Extending a Consensus-based Fuzzy Ordered Weighting Average (FOWA Model in New Water Quality Indices

Directory of Open Access Journals (Sweden)

Mohammad Ali Baghapour

2017-07-01

Full Text Available In developing a specific WQI (Water Quality Index, many water quality parameters are involved with different levels of importance. The impact of experts’ different opinions and viewpoints, current risks affecting their opinions, and plurality of the involved parameters double the significance of the issue. Hence, the current study tries to apply a consensus-based FOWA (Fuzzy Ordered Weighting Average model as one of the most powerful and well-known Multi Criteria Decision Making (MCDM techniques to determine the importance of the used parameters in the development of such WQIs which is shown with an example. This operator has provided the capability of modeling the risks in decision-making through applying the optimistic degree of stakeholders and their power coupled with the use of fuzzy numbers. Totally, 22 water quality parameters for drinking purposes are considered in this study. To determine the weight of each parameter, the viewpoints of 4 decision-making groups of experts are taken into account. After determining the final weights, to validate the use of each parameter in a potential WQI, consensus degrees of both the decision makers and the parameters are calculated. All calculations are carried out by using the expertise software called Group Fuzzy Decision Making (GFDM. The highest and the lowest weight values, 0.999 and 0.073 respectively, are related to Hg and temperature. Regarding the type of consumption that is drinking, the parameters’ weights and ranks are consistent with their health impacts. Moreover, the decision makers’ highest and lowest consensus degrees were 0.9905 and 0.9669, respectively. Among the water quality parameters, temperature (with consensus degree of 0.9972 and Pb (with consensus degree of 0.9665, received the highest and lowest agreement from the decision making group. This study indicates that the weight of parameters in determining water quality largely depends on the experts’ opinions and

Extending a Consensus-based Fuzzy Ordered Weighting Average (FOWA Model in New Water Quality Indices

Directory of Open Access Journals (Sweden)

Mohammad Ali Baghapour

2017-07-01

Full Text Available In developing a specific WQI (Water Quality Index, many quality parameters are involved with different levels of importance. The impact of experts’ different opinions and viewpoints, current risks affecting their opinions, and plurality of the involved parameters double the significance of the issue. Hence, the current study tries to apply a consensus-based FOWA (Fuzzy Ordered Weighting Average model as one of the most powerful and well-known Multi-Criteria Decision- Making (MCDM techniques to determine the importance of the used parameters in the development of such WQIs which is shown with an example. This operator has provided the capability of modeling the risks in decision-making through applying the optimistic degree of stakeholders and their power coupled with the use of fuzzy numbers. Totally, 22 water quality parameters for drinking purposes were considered in this study. To determine the weight of each parameter, the viewpoints of 4 decision-making groups of experts were taken into account. After determining the final weights, to validate the use of each parameter in a potential WQI, consensus degrees of both the decision makers and the parameters are calculated. The highest and the lowest weight values, 0.999 and 0.073 respectively, were related to Hg and temperature. Regarding the type of consumption that was drinking, the parameters’ weights and ranks were consistent with their health impacts. Moreover, the decision makers’ highest and lowest consensus degrees were 0.9905 and 0.9669, respectively. Among the water quality parameters, temperature (with consensus degree of 0.9972 and Pb (with consensus degree of 0.9665, received the highest and lowest agreement with the decision-making group. This study indicated that the weight of parameters in determining water quality largely depends on the experts’ opinions and approaches. Moreover, using the FOWA model provides results accurate and closer- to-reality on the significance of

Clinical practice guidelines and consensus statements in oncology--an assessment of their methodological quality.

Directory of Open Access Journals (Sweden)

Carmel Jacobs

Full Text Available Consensus statements and clinical practice guidelines are widely available for enhancing the care of cancer patients. Despite subtle differences in their definition and purpose, these terms are often used interchangeably. We systematically assessed the methodological quality of consensus statements and clinical practice guidelines published in three commonly read, geographically diverse, cancer-specific journals. Methods Consensus statements and clinical practice guidelines published between January 2005 and September 2013 in Current Oncology, European Journal of Cancer and Journal of Clinical Oncology were evaluated. Each publication was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II rigour of development and editorial independence domains. For assessment of transparency of document development, 7 additional items were taken from the Institute of Medicine's standards for practice guidelines and the Journal of Clinical Oncology guidelines for authors of guidance documents.Consensus statements and clinical practice guidelines published between January 2005 and September 2013 in Current Oncology, European Journal of Cancer and Journal of Clinical Oncology were evaluated. Each publication was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II rigour of development and editorial independence domains. For assessment of transparency of document development, 7 additional items were taken from the Institute of Medicine's standards for practice guidelines and the Journal of Clinical Oncology guidelines for authors of guidance documents.Thirty-four consensus statements and 67 clinical practice guidelines were evaluated. The rigour of development score for consensus statements over the three journals was 32% lower than that of clinical practice guidelines. The editorial independence score was 15% lower for consensus statements than clinical practice guidelines. One journal scored

Development of a consensus taxonomy of sedentary behaviors (SIT: report of Delphi Round 1.

Directory of Open Access Journals (Sweden)

Sebastien Francois Martin Chastin

Full Text Available BACKGROUND: Over the last decade, sedentary behaviors have emerged as a distinctive behavioral paradigm with deleterious effects on health independent of physical activity. The next phase of research is to establish dose response between sedentary behaviors and health outcomes and improve understanding of context and determinants of these behaviors. Establishing a common taxonomy of these behaviors is a necessary step in this process. AIM: The Sedentary behavior International Taxonomy project was developed to establish a classification of sedentary behaviors by use of a formal consensus process. METHODS: The study follows a Delphi process in three Rounds. A preparatory stage informed the development of terms of reference documents. In Round 1, experts were asked to make statements about the taxonomy; 1 its purpose and use ; 2 the domains, categories or facets that should be consider and include; 3 the structure/architecture to arrange and link these domains and facets. In Round 2 experts will be presented with a draft taxonomy emerging from Round 1 and invited to comment and propose alterations. The taxonomy will then be finalised at the outset of this stage. RESULTS: Results of Round 1 are reported here. There is a general consensus that a taxonomy will help advances in research by facilitating systematic and standardised: 1 investigation and analysis; 2 reporting and communication; 3 data pooling, comparison and meta-analysis; 4 development of measurement tools; 4 data descriptions, leading to higher quality in data querying and facilitate discoveries. There is also a consensus that such a taxonomy should be flexible to accommodate diverse purposes of use, and future advances in the field and yet provide a cross-disciplinary common language. A consensual taxonomy structure emerged with nine primary facets (Purpose, Environment, Posture, Social, Measurement, Associated behavior, Status, Time, Type and the draft structure presented here for

Consensus statement on posttraumatic stress disorder from the International Consensus Group on Depression and Anxiety.

Science.gov (United States)

Ballenger, J C; Davidson, J R; Lecrubier, Y; Nutt, D J; Foa, E B; Kessler, R C; McFarlane, A C; Shalev, A Y

2000-01-01

To provide primary care clinicians with a better understanding of management issues in posttraumatic stress disorder (PTSD) and guide clinical practice with recommendations on the appropriate management strategy. The 4 members of the International Consensus Group on Depression and Anxiety were James C. Ballenger (chair), Jonathan R. T. Davidson, Yves Lecrubier, and David J. Nutt. Other faculty invited by the chair were Edna B. Foa, Ronald C. Kessler, Alexander C. McFarlane, and Arieh Y. Shalev. The consensus statement is based on the 6 review articles that are published in this supplement and the scientific literature relevant to the issues reviewed in these articles. Group meetings were held over a 2-day period. On day 1, the group discussed the review articles and the chair identified key issues for further debate. On day 2, the group discussed these issues to arrive at a consensus view. After the group meetings, the consensus statement was drafted by the chair and approved by all attendees. PTSD is often a chronic and recurring condition associated with an increased risk of developing secondary comorbid disorders, such as depression. Selective serotonin reuptake inhibitors are generally the most appropriate choice of first-line medication for PTSD, and effective therapy should be continued for 12 months or longer. The most appropriate psychotherapy is exposure therapy, and it should be continued for 6 months, with follow-up therapy as needed.

Scientific principles for the identification of endocrine-disrupting chemicals: a consensus statement

DEFF Research Database (Denmark)

Solecki, Roland; Kortenkamp, Andreas; Bergman, Åke

2017-01-01

from different disciplines discussed principles and open questions on ED identification as outlined in a draft consensus paper at an expert meeting hosted by the German Federal Institute for Risk Assessment (BfR) in Berlin, Germany on 11-12 April 2016. Participants reached a consensus regarding...... scientific principles for the identification of EDs. The paper discusses the consensus reached on background, definition of an ED and related concepts, sources of uncertainty, scientific principles important for ED identification, and research needs. It highlights the difficulty in retrospectively...... reconstructing ED exposure, insufficient range of validated test systems for EDs, and some issues impacting on the evaluation of the risk from EDs, such as non-monotonic dose-response and thresholds, modes of action, and exposure assessment. This report provides the consensus statement on EDs agreed among all...

RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 1: Evidence analysis and consensus process: collaborative path toward small animal CPR guidelines.

Science.gov (United States)

Boller, Manuel; Fletcher, Daniel J

2012-06-01

To describe the methodology used by the Reassessment Campaign on Veterinary Resuscitation (RECOVER) to evaluate the scientific evidence relevant to small animal CPR and to compose consensus-based clinical CPR guidelines for dogs and cats. This report is part of a series of 7 articles on the RECOVER evidence and knowledge gap analysis and consensus-based small animal CPR guidelines. It describes the organizational structure of RECOVER, the evaluation process employed, consisting of standardized literature searches, the analysis of relevant articles according to study design, species and predefined quality markers, and the drafting of clinical CPR guidelines based on these data. Therefore, this article serves as the methodology section for the subsequent 6 RECOVER articles. Academia, referral practice. RECOVER is a collaborative initiative that systematically evaluated the evidence on 74 topics relevant to small animal CPR and generated 101 clinical CPR guidelines from this analysis. All primary contributors were veterinary specialists, approximately evenly split between academic institutions and private referral practices. The evidence evaluation and guideline drafting processes were conducted according to a predefined sequence of steps designed to reduce bias and increase the repeatability of the findings, including multiple levels of review, culminating in a consensus process. Many knowledge gaps were identified that will allow prioritization of research efforts in veterinary CPR. Collaborative systematic evidence review is organizationally challenging but feasible and effective in veterinary medicine. More experience is needed to refine the process. © Veterinary Emergency and Critical Care Society 2012.

Canadian Association of Gastroenterology Consensus Guidelines on Safety and Quality Indicators in Endoscopy

Directory of Open Access Journals (Sweden)

David Armstrong

2012-01-01

Full Text Available Several organizations worldwide have developed procedure-based guidelines and/or position statements regarding various aspects of quality and safety indicators, and credentialing for endoscopy. Although important, they do not specifically address patient needs or provide a framework for their adoption in the context of endoscopy services. The consensus guidelines reported in this article, however, aimed to identify processes and indicators relevant to the provision of high-quality endoscopy services that will support ongoing quality improvement across many jurisdictions, specifically in the areas of ethics, facility standards and policies, quality assurance, training and education, reporting standards and patient perceptions.

College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference on good laboratory practices in gynecologic cytology: background, rationale, and organization.

Science.gov (United States)

Tworek, Joseph A; Henry, Michael R; Blond, Barbara; Jones, Bruce Allen

2013-02-01

Gynecologic cytopathology is a heavily regulated field, with Clinical Laboratory Improvement Amendments of 1988 mandating the collection of many quality metrics. There is a lack of consensus regarding methods to collect, monitor, and benchmark these data and how these data should be used in a quality assurance program. Furthermore, the introduction of human papilloma virus testing and proficiency testing has provided more data to monitor. To determine good laboratory practices in quality assurance of gynecologic cytopathology. Data were collected through a written survey consisting of 98 questions submitted to 1245 Clinical Laboratory Improvement Amendments-licensed or Department of Defense laboratories. There were 541 usable responses. Additional input was sought through a Web posting of results and questions on the College of American Pathologists Web site. Four senior authors who authored the survey and 28 cytopathologists and cytotechnologists were assigned to 5 working groups to analyze data and present statements on good laboratory practices in gynecologic cytopathology at the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference. Ninety-eight attendees at the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference discussed and voted on good laboratory practice statements to obtain consensus. This paper describes the rationale, background, process, and strengths and limitations of a series of papers that summarize good laboratory practice statements in quality assurance in gynecologic cytopathology.

Australian recommendations for the integration of emergency care for older people: Consensus Statement.

Science.gov (United States)

Lowthian, Judy A; Arendts, Glenn; Strivens, Edward

2018-05-07

Management of older patients during acute illness or injury does not occur in isolation in emergency departments. We aimed to develop a collaborative Consensus Statement to enunciate principles of integrated emergency care. Briefing notes, informed by research and evidence reviews, were developed and evaluated by a Consensus Working Party comprising cross-specialty representation from clinical experts, service providers, consumers and policymakers. The Consensus Working Party then convened to discuss and develop the statement's content. A subcommittee produced a draft, which was reviewed and edited by the Consensus Working Party. Consensus was reached after three rounds of discussion, with 12 principles and six recommendations for how to follow these principles, including an integrated care framework for action. Dissemination will encourage stakeholders and associated policy bodies to embrace the principles and priorities for action, potentially leading to collaborative work practices and improvement of care during and after acute illness or injury. © 2018 AJA Inc.

77 FR 42988 - Updating OSHA Construction Standards Based on National Consensus Standards; Head Protection...

Science.gov (United States)

2012-07-23

.... OSHA-2011-0184] RIN 1218-AC65 Updating OSHA Construction Standards Based on National Consensus... Administration (OSHA), Department of Labor. ACTION: Direct final rule; correction. SUMMARY: OSHA is correcting a... confusion resulting from a drafting error. OSHA published the DFR on June 22, 2012 (77 FR 37587). OSHA also...

Consensus statement on transcultural issues in depression and anxiety from the International Consensus Group on Depression and Anxiety.

Science.gov (United States)

Ballenger, J C; Davidson, J R; Lecrubier, Y; Nutt, D J; Kirmayer, L J; Lépine, J P; Lin, K M; Tajima, O; Ono, Y

2001-01-01

To provide primary care physicians with a better understanding of transcultural issues in depression and anxiety. The 4 members of the International Consensus Group on Depression and Anxiety were James C. Ballenger (chair), Jonathan R. T. Davidson, Yves Lecrubier, and David J. Nutt. Five faculty invited by the chair also participated: Laurence J. Kirmayer, Jean-Pierre Lepine, Keh-Ming Lin, Osamu Tajima, and Yutaka Ono. The consensus statement is based on the 5 review articles that are published in this supplement and the scientific literature relevant to the issues reviewed in these articles. Group meetings were held over a 2-day period. On day 1, the group discussed the review articles, and the chair identified key issues for further debate. On day 2, the group discussed these issues to arrive at a consensus view. After the group meetings, the consensus statement was drafted by the chair and approved by all attendees. The consensus statement underlines the prevalence of depression and anxiety disorders across all cultures and nations while recognizing that cultural differences exist in symptom presentation and prevalence estimates. In all countries, the recognition of depression by clinicians in the primary care setting is low (generally less than 50%), and the consensus group recommends a 2-step process to aid the recognition and diagnosis of depression. In line with the low recognition of depression and anxiety disorders is the finding that only a small proportion of patients with depression or anxiety are receiving appropriate treatments for their condition. Biological diversity across ethnic groups may account for the differential sensitivity of some groups to psychotropic medication, but this area requires further investigation.

Viewpoint – The Washington Consensus, Chilean Water Monopolization and the Peruvian Draft Water Law of the 1990s

Directory of Open Access Journals (Sweden)

Miguel Solanes

2013-06-01

The managers of two public agencies in Peru were concerned about the impact that the Draft Law was to have on Peruvian public interests, such as agriculture, energy, and water supply and sanitation. They spearheaded a coalition, including United States universities (New Mexico, Colorado at Boulder, California at Davis the Water Directorate of Chile, the United Nations Economic Commission for Latin America and the Caribbean, agricultural water communities in Peru, and the technical offices dealing with water at the Inter-American Development Bank and the World Bank, to have a critical discussion of the Draft Law. The discussion took several years, at the end of which the Draft was rejected.

Consensus statement on generalized anxiety disorder from the International Consensus Group on Depression and Anxiety.

Science.gov (United States)

Ballenger, J C; Davidson, J R; Lecrubier, Y; Nutt, D J; Borkovec, T D; Rickels, K; Stein, D J; Wittchen, H U

2001-01-01

To provide primary care clinicians with a better understanding of management issues in generalized anxiety disorder (GAD) and guide clinical practice with recommendations on the appropriate treatment strategy. The 4 members of the International Consensus Group on Depression and Anxiety were James C. Ballenger (chair), Jonathan R.T. Davidson, Yves Lecrubier, and David J. Nutt. Four additional faculty members invited by the chair were Karl Rickels, Hans-Ulrich Wittchen, Dan J. Stein, and Thomas D. Borkovec. The consensus statement is based on the 6 review articles that are published in this supplement and the scientific literature relevant to the issues reviewed in these articles. Group meetings were held over a 2-day period. On day 1, the group discussed the review articles and the chair identified key issues for further debate. On day 2, the group discussed these issues to arrive at a consensus view. After the group meetings, the consensus statement was drafted by the chair and approved by all attendees. GAD is the most common anxiety disorder in primary care and is highly debilitating. Furthermore, it is frequently comorbid with depression and other anxiety disorders, which exacerbates functional impairment. Antidepressants (serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and nonsedating tricyclic antidepressants) are generally the most appropriate first-line pharmacotherapy for GAD, since they are also effective against comorbid psychiatric disorders and are suitable for long-term use. Cognitive-behavioral therapy is the preferred form of psychotherapy for GAD, although when GAD is comorbid with depression, pharmacotherapy is increasingly indicated.

Executive summary of the GeSIDA consensus document on control and monitoring of HIV-infected patients.

Science.gov (United States)

2018-05-21

The continuous increase in our knowledge of HIV medicine and antiretroviral treatment has led us to draft specific consensus documents focused on topics other than antiretroviral therapy, such as treatment of opportunistic diseases, pre- and post-exposure prophylaxis, metabolic abnormalities, treatment of HBV or HCV coinfection, treatment of patients coinfected with tuberculosis, osteoporosis, kidney disorders, and cardiovascular risk. Accordingly, the AIDS Study Group (GeSIDA) of the Spanish Society of Infectious Diseases and Clinical Microbiology has promoted the drafting of this consensus document on the control and monitoring of adult patients infected with HIV. The document provides recommendations on the initial evaluation and subsequent monitoring of HIV-infected patients that will prove useful for all professionals involved in the management of this infection. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Cardio-renal syndromes : report from the consensus conference of the Acute Dialysis Quality Initiative

NARCIS (Netherlands)

Ronco, Claudio; McCullough, Peter; Anker, Stefan D.; Anand, Inder; Aspromonte, Nadia; Bagshaw, Sean M.; Bellomo, Rinaldo; Berl, Tomas; Bobek, Ilona; Cruz, Dinna N.; Daliento, Luciano; Davenport, Andrew; Haapio, Mikko; Hillege, Hans; House, Andrew A.; Katz, Nevin; Maisel, Alan; Mankad, Sunil; Zanco, Pierluigi; Mebazaa, Alexandre; Palazzuoli, Alberto; Ronco, Federico; Shaw, Andrew; Sheinfeld, Geoff; Soni, Sachin; Vescovo, Giorgio; Zamperetti, Nereo; Ponikowski, Piotr

A consensus conference on cardio-renal syndromes (CRS) was held in Venice Italy, in September 2008 under the auspices of the Acute Dialysis Quality Initiative (ADQI). The following topics were matter of discussion after a systematic literature review and the appraisal of the best available evidence:

Australian and New Zealand three-dimensional conformal radiation therapy consensus guidelines for prostate cancer

International Nuclear Information System (INIS)

Skala, M.; Berry, M.; Kneebone, A.; Gogna, K.; Turner, S.; Rolfo, A.; Haworth, A.

2004-01-01

Three-dimensional conformal radiation therapy (3DCRT) has been shown to reduce normal tissue toxicity and allow dose escalation in the curative treatment of prostate cancer. The Faculty of Radiation Oncology Genito-Urinary Group initiated a consensus process to generate evidence-based guidelines for the safe and effective implementation of 3DCRT. All radiation oncology departments in Australia and New Zealand were invited to complete a survey of their prostate practice and to send representatives to a consensus workshop. After a review of the evidence, key issues were identified and debated. If agreement was not reached, working parties were formed to make recommendations. Draft guidelines were circulated to workshop participants for approval prior to publication. Where possible, evidence-based recommendations have been made with regard to patient selection, risk stratification, simulation, planning, treatment delivery and toxicity reporting. This is the first time a group of radiation therapists, physicists and oncologists representing professional radiotherapy practice across Australia and New Zealand have worked together to develop best-practice guidelines. These guidelines should serve as a baseline for prospective clinical trials, outcome research and quality assurance. Copyright (2004) Blackwell Science Pty Ltd

Democracy-based consensus in medicine.

Science.gov (United States)

Greco, Massimiliano; Zangrillo, Alberto; Mucchetti, Marta; Nobile, Leda; Landoni, Paolo; Bellomo, Rinaldo; Landoni, Giovanni

2015-04-01

High-quality evidence and derived guidelines, as typically published in major academic journals, are a major process that shapes physician decision-making worldwide. However, for many aspects of medical practice, there is a lack of High-quality evidence or an overload of somewhat contradictory low-quality information, which makes decision-making a difficult, uncertain, and unpredictable process. When the issues in question are important and evidence limited or controversial, the medical community seeks to establish common ground for "best practice" through consensus conferences and consensus statements or guidelines. Such consensus statements are seen as a useful tool to establish expert agreement, define the boundaries of acceptable practice, provide priorities for the research agenda, and obtain opinions from different countries and healthcare systems. This standard approach, however, can be criticized for being elitist, noninclusive, and poorly representative of the community of clinicians who will have to make decisions about the implementation of such recommendations. Accordingly, the authors propose a new model based on a combination of a local core meeting (detailed review and expert input) followed by a worldwide web-based network assessment (democracy-based consensus). The authors already have applied this approach to develop consensus on all nonsurgical interventions that increase or reduce perioperative mortality in critically ill patients and in those with acute kidney injury. The methodology was based on 5 sequential local and web-based steps. Both a panel of experts and a large number of professionals from all over the world were involved, giving birth to a new type of "democracy-based consensus." This new type of "democracy-based consensus" has the potential to increase grass-root clinician involvement, expand the reach to less-developed countries, provide a more global perspective on proposed interventions, and perhaps more importantly, increase

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

DEFF Research Database (Denmark)

Jefferson, Amanda; Leonard, Helen; Siafarikas, Aris

2016-01-01

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

Seeking worldwide professional consensus on the principles of end-of-life care for the critically ill. The Consensus for Worldwide End-of-Life Practice for Patients in Intensive Care Units (WELPICUS) study.

Science.gov (United States)

Sprung, Charles L; Truog, Robert D; Curtis, J Randall; Joynt, Gavin M; Baras, Mario; Michalsen, Andrej; Briegel, Josef; Kesecioglu, Jozef; Efferen, Linda; De Robertis, Edoardo; Bulpa, Pierre; Metnitz, Philipp; Patil, Namrata; Hawryluck, Laura; Manthous, Constantine; Moreno, Rui; Leonard, Sara; Hill, Nicholas S; Wennberg, Elisabet; McDermid, Robert C; Mikstacki, Adam; Mularski, Richard A; Hartog, Christiane S; Avidan, Alexander

2014-10-15

Great differences in end-of-life practices in treating the critically ill around the world warrant agreement regarding the major ethical principles. This analysis determines the extent of worldwide consensus for end-of-life practices, delineates where there is and is not consensus, and analyzes reasons for lack of consensus. Critical care societies worldwide were invited to participate. Country coordinators were identified and draft statements were developed for major end-of-life issues and translated into six languages. Multidisciplinary responses using a web-based survey assessed agreement or disagreement with definitions and statements linked to anonymous demographic information. Consensus was prospectively defined as >80% agreement. Definitions and statements not obtaining consensus were revised based on comments of respondents, and then translated and redistributed. Of the initial 1,283 responses from 32 countries, consensus was found for 66 (81%) of the 81 definitions and statements; 26 (32%) had >90% agreement. With 83 additional responses to the original questionnaire (1,366 total) and 604 responses to the revised statements, consensus could be obtained for another 11 of the 15 statements. Consensus was obtained for informed consent, withholding and withdrawing life-sustaining treatment, legal requirements, intensive care unit therapies, cardiopulmonary resuscitation, shared decision making, medical and nursing consensus, brain death, and palliative care. Consensus was obtained for 77 of 81 (95%) statements. Worldwide consensus could be developed for the majority of definitions and statements about end-of-life practices. Statements achieving consensus provide standards of practice for end-of-life care; statements without consensus identify important areas for future research.

Quality indicators in the treatment of patients with depression, bipolar disorder or schizophrenia. Consensus study.

Science.gov (United States)

Bernardo, Miquel; de Dios, Consuelo; Pérez, Víctor; Ignacio, Emilio; Serrano, Manuel; Vieta, Eduard; Mira, José Joaquín; Guilabert, Mercedes; Roca, Miquel

To define a set of indicators for mental health care, monitoring quality assurance in schizophrenia, depression and bipolar disorders in Spain. Qualitative research. Consensus-based study involving 6 psychiatrists on the steering committee and a panel of 43 psychiatrists working in several health services in Spain. An initial proposal of 44 indicators for depression, 42 for schizophrenia and 58 for bipolar disorder was elaborated after reviewing the literature. This proposal was analysed by experts using the Delphi technique. The valuation of these indicators in successive rounds allowed those with less degree of consensus to be discarded. Feasibility, sensitivity and clinical relevance were considered. The study was carried out between July 2015 and March 2016. Seventy indicators were defined by consensus: 17 for major depression, 16 for schizophrenia, 17 for bipolar disorder and 20 common to all three pathologies. These indicators included measures related to adequacy, patient safety, exacerbation, mechanical restraint, suicidal behaviour, psychoeducation, adherence, mortality and physical health. This set of indicators allows quality monitoring in the treatment of patients with schizophrenia, depression or bipolar disorder. Mental health care authorities and professionals can use this proposal for developing a balanced scorecard adjusted to their priorities and welfare objectives. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

Consensus guidelines on management of childhood convulsive status epilepticus.

Science.gov (United States)

Mishra, Devendra; Sharma, Suvasini; Sankhyan, Naveen; Konanki, Ramesh; Kamate, Mahesh; Kanhere, Sujata; Aneja, Satinder

2014-12-01

Status epilepticus has a wide etiological spectrum, and significant morbidity and mortality. Management using a pre-determined uniform protocol leads to better outcomes. Multiple protocols for management of childhood status epilepticus are available, without much consensus. A 'Multi-disciplinary Consensus Development Workshop on Management of Status Epilepticus in Children in India' was organized. The invited experts included Pediatricians, Pediatric neurologists, Neurologists, Epileptologists, and Pediatric intensive care specialists from India, with experience in the relevant field. Experts had previously been divided into focus groups and had interacted on telephone and e-mail regarding their group recommendations, and developed consensus on the topic. During the meeting, each group presented their recommendations, which were deliberated upon by the house and a consensus was reached on various issues; the document was finalized after incorporating suggestions of experts on the draft document. To provide consensus guidelines on evaluation and management of convulsive status epilepticus in children in India (excluding neonatal and super-refractory status epilepticus). Each institution should use a pre-determined protocol for management of status epilepticus; pre-hospital management and early stabilization is the key to a satisfactory outcome of status epilepticus. Pharmacotherapy should not be delayed for any investigations; the initial management should consist of a parenteral benzodiazepine by any route feasible. Subsequent management has been detailed. The group also felt the need for more epidemiological research on status epilepticus from India, and identified certain research areas for the purpose.

CADDS [Computer-aided Drafting and Design System] brings quality and precision to the Canadian Maple [research reactor

International Nuclear Information System (INIS)

Goland, D.

1989-01-01

Atomic Energy of Canada Ltd (AECL) has found that using the ''intelligent'' Computer-Aided Drafting and Design System (CADDS) helped address design problems at an early stage and led to productivity gains of around 50 per cent. Other bonuses were the quality and precision of the designs and documents produced. Its application to the MAPLE research reactor project is described. (author)

First Dutch Consensus of Pain Quality Indicators for Pain Treatment Facilities.

Science.gov (United States)

de Meij, Nelleke; van Grotel, Marloes; Patijn, Jacob; van der Weijden, Trudy; van Kleef, Maarten

2016-01-01

There is a general consensus about the need to define and improve the quality of pain treatment facilities. Although guidelines and recommendations to improve the quality of pain practice management have been launched, provision of appropriate pain treatment is inconsistent and the quality of facilities varies widely. The aim of the study was to develop an expert-agreed list of quality indicators applicable to pain treatment facilities. The list was also intended to be used as the basis for a set of criteria for registered status of pain treatment facilities. The University Pain Center Maastricht at the Department of Anesthesiology and Pain Management of the Maastricht University Medical Center conducted a 3-round Delphi study in collaboration with the Board of the Pain Section of the Dutch Society of Anesthesiologists (NVA). Twenty-five quality indicators were selected as relevant to 2 types of pain treatment facilities, pain clinics and pain centers. The final expert-agreed list consisted of 22 quality indicators covering 7 quality domains: supervision, availability of care, staffing level and patient load, quality policy, multidisciplinarity, regionalization, and research and education. This set of quality indicators may facilitate organizational evaluation and improve insight into service quality from the perspectives of patients, pain specialists, and other healthcare professionals. Recommendations for improvements to the current set of quality indicators are made. In 2014 the process of registering pain treatment facilities in the Netherlands started; facilities can register as a pain clinic or pain center. © 2015 World Institute of Pain.

The Japan Lung Cancer Society–Japanese Society for Radiation Oncology consensus-based computed tomographic atlas for defining regional lymph node stations in radiotherapy for lung cancer

International Nuclear Information System (INIS)

Itazawa, Tomoko; Tamaki, Yukihisa; Komiyama, Takafumi; Nishimura, Yasumasa; Nakayama, Yuko; Ito, Hiroyuki; Ohde, Yasuhisa; Kusumoto, Masahiko; Sakai, Shuji; Suzuki, Kenji; Watanabe, Hirokazu; Asamura, Hisao

2017-01-01

The purpose of this study was to develop a consensus-based computed tomographic (CT) atlas that defines lymph node stations in radiotherapy for lung cancer based on the lymph node map of the International Association for the Study of Lung Cancer (IASLC). A project group in the Japanese Radiation Oncology Study Group (JROSG) initially prepared a draft of the atlas in which lymph node Stations 1–11 were illustrated on axial CT images. Subsequently, a joint committee of the Japan Lung Cancer Society (JLCS) and the Japanese Society for Radiation Oncology (JASTRO) was formulated to revise this draft. The committee consisted of four radiation oncologists, four thoracic surgeons and three thoracic radiologists. The draft prepared by the JROSG project group was intensively reviewed and discussed at four meetings of the committee over several months. Finally, we proposed definitions for the regional lymph node stations and the consensus-based CT atlas. This atlas was approved by the Board of Directors of JLCS and JASTRO. This resulted in the first official CT atlas for defining regional lymph node stations in radiotherapy for lung cancer authorized by the JLCS and JASTRO. In conclusion, the JLCS–JASTRO consensus-based CT atlas, which conforms to the IASLC lymph node map, was established.

Kyoto global consensus report on Helicobacter pylori gastritis.

Science.gov (United States)

Sugano, Kentaro; Tack, Jan; Kuipers, Ernst J; Graham, David Y; El-Omar, Emad M; Miura, Soichiro; Haruma, Ken; Asaka, Masahiro; Uemura, Naomi; Malfertheiner, Peter

2015-09-01

To present results of the Kyoto Global Consensus Meeting, which was convened to develop global consensus on (1) classification of chronic gastritis and duodenitis, (2) clinical distinction of dyspepsia caused by Helicobacter pylori from functional dyspepsia, (3) appropriate diagnostic assessment of gastritis and (4) when, whom and how to treat H. pylori gastritis. Twenty-three clinical questions addressing the above-mentioned four domains were drafted for which expert panels were asked to formulate relevant statements. A Delphi method using an anonymous electronic system was adopted to develop the consensus, the level of which was predefined as ≥80%. Final modifications of clinical questions and consensus were achieved at the face-to-face meeting in Kyoto. All 24 statements for 22 clinical questions after extensive modifications and omission of one clinical question were achieved with a consensus level of >80%. To better organise classification of gastritis and duodenitis based on aetiology, a new classification of gastritis and duodenitis is recommended for the 11th international classification. A new category of H. pylori-associated dyspepsia together with a diagnostic algorithm was proposed. The adoption of grading systems for gastric cancer risk stratification, and modern image-enhancing endoscopy for the diagnosis of gastritis, were recommended. Treatment to eradicate H. pylori infection before preneoplastic changes develop, if feasible, was recommended to minimise the risk of more serious complications of the infection. A global consensus for gastritis was developed for the first time, which will be the basis for an international classification system and for further research on the subject. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

American Burn Association Consensus Statements

Science.gov (United States)

2013-08-01

quality consensus conference was underwrit- ten in part by unrestricted educational grants from Molnlycke Health Care and Baxter Health Care. Address... nutrition , psychological outcomes, resuscitation, and wound repair. After reviewing the literature, debating the issues at the consensus conference and...need for intubation, concomitant trauma. 3. Resuscitation characteristics: Lab values (base defi- cit, lactate, hemoglobin /hematocrit, blood urea

Consensus on the clinical management, screening-to-treat, and surveillance of Helicobacter pylori infection to improve gastric cancer control on a nationwide scale.

Science.gov (United States)

Sheu, Bor-Shyang; Wu, Ming-Shiang; Chiu, Cheng-Tang; Lo, Jing-Chuan; Wu, Deng-Chyang; Liou, Jyh-Ming; Wu, Chun-Ying; Cheng, Hsiu-Chi; Lee, Yi-Chia; Hsu, Ping-I; Chang, Chun-Chao; Chang, Wei-Lun; Lin, Jaw-Town

2017-06-01

Previous international consensus statements provided general policies for the management of Helicobacter pylori infection. However, there are geographic differences in the prevalence and antimicrobial resistance of H. pylori, and in the availability of medications and endoscopy. Thus, nationwide or regional consensus statements are needed to improve control of H. pylori infection and gastric cancer. This consensus statement for management of H. pylori in Taiwan has three major sections: (1) optimal diagnosis and indications; (2) current treatment strategies; and (3) screening-to-treat and surveillance for control of gastric cancer. The literature review emphasized recent data for development of draft statements and determination of levels of evidence. Twenty-five Taiwan experts conducted a consensus conference, by a modified Delphi process, to modify the draft statements. Consensus, defined as an agreement of least 80% of the experts, and recommendation grade were determined by anonymous voting. There were 24 consensus statements. Section 1 has seven statements on recommendations for the diagnosis and indications for treatment of H. pylori infection. Section 2 has 10 statements that provide an updated treatment algorithm for first-line, second-line, and third-line regimens. Section 3 has seven statements regarding H. pylori eradication for reducing the risk of gastric cancer, with a cost-benefit analysis. After H. pylori eradication, the consensus highlights the use of endoscopic surveillance and/or chemoprevention to further reduce the burden of gastric cancer. This consensus statement has updated recommendations for improving the clinical management of H. pylori infection in areas such as Taiwan, which have high prevalence of H. pylori infection and gastric cancer. © 2017 The Authors. Helicobacter Published by John Wiley & Sons Ltd.

Applying consensus standards to cask development

International Nuclear Information System (INIS)

Leatham, J.; Abbott, D.G.; Warrant, M.M.

1987-01-01

The Department of Energy's (DOE's) Office of Civilian Radioactive Waste Management is procuring cask systems for transporting commercial spent nuclear fuel and is encouraging development of innovative cask designs and materials to improve system efficiency. New designs and innovative materials require that consensus standards be established so that cask designers and regulators have criteria for determining acceptability. Recent DOE experience in certifying three spent fuel shipping casks, NUPAC-125B, TN-BRP, and TN-REG, is discussed. Certification of the NUPAC-125B was expedited because it was made of conventional American Society for Testing and Materials (ASTM) materials and complied with the American Society of Mechanical Engineers (ASME) Code and Nuclear Regulatory Commission Regulatory Guides. The TN-BRP and TN-REG cask designs are still being reviewed because baskets included in the casks are made of borated stainless steel, which has no ASTM Specification or ASME Code approval. The process of developing and approving consensus standards is discussed, including the role of ANSI and ANSI N14. Specific procedures for ASTM and ASME are described. A draft specification or standard must be prepared and then approved by the appropriate body. For new material applications to the ASME Code, an existing ASTM Specification is needed. These processes may require several years. The status of activities currently in progress to develop consensus standards for spent fuel casks is discussed, including (1) ASME NUPAC, and (2) ASTM Specifications for ductile cast iron and borated stainless steel

AQUILA: assessment of quality in lower limb arthroplasty. An expert Delphi consensus for total knee and total hip arthroplasty.

Science.gov (United States)

Pijls, Bart G; Dekkers, Olaf M; Middeldorp, Saskia; Valstar, Edward R; van der Heide, Huub J L; Van der Linden-Van der Zwaag, Henrica M J; Nelissen, Rob G H H

2011-07-22

In the light of both the importance and large numbers of case series and cohort studies (observational studies) in orthopaedic literature, it is remarkable that there is currently no validated measurement tool to appraise their quality. A Delphi approach was used to develop a checklist for reporting quality, methodological quality and generalizability of case series and cohorts in total hip and total knee arthroplasty with a focus on aseptic loosening. A web-based Delphi was conducted consisting of two internal rounds and three external rounds in order to achieve expert consensus on items considered relevant for reporting quality, methodological quality and generalizability. The internal rounds were used to construct a master list. The first external round was completed by 44 experts, 35 of them completed the second external round and 33 of them completed the third external round. Consensus was reached on an 8-item reporting quality checklist, a 6-item methodological checklist and a 22-item generalizability checklist. Checklist for reporting quality, methodological quality and generalizability for case series and cohorts in total hip and total knee arthroplasty were successfully created through this Delphi. These checklists should improve the accuracy, completeness and quality of case series and cohorts regarding total hip and total knee arthroplasty.

78 FR 2394 - Release of Draft Document Related to the Review of the National Ambient Air Quality Standards for...

Science.gov (United States)

2013-01-11

... Quality Standards, External Review Draft (PA). This document was prepared as part of the current review of... ``anonymous access'' system, which means the EPA will not know your identity or contact information unless you... extent of all identifiable effects on public health or welfare which may be expected from the presence of...

46 CFR 167.55-1 - Draft marks and draft indicating systems.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Draft marks and draft indicating systems. 167.55-1... NAUTICAL SCHOOL SHIPS Special Markings Required § 167.55-1 Draft marks and draft indicating systems. (a... aft to the location of the draft marks, due to a raked stem or cut away skeg, the draft must be...

Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 2: management

Directory of Open Access Journals (Sweden)

Dong Il Park

2018-01-01

Full Text Available Because anti-tumor necrosis factor (anti-TNF therapy has become increasingly popular in many Asian countries, the risk of developing active tuberculosis (TB among anti-TNF users may raise serious health problems in this region. Thus, the Asian Organization for Crohn's and Colitis and the Asia Pacific Association of Gastroenterology have developed a set of consensus statements about risk assessment, detection and prevention of latent TB infection, and management of active TB infection in patients with inflammatory bowel disease (IBD receiving anti-TNF treatment. Twenty-three consensus statements were initially drafted and then discussed by the committee members. The quality of evidence and the strength of recommendations were assessed by using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Web-based consensus voting was performed by 211 IBD specialists from 9 Asian countries concerning each statement. A consensus statement was accepted if at least 75% of the participants agreed. Part 2 of the statements comprised 3 parts: management of latent TB in preparation for anti-TNF therapy, monitoring during anti-TNF therapy, and management of an active TB infection after anti-TNF therapy. These consensus statements will help clinicians optimize patient outcomes by reducing the morbidity and mortality related to TB infections in patients with IBD receiving anti-TNF treatment.

Do not do in COPD: consensus statement on overuse

Directory of Open Access Journals (Sweden)

Villar-Álvarez F

2018-02-01

Full Text Available Felipe Villar-Álvarez,1 Raúl Moreno-Zabaleta,2 Jose Joaquin Mira-Solves,3 Eduardo Calvo-Corbella,4 Salvador Díaz-Lobato,5 Fernando González-Torralba,6 Ascensión Hernando-Sanz,7 Sara Núñez-Palomo,8 Sergio Salgado-Aranda,9 Beatriz Simón-Rodríguez,10 Paz Vaquero-Lozano,11 Isabel María Navarro-Soler12On behalf of “Do not do in COPD” Working Group of the Madrid Society of Pulmonology and Thoracic Surgery (Neumomadrid1Department of Pulmonology, IIS–Fundación Jiménez Díaz, CIBERES, UAM, 2Pulmonology, Inpatient and Noninvasive Mechanical Ventilation, Hospital Universitario Infanta Sofía, Madrid, 3Alicante-Sant Joan Health District, Alicante/Universidad Miguel Hernández Elche/REDISEC, 4Family and Community Medicine, CSU Pozuelo Estación, School of Medicine, UAM, 5Department of Pulmonology, Hospital Ramón y Cajal, Madrid, 6Pulmonology Section, Hospital Universitario del Tajo, Aranjuez, 7Department of Pulmonology, Hospital Universitario 12 de Octubre, 8C.S. Torrelaguna, 9Pulmonology Section, Hospital del Sureste, 10FisioRespiración-Respiratory Physiotherapy Unit, Escuela Universitaria Gimbernat Cantabria, 11S. Pulmonology, CEP Hnos. Sangro HGU Gregorio Marañón, Madrid, 12Calitè Research Group, Universidad Miguel Hernández de Elche, Elche, SpainBackground: To identify practices that do not add value, cause harm, or subject patients with chronic obstructive pulmonary disease (COPD to a level of risk that outweighs possible benefits (overuse.Methods: A qualitative approach was applied. First, a multidisciplinary group of healthcare professionals used the Metaplan technique to draft and rank a list of overused procedures as well as self-care practices in patients with stable and exacerbated COPD. Second, in successive consensus-building rounds, description files were created for each “do not do” (DND recommendation, consisting of a definition, description, quality of supporting evidence for the recommendation, and the indicator

Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 1: risk assessment

Directory of Open Access Journals (Sweden)

Dong Il Park

2018-01-01

Full Text Available Because anti-tumor necrosis factor (anti-TNF therapy has become increasingly popular in many Asian countries, the risk of developing active tuberculosis (TB among anti-TNF users may raise serious health problems in this region. Thus, the Asian Organization for Crohn's and Colitis and the Asia Pacific Association of Gastroenterology have developed a set of consensus statements about risk assessment, detection and prevention of latent TB infection, and management of active TB infection in patients with inflammatory bowel disease (IBD receiving anti-TNF treatment. Twenty-three consensus statements were initially drafted and then discussed by the committee members. The quality of evidence and the strength of recommendations were assessed by using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Web-based consensus voting was performed by 211 IBD specialists from 9 Asian countries concerning each statement. A consensus statement was accepted if at least 75% of the participants agreed. Part 1 of the statements comprised 2 parts: risk of TB infection Recommendaduring anti-TNF therapy, and screening for TB infection prior to commencing anti-TNF therapy. These consensus statements will help clinicians optimize patient outcomes by reducing the morbidity and mortality related to TB infections in patients with IBD receiving anti-TNF treatment.

Building the adult protective services system of tomorrow: The role of the APS national voluntary consensus guidelines.

Science.gov (United States)

Bobitt, Julie; Kuhne, Jamie; Carter, Julie; Whittier Eliason, Stephanie; Twomey, Mary

2018-01-01

In 2015, the Administration for Community Living (ACL) established the first federal "home" for Adult Protective Services (APS). This leadership has included working collaboratively with state Adult Protective Service systems to ensure that older adults and adults with disabilities are afforded the same protections against abuse, neglect, and financial exploitation regardless of where in the country they live. As part of that leadership, ACL created draft Voluntary Consensus Guidelines for State APS Systems. ACL undertook a process of public and stakeholder engagement and analyzed the resulting comments to improve upon the initial draft of the draft to arrive at the final version. This article examines the comments, including the concerns raised by the commenters about specific areas of the Guidelines, areas identified for future research, and reflections and opinions on the role of the federal government in guiding the development of the field of adult protection.

75 FR 49913 - Draft Guidance, “Federal Greenhouse Gas Accounting and Reporting”

Science.gov (United States)

2010-08-16

... provides this draft guidance for public review and comment to ensure accessibility of Federal accounting... COUNCIL ON ENVIRONMENTAL QUALITY Draft Guidance, ``Federal Greenhouse Gas Accounting and Reporting... recommended Federal GHG reporting and accounting procedures. On April 5, 2010, DOE-FEMP submitted the final...

The Quality of Written Peer Feedback on Undergraduates' Draft Answers to an Assignment, and the Use Made of the Feedback

Science.gov (United States)

Walker, Mirabelle

2015-01-01

The research described here investigated the quality and characteristics of peer feedback given on a draft piece of writing in the context of an undergraduate summative assignment. It also investigated whether the recipients made use of the feedback, with the aim of discovering whether some types of feedback were used in preference to others. The…

UK quantitative WB-DWI technical workgroup: consensus meeting recommendations on optimisation, quality control, processing and analysis of quantitative whole-body diffusion-weighted imaging for cancer.

Science.gov (United States)

Barnes, Anna; Alonzi, Roberto; Blackledge, Matthew; Charles-Edwards, Geoff; Collins, David J; Cook, Gary; Coutts, Glynn; Goh, Vicky; Graves, Martin; Kelly, Charles; Koh, Dow-Mu; McCallum, Hazel; Miquel, Marc E; O'Connor, James; Padhani, Anwar; Pearson, Rachel; Priest, Andrew; Rockall, Andrea; Stirling, James; Taylor, Stuart; Tunariu, Nina; van der Meulen, Jan; Walls, Darren; Winfield, Jessica; Punwani, Shonit

2018-01-01

Application of whole body diffusion-weighted MRI (WB-DWI) for oncology are rapidly increasing within both research and routine clinical domains. However, WB-DWI as a quantitative imaging biomarker (QIB) has significantly slower adoption. To date, challenges relating to accuracy and reproducibility, essential criteria for a good QIB, have limited widespread clinical translation. In recognition, a UK workgroup was established in 2016 to provide technical consensus guidelines (to maximise accuracy and reproducibility of WB-MRI QIBs) and accelerate the clinical translation of quantitative WB-DWI applications for oncology. A panel of experts convened from cancer centres around the UK with subspecialty expertise in quantitative imaging and/or the use of WB-MRI with DWI. A formal consensus method was used to obtain consensus agreement regarding best practice. Questions were asked about the appropriateness or otherwise on scanner hardware and software, sequence optimisation, acquisition protocols, reporting, and ongoing quality control programs to monitor precision and accuracy and agreement on quality control. The consensus panel was able to reach consensus on 73% (255/351) items and based on consensus areas made recommendations to maximise accuracy and reproducibly of quantitative WB-DWI studies performed at 1.5T. The panel were unable to reach consensus on the majority of items related to quantitative WB-DWI performed at 3T. This UK Quantitative WB-DWI Technical Workgroup consensus provides guidance on maximising accuracy and reproducibly of quantitative WB-DWI for oncology. The consensus guidance can be used by researchers and clinicians to harmonise WB-DWI protocols which will accelerate clinical translation of WB-DWI-derived QIBs.

Reappraisal of OMERACT 8 draft validation criteria for a soluble biomarker reflecting structural damage endpoints in rheumatoid arthritis, psoriatic arthritis, and spondyloarthritis

DEFF Research Database (Denmark)

Maksymowych, Walter P; Landewé, Robert; Tak, Paul-Peter

2009-01-01

3, CTX-II, RANKL, OPG, CTX-I) followed by a Delphi consensus exercise addressing the importance of individual criteria and identification of omissions in the draft set. (B) Formal debate as well as group discussion centered on the key arguments for inclusion/exclusion of specific criteria. (C...

In-situ burning policy development for California: A consensus approach to policy and decision-making

International Nuclear Information System (INIS)

Addassi, Y. N.

1997-01-01

Current efforts by the California State Dept. of Fish and Game to develop an in-situ burning policy for oil spills in the open-water marine environments of the State were described. The differing perspectives and mandates of the various agency representatives on working groups and the frequent necessity of consensus solutions was highlighted. It was stated that the consensus approach requires more time and energy, however, it is off-set by the benefits of developing good working relationships that will ultimately facilitate decision-making. Current projected timelines for the completed in-situ burning policy, pertinent sections of the draft policy, plans for dealing with negative public reactions to the policy and outreach and public education programs were outlined. 12 refs

ESGAR consensus statement on liver MR imaging and clinical use of liver-specific contrast agents

Energy Technology Data Exchange (ETDEWEB)

Neri, E.; Boraschi, P.; Bartolozzi, C. [University of Pisa, Department of Diagnostic and Interventional Radiology, Pisa (Italy); Bali, M.A.; Matos, C. [Hopital Erasme, MRI Clinics, Department of Radiology, Bruxelles (Belgium); Ba-Ssalamah, A. [The General Hospital of the Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Brancatelli, G. [University of Palermo, Department of Radiology, Palermo (Italy); Alves, F.C. [University Hospital of Coimbra, Medical Imaging Department and Faculty of Medicine, Coimbra (Portugal); Grazioli, L. [Spedali Civili di Brescia, Department of Radiology, Brescia (Italy); Helmberger, T. [Academic Teaching Hospital of the Technical University, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Klinikum Bogenhausen, Munich (Germany); Lee, J.M. [Seoul National University College of Medicine, Division of Abdominal Imaging, Department of Radiology, Seoul (Korea, Republic of); Manfredi, R. [University of Verona, Department of Radiology, Verona (Italy); Marti-Bonmati, L. [Hospital Universitario y Politecnico La Fe, Area Clinica de Imagen Medica, Valencia (Spain); Merkle, E.M. [Universitaetsspital Basel, Klinik fuer Radiologie und Nuklearmedizin, Basel (Switzerland); Op De Beeck, B. [Antwerp University Hospital, Department of Radiology, Edegem (Belgium); Schima, W. [KH Goettlicher Heiland, Krankenhaus der Barmherzigen Schwestern and Sankt Josef-Krankenhaus, Department of Diagnostic and Interventional Radiology, Vienna (Austria); Skehan, S. [St Vincent' s University Hospital, Department of Radiology, Dublin (Ireland); Vilgrain, V. [Assistance Publique-Hopitaux de Paris, APHP, Hopital Beaujon, Radiology Department, Clichy, Paris (France); Zech, C. [Universitaetsspital Basel, Abteilungsleiter Interventionelle Radiologie, Klinik fuer Radiologie und Nuklearmedizin, Basel (Switzerland)

2016-04-15

To develop a consensus and provide updated recommendations on liver MR imaging and the clinical use of liver-specific contrast agents. The European Society of Gastrointestinal and Abdominal Radiology (ESGAR) formed a multinational European panel of experts, selected on the basis of a literature review and their leadership in the field of liver MR imaging. A modified Delphi process was adopted to draft a list of statements. Descriptive and Cronbach's statistics were used to rate levels of agreement and internal reliability of the consensus. Three Delphi rounds were conducted and 76 statements composed on MR technique (n = 17), clinical application of liver-specific contrast agents in benign, focal liver lesions (n = 7), malignant liver lesions in non-cirrhotic (n = 9) and in cirrhotic patients (n = 18), diffuse and vascular liver diseases (n = 12), and bile ducts (n = 13). The overall mean score of agreement was 4.84 (SD ±0.17). Full consensus was reached in 22 % of all statements in all working groups, with no full consensus reached on diffuse and vascular diseases. The consensus provided updated recommendations on the methodology, and clinical indications, of MRI with liver specific contrast agents in the study of liver diseases. (orig.)

Computer Assisted Drafting (CNC) Drawings. Drafting Module 6. Instructor's Guide.

Science.gov (United States)

Missouri Univ., Columbia. Instructional Materials Lab.

This Missouri Vocational Instruction Management System instructor's drafting guide has been keyed to the drafting competency profile developed by state industry and education professionals. This unit contains information on computer-assisted drafting drawings. The guide contains a cross-reference table of instructional materials and 20 worksheets.…

Effects of consensus training on the reliability of auditory perceptual ratings of voice quality.

Science.gov (United States)

Iwarsson, Jenny; Reinholt Petersen, Niels

2012-05-01

This study investigates the effect of consensus training of listeners on intrarater and interrater reliability and agreement of perceptual voice analysis. The use of such training, including a reference voice sample, could be assumed to make the internal standards held in memory common and more robust, which is of great importance to reduce the variability of auditory perceptual ratings. A prospective design with testing before and after training. Thirteen students of audiologopedics served as listening subjects. The ratings were made using a multidimensional protocol with four-point equal-appearing interval scales. The stimuli consisted of text reading by authentic dysphonic patients. The consensus training for each perceptual voice parameter included (1) definition, (2) underlying physiology, (3) presentation of carefully selected sound examples representing the parameter in three different grades followed by group discussions of perceived characteristics, and (4) practical exercises including imitation to make use of the listeners' proprioception. Intrarater reliability and agreement showed a marked improvement for intermittent aphonia but not for vocal fry. Interrater reliability was high for most parameters before training with a slight increase after training. Interrater agreement showed marked increases for most voice quality parameters as a result of the training. The results support the recommendation of specific consensus training, including use of a reference voice sample material, to calibrate, equalize, and stabilize the internal standards held in memory by the listeners. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Developing a set of consensus indicators to support maternity service quality improvement: using Core Outcome Set methodology including a Delphi process.

Science.gov (United States)

Bunch, K J; Allin, B; Jolly, M; Hardie, T; Knight, M

2018-05-16

To develop a core metric set to monitor the quality of maternity care. Delphi process followed by a face-to-face consensus meeting. English maternity units. Three representative expert panels: service designers, providers and users. Maternity care metrics judged important by participants. Participants were asked to complete a two-phase Delphi process, scoring metrics from existing local maternity dashboards. A consensus meeting discussed the results and re-scored the metrics. In all, 125 distinct metrics across six domains were identified from existing dashboards. Following the consensus meeting, 14 metrics met the inclusion criteria for the final core set: smoking rate at booking; rate of birth without intervention; caesarean section delivery rate in Robson group 1 women; caesarean section delivery rate in Robson group 2 women; caesarean section delivery rate in Robson group 5 women; third- and fourth-degree tear rate among women delivering vaginally; rate of postpartum haemorrhage of ≥1500 ml; rate of successful vaginal birth after a single previous caesarean section; smoking rate at delivery; proportion of babies born at term with an Apgar score improvement. Achieving consensus on core metrics for monitoring the quality of maternity care. © 2018 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

Executive Summary, Hydraulic Fracturing Study - Draft Assessment 2015

Science.gov (United States)

In this Executive Summary of the HF Draft report, EPA highlights the reviews of scientific literature to assess the potential for hydraulic fracturing for oil and gas to change the quality or quantity of drinking water resources.

Basic Drafting. Revised.

Science.gov (United States)

Schertz, Karen

This introductory module on drafting includes the technical content and tasks necessary for a student to be employed in an entry-level drafting occupation. The module contains 18 instructional units that cover the following topics: introduction to drafting; tools and equipment; supplies and materials; sketching; scales; drawing format; lettering;…

The CARE guidelines: consensus-based clinical case report guideline development.

Science.gov (United States)

Gagnier, Joel J; Kienle, Gunver; Altman, Douglas G; Moher, David; Sox, Harold; Riley, David

2014-01-01

A case report is a narrative that describes, for medical, scientific, or educational purposes, a medical problem experienced by one or more patients. Case reports written without guidance from reporting standards are insufficiently rigorous to guide clinical practice or to inform clinical study design. Develop, disseminate, and implement systematic reporting guidelines for case reports. We used a three-phase consensus process consisting of (1) pre-meeting literature review and interviews to generate items for the reporting guidelines, (2) a face-to-face consensus meeting to draft the reporting guidelines, and (3) post-meeting feedback, review, and pilot testing, followed by finalization of the case report guidelines. This consensus process involved 27 participants and resulted in a 13-item checklist-a reporting guideline for case reports. The primary items of the checklist are title, key words, abstract, introduction, patient information, clinical findings, timeline, diagnostic assessment, therapeutic interventions, follow-up and outcomes, discussion, patient perspective, and informed consent. We believe the implementation of the CARE (CAse REport) guidelines by medical journals will improve the completeness and transparency of published case reports and that the systematic aggregation of information from case reports will inform clinical study design, provide early signals of effectiveness and harms, and improve healthcare delivery. Copyright © 2014 Reproduced with permission of Global Advances in Health and Medicine. Published by Elsevier Inc. All rights reserved.

