WorldWideScience

Sample records for multiple criteria including

  1. Hybrid multiple criteria decision-making methods

    Zavadskas, Edmundas Kazimieras; Govindan, K.; Antucheviciene, Jurgita

    2016-01-01

    Formal decision-making methods can be used to help improve the overall sustainability of industries and organisations. Recently, there has been a great proliferation of works aggregating sustainability criteria by using diverse multiple criteria decision-making (MCDM) techniques. A number of revi...

  2. Multiple criteria facility location probems : a survey

    Farahani, R.Z.; Steadie Seifi, M.; Asgari, N.

    2010-01-01

    This paper provides a review on recent efforts and development in multi-criteria location problems in three categories including bi-objective, multi-objective and multi-attribute problems and their solution methods. Also, it provides an overview on various criteria used. While there are a few

  3. Recent developemts in multiple criteria decision making

    Z. Zionts

    2003-12-01

    Full Text Available Problems involving more than one criterion abound. To help in the solution of such problems, a field of management science and operations research known as multiple criteria decision making (MCDM has emerged to help solve such problems. In this paper we discuss some recent developments in this important field.

  4. ACR Appropriateness Criteria® Multiple Gestations.

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

    2017-11-01

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

  5. Interim performance criteria for photovoltaic energy systems. [Glossary included

    DeBlasio, R.; Forman, S.; Hogan, S.; Nuss, G.; Post, H.; Ross, R.; Schafft, H.

    1980-12-01

    This document is a response to the Photovoltaic Research, Development, and Demonstration Act of 1978 (P.L. 95-590) which required the generation of performance criteria for photovoltaic energy systems. Since the document is evolutionary and will be updated, the term interim is used. More than 50 experts in the photovoltaic field have contributed in the writing and review of the 179 performance criteria listed in this document. The performance criteria address characteristics of present-day photovoltaic systems that are of interest to manufacturers, government agencies, purchasers, and all others interested in various aspects of photovoltaic system performance and safety. The performance criteria apply to the system as a whole and to its possible subsystems: array, power conditioning, monitor and control, storage, cabling, and power distribution. They are further categorized according to the following performance attributes: electrical, thermal, mechanical/structural, safety, durability/reliability, installation/operation/maintenance, and building/site. Each criterion contains a statement of expected performance (nonprescriptive), a method of evaluation, and a commentary with further information or justification. Over 50 references for background information are also given. A glossary with definitions relevant to photovoltaic systems and a section on test methods are presented in the appendices. Twenty test methods are included to measure performance characteristics of the subsystem elements. These test methods and other parts of the document will be expanded or revised as future experience and needs dictate.

  6. Multivariant design and multiple criteria analysis of building refurbishments

    Kaklauskas, A.; Zavadskas, E. K.; Raslanas, S. [Faculty of Civil Engineering, Vilnius Gediminas Technical University, Vilnius (Lithuania)

    2005-07-01

    In order to design and realize an efficient building refurbishment, it is necessary to carry out an exhaustive investigation of all solutions that form it. The efficiency level of the considered building's refurbishment depends on a great many of factors, including: cost of refurbishment, annual fuel economy after refurbishment, tentative pay-back time, harmfulness to health of the materials used, aesthetics, maintenance properties, functionality, comfort, sound insulation and longevity, etc. Solutions of an alternative character allow for a more rational and realistic assessment of economic, ecological, legislative, climatic, social and political conditions, traditions and for better the satisfaction of customer requirements. They also enable one to cut down on refurbishment costs. In carrying out the multivariant design and multiple criteria analysis of a building refurbishment much data was processed and evaluated. Feasible alternatives could be as many as 100,000. How to perform a multivariant design and multiple criteria analysis of alternate alternatives based on the enormous amount of information became the problem. Method of multivariant design and multiple criteria of a building refurbishment's analysis were developed by the authors to solve the above problems. In order to demonstrate the developed method, a practical example is presented in this paper. (author)

  7. Multiple cost criteria for occupational dose reduction

    James, J.Z.

    1983-01-01

    This paper describes a simple, feasible procedure for deciding if a proposed dose reduction measure is justified under ALARA, based on engineering economic principles of project feasibility analysis. Particular attention is given to the fixing of cost criteria: the importance of melding disparate objectives into a single parameter, and the distinction between a cost criterion and a cost consideration. (author)

  8. THE MULTIPLE CHOICE PROBLEM WITH INTERACTIONS BETWEEN CRITERIA

    Luiz Flavio Autran Monteiro Gomes

    2015-12-01

    Full Text Available ABSTRACT An important problem in Multi-Criteria Decision Analysis arises when one must select at least two alternatives at the same time. This can be denoted as a multiple choice problem. In other words, instead of evaluating each of the alternatives separately, they must be combined into groups of n alternatives, where n = 2. When the multiple choice problem must be solved under multiple criteria, the result is a multi-criteria, multiple choice problem. In this paper, it is shown through examples how this problemcan be tackled on a bipolar scale. The Choquet integral is used in this paper to take care of interactions between criteria. A numerical application example is conducted using data from SEBRAE-RJ, a non-profit private organization that has the mission of promoting competitiveness, sustainable developmentand entrepreneurship in the state of Rio de Janeiro, Brazil. The paper closes with suggestions for future research.

  9. BSN Program Admittance Criteria: Should Emotional Intelligence Be Included?

    Smith, Tanya

    2017-01-01

    Emotional intelligence refers to the ability to identify and monitor emotions and remain aware of how emotions affect thoughts and actions. Emotional intelligence has been discussed as a better predictor of personal and occupational success than performance on intellectual intelligence tests. Despite the importance of one's emotional intelligence, BSN (Bachelor of Science in Nursing) nursing schools routinely admit candidates based on the student's cumulative college course grade point average (GPA). Nursing is a profession that requires one's ability to empathize, care, and react in emotionally sound manners. Is the GPA enough to determine if a student will evolve into a professional nurse? This article will explore the routine admittance criteria for BSN nursing programs and propose the concept of using the emotional intelligence tool as an adjunct to the cumulative college course GPA. The emotional intelligence theory will be identified and applied to the nursing profession. © 2016 Wiley Periodicals, Inc.

  10. Microseismic Monitoring Design Optimization Based on Multiple Criteria Decision Analysis

    Kovaleva, Y.; Tamimi, N.; Ostadhassan, M.

    2017-12-01

    Borehole microseismic monitoring of hydraulic fracture treatments of unconventional reservoirs is a widely used method in the oil and gas industry. Sometimes, the quality of the acquired microseismic data is poor. One of the reasons for poor data quality is poor survey design. We attempt to provide a comprehensive and thorough workflow, using multiple criteria decision analysis (MCDA), to optimize planning micriseismic monitoring. So far, microseismic monitoring has been used extensively as a powerful tool for determining fracture parameters that affect the influx of formation fluids into the wellbore. The factors that affect the quality of microseismic data and their final results include average distance between microseismic events and receivers, complexity of the recorded wavefield, signal-to-noise ratio, data aperture, etc. These criteria often conflict with each other. In a typical microseismic monitoring, those factors should be considered to choose the best monitoring well(s), optimum number of required geophones, and their depth. We use MDCA to address these design challenges and develop a method that offers an optimized design out of all possible combinations to produce the best data acquisition results. We believe that this will be the first research to include the above-mentioned factors in a 3D model. Such a tool would assist companies and practicing engineers in choosing the best design parameters for future microseismic projects.

  11. Evaluation of dairy effluent management options using multiple criteria analysis.

    Hajkowicz, Stefan A; Wheeler, Sarah A

    2008-04-01

    This article describes how options for managing dairy effluent on the Lower Murray River in South Australia were evaluated using multiple criteria analysis (MCA). Multiple criteria analysis is a framework for combining multiple environmental, social, and economic objectives in policy decisions. At the time of the study, dairy irrigation in the region was based on flood irrigation which involved returning effluent to the river. The returned water contained nutrients, salts, and microbial contaminants leading to environmental, human health, and tourism impacts. In this study MCA was used to evaluate 11 options against 6 criteria for managing dairy effluent problems. Of the 11 options, the MCA model selected partial rehabilitation of dairy paddocks with the conversion of remaining land to other agriculture. Soon after, the South Australian Government adopted this course of action and is now providing incentives for dairy farmers in the region to upgrade irrigation infrastructure and/or enter alternative industries.

  12. Primary progressive multiple sclerosis diagnostic criteria: a reappraisal.

    Montalban, X; Sastre-Garriga, J; Filippi, M; Khaleeli, Z; Téllez, N; Vellinga, M M; Tur, C; Brochet, B; Barkhof, F; Rovaris, M; Miller, D H; Polman, C H; Rovira, A; Thompson, A J

    2009-12-01

    The diagnostic criteria used in primary progressive (PP) and relapsing-remitting (RR) multiple sclerosis (MS) show substantial differences. This introduces complexity in the diagnosis of MS which could be resolved if these criteria could be unified in terms of the requirements for dissemination in space (DIS). The aim of this study was to assess whether a single algorithm may be used to demonstrate DIS in all forms of MS. Five sets of RRMS criteria for DIS were applied to a cohort of 145 patients with established PPMS (mean disease duration: 11 years - PPMS-1): C1: Barkhof-Tintoré (as in 2005 McDonald's criteria); C2: Swanton et al. (as in JNNP 2006); C3: presence of oligoclonal bands plus two lesions (as in McDonald's criteria); C4 and C5: a two-step approach was also followed (patients not fulfilling C1 or C2 were then assessed for C3). Two sets of PPMS criteria for DIS were applied: C6: Thompson et al. (as in 2001 McDonald's criteria); C7: 2005 McDonald criteria. A second sample of 55 patients with less than 5 years of disease duration (PPMS-2) was also analysed using an identical approach. For PPMS-1/PPMS-2, fulfilment was: C1:73.8%/66.7%; C2:72.1%/59.3%; C3:89%/79.2%; C4:96%/92.3%; C5:96%/85.7%; C6:85.8%/78.7%; C7:91%/80.4%. Levels of fulfilment suggest that the use of a single set of criteria for DIS in RRMS and PPMS might be feasible, and reinforce the added value of cerebrospinal fluid (CSF) findings to increase fulfilment in PPMS. Unification of the DIS criteria for both RRMS and PPMS could be considered in further revisions of the MS diagnostic criteria.

  13. Purchasing a Used Car Using Multiple Criteria Decision Making

    Edwards, Thomas G.; Chelst, Kenneth R.

    2007-01-01

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

  14. Myth 6: Cosmetic Use of Multiple Selection Criteria

    Friedman-Nimz, Reva

    2009-01-01

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

  15. MULTIPLE CRITERIA DECISION MAKING APPROACH FOR INDUSTRIAL ENGINEER SELECTION USING FUZZY AHP-FUZZY TOPSIS

    Deliktaş, Derya; ÜSTÜN, Özden

    2018-01-01

    In this study, a fuzzy multiple criteria decision-making approach is proposed to select an industrial engineer among ten candidates in a manufacturing environment. The industrial engineer selection problem is a special case of the personal selection problem. This problem, which has hierarchical structure of criteria and many decision makers, contains many criteria. The evaluation process of decision makers also includes ambiguous parameters. The fuzzy AHP is used to determin...

  16. A Hybrid Multiple Criteria Decision Making Model for Supplier Selection

    Chung-Min Wu

    2013-01-01

    Full Text Available The sustainable supplier selection would be the vital part in the management of a sustainable supply chain. In this study, a hybrid multiple criteria decision making (MCDM model is applied to select optimal supplier. The fuzzy Delphi method, which can lead to better criteria selection, is used to modify criteria. Considering the interdependence among the selection criteria, analytic network process (ANP is then used to obtain their weights. To avoid calculation and additional pairwise comparisons of ANP, a technique for order preference by similarity to ideal solution (TOPSIS is used to rank the alternatives. The use of a combination of the fuzzy Delphi method, ANP, and TOPSIS, proposing an MCDM model for supplier selection, and applying these to a real case are the unique features of this study.

  17. MO-D-BRC-04: Multiple-Criteria Optimization Planning

    Donaghue, J. [Akron General Medical Center (United States)

    2016-06-15

    Treatment planning is a central part of radiation therapy, including delineation in tumor volumes and critical organs, setting treatment goals of prescription doses to the tumor targets and tolerance doses to the critical organs, and finally generation of treatment plans to meet the treatment goals. National groups like RTOG have led the effort to standardize treatment goals of the prescription doses to the tumor targets and tolerance doses to the critical organs based on accumulated knowledge from decades of abundant clinical trial experience. The challenge for each clinical department is how to achieve or surpass these set goals within the time constraints of clinical practice. Using fifteen testing cases from different treatment sites such as head and neck, prostate with and without pelvic lymph nodes, SBRT spine, we will present clinically utility of advanced planning tools, including knowledge based, automatic based, and multiple criteria based tools that are clinically implemented. The objectives of this session are: Understand differences among these three advanced planning tools Provide clinical assessments on the utility of the advanced planning tools Discuss clinical challenges of treatment planning with large variations in tumor volumes and their relationships with adjacent critical organs. Ping Xia received research grant from Philips. Jackie Wu received research grant from Varian; P. Xia, Research support by Philips and Varian; Q. Wu, NIH, Varian Medical.

  18. MO-D-BRC-04: Multiple-Criteria Optimization Planning

    Donaghue, J.

    2016-01-01

    Treatment planning is a central part of radiation therapy, including delineation in tumor volumes and critical organs, setting treatment goals of prescription doses to the tumor targets and tolerance doses to the critical organs, and finally generation of treatment plans to meet the treatment goals. National groups like RTOG have led the effort to standardize treatment goals of the prescription doses to the tumor targets and tolerance doses to the critical organs based on accumulated knowledge from decades of abundant clinical trial experience. The challenge for each clinical department is how to achieve or surpass these set goals within the time constraints of clinical practice. Using fifteen testing cases from different treatment sites such as head and neck, prostate with and without pelvic lymph nodes, SBRT spine, we will present clinically utility of advanced planning tools, including knowledge based, automatic based, and multiple criteria based tools that are clinically implemented. The objectives of this session are: Understand differences among these three advanced planning tools Provide clinical assessments on the utility of the advanced planning tools Discuss clinical challenges of treatment planning with large variations in tumor volumes and their relationships with adjacent critical organs. Ping Xia received research grant from Philips. Jackie Wu received research grant from Varian; P. Xia, Research support by Philips and Varian; Q. Wu, NIH, Varian Medical

  19. Formal MRI criteria for the diagnosis of multiple sclerosis

    Harting, I.; Haehnel, S.; Meyding-Lamade, U.

    2004-01-01

    Multiple scloris (MS) is the most common demyelinating inflammatory disease of the central nervous system, presenting with multifocal, disseminated white matter lesions called plaques. Magnetic resonance imaging (MRI) is very sensitive in detecting white matter abnormalities. By demonstrating the spatial and temporal dissemination in patients presenting with isolated clinical findings suggestive of MS, MRI contributes to estimating the likelihood of the disease. Since MRI is highly sensitive but not specific, it is important to apply formal MRI criteria. This article describes the characteristic MRI changes of MS and the so-called McDonald criteria for an MRI-supported diagnosis of MS. (orig.) [de

  20. Considering Interactions among Multiple Criteria for the Server Selection

    Vesna Čančer

    2010-06-01

    Full Text Available Decision-making about server selection is one of the multi-criteria decision-making (MCDM processes where interactions among criteria should be considered. The paper introduces and develops some solutions for considering interactions among criteria in the MCDM problems. In the frame procedure for MCDM by using the group of methods, based on assigning weights, special attention is given to the synthesis of the local alternatives’ values into the aggregate values where the mutual preferential independence between two criteria is not assumed. Firstly, we delineate how to complete the additive model into the multiplicative one with synergic and redundancy elements in the case that criteria are structured in one level and in two levels. Furthermore, we adapted the concept of the fuzzy Choquet integral to the multi-attribute value theory. Studying and comparing the results of the example case of the server selection obtained by both aggregation approaches, the paper highlights the advantages of the first one since it does not require from decision makers to determine the weights of all possible combinations of the criteria and it enables the further use of the most preferred MCDM methods.

  1. Hesitant fuzzy methods for multiple criteria decision analysis

    Zhang, Xiaolu

    2017-01-01

    The book offers a comprehensive introduction to methods for solving multiple criteria decision making and group decision making problems with hesitant fuzzy information. It reports on the authors’ latest research, as well as on others’ research, providing readers with a complete set of decision making tools, such as hesitant fuzzy TOPSIS, hesitant fuzzy TODIM, hesitant fuzzy LINMAP, hesitant fuzzy QUALIFEX, and the deviation modeling approach with heterogeneous fuzzy information. The main focus is on decision making problems in which the criteria values and/or the weights of criteria are not expressed in crisp numbers but are more suitable to be denoted as hesitant fuzzy elements. The largest part of the book is devoted to new methods recently developed by the authors to solve decision making problems in situations where the available information is vague or hesitant. These methods are presented in detail, together with their application to different type of decision-making problems. All in all, the book ...

  2. INTEGRATING MULTIPLE CRITERIA EVALUATION AND GIS IN ECOTOURISM: A REVIEW

    Z. H. Mohd

    2016-09-01

    Full Text Available The concept of 'Eco-tourism' is increasingly heard in recent decades. Ecotourism is one adventure that environmentally responsible intended to appreciate the nature experiences and cultures. Ecotourism should have low impact on environment and must contribute to the prosperity of local residents. This article reviews the use of Multiple Criteria Evaluation (MCE and Geographic Information System (GIS in ecotourism. Multiple criteria evaluation mostly used to land suitability analysis or fulfill specific objectives based on various attributes that exist in the selected area. To support the process of environmental decision making, the application of GIS is used to display and analysis the data through Analytic Hierarchy Process (AHP. Integration between MCE and GIS tool is important to determine the relative weight for the criteria used objectively. With the MCE method, it can resolve the conflict between recreation and conservation which is to minimize the environmental and human impact. Most studies evidences that the GIS-based AHP as a multi criteria evaluation is a strong and effective in tourism planning which can aid in the development of ecotourism industry effectively.

  3. Integrating Multiple Criteria Evaluation and GIS in Ecotourism: a Review

    Mohd, Z. H.; Ujang, U.

    2016-09-01

    The concept of 'Eco-tourism' is increasingly heard in recent decades. Ecotourism is one adventure that environmentally responsible intended to appreciate the nature experiences and cultures. Ecotourism should have low impact on environment and must contribute to the prosperity of local residents. This article reviews the use of Multiple Criteria Evaluation (MCE) and Geographic Information System (GIS) in ecotourism. Multiple criteria evaluation mostly used to land suitability analysis or fulfill specific objectives based on various attributes that exist in the selected area. To support the process of environmental decision making, the application of GIS is used to display and analysis the data through Analytic Hierarchy Process (AHP). Integration between MCE and GIS tool is important to determine the relative weight for the criteria used objectively. With the MCE method, it can resolve the conflict between recreation and conservation which is to minimize the environmental and human impact. Most studies evidences that the GIS-based AHP as a multi criteria evaluation is a strong and effective in tourism planning which can aid in the development of ecotourism industry effectively.

  4. Sustainable national transport planning: Managing multiple objectives and criteria

    Jensen, Anders Vestergaard; Salling, Kim Bang; Leleur, Steen

    not included in the CBA. One important part of the assessment is the selection of criteria to be included and this aspect will be examined by an appraisal study of the Rail Baltica corridor. In the study various alternatives are appraised with an explicit consideration of each alternative’s sustainability...... performance....

  5. Evaluation of the 2010 McDonald multiple sclerosis criteria in children with a clinically isolated syndrome.

    Kornek, Barbara; Schmitl, Beate; Vass, Karl; Zehetmayer, Sonja; Pritsch, Martin; Penzien, Johann; Karenfort, Michael; Blaschek, Astrid; Seidl, Rainer; Prayer, Daniela; Rostasy, Kevin

    2012-12-01

    Magnetic resonance imaging diagnostic criteria for paediatric multiple sclerosis have been established on the basis of brain imaging findings alone. The 2010 McDonald criteria for the diagnosis of multiple sclerosis, however, include spinal cord imaging for detection of lesion dissemination in space. The new criteria have been recommended in paediatric multiple sclerosis. (1) To evaluate the 2010 McDonald multiple sclerosis criteria in children with a clinically isolated syndrome and to compare them with recently proposed magnetic resonance criteria for children; (2) to assess whether the inclusion of spinal cord imaging provided additional value to the 2010 McDonald criteria. We performed a retrospective analysis of brain and spinal cord magnetic resonance imaging scans from 52 children with a clinically isolated syndrome. Sensitivity, specificity and accuracy of the magnetic resonance criteria were assessed. The 2010 McDonald dissemination in space criteria were more sensitive (85% versus 74%) but less specific (80% versus 100%) compared to the 2005 McDonald criteria. The Callen criteria were more accurate (89%) compared to the 2010 McDonald (85%), the 2005 McDonald criteria for dissemination in space (81%), the KIDMUS criteria (46%) and the Canadian Pediatric Demyelinating Disease Network criteria (76%). The 2010 McDonald criteria for dissemination in time were more accurate (93%) than the dissemination in space criteria (85%). Inclusion of the spinal cord did not increase the accuracy of the McDonald criteria.

  6. Nonlinear Knowledge in Kernel-Based Multiple Criteria Programming Classifier

    Zhang, Dongling; Tian, Yingjie; Shi, Yong

    Kernel-based Multiple Criteria Linear Programming (KMCLP) model is used as classification methods, which can learn from training examples. Whereas, in traditional machine learning area, data sets are classified only by prior knowledge. Some works combine the above two classification principle to overcome the defaults of each approach. In this paper, we propose a model to incorporate the nonlinear knowledge into KMCLP in order to solve the problem when input consists of not only training example, but also nonlinear prior knowledge. In dealing with real world case breast cancer diagnosis, the model shows its better performance than the model solely based on training data.

  7. Clustering economies based on multiple criteria decision making techniques

    Mansour Momeni

    2011-10-01

    Full Text Available One of the primary concerns on many countries is to determine different important factors affecting economic growth. In this paper, we study some factors such as unemployment rate, inflation ratio, population growth, average annual income, etc to cluster different countries. The proposed model of this paper uses analytical hierarchy process (AHP to prioritize the criteria and then uses a K-mean technique to cluster 59 countries based on the ranked criteria into four groups. The first group includes countries with high standards such as Germany and Japan. In the second cluster, there are some developing countries with relatively good economic growth such as Saudi Arabia and Iran. The third cluster belongs to countries with faster rates of growth compared with the countries located in the second group such as China, India and Mexico. Finally, the fourth cluster includes countries with relatively very low rates of growth such as Jordan, Mali, Niger, etc.

  8. The computer-aided design of a servo system as a multiple-criteria decision problem

    Udink ten Cate, A.J.

    1986-01-01

    This paper treats the selection of controller gains of a servo system as a multiple-criteria decision problem. In contrast to the usual optimization-based approaches to computer-aided design, inequality constraints are included in the problem as unconstrained objectives. This considerably simplifies

  9. 12th International Conference on Multiple Criteria Decision Making

    Gal, Tomas

    1997-01-01

    The organizers of the 12th International Conference on Multiple Cri­ teria Decision Making (MCDM) held June 19-23, 1995 in Hagen received the second time the opportunity to prepare an international conference on MCDM in Germany; the first opportunity has been the 3rd International Conference on MCDM in Konigswinter, 1979. Quite a time ellapsed since then and therefore it might be interesting to compare some indicators of the development of the International Society on MCDM, which has been founded in Konigswinter. Stanley Zionts has been elected first president and all 44 participants of that Conference became founding members. Today our Society has over 1200 members and its own Journal (MCDM World Scan). In Hagen, 1996, we had 152 participants from 34 countries. It is interesting to mention that also other Groups established their organi­ zation, like the European Working Group on Multiple Criteria Decision Aid, the German Working Group on Decision Theory and Applications, the Multi­ Objective Programming ...

  10. 45 CFR 1308.13 - Eligibility criteria: Visual impairment including blindness.

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Eligibility criteria: Visual impairment including... impairment including blindness. (a) A child is classified as visually impaired when visual impairment, with...) A child is classified as having a visual impairment if central acuity with corrective lenses is...

  11. Mapping of multiple criteria for priority setting of health interventions: an aid for decision makers

    Tromp Noor

    2012-12-01

    Full Text Available Abstract Background In rationing decisions in health, many criteria like costs, effectiveness, equity and feasibility concerns play a role. These criteria stem from different disciplines that all aim to inform health care rationing decisions, but a single underlying concept that incorporates all criteria does not yet exist. Therefore, we aim to develop a conceptual mapping of criteria, based on the World Health Organization’s Health Systems Performance and Health Systems Building Blocks frameworks. This map can be an aid to decision makers to identify the relevant criteria for priority setting in their specific context. Methods We made an inventory of all possible criteria for priority setting on the basis of literature review. We categorized the criteria according to both health system frameworks that spell out a country’s health system goals and input. We reason that the criteria that decision makers use in priority setting exercises are a direct manifestation of this. Results Our map includes thirty-one criteria that are distributed among five categories that reflect the goals of a health system (i.e. to improve level of health, fair distribution of health, responsiveness, social & financial risk protection and efficiency and leadership/governance one category that reflects feasibiliy based on the health system building blocks (i.e. service delivery, health care workforce , information, medical products, vaccines & technologies, financing and. Conclusions This conceptual mapping of criteria, based on well-established health system frameworks, will further develop the field of priority setting by assisting decision makers in the identification of multiple criteria for selection of health interventions.

  12. Multiple criteria decision analysis for health technology assessment.

    Thokala, Praveen; Duenas, Alejandra

    2012-12-01

    Multicriteria decision analysis (MCDA) has been suggested by some researchers as a method to capture the benefits beyond quality adjusted life-years in a transparent and consistent manner. The objectives of this article were to analyze the possible application of MCDA approaches in health technology assessment and to describe their relative advantages and disadvantages. This article begins with an introduction to the most common types of MCDA models and a critical review of state-of-the-art methods for incorporating multiple criteria in health technology assessment. An overview of MCDA is provided and is compared against the current UK National Institute for Health and Clinical Excellence health technology appraisal process. A generic MCDA modeling approach is described, and the different MCDA modeling approaches are applied to a hypothetical case study. A comparison of the different MCDA approaches is provided, and the generic issues that need consideration before the application of MCDA in health technology assessment are examined. There are general practical issues that might arise from using an MCDA approach, and it is suggested that appropriate care be taken to ensure the success of MCDA techniques in the appraisal process. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

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

    Lumley, R; Davenport, R; Williams, A

    2015-03-01

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

  14. Assessment of hydrogen fuel cell applications using fuzzy multiple-criteria decision making method

    Chang, Pao-Long; Hsu, Chiung-Wen; Lin, Chiu-Yue

    2012-01-01

    Highlights: ► This study uses the fuzzy MCDM method to assess hydrogen fuel cell applications. ► We evaluate seven different hydrogen fuel cell applications based on 14 criteria. ► Results show that fuel cell backup power systems should be chosen for development in Taiwan. -- Abstract: Assessment is an essential process in framing government policy. It is critical to select the appropriate targets to meet the needs of national development. This study aimed to develop an assessment model for evaluating hydrogen fuel cell applications and thus provide a screening tool for decision makers. This model operates by selecting evaluation criteria, determining criteria weights, and assessing the performance of hydrogen fuel cell applications for each criterion. The fuzzy multiple-criteria decision making method was used to select the criteria and the preferred hydrogen fuel cell products based on information collected from a group of experts. Survey questionnaires were distributed to collect opinions from experts in different fields. After the survey, the criteria weights and a ranking of alternatives were obtained. The study first defined the evaluation criteria in terms of the stakeholders, so that comprehensive influence criteria could be identified. These criteria were then classified as environmental, technological, economic, or social to indicate the purpose of each criterion in the assessment process. The selected criteria included 14 indicators, such as energy efficiency and CO 2 emissions, as well as seven hydrogen fuel cell applications, such as forklifts and backup power systems. The results show that fuel cell backup power systems rank the highest, followed by household fuel cell electric-heat composite systems. The model provides a screening tool for decision makers to select hydrogen-related applications.

  15. The strategic selecting criteria and performance by using the multiple criteria method

    Lisa Y. Chen

    2008-02-01

    Full Text Available As the increasing competitive intensity in the current service market, organizational capabilities have been recognized as the importance of sustaining competitive advantage. The profitable growth for the firms has been fueled a need to systematically assess and renew the organization. The purpose of this study is to analyze the financial performance of the firms to create an effective evaluating structure for the Taiwan's service industry. This study utilized TOPSIS (technique for order preference by similarity to ideal solution method to evaluate the operating performance of 12 companies. TOPSIS is a multiple criteria decision making method to identify solutions from a finite set of alternatives based upon simultaneous minimization of distance from an ideal point and maximization of distance from a nadir point. By using this approach, this study measures the financial performance of firms through two aspects and ten indicators. The result indicated e-life had outstanding performance among the 12 retailers. The findings of this study provided managers to better understand their market position, competition, and profitability for future strategic planning and operational management.

  16. Prospective validation of criteria, including age, for safe, nonsurgical management of the ruptured spleen

    Smith, J.S. Jr.; Wengrovitz, M.A.; DeLong, B.S. (Pennsylvania State University College of Medicine, Hershey (United States))

    1992-09-01

    One hundred twelve cases of blunt splenic rupture were prospectively entered (October 1987-October 1991) into surgical or nonsurgical management groups using these criteria for the nonsurgical group: hemodynamic stability-age less than 55 years-CT scan appearance of grade I, II, or III injury-absence of concomitant injuries precluding abdominal assessment+absence of other documented abdominal injuries. All ages were included and AAST injury scaling was used. Patients were grouped from the trauma room. The surgical treatment group included 66 patients (49 splenectomies, 17 splenorraphies). These patients were generally older and more severely injured, required more transfused blood, and a longer ICU stay. The nonsurgical group included 46 patients with 33 older than 14 years. There were 3 patients over the age of 55 years inappropriately included in this group, and nonsurgical therapy failed in all three. Statistical analysis (chi 2) showed that more splenic injuries were observed and more spleens were saved with these criteria applied prospectively compared with a previous retrospective series in the same institution. The series had a success rate of 93%, and validates the criteria used for safe, nonsurgical management of the ruptured spleen and adds a new criterion: a maximum age of 55 years.

  17. Prospective validation of criteria, including age, for safe, nonsurgical management of the ruptured spleen

    Smith, J.S. Jr.; Wengrovitz, M.A.; DeLong, B.S.

    1992-01-01

    One hundred twelve cases of blunt splenic rupture were prospectively entered (October 1987-October 1991) into surgical or nonsurgical management groups using these criteria for the nonsurgical group: hemodynamic stability-age less than 55 years-CT scan appearance of grade I, II, or III injury-absence of concomitant injuries precluding abdominal assessment+absence of other documented abdominal injuries. All ages were included and AAST injury scaling was used. Patients were grouped from the trauma room. The surgical treatment group included 66 patients (49 splenectomies, 17 splenorraphies). These patients were generally older and more severely injured, required more transfused blood, and a longer ICU stay. The nonsurgical group included 46 patients with 33 older than 14 years. There were 3 patients over the age of 55 years inappropriately included in this group, and nonsurgical therapy failed in all three. Statistical analysis (chi 2) showed that more splenic injuries were observed and more spleens were saved with these criteria applied prospectively compared with a previous retrospective series in the same institution. The series had a success rate of 93%, and validates the criteria used for safe, nonsurgical management of the ruptured spleen and adds a new criterion: a maximum age of 55 years

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

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

    2008-10-01

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

  19. Assessment of Different Metal Screw Joint Parameters by Using Multiple Criteria Analysis Methods

    Audrius Čereška

    2018-05-01

    Full Text Available This study compares screw joints made of different materials, including screws of different diameters. For that purpose, 8, 10, 12, 14, 16 mm diameter steel screws and various parts made of aluminum (Al, steel (Stl, bronze (Brz, cast iron (CI, copper (Cu and brass (Br are considered. Multiple criteria decision making (MCDM methods such as evaluation based on distance from average solution (EDAS, simple additive weighting (SAW, technique for order of preference by similarity to ideal solution (TOPSIS and complex proportional assessment (COPRAS are utilized to assess reliability of screw joints also considering cost issues. The entropy, criterion impact loss (CILOS and integrated determination of objective criteria weights (IDOCRIW methods are utilized to assess weights of decision criteria and find the best design alternative. Numerical results confirm the validity of the proposed approach.

  20. Plasma Cell Neoplasms (Including Multiple Myeloma)—Patient Version

    Plasma cell neoplasms occur when abnormal plasma cells form cancerous tumors. When there is only one tumor, the disease is called a plasmacytoma. When there are multiple tumors, it is called multiple myeloma. Start here to find information on plasma cell neoplasms treatment, research, and statistics.

  1. Stages of Plasma Cell Neoplasms (Including Multiple Myeloma)

    ... cancer treatment is also called biotherapy or immunotherapy. Immunomodulators are a type of biologic therapy. Thalidomide , lenalidomide , and pomalidomide are immunomodulators used to treat multiple myeloma and other plasma ...

  2. Treatment Options for Plasma Cell Neoplasms (Including Multiple Myeloma)

    ... cancer treatment is also called biotherapy or immunotherapy. Immunomodulators are a type of biologic therapy. Thalidomide , lenalidomide , and pomalidomide are immunomodulators used to treat multiple myeloma and other plasma ...

  3. Multiple criteria decision making with life cycle assessment for material selection of composites

    A. S. Milani

    2011-12-01

    Full Text Available With the advancement of interdisciplinary approaches in today’s modern engineering, current efforts in optimal design of composites include seeking material selection protocols that can (1 simultaneously consider a series of mechanical/electrical/chemical cost criteria over a set of alternative material options, and (2 closely take into account environmental aspects of final products including recycling and end-of-life disposal options. In this paper, in addition to a review of some recent experimental and methodological advances in the above areas, a new application of multiple criteria decision making (MCDM is presented to deal with decision conflicts often seen among design criteria in composite material selection with the help of life cycle assessment (LCA. To show the application, an illustrative case study on a plastic gear material selection is conducted where the cost, mechanical and thermal properties along with environmental impact criteria are to be satisfied simultaneously. A pure plastic gear is compared to a Polyethylene terephthalate (PET/aluminum-powder composite alternative. Results suggest that simple MCDM models, including a signal-to-noise measure adapted to MCDM in the same case study, can be used to explore both trade-offs and design break-even points in large decision spaces as the decision maker’s perspective over environmental, material performance and cost attributes change during the design process. More advanced topics including the account of material data uncertainties are addressed.

  4. Comparison of multiple-criteria decision-making methods - results of simulation study

    Michał Adamczak

    2016-12-01

    Full Text Available Background: Today, both researchers and practitioners have many methods for supporting the decision-making process. Due to the conditions in which supply chains function, the most interesting are multi-criteria methods. The use of sophisticated methods for supporting decisions requires the parameterization and execution of calculations that are often complex. So is it efficient to use sophisticated methods? Methods: The authors of the publication compared two popular multi-criteria decision-making methods: the  Weighted Sum Model (WSM and the Analytic Hierarchy Process (AHP. A simulation study reflects these two decision-making methods. Input data for this study was a set of criteria weights and the value of each in terms of each criterion. Results: The iGrafx Process for Six Sigma simulation software recreated how both multiple-criteria decision-making methods (WSM and AHP function. The result of the simulation was a numerical value defining the preference of each of the alternatives according to the WSM and AHP methods. The alternative producing a result of higher numerical value  was considered preferred, according to the selected method. In the analysis of the results, the relationship between the values of the parameters and the difference in the results presented by both methods was investigated. Statistical methods, including hypothesis testing, were used for this purpose. Conclusions: The simulation study findings prove that the results obtained with the use of two multiple-criteria decision-making methods are very similar. Differences occurred more frequently in lower-value parameters from the "value of each alternative" group and higher-value parameters from the "weight of criteria" group.

  5. MRI criteria for the diagnosis of multiple sclerosis

    Filippi, Massimo; Rocca, Maria A; Ciccarelli, Olga

    2016-01-01

    the value of spinal cord imaging. Since the last update of these criteria, new data on the use of MRI to establish dissemination in space and time have become available, and MRI technology has improved. State-of-the-art MRI findings in these patients were discussed in a MAGNIMS workshop, the goal of which...

  6. MULTIPLE CRITERIA DECISION MAKING IN STRATEGIC PLANNING OF TABLE EGG PRODUCTION

    Ana Crnčan

    2016-06-01

    Full Text Available The main research objective was to analyze and evaluate different systems of table egg production by using the multiple criteria analysis, the method of Analytic Hierarchy Process (AHP in decision making within strategic planning of production. The survey involved 79 producers of table eggs registered in the Records on laying hens’ farms in the Republic of Croatia. In the first stage, the research defined the criteria and sub-criteria for system evaluation which were compared in pairs in order to determine the weight or importance for each of them. Alternatives were evaluation based on definition of priorities of examinees and the extent to which they meet each of the defined criteria and sub-criteria. Intensity of examinees’ preferences were entered into the Expert Choice software in order to evaluate ranking results of egg production systems. Defined model consisted of a quantitative criterion of economic indicators, and the other two referred to qualitative criteria, market indicators and technical-technological factors. Each criterion had its corresponding sub-criteria that were evenly distributed in numerical order. Based on individual assessments of the examinees, overall cumulative evaluation was obtained for the table egg production systems. Accordingly, the most acceptable alternative to egg production is the indoor keeping system (priority 0.301. It is followed by the free-range system of keeping laying hens (priority 0.253. The third-ranked alternative is egg production by hens kept in conventional cages (priority 0.226, while the fourth-ranked least acceptable alternative, as of the total evaluation, is the ecological system of egg production (priority 0.220. Taking into account the obtained results of multiple criteria evaluation as well as EU and world trends in changing consumers’ habits including food safety and quality as well as customers’ preferences towards local market and local products, it is recommended that eggs

  7. A review of multiple stressor studies that include ionising radiation

    Vanhoudt, Nathalie; Vandenhove, Hildegarde; Real, Almudena; Bradshaw, Clare; Stark, Karolina

    2012-01-01

    Studies were reviewed that investigated the combined effects of ionising radiation and other stressors on non-human biota. The aim was to determine the state of research in this area of science, and determine if a review of the literature might permit a gross generalization as to whether the combined effects of multi-stressors and radiation are fundamentally additive, synergistic or antagonistic. A multiple stressor database was established for different organism groups. Information was collected on species, stressors applied and effects evaluated. Studies were mostly laboratory based and investigated two-component mixtures. Interactions declared positive occurred in 58% of the studies, while 26% found negative interactions. Interactions were dependent on dose/concentration, on organism's life stage and exposure time and differed among endpoints. Except for one study, none of the studies predicted combined effects following Concentration Addition or Independent Action, and hence, no justified conclusions can be made about synergism or antagonism. - This review on multiple stressor studies involving radiation, highlights that most experimental designs used did not allow to deduce the nature of the interactive effects.

  8. Criteria for stability of linear dynamical systems with multiple delays ...

    In this study we considered a linear Dynamical system with multiple delays and find suitable conditions on the systems parameters such that for a given initial function, we can define a mapping in a carefully chosen complete metric space on which the mapping has a unique fixed point. An asymptotic stability theory for the ...

  9. Multiple imaging procedures including MRI for the bladder cancer

    Mikata, Noriharu; Suzuki, Makoto; Takeuchi, Takumi; Kunisawa, Yositaka; Fukutani, Keiko; Kawabe, Kazuki

    1986-01-01

    Endoscopic photography, double contrast cystography, transurethral echography, X-ray CT scan, and MRI (magnetic resonance imaging) were utilized for the staging diagnosis of the four patients with carcinoma of the bladder. In the first case, a 70-year-old man, since all of the five imaging procedures suggested a superficial and pedunculated tumor, his bladder cancer was considered T1. The classification of stage T3 carcinoma was made for the second 86-year-old male. Because all of his imaging examinations showed a tumor infiltrating deep muscle and penetrating the bladder wall. The third case was a 36-year-old male. His clinical stage was diagnosed as T2 or T3a by cystophotography, double contrast cystogram, ultrasonography, and X-ray CT scan. However, MRI showed only thickened bladder wall and the infiltrating tumor could not be distinguished from the hypertrophic wall. The last patient, a 85-year-old female, had a smaller Ta cancer. Her double contrast cystography revealed the small tumor at the lateral bladder wall. But, the tumor could not be detected by transaxial, sagittal and coronal scans. Multiple imaging procedures combining MRI and staging diagnosis of the bladder carcinoma were discussed. (author)

  10. Solution of neutron slowing down equation including multiple inelastic scattering

    El-Wakil, S.A.; Saad, A.E.

    1977-01-01

    The present work is devoted the presentation of an analytical method for the calculation of elastically and inelastically slowed down neutrons in an infinite non absorbing homogeneous medium. On the basis of the Central limit theory (CLT) and the integral transform technique the slowing down equation including inelastic scattering in terms of the Green function of elastic scattering is solved. The Green function is decomposed according to the number of collisions. A formula for the flux at any lethargy O (u) after any number of collisions is derived. An equation for the asymptotic flux is also obtained

  11. Assessment of five different guideline indication criteria for spirometry, including modified GOLD criteria, in order to detect COPD: data from 5,315 subjects in the PLATINO study.

    Luize, Ana P; Menezes, Ana Maria B; Perez-Padilla, Rogelio; Muiño, Adriana; López, Maria Victorina; Valdivia, Gonzalo; Lisboa, Carmem; Montes de Oca, Maria; Tálamo, Carlos; Celli, Bartolomé; Nascimento, Oliver A; Gazzotti, Mariana R; Jardim, José R

    2014-10-30

    Spirometry is the gold standard for diagnosing chronic obstructive pulmonary disease (COPD). Although there are a number of different guideline criteria for deciding who should be selected for spirometric screening, to date it is not known which criteria are the best based on sensitivity and specificity. Firstly, to evaluate the proportion of subjects in the PLATINO Study that would be recommended for spirometry testing according to Global initiative for Obstructive Lung Disease (GOLD)-modified, American College of Chest Physicians (ACCP), National Lung Health Education Program (NLHEP), GOLD and American Thoracic Society/European Respiratory Society (ATS/ERS) criteria. Secondly, we aimed to compare the sensitivity, specificity, and positive predictive and negative predictive values, of these five different criteria. Data from the PLATINO study included information on respiratory symptoms, smoking and previous spirometry testing. The GOLD-modified spirometry indication criteria are based on three positive answers out of five questions: the presence of cough, phlegm in the morning, dyspnoea, age over 40 years and smoking status. Data from 5,315 subjects were reviewed. Fewer people had an indication for spirometry (41.3%) according to the GOLD-modified criteria, and more people had an indication for spirometry (80.4%) by the GOLD and ATS/ERS criteria. A low percentage had previously had spirometry performed: GOLD-modified (14.5%); ACCP (13.2%); NLHEP (12.6%); and GOLD and ATS/ERS (12.3%). The GOLD-modified criteria showed the least sensitivity (54.9) and the highest specificity (61.0) for detecting COPD, whereas GOLD and ATS/ERS criteria showed the highest sensitivity (87.9) and the least specificity (20.8). There is a considerable difference in the indication for spirometry according to the five different guideline criteria. The GOLD-modified criteria recruit less people with the greatest sum of sensitivity and specificity.

  12. Integral criteria for large-scale multiple fingerprint solutions

    Ushmaev, Oleg S.; Novikov, Sergey O.

    2004-08-01

    We propose the definition and analysis of the optimal integral similarity score criterion for large scale multmodal civil ID systems. Firstly, the general properties of score distributions for genuine and impostor matches for different systems and input devices are investigated. The empirical statistics was taken from the real biometric tests. Then we carry out the analysis of simultaneous score distributions for a number of combined biometric tests and primary for ultiple fingerprint solutions. The explicit and approximate relations for optimal integral score, which provides the least value of the FRR while the FAR is predefined, have been obtained. The results of real multiple fingerprint test show good correspondence with the theoretical results in the wide range of the False Acceptance and the False Rejection Rates.

  13. Irreversibility and multiplicity: two criteria for the disposal of nuclear wastes

    Rochlin, G.

    1976-01-01

    Two criteria are suggested for comparing waste management methods: technical irreversibility and site multiplicity. These criteria can be used to reduce future risk in the face of inherent uncertainty and to provide for safe disposal without requiring guaranteed future ability to recognize, detect or repair areas of failure

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

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

    2006-10-01

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

  15. Multiple criteria decision making of alternative fuels for waste collection vehicles in southeast region of Serbia

    Petrović Goran S.

    2016-01-01

    Full Text Available In this paper multiple criteria decision making approach of alternative fuels for waste collection vehicles in southeast region of Serbia was presented. Eight alternative fuels and advanced vehicle technologies were ranked according to thirteen criteria, including financial, socio-technical, and environmental. Assessment of alternatives was performed by using the weighted aggregated sum product assessment method and results were verified using multi-objective optimization on the basis of ratio analysis method. Considered criteria were obtained from previous researches and by assessment of professional experts from manufacturing industries, public utility companies, and academics institutions. The analysis showed that both biodiesel fuels - derived from used cooking oil or from vegetable oils are the best alternative fuels for Serbian waste collection vehicles in this point of time. Compressed natural gas-powered vehicles were also ranked high in this analysis, but due to the lack of financial capability for their purchase (especially in southeast region of Serbia, their gradual introduction into the waste collection fleet was proposed.

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

    Laukkanen, Sanna; Kangas, Annika; Kangas, Jyrki

    2002-02-01

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

  17. To Make Good Decision: A Group DSS for Multiple Criteria Alternative Rank and Selection

    Chen-Shu Wang

    2015-01-01

    Full Text Available Decision making is a recursive process and usually involves multiple decision criteria. However, such multiple criteria decision making may have a problem in which partial decision criteria may conflict with each other. An information technology, such as the decision support system (DSS and group DSS (GDSS, emerges to assist decision maker for decision-making process. Both the DSS and GDSS should integrate with a symmetrical approach to assist decision maker to take all decision criteria into consideration simultaneously. This study proposes a GDSS architecture named hybrid decision-making support model (HDMSM and integrated four decision approaches (Delphi, DEMATEL, ANP, and MDS to help decision maker to rank and select appropriate alternatives. The HDMSM consists of five steps, namely, criteria identification, criteria correlation calculation, criteria evaluation, critical criteria selection, and alternative rank and comparison. Finally, to validate the proposed feasibility of the proposed model, this study also conducts a case study to find out the important indexes of corporate social responsibility (CSR from multiple perspectives. As the case study demonstrates the proposed HDMSM enables a group of decision makers to implement the MCDM effectively and help them to analyze the relation and degree of mutual influence among different evaluation factors.

  18. Multiple criteria decision making for sustainable energy and transportation systems. Proceedings

    Ehrgott, Matthias [Auckland Univ. (New Zealand). Dept. of Engineering Science; Naujoks, Boris [Login GmbH, Schwelm (Germany).; Stewart, Theodor J. [Cape Town Univ., Rondebosch (South Africa). Dept. of Statistical Sciences; Wallenius, Jyrki (eds.) [Helsinki School of Economics (Finland). Dept. of Business Technology

    2010-07-01

    In the twenty-first century the sustainability of energy and transportation systems is on the top of the political agenda in many countries around the world and governments are establishing policies towards a sustainable, low emissions energy future. Environmental impacts of human economic activity necessitate the consideration of conflicting goals in decision making processes to develop sustainable systems. Any sustainable development has to reconcile conflicting economic and environmental objectives and criteria. The science of multiple criteria decision making has a lot to offer in addressing this need. Decision making with multiple (conflicting) criteria is the topic of research that is at the heart of the International Society of Multiple Criteria Decision Making. This book is based on selected papers presented at the societies 19th International Conference, held at The University of Auckland, New Zealand, from 7th to 12th January 2008 under the theme ''MCDM for Sustainable Energy and Transportation Systems''. (orig.)

  19. Antiphospholipid syndrome (APS) revisited: Would migraine headaches be included in future classification criteria?

    Noureldine, Mohammad Hassan A; Haydar, Ali A; Berjawi, Ahmad; Elnawar, Rody; Sweid, Ahmad; Khamashta, Munther A; Hughes, Graham R V; Uthman, Imad

    2017-02-01

    Headaches have been extensively reported in Antiphospholipid syndrome (APS)/Antiphospholipid antibodies (aPL)-positive patients. The aim of this study was to highlight the prevalence of headaches among APS/aPL-positive patients and discuss its association with laboratory, clinical and imaging findings. We searched the literature through Google Scholar and PubMed for publications on the epidemiology, pathogenesis, laboratory, imaging and clinical findings, and management of headaches in APS/aPL-positive patients. The following keywords were used: Antiphospholipid, Hughes syndrome, anticardiolipin, lupus anticoagulant, anti-β2 glycoprotein I, headache, migraine, tension, and cluster. All reports published between 1969 and 2015 were included. Migraine is the most commonly reported type of headache in APS/aPL-positive patients. Thrombotic and platelet dysfunction hypotheses have been studied to uncover the pathogenic role of aPL in the development of headaches. Several studies are reporting higher levels of aPL in primary and secondary APS migraineurs, but only few reached statistical significance. Migraine patients without clinical signs/symptoms of cerebral infarction rarely show positive imaging findings. Digital subtraction angiography shows promise in demonstrating small vascular lesions otherwise not detected on computed tomography, magnetic resonance imaging, or cerebral angiograms. Although it may be solitary and harmless in many cases, the deleterious effect of migraine on the quality of life of APS patients prompts rapid diagnosis and proper management. An anticoagulation trial is advisable in APS patients with migraine as many cases of severe, refractory migraine resolved with anticoagulation therapy. The profile of migraine headaches discussed in this study permits its candidacy for inclusion in future APS classification criteria.

  20. Uncertainty and Preference Modelling for Multiple Criteria Vehicle Evaluation

    Qiuping Yang

    2010-12-01

    Full Text Available A general framework for vehicle assessment is proposed based on both mass survey information and the evidential reasoning (ER approach. Several methods for uncertainty and preference modeling are developed within the framework, including the measurement of uncertainty caused by missing information, the estimation of missing information in original surveys, the use of nonlinear functions for data mapping, and the use of nonlinear functions as utility function to combine distributed assessments into a single index. The results of the investigation show that various measures can be used to represent the different preferences of decision makers towards the same feedback from respondents. Based on the ER approach, credible and informative analysis can be conducted through the complete understanding of the assessment problem in question and the full exploration of available information.

  1. Imaging and diagnostic criteria for multiple sclerosis: are we there yet?

    Josey, Lawrence; Curley, Michael; Mousavi, Foroogh Jafari; Taylor, Bruce V.; Lucas, Robyn; Coulthard, Alan

    2012-01-01

    Excluding post traumatic injury, Multiple Sclerosis (MS) is the most common disabling neurological disorder of young adults. Although the effect on mortality is limited, the association of a young demographic and significant morbidity combine to make MS a devastating disease. Since MS was given its first detailed description in 1868, diagnostic criteria continue to evolve. Recently, there has been an international commitment to combine both clinical and paraclinical tests to arrive at an earlier diagnosis. Widespread acceptance of the use of MRI in diagnosis, monitoring and research has made the role of the radiologist more critical than ever in this disease. The primary diagnostic criteria for MS are the International Panel criteria, commonly referred to as the McDonald criteria and it is essential that the radiology community is aware of the work preceding these criteria, so that they are understood in the correct context and the importance acknowledged. Literature review utilising key word search to obtain the historical and current context of magnetic resonance imaging in the diagnosis of MS. A succinct description of the evolution of criteria for the diagnosis of MS. Radiologists must recognise that there are specific diagnostic criteria for MS that continue to evolve as a result of new research, improved technology and clinical experience and it is crucial that these criteria be applied in daily practice. It should be evident that diagnostic imaging criteria for MS will be most effective when combined with standardised MRI protocols such as those published by the international Consortium of Multiple Sclerosis Centres.

  2. Including robustness in multi-criteria optimization for intensity-modulated proton therapy

    Chen, Wei; Unkelbach, Jan; Trofimov, Alexei; Madden, Thomas; Kooy, Hanne; Bortfeld, Thomas; Craft, David

    2012-02-01

    We present a method to include robustness in a multi-criteria optimization (MCO) framework for intensity-modulated proton therapy (IMPT). The approach allows one to simultaneously explore the trade-off between different objectives as well as the trade-off between robustness and nominal plan quality. In MCO, a database of plans each emphasizing different treatment planning objectives, is pre-computed to approximate the Pareto surface. An IMPT treatment plan that strikes the best balance between the different objectives can be selected by navigating on the Pareto surface. In our approach, robustness is integrated into MCO by adding robustified objectives and constraints to the MCO problem. Uncertainties (or errors) of the robust problem are modeled by pre-calculated dose-influence matrices for a nominal scenario and a number of pre-defined error scenarios (shifted patient positions, proton beam undershoot and overshoot). Objectives and constraints can be defined for the nominal scenario, thus characterizing nominal plan quality. A robustified objective represents the worst objective function value that can be realized for any of the error scenarios and thus provides a measure of plan robustness. The optimization method is based on a linear projection solver and is capable of handling large problem sizes resulting from a fine dose grid resolution, many scenarios, and a large number of proton pencil beams. A base-of-skull case is used to demonstrate the robust optimization method. It is demonstrated that the robust optimization method reduces the sensitivity of the treatment plan to setup and range errors to a degree that is not achieved by a safety margin approach. A chordoma case is analyzed in more detail to demonstrate the involved trade-offs between target underdose and brainstem sparing as well as robustness and nominal plan quality. The latter illustrates the advantage of MCO in the context of robust planning. For all cases examined, the robust optimization for

  3. Discrete Material and Thickness Optimization of laminated composite structures including failure criteria

    Lund, Erik

    2017-01-01

    This work extends the Discrete Material and Thickness Optimization approach to structural optimization problems where strength considerations in the form of failure criteria are taken into account for laminated composite structures. It takes offset in the density approaches applied for stress...... constrained topology optimization of single-material problems and develops formulations for multi-material topology optimization problems applied for laminated composite structures. The method can be applied for both stress- and strain-based failure criteria. The large number of local constraints is reduced...

  4. Clinical diagnostic criteria of multiple sclerosis: the role of magnetic resonance imaging

    Belair, M.; Girard, M.

    2004-01-01

    The objective of this article is to summarize the diagnostic criteria recommended by the International Panel on the Diagnosis of Multiple Sclerosis in 2001. The recommendations of another working group, the Consortium of Multiple Sclerosis Centers Consensus Meeting, which met in Vancouver in 2001, concerning the diagnosis and follow-up of patients with multiple sclerosis are also presented in an effort to standardize the protocols for magnetic resonance imaging of these patients. (author)

  5. Developmental trauma disorder: pros and cons of including formal criteria in the psychiatric diagnostic systems

    Schmid Marc

    2013-01-01

    Full Text Available Abstract Background This article reviews the current debate on developmental trauma disorder (DTD with respect to formalizing its diagnostic criteria. Victims of abuse, neglect, and maltreatment in childhood often develop a wide range of age-dependent psychopathologies with various mental comorbidities. The supporters of a formal DTD diagnosis argue that post-traumatic stress disorder (PTSD does not cover all consequences of severe and complex traumatization in childhood. Discussion Traumatized individuals are difficult to treat, but clinical experience has shown that they tend to benefit from specific trauma therapy. A main argument against inclusion of formal DTD criteria into existing diagnostic systems is that emphasis on the etiology of the disorder might force current diagnostic systems to deviate from their purely descriptive nature. Furthermore, comorbidities and biological aspects of the disorder may be underdiagnosed using the DTD criteria. Summary Here, we discuss arguments for and against the proposal of DTD criteria and address implications and consequences for the clinical practice.

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

    Bodziony, Przemysław; Kasztelewicz, Zbigniew; Sawicki, Piotr

    2016-06-01

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

  7. Proposed criteria to differentiate heterogeneous eosinophilic gastrointestinal disorders of the esophagus, including eosinophilic esophageal myositis

    Sato, Hiroki; Nakajima, Nao; Takahashi, Kazuya; Hasegawa, Go; Mizuno, Ken-ichi; Hashimoto, Satoru; Ikarashi, Satoshi; Hayashi, Kazunao; Honda, Yutaka; Yokoyama, Junji; Sato, Yuichi; Terai, Shuji

    2017-01-01

    AIM To define clinical criteria to differentiate eosinophilic gastrointestinal disorder (EoGD) in the esophagus. METHODS Our criteria were defined based on the analyses of the clinical presentation of eosinophilic esophagitis (EoE), subepithelial eosinophilic esophagitis (sEoE) and eosinophilic esophageal myositis (EoEM), identified by endoscopy, manometry and serum immunoglobulin E levels (s-IgE), in combination with histological and polymerase chain reaction analyses on esophageal tissue samples. RESULTS In five patients with EoE, endoscopy revealed longitudinal furrows and white plaques in all, and fixed rings in two. In one patient with sEoE and four with EoEM, endoscopy showed luminal compression only. Using manometry, failed peristalsis was observed in patients with EoE and sEoE with some variation, while EoEM was associated with hypercontractile or hypertensive peristalsis, with elevated s-IgE. Histology revealed the following eosinophils per high-power field values. EoE = 41.4 ± 7.9 in the epithelium and 2.3 ± 1.5 in the subepithelium; sEoE = 3 in the epithelium and 35 in the subepithelium (conventional biopsy); EoEM = none in the epithelium, 10.7 ± 11.7 in the subepithelium (conventional biopsy or endoscopic mucosal resection) and 46.8 ± 16.5 in the muscularis propria (peroral esophageal muscle biopsy). Presence of dilated epithelial intercellular space and downward papillae elongation were specific to EoE. Eotaxin-3, IL-5 and IL-13 were overexpressed in EoE. CONCLUSION Based on clinical and histological data, we identified criteria, which differentiated between EoE, sEoE and EoEM, and reflected a different pathogenesis between these esophageal EoGDs. PMID:28428721

  8. Proposed criteria to differentiate heterogeneous eosinophilic gastrointestinal disorders of the esophagus, including eosinophilic esophageal myositis.

