across the three sequential rounds, from 37–41 participants. Panellists were presented with statements about cultural considerations and communication strategies via online questionnaires and were encouraged to suggest additional content. All statements endorsed as either Essential or Important by ≥ 90% of panel members were written into a guideline document. To assess the panel members’ satisfaction with the research method, participants were invited to provide their feedback after the final survey. Results From a total of 304 statements shown to the panel of experts, 194 statements were endorsed. The methodology was found to be useful and appropriate by the panellists. Conclusion Aboriginal and Torres Strait Islander Youth mental health experts were able to reach consensus about what the appropriate communication strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander adolescent. These outcomes will help ensure that the community provides the best possible support to Aboriginal adolescents who

  13. Providing culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent: development of expert consensus guidelines.

    Science.gov (United States)

    Chalmers, Kathryn J; Bond, Kathy S; Jorm, Anthony F; Kelly, Claire M; Kitchener, Betty A; Williams-Tchen, Aj

    2014-01-28

    It is estimated that the prevalence of mental illness is higher in Aboriginal and Torres Strait Islander adolescents compared to non-Aboriginal adolescents. Despite this, only a small proportion of Aboriginal youth have contact with mental health services, possibly due to factors such as remoteness, language barriers, affordability and cultural sensitivity issues. This research aimed to develop culturally appropriate guidelines for anyone who is providing first aid to an Australian Aboriginal or Torres Strait Islander adolescent who is experiencing a mental health crisis or developing a mental illness. A panel of Australian Aboriginal people who are experts in Aboriginal youth mental health, participated in a Delphi study investigating how members of the public can be culturally appropriate when helping an Aboriginal or Torres Strait Islander adolescent with mental health problems. The panel varied in size across the three sequential rounds, from 37-41 participants. Panellists were presented with statements about cultural considerations and communication strategies via online questionnaires and were encouraged to suggest additional content. All statements endorsed as either Essential or Important by ≥ 90% of panel members were written into a guideline document. To assess the panel members' satisfaction with the research method, participants were invited to provide their feedback after the final survey. From a total of 304 statements shown to the panel of experts, 194 statements were endorsed. The methodology was found to be useful and appropriate by the panellists. Aboriginal and Torres Strait Islander Youth mental health experts were able to reach consensus about what the appropriate communication strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander adolescent. These outcomes will help ensure that the community provides the best possible support to Aboriginal adolescents who are developing mental illnesses or are in a

  14. Expert Meeting Report. Key Innovations for Adding Energy Efficiency to Maintenance Projects

    Energy Technology Data Exchange (ETDEWEB)

    Wood, A. [NAHB Research Center, Upper Marlboro, MD (United States); Wiehagen, J. [NAHB Research Center, Upper Marlboro, MD (United States)

    2012-09-01

    This report describes an expert meeting hosted by the Building America research team NAHB Research Center, which was held on February 8, 2012, in Orlando, Florida. The topic focused on efforts to increase the efficiency of existing homes, specifically for re-roofing and the opportunities for adding energy efficiency upgrades during this major home repair activity.

  15. The First National Report Card on Quality of Health Care in America

    National Research Council Canada - National Science Library

    2004-01-01

    How good is the quality of health care in America? To answer this question Elizabeth McGlynn led a team of experts in the largest and most comprehensive examination ever conducted of health care quality in the United States...

  16. Current practice with endoscopic submucosal dissection in Europe: position statement from a panel of experts

    DEFF Research Database (Denmark)

    Deprez, P H; Bergman, J J; Meisner, S

    2010-01-01

    level, and should include information on indication (Paris classification of lesion, location, and histological results prior to treatment), technique used (e.¿g. type of knife), results (en bloc and R0 resection), complications, and follow-up. The panel also agreed on minimal institutional requirements...

  17. Will the Oxygen-Phosphorus Paradigm Persist? - Expert Views of the Future of Management and Restoration of Eutrophic Lakes

    Science.gov (United States)

    Nygrén, Nina A.; Tapio, Petri; Horppila, Jukka

    2017-11-01

    In the age of climate change, the demand and lack of pure water challenges many communities. Substantial amount of effort is put in every year to manage and restore degraded lakes while the long-term effects of those efforts are only poorly known or monitored. Oxygenation, or aeration, is used extensively for the restoration of eutrophic lakes, although many studies question whether this process improves the status of the lakes in the long-term. The desired effect of oxygenation is based on paradigmatic theories that, in the light of recent literature, might not be adequate when long-term improvements are sought. This article canvasses expert views on the feasibility of the `oxygen-phosphorus paradigm' as well as the future of the management and restoration of eutrophic lakes, based on an international, two-rounded, expert panel survey (Delphi study), employing 200 freshwater experts from 33 nationalities, contacted at three conferences on the topic. The conclusion is that the oxygen-phosphorus paradigm seems to be rather persistent. The experts considered oxygenation to be a valid short-term lake restoration method, but not without harmful side-effects. In addition, experts' low level of trust in the adequacy of the scientific knowledge on the effects of restorations and in the use of the scientific knowledge as a basis of choice of restoration methods, could be signs of a paradigm shift towards an outlook emphasizing more effective catchment management over short-term restorations. The expert panel also anticipated that reducing external nutrient loads from both point and diffuse sources will succeed in the future.

  18. Diagnosing battery behavior with an expert system in Prolog

    International Nuclear Information System (INIS)

    Kirkwood, N.; Weeks, D.J.

    1986-01-01

    Power for the Hubble Space Telescope comes from a system of 20 solar panel assemblies (SPAs) and six nickel-cadmium batteries. The HST battery system is simulated by the HST Electrical Power System (EPS) testbed at Marshall Space Flight Center. The Nickel Cadmium Battery Expert System (NICBES) is being used to diagnose faults of the testbed system, evaluate battery status and provide decision support for the engineer. Extensive telemetry of system operating conditions is relayed through a DEC LSI-11, and sent on to an IBM PC-AT. A BASIC program running on the PC monitors the flow of data, figures cell divergence and recharge ratio and stores these values, along with other selected data, for use by the expert system. The expert system is implemented in the logic programming language Prolog. It has three modes of operation: fault diagnosis, status and advice, and decision support. An alert or failure of the system will trigger a diagnosis by the system to assist the operator. The operator can also request battery status information as well as a number of plots and histograms of recent battery behavior. Trends in EOC and EOD voltage, recharge ratio and divergence are used by the expert system in its analysis of battery status. A future enhancement to the system includes the statistical prediction of battery life. Incorporating learning into the expert system is another possible enhancement; This is a difficult task, but one which could promise great rewards in improved battery performance

  19. Introduction and Overview of the Industrial Interactive Panel Session

    Science.gov (United States)

    Seiler, David

    2014-03-01

    A unique industrial panel covering the challenges and needs of various industries and how being innovative is important. The session involves two invited industry speakers (24 minutes each) who will set the stage for the interactive round table panel session. The Panel, led by moderator Mark Bernius (Morgan Advanced Materials), consists of the two invited speakers plus an additional five industry panelists. The first thirty minutes of the panel session has the five additional panelists introducing themselves and their work/company. These introductions could include what they or their company does, sharing one or two technical highlights, listing some challenges or needs for physicists, and what innovation breakthroughs are needed in their industries. The final hour of the session will be highly interactive with questions to the panel coming from the moderator, the audience, and the panelists themselves. Questions that might be addressed include: how physicists are or could be critical in advancing innovation; how can AIP/APS/FIAP help industry get the physics help they need to be innovative (knowledge, the right staff, etc.); what role can students and post docs play in advancing industry's mission; etc. We invite you to participate in this interactive session and ask our industry experts your own interesting and challenging questions. The invited speakers are George Thompson, Intel, and Rick Watkins, Nike. The panel members also include Jason Cleveland, Asylum Research; Robert Doering, Texas Instruments; William Gallagher, IBM T.J. Watson Research Center; James Hollenhorst, Agilent Technologies; and Martin Poitzsch, Schlumberger-Doll Research.

  20. Expert Meeting on Information Systems in Culture Proceedings (Zagreb, Yugoslavia, September 2-4, 1990).

    Science.gov (United States)

    Institute for Development and International Relations, Zagreb (Yugoslavia).

    This report presents the proceedings from a meeting jointly organized by United Nations Educational, Scientific, and Cultural Organization (UNESCO) and the Yugoslavian Institute for Development and International Relations (IRMO). Experts from 14 institutions and organizations from 7 countries of Africa, Europe, and North America participated in 4…

  1. Análise crítica das recomendações formuladas por um painel de experts para o cuidado clínico de pacientes com Leucemia Mielóide Crônica Critical analysis of the recommendations from an expert panel on the management of patients with Chronic Myeloid Leukemia

    Directory of Open Access Journals (Sweden)

    Nelson Spector

    2008-04-01

    Full Text Available As recomendações sobre Leucemia Mielóide Crônica feitas em 2006 por um painel de experts, em nome do "European Leukemia Network", foram adotadas internacionalmente como um roteiro para a monitoração e tratamento da doença. Passados 18 meses de sua publicação, fazemos aqui um sumário dessas recomendações e em seguida apontamos diversas áreas em que as recomendações poderão ser aperfeiçoadas e atualizadas. Aspectos específicos relacionados à aplicação das recomendações no Brasil são também considerados.The recommendations about chronic myeloid leukemia by a panel of experts in 2006 on behalf of the "European Leukemia Network" have been internationally accepted as a guide for monitoring and treatment of this disease. Eighteen months after its publication, we present here a summary of these recommendations, and point to areas in which they might be improved and updated. Specific aspects of the application of these recommendations in Brazil are also considered.

  2. Thyroid cancer in children living near Chernobyl. Expert panel report on the consequences of the Chernobyl accident

    International Nuclear Information System (INIS)

    Williams, D.; Karaoglou, A.; Chadwick, K.H.

    1993-01-01

    In January 1992, the Radiation Protection Research Action formed a panel of thyroid experts in order to evaluate the current situation concerning reported increased rates of thyroid cancer in children living in the neighbourhood of Chernobyl, where the reactor accident occurred on April 26 1986 and resulted in widespread radioactive contamination over large areas of Belarus, Russia, Ukraine. Studies of the Atom Bomb survivors in Japan have revealed that the incidence of leukemia starts to increase some five years after exposure. For Chernobyl accident health consequences are now becoming evident. Thyroid cancer has already been observed in children. Iodine 131 was seen to pose a specific hazard because it is taken up by the body and concentrated in the thyroid gland. At a dose of 5 Gy to the childhood thyroid about 4000 thyroid cancers per 100000 children exposed can be anticipated. An essential component of the verification of this observation is the study of the pathology of the lesions, which derived from four cell types: follicular cells, C cells, lymphoid cells and connective tumor cells. All distant metastases are lung metastases. Measures to be considered for the prevention of the development of thyroid cancer in a radiation-exposed population include correction of iodine deficiency by iodine prophylaxis and suppression of TSH. There are three methods of diagnosis: ultrasound imaging, thyroid scanning, fine needle aspiration performed by skilled personnel. For the therapy total or near-total thyroidectomy is regarded as the treatment of choice. Radioactive iodine can be used to treat lymph node and distant metastases which take up iodine after a total thyroidectomy. Thyroid hormone replacement should be carried out with TSH suppressive doses of L-Thyroxine. 45 refs., 1 annexe

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

    Science.gov (United States)

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

    2016-01-01

    The Foodborne Disease Burden Epidemiology Reference Group (FERG) was established in 2007 by the World Health Organization (WHO) to estimate the global burden of foodborne diseases (FBDs). This estimation is complicated because most of the hazards causing FBD are not transmitted solely by food; most have several potential exposure routes consisting of transmission from animals, by humans, and via environmental routes including water. This paper describes an expert elicitation study conducted by the FERG Source Attribution Task Force to estimate the relative contribution of food to the global burden of diseases commonly transmitted through the consumption of food. We applied structured expert judgment using Cooke's Classical Model to obtain estimates for 14 subregions for the relative contributions of different transmission pathways for eleven diarrheal diseases, seven other infectious diseases and one chemical (lead). Experts were identified through international networks followed by social network sampling. Final selection of experts was based on their experience including international working experience. Enrolled experts were scored on their ability to judge uncertainty accurately and informatively using a series of subject-matter specific 'seed' questions whose answers are unknown to the experts at the time they are interviewed. Trained facilitators elicited the 5th, and 50th and 95th percentile responses to seed questions through telephone interviews. Cooke's Classical Model uses responses to the seed questions to weigh and aggregate expert responses. After this interview, the experts were asked to provide 5th, 50th, and 95th percentile estimates for the 'target' questions regarding disease transmission routes. A total of 72 experts were enrolled in the study. Ten panels were global, meaning that the experts should provide estimates for all 14 subregions, whereas the nine panels were subregional, with experts providing estimates for one or more subregions

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

    Directory of Open Access Journals (Sweden)

    Tine Hald

    Full Text Available The Foodborne Disease Burden Epidemiology Reference Group (FERG was established in 2007 by the World Health Organization (WHO to estimate the global burden of foodborne diseases (FBDs. This estimation is complicated because most of the hazards causing FBD are not transmitted solely by food; most have several potential exposure routes consisting of transmission from animals, by humans, and via environmental routes including water. This paper describes an expert elicitation study conducted by the FERG Source Attribution Task Force to estimate the relative contribution of food to the global burden of diseases commonly transmitted through the consumption of food.We applied structured expert judgment using Cooke's Classical Model to obtain estimates for 14 subregions for the relative contributions of different transmission pathways for eleven diarrheal diseases, seven other infectious diseases and one chemical (lead. Experts were identified through international networks followed by social network sampling. Final selection of experts was based on their experience including international working experience. Enrolled experts were scored on their ability to judge uncertainty accurately and informatively using a series of subject-matter specific 'seed' questions whose answers are unknown to the experts at the time they are interviewed. Trained facilitators elicited the 5th, and 50th and 95th percentile responses to seed questions through telephone interviews. Cooke's Classical Model uses responses to the seed questions to weigh and aggregate expert responses. After this interview, the experts were asked to provide 5th, 50th, and 95th percentile estimates for the 'target' questions regarding disease transmission routes. A total of 72 experts were enrolled in the study. Ten panels were global, meaning that the experts should provide estimates for all 14 subregions, whereas the nine panels were subregional, with experts providing estimates for one or more

  5. Experimental evaluation of an expert system for nuclear reactor operators

    International Nuclear Information System (INIS)

    Nelson, W.R.

    1984-10-01

    The United States Nuclear Regulatory Commission (USNRC) is supporting a program for the experimental evaluation of an expert system for nuclear reactor operators. A prototype expert system, called the Response Tree System, has been developed and implemented at INEL. The Response Tree System is designed to assess the status of a reactor system following an accident and recommend corrective actions to reactor operators. The system is implemented using color graphic displays and is driven by a computer simulation of the reactor system. Control of the system is accomplished using a transparent touch panel. Controlled experiments are being conducted to measure performance differences between operators using the Response Tree System and those not using it to respond to simulated accident situations. This paper summarizes the methodology and results of the evaluation of the Response Tree System, including the quantitative results obtained in the experiments thus far. Design features of the Response Tree System are discussed, and general conclusions regarding the applicability of expert systems in reactor control rooms are presented

  6. The Determinants of Banks' Liquidity Buffers in Central America

    OpenAIRE

    Corinne Deléchat; Camila Henao; Priscilla Muthoora; Svetlana Vtyurina

    2014-01-01

    Banks’ liquidity holdings are comfortably above legal or prudential requirements in most Central American countries. While good for financial stability, high liquidity may nonetheless hinder financial market development and monetary policy transmission. Using a panel of 96 commercial banks from Central America, Panama and the Dominican Republic for 2006-2010, we find that the demand for precautionary liquidity buffers is associated with measures of bank’s size, profitability, capitalization, ...

  7. A proposed panel of biomarkers of healthy ageing.

    Science.gov (United States)

    Lara, Jose; Cooper, Rachel; Nissan, Jack; Ginty, Annie T; Khaw, Kay-Tee; Deary, Ian J; Lord, Janet M; Kuh, Diana; Mathers, John C

    2015-09-15

    There is no criterion reference for assessing healthy ageing and this creates difficulties when conducting and comparing research on ageing across studies. A cardinal feature of ageing is loss of function which translates into wide-ranging consequences for the individual and for family, carers and society. We undertook comprehensive reviews of the literature searching for biomarkers of ageing on five ageing-related domains including physical capability and cognitive, physiological and musculoskeletal, endocrine and immune functions. Where available, we used existing systematic reviews, meta-analyses and other authoritative reports such as the recently launched NIH Toolbox for assessment of neurological and behavioural function, which includes test batteries for cognitive and motor function (the latter described here as physical capability). We invited international experts to comment on our draft recommendations. In addition, we hosted an experts workshop in Newcastle, UK, on 22-23 October 2012, aiming to help capture the state-of-the-art in this complex area and to provide an opportunity for the wider ageing research community to critique the proposed panel of biomarkers. Here we have identified important biomarkers of healthy ageing classified as subdomains of the main areas proposed. Cardiovascular and lung function, glucose metabolism and musculoskeletal function are key subdomains of physiological function. Strength, locomotion, balance and dexterity are key physical capability subdomains. Memory, processing speed and executive function emerged as key subdomains of cognitive function. Markers of the HPA-axis, sex hormones and growth hormones were important biomarkers of endocrine function. Finally, inflammatory factors were identified as important biomarkers of immune function. We present recommendations for a panel of biomarkers that address these major areas of function which decline during ageing. This biomarker panel may have utility in epidemiological

  8. A panel of 74 AISNPs: Improved ancestry inference within Eastern Asia.

    Science.gov (United States)

    Li, Cai-Xia; Pakstis, Andrew J; Jiang, Li; Wei, Yi-Liang; Sun, Qi-Fan; Wu, Hong; Bulbul, Ozlem; Wang, Ping; Kang, Long-Li; Kidd, Judith R; Kidd, Kenneth K

    2016-07-01

    Many ancestry informative SNP (AISNP) panels have been published. Ancestry resolution in them varies from three to eight continental clusters of populations depending on the panel used. However, none of these panels differentiates well among East Asian populations. To meet this need, we have developed a 74 AISNP panel after analyzing a much larger number of SNPs for Fst and allele frequency differences between two geographically close population groups within East Asia. The 74 AISNP panel can now distinguish at least 10 biogeographic groups of populations globally: Sub-Saharan Africa, North Africa, Europe, Southwest Asia, South Asia, North Asia, East Asia, Southeast Asia, Pacific and Americas. Compared with our previous 55-AISNP panel, Southeast Asia and North Asia are two newly assignable clusters. For individual ancestry assignment, the likelihood ratio and ancestry components were analyzed on a different set of 500 test individuals from 11 populations. All individuals from five of the test populations - Yoruba (YRI), European (CEU), Han Chinese in Henan (CHNH), Rondonian Surui (SUR) and Ticuna (TIC) - were assigned to their appropriate geographical regions unambiguously. For the other test populations, most of the individuals were assigned to their self-identified geographical regions with a certain degree of overlap with adjacent populations. These alternative ancestry components for each individual thus help give a clearer picture of the possible group origins of the individual. We have demonstrated that the new AISNP panel can achieve a deeper resolution of global ancestry. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. Expert surgical consensus for prenatal counseling using the Delphi method.

    Science.gov (United States)

    Berman, Loren; Jackson, Jordan; Miller, Kristen; Kowalski, Rebecca; Kolm, Paul; Luks, Francois I

    2017-11-28

    Pediatric surgeons frequently offer prenatal consultation for congenital pulmonary airway malformation (CPAM) and congenital diaphragmatic hernia (CDH); however, there is no evidence-based consensus to guide prenatal decision making and counseling for these conditions. Eliciting feedback from experts is integral to defining best practice regarding prenatal counseling and intervention. A Delphi consensus process was undertaken using a panel of pediatric surgeons identified as experts in fetal therapy to address current limitations. Areas of discrepancy in the literature on CPAM and CDH were identified and used to generate a list of content and intervention questions. Experts were invited to participate in an online Delphi survey. Items that did not reach first-round consensus were broken down into additional questions, and consensus was achieved in the second round. Fifty-four surgeons (69%) responded to at least one of the two survey rounds. During round one, consensus was reached on 54 of 89 survey questions (61%), and 45 new questions were developed. During round two, consensus was reached on 53 of 60 survey questions (88%). We determined expert consensus to establish guidelines regarding perinatal management of CPAM and CDH. Our results can help educate pediatric surgeons participating in perinatal care of these patients. V. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Evaluation of proposed panel closure modifications at WIPP

    Energy Technology Data Exchange (ETDEWEB)

    Allen, Lawrence E.; Silva, Matthew K.; Channell, James K.; Abel, John F.; Morgan, Dudley R.

    2001-12-31

    A key component in the design of the WIPP repository is the installation of concrete structures as panel seals in the intake and exhaust drifts after a panel has been filled with waste containers. As noted in the EPA final rule, the panel seal closure system is intended to block brine flow between the waste panels at the WIPP. On April 17, 2001, the DOE proposed seven modifications to the EPA concerning the design of the panel closure system. EPA approval of these modifications is necessary since the details of the panel design are specified in EPA’s final rule as a condition for WIPP certification. However, the EPA has not determined whether a rulemaking would be required for these proposed design modifications. On September 4, 2001, the DOE withdrew the request, noting that it would be resubmitted on a future date. The Environmental Evaluation Group (EEG) contracted with two engineers, Dr. John Abel and Dr. Rusty Morgan, to evaluate the proposed modifications. The EEG has accepted the conclusions and recommendations from these two experts: 1) replacement of Salado Mass Concrete with a generic salt-based concrete; 2) replacement of the explosion wall with a construction wall; 3) replacement of freshwater grouting with salt-based grouting; 4) option to allow surface or underground mixing; and 5) option to allow up to one year for completion of closure. The proposed modification to allow local carbonate river rock as aggregate is acceptable pending demonstration that no problems will exist in the resulting concrete. The proposed modification to give the contractor discretion in removal of steel forms is not supported. Instead, several recommendations are made to specifically reduce the number of forms left, thereby reducing potential migration pathways.

  11. Uncertainty in geological linework: communicating the expert's tacit model to the data user(s) by expert elicitation.

    Science.gov (United States)

    Lawley, Russell; Barron, Mark; Lark, Murray

    2015-04-01

    At BGS, expert elicitation has been used to evaluate uncertainty of surveyed boundaries in several, common, geological scenarios. As a result, a 'collective' understanding of the issues surrounding each scenario has emerged. The work has provoked wider debate in three key areas: a) what can we do to resolve those scenarios where a 'consensus' of understanding cannot be achieved b) what does it mean for survey practices and subsequent use of maps in 3D models c) how do we communicate the 'collective' understanding of geological mapping (with or without consensus for specific scenarios). Previous work elicited expert judgement for uncertainty in six contrasting mapping scenarios. In five cases it was possible to arrive at a consensus model; in a sixth case experts with different experience (length of service, academic background) took very different views of the nature of the mapping problem. The scenario concerned identification of the boundary between two contrasting tills (one derived from Triassic source materials being red in colour; the other, derived from Jurassic materials being grey in colour). Initial debate during the elicitation identified that the colour contrast should provide some degree of confidence in locating the boundary via traditional auger-traverse survey methods. However, as the elicitation progressed, it became clear that the complexities of the relationship between the two Tills were not uniformly understood across the experts and the panel could not agree a consensus regarding the spatial uncertainty of the boundary. The elicitation process allowed a significant degree of structured knowledge-exchange between experts of differing backgrounds and was successful in identifying a measure of uncertainty for what was considered a contentious scenario. However, the findings have significant implications for a boundary-scenario that is widely mapped across the central regions of Great Britain. We will discuss our experience of the use of

  12. Clinical Guidelines for Management of Bone Health in Rett Syndrome Based on Expert Consensus and Available Evidence

    DEFF Research Database (Denmark)

    Jefferson, Amanda; Leonard, Helen; Siafarikas, Aris

    2016-01-01

    OBJECTIVES: We developed clinical guidelines for the management of bone health in Rett syndrome through evidence review and the consensus of an expert panel of clinicians. METHODS: An initial guidelines draft was created which included statements based upon literature review and 11 open-ended que...

  13. Neural network based expert system for fault diagnosis of particle accelerators

    International Nuclear Information System (INIS)

    Dewidar, M.M.

    1997-01-01

    Particle accelerators are generators that produce beams of charged particles, acquiring different energies, depending on the accelerator type. The MGC-20 cyclotron is a cyclic particle accelerator used for accelerating protons, deuterons, alpha particles, and helium-3 to different energies. Its applications include isotope production, nuclear reaction, and mass spectroscopy studies. It is a complicated machine, it consists of five main parts, the ion source, the deflector, the beam transport system, the concentric and harmonic coils, and the radio frequency system. The diagnosis of this device is a very complex task. it depends on the conditions of 27 indicators of the control panel of the device. The accurate diagnosis can lead to a high system reliability and save maintenance costs. so an expert system for the cyclotron fault diagnosis is necessary to be built. In this thesis , a hybrid expert system was developed for the fault diagnosis of the MGC-20 cyclotron. Two intelligent techniques, multilayer feed forward back propagation neural network and the rule based expert system, are integrated as a pre-processor loosely coupled model to build the proposed hybrid expert system. The architecture of the developed hybrid expert system consists of two levels. The first level is two feed forward back propagation neural networks, used for isolating the faulty part of the cyclotron. The second level is the rule based expert system, used for troubleshooting the faults inside the isolated faulty part. 4-6 tabs., 4-5 figs., 36 refs

  14. Understanding Peer Review of Scientific Research

    Science.gov (United States)

    Association of American Universities, 2011

    2011-01-01

    An important factor in the success of America's national research system is that federal funds for university-based research are awarded primarily through peer review, which uses panels of scientific experts, or "peers," to evaluate the quality of grant proposals. In this competitive process, proposals compete for resources based on their…

  15. Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System

    OpenAIRE

    Edsberg, Laura E.; Black, Joyce M.; Goldberg, Margaret; McNichol, Laurie; Moore, Lynn; Sieggreen, Mary

    2016-01-01

    Our understanding of pressure injury etiology and development has grown in recent years through research, clinical expertise, and global interdisciplinary expert collaboration. Therefore, the National Pressure Ulcer Advisory Panel (NPUAP) has revised the definition and stages of pressure injury. The revision was undertaken to incorporate the current understanding of the etiology of pressure injuries, as well as to clarify the anatomical features present or absent in each stage of injury. An N...

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

    International Nuclear Information System (INIS)

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

    1996-01-01

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

  17. Level of agreement among Latin American glaucoma subspecialists on the diagnosis and treatment of glaucoma: results of an online survey

    OpenAIRE

    Daniel E. Grigera; Paulo Augusto Arruda Mello; Wilma Lelis Barbosa; Javier Fernando Casiraghi; Rodolfo Perez Grossmann; Alejo Peyret

    2013-01-01

    PURPOSE: The aim of this research was to assess the level of agreement among glaucoma experts in Latin America on key practices related to treatment and diagnosis of glaucoma. METHODS: An online questionnaire was sent to a multinational panel of glaucoma experts. The questionnaire contained 107 statements on the medical treatment (Part 1) and diagnosis (Part 2) of glaucoma, and was developed in Spanish and translated into English. Agreement was defined as >70% of respondents. RESULTS: Fifty p...

  18. Safe handling of plutonium: a panel report

    Energy Technology Data Exchange (ETDEWEB)

    1974-01-01

    This guide results from a meeting of a Panel of Experts held by the International Atomic Energy Agency on 8 to 12 November 1971. It is directed to workers in research laboratories handling plutonium in gram amounts. Contents: aspects of the physical and chemical properties of plutonium; metabolic features of plutonium; facility design features for safe handling of plutonium (layout of facility, working zones, decontamination room, etc.); glove boxes; health surveillance (surveillance of environment and supervision of workers); emergencies; organization. Annexes: types of glove boxes; tables; mobile ..cap alpha.. air sampler; aerosol monitor; bio-assay limits of detection; examples of contamination control monitors.

  19. Defining the content and delivery of an intervention to Change AdhereNce to treatment in BonchiEctasis (CAN-BE): a qualitative approach incorporating the Theoretical Domains Framework, behavioural change techniques and stakeholder expert panels.

    Science.gov (United States)

    McCullough, Amanda R; Ryan, Cristín; O'Neill, Brenda; Bradley, Judy M; Elborn, J Stuart; Hughes, Carmel M

    2015-08-22

    Low patient adherence to treatment is associated with poorer health outcomes in bronchiectasis. We sought to use the Theoretical Domains Framework (TDF) (a framework derived from 33 psychological theories) and behavioural change techniques (BCTs) to define the content of an intervention to change patients' adherence in bronchiectasis (Stage 1 and 2) and stakeholder expert panels to define its delivery (Stage 3). We conducted semi-structured interviews with patients with bronchiectasis about barriers and motivators to adherence to treatment and focus groups or interviews with bronchiectasis healthcare professionals (HCPs) about their ability to change patients' adherence to treatment. We coded these data to the 12 domain TDF to identify relevant domains for patients and HCPs (Stage 1). Three researchers independently mapped relevant domains for patients and HCPs to a list of 35 BCTs to identify two lists (patient and HCP) of potential BCTs for inclusion (Stage 2). We presented these lists to three expert panels (two with patients and one with HCPs/academics from across the UK). We asked panels who the intervention should target, who should deliver it, at what intensity, in what format and setting, and using which outcome measures (Stage 3). Eight TDF domains were perceived to influence patients' and HCPs' behaviours: Knowledge, Skills, Beliefs about capability, Beliefs about consequences, Motivation, Social influences, Behavioural regulation and Nature of behaviours (Stage 1). Twelve BCTs common to patients and HCPs were included in the intervention: Monitoring, Self-monitoring, Feedback, Action planning, Problem solving, Persuasive communication, Goal/target specified:behaviour/outcome, Information regarding behaviour/outcome, Role play, Social support and Cognitive restructuring (Stage 2). Participants thought that an individualised combination of these BCTs should be delivered to all patients, by a member of staff, over several one-to-one and/or group visits in

  20. The use of expert elicitation to quantify uncertainty in incomplete sorption data bases for Waste Isolation Pilot Plant performance assessment

    International Nuclear Information System (INIS)

    Anderson, D.R.; Trauth, K.M.; Hora, S.C.

    1991-01-01

    Iterative, annual performance-assessment calculations are being performed for the Waste Isolation Pilot Plant (WIPP), a planned underground repository in southeastern New Mexico, USA for the disposal of transuranic waste. The performance-assessment calculations estimate the long-term radionuclide releases from the disposal system to the accessible environment. Because direct experimental data in some areas are presently of insufficient quantity to form the basis for the required distributions. Expert judgment was used to estimate the concentrations of specific radionuclides in a brine exiting a repository room or drift as it migrates up an intruding borehole, and also the distribution coefficients that describe the retardation of radionuclides in the overlying Culebra Dolomite. The variables representing these concentrations and coefficients have been shown by 1990 sensitivity analyses to be among the set of parameters making the greatest contribution to the uncertainty in WIPP performance-assessment predictions. Utilizing available information, the experts (one expert panel addressed concentrations and a second panel addressed retardation) developed an understanding of the problem and were formally elicited to obtain probability distributions that characterize the uncertainty in fixed, but unknown, quantities. The probability distributions developed by the experts are being incorporated into the 1991 performance-assessment calculations. 16 refs., 4 tabs

  1. Survey of Expert Opinion on Intelligence: Causes of International Differences in Cognitive Ability Tests.

    Science.gov (United States)

    Rindermann, Heiner; Becker, David; Coyle, Thomas R

    2016-01-01

    Following Snyderman and Rothman (1987, 1988), we surveyed expert opinions on the current state of intelligence research. This report examines expert opinions on causes of international differences in student assessment and psychometric IQ test results. Experts were surveyed about the importance of culture, genes, education (quantity and quality), wealth, health, geography, climate, politics, modernization, sampling error, test knowledge, discrimination, test bias, and migration. The importance of these factors was evaluated for diverse countries, regions, and groups including Finland, East Asia, sub-Saharan Africa, Southern Europe, the Arabian-Muslim world, Latin America, Israel, Jews in the West, Roma (gypsies), and Muslim immigrants. Education was rated by N = 71 experts as the most important cause of international ability differences. Genes were rated as the second most relevant factor but also had the highest variability in ratings. Culture, health, wealth, modernization, and politics were the next most important factors, whereas other factors such as geography, climate, test bias, and sampling error were less important. The paper concludes with a discussion of limitations of the survey (e.g., response rates and validity of expert opinions).

  2. Summary of Prioritized Research Opportunities. Building America Planning Meeting, November 2-4, 2010

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2011-02-01

    This report outlines the results of brainstorming sessions conducted at the Building America Fall 2010 planning meeting, in which research teams and national laboratories identified key research priorities to incorporate into multi-year planning, team research agendas, expert meetings, and technical standing committees.

  3. Effective medical treatment of opiate addiction. National Consensus Development Panel on Effective Medical Treatment of Opiate Addiction.

    Science.gov (United States)

    1998-12-09

    To provide clinicians, patients, and the general public with a responsible assessment of the effective approaches to treat opiate dependence. A nonfederal, nonadvocate, 12-member panel representing the fields of psychology, psychiatry, behavioral medicine, family medicine, drug abuse, epidemiology, and the public. In addition, 25 experts from these same fields presented data to the panel and a conference audience of 600. Presentations and discussions were divided into 3 phases over 2 1/2 days: (1) presentations by investigators working in the areas relevant to the consensus questions during a 2-day public session; (2) questions and statements from conference attendees during open discussion periods that are part of the public session; and (3) closed deliberations by the panel during the remainder of the second day and morning of a third day. The conference was organized and supported by the Office of Medical Applications of Research, National Institutes of Health. The literature was searched through MEDLINE and other National Library of Medicine and online databases from January 1994 through September 1997 and an extensive bibliography of 941 references was provided to the panel and the conference audience. Experts prepared abstracts for their presentations as speakers at the conference with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. The panel, answering predefined questions, developed its conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. The draft statement was made available on the World Wide Web immediately following its

  4. Is corruption good or bad for FDI? Empirical evidence from Asia, Africa and Latin America

    Directory of Open Access Journals (Sweden)

    Jalil Abdul

    2016-01-01

    Full Text Available This article revisits the relationship between corruption and Foreign Direct Investment inflows in a panel of 42 countries from 1984 to 2012 using pooled mean group estimator in a dynamic heterogeneous panel setting using Westerlund and ARDL panel cointegration tests where the estimations are carried out by three different estimators: the pooled mean group (PMG, mean group (MG, and the dynamic fixed effect (DFE estimators in order to examine both the long- and short-term effects of corruption on FDI inflows. The results suggest that corruption has a positive impact on FDI inflows in the case of Asia and Africa; and a negative impact in the case of Latin America.

  5. Recommendations for ICT use in Alzheimer's disease assessment: Monaco CTAD Expert Meeting.

    Science.gov (United States)

    Robert, P H; Konig, A; Andrieu, S; Bremond, F; Chemin, I; Chung, P C; Dartigues, J F; Dubois, B; Feutren, G; Guillemaud, R; Kenisberg, P A; Nave, S; Vellas, B; Verhey, F; Yesavage, J; Mallea, P

    2013-01-01

    Alzheimer disease (AD) and other related dementia represent a major challenge for health care systems within the aging population. It is therefore important to develop better instruments for assessing disease severity and disease progression to optimize patient's care and support to care providers, and also provide better tools for clinical research. In this area, Information and Communication Technologies (ICT) are of particular interest. Such techniques enable accurate and standardized assessments of patients' performance and actions in real time and real life situations. The aim of this article is to provide basic recommendation concerning the development and the use of ICT for Alzheimer's disease and related disorders. During he ICT and Mental Health workshop (CTAD meeting held in Monaco on the 30th October 2012) an expert panel was set up to prepare the first recommendations for the use of ICT in dementia research. The expert panel included geriatrician, epidemiologist, neurologist, psychiatrist, psychologist, ICT engineers, representatives from the industry and patient association. The recommendations are divided into three sections corresponding to 1/ the clinical targets of interest for the use of ICT, 2/ the conditions, the type of sensors and the outputs (scores) that could be used and obtained, 3/ finally the last section concerns specifically the use of ICT within clinical trials.

  6. Examination of U.S. Puberty Timing Data from 1940 to 1994 for Secular Trends: Panel Findings

    Science.gov (United States)

    Five articles based on "The Role of Environmental Factors on the Onset and Progression of Puberty" expert panel workshop findings were published as a Supplement to Pediatrics on Feb. 1, 2008. This workshop, sponsored by EPA, NIEHS, and Serono International and held in November o...

  7. 78 FR 76285 - Proposed Information Collection; Comment Request; Panel Member Survey To Develop Indicators of...

    Science.gov (United States)

    2013-12-17

    ... mathematically. NOAA will apply the Delphi Method to a multi-round survey of panels of individuals with... gather this information, NOAA will conduct a multi-round, iterative survey process based on the Delphi Method, which is a structured method for eliciting and combining expert opinion. The method requires...

  8. Technical assistance in Latin America

    International Nuclear Information System (INIS)

    Oteiza-Quirno, A.

    1976-01-01

    As in the other regions, nuclear technology development in Latin America reflects mainly the degree of technological development already existing in each country. It is quite significant that in nearly all countries in Latin America the medical profession has been the first to show interest in using nuclear techniques. As a result, a country such as Uruguay has become a source of recruitment for technical assistance experts in nuclear medicine to other developing countries, while at the same time it continues to receive assistance for new sophisticated techniques from the IAEA. Part of this assistance, in turn, comes from the neighbouring countries, Argentina and Brazil. For example, an expert from Uruguay is currently assigned under an Agency programme to Costa Rica, El Salvador and Guatemala, and experts from Argentina and Brazil have been sent to Uruguay. This is an example of 'horizontal' development, meaning mutual assistance between developing countries under programmes supported by the United Nations Agencies, which is now being emphasized by the United Nations Development Programme (UNDP). Still in the field of nuclear medicine, another significant model is provided by Bolivia. With assistance from the IAEA, and thanks to the availability of a good professional infrastructure in that country, a net of nuclear medicine services has been started, consisting of a well-developed nuclear medicine centre in La Paz and regional centres in Cochabamba, Sucre and Santa Cruz. Because of its great variations in altitude, Bolivia is in the position of being able to conduct research on the adaptation of man to diverse environmental conditions. The Agency has contributed, and continues to do so, to these programmes by sending experts, providing for training abroad of Bolivian doctors under its fellowship programmes, and providing basic equipment for all four centres. Independently of the cases described above, the IAEA has implemented or is implementing a considerable

  9. Recent advances in acute lymphoblastic leukemia in children and adolescents: an expert panel discussion.

    Science.gov (United States)

    Asselin, Barbara L; Gaynon, Paul; Whitlock, James A

    2013-12-01

    Acute lymphoblastic leukemia (ALL) is the most common form of childhood leukemia, representing 75% to 80% of cases of acute leukemia among children. Dramatic improvements in the cure rates and survival outcomes for children with ALL have been seen over the past several decades; currently the 5-year survival rate for childhood ALL is more than 80%. These improvements have come about because of advances in the understanding of the molecular genetics and pathogenesis of the disease, incorporation of risk-adapted therapy, and the advent of new targeted agents. Scientific advances have provided new insights into leukemogenesis, drug resistance, and host pharmacogenomics, identified novel subtypes of leukemia, and suggested potential targets for therapy. At the same time novel monoclonal antibodies, small molecule inhibitors, chemotherapeutics, and cell-based treatment strategies have been developed and investigated. In this article, experts will discuss some of the current challenges and future directions in the treatment of pediatric ALL. The authors will offer expert guidance to practicing oncologists on how to best incorporate newer treatment approaches into the care of children and adolescents with ALL. The most important ongoing clinical trials in the area will also be reviewed.