Sea ice draft in the Weddell Sea, measured by upward looking sonars

Directory of Open Access Journals (Sweden)

A. Behrendt

2013-06-01

Full Text Available The presented database contains time-referenced sea ice draft values from upward looking sonar (ULS measurements in the Weddell Sea, Antarctica. The sea ice draft data can be used to infer the thickness of the ice. They were collected during the period 1990–2008. In total, the database includes measurements from 13 locations in the Weddell Sea and was generated from more than 3.7 million measurements of sea ice draft. The files contain uncorrected raw drafts, corrected drafts and the basic parameters measured by the ULS. The measurement principle, the data processing procedure and the quality control are described in detail. To account for the unknown speed of sound in the water column above the ULS, two correction methods were applied to the draft data. The first method is based on defining a reference level from the identification of open water leads. The second method uses a model of sound speed in the oceanic mixed layer and is applied to ice draft in austral winter. Both methods are discussed and their accuracy is estimated. Finally, selected results of the processing are presented. The data can be downloaded from doi:10.1594/PANGAEA.785565.

76 FR 62087 - Draft Conservation Plan and Draft Environmental Assessment; Dunes Sagebrush Lizard, Texas

Science.gov (United States)

2011-10-06

...] Draft Conservation Plan and Draft Environmental Assessment; Dunes Sagebrush Lizard, Texas AGENCY: Fish... draft Texas Conservation Plan for the Dunes Sagebrush Lizard (TCP). The draft TCP will function as a... the Applicant for the dunes sagebrush lizard (Sceloporus arenicolus) throughout its range in Texas...

Cumulative effects of wind turbines. Volume 1: Report on the preparation of a planning tool by means of consensus-building

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-07-01

This report summarises the results of the Cumulative Effect of Wind Turbines project which sought to develop guidance on planning and assessing the combined effects of wind energy developments in an area. Details are given of the consensus-building approach, the call for contributions, stakeholder workshops and consultation, the project research, the development and refinement of the guidance, and the completion of the final draft.

31 CFR 500.406 - Drafts under irrevocable letters of credit; documentary drafts.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Drafts under irrevocable letters of credit; documentary drafts. 500.406 Section 500.406 Money and Finance: Treasury Regulations Relating to... ASSETS CONTROL REGULATIONS Interpretations § 500.406 Drafts under irrevocable letters of credit...

31 CFR 515.406 - Drafts under irrevocable letters of credit; documentary drafts.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Drafts under irrevocable letters of credit; documentary drafts. 515.406 Section 515.406 Money and Finance: Treasury Regulations Relating to... CONTROL REGULATIONS Interpretations § 515.406 Drafts under irrevocable letters of credit; documentary...

Consensus on consensus: a synthesis of consensus estimates on human-caused global warming

Science.gov (United States)

Cook, John; Oreskes, Naomi; Doran, Peter T.; Anderegg, William R. L.; Verheggen, Bart; Maibach, Ed W.; Carlton, J. Stuart; Lewandowsky, Stephan; Skuce, Andrew G.; Green, Sarah A.; Nuccitelli, Dana; Jacobs, Peter; Richardson, Mark; Winkler, Bärbel; Painting, Rob; Rice, Ken

2016-04-01

The consensus that humans are causing recent global warming is shared by 90%-100% of publishing climate scientists according to six independent studies by co-authors of this paper. Those results are consistent with the 97% consensus reported by Cook et al (Environ. Res. Lett. 8 024024) based on 11 944 abstracts of research papers, of which 4014 took a position on the cause of recent global warming. A survey of authors of those papers (N = 2412 papers) also supported a 97% consensus. Tol (2016 Environ. Res. Lett. 11 048001) comes to a different conclusion using results from surveys of non-experts such as economic geologists and a self-selected group of those who reject the consensus. We demonstrate that this outcome is not unexpected because the level of consensus correlates with expertise in climate science. At one point, Tol also reduces the apparent consensus by assuming that abstracts that do not explicitly state the cause of global warming (‘no position’) represent non-endorsement, an approach that if applied elsewhere would reject consensus on well-established theories such as plate tectonics. We examine the available studies and conclude that the finding of 97% consensus in published climate research is robust and consistent with other surveys of climate scientists and peer-reviewed studies.

Drafting method of electricity and electron design

International Nuclear Information System (INIS)

Gungbon, Junchun

1989-11-01

This book concentrates on drafting of electricity and electron design. It deals with The meaning of electricity and electron drafting JIS standard regulation the types of drafting and line and letter, basics drafting with projection drafting method, plan projection and development elevation, Drafting method of shop drawing, practical method of design and drafting, Design and drafting of technic and illustration, Connection diagram, Drafting of wiring diagram for light and illumination, Drafting of development connection diagram for sequence control, Drafting of logic circuit sign of flow chart and manual, drafting for a electron circuit diagram and Drawing of PC board.

From 'Compliance-based' to 'Performance-based' Quality - A trend in and evolution of U. S. quality standards

International Nuclear Information System (INIS)

Brown, Douglas A.; Taylor, H. Stephen; Johnson, Robert B.; Erler, Bryan A.; Daley, Thomas J.

1995-01-01

This paper traces the evolution of quality systems for nuclear power plant design, procurement, fabrication, installation, pre-operational testing, operations and maintenance in the U. S., as reflected in consensus standards such as N45.2, NQA-1, etc. Using a 'Defense-In-Depth' Quality Model, it highlights the changes in understanding where the responsibilities for quality should reside. Industries' growing recognition and operating experience show that a 'graded' approach to quality, based on safety significance, can be used to determine which quality criteria apply and the depth of implementing those criteria, resulting in potential long term cost savings and increased effectiveness) is also examined and discussed. Together, these two approaches form the basis for a performance-based quality system suitable for the business and technical environment of the 1990's and beyond. Performance-based Quality System - an approach that focuses on the end results, not the process, that directly contribute to safe and reliable plant operations. This approach includes monitoring performance or condition against predetermined, licensee-established goals, limits, or criteria in a manner sufficient to provide reasonable assurance that the safety function will be fulfilled. These criteria are based upon the design basis safety function, operating experience, and pertinent reliability studies. A licensee is allowed the flexibility to determine how best to achieve the results and adjust the application of quality elements accordingly. The roles of the individual worker, site/line supervision and management, independent quality verifiers (QA and QC), and external regulators are examined in the context of where and how industry quality standards have historically placed emphasis and accountability. The changes in these standards and their of effects are illustrated. Based on industry experience, the current understanding of the controls necessary to achieve safe, reliable and

75 FR 7515 - Notice of Availability of the Draft Environmental Impact Statement/Staff Assessment for the...

Science.gov (United States)

2010-02-19

... Stirling Energy Systems Solar Two Project and Possible California Desert Conservation Area Plan Amendment... Commission (CEC) have prepared a Draft Environmental Impact Statement (EIS), Draft California Desert... impacts of the proposed Solar Two Project on air quality, biological resources, cultural resources, water...

Is There a Consensus on Consensus Methodology? Descriptions and Recommendations for Future Consensus Research.

Science.gov (United States)

Waggoner, Jane; Carline, Jan D; Durning, Steven J

2016-05-01

The authors of this article reviewed the methodology of three common consensus methods: nominal group process, consensus development panels, and the Delphi technique. The authors set out to determine how a majority of researchers are conducting these studies, how they are analyzing results, and subsequently the manner in which they are reporting their findings. The authors conclude with a set of guidelines and suggestions designed to aid researchers who choose to use the consensus methodology in their work.Overall, researchers need to describe their inclusion criteria. In addition to this, on the basis of the current literature the authors found that a panel size of 5 to 11 members was most beneficial across all consensus methods described. Lastly, the authors agreed that the statistical analyses done in consensus method studies should be as rigorous as possible and that the predetermined definition of consensus must be included in the ultimate manuscript. More specific recommendations are given for each of the three consensus methods described in the article.

76 FR 34097 - Notice of Availability of the Draft Environmental Impact Statement, Including a Draft...

Science.gov (United States)

2011-06-10

... Impact Statement, Including a Draft Programmatic Agreement, for the Clark, Lincoln, and White Pine...) has prepared a Draft Environmental Impact Statement (EIS) and a Draft Programmatic Agreement (PA.... 100 N., Nephi Beaver Library, 55 W. Center St., Beaver. The Draft EIS describes and analyzes SNWA's...

General Drafting. Technical Manual.

Science.gov (United States)

Department of the Army, Washington, DC.

The manual provides instructional guidance and reference material in the principles and procedures of general drafting and constitutes the primary study text for personnel in drafting as a military occupational specialty. Included is information on drafting equipment and its use; line weights, conventions and formats; lettering; engineering charts…

Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: an update focusing on refractory reflux disease and Barrett's oesophagus.

Science.gov (United States)

Fock, Kwong Ming; Talley, Nicholas; Goh, Khean Lee; Sugano, Kentaro; Katelaris, Peter; Holtmann, Gerald; Pandolfino, John E; Sharma, Prateek; Ang, Tiing Leong; Hongo, Michio; Wu, Justin; Chen, Minhu; Choi, Myung-Gyu; Law, Ngai Moh; Sheu, Bor-Shyang; Zhang, Jun; Ho, Khek Yu; Sollano, Jose; Rani, Abdul Aziz; Kositchaiwat, Chomsri; Bhatia, Shobna

2016-09-01

Since the publication of the Asia-Pacific consensus on gastro-oesophageal reflux disease in 2008, there has been further scientific advancement in this field. This updated consensus focuses on proton pump inhibitor-refractory reflux disease and Barrett's oesophagus. A steering committee identified three areas to address: (1) burden of disease and diagnosis of reflux disease; (2) proton pump inhibitor-refractory reflux disease; (3) Barrett's oesophagus. Three working groups formulated draft statements with supporting evidence. Discussions were done via email before a final face-to-face discussion. We used a Delphi consensus process, with a 70% agreement threshold, using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria to categorise the quality of evidence and strength of recommendations. A total of 32 statements were proposed and 31 were accepted by consensus. A rise in the prevalence rates of gastro-oesophageal reflux disease in Asia was noted, with the majority being non-erosive reflux disease. Overweight and obesity contributed to the rise. Proton pump inhibitor-refractory reflux disease was recognised to be common. A distinction was made between refractory symptoms and refractory reflux disease, with clarification of the roles of endoscopy and functional testing summarised in two algorithms. The definition of Barrett's oesophagus was revised such that a minimum length of 1 cm was required and the presence of intestinal metaplasia no longer necessary. We recommended the use of standardised endoscopic reporting and advocated endoscopic therapy for confirmed dysplasia and early cancer. These guidelines standardise the management of patients with refractory gastro-oesophageal reflux disease and Barrett's oesophagus in the Asia-Pacific region. 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/

Latin American Consensus for Pediatric Cardiopulmonary Resuscitation 2017: Latin American Pediatric Critical Care Society Pediatric Cardiopulmonary Resuscitation Committee.

Science.gov (United States)

López-Herce, Jesús; Almonte, Enma; Alvarado, Manuel; Bogado, Norma Beatriz; Cyunel, Mariana; Escalante, Raffo; Finardi, Christiane; Guzmán, Gustavo; Jaramillo-Bustamante, Juan C; Madrid, Claudia C; Matamoros, Martha; Moya, Luis Augusto; Obando, Grania; Reboredo, Gaspar; López, Lissette R; Scheu, Christian; Valenzuela, Alejandro; Yerovi, Rocío; Yock-Corrales, Adriana

2018-03-01

To develop a Latin American Consensus about Pediatric Cardiopulmonary Resuscitation. To clarify, reinforce, and adapt some specific recommendations for pediatric patients and to stimulate the implementation of these recommendations in clinical practice. Expert consensus recommendations with Delphi methodology. Latin American countries. Experts in pediatric cardiopulmonary resuscitation from 19 Latin American countries. Delphi methodology for expert consensus. The goal was to reach consensus with all the participating experts for every recommendation. An agreement of at least 80% of the participating experts had to exist in order to deliver a recommendation. Two Delphi voting rounds were sent out electronically. The experts were asked to score between 1 and 9 their level of agreement for each recommendation. The score was then classified into three groups: strong agreement (score 7-9), moderate agreement (score 4-6), and disagreement (score 1-3). Nineteen experts from 19 countries participated in both voting rounds and in the whole process of drafting the recommendations. Sixteen recommendations about organization of cardiopulmonary resuscitation, prevention, basic resuscitation, advanced resuscitation, and postresuscitation measures were approved. Ten of them had a consensus of 100%. Four of them were agreed by all the participants except one (94.7% consensus). One recommendation was agreed by all except two experts (89.4%), and finally, one was agreed by all except three experts (84.2%). All the recommendations reached a level of agreement. This consensus adapts 16 international recommendations to Latin America in order to improve the practice of cardiopulmonary resuscitation in children. Studies should be conducted to analyze the effectiveness of the implementation of these recommendations.

Consensus statement on injury definitions and data collection procedures for studies of injuries in rugby union

Science.gov (United States)

Fuller, Colin W; Molloy, Michael G; Bagate, Christian; Bahr, Roald; Brooks, John H M; Donson, Hilton; Kemp, Simon P T; McCrory, Paul; McIntosh, Andrew S; Meeuwisse, Willem H; Quarrie, Kenneth L; Raftery, Martin; Wiley, Preston

2007-01-01

Wide variations in the definitions and methodologies used for studies of injuries in rugby union have created inconsistencies in reported data and made interstudy comparisons of results difficult. The International Rugby Board established a Rugby Injury Consensus Group (RICG) to reach an agreement on the appropriate definitions and methodologies to standardise the recording of injuries and reporting of studies in rugby union. The RICG reviewed the consensus definitions and methodologies previously published for football (soccer) at a meeting in Dublin in order to assess their suitability for and application to rugby union. Following this meeting, iterative draft statements were prepared and circulated to members of the RICG for comment; a follow‐up meeting was arranged in Dublin, at which time all definitions and procedures were finalised. At this stage, all authors confirmed their agreement with the consensus statement. The agreed document was presented to and approved by the International Rugby Board Council. Agreement was reached on definitions for injury, recurrent injury, non‐fatal catastrophic injury, and training and match exposures, together with criteria for classifying injuries in terms of severity, location, type, diagnosis and causation. The definitions and methodology presented in this consensus statement for rugby union are similar to those proposed for football. Adoption of the proposals presented in this consensus statement should ensure that more consistent and comparable results will be obtained from studies of injuries within rugby union. PMID:17452684

10 CFR 51.74 - Distribution of draft environmental impact statement and supplement to draft environmental impact...

Science.gov (United States)

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Distribution of draft environmental impact statement and supplement to draft environmental impact statement; news releases. 51.74 Section 51.74 Energy NUCLEAR... Impact Statements § 51.74 Distribution of draft environmental impact statement and supplement to draft...

Mississippi Curriculum Framework for Drafting and Design Technology (Program CIP: 48.0102--Architectural Drafting Technology) (Program CIP: 48.0101--General Drafting). Postsecondary Programs.

Science.gov (United States)

Mississippi Research and Curriculum Unit for Vocational and Technical Education, State College.

This document, which is intended for use by community and junior colleges throughout Mississippi, contains curriculum frameworks for the two course sequences of the state's postsecondary-level drafting and design technology program: architectural drafting technology and drafting and design technology. Presented first are a program description and…

The development of a consensus definition for healthcare improvement science (HIS) in seven European countries: A consensus methods approach.

Science.gov (United States)

Skela-Savič, Brigita; Macrae, Rhoda; Lillo-Crespo, Manuel; Rooney, Kevin D

2017-06-01

There is a limited body of research in the field of healthcare improvement science (HIS). Quality improvement and 'change making' should become an intrinsic part of everyone's job, every day in all parts of the healthcare system. The lack of theoretical grounding may partly explain the minimal transfer of health research into health policy. This article seeks to present the development of the definition for healthcare improvement science. A consensus method approach was adopted with a two-stage Delphi process, expert panel and consensus group techniques. A total of 18 participants were involved in the expert panel and consensus group, and 153 answers were analysed as a part of the Delphi survey. Participants were researchers, educators and healthcare professionals from Scotland, Slovenia, Spain, Italy, England, Poland, and Romania. A high level of consensus was achieved for the broad definition in the 2nd Delphi iteration (86%). The final definition was agreed on by the consensus group: 'Healthcare improvement science is the generation of knowledge to cultivate change and deliver person-centred care that is safe, effective, efficient, equitable and timely. It improves patient outcomes, health system performance and population health.' The process of developing a consensus definition revealed different understandings of healthcare improvement science between the participants. Having a shared consensus definition of healthcare improvement science is an important step forward, bringing about a common understanding in order to advance the professional education and practice of healthcare improvement science.

Group consensus peer review in radiation oncology: commitment to quality.

Science.gov (United States)

Duggar, W Neil; Bhandari, Rahul; Yang, Chunli Claus; Vijayakumar, Srinivasan

2018-03-27

Peer review, especially prospective peer review, has been supported by professional organizations as an important element in optimal Radiation Oncology practice based on its demonstration of efficacy at detecting and preventing errors prior to patient treatment. Implementation of peer review is not without barriers, but solutions do exist to mitigate or eliminate some of those barriers. Peer review practice at our institution involves three key elements: new patient conference, treatment planning conference, and chart rounds. The treatment planning conference is an adaptation of the group consensus peer review model from radiology which utilizes a group of peers reviewing each treatment plan prior to implementation. The peer group in radiation oncology includes Radiation Oncologists, Physician Residents, Medical Physicists, Dosimetrists, and Therapists. Thus, technical and clinical aspects of each plan are evaluated simultaneously. Though peer review is held in high regard in Radiation Oncology, many barriers commonly exist preventing optimal implementation such as time intensiveness, repetition, and distraction from clinic time with patients. Through the use of automated review tools and commitment by individuals and administration in regards to staffing, scheduling, and responsibilities, these barriers have been mitigated to implement this Group Consensus Peer Review model into a Radiation Oncology Clinic. A Group Consensus Peer Review model has been implemented with strategies to address common barriers to effective and efficient peer review.

The EPTN consensus-based atlas for CT- and MR-based contouring in neuro-oncology.

Science.gov (United States)

Eekers, Daniëlle Bp; In 't Ven, Lieke; Roelofs, Erik; Postma, Alida; Alapetite, Claire; Burnet, Neil G; Calugaru, Valentin; Compter, Inge; Coremans, Ida E M; Høyer, Morton; Lambrecht, Maarten; Nyström, Petra Witt; Romero, Alejandra Méndez; Paulsen, Frank; Perpar, Ana; de Ruysscher, Dirk; Renard, Laurette; Timmermann, Beate; Vitek, Pavel; Weber, Damien C; van der Weide, Hiske L; Whitfield, Gillian A; Wiggenraad, Ruud; Troost, Esther G C

2018-03-13

To create a digital, online atlas for organs at risk (OAR) delineation in neuro-oncology based on high-quality computed tomography (CT) and magnetic resonance (MR) imaging. CT and 3 Tesla (3T) MR images (slice thickness 1 mm with intravenous contrast agent) were obtained from the same patient and subsequently fused. In addition, a 7T MR without intravenous contrast agent was obtained from a healthy volunteer. Based on discussion between experienced radiation oncologists, the clinically relevant organs at risk (OARs) to be included in the atlas for neuro-oncology were determined, excluding typical head and neck OARs previously published. The draft atlas was delineated by a senior radiation oncologist, 2 residents in radiation oncology, and a senior neuro-radiologist incorporating relevant available literature. The proposed atlas was then critically reviewed and discussed by European radiation oncologists until consensus was reached. The online atlas includes one CT-scan at two different window settings and one MR scan (3T) showing the OARs in axial, coronal and sagittal view. This manuscript presents the three-dimensional descriptions of the fifteen consensus OARs for neuro-oncology. Among these is a new OAR relevant for neuro-cognition, the posterior cerebellum (illustrated on 7T MR images). In order to decrease inter- and intra-observer variability in delineating OARs relevant for neuro-oncology and thus derive consistent dosimetric data, we propose this atlas to be used in photon and particle therapy. The atlas is available online at www.cancerdata.org and will be updated whenever required. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

78 FR 73555 - Deepwater Horizon Oil Spill; Draft Programmatic and Phase III Early Restoration Plan and Draft...

Science.gov (United States)

2013-12-06

... Environmental Impact Statement (Draft Phase III ERP/PEIS). The Draft Phase III ERP/PEIS considers programmatic... programmatic restoration alternatives. The Draft Phase III ERP/PEIS evaluates these restoration alternatives... the Framework Agreement. The Draft Phase III ERP/PEIS also evaluates the environmental consequences of...

EPA scientific integrity policy draft

Science.gov (United States)

Showstack, Randy

2011-08-01

The U.S. Environmental Protection Agency (EPA) issued its draft scientific integrity policy on 5 August. The draft policy addresses scientific ethical standards, communications with the public, the use of advisory committees and peer review, and professional development. The draft policy was developed by an ad hoc group of EPA senior staff and scientists in response to a December 2010 memorandum on scientific integrity from the White House Office of Science and Technology Policy. The agency is accepting public comments on the draft through 6 September; comments should be sent to osa.staff@epa.gov. For more information, see http://www.epa.gov/stpc/pdfs/draft-scientific-integrity-policy-aug2011.pdf.

Causal Evaluation of Acute Recurrent and Chronic Pancreatitis in Children: Consensus From the INSPPIRE Group.

Science.gov (United States)

Gariepy, Cheryl E; Heyman, Melvin B; Lowe, Mark E; Pohl, John F; Werlin, Steven L; Wilschanski, Michael; Barth, Bradley; Fishman, Douglas S; Freedman, Steven D; Giefer, Matthew J; Gonska, Tanja; Himes, Ryan; Husain, Sohail Z; Morinville, Veronique D; Ooi, Chee Y; Schwarzenberg, Sarah J; Troendle, David M; Yen, Elizabeth; Uc, Aliye

2017-01-01

Acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) have been diagnosed in children at increasing rates during the past decade. As pediatric ARP and CP are still relatively rare conditions, little quality evidence is available on which to base the diagnosis and determination of etiology. The aim of the study was to review the current state of the literature regarding the etiology of these disorders and to developed a consensus among a panel of clinically active specialists caring for children with these disorders to help guide the diagnostic evaluation and identify areas most in need of future research. A systematic review of the literature was performed and scored for quality, followed by consensus statements developed and scored by each individual in the group for level of agreement and strength of the supporting data using a modified Delphi method. Scores were analyzed for the level of consensus achieved by the group. The panel reached consensus on 27 statements covering the definitions of pediatric ARP and CP, evaluation for potential etiologies of these disorders, and long-term monitoring. Statements for which the group reached consensus to make no recommendation or could not reach consensus are discussed. This consensus helps define the minimal diagnostic evaluation and monitoring of children with ARP and CP. Even in areas in which we reached consensus, the quality of the evidence is weak, highlighting the need for further research. Improved understanding of the underlying cause will facilitate treatment development and targeting.

Development of a nationwide consensus syllabus of palliative medicine for undergraduate medical education in Japan: a modified Delphi method.

Science.gov (United States)

Kizawa, Yoshiyuki; Tsuneto, Satoru; Tamba, Kaichiro; Takamiya, Yusuke; Morita, Tatsuya; Bito, Seiji; Otaki, Junji

2012-07-01

There is currently no consensus syllabus of palliative medicine for undergraduate medical education in Japan, although the Cancer Control Act proposed in 2007 covers the dissemination of palliative care. To develop a nationwide consensus syllabus of palliative medicine for undergraduate medical education in Japan using a modified Delphi method. We adopted the following three-step method: (1) a workshop to produce the draft syllabus; (2) a survey-based provisional syllabus; (3) Delphi rounds and a panel meeting (modified Delphi method) to produce the working syllabus. Educators in charge of palliative medicine from 63% of the medical schools in Japan collaborated to develop a survey-based provisional syllabus before the Delphi rounds. A panel of 32 people was then formed for the modified Delphi rounds comprising 28 educators and experts in palliative medicine, one cancer survivor, one bereaved family member, and two medical students. The final consensus syllabus consists of 115 learning objectives across seven sections as follows: basic principles; disease process and comprehensive assessment; symptom management; psychosocial care; cultural, religious, and spiritual issues; ethical issues; and legal frameworks. Learning objectives were categorized as essential or desirable (essential: 66; desirable: 49). A consensus syllabus of palliative medicine for undergraduate medical education was developed using a clear and innovative methodology. The final consensus syllabus will be made available for further dissemination of palliative care education throughout the country.

Development of a Draft Core Set of Domains for Measuring Shared Decision Making in Osteoarthritis: An OMERACT Working Group on Shared Decision Making

Science.gov (United States)

Toupin April, Karine; Barton, Jennifer; Fraenkel, Liana; Li, Linda; Grandpierre, Viviane; Guillemin, Francis; Rader, Tamara; Stacey, Dawn; Légaré, France; Jull, Janet; Petkovic, Jennifer; Scholte Voshaar, Marieke; Welch, Vivian; Lyddiatt, Anne; Hofstetter, Cathie; De Wit, Maarten; March, Lyn; Meade, Tanya; Christensen, Robin; Gaujoux-Viala, Cécile; Suarez-Almazor, Maria E.; Boonen, Annelies; Pohl, Christoph; Martin, Richard; Tugwell, Peter

2015-01-01

Objective Despite the importance of shared decision making for delivering patient-centred care in rheumatology, there is no consensus on how to measure its process and outcomes. The aim of this OMERACT working group is to determine the core set of domains for measuring shared decision making in intervention studies in adults with osteoarthritis (OA), from the perspective of patients, health professionals and researchers. Methods We followed the OMERACT Filter 2.0 to develop a draft core domain set, which consisted of: (i) forming an OMERACT working group; (ii) conducting a review of domains of shared decision making; and (iii) obtaining the opinions of stakeholders using a modified nominal group process held at a session activity at the OMERACT 2014 meeting. Results 26 stakeholders from Europe, North America and Australia, including 5 patient research partners, participated in the session activity. Participants identified the following domains for measuring shared decision making to be included as part of the Draft Core Set: 1) Identifying the decision; 2) Exchanging Information; 3) Clarifying views; 4) Deliberating; 5) Making the decision; 6) Putting the decision into practice; and 7) Assessing the impact of the decision. Contextual factors were also suggested. Conclusion We propose a Draft Core Set of shared decision making domains for OA intervention research studies. Next steps include a workshop at OMERACT 2016 to reach consensus on these proposed domains in the wider OMERACT group, as well as detail sub-domains and assess instruments to develop a Core Outcome Measurement Set. PMID:25877502

Development of a Draft Core Set of Domains for Measuring Shared Decision Making in Osteoarthritis: An OMERACT Working Group on Shared Decision Making.

Science.gov (United States)

Toupin-April, Karine; Barton, Jennifer; Fraenkel, Liana; Li, Linda; Grandpierre, Viviane; Guillemin, Francis; Rader, Tamara; Stacey, Dawn; Légaré, France; Jull, Janet; Petkovic, Jennifer; Scholte-Voshaar, Marieke; Welch, Vivian; Lyddiatt, Anne; Hofstetter, Cathie; De Wit, Maarten; March, Lyn; Meade, Tanya; Christensen, Robin; Gaujoux-Viala, Cécile; Suarez-Almazor, Maria E; Boonen, Annelies; Pohl, Christoph; Martin, Richard; Tugwell, Peter S

2015-12-01

Despite the importance of shared decision making for delivering patient-centered care in rheumatology, there is no consensus on how to measure its process and outcomes. The aim of this Outcome Measures in Rheumatology (OMERACT) working group is to determine the core set of domains for measuring shared decision making in intervention studies in adults with osteoarthritis (OA), from the perspectives of patients, health professionals, and researchers. We followed the OMERACT Filter 2.0 method to develop a draft core domain set by (1) forming an OMERACT working group; (2) conducting a review of domains of shared decision making; and (3) obtaining opinions of all those involved using a modified nominal group process held at a session activity at the OMERACT 12 meeting. In all, 26 people from Europe, North America, and Australia, including 5 patient research partners, participated in the session activity. Participants identified the following domains for measuring shared decision making to be included as part of the draft core set: (1) identifying the decision, (2) exchanging information, (3) clarifying views, (4) deliberating, (5) making the decision, (6) putting the decision into practice, and (7) assessing the effect of the decision. Contextual factors were also suggested. We proposed a draft core set of shared decision-making domains for OA intervention research studies. Next steps include a workshop at OMERACT 13 to reach consensus on these proposed domains in the wider OMERACT group, as well as to detail subdomains and assess instruments to develop a core outcome measurement set.

78 FR 64493 - Juneau Hydropower, Inc.; Notice of Subsequent Draft License Application (DLA) and Draft...

Science.gov (United States)

2013-10-29

... Hydropower, Inc.; Notice of Subsequent Draft License Application (DLA) and Draft Preliminary Draft... Hydropower, Inc. e. Name of Project: Sweetheart Lake Hydroelectric Project. f. Location: At the confluence of..., Business Manager, Juneau Hydropower, Inc., P.O. Box 22775, Juneau, AK 99802; 907-789-2775, email: duff...

75 FR 63519 - Notice of Availability of Draft Environmental Assessment and Draft Finding of No Significant...

Science.gov (United States)

2010-10-15

... reduced for certain environmental resource areas (i.e., for transportation, public and occupational health... NUCLEAR REGULATORY COMMISSION [NRC-2009-0435] Notice of Availability of Draft Environmental... of Availability of Draft Environmental Assessment and Draft Finding of No Significant Impact; Notice...

Draft Genome Sequence of Sphingomonas sp. Strain Sph1(2015), Isolated from a Fouled Membrane Filter Used To Produce Drinking Water.

Science.gov (United States)

de Vries, Hendrik J; Marshall, Ian P G; Schreiber, Lars; Plugge, Caroline M

2017-06-15

We report here the high-quality draft genome sequence of Sphingomonas sp. strain Sph1(2015), isolated from a fouled reverse osmosis membrane used for the production of high-quality drinking water. The draft sequence provides insights into the modus operandi of this strain to form biofilms on membrane surfaces. This knowledge offers tools to develop novel antifouling strategies. Copyright © 2017 de Vries et al.

Extensive error in the number of genes inferred from draft genome assemblies.

Directory of Open Access Journals (Sweden)

James F Denton

2014-12-01

Full Text Available Current sequencing methods produce large amounts of data, but genome assemblies based on these data are often woefully incomplete. These incomplete and error-filled assemblies result in many annotation errors, especially in the number of genes present in a genome. In this paper we investigate the magnitude of the problem, both in terms of total gene number and the number of copies of genes in specific families. To do this, we compare multiple draft assemblies against higher-quality versions of the same genomes, using several new assemblies of the chicken genome based on both traditional and next-generation sequencing technologies, as well as published draft assemblies of chimpanzee. We find that upwards of 40% of all gene families are inferred to have the wrong number of genes in draft assemblies, and that these incorrect assemblies both add and subtract genes. Using simulated genome assemblies of Drosophila melanogaster, we find that the major cause of increased gene numbers in draft genomes is the fragmentation of genes onto multiple individual contigs. Finally, we demonstrate the usefulness of RNA-Seq in improving the gene annotation of draft assemblies, largely by connecting genes that have been fragmented in the assembly process.

Suspended Draft: Effects on the Composition and Quality of the Military Workforce in the German Armed Forces

Science.gov (United States)

2016-06-01

soldiers created a selection inequity among potential recruits comparable to the situation in the United States in the 1960s. By 2010, most of the...the inequity of who was drafted and who was not due to the diminishing personnel sizes and the progress toward modern technology and professionalism... gender , important to determine whether the draft is of concern for the individual respondent. Additionally, there are numerous variables with regard

ESMO Consensus Conference on malignant lymphoma

DEFF Research Database (Denmark)

Buske, C; Hutchings, M; Ladetto, M

2018-01-01

The European Society for Medical Oncology (ESMO) consensus conference on mature B cell lymphomas and chronic lymphocytic leukaemia (CLL) was held on 20 June 2015 in Lugano, Switzerland, and included a multidisciplinary panel of 25 leading experts. The aim of the conference was to develop recommen......The European Society for Medical Oncology (ESMO) consensus conference on mature B cell lymphomas and chronic lymphocytic leukaemia (CLL) was held on 20 June 2015 in Lugano, Switzerland, and included a multidisciplinary panel of 25 leading experts. The aim of the conference was to develop...... of the three key areas identified. This manuscript presents the consensus recommendations regarding the clinical management of elderly patients diagnosed with malignant lymphoma. Four clinically-relevant topics identified by the panel were: 1) how to define patient fitness, 2) assessing quality of life, 3......) diagnostic work-up and 4) clinical management of elderly patients with lymphoma. Each of these key topics is addressed in the context of five different lymphoma entities, namely: CLL, follicular lymphoma, mantle cell lymphoma, peripheral T-cell lymphoma and diffuse large B-cell lymphoma. Results, including...

Achieving 90% Adoption of Clinical Practice Guidelines Using the Delphi Consensus Method in a Large Orthopedic Group.

Science.gov (United States)

Bini, Stefano A; Mahajan, John

2016-11-01

Little is known about the implementation rate of clinical practice guidelines (CPGs). Our purpose was to report on the adoption rate of CPGs created and implemented by a large orthopedic group using the Delphi consensus method. The draft CPGs were created before the group's annual meeting by 5 teams each assigned a subset of topics. The draft guidelines included a statement and a summary of the available evidence. Each guideline was debated in both small-group and plenary sessions. Voting was anonymous and a 75% supermajority was required for passage. A Likert scale was used to survey the patient's experience with the process at 1 week, and the Kirkpatrick evaluation model was used to gauge the efficacy of the process over a 6-month time frame. Eighty-five orthopedic surgeons attended the meeting. Fifteen guidelines grouped into 5 topics were created. All passed. Eighty-six percent of attendees found the process effective and 84% felt that participating in the process made it more likely that they would adopt the guidelines. At 1 week, an average of 62% of attendees stated they were practicing the guideline as written (range: 35%-72%), and at 6 months, 96% stated they were practicing them (range: 82%-100%). We have demonstrated that a modified Delphi method for reaching consensus can be very effective in both creating CPGs and leading to their adoption. Further we have shown that the process is well received by participants and that an inclusionary approach can be highly successful. Copyright © 2016 Elsevier Inc. All rights reserved.

Assessment, Diagnosis, and Treatment of HIV-Associated Neurocognitive Disorder: A Consensus Report of the Mind Exchange Program

Science.gov (United States)

Antinori, Andrea; Arendt, Gabriele; Grant, Igor; Letendre, Scott; Chair; Muñoz-Moreno, Jose A.; Eggers, Christian; Brew, Bruce; Brouillette, Marie-Josée; Bernal-Cano, Francisco; Carvalhal, Adriana; Christo, Paulo Pereira; Cinque, Paola; Cysique, Lucette; Ellis, Ronald; Everall, Ian; Gasnault, Jacques; Husstedt, Ingo; Korten, Volkan; Machala, Ladislav; Obermann, Mark; Ouakinin, Silvia; Podzamczer, Daniel; Portegies, Peter; Rackstraw, Simon; Rourke, Sean; Sherr, Lorraine; Streinu-Cercel, Adrian; Winston, Alan; Wojna, Valerie; Yazdanpannah, Yazdan; Arbess, Gordon; Baril, Jean-Guy; Begovac, Josip; Bergin, Colm; Bonfanti, Paolo; Bonora, Stefano; Brinkman, Kees; Canestri, Ana; Cholewińska-Szymańska, Graźyna; Chowers, Michal; Cooney, John; Corti, Marcelo; Doherty, Colin; Elbirt, Daniel; Esser, Stefan; Florence, Eric; Force, Gilles; Gill, John; Goffard, Jean-Christophe; Harrer, Thomas; Li, Patrick; de Kerckhove, Linos Van; Knecht, Gaby; Matsushita, Shuzo; Matulionyte, Raimonda; McConkey, Sam; Mouglignier, Antoine; Oka, Shinichi; Penalva, Augusto; Riesenberg, Klaris; Sambatakou, Helen; Tozzi, Valerio; Vassallo, Matteo; Wetterberg, Peter; Drapato, Alicia Wiercińska

2013-01-01

Many practical clinical questions regarding the management of human immunodeficiency virus (HIV)–associated neurocognitive disorder (HAND) remain unanswered. We sought to identify and develop practical answers to key clinical questions in HAND management. Sixty-six specialists from 30 countries provided input into the program, which was overseen by a steering committee. Fourteen questions were rated as being of greatest clinical importance. Answers were drafted by an expert group based on a comprehensive literature review. Sixty-three experts convened to determine consensus and level of evidence for the answers. Consensus was reached on all answers. For instance, good practice suggests that all HIV patients should be screened for HAND early in disease using standardized tools. Follow-up frequency depends on whether HAND is already present or whether clinical data suggest risk for developing HAND. Worsening neurocognitive impairment may trigger consideration of antiretroviral modification when other causes have been excluded. The Mind Exchange program provides practical guidance in the diagnosis, monitoring, and treatment of HAND. PMID:23175555

Are group consensus in LMX and shared work values related to organizational outcomes?

NARCIS (Netherlands)

Schyns, Birgit

2006-01-01

Leader-member exchange (LMX) refers to the relationship quality between leader and follower. Mostly, LMX is rated individually and related to outcomes. In this study, the focus is on consensus of LMX within a team. However, a high consensus in followers’ perception of their leader does not

Competency Reference for Computer Assisted Drafting.

Science.gov (United States)

Oregon State Dept. of Education, Salem. Div. of Vocational Technical Education.

This guide, developed in Oregon, lists competencies essential for students in computer-assisted drafting (CAD). Competencies are organized in eight categories: computer hardware, file usage and manipulation, basic drafting techniques, mechanical drafting, specialty disciplines, three dimensional drawing/design, plotting/printing, and advanced CAD.…

International consensus for a definition of disease flare in lupus.

Science.gov (United States)

Ruperto, N; Hanrahan, L M; Alarcón, G S; Belmont, H M; Brey, R L; Brunetta, P; Buyon, J P; Costner, M I; Cronin, M E; Dooley, M A; Filocamo, G; Fiorentino, D; Fortin, P R; Franks, A G; Gilkeson, G; Ginzler, E; Gordon, C; Grossman, J; Hahn, B; Isenberg, D A; Kalunian, K C; Petri, M; Sammaritano, L; Sánchez-Guerrero, J; Sontheimer, R D; Strand, V; Urowitz, M; von Feldt, J M; Werth, V P; Merrill, J T

2011-04-01

The Lupus Foundation of America (LFA) convened an international working group to obtain a consensus definition of disease flare in lupus. With help from the Paediatric Rheumatology International Trials Organization (PRINTO), two web-based Delphi surveys of physicians were conducted. Subsequently, the LFA held a second consensus conference followed by a third Delphi survey to reach a community-wide agreement for flare definition. Sixty-nine of the 120 (57.5%) polled physicians responded to the first survey. Fifty-nine of the responses were available to draft 12 preliminary statements, which were circulated in the second survey. Eighty-seven of 118 (74%) physicians completed the second survey, with an agreement of 70% for 9/12 (75%) statements. During the second conference, three alternative flare definitions were consolidated and sent back to the international community. One hundred and sixteen of 146 (79.5%) responded, with agreement by 71/116 (61%) for the following definition: "A flare is a measurable increase in disease activity in one or more organ systems involving new or worse clinical signs and symptoms and/or laboratory measurements. It must be considered clinically significant by the assessor and usually there would be at least consideration of a change or an increase in treatment." The LFA proposes this definition for lupus flare on the basis of its high face validity.

Fifth Ovarian Cancer Consensus Conference of the Gynecologic Cancer InterGroup

DEFF Research Database (Denmark)

Wilson, M K; Pujade-Lauraine, E; Aoki, D

2017-01-01

This manuscript reports the consensus statements regarding recurrent ovarian cancer (ROC), reached at the fifth Ovarian Cancer Consensus Conference (OCCC), which was held in Tokyo, Japan, in November 2015. Three important questions were identified: (i) What are the subgroups for clinical trials i...... including pre-defined patient reported outcomes (PROs), time to second subsequent therapy (TSST), or time until definitive deterioration of quality of life (TUDD)....

Developing drugs for treatment of atopic dermatitis in children (≥3 months to <18 years of age): Draft guidance for industry.

Science.gov (United States)

Siegfried, Elaine C; Jaworski, Jennifer C; Eichenfield, Lawrence F; Paller, Amy; Hebert, Adelaide A; Simpson, Eric L; Altman, Emily; Arena, Charles; Blauvelt, Andrew; Block, Julie; Boguniewicz, Mark; Chen, Suephy; Cordoro, Kelly; Hanna, Diane; Horii, Kimberly; Hultsch, Thomas; Lee, James; Leung, Donald Y; Lio, Peter; Milner, Joshua; Omachi, Theodore; Schneider, Christine; Schneider, Lynda; Sidbury, Robert; Smith, Timothy; Sugarman, Jeffrey; Taha, Sharif; Tofte, Susan; Tollefson, Megha; Tom, Wynnis L; West, Dennis P; Whitney, Lucinda; Zane, Lee

2018-05-01

Atopic dermatitis is the most common chronic skin disease, and it primarily affects children. Although atopic dermatitis (AD) has the highest effect on burden of skin disease, no high-level studies have defined optimal therapy for severe disease. Corticosteroids have been used to treat AD since the 1950s and remain the only systemic medication with Food and Drug Administration approval for this indication in children, despite published guidelines of care that recommend against this option. Several clinical trials with level 1 evidence have supported the use of topical treatments for mild to moderate atopic dermatitis in adults and children, but these trials have had little consistency in protocol design. Consensus recommendations will help standardize clinical development and trial design for children. The Food and Drug Administration issues guidance documents for industry as a source for "the Agency's current thinking on a particular subject." Although they are nonbinding, industry considers these documents to be the standard for clinical development and trial design. Our consensus group is the first to specifically address clinical trial design in this population. We developed a draft guidance document for industry, Developing Drugs for Treatment of Atopic Dermatitis in Children (≥3 months to <18 years of age). This draft guidance has been submitted to the Food and Drug Administration based on a provision in the Federal Register (Good Guidance Practices). © 2018 Wiley Periodicals, Inc.

Developing a clinical pathway for the identification and management of anxiety and depression in adult cancer patients: an online Delphi consensus process.

Science.gov (United States)

Shaw, Joanne M; Price, Melanie A; Clayton, Josephine M; Grimison, Peter; Shaw, Tim; Rankin, Nicole; Butow, Phyllis N

2016-01-01

People with cancer and their families experience high levels of psychological morbidity. However, many cancer services do not routinely screen patients for anxiety and depression, and there are no standardized clinical referral pathways. This study aimed to establish consensus on elements of a draft clinical pathway tailored to the Australian context. A two-round Delphi study was conducted to gain consensus among Australian oncology and psycho-oncology clinicians about the validity of 39 items that form the basis of a clinical pathway that includes screening, assessment, referral and stepped care management of anxiety and depression in the context of cancer. The expert panel comprised 87 multidisciplinary clinician members of the Australian Psycho-oncology Co-operative Research Group (PoCoG). Respondents rated their level of agreement with each statement on a 5-point Likert scale. Consensus was defined as >80% of respondents scoring within 2 points on the Likert scale. Consensus was reached for 21 of 39 items, and a further 15 items approached consensus except for specific contextual factors, after two Delphi rounds. Formal screening for anxiety and depression, a stepped care model of management and recommendations for inclusion of length of treatment and time to review were endorsed. Consensus was not reached on items related to roles and responsibilities, particularly those not applicable across cancer settings. This study identified a core set of evidence- and consensus-based principles considered essential to a stepped care model of care incorporating identification, referral and management of anxiety and depression in adult cancer patients.

75 FR 41452 - Draft Guidance, “Federal Greenhouse Gas Accounting and Reporting”

Science.gov (United States)

2010-07-16

... COUNCIL ON ENVIRONMENTAL QUALITY Draft Guidance, ``Federal Greenhouse Gas Accounting and Reporting... Greenhouse Gas Accounting and Reporting.'' SUMMARY: On October 5, 2009, President Obama signed Executive Order (E.O.) 13514--Federal Leadership in Environmental, Energy, and Economic Performance (74 FR 52117...

Complications to evaluate adult trauma care: An expert consensus study.

Science.gov (United States)

Moore, Lynne; Lauzier, François; Stelfox, Henry Thomas; Le Sage, Natalie; Bourgeois, Gilles; Clément, Julien; Shemilt, Michèle; Turgeon, Alexis F

2014-08-01

Complications affect up to 37% of patients hospitalized for injury and increase mortality, morbidity, and costs. One of the keys to controlling complications for injury admissions is to monitor in-hospital complication rates. However, there is no consensus on which complications should be used to evaluate the quality of trauma care. The objective of this study was to develop a consensus-based list of complications that can be used to assess the acute phase of adult trauma care. We used a three-round Web-based Delphi survey among experts in the field of trauma care quality with a broad range of clinical expertise and geographic diversity. The main outcome measure was median importance rating on a 5-point Likert scale (very low to very high); complications with a median of 4 or greater and no disagreement were retained. A secondary measure was the perceived quality of information on each complication available in patient files. Of 19 experts invited to participate, 17 completed the first (brainstorming) round and 16 (84%) completed all rounds. Of 73 complications generated in Round 1, a total of 25 were retained including adult respiratory distress syndrome, hospital-acquired pneumonia, sepsis, acute renal failure, deep vein thrombosis, pulmonary embolism, wound infection, decubitus ulcers, and delirium. Of these, 19 (76%) were perceived to have high-quality or very high-quality information in patient files by more than 50% of the panel members. This study proposes a consensus-based list of 25 complications that can be used to evaluate the quality of acute adult trauma care. These complications can be used to develop an informative and actionable quality indicator to evaluate trauma care with the goal of decreasing rates of hospital complications and thus improving patient outcomes and resource use. DRG International Classification of Diseases codes are provided.

Quality indicators for the management of Barrett's esophagus, dysplasia, and esophageal adenocarcinoma: international consensus recommendations from the American Gastroenterological Association Symposium.

Science.gov (United States)

Sharma, Prateek; Katzka, David A; Gupta, Neil; Ajani, Jaffer; Buttar, Navtej; Chak, Amitabh; Corley, Douglas; El-Serag, Hashem; Falk, Gary W; Fitzgerald, Rebecca; Goldblum, John; Gress, Frank; Ilson, David H; Inadomi, John M; Kuipers, Ernest J; Lynch, John P; McKeon, Frank; Metz, David; Pasricha, Pankaj J; Pech, Oliver; Peek, Richard; Peters, Jeffrey H; Repici, Alessandro; Seewald, Stefan; Shaheen, Nicholas J; Souza, Rhonda F; Spechler, Stuart J; Vennalaganti, Prashanth; Wang, Kenneth

2015-11-01

The development of and adherence to quality indicators in gastroenterology, as in all of medicine, is increasing in importance to ensure that patients receive consistent high-quality care. In addition, government-based and private insurers will be expecting documentation of the parameters by which we measure quality, which will likely affect reimbursements. Barrett's esophagus remains a particularly important disease entity for which we should maintain up-to-date guidelines, given its commonality, potentially lethal outcomes, and controversies regarding screening and surveillance. To achieve this goal, a relatively large group of international experts was assembled and, using the modified Delphi method, evaluated the validity of multiple candidate quality indicators for the diagnosis and management of Barrett's esophagus. Several candidate quality indicators achieved >80% agreement. These statements are intended to serve as a consensus on candidate quality indicators for those who treat patients with Barrett's esophagus. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

2004 Power marketing program draft environmental impact statement

International Nuclear Information System (INIS)

1996-04-01

This is volume 3 of a draft environmental impact statement from the Western Power Administration's Sierra Nevada Region. Information is included on the following topics: statutory and legal framework; Sierra Nevada region customer groups and economic regions; renewable technology cost information matrix; hydrological assumptions; recreation resources along river reaches and the delta; archaeological and historical aspects; power resources in PROSYM; air quality regulatory structure; energy generation for PROSYM cases; overall power costs for utility, agriculture, and other customers; socioeconomic impacts in specific economic regions; projected air resource impacts; and land use, water quality, and solid waste impact factors

Post-prostatectomy radiation therapy: Consensus guidelines of the Australian and New Zealand Radiation Oncology Genito-Urinary Group

International Nuclear Information System (INIS)

Sidhom, Mark A.; Kneebone, Andrew B.; Lehman, Margot; Wiltshire, Kirsty L.; Millar, Jeremy L.; Mukherjee, Rahul K.; Shakespeare, Thomas P.; Tai, Keen-Hun

2008-01-01

Background and purpose: Three randomised trials have demonstrated the benefit of adjuvant post-prostatectomy radiotherapy (PPRT) for high risk patients. Data also documents the effectiveness of salvage radiotherapy following a biochemical relapse post-prostatectomy. The Radiation Oncology Genito-Urinary Group recognised the need to develop consensus guidelines on to whom, when and how to deliver PPRT. Materials and methods: Draft guidelines were developed and refined at a consensus conference in June 2006 attended by 63 delegates where urological, radiotherapy and diagnostic imaging experts spoke on aspects of PPRT. Unresolved issues were further developed by working parties and redistributed until consensus was reached. Results: Central to the recommendations is that patients with positive surgical margins, seminal vesicle invasion and/or extracapsular extension have a high risk of residual local disease and should be informed of the options of either immediate adjuvant radiotherapy or active surveillance with early salvage in the event of biochemical recurrence. Salvage radiotherapy should be instituted at the earliest confirmation of biochemical recurrence. Detailed contouring guidelines have been developed, defining the regions at risk of residual microscopic disease which should be included in the clinical target volume. The recommended doses are 60-64 Gy for adjuvant, and 60-66 Gy for salvage radiotherapy. The role of hormone therapy in conjunction with PPRT is yet to be defined. Conclusions: These consensus guidelines have been developed to give clinical and technical guidance to radiation oncologists and urologists in the management of high risk post-prostatectomy patients

High quality draft genome sequence of the moderately halophilic bacterium Pontibacillus yanchengensis Y32(T) and comparison among Pontibacillus genomes.

Science.gov (United States)

Huang, Jing; Qiao, Zi Xu; Tang, Jing Wei; Wang, Gejiao

2015-01-01

Pontibacillus yanchengensis Y32(T) is an aerobic, motile, Gram-positive, endospore-forming, and moderately halophilic bacterium isolated from a salt field. In this study, we describe the features of P. yanchengensis strain Y32(T) together with a comparison with other four Pontibacillus genomes. The 4,281,464 bp high-quality-draft genome of strain Y32(T) is arranged into 153 contigs containing 3,965 protein-coding genes and 77 RNA encoding genes. The genome of strain Y32(T) possesses many genes related to its halophilic character, flagellar assembly and chemotaxis to support its survival in a salt-rich environment.

NIH Consensus Conference. Acupuncture.

Science.gov (United States)

1998-11-04

To provide clinicians, patients, and the general public with a responsible assessment of the use and effectiveness of acupuncture to treat a variety of conditions. A nonfederal, nonadvocate, 12-member panel representing the fields of acupuncture, pain, psychology, psychiatry, physical medicine and rehabilitation, drug abuse, family practice, internal medicine, health policy, epidemiology, statistics, physiology, biophysics, and the representatives of the public. In addition, 25 experts from these same fields presented data to the panel and a conference audience of 1200. Presentations and discussions were divided into 3 phases over 2 1/2 days: (1) presentations by investigators working in areas relevant to the consensus questions during a 2-day public session; (2) questions and statements from conference attendees during open discussion periods that were part of the public session; and (3) closed deliberations by the panel during the remainder of the second day and morning of the third. The conference was organized and supported by the Office of Alternative Medicine and the Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md. The literature, produced from January 1970 to October 1997, was searched through MEDLINE, Allied and Alternative Medicine, EMBASE, and MANTIS, as well as through a hand search of 9 journals that were not indexed by the National Library of Medicine. An extensive bibliography of 2302 references was provided to the panel and the conference audience. Expert speakers prepared abstracts of their own conference presentations with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in the open forum and scientific literature. The panel composed a draft statement, which was read in its entirety and circulated to the experts and the audience

Evaluation of Worktext in Mechanical Drafting

Directory of Open Access Journals (Sweden)

Erich D. Cruz

2015-11-01

Full Text Available This study aimed to evaluate Worktext in Drafting Technology 4 (Mechanical Drafting for Bachelor of Technology (BT major in Drafting Technology. It was conducted at University of Rizal System with twenty Drafting and Mechanical Technology professors as respondents. The study used the descriptive evaluative method to describe and evaluate the developed Worktext in DT 4 using the questionnaire-checklist in gathering data. They were asked to evaluate the worktext through the following: objectives, contents, activities, presentation and style, organization, creativity, evaluation, accuracy, completeness and appropriateness. It was found out that the developed worktext with respect to objectives was highly agree, contents was highly agree, activities was highly agree, presentation and style was agree, creativity was highly agree and evaluation was highly agree. Meaning that the items with highly agree interpretations attained excellent level of acceptability while those with agree interpretations obtained extensive level of acceptability with fully achieved and above average Drafting standards, respectively. It was also found out that the developed worktext in terms of accuracy was high, completeness was very high and appropriateness was likewise very high. The researcher recommends that the developed Worktext in Drafting Technology 4 may be adopted for use by the Bachelor of Technology major in Drafting Technology students.

Predicted percentage dissatisfied with ankle draft.

Science.gov (United States)

Liu, S; Schiavon, S; Kabanshi, A; Nazaroff, W W

2017-07-01

Draft is unwanted local convective cooling. The draft risk model of Fanger et al. (Energy and Buildings 12, 21-39, 1988) estimates the percentage of people dissatisfied with air movement due to overcooling at the neck. There is no model for predicting draft at ankles, which is more relevant to stratified air distribution systems such as underfloor air distribution (UFAD) and displacement ventilation (DV). We developed a model for predicted percentage dissatisfied with ankle draft (PPD AD ) based on laboratory experiments with 110 college students. We assessed the effect on ankle draft of various combinations of air speed (nominal range: 0.1-0.6 m/s), temperature (nominal range: 16.5-22.5°C), turbulence intensity (at ankles), sex, and clothing insulation (thermal sensation and air speed at ankles are the dominant parameters affecting draft. The seated subjects accepted a vertical temperature difference of up to 8°C between ankles (0.1 m) and head (1.1 m) at neutral whole-body thermal sensation, 5°C more than the maximum difference recommended in existing standards. The developed ankle draft model can be implemented in thermal comfort and air diffuser testing standards. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Delay-Induced Consensus and Quasi-Consensus in Multi-Agent Dynamical Systems

NARCIS (Netherlands)

Yu, Wenwu; Chen, Guanrong; Cao, Ming; Ren, Wei

2013-01-01

This paper studies consensus and quasi-consensus in multi-agent dynamical systems. A linear consensus protocol in the second-order dynamics is designed where both the current and delayed position information is utilized. Time delay, in a common perspective, can induce periodic oscillations or even

Sparc: a sparsity-based consensus algorithm for long erroneous sequencing reads

Directory of Open Access Journals (Sweden)

Chengxi Ye

2016-06-01

Full Text Available Motivation. The third generation sequencing (3GS technology generates long sequences of thousands of bases. However, its current error rates are estimated in the range of 15–40%, significantly higher than those of the prevalent next generation sequencing (NGS technologies (less than 1%. Fundamental bioinformatics tasks such as de novo genome assembly and variant calling require high-quality sequences that need to be extracted from these long but erroneous 3GS sequences. Results. We describe a versatile and efficient linear complexity consensus algorithm Sparc to facilitate de novo genome assembly. Sparc builds a sparse k-mer graph using a collection of sequences from a targeted genomic region. The heaviest path which approximates the most likely genome sequence is searched through a sparsity-induced reweighted graph as the consensus sequence. Sparc supports using NGS and 3GS data together, which leads to significant improvements in both cost efficiency and computational efficiency. Experiments with Sparc show that our algorithm can efficiently provide high-quality consensus sequences using both PacBio and Oxford Nanopore sequencing technologies. With only 30× PacBio data, Sparc can reach a consensus with error rate <0.5%. With the more challenging Oxford Nanopore data, Sparc can also achieve similar error rate when combined with NGS data. Compared with the existing approaches, Sparc calculates the consensus with higher accuracy, and uses approximately 80% less memory and time. Availability. The source code is available for download at https://github.com/yechengxi/Sparc.

Consensus Convolutional Sparse Coding

KAUST Repository

Choudhury, Biswarup; Swanson, Robin; Heide, Felix; Wetzstein, Gordon; Heidrich, Wolfgang

2017-01-01

In this paper, we propose a new approach to solving CSC as a consensus optimization problem, which lifts these limitations. By learning CSC features from large-scale image datasets for the first time, we achieve significant quality improvements in a number of imaging tasks. Moreover, the proposed method enables new applications in high dimensional feature learning that has been intractable using existing CSC methods. This is demonstrated for a variety of reconstruction problems across diverse problem domains, including 3D multispectral demosaickingand 4D light field view synthesis.