    Sato, Hiroki; Nakajima, Nao; Takahashi, Kazuya; Hasegawa, Go; Mizuno, Ken-Ichi; Hashimoto, Satoru; Ikarashi, Satoshi; Hayashi, Kazunao; Honda, Yutaka; Yokoyama, Junji; Sato, Yuichi; Terai, Shuji

    2017-04-07

    To define clinical criteria to differentiate eosinophilic gastrointestinal disorder (EoGD) in the esophagus. Our criteria were defined based on the analyses of the clinical presentation of eosinophilic esophagitis (EoE), subepithelial eosinophilic esophagitis (sEoE) and eosinophilic esophageal myositis (EoEM), identified by endoscopy, manometry and serum immunoglobulin E levels (s-IgE), in combination with histological and polymerase chain reaction analyses on esophageal tissue samples. In five patients with EoE, endoscopy revealed longitudinal furrows and white plaques in all, and fixed rings in two. In one patient with sEoE and four with EoEM, endoscopy showed luminal compression only. Using manometry, failed peristalsis was observed in patients with EoE and sEoE with some variation, while EoEM was associated with hypercontractile or hypertensive peristalsis, with elevated s-IgE. Histology revealed the following eosinophils per high-power field values. EoE = 41.4 ± 7.9 in the epithelium and 2.3 ± 1.5 in the subepithelium; sEoE = 3 in the epithelium and 35 in the subepithelium (conventional biopsy); EoEM = none in the epithelium, 10.7 ± 11.7 in the subepithelium (conventional biopsy or endoscopic mucosal resection) and 46.8 ± 16.5 in the muscularis propria (peroral esophageal muscle biopsy). Presence of dilated epithelial intercellular space and downward papillae elongation were specific to EoE. Eotaxin-3, IL-5 and IL-13 were overexpressed in EoE. Based on clinical and histological data, we identified criteria, which differentiated between EoE, sEoE and EoEM, and reflected a different pathogenesis between these esophageal EoGDs.

  9. A Posteriori Error Estimates Including Algebraic Error and Stopping Criteria for Iterative Solvers

    Jiránek, P.; Strakoš, Zdeněk; Vohralík, M.

    2010-01-01

    Roč. 32, č. 3 (2010), s. 1567-1590 ISSN 1064-8275 R&D Projects: GA AV ČR IAA100300802 Grant - others:GA ČR(CZ) GP201/09/P464 Institutional research plan: CEZ:AV0Z10300504 Keywords : second-order elliptic partial differential equation * finite volume method * a posteriori error estimates * iterative methods for linear algebraic systems * conjugate gradient method * stopping criteria Subject RIV: BA - General Mathematics Impact factor: 3.016, year: 2010

  10. Robust Inventory System Optimization Based on Simulation and Multiple Criteria Decision Making

    Ahmad Mortazavi

    2014-01-01

    Full Text Available Inventory management in retailers is difficult and complex decision making process which is related to the conflict criteria, also existence of cyclic changes and trend in demand is inevitable in many industries. In this paper, simulation modeling is considered as efficient tool for modeling of retailer multiproduct inventory system. For simulation model optimization, a novel multicriteria and robust surrogate model is designed based on multiple attribute decision making (MADM method, design of experiments (DOE, and principal component analysis (PCA. This approach as a main contribution of this paper, provides a framework for robust multiple criteria decision making under uncertainty.

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

    Dolan, James G

    2010-01-01

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

  12. Novel multiple criteria decision making methods based on bipolar neutrosophic sets and bipolar neutrosophic graphs

    Muhammad, Akram; Musavarah, Sarwar

    2016-01-01

    In this research study, we introduce the concept of bipolar neutrosophic graphs. We present the dominating and independent sets of bipolar neutrosophic graphs. We describe novel multiple criteria decision making methods based on bipolar neutrosophic sets and bipolar neutrosophic graphs. We also develop an algorithm for computing domination in bipolar neutrosophic graphs.

  13. A predictive validity study of the Learning Style Questionnaire (LSQ) using multiple, specific learning criteria

    Kappe, F.R.; Boekholt, L.; den Rooyen, C.; van der Flier, H.

    2009-01-01

    Multiple and specific learning criteria were used to examine the predictive validity of the Learning Style Questionnaire (LSQ). Ninety-nine students in a college of higher learning in The Netherlands participated in a naturally occurring field study. The students were categorized into one of four

  14. A Particle Swarm Optimization Approach to Composing Serial Test Sheets for Multiple Assessment Criteria

    Yin, Peng-Yeng; Chang, Kuang-Cheng; Hwang, Gwo-Jen; Hwang, Gwo-Haur; Chan, Ying

    2006-01-01

    To accurately analyze the problems of students in learning, the composed test sheets must meet multiple assessment criteria, such as the ratio of relevant concepts to be evaluated, the average discrimination degree, difficulty degree and estimated testing time. Furthermore, to precisely evaluate the improvement of student's learning performance…

  15. Application of Multiple Criteria Decision Making to Renovation of Multi-Residential Historic Buildings

    Galiotto, Nicolas; Flourentzou, Flourentzos; Thalmann, Philippe

    2013-01-01

    project, which fulfills simultaneously and optimally all three pillars of sustainability. Multiple criteria decision making methodologies can help to improve the decision environment and handle the whole space of constraints. It therefore leads the stakeholders to find consensual solutions. In this paper...

  16. 45 CFR 1308.11 - Eligibility criteria: Hearing impairment including deafness.

    2010-10-01

    ... OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR... impairment including deafness. (a) A child is classified as deaf if a hearing impairment exists which is so... hearing loss can include impaired listening skills, delayed language development, and articulation...

  17. 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)

    Nanni, Cristina; Rambaldi, Ilaria; Fanti, Stefano; Zamagni, Elena; Cavo, Michele; Versari, Annibale; Chauvie, Stephane; Bianchi, Andrea; Rensi, Marco; Bello, Marilena; Gallamini, Andrea; Patriarca, Francesca; Gay, Francesca; Gamberi, Barbara

    2016-01-01

    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

  18. 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)

    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

  19. Methodology for Selecting Best Management Practices Integrating Multiple Stakeholders and Criteria. Part 1: Methodology

    Mauricio Carvallo Aceves

    2016-02-01

    Full Text Available The implementation of stormwater Best Management Practices (BMPs could help re-establish the natural hydrological cycle of watersheds after urbanization, with each BMP presenting a different performance across a range of criteria (flood prevention, pollutant removal, etc.. Additionally, conflicting views from the relevant stakeholders may arise, resulting in a complex selection process. This paper proposes a methodology for BMP selection based on the application of multi-criteria decision aid (MCDA methods, integrating multiple stakeholder priorities and BMP combinations. First, in the problem definition, the MCDA methods, relevant criteria and design guidelines are selected. Next, information from the preliminary analysis of the watershed is used to obtain a list of relevant BMPs. The third step comprises the watershed modeling and analysis of the BMP alternatives to obtain performance values across purely objective criteria. Afterwards, a stakeholder analysis based on survey applications is carried out to obtain social performance values and criteria priorities. Then, the MCDA methods are applied to obtain the final BMP rankings. The last step considers the sensitivity analysis and rank comparisons in order to draw the final conclusions and recommendations. Future improvements to the methodology could explore inclusion of multiple objective analysis, and alternative means for obtaining social performance values.

  20. Model for CO2 leakage including multiple geological layers and multiple leaky wells.

    Nordbotten, Jan M; Kavetski, Dmitri; Celia, Michael A; Bachu, Stefan

    2009-02-01

    Geological storage of carbon dioxide (CO2) is likely to be an integral component of any realistic plan to reduce anthropogenic greenhouse gas emissions. In conjunction with large-scale deployment of carbon storage as a technology, there is an urgent need for tools which provide reliable and quick assessments of aquifer storage performance. Previously, abandoned wells from over a century of oil and gas exploration and production have been identified as critical potential leakage paths. The practical importance of abandoned wells is emphasized by the correlation of heavy CO2 emitters (typically associated with industrialized areas) to oil and gas producing regions in North America. Herein, we describe a novel framework for predicting the leakage from large numbers of abandoned wells, forming leakage paths connecting multiple subsurface permeable formations. The framework is designed to exploit analytical solutions to various components of the problem and, ultimately, leads to a grid-free approximation to CO2 and brine leakage rates, as well as fluid distributions. We apply our model in a comparison to an established numerical solverforthe underlying governing equations. Thereafter, we demonstrate the capabilities of the model on typical field data taken from the vicinity of Edmonton, Alberta. This data set consists of over 500 wells and 7 permeable formations. Results show the flexibility and utility of the solution methods, and highlight the role that analytical and semianalytical solutions can play in this important problem.

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

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

    2018-05-01

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

  2. 42 CFR 137.327 - May multiple projects be included in a single construction project agreement?

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false May multiple projects be included in a single construction project agreement? 137.327 Section 137.327 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF...-GOVERNANCE Construction Project Assumption Process § 137.327 May multiple projects be included in a single...

  3. Food allergy: a clinician's criteria for including sera in a serum bank.

    Ballmer-Weber, B K; Fernández-Rivas, M

    2008-10-01

    Safety assessment for genetically-engineered crop plants includes assessment for allergic responses. To facilitate this assessment, serum banks should contain well-characterised sera from patients with confirmed food allergies. A serum is defined as well-characterised if it is taken from a patient who has a convincing history of allergic responses to a known allergen or an allergen-containing food, a positive skin prick test (or elevated IgE response), and a positive response in a clinical food challenge.

  4. Should DSM-V include dimensional diagnostic criteria for alcohol use disorders?

    Helzer, John E; Bucholz, Kathleen K; Bierut, Laura Jean; Regier, Darrel A; Schuckit, Marc A; Guth, Sarah E

    2006-02-01

    This program calls attention to the upcoming timetable for the revision of the Diagnostic and Statistical Manual (DSM)-IV and the publication of DSM-V. It is vitally important for Research Society of Alcoholism members to be aware of the current discussions of the important scientific questions related to the next DSM revision and to use the opportunity for input. The title of the symposium highlights 1 key question, i.e., whether the DSM definitions should remain strictly categorical as in the past or whether a dimensional component should be included in this revision. Two substantive and 1 conceptual paper are included in this portion of the symposium. The fourth and final presentation detailing the revision timetable and the opportunities for input is by Dr. Darrel Regier. Dr. Regier is the director of American Psychiatric Institute for Research and Education the research and education branch of the American Psychiatric Association and the organization within the APA that will oversee the DSM revision. The discussion is by Marc Schuckit, who was chair of the Substance Use disorders (SUD) Committee for DSM-IV and cochair of the international group of experts reviewing the SUD definitions for DSM-V.

  5. The prevalence of polycystic ovary syndrome in a normal population according to the Rotterdam criteria versus revised criteria including anti-Mullerian hormone.

    Lauritsen, M P; Bentzen, J G; Pinborg, A; Loft, A; Forman, J L; Thuesen, L L; Cohen, A; Hougaard, D M; Nyboe Andersen, A

    2014-04-01

    What is the prevalence in a normal population of polycystic ovary syndrome (PCOS) according to the Rotterdam criteria versus revised criteria including anti-Müllerian hormone (AMH)? The prevalence of PCOS was 16.6% according to the Rotterdam criteria. When replacing the criterion for polycystic ovaries by antral follicle count (AFC) > 19 or AMH > 35 pmol/l, the prevalence of PCOS was 6.3 and 8.5%, respectively. WHAT IS KNOWN ALREADY?: The Rotterdam criteria state that two out of the following three criteria should be present in the diagnosis of PCOS: oligo-anovulation, clinical and/or biochemical hyperandrogenism and polycystic ovaries (AFC ≥ 12 and/or ovarian volume >10 ml). However, with the advances in sonography, the relevance of the AFC threshold in the definition of polycystic ovaries has been challenged, and AMH has been proposed as a marker of polycystic ovaries in PCOS. From 2008 to 2010, a prospective, cross-sectional study was performed including 863 women aged 20-40 years and employed at Copenhagen University Hospital, Rigshospitalet, Denmark. We studied a subgroup of 447 women with a mean (±SD) age of 33.5 (±4.0) years who were all non-users of hormonal contraception. Data on menstrual cycle disorder and the presence of hirsutism were obtained. On cycle Days 2-5, or on a random day in the case of oligo- or amenorrhoea, sonographic and endocrine parameters were measured. The prevalence of PCOS was 16.6% according to the Rotterdam criteria. PCOS prevalence significantly decreased with age from 33.3% in women polycystic ovaries with a significant age-related decrease from 69.0% in women polycystic ovaries in women with PCOS according to the Rotterdam criteria [area under the curve (AUC) 0.994; 95% confidence interval (CI): 0.990-0.999] and AUC 0.992 (95% CI: 0.987-0.998), respectively], and an AMH cut-off value of 18 pmol/l and AMH Z-score of -0.2 showed the best compromise between sensitivity (91.8 and 90.4%, respectively) and specificity (98.1 and

  6. The revision of RP 91 on criteria for acceptability of radiological (including radiotherapy) and nuclear medicine installations

    Faulkner, K.; Malone, J. F.; Christofides, S.; Lillicrap, S.; Horton, P.

    2013-01-01

    In 1997 the European Commission published Radiation Protection 91: 'Criteria for acceptability of radiological (including radiotherapy) and nuclear medicine installations'(1). This document specified the minimum criteria for acceptability. It has been used to this effect in legislation, codes of practice and by individual professionals. In a single document, it defined a level of performance at which remedial action was required. The document specified a series of parameters which characterised equipment performance and acceptable levels of performance. In its time it proved to be a useful document which was applied in member states to various degrees. Since the publication of Report 91 in 1997(1), a series of weaknesses emerged over time. Development of new radiological systems and technologies, as well as improvements in traditional technologies, has created circumstances where the acceptability criteria were in need of review. These weaknesses were recognised by the European Commission and a tender for its revision was issued. The criteria were developed by a team drawn from a broad range of backgrounds including hospitals, industry, government bodies, regulators and standardisation organisations. Representatives were mainly from Europe, but individuals from the American Association of Physicists in Medicine and International Atomic Energy Agency were included in the drafting process. This study describes the process employed in developing the revised document and the consultation process involved. One of the major difficulties the revision team encountered was related to an understanding of the actual meaning of the EC Directive(2). The view taken by the revision team was that Article 8, paragraph 3 places responsibilities on both the holders of radiological equipment and competent authorities. The acceptability criteria have been produced consistent with the European Commission's Medical Exposures Directive(2), which requires that patient exposures are

  7. Dual worth trade-off method and its application for solving multiple criteria decision making problems

    Feng Junwen

    2006-01-01

    To overcome the limitations of the traditional surrogate worth trade-off (SWT) method and solve the multiple criteria decision making problem more efficiently and interactively, a new method labeled dual worth trade-off (DWT) method is proposed. The DWT method dynamically uses the duality theory related to the multiple criteria decision making problem and analytic hierarchy process technique to obtain the decision maker's solution preference information and finally find the satisfactory compromise solution of the decision maker. Through the interactive process between the analyst and the decision maker, trade-off information is solicited and treated properly, the representative subset of efficient solutions and the satisfactory solution to the problem are found. The implementation procedure for the DWT method is presented. The effectiveness and applicability of the DWT method are shown by a practical case study in the field of production scheduling.

  8. A Hybrid Multiple-Criteria Decision-Making Approach for Photovoltaic Solar Plant Location Selection

    Amy H. I. Lee

    2017-01-01

    Full Text Available Due to decaying fossil resource and increasing environmental consciousness, the demand of renewable energy resources is escalating these days. Photovoltaic solar energy is one of the most popular renewable energy resources in places where sunlight is abundant. The selection of a desirable location for constructing a photovoltaic solar plant is the first and one of the most important stages in the plant construction to provide a long-term energy production. In this paper, a comprehensive multiple-criteria decision-making model, which incorporates the interpretive structural modeling (ISM, fuzzy analytic network process (FANP and VIKOR (VlseKriterijumska OptimizacijaI Kompromisno Resenje in Serbian,meaning multi-criteria optimization and compromise solution, is proposed to select the most suitable photovoltaic solar plant location. The ISM is applied first to determine the interrelationships among the criteria and among the sub-criteria,andtheresults are used to construct a decision-making network. The FANP is applied next to solve the network and to calculate the importance weights of the sub-criteria. Finally, the VIKOR is adopted to determine the ranking of the photovoltaic solar plant locations. The proposed model is applied in a case study in evaluating photovoltaic solar plant locations in Taiwan. By applying the proposed model, decision makers can have a better thinking process and make more appropriate decisions justifiably.

  9. A proposed modification to the McDonald 2010 criteria for the diagnosis of primary progressive multiple sclerosis.

    Kelly, S B

    2013-07-01

    The diagnostic criteria for primary-progressive multiple sclerosis (PPMS) have undergone revision over the last 20 years. Cerebrospinal fluid oligoclonal bands (CSFOBs) have received less emphasis in recent revisions of the McDonald criteria. The aim of this study was to examine the sensitivity of the diagnostic criteria for PPMS with particular reference to spinal cord criteria and examine the utility of CSFOBs in a cohort of PPMS patients.

  10. Plasma Cell Neoplasms (Including Multiple Myeloma)—Health Professional Version

    There are several types of plasma cell neoplasms, including monoclonal gammopathy of undetermined significance (MGUS), isolated plasmacytoma of the bone, extramedullary plasmacytoma, and multiple myeloma. Find evidence-based information on plasma cell neoplasms treatment, research, and statistics.

  11. Application of the McDonald MRI criteria in multiple sclerosis.

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

    2007-08-01

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

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

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

    2007-01-01

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

  13. The Usage and Perception of Pedestrian Zones in Lithuanian Cities: Multiple Criteria and Comparative Analysis

    Rūta Dičiūnaitė-Rauktienė

    2018-03-01

    Full Text Available As pedestrian zones are public spaces in urban areas, they are important in terms of meeting people’s needs. However, it is worth noting that attention should be paid not only to the development of the physical infrastructure, but also to a sustainable balance between the socio-economic and environmental aspects. To guide urban planning and management initiatives towards more sustainable patterns, it is essential to re-examine the already existing characteristics of cities, establishing how they are used and perceived by inhabitants. The present research suggests environmental, economic and social criteria that determine a greater vitality of pedestrian zones in cities and better life quality for the inhabitants. A questionnaire survey was used to assess common attitudes regarding the research topic in major cities in Lithuania. The multiple criteria decision-making COPRAS (COmplex PRoportional ASsessment method was used for the formation of a priority queue. The research results showed the attitudes of inhabitants towards pedestrian zones in Vilnius, Kaunas and Klaipėda. The inhabitants of these three cities regarded social and environmental criteria groups as the most significant. Contrary to what was expected and anticipated, respondents do not consider economic criteria as playing a key role in the sustainable preservation and development of pedestrian zones.

  14. Methodology for Selecting Best Management Practices Integrating Multiple Stakeholders and Criteria. Part 2: Case Study

    Mauricio Carvallo Aceves

    2016-02-01

    Full Text Available The selection of stormwater Best Management Practices (BMPs for mitigating the effects of urbanization on the hydrological cycle could be a complex process due to conflicting stakeholder views, and varying levels of performance of BMPs across a range of criteria (runoff reduction, erosion control, etc.. Part 1 of this article proposed a methodology based on the application of multi-criteria decision aid (MCDA methods, which was tested here on a residential stormwater network in the Montreal area. The case study considered green roofs, rain gardens, rain barrels and pervious pavement over a range of economic, social, and water quality and quantity criteria by applying 4 MCDA methods under three different stakeholder views. The results indicated Elimination et Choix Traduisant la Réalité (ELECTRE III to be the most appropriate method for the methodology, presenting flexibility concerning threshold values, criteria weights, and showing shared top choices across stakeholders (rain gardens, and rain gardens in combination with pervious pavement. The methodology shows potential for more formal applications and research opportunities. Future work may lie in the inclusion of multiple objective optimization, better stakeholder engagement, estimation of economic benefits, water quality modeling, long-term hydrological simulations, and estimating real BMP pollutant removal rates.

  15. Diagnostic Criteria, Classification and Treatment Goals in Multiple Sclerosis: The Chronicles of Time and Space.

    Ntranos, Achilles; Lublin, Fred

    2016-10-01

    Multiple sclerosis (MS) is one of the most diverse human diseases. Since its first description by Charcot in the nineteenth century, the diagnostic criteria, clinical course classification, and treatment goals for MS have been constantly revised and updated to improve diagnostic accuracy, physician communication, and clinical trial design. These changes have improved the clinical outcomes and quality of life for patients with the disease. Recent technological and research breakthroughs will almost certainly further change how we diagnose, classify, and treat MS in the future. In this review, we summarize the key events in the history of MS, explain the reasoning behind the current criteria for MS diagnosis, classification, and treatment, and provide suggestions for further improvements that will keep enhancing the clinical practice of MS.

  16. Designing a solar powered Stirling heat engine based on multiple criteria: Maximized thermal efficiency and power

    Ahmadi, Mohammad Hossein; Sayyaadi, Hoseyn; Dehghani, Saeed; Hosseinzade, Hadi

    2013-01-01

    Highlights: • Thermodynamic model of a solar-dish Stirling engine was presented. • Thermal efficiency and output power of the engine were simultaneously maximized. • A final optimal solution was selected using several decision-making methods. • An optimal solution with least deviation from the ideal design was obtained. • Optimal solutions showed high sensitivity against variation of system parameters. - Abstract: A solar-powered high temperature differential Stirling engine was considered for optimization using multiple criteria. A thermal model was developed so that the output power and thermal efficiency of the solar Stirling system with finite rate of heat transfer, regenerative heat loss, conductive thermal bridging loss, finite regeneration process time and imperfect performance of the dish collector could be obtained. The output power and overall thermal efficiency were considered for simultaneous maximization. Multi-objective evolutionary algorithms (MOEAs) based on the NSGA-II algorithm were employed while the solar absorber temperature and the highest and lowest temperatures of the working fluid were considered the decision variables. The Pareto optimal frontier was obtained and a final optimal solution was also selected using various decision-making methods including the fuzzy Bellman–Zadeh, LINMAP and TOPSIS. It was found that multi-objective optimization could yield results with a relatively low deviation from the ideal solution in comparison to the conventional single objective approach. Furthermore, it was shown that, if the weight of thermal efficiency as one of the objective functions is considered to be greater than weight of the power objective, lower absorber temperature and low temperature ratio should be considered in the design of the Stirling engine

  17. Identification of potential biomarkers from microarray experiments using multiple criteria optimization

    Sánchez-Peña, Matilde L; Isaza, Clara E; Pérez-Morales, Jaileene; Rodríguez-Padilla, Cristina; Castro, José M; Cabrera-Ríos, Mauricio

    2013-01-01

    Microarray experiments are capable of determining the relative expression of tens of thousands of genes simultaneously, thus resulting in very large databases. The analysis of these databases and the extraction of biologically relevant knowledge from them are challenging tasks. The identification of potential cancer biomarker genes is one of the most important aims for microarray analysis and, as such, has been widely targeted in the literature. However, identifying a set of these genes consistently across different experiments, researches, microarray platforms, or cancer types is still an elusive endeavor. Besides the inherent difficulty of the large and nonconstant variability in these experiments and the incommensurability between different microarray technologies, there is the issue of the users having to adjust a series of parameters that significantly affect the outcome of the analyses and that do not have a biological or medical meaning. In this study, the identification of potential cancer biomarkers from microarray data is casted as a multiple criteria optimization (MCO) problem. The efficient solutions to this problem, found here through data envelopment analysis (DEA), are associated to genes that are proposed as potential cancer biomarkers. The method does not require any parameter adjustment by the user, and thus fosters repeatability. The approach also allows the analysis of different microarray experiments, microarray platforms, and cancer types simultaneously. The results include the analysis of three publicly available microarray databases related to cervix cancer. This study points to the feasibility of modeling the selection of potential cancer biomarkers from microarray data as an MCO problem and solve it using DEA. Using MCO entails a new optic to the identification of potential cancer biomarkers as it does not require the definition of a threshold value to establish significance for a particular gene and the selection of a normalization

  18. A Multiple Criteria Decision Making Method Based on Relative Value Distances

    Shyur Huan-jyh

    2015-12-01

    Full Text Available This paper proposes a new multiple criteria decision-making method called ERVD (election based on relative value distances. The s-shape value function is adopted to replace the expected utility function to describe the risk-averse and risk-seeking behavior of decision makers. Comparisons and experiments contrasting with the TOPSIS (Technique for Order Preference by Similarity to the Ideal Solution method are carried out to verify the feasibility of using the proposed method to represent the decision makers’ preference in the decision making process. Our experimental results show that the proposed approach is an appropriate and effective MCDM method.

  19. Scenario-informed multiple criteria analysis for prioritizing investments in electricity capacity expansion

    Martinez, Lauro J.; Lambert, James H.; Karvetski, Christopher W.

    2011-01-01

    Planning the expansion and energy security of electricity capacity for a national electricity utility is a complex task in almost any economy. Planning is usually an iterative activity and can involve the use of large scale planning optimization systems accompanied by assessment of uncertain scenarios emerging from economic, technological, environmental, and regulatory developments. This paper applies a multiple criteria decision analysis to prioritize investment portfolios in capacity expansion and energy security while principally studying the robustness of the prioritization to multiple uncertain and emergent scenarios. The scenarios are identified through interaction with decision makers and stakeholders. The approach finds which scenarios most affect the prioritization of the portfolios and which portfolios have the greatest upside and downside potential across scenarios. The approach fosters innovation in the use of robust and efficient technologies, renewable energy sources, and cleaner energy fuels. A demonstration is provided for assessing the performance of technology portfolios constructed from investments in nine electricity generation technologies in Mexico.

  20. Interobserver agreement on Poser's and the new McDonald's diagnostic criteria for multiple sclerosis.

    Zipoli, V; Portaccio, E; Siracusa, G; Pracucci, G; Sorbi, S; Amato, M P

    2003-10-01

    We assessed the interobserver agreement on the diagnosis of multiple sclerosis (MS) in a study sample consisting of 41 MS (15 relapsing remitting, two secondary progressive, five primary progressive and 19 presenting their first clinical attack) and three non-MS cases. Clinical and paraclinical information was recorded in standardized forms. Four neurologists were asked to make a diagnosis using Poser's and McDonald's criteria and to assess MRI scans according to the McDonald's guidelines. In terms of the kappa statistic (kappa), we found a moderate agreement on the overall diagnosis using both Poser's and McDonald's criteria (kappa, respectively 0.57 and 0.52). As for distinct diagnostic categories, we observed a moderate to substantial agreement for the three McDonald categories (range of kappa values 0.49-0.64) and a fair to substantial agreement for the nine Poser categories (range of kappa values 0.37-0.67). Taking into account clinical information, the agreement on dissemination over time was substantially higher (kappa = 0.69) than that found on dissemination over space (kappa = 0.46). In contrast, for MRI assessment, the agreement for spatial dissemination was substantial (kappa = 0.74) compared with the fair agreement (kappa = 0.25) yielded by dissemination over time. The new McDonald's criteria yield a good overall diagnostic reliability, and compare favourably with Poser's classification in terms of agreement on distinct diagnostic categories.

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

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

    2016-03-01

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

  2. Prediction of protein interaction hot spots using rough set-based multiple criteria linear programming.

    Chen, Ruoying; Zhang, Zhiwang; Wu, Di; Zhang, Peng; Zhang, Xinyang; Wang, Yong; Shi, Yong

    2011-01-21

    Protein-protein interactions are fundamentally important in many biological processes and it is in pressing need to understand the principles of protein-protein interactions. Mutagenesis studies have found that only a small fraction of surface residues, known as hot spots, are responsible for the physical binding in protein complexes. However, revealing hot spots by mutagenesis experiments are usually time consuming and expensive. In order to complement the experimental efforts, we propose a new computational approach in this paper to predict hot spots. Our method, Rough Set-based Multiple Criteria Linear Programming (RS-MCLP), integrates rough sets theory and multiple criteria linear programming to choose dominant features and computationally predict hot spots. Our approach is benchmarked by a dataset of 904 alanine-mutated residues and the results show that our RS-MCLP method performs better than other methods, e.g., MCLP, Decision Tree, Bayes Net, and the existing HotSprint database. In addition, we reveal several biological insights based on our analysis. We find that four features (the change of accessible surface area, percentage of the change of accessible surface area, size of a residue, and atomic contacts) are critical in predicting hot spots. Furthermore, we find that three residues (Tyr, Trp, and Phe) are abundant in hot spots through analyzing the distribution of amino acids. Copyright © 2010 Elsevier Ltd. All rights reserved.

  3. Multiple-Criteria Decision-Making in the Design of Innovative Lock Walls for Barge Impact; Phase 1

    Lambert, James

    2001-01-01

    .... This research project consists of two phases: Phase 1, which culminates with this report, investigated the use of multiple-criteria decision-making in the design process of lock approach walls to consider barge impact and earthquake loads...

  4. Life cycle based dynamic assessment coupled with multiple criteria decision analysis

    Sohn, Joshua; Kalbar, Pradip; Birkved, Morten

    2017-01-01

    the service life of the building. This case study uses both the established and the coupled MCDA assessment methods to quantify and assess the balance of impacts between the production of mineral wool insulation versus the production of space heat. The use of TOPSIS method for calculating single scores......This work looks at coupling Life cycle assessment (LCA) with a dynamic inventory and multiple criteria decision analysis (MCDA) to improve the validity and reliability of single score results for complex systems. This is done using the case study of a representative Danish single family home over...... not matter which impact assessment is applied. However, for the scenarios where other impact categories vary inversely or independently from the climate change impact indicator, such as with renewable energy production, there is need for a more unconventional method, such as the TOPSIS method...

  5. Modeling Carbon Turnover in Five Terrestrial Ecosystems in the Boreal Zone Using Multiple Criteria of Acceptance

    Karlberg, Louise; Gustafsson, David; Jansson, Per-Erik

    2006-01-01

    Estimates of carbon fluxes and turnover in ecosystems are key elements in the understanding of climate change and in predicting the accumulation of trace elements in the biosphere. In this paper we present estimates of carbon fluxes and turnover times for five terrestrial ecosystems using a modeling approach. Multiple criteria of acceptance were used to parameterize the model, thus incorporating large amounts of multi-faceted empirical data in the simulations in a standardized manner. Mean turnover times of carbon were found to be rather similar between systems with a few exceptions, even though the size of both the pools and the fluxes varied substantially. Depending on the route of the carbon through the ecosystem, turnover times varied from less than one year to more than one hundred, which may be of importance when considering trace element transport and retention. The parameterization method was useful both in the estimation of unknown parameters, and to identify variability in carbon turnover in the selected ecosystems

  6. Local Action Groups and Rural Sustainable Development. A spatial multiple criteria approach for efficient territorial planning

    Palmisano, Giovanni Ottomano; Govindan, M.E., PhD.,, Kannan; Boggia, Antonio

    2016-01-01

    Local Action Groups in order to promote the objectives of Rural Sustainable Development within rural municipalities. Each Local Action Group applies the Strengths, Weaknesses, Opportunities and Threats analysis in order to identify for its own rural municipalities the strategic elements to which...... and a Weakness factors and decision alternatives, as well as impossibility of ranking the decision alternatives. Thus, this research aims to overcome the drawbacks of the Strengths, Weaknesses, Opportunities and Threats analysis and to support Local Action Group partnerships in the sustainability evaluation...... of their rural municipalities, and therefore to aid the identification of a common Rural Sustainable Development strategy to allocate the European Agricultural Fund for Rural Development budget. This decision problem was tackled by applying a Multiple Criteria Spatial Decision Support System that integrates...

  7. Exact multiple scattering theory of two-nucleus collisions including the Pauli principle

    Gurvitz, S.A.

    1981-01-01

    Exact equations for two-nucleus scattering are derived in which the effects of the Pauli principle are fully included. Our method exploits a modified equation for the scattering of two identical nucleons, which is obtained at the beginning. Considering proton-nucleus scattering we found that the resulting amplitude has two components, one resembling a multiple scattering series for distinguishable particles, and the other a distorted (A-1) nucleon cluster exchange. For elastic pA scattering the multiple scattering amplitude is found in the form of an optical potential expansion. We show that the Kerman-McManus-Thaler theory of the optical potential could be easily modified to include the effects of antisymmetrization of the projectile with the target nucleons. Nucleus-nucleus scattering is studied first for distinguishable target and beam nucleus. Afterwards the Pauli principle is included, where only the case of deuteron-nucleus scattering is discussed in detail. The resulting amplitude has four components. Two of them correspond to modified multiple scattering expansions and the others are distorted (A-1)- and (A-2)- nucleon cluster exchange. The result for d-A scattering is extended to the general case of nucleus-nucleus scattering. The equations are simple to use and as such constitute an improvement over existing schemes

  8. Scenario and multiple criteria decision analysis for energy and environmental security of military and industrial installations.

    Karvetski, Christopher W; Lambert, James H; Linkov, Igor

    2011-04-01

    Military and industrial facilities need secure and reliable power generation. Grid outages can result in cascading infrastructure failures as well as security breaches and should be avoided. Adding redundancy and increasing reliability can require additional environmental, financial, logistical, and other considerations and resources. Uncertain scenarios consisting of emergent environmental conditions, regulatory changes, growth of regional energy demands, and other concerns result in further complications. Decisions on selecting energy alternatives are made on an ad hoc basis. The present work integrates scenario analysis and multiple criteria decision analysis (MCDA) to identify combinations of impactful emergent conditions and to perform a preliminary benefits analysis of energy and environmental security investments for industrial and military installations. Application of a traditional MCDA approach would require significant stakeholder elicitations under multiple uncertain scenarios. The approach proposed in this study develops and iteratively adjusts a scoring function for investment alternatives to find the scenarios with the most significant impacts on installation security. A robust prioritization of investment alternatives can be achieved by integrating stakeholder preferences and focusing modeling and decision-analytical tools on a few key emergent conditions and scenarios. The approach is described and demonstrated for a campus of several dozen interconnected industrial buildings within a major installation. Copyright © 2010 SETAC.

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

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

    2018-05-31

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

  10. Induced Systemic Tolerance to Multiple Stresses Including Biotic and Abiotic Factors by Rhizobacteria

    Sung-Je Yoo

    2017-06-01

    Full Text Available Recently, global warming and drastic climate change are the greatest threat to the world. The climate change can affect plant productivity by reducing plant adaptation to diverse environments including frequent high temperature; worsen drought condition and increased pathogen transmission and infection. Plants have to survive in this condition with a variety of biotic (pathogen/pest attack and abiotic stress (salt, high/low temperature, drought. Plants can interact with beneficial microbes including plant growth-promoting rhizobacteria, which help plant mitigate biotic and abiotic stress. This overview presents that rhizobacteria plays an important role in induced systemic resistance (ISR to biotic stress or induced systemic tolerance (IST to abiotic stress condition; bacterial determinants related to ISR and/or IST. In addition, we describe effects of rhizobacteria on defense/tolerance related signal pathway in plants. We also review recent information including plant resistance or tolerance against multiple stresses (bioticabiotic. We desire that this review contribute to expand understanding and knowledge on the microbial application in a constantly varying agroecosystem, and suggest beneficial microbes as one of alternative environment-friendly application to alleviate multiple stresses.

  11. The prevalence of polycystic ovary syndrome in a normal population according to the Rotterdam criteria versus revised criteria including anti-Müllerian hormone

    Lauritsen, M P; Bentzen, J G; Pinborg, A

    2014-01-01

    -anovulation, clinical and/or biochemical hyperandrogenism and polycystic ovaries (AFC ≥ 12 and/or ovarian volume >10 ml). However, with the advances in sonography, the relevance of the AFC threshold in the definition of polycystic ovaries has been challenged, and AMH has been proposed as a marker of polycystic ovaries...... ovaries with a significant age-related decrease from 69.0% in women reliable marker of polycystic ovaries in women with PCOS according to the Rotterdam criteria [area....... However, future studies are needed to validate AMH threshold levels, and AMH Z-score may be appropriate to adjust for the age-related decline in the AFC. STUDY FUNDING/COMPETING INTEREST(S): None. TRIAL REGISTRATION NUMBER: Not applicable....

  12. An intelligent, knowledge-based multiple criteria decision making advisor for systems design

    Li, Yongchang

    In systems engineering, design and operation of systems are two main problems which always attract researcher's attentions. The accomplishment of activities in these problems often requires proper decisions to be made so that the desired goal can be achieved, thus, decision making needs to be carefully fulfilled in the design and operation of systems. Design is a decision making process which permeates through out the design process, and is at the core of all design activities. In modern aircraft design, more and more attention is paid to the conceptual and preliminary design phases so as to increase the odds of choosing a design that will ultimately be successful at the completion of the design process, therefore, decisions made during these early design stages play a critical role in determining the success of a design. Since aerospace systems are complex systems with interacting disciplines and technologies, the Decision Makers (DMs) dealing with such design problems are involved in balancing the multiple, potentially conflicting attributes/criteria, transforming a large amount of customer supplied guidelines into a solidly defined set of requirement definitions. Thus, one could state with confidence that modern aerospace system design is a Multiple Criteria Decision Making (MCDM) process. A variety of existing decision making methods are available to deal with this type of decision problems. The selection of the most appropriate decision making method is of particular importance since inappropriate decision methods are likely causes of misleading engineering design decisions. With no sufficient knowledge about each of the methods, it is usually difficult for the DMs to find an appropriate analytical model capable of solving their problems. In addition, with the complexity of the decision problem and the demand for more capable methods increasing, new decision making methods are emerging with time. These various methods exacerbate the difficulty of the selection

  13. A heuristic approach using multiple criteria for environmentally benign 3PLs selection

    Kongar, Elif

    2005-11-01

    Maintaining competitiveness in an environment where price and quality differences between competing products are disappearing depends on the company's ability to reduce costs and supply time. Timely responses to rapidly changing market conditions require an efficient Supply Chain Management (SCM). Outsourcing logistics to third-party logistics service providers (3PLs) is one commonly used way of increasing the efficiency of logistics operations, while creating a more "core competency focused" business environment. However, this alone may not be sufficient. Due to recent environmental regulations and growing public awareness regarding environmental issues, 3PLs need to be not only efficient but also environmentally benign to maintain companies' competitiveness. Even though an efficient and environmentally benign combination of 3PLs can theoretically be obtained using exhaustive search algorithms, heuristics approaches to the selection process may be superior in terms of the computational complexity. In this paper, a hybrid approach that combines a multiple criteria Genetic Algorithm (GA) with Linear Physical Weighting Algorithm (LPPW) to be used in efficient and environmentally benign 3PLs is proposed. A numerical example is also provided to illustrate the method and the analyses.

  14. Pythagorean Fuzzy Muirhead Mean Operators and Their Application in Multiple-Criteria Group Decision-Making

    Jianghong Zhu

    2018-06-01

    Full Text Available As a generalization of the intuitionistic fuzzy set (IFS, a Pythagorean fuzzy set has more flexibility than IFS in expressing uncertainty and fuzziness in the process of multiple criteria group decision-making (MCGDM. Meanwhile, the prominent advantage of the Muirhead mean (MM operator is that it can reflect the relationships among the various input arguments through changing a parameter vector. Motivated by these primary characters, in this study, we introduced the MM operator into the Pythagorean fuzzy context to expand its applied fields. To do so, we presented the Pythagorean fuzzy MM (PFMM operators and Pythagorean fuzzy dual MM (PFDMM operator to fuse the Pythagorean fuzzy information. Then, we investigated their some properties and gave some special cases related to the parameter vector. In addition, based on the developed operators, two MCGDM methods under the Pythagorean fuzzy environment are proposed. An example is given to verify the validity and feasibility of our proposed methods, and a comparative analysis is provided to show their advantages.

  15. Barrier potential design criteria in multiple-quantum-well-based solar-cell structures

    Mohaidat, Jihad M.; Shum, Kai; Wang, W. B.; Alfano, R. R.

    1994-01-01

    The barrier potential design criteria in multiple-quantum-well (MQW)-based solar-cell structures is reported for the purpose of achieving maximum efficiency. The time-dependent short-circuit current density at the collector side of various MQW solar-cell structures under resonant condition was numerically calculated using the time-dependent Schroedinger equation. The energy efficiency of solar cells based on the InAs/Ga(y)In(1-y)As and GaAs/Al(x)Ga(1-x)As MQW structues were compared when carriers are excited at a particular solar-energy band. Using InAs/Ga(y)In(1-y)As MQW structures it is found that a maximum energy efficiency can be achieved if the structure is designed with barrier potential of about 450 meV. The efficiency is found to decline linearly as the barrier potential increases for GaAs/Al(x)Ga(1-x)As MQW-structure-based solar cells.

  16. Intuitionistic fuzzy evidential power aggregation operator and its application in multiple criteria decision-making

    Jiang, Wen; Wei, Boya

    2018-02-01

    The theory of intuitionistic fuzzy sets (IFS) is widely used for dealing with vagueness and the Dempster-Shafer (D-S) evidence theory has a widespread use in multiple criteria decision-making problems under uncertain situation. However, there are many methods to aggregate intuitionistic fuzzy numbers (IFNs), but the aggregation operator to fuse basic probability assignment (BPA) is rare. Power average (P-A) operator, as a powerful operator, is useful and important in information fusion. Motivated by the idea of P-A power, in this paper, a new operator based on the IFS and D-S evidence theory is proposed, which is named as intuitionistic fuzzy evidential power average (IFEPA) aggregation operator. First, an IFN is converted into a BPA, and the uncertainty is measured in D-S evidence theory. Second, the difference between BPAs is measured by Jousselme distance and a satisfying support function is proposed to get the support degree between each other effectively. Then the IFEPA operator is used for aggregating the original IFN and make a more reasonable decision. The proposed method is objective and reasonable because it is completely driven by data once some parameters are required. At the same time, it is novel and interesting. Finally, an application of developed models to the 'One Belt, One road' investment decision-making problems is presented to illustrate the effectiveness and feasibility of the proposed operator.

  17. Allocation of police posts in a medium-sized city: a multiple criteria approach

    Charles Miller Gois de Oliveira

    2015-09-01

    Full Text Available Changes in violent crime rates implies a need for strategies to protect the population. Public safety policies should be focused on preventive security, which has the potential to reduce crime rates. The allocation of the police observation posts contributes to an increase in safety. However, given limited resources, the number of observation units has reduced in most Brazilian cities. Therefore, efficient allocation of these resources is necessary to ensure rational use of security agents. Several aspects influence decisions related to where to install these units, complicating this process. The multiple criteria approach is appropriate in this type of decision-making process, because it allows the decision maker to generate and consolidate knowledge. The results indicate that the most suitable neighborhoods are those with higher rates of violence and greater social gaps. This work presents some benefits to the area of public security, since it formalizes tacit knowledge into explicit knowledge. The information contained in this study may be made available to other public administrators who need to make this kind of decision.

  18. Simplified response monitoring criteria for multiple myeloma in patients undergoing therapy with novel agents using computed tomography

    Schabel, Christoph; Horger, Marius; Kum, Sara [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Weisel, Katja [Department of Internal Medicine II – Hematology & Oncology, Eberhard-Karls-University Tuebingen, Otfried-Müller-Str. 5, 72076 Tuebingen (Germany); Fritz, Jan [Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, 600 N Wolfe St., Baltimore, MD 21287 (United States); Ioanoviciu, Sorin D. [Department of Internal Medicine, Clinical Municipal Hospital Timisoara, Gheorghe Dima Str. 5, 300079 Timisoara (Romania); Bier, Georg, E-mail: georg.bier@med.uni-tuebingen.de [Department of Neuroradiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany)

    2016-12-15

    Highlights: • A simplified method for response monitoring of multiple myeloma is proposed. • Medullary bone lesions of all limbs were included and analysed. • Diameters of ≥2 medullary bone lesions are sufficient for therapy monitoring. - Abstract: Introduction: Multiple myeloma is a malignant hematological disorder of the mature B-cell lymphocytes originating in the bone marrow. While therapy monitoring is still mainly based on laboratory biomarkers, the additional use of imaging has been advocated due to inaccuracies of serological biomarkers or in a-secretory myelomas. Non-enhanced CT and MRI have similar sensitivities for lesions in yellow marrow-rich bone marrow cavities with a favourable risk and cost-effectiveness profile of CT. Nevertheless, these methods are still limited by frequently high numbers of medullary lesions and its time consumption for proper evaluation. Objective: To establish simplified response criteria by correlating size and CT attenuation changes of medullary multiple myeloma lesions in the appendicular skeleton with the course of lytic bone lesions in the entire skeleton. Furthermore to evaluate these criteria with respect to established hematological myeloma-specific parameters for the prediction of treatment response to bortezomib or lenalidomide. Materials and methods: Non-enhanced reduced-dose whole-body CT examinations of 78 consecutive patients (43 male, 35 female, mean age 63.69 ± 9.2 years) with stage III multiple myeloma were retrospectively re-evaluated. On per patient basis, size and mean CT attenuation of 2–4 representative lesions in the limbs were measured at baseline and at a follow-up after a mean of 8 months. Results were compared with the course of lytical bone lesions as well with that of specific hematological biomarkers. Myeloma response was assessed according to the International Myeloma Working Group (IMWG) uniform response criteria. Testing for correlation between response of medullary lesions (Resp

  19. Solving the Problem of Multiple-Criteria Building Design Decisions with respect to the Fire Safety of Occupants: An Approach Based on Probabilistic Modelling

    Egidijus Rytas Vaidogas

    2015-01-01

    Full Text Available The design of buildings may include a comparison of alternative architectural and structural solutions. They can be developed at different levels of design process. The alternative design solutions are compared and ranked by applying methods of multiple-criteria decision-making (MCDM. Each design is characterised by a number of criteria used in a MCDM problem. The paper discusses how to choose MCDM criteria expressing fire safety related to alternative designs. Probability of a successful evacuation of occupants from a building fire and difference between evacuation time and time to untenable conditions are suggested as the most important criteria related to fire safety. These two criteria are treated as uncertain quantities expressed by probability distributions. Monte Carlo simulation of fire and evacuation processes is natural means for an estimation of these distributions. The presence of uncertain criteria requires applying stochastic MCDM methods for ranking alternative designs. An application of the safety-related criteria is illustrated by an example which analyses three alternative architectural floor plans prepared for a reconstruction of a medical building. A MCDM method based on stochastic simulation is used to solve the example problem.

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

    Soltani, Atousa; Hewage, Kasun; Reza, Bahareh; Sadiq, Rehan

    2015-01-01

    Municipal Solid Waste Management (MSWM) is a complicated process that involves multiple environmental and socio-economic criteria. Decision-makers look for decision support frameworks that can guide in defining alternatives, relevant criteria and their weights, and finding a suitable solution. In addition, decision-making in MSWM problems such as finding proper waste treatment locations or strategies often requires multiple stakeholders such as government, municipalities, industries, experts, and/or general public to get involved. Multi-criteria Decision Analysis (MCDA) is the most popular framework employed in previous studies on MSWM; MCDA methods help multiple stakeholders evaluate the often conflicting criteria, communicate their different preferences, and rank or prioritize MSWM strategies to finally agree on some elements of these strategies and make an applicable decision. This paper reviews and brings together research on the application of MCDA for solving MSWM problems with more focus on the studies that have considered multiple stakeholders and offers solutions for such problems. Results of this study show that AHP is the most common approach in consideration of multiple stakeholders and experts and governments/municipalities are the most common participants in these studies. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

    Soltani, Atousa; Hewage, Kasun; Reza, Bahareh; Sadiq, Rehan

    2015-01-01

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

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

    Soltani, Atousa; Hewage, Kasun; Reza, Bahareh; Sadiq, Rehan, E-mail: Rehan.sadiq@ubc.ca

    2015-01-15

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

  3. IMPORTANCE OF MULTIPLE CRITERIA FOR PRIORITY SETTING OF HIV/AIDS INTERVENTIONS.

    Tromp, Noor; Prawiranegara, Rozar; Siregar, Adiatma; Sunjaya, Deni; Baltussen, Rob

    2015-01-01

    This study describes the views of various stakeholders on the importance of different criteria for priority setting of HIV/AIDS interventions in Indonesia. Based on a general list of criteria and a focus group discussion with stakeholders (n = 6), a list was developed of thirty-two criteria that play a role in priority setting in HIV/AIDS control in West-Java province. Criteria were categorized according to the World Health Organization's health system goals and building block frameworks. People living with HIV/AIDS (n = 49), healthcare workers (HCW) (n = 41), the general population (n = 43), and policy makers (n = 22) rated the importance of thirty-two criteria on a 5-point Likert-scale. Thereafter, respondents ranked the highest rated criteria to express more detailed preferences. Stakeholders valued the following criteria as most important for the priority setting of HIV/AIDS interventions: an intervention's impact on the HIV/AIDS epidemic, reduction of stigma, quality of care, effectiveness on individual level, and feasibility in terms of current capacity of the health system (i.e., HCW, product, information, and service requirements), financial sustainability, and acceptance by donors. Overall, stakeholders' preferences for the importance of criteria are similar. Our study design outlines an approach for other settings to identify which criteria are important for priority setting of health interventions. For Indonesia, these study results may be used in priority setting processes for HIV/AIDS control and may contribute to more transparent and systematic allocation of resources.

  4. Using multiple and specific criteria to assess the predictive validity of the Big Five personality factors on academic performance.

    Kappe, F.R.; van der Flier, H.

    2010-01-01

    Multiple and specific academic performance criteria were used to examine the predictive validity of the Big Five personality traits. One hundred thirty-three students in a college of higher learning in The Netherlands participated in a naturally occurring field study. The results of the NEO-FFI were

  5. GIS coupled Multiple Criteria based Decision Support for Classification of Urban Coastal Areas in India

    Dhiman, R.; Kalbar, P.; Inamdar, A. B.

    2017-12-01

    Coastal area classification in India is a challenge for federal and state government agencies due to fragile institutional framework, unclear directions in implementation of costal regulations and violations happening at private and government level. This work is an attempt to improvise the objectivity of existing classification methods to synergies the ecological systems and socioeconomic development in coastal cities. We developed a Geographic information system coupled Multi-criteria Decision Making (GIS-MCDM) approach to classify urban coastal areas where utility functions are used to transform the costal features into quantitative membership values after assessing the sensitivity of urban coastal ecosystem. Furthermore, these membership values for costal features are applied in different weighting schemes to derive Coastal Area Index (CAI) which classifies the coastal areas in four distinct categories viz. 1) No Development Zone, 2) Highly Sensitive Zone, 3) Moderately Sensitive Zone and 4) Low Sensitive Zone based on the sensitivity of urban coastal ecosystem. Mumbai, a coastal megacity in India is used as case study for demonstration of proposed method. Finally, uncertainty analysis using Monte Carlo approach to validate the sensitivity of CAI under specific multiple scenarios is carried out. Results of CAI method shows the clear demarcation of coastal areas in GIS environment based on the ecological sensitivity. CAI provides better decision support for federal and state level agencies to classify urban coastal areas according to the regional requirement of coastal resources considering resilience and sustainable development. CAI method will strengthen the existing institutional framework for decision making in classification of urban coastal areas where most effective coastal management options can be proposed.

  6. Multiple-Criteria Decision Support for a Sustainable Supply Chain: Applications to the Fashion Industry

    Kim Leng Poh

    2017-10-01

    Full Text Available With increasing globalization and international cooperation, the importance of sustainability management across supply chains has received much attention by companies across various industries. Companies therefore strive to implement effective and integrated sustainable supply chain management initiatives to improve their operational and economic performance while also minimizing unnecessary damage to the environment and maintaining their social reputation and images. The paper presents an easy-to-use decision-support approach based on multiple-criteria decision-making (MCDM methodologies that aim to help companies develop effective models for timely decision-making involving sustainable supply chain management strategies. The proposed approach can be used by practitioners to ultimately build a comprehensive Analytic Network Process model that will adequately capture and reveal all the interrelationships and interdependency among the elements in the problem, which is often a very difficult task. To facilitate and simplify this complex process, we propose that hierarchical thinking be used first to structure the essences of the problem capturing only the major issues, and an Analytic Hierarchy Process (AHP model be built. Users can learn from the modeling process and gain much insight into the problem. The AHP can then be extended to an Analytic Network Process (ANP model so as to capture the relationships and interdependencies among the elements. Our approach can reduce the sustainable expertise, effort and information that are often needed to build an ANP model from scratch. We apply our approach to the evaluation of sustainable supply chain management strategies for the fashion industry. Three main dimensions of sustainability—environmental, economic and social—are considered. Based on the literature, we identified four alternative supply chain management strategies. It was found that the Reverse Logistics alternative appears to be the

  7. Convex reformulation of biologically-based multi-criteria intensity-modulated radiation therapy optimization including fractionation effects.

    Hoffmann, Aswin L; den Hertog, Dick; Siem, Alex Y D; Kaanders, Johannes H A M; Huizenga, Henk

    2008-11-21

    Finding fluence maps for intensity-modulated radiation therapy (IMRT) can be formulated as a multi-criteria optimization problem for which Pareto optimal treatment plans exist. To account for the dose-per-fraction effect of fractionated IMRT, it is desirable to exploit radiobiological treatment plan evaluation criteria based on the linear-quadratic (LQ) cell survival model as a means to balance the radiation benefits and risks in terms of biologic response. Unfortunately, the LQ-model-based radiobiological criteria are nonconvex functions, which make the optimization problem hard to solve. We apply the framework proposed by Romeijn et al (2004 Phys. Med. Biol. 49 1991-2013) to find transformations of LQ-model-based radiobiological functions and establish conditions under which transformed functions result in equivalent convex criteria that do not change the set of Pareto optimal treatment plans. The functions analysed are: the LQ-Poisson-based model for tumour control probability (TCP) with and without inter-patient heterogeneity in radiation sensitivity, the LQ-Poisson-based relative seriality s-model for normal tissue complication probability (NTCP), the equivalent uniform dose (EUD) under the LQ-Poisson model and the fractionation-corrected Probit-based model for NTCP according to Lyman, Kutcher and Burman. These functions differ from those analysed before in that they cannot be decomposed into elementary EUD or generalized-EUD functions. In addition, we show that applying increasing and concave transformations to the convexified functions is beneficial for the piecewise approximation of the Pareto efficient frontier.

  8. Optimal diversity of renewable energy alternatives under multiple criteria: An application to the UK

    Shmelev, S.E.; van den Bergh, J.C.J.M.

    2016-01-01

    We propose a multi-criteria analysis of alternative combinations of renewable energy technologies to meet a sustainable energy supply. It takes into account a range of criteria to reflect relevant environmental, social and economic considerations, capture the value of diversity, and reflect

  9. Managing uncertainty in multiple-criteria decision making related to sustainability assessment

    Dorini, Gianluca Fabio; Kapelan, Zoran; Azapagic, Adisa

    2011-01-01

    In real life, decisions are usually made by comparing different options with respect to several, often conflicting criteria. This requires subjective judgements on the importance of different criteria by DMs and increases uncertainty in decision making. This article demonstrates how uncertainty can......: (1) no uncertainty, (2) uncertainty in data/models and (3) uncertainty in models and decision-makers’ preferences. The results shows how characterising and propagating uncertainty can help increase the effectiveness of multi-criteria decision making processes and lead to more informed decision....... be handled in multi-criteria decision situations using Compromise Programming, one of the Multi-criteria Decision Analysis (MCDA) techniques. Uncertainty is characterised using a probabilistic approach and propagated using a Monte Carlo simulation technique. The methodological approach is illustrated...

  10. Cerebellar abnormalities contribute to disability including cognitive impairment in multiple sclerosis.

    Katrin Weier

    Full Text Available The cerebellum is known to be involved not only in motor but also cognitive and affective processes. Structural changes in the cerebellum in relation to cognitive dysfunction are an emerging topic in the field of neuro-psychiatric disorders. In Multiple Sclerosis (MS cerebellar motor and cognitive dysfunction occur in parallel, early in the onset of the disease, and the cerebellum is one of the predilection sites of atrophy. This study is aimed at determining the relationship between cerebellar volumes, clinical cerebellar signs, cognitive functioning and fatigue in MS. Cerebellar volumetry was conducted using T1-weighted MPRAGE magnetic resonance imaging of 172 MS patients. All patients underwent a clinical and brief neuropsychological assessment (information processing speed, working memory, including fatigue testing. Patients with and without cerebellar signs differed significantly regarding normalized cerebellar total volume (nTCV, normalized brain volume (nBV and whole brain T2 lesion volume (LV. Patients with cerebellar dysfunction likewise performed worse in cognitive tests. A regression analysis indicated that age and nTCV explained 26.3% of the variance in SDMT (symbol digit modalities test performance. However, only age, T2 LV and nBV remained predictors in the full model (r(2 = 0.36. The full model for the prediction of PASAT (Paced Auditory Serial Addition Test scores (r(2 = 0.23 included age, cerebellar and T2 LV. In the case of fatigue, only age and nBV (r(2 = 0.17 emerged as significant predictors. These data support the view that cerebellar abnormalities contribute to disability, including cognitive impairment in MS. However, this contribution does not seem to be independent of, and may even be dominated by wider spread MS pathology as reflected by nBV and T2 LV.

  11. Structural health monitoring and damage assessment using measured FRFs from multiple sensors. Part I. The indicator of correlation criteria

    Zang, C.; Friswell, M.I. [Dept. of Aerospace Engineering, Univ. of Bristol, Bristol (United Kingdom); Imregun, M. [Dept. of Mechanical Engineering, Imperial Coll., London (United Kingdom)

    2003-07-01

    This paper presents two criteria for correlating measured frequency responses from multiple sensors and proposes to use them as indicators for structural damage detection. The first criterion is a global shape correlation (GSC) function that is sensitive to mode shape differences but not to relative scales. The second criterion, a global amplitude correlation (GAC) function, is based on actual response amplitudes. Both correlation criteria are a function of frequency and uniquely map a set of complex responses to a real scalar between zero and unity. The averaged integrations of GSC and GAC functions along the frequency points over the measurement range, also called damage indicators, are used to describe the correlation between two sets of vibration data. When a structure state remains unchanged, both correlation criteria are as close to unity simultaneously. Otherwise, the correlation with the reference data will be decreased with changes of structure states. Using GSC and GAC functions has the advantage of being able to deal with incomplete measurements. Also, all available response data are used and hence there is no critical selection of frequency points for damage detection. The above correlation criteria were applied to a bookshelf structure and various cases such as undamaged states, damage locations (single and multiple), damage levels, as well as environmental variability are discussed. As expected, it was found that indicators of correlation criteria were able to identify all various cases correctly. (orig.)

  12. Multiple-criteria approach of evaluation of milk farm models in Bosnia and Herzegovina

    Črtomir Rozman

    2016-07-01

    Full Text Available Cattle breeding is a very important part of agricultural production in Bosnia and Herzegovina (B&H, and milk production has a vital place in cattle breeding production. From an economic point of view, milk production is interesting as it is a daily production which presupposes faster marketing, which accelerates capital movement in agriculture, which in turn enhances liquidity. This research uses analyses of the existing state in milk production. The collected data are processed and cost calculation has been designed which enables the analysis of economic indicators of 4 dairy farm production models in B&H. Based on the collected data on features and values of dairy farm production models in B&H an analysis of expert evaluation was conducted as input data for DEXi method. The aim of this paper is to ascertain the basic indicators of business success of 4 dairy farm production models in B&H. Production-ecological, economic and socio-political features of the mentioned dairy farm models were analyzed. Based on the used criteria a rate of dairy farm production models using DEXi method was conducted. The results of the research in this paper using DEXi method show that the best model for dairy farm is model number four, which includes 45 milk cows.