  10. Using expert judgments to improve chronic wasting disease risk management in Canada.

    Science.gov (United States)

    Oraby, Tamer; Tyshenko, Michael G; Westphal, Margit; Darshan, Shalu; Croteau, Maxine C; Aspinall, Willy; Elsaadany, Susie; Cashman, Neil; Krewski, Daniel

    2016-01-01

    ABSTARCT Chronic wasting disease (CWD) is a neurodegenerative, protein misfolding disease affecting cervids in North America in epidemic proportions. While the existence of CWD has been known for more than 40 years, risk management efforts to date have not been able to curtail the spread of this condition. An expert elicitation exercise was carried out in May 2011 to obtain the views of international experts on both the etiology of CWD and possible CWD risk management strategies. This study presents the results of the following three components of the elicitation exercise: (1) expert views of the most likely scenarios for the evolution of the CWD among cervid populations in Canada, (2) ranking analyses of the importance of direct and indirect transmission routes, and (3) rating analyses of CWD control measures in farmed and wild cervids. The implications of these findings for the development of CWD risk management strategies are described in a Canadian context.

  11. Consumer panel study on elderly people's wishes concerning services.

    Science.gov (United States)

    Valkila, Noora; Litja, Heli; Aalto, Leena; Saari, Arto

    2010-01-01

    This study informs on the wishes and needs of elderly people themselves regarding services for the elderly. The data for the study were gathered using a consumer panel method. Elderly people desire assistance in heavy cleaning chores, in outdoor activities and in carrying out their personal business. Elderly people felt that there should be more recreational services available. Elderly people link aging with feelings of insecurity and loneliness. Becoming a service user for the first time is felt to be a very difficult step to take, and so this decision is postponed as long as possible. The elderly people desire a service for assessing their individual service needs in an organized, expert and objective fashion. The study indicates that elderly people value the human contact gained through service provision. The consumer panel method for collecting data was successful. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  12. Geriatric Assessment-Guided Care Processes for Older Adults: A Delphi Consensus of Geriatric Oncology Experts.

    Science.gov (United States)

    Mohile, Supriya Gupta; Velarde, Carla; Hurria, Arti; Magnuson, Allison; Lowenstein, Lisa; Pandya, Chintan; O'Donovan, Anita; Gorawara-Bhat, Rita; Dale, William

    2015-09-01

    Structured care processes that provide a framework for how oncologists can incorporate geriatric assessment (GA) into clinical practice could improve outcomes for vulnerable older adults with cancer, a growing population at high risk of toxicity from cancer treatment. We sought to obtain consensus from an expert panel on the use of GA in clinical practice and to develop algorithms of GA-guided care processes. The Delphi technique, a well-recognized structured and reiterative process to reach consensus, was used. Participants were geriatric oncology experts who attended NIH-funded U13 or Cancer and Aging Research Group conferences. Consensus was defined as an interquartile range of 2 or more units, or 66.7% or greater, selecting a utility/helpfulness rating of 7 or greater on a 10-point Likert scale. For nominal data, consensus was defined as agreement among 66.7% or more of the group. From 33 invited, 30 participants completed all 3 rounds. Most experts (75%) used GA in clinical care, and the remainder were involved in geriatric oncology research. The panel met consensus that "all patients aged 75 years or older and those who are younger with age-related health concerns" should undergo GA and that all domains (function, physical performance, comorbidity/polypharmacy, cognition, nutrition, psychological status, and social support) should be included. Consensus was met for how GA could guide nononcologic interventions and cancer treatment decisions. Algorithms for GA-guided care processes were developed. This Delphi investigation of geriatric oncology experts demonstrated that GA should be performed for older patients with cancer to guide care processes. Copyright © 2015 by the National Comprehensive Cancer Network.

  13. Peer review panel summary report for technical determination of mixed waste incineration off-gas systems for Rocky Flats

    International Nuclear Information System (INIS)

    1992-01-01

    A Peer Review Panel was convened on September 15-17, 1992 in Boulder, Co. The members of this panel included representatives from DOE, EPA, and DOE contractors along with invited experts in the fields of air pollution control and waste incineration. The primary purpose of this review panel was to make a technical determination of a hold, test and release off gas capture system should be implemented in the proposed RF Pland mixed waste incineration system; or if a state of the art continuous air pollution control and monitoring system should be utilized as the sole off-gas control system. All of the evaluations by the panel were based upon the use of the fluidized bed unit proposed by Rocky Flats and cannot be generalized to other systems

  14. Price competition between an expert and a non-expert

    OpenAIRE

    Bouckaert, J.M.C.; Degryse, H.A.

    1998-01-01

    This paper characterizes price competition between an expert and a non-expert. In contrast with the expert, the non-expert’s repair technology is not always successful. Consumers visit the expert after experiencing an unsuccessful match at the non-expert. This re-entry affects the behaviour of both sellers. For low enough probability of successful repair at the non-expert, all consumers first visit the non-expert, and a ‘timid-pricing’ equilibrium results. If the non-expert’s repair technolog...

  15. EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies), 2014. Scientific Opinion on health benefits of seafood (fish and shellfish) consumption in relation to health risks associated with exposure to methylmercury

    DEFF Research Database (Denmark)

    Tetens, Inge

    2014-01-01

    Following a request from the European Commission to address the risks and benefits as regards fish/seafood consumption related to relevant beneficial substances (e.g. nutrients such as n-3 long-chain polyunsaturated fatty acids) and the contaminant methylmercury, the Panel on Dietetic Products...... effects of seafood consumption in relation to health outcomes and population subgroups that have been identified by the FAO/WHO Joint Expert Consultation on the Risks and Benefits of Fish Consumption and/or the EFSA Panel on Contaminants in the context of a risk assessment related to the presence...... of mercury and methylmercury in food as relevant for the assessment. These included the effects of seafood consumption during pregnancy on functional outcomes of children’s neurodevelopment and the effects of seafood consumption on cardiovascular disease risk in adults. The Panel concluded that consumption...

  16. Interdisciplinary management of EGFR-inhibitor-induced skin reactions: a German expert opinion.

    Science.gov (United States)

    Potthoff, K; Hofheinz, R; Hassel, J C; Volkenandt, M; Lordick, F; Hartmann, J T; Karthaus, M; Riess, H; Lipp, H P; Hauschild, A; Trarbach, T; Wollenberg, A

    2011-03-01

    Anti-epidermal growth factor receptor treatment strategies, i.e. monoclonal antibodies such as cetuximab and panitumumab, or epidermal growth factor receptor (EGFR) small molecule tyrosine kinase inhibitors, such as erlotinib and gefitinib, have expanded the treatment options for different tumor types. Dermatologic toxic effects are the most common side-effects of EGFR inhibitor therapy. They can profoundly affect the patient's quality of life. The aim of this study was to provide interdisciplinary expert recommendations on how to treat patients with skin reactions undergoing anti-EGFR treatment. An expert panel from Germany with expertise in medical oncology, dermatology or clinical pharmacology was convened to develop expert recommendations based on published peer-reviewed literature. The expert recommendations for the state-of-the-art treatment of skin reactions induced by EGFR inhibitor therapy include recommendations for diagnostics and grading as well as grade-specific and stage-adapted treatment approaches and preventive measures. It was concluded that EGFR-inhibitor-related dermatologic reactions should always be treated combining basic care of the skin and a specific therapy adapted to stage and grade of skin reaction. For grade 2 and above, specific treatment recommendations for early- and later-stage skin reactions induced by EGFR-inhibitor therapy were proposed. This paper presents a German national expert opinion for the treatment of skin reactions in patients receiving EGFR inhibitor therapy.

  17. Proceedings of the heavy oil Latin America congress 2011

    International Nuclear Information System (INIS)

    2011-01-01

    This conference brought experts together to explore the challenges faced and opportunities available in the dynamic emerging market for heavy oil which Latin America offers. The conference was attended by over 700 delegates from around the world representing official and private agencies, Latin American governments, national oil companies and service companies in heavy oil producing countries. These participants were given the opportunity to learn about the entire value chain of Latin America's heavy oil industry, with emphasis on balancing challenging environmental and social issues with operational best practices, and they also the opportunity to share their knowledge and expertise with their peers. 17 of the 29 papers presented during this conference have been catalogued separately for inclusion in this database.

  18. Microbiological specifications and testing methods for irradiated food. Report of a panel of experts; Specifications et methodes d'analyse microbiologiques des aliments irradies. Rapport d'un groupe d'etude

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1971-09-01

    In recent years there has been increased interest in the development of food items processed by means of ionizing radiation, wherever that form of preservation might show advantage over other methods. If this method becomes successful, the various items will be commercially exploited; it would then be convenient to have similar legislation in many countries of the world to control this type of processing and to facilitate international trade. To gather information and suggestions in order to devise legislation on irradiated food, a Joint FAO/IAEA/ WHO Expert Committee on the Technical Basis for Legislation on Irradiated Food was held in Rome on 21-28 April 1964. The Committee's report, 'The technical basis for legislation on irradiated food', was published as FAO Atomic Energy Series No.6 and WHO Technical Series No. 316. The Committee's terms of reference were to consider the available evidence on the effect on food of treatment with ionizing radiation in the context of wholesomeness and safety for consumption. Nutritional aspects were taken into account, but microbiological safety and microbiological methods for irradiated food were excluded since these subjects were believed to be too broad for adequate coverage in the working time available at the meeting. However, realizing the importance of radiation microbiology and the need for guidance in formulating regulations in this field, the committee drafted the following recommendation: 'The methods and standards used to ensure the microbiological safety of the irradiated product should, as a matter of urgency, be subject to review by competent international bodies in order that internationally acceptable methods and standards may be agreed upon'. In response to this recommendation an FAO/IAEA Panel on Microbiological Standards and Testing Methods for Irradiated Food was held in Vienna on 22-26 June 1965, in collaboration with the International Association of Microbiological Societies (IAMS). This was a working

  19. Importance of ARCAL Programme to promote technical cooperation in Latin America

    International Nuclear Information System (INIS)

    Dieguez, Jose Antonio Diaz

    1996-01-01

    The ARCAL Programme aims to promote regional co-operation and integration in the nuclear field and to solve common technological problems in Latin America and Caribbean. Emphasis has been given to technicians and researches training through experts interchange, courses, seminars and workshops, making use of the existing infrastructure in the region. During the eleven years of implementation, the ARCAL Programme allowed the training of thousands of professionals and technicians in the various aspects of the nuclear energy for peaceful purposes. Another indisputable achievement of the ARCAL has been the promotion of common knowledge and the link between experts in the region working on similar subjects. (author)

  20. Development of a Thin-Wall Magnesium side door Inner Panel for Automobiles

    Energy Technology Data Exchange (ETDEWEB)

    Jekl, J.; Auld, J.; Sweet, C.; Carter, Jon; Resch, Steve; Klarner, A.; Brevick, J.; Luo, A.

    2015-05-17

    Cast magnesium side door inner panels can provide a good combination of weight, functional, manufacturing and economical requirements. However, several challenges exist including casting technology for thin-wall part design, multi-material incompatibility and relatively low strength vs steel. A project has been initiated, supported by the US Department of Energy, to design and develop a lightweight frame-under-glass door having a thin-wall, full die-cast, magnesium inner panel. This development project is the first of its kind within North America. Phase I of the project is now complete and the 2.0mm magnesium design, through casting process enablers, has met or exceeded all stiffness requirements, with significant mass reduction and part consolidation. In addition, a corrosion mitigation strategy has been established using industry-accepted galvanic isolation methods and coating technologies.

  1. Building America Case Study: Trade-Friendly Retrofit Insulated Panels for Existing Buildings, Albany, New York

    Energy Technology Data Exchange (ETDEWEB)

    2016-03-01

    This project evaluated the effectiveness and affordability of integrating retrofit insulated panels into a re-siding project. The Partnership for Home Innovation (PHI) teamed with New York State Energy Research and Development Authority (NYSERDA), the Albany Housing Authority (AHA), and the New York State Weatherization Assistance Program (WAP) administered by Albany Community Action Partnership to demonstrate an energy retrofit and siding upgrade on a two-story, seven unit, multifamily building in Albany New York (CZ 5). The project focused on accomplishing three goals - doubling the existing wall thermal resistance (from approximately R-13 to a weighted average of R-27), reduction of building air leakage, and completion of the retrofit within a budget where the additional cost for upgrading wall's thermal resistance is equal to the cost of the standard re-siding effort (i.e., the total cost of the energy efficient re-siding scope of work is not more than double the cost of the standard re-siding effort). Lessons learned from the project strongly indicate that the retrofit panel technology can be installed using common installation practices and with minimal training. Other lessons learned include limitation on the use of standard air sealing materials during cold weather installations and the need to develop better installation guidance for trades working with the level of tolerances that may be present in the existing structure. This technology demonstration showed that exterior retrofit panels provide a viable and reasonable option for the siding trades to increase market opportunities and achieve synergistic benefits for aesthetic upgrades to a building's exterior.

  2. Towards a consensus definition of maternal sepsis: results of a systematic review and expert consultation.

    Science.gov (United States)

    Bonet, Mercedes; Nogueira Pileggi, Vicky; Rijken, Marcus J; Coomarasamy, Arri; Lissauer, David; Souza, João Paulo; Gülmezoglu, Ahmet Metin

    2017-05-30

    There is a need for a clear and actionable definition of maternal sepsis, in order to better assess the burden of this condition, trigger timely and effective treatment and allow comparisons across facilities and countries. The objective of this study was to review maternal sepsis definitions and identification criteria and to report on the results of an expert consultation to develop a new international definition of maternal sepsis. All original and review articles and WHO documents, as well as clinical guidelines providing definitions and/or identification criteria of maternal sepsis were included. A multidisciplinary international panel of experts was surveyed through an online consultation in March-April 2016 on their opinion on the existing sepsis definitions, including new definition of sepsis proposed for the adult population (2016 Third International Consensus Definitions for Sepsis and Septic Shock) and importance of different criteria for identification of maternal sepsis. The definition was agreed using an iterative process in an expert face-to-face consensus development meeting convened by WHO and Jhpiego. Standardizing the definition of maternal sepsis and aligning it with the current understanding of sepsis in the adult population was considered a mandatory step to improve the assessment of the burden of maternal sepsis by the expert panel. The literature review and expert consultation resulted in a new WHO consensus definition "Maternal sepsis is a life-threatening condition defined as organ dysfunction resulting from infection during pregnancy, child-birth, post-abortion, or post-partum period". Plans are in progress to validate the new WHO definition of maternal sepsis in a large international population. The operationalization of the new maternal sepsis definition requires generation of a set of practical criteria to identify women with sepsis. These criteria should enable clinicians to focus on the timely initiation of actionable elements of

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

    Science.gov (United States)

    Trutnevyte, Evelina; Azevedo, Inês L.

    2018-03-01

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

  4. Development of geriatric competencies for emergency medicine residents using an expert consensus process.

    Science.gov (United States)

    Hogan, Teresita M; Losman, Eve D; Carpenter, Christopher R; Sauvigne, Karen; Irmiter, Cheryl; Emanuel, Linda; Leipzig, Rosanne M

    2010-03-01

    The emergency department (ED) visit rate for older patients exceeds that of all age groups other than infants. The aging population will increase elder ED patient utilization to 35% to 60% of all visits. Older patients can have complex clinical presentations and be resource-intensive. Evidence indicates that emergency physicians fail to provide consistent high-quality care for elder ED patients, resulting in poor clinical outcomes. The objective was to develop a consensus document, "Geriatric Competencies for Emergency Medicine Residents," by identified experts. This is a minimum set of behaviorally based performance standards that all residents should be able to demonstrate by completion of their residency training. This consensus-based process utilized an inductive, qualitative, multiphase method to determine the minimum geriatric competencies needed by emergency medicine (EM) residents. Assessments of face validity and reliability were used throughout the project. In Phase I, participants (n=363) identified 12 domains and 300 potential competencies. In Phase II, an expert panel (n=24) clustered the Phase I responses, resulting in eight domains and 72 competencies. In Phase III, the expert panel reduced the competencies to 26. In Phase IV, analysis of face validity and reliability yielded a 100% consensus for eight domains and 26 competencies. The domains identified were atypical presentation of disease; trauma, including falls; cognitive and behavioral disorders; emergent intervention modifications; medication management; transitions of care; pain management and palliative care; and effect of comorbid conditions. The Geriatric Competencies for EM Residents is a consensus document that can form the basis for EM residency curricula and assessment to meet the demands of our aging population. Copyright (c) 2010 by the Society for Academic Emergency Medicine.

  5. EFSA CEF Panel (EFSA Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids), 2015. Scientific Opinion on Flavouring Group Evaluation 78, Revision 2 (FGE.78Rev2): Consideration of aliphatic and alicyclic and aromatic hydrocarbons evaluated by JECFA (63rd meeting) structurally

    DEFF Research Database (Denmark)

    Nørby, Karin Kristiane; Beltoft, Vibe Meister

    evaluated through a stepwise approach that integrates information on structure-activity relationships, intake from current uses, toxicological threshold of concern, and available data on metabolism and toxicity. The specifications for the materials of commerce are adequate for all substances. The Panel......The Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids of the European Food Safety Authority was requested to consider evaluations of flavouring substances assessed since 2000 by the Joint FAO/WHO Expert Committee on Food Additives (the JECFA), and to decide whether further...

  6. Panel Analysis

    DEFF Research Database (Denmark)

    Brænder, Morten; Andersen, Lotte Bøgh

    2014-01-01

    Based on our 2013-article, ”Does Deployment to War Affect Soldiers' Public Service Motivation – A Panel Study of Soldiers Before and After their Service in Afghanistan”, we present Panel Analysis as a methodological discipline. Panels consist of multiple units of analysis, observed at two or more...... in research settings where it is not possible to distribute units of analysis randomly or where the independent variables cannot be manipulated. The greatest disadvantage in regard to using panel studies is that data may be difficult to obtain. This is most clearly vivid in regard to the use of panel surveys...... points in time. In comparison with traditional cross-sectional studies, the advantage of using panel studies is that the time dimension enables us to study effects. Whereas experimental designs may have a clear advantage in regard to causal inference, the strength of panel studies is difficult to match...

  7. Planning diabetic retinopathy services – lessons from Latin America

    Directory of Open Access Journals (Sweden)

    Pedro Gomez-Bastar

    2011-09-01

    Full Text Available The World Health Organization encourages the promotion and development of programmes for the prevention, detection, and management of diabetic retinopathy (DR. Such programmes must identify effective strategies and technology so that they can be adapted to the situation in each part of the world. Programmes must also be monitored and continuously improved.The guidelines discussed in this article were developed by experts brought together during workshops hosted by the VISION 2020 Latin America technical subcommittee on DR and technical support was provided by the Pan-American Asociation of Ophthalmology (PAAO. Although these guidelines have been developed for Latin America, we hope that the principles they contain will provide a good starting point for the planning of DR services in other low- and middle-income countries.

  8. Expert Meeting Report: Key Innovations for Adding Energy Efficiency to Maintenance Projects

    Energy Technology Data Exchange (ETDEWEB)

    Wood, A.; Wiehagen, J.

    2012-09-01

    This report describes an expert meeting hosted by the Building America research team NAHB Research Center, which was held on February 8, 2012, in Orlando, Florida. The topic, Key Innovations for Adding Energy Efficiency to Maintenance Projects, was intended to provide direction to more focused efforts to increase the efficiency of existing homes; in this meeting, the focus was specifically for re-roofing and the opportunities for adding energy efficiency upgrades during this major home repair activity.

  9. Expert Nordic perspectives on the potential of novel inhalers to overcome unmet needs in the management of obstructive lung disease

    DEFF Research Database (Denmark)

    Løkke, Anders; Ahlbeck, Lars; Bjermer, Leif

    2015-01-01

    fails to achieve adequate lung deposition and therapeutic effect. In this report, the potential of novel inhaler devices to overcome unmet needs in the management of obstructive lung disease is considered by a panel of Nordic experts. The panel concludes that innovative inhalers can contribute to good......The effective self-management of obstructive lung disease is dependent upon the patient achieving good inhaler technique. However, many current inhalers are complicated to use, which may lead to handling difficulties. These difficulties can cause clinically relevant errors, whereby pharmacotherapy...... disease management and better use of healthcare resources....

  10. How Can Big Data Complement Expert Analysis? A Value Chain Case Study

    Directory of Open Access Journals (Sweden)

    Kyungtae Kim

    2018-03-01

    Full Text Available In the world of big data, there is a need to investigate how data-driven approaches can support expert-based analyses during a technology planning process. To meet this goal, we examined opportunities and challenges for big data analytics in the social sciences, particularly with respect to value chain analysis. To accomplish this, we designed a value chain mapping experiment that aimed to compare the results of expert-based and data-based mappings. In the expert-based approach, we asked an industry expert to visually depict an industry value chain based on insights and collected data. We also reviewed a previously published value chain developed by a panel of industry experts during a national technology planning process. In the data-driven analysis, we used a massive number of business transaction records between companies under the assumption that the data would be useful in identifying relationships between items in a value chain. The case study results demonstrated that data-driven analysis can help researchers understand the current status of industry structures, enabling them to develop more realistic, although less flexible value chain maps. This approach is expected to provide more value when used in combination with other databases. It is important to note that significant effort is required to develop an elaborate analysis algorithm, and data preprocessing is essential for obtaining meaningful results, both of which make this approach challenging. Experts’ insights are still helpful for validating the analytic results in value chain mapping.

  11. NESSUS/EXPERT - An expert system for probabilistic structural analysis methods

    Science.gov (United States)

    Millwater, H.; Palmer, K.; Fink, P.

    1988-01-01

    An expert system (NESSUS/EXPERT) is presented which provides assistance in using probabilistic structural analysis methods. NESSUS/EXPERT is an interactive menu-driven expert system that provides information to assist in the use of the probabilistic finite element code NESSUS/FEM and the fast probability integrator. NESSUS/EXPERT was developed with a combination of FORTRAN and CLIPS, a C language expert system tool, to exploit the strengths of each language.

  12. MO-E-BRB-02: Panel Member

    Energy Technology Data Exchange (ETDEWEB)

    Larner, J. [University of Virginia (United States)

    2016-06-15

    In this interactive session, lung SBRT patient cases will be presented to highlight real-world considerations for ensuring safe and accurate treatment delivery. An expert panel of speakers will discuss challenges specific to lung SBRT including patient selection, patient immobilization techniques, 4D CT simulation and respiratory motion management, target delineation for treatment planning, online treatment alignment, and established prescription regimens and OAR dose limits. Practical examples of cases, including the patient flow thought the clinical process are presented and audience participation will be encouraged. This panel session is designed to provide case demonstration and review for lung SBRT in terms of (1) clinical appropriateness in patient selection, (2) strategies for simulation, including 4D and respiratory motion management, and (3) applying multi imaging modality (4D CT imaging, MRI, PET) for tumor volume delineation and motion extent, and (4) image guidance in treatment delivery. Learning Objectives: Understand the established requirements for patient selection in lung SBRT Become familiar with the various immobilization strategies for lung SBRT, including technology for respiratory motion management Understand the benefits and pitfalls of applying multi imaging modality (4D CT imaging, MRI, PET) for tumor volume delineation and motion extent determination for lung SBRT Understand established prescription regimes and OAR dose limits.

  13. MO-E-BRB-03: Panel Member

    Energy Technology Data Exchange (ETDEWEB)

    Salter, B. [University Utah (United States)

    2016-06-15

    In this interactive session, lung SBRT patient cases will be presented to highlight real-world considerations for ensuring safe and accurate treatment delivery. An expert panel of speakers will discuss challenges specific to lung SBRT including patient selection, patient immobilization techniques, 4D CT simulation and respiratory motion management, target delineation for treatment planning, online treatment alignment, and established prescription regimens and OAR dose limits. Practical examples of cases, including the patient flow thought the clinical process are presented and audience participation will be encouraged. This panel session is designed to provide case demonstration and review for lung SBRT in terms of (1) clinical appropriateness in patient selection, (2) strategies for simulation, including 4D and respiratory motion management, and (3) applying multi imaging modality (4D CT imaging, MRI, PET) for tumor volume delineation and motion extent, and (4) image guidance in treatment delivery. Learning Objectives: Understand the established requirements for patient selection in lung SBRT Become familiar with the various immobilization strategies for lung SBRT, including technology for respiratory motion management Understand the benefits and pitfalls of applying multi imaging modality (4D CT imaging, MRI, PET) for tumor volume delineation and motion extent determination for lung SBRT Understand established prescription regimes and OAR dose limits.

  14. MO-E-BRB-01: Panel Member

    Energy Technology Data Exchange (ETDEWEB)

    Benedict, S. [University of California Davis Medical Center (United States)

    2016-06-15

    In this interactive session, lung SBRT patient cases will be presented to highlight real-world considerations for ensuring safe and accurate treatment delivery. An expert panel of speakers will discuss challenges specific to lung SBRT including patient selection, patient immobilization techniques, 4D CT simulation and respiratory motion management, target delineation for treatment planning, online treatment alignment, and established prescription regimens and OAR dose limits. Practical examples of cases, including the patient flow thought the clinical process are presented and audience participation will be encouraged. This panel session is designed to provide case demonstration and review for lung SBRT in terms of (1) clinical appropriateness in patient selection, (2) strategies for simulation, including 4D and respiratory motion management, and (3) applying multi imaging modality (4D CT imaging, MRI, PET) for tumor volume delineation and motion extent, and (4) image guidance in treatment delivery. Learning Objectives: Understand the established requirements for patient selection in lung SBRT Become familiar with the various immobilization strategies for lung SBRT, including technology for respiratory motion management Understand the benefits and pitfalls of applying multi imaging modality (4D CT imaging, MRI, PET) for tumor volume delineation and motion extent determination for lung SBRT Understand established prescription regimes and OAR dose limits.

  15. Ethical evaluation of research proposals by ethics panels advising the European Commission.

    Science.gov (United States)

    Kolar, Roman

    2004-06-01

    Ethical principles with regard to animal experimentation are referred to in European Union (EU) legislation and other official documents. Therefore, applications for funding of research under the EU's research programme may undergo an ethical review that is carried out by so-called ethics panels, consisting of experts chosen by the European Commission. The work of these panels differs substantially from that of other ethical committees, as they exist on the institutional, local, regional or national level. Their main purpose is not to decide whether a proposed research can be regarded legal, and therefore should be endorsed or licensed; instead, it is to help the Commission in prioritising its funding. The panels may examine other ethical aspects than those of animal experimentation or animal welfare alone, such as the use of human volunteers. This is reflected by the composition of the panels. Their decisions are normally based on consensus. Even though these decisions may refer to EU legislation, the criteria applied are not restricted to those provided by this legislation. Nevertheless, the various aspects of the Commission's ethical evaluation system (e.g. formal and practical basic conditions, information content of applications, type of decisions taken, lacking of any quality control) offers opportunities for improvement.

  16. EFSA CEF Panel (EFSA Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids), 2013. Scientific Opinion on Flavouring Group Evaluation 76, Revision 1 (FGE.76Rev1)

    OpenAIRE

    Beltoft, Vibe Meister; Binderup, Mona-Lise; Frandsen, Henrik Lauritz; Lund, Pia; Nørby, Karin Kristiane

    2013-01-01

    The Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids of the European Food Safety Authority was requested to consider evaluations of flavouring substances assessed since 2000 by the Joint FAO/WHO Expert Committee on Food Additives (JECFA), and to decide whether further evaluation is necessary, as laid down in Commission Regulation (EC) No 1565/2000. The present opinion concerns a group of 26 sulphur-containing heterocyclic compounds evaluated by the JECFA at the 59th m...

  17. Influenza among the elderly in the Americas: a consensus statement

    Directory of Open Access Journals (Sweden)

    Ricardo W. Rüttimann

    2013-06-01

    Full Text Available Influenza exacts a heavy burden on the elderly, a segment of the population that is estimated to experience rapid growth in the near future. In the past decade most developed and several developing countries have recommended influenza vaccination for those > 65 years of age. The World Health Organization (WHO set a goal of 75% influenza vaccination coverage among the elderly by 2010, but it was not achieved. In 2011, the Technical Advisory Group at the Pan American Health Organization, Regional Office of WHO for the Americas, reiterated the influenza vaccine recommendation for older adults. Relatively little information has been compiled on the immunological aspect of aging or on reducing its impact, information particularly relevant for clinicians and gerontologist with firsthand experience confronting its effects. To fill this data gap, in 2012 the Americas Health Foundation (Washington, D.C., United States and the nonprofit, Fighting Infectious Diseases in Emerging Countries (Miami, Florida, United States, convened a panel of Latin American clinicians and gerontologists with expertise in influenza to discuss key issues and develop a consensus statement. The major recommendations were to improve influenza surveillance throughout Latin America so that its impact can be quantified; and to conduct laboratory confirmation of influenza for all patients who have flu-like symptoms and are frail, immunosuppressed, have comorbidities, are respiratory compromised, or have been admitted to a hospital. The panel also noted that: since evidence for antivirals in the elderly is unclear, their use should be handled on a case-by-case basis; despite decreased immunological response, influenza vaccination in older adults is still crucial; indirect immunization strategies should be encouraged; and traditional infection control measures are essential in long-term care facilities.

  18. A practical guideline for examining a uterine niche using ultrasonography in non-pregnant women: a modified Delphi method amongst European experts.

    Science.gov (United States)

    Jordans, I P M; de Leeuw, R; Stegwee, S I; Amso, N N; Barri-Soldevila, P N; van den Bosch, T; Bourne, T; Brolmann, H A M; Donnez, O; Dueholm, M; Hehenkamp, W J K; Jastrow, N; Jurkovic, D; Mashiach, R; Naji, O; Streuli, I; Timmerman, D; Vd Voet, L F; Huirne, J A F

    2018-03-14

    To generate a uniform, internationally recognized guideline for detailed uterine niche evaluation by ultrasonography in non-pregnant women using a modified Delphi method amongst international experts. Fifteen international gynecological experts were recruited by their membership of the European niche taskforce group. All experts were physicians with extensive experience in niche evaluation in clinical practice and/or authors of niche studies. Relevant items for niche measurement were determined based on the results of a literature search and recommendations of a focus group. Two online questionnaires were sent to the expert panel and one group meeting was organized. Consensus was predefined as a consensus rate of at least 70%. In total 15 experts participated in this study. Consensus was reached for a total of 42 items on niche evaluation, including definitions, relevance, method of measurement and tips for visualization of the niche. All experts agreed on the proposed guideline for niche evaluation in non-pregnant women as presented in this paper. Consensus between niche experts was achieved on all items regarding ultrasonographic niche measurement. This article is protected by copyright. All rights reserved.

  19. Expert judgments about transient climate response to alternative future trajectories of radiative forcing.

    Science.gov (United States)

    Zickfeld, Kirsten; Morgan, M Granger; Frame, David J; Keith, David W

    2010-07-13

    There is uncertainty about the response of the climate system to future trajectories of radiative forcing. To quantify this uncertainty we conducted face-to-face interviews with 14 leading climate scientists, using formal methods of expert elicitation. We structured the interviews around three scenarios of radiative forcing stabilizing at different levels. All experts ranked "cloud radiative feedbacks" as contributing most to their uncertainty about future global mean temperature change, irrespective of the specified level of radiative forcing. The experts disagreed about the relative contribution of other physical processes to their uncertainty about future temperature change. For a forcing trajectory that stabilized at 7 Wm(-2) in 2200, 13 of the 14 experts judged the probability that the climate system would undergo, or be irrevocably committed to, a "basic state change" as > or =0.5. The width and median values of the probability distributions elicited from the different experts for future global mean temperature change under the specified forcing trajectories vary considerably. Even for a moderate increase in forcing by the year 2050, the medians of the elicited distributions of temperature change relative to 2000 range from 0.8-1.8 degrees C, and some of the interquartile ranges do not overlap. Ten of the 14 experts estimated that the probability that equilibrium climate sensitivity exceeds 4.5 degrees C is > 0.17, our interpretation of the upper limit of the "likely" range given by the Intergovernmental Panel on Climate Change. Finally, most experts anticipated that over the next 20 years research will be able to achieve only modest reductions in their degree of uncertainty.

  20. Expert systems

    International Nuclear Information System (INIS)

    Haldy, P.A.

    1988-01-01

    The definitions of the terms 'artificial intelligence' and 'expert systems', the methodology, areas of employment and limits of expert systems are discussed. The operation of an expert system is described, especially the presentation and organization of knowledge as well as interference and control. Methods and tools for expert system development are presented and their application in nuclear energy are briefly addressed. 7 figs., 2 tabs., 6 refs

  1. Sources of Economic Fluctuations in Central America

    Directory of Open Access Journals (Sweden)

    Wilfredo Toledo

    2014-06-01

    Full Text Available Using panel data from Central America, this paper studies the determining factors of inflation and aggregate output fluctuations by estimating two Structural Vector Autoregressive (SVAR models. Price and output variables are included in one of the models, whereas M2 and the price of oil are additional variables in the other one. Findings of this study suggest that price is determined by the demand, while output seems to be influenced mainly by the supply shocks in that area. It was also evidenced that the price of oil does not have a significant impact on the general price level in that region.

  2. An expert panel-based study on recognition of gastro-esophageal reflux in difficult esophageal pH-impedance tracings.

    Science.gov (United States)

    Smits, M J; Loots, C M; van Wijk, M P; Bredenoord, A J; Benninga, M A; Smout, A J P M

    2015-05-01

    Despite existing criteria for scoring gastro-esophageal reflux (GER) in esophageal multichannel pH-impedance measurement (pH-I) tracings, inter- and intra-rater variability is large and agreement with automated analysis is poor. To identify parameters of difficult to analyze pH-I patterns and combine these into a statistical model that can identify GER episodes with an international consensus as gold standard. Twenty-one experts from 10 countries were asked to mark GER presence for adult and pediatric pH-I patterns in an online pre-assessment. During a consensus meeting, experts voted on patterns not reaching majority consensus (>70% agreement). Agreement was calculated between raters, between consensus and individual raters, and between consensus and software generated automated analysis. With eight selected parameters, multiple logistic regression analysis was performed to describe an algorithm sensitive and specific for detection of GER. Majority consensus was reached for 35/79 episodes in the online pre-assessment (interrater κ = 0.332). Mean agreement between pre-assessment scores and final consensus was moderate (κ = 0.466). Combining eight pH-I parameters did not result in a statistically significant model able to identify presence of GER. Recognizing a pattern as retrograde is the best indicator of GER, with 100% sensitivity and 81% specificity with expert consensus as gold standard. Agreement between experts scoring difficult impedance patterns for presence or absence of GER is poor. Combining several characteristics into a statistical model did not improve diagnostic accuracy. Only the parameter 'retrograde propagation pattern' is an indicator of GER in difficult pH-I patterns. © 2015 John Wiley & Sons Ltd.

  3. [Medical expert consensus in AH on the clinical use of triple fixed-dose antihypertensive therapy in Spain].

    Science.gov (United States)

    Mazón, P; Galve, E; Gómez, J; Gorostidi, M; Górriz, J L; Mediavilla, J D

    The opinion of experts (different specialties) on the triple fixed-dose antihypertensive therapy in clinical practice may differ. Online questionnaire with controversial aspects of the triple therapy answered by panel of experts in hypertension (HT) using two-round modified Delphi method. The questionnaire was completed by 158 experts: Internal Medicine (49), Nephrology (26), Cardiology (83). Consensus was reached (agreement) on 27/45 items (60%); 7 items showed differences statistically significant. Consensus was reached regarding: Predictive factors in the need for combination therapy and its efficacy vs. increasing the dose of a pretreatment, and advantage of triple therapy (prescription/adherence/cost/pressure control) vs. free combination. This consensus provides an overview of the clinical use of triple therapy in moderate-severe and resistant/difficult to control HT. Copyright © 2016 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. The Cosmetic Ingredient Review Program-Expert Safety Assessments of Cosmetic Ingredients in an Open Forum.

    Science.gov (United States)

    Boyer, Ivan J; Bergfeld, Wilma F; Heldreth, Bart; Fiume, Monice M; Gill, Lillian J

    The Cosmetic Ingredient Review (CIR) is a nonprofit program to assess the safety of ingredients in personal care products in an open, unbiased, and expert manner. Cosmetic Ingredient Review was established in 1976 by the Personal Care Products Council (PCPC), with the support of the US Food and Drug Administration (USFDA) and the Consumer Federation of America (CFA). Cosmetic Ingredient Review remains the only scientific program in the world committed to the systematic, independent review of cosmetic ingredient safety in a public forum. Cosmetic Ingredient Review operates in accordance with procedures modeled after the USFDA process for reviewing over-the-counter drugs. Nine voting panel members are distinguished, such as medical professionals, scientists, and professors. Three nonvoting liaisons are designated by the USFDA, CFA, and PCPC to represent government, consumer, and industry, respectively. The annual rate of completing safety assessments accelerated from about 100 to more than 400 ingredients by implementing grouping and read-across strategies and other approaches. As of March 2017, CIR had reviewed 4,740 individual cosmetic ingredients, including 4,611 determined to be safe as used or safe with qualifications, 12 determined to be unsafe, and 117 ingredients for which the information is insufficient to determine safety. Examples of especially challenging safety assessments and issues are presented here, including botanicals. Cosmetic Ingredient Review continues to strengthen its program with the ongoing cooperation of the USFDA, CFA, the cosmetics industry, and everyone else interested in contributing to the process.