77 FR 17091 - Trust Land Consolidation Draft Plan

Science.gov (United States)

2012-03-23

... DEPARTMENT OF THE INTERIOR Office of the Secretary Trust Land Consolidation Draft Plan AGENCY... reopening the period for commenting on the Cobell Land Consolidation Program Draft Plan (also known as the Trust Land Consolidation Draft Plan), which is the draft plan for accomplishing these goals. DATES...

System for implement draft reduction

DEFF Research Database (Denmark)

2008-01-01

Abstract of WO 2008095503  (A1) There is disclosed a system and method of reducing draft forces when working soil with agricultural soil working implements (206, 211) creating draft forces, the soil working implements (208, 206, 211) beingoperable connectable to a frame (204, 304, 404, 504, 604......, the second part of the width comprising an other part of said width (212) than the first part (222), so as e.g. to reduce draft forces compared to working both first and second parts at the same time....

78 FR 22269 - International Conference on Harmonisation; Draft Guidance on M7 Assessment and Control of DNA...

Science.gov (United States)

2013-04-15

...The Food and Drug Administration (FDA) is announcing the availability of a draft guidance entitled ``M7 Assessment and Control of DNA Reactive (Mutagenic) Impurities in Pharmaceuticals to Limit Potential Carcinogenic Risk.'' The draft guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The draft guidance emphasizes considerations of both safety and quality risk management in establishing levels of mutagenic impurities that are expected to pose negligible carcinogenic risk. It outlines recommendations for assessment and control of mutagenic impurities that reside or are reasonably expected to reside in a final drug substance or product, taking into consideration the intended conditions of human use. The draft guidance is intended to provide guidance for new drug substances and new drug products during their clinical development and subsequent applications for marketing.

An updated Asia Pacific Consensus Recommendations on colorectal cancer screening.

Science.gov (United States)

Sung, J J Y; Ng, S C; Chan, F K L; Chiu, H M; Kim, H S; Matsuda, T; Ng, S S M; Lau, J Y W; Zheng, S; Adler, S; Reddy, N; Yeoh, K G; Tsoi, K K F; Ching, J Y L; Kuipers, E J; Rabeneck, L; Young, G P; Steele, R J; Lieberman, D; Goh, K L

2015-01-01

Since the publication of the first Asia Pacific Consensus on Colorectal Cancer (CRC) in 2008, there are substantial advancements in the science and experience of implementing CRC screening. The Asia Pacific Working Group aimed to provide an updated set of consensus recommendations. Members from 14 Asian regions gathered to seek consensus using other national and international guidelines, and recent relevant literature published from 2008 to 2013. A modified Delphi process was adopted to develop the statements. Age range for CRC screening is defined as 50-75 years. Advancing age, male, family history of CRC, smoking and obesity are confirmed risk factors for CRC and advanced neoplasia. A risk-stratified scoring system is recommended for selecting high-risk patients for colonoscopy. Quantitative faecal immunochemical test (FIT) instead of guaiac-based faecal occult blood test (gFOBT) is preferred for average-risk subjects. Ancillary methods in colonoscopy, with the exception of chromoendoscopy, have not proven to be superior to high-definition white light endoscopy in identifying adenoma. Quality of colonoscopy should be upheld and quality assurance programme should be in place to audit every aspects of CRC screening. Serrated adenoma is recognised as a risk for interval cancer. There is no consensus on the recruitment of trained endoscopy nurses for CRC screening. Based on recent data on CRC screening, an updated list of recommendations on CRC screening is prepared. These consensus statements will further enhance the implementation of CRC screening in the Asia Pacific region. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

ncRNA consensus secondary structure derivation using grammar strings.

Science.gov (United States)

Achawanantakun, Rujira; Sun, Yanni; Takyar, Seyedeh Shohreh

2011-04-01

Many noncoding RNAs (ncRNAs) function through both their sequences and secondary structures. Thus, secondary structure derivation is an important issue in today's RNA research. The state-of-the-art structure annotation tools are based on comparative analysis, which derives consensus structure of homologous ncRNAs. Despite promising results from existing ncRNA aligning and consensus structure derivation tools, there is a need for more efficient and accurate ncRNA secondary structure modeling and alignment methods. In this work, we introduce a consensus structure derivation approach based on grammar string, a novel ncRNA secondary structure representation that encodes an ncRNA's sequence and secondary structure in the parameter space of a context-free grammar (CFG) and a full RNA grammar including pseudoknots. Being a string defined on a special alphabet constructed from a grammar, grammar string converts ncRNA alignment into sequence alignment. We derive consensus secondary structures from hundreds of ncRNA families from BraliBase 2.1 and 25 families containing pseudoknots using grammar string alignment. Our experiments have shown that grammar string-based structure derivation competes favorably in consensus structure quality with Murlet and RNASampler. Source code and experimental data are available at http://www.cse.msu.edu/~yannisun/grammar-string.

Mississippi Curriculum Framework for General Drafting (Program CIP: 48.0101--Drafting, General). Secondary Programs.

Science.gov (United States)

Mississippi Research and Curriculum Unit for Vocational and Technical Education, State College.

This document, which reflects Mississippi's statutory requirement that instructional programs be based on core curricula and performance-based assessment, contains outlines of the instructional units required in local instructional management plans and daily lesson plans for two secondary-level courses in drafting: drafting I and II. Presented…

A checklist to assess the quality of reports on spa therapy and balneotherapy trials was developed using the Delphi consensus method: the SPAC checklist.

Science.gov (United States)

Kamioka, Hiroharu; Kawamura, Yoichi; Tsutani, Kiichiro; Maeda, Masaharu; Hayasaka, Shinya; Okuizum, Hiroyasu; Okada, Shinpei; Honda, Takuya; Iijima, Yuichi

2013-08-01

The purpose of this study was to develop a checklist of items that describes and measures the quality of reports of interventional trials assessing spa therapy. The Delphi consensus method was used to select the number of items in the checklist. A total of eight individuals participated, including an epidemiologist, a clinical research methodologist, clinical researchers, a medical journalist, and a health fitness programmer. Participants ranked on a 9-point Likert scale whether an item should be included in the checklist. Three rounds of the Delphi method were conducted to achieve consensus. The final checklist contained 19 items, with items related to title, place of implementation (specificity of spa), care provider influence, and additional measures to minimize the potential bias from withdrawals, loss to follow-up, and low treatment adherence. This checklist is simple and quick to complete, and should help clinicians and researchers critically appraise the medical and healthcare literature, reviewers assess the quality of reports included in systematic reviews, and researchers plan interventional trials of spa therapy. Copyright © 2013 Elsevier Ltd. All rights reserved.

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Directory of Open Access Journals (Sweden)

Luiz Gonzaga Coelho

2013-04-01

Full Text Available Significant progress has been obtained since the Second Brazilian Consensus Conference on Helicobacter pylori Infection held in 2004, in São Paulo, SP, Brazil, and justify a third meeting to establish updated guidelines on the current management of H. pylori infection. The Third Brazilian Consensus Conference on H pylori Infection was organized by the Brazilian Nucleus for the Study of Helicobacter, a Department of the Brazilian Federation of Gastroenterology and took place on April 12-15, 2011, in Bento Gonçalves, RS, Brazil. Thirty-one delegates coming from the five Brazilian regions and one international guest, including gastroenterologists, pathologists, epidemiologists, and pediatricians undertook the meeting. The participants were allocated in one of the five main topics of the meeting: H pylori, functional dyspepsia and diagnosis; H pylori and gastric cancer; H pylori and other associated disorders; H pylori treatment and retreatment; and, epidemiology of H pylori infection in Brazil. The results of each subgroup were submitted to a final consensus voting to all participants. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. Seventy per cent and more votes were considered as acceptance for the final statement. This article presents the main recommendations and conclusions to guide Brazilian doctors involved in the management of H pylori infection.

Concept of Draft International Standard for a Unified Approach to Space Program Quality Assurance

Science.gov (United States)

Stryzhak, Y.; Vasilina, V.; Kurbatov, V.

2002-01-01

For want of the unified approach to guaranteed space project and product quality assurance, implementation of many international space programs has become a challenge. Globalization of aerospace industry and participation of various international ventures with diverse quality assurance requirements in big international space programs requires for urgent generation of unified international standards related to this field. To ensure successful fulfillment of space missions, aerospace companies should design and process reliable and safe products with properties complying or bettering User's (or Customer's) requirements. Quality of the products designed or processed by subcontractors (or other suppliers) should also be in compliance with the main user (customer)'s requirements. Implementation of this involved set of unified requirements will be made possible by creating and approving a system (series) of international standards under a generic title Space Product Quality Assurance based on a system consensus principle. Conceptual features of the baseline standard in this system (series) should comprise: - Procedures for ISO 9000, CEN and ECSS requirements adaptation and introduction into space product creation, design, manufacture, testing and operation; - Procedures for quality assurance at initial (design) phases of space programs, with a decision on the end product made based on the principle of independence; - Procedures to arrange incoming inspection of products delivered by subcontractors (including testing, audit of supplier's procedures, review of supplier's documentation), and space product certification; - Procedures to identify materials and primary products applied; - Procedures for quality system audit at the component part, primary product and materials supplier facilities; - Unified procedures to form a list of basic performances to be under configuration management; - Unified procedures to form a list of critical space product components, and unified

75 FR 78729 - Notice of Availability of a Draft Environmental Impact Statement for the Sunset Area Community...

Science.gov (United States)

2010-12-16

... agency has addressed the following areas in the Draft EIS: Aesthetics; air quality, including greenhouse... education, safety, health, and social services; socioeconomics, including demographic, employment, and...

Development of quality indicators for physiotherapy for patients with PAOD in the Netherlands: a Delphi study.

Science.gov (United States)

Gijsbers, H J H; Lauret, G J; van Hofwegen, A; van Dockum, T A; Teijink, J A W; Hendriks, H J M

2016-06-01

The aim of the study was to develop quality indicators (QIs) for physiotherapy management of patients with intermittent claudication (IC) in the Netherlands. As part of an international six-step method to develop QIs, an online survey Delphi-procedure was completed. After two Delphi-rounds a validation round was performed. Twenty-six experts were recruited to participate in this study. Twenty-four experts completed two Delphi-rounds. A third round was conducted inviting 1200 qualified and registered physiotherapists of the Dutch integrated care network 'Claudicationet' to validate a draft set of quality indicators. Out of 83 potential QIs in the Dutch physiotherapy guideline on 'Intermittent claudication', consensus among the experts selected nine indicators. All nine quality indicators were validated by 300 physiotherapists. A final set of nine indicators was derived from (1) a Dutch evidence-based physiotherapy guideline, (2) an expert Delphi procedure and (3) a validation by 300 physiotherapists. This set of indicators should be validated in clinical practice. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Analytical and Experimental Draft Force Evaluation of Plastic Coated Chisel Tines

Directory of Open Access Journals (Sweden)

M Barzegar Tabrizi

2017-10-01

Full Text Available Introduction Improving the efficiency of all agricultural operations has always been important for farmers and engineers. It is well known that the force required for cutting a soil using narrow blades is a function of soil and environmental physical properties, tool shape geometry and the tool’s surface characteristics like soil-tool adhesion and friction. Soil tool adhesion can reduce ploughing efficiency and quality. It may also halt the movement of tillage machines in more severe conditions. Adhesion can also disable some machine abilities, which can result in a significant reduction of machine performance. Adhesion of the soil to seed-bed preparation tools like furrowers can significantly affect the germination rate. Reducing soil tool adhesion of furrowers can reduce draft force and improve ploughing efficiency. Many researchers have worked on methods of reducing draft force by modifying the surface material and/or surface texture of the plough tools. A good prediction on draft force of a tool before producing it has always been important for farmers and engineers. There are some models for predicting the draft force of narrow blades in soil. McKyes-Ali’s model is widely used because of its accuracy and simplicity. Ultra-high molecular weight polythene (UHMW-PE is a polymer with ultra-high weight and long molecular chains and is well known for its outstanding physical and chemical properties and self-cleaning abilities, which reduce soil-tool adhesion. The aim of this study was to investigate usability of UHMW-PE coated furrower tines for draft force. Analytical and experimental investigations were carried out during the research. A comparison was conducted between the analytical and the experimental method. The results of this comparison can be used to determine reliability of the analytical model for predicting the draft force improvement caused by the surface modification on tines using different surface coatings. Materials and

Forced draft wet cooling systems

International Nuclear Information System (INIS)

Daubert, A.; Caudron, L.; Viollet, P.L.

1975-01-01

The disposal of the heat released from a 1000MW power plant needs a natural draft tower of about 130m of diameter at the base, and 170m height, or a cooling system with a draft forced by about forty vans, a hundred meters in diameter, and thirty meters height. The plumes from atmospheric cooling systems form, in terms of fluid mechanics, hot jets in a cross current. They consist in complex flows that must be finely investigated with experimental and computer means. The study, currently being performed at the National Hydraulics Laboratory, shows that as far as the length and height of visible plumes are concerned, the comparison is favorable to some types of forced draft cooling system, for low and medium velocities, (below 5 or 6m/s at 10m height. Beyond these velocities, the forced draft sends the plume up to smaller heights, but the plume is generally more dilute [fr

76 FR 381 - Notice of Availability of the Draft Environmental Impact Statement/Draft Environmental Impact...

Science.gov (United States)

2011-01-04

...In accordance with the National Environmental Policy Act of 1969, as amended (NEPA), and the Federal Land Policy and Management Act of 1976, as amended (FLPMA), the Bureau of Land Management (BLM) and the California Public Utilities Commission (CPUC) have prepared a Draft Environmental Impact Statement (EIS), and Draft Environmental Impact Report (EIR) as a joint environmental analysis document for the Iberdrola Renewable/Pacific Wind Development Tule Wind Project (Tule Project) and the San Diego Gas and Electric's (SDG&E) East County Substation Project (ECO Project) and by this notice are announcing the opening of the comment period on the Draft EIS/EIR.

IRIS Toxicological Review of Ammonia (Revised External Review Draft)

Science.gov (United States)

In August 2013, EPA submitted a revised draft IRIS assessment of ammonia to the agency's Science Advisory Board (SAB) and posted this draft on the IRIS website. EPA had previously released a draft of the assessment for public comment, held a public meeting about the draft, and ...

Agitation in cognitive disorders:International Psychogeriatric Association provisional consensus clinical and research definition

OpenAIRE

Cummings, Jeffrey; Mintzer, Jacobo; Brodaty, Henry; Sano, Mary; Banerjee, Sube; Devanand, D. P.; Gauthier, Serge; Howard, Robert; Lanctôt, Krista; Lyketsos, Constantine G.; Peskind, Elaine; Porsteinsson, Anton P.; Reich, Edgardo; Sampaio, Cristina; Steffens, David

2015-01-01

Background: Agitation is common across neuropsychiatric disorders and contributes to disability, institutionalization, and diminished quality of life for patients and their caregivers. There is no consensus definition of agitation and no widespread agreement on what elements should be included in the syndrome. The International Psychogeriatric Association formed an Agitation Definition Work Group (ADWG) to develop a provisional consensus definition of agitation in patients with cognitive diso...

Establishment and calibration of consensus process model for nitrous oxide dynamics in water quality engineering

DEFF Research Database (Denmark)

Domingo-Felez, Carlos

that enhance cost and energy efficiency in BNR, while maintaining effluent quali-ty. Now, increasing attention is placed on direct emissions of nitrous oxide (N2O) as by-product of BNR; N2O is a greenhouse gas (GHG) with a high warming potential and also an ozone depleting chemical compound. Several N2O...... process modelling efforts aim to reproduce ex-perimental data with mathematical equations, structuring our understanding of the system. Various mechanistic models with different structures describ-ing N2O production have been proposed, but no consensus exists between researchers. Hence, the existing plant......-wide GHG models still lack a complete biological process model that can be integrated in a methodology that assess-es N2O emissions and their impact on overall plant performance. A mathematical model structure that describes N2O production during biological nitrogen removal is proposed. Two autotrophic...

78 FR 19733 - Draft General Management Plan and Draft Environmental Impact Statement, Fort Raleigh National...

Science.gov (United States)

2013-04-02

... announce the dates, times, and locations of public meetings on the draft EIS/GMP through the NPS Planning... delivery to the above address. Electronic copies of the Draft EIS/GMP will be available online at http... through additional interpretive efforts, marketing, and facilities. Alternative C, the NPS preferred...

Microscopic enteritis: Bucharest consensus.

Science.gov (United States)

Rostami, Kamran; Aldulaimi, David; Holmes, Geoffrey; Johnson, Matt W; Robert, Marie; Srivastava, Amitabh; Fléjou, Jean-François; Sanders, David S; Volta, Umberto; Derakhshan, Mohammad H; Going, James J; Becheanu, Gabriel; Catassi, Carlo; Danciu, Mihai; Materacki, Luke; Ghafarzadegan, Kamran; Ishaq, Sauid; Rostami-Nejad, Mohammad; Peña, A Salvador; Bassotti, Gabrio; Marsh, Michael N; Villanacci, Vincenzo

2015-03-07

Microscopic enteritis (ME) is an inflammatory condition of the small bowel that leads to gastrointestinal symptoms, nutrient and micronutrient deficiency. It is characterised by microscopic or sub-microscopic abnormalities such as microvillus changes and enterocytic alterations in the absence of definite macroscopic changes using standard modern endoscopy. This work recognises a need to characterize disorders with microscopic and submicroscopic features, currently regarded as functional or non-specific entities, to obtain further understanding of their clinical relevance. The consensus working party reviewed statements about the aetiology, diagnosis and symptoms associated with ME and proposes an algorithm for its investigation and treatment. Following the 5(th) International Course in Digestive Pathology in Bucharest in November 2012, an international group of 21 interested pathologists and gastroenterologists formed a working party with a view to formulating a consensus statement on ME. A five-step agreement scale (from strong agreement to strong disagreement) was used to score 21 statements, independently. There was strong agreement on all statements about ME histology (95%-100%). Statements concerning diagnosis achieved 85% to 100% agreement. A statement on the management of ME elicited agreement from the lowest rate (60%) up to 100%. The remaining two categories showed general agreement between experts on clinical presentation (75%-95%) and pathogenesis (80%-90%) of ME. There was strong agreement on the histological definition of ME. Weaker agreement on management indicates a need for further investigations, better definitions and clinical trials to produce quality guidelines for management. This ME consensus is a step toward greater recognition of a significant entity affecting symptomatic patients previously labelled as non-specific or functional enteropathy.

ConStruct: Improved construction of RNA consensus structures

Directory of Open Access Journals (Sweden)

Steger Gerhard

2008-04-01

Full Text Available Abstract Background Aligning homologous non-coding RNAs (ncRNAs correctly in terms of sequence and structure is an unresolved problem, due to both mathematical complexity and imperfect scoring functions. High quality alignments, however, are a prerequisite for most consensus structure prediction approaches, homology searches, and tools for phylogeny inference. Automatically created ncRNA alignments often need manual corrections, yet this manual refinement is tedious and error-prone. Results We present an extended version of CONSTRUCT, a semi-automatic, graphical tool suitable for creating RNA alignments correct in terms of both consensus sequence and consensus structure. To this purpose CONSTRUCT combines sequence alignment, thermodynamic data and various measures of covariation. One important feature is that the user is guided during the alignment correction step by a consensus dotplot, which displays all thermodynamically optimal base pairs and the corresponding covariation. Once the initial alignment is corrected, optimal and suboptimal secondary structures as well as tertiary interaction can be predicted. We demonstrate CONSTRUCT's ability to guide the user in correcting an initial alignment, and show an example for optimal secondary consensus structure prediction on very hard to align SECIS elements. Moreover we use CONSTRUCT to predict tertiary interactions from sequences of the internal ribosome entry site of CrP-like viruses. In addition we show that alignments specifically designed for benchmarking can be easily be optimized using CONSTRUCT, although they share very little sequence identity. Conclusion CONSTRUCT's graphical interface allows for an easy alignment correction based on and guided by predicted and known structural constraints. It combines several algorithms for prediction of secondary consensus structure and even tertiary interactions. The CONSTRUCT package can be downloaded from the URL listed in the Availability and

A consensus statement on how to conduct inclusive health research.

Science.gov (United States)

Frankena, T K; Naaldenberg, J; Cardol, M; Garcia Iriarte, E; Buchner, T; Brooker, K; Embregts, P; Joosa, E; Crowther, F; Fudge Schormans, A; Schippers, A; Walmsley, J; O'Brien, P; Linehan, C; Northway, R; van Schrojenstein Lantman-de Valk, H; Leusink, G

2018-04-11

The active involvement of people with intellectual disabilities in research, or inclusive research, is relatively common. However, inclusive health research is less common, even though it is expected to lead to appropriate healthcare and increased quality of life. Inclusive health research can build upon lessons learned from inclusive research. A total of 17 experts on inclusive (health) research without intellectual disabilities and 40 experts with intellectual disabilities collaborated in this consensus statement. The consensus statement was developed in three consecutive rounds: (1) an initial feedback round; (2) a roundtable discussion at the 2016 International Association for the Scientific Study of Intellectual and Developmental Disabilities World Congress; and (3) a final feedback round. This consensus statement provides researchers with guidelines, agreed upon by experts in the field, regarding attributes, potential outcomes, reporting and publishing, and future research directions, for designing and conducting inclusive health research. Consensus was reached on how to design and conduct inclusive health research. However, this statement should be continuously adapted to incorporate recent knowledge. The focus of this consensus statement is largely on inclusive health research, but the principles can also be applied to other areas. © 2018 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Chinese expert consensus on programming deep brain stimulation for patients with Parkinson's disease.

Science.gov (United States)

Chen, Shengdi; Gao, Guodong; Feng, Tao; Zhang, Jianguo

2018-01-01

Deep Brain Stimulation (DBS) therapy for the treatment of Parkinson's Disease (PD) is now a well-established option for some patients. Postoperative standardized programming processes can improve the level of postoperative management and programming, relieve symptoms and improve quality of life. In order to improve the quality of the programming, the experts on DBS and PD in neurology and neurosurgery in China reviewed the relevant literatures and combined their own experiences and developed this expert consensus on the programming of deep brain stimulation in patients with PD in China. This Chinese expert consensus on postoperative programming can standardize and improve postoperative management and programming of DBS for PD.

Critical appraisal of the Vienna consensus: performance indicators for assisted reproductive technology laboratories.

Science.gov (United States)

Lopez-Regalado, María Luisa; Martínez-Granados, Luis; González-Utor, Antonio; Ortiz, Nereyda; Iglesias, Miriam; Ardoy, Manuel; Castilla, Jose A

2018-05-24

The Vienna consensus, based on the recommendations of an expert panel, has identified 19 performance indicators for assisted reproductive technology (ART) laboratories. Two levels of reference values are established for these performance indicators: competence and benchmark. For over 10 years, the Spanish embryology association (ASEBIR) has participated in the definition and design of ART performance indicators, seeking to establish specific guidelines for ART laboratories to enhance quality, safety and patient welfare. Four years ago, ASEBIR took part in an initiative by AENOR, the Spanish Association for Standardization and Certification, to develop a national standard in this field (UNE 17900:2013 System of quality management for assisted reproduction laboratories), extending the former requirements, based on ISO 9001, to include performance indicators. Considering the experience acquired, we discuss various aspects of the Vienna consensus and consider certain discrepancies in performance indicators between the consensus and UNE 179007:2013, and analyse the definitions, methodology and reference values used. Copyright © 2018. Published by Elsevier Ltd.

Quality Markers in Cardiology. Main Markers to Measure Quality of Results (Outcomes) and Quality Measures Related to Better Results in Clinical Practice (Performance Metrics). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): A SEC/SECTCV Consensus Position Paper.

Science.gov (United States)

López-Sendón, José; González-Juanatey, José Ramón; Pinto, Fausto; Cuenca Castillo, José; Badimón, Lina; Dalmau, Regina; González Torrecilla, Esteban; López-Mínguez, José Ramón; Maceira, Alicia M; Pascual-Figal, Domingo; Pomar Moya-Prats, José Luis; Sionis, Alessandro; Zamorano, José Luis

2015-11-01

Cardiology practice requires complex organization that impacts overall outcomes and may differ substantially among hospitals and communities. The aim of this consensus document is to define quality markers in cardiology, including markers to measure the quality of results (outcomes metrics) and quality measures related to better results in clinical practice (performance metrics). The document is mainly intended for the Spanish health care system and may serve as a basis for similar documents in other countries. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

77 FR 74508 - Notice of Availability of the Draft Resource Management Plan Amendment, Draft Environmental...

Science.gov (United States)

2012-12-14

... eliminated. A maximum of 7,500 summer and winter landings would be permitted in the project area annually... considered, the BLM must receive written comments on the Draft RMP Amendment/Draft EIS within 90 days... meetings or hearings and any other public involvement activities at least 15 days in advance through public...

Scientific consensus and climate change: the codification of a global research agenda

International Nuclear Information System (INIS)

Boehmer-Christiansen, S.

1993-01-01

The 'scientific consensus' which influenced the Framework Convention on Climate Change was carefully drafted by the Intergovernmental Panel on Climate Change (IPCC) between 1988 and 1992. In spite of it, there have been divergent national responses and policy controversy continues. The willingness of States to reduce the emission of greenhouse gases appears to be declining. An explanation for this is proposed which stresses the question of whether the nature of the scientific advice as sought and given bears some responsibility for the weak policy response. Institutional and personality factors in the formulation of IPCC advice are explored, as is the policy model upon which advice was given. It is concluded that this model is intrinsically unable to generate decisive environmental policy, but rather invites the institutions of the natural sciences and macro-economics to endow their research agendas with claims to policy relevance through the production of future 'findings'. (Author)

76 FR 57760 - Notice of Availability of Draft Resource Management Plan and Draft Environmental Impact Statement...

Science.gov (United States)

2011-09-16

... approximately 707,000 subsurface acres of Federal mineral estate. Decisions in the Colorado River Valley RMP... Availability of Draft Resource Management Plan and Draft Environmental Impact Statement for the Colorado River Valley Field Office, Colorado AGENCY: Bureau of Land Management, Interior. ACTION: Notice of availability...

77 FR 5528 - Trust Land Consolidation Draft Plan

Science.gov (United States)

2012-02-03

... DEPARTMENT OF THE INTERIOR Office of the Secretary Trust Land Consolidation Draft Plan AGENCY... draft plan for accomplishing these goals. DATES: Submit comments by March 19, 2012. ADDRESSES: Send comments on the draft plan to: Elizabeth Appel, Bureau of Indian Affairs, 1001 Indian School Road NW...

Understanding diagnostic variability in breast pathology: lessons learned from an expert consensus review panel

Science.gov (United States)

Allison, Kimberly H; Reisch, Lisa M; Carney, Patricia A; Weaver, Donald L; Schnitt, Stuart J; O’Malley, Frances P; Geller, Berta M; Elmore, Joann G

2015-01-01

Aims To gain a better understanding of the reasons for diagnostic variability, with the aim of reducing the phenomenon. Methods and results In preparation for a study on the interpretation of breast specimens (B-PATH), a panel of three experienced breast pathologists reviewed 336 cases to develop consensus reference diagnoses. After independent assessment, cases coded as diagnostically discordant were discussed at consensus meetings. By the use of qualitative data analysis techniques, transcripts of 16 h of consensus meetings for a subset of 201 cases were analysed. Diagnostic variability could be attributed to three overall root causes: (i) pathologist-related; (ii) diagnostic coding/study methodology-related; and (iii) specimen-related. Most pathologist-related root causes were attributable to professional differences in pathologists’ opinions about whether the diagnostic criteria for a specific diagnosis were met, most frequently in cases of atypia. Diagnostic coding/study methodology-related root causes were primarily miscategorizations of descriptive text diagnoses, which led to the development of a standardized electronic diagnostic form (BPATH-Dx). Specimen-related root causes included artefacts, limited diagnostic material, and poor slide quality. After re-review and discussion, a consensus diagnosis could be assigned in all cases. Conclusions Diagnostic variability is related to multiple factors, but consensus conferences, standardized electronic reporting formats and comments on suboptimal specimen quality can be used to reduce diagnostic variability. PMID:24511905

78 FR 20690 - Draft Environmental Impact Statement, Draft Habitat Conservation Plan, Draft Programmatic...

Science.gov (United States)

2013-04-05

.... Background The Fowler Ridge application is unusual in that 355 wind turbines are already in place and have... Agreement, and Draft Implementing Agreement; Application for an Incidental Take Permit, Fowler Ridge Wind... application from Fowler Ridge Wind Farm LLC, Fowler Ridge II Wind Farm LLC, Fowler Ridge III Wind Farm LLC...

76 FR 59155 - Notice of Availability of South Coast Draft Resource Management Plan Revision and Draft...

Science.gov (United States)

2011-09-23

... policies and emphasis on the management of public lands and local land use planning; and new data that have... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLCAD06000, L16100000.DP0000] Notice of Availability of South Coast Draft Resource Management Plan Revision and Draft Environmental Impact Statement...

Cluster: Drafting. Course: Introduction to Technical Drafting.

Science.gov (United States)

Sanford - Lee County Schools, NC.

The set of 10 units is designed for use with an instructor as an introduction to technical drafting, and is also keyed to other texts. Each unit contains several task packages specifying prerequisites, rationale for learning, objectives, learning activities to be supervised by the instructor, and learning practice. The units cover: drafting…

19 CFR 207.63 - Circulation of draft questionnaires.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 3 2010-04-01 2010-04-01 false Circulation of draft questionnaires. 207.63... SUBSIDIZED EXPORTS TO THE UNITED STATES Five-Year Reviews § 207.63 Circulation of draft questionnaires. (a) The Director shall circulate draft questionnaires to the parties for comment in each full review. (b...

High Quality Draft Genomes of the Type Strains Geobacillus thermocatenulatus DSM 730T, G. uzenensis DSM 23175T And Parageobacillus galactosidasius DSM 18751T.

Science.gov (United States)

Ramaloko, Winnie Thabisa; Koen, Nadine; Polliack, Shamara; Aliyu, Habibu; Lebre, Pedro Humberto; Mohr, Teresa; Oswald, Florian; Zwick, Michaela; Zeigler, Daniel Ray; Neumann, Anke; Syldatk, Christoph; Cowan, Don Arthur; De Maayer, Pieter

2018-01-01

The thermophilic 'Geobacilli' are important sources of thermostable enzymes and other biotechnologically relevant macromolecules. The present work reports the high quality draft genome sequences of previously unsequenced type strains of Geobacillus uzenensis (DSM 23175 T ), G. thermocatenulatus (DSM 730 T ) and Parageobacillus galactosidasius (DSM 18751 T ). Phylogenomic analyses revealed that DSM 18751 T and DSM 23175 T represent later heterotypic synonyms of P. toebii and G. subterraneus , respectively, while DSM 730 T represents the type strain for the species G. thermocatenulatus . These genome sequences will contribute towards a deeper understanding of the ecological and biological diversity and the biotechnological exploitation of the 'geobacilli'.

The Mexican consensus on irritable bowel syndrome.

Science.gov (United States)

Carmona-Sánchez, R; Icaza-Chávez, M E; Bielsa-Fernández, M V; Gómez-Escudero, O; Bosques-Padilla, F; Coss-Adame, E; Esquivel-Ayanegui, F; Flores-Rendón, Á R; González-Martínez, M A; Huerta-Iga, F; López-Colombo, A; Méndez-Gutiérrez, T H; Noble-Lugo, A; Nogueira-de Rojas, J R; Raña-Garibay, R H; Remes-Troche, J M; Roesch-Dietlen, F; Schmulson, M J; Soto-Pérez, J C; Tamayo, J L; Uscanga, L F; Valdovinos, M Á; Valerio-Ureña, J; Zavala-Solares, M R

2016-01-01

Since the publication in 2009 of the Guidelines on the Diagnosis and Treatment of Irritable Bowel Syndrome of the Asociación Mexicana de Gastroenterología (2009 Guidelines), there have been significant advances in our knowledge of the epidemiology, pathophysiology, diagnosis, and treatment of this disease. To present a consensus review of the most current knowledge of IBS, updating the 2009 Guidelines by incorporating new internationally published scientific evidence, with a special interest in Mexican studies. The PubMed literature from January 2009 to March 2015 was reviewed and complemented through a manual search. Articles in English and Spanish were included and preference was given to consensuses, guidelines, systematic reviews, and meta-analyses. Statements referring to the different aspects of the disease were formulated and voted upon by 24 gastroenterologists employing the Delphi method. Once a consensus on each statement was reached, the quality of evidence and strength of recommendation were determined through the GRADE system. Forty-eight statements were formulated, updating the information on IBS and adding the complementary data that did not appear in the 2009 Guidelines regarding the importance of exercise and diet, diagnostic strategies, and current therapy alternatives that were analyzed with more stringent scientific vigor or that emerged within the last 5 years. We present herein a consensus review of the most relevant advances in the study of IBS, updating and complementing the 2009 Guidelines. Several studies conducted in Mexico were included. Copyright © 2016 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

10 CFR 51.81 - Distribution of draft environmental impact statement.

Science.gov (United States)

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Distribution of draft environmental impact statement. 51...-Regulations Implementing Section 102(2) Draft Environmental Impact Statements-Materials Licenses § 51.81 Distribution of draft environmental impact statement. Copies of the draft environmental impact statement and...

10 CFR 51.86 - Distribution of draft environmental impact statement.

Science.gov (United States)

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Distribution of draft environmental impact statement. 51...-Regulations Implementing Section 102(2) Draft Environmental Impact Statements-Rulemaking § 51.86 Distribution of draft environmental impact statement. Copies of the draft environmental impact statement and any...

The Physics of Bump Drafting in Car Racing

Science.gov (United States)

Fiolhais, Miguel C. N.; Amor dos Santos, Susana

2014-01-01

The technique of bump drafting, also known as two-car drafting in motorsports, is analysed in the framework of Newtonian mechanics and simple aerodynamic drag forces. As an apparent unnatural effect that often pleases the enthusiasts of car racing, bump drafting provides a unique pedagogical opportunity for students to gain insights into the…

10 CFR 51.80 - Draft environmental impact statement-materials license.

Science.gov (United States)

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Draft environmental impact statement-materials license. 51...-Regulations Implementing Section 102(2) Draft Environmental Impact Statements-Materials Licenses § 51.80 Draft environmental impact statement—materials license. (a) The NRC staff will either prepare a draft environmental...

Formal consensus to identify clinically important changes in management resulting from the use of cardiovascular magnetic resonance (CMR) in patients who activate the primary percutaneous coronary intervention (PPCI) pathway.

Science.gov (United States)

Pufulete, Maria; Brierley, Rachel C; Bucciarelli-Ducci, Chiara; Greenwood, John P; Dorman, Stephen; Anderson, Richard A; Harris, Jessica; McAlindon, Elisa; Rogers, Chris A; Reeves, Barnaby C

2017-06-22

To define important changes in management arising from the use of cardiovascular magnetic resonance (CMR) in patients who activate the primary percutaneous coronary intervention (PPCI) pathway. Formal consensus study using literature review and cardiologist expert opinion to formulate consensus statements and setting up a consensus panel to review the statements (by completing a web-based survey, attending a face-to-face meeting to discuss survey results and modify the survey to reflect group discussion and completing the modified survey to determine which statements were in consensus). Formulation of consensus statements: four cardiologists (two CMR and two interventional) and six non-clinical researchers. Formal consensus: seven cardiologists (two CMR and three interventional, one echocardiography and one heart failure). Forty-nine additional cardiologists completed the modified survey. Thirty-seven draft statements describing changes in management following CMR were generated; these were condensed into 12 statements and reviewed through the formal consensus process. Three of 12 statements were classified in consensus in the first survey; these related to the role of CMR in identifying the cause of out-of-hospital cardiac arrest, providing a definitive diagnosis in patients found to have unobstructed arteries on angiography and identifying patients with left ventricular thrombus. Two additional statements were in consensus in the modified survey, relating to the ability of CMR to identify patients who have a poor prognosis after PPCI and assess ischaemia and viability in patients with multivessel disease. There was consensus that CMR leads to clinically important changes in management in five subgroups of patients who activate the PPCI pathway. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Improvement of hydro-turbine draft tube efficiency using vortex generator

Directory of Open Access Journals (Sweden)

Xiaoqing Tian

2015-07-01

Full Text Available Computational fluid dynamics simulation was employed in a hydraulic turbine (from inlet tube to draft tube. The calculated turbine efficiencies were compared with measured results, and the relative error is 1.12%. In order to improve the efficiency of the hydraulic turbine, 15 kinds of vortex generators were installed at the vortex development section of the draft tube, and all of them were simulated using the same method. Based on the turbine efficiencies, distribution of streamlines, velocities, and pressures in the draft tube, an optimal draft tube was found, which can increase the efficiency of this hydraulic turbine more than 1.5%. The efficiency of turbine with the optimal draft tube, draft tube with four pairs of middle-sized vortex generator, and draft tube without vortex generator under different heads of turbine (5–14 m was calculated, and it was verified that these two kinds of draft tubes can increase the efficiency of this turbine in every situation.

Orientation, Sketching, Mechanical Drawing, Drafting--Basic: 9253.01.

Science.gov (United States)

Dade County Public Schools, Miami, FL.

The course introduces the student to the drafting trade, freehand sketching, and basic mechanical drawing. The course has no prerequisites and will guide the student into drafting concepts and serve as a foundation for further study in vocational drafting. Requiring a total of 45 class hours, eight hours are utilized in orientation, 15 hours are…

Achieving consensus in environmental programs

International Nuclear Information System (INIS)

Kurstedt, H.A.; Jones, R.M.; Walker, J.A.; Middleman, L.I.

1989-01-01

In this paper, the authors describe a research effort on consensus tied to the Environmental Restoration Program (ERP) within the U.S. Department of Energy's Office of Defense Waste and Transportation Management (DWTM). They define consensus and explain why consensus decisions are not merely desirable but necessary in furthering ERP activities. As examples of their planned applied research, the authors first discuss nominal group technique as a representative consensus-generating tool, and conclude by describing the consensus-related mission of the Waste Management Review Group, established to conduct independent, third-party review of DWTM/ERP plans and activities

Achieving consensus in environmental programs

Energy Technology Data Exchange (ETDEWEB)

Kurstedt, Jr., H. A.; Jones, R. M.; Walker, J. A.; Middleman, L. I.

1989-01-01

In this paper, we describe a new research effort on consensus tied to the Environmental Restoration Program (ERP) within the US Department of Energy's Office of Defense Waste and Transportation Management (DWTM). We define consensus and explain why consensus decisions are not merely desirable but necessary in furthering ERP activities. As examples of our planned applied research, we first discuss Nominal Group Technique as a representative consensus-generating tool, and we conclude by describing the consensus-related mission of the Waste Management Review Group, established at Virginia Tech to conduct independent, third-party review of DWTM/ERP plans and activities. 10 refs.

Quality indicators for blogs and podcasts used in medical education: modified Delphi consensus recommendations by an international cohort of health professions educators.

Science.gov (United States)

Lin, Michelle; Thoma, Brent; Trueger, N Seth; Ankel, Felix; Sherbino, Jonathan; Chan, Teresa

2015-10-01

Quality assurance concerns about social media platforms used for education have arisen within the medical education community. As more trainees and clinicians use resources such as blogs and podcasts for learning, we aimed to identify quality indicators for these resources. A previous study identified 151 potentially relevant quality indicators for these social media resources. To identify quality markers for blogs and podcasts using an international cohort of health professions educators. A self-selected group of 44 health professions educators at the 2014 International Conference on Residency Education participated in a Social Media Summit during which a modified Delphi consensus study was conducted to determine which of the 151 quality indicators met the a priori ≥90% inclusion threshold. Thirteen quality indicators classified into the domains of credibility (n=8), content (n=4) and design (n=1) met the inclusion threshold. The quality indicators that were identified may serve as a foundation for further research on quality indicators of social media-based medical education resources and prompt discussion of their legitimacy as a form of educational scholarship. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[Expert consensus post-marketing evaluation scheme to detect immunotoxicity of Chinese medicine in clinical populations (draft version for comments)].

Science.gov (United States)

Xie, Yan-Ming; Zhao, Yu-Bin; Jiang, Jun-Jie; Chang, Yan-Peng; Zhang, Wen; Shen, Hao; Lu, Peng-Fei

2013-09-01

Through consensus, establish a post-marketing scheme and the technical processes to evaluate Chinese medicine's immunotoxicity on a population, as well as its beneficial influences on the immune system. Provide regulations on the collection, storage and transportation of serum samples. This article applies to the post-marketing scientific evaluation of the immunotoxicity of parenterally administered, and for other ways of taking Chinese medicine.

75 FR 9878 - Draft Principles and Standards Sections of the “Economic and Environmental Principles and...

Science.gov (United States)

2010-03-04

... COUNCIL ON ENVIRONMENTAL QUALITY Draft Principles and Standards Sections of the ``Economic and... the ``Economic and Environmental Principles and Guidelines for Water and Related Land Resources... may be accessed at the Internet addresses indicated: ``Economic and Environmental Principles and...

Dynamic Consensus Algorithm based Distributed Voltage Harmonic Compensation in Islanded Microgrids

DEFF Research Database (Denmark)

Meng, Lexuan; Tang, Fen; Firoozabadi, Mehdi Savaghebi

2015-01-01

generators can be employed as compensators to enhance the power quality on consumer side. However, conventional centralized control is facing obstacles because of the distributed fashion of generation and consumption. Accordingly, this paper proposes a consensus algorithm based distributed hierarchical...

Model-based consensus

NARCIS (Netherlands)

Boumans, M.; Martini, C.; Boumans, M.

2014-01-01

The aim of the rational-consensus method is to produce "rational consensus", that is, "mathematical aggregation", by weighing the performance of each expert on the basis of his or her knowledge and ability to judge relevant uncertainties. The measurement of the performance of the experts is based on

10 CFR 51.85 - Draft environmental impact statement-rulemaking.

Science.gov (United States)

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Draft environmental impact statement-rulemaking. 51.85... Implementing Section 102(2) Draft Environmental Impact Statements-Rulemaking § 51.85 Draft environmental impact... Commission has determined to prepare an environmental impact statement. ...

Ethical and social implications of microdosing clinical trial (2). The draft guidance and the future tasks

International Nuclear Information System (INIS)

Kurihara, Chieko

2008-01-01

Draft of the guidance (GD) for conducting the trial in the title (MCT) was officially announced by Ministry of Health, Labour and Welfare (MHLW) in Dec., 2007, but where the trial part alone was described without the research purposes involved in the starting idea of MCT. The authority invited opinions on the draft until Feb., 2008. This paper describes the detailed content of GD draft and discusses problems in future. GD draft contains: basic concept, range of non-clinical studies necessary for beginning MCT, methods to decide the maximal dose, concept for internal exposure of volunteers when radio-labeled compound is to be administered (for methods by accelerator mass spectrometry (AMS) and positron emission tomography (PET)), quality assurance of the test compound, other notices, and references. The last item contains outlines of concerned laws and regulations (e.g., The Law Concerning Prevention from Radiation Hazards due to Radioisotopes, Etc. and Medical Law); nuclides for AMS (mainly, 14 C) (manufacturing and transporting the test compound containing 14 C, its distribution from MCT client to hospitals, handling in the hospital, and transporting of samples from hospital to AMS facility); and nuclides for PET. Public opinions collected by MHLW will decide the directions hereafter of GD, i.e. the omitted research purposes are additionally incorporated in the present GD draft or are independently described in another newer GD. (R.T.)

Basins 4.0 Climate Assessment Tool (Cat): Supporting Documentation and User Manual (External Review Draft)

Science.gov (United States)

EPA has released of the draft document solely for the purpose of pre-dissemination peer review under applicable Information Quality Guidelines (IQGs). This document has not been formally disseminated by EPA. It does not represent and should not be construed to represent any Agenc...

Impact of computer-aided design and drafting on operator perceptions and performance intentions

Energy Technology Data Exchange (ETDEWEB)

Mandeville, D.E.

1987-01-01

The goal of the introduction of computer-aided design and drafting (CADD) technology is to improve engineering quantity and quality outcomes. What is not so obvious is that the manner in which the operator views the CADD job may affect these outcomes. The study found that: (1) the subjects hold job characteristic beliefs about their jobs that are similar to those held by individuals in related professional and technical positions in other organizations; (2) subjects in routine jobs who had little experience with CADD believe that the characteristics of the job with CADD will be less desirable than there present job utilizing manual drafting; however, experienced users believe that there is little difference; (3) the subjects performing technologically routine jobs indicate that quantity and quality of their jobs decreases with CADD, while holders of technologically nonroutine jobs indicate the opposite; (4) significant but weak relationships existed between job characteristic beliefs, attitudes, and job intentions; however, the model relationships and strengths varied when subgroups were analyzed; and (5) the correlation of social referent group beliefs with subject beliefs are significant but weak.

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Patient-Reported Outcomes in an Enhanced Recovery Pathway.

Science.gov (United States)

Abola, Ramon E; Bennett-Guerrero, Elliott; Kent, Michael L; Feldman, Liane S; Fiore, Julio F; Shaw, Andrew D; Thacker, Julie K M; Gan, Tong J; Miller, Timothy E; Hedrick, Traci L; McEvoy, Matthew D; Mythen, Michael G; Bergamaschi, Roberto; Gupta, Ruchir; Holubar, Stefan D; Senagore, Anthony J; Wischmeyer, Paul E; Carli, Franco; Evans, David C; Guilbert, Sarah; Kozar, Rosemary; Pryor, Aurora; Thiele, Robert H; Everett, Sotiria; Grocott, Mike

2017-12-29

Patient-reported outcomes (PROs) are measures of health status that come directly from the patient. PROs are an underutilized tool in the perioperative setting. Enhanced recovery pathways (ERPs) have primarily focused on traditional measures of health care quality such as complications and hospital length of stay. These measures do not capture postdischarge outcomes that are meaningful to patients such as function or freedom from disability. PROs can be used to facilitate shared decisions between patients and providers before surgery and establish benchmark recovery goals after surgery. PROs can also be utilized in quality improvement initiatives and clinical research studies. An expert panel, the Perioperative Quality Initiative (POQI) workgroup, conducted an extensive literature review to determine best practices for the incorporation of PROs in an ERP. This international group of experienced clinicians from North America and Europe met at Stony Brook, NY, on December 2-3, 2016, to review the evidence supporting the use of PROs in the context of surgical recovery. A modified Delphi method was used to capture the collective expertise of a diverse group to answer clinical questions. During 3 plenary sessions, the POQI PRO subgroup presented clinical questions based on a literature review, presented evidenced-based answers to those questions, and developed recommendations which represented a consensus opinion regarding the use of PROs in the context of an ERP. The POQI workgroup identified key criteria to evaluate patient-reported outcome measures (PROMs) for their incorporation in an ERP. The POQI workgroup agreed on the following recommendations: (1) PROMs in the perioperative setting should be collected in the framework of physical, mental, and social domains. (2) These data should be collected preoperatively at baseline, during the immediate postoperative time period, and after hospital discharge. (3) In the immediate postoperative setting, we recommend using

Assessing risk of draft survey by AHP method

Science.gov (United States)

Xu, Guangcheng; Zhao, Kuimin; Zuo, Zhaoying; Liu, Gang; Jian, Binguo; Lin, Yan; Fan, Yukun; Wang, Fei

2018-04-01

The paper assesses the risks of vessel floating in the seawater for draft survey by using the analytic hierarchy process. On this basis, the paper established draft survey risk index from the view of draft reading, ballast water, fresh water, and calculation process and so on. Then the paper proposes the method to deal with risk assessment using one concrete sample.

What European gynaecologists need to master: Consensus on medical expertise outcomes of pan-European postgraduate training in obstetrics & gynaecology.

Science.gov (United States)

van der Aa, Jessica E; Tancredi, Annalisa; Goverde, Angelique J; Velebil, Petr; Feyereisl, Jaroslav; Benedetto, Chiara; Teunissen, Pim W; Scheele, Fedde

2017-09-01

European harmonisation of training standards in postgraduate medical education in Obstetrics and Gynaecology is needed because of the increasing mobility of medical specialists. Harmonisation of training will provide quality assurance of training and promote high quality care throughout Europe. Pan-European training standards should describe medical expertise outcomes that are required from the European gynaecologist. This paper reports on consensus development on the medical expertise outcomes of pan-European training in Obstetrics and Gynaecology. A Delphi procedure was performed amongst European gynaecologists and trainees in Obstetrics & Gynaecology, to develop consensus on outcomes of training. The consensus procedure consisted of two questionnaire rounds, followed by a consensus meeting. To ensure reasonability and feasibility for implementation of the training standards in Europe, implications of the outcomes were considered in a working group thereafter. We invited 142 gynaecologists and trainees in Obstetrics & Gynaecology for participation representing a wide range of European countries. They were selected through the European Board & College of Obstetrics and Gynaecology and the European Network of Trainees in Obstetrics & Gynaecology. Sixty people participated in round 1 and 2 of the consensus procedure, 38 (63.3%) of whom were gynaecologists and 22 (36.7%) were trainees in Obstetrics & Gynaecology. Twenty-eight European countries were represented in this response. Round 3 of the consensus procedure was performed in a consensus meeting with six experts. Implications of the training outcomes were discussed in a working group meeting, to ensure reasonability and feasibility of the material for implementation in Europe. The entire consensus procedure resulted in a core content of training standards of 188 outcomes, categorised in ten topics. European consensus was developed regarding the medical expertise outcomes of pan-European training in Obstetrics and

On the Drafting of Confidentiality Agreements

DEFF Research Database (Denmark)

Drewsen, Merete; Lando, Henrik; Cummins, Tim

2006-01-01

This is not a theoretical paper but an application of existing law and economic contract theory to the issue of how to draft a specific kind of contract. It is addressed to practitioners and is intended for practical use. It will be part of a Wiki (as in Wikipedia) for contract drafting, which...

Voting-based consensus clustering for combining multiple clusterings of chemical structures

Directory of Open Access Journals (Sweden)

Saeed Faisal

2012-12-01

Full Text Available Abstract Background Although many consensus clustering methods have been successfully used for combining multiple classifiers in many areas such as machine learning, applied statistics, pattern recognition and bioinformatics, few consensus clustering methods have been applied for combining multiple clusterings of chemical structures. It is known that any individual clustering method will not always give the best results for all types of applications. So, in this paper, three voting and graph-based consensus clusterings were used for combining multiple clusterings of chemical structures to enhance the ability of separating biologically active molecules from inactive ones in each cluster. Results The cumulative voting-based aggregation algorithm (CVAA, cluster-based similarity partitioning algorithm (CSPA and hyper-graph partitioning algorithm (HGPA were examined. The F-measure and Quality Partition Index method (QPI were used to evaluate the clusterings and the results were compared to the Ward’s clustering method. The MDL Drug Data Report (MDDR dataset was used for experiments and was represented by two 2D fingerprints, ALOGP and ECFP_4. The performance of voting-based consensus clustering method outperformed the Ward’s method using F-measure and QPI method for both ALOGP and ECFP_4 fingerprints, while the graph-based consensus clustering methods outperformed the Ward’s method only for ALOGP using QPI. The Jaccard and Euclidean distance measures were the methods of choice to generate the ensembles, which give the highest values for both criteria. Conclusions The results of the experiments show that consensus clustering methods can improve the effectiveness of chemical structures clusterings. The cumulative voting-based aggregation algorithm (CVAA was the method of choice among consensus clustering methods.

The draft genome of watermelon (Citrullus lanatus) and resequencing of 20 diverse accessions

DEFF Research Database (Denmark)

Guo, Shaogui; Zhang, Jianguo; Sun, Honghe

2013-01-01

Watermelon, Citrullus lanatus, is an important cucurbit crop grown throughout the world. Here we report a high-quality draft genome sequence of the east Asia watermelon cultivar 97103 (2n = 2× = 22) containing 23,440 predicted protein-coding genes. Comparative genomics analysis provided an evolut...

10 CFR 51.70 - Draft environmental impact statement-general.

Science.gov (United States)

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Draft environmental impact statement-general. 51.70... Implementing Section 102(2) Environmental Impact Statements § 51.70 Draft environmental impact statement—general. (a) The NRC staff will prepare a draft environmental impact statement as soon as practicable...

10 CFR 51.71 - Draft environmental impact statement-contents.

Science.gov (United States)

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Draft environmental impact statement-contents. 51.71... Implementing Section 102(2) Environmental Impact Statements § 51.71 Draft environmental impact statement—contents. (a) Scope. The draft environmental impact statement will be prepared in accordance with the scope...

Towards global consensus on core outcomes for hidradenitis suppurativa research: an update from the HISTORIC consensus meetings I and II*

Science.gov (United States)

Thorlacius, L.; Garg, A.; Ingram, J.R.; Villumsen, B.; Riis, P. Theut; Gottlieb, A.B.; Merola, J.F.; Dellavalle, R.; Ardon, C.; Baba, R.; Bechara, F.G.; Cohen, A.D.; Daham, N.; Davis, M.; Emtestam, L.; Fernández-Peñas, P.; Filippelli, M.; Gibbons, A.; Grant, T.; Guilbault, S.; Gulliver, S.; Harris, C; Harvent, C.; Houston, K.; Kirby, J.S.; Matusiak, L.; Mehdizadeh, A.; Mojica, T.; Okun, M.; Orgill, D.; Pallack, L.; Parks-Miller, A.; Prens, E.P.; Randell, S.; Rogers, C.; Rosen, C.F.; Choon, S.E.; van der Zee, H.H.; Christensen, R.; Jemec, G.B.E.

2018-01-01

Summary Background A core outcomes set (COS) is an agreed minimum set of outcomes that should be measured and reported in all clinical trials for a specific condition. Hidradenitis suppurativa (HS) has no agreed-upon COS. A central aspect in the COS development process is to identify a set of candidate outcome domains from a long list of items. Our long list had been developed from patient interviews, a systematic review of the literature and a healthcare professional survey, and initial votes had been cast in two e-Delphi surveys. In this manuscript, we describe two in-person consensus meetings of Delphi participants designed to ensure an inclusive approach to generation of domains from related items. Objectives To consider which items from a long list of candidate items to exclude and which to cluster into outcome domains. Methods The study used an international and multistakeholder approach, involving patients, dermatologists, surgeons, the pharmaceutical industry and medical regulators. The study format was a combination of formal presentations, small group work based on nominal group theory and a subsequent online confirmation survey. Results Forty-one individuals from 13 countries and four continents participated. Nine items were excluded and there was consensus to propose seven domains: disease course, physical signs, HS-specific quality of life, satisfaction, symptoms, pain and global assessments. Conclusions The HISTORIC consensus meetings I and II will be followed by further e-Delphi rounds to finalize the core domain set, building on the work of the in-person consensus meetings. PMID:29080368

Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)

DEFF Research Database (Denmark)

Chalmers, J. R.; Simpson, Elizabeth M; Apfelbacher, C. J.

2016-01-01

and quality of life for the HOME core outcome set for atopic eczema (AE). Following presentations, which included data from systematic reviews, consensus discussions were held in a mixture of whole group and small group discussions. Small groups were allocated a priori to ensure representation of different...... in addition to their frequency. Much of the discussion on quality of life concerned the Dermatology Life Quality Index and Quality of Life Index for Atopic Dermatitis; however, consensus on a preferred instrument for measuring this domain could not be reached. In summary, POEM is recommended as the HOME core...

Accuracy of professional sports drafts in predicting career potential.

Science.gov (United States)

Koz, D; Fraser-Thomas, J; Baker, J

2012-08-01

The forecasting of talented players is a crucial aspect of building a successful sports franchise and professional sports invest significant resources in making player choices in sport drafts. The current study examined the relationship between career performance (i.e. games played) and draft round for the National Football League, National Hockey League, National Basketball League, and Major League Baseball for players drafted from 1980 to 1989 (n = 4874) against the assumption of a linear relationship between performance and draft round (i.e. that players with the most potential will be selected before players of lower potential). A two-step analysis revealed significant differences in games played across draft rounds (step 1) and a significant negative relationship between draft round and games played (step 2); however, the amount of variance accounted for was relatively low (less than 17%). Results highlight the challenges of accurately evaluating amateur talent. © 2011 John Wiley & Sons A/S.