  13. Thermoelectric material including a multiple transition metal-doped type I clathrate crystal structure

    Yang, Jihui [Lakeshore, CA; Shi, Xun [Troy, MI; Bai, Shengqiang [Shanghai, CN; Zhang, Wenqing [Shanghai, CN; Chen, Lidong [Shanghai, CN; Yang, Jiong [Shanghai, CN

    2012-01-17

    A thermoelectric material includes a multiple transition metal-doped type I clathrate crystal structure having the formula A.sub.8TM.sub.y.sub.1.sup.1TM.sub.y.sub.2.sup.2 . . . TM.sub.y.sub.n.sup.nM.sub.zX.sub.46-y.sub.1.sub.-y.sub.2.sub.- . . . -y.sub.n.sub.-z. In the formula, A is selected from the group consisting of barium, strontium, and europium; X is selected from the group consisting of silicon, germanium, and tin; M is selected from the group consisting of aluminum, gallium, and indium; TM.sup.1, TM.sup.2, and TM.sup.n are independently selected from the group consisting of 3d, 4d, and 5d transition metals; and y.sub.1, y.sub.2, y.sub.n and Z are actual compositions of TM.sup.1, TM.sup.2, TM.sup.n, and M, respectively. The actual compositions are based upon nominal compositions derived from the following equation: z=8q.sub.A-|.DELTA.q.sub.1|y.sub.1-|.DELTA.q.sub.2|y.sub.2- . . . -|.DELTA.q.sub.n|y.sub.n, wherein q.sub.A is a charge state of A, and wherein .DELTA.q.sub.1, .DELTA.q.sub.2, .DELTA.q.sub.n are, respectively, the nominal charge state of the first, second, and n-th TM.

  14. Five criteria for using a surrogate endpoint to predict treatment effect based on data from multiple previous trials.

    Baker, Stuart G

    2018-02-20

    A surrogate endpoint in a randomized clinical trial is an endpoint that occurs after randomization and before the true, clinically meaningful, endpoint that yields conclusions about the effect of treatment on true endpoint. A surrogate endpoint can accelerate the evaluation of new treatments but at the risk of misleading conclusions. Therefore, criteria are needed for deciding whether to use a surrogate endpoint in a new trial. For the meta-analytic setting of multiple previous trials, each with the same pair of surrogate and true endpoints, this article formulates 5 criteria for using a surrogate endpoint in a new trial to predict the effect of treatment on the true endpoint in the new trial. The first 2 criteria, which are easily computed from a zero-intercept linear random effects model, involve statistical considerations: an acceptable sample size multiplier and an acceptable prediction separation score. The remaining 3 criteria involve clinical and biological considerations: similarity of biological mechanisms of treatments between the new trial and previous trials, similarity of secondary treatments following the surrogate endpoint between the new trial and previous trials, and a negligible risk of harmful side effects arising after the observation of the surrogate endpoint in the new trial. These 5 criteria constitute an appropriately high bar for using a surrogate endpoint to make a definitive treatment recommendation. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  15. The total cost of logistics in supplier selection, under conditions of multiple sourcing, multiple criteria and capacity constraint

    Elnaz Bani

    2016-06-01

    Full Text Available This paper presents a mathematical model to solve a multi-objective decision making supplier selection problem. The proposed problem considers three objective functions: the first objective function minimizes the cost of purchasing the products while the second objective function minimizes the due dates and finally the third objective function maximizes the customer satisfaction. The resulted problem is formulated as mixed integer programming and, therefore, we use invasive weed optimization technique to solve the resulted problem. The performance of the proposed model is compared with NSGA II based on different criteria such as mean ideal distance and quality matrix. The preliminary results indicate that the proposed model performs relatively well compared with alternative method.

  16. Dynamic Educational e-Content Selection Using Multiple Criteria in Web-Based Personalized Learning Environments.

    Manouselis, Nikos; Sampson, Demetrios

    This paper focuses on the way a multi-criteria decision making methodology is applied in the case of agent-based selection of offered learning objects. The problem of selection is modeled as a decision making one, with the decision variables being the learner model and the learning objects' educational description. In this way, selection of…

  17. Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ®)—Patient Version

    Plasma cell neoplasms occur when abnormal plasma cells or myeloma cells form tumors in the bones or soft tissues of the body. Multiple myeloma, plasmacytoma, lymphoplasmacytic lymphoma, and monoclonal gammopathy of undetermined significance (MGUS) are different types of plasma cell neoplasms. Find out about risk factors, symptoms, diagnostic tests, prognosis, and treatment for these diseases.

  18. Automatic treatment of multiple wound coils in 3D finite element problems including multiply connected regions

    Leonard, P.J.; Lai, H.C.; Eastham, J.F.; Al-Akayshee, Q.H. [Univ. of Bath (United Kingdom)

    1996-05-01

    This paper describes an efficient scheme for incorporating multiple wire wound coils into 3D finite element models. The scheme is based on the magnetic scalar representation with an additional basis for each coil. There are no restrictions on the topology of coils with respect to ferromagnetic and conductor regions. Reduced scalar regions and cuts are automatically generated.

  19. A Case Study of Tack Tiles[R] Literacy Instruction for a Student with Multiple Disabilities Including Congenital Blindness

    Klenk, Jessicia A.; Pufpaff, Lisa A.

    2011-01-01

    Research on literacy instruction for students with multiple disabilities is limited. Empirical research on braille instruction for students with multiple disabilities that include congenital blindness is virtually nonexistent. This case study offers initial insight into possible methods of early braille literacy instruction for a student with…

  20. Exact criteria for uniqueness and multiplicity of an nth order chemical reaction via catastrophe theory approach. [Determines boundaries between unique and multiple steady state conditions

    Chang, H C; Calo, J M

    1979-01-01

    A simple, generalized technique for the exact determination of the boundaries between regions of unique and of multiple solutions to certain nonlinear equations was developed by applying catastrophe theory to the mapping of implicit and explicit functions. Its application to an nth order reaction in continuous stirred tank reactor (CSTR) yields exact, explicit expressions for the boundaries between regions of single and multiple steady states, expressed in terms of the dimensionless heat transfer coefficient and activation energy. An exact implicit expression for the boundaries between regions of uniqueness and multiplicity was also derived for an nth order reaction in a catalyst particle with an intraparticle concentration gradient and uniform temperature and is fully demonstrated for the first-order reaction. In addition, explicit criteria were developed by assuming the limits on d ln g/d ln q, where g is the effectiveness factor and q the Thiele modulus, proposed by van den Bosch and Luss.

  1. A review of simple multiple criteria decision making analytic procedures which are implementable on spreadsheet packages

    T.J. Stewart

    2003-12-01

    Full Text Available A number of modern multi-criteria decision making aids for the discrete choice problem, are reviewed, with particular emphasis on those which can be implemented on standard commercial spreadsheet packages. Three broad classes of procedures are discussed, namely the analytic hierarchy process, reference point methods, and outranking methods. The broad principles are summarised in a consistent framework, and on a spreadsheet. LOTUS spreadsheets implementing these are available from the author.

  2. Clinical problems of multiple primary cancers including head and neck cancers. From the viewpoint of radiotherapy

    Nishio, Masamichi; Myojin, Miyako; Nishiyama, Noriaki; Taguchi, Hiroshi; Takagi, Masaru; Tanaka, Katsuhiko

    2003-01-01

    A total of 2144 head and neck cancers were treated by radiotherapy at the National Sapporo Hospital between 1974 and 2001. Of these, 313 (14.6%) were found to have other primary cancers besides head and neck cancer, in which double cancers were 79% and triple or more cancers were 21%. Frequency according to primary site of the first head and neck cancer was oral cavity: 107/603 (17.7%), epipharynx cancer: 7/117 (6.0%), oropharyngeal cancer: 63/257 (24.5%), hypopharyngeal cancer: 65/200 (32.5%), laryngeal cancer: 114/558 (20.4%), and nose/paranasal sinus: 4.9% respectively. Esophageal cancer, head and neck cancer, lung cancer and gastric cancer were very frequent as other primary sites combined with the head and neck. The first onset region was the head and neck in 233 out of 313 cases with multiple primary cancers. The five-year survival rate from the onset of head and neck cancers is 52%, 10-year: 30%, and 5-year cause-specific survival rate 82%, and 10-year: 78%, respectively. The treatment possibilities in multiple primary cancers tend to be limited because the treatment areas are sometimes overlapped. New approaches to the treatment of multiple primary cancers should be considered in the future. (author)

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

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

    2016-01-01

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

  4. Multiple shooting applied to robust reservoir control optimization including output constraints on coherent risk measures

    Codas, Andrés; Hanssen, Kristian G.; Foss, Bjarne

    2017-01-01

    The production life of oil reservoirs starts under significant uncertainty regarding the actual economical return of the recovery process due to the lack of oil field data. Consequently, investors and operators make management decisions based on a limited and uncertain description of the reservoir....... In this work, we propose a new formulation for robust optimization of reservoir well controls. It is inspired by the multiple shooting (MS) method which permits a broad range of parallelization opportunities and output constraint handling. This formulation exploits coherent risk measures, a concept...

  5. Capability of multiple selection criteria to evaluate contrasting spring wheat germplasms under arid conditions

    Al-Suhaibani, N. A.; SALAH, E.; El-Hendawy, S. E.; Al-Gaadi, K.; Rehman, S. U.

    2015-01-01

    Selection criteria that would evaluate a large number of germplasm in a rapid and non-destructive manner would be considered advantageous in plant breeding programs. Trade-off between traditional and non-destructive screening criteria in evaluating 90 wheat accessions under water shortage was tested using multivariate statistical techniques. Only three irrigations during the growing cycle of germplasm were applied with the amount of water totalling 2550 m /sup 3/ ha /sup -1/. Sequential path analysis identified one traditional trait (grain weight per plant) and two non-destructive traits (leaf area index and stomatal conductance) as important first-order traits that influenced final grain yield. The three traits, taken together, explained 96.8 percentage of the total variation in grain yield. Total dry weight per plant, green leaf area per plant, harvest index, grain number per plant, leaf water content and canopy temperature were identified as important second-order traits that influenced grain yield. Although canopy temperature was ranked as a second-order trait, it explained 64.4 percentage of the total variation in stomatal conductance. Approximately 78.0 percentage of the total variation in grain weight or leaf area index was explained by the leaf water content (66.2 percentage) and total dry weight (11.5 percentage). The 90 examined spring wheat germplasms were grouped into five clusters based on all agro-physiological traits using the centroid linkage method. The tested wheat germplasm that produce high grain yield under water shortage were characterised by good performance of certain rapid, easy and non-destructive physiological traits such as high leaf area index, high stomatal conductance and low canopy temperature. Therefore, these three traits could be used in combination as quick and easy screening criteria to select suitable genotypes for water-limiting conditions. (author)

  6. Nonrandomized studies are not always found even when selection criteria for health systems intervention reviews include them: a methodological study.

    Glenton, Claire; Lewin, Simon; Mayhew, Alain; Scheel, Inger; Odgaard-Jensen, Jan

    2013-04-01

    Systematic reviews within the Cochrane Effective Practice and Organisation of Care Group (EPOC) can include both randomized and nonrandomized study designs. We explored how many EPOC reviews consider and identify nonrandomized studies, and whether the proportion of nonrandomized studies identified is linked to the review topic. We recorded the study designs considered in 65 EPOC reviews. For reviews that considered nonrandomized studies, we calculated the proportion of identified studies that were nonrandomized and explored whether there were differences in the proportion of nonrandomized studies according to the review topic. Fifty-one (78.5%) reviews considered nonrandomized studies. Forty-six of these reviews found nonrandomized studies, but the proportion varied a great deal (median, 33%; interquartile range, 25--50%). Reviews of health care delivery interventions had lower proportions of nonrandomized studies than those of financial and governance interventions. Most EPOC reviews consider nonrandomized studies, but the degree to which they find them varies. As nonrandomized studies are believed to be at higher risk of bias and their inclusion entails a considerable effort, review authors should consider whether the benefits justify the inclusion of these designs. Research should explore whether it is more useful to consider nonrandomized studies in reviews of some intervention types than others. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. 3D shape optimization of fan vanes for multiple operating regimes subject to efficiency and noise-related excellence criteria and constraints

    Ivo Marinić-Kragić

    2016-01-01

    Full Text Available Fully generic 3D shapes of centrifugal roof fan vanes are explored based on a custom-developed numerical workflow with the ability to vary the vane 3D shape by manipulating the control points of parametric surfaces and change the number of vanes and rotation speed. An excellence formulation is based on design flow efficiency, multi-regime operational conditions and noise criteria for various cases, including multi-objective optimization. Multiple cases of optimization demonstrate the suitability of customized and individualized fan designs for specific working environments according to the selected excellence criteria. Noise analysis is considered as an additional decision-making tool for cases where multiple solutions of equal efficiency are generated and as an additional criteria for multi-objective optimization. The 3D vane shape enables further gains in efficiency compared to 2D shape optimization, while multi-objective optimization with noise as an additional criterion shows potential to greatly reduce the roof fan noise with only small losses in efficiency. The developed workflow which comprises (i a 3D parametric shape modeler, (ii an evolutionary optimizer and (iii a computational fluid dynamics (CFD simulator can be viewed as an integral tool for optimizing the designs of roof fans under custom conditions.

  8. Identification of suitable areas for the occurrence of Rift Valley fever outbreaks in Spain using a multiple criteria decision framework.

    Sánchez-Vizcaíno, Fernando; Martínez-López, Beatriz; Sánchez-Vizcaíno, José Manuel

    2013-07-26

    Rift Valley fever (RVF) is a mosquito-borne viral disease that may produce a considerable impact on the economy in affected countries. In the last decades, the geographic distribution of RVF virus has increased including most of the countries in Africa, Arabia Saudi and Yemen. This situation has raised the concerns regarding its potential introduction in the European Union (EU) countries where the high number of susceptible species and competent vectors may contribute to the spread of the disease and challenge its rapid control. Thus, the identification of the areas and time periods with highest suitability for RVF outbreak occurrence would be useful for improving the early detection and rapid response of the disease into free countries. The objective of this study was to identify suitable areas for the occurrence of RVF outbreaks in Spain using a multiple criteria decision making model based on weighted linear combination of factors in geographical information systems (GIS). To the best of the author's knowledge this is the first comprehensive GIS-based framework that provides risk maps for RVF suitability in an EU country. Spanish zones with the highest suitability for RVF were concentrated in the regions of Extremadura, south-western Castile and Leon, eastern Galicia, Asturias, Cantabria, Basque Country, northern-central and southern region of Andalusia and in the Balearic Islands. October and May were the most suitable months for RVF outbreak occurrence. Methods and results presented here may be useful to target risk-based surveillance strategies and to more cost-effectively control potential RVFV incursions into Spain. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Multiple local minima in IMRT optimization based on dose-volume criteria

    Wu Qiuwen; Mohan, Radhe

    2002-01-01

    Multiple local minima traps are known to exist in dose-volume and dose-response objective functions. Nevertheless, their presence and consequences are not considered impediments in finding satisfactory solutions in routine optimization of IMRT plans using gradient methods. However, there is often a concern that a significantly superior solution may exist unbeknownst to the planner and that the optimization process may not be able to reach it. We have investigated the soundness of the assumption that the presence of multiple minima traps can be ignored. To find local minima, we start the optimization process a large number of times with random initial intensities. We investigated whether the occurrence of local minima depends upon the choice of the objective function parameters and the number of variables and whether their existence is an impediment in finding a satisfactory solution. To learn about the behavior of multiple minima, we first used a symmetric cubic phantom containing a cubic target and an organ-at-risk surrounding it to optimize the beam weights of two pairs of parallel-opposed beams using a gradient technique. The phantom studies also served to test our software. Objective function parameters were chosen to ensure that multiple minima would exist. Data for 500 plans, optimized with random initial beam weights, were analyzed. The search process did succeed in finding the local minima and showed that the number of minima depends on the parameters of the objective functions. It was also found that the consequences of local minima depended on the number of beams. We further searched for the multiple minima in intensity-modulated treatment plans for a head-and-neck case and a lung case. In addition to the treatment plan scores and the dose-volume histograms, we examined the dose distributions and intensity patterns. We did not find any evidence that multiple local minima affect the outcome of optimization using gradient techniques in any clinically

  10. Multiple Crack Growth Prediction in AA2024-T3 Friction Stir Welded Joints, Including Manufacturing Effects

    Carlone, Pierpaolo; Citarella, Roberto; Sonne, Mads Rostgaard

    2016-01-01

    A great deal of attention is currently paid by several industries toward the friction stir welding process to realize lightweight structures. Within this aim, the realistic prediction of fatigue behavior of welded assemblies is a key factor. In this work an integrated finite element method - dual...... boundary element method (FEM-DBEM) procedure, coupling the welding process simulation to the subsequent crack growth assessment, is proposed and applied to simulate multiple crack propagation, with allowance for manufacturing effects. The friction stir butt welding process of the precipitation hardened AA...... on a notched specimen. The whole procedure was finally tested comparing simulation outcomes with experimental data. The good agreement obtained highlights the predictive capability of the method. The influence of the residual stress distribution on crack growth and the mutual interaction between propagating...

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

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

    2015-01-01

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

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

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

    2014-12-01

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

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

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

    2018-02-01

    In 2016, the Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS) network proposed modifications to the MRI criteria to define dissemination in space (DIS) and time (DIT) for the diagnosis of multiple sclerosis in patients with clinically isolated syndrome (CIS). Changes to the DIS definition included removal of the distinction between symptomatic and asymptomatic lesions, increasing the number of lesions needed to define periventricular involvement to three, combining cortical and juxtacortical lesions, and inclusion of optic nerve evaluation. For DIT, removal of the distinction between symptomatic and asymptomatic lesions was suggested. We compared the performance of the 2010 McDonald and 2016 MAGNIMS criteria for multiple sclerosis diagnosis in a large multicentre cohort of patients with CIS to provide evidence to guide revisions of multiple sclerosis diagnostic criteria. Brain and spinal cord MRI and optic nerve assessments from patients with typical CIS suggestive of multiple sclerosis done less than 3 months from clinical onset in eight European multiple sclerosis centres were included in this retrospective study. Eligible patients were 16-60 years, and had a first CIS suggestive of CNS demyelination and typical of relapsing-remitting multiple sclerosis, a complete neurological examination, a baseline brain and spinal cord MRI scan obtained less than 3 months from clinical onset, and a follow-up brain scan obtained less than 12 months from CIS onset. We recorded occurrence of a second clinical attack (clinically definite multiple sclerosis) at months 36 and 60. We evaluated MRI criteria performance for DIS, DIT, and DIS plus DIT with a time-dependent receiver operating characteristic curve analysis. Between June 16, 1995, and Jan 27, 2017, 571 patients with CIS were screened, of whom 368 met all study inclusion criteria. At the last evaluation (median 50·0 months [IQR 27·0-78·4]), 189 (51%) of 368 patients developed clinically definite multiple

  14. Gestational diabetes mellitus: Confusion among medical doctors caused by multiple international criteria.

    Agarwal, Mukesh M; Shah, Syed M; Al Kaabi, Juma; Saquib, Shabnam; Othman, Yusra

    2015-06-01

    The aim of this study was to appraise the current regional practices of screening, diagnosis and follow-up of gestational diabetes mellitus (GDM) because the approach to GDM is frequently inconsistent. A 21-item questionnaire was distributed to physicians taking care of pregnant women in seven hospitals in the United Arab Emirates and one hospital in Oman. Besides assessing their attitudes towards testing for GDM, the questionnaire assessed familiarity with the Hyperglycemia and Pregnancy Outcome study and the International Association of Diabetes in Pregnancy Study Groups GDM guidelines. One hundred and forty-eight (93%) of the 159 questionnaires distributed to the medical doctors (106 [72%] obstetricians and 42 [28%] internists) were returned. For GDM screening, six hospitals used five different tests; two hospitals utilized one single test. For GDM diagnosis, six hospitals employed the 2-h, 75-g oral glucose tolerance test (OGTT) (four different criteria) while two hospitals used the 3-h, 100-g OGTT (single criteria). For post-delivery follow-up, the 2-h, 75-g OGTT and fasting plasma glucose were accepted by 103 (70%) and 38 (26%) of the 148 medical doctors, respectively. Ninety-eight (69%) of 143 responding physicians were aware of the Hyperglycemia and Pregnancy Outcome study, while 85 (61%) of 140 responders were familiar with the guidelines of the International Association of Diabetes in Pregnancy Study Groups; this knowledge was independent of specialty, seniority, academia, years in practice or country trained. Although this study is parochial, its implications are global; that is, further education of caregivers would make the discordant approach to GDM (within and between hospitals) more harmonious and improve the obstetric care of pregnant women. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  15. Problem-solving with multiple interdependent criteria: better solution to complex problems

    Carlsson, C.; Fuller, R.

    1996-01-01

    We consider multiple objective programming (MOP) problems with additive interdependencies, this is when the states of some chosen objective are attained through supportive or inhibitory feed-backs from several other objectives. MOP problems with independent objectives (when the cause-effect relations between the decision variables and the objectives are completely known) will be treated as special cases of the MOP in which we have interdependent objectives. We illustrate our ideas by a simple three-objective real-life problem

  16. The dyad palindromic glutathione transferase P enhancer binds multiple factors including AP1.

    Diccianni, M B; Imagawa, M; Muramatsu, M

    1992-10-11

    Glutathione Transferase P (GST-P) gene expression is dominantly regulated by an upstream enhancer (GPEI) consisting of a dyad of palindromically oriented imperfect TPA (12-O-tetradecanoyl-phorbol-13-acetate)-responsive elements (TRE). GPEI is active in AP1-lacking F9 cells as well in AP1-containing HeLa cells. Despite GPEI's similarity to a TRE, c-jun co-transfection has only a minimal effect on transactivation. Antisense c-jun and c-fos co-transfection experiments further demonstrate the lack of a role for AP1 in GPEI mediated trans-activation in F9 cells, although endogenously present AP1 can influence GPEI in HeLa cells. Co-transfection of delta fosB with c-jun, which forms an inactive c-Jun/delta FosB heterodimer that binds TRE sequences, inhibits GPEI-mediated transcription in AP1-lacking F9 cells as well as AP1-containing HeLa cells. These data suggest novel factor(s) other than AP1 are influencing GPEI. Binding studies reveal multiple nucleoproteins bind to GPEI. These factors are likely responsible for the high level of GPEI-mediated transcription observed in the absence of AP1 and during hepatocarcinogenesis.

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

    Angelis, Aris; Kanavos, Panos

    2017-09-01

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

  18. Multiple Criteria Decision Analysis for Health Care Decision Making--An Introduction: Report 1 of the ISPOR MCDA Emerging Good Practices Task Force.

    Thokala, Praveen; Devlin, Nancy; Marsh, Kevin; Baltussen, Rob; Boysen, Meindert; Kalo, Zoltan; Longrenn, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Ijzerman, Maarten

    2016-01-01

    Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting, objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making and a set of techniques, known under the collective heading multiple criteria decision analysis (MCDA), are useful for this purpose. MCDA methods are widely used in other sectors, and recently there has been an increase in health care applications. In 2014, ISPOR established an MCDA Emerging Good Practices Task Force. It was charged with establishing a common definition for MCDA in health care decision making and developing good practice guidelines for conducting MCDA to aid health care decision making. This initial ISPOR MCDA task force report provides an introduction to MCDA - it defines MCDA; provides examples of its use in different kinds of decision making in health care (including benefit risk analysis, health technology assessment, resource allocation, portfolio decision analysis, shared patient clinician decision making and prioritizing patients' access to services); provides an overview of the principal methods of MCDA; and describes the key steps involved. Upon reviewing this report, readers should have a solid overview of MCDA methods and their potential for supporting health care decision making. Copyright © 2016. Published by Elsevier Inc.

  19. GWAS of clinically defined gout and subtypes identifies multiple susceptibility loci that include urate transporter genes

    Nakayama, A.; Nakaoka, H.; Yamamoto, K.; Sakiyama, M.; Shaukat, A.; Toyoda, Y.; Okada, Y.; Kamatani, Y.; Nakamura, T.; Takada, T.; Inoue, K.; Yasujima, T.; Yuasa, H.; Shirahama, Y.; Nakashima, H.; Shimizu, S.; Higashino, T.; Kawamura, Y.; Ogata, H.; Kawaguchi, M.; Ohkawa, Y.; Danjoh, I.; Tokumasu, A.; Ooyama, K.; Ito, T.; Kondo, T.; Wakai, K.; Stiburkova, B.; Pavelka, K.; Stamp, L.K.; Dalbeth, N.; Sakurai, Y.; Suzuki, H; Hosoyamada, M.; Fujimori, S.; Yokoo, T.; Hosoya, T.; Inoue, I.; Takahashi, A.; Kubo, M.; Ooyama, H.; Shimizu, T.; Ichida, K.; Shinomiya, N.; Merriman, T.R.; Matsuo, H.; Andres, M; Joosten, L.A.; Janssen, M.C.H.; Jansen, T.L.; Liote, F.; Radstake, T.R.; Riches, P.L.; So, A.; Tauches, A.K.

    2017-01-01

    OBJECTIVE: A genome-wide association study (GWAS) of gout and its subtypes was performed to identify novel gout loci, including those that are subtype-specific. METHODS: Putative causal association signals from a GWAS of 945 clinically defined gout cases and 1213 controls from Japanese males were

  20. Using Photovoice to Include People with Profound and Multiple Learning Disabilities in Inclusive Research

    Cluley, Victoria

    2017-01-01

    Background: It is now expected that projects addressing the lives of people with learning disabilities include people with learning disabilities in the research process. In the past, such research often excluded people with learning disabilities, favouring the opinions of family members, carers and professionals. The inclusion of the voices of…

  1. Prospective evaluation of dermatologic surgery complications including patients on multiple antiplatelet and anticoagulant medications.

    Bordeaux, Jeremy S; Martires, Kathryn J; Goldberg, Dori; Pattee, Sean F; Fu, Pingfu; Maloney, Mary E

    2011-09-01

    Few prospective studies have evaluated the safety of dermatologic surgery. We sought to determine rates of bleeding, infection, flap and graft necrosis, and dehiscence in outpatient dermatologic surgery, and to examine their relationship to type of repair, anatomic location of repair, antibiotic use, antiplatelet use, or anticoagulant use. Patients presenting to University of Massachusetts Medical School Dermatology Clinic for surgery during a 15-month period were prospectively entered. Medications, procedures, and complications were recorded. Of the 1911 patients, 38% were on one anticoagulant or antiplatelet medication, and 8.0% were on two or more. Risk of hemorrhage was 0.89%. Complex repair (odds ratio [OR] = 5.80), graft repair (OR = 7.58), flap repair (OR = 11.93), and partial repair (OR = 43.13) were more likely to result in bleeding than intermediate repair. Patients on both clopidogrel and warfarin were 40 times more likely to have bleeding complications than all others (P = .03). Risk of infection was 1.3%, but was greater than 3% on the genitalia, scalp, back, and leg. Partial flap necrosis occurred in 1.7% of flaps, and partial graft necrosis occurred in 8.6% of grafts. Partial graft necrosis occurred in 20% of grafts on the scalp and 10% of grafts on the nose. All complications resolved without sequelae. The study was limited to one academic dermatology practice. The rate of complications in dermatologic surgery is low, even when multiple oral anticoagulant and antiplatelet medications are continued, and prophylactic antibiotics are not used. Closure type and use of warfarin or clopidogrel increase bleeding risk. However, these medications should be continued to avoid adverse thrombotic events. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  2. Determination of optimal pollution levels through multiple-criteria decision making: an application to the Spanish electricity sector

    Linares, P.

    1999-01-01

    An efficient pollution management requires the harmonisation of often conflicting economic and environmental aspects. A compromise has to be found, in which social welfare is maximised. The determination of this social optimum has been attempted with different tools, of which the most correct according to neo-classical economics may be the one based on the economic valuation of the externalities of pollution. However, this approach is still controversial, and few decision makers trust the results obtained enough to apply them. But a very powerful alternative exists, which avoids the problem of monetizing physical impacts. Multiple-criteria decision making provides methodologies for dealing with impacts in different units, and for incorporating the preferences of decision makers or society as a whole, thus allowing for the determination of social optima under heterogeneous criteria, which is usually the case of pollution management decisions. In this paper, a compromise programming model is presented for the determination of the optimal pollution levels for the electricity industry in Spain for carbon dioxide, sulphur dioxide, nitrous oxides, and radioactive waste. The preferences of several sectors of society are incorporated explicitly into the model, so that the solution obtained represents the optimal pollution level from a social point of view. Results show that cost minimisation is still the main objective for society, but the simultaneous consideration of the rest of the criteria achieves large pollution reductions at a low cost increment. (Author)

  3. Identification of Multiple Novel Viruses, Including a Parvovirus and a Hepevirus, in Feces of Red Foxes

    van der Giessen, Joke; Haagmans, Bart L.; Osterhaus, Albert D. M. E.; Smits, Saskia L.

    2013-01-01

    Red foxes (Vulpes vulpes) are the most widespread members of the order of Carnivora. Since they often live in (peri)urban areas, they are a potential reservoir of viruses that transmit from wildlife to humans or domestic animals. Here we evaluated the fecal viral microbiome of 13 red foxes by random PCR in combination with next-generation sequencing. Various novel viruses, including a parvovirus, bocavirus, adeno-associated virus, hepevirus, astroviruses, and picobirnaviruses, were identified. PMID:23616657

  4. GWAS of clinically defined gout and subtypes identifies multiple susceptibility loci that include urate transporter genes

    Nakayama, Akiyoshi; Nakaoka, Hirofumi; Yamamoto, Ken; Sakiyama, Masayuki; Shaukat, Amara; Toyoda, Yu; Okada, Yukinori; Kamatani, Yoichiro; Nakamura, Takahiro; Takada, Tappei; Inoue, Katsuhisa; Yasujima, Tomoya; Yuasa, Hiroaki; Shirahama, Yuko; Nakashima, Hiroshi

    2016-01-01

    Objective A genome-wide association study (GWAS) of gout and its subtypes was performed to identify novel gout loci, including those that are subtype-specific. Methods Putative causal association signals from a GWAS of 945 clinically defined gout cases and 1213 controls from Japanese males were replicated with 1396 cases and 1268 controls using a custom chip of 1961 single nucleotide polymorphisms (SNPs). We also first conducted GWASs of gout subtypes. Replication with Caucasian and New Zeala...

  5. Multiple Criteria Decision Making Combined with VRP: A Categorized Bibliographic Study

    Yahia Zare Mehrjerdi

    2015-08-01

    Full Text Available In this research author reviews references related to the topic of multi criterion (goal programming, multiple objective linear and nonlinear programming, bi-criterion programming, Multi Attribute Decision Making, Compromise Programming, Surrogate Worth Trade-off Method and various versions of vehicle routing problem (VRP, Multi depot VRP (MDVRP, VRP with time windows (VRPWTW, Stochastic VRP (SVRP, Capacitated VRP (CVRP, Fuzzy VRP (FVRP, Location VRP (LVRP, Backhauling VRP(BHVRP, Facility Location VRP (FLVRP, and Inventory control VRP (ICVRP. Although, VRP is a research area with rich research works and powerful researchers there found only 81 articles that relates various vehicle routing type problems with various multiple objectives techniques. This author found that there is no research done in some areas of VRP (i.e., FVRP, ICVRP, LRP and CVRP. It is interesting to see that this research area was completely an unattractive to master students (with zero research reported and a somewhat attractive area to doctoral students (with 6 researches reported. Among the many multi criterion programming techniques available only three of them (goal programming, bi-criterion programming, linear and nonlinear multi objective programming are being employed to solve the problem.

  6. GWAS of clinically defined gout and subtypes identifies multiple susceptibility loci that include urate transporter genes.

    Nakayama, Akiyoshi; Nakaoka, Hirofumi; Yamamoto, Ken; Sakiyama, Masayuki; Shaukat, Amara; Toyoda, Yu; Okada, Yukinori; Kamatani, Yoichiro; Nakamura, Takahiro; Takada, Tappei; Inoue, Katsuhisa; Yasujima, Tomoya; Yuasa, Hiroaki; Shirahama, Yuko; Nakashima, Hiroshi; Shimizu, Seiko; Higashino, Toshihide; Kawamura, Yusuke; Ogata, Hiraku; Kawaguchi, Makoto; Ohkawa, Yasuyuki; Danjoh, Inaho; Tokumasu, Atsumi; Ooyama, Keiko; Ito, Toshimitsu; Kondo, Takaaki; Wakai, Kenji; Stiburkova, Blanka; Pavelka, Karel; Stamp, Lisa K; Dalbeth, Nicola; Sakurai, Yutaka; Suzuki, Hiroshi; Hosoyamada, Makoto; Fujimori, Shin; Yokoo, Takashi; Hosoya, Tatsuo; Inoue, Ituro; Takahashi, Atsushi; Kubo, Michiaki; Ooyama, Hiroshi; Shimizu, Toru; Ichida, Kimiyoshi; Shinomiya, Nariyoshi; Merriman, Tony R; Matsuo, Hirotaka

    2017-05-01

    A genome-wide association study (GWAS) of gout and its subtypes was performed to identify novel gout loci, including those that are subtype-specific. Putative causal association signals from a GWAS of 945 clinically defined gout cases and 1213 controls from Japanese males were replicated with 1396 cases and 1268 controls using a custom chip of 1961 single nucleotide polymorphisms (SNPs). We also first conducted GWASs of gout subtypes. Replication with Caucasian and New Zealand Polynesian samples was done to further validate the loci identified in this study. In addition to the five loci we reported previously, further susceptibility loci were identified at a genome-wide significance level (pgout cases, and NIPAL1 and FAM35A for the renal underexcretion gout subtype. While NIPAL1 encodes a magnesium transporter, functional analysis did not detect urate transport via NIPAL1, suggesting an indirect association with urate handling. Localisation analysis in the human kidney revealed expression of NIPAL1 and FAM35A mainly in the distal tubules, which suggests the involvement of the distal nephron in urate handling in humans. Clinically ascertained male patients with gout and controls of Caucasian and Polynesian ancestries were also genotyped, and FAM35A was associated with gout in all cases. A meta-analysis of the three populations revealed FAM35A to be associated with gout at a genome-wide level of significance (p meta =3.58×10 -8 ). Our findings including novel gout risk loci provide further understanding of the molecular pathogenesis of gout and lead to a novel concept for the therapeutic target of gout/hyperuricaemia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. Novel global robust stability criteria for interval neural networks with multiple time-varying delays

    Xu Shengyuan; Lam, James; Ho, Daniel W.C.

    2005-01-01

    This Letter is concerned with the problem of robust stability analysis for interval neural networks with multiple time-varying delays and parameter uncertainties. The parameter uncertainties are assumed to be bounded in given compact sets and the activation functions are supposed to be bounded and globally Lipschitz continuous. A sufficient condition is obtained by means of Lyapunov functionals, which guarantees the existence, uniqueness and global asymptotic stability of the delayed neural network for all admissible uncertainties. This condition is in terms of a linear matrix inequality (LMI), which can be easily checked by using recently developed algorithms in solving LMIs. Finally, a numerical example is provided to demonstrate the effectiveness of the proposed method

  8. Estimation of taxa included in the first volume of the Red Data Book of the Republic of Mordovia (Russia using the IUCN Red List Categories and Criteria

    Anatoliy A. Khapugin

    2017-05-01

    Full Text Available The paper presents an estimation of taxa included in the first volume of the Red Data Book of the Republic of Mordovia using the IUCN Red List Categories and Criteria. Each taxon is provided by a category and all criteria appropriate for it within the region. The paper contains the estimation results of 177 taxa of vascular plants, mosses and algae from the first volume Red Data Book of the Republic of Mordovia (second edition. Of these, 137 are Threatened: 73 taxa are Critically Endangered (category CR, 41 taxa Endangered (category EN, 23 are Vulnerable (category VU, 31 taxa are Near Threatened (category NT. Nine taxa are in the category Data Deficient (DD, due to a lack of sufficient factual material needed for the evaluation. Another 59 taxa of the Red Data Book of the Republic of Mordovia (35 macromycetes and 24 lichens were not evaluated in the present study, also due to the lack of sufficient data needed for an evaluation. Therefore, these taxa are temporarily in the category Not Evaluated (NE. But they could be assigned to one of the threatened categories when evaluated in the future, according to the Guidelines for Application of IUCN Red List Criteria. This paper is considered as a base for establishing the Red List of plant taxa of the Republic of Mordovia in the future.

  9. Bioactive conformational generation of small molecules: A comparative analysis between force-field and multiple empirical criteria based methods

    Jiang Hualiang

    2010-11-01

    Full Text Available Abstract Background Conformational sampling for small molecules plays an essential role in drug discovery research pipeline. Based on multi-objective evolution algorithm (MOEA, we have developed a conformational generation method called Cyndi in the previous study. In this work, in addition to Tripos force field in the previous version, Cyndi was updated by incorporation of MMFF94 force field to assess the conformational energy more rationally. With two force fields against a larger dataset of 742 bioactive conformations of small ligands extracted from PDB, a comparative analysis was performed between pure force field based method (FFBM and multiple empirical criteria based method (MECBM hybrided with different force fields. Results Our analysis reveals that incorporating multiple empirical rules can significantly improve the accuracy of conformational generation. MECBM, which takes both empirical and force field criteria as the objective functions, can reproduce about 54% (within 1Å RMSD of the bioactive conformations in the 742-molecule testset, much higher than that of pure force field method (FFBM, about 37%. On the other hand, MECBM achieved a more complete and efficient sampling of the conformational space because the average size of unique conformations ensemble per molecule is about 6 times larger than that of FFBM, while the time scale for conformational generation is nearly the same as FFBM. Furthermore, as a complementary comparison study between the methods with and without empirical biases, we also tested the performance of the three conformational generation methods in MacroModel in combination with different force fields. Compared with the methods in MacroModel, MECBM is more competitive in retrieving the bioactive conformations in light of accuracy but has much lower computational cost. Conclusions By incorporating different energy terms with several empirical criteria, the MECBM method can produce more reasonable conformational

  10. A Hybrid Multiple Criteria Group Decision-Making Approach for Green Supplier Selection in the TFT-LCD Industry

    Che-Wei Tsui

    2014-01-01

    Full Text Available The awareness of the need for environmental protection is increasing throughout the world. The focuses of green supplier selection are on considering environmental criteria and strengthening the competitiveness of the entire supply chain. The purpose of this study is to develop a green supplier selection procedure for the thin film transistor liquid crystal display (TFT-LCD industry using polarizer suppliers as an example. First, a decision framework for green supplier selection is developed based on literatures and the supplier audit forms provided by an anonymous flat panel display manufacturer in Taiwan. Then, a hybrid multiple criteria group decision-making (MCGDM method is proposed based on analytic hierarchy process (AHP, entropy, elimination and choice expressing the reality III (ELECTRE III, and the linear assignment method to assist the manufacturer in choosing among four polarizer suppliers. The final ranking results for green supplier selection and different opinions from each department are provided. An improvement report is suggested to enhance suppliers’ performance. For the evaluation procedure, most managers emphasize the importance of current capability and the capability of research and development. Furthermore, we found that the subsidiary supplier should improve quality control competence immediately to be considered as the potential candidate of primary supplier.

  11. Nontypeable pneumococci can be divided into multiple cps types, including one type expressing the novel gene pspK.

    Park, In Ho; Kim, Kyung-Hyo; Andrade, Ana Lucia; Briles, David E; McDaniel, Larry S; Nahm, Moon H

    2012-01-01

    Although virulence of Streptococcus pneumoniae is associated with its capsule, some pathogenic S. pneumoniae isolates lack capsules and are serologically nontypeable (NT). We obtained 64 isolates that were identified as NT "pneumococci" (i.e., bacteria satisfying the conventional definition but without the multilocus sequence typing [MLST]-based definition of S. pneumoniae) by the traditional criteria. All 64 were optochin sensitive and had lytA, and 63 had ply. Twelve isolates had cpsA, suggesting the presence of a conventional but defective capsular polysaccharide synthesis (cps) locus. The 52 cpsA-negative isolates could be divided into three null capsule clades (NCC) based on aliC (aliB-like ORF1), aliD (aliB-like ORF2), and our newly discovered gene, pspK, in their cps loci. pspK encodes a protein with a long alpha-helical region containing an LPxTG motif and a YPT motif known to bind human pIgR. There were nine isolates in NCC1 (pspK(+) but negative for aliC and aliD), 32 isolates in NCC2 (aliC(+) aliD(+) but negative for pspK), and 11 in NCC3 (aliD(+) but negative for aliC and pspK). Among 52 cpsA-negative isolates, 41 were identified as S. pneumoniae by MLST analysis. All NCC1 and most NCC2 isolates were S. pneumoniae, whereas all nine NCC3 and two NCC2 isolates were not S. pneumoniae. Several NCC1 and NCC2 isolates from multiple individuals had identical MLST and cps regions, showing that unencapsulated S. pneumoniae can be infectious among humans. Furthermore, NCC1 and NCC2 S. pneumoniae isolates could colonize mice as well as encapsulated S. pneumoniae, although S. pneumoniae with an artificially disrupted cps locus did not. Moreover, an NCC1 isolate with pspK deletion did not colonize mice, suggesting that pspK is critical for colonization. Thus, PspK may provide pneumococci a means of surviving in the nasopharynx without capsule. IMPORTANCE The presence of a capsule is critical for many pathogenic bacteria, including pneumococci. Reflecting the

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

    Marsh, Kevin; IJzerman, Maarten Joost; Thokala, Praveen; Baltussen, Rob; Boysen, Meindert; Kalo, Zoltan; Longrenn, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Devlin, Nancy

    2016-01-01

    Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making. A set of techniques, known under the collective heading

  13. Multiple Criteria Decision Analysis for Health Care Decision Making—An Introduction: Report 1 of the ISPOR MCDA Emerging Good Practices Task Force

    Thokala, Praveen; Devlin, Nancy; Marsh, Kevin; Baltussen, Rob; Boysen, Meindert; Kalo, Zoltan; Longrenn, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; IJzerman, Maarten Joost

    2016-01-01

    Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting, objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making and a set of techniques, known under the collective heading

  14. A decision support system for mission-based ship routing considering multiple performance criteria

    Dong, You; Frangopol, Dan M.; Sabatino, Samantha

    2016-01-01

    It is crucial to evaluate the risk associated with marine vessels subjected to inclement weather and sea conditions when developing a decision support system for ship routing. The generalized decision making framework developed in this paper performs a variety of tasks, including, but not limited to quantifying the flexural and fatigue performance of ship structures and employing multi-attribute utility theory to evaluate ship mission performance. A structural reliability approach is utilized to compute the probability of failure considering the uncertainties in structural capacity and load effects; specifically, effects of flexural and fatigue damage are investigated. The expected repair cost, cumulative fatigue damage, total travel time, and carbon dioxide emissions associated with ship routing are considered as consequences within the risk assessment procedure adopted in this paper. Additionally, the decision maker’s risk attitude is integrated into the presented approach by employing utility theory. The presented methodology can assist decision makers in making informed decisions concerning ship routing. In order to illustrate its capabilities the approach is applied to the Joint High-speed Sealift Ship. - Highlights: • Multi-attribute utility theory is proposed for the ship routing decision making. • Spectral-based fatigue damage and repair loss are computed. • Travel time and CO_2 emissions are incorporated within the decision making process. • The attitude of the decision maker has significant effects on the utility value.

  15. Potential impact of the implementation of multiple-criteria decision analysis (MCDA) on the Polish pricing and reimbursement process of orphan drugs.

    Kolasa, Katarzyna; Zwolinski, Krzysztof M; Kalo, Zoltan; Hermanowski, Tomasz

    2016-03-10

    The objective of this study was to assess the potential impact of the implementation of multiple-criteria decision analysis (MCDA) on the Polish pricing and reimbursement (P&R) process with regard to orphan drugs. A four step approach was designed. Firstly, a systematic literature review was conducted to select the MCDA criteria. Secondly, a database of orphan drugs was established. Thirdly, health technology appraisals (HTA recommendations) were categorized and an MCDA appraisal was conducted. Finally, a comparison of HTA and MCDA outcomes was carried out. An MCDA outcome was considered positive if more than 50% of the maximum number of points was reached (base case). In the sensitivity analysis, 25% and 75% thresholds were tested as well. Out of 2242 publications, 23 full-text articles were included. The final MCDA tool consisted of ten criteria. In total, 27 distinctive drug-indication pairs regarding 21 drugs were used for the study. Six negative and 21 positive HTA recommendations were issued. In the base case, there were 19 positive MCDA outcomes. Of the 27 cases, there were 12 disagreements between the HTA and MCDA outcomes, the majority of which related to positive HTA guidance for negative MCDA outcomes. All drug-indication pairs with negative HTA recommendations were appraised positively in the MCDA framework. Economic details were available for 12 cases, of which there were 9 positive MCDA outcomes. Amongst the 12 drug-indication pairs, two were negatively appraised in the HTA process, with positive MCDA guidance, and two were appraised in the opposite direction. An MCDA approach may lead to different P&R outcomes compared to a standard HTA process. On the one hand, enrichment of the list of decision making criteria means further scrutiny of a given health technology and as such increases the odds of a negative P&R outcome. On the other hand, it may uncover additional values and as such increase the odds of positive P&R outcomes.

  16. Microvascular decompression for trigeminal neuralgia: comments on a series of 250 cases, including 10 patients with multiple sclerosis.

    Broggi, G; Ferroli, P; Franzini, A; Servello, D; Dones, I

    2000-01-01

    To examine surgical findings and results of microvascular decompression (MVD) for trigeminal neuralgia (TN), including patients with multiple sclerosis, to bring new insight about the role of microvascular compression in the pathogenesis of the disorder and the role of MVD in its treatment. Between 1990 and 1998, 250 patients affected by trigeminal neuralgia underwent MVD in the Department of Neurosurgery of the "Istituto Nazionale Neurologico C Besta" in Milan. Limiting the review to the period 1991-6, to exclude the "learning period" (the first 50 cases) and patients with less than 1 year follow up, surgical findings and results were critically analysed in 148 consecutive cases, including 10 patients with multiple sclerosis. Vascular compression of the trigeminal nerve was found in all cases. The recurrence rate was 15.3% (follow up 1-7 years, mean 38 months). In five of 10 patients with multiple sclerosis an excellent result was achieved (follow up 12-39 months, mean 24 months). Patients with TN for more than 84 months did significantly worse than those with a shorter history (p<0.05). There was no mortality and most complications occurred in the learning period. Surgical complications were not related to age of the patients. Aetiopathogenesis of trigeminal neuralgia remains a mystery. These findings suggest a common neuromodulatory role of microvascular compression in both patients with or without multiple sclerosis rather than a direct causal role. MVD was found to be a safe and effective procedure to relieve typical TN in patients of all ages. It should be proposed as first choice surgery to all patients affected by TN, even in selected cases with multiple sclerosis, to give them the opportunity of pain relief without sensory deficits.

  17. Multiple time-scale optimization scheduling for islanded microgrids including PV, wind turbine, diesel generator and batteries

    Xiao, Zhao xia; Nan, Jiakai; Guerrero, Josep M.

    2017-01-01

    A multiple time-scale optimization scheduling including day ahead and short time for an islanded microgrid is presented. In this paper, the microgrid under study includes photovoltaics (PV), wind turbine (WT), diesel generator (DG), batteries, and shiftable loads. The study considers the maximum...... efficiency operation area for the diesel engine and the cost of the battery charge/discharge cycle losses. The day-ahead generation scheduling takes into account the minimum operational cost and the maximum load satisfaction as the objective function. Short-term optimal dispatch is based on minimizing...

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

    Wen, Shihua; Zhang, Lanju; Yang, Bo

    2014-07-01

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

  19. Use of Multiple Linear Regression Models for Setting Water Quality Criteria for Copper: A Complementary Approach to the Biotic Ligand Model.

    Brix, Kevin V; DeForest, David K; Tear, Lucinda; Grosell, Martin; Adams, William J

    2017-05-02

    Biotic Ligand Models (BLMs) for metals are widely applied in ecological risk assessments and in the development of regulatory water quality guidelines in Europe, and in 2007 the United States Environmental Protection Agency (USEPA) recommended BLM-based water quality criteria (WQC) for Cu in freshwater. However, to-date, few states have adopted BLM-based Cu criteria into their water quality standards on a state-wide basis, which appears to be due to the perception that the BLM is too complicated or requires too many input variables. Using the mechanistic BLM framework to first identify key water chemistry parameters that influence Cu bioavailability, namely dissolved organic carbon (DOC), pH, and hardness, we developed Cu criteria using the same basic methodology used by the USEPA to derive hardness-based criteria but with the addition of DOC and pH. As an initial proof of concept, we developed stepwise multiple linear regression (MLR) models for species that have been tested over wide ranges of DOC, pH, and hardness conditions. These models predicted acute Cu toxicity values that were within a factor of ±2 in 77% to 97% of tests (5 species had adequate data) and chronic Cu toxicity values that were within a factor of ±2 in 92% of tests (1 species had adequate data). This level of accuracy is comparable to the BLM. Following USEPA guidelines for WQC development, the species data were then combined to develop a linear model with pooled slopes for each independent parameter (i.e., DOC, pH, and hardness) and species-specific intercepts using Analysis of Covariance. The pooled MLR and BLM models predicted species-specific toxicity with similar precision; adjusted R 2 and R 2 values ranged from 0.56 to 0.86 and 0.66-0.85, respectively. Graphical exploration of relationships between predicted and observed toxicity, residuals and observed toxicity, and residuals and concentrations of key input parameters revealed many similarities and a few key distinctions between the

  20. Reliability analysis of the auxiliary feedwater system of Angra-1 including common cause failures using the multiple greek letter model

    Lapa, Celso Marcelo Franklin.

    1996-05-01

    The use of redundancy to increase the reliability of industrial systems make them subject to the occurrence of common cause events. The industrial experience and the results of safety analysis studies have indicated that common cause failures are the main contributors to the unreliability of plants that have redundant systems, specially in nuclear power plants. In this Thesis procedures are developed in order to include the impact of common cause failures in the calculation of the top event occurrence probability of the Auxiliary Feedwater System in a typical two-loop Nuclear Power Plant (PWR). For this purpose the Multiple Greek Letter Model is used. (author). 14 refs., 10 figs., 11 tabs

  1. Location Study of Solar Thermal Power Plant in the State of Pernambuco Using Geoprocessing Technologies and Multiple-Criteria Analysis

    Verônica Wilma B. Azevêdo

    2017-07-01

    Full Text Available Solar Thermal Technology for the generation of electricity in large scale has been a reality in the world since the 1980s, when the first large-sized solar plants in the United States were introduced. Brazil presents great potential for the development of large-scale projects, although it is noted that the main barriers for the insertion of this technology in Brazilian market are the lack of incentives and goals and associated costs. In a way to contribute to the insertion of solar thermal technology in Brazil, this paper presents a macro-spatial approach, based on the use of Multiple-Criteria Decision Analysis and Geoprocessing, for the location of solar thermal power plants. The applied methodology for Pernambuco, located in the Northeast Region of Brazil, considered the implantation of parabolic trough solar power plant of 80 MW, operating only in solar mode, without heat storage. Based on performed analysis, it was confirmed that Pernambuco presents great potential for the installation of solar power plants, especially in the backlands of Pernambuco. Performed validations in the model demonstrate that the methodology attended the objective once the consistence between the assigned weights to the thematic layers, individually, and the final Map of site suitability were evidenced.

  2. Comparison and clinical utility evaluation of four multiple allergen simultaneous tests including two newly introduced fully automated analyzers

    John Hoon Rim

    2016-04-01

    Full Text Available Background: We compared the diagnostic performances of two newly introduced fully automated multiple allergen simultaneous tests (MAST analyzers with two conventional MAST assays. Methods: The serum samples from a total of 53 and 104 patients were tested for food panels and inhalant panels, respectively, in four analyzers including AdvanSure AlloScreen (LG Life Science, Korea, AdvanSure Allostation Smart II (LG Life Science, PROTIA Allergy-Q (ProteomeTech, Korea, and RIDA Allergy Screen (R-Biopharm, Germany. We compared not only the total agreement percentages but also positive propensities among four analyzers. Results: Evaluation of AdvanSure Allostation Smart II as upgraded version of AdvanSure AlloScreen revealed good concordance with total agreement percentages of 93.0% and 92.2% in food and inhalant panel, respectively. Comparisons of AdvanSure Allostation Smart II or PROTIA Allergy-Q with RIDA Allergy Screen also showed good concordance performance with positive propensities of two new analyzers for common allergens (Dermatophagoides farina and Dermatophagoides pteronyssinus. The changes of cut-off level resulted in various total agreement percentage fluctuations among allergens by different analyzers, although current cut-off level of class 2 appeared to be generally suitable. Conclusions: AdvanSure Allostation Smart II and PROTIA Allergy-Q presented favorable agreement performances with RIDA Allergy Screen, although positive propensities were noticed in common allergens. Keywords: Multiple allergen simultaneous test, Automated analyzer

  3. Failure Models and Criteria for FRP Under In-Plane or Three-Dimensional Stress States Including Shear Non-Linearity

    Pinho, Silvestre T.; Davila, C. G.; Camanho, P. P.; Iannucci, L.; Robinson, P.

    2005-01-01

    A set of three-dimensional failure criteria for laminated fiber-reinforced composites, denoted LaRC04, is proposed. The criteria are based on physical models for each failure mode and take into consideration non-linear matrix shear behaviour. The model for matrix compressive failure is based on the Mohr-Coulomb criterion and it predicts the fracture angle. Fiber kinking is triggered by an initial fiber misalignment angle and by the rotation of the fibers during compressive loading. The plane of fiber kinking is predicted by the model. LaRC04 consists of 6 expressions that can be used directly for design purposes. Several applications involving a broad range of load combinations are presented and compared to experimental data and other existing criteria. Predictions using LaRC04 correlate well with the experimental data, arguably better than most existing criteria. The good correlation seems to be attributable to the physical soundness of the underlying failure models.

  4. Compound K, a Ginsenoside Metabolite, Inhibits Colon Cancer Growth via Multiple Pathways Including p53-p21 Interactions

    Eugene B. Chang

    2013-01-01

    Full Text Available Compound K (20-O-beta-D-glucopyranosyl-20(S-protopanaxadiol, CK, an intestinal bacterial metabolite of ginseng protopanaxadiol saponins, has been shown to inhibit cell growth in a variety of cancers. However, the mechanisms are not completely understood, especially in colorectal cancer (CRC. A xenograft tumor model was used first to examine the anti-CRC effect of CK in vivo. Then, multiple in vitro assays were applied to investigate the anticancer effects of CK including antiproliferation, apoptosis and cell cycle distribution. In addition, a qPCR array and western blot analysis were executed to screen and validate the molecules and pathways involved. We observed that CK significantly inhibited the growth of HCT-116 tumors in an athymic nude mouse xenograft model. CK significantly inhibited the proliferation of human CRC cell lines HCT-116, SW-480, and HT-29 in a dose- and time-dependent manner. We also observed that CK induced cell apoptosis and arrested the cell cycle in the G1 phase in HCT-116 cells. The processes were related to the upregulation of p53/p21, FoxO3a-p27/p15 and Smad3, and downregulation of cdc25A, CDK4/6 and cyclin D1/3. The major regulated targets of CK were cyclin dependent inhibitors, including p21, p27, and p15. These results indicate that CK inhibits transcriptional activation of multiple tumor-promoting pathways in CRC, suggesting that CK could be an active compound in the prevention or treatment of CRC.

  5. Environmental guidelines for reuse of ash in civil engineering applications - including criteria for Sb and As; Miljoeriktlinjer foer askanvaendning i anlaeggningsbyggande - inklusive haltkriterier foer Sb och As

    Bendz, David; Wik, Ola (Swedish Geotechnical Inst., Linkoeping (Sweden)); Jones, Celia; Pettersson, Michael; Elert, Mark (Kemakta, Stockholm (Sweden))

    2009-07-15

    exposure scenarios including exposure pathways and points of compliance. Risk evaluation becomes an issue of comparing the estimated (-modeled) increased concentrations at specified target points with general human and environmental toxicological criteria. Guidelines have been calculated for two different types of constructions, with or without an impermeable (asphalt-) pavement that prevents rain water from infiltrating into the road. Also the possible exposure of intruding ground water has been taken into account. A set of ashes, for which data on total content and leachability was available in the ALLASKA and MALTE database, have been classified according to three categories of applications/situations. The results show that due to lack of data it could not be assessed whether naphthalene, bens(a)pyren and selen in ashes imply an insignificant risk or not. Cadmium, copper, chromium, mercury, molybdenum, nickel and zinc generally shows a large margin to the calculated guidelines for total content and leachability for most ashes. Thus, ashes in constructions constitute an acceptable risk with respect to these elements. Antimony and lead in ashes fall above the guideline values for leaching in some cases. The total content of arsenic in many ashes exceeds the guideline values when used in an unpaved construction even when taking the oral bioavailabity of arsenic in ashes in consideration. To a lesser extent this also holds for total content of lead. Accordingly, it can not be excluded that the reuse of some ashes in some applications may imply a certain risk. Spreading as dust, deposition on vegetables and the subsequent intake has reveled itself as an important exposure pathway. Little data, theory and models are available on dust generation and transport, the calculations made here are rough and conservative. Also, guidelines for the ash construction left in place in the post use phase are difficult to determine. The health risk associated with intake of vegetables and

  6. An application of multiple criteria decision-making techniques for ranking different national Iranian oil refining and distribution companies

    Ibrahim Nazari

    2012-10-01

    Full Text Available Performance measurement plays an essential role on management of governmental agencies especially when profitability is not the primary concern and we need to consider other important factors than profitability such as customer satisfaction, etc. In this paper, we propose a multi-criteria decision making method to rank different national Iranian oil refining and distribution companies. The proposed study of this paper uses six factors including per capita supply, energy cost, physical productivity of labor, staff participation, quality control inspection of stations and education per capita. The proposed study uses Entropy to find the relative importance of each criterion and TOPSIS to rank 37 alternatives based on cities and three regions. The results of the implementation of our method indicate that central regions close to capital city of the country maintains the highest ranking (0.9122 while southern regions maintains the lowest comes in the lowest priority (0.0569 and the northern region is in the middle (0.7635.

