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Sample records for expert panel interpretation

  1. 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

    ABSTRACT: The Canadian Society for Exercise Physiology, in partnership with the Public Health Agency of Canada, has initiated a review of their physical activity guidelines to promote healthy active living for Canadian children, youth, adults and older adults; previous guidelines were released...... 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...... of physical activity guidelines for asymptomatic populations. The overall guideline development process is being guided and assessed by the AGREE II instrument. A meeting of experts was convened to present the evidence complied to inform the guideline revisions. An independent expert panel was assembled...

  2. Image interpretation criteria for FDG PET/CT in multiple myeloma: a new proposal from an Italian expert panel. IMPeTUs (Italian Myeloma criteria for PET USe)

    Energy Technology Data Exchange (ETDEWEB)

    Nanni, Cristina; Rambaldi, Ilaria; Fanti, Stefano [AOU Policlinico S. Orsola-Malpighi, Nuclear Medicine, Bologna (Italy); Zamagni, Elena; Cavo, Michele [AOU Policlinico S. Orsola-Malpighi, Hematology, Bologna (Italy); Versari, Annibale [IRCSS, Nuclear Medicine, S. Maria Nuova Hospital, Reggio Emilia (Italy); Chauvie, Stephane [Santa Croce e Carle Hospital, Medical Physics Unit, Cuneo (Italy); Bianchi, Andrea [Santa Croce e Carle Hospital, Nuclear Medicine, Cuneo (Italy); Rensi, Marco [AOU S.Maria della Misericordia, Nuclear Medicine, Udine (Italy); Bello, Marilena [AO Citta della Salute e della Scienza, Nuclear Medicine, Torino (Italy); Gallamini, Andrea [A Lacassagne Cancer Center, Research and Innovation Department, Nice (France); Patriarca, Francesca [Udine University, Hematologic Clinic, Udine (Italy); Gay, Francesca [University of Torino, Myeloma Unit, Division of Hematology, Torino (Italy); Gamberi, Barbara [IRCCS, Hematology Unit, Azienda Ospedaliera ASMN, Reggio Emilia (Italy)

    2016-03-15

    FDG PET/CT is able to detect active disease in patients with multiple myeloma (MM) and can be helpful for staging and assessing therapy response, but no standard interpretation criteria have been proposed for the evaluation of FDG PET/CT in MM. A group of Italian nuclear medicine physicians and haematologists met to propose new visual interpretation criteria to standardize FDG PET/CT evaluation in MM patients (Italian Myeloma criteria for PET USe; IMPeTUs) and the reproducibility of these criteria was tested. This Italian multicentre protocol was set up as a subprotocol of EMN02, an international prospective multicentre trial of the European Myeloma Network. The criteria were agreed at multidisciplinary consensus meetings. They include a description of the metabolic state of the bone marrow (BM), number and site of focal PET-positive lesions, the number of osteolytic lesions, and the presence and site of extramedullary disease, paramedullary disease and fractures. A visual degree of uptake was defined for the target lesion and extramedullary lesions according to modified Deauville criteria. MM patients who had undergone FDG PET/CT at baseline (PET-0), after induction (PET-AI) and at the end of treatment (PET-EoT) were enrolled. The patients had been prospectively enrolled in EMN02 and their PET scans were a posteriori reinterpreted in a blinded independent central review process managed by WIDEN registered. Five expert nuclear medicine physicians scored the scans according to the new criteria. A case was considered read when four out of the five reviewers completed the report. Concordance among reviewers on different metrics was calculated using Krippendorff's alpha coefficient. A total of 17 consecutive patients were enrolled. On PET-0, the alpha coefficients for the BM score, the score for the hottest focal lesion, the number of focal lesions and the number of lytic lesions were 0.33 and 0.47, 0.40 and 0.32, respectively. On PET-AI, the alpha coefficients

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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...... 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......-onset disease Udgivelsesdato: 2008/2...

  8. Collaborative update of a rule-based expert system for HIV-1 genotypic resistance test interpretation

    NARCIS (Netherlands)

    Paredes, Roger; Tzou, Philip L.; van Zyl, Gert; Barrow, Geoff; Camacho, Ricardo; Carmona, Sergio; Grant, Philip M.; Gupta, Ravindra K.; Hamers, Raph L.; Harrigan, P. Richard; Jordan, Michael R.; Kantor, Rami; Katzenstein, David A.; Kuritzkes, Daniel R.; Maldarelli, Frank; Otelea, Dan; Wallis, Carole L.; Schapiro, Jonathan M.; Shafer, Robert W.

    2017-01-01

    HIV-1 genotypic resistance test (GRT) interpretation systems (IS) require updates as new studies on HIV-1 drug resistance are published and as treatment guidelines evolve. An expert panel was created to provide recommendations for the update of the Stanford HIV Drug Resistance Database (HIVDB)

  9. 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.

  10. Validating an instrument for clinical supervision using an expert panel.

    Science.gov (United States)

    Hyrkäs, Kristiina; Appelqvist-Schmidlechner, Kaija; Oksa, Lea

    2003-08-01

    Use of research instruments standardised in English-speaking countries is commonplace in non-English speaking countries. This article describes technical, linguistic and conceptual issued raised in the translation and validation of an acceptable country-specific instrument. The Manchester Clinical Supervision Scale was validated for use in clinical supervision in Finland using quantitative and qualitative methods. The approach applied was triangulation. The focus of this paper, is to describe the item validation process of the scale using an expert panel (n=11) by means of the content validity index and panel interview. The process resulted in a country-specific 33-item instrument. The study indicated that content validity index and panel discussion are easy, but reliable ways of demonstrating the instrument's content validity.

  11. Collaborative update of a rule-based expert system for HIV-1 genotypic resistance test interpretation.

    Science.gov (United States)

    Paredes, Roger; Tzou, Philip L; van Zyl, Gert; Barrow, Geoff; Camacho, Ricardo; Carmona, Sergio; Grant, Philip M; Gupta, Ravindra K; Hamers, Raph L; Harrigan, P Richard; Jordan, Michael R; Kantor, Rami; Katzenstein, David A; Kuritzkes, Daniel R; Maldarelli, Frank; Otelea, Dan; Wallis, Carole L; Schapiro, Jonathan M; Shafer, Robert W

    2017-01-01

    HIV-1 genotypic resistance test (GRT) interpretation systems (IS) require updates as new studies on HIV-1 drug resistance are published and as treatment guidelines evolve. An expert panel was created to provide recommendations for the update of the Stanford HIV Drug Resistance Database (HIVDB) GRT-IS. The panel was polled on the ARVs to be included in a GRT report, and the drug-resistance interpretations associated with 160 drug-resistance mutation (DRM) pattern-ARV combinations. The DRM pattern-ARV combinations included 52 nucleoside RT inhibitor (NRTI) DRM pattern-ARV combinations (13 patterns x 4 NRTIs), 27 nonnucleoside RT inhibitor (NNRTI) DRM pattern-ARV combinations (9 patterns x 3 NNRTIs), 39 protease inhibitor (PI) DRM pattern-ARV combinations (13 patterns x 3 PIs) and 42 integrase strand transfer inhibitor (INSTI) DRM pattern-ARV combinations (14 patterns x 3 INSTIs). There was universal agreement that a GRT report should include the NRTIs lamivudine, abacavir, zidovudine, emtricitabine, and tenofovir disoproxil fumarate; the NNRTIs efavirenz, etravirine, nevirapine, and rilpivirine; the PIs atazanavir/r, darunavir/r, and lopinavir/r (with "/r" indicating pharmacological boosting with ritonavir or cobicistat); and the INSTIs dolutegravir, elvitegravir, and raltegravir. There was a range of opinion as to whether the NRTIs stavudine and didanosine and the PIs nelfinavir, indinavir/r, saquinavir/r, fosamprenavir/r, and tipranavir/r should be included. The expert panel members provided highly concordant DRM pattern-ARV interpretations with only 6% of NRTI, 6% of NNRTI, 5% of PI, and 3% of INSTI individual expert interpretations differing from the expert panel median by more than one resistance level. The expert panel median differed from the HIVDB 7.0 GRT-IS for 20 (12.5%) of the 160 DRM pattern-ARV combinations including 12 NRTI, two NNRTI, and six INSTI pattern-ARV combinations. Eighteen of these differences were updated in HIVDB 8.1 GRT-IS to reflect the

  12. Collaborative update of a rule-based expert system for HIV-1 genotypic resistance test interpretation.

    Directory of Open Access Journals (Sweden)

    Roger Paredes

    Full Text Available HIV-1 genotypic resistance test (GRT interpretation systems (IS require updates as new studies on HIV-1 drug resistance are published and as treatment guidelines evolve.An expert panel was created to provide recommendations for the update of the Stanford HIV Drug Resistance Database (HIVDB GRT-IS. The panel was polled on the ARVs to be included in a GRT report, and the drug-resistance interpretations associated with 160 drug-resistance mutation (DRM pattern-ARV combinations. The DRM pattern-ARV combinations included 52 nucleoside RT inhibitor (NRTI DRM pattern-ARV combinations (13 patterns x 4 NRTIs, 27 nonnucleoside RT inhibitor (NNRTI DRM pattern-ARV combinations (9 patterns x 3 NNRTIs, 39 protease inhibitor (PI DRM pattern-ARV combinations (13 patterns x 3 PIs and 42 integrase strand transfer inhibitor (INSTI DRM pattern-ARV combinations (14 patterns x 3 INSTIs.There was universal agreement that a GRT report should include the NRTIs lamivudine, abacavir, zidovudine, emtricitabine, and tenofovir disoproxil fumarate; the NNRTIs efavirenz, etravirine, nevirapine, and rilpivirine; the PIs atazanavir/r, darunavir/r, and lopinavir/r (with "/r" indicating pharmacological boosting with ritonavir or cobicistat; and the INSTIs dolutegravir, elvitegravir, and raltegravir. There was a range of opinion as to whether the NRTIs stavudine and didanosine and the PIs nelfinavir, indinavir/r, saquinavir/r, fosamprenavir/r, and tipranavir/r should be included. The expert panel members provided highly concordant DRM pattern-ARV interpretations with only 6% of NRTI, 6% of NNRTI, 5% of PI, and 3% of INSTI individual expert interpretations differing from the expert panel median by more than one resistance level. The expert panel median differed from the HIVDB 7.0 GRT-IS for 20 (12.5% of the 160 DRM pattern-ARV combinations including 12 NRTI, two NNRTI, and six INSTI pattern-ARV combinations. Eighteen of these differences were updated in HIVDB 8.1 GRT-IS to reflect

  13. NPWT or HRT-dressing? Results of an expert panel and a Delphi panel analysis.

    Science.gov (United States)

    Hermans, M H E; Cutting, K

    2013-11-01

    To investigate the similarities and differences between Hydration Response Technology (HRT) and negative pressure wound therapy (NPWT) with regard to wound bed preparation, and to devise a set of recommendations for their use on the basis of the opinion of two panels. An expert panel that analysed in vitro and clinical data as well as the similarities and differences between the two modalities was established. This culminated in a series of recommendations on which modality to use for which indication. These recommendations were presented to a Delphi panel, consisting of users of both NPWT and HRT-dressing. The panel was then asked to produce its own recommendations. The outcomes and recommendations of both panels were reported. NPWT is the preferred treatment modality for abdominal dehisced wounds, and to a lesser extent, for surgical wound healing by secondary intention. For all other indications, the treatment modalities are at least equal, with HRT-dressing often being the superior mode to treat wounds such as venous leg ulcers, arterial ulcers and vasculitis. In the opinion of the expert panel and the Delphi panel, both modalities share a number of clinical and non-clinical properties. However, because of the numerous advantages of HRT technology, HRT dressing has the potential to replace NPWT in a number of indications, where the patient, health-care providers and institutions may benefit. This study was sponsored by Sorbion GmbH & Co, Senden, Germany. Authors M. Hermans and K. Cutting are consultants to Sorbion GmbH & Co, Senden, Germany.

  14. Working memory performance in expert and novice interpreters

    OpenAIRE

    Köpke, Barbara; Nespoulous, Jean-Luc

    2006-01-01

    International audience; Simultaneous interpreting is generally assumed to be particularly demanding with respect to cognitive resources like attention and working memory, which are thought to gradually increase with professional practice. Experimental data to corroborate such an assumption is still sparse, however. Here we report an in-depth investigation of working memory capacity among 21 professional interpreters (experts), 18 second-year interpreting students (novices) and two control gro...

  15. 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.

  16. Adaptation and validation of the ACMG/AMP variant classification framework for MYH7-associated inherited cardiomyopathies: recommendations by ClinGen's Inherited Cardiomyopathy Expert Panel

    NARCIS (Netherlands)

    Kelly, Melissa A.; Caleshu, Colleen; Morales, Ana; Buchan, Jillian; Wolf, Zena; Harrison, Steven M.; Cook, Stuart; Dillon, Mitchell W.; Garcia, John; Haverfield, Eden; Jongbloed, Jan D. H.; Macaya, Daniela; Manrai, Arjun; Orland, Kate; Richard, Gabriele; Spoonamore, Katherine; Thomas, Matthew; Thomson, Kate; Vincent, Lisa M.; Walsh, Roddy; Watkins, Hugh; Whiffin, Nicola; Ingles, Jodie; van Tintelen, J. Peter; Semsarian, Christopher; Ware, James S.; Hershberger, Ray; Funke, Birgit

    2018-01-01

    PurposeIntegrating genomic sequencing in clinical care requires standardization of variant interpretation practices. The Clinical Genome Resource has established expert panels to adapt the American College of Medical Genetics and Genomics/Association for Molecular Pathology classification framework

  17. A qualitative risk assessment methodology for scientific expert panels.

    Science.gov (United States)

    Dufour, B; Plée, L; Moutou, F; Boisseleau, D; Chartier, C; Durand, B; Ganière, J P; Guillotin, J; Lancelot, R; Saegerman, C; Thébault, A; Hattenberger, A M; Toma, B

    2011-12-01

    Risk assessment can be either quantitative, i.e. providing a numeric estimate of the probability of risk and the magnitude of the consequences, or qualitative, using a descriptive approach. The French Agency for Food, Environmental and Occupational Health and Safety (ANSES), formerly the French Food Safety Agency (AFSSA), bases its assessments on the opinions of scientific panels, such as the ANSES Animal Health Scientific Panel (AH-SP). Owing to the lack of relevant data and the very short period of time usually allowed to assess animal health risks on particular topics, this panel has been using a qualitative risk method for evaluating animal health risks or crises for the past few years. Some experts have drawn attention to the limitations of this method, such as the need to extend the range of adjectives used for the lower probabilities and to develop a way to assess consequences. The aim of this paper is to describe the improved method now established by the AH-SP, taking into account the limitations of the first version. The authors describe a new set of levels for probabilities, as well as the items considered when addressing either animal or human health consequences.

  18. Pancreatic cancer treatment and research: an international expert panel discussion.

    Science.gov (United States)

    Tempero, M A; Berlin, J; Ducreux, M; Haller, D; Harper, P; Khayat, D; Schmoll, H-J; Sobrero, A; Van Cutsem, E

    2011-07-01

    Pancreatic cancer has proven extremely challenging to treat. A collaborative effort is needed to advance research and improve treatment. An expert conference was conducted to elicit perspectives regarding the current treatment and future research of pancreatic cancer. The conference comprised an international panel of experts representing five European countries and the United States. Adjuvant radiotherapy is used more frequently in the United States than in Europe. In locally advanced disease, there is now more emphasis on early chemotherapy in both Europe and the United States. In metastatic disease, combination chemotherapy is commonly used in Europe and the United States. This varies by country. Advancing pancreatic research will require improving biorepositories and developing a roadmap to prioritize therapeutic targets in different models. Small randomized phase II trials of both non-selected and enriched patient populations will help identify activity of new agents. Phase III trials should only be initiated in appropriate patients based on strong clinical and biological signals. Developing drugs in the adjuvant setting may be preferable to eliminate some of the challenges of drug development in the advanced disease setting. Progress in research combined with encouraging improvements from the past offer hope for the future of pancreatic cancer patients.

  19. Expert consensus panel guidelines on geriatric assessment in oncology.

    Science.gov (United States)

    O'Donovan, A; Mohile, S G; Leech, M

    2015-07-01

    Despite consensus guidelines on best practice in the care of older patients with cancer, geriatric assessment (GA) has yet to be optimally integrated into the field of oncology in most countries. There is a relative lack of consensus in the published literature as to the best approach to take, and there is a degree of uncertainty as to how integration of geriatric medicine principles might optimally predict patient outcomes. The aim of the current study was to obtain consensus on GA in oncology to inform the implementation of a geriatric oncology programme. A four-round Delphi process was employed. The Delphi method is a structured group facilitation process, using multiple iterations to gain consensus on a given topic. Consensus was reached on the optimal assessment method and interventions required for the commonly employed domains of GA. Other aspects of GA, such as screening methods and age cut-off for assessment, represented a higher degree of disagreement. The expert panel employed in this study clearly identified the criteria that should be included in a clinical geriatric oncology programme. In the absence of evidence-based guidelines, this may prove useful in the care of older cancer patients. © 2015 John Wiley & Sons Ltd.

  20. Expert Consensus Panel Guidelines on Geriatric Assessment in Oncology

    Science.gov (United States)

    O'Donovan, A.; Mohile, S.G.; Leech, M.

    2015-01-01

    Introduction Despite consensus guidelines on best practice in the care of older patients with cancer, geriatric assessment (GA) has yet to be optimally integrated into the field of oncology in most countries. There is a relative lack of consensus in the published literature as to the best approach to take, and there is a degree of uncertainty as to how integration of geriatric medicine principles might optimally predict patient outcomes. The aim of the current study was to obtain consensus on GA in oncology to inform the implementation of a geriatric oncology programme. Methods A four round Delphi process was employed. The Delphi method is a structured group facilitation process, using multiple iterations in order to gain consensus on a given topic Results Consensus was reached on the optimal assessment method and interventions required for the commonly employed domains of GA. Other aspects of GA, such as screening methods and age cutoff for assessment represented a higher degree of disagreement. Discussion The expert panel employed in this study clearly identified the criteria that should be included in a clinical geriatric oncology programme. In the absence of evidence-based guidelines, this may prove useful in the care of older cancer patients. PMID:25757457

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

    Science.gov (United States)

    The National Toxicology Program Center for the Evaluation of Risks to Human Reproduction (NTP-CERHR) convened an expert panel in May 2004 to evaluate acrylamide. The report of the expert panel, prepared in accordance with CERHR Guidelines, provides a detailed summary of all publi...

  2. 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.

  3. Qualitative study of college tutoring through the expert panel method

    Directory of Open Access Journals (Sweden)

    Inmaculada López Martín

    2014-03-01

    Full Text Available The implementation of a quality Tutorial Action Plan (TAP, in which the integral formation of students is the main objective, is a topical issue in the Spanish university environment . This paper aims to identify the actions contemplated in the TAPs of different Spanish universities and catalog the different types of activities performed by the teachers-tutors in the context of tutorial action. To achieve this, the authors conducted a qualitative analysis based on expert panels. As a result, three main vectors were extracted: Standard elements in a college TAP, critical aspects from tutors and managers of tutorial actions, and tutorial actions with a seal of quality. From the analysis it was concluded that quality tutorial action is the basis for academic excellence. Its achievement requires to clarify and recognize the role of the tutor, adjust appropriately the ratio of students allocated per tutor, and promote the development of transversal skills in students. For this, the authors propose a cross-coordination among teachers, as well as counseling and support; tutor training and professionalism; and the application of working methods that allow proper guidance and monitoring of students. ----------------------------- Estudio Cualitativo sobre Tutoría Universitaria a Través del Método de Panel de Expertos Resumen La implantación de un plan de acción tutorial (PAT de calidad, en el cual la formación integral del alumnado sea lo principal, es un tema de actualidad en el entorno universitario español. El presente trabajo persigue identificar las acciones contempladas en los PAT de diferentes universidades españolas, así como catalogar los diferentes tipos de actividades realizadas por los profesores-tutores en el contexto de la acción tutorial. Para ello se realizó un análisis cualitativo basado en paneles de expertos. Como resultado, se extrajeron tres vectores principales: Elementos habituales en un PAT universitario; Aspectos cr

  4. Biphasic Insulin Analogues in Type 2 Diabetes: Expert Panel Recommendations

    Directory of Open Access Journals (Sweden)

    Sema Akalın

    2011-09-01

    of Biphasic Insulin Aspart 30 treatment has been published recently, these types of guidelines cannot always respond to all of the local requirements. Therefore, it is aimed to prepare a guideline to facilitate the use of Biphasic Insulin Aspart 30 in the right patient, at the right time and in the right manner, as well as to help the physicians. A guideline, aiming to contain current evidences and to meet local requirements, was developed in May and June 2010 by an expert panel composed of experienced endocrinologists working at different parts of Turkey. The guideline includes initial treatment, optimization of initiation dose, and intensification of Biphasic Insulin Aspart 30 during the disease progression. Although previously published global guidelines about initiation, intensification, dose division, dose addition and combination of Biphasic Insulin Aspart 30 with OADs is in applicable situation in general, the content is enlarged by adding some special conditions. Administration information presented in this article forms simply a suggestion rather than a strict recommendation. Since the treatment of every diabetic patient should be individualized, suggestions of this guideline do not have any obligatory power on physicians. Turk Jem 2011; 15: 65-70

  5. EXPERT PANEL OVERSIGHT COMMITTEE ASSESSMENT OF FY2008 CORROSION AND STRESS CORROSION CRACKING SIMULANT TESTING PROGRAM

    Energy Technology Data Exchange (ETDEWEB)

    BOOMER KD

    2009-01-08

    The Expert Panel Oversight Committee (EPOC) has been overseeing the implementation of selected parts of Recommendation III of the final report, Expert Panel workshop for Hanford Site Double-Shell Tank Waste Chemistry Optimization, RPP-RPT-22126. Recommendation III provided four specific requirements necessary for Panel approval of a proposal to revise the chemistry control limits for the Double-Shell Tanks (DSTs). One of the more significant requirements was successful performance of an accelerated stress corrosion cracking (SCC) experimental program. This testing program has evaluated the optimization of the chemistry controls to prevent corrosion in the interstitial liquid and supernatant regions of the DSTs.

  6. Expert panel vs decision-analysis recommendations for postdischarge coronary angiography after myocardial infarction.

    Science.gov (United States)

    Kuntz, K M; Tsevat, J; Weinstein, M C; Goldman, L

    1999-12-15

    Expert panels and decision-analytic techniques are increasingly used to determine the appropriateness of medical interventions, but these 2 approaches use different methods to process evidence. To compare expert panel appropriateness ratings of coronary angiography after myocardial infarction (from the time of hospital discharge to 12 weeks after infarction) with the health gains and cost-effectiveness predicted by a decision-analytic model. Comparison of the degree of importance of the clinical variables considered in expert panel appropriateness ratings vs a previously published decision-analytic model. Identification of 36 clinical scenarios from the expert panel that could be simulated by the decision-analytic model. Appropriateness score and appropriateness classification (expert panel) vs gain in quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio (decision-analytic model). The most important clinical variables were similar in the 2 approaches, with the exercise tolerance test result exerting the greatest leverage on strength of recommendation for angiography. Among the expert panel clinical scenarios considered to be appropriate for coronary angiography that could be simulated in the decision-analysis model, the median (interquartile range) health gain and incremental cost-effectiveness ratio were 0.59 (0.41-0.76) QALYs and $27000 ($23000-$35000) per QALY gained, respectively. Among the clinical scenarios that expert panels considered inappropriate, the corresponding medians (interquartile ranges) were 0.24 (0.19-0.34) QALYs and $54000 ($36000-$58000) per QALY gained. The Spearman rank correlation between appropriateness score and QALY gain was 0.58 (Pappropriateness score and estimated incremental cost-effectiveness ratios was -0.66 (Pappropriateness score and both the health gain and the incremental cost-effectiveness ratio of coronary angiography compared with no angiography in the convalescent phase of acute myocardial infarction

  7. Forms and Levels of Expertness: Interpreting Accounts of Typeface Design

    Directory of Open Access Journals (Sweden)

    Michael Harkins

    2016-01-01

    Full Text Available This article responds to problems arising from defining the notion of “expert” with respect to the subject of text typeface design. What and who is a type design expert? The author has identified that in both contemporary and historical contexts, paucity exists in relation to recorded knowledge regarding the processes of designing text typefaces. Accounts of knowledge of the practice of text typeface design differ in their perspectives relating to what may be deemed expertness. In attempting to explain or rationalize differences in perspectives of such accounts of practice, the problem of describing expertness arose. In terms of degrees of expertise relative to accounts of subject knowledge in text typeface design, the author developed the concept of “vicinage” in order to explore how we render expertness within research enquiry. This concept has the potential to focus future research in the area of defining expertise in typeface design and more generally beyond this field.

  8. Statistical challenges in nursing education and research: an expert panel consensus.

    Science.gov (United States)

    Hayat, Matthew J; Higgins, Melinda; Schwartz, Todd A; Staggs, Vincent S

    2015-01-01

    This article summarizes an expert panel discussion, "Statistical Challenges in Nursing Research," conducted at the 2013 Joint Statistical Meetings. The panel consisted of doctorally prepared statisticians with faculty appointments in United States-based academic nursing programs. The discussion centered on challenges concerning the use of statistics in nursing education and research. Five domains were identified, including perceptions about statistics, statisticians' roles and responsibilities, interdisciplinary collaboration between statisticians and nurse investigators, statistics education, and the use of statistics in the nursing literature.

  9. What defines an Expert? - Uncertainty in the interpretation of seismic data

    Science.gov (United States)

    Bond, C. E.

    2008-12-01

    Studies focusing on the elicitation of information from experts are concentrated primarily in economics and world markets, medical practice and expert witness testimonies. Expert elicitation theory has been applied in the natural sciences, most notably in the prediction of fluid flow in hydrological studies. In the geological sciences expert elicitation has been limited to theoretical analysis with studies focusing on the elicitation element, gaining expert opinion rather than necessarily understanding the basis behind the expert view. In these cases experts are defined in a traditional sense, based for example on: standing in the field, no. of years of experience, no. of peer reviewed publications, the experts position in a company hierarchy or academia. Here traditional indicators of expertise have been compared for significance on affective seismic interpretation. Polytomous regression analysis has been used to assess the relative significance of length and type of experience on the outcome of a seismic interpretation exercise. Following the initial analysis the techniques used by participants to interpret the seismic image were added as additional variables to the analysis. Specific technical skills and techniques were found to be more important for the affective geological interpretation of seismic data than the traditional indicators of expertise. The results of a seismic interpretation exercise, the techniques used to interpret the seismic and the participant's prior experience have been combined and analysed to answer the question - who is and what defines an expert?

  10. 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

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

    NARCIS (Netherlands)

    Plas, A.G. van der; Onwuteaka-Philipsen, B.D.; Watering, M. van de; Jansen, W.J.; Vissers, K.C.P.; Deliens, L.

    2012-01-01

    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

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

    NARCIS (Netherlands)

    van der Plas, A.G.M.; Onwuteaka-Philipsen, B.D.; van de Watering, M.; Jansen, W.J.J.; Vissers, K.C.; Deliens, L.

    2012-01-01

    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

  13. 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 ...

  14. 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

    Endoscopic submucosal dissection (ESD) is the gold standard technique for performing en bloc resection of large superficial tumors in the upper and lower gastrointestinal tract. Experience in Europe, however, is still limited and ESD is only performed in a few selected centers, with low volumes...... of cases, no description of training programs, and few published reports. In 2008, a panel of experts gathered in Rotterdam to discuss indications, training, and the wider use of ESD. The panel of experts and participants reached a consensus on five general statements: 1) ESD aims at treating mucosal...... 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...

  15. QT Interval Screening in Methadone Maintenance Treatment: Report of a SAMHSA Expert Panel

    Science.gov (United States)

    Martin, Judith A.; Campbell, Anthony; Killip, Thomas; Kotz, Margaret; Krantz, Mori J.; Kreek, Mary Jeanne; McCarroll, Brian A.; Mehta, Davendra; Payte, J. Thomas; Stimmel, Barry; Taylor, Trusandra; Wilford, Bonnie B.

    2014-01-01

    In an effort to enhance patient safety in Opioid Treatment Programs (OTPs), the Substance Abuse and Mental Health Services Administration (SAMHSA) convened a multi-disciplinary Expert Panel on the Cardiac Effects of Methadone. Panel members reviewed the literature, regulatory actions, professional guidances, and OTPs’ experiences regarding adverse cardiac events associated with methadone. The Panel concluded that, to the extent possible, every OTP should have a universal Cardiac Risk Management Plan (incorporating clinical assessment, ECG assessment, risk stratification, and prevention of drug interactions) for all patients, and should strongly consider patient-specific risk minimization strategies (such as careful patient monitoring, obtaining ECGs as indicated by a particular patient’s risk profile, and adjusting the methadone dose as needed) for patients with identified risk factors for adverse cardiac events. The Panel also suggested specific modifications to informed consent documents, patient education, staff education, and methadone protocols. PMID:22026519

  16. A bird's eye view: the cognitive strategies of experts interpreting seismic profiles

    Science.gov (United States)

    Bond, C. E.; Butler, R.

    2012-12-01

    Geoscience is perhaps unique in its reliance on incomplete datasets and building knowledge from their interpretation. This interpretation basis for the science is fundamental at all levels; from creation of a geological map to interpretation of remotely sensed data. To teach and understand better the uncertainties in dealing with incomplete data we need to understand the strategies individual practitioners deploy that make them effective interpreters. The nature of interpretation is such that the interpreter needs to use their cognitive ability in the analysis of the data to propose a sensible solution in their final output that is both consistent not only with the original data but also with other knowledge and understanding. In a series of experiments Bond et al. (2007, 2008, 2011, 2012) investigated the strategies and pitfalls of expert and non-expert interpretation of seismic images. These studies focused on large numbers of participants to provide a statistically sound basis for analysis of the results. The outcome of these experiments showed that techniques and strategies are more important than expert knowledge per se in developing successful interpretations. Experts are successful because of their application of these techniques. In a new set of experiments we have focused on a small number of experts to determine how they use their cognitive and reasoning skills, in the interpretation of 2D seismic profiles. Live video and practitioner commentary were used to track the evolving interpretation and to gain insight on their decision processes. The outputs of the study allow us to create an educational resource of expert interpretation through online video footage and commentary with associated further interpretation and analysis of the techniques and strategies employed. This resource will be of use to undergraduate, post-graduate, industry and academic professionals seeking to improve their seismic interpretation skills, develop reasoning strategies for

  17. 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...

  18. Expert panel review of electromagnetic field; Ekspertgruppens gjennomgang av elektromagnetiske felt

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-11-01

    What happens to the body when we are near cell phones, base stations and wireless networks are questions that are much debated in the media. A panel of experts appointed by the Health and transport authorities have reviewed research results, test results and management in this field and concludes that the large number of studies that are considered, not provide evidence that these devices can cause adverse health effects. This information leaflet shows the main conclusions from the review. (eb)

  19. 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.

  20. 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

  1. 78 FR 15012 - Request for Nominations of Experts for a Science Advisory Board Panel To Review EPA's Draft...

    Science.gov (United States)

    2013-03-08

    ... hydrologic connectivity of waters; (b) ecologists with expertise in stream ecology or wetland ecology... individuals in the areas of expertise described above for possible service on this expert panel. Nominations...

  2. Evaluation and management of acute menorrhagia in women with and without underlying bleeding disorders: consensus from an international expert panel

    NARCIS (Netherlands)

    James, Andra H.; Kouides, Peter A.; Abdul-Kadir, Rezan; Dietrich, Jennifer E.; Edlund, Mans; Federici, Augusto B.; Halimeh, Susan; Kamphuisen, Pieter Willem; Lee, Christine A.; Martínez-Perez, Oscar; McLintock, Claire; Peyvandi, Flora; Philipp, Claire; Wilkinson, Jeffrey; Winikoff, Rochelle

    2011-01-01

    Acute menorrhagia is a common gynecological disorder. Prevalence is high among women with inherited bleeding disorders and recent guidance for optimal management is lacking. Following a comprehensive review of the literature, an international expert panel in obstetrics, gynecology and hematology

  3. 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...

  4. Adaptation and validation of the ACMG/AMP variant classification framework for MYH7-associated inherited cardiomyopathies: recommendations by ClinGen's Inherited Cardiomyopathy Expert Panel.

    Science.gov (United States)

    Kelly, Melissa A; Caleshu, Colleen; Morales, Ana; Buchan, Jillian; Wolf, Zena; Harrison, Steven M; Cook, Stuart; Dillon, Mitchell W; Garcia, John; Haverfield, Eden; Jongbloed, Jan D H; Macaya, Daniela; Manrai, Arjun; Orland, Kate; Richard, Gabriele; Spoonamore, Katherine; Thomas, Matthew; Thomson, Kate; Vincent, Lisa M; Walsh, Roddy; Watkins, Hugh; Whiffin, Nicola; Ingles, Jodie; van Tintelen, J Peter; Semsarian, Christopher; Ware, James S; Hershberger, Ray; Funke, Birgit

    2018-01-04

    PurposeIntegrating genomic sequencing in clinical care requires standardization of variant interpretation practices. The Clinical Genome Resource has established expert panels to adapt the American College of Medical Genetics and Genomics/Association for Molecular Pathology classification framework for specific genes and diseases. The Cardiomyopathy Expert Panel selected MYH7, a key contributor to inherited cardiomyopathies, as a pilot gene to develop a broadly applicable approach.MethodsExpert revisions were tested with 60 variants using a structured double review by pairs of clinical and diagnostic laboratory experts. Final consensus rules were established via iterative discussions.ResultsAdjustments represented disease-/gene-informed specifications (12) or strength adjustments of existing rules (5). Nine rules were deemed not applicable. Key specifications included quantitative frameworks for minor allele frequency thresholds, the use of segregation data, and a semiquantitative approach to counting multiple independent variant occurrences where fully controlled case-control studies are lacking. Initial inter-expert classification concordance was 93%. Internal data from participating diagnostic laboratories changed the classification of 20% of the variants (n = 12), highlighting the critical importance of data sharing.ConclusionThese adapted rules provide increased specificity for use in MYH7-associated disorders in combination with expert review and clinical judgment and serve as a stepping stone for genes and disorders with similar genetic and clinical characteristics.GENETICS in MEDICINE advance online publication, 4 January 2018; doi:10.1038/gim.2017.218.

  5. Health Experts' Opinions about Tobacco Control Activities in Iran: Results from a Delphi Panel of National Experts.

    Science.gov (United States)

    Sharifi, Hooman; Hessami, Zahra; Masjedi, Mohammad Reza

    2012-01-01

    Iran signed the Framework Convention on Tobacco Control on June 16, 2003 and it was ratified by the parliament and the House of Representatives on November 6, 2005. Finally, it came into force on February 4, 2006. In this study, we aimed to evaluate health experts' opinion about tobacco control activities in Iran. This was a qualitative case study. We used a series of open-ended questionnaires to assess important information regarding Iranian National Tobacco Control law and FCTC implementation. The study population comprised of health experts. Use of this method ensured the validity of questionnaires' contents. The first round of the questionnaire had been pre-tested in a pilot study. The final structure and lay out of questionnaires consisted of three main parts. The first part was designed with 7 multiple choice questions. Participants were able to rank answers from five (the most important) to one (the least important). The second part comprised four questions mainly on National Tobacco Control Program (NTCP) and the final part was about FCTC. Data collection was carried out between May 2010 and May 2011. In the analysis process each interview was considered as a separate case and then compared to other cases to ascertain variations in answers. All 40 members (100%) of the panel completed the entire process. All the participants had a consensus on tobacco control program in Iran. They believed the prevention programs to be important priorities in this regard. Tobacco Company as a governmental organization is believed to be the main barrier against tobacco control activities in Iran, and banning sales of tobacco to minors and controlling its smuggling are important factors for decreasing the supply of tobacco products. It is essential to implement comprehensive tobacco control law in Iran. It is essential to implement comprehensive tobacco control law in Iran that covers all the priorities mentioned above. Considering the chronological aspect of law

  6. SERDP and ESTCP Expert Panel Workshop on Reducing the Uncertainty of DNAPL Source Zone Remediation

    Science.gov (United States)

    2006-09-01

    Lockport Dolomite SERDP & ESTCP Expert Panel Workshop on Reducing the C-16 Uncertainty of DNAPL Source Zone Remediation The Problem DNAPL...TCA, CT, CHCl3 Peroxide, New Fenton’s PCE, TCE, DCE, VC, CB DCA, CH2Cl2 TCA, CT, CHCl3 Calcium Peroxide PCE,TCE, DCE, VC, CB TCA, CH2Cl2...Benzene 11,084 ND Carbon Tetrachloride 17,152 ND Trichloroethene 7,500 ND Toluene 9,321 ND 1,1,2-Trichloroethane 26,386 ND Tetrachloroethene 3,036 ND

  7. Training Future Physicians about Weapons of Mass Destruction: Report of the Expert Panel on Bioterrorism Education for Medical Students.

    Science.gov (United States)

    Association of American Medical Colleges, Washington, DC.

    The Association of American Medical Colleges (AAMC) convened a multidisciplinary group of experts to share their insights about the learning objectives and educational experiences that they would recommend for the training of future physicians about bioterrorism. The expert panel broadened the scope of their discussion beyond bioterrorism to…

  8. 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.

  9. Expert panel consensus recommendations for home blood pressure monitoring in Asia: the Hope Asia Network.

    Science.gov (United States)

    Park, Sungha; Buranakitjaroen, Peera; Chen, Chen-Huan; Chia, Yook-Chin; Divinagracia, Romeo; Hoshide, Satoshi; Shin, Jinho; Siddique, Saulat; Sison, Jorge; Soenarta, Arieska Ann; Sogunuru, Guru Prasad; Tay, Jam Chin; Turana, Yuda; Wang, Ji-Guang; Zhang, Yuqing; Kario, Kazuomi

    2018-01-31

    Hypertension is the leading cause of mortality throughout Asia. Home blood pressure monitoring has the potential to improve hypertension control and is a useful adjunct to conventional office blood pressure measurements due to its diagnostic accuracy and prognostic value in predicting cardiovascular outcomes. At present, there are no region-specific guidelines addressing the use of home blood pressure monitoring in Asia. Therefore, an expert panel was convened to address the use of home blood pressure monitoring and develop key recommendations to help guide clinical practice throughout the Asia region. The resulting recommendations support the use of home blood pressure monitoring with a validated device as an accurate adjunct for diagnosing hypertension and predicting cardiovascular outcome. Diagnosis and treatment of hypertension should still be guided by conventional office/clinic blood pressure measurements. The expert panel encourages the incorporation of home blood pressure monitoring into local clinical guidelines and offers practical recommendations to ensure continuity of care where a validated home blood pressure device is not available.

  10. Diagnosis and Management of Pemphigus: recommendations by an International Panel of Experts.

    Science.gov (United States)

    Murrell, Dedee F; Peña, Sandra; Joly, Pascal; Marinovic, Branka; Hashimoto, Takashi; Diaz, Luis A; Sinha, Animesh A; Payne, Aimee S; Daneshpazhooh, Maryam; Eming, Rüdiger; Jonkman, Marcel F; Mimouni, Daniel; Borradori, Luca; Kim, Soo-Chan; Yamagami, Jun; Lehman, Julia S; Saleh, Marwah Adly; Culton, Donna A; Czernik, Annette; Zone, John J; Fivenson, David; Ujiie, Hideyuki; Wozniak, Katarzyna; Akman-Karakaş, Ayşe; Bernard, Philippe; Korman, Neil J; Caux, Frédéric; Drenovska, Kossara; Prost-Squarcioni, Catherine; Vassileva, Snejina; Feldman, Ron J; Cardones, Adela Rambi; Bauer, Johann; Ioannides, Dimitrios; Jedlickova, Hana; Palisson, Francis; Patsatsi, Aikaterini; Uzun, Soner; Yayli, Savas; Zillikens, Detlef; Amagai, Masayuki; Hertl, Michael; Schmidt, Enno; Aoki, Valeria; Grando, Sergei A; Shimizu, Hiroshi; Baum, Sharon; Cianchini, Guiseppe; Feliciani, Claudio; Iranzo, Pilar; Mascaró, Jose M; Kowalewski, Cezary; Hall, Russell; Groves, Richard; Harman, Karen E; Marinkovich, M Peter; Maverakis, Emanual; Werth, Victoria P

    2018-02-10

    Several European countries recently developed international diagnostic and management guidelines for pemphigus, which have been instrumental in the standardization of pemphigus management, OBJECTIVE: We now present results from a subsequent Delphi consensus to broaden the generalizability of recommendations. A preliminary survey, based on the European Dermatology Forum (EDF) and the European Academy of Dermatology and Venereology (EADV) guidelines, was sent to a panel of international experts to determine the level of consensus. The results were discussed at the International Bullous Diseases Consensus Group in March 2016 during the annual American Academy of Dermatology (AAD) conference. A second survey was sent following the meeting to more experts to achieve greater international consensus. The 39 experts participated in the first round of the Delphi-survey while 54 from 21 countries completed the second round. The number of statements in the survey was reduced from 175 topics in Delphi I to 24 topics in Delphi II based on Delphi results and meeting discussion. Each recommendation represents the majority opinion and therefore may not reflect all possible treatment options available. We present here the recommendations resulting from this Delphi process. This international consensus includes intravenous CD20 inhibitors as a first line therapy option for moderate to severe pemphigus. Copyright © 2018. Published by Elsevier Inc.

  11. Implementation of human expert heuristics in computer supported infrared spectra interpretation

    Science.gov (United States)

    Andreev, G. N.; Argirov, O. K.

    1995-03-01

    A new version of the expert system EXPIRS is described that owns extended capability to mimic the human expert heuristics used for infrared spectra interpretation. The program coded in PROLOG functions on the basis of symbolic logic. It is provided with an accelerated algorithm for generation of alternative substructure sets, based on: hierarchical organization of the knowledge base, utilization of molecular formula, and a more precise subroutine for selection of the substructures. The system takes into consideration the existence of very strong absorbing characteristic groups and corrects both the current spectrum and the knowledge base in order to improve the prediction ability.

  12. An abductive expert system for interpretation of real-time data

    Energy Technology Data Exchange (ETDEWEB)

    Dabbaghchi, I.; Gursky, R.J. (American Electric Power Service Corp., Columbus, OH (United States))

    1993-07-01

    This paper describes DINT, a data interpretation expert system which can provide an explanation of the real-time operating state of a substation to its operators. DINT is based on a generalized version of the set covering model for diagnostic problem solving. This abductive reasoning model is an object-based, frame-like knowledge representation paradigm. Test cases illustrate the application of the model to the real-time operation of a substation.

  13. Advancing research on endocrine disrupting chemicals in breast cancer: Expert panel recommendations.

    Science.gov (United States)

    Teitelbaum, Susan L; Belpoggi, Fiorella; Reinlib, Les

    2015-07-01

    Breast cancer incidence continues to increase in the US and Europe, a reflection of the growing influence of environment factors that interact with personal genetics. The US Environmental Protection Agency estimates that there are approximately 10,000 endocrine disrupting chemicals among the common daily exposures that could affect the risk of disease. The daunting tasks of identifying, characterizing, and elucidating the mechanisms of endocrine disrupting chemicals in breast cancer need to be addressed to produce a comprehensive model that will facilitate preventive strategies and public policy. An expert panel met to describe and bring attention to needs linking common environmental exposures, critical windows of exposure, and optimal times of assessment in investigating breast cancer risk. The group included investigators with extensive experience in the use of rodent models and in leading population studies and produced a set of recommendations for effective approaches to gaining insights into the environmental origins of breast cancer across the lifespan. Published by Elsevier Inc.

  14. 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

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

    Science.gov (United States)

    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.

    2017-01-01

    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. PMID:27895058

  16. Community-based treatment of late life depression an expert panel-informed literature review.

    Science.gov (United States)

    Frederick, John T; Steinman, Lesley E; Prohaska, Thomas; Satariano, William A; Bruce, Martha; Bryant, Lucinda; Ciechanowski, Paul; Devellis, Brenda; Leith, Katherine; Leyden, Kevin M; Sharkey, Joseph; Simon, Gregory E; Wilson, Nancy; Unützer, Jurgen; Snowden, Mark

    2007-09-01

    To present findings from an expert panel-informed literature review on community-based treatment of late-life depression. A systematic literature review was conducted to appraise publications on community-based interventions for depression in older adults. The search was conducted between March and October 2005. An expert panel of mental health, aging, health services, and epidemiology researchers guided the review and voted on quality and effectiveness of these interventions. A total of 3,543 articles were found with publication dates from 1967 to October 2005; of these, 116 were eligible for inclusion. Adequate data existed to determine effectiveness for the following interventions: depression care management, group and individual psychotherapy for depression, psychotherapy targeting mental health, psychotherapy for caregivers, education and skills training (to manage health problems besides depression; and for caregivers), geriatric health evaluation and management, exercise, and physical rehabilitation and occupational therapy. After reviewing the data, panelists rated the depression care management interventions as effective. Education and skills training, geriatric health evaluation and management, and physical rehabilitation and occupational therapy received ineffective ratings. Other interventions received mixed effectiveness ratings. Insufficient data availability and poor study quality prevented the panelists from rating several reviewed interventions. While several well-described interventions were found to treat depression effectively in community-dwelling older adults, significant gaps still exist. Interventions that did not target depression specifically may be of benefit to older adults, but they should not be presumed to treat depression by themselves. Treating depressed elders may require a multifaceted approach to ensure effectiveness. More research in this area is needed.