Multidisciplinary Rectal Cancer Management: 2nd European Rectal Cancer Consensus Conference (EURECA-CC2)

International Nuclear Information System (INIS)

Valentini, Vincenzo; Aristei, Cynthia; Glimelius, Bengt; Minsky, Bruce D.; Beets-Tan, Regina; Borras, Jose M.; Haustermans, Karin; Maingon, Philippe; Overgaard, Jens; Pahlman, Lars; Quirke, Phil; Schmoll, Hans-Joachim; Sebag-Montefiore, David; Taylor, Irving; Van Cutsem, Eric; Velde, Cornelius Van de; Cellini, Numa; Latini, Paolo

2009-01-01

Background and purpose: During the first decade of the 21st century a number of important European randomized studies were published. In order to help shape clinical practice based on best scientific evidence from the literature, the International Conference on 'Multidisciplinary Rectal Cancer Treatment: Looking for an European Consensus' (EURECA-CC2) was organized in Italy under the endorsement of European Society of Medical Oncology (ESMO), European Society of Surgical Oncology (ESSO), and European Society of Therapeutic Radiation Oncology (ESTRO). Methods: Consensus was achieved using the Delphi method. The document was available to all Committee members as a web-based document customized for the consensus process. Eight chapters were identified: epidemiology, diagnostics, pathology, surgery, radiotherapy and chemotherapy, treatment toxicity and quality of life, follow-up, and research questions. Each chapter was subdivided by a topic, and a series of statements were developed. Each member commented and voted, sentence by sentence thrice. Sentences upon which an agreement was not reached after voting round no. 2 were openly debated during a Consensus Conference in Perugia (Italy) from 11 December to 13 December 2008. A hand-held televoting system collected the opinions of both the Committee members and the audience after each debate. The Executive Committee scored percentage consensus based on three categories: 'large consensus', 'moderate consensus', and 'minimum consensus'. Results: The total number of the voted sentences was 207. Of the 207, 86% achieved large consensus, 13% achieved moderate consensus, and only 3 (1%) resulted in minimum consensus. No statement was disagreed by more than 50% of the members. All chapters were voted on by at least 75% of the members, and the majority was voted on by >85%. Conclusions: This Consensus Conference represents an expertise opinion process that may help shape future programs, investigational protocols, and guidelines

75 FR 36091 - Notice of Availability of the Draft Environmental Impact Statement for Improvements to the...

Science.gov (United States)

2010-06-24

... Environmental Quality Advisor, Portfolio Management Division, Capital Investment Branch (9P2PTC), U.S. General...://www.gsa.gov/nepalibrary . Other matters regarding this environmental review should be referred to Greg... GENERAL SERVICES ADMINISTRATION Notice of Availability of the Draft Environmental Impact Statement...

Cluster: Drafting. Course: Basic Technical Drafting. Research Project.

Science.gov (United States)

Sanford - Lee County Schools, NC.

The set of six units is designed for use with an instructor in basic technical drafting and is also keyed to other texts. Each unit contains several task packages specifying prerequisites, rationale for learning, objectives, learning activities to be supervised by the instructor, and learning practice. The units cover: pictorial drawing; screw…

Dynamic Average Consensus and Consensusability of General Linear Multiagent Systems with Random Packet Dropout

Directory of Open Access Journals (Sweden)

Wen-Min Zhou

2013-01-01

Full Text Available This paper is concerned with the consensus problem of general linear discrete-time multiagent systems (MASs with random packet dropout that happens during information exchange between agents. The packet dropout phenomenon is characterized as being a Bernoulli random process. A distributed consensus protocol with weighted graph is proposed to address the packet dropout phenomenon. Through introducing a new disagreement vector, a new framework is established to solve the consensus problem. Based on the control theory, the perturbation argument, and the matrix theory, the necessary and sufficient condition for MASs to reach mean-square consensus is derived in terms of stability of an array of low-dimensional matrices. Moreover, mean-square consensusable conditions with regard to network topology and agent dynamic structure are also provided. Finally, the effectiveness of the theoretical results is demonstrated through an illustrative example.

Consensus on core phenomena and statements describing Basic Body Awareness Therapy within the movement awareness domain in physiotherapy.

Science.gov (United States)

Skjaerven, L H; Mattsson, M; Catalan-Matamoros, D; Parker, A; Gard, G; Gyllensten, A Lundvik

2018-02-26

Physiotherapists are facing complex health challenges in the treatment of persons suffering from long-lasting musculoskeletal disorders and mental health problems. Basic Body Awareness Therapy (BBAT) is a physiotherapy approach within the movement awareness domain developed to bridge physical, mental, and relational health challenges. The purpose of this study was to reach a consensus on core phenomena and statements describing BBAT. A consensus-building process was conducted using the nominal group technique (NGT). Twenty-one BBAT experts from 10 European countries participated in a concentrated weekend workshop of 20 hours. All participants signed informed consent. Participants reached a consensus on 138 core phenomena, clustered in three overarching categories: clinical core, historical roots, and research and evaluation phenomena. Of the 106 clinical core phenomena, the participants agreed on three categories of phenomena: movement quality, movement awareness practice, and movement awareness therapy and pedagogy. Furthermore, the participants reached 100 percent consensus on 16 of 30 statements describing BBAT. This study provides a consensus on core phenomena and statements describing BBAT. The data reveal phenomena implemented when promoting movement quality through movement awareness. Data provide clarity in some aspects of the vocabulary as fundamental theory. Further reearch will be developed.

R2R - software to speed the depiction of aesthetic consensus RNA secondary structures

Directory of Open Access Journals (Sweden)

Weinberg Zasha

2011-01-01

Full Text Available Abstract Background With continuing identification of novel structured noncoding RNAs, there is an increasing need to create schematic diagrams showing the consensus features of these molecules. RNA structural diagrams are typically made either with general-purpose drawing programs like Adobe Illustrator, or with automated or interactive programs specific to RNA. Unfortunately, the use of applications like Illustrator is extremely time consuming, while existing RNA-specific programs produce figures that are useful, but usually not of the same aesthetic quality as those produced at great cost in Illustrator. Additionally, most existing RNA-specific applications are designed for drawing single RNA molecules, not consensus diagrams. Results We created R2R, a computer program that facilitates the generation of aesthetic and readable drawings of RNA consensus diagrams in a fraction of the time required with general-purpose drawing programs. Since the inference of a consensus RNA structure typically requires a multiple-sequence alignment, the R2R user annotates the alignment with commands directing the layout and annotation of the RNA. R2R creates SVG or PDF output that can be imported into Adobe Illustrator, Inkscape or CorelDRAW. R2R can be used to create consensus sequence and secondary structure models for novel RNA structures or to revise models when new representatives for known RNA classes become available. Although R2R does not currently have a graphical user interface, it has proven useful in our efforts to create 100 schematic models of distinct noncoding RNA classes. Conclusions R2R makes it possible to obtain high-quality drawings of the consensus sequence and structural models of many diverse RNA structures with a more practical amount of effort. R2R software is available at http://breaker.research.yale.edu/R2R and as an Additional file.

R2R - software to speed the depiction of aesthetic consensus RNA secondary structures

Science.gov (United States)

2011-01-01

Background With continuing identification of novel structured noncoding RNAs, there is an increasing need to create schematic diagrams showing the consensus features of these molecules. RNA structural diagrams are typically made either with general-purpose drawing programs like Adobe Illustrator, or with automated or interactive programs specific to RNA. Unfortunately, the use of applications like Illustrator is extremely time consuming, while existing RNA-specific programs produce figures that are useful, but usually not of the same aesthetic quality as those produced at great cost in Illustrator. Additionally, most existing RNA-specific applications are designed for drawing single RNA molecules, not consensus diagrams. Results We created R2R, a computer program that facilitates the generation of aesthetic and readable drawings of RNA consensus diagrams in a fraction of the time required with general-purpose drawing programs. Since the inference of a consensus RNA structure typically requires a multiple-sequence alignment, the R2R user annotates the alignment with commands directing the layout and annotation of the RNA. R2R creates SVG or PDF output that can be imported into Adobe Illustrator, Inkscape or CorelDRAW. R2R can be used to create consensus sequence and secondary structure models for novel RNA structures or to revise models when new representatives for known RNA classes become available. Although R2R does not currently have a graphical user interface, it has proven useful in our efforts to create 100 schematic models of distinct noncoding RNA classes. Conclusions R2R makes it possible to obtain high-quality drawings of the consensus sequence and structural models of many diverse RNA structures with a more practical amount of effort. R2R software is available at http://breaker.research.yale.edu/R2R and as an Additional file. PMID:21205310

R2R--software to speed the depiction of aesthetic consensus RNA secondary structures.

Science.gov (United States)

Weinberg, Zasha; Breaker, Ronald R

2011-01-04

With continuing identification of novel structured noncoding RNAs, there is an increasing need to create schematic diagrams showing the consensus features of these molecules. RNA structural diagrams are typically made either with general-purpose drawing programs like Adobe Illustrator, or with automated or interactive programs specific to RNA. Unfortunately, the use of applications like Illustrator is extremely time consuming, while existing RNA-specific programs produce figures that are useful, but usually not of the same aesthetic quality as those produced at great cost in Illustrator. Additionally, most existing RNA-specific applications are designed for drawing single RNA molecules, not consensus diagrams. We created R2R, a computer program that facilitates the generation of aesthetic and readable drawings of RNA consensus diagrams in a fraction of the time required with general-purpose drawing programs. Since the inference of a consensus RNA structure typically requires a multiple-sequence alignment, the R2R user annotates the alignment with commands directing the layout and annotation of the RNA. R2R creates SVG or PDF output that can be imported into Adobe Illustrator, Inkscape or CorelDRAW. R2R can be used to create consensus sequence and secondary structure models for novel RNA structures or to revise models when new representatives for known RNA classes become available. Although R2R does not currently have a graphical user interface, it has proven useful in our efforts to create 100 schematic models of distinct noncoding RNA classes. R2R makes it possible to obtain high-quality drawings of the consensus sequence and structural models of many diverse RNA structures with a more practical amount of effort. R2R software is available at http://breaker.research.yale.edu/R2R and as an Additional file.

[Thyroid nodules and differentiated thyroid cancer: Brazilian consensus].

Science.gov (United States)

Maia, Ana Luiza; Ward, Laura S; Carvalho, Gisah A; Graf, Hans; Maciel, Rui M B; Maciel, Léa M Zanini; Rosário, Pedro W; Vaisman, Mario

2007-07-01

Thyroid nodules are a common manifestation of thyroid diseases. It is estimated that approximately 10% of adults have palpable thyroid nodules with the frequency increasing throughout life. The major concern on nodule evaluation is the risk of malignancy (5-10%). Differentiated thyroid carcinoma accounts for 90% of all thyroid malignant neoplasias. Although most patients with cancer have a favorable outcome, some individuals present an aggressive form of the disease and poor prognostic despite recent advances in diagnosis and treatment. Here, a set of clinical guidelines for the evaluation and management of patients with thyroid nodules or differentiated thyroid cancer was developed through consensus by 8 member of the Department of Thyroid, Sociedade Brasileira de Endocrinologia e Metabologia. The participants are from different reference medical centers within Brazil, to reflect different practice patterns. Each committee participant was initially assigned to write a section of the document and to submit it to the chairperson, who revised and assembled the sections into a complete draft document, which was then circulated among all committee members for further revision. All committee members further revised and refined the document. The guidelines were developed based on the expert opinion of the committee participants, as well as on previously published information.

Brief Comment on the Draft Land Administration, Use, Registration ...

African Journals Online (AJOL)

D_Behailu

The draft 'Land Administration, Use, Registration and Plan Proclamation (2007. EC)' has been in circulation for a while now. One of the prime objectives of the draft law is to address various counterproductive restrictions in the current federal land proclamation. According to its preamble, the draft aspires to expand the rights ...

World Endometriosis Society consensus on the classification of endometriosis.

Science.gov (United States)

Johnson, Neil P; Hummelshoj, Lone; Adamson, G David; Keckstein, Jörg; Taylor, Hugh S; Abrao, Mauricio S; Bush, Deborah; Kiesel, Ludwig; Tamimi, Rulla; Sharpe-Timms, Kathy L; Rombauts, Luk; Giudice, Linda C

2017-02-01

What is the global consensus on the classification of endometriosis that considers the views of women with endometriosis? We have produced an international consensus statement on the classification of endometriosis through systematic appraisal of evidence and a consensus process that included representatives of national and international, medical and non-medical societies, patient organizations, and companies with an interest in endometriosis. Classification systems of endometriosis, developed by several professional organizations, traditionally have been based on lesion appearance, pelvic adhesions, and anatomic location of disease. One system predicts fertility outcome and none predicts pelvic pain, response to medications, disease recurrence, risks for associated disorders, quality of life measures, and other endpoints important to women and health care providers for guiding appropriate therapeutic options and prognosis. A consensus meeting, in conjunction with pre- and post-meeting processes, was undertaken. A consensus meeting was held on 30 April 2014 in conjunction with the World Endometriosis Society's 12th World Congress on Endometriosis. Rigorous pre- and post-meeting processes, involving 55 representatives of 29 national and international, medical and non-medical organizations from a range of disciplines, led to this consensus statement. A total of 28 consensus statements were made. Of all, 10 statements had unanimous consensus, however none of the statements was made without expression of a caveat about the strength of the statement or the statement itself. Two statements did not achieve majority consensus. The statements covered women's priorities, aspects of classification, impact of low resources, as well as all the major classification systems for endometriosis. Until better classification systems are developed, we propose a classification toolbox (that includes the revised American Society for Reproductive Medicine and, where appropriate, the

High quality draft genome sequence of Janthinobacterium psychrotolerans sp. nov., isolated from a frozen freshwater pond

DEFF Research Database (Denmark)

Gong, Xianzhe; Skrivergaard, Stig; Korsgaard, Benjamin

2017-01-01

denitrification, and fermentation. The draft genome of strain S3-2T has a size of ~5.8 Mbp and contains 5,297 genes, including 115 RNA genes. Based on the phenotypic properties of the strain, the low in silico DNA-DNA hybridization (DDH) values with related genomes (

Consensus double reading of mammograms in private practice

International Nuclear Information System (INIS)

Pacher, B.; Tscherney, R.; Litmann-Rowenta, B.; Liskutin, J.; Mazewski, I.; Leitner, H.; Tscholakoff, D.

2004-01-01

Purpose: To evaluate retrospectively the results of consensus double reading of mammograms in a private practice for a period of 1.5 years (November 2001 to March 2003). Materials and Method: Two independent experts with dedicated training read all mammograms on a weekly basis. All mammograms including sonographic examinations were evaluated independently and categorized using the Bl-RADS classification. The achieved consensus included a possible recommendation for recall or therapy. A total of 3936 mammograms and 1912 sonography studies were evaluated. All cases with BI-RADS 4 and 5 categories were compared with the histologic results. For a period of three months, the acceptance of double reading including a delay of the final report by one week was tested with a questionnaire and informed consent sheet. Results: BI-RADS categories 4 and 5 were found in 57 cases, with 41 consensus results by two independent readers and 26 carcinomas verified by histology. No consensus could be reached in 16 patients, of which 10 had a final histologic result, with 5 benign lesions and 5 carcinomas of less than 1 cm in diameter. Clinical symptoms or alterations were absent in all patients. The 5 carcinomas were discovered by the double reading procedure. The result of the questionnaire (695 questionnaires) showed a refusal rate of 0.7%, with only 5 women refusing the opportunity of double reading their mammograms. Conclusion: Double reading of mammograms by independent experts is feasible, shows a measurable increase in quality and is accepted by almost all women. (orig.)

Staff supplement to the draft report on human engineering guide to control room evaluation: response to comments, sample checklist, draft systems review guidelines, and evaluation procedures

International Nuclear Information System (INIS)

1981-03-01

This staff supplement to Draft Report NUREG/CR-1580, Human Engineering Guide to Control Room Evaluation, provides staff responses to comments on the draft report and supplemental material not provided in the draft report. The supplemental material includes new draft guidelines for the systems review of nuclear power plant control rooms and sample checklists and corresponding human engineering guidelines

2010 International consensus algorithm for the diagnosis, therapy and management of hereditary angioedema

Directory of Open Access Journals (Sweden)

Bowen Tom

2010-07-01

Full Text Available Abstract Background We published the Canadian 2003 International Consensus Algorithm for the Diagnosis, Therapy, and Management of Hereditary Angioedema (HAE; C1 inhibitor [C1-INH] deficiency and updated this as Hereditary angioedema: a current state-of-the-art review: Canadian Hungarian 2007 International Consensus Algorithm for the Diagnosis, Therapy, and Management of Hereditary Angioedema. Objective To update the International Consensus Algorithm for the Diagnosis, Therapy and Management of Hereditary Angioedema (circa 2010. Methods The Canadian Hereditary Angioedema Network (CHAEN/Réseau Canadien d'angioédème héréditaire (RCAH http://www.haecanada.com and cosponsors University of Calgary and the Canadian Society of Allergy and Clinical Immunology (with an unrestricted educational grant from CSL Behring held our third Conference May 15th to 16th, 2010 in Toronto Canada to update our consensus approach. The Consensus document was reviewed at the meeting and then circulated for review. Results This manuscript is the 2010 International Consensus Algorithm for the Diagnosis, Therapy and Management of Hereditary Angioedema that resulted from that conference. Conclusions Consensus approach is only an interim guide to a complex disorder such as HAE and should be replaced as soon as possible with large phase III and IV clinical trials, meta analyses, and using data base registry validation of approaches including quality of life and cost benefit analyses, followed by large head-to-head clinical trials and then evidence-based guidelines and standards for HAE disease management.

Maintaining success, reducing treatment burden, focusing on survivorship: highlights from the third European consensus conference on diagnosis and treatment of germ-cell cancer.

Science.gov (United States)

Beyer, J; Albers, P; Altena, R; Aparicio, J; Bokemeyer, C; Busch, J; Cathomas, R; Cavallin-Stahl, E; Clarke, N W; Claßen, J; Cohn-Cedermark, G; Dahl, A A; Daugaard, G; De Giorgi, U; De Santis, M; De Wit, M; De Wit, R; Dieckmann, K P; Fenner, M; Fizazi, K; Flechon, A; Fossa, S D; Germá Lluch, J R; Gietema, J A; Gillessen, S; Giwercman, A; Hartmann, J T; Heidenreich, A; Hentrich, M; Honecker, F; Horwich, A; Huddart, R A; Kliesch, S; Kollmannsberger, C; Krege, S; Laguna, M P; Looijenga, L H J; Lorch, A; Lotz, J P; Mayer, F; Necchi, A; Nicolai, N; Nuver, J; Oechsle, K; Oldenburg, J; Oosterhuis, J W; Powles, T; Rajpert-De Meyts, E; Rick, O; Rosti, G; Salvioni, R; Schrader, M; Schweyer, S; Sedlmayer, F; Sohaib, A; Souchon, R; Tandstad, T; Winter, C; Wittekind, C

2013-04-01

In November 2011, the Third European Consensus Conference on Diagnosis and Treatment of Germ-Cell Cancer (GCC) was held in Berlin, Germany. This third conference followed similar meetings in 2003 (Essen, Germany) and 2006 (Amsterdam, The Netherlands) [Schmoll H-J, Souchon R, Krege S et al. European consensus on diagnosis and treatment of germ-cell cancer: a report of the European Germ-Cell Cancer Consensus Group (EGCCCG). Ann Oncol 2004; 15: 1377-1399; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of germ-cell cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part I. Eur Urol 2008; 53: 478-496; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of germ-cell cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part II. Eur Urol 2008; 53: 497-513]. A panel of 56 of 60 invited GCC experts from all across Europe discussed all aspects on diagnosis and treatment of GCC, with a particular focus on acute and late toxic effects as well as on survivorship issues. The panel consisted of oncologists, urologic surgeons, radiooncologists, pathologists and basic scientists, who are all actively involved in care of GCC patients. Panelists were chosen based on the publication activity in recent years. Before the meeting, panelists were asked to review the literature published since 2006 in 20 major areas concerning all aspects of diagnosis, treatment and follow-up of GCC patients, and to prepare an updated version of the previous recommendations to be discussed at the conference. In addition, ∼50 E-vote questions were drafted and presented at the conference to address the most controversial areas for a poll of expert opinions. Here, we present the main recommendations and controversies of this meeting. The votes of the panelists are added as online supplements.

Draft Genome Sequence of Bacillus sp. FMQ74, a Dairy-contaminating Isolate from Raw Milk

DEFF Research Database (Denmark)

Okshevsky, Mira Ursula; Regina, Viduthalai R.; Marshall, Ian

2017-01-01

Representatives of the genus Bacillus are common milk contaminants that cause spoilage and flavor alterations of dairy products. Bacillus sp. FMQ74 was isolated from raw milk on a Danish dairy farm. To elucidate the genomic basis of this strain’s survival in the dairy industry, a high-quality draft...

IRIS Toxicological Review of Methanol (Noncancer) (Interagency Science Discussion Draft)

Science.gov (United States)

On May 3, 2013, the Toxicological Review of Methanol (noncancer) (Revised External Review Draft) was posted for public review and comment. Subsequently, the draft Toxicological Review, Appendices, and draft IRIS Summary were reviewed internally by EPA and by other federal agenci...

India's draft nuclear doctrine

International Nuclear Information System (INIS)

Kapur, A.

2000-01-01

India's draft nuclear doctrine and its nuclear and missile testing are a response to recent international, regional and domestic developments. Nehru's policy of nuclear disarmament, non-discriminatory international arrangements and unilateral restraint has been overturned in favour of self-reliant security and negotiated nuclear restraints. The draft nuclear doctrine is aimed at transparency and formalization of existing capacities. It is anchored in the United Nations Charter, based on the legitimacy of self-defence and espouses minimum nuclear deterrence. After the launching of Pokhran II, the debate in India has been settled on weaponization and deployment. The doctrine is not country-specific with respect to threat perceptions, but the author posits that the long-term focus is on China and the short-term on Pakistan. The doctrine emphasizes civilian command and control. India's decision to test incurred diplomatic and other economic costs, but afforded new opportunities for the country to assert itself militarily and politically in Asia and in the world. There were no diplomatic costs in issuing the draft nuclear doctrine, but the author estimates the economic costs of a full-blown (triad) Indian nuclear deterrent. (author)

Puget Sound area electric reliability plan. Draft environmental impact statement

Energy Technology Data Exchange (ETDEWEB)

1991-09-01

The Puget Sound Area Electric Reliability Plan Draft Environmental Impact Statement (DEIS) identifies the alternatives for solving a power system problem in the Puget Sound area. This Plan is undertaken by Bonneville Power Administration (BPA), Puget Sound Power & Light, Seattle City Light, Snohomish Public Utility District No. 1 (PUD), and Tacoma Public Utilities. The Plan consists of potential actions in Puget Sound and other areas in the State of Washington. A specific need exists in the Puget Sound area for balance between east-west transmission capacity and the increasing demand to import power generated east of the Cascades. At certain times of the year, there is more demand for power than the electric system can supply in the Puget Sound area. This high demand, called peak demand, occurs during the winter months when unusually cold weather increases electricity use for heating. The existing power system can supply enough power if no emergencies occur. However, during emergencies, the system will not operate properly. As demand grows, the system becomes more strained. To meet demand, the rate of growth of demand must be reduced or the ability to serve the demand must be increased, or both. The plan to balance Puget Sound`s power demand and supply has these purposes: The plan should define a set of actions that would accommodate ten years of load growth (1994--2003). Federal and State environmental quality requirements should be met. The plan should be consistent with the plans of the Northwest Power Planning Council. The plan should serve as a consensus guideline for coordinated utility action. The plan should be flexible to accommodate uncertainties and differing utility needs. The plan should balance environmental impacts and economic costs. The plan should provide electric system reliability consistent with customer expectations. 29 figs., 24 tabs.

Puget Sound Area Electric Reliability Plan : Draft Environmental Impact State.

Energy Technology Data Exchange (ETDEWEB)

United States. Bonneville Power Administration.

1991-09-01

The Puget Sound Area Electric Reliability Plan Draft Environmental Impact Statement (DEIS) identifies the alternatives for solving a power system problem in the Puget Sound area. This Plan is undertaken by Bonneville Power Administration (BPA), Puget Sound Power Light, Seattle City Light, Snohomish Public Utility District No. 1 (PUD), and Tacoma Public Utilities. The Plan consists of potential actions in Puget Sound and other areas in the State of Washington. A specific need exists in the Puget Sound area for balance between east-west transmission capacity and the increasing demand to import power generated east of the Cascades. At certain times of the year, there is more demand for power than the electric system can supply in the Puget Sound area. This high demand, called peak demand, occurs during the winter months when unusually cold weather increases electricity use for heating. The existing power system can supply enough power if no emergencies occur. However, during emergencies, the system will not operate properly. As demand grows, the system becomes more strained. To meet demand, the rate of growth of demand must be reduced or the ability to serve the demand must be increased, or both. The plan to balance Puget Sound's power demand and supply has these purposes: The plan should define a set of actions that would accommodate ten years of load growth (1994--2003). Federal and State environmental quality requirements should be met. The plan should be consistent with the plans of the Northwest Power Planning Council. The plan should serve as a consensus guideline for coordinated utility action. The plan should be flexible to accommodate uncertainties and differing utility needs. The plan should balance environmental impacts and economic costs. The plan should provide electric system reliability consistent with customer expectations. 29 figs., 24 tabs.

EURECCA colorectal: multidisciplinary management: European consensus conference colon & rectum.

Science.gov (United States)

van de Velde, Cornelis J H; Boelens, Petra G; Borras, Josep M; Coebergh, Jan-Willem; Cervantes, Andres; Blomqvist, Lennart; Beets-Tan, Regina G H; van den Broek, Colette B M; Brown, Gina; Van Cutsem, Eric; Espin, Eloy; Haustermans, Karin; Glimelius, Bengt; Iversen, Lene H; van Krieken, J Han; Marijnen, Corrie A M; Henning, Geoffrey; Gore-Booth, Jola; Meldolesi, Elisa; Mroczkowski, Pawel; Nagtegaal, Iris; Naredi, Peter; Ortiz, Hector; Påhlman, Lars; Quirke, Philip; Rödel, Claus; Roth, Arnaud; Rutten, Harm; Schmoll, Hans J; Smith, Jason J; Tanis, Pieter J; Taylor, Claire; Wibe, Arne; Wiggers, Theo; Gambacorta, Maria A; Aristei, Cynthia; Valentini, Vincenzo

2014-01-01

Care for patients with colon and rectal cancer has improved in the last 20years; however considerable variation still exists in cancer management and outcome between European countries. Large variation is also apparent between national guidelines and patterns of cancer care in Europe. Therefore, EURECCA, which is the acronym of European Registration of Cancer Care, is aiming at defining core treatment strategies and developing a European audit structure in order to improve the quality of care for all patients with colon and rectal cancer. In December 2012, the first multidisciplinary consensus conference about cancer of the colon and rectum was held. The expert panel consisted of representatives of European scientific organisations involved in cancer care of patients with colon and rectal cancer and representatives of national colorectal registries. The expert panel had delegates of the European Society of Surgical Oncology (ESSO), European Society for Radiotherapy & Oncology (ESTRO), European Society of Pathology (ESP), European Society for Medical Oncology (ESMO), European Society of Radiology (ESR), European Society of Coloproctology (ESCP), European CanCer Organisation (ECCO), European Oncology Nursing Society (EONS) and the European Colorectal Cancer Patient Organisation (EuropaColon), as well as delegates from national registries or audits. Consensus was achieved using the Delphi method. For the Delphi process, multidisciplinary experts were invited to comment and vote three web-based online voting rounds and to lecture on the subjects during the meeting (13th-15th December 2012). The sentences in the consensus document were available during the meeting and a televoting round during the conference by all participants was performed. This manuscript covers all sentences of the consensus document with the result of the voting. The consensus document represents sections on diagnostics, pathology, surgery, medical oncology, radiotherapy, and follow-up where

77 FR 66483 - Public Comment on the Draft Federal Urban Design Element and the Draft Update to the Federal...

Science.gov (United States)

2012-11-05

... NCPC review required by law. The new Federal Urban Design Element provides policies that will guide the... public comment a draft new Federal Urban Design Element and draft revisions to the Preservation and... Features Element articulates policies that guide federal actions preserving Washington's historic character...

In Brief: Geoengineering draft statement

Science.gov (United States)

Showstack, Randy

2009-04-01

The American Meteorological Society (AMS) has prepared a draft policy statement on geoengineering the climate system, which the AMS Council is considering for approval. The statement notes, “Geoengineering will not substitute for either aggressive mitigation or proactive adaptation. It could contribute to a comprehensive risk management strategy to slow climate change and alleviate its negative impacts, but the potential for adverse and unintended consequences implies a need for adequate research, appropriate regulation, and transparent consideration.” The statement, if adopted, indicates that AMS recommends enhanced research on the scientific and technological potential for geoengineering the climate system; additional study of the historical, ethical, legal, political, and societal aspects of the geoengineering issues; and the development and analysis of policy options to promote transparency and international cooperation in exploring geoengineering options along with restrictions on reckless efforts to manipulate the climate system. AMS is accepting comments on the draft statement until 23 April. For more information, visit http://ametsoc.org/policy/draftstatements/index.html#draft.

GAINING CONSENSUS: THE STORY OF ''OAK RIDGE TENNESSEE - A CITIZEN'S GUIDE TO THE ENVIRONMENT''

Energy Technology Data Exchange (ETDEWEB)

Craig, Robert; Freeman, Jenny; Gawarecki, Susan L; Hardy, Parker; Kopp, Steve; Mulvenon, Norman A; Pardue, William; Sarno, Doug

2003-02-27

In 2001, a diverse group of citizens ranging from conservationists to industrial developers joined forces to produce a factual description of Oak Ridge's environment and the issues associated with contamination on the U.S. Department of Energy (DOE) reservation. This consensus effort was a result of common values not generally seen in this spectrum of philosophies, and of shared concerns about rising property taxes, declining city services, fleeing retail establishments, and diminishing real estate values. These problems are attributed to waning local DOE budgets coupled with Oak Ridge's national reputation of being contaminated and unsafe. This undeserved reputation harms the city's ability to attract new industry to replace declining federal employment and to induce families to live in the community. Representatives from a spectrum of conservation, environmental, economic development, local government, and civic organizations were invited to meet regarding how to best explain the complex environmental story of Oak Ridge and the DOE reservation. This large group decided to publish a straightforward explanation of the environmental quality of the city and its relationship to the DOE reservation in easy-to-understand language. The result was Oak Ridge, Tennessee--A Citizen's Guide to the Environment, a 28-page glossy booklet, distributed through the Chamber of Commerce and other organizations. The Oak Ridger ensured wide distribution in the community by publishing it as an insert in the daily paper. The material is also available on several web sites. A trifold brochure summarizing and promoting the larger document was also produced for wider distribution. The integrity of the Citizen's Guide was ensured by having a six-member editorial team manage writing and review of the document. There was no direct involvement by the DOE and its contractor. Knowledgeable citizen writers from throughout the community contributed technical and descriptive

Development of a Draft Core Set of Domains for Measuring Shared Decision Making in Osteoarthritis

DEFF Research Database (Denmark)

Toupin-April, Karine; Barton, Jennifer; Fraenkel, Liana

2015-01-01

OBJECTIVE: Despite the importance of shared decision making for delivering patient-centered care in rheumatology, there is no consensus on how to measure its process and outcomes. The aim of this Outcome Measures in Rheumatology (OMERACT) working group is to determine the core set of domains...... for measuring shared decision making in intervention studies in adults with osteoarthritis (OA), from the perspectives of patients, health professionals, and researchers. METHODS: We followed the OMERACT Filter 2.0 method to develop a draft core domain set by (1) forming an OMERACT working group; (2) conducting...... a review of domains of shared decision making; and (3) obtaining opinions of all those involved using a modified nominal group process held at a session activity at the OMERACT 12 meeting. RESULTS: In all, 26 people from Europe, North America, and Australia, including 5 patient research partners...

Discussion on Integration of Welding Coordinator in Welding Quality System of KEPIC(Korea Electric Power Industry code)

Energy Technology Data Exchange (ETDEWEB)

Joo, Hyun-Jae; Sohn, Myoung-Sung; Cho, Kyoung-Youn; Kim, Jong-Hae [Korea Electric Association, Seoul (Korea, Republic of)

2015-05-15

The welding quality system of KEPIC-MQW 'Welding Qualification' referencing ASME BPVC Sec.IX, Part QW requires welding procedures and performance qualification of welder or welding operator excluding welding coordinator. It means that there is potential possibility of any problem in process of welding on nuclear power plants or shop in absence of an welding coordinator who can resolve welding troubles. Therefore, the integration of welding coordinators in the welding quality system of KEPIC can improve welding quality and enhance safety of construction and management of power plants. The introduction of welding coordinator requirement would put economic problems on manufactures for new employment and subsequent management works (eg. training) and field problems making authorized nuclear inspectors to be confused on inspection work scopes. Those predictable problems are expected to be minimized or eliminated through public hearings and/or seminars with regulatory body, the owner, and manufacturers and, most significantly, cooperation with related KEPIC committees. The revision draft was reviewed and discussed with personnel in nuclear industry by holding three workshop and public hearings from 2011 to 2012 and by having a presentation in 2014 KEPIC-Week. Industrial consensus on need for integration of welding coordinators in welding quality system of KEPIC was performed by reasons that it would improve welding quality, guarantee welding reliability, advance expertise, and help export to abroad. However, economic problems on manufacturers for new employment and subsequent management works, for example training, are predicted. Therefore, introduction in stages for minimizing industrial impact regarding manufacturer's scale and permission of utilizing external welding coordinator for small scale manufacturers are required. A new draft version of KEPIC-MQW (if possible, appendices of MQW) including requirements and directives for solving these economic

10 CFR 51.77 - Distribution of draft environmental impact statement.

Science.gov (United States)

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Distribution of draft environmental impact statement. 51...-Regulations Implementing Section 102(2) Draft Environmental Impact Statements-Production and Utilization Facilities § 51.77 Distribution of draft environmental impact statement. (a) In addition to the distribution...

In search for a public health leadership competency framework to support leadership curriculum-a consensus study.

Science.gov (United States)

Czabanowska, Katarzyna; Smith, Tony; Könings, Karen D; Sumskas, Linas; Otok, Robert; Bjegovic-Mikanovic, Vesna; Brand, Helmut

2014-10-01

Competency-based education is increasingly popular, especially in the area of continuing professional development. Many competency frameworks have been developed; however, few address leadership competencies for European public health professionals. The aim of this study was to develop a public health leadership competency framework to inform a leadership curriculum for public health professionals. The framework was developed as part of the Leaders for European Public Health project-supported by the EU Lifelong Learning Programme. The study was carried out in three phases: a literature review, consensus development panel and Delphi survey. The public health leadership competency framework was initially developed from a literature review. A preliminary list of competencies was submitted to a panel of experts. Two consensus development panels were held to evaluate and make changes to the initial draft competency framework. Then two rounds of a Delphi survey were carried out in an effort to reach consensus. Both surveys were presented through Survey Monkey to members of the Association of the Schools of Public Health in the European Region Working Group on Innovation in Public Health Teaching and Education. The framework was developed consisting of 52 competencies organized into eight domains: Systems Thinking; Political Leadership; Collaborative Leadership: Building and Leading Interdisciplinary Teams; Leadership and Communication; Leading Change; Emotional Intelligence and Leadership in Team-based Organizations; Leadership, Organizational Learning and Development and Ethics and Professionalism. The framework can serve as a useful tool in identifying gaps in knowledge and skills, and shaping competency-based continuing professional development leadership curricula for public health professionals in Europe. © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Debate on the Draft--Helping Students Decide Where They Stand.

Science.gov (United States)

Victory, James

1981-01-01

Presents four exercises to help secondary school social studies students understand the complex issues of the draft. Students participate in a mock draft lottery, analyze Phil Och's Draft Dodger Rag, examine how individual experiences affect attitudes, and compare writings by Bill Mauldin and Ron Kovic. (KC)

Standard operating procedures for ESPEN guidelines and consensus papers.

Science.gov (United States)

Bischoff, Stephan C; Singer, Pierre; Koller, Michael; Barazzoni, Rocco; Cederholm, Tommy; van Gossum, André

2015-12-01

The ESPEN Guideline standard operating procedures (SOP) is based on the methodology provided by the Association of Scientific Medical Societies of Germany (AWMF), the Scottish Intercollegiate Guidelines Network (SIGN), and the Centre for Evidence-based Medicine at the University of Oxford. The SOP is valid and obligatory for all future ESPEN-sponsored guideline projects aiming to generate high-quality guidelines on a regular basis. The SOP aims to facilitate the preparation of guideline projects, to streamline the consensus process, to ensure quality and transparency, and to facilitate the dissemination and publication of ESPEN guidelines. To achieve this goal, the ESPEN Guidelines Editorial board (GEB) has been established headed by two chairmen. The GEB will support and supervise the guideline processes and is responsible for the strategic planning of ESPEN guideline activities. Key elements of the SOP are the generation of well-built clinical questions according to the PICO system, a systemic literature search, a classification of the selected literature according to the SIGN evidence levels providing an evidence table, and a clear and straight-forward consensus procedure consisting of online voting's and a consensus conference. Only experts who meet the obligation to disclosure any potential conflict of interests and who are not employed by the Industry can participate in the guideline process. All recommendations will be graded according to the SIGN grading and novel outcome models besides biomedical endpoints. This approach will further extent the leadership of ESPEN in creating up-to-date and suitable for implementation guidelines and in sharing knowledge on malnutrition and clinical nutrition. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

75 FR 8046 - National Environmental Policy Act (NEPA) Draft Guidance, “Consideration of the Effects of Climate...

Science.gov (United States)

2010-02-23

..., ``Consideration of the Effects of Climate Change and Greenhouse Gas Emissions.'' AGENCY: Council On Environmental Quality. ACTION: Notice of Availability, Draft Guidance, ``Consideration of the Effects of Climate Change... visionary and versatile law that can be used effectively to address new environmental challenges facing our...

Implicit Consensus: Blockchain with Unbounded Throughput

OpenAIRE

Ren, Zhijie; Cong, Kelong; Pouwelse, Johan; Erkin, Zekeriya

2017-01-01

Recently, the blockchain technique was put in the spotlight as it introduced a systematic approach for multiple parties to reach consensus without needing trust. However, the application of this technique in practice is severely restricted due to its limitations in throughput. In this paper, we propose a novel consensus model, namely the implicit consensus, with a distinctive blockchain-based distributed ledger in which each node holds its individual blockchain. In our system, the consensus i...

The Limits of Consensus.

Science.gov (United States)

Poster, John B.

Dynamics in the education policy arena suggest that, despite two generations of researchers extolling democratic leadership styles and consensus building over autocratic techniques, wide participation in policymaking and the broadest possible consensus are not always productive: American society has not yet agreed on what schools should…

Final draft consultants report. Consultants' meeting on requirements for reference materials and intercomparison runs - IAEA programme on Analytical Quality Control Services (AQCS), 17-21 April 1994, Kona, HI, USA

International Nuclear Information System (INIS)

2002-01-01

The purpose of the meeting was to define the aims of the Agency's Analytical Quality Control Services (AQCS) programme in view of its uniqueness as an international programme and to establish objectives for the organization of intercomparison runs and production of reference materials and the Agency's services to Member States in future years. This draft report contains the meeting agenda and recommendations made by the consultants. The recommendations are grouped as follows: Mission Statement; Laboratory Qualification; Training and Development; Resources and Technical Concepts; Standing Group of Experts

Overcoming burdens in the regulation of clinical research in children. Proceedings of a consensus conference, in historical context

Directory of Open Access Journals (Sweden)

Levine Robert J

2011-12-01

Full Text Available Abstract Background Many investigators are concerned that the modes of implementation and enforcement of the federal regulations designed to protect children are unduly impeding pediatric clinical research. Objective To assess regulatory impediments to clinical research involving children and to develop recommendations to ameliorate them. Participants The Pediatric Endocrine Society and The Endocrine Society convened a consensus conference involving experts and stakeholders in patient-oriented research involving children and adolescents in 2008. Consensus process Following presentations that reviewed problematic issues around key regulations, participants divided into working groups to develop potential solutions that could be adopted at local and federal levels. Presentations to the full assembly were then debated. A writing committee then drafted a summary of the discussions and main conclusions, placing them in historical context, and submitted it to all participants for comment with the aim of developing consensus. Conclusions Recommendations designed to facilitate the ethical conduct of research involving children addressed the interpretation of ambiguous regulatory terms such as "minimal risk" and "condition" and called for the development by professional societies of best practice primers for common research procedures that would be informative to both investigators and institutional review boards. A call was issued for improved guidance from the Office for Human Research Protections and Food and Drug Administration as well as for the development by professional societies of a process to monitor progress in improving human subject research regulation. Finally, a need for systematic research to define the nature and extent of institutional obstacles to pediatric research was recognized.

Educator Toolkits on Second Victim Syndrome, Mindfulness and Meditation, and Positive Psychology: The 2017 Resident Wellness Consensus Summit

Directory of Open Access Journals (Sweden)

Jon Smart

2018-02-01

Full Text Available Introduction: Burnout, depression, and suicidality among residents of all specialties have become a critical focus of attention for the medical education community. Methods: As part of the 2017 Resident Wellness Consensus Summit in Las Vegas, Nevada, resident participants from 31 programs collaborated in the Educator Toolkit workgroup. Over a seven-month period leading up to the summit, this workgroup convened virtually in the Wellness Think Tank, an online resident community, to perform a literature review and draft curricular plans on three core wellness topics. These topics were second victim syndrome, mindfulness and meditation, and positive psychology. At the live summit event, the workgroup expanded to include residents outside the Wellness Think Tank to obtain a broader consensus of the evidence-based toolkits for these three topics. Results: Three educator toolkits were developed. The second victim syndrome toolkit has four modules, each with a pre-reading material and a leader (educator guide. In the mindfulness and meditation toolkit, there are three modules with a leader guide in addition to a longitudinal, guided meditation plan. The positive psychology toolkit has two modules, each with a leader guide and a PowerPoint slide set. These toolkits provide educators the necessary resources, reading materials, and lesson plans to implement didactic sessions in their residency curriculum. Conclusion: Residents from across the world collaborated and convened to reach a consensus on high-yield—and potentially high-impact—lesson plans that programs can use to promote and improve resident wellness. These lesson plans may stand alone or be incorporated into a larger wellness curriculum.

Educator Toolkits on Second Victim Syndrome, Mindfulness and Meditation, and Positive Psychology: The 2017 Resident Wellness Consensus Summit.

Science.gov (United States)

Chung, Arlene S; Smart, Jon; Zdradzinski, Michael; Roth, Sarah; Gende, Alecia; Conroy, Kylie; Battaglioli, Nicole

2018-03-01

Burnout, depression, and suicidality among residents of all specialties have become a critical focus of attention for the medical education community. As part of the 2017 Resident Wellness Consensus Summit in Las Vegas, Nevada, resident participants from 31 programs collaborated in the Educator Toolkit workgroup. Over a seven-month period leading up to the summit, this workgroup convened virtually in the Wellness Think Tank, an online resident community, to perform a literature review and draft curricular plans on three core wellness topics. These topics were second victim syndrome, mindfulness and meditation, and positive psychology. At the live summit event, the workgroup expanded to include residents outside the Wellness Think Tank to obtain a broader consensus of the evidence-based toolkits for these three topics. Three educator toolkits were developed. The second victim syndrome toolkit has four modules, each with a pre-reading material and a leader (educator) guide. In the mindfulness and meditation toolkit, there are three modules with a leader guide in addition to a longitudinal, guided meditation plan. The positive psychology toolkit has two modules, each with a leader guide and a PowerPoint slide set. These toolkits provide educators the necessary resources, reading materials, and lesson plans to implement didactic sessions in their residency curriculum. Residents from across the world collaborated and convened to reach a consensus on high-yield-and potentially high-impact-lesson plans that programs can use to promote and improve resident wellness. These lesson plans may stand alone or be incorporated into a larger wellness curriculum.

10 CFR 51.73 - Request for comments on draft environmental impact statement.

Science.gov (United States)

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Request for comments on draft environmental impact...-Regulations Implementing Section 102(2) Environmental Impact Statements § 51.73 Request for comments on draft environmental impact statement. Each draft environmental impact statement and each supplement to a draft...

46 CFR 169.755 - Draft marks and draft indicating systems.

Science.gov (United States)

2010-10-01

... Section 169.755 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Vessel Control, Miscellaneous Systems, and Equipment Markings § 169.755 Draft marks and... projections of the marks onto a vertical plane are of uniform height equal to the vertical spacing between...

10 CFR 51.72 - Supplement to draft environmental impact statement.

Science.gov (United States)

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Supplement to draft environmental impact statement. 51.72... Implementing Section 102(2) Environmental Impact Statements § 51.72 Supplement to draft environmental impact statement. (a) The NRC staff will prepare a supplement to a draft environmental impact statement for which a...

Possibilities of consensus: toward democratic moral discourse.

Science.gov (United States)

Jennings, B

1991-08-01

The concept of consensus is often appealed to in discussions of biomedical ethics and applied ethics, and it plays an important role in many influential ethical theories. Consensus is an especially influential notion among theorists who reject ethical realism and who frame ethics as a practice of discourse rather than a body of objective knowledge. It is also a practically important notion when moral decision making is subject to bureaucratic organization and oversight, as is increasingly becoming the case in medicine. Two models of consensus are examined and criticized: pluralistic consensus and overlapping consensus. As an alternative to these models, the paper argues that consensus refers to the dialogic aspects of a broader normative conception of democratic moral agency. When the preconditions for that dialogic democratic practice are met, consensus has a justificatory role in ethics; when they are not, consensus, as distinct from mere agreement, does not emerge and can have no moral authority.

Draft genome sequences of seven isolates of Phytophthora ramorum EU2 from Northern Ireland

Directory of Open Access Journals (Sweden)

Lourdes de la Mata Saez

2015-12-01

Full Text Available Here we present draft-quality genome sequence assemblies for the oomycete Phytophthora ramorum genetic lineage EU2. We sequenced genomes of seven isolates collected in Northern Ireland between 2010 and 2012. Multiple genome sequences from P. ramorum EU2 will be valuable for identifying genetic variation within the clonal lineage that can be useful for tracking its spread.

Semi-supervised consensus clustering for gene expression data analysis

OpenAIRE

Wang, Yunli; Pan, Youlian

2014-01-01

Background Simple clustering methods such as hierarchical clustering and k-means are widely used for gene expression data analysis; but they are unable to deal with noise and high dimensionality associated with the microarray gene expression data. Consensus clustering appears to improve the robustness and quality of clustering results. Incorporating prior knowledge in clustering process (semi-supervised clustering) has been shown to improve the consistency between the data partitioning and do...

Increasing draft capability for retrofit flue gas desulfurization systems

International Nuclear Information System (INIS)

Petersen, R.D.; Basel, B.E.; Mosier, R.J.

1992-01-01

The retrofit installation of flue gas desulfurization (FGD) systems results in significantly higher draft losses for existing generating stations. Consequently, the means for increasing draft capability must be included in many FGD retrofit projects. Consideration is given to several alternatives for increasing draft capability. Alternatives are developed for new induced draft (ID) fans to replace the existing ID fans and for new booster fans to supplement the existing ID fans. Both centrifugal and axial fans are evaluated, as are different means of fan volume control. Each alternative is evaluated on the basis of technical merit and economics. Presented are the development of fan alternatives and results of the technical and economic evaluations

The establishment of an ethical guideline for genetic testing through citizen consensus via the Internet in Taiwan.

Science.gov (United States)

Lin, Chiou-Fen; Lu, Meei-Shiow; Chung, Chun-Chih; Yang, Che-Ming

2010-10-18

With the rapid advance of genetics, the application of genetic testing has become increasingly popular. Test results have had a tremendous impact on individuals who receive the test and his or her family. The ethical, legal, and social implications (ELSI) of genetic testing cannot be overlooked. The Internet is a potential tool for public engagement. This study aimed at establishing ethical guidelines for genetic testing in Taiwan through a participatory citizen consensus approach via the Internet. The research method used was a citizen consensus conference modified by an Internet application and the Delphi technique. The citizen consensus conference is one of the public participation mechanisms. The draft ethical guidelines for genetic testing were written by an expert panel of 10. The Delphi technique was applied to a citizen panel recruited via the Internet until a consensus was reached. Our research population was restricted to people who had Internet access. Included in the citizen panel were 100 individuals. A total of 3 individuals dropped out of the process. The citizen panel was exposed to the issues through Internet learning and sharing. In all, 3 rounds of anonymous questionnaires were administered before a consensus was reached in terms of importance and feasibility. The result was ethical guidelines composed of 4 categories and 25 items. The 4 categories encompassed decision making (6 items), management of tissue samples (5 items), release of results (8 items), and information flow (6 items). On a scale of 1 to 10, the average (SD) importance score for the decision-making category was 9.41 (SD 0.58); for the management of tissue samples category, the average score was 9.62 (SD 0.49); for the release of results category, the average score was 9.34 (SD= 0.59); and for the information flow category, the average score was 9.6 (SD = 0.43). Exploratory analyses indicated that participants with higher education tended to attribute more importance to these

CFD based draft tube hydraulic design optimization

International Nuclear Information System (INIS)

McNabb, J; Murry, N; Mullins, B F; Devals, C; Kyriacou, S A

2014-01-01

The draft tube design of a hydraulic turbine, particularly in low to medium head applications, plays an important role in determining the efficiency and power characteristics of the overall machine, since an important proportion of the available energy, being in kinetic form leaving the runner, needs to be recovered by the draft tube into static head. For large units, these efficiency and power characteristics can equate to large sums of money when considering the anticipated selling price of the energy produced over the machine's life-cycle. This same draft tube design is also a key factor in determining the overall civil costs of the powerhouse, primarily in excavation and concreting, which can amount to similar orders of magnitude as the price of the energy produced. Therefore, there is a need to find the optimum compromise between these two conflicting requirements. In this paper, an elaborate approach is described for dealing with this optimization problem. First, the draft tube's detailed geometry is defined as a function of a comprehensive set of design parameters (about 20 of which a subset is allowed to vary during the optimization process) and are then used in a non-uniform rational B-spline based geometric modeller to fully define the wetted surfaces geometry. Since the performance of the draft tube is largely governed by 3D viscous effects, such as boundary layer separation from the walls and swirling flow characteristics, which in turn governs the portion of the available kinetic energy which will be converted into pressure, a full 3D meshing and Navier-Stokes analysis is performed for each design. What makes this even more challenging is the fact that the inlet velocity distribution to the draft tube is governed by the runner at each of the various operating conditions that are of interest for the exploitation of the powerhouse. In order to determine these inlet conditions, a combined steady-state runner and an initial draft tube analysis

CFD based draft tube hydraulic design optimization

Science.gov (United States)

McNabb, J.; Devals, C.; Kyriacou, S. A.; Murry, N.; Mullins, B. F.

2014-03-01

The draft tube design of a hydraulic turbine, particularly in low to medium head applications, plays an important role in determining the efficiency and power characteristics of the overall machine, since an important proportion of the available energy, being in kinetic form leaving the runner, needs to be recovered by the draft tube into static head. For large units, these efficiency and power characteristics can equate to large sums of money when considering the anticipated selling price of the energy produced over the machine's life-cycle. This same draft tube design is also a key factor in determining the overall civil costs of the powerhouse, primarily in excavation and concreting, which can amount to similar orders of magnitude as the price of the energy produced. Therefore, there is a need to find the optimum compromise between these two conflicting requirements. In this paper, an elaborate approach is described for dealing with this optimization problem. First, the draft tube's detailed geometry is defined as a function of a comprehensive set of design parameters (about 20 of which a subset is allowed to vary during the optimization process) and are then used in a non-uniform rational B-spline based geometric modeller to fully define the wetted surfaces geometry. Since the performance of the draft tube is largely governed by 3D viscous effects, such as boundary layer separation from the walls and swirling flow characteristics, which in turn governs the portion of the available kinetic energy which will be converted into pressure, a full 3D meshing and Navier-Stokes analysis is performed for each design. What makes this even more challenging is the fact that the inlet velocity distribution to the draft tube is governed by the runner at each of the various operating conditions that are of interest for the exploitation of the powerhouse. In order to determine these inlet conditions, a combined steady-state runner and an initial draft tube analysis, using a

Effects of Consensus Training on the Reliability of Auditory Perceptual Ratings of Voice Quality

DEFF Research Database (Denmark)

Iwarsson, Jenny; Petersen, Niels Reinholt

2012-01-01

Objectives/Hypothesis: This study investigates the effect of consensus training of listeners on intrarater and interrater reliability and agreement of perceptual voice analysis. The use of such training, including a reference voice sample, could be assumed to make the internal standards held in m...

European Society for Paediatric Endocrinology Consensus Guidelines on Screening, Diagnosis, and Management of Congenital Hypothyroidism

Science.gov (United States)

Léger, Juliane; Olivieri, Antonella; Donaldson, Malcolm; Torresani, Toni; Krude, Heiko; van Vliet, Guy; Polak, Michel

2014-01-01

Objective: The aim was to formulate practice guidelines for the diagnosis and management of congenital hypothyroidism (CH). Evidence: A systematic literature search was conducted to identify key articles relating to the screening, diagnosis, and management of CH. The evidence-based guidelines were developed with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system, describing both the strength of recommendations and the quality of evidence. In the absence of sufficient evidence, conclusions were based on expert opinion. Consensus Process: Thirty-two participants drawn from the European Society for Paediatric Endocrinology and five other major scientific societies in the field of pediatric endocrinology were allocated to working groups with assigned topics and specific questions. Each group searched the literature, evaluated the evidence, and developed a draft document. These papers were debated and finalized by each group before presentation to the full assembly for further discussion and agreement. Recommendations: The recommendations include: worldwide neonatal screening, approaches to assess the cause (including genotyping) and the severity of the disorder, the immediate initiation of appropriate L-T4 supplementation and frequent monitoring to ensure dose adjustments to keep thyroid hormone levels in the target ranges, a trial of treatment in patients suspected of transient CH, regular assessments of developmental and neurosensory functions, consulting health professionals as appropriate, and education about CH. The harmonization of diagnosis, management, and routine health surveillance would not only optimize patient outcomes, but should also facilitate epidemiological studies of the disorder. Individuals with CH require monitoring throughout their lives, particularly during early childhood and pregnancy. PMID:24446653

76 FR 57751 - Notice of Availability of a Draft Programmatic Environmental Impact Statement for Northern Border...

Science.gov (United States)

2011-09-16

... particular place. Because this effort is programmatic in nature, the Draft PEIS does not define effects for a... the purposes of the PEIS, the Northern Border is defined as the area between the United States and... environmental quality and the government's role in protecting it. The essence of NEPA is the requirement that...

Continuity and consensus

DEFF Research Database (Denmark)

Abrahamson, Peter

2010-01-01

maternal leave. These changes can be explained as adjustments to post-industrial conditions within a political culture relying on class compromises and a broad consensus informed by expert advice coming from civil servants and ad hoc policy commissions. The paper concludes that changes in Danish family...... policy reflect changing conditions for employment and the minding of children and that there has been a high degree of continuity and consensus about the change, as indicated by the strong increase in female labour market involvement....

Governance beyond the European Consensus on Development: What Drives EU Aid Selectivity?

NARCIS (Netherlands)

W. Hout (Wil)

2013-01-01

textabstractThis paper focuses on the ‘governance turn’ in the development policies of the European Union, represented in particular by the adoption of the ‘European Consensus on Development’ in 2005. The main assumption inherent in the EU approach to development is that the quality of governance in

A study of swirl flow in draft tubes

Energy Technology Data Exchange (ETDEWEB)

Dahlhaug, Ole Gunnar

1997-12-31

This thesis presents measurements performed inside conical diffuser and bend, draft tubes of model hydro turbines, and draft tube of a prototype hydro turbine. Experimental results for swirling flow in conical diffuser and bend are presented in three different geometries. The axial velocity decreases at the centre of the tube at high swirl numbers because of an axial pressure gradient set up by the downstream frictional damping of the tangential velocities and the pressure increase downstream of the diffuser. Analytical models of the tangential velocity profiles are found and the radial pressure distribution calculated. Good correlation to the measured pressure distribution was achieved. Diffuser efficiency was calculated based on the equations for velocity and pressure profiles, which gave a qualified estimate of the diffuser hydraulic performance. The calculation shows that the bend reduces the efficiency by more than 30%. For a straight tube followed by a diffuser, numerical calculations were done, using K{epsilon}, RNG and RSM turbulence models for all measured swirl numbers. The K{epsilon} model gave best results for the forced vortex profile at low swirl numbers, while the RSM model gave best results at high swirl number. The turbulent kinetic energy at high swirl numbers gave the largest difference between the calculated and the measured values. Measurements on draft tubes in model turbines show the importance of good draft tube design. Prototype measurements on a Francis turbine show how the outlet draft tube flow should be measured for prototype draft tube evaluation. 54 refs., 118 figs., 2 tabs.