  7. Applicability of bioanalysis of multiple analytes in drug discovery and development: review of select case studies including assay development considerations.

    Srinivas, Nuggehally R

    2006-05-01

    The development of sound bioanalytical method(s) is of paramount importance during the process of drug discovery and development culminating in a marketing approval. Although the bioanalytical procedure(s) originally developed during the discovery stage may not necessarily be fit to support the drug development scenario, they may be suitably modified and validated, as deemed necessary. Several reviews have appeared over the years describing analytical approaches including various techniques, detection systems, automation tools that are available for an effective separation, enhanced selectivity and sensitivity for quantitation of many analytes. The intention of this review is to cover various key areas where analytical method development becomes necessary during different stages of drug discovery research and development process. The key areas covered in this article with relevant case studies include: (a) simultaneous assay for parent compound and metabolites that are purported to display pharmacological activity; (b) bioanalytical procedures for determination of multiple drugs in combating a disease; (c) analytical measurement of chirality aspects in the pharmacokinetics, metabolism and biotransformation investigations; (d) drug monitoring for therapeutic benefits and/or occupational hazard; (e) analysis of drugs from complex and/or less frequently used matrices; (f) analytical determination during in vitro experiments (metabolism and permeability related) and in situ intestinal perfusion experiments; (g) determination of a major metabolite as a surrogate for the parent molecule; (h) analytical approaches for universal determination of CYP450 probe substrates and metabolites; (i) analytical applicability to prodrug evaluations-simultaneous determination of prodrug, parent and metabolites; (j) quantitative determination of parent compound and/or phase II metabolite(s) via direct or indirect approaches; (k) applicability in analysis of multiple compounds in select

  8. A nonlinear model for fluid flow in a multiple-zone composite reservoir including the quadratic gradient term

    Wang, Xiao-Lu; Fan, Xiang-Yu; Nie, Ren-Shi; Huang, Quan-Hua; He, Yong-Ming

    2013-01-01

    Based on material balance and Darcy's law, the governing equation with the quadratic pressure gradient term was deduced. Then the nonlinear model for fluid flow in a multiple-zone composite reservoir including the quadratic gradient term was established and solved using a Laplace transform. A series of standard log–log type curves of 1-zone (homogeneous), 2-zone and 3-zone reservoirs were plotted and nonlinear flow characteristics were analysed. The type curves governed by the coefficient of the quadratic gradient term (β) gradually deviate from those of a linear model with time elapsing. Qualitative and quantitative analyses were implemented to compare the solutions of the linear and nonlinear models. The results showed that differences of pressure transients between the linear and nonlinear models increase with elapsed time and β. At the end, a successful application of the theoretical model data against the field data shows that the nonlinear model will be a good tool to evaluate formation parameters more accurately. (paper)

  9. Enhanced peripheral visual processing in congenitally deaf humans is supported by multiple brain regions, including primary auditory cortex

    Gregory D. Scott

    2014-03-01

    Full Text Available Brain reorganization associated with altered sensory experience clarifies the critical role of neuroplasticity in development. An example is enhanced peripheral visual processing associated with congenital deafness, but the neural systems supporting this have not been fully characterized. A gap in our understanding of deafness-enhanced peripheral vision is the contribution of primary auditory cortex. Previous studies of auditory cortex that use anatomical normalization across participants were limited by inter-subject variability of Heschl’s gyrus. In addition to reorganized auditory cortex (cross-modal plasticity, a second gap in our understanding is the contribution of altered modality-specific cortices (visual intramodal plasticity in this case, as well as supramodal and multisensory cortices, especially when target detection is required across contrasts. Here we address these gaps by comparing fMRI signal change for peripheral versus perifoveal visual stimulation (11-15° vs. 2°-7° in congenitally deaf and hearing participants in a blocked experimental design with two analytical approaches: a Heschl’s gyrus region of interest analysis and a whole brain analysis. Our results using individually-defined primary auditory cortex (Heschl’s gyrus indicate that fMRI signal change for more peripheral stimuli was greater than perifoveal in deaf but not in hearing participants. Whole-brain analyses revealed differences between deaf and hearing participants for peripheral versus perifoveal visual processing in extrastriate visual cortex including primary auditory cortex, MT+/V5, superior-temporal auditory and multisensory and/or supramodal regions, such as posterior parietal cortex, frontal eye fields, anterior cingulate, and supplementary eye fields. Overall, these data demonstrate the contribution of neuroplasticity in multiple systems including primary auditory cortex, supramodal and multisensory regions, to altered visual processing in

  10. Klotho: a humeral mediator in CSF and plasma that influences longevity and susceptibility to multiple complex disorders, including depression.

    Pavlatou, M G; Remaley, A T; Gold, P W

    2016-08-30

    Klotho is a hormone secreted into human cerebrospinal fluid (CSF), plasma and urine that promotes longevity and influences the onset of several premature senescent phenotypes in mice and humans, including atherosclerosis, cardiovascular disease, stroke and osteoporosis. Preliminary studies also suggest that Klotho possesses tumor suppressor properties. Klotho's roles in these phenomena were first suggested by studies demonstrating that a defect in the Klotho gene in mice results in a significant decrease in lifespan. The Klotho-deficient mouse dies prematurely at 8-9 weeks of age. At 4-5 weeks of age, a syndrome resembling human ageing emerges consisting of atherosclerosis, osteoporosis, cognitive disturbances and alterations of hippocampal architecture. Several deficits in Klotho-deficient mice are likely to contribute to these phenomena. These include an inability to defend against oxidative stress in the central nervous system and periphery, decreased capacity to generate nitric oxide to sustain normal endothelial reactivity, defective Klotho-related mediation of glycosylation and ion channel regulation, increased insulin/insulin-like growth factor signaling and a disturbed calcium and phosphate homeostasis accompanied by altered vitamin D levels and ectopic calcification. Identifying the mechanisms by which Klotho influences multiple important pathways is an emerging field in human biology that will contribute significantly to understanding basic physiologic processes and targets for the treatment of complex diseases. Because many of the phenomena seen in Klotho-deficient mice occur in depressive illness, major depression and bipolar disorder represent illnesses potentially associated with Klotho dysregulation. Klotho's presence in CSF, blood and urine should facilitate its study in clinical populations.

  11. Mortality from Musculoskeletal Disorders Including Rheumatoid Arthritis in Southern Sweden: A Multiple-cause-of-death Analysis, 1998-2014.

    Kiadaliri, Aliasghar A; Turkiewicz, Aleksandra; Englund, Martin

    2017-05-01

    To assess mortality related to musculoskeletal (MSK) disorders and rheumatoid arthritis (RA), specifically, among adults (aged ≥ 20 yrs) in southern Sweden using the multiple-cause-of-death approach. All death certificates (DC; n = 201,488) from 1998 to 2014 for adults in the region of Skåne were analyzed when mortality from MSK disorders and RA was listed as the underlying and nonunderlying cause of death (UCD/NUCD). Trends in age-standardized mortality rates (ASMR) were evaluated using joinpoint regression, and associated causes were identified by age- and sex-adjusted observed/expected ratios. MSK (RA) was mentioned on 2.8% (0.8%) of all DC and selected as UCD in 0.6% (0.2%), with higher values among women. Proportion of MSK disorder deaths from all deaths increased from 2.7% in 1998 to 3.1% in 2014, and declined from 0.9% to 0.5% for RA. The mean age at death was higher in DC with mention of MSK/RA than in DC without. The mean ASMR for MSK (RA) was 15.5 (4.3) per 100,000 person-years and declined by 1.1% (3.8%) per year during 1998-2014. When MSK/RA were UCD, pneumonia and heart failure were the main NUCD. When MSK/RA were NUCD, the leading UCD were ischemic heart disease and neoplasms. The greatest observed/expected ratios were seen for infectious diseases (including sepsis) and blood diseases. We observed significant reduction in MSK and RA mortality rates and increase in the mean age at death. Further analyses are required to investigate determinants of these improvements in MSK/RA survival and their potential effect on the Swedish healthcare systems.

  12. A fuzzy approach to a multiple criteria and geographical information system for decision support on suitable locations for biogas plants

    Franco de los Rios, Camilo Andres; Bojesen, Mikkel; Hougaard, Jens Leth

    The purpose of this paper is to model the multi-criteria decision problem of identifying the most suitable facility locations for biogas plants under an integrated decision support methodology. Here the Geographical Information System (GIS) is used for measuring the attributes of the alternatives...... according to a given set of criteria. Measurements are taken in interval form, expressing the natural imprecision of common data, and the Fuzzy Weighted Overlap Dominance (FWOD) procedure is applied for aggregating and exploiting this kind of data, obtaining suitability degrees for every alternative....... The estimation of criteria weights, which is necessary for applying the FWOD procedure, is done by means of the Analytical Hierarchy Process (AHP), such that a combined AHP-FWOD methodology allows identifying the more suitable sites for building biogas plants. We show that the FWOD relevance-ranking procedure...

  13. Criteria CSR

    Vovk, V.; Zateyshikova, O.

    2014-01-01

    In the article the theoretical aspects regarding criteria for assessing CSR proposed by A. Carroll, including: economic, legal, ethical, philanthropic. Based on this, it is proposed to characterize these criteria with respect to the interested parties (stakeholders), including: investors, shareholders suppliers, customers, employees, society and the state. This will make a qualitative assessment of the presence and depth using social responsibility in the company, as well as determine the ext...

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

    Filippi, Massimo; Preziosa, Paolo; Meani, Alessandro

    2018-01-01

    of the distinction between symptomatic and asymptomatic lesions was suggested. We compared the performance of the 2010 McDonald and 2016 MAGNIMS criteria for multiple sclerosis diagnosis in a large multicentre cohort of patients with CIS to provide evidence to guide revisions of multiple sclerosis diagnostic......, 2017, 571 patients with CIS were screened, of whom 368 met all study inclusion criteria. At the last evaluation (median 50·0 months [IQR 27·0-78·4]), 189 (51%) of 368 patients developed clinically definite multiple sclerosis. At 36 months, the two DIS criteria showed high sensitivity (2010 McDonald 0......·32-0·50], and similar AUC (0·63 [0·57-0·68]). Inclusion of optic nerve evaluation resulted in similar sensitivity (0·92 [0·87-0·96]), and slightly lower specificity (0·26 [0·18-0·34]) and AUC (0·59 [0·55-0·64]). AUC values were also similar for DIT (2010 McDonald 0·61 [0·55-0·67] and 2016 MAGNIMS 0·61 [0...

  15. Value-Based Assessment of New Medical Technologies: Towards a Robust Methodological Framework for the Application of Multiple Criteria Decision Analysis in the Context of Health Technology Assessment.

    Angelis, Aris; Kanavos, Panos

    2016-05-01

    In recent years, multiple criteria decision analysis (MCDA) has emerged as a likely alternative to address shortcomings in health technology assessment (HTA) by offering a more holistic perspective to value assessment and acting as an alternative priority setting tool. In this paper, we argue that MCDA needs to subscribe to robust methodological processes related to the selection of objectives, criteria and attributes in order to be meaningful in the context of healthcare decision making and fulfil its role in value-based assessment (VBA). We propose a methodological process, based on multi-attribute value theory (MAVT) methods comprising five distinct phases, outline the stages involved in each phase and discuss their relevance in the HTA process. Importantly, criteria and attributes need to satisfy a set of desired properties, otherwise the outcome of the analysis can produce spurious results and misleading recommendations. Assuming the methodological process we propose is adhered to, the application of MCDA presents three very distinct advantages to decision makers in the context of HTA and VBA: first, it acts as an instrument for eliciting preferences on the performance of alternative options across a wider set of explicit criteria, leading to a more complete assessment of value; second, it allows the elicitation of preferences across the criteria themselves to reflect differences in their relative importance; and, third, the entire process of preference elicitation can be informed by direct stakeholder engagement, and can therefore reflect their own preferences. All features are fully transparent and facilitate decision making.

  16. Notes on 'Hit-And-Run enables efficient weight generation for simulation-based multiple criteria decision analysis'

    van Valkenhoef, Gert; Tervonen, Tommi; Postmus, Douwe

    2014-01-01

    In our previous work published in this journal, we showed how the Hit-And-Run (HAR) procedure enables efficient sampling of criteria weights from a space formed by restricting a simplex with arbitrary linear inequality constraints. In this short communication, we note that the method for generating

  17. Auxiliary variables in multiple imputation in regression with missing X: a warning against including too many in small sample research

    Hardt Jochen

    2012-12-01

    Full Text Available Abstract Background Multiple imputation is becoming increasingly popular. Theoretical considerations as well as simulation studies have shown that the inclusion of auxiliary variables is generally of benefit. Methods A simulation study of a linear regression with a response Y and two predictors X1 and X2 was performed on data with n = 50, 100 and 200 using complete cases or multiple imputation with 0, 10, 20, 40 and 80 auxiliary variables. Mechanisms of missingness were either 100% MCAR or 50% MAR + 50% MCAR. Auxiliary variables had low (r=.10 vs. moderate correlations (r=.50 with X’s and Y. Results The inclusion of auxiliary variables can improve a multiple imputation model. However, inclusion of too many variables leads to downward bias of regression coefficients and decreases precision. When the correlations are low, inclusion of auxiliary variables is not useful. Conclusion More research on auxiliary variables in multiple imputation should be performed. A preliminary rule of thumb could be that the ratio of variables to cases with complete data should not go below 1 : 3.

  18. iStimulation: Apple iPad Use with Children Who Are Visually Impaired, Including Those with Multiple Disabilities

    Campaña, Laura V.; Ouimet, Donald A.

    2015-01-01

    Since its creation in the early 1980s, Light Box, a product developed by the American Printing House for the Blind (APH) that is designed for working on functional vision tasks with children who have visual impairments or multiple disabilities, has been an effective tool to help teach children with visual impairments to locate and track items…

  19. A fuzzy approach to a multiple criteria and Geographical Information System for decision support on suitable locations for biogas plants

    Franco, Camilo; Bojesen, Mikkel; Hougaard, Jens Leth

    2015-01-01

    The purpose of this paper is to model the multi-criteria decision problem of identifying the most suitable facility locations for biogas plants under an integrated decision support methodology. Here the Geographical Information System (GIS) is used for measuring the attributes of the alternatives...... according to a given set of criteria. Measurements are taken in interval form, expressing the natural imprecision of common data, and the Fuzzy Weighted Overlap Dominance (FWOD) procedure is applied for aggregating and exploiting this kind of data, obtaining suitability degrees for every alternative...... suitable sites for building biogas plants. We show that the FWOD relevance-ranking procedure can also be successfully applied over the outcomes of different decision makers, in case a unique social solution is required to exist. The proposed methodology can be used under an integrated decision support...

  20. A multiple criteria decision making for raking alternatives using preference relation matrix based on intuitionistic fuzzy sets

    Mehdi Bahramloo

    2013-10-01

    Full Text Available Ranking various alternatives has been under investigation and there are literally various methods and techniques for making a decision based on various criteria. One of the primary concerns on ranking methodologies such as analytical hierarchy process (AHP is that decision makers cannot express his/her feeling in crisp form. Therefore, we need to use linguistic terms to receive the relative weights for comparing various alternatives. In this paper, we discuss ranking different alternatives based on the implementation of preference relation matrix based on intuitionistic fuzzy sets.

  1. The multi-criteria optimization for the formation of the multiple-valued logic model of a robotic agent

    Bykovsky, A Yu; Sherbakov, A A

    2016-01-01

    The C-valued Allen-Givone algebra is the attractive tool for modeling of a robotic agent, but it requires the consensus method of minimization for the simplification of logic expressions. This procedure substitutes some undefined states of the function for the maximal truth value, thus extending the initially given truth table. This further creates the problem of different formal representations for the same initially given function. The multi-criteria optimization is proposed for the deliberate choice of undefined states and model formation. (paper)

  2. Handling the Multiplicity of Solutions in a Moea Based PDA-THESEUS Framework for Multi-Criteria Sorting

    Covantes Edgar

    2016-11-01

    Full Text Available This paper proposes the combination of the THESEUS multi-criteria sorting method with an evolutionary optimization-based preference-disaggregation analysis. The main features of the combined method are studied by performing an extensive computer experiment that explores many models of preferences and sizes of problems as well as different degrees of decision-maker involvement. As a result of the experiment, the effectiveness of the combined framework and the importance of the decision-maker’s involvement are characterized.

  3. The effects of performance criteria including accounting, market, and economy on the quality of financial reporting: A case study on Tehran Stock Exchange

    Mohammad Mahdi Hosseini

    2013-01-01

    Full Text Available This research studies the effects of performance criteria (accounting, market and economy on the quality of financial reporting in Iran. To evaluate the variable financial reporting quality, the scores given to each company are applied based on the checklist introduced by Iranian Association of Certified Public Accountants and used for the disclosure of the information of the annual financial statements of companies. The statistical population of this research consists of the companies listed on Tehran Stock Exchange over the period 2006-2011. This research, which is classified as applied research, uses the methods of multivariate regression test. The data and hypotheses of this research are analyzed and tested using correlation test and means difference test. The results of the tests conducted on 99 companies indicate that there is a significant and positive relation between the rate of return on equity and the equality of financial reporting. There is also a significant and positive relation between earnings per share and the equality of financial reporting. However, there is no relationship between QTOBIN and the equality of financial reporting. Finally, our results indicate there is a significant and positive relation between market value-added and the equality of financial reporting.

  4. A comparison of perinatal outcomes in singletons and multiples born after IVF or ICSI, stratified for neonatal risk criteria

    van Heesch, Mirjam M. J.; Evers, Johannes L. H.; Dumoulin, John C. M.; van der Hoeven, Mark A. H. B. M.; van Beijsterveldt, Catharina E. M.; Bonsel, Gouke J.; Dykgraaf, Ramon H. M.; van Goudoever, Johannes B.; Koopman-Esseboom, Corine; Nelen, Willianne L. D. M.; Steiner, Katerina; Tamminga, Pieter; Tonch, Nino; van Zonneveld, Piet; Dirksen, Carmen D.

    2014-01-01

    To compare perinatal singleton and multiple outcomes in a large Dutch in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) population and within risk subgroups. Newborns were assigned to a risk category based on gestational age, birthweight, Apgar score and congenital malformation.

  5. Ca analysis: an Excel based program for the analysis of intracellular calcium transients including multiple, simultaneous regression analysis.

    Greensmith, David J

    2014-01-01

    Here I present an Excel based program for the analysis of intracellular Ca transients recorded using fluorescent indicators. The program can perform all the necessary steps which convert recorded raw voltage changes into meaningful physiological information. The program performs two fundamental processes. (1) It can prepare the raw signal by several methods. (2) It can then be used to analyze the prepared data to provide information such as absolute intracellular Ca levels. Also, the rates of change of Ca can be measured using multiple, simultaneous regression analysis. I demonstrate that this program performs equally well as commercially available software, but has numerous advantages, namely creating a simplified, self-contained analysis workflow. Copyright © 2013 The Author. Published by Elsevier Ireland Ltd.. All rights reserved.

  6. Ca analysis: An Excel based program for the analysis of intracellular calcium transients including multiple, simultaneous regression analysis☆

    Greensmith, David J.

    2014-01-01

    Here I present an Excel based program for the analysis of intracellular Ca transients recorded using fluorescent indicators. The program can perform all the necessary steps which convert recorded raw voltage changes into meaningful physiological information. The program performs two fundamental processes. (1) It can prepare the raw signal by several methods. (2) It can then be used to analyze the prepared data to provide information such as absolute intracellular Ca levels. Also, the rates of change of Ca can be measured using multiple, simultaneous regression analysis. I demonstrate that this program performs equally well as commercially available software, but has numerous advantages, namely creating a simplified, self-contained analysis workflow. PMID:24125908

  7. Stepped-wedge cluster randomised controlled trials: a generic framework including parallel and multiple-level designs.

    Hemming, Karla; Lilford, Richard; Girling, Alan J

    2015-01-30

    Stepped-wedge cluster randomised trials (SW-CRTs) are being used with increasing frequency in health service evaluation. Conventionally, these studies are cross-sectional in design with equally spaced steps, with an equal number of clusters randomised at each step and data collected at each and every step. Here we introduce several variations on this design and consider implications for power. One modification we consider is the incomplete cross-sectional SW-CRT, where the number of clusters varies at each step or where at some steps, for example, implementation or transition periods, data are not collected. We show that the parallel CRT with staggered but balanced randomisation can be considered a special case of the incomplete SW-CRT. As too can the parallel CRT with baseline measures. And we extend these designs to allow for multiple layers of clustering, for example, wards within a hospital. Building on results for complete designs, power and detectable difference are derived using a Wald test and obtaining the variance-covariance matrix of the treatment effect assuming a generalised linear mixed model. These variations are illustrated by several real examples. We recommend that whilst the impact of transition periods on power is likely to be small, where they are a feature of the design they should be incorporated. We also show examples in which the power of a SW-CRT increases as the intra-cluster correlation (ICC) increases and demonstrate that the impact of the ICC is likely to be smaller in a SW-CRT compared with a parallel CRT, especially where there are multiple levels of clustering. Finally, through this unified framework, the efficiency of the SW-CRT and the parallel CRT can be compared. © 2014 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

  8. Nonadiabatic dynamics of electron transfer in solution: Explicit and implicit solvent treatments that include multiple relaxation time scales

    Schwerdtfeger, Christine A.; Soudackov, Alexander V.; Hammes-Schiffer, Sharon

    2014-01-01

    The development of efficient theoretical methods for describing electron transfer (ET) reactions in condensed phases is important for a variety of chemical and biological applications. Previously, dynamical dielectric continuum theory was used to derive Langevin equations for a single collective solvent coordinate describing ET in a polar solvent. In this theory, the parameters are directly related to the physical properties of the system and can be determined from experimental data or explicit molecular dynamics simulations. Herein, we combine these Langevin equations with surface hopping nonadiabatic dynamics methods to calculate the rate constants for thermal ET reactions in polar solvents for a wide range of electronic couplings and reaction free energies. Comparison of explicit and implicit solvent calculations illustrates that the mapping from explicit to implicit solvent models is valid even for solvents exhibiting complex relaxation behavior with multiple relaxation time scales and a short-time inertial response. The rate constants calculated for implicit solvent models with a single solvent relaxation time scale corresponding to water, acetonitrile, and methanol agree well with analytical theories in the Golden rule and solvent-controlled regimes, as well as in the intermediate regime. The implicit solvent models with two relaxation time scales are in qualitative agreement with the analytical theories but quantitatively overestimate the rate constants compared to these theories. Analysis of these simulations elucidates the importance of multiple relaxation time scales and the inertial component of the solvent response, as well as potential shortcomings of the analytical theories based on single time scale solvent relaxation models. This implicit solvent approach will enable the simulation of a wide range of ET reactions via the stochastic dynamics of a single collective solvent coordinate with parameters that are relevant to experimentally accessible

  9. The contact-temperature ignition (CTI) criteria for propagating chemical reactions including the effect of moisture and application to Hanford waste

    Cash, R.J.

    1995-01-01

    To assure the continued absence of uncontrolled condensed-phase chemical reactions in connection with the Hanford waste materials, efforts have been underway including both theoretical and experimental investigations to clarify the requirements for such reactions. This document defines the differences and requirements for homogeneous runaway and propagating chemical reactions incuding a discussion of general contact-temperature ignition (CTI) condition for propagating reactions that include the effect of moisture. The CTI condition implies that the contact temperature or interface temperature between reacted and unreacted materials must exceed the ignition temperature and is compared to experimental data including both synthetic ferrocyanide and surrogate organic materials. In all cases, the occurrences of ignition accompanied by self-propagating reactions are consistent with the theoretical anticipations of the CTI condition

  10. Improvement in genetic evaluation of female fertility in dairy cattle using multiple-trait models including milk production traits

    Sun, C; Madsen, P; Lund, M S

    2010-01-01

    This study investigated the improvement in genetic evaluation of fertility traits by using production traits as secondary traits (MILK = 305-d milk yield, FAT = 305-d fat yield, and PROT = 305-d protein yield). Data including 471,742 records from first lactations of Denmark Holstein cows, covering...... the years of inseminations during first lactations from 1995 to 2004, were analyzed. Six fertility traits (i.e., interval in days from calving to first insemination, calving interval, days open, interval in days from first to last insemination, numbers of inseminations per conception, and nonreturn rate...... stability and predictive ability than single-trait models for all the fertility traits, except for nonreturn rate within 56 d after first service. The stability and predictive ability for the model including MILK or PROT were similar to the model including all 3 milk production traits and better than...

  11. Study Modules for Calculus-Based General Physics. [Includes Modules 3-5: Planar Motion; Newton's Laws; and Vector Multiplication].

    Fuller, Robert G., Ed.; And Others

    This is part of a series of 42 Calculus Based Physics (CBP) modules totaling about 1,000 pages. The modules include study guides, practice tests, and mastery tests for a full-year individualized course in calculus-based physics based on the Personalized System of Instruction (PSI). The units are not intended to be used without outside materials;…

  12. Multiple Beneficial Lipids Including Lecithin Detected in the Edible Invasive Mollusk Crepidula fornicata from the French Northeastern Atlantic Coast

    Dagorn, Flore; Buzin, Florence; Couzinet-Mossion, Aurélie; Decottignies, Priscilla; Viau, Michèle; Rabesaotra, Vony; Barnathan, Gilles; Wielgosz-Collin, Gaëtane

    2014-01-01

    The invasive mollusk Crepidula fornicata, occurring in large amounts in bays along the French Northeastern Atlantic coasts, may have huge environmental effects in highly productive ecosystems where shellfish are exploited. The present study aims at determining the potential economic value of this marine species in terms of exploitable substances with high added value. Lipid content and phospholipid (PL) composition of this mollusk collected on the Bourgneuf Bay were studied through four seasons. Winter specimens contained the highest lipid levels (5.3% dry weight), including 69% of PLs. Phosphatidylcholine (PC) was the major PL class all year, accounting for 63.9% to 88.9% of total PLs. Consequently, the winter specimens were then investigated for PL fatty acids (FAs), and free sterols. Dimethylacetals (DMAs) were present (10.7% of PL FA + DMA mixture) revealing the occurrence of plasmalogens. More than forty FAs were identified, including 20:5n-3 (9.4%) and 22:6n-3 (7.3%) acids. Fourteen free sterols were present, including cholesterol at 31.3% of the sterol mixture and about 40% of phytosterols. These data on lipids of C. fornicata demonstrate their positive attributes for human nutrition and health. The PL mixture, rich in PC and polyunsaturated FAs, offers an interesting alternative source of high value-added marine lecithin. PMID:25532566

  13. Multiple beneficial lipids including lecithin detected in the edible invasive mollusk Crepidula fornicata from the French Northeastern Atlantic coast.

    Dagorn, Flore; Buzin, Florence; Couzinet-Mossion, Aurélie; Decottignies, Priscilla; Viau, Michèle; Rabesaotra, Vony; Barnathan, Gilles; Wielgosz-Collin, Gaëtane

    2014-12-22

    The invasive mollusk Crepidula fornicata, occurring in large amounts in bays along the French Northeastern Atlantic coasts, may have huge environmental effects in highly productive ecosystems where shellfish are exploited. The present study aims at determining the potential economic value of this marine species in terms of exploitable substances with high added value. Lipid content and phospholipid (PL) composition of this mollusk collected on the Bourgneuf Bay were studied through four seasons. Winter specimens contained the highest lipid levels (5.3% dry weight), including 69% of PLs. Phosphatidylcholine (PC) was the major PL class all year, accounting for 63.9% to 88.9% of total PLs. Consequently, the winter specimens were then investigated for PL fatty acids (FAs), and free sterols. Dimethylacetals (DMAs) were present (10.7% of PL FA + DMA mixture) revealing the occurrence of plasmalogens. More than forty FAs were identified, including 20:5n-3 (9.4%) and 22:6n-3 (7.3%) acids. Fourteen free sterols were present, including cholesterol at 31.3% of the sterol mixture and about 40% of phytosterols. These data on lipids of C. fornicata demonstrate their positive attributes for human nutrition and health. The PL mixture, rich in PC and polyunsaturated FAs, offers an interesting alternative source of high value-added marine lecithin.

  14. Applying Multiple Criteria Decision Analysis to Comparative Benefit-Risk Assessment : Choosing among Statins in Primary Prevention

    Tervonen, Tommi; Naci, Huseyin; van Valkenhoef, Gert; Ades, Anthony E.; Angelis, Aris; Hillege, Hans L.; Postmus, Douwe

    2015-01-01

    Decision makers in different health care settings need to weigh the benefits and harms of alternative treatment strategies. Such health care decisions include marketing authorization by regulatory agencies, practice guideline formulation by clinical groups, and treatment selection by prescribers and

  15. Evaluation and Comparison of Multiple Test Methods, Including Real-time PCR, for Legionella Detection in Clinical Specimens

    Peci, Adriana; Winter, Anne-Luise; Gubbay, Jonathan B.

    2016-01-01

    Legionella is a Gram-negative bacterium that can cause Pontiac fever, a mild upper respiratory infection and Legionnaire’s disease, a more severe illness. We aimed to compare the performance of urine antigen, culture, and polymerase chain reaction (PCR) test methods and to determine if sputum is an acceptable alternative to the use of more invasive bronchoalveolar lavage (BAL). Data for this study included specimens tested for Legionella at Public Health Ontario Laboratories from 1st January, 2010 to 30th April, 2014, as part of routine clinical testing. We found sensitivity of urinary antigen test (UAT) compared to culture to be 87%, specificity 94.7%, positive predictive value (PPV) 63.8%, and negative predictive value (NPV) 98.5%. Sensitivity of UAT compared to PCR was 74.7%, specificity 98.3%, PPV 77.7%, and NPV 98.1%. Out of 146 patients who had a Legionella-positive result by PCR, only 66 (45.2%) also had a positive result by culture. Sensitivity for culture was the same using either sputum or BAL (13.6%); sensitivity for PCR was 10.3% for sputum and 12.8% for BAL. Both sputum and BAL yield similar results regardless testing methods (Fisher Exact p-values = 1.0, for each test). In summary, all test methods have inherent weaknesses in identifying Legionella; therefore, more than one testing method should be used. Obtaining a single specimen type from patients with pneumonia limits the ability to diagnose Legionella, particularly when urine is the specimen type submitted. Given ease of collection and similar sensitivity to BAL, clinicians are encouraged to submit sputum in addition to urine when BAL submission is not practical from patients being tested for Legionella. PMID:27630979

  16. Evaluation and comparison of multiple test methods, including real-time PCR, for Legionella detection in clinical specimens.

    Adriana Peci

    2016-08-01

    Full Text Available Legionella is a gram-negative bacterium that can cause Pontiac fever, a mild upper respiratory infection and Legionnaire’s disease, a more severe illness. We aimed to compare the performance of urine antigen, culture and PCR test methods and to determine if sputum is an alternative to the use of more invasive bronchoalveolar lavage (BAL. Data for this study included specimens tested for Legionella at PHOL from January 1, 2010 to April 30, 2014, as part of routine clinical testing. We found sensitivity of UAT compared to culture to be 87%, specificity 94.7%, positive predictive value (PPV 63.8% and negative predictive value (NPV 98.5%. Sensitivity of UAT compared to PCR was 74.7%, specificity 98.3%, PPV 77.7% and NPV 98.1%. Of 146 patients who had a Legionella positive result by PCR, only 66(45.2% also had a positive result by culture. Sensitivity for culture was the same using either sputum or BAL (13.6%; sensitivity for PCR was 10.3% for sputum and 12.8% for BAL. Both sputum and BAL yield similar results despite testing methods (Fisher Exact p-values=1.0, for each test. In summary, all test methods have inherent weaknesses in identifying Legionella; thereforemore than one testing method should be used. Obtaining a single specimen type from patients with pneumonia limits the ability to diagnose Legionella, particularly when urine is the specimen type submitted. Given ease of collection, and similar sensitivity to BAL, clinicians are encouraged to submit sputum in addition to urine when BAL submission is not practical, from patients being tested for Legionella.

  17. Airborne electromagnetic detection of shallow seafloor topographic features, including resolution of multiple sub-parallel seafloor ridges

    Vrbancich, Julian; Boyd, Graham

    2014-05-01

    The HoistEM helicopter time-domain electromagnetic (TEM) system was flown over waters in Backstairs Passage, South Australia, in 2003 to test the bathymetric accuracy and hence the ability to resolve seafloor structure in shallow and deeper waters (extending to ~40 m depth) that contain interesting seafloor topography. The topography that forms a rock peak (South Page) in the form of a mini-seamount that barely rises above the water surface was accurately delineated along its ridge from the start of its base (where the seafloor is relatively flat) in ~30 m water depth to its peak at the water surface, after an empirical correction was applied to the data to account for imperfect system calibration, consistent with earlier studies using the same HoistEM system. A much smaller submerged feature (Threshold Bank) of ~9 m peak height located in waters of 35 to 40 m depth was also accurately delineated. These observations when checked against known water depths in these two regions showed that the airborne TEM system, following empirical data correction, was effectively operating correctly. The third and most important component of the survey was flown over the Yatala Shoals region that includes a series of sub-parallel seafloor ridges (resembling large sandwaves rising up to ~20 m from the seafloor) that branch out and gradually decrease in height as the ridges spread out across the seafloor. These sub-parallel ridges provide an interesting topography because the interpreted water depths obtained from 1D inversion of TEM data highlight the limitations of the EM footprint size in resolving both the separation between the ridges (which vary up to ~300 m) and the height of individual ridges (which vary up to ~20 m), and possibly also the limitations of assuming a 1D model in areas where the topography is quasi-2D/3D.

  18. Biallelic germline and somatic mutations in malignant mesothelioma: multiple mutations in transcription regulators including mSWI/SNF genes.

    Yoshikawa, Yoshie; Sato, Ayuko; Tsujimura, Tohru; Otsuki, Taiichiro; Fukuoka, Kazuya; Hasegawa, Seiki; Nakano, Takashi; Hashimoto-Tamaoki, Tomoko

    2015-02-01

    We detected low levels of acetylation for histone H3 tail lysines in malignant mesothelioma (MM) cell lines resistant to histone deacetylase inhibitors. To identify the possible genetic causes related to the low histone acetylation levels, whole-exome sequencing was conducted with MM cell lines established from eight patients. A mono-allelic variant of BRD1 was common to two MM cell lines with very low acetylation levels. We identified 318 homozygous protein-damaging variants/mutations (18-78 variants/mutations per patient); annotation analysis showed enrichment of the molecules associated with mammalian SWI/SNF (mSWI/SNF) chromatin remodeling complexes and co-activators that facilitate initiation of transcription. In seven of the patients, we detected a combination of variants in histone modifiers or transcription factors/co-factors, in addition to variants in mSWI/SNF. Direct sequencing showed that homozygous mutations in SMARCA4, PBRM1 and ARID2 were somatic. In one patient, homozygous germline variants were observed for SMARCC1 and SETD2 in chr3p22.1-3p14.2. These exhibited extended germline homozygosity and were in regions containing somatic mutations, leading to a loss of BAP1 and PBRM1 expression in MM cell line. Most protein-damaging variants were heterozygous in normal tissues. Heterozygous germline variants were often converted into hemizygous variants by mono-allelic deletion, and were rarely homozygous because of acquired uniparental disomy. Our findings imply that MM might develop through the somatic inactivation of mSWI/SNF complex subunits and/or histone modifiers, including BAP1, in subjects that have rare germline variants of these transcription regulators and/or transcription factors/co-factors, and in regions prone to mono-allelic deletion during oncogenesis. © 2014 UICC.

  19. Multi-criteria media mix decision model for advertising multiple product with segment specific and mass media

    Sugandha Aggarwal

    2014-12-01

    Full Text Available Judicious media planning decisions are crucial for successful advertising of products. Media planners extensively use mathematical models supplemented with market research and expert opinion to devise the media plans. Media planning models discussed in the literature largely focus on single products with limited studies related to the multi-product media planning. In this paper we propose a media planning model to allocate limited advertising budget among multiple products advertised in a segmented market and determine the number of advertisements to be given in different media. The proposed model is formulated considering both segment specific and mass media vehicles to maximize the total advertising reach for each product. The model also incorporates the cross product effect of advertising of one product on the other. The proposed formulation is a multi-objective linear integer programming model and interactive linear integer goal programming is discussed to solve the model. A real life case study is presented to illustrate the application of the proposed model.

  20. Relative accuracy of spatial predictive models for lynx Lynx canadensis derived using logistic regression-AIC, multiple criteria evaluation and Bayesian approaches

    Shelley M. ALEXANDER

    2009-02-01

    Full Text Available We compared probability surfaces derived using one set of environmental variables in three Geographic Information Systems (GIS-based approaches: logistic regression and Akaike’s Information Criterion (AIC, Multiple Criteria Evaluation (MCE, and Bayesian Analysis (specifically Dempster-Shafer theory. We used lynx Lynx canadensis as our focal species, and developed our environment relationship model using track data collected in Banff National Park, Alberta, Canada, during winters from 1997 to 2000. The accuracy of the three spatial models were compared using a contingency table method. We determined the percentage of cases in which both presence and absence points were correctly classified (overall accuracy, the failure to predict a species where it occurred (omission error and the prediction of presence where there was absence (commission error. Our overall accuracy showed the logistic regression approach was the most accurate (74.51%. The multiple criteria evaluation was intermediate (39.22%, while the Dempster-Shafer (D-S theory model was the poorest (29.90%. However, omission and commission error tell us a different story: logistic regression had the lowest commission error, while D-S theory produced the lowest omission error. Our results provide evidence that habitat modellers should evaluate all three error measures when ascribing confidence in their model. We suggest that for our study area at least, the logistic regression model is optimal. However, where sample size is small or the species is very rare, it may also be useful to explore and/or use a more ecologically cautious modelling approach (e.g. Dempster-Shafer that would over-predict, protect more sites, and thereby minimize the risk of missing critical habitat in conservation plans[Current Zoology 55(1: 28 – 40, 2009].

  1. More Than Just Accuracy: A Novel Method to Incorporate Multiple Test Attributes in Evaluating Diagnostic Tests Including Point of Care Tests.

    Thompson, Matthew; Weigl, Bernhard; Fitzpatrick, Annette; Ide, Nicole

    2016-01-01

    Current frameworks for evaluating diagnostic tests are constrained by a focus on diagnostic accuracy, and assume that all aspects of the testing process and test attributes are discrete and equally important. Determining the balance between the benefits and harms associated with new or existing tests has been overlooked. Yet, this is critically important information for stakeholders involved in developing, testing, and implementing tests. This is particularly important for point of care tests (POCTs) where tradeoffs exist between numerous aspects of the testing process and test attributes. We developed a new model that multiple stakeholders (e.g., clinicians, patients, researchers, test developers, industry, regulators, and health care funders) can use to visualize the multiple attributes of tests, the interactions that occur between these attributes, and their impacts on health outcomes. We use multiple examples to illustrate interactions between test attributes (test availability, test experience, and test results) and outcomes, including several POCTs. The model could be used to prioritize research and development efforts, and inform regulatory submissions for new diagnostics. It could potentially provide a way to incorporate the relative weights that various subgroups or clinical settings might place on different test attributes. Our model provides a novel way that multiple stakeholders can use to visualize test attributes, their interactions, and impacts on individual and population outcomes. We anticipate that this will facilitate more informed decision making around diagnostic tests.

  2. Optimal Cropping Pattern Based on Multiple Economic, Regional, and Agricultural Sustainability Criteria in Sari, Iran: Application of a Consolidated Model of AHP and Linear Programming

    E. Fallahi

    2016-10-01

    Full Text Available Introduction: Determining a suitable cropping pattern is an important task for planners and requires an exact and realistic decision-making process based on several goals and criteria corresponding to secure the interest of agricultural beneficiaries in long-term. Accordingly, this study reviews the current pattern operated by farmers in Sari, Iran, and intends to provide a cropping pattern that considers the multifold regional and agricultural sustainability criteria along with economic considerations. Materials and Methods: In order to achieve the study goals, a consolidated model of AHP and Linear Programming was applied. For this purpose, we constructed a three-level AHP, including a goal (determining the weight of each crop, seven criteria, and seven alternatives. Profitability, compatibility with regional and geographical conditions, water consumption, environmental effects of cropping, job creation opportunities, skill and proficiency required for producing a crop, and risk taken to cultivate a crop were considered as the criteria in the model. Seven alternative crops including rice, wheat, rapeseed, barley, soybean, clover, and vegetables were considered too. The next step is determining the weight of each criterion with regard to the goal and the weight of each alternative with regard to each criteria. By multiplying these weights, final weights for various crops were obtained from the model. Derived weights for each crop were then applied as objective function coefficients in the Linear Programming model and the model was solved subject to the constraints. Results and Discussion: Optimal cropping pattern determined based on the consolidated model of AHP and Linear Programming and the results compared to a scenario that only looks forward to maximizing the economic interests. Due to the low profitability of rapeseed and barley, these crops eliminated from the pattern in the profit-maximizing scenario. According to the results, the

  3. Efficient Time-Domain Ray-Tracing Technique for the Analysis of Ultra-Wideband Indoor Environments including Lossy Materials and Multiple Effects

    F. Saez de Adana

    2009-01-01

    Full Text Available This paper presents an efficient application of the Time-Domain Uniform Theory of Diffraction (TD-UTD for the analysis of Ultra-Wideband (UWB mobile communications for indoor environments. The classical TD-UTD formulation is modified to include the contribution of lossy materials and multiple-ray interactions with the environment. The electromagnetic analysis is combined with a ray-tracing acceleration technique to treat realistic and complex environments. The validity of this method is tested with measurements performed inside the Polytechnic building of the University of Alcala and shows good performance of the model for the analysis of UWB propagation.

  4. Prediction of preterm birth in multiple pregnancies: development of a multivariable model including cervical length measurement at 16 to 21 weeks' gestation.

    van de Mheen, Lidewij; Schuit, Ewoud; Lim, Arianne C; Porath, Martina M; Papatsonis, Dimitri; Erwich, Jan J; van Eyck, Jim; van Oirschot, Charlotte M; Hummel, Piet; Duvekot, Johannes J; Hasaart, Tom H M; Groenwold, Rolf H H; Moons, Karl G M; de Groot, Christianne J M; Bruinse, Hein W; van Pampus, Maria G; Mol, Ben W J

    2014-04-01

    To develop a multivariable prognostic model for the risk of preterm delivery in women with multiple pregnancy that includes cervical length measurement at 16 to 21 weeks' gestation and other variables. We used data from a previous randomized trial. We assessed the association between maternal and pregnancy characteristics including cervical length measurement at 16 to 21 weeks' gestation and time to delivery using multivariable Cox regression modelling. Performance of the final model was assessed for the outcomes of preterm and very preterm delivery using calibration and discrimination measures. We studied 507 women, of whom 270 (53%) delivered models for preterm and very preterm delivery had a c-index of 0.68 (95% CI 0.63 to 0.72) and 0.68 (95% CI 0.62 to 0.75), respectively, and showed good calibration. In women with a multiple pregnancy, the risk of preterm delivery can be assessed with a multivariable model incorporating cervical length and other predictors.

  5. Reliability of cortical lesion detection on double inversion recovery MRI applying the MAGNIMS-Criteria in multiple sclerosis patients within a 16-months period.

    Tobias Djamsched Faizy

    Full Text Available In patients with multiple sclerosis (MS, Double Inversion Recovery (DIR magnetic resonance imaging (MRI can be used to identify cortical lesions (CL. We sought to evaluate the reliability of CL detection on DIR longitudinally at multiple subsequent time-points applying the MAGNIMs scoring criteria for CLs.26 MS patients received a 3T-MRI (Siemens, Skyra with DIR at 12 time-points (TP within a 16 months period. Scans were assessed in random order by two different raters. Both raters separately marked all CLs on each scan and total lesion numbers were obtained for each scan-TP and patient. After a retrospective re-evaluation, the number of consensus CLs (conL was defined as the total number of CLs, which both raters finally agreed on. CLs volumes, relative signal intensities and CLs localizations were determined. Both ratings (conL vs. non-consensus scoring were compared for further analysis.A total number of n = 334 CLs were identified by both raters in 26 MS patients with a first agreement of both raters on 160 out of 334 of the CLs found (κ = 0.48. After the retrospective re-evaluation, consensus agreement increased to 233 out of 334 CL (κ = 0.69. 93.8% of conL were visible in at least 2 consecutive TP. 74.7% of the conL were visible in all 12 consecutive TP. ConL had greater mean lesion volumes and higher mean signal intensities compared to lesions that were only detected by one of the raters (p<0.05. A higher number of CLs in the frontal, parietal, temporal and occipital lobe were identified by both raters than the number of those only identified by one of the raters (p<0.05.After a first assessment, slightly less than a half of the CL were considered as reliably detectable on longitudinal DIR images. A retrospective re-evaluation notably increased the consensus agreement. However, this finding is narrowed, considering the fact that retrospective evaluation steps might not be practicable in clinical routine. Lesions that were not reliably

  6. The rank-heat plot is a novel way to present the results from a network meta-analysis including multiple outcomes.

    Veroniki, Areti Angeliki; Straus, Sharon E; Fyraridis, Alexandros; Tricco, Andrea C

    2016-08-01

    To present a novel and simple graphical approach to improve the presentation of the treatment ranking in a network meta-analysis (NMA) including multiple outcomes. NMA simultaneously compares many relevant interventions for a clinical condition from a network of trials, and allows ranking of the effectiveness and/or safety of each intervention. There are numerous ways to present the NMA results, which can challenge their interpretation by research users. The rank-heat plot is a novel graph that can be used to quickly recognize which interventions are most likely the best or worst interventions with respect to their effectiveness and/or safety for a single or multiple outcome(s) and may increase interpretability. Using empirical NMAs, we show that the need for a concise and informative presentation of results is imperative, particularly as the number of competing treatments and outcomes in an NMA increases. The rank-heat plot is an efficient way to present the results of ranking statistics, particularly when a large amount of data is available, and it is targeted to users from various backgrounds. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Biological Water Quality Criteria

    Page contains links to Technical Documents pertaining to Biological Water Quality Criteria, including, technical assistance documents for states, tribes and territories, program overviews, and case studies.

  8. MiR-7 triggers cell cycle arrest at the G1/S transition by targeting multiple genes including Skp2 and Psme3.

    Noelia Sanchez

    Full Text Available MiR-7 acts as a tumour suppressor in many cancers and abrogates proliferation of CHO cells in culture. In this study we demonstrate that miR-7 targets key regulators of the G1 to S phase transition, including Skp2 and Psme3, to promote increased levels of p27(KIP and temporary growth arrest of CHO cells in the G1 phase. Simultaneously, the down-regulation of DNA repair-specific proteins via miR-7 including Rad54L, and pro-apoptotic regulators such as p53, combined with the up-regulation of anti-apoptotic factors like p-Akt, promoted cell survival while arrested in G1. Thus miR-7 can co-ordinate the levels of multiple genes and proteins to influence G1 to S phase transition and the apoptotic response in order to maintain cellular homeostasis. This work provides further mechanistic insight into the role of miR-7 as a regulator of cell growth in times of cellular stress.

  9. MO-FG-CAMPUS-TeP2-03: Multi-Criteria Optimization Using Taguchi Method for SRS of Multiple Lesions by Single Isocenter

    Alani, S; Honig, N; Schlocker, A; Corn, B [Tel Aviv Medical Center, Tel Aviv (Israel)

    2016-06-15

    Purpose: This study utilizes the Taguchi Method to evaluate the VMAT planning parameters of single isocenter treatment plans for multiple brain metastases. An optimization model based on Taguchi and utility concept is employed to optimize the planning parameters including: arc arrangement, calculation grid size, calculation model, and beam energy on multiple performance characteristics namely conformity index and dose to normal brain. Methods: Treatment plans, each with 4 metastatic brain lesions were planned using single isocenter technique. The collimator angles were optimized to avoid open areas. In this analysis four planning parameters (a–d) were considered: (a)-Arc arrangements: set1: Gantry 181cw179 couch0; gantry179ccw0, couch315; and gantry0ccw181, couch45. set2: set1 plus additional arc: Gantry 0cw179, couch270. (b)-Energy: 6-MV; 6MV-FFF (c)-Calculation grid size: 1mm; 1.5mm (d)-Calculation models: AAA; Acuros Treatment planning was performed in Varian Eclipse (ver.11.0.30). A suitable orthogonal array was selected (L8) to perform the experiments. After conducting the experiments with the combinations of planning parameters the conformity index (CI) and the normal brain dose S/N ratio for each parameter was calculated. Optimum levels for the multiple response optimizations were determined. Results: We determined that the factors most affecting the conformity index are arc arrangement and beam energy. These tests were also used to evaluate dose to normal brain. In these evaluations, the significant parameters were grid size and calculation model. Using the utility concept we determined the combination of each of the four factors tested in this study that most significantly influence quality of the resulting treatment plans: (a)-arc arrangement-set2, (b)-6MV, (c)-calc.grid 1mm, (d)-Acuros algorithm. Overall, the dominant significant influences on plan quality are (a)-arcarrangement, and (b)-beamenergy. Conclusion: Results were analyzed using ANOVA and

  10. Diagnostic Criteria for Pediatric MS

    J Gordon Millichap

    2013-06-01

    Full Text Available Investigators at Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children’s Hospital of Chicago review the diagnostic criteria for pediatric multiple sclerosis, the differential diagnosis, the 2010 McDonald criteria, and Callen criteria.

  11. Activator Gcn4 employs multiple segments of Med15/Gal11, including the KIX domain, to recruit mediator to target genes in vivo.

    Jedidi, Iness; Zhang, Fan; Qiu, Hongfang; Stahl, Stephen J; Palmer, Ira; Kaufman, Joshua D; Nadaud, Philippe S; Mukherjee, Sujoy; Wingfield, Paul T; Jaroniec, Christopher P; Hinnebusch, Alan G

    2010-01-22

    Mediator is a multisubunit coactivator required for initiation by RNA polymerase II. The Mediator tail subdomain, containing Med15/Gal11, is a target of the activator Gcn4 in vivo, critical for recruitment of native Mediator or the Mediator tail subdomain present in sin4Delta cells. Although several Gal11 segments were previously shown to bind Gcn4 in vitro, the importance of these interactions for recruitment of Mediator and transcriptional activation by Gcn4 in cells was unknown. We show that interaction of Gcn4 with the Mediator tail in vitro and recruitment of this subcomplex and intact Mediator to the ARG1 promoter in vivo involve additive contributions from three different segments in the N terminus of Gal11. These include the KIX domain, which is a critical target of other activators, and a region that shares a conserved motif (B-box) with mammalian coactivator SRC-1, and we establish that B-box is a critical determinant of Mediator recruitment by Gcn4. We further demonstrate that Gcn4 binds to the Gal11 KIX domain directly and, by NMR chemical shift analysis combined with mutational studies, we identify the likely binding site for Gcn4 on the KIX surface. Gcn4 is distinctive in relying on comparable contributions from multiple segments of Gal11 for efficient recruitment of Mediator in vivo.

  12. Patients with neuromyelitis optica have a more severe disease than patients with relapsingremitting multiple sclerosis, including higher risk of dying of a demyelinating disease

    Denis Bernardi Bichuetti

    2013-05-01

    Full Text Available Although neuromyelitis optica (NMO is known to be a more severe disease than relapsing-remitting multiple sclerosis (RRMS, few studies comparing both conditions in a single center have been done. Methods: Comparison of our previously published cohort of 41 NMO patients with 177 RRMS patients followed in the same center, from 1994 to 2007. Results: Mean age of onset was 32.6 for NMO and 30.2 for RRMS (p=0.2062 with mean disease duration of 7.4 years for NMO and 10.3 years for RRMS. Patients with NMO had a higher annualized relapse rate (1.0 versus 0.8, p=0.0013 and progression index (0.9 versus 0.6, p≪0.0001, with more patients reaching expanded disability status scale (EDSS 6.0 (39 versus 17%, p=0.0036. The odds ratio for reaching EDSS 6.0 and being deceased due to NMO in comparison to RRMS were, respectively, 3.14 and 12.15. Conclusion: Patients with NMO have a more severe disease than patients with RRMS, including higher risk of dying of a demyelinating disease.

  13. Dual Criteria Decisions

    Andersen, Steffen; Harrison, Glenn W.; Lau, Morten Igel

    2014-01-01

    The most popular models of decision making use a single criterion to evaluate projects or lotteries. However, decision makers may actually consider multiple criteria when evaluating projects. We consider a dual criteria model from psychology. This model integrates the familiar tradeoffs between...... to the clear role that income thresholds play in such decision making, but does not rule out a role for tradeoffs between risk and utility or probability weighting....

  14. Criteria for Authorship in Bioethics

    Resnik, David B.; Master, Zubin

    2011-01-01

    Multiple authorship is becoming increasingly common in bioethics research. There are well-established criteria for authorship in empirical bioethics research but not for conceptual research. It is important to develop criteria for authorship in conceptual publications to prevent undeserved authorship and uphold standards of fairness and accountability. This article explores the issue of multiple authorship in bioethics and develops criteria for determining who should be an author on a concept...

  15. An Interactive Signed Distance Approach for Multiple Criteria Group Decision-Making Based on Simple Additive Weighting Method with Incomplete Preference Information Defined by Interval Type-2 Fuzzy Sets

    Ting-Yu Chen

    2014-01-01

    Interval type-2 fuzzy sets (T2FSs) with interval membership grades are suitable for dealing with imprecision or uncertainties in many real-world problems. In the Interval type-2 fuzzy context, the aim of this paper is to develop an interactive signed distance-based simple additive weighting (SAW) method for solving multiple criteria group decision-making problems with linguistic ratings and incomplete preference information. This paper first formulates a group decision-making problem with unc...

  16. Multi-criteria weighted order based maintenance decision making

    Dhanisetty, V.S.V.; Verhagen, W.J.C.; Curran, R.

    2017-01-01

    Decision making in daily maintenance requires consideration of multiple factors. The importance of each of the factors fluctuates depending on the repair scenario and the needs of the maintainer. In order to include the prioritisation of multiple criteria, a weighted decision making model is

  17. Defining how aging Pseudotsuga and Abies compensate for multiple stresses through multi-criteria assessment of a functional-structural model

    Maureen C. Kennedy; E. David Ford; Thomas M. Hinckley

    2009-01-01

    Many hypotheses have been advanced about factors that control tree longevity. We use a simulation model with multi-criteria optimization and Pareto optimality to determine branch morphologies in the Pinaceae that minimize the effect of growth limitations due to water stress while simultaneously maximizing carbohydrate gain. Two distinct branch morphologies in the...

  18. Identification and validation of multiple cell surface markers of clinical-grade adipose-derived mesenchymal stromal cells as novel release criteria for good manufacturing practice-compliant production.

    Camilleri, Emily T; Gustafson, Michael P; Dudakovic, Amel; Riester, Scott M; Garces, Catalina Galeano; Paradise, Christopher R; Takai, Hideki; Karperien, Marcel; Cool, Simon; Sampen, Hee-Jeong Im; Larson, A Noelle; Qu, Wenchun; Smith, Jay; Dietz, Allan B; van Wijnen, Andre J

    2016-08-11

    Clinical translation of mesenchymal stromal cells (MSCs) necessitates basic characterization of the cell product since variability in biological source and processing of MSCs may impact therapeutic outcomes. Although expression of classical cell surface markers (e.g., CD90, CD73, CD105, and CD44) is used to define MSCs, identification of functionally relevant cell surface markers would provide more robust release criteria and options for quality control. In addition, cell surface expression may distinguish between MSCs from different sources, including bone marrow-derived MSCs and clinical-grade adipose-derived MSCs (AMSCs) grown in human platelet lysate (hPL). In this work we utilized quantitative PCR, flow cytometry, and RNA-sequencing to characterize AMSCs grown in hPL and validated non-classical markers in 15 clinical-grade donors. We characterized the surface marker transcriptome of AMSCs, validated the expression of classical markers, and identified nine non-classical markers (i.e., CD36, CD163, CD271, CD200, CD273, CD274, CD146, CD248, and CD140B) that may potentially discriminate AMSCs from other cell types. More importantly, these markers exhibit variability in cell surface expression among different cell isolates from a diverse cohort of donors, including freshly prepared, previously frozen, or proliferative state AMSCs and may be informative when manufacturing cells. Our study establishes that clinical-grade AMSCs expanded in hPL represent a homogeneous cell culture population according to classical markers,. Additionally, we validated new biomarkers for further AMSC characterization that may provide novel information guiding the development of new release criteria. Use of Autologous Bone Marrow Aspirate Concentrate in Painful Knee Osteoarthritis (BMAC): Clinicaltrials.gov NCT01931007 . Registered August 26, 2013. MSC for Occlusive Disease of the Kidney: Clinicaltrials.gov NCT01840540 . Registered April 23, 2013. Mesenchymal Stem Cell Therapy in Multiple

  19. The PROMETHEE multiple criteria decision making analysis for selecting the best membrane prepared from sulfonated poly(ether ketone)s and poly(ether sulfone)s for proton exchange membrane fuel cell

    Nikouei, Mohammad Ali; Oroujzadeh, Maryam; Mehdipour-Ataei, Shahram

    2017-01-01

    Proton exchange membrane as the heart of fuel cell has been the topic of many research activities in recent years. Finding a suitable alternative for Nafion membranes is one of the most important issues of interest. This study is dedicated to sulfonated poly(ether ketone) and poly(ether sulfone) membranes. For synthesis of these two groups of polymers, two different isomeric biphenols (meta- and para-) were used and each group of membranes with three different degree of sulfonation (25, 35, and 45%) was synthesized. In this way, twelve different membrane samples were obtained and their properties were evaluated. Since each membrane had some strong and some weak points of properties in comparison to the other ones, using a rational analysis for choosing the best membrane between prepared samples was inevitable. For this purpose a PROMETHEE based multiple criteria decision making approach was applied and for evaluation of the weight of each criterion, Shannon entropy method was used. Final results showed that poly(ether ketone) membranes in selected criteria were better than poly(ether sulfone) membranes and as expected, membranes with the highest degree of sulfonation (45%) were placed at the top ranking levels. - Highlights: • Sulfonated poly(ether ketone)s and Poly(ether sulfone)s were synthesized. • Related membranes for PEMFC were prepared. • The properties of membranes were measured. • Multiple criteria decision making approach was used to ranking the membranes. • PROMETHEE based approach selected poly(ether ketone)s as better choices.