  17. 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.

  18. Group decision making by experts: field study of panels evaluating medical technologies.

    Science.gov (United States)

    Vinokur, A; Burnstein, E; Sechrest, L; Wortman, P M

    1985-07-01

    Decision-making processes and their outcomes were investigated in six consensus development conferences at the National Institutes of Health in which panels of experts evaluated new medical technologies. One hundred seventy-seven self-administered questionnaires were obtained from participants in these conferences. Questionnaire data were analyzed along with data derived from content analyses of the six consensus statements (CS) produced by the conferences. Results of these analyses provide considerable support for the hypotheses that the quality of the outcome (i.e., the CS) is determined by the existence of an interaction process, a decision procedure, and a chairperson, which facilitate the exchange of relevant information. Strong disagreements among the panelists appear to inhibit such exchange and harm the quality of the CS. Personal satisfaction appears to be more strongly related to the quality of the process and of the information disseminated than to the quality of the outcome. A clear relation was found between the panelists' status and expertise, their participation in the process, and their contribution to the CS. The pattern of these findings is quite similar to that obtained in laboratory studies. The role of preconference organizational factors, such as the selection of conference questions, panel, and speakers, and the characteristics of the technology are discussed.

  19. Education policy implications from the Expert Panel on Electronic Media and Youth Violence.

    Science.gov (United States)

    Worthen, Maria R

    2007-12-01

    The research from the Expert Panel on Electronic Media and Youth Violence makes a compelling case for why educators and education policymakers should care about the effects of media on youth behavior, and the growing phenomenon of Internet bullying and harassment. The ability of the U.S. education system to respond is limited not only by competing instructional priorities but also by the governance structure of the education system itself. The federal role is limited to a proportionally small amount of funding for states and schools, to raising public awareness, and to providing research and data. States can set priorities, make requirements, and direct funding. Districts and schools ultimately have the most control over prevention program selection and setting social and behavioral norms. Key implications of the panel's research for educators and education policymakers include: Internet bullying is correlated with school behavior problems; Internet bullying behavior may peak in middle school; Internet bullying shares common predictors with verbal and, to some extent, physical bullying; Media literacy programs may mitigate the negative effects of electronic media on youth. Specific recommendations based on these conclusions are discussed, and research priorities for the prevention and education fields are identified.

  20. 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.

  1. Viral hemorrhagic septicemia virus (VHSV IVb) risk factors and association measures derived by expert panel

    Science.gov (United States)

    ,

    2010-01-01

    Viral hemorrhagic septicemia virus (VHSV) is an OIE-listed pathogen of fish, recently expanding in known host and geographic range in North America. Through a group process designed for subjective probability assessment, an international panel of fish health experts identified and weighted risk factors perceived important to the emergence and spread of the viral genotype, VHSV IVb, within and from the Great Lakes region of the US and Canada. Identified factors included the presence of known VHSV-susceptible species, water temperatures conducive for disease, hydrologic connectivity and proximity to known VHSV-positive areas, untested shipments of live or frozen fish from known positive regions, insufficient regulatory infrastructure for fish health oversight, and uncontrolled exposure to fomites associated with boat and equipment or fish wastes from known VHSV-positive areas. Results provide qualitative insights for use in VHSV surveillance and risk-management planning, and quantitative estimates of contextual risk for use in a Bayesian model combining multiple evidence streams for joint probability assessment of disease freedom status. Consistency checks suggest that the compiled factors positively reflect expert judgment of watershed risk for acquiring VHSV IVb. External validation is recommended as the availability of empirical data permits.

  2. Management of intrathecal catheter-tip inflammatory masses: an updated 2007 consensus statement from an expert panel.

    Science.gov (United States)

    Deer, Timothy; Krames, Elliot S; Hassenbusch, Samuel; Burton, Allen; Caraway, David; Dupen, Stuart; Eisenach, James; Erdek, Michael; Grigsby, Eric; Kim, Phillip; Levy, Robert; McDowell, Gladstone; Mekhail, Nagy; Panchal, Sunil; Prager, Joshua; Rauck, Richard; Saulino, Michael; Sitzman, Todd; Staats, Peter; Stanton-Hicks, Michael; Stearns, Lisa; Dean Willis, K; Witt, William; Follett, Kenneth; Huntoon, Mark; Liem, Leong; Rathmell, James; Wallace, Mark; Buchser, Eric; Cousins, Michael; Ver Donck, Ann

    2008-04-01

    Background.  Expert panel of physicians and nonphysicians, all expert in intrathecal (IT) therapies, convened in the years 2000 and 2003 to make recommendations for the rational use of IT analgesics based on the preclinical and clinical literature known up to those times, presentations of the expert panel, discussions on current practice and standards, and the result of surveys of physicians using IT agents. An expert panel of physicians and convened in 2007 to review previous recommendations and to form recommendations for the rational use of IT agents as they pertain to new scientific and clinical information regarding the etiology, prevention and treatment for IT granuloma. Method.  A review of preclinical and clinical literature from 2000 to 2006 was undertaken and disseminated to an expert panel of physicians. Focused discussions concerning the rational use of IT agents and its relationship to the etiology of, prevention of, and treatment of IT granuloma were held. Results.  This report presents here new knowledge of the etiology of catheter tip granuloma and guidelines for its prevention and treatment. © 2008 International Neuromodulation Society.

  3. Etiologies of Chronic Cough in Pediatric Cohorts: CHEST Guideline and Expert Panel Report.

    Science.gov (United States)

    Chang, Anne B; Oppenheimer, John J; Weinberger, Miles; Grant, Cameron C; Rubin, Bruce K; Irwin, Richard S

    2017-09-01

    There is no published systematic review on the etiologies of chronic cough or the relationship between OSA and chronic cough in children aged ≤ 14 years. We thus undertook a systematic review based on key questions (KQs) using the Population, Intervention, Comparison, Outcome format. The KQs follow: Among children with chronic (> 4 weeks) cough (KQ 1) are the common etiologies different from those in adults? (KQ 2) Are the common etiologies age or setting dependent, or both? (KQ 3) Is OSA a cause of chronic cough in children? We used the CHEST Expert Cough Panel's protocol and the American College of Chest Physicians (CHEST) methodological guidelines and Grading of Recommendations Assessment, Development, and Evaluation framework. Data from the systematic reviews in conjunction with patients' values and preferences and the clinical context were used to form recommendations. Delphi methodology was used to obtain consensus. Combining KQs 1 and 2, we found moderate-level evidence from 10 prospective studies that the etiologies of cough in children are different from those in adults and are setting dependent. Data from three studies found that common etiologies of cough in young children were different from those in older children. However, data relating sleep abnormalities to chronic cough in children were found only in case studies. There is moderate-quality evidence that common etiologies of chronic cough in children are different from those in adults and are dependent on age and setting. As there are few data relating OSA and chronic cough in children, the panel suggested that these children should be managed in accordance with pediatric sleep guidelines. Copyright © 2017. Published by Elsevier Inc.

  4. Application of machine learning and expert systems to Statistical Process Control (SPC) chart interpretation

    Science.gov (United States)

    Shewhart, Mark

    1991-01-01

    Statistical Process Control (SPC) charts are one of several tools used in quality control. Other tools include flow charts, histograms, cause and effect diagrams, check sheets, Pareto diagrams, graphs, and scatter diagrams. A control chart is simply a graph which indicates process variation over time. The purpose of drawing a control chart is to detect any changes in the process signalled by abnormal points or patterns on the graph. The Artificial Intelligence Support Center (AISC) of the Acquisition Logistics Division has developed a hybrid machine learning expert system prototype which automates the process of constructing and interpreting control charts.

  5. Standardization of Negative Controls in Diagnostic Immunohistochemistry: Recommendations From the International Ad Hoc Expert Panel

    Science.gov (United States)

    Torlakovic, Emina E.; Francis, Glenn; Garratt, John; Gilks, Blake; Hyjek, Elizabeth; Ibrahim, Merdol; Miller, Rodney; Nielsen, Søren; Petcu, Eugen B.; Swanson, Paul E.; Taylor, Clive R.; Vyberg, Mogens

    2014-01-01

    Standardization of controls, both positive and negative controls, is needed for diagnostic immunohistochemistry (dIHC). The use of IHC-negative controls, irrespective of type, although well established, is not standardized. As such, the relevance and applicability of negative controls continues to challenge both pathologists and laboratory budgets. Despite the clear theoretical notion that appropriate controls serve to demonstrate the sensitivity and specificity of the dIHC test, it remains unclear which types of positive and negative controls are applicable and/or useful in day-to-day clinical practice. There is a perceived need to provide “best practice recommendations” for the use of negative controls. This perception is driven not only by logistics and cost issues, but also by increased pressure for accurate IHC testing, especially when IHC is performed for predictive markers, the number of which is rising as personalized medicine continues to develop. Herein, an international ad hoc expert panel reviews classification of negative controls relevant to clinical practice, proposes standard terminology for negative controls, considers the total evidence of IHC specificity that is available to pathologists, and develops a set of recommendations for the use of negative controls in dIHC based on “fit-for-use” principles. PMID:24714041

  6. 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.

  7. 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.

  8. Management of neuropsychiatric symptoms of dementia in clinical settings: recommendations from a multidisciplinary expert panel.

    Science.gov (United States)

    Kales, Helen C; Gitlin, Laura N; Lyketsos, Constantine G

    2014-04-01

    Noncognitive neuropsychiatric symptoms (NPS) of dementia (aggression, agitation, depression, anxiety, delusions, hallucinations, apathy, disinhibition) affect individuals with dementia nearly universally across dementia stages and etiologies. NPS are associated with poor outcomes for individuals with dementia and caregivers, including excess morbidity and mortality, greater healthcare use, and earlier nursing home placement, as well as caregiver stress, depression, and difficulty with employment. Although the Food and Drug Administration has not approved pharmacotherapy for NPS, psychotropic medications are frequently used to manage these symptoms, but in the few cases of proven pharmacological efficacy, significant risk of adverse effects may offset benefits. There is evidence of efficacy and limited potential for adverse effects of nonpharmacological treatments, typically considered first line, but their uptake as preferred treatments remains inadequate in real-world clinical settings. Thus, the field currently finds itself in a predicament in terms of management of these difficult symptoms. It was in this context that the University of Michigan Program for Positive Aging, working in collaboration with the Johns Hopkins Alzheimer's Disease Research Center and Center for Innovative Care in Aging sponsored and convened a multidisciplinary expert panel in Detroit, Michigan, in fall 2011 with three objectives: to define critical elements of care for NPS in dementia; to construct an approach describing the sequential and iterative steps of managing NPS in real-world clinical settings that can be used as a basis for integrating nonpharmacological and pharmacological approaches; and to discuss how the approach generated could be implemented in research and clinical care. © Published 2014. This article is a U.S. Government work and is in the public domain in the U.S.A.

  9. Treatment of advanced non-small-cell lung cancer in the elderly: results of an international expert panel.

    Science.gov (United States)

    Gridelli, Cesare; Aapro, Matti; Ardizzoni, Andrea; Balducci, Lodovico; De Marinis, Filippo; Kelly, Karen; Le Chevalier, Thierry; Manegold, Christian; Perrone, Francesco; Rosell, Rafael; Shepherd, Frances; De Petris, Luigi; Di Maio, Massimo; Langer, Corey

    2005-05-01

    The best treatment for elderly patients with advanced non-small-cell lung cancer (NSCLC) is still debated. To guide clinical management of these patients and suggest the priorities for clinical research in this field, an International Expert Panel met in Naples, Italy, on April 19 to 20, 2004. Results and conclusions based on a review of evidence available in the literature to date are presented in this article. A comprehensive geriatric assessment is recommended to better define prognosis and to predict tolerance to treatment. In the first randomized study dedicated to elderly NSCLC patients, single-agent vinorelbine showed superiority over supportive care alone, both in terms of survival and quality of life. In a large randomized trial, gemcitabine plus vinorelbine failed to show any advantage over either agent alone. Subset analyses suggest that the efficacy of platinum-based combination chemotherapy is similar in fit older and younger patients, with an acceptable increase in toxicity for elderly patients. These data should be interpreted cautiously because retrospective subgroup analyses are encumbered by selection bias; hence, randomized trials dedicated to platinum-based chemotherapy for nonselected elderly patients are warranted. Several promising biologic therapies are under investigation; however, with present data, target-based agents as first-line treatment for elderly NSCLC patients are not yet recommended. Clinical research, with trials specifically designed for elderly patients, is mandatory. With the current evidence, single-agent chemotherapy with a third-generation drug (vinorelbine, gemcitabine, a taxane) should be the recommended option for nonselected elderly patients with advanced NSCLC. Platinum-based chemotherapy is a viable option for fit patients with adequate organ function. Best supportive care remains important, in addition to chemotherapy or as the exclusive option for patients who are unsuitable for more aggressive treatment.

  10. Thinking through ethics : the processes of ethical decision-making by novice and expert American sign language interpreters

    OpenAIRE

    Mendoza, Mary Elizabeth

    2010-01-01

    In the course of their work, sign language interpreters are faced with ethical dilemmas that require prioritizing competing moral beliefs and views on professional practice. There are several decision-making models, however, little research has been done on how sign language interpreters learn to identify and make ethical decisions. Through surveys and interviews on ethical decision-making, this study investigates how expert and novice interpreters discuss their ethical decision-making proces...

  11. 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.

  12. Food, plant food, and vegetarian diets in the US dietary guidelines: conclusions of an expert panel

    National Research Council Canada - National Science Library

    Jacobs, Jr, David R; Haddad, Ella H; Lanou, Amy Joy; Messina, Mark J

    2009-01-01

    We summarize conclusions drawn from a panel discussion at the "Fifth International Congress on Vegetarian Nutrition" about the roles of and emphasis on food, plant food, and vegetarianism in current...

  13. Interpretation on Expert Consensus for Diagnosis and Treatment of Melanoma in China

    Directory of Open Access Journals (Sweden)

    Fu-rong DU

    2016-09-01

    Full Text Available In recent years, melanoma has become a tumor with the fastest increase of morbidity in all malignant tumors, and its annual increase is 3%-5%. Both morbidity and mortality of melanoma are low in China, but they are showing an increasing tendency in recent years. However, the morbidity of melanoma is increasing in most European and American countries, but the mortality keeps stable and is not in an increasing tendency along with the increasing morbidity, demonstrating that there are great differences between China and Western countries in the diagnosis and treatment of melanoma. At present, melanoma has become one of the diseases that severely threaten human health. Compared with other common malignant tumors, there are significant differences in the clinical diagnosis and specific treatment of melanoma. To better adapt the rapid development of treatment for melanoma, and to make the clinical practice of melanoma more specific and internationalized in China, Expert Committee on Melanoma, Chinese Society of Clinical Oncology, has updated the Guidelines for Diagnosis and Treatment of Melanoma in China. Therefore, the editorial board of this journal interpreted this guideline in details, aiming to provide the latest and most practical evidence-based evidence for clinical oncologists in China.

  14. Preliminary Experience Using Eye-Tracking Technology to Differentiate Novice and Expert Image Interpretation for Ultrasound-Guided Regional Anesthesia.

    Science.gov (United States)

    Borg, Lindsay K; Harrison, T Kyle; Kou, Alex; Mariano, Edward R; Udani, Ankeet D; Kim, T Edward; Shum, Cynthia; Howard, Steven K

    2017-08-04

    Objective measures are needed to guide the novice's pathway to expertise. Within and outside medicine, eye tracking has been used for both training and assessment. We designed this study to test the hypothesis that eye tracking may differentiate novices from experts in static image interpretation for ultrasound (US)-guided regional anesthesia. We recruited novice anesthesiology residents and regional anesthesiology experts. Participants wore eye-tracking glasses, were shown 5 sonograms of US-guided regional anesthesia, and were asked a series of anatomy-based questions related to each image while their eye movements were recorded. The answer to each question was a location on the sonogram, defined as the area of interest (AOI). The primary outcome was the total gaze time in the AOI (seconds). Secondary outcomes were the total gaze time outside the AOI (seconds), total time to answer (seconds), and time to first fixation on the AOI (seconds). Five novices and 5 experts completed the study. Although the gaze time (mean ± SD) in the AOI was not different between groups (7 ± 4 seconds for novices and 7 ± 3 seconds for experts; P = .150), the gaze time outside the AOI was greater for novices (75 ± 18 versus 44 ± 4 seconds for experts; P = .005). The total time to answer and total time to first fixation in the AOI were both shorter for experts. Experts in US-guided regional anesthesia take less time to identify sonoanatomy and spend less unfocused time away from a target compared to novices. Eye tracking is a potentially useful tool to differentiate novices from experts in the domain of US image interpretation. © 2017 by the American Institute of Ultrasound in Medicine.

  15. Highlights of the Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents.

    Science.gov (United States)

    National Heart, Lung, and Blood Inst. (DHHS/NIH), Bethesda, MD.

    Studies have shown that high blood cholesterol levels play a role in the development of coronary heart disease in adults, and that the process leading to atherosclerosis begins in childhood. To address the problem of high cholesterol levels in children, the Panel on Blood Cholesterol Levels recommends complementary approaches for individuals and…

  16. Optimal management of metastatic castration-resistant prostate cancer: Highlights from a European Expert Consensus Panel

    NARCIS (Netherlands)

    J.M. Fitzpatrick (John); J. Bellmunt (Joaquim); K. Fizazi (Karim); A. Heidenreich (Axel); C.N. Sternberg (Cora); B. Tombal (Bertrand); A. Alcaraz (Antonio); A. Bahl (Amit); S. Bracarda (Sergio); G. Di Lorenzo (Giuseppe); E. Efstathiou (Eleni); S.P. Finn (Stephen); S.D. Fossa (Sophie); S. Gillessen (Silke); P.-L. Kellokumpu-Lehtinen (Pirkko-Liisa); F.E. Lecouvet (Frédéric); S. Oudard (Stéphane); T.M. de Reijke (Theo); C.N. Robson (Craig); M. de Santis (Maria); B. Seruga (Bostjan); R. de Wit (Ronald)

    2014-01-01

    textabstractThe exponential growth of novel therapies for the treatment of metastatic castration-resistant prostate cancer (mCRPC) over the last decade has created an acute need for education and guidance of clinicians regarding optimal strategies for patient management. A multidisciplinary panel of

  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. Update on the use of PCSK9 inhibitors in adults: Recommendations from an Expert Panel of the National Lipid Association.

    Science.gov (United States)

    Orringer, Carl E; Jacobson, Terry A; Saseen, Joseph J; Brown, Alan S; Gotto, Antonio M; Ross, Joyce L; Underberg, James A

    An Expert Panel convened by the National Lipid Association was charged with updating the recommendations on the use of proprotein convertase subtilisin/kexin type 9 (PCSK9) antibody therapy that were provided by the 2015 National Lipid Association Recommendations for the Patient-Centered Management of Dyslipidemia: Part 2. Recent studies have demonstrated the efficacy of these agents in reducing low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol and have confirmed their excellent safety profile. A cardiovascular outcomes study has shown that these agents reduce incident atherosclerotic cardiovascular disease (ASCVD) events in patents with stable ASCVD and concomitant risk factors. The current update provides the Expert Panel's evidence-based recommendations on the clinical utility of PCSK9 inhibitors in patients with stable ASCVD, progressive ASCVD, LDL-C ≥ 190 mg/dL (including polygenic hypercholesterolemia, heterozygous familial hypercholesterolemia and the homozygous familial hypercholesterolemia phenotype) and very-high-risk patients with statin intolerance. Copyright © 2017 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  19. 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.

  20. Perceptions and cognitions from an interpretive talk: comparing visitor responses to expert reviews

    Science.gov (United States)

    Lisa K. Machnik; Brett A. Wright; William E. Hammitt

    2007-01-01

    Interpretation is a communication process which aims to reveal meanings and encourage relationships between visitors and natural or cultural resources rather than simply communicating factual information (Larsen 2003, National Association for Interpretation 2000, Tilden 1957). Effective interpretation offers visitors opportunities to connect with and perceive the...

  1. Data- and expert-driven rule induction and filtering framework for functional interpretation and description of gene sets.

    Science.gov (United States)

    Gruca, Aleksandra; Sikora, Marek

    2017-06-26

    High-throughput methods in molecular biology provided researchers with abundance of experimental data that need to be interpreted in order to understand the experimental results. Manual methods of functional gene/protein group interpretation are expensive and time-consuming; therefore, there is a need to develop new efficient data mining methods and bioinformatics tools that could support the expert in the process of functional analysis of experimental results. In this study, we propose a comprehensive framework for the induction of logical rules in the form of combinations of Gene Ontology (GO) terms for functional interpretation of gene sets. Within the framework, we present four approaches: the fully automated method of rule induction without filtering, rule induction method with filtering, expert-driven rule filtering method based on additive utility functions, and expert-driven rule induction method based on the so-called seed or expert terms - the GO terms of special interest which should be included into the description. These GO terms usually describe some processes or pathways of particular interest, which are related to the experiment that is being performed. During the rule induction and filtering processes such seed terms are used as a base on which the description is build. We compare the descriptions obtained with different algorithms of rule induction and filtering and show that a filtering step is required to reduce the number of rules in the output set so that they could be analyzed by a human expert. However, filtering may remove information from the output rule set which is potentially interesting for the expert. Therefore, in the study, we present two methods that involve interaction with the expert during the process of rule induction. Both of them are able to reduce the number of rules, but only in the case of the method based on seed terms, each of the created rule includes expert terms in combination with the other terms. Further analysis of

  2. Sutureless, rapid deployment valves and stented bioprosthesis in aortic valve replacement: recommendations of an International Expert Consensus Panel.

    Science.gov (United States)

    Gersak, Borut; Fischlein, Theodor; Folliguet, Thierry A; Meuris, Bart; Teoh, Kevin H T; Moten, Simon C; Solinas, Marco; Miceli, Antonio; Oberwalder, Peter J; Rambaldini, Manfredo; Bhatnagar, Gopal; Borger, Michael A; Bouchard, Denis; Bouchot, Olivier; Clark, Stephen C; Dapunt, Otto E; Ferrarini, Matteo; Laufer, Guenther; Mignosa, Carmelo; Millner, Russell; Noirhomme, Philippe; Pfeiffer, Steffen; Ruyra-Baliarda, Xavier; Shrestha, Malakh; Suri, Rakesh M; Troise, Giovanni; Diegeler, Anno; Laborde, Francois; Laskar, Marc; Najm, Hani K; Glauber, Mattia

    2016-03-01

    After a panel process, recommendations on the use of sutureless and rapid deployment valves in aortic valve replacement were given with special respect as an alternative to stented valves. Thirty-one international experts in both sutureless, rapid deployment valves and stented bioprostheses constituted the panel. After a thorough literature review, evidence-based recommendations were rated in a three-step modified Delphi approach by the experts. Literature research could identify 67 clinical trials, 4 guidelines and 10 systematic reviews for detailed text analysis to obtain a total of 28 recommendations. After rating by the experts, 12 recommendations were identified and degree of consensus for each was determined. Proctoring and education are necessary for the introduction of sutureless valves on an institutional basis as well as for the individual training of surgeons. Sutureless and rapid deployment should be considered as the valve prosthesis of first choice for isolated procedures in patients with comorbidities, old age, delicate aortic wall conditions such as calcified root, porcelain aorta or prior implantation of aortic homograft and stentless valves as well as for concomitant procedures and small aortic roots to reduce cross-clamp time. Intraoperative transoesophageal echocardiography is highly recommended, and in case of right anterior thoracotomy, preoperative computer tomography is strongly recommended. Suitable annular sizes are 19-27 mm. There is a contraindication for bicuspid valves only for Type 0 and for annular abscess or destruction due to infective endocarditis. Careful but complete decalcification of the aortic root is recommended to avoid paravalvular leakage; extensive decalcification should be avoided not to create annular defects. Proximal anastomoses of concomitant coronary artery bypass grafting should be placed during a single aortic cross-clamp period or alternatively with careful side clamping. Available evidence suggests that the use

  3. Initial Approach to Childhood Obesity in Spain. A Multisociety Expert Panel Assessment.

    Science.gov (United States)

    Vilallonga, Ramon; Moreno Villares, José Manuel; Yeste Fernández, Diego; Sánchez Santos, Raquel; Casanueva Freijo, Felipe; Santolaya Ochando, Francisco; Leal Hernando, Nuria; Lecube Torelló, Albert; Castaño González, Luis Antonio; Feliu, Albert; Lopez-Nava, Gontrand; Frutos, Dolores; Torres Garcia, Antonio J; Ruiz de Adana, Juan Carlos

    2017-04-01

    In recent years, the incidence of childhood obesity in Europe, and Spain in particular, has increased dramatically. Bariatric surgery could play a major role in treating of adolescents with severe obesity. However, no specific guidelines for bariatric surgery currently exist in Spain. The Board of the Spanish Society for Obesity Surgery and Metabolic Diseases (SECO) proposed a study of childhood obesity by using the Delphi method. This prospective study involved 60 experts from nine national societies. Each society leader recruited experts from their society in obesity-related fields. Two online questionnaires were taken, and consensus on guidelines for various obesity treatments was reached according to the percentage of answers in favor or against inclusion of a given guideline. Based on these results, preoperative, surgical management and follow-up of childhood obesity management among others were analyzed. The survey results indicated significant concern among all societies regarding obesity. There was strong consensus with regard to adolescents and obesity, medical treatment, dietary recommendations, environmental and social factors, and goals for adolescents with obesity. Consensus on the use of intragastric balloons and other techniques was not reached. However, biliopancreatic diversion was rejected as a primary treatment, and mandatory psychological/psychiatric assessment was agreed upon. Inclusion criteria accepted were similar to those for adults with the exception of surgery in those with a body mass index obesity-related societies are aware of the societal problem of childhood obesity. Multisociety development of national approaches may arise from consensus-building studies among specialists.

  4. Expert Radiation Oncologist Interpretations of Involved-Site Radiation Therapy Guidelines in the Management of Hodgkin Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Hoppe, Bradford S. [University of Florida Health Proton Therapy Institute, Jacksonville, Florida (United States); Hoppe, Richard T., E-mail: rhoppe@stanford.edu [Stanford Cancer Institute, Stanford, California (United States)

    2015-05-01

    Purpose: Recently, involved-site radiation therapy (ISRT) guidelines have been developed and published to replace the previous concept of involved-field radiation therapy for patients with lymphoma. However, these ISRT guidelines may be interpreted in different ways, posing difficulties for prospective clinical trials. This study reports survey results regarding interpretation of the ISRT guidelines. Methods and Materials: Forty-four expert lymphoma radiation oncologists were asked to participate in a survey that included 7 different cases associated with 9 questions. The questions pertained to ISRT contouring and asked respondents to choose between 2 different answers (no “correct” answer) and a third write-in option allowed. Results: Fifty-two percent of those surveyed responded to the questionnaire. Among those who responded, 72% have practiced for >10 years, 46% have treated >20 Hodgkin lymphoma cases annually, and 100% were familiar with the ISRT concept. Among the 9 questions associated with the 7 cases, 3 had concordance among the expert radiation oncologists of greater than 70%. Six of the questions had less than 70% concordance (range, 56%-67%). Conclusions: Even among expert radiation oncologists, interpretation of ISRT guidelines is variable. Further guidance for ISRT field design will be needed to reduce variability among practicing physicians.

  5. 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.

  6. Multi-criteria decision analysis for health technology assessment in Canada: insights from an expert panel discussion.

    Science.gov (United States)

    Diaby, Vakaramoko; Goeree, Ron; Hoch, Jeffrey; Siebert, Uwe

    2015-02-01

    Multi-criteria decision analysis (MCDA), a decision-making tool, has received increasing attention in recent years, notably in the healthcare field. For Canada, it is unclear whether and how MCDA should be incorporated into the existing health technology assessment (HTA) decision-making process. To facilitate debate on improving HTA decision-making in Canada, a workshop was held in conjunction with the 8th World Congress on Health Economics of the International Health Economics Association in Toronto, Canada in July 2011. The objective of the workshop was to discuss the potential benefits and challenges related to the use of MCDA for HTA decision-making in Canada. This paper summarizes and discusses the recommendations of an expert panel convened at the workshop to discuss opportunities and concerns with reference to the implementation of MCDA in Canada.

  7. Evaluation and management of acute menorrhagia in women with and without underlying bleeding disorders: consensus from an international expert panel.

    Science.gov (United States)

    James, Andra H; Kouides, Peter A; Abdul-Kadir, Rezan; Dietrich, Jennifer E; Edlund, Mans; Federici, Augusto B; Halimeh, Susan; Kamphuisen, Pieter Willem; Lee, Christine A; Martínez-Perez, Oscar; McLintock, Claire; Peyvandi, Flora; Philipp, Claire; Wilkinson, Jeffrey; Winikoff, Rochelle

    2011-10-01

    Acute menorrhagia is a common gynecological disorder. Prevalence is high among women with inherited bleeding disorders and recent guidance for optimal management is lacking. Following a comprehensive review of the literature, an international expert panel in obstetrics, gynecology and hematology reached consensus on recommendations regarding the management of acute menorrhagia in women without a diagnosed bleeding disorder, as well as in patients with von Willebrand disease, platelet function disorders and other rare hemostatic disorders. The causes and predictors of acute menorrhagia are discussed and special consideration is given for the treatment of women on anticoagulation therapy. This review and accompanying recommendations will provide guidance for healthcare practitioners in the emergency management of acute menorrhagia. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  8. Identifying locally advanced basal cell carcinoma eligible for treatment with vismodegib: an expert panel consensus.

    Science.gov (United States)

    Peris, Ketty; Licitra, Lisa; Ascierto, Paolo A; Corvò, Renzo; Simonacci, Marco; Picciotto, Franco; Gualdi, Giulio; Pellacani, Giovanni; Santoro, Armando

    2015-01-01

    Basal cell carcinoma (BCC) is the most common skin cancer worldwide. Most occur on the head and neck, where cosmetic and functional outcomes are critical. BCC can be locally destructive if not diagnosed early and treated appropriately. Surgery is the treatment of choice for the majority of high-risk lesions. Aggressive, recurrent or unresectable tumors can be difficult to manage. Until recently, no approved systemic therapy was available for locally advanced or metastatic BCC inappropriate for surgery or radiotherapy. Vismodegib provides a systemic treatment option. However, a consensus definition of advanced BCC is lacking. A multidisciplinary panel with expertise in oncology, dermatology, dermatologic surgery and radiation oncology proposes a consensus definition based on published evidence and clinical experience.

  9. Food, plant food, and vegetarian diets in the US dietary guidelines: conclusions of an expert panel.

    Science.gov (United States)

    Jacobs, David R; Haddad, Ella H; Lanou, Amy Joy; Messina, Mark J

    2009-05-01

    We summarize conclusions drawn from a panel discussion at the "Fifth International Congress on Vegetarian Nutrition" about the roles of and emphasis on food, plant food, and vegetarianism in current and future US dietary guidelines. The most general recommendation of the panel was that future dietary guidelines, following the lead of the 2005 Dietary Guidelines Advisory Committee, should emphasize food-based recommendations and thinking to the full extent that evidence allows. Although nutrient-based thinking and Dietary Reference Intakes (DRIs) may help ensure an adequate diet in the sense that deficiency states are avoided, the emphasis on DRIs may not capture many important nutritional issues and may inhibit a focus on foods. More generally, in the context of the conference on vegetarian nutrition, this report focuses on the history and structure of the Dietary Guidelines Advisory Committee, on various plant food-oriented recommendations that are supported by literature evidence, and on mechanisms for participating in the process of forming dietary guidelines. Among recommendations that likely would improve health and the environment, some are oriented toward increased plant food consumption and some toward vegetarianism. The literature on health effects of individual foods and whole lifestyle diets is insufficient and justifies a call for future food-oriented research, including expanding the evidence base for plant-based and vegetarian diets. The Dietary Guidelines Advisory Committee's role should be carried forward to creation of a publicly accessible icon (eg, the current pyramid) and related materials to ensure that the science base is fully translated for the public.

  10. 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

  11. 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...

  12. 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.

  13. Expert Panel Workshop Consensus Statement on the Role of the Environment in the Development of Autoimmune Disease

    Directory of Open Access Journals (Sweden)

    Christine G. Parks

    2014-08-01

    Full Text Available Autoimmune diseases include 80 or more complex disorders characterized by self-reactive, pathologic immune responses in which genetic susceptibility is largely insufficient to determine disease onset. In September 2010, the National Institute of Environmental Health Sciences (NIEHS organized an expert panel workshop to evaluate the role of environmental factors in autoimmune diseases, and the state of the science regarding relevant mechanisms, animal models, and human studies. The objective of the workshop was to analyze the existing data to identify conclusions that could be drawn regarding environmental exposures and autoimmunity and to identify critical knowledge gaps and areas of uncertainty for future study. This consensus document summarizes key findings from published workshop monographs on areas in which “confident” and “likely” assessments were made, with recommendations for further research. Transcribed notes and slides were reviewed to synthesize an overview on exposure assessment and questions addressed by interdisciplinary panels. Critical advances in the field of autoimmune disease research have been made in the past decade. Collaborative translational and interdisciplinary research is needed to elucidate the role of environmental factors in autoimmune diseases. A focus on exposure assessment methodology is needed to improve the effectiveness of human studies, and more experimental studies are needed to focus on causal mechanisms underlying observed associations of environmental factors with autoimmune disease in humans.

  14. Expert Panel Workshop Consensus Statement on the Role of the Environment in the Development of Autoimmune Disease

    Science.gov (United States)

    Parks, Christine G.; Miller, Frederick W.; Pollard, Kenneth Michael; Selmi, Carlo; Germolec, Dori; Joyce, Kelly; Rose, Noel R.; Humble, Michael C.

    2014-01-01

    Autoimmune diseases include 80 or more complex disorders characterized by self-reactive, pathologic immune responses in which genetic susceptibility is largely insufficient to determine disease onset. In September 2010, the National Institute of Environmental Health Sciences (NIEHS) organized an expert panel workshop to evaluate the role of environmental factors in autoimmune diseases, and the state of the science regarding relevant mechanisms, animal models, and human studies. The objective of the workshop was to analyze the existing data to identify conclusions that could be drawn regarding environmental exposures and autoimmunity and to identify critical knowledge gaps and areas of uncertainty for future study. This consensus document summarizes key findings from published workshop monographs on areas in which “confident” and “likely” assessments were made, with recommendations for further research. Transcribed notes and slides were reviewed to synthesize an overview on exposure assessment and questions addressed by interdisciplinary panels. Critical advances in the field of autoimmune disease research have been made in the past decade. Collaborative translational and interdisciplinary research is needed to elucidate the role of environmental factors in autoimmune diseases. A focus on exposure assessment methodology is needed to improve the effectiveness of human studies, and more experimental studies are needed to focus on causal mechanisms underlying observed associations of environmental factors with autoimmune disease in humans. PMID:25196523

  15. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  17. Daylight PDT with MAL - current data and practical recommendations of an expert panel.

    Science.gov (United States)

    Philipp-Dormston, Wolfgang G; Karrer, Sigrid; Petering, Holger; Ulrich, Claas; Dirschka, Thomas; Berking, Carola; Lonsdorf, Anke S; Gerber, Peter Arne; Radakovic, Sonja; Hunger, Robert E; Szeimies, Rolf-Markus

    2015-12-01

    Photodynamic Therapy (PDT) is one of the standard treatment modalities for actinic keratoses (AKs). Daylight PDT (DL-PDT) with MAL cream is a rather recent development, which, instead of an artificial light source, uses daylight for the activation of the photosensitizer. The present review summarizes available data based on a selective literature search, highlights practical aspects, and reflects the authors' expert knowledge in using DL-PDT. With respect to efficacy, study data shows that DL-PDT is noninferior to conventional PDT (cPDT). However, given that DL-PDT is markedly less painful, it is significantly better tolerated than cPDT. In Europe, DL-PDT can be performed from March to October, on sunny as well as on cloudy days. UV protection of untreated areas of the body should be observed. Outside temperature should not fall below 10°C. On hot days, patients should be advised to stay in the shade if necessary. Representing a useful addition to current therapeutic options, DL-PDT with MAL cream is, among others, suitable for patients with field cancerization and/or those who have experienced severe pain associated with cPDT. © 2015 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  18. What Do Geoscience Experts and Novices Look At and What Do They See When Viewing and Interpreting Data Visualizations?

    Science.gov (United States)

    Kastens, K. A.; Shipley, T. F.; Boone, A.

    2012-12-01

    also offer interpretations of causal Earth processes. We identified four types of novice answers: (a) "flat" answers, in which the student describes the patches of color on the screen with no mention of shape or relief; (b) "thing" answers, in which the student mentions an inappropriate object, such as "the Great Wall of China," (c) geomorphology answers, in which the student talks about depth/altitude, relief, or shapes of landforms, and (d) process answers, in which student talks about earth processes, such as earthquakes, erosion, or plate tectonics. Novice "geomorphology" (c) answers resemble expert responses, but lack the rich descriptive detail. The "process" (d) category includes many interpretations that lack any grounding in the evidentiary base available in the viewed data. These findings suggest that instruction around earth data should include an emphasis on thoroughly and accurately describing the features that are present in the data--a skill that our experts display and our novices mostly lack. It is unclear, though, how best to sequence the teaching of descriptive and interpretive skills, since the experts' attention to empirical features in the data is steered by their knowledge of which features have causal significance.

  19. Assessing computerized eye tracking technology for gaining insight into expert interpretation of the 12-lead electrocardiogram: an objective quantitative approach.

    Science.gov (United States)

    Bond, R R; Zhu, T; Finlay, D D; Drew, B; Kligfield, P D; Guldenring, D; Breen, C; Gallagher, A G; Daly, M J; Clifford, G D

    2014-01-01

    It is well known that accurate interpretation of the 12-lead electrocardiogram (ECG) requires a high degree of skill. There is also a moderate degree of variability among those who interpret the ECG. While this is the case, there are no best practice guidelines for the actual ECG interpretation process. Hence, this study adopts computerized eye tracking technology to investigate whether eye-gaze can be used to gain a deeper insight into how expert annotators interpret the ECG. Annotators were recruited in San Jose, California at the 2013 International Society of Computerised Electrocardiology (ISCE). Each annotator was recruited to interpret a number of 12-lead ECGs (N=12) while their eye gaze was recorded using a Tobii X60 eye tracker. The device is based on corneal reflection and is non-intrusive. With a sampling rate of 60Hz, eye gaze coordinates were acquired every 16.7ms. Fixations were determined using a predefined computerized classification algorithm, which was then used to generate heat maps of where the annotators looked. The ECGs used in this study form four groups (3=ST elevation myocardial infarction [STEMI], 3=hypertrophy, 3=arrhythmias and 3=exhibiting unique artefacts). There was also an equal distribution of difficulty levels (3=easy to interpret, 3=average and 3=difficult). ECGs were displayed using the 4x3+1 display format and computerized annotations were concealed. Precisely 252 expert ECG interpretations (21 annotators×12 ECGs) were recorded. Average duration for ECG interpretation was 58s (SD=23). Fleiss' generalized kappa coefficient (Pa=0.56) indicated a moderate inter-rater reliability among the annotators. There was a 79% inter-rater agreement for STEMI cases, 71% agreement for arrhythmia cases, 65% for the lead misplacement and dextrocardia cases and only 37% agreement for the hypertrophy cases. In analyzing the total fixation duration, it was found that on average annotators study lead V1 the most (4.29s), followed by leads V2 (3.83s

  20. Direct and Indirect Costs of Asthma Management in Greece: An Expert Panel Approach.

    Science.gov (United States)

    Souliotis, Kyriakos; Kousoulakou, Hara; Hillas, Georgios; Bakakos, Petros; Toumbis, Michalis; Loukides, Stelios; Vassilakopoulos, Theodoros

    2017-01-01

    Asthma is a major cause of morbidity and mortality and is associated with significant economic burden worldwide. The objectives of this study were to map current resource use associated with the disease management and to estimate the annual direct and indirect costs per adult patient with asthma. A Delphi panel with seven leading pulmonologists was conducted. A semistructured questionnaire was developed to elicit data on resource use and treatment patterns. Unit costs from official, published sources were subsequently assigned to resource use to estimate direct medical costs. Indirect costs were estimated as number of work loss days. Cost base year was 2015, and the perspective adopted was that of the National Organization of Health Care Services Provision, as well as the societal. Patients with asthma are mainly managed by pulmonologists (71.4%) and secondarily by general practitioners and internists (28.6%). The annual cost of managing exacerbations was estimated at €273.1, while maintenance costs were estimated at €1,100.2 per year. Total costs of managing asthma per patient per year were estimated at €2,281.8, 64.4% of which represented direct medical costs. Of the direct costs, pharmaceutical treatment was the key driver, accounting for 63.9 and 41.2% of direct and total costs, respectively. Direct non-medical costs (patient travel and waiting time) were estimated at €152.3. Indirect costs accounted for 28.9% of total costs. Asthma is a chronic condition, the management of which constrains the already limited Greek health care resources. The increasing prevalence of the disease raises concerns as it could translate per patient costs into a significant burden for the Greek health care system. Thus, the prevention, self-management, and improved quality of care for asthma should find a place in the health policy agenda in Greece.

  1. Guidelines for the prevention and treatment of travelers' diarrhea: a graded expert panel report.

    Science.gov (United States)

    Riddle, Mark S; Connor, Bradley A; Beeching, Nicholas J; DuPont, Herbert L; Hamer, Davidson H; Kozarsky, Phyllis; Libman, Michael; Steffen, Robert; Taylor, David; Tribble, David R; Vila, Jordi; Zanger, Philipp; Ericsson, Charles D

    2017-04-01

    : Travelers' diarrhea causes significant morbidity including some sequelae, lost travel time and opportunity cost to both travelers and countries receiving travelers. Effective prevention and treatment are needed to reduce these negative impacts. : This critical appraisal of the literature and expert consensus guideline development effort asked several key questions related to antibiotic and non-antibiotic prophylaxis and treatment, utility of available diagnostics, impact of multi-drug resistant (MDR) colonization associated with travel and travelers' diarrhea, and how our understanding of the gastrointestinal microbiome should influence current practice and future research. Studies related to these key clinical areas were assessed for relevance and quality. Based on this critical appraisal, guidelines were developed and voted on using current standards for clinical guideline development methodology. : New definitions for severity of travelers' diarrhea were developed. A total of 20 graded recommendations on the topics of prophylaxis, diagnosis, therapy and follow-up were developed. In addition, three non-graded consensus-based statements were adopted. : Prevention and treatment of travelers' diarrhea requires action at the provider, traveler and research community levels. Strong evidence supports the effectiveness of antimicrobial therapy in most cases of moderate to severe travelers' diarrhea, while either increasing intake of fluids only or loperamide or bismuth subsalicylate may suffice for most cases of mild diarrhea. Further studies are needed to address knowledge gaps regarding optimal therapies, the individual, community and global health risks of MDR acquisition, manipulation of the microbiome in prevention and treatment and the utility of laboratory testing in returning travelers with persistent diarrhea.

  2. Delphi consensus on the physical health of patients with schizophrenia: evaluation of the recommendations of the Spanish Societies of Psychiatry and Biological Psychiatry by a panel of experts.

    Science.gov (United States)

    Bobes-García, Julio; Saiz-Ruiz, Jerónimo; Bernardo-Arroyo, Miquel; Caballero-Martínez, Fernando; Gilaberte-Asín, Inmaculada; Ciudad-Herrera, Antonio

    2012-01-01

    Available data from scientific literature show that patients with schizophrenia have higher rates of physical comorbidity and excess mortality due to other physical pathologies. The growing interest to investigate and improve the health of these patients has led a group of Spanish experts to publish in 2008 a "Consensus on physical health of patients with schizophrenia from the Spanish Societies of Psychiatry and Biological Psychiatry" (2008 Consensus). These recommendations imply a significant change to the present model of medical attention. To gauge the level of agreement of a group of expert psychiatrists on the clinical criteria and recommendations collected from the scientific literature and the 2008 Consensus on the physical health of patients with schizophrenia. The process involved four phases: 1) Scientific Committee established to manage the study and to define the 66-item questionnaire; 2) Panel of 15 experts in psychiatry is established; 3) Submission of questionnaire to the Expert Panel in two consecutive rounds, with an intermediate processing and sharing of results; 4) Evaluation of results, discussion and conclusions between Scientific Committee and Expert Panel. All items, as set by the Scientific Committee and aligned with the recommendations published in the 2008 Consensus, achieved consensus on agreement from the Expert Panel, except 5 items, for which most of the answers were placed in the indeterminate position rate. The expert criteria shown in this study indicate a global agreement with regard to clinical criteria on the physical health of patients with schizophrenia, as well as with the present recommendations to improve the health of patients having, or at risk to have, other concomitant pathologies. The need to incorporate new intervention guidelines that facilitate a better control and improvement of the physical health of patients with schizophrenia must be disseminated in the psychiatric providers' collectives.

  3. 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…

  4. 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...

  5. Identifying Effective Nurse-Led Care Transition Interventions for Older Adults With Complex Needs Using a Structured Expert Panel.