A study of swirl flow in draft tubes

Energy Technology Data Exchange (ETDEWEB)

Dahlhaug, Ole Gunnar

1998-12-31

This thesis presents measurements performed inside conical diffuser and bend, draft tubes of model hydro turbines, and draft tube of a prototype hydro turbine. Experimental results for swirling flow in conical diffuser and bend are presented in three different geometries. The axial velocity decreases at the centre of the tube at high swirl numbers because of an axial pressure gradient set up by the downstream frictional damping of the tangential velocities and the pressure increase downstream of the diffuser. Analytical models of the tangential velocity profiles are found and the radial pressure distribution calculated. Good correlation to the measured pressure distribution was achieved. Diffuser efficiency was calculated based on the equations for velocity and pressure profiles, which gave a qualified estimate of the diffuser hydraulic performance. The calculation shows that the bend reduces the efficiency by more than 30%. For a straight tube followed by a diffuser, numerical calculations were done, using K{epsilon}, RNG and RSM turbulence models for all measured swirl numbers. The K{epsilon} model gave best results for the forced vortex profile at low swirl numbers, while the RSM model gave best results at high swirl number. The turbulent kinetic energy at high swirl numbers gave the largest difference between the calculated and the measured values. Measurements on draft tubes in model turbines show the importance of good draft tube design. Prototype measurements on a Francis turbine show how the outlet draft tube flow should be measured for prototype draft tube evaluation. 54 refs., 118 figs., 2 tabs.

Rating scale for the assessment of competence in ultrasound-guided peripheral vascular access - a Delphi Consensus Study

DEFF Research Database (Denmark)

Primdahl, Stine C; Todsen, Tobias; Clemmesen, Marie Louise

2016-01-01

a global rating scale (RS) for assessment of UGVA competence based on opinions on the content from ultrasound experts in a modified Delphi consensus study. METHODS: We included experts from anesthesiology, emergency medicine and radiology across university hospitals in Denmark. Nine elements were drafted...... based on existing literature and recommendations from international societies. In a multi-round survey, the experts rated the elements on a five-point Likert scale according to importance, and suggested missing elements. The final Delphi round occurred when >80% of the experts rated all elements ≥4...... on the Likert scale. RESULTS: Sixteen experts consented to participate in the study, one withdrew consent prior to the first Delphi round, and 14 completed all three Delphi rounds. In the first Delphi round the experts excluded one element from the scale and changed the content of two elements. In the second...

Multi-Optimisation Consensus Clustering

Science.gov (United States)

Li, Jian; Swift, Stephen; Liu, Xiaohui

Ensemble Clustering has been developed to provide an alternative way of obtaining more stable and accurate clustering results. It aims to avoid the biases of individual clustering algorithms. However, it is still a challenge to develop an efficient and robust method for Ensemble Clustering. Based on an existing ensemble clustering method, Consensus Clustering (CC), this paper introduces an advanced Consensus Clustering algorithm called Multi-Optimisation Consensus Clustering (MOCC), which utilises an optimised Agreement Separation criterion and a Multi-Optimisation framework to improve the performance of CC. Fifteen different data sets are used for evaluating the performance of MOCC. The results reveal that MOCC can generate more accurate clustering results than the original CC algorithm.

Informed consent -- Building consensus

International Nuclear Information System (INIS)

Lovenheim, R.

1990-01-01

The author shares his observations and offers an approach to 'building consensus' for what he believes is the only environmentally sound option, i.e., safe, permanent disposal of low-level radioactive waste (LLRW). Consensus does not mean unanimity, acceptance, or harmony. The low-level radioactive waste disposal issue is fraught with fear and hysteria. The paper discusses major emotions that fracture public opinion regarding this issue. The author defines consensus as the informed consent of LLRW disposal strategies by a majority of citizens whose cooperation is required to achieve the goals of environmentally sound solution. The political aspects are reviewed. The need for US Department of Energy to fulfill its importance technical assistance role is discussed

78 FR 26616 - Draft NOAA Five Year Research and Development Plan

Science.gov (United States)

2013-05-07

... DEPARTMENT OF COMMERCE Draft NOAA Five Year Research and Development Plan AGENCY: National Oceanic and Atmospheric Administration (NOAA), Department of Commerce (DOC). ACTION: Draft NOAA Five Year Research and Development Plan for Public Review. SUMMARY: NOAA's draft Five Year Research and Development...

Numerical simulation of draft tube flow of a bulb turbine

Energy Technology Data Exchange (ETDEWEB)

Coelho, J.G. [Federal University of Triangulo Mineiro, Institute of Technological and Exact Sciences, Avenida Doutor Randolfo Borges Junior, 1250 – Uberaba – MG (Brazil); Brasil, A.C.P. Jr. [University of Brasilia, Department of Mechanical Engineering, Campus Darcy Ribeiro, Brasilia – DF (Brazil)

2013-07-01

In this work a numerical study of draft tube of a bulb hydraulic turbine is presented, where a new geometry is proposed. This new proposal of draft tube has the unaffected ratio area, a great reduction in his length and approximately the same efficiency of the draft tube conventionally used. The numerical simulations were obtained in commercial software of calculation of flow (CFX-14), using the turbulence model SST, that allows a description of the field fluid dynamic near to the wall. The simulation strategy has an intention of identifying the stall of the boundary layer precisely limits near to the wall and recirculations in the central part, once those are the great causes of the decrease of efficiency of a draft tube. Finally, it is obtained qualitative and quantitative results about the flow in draft tubes.

Draft of regulations for road transport of radioactive wastes

International Nuclear Information System (INIS)

Gese, J.; Zizka, B.

1979-06-01

A draft regulation is presented for the transport of solid and solidified radioactive wastes from nuclear power plants. The draft takes into consideration dosimetric, safety and fire-fighting directives, transport organization, anticipated amounts of radioactive wastes, characteristics of containers, maintenance of vehicles, and equipment of vehicles and personnel. The draft is based on the provisional regulations governing the transport on public roads issued in 1973, valid directives, decrees, acts and standards, and complies with 1973 IAEA requirements. (J.P.)

Analysis of the Kaplan turbine draft tube effect

International Nuclear Information System (INIS)

Motycak, L; Skotak, A; Obrovsky, J

2010-01-01

The aim of this paper is to present information about possible problems and errors which can appear during numerical analyses of low head Kaplan turbines with a view to the runner - draft tube interaction. The setting of numerical model, grid size, used boundary conditions are the interface definition between runner and draft tube are discussed. There are available data from physical model tests which gives a great opportunity to compare CFD and experiment results and on the basis of this comparison to determine the approach to the CFD flow modeling. The main purpose for the Kaplan turbine model measurement was to gather the information about real flow field. The model tests were carried out in new hydraulic laboratory of CKD Blansko Engineering. The model tests were focused on the detailed velocity measurements downstream of the runner by differential pressure probe and on the velocity measurement downstream of the draft tube elbow by Particle Image Velocimetry method (PIV). The data from CFD simulation were compared to the velocity measurement results. In the paper also the design of the original draft tube modification due to flow improvement is discussed in the case of the Kaplan turbine uprating project. The results of the draft tube modification were confirmed by model tests in the hydraulic laboratory as well.

Analysis of the Kaplan turbine draft tube effect

Energy Technology Data Exchange (ETDEWEB)

Motycak, L; Skotak, A; Obrovsky, J, E-mail: motycak.vhs@cbeng.c [CKD Blansko Engineering, a.s., Capkova 2357/5, Blansko 67801 (Czech Republic)

2010-08-15

The aim of this paper is to present information about possible problems and errors which can appear during numerical analyses of low head Kaplan turbines with a view to the runner - draft tube interaction. The setting of numerical model, grid size, used boundary conditions are the interface definition between runner and draft tube are discussed. There are available data from physical model tests which gives a great opportunity to compare CFD and experiment results and on the basis of this comparison to determine the approach to the CFD flow modeling. The main purpose for the Kaplan turbine model measurement was to gather the information about real flow field. The model tests were carried out in new hydraulic laboratory of CKD Blansko Engineering. The model tests were focused on the detailed velocity measurements downstream of the runner by differential pressure probe and on the velocity measurement downstream of the draft tube elbow by Particle Image Velocimetry method (PIV). The data from CFD simulation were compared to the velocity measurement results. In the paper also the design of the original draft tube modification due to flow improvement is discussed in the case of the Kaplan turbine uprating project. The results of the draft tube modification were confirmed by model tests in the hydraulic laboratory as well.

Analysis of the Kaplan turbine draft tube effect

Science.gov (United States)

Motycak, L.; Skotak, A.; Obrovsky, J.

2010-08-01

The aim of this paper is to present information about possible problems and errors which can appear during numerical analyses of low head Kaplan turbines with a view to the runner - draft tube interaction. The setting of numerical model, grid size, used boundary conditions are the interface definition between runner and draft tube are discussed. There are available data from physical model tests which gives a great opportunity to compare CFD and experiment results and on the basis of this comparison to determine the approach to the CFD flow modeling. The main purpose for the Kaplan turbine model measurement was to gather the information about real flow field. The model tests were carried out in new hydraulic laboratory of CKD Blansko Engineering. The model tests were focused on the detailed velocity measurements downstream of the runner by differential pressure probe and on the velocity measurement downstream of the draft tube elbow by Particle Image Velocimetry method (PIV). The data from CFD simulation were compared to the velocity measurement results. In the paper also the design of the original draft tube modification due to flow improvement is discussed in the case of the Kaplan turbine uprating project. The results of the draft tube modification were confirmed by model tests in the hydraulic laboratory as well.

16 CFR 1.84 - Draft environmental impact statements: Availability and comment.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Draft environmental impact statements... Environmental Policy Act of 1969 § 1.84 Draft environmental impact statements: Availability and comment. Except for proposals for legislation, environmental impact statements shall be prepared in two stages: Draft...

10 CFR 51.76 - Draft environmental impact statement-limited work authorization.

Science.gov (United States)

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Draft environmental impact statement-limited work...-Regulations Implementing Section 102(2) Draft Environmental Impact Statements-Production and Utilization Facilities § 51.76 Draft environmental impact statement—limited work authorization. The NRC will prepare a...

10 CFR 51.117 - Draft environmental impact statement-notice of availability.

Science.gov (United States)

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Draft environmental impact statement-notice of... environmental impact statement—notice of availability. (a) Upon completion of a draft environmental impact statement or any supplement to a draft environmental impact statement, the appropriate NRC staff director...

78 FR 77027 - Overhead Clearance (Air-Draft) Accidents

Science.gov (United States)

2013-12-20

... No. USCG-2013-0466] Overhead Clearance (Air-Draft) Accidents AGENCY: Coast Guard, DHS. ACTION... clearance (air-draft) accidents. In its petition, which calls for vessel masters to be provided with... accidents that it says were avoidable and that resulted in damage to or destruction of waterway...

76 FR 9210 - Draft DOC National Aquaculture Policy

Science.gov (United States)

2011-02-16

... DEPARTMENT OF COMMERCE Draft DOC National Aquaculture Policy AGENCY: Commerce. ACTION: Notice of availability of draft aquaculture policy; request for comments. SUMMARY: The Department of Commerce (DOC) is... United States. The intent of the policy is to guide DOC's actions and decisions on aquaculture and to...

23 CFR 771.123 - Draft environmental impact statements.

Science.gov (United States)

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Draft environmental impact statements. 771.123 Section... ENVIRONMENT ENVIRONMENTAL IMPACT AND RELATED PROCEDURES § 771.123 Draft environmental impact statements. (a) A... significant impacts on the environment. When the applicant, after consultation with any project sponsor that...

Introduction to Production/Manufacturing Drafting. Drafting Module 8. Instructor's Guide.

Science.gov (United States)

Missouri Univ., Columbia. Instructional Materials Lab.

This module, 1 of 10 in the Drafting curriculum guide developed in Missouri, contains 3 units of study that include some or all of the following components: performance objectives, lesson plans, information sheets, transparency masters, handouts, assignment sheets, job sheets, a unit test, and answers to the unit test. Special instructions on…

II Brazilian consensus statement on endoscopic ultrasonography.

Science.gov (United States)

Maluf-Filho, Fauze; de Oliveira, Joel Fernandez; Mendonça, Ernesto Quaresma; Carbonari, Augusto; Maciente, Bruno Antônio; Salomão, Bruno Chaves; Medrado, Bruno Frederico; Dotti, Carlos Marcelo; Lopes, César Vivian; Braga, Cláudia Utsch; M Dutra, Daniel Alencar; Retes, Felipe; Nakao, Frank; de Sousa, Giovana Biasia; de Paulo, Gustavo Andrade; Ardengh, Jose Celso; Dos Santos, Juliana Bonfim; Sampaio, Luciana Moura; Okawa, Luciano; Rossini, Lucio; de Brito Cardoso, Manoel Carlos; Ribeiro Camunha, Marco Antonio; Clarêncio, Marcos; Lera Dos Santos, Marcos Eduardo; Franco, Matheus; Schneider, Nutianne Camargo; Mascarenhas, Ramiro; Roda, Rodrigo; Matuguma, Sérgio; Guaraldi, Simone; Figueiredo, Viviane

2017-01-01

At the time of its introduction in the early 80s, endoscopic ultrasonography (EUS) was indicated for diagnostic purposes. Recently, EUS has been employed to assist or to be the main platform of complex therapeutic interventions. From a series of relevant new topics in the literature and based on the need to complement the I Brazilian consensus on EUS, twenty experienced endosonographers identified and reviewed the pertinent literature in databases. The quality of evidence, strength of recommendations, and level of consensus were graded and voted on. Consensus was reached for eight relevant topics: treatment of gastric varices, staging of nonsmall cell lung cancer, biliary drainage, tissue sampling of subepithelial lesions (SELs), treatment of pancreatic fluid collections, tissue sampling of pancreatic solid lesions, celiac neurolysis, and evaluation of the incidental pancreatic cysts. There is a high level of evidence for staging of nonsmall cell lung cancer; biopsy of SELs as the safest method; unilateral and bilateral injection techniques are equivalent for EUS-guided celiac neurolysis, and in patients with visible ganglia, celiac ganglia neurolysis appears to lead to better results. There is a moderate level of evidence for: yield of tissue sampling of pancreatic solid lesions is not influenced by the needle shape, gauge, or employed aspiration technique; EUS-guided and percutaneous biliary drainage present similar clinical success and adverse event rates; plastic and metallic stents are equivalent in the EUS-guided treatment of pancreatic pseudocyst. There is a low level of evidence in the routine use of EUS-guided treatment of gastric varices.

Reduced order model of draft tube flow

International Nuclear Information System (INIS)

Rudolf, P; Štefan, D

2014-01-01

Swirling flow with compact coherent structures is very good candidate for proper orthogonal decomposition (POD), i.e. for decomposition into eigenmodes, which are the cornerstones of the flow field. Present paper focuses on POD of steady flows, which correspond to different operating points of Francis turbine draft tube flow. Set of eigenmodes is built using a limited number of snapshots from computational simulations. Resulting reduced order model (ROM) describes whole operating range of the draft tube. ROM enables to interpolate in between the operating points exploiting the knowledge about significance of particular eigenmodes and thus reconstruct the velocity field in any operating point within the given range. Practical example, which employs axisymmetric simulations of the draft tube flow, illustrates accuracy of ROM in regions without vortex breakdown together with need for higher resolution of the snapshot database close to location of sudden flow changes (e.g. vortex breakdown). ROM based on POD interpolation is very suitable tool for insight into flow physics of the draft tube flows (especially energy transfers in between different operating points), for supply of data for subsequent stability analysis or as an initialization database for advanced flow simulations

Considerations about noise aspects in the EEC draft directive physical agents

NARCIS (Netherlands)

Passchier-Vermeer, W.

1992-01-01

This report contains an overview of and considerations about the Working Draft of a future EEC Directive Physical Agents (draft 1991). The overview in this report is limited to noise exposure. The Draft gives minimum regulations concerning the protection of workers and prevention against the risks

Treatment of Soft Tissue Filler Complications: Expert Consensus Recommendations.

Science.gov (United States)

Urdiales-Gálvez, Fernando; Delgado, Nuria Escoda; Figueiredo, Vitor; Lajo-Plaza, José V; Mira, Mar; Moreno, Antonio; Ortíz-Martí, Francisco; Del Rio-Reyes, Rosa; Romero-Álvarez, Nazaret; Del Cueto, Sofía Ruiz; Segurado, María A; Rebenaque, Cristina Villanueva

2018-04-01

Dermal fillers have been increasingly used in minimally invasive facial esthetic procedures. This widespread use has led to a rise in reports of associated complications. The aim of this expert consensus report is to describe potential adverse events associated with dermal fillers and to provide guidance on their treatment and avoidance. A multidisciplinary group of experts in esthetic treatments convened to discuss the management of the complications associated with dermal fillers use. A search was performed for English, French, and Spanish language articles in MEDLINE, the Cochrane Database, and Google Scholar using the search terms "complications" OR "soft filler complications" OR "injectable complications" AND "dermal fillers" AND "Therapy". An initial document was drafted by the Coordinating Committee, and it was reviewed and modified by the experts, until a final text was agreed upon and validated. The panel addressed consensus recommendations about the classification of filler complications according to the time of onset and about the clinical management of different complications including bruising, swelling, edema, infections, lumps and bumps, skin discoloration, and biofilm formation. Special attention was paid to vascular compromise and retinal artery occlusion. Clinicians should be fully aware of the signs and symptoms related to complications and be prepared to confidently treat them. Establishing action protocols for emergencies, with agents readily available in the office, would reduce the severity of adverse outcomes associated with injection of hyaluronic acid fillers in the cosmetic setting. This document seeks to lay down a set of recommendations and to identify key issues that may be useful for clinicians who are starting to use dermal fillers. Additionally, this document provides a better understanding about the diagnoses and management of complications if they do occur. This journal requires that authors assign a level of evidence to each

Enzyme Replacement Therapy and/or Hematopoietic Stem Cell Transplantation at diagnosis in patients with Mucopolysaccharidosis type I: results of a European consensus procedure

LENUS (Irish Health Repository)

de Ru, Minke H

2011-08-10

Abstract Background Mucopolysaccharidosis type I (MPS I) is a lysosomal storage disorder that results in the accumulation of glycosaminoglycans causing progressive multi-organ dysfunction. Its clinical spectrum is very broad and varies from the severe Hurler phenotype (MPS I-H) which is characterized by early and progressive central nervous system (CNS) involvement to the attenuated Scheie phenotype (MPS I-S) with no CNS involvement. Indication, optimal timing, safety and efficacy of the two available treatment options for MPS I, enzyme replacement therapy (ERT) and hematopoietic stem cell transplantation (HSCT), are subject to continuing debate. A European consensus procedure was organized to reach consensus about the use of these two treatment strategies. Methods A panel of specialists, including 8 specialists for metabolic disorders and 7 bone marrow transplant physicians, all with acknowledged expertise in MPS I, participated in a modified Delphi process to develop consensus-based statements on MPS I treatment. Fifteen MPS I case histories were used to initiate the discussion and to anchor decisions around either treatment mode. Before and at the meeting all experts gave their opinion on the cases (YES\\/NO transplantation) and reasons for their decisions were collected. A set of draft statements on MPS I treatment options composed by a planning committee were discussed and revised during the meeting until full consensus. Results Full consensus was reached on several important issues, including the following: 1) The preferred treatment for patients with MPS I-H diagnosed before age 2.5 yrs is HSCT; 2) In individual patients with an intermediate phenotype HSCT may be considered if there is a suitable donor. However, there are no data on efficacy of HSCT in patients with this phenotype; 3) All MPS I patients including those who have not been transplanted or whose graft has failed may benefit significantly from ERT; 4) ERT should be started at diagnosis and may be

78 FR 66010 - Draft Risk Profile on Pathogens and Filth in Spices; Availability

Science.gov (United States)

2013-11-04

...] Draft Risk Profile on Pathogens and Filth in Spices; Availability AGENCY: Food and Drug Administration... availability of a draft risk profile entitled ``FDA Draft Risk Profile: Pathogens and Filth in Spices'' (draft... posed by consumption of spices in the United States by identifying the most commonly occurring microbial...

Draft 1988 mission plan amendment

International Nuclear Information System (INIS)

1988-06-01

This draft 1988 amendment to the Mission Plan for the Civilian Radioactive Waste Management Program has been prepared by the US Department of Energy (DOE). The purpose is to inform the Congress of the DOE's plans for implementing the provisions of the Nuclear Waste Policy Amendments Act of 1987 (P.L. 100-203) for the Civilian Radioactive Waste Management Program. This document is being submitted in draft form to Federal agencies, states, previously affected Indian Tribes, affected units of local government, and the public. After the consideration of comments, this amendment will be revised as appropriate and submitted to the Congress. 39 refs., 7 figs., 4 tabs

Quality Metrics in Neonatal and Pediatric Critical Care Transport: A National Delphi Project.

Science.gov (United States)

Schwartz, Hamilton P; Bigham, Michael T; Schoettker, Pamela J; Meyer, Keith; Trautman, Michael S; Insoft, Robert M

2015-10-01

The transport of neonatal and pediatric patients to tertiary care facilities for specialized care demands monitoring the quality of care delivered during transport and its impact on patient outcomes. In 2011, pediatric transport teams in Ohio met to identify quality indicators permitting comparisons among programs. However, no set of national consensus quality metrics exists for benchmarking transport teams. The aim of this project was to achieve national consensus on appropriate neonatal and pediatric transport quality metrics. Modified Delphi technique. The first round of consensus determination was via electronic mail survey, followed by rounds of consensus determination in-person at the American Academy of Pediatrics Section on Transport Medicine's 2012 Quality Metrics Summit. All attendees of the American Academy of Pediatrics Section on Transport Medicine Quality Metrics Summit, conducted on October 21-23, 2012, in New Orleans, LA, were eligible to participate. Candidate quality metrics were identified through literature review and those metrics currently tracked by participating programs. Participants were asked in a series of rounds to identify "very important" quality metrics for transport. It was determined a priori that consensus on a metric's importance was achieved when at least 70% of respondents were in agreement. This is consistent with other Delphi studies. Eighty-two candidate metrics were considered initially. Ultimately, 12 metrics achieved consensus as "very important" to transport. These include metrics related to airway management, team mobilization time, patient and crew injuries, and adverse patient care events. Definitions were assigned to the 12 metrics to facilitate uniform data tracking among programs. The authors succeeded in achieving consensus among a diverse group of national transport experts on 12 core neonatal and pediatric transport quality metrics. We propose that transport teams across the country use these metrics to

Assessment and improvement of radiation oncology trainee contouring ability utilizing consensus-based penalty metrics

International Nuclear Information System (INIS)

Hallock, Abhirami; Read, Nancy; D'Souza, David

2012-01-01

The objective of this study was to develop and assess the feasibility of utilizing consensus-based penalty metrics for the purpose of critical structure and organ at risk (OAR) contouring quality assurance and improvement. A Delphi study was conducted to obtain consensus on contouring penalty metrics to assess trainee-generated OAR contours. Voxel-based penalty metric equations were used to score regions of discordance between trainee and expert contour sets. The utility of these penalty metric scores for objective feedback on contouring quality was assessed by using cases prepared for weekly radiation oncology radiation oncology trainee treatment planning rounds. In two Delphi rounds, six radiation oncology specialists reached agreement on clinical importance/impact and organ radiosensitivity as the two primary criteria for the creation of the Critical Structure Inter-comparison of Segmentation (CriSIS) penalty functions. Linear/quadratic penalty scoring functions (for over- and under-contouring) with one of four levels of severity (none, low, moderate and high) were assigned for each of 20 OARs in order to generate a CriSIS score when new OAR contours are compared with reference/expert standards. Six cases (central nervous system, head and neck, gastrointestinal, genitourinary, gynaecological and thoracic) then were used to validate 18 OAR metrics through comparison of trainee and expert contour sets using the consensus derived CriSIS functions. For 14 OARs, there was an improvement in CriSIS score post-educational intervention. The use of consensus-based contouring penalty metrics to provide quantitative information for contouring improvement is feasible.

Recommended procedures for performance testing of radiobioassay laboratories: Volume 1, Quality assurance

International Nuclear Information System (INIS)

Fenrick, H.W.; MacLellan, J.A.

1988-11-01

Draft American National Standards Institute (ANSI) Standard N13.30 (Performance Criteria for Radiobioassay) was developed in response to a concern expressed by the US Department of Energy and US Nuclear Regulatory Commission to help ensure that bioassay laboratories provide accurate and consistent results. The draft standard specifies the criteria for defining the procedures necessary to establish a bioassay performance-testing laboratory and program. The testing laboratory will conduct tests to evaluate the performance of service laboratories. Pacific Northwest Laboratory helped define responsibilities and develop procedures as part of an effort to evaluate the draft ANSI N13.30 performance criteria for quality assurance at bioassay laboratories. This report recommends elements of quality assurance and quality control responsibilities for the bioassay performance-testing laboratory program, including the qualification and performance of personnel and the calibration, certification, and performance of equipment. The data base and recommended records system for documenting radiobioassay performance at the service laboratories are also presented. 15 refs

77 FR 38844 - Notice of NIH Consensus Development Conference: Diagnosing Gestational Diabetes Mellitus

Science.gov (United States)

2012-06-29

... diabetes mellitus should be recommended, if any? 7. What are the key research gaps in the diagnostic... pregnancy). It is defined as carbohydrate intolerance, which is the inability of the body to adequately... for Healthcare Research and Quality's Evidence-based Practice Centers program, and a Consensus...

The Diabetes Surgery Summit consensus conference: recommendations for the evaluation and use of gastrointestinal surgery to treat type 2 diabetes mellitus.

Science.gov (United States)

Rubino, Francesco; Kaplan, Lee M; Schauer, Philip R; Cummings, David E

2010-03-01

To develop guidelines for the use of gastrointestinal surgery to treat type 2 diabetes and to craft an agenda for further research. Increasing evidence demonstrates that bariatric surgery can dramatically ameliorate type 2 diabetes. Not surprisingly, gastrointestinal operations are now being used throughout the world to treat diabetes in association with obesity, and increasingly, for diabetes alone. However, the role for surgery in diabetes treatment is not clearly defined and there are neither clear guidelines for these practices nor sufficient plans for clinical trials to evaluate the risks and benefits of such "diabetes surgery." A multidisciplinary group of 50 voting delegates from around the world gathered in Rome, Italy for the first International Conference on Gastrointestinal Surgery to Treat Type 2 Diabetes--(the "Diabetes Surgery Summit"). During the meeting, available scientific evidence was examined and critiqued by the entire group to assess the strength of evidence and to draft consensus statements. Through an iterative process, draft statements were then serially discussed, debated, edited, reassessed, and finally presented for formal voting. After the Rome meeting, statements that achieved consensus were summarized and distributed to all voting delegates for further input and final approval. These statements were then formally critiqued by representatives of several sientific societies at the 1st World Congress on Interventional Therapies for T2DM (New York, Sept 2008). Input from this discussion was used to generate the current position statement. A Diabetes Surgery Summit (DSS) Position Statement consists of recommendations for clinical and research issues, as well as general concepts and definitions in diabetes surgery. The DSS recognizes the legitimacy of surgical approaches to treat diabetes in carefully selected patients. For example, gastric bypass was deemed a reasonable treatment option for patients with poorly controlled diabetes and a

75 FR 43496 - Department of the Army: Intent to Prepare a Draft Environmental Impact Statement for the General...

Science.gov (United States)

2010-07-26

... implementation of the alternative plans. The District will work as part of a team to include the New York State... Engineers, New York District (District), is preparing a Draft Environmental Impact Statement (DEIS) to...) document in accordance with the President's Council of Environmental Quality (CEQ) Rules and Regulations...

A consensus-based guideline defining the clinical target volume for pelvic lymph nodes in external beam radiotherapy for uterine cervical cancer

International Nuclear Information System (INIS)

Toita, Takafumi; Ohno, Tatsuya; Kaneyasu, Yuko

2010-01-01

The objective of this study was to develop a consensus-based guideline as well as an atlas defining pelvic nodal clinical target volumes in external beam radiotherapy for uterine cervical cancer. A working subgroup to establish the consensus-based guideline on clinical target volumes for uterine cervical cancer was formulated by the Radiation Therapy Study Group of the Japan Clinical Oncology Group in July 2008. The working subgroup consisted of seven radiation oncologists. The process resulting in the consensus included a comparison of contouring on CT images among the members, reviewing of published textbooks and the relevant literature and a distribution analysis of metastatic nodes on computed tomography/magnetic resonance imaging of actual patients. The working subgroup defined the pelvic nodal clinical target volumes for cervical cancer and developed an associated atlas. As a basic criterion, the lymph node clinical target volume was defined as the area encompassed by a 7 mm margin around the applicable pelvic vessels. Modifications were made in each nodal area to cover adjacent adipose tissues at risk of microscopic nodal metastases. Although the bones and muscles were excluded, the bowel was not routinely excluded in the definition. Each of the following pelvic node regions was defined: common iliac, external iliac, internal iliac, obturator and presacral. Anatomical structures bordering each lymph node region were defined for six directions; anterior, posterior, lateral, medial, cranial and caudal. Drafts of the definition and the atlas were reviewed by members of the JCOG Gynecologic Cancer Study Group (GCSG). We developed a consensus-based guideline defining the pelvic node clinical target volumes that included an atlas. The guideline will be continuously updated to reflect the ongoing changes in the field. (author)

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

Science.gov (United States)

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

2012-05-15

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

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

Science.gov (United States)

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

2012-01-01

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

On random pressure pulses in the turbine draft tube

Science.gov (United States)

Kuibin, P. A.; Shtork, S. I.; Skripkin, S. G.; Tsoy, M. A.

2017-04-01

The flow in the conical part of the hydroturbine draft tube undergoes various instabilities due to deceleration and flow swirling at off-design operation points. In particular, the precessing vortex rope develops at part-load regimes in the draft tube. This rope induces periodical low-frequency pressure oscillations in the draft tube. Interaction of rotational (asynchronous) mode of disturbances with the elbow can bring to strong oscillations in the whole hydrodynamical system. Recent researches on flow structure in the discharge cone in a regime of free runner had revealed that helical-like vortex rope can be unstable itself. Some coils of helix close to each other and reconnection appears with generation of a vortex ring. The vortex ring moves toward the draft tube wall and downstream. The present research is focused on interaction of vortex ring with wall and generation of pressure pulses.

43 CFR 46.110 - Incorporating consensus-based management.

Science.gov (United States)

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Incorporating consensus-based management... § 46.110 Incorporating consensus-based management. (a) Consensus-based management incorporates direct... carry out those plans and activities. For the purposes of this Part, consensus-based management involves...

Compliance to consensus recommendations, surgeon's experience, and introduction of a quality assurance and management program: influence on therapy of early-stage ovarian carcinoma.

Science.gov (United States)

Kommoss, Stefan; Harter, Philipp; Traut, Alexander; Strutas, Deivis; Riegler, Nina; Buhrmann, Christine; Gomez, Ruth; du Bois, Andreas

2009-05-01

State-of-the-art surgical staging and adjuvant chemotherapy in early-stage ovarian carcinoma have an impact on patient's outcome, but compliance to guidelines and consensus recommendations is still poor. This article reports on our results before and after introduction of a quality assurance and management program in our clinic in 2001. Patients with ovarian carcinoma limited to the pelvis who underwent primary surgery in our hospital from 1997 to October 2007 were eligible for this study. Univariate and multivariate logistic regression analyses were performed to evaluate the impact of compliance with our management program and physician's experience in ovarian carcinoma surgery on achieving both standards of surgery and chemotherapy. In a total of 117 women, a significant impact on adherence to guideline-defined comprehensive surgical staging was found for poor Eastern Cooperative Oncology Group performance status (odds ratio [OR], 22.16; confidence interval [CI] 3.2-152.0; P = 0.002) and year of surgery before 2001 (OR, 47.60; CI, 9.20-245.22; P grading less than G3 (OR, 4.14; CI, 1.20-14.22; P = 0.02) was a statistically significant predictor for receiving standard adjuvant chemotherapy. Survival analyses showed a trend toward improved survival for patients having received guideline-adopted therapy, but event numbers were too low for adequate analyses. The introduction of a quality assurance program for treatment of ovarian carcinoma represents a major improvement of patient care. It led to a higher compliance with consensus recommendations and showed already a trend toward improved outcome. Further outcome research should focus on methods for implementation of guidelines in daily practice in institutions caring for patients with ovarian carcinoma.

Building consensus in developing radioactive waste management systems

International Nuclear Information System (INIS)

Terrell, R.; Philpott, R.; Smith, S.L.; Gibson, J.

1991-01-01

To successfully develop radioactive waste management systems, national authorities must work to establish consensus on numerous complex issues among many affected and interested parties. This paper explores the meaning of consensus in waste management, with special attention to the different arenas in which consensus is established and how DOE can respond if consensus is withheld. Highlights of other national waste management programs are introduced to provide a broader perspective on consensus. It is suggested that the US waste management program has reached a point where Congress needs to act to reaffirm consensus on the direction of the US program

The UK shielding Forum. Best Practice through consensus

International Nuclear Information System (INIS)

Hobson, J.; Gunston, K.; Gunston, K.

2000-01-01

The UK national shielding Forum has been established to represent all key industry groups in the UK (including the Nuclear Installations Inspectorate (NII), the national regulatory authority). The Forum's aim is to increase awareness and confidence in the range of professional practice within the UK shielding community, with a view to having a coherent and dynamic role within the international shielding community. In the past, no comprehensive representative body covering the whole UK nuclear industry has existed, and the different industry shielding groups have developed local ways of working to address their particular requirements. Inevitably, there are common issues arising from these requirements which benefit from a wider consensus. As a result of the formation of the Forum (initiated by the NII and subsequently chaired by BNFL as an industry key player), expertise, experience and best working practice are now being actively shared between shielding professionals, and there has been a strong and successful drive to achieving consensus on key issues, which is also reflected in the increasing quality of industry-regulator relationships. (author)

Attitude extremity, consensus and diagnosticity

NARCIS (Netherlands)

van der Pligt, J.; Ester, P.; van der Linden, J.

1983-01-01

Studied the effects of attitude extremity on perceived consensus and willingness to ascribe trait terms to others with either pro- or antinuclear attitudes. 611 Ss rated their attitudes toward nuclear energy on a 5-point scale. Results show that attitude extremity affected consensus estimates. Trait

Political Consensus and Fiscal Outcomes

DEFF Research Database (Denmark)

Houlberg, Kurt; Holm Pedersen, Lene

2015-01-01

It is becoming difficult to maintain consensus in a period of economic austerity, and this possibly challenges the ability of democratic institutions to take decisions on tough economic questions. In order to find out how political consensus influences fiscal outcomes, this article sets out...

Veto-Consensus Multiple Kernel Learning

NARCIS (Netherlands)

Zhou, Y.; Hu, N.; Spanos, C.J.

2016-01-01

We propose Veto-Consensus Multiple Kernel Learning (VCMKL), a novel way of combining multiple kernels such that one class of samples is described by the logical intersection (consensus) of base kernelized decision rules, whereas the other classes by the union (veto) of their complements. The

The National Football League Combine: performance differences between drafted and nondrafted players entering the 2004 and 2005 drafts.

Science.gov (United States)

Sierer, S Patrick; Battaglini, Claudio L; Mihalik, Jason P; Shields, Edgar W; Tomasini, Nathan T

2008-01-01

The purpose of this study was to examine performance differences between drafted and nondrafted athletes (N = 321) during the 2004 and 2005 National Football League (NFL) Combines. We categorized players into one of 3 groups: Skill, Big skill, and Linemen. Skill players (SP) consisted of wide receivers, cornerbacks, free safeties, strong safeties, and running backs. Big skill players (BSP) included fullbacks, linebackers, tight ends, and defensive ends. Linemen (LM) consisted of centers, offensive guards, offensive tackles, and defensive tackles. We analyzed player height and mass, as well as performance on the following combine drills: 40-yard dash, 225-lb bench press test, vertical jump, broad jump, pro-agility shuttle, and the 3-cone drill. Student t-tests compared performance on each of these measures between drafted and nondrafted players. Statistical significance was found between drafted and nondrafted SP for the 40-yard dash (P ready themselves for the NFL Combine.

Objective consensus from decision trees.

Science.gov (United States)

Putora, Paul Martin; Panje, Cedric M; Papachristofilou, Alexandros; Dal Pra, Alan; Hundsberger, Thomas; Plasswilm, Ludwig

2014-12-05

Consensus-based approaches provide an alternative to evidence-based decision making, especially in situations where high-level evidence is limited. Our aim was to demonstrate a novel source of information, objective consensus based on recommendations in decision tree format from multiple sources. Based on nine sample recommendations in decision tree format a representative analysis was performed. The most common (mode) recommendations for each eventuality (each permutation of parameters) were determined. The same procedure was applied to real clinical recommendations for primary radiotherapy for prostate cancer. Data was collected from 16 radiation oncology centres, converted into decision tree format and analyzed in order to determine the objective consensus. Based on information from multiple sources in decision tree format, treatment recommendations can be assessed for every parameter combination. An objective consensus can be determined by means of mode recommendations without compromise or confrontation among the parties. In the clinical example involving prostate cancer therapy, three parameters were used with two cut-off values each (Gleason score, PSA, T-stage) resulting in a total of 27 possible combinations per decision tree. Despite significant variations among the recommendations, a mode recommendation could be found for specific combinations of parameters. Recommendations represented as decision trees can serve as a basis for objective consensus among multiple parties.

Objective consensus from decision trees

International Nuclear Information System (INIS)

Putora, Paul Martin; Panje, Cedric M; Papachristofilou, Alexandros; Pra, Alan Dal; Hundsberger, Thomas; Plasswilm, Ludwig

2014-01-01

Consensus-based approaches provide an alternative to evidence-based decision making, especially in situations where high-level evidence is limited. Our aim was to demonstrate a novel source of information, objective consensus based on recommendations in decision tree format from multiple sources. Based on nine sample recommendations in decision tree format a representative analysis was performed. The most common (mode) recommendations for each eventuality (each permutation of parameters) were determined. The same procedure was applied to real clinical recommendations for primary radiotherapy for prostate cancer. Data was collected from 16 radiation oncology centres, converted into decision tree format and analyzed in order to determine the objective consensus. Based on information from multiple sources in decision tree format, treatment recommendations can be assessed for every parameter combination. An objective consensus can be determined by means of mode recommendations without compromise or confrontation among the parties. In the clinical example involving prostate cancer therapy, three parameters were used with two cut-off values each (Gleason score, PSA, T-stage) resulting in a total of 27 possible combinations per decision tree. Despite significant variations among the recommendations, a mode recommendation could be found for specific combinations of parameters. Recommendations represented as decision trees can serve as a basis for objective consensus among multiple parties

Quality scores for 32,000 genomes

DEFF Research Database (Denmark)

Land, Miriam L.; Hyatt, Doug; Jun, Se-Ran

2014-01-01

Background More than 80% of the microbial genomes in GenBank are of ‘draft’ quality (12,553 draft vs. 2,679 finished, as of October, 2013). We have examined all the microbial DNA sequences available for complete, draft, and Sequence Read Archive genomes in GenBank as well as three other major...... public databases, and assigned quality scores for more than 30,000 prokaryotic genome sequences. Results Scores were assigned using four categories: the completeness of the assembly, the presence of full-length rRNA genes, tRNA composition and the presence of a set of 102 conserved genes in prokaryotes....... Most (~88%) of the genomes had quality scores of 0.8 or better and can be safely used for standard comparative genomics analysis. We compared genomes across factors that may influence the score. We found that although sequencing depth coverage of over 100x did not ensure a better score, sequencing read...

The Use of the Delphi and Other Consensus Group Methods in Medical Education Research: A Review.

Science.gov (United States)

Humphrey-Murto, Susan; Varpio, Lara; Wood, Timothy J; Gonsalves, Carol; Ufholz, Lee-Anne; Mascioli, Kelly; Wang, Carol; Foth, Thomas

2017-10-01

Consensus group methods, such as the Delphi method and nominal group technique (NGT), are used to synthesize expert opinions when evidence is lacking. Despite their extensive use, these methods are inconsistently applied. Their use in medical education research has not been well studied. The authors set out to describe the use of consensus methods in medical education research and to assess the reporting quality of these methods and results. Using scoping review methods, the authors searched the Medline, Embase, PsycInfo, PubMed, Scopus, and ERIC databases for 2009-2016. Full-text articles that focused on medical education and the keywords Delphi, RAND, NGT, or other consensus group methods were included. A standardized extraction form was used to collect article demographic data and features reflecting methodological rigor. Of the articles reviewed, 257 met the inclusion criteria. The Modified Delphi (105/257; 40.8%), Delphi (91/257; 35.4%), and NGT (23/257; 8.9%) methods were most often used. The most common study purpose was curriculum development or reform (68/257; 26.5%), assessment tool development (55/257; 21.4%), and defining competencies (43/257; 16.7%). The reporting quality varied, with 70.0% (180/257) of articles reporting a literature review, 27.2% (70/257) reporting what background information was provided to participants, 66.1% (170/257) describing the number of participants, 40.1% (103/257) reporting if private decisions were collected, 37.7% (97/257) reporting if formal feedback of group ratings was shared, and 43.2% (111/257) defining consensus a priori. Consensus methods are poorly standardized and inconsistently used in medical education research. Improved criteria for reporting are needed.

Draft genome of the medaka fish: a comprehensive resource for medaka developmental genetics and vertebrate evolutionary biology.

Science.gov (United States)

Takeda, Hiroyuki

2008-06-01

The medaka Oryzias latipes is a small egg-laying freshwater teleost, and has become an excellent model system for developmental genetics and evolutionary biology. The medaka genome is relatively small in size, approximately 800 Mb, and the genome sequencing project was recently completed by Japanese research groups, providing a high-quality draft genome sequence of the inbred Hd-rR strain of medaka. In this review, I present an overview of the medaka genome project including genome resources, followed by specific findings obtained with the medaka draft genome. In particular, I focus on the analysis that was done by taking advantage of the medaka system, such as the sex chromosome differentiation and the regional history of medaka species using single nucleotide polymorphisms as genomic markers.

Validation of consensus panel diagnosis in dementia.

Science.gov (United States)

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

2010-12-01

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

Global Consensus Recommendations on Prevention and Management of Nutritional Rickets.

Science.gov (United States)

Munns, Craig F; Shaw, Nick; Kiely, Mairead; Specker, Bonny L; Thacher, Tom D; Ozono, Keiichi; Michigami, Toshimi; Tiosano, Dov; Mughal, M Zulf; Mäkitie, Outi; Ramos-Abad, Lorna; Ward, Leanne; DiMeglio, Linda A; Atapattu, Navoda; Cassinelli, Hamilton; Braegger, Christian; Pettifor, John M; Seth, Anju; Idris, Hafsatu Wasagu; Bhatia, Vijayalakshmi; Fu, Junfen; Goldberg, Gail; Sävendahl, Lars; Khadgawat, Rajesh; Pludowski, Pawel; Maddock, Jane; Hyppönen, Elina; Oduwole, Abiola; Frew, Emma; Aguiar, Magda; Tulchinsky, Ted; Butler, Gary; Högler, Wolfgang

2016-02-01

Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to work toward its eradication. A systematic literature search examining the definition, diagnosis, treatment, and prevention of nutritional rickets in children was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system that describe the strength of the recommendation and the quality of supporting evidence. Thirty-three nominated experts in pediatric endocrinology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required.

A State Articulated Instructional Objectives Guide for Occupational Education Programs. State Pilot Model for Drafting (Graphic Communications). Part I--Basic. Part II--Specialty Programs. Section A (Mechanical Drafting and Design). Section B (Architectural Drafting and Design).

Science.gov (United States)

North Carolina State Dept. of Community Colleges, Raleigh.

A two-part articulation instructional objective guide for drafting (graphic communications) is provided. Part I contains summary information on seven blocks (courses) of instruction. They are as follow: introduction; basic technical drafting; problem solving in graphics; reproduction processes; freehand drawing and sketching; graphics composition;…

Nanomaterial Case Studies: Nanoscale Titanium Dioxide (External Review Draft)

Science.gov (United States)

This draft document presents two case studies of nanoscale titanium dioxide (nano-TiO2) used (1) to remove arsenic from drinking water and (2) as an active ingredient in topical sunscreen. The draft case studies are organized around a comprehensive environmental asses...

Attitude Importance and the False Consensus Effect.

Science.gov (United States)

Fabrigar, Leandre R.; Krosnick, Jon A.

1995-01-01

Explores the possibility that importance may regulate the magnitude of the false consensus effect. Analysis revealed a strong false consensus effect but no reliable relation between its magnitude and attitude importance. Results contradict assumptions that the false consensus effect arises from attitudes that directly or indirectly influence…

Asian Consensus Report on Functional Dyspepsia

Science.gov (United States)

Miwa, Hiroto; Ghoshal, Uday C; Gonlachanvit, Sutep; Gwee, Kok-Ann; Ang, Tiing-Leong; Chang, Full-Young; Fock, Kwong Ming; Hongo, Michio; Hou, Xiaohua; Kachintorn, Udom; Ke, Meiyun; Lai, Kwok-Hung; Lee, Kwang Jae; Lu, Ching-Liang; Mahadeva, Sanjiv; Miura, Soichiro; Park, Hyojin; Rhee, Poong-Lyul; Sugano, Kentaro; Vilaichone, Ratha-korn; Wong, Benjamin CY

2012-01-01

Background/Aims Environmental factors such as food, lifestyle and prevalence of Helicobacter pylori infection are widely different in Asian countries compared to the West, and physiological functions and genetic factors of Asians may also be different from those of Westerners. Establishing an Asian consensus for functional dyspepsia is crucial in order to attract attention to such data from Asian countries, to articulate the experience and views of Asian experts, and to provide a relevant guide on management of functional dyspepsia for primary care physicians working in Asia. Methods Consensus team members were selected from Asian experts and consensus development was carried out using a modified Delphi method. Consensus teams collected published papers on functional dyspepsia especially from Asia and developed candidate consensus statements based on the generated clinical questions. At the first face-to-face meeting, each statement was reviewed and e-mail voting was done twice. At the second face-to-face meeting, final voting on each statement was done using keypad voting system. A grade of evidence and a strength of recommendation were applied to each statement according to the method of the GRADE Working Group. Results Twenty-nine consensus statements were finalized, including 7 for definition and diagnosis, 5 for epidemiology, 9 for pathophysiology and 8 for management. Algorithms for diagnosis and management of functional dyspepsia were added. Conclusions This consensus developed by Asian experts shows distinctive features of functional dyspepsia in Asia and will provide a guide to the diagnosis and management of functional dyspepsia for Asian primary care physicians. PMID:22523724

Comments from the Developmental Neurotoxicology Committee of the Japanese Teratology Society on the OECD Guideline for the Testing of Chemicals, Proposal for a New Guideline 426, Developmental Neurotoxicity Study, Draft Document (October 2006 version), and on the Draft Document of the Retrospective Performance Assessment of the Draft Test Guideline 426 on Developmental Neurotoxicity.

Science.gov (United States)

Ema, Makoto; Fukui, Yoshihiro; Aoyama, Hiroaki; Fujiwara, Michio; Fuji, Junichiro; Inouye, Minoru; Iwase, Takayuki; Kihara, Takahide; Oi, Akihide; Otani, Hiroki; Shinomiya, Mitsuhiro; Sugioka, Kozo; Yamano, Tsunekazu; Yamashita, Keisuke H; Tanimura, Takashi

2007-06-01

In October 2006, a new revision of the draft guideline (OECD Guideline for the Testing of Chemicals, Proposal for a New Guideline 426. Developmental Neurotoxicity Study) and Draft Document of the Retrospective Performance Assessment (RPA) of the Draft Test Guideline 426 on Developmental Neurotoxicity were distributed following incorporation of the results of the Expert Consultation Meeting in Tokyo on May 24-26, 2005. The draft guideline consists of 50 paragraphs and an appendix with 102 references; and the draft RPA consists of 37 paragraphs with 109 references. National coordinators were requested to arrange for national expert reviews of these draft documents in their member countries. Members of the Developmental Neurotoxicology (DNT) Committee of the Japanese Teratology Society (JTS) reviewed, discussed, and commented on the draft Test Guideline Proposal. The DNT Committee of the JTS also commented on the draft document of the RPA. These comments were sent to the OECD Secretariat. The DNT Committee of the JTS expects the comments to be useful for the finalization of these draft documents.

WSES consensus conference: Guidelines for first-line management of intra-abdominal infections

Directory of Open Access Journals (Sweden)

Leppaniemi Ari

2011-01-01

Full Text Available Abstract Intra-abdominal infections are still associated with high rate of morbidity and mortality. A multidisciplinary approach to the management of patients with intra-abdominal infections may be an important factor in the quality of care. The presence of a team of health professionals from various disciplines, working in concert, may improve efficiency, outcome, and the cost of care. A World Society of Emergency Surgery (WSES Consensus Conference was held in Bologna on July 2010, during the 1st congress of the WSES, involving surgeons, infectious disease specialists, pharmacologists, radiologists and intensivists with the goal of defining recommendations for the early management of intra-abdominal infections. This document represents the executive summary of the final guidelines approved by the consensus conference.

A Novel Consensus-Based Particle Swarm Optimization-Assisted Trust-Tech Methodology for Large-Scale Global Optimization.

Science.gov (United States)

Zhang, Yong-Feng; Chiang, Hsiao-Dong

2017-09-01

A novel three-stage methodology, termed the "consensus-based particle swarm optimization (PSO)-assisted Trust-Tech methodology," to find global optimal solutions for nonlinear optimization problems is presented. It is composed of Trust-Tech methods, consensus-based PSO, and local optimization methods that are integrated to compute a set of high-quality local optimal solutions that can contain the global optimal solution. The proposed methodology compares very favorably with several recently developed PSO algorithms based on a set of small-dimension benchmark optimization problems and 20 large-dimension test functions from the CEC 2010 competition. The analytical basis for the proposed methodology is also provided. Experimental results demonstrate that the proposed methodology can rapidly obtain high-quality optimal solutions that can contain the global optimal solution. The scalability of the proposed methodology is promising.

1 CFR 15.10 - Information on drafting and publication.

Science.gov (United States)

2010-01-01

... 1 General Provisions 1 2010-01-01 2010-01-01 false Information on drafting and publication. 15.10... drafting and publication. The Director of the Federal Register may prepare, and distribute to agencies... chapter. The Director may also develop and conduct programs of technical instruction. ...

Draft directive on the management of radioactive wastes based on deep geological disposal

International Nuclear Information System (INIS)

Anon.

2010-01-01

The European Commission works on a legal framework to assure that all the member states apply the same standards in all the stages of the management of spent fuels and radioactive wastes till their definitive disposal. The draft propositions are the following. The standards to follow are those proposed by the IAEA. First, each member state has to set a national program dedicated to the management of radioactive wastes. This program will have to detail: the chosen solution, the description of the project, a time schedule, costs and financing. Secondly, the exportation of nuclear wastes for definitive disposal is not allowed unless the 2 countries have agreed to build a common nuclear waste disposal center. Thirdly, the population will have to be informed on the project and will have to take part in the decision process. Fourthly, the standards set by IAEA will be enforced by law. There is a broad consensus between scientists and international organizations like IAEA to consider that the disposal in deep geological layers of high-level radioactive wastes is the most adequate solution. (A.C.)

OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines.

Science.gov (United States)

Zhang, W; Moskowitz, R W; Nuki, G; Abramson, S; Altman, R D; Arden, N; Bierma-Zeinstra, S; Brandt, K D; Croft, P; Doherty, M; Dougados, M; Hochberg, M; Hunter, D J; Kwoh, K; Lohmander, L S; Tugwell, P

2008-02-01

To develop concise, patient-focussed, up to date, evidence-based, expert consensus recommendations for the management of hip and knee osteoarthritis (OA), which are adaptable and designed to assist physicians and allied health care professionals in general and specialist practise throughout the world. Sixteen experts from four medical disciplines (primary care, rheumatology, orthopaedics and evidence-based medicine), two continents and six countries (USA, UK, France, Netherlands, Sweden and Canada) formed the guidelines development team. A systematic review of existing guidelines for the management of hip and knee OA published between 1945 and January 2006 was undertaken using the validated appraisal of guidelines research and evaluation (AGREE) instrument. A core set of management modalities was generated based on the agreement between guidelines. Evidence before 2002 was based on a systematic review conducted by European League Against Rheumatism and evidence after 2002 was updated using MEDLINE, EMBASE, CINAHL, AMED, the Cochrane Library and HTA reports. The quality of evidence was evaluated, and where possible, effect size (ES), number needed to treat, relative risk or odds ratio and cost per quality-adjusted life years gained were estimated. Consensus recommendations were produced following a Delphi exercise and the strength of recommendation (SOR) for propositions relating to each modality was determined using a visual analogue scale. Twenty-three treatment guidelines for the management of hip and knee OA were identified from the literature search, including six opinion-based, five evidence-based and 12 based on both expert opinion and research evidence. Twenty out of 51 treatment modalities addressed by these guidelines were universally recommended. ES for pain relief varied from treatment to treatment. Overall there was no statistically significant difference between non-pharmacological therapies [0.25, 95% confidence interval (CI) 0.16, 0.34] and

Jovan Hadžić's civil procedure code draft (1845

Directory of Open Access Journals (Sweden)

Stanković Uroš

2013-01-01

Full Text Available The article sheds light on civil procedure code draft prepared by renown Serbian lawmaker Jovan Hadžić in 1845. Contrarily to Hadžić's work on producing civil code, his efforts to write civil procedure code are to a large extent obscure. Original text of the draft has not been found. Therefore, one is imposed to reconstruct it with the aid of auxiliary sources, among which the record kept by the commission tasked with revision of the draft, has prevailing significance. The author made an attempt to determine the structure of the draft, as well as the contents of its provisions as accurately as possible, wherein the remarks that the Commission had made were of most assistance. Hadžić consigned his draft to the Prince Aleksandar Karađorđević on August 4th 1845. The Draft consisted of introduction and three parts. The introduction comprised of general provisions. Therein was stipulated principle of trial by written declaration, determined five kinds of courts before which civil procedure should occur and established vacatio legis. The first and concviningly largest part of the Draft was most likely entitled 'On principal litigations and litigation evidence' ('O parnicama glavnima i parničnim dokazatelstvima'. It included diverse rules, such as proceedings before peace courts, proceedings before district courts, ordinary course of litigation (i. e. rules in terms of filing a complaint, scheduling of hearings, subpoenas delivery, procurement of evidence, trial, bankruptcy proceedings, forms of evidence, presentation of evidence and deliberation of judgment, appellate procedure, new trial and enforcement procedure. The third part subsumed the title named 'likvidacija' (literally 'liquidation', whose contents is undeterminable on the basis of existing text of the draft, resolution of bankruptcy proceedings via settlement, resolution of regular litigations via settlement, title named 'on special proceedings and advantages' ('o osobenom

Draft of textbook focused on indirect taxes

OpenAIRE

Nováková, Hana

2012-01-01

The diploma thesis is about draft of textbook which is focused on indirect taxes for business school. The thesis is divided into theoretical and practical part. The theoretical part is focused on teaching tax issues at business school. Readers are introduced with basic studying documents, for example framework educational program and school educational program. In the following part I have conducted didactic analysis of curriculum and textbook of economics for business schools. The draft of t...

Quality of Life After Bariatric Surgery.

Science.gov (United States)

Mazer, Laura M; Azagury, Dan E; Morton, John M

2017-06-01

The purpose of this review is to provide an introduction to quality of life (QOL) outcomes after bariatric surgery and a summary of the current evidence. QOL has been emphasized in bariatric surgery since the NIH Consensus Conference statement in 1991. Initial studies were limited to 1- and 2-year follow-up. More recent findings have expanded the follow-up period up to 12 years, providing a better description of the impact on long-term QOL. Overall, there is little to no consensus regarding the definition of QOL or the ideal survey. Bariatric surgery has the greatest impact on physical QOL, and the impact on mental health remains unclear. There are some specific and less frequently reported threats to quality of life after bariatric surgery that are also discussed. Obesity has a definite impact on quality of life, even without other comorbidities, and surgery for obesity results in significant and lasting improvements in patient-reported quality of life outcomes. This conclusion is limited by a wide variety of survey instruments and absence of consensus on the definition of QOL after bariatric surgery.

Drafting. A Bilingual Text = Dibujo Mecanico. Un Texto Bilingue.

Science.gov (United States)

Los Angeles Unified School District, CA. Div. of Career and Continuing Education.

This bilingual instructional text, one in a series of six texts covering various vocational and technical topics, provides secondary level English and Spanish instruction in drafting. Addressed in the individual units are the following topics: safety, drafting tools and techniques, sketching, geometric construction, working drawings, sectioning,…

The Consensus of Strategic Consensus: A Study of the State of the Art about the Theme

Directory of Open Access Journals (Sweden)

Marcelo Curth

2018-04-01

Full Text Available This paper aims to present the state of the art regarding the strategic consensus, emphasizing the approaches and the nature of the research methods used, the results obtained and the future agenda for this theme studies. Analyzing beyond the last four decades of publications, it was understood that relating the strategic consensus only with the performance and strategic levels can be seen as something limited, suggesting the need to bring to the researching field new aspects and backgrounds as innovation, the methods for generating new ideas, the occurrence beyond the Top Management Team level (TMT, among others. Moreover, concludes that the predominant approach the strategic consensus is a process and the methodology used is based on quantitative techniques. As a suggestion for future studies, this study indicates the investigation of situations in which the strategic consensus is not positive.