  20. Conservative two-step procedure including uterine artery embolization with embosphere and surgical myomectomy for the treatment of multiple fibroids: Preliminary experience

    Malartic, Cécile; Morel, Olivier; Fargeaudou, Yann; Le Dref, Olivier; Fazel, Afchine; Barranger, Emmanuel; Soyer, Philippe

    2012-01-01

    Objective: To evaluate the feasibility and safety of combined uterine artery embolization (UAE) using embosphere and surgical myomectomy as an alternative to radical hysterectomy in premenopausal women with multiple fibroids. Materials and methods: Mid-term clinical outcome (mean, 25 months) of 12 premenopausal women (mean age, 38 years) with multiple and large symptomatic fibroids who desired to retain their uterus and who were treated using combined UAE and surgical myomectomy were retrospectively analyzed. In all women, UAE alone was contraindicated because of large (>10 cm) or subserosal or submucosal fibroids and myomectomy alone was contraindicated because of too many (>10) fibroids. Results: UAE and surgical myomectomy were successfully performed in all women. Myomectomy was performed using laparoscopy (n = 6), open laparotomy (n = 3), hysteroscopy (n = 2), or laparoscopy and hysteroscopy (n = 1). Mean serum hemoglobin level drop was 0.97 g/dL and no blood transfusion was needed. No immediate complications were observed and all women reported resumption of normal menses. During a mean follow-up period of 25 months (range, 14–37 months), complete resolution of initial symptoms along with decrease in uterine volume (mean, 48%) was observed in all women. No further hysterectomy was required in any woman. Conclusion: In premenopausal women with multiple fibroids, the two-step procedure is safe and effective alternative to radical hysterectomy, which allows preserving the uterus. Further prospective studies, however, should be done to determine the actual benefit of this combined approach on the incidence of subsequent pregnancies.

  1. Analysis by multiple criteria for the definition of environmental fragility levels – A case study: watershed of Cará-Cará River, Ponta Grossa/PR

    Marcos Antonio Miara

    2007-06-01

    Full Text Available The GIS (Geographical Information Systems, as a tool for theenvironmental analyses of specific modules, makes possiblethe use of different sources of information simultaneously. Inorder to exploit this characteristic, the present research applieda Multi criteria evaluation (MCE, using also the AHP (AnalyticHierarchy Process for the identification of differentiated levelsof environmental fragility from the definition of weights for theconsidered physical variables. The work has used the Cará-Cará River watershed, Ponta Grossa/PR, as its study area.The results have shown a five-class variation of environmentalfragility, which have been correlated witch the reality, givingsupport to a positive evaluation of the methods which wereused.

  2. A comparison of perinatal outcomes in singletons and multiples born after in vitro fertilization or intracytoplasmic sperm injection stratified for neonatal risk criteria

    van Heesch, M.M.J.; Evers, J.L.H.; Dumoulin, J.C.M.; van der Hoeven, M.A.H.B.; van Beijsterveldt, C.E.M.; Bonsel, G.J.; Dykgraaf, R.H.M.; van Goudoever, J.B.; Koopman-Esseboom, C.; Nelen, W.L.D.M.; Steiner, K.; Tamminga, P.; Tonch, N.; van Zonneveld, P.; Dirksen, C.D.

    2014-01-01

    Objective To compare perinatal singleton and multiple outcomes in a large Dutch in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) population and within risk subgroups. Newborns were assigned to a risk category based on gestational age, birthweight, Apgar score and congenital

  3. A comparison of perinatal outcomes in singletons and multiples born after in vitro fertilization or intracytoplasmic sperm injection stratified for neonatal risk criteria

    Heesch, M.M. van; Evers, J.L.H.; Dumoulin, J.C.; Hoeven, M.A. van der; Beijsterveldt, C.E. van; Bonsel, G.J.; Dykgraaf, R.H.; Goudoever, J.B. van; Koopman-Esseboom, C.; Nelen, W.L.D.M.; Steiner, K.; Tamminga, P.; Tonch, N.; Zonneveld, P. van; Dirksen, C.D.

    2014-01-01

    OBJECTIVE: To compare perinatal singleton and multiple outcomes in a large Dutch in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) population and within risk subgroups. Newborns were assigned to a risk category based on gestational age, birthweight, Apgar score and congenital

  4. Report of Increasing Overdose Deaths that include Acetyl Fentanyl in Multiple Counties of the Southwestern Region of the Commonwealth of Pennsylvania in 2015-2016.

    Dwyer, Jessica B; Janssen, Jennifer; Luckasevic, Todd M; Williams, Karl E

    2018-01-01

    Acetyl fentanyl is a Schedule I controlled synthetic opioid that is becoming an increasingly detected "designer drug." Routine drug screening procedures in local forensic toxicology laboratories identified a total of 41 overdose deaths associated with acetyl fentanyl within multiple counties of the southwestern region of the state of Pennsylvania. The range, median, mean, and standard deviation of blood acetyl fentanyl concentrations for these 41 cases were 0.13-2100 ng/mL, 11 ng/mL, 169.3 ng/mL, and 405.3 ng/mL, respectively. Thirty-six individuals (88%) had a confirmed history of substance abuse, and all but one case (96%) were ruled multiple drug toxicities. This report characterizes this localized trend of overdose deaths associated with acetyl fentanyl and provides further evidence supporting an alarmingly concentrated opiate and opioid epidemic of both traditional and novel drugs within this region of the United States. © 2017 American Academy of Forensic Sciences.

  5. Multiple Criteria Group Decision-Making Considering Symmetry with Regards to the Positive and Negative Ideal Solutions via the Pythagorean Normal Cloud Model for Application to Economic Decisions

    Jinming Zhou

    2018-05-01

    Full Text Available Pythagorean fuzzy sets are highly appealing in dealing with uncertainty as they allow for greater flexibility in regards to the membership and non-membership degrees by extending the set of possible values. In this paper, we propose a multi-criteria group decision-making approach based on the Pythagorean normal cloud. Some cloud aggregation operators are presented in this paper to facilitate the appraisal of the underlying utilities of the alternatives under consideration. The concept and properties of the Pythagorean normal cloud and its backward generation algorithm, aggregation operators and distance measurement are outlined. The proposed approach resembles the TOPSIS technique, which, indeed, considers the symmetry of the distances to the positive and negative ideal solutions. Furthermore, an example from e-commerce is presented to demonstrate and validate the proposed decision-making approach. Finally, the comparative analysis is implemented to check the robustness of the results when the aggregation rules are changed.

  6. Fitting and Phenomenology in Type IA Supernova Cosmology: Generalized Likelihood Analyses for Multiple Evolving Populations and Observations of Near-Infrared Lightcurves Including Host Galaxy Properties

    Ponder, Kara A.

    In the late 1990s, Type Ia supernovae (SNeIa) led to the discovery that the Universe is expanding at an accelerating rate due to dark energy. Since then, many different tracers of acceleration have been used to characterize dark energy, but the source of cosmic acceleration has remained a mystery. To better understand dark energy, future surveys such as the ground-based Large Synoptic Survey Telescope and the space-based Wide-Field Infrared Survey Telescope will collect thousands of SNeIa to use as a primary dark energy probe. These large surveys will be systematics limited, which makes it imperative for our insight regarding systematics to dramatically increase over the next decade for SNeIa to continue to contribute to precision cosmology. I approach this problem by improving statistical methods in the likelihood analysis and collecting near infrared (NIR) SNeIa with their host galaxies to improve the nearby data set and search for additional systematics. Using more statistically robust methods to account for systematics within the likelihood function can increase accuracy in cosmological parameters with a minimal precision loss. Though a sample of at least 10,000 SNeIa is necessary to confirm multiple populations of SNeIa, the bias in cosmology is ˜ 2 sigma with only 2,500 SNeIa. This work focused on an example systematic (host galaxy correlations), but it can be generalized for any systematic that can be represented by a distribution of multiple Gaussians. The SweetSpot survey gathered 114 low-redshift, NIR SNeIa that will act as a crucial anchor sample for the future high redshift surveys. NIR observations are not as affected by dust contamination, which may lead to increased understanding of systematics seen in optical wavelengths. We obtained spatially resolved spectra for 32 SweetSpot host galaxies to test for local host galaxy correlations. For the first time, we probe global host galaxy correlations with NIR brightnesses from the current literature

  7. EPR spectroscopy of MRI-related Gd(III) complexes: simultaneous analysis of multiple frequency and temperature spectra, including static and transient crystal field effects.

    Rast, S; Borel, A; Helm, L; Belorizky, E; Fries, P H; Merbach, A E

    2001-03-21

    For the first time, a very general theoretical method is proposed to interpret the full electron paramagnetic resonance (EPR) spectra at multiple temperatures and frequencies in the important case of S-state metal ions complexed in liquid solution. This method is illustrated by a careful analysis of the measured spectra of two Gd3+ (S = 7/2) complexes. It is shown that the electronic relaxation mechanisms at the origin of the EPR line shape arise from the combined effects of the modulation of the static crystal field by the random Brownian rotation of the complex and of the transient zero-field splitting. A detailed study of the static crystal field mechanism shows that, contrarily to the usual global models involving only second-order terms, the fourth and sixth order terms can play a non-negligible role. The obtained parameters are well interpreted in the framework of the physics of the various underlying relaxation processes. A better understanding of these mechanisms is highly valuable since they partly control the efficiency of paramagnetic metal ions in contrast agents for medical magnetic resonance imaging (MRI).

  8. Novel interstitial deletion of 10q24.3-25.1 associated with multiple congenital anomalies including lobar holoprosencephaly, cleft lip and palate, and hypoplastic kidneys.

    Peltekova, Iskra T; Hurteau-Millar, Julie; Armour, Christine M

    2014-12-01

    Chromosome 10q deletions are rare and phenotypically diverse. Such deletions differ in length and occur in numerous regions on the long arm of chromosome 10, accounting for the wide clinical variability. Commonly reported findings include dysmorphic facial features, microcephaly, developmental delay, and genitourinary abnormalities. Here, we report on a female patient with a novel interstitial 5.54 Mb deletion at 10q24.31-q25.1. This patient had findings in common with a previously reported patient with an overlapping deletion, including renal anomalies and an orofacial cleft, but also demonstrated lobar holoprosencephaly and a Dandy-Walker malformation, features which have not been previously reported with 10q deletions. An analysis of the region deleted in our patient showed numerous genes, such as KAZALD1, PAX2, SEMA4G, ACTRA1, INA, and FGF8, whose putative functions may have played a role in the phenotype seen in our patient. © 2014 Wiley Periodicals, Inc.

  9. Epigenetic profiling of cutaneous T-cell lymphoma: promoter hypermethylation of multiple tumor suppressor genes including BCL7a, PTPRG, and p73.

    van Doorn, Remco; Zoutman, Willem H; Dijkman, Remco; de Menezes, Renee X; Commandeur, Suzan; Mulder, Aat A; van der Velden, Pieter A; Vermeer, Maarten H; Willemze, Rein; Yan, Pearlly S; Huang, Tim H; Tensen, Cornelis P

    2005-06-10

    To analyze the occurrence of promoter hypermethylation in primary cutaneous T-cell lymphoma (CTCL) on a genome-wide scale, focusing on epigenetic alterations with pathogenetic significance. DNA isolated from biopsy specimens of 28 patients with CTCL, including aggressive CTCL entities (transformed mycosis fungoides and CD30-negative large T-cell lymphoma) and an indolent entity (CD30-positive large T-cell lymphoma), were investigated. For genome-wide DNA methylation screening, differential methylation hybridization using CpG island microarrays was applied, which allows simultaneous detection of the methylation status of 8640 CpG islands. Bisulfite sequence analysis was applied for confirmation and detection of hypermethylation of eight selected tumor suppressor genes. The DNA methylation patterns of CTCLs emerging from differential methylation hybridization analysis included 35 CpG islands hypermethylated in at least four of the 28 studied CTCL samples when compared with benign T-cell samples. Hypermethylation of the putative tumor suppressor genes BCL7a (in 48% of CTCL samples), PTPRG (27%), and thrombospondin 4 (52%) was confirmed and demonstrated to be associated with transcriptional downregulation. BCL7a was hypermethylated at a higher frequency in aggressive (64%) than in indolent (14%) CTCL entities. In addition, the promoters of the selected tumor suppressor genes p73 (48%), p16 (33%), CHFR (19%), p15 (10%), and TMS1 (10%) were hypermethylated in CTCL. Malignant T cells of patients with CTCL display widespread promoter hypermethylation associated with inactivation of several tumor suppressor genes involved in DNA repair, cell cycle, and apoptosis signaling pathways. In view of this, CTCL may be amenable to treatment with demethylating agents.

  10. Diseño óptimo de redes hidráulicas bajo criterios múltiples. // Optimal design of water supply nets by means of multiple criteria optimization.

    J. R. Hechavarría Hernández

    2007-05-01

    solutions to determine sufficiently rational solutions to theproblem of designing closed hydraulic networks, at least at the level of considering the generally accepted criteria asimportant to decide on the network's design, including the determination of the most rational trajectory of the network andthe subjective aspects.The present work is the result of the collaboration among the Studies Center of Computer Aided Design and Manufacturing(CAD/CAM of the University of Holguín “Oscar Lucero Moya”, the Studies Center of Renewable Energy Technology(CETER of the Higher Polytechnical Institute “José Antonio Echeverría” and the Enterprise Group of Investigation,Project and Engineering (GEIPI of the National Institute of Hydraulic Resource.Key Words: CAD, hydraulic networks, multiple criteria.

  11. Criteria definition and approaches in green supplier selection – a case study for raw material and packaging of food industry

    Narges Banaeian; Hossein Mobli; Izabela Ewa Nielsen; Mahmoud Omid

    2015-01-01

    This paper formulates an integrated framework for deciding about the green supplier selection criteria in food supply chain and also proposes different methods that account for single and multiple sourcing of supplier selection. Green supplier selection relies on green criteria, so determination of suitable set of criteria will affect decision-maker results directly. In this research, an operational model including combination of general and environmental criteria is introduced for green supp...

  12. Electrophysiological heterogeneity of pacemaker cells in the rabbit intercaval region, including the SA node: insights from recording multiple ion currents in each cell.

    Monfredi, Oliver; Tsutsui, Kenta; Ziman, Bruce; Stern, Michael D; Lakatta, Edward G; Maltsev, Victor A

    2018-03-01

    Cardiac pacemaker cells, including cells of the sinoatrial node, are heterogeneous in size, morphology, and electrophysiological characteristics. The exact extent to which these cells differ electrophysiologically is unclear yet is critical to understanding their functioning. We examined major ionic currents in individual intercaval pacemaker cells (IPCs) sampled from the paracristal, intercaval region (including the sinoatrial node) that were spontaneously beating after enzymatic isolation from rabbit hearts. The beating rate was measured at baseline and after inhibition of the Ca 2+ pump with cyclopiazonic acid. Thereafter, in each cell, we consecutively measured the density of funny current ( I f ), delayed rectifier K + current ( I K ) (a surrogate of repolarization capacity), and L-type Ca 2+ current ( I Ca,L ) using whole cell patch clamp . The ionic current densities varied to a greater extent than previously appreciated, with some IPCs demonstrating very small or zero I f . The density of none of the currents was correlated with cell size, while I Ca,L and I f densities were related to baseline beating rates. I f density was correlated with I K density but not with that of I Ca,L . Inhibition of Ca 2+ cycling had a greater beating rate slowing effect in IPCs with lower I f densities. Our numerical model simulation indicated that 1) IPCs with small (or zero) I f or small I Ca,L can operate via a major contribution of Ca 2+ clock, 2) I f -Ca 2+ -clock interplay could be important for robust pacemaking function, and 3) coupled I f - I K function could regulate maximum diastolic potential. Thus, we have demonstrated marked electrophysiological heterogeneity of IPCs. This heterogeneity is manifested in basal beating rate and response to interference of Ca 2+ cycling, which is linked to I f . NEW & NOTEWORTHY In the present study, a hitherto unrecognized range of heterogeneity of ion currents in pacemaker cells from the intercaval region is demonstrated

  13. A de novo 1q22q23.1 Interstitial Microdeletion in a Girl with Intellectual Disability and Multiple Congenital Anomalies Including Congenital Heart Defect.

    Aleksiūnienė, Beata; Preiksaitiene, Egle; Morkūnienė, Aušra; Ambrozaitytė, Laima; Utkus, Algirdas

    2018-01-01

    Many studies have shown that molecular karyotyping is an effective diagnostic tool in individuals with developmental delay/intellectual disability. We report on a de novo interstitial 1q22q23.1 microdeletion, 1.6 Mb in size, detected in a patient with short stature, microcephaly, hypoplastic corpus callosum, cleft palate, minor facial anomalies, congenital heart defect, camptodactyly of the 4-5th fingers, and intellectual disability. Chromosomal microarray analysis revealed a 1.6-Mb deletion in the 1q22q23.1 region, arr[GRCh37] 1q22q23.1(155630752_157193893)×1. Real-time PCR analysis confirmed its de novo origin. The deleted region encompasses 50 protein-coding genes, including the morbid genes APOA1BP, ARHGEF2, LAMTOR2, LMNA, NTRK1, PRCC, RIT1, SEMA4A, and YY1AP1. Although the unique phenotype observed in our patient can arise from the haploinsufficiency of the dosage-sensitive LMNA gene, the dosage imbalance of other genes implicated in the rearrangement could also contribute to the phenotype. Further studies are required for the delineation of the phenotype associated with this rare chromosomal alteration and elucidation of the critical genes for manifestation of the specific clinical features. © 2018 S. Karger AG, Basel.

  14. Multiple factors, including non-motor impairments, influence decision making with regard to exercise participation in Parkinson's disease: a qualitative enquiry.

    O'Brien, Christine; Clemson, Lindy; Canning, Colleen G

    2016-01-01

    To explore how the meaning of exercise and other factors interact and influence the exercise behaviour of individuals with Parkinson's disease (PD) enrolled in a 6-month minimally supervised exercise program to prevent falls, regardless of whether they completed the prescribed exercise or not. This qualitative study utilised in-depth semi-structured interviews analysed using grounded theory methodology. Four main themes were constructed from the data: adapting to change and loss, the influence of others, making sense of the exercise experience and hope for a more active future. Participation in the PD-specific physiotherapy program involving group exercise provided an opportunity for participants to reframe their identity of their "active" self. Three new influences on exercise participation were identified and explored: non-motor impairments of apathy and fatigue, the belief in a finite energy quota, and the importance of feedback. A model was developed incorporating the themes and influences to explain decision-making for exercise participation in this group. Complex and interacting issues, including non-motor impairments, need to be considered in order to enhance the development and ongoing implementation of effective exercise programmes for people with PD. Exercise participation can assist individuals to reframe their identity as they are faced with losses associated with Parkinson's disease and ageing. Non-motor impairments of apathy and fatigue may influence exercise participation in people with Parkinson's disease. Particular attention needs to be paid to the provision of feedback in exercise programs for people with Parkinson's disease as it important for their decision-making about continuing exercise.

  15. Rating of environmental criteria

    Glueck, K; Krasser, G

    1980-01-01

    After a general theoretical discussion on the question of rating within a framework of cost-benefit studies, first trials as to the quantification and standardisation of twelve selected environmental criteria by means of an indicator system are worked out and compiled. The selection includes the criteria exhaust gas, dust, micro climate, water pollution, water regime, land requirement, vibrations, traffic noise, landscape scene, urban scene, effect of separation and safety risks. An insight is given of the rating practice using an evaluation of the available literature, of a household interview and of an interview of experts. The interviewing of 156 experts as to their rating conception of ten criteria in the second round has provided contributions to the general problem of the evaluation estimate based on multi criteria analysis as well as differentiation of the twelve or ten environmental criteria. The following criteria ratings given by the experts and which are averaged and smoothed are: traffic noise 20,0% +- 8,5; air pollution 15,0% +- 7,0; safety risk 13,0% +- 7,0; soil and water pollution 8,5% +- 5,0; landscape scene 8,0% +- 4,5; urban scene 8,0% +- 4,5; water regime 6,5% +- 3,5 and vibrations 4,5% +- 2,5.

  16. Summarized water quality criteria

    Kempster, P.L.; Hattingh, W.H.J.; Van Vliet, H.R.

    1980-08-01

    The available world literature from 27 sources on existing water quality criteria are summarized for the 15 main uses of water. The minimum, median and maximum specified values for 96 different determinands are included. Under each water use the criteria are grouped according to the functional significance of the determinands e.g. aesthetic/physical effects, high toxic potential, low toxic potential etc. A synopsis is included summarizing salient facts for each determinand such as the conditions under which it is toxic and its relationship to other determinands. The significance of the criteria is briefly discussed and the importance of considering functional interactions between determinands emphasized in evaluating the potential for toxic or beneficial effects. From the source literature it appears that the toxic potential, in addition to being determined by concentration, is also affected by the origin of the substance concerned, i.e. whether from natural sources or from anthropogenic pollution

  17. A multiple criteria decision making technique for supplier selection and inventory management strategy: A case of multi-product and multi-supplier problem

    Morteza Parhizkari

    2013-07-01

    Full Text Available Selection of an appropriate supplier along with planning a good inventory system has become an area of open research for the past few years. In this paper, we present a multi objective decision making supplier and inventory management model where two objectives including the quality and offering price of supplier are minimized, simultaneously. The proposed model is formulated as mixed integer programming and it is converted into an ordinary single objective function using Lp-Norm. In order to find efficient solution, we use NSGA-II as meta-heuristic technique and the performance of the proposed model is examined using some instances. The preliminary results indicate that both Lp-Norm and NSGA-II methods can be used to handle problems in various sizes.

  18. CORAL REEF BIOLOGICAL CRITERIA: USING THE CLEAN ...

    Coral reefs are declining at unprecedented rates worldwide due to multiple interactive stressors including climate change and land-based sources of pollution. The Clean Water Act (CWA) can be a powerful legal instrument for protecting water resources, including the biological inhabitants of coral reefs. The objective of the CWA is to restore and maintain the chemical, physical and biological integrity of water resources. Coral reef protection and restoration under the Clean Water Act begins with water quality standards - provisions of state or Federal law that consist of a designated use(s) for the waters of the United States and water quality criteria sufficient to protect the uses. Aquatic life use is the designated use that is measured by biological criteria (biocriteria). Biocriteria are expectations set by a jurisdiction for the quality and quantity of living aquatic resources in a defined waterbody. Biocriteria are an important addition to existing management tools for coral reef ecosystems. The Technical Support Document “Coral Reef Biological Criteria: Using the Clean Water Act to Protect a National Treasure” will provide a framework to aid States and Territories in their development, adoption, and implementation of coral reef biocriteria in their respective water quality standards. The Technical Support Document “Coral Reef Biological Criteria: Using the Clean Water Act to Protect a National Treasure” will provide a framework for coral re

  19. Water quality criteria for lead

    Nagpal, N.K.

    1987-01-01

    This report is one in a series that establishes water quality criteria for British Columbia. The report sets criteria for lead to protect a number of water uses, including drinking water, freshwater and marine aquatic life, wildlife, livestock, irrigation, and recreation. The criteria are set as either maximum concentrations of total lead that should not be exceeded at any time, or average concentrations that should not be exceeded over a 30-day period. Actual values are summarized.

  20. Continuity between DSM-5 Categorical Criteria and Traits Criteria for Borderline Personality Disorder.

    Bach, Bo; Sellbom, Martin

    2016-08-01

    Borderline personality disorder (BPD) includes a heterogeneous constellation of symptoms operationalized with 9 categorical criteria. As the field of personality disorder (PD) research moves to emphasize dimensional traits in its operationalization, it is important to delineate continuity between the 9 DSM-IV/Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) categorical criteria for BPD and the trait dimensions in DSM-5 Section III. To date, no study has attempted such validation. We examined the associations between the 9 categorical DSM-IV/DSM-5 criteria for BPD and the trait dimensions of the alternative DSM-5 model for PDs in consecutively recruited psychiatric outpatients (N = 142; 68% female; age: mean 29.02, SD 8.38). This was investigated by means of bivariate correlations, followed by multiple logistic regression analysis. The categorical BPD criteria were associated with conceptually related DSM-5 Section III traits (P > 0.001), except for the criterion of chronic feelings of emptiness. Consistent with the proposed traits criteria for BPD in DSM-5 Section III, we found Emotional lability, Anxiousness, Separation insecurity, Depressivity, Impulsivity, Risk taking, and Hostility to capture conceptually coherent BPD categorical criteria, while Suspiciousness was also strongly associated with BPD criteria. At the domain level, this applied to Negative affectivity, Disinhibition, and Psychoticism. Notably, Emotional lability, Impulsivity, and Suspiciousness emerged as unique predictors of BPD (P > 0.05). In addition to the proposed BPD traits criteria, Suspiciousness and features of Psychoticism also augment BPD features. Provided that these findings are replicated in forthcoming research, a modified traits operationalization of BPD is warranted. © The Author(s) 2016.

  1. A Multi-Criteria Approach to Dry Port Location in Developing Economies with Application to Vietnam

    Lam Canh Nguyen

    2016-03-01

    Full Text Available This paper presents a conceptual framework for the inclusion of multiple criteria in the evaluation of dry port location in developing countries from a multiple stakeholder perspective. We present the framework in four steps. The first step encompasses preliminary research to filter the alternative locations for dry port development. In the second step, the stakeholders are clustered in three groups: dry port users, dry port service providers and the wider community. Then, we present the sub-criteria related to dry port location including the associated measuring methods. The third step includes an explanation on the methods used for weighing these criteria and sub-criteria. A multi-criteria analysis is carried out in the final step. We apply the methodological framework to Vietnam. The location of a new dry port project in Vinh Phuc province will be evaluated against two existing inland clearance depots (ICD in Lao Cai and Phu Tho province.

  2. NSSS supplier's response to differing safety criteria

    Cremades, J; Filkin, R; Franke, T [Westinghouse Electric Nuclear Energy Systems Europe (WENESE), Brussels (Belgium)

    1980-11-01

    The limited progress achieved to date in harmonizing national criteria has led to the development of designs which include the most common national requirements. Progress towards harmonization of safety criteria can be accelerated by expanding the IAEA leadership and co-ordination activities, and implementing an integrated approach to criteria development. National and International safety criteria are examined.

  3. Criteria for controlled atmosphere chambers

    Robinson, J.N.

    1980-03-01

    The criteria for design, construction, and operation of controlled atmosphere chambers intended for service at ORNL are presented. Classification of chambers, materials for construction, design criteria, design, controlled atmosphere chamber systems, and operating procedures are presented. ORNL Safety Manual Procedure 2.1; ORNL Health Physics Procedure Manual Appendix A-7; and Design of Viewing Windows are included in 3 appendices

  4. Packaging design criteria for the MCO cask

    Edwards, W.S.

    1996-01-01

    Approximately 2,100 metric tons of unprocessed, irradiated nuclear fuel elements are presently stored in the K Basins (including possibly 700 additional elements from PUREX, N Reactor, and 327 Laboratory). The basin water, particularly in the K East Basin, contains significant quantities of dissolved nuclear isotopes and radioactive fuel corrosion particles. To permit cleanup of the K Basins and fuel conditioning, the fuel will be transported from the 100 K Area to a Canister Storage Building (CSB) in the 200 East area. In order to initiate K Basin cleanup on schedule, the two-year fuel-shipping campaign must begin by December 1997. The purpose of this packaging design criteria is to provide criteria for the design, fabrication, and use of a packaging system to transport the large quantities of irradiated nuclear fuel elements positioned within Multiple Canister Overpacks

  5. Criteria for authorship in bioethics.

    Resnik, David B; Master, Zubin

    2011-10-01

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

  6. Aquatic Life Criteria - Tributyltin (TBT)

    Documents pertaining to 2004 Final Acute and Chronic Ambient Aquatic Life Water Quality Criteria for Tributyltin (TBT) for freshwater and saltwater. These documents include the safe levels of TBT that should protect the majority of species.

  7. User-Centric Multi-Criteria Information Retrieval

    Wolfe, Shawn R.; Zhang, Yi

    2009-01-01

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

  8. Proposed Diagnostic Criteria for Smartphone Addiction.

    Lin, Yu-Hsuan; Chiang, Chih-Lin; Lin, Po-Hsien; Chang, Li-Ren; Ko, Chih-Hung; Lee, Yang-Han; Lin, Sheng-Hsuan

    2016-01-01

    Global smartphone penetration has led to unprecedented addictive behaviors. The aims of this study are to develop diagnostic criteria of smartphone addiction and to examine the discriminative ability and the validity of the diagnostic criteria. We developed twelve candidate criteria for characteristic symptoms of smartphone addiction and four criteria for functional impairment caused by excessive smartphone use. The participants consisted of 281 college students. Each participant was systematically assessed for smartphone-using behaviors by psychiatrist's structured diagnostic interview. The sensitivity, specificity, and diagnostic accuracy of the candidate symptom criteria were analyzed with reference to the psychiatrists' clinical global impression. The optimal model selection with its cutoff point of the diagnostic criteria differentiating the smartphone addicted subjects from non-addicted subjects was then determined by the best diagnostic accuracy. Six symptom criteria model with optimal cutoff point were determined based on the maximal diagnostic accuracy. The proposed smartphone addiction diagnostic criteria consisted of (1) six symptom criteria, (2) four functional impairment criteria and (3) exclusion criteria. Setting three symptom criteria as the cutoff point resulted in the highest diagnostic accuracy (84.3%), while the sensitivity and specificity were 79.4% and 87.5%, respectively. We suggested determining the functional impairment by two or more of the four domains considering the high accessibility and penetration of smartphone use. The diagnostic criteria of smartphone addiction demonstrated the core symptoms "impaired control" paralleled with substance related and addictive disorders. The functional impairment involved multiple domains provide a strict standard for clinical assessment.

  9. Identifying the connective strength between model parameters and performance criteria

    B. Guse

    2017-11-01

    Full Text Available In hydrological models, parameters are used to represent the time-invariant characteristics of catchments and to capture different aspects of hydrological response. Hence, model parameters need to be identified based on their role in controlling the hydrological behaviour. For the identification of meaningful parameter values, multiple and complementary performance criteria are used that compare modelled and measured discharge time series. The reliability of the identification of hydrologically meaningful model parameter values depends on how distinctly a model parameter can be assigned to one of the performance criteria. To investigate this, we introduce the new concept of connective strength between model parameters and performance criteria. The connective strength assesses the intensity in the interrelationship between model parameters and performance criteria in a bijective way. In our analysis of connective strength, model simulations are carried out based on a latin hypercube sampling. Ten performance criteria including Nash–Sutcliffe efficiency (NSE, Kling–Gupta efficiency (KGE and its three components (alpha, beta and r as well as RSR (the ratio of the root mean square error to the standard deviation for different segments of the flow duration curve (FDC are calculated. With a joint analysis of two regression tree (RT approaches, we derive how a model parameter is connected to different performance criteria. At first, RTs are constructed using each performance criterion as the target variable to detect the most relevant model parameters for each performance criterion. Secondly, RTs are constructed using each parameter as the target variable to detect which performance criteria are impacted by changes in the values of one distinct model parameter. Based on this, appropriate performance criteria are identified for each model parameter. In this study, a high bijective connective strength between model parameters and performance criteria

  10. User perspectives on relevance criteria

    Maglaughlin, Kelly L.; Sonnenwald, Diane H.

    2002-01-01

    , partially relevant, or not relevant to their information need; and explained their decisions in an interview. Analysis revealed 29 criteria, discussed positively and negatively, that were used by the participants when selecting passages that contributed or detracted from a document's relevance......This study investigates the use of criteria to assess relevant, partially relevant, and not-relevant documents. Study participants identified passages within 20 document representations that they used to make relevance judgments; judged each document representation as a whole to be relevant...... matter, thought catalyst), full text (e.g., audience, novelty, type, possible content, utility), journal/publisher (e.g., novelty, main focus, perceived quality), and personal (e.g., competition, time requirements). Results further indicate that multiple criteria are used when making relevant, partially...

  11. A de novo 1.58 Mb deletion, including MAP2K6 and mapping 1.28 Mb upstream to SOX9, identified in a patient with Pierre Robin sequence and osteopenia with multiple fractures.

    Smyk, Marta; Roeder, Elizabeth; Cheung, Sau Wai; Szafranski, Przemyslaw; Stankiewicz, Paweł

    2015-08-01

    Defects of long-range regulatory elements of dosage-sensitive genes represent an under-recognized mechanism underlying genetic diseases. Haploinsufficiency of SOX9, the gene essential for development of testes and differentiation of chondrocytes, results in campomelic dysplasia, a skeletal malformation syndrome often associated with sex reversal. Chromosomal rearrangements with breakpoints mapping up to 1.6 Mb up- and downstream to SOX9, and disrupting its distant cis-regulatory elements, have been described in patients with milder forms of campomelic dysplasia, Pierre Robin sequence, and sex reversal. We present an ∼1.58 Mb deletion mapping ∼1.28 Mb upstream to SOX9 that encompasses its putative long-range cis-regulatory element(s) and MAP2K6 in a patient with Pierre Robin sequence and osteopenia with multiple fractures. Low bone mass panel testing using massively parallel sequencing of 23 nuclear genes, including COL1A1 and COL1A2 was negative. Based on the previous mouse model of Map2k6, suggesting that Sox9 is likely a downstream target of the p38 MAPK pathway, and our previous chromosome conformation capture-on-chip (4C) data showing potential interactions between SOX9 promoter and MAP2K6, we hypothesize that deletion of MAP2K6 might have affected SOX9 expression and contributed to our patient's phenotype. © 2015 Wiley Periodicals, Inc.

  12. A Meta-Analysis of the Relations among Training Criteria

    Alliger, George

    1998-01-01

    .... Meta-analysis results among criteria using this framework include the finding of substantial reliabilities across training criteria and reasonable convergence among subdivisions of criteria within a larger level...

  13. Musculoskeletal ultrasound including definitions for ultrasonographic pathology

    Wakefield, RJ; Balint, PV; Szkudlarek, Marcin

    2005-01-01

    Ultrasound (US) has great potential as an outcome in rheumatoid arthritis trials for detecting bone erosions, synovitis, tendon disease, and enthesopathy. It has a number of distinct advantages over magnetic resonance imaging, including good patient tolerability and ability to scan multiple joints...... in a short period of time. However, there are scarce data regarding its validity, reproducibility, and responsiveness to change, making interpretation and comparison of studies difficult. In particular, there are limited data describing standardized scanning methodology and standardized definitions of US...... pathologies. This article presents the first report from the OMERACT ultrasound special interest group, which has compared US against the criteria of the OMERACT filter. Also proposed for the first time are consensus US definitions for common pathological lesions seen in patients with inflammatory arthritis....

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

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

    2015-08-25

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

  15. Problemas multiplicativos envolvendo combinatória: estratégias de resolução empregadas por alunos do Ensino Fundamental público Multiplicative problems including combinatorics: solving strategies adopted by Public Elementary School students

    Leny R. M. Teixeira

    2011-01-01

    was better in problems with two variables and factors with low values. There was no alteration in the performance among the 6th and 9th graders. In general, the difficulties found were related to: 1 intuitive models students have when dealing with multiplication (especially the one including repeated addition; 2 the semantic structure of the problem; 3 numerical preferences regarding the quantity of numerical digits, ways of representing the problem and interpretation of verbal problem statements. Because multiplication is a very complex operation involving abstract cognitive processes in its solution, we believe that the teacher needs to know them to facilitate students' learning.

  16. Criteria for performance evaluation

    David J. Weiss

    2009-03-01

    Full Text Available Using a cognitive task (mental calculation and a perceptual-motor task (stylized golf putting, we examined differential proficiency using the CWS index and several other quantitative measures of performance. The CWS index (Weiss and Shanteau, 2003 is a coherence criterion that looks only at internal properties of the data without incorporating an external standard. In Experiment 1, college students (n = 20 carried out 2- and 3-digit addition and multiplication problems under time pressure. In Experiment 2, experienced golfers (n = 12, also college students, putted toward a target from nine different locations. Within each experiment, we analyzed the same responses using different methods. For the arithmetic tasks, accuracy information (mean absolute deviation from the correct answer, MAD using a coherence criterion was available; for golf, accuracy information using a correspondence criterion (mean deviation from the target, also MAD was available. We ranked the performances of the participants according to each measure, then compared the orders using Spearman's rextsubscript{s}. For mental calculation, the CWS order correlated moderately (rextsubscript{s} =.46 with that of MAD. However, a different coherence criterion, degree of model fit, did not correlate with either CWS or accuracy. For putting, the ranking generated by CWS correlated .68 with that generated by MAD. Consensual answers were also available for both experiments, and the rankings they generated correlated highly with those of MAD. The coherence vs. correspondence distinction did not map well onto criteria for performance evaluation.

  17. Nationally Appropriate Mitigation Action: developing a Multi Criteria Decision Analysis (MCDA ) process for prioritization of NAMAs

    Sharma, Sudhir; Desgain, Denis DR; Sandbukt, Sunniva

    be relevant as next year countries will have to translate their mitigation contribution outlined in their INDCs submitted to UNFCCC into implementation plans. Multiple-criteria decision analysis (MCDA) is a tool commonly used for decision making process, including to rank options or to short-list a limited...

  18. Laser Safety Inspection Criteria

    Barat, K

    2005-01-01

    opportunity to explain audit items to the laser user and thus the reasons for some of these items. Some examples are given from the audit criteria handout. As an explanatory key to the reader, an Operational Safety Procedure (OSP) as a formally reviewed safety procedure required for all Class 3B and Class 4 laser installations. An ''OSP Binder'' contains all safety documentation related to a given laser operation and serves as a central repository for documents, such as the OSP, interlock logs, lessons learned, contact information etc. ''Unattended Operation'' refers to approved procedures for unattended operation of the laser installation and may include operation beyond normal working hours. ''L-train'' is the LLNL training tracking system

  19. Proposed Diagnostic Criteria for Smartphone Addiction.

    Yu-Hsuan Lin

    Full Text Available Global smartphone penetration has led to unprecedented addictive behaviors. The aims of this study are to develop diagnostic criteria of smartphone addiction and to examine the discriminative ability and the validity of the diagnostic criteria.We developed twelve candidate criteria for characteristic symptoms of smartphone addiction and four criteria for functional impairment caused by excessive smartphone use. The participants consisted of 281 college students. Each participant was systematically assessed for smartphone-using behaviors by psychiatrist's structured diagnostic interview. The sensitivity, specificity, and diagnostic accuracy of the candidate symptom criteria were analyzed with reference to the psychiatrists' clinical global impression. The optimal model selection with its cutoff point of the diagnostic criteria differentiating the smartphone addicted subjects from non-addicted subjects was then determined by the best diagnostic accuracy.Six symptom criteria model with optimal cutoff point were determined based on the maximal diagnostic accuracy. The proposed smartphone addiction diagnostic criteria consisted of (1 six symptom criteria, (2 four functional impairment criteria and (3 exclusion criteria. Setting three symptom criteria as the cutoff point resulted in the highest diagnostic accuracy (84.3%, while the sensitivity and specificity were 79.4% and 87.5%, respectively. We suggested determining the functional impairment by two or more of the four domains considering the high accessibility and penetration of smartphone use.The diagnostic criteria of smartphone addiction demonstrated the core symptoms "impaired control" paralleled with substance related and addictive disorders. The functional impairment involved multiple domains provide a strict standard for clinical assessment.

  20. NWTS program criteria for mined geologic disposal of nuclear wasite: site performance criteria

    1981-02-01

    This report states ten criteria governing the suitability of sites for mined geologic disposal of high-level radioactive waste. The Department of Energy will use these criteria in its search for sites and will reevaluate their use when the Nuclear Regulatory Commission issues radioactive waste repository rules. These criteria encompass site geometry, geohydrology, geochemistry, geologic characteristics, tectonic environment, human intrusion, surface characteristics, environment, and potential socioeconomic impacts. The contents of this document include background discussion, site performance criteria, and appendices. The background section describes the waste disposal system, the application of the site criteria, and applicable criteria from NWTS-33(1) - Program Objectives, Functional Requirements and System Performance Criteria. Appendix A, entitled Comparison with Other Siting Criteria compares the NWTS criteria with those recommended by other agencies. Appendix B contains DOE responses to public comments received on the January 1980 draft of this document. Appendix C is a glossary

  1. Aversive Stimulation -- Criteria for Application.

    O'Donnell, Patrick A.; Ohlson, Glenn A.

    Criteria for applying aversive stimulation with severely handicapped children are examined, and practical and ethical issues are considered. Factors seen to influence punishment outcomes include timing, intensity, and schedule of reinforcement. Suggested is the need for further research on the comparative effectiveness of positive and negative…

  2. Design criteria for advanced reactors

    Dennielou, Y.

    1991-01-01

    Design criteria for advanced reactors are discussed, including safety aspects, site selection, problems related to maintenance and possibility of repairing or replacing structures or components of a nuclear power plant, the human factor considerations. Bearing in mind that some of these criteria are the subject of consensus at international level, the author suggests to establish a table of different operator requirements, to prepare a dossier on the comparison of input data for probabilistic risk analysis, to take into consideration the means to control a severe accident from the very start of the design

  3. Multi-criteria decision making with overlapping criteria

    Mohammed Shahid Abdulla

    2012-09-01

    Full Text Available The evidential reasoning (ER algorithm for multi-criteria decision making (MCDM performs aggregation of the assessments of multiple experts, one each for every attribute (or subsystem or criterion of a given system. Two variants of ER are proposed, that handle a scenario where more than one expert assesses an attribute. The first algorithm handles the case of multiple experts who assess an attribute of a larger system. Experiments compare a modification of ER for this scenario which results in poorer detection. The second algorithm is used when experts have overlapping areas of expertise among the subsystems. A comparison is made with a variant of ER in the literature. Both algorithms are examples of novel ‘exclusive’ and ‘inclusive’ ER.

  4. An objective approach to determining criteria weights

    Milić R. Milićević

    2012-01-01

    Full Text Available This paper presents an objective approach to determining criteria weights that can be successfully used in multiple criteria models. The methods of entropy, CRITIC and FANMA are presented in this paper as well as a possible combination of the methods of objective and subjective approaches. Although based on different theoretical settings, and therefore with different algorithms of realization, all methods have a decision matrix as a starting point. An objective approach to determining the weight of criteria eliminates the negative impacts of a decision maker on criteria weights as well as on the final solution of multicriteria problems. The main aim of this paper is to systematize description procedures as a kind of help when encountering a problem of determining the criteria weights for solving multicriteria tasks. A possibility of the method application is shown in a numerical example.

  5. Repository operational criteria analysis

    Hageman, J.P.; Chowdhury, A.H.

    1992-08-01

    The objective of the ''Repository Operational Criteria (ROC) Feasibility Studies'' (or ROC task) was to conduct comprehensive and integrated analyses of repository design, construction, and operations criteria in 10 CFR Part 60 regulations, considering the interfaces and impacts of any potential changes to those regulations. The study addresses regulatory criteria related to the preclosure aspects of the geologic repository. The study task developed regulatory concepts or potential repository operational criteria (PROC) based on analysis of a repository's safety functions and other regulations for similar facilities. These regulatory concepts or PROC were used as a basis to assess the sufficiency and adequacy of the current criteria in 10 CFR Part 60. Where the regulatory concepts were same as current operational criteria, these criteria were referenced. The operations criteria referenced or the PROC developed are given in this report. Detailed analyses used to develop the regulatory concepts and any necessary PROC for those regulations that may require a minor change are also presented. The results of the ROC task showed a need for further analysis and possible major rule change related to the design bases of a geologic repository operations area, siting, and radiological emergency planning

  6. CCS site characterisation criteria

    Bachu, S.; Hawkes, C.; Lawton, D.; Pooladi-Darvish, M.; Perkins, E.

    2009-12-15

    IEA GHG recently commissioned the Alberta Research Counil in Canada to conduct a review of storage site selection criteria and site characterisation methods in order to produce a synthesis report. This report reviews the literature on the subject on the site seleciton and characterisation since the publication of the IPCC Special Report on CCS, and provides a synthesis and classification of criteria. 161 refs.

  7. Green Supplier Selection Criteria

    Nielsen, Izabela Ewa; Banaeian, Narges; Golinska, Paulina

    2014-01-01

    Green supplier selection (GSS) criteria arise from an organization inclination to respond to any existing trends in environmental issues related to business management and processes, so GSS is integrating environmental thinking into conventional supplier selection. This research is designed...... to determine prevalent general and environmental supplier selection criteria and develop a framework which can help decision makers to determine and prioritize suitable green supplier selection criteria (general and environmental). In this research we considered several parameters (evaluation objectives......) to establish suitable criteria for GSS such as their production type, requirements, policy and objectives instead of applying common criteria. At first a comprehensive and deep review on prevalent and green supplier selection literatures performed. Then several evaluation objectives defined to assess the green...

  8. Plutonium storage criteria

    Chung, D. [Scientech, Inc., Germantown, MD (United States); Ascanio, X. [Dept. of Energy, Germantown, MD (United States)

    1996-05-01

    The Department of Energy has issued a technical standard for long-term (>50 years) storage and will soon issue a criteria document for interim (<20 years) storage of plutonium materials. The long-term technical standard, {open_quotes}Criteria for Safe Storage of Plutonium Metals and Oxides,{close_quotes} addresses the requirements for storing metals and oxides with greater than 50 wt % plutonium. It calls for a standardized package that meets both off-site transportation requirements, as well as remote handling requirements from future storage facilities. The interim criteria document, {open_quotes}Criteria for Interim Safe Storage of Plutonium-Bearing Solid Materials{close_quotes}, addresses requirements for storing materials with less than 50 wt% plutonium. The interim criteria document assumes the materials will be stored on existing sites, and existing facilities and equipment will be used for repackaging to improve the margin of safety.

  9. ACR appropriateness criteria jaundice.

    Lalani, Tasneem; Couto, Corey A; Rosen, Max P; Baker, Mark E; Blake, Michael A; Cash, Brooks D; Fidler, Jeff L; Greene, Frederick L; Hindman, Nicole M; Katz, Douglas S; Kaur, Harmeet; Miller, Frank H; Qayyum, Aliya; Small, William C; Sudakoff, Gary S; Yaghmai, Vahid; Yarmish, Gail M; Yee, Judy

    2013-06-01

    A fundamental consideration in the workup of a jaundiced patient is the pretest probability of mechanical obstruction. Ultrasound is the first-line modality to exclude biliary tract obstruction. When mechanical obstruction is present, additional imaging with CT or MRI can clarify etiology, define level of obstruction, stage disease, and guide intervention. When mechanical obstruction is absent, additional imaging can evaluate liver parenchyma for fat and iron deposition and help direct biopsy in cases where underlying parenchymal disease or mass is found. Imaging techniques are reviewed for the following clinical scenarios: (1) the patient with painful jaundice, (2) the patient with painless jaundice, and (3) the patient with a nonmechanical cause for jaundice. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  10. Criteria for decommissioning

    Ricci, P.F.

    1988-01-01

    In this paper the authors describe three risk acceptability criteria as parts of a strategy to clean up decommissioned facilities, related to both the status quo and to a variety of alternative technical clean-up options. The acceptability of risk is a consideration that must enter into any decision to establish when a site is properly decommissioned. To do so, both the corporate and public aspects of the acceptability issue must be considered. The reasons for discussion the acceptability of risk are to: Legitimize the process for making cleanup decisions; Determine who is at risk, who benefits, and who bears the costs of site cleanup, for each specific cleanup option, including the do nothing option; Establish those factors that, taken as a whole, determine measures of acceptability; Determine chemical-specific aggregate and individual risk levels; and Establish levels for cleanup. The choice of these reasons is pragmatic. The method consistent with these factors is risk-risk-effectiveness: the level of cleanup must be consistent with the foreseeable use of the site and budget constraints. Natural background contamination is the level below which further cleanup is generally inefficient. Case-by-case departures from natural background are to be considered depending on demonstrated risk. For example, a hot spot is obviously a prima facie exception, but should be rebuttable. Rebuttability means that, through consensus, the ''hot spot'' is shown not to be associated with exposure

  11. FHR Generic Design Criteria

    Flanagan, George F [ORNL; Holcomb, David Eugene [ORNL; Cetiner, Sacit M [ORNL

    2012-06-01

    The purpose of this document is to provide an initial, focused reference to the safety characteristics of and a licensing approach for Fluoride-Salt-Cooled High-Temperature Reactors (FHRs). The document does not contain details of particular reactor designs nor does it attempt to identify or classify either design basis or beyond design basis accidents. Further, this document is an initial attempt by a small set of subject matter experts to document the safety and licensing characteristics of FHRs for a larger audience. The document is intended to help in setting the safety and licensing research, development, and demonstration path forward. Input from a wider audience, further technical developments, and additional study will be required to develop a consensus position on the safety and licensing characteristics of FHRs. This document begins with a brief overview of the attributes of FHRs and then a general description of their anticipated safety performance. Following this, an overview of the US nuclear power plant approval process is provided that includes both test and power reactors, as well as the role of safety standards in the approval process. The document next describes a General Design Criteria (GDC) - based approach to licensing an FHR and provides an initial draft set of FHR GDCs. The document concludes with a description of a path forward toward developing an FHR safety standard that can support both a test and power reactor licensing process.

  12. Multi-Criteria Analysis for Solar Farm Location Suitability

    Mierzwiak, Michal; Calka, Beata

    2017-12-01

    Currently the number of solar farms, as a type of renewable sources of energy, is growing rapidly. Photovoltaic power stations have many advantages, which is an incentive for their building and development. Solar energy is readily available and inexhaustible, and its production is environmentally friendly. In the present study multiple environmental and economic criteria were taken into account to select a potential photovoltaic farm location, with particular emphasis on: protected areas, land cover, solar radiation, slope angle, proximity to roads, built-up areas, and power lines. Advanced data analysis were used because of the multiplicity of criteria and their diverse influence on the choice of a potential location. They included the spatial analysis, the Weighted Linear Combination Technique (WLC), and the Analytic Hierarchy Process (AHP) as a decisionmaking method. The analysis was divided into two stages. In the first one, the areas where the location of solar farms was not possible were excluded. In the second one, the best locations meeting all environmental and economic criteria were selected. The research was conducted for the Legionowo District, using data from national surveying and mapping resources such as: BDOT10k (Database of Topographic Objects), NMT (Numerical Terrain Model), and lands and buildings register. Finally, several areas meeting the criteria were chosen. The research deals with solar farms with up to 40 kW power. The results of the study are presented as thematic maps. The advantage of the method is its versatility. It can be used not only for any area, but with little modification of the criteria, it can also be applied to choose a location for wind farms.

  13. A NSSS supplier's response to differing safety criteria

    Cremades, J.; Filkin, R.; Franke, Th.

    1980-01-01

    The limited progress achieved to date in harmonizing national criteria has led to the development of designs which include the most common national requirements. Progress towards harmonization of safety criteria can be accelerated by expanding the IAEA leadership and co-ordination activities, and implementing an integrated approach to criteria development. National and International safety criteria are examined. (author)

  14. Multiple homicides.

    Copeland, A R

    1989-09-01

    A study of multiple homicides or multiple deaths involving a solitary incident of violence by another individual was performed on the case files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, Florida, during 1983-1987. A total of 107 multiple homicides were studied: 88 double, 17 triple, one quadruple, and one quintuple. The 236 victims were analyzed regarding age, race, sex, cause of death, toxicologic data, perpetrator, locale of the incident, and reason for the incident. This article compares this type of slaying with other types of homicide including those perpetrated by serial killers. Suggestions for future research in this field are offered.

  15. Multimodal freight investment criteria.

    2010-07-01

    Literature was reviewed on multi-modal investment criteria for freight projects, examining measures and techniques for quantifying project benefits and costs, as well as ways to describe the economic importance of freight transportation. : A limited ...

  16. Water Quality Criteria

    EPA develops water quality criteria based on the latest scientific knowledge to protect human health and aquatic life. This information serves as guidance to states and tribes in adopting water quality standards.

  17. Aquatic Life Criteria - Ammonia

    Documents related to EPA's final 2013 Aquatic Life Ambient Water Quality Criteria for Ammonia (Freshwater). These documents pertain to the safe levels of Ammonia in water that should protect to the majority of species.

  18. Aquatic Life Criteria - Copper

    Documents pertain to Aquatic Life Ambient Water Quality criteria for Copper (2007 Freshwater, 2016 Estuarine/marine). These documents contain the safe levels of Copper in water that should protect to the majority of species.

  19. Integrated Criteria Document Chromium

    Slooff W; Cleven RFMJ; Janus JA; van der Poel P; van Beelen P; Boumans LJM; Canton JH; Eerens HC; Krajnc EI; de Leeuw FAAM; Matthijsen AJCM; van de Meent D; van der Meulen A; Mohn GR; Wijland GC; de Bruijn PJ; van Keulen A; Verburgh JJ; van der Woerd KF

    1990-01-01

    Betreft de engelse versie van rapport 758701001
    Bij dit rapport behoort een appendix onder hetzelfde nummer getiteld: "Integrated Criteria Document Chromium: Effects" Auteurs: Janus JA; Krajnc EI
    (appendix: see 710401002A)

  20. Efficacy of melflufen, a peptidase targeted therapy, and dexamethasone in an ongoing open-label phase 2a study in patients with relapsed and relapsed-refractory multiple myeloma (RRMM) including an initial report on progression free survival

    Voorhees, P. M.; Magarotto, V.; Sonneveld, P.

    2015-01-01

    to DNA or is readily metabolized by intracellular peptidases into hydrophilic alkylating metabolites. With targeted delivery of alkylating metabolites to tumor cells in vitro (such as multiple myeloma that are rich in activating peptidase), melflufen exerts a 20-100 fold higher anti-tumor potency...... and produces a 20 fold higher intracellular concentration of alkylating moieties compared with melphalan. Methods: Melflufen is evaluated in combination with dexamethasone (dex) 40 mg weekly in an ongoing Phase 1/2a study. RRMM patients with measurable disease and at least 2 prior lines of therapy are eligible......%) and constipation and epistaxis (13%). Treatment-related Grade 3 or 4 AEs were reported in 27 patients (87%). Those occurring in >5% of patients were thrombocytopenia (68%), neutropenia (55%), anemia (42%), leukopenia (32%) and febrile neutropenia, fatigue, pyrexia, asthenia and hyperglycemia each occurred in 6...

  1. Priority setting of health interventions: the need for multi-criteria decision analysis

    Baltussen Rob

    2006-08-01

    Full Text Available Abstract Priority setting of health interventions is often ad-hoc and resources are not used to an optimal extent. Underlying problem is that multiple criteria play a role and decisions are complex. Interventions may be chosen to maximize general population health, to reduce health inequalities of disadvantaged or vulnerable groups, ad/or to respond to life-threatening situations, all with respect to practical and budgetary constraints. This is the type of problem that policy makers are typically bad at solving rationally, unaided. They tend to use heuristic or intuitive approaches to simplify complexity, and in the process, important information is ignored. Next, policy makers may select interventions for only political motives. This indicates the need for rational and transparent approaches to priority setting. Over the past decades, a number of approaches have been developed, including evidence-based medicine, burden of disease analyses, cost-effectiveness analyses, and equity analyses. However, these approaches concentrate on single criteria only, whereas in reality, policy makers need to make choices taking into account multiple criteria simultaneously. Moreover, they do not cover all criteria that are relevant to policy makers. Therefore, the development of a multi-criteria approach to priority setting is necessary, and this has indeed recently been identified as one of the most important issues in health system research. In other scientific disciplines, multi-criteria decision analysis is well developed, has gained widespread acceptance and is routinely used. This paper presents the main principles of multi-criteria decision analysis. There are only a very few applications to guide resource allocation decisions in health. We call for a shift away from present priority setting tools in health – that tend to focus on single criteria – towards transparent and systematic approaches that take into account all relevant criteria

  2. CDW-EIS calculations for multiple ionization of Ne, Ar, Kr and Xe by the impact of H{sup +} and He{sup +}, including post-collisional electron emission

    Montanari, C C; Miraglia, J E [Instituto de AstronomIa y FIsica del Espacio, casilla de correo 67, sucursal 28, C1428EGA, Buenos Aires (Argentina); Montenegro, E C, E-mail: mclaudia@iafe.uba.a [Instituto de FIsica, Universidade Federal de Rio de Janeiro, Caixa Postal 68528, Rio de Janeiro 21945-970, RJ (Brazil)

    2010-08-28

    We present theoretical single to quintuple ionization cross sections for Ne, Ar, Kr and Xe bombarded by H{sup +} and He{sup +}. Post-collisional contributions due to Auger-like processes are taken into account using recent photoionization data. The present continuum distorted wave-eikonal initial state (CDW-EIS) and first Born approximation results are compared with the experimental data available in the energy range of 50-10 000 keV amu{sup -1} for H{sup +} on Ne and Ar, and 50-1000 keV amu{sup -1} for the other cases. In general, the combination of the CDW-EIS with the post-collisional branching ratios describes well the multiple ionization data above 300 keV amu{sup -1}, showing a clear tendency to coalesce with the first Born approximation at high energies. The surprising result of this work is the good performance of the first Born approximation which describes rather well the experimental data of double and triple ionization, even in the intermediate energy range (50-300 keV amu{sup -1}), where direct ionization is the dominant contribution.

  3. Development of threshold action criteria for light water reactors

    Okrent, D.; Baldewicz, W.L.

    1982-06-01

    A survey of recently threshold criteria for regulatory action on LWRs is presented together with some commentary. This is followed by a new proposal for threshold action criteria which includes some different risk attributes than are found in previous criteria. Some preliminary risk values are suggested for the criteria and then evaluated in terms of a few hypothetical accident scenarios. Finally, several licensing issues are examined in terms of various threshold action criteria

  4. Progress in the diagnosis and treatment of multiple sclerosis

    Shi-fang HOU

    2014-10-01

    Full Text Available The growing number of disease modifying drugs (DMDs approved for multiple sclerosis (MS treatment is a significant step forward and provides new options for MS patients. This article summarizes the clinical research highlights of MS, including clinical manifestations, accessory examinations, diagnostic criteria and progress of treatment. doi: 10.3969/j.issn.1672-6731.2014.10.004

  5. Retinopathy of prematurity screening criteria and workload ...

    Larger infants require screening to include a few outliers, but they ... Making local screening criteria narrower on the basis of a limited evidence base may be dangerous. Risk factors for CSROP in larger infants need to be researched.

  6. Retinopathy of prematurity screening criteria and workload ...

    Larger infants require screening to include a few outliers, but they require ... Making local screening criteria narrower on the basis of a limited evidence base may be dangerous. Risk factors for CSROP in larger infants need to be researched.