  5. Phenotypic variability in a panel of strawberry cultivars from North America and the European Union

    Science.gov (United States)

    The phenotypic diversity in 96 antique and modern cultivars from the European Union and North America was evaluated in Michigan and Oregon, in 2011 and 2012. A total of thirty-five fruit and developmental characteristics were measured. Significant differences (p < 0.05) were observed among cultivars...

  6. Expert Systems

    OpenAIRE

    Lucas, P.J.F.

    2005-01-01

    Expert systems mimic the problem-solving activity of human experts in specialized domains by capturing and representing expert knowledge. Expert systems include a knowledge base, an inference engine that derives conclusions from the knowledge, and a user interface. Knowledge may be stored as if-then rules, orusing other formalisms such as frames and predicate logic. Uncertain knowledge may be represented using certainty factors, Bayesian networks, Dempster-Shafer belief functions, or fuzzy se...

  7. Expert Meeting Report: Windows Options for New and Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Ojczyk, C.; Carmody, J.; Haglund, K.

    2013-05-01

    The NorthernSTAR Building America Partnership held an Expert Meeting on Windows Options for New and Existing Homes on November 14, 2011 at the Nolte Building on the campus of the University of Minnesota in Minneapolis, MN. Featured speakers included John Carmody and Pat Huelman of the University of Minnesota, Charlie Curcija of Lawrence Berkeley National Laboratory, Jim Larson of Cardinal Glass Industries, Peter Yost of Building Green, Peter Baker of Building Science Corporation, and Theresa Weston of Du Pont Innovations. Audience participation was actively encouraged during each presentation to uncover need and promote dialog among researchers and industry professionals.

  8. Expert Meeting Report. Windows Options for New and Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Ojczyck, C. [Univ. of Minnesota, St. Paul, MN (United States); Carmody, J. [Univ. of Minnesota, St. Paul, MN (United States); Haglund, K. [Univ. of Minnesota, St. Paul, MN (United States)

    2013-05-01

    The NorthernSTAR Building America Partnership held an Expert Meeting on Windows Options for New and Existing Homes on November 14, 2011, at the Nolte Building on the campus of the University of Minnesota in Minneapolis, MN. Featured speakers included John Carmody and Pat Huelman of the University of Minnesota, Charlie Curcija of Lawrence Berkeley National Laboratory, Jim Larson of Cardinal Glass Industries, Peter Yost of Building Green, Peter Baker of Building Science Corporation, and Theresa Weston of Du Pont Innovations. Audience participation was actively encouraged during each presentation to uncover need and promote dialog among researchers and industry professionals.

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

    Science.gov (United States)

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

    2016-07-01

    There is an urgent need for consensus on what defines a chronic obstructive pulmonary disease (COPD) self-management intervention. We aimed to obtain consensus regarding the conceptual definition of a COPD self-management intervention by engaging an international panel of COPD self-management experts using Delphi technique features and an additional group meeting.In each consensus round the experts were asked to provide feedback on the proposed definition and to score their level of agreement (1=totally disagree; 5=totally agree). The information provided was used to modify the definition for the next consensus round. Thematic analysis was used for free text responses and descriptive statistics were used for agreement scores.In total, 28 experts participated. The consensus round response rate varied randomly over the five rounds (ranging from 48% (n=13) to 85% (n=23)), and mean definition agreement scores increased from 3.8 (round 1) to 4.8 (round 5) with an increasing percentage of experts allocating the highest score of 5 (round 1: 14% (n=3); round 5: 83% (n=19)).In this study we reached consensus regarding a conceptual definition of what should be a COPD self-management intervention, clarifying the requisites for such an intervention. Operationalisation of this conceptual definition in the near future will be an essential next step. The content of this work is not subject to copyright. Design and branding are copyright ©ERS 2016.

  10. International, Expert-Based, Consensus Statement Regarding the Management of Acute Diverticulitis.

    Science.gov (United States)

    O'Leary, D Peter; Lynch, Noel; Clancy, Cillian; Winter, Desmond C; Myers, Eddie

    2015-09-01

    This Delphi study provides consensus related to many aspects of acute diverticulitis and identifies other areas in need of research. To generate an international, expert-based, consensus statement to address controversies in the management of acute diverticulitis. This study was conducted using the Delphi technique from April 3 through October 21, 2014. A survey website was used and a panel of acute diverticulitis experts was formed via the snowball method. The top 5 acute diverticulitis experts in 5 international geographic regions were identified based on their number of publications related to acute diverticulitis. The Delphi study used 3 rounds of questions, after which the consensus statement was collated. A consensus statement related to the management of acute diverticulitis. Twenty items were selected for inclusion in the consensus statement following 3 rounds of questioning. A clear definition of uncomplicated and complicated diverticulitis is provided. In uncomplicated diverticulitis, consensus was reached regarding appropriate laboratory and radiological evaluation of patients as well as nonsurgical, surgical, and follow-up strategies. A number of important topics, including antibiotic treatment, failed to reach consensus. In addition, consensus was reached regarding many nonsurgical and surgical treatment strategies in complicated diverticulitis. Controversy continues internationally regarding the management of acute diverticulitis. This study demonstrates that there is more nonconsensus among experts than consensus regarding most issues, even in the same region. It also provides insight into the status quo regarding the treatment of acute diverticulitis and provides important direction for future research.

  11. Expert Statement on the Single-Agent Use of Inhaled Bronchodilator in the Treatment of Stable Mild-Moderate Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Riesco Miranda, Juan Antonio; Alcázar, Bernardino; Alfageme, Inmaculada; Casanova, Ciro; Celli, Bartolomé; de-Torres, Juan P; Jiménez Ruiz, Carlos A

    2017-10-01

    To describe the evidence- and experience-based expert consensus on the use of single-agent bronchodilators in patients with stable mild-moderate chronic obstructive pulmonary disease (COPD). Using Delphi methodology, a panel of 7 respiratory medicine experts was established, who, in the first nominal group meeting defined the scope, users, and document sections. The panel drew up 14 questions on the use of single-agent bronchodilators in patients with mild-moderate stable COPD to be answered with a systematic review of the literature. The results of the review were discussed in a second nominal group meeting and 17 statements were generated. Agreement/disagreement with the statements was tested among16 different experts including respiratory medicine experts and primary care physicians. Statements were scored from1 (total disagreement) to10 (total agreement). Agreement was considered if at least 70% voted ≥7. The level of evidence and grade of recommendation of the systematic literature review was assessed using the Oxford Centre for Evidence-based Medicine levels. A total of 12 of the 17 statements were selected. Specific statements were generated on different profiles of patients with stable mild-moderate COPD in whom single-agent bronchodilators could be prescribed. These statements on the use of single-agent bronchodilators might improve the outcomes and prognosis of patients with stable mild-moderate COPD. Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Lessons Learned- The Use of Formal Expert Elicitation in Probablistic Seismic Hazard

    Energy Technology Data Exchange (ETDEWEB)

    K.J. Coppersmith; R.C. Perman; R.R. Youngs

    2006-05-10

    Probabilistic seismic hazard analyses provide the opportunity, indeed the requirement, to quantify the uncertainties in important inputs to the analysis. The locations of future earthquakes, their recurrence rates and maximum size, and the ground motions that will result at a site of interest are all quantities that require careful consideration because they are uncertain. The earliest PSHA models [Cornell, 1968] provided solely for the randomness or aleatory variability in these quantities. The most sophisticated seismic hazard models today, which include quantified uncertainties, are merely more realistic representations of this basic aleatory model. All attempts to quantify uncertainties require expert judgment. Further, all uncertainty models should endeavor to consider the range of views of the larger technical community at the time the hazard analysis is conducted. In some cases, especially for large projects under regulatory review, formal structured methods for eliciting expert judgments have been employed. Experience has shown that certain key elements are required for these assessments to be successful, including: (1) experts should be trained in probability theory, uncertainty quantification, and ways to avoid common cognitive biases; (2) comprehensive and user-friendly databases should be provided to the experts; (3) experts should be required to evaluate all potentially credible hypotheses; (4) workshops and other interactions among the experts and proponents of published viewpoints should be encouraged; (5) elicitations are best conducted in individual interview sessions; (6) feedback should be provided to the experts to give them insight into the significance of alternative assessments to the hazard results; and (7) complete documentation should include the technical basis for all assessments. Case histories are given from seismic hazard analyses in Europe, western North America, and the stable continental region of the United States.

  13. Integrated Thermal Treatment Systems study: US Department of Energy Internal Review Panel report

    International Nuclear Information System (INIS)

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

    1995-04-01

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

  14. Sustainable Construction for Urban Infill Development Using Engineered Massive Wood Panel Systems

    Directory of Open Access Journals (Sweden)

    Steffen Lehmann

    2012-10-01

    Full Text Available Prefabricated engineered solid wood panel construction systems can sequester and store CO2. Modular cross-laminated timber (CLT, also called cross-lam panels form the basis of low-carbon, engineered construction systems using solid wood panels that can be used to build residential infill developments of 10 storeys or higher. Multi-apartment buildings of 4 to 10 storeys constructed entirely in timber, such as recently in Europe, are innovative, but their social and cultural acceptance in Australia and North America is at this stage still uncertain. Future commercial utilisation is only possible if there is a user acceptance. The author is part of a research team that aims to study two problems: first models of urban infill; then focus on how the use of the CLT systems can play an important role in facilitating a more livable city with better models of infill housing. Wood is an important contemporary building resource due to its low embodied energy and unique attributes. The potential of prefabricated engineered solid wood panel systems, such as CLT, as a sustainable building material and system is only just being realised around the globe. Since timber is one of the few materials that has the capacity to store carbon in large quantities over a long period of time, solid wood panel construction offers the opportunity of carbon engineering, to turn buildings into ‘carbon sinks’. Thus some of the historically negative environmental impact of urban development and construction can be turned around with CLT construction on brownfield sites.

  15. An expert system model for mapping tropical wetlands and peatlands reveals South America as the largest contributor.

    Science.gov (United States)

    Gumbricht, Thomas; Roman-Cuesta, Rosa Maria; Verchot, Louis; Herold, Martin; Wittmann, Florian; Householder, Ethan; Herold, Nadine; Murdiyarso, Daniel

    2017-09-01

    Wetlands are important providers of ecosystem services and key regulators of climate change. They positively contribute to global warming through their greenhouse gas emissions, and negatively through the accumulation of organic material in histosols, particularly in peatlands. Our understanding of wetlands' services is currently constrained by limited knowledge on their distribution, extent, volume, interannual flood variability and disturbance levels. We present an expert system approach to estimate wetland and peatland areas, depths and volumes, which relies on three biophysical indices related to wetland and peat formation: (1) long-term water supply exceeding atmospheric water demand; (2) annually or seasonally water-logged soils; and (3) a geomorphological position where water is supplied and retained. Tropical and subtropical wetlands estimates reach 4.7 million km 2 (Mkm 2 ). In line with current understanding, the American continent is the major contributor (45%), and Brazil, with its Amazonian interfluvial region, contains the largest tropical wetland area (800,720 km 2 ). Our model suggests, however, unprecedented extents and volumes of peatland in the tropics (1.7 Mkm 2 and 7,268 (6,076-7,368) km 3 ), which more than threefold current estimates. Unlike current understanding, our estimates suggest that South America and not Asia contributes the most to tropical peatland area and volume (ca. 44% for both) partly related to some yet unaccounted extended deep deposits but mainly to extended but shallow peat in the Amazon Basin. Brazil leads the peatland area and volume contribution. Asia hosts 38% of both tropical peat area and volume with Indonesia as the main regional contributor and still the holder of the deepest and most extended peat areas in the tropics. Africa hosts more peat than previously reported but climatic and topographic contexts leave it as the least peat-forming continent. Our results suggest large biases in our current understanding of

  16. Summary of Prioritized Research Opportunities: Building America Program Planning Meeting, Washington, D.C., November 2-4, 2010

    Energy Technology Data Exchange (ETDEWEB)

    2011-02-01

    This report outlines the results of brainstorming sessions conducted at the Building America Fall 2010 planning meeting, in which research teams and national laboratories identified key research priorities to incorporate into multi-year planning, team research agendas, expert meetings, and technical standing committees.

  17. Panel and planar experimental shear behavior of wood panels ...

    African Journals Online (AJOL)

    Panel shear strength along the thickness and planar shear along the length of wood panels laminated softwood oriented OSB 10 mm thick, conditioned at different moisture contents (anhydrous medium, ambient temperature and humid medium) was measured on standardized test specimens, cut in half lengthwise panel ...

  18. Expert - Non-expert differences in visual behaviour during alpine slalom skiing.

    Science.gov (United States)

    Decroix, Marjolein; Wazir, Mohd Rozilee Wazir Norjali; Zeuwts, Linus; Deconinck, Frederik F J A; Lenoir, Matthieu; Vansteenkiste, Pieter

    2017-10-01

    The aim of this study was to investigate visual behaviour of expert and non-expert ski athletes during an alpine slalom. Fourteen non-experts and five expert slalom skiers completed an alpine slalom course in an indoor ski slope while wearing a head-mounted eye tracking device. Experts completed the slalom clearly faster than non-experts, but no significant difference was found in timing and position of the turn initiation. Although both groups already looked at future obstacles approximately 0,5s before passing the upcoming pole, the higher speed of experts implied that they shifted gaze spatially earlier in the bend than non-experts. Furthermore, experts focussed more on the second next pole while non-expert slalom skiers looked more to the snow surface immediately in front of their body. No difference was found in the fixation frequency, average fixation duration, and quiet eye duration between both groups. These results suggest that experts focus on the timing of their actions while non-experts still need to pay attention to the execution of these actions. These results also might suggest that ski trainers should instruct non-experts and experts to focus on the next pole and, shift their gaze to the second next pole shortly before reaching it. Based on the current study it seems unadvisable to instruct slalom skiers to look several poles ahead during the actual slalom. However, future research should test if these results still hold on a real outdoor slope, including multiple vertical gates. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Optimum design of composite panel with photovoltaic-thermo module. Absorbing effect of cooling panel; Hikari netsu fukugo panel no saiteki sekkei. Reikyaku panel no kyunetsu koka

    Energy Technology Data Exchange (ETDEWEB)

    Sato, M; Kikuchi, S; Tani, T [Science University of Tokyo, Tokyo (Japan); Kadotani, K; Imaizumi, H [Komatsu Ltd., Tokyo (Japan)

    1996-10-27

    The composite panel with photovoltaic-thermo module becomes higher in energy-saving than the conventional air-conditioning system by the independent radiational heating and cooling effect obtained when the generating panel using a solar cell module is combined with the heating and cooling panel using a thermo-element module. The output of a solar cell module can be directly used because the solar cell module operates in AC. This paper reports the relation between the absorbed value and power consumption of the cooling panel, while paying attention to the cooling panel. The performance coefficient of the maximum absorbed value from an non-absorbing substance to a cooling panel is 2 to 3. Assume that the cooling panel during non-adiabatic operation is operated using a solar cell module of 800 W/m{sup 2} in solar intensity and 15% in conversion efficiency. The cooling-surface temperature difference is 12.12 K, and the maximum absorbed value of a non-absorbing substance to a cooling panel is 39.12 W/m{sup 2}. The absorbed value of the outer temperature to the cooling panel is 74.4 W/m{sup 2}, and each performance coefficient is 3.26 and 0.62. The absorbed value must be calculated for evaluation from the cooling-surface temperature difference measured directly from the cooling panel. 4 refs., 8 figs., 1 tab.

  20. Data Base Management Systems Panel. Third workshop summary

    Science.gov (United States)

    Urena, J. L. (Editor)

    1981-01-01

    The discussions and results of a review by a panel of data base management system (DRMS) experts of various aspects of the use of DBMSs within NASA/Office of Space and Terrestrial Applications (OSTA) and related organizations are summarized. The topics discussed included the present status of the use of DBMS technology and of the various ongoing DBMS-related efforts within NASA. The report drafts of a study that seeks to determine the functional requirements for a generalized DBMS for the NASA/OSTA and related data bases are examined. Future problems and possibilities with the use of DBMS technology are also considered. A list of recommendations for NASA/OSTA data systems is included.

  1. The impact of the internet on community pharmacy practice: a comparison of a Delphi panel's forecast with emerging trends.

    Science.gov (United States)

    Holmes, Erin R; Tipton, David J; Desselle, Shane P

    2002-01-01

    The purpose of this study was to forecast the impact of Internet pharmacy commerce on various stakeholders. A panel of experts assembled from a list of academicians in the social and administrative pharmaceutical sciences participated in a three-iteration Delphi procedure. Feedback from the aggregate responses of the panel was used to construct questionnaires employed in subsequent iterations of the Delphi. The panel converged to form a consensus upon a variety of issues. They forecasted the attainment of a 10-15% share in the market of prescription and over-the-counter pharmaceuticals through on-line purchases, the formation of strategic alliances among stakeholders in the drug distribution process, a shift in marketing strategies by brick-and-mortar stores, an increase in the prevalence of niching among pharmacy service providers and a subsequent growth in the implementation of cognitive services throughout the industry. With few exceptions, the forecast produced by the Delphi panel appears to be coming to fruition.

  2. Genomic Insights into the Ancestry and Demographic History of South America

    Science.gov (United States)

    Homburger, Julian R.; Moreno-Estrada, Andrés; Gignoux, Christopher R.; Nelson, Dominic; Sanchez, Elena; Ortiz-Tello, Patricia; Pons-Estel, Bernardo A.; Acevedo-Vasquez, Eduardo; Miranda, Pedro; Langefeld, Carl D.; Gravel, Simon; Alarcón-Riquelme, Marta E.; Bustamante, Carlos D.

    2015-01-01

    South America has a complex demographic history shaped by multiple migration and admixture events in pre- and post-colonial times. Settled over 14,000 years ago by Native Americans, South America has experienced migrations of European and African individuals, similar to other regions in the Americas. However, the timing and magnitude of these events resulted in markedly different patterns of admixture throughout Latin America. We use genome-wide SNP data for 437 admixed individuals from 5 countries (Colombia, Ecuador, Peru, Chile, and Argentina) to explore the population structure and demographic history of South American Latinos. We combined these data with population reference panels from Africa, Asia, Europe and the Americas to perform global ancestry analysis and infer the subcontinental origin of the European and Native American ancestry components of the admixed individuals. By applying ancestry-specific PCA analyses we find that most of the European ancestry in South American Latinos is from the Iberian Peninsula; however, many individuals trace their ancestry back to Italy, especially within Argentina. We find a strong gradient in the Native American ancestry component of South American Latinos associated with country of origin and the geography of local indigenous populations. For example, Native American genomic segments in Peruvians show greater affinities with Andean indigenous peoples like Quechua and Aymara, whereas Native American haplotypes from Colombians tend to cluster with Amazonian and coastal tribes from northern South America. Using ancestry tract length analysis we modeled post-colonial South American migration history as the youngest in Latin America during European colonization (9–14 generations ago), with an additional strong pulse of European migration occurring between 3 and 9 generations ago. These genetic footprints can impact our understanding of population-level differences in biomedical traits and, thus, inform future medical

  3. Genomic Insights into the Ancestry and Demographic History of South America.

    Directory of Open Access Journals (Sweden)

    Julian R Homburger

    2015-12-01

    Full Text Available South America has a complex demographic history shaped by multiple migration and admixture events in pre- and post-colonial times. Settled over 14,000 years ago by Native Americans, South America has experienced migrations of European and African individuals, similar to other regions in the Americas. However, the timing and magnitude of these events resulted in markedly different patterns of admixture throughout Latin America. We use genome-wide SNP data for 437 admixed individuals from 5 countries (Colombia, Ecuador, Peru, Chile, and Argentina to explore the population structure and demographic history of South American Latinos. We combined these data with population reference panels from Africa, Asia, Europe and the Americas to perform global ancestry analysis and infer the subcontinental origin of the European and Native American ancestry components of the admixed individuals. By applying ancestry-specific PCA analyses we find that most of the European ancestry in South American Latinos is from the Iberian Peninsula; however, many individuals trace their ancestry back to Italy, especially within Argentina. We find a strong gradient in the Native American ancestry component of South American Latinos associated with country of origin and the geography of local indigenous populations. For example, Native American genomic segments in Peruvians show greater affinities with Andean indigenous peoples like Quechua and Aymara, whereas Native American haplotypes from Colombians tend to cluster with Amazonian and coastal tribes from northern South America. Using ancestry tract length analysis we modeled post-colonial South American migration history as the youngest in Latin America during European colonization (9-14 generations ago, with an additional strong pulse of European migration occurring between 3 and 9 generations ago. These genetic footprints can impact our understanding of population-level differences in biomedical traits and, thus, inform

  4. Genomic Insights into the Ancestry and Demographic History of South America.

    Science.gov (United States)

    Homburger, Julian R; Moreno-Estrada, Andrés; Gignoux, Christopher R; Nelson, Dominic; Sanchez, Elena; Ortiz-Tello, Patricia; Pons-Estel, Bernardo A; Acevedo-Vasquez, Eduardo; Miranda, Pedro; Langefeld, Carl D; Gravel, Simon; Alarcón-Riquelme, Marta E; Bustamante, Carlos D

    2015-12-01

    South America has a complex demographic history shaped by multiple migration and admixture events in pre- and post-colonial times. Settled over 14,000 years ago by Native Americans, South America has experienced migrations of European and African individuals, similar to other regions in the Americas. However, the timing and magnitude of these events resulted in markedly different patterns of admixture throughout Latin America. We use genome-wide SNP data for 437 admixed individuals from 5 countries (Colombia, Ecuador, Peru, Chile, and Argentina) to explore the population structure and demographic history of South American Latinos. We combined these data with population reference panels from Africa, Asia, Europe and the Americas to perform global ancestry analysis and infer the subcontinental origin of the European and Native American ancestry components of the admixed individuals. By applying ancestry-specific PCA analyses we find that most of the European ancestry in South American Latinos is from the Iberian Peninsula; however, many individuals trace their ancestry back to Italy, especially within Argentina. We find a strong gradient in the Native American ancestry component of South American Latinos associated with country of origin and the geography of local indigenous populations. For example, Native American genomic segments in Peruvians show greater affinities with Andean indigenous peoples like Quechua and Aymara, whereas Native American haplotypes from Colombians tend to cluster with Amazonian and coastal tribes from northern South America. Using ancestry tract length analysis we modeled post-colonial South American migration history as the youngest in Latin America during European colonization (9-14 generations ago), with an additional strong pulse of European migration occurring between 3 and 9 generations ago. These genetic footprints can impact our understanding of population-level differences in biomedical traits and, thus, inform future medical

  5. Use of expert opinion for animal disease decisions: an example of foot-and-mouth disease status designation.

    Science.gov (United States)

    Garabed, R B; Perez, A M; Johnson, W O; Thurmond, M C

    2009-11-01

    When data representing a preferred measurement of risk cannot be obtained, as is often the case for global animal diseases, decisions that affect millions of people and their animals are typically made based on expert opinion. Expert opinion can be and has been used to address the critical lack of data existing for prevalence and incidence of many global diseases, including foot-and-mouth disease (FMD). However, when a conclusion based on expert opinion applies to a topic as sensitive as FMD, which has tremendous economic, political, and social implications, care should be taken to understand the accuracy of and differences in the opinion data. The differences in experts' opinions and the relative accuracy of an expert opinion elicitation for "diagnosing" country-level FMD presence were examined for the years 1997-2003 using Bayesian methods. A formal survey of eight international FMD experts revealed that individual experts had different opinions as to the probability of finding FMD in a country. However, a weighted average of the experts' responses was relatively accurate (91% sensitivity and 85% specificity) at identifying the FMD status of a country, compared to using a method that employed information available from World Organization for Animal Health (OIE). The most apparent disagreements between individual experts and available information were found for Indonesia, South Korea, and South America, and, in general, the experts seemed to believe that countries in South Asia were more likely to be positive than other countries that reported FMD cases to OIE. This study highlights new methodology that offers a standardized, quantitative, and systematic means by which expert opinion can be used and assessed.

  6. Expert initial review of Columbia River Basin salmonid management models: Summary report

    International Nuclear Information System (INIS)

    Barnthouse, L.W.

    1993-10-01

    Over the past years, several fish passage models have been developed to examine the downstream survival of salmon during their annual migration through the Columbia River reservoir system to below Bonneville Dam. More recently, models have been created to simulate the survival of salmon throughout the entire life cycle. The models are used by various regional agencies and native American tribes to assess impacts of dam operation, harvesting, and predation on salmonid abundance. These models are now also being used to assess extinction probabilities and evaluate restoration alternatives for threatened and endangered salmonid stocks. Oak Ridge National Laboratory (ORNL) coordinated an initial evaluation of the principal models by a panel of outside, expert reviewers. None of the models were unequivocally endorsed by any reviewer. Significant strengths and weaknesses were noted for each with respect to reasonability of assumptions and equations, adequacy of documentation, adequacy of supporting data, and calibration procedures. Although the models reviewed differ in some important respects, all reflect a common conceptual basis in classical population dynamic theory and a common empirical basis consisting of the available time series of salmonid stock data, hydrographic records, experimental studies of dam passage parameters, and measurements of reservoir mortality. The results of this initial review are not to be construed as a comprehensive scientific peer review of existing Columbia River Basin (CRB) salmon population models and data. The peer review process can be enhanced further by a dynamic exchange regional modelers and scientific panel experts involving interaction and feedback

  7. EFSA CEF Panel (EFSA Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids), 2016 Scientific Opinion on Flavouring Group Evaluation 75, Revision 1 (FGE.75Rev1): Consideration of tetrahydrofuran derivatives evaluated by JECFA (63rd meeting) structurally related to tetrahydrofuran

    DEFF Research Database (Denmark)

    Beltoft, Vibe Meister; Nørby, Karin Kristiane

    The Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids (CEF) of the EFSA was requested to consider evaluations of flavouring substances assessed since 2000 by the Joint FAO/WHO Expert Committee on Food Additives (the JECFA), and to decide whether further evaluation is neces......The Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids (CEF) of the EFSA was requested to consider evaluations of flavouring substances assessed since 2000 by the Joint FAO/WHO Expert Committee on Food Additives (the JECFA), and to decide whether further evaluation...... for anhydrolinalool oxide (5) [FL-no: 13.097]. The substances were evaluated through a stepwise approach that integrates information on structure-activity relationships, intake from current uses, toxicological threshold of concern, and available data on metabolism and toxicity. The JECFA concluded all the 11...... with the JECFA conclusion ‘No safety concern at estimated level of intake as flavouring substances’ based on the maximised survey-derived daily intake (MSDI) approach. The specifications for the materials of commerce have also been considered and for all 11 substances, the information is adequate....

  8. Experiencia y resultados de la aplicación de la técnica consenso de panel Uso empírico para la selección de dos organizaciones tolimenses

    Directory of Open Access Journals (Sweden)

    Mario Enrique Uribe-Macías

    2015-07-01

    Full Text Available A research project was conducted – funded by the Central Committee of Research of the University of Tolima – for analyzing the adopted strategies by two organizations and the positive and negative nimpacts that they generated in business life: In order to select the companies that must be studied, was established it would apply a method of expert people of the region, with deep knowledge about the topic. This paper question is: ¿how to select those companies using the more objective possible way? To answer it the consensus panel (expert technique, was developed; it is explained not only its development view but the obtained results. It is theoretically supported on the issues of business history, strategy and on the conceptualization about consensus panel. The main conclusion is the consensus panel is an appropriate tool for using with management teams, whose characteristics are the knowledge and expertise in the business sector, the realization of their contributions and the set time for their activities. To the future, it is important the technique application in similar exercises for any kind of research project. Keywords: Strategy, Corporate history, Consensus panel, Tolima organizations

  9. Selecting and training a panel to evaluate the rancid defect in soybean oil and fish hamburgers

    Directory of Open Access Journals (Sweden)

    C. Marques

    2017-09-01

    Full Text Available Due to its composition of unsaturated and polyunsaturated fatty acids, oils and fats are very susceptible to oxidation, with rancidity being one of the main defects. Among the several existing methodologies to monitor oxidation in foods, sensory analysis stands out because of the sensitivity of responses. Accordingly, this study aimed to select and train a panel of expert assessors to identify the rancid flavor, showing the statistical steps in the process. Assessors were selected according to their individual performance, statistically analyzed by ANOVA and Tukey’s mean comparison, Wald Sequential Analysis and chi-square test. The validation of the trained panel was carried out with the sensory analysis of fish burgers and soybean oil. F Value and box-plot graphic methods were effective for better visualization of results when used along with the mean and standard deviation tables. The final trained panel consisted of seven assessors, who have been able to identify and differentiate rancid taste in both samples used for validation.

  10. Selecting and training a panel to evaluate the rancid defect in soybean oil and fish hamburgers

    International Nuclear Information System (INIS)

    Marques, C.; Dos Reis, A.S.; Da Silva, L.D.; Carpes, S.T.; Mitterer-Daltoé, M.L.

    2017-01-01

    Due to its composition of unsaturated and polyunsaturated fatty acids, oils and fats are very susceptible to oxidation, with rancidity being one of the main defects. Among the several existing methodologies to monitor oxidation in foods, sensory analysis stands out because of the sensitivity of responses. Accordingly, this study aimed to select and train a panel of expert assessors to identify the rancid flavor, showing the statistical steps in the process. Assessors were selected according to their individual performance, statistically analyzed by ANOVA and Tukey’s mean comparison, Wald Sequential Analysis and chi-square test. The validation of the trained panel was carried out with the sensory analysis of fish burgers and soybean oil. F Value and box-plot graphic methods were effective for better visualization of results when used along with the mean and standard deviation tables. The final trained panel consisted of seven assessors, who have been able to identify and differentiate rancid taste in both samples used for validation. [es

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-06-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-06-15

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

  13. Expert views on most suitable monetary incentives on food to stimulate healthy eating.

    Science.gov (United States)

    Waterlander, Wilma E; Steenhuis, Ingrid H M; de Vet, Emely; Schuit, Albertine J; Seidell, Jacob C

    2010-06-01

    Pricing strategies are an important component in the marketing mix and may also be useful in stimulating healthier food choices. However, due to competing interests and feasibility problems, the introduction of pricing strategies is complicated. For successfully introducing food pricing strategies, it is essential to explore incentives that are not only promising but also realizable and being approved by different sectors. We aimed to assemble a list of pricing strategies by exploring expert views using the Delphi method. Subjects included experts from academia, industry, retail, agriculture, policymakers, consumers and non-governmental organizations. Data were collected in three rounds. In round one, experts designed promising pricing strategies. Based on a time-budget model incorporating Sleep, Leisure, Occupation, Transportation and Home-based activities, these strategies were in the subsequent rounds judged on several criteria. Results were analysed using median and interquartile deviations scores. We found fair consensus levels among experts and a varied list of promising pricing strategies. The panel agreed on the potential success of offering small presents, providing price-cuts on healthy foods and discounting healthier foods more frequently. Also, it was found that experts gave higher rates to pricing strategies for which the implementation responsibilities could be placed elsewhere. The resulted list of promising monetary incentives is an essential first step for the future design of pricing strategies. Following this study, it is important to determine how to make solid agreements on responsibility and implementation issues. Also, consumer perceptions regarding the proposed pricing strategies should be studied.

  14. Expert ease

    Energy Technology Data Exchange (ETDEWEB)

    1984-04-01

    Expert-ease allows the most inexperienced of computer users to build an expert system in a matter of hours. It is nothing more or less than a computer based problem-solving system. It allows the expert to preserve his or her knowledge in the form of rules, which can be applied to problems put to the system by the non-expert. The crucial piece of software at the heart of Expert-Ease extracts rules from data, and is called the analogue concept learning system. It was developed by Intelligent Terminals Ltd. and supplied to Export Software International to be incorporated into a commercially attractive package for business users. The resulting product runs on the Act Sirius and the IBM PC and compatibles. It is a well conceived and polished product with a popular appeal that should ensure widespread acceptance even at a cost of >1500 plus vat.

  15. Stressed skin panels

    Energy Technology Data Exchange (ETDEWEB)

    Anon

    2001-07-01

    Advantages and disadvantages of stressed skin panels, also known as structural insulated panels (SIPs), are discussed as material and labour-saving alternatives to traditional stick framing. Stressed skin panels are manufactured 'sandwich' assemblies with a rigid insulating polystyrene foam core, whose interior and exterior surfaces are bonded into panels. The skins distribute and carry the structural loading while the bonded foam core provides insulation and keeps the two skins aligned. Since there are fewer framing members, there is little thermal bridging and the R-value remains high. SIPs are usually manufactured in four feet by eight feet panels, although some manufacturers can produce panels up to eight feet by forty feet. SIPs are resource efficient as they use less wood than conventional framing (about 25 per cent less); can structurally cover large spans, requiring less supplementary framing. Use of SIPs eliminate the need for headers over small openings; provide the ability to nail anywhere; create less scrap and waste; lessen vulnerability to unfavourable weather and other job-site hazards, can reduce delays, and often can produce significant savings in material and labour costs. Limitations include the more complex approaches to plumbing and electrical systems, although this can be minimized by designers by incorporating much of the plumbing and electrical work on interior (non-panel) walls. Most stressed skin panels require one-half inch interior gypsum drywall. If become wet, stressed skin panels take a long time to dry out and may harbour mold growth. Larger stressed-skin panels used in floors and roofs, may require cranes or other machinery for handling because of their weight. Although not without some environmental impact, overall, stressed skin panels are judged to be a resource-efficient building technology with significant energy-efficiency benefits and distinct advantages over stick framing. 3 photos.

  16. Expert System

    DEFF Research Database (Denmark)

    Hildebrandt, Thomas Troels; Cattani, Gian Luca

    2016-01-01

    An expert system is a computer system for inferring knowledge from a knowledge base, typically by using a set of inference rules. When the concept of expert systems was introduced at Stanford University in the early 1970s, the knowledge base was an unstructured set of facts. Today the knowledge b...... for the application of expert systems, but also raises issues regarding privacy and legal liability....

  17. WTEC Panel Report on International Assessment of Research and Development in Simulation-Based Engineering and Science

    Energy Technology Data Exchange (ETDEWEB)

    Glotzer, S. C.; Kim, S.; Cummings, P. T.; Deshmukh, A.; Head-Gordon, M.; Karniadakis, G.; Petzold, L.; Sagui, C.; Shinozuka, M.

    2013-07-30

    This WTEC panel report assesses the international research and development activities in the field of Simulation- Based Engineering and Science (SBE&S). SBE&S involves the use of computer modeling and simulation to solve mathematical formulations of physical models of engineered and natural systems. SBE&S today has reached a level of predictive capability that it now firmly complements the traditional pillars of theory and experimentation/observation. As a result, computer simulation is more pervasive today – and having more impact – than at any other time in human history. Many critical technologies, including those to develop new energy sources and to shift the cost-benefit factors in healthcare, are on the horizon that cannot be understood, developed, or utilized without simulation. A panel of experts reviewed and assessed the state of the art in SBE&S as well as levels of activity overseas in the broad thematic areas of life sciences and medicine, materials, and energy and sustainability; and in the crosscutting issues of next generation hardware and algorithms; software development; engineering simulations; validation, verification, and uncertainty quantification; multiscale modeling and simulation; and SBE&S education. The panel hosted a U.S. baseline workshop, conducted a bibliometric analysis, consulted numerous experts and reports, and visited 59 institutions and companies throughout East Asia and Western Europe to explore the active research projects in those institutions, the computational infrastructure used for the projects, the funding schemes that enable the research, the collaborative interactions among universities, national laboratories, and corporate research centers, and workforce needs and development for SBE&S.

  18. Materials Substitution and Recycling. Proceedings of the Meeting of the Structures and Materials Panel (57th) Held at Vimeiro, Portugal on 14-19 October 1983.

    Science.gov (United States)

    1984-04-01

    No.356 MATERIALS SUBSTITUTION AND RECYCLING Papers presented at the 5 7th Meeting of the Structures and Materials Panel in Vimneiro, Portupi. 19 -14...nation. The mission of AGARD is carried out through the Panels which are composed of experts appointed by the National Delegates, the Consultant and...composition. The quality heat treatment for monocrystalline alloys such as CMSX2 normally consists of a 3-stage process, viz., Stage 1 2-3 hours @ 1260°C

  19. Effect of manual tilt adjustments on incident irradiance on fixed and tracking solar panels

    International Nuclear Information System (INIS)

    Lubitz, William David

    2011-01-01

    Hourly typical meteorological year (TMY3) data was utilized with the Perez radiation model to simulate solar radiation on fixed, azimuth tracking and two axis tracking surfaces at 217 geographically diverse temperate latitude sites across the contiguous United States of America. The optimum tilt angle for maximizing annual irradiation on a fixed south-facing panel varied from being equal to the latitude at low-latitude, high clearness sites, to up to 14 o less than the latitude at a north-western coastal site with very low clearness index. Across the United States, the optimum tilt angle for an azimuth tracking panel was found to be on average 19 o closer to vertical than the optimum tilt angle for a fixed, south-facing panel at the same site. Azimuth tracking increased annual solar irradiation incident on a surface by an average of 29% relative to a fixed south-facing surface at optimum tilt angle. Two axis tracking resulted in an average irradiation increase of 34% relative to the fixed surface. Introduction of manual surface tilt changes during the year produced a greater impact for non-tracking surfaces than it did for azimuth tracking surfaces. Even monthly tilt changes only resulted in an average annual irradiation increase of 5% for fixed panels and 1% for azimuth tracked surfaces, relative to using a single optimized tilt angle in each case. In practice, the decision whether to manually tilt panels requires balancing the added cost in labor and the panel support versus the extra energy generation and the cost value of that energy. A spreadsheet file is available that gives individual results for each of the 217 simulated sites.

  20. A review of traditional and novel treatments for seizures in autism spectrum disorder: findings from a systematic review and expert panel.

    Science.gov (United States)

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

    2013-09-13

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

  1. A review of traditional and novel treatments for seizures in autism spectrum disorder: Findings from a systematic review and expert panel.

    Directory of Open Access Journals (Sweden)

    Richard Eugene Frye

    2013-09-01

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

  2. Does Climate Change Mitigation Activity Affect Crude Oil Prices? Evidence from Dynamic Panel Model

    Directory of Open Access Journals (Sweden)

    Jude C. Dike

    2014-01-01

    Full Text Available This paper empirically investigates how climate change mitigation affects crude oil prices while using carbon intensity as the indicator for climate change mitigation. The relationship between crude oil prices and carbon intensity is estimated using an Arellano and Bond GMM dynamic panel model. This study undertakes a regional-level analysis because of the geographical similarities among the countries in a region. Regions considered for the study are Africa, Asia and Oceania, Central and South America, the EU, the Middle East, and North America. Results show that there is a positive relationship between crude oil prices and carbon intensity, and a 1% change in carbon intensity is expected to cause about 1.6% change in crude oil prices in the short run and 8.4% change in crude oil prices in the long run while the speed of adjustment is 19%.