    Science.gov (United States)

    Jeffs, Lianne; Kuluski, Kerry; Law, Madelyn; Saragosa, Marianne; Espin, Sherry; Ferris, Ella; Merkley, Jane; Dusek, Brenda; Kastner, Monika; Bell, Chaim M

    2017-04-01

    Nursing plays a central role in facilitating care transitions for complex older adults, yet there is no consensus of the components of nurse-led care transitions interventions to facilitate high quality care transitions among complex older adults. A structured expert panel was established with the purpose of identifying effective nurse-led care transition interventions. A modified Delphi consensus technique based on the RAND method was employed. Panelists (n = 23) were asked to individually rate a series of statements derived from a realist synthesis of the literature for relevance, feasibility and likely impact. Statements receiving an aggregate score of ≥75% (7/9) were reviewed and revised at a face-to-face consensus meeting. A second round of rating following the same process as round one was used, followed by a final ranking of the statements. The five highest ranked intervention components and contextual factors were: (a) educating and coaching patients, their family members and caregivers about self-management skills; (b) ensuring patients, their family members and caregivers are aware of follow-up medical appointments and postdischarge care plan; (c) using standardized documentation tools and comprehensive communication strategies during care transitions; (d) optimizing nurses' roles and scopes of practice across the care transitions spectrum; and (e) having strong leadership, strategic alignment and accountability structures in organizations to enable quality care transitions for the complex older person population. Key insights on optimizing the nurses' roles and scope of practice during care transitions included having nurses provide "warm hand-offs" and serve as the "go-to person." The panel also identified current challenges to optimizing the nurses' roles and scope of practice across care transition points. Future research is required to determine effective nurse-led intervention components and in which context do they work or do not. © 2017 Sigma

  6. 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.

  7. [Use of interpreters in the context of insurance psychiatric expert assessment].

    Science.gov (United States)

    Schleifer, Roman; Dittmann, Volker; Ebner, Gerhard; Seifritz, Erich; Liebrenz, Michael

    2015-03-11

    Limited knowledge of the German language represents a serious barrier for migrants into Switzerland to communicate successfully in a variety of health care settings, which may result not just in delayed access to treatment and poorer outcome, but also in difficulties judging eligibility for health and other social benefits. Especially when conducting disability and other occupational capacity evaluations, clinicians of all medical fields, but particularly psychiatrists, are required to obtain abundant information to allow them to perform a thorough mental health examination and to form a differentiated view of an evaluee's work capacity. Within a clinical context different translation and interpreting strategies are in use, and each strategy has its advantages and disadvantages. This mini-review describes the legal and modal aspects as well as the clinical-practical implications of the use of such interpreting services during disability evaluations.

  8. 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; Dewda, Pavitra Raj; Thakor, Priti; Esteves, Sandro C

    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.

  9. Polyanalgesic Consensus Conference 2003: an update on the management of pain by intraspinal drug delivery-- report of an expert panel.

    Science.gov (United States)

    Hassenbusch, Samuel J; Portenoy, Russell K; Cousins, Michael; Buchser, Eric; Deer, Timothy R; Du Pen, Stuart L; Eisenach, James; Follett, Kenneth A; Hildebrand, Keith R; Krames, Elliot S; Levy, Robert M; Palmer, Pamela P; Rathmell, James P; Rauck, Richard L; Staats, Peter S; Stearns, Lisa; Willis, K Dean

    2004-06-01

    Intraspinal drug infusion using fully implantable pump and catheter systems is a safe and effective therapy for selected patients with chronic pain. The options for this approach are increasing, as drugs that are commercially available for systemic administration are adapted to this use and other drugs that are in development specifically for intraspinal administration become available. In 2000 a Polyanalgesic Consensus Conference was organized to evaluate the existing literature and develop guidelines for drug selection. The major outcome of this effort, an algorithm for drug selection, was based on the best available evidence at the time. Rapid changes have occurred in the science and practice of intraspinal infusion and a Polyanalgesic Consensus Conference 2003 was organized to pursue the following goals: 1) to review the literature on intraspinal drug infusion since 1999, 2) to revise the 2000 drug-selection algorithm, 3) to develop guidelines for optimizing drug dosage and concentration, 4) to create a process for documenting minimum evidence supporting the use of a drug for intraspinal infusion, and 5) to clarify issues pertaining to compounding of drugs. Based on the best available evidence and expert opinion, consensus recommendations were developed in all these areas. The panel's conclusions may provide a foundation for clinical practice and a rational basis for new research.

  10. [The frequency of medical malpractice: the results of the German Expert Panels and Arbitration Boards for Medical Liability].

    Science.gov (United States)

    Schaffartzik, Walter; Neu, Johann

    2008-01-01

    The Gutachterkommissionen and Schlichtungsstellen in Germany (Expert Panels and Arbitration Boards for Medical Liability) were founded in the 1970s in order to serve as an institution other than the courts where suspected incidents of malpractice can be evaluated. The "Medical Error Reporting System" (MERS) was developed by the North German Schlichtungsstelle. The data it provides serve as the basis for the national statistics published by the Bundesärztekammer (German Medical Association). 7201 factual decisions were made. In 5074 proceedings no malpractice cases or risk disclosure problems were discovered, while in 2127 proceedings either of the two problems was noticed, and in 1,683 proceedings these problems were rated as being causative in the claimed harm and led to the recommendation to grant financial compensation to the patient. The MERS data reveal that most of the diagnoses which led patients to file a claim with the Gutachterkommissionen and Schlichtungsstellen referred to orthopaedics and traumatology and in the majority of cases reproaches were directed at surgical therapy. Doctors must strive to minimise malpractice and harm caused by medical treatment. With the help of the national statistics of the Bundesärztekammer derived from MERS the doctor can easily access information on cases of medical malpractice and harm in his or her discipline. This knowledge helps to foresee risks in a patient's treatment and to avoid errors.

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

    Energy Technology Data Exchange (ETDEWEB)

    Gosselin, P. [Inst. national de sante publique, Quebec, PQ (Canada); Hrudey, S.E. [Alberta Univ., Edmonton, AB (Canada). Faculty of Medicine and Dentistry, Div. of Analytical and Environmental Toxicology; Naeth, M.A. [Alberta Univ., Edmonton, AB (Canada). Faculty of Agricultural, Life, and Environmental Sciences; Plourde, A. [Alberta Univ., Edmonton, AB (Canada). Dept. of Economics; Therrien, R. [Natural Sciences and Engineering Research Council of Canada, Ottawa, ON (Canada); Laval Univ., Quebec City, PQ (Canada). Dept. of Geology and Geological Engineering; Van Der Kraak, G. [Guelph Univ., ON (Canada). Dept. of Integrative Biology; Guelph Univ., ON (Canada). College of Biological Science; Xu, Z. [Alberta Univ., Edmonton, AB (Canada). Faculty of Engineering

    2010-12-15

    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.

  12. 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

  13. The Development of Expertise in Radiology: In Chest Radiograph Interpretation, "Expert" Search Pattern May Predate "Expert" Levels of Diagnostic Accuracy for Pneumothorax Identification.

    Science.gov (United States)

    Kelly, Brendan S; Rainford, Louise A; Darcy, Sarah P; Kavanagh, Eoin C; Toomey, Rachel J

    2016-07-01

    Purpose To investigate the development of chest radiograph interpretation skill through medical training by measuring both diagnostic accuracy and eye movements during visual search. Materials and Methods An institutional exemption from full ethical review was granted for the study. Five consultant radiologists were deemed the reference expert group, and four radiology registrars, five senior house officers (SHOs), and six interns formed four clinician groups. Participants were shown 30 chest radiographs, 14 of which had a pneumothorax, and were asked to give their level of confidence as to whether a pneumothorax was present. Receiver operating characteristic (ROC) curve analysis was carried out on diagnostic decisions. Eye movements were recorded with a Tobii TX300 (Tobii Technology, Stockholm, Sweden) eye tracker. Four eye-tracking metrics were analyzed. Variables were compared to identify any differences between groups. All data were compared by using the Friedman nonparametric method. Results The average area under the ROC curve for the groups increased with experience (0.947 for consultants, 0.792 for registrars, 0.693 for SHOs, and 0.659 for interns; P = .009). A significant difference in diagnostic accuracy was found between consultants and registrars (P = .046). All four eye-tracking metrics decreased with experience, and there were significant differences between registrars and SHOs. Total reading time decreased with experience; it was significantly lower for registrars compared with SHOs (P = .046) and for SHOs compared with interns (P = .025). Conclusion Chest radiograph interpretation skill increased with experience, both in terms of diagnostic accuracy and visual search. The observed level of experience at which there was a significant difference was higher for diagnostic accuracy than for eye-tracking metrics. (©) RSNA, 2016 Online supplemental material is available for this article.

  14. Use of Management Pathways or Algorithms in Children With Chronic Cough: CHEST Guideline and Expert Panel Report.

    Science.gov (United States)

    Chang, Anne B; Oppenheimer, John J; Weinberger, Miles M; Rubin, Bruce K; Weir, Kelly; Grant, Cameron C; Irwin, Richard S

    2017-04-01

    Using management algorithms or pathways potentially improves clinical outcomes. We undertook systematic reviews to examine various aspects in the generic approach (use of cough algorithms and tests) to the management of chronic cough in children (aged ≤ 14 years) based on key questions (KQs) using the Population, Intervention, Comparison, Outcome format. We used the CHEST Expert Cough Panel's protocol for the systematic reviews and the American College of Chest Physicians (CHEST) methodological guidelines and Grading of Recommendations Assessment, Development and Evaluation framework. Data from the systematic reviews in conjunction with patients' values and preferences and the clinical context were used to form recommendations. Delphi methodology was used to obtain the final grading. Combining data from systematic reviews addressing five KQs, we found high-quality evidence that a systematic approach to the management of chronic cough improves clinical outcomes. Although there was evidence from several pathways, the highest evidence was from the use of the CHEST approach. However, there was no or little evidence to address some of the KQs posed. Compared with the 2006 Cough Guidelines, there is now high-quality evidence that in children aged ≤ 14 years with chronic cough (> 4 weeks' duration), the use of cough management protocols (or algorithms) improves clinical outcomes, and cough management or testing algorithms should differ depending on the associated characteristics of the cough and clinical history. A chest radiograph and, when age appropriate, spirometry (pre- and post-β2 agonist) should be undertaken. Other tests should not be routinely performed and undertaken in accordance with the clinical setting and the child's clinical symptoms and signs (eg, tests for tuberculosis when the child has been exposed). Copyright © 2017 American College of Chest Physicians. All rights reserved.

  15. Regulatory considerations surrounding the deployment of Bt-expressing cowpea in Africa: report of the deliberations of an expert panel.

    Science.gov (United States)

    Huesing, Joseph; Romeis, Jörg; Ellstrand, Norman; Raybould, Alan; Hellmich, Richard; Wolt, Jeff; Ehlers, Jeff; Dabiré, Clémentine; Fatokun, Christian; Hokanson, Karen; Ishiyaku, Mohammad F; Margam, Venu; Obokoh, Nompumelelo; Mignouna, Jacob; Nangayo, Francis; Ouedraogo, Jeremy; Pasquet, Rémy; Pittendrigh, Barry; Schaal, Barbara; Stein, Jeff; Tamò, Manuele; Murdock, Larry

    2011-01-01

    Cowpea (Vigna unguiculata spp unguiculata) is adapted to the drier agro-ecological zones of West Africa where it is a major source of dietary protein and widely used as a fodder crop. Improving the productivity of cowpea can enhance food availability and security in West Africa. Insect predation--predominately from the legume pod borer (Maruca vitrata), flower thrips (Megalurothrips sjostedti) and a complex of pod-sucking bugs (e.g., Clavigralla spp)--is a major yield-limiting factor in West African cowpea production. Dramatic increases in yield are shown when M. vitrata is controlled with insecticides. However, availability, costs, and safety considerations limit pesticides as a viable option for boosting cowpea production. Development of Bt-cowpea through genetic modification (GM) to control the legume pod borer is a promising approach to cowpea improvement. Cowpea expressing the lepidopteran-active Cry1Ab protein from Bacillus thuringiensis is being developed as a first generation Bt-cowpea crop for West Africa. Appropriate stewardship of Bt-cowpea to assure its sustainability under West African conditions is critical to its successful development. A first step in this process is an environmental risk assessment to determine the likelihood and magnitude of adverse effects of the Cry1Ab protein on key environmental protection goals in West Africa. Here we describe the results of an expert panel convened in 2009 to develop the problem formulation phase for Bt-cowpea and to address specific issues around gene flow, non-target arthropods, and insect resistance management.

  16. The suitability of caffeinated drinks for children: a systematic review of randomised controlled trials, observational studies and expert panel guidelines.

    Science.gov (United States)

    Ruxton, C H S

    2014-08-01

    The increased availability of caffeinated drinks raises questions about the level of caffeine that is appropriate for children, as well as the benefits and risks associated with their consumption. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, this systematic review evaluates evidence from randomised controlled trials investigating the effects of caffeine on cognition, behaviour, mood and exercise performance in children. Observational studies and expert panel guidelines are also discussed. One hundred and nine studies were found, with 11 randomised controlled trials and 13 observational studies meeting the criteria. High caffeine intakes (e.g. >5 mg kg(-1) body weight day(-1)) were associated with an increased risk of anxiety and withdrawal symptoms. However, smaller amounts were not linked with such effects and may benefit cognitive function and sports performance based on adult studies. The evidence suggests that children and adolescents should limit daily caffeine consumption to 2.5 mg kg(-1) body weight day(-1), equating to one or two cups of tea or one small cup of coffee. Lower contributors of caffeine, such as tea, may be more appropriate for children because they contribute to daily fluid intakes and provide flavonoids. By contrast, caffeinated soft drinks may be less suitable options for children as a result of their acidity, higher caffeine content, presence of added sugar (in some cases) and absence of bioactive compounds. More studies are needed to determine the intakes that represent a risk and whether there may be benefits for alertness and sports performance with moderate intakes of caffeine. © 2013 The British Dietetic Association Ltd.

  17. Polyanalgesic consensus conference 2007: recommendations for the management of pain by intrathecal (intraspinal) drug delivery: report of an interdisciplinary expert panel.

    Science.gov (United States)

    Deer, Timothy; Krames, Elliot S; Hassenbusch, Samuel J; Burton, Allen; Caraway, David; Dupen, Stuart; Eisenach, James; Erdek, Michael; Grigsby, Eric; Kim, Phillip; Levy, Robert; McDowell, Gladstone; Mekhail, Nagy; Panchal, Sunil; Prager, Joshua; Rauck, Richard; Saulino, Michael; Sitzman, Todd; Staats, Peter; Stanton-Hicks, Michael; Stearns, Lisa; Willis, K Dean; Witt, William; Follett, Kenneth; Huntoon, Marc; Liem, Leong; Rathmell, James; Wallace, Mark; Buchser, Eric; Cousins, Michael; Ver Donck, Anne

    2007-10-01

    Background.  Expert panels of physicians and nonphysicians in the field of intrathecal therapies convened in 2000 and 2003 to make recommendations for the rational use of intrathecal analgesics based on the preclinical and clinical literature known up to those times. An expert panel of physicians convened in 2007 to update previous recommendations and to form guidelines for the rational use of intrathecal opioid and nonopioid agents. Methods.  A review of preclinical and clinical published relevant studies from 2000 to 2006 was undertaken and disseminated to a convened expert panel of physicians and nonphysicians. Focused discussions were held on the rational use of intrathecal agents and a survey asking questions regarding intrathecal therapies management was given to the panelists. Results.  The panelists, after review of the literature from 2000 to 2006 and discussion, created an updated algorithm for the rational use of intrathecal opioid and nonopioid agents in patients with nonmalignant and end-of-life pain. Of note is that the panelists felt that ziconotide, based on new and relevant literature and experience, should be updated to a line one intrathecal drug.

  18. 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.

  19. 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

    Introduction: 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.

  20. Mimicking human expert interpretation of remotely sensed raster imagery by using a novel segmentation analysis within ArcGIS

    Science.gov (United States)

    Le Bas, Tim; Scarth, Anthony; Bunting, Peter

    2015-04-01

    Traditional computer based methods for the interpretation of remotely sensed imagery use each pixel individually or the average of a small window of pixels to calculate a class or thematic value, which provides an interpretation. However when a human expert interprets imagery, the human eye is excellent at finding coherent and homogenous areas and edge features. It may therefore be advantageous for computer analysis to mimic human interpretation. A new toolbox for ArcGIS 10.x will be presented that segments the data layers into a set of polygons. Each polygon is defined by a K-means clustering and region growing algorithm, thus finding areas, their edges and any lineations in the imagery. Attached to each polygon are the characteristics of the imagery such as mean and standard deviation of the pixel values, within the polygon. The segmentation of imagery into a jigsaw of polygons also has the advantage that the human interpreter does not need to spend hours digitising the boundaries. The segmentation process has been taken from the RSGIS library of analysis and classification routines (Bunting et al., 2014). These routines are freeware and have been modified to be available in the ArcToolbox under the Windows (v7) operating system. Input to the segmentation process is a multi-layered raster image, for example; a Landsat image, or a set of raster datasets made up from derivatives of topography. The size and number of polygons are set by the user and are dependent on the imagery used. Examples will be presented of data from the marine environment utilising bathymetric depth, slope, rugosity and backscatter from a multibeam system. Meaningful classification of the polygons using their numerical characteristics is the next goal. Object based image analysis (OBIA) should help this workflow. Fully calibrated imagery systems will allow numerical classification to be translated into more readily understandable terms. Peter Bunting, Daniel Clewley, Richard M. Lucas and Sam

  1. 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

  2. 77 FR 15753 - Request for Nominations of Experts for a Science Advisory Board Panel To Review EPA's Web-Based...

    Science.gov (United States)

    2012-03-16

    ... the condition of whole ecosystems; (f) statisticians with expertise in analysis of environmental..., subcommittees and advisory panels; and (f) for the Panel as a whole, diversity of expertise and viewpoints. The... Environmental Protection Agency Science Advisory Board (EPA-SAB-EC-02-010), which is posted on the SAB Web site...

  3. Patient engagement in the process of planning and designing outpatient care improvements at the Veterans Administration Health-care System: findings from an online expert panel.

    Science.gov (United States)

    Khodyakov, Dmitry; Stockdale, Susan E; Smith, Nina; Booth, Marika; Altman, Lisa; Rubenstein, Lisa V

    2017-02-01

    There is a strong interest in the Veterans Administration (VA) Health-care System in promoting patient engagement to improve patient care. We solicited expert opinion using an online expert panel system with a modified Delphi structure called ExpertLens™ . Experts reviewed, rated and discussed eight scenarios, representing four patient engagement roles in designing and improving VA outpatient care (consultant, implementation advisor, equal stakeholder and lead stakeholder) and two VA levels (local and regional). Rating criteria included desirability, feasibility, patient ability, physician/staff acceptance and impact on patient-centredness and care quality. Data were analysed using the RAND/UCLA Appropriateness Method for determining consensus. Experts rated consulting with patients at the local level as the most desirable and feasible patient engagement approach. Engagement at the local level was considered more desirable than engagement at the regional level. Being an equal stakeholder at the local level received the highest ratings on the patient-centredness and health-care quality criteria. Our findings illustrate expert opinion about different approaches to patient engagement and highlight the benefits and challenges posed by each. Although experts rated local consultations with patients on an as-needed basis as most desirable and feasible, they rated being an equal stakeholder at the local level as having the highest potential impact on patient-centredness and care quality. This result highlights a perceived discrepancy between what is most desirable and what is potentially most effective, but suggests that routine local engagement of patients as equal stakeholders may be a desirable first step for promoting high-quality, patient-centred care. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  4. Aflibercept treatment for neovascular AMD beyond the first year: consensus recommendations by a UK expert roundtable panel, 2017 update

    Directory of Open Access Journals (Sweden)

    Patel PJ

    2017-11-01

    Full Text Available Praveen J Patel,1 Helen Devonport,2 Sobha Sivaprasad,1 Adam H Ross,3 Gavin Walters,4 Richard P Gale,5 Andrew J Lotery,6 Sajjad Mahmood,7 James S Talks,8 Jackie Napier9 1National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK; 2The Ophthalmology Department, Bradford Royal Infirmary, Bradford, UK; 3The Ophthalmology Department, Bristol Eye Hospital, Bristol, UK; 4Department of Ophthalmology, Harrogate District Hospital, Harrogate, UK; 5The Ophthalmology Department, The York Hospital and Department of Health Sciences, University of York, York, UK; 6Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; 7Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; 8Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK; 9Medical Affairs, Bayer plc, Reading, Berkshire, UK Abstract: National recommendations on continued administration of aflibercept solution for injection after the first year of treatment for neovascular age-related macular degeneration (nAMD have been developed by an expert panel of UK retina specialists, based on clinician experience and treatment outcomes seen in year 2. The 2017 update reiterates that the treatment goal is to maintain or improve the macular structural and functional gains achieved in year 1 while attempting to reduce or minimize the treatment burden, recognizing the need for ongoing treatment. At the end of year 1 (ie, the decision visit at month 11, two treatment options should be considered: do not extend the treatment interval and maintain fixed 8-weekly dosing, or extend the treatment interval using a treat-and-extend regimen up to a maximum 12 weeks. Criteria for considering not extending the treatment interval are persistent macular fluid with stable

  5. Are the psychosocial aspects of weapons of mass destruction incidents addressed in the Federal Response Plan: summary of an expert panel.

    Science.gov (United States)

    Becker, S M

    2001-12-01

    Within the domestic preparedness community, there is a growing recognition of the importance of psychosocial issues in weapons of mass destruction (WMD) incidents. Whereas social and behavioral issues were only infrequently considered just a few years ago, they are now coming to be seen as central to consequence management efforts. As a result, discussions in the domestic preparedness community are beginning to consider the extent to which psychosocial effects are addressed in the Federal Response Plan and the degree to which additional preparedness and response steps may be needed. To grapple with this crucial issue, an expert panel was brought together at the International Conference on the Operational Impact of Psychological Casualties from Weapons of Mass Destruction. The panel brought together a wide range of specialists from federal agencies, the armed services, and the academic community. This article summarizes the views and assessments of the panelists as well as their policy recommendations for enhancing preparedness.

  6. Re-Codified Standards from the Perspective of Language Experts: Credentials, Practice and Attitudes Amongst Translators and Interpreters of the Bosnian, Croatian and Serbian Languages

    Science.gov (United States)

    Hlavac, Jim

    2015-01-01

    This article examines aspects of linguistic behaviour, attitudes and professional practices amongst a group of 47 "expert users" who are translators or interpreters for one, two or three of the following languages: Bosnian, Croatian and Serbian. The official terms for these languages in the respective successor states of Socialist…

  7. SUMMARY AND RECOMMENDATIONS OF THE EXPERT PANEL OVERSIGHT COMMITTEE MEETING ON DOUBLE-SHELL TANK CORROSION MONITORING AND TESTING HELD AUGUST 4-5 2008

    Energy Technology Data Exchange (ETDEWEB)

    BOOMER KD

    2009-01-08

    The Expert Panel Oversight Committee (EPOC) on Double-Shell Tank Corrosion Monitoring and Testing has been overseeing the Fiscal Year FY 2008 experimental program being performed at CC Technologies (CCT) to optimize the chemistry control for corrosion limits in Double-Shell Tanks (DSTs). The EPOC met at the M & D Professional Services Conference Facility on August 4 and 5, 2008 to discuss various aspects of that responsibility including FY 2009 planning. Formal presentations were made to update the EPOC on the these subjects.

  8. Interpretations

    Science.gov (United States)

    Bellac, Michel Le

    2014-11-01

    Although nobody can question the practical efficiency of quantum mechanics, there remains the serious question of its interpretation. As Valerio Scarani puts it, "We do not feel at ease with the indistinguishability principle (that is, the superposition principle) and some of its consequences." Indeed, this principle which pervades the quantum world is in stark contradiction with our everyday experience. From the very beginning of quantum mechanics, a number of physicists--but not the majority of them!--have asked the question of its "interpretation". One may simply deny that there is a problem: according to proponents of the minimalist interpretation, quantum mechanics is self-sufficient and needs no interpretation. The point of view held by a majority of physicists, that of the Copenhagen interpretation, will be examined in Section 10.1. The crux of the problem lies in the status of the state vector introduced in the preceding chapter to describe a quantum system, which is no more than a symbolic representation for the Copenhagen school of thought. Conversely, one may try to attribute some "external reality" to this state vector, that is, a correspondence between the mathematical description and the physical reality. In this latter case, it is the measurement problem which is brought to the fore. In 1932, von Neumann was first to propose a global approach, in an attempt to build a purely quantum theory of measurement examined in Section 10.2. This theory still underlies modern approaches, among them those grounded on decoherence theory, or on the macroscopic character of the measuring apparatus: see Section 10.3. Finally, there are non-standard interpretations such as Everett's many worlds theory or the hidden variables theory of de Broglie and Bohm (Section 10.4). Note, however, that this variety of interpretations has no bearing whatsoever on the practical use of quantum mechanics. There is no controversy on the way we should use quantum mechanics!

  9. Development of an Expert System as a Diagnostic Support of Cervical Cancer in Atypical Glandular Cells, Based on Fuzzy Logics and Image Interpretation

    Directory of Open Access Journals (Sweden)

    Karem R. Domínguez Hernández

    2013-01-01

    Full Text Available Cervical cancer is the second largest cause of death among women worldwide. Nowadays, this disease is preventable and curable at low cost and low risk when an accurate diagnosis is done in due time, since it is the neoplasm with the highest prevention potential. This work describes the development of an expert system able to provide a diagnosis to cervical neoplasia (CN precursor injuries through the integration of fuzzy logics and image interpretation techniques. The key contribution of this research focuses on atypical cases, specifically on atypical glandular cells (AGC. The expert system consists of 3 phases: (1 risk diagnosis which consists of the interpretation of a patient’s clinical background and the risks for contracting CN according to specialists; (2 cytology images detection which consists of image interpretation (IM and the Bethesda system for cytology interpretation, and (3 determination of cancer precursor injuries which consists of in retrieving the information from the prior phases and integrating the expert system by means of a fuzzy logics (FL model. During the validation stage of the system, 21 already diagnosed cases were tested with a positive correlation in which 100% effectiveness was obtained. The main contribution of this work relies on the reduction of false positives and false negatives by providing a more accurate diagnosis for CN.

  10. Development of Cardiovascular Quality Indicators for Rheumatoid Arthritis: Results from an International Expert Panel Using a Novel Online Process.

    Science.gov (United States)

    Barber, Claire E H; Marshall, Deborah A; Alvarez, Nanette; Mancini, G B John; Lacaille, Diane; Keeling, Stephanie; Aviña-Zubieta, J Antonio; Khodyakov, Dmitry; Barnabe, Cheryl; Faris, Peter; Smith, Alexa; Noormohamed, Raheem; Hazlewood, Glen; Martin, Liam O; Esdaile, John M

    2015-09-01

    Patients with rheumatoid arthritis (RA) have a high risk of premature cardiovascular disease (CVD). We developed CVD quality indicators (QI) for screening and use in rheumatology clinics. A systematic review was conducted of the literature on CVD risk reduction in RA and the general population. Based on the best practices identified from this review, a draft set of 12 candidate QI were presented to a Canadian panel of rheumatologists and cardiologists (n = 6) from 3 academic centers to achieve consensus on the QI specifications. The resulting 11 QI were then evaluated by an online modified-Delphi panel of multidisciplinary health professionals and patients (n = 43) to determine their relevance, validity, and feasibility in 3 rounds of online voting and threaded discussion using a modified RAND/University of California, Los Angeles Appropriateness Methodology. Response rates for the online panel were 86%. All 11 QI were rated as highly relevant, valid, and feasible (median rating ≥ 7 on a 1-9 scale), with no significant disagreement. The final QI set addresses the following themes: communication to primary care about increased CV risk in RA; CV risk assessment; defining smoking status and providing cessation counseling; screening and addressing hypertension, dyslipidemia, and diabetes; exercise recommendations; body mass index screening and lifestyle counseling; minimizing corticosteroid use; and communicating to patients at high risk of CVD about the risks/benefits of nonsteroidal antiinflammatory drugs. Eleven QI for CVD care in patients with RA have been developed and are rated as highly relevant, valid, and feasible by an international multidisciplinary panel.

  11. Birds of a feather? A comparison of the personality profiles of aspiring interpreters and other language experts

    OpenAIRE

    Rosiers, Alexandra; Eyckmans, June

    2017-01-01

    Since the early days of translation and interpreting studies, scholars have emphasized the value of certain personality related traits for translation and interpreting performance. Especially in the conference interpreter world preconceived opinions about the desired personality traits for conference interpreters seem to exist. However, there is little to no empirical evidence to either corroborate or refuse these ideas. In this paper we aim to explore a set of individual difference variables...

  12. Treatment of acute hepatitis C: recommendations from an expert panel of the Italian Society of Infectious and Tropical Diseases.

    Science.gov (United States)

    Gaeta, Giovanni B; Puoti, Massimo; Coppola, Nicola; Santantonio, Teresa; Bruno, Raffaele; Chirianni, Antonio; Galli, Massimo

    2017-12-13

    This paper is aimed at providing practical recommendations for the management of acute hepatitis C (AHC). This is an expert position paper based on the literature revision. Final recommendations were graded by level of evidence and strength of the recommendations. Treatment of AHC with direct-acting antivirals (DAA) is safe and effective; it overcomes the limitations of INF-based treatments. Early treatment with DAA should be offered when available.

  13. From diagnosis to therapy in lung cancer: management of CT detected pulmonary nodules, a summary of the 2015 Chinese-German Lung Cancer Expert Panel.

    Science.gov (United States)

    Su, Chunxia; Meyer, Mathias; Pirker, Robert; Voigt, Wieland; Shi, Jingyun; Pilz, Lothar; Huber, Rudolf M; Wu, Yilong; Wang, Jinghong; He, Yonglan; Wang, Xuan; Zhang, Jian; Zhi, Xiuyi; Shi, Meiqi; Zhu, Bo; Schoenberg, Stefan S; Henzler, Thomas; Manegold, Christian; Zhou, Caicun; Roessner, Eric Dominic

    2016-08-01

    The first Chinese-German Lung Cancer Expert Panel was held in November 2015 one day after the 7th Chinese-German Lung Cancer Forum, Shanghai. The intention of the meeting was to discuss strategies for the diagnosis and treatment of lung cancer within the context of lung cancer screening. Improved risk classification criteria and novel imaging approaches for screening populations are highly required as more than half of lung cancer cases are false positive during the initial screening round if the National Lung Screening Trial (NLST) demographic criteria [≥30 pack years (PY) of cigarettes, age ≥55 years] are applied. Moreover, if the NLST criteria are applied to the Chinese population a high number of lung cancer patients are not diagnosed due to non-smoking related risk factors in China. The primary goal in the evaluation of pulmonary nodules (PN) is to determine whether they are malignant or benign. Volumetric based screening concepts such as investigated in the Dutch-Belgian randomized lung cancer screening trial (NELSON) seem to achieve higher specificity. Chest CT is the best imaging technique to identify the origin and location of the nodule since 20% of suspected PN found on chest X-ray turn out to be non-pulmonary lesions. Moreover, novel state-of-the-art CT systems can reduce the radiation dose for lung cancer screening acquisitions down to a level of 0.1 mSv with improved image quality to novel reconstruction techniques and thus reduce concerns related to chest CT as the primary screening technology. The aim of the first part of this manuscript was to summarize the current status of novel diagnostic techniques used for lung cancer screening and minimally invasive treatment techniques for progressive PNs that were discussed during the first Chinese-German Lung Cancer. This part should serve as an educational part for the readership of the techniques that were discussed during the Expert Panel. The second part summarizes the consensus recommendations

  14. 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.)

  15. 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

  16. 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.

  17. The appropriate use of non-steroidal anti-inflammatory drugs in rheumatic disease: opinions of a multidisciplinary European expert panel.

    Science.gov (United States)

    Burmester, Gerd; Lanas, Angel; Biasucci, Luigi; Hermann, Matthias; Lohmander, Stefan; Olivieri, Ignazio; Scarpignato, Carmelo; Smolen, Josef; Hawkey, Chris; Bajkowski, Adam; Berenbaum, Francis; Breedveld, Ferdinand; Dieleman, Peter; Dougados, Maxime; MacDonald, Thomas; Mola, Emilio Martin; Mets, Tony; Van den Noortgate, Nele; Stoevelaar, Herman

    2011-05-01

    Given the safety issues of non-steroidal anti-inflammatory drugs (NSAID) and the robustness of guidelines, making treatment choices in daily clinical practice is increasingly difficult. This study aimed systematically to analyse the opinions of a multidisciplinary European expert panel on the appropriateness of different NSAID, with or without the use of a proton pump inhibitor (PPI), in individual patients with chronic rheumatic disease. /Using the Research and Development/University of California at Los Angeles appropriateness method, the appropriateness of five (non-)selective NSAID with or without a PPI was assessed for 144 hypothetical patient profiles, ie, unique combinations of cardiovascular and gastrointestinal risk factors. Appropriateness statements were calculated for all indications. All options without PPI were considered appropriate in patients with no gastrointestinal/cardiovascular risk factors. Cyclooxygenase-2 selective inhibitors (C2SI) alone and non-selective NSAID plus PPI were preferred for patients with elevated gastrointestinal risk and low cardiovascular risk. Naproxen plus PPI was favoured in patients with high cardiovascular risk. For the combination of high gastrointestinal/high cardiovascular risk the use of any NSAID was discouraged; if needed, naproxen plus PPI or a C2SI plus PPI could be considered. The panel results may support treatment considerations at the level of individual patients, according to their gastrointestinal/cardiovascular risk profile.

  18. Risk assessment of gene flow from genetically engineered virus resistant cassava to wild relatives in Africa: an expert panel report.

    Science.gov (United States)

    Hokanson, Karen E; Ellstrand, Norman C; Dixon, Alfred G O; Kulembeka, Heneriko P; Olsen, Kenneth M; Raybould, Alan

    2016-02-01

    The probability and consequences of gene flow to wild relatives is typically considered in the environmental risk assessment of genetically engineered crops. This is a report from a discussion by a group of experts who used a problem formulation approach to consider existing information for risk assessment of gene flow from cassava (Manihot esculenta) genetically engineered for virus resistance to the 'wild' (naturalized) relative M. glaziovii in East Africa. Two environmental harms were considered in this case: (1) loss of genetic diversity in the germplasm pool, and (2) loss of valued species, ecosystem resources, or crop yield and quality due to weediness or invasiveness of wild relatives. Based on existing information, it was concluded that gene flow will occur, but it is not likely that this will reduce the genetic diversity in the germplasm pool. There is little existing information about the impact of the virus in natural populations that could be used to inform a prediction about whether virus resistance would lead to an increase in reproduction or survival, hence abundance of M. glaziovii. However, an increase in the abundance of M. glaziovii should be manageable, and would not necessarily lead to the identified environmental harms.

  19. Non-Hodgkin lymphoma in Chile: a review of 207 consecutive adult cases by a panel of five expert hematopathologists.

    Science.gov (United States)

    Cabrera, Maria Elena; Martinez, Virginia; Nathwani, Bharat N; Muller-Hermelink, H Konrad; Diebold, Jacques; Maclennan, Kenneth A; Armitage, James; Weisenburger, Dennis D

    2012-07-01

    The distribution of subtypes of non-Hodgkin lymphoma (NHL) in Latin America is not well known. This Chilean study included 207 consecutive cases of NHL diagnosed at five cancer centers in the capital, Santiago, and one center in Viña del Mar. All cases were reviewed and classified independently by five expert hematopathologists according to the 2001 World Health Organization classification of NHL. A consensus diagnosis of NHL was reached in 195 of the 207 cases (94%). B-cell lymphomas constituted 88% of NHL, and diffuse large B-cell lymphoma (DLBCL, 38.5%) and follicular lymphoma (25.1%) were the most common subtypes. There was a high frequency of marginal zone B-cell lymphoma (10.3%), as well as of extranodal natural killer (NK)/T-cell lymphoma, nasal type (2.6%) and adult T-cell leukemia/lymphoma (0.5%). Extranodal presentation was seen in 74 of the 195 cases (38%) and the most common extranodal presentation was in the stomach (37.6%). The most common gastric lymphoma was DLBCL (54.5%) followed by mucosa-associated lymphoid tissue (MALT) lymphoma (41%). Overall, the frequency of NHL subtypes in Chile is between that reported in Western and Eastern countries, which is probably a reflection of the admixture of ethnicities as well as the environment and socioeconomic status of its population.

  20. Comprehensive Diagnostic Assessment of Health Status of Patients with Asthma or COPD: A Delphi Panel Study among Dutch Experts.

    Science.gov (United States)

    van den Akker, Edmée F M M; Van't Hul, Alex J; Birnie, Erwin; Chavannes, Niels H; Rutten-van Mölken, Maureen P M H; In't Veen, Johannes C C M

    2017-04-01

    A comprehensive diagnostic assessment is needed to improve understanding of the health status of patients with chronic obstructive pulmonary disease (COPD) or asthma. Therefore, this study investigated which components and subsequent instruments should be part of a holistic assessment in secondary care. We also explored which data need to be exchanged for an adequate transfer of patients between primary and secondary care, and vice versa. A cross-sectional Web-based survey was conducted among Dutch healthcare professionals using a Delphi-like procedure; these included professionals working in primary or secondary care, medical advisors of health insurance companies and patients' representatives. The national guidelines were used as a starting point, resulting in a questionnaire addressing 55 components related to a comprehensive diagnostic assessment, covering the domains physiological impairments, symptoms, functional limitations and quality of life. Of the 151 experts and stakeholders invited, 92 (60.9%) completed the first round and 79 (52.3%) the second round; most respondents were pulmonologists. There was a high level of agreement between respondents from primary versus secondary care regarding which components should be measured during a comprehensive assessment of patients with asthma or COPD in secondary care and the instruments to measure these components. Regarding the exchange of information, upon referral, pulmonologists required little information from the general practitioners, whereas general practitioners required more extensive information after referral. An overview is provided of what should be part of a holistic assessment of health status in asthma and COPD. This information can be used as input for integrated care pathways.

  1. Management of stroke patients submitted to botulinum toxin type A therapy: a Delphi survey of an Italian expert panel of specialist injectors.

    Science.gov (United States)

    Franceschini, M; Iocco, M; Molteni, F; Santamato, A; Smania, N

    2014-10-01

    should be assessed at repeated follow-up visits. This expert panel survey can provide guidance for clinicians in the assessment of patients treated with BTX-A therapy.

  2. 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

  3. Effects of personal experiences on the interpretation of the meaning of colours used in the displays and controls in electric control panels.

    Science.gov (United States)

    Lee, Inseok; Hwang, Won-Gue

    2015-01-01

    A survey was conducted to examine how personal experiences affect the interpretation of the meaning of display and control colours on electric control panels (ECPs). In Korea, the red light on ECPs represents a normal state of operation, while the green light represents a stopped state of operation; this appears to contradict the general stereotypes surrounding these colours. The survey results indicated that the participants who had experience in using ECPs interpreted the colour meaning differently from the other participant group. More than half of the experienced participants regarded the coloured displays and controls as they were designed, while most participants in the other group appeared to interpret the colours in accordance with the stereotypes. It is presumed that accidents related to human errors can occur when non-experienced people use the ECPs, which are easily accessible in many buildings. Practitioner Summary: A survey was conducted to investigate how personal experiences affect the interpretation of the function meanings of coloured lights on electrical control panels. It was found that the interpretation varies according to personal experiences, which can induce accidents related to human errors while operating electrical equipment.

  4. Performance of the FilmArray® blood culture identification panel utilized by non-expert staff compared with conventional microbial identification and antimicrobial resistance gene detection from positive blood cultures.

    Science.gov (United States)

    McCoy, Morgan H; Relich, Ryan F; Davis, Thomas E; Schmitt, Bryan H

    2016-07-01

    Utilization of commercially available rapid platforms for microbial identification from positive blood cultures is useful during periods of, or in laboratories with, limited expert staffing. We compared the results of the FilmArray® BCID Panel performed by non-expert technologists to those of conventional methods for organism identification performed by skilled microbiologists. Within 8 h of signalling positive by a continuous monitoring blood culture system, positive bottles were analysed by the FilmArray BCID Panel. Data from these analyses were compared to standard-of-care testing, which included conventional and automated methods. To gauge the ease of use of the BCID Panel by non-expert staff, technologists unfamiliar with diagnostic bacteriology performed the testing without prior knowledge of the Gram stain results, or even whether organisms were detected. Identifications of 172/200 (86 %) positive blood cultures using the BCID Panel were consistent with identifications provided by standard-of-care methods. Standard-of-care testing identified organisms in 20 positive blood cultures, which were not represented on the BCID Panel. Seven (3.5 %) blood cultures demonstrated a discrepancy between the methods, which could not be attributed to either a lack of representation on the panel or unclear separate detection of organisms in a mixed blood culture of a shared genus or grouping of organisms, e.g. Staphylococcus or Enterobacteriaceae . One (0.5 %) blood culture yielded invalid results on two separate panels, so it was eliminated from the study. The easy-to-use FilmArray® technology shows good correlation with blood culture identification and antibiotic resistance detection performed by conventional methods. This technology may be particularly useful in laboratories with limited staffing or limited technical expertise.

  5. Management of metastatic castration-resistant prostate cancer: A focus on radium-223: Opinions and suggestions from an expert multidisciplinary panel.

    Science.gov (United States)

    Baldari, Sergio; Boni, Giuseppe; Bortolus, Roberto; Caffo, Orazio; Conti, Giario; De Vincentis, Giuseppe; Monari, Fabio; Procopio, Giuseppe; Santini, Daniele; Seregni, Ettore; Valdagni, Riccardo

    2017-05-01

    Radium-223, a calcium mimetic bone-seeking radionuclide that selectively targets bone metastases with alpha particles, is approved for the treatment of men with metastatic castration-resistant prostate cancer (mCRPC) and symptomatic bone metastases. In patients with mCRPC, treatment with radium-223 has been associated with survival benefit, regardless of prior docetaxel use, and also has a positive impact on symptomatic skeletal events and quality of life. Radium-223 is best suited for patients with symptomatic mCRPC and bone-predominant disease and no visceral metastases, and may lead to better outcomes when given early in the course of the disease. An expert multidisciplinary panel convened in Milan, Italy to review the current best-evidence literature on radium-223 and to convey their personal expertise with the use of radium-223 and identify possible strategies for best practice. This article summarizes the best available evidence for the use of radium-223, discusses the essential role of the multidisciplinary team in delivering effective treatment for mCRPC, clarifies pre- and post-treatment evaluation and monitoring, and outlines future scenarios for radium-223 in the treatment of men with MCRPC. Copyright © 2017. Published by Elsevier B.V.

  6. Somatic Cough Syndrome (Previously Referred to as Psychogenic Cough) and Tic Cough (Previously Referred to as Habit Cough) in Adults and Children: CHEST Guideline and Expert Panel Report.

    Science.gov (United States)

    Vertigan, Anne E; Murad, Mohammad H; Pringsheim, Tamara; Feinstein, Anthony; Chang, Anne B; Newcombe, Peter A; Rubin, Bruce K; McGarvey, Lorcan P; Weir, Kelly; Altman, Kenneth W; Weinberger, Miles; Irwin, Richard S; Adams, Todd M; Altman, Kenneth W; Barker, Alan F; Birring, Surinder S; Blackhall, Fiona; Bolser, Donald C; Boulet, Louis-Philippe; Braman, Sidney S; Brightling, Christopher; Callahan-Lyon, Priscilla; Canning, Brendan J; Chang, Anne B; Coeytaux, Remy; Cowley, Terrie; Davenport, Paul; Diekemper, Rebecca L; Ebihara, Satoru; El Solh, Ali A; Escalante, Patricio; Feinstein, Anthony; Field, Stephen K; Fisher, Dina; French, Cynthia T; Gibson, Peter; Gold, Philip; Gould, Michael K; Grant, Cameron; Harding, Susan M; Harnden, Anthony; Hill, Adam T; Irwin, Richard S; Kahrilas, Peter J; Keogh, Karina A; Lane, Andrew P; Lim, Kaiser; Malesker, Mark A; Mazzone, Peter; Mazzone, Stuart; McCrory, Douglas C; McGarvey, Lorcan; Molasiotis, Alex; Murad, M Hassan; Newcombe, Peter; Nguyen, Huong Q; Oppenheimer, John; Prezant, David; Pringsheim, Tamara; Restrepo, Marcos I; Rosen, Mark; Rubin, Bruce; Ryu, Jay H; Smith, Jaclyn; Tarlo, Susan M; Vertigan, Anne E; Wang, Gang; Weinberger, Miles; Weir, Kelly; Wiener, Renda Soylemez

    2015-07-01

    We conducted a systematic review on the management of psychogenic cough, habit cough, and tic cough to update the recommendations and suggestions of the 2006 guideline on this topic. We followed the American College of Chest Physicians (CHEST) methodologic guidelines and the Grading of Recommendations, Assessment, Development, and Evaluation framework. The Expert Cough Panel based their recommendations on data from the systematic review, patients' values and preferences, and the clinical context. Final grading was reached by consensus according to Delphi methodology. The results of the systematic review revealed only low-quality evidence to support how to define or diagnose psychogenic or habit cough with no validated diagnostic criteria. With respect to treatment, low-quality evidence allowed the committee to only suggest therapy for children believed to have psychogenic cough. Such therapy might consist of nonpharmacologic trials of hypnosis or suggestion therapy, or combinations of reassurance, counseling, and referral to a psychologist, psychotherapy, and appropriate psychotropic medications. Based on multiple resources and contemporary psychologic, psychiatric, and neurologic criteria (Diagnostic and Statistical Manual of Mental Disorders, 5th edition and tic disorder guidelines), the committee suggests that the terms psychogenic and habit cough are out of date and inaccurate. Compared with the 2006 CHEST Cough Guidelines, the major change in suggestions is that the terms psychogenic and habit cough be abandoned in favor of somatic cough syndrome and tic cough, respectively, even though the evidence to do so at this time is of low quality.