Introduction and methodology – Guidelines on Parenteral Nutrition, Chapter 1

Directory of Open Access Journals (Sweden)

Jauch, K. W.

2009-11-01

Full Text Available Guidelines for Parenteral Nutrition were prepared by the German Society for Nutritional Medicine (http://www.dgem.de/, in collaboration with other medical associations to provide guidance for quality assurance for parenteral nutrition (PN practice, and to promoting health and quality of life of patients concerned. A coordination team proposed topics, working group leaders who along with working group members performed systematic literatur searches and drafted recommendations in a nominal group process. Recommendations were discussed and agreed upon in a structured consensus conference process, followed by a Delphi consensus. The current English version of the guidelines was written and updated during the period between the last quarter of 2007 and the first quarter of 2009. The recommendations of the guidelines should be reviewed, and if necessary updated five years after publication.

A manually annotated Actinidia chinensis var. chinensis (kiwifruit) genome highlights the challenges associated with draft genomes and gene prediction in plants.

Science.gov (United States)

Pilkington, Sarah M; Crowhurst, Ross; Hilario, Elena; Nardozza, Simona; Fraser, Lena; Peng, Yongyan; Gunaseelan, Kularajathevan; Simpson, Robert; Tahir, Jibran; Deroles, Simon C; Templeton, Kerry; Luo, Zhiwei; Davy, Marcus; Cheng, Canhong; McNeilage, Mark; Scaglione, Davide; Liu, Yifei; Zhang, Qiong; Datson, Paul; De Silva, Nihal; Gardiner, Susan E; Bassett, Heather; Chagné, David; McCallum, John; Dzierzon, Helge; Deng, Cecilia; Wang, Yen-Yi; Barron, Lorna; Manako, Kelvina; Bowen, Judith; Foster, Toshi M; Erridge, Zoe A; Tiffin, Heather; Waite, Chethi N; Davies, Kevin M; Grierson, Ella P; Laing, William A; Kirk, Rebecca; Chen, Xiuyin; Wood, Marion; Montefiori, Mirco; Brummell, David A; Schwinn, Kathy E; Catanach, Andrew; Fullerton, Christina; Li, Dawei; Meiyalaghan, Sathiyamoorthy; Nieuwenhuizen, Niels; Read, Nicola; Prakash, Roneel; Hunter, Don; Zhang, Huaibi; McKenzie, Marian; Knäbel, Mareike; Harris, Alastair; Allan, Andrew C; Gleave, Andrew; Chen, Angela; Janssen, Bart J; Plunkett, Blue; Ampomah-Dwamena, Charles; Voogd, Charlotte; Leif, Davin; Lafferty, Declan; Souleyre, Edwige J F; Varkonyi-Gasic, Erika; Gambi, Francesco; Hanley, Jenny; Yao, Jia-Long; Cheung, Joey; David, Karine M; Warren, Ben; Marsh, Ken; Snowden, Kimberley C; Lin-Wang, Kui; Brian, Lara; Martinez-Sanchez, Marcela; Wang, Mindy; Ileperuma, Nadeesha; Macnee, Nikolai; Campin, Robert; McAtee, Peter; Drummond, Revel S M; Espley, Richard V; Ireland, Hilary S; Wu, Rongmei; Atkinson, Ross G; Karunairetnam, Sakuntala; Bulley, Sean; Chunkath, Shayhan; Hanley, Zac; Storey, Roy; Thrimawithana, Amali H; Thomson, Susan; David, Charles; Testolin, Raffaele; Huang, Hongwen; Hellens, Roger P; Schaffer, Robert J

2018-04-16

Most published genome sequences are drafts, and most are dominated by computational gene prediction. Draft genomes typically incorporate considerable sequence data that are not assigned to chromosomes, and predicted genes without quality confidence measures. The current Actinidia chinensis (kiwifruit) 'Hongyang' draft genome has 164 Mb of sequences unassigned to pseudo-chromosomes, and omissions have been identified in the gene models. A second genome of an A. chinensis (genotype Red5) was fully sequenced. This new sequence resulted in a 554.0 Mb assembly with all but 6 Mb assigned to pseudo-chromosomes. Pseudo-chromosomal comparisons showed a considerable number of translocation events have occurred following a whole genome duplication (WGD) event some consistent with centromeric Robertsonian-like translocations. RNA sequencing data from 12 tissues and ab initio analysis informed a genome-wide manual annotation, using the WebApollo tool. In total, 33,044 gene loci represented by 33,123 isoforms were identified, named and tagged for quality of evidential support. Of these 3114 (9.4%) were identical to a protein within 'Hongyang' The Kiwifruit Information Resource (KIR v2). Some proportion of the differences will be varietal polymorphisms. However, as most computationally predicted Red5 models required manual re-annotation this proportion is expected to be small. The quality of the new gene models was tested by fully sequencing 550 cloned 'Hort16A' cDNAs and comparing with the predicted protein models for Red5 and both the original 'Hongyang' assembly and the revised annotation from KIR v2. Only 48.9% and 63.5% of the cDNAs had a match with 90% identity or better to the original and revised 'Hongyang' annotation, respectively, compared with 90.9% to the Red5 models. Our study highlights the need to take a cautious approach to draft genomes and computationally predicted genes. Our use of the manual annotation tool WebApollo facilitated manual checking and

Consensus statement on genetic research in dementia

DEFF Research Database (Denmark)

Rikkert, M.G. Olde; der, V van; Burns, A.

2008-01-01

In this article, the authors describe how the European Dementia Consensus Network developed a consensus on research ethics in dementia, taking into account the questions posed by the era of genetic research and its new research methods. The consensus process started with a Delphi procedure...... to analyze relevant stakeholders' positions by describing their statements on the possibilities and limitations of research into genetic determinants of Alzheimer disease and to describe and analyze the moral desirability of genetic research on Alzheimer disease. The conclusions drawn from the Delphi...... procedure fuelled the development of the consensus statement, which is presented in this paper. The consensus statement aims to stimulate ethically acceptable research in the field of dementia and the protection of vulnerable elderly patients with dementia from application of inadequate research methods...

Consensus states of local majority rule in stochastic process

Energy Technology Data Exchange (ETDEWEB)

Luo, Yu-Pin [Department of Electronic Engineering, National Formosa University, Huwei, 63201, Taiwan (China); Tang, Chia-Wei; Xu, Hong-Yuan [Department of Physics, Chung-Yuan Christian University, Chungli, 32023, Taiwan (China); Wu, Jinn-Wen [Department of Applied Mathematics, Chung-Yuan Christian University, Chungli, 32023, Taiwan (China); Huang, Ming-Chang, E-mail: mchuang@cycu.edu.tw [Center for Theoretical Science and Department of Physics, Chung-Yuan Christian University, Chungli, 32023, Taiwan (China)

2015-04-03

A sufficient condition for a network system to reach a consensus state of the local majority rule is shown. The influence of interpersonal environment on the occurrence probability of consensus states for Watts–Strogatz and scale-free networks with random initial states is analyzed by numerical method. We also propose a stochastic local majority rule to study the mean first passage time from a random state to a consensus and the escape rate from a consensus state for systems in a noisy environment. Our numerical results show that there exists a window of fluctuation strengths for which the mean first passage time from a random to a consensus state reduces greatly, and the escape rate of consensus states obeys the Arrhenius equation in the window. - Highlights: • A sufficient condition for reaching a consensus. • The relation between the geometry of networks and the reachability of a consensus. • Stochastic local majority rule. • The mean first-passage time and the escape rate of consensus states.

Consensus states of local majority rule in stochastic process

International Nuclear Information System (INIS)

Luo, Yu-Pin; Tang, Chia-Wei; Xu, Hong-Yuan; Wu, Jinn-Wen; Huang, Ming-Chang

2015-01-01

A sufficient condition for a network system to reach a consensus state of the local majority rule is shown. The influence of interpersonal environment on the occurrence probability of consensus states for Watts–Strogatz and scale-free networks with random initial states is analyzed by numerical method. We also propose a stochastic local majority rule to study the mean first passage time from a random state to a consensus and the escape rate from a consensus state for systems in a noisy environment. Our numerical results show that there exists a window of fluctuation strengths for which the mean first passage time from a random to a consensus state reduces greatly, and the escape rate of consensus states obeys the Arrhenius equation in the window. - Highlights: • A sufficient condition for reaching a consensus. • The relation between the geometry of networks and the reachability of a consensus. • Stochastic local majority rule. • The mean first-passage time and the escape rate of consensus states

Multilevel stake holder consensus building in radioactive waste management

International Nuclear Information System (INIS)

Dreimanis, Andrejs

2008-01-01

Full text: The increased demand of our society to its quality of life, global security and environmental safety as well as to observing a basic ethical principle of equity have advanced our attitude towards the recent proposals to develop shared multinational projects in the use of nuclear energy technologies, in particular, to: a) Siting of shared deep repositories for high-level radioactive waste (RW) and spent nuclear fuel safe disposal. In turn, arrangement of multinational facilities requires to gain more complex consensus between all involved parties. Method: We propose an interdisciplinary synergetic approach to multilevel consensus building for siting and construction of shared multinational repositories for RW deep disposal, based on self-organization (SO) of various stake holders, chaos and fuzziness concepts as well as Ashby principle of requisite variety. In the siting of a multi-national repository there appears an essential novel component of stake holder consensus building, namely: to reach consent - political, social, economic, ecological - among international partners, in addition to solving the whole set of intra-national consensus building items. An entire partnering country is considered as a national stake holder, represented by the national government, being faced to simultaneous seeking an upward (international) and a downward (intra-national) consensus in a psychologically stressed environment, having possibly diverse political, economic and social interests. Main Results: Following inferences about building of multilevel consensus are developed: 1) The basis of synergetic approach to stake holder interaction - informational SO, by forming a knowledge-creating stake holder community via cooperation and competition among individuals, public bodies/groups, companies, institutions; 2) Building of international stake holder consensus could be promoted by activating and diversifying multilateral interactions between intra- and international stake

77 FR 29317 - Fiscal Year 2012 Draft Work Plan

Science.gov (United States)

2012-05-17

... DENALI COMMISSION Fiscal Year 2012 Draft Work Plan AGENCY: Denali Commission. ACTION: Notice... Commission develop proposed work plans for future spending and that the annual Work Plan be published in the... Commission Draft Work Plan for Federal Fiscal Year 2012. DATES: Comments and related material to be received...

Pragmatism and Political Pluralism - Consensus and Pluralism

Directory of Open Access Journals (Sweden)

Michele Marsonet

2015-07-01

In our day the German philosopher Jürgen Habermas has in a way revived these Peircean insights, putting forward an influential theory to the effect that consensus indeed plays a key role in human praxis, so that the primary task of philosophy is to foster it by eliminating the disagreement which we constantly have to face in the course of our daily life. In his “communicative theory of consensus,” furthermore, he claims that human communication rests on an implicit commitment to a sort of “ideal speech situation” which is the normative foundation of agreement in linguistic matters. Consequently, the quest for consensus is a constitutive feature of our nature of (rational human beings: rationality and consensus are tied together. A very strong consequence derives from Habermas’ premises: were we to abandon the search for consensus we would lose rationality, too, and this makes us understand that he views the pursuit of consensus as a regulative principle (rather than as a merely practical objective. Rescher opposes both Peirce’s eschatological view and Habermas’ regulative and idealized one.

Canadian Consensus Conference on the Management of Gastroesophageal Reflux Disease in Adults – Update 2004

Directory of Open Access Journals (Sweden)

David Armstrong

2005-01-01

Full Text Available BACKGROUND: Gastroesophageal reflux disease (GERD is the most prevalent acid-related disorder in Canada and is associated with significant impairment of health-related quality of life. Since the last Canadian Consensus Conference in 1996, GERD management has evolved substantially.

Categorizing segmentation quality using a quantitative quality assurance algorithm

International Nuclear Information System (INIS)

Rodrigues, George; Louie, Alexander; Best, Lara

2012-01-01

Obtaining high levels of contouring consistency is a major limiting step in optimizing the radiotherapeutic ratio. We describe a novel quantitative methodology for the quality assurance (QA) of contour compliance referenced against a community set of contouring experts. Two clinical tumour site scenarios (10 lung cases and one prostate case) were used with QA algorithm. For each case, multiple physicians (lung: n = 6, prostate: n = 25) segmented various target/organ at risk (OAR) structures to define a set of community reference contours. For each set of community contours, a consensus contour (Simultaneous Truth and Performance Level Estimation (STAPLE)) was created. Differences between each individual community contour versus the group consensus contour were quantified by consensus-based contouring penalty metric (PM) scores. New observers segmented these same cases to calculate individual PM scores (for each unique target/OAR) for each new observer–STAPLE pair for comparison against the community and consensus contours. Four physicians contoured the 10 lung cases for a total of 72 contours for quality assurance evaluation against the previously derived community consensus contours. A total of 16 outlier contours were identified by the QA system of which 11 outliers were due to over-contouring discrepancies, three were due to over-/under-contouring discrepancies, and two were due to missing/incorrect nodal contours. In the prostate scenario involving six physicians, the QA system detected a missing penile bulb contour, systematic inner-bladder contouring, and under-contouring of the upper/anterior rectum. A practical methodology for QA has been demonstrated with future clinical trial credentialing, medical education and auto-contouring assessment applications.

Automated consensus contour building for prostate MRI.

Science.gov (United States)

Khalvati, Farzad

2014-01-01

Inter-observer variability is the lack of agreement among clinicians in contouring a given organ or tumour in a medical image. The variability in medical image contouring is a source of uncertainty in radiation treatment planning. Consensus contour of a given case, which was proposed to reduce the variability, is generated by combining the manually generated contours of several clinicians. However, having access to several clinicians (e.g., radiation oncologists) to generate a consensus contour for one patient is costly. This paper presents an algorithm that automatically generates a consensus contour for a given case using the atlases of different clinicians. The algorithm was applied to prostate MR images of 15 patients manually contoured by 5 clinicians. The automatic consensus contours were compared to manual consensus contours where a median Dice similarity coefficient (DSC) of 88% was achieved.

Ocular allergy latin american consensus

Directory of Open Access Journals (Sweden)

Myrna Serapião dos Santos

2011-12-01

Full Text Available PURPOSE: To establish current definition, classification and staging, and to develop diagnosis and treatment recommendations for ocular allergy, by using Delphi approach. METHODS: Ten Latin American experts on ocular allergy participated in a 4-round Delphi panel approach. Four surveys were constructed and answered by panelists. A two-thirds majority was defined as consensus. Definition, classification, staging and diagnosis and treatment recommendations were the main outcomes. RESULTS: "Ocular allergy" was proposed as the general term to describe ocular allergic diseases. Consensus regarding classification was not reached. Signs and symptoms were considered extremely important for the diagnosis. It was consensus that a staging system should be proposed based on the disease severity. Environmental control, avoidance of allergens and the use of artificial tears were recommended as first line treatment. The secondary treatment should include topical anti-histamines, mast cell stabilizers and multi actions drugs. Topical non-steroidal anti-inflammatory and vasoconstrictors were not recommended. Topical corticosteroids were recommended as third line of treatment for the most severe keratoconjunctivitis. Consensus was not reached regarding the use of systemic corticosteroids or immunosuppressant. Surgical approach and unconventional treatments were not recommended as routine. CONCLUSION: The task of creating guidelines for ocular allergies showed to be very complex. Many controversial topics remain unsolved. A larger consensus including experts from different groups around the world may be needed to further improve the current recommendations for several aspects of ocular allergy.

77 FR 42495 - Release of Draft Documents Related to the Review of the National Ambient Air Quality Standards...

Science.gov (United States)

2012-07-19

... (email) to a-and-r[email protected] , Attention Docket ID No. EPA-HQ-OAR-2008-0699. Fax: Fax your comments... External Review Draft (EPA-452/P-12-002; August 2012), please contact Ms. Susan Lyon Stone, Office of Air... Triangle Park, NC 27711; email: stone[email protected] ; telephone: 919-541-1146; fax: 919-541-0237. General...

Advanced Technical Drafting (Industrial Arts) Curriculum Guide. Bulletin 1751.

Science.gov (United States)

Louisiana State Dept. of Education, Baton Rouge. Div. of Vocational Education.

This curriculum guide contains materials for a 17-unit course in advanced technical drafting, a followup to the basic technical drafting course in the industrial arts curriculum for grades 10-12. It is intended for use by industrial arts teachers, supervisors, counselors, administrators, and teacher educators. A three-page course overview provides…

Drafting Lab Management Guide.

Science.gov (United States)

Ohio State Univ., Columbus. Instructional Materials Lab.

This manual was developed to guide drafting instructors and vocational supervisors in sequencing laboratory instruction and controlling the flow of work for a 2-year machine trades training program. The first part of the guide provides information on program management (program description, safety concerns, academic issues, implementation…

Evaluations for draft reports on geological disposal

International Nuclear Information System (INIS)

Maekawa, Keisuke; Igarashi, Hiroshi

2002-10-01

This report summarizes the results of the technical evaluations on two reports which are named as 'Overview of the Geological Disposal Facility' and Considerable Factors on Selection of Potential Sites for Geological Disposal' drafted by NUMO (Nuclear Waste Management Organization of Japan). The review of each draft report has been referred to committee (held on 9th September, 2002) and working group (held on 1st October, 2002) which were organized in order to confirm a progress of implementation of geological disposal by government. (author)

Agitation in cognitive disorders: International Psychogeriatric Association provisional consensus clinical and research definition.

Science.gov (United States)

Cummings, Jeffrey; Mintzer, Jacobo; Brodaty, Henry; Sano, Mary; Banerjee, Sube; Devanand, D P; Gauthier, Serge; Howard, Robert; Lanctôt, Krista; Lyketsos, Constantine G; Peskind, Elaine; Porsteinsson, Anton P; Reich, Edgardo; Sampaio, Cristina; Steffens, David; Wortmann, Marc; Zhong, Kate

2015-01-01

Agitation is common across neuropsychiatric disorders and contributes to disability, institutionalization, and diminished quality of life for patients and their caregivers. There is no consensus definition of agitation and no widespread agreement on what elements should be included in the syndrome. The International Psychogeriatric Association formed an Agitation Definition Work Group (ADWG) to develop a provisional consensus definition of agitation in patients with cognitive disorders that can be applied in epidemiologic, non-interventional clinical, pharmacologic, non-pharmacologic interventional, and neurobiological studies. A consensus definition will facilitate communication and cross-study comparison and may have regulatory applications in drug development programs. The ADWG developed a transparent process using a combination of electronic, face-to-face, and survey-based strategies to develop a consensus based on agreement of a majority of participants. Nine-hundred twenty-eight respondents participated in the different phases of the process. Agitation was defined broadly as: (1) occurring in patients with a cognitive impairment or dementia syndrome; (2) exhibiting behavior consistent with emotional distress; (3) manifesting excessive motor activity, verbal aggression, or physical aggression; and (4) evidencing behaviors that cause excess disability and are not solely attributable to another disorder (psychiatric, medical, or substance-related). A majority of the respondents rated all surveyed elements of the definition as "strongly agree" or "somewhat agree" (68-88% across elements). A majority of the respondents agreed that the definition is appropriate for clinical and research applications. A provisional consensus definition of agitation has been developed. This definition can be used to advance interventional and non-interventional research of agitation in patients with cognitive impairment.

Investigations into dynamics of a draft of mine cars with two locomotives during electric braking

Energy Technology Data Exchange (ETDEWEB)

Sikora-Iliew, R; Szklarski, L; Thuc, Thai Duy

1983-03-01

The computerized simulation of electric braking of a draft of GRANBY-5 mine cars and two locomotives (Ld2 locomotives with LDO30 electric series motors) is discussed. The following stages of simulation are analyzed: constructing a mathematical model of the draft of mine cars during electric (dynamic) braking, equations which describe dynamic states of locomotives, mine cars and electric motors during dynamic braking, equations for stability assessment of the draft during dynamic braking. The analog model for simulation of dynamic braking of the draft is given. Simulation results are shown in 10 diagrams. The WAT-1000 hybrid computer is used. Simulation shows that dynamic braking causes occurrence of maximum forces in the couplers between a locomotive and a mine car. When two locomotives are used the maximum force in couplers is lower than in a draft with one locomotive. Braking distance does not depend on position of locomotives in a draft of mine cars. Doubling draft speed causes braking distance to increase by 4 times. Optimum stability conditions of a draft of mine cars are guaranteed when one locomotive is placed at the draft head and a second is separated from the first one by one third of the draft length. 6 references

Development of consensus guidance to facilitate service redesign around pharmacist prescribing in UK hospital practice.

Science.gov (United States)

Tonna, Antonella; McCaig, Dorothy; Diack, Lesley; West, Bernice; Stewart, Derek

2014-10-01

The last decade has seen a drive towards non-medical prescribing in the United Kingdom (UK). However, there is a dearth of any published literature on applying the principles of service redesign to support pharmacist prescribing in any sphere of practice. To develop consensus guidance to facilitate service redesign around pharmacist prescribing. UK hospital practice. The Delphi technique was used to measure consensus of a panel of expert opinion holders in Scotland. Individuals with key strategic and operational roles in implementing initiatives of pharmacy practice and medicines management were recruited as experts. An electronic questionnaire consisting of 30 statements related to pharmacist prescribing service redesign was developed. These were presented as five-point Likert scales with illustrative quotes. Consensus, defined as 70 % of panel members agreeing (ranked strongly agree/agree) with each statement. Responses were obtained from 35/40 (87.5 %) experts in round one and 29 (72.5 %) in round two. Consensus in round one was achieved for 27/30 of statements relating to aspects of generic 'service development' (e.g. succession planning, multidisciplinary working, quality evaluation, practice development and outcome measures) and 'pharmacist prescribing role development' (e.g. education and future orientation of service). Issues of disagreement were around targeting of pharmacist prescribing to clinical specialities and financial remuneration for prescribing in the hospital setting. Consensus guidance has been developed to facilitate service redesign around hospital pharmacist prescribing.

Why Consensus?

Directory of Open Access Journals (Sweden)

Francesca Polletta

2016-05-01

Full Text Available Activists have long justified their egalitarian organizational forms in prefigurative terms. Making decisions by consensus, decentralizing organization, and rotating leadership serves to model the radically democratic society that activists hope to bring into being. Our comparison of consensus-based decision-making in three historical periods, however, shows that activists have understood the purposes of prefiguration in very different ways. Whereas radical pacifists in the 1940s saw their cooperative organizations as sustaining movement stalwarts in a period of political repression, new left activists in the 1960s imagined that their radically democratic practices would be adopted by ever-widening circles. Along with the political conditions in which they have operated, activists’ distinctive understandings of equality have also shaped the way they have made decisions. Our interviews with 30 leftist activists today reveal a view of decision-making as a place to work through inequalities that are informal, unacknowledged, and pervasive.

75 FR 9613 - Draft NIJ Restraints Standard for Criminal Justice

Science.gov (United States)

2010-03-03

... DEPARTMENT OF JUSTICE Office of Justice Programs [OJP (NIJ) Docket No. 1512] Draft NIJ Restraints Standard for Criminal Justice AGENCY: National Institute of Justice, Office of Justice Programs, DOJ. ACTION: Notice of Draft NIJ Restraints Standard for Criminal Justice and Certification Program...

Constructive conflict and staff consensus in substance abuse treatment.

Science.gov (United States)

Melnick, Gerald; Wexler, Harry K; Chaple, Michael; Cleland, Charles M

2009-03-01

Previous studies demonstrated the relationship between consensus among both staff and clients with client engagement in treatment and between client consensus and 1-year treatment outcomes. The present article explores the correlates of staff consensus, defined as the level of agreement among staff as to the importance of treatment activities in their program, using a national sample of 80 residential substance abuse treatment programs. Constructive conflict resolution had the largest effect on consensus. Low client-to-staff ratios, staff education, and staff experience in substance abuse treatment were also significantly related to consensus. Frequency of training, an expected correlate of consensus, was negatively associated with consensus, whereas frequency of supervision was not a significant correlate. The implications of the findings for future research and program improvement are discussed.

Nuclear quality assurance operating philosophy: A quality-oriented approach

International Nuclear Information System (INIS)

Corcoran, W.R.; Geiger, J.E.; Heibel, R.E.; Cotton, J.B.; Sabol, A.R.

1992-01-01

Quality assurance programs have been part of the nuclear utility management process since the publication of the draft of 10CFR50 Appendix B in the late 1960s. The unwritten operational philosophy of nuclear quality assurance organizations focused on compliance with federal regulations. Adverse experiences, including operational events and extended shutdowns, prompted the gradual adoption of isolated practices extending beyond compliance orientation. These practices have an orientation that accommodates a definition of quality, a perspective of the role of nuclear quality assurance organizations in the overall concept of defense-in-depth, a definition of the segments of the nuclear quality assurance mission, and recent advances in the understanding of self-assessment. Observation of these practices at various nuclear utilities resulted in a syntheses of practices and approaches into a coherent quality-oriented nuclear quality assurance operating philosophy that is not totally adopted at any one utility

76 FR 61402 - Draft Nuclear Regulatory Commission Fiscal Year 2012-2016 Strategic Plan

Science.gov (United States)

2011-10-04

...-2016 Strategic Plan AGENCY: Nuclear Regulatory Commission. ACTION: Draft NUREG; request for comment... comment on draft NUREG-1614, Volume 5. ``U.S. Nuclear Regulatory Commission, FY 2012-2016 Strategic Plan,'' dated September 2011. The NRC's draft FY 2012-2016 strategic plan describes the agency's mission and...

Design optimization of hydraulic turbine draft tube based on CFD and DOE method

Science.gov (United States)

Nam, Mun chol; Dechun, Ba; Xiangji, Yue; Mingri, Jin

2018-03-01

In order to improve performance of the hydraulic turbine draft tube in its design process, the optimization for draft tube is performed based on multi-disciplinary collaborative design optimization platform by combining the computation fluid dynamic (CFD) and the design of experiment (DOE) in this paper. The geometrical design variables are considered as the median section in the draft tube and the cross section in its exit diffuser and objective function is to maximize the pressure recovery factor (Cp). Sample matrixes required for the shape optimization of the draft tube are generated by optimal Latin hypercube (OLH) method of the DOE technique and their performances are evaluated through computational fluid dynamic (CFD) numerical simulation. Subsequently the main effect analysis and the sensitivity analysis of the geometrical parameters of the draft tube are accomplished. Then, the design optimization of the geometrical design variables is determined using the response surface method. The optimization result of the draft tube shows a marked performance improvement over the original.

The emergence of consensus: a primer

Science.gov (United States)

Baronchelli, Andrea

2018-02-01

The origin of population-scale coordination has puzzled philosophers and scientists for centuries. Recently, game theory, evolutionary approaches and complex systems science have provided quantitative insights on the mechanisms of social consensus. However, the literature is vast and widely scattered across fields, making it hard for the single researcher to navigate it. This short review aims to provide a compact overview of the main dimensions over which the debate has unfolded and to discuss some representative examples. It focuses on those situations in which consensus emerges `spontaneously' in the absence of centralized institutions and covers topics that include the macroscopic consequences of the different microscopic rules of behavioural contagion, the role of social networks and the mechanisms that prevent the formation of a consensus or alter it after it has emerged. Special attention is devoted to the recent wave of experiments on the emergence of consensus in social systems.

Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting.

Science.gov (United States)

Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

2012-09-01

The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes research. In June 2011, the HOME initiative conducted a consensus study involving 43 individuals from 10 countries, representing different stakeholders (patients, clinicians, methodologists, pharmaceutical industry) to determine core outcome domains for atopic eczema trials, to define quality criteria for atopic eczema outcome measures and to prioritize topics for atopic eczema outcomes research. Delegates were given evidence-based information, followed by structured group discussion and anonymous consensus voting. Consensus was achieved to include clinical signs, symptoms, long-term control of flares and quality of life into the core set of outcome domains for atopic eczema trials. The HOME initiative strongly recommends including and reporting these core outcome domains as primary or secondary endpoints in all future atopic eczema trials. Measures of these core outcome domains need to be valid, sensitive to change and feasible. Prioritized topics of the HOME initiative are the identification/development of the most appropriate instruments for the four core outcome domains. HOME is open to anyone with an interest in atopic eczema outcomes research. © 2012 John Wiley & Sons A/S.

A Self-Categorization Explanation for Opinion Consensus Perceptions

Science.gov (United States)

Zhang, Jinguang; Reid, Scott A.

2013-01-01

The public expression of opinions (and related communicative activities) hinges upon the perception of opinion consensus. Current explanations for opinion consensus perceptions typically focus on egocentric and other biases, rather than functional cognitions. Using self-categorization theory we showed that opinion consensus perceptions flow from…

Business plan: Supplemental draft environmental impact statement. Volume 2. Appendices

International Nuclear Information System (INIS)

1995-02-01

This document contains the appendices for the Bonneville Power Administration (BPA) Business Plan: Supplemental Draft Environmental Impact Statement. Included are: BPA products and services; Rate design; Methodology and assumptions for numerical analysis; Retail utility operations; Comments and responses to the draft business plan EIS

49 CFR 520.23 - Preparation of draft environmental impact statements.

Science.gov (United States)

2010-10-01

... social, economic, and environmental consequences. (b) Form and content requirements. Attachment 1 of this... environmental issues involved and take responsibility for the scope and content of draft and final environmental... 49 Transportation 6 2010-10-01 2010-10-01 false Preparation of draft environmental impact...

Business Plan : Supplemental Draft Environmental Impact Statement, Volume 2, Appendices.

Energy Technology Data Exchange (ETDEWEB)

United States. Bonneville Power Administration.

1995-02-01

This document contains the appendices for the Bonneville Power Administration (BPA) Business Plan: Supplemental Draft Environmental Impact Statement. Included are: BPA products and services; Rate design; Methodology and assumptions for numerical analysis; Retail utility operations; Comments and responses to the draft business plan EIS.

Consensus on Recording Deep Endometriosis Surgery: the CORDES statement.

Science.gov (United States)

Vanhie, A; Meuleman, C; Tomassetti, C; Timmerman, D; D'Hoore, A; Wolthuis, A; Van Cleynenbreugel, B; Dancet, E; Van den Broeck, U; Tsaltas, J; Renner, S P; Ebert, A D; Carmona, F; Abbott, J; Stepniewska, A; Taylor, H; Saridogan, E; Mueller, M; Keckstein, J; Pluchino, N; Janik, G; Zupi, E; Minelli, L; Cooper, M; Dunselman, G; Koh, C; Abrao, M S; Chapron, C; D'Hooghe, T

2016-06-01

Which essential items should be recorded before, during and after endometriosis surgery and in clinical outcome based surgical trials in patients with deep endometriosis (DE)? A DE surgical sheet (DESS) was developed for standardized reporting of the surgical treatment of DE and an international expert consensus proposal on relevant items that should be recorded in surgical outcome trials in women with DE. Surgery is an important treatment for symptomatic DE. So far, data have been reported in such a way that comparison of different surgical techniques is impossible. Therefore, we present an international expert proposal for standardized reporting of surgical treatment and surgical outcome trials in women with DE. International expert consensus based on a systematic review of literature. Taking into account recommendations from Consolidated Standards of Reporting Trials (CONSORT), the Innovation Development Exploration Assessment and Long-term Study (IDEAL), the Initiative on Methods, Measurement and Pain Assessment in Clinical trials (IMMPACT) and the World Endometriosis Research Foundation Phenome and Biobanking Harmonisation Project (WERF EPHect), a systematic literature review on surgical treatment of DE was performed and resulted in a proposal for standardized reporting, adapted by contributions from eight members of the multidisciplinary Leuven University Hospitals Endometriosis Care Program, from 18 international experts and from audience feedback during three international meetings. We have developed the DESS to record in detail the surgical procedures for DE, and an international consensus on pre-, intra- and post-operative data that should be recorded in surgical outcome trials on DE. The recommendations in this paper represent a consensus among international experts based on a systematic review of the literature. For several items and recommendations, high-quality RCTs were not available. Further research is needed to validate and evaluate the

Replacement Nuclear Research Reactor. Supplement to Draft Environmental Impact Statement. Volume 3

International Nuclear Information System (INIS)

1999-01-01

The Draft Environmental Impact Statement for a replacement research reactor at Lucas Heights, was available for public examination and comment for some three months during 1998. A Supplement to the Draft Environmental Impact Statement (Draft EIS) has been completed and was lodged with Environment Australia on 18 January 1999. The Supplement is an important step in the overall environmental assessment process. It reviews submissions received and provides the proponent's response to issues raised in the public review period. General issues extracted from submissions and addressed in the Supplement include concern over liability issues, Chernobyl type accidents, the ozone layer and health issues. Further studies, relating to issues raised in the public submission process, were undertaken for the Supplementary EIS. These studies confirm, in ANSTO's view, the findings of the Draft EIS and hence the findings of the Final EIS are unchanged from the Draft EIS

Replacement Nuclear Research Reactor. Supplement to Draft Environmental Impact Statement. Volume 3

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-01-01

The Draft Environmental Impact Statement for a replacement research reactor at Lucas Heights, was available for public examination and comment for some three months during 1998. A Supplement to the Draft Environmental Impact Statement (Draft EIS) has been completed and was lodged with Environment Australia on 18 January 1999. The Supplement is an important step in the overall environmental assessment process. It reviews submissions received and provides the proponent`s response to issues raised in the public review period. General issues extracted from submissions and addressed in the Supplement include concern over liability issues, Chernobyl type accidents, the ozone layer and health issues. Further studies, relating to issues raised in the public submission process, were undertaken for the Supplementary EIS. These studies confirm, in ANSTO`s view, the findings of the Draft EIS and hence the findings of the Final EIS are unchanged from the Draft EIS

Consensus for the brain metastases treatment

International Nuclear Information System (INIS)

Rabadan, Alejandra; Diez, Blanca; Martinez, Ana M.; Antico, Julio; Saidon, Patricia; Christiansen, Silvia; Rojas, Galeno

2006-01-01

The advancement in oncology therapies has made brain metastases treatment a major factor influencing the survival time and quality of life of patients with cancer. Although there are numerous publications on the issue, there is not yet to be consensus regarding the best strategy for treatment, which is probably due to population heterogeneity in terms of functional status, type of neoplasia, control of the systemic disease, and the number and localization of the lesions in the central nervous system. Our objective is to present general recommendations based on rational analysis in order to guide the practical management of brain metastases. With this purpose, a multidisciplinary team composed by neurosurgeons, neuro-oncologists, neuro-pathologist, radio therapist and neurologists was brought together, conducting a thorough search, in english and spanish, for publications in Pub- Med from 1980 to July 2006 (the starting period was set at the beginning of use of RM in medical practice). Review and original articles with n= or >20 were selected. Also, book chapters of renowned authors in the different consulted areas were included. The assessment of the literature, in addition to the experience of the authors allowed for the development of the 'Consensus for the brain metastases treatment'. Finally, the authors expect the present work will contribute to the multidisciplinary approach for the management of brain metastases with simple and practical recommendations, and probably stimulating future developments in this field. (author)

The Copenhagen Consensus Conference 2016

DEFF Research Database (Denmark)

Bangsbo, Jens; Krustrup, Peter; Duda, Joan

2016-01-01

that consists of many structured and unstructured forms within school and out-of-school-time contexts, including organised sport, physical education, outdoor recreation, motor skill development programmes, recess, and active transportation such as biking and walking. This consensus statement presents the accord......From 4 to 7 April 2016, 24 researchers from 8 countries and from a variety of academic disciplines gathered in Snekkersten, Denmark, to reach evidence-based consensus about physical activity in children and youth, that is, individuals between 6 and 18 years. Physical activity is an overarching term...... on the effects of physical activity on children’s and youth’s fitness, health, cognitive functioning, engagement, motivation, psychological well-being and social inclusion, as well as presenting educational and physical activity implementation strategies. The consensus was obtained through an iterative process...

Reconciling patient and provider priorities for improving the care of critically ill patients: A consensus method and qualitative analysis of decision making.

Science.gov (United States)

McKenzie, Emily; Potestio, Melissa L; Boyd, Jamie M; Niven, Daniel J; Brundin-Mather, Rebecca; Bagshaw, Sean M; Stelfox, Henry T

2017-12-01

Providers have traditionally established priorities for quality improvement; however, patients and their family members have recently become involved in priority setting. Little is known about how to reconcile priorities of different stakeholder groups into a single prioritized list that is actionable for organizations. To describe the decision-making process for establishing consensus used by a diverse panel of stakeholders to reconcile two sets of quality improvement priorities (provider/decision maker priorities n=9; patient/family priorities n=19) into a single prioritized list. We employed a modified Delphi process with a diverse group of panellists to reconcile priorities for improving care of critically ill patients in the intensive care unit (ICU). Proceedings were audio-recorded, transcribed and analysed using qualitative content analysis to explore the decision-making process for establishing consensus. Nine panellists including three providers, three decision makers and three family members of previously critically ill patients. Panellists rated and revised 28 priorities over three rounds of review and reached consensus on the "Top 5" priorities for quality improvement: transition of patient care from ICU to hospital ward; family presence and effective communication; delirium screening and management; early mobilization; and transition of patient care between ICU providers. Four themes were identified as important for establishing consensus: storytelling (sharing personal experiences), amalgamating priorities (negotiating priority scope), considering evaluation criteria and having a priority champion. Our study demonstrates the feasibility of incorporating families of patients into a multistakeholder prioritization exercise. The approach described can be used to guide consensus building and reconcile priorities of diverse stakeholder groups. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Quality indicators for all dimensions of infertility care quality: consensus between professionals and patients

NARCIS (Netherlands)

Dancet, E.A.; D'Hooghe, T.M.; Spiessens, C.; Sermeus, W.; Neubourg, D. De; Karel, N.; Kremer, J.A.M.; Nelen, W.L.D.M.

2013-01-01

STUDY QUESTION: What is the relative importance of the six dimensions of quality of care according to different stakeholders and can a quality indicator set address all six quality dimensions and incorporate the views from professionals working in different disciplines and from patients? SUMMARY

Crafting consensus

Czech Academy of Sciences Publication Activity Database

Zápal, Jan

2017-01-01

Roč. 173, 1–2 (2017), s. 169-200 ISSN 0048-5829 R&D Projects: GA ČR(CZ) GP14-27902P Institutional support: Progres-Q24 Keywords : consensus building * agenda setting * vote buying Subject RIV: AH - Economics OBOR OECD: Economic Theory Impact factor: 0.788, year: 2016

Quality assurance of metabolomics.

Science.gov (United States)

Bouhifd, Mounir; Beger, Richard; Flynn, Thomas; Guo, Lining; Harris, Georgina; Hogberg, Helena; Kaddurah-Daouk, Rima; Kamp, Hennicke; Kleensang, Andre; Maertens, Alexandra; Odwin-DaCosta, Shelly; Pamies, David; Robertson, Donald; Smirnova, Lena; Sun, Jinchun; Zhao, Liang; Hartung, Thomas

2015-01-01

Metabolomics promises a holistic phenotypic characterization of biological responses to toxicants. This technology is based on advanced chemical analytical tools with reasonable throughput, including mass-spectroscopy and NMR. Quality assurance, however - from experimental design, sample preparation, metabolite identification, to bioinformatics data-mining - is urgently needed to assure both quality of metabolomics data and reproducibility of biological models. In contrast to microarray-based transcriptomics, where consensus on quality assurance and reporting standards has been fostered over the last two decades, quality assurance of metabolomics is only now emerging. Regulatory use in safety sciences, and even proper scientific use of these technologies, demand quality assurance. In an effort to promote this discussion, an expert workshop discussed the quality assurance needs of metabolomics. The goals for this workshop were 1) to consider the challenges associated with metabolomics as an emerging science, with an emphasis on its application in toxicology and 2) to identify the key issues to be addressed in order to establish and implement quality assurance procedures in metabolomics-based toxicology. Consensus has still to be achieved regarding best practices to make sure sound, useful, and relevant information is derived from these new tools.

Supplement to the Surplus Plutonium Disposition Draft Environmental Impact Statement

Energy Technology Data Exchange (ETDEWEB)

N/A

1999-05-14

On May 22, 1997, DOE published a Notice of Intent in the Federal Register (62 Federal Register 28009) announcing its decision to prepare an environmental impact statement (EIS) that would tier from the analysis and decisions reached in connection with the ''Storage and Disposition of Weapons-Usable Fissile Materials Final Programmatic EIS (Storage and Disposition PEIS)''. ''The Surplus Plutonium Disposition Draft Environmental Impact Statement'' (SPD Draft EIS) (DOWEIS-0283-D) was prepared in accordance with NEPA and issued in July 1998. It identified the potential environmental impacts of reasonable alternatives for the proposed siting, construction, and operation of three facilities for plutonium disposition. These three facilities would accomplish pit disassembly and conversion, immobilization, and MOX fuel fabrication. For the alternatives that included MOX fuel fabrication, the draft also described the potential environmental impacts of using from three to eight commercial nuclear reactors to irradiate MOX fuel. The potential impacts were based on a generic reactor analysis that used actual reactor data and a range of potential site conditions. In May 1998, DCE initiated a procurement process to obtain MOX fuel fabrication and reactor irradiation services. The request for proposals defined limited activities that may be performed prior to issuance of the SPD EIS Record of Decision (ROD) including non-site-specific work associated with the development of the initial design for the MOX fuel fabrication facility, and plans (paper studies) for outreach, long lead-time procurements, regulatory management, facility quality assurance, safeguards, security, fuel qualification, and deactivation. No construction on the proposed MOX facility would begin before an SPD EIS ROD is issued. In March 1999, DOE awarded a contract to Duke Engineering & Services; COGEMA, Inc.; and Stone & Webster (known as DCS) to provide the requested

Supplement to the Surplus Plutonium Disposition Draft Environmental Impact Statement

International Nuclear Information System (INIS)

1999-01-01

On May 22, 1997, DOE published a Notice of Intent in the Federal Register (62 Federal Register 28009) announcing its decision to prepare an environmental impact statement (EIS) that would tier from the analysis and decisions reached in connection with the ''Storage and Disposition of Weapons-Usable Fissile Materials Final Programmatic EIS (Storage and Disposition PEIS)''. ''The Surplus Plutonium Disposition Draft Environmental Impact Statement'' (SPD Draft EIS) (DOWEIS-0283-D) was prepared in accordance with NEPA and issued in July 1998. It identified the potential environmental impacts of reasonable alternatives for the proposed siting, construction, and operation of three facilities for plutonium disposition. These three facilities would accomplish pit disassembly and conversion, immobilization, and MOX fuel fabrication. For the alternatives that included MOX fuel fabrication, the draft also described the potential environmental impacts of using from three to eight commercial nuclear reactors to irradiate MOX fuel. The potential impacts were based on a generic reactor analysis that used actual reactor data and a range of potential site conditions. In May 1998, DCE initiated a procurement process to obtain MOX fuel fabrication and reactor irradiation services. The request for proposals defined limited activities that may be performed prior to issuance of the SPD EIS Record of Decision (ROD) including non-site-specific work associated with the development of the initial design for the MOX fuel fabrication facility, and plans (paper studies) for outreach, long lead-time procurements, regulatory management, facility quality assurance, safeguards, security, fuel qualification, and deactivation. No construction on the proposed MOX facility would begin before an SPD EIS ROD is issued. In March 1999, DOE awarded a contract to Duke Engineering and Services; COGEMA, Inc.; and Stone and Webster (known as DCS) to provide the requested services. The procurement process

Consensus guidelines for the uniform reporting of study ethics in anatomical research within the framework of the anatomical quality assurance (AQUA) checklist.

Science.gov (United States)

Henry, Brandon Michael; Vikse, Jens; Pekala, Przemyslaw; Loukas, Marios; Tubbs, R Shane; Walocha, Jerzy A; Jones, D Gareth; Tomaszewski, Krzysztof A

2018-05-01

Unambiguous reporting of a study's compliance with ethical guidelines in anatomical research is imperative. As such, clear, universal, and uniform reporting guidelines for study ethics are essential. In 2016, the International Evidence-Based Anatomy Working group in collaboration with international partners established reporting guidelines for anatomical studies, the Anatomical Quality Assurance (AQUA) Checklist. In this elaboration of the AQUA Checklist, consensus guidelines for reporting study ethics in anatomical studies are provided with in the framework of the AQUA Checklist. The new guidelines are aimed to be applicable to research across the spectrum of the anatomical sciences, including studies on both living and deceased donors. The authors hope the established guidelines will improve ethical compliance and reporting in anatomical research. Clin. Anat. 31:521-524, 2018. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

A Hybrid Distance-Based Ideal-Seeking Consensus Ranking Model

Directory of Open Access Journals (Sweden)

Madjid Tavana

2007-01-01

Full Text Available Ordinal consensus ranking problems have received much attention in the management science literature. A problem arises in situations where a group of k decision makers (DMs is asked to rank order n alternatives. The question is how to combine the DM rankings into one consensus ranking. Several different approaches have been suggested to aggregate DM responses into a compromise or consensus ranking; however, the similarity of consensus rankings generated by the different algorithms is largely unknown. In this paper, we propose a new hybrid distance-based ideal-seeking consensus ranking model (DCM. The proposed hybrid model combines parts of the two commonly used consensus ranking techniques of Beck and Lin (1983 and Cook and Kress (1985 into an intuitive and computationally simple model. We illustrate our method and then run a Monte Carlo simulation across a range of k and n to compare the similarity of the consensus rankings generated by our method with the best-known method of Borda and Kendall (Kendall 1962 and the two methods proposed by Beck and Lin (1983 and Cook and Kress (1985. DCM and Beck and Lin's method yielded the most similar consensus rankings, whereas the Cook-Kress method and the Borda-Kendall method yielded the least similar consensus rankings.

Report from the fifth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative).

Science.gov (United States)

Chalmers, J R; Thomas, K S; Apfelbacher, C; Williams, H C; Prinsen, C A; Spuls, P I; Simpson, E; Gerbens, L A A; Boers, M; Barbarot, S; Stalder, J F; Abuabara, K; Aoki, V; Ardeleanu, M; Armstrong, J; Bang, B; Berents, T L; Burton, T; Butler, L; Chubachi, T; Cresswell-Melville, A; DeLozier, A; Eckert, L; Eichenfield, L; Flohr, C; Futamura, M; Gadkari, A; Gjerde, E S; van Halewijn, K F; Hawkes, C; Howells, L; Howie, L; Humphreys, R; Ishii, H A; Kataoka, Y; Katayama, I; Kouwenhoven, W; Langan, S M; Leshem, Y A; Merhand, S; Mina-Osorio, P; Murota, H; Nakahara, T; Nunes, F P; Nygaard, U; Nygårdas, M; Ohya, Y; Ono, E; Rehbinder, E; Rogers, N K; Romeijn, G L E; Schuttelaar, M L A; Sears, A V; Simpson, M A; Singh, J A; Srour, J; Stuart, B; Svensson, Å; Talmo, G; Talmo, H; Teixeira, H D; Thyssen, J P; Todd, G; Torchet, F; Volke, A; von Kobyletzki, L; Weisshaar, E; Wollenberg, A; Zaniboni, M

2018-05-01

This is the report from the fifth meeting of the Harmonising Outcome Measures for Eczema initiative (HOME V). The meeting was held on 12-14 June 2017 in Nantes, France, with 81 participants. The main aims of the meeting were (i) to achieve consensus over the definition of the core domain of long-term control and how to measure it and (ii) to prioritize future areas of research for the measurement of the core domain of quality of life (QoL) in children. Moderated whole-group and small-group consensus discussions were informed by presentations of qualitative studies, systematic reviews and validation studies. Small-group allocations were performed a priori to ensure that each group included different stakeholders from a variety of geographical regions. Anonymous whole-group voting was carried out using handheld electronic voting pads according to predefined consensus rules. It was agreed by consensus that the long-term control domain should include signs, symptoms, quality of life and a patient global instrument. The group agreed that itch intensity should be measured when assessing long-term control of eczema in addition to the frequency of itch captured by the symptoms domain. There was no recommendation of an instrument for the core outcome domain of quality of life in children, but existing instruments were assessed for face validity and feasibility, and future work that will facilitate the recommendation of an instrument was agreed upon. © 2018 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.

The shape of natural draft cooling towers

International Nuclear Information System (INIS)

Grange, J.L.

1992-07-01

The shape of cooling towers is more often designed empirically. There, it is considered from a theoretical point of view. The analysis of dynamic of natural draft and of the air flow in a cooling tower shell is presented. It is shown, that although it is convergent, a tower works like a diffuser for pressure recovery. And it is turbulence that produces a transfer of kinetic energy and allows a good operation of the diffusor. The equations permit to define a shell profile which depends upon the operating conditions of the cooling tower. In the same way, a stability criteria for natural draft depending upon operating conditions is established. A heating model of one meter diameter has been built in a thermal similitude. The turbulence rate has been measured with a hot wire anemometer at the tower exit and visualizations have also been made. Natural draft stability has been studied by these means for four different shell shapes and a wide range of operating conditions. Experimental and theoretical results agree satisfactorily and experiments can be considered as a validation of theory

Consensus Guidelines for Delineation of Clinical Target Volume for Intensity-Modulated Pelvic Radiotherapy for the Definitive Treatment of Cervix Cancer

International Nuclear Information System (INIS)

Lim, Karen; Small, William; Portelance, Lorraine; Creutzberg, Carien; Juergenliemk-Schulz, Ina M.; Mundt, Arno; Mell, Loren K.; Mayr, Nina; Viswanathan, Akila; Jhingran, Anuja; Erickson, Beth; De Los Santos, Jennifer; Gaffney, David; Yashar, Catheryn; Beriwal, Sushil; Wolfson, Aaron

2011-01-01

Purpose: Accurate target definition is vitally important for definitive treatment of cervix cancer with intensity-modulated radiotherapy (IMRT), yet a definition of clinical target volume (CTV) remains variable within the literature. The aim of this study was to develop a consensus CTV definition in preparation for a Phase 2 clinical trial being planned by the Radiation Therapy Oncology Group. Methods and Materials: A guidelines consensus working group meeting was convened in June 2008 for the purposes of developing target definition guidelines for IMRT for the intact cervix. A draft document of recommendations for CTV definition was created and used to aid in contouring a clinical case. The clinical case was then analyzed for consistency and clarity of target delineation using an expectation maximization algorithm for simultaneous truth and performance level estimation (STAPLE), with kappa statistics as a measure of agreement between participants. Results: Nineteen experts in gynecological radiation oncology generated contours on axial magnetic resonance images of the pelvis. Substantial STAPLE agreement sensitivity and specificity values were seen for gross tumor volume (GTV) delineation (0.84 and 0.96, respectively) with a kappa statistic of 0.68 (p < 0.0001). Agreement for delineation of cervix, uterus, vagina, and parametria was moderate. Conclusions: This report provides guidelines for CTV definition in the definitive cervix cancer setting for the purposes of IMRT, building on previously published guidelines for IMRT in the postoperative setting.

[Consensus document on overactive bladder in older patients].

Science.gov (United States)

Verdejo-Bravo, Carlos; Brenes-Bermúdez, Francisco; Valverde-Moyar, Maria Victoria; Alcántara-Montero, Antonio; Pérez-León, Noemí

2015-01-01

Overactive nladder (OAB) is a clinical entity with a high prevalence in the population, having a high impact on quality of life, especially when it occurs with urge urinary incontinence. It is very important to highlight the low rate of consultation of this condition by the older population. This appears to depend on several factors (educational, cultural, professional), and thus leads to the low percentage of older patients who receive appropriate treatment and, on the other hand, a large percentage of older patients with a significant deterioration in their quality of life. Therefore, Scientific societies and Working Groups propose the early detection of OAB in their documents and clinical guidelines. Its etiology is not well known, but is influenced by cerebrovascular processes and other neurological problems, abnormalities of the detrusor muscle of bladder receptors, and obstructive and inflammatory processes of the lower urinary tract. Its diagnosis is clinical, and in the great majority of the cases it can be possible to establish its diagnosis and etiopathogenic orientation, without the need for complex diagnostic procedures. Currently, there are effective treatments for OAB, and we should decide the most appropriate for each elderly patient, based on their individual characteristics. Based on the main clinical practice guidelines, a progressive treatment is proposed, with the antimuscarinics being the most recommended drug treatment. Therefore, a group of very involved professionals in clinical practice for the elderly, and representing two scientific Societies (Spanish Society of Geriatrics and Gerontology [SEGG], and the Spanish Society of Primary Care Physicians [SEMERGEN]) developed this consensus document with the main objective of establishing practices and valid strategies, focused to simplify the management of this clinical entity in the elderly population, and especially to improve their quality of life. The recommendations presented in this

IMPLICATIONS OF THE CURRENT EXPOSURE DRAFT ON AUDIT REPORTING

Directory of Open Access Journals (Sweden)

George Silviu CORDOȘ

2015-04-01

Full Text Available The regulatory changes come as a response to perceived deficiencies in the postfinancial crisis, and their goal is to improve users' perception of the usefulness and quality of the audit report. The article approaches the subject of these proposals to revise the standards and their implications for the audit report. The article is divided into five parts: the first part the authors present a brief introduction to the subject matter; the second part presents the research methodology; the third part the authors present a review of the literature research; the fourth section presents an analysis of the responses of EU respondents to the Exposure Draft issued by the IAASB in July 2013 and the last part the authors present research findings, limitations and perspectives.

Consensus of recommendations guiding comparative effectiveness research methods.

Science.gov (United States)

Morton, Jacob B; McConeghy, Robert; Heinrich, Kirstin; Gatto, Nicolle M; Caffrey, Aisling R

2016-12-01

Because of an increasing demand for quality comparative effectiveness research (CER), methods guidance documents have been published, such as those from the Agency for Healthcare Research and Quality (AHRQ) and the Patient-Centered Outcomes Research Institute (PCORI). Our objective was to identify CER methods guidance documents and compare them to produce a summary of important recommendations which could serve as a consensus of CER method recommendations. We conducted a systematic literature review to identify CER methods guidance documents published through 2014. Identified documents were analyzed for methods guidance recommendations. Individual recommendations were categorized to determine the degree of overlap. We identified nine methods guidance documents, which contained a total of 312 recommendations, 97% of which were present in two or more documents. All nine documents recommended transparency and adaptation for relevant stakeholders in the interpretation and dissemination of results. Other frequently shared CER methods recommendations included: study design and operational definitions should be developed a priori and allow for replication (n = 8 documents); focus on areas with gaps in current clinical knowledge that are relevant to decision-makers (n = 7); validity of measures, instruments, and data should be assessed and discussed (n = 7); outcomes, including benefits and harms, should be clinically meaningful, and objectively measured (n = 7). Assessment for and strategies to minimize bias (n = 6 documents), confounding (n = 6), and heterogeneity (n = 4) were also commonly shared recommendations between documents. We offer a field-consensus guide based on nine CER methods guidance documents that will aid researchers in designing CER studies and applying CER methods. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Establishing Key Performance Indicators [KPIs] and Their Importance for the Surgical Management of Inflammatory Bowel Disease-Results From a Pan-European, Delphi Consensus Study.

Science.gov (United States)

Morar, Pritesh S; Hollingshead, James; Bemelman, Willem; Sevdalis, Nick; Pinkney, Thomas; Wilson, Graeme; Dunlop, Malcolm; Davies, R Justin; Guy, Richard; Fearnhead, Nicola; Brown, Steven; Warusavitarne, Janindra; Edwards, Cathryn; Faiz, Omar

2017-10-27

Key performance indicators [KPIs] exist across a range of areas in medicine. They help to monitor outcomes, reduce variation, and drive up standards across services. KPIs exist for inflammatory bowel disease [IBD] care, but none specifically cover inflammatory bowel disease [IBD] surgical service provision. This was a consensus-based study using a panel of expert IBD clinicians from across Europe. Items were developed and fed through a Delphi process to achieve consensus. Items were ranked on a Likert scale from 1 [not important] to 5 [very important]. Consensus was defined when the inter quartile range was ≤ 1, and items with a median score > 3 were considered for inclusion. A panel of 21 experts [14 surgeons and 7 gastroenterologists] was recruited. Consensus was achieved on procedure-specific KPIs for ileocaecal and perianal surgery for Crohn's disease, [N = 10] with themes relating to morbidity [N = 7], multidisciplinary input [N = 2], and quality of life [N = 1]; and for subtotal colectomy, proctocolectomy and ileoanal pouch surgery for ulcerative colitis [N = 11], with themes relating to mortality [N = 2], morbidity [N = 8], and service provision [N = 1]. Consensus was also achieved for measures of the quality of IBD surgical service provision and quality assurance in IBD surgery. This study has provided measurable KPIs for the provision of surgical services in IBD. These indicators cover IBD surgery in general, the governance and structures of the surgical services, and separate indicators for specific subareas of surgery. Monitoring of IBD services with these KPIs may reduce variation across services and improve quality. Copyright © 2017 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com

Draft Genome Sequence of Telmatospirillum siberiense 26-4b1, an Acidotolerant Peatland Alphaproteobacterium Potentially Involved in Sulfur Cycling.