  3. Comprehensive metabolic panel

    Science.gov (United States)

    Metabolic panel - comprehensive; Chem-20; SMA20; Sequential multi-channel analysis with computer-20; SMAC20; Metabolic panel 20 ... Chernecky CC, Berger BJ. Comprehensive metabolic panel (CMP) - blood. In: ... Tests and Diagnostic Procedures . 6th ed. St Louis, MO: ...

  4. Noise Reduction in Double‿Panel Structures by Cavity and Panel Resonance Control

    NARCIS (Netherlands)

    Ho, J.; Berkhoff, Arthur P.

    2011-01-01

    This paper presents an investigation of the cavity and the panel resonance control in a double‿panel structure. The double‿panel structure, which consists of two panels with air in the gap, is widely adopted in many applications such as aerospace due to its light weight and effective

  5. Noise reduction in double-panel structures by cavity and panel resonance control

    NARCIS (Netherlands)

    Ho, J.-H.; Berkhoff, A.P

    2011-01-01

    This paper presents an investigation of the cavity and the panel resonance control in a double‐panel structure. The double‐panel structure, which consists of two panels with air in the gap, is widely adopted in many applications such as aerospace due to its light weight and effective

  6. A multi-criteria decision analysis approach to assessing malaria risk in northern South America

    Directory of Open Access Journals (Sweden)

    Temitope O. Alimi

    2016-03-01

    Full Text Available Abstract Background Malaria control in South America has vastly improved in the past decade, leading to a decrease in the malaria burden. Despite the progress, large parts of the continent continue to be at risk of malaria transmission, especially in northern South America. The objectives of this study were to assess the risk of malaria transmission and vector exposure in northern South America using multi-criteria decision analysis. Methods The risk of malaria transmission and vector exposure in northern South America was assessed using multi-criteria decision analysis, in which expert opinions were taken on the key environmental and population risk factors. Results Results from our risk maps indicated areas of moderate-to-high risk along rivers in the Amazon basin, along the coasts of the Guianas, the Pacific coast of Colombia and northern Colombia, in parts of Peru and Bolivia and within the Brazilian Amazon. When validated with occurrence records for malaria, An. darlingi, An. albimanus and An. nuneztovari s.l., t-test results indicated that risk scores at occurrence locations were significantly higher (p < 0.0001 than a control group of geographically random points. Conclusion In this study, we produced risk maps based on expert opinion on the spatial representation of risk of potential vector exposure and malaria transmission. The findings provide information to the public health decision maker/policy makers to give additional attention to the spatial planning of effective vector control measures. Therefore, as the region tackles the challenge of malaria elimination, prioritizing areas for interventions by using spatially accurate, high-resolution (1 km or less risk maps may guide targeted control and help reduce the disease burden in the region.

  7. EXPERT SYSTEMS

    OpenAIRE

    Georgiana Marin; Mihai Catalin Andrei

    2011-01-01

    In recent decades IT and computer systems have evolved rapidly in economic informatics field. The goal is to create user friendly information systems that respond promptly and accurately to requests. Informatics systems evolved into decision assisted systems, and such systems are converted, based on gained experience, in expert systems for creative problem solving that an organization is facing. Expert systems are aimed at rebuilding human reasoning on the expertise obtained from experts, sto...

  8. PERBANDINGAN UNJUK KERJA ANTARA PANEL SEL SURYA BERPENJEJAK DENGAN PANEL SEL SURYA DIAM

    Directory of Open Access Journals (Sweden)

    Syafaruddin Ch

    2010-07-01

    Full Text Available The ability to produce electrical energy at Solar Power Plant  is highly dependent on the magnitude and duration of sun exposure on the solar cell panels. The movement of the sun from east to west that periodicity in every day is a problem at  the  optimization generation of electricity at  Solar Power Plant   if using solar panel that motionless. This is because the solar cell panel can not catch the maximum sun exposure. To solve the above problem then designed a solar cell panel  tracker  capable of follo-wing the movements of the sun. Then conducted a test to see the performance of solar cell pa-nel  tracker  and compare it with the performance of solar cell panel was motionless. The testing doing along 6 days, with way to irradiate the panel of solar cells  tracker  and panels of solar cell motionless with sun exposure  along a  full day. Then the electric current generated each panel were recorded. The comparison of current then generating comparison of electric power delivery. The result show that the solar cell panel  tracker  produce the average current is 2.19 A whereas solar-cell panel still 1.97 A.  This result   indicate that average power for solar cell panel  tracker  39.41 W while for solar cell panel that motionless is  35.46 W. These results indicate that the performance of solar cell panel  tracker  better than  solar cell panel motionless.

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

    International Nuclear Information System (INIS)

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

    1984-11-01

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

  10. Noise Reduction in Double‿Panel Structures by Cavity and Panel Resonance Control

    OpenAIRE

    Ho, J.; Berkhoff, Arthur P.

    2011-01-01

    This paper presents an investigation of the cavity and the panel resonance control in a double‿panel structure. The double‿panel structure, which consists of two panels with air in the gap, is widely adopted in many applications such as aerospace due to its light weight and effective transmission‿loss at high frequency. However, the resonance of the cavity and the poor transmission‿loss at low frequency limit its noise control performance. Applying active control forces on the panels or utili...

  11. Expert and competent non-expert visual cues during simulated diagnosis in intensive care.

    Science.gov (United States)

    McCormack, Clare; Wiggins, Mark W; Loveday, Thomas; Festa, Marino

    2014-01-01

    The aim of this study was to examine the information acquisition strategies of expert and competent non-expert intensive care physicians during two simulated diagnostic scenarios involving respiratory distress in an infant. Specifically, the information acquisition performance of six experts and 12 competent non-experts was examined using an eye-tracker during the initial 90 s of the assessment of the patient. The results indicated that, in comparison to competent non-experts, experts recorded longer mean fixations, irrespective of the scenario. When the dwell times were examined against specific areas of interest, the results revealed that competent non-experts recorded greater overall dwell times on the nurse, where experts recorded relatively greater dwell times on the head and face of the manikin. In the context of the scenarios, experts recorded differential dwell times, spending relatively more time on the head and face during the seizure scenario than during the coughing scenario. The differences evident between experts and competent non-experts were interpreted as evidence of the relative availability of task-specific cues or heuristics in memory that might direct the process of information acquisition amongst expert physicians. The implications are discussed for the training and assessment of diagnostic skills.

  12. Oral contraception and menstrual bleeding during treatment of venous thromboembolism: Expert opinion versus current practice: Combined results of a systematic review, expert panel opinion and an international survey

    NARCIS (Netherlands)

    Klok, F. A.; Schreiber, K.; Stach, K.; Ageno, W.; Middeldorp, S.; Eichinger, S.; Delluc, A.; Blondon, M.; Ay, C.

    2017-01-01

    The optimal management of oral contraception and menstrual bleeding during treatment of venous thromboembolism (VTE) is largely unknown. We aimed to elicit expert opinion and compare that to current practice as assessed by a world-wide international web-based survey among physicians. 10

  13. Universal Health Coverage in Francophone Sub-Saharan Africa: Assessment of Global Health Experts' Confidence in Policy Options.

    Science.gov (United States)

    Paul, Elisabeth; Fecher, Fabienne; Meloni, Remo; van Lerberghe, Wim

    2018-05-29

    Many countries rely on standard recipes for accelerating progress toward universal health coverage (UHC). With limited generalizable empirical evidence, expert confidence and consensus plays a major role in shaping country policy choices. This article presents an exploratory attempt conducted between April and September 2016 to measure confidence and consensus among a panel of global health experts in terms of the effectiveness and feasibility of a number of policy options commonly proposed for achieving UHC in low- and middle-income countries, such as fee exemptions for certain groups of people, ring-fenced domestic health budgets, and public-private partnerships. To ensure a relative homogeneity of contexts, we focused on French-speaking sub-Saharan Africa. We initially used the Delphi method to arrive at expert consensus, but since no consensus emerged after 2 rounds, we adjusted our approach to a statistical analysis of the results from our questionnaire by measuring the degree of consensus on each policy option through 100 (signifying total consensus) minus the size of the interquartile range of the individual scores. Seventeen global health experts from various backgrounds, but with at least 20 years' experience in the broad region, participated in the 2 rounds of the study. The results provide an initial "mapping" of the opinions of a group of experts and suggest interesting lessons. For the 18 policy options proposed, consensus emerged only on strengthening the supply of quality primary health care services (judged as being effective with a confidence score of 79 and consensus score of 90), and on fee exemptions for the poorest (judged as being fairly easy to implement with a confidence score of 66 and consensus score of 85). For none of the 18 common policy options was there consensus on both potential effectiveness and feasibility, with very diverging opinions concerning 5 policy options. The lack of confidence and consensus within the panel seems to

  14. Expert and Competent Non-Expert Visual Cues during Simulated Diagnosis in Intensive Care

    Directory of Open Access Journals (Sweden)

    Clare eMcCormack

    2014-08-01

    Full Text Available The aim of this study was to examine the information acquisition strategies of expert and competent non-expert intensive care physicians during two simulated diagnostic scenarios involving respiratory distress in an infant. Specifically, the information acquisition performance of six experts and 12 competent non-experts was examined using an eye tracker during the initial 90 seconds of the assessment of the patient. The results indicated that, in comparison to competent non-experts, experts recorded longer mean fixations, irrespective of the scenario. When the dwell times were examined against specific areas of interest, the results revealed that competent non-experts recorded greater overall dwell times on the nurse, where experts recorded relatively greater dwell times on the head and face of the manikin. In the context of the scenarios, experts recorded differential dwell times, spending relatively more time on the head and face during the seizure scenario than during the coughing scenario. The differences evident between experts and competent non-experts were interpreted as evidence of the relative availability of task-specific cues or heuristics in memory that might direct the process of information acquisition amongst expert physicians. The implications are discussed for the training and assessment of diagnostic skills.

  15. Paneling architectural freeform surfaces

    KAUST Repository

    Eigensatz, Michael

    2010-07-25

    The emergence of large-scale freeform shapes in architecture poses big challenges to the fabrication of such structures. A key problem is the approximation of the design surface by a union of patches, so-called panels, that can be manufactured with a selected technology at reasonable cost, while meeting the design intent and achieving the desired aesthetic quality of panel layout and surface smoothness. The production of curved panels is mostly based on molds. Since the cost of mold fabrication often dominates the panel cost, there is strong incentive to use the same mold for multiple panels. We cast the major practical requirements for architectural surface paneling, including mold reuse, into a global optimization framework that interleaves discrete and continuous optimization steps to minimize production cost while meeting user-specified quality constraints. The search space for optimization is mainly generated through controlled deviation from the design surface and tolerances on positional and normal continuity between neighboring panels. A novel 6-dimensional metric space allows us to quickly compute approximate inter-panel distances, which dramatically improves the performance of the optimization and enables the handling of complex arrangements with thousands of panels. The practical relevance of our system is demonstrated by paneling solutions for real, cutting-edge architectural freeform design projects.

  16. Paneling architectural freeform surfaces

    KAUST Repository

    Eigensatz, Michael

    2010-07-26

    The emergence of large-scale freeform shapes in architecture poses big challenges to the fabrication of such structures. A key problem is the approximation of the design surface by a union of patches, socalled panels, that can be manufactured with a selected technology at reasonable cost, while meeting the design intent and achieving the desired aesthetic quality of panel layout and surface smoothness. The production of curved panels is mostly based on molds. Since the cost of mold fabrication often dominates the panel cost, there is strong incentive to use the same mold for multiple panels. We cast the major practical requirements for architectural surface paneling, including mold reuse, into a global optimization framework that interleaves discrete and continuous optimization steps to minimize production cost while meeting user-specified quality constraints. The search space for optimization is mainly generated through controlled deviation from the design surface and tolerances on positional and normal continuity between neighboring panels. A novel 6-dimensional metric space allows us to quickly compute approximate inter-panel distances, which dramatically improves the performance of the optimization and enables the handling of complex arrangements with thousands of panels. The practical relevance of our system is demonstrated by paneling solutions for real, cutting-edge architectural freeform design projects. © 2010 ACM.

  17. Tuberculosis control in the Americas: current approaches.

    Science.gov (United States)

    Pio, A; Western, K

    1976-01-01

    Tuberculosi remains a serious public health problem in the Americas, and it has not declined as rapidly or as much as experts projected it would in the 1940's. Scientific advances in control of the disease over the last three decades have produced effective chemotherapeutic agents, established the immunizing capacity of BCG vaccine, and demonstrated the superior value of bacteriologic diagnosis in symptomatic individuals over mass community x-ray surveys, which are both inefficient and costly. They have also shown that most cases can be treated on an ambulatory basis, obviating the need for the lengthy hospital stays which have heretofore weighed so heavily on budgets. By standardization of control methods, both for diagnosis and for chemotherapy, these tasks can be taken on by polyvalent staff in the general health services, whose wide coverage places them in a position to reach a much larger segment of the population than that attended by the traditional vertical system. To a greater or lesser degree, all the countries in the Americas are beginning to orient their strategies in this direction, and some of them already have considerable progress to report.

  18. Comparisons between various cavity and panel noise reduction control in double-panel structures

    NARCIS (Netherlands)

    Ho, J.H.; Kalverboer, J.; Berkhoff, A.P.

    2012-01-01

    This paper presents comparisons between various panel and cavity resonance control methods to reduce the transmitted sound in a double-panel structure. The double-panel, which consists of two panels with air in the gap, has the advantages of low weight and effective transmission-loss at high

  19. Latin-American guidelines for opioid use in chronic nononcologic pain.

    Science.gov (United States)

    Lara-Solares, Argelia; Aguayo Zamora, Carlos; Amescua García, César; Garcia, João Batista Santos; Berenguel Cook, María Del Rosario; Bonilla Sierra, Patricia; Campos Kraychete, Durval; Flores Cantisani, José Alberto; Guerrero, Carlos; Guillén Núñez, María Del Rocío; Hernández Castro, John Jairo; Hernández Ortíz, Andrés; Jreige Iskandar, Aziza; Lech, Osvandré; Macías Guerra, Jacqueline; Ramírez Samayoa, Gerardo; Rangel Morillo, Edwin; Rico Pazos, María Antonieta; Sempértegui Gallegos, Manuel

    2017-05-01

    Latin-American experts in the use of opioids in patients with chronic nononcologic pain (CNOP) have updated existing recommendations to current Latin-American reality. Several key opinion leaders from Latin America participated in a face-to-face meeting in Guatemala (April 2015) to discuss the use of opioids in CNOP. Subgroups of experts worked on specific topics, reviewed the literature and shaped the final manuscript. The expert panel developed guidelines taking into consideration the utility of both opioid and nonopioid analgesics and factors pertaining to their efficacy, safety, adherence, administration and risks for abuse/addiction. Latin-American guidelines for the use of opioids in CNOP should improve pain relief and patients' quality of life by increasing access to these effective agents.

  20. Plutonium - the ultrapoison? An expert's opinion about an expert opinion

    International Nuclear Information System (INIS)

    Stoll, W.; Becker, K.

    1989-01-01

    In an expert opinion written by Professor H. Kuni, Marburg, for the North Rhine-Westphalian state government, plutonium is called by far the most dangerous element in the Periodic Table. The Marburg medical expert holds that even improved legal instruments are unable to warrant effective protection of the workers handling this material, in the light of the present standards of industrial safety, because of radiological conditions and measuring problems with plutonium isotopes. In this article by an internationally renowned expert in the field, the ideas expressed in the expert opinion about the toxicity of plutonium, the cause-and-effect relationship in radiation damage by plutonium, and recent findings about the toxicity are subjected to a critical review. On the basis of results of radiation protection and of case studies, the statements in the expert opinion are contrasted with facts which make them appear in a very different light. (orig./RB) [de

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

    Science.gov (United States)

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

    2011-01-01

    This article describes a Delphi-based expert judgment study aimed at the selection of indicators to identify the occurrence of emerging mycotoxin hazards related to Fusarium spp. in wheat supply chains. A panel of 29 experts from 12 European countries followed a holistic approach to evaluate the most important indicators for different chain stages (growth, transport and storage, and processing) and their relative importance. After three e-mailing rounds, the experts reached consensus on the most important indicators for each of the three stages: wheat growth, transport and storage, and processing. For wheat growth, these indicators include: relative humidity/rainfall, crop rotation, temperature, tillage practice, water activity of the kernels, and crop variety/cultivar. For the transport and storage stage, they include water activity in the kernels, relative humidity, ventilation, temperature, storage capacity, and logistics. For wheat processing, indicators include quality data, fraction of the cereal used, water activity in the kernels, quality management and traceability systems, and carryover of contamination. The indicators selected in this study can be used in an identification system for the occurrence of emerging mycotoxin hazards in wheat supply chains. Such a system can be used by risk managers within governmental (related) organizations and/or the food and feed industry in order to react proactively to the occurrence of these emerging mycotoxins. © 2010 Society for Risk Analysis.

  2. Uncertainty in geological linework: communicating the expert's tacit model to the data user(s) by expert elicitation.

    Science.gov (United States)

    Lawley, Russell; Barron, Mark; Lee, Katy

    2014-05-01

    elicitation is to extract this model in a useable, quantitative, form by a robust and transparent procedure. At BGS expert elicitation is being used to evaluate the uncertainty of mapped boundaries in different common mapping scenarios, with a view to building a 'collective' understanding of the challenges each scenario presents. For example, a 'sharp contact (at surface) between highly contrasting sedimentary rocks' represents one level of survey challenge that should be accurately met by all surveyors, even novices. In contrast, a 'transitional boundary defined by localised facies-variation' may require much more experience to resolve (without recourse to significantly more sampling). We will describe the initial phase of this exercise in which uncertainty models were elicited for mapped boundaries in six contrasting scenarios. Each scenario was presented to a panel of experts with varied expertise and career history. In five cases it was possible to arrive at a consensus model, in a sixth case experts with different experience took different views of the nature of the mapping problem. We will discuss our experience of the use of elicitation methodology and the implications of our results for further work at the BGS to quantify uncertainty in map products. In particular we will consider the value of elicitation as a means to capture the expertise of individuals as they retire, and as the composition of the organization's staff changes in response to the management and policy decisions.

  3. Expert status and performance.

    Directory of Open Access Journals (Sweden)

    Mark A Burgman

    Full Text Available Expert judgements are essential when time and resources are stretched or we face novel dilemmas requiring fast solutions. Good advice can save lives and large sums of money. Typically, experts are defined by their qualifications, track record and experience. The social expectation hypothesis argues that more highly regarded and more experienced experts will give better advice. We asked experts to predict how they will perform, and how their peers will perform, on sets of questions. The results indicate that the way experts regard each other is consistent, but unfortunately, ranks are a poor guide to actual performance. Expert advice will be more accurate if technical decisions routinely use broadly-defined expert groups, structured question protocols and feedback.

  4. Solar reflection panels

    Science.gov (United States)

    Diver, Jr., Richard B.; Grossman, James W [Albuquerque, NM; Reshetnik, Michael [Boulder, CO

    2006-07-18

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

  5. Ottawa Panel evidence-based clinical practice guidelines for therapeutic exercise in the management of hip osteoarthritis.

    Science.gov (United States)

    Brosseau, Lucie; Wells, George A; Pugh, Arlanna G; Smith, Christine Am; Rahman, Prinon; Àlvarez Gallardo, Inmaculada C; Toupin-April, Karine; Loew, Laurianne; De Angelis, Gino; Cavallo, Sabrina; Taki, Jade; Marcotte, Rachel; Fransen, Marlene; Hernandez-Molina, Gabriela; Kenny, Glen P; Regnaux, Jean-Philippe; Lefevre-Colau, Marie-Martine; Brooks, Sydney; Laferriere, Lucie; McLean, Linda; Longchamp, Guy

    2016-10-01

    The primary objective is to identify effective land-based therapeutic exercise interventions and provide evidence-based recommendations for managing hip osteoarthritis. A secondary objective is to develop an Ottawa Panel evidence-based clinical practice guideline for hip osteoarthritis. The search strategy and modified selection criteria from a Cochrane review were used. Studies included hip osteoarthritis patients in comparative controlled trials with therapeutic exercise interventions. An Expert Panel arrived at a Delphi survey consensus to endorse the recommendations. The Ottawa Panel hierarchical alphabetical grading system (A, B, C+, C, D, D+, or D-) considered the study design (level I: randomized controlled trial and level II: controlled clinical trial), statistical significance (p osteoarthritis. Strength training exercises displayed the greatest improvements for pain (Grade A), disability (Grades A and C+), physical function (Grade A), stiffness (Grade A), and range of motion (Grade A) within a short time period (8-24 weeks). Stretching also greatly improved physical function (Grade A), and flexibility exercises improved pain (Grade A), range of motion (Grade A), physical function (Grade A), and stiffness (Grade C+). The Ottawa Panel recommends land-based therapeutic exercise, notably strength training, for management of hip osteoarthritis in reducing pain, stiffness and self-reported disability, and improving physical function and range of motion. © The Author(s) 2015.

  6. Medical Expert Systems Survey

    OpenAIRE

    Abu-Nasser, Bassem S.

    2017-01-01

    International audience; There is an increased interest in the area of Artificial Intelligence in general and expert systems in particular. Expert systems are rapidly growing technology. Expert systems are a branch of Artificial Intelligence which is having a great impact on many fields of human life. Expert systems use human expert knowledge to solve complex problems in many fields such as Health, science, engineering, business, and weather forecasting. Organizations employing the technology ...

  7. Inter-expert and intra-expert reliability in sleep spindle scoring

    DEFF Research Database (Denmark)

    Wendt, Sabrina Lyngbye; Welinder, Peter; Sørensen, Helge Bjarup Dissing

    2015-01-01

    Objectives To measure the inter-expert and intra-expert agreement in sleep spindle scoring, and to quantify how many experts are needed to build a reliable dataset of sleep spindle scorings. Methods The EEG dataset was comprised of 400 randomly selected 115 s segments of stage 2 sleep from 110...... with higher reliability than the estimation of spindle duration. Reliability of sleep spindle scoring can be improved by using qualitative confidence scores, rather than a dichotomous yes/no scoring system. Conclusions We estimate that 2–3 experts are needed to build a spindle scoring dataset...... with ‘substantial’ reliability (κ: 0.61–0.8), and 4 or more experts are needed to build a dataset with ‘almost perfect’ reliability (κ: 0.81–1). Significance Spindle scoring is a critical part of sleep staging, and spindles are believed to play an important role in development, aging, and diseases of the nervous...

  8. Clinical application of multigene panels: challenges of next generation counseling and cancer risk management

    Directory of Open Access Journals (Sweden)

    Thomas Paul Slavin

    2015-09-01

    Full Text Available Background: Multigene panels can be a cost- and time-effective alternative to sequentially testing multiple genes, especially with a mixed family cancer phenotype. However, moving beyond our single-gene testing paradigm has unveiled many new challenges to the clinician. The purpose of this article is to familiarize the reader with some of the challenges, as well as potential opportunities, of expanded hereditary cancer panel testing. Methods: We include results from 348 commercial multigene panel tests ordered from January 1, 2014, through October 1, 2014, by clinicians associated with the City of Hope’s Clinical Cancer Genetics Community of Practice. We also discuss specific challenging cases that arose during this period involving abnormalities in the genes: CDH1, TP53, PMS2, PALB2, CHEK2, NBN, and RAD51C. Results: If historically high risk genes only were included in the panels (BRCA1, BRCA2, MSH6, PMS2, TP53, APC, CDH1, the results would have been positive only 6.2% of the time, instead of 17%. Results returned with variants of uncertain significance (VUS 42% of the time. Conclusion: These figures and cases stress the importance of adequate pretest counseling in anticipation of higher percentages of positive, VUS, unexpected, and ambiguous test results. Test result ambiguity can be limited by the use of phenotype specific panels; if found, multiple resources (the literature, reference laboratory, colleagues, national experts, and research efforts can be accessed to better clarify counseling and management for the patient and family. For pathogenic variants in low and moderate risk genes, empiric risk modeling based on the patient’s personal and family history of cancer may supersede gene-specific risk. Commercial laboratory and patient contributions to public databases and research efforts will be needed to better classify variants and reduce clinical ambiguity of multigene panels.

  9. Elia Kazan's America America: A Message for America.

    Science.gov (United States)

    Molofsky, Merle

    2018-06-01

    Elia Kazan's 1963 film, America America is a tribute to the immigrant experience of his own forebears, and has relevance to the refugee crisis of today. In stark black and white cinematography, the film provides insight into the refugee-immigrant experience, personified in Stavros, a young man longing for freedom, obsessed with an idealized America. His hope and innocence cannot safeguard him. His memories of his happy childhood and loving family create idealizing transferences to a world of others who manipulate and betray him as he undertakes his quest. Eventually he too learns to manipulate and betray, unconsciously identifying with the aggressor. History will offer ethical challenges, the black and white cinematography mirroring the black and white perception of good and bad, the shades of grey evoking a maturation of understanding.

  10. Proficiency testing for sensory profile panels : measuring panel performance

    NARCIS (Netherlands)

    Mcewan, J.A.; Hunter, E.A.; Gemert, L.J. van; Lea, P.

    2002-01-01

    Proficiency testing in sensory analysis is an important step towards demonstrating that results from one sensory panel are consistent with the results of other sensory panels. The uniqueness of sensory analysis poses some specific problems for measuring the proficiency of the human instrument

  11. International study of expert judgment on therapeutic use of benzodiazepines and other psychotherapeutic medications: VI. Trends in recommendations for the pharmacotherapy of anxiety disorders, 1992-1997.

    Science.gov (United States)

    Uhlenhuth, E H; Balter, M B; Ban, T A; Yang, K

    1999-01-01

    To assemble expert clinical experience and judgment regarding the treatment of anxiety disorders in a systematic, quantitative manner, particularly with respect to changes during the preceding five years. A panel of 73 internationally recognized experts in the pharmacotherapy of anxiety and depression was constituted by multistage peer nomination. Sixty-six completed a questionnaire in 1992, and 51 of those completed a follow-up questionnaire in 1997. This report focuses on the experts' responses to questions about therapeutic options relevant to seven vignettes describing typical cases of different anxiety disorders. The preferred initial treatment strategy in 1992 was a combination of medication with a psychological therapy for all vignettes except simple phobia, where a psychological procedure alone was favored. There was little change in 1997, primarily some decrease in the choice of psychological therapy and some increase in the choice of medication for social phobia. Experts recommending a medication in 1992 most often chose as first-line treatment a benzodiazepine anxiolytic (BZ) for panic disorder (PD), generalized anxiety disorder (GAD), simple phobia, and adjustment disorder. They recommended a beta-blocker most often for social phobia and a tricyclic anti-depressant (TCA) for agoraphobia and obsessive-compulsive disorder (OCD). Nearly a fourth chose a combination of medications, usually a TCA plus a BZ. In 1997, the expert panel's most frequent recommendation for agoraphobia, PD, and OCD changed to a specific serotonin reuptake inhibitor (SSRI); and they also recommended these compounds more often for GAD, social phobia, and simple phobia. Fewer experts chose BZs or TCAs. However, in 1997 many again chose a combination of medications, often a BZ plus a SSRI, so that, overall, there was only a small decline in recommendations for BZs. As second-line medications (1997 only), the experts recommended SSRIs most often for most vignettes, but a TCA for PD and

  12. Large thermal protection system panel

    Science.gov (United States)

    Weinberg, David J. (Inventor); Myers, Franklin K. (Inventor); Tran, Tu T. (Inventor)

    2003-01-01

    A protective panel for a reusable launch vehicle provides enhanced moisture protection, simplified maintenance, and increased temperature resistance. The protective panel includes an outer ceramic matrix composite (CMC) panel, and an insulative bag assembly coupled to the outer CMC panel for isolating the launch vehicle from elevated temperatures and moisture. A standoff attachment system attaches the outer CMC panel and the bag assembly to the primary structure of the launch vehicle. The insulative bag assembly includes a foil bag having a first opening shrink fitted to the outer CMC panel such that the first opening and the outer CMC panel form a water tight seal at temperatures below a desired temperature threshold. Fibrous insulation is contained within the foil bag for protecting the launch vehicle from elevated temperatures. The insulative bag assembly further includes a back panel coupled to a second opening of the foil bag such that the fibrous insulation is encapsulated by the back panel, the foil bag, and the outer CMC panel. The use of a CMC material for the outer panel in conjunction with the insulative bag assembly eliminates the need for waterproofing processes, and ultimately allows for more efficient reentry profiles.

  13. Reflecting variable opening insulating panel

    International Nuclear Information System (INIS)

    Nungesser, W.T.

    1976-01-01

    A description is given of a reflecting variable opening insulating panel assembly, comprising a static panel assembly of reflecting insulation sheets forming a cavity along one side of the panel and a movable panel opening out by sliding from the cavity of the static panel, and a locking device for holding the movable panel in a position extending from the cavity of the static panel. This can apply to a nuclear reactor of which the base might require maintenance and periodical checking and for which it is desirable to have available certain processes for the partial dismantling of the insulation [fr

  14. When does atopic dermatitis warrant systemic therapy? Recommendations from an expert panel of the International Eczema Council.

    Science.gov (United States)

    Simpson, Eric L; Bruin-Weller, Marjolein; Flohr, Carsten; Ardern-Jones, Michael R; Barbarot, Sebastien; Deleuran, Mette; Bieber, Thomas; Vestergaard, Christian; Brown, Sara J; Cork, Michael J; Drucker, Aaron M; Eichenfield, Lawrence F; Foelster-Holst, Regina; Guttman-Yassky, Emma; Nosbaum, Audrey; Reynolds, Nick J; Silverberg, Jonathan I; Schmitt, Jochen; Seyger, Marieke M B; Spuls, Phyllis I; Stalder, Jean-Francois; Su, John C; Takaoka, Roberto; Traidl-Hoffmann, Claudia; Thyssen, Jacob P; van der Schaft, Jorien; Wollenberg, Andreas; Irvine, Alan D; Paller, Amy S

    2017-10-01

    Although most patients with atopic dermatitis (AD) are effectively managed with topical medication, a significant minority require systemic therapy. Guidelines for decision making about advancement to systemic therapy are lacking. To guide those considering use of systemic therapy in AD and provide a framework for evaluation before making this therapeutic decision with the patient. A subgroup of the International Eczema Council determined aspects to consider before prescribing systemic therapy. Topics were assigned to expert reviewers who performed a topic-specific literature review, referred to guidelines when available, and provided interpretation and expert opinion. We recommend a systematic and holistic approach to assess patients with severe signs and symptoms of AD and impact on quality of life before systemic therapy. Steps taken before commencing systemic therapy include considering alternate or concomitant diagnoses, avoiding trigger factors, optimizing topical therapy, ensuring adequate patient/caregiver education, treating coexistent infection, assessing the impact on quality of life, and considering phototherapy. Our work is a consensus statement, not a systematic review. The decision to start systemic medication should include assessment of severity and quality of life while considering the individual's general health status, psychologic needs, and personal attitudes toward systemic therapies. Copyright © 2017 American Academy of Dermatology, Inc. All rights reserved.

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

    Science.gov (United States)

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

    2017-09-11

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

  16. Can fire safety in hotels be improved? Results from the survey of a panel of experts in Spain.

    Science.gov (United States)

    Rubio-Romero, Juan Carlos; Márquez-Sierra, Francisco; Suárez-Cebador, Manuel

    2016-06-08

    The hotel industry is an important driver of the European labour market with over 250,000 hotels employing some 2 million people. In Spain, 240 workers were injured by fires in hotels from 2004 to 2008. Fire is considered to be the most important risk in the hotel industry, but the lack of an EU-wide data recording system for hotels makes it difficult to give exact figures for fire events. We analysed the state of fire prevention systems in hotels in Spain with the aim of proposing strategies to improve fire safety. A 10-item questionnaire was administered from 2007 to 2009 to 15 Spanish experts in fire safety. The questions were measured using a Likert scale and classified into 4 sections: current state of installations, influence of establishment characteristics, application of regulations and priority ranking of actions. Descriptive statistics summarized the data and t-tests evaluated the agreement foreach statement in the questionnaire. The statistical analysis showed homogeneity in the responses by the experts in all four categories: current state of fire safety installations, influence of establishment characteristics, application of regulations, and priority of actions. There was consensus among the experts over the necessity to improve the enforcement of regulations and also regarding the existence of an association between the hotel category (in Spain they are ranked using a 1 to 5 "star" rating system) and the level of fire safety; hotels with a higher category had higher levels of safety. There is a need to identify ways to apply fire safety standards to older hotels so that they comply with new regulations, to standardize regulations for different regions and countries, to improve the maintenance of installations and equipment, to increase the effectiveness of inspections conducted by government bodies, and to raise the general awareness of stakeholders involved in hotel fire prevention.

  17. Recommendations for Management of Endemic Diseases and Travel Medicine in Solid-Organ Transplant Recipients and Donors: Latin America.

    Science.gov (United States)

    Clemente, Wanessa Trindade; Pierrotti, Lígia Camera; Abdala, Edson; Morris, Michele I; Azevedo, Luiz S; López-Vélez, Rogelio; Cuenca-Estrella, Manuel; Torre-Cisneros, Julian; Petersen, Eskild; Camargo, Luis Fernando A; Wright, Alissa Jade; Beeching, Nicholas J; Vilela, Eduardo Garcia; Santoro-Lopes, Guilherme; Len, Oscar; Stucchi, Raquel S B; Manuel, Oriol; Faria, Luciana Costa; Leblebicioglu, Hakan; Huprikar, Shirish; Molina, Israel; Mourão, Paulo Henrique Orlandi; Kotton, Camille N; Aguado, José María

    2018-02-01

    The Recommendations for Management of Endemic Diseases and Travel Medicine in Solid-Organ Transplant Recipients and Donors: Latin America clinical practice guideline is intended to guide clinicians caring for solid-organ transplant (SOT) donors, candidates and recipients regarding infectious diseases (ID) issues related to this geographical region, mostly located in the tropics. These recommendations are based on both systematic reviews of relevant literature and expert opinion from both transplant ID and travel medicine specialists. The guidelines provide recommendations for risk evaluation and laboratory investigation, as well as management and prevention of infection of the most relevant endemic diseases of Latin America. This summary includes a brief description of the guideline recommendations but does not include the complete rationale and references for each recommendation, which is available in the online version of the article, published in this journal as a supplement. The supplement contains 10 reviews referring to endemic or travel diseases (eg, tuberculosis, Chagas disease [ChD], leishmaniasis, malaria, strongyloidiasis and schistosomiasis, travelers diarrhea, arboviruses, endemic fungal infections, viral hepatitis, and vaccines) and an illustrative section with maps (http://www.pmourao.com/map/). Contributors included experts from 13 countries (Brazil, Canada, Chile, Denmark, France, Italy, Peru, Spain, Switzerland, Turkey, United Kingdom, United States, and Uruguay) representing four continents (Asia, the Americas and Europe), along with scientific and medical societies.

  18. Real time expert systems

    International Nuclear Information System (INIS)

    Asami, Tohru; Hashimoto, Kazuo; Yamamoto, Seiichi

    1992-01-01

    Recently, aiming at the application to the plant control for nuclear reactors and traffic and communication control, the research and the practical use of the expert system suitable to real time processing have become conspicuous. In this report, the condition for the required function to control the object that dynamically changes within a limited time is presented, and the technical difference between the real time expert system developed so as to satisfy it and the expert system of conventional type is explained with the actual examples and from theoretical aspect. The expert system of conventional type has the technical base in the problem-solving equipment originating in STRIPS. The real time expert system is applied to the fields accompanied by surveillance and control, to which conventional expert system is hard to be applied. The requirement for the real time expert system, the example of the real time expert system, and as the techniques of realizing real time processing, the realization of interruption processing, dispersion processing, and the mechanism of maintaining the consistency of knowledge are explained. (K.I.)

  19. Puncture panel optimization

    International Nuclear Information System (INIS)

    Glass, R.E.; Longenbaugh, R.S.

    1986-01-01

    Sandia National Laboratories developed the TRansUranic PACkage Transporter (TRUPACT) to transport defense contact-handled transuranic wastes. The package has been designed to meet the normal and hypothetical accident conditions in 10CFR71 which includes the demonstrated ability to survive a 1-meter drop onto a mild steel pin. The puncture protection is provided by puncture resistant panels. In conjunction with the development of TRUPACT, a series of experiments has been conducted to reduce the weight of the puncture resistant panels. The initial scoping tests resulted in a preliminary design incorporating 30 layers of Kevlar. This design has been shown to meet the regulatory puncture test. To reduce the weight of this panel, subscale tests were conducted on panels utilizing Kevlar yarns with varying mass per unit length (denier) as well as different resins. This paper reviews the testing undertaken in the original panel development and discusses the results obtained from the recent subscale and full-scale optimization tests

  20. Cavity Control and Panel Control Strategies in Double-Panel Structures for Transmitted Noise Reduction

    NARCIS (Netherlands)

    Ho, J.; Kalverboer, J.; Berkhoff, Arthur P.

    2012-01-01

    Investigation and comparisons of the cavity control and the panel control in a double-panel structure are presented in this paper. The double-panel structure, which comprises two panels with air in the gap, provides the advantages of low sound-transmission at high frequency, low heat-transmission

  1. Hepatic (Liver) Function Panel

    Science.gov (United States)

    ... Educators Search English Español Blood Test: Hepatic (Liver) Function Panel KidsHealth / For Parents / Blood Test: Hepatic (Liver) ... kidneys ) is working. What Is a Hepatic (Liver) Function Panel? A liver function panel is a blood ...

  2. Report of the Panel on Kinetics and Applications of Pulsed Research Reactors

    International Nuclear Information System (INIS)

    1966-03-01

    The question of the dynamic behaviour of a reactor subjected to a highly supercritical condition has had special interest for reactor physicists because of the reactor safety implications involved. The large amount of experimental and theoretical work done during the past dozen years or sc to understand fast transient behaviour and the inherent safety characteristics of reactors has not only helped to ease the concern of reactor designers about the consequences of a prompt critical excursion, but, by demonstrating the feasibility of operating certain types of reactors in a pulsed fashion has led to the development of an extremely useful research tool. Pulsed research reactors of a number of different kinds are in operation, while newer, higher performance systems are presently being designed and constructed. Such devices are being used more and more for research in physics, chemistry and reactor engineering, and with the advent of the newer machines, new research areas will become accessible. Because of the rapidly growing interest in the utilization of pulsed reactors for research, the IAEA convened a panel of experts in this field to review recent progress in the design and application of pulsed reactors to consider the problems of converting an existing pool type research reactor to a pulsing types and to consider future potentialities. The panel met in Vienna from 17 to 21 May 1965. This report of the panel summarizes the discussions

  3. Panel Resonance Control and Cavity Control in Double-Panel Structures for Active Noise Reduction

    NARCIS (Netherlands)

    Ho, J.; Berkhoff, Arthur P.