  7. Perspectives in quantum physics: Epistemological, ontological and pedagogical An investigation into student and expert perspectives on the physical interpretation of quantum mechanics, with implications for modern physics instruction

    Science.gov (United States)

    Baily, Charles Raymond

    A common learning goal for modern physics instructors is for students to recognize a difference between the experimental uncertainty of classical physics and the fundamental uncertainty of quantum mechanics. Our studies suggest this notoriously difficult task may be frustrated by the intuitively realist perspectives of introductory students, and a lack of ontological flexibility in their conceptions of light and matter. We have developed a framework for understanding and characterizing student perspectives on the physical interpretation of quantum mechanics, and demonstrate the differential impact on student thinking of the myriad ways instructors approach interpretive themes in their introductory courses. Like expert physicists, students interpret quantum phenomena differently, and these interpretations are significantly influenced by their overall stances on questions central to the so-called measurement problem: Is the wave function physically real, or simply a mathematical tool? Is the collapse of the wave function an ad hoc rule, or a physical transition not described by any equation? Does an electron, being a form of matter, exist as a localized particle at all times? These questions, which are of personal and academic interest to our students, are largely only superficially addressed in our introductory courses, often for fear of opening a Pandora's Box of student questions, none of which have easy answers. We show how a transformed modern physics curriculum (recently implemented at the University of Colorado) may positively impact student perspectives on indeterminacy and wave-particle duality, by making questions of classical and quantum reality a central theme of our course, but also by making the beliefs of our students, and not just those of scientists, an explicit topic of discussion.

  8. La praxi avaluadora de l’acreditació des del panel d’experts: una autoetnografia de cas en la Comunitat de Madrid

    Directory of Open Access Journals (Sweden)

    Juan Arturo Rubio Arostegui

    2017-10-01

    Full Text Available L’acreditació es defineix per les agències de qualitat de l’Espai Europeu d’Educació Superior com un element clau en la gestió de la qualitat i la millora contínua dels processos d’ensenyament-aprenentatge a la universitat. Aquesta pràctica institucional comença a desenvolupar-se en 2014 a Espanya. L’article il·lustra el cas de l’agència de qualitat del sistema universitari madrileny, com a anàlisi de cas, per mitjà de l’experiència del propi autor com a panelista en l’acreditació dels títols. Metodològicament es parteix de l’enfocament autoetnogràfic i de la teoria de l’interaccionisme simbòlic, per poder desvetlar i analitzar el procés i les cultures avaluatives. Per a fer-ho, es tracen dos eixos d’anàlisis: els resultats d’aprenentatge i el valor de la recerca en els recursos humans adscrits al títol, tots dos considerats per les agències de qualitat com a criteris crítics perquè l’informe final del títol siga favorable. A través d’aquests dos criteris es plantegen les interaccions que es donen en el panel d’experts en les diferents fases del procés d’acreditació.

  9. 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

  10. 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

  11. Barrett's oesophagus patients with low-grade dysplasia can be accurately risk-stratified after histological review by an expert pathology panel

    NARCIS (Netherlands)

    Duits, Lucas C.; Phoa, K. Nadine; Curvers, Wouter L.; Ten Kate, Fiebo J W; Meijer, Gerrit A.; Seldenrijk, Cees A.; Offerhaus, G. Johan; Visser, Mike; Meijer, Sybren L.; Krishnadath, Kausilia K.; Tijssen, Jan G P; Mallant-Hent, Rosalie C.; Bergman, Jacques J G H M

    Objective Reported malignant progression rates for low-grade dysplasia (LGD) in Barrett's oesophagus (BO) vary widely. Expert histological review of LGD is advised, but limited data are available on its clinical value. This retrospective cohort study aimed to determine the value of an expert

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  13. Report of an Expert Panel on the reanalysis by of a 90-day study conducted by Monsanto in support of the safety of a genetically modified corn variety (MON 863).

    Science.gov (United States)

    Doull, J; Gaylor, D; Greim, H A; Lovell, D P; Lynch, B; Munro, I C

    2007-11-01

    MON 863, a genetically engineered corn variety that contains the gene for modified Bacillus thuringiensis Cry3Bb1 protein to protect against corn rootworm, was tested in a 90-day toxicity study as part of the process to gain regulatory approval. This study was reanalyzed by Séralini et al. who contended that the study showed possible hepatorenal effects of MON 863. An Expert Panel was convened to assess the original study results as analyzed by the Monsanto Company and the reanalysis conducted by Séralini et al. The Expert Panel concludes that the Séralini et al. reanalysis provided no evidence to indicate that MON 863 was associated with adverse effects in the 90-day rat study. In each case, statistical findings reported by both Monsanto and Séralini et al. were considered to be unrelated to treatment or of no biological or clinical importance because they failed to demonstrate a dose-response relationship, reproducibility over time, association with other relevant changes (e.g., histopathology), occurrence in both sexes, difference outside the normal range of variation, or biological plausibility with respect to cause-and-effect. The Séralini et al. reanalysis does not advance any new scientific data to indicate that MON 863 caused adverse effects in the 90-day rat study.

  14. FIFRA Scientific Advisory Panel

    Science.gov (United States)

    Experts on the Federal Insecticide, Fungicide, and Rodenticide Act Scientific Advisory Panel provide independent scientific advice to the EPA on a wide range of health and safety issues related to pesticides.

  15. Guidance for evaluating mass communication health initiatives: summary of an expert panel discussion sponsored by the Centers for Disease Control and Prevention.

    Science.gov (United States)

    Abbatangelo-Gray, Jodie; Cole, Galen E; Kennedy, May G

    2007-09-01

    In May 2004, 12 experts in evaluating large-scale health communication programs came to the Centers for Disease Control and Prevention to participate in an electronic focus group discussion. They offered advice on topics ranging from the role of logic models to the best strategies for controlling for self-selection bias in surveys regarding outcomes of exposure to mass media health messages. The experts also highlighted health communication evaluation topics that have received too little scientific attention. Finally, they made strategic policy recommendations. Use of the state-of-the-art evaluation methods that they recommended could improve the communication of factual and persuasive health messages and help to guard the public health of the nation. Their advice may also advance evaluation practice in other substantive areas, especially where it is difficult or impossible to implement randomized designs.

  16. Breast cancer screening in the era of density notification legislation: summary of 2014 Massachusetts experience and suggestion of an evidence-based management algorithm by multi-disciplinary expert panel.

    Science.gov (United States)

    Freer, Phoebe E; Slanetz, Priscilla J; Haas, Jennifer S; Tung, Nadine M; Hughes, Kevin S; Armstrong, Katrina; Semine, A Alan; Troyan, Susan L; Birdwell, Robyn L

    2015-09-01

    Stemming from breast density notification legislation in Massachusetts effective 2015, we sought to develop a collaborative evidence-based approach to density notification that could be used by practitioners across the state. Our goal was to develop an evidence-based consensus management algorithm to help patients and health care providers follow best practices to implement a coordinated, evidence-based, cost-effective, sustainable practice and to standardize care in recommendations for supplemental screening. We formed the Massachusetts Breast Risk Education and Assessment Task Force (MA-BREAST) a multi-institutional, multi-disciplinary panel of expert radiologists, surgeons, primary care physicians, and oncologists to develop a collaborative approach to density notification legislation. Using evidence-based data from the Institute for Clinical and Economic Review, the Cochrane review, National Comprehensive Cancer Network guidelines, American Cancer Society recommendations, and American College of Radiology appropriateness criteria, the group collaboratively developed an evidence-based best-practices algorithm. The expert consensus algorithm uses breast density as one element in the risk stratification to determine the need for supplemental screening. Women with dense breasts and otherwise low risk (20% lifetime) should consider supplemental screening MRI in addition to routine mammography regardless of breast density. We report the development of the multi-disciplinary collaborative approach to density notification. We propose a risk stratification algorithm to assess personal level of risk to determine the need for supplemental screening for an individual woman.

  17. 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

  18. Treatment of non muscle invasive bladder tumor related to the problem of bacillus Calmette-Guerin availability. Consensus of a Spanish expert's panel. Spanish Association of Urology.

    Science.gov (United States)

    Fernández-Gómez, J M; Carballido-Rodríguez, J; Cozar-Olmo, J M; Palou-Redorta, J; Solsona-Narbón, E; Unda-Urzaiz, J M

    2013-01-01

    Since June 2012, the has been a worldwide lack of available of the Connaught strain. In December 2012, a group of experts met in the Spanish Association of Urology to analyze this situation and propose alternatives. To present the work performed by said committee and the resulting recommendations. An update has been made of the principal existing evidence in the treatment of middle and high risk tumors. Special mention has been made regarding the those related with the use of BCG and their possible alternative due to the different availability of BCG. In tumors with high risk of progression, immediate cystectomy should be considered when BCG is not available, with dose reduction or alternating with chemotherapy as methods to economize on the use of BCG when availability is reduced. In tumors having middle risk of progression, chemotherapy can be used, although when it is associated to a high risk of relapse, BCG would be indicated if available with the mentioned savings guidelines. BCG requires maintenance to maintain its effectiveness, it being necessary to optimize the application of endovesical chemotherapy and to use systems that increase its penetration into the bladder wall (EMDA) if they are available. Due to the scarcity of BCG, it has been necessary to agree on a series of recommendations that have been published on the web page of the Spanish Association of Urology. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  19. Sensory evaluation of boar-taint-containing minced meat, dry-cured ham and dry fermented sausage by a trained expert panel and consumers.

    Science.gov (United States)

    Verplanken, Kaat; Wauters, Jella; Vercruysse, Vicky; Aluwé, Marijke; Vanhaecke, Lynn

    2017-10-15

    One of the main issues related to entire male pigs is the occurrence of boar taint, an off-odour, which compromises meat consumability. In this study, odour thresholds (indole: 24-65µgkg(-1), skatole: 44-89µgkg(-1), androstenone: 121-342µgkg(-1)) for the boar taint compounds were estimated in minced meat, dry fermented sausage and dry-cured ham. Afterwards, sensory evaluation of these products containing 10% tainted meat (minced meat and dry fermented sausage) or moderate boar taint compound levels (dry-cured ham) occurred. The beneficial effect of diluting tainted meat was demonstrated, as no significant difference in consumability was observed between gilts and 10% tainted meat by experts as well as consumers. Also dry-curing proved a promising technique for masking boar taint and preventing consumer dissatisfaction. The obtained results demonstrate the applicability of the estimated thresholds in meat as a tool for identifying masking and reducing strategies on the perception of boar taint. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Synopsis of Guidelines for the Clinical Management of Cerebral Cavernous Malformations: Consensus Recommendations Based on Systematic Literature Review by the Angioma Alliance Scientific Advisory Board Clinical Experts Panel.

    Science.gov (United States)

    Akers, Amy; Al-Shahi Salman, Rustam; A Awad, Issam; Dahlem, Kristen; Flemming, Kelly; Hart, Blaine; Kim, Helen; Jusue-Torres, Ignacio; Kondziolka, Douglas; Lee, Cornelia; Morrison, Leslie; Rigamonti, Daniele; Rebeiz, Tania; Tournier-Lasserve, Elisabeth; Waggoner, Darrel; Whitehead, Kevin

    2017-05-01

    Despite many publications about cerebral cavernous malformations (CCMs), controversy remains regarding diagnostic and management strategies. To develop guidelines for CCM management. The Angioma Alliance ( www.angioma.org ), the patient support group in the United States advocating on behalf of patients and research in CCM, convened a multidisciplinary writing group comprising expert CCM clinicians to help summarize the existing literature related to the clinical care of CCM, focusing on 5 topics: (1) epidemiology and natural history, (2) genetic testing and counseling, (3) diagnostic criteria and radiology standards, (4) neurosurgical considerations, and (5) neurological considerations. The group reviewed literature, rated evidence, developed recommendations, and established consensus, controversies, and knowledge gaps according to a prespecified protocol. Of 1270 publications published between January 1, 1983 and September 31, 2014, we selected 98 based on methodological criteria, and identified 38 additional recent or relevant publications. Topic authors used these publications to summarize current knowledge and arrive at 23 consensus management recommendations, which we rated by class (size of effect) and level (estimate of certainty) according to the American Heart Association/American Stroke Association criteria. No recommendation was level A (because of the absence of randomized controlled trials), 11 (48%) were level B, and 12 (52%) were level C. Recommendations were class I in 8 (35%), class II in 10 (43%), and class III in 5 (22%). Current evidence supports recommendations for the management of CCM, but their generally low levels and classes mandate further research to better inform clinical practice and update these recommendations. The complete recommendations document, including the criteria for selecting reference citations, a more detailed justification of the respective recommendations, and a summary of controversies and knowledge gaps, was

  1. Evaluation of tuberculosis diagnostics in children: 2. Methodological issues for conducting and reporting research evaluations of tuberculosis diagnostics for intrathoracic tuberculosis in children. Consensus from an expert panel.

    Science.gov (United States)

    Cuevas, Luis E; Browning, Renee; Bossuyt, Patrick; Casenghi, Martina; Cotton, Mark F; Cruz, Andrea T; Dodd, Lori E; Drobniewski, Francis; Gale, Marianne; Graham, Stephen M; Grzemska, Malgosia; Heinrich, Norbert; Hesseling, Anneke C; Huebner, Robin; Jean-Philippe, Patrick; Kabra, Sushil Kumar; Kampmann, Beate; Lewinsohn, Deborah; Li, Meijuan; Lienhardt, Christian; Mandalakas, Anna M; Marais, Ben J; Menzies, Heather J; Montepiedra, Grace; Mwansambo, Charles; Oberhelman, Richard; Palumbo, Paul; Russek-Cohen, Estelle; Shapiro, David E; Smith, Betsy; Soto-Castellares, Giselle; Starke, Jeffrey R; Swaminathan, Soumya; Wingfield, Claire; Worrell, Carol

    2012-05-15

    Confirming the diagnosis of childhood tuberculosis is a major challenge. However, research on childhood tuberculosis as it relates to better diagnostics is often neglected because of technical difficulties, such as the slow growth in culture, the difficulty of obtaining specimens, and the diverse and relatively nonspecific clinical presentation of tuberculosis in this age group. Researchers often use individually designed criteria for enrollment, diagnostic classifications, and reference standards, thereby hindering the interpretation and comparability of their findings. The development of standardized research approaches and definitions is therefore needed to strengthen the evaluation of new diagnostics for detection and confirmation of tuberculosis in children. In this article we present consensus statements on methodological issues for conducting research of Tuberculosis diagnostics among children, with a focus on intrathoracic tuberculosis. The statements are complementary to a clinical research case definition presented in an accompanying publication and suggest a phased approach to diagnostics evaluation; entry criteria for enrollment; methods for classification of disease certainty, including the rational use of culture within the case definition; age categories and comorbidities for reporting results; and the need to use standard operating procedures. Special consideration is given to the performance of microbiological culture in children and we also recommend for alternative methodological approaches to report findings in a standardized manner to overcome these limitations are made. This consensus statement is an important step toward ensuring greater rigor and comparability of pediatric tuberculosis diagnostic research, with the aim of realizing the full potential of better tests for children.

  2. 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.

  3. Unsaturated Zone Flow Model Expert Elicitation Project

    Energy Technology Data Exchange (ETDEWEB)

    Coppersmith, K. J.

    1997-05-30

    This report presents results of the Unsaturated Zone Flow Model Expert Elicitation (UZFMEE) project at 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 objective of this project was to identify and assess the uncertainties associated with certain key components of the unsaturated zone flow system at Yucca Mountain. This assessment reviewed the data inputs, modeling approaches, and results of the unsaturated zone flow model (termed the ''UZ site-scale model'') being developed by Lawrence Berkeley National Laboratory (LBNL) and the US Geological Survey (USGS). In addition to data input and modeling issues, the assessment focused on percolation flux (volumetric flow rate per unit cross-sectional area) at the potential repository horizon. An understanding of unsaturated 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 unsaturated flow processes, including uncertainty in both the models used to represent physical controls on unsaturated zone flow and the parameter values used in the models. To ensure 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 uncertainties about key issues regarding the unsaturated zone at the Yucca

  4. Prevalence of the metabolic syndrome using the Third Report of the National Cholesterol Educational Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) and the modified ATP III definitions for Japanese and Mongolians.

    Science.gov (United States)

    Enkhmaa, Byambaa; Shiwaku, Kuninori; Anuurad, Erdembileg; Nogi, Akiko; Kitajima, Keiko; Yamasaki, Masayuki; Oyunsuren, Tsendsuren; Yamane, Yosuke

    2005-02-01

    A clustering of insulin resistance, hypertension, and dyslipidemia has been labeled as metabolic syndrome. Asians have a lower frequency of obesity than do Caucasians but have an increasing tendency toward metabolic syndrome. We conducted a cross-sectional study of individuals aged 30-60 years. We analyzed the health data of 596 Japanese and Mongolians for metabolic syndrome based on the Third Report of the National Cholesterol Educational Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) definition and the three modified ATP III definitions. The prevalence of metabolic syndrome using ATP III criteria was 6% for the Japanese and 12% for the Mongolians, a remarkable lower prevalence relative to the reported prevalence in the United States. With the exception of visceral obesity, the prevalences of individual metabolic abnormalities within each of the two Asian groups were similar to each other and to reported rates of prevalence in the United States. A universal metabolic syndrome definition is inappropriate for comparisons of metabolic syndrome among Asian ethnic groups. We believe that the ATP III index for visceral obesity should be adjusted for Asian populations.

  5. 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.

    Science.gov (United States)

    Paillot, Romain; Rash, Nicola L; Garrett, Dion; Prowse-Davis, Leah; Montesso, Fernando; Cullinane, Ann; Lemaitre, Laurent; Thibault, Jean-Christophe; Wittreck, Sonia; Dancer, Agnes

    2016-11-25

    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.

  6. Interpretation and application of the offside law by expert assistant referees: perception of spatial positions in complex dynamic events on and off the field.

    Science.gov (United States)

    Gilis, Bart; Helsen, Werner; Catteeuw, Peter; Van Roie, Evelien; Wagemans, Johan

    2009-04-01

    Baldo et al. (2002) and Helsen et al. (2006) considered the flash-lag effect to explain errors made by assistant referees when judging offside in association football. The main aims of the present study were as follows: (1) to determine whether the flash-lag effect emerges in offside situations on the field of play or off the field when presented as computer animations or as video footage of real-life matches; (2) to examine offside decision-making errors in two standards of assistant referee - international FIFA and Belgian national referees. The results support the flash-lag hypothesis in several ways. First, both the FIFA and Belgian assistant referees were more likely to make errors by raising their flag when they had to assess offside situations on the field of play and when presented as three-a-side computer animations. Second, more flag errors were made when the defender moved in the opposite direction to that of the attacker. Third, the strategy of raising the flag in case of doubt was not observed when an interpretation of the offside law had to be made about the involvement of play of an attacker. Future research is needed to examine the extent to which on- and off-the-field training sessions can be used as training tools to improve offside decision-making.

  7. Expert Witness

    African Journals Online (AJOL)

    Adele

    discipline that permits them to testify to an opinion that will aid a judge or jury in resolving a question that is beyond the understanding or competence of laypersons. An expert witness is an expert who makes his or her knowledge available to a court (a tribunal or any other forum where formal rules of evidence apply) to help ...

  8. 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...... base of expert systems is often given in terms of an ontology, extracted and built from various data sources by employing natural language-processing and statistics. To emphasize such capabilities, the term “expert” is now often replaced by “cognitive,” “knowledge,” “knowledge-based,” or “intelligent......” system. With very few exceptions, general-purpose expert systems have failed to emerge so far. However, expert systems are applied in specialized domains, particularly in healthcare. The increasing availability of large quantities of data to organizations today provides a valuable opportunity...

  9. Identification and evaluation of scientific uncertainties related to fish and aquatic resources in the Colorado River, Grand Canyon - summary and interpretation of an expert-elicitation questionnaire

    Science.gov (United States)

    Kennedy, Theodore A.

    2013-01-01

    resilient decisionmaking and problem-solving is incorporation of a wide range of perspectives (Carpenter and others, 2009). To ensure that a wide range of scientists had an opportunity to weigh in on the strategic science questions, the GCMRC elicited additional perspectives through written questionnaires. Independently soliciting responses from scientists through questionnaires had the added advantage of allowing all scientists to freely and openly share their views on complex and controversial topics—something which may not have occurred in the group setting of the June 2011 Knowledge Assessment Workshop because of dominance by one or more scientists. The purpose of this report is to document and interpret the questionnaire responses.

  10. Metabolic Panel

    Science.gov (United States)

    A metabolic panel is a group of tests that measures different chemicals in the blood. These tests are usually ... kidneys and liver. There are two types: basic metabolic panel (BMP) and comprehensive metabolic panel (CMP). The ...

  11. Expert opinions on SME Transfers Hazards for policymakers and entrepreneurs

    NARCIS (Netherlands)

    Lex van Teeffelen

    2009-01-01

    The EU and national governments rely on expert panels and opinions for their policies (EU, 2003; EU, 2006a; EU, 2006b) on SME ownership transfers. Also entrepreneurs depend on expert opinions and advice. We know from expert studies that expert judgment may lead to confusion and conflicting results.

  12. Image Interpretation Using an Expert System

    Science.gov (United States)

    1986-12-01

    Ecuadorian Navy B.S., Escuela Superior Naval, Ecuador, 1976 Submitted in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE IN...Postgraduate School Monterey, California 93943 5. Direccion de Educacion 2 Primera Zona Naval Guayaquil-Ecuador 6. Office of the Naval Attache 1 Embassv of

  13. The use of statins alone, or in combination with pioglitazone and other drugs, for the treatment of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis and related cardiovascular risk. An Expert Panel Statement.

    Science.gov (United States)

    Athyros, Vasilios G; Alexandrides, Theodore K; Bilianou, Helen; Cholongitas, Evangelos; Doumas, Michael; Ganotakis, Emmanuel S; Goudevenos, John; Elisaf, Moses S; Germanidis, Georgios; Giouleme, Olga; Karagiannis, Asterios; Karvounis, Charalambos; Katsiki, Niki; Kotsis, Vasilios; Kountouras, Jannis; Liberopoulos, Evangelos; Pitsavos, Christos; Polyzos, Stergios; Rallidis, Loukianos S; Richter, Dimitrios; Tsapas, Apostolos G; Tselepis, Alexandros D; Tsioufis, Konstantinos; Tziomalos, Konstantinos; Tzotzas, Themistoklis; Vasiliadis, Themistoklis G; Vlachopoulos, Charalambos; Mikhailidis, Dimitri P; Mantzoros, Christos

    2017-06-01

    Non-alcoholic fatty liver disease (NAFLD), the most common liver disease, is characterized by accumulation of fat (>5% of the liver tissue), in the absence of alcohol abuse or other chronic liver diseases. It is closely related to the epidemic of obesity, metabolic syndrome or type 2 diabetes mellitus (T2DM). NAFLD can cause liver inflammation and progress to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis or hepatocellular cancer (HCC). Nevertheless, cardiovascular disease (CVD) is the most common cause of death in NAFLD/NASH patients. Current guidelines suggest the use of pioglitazone both in patients with T2DM and in those without. The use of statins, though considered safe by the guidelines, have very limited use; only 10% in high CVD risk patients are on statins by tertiary centers in the US. There are data from several animal studies, 5 post hoc analyses of prospective long-term survival studies, and 5 rather small biopsy proven NASH studies, one at baseline and on at the end of the study. All these studies provide data for biochemical and histological improvement of NAFLD/NASH with statins and in the clinical studies large reductions in CVD events in comparison with those also on statins and normal liver. Ezetimibe was also reported to improve NAFLD. Drugs currently in clinical trials seem to have potential for slowing down the evolution of NAFLD and for reducing liver- and CVD-related morbidity and mortality, but it will take time before they are ready to be used in everyday clinical practice. The suggestion of this Expert Panel is that, pending forthcoming randomized clinical trials, physicians should consider using a PPARgamma agonist, such as pioglitazone, or, statin use in those with NAFLD/NASH at high CVD or HCC risk, alone and/or preferably in combination with each other or with ezetimibe, for the primary or secondary prevention of CVD, and the avoidance of cirrhosis, liver transplantation or HCC, bearing in mind that CVD is the main cause

  14. 40 CFR 194.26 - Expert judgment.

    Science.gov (United States)

    2010-07-01

    ... FOR THE CERTIFICATION AND RE-CERTIFICATION OF THE WASTE ISOLATION PILOT PLANT'S COMPLIANCE WITH THE 40... judgment elicitation processes and the reasoning behind those results. Documentation of interviews used to... and technical views to expert panels as input to any expert elicitation process. ...

  15. Translating Guidelines Into Practice: Interpreting the 2016 ACC Expert Consensus Decision Pathway on the Role of Non-Statin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk.

    Science.gov (United States)

    Waite, Laura H; Phan, Yvonne L; Spinler, Sarah A

    2017-10-01

    In 2016, the American College of Cardiology released a decision pathway, based on expert consensus, to guide use of non-statin agents in the management of atherosclerotic cardiovascular disease risk. The purpose of this article is to assist practitioners, health systems and managed care entities with interpreting this consensus statement in order to simplify implementation of the recommendations into patient care. Major themes from the consensus statement are briefly summarized and explained. Drug therapy recommendations are condensed into a single algorithm, while tables correlate each recommended regimen with the appropriate patient population from both a patient-level and systems-level perspective. Finally, a patient case with evidence-based decision support is explored. These tools allow practitioners to make appropriate patient-specific decisions about the use of non-statin pharmacotherapy and enable health systems and managed care entities to more readily identify guideline-appropriate use of these agents upon review of patient profiles or prescribing patterns. This article provides resources for healthcare providers that facilitate uptake of these recommendations into clinical practice.

  16. ExpertFOAF recommends experts

    DEFF Research Database (Denmark)

    Iofcu, Tereza; Diederich, Joerg; Dolog, Peter

    2007-01-01

    the GrowBag approach [1]. The main assumption is that such user profiles can provide good hints about users' expertise. Such extended FOAF files (called ExpertFOAF) can be published on a user's home page, on web pages of institutions or conferences to characterize them. They can be crawled by distributed...

  17. 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

  18. 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...

  19. Evidence-based recommendations for the management of ankylosing spondylitis: systematic literature search of the 3E Initiative in Rheumatology involving a broad panel of experts and practising rheumatologists

    DEFF Research Database (Denmark)

    Sidiropoulos, P.I.; Hatemi, G.; Song, I.H.

    2008-01-01

    of enthesitis. The compiled agreement among experts ranged from 72% to 93%. CONCLUSION: Recommendations for the management of AS were developed using an evidence-based approach followed by expert/physician consensus with high level of agreement. Involvement of a larger and more representative group......OBJECTIVE: Recommendations and/or guidelines represent a popular way of integrating evidence-based medicine into clinical practice. The 3E Initiatives is a multi-national effort to develop recommendations for the management of rheumatic diseases, which involves a large number of experts combined...... with practising rheumatologists addressing specific questions relevant to clinical practice. METHODS: Ten countries participated in three rounds of discussions and votes concerning the management of AS. A set of nine questions was formulated in the domains of diagnosis, monitoring and treatment, after a Delphi...

  20. Multinational evidence-based recommendations for the diagnosis and management of gout: integrating systematic literature review and expert opinion of a broad panel of rheumatologists in the 3e initiative

    NARCIS (Netherlands)

    Sivera, Francisca; Andrés, Mariano; Carmona, Loreto; Kydd, Alison S. R.; Moi, John; Seth, Rakhi; Sriranganathan, Melonie; van Durme, Caroline; van Echteld, Irene; Vinik, Ophir; Wechalekar, Mihir D.; Aletaha, Daniel; Bombardier, Claire; Buchbinder, Rachelle; Edwards, Christopher J.; Landewé, Robert B.; Bijlsma, Johannes W.; Branco, Jaime C.; Burgos-Vargas, Rubén; Catrina, Anca I.; Elewaut, Dirk; Ferrari, Antonio J. L.; Kiely, Patrick; Leeb, Burkhard F.; Montecucco, Carlomaurizio; Müller-Ladner, Ulf; Ostergaard, Mikkel; Zochling, Jane; Falzon, Louise; van der Heijde, Désirée M.

    2014-01-01

    We aimed to develop evidence-based multinational recommendations for the diagnosis and management of gout. Using a formal voting process, a panel of 78 international rheumatologists developed 10 key clinical questions pertinent to the diagnosis and management of gout. Each question was investigated

  1. 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

  2. Liver Panel

    Science.gov (United States)

    ... Analysis Kidney Stone Risk Panel KRAS Mutation Lactate Lactate Dehydrogenase (LD) Lactoferrin Lactose Tolerance Tests LDL Cholesterol LDL ... GGT) – another enzyme found mainly in liver cells Lactate dehydrogenase (LD) – an enzyme released with cell damage; found ...

  3. Liver Panel

    Science.gov (United States)

    ... Links Patient Resources For Health Professionals Subscribe Search Liver Panel Send Us Your Feedback Choose Topic At ... Images View Sources Ask Us Also Known As Liver Profile Liver Function Tests LFTs Formal Name Hepatic ...

  4. Software for interpreting cardiopulmonary exercise tests

    Directory of Open Access Journals (Sweden)

    Corry David B

    2007-10-01

    Full Text Available Abstract Background Cardiopulmonary exercise testing (CPET has become an important modality for the evaluation and management of patients with a diverse array of medical problems. However, interpreting these tests is often difficult and time consuming, requiring significant expertise. Methods We created a computer software program (XINT that assists in CPET interpretation. The program uses an integrative approach as recommended in the Official Statement of the American Thoracic Society/American College of Chest Physicians (ATS/ACCP on Cardiopulmonary Exercise Testing. In this paper we discuss the principles behind the software. We also provide the detailed logic in an accompanying file (Additional File 1. The actual program and the open source code are also available free over the Internet at http://www.xint.org. For convenience, the required download files can also be accessed from this article. Additional file 1 XINTlogic. This file provides the detailed logic used by the XINT program. The variable names are described in Table 1. The actual source code may also be read directly simply by opening the source code with a text editor. Click here for file Results To test the clinical usefulness of XINT, we present the computer generated interpretations of the case studies discussed in the ATS/ACCP document in another accompanying file (Additional File 2. We believe the interpretations are consistent with the document's criteria and the interpretations given by the expert panel. Additional file 2 XINTinterpretations. These are the XINT generated reports based on the five examples provided in the ATS/ACCP statement on cardiopulmonary exercise testing 1. Click here for file Conclusion Computers have become an integral part of modern life. Peer-reviewed scientific journals are now able to present not just medical concepts and experimental studies, but actual functioning medical interpretive software. This has enormous potential to improve medical

  5. Multinational evidence-based recommendations for the diagnosis and management of gout: integrating systematic literature review and expert opinion of a broad panel of rheumatologists in the 3e initiative.

    Science.gov (United States)

    Sivera, Francisca; Andrés, Mariano; Carmona, Loreto; Kydd, Alison S R; Moi, John; Seth, Rakhi; Sriranganathan, Melonie; van Durme, Caroline; van Echteld, Irene; Vinik, Ophir; Wechalekar, Mihir D; Aletaha, Daniel; Bombardier, Claire; Buchbinder, Rachelle; Edwards, Christopher J; Landewé, Robert B; Bijlsma, Johannes W; Branco, Jaime C; Burgos-Vargas, Rubén; Catrina, Anca I; Elewaut, Dirk; Ferrari, Antonio J L; Kiely, Patrick; Leeb, Burkhard F; Montecucco, Carlomaurizio; Müller-Ladner, Ulf; Ostergaard, Mikkel; Zochling, Jane; Falzon, Louise; van der Heijde, Désirée M

    2014-02-01

    We aimed to develop evidence-based multinational recommendations for the diagnosis and management of gout. Using a formal voting process, a panel of 78 international rheumatologists developed 10 key clinical questions pertinent to the diagnosis and management of gout. Each question was investigated with a systematic literature review. Medline, Embase, Cochrane CENTRAL and abstracts from 2010-2011 European League Against Rheumatism and American College of Rheumatology meetings were searched in each review. Relevant studies were independently reviewed by two individuals for data extraction and synthesis and risk of bias assessment. Using this evidence, rheumatologists from 14 countries (Europe, South America and Australasia) developed national recommendations. After rounds of discussion and voting, multinational recommendations were formulated. Each recommendation was graded according to the level of evidence. Agreement and potential impact on clinical practice were assessed. Combining evidence and clinical expertise, 10 recommendations were produced. One recommendation referred to the diagnosis of gout, two referred to cardiovascular and renal comorbidities, six focused on different aspects of the management of gout (including drug treatment and monitoring), and the last recommendation referred to the management of asymptomatic hyperuricaemia. The level of agreement with the recommendations ranged from 8.1 to 9.2 (mean 8.7) on a 1-10 scale, with 10 representing full agreement. Ten recommendations on the diagnosis and management of gout were established. They are evidence-based and supported by a large panel of rheumatologists from 14 countries, enhancing their utility in clinical practice.

  6. Expert witness perceptions of bias in experts.

    Science.gov (United States)

    Commons, Michael Lamport; Miller, Patrice Marie; Gutheil, Thomas G

    2004-01-01

    A pilot study of perceptions of different sources of expert bias, as well as of personal investment in case outcomes, was performed among attendees at a workshop at an annual meeting of the American Academy of Psychiatry and the Law. Participants were asked to rate hypothetical responses by experts to various case outcomes and the biasing potential of different kinds of situations for opposing or other experts. A factor analysis produced two factors. Factor 1 included questions about situations that were obviously biasing (such as working only for the defense). Factor 2 included questions assessing the potential of certain situations to cause bias in experts, or how likely experts thought other experts were to be biased. In general, experts identified only four areas to be overtly biasing. All occurred within situations in which experts worked only for one or the other side of civil or criminal cases. Experts otherwise thought other experts were reasonably bias free and well able to compensate for any bias when it occurred. The data suggest that experts may deal with bias by turning down cases that may cause them personal discomfort.

  7. Management of neutropenic patients in the intensive care unit (NEWBORNS EXCLUDED) recommendations from an expert panel from the French Intensive Care Society (SRLF) with the French Group for Pediatric Intensive Care Emergencies (GFRUP), the French Society of Anesthesia and Intensive Care (SFAR), the French Society of Hematology (SFH), the French Society for Hospital Hygiene (SF2H), and the French Infectious Diseases Society (SPILF).

    Science.gov (United States)

    Schnell, David; Azoulay, Elie; Benoit, Dominique; Clouzeau, Benjamin; Demaret, Pierre; Ducassou, Stéphane; Frange, Pierre; Lafaurie, Matthieu; Legrand, Matthieu; Meert, Anne-Pascale; Mokart, Djamel; Naudin, Jérôme; Pene, Frédéric; Rabbat, Antoine; Raffoux, Emmanuel; Ribaud, Patricia; Richard, Jean-Christophe; Vincent, François; Zahar, Jean-Ralph; Darmon, Michael

    2016-12-01

    Neutropenia is defined by either an absolute or functional defect (acute myeloid leukemia or myelodysplastic syndrome) of polymorphonuclear neutrophils and is associated with high risk of specific complications that may require intensive care unit (ICU) admission. Specificities in the management of critically ill neutropenic patients prompted the establishment of guidelines dedicated to intensivists. These recommendations were drawn up by a panel of experts brought together by the French Intensive Care Society in collaboration with the French Group for Pediatric Intensive Care Emergencies, the French Society of Anesthesia and Intensive Care, the French Society of Hematology, the French Society for Hospital Hygiene, and the French Infectious Diseases Society. Literature review and formulation of recommendations were performed using the Grading of Recommendations Assessment, Development and Evaluation system. Each recommendation was then evaluated and rated by each expert using a methodology derived from the RAND/UCLA Appropriateness Method. Six fields are covered by the provided recommendations: (1) ICU admission and prognosis, (2) protective isolation and prophylaxis, (3) management of acute respiratory failure, (4) organ failure and organ support, (5) antibiotic management and source control, and (6) hematological management. Most of the provided recommendations are obtained from low levels of evidence, however, suggesting a need for additional studies. Seven recommendations were, however, associated with high level of evidences and are related to protective isolation, diagnostic workup of acute respiratory failure, medical management, and timing surgery in patients with typhlitis.

  8. Multinational evidence-based recommendations for pain management by pharmacotherapy in inflammatory arthritis: integrating systematic literature research and expert opinion of a broad panel of rheumatologists in the 3e Initiative.

    Science.gov (United States)

    Whittle, Samuel L; Colebatch, Alexandra N; Buchbinder, Rachelle; Edwards, Christopher J; Adams, Karen; Englbrecht, Matthias; Hazlewood, Glen; Marks, Jonathan L; Radner, Helga; Ramiro, Sofia; Richards, Bethan L; Tarner, Ingo H; Aletaha, Daniel; Bombardier, Claire; Landewé, Robert B; Müller-Ladner, Ulf; Bijlsma, Johannes W J; Branco, Jaime C; Bykerk, Vivian P; da Rocha Castelar Pinheiro, Geraldo; Catrina, Anca I; Hannonen, Pekka; Kiely, Patrick; Leeb, Burkhard; Lie, Elisabeth; Martinez-Osuna, Píndaro; Montecucco, Carlomaurizio; Ostergaard, Mikkel; Westhovens, Rene; Zochling, Jane; van der Heijde, Désirée

    2012-08-01

    To develop evidence-based recommendations for pain management by pharmacotherapy in patients with inflammatory arthritis (IA). A total of 453 rheumatologists from 17 countries participated in the 2010 3e (Evidence, Expertise, Exchange) Initiative. Using a formal voting process, 89 rheumatologists representing all 17 countries selected 10 clinical questions regarding the use of pain medications in IA. Bibliographic fellows undertook a systematic literature review for each question, using MEDLINE, EMBASE, Cochrane CENTRAL and 2008-09 European League Against Rheumatism (EULAR)/ACR abstracts. Relevant studies were retrieved for data extraction and quality assessment. Rheumatologists from each country used this evidence to develop a set of national recommendations. Multinational recommendations were then formulated and assessed for agreement and the potential impact on clinical practice. A total of 49,242 references were identified, from which 167 studies were included in the systematic reviews. One clinical question regarding different comorbidities was divided into two separate reviews, resulting in 11 recommendations in total. Oxford levels of evidence were applied to each recommendation. The recommendations related to the efficacy and safety of various analgesic medications, pain measurement scales and pain management in the pre-conception period, pregnancy and lactation. Finally, an algorithm for the pharmacological management of pain in IA was developed. Twenty per cent of rheumatologists reported that the algorithm would change their practice, and 75% felt the algorithm was in accordance with their current practice. Eleven evidence-based recommendations on the management of pain by pharmacotherapy in IA were developed. They are supported by a large panel of rheumatologists from 17 countries, thus enhancing their utility in clinical practice.

  9. Medical Expert Systems Survey

    OpenAIRE

    Abu-Nasser, Bassem S.

    2017-01-01

    International audience; There is an increase interest in the area of Artificial Intelligence in general and expert systems in particular. Expert systems are rapidly growing technology. Expert system is 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 of ...

  10. 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…

  11. Large Scale Glazed Concrete Panels

    DEFF Research Database (Denmark)

    Bache, Anja Margrethe

    2010-01-01

    and finally Lene Tranberg and Bøje Lungård’s Elsinore water purification plant. These buildings have qualities that I would like applied, perhaps transformed or most preferably, if possible, interpreted anew, for the large glazed concrete panels I shall develop. The article is ended and concluded...

  12. 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.

  13. 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...

  14. Opioids and the management of chronic severe pain in the elderly: consensus statement of an International Expert Panel with focus on the six clinically most often used World Health Organization Step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone).

    Science.gov (United States)

    Pergolizzi, Joseph; Böger, Rainer H; Budd, Keith; Dahan, Albert; Erdine, Serdar; Hans, Guy; Kress, Hans-Georg; Langford, Richard; Likar, Rudolf; Raffa, Robert B; Sacerdote, Paola

    2008-01-01

    status need to be taken carefully into account when addressing pain in the elderly. World Health Organization step III opioids are the mainstay of pain treatment for cancer patients and morphine has been the most commonly used for decades. In general, high level evidence data (Ib or IIb) exist, although many studies have included only few patients. Based on these studies, all opioids are considered effective in cancer pain management (although parts of cancer pain are not or only partially opioid sensitive), but no well-designed specific studies in the elderly cancer patient are available. Of the 2 opioids that are available in transdermal formulation--fentanyl and buprenorphine--fentanyl is the most investigated, but based on the published data both seem to be effective, with low toxicity and good tolerability profiles, especially at low doses. 2. The use of opioids in noncancer-related pain: Evidence is growing that opioids are efficacious in noncancer pain (treatment data mostly level Ib or IIb), but need individual dose titration and consideration of the respective tolerability profiles. Again no specific studies in the elderly have been performed, but it can be concluded that opioids have shown efficacy in noncancer pain, which is often due to diseases typical for an elderly population. When it is not clear which drugs and which regimes are superior in terms of maintaining analgesic efficacy, the appropriate drug should be chosen based on safety and tolerability considerations. Evidence-based medicine, which has been incorporated into best clinical practice guidelines, should serve as a foundation for the decision-making processes in patient care; however, in practice, the art of medicine is realized when we individualize care to the patient. This strikes a balance between the evidence-based medicine and anecdotal experience. Factual recommendations and expert opinion both have a value when applying guidelines in clinical practice. 3. The use of opioids in

  15. Conference Interpreters

    DEFF Research Database (Denmark)

    Leal Lobato, Ana Isabel

    2017-01-01

    Conference Interpreters: How to serve the cause of minorized communities in the new postmonolingual / ‘postmonodiscoursive’ order,......Conference Interpreters: How to serve the cause of minorized communities in the new postmonolingual / ‘postmonodiscoursive’ order,...

  16. Interpreting Idioms.

    Science.gov (United States)

    Kemper, Susan; Estill, Robert

    A study investigated the immediate comprehension processes involved in the interpretation of English idiomatic expressions. Idioms such as "bury the hatchet" were presented to 48 college students in sentential contexts that either biased the subject toward a literal or a figurative interpretation or left the interpretation ambiguous. In control…

  17. Eliciting expert knowledge in conservation science.

    Science.gov (United States)

    Martin, Tara G; Burgman, Mark A; Fidler, Fiona; Kuhnert, Petra M; Low-Choy, Samantha; McBride, Marissa; Mengersen, Kerrie

    2012-02-01

    Expert knowledge is used widely in the science and practice of conservation because of the complexity of problems, relative lack of data, and the imminent nature of many conservation decisions. Expert knowledge is substantive information on a particular topic that is not widely known by others. An expert is someone who holds this knowledge and who is often deferred to in its interpretation. We refer to predictions by experts of what may happen in a particular context as expert judgments. In general, an expert-elicitation approach consists of five steps: deciding how information will be used, determining what to elicit, designing the elicitation process, performing the elicitation, and translating the elicited information into quantitative statements that can be used in a model or directly to make decisions. This last step is known as encoding. Some of the considerations in eliciting expert knowledge include determining how to work with multiple experts and how to combine multiple judgments, minimizing bias in the elicited information, and verifying the accuracy of expert information. We highlight structured elicitation techniques that, if adopted, will improve the accuracy and information content of expert judgment and ensure uncertainty is captured accurately. We suggest four aspects of an expert elicitation exercise be examined to determine its comprehensiveness and effectiveness: study design and context, elicitation design, elicitation method, and elicitation output. Just as the reliability of empirical data depends on the rigor with which it was acquired so too does that of expert knowledge. ©2011 Australian Governmemt Conservation Biology©2011 Society for Conservation Biology.

  18. 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.

  19. Panel discussion

    Energy Technology Data Exchange (ETDEWEB)

    No Author Given

    1975-01-01

    Panel discussion: summation and future projections. Introductory remarks by panelists followed by questions and comments from the floor. Panelists: Dr. Joseph Barnea (former director of Resources and Transport for the United Nations; energy consultant to the United Nations Institute for Training and Research (UNITAR)); the Honorable Clyde F. Bel, Jr. (member of the Louisiana House of Representatives representing District 90 and New Orleans); Dr. David Lombard (acting chief of the Advanced Systems Branch of the Division of Geothermal Energy Research and Technology, Energy Research and Development Administration (ERDA)); Fred C. Repper (vice-president of Central Power and Light Company in Corpus Christi, Texas); Dr. Hans Suter (environmental consultant in Corpus Christi, Texas; environmental columnist for the Corpus Christi Caller Times). Session chairman: Herbert Woodson.

  20. Forensic experts' perceptions of expert bias.

    Science.gov (United States)

    Commons, Michael Lamport; Miller, Patrice Marie; Li, Eva Yujia; Gutheil, Thomas Gordon

    2012-01-01

    How do expert witnesses perceive the possible biases of their fellow expert witnesses? Participants, who were attendees at a workshop at the American Academy of Psychiatry and Law were asked to rate for their biasing potential a number of situations that might affect the behavior of an opposing expert. A Rasch analysis produced a linear scale as to the perceived biasing potential of these different kinds of situations from the most biasing to the least biasing. Working for only one side in both civil and criminal cases had large scaled values and also were the first factor. In interesting contrast, a) an opposing expert also serving as the litigant's treater and b) an opposing expert being viewed as a "hired gun" (supplying an opinion only for money) were two situations viewed as not very biasing. Order of Hierarchical Complexity also accounted for items from the 1st, 2nd and 3rd factors. The result suggests that the difficulty in understanding the conceptual basis of bias underlies the perception of how biased a behavior or a situation is. The more difficult to understand the questionnaire item, the less biasing its behavior or situation is perceived by participants. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. 75 FR 73080 - Science Advisory Board Staff Office; Request for Nominations of Experts for the SAB...