  7. Radiological design criteria

    Selby, J.M.; Andersen, B.V.; Carter, L.A.; Waite, D.A.

    1977-01-01

    Many new nuclear facilities are unsatisfactory from a radiation protection point of view, particularly when striving to maintain occupational exposure as low as practicable 'ALAP'. Radiation protection is achieved through physical protective features supplemented by administrative controls. Adequate physical protective feature should be achieved during construction so that supplemental administrative controls may be kept simple and workable. Many nuclear facilities fall short of adequate physical protective features, thus, remedial and sometimes awkward administrative procedures are required to safely conduct work. In reviewing the various handbooks, reports and regulations which deal with radiation protection, it may be noted that there is minimal radiological design guidance for application to nuclear facilities. A set of criteria or codes covering functional areas rather than specific nuclear facility types is badly needed. The following are suggested as functional areas to be considered: characterization of the Facility; siting and access; design exposure limits; layout (people and materials flow); ventilation and effluent control; radiation protection facilities and systems. The application of such radiological design criteria early in the design process would provide some assurance that nuclear facilities will be safe, flexible, and efficient with a minimum of costly retrofitting or administrative restrictions. Criteria which we have found helpful in these functional areas is discussed together with justification for adoption of such criteria and identification of problems which still require solution

  8. Comments on confinement criteria

    Kurak, V.; Schroer, B.; Swieca, J.A.

    1977-01-01

    For a QED 2 model with SU(n) flavour, the nature of the physical states space is more subtle than one expects on the basis of the loop criterion for confinement. One may have colour confinement without confinement of the fundamental flavour representation. Attempts to formulate confinement criteria in which the quark fields play a more fundamental role are discussed [pt

  9. Multiple Sclerosis.

    Plummer, Nancy; Michael, Nancy, Ed.

    This module on multiple sclerosis is intended for use in inservice or continuing education programs for persons who administer medications in long-term care facilities. Instructor information, including teaching suggestions, and a listing of recommended audiovisual materials and their sources appear first. The module goal and objectives are then…

  10. Packaging design criteria for the MCO cask

    Clements, M.D.

    1996-01-01

    Approximately 2,100 metric tons of unprocessed, irradiated nuclear fuel elements are presently stored in the K Basins. To permit cleanup of the K Basins and fuel conditioning, the fuel will be transported from the K Basins to a Canister Storage Building in the 200 East Area. The purpose of this packaging design criteria is to provide criteria for the design, fabrication, and use of a packaging system to transport the large quantities of irradiated nuclear fuel elements positioned within Multiple Canister Overpacks

  11. Working Towards Unified Safety Design Criteria for Modular High Temperature Gas-cooled Reactor Designs

    Reitsma, Frederik; Silady, Fred; Kunitomi, Kazuhiko

    2014-01-01

    The Nuclear Power Development Section of the IAEA recently received approval for a Coordinated Research Project (CRP) to investigate and make proposals on modular High Temperature Gas-cooled Reactor (HTGR) Safety design criteria. It is expected that these criteria would consider past experience and existing safety standards in the light of modular HTGR material and design characteristics to propose safety design criteria. It will consider the deterministic and risk-informed safety design standards that apply to the wide spectrum of Off- normal events under development worldwide for existing and planned HTGRs. The CRP would also take into account lessons from the Fukushima Daiichi accident, clarifying the safety approach and safety evaluation criteria for design and beyond design basis events, including those events that can affect multiple reactor modules and/or are dependent on the application proximate to the plant site. (e. g., industrial process steam/heat). The logical flow of criteria is from the fundamental inherent safety characteristics of modular HTGRs and associated expected performance characteristics, to the safety functions required to ensure those characteristics during the wide spectrum of Off-normal events, and finally to specific criteria related to those functions. This is detailed in the paper with specific examples included of how it may be applied. The results of the CRP will be made available to the member states and HTGR community. (author)

  12. Human Systems Design Criteria

    Rasmussen, Jens

    1982-01-01

    This paper deals with the problem of designing more humanised computer systems. This problem can be formally described as the need for defining human design criteria, which — if used in the design process - will secure that the systems designed get the relevant qualities. That is not only...... the necessary functional qualities but also the needed human qualities. The author's main argument is, that the design process should be a dialectical synthesis of the two points of view: Man as a System Component, and System as Man's Environment. Based on a man's presentation of the state of the art a set...... of design criteria is suggested and their relevance discussed. The point is to focus on the operator rather than on the computer. The crucial question is not to program the computer to work on its own conditions, but to “program” the operator to function on human conditions....

  13. Intelligent intefrace design criteria

    Sicard, Y.; Siebert, S.; Thebault, M.H.

    1990-01-01

    Optimum adequation between control means and the capacities of the teams of operators is sought for to achieve computerization of control and monitoring interfaces. Observation of the diagnosis activity of populations of operators in incident situations on a simulator enables design criteria well-suited to the characteristics of the detection, interpretation of symptoms and incident location tasks to be defined. A software tool based on a qualitative approach enables the design process to be systematized

  14. Multiple transcription factors directly regulate Hox gene lin-39 expression in ventral hypodermal cells of the C. elegans embryo and larva, including the hypodermal fate regulators LIN-26 and ELT-6.

    Liu, Wan-Ju; Reece-Hoyes, John S; Walhout, Albertha J M; Eisenmann, David M

    2014-05-13

    Hox genes encode master regulators of regional fate specification during early metazoan development. Much is known about the initiation and regulation of Hox gene expression in Drosophila and vertebrates, but less is known in the non-arthropod invertebrate model system, C. elegans. The C. elegans Hox gene lin-39 is required for correct fate specification in the midbody region, including the Vulval Precursor Cells (VPCs). To better understand lin-39 regulation and function, we aimed to identify transcription factors necessary for lin-39 expression in the VPCs, and in particular sought factors that initiate lin-39 expression in the embryo. We used the yeast one-hybrid (Y1H) method to screen for factors that bound to 13 fragments from the lin-39 region: twelve fragments contained sequences conserved between C. elegans and two other nematode species, while one fragment was known to drive reporter gene expression in the early embryo in cells that generate the VPCs. Sixteen transcription factors that bind to eight lin-39 genomic fragments were identified in yeast, and we characterized several factors by verifying their physical interactions in vitro, and showing that reduction of their function leads to alterations in lin-39 levels and lin-39::GFP reporter expression in vivo. Three factors, the orphan nuclear hormone receptor NHR-43, the hypodermal fate regulator LIN-26, and the GATA factor ELT-6 positively regulate lin-39 expression in the embryonic precursors to the VPCs. In particular, ELT-6 interacts with an enhancer that drives GFP expression in the early embryo, and the ELT-6 site we identified is necessary for proper embryonic expression. These three factors, along with the factors ZTF-17, BED-3 and TBX-9, also positively regulate lin-39 expression in the larval VPCs. These results significantly expand the number of factors known to directly bind and regulate lin-39 expression, identify the first factors required for lin-39 expression in the embryo, and hint at a

  15. Defining active progressive multiple sclerosis

    Sellebjerg, Finn; Börnsen, Lars; Ammitzbøll, Cecilie

    2017-01-01

    BACKGROUND: It is unknown whether disease activity according to consensus criteria (magnetic resonance imaging activity or clinical relapses) associate with cerebrospinal fluid (CSF) changes in progressive multiple sclerosis (MS). OBJECTIVE: To compare CSF biomarkers in active and inactive...

  16. Simplified Stability Criteria for Delayed Neutral Systems

    Xinghua Zhang

    2014-01-01

    Full Text Available For a class of linear time-invariant neutral systems with neutral and discrete constant delays, several existing asymptotic stability criteria in the form of linear matrix inequalities (LMIs are simplified by using matrix analysis techniques. Compared with the original stability criteria, the simplified ones include fewer LMI variables, which can obviously reduce computational complexity. Simultaneously, it is theoretically shown that the simplified stability criteria and original ones are equivalent; that is, they have the same conservativeness. Finally, a numerical example is employed to verify the theoretic results investigated in this paper.

  17. Layered evaluation of multi-criteria collaborative filtering for scientific paper recommendation

    Manouselis, N.; Verbert, K.; Alexandrov, V.; Lees, M.; Krzhizhanovskaya, V.; Dongarra, J.; Sloot, P.M.A.

    2013-01-01

    Recommendation algorithms have been researched extensively to help people deal with abundance of information. In recent years, the incorporation of multiple relevance criteria has attracted increased interest. Such multi-criteria recommendation approaches are researched as a paradigm for building

  18. How Turkey Meets MPOWER Criteria?

    Nazmi Bilir

    2013-02-01

    Full Text Available In 2003 World Health Assembly adopted an international treaty on tobacco control; FCTC, Framework Convention on Tobacco Control. Five year later World Health Organization (WHO declared the six effective approach for tobacco control, under the name of MPOWER. In the following years, WHO evaluated the level of implementation of MPOWER criteria in the countries. In this article, how Turkey implemented these six criteria will be discussed. Monitor tobacco use and prevention policies: Monitoring of tobacco use prevalence has been successfully monitored in Turkey through Global Adult Tobacco Survey, Global Youth Tobacco Survey and Health Professionals Tobacco Use Survey. Nevertheless, monitoring of tobacco industry activities was not successfully implemented. Protect people from tobacco smoke: Smoking was banned in most of the indoor public places in Turkey since 1996, and Turkey became a complete smoke-free country by the exposion of smoke-free places including the hospitality workplaces in 2008. Offer help to quit tobacco use: Although smoking cessation services has been a bit late in Turkey, availability of smoking cessation drugs and the establishment of free quitline services made Turkey successful in this regard. Warn about the dangers of tobacco: Since 1996, all TV channels have a duty of broadcasting programs on harms of tobacco use, not less than 90 minutes in a month and it has been implemented successfully. Additionally written messages indicating harms of tobacco has been printed on the packs since 1988 and pictures was added in 2010. But since the average surface area covered by the messages in less than 50% of the total surface of the pack, Turkey was not regarded as to meet the requirement. Enforce bans on tobacco advertising, promotion and sponsorship: All kinds of tobacco advertisement and promotion was banned by the Law in 1996. But the tobacco products was not in closed boxes at the sales points. Turkey was not found as successful

  19. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders

    Banwell, Brenda; Bennett, Jeffrey L.; Cabre, Philippe; Carroll, William; Chitnis, Tanuja; de Seze, Jérôme; Fujihara, Kazuo; Greenberg, Benjamin; Jacob, Anu; Jarius, Sven; Lana-Peixoto, Marco; Levy, Michael; Simon, Jack H.; Tenembaum, Silvia; Traboulsee, Anthony L.; Waters, Patrick; Wellik, Kay E.

    2015-01-01

    Neuromyelitis optica (NMO) is an inflammatory CNS syndrome distinct from multiple sclerosis (MS) that is associated with serum aquaporin-4 immunoglobulin G antibodies (AQP4-IgG). Prior NMO diagnostic criteria required optic nerve and spinal cord involvement but more restricted or more extensive CNS involvement may occur. The International Panel for NMO Diagnosis (IPND) was convened to develop revised diagnostic criteria using systematic literature reviews and electronic surveys to facilitate consensus. The new nomenclature defines the unifying term NMO spectrum disorders (NMOSD), which is stratified further by serologic testing (NMOSD with or without AQP4-IgG). The core clinical characteristics required for patients with NMOSD with AQP4-IgG include clinical syndromes or MRI findings related to optic nerve, spinal cord, area postrema, other brainstem, diencephalic, or cerebral presentations. More stringent clinical criteria, with additional neuroimaging findings, are required for diagnosis of NMOSD without AQP4-IgG or when serologic testing is unavailable. The IPND also proposed validation strategies and achieved consensus on pediatric NMOSD diagnosis and the concepts of monophasic NMOSD and opticospinal MS. PMID:26092914

  20. Treatment Option Overview (Plasma Cell Neoplasms Including Multiple Myeloma)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends on the ... going up even though treatment is given. Treatment Option Overview Key Points There are different types of ...

  1. Criteria for software modularization

    Card, David N.; Page, Gerald T.; Mcgarry, Frank E.

    1985-01-01

    A central issue in programming practice involves determining the appropriate size and information content of a software module. This study attempted to determine the effectiveness of two widely used criteria for software modularization, strength and size, in reducing fault rate and development cost. Data from 453 FORTRAN modules developed by professional programmers were analyzed. The results indicated that module strength is a good criterion with respect to fault rate, whereas arbitrary module size limitations inhibit programmer productivity. This analysis is a first step toward defining empirically based standards for software modularization.

  2. Exploring the Proposed DSM-5 Criteria in a Clinical Sample

    Taheri, Azin; Perry, Adrienne

    2012-01-01

    The proposed DSM-5 criteria for Autism Spectrum Disorder (ASD) depart substantially from the previous DSM-IV criteria. In this file review study of 131 children aged 2-12, previously diagnosed with either Autistic Disorder or Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), 63% met the new DSM-5 ASD criteria, including 81%…

  3. Dynamic criteria for partitioning and transmutation

    Lu, A.H.

    1991-11-01

    This paper addresses dynamic criteria intended to optimize partitioning and transmutation (P-T) concept development supporting improved nuclear waste management. Six criteria are proposed initially and the rationale for each is briefly explained. Each criterion is used as a measure (or dimension) on which the developed concepts can be evaluated. The criteria allow the P-T concepts to be evaluated in an integral system including long-term energy needs, fuel cycle, and waste management. New criteria will be identified along with the P-T concept development, and each criterion will be realistically weighted so that it is comparable in an overall criteria evaluation. The weights are subject to change as a result of technical advancements and public perception on various issues. Incomplete criteria will result in a poor choice because important factors may not be considered when the decision is made. A successful decision on the optimal P-T system depends on the completeness of criteria (dimensions) as well as realistic weights assigned to each criterion

  4. Analysis of Paper reduction schemes to develop selection criteria for ofdm signals

    Abro, F.R.

    2015-01-01

    This paper presents a review of different PAPR (Peak to Average Power Ratio) reduction schemes of OFDM (Orthogonal Frequency Division Multiplexing) signals. The schemes that have been considered include Clipping and Filtering, Coding, ACE (Active Contstellation Extension), SLM (Selected Mapping), PTS (Partial Transmit Sequence), TI (Tone Injection) and TR (Tone Reservation). A comparative analysis has been carried out qualitatively. It has been demonstrated how these schemes can be combined with MIMO (Multiple Input Multiple Output) technologies. Finally, criteria for selection of PAPR reduction schemes of OFDM systems are discussed. (author)

  5. Multi-criteria Generation-Expansion Planning with Carbon dioxide emissions and Nuclear Safety considerations

    Lee, Hun Gyu; Kim, Young Chang

    2010-01-01

    A multiple criteria decision making (MCDM) method is developed to aid decision makers in Generation Expansion planning and management. Traditionally, the prime objective of an electric utility's generation-expansion planning has been to determine the minimum cost supply plans that meet expected demands over a planning horizon (typically 10 to 30 years). Today, however, the nature of decision environments has changed substantially. Increased policy attention is given to solve the multiple tradeoff function including environmental and social factors as well as economic one related to nuclear power expansion. In order to deal with this MCDM problem, the Analytic Hierarchy Process (AHP) Model is applied

  6. Safety and reliability criteria

    O'Neil, R.

    1978-01-01

    Nuclear power plants and, in particular, reactor pressure boundary components have unique reliability requirements, in that usually no significant redundancy is possible, and a single failure can give rise to possible widespread core damage and fission product release. Reliability may be required for availability or safety reasons, but in the case of the pressure boundary and certain other systems safety may dominate. Possible Safety and Reliability (S and R) criteria are proposed which would produce acceptable reactor design. Without some S and R requirement the designer has no way of knowing how far he must go in analysing his system or component, or whether his proposed solution is likely to gain acceptance. The paper shows how reliability targets for given components and systems can be individually considered against the derived S and R criteria at the design and construction stage. Since in the case of nuclear pressure boundary components there is often very little direct experience on which to base reliability studies, relevant non-nuclear experience is examined. (author)

  7. Combining the IADPSG criteria with the WHO diagnostic criteria for ...

    Macrosomia or at least one adverse outcome were more likely in GDM patients who met the diagnostic criteria by both the IADPSG and WHO criteria (P = 0.001). Conclusion: A diagnosis of GDM that meets both the WHO and IADPSG criteria provides stronger prediction for adverse pregnancy outcome than a diagnosis that ...

  8. DISPOSABLE CANISTER WASTE ACCEPTANCE CRITERIA

    R.J. Garrett

    2001-07-30

    The purpose of this calculation is to provide the bases for defining the preclosure limits on radioactive material releases from radioactive waste forms to be received in disposable canisters at the Monitored Geologic Repository (MGR) at Yucca Mountain. Specifically, this calculation will provide the basis for criteria to be included in a forthcoming revision of the Waste Acceptance System Requirements Document (WASRD) that limits releases in terms of non-isotope-specific canister release dose-equivalent source terms. These criteria will be developed for the Department of Energy spent nuclear fuel (DSNF) standard canister, the Multicanister Overpack (MCO), the naval spent fuel canister, the High-Level Waste (HLW) canister, the plutonium can-in-canister, and the large Multipurpose Canister (MPC). The shippers of such canisters will be required to demonstrate that they meet these criteria before the canisters are accepted at the MGR. The Quality Assurance program is applicable to this calculation. The work reported in this document is part of the analysis of DSNF and is performed using procedure AP-3.124, Calculations. The work done for this analysis was evaluated according to procedure QAP-2-0, Control of Activities, which has been superseded by AP-2.21Q, Quality Determinations and Planning for Scientific, Engineering, and Regulatory Compliance Activities. This evaluation determined that such activities are subject to the requirements of DOE/RW/0333P, Quality Assurance Requirements and Description (DOE 2000). This work is also prepared in accordance with the development plan titled Design Basis Event Analyses on DOE SNF and Plutonium Can-In-Canister Waste Forms (CRWMS M&O 1999a) and Technical Work Plan For: Department of Energy Spent Nuclear Fuel Work Packages (CRWMS M&O 2000d). This calculation contains no electronic data applicable to any electronic data management system.

  9. Containment penetration design criteria and implementation

    Perry, R.F.; Rigamonti, G.; Dainora, J.

    1975-01-01

    A rational design criteria is presented which serves as a basis for the design and analysis of containment piping penetrations. The criteria includes the effect of temperature as well as mechanical loads for the full range of plant conditions. With this criteria various penetration flued head designs have been compared and optimization achieved. Sleeve wall dimensions and containment loads have been determined without reference to piping configuration. An interaction theory which allows the implementation of the criteria for the determination of design loads and minimum sleeve wall thickness. The interaction theory developed applies to elastic-perfectly plastic cylinders (pipes and sleeves) and accounts for the simultaneous load resultants of transverse shear force, bending moment, torsional moment, and axial force in addition to internal pipe pressure. Application of the theory developed to the determination of sleeve thickness and containment design loads is presented in detail. (Auth.)

  10. National Recommended Water Quality Criteria

    U.S. Environmental Protection Agency — The National Recommended Water Quality Criteria is a compilation of national recommended water quality criteria for the protection of aquatic life and human health...

  11. Laser Safety Inspection Criteria

    Barat, K.

    2005-01-01

    A responsibility of the Laser Safety Officer (LSO) is to perform laser audits. The American National Standard Z136.1 Safe Use of Lasers references this requirement through several sections. One such reference is Section 1.3.2.8, Safety Features Audits, ''The LSO shall ensure that the safety features of the laser installation facilities and laser equipment are audited periodically to assure proper operation''. The composition, frequency and rigor of that inspection/audit rests in the hands of the LSO. A common practice for institutions is to develop laser audit checklists or survey forms It is common for audit findings from one inspector or inspection to the next to vary even when reviewing the same material. How often has one heard a comment, ''well this area has been inspected several times over the years and no one ever said this or that was a problem before''. A great number of audit items, and therefore findings, are subjective because they are based on the experience and interest of the auditor to particular items on the checklist. Beam block usage, to one set of eyes might be completely adequate, while to another, inadequate. In order to provide consistency, the Laser Safety Office of the National Ignition Facility Directorate has established criteria for a number of items found on the typical laser safety audit form. The criteria are distributed to laser users. It serves two broad purposes; first, it gives the user an expectation of what will be reviewed by an auditor. Second, it is an opportunity to explain audit items to the laser user and thus the reasons for some of these items, such as labelling of beam blocks

  12. Potential games and interactive decisions with multiple criteria

    Voorneveld, M.

    1999-01-01

    Game theory is a mathematical theory for analyzing strategic interaction between decision makers. This thesis covers two game-theoretic topics. The first part of this thesis deals with potential games: noncooperative games in which the information about the goals of the separate players that is

  13. Multiple criteria decision analysis (MCDA): A tool to support ...

    The National Water Act (NWA) of 1998 has been promulgated in South Africa to support the attainment of sustainable water resource use. Before the Act was promulgated, landowners were entitled to unlimited groundwater use. The Act rectified this anomaly; however, the practical application of sustainable development ...

  14. Electronic Commerce Success Model: A Search for Multiple Criteria

    Didi Achjari

    2004-01-01

    Full Text Available The current study attempts to develop and examine framework of e-commerce success. In order to obtain comprehensive and robust measures, the framework accomodates key factors that are identified in the literature concerning the success of electronic commerce. The structural model comprises of four exogenous variables (Internal Driver, Internal Impediment, External Driver and Exgternal Impediment and one endogenous variable (Electornic Commerce Success eith 24 observed variables. The study that was administered within large Australian companies using questionaire survey concluded that benefits for both internal organization and external parties from the use of e-commerce were the main factor tro predict perceived and/or expected success of electronic commerce.

  15. Analysis of operating criteria: Multiple lakes at Voyageurs National Park

    Flug, M.; Kallemeyn, L.W.

    1993-01-01

    An overview of lake and river regulation at Voyageurs National Park, which resides on the Minnesota-Ontario border, is given to demonstrate how water policy agreements can work. In 1905 the United States and Canada authorized private dams with turbines on the Rainy River. The International Joint Commission regulates these dams. The National Park Service is mandated to preserve the natural environment for future generations. State, private, and public sector interests are tourism, flood protection, the pulp and paper industry, native wild rice growth; etc. Rule curves for regulating reservoirs have changed and committee with broad representation is cooperating to better manage the waters of Namakan Reservoir and Rainy Lake

  16. Evaluating clean energy alternatives for Jiangsu, China: An improved multi-criteria decision making method

    Zhang, Ling; Zhou, Peng; Newton, Sidney; Fang, Jian-xin; Zhou, De-qun; Zhang, Lu-ping

    2015-01-01

    Promoting the utilization of clean energy has been identified as one potential solution to addressing environmental pollution and achieving sustainable development in many countries around the world. Evaluating clean energy alternatives includes a requirement to balance multiple conflict criteria, including technology, environment, economy and society, all of which are incommensurate and interdependent. Traditional MCDM (multi-criteria decision making) methods, such as the weighted average method, often fail to aggregate such criteria consistently. In this paper, an improved MCDM method based on fuzzy measure and integral is developed and applied to evaluate four primary clean energy options for Jiangsu Province, China. The results confirm that the preferred clean energy option for Jiangsu is solar photovoltaic, followed by wind, biomass and finally nuclear. A sensitivity analysis is also conducted to evaluate the values of clean energy resources for Jiangsu. The ordered weighted average method is also applied to compare the method mentioned above in our empirical study. The results show that the improved MCDM method provides higher discrimination between alternative clean energy alternatives. - Highlights: • Interactions among evaluation criteria of clean energy resources are taken into account. • An improved multi-criteria decision making (MCDM) method is proposed based on entropy weight method, fuzzy measure and integral. • Clean energy resources of Jiangsu are evaluated with the improved MCDM method, and their ranks are identified.

  17. Criteria for exact qudit universality

    Brennen, Gavin K.; O'Leary, Dianne P.; Bullock, Stephen S.

    2005-01-01

    We describe criteria for implementation of quantum computation in qudits. A qudit is a d-dimensional system whose Hilbert space is spanned by states vertical bar 0>, vertical bar 1>, ..., vertical bar d-1>. An important earlier work [A. Muthukrishnan and C.R. Stroud, Jr., Phys. Rev. A 62, 052309 (2000)] describes how to exactly simulate an arbitrary unitary on multiple qudits using a 2d-1 parameter family of single qudit and two qudit gates. That technique is based on the spectral decomposition of unitaries. Here we generalize this argument to show that exact universality follows given a discrete set of single qudit Hamiltonians and one two-qudit Hamiltonian. The technique is related to the QR-matrix decomposition of numerical linear algebra. We consider a generic physical system in which the single qudit Hamiltonians are a small collection of H jk x =(ℎ/2π)Ω(vertical bar k> jk y =(ℎ/2π)Ω(i vertical bar k> jk x,y are allowed Hamiltonians. One qudit exact universality follows iff this graph is connected, and complete universality results if the two-qudit Hamiltonian H=(ℎ/2π)Ω vertical bar d-1,d-1> 87 Rb and construct an optimal gate sequence using Raman laser pulses

  18. Criteria for onset of firestorms

    Carrier, G.F.; Fendell, F.E.; Feldman, P.S.

    1983-01-01

    Quantitative criteria are evolved for onset of firestorms, severe stationary (nonpropagating) holocausts arising via merger of fires from multiple simultaneous ignitions in a heavily fuel-laden urban environment. Within an hour, surface-level radial inflow from all directions sustains a large-diameter convective column that eventually reaches altitude of about 10 km (e.g., Hamburg, Dresden, Hiroshima). As the firestorm achieves peak intensity (2 to 3 hours after the ignitions), inflow speeds are inferred to attain 25 to 50 m/s; typically 12 km 2 are reduced to ashes, before winds relax to ambient levels in six-to-nine hours. Here the firestorm is interpreted to be a mesocyclone (rotating severe local storm). Even with exceedingly large heat release sustained over a concentrated area, in the presence of a very nearly autoconvectively unstable atmospheric stratification, onset of vigorous swirling on the scale of two hours requires more than concentration of circulation associated with the rotation of the earth; rather, a preexisting, if weak, circulation appears necessary for firestorm cyclogenesis

  19. Multi criteria analysis in the renewable energy industry

    San Cristóbal Mateo, José Ramón

    2012-01-01

    Decision makers in the Renewable Energy sector face an increasingly complex social, economic, technological, and environmental scenario in their decision process. Different groups of decision-makers become involved in the process, each group bringing along different criteria therefore, policy formulation for fossil fuel substitution by Renewable Energies must be addressed in a multi-criteria context. Multi Criteria Analysis in the Renewable Energy Industry is a direct response to the increasing interest in the Renewable Energy industry which can be seen as an important remedy to many environmental problems that the world faces today. The multiplicity of criteria and the increasingly complex social, economic, technological, and environmental scenario makes multi-criteria analysis a valuable tool in the decision-making process for fossil fuel substitution. The detailed chapters explore the use of the Multi-criteria decision-making methods and how they provide valuable assistance in reaching equitable and accept...

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

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

    2016-03-01

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

  1. New seismograph includes filters

    1979-11-02

    The new Nimbus ES-1210 multichannel signal enhancement seismograph from EG and G geometrics has recently been redesigned to include multimode signal fillers on each amplifier. The ES-1210F is a shallow exploration seismograph for near subsurface exploration such as in depth-to-bedrock, geological hazard location, mineral exploration, and landslide investigations.

  2. Generalized internal multiple imaging

    Zuberi, Mohammad Akbar Hosain

    2014-12-04

    Various examples are provided for generalized internal multiple imaging (GIMI). In one example, among others, a method includes generating a higher order internal multiple image using a background Green\\'s function and rendering the higher order internal multiple image for presentation. In another example, a system includes a computing device and a generalized internal multiple imaging (GIMI) application executable in the computing device. The GIMI application includes logic that generates a higher order internal multiple image using a background Green\\'s function and logic that renders the higher order internal multiple image for display on a display device. In another example, a non-transitory computer readable medium has a program executable by processing circuitry that generates a higher order internal multiple image using a background Green\\'s function and renders the higher order internal multiple image for display on a display device.

  3. Generalized internal multiple imaging

    Zuberi, Mohammad Akbar Hosain; Alkhalifah, Tariq

    2014-01-01

    Various examples are provided for generalized internal multiple imaging (GIMI). In one example, among others, a method includes generating a higher order internal multiple image using a background Green's function and rendering the higher order internal multiple image for presentation. In another example, a system includes a computing device and a generalized internal multiple imaging (GIMI) application executable in the computing device. The GIMI application includes logic that generates a higher order internal multiple image using a background Green's function and logic that renders the higher order internal multiple image for display on a display device. In another example, a non-transitory computer readable medium has a program executable by processing circuitry that generates a higher order internal multiple image using a background Green's function and renders the higher order internal multiple image for display on a display device.

  4. Decision criteria in PSA applications

    Holmberg, J.E.; Pulkkinen, U.; Rosqvist, T.; Simola, K.

    2001-11-01

    Along with the adoption of risk informed decision making principles, the need for formal probabilistic decision rule or criteria has been risen. However, there are many practical and theoretical problems in the application of probabilistic criteria. One has to think what is the proper way to apply probabilistic rules together with deterministic ones and how the criteria are weighted with respect to each other. In this report, we approach the above questions from the decision theoretic point of view. We give a short review of the most well known probabilistic criteria, and discuss examples of their use. We present a decision analytic framework for evaluating the criteria, and we analyse how the different criteria behave under incompleteness or uncertainty of the PSA model. As the conclusion of our analysis we give recommendations on the application of the criteria in different decision situations. (au)

  5. Analytic device including nanostructures

    Di Fabrizio, Enzo M.; Fratalocchi, Andrea; Totero Gongora, Juan Sebastian; Coluccio, Maria Laura; Candeloro, Patrizio; Cuda, Gianni

    2015-01-01

    A device for detecting an analyte in a sample comprising: an array including a plurality of pixels, each pixel including a nanochain comprising: a first nanostructure, a second nanostructure, and a third nanostructure, wherein size of the first nanostructure is larger than that of the second nanostructure, and size of the second nanostructure is larger than that of the third nanostructure, and wherein the first nanostructure, the second nanostructure, and the third nanostructure are positioned on a substrate such that when the nanochain is excited by an energy, an optical field between the second nanostructure and the third nanostructure is stronger than an optical field between the first nanostructure and the second nanostructure, wherein the array is configured to receive a sample; and a detector arranged to collect spectral data from a plurality of pixels of the array.

  6. Saskatchewan resources. [including uranium

    1979-09-01

    The production of chemicals and minerals for the chemical industry in Saskatchewan are featured, with some discussion of resource taxation. The commodities mentioned include potash, fatty amines, uranium, heavy oil, sodium sulfate, chlorine, sodium hydroxide, sodium chlorate and bentonite. Following the successful outcome of the Cluff Lake inquiry, the uranium industry is booming. Some developments and production figures for Gulf Minerals, Amok, Cenex and Eldorado are mentioned.

  7. Defining criteria related to wastes for use in multi-criteria decision tool for nuclear accidents

    Silva, Diogo N.G.; Guimaraes, Jean R.D., E-mail: dneves@biof.ufrj.br, E-mail: jeanrdg@biof.ufrj.br [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Instituto de Biofisica Carlos Chagas Filho; Rochedo, Elaine R.R.; De Luca, Christiano, E-mail: elainerochedo@gmail.com, E-mail: christiano_luca@hotmail.com [Instituto Militar de Engenharia (IME), Rio de Janeiro, RJ (Brazil). Programa de Engenharia Nuclear; Rochedo, Pedro R.R., E-mail: rochedopedro@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Instituto Alberto Luiz Coimbra de Pos-Graduacao e Pesquisa de Engenharia

    2013-07-01

    The selection of protective measures and strategies for remediation of contaminated areas after a nuclear accident must be based on previously established criteria in order to prevent stress of the population and the unnecessary exposure of workers. After a nuclear accident resulting in environmental contamination, decisions on remediation of areas is complex due to the large numbers of factors involved in decontamination processes. This work is part of a project which aims to develop a multi-criteria tool to support a decision-making process in cases of a radiological or a nuclear accident in Brazil. First, a database of remediation strategies for contaminated areas was created. In this process, the most relevant aspects for the implementation of these strategies were considered, including technical criteria regarding aspects related to the generation of wastes in a reference urban area, which are discussed in this paper. The specific objective of this study is to define criteria for the aspects of radioactive wastes, resulted by the implementation of some urban measures, in order to be incorporated in a multi-criteria decision tool. Main aspects considered were the type, the amount and the type of treatment necessary for each procedure. The decontamination procedures are then classified according to the selected criteria in order to feed the multi-criteria decision tool. This paper describes the steps for the establishment of these criteria and evaluates the potential for future applications in order to improve predictions and to support the decisions to be made. (author)

  8. Defining criteria related to wastes for use in multi-criteria decision tool for nuclear accidents

    Silva, Diogo N.G.; Guimaraes, Jean R.D.; Rochedo, Elaine R.R.; De Luca, Christiano; Rochedo, Pedro R.R.

    2013-01-01

    The selection of protective measures and strategies for remediation of contaminated areas after a nuclear accident must be based on previously established criteria in order to prevent stress of the population and the unnecessary exposure of workers. After a nuclear accident resulting in environmental contamination, decisions on remediation of areas is complex due to the large numbers of factors involved in decontamination processes. This work is part of a project which aims to develop a multi-criteria tool to support a decision-making process in cases of a radiological or a nuclear accident in Brazil. First, a database of remediation strategies for contaminated areas was created. In this process, the most relevant aspects for the implementation of these strategies were considered, including technical criteria regarding aspects related to the generation of wastes in a reference urban area, which are discussed in this paper. The specific objective of this study is to define criteria for the aspects of radioactive wastes, resulted by the implementation of some urban measures, in order to be incorporated in a multi-criteria decision tool. Main aspects considered were the type, the amount and the type of treatment necessary for each procedure. The decontamination procedures are then classified according to the selected criteria in order to feed the multi-criteria decision tool. This paper describes the steps for the establishment of these criteria and evaluates the potential for future applications in order to improve predictions and to support the decisions to be made. (author)

  9. Criteria of site assessment

    Gibbs, P.; Fuchs, H.

    1975-01-01

    The criteria which lead to the choice of a particular site for a nuclear power station are in general very similar to those which would apply to any other type of power station. The principal differences derive from the simpler transport problems for the fuel compared with, say, solid fuel and the special safety considerations which attach to nuclear reactors. The search for a suitable site obviously starts by considering where the power is needed, i.e. where the load centers are and also the existing transmission network which may help to bring the power from a more remote site to the load centers. This economic incentive to put the plant close to loads conflicts directly with the nuclear safety argument which favours more remote siting, and part of the problem of site selection is to reconcile these two matters. In addition, there are many other important matters which will be considered later concerning the adequacy of cooling water supplies, foundation conditions, etc., all of which must be examined in considerable detail. (orig./TK) [de

  10. Safety criteria for nuclear chemical plants

    Ball, P.W.; Curtis, L.M.

    1983-01-01

    Safety measures have always been required to limit the hazards due to accidental release of radioactive substances from nuclear power plants and chemical plants. The risk associated with the discharge of radioactive substances during normal operation has also to be kept acceptably low. BNFL (British Nuclear Fuels Ltd.) are developing risk criteria as targets for safe plant design and operation. The numerical values derived are compared with these criteria to see if plants are 'acceptably safe'. However, the criteria are not mandatory and may be exceeded if this can be justified. The risk assessments are subject to independent review and audit. The Nuclear Installations Inspectorate also has to pass the plants as safe. The assessment principles it uses are stated. The development of risk criteria for a multiplant site (nuclear chemical plants tend to be sited with many others which are related functionally) is discussed. This covers individual members of the general public, societal risks, risks to the workforce and external hazards. (U.K.)

  11. Multi-criteria decision making to support waste management: A critical review of current practices and methods.

    Goulart Coelho, Lineker M; Lange, Liséte C; Coelho, Hosmanny Mg

    2017-01-01

    Solid waste management is a complex domain involving the interaction of several dimensions; thus, its analysis and control impose continuous challenges for decision makers. In this context, multi-criteria decision-making models have become important and convenient supporting tools for solid waste management because they can handle problems involving multiple dimensions and conflicting criteria. However, the selection of the multi-criteria decision-making method is a hard task since there are several multi-criteria decision-making approaches, each one with a large number of variants whose applicability depends on information availability and the aim of the study. Therefore, to support researchers and decision makers, the objectives of this article are to present a literature review of multi-criteria decision-making applications used in solid waste management, offer a critical assessment of the current practices, and provide suggestions for future works. A brief review of fundamental concepts on this topic is first provided, followed by the analysis of 260 articles related to the application of multi-criteria decision making in solid waste management. These studies were investigated in terms of the methodology, including specific steps such as normalisation, weighting, and sensitivity analysis. In addition, information related to waste type, the study objective, and aspects considered was recorded. From the articles analysed it is noted that studies using multi-criteria decision making in solid waste management are predominantly addressed to problems related to municipal solid waste involving facility location or management strategy.

  12. Being Included and Excluded

    Korzenevica, Marina

    2016-01-01

    Following the civil war of 1996–2006, there was a dramatic increase in the labor mobility of young men and the inclusion of young women in formal education, which led to the transformation of the political landscape of rural Nepal. Mobility and schooling represent a level of prestige that rural...... politics. It analyzes how formal education and mobility either challenge or reinforce traditional gendered norms which dictate a lowly position for young married women in the household and their absence from community politics. The article concludes that women are simultaneously excluded and included from...... community politics. On the one hand, their mobility and decision-making powers decrease with the increase in the labor mobility of men and their newly gained education is politically devalued when compared to the informal education that men gain through mobility, but on the other hand, schooling strengthens...

  13. Multi-criteria decision analysis: Limitations, pitfalls, and practical difficulties

    Kujawski, Edouard

    2003-02-01

    The 2002 Winter Olympics women's figure skating competition is used as a case study to illustrate some of the limitations, pitfalls, and practical difficulties of Multi-Criteria Decision Analysis (MCDA). The paper compares several widely used models for synthesizing the multiple attributes into a single aggregate value. The various MCDA models can provide conflicting rankings of the alternatives for a common set of information even under states of certainty. Analysts involved in MCDA need to deal with the following challenging tasks: (1) selecting an appropriate analysis method, and (2) properly interpreting the results. An additional trap is the availability of software tools that implement specific MCDA models that can beguile the user with quantitative scores. These conclusions are independent of the decision domain and they should help foster better MCDA practices in many fields including systems engineering trade studies.

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

    Benbenek, Daniel; Soloff, Jason; Lieb, Erica

    2010-01-01

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

  15. Identifying Effectiveness Criteria for Internet Payment Systems.

    Shon, Tae-Hwan; Swatman, Paula M. C.

    1998-01-01

    Examines Internet payment systems (IPS): third-party, card, secure Web server, electronic token, financial electronic data interchange (EDI), and micropayment based. Reports the results of a Delphi survey of experts identifying and classifying IPS effectiveness criteria and classifying types of IPS providers. Includes the survey invitation letter…

  16. Hanford Site solid waste acceptance criteria

    Ellefson, M.D.

    1998-01-01

    Order 5820.2A requires that each treatment, storage, and/or disposal facility (referred to in this document as TSD unit) that manages low-level or transuranic waste (including mixed waste and TSCA PCB waste) maintain waste acceptance criteria. These criteria must address the various requirements to operate the TSD unit in compliance with applicable safety and environmental requirements. This document sets forth the baseline criteria for acceptance of radioactive waste at TSD units operated by WMH. The criteria for each TSD unit have been established to ensure that waste accepted can be managed in a manner that is within the operating requirements of the unit, including environmental regulations, DOE Orders, permits, technical safety requirements, waste analysis plans, performance assessments, and other applicable requirements. Acceptance criteria apply to the following TSD units: the Low-Level Burial Grounds (LLBG) including both the nonregulated portions of the LLBG and trenches 31 and 34 of the 218-W-5 Burial Ground for mixed waste disposal; Central Waste Complex (CWC); Waste Receiving and Processing Facility (WRAP); and T Plant Complex. Waste from all generators, both from the Hanford Site and from offsite facilities, must comply with these criteria. Exceptions can be granted as provided in Section 1.6. Specific waste streams could have additional requirements based on the 1901 identified TSD pathway. These requirements are communicated in the Waste Specification Records (WSRds). The Hanford Site manages nonradioactive waste through direct shipments to offsite contractors. The waste acceptance requirements of the offsite TSD facility must be met for these nonradioactive wastes. This document does not address the acceptance requirements of these offsite facilities

  17. Combining the IADPSG criteria with the WHO diagnostic criteria for ...

    The International Association of Diabetes in Pregnancy Study Group (IADPSG) and World Health ... Macrosomia or at least one adverse outcome were more likely in GDM patients who ... criteria for GDM in the ADA's more recent position statement.[18] .... at risk for postpartum type 2 DM;[27] the IADPSG criteria on the other ...

  18. Multiple Perspectives / Multiple Readings

    Simon Biggs

    2005-01-01

    Full Text Available People experience things from their own physical point of view. What they see is usually a function of where they are and what physical attitude they adopt relative to the subject. With augmented vision (periscopes, mirrors, remote cameras, etc we are able to see things from places where we are not present. With time-shifting technologies, such as the video recorder, we can also see things from the past; a time and a place we may never have visited.In recent artistic work I have been exploring the implications of digital technology, interactivity and internet connectivity that allow people to not so much space/time-shift their visual experience of things but rather see what happens when everybody is simultaneously able to see what everybody else can see. This is extrapolated through the remote networking of sites that are actual installation spaces; where the physical movements of viewers in the space generate multiple perspectives, linked to other similar sites at remote locations or to other viewers entering the shared data-space through a web based version of the work.This text explores the processes involved in such a practice and reflects on related questions regarding the non-singularity of being and the sense of self as linked to time and place.

  19. Proliferation resistance criteria for fissile material disposition

    Close, D.A.; Fearey, B.L.; Markin, J.T.; Rutherford, D.A.; Duggan, R.A.; Jaeger, C.D.; Mangan, D.L.; Moya, R.W.; Moore, L.R.; Strait, R.S.

    1995-04-01

    The 1994 National Academy of Sciences study open-quotes Management and Disposition of Excess Weapons Plutoniumclose quotes defined options for reducing the national and international proliferation risks of materials declared excess to the nuclear weapons program. This report proposes criteria for assessing the proliferation resistance of these options. The criteria are general, encompassing all stages of the disposition process from storage through intermediate processing to final disposition including the facilities, processing technologies and materials, the level of safeguards for these materials, and the national/subnational threat to the materials

  20. NEVADA TEST SITE WASTE ACCEPTANCE CRITERIA

    U.S. DEPARTMENT OF ENERGY, NATIONAL NUCLEAR SECURITY ADMINISTRATION, NEVADA SITE OFFICE

    2005-01-01

    This document establishes the U. S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) waste acceptance criteria (WAC). The WAC provides the requirements, terms, and conditions under which the Nevada Test Site will accept low-level radioactive and mixed waste for disposal. Mixed waste generated within the State of Nevada by NNSA/NSO activities is accepted for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the Nevada Test Site Area 3 and Area 5 Radioactive Waste Management Site for storage or disposal

  1. Nevada Test Site Waste Acceptance Criteria

    U. S. Department of Energy, National Nuclear Security Administration Nevada Site Office

    2005-01-01

    This document establishes the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) waste acceptance criteria (WAC). The WAC provides the requirements, terms, and conditions under which the Nevada Test Site (NTS) will accept low-level radioactive (LLW) and mixed waste (MW) for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NTS Area 3 and Area 5 Radioactive Waste Management Complex (RWMC) for storage or disposal

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

    Dietrich, Jörg

    2016-05-01

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

  3. Nonreactor nuclear facilities: standards and criteria guide

    Brynda, W.J.; Junker, L.; Karol, R.C.; Lobner, P.R.; Goldman, L.A.

    1981-09-01

    This guide is a source document that identifies standards, codes, and guides that address the nuclear safety considerations pertinent to nuclear facilities as defined in DOE Order 5480.1, Chapter V, Safety of Nuclear Facilities. The guidance and criteria provided are directed toward areas of safety usually addressed in a Safety Analysis Report. The areas of safety include, but are not limited to, siting, principal design criteria and safety system design guidelines, radiation protection, accident analysis, and quality assurance. The guide is divided into two sections: general guidelines and appendices. Those guidelines that are broadly applicable to most nuclear facilities are presented in the general guidelines. These general guidelines may have limited applicability to subsurface facilities such as waste repositories. Guidelines specific to the various types or categories of nuclear facilities are presented in the appendices. These facility-specific appendices provide guidelines and identify standards and criteria that should be considered in addition to, or in lieu of, the general guidelines

  4. Nonreactor nuclear facilities: Standards and criteria guide

    Brynda, W.J.; Scarlett, C.H.; Tanguay, G.E.; Lobner, P.R.

    1986-09-01

    This guide is a source document that identifies standards, codes, and guides that address the nuclear safety considerations pertinent to nuclear facilities as defined in DOE 5480.1A, Chapter V, ''Safety of Nuclear Facilities.'' The guidance and criteria provided is directed toward areas of safety usually addressed in a Safety Analysis Report. The areas of safety include, but are not limited to, siting, principal design criteria and safety system design guidelines, radiation protection, accident analysis, conduct of operations, and quality assurance. The guide is divided into two sections: general guidelines and appendices. Those guidelines that are broadly applicable to most nuclear facilities are presented in the general guidelines. Guidelines specific to the various types or categories of nuclear facilities are presented in the appendices. These facility-specific appendices provide guidelines and identify standards and criteria that should be considered in addition to, or in lieu of, the general guidelines. 25 figs., 62 tabs

  5. Maintenance evaluation using risk based criteria

    Torres Valle, A.

    1996-01-01

    The maintenance evaluation is currently performed by using economic and, in some case, technical equipment failure criteria, however this is done to a specific equipment level. In general, when statistics are used the analysis for maintenance optimization are made isolated and whit a post mortem character; The integration provided by mean of Probabilistic Safety assessment (PSA) together with the possibilities of its applications, allow for evaluation of maintenance on the basis of broader scope criteria in regard to those traditionally used. The evaluate maintenance using risk based criteria, is necessary to follow a dynamic and systematic approach, in studying the maintenance strategy, to allow for updating the initial probabilistic models, for including operational changes that often take place during operation of complex facilities. This paper proposes a dynamic evaluation system of maintenance task. The system is illustrated by means of a practical example

  6. Developing criteria to establish Trusted Digital Repositories

    Faundeen, John L.

    2017-01-01

    This paper details the drivers, methods, and outcomes of the U.S. Geological Survey’s quest to establish criteria by which to judge its own digital preservation resources as Trusted Digital Repositories. Drivers included recent U.S. legislation focused on data and asset management conducted by federal agencies spending $100M USD or more annually on research activities. The methods entailed seeking existing evaluation criteria from national and international organizations such as International Standards Organization (ISO), U.S. Library of Congress, and Data Seal of Approval upon which to model USGS repository evaluations. Certification, complexity, cost, and usability of existing evaluation models were key considerations. The selected evaluation method was derived to allow the repository evaluation process to be transparent, understandable, and defensible; factors that are critical for judging competing, internal units. Implementing the chosen evaluation criteria involved establishing a cross-agency, multi-disciplinary team that interfaced across the organization. 

  7. Rationales for the Lightning Launch Commit Criteria

    Willett, John C. (Editor); Merceret, Francis J. (Editor); Krider, E. Philip; O'Brien, T. Paul; Dye, James E.; Walterscheid, Richard L.; Stolzenburg, Maribeth; Cummins, Kenneth; Christian, Hugh J.; Madura, John T.

    2016-01-01

    Since natural and triggered lightning are demonstrated hazards to launch vehicles, payloads, and spacecraft, NASA and the Department of Defense (DoD) follow the Lightning Launch Commit Criteria (LLCC) for launches from Federal Ranges. The LLCC were developed to prevent future instances of a rocket intercepting natural lightning or triggering a lightning flash during launch from a Federal Range. NASA and DoD utilize the Lightning Advisory Panel (LAP) to establish and develop robust rationale from which the criteria originate. The rationale document also contains appendices that provide additional scientific background, including detailed descriptions of the theory and observations behind the rationales. The LLCC in whole or part are used across the globe due to the rigor of the documented criteria and associated rationale. The Federal Aviation Administration (FAA) adopted the LLCC in 2006 for commercial space transportation and the criteria were codified in the FAA's Code of Federal Regulations (CFR) for Safety of an Expendable Launch Vehicle (Appendix G to 14 CFR Part 417, (G417)) and renamed Lightning Flight Commit Criteria in G417.

  8. Principles and Criteria for Design

    Beghin, D.; Cervetto, D.; Hansen, Peter Friis

    1997-01-01

    The mandate of ISSC Committee IV.1 on principles and Criteria for Design is to report on the following:The ongoing concern for quantification of general economic and safety criteria for marine structures and for the development of appropriate principles for rational life cycle design using...

  9. Diagnostic criteria for vascular dementia

    Scheltens, P.; Hijdra, A. H.

    1998-01-01

    The term vascular dementia implies the presence of a clinical syndrome (dementia) caused by, or at least assumed to be caused by, a specific disorder (cerebrovascular disease). In this review, the various sets of criteria used to define vascular dementia are outlined. The various sets of criteria

  10. Naturalist Intelligence Among the Other Multiple Intelligences [In Bulgarian

    R. Genkov

    2007-09-01

    Full Text Available The theory of multiple intelligences was presented by Gardner in 1983. The theory was revised later (1999 and among the other intelligences a naturalist intelligence was added. The criteria for distinguishing of the different types of intelligences are considered. While Gardner restricted the analysis of the naturalist intelligence with examples from the living nature only, the present paper considered this problem on wider background including objects and persons of the natural sciences.

  11. Failure Criteria for Reinforced Materials

    Rathkjen, Arne

    Failure of materials is often characterized as ductile yielding, brittle fracture, creep rupture, etc., and different criteria given in terms of different parameters have been used to describe different types of failure. Only criteria expressing failure in terms of stress are considered in what...... place until the matrix, the continuous component of the composite, fails. When an isotropic matrix is reinforced as described above, the result is an anisotropic composite material. Even if the material is anisotropic, it usually exhibits a rather high degree of symmetry and such symmetries place...... certain restrictions on the form of the failure criteria for anisotropic materials. In section 2, some failure criteria for homogenous materials are reviewed. Both isotropic and anisotropic materials are described, and in particular the constraints imposed on the criteria from the symmetries orthotropy...

  12. Comparing new diagnostic criteria of 2010 ACR/EULAR with 1987 ACR criteria in rheumatoid arthritis

    Fatemeh Shirani

    2017-01-01

    Full Text Available Background: Rheumatoid Arthritis (RA is a chronic inflammatory disease presenting with inflammation, tenderness and destruction of the synovial joints, resulting in severe disability and early death due to complication of disease. Previous diagnostic criteria are not useful for identifying patients who need early treatment. Thus, new diagnostic criteria for faster diagnosis of disease are introduced in 2010. The aim of this study was to compared 1987 ACR (American College of Rheumatology criteria and 2010 ACR/EULAR (European League Against Rheumatism classification criteria for diagnosis of rheumatoid arthritis. Methods: In this Cohort prospective study, patients with early arthritis were evaluated   according to the old and new diagnostic criteria and followed-up every two monthly for one year (2012-2013 in Hazrat-e Rasool University Hospital, Tehran. Inclusion criteria of this study were age more than 18 year and indefinite diagnosis of arthritis. For all of patients physical examination by expert rheumatologist was done and lab data include erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, anti-cyclic citrullinated peptide (Anti-CCP and rheumatoid factor was requested. The sensitivity, specificity, positive and negative predictive values were then determined for each diagnostic criteria. Results: In this study 104 patients including 28 males (26.9% and 76 females (73.1% with the mean age of 44.2±13.7 years were included. At the end of one year follow-up, 82 were diagnosed to have RA while other 22 patients were not categorized as RA. Sensitivity for ESR, CRP, Anti-CCP and rheumatoid factor in 2010 ACR/EULAR criteria was 52%, 19%, 48%, 28% and specificity for them was 45%, 71%, 27%, 79% respectively. Number of small and large joint arthritis were more in patients with Rheumatoid Arthritis (RA rather than other arthritis (P=0.0001. Sensitivity and specificity for small joints involvement was 87% and 54% and for large joints

  13. Multiple-Ring Digital Communication Network

    Kirkham, Harold

    1992-01-01

    Optical-fiber digital communication network to support data-acquisition and control functions of electric-power-distribution networks. Optical-fiber links of communication network follow power-distribution routes. Since fiber crosses open power switches, communication network includes multiple interconnected loops with occasional spurs. At each intersection node is needed. Nodes of communication network include power-distribution substations and power-controlling units. In addition to serving data acquisition and control functions, each node acts as repeater, passing on messages to next node(s). Multiple-ring communication network operates on new AbNET protocol and features fiber-optic communication.

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

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

    2012-04-01

    Maxillectomy defects are complex and involve a number of anatomic structures. Several maxillectomy defect classifications have been proposed with no universal acceptance among surgeons and prosthodontists. Established criteria for describing the maxillectomy defect are lacking. This systematic review aimed to evaluate classification systems in the available literature, to provide a critical appraisal, and to identify the criteria necessary for a universal description of maxillectomy and midfacial defects. An electronic search of the English language literature between the periods of 1974 and June 2011 was performed by using PubMed, Scopus, and Cochrane databases with predetermined inclusion criteria. Key terms included in the search were maxillectomy classification, maxillary resection classification, maxillary removal classification, maxillary reconstruction classification, midfacial defect classification, and midfacial reconstruction classification. This was supplemented by a manual search of selected journals. After application of predetermined exclusion criteria, the final list of articles was reviewed in-depth to provide a critical appraisal and identify criteria for a universal description of a maxillectomy defect. The electronic database search yielded 261 titles. Systematic application of inclusion and exclusion criteria resulted in identification of 14 maxillectomy and midfacial defect classification systems. From these articles, 6 different criteria were identified as necessary for a universal description of a maxillectomy defect. Multiple deficiencies were noted in each classification system. Though most articles described the superior-inferior extent of the defect, only a small number of articles described the anterior-posterior and medial-lateral extent of the defect. Few articles listed dental status and soft palate involvement when describing maxillectomy defects. No classification system has accurately described the maxillectomy defect, based on

  15. Nevada Test Site Waste Acceptance Criteria, December 2000

    NONE

    2000-12-01

    This document establishes the US Department of Energy, Nevada Operations Office waste acceptance criteria. The waste acceptance criteria provides the requirements, terms, and conditions under which the Nevada Test Site will accept low-level radioactive waste and mixed waste for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the Nevada Test Site Area 3 and Area 5 Radioactive Waste Management Sites for storage or disposal.

  16. Seismic re-evaluation criteria for Bohunice V1 reconstruction

    Campbell, R.; Schlund, H.; Warnken, L.

    2001-01-01

    Bohunice V1 in Slovakia is a Russian designed two unit WWER 440, Model 230 Pressurized Water Reactor. The plant was not originally designed for earthquake. Subsequent and ongoing reassessments now confirm that the seismic hazard at the site is significant. EBO, the plant owner has contracted with a consortium lead by Siemens AG (REKON) to do major reconstruction of the plant to significantly enhance its safety systems by the addition of new systems and the upgrading of existing systems. As part of the reconstruction, a complete seismic assessment and upgrading is required for existing safety relevant structures, systems and components. It is not practical to conduct this reassessment and upgrading using criteria applied to new design of nuclear power plants. Alternate criteria may be used to achieve adequate safety goals. Utilities in the U.S. have faced several seismic issues with operating NPPs and to resolve these issues, alternate criteria have been developed which are much more cost effective than use of criteria for new design. These alternate criteria incorporate the knowledge obtained from investigation of the performance of equipment in major earthquakes and include provisions for structures and passive equipment to deform beyond the yield point, yet still provide their essential function. IAEA has incorporated features of these alternate criteria into draft Technical Guidelines for application to Bohunice V1 and V2. REKON has developed plant specific criteria and procedures for the Bohunice V1 reconstruction that incorporate major features of the U.S. developed alternate criteria, comply to local codes and which envelop the draft IAEA Technical Guidelines. Included in these criteria and procedures are comprehensive walkdown screening criteria for equipment, piping, HVAC and cable raceways, analytical criteria which include inelastic energy absorption factors defined on an element basis and testing criteria which include specific guidance on interpretation

  17. Nevada Test Site Waste Acceptance Criteria, December 2000

    2000-01-01

    This document establishes the US Department of Energy, Nevada Operations Office waste acceptance criteria. The waste acceptance criteria provides the requirements, terms, and conditions under which the Nevada Test Site will accept low-level radioactive waste and mixed waste for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the Nevada Test Site Area 3 and Area 5 Radioactive Waste Management Sites for storage or disposal

  18. Multiple sclerosis

    ... indwelling catheter Osteoporosis or thinning of the bones Pressure sores Side effects of medicines used to treat the ... Daily bowel care program Multiple sclerosis - discharge Preventing pressure ulcers Swallowing problems Images Multiple sclerosis MRI of the ...

  19. Analysing and Comparing Encodability Criteria

    Kirstin Peters

    2015-08-01

    Full Text Available Encodings or the proof of their absence are the main way to compare process calculi. To analyse the quality of encodings and to rule out trivial or meaningless encodings, they are augmented with quality criteria. There exists a bunch of different criteria and different variants of criteria in order to reason in different settings. This leads to incomparable results. Moreover it is not always clear whether the criteria used to obtain a result in a particular setting do indeed fit to this setting. We show how to formally reason about and compare encodability criteria by mapping them on requirements on a relation between source and target terms that is induced by the encoding function. In particular we analyse the common criteria full abstraction, operational correspondence, divergence reflection, success sensitiveness, and respect of barbs; e.g. we analyse the exact nature of the simulation relation (coupled simulation versus bisimulation that is induced by different variants of operational correspondence. This way we reduce the problem of analysing or comparing encodability criteria to the better understood problem of comparing relations on processes.

  20. Articulating Material Criteria

    Hasling, Karen Marie

    2013-01-01

    , imitate and articulate the students’ inclusion of materials. This paper particularly discusses the experiences made and ideas generated after the execution of a material science course for second year students, with emphasis on the concept of the material selection matrix as an educational tool......This paper discusses the experiences and potentials with materials teaching at the Institute for Product Design at Kolding School of Design, using materials teaching as experiments in my PhD project. The project intents to create a stronger material awareness among product design students...... with emphasis on sustainability. The experiments aim to develop an understanding of, how product design students include materials in their design practice and how tools can be developed that further enhance this. Hence experiments are essential for the progress of the PhD project as they help to observe...