    2011-01-01

    An analytical and experimental investigation of panel resonance control and cavity control in a double-panel structure is presented in this paper. The double-panel structure, which consists of two panels with air in the gap, is widely adopted in many applications such as aerospace due to its low

  4. Current state of knowledge and experts' perspective on the subcutaneous implantable cardioverter-defibrillator.

    Science.gov (United States)

    Santini, Massimo; Cappato, Riccardo; Andresen, Dietrich; Brachmann, Johannes; Davies, D Wyn; Cleland, John; Filippi, Alessandro; Gronda, Edoardo; Hauer, Richard; Steinbeck, Gerhard; Steinhaus, David

    2009-06-01

    ICD implantation is today a well-recognized therapy to prevent sudden cardiac death. The available implantable devices at present need the use of permanent endocavitary leads which may cause, in some instances, serious troubles to the patients (lead dislodgement, ventricular perforation, lead infections, etc.). A new implantable defibrillator provided by only a subcutaneous lead is at present under evaluation. Its potential indications, usefulness benefits, and problems represent an interesting field of investigation and discussion. This paper describes the conclusions recently reached by a panel of experts, with regard to the potential role of an implantable subcutaneous defibrillator in the prevention of sudden cardiac death.

  5. Antifungal pharmacodynamics: Latin America's perspective

    Directory of Open Access Journals (Sweden)

    Javier M. Gonzalez

    2017-01-01

    Full Text Available The current increment of invasive fungal infections and the availability of new broad-spectrum antifungal agents has increased the use of these agents by non-expert practitioners, without an impact on mortality. To improve efficacy while minimizing prescription errors and to reduce the high monetary cost to the health systems, the principles of pharmacokinetics (PK and pharmacodynamics (PD are necessary. A systematic review of the PD of antifungals agents was performed aiming at the practicing physician without expertise in this field. The initial section of this review focuses on the general concepts of antimicrobial PD. In vitro studies, fungal susceptibility and antifungal serum concentrations are related with different doses and dosing schedules, determining the PD indices and the magnitude required to obtain a specific outcome. Herein the PD of the most used antifungal drug classes in Latin America (polyenes, azoles, and echinocandins is discussed.

  6. International recommendations for national patient safety incident reporting systems: an expert Delphi consensus-building process.

    Science.gov (United States)

    Howell, Ann-Marie; Burns, Elaine M; Hull, Louise; Mayer, Erik; Sevdalis, Nick; Darzi, Ara

    2017-02-01

    Patient safety incident reporting systems (PSRS) have been established for over a decade, but uncertainty remains regarding the role that they can and ought to play in quantifying healthcare-related harm and improving care. To establish international, expert consensus on the purpose of PSRS regarding monitoring and learning from incidents and developing recommendations for their future role. After a scoping review of the literature, semi-structured interviews with experts in PSRS were conducted. Based on these findings, a survey-based questionnaire was developed and subsequently completed by a larger expert panel. Using a Delphi approach, consensus was reached regarding the ideal role of PSRSs. Recommendations for best practice were devised. Forty recommendations emerged from the Delphi procedure on the role and use of PSRS. Experts agreed reporting system should not be used as an epidemiological tool to monitor the rate of harm over time or to appraise the relative safety of hospitals. They agreed reporting is a valuable mechanism for identifying organisational safety needs. The benefit of a national system was clear with respect to medication error, device failures, hospital-acquired infections and never events as these problems often require solutions at a national level. Experts recommended training for senior healthcare professionals in incident investigation. Consensus recommendation was for hospitals to take responsibility for creating safety solutions locally that could be shared nationally. We obtained reasonable consensus among experts on aims and specifications of PSRS. This information can be used to reflect on existing and future PSRS, and their role within the wider patient safety landscape. The role of PSRS as instruments for learning needs to be elaborated and developed further internationally. 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/.

  7. Technology Solutions for Existing Homes Case Study: Trade-Friendly Retrofit Insulated Panels for Existing Buildings

    Energy Technology Data Exchange (ETDEWEB)

    None

    2016-03-01

    For this project with the U.S. Department of Energy Building America team Home Innovation Research Labs, the retrofit insulated panels relied on an enhanced expanded polystyrene (EPS) for thermal resistance of R-4.5/inch, which is an improvement of 10% over conventional (white-colored) EPS. EPS, measured by its life cycle, is an alternative to commonly used extruded polystyrene and spray polyurethane foam. It is a closed-cell product made up of 90% air, and it requires about 85% fewer petroleum products for processing than other rigid foams.

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

    Science.gov (United States)

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

    2016-09-18

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

  9. Performance comparison between silicon solar panel and dye-sensitized solar panel in Malaysia

    Science.gov (United States)

    Hamed, N. K. A.; Ahmad, M. K.; Urus, N. S. T.; Mohamad, F.; Nafarizal, N.; Ahmad, N.; Soon, C. F.; Ameruddin, A. S.; Faridah, A. B.; Shimomura, M.; Murakami, K.

    2017-09-01

    In carrying out experimental research in performance between silicon solar panel and dye-sensitive solar panel, we have been developing a device and a system. This system has been developed consisting of controllers, hardware and software. This system is capable to get most of the input sources. If only need to change the main circuit and coding for a different source input value. This device is able to get the ambient temperature, surface temperature, surrounding humidity, voltage with load, current with load, voltage without load and current without load and save the data into external memory. This device is able to withstand the heat and rain as it was fabricated in a waterproof box. This experiment was conducted to examine the performance of both the solar panels which are capable to maintain their stability and performance. A conclusion based on data populated, the distribution of data for dye-sensitized solar panel is much better than silicon solar panel as dye-sensitized solar panel is very sensitive to heat and not depend only on midday where is that is the maximum ambient temperature for both solar panel as silicon solar panel only can give maximum and high output only when midday.

  10. Analysis of 3-panel and 4-panel microscale ionization sources

    International Nuclear Information System (INIS)

    Natarajan, Srividya; Parker, Charles B.; Glass, Jeffrey T.; Piascik, Jeffrey R.; Gilchrist, Kristin H.; Stoner, Brian R.

    2010-01-01

    Two designs of a microscale electron ionization (EI) source are analyzed herein: a 3-panel design and a 4-panel design. Devices were fabricated using microelectromechanical systems technology. Field emission from carbon nanotube provided the electrons for the EI source. Ion currents were measured for helium, nitrogen, and xenon at pressures ranging from 10 -4 to 0.1 Torr. A comparison of the performance of both designs is presented. The 4-panel microion source showed a 10x improvement in performance compared to the 3-panel device. An analysis of the various factors affecting the performance of the microion sources is also presented. SIMION, an electron and ion optics software, was coupled with experimental measurements to analyze the ion current results. The electron current contributing to ionization and the ion collection efficiency are believed to be the primary factors responsible for the higher efficiency of the 4-panel microion source. Other improvements in device design that could lead to higher ion source efficiency in the future are also discussed. These microscale ion sources are expected to find application as stand alone ion sources as well as in miniature mass spectrometers.

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

    Science.gov (United States)

    Zahir, Sajjad; Chang, Chew Lik

    1992-01-01

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

  12. Being an expert

    International Nuclear Information System (INIS)

    Brechet, Y.; Musseau, O.; Bruna, G.; Sperandio, M.; Roulleaux-Dugage, M.; Andrieux, S.; Metteau, L.

    2014-01-01

    This series of short articles are dedicated to the role of the expert in the enterprise. There is an important difference between a scientific counsellor and an expert, the expert, recognized by his peers, can speak publicly in his field of expertise but has a duty of transparency while the job of a scientific counsellor requires confidentiality. The making and the use of an expert in an enterprise requires a dedicated organization. The organization of the expertise in 5 enterprises in nuclear industry are considered: CEA (French Alternative Energies and Atomic Energy Commission), IRSN (Institute of Radioprotection and Nuclear Safety), AREVA, ANDRA (National Radioactive Waste Management Agency) and EDF (Electricity of France)

  13. The Pathway to a Safe and Effective Spaceflight Medication Formulary: Expert Review Panel Recommendations

    Science.gov (United States)

    Daniels, V. R.; Bayuse, T. M.; Mulcahy, R. A.; McGuire, R. K. M.; Antonsen, E. L.

    2018-01-01

    Exploration spaceflight poses several challenges to the provision of a comprehensive medication formulary. This formulary must accommodate the size and space limitations of the spacecraft, while addressing individual medication needs and preferences of the crew, consequences of a degrading inventory over time, the inability to resupply used or expired medications, and the need to forecast the best possible medication candidates to treat conditions that may occur. The Exploration Medical Capability (ExMC) Element's Pharmacy Project Team has developed a research plan (RP) that is focused on evidence-based models and theories as well as new diagnostic tools, treatments, or preventive measures aimed to ensure an available, safe, and effective pharmacy sufficient to manage potential medical threats during exploration spaceflight. Here, we will discuss the ways in which the ExMC Pharmacy Project Team pursued expert evaluation and guidance, and incorporated acquired insight into an achievable research pathway, reflected in the revised RP.

  14. Guidelines for the Management of Wet Age-Related Macular Degeneration: Recommendations from a Panel of Greek Experts.

    Science.gov (United States)

    Androudi, Sofia; Dastiridou, Anna; Pharmakakis, Nikolaos; Stefaniotou, Maria; Kalogeropoulos, Christos; Symeonidis, Chrysanthos; Charonis, Alexandros; Tsilimbaris, Miltiadis

    2016-05-01

    To propose guidelines for the management of patients with wet age-related macular degeneration (wAMD), taking into account the results of large multicenter studies and clinical experience of retina experts. A team of retina experts developed a consensus paper after three consecutive meetings. The group was focused on guidelines to help clinical decision-making around the definition of successful treatment and the definition of non-response to therapy. Parameters suggestive of a successful response to treatments included: any gain in best corrected visual acuity (BCVA) or vision loss that is less than 5-10 Early Treatment Diabetic Retinopathy Study (ETDRS) letters, reduction of central retinal thickness, partial or complete absorption of subretinal fluid (SRF), reduction of intraretinal fluid, reduction of pigment epithelial detachment or restoration of the anatomy of outer retinal layers. Non-response to current treatment was considered in the case of loss of BCVA greater than 10 ETDRS letters, increased retinal edema or increase of SRF as evidenced by optical coherence tomography or new bleeding in biomicroscopy. The introduction of anti-VEGF agents revolutionized the treatment of wAMD. Given the complexity of the disease, the emerging new agents and the difference of cases recruited in clinical trials compared to those appearing in every-day practice, it is essential to individualize treatment options taking into account the results of clinical trials.

  15. Expert judgement on inadvertent human intrusion into the Waste Isolation Pilot Plant

    International Nuclear Information System (INIS)

    Hora, S.C.; von Winterfeldt, D.; Trauth, K.M.

    1991-12-01

    Four expert-judgment teams have developed analyses delineating possible future societies in the next 10,000 years in the vicinity of the Waste Isolation Pilot Plant (WIPP). Expert-judgment analysis was used to address the question of future societies because neither experimentation, observation, nor modeling can resolve such uncertainties. Each of the four, four-member teams, comprised of individuals with expertise in the physical, social, or political sciences, developed detailed qualitative assessments of possible future societies. These assessments include detailed discussions of the underlying physical and societal factors that would influence society and the likely modes of human-intrusion at the WIPP, as well as the probabilities of intrusion. Technological development, population growth, economic development, conservation of information, persistence of government control, and mitigation of danger from nuclear waste were the factors the teams believed to be most important. Likely modes of human-intrusion were categorized as excavation, disposal/storage, tunneling, drilling, and offsite activities. Each team also developed quantitative assessments by providing probabilities of various alternative futures, of inadvertent human intrusion, and in some cases, of particular modes of intrusion. The information created throughout this study will be used in conjunction with other types of information, including experimental data, calculations from physical principles and computer models, and perhaps other judgments, as input to ''performance assessment.'' The more qualitative results of this study will be used as input to another expert panel considering markers to deter inadvertent human intrusion at the WIPP

  16. Molybdenum-99 supply: a global issue

    International Nuclear Information System (INIS)

    Cote, R.V.

    2011-01-01

    This article discusses the global supply of Molybdenum 99 used in nuclear medicine. Following a disruption in supplies of isotopes in the last few years, a Canadian expert panel assessed the most viable options for securing a sustainable supply of Technitium 99 over the medium to long term. The general recommendations were to strive for diversity and redundancy throughout the supply chain, leverage multi-use infrastructure, continue with international coordination and seek processing standardization within North America.

  17. Antinuclear antibody panel

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003535.htm Antinuclear antibody panel To use the sharing features on this page, please enable JavaScript. The antinuclear antibody panel is a blood test that looks at ...

  18. Hepatitis virus panel

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003558.htm Hepatitis virus panel To use the sharing features on this page, please enable JavaScript. The hepatitis virus panel is a series of blood tests used ...

  19. System Experts and Decision Making Experts in Transdisciplinary Projects

    Science.gov (United States)

    Mieg, Harald A.

    2006-01-01

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

  20. REINFORCED COMPOSITE PANEL

    DEFF Research Database (Denmark)

    2003-01-01

    A composite panel having front and back faces, the panel comprising facing reinforcement, backing reinforcement and matrix material binding to the facing and backing reinforcements, the facing and backing reinforcements each independently comprising one or more reinforcing sheets, the facing rein...... by matrix material, the facing and backing reinforcements being interconnected to resist out-of-plane relative movement. The reinforced composite panel is useful as a barrier element for shielding structures, equipment and personnel from blast and/or ballistic impact damage....

  1. Expert elicitation on ultrafine particles: likelihood of health effects and causal pathways

    Directory of Open Access Journals (Sweden)

    Brunekreef Bert

    2009-07-01

    Full Text Available Abstract Background Exposure to fine ambient particulate matter (PM has consistently been associated with increased morbidity and mortality. The relationship between exposure to ultrafine particles (UFP and health effects is less firmly established. If UFP cause health effects independently from coarser fractions, this could affect health impact assessment of air pollution, which would possibly lead to alternative policy options to be considered to reduce the disease burden of PM. Therefore, we organized an expert elicitation workshop to assess the evidence for a causal relationship between exposure to UFP and health endpoints. Methods An expert elicitation on the health effects of ambient ultrafine particle exposure was carried out, focusing on: 1 the likelihood of causal relationships with key health endpoints, and 2 the likelihood of potential causal pathways for cardiac events. Based on a systematic peer-nomination procedure, fourteen European experts (epidemiologists, toxicologists and clinicians were selected, of whom twelve attended. They were provided with a briefing book containing key literature. After a group discussion, individual expert judgments in the form of ratings of the likelihood of causal relationships and pathways were obtained using a confidence scheme adapted from the one used by the Intergovernmental Panel on Climate Change. Results The likelihood of an independent causal relationship between increased short-term UFP exposure and increased all-cause mortality, hospital admissions for cardiovascular and respiratory diseases, aggravation of asthma symptoms and lung function decrements was rated medium to high by most experts. The likelihood for long-term UFP exposure to be causally related to all cause mortality, cardiovascular and respiratory morbidity and lung cancer was rated slightly lower, mostly medium. The experts rated the likelihood of each of the six identified possible causal pathways separately. Out of these

  2. Rational Design of Composite Panels

    DEFF Research Database (Denmark)

    Riber, Hans Jørgen

    1996-01-01

    A non-linear structural model for composite panels is presented. The non-linear terms in the lateral displacements are modelled as an additional set of lateral loads acting on the panel. Hence the solution is reduced to that of an equivalent panel with small displacements In order to treat sandwich...... Norske Veritas', DNV, building rules concerning high-speed light craft, in which the panel scantlings are often restricted by a maximum lateral deflection connected with the panel span....

  3. Review Symposium. "Working in America: A Blueprint for the New Labor Market," by Paul Osterman, Thomas A. Kochan, Richard Locke, and Michael J. Piore.

    Science.gov (United States)

    Katz, Harry C., Ed.

    2002-01-01

    A panel comments on the book, Working in America, and implications for the U.S. labor market, including declining traditional internal labor markets, the need for private versus public policy interventions, international labor policy, and value-based policy. Commentators include David Neumark, Peter Cappelli, Sanford M. Jacoby, Rebecca M. Blank,…

  4. Composite panel development at JPL

    Science.gov (United States)

    Mcelroy, Paul; Helms, Rich

    1988-01-01

    Parametric computer studies can be use in a cost effective manner to determine optimized composite mirror panel designs. An InterDisciplinary computer Model (IDM) was created to aid in the development of high precision reflector panels for LDR. The materials properties, thermal responses, structural geometries, and radio/optical precision are synergistically analyzed for specific panel designs. Promising panels designs are fabricated and tested so that comparison with panel test results can be used to verify performance prediction models and accommodate design refinement. The iterative approach of computer design and model refinement with performance testing and materials optimization has shown good results for LDR panels.

  5. Expert auditors’ services classification

    OpenAIRE

    Jolanta Wisniewska

    2013-01-01

    The profession of an expert auditor is a public trust occupation with a distinctive feature of taking responsibility for actions in the public interest. The main responsibility of expert auditors is performing financial auditing; however, expert auditors are prepared to carry out different tasks which encompass a wide plethora of financial and auditing services for different kinds of institutions and companies. The aim of the article is first of all the description of expert auditors’ service...

  6. An expert elicitation process to project the frequency and magnitude of Florida manatee mortality events caused by red tide (Karenia brevis)

    Science.gov (United States)

    Martin, Julien; Runge, Michael C.; Flewelling, Leanne J.; Deutsch, Charles J.; Landsberg, Jan H.

    2017-11-20

    Red tides (blooms of the harmful alga Karenia brevis) are one of the major sources of mortality for the Florida manatee (Trichechus manatus latirostris), especially in southwest Florida. It has been hypothesized that the frequency and severity of red tides may increase in the future because of global climate change and other factors. To improve our ecological forecast for the effects of red tides on manatee population dynamics and long-term persistence, we conducted a formal expert judgment process to estimate probability distributions for the frequency and relative magnitude of red-tide-related manatee mortality (RTMM) events over a 100-year time horizon in three of the four regions recognized as manatee management units in Florida. This information was used to update a population viability analysis for the Florida manatee (the Core Biological Model). We convened a panel of 12 experts in manatee biology or red-tide ecology; the panel met to frame, conduct, and discuss the elicitation. Each expert provided a best estimate and plausible low and high values (bounding a confidence level of 80 percent) for each parameter in each of three regions (Northwest, Southwest, and Atlantic) of the subspecies’ range (excluding the Upper St. Johns River region) for two time periods (0−40 and 41−100 years from present). We fitted probability distributions for each parameter, time period, and expert by using these three elicited values. We aggregated the parameter estimates elicited from individual experts and fitted a parametric distribution to the aggregated results.Across regions, the experts expected the future frequency of RTMM events to be higher than historical levels, which is consistent with the hypothesis that global climate change (among other factors) may increase the frequency of red-tide blooms. The experts articulated considerable uncertainty, however, about the future frequency of RTMM events. The historical frequency of moderate and intense RTMM (combined) in

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

    DEFF Research Database (Denmark)

    Kesäniemi, Antero; Riddoch, Chris J; Reeder, Bruce

    2010-01-01

    in 2002, 2002, 1998 and 1999 respectively. Several background papers from this project were published recently and provide foundation evidence upon which to base new guidelines. Furthermore, comprehensive systematic reviews were completed to ensure a rigorous evaluation of evidence informing the revision...... to review the background materials and systematic reviews; listen to the presentations and discussions at the expert meeting; ask for clarification; and produce the present paper representing their interpretation of the evidence including grading of the evidence and their identification of needs for future...

  8. Supersonic Panel Flutter Test Results for Flat Fiber-Glass Sandwich Panels with Foamed Cores

    Science.gov (United States)

    Tuovila, W. J.; Presnell, John G., Jr.

    1961-01-01

    Flutter tests have been made on flat panels having a 1/4 inch-thick plastic-foam core covered with thin fiber-glass laminates. The testing was done in the Langley Unitary Plan wind tunnel at Mach numbers from 1.76 t o 2.87. The flutter boundary for these panels was found to be near the flutter boundary of thin metal panels when compared on the basis of an equivalent panel stiffness. The results also demonstrated that the depth of the cavity behind the panel has a pronounced influence on flutter. Changing the cavity depth from 1 1/2 inches to 1/2 inch reduced the dynamic pressure at start of flutter by 40 percent. No flutter was obtained when the spacers on the back of the panel were against the bottom of the cavity.

  9. Panel Resource Management (PRM) Implementation and Effects within Safety Review Panel Settings and Dynamics

    Science.gov (United States)

    Taylor, Robert W.; Nash, Sally K.

    2007-01-01

    While technical training and advanced degree's assure proficiency at specific tasks within engineering disciplines, they fail to address the potential for communication breakdown and decision making errors familiar to multicultural environments where language barriers, intimidating personalities and interdisciplinary misconceptions exist. In an effort to minimize these pitfalls to effective panel review, NASA's lead safety engineers to the ISS Safety Review Panel (SRP), and Payload Safety Review Panel (PSRP) initiated training with their engineers, in conjunction with the panel chairs, and began a Panel Resource Management (PRM) program. The intent of this program focuses on the ability to reduce the barriers inhibiting effective participation from all panel attendees by bolstering participants confidence levels through increased communication skills, situational awareness, debriefing, and a better technical understanding of requirements and systems.

  10. Solar panel cleaning robot

    Science.gov (United States)

    Nalladhimmu, Pavan Kumar Reddy; Priyadarshini, S.

    2018-04-01

    As the demand of electricity is increasing, there is need to using the renewable sources to produce the energy at present of power shortage, the use of solar energy could be beneficial to great extent and easy to get the maximum efficiency. There is an urgent in improving the efficiency of solar power generation. Current solar panels setups take a major power loss when unwanted obstructions cover the surface of the panels. To make solar energy more efficiency of solar array systems must be maximized efficiency evaluation of PV panels, that has been discussed with particular attention to the presence of dust on the efficiency of the PV panels have been highlighted. This paper gives the how the solar panel cleaning system works and designing of the cleaning system.

  11. EFSA CEF Panel (EFSA Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids), 2013. Scientific Opinion on Flavouring Group Evaluation 73, Revision 2 (FGE.73Rev2). Consideration of alicyclic primary alcohols, aldehydes, acids and related esters evaluated by JECFA (59th meeting

    DEFF Research Database (Denmark)

    Beltoft, Vibe Meister; Binderup, Mona-Lise; Frandsen, Henrik Lauritz

    The Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids of the European Food Safety Authority was requested to consider evaluations of flavouring substances assessed since 2000 by the Joint FAO/WHO Expert Committee on Food Additives (the JECFA), and to decide whether further...... uses, toxicological threshold of concern, and available data on metabolism and toxicity. The Panel agrees with the application of the Procedure as performed by the JECFA for all 18 substances [FL-no: 02.114, 02.141, 05.098, 05.104, 05.112, 05.119, 05.123, 08.034, 08.060, 08.067, 09.028, 09.034, 09...... for the materials of commerce have also been considered and for all 18 substances, the information is adequate....

  12. Lightweight, Thermally Insulating Structural Panels

    Science.gov (United States)

    Eisen, Howard J.; Hickey, Gregory; Wen, Liang-Chi; Layman, William E.; Rainen, Richard A.; Birur, Gajanana C.

    1996-01-01

    Lightweight, thermally insulating panels that also serve as structural members developed. Honeycomb-core panel filled with low-thermal-conductivity, opacified silica aerogel preventing convection and minimizes internal radiation. Copper coating on face sheets reduces radiation. Overall thermal conductivities of panels smaller than state-of-art commercial non-structurally-supporting foam and fibrous insulations. On Earth, panels suitable for use in low-air-pressure environments in which lightweight, compact, structurally supporting insulation needed; for example, aboard high-altitude aircraft or in partially evacuated panels in refrigerators.

  13. Predicting Consumer Effort in Finding and Paying for Health Care: Expert Interviews and Claims Data Analysis.

    Science.gov (United States)

    Long, Sandra; Monsen, Karen A; Pieczkiewicz, David; Wolfson, Julian; Khairat, Saif

    2017-10-12

    For consumers to accept and use a health care information system, it must be easy to use, and the consumer must perceive it as being free from effort. Finding health care providers and paying for care are tasks that must be done to access treatment. These tasks require effort on the part of the consumer and can be frustrating when the goal of the consumer is primarily to receive treatments for better health. The aim of this study was to determine the factors that result in consumer effort when finding accessible health care. Having an understanding of these factors will help define requirements when designing health information systems. A panel of 12 subject matter experts was consulted and the data from 60 million medical claims were used to determine the factors contributing to effort. Approximately 60 million claims were processed by the health care insurance organization in a 12-month duration with the population defined. Over 292 million diagnoses from claims were used to validate the panel input. The results of the study showed that the number of people in the consumer's household, number of visits to providers outside the consumer's insurance network, number of adjusted and denied medical claims, and number of consumer inquiries are a proxy for the level of effort in finding and paying for care. The effort level, so measured and weighted per expert panel recommendations, differed by diagnosis. This study provides an understanding of how consumers must put forth effort when engaging with a health care system to access care. For higher satisfaction and acceptance results, health care payers ideally will design and develop systems that facilitate an understanding of how to avoid denied claims, educate on the payment of claims to avoid adjustments, and quickly find providers of affordable care. ©Sandra Long, Karen A. Monsen, David Pieczkiewicz, Julian Wolfson, Saif Khairat. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 12.10.2017.

  14. IncobotulinumtoxinA in aesthetics: Russian multidisciplinary expert consensus recommendations

    Directory of Open Access Journals (Sweden)

    Yutskovskaya Y

    2015-06-01

    . The expert group reviewed and analyzed the existing evidence, consensus recommendations, and Russian experts’ extensive practical experience of incobotulinumtoxinA in aesthetics to reach consensus on optimal doses, potential dose adjustments, and injection sites of incobotulinumtoxinA for facial aesthetics. Results: All experts developed guidance on the optimal doses for incobotulinumtoxinA treatment of different regions of the upper and lower face. The expert panel agreed that there are no differences in the efficacy and duration of the effect between the four BoNT/As that are commercially available for facial aesthetic indications in Russia and that, when administered correctly, all BoNT/As can achieve optimal results. Experts also agreed that nonresponse to BoNT/A can be caused by neutralizing antibodies. Conclusion: On the basis of the scientific and clinical evidence available for incobotulinumtoxinA, coupled with the extensive clinical experience of the consensus group, experts recommended the optimal doses of incobotulinumtoxinA effective for treatment of wrinkles of the upper and lower face to achieve the expected aesthetic outcome. These first Russian guidelines on the optimal use of incobotulinumtoxinA for augmentation of glabellar lines, periorbital wrinkles, forehead lines, bunny lines, perioral wrinkles, depressor anguli oris, mentalis, masseters and platysmal bands, and performing the Nefertiti lift, are presented here. Keywords: incobotulinumtoxinA, free from complexing proteins, consensus guidelines, facial lines, dosage, aesthetics, Russia

  15. PERBANDINGAN UNJUK KERJA ANTARA PANEL SEL SURYA BERPENJEJAK DENGAN PANEL SEL SURYA DIAM

    OpenAIRE

    Syafaruddin Ch

    2010-01-01

    The ability to produce electrical energy at Solar Power Plant  is highly dependent on the magnitude and duration of sun exposure on the solar cell panels. The movement of the sun from east to west that periodicity in every day is a problem at  the  optimization generation of electricity at  Solar Power Plant   if using solar panel that motionless. This is because the solar cell panel can not catch the maximum sun exposure. To solve the above problem then designed a solar cell panel  tracker...

  16. IAEA Nobel Prize money fights cancer crisis in Latin America

    International Nuclear Information System (INIS)

    2007-01-01

    Full text: More than 60 of the world's leading cancer experts are being brought together in Buenos Aires, 23-27 April 2007, by the International Atomic Energy Agency (IAEA) to assess Latin America's growing cancer burden. Poor medical facilities and lack of trained personnel and funding are limiting countries' ability to expand cancer care services and treat patients, while cancer rates are expected to double by 2020. More than 70 per cent of all cancer deaths occur in low and middle income countries and globally cancer kills more people than AIDS, malaria and tuberculosis combined. Through its Programme of Action for Cancer Therapy (PACT) the IAEA is using funds, awarded for the 2005 Nobel Peace Prize, to sponsor training workshops, such as the Buenos Aires event, that alert policy makers and health experts to the pressing need for national cancer control plans and programmes. 'I hope that this event in Latin America is the first of many that will enable us to work together to help combat this dreadful disease and provide quality of life to our fellow human beings,' said Director General of the IAEA, Dr. Mohamed ElBaradei. 'Cancer is a disease that is spreading very fast in the developing world and we have come to realise that we have to do much more to combat it in this part of the world.' In Latin America, there are an estimated 450,000 cancer deaths annually. The most commonly occurring cancers in men are prostate, stomach, lung, and colorectal and in women the most commonly occurring cancers are breast, cervix, stomach and colorectal. Breast and cervical cancer can be prevented through screening and early detection and can be cured in the early stages with effective treatment. The World Health Organization (WHO) warns that cancer will soon reach epidemic proportions, causing up to 10 million deaths a year by 2020. Yet at least one third of all cancers are preventable. A further one third of cases can be effectively treated if detected early. PACT was

  17. IAEA Nobel Prize money fights cancer crisis in Latin America

    International Nuclear Information System (INIS)

    2007-01-01

    Full text: More than 60 of the world's leading cancer experts are being brought together in Buenos Aires, 23-27 April 2007, by the International Atomic Energy Agency (IAEA) to assess Latin America's growing cancer burden. Poor medical facilities and lack of trained personnel and funding are limiting countries' ability to expand cancer care services and treat patients, while cancer rates are expected to double by 2020. More than 70 per cent of all cancer deaths occur in low and middle income countries and globally cancer kills more people than AIDS, malaria and tuberculosis combined. Through its Programme of Action for Cancer Therapy (PACT) the IAEA is using funds, awarded for the 2005 Nobel Peace Prize, to sponsor training workshops, such as the Buenos Aires event, that alert policy makers and health experts to the pressing need for national cancer control plans and programmes. 'I hope that this event in Latin America is the first of many that will enable us to work together to help combat this dreadful disease and provide quality of life to our fellow human beings,' said Director General of the IAEA, Dr. Mohamed ElBaradei. 'Cancer is a disease that is spreading very fast in the developing world and we have come to realise that we have to do much more to combat it in this part of the world.' In Latin America, there are an estimated 450,000 cancer deaths annually. The most commonly occurring cancers in men are prostate, stomach, lung, and colorectal and in women the most commonly occurring cancers are breast, cervix, stomach and colorectal. Breast and cervical cancer can be prevented through screening and early detection and can be cured in the early stages with effective treatment. The World Health Organization (WHO) warns that cancer will soon reach epidemic proportions, causing up to 10 million deaths a year by 2020. Yet at least one third of all cancers are preventable. A further one third of cases can be effectively treated if detected early. PACT was

  18. Panel data analysis using EViews

    CERN Document Server

    Agung, I Gusti Ngurah

    2013-01-01

    A comprehensive and accessible guide to panel data analysis using EViews software This book explores the use of EViews software in creating panel data analysis using appropriate empirical models and real datasets. Guidance is given on developing alternative descriptive statistical summaries for evaluation and providing policy analysis based on pool panel data. Various alternative models based on panel data are explored, including univariate general linear models, fixed effect models and causal models, and guidance on the advantages and disadvantages of each one is given. Panel Data Analysis

  19. Upstream fish migration. Report of the hydro power panel of experts; Fischaufstieg. Bericht aus der Expertengruppe Wasserkraft

    Energy Technology Data Exchange (ETDEWEB)

    Roger, Sebastian [RWE Innogy GmbH, Essen (Germany). Asset Management Hydro National; Kaefer, Sabine [Verbund Hydro Power AG, Villach (Austria); Ulrich, Jochen [EDH Energiedienst Holding AG, Laufenburg (Switzerland). Oekologie und Werkdienst; Zemanek, Friedrich [evn naturkraft Erzeugungsgesellschaft m.b.H., Maria Enzersdorf (Austria)

    2013-10-01

    In recent years, ecological regulations and environmental demands have steadily increased on European, national, and on Federal State level. One key issue of Federal implementations of the European water framework directive is to achieve the environmental targets by establishing the passability for fish. In support of its member companies, VGB (TC 'Hydro Power Plants') set up a transnational expert group. This group was to analyse, compare, and evaluate different essential guidelines for fish passes and residual flows including the exchange of experience and the provision of practical examples. (orig.)

  20. RECIPANEL: RECYCLED PAPER PANELS

    Directory of Open Access Journals (Sweden)

    HERNÁN CAÑOLA

    2012-01-01

    Full Text Available En este artículo se estudia la fabricación y el comportamiento mecánico de paneles a base de papel reciclado. El objetivo principal del proyecto es producir un prototipo de panel que emplee elementos provenientes de residuos sólidos (papel periódico y de un material conglomerante (cemento Portland blanco. El panel debe ser económico, debe tener buenas propiedades mecánicas y debe tener dimensiones comerciales para su uso en muros tabiques y en cielos falsos en la industria de la construcción. El Recipanel es un panel no estructural a base de papel reciclado. El Recipanel cumple las normas colombianas en lo relativo a los paneles de uso no estructural y presenta además unas excelentes características mecánicas.

  1. EFSA CEF Panel (EFSA Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids), 2013. Scientific Opinion on Flavouring Group Evaluation 72, Revision 1 (FGE.72Rev1): Consideration of aliphatic, branched-chain saturated and unsaturated alcohols, aldehydes, acids, and related esters

    DEFF Research Database (Denmark)

    Beltoft, Vibe Meister; Binderup, Mona-Lise; Frandsen, Henrik Lauritz

    The Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids of the European Food Safety Authority was requested to consider evaluations of flavouring substances assessed since 2000 by the Joint FAO/WHO Expert Committee on Food Additives (the JECFA), and to decide whether further...... threshold of concern, and available data on metabolism and toxicity. The Panel agrees with the application of the Procedure as performed by the JECFA for all 23 substances considered in this FGE and agrees with the JECFA conclusion, “No safety concern at estimated levels of intake as flavouring substances......” based on the MSDI approach. Besides the safety assessment of these flavouring substances, the specifications for the materials of commerce have also been considered and for all 23 substances, the information is adequate...

  2. Indications for use of thoracic, abdominal, pelvic, and vascular damage control interventions in trauma patients: A content analysis and expert appropriateness rating study.

    Science.gov (United States)

    Roberts, Derek J; Bobrovitz, Niklas; Zygun, David A; Ball, Chad G; Kirkpatrick, Andrew W; Faris, Peter D; Parry, Neil; Nicol, Andrew J; Navsaria, Pradeep H; Moore, Ernest E; Leppäniemi, Ari K; Inaba, Kenji; Fabian, Timothy C; D'Amours, Scott; Brohi, Karim; Stelfox, Henry T

    2015-10-01

    The use of abbreviated or damage control (DC) interventions may improve outcomes in severely injured patients when appropriately indicated. We sought to determine which indications for DC interventions have been most commonly reported in the peer-reviewed literature to date and evaluate the opinions of experts regarding the appropriateness (expected benefit-to-harm ratio) of the reported indications for use in practice. Two investigators used an abbreviated grounded theory method to synthesize indications for 16 different DC interventions reported in peer-reviewed articles between 1983 and 2014 into a reduced number of named, content-characteristic codes representing unique indications. For each indication code, an international panel of trauma surgery experts (n = 9) then rated the appropriateness of conducting the DC intervention of interest in an adult civilian trauma patient. The 424 indications identified in the literature were synthesized into 101 unique indications. The panel assessed 12 (70.6%) of the coded indications for the 7 different thoracic, 47 (78.3%) for the 7 different abdominal/pelvic, and 18 (75.0%) for the 2 different vascular interventions to be appropriate for use in practice. These included indications for rapid lung-sparing surgery (pneumonorrhaphy, pulmonary tractotomy, and pulmonary wedge resection) (n = 1); pulmonary tractotomy (n = 3); rapid, simultaneously stapled pneumonectomy (n = 1); therapeutic mediastinal and/or pleural space packing (n = 4); temporary thoracic closure (n = 3); therapeutic perihepatic packing (n = 28); staged pancreaticoduodenectomy (n = 2); temporary abdominal closure (n = 12); extraperitoneal pelvic packing (n = 5); balloon catheter tamponade (n = 6); and temporary intravascular shunting (n = 11). This study identified a list of candidate appropriate indications for use of 12 different DC interventions that were suggested by authors of peer-reviewed articles and assessed by a panel of independent experts to be

  3. The United States of America and the People`s Republic of China experts report on integrated gasification combined-cycle technology (IGCC)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-12-01

    A report written by the leading US and Chinese experts in Integrated Gasification Combined Cycle (IGCC) power plants, intended for high level decision makers, may greatly accelerate the development of an IGCC demonstration project in the People`s Republic of China (PRC). The potential market for IGCC systems in China and the competitiveness of IGCC technology with other clean coal options for China have been analyzed in the report. Such information will be useful not only to the Chinese government but also to US vendors and companies. The goal of this report is to analyze the energy supply structure of China, China`s energy and environmental protection demand, and the potential market in China in order to make a justified and reasonable assessment on feasibility of the transfer of US Clean Coal Technologies to China. The Expert Report was developed and written by the joint US/PRC IGCC experts and will be presented to the State Planning Commission (SPC) by the President of the CAS to ensure consideration of the importance of IGCC for future PRC power production.

  4. A comparative analysis between the relation of income distribution and economic regional integration in East Asia and Latin America

    Directory of Open Access Journals (Sweden)

    Ángela Jeaneth Ospina Enciso

    2011-06-01

    Full Text Available This paper analyses the relationship between inequality and de facto regional economic integration during the last two decades in Latin America and East Asia Pacific regions, focusing on intra-regional exports. Globalization has been considered as a driving of inequality, although export-led growth models are associated with high economic growth rates. Export-led growth models have been more dynamic in East Asia than in Latin America, through the development of supply chain networks of intermediate and final goods. Research questions explore the relation between inequality and patterns of de facto intra-regional trade. Empirical analysis uses a fixed effects panel data with Heteroskedasticity and Autocorrelation Consistent (HAC covariance matrix. Results showed that increments in regional intra-trade are associated with reductions of inequality, more in East Asia Pacific than in Latin America. The contribution of this paper is the introduction of intra-regional trade as a new factor that is negatively associated with inequality.