    Science.gov (United States)

    2010-11-29

    ... AGENCY Science Advisory Board Staff Office; Request for Nominations of Experts for the SAB.... SUMMARY: The EPA Science Advisory Board (SAB) Staff Office is requesting public nominations of experts to... hazards of PCBs. The SAB Staff Office will form an expert panel to review the PCBs assessment. The SAB (42...

  2. Heat exchanger panel

    Science.gov (United States)

    Warburton, Robert E. (Inventor); Cuva, William J. (Inventor)

    2005-01-01

    The present invention relates to a heat exchanger panel which has broad utility in high temperature environments. The heat exchanger panel has a first panel, a second panel, and at least one fluid containment device positioned intermediate the first and second panels. At least one of the first panel and the second panel have at least one feature on an interior surface to accommodate the at least one fluid containment device. In a preferred embodiment, each of the first and second panels is formed from a high conductivity, high temperature composite material. Also, in a preferred embodiment, the first and second panels are joined together by one or more composite fasteners.

  3. Knowledge-Acquisition Tool For Expert System

    Science.gov (United States)

    Disbrow, James D.; Duke, Eugene L.; Regenie, Victoria A.

    1988-01-01

    Digital flight-control systems monitored by computer program that evaluates and recommends. Flight-systems engineers for advanced, high-performance aircraft use knowlege-acquisition tool for expert-system flight-status monitor suppling interpretative data. Interpretative function especially important in time-critical, high-stress situations because it facilitates problem identification and corrective strategy. Conditions evaluated and recommendations made by ground-based engineers having essential knowledge for analysis and monitoring of performances of advanced aircraft systems.

  4. Introduction to expert systems

    Energy Technology Data Exchange (ETDEWEB)

    Jackson, P.

    1986-01-01

    Expert systems have become one of the most exciting applications within the domain of artificial intelligence. Further interest has been provoked by Japan's Fifth Generation Project, which identifies expert or knowledge-based systems as a key element in the computer systems of the future. This book presents an introduction to expert systems at a level suited to the undergraduate student and the interested layman. It surveys the three main techniques for knowledge representation - rules, frames and logic. and describes in detail the expert systems which employ them. Contents: Expert systems and artificial intelligence; Formalisms for knowledge representation; MYCIN; Medical diagnosis using rules. MYCIN derivatives; TEIRESIAS, EMYCIN, and GUIDON; RI: recognition as a problem-solving strategy; CENTAUR: a combination of frames metalevel inference and commonsense reasoning in MECHO; Tools for building expert systems; Summary and conclusions; Exercises.

  5. Reporting Guidelines for the Use of Expert Judgement in Model-Based Economic Evaluations.

    Science.gov (United States)

    Iglesias, Cynthia P; Thompson, Alexander; Rogowski, Wolf H; Payne, Katherine

    2016-11-01

    Expert judgement has a role in model-based economic evaluations (EEs) of healthcare interventions. This study aimed to produce reporting criteria for two types of study design to use expert judgement in model-based EE: (i) an expert elicitation (quantitative) study; and (ii) a Delphi study to collate (qualitative) expert opinion. A two-round online Delphi process identified the degree of consensus for four core definitions (expert; expert parameter values; expert elicitation study; expert opinion) and two sets of reporting criteria in a purposive sample of experts. The initial set of reporting criteria comprised 17 statements for reporting a study to elicit parameter values and/or distributions and 11 statements for reporting a Delphi survey to obtain expert opinion. Fifty experts were invited to become members of the Delphi process panel by e-mail. Data analysis summarised the extent of agreement (using a pre-defined 75 % 'consensus' threshold) on the definitions and suggested reporting criteria. Free-text comments were analysed using thematic analysis. The final panel comprised 12 experts. Consensus was achieved for the definitions of expert (88 %); expert parameter values (83 %); and expert elicitation study (83 %). The panel recommended criteria to use when reporting an expert elicitation study (16 criteria) and a Delphi study to collate expert opinion (11 criteria). This study has produced guidelines for reporting two types of study design to use expert judgement in model-based EE: (i) an expert elicitation study requiring 16 reporting criteria; and (ii) a Delphi study to collate expert opinion requiring 11 reporting criteria.

  6. Expert paper for the Future Panel on Public Health Genomics

    NARCIS (Netherlands)

    Stemerding, D.; Krom, A.

    2013-01-01

    Developments in public health genomics (PHG) hold the promise to be beneficial for individuals and to promote public health. Central to this paper is the idea that given the range of uncertainties and ambiguities related to genome-based information and technologies (GBIT), the responsible

  7. 21 CFR 516.141 - Qualified expert panels.

    Science.gov (United States)

    2010-04-01

    ... Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... another entity, such as a university). (ii) Has any employment, contractual, or other financial... remuneration (institution/self), time period, sponsor (government, firm, institution, individual), role of the...

  8. Submission to the Expert Panels, Ministry of Education and Training.

    Science.gov (United States)

    Pathways: The Ontario Journal of Outdoor Education, 1997

    1997-01-01

    Presents a rationale for integrating outdoor education with all subject areas that focuses on the interdisciplinary nature of outdoor education, authenticity of outdoor experiences, and affective component of outdoor education. Summarizes information submitted to Canada's Ministry of Education and Training from secondary science teachers and…

  9. Reaching global health goals: an expert panel | IDRC - International ...

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

    2017-05-04

    May 4, 2017 ... Canada-Latin America and Caribbean Zika Virus Research Program. A new funding opportunity on Zika virus is responding to the virus outbreak and the health threat it represents for the affected populations in the hardest hit countries in Latin America and the... View moreCanada-Latin America and ...

  10. Strategic Choice Analysis by Expert Panels for Migration Impact Assessment

    NARCIS (Netherlands)

    Kourtit, K.; Nijkamp, P.

    2011-01-01

    International migration is a source of policy and research interest in many countries. This paper provides a review of experiences and findings from migration impact assessment worldwide. Various findings are briefly summarised in the context of a systematic migration SWOT analysis for five distinct

  11. Endoscopic Lung Volume Reduction : An Expert Panel Recommendation

    NARCIS (Netherlands)

    Herth, Felix J. F.; Slebos, Dirk-Jan; Rabe, Klaus F.; Shah, Pallav L.

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) is a progressive condition comprising a constellation of disorders from chronic bronchitis, airflow obstruction through to emphysema. The global burden of COPD is estimated at more than 6% of the population. The standard of care is based on a combination

  12. Qualitative Study of College Tutoring through the Expert Panel Method

    Science.gov (United States)

    López Martin, Inmaculada; Blanco Fernández, Ascensión; Pagán Marín, Rosa Ma.; Gazapo Andrade, Bienvenido; De Arana del Valle, José Ma.; Pizarro Juanas, Esther A.; Pascual, Beatriz Martínez

    2014-01-01

    The implementation of a quality Tutorial Action Plan (TAP), in which the integral formation of students is the main objective, is a topical issue in the Spanish university environment. This paper aims to identify the actions contemplated in the TAPs of different Spanish universities and catalog the different types of activities performed by the…

  13. Hepatic (Liver) Function Panel

    Science.gov (United States)

    ... for Educators Search English Español Blood Test: Hepatic (Liver) Function Panel KidsHealth / For Parents / Blood Test: Hepatic ( ... or kidneys ) is working. What Is a Hepatic (Liver) Function Panel? A liver function panel is a ...

  14. 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) - ... Diagnostic Procedures . 6th ed. St Louis, MO: Elsevier Saunders; ...

  15. How Expert Designers Design

    NARCIS (Netherlands)

    Dr. Peter Sloep; J. van Merrienboer; C. Carr; P. Kirschner

    2003-01-01

    This paper discusses two studies - the one in a business context, the other in a university context - carried out with expert educational designers. The studies aimed to determine the priorities experts claim to employ when designing competence-based learning environments. Designers in both contexts

  16. Expert Systems in Education.

    Science.gov (United States)

    Hartschuh, Wayne

    This paper argues that the concepts and techniques used in the development of expert systems should be expanded and applied to the field of education, particularly in the area of intelligent tutoring systems. It is noted that expert systems are a well known area of artificial intelligence and have been proven effective in well-defined topic areas.…

  17. 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

    Uncertainty in geological linework: communicating the expert's tacit model to the data user(s) by expert elicitation. R. Lawley, M. Barron and K. Lee. NERC - British Geological Survey, Environmental Science Centre, Keyworth, Nottingham, UK, NG12 5GG The boundaries mapped in traditional field geological survey are subject to a wide range of inherent uncertainties. A map at a survey-scale of 1:10,000 is created by a combination of terrain interpretation, direct observations from boreholes and exposures (often sparsely distributed), and indirect interpretation of proxy variables such as soil properties, vegetation and remotely sensed images. A critical factor influencing the quality of the final map is the skill and experience of the surveyor to bring this information together in a coherent conceptual model. The users of geological data comprising or based on mapped boundaries are increasingly aware of these uncertainties, and want to know how to manage them. The growth of 3D modelling, which takes 2D surveys as a starting point, adds urgency to the need for a better understanding of survey uncertainties; particularly where 2D mapping of variable vintage has been compiled into a national coverage. Previous attempts to apply confidence on the basis of metrics such as data density, survey age or survey techniques have proved useful for isolating single, critical, factors but do not generally succeed in evaluating geological mapping 'in the round', because they cannot account for the 'conceptual' skill set of the surveyor. The British Geological Survey (BGS) is using expert elicitation methods to gain a better understanding of uncertainties within the national geological map of Great Britain. The expert elicitation approach starts with the assumption that experienced surveyors have an intuitive sense of the uncertainty of the boundaries that they map, based on a tacit model of geology and its complexity and the nature of the surveying process. The objective of

  18. Interpretation miniatures

    Science.gov (United States)

    Nikolić, Hrvoje

    Most physicists do not have patience for reading long and obscure interpretation arguments and disputes. Hence, to attract attention of a wider physics community, in this paper various old and new aspects of quantum interpretations are explained in a concise and simple (almost trivial) form. About the “Copenhagen” interpretation, we note that there are several different versions of it and explain how to make sense of “local nonreality” interpretation. About the many-world interpretation (MWI), we explain that it is neither local nor nonlocal, that it cannot explain the Born rule, that it suffers from the preferred basis problem, and that quantum suicide cannot be used to test it. About the Bohmian interpretation, we explain that it is analogous to dark matter, use it to explain that there is no big difference between nonlocal correlation and nonlocal causation, and use some condensed-matter ideas to outline how nonrelativistic Bohmian theory could be a theory of everything. We also explain how different interpretations can be used to demystify the delayed choice experiment, to resolve the problem of time in quantum gravity, and to provide alternatives to quantum nonlocality. Finally, we explain why is life compatible with the second law.

  19. Objective interpretation as conforming interpretation

    Directory of Open Access Journals (Sweden)

    Lidka Rodak

    2011-12-01

    Full Text Available The practical discourse willingly uses the formula of “objective interpretation”, with no regards to its controversial nature that has been discussed in literature.The main aim of the article is to investigate what “objective interpretation” could mean and how it could be understood in the practical discourse, focusing on the understanding offered by judicature.The thesis of the article is that objective interpretation, as identified with textualists’ position, is not possible to uphold, and should be rather linked with conforming interpretation. And what this actually implies is that it is not the virtue of certainty and predictability – which are usually associated with objectivity- but coherence that makes the foundation of applicability of objectivity in law.What could be observed from the analyses, is that both the phenomenon of conforming interpretation and objective interpretation play the role of arguments in the interpretive discourse, arguments that provide justification that interpretation is not arbitrary or subjective. With regards to the important part of the ideology of legal application which is the conviction that decisions should be taken on the basis of law in order to exclude arbitrariness, objective interpretation could be read as a question “what kind of authority “supports” certain interpretation”? that is almost never free of judicial creativity and judicial activism.One can say that, objective and conforming interpretation are just another arguments used in legal discourse.

  20. Interpreting chromosomal abnormalities using Prolog.

    Science.gov (United States)

    Cooper, G; Friedman, J M

    1990-04-01

    This paper describes an expert system for interpreting the standard notation used to represent human chromosomal abnormalities, namely, the International System for Human Cytogenetic Nomenclature. Written in Prolog, this program is very powerful, easy to maintain, and portable. The system can be used as a front end to any database that employs cytogenetic notation, such as a patient registry.

  1. Interpretive Experiments

    Science.gov (United States)

    DeHaan, Frank, Ed.

    1977-01-01

    Describes an interpretative experiment involving the application of symmetry and temperature-dependent proton and fluorine nmr spectroscopy to the solution of structural and kinetic problems in coordination chemistry. (MLH)

  2. Expert F# 20

    CERN Document Server

    Syme, Don; Cisternino, Antonio

    2009-01-01

    Expert F# 2.0 is about practical programming in a beautiful language that puts the power and elegance of functional programming into the hands of professional developers. In combination with .NET, F# achieves unrivaled levels of programmer productivity and program clarity. Expert F# 2.0 is * The authoritative guide to F# by the inventor of F# * A comprehensive reference of F# concepts, syntax, and features * A treasury of expert F# techniques for practical, real-world programming F# isn't just another functional programming language. It's a general-purpose language ideal for real-world develop

  3. Benchmarking expert system tools

    Science.gov (United States)

    Riley, Gary

    1988-01-01

    As part of its evaluation of new technologies, the Artificial Intelligence Section of the Mission Planning and Analysis Div. at NASA-Johnson has made timing tests of several expert system building tools. Among the production systems tested were Automated Reasoning Tool, several versions of OPS5, and CLIPS (C Language Integrated Production System), an expert system builder developed by the AI section. Also included in the test were a Zetalisp version of the benchmark along with four versions of the benchmark written in Knowledge Engineering Environment, an object oriented, frame based expert system tool. The benchmarks used for testing are studied.

  4. Topic variability and criteria in interpretational history teaching

    NARCIS (Netherlands)

    Wansink, B.G.J.|info:eu-repo/dai/nl/313999481; Akkerman, S.F.|info:eu-repo/dai/nl/217379788; Wubbels, T.|info:eu-repo/dai/nl/070651361

    2017-01-01

    This paper studies the teacher perceived applicability of historical topics for interpretational history teaching and the criteria teachers use to evaluate this applicability. For this study, 15 expert history teachers in the Netherlands striving for interpretational history teaching were

  5. 75 FR 7469 - Panel Member List for Hydropower Licensing Study Dispute Resolution; Notice Extending Filing Date...

    Science.gov (United States)

    2010-02-19

    ... Energy Regulatory Commission Panel Member List for Hydropower Licensing Study Dispute Resolution; Notice Extending Filing Date for Applications for Panel Member List for Hydropower Licensing Study Dispute...) requested applications to be included on a list of resource experts willing to serve as a third panel member...

  6. 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

    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....... Equal weights combinations were also calculated. The main conclusions on expert performance are: (1) SEJ does provide a science-based method for attribution of the global burden of foodborne diseases; (2) equal weighting of experts per panel increased statistical accuracy to acceptable levels...

  7. Expert judgment on markers to deter inadvertent human intrusion into the Waste Isolation Pilot Plant

    Energy Technology Data Exchange (ETDEWEB)

    Trauth, K.M. [Sandia National Labs., Albuquerque, NM (United States); Hora, S.C. [Hawaii Univ., Hilo, HI (United States); Guzowski, R.V. [Science Applications International Corp., San Diego, CA (United States)

    1993-11-01

    The expert panel identified basic principles to guide current and future marker development efforts: (1) the site must be marked, (2) message(s) must be truthful and informative, (3) multiple components within a marker system, (4) multiple means of communication (e.g., language, pictographs, scientific diagrams), (5) multiple levels of complexity within individual messages on individual marker system elements, (6) use of materials with little recycle value, and (7) international effort to maintain knowledge of the locations and contents of nuclear waste repositories. The efficacy of the markers in deterring inadvertent human intrusion was estimated to decrease with time, with the probability function varying with the mode of intrusion (who is intruding and for what purpose) and the level of technological development of the society. The development of a permanent, passive marker system capable of surviving and remaining interpretable for 10,000 years will require further study prior to implementation.

  8. Penultimate interpretation.

    Science.gov (United States)

    Neuman, Yair

    2010-10-01

    Interpretation is at the center of psychoanalytic activity. However, interpretation is always challenged by that which is beyond our grasp, the 'dark matter' of our mind, what Bion describes as ' O'. O is one of the most central and difficult concepts in Bion's thought. In this paper, I explain the enigmatic nature of O as a high-dimensional mental space and point to the price one should pay for substituting the pre-symbolic lexicon of the emotion-laden and high-dimensional unconscious for a low-dimensional symbolic representation. This price is reification--objectifying lived experience and draining it of vitality and complexity. In order to address the difficulty of approaching O through symbolization, I introduce the term 'Penultimate Interpretation'--a form of interpretation that seeks 'loopholes' through which the analyst and the analysand may reciprocally save themselves from the curse of reification. Three guidelines for 'Penultimate Interpretation' are proposed and illustrated through an imaginary dialogue. Copyright © 2010 Institute of Psychoanalysis.

  9. Quantum interpretations

    Energy Technology Data Exchange (ETDEWEB)

    Goernitz, T.; Weizsaecker, C.F.V.

    1987-10-01

    Four interpretations of quantum theory are compared: the Copenhagen interpretation (C.I.) with the additional assumption that the quantum description also applies to the mental states of the observer, and three recent ones, by Kochen, Deutsch, and Cramer. Since they interpret the same mathematical structure with the same empirical predictions, it is assumed that they formulate only different linguistic expressions of one identical theory. C.I. as a theory on human knowledge rests on a phenomenological description of time. It can be reconstructed from simple assumptions on predictions. Kochen shows that mathematically every composite system can be split into an object and an observer. Deutsch, with the same decomposition, describes futuric possibilities under the Everett term worlds. Cramer, using four-dimensional action at a distance (Wheeler-Feynman), describes all future events like past facts. All three can be described in the C.I. frame. The role of abstract nonlocality is discussed.

  10. Naturopathic Oncology Modified Delphi Panel.

    Science.gov (United States)

    Hill, Jacob; Hodsdon, Wendy; Schor, Jacob; McKinney, Neil; Rubin, Daniel; Seely, Dugald; Parmar, Gurdev; Birdsall, Tim; Alschuler, Lise; Lamson, Davis; Birdsall, Shauna; Zwickey, Heather

    2016-03-01

    Naturopathic oncology is a relatively new and emerging field capable of providing professional integrative or alternative services to cancer patients. Foundational research is critical to identify topics in the clinical and research development of naturopathic oncology for future growth of the field. This study implements a modified Delphi protocol to develop expert consensus regarding ethics, philosophy, and research development in naturopathic oncology. The modified protocol implements a nomination process to select a panel of 8 physicians and to assist in question formulation. The protocol includes an in-person discussion of 6 questions with multiple iterations to maintain the concept of the Delphi methodology as well as a postdiscussion consensus survey. The protocol identified, ranked, and established consensus for numerous themes per question. Underlying key topics include integration with conventional medicine, evidence-based medicine, patient education, patient safety, and additional training requirements for naturopathic oncologists. The systematic nomination and questioning of a panel of experts provides a foundational and educational resource to assist in clarification of clinical ethics, philosophy, and research development in the emerging field of naturopathic oncology. © The Author(s) 2015.

  11. Interpreting Physics

    CERN Document Server

    MacKinnon, Edward

    2012-01-01

    This book is the first to offer a systematic account of the role of language in the development and interpretation of physics. An historical-conceptual analysis of the co-evolution of mathematical and physical concepts leads to the classical/quatum interface. Bohrian orthodoxy stresses the indispensability of classical concepts and the functional role of mathematics. This book analyses ways of extending, and then going beyond this orthodoxy orthodoxy. Finally, the book analyzes how a revised interpretation of physics impacts on basic philosophical issues: conceptual revolutions, realism, and r

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

    National Research Council Canada - National Science Library

    Effing, T.W; Vercoulen, J.H; Bourbeau, J; Trappenburg, J; Lenferink, A; Cafarella, P; Coultas, D; Meek, P; Valk, P. van de; Bischoff, E.W; Bucknall, C; Dewan, N.A; Early, F; Fan, V; Frith, P; Janssen, D.J; Mitchell, K; Morgan, M; Nici, L; Patel, I; Walters, H; Rice, K.L; Singh, S; ZuWallack, R; Benzo, R; Goldstein, R; Partridge, M.R; van der Palen, J

    2016-01-01

    ...) 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...

  13. 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.

  14. 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…

  15. Soft Expert Sets

    Directory of Open Access Journals (Sweden)

    Shawkat Alkhazaleh

    2011-01-01

    Full Text Available In 1999, Molodtsov introduced the concept of soft set theory as a general mathematical tool for dealing with uncertainty. Many researchers have studied this theory, and they created some models to solve problems in decision making and medical diagnosis, but most of these models deal only with one expert. This causes a problem with the user, especially with those who use questionnaires in their work and studies. In our model, the user can know the opinion of all experts in one model. So, in this paper, we introduce the concept of a soft expert set, which will more effective and useful. We also define its basic operations, namely, complement, union intersection AND, and OR. Finally, we show an application of this concept in decision-making problem.

  16. 75 FR 27554 - Science Advisory Board Staff Office; Request for Nominations of Experts for the SAB Arsenic...

    Science.gov (United States)

    2010-05-17

    ... AGENCY Science Advisory Board Staff Office; Request for Nominations of Experts for the SAB Arsenic Review...: The Science Advisory Board (SAB) Staff Office is requesting public nominations of experts to form an... basis for Agency positions and regulations. The SAB Staff Office will form an expert panel to review ORD...

  17. Expert Oracle application express

    CERN Document Server

    Scott, John Edward

    2011-01-01

    Expert Oracle Application Express brings you groundbreaking insights into developing with Oracle's enterprise-level, rapid-development tool from some of the best practitioners in the field today. Oracle Application Express (APEX) is an entirely web-based development framework that is built into every edition of Oracle Database. The framework rests upon Oracle's powerful PL/SQL language, enabling power users and developers to rapidly develop applications that easily scale to hundreds, even thousands of concurrent users. The 13 authors of Expert Oracle Application Express build their careers aro

  18. BMP (Basic Metabolic Panel)

    Science.gov (United States)

    ... Links Patient Resources For Health Professionals Subscribe Search Basic Metabolic Panel (BMP) Send Us Your Feedback Choose ... Screen Chem 7 SMA 7 SMAC7 Formal Name Basic Metabolic Panel This article was last reviewed on ...

  19. Hepatitis virus panel

    Science.gov (United States)

    ... this 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 ...

  20. 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 ...

  1. 76 FR 54466 - Request for Nominations of Experts for the Science Advisory Board's Animal Feeding Operation...

    Science.gov (United States)

    2011-09-01

    ... AGENCY Request for Nominations of Experts for the Science Advisory Board's Animal Feeding Operation... at [email protected] . General information concerning the EPA Science Advisory Board can be found..., subcommittees and advisory panels; and, (f) for the Panel as a whole, diversity of expertise and viewpoints. The...

  2. 78 FR 53144 - Request for Nominations of Experts To Augment the Science Advisory Board Chemical Assessment...

    Science.gov (United States)

    2013-08-28

    ... AGENCY Request for Nominations of Experts To Augment the Science Advisory Board Chemical Assessment... Protection Agency (EPA). ACTION: Notice. SUMMARY: The EPA Science Advisory Board (SAB) Staff Office requests...) skills working in committees, subcommittees and advisory panels; and, (f) for the panel as a whole...

  3. Capital Expert System

    Science.gov (United States)

    Dowell, Laurie; Gary, Jack; Illingworth, Bill; Sargent, Tom

    1987-05-01

    Gathering information, necessary forms, and financial calculations needed to generate a "capital investment proposal" is an extremely complex and difficult process. The intent of the capital investment proposal is to ensure management that the proposed investment has been thoroughly investigated and will have a positive impact on corporate goals. Meeting this requirement typically takes four or five experts a total of 12 hours to generate a "Capital Package." A Capital Expert System was therefore developed using "Personal Consultant." The completed system is hybrid and as such does not depend solely on rules but incorporates several different software packages that communicate through variables and functions passed from one to another. This paper describes the use of expert system techniques, methodology in building the knowledge base, contexts, LISP functions, data base, and special challenges that had to be overcome to create this system. The Capital Expert System is the successful result of a unique integration of artificial intelligence with business accounting, financial forms generation, and investment proposal expertise.

  4. Seismic hazard analysis. Volume 5. Review panel, Ground Motion Panel, and feedback results

    Energy Technology Data Exchange (ETDEWEB)

    Bernreuter, D. L.

    1981-08-01

    The Site Specific Spectra Project (SSSP) was a multi-year study funded by the US Nuclear Regulatory Commission to provide estimates of the seismic hazards at a number of nuclear power plant sites in the Eastern US. 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 US 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. 22 figs.

  5. Expert assessment of exposure to carcinogens in Norway's offshore petroleum industry.

    Science.gov (United States)

    Steinsvåg, Kjersti; Bråtveit, Magne; Moen, Bente; Austgulen, Li V-Torill; Hollund, Bjørg Eli; Haaland, Inger Margrethe; Naerheim, Jakob; Svendsen, Kristin; Kromhout, Hans

    2008-03-01

    This study presents and evaluates an expert group's assessment of exposure to carcinogens for defined job categories in Norway's offshore petroleum industry, 1970-2005, to provide exposure information for a planned cohort study on cancer. Three university and five industry experts in occupational hygiene individually assessed the likelihood of exposure to 1836 combinations of carcinogens (n=17), job categories (n=27) and time periods (n=4). In subsequent plenary discussions, the experts agreed on exposed combinations. Agreement between the individual and the panel assessments was calculated by Cohen's kappa index. Using the panel assessment as reference, sensitivity and specificity were estimated. The eight experts assessed 63% of the 1836 combinations in plenary, resulting in 265 (14%) convened exposed combinations. Chlorinated hydrocarbons, benzene and inhalation of mineral oils had the highest number of exposed job categories (n=14, 9 and 10, respectively). The job categories classified as exposed to the highest numbers of carcinogens were the mechanics (n=10), derrick workers (n=6) and process technicians (n=5). The agreement between the experts' individual assessments and the panel assessment was kappa=0.53-0.74. The sensitivity was 0.55-0.86 and specificity 0.91-0.97. For these parameters, there were no apparent differences between the university experts and the industry experts. The resulting 265 of 1836 possible exposure combinations convened as "exposed" by expert assessment is presented in this study. The experts' individual ratings highly agreed with the succeeding panel assessment. Correlation was found between years of experience of the raters and agreement with the panel. The university experts and the industry experts' assessments had no apparent differences. Further validation of the exposure assessment is suggested, such as by new sampling data or observational studies.

  6. Objective interpretation as conforming interpretation

    OpenAIRE

    Lidka Rodak

    2011-01-01

    The practical discourse willingly uses the formula of “objective interpretation”, with no regards to its controversial nature that has been discussed in literature.The main aim of the article is to investigate what “objective interpretation” could mean and how it could be understood in the practical discourse, focusing on the understanding offered by judicature.The thesis of the article is that objective interpretation, as identified with textualists’ position, is not possible to uphold, and ...

  7. 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…

  8. Anatomy and history of an external quality assessment program for interpretative comments in clinical biochemistry.

    Science.gov (United States)

    Vasikaran, Samuel D

    2015-05-01

    The provision of clinical interpretation of results, either verbally or in the printed report, may be considered an integral part of clinical biochemistry diagnostic service. Proficiency testing or external quality assessment (EQA) of such activity may be useful in education, training, continuing professional development and ensuring the quality of such service. Details of the Patient Report Comments Program (RPCProgram) developed by the Royal College of Pathologists of Australasia (RCPA) Chemical Pathology Quality Assurance Programs Pty Ltd (QAP) is described in this review. The program is aimed at pathologists, clinical scientists and trainees. Registered participants are provided a report with case details and a set of clinical biochemistry results at monthly intervals and submit an interpretative comment for the report. Comments received are broken up into components that are translated into common key phrases. An expert panel evaluates the key phrases, classifies them according to appropriateness and drafts a suggested comment, a case summary and a rationale, which are included in a summary report returned to participants. There is considerable diversity in the quality of interpretative comments received from participants of the PRCProgram. The primary purpose of EQA of interpretative commenting is educational self-assessment, and they are recognized as a continuing professional development activity. Whilst there is some evidence for the utility of interpretative comments in improving patient outcomes, evidence for the utility of EQA in improving quality of comments is awaited. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  9. Expert Script Generator

    Science.gov (United States)

    Sliwa, Nancy E.; Cooper, Eric G.

    1991-01-01

    Program provides additional level of interface to facilitate use of telerobotic system. ESG (Expert Script Generator) is software package automatically generating high-level task objective commands from complex menu-driven language of the NASA Intelligent Systems Research Laboratory (ISRL). Makes telerobotics laboratory accessible to researchers not familiar with comprehensive language developed by ISRL for interacting with various systems of ISRL test bed. Incorporates expert-system technology to capture typical rules of operation that skilled operator uses. Result: operator interfact optimizing ability of system to perform task remotely in hazardous environment, in timely manner, and without undue stress to operator, while minimizing change for operator erros that damage equipment. Written in CLIPS.

  10. Bioethics for Technical Experts

    Science.gov (United States)

    Asano, Shigetaka

    Along with rapidly expanding applications of life science and technology, technical experts have been implicated more and more often with ethical, social, and legal problems than before. It should be noted that in this background there are scientific and social uncertainty elements which are inevitable during the progress of life science in addition to the historically-established social unreliability to scientists and engineers. In order to solve these problems, therefore, we should establish the social governance with ‘relief’ and ‘reliance’ which enables for both citizens and engineers to share the awareness of the issues, to design social orders and criterions based on hypothetical sense of values for bioethics, to carry out practical use management of each subject carefully, and to improve the sense of values from hypothetical to universal. Concerning these measures, the technical experts can learn many things from the present performance in the medical field.

  11. Expert PLSQL Practices

    CERN Document Server

    Beresniewicz, John

    2011-01-01

    Expert PL/SQL Practices is a book of collected wisdom on PL/SQL programming from some of the best and the brightest in the field. Each chapter is a deep-dive into a specific problem, technology, or feature set that you'll face as a PL/SQL programmer. Each author has chosen their topic out of the strong belief that what they share can make a positive difference in the quality and scalability of code that you write. The path to mastery begins with syntax and the mechanics of writing statements to make things happen. If you've reached that point with PL/SQL, then let the authors of Expert PL/SQL

  12. Evolution of expert systems

    Energy Technology Data Exchange (ETDEWEB)

    Biancoli, L.

    1984-03-01

    A brief exposition of the nature and functions of expert systems (knowledge based systems) and some remarks upon the way in which they resemble, but fall far short of, the very largely intuitive action of the human brain are given. The remainder of the article consists of summaries of the work being done in this field by organisations in Italy, namely: ISPRA; Delphi Electronic Design Systems, VIAREGGIO; SPL Italia SPA, (VA), Milan; Italservice Srl, Milan; and Artificial Intelligence Software, Rovigo.

  13. ALICE Expert System

    CERN Document Server

    Ionita, C

    2014-01-01

    The ALICE experiment at CERN employs a number of human operators (shifters), who have to make sure that the experiment is always in a state compatible with taking Physics data. Given the complexity of the system and the myriad of errors that can arise, this is not always a trivial task. The aim of this paper is to describe an expert system that is capable of assisting human shifters in the ALICE control room. The system diagnoses potential issues and attempts to make smart recommendations for troubleshooting. At its core, a Prolog engine infers whether a Physics or a technical run can be started based on the current state of the underlying sub-systems. A separate C++ component queries certain SMI objects and stores their state as facts in a Prolog knowledge base. By mining the data stored in dierent system logs, the expert system can also diagnose errors arising during a run. Currently the system is used by the on-call experts for faster response times, but we expect it to be adopted as a standard tool by reg...

  14. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Kerr, R.A.

    1996-11-08

    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.

  17. An Interpreter's Interpretation: Sign Language Interpreters' View of Musculoskeletal Disorders

    National Research Council Canada - National Science Library

    Johnson, William L

    2003-01-01

    Sign language interpreters are at increased risk for musculoskeletal disorders. This study used content analysis to obtain detailed information about these disorders from the interpreters' point of view...

  18. Expert Consensus on Cosmetic Outcomes After Treatment of Actinic Keratosis.

    Science.gov (United States)

    Berman, Brian; Ablon, Glynis R; Bhatia, Neal D; Ceilley, Roger I; Goldberg, David J; Nestor, Mark S; Weinkle, Susan H

    2017-03-01

    Dermatologists treat actinic keratosis (AK) primarily because these lesions have the potential to progress to invasive squamous cell carcinoma. Patients, on the other hand, generally seek treatment to remove the lesions and achieve an improved appearance of their skin following treatment. In selecting a treatment option for AK, dermatologists should consider post-treatment cosmesis, because cosmetic outcomes differ across AK treatments. To obtain expert opinion on the cosmetic sequelae related to chronically photodamaged skin and the treatment of AK, an expert panel meeting among dermatologists was conducted in February 2016. These experts reviewed current treatment options for photodamage, including AK, and discussed the relative merits of the various cosmetic assessments commonly used by investigators and patients in both clinical trial and dermatology practice settings. A main goal of the expert panel meeting was to propose assessment tools that could be specifically designed to characterize cosmesis results after treatment of AK. The panel agreed that existing tools for measurement of cosmetic outcomes following treatment of photodamage could also be used to evaluate cosmesis after treatment of AK. Digital photography is probably the best method used for this, with validation by other technologies. Better measurement tools specifically for assessing cosmesis after AK treatment are needed. Once they are developed and validated, regulatory agencies should be educated about the importance of including cosmetic outcomes as a component of product labeling. J Drugs Dermatol. 2017;16(3):260-265..

  19. [Expert Opinions in Court: Liability of the Expert].

    Science.gov (United States)

    Schiltenwolf, Marcus; Beckmann, Nickolas; Gaidzik, Peter

    2017-12-01

    Experts in criminal, civil and, increasingly, in social court cases have to present their expert opinions in court. This should be regarded not only as a burden, even if this may at times appear superfluous to the expert, perhaps because the discussion is mere repetition of the opinion he has already written, or because the questions appear to be biased against the expert. Nonetheless, the expert is always advised to appear calm and objective during the interrogation by judges and parties or participants and their legal representatives, and should not allow himself or herself to be provoked by questioning. Furthermore, it may be necessary to correct the written expert statement in the course of the interrogation, but this can be a sign of a truly competent medical expert. The expert consulted can be held liable for adverse health effects resulting from the interrogation and investigation, as well as for deliberate or grossly faulty reports. Georg Thieme Verlag KG Stuttgart · New York.

  20. Adult Treatment Panel II versus Adult Treatment Panel III: what has changed and why?

    Science.gov (United States)

    Pasternak, Richard

    2002-03-07

    The Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel [ATP] III) differs in several ways from the ATP II guidelines. Several principal advances include (1) new risk levels for major lipid measures, (2) increased emphasis on primary prevention, (3) inclusion of high-risk groups in secondary prevention, (4) broader lifestyle program, and (5) increased focus on implementation and adherence. The purpose of this article is to discuss the major changes in ATP III and to highlight the benefits of the new guidelines in the management of hypercholesterolemia in adults.

  1. Report on Expert Interviews

    OpenAIRE

    Marian, Livia

    2012-01-01

    This short report represents a summary of the analysis conducted so far on the GfK Panel Data. The focus was on the main three types of raw meat: chicken, pork, beef, as well as three categories of processed food products: liver paste, cold cuts and sausages. The aim was to look at the market indicators for each one of the six sub-categories, out of which market share and penetration were considered to be the most important. Besides these two indicators, I also included some extra calculatio...

  2. 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...... 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....

  3. 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.

  4. 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

  5. Bipolar Neutrosophic Soft Expert Sets

    OpenAIRE

    Şahin, Mehmet; Deli, İrfan; Uluçay, Vakkas

    2016-01-01

    In this paper, we introduce concept of bipolar neutrosophic soft expert set and its some operations. Also, we propose score, certainty and accuracy functions to compare the bipolar neutrosophic soft expert sets. We give examples for these concepts. 

  6. Limitations of Expert Evidence

    OpenAIRE

    Serpil Salaçin

    1997-01-01

    Limitations of Expert Evidence Edited by Stephen Leadbeatter MB ChB MCRPath ISBN 1 86016 029 8 Printed in Great Britain by Cathedral Print Services Ltd, Salisbury, 1996 Kitap 25 Ekim 1994 te The Royal College of Physicians ve The Royal College of Pathologists tarafından düzenlenen konferanstan sonra hekimlere ve avukatlara konuyu tartışmaya açmak için basılmış. Bilirkişi görüşünün temel filozofisinin, bu görevi yapanlar ve bu hizmeti alanların yapabileceklerin...

  7. Expert Oracle Exadata

    CERN Document Server

    Johnson, Randy

    2011-01-01

    Throughout history, advances in technology have come in spurts. A single great idea can often spur rapid change as the idea takes hold and is propagated, often in totally unexpected directions. Exadata embodies such a change in how we think about and manage relational databases. The key change lies in the concept of offloading SQL processing to the storage layer. That concept is a huge win, and its implementation in the form of Exadata is truly a game changer. Expert Oracle Exadata will give you a look under the covers at how the combination of hardware and software that comprise Exadata actua

  8. Teaching and Understanding of Quantum Interpretations in Modern Physics Courses

    Science.gov (United States)

    Baily, Charles; Finkelstein, Noah D.

    2010-01-01

    Just as expert physicists vary in their personal stances on interpretation in quantum mechanics, instructors vary on whether and how to teach interpretations of quantum phenomena in introductory modern physics courses. In this paper, we document variations in instructional approaches with respect to interpretation in two similar modern physics…

  9. Expert Systems - A Natural History

    OpenAIRE

    Shadbolt, N. R.

    1989-01-01

    This paper examines the origins, current state and future prospects for expert systems. The origins are traced from the schism with classic Artificial Intelligence. The characteristics of early expert systems are described and contrasted with more recent developments. A number of influential forces operating on present day systems are reviewed. The future trends in the evolution of expert systems are discussed.

  10. Application of expert systems technology in water-quality modeling

    Energy Technology Data Exchange (ETDEWEB)

    Barnwell, T.O.; Brown, L.C.; Marek, W.

    1989-01-01

    Computerized modeling is becoming an integral part of decision making in water pollution control. Expert Systems is an innovative methodology that can assist in building, using, and interpreting the output of the models. The paper reviews the use and evaluates the potential of expert systems technology in environmental modeling and describes the elements of an expert advisor for the stream water quality model QUAL2E. Some general conclusions are presented about the tools available to develop the system, the level of available technology in knowledge-based engineering, and the value of approaching problems from a knowledge engineering perspective.

  11. Expert systems for on line security assessment

    Energy Technology Data Exchange (ETDEWEB)

    Christie, R.D.; Talukdar, S.N.

    1988-05-01

    This paper argues that automatic security assessment schemes cannot generate information of high quality until their architectures, which are now wholly algorithmic, are changed to hybrids combining algorithms with expert systems. In particular, numerical algorithms should continue to be used for simulating the effects of contingencies, but expert systems should be developed for selecting the contingencies and interpreting the simulation results. These changes will make automatic schemes more closely resemble the manual schemes that are used off line too generate assessment information of high quality. The problems of integrating hybrid software into existing Energy Management Systems (EMSs) are far from trivial. The paper goes on to discuss these problems and suggest a solution, namely the use of a network of workstations tied to existing EMS computers.

  12. 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.

  13. Quantitative ultrasound techniques for the assessment of osteoporosis: expert agreement on current status. The International Quantitative Ultrasound Consensus Group

    National Research Council Canada - National Science Library

    Glüer, C C

    1997-01-01

    .... The performance of QUS techniques has been evaluated in a large number of studies. Reviewing existing knowledge, an international expert panel formulated the following consensus regarding the current status of this technology...

  14. Let the Experts Decide?

    DEFF Research Database (Denmark)

    Morton, Rebecca; Tyran, Jean-Robert

    in information quality is large, we find that voting groups largely coordinate on the SVC equilibrium which is also Pareto Optimal. However, we find that when the asymmetry in information quality is not large and the Pareto Optimal equilibrium is for all to participate, significant numbers of voters with low...... quality information abstain. Furthermore, we find that information asymmetry induces voters with low quality information to coordinate on a non-equilibrium outcome. This suggests that coordination on "letting the experts" decide is a likely voting norm that sometimes validates SVC equilibrium predictions......We examine abstention when voters in standing committees are asymmetrically informed and there are multiple pure strategy equilibria-swing voter's curse (SVC) equilibria where voters with low quality information abstain and equilibria when all participants vote their information. When the asymmetry...

  15. Expert Systems: How Far Can They Go? Part One

    OpenAIRE

    Davis, Randall

    1989-01-01

    A panel session at the 1989 International Joint Conference on artificial intelligence in Los Angeles dealt with the subject of knowledge-based systems; the session was entitled "Expert Systems: How Far Can They Go?" The panelists included Randall Davis (Massachusetts Institute of Technology); Stuart Dreyfus (University of California at Berkeley); Brian Smith (Xerox Palo Alto Research Center); and Terry Winograd (Stanford University), chairman. The article begins with Winograd's original charg...

  16. Expert Systems: How Far Can They Go? Part Two

    OpenAIRE

    Davis, Randall

    1989-01-01

    A panel session at the 1989 International Joint Conference on Artificial Intelligence in Los Angeles dealt with the subject of knowledge-based systems; the session was entitled "Expert Systems: How Far Can They Go?" The panelists included Randall Davis (Massachusetts Institute of Technology); Stuart Dreyfus (University of California at Berkeley); Brian Smith (Xerox Palo Alto Research Center); and Terry Winograd (Stanford University), chairman. Part 1 of this article, which appeared in the Spr...

  17. 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)

  18. Structural interpretation of seismic data and inherent uncertainties

    Science.gov (United States)

    Bond, Clare

    2013-04-01

    Geoscience is perhaps unique in its reliance on incomplete datasets and building knowledge from their interpretation. This interpretation basis for the science is fundamental at all levels; from creation of a geological map to interpretation of remotely sensed data. To teach and understand better the uncertainties in dealing with incomplete data we need to understand the strategies individual practitioners deploy that make them effective interpreters. The nature of interpretation is such that the interpreter needs to use their cognitive ability in the analysis of the data to propose a sensible solution in their final output that is both consistent not only with the original data but also with other knowledge and understanding. In a series of experiments Bond et al. (2007, 2008, 2011, 2012) investigated the strategies and pitfalls of expert and non-expert interpretation of seismic images. These studies focused on large numbers of participants to provide a statistically sound basis for analysis of the results. The outcome of these experiments showed that a wide variety of conceptual models were applied to single seismic datasets. Highlighting not only spatial variations in fault placements, but whether interpreters thought they existed at all, or had the same sense of movement. Further, statistical analysis suggests that the strategies an interpreter employs are more important than expert knowledge per se in developing successful interpretations. Experts are successful because of their application of these techniques. In a new set of experiments a small number of experts are focused on to determine how they use their cognitive and reasoning skills, in the interpretation of 2D seismic profiles. Live video and practitioner commentary were used to track the evolving interpretation and to gain insight on their decision processes. The outputs of the study allow us to create an educational resource of expert interpretation through online video footage and commentary with

  19. Modeling Surgical Technical Skill Using Expert Assessment for Automated Computer Rating.

    Science.gov (United States)

    Azari, David P; Frasier, Lane L; Quamme, Sudha R Pavuluri; Greenberg, Caprice C; Pugh, Carla M; Greenberg, Jacob A; Radwin, Robert G

    2017-09-06

    Computer vision was used to predict expert performance ratings from surgeon hand motions for tying and suturing tasks. Existing methods, including the objective structured assessment of technical skills (OSATS), have proven reliable, but do not readily discriminate at the task level. Computer vision may be used for evaluating distinct task performance throughout an operation. Open surgeries was videoed and surgeon hands were tracked without using sensors or markers. An expert panel of 3 attending surgeons rated tying and suturing video clips on continuous scales from 0 to 10 along 3 task measures adapted from the broader OSATS: motion economy, fluidity of motion, and tissue handling. Empirical models were developed to predict the expert consensus ratings based on the hand kinematic data records. The predicted versus panel ratings for suturing had slopes from 0.73 to 1, and intercepts from 0.36 to 1.54 (Average R = 0.81). Predicted versus panel ratings for tying had slopes from 0.39 to 0.88, and intercepts from 0.79 to 4.36 (Average R = 0.57). The mean square error among predicted and expert ratings was consistently less than the mean squared difference among individual expert ratings and the eventual consensus ratings. The computer algorithm consistently predicted the panel ratings of individual tasks, and were more objective and reliable than individual assessment by surgical experts.

  20. POPOVER Review Panel report

    Energy Technology Data Exchange (ETDEWEB)

    Davito, A.; Baker, C.J.; King, C.J.; Costerus, B.; Nelson, T.; Prokosch, D.; Pastrnak, J.; Grace, P.