Science.gov (United States)

Hausmann, Bela; Pjevac, Petra; Schreck, Katharina; Herbold, Craig W; Daims, Holger; Wagner, Michael; Loy, Alexander

2018-01-25

The facultative anaerobic chemoorganoheterotrophic alphaproteobacterium Telmatospirillum siberiense 26-4b1 was isolated from a Siberian peatland. We report here a 6.20-Mbp near-complete high-quality draft genome sequence of T. siberiense that reveals expected and novel metabolic potential for the genus Telmatospirillum , including genes for sulfur oxidation. Copyright © 2018 Hausmann et al.

78 FR 56271 - FY 2014-2020 Draft VA Strategic Plan

Science.gov (United States)

2013-09-12

... DEPARTMENT OF VETERANS AFFAIRS FY 2014-2020 Draft VA Strategic Plan AGENCY: Department of Veterans... Affairs (VA) is announcing the availability of the FY 2014-2020 Draft VA Strategic Plan (Strategic Plan... Act of 2010 (GPRAMA) (Pub. L. 111-352). The Strategic Plan provides the Department's long-term...

The Bacteriostasis Study of Nisin for the Raspberry Health Draft Beer

Science.gov (United States)

Sun, Jinxu; Zhu, Hui xia; Guo, Jiping; Xiao, Dong Guang

The raspberry healthy draft beer was obtained by adding the extracting of raspberry into the raw fermentation materials of beer, in order to prolong the shelf life, the different concentrations nisin were added to the the raspberry healthy draft beer, the result shown that nisin could have obvious influence on the shelf life, the shelf life prolonged with nisin concentrations adding, the shelf life raspberry healthy draft beer was 44d after adding 0.02 nisin mg/mL, the shelf life prolonged 36d than blank.

Hilar cholangiocarcinoma: expert consensus statement.

Science.gov (United States)

Mansour, John C; Aloia, Thomas A; Crane, Christopher H; Heimbach, Julie K; Nagino, Masato; Vauthey, Jean-Nicolas

2015-08-01

An American Hepato-Pancreato-Biliary Association (AHPBA)-sponsored consensus meeting of expert panellists met on 15 January 2014 to review current evidence on the management of hilar cholangiocarcinoma in order to establish practice guidelines and to agree consensus statements. It was established that the treatment of patients with hilar cholangiocarcinoma requires a coordinated, multidisciplinary approach to optimize the chances for both durable survival and effective palliation. An adequate diagnostic and staging work-up includes high-quality cross-sectional imaging; however, pathologic confirmation is not required prior to resection or initiation of a liver transplant trimodal treatment protocol. The ideal treatment for suitable patients with resectable hilar malignancy is resection of the intra- and extrahepatic bile ducts, as well as resection of the involved ipsilateral liver. Preoperative biliary drainage is best achieved with percutaneous transhepatic approaches and may be indicated for patients with cholangitis, malnutrition or hepatic insufficiency. Portal vein embolization is a safe and effective strategy for increasing the future liver remnant (FLR) and is particularly useful for patients with an FLR of hilar cholangiocarcinoma should be evaluated for a standard trimodal protocol incorporating external beam and endoluminal radiation therapy, systemic chemotherapy and liver transplantation. Post-resection chemoradiation should be offered to patients who show high-risk features on surgical pathology. Chemoradiation is also recommended for patients with locally advanced, unresectable hilar cancers. For patients with locally recurrent or metastatic hilar cholangiocarcinoma, first-line chemotherapy with gemcitabine and cisplatin is recommended based on multiple Phase II trials and a large randomized controlled trial including a heterogeneous population of patients with biliary cancers. © 2015 International Hepato-Pancreato-Biliary Association.

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

Science.gov (United States)

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

2015-01-01

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

Taxation of Income from Selling Property: Changes of New Income Tax Law Draft

Directory of Open Access Journals (Sweden)

Canatay HACIKÖYLÜ

2016-12-01

Full Text Available There are provisions in Income Tax Law No. 193 and Corporate Tax Law No. 5520 on the nature and taxation of income that real and legal persons acquire from real estate sales. There have been many changes in these provisions over time, but the changes made didnt meet the needs, and they distorted the systematic structure of the Laws. For these and similar reasons, the income tax law draft has been prepared based on Income Tax Law and Corporate Tax Law. With the draft, the Income Tax Law No. 193 and the Corporate Tax Law No. 5520 will be abolished. Draft is aimed to regulate the procedures and principles regarding the income tax on the income of real persons and institutions. In this study, the current situation and the regulations of the draft will be discussed. Moreover, It will be evaluate whether the regulations in the draft law are sufficient. Suggestions will be put forth to determine and declare the real value of the property in order to achieve the intended objectives in draft.

Consensus-based recommendations for case report in Chinese medicine (CARC).

Science.gov (United States)

Fu, Shu-Fei; Cheng, Chung-Wah; Zhang, Li; Zhong, Linda Li-Dan; Kun, Wai; Lin, Jia; Zhang, Bo-Li; Wang, Yong-Yan; Shang, Hong-Cai; Bian, Zhao-Xiang

2016-01-01

Case reports are valuable clinical evidence in traditional Chinese medicine (TCM). However, the general reporting quality is suboptimal. A working group comprising 20 members was set up to develop systematic recommendations on case report in Chinese medicine (CARC). The working group (CARC group) developed a primary checklist based on reviewing the general reporting quality of case reports in TCM and thorough internal discussion. Two-round consensus process had been carried out among clinical experts, evidence-based medicine methodologists, medical journal editors and clinical practitioners with designated questionnaire embedded with the primary checklist. In total, 118 participants from 17 provinces of China and Korea completed the questionnaires. Their feedback was analyzed and discussed by the CARC group. The checklist was amended accordingly, and the final version, comprising 16-item, is presented here. Under the framework of CARC recommendations, the reporting quality of case reports in TCM can be improved.

A high-coverage draft genome of the mycalesine butterfly Bicyclus anynana.

Science.gov (United States)

Nowell, Reuben W; Elsworth, Ben; Oostra, Vicencio; Zwaan, Bas J; Wheat, Christopher W; Saastamoinen, Marjo; Saccheri, Ilik J; Van't Hof, Arjen E; Wasik, Bethany R; Connahs, Heidi; Aslam, Muhammad L; Kumar, Sujai; Challis, Richard J; Monteiro, Antónia; Brakefield, Paul M; Blaxter, Mark

2017-07-01

The mycalesine butterfly Bicyclus anynana, the "Squinting bush brown," is a model organism in the study of lepidopteran ecology, development, and evolution. Here, we present a draft genome sequence for B. anynana to serve as a genomics resource for current and future studies of this important model species. Seven libraries with insert sizes ranging from 350 bp to 20 kb were constructed using DNA from an inbred female and sequenced using both Illumina and PacBio technology; 128 Gb of raw Illumina data was filtered to 124 Gb and assembled to a final size of 475 Mb (∼×260 assembly coverage). Contigs were scaffolded using mate-pair, transcriptome, and PacBio data into 10 800 sequences with an N50 of 638 kb (longest scaffold 5 Mb). The genome is comprised of 26% repetitive elements and encodes a total of 22 642 predicted protein-coding genes. Recovery of a BUSCO set of core metazoan genes was almost complete (98%). Overall, these metrics compare well with other recently published lepidopteran genomes. We report a high-quality draft genome sequence for Bicyclus anynana. The genome assembly and annotated gene models are available at LepBase (http://ensembl.lepbase.org/index.html). © The Authors 2017. Published by Oxford University Press.

75 FR 22162 - Draft NIJ Duty Holster Retention Standard for Law Enforcement

Science.gov (United States)

2010-04-27

...In an effort to obtain comments from interested parties, the U.S. Department of Justice, Office of Justice Programs, National Institute of Justice will make available to the general public two draft documents: (1) A draft standard entitled, ``NIJ Duty Holster Retention Standard for Law Enforcement'' and (2) a draft companion document entitled, ``NIJ Duty Holster Retention Certification Program Requirements.'' The opportunity to provide comments on these two documents is open to industry technical representatives, law enforcement agencies and organizations, research, development and scientific communities, and all other stakeholders and interested parties. Those individuals wishing to obtain and provide comments on the draft documents under consideration are directed to the following Web site: http://www.justnet.org.

Consensus in Guidelines for Evaluation of DSD by the Texas Children's Hospital Multidisciplinary Gender Medicine Team

Directory of Open Access Journals (Sweden)

Macias CharlesG

2010-08-01

Full Text Available The Gender Medicine Team (GMT, comprised of members with expertise in endocrinology, ethics, genetics, gynecology, pediatric surgery, psychology, and urology, at Texas Children's Hospital and Baylor College of Medicine formed a task force to formulate a consensus statement on practice guidelines for managing disorders of sexual differentiation (DSD and for making sex assignments. The GMT task force reviewed published evidence and incorporated findings from clinical experience. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE was used to assess the quality of evidence presented in the literature for establishing evidence-based guidelines. The task force presents a consensus statement regarding specific diagnostic and therapeutic issues in the management of individuals who present with DSD. The consensus statement includes recommendations for (1 laboratory workup, (2 acute management, (3 sex assignment in an ethical framework that includes education and involvement of the parents, and (4 surgical management.

The Draft Directive on Consumer Rights: Choices Made and Arguments Used

Directory of Open Access Journals (Sweden)

Willem H. van Boom

2009-11-01

Full Text Available The 2008 proposal for a Directive on Consumer Rights (hereinafter: the Draft aims at reorganizing the acquis of four specific European directives on consumer protection into a more coherent codification of consumer rights. Specifically, it contains rules on precontractual information duties, on withdrawal rights for distance and off-premises contracts, on consumer sales and on general contract terms in consumer contracts. In replacing the four directives with a minimum harmonization character, the Draft marks a further step towards full harmonization of consumer contract law in Europe. This is an unsettling step because the level of protection offered to consumers in the Draft hardly exceeds the level of protection offered by the four directives mentioned earlier. Instead, it diminishes this protection in some regards. In light of all this, the question arises whether the policy choices underlying the Draft are, in fact, convincingly underpinned by solid argumentation. This article addresses this issue by first analyzing the Draft's use of the generic concept of “contracts between consumers and traders”. It is argued that full harmonization of a badly delineated territory is ill-advised. Subsequently, the argumentative power of the policy considerations forwarded by the European Commission in its Regulatory Assessment Study is tested. The article concludes that the Commission’s assessment of expected costs and benefits of the Draft is waver-thin and geared towards persuading the reader of the aptness of choices already made. In some respects, the evidence presented by the Commission is outright unconvincing. At certain points, the Draft even fuels the reader’s suspicion of foregone conclusions. Overall, the need for reduction of the level of protection offered by the current minimum harmonization directives is poorly argued by the Commission and appears, in a number of important ways, not to reflect the socio-economic relationships that

RCA annual report 1996. Draft

International Nuclear Information System (INIS)

1997-02-01

In accordance with Article VII.4 of the Regional Co-operative Agreement for Research, Development and Training Related to Nuclear Science and Technology 1987 and extended in 1992, a draft report of activities for the calendar year 1996 is submitted

75 FR 59268 - Draft Guidance for Industry: Acidified Foods; Availability

Science.gov (United States)

2010-09-27

... fermented dairy products, such as yogurt, belong to a separate category that is not relevant to the... the draft guidance, processors of non-acidified foods (e.g., some acid foods or fermented foods) who... regulations. Under the draft guidance, processors of acid foods and fermented foods who conclude that such...

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Postoperative Gastrointestinal Dysfunction Within an Enhanced Recovery Pathway for Elective Colorectal Surgery.

Science.gov (United States)

Hedrick, Traci L; McEvoy, Matthew D; Mythen, Michael Monty G; Bergamaschi, Roberto; Gupta, Ruchir; Holubar, Stefan D; Senagore, Anthony J; Gan, Tong Joo; Shaw, Andrew D; Thacker, Julie K M; Miller, Timothy E; Wischmeyer, Paul E; Carli, Franco; Evans, David C; Guilbert, Sarah; Kozar, Rosemary; Pryor, Aurora; Thiele, Robert H; Everett, Sotiria; Grocott, Mike; Abola, Ramon E; Bennett-Guerrero, Elliott; Kent, Michael L; Feldman, Liane S; Fiore, Julio F

2018-06-01

The primary driver of length of stay after bowel surgery, particularly colorectal surgery, is the time to return of gastrointestinal (GI) function. Traditionally, delayed GI recovery was thought to be a routine and unavoidable consequence of surgery, but this has been shown to be false in the modern era owing to the proliferation of enhanced recovery protocols. However, impaired GI function is still common after colorectal surgery, and the current literature is ambiguous with regard to the definition of postoperative GI dysfunction (POGD), or what is typically referred to as ileus. This persistent ambiguity has impeded the ability to ascertain the true incidence of the condition and study it properly within a research setting. Furthermore, a rational and standardized approach to prevention and treatment of POGD is needed. The second Perioperative Quality Initiative brought together a group of international experts to review the published literature and provide consensus recommendations on this important topic with the goal to (1) develop a rational definition for POGD that can serve as a framework for clinical and research efforts; (2) critically review the evidence behind current prevention strategies and provide consensus recommendations; and (3) develop rational treatment strategies that take into account the wide spectrum of impaired GI function in the postoperative period.

Using the modified Delphi method to establish clinical consensus for the diagnosis and treatment of patients with rotator cuff pathology

Directory of Open Access Journals (Sweden)

Breda H. Eubank

2016-05-01

Full Text Available Abstract Background Patients presenting to the healthcare system with rotator cuff pathology do not always receive high quality care. High quality care occurs when a patient receives care that is accessible, appropriate, acceptable, effective, efficient, and safe. The aim of this study was twofold: 1 to develop a clinical pathway algorithm that sets forth a stepwise process for making decisions about the diagnosis and treatment of rotator cuff pathology presenting to primary, secondary, and tertiary healthcare settings; and 2 to establish clinical practice guidelines for the diagnosis and treatment of rotator cuff pathology to inform decision-making processes within the algorithm. Methods A three-step modified Delphi method was used to establish consensus. Fourteen experts representing athletic therapy, physiotherapy, sport medicine, and orthopaedic surgery were invited to participate as the expert panel. In round 1, 123 best practice statements were distributed to the panel. Panel members were asked to mark “agree” or “disagree” beside each statement, and provide comments. The same voting method was again used for round 2. Round 3 consisted of a final face-to-face meeting. Results In round 1, statements were grouped and reduced to 44 statements that met consensus. In round 2, five statements reached consensus. In round 3, ten statements reached consensus. Consensus was reached for 59 statements representing five domains: screening, diagnosis, physical examination, investigations, and treatment. The final face-to-face meeting was also used to develop clinical pathway algorithms (i.e., clinical care pathways for three types of rotator cuff pathology: acute, chronic, and acute-on-chronic. Conclusion This consensus guideline will help to standardize care, provide guidance on the diagnosis and treatment of rotator cuff pathology, and assist in clinical decision-making for all healthcare professionals.

Using the modified Delphi method to establish clinical consensus for the diagnosis and treatment of patients with rotator cuff pathology.

Science.gov (United States)

Eubank, Breda H; Mohtadi, Nicholas G; Lafave, Mark R; Wiley, J Preston; Bois, Aaron J; Boorman, Richard S; Sheps, David M

2016-05-20

Patients presenting to the healthcare system with rotator cuff pathology do not always receive high quality care. High quality care occurs when a patient receives care that is accessible, appropriate, acceptable, effective, efficient, and safe. The aim of this study was twofold: 1) to develop a clinical pathway algorithm that sets forth a stepwise process for making decisions about the diagnosis and treatment of rotator cuff pathology presenting to primary, secondary, and tertiary healthcare settings; and 2) to establish clinical practice guidelines for the diagnosis and treatment of rotator cuff pathology to inform decision-making processes within the algorithm. A three-step modified Delphi method was used to establish consensus. Fourteen experts representing athletic therapy, physiotherapy, sport medicine, and orthopaedic surgery were invited to participate as the expert panel. In round 1, 123 best practice statements were distributed to the panel. Panel members were asked to mark "agree" or "disagree" beside each statement, and provide comments. The same voting method was again used for round 2. Round 3 consisted of a final face-to-face meeting. In round 1, statements were grouped and reduced to 44 statements that met consensus. In round 2, five statements reached consensus. In round 3, ten statements reached consensus. Consensus was reached for 59 statements representing five domains: screening, diagnosis, physical examination, investigations, and treatment. The final face-to-face meeting was also used to develop clinical pathway algorithms (i.e., clinical care pathways) for three types of rotator cuff pathology: acute, chronic, and acute-on-chronic. This consensus guideline will help to standardize care, provide guidance on the diagnosis and treatment of rotator cuff pathology, and assist in clinical decision-making for all healthcare professionals.

Rules of international law applicable to transfrontier pollution. Draft

International Nuclear Information System (INIS)

Anon.

1983-01-01

During the 1982 conference of the International Law Association (ILA) in Montreal the ILA discussed and adopted a draft of rules of international law applicable to transfrontier pollution. The draft presents criteria for the definition of transfrontier pollution and sets out rules for the prevention of such pollution and recommendations for a system of multilateral information, consultation, and co-operation in case of energy. (HP) [de

Consensus Convolutional Sparse Coding

KAUST Repository

Choudhury, Biswarup

2017-12-01

Convolutional sparse coding (CSC) is a promising direction for unsupervised learning in computer vision. In contrast to recent supervised methods, CSC allows for convolutional image representations to be learned that are equally useful for high-level vision tasks and low-level image reconstruction and can be applied to a wide range of tasks without problem-specific retraining. Due to their extreme memory requirements, however, existing CSC solvers have so far been limited to low-dimensional problems and datasets using a handful of low-resolution example images at a time. In this paper, we propose a new approach to solving CSC as a consensus optimization problem, which lifts these limitations. By learning CSC features from large-scale image datasets for the first time, we achieve significant quality improvements in a number of imaging tasks. Moreover, the proposed method enables new applications in high-dimensional feature learning that has been intractable using existing CSC methods. This is demonstrated for a variety of reconstruction problems across diverse problem domains, including 3D multispectral demosaicing and 4D light field view synthesis.

Consensus Convolutional Sparse Coding

KAUST Repository

Choudhury, Biswarup

2017-04-11

Convolutional sparse coding (CSC) is a promising direction for unsupervised learning in computer vision. In contrast to recent supervised methods, CSC allows for convolutional image representations to be learned that are equally useful for high-level vision tasks and low-level image reconstruction and can be applied to a wide range of tasks without problem-specific retraining. Due to their extreme memory requirements, however, existing CSC solvers have so far been limited to low-dimensional problems and datasets using a handful of low-resolution example images at a time. In this paper, we propose a new approach to solving CSC as a consensus optimization problem, which lifts these limitations. By learning CSC features from large-scale image datasets for the first time, we achieve significant quality improvements in a number of imaging tasks. Moreover, the proposed method enables new applications in high dimensional feature learning that has been intractable using existing CSC methods. This is demonstrated for a variety of reconstruction problems across diverse problem domains, including 3D multispectral demosaickingand 4D light field view synthesis.

Consensus Convolutional Sparse Coding

KAUST Repository

Choudhury, Biswarup; Swanson, Robin; Heide, Felix; Wetzstein, Gordon; Heidrich, Wolfgang

2017-01-01

Convolutional sparse coding (CSC) is a promising direction for unsupervised learning in computer vision. In contrast to recent supervised methods, CSC allows for convolutional image representations to be learned that are equally useful for high-level vision tasks and low-level image reconstruction and can be applied to a wide range of tasks without problem-specific retraining. Due to their extreme memory requirements, however, existing CSC solvers have so far been limited to low-dimensional problems and datasets using a handful of low-resolution example images at a time. In this paper, we propose a new approach to solving CSC as a consensus optimization problem, which lifts these limitations. By learning CSC features from large-scale image datasets for the first time, we achieve significant quality improvements in a number of imaging tasks. Moreover, the proposed method enables new applications in high-dimensional feature learning that has been intractable using existing CSC methods. This is demonstrated for a variety of reconstruction problems across diverse problem domains, including 3D multispectral demosaicing and 4D light field view synthesis.

The first draft reference genome of the American mink ( Neovison vison )

DEFF Research Database (Denmark)

Cai, Zexi; Petersen, Bent; Sahana, Goutam

2017-01-01

The American mink (Neovison vison) is a semiaquatic species of mustelid native to North America. It’s an important animal for the fur industry. Many efforts have been made to locate genes influencing fur quality and color, but this search has been impeded by the lack of a reference genome. Here we...... present the first draft genome of mink. In our study, two mink individuals were sequenced by Illumina sequencing with 797 Gb sequence generated. Assembly yielded 7,175 scaffolds with an N50 of 6.3 Mb and length of 2.4 Gb including gaps. Repeat sequences constitute around 31% of the genome, which is lower...

Computational study of a low head draft tube and validation with experimental data

Energy Technology Data Exchange (ETDEWEB)

Henau, V De; Payette, F A; Sabourin, M [Alstom Power Systems, Hydro 1350 chemin Saint-Roch, Sorel-Tracy (Quebec), J3R 5P9 (Canada); Deschenes, C; Gagnon, J M; Gouin, P, E-mail: vincent.dehenau@power.alstom.co [Hydraulic Machinery Laboratory, Laval University 1065 ave. de la Medecine, Quebec (Canada)

2010-08-15

The objective of this paper is to investigate methodologies to improve the reliability of CFD analysis of low head turbine draft tubes. When only the draft tube performance is investigated, the study indicates that draft tube only simulations with an adequate treatment of the inlet boundary conditions for velocity and turbulence are a good alternative to rotor/stator (stage) simulations. The definition of the inlet velocity in the near wall regions is critical to get an agreement between the stage and draft tube only solutions. An average turbulent kinetic energy intensity level and average turbulent kinetic energy dissipation length scale are sufficient as turbulence inlet conditions as long as these averages are coherent with the stage solution. Comparisons of the rotor/stator simulation results to the experimental data highlight some discrepancies between the predicted draft tube flow and the experimental observations.

Environmental Regulatory Compliance Plan for site: Draft characterization of the Yucca Mountain site:Draft

International Nuclear Information System (INIS)

1988-01-01

The objective of the EMMP is to document compliance with the NWPA. To do so, a summary description of site characterization activites is provided, based on the consultation draft of the SCP. Subsequent chpaters identify those technical areas having the potential to be impacted by site characterization activities and the monitoring plans proposed to identify whether those impacts acutally occur. Should monitoring confirm the potential for significant adverse impact, mitigative measures will be developed. In the context of site characterization, mitigation is defined as those changes in site characterization activities that serve to avoid or minimize, to the maximum extent practicle, any significant adverse environmental impacts. Although site characterization activies involve both surface and subsurface activities, it is the surface-based aspect of site characterization that is addressed in detailed by the EMMP. The schedule and duration of these activities is given in the consultation draft of the SCP. A breif summary of all proposed activities is given in the EMMP. 10 refs., 8 figs

Implementation of quality assurance and quality control in the Nuclear Analytical Laboratory of the Estonian Radiation Protection Centre

International Nuclear Information System (INIS)

Koeoep, T.; Jakobson, E.

2002-01-01

The Analytical Laboratory of the Estonian Radiation Protection Centre is in the process of implementing the system of Quality Assurance (QA) and Quality Control (QC) in the framework of the IAEA TC Project RER/2/004/ 'QA/QC of Nuclear Analytical Techniques'. The draft Quality Manual with annexes has been prepared accordingly to the ISO 17025 Guide, documents and other printed material delivered on the seminars of the project. The laboratory supply has been supplemented with necessary equipment for guaranteeing of quality. Proficiency testing included in the project has been performed successfully. (author)

Spanish-Portuguese consensus statement on use of daylight-mediated photodynamic therapy with methyl aminolevulinate in the treatment of actinic keratosis.

Science.gov (United States)

Gilaberte, Y; Aguilar, M; Almagro, M; Correia, O; Guillén, C; Harto, A; Pérez-García, B; Pérez-Pérez, L; Redondo, P; Sánchez-Carpintero, I; Serra-Guillén, C; Valladares, L M

2015-10-01

Daylight-mediated photodynamic therapy (PDT) is a new type of PDT that is as effective as conventional PDT in grade 1 and 2 actinic keratosis but with fewer adverse effects, resulting in greater efficiency. The climatic conditions in the Iberian Peninsula require an appropriately adapted consensus protocol. We describe a protocol for the treatment of grade 1 and 2 actinic keratosis with daylight-mediated PDT and methyl aminolevulinate (MAL) adapted to the epidemiological and clinical characteristics of Spanish and Portuguese patients and the climatic conditions of both countries. Twelve dermatologists from different parts of Spain and Portugal with experience in the treatment of actinic keratosis with PDT convened to draft a consensus statement for daylight-mediated PDT with MAL in these countries. Based on a literature review and their own clinical experience, the group developed a recommended protocol. According to the recommendations adopted, patients with multiple grade 1 and 2 lesions, particularly those at risk of developing cancer, are candidates for this type of therapy. Daylight-mediated PDT can be administered throughout the year, although it is not indicated at temperatures below 10°C or at excessively high temperatures. Likewise, therapy should not be administered when it is raining, snowing, or foggy. The procedure is simple, requiring application of a sunscreen with a protection factor of at least 30 based exclusively on organic filters, appropriate preparation of the lesions, application of MAL without occlusion, and activation in daylight for 2hours. This consensus statement represents a practical and detailed guideline to achieve maximum effectiveness of daylight-mediated PDT with MAL in Spain and Portugal with minimal adverse effects. Copyright © 2015 Elsevier España, S.L.U. and AEDV. All rights reserved.

High-quality draft genome sequence of Ensifer meliloti Mlalz-1, a microsymbiont of Medicago laciniata (L.) miller collected in Lanzarote, Canary Islands, Spain.

Science.gov (United States)

Osman, Wan Adnawani Meor; van Berkum, Peter; León-Barrios, Milagros; Velázquez, Encarna; Elia, Patrick; Tian, Rui; Ardley, Julie; Gollagher, Margaret; Seshadri, Rekha; Reddy, T B K; Ivanova, Natalia; Woyke, Tanja; Pati, Amrita; Markowitz, Victor; Baeshen, Mohamed N; Baeshen, Naseebh Nabeeh; Kyrpides, Nikos; Reeve, Wayne

2017-01-01

10.1601/nm.1335 Mlalz-1 (INSDC = ATZD00000000) is an aerobic, motile, Gram-negative, non-spore-forming rod that was isolated from an effective nitrogen-fixing nodule of Medicago laciniata (L.) Miller from a soil sample collected near the town of Guatiza on the island of Lanzarote, the Canary Islands, Spain. This strain nodulates and forms an effective symbiosis with the highly specific host M. laciniata . This rhizobial genome was sequenced as part of the DOE Joint Genome Institute 2010 Genomic Encyclopedia for Bacteria and Archaea-Root Nodule Bacteria (GEBA-RNB) sequencing project. Here the features of 10.1601/nm.1335 Mlalz-1 are described, together with high-quality permanent draft genome sequence information and annotation. The 6,664,116 bp high-quality draft genome is arranged in 99 scaffolds of 100 contigs, containing 6314 protein-coding genes and 74 RNA-only encoding genes. Strain Mlalz-1 is closely related to 10.1601/nm.1335 10.1601/strainfinder?urlappend=%3Fid%3DIAM+12611 T , 10.1601/nm.1334 A 321 T and 10.1601/nm.17831 10.1601/strainfinder?urlappend=%3Fid%3DORS+1407 T , based on 16S rRNA gene sequences. gANI values of ≥98.1% support the classification of strain Mlalz-1 as 10.1601/nm.1335. Nodulation of M. laciniata requires a specific nodC allele, and the nodC gene of strain Mlalz-1 shares ≥98% sequence identity with nodC of M. laciniata -nodulating 10.1601/nm.1328 strains, but ≤93% with nodC of 10.1601/nm.1328 strains that nodulate other Medicago species. Strain Mlalz-1 is unique among sequenced 10.1601/nm.1335 strains in possessing genes encoding components of a T2SS and in having two versions of the adaptive acid tolerance response lpiA-acvB operon. In 10.1601/nm.1334 strain 10.1601/strainfinder?urlappend=%3Fid%3DWSM+419, lpiA is essential for enhancing survival in lethal acid conditions. The second copy of the lpiA-acvB operon of strain Mlalz-1 has highest sequence identity (> 96%) with that of 10.1601/nm.1334 strains, which suggests genetic

Lack of consensus in social systems

Science.gov (United States)

Benczik, I. J.; Benczik, S. Z.; Schmittmann, B.; Zia, R. K. P.

2008-05-01

We propose an exactly solvable model for the dynamics of voters in a two-party system. The opinion formation process is modeled on a random network of agents. The dynamical nature of interpersonal relations is also reflected in the model, as the connections in the network evolve with the dynamics of the voters. In the infinite time limit, an exact solution predicts the emergence of consensus, for arbitrary initial conditions. However, before consensus is reached, two different metastable states can persist for exponentially long times. One state reflects a perfect balancing of opinions, the other reflects a completely static situation. An estimate of the associated lifetimes suggests that lack of consensus is typical for large systems.

Spanish Consensus Statement

Science.gov (United States)

Rey, Guillermo Álvarez; Cuesta, Jordi Ardevol; Loureda, Rafael Arriaza; España, Fernando Ávila; Matas, Ramón Balius; Pazos, Fernando Baró; de Dios Beas Jiménez, Juan; Rosell, Jorge Candel; Fernandez, César Cobián; Ros, Francisco Esparza; Colmenero, Josefina Espejo; de Prado, Jorge Fernández; Cota, Juan José García; González, Jose Ignacio Garrido; Santander, Manuela González; Munilla, Miguel Ángel Herrador; Ruiz, Francisco Ivorra; Díaz, Fernando Jiménez; Marqueta, Pedro Manonelles; Fernandez, Antonio Maestro; Benito, Juan José Muñoz; Vilás, Ramón Olivé; Teres, Xavier Peirau; Amaro, José Peña; Roque, Juan Pérez San; Parenteu, Christophe Ramírez; Serna, Juan Ribas; Álvarez, Mikel Sánchez; Marchori, Carlos Sanchez; Soto, Miguel del Valle; Alonso, José María Villalón; García, Pedro Guillen; de la Iglesia, Nicolas Hugo; Alcorocho, Juan Manuel Lopez

2015-01-01

On the 21st of March, 2015, experts met at Clínica CEMTRO in Madrid, Spain, under the patronage of The Spanish Society for Sports Traumatology (SETRADE), The Spanish Federation of Sports Medicine (FEMEDE), The Spanish Association of Medical Services for Football Clubs (AEMEF), and The Spanish Association of Medical Services for Basketball Clubs (AEMB) with the aim of establishing a round table that would allow specialists to consider the most appropriate current general actions to be taken when treating muscle tears in sport, based on proven scientific data described in the medical literature. Each expert received a questionnaire prior to the aforementioned meeting comprising a set of questions concerning therapeutic indications generally applied in the different stages present during muscle repair. The present Consensus Document is the result of the answers to the questionnaire and resulting discussion and consensus over which are the best current indications in the treatment of muscle tears in sport. Avoiding immobilization, not taking nonsteroidal anti-inflammatory drugs (NSAIDs) randomly, fostering early mobilization, increasing vascularization of injured, site and regulating inflammatory mechanisms—without inhibiting these from the early stages of the recovery period—all stood out as main points of the Consensus Document. Additionally, there is controversy concerning cell stimulation techniques and the use of growth factors or cell inhibitors. The decision concerning discharge was unanimous, as was the criteria considered when it came to performing sport techniques without pain. PMID:27213161

12 CFR 516.20 - What information must I include in my draft business plan?

Science.gov (United States)

2010-01-01

... business plan? 516.20 Section 516.20 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE... What information must I include in my draft business plan? If you must submit a draft business plan... described in the savings association's draft business plan; and (d) Demonstrate how applicable requirements...

78 FR 44117 - Notice of a Public Comment Period on the Draft IRIS Carcinogenicity Assessment for Ethylene Oxide

Science.gov (United States)

2013-07-23

... Public Comment Period on the Draft IRIS Carcinogenicity Assessment for Ethylene Oxide AGENCY... Carcinogenicity of Ethylene Oxide'' (EPA/635/R-13/128a) and on the draft peer review charge questions. The draft... on the draft Evaluation of the Inhalation Carcinogenicity of Ethylene Oxide and on the draft peer...

75 FR 63188 - Draft Guidance for Industry: Early Clinical Trials With Live Biotherapeutic Products: Chemistry...

Science.gov (United States)

2010-10-14

...] Draft Guidance for Industry: Early Clinical Trials With Live Biotherapeutic Products: Chemistry...: Chemistry, Manufacturing, and Control Information'' dated September 2010. The draft guidance provides... Products: Chemistry, Manufacturing, and Control Information'' dated September 2010. The draft guidance...

78 FR 17653 - Upper Great Plains Wind Energy Draft Programmatic Environmental Impact Statement (DOE/EIS-0408)

Science.gov (United States)

2013-03-22

... Wildlife Service Upper Great Plains Wind Energy Draft Programmatic Environmental Impact Statement (DOE/EIS... Plains Wind Energy Draft Programmatic Environmental Impact Statement (Draft [[Page 17654

Consensus algorithm in smart grid and communication networks

Science.gov (United States)

Alfagee, Husain Abdulaziz

On a daily basis, consensus theory attracts more and more researches from different areas of interest, to apply its techniques to solve technical problems in a way that is faster, more reliable, and even more precise than ever before. A power system network is one of those fields that consensus theory employs extensively. The use of the consensus algorithm to solve the Economic Dispatch and Load Restoration Problems is a good example. Instead of a conventional central controller, some researchers have explored an algorithm to solve the above mentioned problems, in a distribution manner, using the consensus algorithm, which is based on calculation methods, i.e., non estimation methods, for updating the information consensus matrix. Starting from this point of solving these types of problems mentioned, specifically, in a distribution fashion, using the consensus algorithm, we have implemented a new advanced consensus algorithm. It is based on the adaptive estimation techniques, such as the Gradient Algorithm and the Recursive Least Square Algorithm, to solve the same problems. This advanced work was tested on different case studies that had formerly been explored, as seen in references 5, 7, and 18. Three and five generators, or agents, with different topologies, correspond to the Economic Dispatch Problem and the IEEE 16-Bus power system corresponds to the Load Restoration Problem. In all the cases we have studied, the results met our expectations with extreme accuracy, and completely matched the results of the previous researchers. There is little question that this research proves the capability and dependability of using the consensus algorithm, based on the estimation methods as the Gradient Algorithm and the Recursive Least Square Algorithm to solve such power problems.

Consensus clustering approach to group brain connectivity matrices

Directory of Open Access Journals (Sweden)

Javier Rasero

2017-10-01

Full Text Available A novel approach rooted on the notion of consensus clustering, a strategy developed for community detection in complex networks, is proposed to cope with the heterogeneity that characterizes connectivity matrices in health and disease. The method can be summarized as follows: (a define, for each node, a distance matrix for the set of subjects by comparing the connectivity pattern of that node in all pairs of subjects; (b cluster the distance matrix for each node; (c build the consensus network from the corresponding partitions; and (d extract groups of subjects by finding the communities of the consensus network thus obtained. Different from the previous implementations of consensus clustering, we thus propose to use the consensus strategy to combine the information arising from the connectivity patterns of each node. The proposed approach may be seen either as an exploratory technique or as an unsupervised pretraining step to help the subsequent construction of a supervised classifier. Applications on a toy model and two real datasets show the effectiveness of the proposed methodology, which represents heterogeneity of a set of subjects in terms of a weighted network, the consensus matrix.

76 FR 10892 - Aquatic Ecosystems, Water Quality, and Global Change: Challenges of Conducting Multi-Stressor...

Science.gov (United States)

2011-02-28

...: EPA is announcing the release of the draft report titled, ``Aquatic Ecosystems, Water Quality, and... relative vulnerability of water quality and aquatic ecosystems, across the United States, to the potential... mailing address, and the document title, ``Aquatic Ecosystems, Water Quality, and Global Change...

Development of dietary pattern evaluation tool for adults and correlation with Dietary Quality Index

OpenAIRE

Lee, Yeo Do; Kim, Kyung Won; Choi, Kyung-Suk; Kim, Misung; Cho, Yeo Jin; Sohn, Cheongmin

2016-01-01

BACKGROUND/OBJECTIVES As the prevalence of chronic diseases has risen, the need for straightforward diagnostic tools for monitoring nutrition status to improve nutrition counseling and disease prevention has likewise increased. This study developed an easily usable dietary behavior pattern diagnosis checklist and investigated its correlation with dietary quality index. SUBJECTS/METHODS A draft dietary pattern evaluation tool was generated by analyzing previous studies. The draft questionnaire...

Cultural Consensus Theory for the ordinal data case.

Science.gov (United States)

Anders, Royce; Batchelder, William H

2015-03-01

A Cultural Consensus Theory approach for ordinal data is developed, leading to a new model for ordered polytomous data. The model introduces a novel way of measuring response biases and also measures consensus item values, a consensus response scale, item difficulty, and informant knowledge. The model is extended as a finite mixture model to fit both simulated and real multicultural data, in which subgroups of informants have different sets of consensus item values. The extension is thus a form of model-based clustering for ordinal data. The hierarchical Bayesian framework is utilized for inference, and two posterior predictive checks are developed to verify the central assumptions of the model.

Automatic drafting system for lined tanks used for nuclear power plants

International Nuclear Information System (INIS)

Sasaki, Ryoichi; Kikuchi, Nobuo

1981-01-01

The concrete vessels lined with metallic sheets are used widely in chemical and food industries and nuclear power plants. Especially in nuclear power plants, rectangular lined tanks have been adopted mainly to store radioactive liquid and solid wastes recently, because of the good volume efficiency. Though the basic structure of the lined tanks is the same, the volume and the form change according to the kinds of stored matters and the positions of pipe connections, and the form of individual lining sheets diversifies. As much labor and time are consumed for the drawing, automatic drafting was planned, and the conditions of application were studied. As for the conditions of application, the following metters are conceivable: the standardized method of design of equipments, the handling of figures numerically or by mathematical formulas, troublesome calculation, the works likely to cause mistake, many drawings for production and so on. The lined tanks almost satisfy these conditions, therefore the automatic drafting was promoted, and good results were obtained. the range of application of the automatic drafting system, the standardization of the form of lined tanks, the size of lining sheets, part number and welding number, the composition of the automatic drafting system, the outline of the program, and the effectiveness of automatic drafting are described. (Kako, I.)

On the Control of Consensus Networks: Theory and Applications

Science.gov (United States)

Hudoba de Badyn, Mathias

Signed networks allow the study of positive and negative interactions between agents. In this thesis, three papers are presented that address controllability of networked dynamics. First, controllability of signed consensus networks is approached from a symmetry perspective, for both linear and nonlinear consensus protocols. It is shown that the graph-theoretic property of signed networks known as structural balance renders the consensus protocol uncontrollable when coupled with a certain type of symmetry. Stabilizability and output controllability of signed linear consensus is also examined, as well as a data-driven approach to finding bipartite consensus stemming from structural balance for signed nonlinear consensus. Second, an algorithm is constructed that allows one to grow a network while preserving controllability, and some generalizations of this algorithm are presented. Submodular optimization is used to analyze a second algorithm that adds nodes to a network to maximize the network connectivity.

Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)

OpenAIRE

Chalmers, J.R.; Simpson, E.; Apfelbacher, C.J.; Thomas, K.S.; von Kobyletzki, L.; Schmitt, J.; Singh, J.A.; Svensson, Å.; Williams, H.C.; Abuabara, K.; Aoki, V.; Ardeleanu, M.; Awici-Rasmussen, M.; Barbarot, S.; Berents, T.L.

2016-01-01

This article is a report of the fourth meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in Malmö, Sweden on 23–24 April 2015 (HOME IV). The aim of the meeting was to achieve consensus over the preferred outcome instruments for measuring patient-reported symptoms and quality of life for the HOME core outcome set for atopic eczema (AE). Following presentations, which included data from systematic reviews, consensus discussions were held in a mixture of whole group a...

76 FR 10908 - Draft Guidance for Industry on Medication Guides-Distribution Requirements and Inclusion of...

Science.gov (United States)

2011-02-28

...] Draft Guidance for Industry on Medication Guides--Distribution Requirements and Inclusion of Medication... a draft guidance for industry entitled ``Medication Guides--Distribution Requirements and Inclusion... Inclusion of Medication Guides in Risk Evaluation and Mitigation Strategies (REMS).'' This draft guidance is...

Numerical and Experimental Study on a Model Draft Tube with Vortex Generators

Directory of Open Access Journals (Sweden)

Tian Xiaoqing

2013-01-01

Full Text Available A model water turbine draft tube containing vortex generators (VG was studied. Numerical simulations were performed to investigate 55 design variations of the vortex generators in a draft tube. After analyzing the shapes of streamlines and velocity distributions in the tube and comparing static pressure recovery coefficients (SPRC in different design variations, an optimum vortex generator layout, which can raise SPRC of the draft tube by 4.8 percent, was found. To verify the effectiveness of the vortex generator application, a series of experiments were carried out. The results show that by choosing optimal vortex generator parameters, such as the installation type, installation position, blade-to-blade distance, and blade inclination angle, the draft tube equipped vortex generators can effectively raise their SPRC andworking stability.

Public Awareness of the Scientific Consensus on Climate

Directory of Open Access Journals (Sweden)

Lawrence C. Hamilton

2016-11-01

Full Text Available Questions about climate change elicit some of the widest political divisions of any items on recent U.S. surveys. Severe polarization affects even basic questions about the reality of anthropogenic climate change (ACC, or whether most scientists agree that humans are changing the Earth’s climate. Statements about scientific consensus have been contentious among social scientists, with some arguing for consensus awareness as a “gateway cognition” that leads to greater public acceptance of ACC, but others characterizing consensus messaging (deliberate communication about the level of scientific agreement as a counterproductive tactic that exacerbates polarization. A series of statewide surveys, with nationwide benchmarks, repeated questions about the reality of ACC and scientific consensus many times over 2010 to 2016. These data permit tests for change in beliefs and polarization. ACC and consensus beliefs have similar trends and individual background predictors. Both rose gradually by about 10 points over 2010 to 2016, showing no abrupt shifts that might correspond to events such as scientific reports, leadership statements, or weather. Growing awareness of the scientific consensus, whether from deliberate messaging or the cumulative impact of many studies and publicly engaged scientists, provides the most plausible explanation for this rise in both series. In state-level data, the gap between liberal and conservative views on the reality of ACC did not widen over this period, whereas the liberal–conservative gap regarding existence of a scientific consensus narrowed.

Research and Development of Natural Draft Ultra-Low Emissions Burners for Gas Appliances

Energy Technology Data Exchange (ETDEWEB)

Therkelsen, Peter [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Cheng, Robert [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sholes, Darren [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2017-08-31

Combustion systems used in residential and commercial cooking appliances must be robust and easy to use while meeting air quality standards. Current air quality standards for cooking appliances are far greater than other stationary combustion equipment. By developing an advanced low emission combustion system for cooking appliances, the air quality impacts from these devices can be reduced. This project adapted the Lawrence Berkeley National Laboratory (LBNL) Ring-Stabilizer Burner combustion technology for residential and commercial natural gas fired cooking appliances (such as ovens, ranges, and cooktops). LBNL originally developed the Ring-Stabilizer Burner for a NASA funded microgravity experiment. This natural draft combustion technology reduces NOx emissions significantly below current SCAQMD emissions standards without post combustion treatment. Additionally, the Ring-Stabilizer Burner technology does not require the assistance of a blower to achieve an ultra-low emission lean premix flame. The research team evaluated the Ring-Stabilizer Burner and fabricated the most promising designs based on their emissions and turndown.

Three draft genomes of Vibrio coralliilyticus strains isolated from bivalve hatcheries

Science.gov (United States)

Reported here are the draft genomes of three Vibrio coralliilyticus isolates RE87, AIC-7, and 080116A. Each strain was isolated in association with diseased oyster larvae in commercial aquaculture systems. These draft genomes will be useful for further studies in understanding the genomic features...

Traditional Engineering Graphics versus Computer-Aided Drafting: A View from Academe.

Science.gov (United States)

Foster, Robert J.

1987-01-01

Argues for a legitimate role of manually expressed engineering graphics within engineering education as a needed support for computer-assisted drafting work. Discusses what and how students should learn as well as trends in engineering graphics education. Compares and contrasts manual and computer drafting methods. (CW)

77 FR 22247 - Veterinary Feed Directive; Draft Text for Proposed Regulation

Science.gov (United States)

2012-04-13

.... FDA-2010-N-0155] Veterinary Feed Directive; Draft Text for Proposed Regulation AGENCY: Food and Drug... the efficiency of FDA's Veterinary Feed Directive (VFD) program. The Agency is making this draft text..., rm. 1061, Rockville, MD 20852. FOR FURTHER INFORMATION CONTACT: Sharon Benz, Center for Veterinary...

Spanish consensus on the use of natalizumab (Tysabri®)-2013.

Science.gov (United States)

Fernández, O; García-Merino, J A; Arroyo, R; Álvarez-Cermeño, J C; Izquierdo, G; Saiz, A; Olascoaga, J; Rodríguez-Antigüedad, A; Prieto, J M; Oreja-Guevara, C; Hernández, M A; Moral, E; Meca, J; Montalbán, X

2015-06-01

Natalizumab treatment has been shown to be very efficacious in clinical trials and very effective in clinical practice in patients with relapsing-remitting multiple sclerosis, by reducing relapses, slowing disease progression, and improving magnetic resonance imaging patterns. However, the drug has also been associated with a risk of progressive multifocal leukoencephalopathy (PML). The first consensus statement on natalizumab use, published in 2011, has been updated to include new data on diagnostic procedures, monitoring for patients undergoing treatment, PML management, and other topics of interest including the management of patients discontinuing natalizumab. This updated version followed the method used in the first consensus. A group of Spanish experts in multiple sclerosis (the authors of the present document) reviewed all currently available literature on natalizumab and identified the relevant topics would need updating based on their clinical experience. The initial draft passed through review cycles until the final version was completed. Studies in clinical practice have demonstrated that changing to natalizumab is more effective than switching between immunomodulators. They favour early treatment with natalizumab rather than using natalizumab in a later stage as a rescue therapy. Although the drug is very effective, its potential adverse effects need to be considered, with particular attention to the patient's likelihood of developing PML. The neurologist should carefully explain the risks and benefits of the treatment, comparing them to the risks of multiple sclerosis in terms the patient can understand. Before treatment is started, laboratory tests and magnetic resonance images should be available to permit proper follow-up. The risk of PML should be stratified as high, medium, or low according to presence or absence of anti-JC virus antibodies, history of immunosuppressive therapy, and treatment duration. Although the presence of anti-JC virus

Center to Advance Palliative Care palliative care clinical care and customer satisfaction metrics consensus recommendations.

Science.gov (United States)

Weissman, David E; Morrison, R Sean; Meier, Diane E

2010-02-01

Data collection and analysis are vital for strategic planning, quality improvement, and demonstration of palliative care program impact to hospital administrators, private funders and policymakers. Since 2000, the Center to Advance Palliative Care (CAPC) has provided technical assistance to hospitals, health systems and hospices working to start, sustain, and grow nonhospice palliative care programs. CAPC convened a consensus panel in 2008 to develop recommendations for specific clinical and customer metrics that programs should track. The panel agreed on four key domains of clinical metrics and two domains of customer metrics. Clinical metrics include: daily assessment of physical/psychological/spiritual symptoms by a symptom assessment tool; establishment of patient-centered goals of care; support to patient/family caregivers; and management of transitions across care sites. For customer metrics, consensus was reached on two domains that should be tracked to assess satisfaction: patient/family satisfaction, and referring clinician satisfaction. In an effort to ensure access to reliably high-quality palliative care data throughout the nation, hospital palliative care programs are encouraged to collect and report outcomes for each of the metric domains described here.

Consensus Based Nuclear Public-Hearing System Model

International Nuclear Information System (INIS)

Young Wook Lee; Suk Hoon Kim; Young Ho Cho; Hyun Seok Ko; Dong Hoon Shin; Chang Sun Kang; Joo Hyun Moon

2006-01-01

Although the government admit the benefit of construction of a nuclear facility for national electric source, related policy could be developed and carried out only if the public, especially who have some stake on it, recognize the benefit and accept the policy. For public participation, Korea has a system of public-hearing in accordance with the law. Because of the absence of the detailed way for public opinion aggregation and for the reflection of the aggregated opinion, Korean public-hearing system is only a conceptual model. Therefore, some specific system for Korean Public-Hearing should be developed and applied. In this study, to share the right of decision making, which is an ultimate concept for public participation, decision making components and the characteristics of each phase are analyzed. The criteria weight for assessment and comparison with alternatives are founded as a valuation factor of the decision making components, which should be based on the social consensus. On these foundations, a system for aggregation and reflection of the public opinion was proposed. The system named 'CPDM' (Consensus based Participatory Decision Making) has three authority groups for decision making. At first, 'advisory experts group' play a role for the technical assessment and the serve utility value on the criteria for each alternatives. Next, 'participatory deliberation group' play a role for consensus building on the relative-importance (weight) between the criteria by feedback to promote degree of consensus. Lastly including gentlemen of the long robe, 'expert group for decision making' play a role to reflect the utility and weight and make a decision with agreement for performance of it. Also, in this study, a mathematical model for the quantification of the degree of consensus was conceptualized using Ordered Weighted Averaging (OWA) aggregation operator and fuzzy similarity theory, which is a comparison concept. Since this model enables influence of each

76 FR 51034 - Availability of Draft NTP Monograph on Potential Developmental Effects of Cancer Chemotherapy...

Science.gov (United States)

2011-08-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Availability of Draft NTP Monograph on Potential... Meeting To Peer Review Draft Monograph AGENCY: Division of the National Toxicology Program (DNTP...: Availability of Draft Monograph; Request for Comments; Announcement of a Peer Review Panel Meeting. SUMMARY...

Yakima Fisheries Project : Revised Draft Environmental Impact Statement.

Energy Technology Data Exchange (ETDEWEB)

United States. Bonneville Power Administration.

1995-05-01

BPA proposes to fund several fishery-related activities in the Yakima River Basin. The Yakima Fisheries Project (YFP), included in the Northwest Power Planning Council`s fish and wildlife program, would be jointly managed by the State of Washington and the Yakima Indian Nation. Fisheries resources in the Yakima River are severely reduced from historical levels and there is a significant potential for enhancement of these resources. BPA`s proposed action is to fund (1) information gathering on the implementation of supplementation techniques and on feasibility of reintroducing coho salmon in an environment where native populations have become extinct; (2) research activities based on continuous assessment, feedback and improvement of research design and activities ({open_quotes}adaptive management{close_quotes}); and (3) the construction, operation, and maintenance of facilities for supplementing populations of upper Yakima spring chinook salmon. The project has been considerably revised from the original proposal described in the first draft EIS. Examined in addition to No Action (which would leave present anadromous fisheries resources unchanged in the, Basin) are two alternatives for action: (1) supplementation of depressed natural populations of upper Yakima spring chinook and (2) that same supplementation plus a study to determine the feasibility of re-establishing (via stock imported from another basin) naturally spawning population and a significant fall fishery for coho in the Yakima Basin. Alternative 2 has been identified as the preferred action. Major issues examined in the Revised Draft EIS include potential impacts of the project on genetic and ecological resources of existing fish populations, on water quality and quantity, on threatened and endangered species listed under the Endangered Species Act, and on the recreational fishery.

Scenario drafting to anticipate future developments in technology assessment

Directory of Open Access Journals (Sweden)

Retèl Valesca P

2012-08-01

Full Text Available Abstract Background Health Technology Assessment (HTA information, and in particular cost-effectiveness data is needed to guide decisions, preferably already in early stages of technological development. However, at that moment there is usually a high degree of uncertainty, because evidence is limited and different development paths are still possible. We developed a multi-parameter framework to assess dynamic aspects of a technology -still in development-, by means of scenario drafting to determine the effects, costs and cost-effectiveness of possible future diffusion patterns. Secondly, we explored the value of this method on the case of the clinical implementation of the 70-gene signature for breast cancer, a gene expression profile for selecting patients who will benefit most from chemotherapy. Methods To incorporate process-uncertainty, ten possible scenarios regarding the introduction of the 70-gene signature were drafted with European experts. Out of 5 most likely scenarios, 3 drivers of diffusion (non-compliance, technical failure, and uptake were quantitatively integrated in a decision-analytical model. For these scenarios, the cost-effectiveness of the 70-gene signature expressed in Incremental Cost-Effectiveness Ratios (ICERs was compared to clinical guidelines, calculated from the past (2005 until the future (2020. Results In 2005 the ICER was €1,9 million/quality-adjusted-life-year (QALY, meaning that the 70-gene signature was not yet cost-effective compared to the current clinical guideline. The ICER for the 70-gene signature improved over time with a range of €1,9 million to €26,145 in 2010 and €1,9 million to €11,123/QALY in 2020 depending on the separate scenario used. From 2010, the 70-gene signature should be cost-effective, based on the combined scenario. The uptake-scenario had strongest influence on the cost-effectiveness. Conclusions When optimal diffusion of a technology is sought, incorporating process

Performance indicators for clinical practice management in primary care in Portugal: consensus from a Delphi study.

Science.gov (United States)

Basto-Pereira, Miguel; Furtado, Sara Isabel Félix; Silva, Ricardo Jorge Pereira; Fachado González, Francisco; Vara Fernandes, Tito Manuel; Correia de Sousa, Jaime; Yaphe, John

2015-03-01

Performance indicators assessing the quality of medical care and linked to pay for performance may cause disagreement. Portuguese indicators included in recent health care reform are controversial. To obtain consensus from opinion leaders in family medicine regarding the performance indicators for practice management used in the evaluation of Family Health Units in Portugal. Eighty-nine specialists in primary care were invited to answer the following question in an online Delphi study: 'Which performance indicators should be assessed regarding the organization and management of clinical practice in primary care in Portugal?' A Likert scale was used to evaluate validity, reliability, feasibility and sensitivity to change. Twenty-seven experts participated in the second round and achieved a high degree of consensus. Eight categories were created for analysis. The experts suggested the use of existing indicators as well as new indicators. Thirty-nine indicators suggested by the experts are currently in use in Portugal. The assessment of the number of clinical acts performed, the number of administrative acts, and evaluation of the clinical demographic profile achieved a high degree of consensus. The expert panel suggested fifty new indicators. Five categories of these new indicators had a high degree of consensus, and three categories had a low degree of consensus. The expert panel recommended that performance indicators of practice management should first assess the quantity of clinical and administrative activities undertaken. These indicators must take into account the human and financial resources available to the clinic and its demographic context.

A post-assembly genome-improvement toolkit (PAGIT) to obtain annotated genomes from contigs.

Science.gov (United States)

Swain, Martin T; Tsai, Isheng J; Assefa, Samual A; Newbold, Chris; Berriman, Matthew; Otto, Thomas D

2012-06-07

Genome projects now produce draft assemblies within weeks owing to advanced high-throughput sequencing technologies. For milestone projects such as Escherichia coli or Homo sapiens, teams of scientists were employed to manually curate and finish these genomes to a high standard. Nowadays, this is not feasible for most projects, and the quality of genomes is generally of a much lower standard. This protocol describes software (PAGIT) that is used to improve the quality of draft genomes. It offers flexible functionality to close gaps in scaffolds, correct base errors in the consensus sequence and exploit reference genomes (if available) in order to improve scaffolding and generating annotations. The protocol is most accessible for bacterial and small eukaryotic genomes (up to 300 Mb), such as pathogenic bacteria, malaria and parasitic worms. Applying PAGIT to an E. coli assembly takes ∼24 h: it doubles the average contig size and annotates over 4,300 gene models.

76 FR 22721 - Notice of Availability of Draft Resource Management Plans and Associated Environmental Impact...

Science.gov (United States)

2011-04-22

...] Notice of Availability of Draft Resource Management Plans and Associated Environmental Impact Statement for the Bighorn Basin Resource Management Plan Revision Project, Cody and Worland Field Offices... Draft Resource Management Plan (RMP) for the Cody Field Office, a Draft RMP for the Worland Field Office...