  1. Articulating Material Criteria

    Hasling, Karen Marie

    2013-01-01

    This paper discusses the experiences and potentials with materials teaching at the Institute for Product Design at Kolding School of Design, using materials teaching as experiments in my PhD project. The project intents to create a stronger material awareness among product design students...... with emphasis on sustainability. The experiments aim to develop an understanding of, how product design students include materials in their design practice and how tools can be developed that further enhance this. Hence experiments are essential for the progress of the PhD project as they help to observe....... Furthermore the purpose is to initiate a discussion on, how to create educational tools for material awareness creation in the design education e.g. by applying objective and quantitative methods in an otherwise often subjective design process....

  2. Diagnostic criteria in MR neurography

    Baeumer, P.

    2017-01-01

    Peripheral neuropathies are frequent and can mostly be correctly diagnosed by clinical examination and electrophysiology; however, diagnostically difficult cases are sometimes encountered especially with respect to precise localization of nerve lesions. Imaging of the peripheral nervous system has been shown to provide additional useful diagnostic information. In addition to the more widely available nerve sonography, magnetic resonance neurography (MRN) is the method of choice in diagnostically complex cases. The most important pulse sequence is a T2-weighted fat-saturated pulse sequence with high in-plane resolution and detects increased T2-weighted signals of nerve fascicles as a highly sensitive sign for nerve lesions. Further established diagnostic criteria are nerve caliber and, less commonly used, contrast agent uptake. The spatial pattern of nerve lesions aids in the diagnostic classification of neuropathies. Functional imaging techniques, such as diffusion tensor imaging (DTI) and nerve perfusion are currently under examination with respect to the clinical potential. If all other diagnostic methods, including clinical examination, electrophysiology and nerve sonography do not arrive at an unambiguous diagnosis of a peripheral neuropathy, MRN should be used. The special value of MRN is demonstrated particularly in complex nerve lesions, such as traumatic plexopathies and in partial fascicular neuropathies and many other indications. (orig.) [de

  3. Clinical Criteria for Physician Aid in Dying.

    Orentlicher, David; Pope, Thaddeus Mason; Rich, Ben A

    2016-03-01

    More than 20 years ago, even before voters in Oregon had enacted the first aid in dying (AID) statute in the United States, Timothy Quill and colleagues proposed clinical criteria AID. Their proposal was carefully considered and temperate, but there were little data on the practice of AID at the time. (With AID, a physician writes a prescription for life-ending medication for a terminally ill, mentally capacitated adult.) With the passage of time, a substantial body of data on AID has developed from the states of Oregon and Washington. For more than 17 years, physicians in Oregon have been authorized to provide a prescription for AID. Accordingly, we have updated the clinical criteria of Quill, et al., based on the many years of experience with AID. With more jurisdictions authorizing AID, it is critical that physicians can turn to reliable clinical criteria. As with any medical practice, AID must be provided in a safe and effective manner. Physicians need to know (1) how to respond to a patient's inquiry about AID, (2) how to assess patient decision making capacity, and (3) how to address a range of other issues that may arise. To ensure that physicians have the guidance they need, Compassion & Choices convened the Physician Aid-in-Dying Clinical Criteria Committee, in July 2012, to create clinical criteria for physicians who are willing to provide AID to patients who request it. The committee includes experts in medicine, law, bioethics, hospice, nursing, social work, and pharmacy. Using an iterative consensus process, the Committee drafted the criteria over a one-year period.

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

    Cécile Aenishaenslin

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

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

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

    2015-01-01

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

  6. Sediment quality criteria: A review with recommendations for developing criteria for the Hanford Site

    Driver, C.J.

    1994-05-01

    Criteria for determining the quality of liver sediment are necessary to ensure that concentrations of contaminants in aquatic systems are within acceptable limits for the protection of aquatic and human life. Such criteria should facilitate decision-making about remediation, handling, and disposal of contaminants. Several approaches to the development of sediment quality criteria (SQC) have been described and include both descriptive and numerical methods. However, no single method measures all impacts at all times to all organisms (U.S. EPA 1992b). The U.S. EPA`s interest is primarily in establishing chemically based, numerical SQC that are applicable nation-wide (Shea 1988). Of the approaches proposed for SQC development, only three are being considered for numerical SQC on a national level. These approaches include an Equilibrium Partitioning Approach, a site-specific method using bioassays (the Apparent Effects Threshold Approach), and an approach similar to EPA`s water quality criteria (Pavlou and Weston 1984). Although national (or even regional) criteria address a number of political, litigative, and engineering needs, some researchers feel that protection of benthic communities require site-specific, biologically based criteria (Baudo et al. 1990). This is particularly true for areas where complex mixtures of contaminants are present in sediments. Other scientifically valid and accepted procedures for freshwater SQC include a background concentration approach, methods using field or spiked bioassays, a screening level concentration approach, the Apparent Effects Threshold Approach, the Sediment Quality Triad, the International Joint Commission Sediment Assessment Strategy, and the National Status and Trends Program Approach. The various sediment assessment approaches are evaluated for application to the Hanford Reach and recommendations for Hanford Site sediment quality criteria are discussed.

  7. The value of conventional high-field MRI in MS in the light of the McDonald criteria: a literature review

    Larsen, Line Sofie Lunde; Larsson, H B W; Frederiksen, Jette Lautrup Battistini

    2010-01-01

    The diagnosis of MS is based on the revised McDonald criteria and is multidisciplinary. Both clinical and paraclinical measures are included. High-field magnetic resonance imaging (MRI) is becoming increasingly available and it is therefore necessary to clarify possible advantages of high-field MRI...... multiple sclerosis. Further larger studies of patients with clinically isolated syndromes are needed to settle the question of a diagnostic consequence of high-field imaging in MS. We suggest that the next revision of the McDonald diagnostic criteria include a recommendation of field strength....

  8. International investment criteria

    Boivin, D.

    1998-01-01

    Cost elements of a typical petrochemical business were examined. Feedstock is considered to be the primary cost factor for the petrochemical industry, amounting to about 65 per cent of revenue. Therefore, the supply and price of feedstock is the main determinant in choosing the location of a petrochemical plant. The second issue in determining a petrochemical location is the infrastructure such as the availability of pipelines, roads and ports. Other determining factors include construction costs, the ability to get trained personnel to operate sophisticated petrochemical facilities, the prevailing tax regime, and the physical and political environment. Nova Chemicals conducted a study to compare the effective tax rates in Ontario, Alberta, British Columbia, Quebec, Louisiana and Texas. Quebec, Alberta, Ontario, and Louisiana are very close in terms of of the overall impact of taxes, although Canadian provinces are disadvantaged versus other jurisdictions in view of the Canadian withholding tax. It was also noted that other countries which are keen to develop petrochemical industries provide tax holidays of periods of eight to twelve years. These tax regimes are important factors in the decision-making process that is driving the globalization of the chemical industry. It is, however, equally important to weigh the issue of political and economic risk. The melt-down of the Asian economies provides ample demonstration of the importance of political stability. 1 tab

  9. Foreign criteria and programs

    Swinth, K.L.; Thompson, I.M.G.

    1993-03-01

    The concept of measurement quality assurance (MQA) as embodied in National Institute of Standards and Technology (NIST) programs is not generally used within European programs for testing or accreditation. Although the essential elements of quality control and quality assurance are in the European programs, the concept of testing the capability of the laboratory itself, in terms of its performance for the designated measurements, may not be included. Rather, the European programs use the concept of periodic calibration of laboratory reference standards against the next highest level of standards. Thus, they embody the concept of measurement traceability to appropriate primary standards. Within Europe a series of calibration accreditation programs has been established in the various countries tied together through a multilateral agreement. The radiation measurement programs are based on the International Organization for Standardization (ISO) 9000 series of standards. The purpose of this paper is to outline the overall operation of European Accreditation Programs in the radiation calibration and measurement areas. The operation of the radiation measurement programs of the National Measurement Accreditation Service (NAMAS) in the United Kingdom is described in detail along with other European programs. The manner in which these programs relate to individual dosimetry service programs is also described

  10. Consultation on microbiological criteria for foods to be further processed including by irradiation

    1989-01-01

    Many foods carry microorganisms that may have serious consequences for the health of the consumer. There is thus often a need for processing to eliminate the resulting health hazards. Concern has been expressed that treatments, especially irradiation, might be applied to clean up food that has not been hygienically processed. Adherence to good manufacturing practice can greatly assist food processors to ensure food quality and safety. Figs

  11. A Holistic Approach Including Biological and Geological Criteria for Integrative Management in Protected Areas.

    Peña, Lorena; Monge-Ganuzas, Manu; Onaindia, Miren; De Manuel, Beatriz Fernández; Mendia, Miren

    2017-02-01

    Biodiversity hotspots and geosites are indivisible parts of natural heritage. Therefore, an adequate spatial delimitation and understanding of both and their linkages are necessary in order to be able to establish conservation policies. Normally, biodiversity hotspots are a typical target for those policies but, generally, geosites are not taken into account. Thus, this paper aims to fill this gap by providing an easily replicable method for the identification and integration of the geosites and the biodiversity hotspots in a Network for Integrative Nature Conservation that highlights their linkages. The method here presented has been applied to Urdaibai Biosphere Reserve situated in southeastern of the Bay of Biscay. The obtained results indicate that some geosites that are not directly related with biodiversity hotspots remain unprotected. Thus, from the study carried out, it can be stated that we conserving just the biodiversity hotspots is not enough to conserve the whole natural heritage of a protected area, as some plots interesting due to their relevant geoheritage remain unprotected. Therefore, it is necessary to fully integrate geosites into the planning documents of protected areas as a part of an ecosystem approach. The ecosystem approach recognizes the integrity of abiotic and biotic elements in nature conservation policies. Moreover, the proposed framework and the innovative methodology can be used as an easy input to identify priority areas for conservation, to improve the protected areas conservation planning, and to demonstrate the linkages between biodiversity hotspots and geosites.

  12. A Holistic Approach Including Biological and Geological Criteria for Integrative Management in Protected Areas

    Peña, Lorena; Monge-Ganuzas, Manu; Onaindia, Miren; De Manuel, Beatriz Fernández; Mendia, Miren

    2017-02-01

    Biodiversity hotspots and geosites are indivisible parts of natural heritage. Therefore, an adequate spatial delimitation and understanding of both and their linkages are necessary in order to be able to establish conservation policies. Normally, biodiversity hotspots are a typical target for those policies but, generally, geosites are not taken into account. Thus, this paper aims to fill this gap by providing an easily replicable method for the identification and integration of the geosites and the biodiversity hotspots in a Network for Integrative Nature Conservation that highlights their linkages. The method here presented has been applied to Urdaibai Biosphere Reserve situated in southeastern of the Bay of Biscay. The obtained results indicate that some geosites that are not directly related with biodiversity hotspots remain unprotected. Thus, from the study carried out, it can be stated that we conserving just the biodiversity hotspots is not enough to conserve the whole natural heritage of a protected area, as some plots interesting due to their relevant geoheritage remain unprotected. Therefore, it is necessary to fully integrate geosites into the planning documents of protected areas as a part of an ecosystem approach. The ecosystem approach recognizes the integrity of abiotic and biotic elements in nature conservation policies. Moreover, the proposed framework and the innovative methodology can be used as an easy input to identify priority areas for conservation, to improve the protected areas conservation planning, and to demonstrate the linkages between biodiversity hotspots and geosites.

  13. Multiple sclerosis - etiology and diagnostic potential.

    Kamińska, Joanna; Koper, Olga M; Piechal, Kinga; Kemona, Halina

    2017-06-30

    Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disease of autoimmune originate. The main agents responsible for the MS development include exogenous, environmental, and genetic factors. MS is characterized by multifocal and temporally scattered central nervous system (CNS) damage which lead to the axonal damage. Among clinical courses of MS it can be distinguish relapsing-remitting multiple sclerosis (RRMS), secondary progressive multiple sclerosis (SPSM), primary progressive multiple sclerosis (PPMS), and progressive-relapsing multiple sclerosis (RPMS). Depending on the severity of signs and symptoms MS can be described as benign MS or malignant MS. MS diagnosis is based on McDonald's diagnostic criteria, which link clinical manifestation with characteristic lesions demonstrated by magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis, and visual evoked potentials. Among CSF laboratory tests used to the MS diagnosis are applied: Tibbling & Link IgG index, reinbegrams, and CSF isoelectrofocusing for oligoclonal bands detection. It should be emphasized, that despite huge progress regarding MS as well as the availability of different diagnostics methods this disease is still a diagnostic challenge. It may result from fact that MS has diverse clinical course and there is a lack of single test, which would be of appropriate diagnostic sensitivity and specificity for quick and accurate diagnosis.

  14. Multiple sclerosis - etiology and diagnostic potential

    Joanna Kamińska

    2017-06-01

    Full Text Available Multiple sclerosis (MS is a chronic inflammatory and demyelinating disease of autoimmune originate. The main agents responsible for the MS development include exogenous, environmental, and genetic factors. MS is characterized by multifocal and temporally scattered central nervous system (CNS damage which lead to the axonal damage. Among clinical courses of MS it can be distinguish relapsing-remitting multiple sclerosis (RRMS, secondary progressive multiple sclerosis (SPSM, primary progressive multiple sclerosis (PPMS, and progressive-relapsing multiple sclerosis (RPMS. Depending on the severity of signs and symptoms MS can be described as benign MS or malignant MS. MS diagnosis is based on McDonald’s diagnostic criteria, which link clinical manifestation with characteristic lesions demonstrated by magnetic resonance imaging (MRI, cerebrospinal fluid (CSF analysis, and visual evoked potentials. Among CSF laboratory tests used to the MS diagnosis are applied: Tibbling & Link IgG index, reinbegrams, and CSF isoelectrofocusing for oligoclonal bands detection. It should be emphasized, that despite huge progress regarding MS as well as the availability of differentdiagnostics methods this disease is still a diagnostic challenge. It may result from fact that MS has diverse clinical course and there is a lack of single test, which would be of appropriate diagnostic sensitivity and specificity for quick and accurate diagnosis.

  15. Floorball game skills (evaluation criteria)

    Chlumský, Marek

    2013-01-01

    Title: Playing skills in floorball (evaluation criteria). Target: To create a list of playing skills which an ideal player should demonstrate. Find and verify the evaluation criteria of these skills and inspire trainers to develop these skills in the best way. Methods: Informal interviews, individually structured interviews, analysis and verification of data, pilot testing. Results: Defined playing skills in floorball, developed scale of values of floorball playing skills, creation of exercis...

  16. Reliability criteria for voltage stability

    Taylor, Carson W; Silverstein, Brian L [Bonneville Power Administration, Portland, OR (United States)

    1994-12-31

    In face of costs pressures, there is need to allocate scare resources more effectively in order to achieve voltage stability. This naturally leads to development of probabilistic criteria and notions of rick management. In this paper it is presented a discussion about criteria for long term voltage stability limited to the case in which the time frames are topically several minutes. (author) 14 refs., 1 fig.

  17. MULTIPLE OBJECTS

    A. A. Bosov

    2015-04-01

    Full Text Available Purpose. The development of complicated techniques of production and management processes, information systems, computer science, applied objects of systems theory and others requires improvement of mathematical methods, new approaches for researches of application systems. And the variety and diversity of subject systems makes necessary the development of a model that generalizes the classical sets and their development – sets of sets. Multiple objects unlike sets are constructed by multiple structures and represented by the structure and content. The aim of the work is the analysis of multiple structures, generating multiple objects, the further development of operations on these objects in application systems. Methodology. To achieve the objectives of the researches, the structure of multiple objects represents as constructive trio, consisting of media, signatures and axiomatic. Multiple object is determined by the structure and content, as well as represented by hybrid superposition, composed of sets, multi-sets, ordered sets (lists and heterogeneous sets (sequences, corteges. Findings. In this paper we study the properties and characteristics of the components of hybrid multiple objects of complex systems, proposed assessments of their complexity, shown the rules of internal and external operations on objects of implementation. We introduce the relation of arbitrary order over multiple objects, we define the description of functions and display on objects of multiple structures. Originality.In this paper we consider the development of multiple structures, generating multiple objects.Practical value. The transition from the abstract to the subject of multiple structures requires the transformation of the system and multiple objects. Transformation involves three successive stages: specification (binding to the domain, interpretation (multiple sites and particularization (goals. The proposed describe systems approach based on hybrid sets

  18. Toxic chemical risk acceptance criteria

    Craig, D.K.; Davis, J.; Lee, L.; Lein, P.; Omberg, S.

    1992-01-01

    This paper presents recommendations of a subcommittee of the Westinghouse M ampersand 0 Nuclear Facility Safety Committee concerning toxic chemical risk acceptance criteria. Two sets of criteria have been developed, one for use in the hazard classification of facilities, and the second for use in comparing risks in DOE non-reactor nuclear facility Safety Analysis Reports. The Emergency Response Planning Guideline (ERPG) values are intended to provide estimates of concentration ranges for specific chemicals above which exposure would be expected to lead to adverse heath effects of increasing severity for ERPG-1, -2, and -3s. The subcommittee recommends that criteria for hazard class or risk range be based on ERPGs for all chemicals. Probability-based Incremental Cancer Risk (ICR) criteria are recommended for additional analyses of risks from all known or suspected human carcinogens. Criteria are given for both on-site and off-site exposure. The subcommittee also recommends that the 5-minute peak concentration be compared with the relevant criterion with no adjustment for exposure time. Since ERPGs are available for only a limited number of chemicals, the subcommittee has developed a proposed hierarchy of concentration limit parameters for the different criteria

  19. Developing 2 C-compatible investment criteria

    Roeser, Frauke [NewClimate - Institute for Climate Policy and Global Sustainability gGmbH, Bonn (Germany); Weischer, Lutz [Germanwatch e.V., Koeln (Germany); Thomae, Jakob [2degrees Investing Initiative, New York, NY (United States); Hoehne, Niklas; Hagemann, Markus; El Alaoui, Alexander; Bals, Christoph; Eckstein, David; Kreft, Soenke; Rosse, Morten

    2015-11-30

    This report studies the development of criteria for assessing the compatibility of financial investments with the international goal to limit global temperature increase to below 2 C above pre-industrial levels. The findings are intended as a starting point and a key input for a longer term process to develop consensus-based 2 C investing criteria. The focus here is placed on investments in projects and physical assets, in particular of development and climate finance organisations. In order to limit global temperature increase to 2 C, global greenhouse gas (GHG) emissions will have to be reduced significantly, eventually to zero, during the course of this century. This requires shifting capital from high to low carbon investments as well as significant capital mobilisation for investments in 2 C-compatible infrastructure. Given the long lifetime of physical assets, and the urgency of decarbonisation over the coming decades, this needs to begin today. Public financial institutions can play a prominent role in contributing to aligning investment flows with the 2 C limit, as well as in closing the current infrastructure investment gap, responding to their explicit or implicit climate mandates and leadership role in the finance sector. The majority of international financial institutions integrate climate considerations into their finance decisions to some degree, and are familiar with different types of criteria, including positive and negative lists, qualitative and quantitative benchmarks, and the use of shadow carbon pricing. However, current approaches do not link to the 2 C limit. 2 C investment criteria are therefore needed to guide investors in this regard. Such criteria may also support other purposes, including an understanding of climate risks and improved reporting and accountability.

  20. Developing 2 C-compatible investment criteria

    Roeser, Frauke; Weischer, Lutz; Thomae, Jakob; Hoehne, Niklas; Hagemann, Markus; El Alaoui, Alexander; Bals, Christoph; Eckstein, David; Kreft, Soenke; Rosse, Morten

    2015-01-01

    This report studies the development of criteria for assessing the compatibility of financial investments with the international goal to limit global temperature increase to below 2 C above pre-industrial levels. The findings are intended as a starting point and a key input for a longer term process to develop consensus-based 2 C investing criteria. The focus here is placed on investments in projects and physical assets, in particular of development and climate finance organisations. In order to limit global temperature increase to 2 C, global greenhouse gas (GHG) emissions will have to be reduced significantly, eventually to zero, during the course of this century. This requires shifting capital from high to low carbon investments as well as significant capital mobilisation for investments in 2 C-compatible infrastructure. Given the long lifetime of physical assets, and the urgency of decarbonisation over the coming decades, this needs to begin today. Public financial institutions can play a prominent role in contributing to aligning investment flows with the 2 C limit, as well as in closing the current infrastructure investment gap, responding to their explicit or implicit climate mandates and leadership role in the finance sector. The majority of international financial institutions integrate climate considerations into their finance decisions to some degree, and are familiar with different types of criteria, including positive and negative lists, qualitative and quantitative benchmarks, and the use of shadow carbon pricing. However, current approaches do not link to the 2 C limit. 2 C investment criteria are therefore needed to guide investors in this regard. Such criteria may also support other purposes, including an understanding of climate risks and improved reporting and accountability.

  1. Top-level regulatory criteria for the standard MHTGR

    NONE

    1986-10-15

    The Licensing Plan for the Standard MHTGR (Ref. 1) describes a program to support a U.S. Nuclear Regulatory Commission (NRC) design review and approval. The Plan calls for the submittal of Top-Level Regulatory Criteria to the NRC for concurrence with their completeness and acceptability for the MHTGR program. The Top-Level Regulatory Criteria are defined as the standards for judging licensability that directly specify acceptable limits for protection of the public health and safety and the environment. The criteria proposed herein are for normal plant operation and a broad spectrum of anticipated events, including accidents. The approach taken is to define a set of criteria which are general as opposed to being design specific. Specifically, it is recommended that criteria be met which: 1. Are less prescriptive than current regulation, thereby encouraging maximum flexibility in design approaches. 2. Are measurable. 3. Are not more strict than the criteria for current power plants.

  2. Ambient water quality criteria for mercury: Technical appendix

    Nagpal, N.K.

    1989-01-01

    This document discusses the effects of mercury on various water uses, including drinking water, aquatic life, wildlife, livestock water supply, irrigation, recreation and aesthetics, and industrial water supplies. Standards, objectives, and criteria from national and international jurisdictions are reviewed, providing a basis, along with other information available from the literature, for criteria recommended to protect water uses in British Columbia from anthropogenic mercury.

  3. Selection criteria for a radiography programme in South Africa ...

    Background: Selection criteria used to admit students to a radiography programme at the Central University of Technology (CUT) included academic criteria, as well as the General Scholastic Aptitude Test (GSAT) and Self-directed Search (SDS) Questionnaire. Aims and objectives: The aim of the study was to identify which ...

  4. Multiple oncocytomas and renal carcinoma

    Velasquez, G.; Glass, T.A.; D'Souza, V.J.; Formanek, A.G.

    1984-01-01

    Renal oncocytoma, although rare, is being diagnosed more frequently, and criteria to differentiate it from other tumors have been described. Multiple oncocytomas have been reported, but an association between multiple oncocytomas and renal carcinoma in the same kidney has not been described. The authors report a case with two oncocytomas and a renal carcinoma in the right kidney as well as a right adrenal adenoma

  5. Multiple stabbing in sex-related homicides.

    Radojević, Nemanja; Radnić, Bojana; Petković, Stojan; Miljen, Maletin; Curović, Ivana; Cukić, Dragana; Soć, Miodrag; Savić, Slobodan

    2013-07-01

    It is possible that sexually driven homicides are the consequence of sexual deviation, but more often than not the main cause of such homicides stems from a non-paraphilic person's emotional component. It is known that homicides which involve multiple stabbing are very often the result of the assailant's highly expressed affect. This study tries to establish whether such homicides are essentially related to the sexual motives of the murderer. This paper is conducted through a retrospective autopsy study that includes 766 cases of homicides. These were reviewed and analysed according to the motive of the homicide, as well as by method, age, and gender of the victim, and the relationship between the victim and the assailant. The motives of homicides are classified as non-sexual and sexual, including homicides related to rape, jealousy, amorous affairs outside of an established relationship, deviant sexual behaviour of psychiatric patients, paraphilia, and disturbed emotional relationships between the victim and the assailant. Cases include both hetero- and homosexual relationships. Multiple stabbing occurs significantly more frequently in sex-related homicides (≥ 3 stab wounds) than in other homicide types. When the criteria for multiple stabbing are changed (≥ 4, 5, or 25 stab wounds), the percentage of sex-related homicides rises in every group in relation to the increased number of wounds. Sensitivity and specificity are represented by ROC curves for 3, 5 and 7 stab wounds. The correlation coefficients between multiple stabbing and sex-related homicides regarding gender are all near 0.9. For female victims, all homicides committed by 25 and more stab wounds were found to be sex-related. Statistically, jealousy was the most frequent motive for sex-related multiple stabbing homicides. Regardless of age, homicides involving multiple stabbings should be considered sex-related, especially when the victim is female. Copyright © 2013 Elsevier Ltd and Faculty of

  6. Obstetric and perinatal outcome of multiple pregnancy

    Qazi, G.

    2011-01-01

    To determine the obstetric and perinatal outcome in multiple pregnancies at a teaching hospital. The analysis included data on all women between 20 and 35 years of age with 24 completed weeks gestation having multiple pregnancies during the study period after applying the exclusion criteria. The data retrieved from the hospital-based maternal health medical records included demographic details, complications of pregnancy, and maternal and neonatal outcomes. The data was expressed as frequencies, percentages, mean and standard deviation. Normal distribution of continuous variables was determined by Shapiro Wilk test. The differences in the mean birth weight of the first and second twin were compared by student's t-test considering a p-value less than 0.05 as statistically significant. There were a total of 161 multiple pregnancies with the overall incidence of 37.1 per 1,000 births (3.2%) during the study period. One hundred and twenty two cases had the inclusion criteria applicable. There were 9 triplets among these of whom seven were received as intrauterine death and the other two were lost to follow-up. The four leading maternal adverse outcomes were anemia (74.6%), preterm delivery (31%), pregnancy - induced hypertension (30%) and preterm premature rupture of membranes (26.2%). Median gestational age at delivery was 37 weeks. Most common route of delivery was caesarean section (53.3%). Most common neonatal complication was low birth weight. Prematurity was the most common cause of neonatal death. Multiple pregnancy have high maternal and neonatal complications, especially preterm delivery that increases risk of significant neonatal morbidity and mortality. (author)

  7. Criteria for prioritization of HIV programs in Viet Nam: a discrete choice experiment

    Ali Safarnejad

    2017-11-01

    Full Text Available Abstract Background With the decline in funding for Viet Nam’s response to the HIV epidemic, there is a need for evidence on the criteria to guide the prioritization of HIV programs. There is a gap in the research on the relative importance of multiple criteria for prioritizing a package of interventions. This study elicits preferences and the trade-offs made between different HIV programs by relevant stakeholders and decision-makers in Viet Nam. It also pays attention to how differences in social and professional characteristics of stakeholders and their agency affiliations shape preferences for HIV program criteria in Viet Nam. Methods This study uses self-explicated ranking and discrete choice experiments to determine the relative importance of five criteria - effectiveness, feasibility, cost-effectiveness, rate of investment and prevention/treatment investment ratio - to stakeholders when they evaluate and select hypothetical HIV programs. The study includes 69 participants from government, civil society, and international development partners. Results Results of the discrete choice experiment show that overall the feasibility criterion is ranked highest in importance to the participants when choosing a hypothetical HIV program, followed by sustainability, treatment to prevention spending ratio, and effectiveness. The participant’s work in management, programming, or decision-making has a significant effect on the importance of some criteria to the participant. In the self-explicated ranking effectiveness is the most important criterion and the cost-effectiveness criterion ranks low in importance across all groups. Conclusions This study has shown that the preferred HIV program in Viet Nam is feasible, front-loaded for sustainability, has a higher proportion of investment on prevention, saves more lives and prevents more infections. Similarities in government and civil society rankings of criteria can create common grounds for future

  8. Criteria for prioritization of HIV programs in Viet Nam: a discrete choice experiment.

    Safarnejad, Ali; Pavlova, Milena; Son, Vo Hai; Phuong, Huynh Lan; Groot, Wim

    2017-11-13

    With the decline in funding for Viet Nam's response to the HIV epidemic, there is a need for evidence on the criteria to guide the prioritization of HIV programs. There is a gap in the research on the relative importance of multiple criteria for prioritizing a package of interventions. This study elicits preferences and the trade-offs made between different HIV programs by relevant stakeholders and decision-makers in Viet Nam. It also pays attention to how differences in social and professional characteristics of stakeholders and their agency affiliations shape preferences for HIV program criteria in Viet Nam. This study uses self-explicated ranking and discrete choice experiments to determine the relative importance of five criteria - effectiveness, feasibility, cost-effectiveness, rate of investment and prevention/treatment investment ratio - to stakeholders when they evaluate and select hypothetical HIV programs. The study includes 69 participants from government, civil society, and international development partners. Results of the discrete choice experiment show that overall the feasibility criterion is ranked highest in importance to the participants when choosing a hypothetical HIV program, followed by sustainability, treatment to prevention spending ratio, and effectiveness. The participant's work in management, programming, or decision-making has a significant effect on the importance of some criteria to the participant. In the self-explicated ranking effectiveness is the most important criterion and the cost-effectiveness criterion ranks low in importance across all groups. This study has shown that the preferred HIV program in Viet Nam is feasible, front-loaded for sustainability, has a higher proportion of investment on prevention, saves more lives and prevents more infections. Similarities in government and civil society rankings of criteria can create common grounds for future policy dialogues between stakeholders. Innovative models of planning should

  9. Minimizing impacts of land use change on ecosystem services using multi-criteria heuristic analysis.

    Keller, Arturo A; Fournier, Eric; Fox, Jessica

    2015-06-01

    Development of natural landscapes to support human activities impacts the capacity of the landscape to provide ecosystem services. Typically, several ecosystem services are impacted at a single development site and various footprint scenarios are possible, thus a multi-criteria analysis is needed. Restoration potential should also be considered for the area surrounding the permanent impact site. The primary objective of this research was to develop a heuristic approach to analyze multiple criteria (e.g. impacts to various ecosystem services) in a spatial configuration with many potential development sites. The approach was to: (1) quantify the magnitude of terrestrial ecosystem service (biodiversity, carbon sequestration, nutrient and sediment retention, and pollination) impacts associated with a suite of land use change scenarios using the InVEST model; (2) normalize results across categories of ecosystem services to allow cross-service comparison; (3) apply the multi-criteria heuristic algorithm to select sites with the least impact to ecosystem services, including a spatial criterion (separation between sites). As a case study, the multi-criteria impact minimization algorithm was applied to InVEST output to select 25 potential development sites out of 204 possible locations (selected by other criteria) within a 24,000 ha property. This study advanced a generally applicable spatial multi-criteria approach for 1) considering many land use footprint scenarios, 2) balancing impact decisions across a suite of ecosystem services, and 3) determining the restoration potential of ecosystem services after impacts. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Criteria for Developing a Successful Privatization Project

    1989-05-01

    conceptualization and planning are required when pursuing privatization projects. In fact, privatization project proponents need to know how to...selection of projects for analysis, methods of acquiring information about these projects, and the analysis framwork . Chapter IV includes the analysis. A...performed an analysis to determine cormion conceptual and creative approaches and lessons learned. This analysis was then used to develop criteria for

  11. Multi-criteria decision making approaches for green supply chains

    Banasik, Aleksander; Bloemhof-Ruwaard, Jacqueline M.; Kanellopoulos, Argyris; Claassen, G.D.H.; Vorst, van der Jack G.A.J.

    2016-01-01

    Designing Green Supply Chains (GSCs) requires complex decision-support models that can deal with multiple dimensions of sustainability while taking into account specific characteristics of products and their supply chain. Multi-Criteria Decision Making (MCDM) approaches can be used to quantify

  12. Multi-criteria comparative evaluation of spallation reaction models

    Andrianov, Andrey; Andrianova, Olga; Konobeev, Alexandr; Korovin, Yury; Kuptsov, Ilya

    2017-09-01

    This paper presents an approach to a comparative evaluation of the predictive ability of spallation reaction models based on widely used, well-proven multiple-criteria decision analysis methods (MAVT/MAUT, AHP, TOPSIS, PROMETHEE) and the results of such a comparison for 17 spallation reaction models in the presence of the interaction of high-energy protons with natPb.

  13. Air Conditioner Selection with TOPSIS and VIKOR Methods In Multi Criteria Decision Making

    İrfan ERTUĞRUL

    2014-06-01

    Full Text Available Technological and global changes nowadays enable air conditioning sector to gain a higher importance. Short and long term risks for comsumers, the use of air conditioningtechnology with cost minimization, the increase of product charesteristics and firms, and the variability of product features have led to the need for multi-criteria decision. Therefore, caring the multiple criteria and the alternatives, the multi-criteria decision making techniques are taken to the scope of application. The purpose of the study is to determine the factors which affect the decision of air conditioning choice and to present the preference ranking suggestion. Having the nearly have got the approximately equivalent heating and cooling capacity, air conditionings in A+ class are included in the scope of related research. In application, when choosing air conditioning products, Topsis and Vikor that are multi-criteria decision-making methods are used and the results are compared and evaluated. When choosing air conditioning products, preference plansa re presented in the application.

  14. Multi-criteria model for sustainable development using goal programming applied to the United Arab Emirates

    Jayaraman, Raja; Colapinto, Cinzia; Torre, Davide La; Malik, Tufail

    2015-01-01

    Sustainable development requires implementing suitable policies integrating several competing objectives on economic, environmental, energy and social criteria. Multi-Criteria Decision Analysis (MCDA) using goal programming is a popular and widely used technique to study decision problems in the face of multiple conflicting objectives. MCDA assists policy makers by providing clarity in choosing between alternatives for strategic planning and investments. In this paper, we propose a weighted goal programming model that integrates efficient allocation of resources to simultaneously achieve sustainability related goals on GDP growth, electricity consumption and GHG emissions. We validate the model with application to key economic sectors of the United Arab Emirates to achieve sustainable development goals by the year 2030. The model solution provides a quantitative justification and a basis for comparison in planning future energy requirements and an indispensable requirement to include renewable sources to satisfy long-term energy requirements. - Highlights: • Multi-criteria model for achieving sustainability goals by year 2030. • Integrates criteria on electricity, GDP, GHG emissions for optimal labor allocation. • Future electricity demand requires contribution from renewable sources • Enables planning for long term investments towards energy sustainability.

  15. Social Advertising Quality: Assessment Criteria

    S. B. Kalmykov

    2017-01-01

    Full Text Available Purpose: the The purpose of the publication is development of existing criterial assessment in social advertising sphere. The next objectives are provided for its achievement: to establish research methodology, to develop the author’s version of necessary notional apparatus and conceptual generalization, to determine the elements of social advertising quality, to establish the factors of its quality, to conduct the systematization of existing criteria and measuring instruments of quality assessment, to form new criteria of social advertising quality, to apply received results for development of criterial assessment to determine the further research perspectives. Methods: the methodology of research of management of social advertising interaction with target audience, which has dynamic procedural character with use of sociological knowledge multivariate paradigmatic status, has been proposed. Results: the primary received results: the multivariate paradigmatic research basis with use of works of famous domestic and foreign scientists in sociology, qualimetry and management spheres; the definitions of social advertising, its quality, sociological quality provision system, target audience behavior model during social advertising interaction are offered; the quality factors with three groups by level of effect on consumer are established; the systematization of existing quality and its measure instruments assessment criteria by detected social advertising quality elements are conducted; the two new criteria and its management quality assessment measuring instruments in social advertising sphere are developed; the one of the common groups of production quality criteria – adaptability with considering of new management quality criteria and conducted systematization of existing social advertising creative quality assessment criteria development; the perspective of further perfection of quality criterial assessment based on social advertising

  16. Impact of a pain protocol including hypnosis in major burns.

    Berger, Mette M; Davadant, Maryse; Marin, Christian; Wasserfallen, Jean-Blaise; Pinget, Christophe; Maravic, Philippe; Koch, Nathalie; Raffoul, Wassim; Chiolero, René L

    2010-08-01

    Pain is a major issue after burns even when large doses of opioids are prescribed. The study focused on the impact of a pain protocol using hypnosis on pain intensity, anxiety, clinical course, and costs. All patients admitted to the ICU, aged >18 years, with an ICU stay >24h, accepting to try hypnosis, and treated according to standardized pain protocol were included. Pain was scaled on the Visual Analog Scale (VAS) (mean of daily multiple recordings), and basal and procedural opioid doses were recorded. Clinical outcome and economical data were retrieved from hospital charts and information system, respectively. Treated patients were matched with controls for sex, age, and the burned surface area. Forty patients were admitted from 2006 to 2007: 17 met exclusion criteria, leaving 23 patients, who were matched with 23 historical controls. Altogether patients were 36+/-14 years old and burned 27+/-15%BSA. The first hypnosis session was performed after a median of 9 days. The protocol resulted in the early delivery of higher opioid doses/24h (ppatient. A pain protocol including hypnosis reduced pain intensity, improved opioid efficiency, reduced anxiety, improved wound outcome while reducing costs. The protocol guided use of opioids improved patient care without side effects, while hypnosis had significant psychological benefits.

  17. Criteria for saturated magnetization loop

    Harres, A.; Mikhov, M.; Skumryev, V.; Andrade, A.M.H. de; Schmidt, J.E.; Geshev, J.

    2016-01-01

    Proper estimation of magnetization curve parameters is vital in studying magnetic systems. In the present article, criteria for discrimination non-saturated (minor) from saturated (major) hysteresis loops are proposed. These employ the analysis of (i) derivatives of both ascending and descending branches of the loop, (ii) remanent magnetization curves, and (iii) thermomagnetic curves. Computational simulations are used in order to demonstrate their validity. Examples illustrating the applicability of these criteria to well-known real systems, namely Fe_3O_4 and Ni fine particles, are provided. We demonstrate that the anisotropy-field value estimated from a visual examination of an only apparently major hysteresis loop could be more than two times lower than the real one. - Highlights: • Proper estimation of hysteresis-loop parameters is vital in magnetic studies. • We propose criteria for discrimination minor from major hysteresis loops. • The criteria analyze magnetization, remanence and ZFC/FC curves and/or their derivatives. • Examples of their application on real nanoparticles systems are given. • Using the criteria could avoid twofold or bigger saturation-field underestimation errors.

  18. Criteria for saturated magnetization loop

    Harres, A. [Departamento de Física, UFSM, Santa Maria, 97105-900 Rio Grande do Sul (Brazil); Mikhov, M. [Faculty of Physics, University of Sofia, 1164 Sofia (Bulgaria); Skumryev, V. [Institució Catalana de Recerca i Estudis Avançats, 08010 Barcelona (Spain); Departament de Física, Universitat Autònoma de Barcelona, 08193 Barcelona (Spain); Andrade, A.M.H. de; Schmidt, J.E. [Instituto de Física, UFRGS, Porto Alegre, 91501-970 Rio Grande do Sul (Brazil); Geshev, J., E-mail: julian@if.ufrgs.br [Departament de Física, Universitat Autònoma de Barcelona, 08193 Barcelona (Spain); Instituto de Física, UFRGS, Porto Alegre, 91501-970 Rio Grande do Sul (Brazil)

    2016-03-15

    Proper estimation of magnetization curve parameters is vital in studying magnetic systems. In the present article, criteria for discrimination non-saturated (minor) from saturated (major) hysteresis loops are proposed. These employ the analysis of (i) derivatives of both ascending and descending branches of the loop, (ii) remanent magnetization curves, and (iii) thermomagnetic curves. Computational simulations are used in order to demonstrate their validity. Examples illustrating the applicability of these criteria to well-known real systems, namely Fe{sub 3}O{sub 4} and Ni fine particles, are provided. We demonstrate that the anisotropy-field value estimated from a visual examination of an only apparently major hysteresis loop could be more than two times lower than the real one. - Highlights: • Proper estimation of hysteresis-loop parameters is vital in magnetic studies. • We propose criteria for discrimination minor from major hysteresis loops. • The criteria analyze magnetization, remanence and ZFC/FC curves and/or their derivatives. • Examples of their application on real nanoparticles systems are given. • Using the criteria could avoid twofold or bigger saturation-field underestimation errors.

  19. [Inappropriate prescription in older patients: the STOPP/START criteria].

    Delgado Silveira, Eva

    2009-09-01

    Older people are a heterogeneous group of patients, often with multiple comorbidities for which they are prescribed a large number of drugs, leading to an increased risk of adverse drug reactions (ADR) and drug interactions. This risk is compounded by physiological age-related changes in physiology, changes in drug pharmacokinetics and pharmacodynamics, as well as by disease-related, functional and social issues. Inappropriate prescription of drugs is common in the older individuals and contributes to the increased risk of ADR. Several tools have been developed to detect potentially inappropriate prescription, the most frequently used in Spain being Beers\\' criteria. However, the value of these criteria is limited, especially as they were developed in a different healthcare system. In this article, the Spanish version of a new tool to detect potentially inappropriate prescriptions-STOPP (Screening Tool of Older Person\\'s Prescriptions) and START (Screening Tool to Alert doctors to Right i.e. appropriate, indicated Treatment) criteria-is presented. The creation, development, reliability, and use of these criteria in routine practice is described and discussed. These criteria have shown better sensitivity than Beers\\' criteria in detecting prescription problems and have the added value of being able to detect not only inappropriate prescription of some drugs, but also the omission of well indicated drugs. The STOPP\\/START criteria could become a useful screening tool to improve prescription in older people.

  20. Evaluation criteria for spectral design of camouflage

    Škerlind, Christina; Fagerström, Jan; Hallberg, Tomas; Kariis, Hans

    2015-10-01

    In development of visual (VIS) and infrared (IR) camouflage for signature management, the aim is the design of surface properties of an object to spectrally match or adapt to a background and thereby minimizing the contrast perceived by a threatening sensor. The so called 'ladder model" relates the requirements for task measure of effectiveness with surface structure properties through the steps signature effectiveness and object signature. It is intended to link materials properties via platform signature to military utility and vice versa. Spectral design of a surface intends to give it a desired wavelength dependent optical response to fit a specific application of interest. Six evaluation criteria were stated, with the aim to aid the process to put requirement on camouflage and for evaluation. The six criteria correspond to properties such as reflectance, gloss, emissivity, and degree of polarization as well as dynamic properties, and broadband or multispectral properties. These criteria have previously been exemplified on different kinds of materials and investigated separately. Anderson and Åkerlind further point out that the six criteria rarely were considered or described all together in one and same publication previously. The specific level of requirement of the different properties must be specified individually for each specific situation and environment to minimize the contrast between target and a background. The criteria or properties are not totally independent of one another. How they are correlated is part of the theme of this paper. However, prioritization has been made due to the limit of space. Therefore all of the interconnections between the six criteria will not be considered in the work of this report. The ladder step previous to digging into the different material composition possibilities and choice of suitable materials and structures (not covered here), includes the object signature and decision of what the spectral response should be

  1. Multiple Myeloma

    proteinuria was also a poor prognostic finding,. but only because of its association with renal failure. Patients with. Bence-Jones protcinur;a and normal renal ... chemotherapy. The mean time which elapsed before the criteria of response were achieved, was 7 months. Five ad- ditional patients who are at present being ...

  2. Multiple sclerosis

    Grunwald, I.Q.; Kuehn, A.L.; Backens, M.; Papanagiotou, P.; Shariat, K.; Kostopoulos, P.

    2008-01-01

    Multiple sclerosis is the most common chronic inflammatory disease of myelin with interspersed lesions in the white matter of the central nervous system. Magnetic resonance imaging (MRI) plays a key role in the diagnosis and monitoring of white matter diseases. This article focuses on key findings in multiple sclerosis as detected by MRI. (orig.) [de

  3. What criteria do decision makers in Thailand use to set priorities for vaccine introduction?

    Pooripussarakul, Siriporn; Riewpaiboon, Arthorn; Bishai, David; Muangchana, Charung; Tantivess, Sripen

    2016-08-02

    There is a need to identify rational criteria and set priorities for vaccines. In Thailand, many licensed vaccines are being considering for introduction into the Expanded Program on Immunization; thus, the government has to make decisions about which vaccines should be adopted. This study aimed to set priorities for new vaccines and to facilitate decision analysis. We used a best-worst scaling study for rank-ordering of vaccines. The candidate vaccines were determined by a set of criteria, including burden of disease, target age group, budget impact, side effect, effectiveness, severity of disease, and cost of vaccine. The criteria were identified from a literature review and by in-depth, open-ended interviews with experts. The priority-setting model was conducted among three groups of stakeholders, including policy makers, healthcare professionals and healthcare administrators. The vaccine data were mapped and then calculated for the probability of selection. From the candidate vaccines, the probability of hepatitis B vaccine being selected by all respondents (96.67 %) was ranked first. This was followed, respectively, by pneumococcal conjugate vaccine-13 (95.09 %) and Haemophilus influenzae type b vaccine (90.87 %). The three groups of stakeholders (policy makers, healthcare professionals and healthcare administrators) showed the same ranking trends. Most severe disease, high fever rate and high disease burden showed the highest coefficients for criterion levels being selected by all respondents. This result can be implied that a vaccine which can prevent most severe disease with high disease burden and has low safety has a greater chance of being selected by respondents in this study. The priority setting of vaccines through a multiple-criteria approach could contribute to transparency and accountability in the decision-making process. This is a step forward in the development of an evidence-based approach that meets the need of developing country. The

  4. Inappropriate prescribing: criteria, detection and prevention.

    O'Connor, Marie N

    2012-06-01

    Inappropriate prescribing is highly prevalent in older people and is a major healthcare concern because of its association with negative healthcare outcomes including adverse drug events, related morbidity and hospitalization. With changing population demographics resulting in increasing proportions of older people worldwide, improving the quality and safety of prescribing in older people poses a global challenge. To date a number of different strategies have been used to identify potentially inappropriate prescribing in older people. Over the last two decades, a number of criteria have been published to assist prescribers in detecting inappropriate prescribing, the majority of which have been explicit sets of criteria, though some are implicit. The majority of these prescribing indicators pertain to overprescribing and misprescribing, with only a minority focussing on the underprescribing of indicated medicines. Additional interventions to optimize prescribing in older people include comprehensive geriatric assessment, clinical pharmacist review, and education of prescribers as well as computerized prescribing with clinical decision support systems. In this review, we describe the inappropriate prescribing detection tools or criteria most frequently cited in the literature and examine their role in preventing inappropriate prescribing and other related healthcare outcomes. We also discuss other measures commonly used in the detection and prevention of inappropriate prescribing in older people and the evidence supporting their use and their application in everyday clinical practice.

  5. OSCILLATION CRITERIA FOR FORCED SUPERLINEAR DIFFERENCE EQUATIONS

    2008-01-01

    Using Riccati transformation techniques,some oscillation criteria for the forced second-order superlinear difference equations are established.These criteria are dis- crete analogues of the criteria for differential equations proposed by Yan.

  6. A Hybrid Approach Using ISM For Leveling Agile Criteria And Fuzzy AHP To Determine The Relative Weights Of Evaluation Criteria And Fuzzy TOPSIS To Rank The Alternatives

    Mahdi Karbasian1

    2012-02-01

    Full Text Available In today’s organizations, performance measurement comes more to the foreground with the advancement in the high technology. Supplier selection is an important issue in supply chain management. In recent years, determining the best supplier in the supply chain has become a key strategic consideration. However, these decisions usually involve several objectives or criteria, and it is often necessary to compromise among possibly conflicting factors. Thus, the multiple criteria decision making (MCDM becomes a useful approach to solve this kind of problem. In order to use the conceptual framework for measuring performance supplier, a methodology that takes into account both quantitative and qualitative factors and the interrelations between them should be utilized. for leveling an integrated approach of analytic hierarchy process AHP and fuzzy TOPSIS method is proposed to obtain final ranking. The interactions among the criteria are also analyzed before arriving at a decision for the selection of supplier from among six alternatives. Linguistic values are used to assess the ratings and weights for criterion. These linguistic ratings can be expressed in triangular fuzzy numbers. Then, a hierarchy multiple criteria decision-making (MCDM model based on fuzzy-sets theory including FAHP and FTOPSIS are applied. There are two approaches for aggregating values including relative importance of evaluation criteria with respect to the overall objective and rating of alternatives with respect to each criterion in fuzzy group TOPSIS: First aggregation and Last aggregation. In first aggregation approach weight of each criterion and rating of alternatives with respect to each criterion gained from decision makers are aggregated at first and TOPSIS method then apply to these aggregate values. In last aggregation approach weight of each criterion and rating of alternatives with respect to each criterion gained from decision makers are used in TOPSIS method

  7. Multi-Criteria Sustainability Assessment of Urban Sludge Treatment Technologies

    An, Da; Xi, Beidou; Ren, Jingzheng

    2017-01-01

    to determine the weights of the criteria for sustainability assessment, and extension theory was used to prioritize the alternative technologies for the treatment of urban sewage sludge and grade their sustainability performances. An illustrative case including three technologies (compositing, incineration...

  8. Diagnostic criteria for sarcopenia relate differently to insulin resistance

    Bijlsma, A.Y.; Meskers, C.G.M.; van Heemst, D.; Westendorp, R.G.J.; Craen, A.J.M.; Maier, A.B.

    2013-01-01

    Skeletal muscle is important in insulinstimulated glucose uptake. Sarcopenia is, therefore, a possible risk factor for insulin resistance. Currently, different diagnostic criteria for sarcopenia include low muscle mass, muscle strength, and walking speed. We assessed these muscle characteristics in

  9. Nevada National Security Site Waste Acceptance Criteria

    NSTec Environmental Management

    2010-09-03

    This document establishes the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) Nevada National Security Site Waste Acceptance Criteria (NNSSWAC). The NNSSWAC provides the requirements, terms, and conditions under which the Nevada National Security Site (NNSS) will accept low-level radioactive waste and mixed low-level waste for disposal. The NNSSWAC includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NNSS Area 3 and Area 5 Radioactive Waste Management Complex for disposal. The NNSA/NSO and support contractors are available to assist you in understanding or interpreting this document. For assistance, please call the NNSA/NSO Waste Management Project at (702) 295-7063 or fax to (702) 295-1153.

  10. Packaging Design Criteria for the MCO Cask

    FLANAGAN, B.D.

    2000-01-01

    Approximately 2,100 metric tons of unprocessed, irradiated, nuclear fuel elements are presently stored in the K Basins (including approximately 700 additional elements from the Plutonium-Uranium Extraction Plant, N Reactor, and 327 Laboratory). To permit cleanup of the K Basins and fuel conditioning, the fuel will be transported from the 100 K Area to a Canister Storage Building (CSB) in the 200 East Area. The purpose of this packaging design criteria is to provide criteria for the design, fabrication, and use of a packaging system to transport the large quantities of irradiated nuclear fuel elements positioned within Multi-canister Overpacks. Concurrent with the K Basin cleanup, 72 Shippingport Pressurized Water Reactor Core 2 fuel assemblies will be transported from T Plant to the CSB to provide space at T Plant for K Basin sludge canisters

  11. Nevada National Security Site Waste Acceptance Criteria

    2010-01-01

    This document establishes the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) Nevada National Security Site Waste Acceptance Criteria (NNSSWAC). The NNSSWAC provides the requirements, terms, and conditions under which the Nevada National Security Site (NNSS) will accept low-level radioactive waste and mixed low-level waste for disposal. The NNSSWAC includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NNSS Area 3 and Area 5 Radioactive Waste Management Complex for disposal. The NNSA/NSO and support contractors are available to assist you in understanding or interpreting this document. For assistance, please call the NNSA/NSO Waste Management Project at (702) 295-7063 or fax to (702) 295-1153.

  12. Nevada National Security Site Waste Acceptance Criteria

    2011-01-01

    This document establishes the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) Nevada National Security Site Waste Acceptance Criteria (NNSSWAC). The NNSSWAC provides the requirements, terms, and conditions under which the Nevada National Security Site (NNSS) will accept low-level radioactive waste and mixed low-level waste for disposal. The NNSSWAC includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NNSS Area 3 and Area 5 Radioactive Waste Management Complex for disposal. The NNSA/NSO and support contractors are available to assist you in understanding or interpreting this document. For assistance, please call the NNSA/NSO Waste Management Project at (702) 295-7063 or fax to (702) 295-1153.

  13. Accident analysis and DOE criteria

    Graf, J.M.; Elder, J.C.

    1982-01-01

    In analyzing the radiological consequences of major accidents at DOE facilities one finds that many facilities fall so far below the limits of DOE Order 6430 that compliance is easily demonstrated by simple analysis. For those cases where the amount of radioactive material and the dispersive energy available are enough for accident consequences to approach the limits, the models and assumptions used become critical. In some cases the models themselves are the difference between meeting the criteria or not meeting them. Further, in one case, we found that not only did the selection of models determine compliance but the selection of applicable criteria from different chapters of Order 6430 also made the difference. DOE has recognized the problem of different criteria in different chapters applying to one facility, and has proceeded to make changes for the sake of consistency. We have proposed to outline the specific steps needed in an accident analysis and suggest appropriate models, parameters, and assumptions. As a result we feed DOE siting and design criteria will be more fairly and consistently applied

  14. Risk based seismic design criteria

    Kennedy, R.P.

    1999-01-01

    In order to develop a risk based seismic design criteria the following four issues must be addressed: (1) What target annual probability of seismic induced unacceptable performance is acceptable? (2) What minimum seismic margin is acceptable? (3) Given the decisions made under Issues 1 and 2, at what annual frequency of exceedance should the safe-shutdown-earthquake (SSE) ground motion be defined? (4) What seismic design criteria should be established to reasonably achieve the seismic margin defined under Issue 2? The first issue is purely a policy decision and is not addressed in this paper. Each of the other three issues are addressed. Issues 2 and 3 are integrally tied together so that a very large number of possible combinations of responses to these two issues can be used to achieve the target goal defined under Issue 1. Section 2 lays out a combined approach to these two issues and presents three potentially attractive combined resolutions of these two issues which reasonably achieves the target goal. The remainder of the paper discusses an approach which can be used to develop seismic design criteria aimed at achieving the desired seismic margin defined in resolution of Issue 2. Suggestions for revising existing seismic design criteria to more consistently achieve the desired seismic margin are presented. (orig.)

  15. Nuclear waste disposal: two social criteria

    Rochlin, G.I.

    1977-01-01

    Two criteria--technical irreversibility and site multiplicity--have been suggested for use in establishing standards for the disposal of nuclear wastes. They have been constructed specifically to address the reduction of future risk in the face of inherent uncertainty concerning the social and political developments that might occur over the required periods of waste isolation, to provide for safe disposal without the requirement of a guaranteed future ability to recognize, detect, or repair errors and failures. Decisions as to how to apply or weigh these criteria in conjunction with other waste management goals must be made by societies and their governments. The purpose of this paper was not to preempt this process, but to construct a framework that facilitates consideration of the ethical and normative components of the problem of nuclear waste disposal. The minimum ethical obligation of a waste disposal plan is to examine most thoroughly the potential consequences of present actions, to acknowledge them openly, and to minimize the potential for irremediable harm. An ethically sound waste management policy must reflect not only our knowledge and skills, but our limitations as well

  16. Evaluating Dependence Criteria for Caffeine.

    Striley, Catherine L W; Griffiths, Roland R; Cottler, Linda B

    2011-12-01

    Background: Although caffeine is the most widely used mood-altering drug in the world, few studies have operationalized and characterized Diagnostic and Statistical Manual IV (DSM-IV) substance dependence criteria applied to caffeine. Methods: As a part of a nosological study of substance use disorders funded by the National Institute on Drug Abuse, we assessed caffeine use and dependence symptoms among high school and college students, drug treatment patients, and pain clinic patients who reported caffeine use in the last 7 days and also reported use of alcohol, nicotine, or illicit drugs within the past year ( n =167). Results: Thirty-five percent met the criteria for dependence when all seven of the adopted DSM dependence criteria were used. Rates of endorsement of several of the most applicable diagnostic criteria were as follows: 26% withdrawal, 23% desire to cut down or control use, and 44% continued use despite harm. In addition, 34% endorsed craving, 26% said they needed caffeine to function, and 10% indicated that they talked to a physician or counselor about problems experienced with caffeine. There was a trend towards increased caffeine dependence among those dependent on nicotine or alcohol. Within a subgroup that had used caffeine, alcohol, and nicotine in the past year, 28% fulfilled criteria for caffeine dependence compared to 50% for alcohol and 80% for nicotine. Conclusion: The present study adds to a growing literature suggesting the reliability, validity, and clinical utility of the caffeine dependence diagnosis. Recognition of caffeine dependence in the DSM-V may be clinically useful.

  17. Multiple Sclerosis and Vitamin D

    ... Editors David C. Spencer, MD Steven Karceski, MD Multiple sclerosis and vitamin D Andrew J. Solomon, MD WHAT ... caused by improper immune responses (autoimmune diseases), including multiple sclerosis (MS). A recent Patient Page in Neurology provided ...

  18. MULTI-CRITERIA APPROACH FOR DESIGNING SUSTAINABLE DRAINAGE IN MALANG RESIDENTIAL AREA INDONESIA

    HAPSARI Ratih Indri

    2016-07-01

    Full Text Available Environmentally sound approach for sustainable urban drainage could promote infiltration and lower the risk of flooding. This study presents the framework to evaluate the drainage alternatives considering multiple aspects including water quantity, life cycle cost and amenity. This approach is verified through application at a residential area in Malang city Indonesia. Different combinations of drainage components comprising of drainage channels, infiltration wells and biopore absorption holes are assessed regarding runoff reduction, present value of life cycle cost, and willingness to pay for the convenience. The first part describes the effective designs of sustainable drainage components in the houses as well as in the public spaces of the housing. The second part of this study describes the use of analytic hierarchy process for weight assignment of sustainability criteria and multiple benefit calculation. The study recommends infiltration wells and biopore absorption holes together with drainage channels as the best management practice of sustainable drainage system based on its overall sustainability index.

  19. Multiple Sclerosis

    Multiple sclerosis (MS) is a nervous system disease that affects your brain and spinal cord. It damages the myelin sheath, the material that surrounds and protects your nerve cells. This damage slows down ...

  20. Multiple myeloma.

    Collins, Conor D

    2012-02-01

    Advances in the imaging and treatment of multiple myeloma have occurred over the past decade. This article summarises the current status and highlights how an understanding of both is necessary for optimum management.

  1. Multiple mononeuropathy

    ... with multiple mononeuropathy are prone to new nerve injuries at pressure points such as the knees and elbows. They should avoid putting pressure on these areas, for example, by not leaning on the elbows, crossing the knees, ...

  2. Rehabilitation after labral repair and femoroacetabular decompression: criteria-based progression through the return to sport phase.