    1996-04-10

    The POPOVER series of high explosive (HE) certification tests was conducted at the Big Explosives Experimental Facility (BEEF) in Area 4 of the Nevada Test Site (NTS). The two primary objectives of POPOVER were to certify that: (1) BEEF meets DOE requirements for explosives facilities and is safe for personnel-occupied operations during testing of large charges of conventional HE. (2) Facility structures and equipment will function as intended when subjected to the effects of these charges. After careful analysis of test results, the POPOVER Review Panel concludes that the POPOVER series met both objectives. Further details on the Review Panel`s conclusions are included in Section 7--Findings and Recommendations.

  1. ESG - EXPERT SCRIPT GENERATOR

    Science.gov (United States)

    Cooper, E. G.

    1994-01-01

    The Automation Technology Branch of NASA's Langley Research Center is employing increasingly complex degrees of operator/robot cooperation (telerobotics). A good relationship between the operator and computer is essential for smooth performance by a telerobotic system. ESG (Expert Script Generator) is a software package that automatically generates high-level task objective commands from the NASA Intelligent Systems Research Lab's (ISRL's) complex menu-driven language. ESG reduces errors and makes the telerobotics lab accessible to researchers who are not familiar with the comprehensive language developed by ISRL for interacting with the various systems of the ISRL testbed. ESG incorporates expert system technology to capture the typical rules of operation that a skilled operator would use. The result is an operator interface which optimizes the system's capability to perform a task remotely in a hazardous environment, in a timely manner, and without undue stress to the operator, while minimizing the chance for operator errors that may damage equipment. The intricate menu-driven command interface which provides for various control modes of both manipulators and their associated sensors in the TeleRobotic System Simulation (TRSS) has a syntax which is both irregular and verbose. ESG eliminates the following two problems with this command "language": 1) knowing the correct command sequence to accomplish a task, and 2) inputting a known command sequence without typos and other errors. ESG serves as an additional layer of interface, working in conjunction with the menu command processor, not supplanting it. By specifying task-level commands, such as GRASP, CONNECT, etc., ESG will generate the appropriate menu elements to accomplish the task. These elements will be collected in a script file which can then be executed by the ISRL menu command processor. In addition, the operator can extend the list of task-level commands to include customized tasks composed of sub

  2. Outlier Detection and Explanation for Domain Experts

    DEFF Research Database (Denmark)

    Micenková, Barbora

    In many data exploratory tasks, extraordinary and rarely occurring patterns called outliers are more interesting than the prevalent ones. For example, they could represent frauds in insurance, intrusions in network and system monitoring, or motion in video surveillance. Decades of research have...... produced various outlier detection algorithms. It is commonly known that these algorithms are difficult to apply and interpret in practice for a variety of reasons. In this thesis we propose novel algorithms that provide robust performance, support for validation and interpretability for outlier detection...... in practice and we empirically evaluate them on synthetic and real world data sets. First, we tackle the problem that most algorithms leave the end user without any explanation of how or why the identified outliers deviate. Such knowledge is important for domain experts in order to be able to validate...

  3. Blue Ribbon Panel Report

    Science.gov (United States)

    An NCI Cancer Currents blog by the NCI acting director thanking the cancer community for contributing to the Cancer Moonshot Blue Ribbon Panel report, which was presented to the National Cancer Advisory Board on September 7.

  4. Autoimmune liver disease panel

    Science.gov (United States)

    Liver disease test panel - autoimmune ... Autoimmune disorders are a possible cause of liver disease. The most common of these diseases are autoimmune hepatitis and primary biliary cholangitis (formerly called primary biliary cirrhosis). This group of tests ...

  5. Basic metabolic panel

    Science.gov (United States)

    ... Sequential multi-channel analysis with computer-7; SMA7; Metabolic panel 7; CHEM-7 ... Bope ET, Kellerman RD. Endocrine and metabolic disorders. In: Bope ET, ... PA: Elsevier; 2017:chap 5. Oh MS, Briefel G. Evaluation ...

  6. CF Mutation Panel

    Science.gov (United States)

    ... Testing Leptin Levetiracetam Lipase Lipid Profile Lipoprotein (a) Lithium Liver Panel Lp-PLA2 Lupus Anticoagulant Testing Luteinizing ... L. et. al. (2011 September 29). Kids in America Newborn Screening for Cystic Fibrosis. Medscape Today News ...

  7. 75 FR 80050 - Science Advisory Board Staff Office; Request for Nominations of Experts To Augment the SAB...

    Science.gov (United States)

    2010-12-21

    ... AGENCY Science Advisory Board Staff Office; Request for Nominations of Experts To Augment the SAB...-mail at [email protected] . General information concerning the EPA Science Advisory Board can be... and advisory panels; and, (f) for the Panel as a whole, diversity of expertise and viewpoints. The SAB...

  8. 77 FR 50505 - Science Advisory Board Staff Office Request for Nominations of Experts for the SAB Hydraulic...

    Science.gov (United States)

    2012-08-21

    ... AGENCY Science Advisory Board Staff Office Request for Nominations of Experts for the SAB Hydraulic...; and, (f) for the panel as a whole, diversity of expertise and viewpoints. The SAB Staff Office's...: Overview of the Panel Formation Process at the Environmental Protection Agency Science Advisory Board (EPA...

  9. 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.

  10. Expert systems for satellite stationkeeping

    Science.gov (United States)

    Mekaru, M. M.; Wright, M. A.

    The feasibility of implementing artificial intelligence on satellites is evaluated, with the aim of using an onboard expert system to perform effective stationkeeping functions without assistance from the ground. The Defense Satellite Communication System (DSCS III) is used as an example. The cost for implementing a satellite stationkeeping expert system is analyzed. A ground-based expert system could reduce the current number of support personnel for the stationkeeping task. Results of analyzing a possible flight system are quite promising. An expert system for satellite stationkeeping seems feasible, appears cost-effective, and offers increased satellite endurance through autonomous operations.

  11. Hexagon solar power panel

    Science.gov (United States)

    Rubin, Irwin

    1978-01-01

    A solar energy panel comprises a support upon which silicon cells are arrayed. The cells are wafer thin and of two geometrical types, both of the same area and electrical rating, namely hexagon cells and hourglass cells. The hourglass cells are composites of half hexagons. A near perfect nesting relationship of the cells achieves a high density packing whereby optimum energy production per panel area is achieved.

  12. Hexagon solar power panel

    Science.gov (United States)

    Rubin, I. (Inventor)

    1978-01-01

    A solar energy panel support is described upon which silicon cells are arrayed. The cells are wafer thin and of two geometrical types, both of the same area and electrical rating, namely hexagon cells and hourglass cells. The hourglass cells are composites of half hexagons. A near perfect nesting relationship of the cells achieves a high density packing whereby optimum energy production per panel area is achieved.

  13. Pop-Art Panels

    Science.gov (United States)

    Alford, Joanna

    2012-01-01

    James Rosenquist's giant Pop-art panels included realistic renderings of well-known contemporary foods and objects, juxtaposed with famous people in the news--largely from the 1960s, '70s and '80s--and really serve as visual time capsules. In this article, eighth-graders focus on the style of James Rosenquist to create their own Pop-art panel that…

  14. Le CRDI tient un débat d'experts au Gender Summit d'Amérique du ...

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

    6 nov. 2017 ... The expert panel will be moderated by IDRC President Jean Lebel and features: Le débat d'experts sera animé par le président du CRDI, Jean Lebel. Les participants sont : Karen Craggs-Milne, directrice, groupe international, Institut africain des sciences mathématiques (Rwanda);; Jac sm Kee, ...

  15. Use of a Delphi panel to establish consensus for recommended uses of selected balance assessment approaches.

    Science.gov (United States)

    McGinnis, Patricia Q; Wainwright, Susan F; Hack, Laurita M; Nixon-Cave, Kim; Michlovitz, Susan

    2010-08-01

    The Delphi survey is a useful mechanism to make recommendations for clinical judgments in the absence of practice guidelines for evidence-based decision making. Although there is a great deal of literature about the topic of various methods of balance assessment, decisions about application of research evidence for clinical practice may be subject to personal interpretation and/or biases of the reader. In this study, a panel of informed experts was used through a Delphi process to establish consensus regarding the recommended use of selected balance assessment methods based on the literature. Selective recruitment of experienced faculty members with advanced degrees and/or specialist certification in the content area identified seven knowledgeable informants. The panel participated in three rounds of discussion to develop a consensus-based summary of the recommended use of balance assessment methods commonly used in clinical practice and suggest how those measures fit within the framework of the Patient/Client Management Model of physical therapy practice. The outcomes of the Delphi process form a basis for recommended practice in the examination of patients with balance deficits and serve as a starting point in the development of evidence-based practice guidelines.

  16. Design of interpretable fuzzy systems

    CERN Document Server

    Cpałka, Krzysztof

    2017-01-01

    This book shows that the term “interpretability” goes far beyond the concept of readability of a fuzzy set and fuzzy rules. It focuses on novel and precise operators of aggregation, inference, and defuzzification leading to flexible Mamdani-type and logical-type systems that can achieve the required accuracy using a less complex rule base. The individual chapters describe various aspects of interpretability, including appropriate selection of the structure of a fuzzy system, focusing on improving the interpretability of fuzzy systems designed using both gradient-learning and evolutionary algorithms. It also demonstrates how to eliminate various system components, such as inputs, rules and fuzzy sets, whose reduction does not adversely affect system accuracy. It illustrates the performance of the developed algorithms and methods with commonly used benchmarks. The book provides valuable tools for possible applications in many fields including expert systems, automatic control and robotics.

  17. IncobotulinumtoxinA in aesthetics: Russian multidisciplinary expert consensus recommendations

    Science.gov (United States)

    Yutskovskaya, Yana; Gubanova, Elena; Khrustaleva, Irina; Atamanov, Vasiliy; Saybel, Anastasiya; Parsagashvili, Elena; Dmitrieva, Irina; Sanchez, Elena; Lapatina, Natalia; Korolkova, Tatiana; Saromytskaya, Alena; Goltsova, Elena; Satardinova, Elmira

    2015-01-01

    Background Although there are various international consensus recommendations on the use of botulinum neurotoxin type A (BoNT/A) in facial aesthetics, there are no global or Russian guidelines on the optimal dose of incobotulinumtoxinA, free from complexing proteins, within specific aesthetic indications. This article reports the outcomes of two expert consensus meetings, conducted to review and analyze efficacy and tolerability data for incobotulinumtoxinA in various facial aesthetic indications and to give expert consensus recommendations to ensure best clinical practice among Russian clinicians. Methods Thirteen dermatology and/or plastic surgery experts attended meetings held in Paris, France (November 2013), and Moscow, Russia (March 2014). 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

  18. Engineering monitoring expert system's developer

    Science.gov (United States)

    Lo, Ching F.

    1991-01-01

    This research project is designed to apply artificial intelligence technology including expert systems, dynamic interface of neural networks, and hypertext to construct an expert system developer. The developer environment is specifically suited to building expert systems which monitor the performance of ground support equipment for propulsion systems and testing facilities. The expert system developer, through the use of a graphics interface and a rule network, will be transparent to the user during rule constructing and data scanning of the knowledge base. The project will result in a software system that allows its user to build specific monitoring type expert systems which monitor various equipments used for propulsion systems or ground testing facilities and accrues system performance information in a dynamic knowledge base.

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

    Energy Technology Data Exchange (ETDEWEB)

    Cudahy, J.; Escarda, T.; Gimpel, R. [and others

    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.

  20. Personality Measurement and Assessment in Large Panel Surveys*

    Science.gov (United States)

    Roberts, Brent; Jackson, Joshua J.; Duckworth, Angela L.; Von Culin, Katherine

    2013-01-01

    Personality tests are being added to large panel studies with increasing regularity, such as the Health and Retirement Study (HRS). To facilitate the inclusion and interpretation of these tests, we provide some general background on personality psychology, personality assessment, and the validity of personality tests. In this review, we provide background on definitions of personality, the strengths and weaknesses of the self-report approaches to personality testing typically used in large panel studies, and the validity of personality tests for three outcomes: genetics, income, and health. We conclude with recommendations on how to improve personality assessment in future panel studies. PMID:23503719

  1. Advanced solar panel designs

    Science.gov (United States)

    Ralph, E. L.; Linder, E.

    1995-10-01

    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. Frenchglen Interpretive Plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The purpose of this interpretive plan is to provide guidance for the development of the interpretive exhibits for the Frenchglen Interpretive Center, as well as the...

  3. Panel 3 - characterization

    Energy Technology Data Exchange (ETDEWEB)

    Erck, R.A.; Erdemir, A.; Janghsing Hsieh; Lee, R.H.; Xian Zheng Pan; Deming Shu [Argonne National Lab., IL (United States); Feldman, A. [National Inst. of Standards and Technology, Gaithersburg, MD (United States); Glass, J.T. [North Carolina State Univ., Raleigh (United States); Kleimer, R. [Coors Ceramics Co., Golden, CO (United States); Lawton, E.A. [JPL/Caltech, Pasadena, CA (United States); McHargue, C.J. [Univ. of Tennessee, Knoxville (United States)

    1993-01-01

    The task of this panel was to identify and prioritize needs in the area of characterization of diamond and diamond-like-carbon (DLC) films for use in the transportation industry. Until recent advances in production of inexpensive films of diamonds and DLC, it was not feasible that these materials could be mass produced. The Characterization Panel is restricting itself to identifying needs in areas that would be most useful to manufacturers and users in producing and utilizing diamond and DLC coatings in industry. These characterization needs include in-situ monitoring during growth, relation of structure to performance, and standards and definitions.

  4. EDNA-An expert software system for comparison and evaluation of DNA profiles in forensic casework

    DEFF Research Database (Denmark)

    Haldemann, B.; Dornseifer, S.; Heylen, T.

    2015-01-01

    eDNA is an expert software system for DNA profile comparison, match interpretation and automated report generation in forensic DNA casework. Process automation and intelligent graphical representation maximise reliability of DNA evidence, while facilitating and accelerating the work of DNA experts....

  5. The Effect of Different Levels of Expertise on Interpretation of Dental X-Rays.

    Science.gov (United States)

    Dijkstra, S.; And Others

    The interpretation of dental X-rays by novices (students) and experts (dentists practicing more than 3 years) was compared. Eight fifth-year novices and eight experts were presented three types of problem X-ray (easy, difficult, and control). Experts were faster in solving the problems and their diagnoses were more accurate. Analysis of eye…

  6. Topic Variability and Criteria in Interpretational History Teaching

    Science.gov (United States)

    Wansink, Bjorn; Akkerman, Sanne; Wubbels, Theo

    2017-01-01

    This paper studies the teacher perceived applicability of historical topics for interpretational history teaching and the criteria teachers use to evaluate this applicability. For this study, 15 expert history teachers in the Netherlands striving for interpretational history teaching were purposefully selected. Teachers were asked to mention…

  7. CRN5EXP: Expert system for statistical quality control

    Science.gov (United States)

    Hentea, Mariana

    1991-01-01

    The purpose of the Expert System CRN5EXP is to assist in checking the quality of the coils at two very important mills: Hot Rolling and Cold Rolling in a steel plant. The system interprets the statistical quality control charts, diagnoses and predicts the quality of the steel. Measurements of process control variables are recorded in a database and sample statistics such as the mean and the range are computed and plotted on a control chart. The chart is analyzed through patterns using the C Language Integrated Production System (CLIPS) and a forward chaining technique to reach a conclusion about the causes of defects and to take management measures for the improvement of the quality control techniques. The Expert System combines the certainty factors associated with the process control variables to predict the quality of the steel. The paper presents the approach to extract data from the database, the reason to combine certainty factors, the architecture and the use of the Expert System. However, the interpretation of control charts patterns requires the human expert's knowledge and lends to Expert Systems rules.

  8. Interim positron emission tomography scans in diffuse large B-cell lymphoma: an independent expert nuclear medicine evaluation of the Eastern Cooperative Oncology Group E3404 study.

    Science.gov (United States)

    Horning, Sandra J; Juweid, Malik E; Schöder, Heiko; Wiseman, Gregory; McMillan, Alex; Swinnen, Lode J; Advani, Ranjana; Gascoyne, Randy; Quon, Andrew

    2010-01-28

    Positive interim positron emission tomography (PET) scans are thought to be associated with inferior outcomes in diffuse large B-cell lymphoma. In the E3404 diffuse large B-cell lymphoma study, PET scans at baseline and after 3 cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone were centrally reviewed by a single reader. To determine the reproducibility of interim PET interpretation, an expert panel of 3 external nuclear medicine physicians visually scored baseline and interim PET scans independently and were blinded to clinical information. The binary Eastern Cooperative Oncology Group (ECOG) study criteria were based on modifications of the Harmonization Criteria; the London criteria were also applied. Of 38 interim scans, agreement was complete in 68% and 71% by ECOG and London criteria, respectively. The range of PET(+) interim scans was 16% to 34% (P = not significant) by reviewer. Moderate consistency of reviews was observed: kappa statistic = 0.445 using ECOG criteria, and kappa statistic = 0.502 using London criteria. These data, showing only moderate reproducibility among nuclear medicine experts, indicate the need to standardize PET interpretation in research and practice. This trial was registered at www.clinicaltrials.gov as #NCT00274924 [corrected].

  9. Artificial Intelligence and Expert Systems.

    Science.gov (United States)

    Wilson, Harold O.; Burford, Anna Marie

    1990-01-01

    Delineates artificial intelligence/expert systems (AI/ES) concepts; provides an exposition of some business application areas; relates progress; and creates an awareness of the benefits, limitations, and reservations of AI/ES. (Author)

  10. Expert opinion vs. empirical evidence

    Science.gov (United States)

    Herman, Rod A; Raybould, Alan

    2014-01-01

    Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years spurred by examples where evidence indicated that certain treatments recommended by expert opinions increased death rates. We suggest that scientific evidence should also take priority over expert opinion in the regulation of genetically modified crops (GM). Examples of regulatory data requirements that are not justified based on the mass of evidence are described, and it is suggested that expertise in risk assessment should guide evidence-based regulation of GM crops. PMID:24637724

  11. Experts views' on Digital Competence

    NARCIS (Netherlands)

    Janssen, José; Stoyanov, Slavi

    2013-01-01

    Janssen, J., & Stoyanov, S. (2012, 20 November). Online Consultation for a Digital Competence Framework: Experts' views on Digital Competence. Workshop presentation at the Institute for Prospective Technological Studies, Seville, Spain.

  12. Photovoltaic-Panel Laminator

    Science.gov (United States)

    Keenan, R.

    1985-01-01

    Two-piece unit heats and presses protective layers to form laminate. Rubber diaphragm between upper and lower vacuum chambers alternates between neutral position and one that presses against solar-cell array, supplying distributed force necessary to press layers of laminate together. Encapsulation helps to protect cells from environment and to ensure long panel life while allowing efficient generation of electricity from Sunlight.

  13. Student Panels, Business Administration

    DEFF Research Database (Denmark)

    Rask, Morten

    of MSc programmes, the MSc coordinator as well as the administrative secretary. A student panel meets with the department twice in the first year: Early in February to sum up experience from the first semester and in early in June to sum up experience from the second semester. At semester start each MSc...

  14. A theory of expert leadership

    OpenAIRE

    Goodall, Amanda H.

    2012-01-01

    How much knowledge should leaders have of their organization's core business? This is an important question but not one that has been addressed in the management literature. In a new 'theory of expert leadership' (TEL), this paper blends conceptual work with recent empirical evidence. It suggests that organizations perform more effectively when led by individuals who have a deep understanding of the core business of their organization. Being a capable general manager is not sufficient. Expert...

  15. Expert opinion vs. empirical evidence

    OpenAIRE

    Herman, Rod A.; Raybould, Alan

    2014-01-01

    Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years sp...

  16. Genetic heterogeneity in HER2 testing in breast cancer: panel summary and guidelines.

    Science.gov (United States)

    Vance, Gail H; Barry, Todd S; Bloom, Kenneth J; Fitzgibbons, Patrick L; Hicks, David G; Jenkins, Robert B; Persons, Diane L; Tubbs, Raymond R; Hammond, M Elizabeth H

    2009-04-01

    Intratumoral heterogeneity of HER2 gene amplification has been well documented and represents subclonal diversity within the tumor. The reported incidence of intratumor HER2 amplification genetic heterogeneity ranges in the literature from approximately 5% to 30%. The presence of HER2 genetic heterogeneity may increase subjectivity in HER2 interpretation by the pathologist. To define HER2 genetic heterogeneity and to provide practice guidelines for examining and reporting breast tumors with genetic heterogeneity for improvement of HER2 testing in breast cancer. We convened an expert panel to discuss HER2 gene amplification testing by fluorescence in situ hybridization. Components addressed included a definition of HER2 amplification heterogeneity, practice guidelines for examination of the tissue, and reporting criteria for this analysis. Genetic heterogeneity for amplification of HER2 gene status in invasive breast cancer is defined and guidelines established for assessing and reporting HER2 results in these cases. These guidelines are additive to and expand those published in 2007 by the American Society of Clinical Oncology and the College of American Pathologists. Standardized methods for analysis will improve the accuracy and consistency of interpretation of HER2 gene amplification status in breast cancer.

  17. 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...

  18. An expert system for the calculation of sample size.

    Science.gov (United States)

    Ebell, M H; Neale, A V; Hodgkins, B J

    1994-06-01

    Calculation of sample size is a useful technique for researchers who are designing a study, and for clinicians who wish to interpret research findings. The elements that must be specified to calculate the sample size include alpha, beta, Type I and Type II errors, 1- and 2-tail tests, confidence intervals, and confidence levels. A computer software program written by one of the authors (MHE), Sample Size Expert, facilitates sample size calculations. The program uses an expert system to help inexperienced users calculate sample sizes for analytic and descriptive studies. The software is available at no cost from the author or electronically via several on-line information services.

  19. Expert validation of a teamwork assessment rubric: A modified Delphi study.

    Science.gov (United States)

    Parratt, Jenny A; Fahy, Kathleen M; Hutchinson, Marie; Lohmann, Gui; Hastie, Carolyn R; Chaseling, Marilyn; O'Brien, Kylie

    2016-01-01

    Teamwork is a 'soft skill' employability competence desired by employers. Poor teamwork skills in healthcare have an impact on adverse outcomes. Teamwork skills are rarely the focus of teaching and assessment in undergraduate courses. The TeamUP Rubric is a tool used to teach and evaluate undergraduate students' teamwork skills. Students also use the rubric to give anonymised peer feedback during team-based academic assignments. The rubric's five domains focus on planning, environment, facilitation, conflict management and individual contribution; each domain is grounded in relevant theory. Students earn marks for their teamwork skills; validity of the assessment rubric is critical. To what extent do experts agree that the TeamUP Rubric is a valid assessment of 'teamwork skills'? Modified Delphi technique incorporating Feminist Collaborative Conversations. A heterogeneous panel of 35 professionals with recognised expertise in communications and/or teamwork. Three Delphi rounds using a survey that included the rubric were conducted either face-to-face, by telephone or online. Quantitative analysis yielded item content validity indices (I-CVI); minimum consensus was pre-set at 70%. An average of the I-CVI also yielded sub-scale (domain) (D-CVI/Ave) and scale content validity indices (S-CVI/Ave). After each Delphi round, qualitative data were analysed and interpreted; Feminist Collaborative Conversations by the research team aimed to clarify and confirm consensus about the wording of items on the rubric. Consensus (at 70%) was obtained for all but one behavioural descriptor of the rubric. We modified that descriptor to address expert concerns. The TeamUP Rubric (Version 4) can be considered to be well validated at that level of consensus. The final rubric reflects underpinning theory, with no areas of conceptual overlap between rubric domains. The final TeamUP Rubric arising from this study validly measures individual student teamwork skills and can be used with

  20. Limitations of Expert Evidence

    Directory of Open Access Journals (Sweden)

    Serpil Salaçin

    1997-10-01

    Full Text Available Limitations of Expert Evidence Edited by Stephen Leadbeatter MB ChB MCRPath ISBN 1 86016 029 8 Printed in Great Britain by Cathedral Print Services Ltd, Salisbury, 1996 Kitap 25 Ekim 1994 te The Royal College of Physicians ve The Royal College of Pathologists tarafından düzenlenen konferanstan sonra hekimlere ve avukatlara konuyu tartışmaya açmak için basılmış. Bilirkişi görüşünün temel filozofisinin, bu görevi yapanlar ve bu hizmeti alanların yapabileceklerinin sınırlarının tartışılması amaçlanmış.Seksen altı sayfadan oluşan kitabın fiatı on iki İngiliz Sterlini. Kitap üç bölüm ve bunların altında toplanan on ana başlıktan oluşmakta. Elinize aldığınızda küçük boyutu ve anlaşılır dili ile hemen okunup bitirelecek kitaplardan sanılıyor. En azından ben böyle düşünmüştüm. Ancak daha L A Tuınberg ve A J Bellinham’ın ön yazısında ben çarpıldım. Değerli yazarların kaleme aldığı başlıklar ve gündeme getirdiği tartışmaların tüm Adli Bilimlerle uğraşanların dikkatle okuması gereken cinsten olduğu kanısındayım. Birinci bölüm The Legal Perspective iki anabaşlıktan oluşuyor, The Criminal legal perspective Honour Judje Martin Stephens tarafından yazılmış,bilirkişi olarak görev yapabilmek için belgelenmiş bir eğitim olması gerektiği, mahkemelerde ya da yazılı raporlarda verilebilecek görüşlerin incelikleri tartışılmış. Bu bölümün ikinci anabaşlığı The civil legal perspective avukat Jennifer Cummin tarafından yazılmış. Toplum gözünde bilirkişinin anlamı ve mahkemenin bilirkişi görüşünü değişmez bilimsel doğru gibi algılayarak düştüğü bilimsel yanılgı ve raporlardaki kavram farkı dile getirilmiş. İkinci Bölüm The Medical And Scientific Perspective başlığı altında Roger C Evans MD Clinical evidence başlığında toplumun hasta tedavisi ve bilirkişilik hizmetinden beklentilerinin unrealistik olduğu ve

  1. 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 ...

  2. Different roles and viewpoints of scientific experts in advising on environmental health risks.

    Science.gov (United States)

    Spruijt, Pita; Knol, Anne B; Torenvlied, René; Lebret, Erik

    2013-10-01

    Environmental health risks are often complex, largescale, and uncertain. The uncertainties inherent in these problems permit differences among experts in the appraisal of risks. This raises the question of whether different expert roles exist and, if so, how this affects the policy advice that is given. Here, we present a pilot study of the different roles and viewpoints that can be discerned among scientific experts in the Netherlands. Q methodology was used to empirically explore existing theoretical treatises on different expert roles. In total, 26 electromagnetic field (EMF) experts and 21 particulate matter (PM) experts participated. The responses were analyzed separately for EMF and PM respondents using Q factor analysis. In both the EMF and PM domain, three different expert roles were identified. This suggests that particular expert roles depend on the specific environmental health risk. The results indicate that different expert roles exist among scientists who provide policy advice on environmental health risks. This empirical study adds new data and insights to the literature on expert roles. The results of this study are relevant for the selection and composition of expert committees and the interpretation of expert advice. © 2013 Society for Risk Analysis.

  3. ICADS: A cooperative decision making model with CLIPS experts

    Science.gov (United States)

    Pohl, Jens; Myers, Leonard

    1991-01-01

    A cooperative decision making model is described which is comprised of six concurrently executing domain experts coordinated by a blackboard control expert. The focus application field is architectural design, and the domain experts represent consultants in the area of daylighting, noise control, structural support, cost estimating, space planning, and climate responsiveness. Both the domain experts and the blackboard were implemented as production systems, using an enhanced version of the basic CLIPS package. Acting in unison as an Expert Design Advisor, the domain and control experts react to the evolving design solution progressively developed by the user in a 2-D CAD drawing environment. A Geometry Interpreter maps each drawing action taken by the user to real world objects, such as spaces, walls, windows, and doors. These objects, endowed with geometric and nongeometric attributes, are stored as frames in a semantic network. Object descriptions are derived partly from the geometry of the drawing environment and partly from knowledge bases containing prototypical, generalized information about the building type and site conditions under consideration.

  4. LCD Panels: The Electronic Wonder.

    Science.gov (United States)

    Anderson, Glenn

    1994-01-01

    Describes Liquid Crystal Display (LCD) panels and their use in the classroom. Topics discussed include active versus passive matrix panels; the number of pixels; projectors, including transmissive or reflective overhead projectors; costs; and vendors that supply LCDs. (LRW)

  5. 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...

  6. How patent experts create patent breadth

    DEFF Research Database (Denmark)

    Beukel, Karin

    Science as an input to patented inventions is a fundamental of economic growth. However, our understanding of how science is transformed into patents is limited. In the present paper I seek to fill this gap by examining the micro-foundations of science-patent transformations. Using an inductive......, grounded theory approach to study the transformation of 12 scientific discoveries into patents I recast the relationship between science and patents: I show it as a particular process that affects patent breadth. Exploiting surplus patent breadth depends on the processes of abstraction and cognitive...... variety, which can be mobilized by patenting experts. The theory is tested using a recently published algebraic interpretive method for examining causal relationships in small-N studies....

  7. How patent experts create patent breadth

    DEFF Research Database (Denmark)

    Beukel, Karin

    2014-01-01

    Science as an input to patented inventions is a fundamental of economic growth. However, our understanding of how science is transformed into patents is limited. In the present paper I seek to fill this gap by examining the micro-foundations of science-patent transformations. Using an inductive......, grounded theory approach to study the transformation of 12 scientific discoveries into patents I recast the relationship between science and patents: I show it as a particular process that affects patent breadth. Exploiting surplus patent breadth depends on the processes of abstraction and cognitive...... variety, which can be mobilized by patenting experts. The theory is tested using a recently published algebraic interpretive method for examining causal relationships in small-N studies....

  8. How patent experts create patent breadth

    DEFF Research Database (Denmark)

    Beukel, Karin

    2017-01-01

    Science as an input to patented inventions is a fundamental of economic growth. However, our understanding of how science is transformed into patents is limited. In the present paper I seek to fill this gap by examining the micro-foundations of science-patent transformations. Using an inductive......, grounded theory approach to study the transformation of 12 scientific discoveries into patents I recast the relationship between science and patents: I show it as a particular process that affects patent breadth. Exploiting surplus patent breadth depends on the processes of abstraction and cognitive...... variety, which can be mobilized by patenting experts. The theory is tested using a recently published algebraic interpretive method for examining causal relationships in small-N studies....

  9. Expert system for spacecraft command and control

    Science.gov (United States)

    Wagner, R. E.

    The application of AI techniques to the automation of ground control functions in the defense satellite communication system (DSCS) is described. The aim of this effort is to lower the vulnerability of the DSCS to attack; a first step is the design of software for spacecraft maintenance and control. The benefits of automation and the need for high-level implementation are reviewed. A knowledge-based or expert approach was chosen to automate telemetry-interpretation, trend-analysis, anomaly-resolution, and status-maintenance functions now performed solely by operators; and a design concept was developed to meet the requirements of extendability, simplicity, and explicitness. Rule-based and logic-based knowledge-representation schemes, and data-driven and goal-driven control strategies are compared. The programming tools developed by the different organizations participating in the AI effort are indicated in a table.

  10. Interpreting Impoliteness: Interpreters’ Voices

    Directory of Open Access Journals (Sweden)

    Tatjana Radanović Felberg

    2017-11-01

    Full Text Available Interpreters in the public sector in Norway interpret in a variety of institutional encounters, and the interpreters evaluate the majority of these encounters as polite. However, some encounters are evaluated as impolite, and they pose challenges when it comes to interpreting impoliteness. This issue raises the question of whether interpreters should take a stance on their own evaluation of impoliteness and whether they should interfere in communication. In order to find out more about how interpreters cope with this challenge, in 2014 a survey was sent to all interpreters registered in the Norwegian Register of Interpreters. The survey data were analyzed within the theoretical framework of impoliteness theory using the notion of moral order as an explanatory tool in a close reading of interpreters’ answers. The analysis shows that interpreters reported using a variety of strategies for interpreting impoliteness, including omissions and downtoning. However, the interpreters also gave examples of individual strategies for coping with impoliteness, such as interrupting and postponing interpreting. These strategies border behavioral strategies and conflict with the Norwegian ethical guidelines for interpreting. In light of the ethical guidelines and actual practice, mapping and discussing different strategies used by interpreters might heighten interpreters’ and interpreter-users’ awareness of the role impoliteness can play in institutional interpreter– mediated encounters. 

  11. Mounting clips for panel installation

    Energy Technology Data Exchange (ETDEWEB)

    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.

  12. Measuring the match between evaluators and evaluees : cognitive distances between panel members and research groups at the journal level

    NARCIS (Netherlands)

    Rahman, A.I.M.J.; Guns, R.; Leydesdorff, L.; Engels, T.C.E.

    2016-01-01

    When research groups are evaluated by an expert panel, it is an open question how one can determine the match between panel and research groups. In this paper, we outline two quantitative approaches that determine the cognitive distance between evaluators and evaluees, based on the journals they

  13. 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...

  14. Treatment for Addiction: Advancing the Common Good. Recommendations from a Join Together Policy Panel on Treatment and Recovery.

    Science.gov (United States)

    Join Together, Boston, MA.

    Join Together convened a panel of experts to review U.S. policies for addiction treatment and recovery. Although the panel reached an agreement on six recommendations for policy changes that can make help more accessible and expand treatment to more people. These recommendations are: (1) treatment for alcoholism and other drug addiction must be…

  15. Rotating Machinery Predictive Maintenance Through Expert System

    Directory of Open Access Journals (Sweden)

    M. Sarath Kumar

    2000-01-01

    Full Text Available Modern rotating machines such as turbomachines, either produce or absorb huge amount of power. Some of the common applications are: steam turbine-generator and gas turbine-compressor-generator trains produce power and machines, such as pumps, centrifugal compressors, motors, generators, machine tool spindles, etc., are being used in industrial applications. Condition-based maintenance of rotating machinery is a common practice where the machine's condition is monitored constantly, so that timely maintenance can be done. Since modern machines are complex and the amount of data to be interpreted is huge, we need precise and fast methods in order to arrive at the best recommendations to prevent catastrophic failure and to prolong the life of the equipment. In the present work using vibration characteristics of a rotor-bearing system, the condition of a rotating machinery (electrical rotor is predicted using an off-line expert system. The analysis of the problem is carried out in an Object Oriented Programming (OOP framework using the finite element method. The expert system which is also developed in an OOP paradigm gives the type of the malfunctions, suggestions and recommendations. The system is implemented in C++.

  16. 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...

  17. Expert opinion survey on the impacts of air pollutants on forests of the USA

    Science.gov (United States)

    J.M. Pye; J.E. de Steiguer; C. Love

    1988-01-01

    A panel of experts was surveyed to obtain five air pollutants (SO2 NO2, O3, H2SO4, and HNO3) on growth, mortality, and leaf area of forests of the continental U.S. for later input to economic analysis. Results from the first two of three...

  18. 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.

  19. Clinical Space Medicine Panel

    Science.gov (United States)

    Baisden, Denise L.; Billica, Roger (Technical Monitor)

    2000-01-01

    The practice of space medicine is diverse. It includes routine preventive medical care of astronauts and pilots, the development of inflight medical capability and training of flight crews as well as the preflight, inflight, and postflight medical assessment and monitoring. The Johnson Space Center Medical Operations Branch is a leader in the practice of space medicine. The papers presented in this panel will demonstrate some of the unique aspects of space medicine.

  20. Diagnosing battery behavior with an expert system in PROLOG

    Science.gov (United States)

    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. A BASIC program running on a 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.

  1. Renal replacement therapy in adult and pediatric intensive care : Recommendations by an expert panel from the French Intensive Care Society (SRLF) with the French Society of Anesthesia Intensive Care (SFAR) French Group for Pediatric Intensive Care Emergencies (GFRUP) the French Dialysis Society (SFD).

    Science.gov (United States)

    Vinsonneau, Christophe; Allain-Launay, Emma; Blayau, Clarisse; Darmon, Michael; Ducheyron, Damien; Gaillot, Theophile; Honore, Patrick M; Javouhey, Etienne; Krummel, Thierry; Lahoche, Annie; Letacon, Serge; Legrand, Matthieu; Monchi, Mehran; Ridel, Christophe; Robert, René; Schortgen, Frederique; Souweine, Bertrand; Vaillant, Patrick; Velly, Lionel; Osman, David; Van Vong, Ly

    2015-12-01

    Acute renal failure (ARF) in critically ill patients is currently very frequent and requires renal replacement therapy (RRT) in many patients. During the last 15 years, several studies have considered important issues regarding the use of RRT in ARF, like the time to initiate the therapy, the dialysis dose, the types of catheter, the choice of technique, and anticoagulation. However, despite an abundant literature, conflicting results do not provide evidence on RRT implementation. We present herein recommendations for the use of RRT in adult and pediatric intensive care developed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system by an expert group of French Intensive Care Society (SRLF), with the participation of the French Society of Anesthesia and Intensive Care (SFAR), the French Group for Pediatric Intensive Care and Emergencies (GFRUP), and the French Dialysis Society (SFD). The recommendations cover 4 fields: criteria for RRT initiation, technical aspects (access routes, membranes, anticoagulation, reverse osmosis water), practical aspects (choice of the method, peritoneal dialysis, dialysis dose, adjustments), and safety (procedures and training, dialysis catheter management, extracorporeal circuit set-up). These recommendations have been designed on a practical point of view to provide guidance for intensivists in their daily practice.

  2. 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.

  3. A Phenomenology of Expert Musicianship

    DEFF Research Database (Denmark)

    Høffding, Simon

    This dissertation develops a phenomenology of expert musicianship through an interdisciplinary approach that integrates qualitative interviews with the Danish String Quartet with philosophical analyses drawing on ideas and theses found in phenomenology, philosophy of mind, cognitive science...... and psychology of music. The dissertation is structured through the asking, analyzing and answering of three primary questions, namely: 1) What is it like to be an expert? 2) What is the general phenomenology of expert musicianship? 3) What happens to the self in deep musical absorption? The first question...... targets a central debate in philosophy and psychology on whether reflection is conducive for, or detrimental to, skillful performance. My analyses show that the concepts assumed in the literature on this question are poorly defined and gloss over more important features of expertise. The second question...

  4. Database and Expert Systems Applications

    DEFF Research Database (Denmark)

    Viborg Andersen, Kim; Debenham, John; Wagner, Roland

    This book constitutes the refereed proceedings of the 16th International Conference on Database and Expert Systems Applications, DEXA 2005, held in Copenhagen, Denmark, in August 2005.The 92 revised full papers presented together with 2 invited papers were carefully reviewed and selected from 390......, reasoning and learning, network management and mobile systems, expert systems and decision support, and information modelling.......This book constitutes the refereed proceedings of the 16th International Conference on Database and Expert Systems Applications, DEXA 2005, held in Copenhagen, Denmark, in August 2005.The 92 revised full papers presented together with 2 invited papers were carefully reviewed and selected from 390...... submissions. The papers are organized in topical sections on workflow automation, database queries, data classification and recommendation systems, information retrieval in multimedia databases, Web applications, implementational aspects of databases, multimedia databases, XML processing, security, XML...

  5. Helping operators improve plant performance emdash HEATXPRT; An on-line expert system

    Energy Technology Data Exchange (ETDEWEB)

    Henry, R.E.; Sopocy, D.M.; Montanus, J.A. (Sargent and Lundy, Chicago, IL (US)); Blanco, M.A. (Electric Power Research Inst., Palo Alto, CA (US)); Bleakley, K.W. (Northern Indiana Public Service Co., Hammond, IN (US)); Perry, S.A. (Will County Station, Commonwealth Edison Co., Romeoville, IL (US))

    1992-01-01

    An on-line expert system for fossil fuel power plants, Heat Rate Degradation Advisor, or HEATXPRT, is being developed. This expert system will be used to automate the interpretation of plant operating data using available on-line plant physical and performance data, along with manual input of additional measurements and observations when necessary. This expert system will operate on a microcomputer and will interface with existing plant data acquisition and/or thermal performance monitoring systems, which presents a variety of design challenges. Several significant features of this expert system are discussed in this paper, including the design of a modular expert system architecture, design of a consistent user interface, development of a standard specification for information transfer, application of sensor validation techniques, and development of a knowledge base suitable for the interpretation of on-line data.

  6. [Quality scale for preschool spirometry interpretation].

    Science.gov (United States)

    Gatto, Francisca; Bedregal, Paula; Ubilla, Carlos; Barrientos, Hortensia; Caussade, Solange

    2017-02-01

    Since 2007, there are international guidelines for implementation and interpretation of spirometry in preschool children. A percentage of these patients cannot obtain maneuvers that meet all eligibility criteria. The objective of this study was to develop a quality scale for interpreting these partially acceptable spirometry. Delphi methodology was used, which allows to reach consensus among experts analyzing a defined problem. We invited to participate pediatric pneumologists dedicated to lung function and who participated actively in scientific specialty societies in Chile. Successive rounds were conducted with questionnaires about criteria used to assess spirometry in preschool children. These criteria define the acceptability of spirometric maneuvers according to international guidelines. Proposed quality grades were “very good”, “good”, “fair” and “bad”. Thirteen of the 15 invited experts accepted our invitation. In the first round 9 disagreed with the degree of “regular” quality. In the second round this was removed and 11 experts answered, 9 of them agreed with the use of this new version. The most contentious criterion was the end of expiration. Most experts agreed with the final scale, using “very good”, “good” and “bad” judgments. This would help to improve the performance of spirometry in children between 2 and 5 years.

  7. 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

  8. Database and Expert Systems Applications

    DEFF Research Database (Denmark)

    Viborg Andersen, Kim; Debenham, John; Wagner, Roland

    This book constitutes the refereed proceedings of the 16th International Conference on Database and Expert Systems Applications, DEXA 2005, held in Copenhagen, Denmark, in August 2005.The 92 revised full papers presented together with 2 invited papers were carefully reviewed and selected from 390...... submissions. The papers are organized in topical sections on workflow automation, database queries, data classification and recommendation systems, information retrieval in multimedia databases, Web applications, implementational aspects of databases, multimedia databases, XML processing, security, XML......, reasoning and learning, network management and mobile systems, expert systems and decision support, and information modelling....

  9. A Phenomenology of Expert Musicianship

    DEFF Research Database (Denmark)

    Høffding, Simon

    targets a central debate in philosophy and psychology on whether reflection is conducive for, or detrimental to, skillful performance. My analyses show that the concepts assumed in the literature on this question are poorly defined and gloss over more important features of expertise. The second question...... and psychology of music. The dissertation is structured through the asking, analyzing and answering of three primary questions, namely: 1) What is it like to be an expert? 2) What is the general phenomenology of expert musicianship? 3) What happens to the self in deep musical absorption? The first question...

  10. Expert and novice facilitated modelling

    DEFF Research Database (Denmark)

    Tavella, Elena; Papadopoulos, Thanos

    2015-01-01

    This paper provides an empirical study based on action research in which expert and novice facilitators in facilitated modelling workshops are compared. There is limited empirical research analysing the differences between expert and novice facilitators. Aiming to address this gap we study......, and empirically supports the claim that facilitation skills can be taught to participants to enable them to self-facilitate workshops. Differences were also found, which led to the introduction of a new dimension—‘internal versus external’ facilitation. The implications of our findings for effective training...

  11. A Phenomenology of Expert Musicianship

    DEFF Research Database (Denmark)

    Høffding, Simon

    and psychology of music. The dissertation is structured through the asking, analyzing and answering of three primary questions, namely: 1) What is it like to be an expert? 2) What is the general phenomenology of expert musicianship? 3) What happens to the self in deep musical absorption? The first question...... targets a central debate in philosophy and psychology on whether reflection is conducive for, or detrimental to, skillful performance. My analyses show that the concepts assumed in the literature on this question are poorly defined and gloss over more important features of expertise. The second question...

  12. Interpreting physicochemical experimental data sets.

    Science.gov (United States)

    Colclough, Nicola; Wenlock, Mark C

    2015-09-01

    With the wealth of experimental physicochemical data available to chemoinformaticians from the literature, commercial, and company databases an increasing challenge is the interpretation of such datasets. Subtle differences in experimental methodology used to generate these datasets can give rise to variations in physicochemical property values. Such methodology nuances will be apparent to an expert experimentalist but not necessarily to the data analyst and modeller. This paper describes the differences between common methodologies for measuring the four most important physicochemical properties namely aqueous solubility, octan-1-ol/water distribution coefficient, pK(a) and plasma protein binding highlighting key factors that can lead to systematic differences. Insight is given into how to identify datasets suitable for combining.

  13. Blood Test: Comprehensive Metabolic Panel (CMP)

    Science.gov (United States)

    ... Voice in Health Care Decisions Blood Test: Comprehensive Metabolic Panel (CMP) KidsHealth > For Parents > Blood Test: Comprehensive Metabolic Panel ( ... or kidneys) is working. What Is a Comprehensive Metabolic Panel (CMP)? The comprehensive metabolic panel (CMP) is a ...