  5. Make Your Own Solar Panel.

    Science.gov (United States)

    Suzuki, David

    1992-01-01

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

  6. Solar panel parallel mounting configuration

    Science.gov (United States)

    Mutschler, Jr., Edward Charles (Inventor)

    1998-01-01

    A spacecraft includes a plurality of solar panels interconnected with a power coupler and an electrically operated device to provide power to the device when the solar cells are insolated. The solar panels are subject to bending distortion when entering or leaving eclipse. Spacecraft attitude disturbances are reduced by mounting each of the solar panels to an elongated boom made from a material with a low coefficient of thermal expansion, so that the bending of one panel is not communicated to the next. The boom may be insulated to reduce its bending during changes in insolation. A particularly advantageous embodiment mounts each panel to the boom with a single mounting, which may be a hinge. The single mounting prevents transfer of bending moments from the panel to the boom.

  7. Readability of written medicine information materials in Arabic language: expert and consumer evaluation.

    Science.gov (United States)

    Al Aqeel, Sinaa; Abanmy, Norah; Aldayel, Abeer; Al-Khalifa, Hend; Al-Yahya, Maha; Diab, Mona

    2018-02-27

    Written Medicine Information (WMI) is one of the sources that patients use to obtain information concerning medicine. This paper aims to assess the readability of two types of WMIs in Arabic language based on vocabulary use and sentence structure using a panel of experts and consumers. This is a descriptive study. Two different types of materials, including the online text from King Abdullah Bin Abdulaziz Arabic Health Encyclopaedia (KAAHE) and medication leaflets submitted by the manufacturers to the Saudi Food and Drug Authority (SFDA) were evaluated. We selected a group of sentences from each WMI. The readability was assessed by experts (n = 5) and consumers (n = 5). The sentence readability of each measured using a specific criteria and rated as 1 = easy, 2 = intermediate, or 3 = difficult. A total of 4476 sentences (SFDA 2231; KAHEE 2245) extracted from websites or patient information leaflets on 50 medications and evaluated. The majority of the vocabulary and sentence structure was considered easy by both expert (SFDA: 68%; KAAHE: 76%) and consumer (SFDA: 76%; KAAHE: 84%) groups. The sentences with difficult or intermediate vocabulary and sentence structure are derived primarily from the precautions and side effects sections. The SFDA and KAAHE WMIs are easy to read and understand as judged by our study sample. However; there is room for improvement, especially in sections related to the side effects and precautions.

  8. A test battery measuring auditory capabilities of listening panels

    DEFF Research Database (Denmark)

    Ghani, Jody; Ellermeier, Wolfgang; Zimmer, Karin

    2005-01-01

    a battery of tests covering a larger range of auditory capabilities in order to assess individual listeners. The format of all tests is kept as 'objective' as possible by using a three-alternative forced-choice paradigm in which the subject must choose which of the sound samples is different, thus keeping...... the instruction to the subjects simple and common for all tests. Both basic (e.g. frequency discrimination) and complex (e.g. profile analysis) psychoacoustic tests are covered in the battery and a threshold of discrimination or detection is obtained for each test. Data were collected on 24 listeners who had been...... recruited for participation in an expert listening panel for evaluating the sound quality of hi-fi audio systems. The test battery data were related to the actual performance of the listeners when judging the degradation in quality produced by audio codecs....

  9. JETC (Japanese Technology Evaluation Center) Panel Report on High Temperature Superconductivity in Japan

    Science.gov (United States)

    Shelton, Duane; Gamota, George

    1989-01-01

    The Japanese regard success in R and D in high temperature superconductivity as an important national objective. The results of a detailed evaluation of the current state of Japanese high temperature superconductivity development are provided. The analysis was performed by a panel of technical experts drawn from U.S. industry and academia, and is based on reviews of the relevant literature and visits to Japanese government, academic and industrial laboratories. Detailed appraisals are presented on the following: Basic research; superconducting materials; large scale applications; processing of superconducting materials; superconducting electronics and thin films. In all cases, comparisons are made with the corresponding state-of-the-art in the United States.

  10. Mounting clips for panel installation

    Science.gov (United States)

    Cavieres, Andres; Al-Haddad, Tristan; Goodman, Joseph

    2017-07-11

    A photovoltaic panel mounting clip comprising a base, central indexing tabs, flanges, lateral indexing tabs, and vertical indexing tabs. The mounting clip removably attaches one or more panels to a beam or the like structure, both mechanically and electrically. It provides secure locking of the panels in all directions, while providing guidance in all directions for accurate installation of the panels to the beam or the like structure.

  11. Integrating clinicians, knowledge and data: expert-based cooperative analysis in healthcare decision support.

    Science.gov (United States)

    Gibert, Karina; García-Alonso, Carlos; Salvador-Carulla, Luis

    2010-09-30

    Decision support in health systems is a highly difficult task, due to the inherent complexity of the process and structures involved. This paper introduces a new hybrid methodology Expert-based Cooperative Analysis (EbCA), which incorporates explicit prior expert knowledge in data analysis methods, and elicits implicit or tacit expert knowledge (IK) to improve decision support in healthcare systems. EbCA has been applied to two different case studies, showing its usability and versatility: 1) Bench-marking of small mental health areas based on technical efficiency estimated by EbCA-Data Envelopment Analysis (EbCA-DEA), and 2) Case-mix of schizophrenia based on functional dependency using Clustering Based on Rules (ClBR). In both cases comparisons towards classical procedures using qualitative explicit prior knowledge were made. Bayesian predictive validity measures were used for comparison with expert panels results. Overall agreement was tested by Intraclass Correlation Coefficient in case "1" and kappa in both cases. EbCA is a new methodology composed by 6 steps:. 1) Data collection and data preparation; 2) acquisition of "Prior Expert Knowledge" (PEK) and design of the "Prior Knowledge Base" (PKB); 3) PKB-guided analysis; 4) support-interpretation tools to evaluate results and detect inconsistencies (here Implicit Knowledg -IK- might be elicited); 5) incorporation of elicited IK in PKB and repeat till a satisfactory solution; 6) post-processing results for decision support. EbCA has been useful for incorporating PEK in two different analysis methods (DEA and Clustering), applied respectively to assess technical efficiency of small mental health areas and for case-mix of schizophrenia based on functional dependency. Differences in results obtained with classical approaches were mainly related to the IK which could be elicited by using EbCA and had major implications for the decision making in both cases. This paper presents EbCA and shows the convenience of

  12. Integrating clinicians, knowledge and data: expert-based cooperative analysis in healthcare decision support

    Directory of Open Access Journals (Sweden)

    García-Alonso Carlos

    2010-09-01

    Full Text Available Abstract Background Decision support in health systems is a highly difficult task, due to the inherent complexity of the process and structures involved. Method This paper introduces a new hybrid methodology Expert-based Cooperative Analysis (EbCA, which incorporates explicit prior expert knowledge in data analysis methods, and elicits implicit or tacit expert knowledge (IK to improve decision support in healthcare systems. EbCA has been applied to two different case studies, showing its usability and versatility: 1 Bench-marking of small mental health areas based on technical efficiency estimated by EbCA-Data Envelopment Analysis (EbCA-DEA, and 2 Case-mix of schizophrenia based on functional dependency using Clustering Based on Rules (ClBR. In both cases comparisons towards classical procedures using qualitative explicit prior knowledge were made. Bayesian predictive validity measures were used for comparison with expert panels results. Overall agreement was tested by Intraclass Correlation Coefficient in case "1" and kappa in both cases. Results EbCA is a new methodology composed by 6 steps:. 1 Data collection and data preparation; 2 acquisition of "Prior Expert Knowledge" (PEK and design of the "Prior Knowledge Base" (PKB; 3 PKB-guided analysis; 4 support-interpretation tools to evaluate results and detect inconsistencies (here Implicit Knowledg -IK- might be elicited; 5 incorporation of elicited IK in PKB and repeat till a satisfactory solution; 6 post-processing results for decision support. EbCA has been useful for incorporating PEK in two different analysis methods (DEA and Clustering, applied respectively to assess technical efficiency of small mental health areas and for case-mix of schizophrenia based on functional dependency. Differences in results obtained with classical approaches were mainly related to the IK which could be elicited by using EbCA and had major implications for the decision making in both cases. Discussion This

  13. Delegating Decisions to Experts

    Science.gov (United States)

    Li, Hao; Suen, Wing

    2004-01-01

    We present a model of delegation with self-interested and privately informed experts. A team of experts with extreme but opposite biases is acceptable to a wide range of decision makers with diverse preferences, but the value of expertise from such a team is low. A decision maker wants to appoint experts who are less partisan than he is in order…

  14. Chronic kidney disease of nontraditional etiology in Central America: a provisional epidemiologic case definition for surveillance and epidemiologic studies.

    Science.gov (United States)

    Lozier, Matthew; Turcios-Ruiz, Reina Maria; Noonan, Gary; Ordunez, Pedro

    2016-11-01

    SYNOPSIS Over the last two decades, experts have reported a rising number of deaths caused by chronic kidney disease (CKD) along the Pacific coast of Central America, from southern Mexico to Costa Rica. However, this specific disease is not associated with traditional causes of CKD, such as aging, diabetes, or hypertension. Rather, this disease is a chronic interstitial nephritis termed chronic kidney disease of nontraditional etiology (CKDnT). According to the Pan American Health Organization (PAHO) mortality database, there are elevated rates of deaths related to kidney disease in many of these countries, with the highest rates being reported in El Salvador and Nicaragua. This condition has been identified in certain agricultural communities, predominantly among male farmworkers. Since CKD surveillance systems in Central America are under development or nonexistent, experts and governmental bodies have recommended creating standardized case definitions for surveillance purposes to monitor and characterize this epidemiological situation. A group of experts from Central American ministries of health, the U.S. Centers for Disease Control and Prevention (CDC), and PAHO held a workshop in Guatemala to discuss CKDnT epidemiologic case definitions. In this paper, we propose that CKD in general be identified by the standard definition internationally accepted and that a suspect case of CKDnT be defined as a person age CKDnT is defined as a suspect case with the same findings confirmed three or more months later.

  15. How to Meet the Last OIE Expert Surveillance Panel Recommendations on Equine Influenza (EI Vaccine Composition: A Review of the Process Required for the Recombinant Canarypox-Based EI Vaccine

    Directory of Open Access Journals (Sweden)

    Romain Paillot

    2016-11-01

    Full Text Available Vaccination is highly effective to prevent, control, and limit the impact of equine influenza (EI, a major respiratory disease of horses. However, EI vaccines should contain relevant equine influenza virus (EIV strains for optimal protection. The OIE expert surveillance panel annually reviews EIV evolution and, since 2010, the use of Florida clade 1 and 2 sub-lineages representative vaccine strains is recommended. This report summarises the development process of a fully- updated recombinant canarypox-based EI vaccine in order to meet the last OIE recommendations, including the vaccine mode of action, production steps and schedule. The EI vaccine ProteqFlu contains 2 recombinant canarypox viruses expressing the haemagglutinin of the A/equine/Ohio/03 and A/equine/Richmond/1/07 isolates (Florida clade 1 and 2 sub-lineages, respectively. The updated EI vaccine was tested for efficacy against the representative Florida clade 2 EIV strain A/equine/Richmond/1/07 in the Welsh mountain pony model. Protective antibody response, clinical signs of disease and virus shedding were compared with unvaccinated control ponies. Significant protection was measured in vaccinated ponies, which supports the vaccine registration. The recombinant canarypox-based EI vaccine was the first fully updated EI vaccine available in the EU, which will help to minimise the increasing risk of vaccine breakdown due to constant EIV evolution through antigenic drift.

  16. Los anticuerpos monoclonales en la caracterización y vigilancia de los virus de la rabia en América Latina y el Caribe Monoclonal antibodies for rabies virus characterization and epidemiological surveillance in Latin America and the Caribbean

    Directory of Open Access Journals (Sweden)

    2000-09-01

    Full Text Available As one of the activities of the Rabies Reference Laboratories Consortium of the Pan American Health Organization, a technical consultation meeting was held in late 1999 where well-known experts from Europe, North America, and South America analyzed the contributions to rabies epidemiological surveillance in Latin America and the Caribbean made by techniques of antigenic typing based on monoclonal antibodies and by techniques of genetic typing based on gene sequencing.

  17. Application of expert systems

    Energy Technology Data Exchange (ETDEWEB)

    Basden, A

    1983-11-01

    This article seeks to bring together a number of issues relevant to the application of expert systems by discussing their advantages and limitations, their roles and benefits, and the influence that real-life applications might have on the design of expert systems software. Part of the expert systems strategy of one major chemical company is outlined. Because it was in constructing one particular expert system that many of these issues became important this system is described briefly at the start of the paper and used to illustrate much of the later discussion. It is of the plausible-inference type and has application in the field of materials engineering. 22 references.

  18. Counselor Expert System | Debretsion | Zede Journal

    African Journals Online (AJOL)

    An expert system plays an important role on alleviating primarily shortage of experts in a specific area of interest. With the help of an expert system, personnel with little expertise can solve problems that require expert knowledge. In this paper all major aspects of an expert system development have been presented.

  19. Panel Session

    DEFF Research Database (Denmark)

    Bertelsen, Olav Wedege

    2004-01-01

    In this panel session, four researchers will discuss the role of a theoretical foundation, in particular AT, in the design of information technology based artefacts. The general discussion will take of from a specific examination of the ActAD approach.......In this panel session, four researchers will discuss the role of a theoretical foundation, in particular AT, in the design of information technology based artefacts. The general discussion will take of from a specific examination of the ActAD approach....

  20. MO-E-BRB-00: PANEL DISCUSSION: SBRT/SRS Case Studies - Lung

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

    In this interactive session, lung SBRT patient cases will be presented to highlight real-world considerations for ensuring safe and accurate treatment delivery. An expert panel of speakers will discuss challenges specific to lung SBRT including patient selection, patient immobilization techniques, 4D CT simulation and respiratory motion management, target delineation for treatment planning, online treatment alignment, and established prescription regimens and OAR dose limits. Practical examples of cases, including the patient flow thought the clinical process are presented and audience participation will be encouraged. This panel session is designed to provide case demonstration and review for lung SBRT in terms of (1) clinical appropriateness in patient selection, (2) strategies for simulation, including 4D and respiratory motion management, and (3) applying multi imaging modality (4D CT imaging, MRI, PET) for tumor volume delineation and motion extent, and (4) image guidance in treatment delivery. Learning Objectives: Understand the established requirements for patient selection in lung SBRT Become familiar with the various immobilization strategies for lung SBRT, including technology for respiratory motion management Understand the benefits and pitfalls of applying multi imaging modality (4D CT imaging, MRI, PET) for tumor volume delineation and motion extent determination for lung SBRT Understand established prescription regimes and OAR dose limits.

  1. Understanding diagnostic variability in breast pathology: lessons learned from an expert consensus review panel

    Science.gov (United States)

    Allison, Kimberly H; Reisch, Lisa M; Carney, Patricia A; Weaver, Donald L; Schnitt, Stuart J; O’Malley, Frances P; Geller, Berta M; Elmore, Joann G

    2015-01-01

    Aims To gain a better understanding of the reasons for diagnostic variability, with the aim of reducing the phenomenon. Methods and results In preparation for a study on the interpretation of breast specimens (B-PATH), a panel of three experienced breast pathologists reviewed 336 cases to develop consensus reference diagnoses. After independent assessment, cases coded as diagnostically discordant were discussed at consensus meetings. By the use of qualitative data analysis techniques, transcripts of 16 h of consensus meetings for a subset of 201 cases were analysed. Diagnostic variability could be attributed to three overall root causes: (i) pathologist-related; (ii) diagnostic coding/study methodology-related; and (iii) specimen-related. Most pathologist-related root causes were attributable to professional differences in pathologists’ opinions about whether the diagnostic criteria for a specific diagnosis were met, most frequently in cases of atypia. Diagnostic coding/study methodology-related root causes were primarily miscategorizations of descriptive text diagnoses, which led to the development of a standardized electronic diagnostic form (BPATH-Dx). Specimen-related root causes included artefacts, limited diagnostic material, and poor slide quality. After re-review and discussion, a consensus diagnosis could be assigned in all cases. Conclusions Diagnostic variability is related to multiple factors, but consensus conferences, standardized electronic reporting formats and comments on suboptimal specimen quality can be used to reduce diagnostic variability. PMID:24511905

  2. 78 FR 41937 - Joint Meeting of the Gastroenterology-Urology Panel and the Radiological Devices Panel of the...

    Science.gov (United States)

    2013-07-12

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0816] Joint Meeting of the Gastroenterology-Urology Panel and the Radiological Devices Panel of the Medical...: Gastroenterology-Urology Panel and Radiological Devices Panel of the Medical Devices Advisory Committee. General...

  3. Sleep-spindle detection: crowdsourcing and evaluating performance of experts, non-experts and automated methods

    DEFF Research Database (Denmark)

    Warby, Simon C.; Wendt, Sabrina Lyngbye; Welinder, Peter

    2014-01-01

    to crowdsource spindle identification by human experts and non-experts, and we compared their performance with that of automated detection algorithms in data from middle- to older-aged subjects from the general population. We also refined methods for forming group consensus and evaluating the performance...... of event detectors in physiological data such as electroencephalographic recordings from polysomnography. Compared to the expert group consensus gold standard, the highest performance was by individual experts and the non-expert group consensus, followed by automated spindle detectors. This analysis showed...... that crowdsourcing the scoring of sleep data is an efficient method to collect large data sets, even for difficult tasks such as spindle identification. Further refinements to spindle detection algorithms are needed for middle- to older-aged subjects....

  4. Interaction between physiological and subjective states predicts the effect of a judging panel on the postures of cellists in performance

    Directory of Open Access Journals (Sweden)

    Satoshi eEndo

    2014-08-01

    Full Text Available This study investigated the effect of a panel of judges on the movements and postures of cellists in performance. 24 expert cellists played a short piece of music, to a metronome beat, in the presence and absence of the panel. Kinematic analyses showed that in the presence of the panel the temporal execution of left arm shifting movements became less variable and closer to the metronome beat. In contrast, the panel's presence had no reliable effect on their spatial accuracy. A detailed postural analysis indicated that left elbow angle during execution of a given high note was correlated with level of heart rate, though the nature of this correlation was systematically affected by the relevant participant's subjective state: if anxious, a higher heart rate correlated with a more flexed elbow, if not anxious then with a more extended elbow. Our results suggest a change in physiological state alone does not reliably predict a change in behaviour in performing cellists, which instead depends on the interaction between physiological state and subjective experience of anxiety. This highlights a need to distinguish performance anxiety from physiological arousal, to which end we advocate currency for the specific term performance arousal to describe heightened physiological activity in a performer.

  5. Surgical experts: born or made?

    Science.gov (United States)

    Sadideen, Hazim; Alvand, Abtin; Saadeddin, Munir; Kneebone, Roger

    2013-01-01

    The concept of surgical expertise and the processes involved in its development are topical, and there is a constant drive to identify reliable measures of expert performance in surgery. This review explores the notion of whether surgical experts are "born" or "made", with reference to educational theory and pertinent literature. Peer-reviewed publications, books, and online resources on surgical education, expertise and training were reviewed. Important themes and aspects of expertise acquisition were identified in order to better understand the concept of a surgical expert. The definition of surgical expertise and several important aspects of its development are highlighted. Innate talent plays an important role, but is insufficient on its own to produce a surgical expert. Multiple theories that explore motor skill acquisition and memory are relevant, and Ericsson's theory of the development of competence followed by deliberate self-practice has been especially influential. Psychomotor and non-technical skills are necessary for progression in the current climate in light of our training curricula; surgical experts are adaptive experts who excel in these. The literature suggests that surgical expertise is reached through practice; surgical experts are made, not born. A deeper understanding of the nature of expert performance and its development will ensure that surgical education training programmes are of the highest possible quality. Surgical educators should aim to develop an expertise-based approach, with expert performance as the benchmark. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  6. Law for nuclear experts only

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, H [Kernforschungszentrum Karlsruhe G.m.b.H. (Germany, F.R.)

    1980-02-01

    The Federal Ministry of the Interior is preparing an ordinance on expert consultants under the Atomic Energy Act which, among other topics, is to include legal norms for the criteria to be met by experts in terms of non-partisanship, training, capabilities, technical equipment and cooperation in expert organizations of members of various scientific and technical disciplines. A summary of general criteria relating to the qualification, selection and status of experts called in by the legislative and executive branches and by courts of law, which could be organized as a series of guidelines without any original qualities of legal norms, could be recommended in view of the increasing quantitative and qualitative importance of experts. However, passing an ordinance merely fixing and putting into concrete terms the image of an 'expert under the Atomic Energy Act' is intolerable, because the status of scientific and technical experts by far extends beyond the field of nuclear law in our industrial society characterized by a far reaching division of labor. Weak points in the organization of expert services are not confined to technology or nuclear power. Separate rules establishing legal norms are not convincing also for reasons of technology policy and legal policy as well as for those of social psychology and practice.

  7. Expert Systems for the Analytical Laboratory.

    Science.gov (United States)

    de Monchy, Allan R.; And Others

    1988-01-01

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

  8. Treatment of Soft Tissue Filler Complications: Expert Consensus Recommendations.

    Science.gov (United States)

    Urdiales-Gálvez, Fernando; Delgado, Nuria Escoda; Figueiredo, Vitor; Lajo-Plaza, José V; Mira, Mar; Moreno, Antonio; Ortíz-Martí, Francisco; Del Rio-Reyes, Rosa; Romero-Álvarez, Nazaret; Del Cueto, Sofía Ruiz; Segurado, María A; Rebenaque, Cristina Villanueva

    2018-04-01

    Dermal fillers have been increasingly used in minimally invasive facial esthetic procedures. This widespread use has led to a rise in reports of associated complications. The aim of this expert consensus report is to describe potential adverse events associated with dermal fillers and to provide guidance on their treatment and avoidance. A multidisciplinary group of experts in esthetic treatments convened to discuss the management of the complications associated with dermal fillers use. A search was performed for English, French, and Spanish language articles in MEDLINE, the Cochrane Database, and Google Scholar using the search terms "complications" OR "soft filler complications" OR "injectable complications" AND "dermal fillers" AND "Therapy". An initial document was drafted by the Coordinating Committee, and it was reviewed and modified by the experts, until a final text was agreed upon and validated. The panel addressed consensus recommendations about the classification of filler complications according to the time of onset and about the clinical management of different complications including bruising, swelling, edema, infections, lumps and bumps, skin discoloration, and biofilm formation. Special attention was paid to vascular compromise and retinal artery occlusion. Clinicians should be fully aware of the signs and symptoms related to complications and be prepared to confidently treat them. Establishing action protocols for emergencies, with agents readily available in the office, would reduce the severity of adverse outcomes associated with injection of hyaluronic acid fillers in the cosmetic setting. This document seeks to lay down a set of recommendations and to identify key issues that may be useful for clinicians who are starting to use dermal fillers. Additionally, this document provides a better understanding about the diagnoses and management of complications if they do occur. This journal requires that authors assign a level of evidence to each

  9. Expert system application for prioritizing preventive actions for shift work: shift expert.

    Science.gov (United States)

    Esen, Hatice; Hatipoğlu, Tuğçen; Cihan, Ahmet; Fiğlali, Nilgün

    2017-09-19

    Shift patterns, work hours, work arrangements and worker motivations have increasingly become key factors for job performance. The main objective of this article is to design an expert system that identifies the negative effects of shift work and prioritizes mitigation efforts according to their importance in preventing these negative effects. The proposed expert system will be referred to as the shift expert. A thorough literature review is conducted to determine the effects of shift work on workers. Our work indicates that shift work is linked to demographic variables, sleepiness and fatigue, health and well-being, and social and domestic conditions. These parameters constitute the sections of a questionnaire designed to focus on 26 important issues related to shift work. The shift expert is then constructed to provide prevention advice at the individual and organizational levels, and it prioritizes this advice using a fuzzy analytic hierarchy process model, which considers comparison matrices provided by users during the prioritization process. An empirical study of 61 workers working on three rotating shifts is performed. After administering the questionnaires, the collected data are analyzed statistically, and then the shift expert produces individual and organizational recommendations for these workers.

  10. Different contributions of internal reviewers and external experts to labelling decisions on therapeutic indications in new drug reviews in Japan.

    Science.gov (United States)

    Yokota, M; Kusama, M; Matsuki, N; Ono, S

    2013-12-01

    External experts play an important role in shaping regulatory decisions in the new drug review process in the United States, Europe and Japan. No rigorous study has been performed addressing how and to what extent external experts, in contrast to internal reviewers in the agency, influence the regulatory decisions during new drug reviews. We examined their contributions in Japanese regulatory reviews in contrast to the internal reviewers, focusing on the labelling decision on therapeutic indications. With the data set of 219 new molecular entities (NMEs) approved in Japan from 2000 to 2009, we observed how proposed indications in labelling were modified in a stepwise manner during the review process and conducted multinomial logistic analysis to examine the possible mechanism behind. We found that interim assessment of indications by the internal reviewers was modified substantially by the influence of the external experts in about 20% of the 219 NMEs. Our analysis suggested that internal reviewers provided their opinion mainly based on strict review discipline, whereas external experts added flexibility and reality to their reviews. Our analysis revealed different evaluations between internal reviewers and external experts during regulatory discussions in new drug reviews and how the external panel contributes to changing internal decisions. This study provides a new and quantitative approach to better label setting by emphasizing the contributions of each stakeholder in new drug reviews, which would improve the efficiency, quality and transparency of new drug reviews to enhance public health. © 2013 John Wiley & Sons Ltd.

  11. Micro-inverter solar panel mounting

    Science.gov (United States)

    Morris, John; Gilchrist, Phillip Charles

    2016-02-02

    Processes, systems, devices, and articles of manufacture are provided. Each may include adapting micro-inverters initially configured for frame-mounting to mounting on a frameless solar panel. This securement may include using an adaptive clamp or several adaptive clamps secured to a micro-inverter or its components, and using compressive forces applied directly to the solar panel to secure the adaptive clamp and the components to the solar panel. The clamps can also include compressive spacers and safeties for managing the compressive forces exerted on the solar panels. Friction zones may also be used for managing slipping between the clamp and the solar panel during or after installation. Adjustments to the clamps may be carried out through various means and by changing the physical size of the clamps themselves.

  12. 1994 Panel 1 Utilization Plan

    International Nuclear Information System (INIS)

    1994-01-01

    The Waste Isolation Pilot Plant (WIPP) is intended to receive, handle, and permanently dispose of transuranic (TRU) waste. To fulfill this mission, the U.S. Department of Energy (DOE) constructed a full-scale facility to demonstrate both technical and operational principles of the permanent isolation of TRU waste. The WIPP consists of surface and underground facilities. Panel 1 is situated in the underground facility horizon which is located approximately 2,150 feet below the surface in the predominantly halite Salado Formation. The Panel 1 Utilization Plan provides a strategy for the optimum use of Panel 1 which is consistent with the priorities established by the DOE to accomplish the WIPP mission. These priorities, which include maintaining personnel safety, conducting performance assessment, and continued operational enhancements, are the guiding premise for the decisions on the planned usage of the WIPP underground facility. The continuation of ongoing investigations along with the planned testing and training to be carried out in Panel 1 will enhance the current knowledge and understanding of the operational and geotechnical aspects of the panel configuration. This enhancement will ultimately lead to safer, more efficient, and more cost-effective methods of operation. Excavation of the waste storage area began in May 1986 with the mining of entries to Panel 1. The original design for the waste storage rooms at the WIPP provided a limited period of time during which to mine the openings and to emplace waste. Each panel, consisting of seven storage rooms, was scheduled to be mined and filled in less than 5 years. Panel 1 was developed to receive waste for a demonstration phase that was scheduled to start in October 1988. The demonstration phase was deferred, and the experimental test program was modified to use contact-handled (CH) transuranic waste in bin-scale tests, planned for Room 1, Panel 1

  13. Experts in science and society

    CERN Document Server

    Gigerenzer, Gerd

    2004-01-01

    In today's complex world, we have come to rely increasingly on those who have expertise in specific areas and can bring their knowledge to bear on crucial social, political and scientific questions. Taking the viewpoint that experts are consulted when there is something important at stake for an individual, a group, or society at large, Experts in Science and Society explores expertise as a relational concept. How do experts balance their commitment to science with that to society? How does a society actually determine that a person has expertise? What personal traits are valued in an expert? From where does the expert derive authority? What makes new forms of expertise emerge? These and related questions are addressed from a wide range of areas in order to be inclusive, as well as to demonstrate similarities across areas. Likewise, in order to be culturally comparative, this volume includes examples and discussions of experts in different countries and even in different time periods. The topics include the r...

  14. Expert system in PNC, 5

    International Nuclear Information System (INIS)

    Tobita, Yoshimasa; Yamaguchi, Takashi; Matsumoto, Mitsuo; Ono, Kiyoshi.

    1990-01-01

    The computer code system which can evaluate the mass balance and cycle cost in nuclear fuel cycle has been developing a PNC using an artificial intelligence technique. This system is composed of the expert system, data base and analysis codes. The expert system is the most important one in the system and the content of the expert system is explained in this paper. The expert system has the three functions. The first is the function of understanding the meaning of user's questions by natural language, the second is the function of selecting the best way to solve the problem given by the user using the knowledge which is already installed in the system, and the last is the function of answering the questions. The knowledge of the experts installed in the expert system is represented by the frame-type rules. Therefore, the knowledge will be simply added to the system, and consequently the system will be easily extended. (author)

  15. Data quality in probability-based online panels: Nonresponse, attrition, and panel conditioning

    NARCIS (Netherlands)

    Struminskaya, B.; Methodology and statistics for the behavioural and social sciences

    2014-01-01

    Online panels – surveys administered over the Internet in which persons are asked to complete surveys regularly – offer cost reductions compared to surveys that use more traditional modes of data collection (face-to-face, telephone, and mail). However, some characteristics of online panels may cause

  16. Experts on public trial

    DEFF Research Database (Denmark)

    Blok, Anders

    2007-01-01

    a case study of the May 2003 Danish consensus conference on environmental economics as a policy tool, the article reflects on the politics of expert authority permeating practices of public participation. Adopting concepts from the sociology of scientific knowledge (SSK), the conference is seen......-than-successful defense in the citizen perspective. Further, consensus conferences are viewed alternatively as "expert dissent conferences," serving to disclose a multiplicity of expert commitments. From this perspective, some challenges for democratizing expertise through future exercises in public participation...

  17. Solar panel truss mounting systems and methods

    Energy Technology Data Exchange (ETDEWEB)

    Al-Haddad, Tristan Farris; Cavieres, Andres; Gentry, Russell; Goodman, Joseph; Nolan, Wade; Pitelka, Taylor; Rahimzadeh, Keyan; Brooks, Bradley; Lohr, Joshua; Crooks, Ryan; Porges, Jamie; Rubin, Daniel

    2016-06-28

    An exemplary embodiment of the present invention provides a solar panel truss mounting system comprising a base and a truss assembly coupled to the base. The truss assembly comprises a first panel rail mount, second panel rail mount parallel to the first panel rail mount, base rail mount parallel to the first and second panel rail mounts, and a plurality of support members. A first portion of the plurality of support members extends between the first and second panel rail mounts. A second portion of the plurality of support members extends between the first panel rail mount and the base rail mount. A third portion of the plurality of support members extends between the second panel rail mount and the base rail mount. The system can further comprise a plurality of connectors for coupling a plurality of photovoltaic solar panels to the truss assembly.

  18. Solar panel truss mounting systems and methods

    Energy Technology Data Exchange (ETDEWEB)

    Al-Haddad, Tristan Farris; Cavieres, Andres; Gentry, Russell; Goodman, Joseph; Nolan, Wade; Pitelka, Taylor; Rahimzadeh, Keyan; Brooks, Bradley; Lohr, Joshua; Crooks, Ryan; Porges, Jamie; Rubin, Daniel

    2018-01-30

    An exemplary embodiment of the present invention provides a solar panel truss mounting system comprising a base and a truss assembly coupled to the base. The truss assembly comprises a first panel rail mount, second panel rail mount parallel to the first panel rail mount, base rail mount parallel to the first and second panel rail mounts, and a plurality of support members. A first portion of the plurality of support members extends between the first and second panel rail mounts. A second portion of the plurality of support members extends between the first panel rail mount and the base rail mount. A third portion of the plurality of support members extends between the second panel rail mount and the base rail mount. The system can further comprise a plurality of connectors for coupling a plurality of photovoltaic solar panels to the truss assembly.

  19. Solar panel truss mounting systems and methods

    Science.gov (United States)

    Al-Haddad, Tristan Farris; Cavieres, Andres; Gentry, Russell; Goodman, Joseph; Nolan, Wade; Pitelka, Taylor; Rahimzadeh, Keyan; Brooks, Bradley; Lohr, Joshua; Crooks, Ryan; Porges, Jamie; Rubin, Daniel

    2015-10-20

    An exemplary embodiment of the present invention provides a solar panel truss mounting system comprising a base and a truss assembly coupled to the base. The truss assembly comprises a first panel rail mount, second panel rail mount parallel to the first panel rail mount, base rail mount parallel to the first and second panel rail mounts, and a plurality of support members. A first portion of the plurality of support members extends between the first and second panel rail mounts. A second portion of the plurality of support members extends between the first panel rail mount and the base rail mount. A third portion of the plurality of support members extends between the second panel rail mount and the base rail mount. The system can further comprise a plurality of connectors for coupling a plurality of photovoltaic solar panels to the truss assembly.

  20. Reflection group on 'Expert Culture'

    International Nuclear Information System (INIS)

    Eggermont, G.

    2000-01-01

    As part of SCK-CEN's social sciences and humanities programme, a reflection group on 'Expert Culture' was established. The objectives of the reflection group are: (1) to clarify the role of SCK-CEN experts; (2) to clarify the new role of expertise in the evolving context of risk society; (3) to confront external views and internal SCK-CEN experiences on expert culture; (4) to improve trust building of experts and credibility of SCK-CEN as a nuclear actor in society; (5) to develop a draft for a deontological code; (6) to integrate the approach in training on assertivity and communication; (7) to create an output for a topical day on the subject of expert culture. The programme, achievements and perspectives of the refection group are summarised

  1. PSG-EXPERT. An expert system for the diagnosis of sleep disorders.

    Science.gov (United States)

    Fred, A; Filipe, J; Partinen, M; Paiva, T

    2000-01-01

    This paper describes PSG-EXPERT, an expert system in the domain of sleep disorders exploring polysomnographic data. The developed software tool is addressed from two points of view: (1)--as an integrated environment for the development of diagnosis-oriented expert systems; (2)--as an auxiliary diagnosis tool in the particular domain of sleep disorders. Developed over a Windows platform, this software tool extends one of the most popular shells--CLIPS (C Language Integrated Production System) with the following features: backward chaining engine; graph-based explanation facilities; knowledge editor including a fuzzy fact editor and a rules editor, with facts-rules integrity checking; belief revision mechanism; built-in case generator and validation module. It therefore provides graphical support for knowledge acquisition, edition, explanation and validation. From an application domain point of view, PSG-Expert is an auxiliary diagnosis system for sleep disorders based on polysomnographic data, that aims at assisting the medical expert in his diagnosis task by providing automatic analysis of polysomnographic data, summarising the results of this analysis in terms of a report of major findings and possible diagnosis consistent with the polysomnographic data. Sleep disorders classification follows the International Classification of Sleep Disorders. Major features of the system include: browsing on patients data records; structured navigation on Sleep Disorders descriptions according to ASDA definitions; internet links to related pages; diagnosis consistent with polysomnographic data; graphical user-interface including graph-based explanatory facilities; uncertainty modelling and belief revision; production of reports; connection to remote databases.

  2. Expert Systems: An Overview for Teacher-Librarians.

    Science.gov (United States)

    Orwig, Gary; Barron, Ann

    1992-01-01

    Provides an overview of expert systems for teacher librarians. Highlights include artificial intelligence and expert systems; the development of the MYCIN medical expert system; rule-based expert systems; the use of expert system shells to develop a specific system; and how to select an appropriate application for an expert system. (11 references)…

  3. Training centres in Latin America

    International Nuclear Information System (INIS)

    1959-01-01

    Early 1958 the Brazilian representative on the Board of Governors of the International Atomic Energy Agency - supported by the Governors from Argentina and Guatemala -proposed that a study should be made of the possibility of setting up one or more atomic energy training centres in Latin America. On the Board's recommendation, the Director General of the Agency appointed a fact-finding team to make anon-the-spot study. In drafting this report the team was invited to consider the following points: (a) The need for establishing one or more regional training centres; (b) Existing facilities that are being or could be used for training, together with technical data concerning them; (c) The general scientific technological and industrial conditions of the countries visited insofar as they have a bearing on their training needs and capabilities. The authors of the report conclude that 'a training centre in radio-botany should provide vitally needed knowledge and vitally needed specialists to all the agricultural installations in Latin America. A training centre like this might provide an excellent model upon which to base training centres in other areas'. The report recommends that: 1. The Agency should meet the requests of Latin American universities by, for example, supplying equipment and sending experts; 2. At least one specialized training centre should be established as soon as possible. Taking as an example the field of radio-botany, such a centre would provide trained specialists in radio-botany to agricultural institutions throughout Latin America and also provide basic research results vital to agriculture. The cost of new facilities might be of the order of $7 500 000, with an annual budget of approximately $650 000. Staff required: 40 scientists and 175 employees; 3. Whenever it appears feasible to gather necessary staff of high creative ability and established productivity and when funds can be made available for facilities, equipment and operating costs, at

  4. Training centres in Latin America

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1959-04-15

    Early 1958 the Brazilian representative on the Board of Governors of the International Atomic Energy Agency - supported by the Governors from Argentina and Guatemala -proposed that a study should be made of the possibility of setting up one or more atomic energy training centres in Latin America. On the Board's recommendation, the Director General of the Agency appointed a fact-finding team to make anon-the-spot study. In drafting this report the team was invited to consider the following points: (a) The need for establishing one or more regional training centres; (b) Existing facilities that are being or could be used for training, together with technical data concerning them; (c) The general scientific technological and industrial conditions of the countries visited insofar as they have a bearing on their training needs and capabilities. The authors of the report conclude that 'a training centre in radio-botany should provide vitally needed knowledge and vitally needed specialists to all the agricultural installations in Latin America. A training centre like this might provide an excellent model upon which to base training centres in other areas'. The report recommends that: 1. The Agency should meet the requests of Latin American universities by, for example, supplying equipment and sending experts; 2. At least one specialized training centre should be established as soon as possible. Taking as an example the field of radio-botany, such a centre would provide trained specialists in radio-botany to agricultural institutions throughout Latin America and also provide basic research results vital to agriculture. The cost of new facilities might be of the order of $7 500 000, with an annual budget of approximately $650 000. Staff required: 40 scientists and 175 employees; 3. Whenever it appears feasible to gather necessary staff of high creative ability and established productivity and when funds can be made available for facilities, equipment and operating costs, at

  5. Graphite/epoxy orthogrid panel fabrication

    Science.gov (United States)

    Lager, J. R.