    Wahoff, Michael; Dischiavi, Steve; Hodge, Jenna; Pharez, Joseph D

    2014-11-01

    Rehabilitation following hip arthroscopy for femoroacetabular impingement (FAI) and labral-chondral dysfunction has evolved rapidly over the past 15 years. There have been multiple commentaries published on rehabilitation following hip arthroscopy without any published standardized objective criteria to address the advancement of the athlete through the phases of rehabilitation. The purpose of this clinical commentary is to describe a criteria driven algorithm for safe integration and return to sport rehabilitation following hip arthroscopy. The criteria based program allows for individuality of the athlete while providing guidance from early post-operative phases through late return to sport phases of rehabilitation. Emphasis is placed on the minimum criteria to advance including healing restraints, patient reported outcomes, range of motion, core and hip stability, postural control, symmetry with functional tasks and gait, strength, power, endurance, agility, and sport-specific tasks. Evidence to support the criteria will be offered as available. Despite limitations, this clinical commentary will offer a guideline for safe return to sport for the athlete while identifying areas for further investigation. 5.

  3. Improved exposure estimation in soil screening and cleanup criteria for volatile organic chemicals.

    DeVaull, George E

    2017-09-01

    Soil cleanup criteria define acceptable concentrations of organic chemical constituents for exposed humans. These criteria sum the estimated soil exposure over multiple pathways. Assumptions for ingestion, dermal contact, and dust exposure generally presume a chemical persists in surface soils at a constant concentration level for the entire exposure duration. For volatile chemicals, this is an unrealistic assumption. A calculation method is presented for surficial soil criteria that include volatile depletion of chemical for these uptake pathways. The depletion estimates compare favorably with measured concentration profiles and with field measurements of soil concentration. Corresponding volatilization estimates compare favorably with measured data for a wide range of volatile and semivolatile chemicals, including instances with and without the presence of a mixed-chemical residual phase. Selected examples show application of the revised factors in estimating screening levels for benzene in surficial soils. Integr Environ Assess Manag 2017;13:861-869. © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC). © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

  4. Sustainable energy planning by using multi-criteria analysis application in the island of Crete

    Tsoutsos, Theocharis; Drandaki, Maria; Frantzeskaki, Niki; Iosifidis, Eleftherios; Kiosses, Ioannis

    2009-01-01

    The sustainable energy planning includes a variety of objectives, as the decision-making is directly related to the processes of analysis and management of different types of information (technological, environmental, economic and social). Very often, the traditional evaluation methods, such as the cost-benefit analysis and macro-economic indicators, are not sufficient to integrate all the elements included in an environmentally thorough energy plan. On the contrary the multiple criteria methods provide a tool, which is more appropriate to assemble and to handle a wide range of variables that is evaluated in different ways and thus offer valid decision support. This paper exploits the multi-criteria methodology for the sustainable energy planning on the island of Crete in Greece. A set of energy planning alternatives are determined upon the implementation of installations of renewable energy sources on the island and are assessed against economic, technical, social and environmental criteria identified by the actors involved in the energy planning arena. The study constitutes an exploratory analysis with the potential to assist decision makers responsible for regional energy planning, providing them the possibility of creating classifications of alternative sustainable energy alternatives.

  5. Induced simplified neutrosophic correlated aggregation operators for multi-criteria group decision-making

    Şahin, Rıdvan; Zhang, Hong-yu

    2018-03-01

    Induced Choquet integral is a powerful tool to deal with imprecise or uncertain nature. This study proposes a combination process of the induced Choquet integral and neutrosophic information. We first give the operational properties of simplified neutrosophic numbers (SNNs). Then, we develop some new information aggregation operators, including an induced simplified neutrosophic correlated averaging (I-SNCA) operator and an induced simplified neutrosophic correlated geometric (I-SNCG) operator. These operators not only consider the importance of elements or their ordered positions, but also take into account the interactions phenomena among decision criteria or their ordered positions under multiple decision-makers. Moreover, we present a detailed analysis of I-SNCA and I-SNCG operators, including the properties of idempotency, commutativity and monotonicity, and study the relationships among the proposed operators and existing simplified neutrosophic aggregation operators. In order to handle the multi-criteria group decision-making (MCGDM) situations where the weights of criteria and decision-makers usually correlative and the criterion values are considered as SNNs, an approach is established based on I-SNCA operator. Finally, a numerical example is presented to demonstrate the proposed approach and to verify its effectiveness and practicality.

  6. Investigation of effective decision criteria for multiobjective optimization in IMRT.

    Holdsworth, Clay; Stewart, Robert D; Kim, Minsun; Liao, Jay; Phillips, Mark H

    2011-06-01

    To investigate how using different sets of decision criteria impacts the quality of intensity modulated radiation therapy (IMRT) plans obtained by multiobjective optimization. A multiobjective optimization evolutionary algorithm (MOEA) was used to produce sets of IMRT plans. The MOEA consisted of two interacting algorithms: (i) a deterministic inverse planning optimization of beamlet intensities that minimizes a weighted sum of quadratic penalty objectives to generate IMRT plans and (ii) an evolutionary algorithm that selects the superior IMRT plans using decision criteria and uses those plans to determine the new weights and penalty objectives of each new plan. Plans resulting from the deterministic algorithm were evaluated by the evolutionary algorithm using a set of decision criteria for both targets and organs at risk (OARs). Decision criteria used included variation in the target dose distribution, mean dose, maximum dose, generalized equivalent uniform dose (gEUD), an equivalent uniform dose (EUD(alpha,beta) formula derived from the linear-quadratic survival model, and points on dose volume histograms (DVHs). In order to quantatively compare results from trials using different decision criteria, a neutral set of comparison metrics was used. For each set of decision criteria investigated, IMRT plans were calculated for four different cases: two simple prostate cases, one complex prostate Case, and one complex head and neck Case. When smaller numbers of decision criteria, more descriptive decision criteria, or less anti-correlated decision criteria were used to characterize plan quality during multiobjective optimization, dose to OARs and target dose variation were reduced in the final population of plans. Mean OAR dose and gEUD (a = 4) decision criteria were comparable. Using maximum dose decision criteria for OARs near targets resulted in inferior populations that focused solely on low target variance at the expense of high OAR dose. Target dose range, (D

  7. Inappropriate prescribing in the older population: need for new criteria.

    O'Mahony, Denis

    2012-02-03

    Inappropriate prescribing (IP) is a common and serious global healthcare problem in elderly people, leading to increased risk of adverse drug reactions (ADRs), polypharmacy being the main risk factor for both IP and ADRs. IP in older people is highly prevalent but preventable; hence screening tools for IP have been devised, principally Beers\\' Criteria and the Inappropriate Prescribing in the Elderly Tool (IPET). Although Beers\\' Criteria have become the most widely cited IP criteria in the literature, nevertheless, they have serious deficiencies, including several drugs that are rarely prescribed nowadays, a lack of structure in the presentation of the criteria and omission of several important and common IP instances. New, more up-to-date, systems-based and easily applicable criteria are needed that can be applied in the routine clinical setting.

  8. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2.

    O'Mahony, Denis; O'Sullivan, David; Byrne, Stephen; O'Connor, Marie Noelle; Ryan, Cristin; Gallagher, Paul

    2015-03-01

    Screening tool of older people's prescriptions (STOPP) and screening tool to alert to right treatment (START) criteria were first published in 2008. Due to an expanding therapeutics evidence base, updating of the criteria was required. We reviewed the 2008 STOPP/START criteria to add new evidence-based criteria and remove any obsolete criteria. A thorough literature review was performed to reassess the evidence base of the 2008 criteria and the proposed new criteria. Nineteen experts from 13 European countries reviewed a new draft of STOPP & START criteria including proposed new criteria. These experts were also asked to propose additional criteria they considered important to include in the revised STOPP & START criteria and to highlight any criteria from the 2008 list they considered less important or lacking an evidence base. The revised list of criteria was then validated using the Delphi consensus methodology. The expert panel agreed a final list of 114 criteria after two Delphi validation rounds, i.e. 80 STOPP criteria and 34 START criteria. This represents an overall 31% increase in STOPP/START criteria compared with version 1. Several new STOPP categories were created in version 2, namely antiplatelet/anticoagulant drugs, drugs affecting, or affected by, renal function and drugs that increase anticholinergic burden; new START categories include urogenital system drugs, analgesics and vaccines. STOPP/START version 2 criteria have been expanded and updated for the purpose of minimizing inappropriate prescribing in older people. These criteria are based on an up-to-date literature review and consensus validation among a European panel of experts. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society.

  9. Geomembrane selection criteria for uranium tailings ponds

    Mitchell, D.H.; Cuello, R.

    1986-09-01

    The selection criteria, particularly those involving chemical compatibility, of geomembranes to be used in ponds at uranium mill operations are discussed. The principal functional criteria which a geomembrane must meet for this application are: (1) a specified service life and (2) low permeability. Chemical compatibility with the waste is essential in meeting these functional criteria. In two different types of aging tests using simulated acidic uranium mill waste, degradation of chemical and physical properties were examined in geomembranes of high-density polyethylene, polyvinyl chloride, and chlorosulfonated polyethylene. Compatibility tests according to the National Sanitation Foundation procedures are recommended to ascertain the stability of certain physical properties of the proposed geomembrane. Actual experience with a specific geomembrane in an identical application is probably the best method to assure compatibility; however, this experience is frequently not available. Experience with a geomembrane in similar applications is valuable in the selection process, however, small differences in either the geomembrane formulation or the waste composition may result in large differences in performance of the geomembrane. It is likely that many geomembranes have acceptable chemical stability for typical uranium mill applications, therefore, additional factors in the selection processes will include seaming characteristics, mechanical properties, site characteristics, and costs

  10. Ecological radiation protection criteria for nuclear power

    Kryshev, I.I.

    1993-01-01

    By now a large quantity of radioactive hazards of all sizes and shapes has accumulated in Russia. They include RBMK, VVER, and BN (fast-neutron) nuclear power plants, nuclear fuel processing plants, radioactive waste dumps, ships with nuclear power units, etc. In order to evaluate the radioecological situation correctly, the characteristics of the radioactive contamination must be compiled in these areas with some system of criteria which will provide an acceptable level of ecological safety. Currently health criteria for radiation protection are, which are oriented to man's radiation protection, predominate. Here the concept of a thresholdless linear dose-response dependence, which has been confirmed experimentally only at rather high doses (above 1 Gy), is taken as the theoretical basis for evaluating and normalizing radiation effects. According to one opinion, protecting people against radiation is sufficient to protect other types of organisms, although they are not necessarily of the same species. However, from the viewpoint of ecology, this approach is incorrect, because it does not consider radiation dose differences between man and other living organisms. The article discusses dose-response dependences for various organisms, biological effects of ionizing radiation, and appropriate radiation protection criteria

  11. Diagnosis of multiple system atrophy.

    Palma, Jose-Alberto; Norcliffe-Kaufmann, Lucy; Kaufmann, Horacio

    2018-05-01

    Multiple system atrophy (MSA) may be difficult to distinguish clinically from other disorders, particularly in the early stages of the disease. An autonomic-only presentation can be indistinguishable from pure autonomic failure. Patients presenting with parkinsonism may be misdiagnosed as having Parkinson disease. Patients presenting with the cerebellar phenotype of MSA can mimic other adult-onset ataxias due to alcohol, chemotherapeutic agents, lead, lithium, and toluene, or vitamin E deficiency, as well as paraneoplastic, autoimmune, or genetic ataxias. A careful medical history and meticulous neurological examination remain the cornerstone for the accurate diagnosis of MSA. Ancillary investigations are helpful to support the diagnosis, rule out potential mimics, and define therapeutic strategies. This review summarizes diagnostic investigations useful in the differential diagnosis of patients with suspected MSA. Currently used techniques include structural and functional brain imaging, cardiac sympathetic imaging, cardiovascular autonomic testing, olfactory testing, sleep study, urological evaluation, and dysphagia and cognitive assessments. Despite advances in the diagnostic tools for MSA in recent years and the availability of consensus criteria for clinical diagnosis, the diagnostic accuracy of MSA remains sub-optimal. As other diagnostic tools emerge, including skin biopsy, retinal biomarkers, blood and cerebrospinal fluid biomarkers, and advanced genetic testing, a more accurate and earlier recognition of MSA should be possible, even in the prodromal stages. This has important implications as misdiagnosis can result in inappropriate treatment, patient and family distress, and erroneous eligibility for clinical trials of disease-modifying drugs. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Carotid Consensus Panel duplex criteria can replace modified University of Washington criteria without affecting accuracy.

    Kim, Ann H; Augustin, Gener; Shevitz, Andrew; Kim, Hannah; Trivonovich, Michael R; Powell, Alexis R; Kumins, Norman; Tarr, Robert; Kashyap, Vikram S

    2018-04-01

    The decision to intervene for internal carotid stenosis often depends on the degree of stenosis seen on duplex ultrasound (US). The aim of this study is to compare the diagnostic accuracy of two criteria: modified University of Washington (UW) and 2003 Carotid Consensus Panel (CCP). All patients undergoing US in an accredited (IAC) vascular laboratory from January 2010 to June 2015 were reviewed ( n=18,772 US exams). Patients receiving a neck computed tomography angiography (CTA) within 6 months of the US were included in the study ( n=254). The degree of stenosis was determined by UW/CCP criteria and confirmed on CTA images using North American Symptomatic Carotid Endarterectomy Trial (NASCET)/European Carotid Surgery Trial (ECST) schema. Kappa analysis with 95% confidence intervals (CIs) were utilized to determine duplex-CTA agreement. A total of 417 carotid arteries from 221 patients were assessed in this study. The modified UW criteria accurately classified 266 (63.9%, kappa = 0.321, 95% CI 0.255 to 0.386) cases according to NASCET-derived measurements. The sensitivity, specificity, and accuracy at ≥ 60% stenosis were 65.7%, 81.3%, and 81.9%. The CCP criteria resulted in 296 (70.9%) accurate diagnoses (kappa = 0.359, 95% CI 0.280 to 0.437). At ≥ 70% stenosis, the sensitivity, specificity and accuracy were 38.8%, 91.6%, and 87.1% for NASCET. Comparison of the duplex results to ECST-derived CTA measurements revealed a similar trend (UW 53.1%, κ = 0.301 vs CCP 62.1%, κ = 0.315). The CCP criteria demonstrate a higher concordance rate with measurements taken from CTAs. The CCP criteria may be more sensitive in classifying clinically significant degrees of stenosis without a loss in diagnostic accuracy.

  13. Multi-criteria, personalized route planning using quantifier-guided ordered weighted averaging operators

    Nadi, S.; Delavar, M. R.

    2011-06-01

    This paper presents a generic model for using different decision strategies in multi-criteria, personalized route planning. Some researchers have considered user preferences in navigation systems. However, these prior studies typically employed a high tradeoff decision strategy, which used a weighted linear aggregation rule, and neglected other decision strategies. The proposed model integrates a pairwise comparison method and quantifier-guided ordered weighted averaging (OWA) aggregation operators to form a personalized route planning method that incorporates different decision strategies. The model can be used to calculate the impedance of each link regarding user preferences in terms of the route criteria, criteria importance and the selected decision strategy. Regarding the decision strategy, the calculated impedance lies between aggregations that use a logical "and" (which requires all the criteria to be satisfied) and a logical "or" (which requires at least one criterion to be satisfied). The calculated impedance also includes taking the average of the criteria scores. The model results in multiple alternative routes, which apply different decision strategies and provide users with the flexibility to select one of them en-route based on the real world situation. The model also defines the robust personalized route under different decision strategies. The influence of different decision strategies on the results are investigated in an illustrative example. This model is implemented in a web-based geographical information system (GIS) for Isfahan in Iran and verified in a tourist routing scenario. The results demonstrated, in real world situations, the validity of the route planning carried out in the model.

  14. Reflexive criteria of sociological research

    R T Ubaydullaeva

    2014-12-01

    Full Text Available The article is devoted to the sociological criteria of explaining the way of thinking and actions of subjects, their spiritual and moral positions and intellectual forces that form the laws of social life. The author seeks to adapt such categories as ‘meaning of life’, ‘human dignity’, ‘rationality’ etc. for the purposes of sociological analysis by methodological construction of some real life dichotomies such as ‘subjective meaning and social function’, ‘the real and the ideal’, ‘the demanded and the excluded’. Thus, the author studies economic, political and technical processes in terms of both positivity and negativity of social interaction and states that given the increasing differentiation of the society and the contradictory trends of social development the reflexive criteria that take into account the socio-cultural nature of the man help to find one’s own model of development.

  15. New facility shield design criteria

    Howell, W.P.

    1981-07-01

    The purpose of the criteria presented here is to provide standard guidance for the design of nuclear radiation shields thoughout new facilities. These criteria are required to assure a consistent and integrated design that can be operated safely and economically within the DOE standards. The scope of this report is confined to the consideration of radiation shielding for contained sources. The whole body dose limit established by the DOE applies to all doses which are generally distributed throughout the trunk of the body. Therefore, where the whole body is the critical organ for an internally deposited radionuclide, the whole body dose limit applies to the sum of doses received must assure control of the concentration of radionuclides in the building atmosphere and thereby limit the dose from internal sources

  16. Evaluating Dependence Criteria for Caffeine

    Striley, Catherine L.W.; Griffiths, Roland R.; Cottler, Linda B.

    2011-01-01

    Background: Although caffeine is the most widely used mood-altering drug in the world, few studies have operationalized and characterized Diagnostic and Statistical Manual IV (DSM-IV) substance dependence criteria applied to caffeine. Methods: As a part of a nosological study of substance use disorders funded by the National Institute on Drug Abuse, we assessed caffeine use and dependence symptoms among high school and college students, drug treatment patients, and pain clinic patients who re...

  17. Radiological criteria in nuclear emergencies

    Carrillo, D.; Diaz de la Cruz, F.

    1985-01-01

    It is pretended to enlighten the way to adopt the recommendations, from supranational organizations or the practices followed in other countries, to the peculiarities existing in Spain for the specific case of Nuclear Emergency Response Planning. The adaptation has been focalized in the criteria given by the Spanish Nuclear Safety Council and has taken into account the radiological protection levels, which have been considered adequate for Spanish population in case of nuclear accidents. (author)

  18. Sampling criteria in multicollection searching.

    Gilio, A.; Scozzafava, R.; Marchetti, P. G.

    In the first stage of the document retrieval process, no information concerning relevance of a particular document is available. On the other hand, computer implementation requires that the analysis be made only for a sample of retrieved documents. This paper addresses the significance and suitability of two different sampling criteria for a multicollection online search facility. The inevitability of resorting to a logarithmic criterion in order to achieve a "spread of representativeness" from the multicollection is demonstrated.

  19. Position paper: Seismic design criteria

    Farnworth, S.K.

    1995-01-01

    The purpose of this paper is to document the seismic design criteria to be used on the Title 11 design of the underground double-shell waste storage tanks and appurtenant facilities of the Multi-Function Waste Tank Facility (MWTF) project, and to provide the history and methodologies for determining the recommended Design Basis Earthquake (DBE) Peak Ground Acceleration (PGA) anchors for site-specific seismic response spectra curves. Response spectra curves for use in design are provided in Appendix A

  20. [Multiple meningiomas].

    Terrier, L-M; François, P

    2016-06-01

    Multiple meningiomas (MMs) or meningiomatosis are defined by the presence of at least 2 lesions that appear simultaneously or not, at different intracranial locations, without the association of neurofibromatosis. They present 1-9 % of meningiomas with a female predominance. The occurrence of multiple meningiomas is not clear. There are 2 main hypotheses for their development, one that supports the independent evolution of these tumors and the other, completely opposite, that suggests the propagation of tumor cells of a unique clone transformation, through cerebrospinal fluid. NF2 gene mutation is an important intrinsic risk factor in the etiology of multiple meningiomas and some exogenous risk factors have been suspected but only ionizing radiation exposure has been proven. These tumors can grow anywhere in the skull but they are more frequently observed in supratentorial locations. Their histologic types are similar to unique meningiomas of psammomatous, fibroblastic, meningothelial or transitional type and in most cases are benign tumors. The prognosis of these tumors is eventually good and does not differ from the unique tumors except for the cases of radiation-induced multiple meningiomas, in the context of NF2 or when diagnosed in children where the outcome is less favorable. Each meningioma lesion should be dealt with individually and their multiple character should not justify their resection at all costs. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  1. Coping strategies and mood profiles in patients with multiple sclerosis

    Aysel Milanlioglu

    2014-07-01

    Full Text Available Objective: The aim of the present study was to investigate the coping strategies, mood characteristics and the association between these aspects in patients diagnosed with multiple sclerosis and healthy subjects. Method: Fifty consecutive patients who were diagnosed with multiple sclerosis according to McDonald criteria and thirty-one healthy subjects were included in the study. In addition to the sociodemographic form, Expanded Disability Status Scale (EDSS, Coping Orientation for Problem Experiences Scale (COPE, and Profile of Mood States (POMS tests were applied to the participants. Results: Non-functional coping strategies were significantly higher in the secondary-progressive type (p≤0.05. Depression-dejection, fatigue-inertia and total POMS scores were significantly higher in the secondary-progressive type (p≤0.05. Conclusion: The results of our study demonstrate the importance of rehabilitation programs that encourage exercise among patients with multiple sclerosis to increase vigor-activity levels.

  2. Repository operational criteria comparative analysis

    Hageman, J.P.; Chowdhury, A.H.

    1994-06-01

    The objective of the ''Repository Operational Criteria (ROC) Feasibility Studies'' (or ROC task) was to conduct comprehensive and integrated analyses of repository design, construction, and operations criteria in 10 CFR Part 60 regulations considering the interfaces among the components of the regulations and impacts of any potential changes to those regulations. The ROC task addresses regulatory criteria and uncertainties related to the preclosure aspects of the geologic repository. Those parts of 10 CFR Part 60 that require routine guidance or minor changes to the rule were addressed in Hageman and Chowdhury, 1992. The ROC task shows a possible need for further regulatory clarity, by major changes to the rule, related to the design bases and siting of a geologic repository operations area and radiological emergency planning in order to assure defense-in-depth. The analyses, presented in this report, resulted in the development and refinement of regulatory concepts and their supporting rationale for recommendations for potential major changes to 10 CFR Pan 0 regulations

  3. NWTS program criteria for mined geologic disposal of nuclear waste: program objectives, functional requirements, and system performance criteria

    1982-03-01

    The NWTS-33 series, of which this document is a part, provides guidance for the National Waste Terminal Storage (NWTS) program in the development and implementation of licensed mined geologic disposal systems for solidified high-level and TRU wastes. Program objectives, functional requirements, and system performance criteria are found in this document. At the present time final criteria have not been issued by the Nuclear Regulatory Commission (NRC) and Environmental Protection Agency (EPA). The criteria in these documents have been developed on the basis of DOE's judgment of what is required to protect the health and safety of the public and the quality of the environment. It is expected that these criteria will be consistent with regulatory standards. The criteria will be re-evaluated on a periodic basis to ensure that they remain consistent with national waste management policy and regulatory requirements. A re-evaluation will be made when final criteria are promulgated by the NRC and EPA. A background section that briefly describes the mined geologic disposal system and explains the hierarchy and application of the NWTS criteria is included in Section 2.0. Secton 3.0 presents the program objectives, Section 4.0 functional requirements, Secton 5.0 the system performance criteria, and Section 6.0 quality assurance and standards. A draft of this document was issued for public comment in April 1981. Appendix A contains the DOE responses to the comments received. Appendix B is a glossary

  4. Multiple sclerosis

    Stenager, Egon; Stenager, E N; Knudsen, Lone

    1994-01-01

    In a cross-sectional study of 117 randomly selected patients (52 men, 65 women) with definite multiple sclerosis, it was found that 76 percent were married or cohabitant, 8 percent divorced. Social contacts remained unchanged for 70 percent, but outgoing social contacts were reduced for 45 percent......, need for structural changes in home and need for pension became greater with increasing physical handicap. No significant differences between gender were found. It is concluded that patients and relatives are under increased social strain, when multiple sclerosis progresses to a moderate handicap...

  5. A demonstration of NIOSH push-pull ventilation criteria.

    Klein, M K

    1987-03-01

    This paper summarizes the results of a study performed on an actual chrome plating tank in order to validate criteria for push-pull ventilation systems developed by Huebener and Hughes at NIOSH. Validation of the criteria was made by taking area industrial hygiene samples for hexavalent and total chrome at ten locations around the plating tank. The sampling was performed during actual production runs or while the tank was operating with a dummy load. The sampling data are summarized. The data show that the push-pull system, operating at Huebener's criteria, could control emissions to below the current standards and guidelines. Conclusions and recommendations are included.

  6. Prospective Evaluation of Magnetic Resonance Imaging and [18F]Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography at Diagnosis and Before Maintenance Therapy in Symptomatic Patients With Multiple Myeloma Included in the IFM/DFCI 2009 Trial: Results of the IMAJEM Study.

    Moreau, Philippe; Attal, Michel; Caillot, Denis; Macro, Margaret; Karlin, Lionel; Garderet, Laurent; Facon, Thierry; Benboubker, Lotfi; Escoffre-Barbe, Martine; Stoppa, Anne-Marie; Laribi, Kamel; Hulin, Cyrille; Perrot, Aurore; Marit, Gerald; Eveillard, Jean-Richard; Caillon, Florence; Bodet-Milin, Caroline; Pegourie, Brigitte; Dorvaux, Veronique; Chaleteix, Carine; Anderson, Kenneth; Richardson, Paul; Munshi, Nikhil C; Avet-Loiseau, Herve; Gaultier, Aurelie; Nguyen, Jean-Michel; Dupas, Benoit; Frampas, Eric; Kraeber-Bodere, Françoise

    2017-09-01

    Purpose Magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET-CT) are important imaging techniques in multiple myeloma (MM). We conducted a prospective trial in patients with MM aimed at comparing MRI and PET-CT with respect to the detection of bone lesions at diagnosis and the prognostic value of the techniques. Patients and Methods One hundred thirty-four patients received a combination of lenalidomide, bortezomib, and dexamethasone (RVD) with or without autologous stem-cell transplantation, followed by lenalidomide maintenance. PET-CT and MRI were performed at diagnosis, after three cycles of RVD, and before maintenance therapy. The primary end point was the detection of bone lesions at diagnosis by MRI versus PET-CT. Secondary end points included the prognostic impact of MRI and PET-CT regarding progression-free (PFS) and overall survival (OS). Results At diagnosis, MRI results were positive in 127 of 134 patients (95%), and PET-CT results were positive in 122 of 134 patients (91%; P = .33). Normalization of MRI after three cycles of RVD and before maintenance was not predictive of PFS or OS. PET-CT became normal after three cycles of RVD in 32% of the patients with a positive evaluation at baseline, and PFS was improved in this group (30-month PFS, 78.7% v 56.8%, respectively). PET-CT normalization before maintenance was described in 62% of the patients who were positive at baseline. This was associated with better PFS and OS. Extramedullary disease at diagnosis was an independent prognostic factor for PFS and OS, whereas PET-CT normalization before maintenance was an independent prognostic factor for PFS. Conclusion There is no difference in the detection of bone lesions at diagnosis when comparing PET-CT and MRI. PET-CT is a powerful tool to evaluate the prognosis of de novo myeloma.

  7. Selection of bioaccumulation criteria for environmental emergency (E2) planning

    Ketcheson, K.; Hradecky, K.; Gagne, M.; St-Amant-Verret, M.

    2006-01-01

    Environment Canada's Environmental Emergency regulations require the evaluation of a substance by a Risk Evaluation Framework (REF). Bioaccumulation criteria are used within the environmental hazard ratings section of the REF to determine the risk of a substance to organisms and are obtained from 3 types of measurements depending on data reliability: (1) bioaccumulation factors (BAF); (2) bioconcentration factors (BCF); and (3) an octanol-water partition coefficient (log K ow ). This paper presented details of a study of international and regional bioaccumulation criteria conducted to aid in determining appropriate criteria for E2 regulations and plans, with specific reference to substances toxic to aquatic organisms. An E2 plan is required if a substance has a bioconcentration factor of more than 500 in conjunction with aquatic toxicity. Bioaccumulation criteria from several sources for 745 substances were obtained to aid in choosing the most important parameters. Various international and regional criteria were examined and corresponding sources were summarized, and different source criteria was compared with empirical chemical data. The criteria chosen included both log K ow values and BCF values, although it was suggested that BCF and BAF are more realistic measures of bioaccumulation than log K ow , as they are derived from animal studies. The chosen values agreed with the virtual elimination criteria set out by the Canadian Environmental Protection Act (CEPA) 1999 as well as United States Environmental Protection Agency (EPA) criteria. It was concluded that the bioaccumulation criteria for E2 planning will help Environment Canada ensure the protection of the environment from hazardous substances. 11 refs., 3 tabs., 5 figs

  8. Novel and conventional working fluid mixtures for solar Rankine cycles: Performance assessment and multi-criteria selection

    Mavrou, Paschalia; Papadopoulos, Athanasios I.; Stijepovic, Mirko Z.; Seferlis, Panos; Linke, Patrick; Voutetakis, Spyros

    2015-01-01

    This work investigates the performance of working fluid mixtures for use in solar ORC (Organic Rankine Cycle systems) with heat storage employing FPC (Flat Plate Collectors). Several mixtures are considered including conventional choices often utilized in ORC as well as novel mixtures previously designed using advanced computer aided molecular design methods (Papadopoulos et al., 2013). The impact of heat source variability on the ORC performance is assessed for different working fluid mixtures. Solar radiation is represented in detail through actual, hourly averaged data for an entire year. A multi-criteria mixture selection methodology unveils important trade-offs among several important system operating parameters and efficiently highlights optimum operating ranges. Such parameters include the ORC thermal efficiency, the net generated power, the volume ratio across the turbine, the mass flow rate of the ORC working fluid, the evaporator temperature glide, the temperature drop in the storage tank, the ORC total yearly operating duration, the required collector aperture area to generate 1 kW of power and the irreversibility. A mixture of neopentane – 2-fluoromethoxy-2-methylpropane at 70% neopentane is found to be the most efficient in all the considered criteria simultaneously. - Highlights: • Investigation of novel and conventional working fluid mixtures for solar ORCs. • Systematic, multi-criteria assessment methodology for mixture selection. • Simultaneous consideration of multiple important mixture performance criteria. • Effects of year-round solar variability in a solar ORC with heat storage tank

  9. Fission neutron multiplicity calculations

    Maerten, H.; Ruben, A.; Seeliger, D.

    1991-01-01

    A model for calculating neutron multiplicities in nuclear fission is presented. It is based on the solution of the energy partition problem as function of mass asymmetry within a phenomenological approach including temperature-dependent microscopic energies. Nuclear structure effects on fragment de-excitation, which influence neutron multiplicities, are discussed. Temperature effects on microscopic energy play an important role in induced fission reactions. Calculated results are presented for various fission reactions induced by neutrons. Data cover the incident energy range 0-20 MeV, i.e. multiple chance fission is considered. (author). 28 refs, 13 figs

  10. Multiple myeloma

    Sohn, Jeong Ick; Ha, Choon Ho; Choi, Karp Shik

    1994-01-01

    Multiple myeloma is a malignant plasma cell tumor that is thought to originate proliferation of a single clone of abnormal plasma cell resulting production of a whole monoclonal paraprotein. The authors experienced a case of multiple myeloma with severe mandibular osteolytic lesions in 46-year-old female. As a result of careful analysis of clinical, radiological, histopathological features, and laboratory findings, we diagnosed it as multiple myeloma, and the following results were obtained. 1. Main clinical symptoms were intermittent dull pain on the mandibular body area, abnormal sensation of lip and pain due to the fracture on the right clavicle. 2. Laboratory findings revealed M-spike, reversed serum albumin-globulin ratio, markedly elevated ESR and hypercalcemia. 3. Radiographically, multiple osteolytic punched-out radiolucencies were evident on the skull, zygoma, jaw bones, ribs, clavicle and upper extremities. Enlarged liver and increased uptakes on the lesional sites in RN scan were also observed. 4. Histopathologically, markedly hypercellular marrow with sheets of plasmoblasts and megakaryocytes were also observed.

  11. Multiple sclerosis

    Stenager, E; Jensen, K

    1988-01-01

    Forty-two (12%) of a total of 366 patients with multiple sclerosis (MS) had psychiatric admissions. Of these, 34 (81%) had their first psychiatric admission in conjunction with or after the onset of MS. Classification by psychiatric diagnosis showed that there was a significant positive correlation...

  12. Multiple sclerosis

    Stenager, E; Knudsen, L; Jensen, K

    1991-01-01

    In a cross-sectional investigation of 116 patients with multiple sclerosis, the social and sparetime activities of the patient were assessed by both patient and his/her family. The assessments were correlated to physical disability which showed that particularly those who were moderately disabled...

  13. Multiple sclerosis

    Stenager, E; Jensen, K

    1990-01-01

    An investigation on the correlation between ability to read TV subtitles and the duration of visual evoked potential (VEP) latency in 14 patients with definite multiple sclerosis (MS), indicated that VEP latency in patients unable to read the TV subtitles was significantly delayed in comparison...

  14. Multiple sclerosis

    Stenager, E; Knudsen, L; Jensen, K

    1994-01-01

    In a cross-sectional study of 94 patients (42 males, 52 females) with definite multiple sclerosis (MS) in the age range 25-55 years, the correlation of neuropsychological tests with the ability to read TV-subtitles and with the use of sedatives is examined. A logistic regression analysis reveals...

  15. Parenting Multiples

    ... when your babies do. Though it can be hard to let go of the thousand other things you need to do, remember that your well-being is key to your ability to take care of your babies. What Problems Can Happen? It may be hard to tell multiple babies apart when they first ...

  16. Development of comprehensive waste acceptance criteria for commercial nuclear waste

    O'Hara, F.A.; Miller, N.E.; Ausmus, B.S.; Yates, K.R.; Means, J.L.; Christensen, R.N.; Kulacki, F.A.

    1979-01-01

    A detailed methodology is presented for the identification of the characteristics of commercial nuclear waste which may require criteria. This methodology is analyzed as a six-step process which begins with identification of waste operations and proceeds until the waste characteristics affecting the potential release of radionuclides are determined. All waste types and operations were analyzed using the methodology presented. Several illustrative example are included. It is found that thirty-three characteristics can be identified as possibly requiring criteria

  17. Criteria for accepting piping vibrations measured during FFTF plant startup

    Huang, S.N.

    1981-03-01

    Piping in the Fast Flux Test Facility is subjected to low-amplitude, high cycle vibration over the plant lifetime. Excitation sources include the mechanical vibration induced by main centrifugal pumps, auxiliary reciprocating pumps, EM pumps and possible flow oscillations. Vibration acceptance criteria must be established which will prevent excessive pipe and support fatigue damage when satified. This paper describes the preparation of such criteria against pipe failure used for acceptance testing of the Fast Flux Test Facility main heat transport piping

  18. Automobile Tire Assessment: A Multi-Criteria Approach

    Ateekh-Ur-Rehman

    2017-02-01

    Full Text Available In response to the present dynamic market, automobile manufacturing industries are constantly evaluating and improving their manufacturing strategies to stay competitive. It is also evident that they evaluate those strategies considering multiple criteria. In one such case, an automobile project manager has to ensure that the selected tire (among the available alternatives complies with the prospective automobile’s performance. This paper presents an approach for the assessment of alternative automobile tires taking into account multiple criteria, such as tire sustainability, tire road performance, environmental issues, tire purchase cost and tire road grip. The presented approach is quite helpful to any decision maker who is interested not only in ranking alternatives but also in establishing the superiority of an alternative over others. The approach also helps to specify the position of each alternative with respect to ideal solution. A case illustration is used to demonstrate an application of the approach.

  19. Ecological criteria for evaluating candidate sites for marine reserves

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

    2003-01-01

    Several schemes have been developed to help select the locations of marine reserves. All of them combine social, economic, and biological criteria, and few offer any guidance as to how to prioritize among the criteria identified. This can imply that the relative weights given to different criteria are unimportant. Where two sites are of equal value ecologically, then socioeconomic criteria should dominate the choice of which should be protected. However, in many cases, socioeconomic criteria are given equal or greater weight than ecological considerations in the choice of sites. This can lead to selection of reserves with little biological value that fail to meet many of the desired objectives. To avoid such a possibility, we develop a series of criteria that allow preliminary evaluation of candidate sites according to their relative biological values in advance of the application of socioeconomic criteria. We include criteria that, while not strictly biological, have a strong influence on the species present or ecological processes. Our scheme enables sites to be assessed according to their biodiversity, the processes which underpin that diversity, and the processes that support fisheries and provide a spectrum of other services important to people. Criteria that capture biodiversity values include biogeographic representation, habitat representation and heterogeneity, and presence of species or populations of special interest (e.g., threatened species). Criteria that capture sustainability of biodiversity and fishery values include the size of reserves necessary to protect viable habitats, presence of exploitable species, vulnerable life stages, connectivity among reserves, links among ecosystems, and provision of ecosystem services to people. Criteria measuring human and natural threats enable candidate sites to be eliminated from consideration if risks are too great, but also help prioritize among sites where threats can be mitigated by protection. While our

  20. Surface dust criteria for dioxin and dioxin-like compounds for re-entry to buildings

    Greene, J.; Brorby, G.; Warmerdam, J. [Exponent, Oakland, CA (United States); Paustenbach, D. [ChemRisk, San Francisco, CA (United States)

    2004-09-15

    Introduction. Building reentry criteria for dioxin TEQ, as measured by surface wipes, vary greatly, from as low as 1 ng/m{sup 2} to as high as 125 ng/m{sup 2}1. Recently, the World Trade Center Indoor Air Taskforce calculated a reentry criterion of 2 ng TEQ/m{sup 2} for a residential exposure. This number was based on the EPA's draft cancer slope factor (CSF) of 1 x 10{sup 6} (mg/kg-day)-1, and various exposure parameters, dermal absorption values, and a cancer risk criterion of 1 x 10{sup -4}. An indoor 'degradation' parameter was also included in the calculations. However, a single criterion based on a single set of assumptions cannot be universally applied to all sites with contaminated surfaces. Reentry criteria that consider a wider range of exposure scenarios, exposure pathways, bioavailability, and behavioral parameters would be very useful to risk managers who may have to address multiple diverse situations in the coming years. This paper describes our recommended reentry ''building surface'' criteria for four exposure scenarios: (1) adult occupational, (2) adult residential, (3) childhood ''occupational'' (i.e., school), and (4) childhood residential.

  1. Productive Regions: Criteria and Classification

    Vlasyuk L. I.

    2012-03-01

    Full Text Available An official statistical dataset for 80 territorial subjects of the Russian Federation for 2000, 2007 and 2009 has proved the hypothesis that, under the neoclassical concept, the resources move to regions with the highest marginal productivity of the factors of production, which leads to the accumulation of investment resources, while providing financial and social efficiency. Based on cluster analysis by three performance criteria, productive regions are identified, which are dominated by regions productive in the extraction of minerals. It is shown that the stability of the factors’ distribution in space determines the current and future specialization of regional economies

  2. Training review criteria and procedures

    1993-01-01

    This document provides direction to NRC personnel for reviewing training programs at nuclear power plants to verify compliance with the requirements of 10 CFR 50. 120 and 10 CFR 55 as applicable. It describes the process for evaluating the effectiveness of training programs, provides aids for collection of information during interviews and observations, and provides criteria for evaluating the implementation of a systems approach to training. This document is not intended to have the effect of a regulation, it establishes no binding requirements or interpretations of NRC regulations. It is intended as guidance only

  3. Quality criteria for landscape visualisation

    Waldi, H.-P.; Witt, U. de

    1996-01-01

    The rapid expansion of wind energy utilisation in Western Europe can strain the limits of social acceptance with citizens living in wind development areas. One of the problems wind farm engineers and local authorities face is the visual impact of wind turbines. To determine the influence on the landscape visualisations of wind farms photorealistic compositions are used. In many cases it is part of the planning procedure. The quality of this visualization can strongly influence the success of the permission procedure. We will give criteria which can give help to reduce the possibility of unwanted manipulations. (author)

  4. Evidence for the diagnostic criteria of delirium: an update.

    Blazer, Dan G; van Nieuwenhuizen, Adrienne O

    2012-05-01

    Since the publication of DSM-III in 1980, the essential criteria for delirium have been reduced progressively through DSM-III-R to DSM-IV. As the field moves toward DSM-V and ICD-11, new data can shed light on the nosological changes that are needed so that diagnostic criteria can reflect empirical data. In this study, we reassess the existing or potential criteria for delirium. Phenomenological studies in recent years have informed the criteria for delirium, including the appropriateness of the term 'consciousness' as a core symptom of the diagnosis, additional symptoms of delirium that are frequent but are not currently part of the diagnostic criteria, subsyndromal delirium, motoric subtypes of delirium (hyperactive, hypoactive), and the association of delirium with dementia. Recent studies suggest that motoric subtypes should be included as a subtype for delirium but that subsyndromal delirium, although a useful research construct, should not be included in clinical diagnostic criteria given the frequent fluctuation in symptoms over short periods. In addition, though the core symptoms are probably adequate to make the diagnosis, clinicians must be aware of the frequency of other symptoms, for symptoms such as profound sleep disturbance or psychotic symptoms may dominate the clinical picture.

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

    Wakefield, Jerome C; First, Michael B

    2012-02-01

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

  6. Hanford Site solid waste acceptance criteria

    Willis, N.P.; Triner, G.C.

    1991-09-01

    Westinghouse Hanford Company manages the Hanford Site solid waste treatment, storage, and disposal facilities for the US Department of Energy Field Office, Richland under contract DE-AC06-87RL10930. These facilities include radioactive solid waste disposal sites, radioactive solid waste storage areas and hazardous waste treatment, storage, and/or disposal facilities. This manual defines the criteria that must be met by waste generators for solid waste to be accepted by Westinghouse Hanford Company for treatment, storage and/or disposal facilities. It is to be used by all waste generators preparing radioactive solid waste for storage or disposal at the Hanford Site facilities and for all Hanford Site generators of hazardous waste. This manual is also intended for use by Westinghouse Hanford Company solid waste technical staff involved with approval and acceptance of solid waste. The criteria in this manual represent a compilation of state and federal regulations; US Department of Energy orders; Hanford Site requirements; and other rules, regulations, guidelines, and standards as they apply to management of solid waste. Where appropriate, these requirements are included in the manual by reference. It is the intent of this manual to provide guidance to the waste generator in meeting the applicable requirements

  7. TOKYO criteria 2014 for transpapillary biliary stenting.

    Isayama, Hiroyuki; Hamada, Tsuyoshi; Yasuda, Ichiro; Itoi, Takao; Ryozawa, Shomei; Nakai, Yousuke; Kogure, Hirofumi; Koike, Kazuhiko

    2015-01-01

    It is difficult to carry out meta-analyses or to compare the results of different studies of biliary stents because there is no uniform evaluation method. Therefore, a standardized reporting system is required. We propose a new standardized system for reporting on biliary stents, the 'TOKYO criteria 2014', based on a consensus among Japanese pancreatobiliary endoscopists. Instead of stent occlusion, we use recurrent biliary obstruction, which includes occlusion and migration. The time to recurrent biliary obstruction was estimated using Kaplan-Meier analysis with the log-rank test. We can evaluate both plastic and self-expandable metallic stents (uncovered and covered). We also propose specification of the cause of recurrent biliary obstruction, identification of complications other than recurrent biliary obstruction, indication of severity, measures of technical and clinical success, and a standard for clinical care. Most importantly, the TOKYO criteria 2014 allow comparison of biliary stent quality across studies. Because blocked stents can be drained not only using transpapillary techniques but also by an endoscopic ultrasonography-guided transmural procedure, we should devise an evaluation method that includes transmural stenting in the near future. © 2014 The Authors. Digestive Endoscopy © 2014 Japan Gastroenterological Endoscopy Society.

  8. A proposal of criteria for the classification of systemic sclerosis.

    Nadashkevich, Oleg; Davis, Paul; Fritzler, Marvin J

    2004-11-01

    Sensitive and specific criteria for the classification of systemic sclerosis are required by clinicians and investigators to achieve higher quality clinical studies and approaches to therapy. A clinical study of systemic sclerosis patients in Europe and Canada led to a set of criteria that achieve high sensitivity and specificity. Both clinical and laboratory investigations of patients with systemic sclerosis, related conditions and diseases with clinical features that can be mistaken as part of the systemic sclerosis spectrum were undertaken. Laboratory investigations included the detection of autoantibodies to centromere proteins, Scl-70 (topoisomerase I), and fibrillarin (U3-RNP). Based on the investigation of 269 systemic sclerosis patients and 720 patients presenting with related and confounding conditions, the following set of criteria for the classification of systemic sclerosis was proposed: 1) autoantibodies to: centromere proteins, Scl-70 (topo I), fibrillarin; 2) bibasilar pulmonary fibrosis; 3) contractures of the digital joints or prayer sign; 4) dermal thickening proximal to the wrists; 5) calcinosis cutis; 6) Raynaud's phenomenon; 7) esophageal distal hypomotility or reflux-esophagitis; 8) sclerodactyly or non-pitting digital edema; 9) teleangiectasias. The classification of definite SSc requires at least three of the above criteria. Criteria for the classification of systemic sclerosis have been proposed. Preliminary testing has defined the sensitivity and specificity of these criteria as high as 99% and 100%, respectively. Testing and validation of the proposed criteria by other clinical centers is required.

  9. Ventilation criteria for IDMS facility

    Lambert, D.P.

    1996-01-01

    Both Facility Evaluation Board (FEB) reviews of the Integrated DWPF Melter System (IDMS) have identified the inconsistency of the current IDMS Process Hazards Review (PHR) versus actual IDMS practice as regards the criteria to contain air borne pollutants that may be present in the Process Room (e.g. benzene and mercury). The PHR states that a 1.0 in. wc pressure differential be maintained between the IDMS Process Room and Building 672-T. In addition, the PHR further specifies that the linear velocity through openings into the Process Room (e.g. open doors) be equal to or greater than 150 fpm. Finally, the PHR recommended that mercury vapor and benzene monitors be installed in the Process Room ventilation exhaust to alert personnel to the presence of vapors of benzene and/or mercury before entering the Process Room. This report summarizes the results of reassessment of these criteria and the specific recommendation for permanent installation of mercury and benzene vapor monitors in the vapor exhaust of the Process Room

  10. Donor selection criteria and procurement

    Agcaoili, N.R.

    1999-01-01

    Donor selection is one of the most important aspects of tissue banking practice. Without a good donor selection criteria, the results of any effort of trying to preserve tissues will have disastrous outcome for the recipient of these tissues. While with a very good and strict donor selection the Tissue Bank can guarantee safe and effective tissue allografts. There are significant aspects in the history and physical examination of the donor that must be emphasized. A donor exclusion criteria has also been formulated together with a list of all the needed laboratory examinations to eliminate possible diseases that may be transferred from the donor. The methods of procurement of tissue allografts from living and cadaver donors will be described. The limitations and advantages of each will be taken.There are also special restrictions that are important in the practice of removing the tissues from the donors. All the necessary equipment should be ready and the potential risk on the personnel should be known to all doing Tissue Banking

  11. Nuclear reactor philosophy and criteria

    Atchison, R.J.

    1979-07-01

    Nuclear power plant safety criteria and principles developed in Canada are directed towards minimizing the chance of failure of the fuel and preventing or reducing to an acceptably low level the escape of fission products should fuel failure occur. Safety criteria and practices are set forth in the Reactor Siting Guide, which is based upon the concept of defence in depth. The Guide specifies that design and construction shall follow the best applicable code, standard or practice; the total of all serious process system failures shall not exceed one in three years; special safety systems are to be physically and functionally separate from process systems and each other; and safety systems shall be testable, with unavailability less than 10 - 3 . Doses to the most exposed member of the public due to normal operation, serious process failures, and dual failures are specified. Licensees are also required to consider the effects of extreme conditions due to airplane crashes, explosions, turbine disintegration, pipe burst, and natural disasters. Safety requirements are changing as nuclear power plant designs evolve and in response to social and economic pressures

  12. Participatory flood vulnerability assessment: a multi-criteria approach

    M. M. de Brito

    2018-01-01

    Full Text Available This paper presents a participatory multi-criteria decision-making (MCDM approach for flood vulnerability assessment while considering the relationships between vulnerability criteria. The applicability of the proposed framework is demonstrated in the municipalities of Lajeado and Estrela, Brazil. The model was co-constructed by 101 experts from governmental organizations, universities, research institutes, NGOs, and private companies. Participatory methods such as the Delphi survey, focus groups, and workshops were applied. A participatory problem structuration, in which the modellers work closely with end users, was used to establish the structure of the vulnerability index. The preferences of each participant regarding the criteria importance were spatially modelled through the analytical hierarchy process (AHP and analytical network process (ANP multi-criteria methods. Experts were also involved at the end of the modelling exercise for validation. The final product is a set of individual and group flood vulnerability maps. Both AHP and ANP proved to be effective for flood vulnerability assessment; however, ANP is preferred as it considers the dependences among criteria. The participatory approach enabled experts to learn from each other and acknowledge different perspectives towards social learning. The findings highlight that to enhance the credibility and deployment of model results, multiple viewpoints should be integrated without forcing consensus.

  13. Participatory flood vulnerability assessment: a multi-criteria approach

    Madruga de Brito, Mariana; Evers, Mariele; Delos Santos Almoradie, Adrian

    2018-01-01

    This paper presents a participatory multi-criteria decision-making (MCDM) approach for flood vulnerability assessment while considering the relationships between vulnerability criteria. The applicability of the proposed framework is demonstrated in the municipalities of Lajeado and Estrela, Brazil. The model was co-constructed by 101 experts from governmental organizations, universities, research institutes, NGOs, and private companies. Participatory methods such as the Delphi survey, focus groups, and workshops were applied. A participatory problem structuration, in which the modellers work closely with end users, was used to establish the structure of the vulnerability index. The preferences of each participant regarding the criteria importance were spatially modelled through the analytical hierarchy process (AHP) and analytical network process (ANP) multi-criteria methods. Experts were also involved at the end of the modelling exercise for validation. The final product is a set of individual and group flood vulnerability maps. Both AHP and ANP proved to be effective for flood vulnerability assessment; however, ANP is preferred as it considers the dependences among criteria. The participatory approach enabled experts to learn from each other and acknowledge different perspectives towards social learning. The findings highlight that to enhance the credibility and deployment of model results, multiple viewpoints should be integrated without forcing consensus.

  14. Multiple sclerosis

    Sadashima, Hiromichi; Kusaka, Hirofumi; Imai, Terukuni; Takahashi, Ryosuke; Matsumoto, Sadayuki; Yamamoto, Toru; Yamasaki, Masahiro; Maya, Kiyomi

    1986-01-01

    Eleven patients with a definite diagnosis of multiple sclerosis were examined in terms of correlations between the clinical features and the results of cranial computed tomography (CT), and magnetic resonance imaging (MRI). Results: In 5 of the 11 patients, both CT and MRI demonstrated lesions consistent with a finding of multiple sclerosis. In 3 patients, only MRI demonstrated lesions. In the remaining 3 patients, neither CT nor MRI revealed any lesion in the brain. All 5 patients who showed abnormal findings on both CT and MRI had clinical signs either of cerebral or brainstem - cerebellar lesions. On the other hand, two of the 3 patients with normal CT and MRI findings had optic-nerve and spinal-cord signs. Therefore, our results suggested relatively good correlations between the clinical features, CT, and MRI. MRI revealed cerebral lesions in two of the four patients with clinical signs of only optic-nerve and spinal-cord lesions. MRI demonstrated sclerotic lesions in 3 of the 6 patients whose plaques were not detected by CT. In conclusion, MRI proved to be more helpful in the demonstration of lesions attributable to chronic multiple sclerosis. (author)

  15. Defining Multiple Chronic Conditions for Quality Measurement.

    Drye, Elizabeth E; Altaf, Faseeha K; Lipska, Kasia J; Spatz, Erica S; Montague, Julia A; Bao, Haikun; Parzynski, Craig S; Ross, Joseph S; Bernheim, Susannah M; Krumholz, Harlan M; Lin, Zhenqiu

    2018-02-01

    Patients with multiple chronic conditions (MCCs) are a critical but undefined group for quality measurement. We present a generally applicable systematic approach to defining an MCC cohort of Medicare fee-for-service beneficiaries that we developed for a national quality measure, risk-standardized rates of unplanned admissions for Accountable Care Organizations. To define the MCC cohort we: (1) identified potential chronic conditions; (2) set criteria for cohort conditions based on MCC framework and measure concept; (3) applied the criteria informed by empirical analysis, experts, and the public; (4) described "broader" and "narrower" cohorts; and (5) selected final cohort with stakeholder input. Subjects were patients with chronic conditions. Participants included 21.8 million Medicare fee-for-service beneficiaries in 2012 aged 65 years and above with ≥1 of 27 Medicare Chronic Condition Warehouse condition(s). In total, 10 chronic conditions were identified based on our criteria; 8 of these 10 were associated with notably increased admission risk when co-occurring. A broader cohort (2+ of the 8 conditions) included 4.9 million beneficiaries (23% of total cohort) with an admission rate of 70 per 100 person-years. It captured 53% of total admissions. The narrower cohort (3+ conditions) had 2.2 million beneficiaries (10%) with 100 admissions per 100 person-years and captured 32% of admissions. Most stakeholders viewed the broader cohort as best aligned with the measure concept. By systematically narrowing chronic conditions to those most relevant to the outcome and incorporating stakeholder input, we defined an MCC admission measure cohort supported by stakeholders. This approach can be used as a model for other MCC outcome measures.

  16. Core and Peripheral Criteria of Video Game Addiction in the Game Addiction Scale for Adolescents

    Brunborg, Geir Scott; Hanss, Daniel; Mentzoni, Rune Aune; Pallesen, St?le

    2015-01-01

    Abstract Assessment of video game addiction often involves measurement of peripheral criteria that indicate high engagement with games, and core criteria that indicate problematic use of games. A survey of the Norwegian population aged 16?74 years (N=10,081, response rate 43.6%) was carried out in 2013, which included the Gaming Addiction Scale for Adolescents (GAS). Confirmatory factor analysis showed that a two-factor structure, which separated peripheral criteria from core criteria, fitted...

  17. Prevalence, demographics and clinical characteristics of multiple sclerosis in Qatar.

    Deleu, Dirk; Mir, Danial; Al Tabouki, Ahmed; Mesraoua, Rim; Mesraoua, Boulenouar; Akhtar, Naveed; Al Hail, Hassan; D'souza, Atlantic; Melikyan, Gayane; Imam, Yahia Z B; Osman, Yasir; Elalamy, Osama; Sokrab, Tageldin; Kamran, Sadaat; Ruiz Miyares, Francisco; Ibrahim, Faiza

    2013-05-01

    No published epidemiologic data on multiple sclerosis (MS) in Qatar exist. Our objectives were to determine the prevalence, demographics and clinical characteristics of MS in the Middle Eastern country of Qatar. We analyzed data for Qatari MS patients fulfilling the McDonald diagnostic criteria. A total of 154 patients fulfilled the inclusion criteria. On 31 April 2010, the crude prevalence of MS in Qatar was 64.57 per 100,000 inhabitants (95% CI: 58.31-70.37). The female-to-male ratio was 1.33:1. A positive family history was found in 10.4% of included MS patients. We conclude that Qatar is now a medium-to-high risk area for MS, with some important differences in clinical characteristics as compared to other countries in the region.

  18. Serum total antioxidant capacity in patients with multiple sclerosis

    Almira Hadžović-Džuvo

    2011-02-01

    Full Text Available Multiple sclerosis (MS is a chronic inflammatory disease of the central nervous system (CNS. It is characterized by loss of myelin, the fatty tissue that surrounds and protects nerve fibres allowing them to conduct electrical impulses. Recent data indicate that oxidative stress (OS plays a major role in the pathogenesis of multiple sclerosis (MS. The aim of this study was to estimate level of serum total antioxidative capacity in patients with multiple sclerosis. Our cross-sectional study included 33 patients with MS and 24 age and sex matched control subjects. All our patients had a Poser criteria for definite diagnostic categories of multiple sclerosis. Serum total antioxidant capacity (TAC was measured by quantitative colorimetric determination, using Total antioxidant Capacity-QuantiCromAntioxidant Assay Kit (BioAssay systems, USA; DTAC-100. Mean serum TAC in multiple sclerosis group of patients was 119.2 mM Trolox equivalents and was significantly lower (p<0.001 compared to the control group of subjects (167.1 mM Trolox equivalents. Our results showed that oxidative stress plays an important role in pathogenesis of multiple sclerosis. This finding, also, suggests the importance of antioxidants in diet and therapy of MS patients.

  19. Psychiatric disorders in single and multiple sexual murderers.

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

    2007-01-01

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

  20. Development of statewide geriatric patients trauma triage criteria.

    Werman, Howard A; Erskine, Timothy; Caterino, Jeffrey; Riebe, Jane F; Valasek, Tricia

    2011-06-01

    The geriatric population is unique in the type of traumatic injuries sustained, physiological responses to those injuries, and an overall higher mortality when compared to younger adults. No published, evidence-based, geriatric-specific field destination criteria exist as part of a statewide trauma system. The Trauma Committee of the Ohio Emergency Medical Services (EMS) Board sought to develop specific criteria for geriatric trauma victims. A literature search was conducted for all relevant literature to determine potential, geriatric-specific, field-destination criteria. Data from the Ohio Trauma Registry were used to compare elderly patients, defined as age >70 years, to all patients between the ages of 16 to 69 years with regards to mortality risk in the following areas: (1) Glasgow Coma Scale (GCS) score; (2) systolic blood pressure (SBP); (3) falls associated with head, chest, abdominal or spinal injury; (4) mechanism of injury; (5) involvement of more than one body system as defined in the Barell matrix; and (6) co-morbidities and motor vehicle collision with one or more long bone fracture. For GCS score and SBP, those cut-off points with equal or greater risk of mortality as compared to current values were chosen as proposed triage criteria. For other measures, any criterion demonstrating a statistically significant increase in mortality risk was included in the proposed criteria. The following criteria were identified as geriatric-specific criteria: (1) GCS score trauma; (2) SBP trauma. In addition, these data suggested that elderly patients with specific co-morbidities be given strong consideration for evaluation in a trauma center. The state of Ohio is the first state to develop evidence-based geriatric-specific field-destination criteria using data from its state-mandated trauma registry. Further analysis of these criteria will help determine their effects on over-triage and under-triage of geriatric victims of traumatic injuries and the impact on the