  14. Establishing Yourself as an Expert in Nutrition Science: Advice for Young Professionals.

    Science.gov (United States)

    Ciappio, Eric D; Lesser, Mary N R

    2016-01-01

    In today's world in which there is a surplus of both scientists and online nutrition "experts," how do young professionals establish themselves? Becoming established as an expert requires selling yourself and your ideas to your colleagues and the general public by using effective communication skills. Helping young professionals develop these skills was the goal of a panel held at the ASN Scientific Sessions and Annual Meeting at Experimental Biology 2015. This panel featured a set of distinguished speakers who discussed techniques and strategies to enhance professional reputations centered around effectively leveraging communication platforms and opportunities to engage with colleagues. Early-career nutrition scientists can use the guidance provided by the panelists to improve their visibility and be a champion for themselves in order to establish themselves as experts in the field. © 2016 American Society for Nutrition.

  15. Nutritional advice for community patients: insights from a panel discussion.

    Science.gov (United States)

    Thomas, Linda V; Jenkins, Gill; Belton, Julie; Clements, Suzie; Jacob, Ciara; Johnson, Naomi; Joy, Deirdre; Low, Jennifer; Munson, Eileen; Sheppard, Jessica

    2016-03-01

    This article describes the conclusions of an expert panel that discussed four case studies; these were examples of patients typically encountered by nurses working in the community. The panel considered the nutritional and lifestyle advice that could be given by nurses relating to conditions such as irritable bowel syndrome (IBS), depression, chronic fatigue syndrome, vulnerability to common infections, elderly care, recurrent urinary tract infection, antibiotic use, and risk of type 2 diabetes. A general conclusion was the importance of motivational interviewing techniques in achieving full understanding of patients' concerns and to determine the best health strategy. As well as specific guidance appropriate for each disorder, a range of information sources for both health professionals and patients are listed in the paper. The panel noted that, although general nutritional advice can be given by nurses working at GP surgeries and in the community, patients should always be referred to registered dietitians or nutritionists if significant dietary changes are considered.

  16. Database and Expert Systems Applications

    DEFF Research Database (Denmark)

    Viborg Andersen, Kim; Debenham, John; Wagner, Roland

    submissions. The papers are organized in topical sections on workflow automation, database queries, data classification and recommendation systems, information retrieval in multimedia databases, Web applications, implementational aspects of databases, multimedia databases, XML processing, security, XML......, reasoning and learning, network management and mobile systems, expert systems and decision support, and information modelling....

  17. QUEST: Quality of Expert Systems

    NARCIS (Netherlands)

    Perre, M.

    1991-01-01

    TNO Physics and Electronics laboratory, in collaboration with the University of Limburg and the Research Institute for Knowledge Systems, worked on a technology project named 'QUEST: Quality of Expert Systems' [FEL90]. QUEST was carried out under commision of the Dutch Ministry of Defence. A strong

  18. Computers that Think Like Experts.

    Science.gov (United States)

    Kinnucan, Paul

    1984-01-01

    Discusses the nature of expert systems, including various techniques they use to represent knowledge (such as production rules, semantic networks, frames, first-order logic, and others), system interactions, and such problem domains as science, medicine, computer configuration, trouble-shooting/repair, and oil/mineral exploration. Also discusses…

  19. Laserjet Printer Troubleshooting Expert System

    African Journals Online (AJOL)

    SOFTLINKS DIGITAL

    This paper model an expert system called LAPTEX for troubleshooting LaserJet printers' faults. Today, with the innumerable advances in information technologies, computerizing printer's fault troubleshooting and identifying faults is far becoming so vital. Also, printers' fault detection is a complicated process that requires a ...

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

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Abraham J., E-mail: wua@mskcc.org [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Bosch, Walter R. [Washington University, St. Louis, Missouri (United States); Chang, Daniel T. [Stanford Cancer Institute, Stanford, California (United States); Hong, Theodore S. [Massachusetts General Hospital, Boston, Massachusetts (United States); Jabbour, Salma K. [Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey (United States); Kleinberg, Lawrence R. [Johns Hopkins Medical Center, Baltimore, Maryland (United States); Mamon, Harvey J. [Brigham and Women' s Hospital, Boston, Massachusetts (United States); Thomas, Charles R. [Knight Cancer Institute, Oregon Health & Sciences University, Portland, Oregon (United States); Goodman, Karyn A. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2015-07-15

    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.

  1. Interpreting. PEPNet Tipsheet

    Science.gov (United States)

    Darroch, Kathleen

    2010-01-01

    An interpreter's role is to facilitate communication and convey all auditory and signed information so that both hearing and deaf individuals may fully interact. The common types of services provided by interpreters are: (1) American Sign Language (ASL) Interpretation--a visual-gestural language with its own linguistic features; (2) Sign Language…

  2. Engineering Definitional Interpreters

    DEFF Research Database (Denmark)

    Midtgaard, Jan; Ramsay, Norman; Larsen, Bradford

    2013-01-01

    A definitional interpreter should be clear and easy to write, but it may run 4--10 times slower than a well-crafted bytecode interpreter. In a case study focused on implementation choices, we explore ways of making definitional interpreters faster without expending much programming effort. We...

  3. The Naive Expert and the Gifted Child.

    Science.gov (United States)

    Timpson, William M.; Jones, Christine

    1989-01-01

    Mentorship programs are described which involve gifted students and subject experts with no prior knowledge about students' personalities or preconceptions about their abilities, known as "naive experts." The students are challenged by the experts' high expectations and respond to the experts' enthusiasm for sharing their knowledge and…

  4. Concentrating photovoltaic solar panel

    Science.gov (United States)

    Cashion, Steven A; Bowser, Michael R; Farrelly, Mark B; Hines, Braden E; Holmes, Howard C; Johnson, Jr., Richard L; Russell, Richard J; Turk, Michael F

    2014-04-15

    The present invention relates to photovoltaic power systems, photovoltaic concentrator modules, and related methods. In particular, the present invention features concentrator modules having interior points of attachment for an articulating mechanism and/or an articulating mechanism that has a unique arrangement of chassis members so as to isolate bending, etc. from being transferred among the chassis members. The present invention also features adjustable solar panel mounting features and/or mounting features with two or more degrees of freedom. The present invention also features a mechanical fastener for secondary optics in a concentrator module.

  5. Photovoltaic panel clamp

    Science.gov (United States)

    Brown, Malcolm P.; Mittan, Margaret Birmingham; Miros, Robert H. J.; Stancel, Robert

    2013-03-19

    A photovoltaic panel clamp includes an upper and lower section. The interface between the assembled clamp halves and the module edge is filled by a flexible gasket material, such as EPDM rubber. The gasket preferably has small, finger like protrusions that allow for easy insertion onto the module edge while being reversed makes it more difficult to remove them from the module once installed. The clamp includes mounting posts or an integral axle to engage a bracket. The clamp also may include a locking tongue to secure the clamp to a bracket.

  6. Auto-interpreter for CYP2D6 SNaPshot genotyping.

    Science.gov (United States)

    Ong, Sungmoon; Jeong, Hye-Eun; Lee, Sang Seop; Shon, Ji-Hong; Shin, Jae-Gook; Kim, Eun-Young

    2008-11-06

    CYP2D6 genotyping using SNaPshot method is a very useful tool clinically. However it's hard to interpret the obtained data as a genotype without training. Thus SNaPshot auto-interpreter for the genotype was designed to interpret obtained raw data to a genotype. The auto-interpreter showed good concordance with experts' reading. The validated auto-interpreter of CYP2D6 genotyping using SNaPshot can contribute to accelerating the clinical use.

  7. Capturing expert uncertainty in spatial cumulative impact assessments.

    Science.gov (United States)

    Jones, Alice R; Doubleday, Zoë A; Prowse, Thomas A A; Wiltshire, Kathryn H; Deveney, Marty R; Ward, Tim; Scrivens, Sally L; Cassey, Phillip; O'Connell, Laura G; Gillanders, Bronwyn M

    2018-01-23

    Understanding the spatial distribution of human impacts on marine environments is necessary for maintaining healthy ecosystems and supporting 'blue economies'. Realistic assessments of impact must consider the cumulative impacts of multiple, coincident threats and the differing vulnerabilities of ecosystems to these threats. Expert knowledge is often used to assess impact in marine ecosystems because empirical data are lacking; however, this introduces uncertainty into the results. As part of a spatial cumulative impact assessment for Spencer Gulf, South Australia, we asked experts to estimate score ranges (best-case, most-likely and worst-case), which accounted for their uncertainty about the effect of 32 threats on eight ecosystems. Expert scores were combined with data on the spatial pattern and intensity of threats to generate cumulative impact maps based on each of the three scoring scenarios, as well as simulations and maps of uncertainty. We compared our method, which explicitly accounts for the experts' knowledge-based uncertainty, with other approaches and found that it provides smaller uncertainty bounds, leading to more constrained assessment results. Collecting these additional data on experts' knowledge-based uncertainty provides transparency and simplifies interpretation of the outputs from spatial cumulative impact assessments, facilitating their application for sustainable resource management and conservation.

  8. The World (of Warcraft through the eyes of an expert

    Directory of Open Access Journals (Sweden)

    Yousri Marzouki

    2017-09-01

    Full Text Available Negative correlations between pupil size and the tendency to look at salient locations were found in recent studies (e.g., Mathôt et al., 2015. It is hypothesized that this negative correlation might be explained by the mental effort put by participants in the task that leads in return to pupil dilation. Here we present an exploratory study on the effect of expertise on eye-movement behavior. Because there is no available standard tool to evaluate WoW players’ expertise, we built an off-game questionnaire testing players’ knowledge about WoW and acquired skills through completed raids, highest rated battlegrounds, Skill Points, etc. Experts (N = 4 and novices (N = 4 in the massively multiplayer online role-playing game World of Warcraft (WoW viewed 24 designed video segments from the game that differ in regards with their content (i.e, informative locations and visual complexity (i.e, salient locations. Consistent with previous studies, we found a negative correlation between pupil size and the tendency to look at salient locations (experts, r =  − .17, p < .0001, and novices, r =  − .09, p < .0001. This correlation has been interpreted in terms of mental effort: People are inherently biased to look at salient locations (sharp corners, bright lights, etc., but are able (i.e., experts to overcome this bias if they invest sufficient mental effort. Crucially, we observed that this correlation was stronger for expert WoW players than novice players (Z =  − 3.3, p = .0011. This suggests that experts learned to improve control over eye-movement behavior by guiding their eyes towards informative, but potentially low-salient areas of the screen. These findings may contribute to our understanding of what makes an expert an expert.

  9. Making a team of experts into an expert team.

    Science.gov (United States)

    Charney, Carol

    2011-10-01

    Health care has traditionally been delivered primarily by experts working individually in a decentralized system lacking cohesive organization among professional disciplines. Only recently have the advantages of teamwork training been acknowledged in health care. This article explores the history, benefits, and recommendations for team training in neonatal care. TeamSTEPPS (Rockville, MD) and the revised Neonatal Resuscitation Program are cited as promising models for improved neonatal outcomes through professional teamwork.

  10. The "Virtual" Panel: A Computerized Model for LGBT Speaker Panels.

    Science.gov (United States)

    Beasley, Christopher; Torres-Harding, Susan; Pedersen, Paula J

    2012-10-01

    Recent societal trends indicate more tolerance for homosexuality, but prejudice remains on college campuses. Speaker panels are commonly used in classrooms as a way to educate students about sexual diversity and decrease negative attitudes toward sexual diversity. The advent of computer delivered instruction presents a unique opportunity to broaden the impact of traditional speaker panels. The current investigation examined the influence of an interactive "virtual" gay and lesbian speaker panel on cognitive, affective, and behavioral homonegativity. Findings suggest the computer-administered panel is lowers homonegativity, particularly for affective experiential homonegativity. The implications of these findings for research and practice are discussed.

  11. 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.

  12. 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.

  13. 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...

  14. Interpretation biases in paranoia.

    Science.gov (United States)

    Savulich, George; Freeman, Daniel; Shergill, Sukhi; Yiend, Jenny

    2015-01-01

    Information in the environment is frequently ambiguous in meaning. Emotional ambiguity, such as the stare of a stranger, or the scream of a child, encompasses possible good or bad emotional consequences. Those with elevated vulnerability to affective disorders tend to interpret such material more negatively than those without, a phenomenon known as "negative interpretation bias." In this study we examined the relationship between vulnerability to psychosis, measured by trait paranoia, and interpretation bias. One set of material permitted broadly positive/negative (valenced) interpretations, while another allowed more or less paranoid interpretations, allowing us to also investigate the content specificity of interpretation biases associated with paranoia. Regression analyses (n=70) revealed that trait paranoia, trait anxiety, and cognitive inflexibility predicted paranoid interpretation bias, whereas trait anxiety and cognitive inflexibility predicted negative interpretation bias. In a group comparison those with high levels of trait paranoia were negatively biased in their interpretations of ambiguous information relative to those with low trait paranoia, and this effect was most pronounced for material directly related to paranoid concerns. Together these data suggest that a negative interpretation bias occurs in those with elevated vulnerability to paranoia, and that this bias may be strongest for material matching paranoid beliefs. We conclude that content-specific biases may be important in the cause and maintenance of paranoid symptoms. Copyright © 2014. Published by Elsevier Ltd.

  15. 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.

  16. Desain Panel Absorpsi Difusor Bunu

    Directory of Open Access Journals (Sweden)

    Indradjaja Makainas

    2017-03-01

    Full Text Available Panel Absorpsi Difusor Bunu adalah panel akustik yang berfungsi sebagai penyerap sekaligus pemencar bunyi yang terbuat dari sabut kelapa (bunu. Panel ini digunakan untuk mendapatkan Waktu Dengung (ReveberationTime sesuai standar kenyamanan pendengaran didalam ruang teater rumah (home theater, ruang karaoke, studio penyiaran radio, studio rekaman, ruang kelas/siding ,ruangi badah, auditorium. Bunu sebagai bahan yang melimpah di seluruh pelosok Nusantara yang dikenal dengan sebutan kepulauan Nyiur Melambai perlu dimaksimalkan pemanfaatannya. Didaerah umumnya bunu hanya dijadikan sebagai bahan bakar memasak, malah menjadi limbah dari hasil pengolahan kopra. Panel dikerjakan di AKAS desa Rantewringin kabupaten Kebumen provinsi Jawa Tengah dengan cara manua lkecual idalam menguraikan sabut kelapa menjadi serat (coirfibre dan serbuk (cocopeat. Bahan pembuat panel adalah seratnya yang disusun berlapis. Panel dibuat dalam 2 (dua jenis terdiri dari yang datar yang disebut panel indrabunu 01 dan piramida disebut indrabunu 02, untuk mendapatkan nilai koefisien serap αyang berbeda. Pengujian nilai α dari panel dilakukan di Laboratorium Akustik Pusat Penelitian Metrologi LIPI Serpong. Kata Kunci : bunu,panel,absorpsi,difusor

  17. 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)

  18. Expert witness and Jungian archetypes.

    Science.gov (United States)

    Lallave, Juan Antonio; Gutheil, Thomas Gordon

    2012-01-01

    Jung's theories of archetype, shadow, and the personal and collective unconscious provide a postmodern framework in which to consider the role of the expert witness in judicial proceedings. Archetypal themes, motifs, and influences help to illuminate the shadow of the judicial system and projections and behaviors among the cast of the court in pursuing justice. This article speaks to archetypal influences and dialectical tensions encountered by the expert witness in this judicial drama. The archetype of Justice is born from the human need for order and relational fairness in a world of chaos. The persona of justice is the promise of truth in the drama. The shadow of justice is untruth, the need to win by any means. The dynamics of the trickster archetype serve and promote injustice. These influences are examined by means of a case example. This approach will deepen understanding of court proceedings and the role of the expert witness in the heroic quest for justice. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Expert System for ASIC Imaging

    Science.gov (United States)

    Gupta, Shri N.; Arshak, Khalil I.; McDonnell, Pearse; Boyce, Conor; Duggan, Andrew

    1989-07-01

    With the developments in the techniques of artificial intelligence over the last few years, development of advisory, scheduling and similar class of problems has become very convenient using tools such as PROLOG. In this paper an expert system has been described which helps lithographers and process engineers in several ways. The methodology used is to model each work station according to its input, output and control parameters, combine these work stations in a logical sequence based on past experience and work out process schedule for a job. In addition, all the requirements vis-a-vis a particular job parameters are converted into decision rules. One example is the exposure time, develop time for a wafer with different feature sizes would be different. This expert system has been written in Turbo Prolog. By building up a large number of rules, one can tune the program to any facility and use it for as diverse applications as advisory help, trouble shooting etc. Leitner (1) has described an advisory expert system that is being used at National Semiconductor. This system is quite different from the one being reported in the present paper. The approach is quite different for one. There is stress on job flow and process for another.

  20. Diffusion-weighted MRI to assess response to chemoradiotherapy in rectal cancer: main interpretation pitfalls and their use for teaching

    NARCIS (Netherlands)

    Lambregts, Doenja M. J.; van Heeswijk, Miriam M.; Delli Pizzi, Andrea; van Elderen, Saskia G. C.; Andrade, Luisa; Peters, Nicky H. G. M.; Kint, Peter A. M.; Osinga-de Jong, Margreet; Bipat, Shandra; Ooms, Rik; Lahaye, Max J.; Maas, Monique; Beets, Geerard L.; Bakers, Frans C. H.; Beets-Tan, Regina G. H.

    2017-01-01

    To establish the most common image interpretation pitfalls for non-expert readers using diffusion-weighted imaging (DWI) to assess response to chemoradiotherapy in patients with rectal cancer and to explore the use of these pitfalls in an expert teaching setting. Two independent non-expert readers

  1. Genre and Interpretation

    DEFF Research Database (Denmark)

    Auken, Sune

    2015-01-01

    Despite the immensity of genre studies as well as studies in interpretation, our understanding of the relationship between genre and interpretation is sketchy at best. The article attempts to unravel some of intricacies of that relationship through an analysis of the generic interpretation carried...... out by us all in everyday life, and the role of generic interpretation in scholarly work. The article argues that the role played by genre in interpretation has as much to do with the individual characteristics of an utterance as with its relationship to other utterances. An interest in the generic...... traits of an utterance will lead to a characterization of its individual, as well as its general characteristics. The article proceeds to describe three central concepts within genre studies that are applicable to generic interpretation: “horizon of expectation,” “world,” and the triad “theme...

  2. On court interpreters' visibility

    DEFF Research Database (Denmark)

    Dubslaff, Friedel; Martinsen, Bodil

    of the service they receive. Ultimately, the findings will be used for training purposes. Future - and, for that matter, already practising - interpreters as well as the professional users of interpreters ought to take the reality of the interpreters' work in practice into account when assessing the quality...... in by the participants almost immediately after the interrogations and supplemented by interviews. The main objective of the project is to explore the interpreters' own perception of the quality of the service they render as well as the professional users´ and the other language users' perception of the quality...... of the interpreter as an invisible language switcher. However, a closer look at the data shows that, even in a less complex constellation like the one analysed here, there is clear evidence of the interpreter's visibility. We shall identify various forms of visibility based on the discourse data...

  3. 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

  4. Interpreting land records

    CERN Document Server

    Wilson, Donald A

    2014-01-01

    Base retracement on solid research and historically accurate interpretation Interpreting Land Records is the industry's most complete guide to researching and understanding the historical records germane to land surveying. Coverage includes boundary retracement and the primary considerations during new boundary establishment, as well as an introduction to historical records and guidance on effective research and interpretation. This new edition includes a new chapter titled "Researching Land Records," and advice on overcoming common research problems and insight into alternative resources wh

  5. Human Research Program 2010 Chair Standing Review Panel Meeting

    Science.gov (United States)

    Steinberg, Susan

    2011-01-01

    /Project representatives and maybe outside experts), to interpret the several meanings of integration and how they best can be implemented for the HRP. Another suggestion regarding integration between HRP Elements/Projects is that the HRP convene a meeting of scientists who have a good record of pursuing multidisciplinary/integrative research in the general areas that are relevant to the HRP; identify those that are of high priority; and then support research on those, giving priority to multidisciplinary/integrative teams in which all relevant HRP disciplines are represented. Some of these teams may be already established and functioning within the HRP; others might be organized in response to NASA's research announcements. Lastly, the Chair (+1) SRP felt that there were two overarching issues that spanned across all of the HRP Elements/Projects. The first, which was discussed in great detail, is access to the astronaut medical records, psychological as well as physical. New research will not be useful unless one has access to what has been done, what has worked, and what has not worked. Second is access to records of what medications are being taken by the astronauts while in-flight. The Chair (+1) SRP feels that there needs to be good medical reconciliation to know beginning to end what is happening healthwise to the astronauts.

  6. Acquisition of Expert/Non-Expert Vocabulary from Reformulations.

    Science.gov (United States)

    Antoine, Edwige; Grabar, Natalia

    2017-01-01

    Technical medical terms are complicated to be correctly understood by non-experts. Vocabulary, associating technical terms with layman expressions, can help in increasing the readability of technical texts and their understanding. The purpose of our work is to build this kind of vocabulary. We propose to exploit the notion of reformulation following two methods: extraction of abbreviations and of reformulations with specific markers. The segments associated thanks to these methods are aligned with medical terminologies. Our results allow to cover over 9,000 medical terms and show precision of extractions between 0.24 and 0.98. The results and analyzed and compared with the existing work.

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

    OpenAIRE

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

    2017-01-01

    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...

  8. HIV2EU: supporting standardized HIV-2 drug resistance interpretation in Europe

    Directory of Open Access Journals (Sweden)

    F Brun-Vezinet

    2012-11-01

    Full Text Available Various items are complicating the treatment of HIV-2 infected patients. Compared to HIV-1 there is much less treatment experience, no evidence from randomized control trials, a reduced number of effective drugs and no broadly available test for viral load monitoring. In case of treatment failure there is only limited guidance and presently no easy accessible tool for nucleic acid sequence interpretation available. To solve this problem, we initiated an expert workshop to address some of these problems. A panel of experts from four different European countries voted on a rule set for interpretation of mutations in the HIV-2 protease, reverse transcriptase and integrase. Rules were proposed by each member and were then modified during discussion by considering data gained from HIV-1 and accumulated experience of the follow up of HIV-2-infected patients. Based on the HIV-GRADE internet-tool an online tool was developed to make the rule set easily accessible and usable. Rules were laid down for the interpretation of HIV-2 drug resistance to NRTIs, PIs and INIs (integrase inhibitors. Due to natural resistance of HIV-2, usage of NNRTIs and T-20 was not recommended as part of an antiretroviral regimen for HIV-2. These rules were then translated in a machine interpretable format (algorithm specification interface, ASI and the HIV-GRADE tool was extended for usage of HIV-2 sequences. Further consensus sequences were generated from the reference sequence data set provided by Los Alamos National Laboratories. In contrast to HIV-1, mutations were compared to a group specific consensus sequence (Group A or Group B and not to a consensus sequence from the most predominant HIV-2 Group A. This change was necessary due to significant differences between the various HIV-2 strains. We developed a rule set and an automated tool for HIV-2 drug resistance analyses. This tool and the rules will be freely available on the internet. Access to the pre

  9. Plane and parabolic solar panels

    OpenAIRE

    Sales, J. H. O.; Suzuki, A. T.

    2009-01-01

    We present a plane and parabolic collector that absorbs radiant energy and transforms it in heat. Therefore we have a panel to heat water. We study how to increment this capture of solar beams onto the panel in order to increase its efficiency in heating water.

  10. Panel Smooth Transition Regression Models

    DEFF Research Database (Denmark)

    González, Andrés; Terasvirta, Timo; Dijk, Dick van

    We introduce the panel smooth transition regression model. This new model is intended for characterizing heterogeneous panels, allowing the regression coefficients to vary both across individuals and over time. Specifically, heterogeneity is allowed for by assuming that these coefficients are bou...

  11. 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.

  12. Prosody and Interpretation

    Science.gov (United States)

    Erekson, James A.

    2010-01-01

    Prosody is a means for "reading with expression" and is one aspect of oral reading competence. This theoretical inquiry asserts that prosody is central to interpreting text, and draws distinctions between "syntactic" prosody (for phrasing) and "emphatic" prosody (for interpretation). While reading with expression appears as a criterion in major…

  13. Linguistics in Text Interpretation

    DEFF Research Database (Denmark)

    Togeby, Ole

    2011-01-01

    A model for how text interpretation proceeds from what is pronounced, through what is said to what is comunicated, and definition of the concepts 'presupposition' and 'implicature'.......A model for how text interpretation proceeds from what is pronounced, through what is said to what is comunicated, and definition of the concepts 'presupposition' and 'implicature'....

  14. 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...... and in vitro toxicity testing. The article concludes with a set of recommendations for extended use and further development of microbioreactors....

  15. Expert SQL Server 2008 Development

    CERN Document Server

    Machanic, Adam

    2009-01-01

    Expert SQL Server 2008 Development is aimed at SQL Server developers ready to move beyond Books Online. Author and experienced developer Alastair Aitchison shows you how to think about SQL Server development as if it were any other type of development. You'll learn to manage testing in SQL Server and to properly deal with errors and exceptions. The book also covers critical, database-centric topics such as managing concurrency and securing your data and code through proper privileges and authorization. Alastair places focus on sound development and architectural practices that will help you be

  16. Expert Oracle RAC 12c

    CERN Document Server

    Shamsudeen, Riyaj; Yu, Kai; Farooq, Tariq

    2013-01-01

    Expert Oracle RAC 12c is a hands-on book helping you understand and implement Oracle Real Application Clusters (RAC), and to reduce the total-cost-of-ownership (TCO) of a RAC database. As a seasoned professional, you are probably aware of the importance of understanding the technical details behind the RAC stack. This book provides deep understanding of RAC concepts and implementation details that you can apply toward your day-to-day operational practices. You'll be guided in troubleshooting and avoiding trouble in your installation. Successful RAC operation hinges upon a fast-performing netwo

  17. Analysis of the drilling sound component from expert performance in a maxillo-facial surgery

    DEFF Research Database (Denmark)

    Hoffmann, Pablo F.; Gosselin, Florian; Taha, Farid

    2009-01-01

    Auditory displays can have a great potential in surgical simulators that aim at training skills associated to the correct interpretation of auditory information. Here, we present preliminary results in the analysis of the sound produced by the drilling procedure in a maxillo-facial surgery when...... performed by expert surgeons. The motivation of this work is to find relevant acoustic parameters that allow for an efficient synthesis method of auditory displays so that they can effectively convey information on expert surgical drilling....

  18. Expert Systems for auditing management information systems

    Directory of Open Access Journals (Sweden)

    Gheroghe Popescu

    2007-05-01

    Full Text Available Expert systems are built with the help of: specialised programming languages or expert system generators (shell. But this structure was reached after tens of years of work and research, because expert systems are nothing but pragmatic capitalisation of the results of research carried out in artificial intelligence and theory of knowledge.

  19. Enhancing the Learning Process with Expert Systems.

    Science.gov (United States)

    Karake, Zeinab A.

    1990-01-01

    Discusses the use of artificial intelligence and expert system shells to enhance the learning process of graduate or undergraduate statistics students. A student exercise is described using STAT-EXPERT, an expert system designed to help students select the appropriate statistical analysis technique. (25 references) (LRW)

  20. Differentiating Experts' Anticipatory Skills in Beach Volleyball

    Science.gov (United States)

    Canal-Bruland, Rouwen; Mooren, Merel; Savelsbergh, Geert J. P.

    2011-01-01

    In this study, we examined how perceptual-motor expertise and watching experience contribute to anticipating the outcome of opponents' attacking actions in beach volleyball. To this end, we invited 8 expert beach volleyball players, 8 expert coaches, 8 expert referees, and 8 control participants with no beach volleyball experience to watch videos…

  1. Fire Effects, Education, and Expert Systems

    Science.gov (United States)

    Robert E. Martin

    1987-01-01

    Predicting the effects of fires in the year 2000 and beyond will be enhanced by the use of expert systems. Although our predictions may have broad confidence limits, expert systems should help us to improve the predictions and to focus on the areas where improved knowledge is most needed. The knowledge of experts can be incorporated into previously existing knowledge...

  2. Evaluating Econometric Models and Expert Intuition

    NARCIS (Netherlands)

    R. Legerstee (Rianne)

    2012-01-01

    textabstractThis thesis is about forecasting situations which involve econometric models and expert intuition. The first three chapters are about what it is that experts do when they adjust statistical model forecasts and what might improve that adjustment behavior. It is investigated how expert

  3. Contextual Factors for Finding Similar Experts

    DEFF Research Database (Denmark)

    Hofmann, Katja; Balog, Krisztian; Bogers, Toine

    2010-01-01

    -seeking models, are rarely taken into account. In this article, we extend content-based expert-finding approaches with contextual factors that have been found to influence human expert finding. We focus on a task of science communicators in a knowledge-intensive environment, the task of finding similar experts...

  4. Interpretable Categorization of Heterogeneous Time Series Data

    Science.gov (United States)

    Lee, Ritchie; Kochenderfer, Mykel J.; Mengshoel, Ole J.; Silbermann, Joshua

    2017-01-01

    We analyze data from simulated aircraft encounters to validate and inform the development of a prototype aircraft collision avoidance system. The high-dimensional and heterogeneous time series dataset is analyzed to discover properties of near mid-air collisions (NMACs) and categorize the NMAC encounters. Domain experts use these properties to better organize and understand NMAC occurrences. Existing solutions either are not capable of handling high-dimensional and heterogeneous time series datasets or do not provide explanations that are interpretable by a domain expert. The latter is critical to the acceptance and deployment of safety-critical systems. To address this gap, we propose grammar-based decision trees along with a learning algorithm. Our approach extends decision trees with a grammar framework for classifying heterogeneous time series data. A context-free grammar is used to derive decision expressions that are interpretable, application-specific, and support heterogeneous data types. In addition to classification, we show how grammar-based decision trees can also be used for categorization, which is a combination of clustering and generating interpretable explanations for each cluster. We apply grammar-based decision trees to a simulated aircraft encounter dataset and evaluate the performance of four variants of our learning algorithm. The best algorithm is used to analyze and categorize near mid-air collisions in the aircraft encounter dataset. We describe each discovered category in detail and discuss its relevance to aircraft collision avoidance.

  5. Common problems in the elicitation and analysis of expert opinion affecting probabilistic safety assessments

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, M.A.; Booker, J.M.

    1990-01-01

    Expert opinion is frequently used in probabilistic safety assessment (PSA), particularly in estimating low probability events. In this paper, we discuss some of the common problems encountered in eliciting and analyzing expert opinion data and offer solutions or recommendations. The problems are: that experts are not naturally Bayesian. People fail to update their existing information to account for new information as it becomes available, as would be predicted by the Bayesian philosophy; that experts cannot be fully calibrated. To calibrate experts, the feedback from the known quantities must be immediate, frequent, and specific to the task; that experts are limited in the number of things that they can mentally juggle at a time to 7 {plus minus} 2; that data gatherers and analysts can introduce bias by unintentionally causing an altering of the expert's thinking or answers; that the level of detail the data, or granularity, can affect the analyses; and the conditioning effect poses difficulties in gathering and analyzing of the expert data. The data that the expert gives can be conditioned on a variety of factors that can affect the analysis and the interpretation of the results. 31 refs.

  6. Expert system validation in prolog

    Science.gov (United States)

    Stock, Todd; Stachowitz, Rolf; Chang, Chin-Liang; Combs, Jacqueline

    1988-01-01

    An overview of the Expert System Validation Assistant (EVA) is being implemented in Prolog at the Lockheed AI Center. Prolog was chosen to facilitate rapid prototyping of the structure and logic checkers and since February 1987, we have implemented code to check for irrelevance, subsumption, duplication, deadends, unreachability, and cycles. The architecture chosen is extremely flexible and expansible, yet concise and complementary with the normal interactive style of Prolog. The foundation of the system is in the connection graph representation. Rules and facts are modeled as nodes in the graph and arcs indicate common patterns between rules. The basic activity of the validation system is then a traversal of the connection graph, searching for various patterns the system recognizes as erroneous. To aid in specifying these patterns, a metalanguage is developed, providing the user with the basic facilities required to reason about the expert system. Using the metalanguage, the user can, for example, give the Prolog inference engine the goal of finding inconsistent conclusions among the rules, and Prolog will search the graph intantiations which can match the definition of inconsistency. Examples of code for some of the checkers are provided and the algorithms explained. Technical highlights include automatic construction of a connection graph, demonstration of the use of metalanguage, the A* algorithm modified to detect all unique cycles, general-purpose stacks in Prolog, and a general-purpose database browser with pattern completion.

  7. Syndromic Panel-Based Testing in Clinical Microbiology.

    Science.gov (United States)

    Ramanan, Poornima; Bryson, Alexandra L; Binnicker, Matthew J; Pritt, Bobbi S; Patel, Robin

    2018-01-01

    The recent development of commercial panel-based molecular diagnostics for the rapid detection of pathogens in positive blood culture bottles, respiratory specimens, stool, and cerebrospinal fluid has resulted in a paradigm shift in clinical microbiology and clinical practice. This review focuses on U.S. Food and Drug Administration (FDA)-approved/cleared multiplex molecular panels with more than five targets designed to assist in the diagnosis of bloodstream, respiratory tract, gastrointestinal, or central nervous system infections. While these panel-based assays have the clear advantages of a rapid turnaround time and the detection of a large number of microorganisms and promise to improve health care, they present certain challenges, including cost and the definition of ideal test utilization strategies (i.e., optimal ordering) and test interpretation. Copyright © 2017 American Society for Microbiology.

  8. Precision reproductive medicine: multigene panel testing for infertility risk assessment.

    Science.gov (United States)

    Collins, Stephen C

    2017-08-01

    The concept of precision medicine relies on a thorough understanding of the consequences of unique features of individual patients, such as environmental exposures and genetic profiles. A key component of implementing individualized care in this paradigm will be improved assessment of genetic risk. Compared with single gene tests, multigene panel testing-which has recently become commercially available for female infertility-offers the possibility of a more comprehensive and efficient risk evaluation. However, as the use of multigene panel testing for breast cancer risk has shown, this approach must be used judiciously to ensure its usefulness in a clinical setting. Key challenges which have been encountered in oncology include the interpretation of gene variants of questionable clinical effect and a lack of evidence to guide management after variants are identified. In this review, the core concepts of multigene panel testing for risk assessment are discussed, with careful attention to both its shortcomings as well as its potential for benefit in reproductive medicine.

  9. Hirsch on interpretation.

    Directory of Open Access Journals (Sweden)

    Andrzej Szahaj

    2013-01-01

    Full Text Available The main aim of the article is to reconstruct and critique E.D. Hirsch’s position in the debate about the necessary conditions and results of any interpretation. The author of this article seeks to demonstrate the difficulties connected with the intentionalist approach to the theory of interpretation which is typical of E.D. Hirsch and which unjustifiably privileges authorial intention. He also attempts to uncover the hidden assumptions of this approach by showing that, generally speaking, the dualist tendencies that are present in Hirsch’s theory cannot be justified. One of the objectives of this article is to propose an alternative approach to interpretation, which has been inspired by Stanley Fish and which emphasizes the integrity and monistic nature of interpretation as well as its constructivist and inevitably evaluative character. The author points to the fact that the arbitrarily established evaluation limits are unjustified as there is an element of evaluation on every level of interpretation and that the difference between understanding and interpretation cannot be validated. Also, one cannot interpret a text without each time referring to the social and cultural context.

  10. Expert assessment of the current state of the energy management system in the company

    Science.gov (United States)

    Minnullina, Anna; Abdrazakov, Rais

    2017-10-01

    The authors’ expert assessment of the current state of the energy management system in the company is proposed in the article. The experts are invited to assess the status of the energy management system in the following categories: energy policy, organizational structure, training, motivation, control, communication, investment, and energy consumption culture. For the purposes of interpretation of the results of the expert evaluation obtained, a gradation based on a possible range of values is proposed. The expert evaluation allows representing the status of the energy management system in general and at each of its individual levels, which makes it possible to identify the problem areas more accurately. To confirm the applied nature of the proposed methodology, the authors assessed the opinions of 8 experts, employed by the road construction company of the Tyumen Region and related in one way or another to the process of energy consumption in the company due to the nature of their activities.

  11. 7 CFR 1940.968 - Rural Economic Development Review Panel Grant (Panel Grant).

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 13 2010-01-01 2009-01-01 true Rural Economic Development Review Panel Grant (Panel... of Certain Rural Development Programs § 1940.968 Rural Economic Development Review Panel Grant (Panel... associated with a State rural economic development review panel. (b) Objective. The objective of the Panel...

  12. Interpretation as doing

    DEFF Research Database (Denmark)

    Majgaard Krarup, Jonna

    2008-01-01

    The intent of the paper is to address and discuss relationships between the aesthetic perception and interpretation of contemporary landscape architecture. I will try to do this by setting up a cross-disciplinary perspective that looks into themes from the contemporary art scene and aesthetic...... concept of landscape and design in landscape architecture, and hereby address the question of how interpretation might be processed. It is also my premise that a key point in this is the interplay between different sensory experiences of both material and non-material aspects......, and that it is this interplay that the individual collects into an entity – an interpretation – through an intellectual process....

  13. Improved segmentation of ultrasound brain tissue incorporating expert evaluation.

    Science.gov (United States)

    Vansteenkiste, Ewout; Pizurica, Aleksandra; Philips, Wilfried

    2005-01-01

    The quantitative analysis of medical ultrasound images for the purpose of diagnosis is a difficult task due to the speckle noise present in the images. Nowadays medical doctors depend strongly on the visual interpretation of the images which is subjective to some account. Trying to reduce this noise should assist the experts in a better understanding of some pathologies. We focus on a brain disease called periventricular leukomalacia, also called white matter damage, which occurs frequently on premature neonates. For the moment the affected brain tissue is segmented semi-automatically using two different techniques that take the speckle noise into little account. Here we propose a framework which includes an efficient preprocessing step and relying on expert-based evaluation we develop an integrated segmentation method, which yields a more accurate and better reproducible segmentation.

  14. 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

  15. Glass/Epoxy Door Panel for Automobiles

    Science.gov (United States)

    Bauer, J. L. JR.

    1985-01-01

    Lightweight panel cost-effective. Integrally-molded intrusion strap key feature of composite outer door panel. Strap replaces bulky and heavy steel instrusion beam of conventional door. Standard steel inner panel used for demonstration purposes. Door redesigned to exploit advantages of composite outer panel thinner. Outer panel for automobilie door, made of glass/epoxy composite material, lighter than conventional steel door panel, meets same strength requirements, and less expensive.

  16. Interpretive Error in Radiology.

    Science.gov (United States)

    Waite, Stephen; Scott, Jinel; Gale, Brian; Fuchs, Travis; Kolla, Srinivas; Reede, Deborah

    2017-04-01

    Although imaging technology has advanced significantly since the work of Garland in 1949, interpretive error rates remain unchanged. In addition to patient harm, interpretive errors are a major cause of litigation and distress to radiologists. In this article, we discuss the mechanics involved in searching an image, categorize omission errors, and discuss factors influencing diagnostic accuracy. Potential individual- and system-based solutions to mitigate or eliminate errors are also discussed. Radiologists use visual detection, pattern recognition, memory, and cognitive reasoning to synthesize final interpretations of radiologic studies. This synthesis is performed in an environment in which there are numerous extrinsic distractors, increasing workloads and fatigue. Given the ultimately human task of perception, some degree of error is likely inevitable even with experienced observers. However, an understanding of the causes of interpretive errors can help in the development of tools to mitigate errors and improve patient safety.

  17. Cytological artifacts masquerading interpretation

    Directory of Open Access Journals (Sweden)

    Khushboo Sahay

    2013-01-01

    Conclusions: In order to justify a cytosmear interpretation, a cytologist must be well acquainted with delayed fixation-induced cellular changes and microscopic appearances of common contaminants so as to implicate better prognosis and therapy.

  18. Life Cycle Interpretation

    DEFF Research Database (Denmark)

    Bonou, Alexandra; Olsen, Stig Irving

    2017-01-01

    The interpretation is the final phase of an LCA where the results of the other phases are considered together and analysed in the light of the uncertainties of the applied data and the assumptions that have been made and documented throughout the study. This chapter teaches how to perform...... an interpretation. The process of interpretation starts with identification of potentially significant issues in the previous stages of goal and scope definition, inventory analysis and impact assessment, and examples of potential significant issues are given for each phase. The significance is then determined...... is given on how to draw conclusions based on the previous steps of the interpretation, qualify the conclusions in terms of their robustness, and develop recommendations based on the results of the study....

  19. Testing panels in shear and biaxial compression

    Science.gov (United States)

    Neary, J. K.

    1979-01-01

    Hydraulic jacks simultaneously apply torsion, axial compression, and lateral compression to structural panels. Jacks are suitable for testing large panels used in aircraft, lightweight trucks, and buses.

  20. 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.

  1. The making of expert witness: the valuers' perspective | Babawale ...

    African Journals Online (AJOL)

    This paper examines the role of the expert witness in the process of justice administration. As the saying goes, not all 'experts' make good 'expert witness' as there is more to being an 'expert witness' than there is to being an 'expert'. That is, being an 'expert witness' does not necessarily connote that the witness is an expert ...

  2. Sign Language Interpreters' Training

    OpenAIRE

    Andriakopoulou, Eirini; Bouras, Christos; Giannaka, Eri

    2007-01-01

    Nowadays, the evolution of technology and the increasing use of computers gave the opportunity for developing new methods of education of deaf individuals and sign language interpreters. The e-learning environments that have been developed for the education of sign language provide web-based courses, designed to effectively teach to anyone the Sign Language. Recognizing the difficulties and barriers of sign language training as well as the importance of sign language interpreters for the comm...

  3. Meta-interpreting SETL

    Directory of Open Access Journals (Sweden)

    D. Aliffi

    1988-11-01

    Full Text Available This paper describes a SETL interpreter written in SETL. This module may be reused as a basis to build debuggers, type checkers, symbolic executers, tracers, and many other general purpose programming tools. Other more advanced uses include experimenting with altered semantics for SETL and building interpreters for multi-paradigm languages, as in SetLog project, which aims at constructing a language integrating logic programming and set-oriented programming.

  4. Interpreter-mediated dentistry.

    Science.gov (United States)

    Bridges, Susan; Drew, Paul; Zayts, Olga; McGrath, Colman; Yiu, Cynthia K Y; Wong, H M; Au, T K F

    2015-05-01

    The global movements of healthcare professionals and patient populations have increased the complexities of medical interactions at the point of service. This study examines interpreter mediated talk in cross-cultural general dentistry in Hong Kong where assisting para-professionals, in this case bilingual or multilingual Dental Surgery Assistants (DSAs), perform the dual capabilities of clinical assistant and interpreter. An initial language use survey was conducted with Polyclinic DSAs (n = 41) using a logbook approach to provide self-report data on language use in clinics. Frequencies of mean scores using a 10-point visual analogue scale (VAS) indicated that the majority of DSAs spoke mainly Cantonese in clinics and interpreted for postgraduates and professors. Conversation Analysis (CA) examined recipient design across a corpus (n = 23) of video-recorded review consultations between non-Cantonese speaking expatriate dentists and their Cantonese L1 patients. Three patterns of mediated interpreting indicated were: dentist designated expansions; dentist initiated interpretations; and assistant initiated interpretations to both the dentist and patient. The third, rather than being perceived as negative, was found to be framed either in response to patient difficulties or within the specific task routines of general dentistry. The findings illustrate trends in dentistry towards personalized care and patient empowerment as a reaction to product delivery approaches to patient management. Implications are indicated for both treatment adherence and the education of dental professionals. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Personality Measurement and Assessment in Large Panel Surveys*

    OpenAIRE

    Roberts, Brent; Jackson, Joshua J.; Duckworth, Angela L.; Von Culin, Katherine

    2011-01-01

    Personality tests are being added to large panel studies with increasing regularity, such as the Health and Retirement Study (HRS). To facilitate the inclusion and interpretation of these tests, we provide some general background on personality psychology, personality assessment, and the validity of personality tests. In this review, we provide background on definitions of personality, the strengths and weaknesses of the self-report approaches to personality testing typically used in large pa...

  6. Database and Expert Systems Applications

    DEFF Research Database (Denmark)

    Viborg Andersen, Kim; Debenham, John; Wagner, Roland

    schemata, query evaluation, semantic processing, information retrieval, temporal and spatial databases, querying XML, organisational aspects of databases, natural language processing, ontologies, Web data extraction, semantic Web, data stream management, data extraction, distributed database systems......This book constitutes the refereed proceedings of the 16th International Conference on Database and Expert Systems Applications, DEXA 2005, held in Copenhagen, Denmark, in August 2005.The 92 revised full papers presented together with 2 invited papers were carefully reviewed and selected from 390...... submissions. The papers are organized in topical sections on workflow automation, database queries, data classification and recommendation systems, information retrieval in multimedia databases, Web applications, implementational aspects of databases, multimedia databases, XML processing, security, XML...

  7. Consumer versus expert hazard identification

    DEFF Research Database (Denmark)

    Hagemann, Kit S.; Scholderer, Joachim

    2007-01-01

    Novel foods have been the object of intense public debate in recent years. Despite efforts to communicate the outcomes of risk assessments to consumers, public confidence in the management of potential risks has been low. Various reasons behind this have been identified, chiefly a disagreement...... between technical experts and consumers over the nature of the hazards on which risk assessments should focus, and perceptions of insufficient openness about uncertainties in risk assessment. Whilst previous research has almost exclusively focused on genetically modified foods, the present paper...... of uncertainty. Furthermore, a number of misconceptions became apparent in the study of laypeople's mental models, often related to the regulatory system governing risk assessments of novel foods. Critical issue are outlined and communication needs are discussed....