    1978-01-01

    The structural concept considered for a spacecraft body structure is a grid stiffened skin with a skin laminate configuration and the stiffener grid geometry selected to best suit the design requirements. The orthogrid panel developed weighs 0.55 lb/sq ft and resisted an ultimate in-plane shear load of 545 lbf/in. The basic concept of a grid stiffener composite panel is that a relatively thin skin is reinforced with a gridwork of stiffeners so that the overall panel can resist design loads without becoming structurally unstable or being overstressed. The main feature of the orthogrid panel design is that it provides the potential for low cost structural panels when advanced to the production phase. The most innovative part of the fabrication method is the foam/fiberglass stiffener web grid billet fabrication and machining to size.

  6. Accuracy and interobserver agreement between MR-non-expert radiologists and MR-experts in reading MRI for suspected appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Leeuwenburgh, Marjolein M.N., E-mail: m.m.leeuwenburgh@amc.uva.nl [Department of Surgery, Academic Medical Center, University of Amsterdam (Netherlands); Department of Radiology, Academic Medical Center, University of Amsterdam (Netherlands); Wiarda, Bart M. [Department of Radiology, Alkmaar Medical Center, Alkmaar (Netherlands); Jensch, Sebastiaan [Department of Radiology, Sint Lucas Andreas Hospital, Amsterdam (Netherlands); Wouter van Es, H. [Department of Radiology, Sint Antonius Hospital, Nieuwegein (Netherlands); Stockmann, Hein B.A.C. [Department of Surgery, Kennemer Gasthuis, Haarlem (Netherlands); Gratama, Jan Willem C. [Department of Radiology, Gelre Hospitals, Apeldoorn (Netherlands); Cobben, Lodewijk P.J. [Department of Radiology, Haaglanden Medical Center, Leidschendam (Netherlands); Bossuyt, Patrick M.M. [Department of Clinical Epidemiology, Academic Medical Center, University of Amsterdam (Netherlands); Boermeester, Marja A. [Department of Surgery, Academic Medical Center, University of Amsterdam (Netherlands); Stoker, Jaap [Department of Radiology, Academic Medical Center, University of Amsterdam (Netherlands)

    2014-01-15

    Objective: To compare accuracy and interobserver agreement between radiologists with limited experience in the evaluation of abdominal MRI (non-experts), and radiologists with longer MR reading experience (experts), in reading MRI in patients with suspected appendicitis. Methods: MR imaging was performed in 223 adult patients with suspected appendicitis and read independently by two members of a team of eight MR-inexperienced radiologists, who were trained with 100 MR examinations previous to this study (non-expert reading). Expert reading was performed by two radiologists with a larger abdominal MR experience (>500 examinations) in consensus. A final diagnosis was assigned after three months based on all available information, except MRI findings. We estimated MRI sensitivity and specificity for appendicitis and for all urgent diagnoses separately. Interobserver agreement was evaluated using kappa statistics. Results: Urgent diagnoses were assigned to 147 of 223 patients; 117 had appendicitis. Sensitivity for appendicitis was 0.89 by MR-non-expert radiologists and 0.97 in MR-expert reading (p = 0.01). Specificity was 0.83 for MR-non-experts versus 0.93 for MR-expert reading (p = 0.002). MR-experts and MR-non-experts agreed on appendicitis in 89% of cases (kappa 0.78). Accuracy in detecting urgent diagnoses was significantly lower in MR-non-experts compared to MR-expert reading: sensitivity 0.84 versus 0.95 (p < 0.001) and specificity 0.71 versus 0.82 (p = 0.03), respectively. Agreement on urgent diagnoses was 83% (kappa 0.63). Conclusion: MR-non-experts have sufficient sensitivity in reading MRI in patients with suspected appendicitis, with good agreement with MR-expert reading, but accuracy of MR-expert reading was higher.

  7. Accuracy and interobserver agreement between MR-non-expert radiologists and MR-experts in reading MRI for suspected appendicitis

    International Nuclear Information System (INIS)

    Leeuwenburgh, Marjolein M.N.; Wiarda, Bart M.; Jensch, Sebastiaan; Wouter van Es, H.; Stockmann, Hein B.A.C.; Gratama, Jan Willem C.; Cobben, Lodewijk P.J.; Bossuyt, Patrick M.M.; Boermeester, Marja A.; Stoker, Jaap

    2014-01-01

    Objective: To compare accuracy and interobserver agreement between radiologists with limited experience in the evaluation of abdominal MRI (non-experts), and radiologists with longer MR reading experience (experts), in reading MRI in patients with suspected appendicitis. Methods: MR imaging was performed in 223 adult patients with suspected appendicitis and read independently by two members of a team of eight MR-inexperienced radiologists, who were trained with 100 MR examinations previous to this study (non-expert reading). Expert reading was performed by two radiologists with a larger abdominal MR experience (>500 examinations) in consensus. A final diagnosis was assigned after three months based on all available information, except MRI findings. We estimated MRI sensitivity and specificity for appendicitis and for all urgent diagnoses separately. Interobserver agreement was evaluated using kappa statistics. Results: Urgent diagnoses were assigned to 147 of 223 patients; 117 had appendicitis. Sensitivity for appendicitis was 0.89 by MR-non-expert radiologists and 0.97 in MR-expert reading (p = 0.01). Specificity was 0.83 for MR-non-experts versus 0.93 for MR-expert reading (p = 0.002). MR-experts and MR-non-experts agreed on appendicitis in 89% of cases (kappa 0.78). Accuracy in detecting urgent diagnoses was significantly lower in MR-non-experts compared to MR-expert reading: sensitivity 0.84 versus 0.95 (p < 0.001) and specificity 0.71 versus 0.82 (p = 0.03), respectively. Agreement on urgent diagnoses was 83% (kappa 0.63). Conclusion: MR-non-experts have sufficient sensitivity in reading MRI in patients with suspected appendicitis, with good agreement with MR-expert reading, but accuracy of MR-expert reading was higher

  8. Acoustically Tailored Composite Rotorcraft Fuselage Panels

    Science.gov (United States)

    Hambric, Stephen; Shepherd, Micah; Koudela, Kevin; Wess, Denis; Snider, Royce; May, Carl; Kendrick, Phil; Lee, Edward; Cai, Liang-Wu

    2015-01-01

    A rotorcraft roof sandwich panel has been redesigned to optimize sound power transmission loss (TL) and minimize structure-borne sound for frequencies between 1 and 4 kHz where gear meshing noise from the transmission has the most impact on speech intelligibility. The roof section, framed by a grid of ribs, was originally constructed of a single honeycomb core/composite face sheet panel. The original panel has coincidence frequencies near 700 Hz, leading to poor TL across the frequency range of 1 to 4 kHz. To quiet the panel, the cross section was split into two thinner sandwich subpanels separated by an air gap. The air gap was sized to target the fundamental mass-spring-mass resonance of the double panel system to less than 500 Hz. The panels were designed to withstand structural loading from normal rotorcraft operation, as well as 'man-on-the-roof' static loads experienced during maintenance operations. Thin layers of VHB 9469 viscoelastomer from 3M were also included in the face sheet ply layups, increasing panel damping loss factors from about 0.01 to 0.05. Measurements in the NASA SALT facility show the optimized panel provides 6-11 dB of acoustic transmission loss improvement, and 6-15 dB of structure-borne sound reduction at critical rotorcraft transmission tonal frequencies. Analytic panel TL theory simulates the measured performance quite well. Detailed finite element/boundary element modeling of the baseline panel simulates TL slightly more accurately, and also simulates structure-borne sound well.

  9. Paneling architectural freeform surfaces

    KAUST Repository

    Eigensatz, Michael; Kilian, Martin; Schiftner, Alexander; Mitra, Niloy J.; Pottmann, Helmut; Pauly, Mark

    2010-01-01

    with a selected technology at reasonable cost, while meeting the design intent and achieving the desired aesthetic quality of panel layout and surface smoothness. The production of curved panels is mostly based on molds. Since the cost of mold fabrication

  10. Chronic kidney disease of nontraditional etiology in Central America: a provisional epidemiologic case definition for surveillance and epidemiologic studies

    Directory of Open Access Journals (Sweden)

    Matthew Lozier

    Full Text Available SYNOPSIS Over the last two decades, experts have reported a rising number of deaths caused by chronic kidney disease (CKD along the Pacific coast of Central America, from southern Mexico to Costa Rica. However, this specific disease is not associated with traditional causes of CKD, such as aging, diabetes, or hypertension. Rather, this disease is a chronic interstitial nephritis termed chronic kidney disease of nontraditional etiology (CKDnT. According to the Pan American Health Organization (PAHO mortality database, there are elevated rates of deaths related to kidney disease in many of these countries, with the highest rates being reported in El Salvador and Nicaragua. This condition has been identified in certain agricultural communities, predominantly among male farmworkers. Since CKD surveillance systems in Central America are under development or nonexistent, experts and governmental bodies have recommended creating standardized case definitions for surveillance purposes to monitor and characterize this epidemiological situation. A group of experts from Central American ministries of health, the U.S. Centers for Disease Control and Prevention (CDC, and PAHO held a workshop in Guatemala to discuss CKDnT epidemiologic case definitions. In this paper, we propose that CKD in general be identified by the standard definition internationally accepted and that a suspect case of CKDnT be defined as a person age < 60 years with CKD, without type 1 diabetes mellitus, hypertensive diseases, and other well-known causes of CKD. A probable case of CKDnT is defined as a suspect case with the same findings confirmed three or more months later.

  11. Intelligent programs-expert systems

    Energy Technology Data Exchange (ETDEWEB)

    Gledhill, V X

    1982-01-01

    In recent years, computer scientists have developed what are called expert systems. These programs have three fundamental components: a knowledge base, which changes with experience; an inference engine which enables the program to make decisions; and an interface that allows the program to communicate with the person using the system. Expert systems have been developed successfully in areas such as medical diagnosis, geology, and computer maintenance. This paper describes the evolution and basic principles of expert systems and give some examples of their use.

  12. Solar-Panel Dust Accumulation and Cleanings

    Science.gov (United States)

    2005-01-01

    Air-fall dust accumulates on the solar panels of NASA's Mars Exploration Rovers, reducing the amount of sunlight reaching the solar arrays. Pre-launch models predicted steady dust accumulation. However, the rovers have been blessed with occasional wind events that clear significant amounts of dust from the solar panels. This graph shows the effects of those panel-cleaning events on the amount of electricity generated by Spirit's solar panels. The horizontal scale is the number of Martian days (sols) after Spirit's Jan. 4, 2005, (Universal Time) landing on Mars. The vertical scale indicates output from the rover's solar panels as a fraction of the amount produced when the clean panels first opened. Note that the gradual declines are interrupted by occasional sharp increases, such as a dust-cleaning event on sol 420.

  13. Panel fabrication utilizing GaAs solar cells

    Science.gov (United States)

    Mardesich, N.

    1984-01-01

    The development of the GaAs solar cells for space applications is described. The activities in the fabrication of GaAs solar panels are outlined. Panels were fabricated while introducing improved quality control, soldering laydown and testing procedures. These panels include LIPS II, San Marco Satellite, and a low concentration panel for Rockwells' evaluation. The panels and their present status are discussed.

  14. Attic Retrofits Using Nail-Base Insulated Panels

    Energy Technology Data Exchange (ETDEWEB)

    Mallay, David [Home Innovation Research Labs; Kochkin, Vladimir [Home Innovation Research Labs

    2018-03-26

    This project developed and demonstrated a roof/attic energy retrofit solution using nail-base insulated panels for existing homes where traditional attic insulation approaches are not effective or feasible. Nail-base insulated panels (retrofit panels) consist of rigid foam insulation laminated to one face of a wood structural panel. The prefabricated panels are installed above the existing roof deck during a reroofing effort.

  15. Analysing sensory panel performance in a proficiency test using the PanelCheck software

    DEFF Research Database (Denmark)

    Tomic, O.; Luciano, G.; Nilsen, A.

    2010-01-01

    Check software, a workflow is proposed that guides the user through the data analysis process. This allows practitioners and non-statisticians to get an overview over panel performances in a rapid manner without the need to be familiar with details on the statistical methods. Visualisation of data analysis...... results plays an important role as this provides a time saving and efficient way of screening and investigating sensory panel performances. Most of the statistical methods used in this paper are available in the open source software PanelCheck, which may be downloaded and used for free....

  16. Guidance for contact tracing of cases of Lassa fever, Ebola or Marburg haemorrhagic fever on an airplane: results of a European expert consultation.

    Science.gov (United States)

    Gilsdorf, Andreas; Morgan, Dilys; Leitmeyer, Katrin

    2012-11-21

    Travel from countries where viral haemorrhagic fevers (VHF) are endemic has increased significantly over the past decades. In several reported VHF events on airplanes, passenger trace back was initiated but the scale of the trace back differed considerably. The absence of guidance documents to help the decision on necessity and scale of the trace back contributed to this variation.This article outlines the recommendations of an expert panel on Lassa fever, Ebola and Marburg haemorrhagic fever to the wider scientific community in order to advise the relevant stakeholders in the decision and scale of a possible passenger trace back. The evidence was collected through review of published literature and through the views of an expert panel. The guidance was agreed by consensus. Only a few events of VHF cases during air travel are reported in literature, with no documented infection in followed up contacts, so that no evidence of transmission of VHF during air travel exists to date. Based on this and the expert opinion, it was recommended that passenger trace back was undertaken only if: the index case had symptoms during the flight; the flight was within 21 days after detection of the event; and for Lassa fever if exposure of body fluid has been reported. The trace back should only be done after confirmation of the index case. Passengers and crew with direct contact, seat neighbours (+/- 1 seat), crew and cleaning personal of the section of the index case should be included in the trace back. No evidence has been found for the transmission of VHF in airplanes. This information should be taken into account, when a trace back decision has to be taken, because such a measure produces an enormous work load. The procedure suggested by the expert group can guide decisions made in future events, where a patient with suspected VHF infection travelled on a plane. However, the actual decision on start and scale of a trace back always lies in the hands of the responsible people

  17. A demonstration of expert systems applications in transportation engineering : volume I, transportation engineers and expert systems.

    Science.gov (United States)

    1987-01-01

    Expert systems, a branch of artificial-intelligence studies, is introduced with a view to its relevance in transportation engineering. Knowledge engineering, the process of building expert systems or transferring knowledge from human experts to compu...

  18. Mounting clips for panel installation

    Science.gov (United States)

    Cavieres, Andres; Al-Haddad, Tristan; Goodman, Joseph; Valdes, Francisco

    2017-02-14

    An exemplary mounting clip for removably attaching panels to a supporting structure comprises a base, spring locking clips, a lateral flange, a lever flange, and a spring bonding pad. The spring locking clips extend upwardly from the base. The lateral flange extends upwardly from a first side of the base. The lateral flange comprises a slot having an opening configured to receive at least a portion of one of the one or more panels. The lever flange extends outwardly from the lateral flange. The spring bonding flange extends downwardly from the lever flange. At least a portion of the first spring bonding flange comprises a serrated edge for gouging at least a portion of the one or more panels when the one or more panels are attached to the mounting clip to electrically and mechanically couple the one or more panels to the mounting clip.

  19. ALDS 1978 panel review. [PNL

    Energy Technology Data Exchange (ETDEWEB)

    Hall, D.L. (ed.)

    1979-08-01

    Pacific Northwest Laboratory (PNL) is examining the analysis of large data sets (ALDS). After one year's work, a panel was convened to evaluate the project. This document is the permanent record of that panel review. It consists of edited transcripts of presentations made to the panel by the PNL staff, a summary of the responses of the panel to these presentations, and PNL's plans for the development of the ALDS project. The representations of the PNL staff described various aspects of the project and/or the philosophy surrounding the project. Supporting materials appear in appendixes. 20 figures, 4 tables. (RWR)

  20. Expert system technology for the military

    International Nuclear Information System (INIS)

    Franklin, J.E.; Carmody, C.L.; Buteau, B.L.; Keller, K.; Levitt, T.S.

    1988-01-01

    This paper is concerned with the applications of expert systems to complex military problems. A brief description of needs for expert systems in the military arena is given. A short tutorial on some of the elements of an expert system is found in Appendix I. An important aspect of expert systems concerns using uncertain information and ill-defined procedures. Many of the general techniques of dealing with uncertainty are described in Appendix II. These techniques include Bayesian certainty factors, Dempster-Shafer theory of uncertainty, and Zadeh's fuzzy set theory. The major portion of the paper addresses specific expert system examples such as resource allocation, identification of radar images, maintenance and troubleshooting of electronic equipment, and the interpretation and understanding of radar images. Extensions of expert systems to incorporate learning are examined in the context of military intelligence to determine the disposition, location, and intention of the adversary. The final application involves the use of distributed communicating cooperating expert systems for battle management. Finally, the future of expert systems and their evolving capabilities are discussed

  1. Advanced solar panel designs

    Science.gov (United States)

    Ralph, E. L.; Linder, E.

    1995-01-01

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

  2. Expert systems: A 5-year perspective

    International Nuclear Information System (INIS)

    MacAllister, D.J.; Day, R.; McCormack, M.D.

    1996-01-01

    This paper gives an overview of a major integrated oil company's experience with artificial intelligence (AI) over the last 5 years, with an emphasis on expert systems. The authors chronicle the development of an AI group, including details on development tool selection, project selection strategies, potential pitfalls, and descriptions of several completed expert systems. Small expert systems produced by teams of petroleum technology experts and experienced expert system developers that are focused in well-defined technical areas have produced substantial benefits and accelerated petroleum technology transfer

  3. Preventing the Complications Associated with the Use of Dermal Fillers in Facial Aesthetic Procedures: An Expert Group Consensus Report.

    Science.gov (United States)

    Urdiales-Gálvez, Fernando; Delgado, Nuria Escoda; Figueiredo, Vitor; Lajo-Plaza, José V; Mira, Mar; Ortíz-Martí, Francisco; Del Rio-Reyes, Rosa; Romero-Álvarez, Nazaret; Del Cueto, Sofía Ruiz; Segurado, María A; Rebenaque, Cristina Villanueva

    2017-06-01

    The use of dermal fillers in minimally invasive facial aesthetic procedures has become increasingly popular of late, yet as the indications and the number of procedures performed increase, the number of complications is also likely to increase. Paying special attention to specific patient characteristics and to the technique used can do much to avoid these complications. Indeed, a well-trained physician can also minimize the impact of such problems when they do occur. A multidisciplinary group of experts in aesthetic treatments reviewed the main factors associated with the complications that arise when using dermal fillers. A search of English, French and Spanish language articles in PubMed was performed using the terms "complications" OR "soft filler complications" OR "injectable complications" AND "dermal fillers". An initial document was drafted that reflected the complications identified and recommendations as to how they should be handled. This document was then reviewed and modified by the expert panel, until a final text was agreed upon and validated. The panel addressed consensus recommendations about the preparation, the procedure and the post-procedural care. The panel considered it crucial to obtain an accurate medical history to prevent potential complications. An additional clinical assessment, including standardized photography, is also crucial to evaluate the outcomes and prevent potential complications. Furthermore, the state of the operating theatre, the patient's health status and the preparation of the skin are critical to prevent superficial soft tissue infections. Finally, selecting the appropriate technique, based on the physician's experience, as well as the characteristics of the patient and filler, helps to ensure successful outcomes and limits the complications. This consensus document provides key elements to help clinicians who are starting to use dermal fillers to employ standard procedures and to understand how best to prevent

  4. Use of expert consensus to improve atherogenic dyslipidemia management.

    Science.gov (United States)

    Millán Núñez-Cortés, Jesús; Pedro-Botet, Juan; Brea-Hernando, Ángel; Díaz-Rodríguez, Ángel; González-Santos, Pedro; Hernández-Mijares, Antonio; Mantilla-Morató, Teresa; Pintó-Sala, Xavier; Simó, Rafael

    2014-01-01

    Although atherogenic dyslipidemia is a recognized cardiovascular risk factor, it is often underassessed and thus undertreated and poorly controlled in clinical practice. The objective of this study was to reach a multidisciplinary consensus for the establishment of a set of clinical recommendations on atherogenic dyslipidemia to optimize its prevention, early detection, diagnostic evaluation, therapeutic approach, and follow-up. After a review of the scientific evidence, a scientific committee formulated 87 recommendations related to atherogenic dyslipidemia, which were grouped into 5 subject areas: general concepts (10 items), impact and epidemiology (4 items), cardiovascular risk (32 items), detection and diagnosis (19 items), and treatment (22 items). A 2-round modified Delphi method was conducted to compare the opinions of a panel of 65 specialists in cardiology (23%), endocrinology (24.6%), family medicine (27.7%), and internal medicine (24.6%) on these issues. After the first round, the panel reached consensus on 65 of the 87 items discussed, and agreed on 76 items by the end of the second round. Insufficient consensus was reached on 3 items related to the detection and diagnosis of atherogenic dyslipidemia and 3 items related to the therapeutic goals to be achieved in these patients. The external assessment conducted by experts on atherogenic dyslipidemia showed a high level of professional agreement with the proposed clinical recommendations. These recommendations represent a useful tool for improving the clinical management of patients with atherogenic dyslipidemia. A detailed analysis of the current scientific evidence is required for those statements that eluded consensus. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  5. Quality assessment of expert answers to lay questions about cystic fibrosis from various language zones in Europe: the ECORN-CF project

    Directory of Open Access Journals (Sweden)

    d'Alquen Daniela

    2012-02-01

    Full Text Available Abstract Background The European Centres of Reference Network for Cystic Fibrosis (ECORN-CF established an Internet forum which provides the opportunity for CF patients and other interested people to ask experts questions about CF in their mother language. The objectives of this study were to: 1 develop a detailed quality assessment tool to analyze quality of expert answers, 2 evaluate the intra- and inter-rater agreement of this tool, and 3 explore changes in the quality of expert answers over the time frame of the project. Methods The quality assessment tool was developed by an expert panel. Five experts within the ECORN-CF project used the quality assessment tool to analyze the quality of 108 expert answers published on ECORN-CF from six language zones. 25 expert answers were scored at two time points, one year apart. Quality of answers was also assessed at an early and later period of the project. Individual rater scores and group mean scores were analyzed for each expert answer. Results A scoring system and training manual were developed analyzing two quality categories of answers: content and formal quality. For content quality, the grades based on group mean scores for all raters showed substantial agreement between two time points, however this was not the case for the grades based on individual rater scores. For formal quality the grades based on group mean scores showed only slight agreement between two time points and there was also poor agreement between time points for the individual grades. The inter-rater agreement for content quality was fair (mean kappa value 0.232 ± 0.036, p Conclusions The quality assessment tool described in this study was feasible and reliable when content quality was assessed by a group of raters. Within ECORN-CF, the tool will help ensure that CF patients all over Europe have equal possibility of access to high quality expert advice on their illness.

  6. Quality assessment of expert answers to lay questions about cystic fibrosis from various language zones in Europe: the ECORN-CF project.

    Science.gov (United States)

    d'Alquen, Daniela; De Boeck, Kris; Bradley, Judy; Vávrová, Věra; Dembski, Birgit; Wagner, Thomas O F; Pfalz, Annette; Hebestreit, Helge

    2012-02-06

    The European Centres of Reference Network for Cystic Fibrosis (ECORN-CF) established an Internet forum which provides the opportunity for CF patients and other interested people to ask experts questions about CF in their mother language. The objectives of this study were to: 1) develop a detailed quality assessment tool to analyze quality of expert answers, 2) evaluate the intra- and inter-rater agreement of this tool, and 3) explore changes in the quality of expert answers over the time frame of the project. The quality assessment tool was developed by an expert panel. Five experts within the ECORN-CF project used the quality assessment tool to analyze the quality of 108 expert answers published on ECORN-CF from six language zones. 25 expert answers were scored at two time points, one year apart. Quality of answers was also assessed at an early and later period of the project. Individual rater scores and group mean scores were analyzed for each expert answer. A scoring system and training manual were developed analyzing two quality categories of answers: content and formal quality. For content quality, the grades based on group mean scores for all raters showed substantial agreement between two time points, however this was not the case for the grades based on individual rater scores. For formal quality the grades based on group mean scores showed only slight agreement between two time points and there was also poor agreement between time points for the individual grades. The inter-rater agreement for content quality was fair (mean kappa value 0.232 ± 0.036, p value 0.105 ± 0.024, p change over time. The quality assessment tool described in this study was feasible and reliable when content quality was assessed by a group of raters. Within ECORN-CF, the tool will help ensure that CF patients all over Europe have equal possibility of access to high quality expert advice on their illness. © 2012 d’Alquen et al; licensee BioMed Central Ltd.

  7. Computer Based Expert Systems.

    Science.gov (United States)

    Parry, James D.; Ferrara, Joseph M.

    1985-01-01

    Claims knowledge-based expert computer systems can meet needs of rural schools for affordable expert advice and support and will play an important role in the future of rural education. Describes potential applications in prediction, interpretation, diagnosis, remediation, planning, monitoring, and instruction. (NEC)

  8. Panel acoustic contribution analysis.

    Science.gov (United States)

    Wu, Sean F; Natarajan, Logesh Kumar

    2013-02-01

    Formulations are derived to analyze the relative panel acoustic contributions of a vibrating structure. The essence of this analysis is to correlate the acoustic power flow from each panel to the radiated acoustic pressure at any field point. The acoustic power is obtained by integrating the normal component of the surface acoustic intensity, which is the product of the surface acoustic pressure and normal surface velocity reconstructed by using the Helmholtz equation least squares based nearfield acoustical holography, over each panel. The significance of this methodology is that it enables one to analyze and rank relative acoustic contributions of individual panels of a complex vibrating structure to acoustic radiation anywhere in the field based on a single set of the acoustic pressures measured in the near field. Moreover, this approach is valid for both interior and exterior regions. Examples of using this method to analyze and rank the relative acoustic contributions of a scaled vehicle cabin are demonstrated.

  9. Advanced Solar Panel Designs

    Science.gov (United States)

    Ralph, E. L.; Linder, E. B.

    1995-01-01

    Solar panel designs that utilize new high-efficiency solar cells and lightweight rigid panel technologies are described. The resulting designs increase the specific power (W/kg) achievable in the near-term and are well suited to meet the demands of higher performance small satellites (smallsats). Advanced solar panel designs have been developed and demonstrated on two NASA SBIR contracts at Applied Solar. The first used 19% efficient, large area (5.5 cm x 6.5 cm) GaAs/Ge solar cells with a lightweight rigid graphite epoxy isogrid substrate configuration. A 1,445 sq cm coupon was fabricated and tested to demonstrate 60 W/kg with a high potential of achieving 80 W/kg. The second panel design used new 22% efficiency, dual-junction GaInP2/GaAs/Ge solar cells combined with a lightweight aluminum core/graphite fiber mesh facesheet substrate. A 1,445 sq cm coupon was fabricated and tested to demonstrate 105 W/kg with the potential of achieving 115 W/kg.

  10. 2016 Expert consensus document on prevention, diagnosis and treatment of short-term peripheral venous catheter-related infections in adults

    Directory of Open Access Journals (Sweden)

    Josep A. Capdevila

    2016-07-01

    Full Text Available The use of endovascular catheters is a routine practice in secondary and tertiary care level hospitals. The short-term use of peripheral catheters has been found to be associated with the risk of nosocomial bacteraemia, resulting in morbidity and mortality. Staphylococcus aureus is mostly associated with peripheral catheter insertion. This Consensus Document has been prepared by a panel of experts of the Spanish Society of Cardiovascular Infections, in cooperation with experts from the Spanish Society of Internal Medicine, Spanish Society of Chemotherapy, and the Spanish Society of Thoracic-Cardiovascular Surgery, and aims to define and establish guidelines for the management of short duration peripheral vascular catheters. The document addresses the indications for insertion, catheter maintenance, registering, diagnosis and treatment of infection, indications for removal, as well as placing an emphasis on continuous education as a drive toward quality. Implementation of these guidelines will allow uniformity in use, thus minimizing the risk of infections and their complications.

  11. EFSA CEF Panel (EFSA Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids), 2013. Scientific Opinion on Flavouring Group Evaluation 76, Revision 1 (FGE.76Rev1)

    DEFF Research Database (Denmark)

    Beltoft, Vibe Meister; Binderup, Mona-Lise; Frandsen, Henrik Lauritz

    The Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids of the European Food Safety Authority was requested to consider evaluations of flavouring substances assessed since 2000 by the Joint FAO/WHO Expert Committee on Food Additives (JECFA), and to decide whether further...... by Industry for use as a flavouring substance in Europe and will therefore not be considered any further. The substances were evaluated through a stepwise approach that integrates information on structure-activity relationships, intake from current uses, toxicological threshold of concern, and available data...... as flavouring substances, as these substances could not be evaluated because of concern with respect to genotoxicity. Besides the safety assessment of these flavouring substances, the specifications for the materials of commerce have also been considered and for all 26 substances, the information is adequate....

  12. [Deontology of the medical expert].

    Science.gov (United States)

    Raszeja, S

    1995-09-01

    The authority of prosecuting organ to choose the expert, set his task and verify the following opinion is defined. The qualities of the medical expert and his duties are described, referring to: -his expertise; -his morality; -his ability to issue an independent (objective) opinion. Detailed rules, which can be ascribed to a specific medical expert's deontological code, are listed and explained.

  13. EFSA CEF Panel (EFSA Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids), 2014. Scientific Opinion on Flavouring Group Evaluation 94, Revision 2 (FGE.94Rev2): Consideration of aliphatic amines and amides evaluated in an addendum to the group of aliphatic and aromatic amines

    DEFF Research Database (Denmark)

    Beltoft, Vibe Meister; Binderup, Mona-Lise; Frandsen, Henrik Lauritz

    The Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids of the European Food Safety Authority was requested to consider evaluations of flavouring substances assessed since 2000 by the Joint FAO/WHO Expert Committee on Food Additives (the JECFA), and to decide whether further......-(3,4-dimethoxyphenyl)-ethyl]-acrylamide [FL-no: 16.090]. The substances were evaluated through a stepwise approach that integrates information on structure-activity relationships, intake from current uses, toxicological threshold of concern and available data on metabolism and toxicity. The Panel agrees with JECFA...... conclusion “No safety concern at estimated levels of intake as flavouring substances” based on the MSDI approach for all substances considered in this FGE. Besides the safety assessment of these flavouring substances, the specifications for the materials of commerce have been considered and for all 12...

  14. EFSA CEF Panel (EFSA Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids), 2014. Scientific Opinion on Flavouring Group Evaluation 74, Revision 3 (FGE.74Rev3): Consideration of Simple Aliphatic Sulphides and Thiols evaluated by the JECFA (53rd and 61st meeting) Structurally

    DEFF Research Database (Denmark)

    Beltoft, Vibe Meister; Binderup, Mona-Lise; Frandsen, Henrik Lauritz

    The Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids of the European Food Safety Authority was requested to consider evaluations of flavouring substances assessed since 2000 by the Joint FAO/WHO Expert Committee on Food Additives (the JECFA), and to decide whether further...... that integrates information on structure-activity relationships, intake from current uses, toxicological threshold of concern, and available data on metabolism and toxicity. For nine substances [FL-no: 12.088, 12.179, 12.198, 12.212, 12.238, 12.239, 12.255, 12.257 and 12.291] considered in this FGE, the Panel...... concluded that they would pose “No safety concern at estimated levels of intake as flavouring substances” based on the MSDI approach. Besides the safety assessment of these flavouring substances, the specifications for the materials of commerce have also been considered for the substances evaluated through...

  15. Inclusion of Population-specific Reference Panel from India to the 1000 Genomes Phase 3 Panel Improves Imputation Accuracy.

    Science.gov (United States)

    Ahmad, Meraj; Sinha, Anubhav; Ghosh, Sreya; Kumar, Vikrant; Davila, Sonia; Yajnik, Chittaranjan S; Chandak, Giriraj R

    2017-07-27

    Imputation is a computational method based on the principle of haplotype sharing allowing enrichment of genome-wide association study datasets. It depends on the haplotype structure of the population and density of the genotype data. The 1000 Genomes Project led to the generation of imputation reference panels which have been used globally. However, recent studies have shown that population-specific panels provide better enrichment of genome-wide variants. We compared the imputation accuracy using 1000 Genomes phase 3 reference panel and a panel generated from genome-wide data on 407 individuals from Western India (WIP). The concordance of imputed variants was cross-checked with next-generation re-sequencing data on a subset of genomic regions. Further, using the genome-wide data from 1880 individuals, we demonstrate that WIP works better than the 1000 Genomes phase 3 panel and when merged with it, significantly improves the imputation accuracy throughout the minor allele frequency range. We also show that imputation using only South Asian component of the 1000 Genomes phase 3 panel works as good as the merged panel, making it computationally less intensive job. Thus, our study stresses that imputation accuracy using 1000 Genomes phase 3 panel can be further improved by including population-specific reference panels from South Asia.

  16. Honeycomb metal panel

    International Nuclear Information System (INIS)

    1979-01-01

    Product constituted by a honeycomb metal panel that can be employed to advantage for manufacturing lagging by sandwiching it between two plane sheets, utilized in particular in the nuclear industry where lagging has to have a very long life strength. The honeycomb metal panel is made of an expanded metal extrusion previously cut so as to form, after additional drawing, a honeycomb structure with square or rectangular cells with a plane surface [fr

  17. Exascale Workshop Panel Report Meeting

    Energy Technology Data Exchange (ETDEWEB)

    Khaleel, Mohammad A.

    2010-07-01

    The Exascale Review Panel consists of 12 scientists and engineers with experience in various aspects of high-performance computing and its application, development, and management. The Panel hear presentations by several representatives of the workshops and town meetings convened over the past few years to examine the need for exascale computation capability and the justification for a U.S. Department of Energy (DOE) program to develop such capability. This report summarizes information provided by the presenters and substantial written reports to the Panel in advance of the meeting in Washington D.C. on January 19-20, 2010. The report also summarizes the Panel's conclusions with regard to the justification of a DOE-led exascale initiative.

  18. Expert systems: An overview

    International Nuclear Information System (INIS)

    Verdejo, F.

    1985-01-01

    The purpose of this article is to introduce readers to the basic principles of rule-based expert systems. Four topics are discussed in subsequent sections: (1) Definition; (2) Structure of an expert system; (3) State of the art and (4) Impact and future research. (orig.)

  19. Bronchial Thermoplasty in Severe Asthma: Best Practice Recommendations from an Expert Panel.

    Science.gov (United States)

    Bonta, Peter I; Chanez, Pascal; Annema, Jouke T; Shah, Pallav L; Niven, Robert

    2018-01-01

    Bronchial thermoplasty (BT) is a bronchoscopic treatment for patients with severe asthma who remain symptomatic despite optimal medical therapy. In this "expert best practice" paper, the background and practical aspects of BT are highlighted. Randomized, controlled clinical trials have shown BT to be safe and effective in reducing severe exacerbations, improving quality of life, and decreasing emergency department visits. Five-year follow-up studies have provided evidence of the functional stability of BT-treated patients with persistence of a clinical benefit. The Global Initiative for Asthma (GINA) guidelines state that BT can be considered as a treatment option for adult asthma patients at step 5. Patient selection for BT requires close collaboration between interventional pulmonologists and severe asthma specialists. Key patient selection criteria for BT will be reviewed. BT therapy is delivered in 3 separate bronchoscopy sessions at least 3 weeks apart, covering different regions of the lung separately. Patients are treated with 50 mg/day of prednisolone or equivalent for 5 days, starting treatment 3 days prior to the procedure. The procedure is performed under moderate-to-deep sedation or general anesthesia. At bronchos-copy a single-use catheter with a basket design is inserted through the instrument channel and the energy is delivered by a radiofrequency (RF) generator (AlairTM Bronchial Thermoplasty System). BT uses temperature-controlled RF energy to impact airway remodeling, including a reduction of excessive airway smooth muscle within the airway wall, which has been recognized as a predominant feature of asthma. The treatment should be performed in a systemic manner, starting at the most distal part of the (sub)segmental airway, then moving proximally to the main bronchi, ensuring that the majority of the airways are treated. In general, 40-70 RF activations are provided in the lower lobes, and between 50 and 100 activations in the upper lobes combined

  20. Preserving experience through expert systems

    International Nuclear Information System (INIS)

    Jelinek, J.B.; Weidman, S.H.

    1989-01-01

    Expert systems technology, one of the branches in the field of computerized artificial intelligence, has existed for >30 yr but only recently has been made available on commercially standard hardware and software platforms. An expert system can be defined as any method of encoding knowledge by representing that knowledge as a collection of facts or objects. Decisions are made by the expert program by obtaining data about the problem or situation and correlating encoded facts (knowledge) to the data until a conclusion can be reached. Such conclusions can be relayed to the end user as expert advice. Realizing the potential of this technology, General Electric (GE) Nuclear Energy (GENE) has initiated a development program in expert systems applications; this technology offers the potential for packaging, distributing, and preserving nuclear experience in a software form. The paper discusses application fields, effective applications, and knowledge acquisition and knowledge verification

  1. Operational expert system applications in Canada

    CERN Document Server

    Suen, Ching Y

    1992-01-01

    This book is part of a new series on operational expert systems worldwide. Expert systems are now widely used in different parts of the world for various applications. The past four years have witnessed a steady growth in the development and deployment of expert systems in Canada. Research in this field has also gained considerable momentum during the past few years. However, the field of expert systems is still young in Canada. This book contains 13 chapters contributed by 31 experts from both universities and industries across Canada covering a wide range of applications related to electric

  2. Grounds of two positions photovoltaic panels

    OpenAIRE

    Castán Fortuño, Fernando

    2008-01-01

    The objective of this Master Thesis is to find the optimum positioning for a two positions photovoltaic panel. Hence, it will be implemented a model in order to optimize the energy of the sun that the photovoltaic panel is receiving by its positioning. Likewise this project will include the comparison with other photovoltaic panel systems as the single position photovoltaics panels. Ultimately, it is also going to be designed a system array for the optimized model of two positions photovoltai...