Preliminary application of the draft code case for alloy 617 for a high temperature component

International Nuclear Information System (INIS)

Lee, Hyeong Yeon; Kim, Yong Wan; Song, Kee Nam

2008-01-01

The ASME draft Code Case for Alloy 617 was developed in the late 1980s for the design of very-high-temperature gas cooled reactors. The draft Code Case was patterned after the ASME Code Section III Subsection NH and was intended to cover Ni-Cr-Co-Mo Alloy 617 to 982 .deg. C (1800 .deg. F). But the draft Code Case is still in an incomplete status, lacking necessary material properties and design data. In this study, a preliminary evaluation on the creep-fatigue damage for a high temperature hot duct pipe structure has been carried out according to the draft Code Case. The evaluation procedures and results according to the draft Code Case for Alloy 617 material were compared with those of the ASME Subsection NH and RCC-MR for Alloy 800H material. It was shown that many data including material properties, fatigue and creep data should be supplemented for the draft Code Case. However, when the evaluation results on the creep-fatigue damage according to the draft Code Case, ASME-NH and RCC-MR were compared based on the preliminary evaluation, it was shown that the Alloy 617 results from the draft Code Case tended to be more resistant to the creep damage while less resistant to the fatigue damage than those from the ASME-NH and RCC-MR

International Veterinary Epilepsy Task Force consensus proposal

DEFF Research Database (Denmark)

Bhatti, Sofie F M; De Risio, Luisa; Muñana, Karen

2015-01-01

with the initial drug is unsatisfactory, and 4) when treatment changes should be considered. In this consensus proposal, an overview is given on the aim of AED treatment, when to start long-term treatment in canine epilepsy and which veterinary AEDs are currently in use for dogs. The consensus proposal for drug...... treatment protocols, 1) is based on current published evidence-based literature, 2) considers the current legal framework of the cascade regulation for the prescription of veterinary drugs in Europe, and 3) reflects the authors' experience. With this paper it is aimed to provide a consensus...

78 FR 49318 - Availability of Draft Advisory Circular (AC) 90-106A and AC 20-167A

Science.gov (United States)

2013-08-13

...] Availability of Draft Advisory Circular (AC) 90-106A and AC 20- 167A AGENCY: Federal Aviation Administration... of draft Advisory Circular (AC) 90-106A, Enhanced Flight Vision Systems and draft AC 20- 167A... Federal holidays. FOR FURTHER INFORMATION CONTACT: For technical questions concerning draft AC 90-106A...

Production of charcoal from woods and bamboo in a small natural draft carbonizer

Energy Technology Data Exchange (ETDEWEB)

Tippayawong, Nakorn; Saengow, Nakarin; Chaiya, Ekarin

2010-07-01

There is a strong domestic market for charcoal in Thailand and many developing countries. Charcoal is usually made from biomass materials in small scale, simple kilns. Traditional charcoal making kilns adopts a process that is very inefficient, and damaging to the environment. In this work, an alternative charcoal reactor based on natural draft, pyrolysis gas burning concept was proposed and demonstrated. Tests with longan woods and bamboo showed that good quality charcoal can be produced in shorter time with lower pollution emissions, compared with traditional kilns. The proposed carbonizer proved to be suitable for small scale, charcoal production in rural area.

Quality indicators for diagnosis and treatment of respiratory tract infections in general practice: a modified Delphi study

DEFF Research Database (Denmark)

Hansen, Malene Plejdrup; Bjerrum, Lars; Gahrn-Hansen, Bente

2010-01-01

was achieved in both Delphi rounds. A total of 41 of the proposed 59 quality indicators attained consensus. None of the quality indicators focusing on the diagnostic process achieved consensus. Consensus was attained for 14 quality indicators focusing on the decision regarding antibiotic treatment and for 27...... quality indicators focusing on the choice of antibiotics. CONCLUSION: This study resulted in a final set of 41 quality indicators concerning respiratory tract infections in general practice. These quality indicators may be used to strengthen general practitioners' focus on their management of patients......OBJECTIVE: To develop a set of quality indicators focusing on the diagnosis and treatment of respiratory tract infections in general practice. DESIGN: A modified 2-round Delphi study. SETTING: General practice. SUBJECTS: A panel of 27 experts (13 countries) comprising mainly general practitioners...

NIH consensus development statement on management of hepatitis B.

Science.gov (United States)

Belongia, E A; Costa, J; Gareen, I F; Grem, J L; Inadomi, J M; Kern, E R; McHugh, J A; Petersen, G M; Rein, M F; Sorrell, M F; Strader, D B; Trotter, H T

To provide health care providers, patients, and the general public with a responsible assessment of currently available data on the management of hepatitis B. A non-DHHS, nonadvocate 12-member panel representing the fields of hepatology and liver transplantation, gastroenterology, public health and epidemiology, infectious diseases, pathology, oncology, family practice, internal medicine, and a public representative. In addition, 22 experts from pertinent fields presented data to the panel and conference audience. Presentations by experts and a systematic review of the literature prepared by the Minnesota Evidence-based Practice Center, through the Agency for Healthcare Research and Quality. Scientific evidence was given precedence over anecdotal experience. The panel drafted its statement based on scientific evidence presented in open forum and on published scientific literature. The draft statement was presented on the final day of the conference and circulated to the audience for comment. The panel released a revised statement later that day at http://consensus.nih.gov. This statement is an independent report of the panel and is not a policy statement of the NIH or the Federal Government. The most important predictors of cirrhosis or hepatocellular carcinoma in persons who have chronic HBV are persistently elevated HBV DNA and ALT levels in blood. Other risk factors include HBV genotype C infection, male sex, older age, family history of hepatocellular carcinoma, and co-infection with HCV or HIV. The major goals of anti-HBV therapy are to prevent the development of progressive disease, specifically cirrhosis and liver failure, as well as hepatocellular carcinoma development and subsequent death. To date, no RCTs of anti-HBV therapies have demonstrated a beneficial impact on overall mortality, liver-specific mortality, or development of hepatocellular carcinoma. Most published reports of hepatitis therapy use changes in short-term virologic, biochemical, and

Re: “Comments on draft rules for granting Foreign Tax Credit”

NARCIS (Netherlands)

Sanghavi, Dhruv

2016-01-01

This letter to the Indian Ministry of Finance critically reviews the proposed rules for the grant of credit in India for taxes paid in a foreign country (Draft Rules). It points out what is perhaps the most egregious drawback in the Draft Rules - they do not consider the erosive impact foreign

[SECOT consensus on medial femorotibial osteoarthritis].

Science.gov (United States)

Moreno, A; Silvestre, A; Carpintero, P

2013-01-01

A consensus, prepared by SECOT, is presented on the management of medial knee compartment osteoarthritis, in order to establish clinical criteria and recommendations directed at unifying the criteria in its management, dealing with the factors involved in the pathogenesis of medial femorotibial knee osteoarthritis, the usefulness of diagnostic imaging techniques, and the usefulness of arthroscopy. Conservative and surgical treatments are also analysed. The experts consulted showed a consensus (agreed or disagreed) in 65.8% of the items considered, leaving 14items where no consensus was found, which included the aetiopathogenesis of the osteoarthritis, the value of NMR in degenerative disease, the usefulness of COX-2 and the chondroprotective drugs, as well as on the ideal valgus tibial osteotomy technique. © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

Bruxism defined and graded: an international consensus

NARCIS (Netherlands)

Lobbezoo, F.; Ahlberg, J.; Glaros, A.G.; Kato, T.; Koyano, K.; Lavigne, G.J.; de Leeuw, R.; Manfredini, D.; Svensson, P.; Winocur, E.

2013-01-01

To date, there is no consensus about the definition and diagnostic grading of bruxism. A written consensus discussion was held among an international group of bruxism experts as to formulate a definition of bruxism and to suggest a grading system for its operationalisation. The expert group defined

OGC Consensus: How Successful Standards Are Made

Directory of Open Access Journals (Sweden)

Carl Reed

2015-09-01

Full Text Available This paper describes the history, background, and current status of the Open Geospatial Consortium (OGC standards development consensus process. The roots of the formation of the OGC lie in the early 1990s when a very strong market requirement for exchanging GIS data content was clearly stated. At that time, each GIS vendor had their own formats for publishing and/or exchanging their GIS data. There was no mechanism or organization that provided a forum for the GIS vendors and GIS data users to collaborate and agree on how to share GIS data. That requirement, along with the vision of a few individuals, led to the formation of the OGC. This paper describes the early development of the consensus process in the OGC, how this process has evolved over time, why consensus is so important for defining open standards that are implemented in the marketplace, and the future of the OGC consensus process.

IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE) (Public Comment Draft)

Science.gov (United States)

In September 2016, the U.S. Environmental Protection Agency's (USEPA) released the draft Integrated Risk Information System (IRIS) Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE). Consistent with the 2013 IRIS Enhancements, draft IRIS assessments are released prior to e...

Definition and diagnosis of small fiber neuropathy: consensus from the Peripheral Neuropathy Scientific Department of the Brazilian Academy of Neurology

Directory of Open Access Journals (Sweden)

Francisco de Assis Aquino Gondim

Full Text Available ABSTRACT The aim of this study was to describe the results of a Brazilian Consensus on Small Fiber Neuropathy (SFN. Fifteen neurologists (members of the Brazilian Academy of Neurology reviewed a preliminary draft. Eleven panelists got together in the city of Fortaleza to discuss and finish the text for the manuscript submission. Small fiber neuropathy can be defined as a subtype of neuropathy characterized by selective involvement of unmyelinated or thinly myelinated sensory fibers. Its clinical picture includes both negative and positive manifestations: sensory (pain/dysesthesias/pruritus or combined sensory and autonomic complaints, associated with an almost entirely normal neurological examination. Standard electromyography is normal. A growing list of medical conditions is associated with SFN. The classification of SFN may also serve as a useful terminology to uncover minor discrepancies in the normal values from different neurophysiology laboratories. Several techniques may disclose sensory and/or autonomic impairment. Further studies are necessary to refine these techniques and develop specific therapies.

AGILE DRAFTING OF OUTSOURCING CONTRACTS

DEFF Research Database (Denmark)

Schlichter, Bjarne Rerup; Storgaard, Kristian

2015-01-01

and in several parallel tracks using different competencies. By the use of an illustrative case-study, this paper explores how scrum can be applied to enhance the process of drafting outsourcing contracts. The analysis indicates that the use of an agile method, such as Scrum, can be beneficial in this context...

Shape optimization of draft tubes for Agnew microhydro turbines

International Nuclear Information System (INIS)

Shojaeefard, Mohammad Hasan; Mirzaei, Ammar; Babaei, Ali

2014-01-01

Highlights: • The draft tube of Agnew microhydro turbine was optimized. • Pareto optimal solutions were determined by neural networks and NSGA-II algorithm. • The pressure recovery factor increases with height and angle over design ranges. • The loss coefficient reaches the minimum values at angles about 2 o . • Swirl of the incoming flow has great influence on the optimization results. - Abstract: In this study, the shape optimization of draft tubes utilized in Agnew type microhydro turbines has been discussed. The design parameters of the draft tube such as the cone angle and the height above the tailrace are considered in defining an optimization problem whose goal is to maximize the pressure recovery factor and minimize the energy loss coefficient of flow. The design space is determined by considering the experimental constraints and parameterized by the method of face-centered uniform ascertain distribution. The numerical simulations are performed using the boundary conditions found from laboratory tests and the obtained results are analyzed to create and validate a feed-forward neural network model, which is implemented as a surrogate model. The optimal Pareto solutions are finally determined using the NSGA-II evolutionary algorithm and compared for different inlet conditions. The results predict that the high swirl of the incoming flow drastically reduces the performance of the draft tube

The Mexican consensus on chronic constipation

Directory of Open Access Journals (Sweden)

J.M. Remes-Troche

2018-04-01

Full Text Available Introduction: Significant advances have been made in the knowledge and understanding of the epidemiology, pathophysiology, diagnosis, and treatment of chronic constipation, since the publication of the 2011 guidelines on chronic constipation diagnosis and treatment in Mexico from the Asociación Mexicana de Gastroenterología. Aims: To present a consensus review of the current state of knowledge about chronic constipation, providing updated information and integrating the new scientific evidence. Methods: Three general coordinators reviewed the literature published within the time frame of January 2011 and January 2017. From that information, 62 initial statements were formulated and then sent to 12 national experts for their revision. The statements were voted upon, using the Delphi system in 3 voting rounds (2 electronic and one face-to-face. The statements were classified through the GRADE system and those that reached agreement > 75% were included in the consensus. Results and conclusions: The present consensus is made up of 42 final statements that provide updated knowledge, supplementing the information that had not been included in the previous guidelines. The strength of recommendation and quality (level of evidence were established for each statement. The current definitions of chronic constipation, functional constipation, and opioid-induced constipation are given, and diagnostic strategies based on the available diagnostic methods are described. The consensus treatment recommendations were established from evidence on the roles of diet and exercise, fiber, laxatives, new drugs (such as prucalopride, lubiprostone, linaclotide, plecanatide, biofeedback therapy, and surgery. Resumen: Introducción: Desde la publicación de las guías de diagnóstico y tratamiento del estreñimiento crónico (EC en México de la Asociación Mexicana de Gastroenterología en el 2011 se han producido avances significativos en el conocimiento de la

Pharmacologic management of chronic neuropathic pain

Science.gov (United States)

Mu, Alex; Weinberg, Erica; Moulin, Dwight E.; Clarke, Hance

2017-01-01

Abstract Objective To provide family physicians with a practical clinical summary of the Canadian Pain Society (CPS) revised consensus statement on the pharmacologic management of neuropathic pain. Quality of evidence A multidisciplinary interest group within the CPS conducted a systematic review of the literature on the current treatments of neuropathic pain in drafting the revised consensus statement. Main message Gabapentinoids, tricyclic antidepressants, and serotonin-norepinephrine reuptake inhibitors are the first-line agents for treating neuropathic pain. Tramadol and other opioids are recommended as second-line agents, while cannabinoids are newly recommended as third-line agents. Other anticonvulsants, methadone, tapentadol, topical lidocaine, and botulinum toxin are recommended as fourth-line agents. Conclusion Many pharmacologic analgesics exist for the treatment of neuropathic pain. Through evidence-based recommendations, the CPS revised consensus statement helps guide family physicians in the management of patients with neuropathic pain. PMID:29138154

First Draft of the Research Agenda

DEFF Research Database (Denmark)

Dahl, Hanne Marlene; Pieper, Michael; Fahnøe, Kristian

This report is a draft of a research agenda that the consortium INNOSERV has provided to the European Commission. It is the result of the work of researchers and insights provided by users, practitioners, experts and policy-makers involving around 20 examples of innovative practices from different...... and provide one of several sources of input from social platforms for HORISON 2020. INNOSERV is a social platform consisting of experts from various EU countries and key stakeholders and is itself an innovation in how researchers work together with representatives from various parts of society, thereby...... ensuring the relevance of the suggested draft of a research agenda. The seven themes identified are: User-centeredness innovation in social services, Innovation in institutional development, Framing of social services in relation to innovation, The governance of innovation, Influence of regional and local...

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

International Nuclear Information System (INIS)

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

2015-01-01

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

International consensus on safety principles

International Nuclear Information System (INIS)

Warnecke, E.

1993-01-01

The International Atomic Energy Agency (IAEA) has been regularly requested by its Member States to provide evidence that radioactive waste can be managed safely and to help demonstrate a harmonization of approach at the international level by providing safety documents. In response, IAEA established a special series of safety documents devoted to radioactive waste management. These documents will be elaborated within the Radioactive Waste Safety Standards (RADWASS) programme [1,2] which covers all aspects of radioactive waste management. The RADWASS programme develops a series of international consensus documents on all parts of the safe management of radioactive waste, including disposal. The purpose of the RADWASS programme is to (i) document existing international consensus in the approaches and methodologies for safe radioactive waste management, (ii) create a mechanism to establish consensus where it does not exist and (iii) provide Member States with a comprehensive series of internationally agreed upon documents to complement national standards and criteria. This paper describes the RADWASS programme, and covers the structure, implementation plans and status of documents under preparation

Achieving diagnosis by consensus

LENUS (Irish Health Repository)

Kane, Bridget

2009-08-01

This paper provides an analysis of the collaborative work conducted at a multidisciplinary medical team meeting, where a patient’s definitive diagnosis is agreed, by consensus. The features that distinguish this process of diagnostic work by consensus are examined in depth. The current use of technology to support this collaborative activity is described, and experienced deficiencies are identified. Emphasis is placed on the visual and perceptual difficulty for individual specialities in making interpretations, and on how, through collaboration in discussion, definitive diagnosis is actually achieved. The challenge for providing adequate support for the multidisciplinary team at their meeting is outlined, given the multifaceted nature of the setting, i.e. patient management, educational, organizational and social functions, that need to be satisfied.

77 FR 46986 - Revisions to Electric Quarterly Report Filing Process; Availability of Draft XML Schema

Science.gov (United States)

2012-08-07

... Supplementary Information Section below for details. DATES: The draft XML Schema is now available at the links...] Revisions to Electric Quarterly Report Filing Process; Availability of Draft XML Schema AGENCY: Federal... Regulatory Commission is making available on its Web site ( http://www.ferc.gov ) a draft of the XML schema...

Core Outcomes for Colorectal Cancer Surgery: A Consensus Study.

Directory of Open Access Journals (Sweden)

Angus G K McNair

2016-08-01

second surveys, respectively. Consensus meetings generated agreement on a 12 domain COS. This constituted five perioperative outcome domains (including anastomotic leak, four quality of life outcome domains (including fecal urgency and incontinence, and three oncological outcome domains (including long-term survival.This study used robust consensus methodology to develop a core outcome set for use in colorectal cancer surgical trials. It is now necessary to validate the use of this set in research practice.

Protein structural model selection by combining consensus and single scoring methods.

Directory of Open Access Journals (Sweden)

Zhiquan He

Full Text Available Quality assessment (QA for predicted protein structural models is an important and challenging research problem in protein structure prediction. Consensus Global Distance Test (CGDT methods assess each decoy (predicted structural model based on its structural similarity to all others in a decoy set and has been proved to work well when good decoys are in a majority cluster. Scoring functions evaluate each single decoy based on its structural properties. Both methods have their merits and limitations. In this paper, we present a novel method called PWCom, which consists of two neural networks sequentially to combine CGDT and single model scoring methods such as RW, DDFire and OPUS-Ca. Specifically, for every pair of decoys, the difference of the corresponding feature vectors is input to the first neural network which enables one to predict whether the decoy-pair are significantly different in terms of their GDT scores to the native. If yes, the second neural network is used to decide which one of the two is closer to the native structure. The quality score for each decoy in the pool is based on the number of winning times during the pairwise comparisons. Test results on three benchmark datasets from different model generation methods showed that PWCom significantly improves over consensus GDT and single scoring methods. The QA server (MUFOLD-Server applying this method in CASP 10 QA category was ranked the second place in terms of Pearson and Spearman correlation performance.

Lummi Bay Marina, Whatcom County, Washington. Draft Detailed Project Report and Draft Environmental Impact Statement.

Science.gov (United States)

1983-12-01

the eastern north Pacific Ocean at s *me season of the year, which are listed as endangered "jnder the Lndangercd Spc ;ici; hcL of 1973, and which...efficient vessel operation. The selection of channel depth was dependent upon the loaded draft of expected vessels, squat or sinkage. trim maneuverability

Lone ranger decision making versus consensus decision making: Descriptive analysis

OpenAIRE

Maite Sara Mashego

2015-01-01

Consensus decision making, concerns group members make decisions together with the requirement of reaching a consensus that is all members abiding by the decision outcome. Lone ranging worked for sometime in a autocratic environment. Researchers are now pointing to consensus decision-making in organizations bringing dividend to many organizations. This article used a descriptive analysis to compare the goodness of consensus decision making and making lone ranging decision management. This art...

76 FR 55941 - Notice of Availability of the Draft Bakersfield Resource Management Plan and Draft Environmental...

Science.gov (United States)

2011-09-09

... a telecommunications device for the deaf (TDD) may call the Federal Information Relay Service (FIRS... development and other land use authorizations with resource values; and (6) climate change. The Draft RMP... authorizations, livestock grazing, mineral development and recreation. Bitter Creek (6,121 acres): This newly...

Assessing excellence in translational cancer research: a consensus based framework.

Science.gov (United States)

Rajan, Abinaya; Caldas, Carlos; van Luenen, Henri; Saghatchian, Mahasti; van Harten, Wim H

2013-10-29

It takes several years on average to translate basic research findings into clinical research and eventually deliver patient benefits. An expert-based excellence assessment can help improve this process by: identifying high performing Comprehensive Cancer Centres; best practices in translational cancer research; improving the quality and efficiency of the translational cancer research process. This can help build networks of excellent Centres by aiding focused partnerships. In this paper we report on a consensus building exercise that was undertaken to construct an excellence assessment framework for translational cancer research in Europe. We used mixed methods to reach consensus: a systematic review of existing translational research models critically appraised for suitability in performance assessment of Cancer Centres; a survey among European stakeholders (researchers, clinicians, patient representatives and managers) to score a list of potential excellence criteria, a focus group with selected representatives of survey participants to review and rescore the excellence criteria; an expert group meeting to refine the list; an open validation round with stakeholders and a critical review of the emerging framework by an independent body: a committee formed by the European Academy of Cancer Sciences. The resulting excellence assessment framework has 18 criteria categorized in 6 themes. Each criterion has a number of questions/sub-criteria. Stakeholders favoured using qualitative excellence criteria to evaluate the translational research "process" rather than quantitative criteria or judging only the outputs. Examples of criteria include checking if the Centre has mechanisms that can be rated as excellent for: involvement of basic researchers and clinicians in translational research (quality of supervision and incentives provided to clinicians to do a PhD in translational research) and well designed clinical trials based on ground-breaking concepts (innovative

75 FR 78980 - Notice of Availability of the Draft Programmatic Environmental Impact Statement for Solar Energy...

Science.gov (United States)

2010-12-17

...] Notice of Availability of the Draft Programmatic Environmental Impact Statement for Solar Energy... Draft Programmatic Environmental Impact Statement (EIS) for Solar Energy Development in Six Southwestern... preferred method of commenting. Mail: Addressed to: Solar Energy Draft Programmatic EIS, Argonne National...

77 FR 56909 - Notice of Comment Period Extension for the Revised Draft Environmental Impact Report/Supplemental...

Science.gov (United States)

2012-09-14

... for the Revised Draft Environmental Impact Report/Supplemental Draft Environmental Impact Statement... Supplemental Draft Environmental Impact Statement (EIS) for the Fresno to Bakersfield Section of the California... this decision to be responsive to stakeholder requests and to encourage comprehensive public...

A conceptualisation framework for building consensus on environmental sensitivity.

Science.gov (United States)

González Del Campo, Ainhoa

2017-09-15

Examination of the intrinsic attributes of a system that render it more or less sensitive to potential stressors provides further insight into the baseline environment. In impact assessment, sensitivity of environmental receptors can be conceptualised on the basis of their: a) quality status according to statutory indicators and associated thresholds or targets; b) statutory protection; or c) inherent risk. Where none of these considerations are pertinent, subjective value judgments can be applied to determine sensitivity. This pragmatic conceptual framework formed the basis of a stakeholder consultation process for harmonising degrees of sensitivity of a number of environmental criteria. Harmonisation was sought to facilitate their comparative and combined analysis. Overall, full or wide agreement was reached on relative sensitivity values for the large majority of the reviewed criteria. Consensus was easier to reach on some themes (e.g. biodiversity, water and cultural heritage) than others (e.g. population and soils). As anticipated, existing statutory measures shaped the outcomes but, ultimately, knowledge-based values prevailed. The agreed relative sensitivities warrant extensive consultation but the conceptual framework provides a basis for increasing stakeholder consensus and objectivity of baseline assessments. This, in turn, can contribute to improving the evidence-base for characterising the significance of potential impacts. Copyright © 2017 Elsevier Ltd. All rights reserved.

Top management leadership style and quality of care in nursing homes.

Science.gov (United States)

Castle, Nicholas G; Decker, Frederic H

2011-10-01

The purpose of this study was to examine the association of Nursing Home Administrator (NHA) leadership style and Director of Nursing (DON) leadership style with quality of care. Leaders were categorized into 4 groups: consensus managers, consultative autocrats, shareholder managers, or autocrats. This leadership style assessment came from primary data collected from approximately 4,000 NHAs and DONs that was linked to quality information (i.e., Nursing Home Compare Quality Measures and 5-Star rating scores) and nursing home information (i.e., Online Survey, Certification, And Reporting data). A consensus manager leadership style has a strong association with better quality. Top managers using this style solicit and act upon input from their employees. For NHAs exhibiting this leadership style, the coefficients on 5 of the 7 quality indicators are statistically significant, and all 7 are significant when the DON exhibits this style. When the NHA and DON both have a consensus manager leadership style, 6 of the 7 quality indicator coefficients are significantly associated with better quality. The findings indicate that NHA and DON leadership style is associated with quality of care. Leadership strategies are amenable to change; thus, the findings of this study may be used to develop policies for promoting more effective leadership in nursing homes.

Towards new educational potentialities: Review and commentary of the Preliminary draft Act on higher education

Directory of Open Access Journals (Sweden)

Madžar Ljubomir

2005-01-01

Full Text Available The Higher Education Act is a long-awaited legal act. A number of uncompleted attempts to prepare it have been undertaken in the course of the last three years. So far without success. Having been and still being a matter of highest social priority, the renewed effort to create and subsequently to enact this act is welcome as a worthwhile and a highly productive endeavor. Welcome also are the main innovations offered by this act, particularly its conspicuous consistency with the Bologna Declaration and other internationally launched and accepted documents. The draft act follows the international documents tracing down the paths of the future development of the educational systems of the European countries and providing for their mutual compatibility. A number of other positive contributions of the draft act are singled out, such as introducing clear and rigorous criteria and procedures for accreditation and quality control, introducing a wide coverage of arts and sciences as a precondition for an institution of higher education to qualify as a university, flexibility in the regime of studying including the domestic and international mobility of the students and requirement for the schools of higher education to have large cores of permanently employed teaching staff. A much larger part of the paper is, however, devoted to critical commentaries. To begin with, the draft is produced without any participation of the private universities, which is seen as a form of discrimination. The organizational pattern of a university is laid out with insufficient clarity and the status of departments (faculties is particularly short of precision and even contradictory. The draft seems to be laden with the old bias towards excessive and potentially disastrous centralization, drastically reducing the decision making capacity of the system. The treatment of the property of the departments (faculties is found inconsistent and legally unfounded. Inconsistency is

Status of conversion of NE standards to national consensus standards

International Nuclear Information System (INIS)

Jennings, S.D.

1990-06-01

One major goal of the Nuclear Standards Program is to convert existing NE standards into national consensus standards (where possible). This means that an NE standard in the same subject area using the national consensus process. This report is a summary of the activities that have evolved to effect conversion of NE standards to national consensus standards, and the status of current conversion activities. In some cases, all requirements in an NE standard will not be incorporated into the published national consensus standard because these requirements may be considered too restrictive or too specific for broader application by the nuclear industry. If these requirements are considered necessary for nuclear reactor program applications, the program standard will be revised and issued as a supplement to the national consensus standard. The supplemental program standard will contain only those necessary requirements not reflected by the national consensus standard. Therefore, while complete conversion of program standards may not always be realized, the standards policy has been fully supported in attempting to make maximum use of the national consensus standard. 1 tab

Consensus of Multi-Agent Systems with Prestissimo Scale-Free Networks

International Nuclear Information System (INIS)

Yang Hongyong; Lu Lan; Cao Kecai; Zhang Siying

2010-01-01

In this paper, the relations of the network topology and the moving consensus of multi-agent systems are studied. A consensus-prestissimo scale-free network model with the static preferential-consensus attachment is presented on the rewired link of the regular network. The effects of the static preferential-consensus BA network on the algebraic connectivity of the topology graph are compared with the regular network. The robustness gain to delay is analyzed for variable network topology with the same scale. The time to reach the consensus is studied for the dynamic network with and without communication delays. By applying the computer simulations, it is validated that the speed of the convergence of multi-agent systems can be greatly improved in the preferential-consensus BA network model with different configuration. (interdisciplinary physics and related areas of science and technology)

Blockchain Consensus Protocols in the Wild

OpenAIRE

Cachin, Christian; Vukolić, Marko

2017-01-01

A blockchain is a distributed ledger for recording transactions, maintained by many nodes without central authority through a distributed cryptographic protocol. All nodes validate the information to be appended to the blockchain, and a consensus protocol ensures that the nodes agree on a unique order in which entries are appended. Consensus protocols for tolerating Byzantine faults have received renewed attention because they also address blockchain systems. This work discusses the process o...

Developing syndrome definitions based on consensus and current use

Science.gov (United States)

Dowling, John N; Baer, Atar; Buckeridge, David L; Cochrane, Dennis; Conway, Michael A; Elkin, Peter; Espino, Jeremy; Gunn, Julia E; Hales, Craig M; Hutwagner, Lori; Keller, Mikaela; Larson, Catherine; Noe, Rebecca; Okhmatovskaia, Anya; Olson, Karen; Paladini, Marc; Scholer, Matthew; Sniegoski, Carol; Thompson, David; Lober, Bill

2010-01-01

Objective Standardized surveillance syndromes do not exist but would facilitate sharing data among surveillance systems and comparing the accuracy of existing systems. The objective of this study was to create reference syndrome definitions from a consensus of investigators who currently have or are building syndromic surveillance systems. Design Clinical condition–syndrome pairs were catalogued for 10 surveillance systems across the United States and the representatives of these systems were brought together for a workshop to discuss consensus syndrome definitions. Results Consensus syndrome definitions were generated for the four syndromes monitored by the majority of the 10 participating surveillance systems: Respiratory, gastrointestinal, constitutional, and influenza-like illness (ILI). An important element in coming to consensus quickly was the development of a sensitive and specific definition for respiratory and gastrointestinal syndromes. After the workshop, the definitions were refined and supplemented with keywords and regular expressions, the keywords were mapped to standard vocabularies, and a web ontology language (OWL) ontology was created. Limitations The consensus definitions have not yet been validated through implementation. Conclusion The consensus definitions provide an explicit description of the current state-of-the-art syndromes used in automated surveillance, which can subsequently be systematically evaluated against real data to improve the definitions. The method for creating consensus definitions could be applied to other domains that have diverse existing definitions. PMID:20819870

Consensus on measurement properties and feasibility of performance tests for the exercise and sport sciences: a Delphi study.

Science.gov (United States)

Robertson, Sam; Kremer, Peter; Aisbett, Brad; Tran, Jacqueline; Cerin, Ester

2017-12-01

Performance tests are used for multiple purposes in exercise and sport science. Ensuring that a test displays an appropriate level of measurement properties for use within a population is important to ensure confidence in test findings. The aim of this study was to obtain subject matter expert consensus on the measurement and feasibility properties that should be considered for performance tests used in the exercise and sport sciences and how these should be defined. This information was used to develop a checklist for broader dissemination. A two-round Delphi study was undertaken including 33 exercise scientists, academics and sport scientists. Participants were asked to rate the importance of a range of measurement properties relevant to performance tests in exercise and sport science. Responses were obtained in binary and Likert-scale formats, with consensus defined as achieving 67% agreement on each question. Consensus was reached on definitions and terminology for all items. Ten level 1 items (those that achieved consensus on all four questions) and nine level 2 items (those achieving consensus on ≥2 questions) were included. Both levels were included in the final checklist. The checklist developed from this study can be used to inform decision-making and test selection for practitioners and researchers in the exercise and sport sciences. This can facilitate knowledge sharing and performance comparisons across sub-disciplines, thereby improving existing field practice and research methodological quality.

76 FR 7817 - Announcing Draft Federal Information Processing Standard 180-4, Secure Hash Standard, and Request...

Science.gov (United States)

2011-02-11

...-02] Announcing Draft Federal Information Processing Standard 180-4, Secure Hash Standard, and Request... and request for comments. SUMMARY: This notice announces the Draft Federal Information Processing..., Information Technology Laboratory, Attention: Comments on Draft FIPS 180-4, 100 Bureau Drive--Stop 8930...

48 CFR 28.204-2 - Certified or cashiers checks, bank drafts, money orders, or currency.

Science.gov (United States)

2010-10-01

... checks, bank drafts, money orders, or currency. 28.204-2 Section 28.204-2 Federal Acquisition Regulations... Other Security for Bonds 28.204-2 Certified or cashiers checks, bank drafts, money orders, or currency... draft, Post Office money order, or currency, in an amount equal to the penal sum of the bond, instead of...

Model-based consensus

NARCIS (Netherlands)

Boumans, Marcel

2014-01-01

The aim of the rational-consensus method is to produce “rational consensus”, that is, “mathematical aggregation”, by weighing the performance of each expert on the basis of his or her knowledge and ability to judge relevant uncertainties. The measurement of the performance of the experts is based on

Numerical Investigation of the Flow Structure in a Kaplan Draft Tube at Part Load

Science.gov (United States)

Maddahian, R.; Cervantes, M. J.; Sotoudeh, N.

2016-11-01

This research presents numerical simulation of the unsteady flow field inside the draft tube of a Kaplan turbine at part load condition. Due to curvature of streamlines, the ordinary two-equations turbulence models fail to predict the flow features. Therefore, a modification of the Shear Stress Transport (SST-SAS) model is utilized to approximate the turbulent stresses. A guide vane, complete runner and draft tube are considered to insure the real boundary conditions at the draft tube inlet. The outlet boundary is assumed to discharge into the atmosphere. The obtained pressure fluctuations inside the draft tube are in good agreement with available experimental data. In order to further investigate the RVR formation and its movement, the λ2 criterion, relating the position of the vortex core and strength to the second largest Eigen value of the velocity gradient tensor, is employed. The method used for vortex identification shows the flow structure and vortex motion inside the draft tube accurately.

Anomalous Hydrodynamic Drafting of Interacting Flapping Flags

Science.gov (United States)

Ristroph, Leif; Zhang, Jun

2008-11-01

In aggregates of objects moving through a fluid, bodies downstream of a leader generally experience reduced drag force. This conventional drafting holds for objects of fixed shape, but interactions of deformable bodies in a flow are poorly understood, as in schools of fish. In our experiments on “schooling” flapping flags, we find that it is the leader of a group who enjoys a significant drag reduction (of up to 50%), while the downstream flag suffers a drag increase. This counterintuitive inverted drag relationship is rationalized by dissecting the mutual influence of shape and flow in determining drag. Inverted drafting has never been observed with rigid bodies, apparently due to the inability to deform in response to the altered flow field of neighbors.

Draft Title V Operating Permit: Andeavor Field Services, LLC - Walker Hollow Compressor Station

Science.gov (United States)

Draft Title V Operating Permit, statement of basis, public notice bulletin, and the administrative permit docket (application and other supporting documents) for the Draft Part 71 Permit for Andeavor Field Services, LLC - Walker Hollow CS.

76 FR 57759 - Notice of Availability of Draft Resource Management Plan and Draft Environmental Impact Statement...

Science.gov (United States)

2011-09-16

... federally-owned subsurface mineral estate. The Colorado River Valley Field Office and the KFO were... Office, Colorado AGENCY: Bureau of Land Management, Interior. ACTION: Notice of availability. SUMMARY: In... Avenue, Kremmling, Colorado 80459. Copies of the Kremmling Draft RMP/EIS are available in the KFO at the...

Construction of barley consensus map showing chromosomal ...

African Journals Online (AJOL)

In the past, it has been difficult to accurately determine the location of many types of barley molecular markers due to the lack of commonality between international barley linkage maps. In this study, a consensus map of barley was constructed from five different maps (OWB, VxHs, KxM, barley consensus 2 and barley ...

78 FR 15894 - Draft Qualitative Risk Assessment of Risk of Activity/Food Combinations for Activities (Outside...

Science.gov (United States)

2013-03-13

.... FDA-2012-N-1258] Draft Qualitative Risk Assessment of Risk of Activity/Food Combinations for... comment period for a document entitled ``Draft Qualitative Risk Assessment of Risk of Activity/ [[Page... ``Draft Qualitative Risk Assessment of Risk of Activity/Food Combinations for Activities (Outside the Farm...

78 FR 50088 - Notice of Availability of the Northwest Colorado Greater Sage-Grouse Draft Resource Management...

Science.gov (United States)

2013-08-16

... Availability of the Northwest Colorado Greater Sage- Grouse Draft Resource Management Plan Amendment and Draft... Land Management (BLM) has prepared a Northwest Colorado Greater Sage-Grouse Draft Resource Management.../or mailings. ADDRESSES: You may submit comments related to the Northwest Colorado Greater Sage-Grouse...

76 FR 45647 - Consensus Standards, Light-Sport Aircraft

Science.gov (United States)

2011-07-29

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Consensus Standards, Light-Sport... previously accepted consensus standards relating to the provisions of the Sport Pilot and Light-Sport... Light Sport Aircraft developed the revised standards with Federal Aviation Administration (FAA...

Consensus building on the development of a stress-based indicator for LCA-based impact assessment of water consumption

NARCIS (Netherlands)

Boulay, Anne Marie; Bare, Jane; Camillis, De Camillo; Döll, Petra; Gassert, Francis; Gerten, Dieter; Humbert, Sebastien; Inaba, Atsushi; Itsubo, Norihiro; Lemoine, Yann; Margni, Manuele; Motoshita, Masaharu; Núñez, Montse; Pastor, A.V.; Ridoutt, Brad; Schencker, Urs; Shirakawa, Naoki; Vionnet, Samuel; Worbe, Sebastien; Yoshikawa, Sayaka; Pfister, Stephan

2015-01-01

Purpose: The WULCA group, active since 2007 on Water Use in LCA, commenced the development of consensus-based indicators in January 2014. This activity is planned to last 2 years and covers human health, ecosystem quality, and a stress-based indicator. This latter encompasses potential

75 FR 27579 - Bison Brucellosis Remote Vaccination, Draft Environmental Impact Statement, Yellowstone National...

Science.gov (United States)

2010-05-17

... DEPARTMENT OF THE INTERIOR National Park Service Bison Brucellosis Remote Vaccination, Draft... Brucellosis Remote Vaccination Program, Yellowstone National Park. SUMMARY: Pursuant to the National... the Bison Brucellosis Remote Vaccination Draft Environmental Impact Statement (EIS) for Yellowstone...

Model of Decision Making through Consensus in Ranking Case

Science.gov (United States)

Tarigan, Gim; Darnius, Open

2018-01-01

The basic problem to determine ranking consensus is a problem to combine some rankings those are decided by two or more Decision Maker (DM) into ranking consensus. DM is frequently asked to present their preferences over a group of objects in terms of ranks, for example to determine a new project, new product, a candidate in a election, and so on. The problem in ranking can be classified into two major categories; namely, cardinal and ordinal rankings. The objective of the study is to obtin the ranking consensus by appying some algorithms and methods. The algorithms and methods used in this study were partial algorithm, optimal ranking consensus, BAK (Borde-Kendal)Model. A method proposed as an alternative in ranking conssensus is a Weighted Distance Forward-Backward (WDFB) method, which gave a little difference i ranking consensus result compare to the result oethe example solved by Cook, et.al (2005).

Experts' consensus on use of electronic cigarettes: a Delphi survey from Switzerland.

Science.gov (United States)

Blaser, Jeremie; Cornuz, Jacques

2015-04-15

In some countries, nicotine-containing electronic cigarettes (e-cigarettes) are considered a consumer product without specific regulations. In others (eg, Switzerland), the sale of e-cigarettes containing nicotine is forbidden, despite the eagerness of many smokers to obtain them. As scientific data about efficacy and long-term safety of these products are scarce, tobacco control experts are divided on how to regulate them. In order to gain consensus among experts to provide recommendations to health authorities, we performed a national consensus study. We used a Delphi method with electronic questionnaires to bring together the opinion of Swiss experts on e-cigarettes. 40 Swiss experts from across the country. We measured the degree of consensus between experts on recommendations regarding regulation, sale, use of and general opinion about e-cigarettes containing nicotine. New recommendations and statements were added following the experts' answers and comments. There was consensus that e-cigarettes containing nicotine should be made available, but only under specific conditions. Sale should be restricted to adults, using quality standards, a maximum level of nicotine and with an accompanying list of authorised ingredients. Advertisement should be restricted and use in public places should be forbidden. These recommendations encompass three principles: (1) the reality principle, as the product is already on the market; (2) the prevention principle, as e-cigarettes provide an alternative to tobacco for actual smokers, and (3) the precautionary principle, to protect minors and non-smokers, since long-term effects are not yet known. Swiss authorities should design specific regulations to sell nicotine-containing e-cigarettes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A 1,681-locus consensus genetic map of cultivated cucumber including 67 NB-LRR resistance gene homolog and ten gene loci.

Science.gov (United States)

Yang, Luming; Li, Dawei; Li, Yuhong; Gu, Xingfang; Huang, Sanwen; Garcia-Mas, Jordi; Weng, Yiqun

2013-03-25

Cucumber is an important vegetable crop that is susceptible to many pathogens, but no disease resistance (R) genes have been cloned. The availability of whole genome sequences provides an excellent opportunity for systematic identification and characterization of the nucleotide binding and leucine-rich repeat (NB-LRR) type R gene homolog (RGH) sequences in the genome. Cucumber has a very narrow genetic base making it difficult to construct high-density genetic maps. Development of a consensus map by synthesizing information from multiple segregating populations is a method of choice to increase marker density. As such, the objectives of the present study were to identify and characterize NB-LRR type RGHs, and to develop a high-density, integrated cucumber genetic-physical map anchored with RGH loci. From the Gy14 draft genome, 70 NB-containing RGHs were identified and characterized. Most RGHs were in clusters with uneven distribution across seven chromosomes. In silico analysis indicated that all 70 RGHs had EST support for gene expression. Phylogenetic analysis classified 58 RGHs into two clades: CNL and TNL. Comparative analysis revealed high-degree sequence homology and synteny in chromosomal locations of these RGH members between the cucumber and melon genomes. Fifty-four molecular markers were developed to delimit 67 of the 70 RGHs, which were integrated into a genetic map through linkage analysis. A 1,681-locus cucumber consensus map including 10 gene loci and spanning 730.0 cM in seven linkage groups was developed by integrating three component maps with a bin-mapping strategy. Physically, 308 scaffolds with 193.2 Mbp total DNA sequences were anchored onto this consensus map that covered 52.6% of the 367 Mbp cucumber genome. Cucumber contains relatively few NB-LRR RGHs that are clustered and unevenly distributed in the genome. All RGHs seem to be transcribed and shared significant sequence homology and synteny with the melon genome suggesting conservation of

Safety requirements to be met in final storage of heat-producing waste an evaluation of the BMU draft

International Nuclear Information System (INIS)

Thomauske, B.

2008-01-01

criticized also by RSK and SSK. - Key points to be regulated, such as dose limits or requirements with respect to human intervention, are shifted to guidelines yet to be established. - There is no waste management concept underlying the safety requirements. As a consequence, the draft should be withdrawn by the Federal Ministry for the Environment and replaced by a version revised from scratch and offering assured quality. (orig.)

76 FR 66040 - NIST Framework and Roadmap for Smart Grid Interoperability Standards, Release 2.0 (Draft...

Science.gov (United States)

2011-10-25

...-01] NIST Framework and Roadmap for Smart Grid Interoperability Standards, Release 2.0 (Draft... draft version of the NIST Framework and Roadmap for Smart Grid Interoperability Standards, Release 2.0... Roadmap for Smart Grid Interoperability Standards, Release 2.0 (Release 2.0) (Draft) for public review and...

76 FR 38187 - International Conference on Harmonisation; Draft Guidance on Q11 Development and Manufacture of...

Science.gov (United States)

2011-06-29

...] International Conference on Harmonisation; Draft Guidance on Q11 Development and Manufacture of Drug Substances... Manufacture of Drug Substances.'' The draft guidance was prepared under the auspices of the International... that a draft guidance entitled ``Q11 Development and Manufacture of Drug Substances'' should be made...

78 FR 68852 - Draft Guidance for Industry on Acrylamide in Foods; Availability

Science.gov (United States)

2013-11-15

... placing preparation and cooking instructions on frozen French fry packages. Lastly, the draft guidance is... high-temperature cooking. The draft guidance is intended to suggest a range of possible approaches to... during certain types of high-temperature cooking, and is a concern because it can cause cancer in...

76 FR 64327 - Office of Oceanic and Atmospheric Research Draft Strategic Plan

Science.gov (United States)

2011-10-18

...: 111003608-1608-01] Office of Oceanic and Atmospheric Research Draft Strategic Plan AGENCY: Office of Oceanic... notice announces that OAR's draft Strategic Plan (FY12- 18) is available for public review and comment... next six years. These goals and objectives will provide guidance and strategic direction for program...

75 FR 57081 - Revised Draft Safety Culture Policy Statement: Request for Comments

Science.gov (United States)

2010-09-17

... culture. Experience has shown that certain personal and organizational traits are present in a positive safety culture. A trait, in this case, is a pattern of thinking, feeling, and behaving that emphasizes... organizational environments. IV. Changes to the Initial Draft Statement of Policy Like the initial draft SOP, the...

A collaborative platform for consensus sessions in pathology over Internet.

Science.gov (United States)

Zapletal, Eric; Le Bozec, Christel; Degoulet, Patrice; Jaulent, Marie-Christine

2003-01-01

The design of valid databases in pathology faces the problem of diagnostic disagreement between pathologists. Organizing consensus sessions between experts to reduce the variability is a difficult task. The TRIDEM platform addresses the issue to organize consensus sessions in pathology over the Internet. In this paper, we present the basis to achieve such collaborative platform. On the one hand, the platform integrates the functionalities of the IDEM consensus module that alleviates the consensus task by presenting to pathologists preliminary computed consensus through ergonomic interfaces (automatic step). On the other hand, a set of lightweight interaction tools such as vocal annotations are implemented to ease the communication between experts as they discuss a case (interactive step). The architecture of the TRIDEM platform is based on a Java-Server-Page web server that communicate with the ObjectStore PSE/PRO database used for the object storage. The HTML pages generated by the web server run Java applets to perform the different steps (automatic and interactive) of the consensus. The current limitations of the platform is to only handle a synchronous process. Moreover, improvements like re-writing the consensus workflow with a protocol such as BPML are already forecast.

POSSIBLE ROLE OF INDOOR RADON REDUCTION SYSTEMS IN BACK-DRAFTING RESIDENTIAL COMBUSTION APPLIANCES

Science.gov (United States)

The article gives results of a computational sensitivity analysis conducted to identify conditions under which residential active soil depressurization (ASD) systems for indoor radon reduction might contribute to or create back-drafting of natural draft combustion appliances. Par...

The possible role of indoor radon reduction systems in back-drafting residential combustion appliances

International Nuclear Information System (INIS)

Henschel, D.B.

1997-01-01

A computational sensitivity analysis was conducted to identify the conditions under which residential active soil depressurization (ASD) systems for indoor radon reduction might most likely exacerbate or create back-drafting of natural-draft combustion appliances. Parameters varied included: house size; normalized leakage area; exhaust rate of exhaust appliances other than the ASD system; and the amount of house air exhausted by the ASD system. Even with a reasonably conservative set of assumptions, it is predicted that ASD systems should not exacerbate or create back- drafting in most of the U.S. housing stock. Only at normalized leakage areas lower than 3 to 4 cm 2 commercial at 4 Pa) per m 2 of floor area should ASD contribute to back-drafting, even in small houses at high ASD exhaust rates (compared to a mean of over 10 cm 2 /m 2 determined from data on over 12,000 U.S. houses). But on the other hand, even with a more forgiving set of assumptions, it is predicted that ASD systems could contribute to back-drafting in some fraction of the housing stock -houses tighter than about 1 to 2 cm 2 /m 2 - even in large houses at minimal ASD exhaust rates. It is not possible to use parameters such as house size or ASD system flow rate to estimate reliably the risk that an ASD system might contribute to back-drafting in a given house. Spillage/back-draft testing would be needed for essentially all installations. (au) 18 refs

Kyoto global consensus report on Helicobacter pylori gastritis

NARCIS (Netherlands)

K. Sugano (Kentaro); J. Tack (Jan); E.J. Kuipers (Ernst); D.Y. Graham (David Y.); E. El-Omar; S. Miura (Soichiro); K. Haruma (Ken); M. Asaka (Masahiro); N. Uemura (Naomi); P. Malfertheiner

2015-01-01

textabstractObjective To present results of the Kyoto Global Consensus Meeting, which was convened to develop global consensus on (1) classification of chronic gastritis and duodenitis, (2) clinical distinction of dyspepsia caused by Helicobacter pylori from functional dyspepsia, (3) appropriate

32 CFR 989.19 - Draft EIS.

Science.gov (United States)

2010-07-01

... summary to the public with an attached list of locations (such as public libraries) where the entire draft... a proposed action will potentially have disproportionately high and adverse human health or... as when there has been a significant change in circumstances, development of significant new...

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

Science.gov (United States)

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

2010-03-01

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

78 FR 64428 - Draft Qualitative Risk Assessment of Risk of Activity/Animal Food Combinations for Activities...

Science.gov (United States)

2013-10-29

.... FDA-2013-N-1043] Draft Qualitative Risk Assessment of Risk of Activity/Animal Food Combinations for... entitled ``Draft Qualitative Risk Assessment of Risk of Activity/Animal Food Combinations for Activities...(n) of the FD&C Act. II. Qualitative Risk Assessment As explained in the draft RA, we conducted the...

76 FR 24511 - Cabo Rojo National Wildlife Refuge, Cabo Rojo, Puerto Rico; Draft Comprehensive Conservation Plan...

Science.gov (United States)

2011-05-02

... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R4-R-2010-N277; 40136-1265-0000-S3] Cabo Rojo National Wildlife Refuge, Cabo Rojo, Puerto Rico; Draft Comprehensive Conservation Plan and... draft comprehensive conservation plan and environmental assessment (Draft CCP/EA) for Cabo Rojo National...

Development and validation of a psychometric scale for assessing PA chest image quality: A pilot study

International Nuclear Information System (INIS)

Mraity, H.; England, A.; Akhtar, I.; Aslam, A.; De Lange, R.; Momoniat, H.; Nicoulaz, S.; Ribeiro, A.; Mazhir, S.; Hogg, P.

2014-01-01

Purpose: To develop and validate a psychometric scale for assessing image quality perception for chest X-ray images. Methods: Bandura's theory was used to guide scale development. A review of the literature was undertaken to identify items/factors which could be used to evaluate image quality using a perceptual approach. A draft scale was then created (22 items) and presented to a focus group (student and qualified radiographers). Within the focus group the draft scale was discussed and modified. A series of seven postero-anterior chest images were generated using a phantom with a range of image qualities. Image quality perception was confirmed for the seven images using signal-to-noise ratio (SNR 17.2–36.5). Participants (student and qualified radiographers and radiology trainees) were then invited to independently score each of the seven images using the draft image quality perception scale. Cronbach alpha was used to test interval reliability. Results: Fifty three participants used the scale to grade image quality perception on each of the seven images. Aggregated mean scale score increased with increasing SNR from 42.1 to 87.7 (r = 0.98, P < 0.001). For each of the 22 individual scale items there was clear differentiation of low, mid and high quality images. A Cronbach alpha coefficient of >0.7 was obtained across each of the seven images. Conclusion: This study represents the first development of a chest image quality perception scale based on Bandura's theory. There was excellent correlation between the image quality perception scores derived using the scale and the SNR. Further research will involve a more detailed item and factor analysis

78 FR 12329 - Distinguishing Medical Device Recalls From Product Enhancements; Reporting Requirements; Draft...

Science.gov (United States)

2013-02-22

... medical devices to take timely action to correct violative devices or remove them from the marketplace...] Distinguishing Medical Device Recalls From Product Enhancements; Reporting Requirements; Draft Guidance for... draft guidance entitled ``Distinguishing Medical Device Recalls From Product Enhancements; Reporting...

75 FR 53979 - Bison Brucellosis Remote Vaccination, Draft Environmental Impact Statement, Yellowstone National...

Science.gov (United States)

2010-09-02

... DEPARTMENT OF THE INTERIOR National Park Service Bison Brucellosis Remote Vaccination, Draft Environmental Impact Statement, Yellowstone National Park, Wyoming ACTION: Reopening of public comment period... Brucellosis Remote Vaccination Draft Environmental Impact Statement. The original comment period was from 28...

Negative-pressure wound therapy with instillation: international consensus guidelines.

Science.gov (United States)

Kim, Paul J; Attinger, Christopher E; Steinberg, John S; Evans, Karen K; Lehner, Burkhard; Willy, Christian; Lavery, Larry; Wolvos, Tom; Orgill, Dennis; Ennis, William; Lantis, John; Gabriel, Allen; Schultz, Gregory

2013-12-01

Negative-pressure wound therapy with instillation is increasingly utilized as an adjunct therapy for a wide variety of wounds. Despite its growing popularity, there is a paucity of evidence and lack of guidance to provide effective use of this therapy. A panel of experts was convened to provide guidance regarding the appropriate use of negative-pressure wound therapy with instillation. A face-to-face meeting was held where the available evidence was discussed and individual clinical experience with this therapy was shared. Follow-up communication among the panelists continued until consensus was achieved. The final consensus recommendations were derived through more than 80 percent agreement among the panelists. Nine consensus statements were generated that address the appropriate use of negative-pressure wound therapy with instillation. The question of clinical effectiveness of this therapy was not directly addressed by the consensus panel. This document serves as preliminary guidelines until more robust evidence emerges that will support or modify these consensus recommendations.

US Cystic Fibrosis Foundation and European Cystic Fibrosis Society consensus recommendations for the management of non-tuberculous mycobacteria in individuals with cystic fibrosis.

Science.gov (United States)

Floto, R Andres; Olivier, Kenneth N; Saiman, Lisa; Daley, Charles L; Herrmann, Jean-Louis; Nick, Jerry A; Noone, Peadar G; Bilton, Diana; Corris, Paul; Gibson, Ronald L; Hempstead, Sarah E; Koetz, Karsten; Sabadosa, Kathryn A; Sermet-Gaudelus, Isabelle; Smyth, Alan R; van Ingen, Jakko; Wallace, Richard J; Winthrop, Kevin L; Marshall, Bruce C; Haworth, Charles S

2016-01-01

Non-tuberculous mycobacteria (NTM) are ubiquitous environmental organisms that can cause chronic pulmonary infection, particularly in individuals with pre-existing inflammatory lung disease such as cystic fibrosis (CF). Pulmonary disease caused by NTM has emerged as a major threat to the health of individuals with CF but remains difficult to diagnose and problematic to treat. In response to this challenge, the US Cystic Fibrosis Foundation (CFF) and the European Cystic Fibrosis Society (ECFS) convened an expert panel of specialists to develop consensus recommendations for the screening, investigation, diagnosis and management of NTM pulmonary disease in individuals with CF. Nineteen experts were invited to participate in the recommendation development process. Population, Intervention, Comparison, Outcome (PICO) methodology and systematic literature reviews were employed to inform draft recommendations. An anonymous voting process was used by the committee to reach consensus. All committee members were asked to rate each statement on a scale of: 0, completely disagree, to 9, completely agree; with 80% or more of scores between 7 and 9 being considered 'good' agreement. Additionally, the committee solicited feedback from the CF communities in the USA and Europe and considered the feedback in the development of the final recommendation statements. Three rounds of voting were conducted to achieve 80% consensus for each recommendation statement. Through this process, we have generated a series of pragmatic, evidence-based recommendations for the screening, investigation, diagnosis and treatment of NTM infection in individuals with CF as an initial step in optimising management for this challenging condition. 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/

Benefit-risk of Patients' Online Access to their Medical Records: Consensus Exercise of an International Expert Group.

Science.gov (United States)

Liyanage, Harshana; Liaw, Siaw-Teng; Konstantara, Emmanouela; Mold, Freda; Schreiber, Richard; Kuziemsky, Craig; Terry, Amanda L; de Lusignan, Simon

2018-04-22

 Patients' access to their computerised medical records (CMRs) is a legal right in many countries. However, little is reported about the benefit-risk associated with patients' online access to their CMRs.  To conduct a consensus exercise to assess the impact of patients' online access to their CMRs on the quality of care as defined in six domains by the Institute of Medicine (IoM), now the National Academy of Medicine (NAM).  A five-round Delphi study was conducted. Round One explored experts' (n = 37) viewpoints on providing patients with access to their CMRs. Round Two rated the appropriateness of statements arising from Round One (n = 16). The third round was an online panel discussion of findings (n = 13) with the members of both the International Medical Informatics Association and the European Federation of Medical Informatics Primary Health Care Informatics Working Groups. Two additional rounds, a survey of the revised consensus statements and an online workshop, were carried out to further refine consensus statements.  Thirty-seven responses from Round One were used as a basis to initially develop 15 statements which were categorised using IoM's domains of care quality. The experts agreed that providing patients online access to their CMRs for bookings, results, and prescriptions increased efficiency and improved the quality of medical records. Experts also anticipated that patients would proactively use their online access to share data with different health care providers, including emergencies. However, experts differed on whether access to limited or summary data was more useful to patients than accessing their complete records. They thought online access would change recording practice, but they were unclear about the benefit-risk of high and onerous levels of security. The 5-round process, finally, produced 16 consensus statements.  Patients' online access to their CMRs should be part of all CMR systems. It improves the process

21 CFR 10.80 - Dissemination of draft Federal Register notices and regulations.