  8. Language theory and expert systems

    Directory of Open Access Journals (Sweden)

    Attilio Agodi

    1988-11-01

    Full Text Available Some remarks on the problem of knowledge representation and processing, as recognized in connection with the use of computers in the scientific research work, emphasizes the relevance of these problems for the studies on both the theory of languages and the expert system. A consideration of the common traits in the recent history of these studies, with reference to the use of computers on texts in natural language motivates the introduction of set theoretic and algebraic methods, suitable for applications in the analysis and in the automatic treatment of languages, based on the concept of model sets and on relational structures suggested from the connections between syntax and semantics evidenced in some example of sub-languages corresponding to theories of different classes of physical phenomena. Some details of these methods are evidenced, which have already successfully used or whose applications appears suggestive of interesting development.

  9. Proceedings of the 3rd Expert Consultation and Planning Meeting on Infant and Young Child Nutrition--(Part 2).

    Science.gov (United States)

    Amarra, Sofia; Chan, Pauline

    2013-04-01

    The Infant and Early Childhood Nutrition Task Force, International Life Sciences Institute Southeast Asia (ILSI SEA) Region, organised the 1st and 2nd Expert Consultation and Planning Meeting on Infant and Early Childhood Nutrition in 2009 and 2011, respectively. The goal of the consultations was "to generate and promote relevant science-based information that will help improve nutritional status, growth and development of infants and young children in Southeast Asia." An Expert Panel Core Group was created whose role is to provide advice and recommendations through a review of current scientific knowledge regarding issues related to early childhood growth and nutrition. The Panel is composed of experts representing 7 countries (China, Indonesia, Malaysia, Philippines, Singapore, Thailand, and Vietnam). In July 2012, the Panel convened the 3rd Expert Consultation and Planning Meeting on Infant and Young Child Nutrition in Singapore. This report presents the highlights of the meeting and recommendations made by the Panel on ways to improve infant and young child nutrition in Southeast Asia. The effective use of WHO indicators for assessing infant and young child feeding practices, mitigating the effects of maternal employment on breastfeeding, using behaviour change communication, updating the education of health personnel, and improving maternal health were considered important actions to be taken. Since current feeding practices in Southeast Asia fall short of WHO recommendations, studies are needed to develop strategies which take into consideration the diverse cultural settings that characterise the region.

  10. Working group activities of AGARD propulsion and energetics panel

    Science.gov (United States)

    Ucer, A. S.

    1994-04-01

    One of the major activities of AGARD panels is to form working groups, which assemble experts who work on the particular subject for two or three years. As a result of the work, an advisory report is published, which complies the state-of-the-art knowledge on the chosen specific topic. This paper explains the philosophy and procedures adopted during the formation of working groups of the Propulsion and Energetics Panel. Working groups concerning gas turbine technologies are presented. The selected working groups aim to improve the computational and experimental knowledge that would lead to the design of advanced aero gas turbine engines. Objective, scope, procedure, and important results of each working group will be explained. Working groups that were active during the 1980s and which were presently active are covered.

  11. 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.

  12. 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.

  13. [: an expert report by Dr. Egas Moniz on homosexuality].

    Science.gov (United States)

    Molina Artaloytia, Francisco

    2016-01-01

    At the beginning of the 20th century, the noted Nobel prize-winning Portuguese neurologist Egas Moniz made an expert analysis on homosexuality in a marriage annulment case of major value as an example of the effective application of sexological knowledge of that period. Contemporary republican legislation established marriage annulment in medical terms and punished relations between persons of the same sex, or contra natura. In his report, Moniz attempted to interpret distinctive elements of the life of the subject using sexological categories, illustrating the interaction between these categories and the changing forms adopted by homosexuality (or homosexual people) of the time.

  14. Pharmacologic and Nonpharmacologic Treatment for Acute Cough Associated With the Common Cold: CHEST Expert Panel Report.

    Science.gov (United States)

    Malesker, Mark A; Callahan-Lyon, Priscilla; Ireland, Belinda; Irwin, Richard S

    2017-11-01

    Acute cough associated with the common cold (CACC) causes significant impairment in quality of life. Effective treatment approaches are needed for CACC. We conducted a systematic review on the management of CACC to update the recommendations and suggestions of the CHEST 2006 guideline on this topic. This systematic review of randomized controlled trials (RCTs) asked the question: Is there evidence of clinically relevant treatment effects for pharmacologic or nonpharmacologic therapies in reducing the duration/severity of acute CACC? Studies of adults and pediatric patients with CACC were included and assessed for relevance and quality. Based on the systematic review, guideline suggestions were developed and voted on using the American College of Chest Physicians organization methodology. Six systematic reviews and four primary studies identified from updated literature searches for each of the reviews or from hand searching were included and reported data on 6,496 participants with CACC who received one or more of a variety of interventions. The studies used an assortment of descriptors and assessments to identify CACC. The evidence supporting the management of CACC is overall of low quality. This document provides treatment suggestions based on the best currently available evidence and identifies gaps in our knowledge and areas for future research. Copyright © 2017 American College of Chest Physicians. All rights reserved.

  15. Regulation of Dietary Supplements in the Military. Report of an Expert Panel

    Science.gov (United States)

    2011-01-01

    als with known sedative properties, anabolic steroids and their precursors, creatine, glan- dular extracts , echinacea, and other substances.1 U.S...Projects Agency worked with a small startup company to produce and test a chewable form of quercetin, a plant flavonoid with antioxidant effects that

  16. Informed consent in clinical research: Consensus recommendations for reform identified by an expert interview panel.

    Science.gov (United States)

    Lorell, Beverly H; Mikita, J Stephen; Anderson, Annick; Hallinan, Zachary P; Forrest, Annemarie

    2015-12-01

    Informed consent is the cornerstone for protection of human subjects in clinical trials. However, a growing body of evidence suggests that reform of the informed consent process in the United States is needed. The Clinical Trials Transformation Initiative conducted interviews with 25 experienced observers of the informed consent process to identify limitations and actionable recommendations for change. There was broad consensus that current practices often fail to meet the ethical obligation to inform potential research participants during the informed consent process. The most frequent single recommendation, which would affect all participants in federally regulated clinical research, was reform of the informed consent document. The interviews also identified the need for reform of clinical research review by institutional review boards, including transitioning to a single institutional review board for multi-site trials. The consensus recommendations from the interviewees provide a framework for meaningful change in the informed consent process. Although some proposed changes are feasible for rapid implementation, others such as substantive reform of the informed consent document may require change in federal regulations. © The Author(s) 2015.

  17. Enlargement Futures Project: Expert Panel on Technology, Knowledge and Learning. Final Report.

    Science.gov (United States)

    Gourova, Elissaveta; Ducatel, Ken; Gavigan, James; Scapolo, Fabiana; Di Pietrogiacomo, Paola

    The next 10 years provide an opportunity for the European Union (EU) to renew the science and technology (S&T) base and build necessary knowledge-society capacities and capabilities in Pre-Accession Countries (PACs). Applied research has faced a major downsize; redressing the balance in the research and development systems is urgently needed.…

  18. 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

    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....

  19. Definitions and outcome measures for bullous pemphigoid : Recommendations by an international panel of experts

    NARCIS (Netherlands)

    Murrell, Dedee F.; Daniel, Benjamin S.; Joly, Pascal; Borradori, Luca; Amagai, Masayuki; Hashimoto, Takashi; Caux, Frederic; Marinovic, Branka; Sinha, Animesh A.; Hertl, Michael; Bernard, Philippe; Sirois, David; Cianchini, Giuseppe; Fairley, Janet A.; Jonkman, Marcel F.; Pandya, Amit G.; Rubenstein, David; Zillikens, Detlef; Payne, Aimee S.; Woodley, David; Zambruno, Giovanna; Aoki, Valeria; Pincelli, Carlo; Diaz, Luis; Hall, Russell P.; Meurer, Michael; Mascaro, Jose M.; Schmidt, Enno; Shimizu, Hiroshi; Zone, John; Swerlick, Robert; Mimouni, Daniel; Culton, Donna; Lipozencic, Jasna; Bince, Benjamin; Grando, Sergei A.; Bystryn, Jean-Claude; Werth, Victoria P.

    Our scientific knowledge of bullous pemphigoid (BP) has dramatically progressed in recent years. However, despite the availability of various therapeutic options for the treatment of inflammatory diseases, only a few multicenter controlled trials have helped to define effective therapies in BP. A

  20. IDRC to host expert panel at Gender Summit North America | IDRC ...

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

    2017-11-06

    Nov 6, 2017 ... Inaugurated in 2011, Gender Summits are a series of action-based global events to promote gender equality in research and innovation. Held in Canada for the first time, the Gender Summit North America 2017 brings together advocates of gender equality policy from the fields of science, innovation, and ...

  1. Placebo use in vaccine trials: recommendations of a WHO expert panel.

    Science.gov (United States)

    Rid, Annette; Saxena, Abha; Baqui, Abdhullah H; Bhan, Anant; Bines, Julie; Bouesseau, Marie-Charlotte; Caplan, Arthur; Colgrove, James; Dhai, Ames; Gomez-Diaz, Rita; Green, Shane K; Kang, Gagandeep; Lagos, Rosanna; Loh, Patricia; London, Alex John; Mulholland, Kim; Neels, Pieter; Pitisuttithum, Punee; Sarr, Samba Cor; Selgelid, Michael; Sheehan, Mark; Smith, Peter G

    2014-08-20

    Vaccines are among the most cost-effective interventions against infectious diseases. Many candidate vaccines targeting neglected diseases in low- and middle-income countries are now progressing to large-scale clinical testing. However, controversy surrounds the appropriate design of vaccine trials and, in particular, the use of unvaccinated controls (with or without placebo) when an efficacious vaccine already exists. This paper specifies four situations in which placebo use may be acceptable, provided that the study question cannot be answered in an active-controlled trial design; the risks of delaying or foregoing an efficacious vaccine are mitigated; the risks of using a placebo control are justified by the social and public health value of the research; and the research is responsive to local health needs. The four situations are: (1) developing a locally affordable vaccine, (2) evaluating the local safety and efficacy of an existing vaccine, (3) testing a new vaccine when an existing vaccine is considered inappropriate for local use (e.g. based on epidemiologic or demographic factors), and (4) determining the local burden of disease. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. 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

    cancer; 2) treatment aims for R0 resection; 3) ESD should meet quality standards; 4) ESD should be performed following national or European Society of Gastrointestinal Endoscopy (ESGE) guidelines or under institutional review board approval; and 5) ESD cases should be registered. Due to the high level...... of expertise needed to perform the technique safely, ESD should be performed in a step-up approach, starting with lesions presenting in the rectum or in the distal stomach, then colon, proximal stomach, and finally in the esophagus. Registration is advised either at the local site or at a national or ESGE...

  3. Building the Future of Environmental Public Health Tracking: Proceedings and Recommendations of an Expert Panel Workshop.

    Science.gov (United States)

    Fox, Mary A; Baksh, Sheriza; Lam, Juleen; Resnick, Beth

    2017-06-01

    Since 2002, the national Environmental Health Tracking Program of the Centers for Disease Control and Prevention (CDC) has provided vital support to state environmental public health efforts while simultaneously building a nationwide network of state, local, and academic partners to improve our nation’s capacity to understand and respond to environmental threats to public health. As part of program review and strategic planning, national thought leaders in environmental public health were convened to assess progress, identify gaps and challenges, and provide recommendations for enhancing the utility and impact of the Tracking Program. Several opportunities were identified. Chief among these was the need for continued and expanded CDC leadership to develop a coordinated Tracking Program agenda identifying specific scientific goals, data needs, and initiatives. Recommendations for future growth included expanded data availability and program coverage: i.e., making data available at the community scale and establishing tracking programs in all 50 states. Finally, a set of recommendations emphasizing communication to decision makers and the public was made that will be integral to the future utility and success of the Tracking Program.

  4. The role of bromocriptine-QR in the management of type 2 diabetes expert panel recommendations.

    Science.gov (United States)

    Garber, Alan J; Blonde, Lawrence; Bloomgarden, Zachary T; Handelsman, Yehuda; Dagogo-Jack, Samuel

    2013-01-01

    To review available data on the efficacy and safety of bromocriptine-QR (BQR) and to consider its role in the management of Type 2 diabetes mellitus (T2DM). Published literature reporting the efficacy and safety of BQR in the treatment of T2DM was reviewed, including peer-reviewed abstracts and poster presentations. BQR is an oral hypoglycemic agent with a novel mechanism of action that appears to involve enhancement of morning central nervous system (CNS) dopaminergic activity, resulting in improved insulin sensitivity and reduced hepatic glucose output. Adjunctive treatment with BQR in the dosing range of 1.6 to 4.8 mg/d may result in a mean (95% confidence interval [CI]) reduction in glycated hemoglobin (A1c) levels of 0.69% (0.97%, 0.41%). Treatment with BQR appears to be associated with minimal intrinsic risk of hypoglycemia, and does not appear to be associated with clinically significant adverse effects on weight, triglycerides, free fatty acids, or blood pressure. The favorable cardiovascular risk profile of BQR suggests that it may be useful in the treatment of patients with T2DM with a history of cardiovascular disease (CVD) or who have significant risk factors for CVD. However, knowledge of the efficacy and safety of BQR is limited by the relatively small clinical trials database. As a result, there is currently insufficient information on the safety and efficacy of adjunctive BQR in T2DM patients being treated with several common diabetes regimens (e.g., thiazolidinediones, insulin).

  5. Final report of the Cosmetic Ingredient Review Expert Panel on the safety assessment of methyl acetate.

    Science.gov (United States)

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

    2012-01-01

    Alkyl acetates, as well as acetic acid and acetate salts, are widely used cosmetic ingredients, with a wide range of functions as fragrances, solvents, or skin-conditioning agents, depending on the specific ingredient. Available data on alkyl acetates, and acetic acid and the alcohol to which they could be metabolized, were considered adequate to support the safety of the entire group in the present practices of use and concentration in cosmetics.

  6. Improving Army Basic Research: Report of an Expert Panel on the Future of Army Laboratories

    Science.gov (United States)

    2012-01-01

    married to Sandy Decker, a former city council member and mayor of Los Gatos , California, where they both currently reside. Gil maintains an active...interest in national security and defense, the local government of Los Gatos , and youth science education. William H. (Bud) Forster Bud Forster

  7. New approaches for the treatment of diabetic macular oedema: recommendations by an expert panel

    NARCIS (Netherlands)

    Bandello, F.; Cunha-Vaz, J.; Chong, N. V.; Lang, G. E.; Massin, P.; Mitchell, P.; Porta, M.; Prünte, C.; Schlingemann, R.; Schmidt-Erfurth, U.

    2012-01-01

    The current standard therapy for patients with diabetic macular oedema (DME)-Ffocal/grid laser photocoagulation-usually does not improve impaired vision, and many patients lose vision despite laser therapy. Recent approval of ranibizumab by the European Medicines Agency to treat visual impairment

  8. Statin intolerance - an attempt at a unified definition. Position paper from an International Lipid Expert Panel.

    Science.gov (United States)

    Banach, Maciej; Rizzo, Manfredi; Toth, Peter P; Farnier, Michel; Davidson, Michael H; Al-Rasadi, Khalid; Aronow, Wilbert S; Athyros, Vasilis; Djuric, Dragan M; Ezhov, Marat V; Greenfield, Robert S; Hovingh, G Kees; Kostner, Karam; Serban, Corina; Lighezan, Daniel; Fras, Zlatko; Moriarty, Patrick M; Muntner, Paul; Goudev, Assen; Ceska, Richard; Nicholls, Stephen J; Broncel, Marlena; Nikolic, Dragana; Pella, Daniel; Puri, Raman; Rysz, Jacek; Wong, Nathan D; Bajnok, Laszlo; Jones, Steven R; Ray, Kausik K; Mikhailidis, Dimitri P

    2015-06-01

    Statins are one of the most commonly prescribed drugs in clinical practice. They are usually well tolerated and effectively prevent cardiovascular events. Most adverse effects associated with statin therapy are muscle-related. The recent statement of the European Atherosclerosis Society (EAS) has focused on statin-associated muscle symptoms (SAMS), and avoided the use of the term 'statin intolerance'. Although muscle syndromes are the most common adverse effects observed after statin therapy, excluding other side effects might underestimate the number of patients with statin intolerance, which might be observed in 10 - 15% of patients. In clinical practice, statin intolerance limits effective treatment of patients at risk of, or with, cardiovascular disease. Knowledge of the most common adverse effects of statin therapy that might cause statin intolerance and the clear definition of this phenomenon is crucial to effectively treat patients with lipid disorders. Therefore, the aim of this position paper was to suggest a unified definition of statin intolerance, and to complement the recent EAS statement on SAMS, where the pathophysiology, diagnosis and the management were comprehensively presented.

  9. At Student Seminar, Expert Panel Lauds HPV Vaccine for Cancer Prevention | Poster

    Science.gov (United States)

    Interns were promised pizza, but they got more than just food as they watched “Someone You Love: The HPV Epidemic” at this summer’s second student seminar. In the Building 549 auditorium, students learned about human papillomavirus (HPV) infection, the most common sexually transmitted infection (STI).

  10. [Expert systems in medicine: possible uses in anesthesia].

    Science.gov (United States)

    Petersen, J; Kochs, E; Kochs, H D

    1994-04-01

    The euphoric assumption that powerful computers fed with sophisticated software programmes may serve as a substitute for human knowledge and decision making has been replaced by a more realistic concept of how computers may help in collecting data and their interpretation on the basis of human knowledge and experience. The computer is now used as a dedicated tool to support man in overtaking cumbersome and monotonous processes and tedious calculations. Running 24 hours a day, a specific feature of the computer is that depending on unequivocal software programmes it does neither forget or alter commands and information. Computer programmes imitating human thinking and information processing are called expert or knowledge based systems. These are especially useful when multiple possible combinations of data make a given task very complex. This review presents several systems used in different medical disciplines to describe fundamental ideas, different problem-solving methods, techniques and possible working fields including anaesthesia. It is made clear why computers have found widespread use in all administrative areas. In contrast, no system comparable in potency has been developed for use in clinical medicine in spite of 25 years of research in expert systems. This review starts with a definition of expert knowledge and the appropriate transformation of this knowledge to the computer. In addition, a general survey about the structure of expert systems and a state of the art in some current problem solving methods is given. Additional aspects and restrictions including technical, psychological and legal problems which seem to be unimportant from the outside but are essential for the development of expert systems are presented.

  11. Methods for combining experts' probability assessments.

    Science.gov (United States)

    Jacobs, R A

    1995-09-01

    This article reviews statistical techniques for combining multiple probability distributions. The framework is that of a decision maker who consults several experts regarding some events. The experts express their opinions in the form of probability distributions. The decision maker must aggregate the experts' distributions into a single distribution that can be used for decision making. Two classes of aggregation methods are reviewed. When using a supra Bayesian procedure, the decision maker treats the expert opinions as data that may be combined with its own prior distribution via Bayes' rule. When using a linear opinion pool, the decision maker forms a linear combination of the expert opinions. The major feature that makes the aggregation of expert opinions difficult is the high correlation or dependence that typically occurs among these opinions. A theme of this paper is the need for training procedures that result in experts with relatively independent opinions or for aggregation methods that implicitly or explicitly model the dependence among the experts. Analyses are presented that show that m dependent experts are worth the same as k independent experts where k < or = m. In some cases, an exact value for k can be given; in other cases, lower and upper bounds can be placed on k.

  12. The Interpretive Function

    DEFF Research Database (Denmark)

    Agerbo, Heidi

    2017-01-01

    Approximately a decade ago, it was suggested that a new function should be added to the lexicographical function theory: the interpretive function(1). However, hardly any research has been conducted into this function, and though it was only suggested that this new function was relevant to incorp......Approximately a decade ago, it was suggested that a new function should be added to the lexicographical function theory: the interpretive function(1). However, hardly any research has been conducted into this function, and though it was only suggested that this new function was relevant...... to incorporate into lexicographical theory, some scholars have since then assumed that this function exists(2), including the author of this contribution. In Agerbo (2016), I present arguments supporting the incorporation of the interpretive function into the function theory and suggest how non-linguistic signs...... can be treated in specific dictionary articles. However, in the current article, due to the results of recent research, I argue that the interpretive function should not be considered an individual main function. The interpretive function, contrary to some of its definitions, is not connected...

  13. Expert Meeting Report: Foundations Research Results

    Energy Technology Data Exchange (ETDEWEB)

    Ojczyk, C.; Huelman, P.; Carmody, J.

    2013-05-01

    In the Expert Meeting Plan, the NorthernSTAR Team proposed to host two Expert Meetings in calendar year 2011. Invitees to the meetings would include experts in the current field of study, other BA team members, and representatives from DOE and NREL. They will invite leading industry experts to present at these meetings. The Expert Meetings will focus on key systems areas that will be required to meet the Building America performance goals and shall be sufficiently narrow in scope that specific conclusions, action items, and delegation of future tasks can be identified and completed. The two expert meeting topics are 'Foundations' and 'Window Retrofit.' The first session is designed as a webinar only and the second will be a live meeting.

  14. 7 CFR 2902.19 - Composite panels.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Composite panels. 2902.19 Section 2902.19 Agriculture... Composite panels. (a) Definitions. (1) Plastic lumber composite panels. Engineered products suitable for non... composite panels. Engineered products designed for use as structural and sound deadening material suitable...

  15. Restraint Age Forming Of Machined Panels

    Science.gov (United States)

    Wood, Rebecca

    1993-01-01

    Panels bent permanently without cracking. In restraint age forming, panel wrapped onto mandrel having necessary curved contour, restrained on mandrel clamps and vacuum, and heat treated. When panel released after end of heat treatment, retains contour of mandrel except for small springback. Process repeatable: panels subsequently processed under same mechanical and thermal conditions on same contour emerge with same final contour.

  16. Conjunctive interpretations of disjunctions

    Directory of Open Access Journals (Sweden)

    Robert van Rooij

    2010-09-01

    Full Text Available In this extended commentary I discuss the problem of how to account for "conjunctive" readings of some sentences with embedded disjunctions for globalist analyses of conversational implicatures. Following Franke (2010, 2009, I suggest that earlier proposals failed, because they did not take into account the interactive reasoning of what else the speaker could have said, and how else the hearer could have interpreted the (alternative sentence(s. I show how Franke's idea relates to more traditional pragmatic interpretation strategies. doi:10.3765/sp.3.11 BibTeX info

  17. Reflections and Interpretations

    DEFF Research Database (Denmark)

    Reflections and Interpretations is an anthology on The Freedom Writers’ methodology. It is an anthology for all those with a professional need for texts explaining, not only how The Freedom Writers’ tools are being used, but also why they work so convincingly well. It is not an anthology of guide......Reflections and Interpretations is an anthology on The Freedom Writers’ methodology. It is an anthology for all those with a professional need for texts explaining, not only how The Freedom Writers’ tools are being used, but also why they work so convincingly well. It is not an anthology...

  18. Interpretations of Quantum Mechanics

    Directory of Open Access Journals (Sweden)

    Pickl Peter

    2014-04-01

    Full Text Available The problems of modern physics are man made. The Copenhagen version of quantum mechanics is formulated in a vague prosaic way, inconsistencies and paradoxes are the price. New interpretations try to solve the problem, however a reformulation rather than an interpretation is needed. In this manuscript I will point out, where the Copenhagen formulation of quantum mechanics is flawed and how one can make sense out of it. Then I will show, that it is possible to give a precise formulation of quantum mechanics without losing its compelling ability in describing experiments.

  19. Interpretations of Quantum Mechanics

    Science.gov (United States)

    Pickl, Peter

    2014-04-01

    The problems of modern physics are man made. The Copenhagen version of quantum mechanics is formulated in a vague prosaic way, inconsistencies and paradoxes are the price. New interpretations try to solve the problem, however a reformulation rather than an interpretation is needed. In this manuscript I will point out, where the Copenhagen formulation of quantum mechanics is flawed and how one can make sense out of it. Then I will show, that it is possible to give a precise formulation of quantum mechanics without losing its compelling ability in describing experiments.

  20. Normative interpretations of diversity

    DEFF Research Database (Denmark)

    Lægaard, Sune

    2009-01-01

    Normative interpretations of particular cases consist of normative principles or values coupled with social theoretical accounts of the empirical facts of the case. The article reviews the most prominent normative interpretations of the Muhammad cartoons controversy over the publication of drawings...... of the Prophet Muhammad in the Danish newspaper Jyllands-Posten. The controversy was seen as a case of freedom of expression, toleration, racism, (in)civility and (dis)respect, and the article notes different understandings of these principles and how the application of them to the controversy implied different...

  1. Succession planning for technical experts

    Energy Technology Data Exchange (ETDEWEB)

    Kirk, Bernadette Lugue [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Cain, Ronald A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Dewji, Shaheen A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Agreda, Carla L. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-07-01

    This report describes a methodology for identifying, evaluating, and mitigating the loss of key technical skills at nuclear operations facilities. The methodology can be adapted for application within regulatory authorities and research and development organizations, and can be directly applied by international engagement partners of the Department of Energy’s National Nuclear Security Administration (NNSA). The resultant product will be of direct benefit to two types of NNSA missions: (1) domestic human capital development programs tasked to provide focused technical expertise to succeed an aging nuclear operations workforce, and (2) international safeguards programs charged with maintaining operational safeguards for developing/existing nuclear power program in nations where minimal available resources must be used effectively. This report considers succession planning and the critical skills necessary to meet an institution’s goals and mission. Closely tied to succession planning are knowledge management and mentorship. In considering succession planning, critical skill sets are identified and are greatly dependent on the subject matter expert in question. This report also provides examples of critical skills that are job specific.

  2. Forecasting the use of electronic health records: an expert opinion approach.

    Science.gov (United States)

    Blavin, Fredric Evan; Buntin, Melinda Beeuwkes

    2013-01-01

    To promote the widespread adoption and use of electronic health records (EHRs), in 2011, CMS started making Medicare and Medicaid incentive payments to providers who demonstrate that they are "meaningful users" of certified EHR systems. This paper combines an expert opinion method, a modified Delphi technique, with a technological diffusion framework to create a forecast of the percent of office-based physicians who will become adopters and "meaningful users" of health information technology from 2012 to 2019. The panel consisted of 18 experts from industry, academia, and government who are knowledgeable about the adoption and use of EHRs in office-based settings and are recognized as opinion leaders in their respective professions. Overall, the expert panel projected that primary care physicians in large group practices are more likely to achieve the meaningful use of EHRS relative to primary care physicians in small group practices and all other specialists: the group projected that 65 percent of primary care physicians in large group practices, 45 percent of primary care physicians in small group practices, and 44 percent of all other specialists could achieve meaningful use by 2015. In 2019, these projections increase to 80 percent, 65 percent, and 66 percent for these three groups, respectively. The information from this study is especially valuable when there is a lack of data and a high degree of uncertainty in a new policy environment and could help inform and evaluate government programs, such as the Regional Extension Centers (REC), by providing data from leading experts.

  3. 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

  4. Expert systems to improve plant operability

    Energy Technology Data Exchange (ETDEWEB)

    Sopocy, D.M.; Glazer, A.R. (Sargent and Lundy, Chicago, IL (USA)); Jonas, O. (Jonas, Inc., Wilmington, DE (US)); Rice, J.K. (James K. Rice, Chartered, Olney, MD (US))

    1988-01-01

    Prospective expert system applications in the power industry generally are in one of the following categories:esign, information management, plant operations, and equipment diagnostics. Many power facility expert system efforts are four plant operations. Several of these applications help optimize plant operation and also detect developing problems and suggest remedial action before the occurrence of any serious consequences. Many types of plant processes and equipment can benefit from routine trending and evaluation of operating data by this type of expert system. This paper discusses a variety of special considerations for the development and implementation of expert systems for plant operations, both in general and as exemplified by CYCLEXPRT.

  5. Management of anaphylaxis in primary care: Canadian expert consensus recommendations.

    Science.gov (United States)

    Waserman, S; Chad, Z; Francoeur, M J; Small, P; Stark, D; Vander Leek, T K; Kaplan, A; Kastner, M

    2010-09-01

    Anaphylaxis is often managed inadequately. We used findings from a systematic review of gaps in anaphylaxis management to develop evidence-based recommendations for gaps rated as clinically important by a panel of Canadian allergy experts. The nominal group technique (NGT) consensus methodology was used to develop evidence-based recommendations for the management of anaphylaxis in primary care. Physician-specific gaps from our systematic review were prioritized by consensus meeting participants in two rounds, which involved the rating, discussion, and re-rating of gaps. Using current anaphylaxis guidelines, recommendations were then developed for each category of gaps that were identified by the panel as clinically important. Thirty unique physician gaps from the systematic review were categorized according to gaps of knowledge and anaphylaxis practice behaviors. The panel rated diagnosis of anaphylaxis, and when and how to use epinephrine auto-injectors as clinically important knowledge gaps; and rated infrequent or delayed epinephrine administration, low rate of auto-injector prescription, and infrequent or no referrals to allergy specialists after a reaction as important practice behavior gaps. Evidence from four guidelines was used to support the consensus recommendation statements for three resulting categories of gap themes: anaphylaxis management, epinephrine use, and follow-up care. We used an NGT consensus methodology to develop an educational resource for primary care physicians and allergists to better understand how to manage patients with anaphylaxis. Next steps include testing our findings against observed data in primary care settings and to develop other strategies or tools to overcome gaps in anaphylaxis management.

  6. 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

  7. Interpreting & Biomechanics. PEPNet Tipsheet

    Science.gov (United States)

    PEPNet-Northeast, 2001

    2001-01-01

    Cumulative trauma disorder (CTD) refers to a collection of disorders associated with nerves, muscles, tendons, bones, and the neurovascular (nerves and related blood vessels) system. CTD symptoms may involve the neck, back, shoulders, arms, wrists, or hands. Interpreters with CTD may experience a variety of symptoms including: pain, joint…

  8. Conflicts in interpretation

    NARCIS (Netherlands)

    Bouma, G.; Hendriks, P.; Hoop, H. de; Krämer, I.; Swart, Henriëtte de; Zwarts, J.

    2007-01-01

    The leading hypothesis of this paper is that interpretation is a process of constraint satisfaction, conflict resolution, and optimization, along the lines of Optimality Theory. Support for this view is drawn from very different domains, and based on both experimental and theoretical research. We

  9. Listening and Message Interpretation

    Science.gov (United States)

    Edwards, Renee

    2011-01-01

    Message interpretation, the notion that individuals assign meaning to stimuli, is related to listening presage, listening process, and listening product. As a central notion of communication, meaning includes (a) denotation and connotation, and (b) content and relational meanings, which can vary in ambiguity and vagueness. Past research on message…

  10. Interpreting the Santal Rebellion

    DEFF Research Database (Denmark)

    Andersen, Peter Birkelund

    2016-01-01

    Postcolonial studies have interpreted the Santal Rebellion, the hul of 1855, as a peasant rebellion that the colonial power construed as an ethnic rebellion (R. Guha). Anthropologists and historians have stressed the near-complete mobilisation of the Santals, whereas a later colonial historian (W...

  11. Food sustainability: diverging interpretations

    NARCIS (Netherlands)

    Aiking, H.; de Boer, J.

    2004-01-01

    The concept of sustainability in general and food sustainability, in particular, entails many aspects and many interpretations. During a conference on food sustainability a broad, multidisciplinary picture was painted and many key issues were dealt with, from ecology, economy and society. In

  12. Diplomatic Worldview: Interpretative Pluralism

    Directory of Open Access Journals (Sweden)

    Bayzhol I. Karipbaev

    2013-01-01

    Full Text Available This article is devoted to topical issues of interpretative pluralism, which formed the basis of the modern worldview. The attitude "world as text" enables to reveal new methodological, ontological and axiological perspectives of man’s self-determination in this world, his possibilities to participate in social reality construction. Such approach, offered within postmodernism, enables to expand our epistemological horizons.

  13. Translation, Interpreting and Lexicography

    DEFF Research Database (Denmark)

    Dam, Helle Vrønning; Tarp, Sven

    2018-01-01

    in the sense that their practice fields are typically ‘about something else’. Translators may, for example, be called upon to translate medical texts, and interpreters may be assigned to work on medical speeches. Similarly, practical lexicography may produce medical dictionaries. In this perspective, the three...

  14. Interpretations of Greek Mythology

    NARCIS (Netherlands)

    Bremmer, Jan

    1987-01-01

    This collection of original studies offers new interpretations of some of the best known characters and themes of Greek mythology, reflecting the complexity and fascination of the Greek imagination. Following analyses of the concept of myth and the influence of the Orient on Greek mythology, the

  15. Interpreting the Constitution.

    Science.gov (United States)

    Brennan, William J., Jr.

    1987-01-01

    Discusses constitutional interpretations relating to capital punishment and protection of human dignity. Points out the document's effectiveness in creating a new society by adapting its principles to current problems and needs. Considers two views of the Constitution that lead to controversy over the legitimacy of judicial decisions. (PS)

  16. Interpretation as conflict resolution

    NARCIS (Netherlands)

    Swart, Henriëtte de; Zwart, J.

    Semantic interpretation is not a simple process. When we want to know what a given sentence means, more is needed than just a simple ‘adding up’ of the meanings of the component words. Not only can the words in a sentence interact and conflict with each other, but also with the linguistic and

  17. 77 FR 30044 - Occupational Information Development Advisory Panel Meeting

    Science.gov (United States)

    2012-05-21

    ... ADMINISTRATION Occupational Information Development Advisory Panel Meeting AGENCY: Social Security Administration... Occupational Information Development Advisory Panel (Panel) is a discretionary panel, established under the... Information Development Advisory Panel, Social Security Administration, 6401 Security Boulevard, Robert M...

  18. What Geoscience Experts and Novices Look At, and What They See, When Viewing Data Visualizations

    Science.gov (United States)

    Kastens, Kim A.; Shipley, Thomas F.; Boone, Alexander P.; Straccia, Frances

    2016-01-01

    This study examines how geoscience experts and novices make meaning from an iconic type of data visualization: shaded relief images of bathymetry and topography. Participants examined, described, and interpreted a global image, two high-resolution seafloor images, and 2 high-resolution continental images, while having their gaze direction…

  19. An interactive testbed for development of expert tools for pattern recognition

    Science.gov (United States)

    Wharton, Stephen W.

    1988-01-01

    The initial implementation of an interactive testbed for development of expert system applications in image processing, i.e., a toolbox of procedures designed to facilitate the capture of expert knowledge for region grouping and analysis is described. The user can elect to interactively enter commands (via a command interpreter) for region manipulation to, in effect, simulate the actions of a hypothetical expert system. The user can then incorporate any rules and procedures as derived from interactive experimentation into customized region processing procedures using the library of utility functions. An iterative technique based on image pyramids is used to compute the initial region segmentation without the use of process parameters. These regions can then be interactively examined and manipulated using the command interpreter.

  20. Explosion probability of unexploded ordnance: expert beliefs.

    Science.gov (United States)

    MacDonald, Jacqueline Anne; Small, Mitchell J; Morgan, M G

    2008-08-01

    This article reports on a study to quantify expert beliefs about the explosion probability of unexploded ordnance (UXO). Some 1,976 sites at closed military bases in the United States are contaminated with UXO and are slated for cleanup, at an estimated cost of $15-140 billion. Because no available technology can guarantee 100% removal of UXO, information about explosion probability is needed to assess the residual risks of civilian reuse of closed military bases and to make decisions about how much to invest in cleanup. This study elicited probability distributions for the chance of UXO explosion from 25 experts in explosive ordnance disposal, all of whom have had field experience in UXO identification and deactivation. The study considered six different scenarios: three different types of UXO handled in two different ways (one involving children and the other involving construction workers). We also asked the experts to rank by sensitivity to explosion 20 different kinds of UXO found at a case study site at Fort Ord, California. We found that the experts do not agree about the probability of UXO explosion, with significant differences among experts in their mean estimates of explosion probabilities and in the amount of uncertainty that they express in their estimates. In three of the six scenarios, the divergence was so great that the average of all the expert probability distributions was statistically indistinguishable from a uniform (0, 1) distribution-suggesting that the sum of expert opinion provides no information at all about the explosion risk. The experts' opinions on the relative sensitivity to explosion of the 20 UXO items also diverged. The average correlation between rankings of any pair of experts was 0.41, which, statistically, is barely significant (p= 0.049) at the 95% confidence level. Thus, one expert's rankings provide little predictive information about another's rankings. The lack of consensus among experts suggests that empirical studies

  1. Practical problems in aggregating expert opinions

    Energy Technology Data Exchange (ETDEWEB)

    Booker, J.M.; Picard, R.R.; Meyer, M.A.

    1993-11-01

    Expert opinion is data given by a qualified person in response to a technical question. In these analyses, expert opinion provides information where other data are either sparse or non-existent. Improvements in forecasting result from the advantageous addition of expert opinion to observed data in many areas, such as meteorology and econometrics. More generally, analyses of large, complex systems often involve experts on various components of the system supplying input to a decision process; applications include such wide-ranging areas as nuclear reactor safety, management science, and seismology. For large or complex applications, no single expert may be knowledgeable enough about the entire application. In other problems, decision makers may find it comforting that a consensus or aggregation of opinions is usually better than a single opinion. Many risk and reliability studies require a single estimate for modeling, analysis, reporting, and decision making purposes. For problems with large uncertainties, the strategy of combining as diverse a set of experts as possible hedges against underestimation of that uncertainty. Decision makers are frequently faced with the task of selecting the experts and combining their opinions. However, the aggregation is often the responsibility of an analyst. Whether the decision maker or the analyst does the aggregation, the input for it, such as providing weights for experts or estimating other parameters, is imperfect owing to a lack of omniscience. Aggregation methods for expert opinions have existed for over thirty years; yet many of the difficulties with their use remain unresolved. The bulk of these problem areas are summarized in the sections that follow: sensitivities of results to assumptions, weights for experts, correlation of experts, and handling uncertainties. The purpose of this paper is to discuss the sources of these problems and describe their effects on aggregation.

  2. Solar Panel based Milk Pasteurization

    DEFF Research Database (Denmark)

    Nielsen, Kirsten Mølgaard; Pedersen, Tom Søndergaard

    This paper treats the subject of analysis, design and development of the control system for a solar panel based milk pasteurization system to be used in small villages in Tanzania. The analysis deals with the demands for an acceptable pasteurization, the varying energy supply and the low cost, low...... complexity, simple user interface and high reliability demands. Based on these demands a concept for the pasteurization system is established and a control system is developed. A solar panel has been constructed and the energy absorption has been tested in Tanzania. Based on the test, the pasteurization...... system is dimensioned. A functional prototype of the pasteurization facility with a capacity of 200 l milk/hour has been developed and tested. The system is prepared for solar panels as the main energy source and is ready for a test in Tanzania....

  3. Solar Panel based Milk Pasteurization

    DEFF Research Database (Denmark)

    Nielsen, Kirsten Mølgaard; Pedersen, Tom Søndergaard

    2002-01-01

    This paper treats the subject of analysis, design and development of the control system for a solar panel based milk pasteurization system to be used in small villages in Tanzania. The analysis deals with the demands for an acceptable pasteurization, the varying energy supply and the low cost, low...... complexity, simple user interface and high reliability demands. Based on these demands a concept for the pasteurization system is established and a control system is developed. A solar panel has been constructed and the energy absorption has been tested in Tanzania. Based on the test, the pasteurization...... system is dimensioned. A functional prototype of the pasteurization facility with a capacity of 200 l milk/hour has been developed and tested. The system is prepared for solar panels as the main energy source and is ready for a test in Tanzania....

  4. 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

  5. Knowledge acquisition for a simple expert controller

    Science.gov (United States)

    Bieker, B.

    1987-01-01

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

  6. Experts' Opinion: A Powerful Evaluation Tool.

    Science.gov (United States)

    Nevo, David

    Experts' opinion is proposed as a valuable evaluation tool. Advantages of this method include the relative cost effectiveness when compared with other data collection methods. It is a time-saving method important in formative evaluation when a decision must be made concerning implementation of a course of action. When experts are carefully…

  7. [How to expose fraudulent expert witnesses].

    Science.gov (United States)

    Wimmer, W

    1990-01-01

    In our courtrooms you can meet, up to this day, experts of dubious qualities if not mere shams and deceivers. They are found in all sciences, but also in pseudo-sciences as paramedicine and parapsychology. In any case such expert pretenders must be exposed by the judge to prevent dangerous miscarriage of justice. Examples are given how to unmask the fraudulent rascals.

  8. Contextual factors for finding similar experts

    NARCIS (Netherlands)

    Hofmann, K.; Balog, K.; Bogers, T.; de Rijke, M.

    2010-01-01

    Expertise-seeking research studies how people search for expertise and choose whom to contact in the context of a specific task. An important outcome are models that identify factors that influence expert finding. Expertise retrieval addresses the same problem, expert finding, but from a

  9. The "Virtual" Panel: A Computerized Model for LGBT Speaker Panels

    Science.gov (United States)

    Beasley, Christopher; Torres-Harding, Susan; Pedersen, Paula J.

    2012-01-01

    Recent societal trends indicate more tolerance for homosexuality, but prejudice remains on college campuses. Speaker panels are commonly used in classrooms as a way to educate students about sexual diversity and decrease negative attitudes toward sexual diversity. The advent of computer-delivered instruction presents a unique opportunity to…

  10. Expert advisor for the QUAL2E water-quality model

    Energy Technology Data Exchange (ETDEWEB)

    Barnwell, T.O.; Brown, L.C.; Marek, W.

    1987-12-01

    Computer modeling is becoming an integral part of decision making in water-pollution control. Problems increasingly involve complex interactions among elements of the environment and large, multi-media modeling systems must be built to understand these interactions. Expert systems is an innovative methodology that can assist in building, using, and interpreting the output of these models. The paper reviews the use and evaluates the potential of expert systems technology in environmental modeling and describes elements of an expert advisor for the stream water-quality model QUAL2E. QUAL2E has a long history of use both in the United States and worldwide and is a proven, effective modeling tool for analyzing the dissolved oxygen balance in a stream or river. Because of the widespread usage, a body of experience and empirical knowledge about the computer program has been gained that is ideal for codification in an expert system.

  11. Impact of Expert Teaching Quality on Novice Academic Performance in the Jigsaw Cooperative Learning Method

    Science.gov (United States)

    Berger, Roland; Hänze, Martin

    2015-01-01

    We assessed the impact of expert students' instructional quality on the academic performance of novice students in 12th-grade physics classes organized in an expert model of cooperative learning ('jigsaw classroom'). The instructional quality of 129 expert students was measured by a newly developed rating system. As expected, when aggregating across all four subtopics taught, regression analysis revealed that academic performance of novice students increases with the quality of expert students' instruction. The difficulty of subtopics, however, moderates this effect: higher instructional quality of more difficult subtopics did not lead to better academic performance of novice students. We interpret this finding in the light of Cognitive Load Theory. Demanding tasks cause high intrinsic cognitive load and hindered the novice students' learning.

  12. 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.

  13. Expert systems in treating substance abuse.

    Science.gov (United States)

    Wesson, D R; Hink, R H

    1990-05-01

    Computer programs can assist humans in solving complex problems that cannot be solved by traditional computational techniques using mathematic formulas. These programs, or "expert systems," are commonly used in finance, engineering, and computer design. Although not routinely used in medicine at present, medical expert systems have been developed to assist physicians in solving many kinds of medical problems that traditionally require consultation from a physician specialist. No expert systems are available specifically for drug abuse treatment, but at least one is under development. Where access to a physician specialist in substance abuse is not available for consultation, this expert system will extend specialized substance abuse treatment expertise to nonspecialists. Medical expert systems are a developing technologic tool that can assist physicians in practicing better medicine.

  14. Expert Evidence and International Criminal Justice

    DEFF Research Database (Denmark)

    Appazov, Artur

    The book is a comprehensive narration of the use of expertise in international criminal trials offering reflection on standards concerning the quality and presentation of expert evidence. It analyzes and critiques the rules governing expert evidence in international criminal trials...... and the strategies employed by counsel and courts relying upon expert evidence and challenges that courts face determining its reliability. In particular, the author considers how the procedural and evidentiary architecture of international criminal courts and tribunals influences the courts' ability to meaningfully...... incorporate expert evidence into the rational fact-finding process. The book provides analysis of the unique properties of expert evidence as compared with other forms of evidence and the challenges that these properties present for fact-finding in international criminal trials. It draws conclusions about...

  15. Can experts judge elections? Testing the validity of expert judgments for measuring election integrity

    NARCIS (Netherlands)

    Martinez i Coma, F.; van Ham, C.T.

    2015-01-01

    Expert surveys have been used to measure a wide variety of phenomena in political science, ranging from party positions, to corruption, to the quality of democracy and elections. However, expert judgments raise important validity concerns, both about the object being measured as well as the experts.

  16. 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 sl...

  17. 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.

  18. 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

    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.

  19. 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.

  20. Interpretation and consumption

    Directory of Open Access Journals (Sweden)

    Marcin Rychlewski

    2011-01-01

    Full Text Available The author discusses some theoretical problems associated with the description of the modern book market. In particular, he is interested in the release notes and book covers in the context of the literary categories of interpretation and reception. He postulates that the marketing practices of publishers should be called a “manipulative interpretation”, insofar as the information about books and book covers fulfills a double function: that of advertising and affecting the reception of the text. Referring to the two types of interpretation, “exegesis” and “usage”, he believes that the discussed phenomena fall between these two extremes. Both the release notes and book covers are the domain of a limited “usage”, the accuracy of which verifies the market.