  3. Orbiter radiator panel solar focusing test

    Science.gov (United States)

    Howell, H. R.; Rankin, J. G.

    1983-01-01

    Test data are presented which define the area around the Orbiter radiator panels for which the solar reflections are concentrated to one-sun or more. The concave shape of the panels and their specular silver/Teflon coating causes focusing of the reflected solar energy which could have adverse heating effects on equipment or astronaut extravehicular activity (EVA) in the vicinity of the radiator panels. A room ambient test method was utilized with a one-tenth scale model of the radiator panels.

  4. Expert Systems as Tools for Technical Communicators.

    Science.gov (United States)

    Grider, Daryl A.

    1994-01-01

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

  5. An expert system for uranium exploration

    International Nuclear Information System (INIS)

    Chhipa, V.K.; Sengupta, M.

    1989-01-01

    Artificial intelligence is an emerging technology in the field of computer application. Expert systems have been developed to imitate human intelligence and reasoning process. Expert systems have much scope of application in the decision making process in mineral exploration as such decisions are highly subjective and expert opinions are very helpful. This paper presents a small expert system to analyze the reasoning process in exploring for uranium deposits in sandstone

  6. Expert software for accident identification

    International Nuclear Information System (INIS)

    Dobnikar, M.; Nemec, T.; Muehleisen, A.

    2003-01-01

    Each type of an accident in a Nuclear Power Plant (NPP) causes immediately after the start of the accident variations of physical parameters that are typical for that type of the accident thus enabling its identification. Examples of these parameter are: decrease of reactor coolant system pressure, increase of radiation level in the containment, increase of pressure in the containment. An expert software enabling a fast preliminary identification of the type of the accident in Krsko NPP has been developed. As input data selected typical parameters from Emergency Response Data System (ERDS) of the Krsko NPP are used. Based on these parameters the expert software identifies the type of the accident and also provides the user with appropriate references (past analyses and other documentation of such an accident). The expert software is to be used as a support tool by an expert team that forms in case of an emergency at Slovenian Nuclear Safety Administration (SNSA) with the task to determine the cause of the accident, its most probable scenario and the source term. The expert software should provide initial identification of the event, while the final one is still to be made after appropriate assessment of the event by the expert group considering possibility of non-typical events, multiple causes, initial conditions, influences of operators' actions etc. The expert software can be also used as an educational/training tool and even as a simple database of available accident analyses. (author)

  7. FEMA DFIRM Panel Scheme Polygons

    Data.gov (United States)

    Minnesota Department of Natural Resources — This layer contains information about the Flood Insurance Rate Map (FIRM) panel areas. The spatial entities representing FIRM panels are polygons. The polygon for...

  8. Improved Use of Small Reference Panels for Conditional and Joint Analysis with GWAS Summary Statistics.

    Science.gov (United States)

    Deng, Yangqing; Pan, Wei

    2018-06-01

    Due to issues of practicality and confidentiality of genomic data sharing on a large scale, typically only meta- or mega-analyzed genome-wide association study (GWAS) summary data, not individual-level data, are publicly available. Reanalyses of such GWAS summary data for a wide range of applications have become more and more common and useful, which often require the use of an external reference panel with individual-level genotypic data to infer linkage disequilibrium (LD) among genetic variants. However, with a small sample size in only hundreds, as for the most popular 1000 Genomes Project European sample, estimation errors for LD are not negligible, leading to often dramatically increased numbers of false positives in subsequent analyses of GWAS summary data. To alleviate the problem in the context of association testing for a group of SNPs, we propose an alternative estimator of the covariance matrix with an idea similar to multiple imputation. We use numerical examples based on both simulated and real data to demonstrate the severe problem with the use of the 1000 Genomes Project reference panels, and the improved performance of our new approach. Copyright © 2018 by the Genetics Society of America.

  9. High temperature structural sandwich panels

    Science.gov (United States)

    Papakonstantinou, Christos G.

    High strength composites are being used for making lightweight structural panels that are being employed in aerospace, naval and automotive structures. Recently, there is renewed interest in use of these panels. The major problem of most commercial available sandwich panels is the fire resistance. A recently developed inorganic matrix is investigated for use in cases where fire and high temperature resistance are necessary. The focus of this dissertation is the development of a fireproof composite structural system. Sandwich panels made with polysialate matrices have an excellent potential for use in applications where exposure to high temperatures or fire is a concern. Commercial available sandwich panels will soften and lose nearly all of their compressive strength temperatures lower than 400°C. This dissertation consists of the state of the art, the experimental investigation and the analytical modeling. The state of the art covers the performance of existing high temperature composites, sandwich panels and reinforced concrete beams strengthened with Fiber Reinforced Polymers (FRP). The experimental part consists of four major components: (i) Development of a fireproof syntactic foam with maximum specific strength, (ii) Development of a lightweight syntactic foam based on polystyrene spheres, (iii) Development of the composite system for the skins. The variables are the skin thickness, modulus of elasticity of skin and high temperature resistance, and (iv) Experimental evaluation of the flexural behavior of sandwich panels. Analytical modeling consists of a model for the flexural behavior of lightweight sandwich panels, and a model for deflection calculations of reinforced concrete beams strengthened with FRP subjected to fatigue loading. The experimental and analytical results show that sandwich panels made with polysialate matrices and ceramic spheres do not lose their load bearing capability during severe fire exposure, where temperatures reach several

  10. BWR recirculation pump diagnostic expert system

    International Nuclear Information System (INIS)

    Chiang, S.C.; Morimoto, C.N.; Torres, M.R.

    2004-01-01

    At General Electric (GE), an on-line expert system to support maintenance decisions for BWR recirculation pumps for nuclear power plants has been developed. This diagnostic expert system is an interactive on-line system that furnishes diagnostic information concerning BWR recirculation pump operational problems. It effectively provides the recirculation pump diagnostic expertise in the plant control room continuously 24 hours a day. The expert system is interfaced to an on-line monitoring system, which uses existing plant sensors to acquire non-safety related data in real time. The expert system correlates and evaluates process data and vibration data by applying expert rules to determine the condition of a BWR recirculation pump system by applying knowledge based rules. Any diagnosis will be automatically displayed, indicating which pump may have a problem, the category of the problem, and the degree of concern expressed by the validity index and color hierarchy. The rules incorporate the expert knowledge from various technical sources such as plant experience, engineering principles, and published reports. These rules are installed in IF-THEN formats and the resulting truth values are also expressed in fuzzy terms and a certainty factor called a validity index. This GE Recirculation Pump Expert System uses industry-standard software, hardware, and network access to provide flexible interfaces with other possible data acquisition systems. Gensym G2 Real-Time Expert System is used for the expert shell and provides the graphical user interface, knowledge base, and inference engine capabilities. (author)

  11. Reliability Study in Solar Panels

    OpenAIRE

    Español Lifante, Albert

    2012-01-01

    Crystalline silicon Modules are formed by single silicon photovoltaic cells. Since each one of these cells individually contributes to the overall electric power of the panel, the failure of one of them directly affects to its benefits and performance. To Minimize these negative effects, junction boxes with few bypass diodes are usually included in Photovoltaic Solar panels. A still experimental way to built solar panels is to integrate bypass diodes in every single cell, which would in...

  12. Sound transmission loss of composite sandwich panels

    Science.gov (United States)

    Zhou, Ran

    Light composite sandwich panels are increasingly used in automobiles, ships and aircraft, because of the advantages they offer of high strength-to-weight ratios. However, the acoustical properties of these light and stiff structures can be less desirable than those of equivalent metal panels. These undesirable properties can lead to high interior noise levels. A number of researchers have studied the acoustical properties of honeycomb and foam sandwich panels. Not much work, however, has been carried out on foam-filled honeycomb sandwich panels. In this dissertation, governing equations for the forced vibration of asymmetric sandwich panels are developed. An analytical expression for modal densities of symmetric sandwich panels is derived from a sixth-order governing equation. A boundary element analysis model for the sound transmission loss of symmetric sandwich panels is proposed. Measurements of the modal density, total loss factor, radiation loss factor, and sound transmission loss of foam-filled honeycomb sandwich panels with different configurations and thicknesses are presented. Comparisons between the predicted sound transmission loss values obtained from wave impedance analysis, statistical energy analysis, boundary element analysis, and experimental values are presented. The wave impedance analysis model provides accurate predictions of sound transmission loss for the thin foam-filled honeycomb sandwich panels at frequencies above their first resonance frequencies. The predictions from the statistical energy analysis model are in better agreement with the experimental transmission loss values of the sandwich panels when the measured radiation loss factor values near coincidence are used instead of the theoretical values for single-layer panels. The proposed boundary element analysis model provides more accurate predictions of sound transmission loss for the thick foam-filled honeycomb sandwich panels than either the wave impedance analysis model or the

  13. 75 FR 82376 - North American Free Trade Agreement, Article 1904 NAFTA Panel Reviews; Request for Panel Review

    Science.gov (United States)

    2010-12-30

    ... Mexico and the People's Republic of China. This determination was published in the Federal Register (75... Panel Review. SUMMARY: On December 22, 2010, the Government of Mexico filed a First Request for Panel... Government of Mexico established Rules of Procedure for Article 1904 Binational Panel Reviews (``Rules...

  14. Trendwatch combining expert opinion

    NARCIS (Netherlands)

    Hendrix, E.M.T.; Kornelis, M.; Pegge, S.M.; Galen, van M.A.

    2006-01-01

    In this study, focus is on a systematic way to detect future changes in trends that may effect the dynamics in the agro-food sector, and on the combination of opinions of experts. For the combination of expert opinions, the usefulness of multilevel models is investigated. Bayesian data analysis is

  15. Mapping on complex neutrosophic soft expert sets

    Science.gov (United States)

    Al-Quran, Ashraf; Hassan, Nasruddin

    2018-04-01

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

  16. Is the Central America forearc sliver part of the North America plate?

    Science.gov (United States)

    Guzman-Speziale, M.

    2012-04-01

    The Central America Forearc sliver is located between the Central America volcanic arc and the Middle America trench. Several authors have suggested that the forearc is being displaced to the northwest with respect to the Caribbean plate; they point to right-lateral, normal-faulting earthquakes along the Central America volcanic arc as prime evidence of this displacement. Apparently, the forearc continues to the northwest into southeastern Mexico, although this portion of the forearc is not being displaced. I present evidence that suggests that the forearc indeed continues into southeastern Mexico and that it belongs to the North America plate. Physiographically, there is a continuity of the forearc into the Coastal plains of southeastern (Chiapas) Mexico, across the Motagua and Polochic faults. Offshore, cross-sections of the Middle America trench are similar along the mexican (Chiapas) segment, and the Central American segment. Furthermore, at the northwestern end of the coastal plain there are no compressive structures, which suggests that the coastal plain is not being displaced to the northwest. As a matter of fact, fault-plane solutions for shallow earthquakes show extension rather than compression. Shallow, interplate earthquakes along the trench show similar parameters along both segments. P-axes and earthquake slip vectors have consistent azimuths, which relate better with Cocos-North America convergence than with Cocos-Caribbean. Azimuth of T-axes for normal-faulting earthquakes also agree well with Cocos-North America convergence. Similarity in several parameters is thus found across both segments, the Chiapas coastal plain and the Central America forearc sliver proper. This suggests that both segments are continuous and probably one and the same, and belonging to the North America plate. Perhaps more properly, the forearc sliver extends into southeastern Mexico and is part of the zone of deformation associated to the Cocos-North America-Caribbean plates

  17. Development of Electrostatically Clean Solar Array Panels

    Science.gov (United States)

    Stern, Theodore G.

    2000-01-01

    Certain missions require Electrostatically Clean Solar Array (ECSA) panels to establish a favorable environment for the operation of sensitive scientific instruments. The objective of this program was to demonstrate the feasibility of an ECSA panel that minimizes panel surface potential below 100mV in LEO and GEO charged particle environments, prevents exposure of solar cell voltage and panel insulating surfaces to the ambient environment, and provides an equipotential, grounded structure surrounding the entire panel. An ECSA panel design was developed that uses a Front Side Aperture-Shield (FSA) that covers all inter-cell areas with a single graphite composite laminate, composite edge clips for connecting the FSA to the panel substrate, and built-in tabs that interconnect the FSA to conductive coated coverglasses using a conductive adhesive. Analysis indicated the ability of the design to meet the ECSA requirements. Qualification coupons and a 0.5m x 0.5m prototype panel were fabricated and tested for photovoltaic performance and electrical grounding before and after exposure to acoustic and thermal cycling environments. The results show the feasibility of achieving electrostatic cleanliness with a small penalty in mass, photovoltaic performance and cost, with a design is structurally robust and compatible with a wide range of current solar panel technologies.

  18. Solar panel foundation device

    Energy Technology Data Exchange (ETDEWEB)

    Hawley, W.W.

    1983-03-29

    A transportable solar panel foundation device which has a bottom member, at least one upstanding side member, and an essentially open top. The side members are angled to permit nesting of a plurality of the foundation devices, and reinforcement pads are carried by the foundation device to support legs for one or more solar panels.

  19. Law Panel in action.

    Science.gov (United States)

    Odulana, J

    In September 1976 the Africa Regional Council (ARC) of IPPF created a Law Panel to 1) advise the ARC on the emphasis of laws and parenthood programs in the region, 2) investigate legal obstacles to family planning and ways of removing them, 3) institute a monitoring service on laws and court decisions affecting planned parenthood, and 4) prepare a list of lawyers and legal reformers by country. The panel has 1) recommended adoption of an IPPF Central Medical Committee and Central Law Panel statement on sterilization, adolescent fertility control, and the use of medical and auxiliary personnel in family planning services with guidelines for Africa; 2) appointed National Legal Correspondents to carry on the monitoring service mentioned above in 18 countries; and 3) discussed solutions to problems in delivering family planning services with family planning associations in Tanzania, Zambia, Mauritius, Madagascar, and Kenya. Laws governing family planning education and services, marriage, divorce, and maternity benefits in these countries are summarized. In 1978 the panel will hold 2 workshops on law and the status of women.

  20. PVT Panels. Fully renewable and competitive

    International Nuclear Information System (INIS)

    Bakker, M.; Strootman, K.J.; Jong, M.J.M.

    2003-10-01

    A photovoltaic/thermal (PVT) panel is a combination of photovoltaic cells with a solar thermal collector, generating solar electricity and solar heat simultaneously. PVT panels generate more solar energy per unit surface area than a combination of separate PV panels and solar thermal collectors, and share the aesthetic advantage of PV. After several years of research, PVT panels have been developed into a product that is now ready for market introduction. One of the most promising system concepts, consisting of 25 m 2 of PVT panels and a ground coupled heat pump, has been simulated in TRNSYS, and has been found to be able to fully cover both the building related electricity and heat consumption, while keeping the long-term average ground temperature constant. The cost and payback time of such a system have been determined; it has been found that the payback time of this system is approximately two-thirds of the payback time of an identical system but with 21 m 2 of PV panels and 4 m 2 of solar thermal collectors. Finally, by looking at the expected growth in the PV and solar thermal collector market, the market potential for for PVT panels has been found to be very large

  1. EFSA CEF Panel (EFSA Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids), 2014. Scientific Opinion on Flavouring Group Evaluation 91, Re vision 2 (FGE.91Rev2): Consid eration of simple aliphatic and aromatic sulphides and thiols evaluated by the JECFA (53rd and 68th meetings

    DEFF Research Database (Denmark)

    Beltoft, Vibe Meister; Binderup, Mona-Lise; Frandsen, Henrik Lauritz

    The Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids of the European Food Safety Authority was requested to consider evaluations of flavouring substances assessed since 2000 by the Joint FAO/WHO Expert Committee on Food Additives (the JECFA), and to decide whether further...... that integrates information on structure-activity relationships, intake from current uses, toxicological threshold of concern, and available data on metabolism and toxicity. For 36 substances considered in this FGE the Panel concluded that they would pose “No safety concern at estimated levels of intake...... related substance. Besides the safety assessment of these flavouring substances, the specifications for the materials of commerce have also been considered and for all 44 substances, the information is adequate. For candidate substance 3-(methylthio)heptenal [FL-no: 12.273], which contains 5 to7 % of an α...

  2. Expert Judgement Assessment & SCENT Ontological Analysis

    Directory of Open Access Journals (Sweden)

    NICHERSU Iulian

    2018-05-01

    Full Text Available This study aims to provide insights in the starting point of the Horizon 2020 ECfunded project SCENT (Smart Toolbox for Εngaging Citizens into a People-Centric Observation Web Citizen Observatory (CO in terms of existing infrastructure, existing monitoring systems and some discussion on the existing legal and administrative framework that relate to flood monitoring and management in the area of Danube Delta. The methodology used in this approach is based on expert judgement and ontological analysis, using the information collected from the identified end-users of the SCENT toolbox. In this type of analysis the stages of flood monitoring and management that the experts are involved in are detailed. This is done through an Expert Judgement Assessment analysis. The latter is complemented by a set of Key Performance Indicators that the stakeholders have assessed and/or proposed for the evaluation of the SCENT demonstrations, for the impact of the project and finally for SCENT toolbox performance and usefulness. The second part of the study presents an analysis that attempts to map the interactions between different organizations and components of the existing monitoring systems in the Danube Delta case study. Expert Judgement (EJ allows to gain information from specialists in a specific field through a consultation process with one or more experts that have experience in similar and complementary topics. Expert judgment, expert estimates, or expert opinion are all terms that refer to the contents of the problem; estimates, outcomes, predictions, uncertainties, and their corresponding assumptions and conditions are all examples of expert judgment. Expert Judgement is affected by the process used to gather it. On the other hand, the ontological analysis comes to complete this study, by organizing and presenting the connections behind the flood management and land use systems in the three phases of the flood event.

  3. Expert views on how language education may develop in the next 20 years and what CALL could contribute

    Directory of Open Access Journals (Sweden)

    Ton Koenraad Koenraad

    2014-03-01

    Full Text Available The celebration of EUROCALL’s twentieth anniversary provides a proper occasion to reflect on the future of language teaching and the role of CALL in these developments. In this paper we present the views of six authorities on language teaching and learning from different EU countries. All of them have a special interest in CALL and/or are CALL experts and well respected EUROCALL members, such as the late Graham Davies. We present a selection of their observations based on a summary of the Skype interviews in which they contributed to a symposium entitled ‘And now for another century of modern language teaching…’ organised by the Dutch national Association of Language Teachers on the occasion of its first centennial in 2011. To provide a more global (or at least European perspective, the interviewees were asked to cover the same topics that were central to the live panel discussion delivered by six Dutch participants representing a variety of perspectives: secondary and university teachers, students, curriculum experts and teacher educators. By way of preparation, all involved had been given a number of challenging statements related to some aspects of the discussion theme: the characteristics of the future learning environment, teacher, learner, pedagogy and technology. In this audio-supported document we will focus on interesting points of view particularly related to pedagogy and technology expressed in the interviews. A video report summary of the live discussion (in Dutch is available on the limited CD edition with recordings of the centennial festivities. For an impression of the panel discussion and other symposium activities see this video report on YouTube.

  4. Panel cutting method: new approach to generate panels on a hull in Rankine source potential approximation

    Directory of Open Access Journals (Sweden)

    Hee-Jong Choi

    2011-12-01

    Full Text Available In the present study, a new hull panel generation algorithm, namely panel cutting method, was developed to predict flow phenomena around a ship using the Rankine source potential based panel method, where the iterative method was used to satisfy the nonlinear free surface condition and the trim and sinkage of the ship was taken into account. Numerical computations were performed to investigate the validity of the proposed hull panel generation algorithm for Series 60 (CB=0.60 hull and KRISO container ship (KCS, a container ship designed by Maritime and Ocean Engineering Research Institute (MOERI. The computational results were validated by comparing with the existing experimental data.

  5. Panel cutting method: new approach to generate panels on a hull in Rankine source potential approximation

    Science.gov (United States)

    Choi, Hee-Jong; Chun, Ho-Hwan; Park, Il-Ryong; Kim, Jin

    2011-12-01

    In the present study, a new hull panel generation algorithm, namely panel cutting method, was developed to predict flow phenomena around a ship using the Rankine source potential based panel method, where the iterative method was used to satisfy the nonlinear free surface condition and the trim and sinkage of the ship was taken into account. Numerical computations were performed to investigate the validity of the proposed hull panel generation algorithm for Series 60 (CB=0.60) hull and KRISO container ship (KCS), a container ship designed by Maritime and Ocean Engineering Research Institute (MOERI). The computational results were validated by comparing with the existing experimental data.

  6. TU-A-BRB-02: Panel Member

    International Nuclear Information System (INIS)

    Ma, L.

    2016-01-01

    Brain stereotactic radiosurgery (SRS) and spine stereotactic body radiation therapy (SBRT) are commonly treated by a multidisciplinary team of neurosurgeons, radiation oncologists, and medical physicists. However the treatment objectives, constraints, and technical considerations involved can be quite different between the two techniques. In this interactive session an expert panel of speakers will present clinical brain SRS and spine SBRT cases in order to demonstrate real-world considerations for ensuring safe and accurate treatment delivery and to highlight the significant differences in approach for each treatment site. The session will include discussion of topic such as clinical indications, immobilization, target definition, normal tissue tolerance limits, and beam arrangements. Learning Objectives: Understand the differences in indications and dose/fractionation strategies for intracranial SRS and spine SBRT. Describe the different treatment modalities which can be used to deliver intracranial SRS and spine SBRT. Cite the major differences in treatment setup and delivery principles between intracranial and spine treatments. Identify key critical structures and clinical dosimetric tolerance levels for spine SBRT and intracranial SRS. Understand areas of ongoing work to standardize intracranial SRS and spine SBRT procedures. Schlesinger: Research support: Elekta Instruments, AB; D. Schlesinger, Elekta Instruments, AB - research support; B. Winey, No relevant external funding for this subject.

  7. TU-A-BRB-03: Panel Member

    International Nuclear Information System (INIS)

    Winey, B.

    2016-01-01

    Brain stereotactic radiosurgery (SRS) and spine stereotactic body radiation therapy (SBRT) are commonly treated by a multidisciplinary team of neurosurgeons, radiation oncologists, and medical physicists. However the treatment objectives, constraints, and technical considerations involved can be quite different between the two techniques. In this interactive session an expert panel of speakers will present clinical brain SRS and spine SBRT cases in order to demonstrate real-world considerations for ensuring safe and accurate treatment delivery and to highlight the significant differences in approach for each treatment site. The session will include discussion of topic such as clinical indications, immobilization, target definition, normal tissue tolerance limits, and beam arrangements. Learning Objectives: Understand the differences in indications and dose/fractionation strategies for intracranial SRS and spine SBRT. Describe the different treatment modalities which can be used to deliver intracranial SRS and spine SBRT. Cite the major differences in treatment setup and delivery principles between intracranial and spine treatments. Identify key critical structures and clinical dosimetric tolerance levels for spine SBRT and intracranial SRS. Understand areas of ongoing work to standardize intracranial SRS and spine SBRT procedures. Schlesinger: Research support: Elekta Instruments, AB; D. Schlesinger, Elekta Instruments, AB - research support; B. Winey, No relevant external funding for this subject.

  8. TU-A-BRB-02: Panel Member

    Energy Technology Data Exchange (ETDEWEB)

    Ma, L. [UCSF Comprehensive Cancer Center (United States)

    2016-06-15

    Brain stereotactic radiosurgery (SRS) and spine stereotactic body radiation therapy (SBRT) are commonly treated by a multidisciplinary team of neurosurgeons, radiation oncologists, and medical physicists. However the treatment objectives, constraints, and technical considerations involved can be quite different between the two techniques. In this interactive session an expert panel of speakers will present clinical brain SRS and spine SBRT cases in order to demonstrate real-world considerations for ensuring safe and accurate treatment delivery and to highlight the significant differences in approach for each treatment site. The session will include discussion of topic such as clinical indications, immobilization, target definition, normal tissue tolerance limits, and beam arrangements. Learning Objectives: Understand the differences in indications and dose/fractionation strategies for intracranial SRS and spine SBRT. Describe the different treatment modalities which can be used to deliver intracranial SRS and spine SBRT. Cite the major differences in treatment setup and delivery principles between intracranial and spine treatments. Identify key critical structures and clinical dosimetric tolerance levels for spine SBRT and intracranial SRS. Understand areas of ongoing work to standardize intracranial SRS and spine SBRT procedures. Schlesinger: Research support: Elekta Instruments, AB; D. Schlesinger, Elekta Instruments, AB - research support; B. Winey, No relevant external funding for this subject.

  9. TU-A-BRB-03: Panel Member

    Energy Technology Data Exchange (ETDEWEB)

    Winey, B. [Massachusetts General Hospital (United States)

    2016-06-15

    Brain stereotactic radiosurgery (SRS) and spine stereotactic body radiation therapy (SBRT) are commonly treated by a multidisciplinary team of neurosurgeons, radiation oncologists, and medical physicists. However the treatment objectives, constraints, and technical considerations involved can be quite different between the two techniques. In this interactive session an expert panel of speakers will present clinical brain SRS and spine SBRT cases in order to demonstrate real-world considerations for ensuring safe and accurate treatment delivery and to highlight the significant differences in approach for each treatment site. The session will include discussion of topic such as clinical indications, immobilization, target definition, normal tissue tolerance limits, and beam arrangements. Learning Objectives: Understand the differences in indications and dose/fractionation strategies for intracranial SRS and spine SBRT. Describe the different treatment modalities which can be used to deliver intracranial SRS and spine SBRT. Cite the major differences in treatment setup and delivery principles between intracranial and spine treatments. Identify key critical structures and clinical dosimetric tolerance levels for spine SBRT and intracranial SRS. Understand areas of ongoing work to standardize intracranial SRS and spine SBRT procedures. Schlesinger: Research support: Elekta Instruments, AB; D. Schlesinger, Elekta Instruments, AB - research support; B. Winey, No relevant external funding for this subject.

  10. TU-A-BRB-01: Panel Member

    Energy Technology Data Exchange (ETDEWEB)

    Schlesinger, D. [University of Virginia Health Systems (United States)

    2016-06-15

    Brain stereotactic radiosurgery (SRS) and spine stereotactic body radiation therapy (SBRT) are commonly treated by a multidisciplinary team of neurosurgeons, radiation oncologists, and medical physicists. However the treatment objectives, constraints, and technical considerations involved can be quite different between the two techniques. In this interactive session an expert panel of speakers will present clinical brain SRS and spine SBRT cases in order to demonstrate real-world considerations for ensuring safe and accurate treatment delivery and to highlight the significant differences in approach for each treatment site. The session will include discussion of topic such as clinical indications, immobilization, target definition, normal tissue tolerance limits, and beam arrangements. Learning Objectives: Understand the differences in indications and dose/fractionation strategies for intracranial SRS and spine SBRT. Describe the different treatment modalities which can be used to deliver intracranial SRS and spine SBRT. Cite the major differences in treatment setup and delivery principles between intracranial and spine treatments. Identify key critical structures and clinical dosimetric tolerance levels for spine SBRT and intracranial SRS. Understand areas of ongoing work to standardize intracranial SRS and spine SBRT procedures. Schlesinger: Research support: Elekta Instruments, AB; D. Schlesinger, Elekta Instruments, AB - research support; B. Winey, No relevant external funding for this subject.

  11. TU-A-BRB-01: Panel Member

    International Nuclear Information System (INIS)

    Schlesinger, D.

    2016-01-01

    Brain stereotactic radiosurgery (SRS) and spine stereotactic body radiation therapy (SBRT) are commonly treated by a multidisciplinary team of neurosurgeons, radiation oncologists, and medical physicists. However the treatment objectives, constraints, and technical considerations involved can be quite different between the two techniques. In this interactive session an expert panel of speakers will present clinical brain SRS and spine SBRT cases in order to demonstrate real-world considerations for ensuring safe and accurate treatment delivery and to highlight the significant differences in approach for each treatment site. The session will include discussion of topic such as clinical indications, immobilization, target definition, normal tissue tolerance limits, and beam arrangements. Learning Objectives: Understand the differences in indications and dose/fractionation strategies for intracranial SRS and spine SBRT. Describe the different treatment modalities which can be used to deliver intracranial SRS and spine SBRT. Cite the major differences in treatment setup and delivery principles between intracranial and spine treatments. Identify key critical structures and clinical dosimetric tolerance levels for spine SBRT and intracranial SRS. Understand areas of ongoing work to standardize intracranial SRS and spine SBRT procedures. Schlesinger: Research support: Elekta Instruments, AB; D. Schlesinger, Elekta Instruments, AB - research support; B. Winey, No relevant external funding for this subject.

  12. A law for nuclear experts only

    International Nuclear Information System (INIS)

    Wagner, H.

    1980-01-01

    The Federal Ministry of the Interior is preparing an ordinance on expert consultants under the Atomic Energy Act which, among other topics, is to include legal norms for the criteria to be met by experts in terms of non-partisanship, training, capabilities, technical equipment and cooperation in expert organizations of members of various scientific and technical disciplines. A summary of general criteria relating to the qualification, selection and status of experts called in by the legislative and executive branches and by courts of law, which could be organized as a series of guidelines without any original qualities of legal norms, could be recommended in view of the increasing quantitative and qualitative importance of experts. However, passing an ordinance merely fixing and putting into concrete terms the image of an 'expert under the Atomic Energy Act' is intolerable, because the status of scientific and technical experts by far extends beyond the field of nuclear law in our industrial society characterized by a far reaching division of labor. Weak points in the organization of expert services are not confined to technology or nuclear power. Separate rules establishing legal norms are not convincing also for reasons of technology policy and legal policy as well as for those of social psychology and practice. (orig.) 891 HP/orig. 892 MKO [de

  13. Reporting studies on time to diagnosis: proposal of a guideline by an international panel (REST).

    Science.gov (United States)

    Launay, Elise; Cohen, Jérémie F; Bossuyt, Patrick M; Buekens, Pierre; Deeks, Jonathan; Dye, Timothy; Feltbower, Richard; Ferrari, Andrea; Kramer, Michael; Leeflang, Mariska; Moher, David; Moons, Karel G; von Elm, Erik; Ravaud, Philippe; Chalumeau, Martin

    2016-09-27

    Studies on time to diagnosis are an increasing field of clinical research that may help to plan corrective actions and identify inequities in access to healthcare. Specific features of time to diagnosis studies, such as how participants were selected and how time to diagnosis was defined and measured, are poorly reported. The present study aims to derive a reporting guideline for studies on time to diagnosis. Each item of a list previously used to evaluate the completeness of reporting of studies on time to diagnosis was independently evaluated by a core panel of international experts (n = 11) for relevance and readability before an open electronic discussion allowed consensus to be reached on a refined list. The list was then submitted with an explanatory document to first, last and/or corresponding authors (n = 98) of published systematic reviews on time to diagnosis (n = 45) for relevance and readability, and finally approved by the core expert panel. The refined reporting guideline consists of a 19-item checklist: six items are about the process of participant selection (with a suggested flowchart), six about the definition and measurement of time to diagnosis, and three about optional analyses of associations between time to diagnosis and participant characteristics and health outcomes. Of 24 responding authors of systematic reviews, more than 21 (≥88 %) rated the items as relevant, and more than 17 (≥70 %) as readable; 19 of 22 (86 %) authors stated that they would potentially use the reporting guideline in the future. We propose a reporting guideline (REST) that could help authors, reviewers, and editors of time to diagnosis study reports to improve the completeness and the accuracy of their reporting.

  14. Operational expert system applications in Europe

    CERN Document Server

    Zarri, Gian Piero

    1992-01-01

    Operational Expert System Applications in Europe describes the representative case studies of the operational expert systems (ESs) that are used in Europe.This compilation provides examples of operational ES that are realized in 10 different European countries, including countries not usually examined in the standard reviews of the field.This book discusses the decision support system using several artificial intelligence tools; expert systems for fault diagnosis on computerized numerical control (CNC) machines; and expert consultation system for personal portfolio management. The failure prob

  15. Solar panel assembly and support pad

    Energy Technology Data Exchange (ETDEWEB)

    Hawley, W.W.

    1980-10-07

    A solar panel assembly is described comprising at least one solar panel, support means for carrying said panel, and at least one support pad having a base plate, upstanding longitudinal sides, and spaced apart flange means for connection to said support means, said upstanding sides and opposed flange means defining an interior volume for receiving and holding weighting material.

  16. An inter-observer agreement study of autofluorescence endoscopy in Barrett's esophagus among expert and non-expert endoscopists.

    Science.gov (United States)

    Mannath, J; Subramanian, V; Telakis, E; Lau, K; Ramappa, V; Wireko, M; Kaye, P V; Ragunath, K

    2013-02-01

    Autofluorescence imaging (AFI), which is a "red flag" technique during Barrett's surveillance, is associated with significant false positive results. The aim of this study was to assess the inter-observer agreement (IOA) in identifying AFI-positive lesions and to assess the overall accuracy of AFI. Anonymized AFI and high resolution white light (HRE) images were prospectively collected. The AFI images were presented in random order, followed by corresponding AFI + HRE images. Three AFI experts and 3 AFI non-experts scored images after a training presentation. The IOA was calculated using kappa and accuracy was calculated with histology as gold standard. Seventy-four sets of images were prospectively collected from 63 patients (48 males, mean age 69 years). The IOA for number of AF positive lesions was fair when AFI images were presented. This improved to moderate with corresponding AFI and HRE images [experts 0.57 (0.44-0.70), non-experts 0.47 (0.35-0.62)]. The IOA for the site of AF lesion was moderate for experts and fair for non-experts using AF images, which improved to substantial for experts [κ = 0.62 (0.50-0.72)] but remained at fair for non-experts [κ = 0.28 (0.18-0.37)] with AFI + HRE. Among experts, the accuracy of identifying dysplasia was 0.76 (0.7-0.81) using AFI images and 0.85 (0.79-0.89) using AFI + HRE images. The accuracy was 0.69 (0.62-0.74) with AFI images alone and 0.75 (0.70-0.80) using AFI + HRE among non-experts. The IOA for AF positive lesions is fair to moderate using AFI images which improved with addition of HRE. The overall accuracy of identifying dysplasia was modest, and was better when AFI and HRE images were combined.

  17. Targeted NGS meets expert clinical characterization: Efficient diagnosis of spastic paraplegia type 11

    Directory of Open Access Journals (Sweden)

    Cristina Castro-Fernández

    2015-06-01

    Full Text Available Next generation sequencing (NGS is transforming the diagnostic approach for neurological disorders, since it allows simultaneous analysis of hundreds of genes, even based on just a broad, syndromic patient categorization. However, such an approach bears a high risk of incidental and uncertain genetic findings. We report a patient with spastic paraplegia whose comprehensive neurological and imaging examination raised a high clinical suspicion of SPG11. Thus, although our NGS pipeline for this group of disorders includes gene panel and exome sequencing, in this sample only the spatacsin gene region was captured and subsequently searched for mutations. Two probably pathogenic variants were quickly and clearly identified, confirming the diagnosis of SPG11. This case illustrates how combination of expert clinical characterization with highly oriented NGS protocols leads to a fast, cost-efficient diagnosis, minimizing the risk of findings with unclear significance.

  18. JERAMI SEBAGAI BAHAN BAKU PANEL AKUSTIK PELAPIS DINDING

    Directory of Open Access Journals (Sweden)

    Christina E. Mediastika

    2008-01-01

    Full Text Available The demand of walling panels with acoustic qualification has surprisingly increased, due to the needs for home theaters and mini recording studios in the increase of environmental noise. Therefore, good supply of acoustic panels, especially those with lower price are necessary. A series of study to explore possibility in using paddy-straw as main material to construct cheap and high quality panels has been developed. Prior to this study, an earlier small research showed there was a great potency in using paddy-straw as panels, especially ones drawn from paddy in type IR. The earlier study recommends further research to examine strength of compression and tensile of the constructed panels to go for building materials, which is presented in this paper. Acoustic qualification of the panels is subject for further reserach. Abstract in Bahasa Indonesia: Kebutuhan akan panel pelapis dinding yang bersifat akustik terus meningkat seiring meningkatnya kebisingan dan kebutuhan terhadap ruang studio pribadi. Ketersediaan panel pelapis dinding dengan harga yang lebih terjangkau seperti yang terbuat dari bahan limbah sangatlah dibutuhkan. Pada penelitian awal telah diselidiki kemungkinan penggunaan jerami yang merupakan limbah sebagai bahan baku pembuatan panel akustik. Penelitian tersebut menunjukkan bahwa jerami sangat potensial digunakan sebagai bahan aku panel, terutama jerami padi berjenis IR. Selanjutnya panel jerami ini perlu mendapatkan perlakukan uji desak dan lentur untuk memastikan kemampuannya menahan berat sendiri dan kekuatannya saat proses penggunaan, sebelum akhirnya mengalami pengujian berkaitan dengan kualitas akustik. Kekuatan desak dan lentur panel dimaksud, tersaji dalam tulisan ini. Kata kunci: panel jerami, uji desak, uji lentur.

  19. Report of Industry Panel Group

    Science.gov (United States)

    Gallimore, Simon; Gier, Jochen; Heitland, Greg; Povinelli, Louis; Sharma, Om; VandeWall, Allen

    2006-01-01

    A final report is presented from the industry panel group. The contents include: 1) General comments; 2) Positive progress since Minnowbrook IV; 3) Industry panel outcome; 4) Prioritized turbine projects; 5) Prioritized compressor projects; and 6) Miscellaneous.

  20. Expert system application education project

    Science.gov (United States)

    Gonzelez, Avelino J.; Ragusa, James M.

    1988-01-01

    Artificial intelligence (AI) technology, and in particular expert systems, has shown potential applicability in many areas of operation at the Kennedy Space Center (KSC). In an era of limited resources, the early identification of good expert system applications, and their segregation from inappropriate ones can result in a more efficient use of available NASA resources. On the other hand, the education of students in a highly technical area such as AI requires an extensive hands-on effort. The nature of expert systems is such that proper sample applications for the educational process are difficult to find. A pilot project between NASA-KSC and the University of Central Florida which was designed to simultaneously address the needs of both institutions at a minimum cost. This project, referred to as Expert Systems Prototype Training Project (ESPTP), provided NASA with relatively inexpensive development of initial prototype versions of certain applications. University students likewise benefit by having expertise on a non-trivial problem accessible to them at no cost. Such expertise is indispensible in a hands-on training approach to developing expert systems.